The impact of the human immunodeficiency virus type 1 on the management of severe malnutrition in Malawi

Abstract

A study was undertaken in a central nutritional rehabilitation unit in southern Malawi to assess the impact of HIV infection on clinical presentation and case fatality rate. HIV seroprevalence in 250 severely malnourished children over 1 year of age was 34.4% and overall mortality was 28%. HIV infection was associated significantly more frequently with marasmus (62.2%) than with kwashiorkor (21.7%) (p<0.0001). Breastfed children presenting with severe malnutrition were significantly more likely to be HIV-seropositive (p<0.001). Clinical and radiological features were generally not helpful in distinguishing HIV-seropositive from HIV-seronegative children. The case fatality rate was significan..