id	title	authors	journal	keywords	abstract									
944	"The President's Emergency Plan for AIDS Relief (PEPFAR); Second Generation Indicators of Mental Health Related to Prevention, Treatment and Care.  "	"Linn JG, Quive M, Fako T, Poku K. "	"International Sociological Association; 20102010.In 2008, the second generation of The President's Emergency Plan for AIDS Relief (PEPFAR), which principally provides anti-retroviral (ART) therapy to 15 focus countries in Africa, the Caribbean, and Asia was launched."		"By 2013, it seeks to treat at least 3 million people, prevent 12 million new HIV infections, care for 12 million people including 5 million orphans & vulnerable children (OVCs), provide at least 80% of the target population with PMTCT services, and train at least 140,000 new health care workers (CDC, 2009). The second PEPFAR follows a partnership framework model; a new approach that emphasizes strengthening country capacity, ownership, and leadership. Further, there is a focus on the development of comprehensive HIV programs with three overlapping areas: Prevention, including behavior change, management of STIs, use of condoms, & safety of blood products; Care, including ART, medical care, VCT, PMTCT, HBC, palliative care, nutrition & OI treatment; and Impact Mitigation, including OVCs, policy, & stigma reduction. High quality surveillance/monitoring systems capable of providing strategic information are integral to the success of the new generation of PEPFAR (VGH, 2009). These systems are built upon the PEPFAR ""Next Generation Indicators,"" which promote better in-country & global harmonization of indicators. There is more attention to measures of coverage (i.e., program & population coverage) & quality (i.e., the Institute of Medicine key dimensions of structure, process, & outcome). This paper focuses on mental health indicators related to prevention, treatment, and care (e.g., number of people living with HIV/AIDS reached with a minimum package of prevention; number of eligible adults and children provided with psychological, social, & spiritual support; & number of individuals who received Testing and Counseling [T&C] services for HIV & received their test results). We discuss the utility of these indicators for host country governments to plan, monitor, & manage a coordinated national response to the HIV/AIDS epidemic & to demonstrate the progress of PEPFAR to the U.S. Congress & the International donor community."									
831	HIV seropositivity in hospitalized children with high clinical likelihood of AIDS.	"Lahiri S, Shahab T, Malik A, Alam S."	Indian Pediatrics. 2002;39(4):372-5.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh3&AN=20023064057	"122 hospitalized children (aged 3 months-12 years) from India, with high clinical likelihood of acquired immune deficiency syndrome (AIDS) were screened between August 1997 and February 1999 to determine the prevalence of human immunodeficiency virus (HIV) infection. The selection of cases was based on the WHO clinical criteria for diagnosis of AIDS in children in Developing Countries. Results revealed that only one child was seropositive for HIV. Of the 122 patients, 100 (81.9%), 76 (62.3%) and 38 (31.1%) cases presented with the major criteria of failure to thrive, fever for more than a month, and diarrhoea for more than a month, respectively. Among the minor criteria, cough for more than one month (45.9%) was the most common presentation, followed by generalized lymphadenopathy (10.7%) and generalized dermatitis (4.1%). Oropharyngeal candidosis and recurrent respiratory infections were present in 4.92% each. Severe wasting with stunting was observed in several cases. Tuberculosis was confirmed in 42 cases (34.4%) and 28 (23%) had tuberculous meningitis. It is concluded that the presence of HIV infection in this area is low. In addition, the diagnosis of AIDS cannot be based on WHO clinical criteria alone."									
1434	Urinary excretion and plasma vitamin E levels in patients with AIDS.	"Jordao AA, Jr., Silveira S, Castro Figueiredo JFd, Vannucchi H."	Nutrition. 1998;14(5):423-6.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh2&AN=19981410877	"28 people who were serologically positive for human immunodeficiency virus (HIV-1) were recruited and divided into 2 groups: 16 people with acquired immunodeficiency disorder (AIDS) (< 200/mmsuperscript 3 CD4<sup>+</sup> T lymphocytes); and 12 HIV-positive people (200-500/mmsuperscript 3 CD4<sup>+</sup> T lymphocytes). The control group consisted of 11 healthy individuals. Urinary and plasma vitamin E concentrations were determined by HPLC. Patients with AIDS presented decreased plasma vitamin E concentrations (15.25+or-12.19 micro mol/litre) compared with those with HIV alone (26.40+or-17.01 micro mol/litre) and controls (40.03+or-31.80 micro mol/litre) groups. Urinary vitamin E excretion was higher in the AIDS group (0.86+or-0.99 micro mol/24 h) than in the HIV group (0.62+or-0.46 micro mol/24 h) and considerably higher than in the control group (0.05+or-0.13 micro mol/24 h). These results indicate increased vitamin E excretion in the urine of people with AIDS and people with HIV-1, leading to a decrease in the plasma concentration of this vitamin. Systematic monitoring of plasma and urinary vitamin E concentrations was recommended for patients with HIV and patients with AIDS and, if necessary, the combination of existing medical therapy with vitamin supplementation to maintain the nutritional status related to vitamin E."									
654	Nutritional status of HIV-1 seropositive patients in the Free State province of South Africa: anthropometric and dietary profile.	"Dannhauser A, Staden AMv, Ryst Evd, Nel M, Marais N, Erasmus E, Attwood EM, et al."	European Journal of Clinical Nutrition. 1999;53(3):165-73.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh2&AN=19991404003	"81 HIV-1 seropositive patients (mean age of 34 years) in different stages of disease attending the Immunology Clinic at the Pelonomi Hospital, Bloemfontein, South Africa were recruited in 1995. 11 of the subjects were followed up in 1997. Anthropometric data including current weight, height, triceps skinfold thickness, mid-upper-arm circumference, body mass index (BMI) and bone-free arm muscle area were collected. Nutrient intake was estimated using a diet history in combination with a standardised food frequency questionnaire. The men were leaner (BMI=18.9) than the women (BMI=22.7) and patients with a cd4<sup>+</sup> T cell count <200 (stage III) tended to have the lowest median values for all anthropometric measurements. More than half the patients had a low intake (<67% of the recommended dietary allowances) of ascorbic acid, vitamin B<sub>6</sub>, vitamin D, retinol, Ca, Fe and Zn. In the 11 follow up patients, higher nutrient intakes were observed, while the anthropometric measurements were the same or slightly lower. It is concluded that HIV/AIDS patients from this population are malnourished. There was, however, no association between disease stage and nutritional status. Nutritional supplementation of HIV/AIDS patients should be considered, as this might lead to improved immune function in these patients."									
1739	Nutritional management after colonic interposition.	Basson A.	SAJCN South African Journal of Clinical Nutrition. 2011;24(3):155-7.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20113314024	"A 22-year-old HIV-positive man was admitted on 5 October 2009 after a suicide attempt by ingestion of caustic fluid (bleach) [South Africa]. On admission, he was underweight with a body mass index of 14.8 kg/m<sup>2</sup>. An emergency total gastrectomy, splenectomy and oesophagectomy with blind loop oesophagus was performed on 6 October 2009 and a feeding jejunostomy (PEJ) was inserted. Two litres of a standard polymeric fibre-containing ready-to-hang feed was started via the PEJ at 83 ml/h (run over 24 h) for inpatient nutritional rehabilitation and maintenance. Three months later, he was discharged and managed at home on 2 litres standard polymeric bolus feeds of 250 ml/bolus. He was referred for a colonic interposition and readmitted in May 2010. His feeds were changed to 1 litre high-protein and 1 litre fibre-containing polymeric feed to continue nutritional rehabilitation based on his weight of 56 kg and BMI of 18.7 kg/m<sup>2</sup>. Colonic interposition surgery was performed on 13 July 2010 and was complicated by restenosis of the proximal anastomosis causing continued reflux and aspiration and one course of aspiration pneumonia, which was treated. Oesophagoscopy revealed severe laryngeal fibrosis and vocal cord paralysis. On 13 January 2011, a total laryngectomy with tracheostomy placement and revision of the pharyngeal-colonic anastomosis was performed to restore swallowing ability. 12 days after the laryngectomy, a barium swallow revealed no leaks, stenosis or aspiration, and he started a liquid diet, experiencing regurgitation only in the supine position. Two days later he was started on pureed foods. Once oral intake had been well established, PEJ feeds were discontinued. However, the PEJ was not removed until several outpatient visits later, in case of complications. He was appropriately counselled as per the gastrectomy and oesophagectomy dietary guidelines throughout the course of rehabilitation."									
1424	"Case 18-2009: A 24-year-old woman with AIDS and tuberculosis with progressive cough, dyspnea, and wasting."	"Wilson D, Hurtado RM, Digumarthy S."	New England Journal of Medicine. 2009 04 Jun;360(23):2456-64+396.		"A 24-year-old woman with the acquired immunodeficiency syndrome (AIDS) and pulmonary tuberculosis was admitted to a hospital in South Africa because of progressive cough, dyspnea, and wasting. A diagnosis of tuberculosis had been made 7 months earlier, and HIV infection 6 months earlier. Cough and positive sputum smears persisted, and despite broad-spectrum antibiotic therapy and supportive care, her condition worsened and she died on the 20th hospital day. Copyright 2009 Massachusetts Medical Society."									
1284	A gardener who coughed up blood.	"Chopdat N, Menezes CN, John MA, Mahomed N, Grobusch MP."	Lancet. 2007;370(9597).	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20073248932	"A 32-year-old HIV-positive male gardener was referred to a hospital in South Africa, in April 2006, with a cough of 2 weeks, mild haemoptysis and diffuse pleuritic chest pain. On examination, he was underweight or short of breath. He had cervical, axillary and inguinal lymphadenopathy. Coarse crackles over both lungs and palpable liver below the costal margin were observed. Chest radiography showed many round opacities. Abdominal ultrasonography showed many hypoechogenic lesions in the liver. Blood tests revealed mild anaemia. The CD4 cell count was only 27/ micro l, and the serum concentrations of alkaline phosphatase and gamma -glutamyltransferase were increased. The serological test was positive for hepatitis C. Computed tomography (CT) of the chest and abdomen showed many cystic lesions in the lungs and liver. An indirect haemagglutination assay was positive for Echinococcus spp. Albendazole (400 mg twice daily) and prednisolone were prescribed. He was discharged after 2 weeks, and completed the course of albendazole, which consisted of three 4-week periods of medication, separated by one-week intervals. In August 2006, repeat CT of the chest and abdomen revealed that the cysts had decreased in size and number."									
947	Predictors of low CD4 count in resource-limited settings: based on an antiretroviral-naive heterosexual Thai population.	"Costello C, Nelson KE, Jamieson DJ, Spacek L, Sennun S, Tovanabutra S, Rungruengthanakit K, et al."	"JAIDS, Journal of Acquired Immune Deficiency Syndromes. 2005;39(2):242-8."	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh3&AN=20053112455	"A barrier to the appropriate provision of antiretroviral therapy to treat immunosuppressed HIV-infected persons in resource-poor countries is identifying who requires treatment. The World Health Organization (WHO) has suggested using a clinical algorithm combined with a total lymphocyte count (TLC)<1200 cells/mm<sup>3</sup> as a surrogate for a CD4 count less than 200 cells/mm<sup>3</sup> when it is not possible to measure the CD4 count. We evaluated various TLC levels, anemia, and body mass index and compared our data with the WHO criteria to develop a more sensitive algorithm to predict CD4 counts of <200 cells/mm<sup>3</sup> and <350 cells/mm<sup>3</sup> in 839 men and women from Thailand infected with HIV-1 subtype E (CRF01_AE). The December 2003 WHO guidelines had a sensitivity of 34.1% in men and 31.8% in women to detect persons with a CD4 count <200 cells/mm<sup>3</sup> in this HIV-infected population from Thailand. The use of a TLC<1500 cells/mm<sup>3</sup> or TLC<2000 cells/mm<sup>3</sup> combined with anemia or WHO stage II infection doubled the sensitivity to detect persons with a CD4 count <200 (63.0% in men, 68.2% in women) with less than a 6% decrease in specificity."									
614	"Nutritional status of under fives attending maternal and child health clinics in Dar es Salaam, Tanzania."	"Matee MIN, Msengi AE, Simon E, Lyamuya EF, Mwinula JH, Mbena EC, Mbena EC, et al."	East African Medical Journal. 1997;74(6):368-71.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh2&AN=19981407245	"A cross-sectional anthropometric study was conducted involving children aged 6-24 months who from July to August 1993 were attending Magomeni maternal and child health (MCH) clinic and children aged 18 months to 5 years who were attending Lugalo and Mwananyamala MCH clinics for routine growth monitoring and for vaccination between May to August 1994. The data collected included age, birth weight, sex, weight, height, breast feeding status and HIV-1 serostatus. Of the 961 boys and 893 girls enrolled, 31.6% were stunted, 14.6% were underweight and 2.9% were wasted. The highest percentage of stunting and wasting was observed between 11 and 25 months and 36-40 months. Of the 849 children tested for HIV-1, 14 (1.7%) were seropositive and 2 out of 770 (0.3%) were born with low weight. HIV seropositivity and low birth weight were associated with stunting and wasting. It is concluded that malnutrition is still a sizeable problem among children attending urban MCH clinics in Dar es Salaam especially among those aged less than three years, to whom special malnutrition control strategies should be targeted."									
278	Cor pulmonale in children with human immunodeficiency virus infection.	"Bannerman C, Chitsike I."	Annals of Tropical Paediatrics. 1995;15(2):129-34.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med3&AN=7677413	"A cross-sectional echocardiographic study of 50 black Zimbabwean children with clinical human immunodeficiency virus (HIV) infection was carried out. The median age was 9 months. Seventy per cent had chronic cough, 60% respiratory distress and 40% cyanosis. Sixty per cent had pericardial effusion and 48% right ventricular hypertrophy (RVH) and dilation. However, the clinical diagnosis of heart failure was difficult as most of these children (80%) had hepatomegaly. These findings suggest that respiratory disease plays a role in the causation of RVH in these children. As cardiac causes of RVH were absent, this was presumed to be due to cor pulmonale. HIV-infected children presenting with respiratory distress may have clinically unapparent cor pulmonale. Early and appropriate management may by beneficial."									
248	"Body composition in adults infected with human immunodeficiency virus in Khon Kaen, Thailand."	"Ludy MJ, Hendricks K, Houser R, Chetchotisakd P, Mootsikapun P, Anunnatsiri S, Price E, et al."	American Journal of Tropical Medicine and Hygiene. 2005;73(4):815-9.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh3&AN=20053216878	"A cross-sectional study of 77 patients infected with human immunodeficiency virus (HIV) in Khon Kaen, Thailand examined association of nutritional status with active opportunistic infections (AOIs)/HIV status and assessed degree of correlation between bioelectrical impedance analysis (BIA) and anthropometry. Many patients (41.3%) were malnourished using World Health Organization criteria for underweight, and malnutrition was associated with AOI status. Unconditional odds ratios (P<0.05) for AOI as opposed to no AOI were 4.57 for underweight, 9.87 for severe underweight, 2.55 for triceps <10th percentile, and 5.22 for mid-arm circumference <10th percentile. Body fat composition from BIA, anthropometry, and body mass index were moderate to highly correlated (P<0.001), with the highest correlation between BIA and subscapular skinfold (r=0.86) and the lowest between BIA and triceps skinfold (r=0.54). Insights were gained about relative value of using various measurements to assess nutritional status of HIV-infected populations."									
1679	Systemic immune activation as a potential determinant of wasting in Zambians with HIV-related diarrhoea.	"Kelly P, Summerbell C, Ngwenya B, Mandanda B, Hosp M, Fuchs D, Wachter H, et al."	Qjm. 1996;89(11):831-7.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh2&AN=19972001250	"A cross-sectional study of body composition measured anthropometrically in 75 adult patients with HIV-related persistent diarrhoea in Lusaka, Zambia, and its relationship to gastrointestinal infection and systemic immune activation assessed using serum neopterin and soluble tumour necrosis factor receptor (sTNF-R55) concentrations, is reported. Patients as a group were generally severely wasted (mean body mass index (BMI) 15.8 kg/msuperscript 2, range 11-22), but the severity of wasting was related neither to oesophageal candidosis nor to intestinal infection. In men but not women, all measures of nutritional status were negatively related to serum sTNF-R55 concentration. Some wasted patients had cutaneous features of malnutrition, again associated with higher sTNFR55 concentrations, and 2 had peripheral oedema. The diarrhoea-wasting syndrome in this part of Africa appeared to be associated with evidence of high cytokine activity in men, rather than oesophageal candidosis or any particular intestinal opportunistic infection. This immune activation requires further investigation in the context of the sex difference observed."									
636	"Health problems and expenditure in an area with food crisis: Mekit Woreda, North Wollo Zone."	"Melese M, Demeke B, Elreedy S, Deconinck H."	Ethiopian Journal of Health Development. 2001;15(1):1-9.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh3&AN=20013073130	"A cross-sectional study was conducted to assess the health problems, health-coping strategies and health care demand of non-displaced communities in food crisis areas in Amhara Region, North Wollo Zone, Ethiopia, during May-July 1998. A total of 531 households (2547 people; 52.9% were males and 47.1% were females) were selected using a multi-stage sampling procedure. Out of the 2547 household members, 748 (29.4%) were reported ill, of whom 122 (16.3%) were treated in health institutions, 95 (12.7%) by traditional healers, 7 (0.9%) by self-medication, and 524 (70.1%) did not seek medical attention. The annual per capita income was estimated to be $43.70. One hundred forty-eight households provided information on the sources of income they used to pay for health services: 72 (48.6%) from the sale of animals and animal products; 32 (21.6%) from the sale of grains; 14 (9.5%) from loans; 11 (7.4%) from savings; 5 (3.4%) from the sale of household utensils; and the remaining 14 (9.5%) from the sale of firewood, working in food or cash-for-work programmes, remittances and petty trading. 454 (85.5%) households were dependent on food aids and 24.6% were found to consume famine food Lathyrus sativus (legumes), which results to neurotoxicity when consumed for a long period as main diet. It is concluded that the health-coping mechanisms are extremely exhausted during food crisis to the extent that families cannot seek any kind of medical care. It is recommended that health aid should be part of food aid during food crisis."									
482	Body mass index in individuals with HIV infection and factors associated with thinness and overweight/obesity.	"Mariz CdA, Albuquerque MdFPMd, Ximenes RAdA, Melo HRLd, Bandeira F, Braga e Oliveira TG, Carvalho EHd, et al."	Cadernos de Saude Publica. 2011;27(10):1997-2008.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20113384779	"A cross-sectional study was conducted using body mass index (BMI) to estimate the prevalence of thinness and overweight/obesity and associated factors in 2,018 individuals with HIV/AIDS attending health services referral centers. The dependent variable was classified as thinness, overweight/obesity and eutrophy. Multinomial logistic regression analyses were performed considering eutrophy as the reference level. The prevalence of thinness was 8.8% and of overweight/obesity, 32.1%. The variables associated with thinness were anemia and CD4 cell count <200 mm<sup>3</sup>. The variables associated with risk of overweight/obesity were age >=40 years and diabetes, and the variables identified as decreasing likelihood of overweight/obesity were having no long-term partner, smoking, presence of an opportunistic disease, anemia, and albumin levels <3.5 mg/dL. The main nutritional problem observed in this population was overweight and obesity, which were much more prevalent than thinness. Older individuals with diabetes should be targeted for nutritional interventions and lifestyle changes."									
483	Body mass index in individuals with HIV infection and factors associated with thinness and overweight/obesity.	"Mariz Cde A, Albuquerque Mde F, Ximenes RA, Melo HR, Bandeira F, Oliveira TG, Carvalho EH, et al."	Cadernos de Saude Publica. 2011;27(10):1997-2008.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=22031204	"A cross-sectional study was conducted using body mass index (BMI) to estimate the prevalence of thinness and overweight/obesity and associated factors in 2,018 individuals with HIV/AIDS attending health services referral centers. The dependent variable was classified as thinness, overweight/obesity and eutrophy. Multinomial logistic regression analyses were performed considering eutrophy as the reference level. The prevalence of thinness was 8.8% and of overweight/obesity, 32.1%. The variables associated with thinness were anemia and CD4 cell count < 200mm3. The variables associated with risk of overweight/obesity were age > 40 years and diabetes, and the variables identified as decreasing likelihood of overweight/obesity were having no long-term partner, smoking, presence of an opportunistic disease, anemia, and albumin levels < 3.5mg/dL. The main nutritional problem observed in this population was overweight and obesity, which were much more prevalent than thinness. Older individuals with diabetes should be targeted for nutritional interventions and lifestyle changes."									
958	"Clinical presentation of hospitalized adult patients with HIV infection and AIDS in Bangkok, Thailand."	"Tansuphasawadikul S, Amornkul PN, Tanchanpong C, Limpakarnjanarat K, Kaewkungwal J, Likanonsakul S, Eampokalap B, et al."	"JAIDS, Journal of Acquired Immune Deficiency Syndromes. 1999;21(4):326-32."	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh3&AN=20002004838	"A cross-sectional survey of hospital admissions during November 1993 to June 1996 was conducted to characterize the clinical spectrum of disease and immune status of adult HIV-1-infected patients in Bangkok, Thailand. Demographic, clinical, and laboratory data were collected from HIV-infected inpatients (>=14 years old) at an infectious diseases hospital. Of 16 717 persons admitted, 3112 (18.6%) were HIV-seropositive, 2261 of whom were admitted for the first time. Of 2261, 1926 (85.2%) were male, 1942 (85.9%) had been infected heterosexually or by means not related to drug use, 319 (14.1%) were injecting drug users (IDUs), and 1553 (68.7%) had AIDS. The most common AIDS-defining conditions were extrapulmonary cryptococcosis (EPC; 38.4%), tuberculosis (TB; 37.4%) and wasting syndrome (WS; 8.1%). IDUs were more likely (P<0.05) to have TB or WS, but less likely (P<0.05) to have EPC or Pneumocystis carinii pneumonia than patients with no history of injecting drug use. Lymphocyte counts were measured for 2047 (90.5%) patients; 81.8% had <=1500 lymphocytes/ micro l. It is concluded that these HIV-infected patients were admitted with severe immunosuppression. Cryptococcosis and TB are major problems and differ in prevalence among IDUs and persons infected sexually."									
1849	Bolivia 2003: results from the demographic and health survey.		Studies in Family Planning. 2008;39(1):73-8.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20083064561	"A demographic and health survey was carried out in Bolivia between 9 August 2003 and 23 January 2004. Data were collected from 19 207 households and complete interviews were conducted with 17 654 women aged 15-49 years and 6230 men aged 15-59 years. Data on fertility (fertility preference, contraception, marital status, assistance during childbirth, postpartum variables), infant mortality, disease prevention and treatment, nutritional status and knowledge of human immunodeficiency virus and acquired immune deficiency syndrome were presented."									
1503	Mortality in children admitted to Port Moresby General Hospital: how can we improve our hospital outcomes?	"Nasi T, Vince JD, Mokela D."	Papua New Guinea Medical Journal. 2003;46(3-4):113-24.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=16454393	"A detailed audit, part retrospective and part prospective, of deaths occurring in children admitted to the children's wards of the Port Moresby General Hospital over a 12-month period was made. 238 children died out of the 4898 admitted, an overall case fatality rate of 4.9%, with a monthly range of 3.7%-9.6%. The proportion of deaths approximated the proportion of admissions in each age group. 92% of the children had a weight of less than 80% of the standard weight for age and 30% weighed less than 60% of the standard weight for age. 24 (11%) of the deaths occurred within the first 6 hours of admission, 39 (17%) within the first 12 hours and 58 (26%) within the first 24 hours. 89 children (40%) died more than one week after admission. Pneumonia, meningitis, measles and septicaemia were the four leading certified causes of death and paediatric AIDS was the fifth. Less than half of the deceased children were appropriately immunized for their age. 27 deaths (12%) were assessed as preventable. 150 (67%) were classified as from treatable causes but unavoidable, 18 (8%) from untreatable causes, 22 (10%) of undetermined cause and 34 (15%) avoidable. The factors associated with avoidable deaths were delayed treatment (20 children), inadequate treatment (8 children), incorrect treatment (1 child) and others (5 children). Infant and child mortality could be reduced by general measures such as improving community nutrition and immunization status and improving care-seeking behaviour. Hospital-related measures to reduce mortality include improving the accuracy and effectiveness of triage and provision of adequate staffing levels and bed space. Periodic in-depth audit is necessary to assess quality of patient care, to identify problems and to point towards their solution. Accurate recordkeeping is essential for appropriate audit and planning."									
1131	High food prices and the global financial crisis have reduced access to nutritious food and worsened nutritional status and health.	"Brinkman HJ, de Pee S, Sanogo I, Subran L, Bloem MW."	Journal of Nutrition. 2010;140(1):153S-61S.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=19939996	"A global economic and financial crisis is engulfing the developing world, coming on top of high food and fuel prices. This paper assesses the impact of the crises on food consumption, nutrition, and health. Several methods were applied, including risk analysis using the cost of the food basket, assessment surveys, simulations, regression analysis using a food consumption score (FCS), reflecting diet frequency and diversity, and a review of the impact of such dietary changes on nutritional status and health. The cost of the food basket increased in several countries, forcing households to reduce quality and quantity of food consumed. The FCS, which is a measure of diet diversity, is negatively correlated with food prices. Simulations show that energy consumption declined during 2006-2010 in nearly all developing regions, resulting potentially in an additional 457 million people (of 4.5 billion) at risk of being hungry and many more unable to afford the dietary quality required to perform, develop, and grow well. As a result of the crises, large numbers of vulnerable households have reduced the quality and quantity of foods they consume and are at risk of increased malnutrition. Population groups most affected are those with the highest requirements, including young children, pregnant and lactating women, and the chronically ill (particularly people with HIV/AIDS and tuberculosis). Because undernutrition during the first 2 y of life has life-long consequences, even short-term price rises will have long-term effects. Thus, measures to mitigate the impact of the crises are urgently required."									
1132	High food prices and the global financial crisis have reduced access to nutritious food and worsened nutritional status and health.	"Brinkman HJ, Pee Sd, Sanogo I, Subran L, Bloem MW."	Journal of Nutrition. 2010;140(1):153S-61S.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20103042584	"A global economic and financial crisis is engulfing the developing world, coming on top of high food and fuel prices. This paper assesses the impact of the crises on food consumption, nutrition, and health. Several methods were applied, including risk analysis using the cost of the food basket, assessment surveys, simulations, regression analysis using a food consumption score (FCS), reflecting diet frequency and diversity, and a review of the impact of such dietary changes on nutritional status and health. The cost of the food basket increased in several countries, forcing households to reduce quality and quantity of food consumed. The FCS, which is a measure of diet diversity, is negatively correlated with food prices. Simulations show that energy consumption declined during 2006-2010 in nearly all developing regions, resulting potentially in an additional 457 million people (of 4.5 billion) at risk of being hungry and many more unable to afford the dietary quality required to perform, develop, and grow well. As a result of the crises, large numbers of vulnerable households have reduced the quality and quantity of foods they consume and are at risk of increased malnutrition. Population groups most affected are those with the highest requirements, including young children, pregnant and lactating women, and the chronically ill (particularly people with HIV/AIDS and tuberculosis). Because undernutrition during the first 2 y of life has life-long consequences, even short-term price rises will have long-term effects. Thus, measures to mitigate the impact of the crises are urgently required."									
1956	"Protective effect of Bacillus Calmette-Guerin (BCG) vaccination in children with extra-pulmonary tuberculosis, but not the pulmonary disease. A case-control study in Rosario, Argentina."	"Bonifachich E, Chort M, Astigarraga A, Diaz N, Brunet B, Pezzotto SM, Bottasso O."	Vaccine. 2006;24(15):2894-9.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=16434130	"A hospital-based case-control study was carried out at the Vilela Children's Hospital in Rosario, Argentina, to measure the protection conferred by BCG vaccination against tuberculosis (TB). The study included 148 newly diagnosed cases of TB (75 males and 73 females, mean age 3.34+/-2.97 years, S.D.), 134 of them with pulmonary TB and 14 cases with extra-pulmonary disease. Controls (425 males and 357 females, 3.39+/-2.98 years) were selected randomly among children who attended to the Hospital showing, neither respiratory diseases nor any other infectious illnesses. Information on BCG vaccination history was assessed from scars or immunisation records. All participants were negative to human immunodeficiency virus and belonged to the lower and upper-lower socioeconomic status, being similar in place of residence and ethnic characteristics. Rate of vaccinated children was 92.6% of cases and 94.5% of controls (3.4 and 3.9% of them without scars, respectively). Regarding the total cases, the protective association between BCG and TB was statistically insignificant, as was for the pulmonary form. Among cases with extra-pulmonary disease, vaccine effectiveness attained significance [79% (95% CI=26-94)], no matter their age, sex or nutritional status. BCG vaccination exerted a beneficial role in extra-pulmonary TB, even in children not seriously undernourished."									
1130	Perceptions of the role of maternal nutrition in HIV-positive breast-feeding women in Malawi.	"Bentley ME, Corneli AL, Piwoz E, Moses A, Nkhoma J, Tohill BC, Ahmed Y, et al."	Journal of Nutrition. 2005;135(4):945-9.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh3&AN=20053101989	"A neglected issue in the literature on maternal nutrition and HIV is how HIV-positive women perceive their own bodies, health, and well-being, particularly in light of their infection, and whether these perceptions influence their infant feeding practices and their perceived ability to breast-feed exclusively through 6 mo. We conducted formative research to better understand breast-feeding practices and perceptions, and to inform the Breastfeeding, Antiretroviral, and Nutrition (BAN) Study, a clinical trial to evaluate antiretroviral and nutrition interventions to reduce mother-to-child transmission of HIV during breast-feeding in Lilongwe, Malawi. 22 HIV-positive women living in semirural areas on the periphery of Lilongwe participated in in-depth interviews. In an adaptation of the body-silhouette methodology, nine culturally appropriate body silhouettes, representing a continuum of very thin to very large shapes, were used to elicit women's views on their present, previous-year, and preferred body shapes, and on the shape they perceived as healthy. The narrative scenario method was also used to explore women's views on 2 fictional women infected with HIV and their ability to exclusively breast-feed. Women perceived larger body shapes as healthy, because fatness is considered a sign of good health and absence of disease, and many recognized the role of nutrition in achieving a preferred or healthy body shape. Several women believed their nutritional status (body size) was declining because of their illness. Women were concerned that breast-feeding may increase the progression of HIV, suggesting that international guidelines to promote appropriate infant feeding practices for infants whose mothers are infected with HIV should focus on the mother's health and well-being, as well as the infant's."									
69	HIV infection in Haiti: natural history and disease progression.	"Deschamps MM, Fitzgerald DW, Pape JW, Johnson WD, Jr."	Aids. 2000;14(16):2515-21.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh3&AN=20003020779	"A prospective longitudinal cohort study was conducted to define the natural history and disease progression of HIV infection in a developing country. Forty-two patients with documented dates of HIV seroconversion, recruited during September 1985-September 1997 were followed in Port-au-Prince, Haiti. Patients were seen at 3 month intervals or when ill. Patients were treated for bacterial, mycobacterial, parasitic, and fungal infections, but antiretroviral therapy was not available. Patients were followed until death or until 1 January 2000; median follow-up was 66 months. By Kaplan-Meier analyses, the median time to symptomatic HIV disease (CDC category B or C) was 3.0 years [95% confidence interval (CI) 2.3-5.0 years]. The median time to AIDS (CDC category C) was 5.2 years (95% CI 4.7-6.5 years), and the median time to death was 7.4 years (95% CI 6.2-10.2 years). Community-acquired infections, including respiratory tract infections, acute diarrhoea, and skin infections were common in the pre-AIDS period. AIDS-defining illnesses included tuberculosis, wasting syndrome, cryptosporidiosis, cyclosporiasis, Candida oesophagitis, toxoplasmosis, and cryptococcal meningitis. Rapid progression to death was associated with anaemia at the time of seroconversion hazards ratio (HR) 4.1 (95% CI 1.1-15.0), age greater than 35 years at seroconversion HR 4.4 (95% CI 1.1-16.6), and lymphopenia at seroconversion HR 11.0 (95% CI 2.3-53.0). This report documents rapid disease progression from HIV seroconversion until death among patients living in a developing country. Interventions, including nutritional support and prophylaxis of common community-acquired infections during the pre-AIDS period may slow disease progression and prolong life for HIV-infected individuals in less-developed countries."									
