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Improving survival of children with severe acute malnutrition in HIV-prevalent settings

Pamela Fergusson1, Andrew Tomkins, Marko Kerac

  • 1Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK.

International Health
|September 17, 2013
PubMed

Insights

Improving survival for children with severe acute malnutrition (SAM) in sub-Saharan Africa requires addressing HIV. Integrating HIV identification and care into SAM management is crucial for reducing mortality in these vulnerable children.

Area of Science:

  • Global Health
  • Pediatric Nutrition
  • Infectious Diseases

Background:

  • Sub-Saharan Africa faces significant challenges in managing severe acute malnutrition (SAM) in children, particularly in regions with high HIV prevalence.
  • While facility-based and community-based management have reduced mortality, persistent deaths, largely linked to HIV, necessitate further interventions.

Purpose of the Study:

  • To explore strategies for improving survival rates in children with SAM in sub-Saharan Africa.
  • To identify key areas for intervention, including HIV identification, enhanced case management for HIV-infected children, strengthening general SAM care, and improving early detection and program coverage.

Main Methods:

  • Review of existing strategies for facility-based and community-based management of SAM.
  • Exploration of integrated approaches for HIV testing and treatment within SAM care programs.
  • Analysis of the need for updated international guidelines adapted to local contexts.

Main Results:

  • Improvements in facility- and community-based management have decreased SAM-related mortality.
  • HIV remains a significant contributor to resistant mortality in children with SAM.
  • HIV-infected children with SAM face particularly high mortality risks.

Conclusions:

  • Effective interventions exist to improve survival for children with SAM in HIV-prevalent settings.
  • Integrating HIV testing and treatment into SAM care is essential for reducing mortality.
  • There is an urgent need to update international guidelines and implement existing evidence-based strategies while researching knowledge gaps.

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