Mortality, length of hospital stay, and nutritional status improvement in severely malnourished children with HIV infection in a tertiary center
Abstract: Severe malnutrition
contributes to child mortality rates, especially in children under five years
of age. Concomitant HIV infection further increases the risk of death.
Objective To evaluate the impact of HIV infection on mortality, length of
hospital stay and improvement of nutritional status in severely malnourished
inpatients under five years of age.
Methods This retrospective study included children aged less than 5 years
and admitted to a tertiary hospital for severe malnutrition. We excluded those
with incomplete data, as well as those transferred to other hospitals or
discharged against medical advice. Outcome measures were live/death status,
length of hospital stay and improvement of nutritional status (weight gain and
improved weight-for-height Z score).
Results Of 104 eligible patients, 97 were included as study subjects.
Their mean ages were 25.8 (SD 17.3) months for HIV-infected children and 16.3
(SD 15.3) months for HIV-uninfected children. Death occurred in 31.8% and 18.7%
of HIV-infected and uninfected subjects, respectively. Median length of
hospital stay was 14.5 (range 5-51) days and 11 (range 1-99) days,
respectively. There were no statistically significant differences in death
rates or length of hospital stay between the two groups. Weight-for-height Z
scores (WHZ) on admission and discharge in HIV-infected children were lower
than those of uninfected children, but the weight gain (median weight gain of
0.45 (-0.26 to 1.9) kg vs 0.38 (-0.81 to 2.2) kg in HIV-infected and uninfected
children, respectively) and improvement of WHZ [1 (SD 1.1) vs 0.9 (SD 1),
respectively] were similar.
Conclusion Severely malnourished children with HIV infection had higher
mortality rate, and longer hospitalizations than the uninfected group, although
the differences were not statistically significant. They also had lower mean
WHZ scores at admission and discharge, but nutritional improvement was similar
to those who were HIV-negative.
Author: Yoga Devaera
Journal Code: jpkedokterangg120138