1380	"Pellagra in lome, prevalence of HIV infection."	"Pitche P, Kombate K, Tchangai-Walla K."	Medecine et Nutrition. 1999;35(5):185-90.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh3&AN=20001408112	"A prospective study was conducted over 3 years (1996-1998) in a dermatology unit and internal Medicine services of the teaching Hospital in Lome, Togo. Patients with pellagra in whom a human immunodeficiency virus (HIV) serology was conducted were studied. 108 cases of pellagra were diagnosed (59 females and 49 males, mean age 41 years). In 6 of the 108 patients with pellagra, HIV serology was positive (5.5 p/100; 2 patients had AIDS symptoms, 4 were asymptomatic). The symptomatology of the patients who had HIV infection were not different to some of the patients without HIV infection. The principal aetiology of pellagra in this study was: nutritional deficiency (n=30); alcoholism (n=15); the association nutritional deficiency and alcoholism (n=60). The results of this study document the low prevalence of HIV infection in patients with pellagra, and confirms the aetiologic and epidemiologic profile of pellagra in poor countries."									
1071	Prevalence of HIV infection and AIDS symptomatology in malnourished children - a hospital based study.	"Khriemenuo A, Sudha RVR, Singh KI, Singh NB, Singh PI."	Journal of Communicable Diseases. 2004;36(1):45-52.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh3&AN=20053160267	"A prospective study was conducted to determine the prevalence of human immunodeficiency virus (HIV) infection and acquired immune deficiency syndrome (AIDS) symptoms in 175 malnourished children (aged 1.5-12 years) at the Department of Pediatrics, Regional Institute of Medical Sciences Hospital, Imphal, Manipur, India, during January 2001-June 2002. Detailed medical history was taken and clinical examination was performed. Serum samples were screened for HIV infection using ELISA, and AIDS diagnosis was based on the clinical case definition of AIDS by the National AIDS Control Organization. The results showed that 70 children were underweight, 52 had marasmus, 31 had marasmic kwashiorkor, and 22 had kwashiorkor. 38 children were HIV seropositive, giving a seroprevalence rate of 21.7%. HIV seroprevalence was highest in children aged 1.5-3 years (47.4%). Underweight children had the highest HIV seroprevalence (47.4%), followed by children with marasmus (28.9%), marasmic kwashiorkor (13.2%) and kwashiorkor (10.5%). The male to female ratio among seropositive children was 1.5:1. The causative agent was HIV-1 in all cases. The mode of HIV transmission was vertical in 36 (94.7%) children. Prolonged fever, oral candidosis, disseminated maculopapular dermatitis, generalized lymphadenopathy, anaemia and hypoalbuminaemia were significantly more frequent in HIV seropositive than seronegative children. Irrespective of HIV serostatus, 61 (34.9%) of 175 malnourished children fulfilled the AIDS criteria. 36 (64.7%) HIV seropositive children had AIDS, while 25 (18.2%) HIV seronegative children fulfilled the AIDS clinical criteria. 13 (34.2%) HIV seropositive children died in the hospital or at home. It is suggested that further studies using larger community-based data be conducted before recommending mandatory HIV testing in malnourished children."									
1832	Is dengue severity related to nutritional status?	"Kalayanarooj S, Nimmannitya S."	Southeast Asian Journal of Tropical Medicine & Public Health. 2005;36(2):378-84.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=15916044	"A retrospective review of dengue patients admitted to Queen Sirikit National Institute of Child Health (previously known as Children's Hospital) from 1995 to 1999 revealed 4,532 confirmed cases of dengue infection; 80.9% were dengue hemorrhagic fever (DHF) and 19.1% were dengue fever cases (DF). Among the DHF patients; 30.6% had shock. The majority of them, 66.6%, had a normal nutritional status, while 9.3% were malnourished and 24.2% had obesity as classified by weight for age. Compared with control patients with other diagnoses (excluding HIV/AIDS patients), malnourished children had a lower risk of contracting dengue infection (odds ratio = 0.48, 95% Cl = 0.39-0.60, p = 0.000) while obese children had a greater risk of infection with dengue viruses (odds ratio = 1.96, 95% Cl = 1.55-2.5, p = 0.000). The clinical signs, symptoms and laboratory findings of dengue were almost the same among the 3 groups of malnourished, normal, and obese patients. The minor differences observed were that in obese children liver enlargement was found less often; maculopapular/convalescence rash and elevations of alanine aminotransferase were found more often. Malnourished patients had a higher risk of developing shock (37.8%) than normal (29.9%) and obese patients (30.2%) (p = 0.000). Obese patients had more unusual presentations: encephalopathy (1.3%) and associated infections (4.8%), than normal (0.5% and 2.7%) and malnourished patients (1.2% and 3.1%). Complications of fluid overload were found more in obese patients (6.5%) compared to normal (3.2%) and malnourished patients (2.1%) (p = 0.000). The case-fatality rates (CFR) in malnourished patients and obese patients were 0.5% and 0.4%, respectively, while in normal patients the CFR was 0.07%. Under and over nutrition DHF patients had either a greater risk of shock or unusual presentations and complications, which can lead to severe disease or complications and probably a higher CFR."									
1748	AIDS in Africa - survival according to AIDS-defining illness.	"Post FA, Badri M, Wood R, Maartens G."	SAMJ South African Medical Journal. 2001;91(7):583-6.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh3&AN=20013121029	"A retrospective study was conducted in South Africa to evaluate the prognostic significance of the type of AIDS-defining illness (ADI) and performance status in a cohort of AIDS patients. 280 patients with AIDS (as defined by the proposed WHO clinical staging system), who attended two Cape Town-based HIV clinics between 1984 and 1997, were stratified according to the type of initial ADI. Survival associated with each opportunistic event was determined by Kaplan-Meier analysis. Cox proportional hazard analysis was used to determine relative risk for death associated with three strata of ADI. Results showed that the median survival associated with various initial ADIs varied from less than 3 months (encephalopathy and wasting), to over 2 years (extrapulmonary tuberculosis and herpes simplex virus infection). This effect of ADI on outcome was most striking in patients with relatively preserved CD4 counts (CD4 >50/ micro l). A performance status score 4 predicted 50% mortality at 1 month, irrespective of co-morbidity. It is concluded that the type of ADI is an important determinant of survival, particularly in patients with preserved CD4 counts. The stratification of patients by type of ADI and performance status may be useful in the management of patients with advanced HIV infection in resource-limited environments."									
556	Home parenteral nutrition in adults: a european multicentre survey in 1997. ESPEN-Home Artificial Nutrition Working Group.	"Bakker H, Bozzetti F, Staun M, Leon-Sanz M, Hebuterne X, Pertkiewicz M, Shaffer J, et al."	Clinical Nutrition. 1999;18(3):135-40.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=10451476	"A retrospective survey on home parenteral nutrition (HPN) in Europe was performed from January to December 1997. Data were compared to a similar study performed in 1993. A questionnaire of HPN practice was designed by the members of the ESPEN-HAN group. This involved adult patients (older than 16 years) newly registered in an HPN program between 1 January and 31 December 1997 and included: number of patients, underlying diseases and a 6-12 month outcome. Incidence and prevalence (at 1.1.1998) of adult HPN were calculated according to the estimated total population in 1997 for the countries in which more than 80% of HPN patients were reported.A total of 494 patients were registered in 73 centres from nine countries (Belgium (B), Denmark (D), France (F), Poland (P), Spain (S), Sweden (Sw), United Kingdom (UK), The Netherlands (N) and Germany (G). The underlying diseases for HPN in 494 patients were cancer (39%), Crohn's (19%), vascular diseases (15%), radiation enteritis (7%), AIDS (2%), other diseases with intestinal failure (18%). Incidence (patients/million inhabitants/year) were in N (3), F. (2.9), D. (2.8), B. (2.6), UK (1. 2), S (0.7) and P (0.36), respectively. Prevalence were in D. (12.7). U.K. (3.7), N. (3.7), F (3.6), B (3.0), P (1.1), S (0.65). After this 6-12 months follow-up (n=284), the mortality was respectively 4% in Crohn's disease, 13% in vascular diseases, 16% in others, 21% in radiaton enteritis, 34% in AIDS, 74% in cancer. Incidences and prevalences modestly increased in these seven European countries in 1997 in comparison to 1993. The percentages of underlying diseases in these countries remained similar except for AIDS that significantly decreased (from 7% to 2%). Outcomes did not significantly differ in the 4-year period except for AIDS (34% instead of 88% mortality) and could have been related to newer, more efficacious therapy. Copyright 1999 Harcourt Publishers Ltd."									
233	Human immunodeficiency virus-associated diarrhea and wasting in Zambia: selected risk factors and clinical associations.	"Chintu C, Dupont HL, Kaile T, Mahmoud M, Marani S, Baboo KS, Mwansa W, et al."	American Journal of Tropical Medicine & Hygiene. 1998;59(1):38-41.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=9684624	"A significant association was observed among human immunodeficiency virus (HIV)-positive adult cases in Lusaka, Zambia compared with HIV-negative controls for chronic diarrhea (68% versus 22%; P < 0.05), weight loss (54% versus 30%; P < 0.05), lymphadenopathy (44% versus 15%; P < 0.05), and skin eruption (33% versus 7%; P < 0.05). Among the HIV-positive children, a higher proportion had clinical evidence of tuberculosis when compared with HIV-negative children (8% versus 1%; P < 0.05). The study demonstrated an association between weight loss in HIV-positive adults and children and chronic diarrhea (odds ratio [OR] = 12.7, 95% confidence interval [CI] = 6.4-25.5; P < 0.001), persistent cough (OR = 7.2, 95% CI = 2.9-14.5; P < 0.001), and an age of 31-45 years (OR = 3.8, 95% CI = 1.8-8.3; P < 0.01). The factors associated with mortality in HIV positive patients included chronic diarrhea (OR = 7.4, 95% CI = 1.6-34; P < 0.01), and lymphadenopathy (OR = 3.89, 95% CI = 1.2-12.2; P < 0.04)."									
244	Human immunodeficiency virus-associated diarrhea and wasting in Zambia: Selected risk factors and clinical associations.	"Chintu C, Dupont HL, Kaile T, Mahmoud M, Marani S, Baboo KS, Mwansa W, et al."	American Journal of Tropical Medicine and Hygiene. 1998;59(1):38-41.		"A significant association was observed among human immunodeficiency virus (HIV)-positive adult cases in Lusaka, Zambia compared with HIV-negative controls for chronic diarrhea (68% versus 22%; P < 0.05), weight loss (54% versus 30%; P < 0.05), lymphadenopathy (44% versus 15%; P < 0.05), and skin eruption (33% versus 7%; P < 0.05). Among the HIV-positive children, a higher proportion had clinical evidence of tuberculosis when compared with HIV- negative children (8% versus 1%; P < 0.05). The study demonstrated an association between weight loss in HIV-positive adults and children and chronic diarrhea (odds ratio [OR] = 12.7, 95% confidence interval [CI] = 6.4- 25.5; P < 0.001), persistent cough (OR = 7.2, 95% CI = 2.9-14.5; P < 0.001), and an age of 31-45 years (OR = 3.8, 95% CI = 1.8-8.3; P < 0.01). The factors associated with mortality in HIV positive patients included chronic diarrhea (OR = 7.4, 95% CI = 1.6-34; P < 0.01), and lymphadenopathy (OR = 3.89, 95% CI = 1.2-12.2; P < 0.04)."									
828	Nutritional assessment of newborns of HIV infected mothers.	Gangar J.	Indian Pediatrics. 2009;46(4):339-41.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20093111958	"A study was conducted between January 2006 and December 2006 to compare the nutritional status of 50 liveborn, full-term neonates of human immunodeficiency virus (HIV)-infected mothers to 50 liveborn, full-term, neonates of HIV-seronegative mothers. All neonates were delivered at Dr. VM Medical College and Government Hospital, Solapur, Maharashtra, India. The risk of malnutrition (OR) in babies born to HIV seropositive mothers was 5, 4, 3 and 10 times compared to babies of HIV seronegative mothers using birthweight, mid-arm circumference to head circumference ratio (MAC/HC) ratio, ponderal index (PI), and clinical assessment of nutritional status (CAN) score as criteria, respectively. The mean weight gain during pregnancy in mothers was 6.5+or-1.0 kg in HIV seropositive mothers against 7.2+or-0.8 kg in HIV seronegative mothers. The coefficient of correlation for weight gain of mothers during pregnancy and birthweight of newborn is high (r=0.91) as compared to other anthropometrical measurements."									
1888	Moderate to severe malnutrition in patients with tuberculosis is a risk factor associated with early death.	"Zachariah R, Spielmann MP, Harries AD, Salaniponi FM."	Transactions of the Royal Society of Tropical Medicine & Hygiene. 2002;96(3):291-4.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=12174782	"A study was conducted in new patients registered with tuberculosis (TB) in a rural district of Malawi to determine (i) the prevalence of malnutrition on admission and (ii) the association between malnutrition and early mortality (defined as death within the first 4 weeks of treatment). There were 1181 patients with TB (576 men and 605 women), whose overall rate of infection with human immunodeficiency virus (HIV) was 80%. 673 TB patients (57%) were malnourished on admission (body mass index [BMI] < 18.5 kg/m2). There were 259 patients (22%) with mild malnutrition (BMI 17.0-18.4 kg/m2), 168 (14%) with moderate malnutrition (BMI 16.0-16.9 kg/m2) and 246 (21%) with severe malnutrition (BMI < 15.9 kg/m2). 95 patients (8%) died during the first 4 weeks. Significant risk factors for early mortality included increasing degrees of malnutrition, age > 35 years, and HIV seropositivity. Among all the 1181 patients, 10.9% of the 414 patients with moderate to severe malnutrition died in the first 4 weeks compared with 6.5% of the 767 patients with normal to mild malnutrition (odds ratio 1.8, 95% confidence interval 1.1-2.7). In patients with TB, BMI < 17.0 kg/m2 is associated with an increased risk of early death."									
1896	Moderate to severe malnutrition in patients with tuberculosis is a risk factor associated with early death.	"Zachariah R, Spielmann MP, Harries AD, Salaniponi FML."	Transactions of the Royal Society of Tropical Medicine and Hygiene. 2002;96(3):291-4.		"A study was conducted in new patients registered with tuberculosis (TB) in a rural district of Malawi to determine (i) the prevalence of malnutrition on admission and (ii) the association between malnutrition and early mortality (defined as death within the first 4 weeks of treatment). There were 1181 patients with TB (576 men and 605 women), whose overall rate of infection with human immunodeficiency virus (HIV) was 80%. 673 TB patients (57%) were malnourished on admission (body mass index [BMI] <18.5 kg/m<sup>2</sup>). There were 259 patients (22%) with mild malnutrition (BMI 17.0-18.4 kg/m<sup>2</sup>), 168 (14%) with moderate malnutrition (BMI 16.0-16.9 kg/m<sup>2</sup>) and 246 (21%) with severe malnutrition (BMI < 15.9 kg/m<sup>2</sup>). 95 patients (8%) died during the first 4 weeks. Significant risk factors for early mortality included increasing degrees of malnutrition, age > 35 years, and HIV seropositivity. Among all the 1181 patients, 10.9% of the 414 patients with moderate to severe malnutrition died in the first 4 weeks compared with 6.5% of the 767 patients with normal to mild malnutrition (odds ratio 1.8, 95% confidence interval 1.1-2.7). In patients with TB, BMI < 17.0 kg/m<sup>2</sup> is associated with an increased risk of early death."									
83	Is total lymphocyte count a reliable predictor of the CD4 lymphocyte cell count in resource-limited settings?	"Liotta G, Perno CF, Ceffa S, Gialloreti LE, Coehlo E, Erba F, Guidotti G, et al."	Aids. 2004;18(7):1082-3.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh3&AN=20043074553	"A study was conducted to assess the impact of considering total lymphocyte count (TLC) alone on the introduction of antiretroviral therapy in an asymptomatic human immunodeficiency virus (HIV)-infected African population undergoing regular CD4+ controls. The effectiveness of TLC as a marker of immunosuppression was compared with that of another marker, body mass index (BMI). The study was conducted during March 2002-May 2003 by analysing 651 paired TLC and CD4+ counts collected from HIV patients from a hospital in Matola-Mapulo, Mozambique. The 2-tailed Pearson correlation between CD4+ count and BMI and TLC were r=0.341 and r=0.314, respectively (P<0.001 in both cases). The classification capability of the 2 models was 65.2% for BMI and 67.6% for TLC; sensitivity was 47% and 48.9%, respectively, whereas specificity was 78.5% for BMI and 81.3% for TLC. It is concluded that the use of TLC as a surrogate for CD4+ count is unjustified."									
1906	"Opportunistic intestinal parasitic infections in human immunodeficiency virus infected patients in Mangalore, south India."	"Shalani S, Shrikala B, Kurnvilla T, Prashanth HV, Dominic RMS."	Tropical Doctor. 2003;33(4).	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh3&AN=20033177786	"A study was conducted to determine the importance of parasites in the diarrhoea wasting syndrome associated with acquired immune deficiency syndrome (AIDS). During January 1998-June 2000, faecal samples were collected from 120 HIV-infected patients with chronic diarrhoea and weight loss in Mangalore, Karnataka, India. These samples were examined for parasites. The results showed that faecal samples of 37 (30.83%) patients had parasites: oocyst of Cryptosporidium spp. in 21 (17.5%); Microsporidium [Microspora] spp. in 6 (5%); Isospora belli in 3 (2.5%); trophozoites and cysts of Giardia lamblia [G. duodenalis] in 4 (3.3%); and larvae of Strongyloides stercoralis in 3 (2.5%). Among the 37 patients, 8 faecal samples showed more than one parasite. In addition, 10 patients suffering from diarrhoea had helminth infections, 4 of which were associated with Ascaris lumbricoides, 3 with Ancylostoma duodenale and 3 with Trichuris trichiura. It is concluded that intestinal parasitic infection is an important cause of chronic diarrhoea among patients with HIV infection."									
330	Clinical manifestations and survival trends during the first 12 years of the AIDS epidemic in Mexico.	"Villasis-Keever A, Rangel-Frausto MS, Ruiz-Palacios G, Leon-Rosales SPd."	Archives of Medical Research. 2001;32(1):62-5.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh3&AN=20013050628	"A study was conducted to evaluate survival trends (1984-95), the prevalence of AIDS-defining conditions, and the role of treatment with zidovudine and/or prophylaxis with trimethoprim-sulfamethoxazole (TMP-SMX) in survival following AIDS diagnosis. We reviewed the clinical charts and postmortem studies of all patients admitted to the HIV Clinic in Mexico from 1984-95. Three groups were identified according to the following dates of HIV diagnosis: (1) 1984-88; (2) 1989-92, and (3) 1993-95. We studied 909 charts. During the study period, 744 (81.6%) patients developed AIDS. Median survival increased from 11.7 months in group 1 to 15.4 and 17.5 months in groups 2 and 3, respectively (p<0.05). We observed the following important changes in the frequency of AIDS-defining conditions over the study period: Pneumocystis carinii pneumonia (PCP) decreased from 24.8 to 17 and 14% in groups 1, 2, and 3, respectively, (p=0.008), and Kaposi's sarcoma (KS), from 31.1 to 10.5 and 13.5% (p<0.001). On the other hand, there was an increase in cytomegalovirus disease with 12.4, 20.4, and 18.6% (p=0.04) and wasting syndrome with 36, 45, and 57% (p<0.001). In the proportional hazard model for death, zidovudine or TMP-SMX use was associated with a protective effect. It is concluded that survival is improving among patients with HIV infection at our institution. The prevalence of AIDS-defining conditions has changed over the last 12 years. There has been a diminution of PCP and KS, whereas cases of CMV disease and wasting syndrome increased."									
466	Selenium deficiency and oxidative stress in asymptomatic HIV-1-infected patients in Cote d'Ivoire.	"Djinhi J, Tiahou G, Zirihi G, Lohoues E, Monde A, Camara C, Sess E."	Bulletin de la Societe de Pathologie Exotique. 2009;102(1):11-3.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20093077888	"A study was conducted to evaluate the oxidative stress and selenium status and the antioxidant capacity of asymptomatic Human immunodeficiency virus 1 (HIV 1)-infected patients from Cote d'Ivoire. The study involved 30 asymptomatic HIV 1-infected patients, aged 18 to 50 years old, selected from the Centre Integre de Recherche Bioclinique d'Abidjan who have not yet been treated by antiretroviral medications and a non-infected group. Oxidative stress indicators malondialdehyde (MDA) and advanced oxidation protein products (AOPP) were measured by spectrofluorimetric method and spectrophotometric method, respectively. Selenium, vitamin E and vitamin A concentrations were evaluated according to the HPLC method. Results showed that all the patients were deficient in selenium (0.58+or-0.12 micro mol/litre vs 1.80+or-0.31 micro mol/litre, P<0.0001). Vitamin E plasma level (27.47+or-8.33 micro mo/litre vs 19.10+or-5.33 micro mol/litre, P<0.0001) and the oxidative stress indicators MDA (3.32+or-0.40 nmol/litre vs 0.99+or-0.26 nmol/litre P<0.0001) and AOPP (62.49+or-13.75 micro mol/litre vs 39.49+or-21.27 micro mol/litre P<0.0001) were significantly higher in the infected group. These results revealed a severe selenium deficiency and oxidative stress in HIV 1-infected asymptomatic persons from Cote d'Ivoire."									
103	Indirect markers to initiate highly active antiretroviral therapy in a rural African setting.	"Tassie JM, Marquardt T, Damisoni H, Odhiambo OD, Mulemba M, Szumilin E, Legros D."	Aids. 2004;18(8):1226-8.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh3&AN=20043096093	"A study was conducted to evaluate the value of WHO clinical staging, body mass index (BMI), haemoglobinemia and total lymphocyte count (TLC) as markers for initiating highly active antiretroviral therapy (HAART) in a rural African project. The study was conducted in Chiradzulu District Hospital, Malawi. A total of 206 HIV-positive adult patients were included, 135 (66%) following post-test counselling and 71 in median 5 months after testing. The median age was 32 years and 121 (59%) were women. Overall, 125 patients (61%) were eligible for HAART (stage 4 or CD4 cell count <200 cells/ micro l). Overall, 106 patients (52%) had a CD4 cell count of less than 200 cells/ micro l. The CD4 cell count was weakly correlated with BMI (r=0.33), haemoglobinemia (r=0.38) and TLC (r=0.51) (P<0.0001 for each). To identify patients with less than 200 CD4 cells/ micro l, stage 3 or stage 4 presented with similar predictive values. The algorithm stage 3 or 4 or TLC of less than 1200 cells/ micro l had a sensitivity of 93% and a specificity of 49%. The algorithm stage 4 or stages 2-3 with a TLC of less than 1200 cells/ micro l presented with a sensitivity of 61%. Combined with clinical stage and TLC, BMI and haemoglobinemia added little in detecting severe immunodeficiency."									
1479	Nutritional status survey and dietary intervention for HIV infected individuals and AIDS patients.	"Yin W, Tian X, Jia Y."	Occupation and Health. 2011;27(4):373-5.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20113274327	"A study was conducted to investigate the nutritional status of HIV infected individuals and AIDS patients in rural areas of Henan Province, and to provide basic evidence for adjusting diet structure and implementing dietary intervention. A total of 30 healthy people aged 30-65 years old were selected as the control group, 40 individuals with HIV infection and 42 AIDS patients as the observation group. Physical examination, dietary survey and blood biochemical examination were conducted on the 2 groups. The data were processed by statistical software SPSS 13.0. The differences of per-capita daily intakes of cereals, vegetables and eggs were significant between 2 groups (P<0.05). Diet structure was cereal-based, with lower intake of fruits and vegetables, seriously inadequate intake of beans, milk, poultry meat and aquatic products, unreasonable ratio of energy to nutrients, low levels of zinc in blood and albumin, and low serum calcium level. As most patients infected with HIV and sufferers from AIDS are in the incubation or early period of AIDS, the overall nutritional status of the respondents are tolerable. Dietary structure is irrational. A variety of vitamins and minerals need to be supplemented. Energy and protein (especially high-quality protein) need to be added."									
348	"Although the situation is improving, women and children still face serious health problems in India."	"Westly SB, Mishra VK."	Asia Pacific Population & Policy. 2001;56:1-4.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh3&AN=20013024883	"A summary of the results of the 2nd National Family Health Survey conducted in India between November 1998 and December 1999 is presented. Data presented include information on infant, child and maternal mortality; the health and nutritional status of women and children; aspects of health care and the utilization of health sevices; and fertility and family planning. Of particular interest are: child immunization, infant feeding and care, maternal medical care, and Acquired Immune Deficiency Syndrome awareness. The policy implications of the results are discussed."									
1697	"Microsporidian spores in the faeces of young children, with and without diarrhoea, from Tucuman, Argentina."	"Valperga SM, Jogna Prat SAd, Valperga GJOd, Lazarte SG, Trejo AVd, Diaz N, Huttman HM."	Revista Argentina de Microbiologia. 1999;31(3):157-64.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh2&AN=19990808152	"A survey of microsporidian spores was carried out between September 1995 and December 1997 in the faeces of 344 infants aged between 1 and 24 months who had been hospitalized in Tucuman, Argentina. The children were grouped according to whether they had severe diarrhoea (group 1, n=222) or other pathologies excluding gastroenteritis (group 2, n=122). Spores were detected by light microscopy of stained smears, using the Weber modified Kokoskin method. Parasitological and bacteriological studies were also carried out and the nutritional status of each child was determined. In group 1 children, Microspora were found in 16 cases (7.2%), 4 of whom were well nourished and 12 were undernourished. In 8 of the 16 cases in group 1, Microspora were associated with other enteropathogens. In group 2, Microspora were detected in 10 cases (8.2%), 4 of whom were well nourished, 4 were undernourished and no data were available for the other 2 cases. Five of the 10 cases in group 2 were associated with other enteropathogens. It was assumed that the study sample was essentially HIV-negative. The occurrence of Microspora did not show significant differences between children with or without diarrhoea or between well nourished or undernourished children."									
522	"Effect of providing vitamin supplements to human immunodeficiency virus-infected, lactating mothers on the child's morbidity and CD4<sup>+</sup> cell counts."	"Fawzi WW, Msamanga GI, Wei R, Spiegelman D, Antelman G, Villamor E, Manji K, et al."	Clinical Infectious Diseases. 2003;36(8):1053-62.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh3&AN=20033096577	"A total of 1078 human immunodeficiency virus (HIV) type 1-infected women from Tanzania were randomized in a placebo-controlled trial using a factorial design to examine the effects of supplementation with vitamin A (preformed vitamin A and beta carotene) and/or multivitamins (vitamins B, C, and E). Supplements were given during pregnancy and lactation. Children of women in the multivitamin arms had a significantly lower risk of diarrhea than did those in the no-multivitamin arm (P=.03). The mean CD4<sup>+</sup> cell count was 151 cells/ micro L higher among children in the multivitamin arms than among those in the no-multivitamin arm (P=.0006). HIV-positive children experienced a benefit apparently similar to that in HIV-negative children (P=.34, by test for interaction). Maternal receipt of vitamin A significantly reduced the risk that the child would have cough with a rapid respiratory rate, a proxy for pneumonia (P=.03), but receipt of vitamin A had no effect on diarrhea or CD4<sup>+</sup> cell count. Provision of multivitamin supplements (including those with vitamins B, C, and E) to HIV-infected, lactating women may be a low-cost intervention to improve their children's health."									
521	"Effect of providing vitamin supplements to human immunodeficiency virus-infected, lactating mothers on the child's morbidity and CD4+ cell counts."	"Fawzi WW, Msamanga GI, Wei R, Spiegelman D, Antelman G, Villamor E, Manji K, et al."	Clinical Infectious Diseases. 2003;36(8):1053-62.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=12684919	"A total of 1078 human immunodeficiency virus (HIV) type 1-infected women from Tanzania were randomized in a placebo-controlled trial using a factorial design to examine the effects of supplementation with vitamin A (preformed vitamin A and beta carotene) and/or multivitamins (vitamins B, C, and E). Supplements were given during pregnancy and lactation. Children of women in the multivitamin arms had a significantly lower risk of diarrhea than did those in the no-multivitamin arm (P=.03). The mean CD4+ cell count was 151 cells/microL higher among children in the multivitamin arms than among those in the no-multivitamin arm (P=.0006). HIV-positive children experienced a benefit apparently similar to that in HIV-negative children (P=.34, by test for interaction). Maternal receipt of vitamin A significantly reduced the risk that the child would have cough with a rapid respiratory rate, a proxy for pneumonia (P=.03), but receipt of vitamin A had no effect on diarrhea or CD4+ cell count. Provision of multivitamin supplements (including those with vitamins B, C, and E) to HIV-infected, lactating women may be a low-cost intervention to improve their children's health."									
1559	Creating and validating an algorithm to measure AIDS mortality in the adult population using verbal autopsy.	"Lopman BA, Barnabas RV, Boerma JT, Chawira G, Gaitskell K, Harrop T, Mason P, et al."	PLoS Medicine. 2006;3(8).	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20063173733	"A verbal autopsy questionnaire was administered to caregivers of 381 adults of known HIV status who died between 1998 and 2003 in Manicaland, eastern Zimbabwe. Individuals who were HIV positive and did not die in an accident or during childbirth (74%; n=282) were considered to have died of AIDS in the gold standard. Verbal autopsies were randomly allocated to a training dataset (n=279) to generate classification criteria or a test dataset (n=102) to verify criteria. A rule-based algorithm created to minimise false positives had a specificity of 66% and a sensitivity of 76%. Eight predictors (weight loss, wasting, jaundice, herpes zoster, presence of abscesses or sores, oral candidiasis, acute respiratory tract infections, and vaginal tumours) were included in the algorithm. In the test dataset of verbal autopsies, 69% of deaths were correctly classified as AIDS/non-AIDS, and it was not necessary to invoke a differential diagnosis of tuberculosis. Presence of any one of these criteria gave a post-test probability of AIDS death of 0.84. Analysis of verbal autopsy data in this rural Zimbabwean population revealed a distinct pattern of signs and symptoms associated with AIDS mortality. Using these signs and symptoms, demographic surveillance data on AIDS deaths may allow for the estimation of AIDS mortality and even HIV prevalence."									
