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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">What’s new? Investigating risk factors for severe childhood malnutrition in a high HIV prevalence South African setting<xref ref-type="fn" rid="FN1">1</xref></title><author><name sortKey="Saloojee, Haroon" sort="Saloojee, Haroon" uniqKey="Saloojee H" first="Haroon" last="Saloojee">Haroon Saloojee</name><affiliation><nlm:aff id="A1">Department of Paediatrics and Child Health, University of the Witwatersrand, Johannesburg, South Africa</nlm:aff></affiliation></author><author><name sortKey="De Maayer, Tim" sort="De Maayer, Tim" uniqKey="De Maayer T" first="Tim" last="De Maayer">Tim De Maayer</name><affiliation><nlm:aff id="A1">Department of Paediatrics and Child Health, University of the Witwatersrand, Johannesburg, South Africa</nlm:aff></affiliation></author><author><name sortKey="Garenne, Michel L" sort="Garenne, Michel L" uniqKey="Garenne M" first="Michel L." last="Garenne">Michel L. Garenne</name><affiliation><nlm:aff id="A2">MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, University of the Witwatersrand, South Africa</nlm:aff></affiliation><affiliation><nlm:aff id="A3">Institut Pasteur, Unité d’Epidémiologie des Maladies Emergentes, Paris, France</nlm:aff></affiliation></author><author><name sortKey="Kahn, Kathleen" sort="Kahn, Kathleen" uniqKey="Kahn K" first="Kathleen" last="Kahn">Kathleen Kahn</name><affiliation><nlm:aff id="A2">MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, University of the Witwatersrand, South Africa</nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">17676510</idno><idno type="pmc">2830109</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2830109</idno><idno type="RBID">PMC:2830109</idno><idno type="doi">10.1080/14034950701356435</idno><date when="2007">2007</date><idno type="wicri:Area/Pmc/Corpus">001888</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">001888</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">What’s new? Investigating risk factors for severe childhood malnutrition in a high HIV prevalence South African setting<xref ref-type="fn" rid="FN1">1</xref></title><author><name sortKey="Saloojee, Haroon" sort="Saloojee, Haroon" uniqKey="Saloojee H" first="Haroon" last="Saloojee">Haroon Saloojee</name><affiliation><nlm:aff id="A1">Department of Paediatrics and Child Health, University of the Witwatersrand, Johannesburg, South Africa</nlm:aff></affiliation></author><author><name sortKey="De Maayer, Tim" sort="De Maayer, Tim" uniqKey="De Maayer T" first="Tim" last="De Maayer">Tim De Maayer</name><affiliation><nlm:aff id="A1">Department of Paediatrics and Child Health, University of the Witwatersrand, Johannesburg, South Africa</nlm:aff></affiliation></author><author><name sortKey="Garenne, Michel L" sort="Garenne, Michel L" uniqKey="Garenne M" first="Michel L." last="Garenne">Michel L. Garenne</name><affiliation><nlm:aff id="A2">MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, University of the Witwatersrand, South Africa</nlm:aff></affiliation><affiliation><nlm:aff id="A3">Institut Pasteur, Unité d’Epidémiologie des Maladies Emergentes, Paris, France</nlm:aff></affiliation></author><author><name sortKey="Kahn, Kathleen" sort="Kahn, Kathleen" uniqKey="Kahn K" first="Kathleen" last="Kahn">Kathleen Kahn</name><affiliation><nlm:aff id="A2">MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, University of the Witwatersrand, South Africa</nlm:aff></affiliation></author></analytic><series><title level="j">Scandinavian journal of public health. Supplement</title><idno type="ISSN">1403-4956</idno><imprint><date when="2007">2007</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="S1"><title>Aim</title><p id="P1">To identify risk factors for severe childhood malnutrition in a rural South African district with a high HIV/AIDS prevalence.</p></sec><sec id="S2"><title>Design</title><p id="P2">Case-control study.</p></sec><sec id="S3"><title>Setting</title><p id="P3">Bushbuckridge District, Limpopo Province, South Africa.</p></sec><sec id="S4"><title>Participants</title><p id="P4">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.</p></sec><sec id="S5"><title>Results</title><p id="P5">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).</p></sec><sec id="S6"><title>Conclusions</title><p id="P6">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.