The Impact of Undernutrition and Anemia on HIV-Related Mortality Among Children on ART in Sub-Saharan Africa: A

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Sisay Moges1, Bereket Aberham Lajore2, Abera Feyisa Oleba3

  • 1Department of Family Health, Hossana College of Science, Hosanna, Ethiopia. Sisaymoges55@gmail.com.

Journal of Epidemiology and Global Health
|November 14, 2024
PubMed

Insights

Malnutrition and anemia significantly increase HIV-related deaths in children on antiretroviral therapy (ART) in sub-Saharan Africa. These conditions, especially in children under five, demand integrated nutrition and HIV care strategies for improved survival.

Area of Science:

  • Pediatric Infectious Diseases
  • Global Health
  • Nutritional Epidemiology

Background:

  • High mortality rates persist in HIV-infected children despite antiretroviral therapy (ART) access in sub-Saharan Africa.
  • Undernutrition and anemia are prevalent issues in the region, impacting child health outcomes.
  • The combined effect of malnutrition and anemia on HIV-related mortality in children on ART was previously unquantified in this population.

Purpose of the Study:

  • To investigate the pooled effect of undernutrition and anemia on HIV-related mortality among children receiving ART in sub-Saharan Africa.
  • To identify specific nutritional deficiencies and anemia as risk factors for mortality in this vulnerable group.
  • To inform public health strategies by highlighting the critical interplay between nutritional status and HIV treatment outcomes.

Main Methods:

  • A systematic literature search was conducted across major databases (PubMed/MEDLINE, Embase, CINAHL, Web of Science) for observational studies.
  • Studies published between January 1, 2010, and April 24, 2024, focusing on risk factors for undernutrition, anemia, and HIV-related mortality in children were included.
  • A meta-analysis using random effect models was performed on data from 27 studies involving 61,796 participants.

Main Results:

  • Severe wasting (HR: 2.49), being underweight (HR: 2.11), and anemia (HR: 2.58) were significantly associated with increased HIV-related mortality in children.
  • The risk of death associated with anemia was notably higher in children under five years of age compared to older children.
  • The findings underscore the critical impact of nutritional status and anemia on survival rates for children with HIV.

Conclusions:

  • Undernutrition and anemia are significant contributors to HIV-related mortality in sub-Saharan African children on ART.
  • The detrimental impact of malnutrition and anemia is more pronounced in children under five, emphasizing the need for early intervention.
  • Integrated programs combining nutritional support with HIV treatment are essential for improving survival rates in this population.
Abstract

Keywords:
ChildrenEffect of anemiaEffect of undernutritionRisk factor for HIV mortalitySub-saharan Africa

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