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

Ann Trop Paediatr. 2000 Mar;20(1):50-6. doi: 10.1080/02724930092075.


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 significantly higher for HIV-seropositive children (RR 1.6 [95% CI 1.14-2.24]). The increasing difficulties of managing the growing impact of HIV infection on severely malnourished children in Malawi are discussed in the context of reduced support for nutritional rehabilitation units.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Child
  • Child, Preschool
  • Female
  • HIV Seropositivity / complications*
  • HIV Seropositivity / mortality
  • HIV Seroprevalence
  • HIV-1 / immunology*
  • Humans
  • Infant
  • Kwashiorkor / mortality
  • Kwashiorkor / therapy
  • Kwashiorkor / virology
  • Malawi / epidemiology
  • Male
  • Protein-Energy Malnutrition / mortality
  • Protein-Energy Malnutrition / therapy
  • Protein-Energy Malnutrition / virology*
  • Survival Rate