1729	"Report and policy brief from the 4th Africa Conference on Social Aspects of HIV/AIDS Research: Innovations in access to prevention, treatment and care in HIV/AIDS, Kisumu, Kenya, 29 April-3 May 2007."	"Setswe G, Peltzer K, Banyini M, Skinner D, Seager J, Maile S, Sedumedi S, et al."	Sahara J: Journal of Social Aspects of HIV/AIDS/Journal de Aspects Sociaux du VIH/SIDA. 2007 Aug 2007;4(2):640-51.	http://search.proquest.com/docview/60310286?accountid=26724	"About 520 delegates from all over Africa and 21 countries attended the conference. This report and policy brief summarises the key findings and suggested policy options that emerged from rapporteur reports of conference proceedings including the following themes: (1) Orphans and vulnerable children, (2) Treatment, (3) Prevention, (4) Gender and male involvement, (5) Male circumcision, (6) People living with HIV/AIDS, (7) Food and nutrition, (8) Socioeconomics, and (9) Politics/policy. Two (11.8%) of the 17 OVC projects from the three countries were classified as best practice interventions. Of the 83 abstracts that were accepted at the conference, only 7 (8.4%) were dealing with antiretroviral therapy (ART).There has been tremendous effort by various organisations to provide information about prevention of HIV/AIDS. Information received by adolescents has been effective in increasing their knowledge, but without positive sexual behaviour change. The conference noted the contribution of gender discrimination and violence to the HIV epidemic and the different risks that men and women face in relation to the epidemic. Social scientists need to study the deep cultural meanings attached to male circumcision among different ethnic groups to be able to guide the debate on the latest biomedical findings on the protective effect of circumcision against HIV. Palliative care and support is crucial for coping among people living with HIV/AIDS (PLWHA) in order to deal with medical and psychological issues. Results from several countries have helped researchers to explore alternative ways of examining poverty in the context of HIV and AIDS. Policy frameworks which are likely to succeed in combating HIV/AIDS need to be updated to cover issues of access, testing, disclosure and stigma. In general, the conference was successful in identifying innovations in access to prevention, treatment and care in HIV/AIDS. Adapted from the source document."									
1786	Health and welfare effects of integrating AIDS treatment with food assistance in resource constrained settings: A systematic review of theory and evidence.	"Tirivayi N, Groot W."	Social Science & Medicine. 2011;73(5):685-92.	http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=2011253552&site=ehost-live	"Abstract: The article systematically reviews theory and existing empirical evidence on the health and welfare effects of integrating AIDS treatment with food assistance. While theoretical predictions point to possible improvements in health, consumption and ambiguous effects on labor supply, there are few empirical studies that used robust designs. Five empirical studies are reviewed and in two of them, food assistance improves nutritional status, especially when provided in the form of ready to use therapeutic feeding. However because of methodological concerns, the positive effects of food assistance on weight gain warrant cautious interpretation. One study found a positive association between food assistance and adherence. While no quantitative study evaluated welfare effects, respondents in a qualitative study self-reported the resumption of labor activities, increased dietary diversity and food consumption. There is still limited evidence on the role of duration of AIDS treatment and programmatic aspects like targeting, composition and duration of food assistance. The major conclusion of the paper is that there is still need for further research based on robust designs which investigates both health and household welfare effects."									
1558	Natural products for the treatment of HIV/AIDS.	"Klimkait T, Hamy F, Vidal V, Gericke N, Sanglier JJ, Guitard P, Giger R, et al."	Planta Medica. 2009 July;75 (9).		"Access to anti-viral drug (ARV) therapy remains a serious issue for poor people in developing countries. Despite the influx of major funds in Sub-Saharan Africa over the last few years (10 billion USD in 2008) only about one third of all patients get regular access to ARV therapy. For people living with HIV/AIDS that do not fulfill the criteria of fullblown AIDS, there are very few options. Traditional medicines have long filled this gap albeit under conditions that are not optimal. EMF would like to contribute in three ways to better health care, i) in supplementing ARV therapy in fullblown AIDS patients with medicines that can contribute to the well being, quality of life and life span, ii) supporting AIDS patients that are unable to access ARV therapy with alternative medicines, iii) in providing such medicines to people with HIV/AIDS that are not yet fully symptomatic. The goal of EMF is to discover, develop and ultimately bring to market a diverse portfolio of three types of products: i) Food supplements that fulfill safety criteria and have a favorable nutritional effect in people with HIV/AIDS, ii) Complementary medicines that are safe and demonstrably, in limited Phase I/phase II clinical trials have a positive and measurable effect on the quality of life of people with HIV/AIDS, and iii) novel anti-AIDS therapies registered for treatment of HIV/AIDS. EMF is a charity-funded, not-for-profit organization that has since its inception in 2004 studied a large variety of more than 12'000 Natural Products for use in above settings. Important partners in this endeavor were the Natural Products Unit at Novartis AG, and are InPheno AG in Basel for the systematic testing of antiviral activity in a variety of cellular systems employing several HIV-1 substrains that are representative of the African epidemiology, CSIR in Pretoria, SA (Dr. Vinesh Maharaj) and, most recently, the Molecular Biology Institute in Yaounde, Cameroun (Dr. Celine Nkenfou Nguefeu) and the Institute of Pharmaceutical Biology, Pharmazentrum, University Basel (Prof. M. Hamburger & Dr. O. Potterat). A number of antivirally attractive product candidates have been discovered that are now in the process of being tested for their pharmacological suitability and developability. Some concrete examples of such products will be presented."									
527	Macronutrient supplementation for malnourished HIV-infected adults: a review of the evidence in resource-adequate and resource-constrained settings.	"Koethe JR, Chi BH, Megazzini KM, Heimburger DC, Stringer JS."	Clinical Infectious Diseases. 2009;49(5):787-98.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=19624276	"Access to antiretroviral therapy (ART) for human immunodeficiency virus (HIV) infection has expanded rapidly throughout sub-Saharan Africa, but malnutrition and food insecurity have emerged as major barriers to the success of ART programs. Protein-calorie malnutrition (a common form of malnutrition in the region) hastens HIV disease progression, and food insecurity is a barrier to medication adherence. Analyses of patient outcomes have identified a low body mass index after the start of ART as an independent predictor of early mortality, but the causes of a low body mass index are multifactorial (eg, normal anthropometric variation, chronic inadequate food intake, and/or wasting associated with HIV infection and other infectious diseases). Although there is much information on population-level humanitarian food assistance, few data exist to measure the effectiveness of macronutrient supplementation or to identify individuals most likely to benefit. In this report, we review the current evidence supporting macronutrient supplementation for HIV-infected adults, we report on clinical trials in resource-adequate and resource-constrained settings, and we highlight priority areas for future research. [References: 104]"									
528	Macronutrient supplementation for malnourished HIV-infected adults: A review of the evidence in resource-adequate and resource-constrained settings.	"Koethe JR, Chi BH, Megazzini KM, Heimburger DC, Stringer JSA."	Clinical Infectious Diseases. 2009 01 Sep;49(5):787-98.		"Access to antiretroviral therapy (ART) for human immunodeficiency virus (HIV) infection has expanded rapidly throughout sub-Saharan Africa, but malnutrition and food insecurity have emerged as major barriers to the success of ART programs. Protein-calorie malnutrition (a common form of malnutrition in the region) hastens HIV disease progression, and food insecurity is a barrier to medication adherence. Analyses of patient outcomes have identified a low body mass index after the start of ART as an independent predictor of early mortality, but the causes of a low body mass index are multifactorial (eg, normal anthropometric variation, chronic inadequate food intake, and/or wasting associated with HIV infection and other infectious diseases). Although there is much information on population-level humanitarian food assistance, few data exist to measure the effectiveness of macronutrient supplementation or to identify individuals most likely to benefit. In this report, we review the current evidence supporting macronutrient supplementation for HIV-infected adults, we report on clinical trials in resource-adequate and resource-constrained settings, and we highlight priority areas for future research. 2009 by the Infectious Diseases Society of America. All rights reserved."									
1868	Risk factors associated with low birth weight of neonates among pregnant women attending a referral hospital in northern Tanzania.	Siza JE.	Tanzania Journal of Health Research. 2008;10(1):1-8.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20083194083	"According to the World Health Organization low birth weight (LBW) babies are those born with less than 2500 g. A descriptive retrospective cross-sectional study using existing data from a one-year (2001) block of birth registers of 3464 pregnant women was done at Kilimanjaro Christian Medical Centre in Moshi, Tanzania. The objective was to determine factors associated with LBW and their contribution to the problem. Out of 648 pregnant women who were tested for HIV infection 59 (9.1%) were positive for the infection. Twelve (20.3%) of HIV positive women gave birth to LBW neonates. HIV positive women were twice more likely to give birth to LBW infants than HIV negative ones ( chi <sup>2</sup>=6.7; P<0. 01; OR=2.4; 1.1, 5.1). Mothers without formal education were 4 times more likely to give birth to LBW neonates than those who had attained higher education (OR=3.6; 2.2, 5.9). There was a linear decrease in low birth weights of newborns as fraternal educational level increased ( chi <sup>2</sup> for linear trend=42.7; P<0.01). There was no statistically significant difference among parents' occupations regarding LBW of their newborns. Unmarried mothers were more likely to give birth to LBW neonates as compared to their married counterparts (OR=1.65; 1.2, 2.2) and the difference was statistically significant ( chi <sup>2</sup>=13.0, P<0.01). Hypertension, pre-eclampsia and eclampsia disease complex had the highest prevalence (46.67%) and population attributable fraction of low birth weight (PAF=25.2%; CI=22.0-27.6). Bleeding and schistosomiasis had the same prevalence (33.33%) of LBW babies. Other complications and diseases which contributed to high prevalence of LBW included anaemia (25%), thromboembolic diseases (20%), tuberculosis (17%) and malaria (14.8%). Prevalence of LBW was high in women with premature rupture of membrane (38%), placenta previa (17%) and abruption of placenta (15.5%). LBW was strongly associated with gestational age below 37 weeks (OR=2; CI=1.5, 2.8) contributing to 42% of LBW deliveries in the study population (PAF=42.4%: 25, 55). Pregnant women with malnutrition (BMI<18) gave the highest proportions 17% of LBW children followed by underweight (BMI; 18-22) who gave 15.5% of LBW neonates. There was a statistical significant difference between the proportions of LBW infants from mothers who did not receive antenatal care (28.6%) and those who attended for the services (13.8%) ( chi <sup>2</sup>=8.8; P=0.01). There is need of increasing promotion of reproductive health services in relation to safe motherhood at community level in order to reduce risk factors of LBW."									
46	"Co-existence of over- and undernutrition related diseases in low income, high-burden countries: a contribution towards the 17th IUNS Congress of Nutrition, Vienna Austria 2001."	"Rutengwe R, Oldewage-Theron W, Oniang'o R, Vorster HH."	"African Journal of Food, Agriculture, Nutrition and Development. 2001;1(1):34-42."	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh3&AN=20053133822	"Adequate nutrition is a basic human right, but globally it remains unmet for many pre-school children. Poverty, food insecurity and malnutrition continue to be obstacles to human rights, quality of life and dignity. The 1995 goal to eradicate poverty in the world by 2020 is not on target in developing countries; rather, poverty has been increasing. Over 800 million people suffer from malnutrition in developing countries and over 20% of the populations are hungry. About one third of the world's population suffer from micronutrient deficiencies and hundreds of millions suffer from chronic diseases of lifestyle. Prevalence rates, particularly low birth weight, stunting and underweight, remain high particularly in Eastern Africa and South Central Asia. More than a third of all children in developing countries remain constrained in their physical growth and cognitive development. The 1990 ambitious goal of halving childhood underweight prevalence by the year 2000 has not been achieved by most countries. Global progress in fighting malnutrition is slow and crippled by rapid increase of both communicable and non-communicable diseases, the so-called ""double burden of disease"". About 115 million people suffered from obesity related diseases in the year 2000. Overweight and obesity (globesity) prevalence is advancing rapidly in developing countries. Cardiovascular diseases (CVD), myocardial infarction, angina pectoris and stroke as one of the most important causes of mortality and morbidity globally, will continue to be first and second leading causes of death in the world. Most developing countries, including South Africa, currently are in the process of transition and experiencing the double burden of both communicable and non-communicable diseases in which chronic diseases of lifestyle such as CVD have emerged while the battle against infectious diseases has not been won. In the last few years the HIV/AIDS epidemic has spread extremely rapidly and is likely to double overall mortality rates, undermine child survival and halve the life expectancy over the next five years. The co-existence of over- and under-nutrition calls for urgent innovative strategies and interventions to tackle the problem. The importance of prevention as the most sensible strategy is emphasised. This overview emphasises that, in planning nutrition strategies and interventions in low income, high-burden countries such as South Africa risk factors for both over- and under-nutrition and related diseases should be targeted and addressed."									
1302	Health of the world's adolescents: A synthesis of internationally comparable data.	"Patton GC, Coffey C, Cappa C, Currie D, Riley L, Gore F, Degenhardt L, et al."	The Lancet. 2012 April;379(9826):1665-75.		"Adolescence and young adulthood offer opportunities for health gains both through prevention and early clinical intervention. Yet development of health information systems to support this work has been weak and so far lagged behind those for early childhood and adulthood. With falls in the number of deaths in earlier childhood in many countries and a shifting emphasis to non-communicable disease risks, injuries, and mental health, there are good reasons to assess the present sources of health information for young people. We derive indicators from the conceptual framework for the Series on adolescent health and assess the available data to describe them. We selected indicators for their public health importance and their coverage of major health outcomes in young people, health risk behaviours and states, risk and protective factors, social role transitions relevant to health, and health service inputs. We then specify definitions that maximise international comparability. Even with this optimisation of data usage, only seven of the 25 indicators, covered at least 50% of the world's adolescents. The worst adolescent health profiles are in sub-Saharan Africa, with persisting high mortality from maternal and infectious causes. Risks for non-communicable diseases are spreading rapidly, with the highest rates of tobacco use and overweight, and lowest rates of physical activity, predominantly in adolescents living in low-income and middle-income countries. Even for present global health agendas, such as HIV infection and maternal mortality, data sources are incomplete for adolescents. We propose a series of steps that include better coordination and use of data collected across countries, greater harmonisation of school-based surveys, further development of strategies for socially marginalised youth, targeted research into the validity and use of these health indicators, advocating for adolescent-health information within new global health initiatives, and a recommendation that every country produce a regular report on the health of its adolescents."									
445	AIDS-associated diarrhea and wasting in Northeast Brazil is associated with subtherapeutic plasma levels of antiretroviral medications and with both bovine and human subtypes of Cryptosporidium parvum.	"Brantley RK, Williams KR, Silva TM, Sistrom M, Thielman NM, Ward H, Lima AA, et al."	Brazilian Journal of Infectious Diseases. 2003;7(1):16-22.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=12807688	"Advanced HIV infection is frequently complicated by diarrhea, disruption of bowel structure and function, and malnutrition. Resulting malabsorption of or pharmacokinetic changes in antiretroviral agents might lead to subtherapeutic drug dosing and treatment failure in individual patients, and could require dose adjustment and/or dietary supplements during periods of diarrheal illness. We determined the plasma levels of antiretroviral medications in patients that had already been started on medication by their physicians, in an urban infectious diseases hospital in northeast Brazil. We also obtained blood samples from patients hospitalized for diarrhea or AIDS-associated wasting, and we found reduced stavudine and didanosine levels in comparison with outpatients without diarrhea or wasting who had been treated at the same hospital clinic. There was a predominance of the protozoal pathogens Cryptosporidium and Isospora belli, typical opportunistic pathogens of AIDS-infected humans, in the stool samples of inpatients with diarrhea. We conclude that severe diarrhea and wasting in this population is associated with both protozoal pathogens and subtherapeutic levels of antiretroviral medications."									
756	Adaptation to climate change in Africa: Challenges and opportunities identified from Ethiopia.	"Conway D, Schipper EF."	Global Environmental Change. 2011 Feb 2011;21(1):227-37.	http://search.proquest.com/docview/855538688?accountid=26724	"Africa is widely held to be highly vulnerable to future climate change and Ethiopia is often cited as one of the most extreme examples. With this in mind we seek to identify entry points to integrate short- to medium-term climate risk reduction within development activities in Africa, drawing from experiences in Ethiopia. To achieve this we employ a range of data and methods. We examine the changing nature of climate risks using analysis of recent climate variability, future climate scenarios and their secondary impacts. We assess the effects of climate variability on agricultural production and national GDP. Entry points and knowledge gaps in relation to mainstreaming climate risks in Ethiopia are identified using the Government's plan for poverty reduction. We end with a case study incorporating climate risks through drought insurance within the current social protection programme in Ethiopia, which provides support to 8.3 million people. Rainfall behaviour in Ethiopia shows no marked emergent changes and future climate projections show continued warming but very mixed patterns of rainfall change. Economic analysis highlights sensitivities within the economy to large-scale drought, however, while the effects are clear in major drought years in other years the relationship is weak. For social protection fairly small positive and negative effects on the number of recipients and frequency of cash payments during drought occur under the extreme range of climate model rainfall projections (2020s). Our analysis highlights several important challenges and opportunities for addressing climate risks. Challenges primarily relate to the large uncertainties in climate projections for parts of Africa, a weak evidence base of complex, often non-deterministic, climate-society interactions and institutional issues. Opportunities relate to the potential for low-regrets measures to reduce vulnerability to current climate variability which can be integrated with relatively modest effort within a shift in Africa from a disaster-focused view of climate to a long-term perspective that emphasises livelihood security and vulnerability reduction."									
1316	The research progression of AIDS diarrhea treated with TCM.	"Yan L, Guo H."	Liaoning Journal of Traditional Chinese Medicine. 2011;38(12):2490-2.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20123115718	"AIDS diarrhea is a kind of AIDS common complications. HIV infected and AIDS patients with diarrhea, which is the major clinical manifestation suffer from this clisase. It is one of the main reasons of HIV/AIDS patients death. The clinical manifestations are chronic diarrhea, loss of body weight, malnutrition and wasting syndrome. Western medicine think there are many causes of AIDS, according to diarrhea or biological factors invasion, which can be divided into two types of infectious and noninfectious. The pathogenesis is unclear, for a variety of factors may be the reason. TCM holds that AIDS diarrhea main pathogenesis is filled of pathogenic dampness obstructing the spleen, small intestine can not separating the lucid from the turbiddysfunction, large intestine without conduction change, wet inside, resulting in happen diarrhea. In treatment, according to TCM theory TDS and acupuncture can get good curative effect."									
6	Adherence behavior and the impact of HAART on quality of life of Ugandan adults.	Kalanzi DJN.			"AIDS is no longer a death sentence due to the availability of highly active antiretroviral drugs (HAART) used to treat HIV. The international community is increasing access of HAART to low-resource regions. However, treatment failure and disease progression due to sub-optimal adherence are a public health concern. This study examines adherence behavior and the impact of HAART on perceived quality of life. Data utilized in this study were collected in 2007 and the sample is composed of 70 participants between ages 18 and 64 that were currently on HAART, who were selected using convenience sampling and were affiliated with three HAART providing centers in Uganda. Thirty seven percent of the participants were soldiers and 63% were civilians. The average years of schooling were 9. Fifty six percent of the participants were female. The median monthly income of respondents was $28. Eighty two percent of the participants began HAART after 2004. Some of the questions addressed include: How are individuals on HAART adhering to treatment? What factors influence highly active antiretroviral drug adherence behavior? What factors influence life style recommendations adherence behavior? What is the impact of HAART on perceived physical and psychological health among individuals undergoing treatment? Lack of food was the major influential factor for skipping taking medication, and side effects had the least impact on skipping taking medication. Gender power imbalances, economic need and cultural beliefs increased adherence failure because they were a hindrance to the regular use of condoms, having sex with only one partner, or having good nutrition. The effects of HAART on perceived psychological health were reported to be somewhat less as compared to physical health. In reference to physical health, respondents testified of clinical gains. Although the majority of participants reported improvements in psychological health, numerous respondents expressed continued feelings of anxiety, fear, and loneliness. Theoretical and practical implications of the findings as well as direction for future research are also discussed. Copies of dissertations may be obtained by addressing your request to ProQuest, 789 E. Eisenhower Parkway, P.O. Box 1346, Ann Arbor, MI 48106-1346. Telephone 1-800-521-3042; e-mail: disspub@umi.com"									
902	"Presentation and survival of patients with AIDS-related Kaposi's sarcoma in Jos, Nigeria."	"Agaba PA, Sule HM, Ojoh RO, Hassan Z, Apena L, Mu'Azu MA, Badung B, et al."	International Journal of STD and AIDS. 2009 June;20(6):410-3.		"AIDS-related Kaposi's sarcoma (AIDS-KS) remains a significant cause of morbidity and mortality. We describe the pattern of presentation and survival in Jos, Nigeria. We identified 48 HIV-positive patients with AIDS-KS and matched them for age and sex with an equal number of HIV-positive patients without AIDS-KS. We compared their clinical, immunological, virological characteristics and survival. They were similar in age and body mass index profile but patients with AIDS-KS had more tuberculosis co-infection (P, 0.02), lower median CD4 count (P, 0.003) and higher mortality (P, 0.002). Surprisingly, patients with AIDS-KS had lower levels of median viral load (29,347 copies/mL) compared with controls (80,533 copies/mL). We recommend specific AIDS-KS therapy in addition to highly active antiretroviral therapy in order to improve survival."									
1412	Prevalence and risk factors for chronic kidney disease among HIV-infected antiretroviral therapy-naive patients in Mainland China: A multicenter cross-sectional study.	"Cao Y, Gong M, Han Y, Xie J, Li X, Zhang L, Li Y, et al."	Nephrology. 2013 April;18(4):307-12.		"Aim The aim of the study was to evaluate the prevalence and risk factors of chronic kidney disease (CKD) among HIV-infected antiretroviral therapy (ART)-naive patients in Mainland China. Methods In this multicenter cross-sectional study, glomerular filtration rate (GFR) was calculated using the Modification of Diet in Renal Disease (MDRD) equation. CKD was defined as GFR<sub>MDRD</sub> < 60 mL/min per 1.73 m<sup>2</sup> and/or isolated proteinuria (>=1 + on urine dipstick) that persisted at month 3 after the baseline assessment. Risk factors associated with CKD were examined using univariate analysis and multivariate logistic regression analysis. Results In total, 538 HIV-infected ART-naive patients were included in this study. There were 399 male and 139 female patients. The mean age was 36.5 +/- 10.0 years. The prevalence of hypertension, glycometabolism abnormities, and CKD were 3.2%, 3.0%, and 16.1%, respectively. Thirteen (2.4%) patients had estimated GFR (eGFR) < 60 mL/min per 1.73 m<sup>2</sup>, while 73 (13.7%) patients had proteinuria. Using univariate analysis, CKD was found to be significantly (P < 0.05) associated with age, hypertension, HCV co-infection, and plasma HIV-1 viral load >= 100 000 copies/mL. In the multivariate logistic regression model, older age (increased by an interval of 10 years; P = 0.002), HCV co-infection (P = 0.039), and plasma HIV-1 viral load >= 100 000 copies/mL (P = 0.011) were significantly associated with CKD. Conclusion The incidence of CKD is high in Chinese HIV-infected ART-naive patients. Traditional risk factors for renal disease, such as advancing age, HCV co-infection, and higher plasma viral load were correlated with CKD in the present patient samples. Summary at a Glance This study shows that chronic kidney disease occurs in 16% of Chinese HIV-infected antiretroviral-therapy-naive patients, particularly in association with older age, hepatitis C virus co-infection and higher plasma viral load. 2013 The Authors. Nephrology 2013 Asian Pacific Society of Nephrology."									
596	"Neurodevelopmental impairment among infants born to mothers infected with human immunodeficiency virus and uninfected mothers from three peri-urban primary care clinics in Harare, Zimbabwe."	"Kandawasvika GQ, Ogundipe E, Gumbo FZ, Kurewa EN, Mapingure MP, Stray-Pedersen B."	Developmental Medicine & Child Neurology. 2011;53(11):1046-52.	http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=2011328771&site=ehost-live	"Aim The aim of this article is to document the risk of neurodevelopmental impairment (NDI) among infants enrolled in a programme for the prevention of mother-to-child transmission of HIV (human immunodeficiency virus) in Zimbabwe using the Bayley Infant Neurodevelopmental Screener (BINS). Method We prospectively followed up infants at three primary care clinics in Harare, Zimbabwe. Neurodevelopmental assessments using the BINS were conducted during the first 12 months of life. NDI risk category and associated risk factors were examined. Results Of the 598 infants assessed, 305 (51%) were female and 293 (49%) were male. Sixty-five infants (11%) were infected with HIV, 188 (31%) were exposed but uninfected, 287 (48%) were unexposed, and 58 (10%) were of unknown status. The prevalence of a high risk of NDI was 9.4% (95% confidence interval [CI] 7.1-11.1%): 9.2% in males and 9.6% in females. Of the 598 infants, 549 (92%) had ever been breastfed, 49% of whom had mothers infected with HIV. The risk of NDI was higher among infants infected early with HIV, i.e. by 3 months of age (p value <0.001). The NDI high-risk category included twice as many infants infected with HIV as uninfected infants (odds ratio [OR] 2.1; 95% CI 1.0-4.3). After adjusting for other factors, head circumference and family financial subsistence remained risk factors for NDI with an OR of 2.22 (1.04-4.82) and 2.55 (1.02-6.36) respectively. Interpretation The background prevalence of high-risk NDI category of 9.4% across groups seems high but is similar to that reported previously in developing countries. Integration of an early infant neurodevelopmental screening programme into child HIV management protocols will assist in the early referral of children exposed to HIV."									
745	"Factors associated with survival among adults with HIV-associated TB in Guangxi, China: A retrospective cohort study."	"Zhang Y, Sun K, Yu L, Tang Z, Huang S, Meng Z, Zheng Y, et al."	Future Virology. 2012 September;7(9):933-42.		"Aim: Although China has the second highest burden of TB in the world and faces a burgeoning HIV epidemic, the epidemiology and 12-month clinical outcomes of HIV-infected TB patients have not previously been reported. Methods: We reviewed records of all HIV-infected adults diagnosed with culture-confirmed TB from four HIV clinics in Guangxi, China from August 2006 to December 2008. Factors associated with patients survival within 12 months after TB diagnosis were evaluated in Cox proportional hazards models. Results: Among the 201 patients included, 47 (23%) died within 12 months. Median CD4 count at TB diagnosis was 37 cells/mm<sup>3</sup> (interquartile range: 16-102). Receiving HAART (adjusted hazard ratio [AHR]: 4.2; 95% CI: 1.6-10.8), receiving TB treatment (AHR: 9.0; 95% CI: 1.5-53.5) and baseline BMI >= 18.5 (AHR: 8.4; 95% CI: 1.9-35.8) were independently associated with survival. Among 171 (85%) patients who received TB treatment, receiving HAART (HR: 5.1; 95% CI: 2.4-10.7) was the only factor significantly associated with survival. Conclusion: HIV-infected Chinese patients diagnosed with TB in Guangxi are at high risk of death within 12 months, a risk that is strongly mitigated by antiretroviral therapy. Improving survival from HIV-associated TB in China will require the integration of TB and HIV programs to improve access to treatment for both diseases. 2012 Future Medicine Ltd."									
16	Childhood death auditing to improve paediatric care.	"Krug A, Patrick M, Pattinson RC, Stephen C."	Acta Paediatrica. 2006;95(11):1467-73.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=17062479	"AIM: Field-testing a paediatric mortality audit system at eight sites in South Africa to assess its feasibility, to collect local data on common causes of death in children under 5 y, and to determine health system failure, missed opportunities of intervention and substandard care (modifiable factors)."	METHODS: The study tested the Under-5 Healthcare Problem Identification Programme (U5PIP). The sites represent different levels of paediatric healthcare. Study period: 1 September 2003-31 August 2004. Study population: Under-5 patients admitted to study hospitals. Cases: Under-5 patients who died in study hospitals.	"RESULTS: In total, 1532 under-5 deaths occurred, representing a case-fatality rate of 7.8%. Main causes of death were lower respiratory tract infections (33%), gastroenteritis (15%) and septicaemia (12%). Sixty per cent of the deaths were HIV/AIDS related. Sixty-nine per cent of children who died were underweight. Administrative modifiable factors were present in 31% of deaths. Clinical personnel-related modifiable factors were detected in 26% at the clinic level and in 33-37% at the hospital level."	"CONCLUSION: The U5PIP is feasible for ongoing mortality reviews by paediatric teams as part of routine work. Information on common causes of death and modifiable factors in this study focus on the impact of HIV/AIDS, malnutrition and resource allocation, and can be used for interventions to improve paediatric healthcare."						
808	Effect of bovine colostrum-based food supplement in the treatment of HIV-associated diarrhea in Northern Uganda: a randomized controlled trial.	"Kaducu FO, Okia SA, Upenytho G, Elfstrand L, Floren CH."	Indian Journal of Gastroenterology. 2011;30(6):270-6.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=22161540	AIM: HIV-associated diarrhea is common in HIV/AIDS patients in developing countries. An earlier uncontrolled study showed that a nutritional product made from bovine colostrum (ColoPlus) alleviates HIV-associated diarrhea. We performed a randomized single-blind controlled trial of addition of colostrum-based supplement (ColoPlus) to standard anti-diarrhea treatment in HIV/AIDS patients with diarrhea.	"METHODS: Eighty-seven adult patients with HIV-associated diarrhea were recruited at Gulu Hospital and four community clinics in Northern Uganda. Forty-five patients were randomized to receive 50 g of colostrum-based supplement twice a day for 4 weeks in addition to standard anti-diarrhea treatment, and 42 patients received standard anti-diarrhea treatment alone. Patients were followed up for 9 weeks. Daily stool frequency was recorded, and body weight and body mass index were evaluated at weeks 1, 4 and 9. Baseline CD4+ count was measured at baseline and at week 9."	"RESULTS: Mean daily stool frequency decreased by 79% from 7.5 to 1.3 motions over the study period in patients on colostrum-based supplement, compared to a 58% reduction in controls (p<0.001). Self-reported fatigue was reduced by 85% in patients on colostrum-based supplement by week 9 compared to 43% reduction amongst controls (p<0.001). Patients on colostrum-based supplement had 11% increase (p<0,001) in mean body weight and body mass index by week 9, but no changes were observed in control subjects. Mean CD4+ count increased by 14% for patients on colostrum-based supplement, in contrast to 12% decrease in controls (p<0.001)."	CONCLUSIONS: This study shows that addition of colostrum-based supplement to standard therapy is effective in treatment of HIV-associated diarrhea.						
1180	Outcomes of human immunodeficiency virus-infected and -exposed children undergoing surgery-a prospective study.	"Karpelowsky JS, Leva E, Kelley B, Numanoglu A, Rode H, Millar AJW."	Journal of Pediatric Surgery. 2009 April;44(4):681-7.		"Aim: Human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) is a worldwide pandemic. Mother-to-child transmission programs should theoretically minimize vertical transfer of the virus, but with variable effectiveness of implementation a significant number of children become infected and may present for emergency, diagnostic, and elective surgery. The aim of this study was to prospectively document the clinical presentation, the spectrum of pathology, and surgical outcomes of patients presenting to our hospital. This formed part of a pilot study of a collaborative international working group studying HIV infection in children, which included the Buzzi Children's Hospital Milan, Italy; the University of San Diego, California, USA; and the Red Cross War Memorial Children's Hospital and University of Cape Town, School of Adolescent and Child Health, Cape Town, South Africa. Method: Clinical data from all children admitted to the surgical service of the Red Cross War Memorial Children's Hospital between July 2004 and December 2006 with either a history of HIV exposure (born to an HIV-infected mother) or confirmation of HIV infection by ELISA or polymerase chain reaction was collected. The clinical course was documented prospectively for the duration of admission and subsequent follow-up as recorded in case records review. The spectrum of pathology, surgical intervention, outcome, complications, World Health Organization stage of AIDS, and type of antiretroviral therapy were all noted. Comparative outcomes and subgroup analysis were not done in this part of the study. Results: One hundred and thirteen patients were included in the study over the 30-month period. The average age was 24 months (1 day to 11 years). Seventy-nine (70%) of the 113 patients were infected and 34 (30%) were exposed, 9 of whom subsequently tested negative. Of the infected group, 53 (67%) patients were on antiretroviral therapy. The extent of disease in the infected group of patients according to the 2006 World Health Organization criteria was as follows: stage 1, 4 (5%); stage 2, 12 (15%); stage 3, 51 (65%); and stage 4, 12 (15%). All patients had nutritional assessments and were plotted on growth curves. Sixty-two (54%) were found to be malnourished and 41 (36%) of the children were found to have comorbid disease processes. Eighteen patients (16%) were treated with antibiotics or conservative therapy alone. The remaining 95 patients (84%) underwent an average of 1.6 procedures (range, 1-35), 59 (52%) in an elective manner and 36 (31%) as an emergency. When assessing the relationship of HIV to the presenting disease state, 58 (73.4%) had HIV-related diseases and 52 (46%) presented with sepsis. A total of 29 (25%) patients had surgical complications of which 6 (20%) were not considered to be HIV related. Nine (31%) had, in retrospect, incorrect management of the presenting disease, leaving 14 (48%) who potentially had HIV-related complications of poor wound healing and sepsis. A total of 100 (88%) were discharged alive, 6 (5.3%) died, and 7 (6 %) were lost to follow-up. Long-term follow-up of 50 patients for an average of 8 months revealed one further mortality. Conclusion: Human immunodeficiency virus-positive and -exposed patients present a unique challenge in management which is complicated by concomitant disease and poor nutrition. These patients require an expanded differential diagnosis. We believe that, although on the surface there may be a higher complication rate, this needs to be confirmed in an expanded comparative cohort study, which is underway and that patients should still receive the benefit of full surgical intervention. 2009 Elsevier Inc. All rights reserved."									