</p><p id="P7"><graphic xlink:href="ukmss-28816-f0001.jpg" position="float"></graphic></p></sec></div></front></TEI><pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<pmc-dir>properties manuscript</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-journal-id">100883504</journal-id><journal-id journal-id-type="pubmed-jr-id">22249</journal-id><journal-id journal-id-type="nlm-ta">Scand J Public Health Suppl</journal-id><journal-id journal-id-type="iso-abbrev">Scand J Public Health Suppl</journal-id><journal-title-group><journal-title>Scandinavian journal of public health. Supplement</journal-title></journal-title-group><issn pub-type="ppub">1403-4956</issn></journal-meta><article-meta><article-id pub-id-type="pmid">17676510</article-id><article-id pub-id-type="pmc">2830109</article-id><article-id pub-id-type="doi">10.1080/14034950701356435</article-id><article-id pub-id-type="manuscript">UKMS28816</article-id><article-categories><subj-group subj-group-type="heading"><subject>Article</subject></subj-group></article-categories><title-group><article-title>What’s new? Investigating risk factors for severe childhood malnutrition in a high HIV prevalence South African setting<xref ref-type="fn" rid="FN1">1</xref></article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>SALOOJEE</surname><given-names>HAROON</given-names></name><xref ref-type="aff" rid="A1">1</xref></contrib><contrib contrib-type="author"><name><surname>DE MAAYER</surname><given-names>TIM</given-names></name><xref ref-type="aff" rid="A1">1</xref></contrib><contrib contrib-type="author"><name><surname>GARENNE</surname><given-names>MICHEL L.</given-names></name><xref ref-type="aff" rid="A2">2</xref><xref ref-type="aff" rid="A3">3</xref></contrib><contrib contrib-type="author"><name><surname>KAHN</surname><given-names>KATHLEEN</given-names></name><xref ref-type="aff" rid="A2">2</xref></contrib></contrib-group><aff id="A1"><label>1</label>Department of Paediatrics and Child Health, University of the Witwatersrand, Johannesburg, South Africa</aff><aff id="A2"><label>2</label>MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, University of the Witwatersrand, South Africa</aff><aff id="A3"><label>3</label>Institut Pasteur, Unité d’Epidémiologie des Maladies Emergentes, Paris, France</aff><author-notes><corresp id="CR1">Correspondence: Haroon Saloojee, Division of Community Paediatrics, Department of Paediatrics and Child Health, The Memorial Institute (TMI), University of the Witwatersrand, Private Bag 3, PO Wits, 2050 South Africa. Tel: +27-11-4815196. <email>Haroon.Saloojee@wits.ac.za</email></corresp></author-notes><pub-date pub-type="nihms-submitted"><day>17</day><month>2</month><year>2010</year></pub-date><pub-date pub-type="ppub"><month>8</month><year>2007</year></pub-date><pub-date pub-type="pmc-release"><day>01</day><month>3</month><year>2010</year></pub-date><volume>69</volume><fpage>96</fpage><lpage>106</lpage><permissions><copyright-statement>© 2007 Taylor & Francis</copyright-statement><copyright-year>2007</copyright-year></permissions><abstract><sec id="S1"><title>Aim</title><p id="P1">To identify risk factors for severe childhood malnutrition in a rural South African district with a high HIV/AIDS prevalence.</p></sec><sec id="S2"><title>Design</title><p id="P2">Case-control study.</p></sec><sec id="S3"><title>Setting</title><p id="P3">Bushbuckridge District, Limpopo Province, South Africa.</p></sec><sec id="S4"><title>Participants</title><p id="P4">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.</p></sec><sec id="S5"><title>Results</title><p id="P5">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).</p></sec><sec id="S6"><title>Conclusions</title><p id="P6">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.</p><p id="P7"><graphic xlink:href="ukmss-28816-f0001.jpg" position="float"></graphic></p></sec></abstract><kwd-group><kwd>Case-control study</kwd><kwd>drug abuse</kwd><kwd>food intake</kwd><kwd>HIV/AIDS</kwd><kwd>kwashiorkor</kwd><kwd>malnutrition</kwd><kwd>marasmus</kwd><kwd>poverty</kwd><kwd>risk factors</kwd><kwd>South Africa</kwd></kwd-group><funding-group><award-group><funding-source country="United Kingdom">Wellcome Trust : </funding-source><award-id>069683 || WT</award-id></award-group></funding-group></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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