Intestinal and systemic infection, HIV, and mortality in Zambian children with persistent diarrhea and malnutrition
Intestinal and systemic infection, HIV, and mortality in Zambian children with persistent diarrhea and malnutrition
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DOI：
10.1097/00005176-200105000-00011
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发表时间：
2001-05-01
影响因子：
2.9
通讯作者：
Chintu, C
中科院分区：
文献类型：
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作者：
Amadi, B;Kelly, P;Chintu, C
背景资料：持续性腹泻-营养不良综合征是感染和免疫衰竭的综合征，涉及蛋白质、热量和微量营养素消耗以及代谢紊乱。我们报告的影响，艾滋病毒感染的传染病，临床表现，死亡率在赞比亚儿童持续腹泻和nutritional.Methods：两百名儿童（94名男孩和106名女孩，6-24个月大）进行了检查入院营养不良病房大学教学医院在卢萨卡，赞比亚。结果：在108名儿童（54%）中发现了HIV抗体。常见的肠道感染（隐孢子虫[26%]和非伤寒沙门氏菌[18%]）、败血症（17%）和经洗胃证实的肺结核（13.5%）在HIV血清阳性儿童中并不比HIV血清阴性儿童更常见。艾滋病毒血清反应阳性的儿童更容易患消瘦症，而艾滋病毒血清反应阴性的儿童更容易患恶性营养不良症。HIV血清阳性儿童最低年龄别体重z评分（中位数为-4.4;四分位距[IQR]为-5.0 ~-3.8）低于HIV血清阴性儿童（中位数为-3.7; IQR为-4.2 ~-3.1; P < 0.0001）。年龄别身高、身高别体重z评分和中上臂围显示出相似的差异。在200名儿童中，39（19.5%）在28天内死亡;隐孢子虫病和消瘦症是唯一的独立预测death.Conclusions：虽然肠道和全身感染没有不同的HIV-血清阳性和HIV-血清阴性的儿童，HIV影响所有儿童的营养状况。隐孢子虫病和消瘦症与较高的死亡率相关。
Background: Persistent diarrhea-malnutrition syndrome is a complex of infection and immune failure that involves protein, calorie and micronutrient depletion, and metabolic disturbances. We report an analysis of the impact of HIV infection on infectious disease, clinical presentation, and mortality in Zambian children with persistent diarrhea and malnutrition.Methods: Two hundred children (94 boys and 106 girls, 6-24 months old) were examined on admission to the malnutrition ward of University Teaching Hospital in Lusaka, Zambia. There was then 1 month of follow-up.Results: Antibodies to HIV were found in 108 of the children (54%). The common intestinal infections (Cryptosporidium parvum [26%] and nontyphoid Salmonella spp [18%]), septicemia (17%), and pulmonary tuberculosis confirmed by gastric lavage (13.5%) were not significantly more common in HIV-seropositive than in HIV-seronegative children. HIV- seropositive children were more likely to have marasmus whereas HIV-seronegative children were more likely to have kwashiorkor. Weight-for-age z scores at nadir (postedema) were lower in HIV-seropositive children (median, -4.4; interquartile range [IQR], -5.0 to -3.8) than in HIV-seronegative children (median, -3.7; IQR, -4.2 to -3.1; P < 0.0001). Height-for-age and weight-for-height z scores and mid-upper arm circumference showed a similar difference. Of the 200 children, 39 (19.5%) died within 28 days; cryptosporidiosis and marasmus were the only independent predictors of death.Conclusions: Although intestinal and systemic infections did not differ for HIV-seropositive and HIV-seronegative children, HIV influenced nutritional states of all children. Cryptosporidiosis and marasmus were associated with higher mortality.