599	Anthropometric characteristics and cardiometabolic risk factors in a sample of urban-dwelling adults in Senegal.	"Fontbonne A, Cournil A, Cames C, Mercier S, Coly AN, Lacroux A, Dupuy AM, et al."	Diabetes & Metabolism. 2011;37(1):52-8.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=21112227	AIM: The aim of this study was to analyze the relationship between anthropometric characteristics and cardiometabolic risk factors in urban-dwelling adults in Senegal to evaluate future threats to the public health in terms of chronic diseases.	"METHODS: Age- and gender-matched control subjects for a study on the prevalence of lipodystrophy in HIV+ patients were selected between June and September 2006 from the general population through systematic home visits guided by area of residence of cases. After consenting to participate, these subjects underwent anthropometric, clinical and biological examinations in their homes."	"RESULTS: The sample included 60 men and 106 women, mean age of 43.2 +/- 9.4 years. Although the prevalence of overweight and obesity was much higher in women (30.2 and 29.2%, respectively) vs. 23.3 and 3.4%, respectively, in men (P<0.001), the women had lower waist-to-hip ratios (mean [95% CI]: 0.78 [0.77-0.80] vs. 0.86 [0.84-0.88] in men; P<10(-4)) and better systolic blood pressure, triglyceride and high-density lipoprotein (HDL)-cholesterol levels. However, their insulin levels were significantly higher (32.1 [28.2-36.5] pmol/l vs. 25.5 [21.0-30.8] in men; P<0.04). Principal component analysis showed that glucose and insulin correlated with subcutaneous fat, whereas blood pressure correlated with central fat distribution. Lipids were distributed between these two factors."	"CONCLUSION: Obesity still appears to be rare in Senegalese urban-dwelling men, whereas women, despite their overweight, have no untoward cardiometabolic profiles. However, the observed correlations between cardiometabolic risk factors and the amount and/or distribution of body fat suggest that obesity prevention should not be overlooked in the public health agenda for sub-Saharan Africa. Copyright 2010 Elsevier Masson SAS. All rights reserved."						
1170	Effect of HIV-1 infection and increasing immunosuppression on menstrual function.	"Ezechi OC, Jogo A, Gab-Okafor C, Onwujekwe DI, Ezeobi PM, Gbajabiamila T, Adu RA, et al."	Journal of Obstetrics and Gynaecology Research. 2010 October;36(5):1053-8.		"Aim: The aim of this study was to determine the prevalence, pattern and determinants of menstrual abnormalities in HIV-positive Nigerian women. Methods: A cross-sectional study was carried out involving 3473 (2549 HIV-seropositive and 924 seronegative) consecutive and consenting women seen at the HIV treatment centers at the Nigerian Institute of Medical Research, Lagos and the Federal Medical Centre, Markurdi. Results: The sociodemographic characteristics of the two groups were comparable, except for body mass index (BMI): the HIV-negative women (28.1 +/- 8.1) had statistically significantly (P < 0.005) higher BMI compared to the HIV-positive women (21.9 +/- 7.5). Menstrual abnormalities were significantly more common in women living with HIV/AIDS (29.1%) compared to the HIV-negative (18.9%) women (P < 0.001). The proportions of women in the two groups with intermenstrual bleeding, menorrhagia, hypermenorrhea, and postcoital bleeding were similar (P > 0.005), however amenorrhea, oligomenorrhea, irregular periods and secondary dysmenorrhea were more common in the HIV-positive women (P < 0.02). Primary dysmenorrhea was less common in HIV-positive women (P < 0.03). Among the HIV-positive women, menstrual dysfunction was more common in women living with HIV/AIDS with opportunistic infections, CD4 count < 200, not undertaking therapy, symptomatic disease and BMI < 20. However, after controlling for cofounders, only CD4 < 200 (odds ratio [OR], 3.65; 95% confidence interval [CI], 1.2-9.7), BMI < 20 (OR, 2.4; 95%CI, 1.3-3.5) and not taking antiretroviral drugs (OR, 2.05; CI, 1.7-6.5) were associated with amenorrhea, oligomenorrhea, irregular periods and secondary dysmenorrhea. Conclusion: HIV-positive women in this study experienced more menstrual abnormalities of amenorrhea, oligomenorrhea, and irregular periods compared to the HIV-negative controls. HIV-positive women with CD4 count < 200, BMI < 20 and who do not take antiretroviral drugs are at the greatest risk. 2010 Japan Society of Obstetrics and Gynecology."									
1037	Nutritional counselling: an intervention for HIV-positive patients.	"Tabi M, Vogel RL."	Journal of Advanced Nursing. 2006;54(6):676-82.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=16796659	"AIM: This paper reports an investigation of the effectiveness of nutritional counselling as an intervention to improve health outcomes for HIV-positive patients in Ghana, West Africa."	"BACKGROUND: In Ghana, like many developing countries, more patients with HIV and AIDS die because of their poor nutritional status than from the disease itself. With the lack of highly active anti-retroviral therapy for most HIV-infected patients in developing countries, nutritional counselling about high protein diet can be an essential intervention to reduce weight loss and improve weight gain and survival outcomes."	"METHOD: We used secondary-analytic data collected in summer 2003. Recorded monthly weights of HIV-positive patients were obtained and analysed for 25 people, whose ages ranged from 21 to 60 years, with a mean of 39.4 years (sd = 10.13)."	RESULTS: HIV-positive patients responded favourably to nutritional counselling about protein dietary intake as an intervention to improve weight gain. Repeated measures showed a statistically significant weight gain (P = 0.008).	"CONCLUSION: In the absence of anti-retroviral therapy, high protein nutrition can be an effective intervention for HIV-positive patients in developing countries. The health and nutritional status of the patients can be improved through nutritious food, allowing them to lead longer and better quality lives."					
1260	Improving the management of severe acute malnutrition in an area of high HIV prevalence.	"Sadler K, Kerac M, Collins S, Khengere H, Nesbitt A."	Journal of Tropical Pediatrics. 2008;54(6):364-9.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=18450820	"AIM: To assess the clinical outcomes of a combined approach to the treatment of severe acute malnutrition in an area of high HIV prevalence using: (i) an initial inpatient phase, based on WHO guidelines and (ii) an outpatient recovery phase using ready-to-use therapeutic food."	METHODS: An operational prospective cohort study implemented in a referral hospital in Southern Malawi between May 2003 and 2004. Patient outcomes were compared with international standards and with audits carried out during the year preceding the study.	"RESULTS: Inpatient mortality was 18% compared to 29% the previous year. Programme recovery rate was 58.1% compared to 45% the previous year. The overall programme mortality rate was 25.7%. Of the total known HIV seropositive children, 49.5% died."	CONCLUSIONS: Inpatient mortality and cure rates improved compared to pre-study data but the overall mortality rate did not meet international standards. Additional interventions will be needed if these standards are to be achieved.						
1805	"Nutritional, immune, micronutrient and health status of HIV-infected children in care centres in Mangaung."	"Steenkamp L, Dannhauser A, Walsh D, Joubert G, Veldman FJ, Van Der Watt E, Cox C, et al."	South African Journal of Clinical Nutrition. 2009;22(3):131-6.		"Aim: To assess the nutritional, immune, micronutrient and health status of antiretroviral-naive HIV-infected children. Method: A cross-sectional descriptive study was undertaken between September 2004 and March 2006 amongst HIV-infected children of which none received antiretroviral therapy, in care centres in Mangaung, Free State. Results: The study included 37 clinically stable and food-secure HIV-infected children. Their median age was 5.4 years (range 1.2-10.2 years). Fifteen children (41%) were underweight, 30 (81%) were stunted and one (3%) was wasted. The most commonly observed clinical features were lymphadenopathy (84%), skin rashes (51%), hepatomegaly (32%) and pallor (41%). Eight per cent of children had features of TB, while 19% had a lower respiratory tract infection. The median viral load of the group (n = 35) was 117 000 copies/ml, the median CD4<sup>+</sup> cell count was 477 cells/mm3 and the median CD4 percentage was 22.5%. A significant negative correlation could be demonstrated between viral load and nutritional indicators. Children had deficient serum levels relative to normal reference values for glutathione (91% of children), albumin (78%), vitamin A (63%), vitamin D (44%), zinc (38%) and vitamin E (13%). Sixty per cent of the children were anaemic and 30% were iron deficient. Conclusion: A high prevalence of acute and chronic malnutrition and micronutrient deficiencies occurred among HIV-infected children residing in care centres. The study highlights the need to investigate early initiation of antiretroviral therapy and nutrition interventions, including aggressive supplementation, in order to improve the prognosis of these children."									
18	"Home-based therapy with ready-to-use therapeutic food is of benefit to malnourished, HIV-infected Malawian children."	"Ndekha MJ, Manary MJ, Ashorn P, Briend A."	Acta Paediatrica. 2005;94(2):222-5.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=15981758	"AIM: To determine if home-based nutritional therapy will benefit a significant fraction of malnourished, HIV-infected Malawian children, and to determine if ready-to-use therapeutic food (RUTF) is more effective in home-based nutritional therapy than traditional foods."	"METHODS: 93 HIV-positive children >1 y old discharged from the nutrition unit in Blantyre, Malawi were systematically allocated to one of three dietary regimens: RUTF, RUTF supplement or blended maize/soy flour. RUTF and maize/soy flour provided 730 kJ x kg(-1) x d(-1), while the RUTF supplement provided a fixed amount of energy, 2100 kJ/d. These children did not receive antiretroviral chemotherapy. Children were followed fortnightly. Children completed the study when they reached 100% weight-for-height, relapsed or died. Outcomes were compared using regression modeling to account for differences in the severity of malnutrition between the dietary groups."	RESULTS: 52/93 (56%) of all children reached 100% weight-for-height. Regression modeling found that the children receiving RUTF gained weight more rapidly and were more likely to reach 100% weight-for-height than the other two dietary groups (p < 0.05).	"CONCLUSION: More than half of malnourished, HIV-infected children not receiving antiretroviral chemotherapy benefit from home-based nutritional rehabilitation. Home-based therapy RUTF is associated with more rapid weight gain and a higher likelihood of reaching 100% weight-for-height."						
257	"Cryptosporidium infection in undernourished children with HIV/AIDS in Jos, Nigeria."	"Banwat EB, Egah DZ, Audu ES, Onile BA, Datong PR."	Annals of African Medicine. 2004;3(2):80-2.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh3&AN=20053014455	"Aim: To determine the prevalence of Cryptosporidium infection in children with both HIV/AIDS and protein energy malnutrition in Jos, Nigeria. Method: Blood and faecal samples collected from 52 HIV-seropositive and 52 HIV-seronegative children (controls) (aged 0-5 years) were collected, and screened for HIV and Cryptosporidium oocysts, respectively. The sera were screened by double ELISA and the faeces by the modified Ziehl-Neelsen method. Results: Of the 52 HIV-seropositive undernourished children, none excreted Cryptosporidium oocysts in their faeces, while 2 (3.8%) of the control group excreted the oocyst. Conclusion: Cryptosporidium infection seems to be uncommon among undernourished children (aged 0-5 years) with HIV/AIDS in Jos."									
1827	Determining the prevalence of malnutrition in hospitalized paediatric patients.	"Marino LV, Goddard E, Workman L."	South African Medical Journal Suid-Afrikaanse Tydskrif Vir Geneeskunde. 2006;96(9 Pt 2):993-5.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=17077931	AIM: To determine the prevalence of malnutrition in hospitalised paediatric patients at Red Cross War Memorial Children's Hospital.	METHOD: A 1-day cross-sectional survey was completed in all medical and surgical wards and some specialist outpatient clinics.	"RESULTS: A total of 227 children participated in the study. Thirty-five per cent of patients were moderately malnourished (< or = -2 z-score), of whom 70% had no road to health card with them. Thirty-four per cent of children under 60 months of age received supplements in addition to a normal ward diet, 7.8% were enterally fed and less than 1% were parenterally fed. Almost 14% of children were found to be overweight/obese, which is higher than the national average of 6%. The prevalence of HIV infection on the day of the audit was 18% across all age groups compared with the Western Cape antenatal prevalence of 15.7% (2005)."	"CONCLUSION: The overall prevalence of undernutrition was 34%, which is comparable with similar studies. However, the proportion of overweight children (14%) was greater than the national average. In view of the level of malnutrition seen, a nutrition risk-screening tool, identifying risk factors for malnutrition such as food access and vulnerability, should be developed. The tool should be used to assess nutrition status and risk during the course of hospitalisation, in addition to planning appropriate nutrition care plan interventions for discharge."						
20	The effect of nutritional support on weight gain of HIV-infected children with prolonged diarrhoea.	"Rollins NC, van den Broeck J, Kindra G, Pent M, Kasambira T, Bennish ML."	Acta Paediatrica. 2007;96(1):62-8.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=17187606	AIM: To examine the effect on growth and immunity of enhanced calorie and protein provision to HIV-infected children presenting with prolonged diarrhoea.	"METHODS: A total of 169 HIV-infected children aged 6-36 months with diarrhoea for 7 days or more were randomly assigned to either standard nutrition support for children with prolonged diarrhoea or an enhanced diet started during hospitalisation and continued after discharge. The change in weight between enrolment and 8, 14 and 26 weeks and changes in plasma HIV-RNA and CD4 cell count at 8 and 26 weeks were estimated."	"RESULTS: Children receiving enhanced nutrition achieved significantly more weight gain (p < 0.001) between enrolment and 8 weeks than children on the standard diet (median increase in weight-for-age standard deviation score +1.02 vs. +0.01). After 8 weeks median weight velocity was normal and similar in both groups. The change in median CD4 count was similar in both groups. The 26-week mortality rate was high in both groups (standard support: 22%, enhanced support: 29%)."	"CONCLUSIONS: Nutrition support of children with advanced HIV infection and prolonged diarrhoea resulted in significant and sustained weight gain, but did not improve CD4 counts or survival. These results support integrated nutrition interventions for HIV-infected children."						
19	The effect of nutritional support on weight gain of HIV-infected children with prolonged diarrhoea.	"Rollins NC, Broeck Jvd, Kindra G, Pent M, Kasambira T, Bennish ML."	Acta Paediatrica. 2007;96(1):62-8.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20073014504	"Aim: To examine the effect on growth and immunity of enhanced calorie and protein provision to HIV-infected children with prolonged diarrhoea. Methods: 169 HIV-infected children aged 6-36 months with diarrhoea for 7 days or more presenting to King Edward VIII Hospital, Durban, South Africa, were recruited into the study between 1 May 1998 and 31 March 2000. They were randomly assigned to either standard nutritional support for children with prolonged diarrhoea or an enhanced diet started during hospitalization and continued after discharge. The change in body weight between the time of enrolment and 8, 14 and 26 weeks, and the changes in plasma HIV-RNA and CD4 cell count at 8 and 26 weeks were estimated. Results: Children receiving enhanced nutrition achieved significantly more weight gain (P<0.001) between enrolment and 8 weeks than children on the standard diet (median increase in weight-for-age standard deviation score, +1.02 vs. +0.01). After 8 weeks, the median weight velocity was normal and similar in both groups. The change in median CD4 count was similar in both groups. The 26-week mortality rate was high in both groups (standard support, 22%; enhanced support, 29%). Conclusions: Nutritional support of children with advanced HIV infection and prolonged diarrhoea resulted in significant and sustained weight gain, but did not improve CD4 counts or survival. These results support integrated nutrition interventions for HIV-infected children."									
1767	What's new? Investigating risk factors for severe childhood malnutrition in a high HIV prevalence South African setting.	"Saloojee H, De Maayer T, Garenne ML, Kahn K."	Scandinavian Journal of Public Health Supplement. 2007;69:96-106.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medc&AN=17676510	AIM: To identify risk factors for severe childhood malnutrition in a rural South African district with a high HIV/AIDS prevalence.	DESIGN: Case-control study.	"SETTING: Bushbuckridge District, Limpopo Province, South Africa."	"PARTICIPANTS: 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."	"RESULTS: 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)."	"CONCLUSIONS: 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."				
1402	Pediatric highly active antiretroviral therapy in Mozambique: an integrated model of care.	"Marazzi MC, Germano P, Liotta G, Buonomo E, Guidotti G, Palombi L."	Minerva Pediatrica. 2006;58(5):483-90.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=17008860	AIM: To test the impact of a public health model to implement HIV pediatric care in Limited Resource Settings.	"METHODS: A retrospective study on the clinical files of 679 Mozambican children (mean age 4.4 years; SD 3.2), has been carried out. The pediatric patients received HAART (Highly Active Anti-Retroviral Therapy) in the framework of DREAM, a nationwide public health program offering an integrated model of care to HIV patients including free-of-charge HAART and monitoring, nutritional assessment and supplementation, peer-to-peer education, active tracing of the dropped out patients."	RESULTS: HAART was started in 297 subjects out of 679. The median time of treatment was 286 (IQ 25-75:125-465). Mortality rate was lower in the sub-sample receiving HAART (8.4%; CI 95%: 5.2-11.6 vs 13.1%; CI 95%: 9.7-16.5). After 6 months of treatment the percentage of viral load lower than 400 copies/mL rose from 4.9% to 46.3%. The percentage of patients with less than 15% of CD4 cells out of the total lymphocyte count and the percentage of patients below the 2 z-score decreased from 56.4% and 58.1% to 8.8% and 38.1% respectively.	"CONCLUSIONS: Pediatric HAART in limited resource settings often face difficulties to handle complex treatment schemes, but the implemented model seems to be an effective tool to reduce mortality rate in HIV positive pediatric population."						
275	Reduction of unnecessary transfusion and intravenous fluids in severely malnourished children is not enough to reduce mortality.	"Bachou H, Tumwine JK, Mwadime RK, Ahmed T, Tylleskar T."	Annals of Tropical Paediatrics. 2008;28(1):23-33.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=18318946	"AIM: To test whether standardising the use of blood transfusions and intravenous (IV) infusions could reduce fatality in severely malnourished children admitted to Mulago Hospital, Kampala."	"METHODS: Improved adherence to the WHO protocol for blood transfusion and IV fluids was effected in patients with severe malnutrition by continuous medical education. A 'before and after' design was used to study 450 severely malnourished children (weight-for-height < -3 Z-score or presence of oedema) under 60 months of age. A total of 220 pre- and 230 post-'improved practice' patients were enrolled consecutively during the periods September to November 2003 and September to December 2004, respectively. Patients were followed up until discharge or death. The Kaplan-Meier survival curve and the Cox regression hazard model were used for univariate and multivariate analyses, respectively."	"RESULTS: Overall case fatality was 23.6% (52/220) in the pre-period and 24.8% (57/230) in the post-period (p=0.78). Most of the deaths occurred in the 1st week of admission (73%, 38/52 in the pre-period and 61%, 35/57 in the post-period) and were of children who had received blood transfusion or IV infusion or both in the pre-period. Mortality in children transfused and/or infused was significantly reduced in the post-period (82%, 31/38 in the pre-period vs 23%, 8/35 in the post-period, p=0.008). In the post-period, there was a significant reduction in the number of inappropriate blood transfusions (18%, 34/194 vs 3.5%, 8/230, p=0.01) and IV fluid infusions (27%, 52/194 vs 9%, 20/230, p<0.001). Survival improved in children who received blood transfusions in the post-period [hazards ratio (HR) 0.22, 95% CI 0.30-1.67 vs HR 4.80, 95% CI 1.71-13.51], as did that of children who received IV infusions (HR 2.10, 95% CI 0.84-5.23 vs HR 3.91, 95% CI 1.10-14.04)."	"CONCLUSION: Management according to the WHO protocol for severe malnutrition can reduce the need for blood and IV infusions. However, further studies are required to verify whether full implementation of the WHO protocol reduces the high case fatality in sub-Saharan hospitals."						
594	"The role of weight for age and disease stage in poor psychomotor outcome of HIV-infected children in Kilifi, Kenya."	"Abubakar A, Holding P, Newton CR, van Baar A, van de Vijver FJ."	Developmental Medicine & Child Neurology. 2009;51(12):968-73.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=19486107	AIM: We aimed to investigate the contribution of disease stage and weight for age to the variability in psychomotor outcome observed among children with human immunodeficiency virus (HIV) infection.	"METHOD: This cross-sectional study involved 48 Kenyan children (20 females, 28 males) aged 6 to 35 months (mean 19.9mo SD 8.9) exposed prenatally to HIV. Two subgroups of HIV-exposed children were seen: those who were HIV-infected and those who were uninfected. The reference population was composed of 319 children (159 females, 160 males) aged 6-35 months, (mean age = 19 months, SD=8.43) randomly selected from the community. Disease stage varied from stage 1 to stage 3, reflecting progression from primary HIV infection to advanced HIV infection and acquired immune deficiency syndrome. A locally developed and validated measure, the Kilifi Developmental Inventory, was used to assess psychomotor development."	"RESULT: Using age-corrected psychomotor scores, a significant main effect of HIV status was observed (F((2,38.01))=7.89, p<0.001). Children in the HIV-infected group had lower mean psychomotor scores than the HIV-exposed children and the reference group. In the HIV-infected group, disease stage was a negative predictor and weight for age a positive predictor of psychomotor outcome."	"INTERPRETATION: Weight for age and disease stage provide viable, easily measurable benchmarks to specify when frequent developmental monitoring and psychomotor rehabilitation are required. Nutritional intervention and other measures aimed at slowing disease progression may delay the onset and severity of psychomotor impairment in the paediatric HIV population in Africa."						
1686	Referral of patients with kidney impairment for specialist care in developing country of sub-saharan Africa.	"Halle MPE, Kengne AP, Ashuntantang G."	Renal Failure. 2009;31(5):341-8.		"Aim. The aim of this study was to assess the referral pattern of patients with kidney impairment in Cameroon. Methods. Medical files of patients received at the out-patients department of nephrology from January 2001 to December 2003 at the Yaounde General Hospital were reviewed. Individual information recorded included age, sex, and referral sources. Data on etiologic and co-morbidity factors, clinical signs of CRF, anthropometric measurements, blood pressure, and biological variables were recorded. Patients were staged for kidney damage in three groups following an adaptation of the Kidney Disease Outcome Quality Initiative (KDOQI) guide recommendations, using the creatinine clearance derived from the Cockroft-Gault equation. Results. Of the 183 patients received during the study period, 140 (77.8) fulfilled the entry criteria. Men (70) were more represented, and mean age was 50.19 +/- 1.07 years. Hypertension (62.1) and diabetes mellitus (26.4) were the most frequent risk factors. There was no major difference between men and women for most clinical and biological variables. Patients were referred mostly by cardiologist (31.4) and general practitioners (29.3). Late referral (GFR <30 mLmin) encompassed 82.8 of participants. Regardless of the referral source, the overall trend was toward late referral. Clinical and biological profiles worsen with advanced stage of kidney impairment. In general, management of patients prior to referral was poor. Conclusions. This study has revealed the disconcerting high rate of late referral to nephrologists in this context. Many potential factors can account for this observed pattern, and it is worth investigating to improve referral and outcomes of patients with kidney diseases in Cameroon. 2009 Informa UK Ltd."									
1426	Incidence of hepatotoxicity of highly active antiretroviral therapy in a tertiary health centre in Nigeria.	"Ugiagbe RA, Malu AO, Bojuwoye BJ, Onunu AN."	Nigerian Postgraduate Medical Journal. 2012;19(3):127-32.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=23064166	AIMS AND OBJECTIVES: The aim of this study was to determine the incidence of hepatotoxicity of HAART in HIV infected patients in a tertiary health centre in Nigeria.	"MATERIALS AND METHODS: This study was carried out on HIV patients on HAART attending infectious disease clinic, gastroenterology clinic or admitted into the medical wards of University of Benin Teaching Hospital. HAART-naive HIV patients were used as controls. A clinical evaluation and relevant laboratory investigations were done. Hepatotoxicity was defined using a standardised toxicity grade scale."	RESULTS: A total of 84 cases and 42 controls were studied. The mean ages were 35.2+/- 9.9years and 35.5+/-9.0 years for the cases and the controls respectively. Over 70% of the study population and controls were females. The overall incidence of hepatotoxicity was 17.9% and severe hepatotoxicity occurred in 10.7% of the patients. Alcohol use and being underweight were independent risk factors for hepatotoxicity.	CONCLUSION: This prospective study clearly shows that there was appreciable hepatotoxicity associated with HAART in the study patients as found in other parts of the world. There is a need for regular monitoring of liver function in these patients because of the risk of hepatotoxicity.						
452	CYP2B6 (c.516G->T) and CYP2A6 (*9B and/or *17) polymorphisms are independent predictors of efavirenz plasma concentrations in HIV-infected patients.	"Kwara A, Lartey M, Sagoe KW, Rzek NL, Court MH."	British Journal of Clinical Pharmacology. 2009 April;67(4):427-36.		"AIMS Interindividual variability in efavirenz pharmacokinetics is not entirely explained by the well-recognized CYP2B6 516G->T single nucleotide polymorphism. The aim of this study was to determine whether polymorphisms in the CYP2A6 gene can be used to enhance the predictability of efavirenz concentrations in human immunodeficiency virus (HIV)-infected native African patients. METHODS Mid-dose efavirenz plasma concentrations were determined at 4 and 8 weeks following initiation of antiretroviral therapy in 65 HIV-infected Ghanaian patients. Selected CYP2B6 and CYP2A6 genotypes were determined by commercial 5'-nuclease assays. Relationships between averaged 4- and 8-week mid-dose efavirenz concentrations, demographic variables and genotypes were evaluated by univariate and multivariate statistical approaches including gene-gene interactions. RESULTS CYP2B6 c.516G->T, CYP2B6 c.983T->C, CYP2A6*9B and CYP2A6*17 allele frequencies were 45, 4, 5 and 12%, respectively. Rifampicin therapy, gender, age and body mass index had no significant influence on efavirenz mid-dose concentrations. Median efavirenz concentrations were more than five times higher (P < 0.001) in patients with CYP2B6 c.516TT genotype compared with GG and GT genotypes. Although none of the CYP2A6 genotypes was associated with altered efavirenz concentrations individually, CYP2A6*9B and/or CYP2A6*17 carriers showed a 1.8 times higher median efavirenz concentration (P = 0.017) compared with noncarriers. Multiple linear regression analysis indicated that the CYP2B6 c.516G->T polymorphism and CYP2A6 slow-metabolizing variants accounted for as much as 36 and 12% of the total variance in efavirenz concentrations, respectively. CONCLUSIONS Our findings support previous work showing efavirenz oxidation by CYP2A6, and suggest that both CYP2A6 and CYP2B6 genotyping may be useful for predicting efavirenz plasma concentrations. 2009 The British Pharmacological Society."									
324	Impact of disability on survival from severe acute malnutrition in a developing country setting-a longitudinal cohort study.	"Kerac M, Chagaluka G, Kett M, Groce N, Bunn J."	Archives of Disease in Childhood. 2012 May;97:A43-A4.		"Aims Severe acute malnutrition (SAM) causes over 1 million under-5 child deaths in developing countries each year. Among those at risk are children with disabilities. Because their growth often differs from that of non-disabled peers, they are often excluded from SAM-related studies. Little data is therefore available on their outcomes from SAM. We aimed to address this gap by describing: Prevalence of disability among a cohort of children with SAM Short and long term outcomes among disabled children with SAM. Methods Secondary data analysis. All children admitted to an urban nutrition rehabilitation unit in Malawi between July 2006 and March 2007 were monitored and followed-up at 1 year post discharge. Results Of 1024 children, 60 (5.9%) had an obvious disability: most commonly developmental delay or cerebral palsy (46/60, 77%). Multivariable logistic regression incorporating age, sex, admission anthropometry, oedema and HIV status showed that disabled children were significantly less likely to be HIV positive (p<0.001) and more likely to have a weight-for-height Z score of <-3 (p=0.047). Disabled children were significantly more likely to die in the first 90 days of treatment (hazard ratio 2.29, 95% CI 1.36-3.85, p=0.002 and also more likely to die in the longer term (HR 2.29, 95% CI 1.51-3.45, p<0.001). Conclusions Our data suggest that children with disability are a particularly vulnerable SAM subgroup, with high risk of mortality both short and long term. It is important to recognise that there may be many modifiable factors underlying this observation: it is unlikely explained by greater physiological vulnerability alone. Social factors might include suboptimal care practices at home and in communities which increase the risk of a disabled child developing SAM; delayed presentation to care when problems do arise; suboptimal post-SAM care. Treatment services also need to be more proactive about their approach to disability. Protocols should recognise and offer guidance to help identify and care for children with disability. This might include closer referral linkages with disability support services. Finally, more research focusing on this group is needed to determine how treatments might be improved and better tailored to those with underlying disability."									
597	The effect of a basic home stimulation programme on the development of young children infected with HIV.	"Potterton J, Stewart A, Cooper P, Becker P."	Developmental Medicine & Child Neurology. 2010;52(6):547-51.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=20002116	AIMS: The human immunodeficiency virus (HIV) potentially causes a significant encephalopathy and resultant developmental delay in infected children. The aim of this study was to determine whether a home-based intervention programme could have an impact on the neurodevelopmental status of children infected with HIV.	"METHOD: A longitudinal, randomized, controlled trial was conducted. A total of 122 children aged less than 2 years 6 months were assigned to either a comparison or an experimental group. Children in the experimental group were given a home stimulation programme that was updated every 3 months. The home programme included activities to promote motor, cognitive, and speech and language development. Children in the comparison group received no developmental intervention. Children were assessed by a blinded assessor at baseline, 6 months, and 12 months using the Bayley Scales of Infant Development, 2nd edition."	"RESULTS: The children in this study came from poor socioeconomic backgrounds and their nutritional status was suboptimal. The experimental group included 60 children (30 males, 30 females) with a mean age of 18 months (SD 8.1 mo). The comparison group included 62 children (32 males, 30 females) with a mean age 19 months (SD 8.2 mo). Cognitive and motor development were severely affected at baseline, with 52% of the children having severe cognitive delay and 72% having severe motor delay at baseline. Children in the experimental group showed significantly greater improvement in cognitive (p=0.010) and motor (p=0.020) development over time than children in the comparison group."	INTERPRETATION: A home stimulation programme taught to the caregiver can significantly improve cognitive and motor development in young children infected with HIV.						
