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Primary malnutrition. Can we always tell?
C A Stephen1, M M Thame, R Gray
1Tropical Metabolism Research Unit, Sickle Cell Unit and Epidemiology Research Unit, Tropical Medicine Research Institute, University of the West Indies, Kingston 7, Jamaica, West Indies.
The West Indian Medical Journal
|December 28, 2002
Summary
Disease patterns in the Caribbean are shifting, with rising HIV/AIDS cases impacting severe childhood malnutrition (SCM). Secondary SCM, often linked to medical disorders like HIV/AIDS, significantly increased, highlighting the need for ongoing vigilance.
Area of Science:
- Pediatrics
- Public Health
- Infectious Diseases
Background:
- Disease patterns in the English-speaking Caribbean have shifted over two decades.
- Decreased infectious diseases, increased chronic non-communicable disorders, and rising HIV/AIDS incidence observed.
- Malnutrition remains a significant public health concern, potentially influenced by epidemiological transition.
Purpose of the Study:
- To examine how changing disease patterns affect the presentation of severe childhood malnutrition (SCM).
- To analyze trends in primary and secondary SCM over a ten-year period.
Main Methods:
- Retrospective review of 435 children admitted to the Tropical Metabolism Research Unit (TMRU) between 1990 and 1999.
- Identification of 25 children with severe childhood malnutrition (SCM) due to a defined medical or surgical disorder (secondary SCM).
- Regression analyses to assess trends in primary and secondary SCM incidence.
Main Results:
- The largest group among secondary SCM admissions was HIV/AIDS (60%).
- A non-significant decline in primary SCM cases was observed (IRR = 0.99).
- A significant increase in secondary SCM cases was found (IRR = 1.18, p = 0.02).
Conclusions:
- The rise in secondary SCM, particularly associated with HIV/AIDS, necessitates continued vigilance.
- Healthcare providers should be aware of the impact of HIV/AIDS on severe childhood malnutrition presentations.
- Ongoing monitoring of malnutrition trends is crucial in the context of evolving disease patterns.