What's new? Investigating risk factors for severe childhood malnutrition in a high HIV prevalence South African setting1
Open Access
- 1 August 2007
- journal article
- other
- Published by SAGE Publications in Scandinavian Journal of Public Health
- Vol. 35 (69_suppl), 96-106
- https://doi.org/10.1080/14034950701356435
Abstract
Aim: To identify risk factors for severe childhood malnutrition in a rural South African district with a high HIV/AIDS prevalence. Design: Case-control study. Setting: Bushbuckridge District, Limpopo Province, South Africa. Participants: 100 children with severe malnutrition (marasmus, kwashiorkor, and marasmic kwashiorkor) were compared with 200 better nourished (>-2 SD weight-for-age) controls, matched by age and village of residence. Bivariate and multivariate analyses were conducted on a variety of biological and social risk factors. Results: HIV status was known only for a minority of cases (39%), of whom 87% were HIV positive, while 45% of controls were stunted. In multivariate analysis, risk factors for severe malnutrition included suspicion of HIV in the family (parents or children) (OR 217.7, 95% CI 22.7—2091.3), poor weaning practices (OR 3.0, 95% CI 2.0—4.6), parental death (OR 38.0, 95% CI 3.8—385.3), male sex (OR 2.7, 95% CI 1.2—6.0), and higher birth order (third child or higher) (OR 2.3, 95% CI 1.0—5.1). Protective factors included a diverse food intake (OR 0.53, 95% CI 0.41—0.67) and receipt of a state child support grant (OR 0.44, 95% CI 0.20—0.97). A borderline association existed for family wealth (OR 0.9 per unit, 95% CI 0.83—1.0), father smoking marijuana (OR 3.9, 95% CI 1.1— 14.5), and history of a pulmonary tuberculosis contact (OR 3.2, 95% CI 0.9—11.0). Conclusions: Despite the increasing contribution of HIV to the development of severe malnutrition, traditional risk factors such as poor nutrition, parental disadvantage and illness, poverty, and social inequity remain important contributors to the prevalence of severe malnutrition. Interventions aiming to prevent and reduce severe childhood malnutrition in high HIV prevalence settings need to encompass the various dimensions of the disease: nutritional, economic, and social, and address the prevention and treatment of HIV/AIDS.Keywords
This publication has 38 references indexed in Scilit:
- Nutritional and Clinical Status of Children Admitted to the Malnutrition Ward, Maputo Central Hospital: A Comparison of Data from 2001 and 1983Journal of Tropical Pediatrics, 2005
- WHO guidelines for management of severe malnutrition in rural South African hospitals: effect on case fatality and the influence of operational factorsThe Lancet, 2004
- Who dies from what? Determining cause of death in South Africa's rural north‐eastTropical Medicine & International Health, 1999
- Risk factors for protein-energy malnutrition in pre-school shantytown children in São Paulo, BrazilSao Paulo Medical Journal, 1998
- Risk Factors for the Prevalence of Malnutrition among Urban Children in Ghana.Journal of Nutritional Science and Vitaminology, 1998
- RISK FACTORS FOR MALNUTRITION IN SOUTH INDIAN CHILDRENJournal of Biosocial Science, 1997
- The Effects of Maternal Education on Child Nutritional Status Depend on Socio-Environmental ConditionsInternational Journal of Epidemiology, 1996
- Letters to the EditorJournal of Tropical Pediatrics, 1994
- Risk Factors for Persistent Diarrhoea and Malnutrition in Myanmar Children I:Socio-anthropological Risk FactorsJournal of Tropical Pediatrics, 1994
- Risk Factors for Clinical Marasmus: A Case-Control Study of Bangladeshi ChildrenInternational Journal of Epidemiology, 1993