1186	Lessons learned from maternal deaths at an East African health center.	"Zeck W, Kelters I, Lang U, Petru E."	Journal of Perinatal Medicine. 2006;34(6):459-61.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20073114599	"Aims: To analyse maternal deaths occurring at the Mikumi Health Center in Tanzania, East Africa, to discuss causes for the high maternal mortality rate at the Health Center, and to define possible strategies for the reduction of maternal deaths. Methods: Between 2002 and 2003, a total of nine maternal deaths were identified and analysed from hospital records of the East-African Mikumi Health Center. Results: During the two-year period, the total number of deliveries was 977 including two maternal deaths during pregnancy and seven deaths during labour or postpartum (0.7% of total deliveries). The maternal mortality ratio (MMR) was 921 per 100 000 live births. The maternal average age was 27 years (range 18-37). The average interval between the first contact with the Health Center and maternal death was 3.5 days. Conclusion: The main cause for maternal complications and subsequent deaths might have been the patient's delayed presentation at the Health Center. Aggravating circumstances such as long distance from the health services and hospital fees hinder patients from a timely and eventually life-saving presentation. The womens' low educational level affects their health as well as their nutritional state and thus increases the maternal death rate. Strategies to prevent maternal deaths at the Mikumi Health Center include measures to raise awareness about consequences of poor maternal health, to improve general education especially for young women, to increase the number of professional birth attendants in the region, to improve family planning services and sexual education with special reference to HIV/AIDS. Additionally, improvement of the first referral facilities around the Mikumi Health Center according to the ""essential obstetric functions"" recommended by the WHO seems crucial."									
43	"Nutritional status of HIV/AIDS orphaned children in households headed by the elderly in Rakai District, South Western Uganda."	"Kikafunda JK, Namusoke HK."	"African Journal of Food, Agriculture, Nutrition and Development. 2006;6(1)."	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20063138486	"Although a lot of research has been conducted on the role of good nutrition in mitigating the effects of HIV/AIDS, little is known about the health and nutritional status of HIV/AIDS orphaned children who mostly live with their elderly grand parents. The major objective of this study was therefore to assess the nutritional status of HIV/AIDS orphaned children (<10 years) living with their elderly relatives in Rakai District, Uganda; compared to non-orphaned children living with both parents in ordinary homes. The study was a cross-sectional comparative survey that employed both qualitative and quantitative methodologies. A questionnaire was administered to 100 caretakers of the orphaned children and 50 caretakers of non-orphaned children, which explored the effect of socio-demographic factors on the nutritional status of the children. The children's nutritional status was assessed anthropometrically using the weight for age nutritional indicator. Key information was sought from those with authority in the area. The results revealed high levels of malnutrition among orphaned children as almost half of them (47%) were found to be underweight. This level of underweight was significantly (p<0.05) higher than the figure of 28% found in the children with both parents. In addition, whereas the usual situation is for the under-nutrition to decline as the child grows older, for the AIDS orphans, it was the opposite with levels of underweight rising from 7% through 16% to 24% in the 0-24, 25-60, and above 60-month age groups, respectively. Underweight prevalence among the orphans was twice that found in the general population for under-five children, ie, 47% in the AIDS orphans compared to 23% of the children in the general population. More than half of the elderly care-takers (59%) had no formal education, making adoption of improved child rearing practices a challenge. The findings show that malnutrition in Rakai District is a big problem resulting from a number of factors among them poverty, illiteracy, big family sizes, and the effects of the HIV/AIDS pandemic. Homes visited did not have enough of both material and psychological support to sufficiently care for their families. Overall, the study findings reveal that HIV/AIDS orphaned children living with their elderly relatives have poor nutritional status and recommends that the extent of support to meet the needs of these children and their elderly caretakers be increased."									
1160	Iron deficiency anemia is highly prevalent among human immunodeficiency virus-infected and uninfected infants in Uganda.	"Totin D, Ndugwa C, Mmiro F, Perry RT, Jackson JB, Semba RD."	Journal of Nutrition. 2002;132(3):423-9.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=11880566	"Although anemia is a common finding among human immunodeficiency (HIV)-infected infants in sub-Saharan Africa, the factors contributing to the pathogenesis of anemia have not been well characterized. We sought to characterize the relative contribution of iron deficiency and chronic disease to the anemia among infants. Hemoglobin, ferritin, erythropoietin, tumor necrosis factor-alpha (TNF-alpha), neopterin, CD4(+) lymphocyte count and plasma HIV load were measured in 165 HIV-infected and 39 uninfected 9-mo-old infants seen in an outpatient pediatric clinic in Kampala, Uganda. Among HIV-infected and uninfected infants, the prevalence of anemia (hemoglobin < 110 g/L) was 90.9 and 76.9%, respectively (P = 0.015), and the prevalence of iron deficiency anemia (hemoglobin < 110 g/L and ferritin < 12 microg/L) was 44.3 and 45.4%, respectively (P = 0.92). The relatively higher prevalence of anemia among HIV-infected infants was attributed to the anemia of chronic disease. Among infants with and without iron deficiency, the fitted regression line was log(10) plasma erythropoietin = 2.86 - 0.016.hemoglobin, and log(10) plasma erythropoietin = 4.11 - 0.028.hemoglobin, respectively, with a difference in the slope of the regression lines between log(10) erythropoietin and hemoglobin among infants with and without iron deficiency (P = 0.049). Infants in Uganda have an extremely high prevalence of anemia, and nearly half of the anemia is due to iron deficiency. The erythropoietin response to anemia appears to be upregulated among infants with iron deficiency."									
121	Health regains but livelihoods lag: findings from a study with people on ART in Zambia and Kenya.	"Samuels FA, Rutenberg N."	AIDS Care. 2011;23(6):748-54.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=21574075	"Although ART is increasingly accessible and eases some stresses, it creates other challenges including the importance of food security to enhance ART-effectiveness. This paper explores the role livelihood strategies play in achieving food security and maintaining nutritional status among ART patients in Kenya and Zambia. Ongoing quantitative studies exploring adherence to ART in Mombasa, Kenya (n=118) and in Lusaka, Zambia (n=375) were used to identify the relationship between BMI and adherence; an additional set of in-depth interviews with people on ART (n=32) and members of their livelihood networks (n=64) were undertaken. Existing frameworks and scales for measuring food security and a positive deviance approach was used to analyse data. Findings show the majority of people on ART in Zambia are food insecure; similarly most respondents in both countries report missing meals. Snacking is important for dietary intake, especially in Kenya. Most food is purchased in both countries. Having assets is key for achieving livelihood security in both Kenya and Zambia. Food supplementation is critical to survival and for developing social capital since most is shared amongst family members and others. Whilst family and friends are key to an individual's livelihood network, often more significant for daily survival is proximity to people and the ability to act immediately, characteristics most often found amongst neighbours and tenants. In both countries findings show that with ART health has rebounded but livelihoods lag. Similarly, in both countries respondents with high adherence and high BMI are more self-reliant, have multiple income sources and assets; those with low adherence and low BMI have more tenuous livelihoods and were less likely to have farms/gardens. Food supplementation is, therefore, not a long-term solution. Building on existing livelihood strategies represents an alternative for programme managers and policy-makers as do other strategies including supporting skills and asset accumulation."									
1159	"Severity of human immunodeficiency virus infection is associated with decreased phase angle, fat mass and body cell mass in adults with pulmonary tuberculosis infection in Uganda."	"Shah S, Whalen C, Kotler DP, Mayanja H, Namale A, Melikian G, Mugerwa R, et al."	Journal of Nutrition. 2001;131(11):2843-7.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=11694606	"Although coinfection with tuberculosis and human immunodeficiency virus (HIV) is emerging as a major problem in many developing countries, nutritional status has not been well characterized in adults with tuberculosis and HIV infection. We compared nutritional status between 261 HIV-positive and 278 HIV-negative adults with pulmonary tuberculosis in Kampala, Uganda, using anthropometry and bioelectrical impedance analysis. Among 163 HIV-positive and 199 HIV-negative men, intracellular water-to-extracellular water (ICW:ECW) ratio was 1.48 +/- 0.26 and 1.59 +/- 0.48 (P = 0.006) and phase angle was 5.42 +/- 1.05 and 5.76 +/- 1.30 (P = 0.009), respectively. Among 98 HIV-positive and 79 HIV-negative women, ICW:ECW was 1.19 +/- 0.16 and 1.23 +/- 0.15 (P = 0.11) and phase angle was 5.35 +/- 1.27 and 5.43 +/- 0.93 (P = 0.61), respectively. There were no significant differences in BMI, body cell mass, fat mass or fat-free mass between HIV-positive and HIV-negative adults. Among HIV-positive subjects, BMI, ICW:ECW, body cell mass, fat mass and phase angle were significantly lower among those with CD4(+) lymphocytes < or = 200 cells/microL compared with those who had > 200 cells/microL. In sub-Saharan Africa, coinfection with pulmonary tuberculosis and HIV is associated with smaller body cell mass and intracellular water, but not fat-free mass, and by large differences in ICW:ECW and phase angle alpha."									
1557	"Weather patterns, food security and humanitarian response in sub-Saharan Africa."	Haile M.	Philosophical Transactions of the Royal Society of London - Series B: Biological Sciences. 2005;360(1463):2169-82.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=16433102	"Although considerable achievements in the global reduction of hunger and poverty have been made, progress in Africa so far has been very limited. At present, a third of the African population faces widespread hunger and chronic malnutrition and is exposed to a constant threat of acute food crisis and famine. The most affected are rural households whose livelihood is heavily dependent on traditional rainfed agriculture. Rainfall plays a major role in determining agricultural production and hence the economic and social well being of rural communities. The rainfall pattern in sub-Saharan Africa is influenced by large-scale intra-seasonal and inter-annual climate variability including occasional El Nino events in the tropical Pacific resulting in frequent extreme weather event such as droughts and floods that reduce agricultural outputs resulting in severe food shortages. Households and communities facing acute food shortages are forced to adopt coping strategies to meet the immediate food requirements of their families. These extreme responses may have adverse long-term, impacts on households' ability to have sustainable access to food as well as the environment. The HIV/AIDS crisis has also had adverse impacts on food production activities on the continent. In the absence of safety nets and appropriate financial support mechanisms, humanitarian aid is required to enable households effectively cope with emergencies and manage their limited resources more efficiently. Timely and appropriate humanitarian aid will provide households with opportunities to engage in productive and sustainable livelihood strategies. Investments in poverty reduction efforts would have better impact if complemented with timely and predictable response mechanisms that would ensure the protection of livelihoods during crisis periods whether weather or conflict-related. With an improved understanding of climate variability including El Nino, the implications of weather patterns for the food security and vulnerability of rural communities have become more predictable and can be monitored effectively. The purpose of this paper is to investigate how current advances in the understanding of climate variability, weather patterns and food security could contribute to improved humanitarian decision-making. The paper will propose new approaches for triggering humanitarian responses to weather-induced food crises. [References: 10]"									
618	Influence of mothers' characteristics on their perceptions and use of the growth chart.	"Al-Nahedh N, Bamgboye EA."	Eastern Mediterranean Health Journal. 2003;9(5-6):974-80.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=16450527	"Although growth charts are recommended for monitoring children, recent reports indicate poor use by mothers. We investigated maternal knowledge and perceptions of growth charts and identified characteristics affecting use. At outpatient paediatric clinics of a Riyadh hospital, 305 mothers with children under age 5 were interviewed by questionnaire during May-June 2001. Overall awareness of growth charts was 35.8% and ever-use was 8.6%. Education, parity and number of living children were significantly associated with knowledge. Among mothers who ever used growth charts (8.7%), only 10% reported doctors recommended changes in health care because of them. Overall, 71% wanted to monitor their child's growth, but 20% did not know how. Increased health education in all health care delivery systems is needed."									
1474	Relation of vitamin A and carotenoid status to growth failure and mortality among Ugandan infants with human immunodeficiency virus.	"Melikian G, Mmiro F, Ndugwa C, Perry R, Jackson B, Garrett E, Tielsch J, et al."	Nutrition; 2001.  25 ref;17(7/8):567-72.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh3&AN=20013100481	"Although growth failure is common during paediatric infection with human immunodeficiency virus (HIV) and associated with increased mortality, the relation of specific nutritional factors with growth and mortality has not been well characterized. A longitudinal study was conducted with 194 HIV-infected infants in Kampala, Uganda. All infants were born to HIV-infected mothers seen at Mulago Hospital in Kampala, between October 1994 and September 1999. Plasma vitamin A, carotenoids ( alpha -carotene, beta -carotene, beta -cryptoxanthin, lycopene, and lutein/zeaxanthin), and vitamin E were measured at age 14 weeks, and weight and height were followed up to age 12 months. Vitamin A and low plasma carotenoid concentrations were predictive of decreased weight and height velocity. Between ages 14 weeks and 12 months, 32% of infants died. Underweight, stunting, and low concentrations of plasma carotenoids were associated with increased risk of death in univariate analyses. Plasma vitamin A concentrations were not associated with risk of death. In a final multivariate model adjusting for weight-for-age, plasma beta -carotene was significantly associated with increased mortality (odds ratio: 3.16, 95% confidence interval: 1.38-7.21, P<0.006). These data suggest that low concentrations of plasma carotenoids are associated with increased risk of death during HIV infection among infants in Uganda."									
1438	Relation of vitamin A and carotenoid status to growth failure and mortality among Ugandan infants with human immunodeficiency virus.	"Melikian G, Mmiro F, Ndugwa C, Perry R, Jackson JB, Garrett E, Tielsch J, et al."	Nutrition. 2001;17(7-8):567-72.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=11448574	"Although growth failure is common during pediatric infection with human immunodeficiency virus (HIV) and associated with increased mortality, the relation of specific nutrition factors with growth and mortality has not been well characterized. A longitudinal study was conducted with 194 HIV-infected infants in Kampala, Uganda. Plasma vitamin A, carotenoids (alpha-carotene, beta-carotene, beta-cryptoxanthin, lycopene, and lutein/zeaxanthin), and vitamin E were measured at age 14 wk, and weight and height were followed up to age 12 mo. Vitamin A and low plasma carotenoid concentrations were predictive of decreased weight and height velocity. Between ages 14 wk and 12 mo, 32% of infants died. Underweight, stunting, and low concentrations of plasma carotenoids were associated with increased risk of death in univariate analyses. Plasma vitamin A concentrations were not associated with risk of death. In a final multivariate model adjusting for weight-for-age, plasma beta-carotene was significantly associated with increased mortality (odds ratio: 3.16, 95% confidence interval: 1.38 to 7.21, P < 0.006). These data suggest that low concentrations of plasma carotenoids are associated with increased risk of death during HIV infection among infants in Uganda."									
741	HIV/AIDS and nutrition: helping families and communities to cope.	"Egal F, Valstar A."	"Food, Nutrition and Agriculture. 1999;25:20-5."	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh3&AN=20001415729	"Although human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) is viewed primarily as a health problem, a health approach alone is not sufficient to prevent the spread of the disease and mitigate its impact on both individuals and society. Commonly, rural development workers have not given attention to HIV/AIDS, leading to marginalization and destitution of affected households. With an estimated 16 000 new infections per day worldwide, the AIDS epidemic should be a primary focus of development assistance in affected countries. The interaction between HIV/AIDS and nutrition can be seen from biological and socio-economic perspectives. Biologically, there are multiple relations between HIV/AIDS and nutritional status: good nutritional status might reduce the chances of infection or extend the lives of patients. Improving nutrition requires an integrated approach to household food security, health and care. In communities affected by HIV/AIDS, nutrition education and the timely transfer of knowledge and skills to prevent their loss to the household and the wider community are required. Participatory techniques are essential to forming an understanding of the specific constraints HIV/AIDS-affected communities are facing and to designing adequate responses. Since HIV/AIDS issues are highly sensitive and require behavioural change, appropriate communication strategies are crucial. The inclusion of HIV/AIDS considerations into agricultural and nutrition strategies is relatively new; cross-sectoral and interinstitutional collaboration is required in order to develop appropriate strategies, through operation research and documentation and evaluation of experiences."									
1392	Iron supplementation during human immunodeficiency virus infection: a double-edged sword?	"Clark TD, Semba RD."	Medical Hypotheses. 2001;57(4):476-9.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=11601873	"Although iron supplementation is considered beneficial for groups at risk for anemia, concern has been raised that it could be harmful during human immunodeficiency virus (HIV) infection. Studies suggest: (1) faster HIV disease progression in thalassemia major patients receiving inadequate doses of iron-chelating drug; (2) higher mortality among patients receiving iron supplementation with dapsone compared with aerosolized pentamidine for prophylaxis against Pneumocytis carinii pneumonia; (3) higher iron stores and mortality among patients with haptoglobin Hp 2-2 phenotype; and (4) shorter survival among patients with high bone marrow iron deposition. These studies largely involved men in developed countries. Among HIV-infected pregnant women in Africa with a high prevalence of iron deficiency, no relationship was found between indicators of iron status and HIV disease severity. The available data do not contraindicate the current practice of iron supplementation in developing countries where there is a high prevalence of both HIV infection and iron deficiency. Copyright 2001 Harcourt Publishers Ltd."									
1491	Malnutrition in developing countries.	"Walton E, Allen S."	Paediatrics and Child Health. 2011 September;21(9):418-24.		"Although now rare in industrialized countries, severe acute malnutrition is unfortunately still common throughout the developing world and is a key contributor to both global childhood morbidity and mortality. This review describes the epidemiology of malnutrition and the presentation and pathophysiology of the severe syndromic forms - marasmus and kwashiorkor. The gold standards for diagnosis and management are detailed and the challenges of implementation in the basic healthcare systems of the developing world are discussed. As the leading cause of ill health in the world today, more effective treatment and prevention of malnutrition must be a priority for the global healthcare community. 2011."									
1681	"Livelihood strategies and nutritional status of grandparent caregivers of AIDS orphans in Nyando District, Kenya."	Wangui EE.	Qualitative Health Research. 2009;19(12):1702-15.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=19949220	"Although the growing role of grandparents as primary caregivers of AIDS orphans in sub-Saharan Africa has been established by previous research, few scholars have undertaken studies to explore the experiences of older persons in this new role. In this study, I used qualitative research methods to examine livelihood strategies that influenced the nutritional status of grandparent caregivers, a population largely neglected in the literature on African livelihoods. In this article I highlight the agency of older persons by identifying responses that promote their livelihood resilience. My research was guided by the sustainable livelihoods framework and involved in-depth individual interviews with 30 grandparent caregivers selected based on their nutritional status. Focus group discussions and key informant interviews were also conducted. Results indicate that the ability to mobilize new sources of labor for food production and new social networks to facilitate other forms of food entitlement are critical to nutritional status. These results are important in designing interventions targeting vulnerable grandparent caregivers."									
1959	"Effects of vitamins, including vitamin A, on HIV/AIDS patients."	"Mehta S, Fawzi W."	Vitamins & Hormones. 2007;75:355-83.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=17368322	"An estimated 25 million lives have been lost to acquired immune-deficiency syndrome (AIDS) since the immunodeficiency syndrome was first described in 1981. The progress made in the field of treatment in the form of antiretroviral therapy (ART) for HIV disease/AIDS has prolonged as well as improved the quality of life of HIV-infected individuals. However, access to such treatment remains a major concern in most parts of the world, especially in the developing countries. Hence, there is a constant need to find low-cost interventions to complement the role of ART in prevention of HIV infection and slowing clinical disease progression. Nutritional interventions, particularly vitamin supplementation, have the potential to be a low-cost method for being such an intervention by virtue of their modulation of the immune system. Among all the vitamins, the role of vitamin A has been studied most extensively; most observational studies have found that low vitamin A levels are associated with increased risk of transmission of HIV from mother to child. This finding has not been supported by large randomized trials of vitamin A supplementation; on the contrary, these trials have found that vitamin A supplementation increases the risk of mother-to-child transmission (MTCT). There are a number of potential mechanisms that might explain these contradictory findings. One is the issue of reverse causality in observational studies-for instance, advanced HIV disease may suppress release of vitamin A from the liver. This would lead to low levels of vitamin A in the plasma despite the body having enough vitamin A liver stores. Further, advanced HIV disease is likely to increase the risk of MTCT, and hence it would appear that low serum vitamin A levels are associated with increased MTCT. The HIV genome also has a retinoic acid receptor element-hence, vitamin A may increase HIV replication via interacting with this element, thus increasing risk of MTCT. Finally, vitamin A is known to increase lymphoid cell differentiation, which leads to an increase in CCR5 receptors. These receptors are essential for attachment of HIV to the lymphocytes and therefore, an increase in their number is likely to increase HIV replication. Vitamin A supplementation in HIV-infected children, on the other hand, has been associated with protective effects against mortality and morbidity, similar to that seen in HIV-negative children. The risk for lower respiratory tract infection and severe watery diarrhea has been shown to be lower in HIV-infected children supplemented with vitamin A. All-cause mortality and AIDS-related deaths have also been found to be lower in vitamin A-supplemented HIV-infected children. The benefits of multivitamin supplementation, particularly vitamins B, C, and E, have been more consistent across studies. Multivitamin supplementation in HIV-infected pregnant mothers has been shown to reduce the incidence of adverse pregnancy outcomes such as fetal loss and low birth weight. It also has been shown to decrease rates of MTCT among women who have poor nutritional or immunologic status. Further, multivitamin supplementation reduces the rate of HIV disease progression among patients in early stage of disease, thus delaying the need for ART by prolonging the pre-ART stage. In brief, there is no evidence to recommend vitamin A supplementation of HIV-infected pregnant women; however, periodic vitamin A supplementation of HIV-infected infants and children is beneficial in reducing all-cause mortality and morbidity and is recommended. Similarly, multivitamin supplementation of people infected with HIV, particularly pregnant women, is strongly suggested. [References: 99]"									
1696	"[Microsporidian spores in the stool specimens of toddlers, with or without diarrhea, from Tucuman, Argentina]."	"Valperga SM, de Jogna Prat SA, de Valperga GJ, Lazarte SG, de Trejo AV, Diaz N, Huttman HM."	Revista Argentina de Microbiologia. 1999;31(3):157-64.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=10509394	"An investigation has been carried out from September 1995 to December 1997 to search for microsporidian spores in the stool specimens of 344 toddlers aged 1 to 24 months, hospitalized at a pediatric institution in Tucuman. They were classified in two groups: I, made up of 222 children suffering from severe diarrheas, and II by 122 affected by different pathologies, except gastroenteritis. The detection of microsporidia was done by light microscopy in smears of stained stool specimens by using the Weber modified Kokoskin method. Copro-parasitological and coprobacteriological studies were also carried out and the nutritional status of each child was determined. In group I, microsporidia were found in 12/122 cases (7.2%), 4/68 belong to eutrophic children (5.9%), and 12/137 to undernourished children (8.8%); 8/16 positives were found to be related with other enteropatogenics. In group II, microsporidia were detected in 10/122 (8.2%), 4/47 in eutrophic children (8.5%), 4/54 in undernourished children (7.4%) and without data in two cases. They were related with other enteropatogenics in 5/10 positives. Tucuman can be estimated as an area with a low rate of HIV infection in toddlers, then it can be estimated that the studied sample was essentially HIV negative. The occurrence of microsporidia was important and did not show significant differences between toddlers with or without diarrhea, eutrophic or undernourished children."									
1838	Persistent undernutrition amongst preschool children a decade after democracy.	"Jinabhai CC, Taylor M, Sullivan K."	Southern African Journal of Epidemiology & Infection. 2006;21(1):26-30.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20073159398	"An investigation was undertaken in 2004 by the KwaZulu-Natal Income Dynamics Study (KIDS) which provided an opportunity to assess the nutritional status of preschool children (6 months to less than 7 years) a decade after democracy. During the past decade, Government has initiated a range of nutritional programmes to improve children's health and nutritional status. The KIDS survey investigated over 1200 households selected via census enumerator areas throughout the province. Of the 1146 children, 574 (50.1%) were boys and 572 (49.9%) girls, with a mean age of 47.0 (SD 22.6) months for boys and 44.8 (SD 22.2) months for girls. There were statistically significant gender differences for height with boys taller than girls (p=0.002). Mean weight of boys and girls was similar (p=0.87), as was BMI (p=0.17). Overall, 1.6% of children were wasted, 7.5% were underweight and 19.8% were stunted; boys were significantly more wasted than girls (p=0.007) and more underweight (p=0.002), but not stunted (p=0.2). Chi-square tests of trend over age group found a significant decrease in wasting from 1-6 years of age (p=0.03), but not for underweight (p=0.75). There was a significant decrease in overweight (p<0.0005) and in stunting (p=0.006) from 1-6 years. The persistence of an unacceptably high prevalence of under-nutrition constitutes a public health problem amongst KwaZulu-Natal children. The key finding of this study was that the prevalence of stunting among preschool children shows minimal change when compared with the 1994 SAVACG study: wasting of 0.79% (1994) vs 1.6% (2004), overweight of 4.2% (1994) vs 7.5% (2004) and stunting of 15.6% (1994) vs 19.6% (2004). In addition to nutritional programmes, other multi-factorial interventions targeting factors such as poverty, HIV/AIDS, and concomitant infections, as reflected in the UNICEF conceptual framework, are required to address persistent stunting among young children."									
451	Effect of a liquid nutritional supplement on viral load and haematological parameters in HIV-positive/AIDS patients.	"Oguntibeju OO, Heever WMJvd, Schalkwyk FEv."	British Journal of Biomedical Science. 2006;63(3):134-9.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20063180125	"An open-labelled, multiple-dose clinical trial was conducted to determine the effect of a nutritional liquid supplement on viral load and haematological parameters in human immunodeficiency virus (HIV)-positive/acquired immune deficiency syndrome (AIDS) patients in South Africa. 29 patients (18-65 years) completed this study. The study involved a baseline visit and monthly visits to Medi Inn clinic and Tsepo House (home-based care) between April and September 2003. CD4+ T cell count (P<0.03) and viral load (P<0.002) showed significant differences between the baseline and final visit. The supplement showed no positive effect on CD4+ T cell count, which decreased significantly with disease progression (P<0.03); however, the supplement demonstrated a significantly positive effect on viral load (P<0.002). It is concluded that supplementation significantly reduced viral load and had an effect on some haematological parameters, suggesting clinical benefit worthy of larger clinical trials."									
468	Prevention of diarrhoea in young children in developing countries.	"Huttly SR, Morris SS, Pisani V."	Bulletin of the World Health Organization. 1997;75(2):163-74.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=9185369	"An updated review of nonvaccine interventions for the prevention of childhood diarrhoea in developing countries is presented. The importance of various key preventive strategies (breast-feeding, water supply and sanitation improvements) is confirmed and certain aspects of others (promotion of personal and domestic hygiene, weaning education/food hygiene) are refined. Evidence is also presented to suggest that, subject to cost-effectiveness examination, two other strategies-vitamin A supplementation and the prevention of low birth weight-should be promoted to the first category of interventions, as classified by Feachem, i.e. those which are considered to have high effectiveness and strong feasibility. [References: 111]"									
899	Factors associated with anaemia in HIV-infected individuals in southern India.	"Subbaraman R, Devaleenal B, Selvamuthu P, Yepthomi T, Solomon SS, Mayer KH, Kumarasamy N."	International Journal of STD & AIDS. 2009;20(7):489-92.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=19541892	"Anaemia accelerates disease progression and increases mortality among HIV-infected individuals. Few studies have characterized this problem in developing countries. Haemoglobin values of adults presenting to an HIV tertiary care center in India between 1996 and 2007 were collected (n = 6996). Multivariate logistic regression analysis was performed to examine associations among anaemia, HIV progression and co-morbidities. Overall, anaemia prevalence was 41%. Twenty percent of patients with CD4 counts >500 cells/microL were anaemic, compared with 64% of those with CD4 counts <100 cells/microL (P < 0.001). In multivariate analysis, CD4 count <100 cells/microL (odds ratio [OR]:5.0, confidence interval [CI]:4.0-6.3), underweight body mass index (OR:4.8, CI:3.6-6.5), female gender (OR:3.1, CI:2.8-3.6) and tuberculosis (TB) (OR:1.6, CI:1.4-1.8) were significantly associated with anaemia. In this setting, management of anaemia should focus on antiretroviral therapy, nutritional supplementation and TB control. The high anaemia prevalence among patients meeting criteria for antiretroviral therapy highlights the need for increased access to non-zidovudine nucleoside reverse transcriptase inhibitors in developing countries."									
1867	"Anaemia among pregnant women in northern Tanzania: Prevalence, risk factors and effect on perinatal outcomes."	"Msuya SE, Hussein TH, Uriyo J, Sam NE, Stray-Pedersen B."	Tanzania Journal of Health Research. 2011 January;13(1):40-9.		"Anaemia during pregnancy is associated with negative maternal and neonatal outcomes. However, there is limited data regarding prevalence and effects of anaemia during pregnancy in northern Tanzania. The objective of this study was to determine the prevalence and possible risk factors for anaemia and its effect on perinatal outcomes among pregnant women attending antenatal care in Moshi Municipality in northern Tanzania. A cohort of pregnant women aged 14-43 years and in their 3rd trimester, was recruited from two primary health care clinics between June 2002 and March 2004. Interviews, anthropometric measurements and haematological examinations were conducted on 2654 consenting women. Perinatal outcomes were recorded during delivery and at 1 week after delivery. Of the 2654 participants, 47.4% had anaemia (haemoglobin [Hb] <11g/dl), 35.3% had mild anaemia (Hb= 9-10.9g/dl), 9.9% had moderate anaemia (Hb =7-8.9g/dl), and 2.1% had severe anaemia (Hb < 7 g/dl). Anaemia was significantly more prevalent in HIV-positive (56.4%) than in HIV-negative women (46.7%), (P = 0.01). In logistic regression anaemia was independently associated with maternal HIV (OR= 1.5), malaria (OR= 5.2), clinic of recruitment (OR= 1.5) and low income (OR= 1.9). Pregnant women with anaemia were more likely to have low birth weight (LBW) infants. Compared with non-anaemic women, the risk of LBW was 1.6 times and 4.8 times higher for children born to women with moderate and severe anaemia, respectively. In conclusion, anaemia in pregnancy is a severe public health problem in northern Tanzania. Control of maternal anaemia may be one important strategy to prevent LBW in this setting. Measures to prevent malaria and to control anaemia among all pregnant women irrespective of HIV status, should be strengthened. Outside of the health sector broader approaches for anaemia prevention targeting women of lower income, are required."									
281	Risk factors and cumulative incidence of anaemia among human immunodeficiency virus-infected children in Uganda.	"Clark TD, Mmiro F, Ndugwa C, Perry RT, Jackson JB, Melikian G, Semba RD."	Annals of Tropical Paediatrics. 2002;22(1):11-7.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=11926044	"Anaemia has not been well characterised among HIV-infected children in sub-Saharan Africa. Baseline prevalence and cumulative incidence of anaemia (haemoglobin < 110 g/L) were 91.7% and 100% and, for moderate anaemia (haemoglobin < 90 g/L), were 35.1% and 58.4%, respectively, among 225 HIV-infected children followed from 9 to 36 months of age. Hospitalisation, suspected tuberculosis, malaria and height-for-age Z-score <-2 were significantly associated with moderate anaemia. Moderate anaemia and weight-for-height Z-score <-2 were associated with mortality. Anaemia is common and associated with increased mortality in HIV-infected children."									
179	Etiology of anemia in pregnancy in south Malawi.	"Broek NRvd, Letsky EA."	American Journal of Clinical Nutrition. 2000;72(1 Supplement).	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh3&AN=20001419284	"Anaemia in pregnancy is a major public health problem in developing countries. In sub-Saharan Africa, such anaemia is generally accepted as resulting from nutritional deficiencies, particularly iron deficiency. We comprehensively assessed the full spectrum of nutritional and nonnutritional factors associated with pregnancy anaemia. Iron, folate, vitamin B-12, and vitamin A were measured in serum in a cross-sectional study of 150 pregnant women in Blantyre, Malawi. Bone marrow aspirates were evaluated, peripheral blood films were examined for malaria parasites, stool and urine samples were examined for helminthic infection, and tests were done for genetic disorders and for HIV infection. C-reactive protein (CRP) concentrations and erythrocyte sedimentation rates were measured as markers of inflammation. Of the 150 anaemic women, 23% were iron deficient with no evidence of folate, vitamin B-12, or vitamin A deficiencies; 32% were deficient in iron and one or more of the other micronutrients; 26% were not iron deficient but had evidence of one of the other micronutrient deficiencies, most often vitamin A; and 19% were not deficient in any of the micronutrients studied. CRP concentrations were notably high in 54% of the anaemic women with no nutritional deficiencies and in 73.5% of the anaemic women who were iron replete by bone marrow assessment. The role of chronic inflammation as a possible contributing factor to anaemia in pregnancy has important implications for the clinical evaluation and treatment of women."									
1465	"Positive association between dietary iron intake and iron status in HIV-infected children in Johannesburg, South Africa."	"Kruger HS, Balk LJ, Viljoen M, Meyers TM."	Nutrition Research. 2013;33(1):50-8.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=23351410	"Anemia is a common complication of pediatric HIV infection and is associated with suboptimal cognitive performance and growth failure. Routine iron supplementation is not provided to South African HIV-infected children. We hypothesized that dietary iron intake without supplementation is sufficient to protect against iron deficiency (ID) in HIV-infected children receiving highly active antiretroviral therapy. In this prospective study, the difference between dietary intakes of iron-deficient children (soluble transferrin receptor >9.4 mg/L) and iron-sufficient children after 18 months on highly active antiretroviral therapy was examined. The association between iron intake and hemoglobin (Hb) concentration was also assessed. Longitudinal data collected for 18 months from 58 HIV-infected African children were assessed by generalized estimation equations, with adjustment for demographic information, dietary intakes, growth parameters, and CD4%. After adjustment for covariates, the longitudinal association between dietary iron intake and Hb concentration remained significant. This association shows that for every 1-mg increase in iron intake per day, Hb increases by 1.1 g/L (P < .001). Mean Hb increased significantly after 18 months of follow-up (106 +/- 14 to 129 +/- 14 g/L, P < .01), but soluble transferrin receptor also increased (7.7 +/- 2.7 to 8.9 +/- 3.0 mg/L, P < .01). The incidence of ID increased from 15.2% at baseline to 37.2% after 18 months. Children with animal protein intakes greater than >20 g/d had significantly lower odds for ID at 18 months than did children with lower intakes (odds ratio, 0.40; 95% confidence interval, 0.21-0.77). Dietary iron intake was insufficient to protect against ID, pointing to a need for low-dose iron supplementation for iron-deficient HIV-infected children and interventions to increase the consumption of animal protein. Copyright 2013 Elsevier Inc. All rights reserved."									
836	Vitamin B12 deficiency megaloblastic anemia in a patient with acquired immunodeficiency syndrome.	"Kim B, Kim J, Hwang S, Lee Y, Park J, Moon S, Choi J, et al."	Infection and Chemotherapy. 2011;43(3):266-9.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20113233441	"Anemia is the most common hematologic finding in patients with advanced infections caused by human immunodeficiency virus (HIV) or advanced acquired immunodeficiency syndrome (AIDS). Among many etiologies of HIV-associated anemia, vitamin B12 deficiency plays an important role, mostly due to malabsorption or HIV enteropathy. We experienced a case of megaloblastic anemia caused by vitamin B12 deficiency in a male patient with an AIDS who had no structural gastrointestinal problem. He showed severe anemia, leukopenia, thrombocytopenia and suspicious neurologic manifestations such as aggravation of dementia and gait disturbance. With vitamin B12 and folate treatment, the patient's general condition and hematologic features were improved successfully."									
1706	Malnutrition and hypovitaminosis A in AIDS patients.	"Silveira SA, Figueiredo JFdC, Jordao Junior A, Unamuno MdRDd, Rodrigues MdLV, Vannucchi H."	Revista da Sociedade Brasileira de Medicina Tropical. 1999;32(2):119-24.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh2&AN=19992006000	"Anthropometric measurements and biochemical studies were performed on HIV-infected individuals and on patients with AIDS from the Ribeirao Preto region, SP, Brazil, in order to evaluate their nutritional and vitamin A status. Plasma retinol was measured by HPLC, and hepatic vitamin A stores were evaluated by the relative dose response (RDR) test. Patients with AIDS were significantly undernourished, with more marked alterations in the body fat compartment and a relative preservation of the parameters related to muscle mass (pattern of malnutrition predominantly of the marasmus type). Plasma retinol values below 1.05 micro mol/litre were observed in 25% of the patients with AIDS and in 17.3% of HIV-infected patients; RDR values indicating low body stores of vitamin A were detected in 28% of the subjects. There was no correlation between serum retinol levels and CD4 lymphocyte counts, clinical diagnosis of AIDS, or low body mass index (BMI). However, hypovitaminosis A status was associated with low BMI."									
289	Therapeutic strategies for children with HIV infectious risks and infected in a country with limited medical resources. [French]	Les defis de la prise en charge des enfants exposes ou infectes par le VIH dans les pays a ressources limitees.	Penda I.		Antibiotiques. 2009 September;11(3):158-63.									
144	Growth in HIV-infected children receiving antiretroviral therapy at a pediatric infectious diseases clinic in Uganda.	"Kabue MM, Kekitiinwa A, Maganda A, Risser JM, Chan WY, Kline MW."	AIDS Patient Care and STDs. 2008;22(3):245-51.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20083071376	"Antiretroviral therapy (ART) improves growth and survival of HIV-infected individuals. We designed a retrospective cohort study to assess clinical factors associated with growth in HIV-infected children on ART in Uganda between July 2003 and March 2006. Height and weight measurements taken pre- and post-ART initiation for at least 6 months were age- and gender-standardized to CDC 2000 reference. We analyzed medical records of 749 children receiving ART. Descriptive and logistic regression analyses were conducted to identify covariates associated with risk of either stunting or being underweight. Longitudinal regression analysis with a mixed model using autoregressive covariance structure was used to compare change in height and weight before and after initiation of ART. The mean age of the study population at first visit was 7.5 years. Mean height-for-age, weight-for-age, and weight-for-height percentiles at first visit were 8.6, 7.7, and 7.9, respectively. At last visit mean height-for-age, weight-for-age, and weight-for-height percentiles were 8.6, 13.3, and 13.8, respectively. Baseline weight-for-age z score of 1 or more was protective against stunting (odds ratio [OR] 0.25, confidence interval [CI] 0.180.35) while baseline height-for-age z score of 1 or more was protective against becoming underweight (OR 0.75, CI 0.630.88). Children in World Health Organization (WHO) stages II, III, and IV at baseline were 1.5 times more likely to become underweight (OR 1.51, CI 1.072.14). Initiation of ART resulted in improvement in mean standardized weight-for-age z score and weight-for-age percentiles (p<0.001). Weight-for-age percentile and z score improved significantly after initiation of ART. This pediatric population gained weight more rapidly than height after initiation of ART."									
588	Disease progression in children with vertically-acquired HIV infection in sub-Saharan Africa: Reviewing the need for HIV treatment.	"Little K, Thorne C, Luo C, Bunders M, Ngongo N, McDermott P, Newell ML."	Current HIV Research. 2007 March;5(2):139-53.		"Approximately 700,000 children become newly infected with HIV annually, mainly through mother-to-child transmission (MTCT), making paediatric HIV a leading cause of morbidity and mortality worldwide. The substantial interest in preventing MTCT (PMTCT) has generated information on rates of transmission and associated factors, but there is a lack of information on disease progression and mortality in vertically-infected children, especially from resource-poor settings. Peer-review journals with titles or abstracts containing reference to the review's themes were selected using widely available search engines. We review relevant literature on mortality in children born to HIV infected mothers; morbidity and mortality associated with paediatric HIV infections; eligibility to and efficacy of antiretroviral therapy (ART). Child mortality is independently associated with maternal HIV status and maternal death, with paediatric infection resulting in ~4 fold increase in mortality by age 2 years. Morbidities seen in infected children were similar to those seen in uninfected children, although the rates and recurrences of illness were greater. There is some evidence that progression to AIDS may be more rapid in resource poor settings, although data on this are very limited. PMTCT and paediatric ART have been shown to be highly successful in resource-limited settings, but are not universally applied. Further efforts to increase coverage of both PMTCT and paediatric ART could substantially reduce the numbers of children becoming infected and improve survival of those infected. Additionally, improvements in health infrastructures could improve care provision, not only through improved detection and monitoring but also through treatment of co-morbidities and nutritional support. 2007 Bentham Science Publishers Ltd."									
333	Evaluation of the maternal perception of her child's weight and Body mass index heritability in mestizas dyads in Southeastern Mexico. [Spanish]	Evaluacion de la percepcion materna del peso del hijo y de la heredabilidad del IMC en diadas mestizas del Sureste de Mexico.	"Flores-Pena Y, Camal-Rios NY, Cerda-Flores RM."		Archivos Latinoamericanos de Nutricion. 2011;61(4):389-95.									
37	"AIDS, Individual Behaviour and the Unexplained Remaining Variation."	Katz A.	African Journal of AIDS Research. 2002 Nov 2002;1(2):125-42.	http://search.proquest.com/docview/60465332?accountid=26724	"Argues that individual behavior alone cannot possibly account for the enormous variation in HIV prevalence between population groups, countries, & regions, & that the international AIDS community has neglected the unexplained remaining variation. Biological vulnerability to HIV due to seriously deficient immune systems has been ignored as a determinant of the high levels of infection in certain populations. This is in sharp contrast to well-proven public health approaches to other infectious diseases. In particular, it is argued that poor nutrition & co-infection with the myriad of other diseases of poverty including tuberculosis, malaria, leishmaniasis, & parasitic infections, have been neglected as root causes of susceptibility, infectiousness, & high rates of transmission of HIV at the level of populations. Vulnerability in terms of non-biological factors such as labor migration, prostitution, exchange of sex for survival, population movements due to war & violence, has received some attention but the solutions proposed to these problems are also inappropriately focused on individual behavior & suffer from the same neglect of economic & political root causes. As the foundation for the international community's response to the AIDS pandemic, explanations of HIV/AIDS epidemiology in terms of individual behavior are not only grossly inadequate, they are highly stigmatizing & may, in some cases, be racist. They have diverted attention from poverty & powerlessness as root causes of vulnerability to infection &, as such, they are a waste of scarce resources. A return to a basic needs approach to all the diseases of poverty is nothing more than proven public health wisdom & experience. A sustainable & meaningful response to AIDS is simultaneously a sustainable & meaningful response to all the diseases of poverty. The obstacles to the adoption of this approach are economic & political, & must be confronted at the level of international financial institutions, the globalization of neoliberal economic systems, the growing power imbalances between & within nations, & the undermining of democracy & national sovereignty. An alternative strategy for AIDS & the other diseases of poverty would build on macroeconomic reforms for a fair, rational, & sustainable international economic order so that democratically elected governments may meet their people's basic needs, including health, without external interference. 135 References. Adapted from the source document."									
335	"Profile of patients with hypertension included in a cohort with HIV/AIDS in the state of pernambuco, Brazil. [Portuguese, English]"	"Perfil dos pacientes com hipertensao arterial incluidos em uma coorte com HIV/AIDS em pernambuco, Brasil."	"De Arruda Junior ER, Lacerda HR, Moura LCRV, De Fatima M, De Albuquerque PM, De Barros Miranda Filho D, Diniz GTN, et al."		Arquivos Brasileiros de Cardiologia. 2010 October;95(5):640-7.									
336	Prevalence of HIV-associated lipodystrophy in Brazilian outpatients: Relation with metabolic syndrome and cardiovascular risk factors. [Portuguese]	Prevalencia da lipodistrofia associada ao HIV em pacientes ambulatoriais Brasileiros: Relacao com sindrome metabolica e fatores de risco cardiovascular.	"Diehl LA, Dias JR, Paes ACS, Thomazini MC, Garcia LR, Cinagawa E, Wiechmann SL, et al."		Arquivos Brasileiros de Endocrinologia e Metabologia. 2008 June;52(4):658-67.									
339	"Prevalence of obesity and cardiovascular risk in patients with HIV/AIDS in porto alegre, Brazil"	"Prevalencia de obesidade e risco cardiovascular em pacientes com HIV/AIDS em porto alegre, Brasil."	"Kroll AF, Sprinz E, Leal SC, Labrea MG, Setubal S."		Arquivos Brasileiros de Endocrinologia e Metabologia. 2012 March;56(2):137-41.									
1227	Prevalence of lipodystrophy and dyslipidemia among patients with HIV infection on generic ART in rural South India.	"Kalyanasundaram AP, Jacob SM, Hemalatha R, Sivakumar MR."	Journal of the International Association of Physicians in AIDS Care. 2012 September-October;11(5):329-34.		"As antiretroviral therapy (ART) becomes more available to the HIV-infected population, it is important to determine the prevalence of its long-term complications. In this cross-sectional study, 145 HIV-positive patients on ART, 146 HIV-positive patients not on ART, and 72 HIV-negative individuals visiting the Namakkal District Head Quarters Hospital, Tamil Nadu, India, were recruited from February 2007 to April 2009. Among the patients on ART, the prevalence of lipodystrophy was 60.7%; 22.7% with lipohypertrophy, 51.1% with lipoatrophy, and 22.7% with mixed pattern. The proportion of patients with dyslipidemia was significantly higher in the treatment group when compared to ART-naive and HIV-negative controls (P =.00). Total duration of ART was significantly associated with lipodystrophy (P =.04) and dyslipidemia (P =.01). Also, by logistic regression, abnormal metabolic levels were a risk factor in lipodystrophy (P =.02). This study highlights the need for development of inexpensive and accessible treatments for the reduction of lipodystrophy. SAGE Publications 2011."									
436	Cambodian health in transition.	"Heng MB, Key PJ."	BMJ. 1995;311(7002):435-7.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med3&AN=7640594	"As conflict and suffering in Bosnia, Chechnya, Rwanda, and Zaire continue to be at the forefront of world attention, some countries seem to be largely forgotten. It is timely to take stock of conditions in the small country of Cambodia as it struggles to take its place after a long period of isolation. Countless Cambodians and ethic Vietnamese have died there this year and during the past 25 years, victims of senseless killing or preventable disease."									
118	Evidence base for children affected by HIV and AIDS in low prevalence and concentrated epidemic countries: applicability to programming guidance from high prevalence countries.	"Franco LM, Burkhalter B, de Wagt A, Jennings L, Kelley AG, Hammink ME."	AIDS Care. 2009;21 Suppl 1:49-59.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=22380979	"As global commitment grows to protect and support children affected by HIV and AIDS, questions remain about how best to meet the needs of these children in low prevalence settings and whether information from high prevalence countries can appropriately guide programming in these settings. A 2007 search for the evidence in low prevalence settings on situational challenges of HIV and AIDS-affected children and interventions to address these challenges identified 413 documents. They were reviewed and judged for quality of documentation and scientific rigor. Information was compiled across eight types of challenges (health and health care, nutrition and food security, education, protection, placement, psychosocial development, socioeconomic status, and stigma/discrimination); and also assessed was strength of evidence for situational and intervention findings. Results were compared to three programming principles drawn from research in high prevalence countries: family-centered preventive efforts, treatment, and care; family-focused support to ensure capacity to care for and protect these children; and sustaining economic livelihood of HIV and AIDS-affected households. Findings show that children affected by HIV and AIDS in low prevalence settings face increased vulnerabilities similar to those in high prevalence settings. These findings support seeking and testing programmatic directions for interventions identified in high prevalence settings. However, low prevalence settings/countries are extremely diverse, and the strength of the evidence base among them was mixed (strong, moderate, and weak in study design and documentation), geographically limited, and had insufficient evidence on interventions to draw conclusions about how best to reduce additional vulnerabilities of affected children. Information on family, economic, sociocultural, and political factors within local contexts will be vital in the development of appropriate strategies to mitigate vulnerabilities."									
1962	The system of multilevel diagnostics and corrections of infringements of the status of nutrition of the patients with cardiovascular diseases.	"Pogozheva AV, Derbeneva SA, Bogdanov AR, Kaganov BS."	Voprosy Pitaniya. 2009;78(3):43-51.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20103094283	"As is known, the pathology of cardiovascular systems depends on nutrition and occupies leading positions in structure general morbidity and mortality of the population of Russian Federation. The system of nutritional and medical aids - ""Nutritest"" and ""Nutricor"", represent the technology of diagnostics of infringements the status of nutrition, estimations of risk of development of cardiovascular diseases, and ways of their high-grade correction."									
1961	The system of multilevel diagnostics and corrections of infringements of the status of nutrition of the patients with cardiovascular diseases. [Russian].	"Pogozheva AV, Derbeneva SA, Bogdanov AR, Kaganov BS."	Voprosy Pitaniia. 2009;78(3):43-51.		"As is known, the pathology of cardiovascular systems depends on nutrition and occupies leading positions in structure general morbidity and mortality of the population of Russian Federation. The system of nutritional and medical aids - <<Nutritest>> and <<Nutricor>>, represent the technology of diagnostics of infringements the status of nutrition, estimations of risk of development of cardiovascular diseases, and ways of their high-grade correction."									
1960	[The system of multilevel diagnostics and corrections of nutrition status disorders in the patients with cardiovascular diseases].	"Pogozheva AV, Derbeneva SA, Bogdanov AR, Kaganov BS."	Voprosy Pitaniia. 2009;78(3):43-51.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=19663303	"As is known, the pathology of cardiovascular systems depends on nutrition and occupies leading positions in structure general morbidity and mortality of the population of Russian Federation. The system of nutritional and medical aids--""Nutritest"" and ""Nutricor"", represent the technology of diagnostics of infringements the status of nutrition, estimations of risk of development of cardiovascular diseases, and ways of their high-grade correction."									
1980	Chasing Success: Health Sector Aid and Mortality.	Wilson SE.	World Development. 2011 Nov 2011;39(11):2032-43.	http://search.proquest.com/docview/908718479?accountid=26724	"As many cases studies show, successful public health measures are being implemented in many places around the globe, and country-level mortality has fallen significantly in recent decades in all but a few countries. Are the two linked? Does development assistance for health (DAH) improve, on balance, recipient countries' mortality trajectory? Using a new data source containing DAH on 96 high mortality countries, the regression analysis shows no effect of DAH on mortality. Other types of aid, including water development, also have no effect. Economic growth, on the other hand, has a strong negative effect on mortality. These findings confirm and build upon recent work by and are shown to be robust to a variety of sensitivity analyses and alternative model specifications and estimation methods. This analysis also shows that the effectiveness of DAH has not increased over time, even as the level of that funding has increased fourfold, though spending on infectious diseases and family planning may have caused small reductions in mortality. Furthermore, even though it is encouraging that DAH has tended to go where the need is highest, it also goes to states that have experienced the greatest mortality reductions in the recent past. In other words, DAH appears to be following success, rather than causing it."									
798	Pendulum swings in HIV-1 and infant feeding policies: Now halfway back.	"Kuhn L, Aldrovandi G."	"Human Immunodeficiency Virus type 1 (HIV-1) and Breastfeeding: Science, Researh Advances, and Policy. 2012;Advances in Experimental Medicine and Biology. 743:273-87."		"As one of the defining characteristics of mammalian reproduction, it should come as no surprise that breastfeeding is the norm, the healthiest practice for both mothers and infants regardless of where they live [1]. Benefits of breastfeeding have been noticed by health practitioners since the middle ages with poignant records of the outcomes of foundlings given human milk compared to those fed with artificial feeds [2]. By the mid-twentieth century, the industry producing and selling infant formula was so confident that their product was equivalent to mother nature's ""product"" that a vast population-level experiment was conducted with tragic results. Infant formula began to be actively promoted in sub-Saharan Africa leading to the well-publicized increases in infant death [3]. 2012 Springer Science+Business Media New York."									
1153	The prevalence of stunting is high in HIV-1-exposed uninfected infants in Kenya.	"McGrath CJ, Nduati R, Richardson BA, Kristal AR, Mbori-Ngacha D, Farquhar C, John-Stewart GC."	Journal of Nutrition. 2012;142(4):757-63.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=22378334	"As prevention of mother-to-child HIV-1 transmission (PMTCT) programs decrease the numbers of HIV-1-infected infants, it remains important to improve growth in HIV-1-exposed, uninfected (EU) infants. To determine the growth rate and predictors of growth faltering in breast-fed and formula-fed EU infants, growth analyses [weight-for-age (WAZ), weight-for-length (WLZ), and length-for-age (LAZ) Z-scores] were conducted by using data from a randomized feeding trial in HIV-1-infected women in Kenya. Growth faltering in EU infants was compared based on randomization to breastfeeding (BF) or formula feeding (FF) using Cox proportional hazards regression models. Linear mixed-effects models determined rate and cofactors of length growth. Among 338 EU infants, 164 (49%) were breast-fed and 174 (51%) formula-fed. In both arms, growth declined steadily during follow-up. By 2 y, 29% of children were underweight (WAZ < -2), 18% were wasted (WLZ < -2), and 58% were stunted (LAZ < -2), with no differences by feeding arm. Higher maternal education (y) and taller stature (cm) were associated with a decreased risk of underweight and stunting [underweight: adjusted HR (aHR) = 0.90 (95% CI: 0.83, 0.99), P = 0.03, and aHR = 0.92 (95% CI: 0.87, 0.97), P = 0.002; and stunting: aHR = 0.91 (95% CI: 0.85, 0.97), P = 0.003, and aHR = 0.96 (95% CI: 0.92, 0.99), P = 0.02, respectively]. Diarrhea was associated with an increased risk of wasting [aHR = 2.26 (95% CI: 1.11, 4.62), P = 0.03]. In multivariate analyses, FF was associated with slower declines in length velocity [0.24 LAZ/y (95% CI: 0.06, 0.43), P = 0.009]. Despite being uninfected, HIV-1-exposed infants showed frequent growth faltering, suggesting the need for vigilance in recognizing stunting within PMTCT programs. The slower rate of decline in length growth with FF may reflect benefits of micronutrients. Because BF is the best option for HIV-1-infected mothers in resource-limited settings, nutritional interventions should be examined for their impact on growth in EU breast-fed infants."									
1690	The Impact of Caregiving on the Health and Well-being of Kenyan Luo Grandparents.	"Ice GH, Yogo J, Heh V, Juma E."	Research on Aging. 2010 Jan 2010;32(1):40-66.	http://search.proquest.com/docview/60330266?accountid=26724	"As the HIV/AIDS pandemic progresses in Africa, elders are increasingly responsible for the care of orphans. Several reports suggest that elderly Africans do not have the resources to provide care and are at risk of poor health, but few studies have systematically measured health of caregivers. The Kenyan Grandparents Study is a longitudinal study designed to compare elder Luo caregivers to noncaregiving peers. Several measures of health were collected, including body mass index (BMI), blood pressure, glucose, and hemoglobin. In addition, self-perceived health and mental health were measured using the MOS Short-Form 36 (SF-36). It was hypothesized that caregivers would have poorer health than noncaregivers and that the difference in health would widen over the three waves of the study. Caregiving did not affect physical health but did act to decrease mental health and perceived health over time. [Reprinted by permission of Sage Publications Inc., copyright holder.]"									
1073	"Using Survey Results Regarding Hepatitis B Knowledge, Community Awareness and Testing Behavior Among Asians to Improve the San Francisco Hep B Free Campaign."	"Shiau R, Bove F, Henne J, Zola J, Fang T, Fernyak S."	Journal of Community Health. 2012 Apr 2012;37(2):350-64.	http://search.proquest.com/docview/929614824?accountid=26724	"Asians are disproportionately affected by chronic hepatitis B (HBV) infection and its fatal consequences. The Hep B Free campaign was launched to eliminate HBV in San Francisco by increasing awareness, testing, vaccination and linkage to care. The campaign conducted 306 street intercept and telephone interviews of San Francisco Asians to assess current levels of HBV knowledge, testing behaviors and effectiveness of existing campaign media materials. One-third of respondents ranked HBV as a key health issue in the Asian community, second to diabetes. General HBV awareness is high (85%); however, a majority could not name an effective prevention method. Sixty percent reported having been tested for HBV; provider recommendation was the most often cited reason for testing. Respondents reported a high level of trust in their providers to correctly assess which health issues they may be at risk for developing and test accordingly, confirming that efforts to increase HBV testing among Asians must simultaneously mobilize the public to request testing and compel providers to test high-risk patients. Regarding community awareness, more than half reported hearing more about HBV recently; younger respondents were more likely to have encountered campaign materials and recall correct HBV facts. Assessment of specific campaign materials found that while upbeat images and taglines captured attention and destigmatized HBV, messages that emphasize the pervasiveness and deadly consequence of infection were more likely to drive respondents to seek education and testing. The campaign used survey results to focus efforts on more intensive provider outreach and to create messages for a new public outreach media campaign."									
1313	Effectiveness of antiretroviral therapy among HIV-infected children in sub-Saharan Africa.	"Sutcliffe CG, van Dijk JH, Bolton C, Persaud D, Moss WJ."	The Lancet Infectious Diseases. 2008 August;8(8):477-89.		"Assessment of antiretroviral treatment programmes for HIV-infected children in sub-Saharan Africa is important to enable the development of effective care and improve treatment outcomes. We review the effectiveness of paediatric antiretroviral treatment programmes in sub-Saharan Africa and discuss the implications of these findings for the care and treatment of HIV-infected children in this region. Available reports indicate that programmes in sub-Saharan Africa achieve treatment outcomes similar to those in North America and Europe. However, progress in several areas is required to improve the care of HIV-infected children in sub-Saharan Africa. The findings emphasise the need for low-cost diagnostic tests that allow for earlier identification of HIV infection in infants living in sub-Saharan Africa, improved access to antiretroviral treatment programmes, including expansion of care into rural areas, and the integration of antiretroviral treatment programmes with other health-care services, such as nutritional support. 2008 Elsevier Ltd. All rights reserved."									
1072	Nutrition Assessment of Horse-Racing Athletes.	"Cotugna N, Snider O, Windish J."	Journal of Community Health. 2011 Apr 2011;36(2):261-4.	http://search.proquest.com/docview/886096014?accountid=26724	"Athletes involved in horse racing face weight restrictions like wrestlers and dancers, however, the literature is sparse pertaining to nutritional habits of jockeys. The practice of ""making weight"" causes these athletes to engage in potentially unhealthy practices. A gap in nutritionally sound practices and methods used by jockeys was identified and a desire for nutrition education was expressed to Cooperative Extension of Delaware by representatives of the riders at Delaware Park Race Track. Nutrition assessment was done using the Nutrition Care Process. Twenty jockeys were interviewed using an assessment form developed to target areas of disordered eating. Body mass index (BMI), mean weight loss on race day, methods of weight loss and ease of weight maintenance were examined. The jockeys were also asked for areas they wished to receive nutrition education on in the future. The BMI of the 20 jockeys ranged from 17.0 to 21.4 during racing season, with only one jockey in the ""underweight"" category. This range increased to 19.1-24.0 when the riders were not riding. The most common method of weight loss was the use of steam rooms, to lose an average 2.5lb in 1day. Eight of 20, the most common response, reported it very easy to maintain their racing weight. The jockeys reported interest in future education sessions on meal planning and healthy food ideas. The assessment was used as the basis to develop nutrition education materials and presentations for the riders at the race track."									
1493	The interrelationship between nutrition and the immune system in HIV infection: a review.	"Oguntibeju OO, van den Heever WM, Van Schalkwyk FE."	Pakistan Journal of Biological Sciences. 2007;10(24):4327-38.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=19093495	"Available scientific evidence has revealed that macronutrients and micronutrients are critical for fighting HIV-infection, because they are required by the immune system and major organs to attack infectious pathogens, HIV inclusive. It is believed that weight gain or maintenance might be achieved through good nutrition and has helped to reduce the consequences of wasting in people living with HIV/AIDS. Nutrition has helped to strengthen the immune system and reduce the severity and impact of opportunistic infections in people living with HIV/AIDS. It is known that an immune dysfunction as a result of HIV/AIDS leads to malnutrition and this in turn leads to further immune dysfunction. Various research studies have confirmed that nutrient deficiencies are associated with immune dysfunction and accelerated progression to AIDS. In this review, the interrelationship between nutrition and immune system in HIV infection is presented. [References: 97]"									
1495	The interrelationship between nutrition and the immune system in HIV infection: A review.	"Oguntibeju OO, Van Den Heever WMJ, Van Schalkwyk FE."	Pakistan Journal of Biological Sciences. 2007 15 Dec;10(24):4327-38.		"Available scientific evidence has revealed that macronutrients and micronutrients are critical for fighting HIV-infection, because they are required by the immune system and major organs to attack infectious pathogens, HIV inclusive. It is believed that weight gain or maintenance might be achieved through good nutrition and has helped to reduce the consequences of wasting in people living with HIV/AIDS. Nutrition has helped to strengthen the immune system and reduce the severity and impact of opportunistic infections in people living with HIV/AIDS. It is known that an immune dysfunction as a result of HIV/AIDS leads to malnutrition and this in turn leads to further immune dysfunction. Various research studies have confirmed that nutrient deficiencies are associated with immune dysfunction and accelerated progression to AIDS. In this review, the interrelationship between nutrition and immune system in HIV infection is presented. 2007 Asian Network for Scientific Information."									
906	Safety studies regarding a standardized extract of fermented wheat germ.	"Heimbach JT, Sebestyen G, Semjen G, Kennepohl E."	International Journal of Toxicology. 2007;26(3):253-9.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=17564907	"Avemar pulvis is a powder consisting of an aqueous extract of fermented wheat germ, with the drying aids maltodextrin and silicon dioxide, standardized to contain approximately 200 microg/g of the natural constituent 2,6-dimethoxy-p-benzoquinone. The results of toxicological and clinical studies of this product demonstrate its safety for its intended use as a dietary supplement ingredient in the United States. Avemar pulvis has been used in Hungary since 1998 and is approved in that country, as well as in the Czech Republic, Bulgaria, and Romania, as a ""medical nutriment for cancer patients."" Acute and subacute toxicity studies using rodents orally administered Avemar pulvis showed that dose levels (2000 to 3000 mg/kg body weight [bw]/day) exceeding the normal recommended oral dosage (8.5 g/day or 121 mg/kg bw/day for a 70-kg individual) by up to approximately 25-fold caused no adverse effects. The test substance showed no evidence of mutagenicity or genotoxicity in vitro or in vivo. Clinical studies using Avemar pulvis as a supplement to drug therapy in cancer patients at doses of 8.5 g/day not only showed no evidence of toxicity, but also showed a reduction in the side effects of chemotherapy. Overall, it was concluded that Avemar pulvis would not be expected to cause adverse effects under the conditions of its intended use as an ingredient in dietary supplements."									
427	Low haemoglobin predicts early mortality among adults starting antiretroviral therapy in an HIV care programme in South Africa: a cohort study.	"Russell EC, Charalambous S, Pemba L, Churchyard GJ, Grant AD, Fielding K."	BMC Public Health. 2010;10(433).	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20103244730	"Background - Antiretroviral therapy (ART) has dramatically reduced morbidity and mortality among people with HIV infection; however, mortality after the start of ART is high in resource-limited settings. We investigated risk factors for mortality among adults starting ART in a multi-clinic community programme in South Africa. Methods - Cohort of adults starting ART at 27 clinics between February 2005 and June 2006, followed to 31st March 2007. Kaplan-Meier survival estimates were used to describe overall mortality. Shared frailty Cox regression was used to identify baseline risk factors for early mortality. Results - Among 1350 participants (median age 35.5 years, 60% female, median CD4 count 83/muL [interquartile range (27-147)], median follow-up 13.4 months), there were 185 deaths, overall mortality rate 13/100 pyrs; for 0-3, 3-9 and >9 months from ART start mortality rates were 24, 13 and 6/100 pyrs respectively. 43% of the deaths were in the first 3 months of treatment. Risk factors for mortality in univariable analysis were baseline CD4 count, viral load, haemoglobin and body mass index, in multivariable analysis adjusting for age and gender, only CD4 count and haemoglobin remained independently associated with proportional hazards not being satisfied for haemoglobin. Adjusted hazard ratios (aHR) for participants with haemoglobin <8, 8.1-9.9, >11.9(f)/12.9 (m) g/mL were 4.99, 3.05 and 0.12 respectively comparing to 10-11.9 (f) /12.9 (m)g/mL in the first 3 months of ART. aHRs for CD4 counts were 0.40, 0.38 and 0.34 for 50-99, 100-200 and >200/muL comparing to <50/muL. Conclusions - The high mortality rate in the first 3 months underlines the need for earlier HIV diagnosis so that ART can be initiated earlier. Low haemoglobin and low CD4 count are both strong predictors of mortality, and could be used to identify individuals at high risk who might benefit from intensive case management."									
1594	Zinc or multiple micronutrient supplementation to reduce diarrhea and respiratory disease in South African children: a randomized controlled trial.	"Luabeya KKA, Mpontshane N, Mackay M, Ward H, Elson I, Chhagan M, Tomkins A, et al."	PLos One. 2007;44.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20103240664	"Background - Prophylactic zinc supplementation has been shown to reduce diarrhea and respiratory illness in children in many developing countries, but its efficacy in children in Africa is uncertain. Objective - To determine if zinc, or zinc plus multiple micronutrients, reduces diarrhea and respiratory disease prevalence. Design - Randomized, double-blind, controlled trial. Setting - Rural community in South Africa. Participants - Three cohorts: 32 HIV-infected children; 154 HIV-uninfected children born to HIV-infected mothers; and 187 HIV-uninfected children born to HIV-uninfected mothers. Interventions - Children received either 1250 IU of vitamin A; vitamin A and 10 mg of zinc; or vitamin A, zinc, vitamins B1, B2, B6, B12, C, D, E, and K and copper, iodine, iron, and niacin starting at 6 months and continuing to 24 months of age. Homes were visited weekly. Outcome Measures - Primary outcome was percentage of days of diarrhea per child by study arm within each of the three cohorts. Secondary outcomes were prevalence of upper respiratory symptoms and percentage of children who ever had pneumonia by maternal report, or confirmed by the field worker. Results - Among HIV-uninfected children born to HIV-infected mothers, median percentage of days with diarrhea was 2.3% for 49 children allocated to vitamin A; 2.5% in 47 children allocated to receive vitamin A and zinc; and 2.2% for 46 children allocated to multiple micronutrients (P=0.852). Among HIV-uninfected children born to HIV-uninfected mothers, median percentage of days of diarrhea was 2.4% in 56 children in the vitamin A group; 1.8% in 57 children in the vitamin A and zinc group; and 2.7% in 52 children in the multiple micronutrient group (P=0.857). Only 32 HIV-infected children were enrolled, and there were no differences between treatment arms in the prevalence of diarrhea. The prevalence of upper respiratory symptoms or incidence of pneumonia did not differ by treatment arms in any of the cohorts. Conclusion - When compared with vitamin A alone, supplementation with zinc, or with zinc and multiple micronutrients, did not reduce diarrhea and respiratory morbidity in rural South African children."									
633	Vitamin profile of pregnant women living with HIV/AIDS.	"Machado RHV, Bonafe S, Castelo A, Patin RV."	e-SPEN Journal. 2013 June;8(3):e108-e12.		"Background & aims: Maternal adequate micronutrient storage contributes to reducing morbidity and mortality of their children during the first two years of life. This study aimed at identifying hypovitaminosises among Brazilian HIV infected pregnant women and investigating their association with nutritional status, CD4<sup>+</sup> cell counts, viral load and HAART use. Methods: Cross-sectional study with 49 HIV infected pregnant women. Inclusion criteria followed: (1) HIV infection laboratory confirmation (HIV and HIV RNA); (2) Confirmed pregnancy, (3) Age above 14years old; (4) Written consent. Exclusion criteria consisted of at least one of the following: (1) Use of any nutritional/multivitamin supplement (except iron or folinic acid); (2) Presence of nutritional counseling during the current pregnancy; (3) Presence of acute phase opportunistic diseases associated with HIV infection. Patients were evaluated according to anthropometric (gestational BMI, based on the curve of weight gain corrected for gestational age) and laboratory parameters (analysis of vitamin A, E, C, D, B6 and B12, CD4<sup>+</sup> cell count, viral load, lipid profile, homocysteine and C-reactive protein). Blood samples were collected in 5mL dry tubes with separating gel, after 12h fasting. Vitamin profile was measured by HPLC. Results were classified according to abnormal ranges proposed for pregnant women. Results: Low gestational weight was higher in women with CD4<sup>+</sup> <200cells/mm<sup>3</sup> [OR = 12.5; 95% CI 2,00,77,89; p = 0.007]. Prevalence of abnormal serum concentrations was 38.8% for vitamin D, 14.3% for vitamin A, 22.4% for vitamin E, 12.2% for vitamin C, 53.2% for vitamin B6 and 32.6% for vitamin B12. C-reactive protein was associated with vitamin E [OR = 0.23, 95% CI 0.053, 1.01, p = 0.03] and A [OR = 0.15, 95% CI 0.028, 0.84, p = 0.03]. Homocysteine was not associated with lower vitamin concentrations. Women with optimal B12 levels were 4.3 times more likely to have CD4<sup>+</sup> >200cells/mm<sup>3</sup> [OR = 0.23, 0.58 to 0.905, 95% CI, p = 0.03]. HIV viral load has not been significantly associated with vitamin concentrations. Conclusions: There was high prevalence of abnormal concentrations of vitamin A, D, B6 and B12. Nutritional status was associated with CD4<sup>+</sup> cell count and vitamins were associated with immune function and inflammatory markers. There is need for more studies on this matter in Brazil. Vitamin serum levels should be monitored in these patients during prenatal care, and results underscore the importance of early nutritional intervention to ensure favorable pregnancy and birth outcomes, specially regarding the vitamin profile described here. 2013 European Society for Clinical Nutrition and Metabolism."									
557	Validity of impedance-based equations for the prediction of total body water as measured by deuterium dilution in Cameroonian HIV-infected patients treated with antiretroviral treatment.	"Medoua GN, Ndzana Abomo AC, Essa'a VJ, Sobgui CM, Messomo MTG, Rikong HA."	Clinical Nutrition. 2008 December;27(6):881-8.		"Background & aims: No information is available on the validity of impedance-based equations for the prediction of body composition in Cameroonian HIV-infected patients treated with antiretroviral drugs. Equations for the prediction of total body water (TBW) have the tendency to be population-specific, and this may be due to biological factors, such as variable body geometry and physiological state. We tested the validity of equations derived from different racial backgrounds for predicting TBW from bioelectrical impedance analysis measurements. Method: The TBW content of 56 Cameroonian HIV patients (19 men and 37 women) treated with the first-line ARV regimen was measured by deuterium dilution and compared with those predicted by 12 equations developed respectively in samples of white, black, black and white, or unspecified racial background subjects. Results: Pure errors in predicting TBW showed acceptable value for all the equations tested. Four equations (three from whites and one from blacks and whites) yielded a non-significant bias; however, equation H which presented the narrower 95% confidence interval and the smaller pure error was recommended for the prediction of TBW in Cameroonian HIV-infected patients treated with antiretroviral drugs. In all other cases, we observed either an overestimation or underestimation of TBW with variable bias values. Conclusion: The absence of a clear trend in cross-validation among equations according to their origin and the probable effect of physiological state should encourage further exploration of the causes of the lack of validity. 2008 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism."									
809	Pharmacokinetics of lamivudine & stavudine in generic fixed-dose combinations in HIV-1 infected adults in India.	"Hemanth Kumar AK, Ramachandran G, Rajasekaran S, Padmapriyadarsini C, Narendran G, Subramanyam SAS, Kumaraswami V, et al."	Indian Journal of Medical Research. 2009;130(4):451-7.		"Background & objectives: Antiretroviral drug concentrations are important determinants of clinical response to a drug accounting for both toxicity and efficacy. Several factors such as age, ethnicity, body weight and patients' immune status may influence antiretroviral drug concentrations. The aim of the study was to determine the influence of immunological status, sex and body mass index on the steady state pharmacokinetics of lamivudine (3TC) and stavudine (d4T) in HIV-infected adults, who were undergoing treatment with generic fixed dose combinations (FDC) of these drugs in India. Methods: Twenty seven HIV-1 infected patients receiving antiretroviral treatment (ART) for at least two weeks at the Government ART clinic at Tambaram, Chennai, took part in the study. Serial blood samples were collected predosing and at different time points after drug administration. Plasma 3TC and d4T levels were estimated by HPLC. Results: The patients' immune status, sex or body mass index had no impact on the pharmacokinetics of 3TC. In the case of d4T, peak concentration was significantly lower in patients with CD4 cell counts < 200 cells/mul than those with >= 200 cells/ mul (P < 0.05), but were within the therapeutic range. The mean CD4 cell counts increased from 101 cells/mul at initiation of ART to 366 cells/mul at 12 months of treatment. Interpretation & conclusions: Blood levels of 3TC and d4T drugs that are part of generic FDCs commonly used by HIV-infected individuals in India were within the therapeutic range and not influenced by nutritional or immune status. There was a significant improvement in CD4 cell counts over 12 months of treatment. Indian generic FDCs manufactured and used widely in the developing world provide effective concentrations of antiretroviral drugs."									
810	Pharmacokinetics of lamivudine & stavudine in generic fixed-dose combinations in HIV-1 infected adults in India.	"Kumar AKH, Geetha R, Rajasekaran S, Padmapriyadarsini C, Narendran G, Anitha S, Sudha S, et al."	Indian Journal of Medical Research. 2009;130(4):451-7.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20123008389	"Background & objectives: Antiretroviral drug concentrations are important determinants of clinical response to a drug accounting for both toxicity and efficacy. Several factors such as age, ethnicity, body weight and patients' immune status may influence antiretroviral drug concentrations. The aim of the study was to determine the influence of immunological status, sex and body mass index on the steady state pharmacokinetics of lamivudine (3TC) and stavudine (d4T) in HIV-infected adults, who were undergoing treatment with genetic fixed dose combinations (FDC) of these drugs in India. Methods: Twenty seven HIV-1 infected patients receiving antiretroviral treatment (ART) for at least two weeks at the Government ART clinic at Tambaram, Chennai, took part in the study. Serial blood samples were collected predosing and at different time points after drug administration. Plasma 3TC and d4T levels were estimated by HPLC. Results: The patients' immune status, sex or body mass index had no impact on the pharmacokinetics of 3TC. In the case of d4T, peak concentration was significantly lower in patients with CD4 cell counts <200 cells/ micro l than those with >=200 cells/ micro l (P<0.05), but were within the therapeutic range. The mean CD4 cell counts increased from 101 cells/ micro l at initiation of ART to 366 cells/ micro l at 12 months of treatment. Interpretation & conclusions: Blood levels of 3TC and d4T drugs that are part of generic FDCs commonly used by HIV-infected individuals in India were within the therapeutic range and non influenced by nutritional or immune status. There was a significant improvement in CD4 cell counts over 12 months of treatment. Indian generic FDCs manufactured and used widely in the developing world provide effective concentrations of antiretroviral drugs."									
811	Dietary adequacy of HIV infected individuals in north India - a cross-sectional analysis. (Special Issue: HIV/AIDS research.).	"Sachdeva RK, Aman S, Ajay W, Vandana D, Surjit S, Subhash V."	Indian Journal of Medical Research. 2011;134(6):967-71.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20123092305	"Background & objectives: Dietary inadequacy is common in developing countries and so is in immune-deficient HIV infected individuals. Hence, an assessment of dietary patterns was done among a group of HIV infected individuals and compared with recommended dietary allowances. Methods: One hundred consecutive HIV infected individuals were interviewed from the Immunodeficiency Clinic of a tertiary care center at Chandigarh. Dietary intake was assessed by 24 h recall method. Mean carbohydrate, protein and fat intakes were evaluated. Mean difference in the calorie intake from recommended dietary intake was then calculated. Mean absolute CD4 cell count was calculated and correlated with BMI and mean calorie intake. Results: Mean weight and BMI of the individuals participated in the study was 58.6+or-11.7 (range, 34-94) kg and 21.5+or-3.7 (range, 13.6-36.7) kg/m<sup>2</sup>, respectively. Mean total calories intake was 1713+or-292.8 (860-2525) calories/day and mean difference in the calories taken from the standard values was 249.5+or-190.7 (10.6-967.5) calories/day. There was no significant correlation between CD4 cell count and total calories taken. Interpretation & conclusions: In HIV-infected individuals the energy intake was significantly lower than the recommended average intake. Hence, efforts should be taken to ensure that HIV-infected individuals have access to high-quality, nutritious food choices that promote optimal dietary patterns."									
812	Dietary adequacy of HIV infected individuals in north India--a cross-sectional analysis.	"Sachdeva RK, Sharma A, Wanchu A, Dogra V, Singh S, Varma S."	Indian Journal of Medical Research. 2011;134(6):967-71.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=22310830	"BACKGROUND & OBJECTIVES: Dietary inadequacy is common in developing countries and so is in immune-deficient HIV infected individuals. Hence, an assessment of dietary patterns was done among a group of HIV infected individuals and compared with recommended dietary allowances."	"METHODS: One hundred consecutive HIV infected individuals were interviewed from the Immunodeficiency Clinic of a tertiary care center at Chandigarh. Dietary intake was assessed by 24 h recall method. Mean carbohydrate, protein and fat intakes were evaluated. Mean difference in the calorie intake from recommended dietary intake was then calculated. Mean absolute CD4 cell count was calculated and correlated with BMI and mean calorie intake."	"RESULTS: Mean weight and BMI of the individuals participated in the study was 58.6 +/- 11.7 (range, 34 - 94) kg and 21.5 +/- 3.7 (range, 13.6 - 36.7) kg/m [2] , respectively. Mean total calories intake was 1713 +/- 292.8 (860 - 2525) calories/day and mean difference in the calories taken from the standard values was 249.5 +/- 190.7 (10.6 - 967.5) calories/day. There was no significant correlation between CD4 cell count and total calories taken."	"INTERPRETATION & CONCLUSIONS: In HIV-infected individuals the energy intake was significantly lower than the recommended average intake. Hence, efforts should be taken to ensure that HIV-infected individuals have access to high-quality, nutritious food choices that promote optimal dietary patterns."						
813	Dietary adequacy of HIV infected individuals in north India - A cross-sectional analysis.	"Sachdeva RK, Sharma A, Wanchu A, Dogra V, Singh S, Varma S."	Indian Journal of Medical Research. 2011 December;134(12):967-71.		"Background & objectives: Dietary inadequacy is common in developing countries and so is in immunedeficient HIV infected individuals. Hence, an assessment of dietary patterns was done among a group of HIV infected individuals and compared with recommended dietary allowances. Methods: One hundred consecutive HIV infected individuals were interviewed from the Immunodeficiency Clinic of a tertiary care center at Chandigarh. Dietary intake was assessed by 24 h recall method. Mean carbohydrate, protein and fat intakes were evaluated. Mean difference in the calorie intake from recommended dietary intake was then calculated. Mean absolute CD4 cell count was calculated and correlated with BMI and mean calorie intake. Results: Mean weight and BMI of the individuals participated in the study was 58.6 +/- 11.7 (range, 34 - 94) kg and 21.5 +/- 3.7 (range, 13.6 - 36.7) kg/m<sup>2</sup>, respectively. Mean total calories intake was 1713 +/- 292.8 (860 - 2525) calories/day and mean difference in the calories taken from the standard values was 249.5 +/- 190.7 (10.6 - 967.5) calories/day. There was no significant correlation between CD4 cell count and total calories taken. Interpretation & conclusions: In HIV-infected individuals the energy intake was significantly lower than the recommended average intake. Hence, efforts should be taken to ensure that HIV-infected individuals have access to high-quality, nutritious food choices that promote optimal dietary patterns."									
814	Prevalence of multidrug-resistant tuberculosis among newly diagnosed cases of sputum-positive pulmonary tuberculosis.	"Sharma SK, Kaushik G, Jha B, George N, Arora SK, Gupta D, Singh U, et al."	"Indian Journal of Medical Research, Supplement. 2011 March;133(3):308-11."		"Background & objectives: The prevalence of multidrug-resistant tuberculosis (MDR-TB) is increasing throughout the world. Although previous treatment for TB is the most important risk factor for development of MDR-TB, treatment-naive patients are also at risk due to either spontaneous mutations or transmission of drug-resistant strains. We sought to ascertain the prevalence of MDR-TB among new cases of sputum-positive pulmonary TB. Methods: This was a prospective, observational study involving newly diagnosed cases of sputum-positive pulmonary tuberculosis diagnosed between 2008 and 2009 carried out in New Delhi, India. All sputum-positive TB cases were subjected to mycobacterial culture and first-line drug-susceptibility testing (DST). MDR-TB was defined as TB caused by bacilli showing resistance to at least isoniazid and rifampicin. Results: A total of 218 cases of sputum-positive pulmonary tuberculosis were enrolled between 2008 and 2009. Of these, 41 cases had negative mycobacterial cultures and DST was carried out in 177 cases. The mean age of the patients was 27.8 +/- 10.2 yr; 59 patients (27%) were female. All patients tested negative for HIV infection. Out of 177 cases, two cases of MDR-TB were detected. Thus, the prevalence of MDR-TB among newly diagnosed pulmonary tuberculosis patients was 1.1 per cent. Interpretation & conclusions: MDR-TB prevalence is low among new cases of sputum-positive pulmonary TB treated at primary care level in Delhi. Nation-wide and State-wide representative data on prevalence of MDR-TB are lacking. Efforts should be directed towards continued surveillance for MDR-TB among newly diagnosed TB cases."									
1810	Assessment of HIV lipodystrophy syndrome (HIV LDS): Diagnostic accuracy of common methods and of a new tool.	"Wenhold F, Van Wyk EC, Becker P."	South African Journal of Clinical Nutrition. 2010;2):S16-S7.		"Background and aim: and Assessment of HIV LDS is not standardised in South Africa. This study aimed to determine in HIV+ females on Highly Active Antiretroviral Therapy in an urban Immunology Outpatient Clinic the agreement between five commonly used methods (National Cholesterol Education Program [NCEP] criteria, subjective self-reporting, anthropometry [Kotler, routine, Dong & Hendriks]) with an objective case definition (reference standard), and to develop and cross-validate a new classification tool. Methods: Purposeful sampling with a screening protocol divided the study population (N=1421) into a case and a control group. From these two groups a random sample of 79 cases and 73 controls was selected (age: 38+/-8y). Standard techniques were followed during data collection. Diagnostic testing, logistic regression, receiver operating characteristics (ROC) curves and cross-validation were employed to determine agreement, and to develop and validate a new classification tool. Results: Occurance figures for HIV LDS in this sample ranged from 11% (Dong&Hendriks-anthropometry) to 55% (Kotler-anthropometry) versus 28% for the reference standard. The diagnostic properties (sensitivity, specificity) of the index tests were: NCEP criteria: (45%, 83%); subjective self-reporting (74%, 59%); Kotleranthropometry (71%, 52%); routine-anthropometry (62%, 54%); and Dong&Hendricks-anthropometry: (10%, 88%). The new classification tool had sensitivity 81%, specificity 79%, and area under ROC curve 0.88. Conclusion: The five index tests give differing results. In a resource limited setting the NCEP criteria appear to be the ""best"" among the methods tested for identifying HIV LDS. The new tool showed substantially better diagnostic properties."									
1081	Prevalence and etiology of persistently elevated alanine aminotransferase levels in healthy Iranian blood donors.	"Pourshams A, Malekzadeh R, Monavvari A, Akbari MR, Mohamadkhani A, Yarahmadi S, Seddighi N, et al."	Journal of Gastroenterology and Hepatology. 2005 February;20(2):229-33.		"Background and Aim: Causes of elevated serum alanine aminotransferase (ALT) levels vary depending on the population under study. The aim of this study was to determine the prevalence and causes of elevated ALT levels among apparently healthy Iranian blood donors in Tehran. Methods: A total of 1959 (1465 male) randomly selected blood donors were enrolled in the study. Body mass index (BMI), viral markers and ALT levels were measured. If ALT was elevated (> 40 U/L), it was rechecked twice within 6 months. Blood donors with >=2 times elevated ALT levels (persistently elevated ALT) were invited for further evaluation. Results: A total of 100 donors (5.1%) had elevated ALT levels at the first measurement. Fifty-two persons (2.65%) were found to have persistently elevated serum ALT. Among subjects with persistently elevated serum ALT, non-alcoholic steatohepatitis (NASH) was diagnosed in 46 (88.4%), chronic hepatitis C virus (HCV) infection in four (7.7%), alcoholic liver disease in one (1.92%), and drug-induced liver disease in one (1.92%). The prevalence of NASH and HCV infection in the studied population was 2.35% and 0.4%, respectively. The mean BMI of NASH subjects was 30.58 kg/m<sup>2</sup>, compared with 27.28 kg/m<sup>2</sup> of those without NASH (P < 0.001). Conclusion: Non-alcoholic steatohepatitis is the most common cause of persistently elevated serum ALT in the asymptomatic Iranian blood donors in Tehran. 2004 Blackwell Publishing Asia Pty Ltd."									
1234	Cofactors for low serum albumin levels among HIV-infected individuals in Southern India.	"Sundaram M, Srinivas CN, Shankar EM, Balakrishnan P, Solomon S, Kumarasamy N."	Journal of the International Association of Physicians in AIDS Care. 2009;8(3):161-4.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20093176698	"Background and aims. Malnutrition and low serum albumin among human immunodeficiency virus (HIV)-infected individuals are cofactors for HIV disease progression. The present study aimed to identify the proportion of HIV-infected individuals with low serum albumin and the possible cofactors among highly active antiretroviral therapy (HAART) experienced and HAART naive individuals. Methods. A total of 835 HIV-infected individuals (HAART-experienced, HAART-naive) were included in the study. Results. Of the 835 individuals, 44.6% had normal (4.2-5.2 g/dL) and 55.4% had abnormal (<4.2 g/dL) albumin levels. The abnormal group had significantly lower body mass index (BMI) compared with the normal group (P=.02). Among those with abnormal albumin, 388 (84%) were HAART experienced compared with 239 (64%) with normal albumin (P<.001). Among the abnormal group, 259 (55.9%) had CD4 count <200 cells/ micro L as compared with 124 (33.3%) in the normal group (P<.001). Conclusions. CD4 count and lower were the major cofactors for low serum albumin among HIV-infected individuals. Therefore, serum albumin would be a useful biochemical test for HIV disease in resource-limited settings."									
849	Skin diseases in south-east Nigeria: a current perspective.	Nnoruka EN.	International Journal of Dermatology. 2005;44(1):29-33.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=15663655	"BACKGROUND AND OBJECTIVE: The incidence of skin diseases in south-east Nigeria during the present decade was analyzed and compared with results from other parts of Nigeria, particularly those in the same zone, obtained more than 30 years ago. This study was carried out to update the recent clinical picture of skin diseases in our environment in view of the rapid development, urbanization and advances in the region."	"PATIENTS AND METHODS: Consecutive new patients seen at the dermatology clinic of the University of Nigeria, Teaching Hospital, Enugu, Nigeria, from February 1999 to March 2001 were included in this prospective study. Only cases seen and examined by the author were included in this study to ensure uniformity of diagnosis."	"RESULTS: A total of 2871 patients were observed within the study period. Adults accounted for 69.7% and were aged between 18 and 73 years, while the male:female ratio was 1.3:1. Allergic skin diseases (24.9%) were the commonest skin disorders identified, as opposed to infestations which accounted for an extremely high result of 33.7% (for the same region between 1968 and 1971). In second place was infections/infestations (19.1%). A reversal of picture was thus observed. Within the allergic disorders; eczemas/dermatitis were found to be the most prevalent followed by follicular (13.7%) and pigmentary disorders (11.1%). Sexually transmitted diseases and HIV/AIDs have increased significantly and accounted for 5.4%. Blistering diseases (1.1%) and malignancies (0.5%) occurred less frequently, similar to results found in recent decades for the same region."	"CONCLUSION: The current picture of skin diseases in south-east Nigeria has changed significantly from mere infections to allergic skin, follicular and pigmentary disorders. Cutaneous lesions secondary to STDs and HIV/AIDs have also increased. Skin lesions related to malnutrition, kwashiorkor and starvation were not observed nor were cutaneous tuberculosis, yaws or pediculosis, while blistering disorders and malignancies remained almost the same. The current picture is similar to that in other developing and Afro-Caribbean countries. Primary-care physicians and health-care providers in Nigeria/Africa need to be aware of the globally changing pattern of skin diseases in the region to enable the allocation of necessary resources (financial, material and human) to manage these skin diseases."						
269	Nutrient adequacy of foods consumed by HIV/AIDS infected women in Mumias District - Kenya.	"Shikuri R, Mbugua S, Mwangi A."	Annals of Nutrition and Metabolism. 2013 May;62:72.		"Background and Objectives: Proper diets help HIV/AIDS patients to cope with the strong medicines used to treat opportunistic infections associated with the virus such as tuberculosis (TB) and avert malnutrition. In addition, micronutrients improve the body's ability to clear by-products and other toxins from the strong anti-TB drugs, thereby reducing skin inflammation and blisters. Mediterranean diet incorporates the basics of healthy eating which include fruits, vegetables, fish and whole grains, and limit unhealthy fats for prevention of major chronic diseases. The objective of this study therefore was to find out the nutrient adequacy for foods consumed by HIV/AIDS positive women in Mumias district and their impact on HIV progression. This will be used to design and develop a food based intervention strategy using locally available foods rich in micro-nutrients as a tool for management of HIV positive status. Methods: This study was composed of a cross-sectional and intervention study designsPhase one was composed of a crosssectional study of 137 women living with HIV/AIDS in Mumias district to determine their nutrient adequacy. The P value for statistical significance test was set at <0.05. Results: Quantitative analysis was achieved using SPSS software package. Descriptive statistics such as means and standard deviations were used to organize, describe and summarize the data on socio-economic and anthropometric measurements of the respondents. Anthropometry was used to provide valuable information on development in size and body composition of the women More than half of the women were found to consume foods that were inadequate in nutrients. Conclusions: Given that more than half of the women were malnourished there was need to develop a Food based intervention from foods locally produced and consumed by the women and the product commercialized so as to empower these women and improve their livelihoods and health."									
1842	"Changes in body composition and other anthropometric measures of female subjects on highly active antiretroviral therapy (HAART): A pilot study in Kwazulu-Natal, South Africa."	"Esposito FM, Coutsoudis A, Visser J, Kindra G."	Southern African Journal of HIV Medicine. 2008 Spring(32):36-43.		"Background and objectives. An understanding of the effect of highly active antiretroviral therapy (HAART) on various aspects of health, including nutritional status, is needed to ensure that population-specific guidelines can be developed for South Africa. This study aimed to investigate the changes in body composition and other anthropometric measures that occur in HIV-infected women after the initiation of HAART and to explore the relationship between these measures and CD4 lymphocyte count. Design and setting. A longitudinal study was carried out at the Umkhumbane Community Health Centre, KwaZulu-Natal. Subjects. 30 HIV-infected adult women who started HAART between March 2007 and October 2007. Methods. Anthropometric measurements and bioelectrical impedance analysis were performed at baseline and 24 weeks after commencing HAART. CD4 lymphocyte counts were done at baseline and at the 24-week visit. Results. There was a statistically significant increase in all anthropometric measures except waist-hip ratio and lean body mass. The mean weight change (+/- standard deviation) was 3.4+/-5.8 kg (p=0.006). Mean body mass index (BMI) (kg/m<sup>2</sup>) increased from 25.6+/-5.7 to 27.3+/-5.6 (p=0.007). Seventy per cent of subjects gained weight, 18.5% had a stable weight and 11.1% lost weight. Subjects with lower CD4 lymphocyte counts experienced greater increases in weight, BMI, fat mass and body fat percentage. No significant association was found between anthropometric changes and change in CD4 count between baseline and the 24-week visit. Conclusions. The findings demonstrate the value of including circumference measurements and body composition techniques as part of nutritional status assessment. Research is needed to determine the best methods of bringing about favourable anthropometric changes to enhance the health of patients on HAART."									
1974	Effectiveness of antiretroviral therapy in treating paediatric HIV/AIDS in Jamaica.	"Pierre RB, Steel-Duncan JC, Evans-Gilbert T, Rodriguez B, Moore J, Palmer P, Smikle MF, et al."	West Indian Medical Journal. 2008 June;57(3):223-30.		"Background and Purpose: Paediatric HIV/AIDS remains a significant challenge in developing countries. We describe the effectiveness of interventions in HIV-infected children attending Paediatric Infectious Diseases Clinics in Jamaica. Methods: One hundred and ninety-seven HIV-infected children were followed prospectively in multicentre ambulatory clinics between September 1, 2002 and August 31, 2005, in the Kingston Paediatric and Perinatal HIV/AIDS Programme, Jamaica, and their outcomes described. Results: Median follow-up was 23 child-months (interquartile range [IQR] 12-31) with 12 children (6.0%) lost to follow-up and deaths (n = 13) occurred at 4.64 per 100 child-years of follow-up. Median age was 5.0 years (IQR 2.2-8.1) and 32.1% had Centers for Disease Control and Prevention (CDC) category C disease at enrolment; 62% were ever on antiretroviral therapy (ART) with median duration of 15.4 months (IQR 5.5-25.5); 85% initiated ART with zidovudine/lamivudine/nevirapine. Mean weight-for-height 0.13 +/- 1.02 (mean difference -1.71 [95% Confidence interval (CI) -2.73, -0.69]; p = 0.001) and body mass index-for-age 0.05 +/- 1.11 (mean dfference -1.11, [CI -1.79, -0.43]; p = 0.002); z scores increased after 24 months on ART; however, children remained stunted. Reductions in the incidence of hospitalizations (mean diff 30.95, [CI 3.12, 58.78]; p = 0.03) and in episodes of pneumonia, culture-positive sepsis and tuberculosis occurred in those on ART. Conclusions: A successfully implemented ambulatory model for paediatric HIV care in Jamaica has improved the quality of life and survival of HIV-infected children."									
1074	Clinical features to predict refractory cryptococcal meningitis: Ten years of clinical experience in three centers.	"Xu XG, Fang W, Chen M, Zhou J, Pan B, Pan WH, Liao WQ, et al."	Journal of Dermatology. 2012 June;39:186-7.		"Background Cryptococcal meningitis is a potential fatal disease, especially in immunocompromised patients. Fortunately, the mortality rate decreased significantly in recent years, with the combination therapy of effective antifungal drug such as amphotericin B, flucytosine and voriconazole. Currently, one of the important problems is how to identify and deal with the refractory cases. Therefore, we summarize the clinical features to predict refractory cryptococcal meningitis. Methods We conducted a retrospective review of medical records of patients diagnosed with cryptococcal meningitis from January 2000 to December 2011 in three centers. Taking effective dose of antifungal treatment, a consistently positive culture in cerebrospinal fluid (CSF) or intracranial pressure higher than 300mmHg (40 kPa) for four weeks was considered to be refractory. Variables included age, body mass index (BMI), underlying diseases, intracranial pressure, CSF protein content, cryptococcal count, CSF cryptococcal antigen (CrAg) titre, serum hemoglobin (Hb), white blood cell (WBC) count, alanine aminotransferase (ALT), aspartate aminotransferase (AST), lipids, potassium concentration, CD4 lymphocyte count, and therapeutic regimen. Results In 132 cryptococcal meningitis patients, 8 (6%) were identified as refractory cases. Among all variables, infection with AIDS/HIV (P <0.001), Hb < 90g/L (P <0.05), potassium concentration <2.7 mg/L (P <0.001), intracranial pressure >400 mmHg (53.2 kPa) (P <0.05) and CSF CrAg titre >1:1024 (P <0.05) were significantly related to a refractory outcome. Conclusion Although it is difficult to deal with refractory cryptococcal meningitis nowadays, some cases can be predicted early enough, so as to be treated appropriately and have relatively good outcomes."									
508	"Diagnosis of pulmonary tuberculosis among asymptomatic HIV+ patients in Guangxi, China."	"Zhang Y, Yu L, Tang ZR, Huang SB, Zheng YJ, Meng ZH, Sun K, et al."	Chinese Medical Journal. 2010 December 5;123(23):3400-5.		"Background Pulmonary tuberculosis (PTB) among asymptomatic Chinese patients with HIV infection has not been investigated despite high tuberculosis burden in China. This study was aimed to evaluate the prevalence, risk factors and clinical outcomes of PTB among asymptomatic patients with HIV/AIDS in Guangxi to facilitate the development of diagnostic and treatment strategies. Methods All asymptomatic adult HIV-infected patients with CD4 <350 cells/mul who attended four HIV clinics in Guangxi between August 2006 and March 2008 were evaluated for active PTB with physical examination, chest X-ray (CXR), sputum smear and/or sputum liquid culture. Data were described using median (interquartile range, IQR) and frequencies. Univariate and multivariate Logistic regression analyses were performed to identify risk factors associated with PTB. Results Among 340 asymptomatic subjects, 15 (4%) were diagnosed with PTB, with 4 (27%) sputum smear positive and 8 (53%) sputum culture positive. CXR has higher diagnostic sensitivity (87%) than sputum smear (25%) and sputum culture (67%), but lower specificity (56%) compared with sputum smear (99%) and culture (100%). In univariate analysis, injection drug user, body mass index (BMI) <18 kg/m<sup>2</sup>, CD4 <50 cells/mul and presence of peripheral lymphadenopathy were associated with an increased risk of asymptomatic PTB, while in multivariate analysis only peripheral lymphadenopathy maintained statistical significance (OR=7.6, 95% CI 1.4-40). Patients with negative smear and minor or no abnormalities on CXR had longer interval between screening and TB treatment. Conclusions PTB was relatively common in this group of HIV<sup>+</sup> asymptomatic Chinese patients. Diagnosis is challenging especially where sputum culture is unavailable. These findings suggest that an enhanced evaluation for PTB needs to be integrated with HIV care in China and transmission prevention in China to control at both households and health care facilities, especially for patients with factors associated with a higher risk of PTB."									
1289	Assessment of inpatient paediatric care in first referral level hospitals in 13 districts in Kenya.	"English M, Esamai F, Wasunna A, Were F, Ogutu B, Wamae A, Snow RW, et al."	Lancet. 2004 12 Jun;363(9425):1948-53.		"Background The district hospital is considered essential for delivering basic, cost-effective health care to children in resource poor countries. We aimed to investigate the performance of these facilities in Kenya. Methods Government hospitals providing first referral level care were prospectively sampled from 13 Kenyan districts. Workload statistics and data documenting the management and care of admitted children were obtained by specially trained health workers. Findings Data from 14 hospitals were surveyed with routine statistics showing considerable variation in inpatient paediatric mortality (range 4-15%) and specific case fatality rates (eg, anaemia 3-46%). The value of these routine data is seriously undermined by missing data, apparent avoidance of a diagnosis of HIV/AIDS, and absence of standard definitions. Case management practices are often not in line with national or international guidelines. For malaria, signs defining severity such as the level of consciousness and degree of respiratory distress are often not documented (range per hospital 0-100% and 9-77%, respectively), loading doses of quinine are rarely given (3% of cases) and dose errors are not uncommon. Resource constraints such as a lack of nutritional supplements for malnourished children also restrict the provision of basic, effective care. Interpretation Even crude performance measures suggest there is a great need to improve care and data quality, and to identify and tackle key health system constraints at the first referral level in Kenya. Appropriate intervention might lead to more effective use of health workers' efforts in such hospitals."									
1694	Interventions to promote adherence to Antiretroviral Therapy (HAART) among adult patients at an HIV/AIDS program in Uganda.	"Muhumuza S, Gwokyalya V, Kutamba E."	Retrovirology. 2010;7:P57.		"Background To document successful interventions for promoting Adherence to ART among adult patients at Mulago hospital AIDS (ISS) clinic. Methods A retrospective cohort analysis was performed on data of 2,521 adult patients on ART for >= 1 at Mulago hospital AIDS (ISS) clinic between August 2005 and June 2009. The average adherence score for each patient was used for analysis. Adherence to ART was defined as good adherence for patients taking >= 95% of the prescribed ART doses and poor for patients taking < 95% of the prescribed ART doses. Results Of the 2,521 patients active on ART, 65% (1,638) were female. Median age was 34 years (IQR: 29-40). Median CD4+ cell count at ART initiation and Body Mass Index (BMI) were 134 cells/mm<sup>3</sup> (IQR: 56-198) and 21.2 kg/ m<sup>2</sup> (IQR 19.3-23.5) respectively. Good adherence of >= 95% was observed in 2,406 (95.4%) of the patients Discussion High rates of adherence to ART can be achieved in a setting with multiple interventions for adherence promotion."									
1695	Clinical and immulogical outcomes among adult patients receiving Antiretroviral Therapy (ART) at an HIV/AIDS program in Uganda.	"Muhumuza S, Ssempiira J, Semitala F, Namusobya J, Ouma J, Mbabazi E, Kamya M."	Retrovirology. 2010;7:P43.		"Background To evaluate clinical and immunological outcomes and the associated factors among adult patients receiving ART at MJAP, Uganda. Methods A retrospective cohort analysis of patient data on ART between August 2005 and June 2009 at Mulago Hospital AIDS (ISS) clinic. Changes in Body Mass Index (BMI) and CD4 cell count, incidence of Opportunistic Infections (OIs) and mortality were compared with the patients' socio-demographics, WHO stage and CD4 count at initiation of ART, ART regimen and adherence levels. Odds ratios, 95% confidence intervals, chi square tests, logistic regression and Cox proportional hazard model were used for analysis. Results Of the 4,824 patients on ART, 65% (3,120) were female, median age; 33 years (IQR: 28-40). Total follow up time was 5824.9 Person Years (PY). Median CD4+ count and BMI at ART initiation was 138 cells/mm<sup>3</sup> (IQR: 60-200) and 21.2 kg/m<sup>2</sup> (IQR 19.2-23.7) respectively. 10.6% developed OIs, 239 (5%) patients died. Incidence of death was 4.12/100 PY (95% CI 3.63-4.68). Gain in CD4 count and BMI was observed in 68% and 63% of the patients respectively. Median increase in CD4 count was 174 cells/mm<sup>3</sup> (IQR 96-278) and mean increase in BMI was 1.5 kg/m<sup>2</sup> (S.D 2.82). Increase in CD4 count and BMI was associated with increased income, adherence = 95%, WHO stages III & IV and CD4 count < 100 (P < 0.05). The risk of developing an OI was associated with CD4 count < 100, WHO stages III & IV (P < 0.001) and decreasing levels of education (c<sup>2</sup> for trend = 7.7 (df) = 1, P = 0.005). Mortality was higher in patients in WHO stage III & IV (H.R 2.57, P < 0.001) and lower in patients with CD4 count =100, (H.R 0.32, P < 0.001) and adherence = 95% (HR 0.55, P < 0.001). Discussion Early initiation of ART, good adherence, improved income and education status are associated with increased survival and positive clinical and immunological outcomes among patients on ART."									
1218	Increased vulnerability of rural children on antiretroviral therapy attending public health facilities in South Africa: a retrospective cohort study.	"Fatti G, Bock P, Grimwood A, Eley B."	Journal of the International AIDS Society. 2010;13:46.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=21108804	"BACKGROUND: A large proportion of the 340,000 HIV-positive children in South Africa live in rural areas, yet there is little sub-Saharan data comparing rural paediatric antiretroviral therapy (ART) programme outcomes with urban facilities. We compared clinical, immunological and virological outcomes between children at seven rural and 37 urban facilities across four provinces in South Africa."	"METHODS: We conducted a retrospective cohort study of routine data of children enrolled on ART between November 2003 and March 2008 in three settings, namely: urban residence and facility attendance (urban group); rural residence and facility attendance (rural group); and rural residents attending urban facilities (rural/urban group). Outcome measures were: death, loss to follow up (LTFU), virological suppression, and changes in CD4 percentage and weight-for-age-z (WAZ) scores. Kaplan-Meier estimates, logrank tests, multivariable Cox regression and generalized estimating equation models were used to compare outcomes between groups."	"RESULTS: In total, 2332 ART-naive children were included, (1727, 228 and 377 children in the urban, rural and rural/urban groups, respectively). At presentation, rural group children were older (6.7 vs. 5.6 and 5.8 years), had lower CD4 cell percentages (10.0% vs. 12.8% and 12.7%), lower WAZ scores (-2.06 vs. -1.46 and -1.41) and higher proportions with severe underweight (26% vs.15% and 15%) compared with the urban and rural/urban groups, respectively. Mortality was significantly higher in the rural group and LTFU significantly increased in the rural/urban group. After 24 months of ART, mortality probabilities were 3.4% (CI: 2.4-4.8%), 7.7% (CI: 4.5-13.0%) and 3.1% (CI: 1.7-5.6%) p = 0.0137; LTFU probabilities were 11.5% (CI: 9.3-14.0%), 8.8% (CI: 4.5-16.9%) and 16.6% (CI: 12.4-22.6%), p = 0.0028 in the urban, rural and rural/urban groups, respectively. The rural group had an increased adjusted mortality probability, adjusted hazards ratio 2.41 (CI: 1.25-4.67) and the rural/urban group had an increased adjusted LTFU probability, aHR 2.85 (CI: 1.41-5.79). The rural/urban group had a decreased adjusted probability of virological suppression compared with the urban group at any timepoint on treatment, adjusted odds ratio 0.67 (CI: 0.48-0.93)."	"CONCLUSIONS: Rural HIV-positive children are a vulnerable group, exhibiting delayed access to ART and an increased risk of poor outcomes while on ART. Expansion of rural paediatric ART programmes, with future research exploring improvements to rural health system effectiveness, is required."						
1219	Nutrition and inflammation serum biomarkers are associated with 12-week mortality among malnourished adults initiating antiretroviral therapy in Zambia.	"Koethe JR, Blevins M, Nyirenda C, Kabagambe EK, Shepherd BE, Wester CW, Zulu I, et al."	Journal of the International AIDS Society. 2011;14:19.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=21477359	"BACKGROUND: A low body mass index (BMI) at antiretroviral therapy (ART) initiation is a strong predictor of mortality among HIV-infected adults in resource-constrained settings. The relationship between nutrition and inflammation-related serum biomarkers and early treatment outcomes (e.g., less than 90 days) in this population is not well described."	"METHODS: An observational cohort of 142 HIV-infected adults in Lusaka, Zambia, with BMI under 16 kg/m2 or CD4+ lymphocyte counts of less than 50 cells/mm3, or both, was followed prospectively during the first 12 weeks of ART. Baseline and serial post-treatment phosphate, albumin, ferritin and highly sensitive C-reactive protein (hsCRP) serum levels were measured. The primary outcome was mortality."	"RESULTS: Lower baseline phosphate and albumin serum levels, and higher ferritin and hsCRP, were significantly associated with mortality prior to 12 weeks (p<0.05 for all comparisons), independent of known risk factors for early ART-associated mortality in sub-Saharan Africa. The time-dependent interval change in albumin was associated with mortality after adjusting for the baseline value (AHR 0.62 [0.43, 0.89] per 5 g/L increase), but changes in the other biomarkers were not."	"CONCLUSIONS: The predictive value of serum biomarkers for early mortality in a cohort of adults with malnutrition and advanced HIV in a resource-constrained setting was primarily driven by pre-treatment values, rather than post-ART changes. Interventions to promote earlier HIV diagnosis and treatment, address nutritional deficiencies, and identify the etiologies of increased systemic inflammation may improve ART outcomes in this vulnerable population."						
1297	Child survival gains in Tanzania: analysis of data from demographic and health surveys.	"Masanja H, de Savigny D, Smithson P, Schellenberg J, John T, Mbuya C, Upunda G, et al."	Lancet. 2008;371(9620):1276-83.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=18406862	BACKGROUND: A recent national survey in Tanzania reported that mortality in children younger than 5 years dropped by 24% over the 5 years between 2000 and 2004. We aimed to investigate yearly changes to identify what might have contributed to this reduction and to investigate the prospects for meeting the Millennium Development Goal for child survival (MDG 4).	"METHODS: We analysed data from the four demographic and health surveys done in Tanzania since 1990 to generate estimates of mortality in children younger than 5 years for every 1-year period before each survey back to 1990. We estimated trends in mortality between 1990 and 2004 by fitting Lowess regression, and forecasted trends in mortality in 2005 to 2015. We aimed to investigate contextual factors, whether part of Tanzania's health system or not, that could have affected child mortality."	"FINDINGS: Disaggregated estimates of mortality showed a sharp acceleration in the reduction in mortality in children younger than 5 years in Tanzania between 2000 and 2004. In 1990, the point estimate of mortality was 141.5 (95% CI 141.5-141.5) deaths per 1000 livebirths. This was reduced by 40%, to reach a point estimate of 83.2 (95% CI 70.1-96.3) deaths per 1000 livebirths in 2004. The change in absolute risk was 58.4 (95% CI 32.7-83.8; p<0.0001). Between 1999 and 2004 we noted important improvements in Tanzania's health system, including doubled public expenditure on health; decentralisation and sector-wide basket funding; and increased coverage of key child-survival interventions, such as integrated management of childhood illness, insecticide-treated nets, vitamin A supplementation, immunisation, and exclusive breastfeeding. Other determinants of child survival that are not related to the health system did not change between 1999 and 2004, except for a slow increase in the HIV/AIDS burden."	INTERPRETATION: Tanzania could attain MDG 4 if this trend of improved child survival were to be sustained. Investment in health systems and scaling up interventions can produce rapid gains in child survival.						
981	Complete blood cell count as a surrogate CD4 cell marker for HIV monitoring in resource-limited settings.	"Chen RY, Westfall AO, Hardin JM, Miller-Hardwick C, Stringer JSA, Raper JL, Vermund SH, et al."	Journal of Acquired Immune Deficiency Syndromes. 2007 April;44(5):525-30.		"BACKGROUND: A total lymphocyte count (TLC) of 1200 cells/mL has been used as a surrogate for a CD4 count of 200 cells/muL in resource-limited settings with varying results. We developed a more effective method based on a decision tree algorithm to classify subjects. METHODS: A decision tree was used to develop models with the variables TLC, hemoglobin, platelet count, gender, body mass index, and antiretroviral treatment status of subjects from the University of Alabama at Birmingham (UAB) observational database. Models were validated on data from the Birmingham Veterans Affairs Medical Center (BVAMC) and Zambia, with primary decision trees also generated from these data. RESULTS: A total of 1189 patients from the UAB observational database were included. The UAB decision tree classified a CD4 count <=200 cells/muL as better than a TLC cut-point of 1200 cells/mL, based on the area under the curve of the receiver-operator characteristic curve (P < 0.0001). When applied to data from the BVAMC and Zambia, the UAB-based decision tree performed better than the TLC cut-point of 1200 cells/mL (BVAMC: P < 0.0001; Zambia: P = 0.0009) but worse than a decision tree based on local data (BVAMC: P <= 0.0001; Zambia: P <= 0.0001). CONCLUSION: A decision tree algorithm based on local data identifies low CD4 cell counts better than one developed from a different population or a TLC cut-point of 1200 cells/mL. 2007 Lippincott Williams & Wilkins, Inc."									
411	Nutritional status and HIV in rural South African children.	"Kimani-Murage EW, Norris SA, Pettifor JM, Tollman SM, Klipstein-Grobusch K, Gomez-Olive XF, Dunger DB, et al."	BMC Pediatrics. 2011;11:23.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=21439041	"BACKGROUND: Achieving the Millennium Development Goals that aim to reduce malnutrition and child mortality depends in part on the ability of governments/policymakers to address nutritional status of children in general and those infected or affected by HIV/AIDS in particular. This study describes HIV prevalence in children, patterns of malnutrition by HIV status and determinants of nutritional status."	"METHODS: The study involved 671 children aged 12-59 months living in the Agincourt sub-district, rural South Africa in 2007. Anthropometric measurements were taken and HIV testing with disclosure was done using two rapid tests. Z-scores were generated using WHO 2006 standards as indicators of nutritional status. Linear and logistic regression analyses were conducted to establish the determinants of child nutritional status."	"RESULTS: Prevalence of malnutrition, particularly stunting (18%), was high in the overall sample of children. HIV prevalence in this age group was 4.4% (95% CI: 2.79 to 5.97). HIV positive children had significantly poorer nutritional outcomes than their HIV negative counterparts. Besides HIV status, other significant determinants of nutritional outcomes included age of the child, birth weight, maternal age, age of household head, and area of residence."	"CONCLUSIONS: This study documents poor nutritional status among children aged 12-59 months in rural South Africa. HIV is an independent modifiable risk factor for poor nutritional outcomes and makes a significant contribution to nutritional outcomes at the individual level. Early paediatric HIV testing of exposed or at risk children, followed by appropriate health care for infected children, may improve their nutritional status and survival."						
566	Nutritional interventions for reducing morbidity and mortality in people with HIV.	"Grobler L, Siegfried N, Visser ME, Mahlungulu SS, Volmink J."	Cochrane Database of Systematic Reviews. 2013(2).	http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=2009822771&site=ehost-live	"BACKGROUND: Adequate nutrition is important for optimal immune and metabolic function. Dietary support may, therefore, improve clinical outcomes in HIV-infected individuals by reducing the incidence of HIV-associated complications and attenuating progression of HIV disease, improving quality of life and ultimately reducing disease-related mortality. OBJECTIVES: To evaluate the effectiveness of various macronutrient interventions, given orally, in reducing morbidity and mortality in adults and children living with HIV infection. SEARCH METHODS: We searched CENTRAL (up to August 2011), MEDLINE (1966 to August 2011), EMBASE (1988 to August 2011), LILACS (up to February 2012), and Gateway (March 2006-February 2010). We also scanned reference lists of articles and contacted authors of relevant studies and other researchers. SELECTION CRITERIA: Randomised controlled trials evaluating the effectiveness of macronutrient interventions compared with no nutritional supplements or placebo in the management of adults and children infected with HIV. DATA COLLECTION AND ANALYSIS: Three reviewers independently applied study selection criteria, assessed study quality, and extracted data. Effects were assessed using mean difference and 95% confidence intervals. Homogenous studies were combined wherever it was clinically meaningful to do so and a meta-analysis using the random effects model was conducted. MAIN RESULTS: Fourteen trials (including 1725 HIV positive adults and 271 HIV positive children), were included in this review. Neither supplementary food nor daily supplement of Spirulina significantly altered the risk of death compared with no supplement or placebo in malnourished, ART naive adult participants in the two studies which reported on this outcome. A nutritional supplement enhanced with protein did not significantly alter the risk of death compared to standard nutritional care in children with prolonged diarrhoea. Supplementation with macronutrient formulas given to provide protein and/or energy and fortified with micronutrients, in conjunction with nutrition counselling, significantly improved energy intake (3 trials; n=131; MD 393.57 kcal/day; 95% CI: 224.66 to 562.47;p<0.00001) and protein intake (2 trials; n=81; MD 23.5 g/day; 95% CI: 12.68, 34.01; p<0.00001) compared with no nutritional supplementation or nutrition counselling alone in adult participants with weight loss. In general supplementation with specific macronutrients such as amino acids, whey protein concentration or Spirulina did not significantly alter clinical, anthropometric or immunological outcomes compared with placebo in HIV-infected adults and children. AUTHORS' CONCLUSIONS: Given the current evidence base, which is limited to fourteen relatively small trials all evaluating different macronutrient supplements in different populations at different stages of HIV infection and with varying treatment status, no firm conclusions can be drawn about the effects of macronutrient supplementation on morbidity and mortality in people living with HIV. It is, however, promising to see more studies being conducted in low-income countries, and particularly in children, where macronutrient supplementation both pre-antiretroviral treatment and in conjunction with antiretroviral treatment might prove to be beneficial."	[CINAHL Note: The Cochrane Collaboration systematic reviews contain interactive software that allows various calculations in the MetaView.]								
374	Effect of nutritional factors on adherence to antiretroviral therapy among HIV-infected adults: A case control study in Northern Ethiopia.	"Berhe N, Tegabu D, Alemayehu M."	BMC Infectious Diseases. 2013 23 May;13(1).		"Background: Adherence to antiretroviral treatment is critical for suppression of viral replication, reduced destruction of CD<sub>4</sub> cells, prevention of viral resistance, promotion of immune reconstitution and slowed disease progression. This study sought to determine the effect of nutritional factors on adherence to ART among HIV-infected adults on ART.Methods: Matched case control study design (matched by age and sex) was employed. Data was collected from ART registration chart, pre-tested structured data extraction format, anthropometric measurements and by interview. Conditional logistic regression was used to compute the relevant associations among the variables by STATA version 10.Results: From 174 paired subjects participated in the study 80 (46%) pair were males and 94 (54%) pair were females on ART for at least one year prior to the survey. The mean age (+/-SD) for the non-adherent was 38.4 +/- 8.1years and for the adherent subjects was 38.5 +/- 8.4 years. Malnutrition with BMI less than 18.5 Kg/m<sup>2</sup> in the adherent group was 14 (8%) and that of the non-adherent group was 74 (42.5%) which was associated with non-adherence to ART (AOR 10.0, 95%CI 4.3 - 54.7). Inability to get enough and quality food was also associated with non-adherence to ART (AOR 2.1, 95%CI 1.1 - 11.5).Conclusions: Malnutrition, inability to get enough and/or quality food and consumption pattern which is less than three meals per day were significantly associated with non-adherence to ART. Therefore, the capacity to effectively manage the food and nutrition implications of ART adherence is a critical factor in the success of antiretroviral therapy in resource limited settings. 2013 Berhe et al.; licensee BioMed Central Ltd."									
387	Effect of nutritional factors on adherence to antiretroviral therapy among HIV-infected adults: a case control study in Northern Ethiopia.	"Negassie B, Desalegn T, Mekuriaw A."	BMC Infectious Diseases. 2013;13(233).	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20133212308	"Background: Adherence to antiretroviral treatment is critical for suppression of viral replication, reduced destruction of CD<sub>4</sub> cells, prevention of viral resistance, promotion of immune reconstitution and slowed disease progression. This study sought to determine the effect of nutritional factors on adherence to ART among HIV-infected adults on ART. Methods: Matched case control study design (matched by age and sex) was employed. Data was collected from ART registration chart, pre-tested structured data extraction format, anthropometric measurements and by interview. Conditional logistic regression was used to compute the relevant associations among the variables by STATA version 10. Results: From 174 paired subjects participated in the study 80 (46%) pair were males and 94 (54%) pair were females on ART for at least one year prior to the survey. The mean age (+or-SD) for the non-adherent was 38.4+or-8.1 years and for the adherent subjects was 38.5+or-8.4 years. Malnutrition with BMI less than 18.5 Kg/m<sup>2</sup> in the adherent group was 14 (8%) and that of the non-adherent group was 74 (42.5%) which was associated with non-adherence to ART (AOR 10.0, 95%CI 4.3-54.7). Inability to get enough and quality food was also associated with non-adherence to ART (AOR 2.1, 95%CI 1.1-11.5). Conclusions: Malnutrition, inability to get enough and/or quality food and consumption pattern which is less than three meals per day were significantly associated with non-adherence to ART. Therefore, the capacity to effectively manage the food and nutrition implications of ART adherence is a critical factor in the success of antiretroviral therapy in resource limited settings."									
772	A study of nutritional status and high risk behavior of adolescents in Ahmedabad: a Cross Sectional study.	"Mital P, Bala DV, Hemant T."	"Healthline, Journal of Indian Association of Preventive and Social Medicine. 2011;2(1):21-6."	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20113327901	"Background: Adolescence is a distinct age group (10-19 yrs) with complex needs because of physical and psychological development during puberty. Aim: To evaluate adolescents' nutritional status and high risk behavior. Settings and design: A Cross Sectional study was conducted in West Zone of Ahmedabad Municipal Corporation, Gujarat. Methods & Material: 401 students (10-19 years) from 10 schools and colleges surveyed using pretested questionnaire about nutritional status and high risk behavior. To analyze nutritional status height, weight and BMI were taken and analyzed using WHO growth standards 2007. Statistical analysis: Qualitative data analysis done using Epi Info and WHO Anthro Plus softwares. Results: 47.4% (95% CI=30.7%-64.6%) were stunted and 19.5% (95%CI=12.6%-28.7%) were overweight according to WHO growth standards 2007. Awareness about HIV/AIDS was 93.27% and main media of awareness was television(55.35%). 13.22% were sexually active and 35.85% used condoms during last sexual act. 22.56% have habit of masturbation. 25.19% students believe masturbation is bad habit. Only boys (15.9%) had addiction and common was tobacco chewing (61.29%). No one was Intravenous Drug User. Mean age for menarche was 12.84 yrs. From them 60.93% have problems during menstruation. Most common problem was dysmenorrhea (58.7%). For discussing sexual health problems, 74.64% students prefer with friends. Conclusions: Adolescents have many health problems that need to be taken care of by effective interventions. Key message: Nationwide adolescent health data is inadequate. Focus must be given on analyzing adolescent health issues and to solve them."									
1215	Association between HIV replication and serum leptin levels: an observational study of a cohort of HIV-1-infected South African women.	"Azzoni L, Crowther NJ, Firnhaber C, Foulkes AS, Yin X, Glencross D, Gross R, et al."	Journal of the International AIDS Society. 2010;13:33.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=20822522	"BACKGROUND: Advanced HIV infection can result in lipoatrophy and wasting, even in the absence of ongoing opportunistic infections, suggesting that HIV may directly affect adipose tissue amount and distribution."	"METHODS: We assessed the relationship of fat (measured using anthropometry, DEXA, MRI scans) or markers related to glucose and lipid metabolism with viral load in a cross-sectional sample of 83 antiretroviral-naive HIV-1-infected South African women. A multivariable linear model was fitted to log10VL to assess the combined effect of these variables."	"RESULTS: In addition to higher T cell activation, women with viral load greater than the population median had lower waist circumference, body mass index and subcutaneous abdominal fat, as well as lower serum leptin. We demonstrate that leptin serum levels are inversely associated with viral replication, independent of the amount of adipose tissue. This association is maintained after adjusting for multiple variables associated with disease progression (i.e., cellular activation and innate immunity effector levels)."	"CONCLUSIONS: Our results demonstrate that serum leptin levels are inversely associated with viral replication, independent of disease progression: we postulate that leptin may affect viral replication."						
874	The use of alcohol and related health risks in patients with HIV infection in South Africa.	"Huis in't Veld D, Skaal L, Peltzer K, Hanappe M, Colebunders R, Pengpid S."	International Journal of Infectious Diseases. 2012 June;16:e183.		"Background: Alcohol abuse poses risks for increased morbidity and mortality among patients with HIV. This study aimed to determine the prevalence of alcohol use and other risk factors in a sample of primary care patients with HIV in South Africa. Methods: We conducted a cross-sectional survey in outpatients with HIV in two primary health care HIV clinics near Pretoria, South Africa. Alcohol use was assessed with the Alcohol Use Disorder Identification Test (AUDIT) questionnaire. Other data collected was related to health related quality of life (WHOQol- HIVBREF), depression (CES-D), sexual behavior, internalized AIDS stigma, HIV related information and adherence (self-reported 7 day recall of missed doses and Visual Analogue Scale). Results: The sample included 593 patients (65.1% women, 84.7% started antiretroviral therapy (ART), median age of 37 years). The risk related to alcohol use was low in 66.4% (AUDIT score <8), moderate in 29.5% (AUDIT score 8-19) and high in 4.1% (AUDIT score 20-40) of the patients. The proportion of men was higher among those with moderate (48%) and high (79.1%) alcohol use compared with those with low (26.4%) alcohol use (p < 0.001). Compared to the low risk group, patients with high risk alcohol use were younger (mean age of 33.6 vs 38.4 years; p < 0.05). In the high and moderate alcohol risk groups there was a trend towards lower levels of adherence to ART (VAS 78.5/88.1/93.3, p > 0.05), more depressive feelings (CES-D 12.7/9.3/8.1, p > 0.05) and more stigma experience (stigma score: 3.2/2.2/2.3, p > 0.05) compared to the low risk alcohol group. The higher the alcohol risk, the lower the quality of life, the higher the use of tobacco and the higher the frequency of sexual intercourses and sexual intercourses without condom use. Body mass index was significantly lower in the high alcohol risk groups compared to the low alcohol risk group (21.2 (95% CI 19.1;23.2) versus 24.7 (95% CI 24.1;25.2)). Conclusion: A high number of patients with HIV infection were found to be risky alcohol users which impacted negatively on ART adherence, sexual risk behaviour and quality of life."									
169	Phosphatidylethanol (PEth) as a biomarker of alcohol consumption in HIV-positive patients in sub-Saharan Africa.	"Hahn JA, Dobkin LM, Mayanja B, Emenyonu NI, Kigozi IM, Shiboski S, Bangsberg DR, et al."	Alcoholism: Clinical and Experimental Research. 2012;36(5):854-62.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20123191133	"Background: Alcohol is heavily consumed in sub-Saharan Africa and affects HIV transmission and treatment and is difficult to measure. Our goal was to examine the test characteristics of a direct metabolite of alcohol consumption, phosphatidylethanol (PEth). Methods: Persons infected with HIV were recruited from a large HIV clinic in southwestern Uganda. We conducted surveys and breath alcohol concentration (BRAC) testing at 21 daily home or drinking establishment visits, and blood was collected on day 21 (n=77). PEth in whole blood was compared with prior 7-, 14-, and 21-day alcohol consumption. Results: (i) The receiver operator characteristic area under the curve (ROC-AUC) was highest for PEth versus any consumption over the prior 21 days (0.92; 95% confidence interval [CI]: 0.86 to 0.97). The sensitivity for any detectable PEth was 88.0% (95% CI: 76.0 to 95.6) and the specificity was 88.5% (95% CI: 69.8 to 97.6). (ii) The ROC-AUC of PEth versus any 21-day alcohol consumption did not vary with age, body mass index, CD4 cell count, hepatitis B virus infection, and antiretroviral therapy status, but was higher for men compared with women (p=0.03). (iii) PEth measurements were correlated with several measures of alcohol consumption, including number of drinking days in the prior 21days (Spearman r=0.74, p<0.001) and BRAC (r=0.75, p<0.001). Conclusions: The data add support to the body of evidence for PEth as a useful marker of alcohol consumption with high ROC-AUC, sensitivity, and specificity. Future studies should further address the period and level of alcohol consumption for which PEth is detectable."									
88	Is HIV-2-induced AIDS different from HIV-1-associated AIDS? Data from a West African clinic.	"Martinez-Steele E, Awasana AA, Corrah T, Sabally S, Sande Mvd, Jaye A, Togun T, et al."	Aids. 2007;21(3):317-24.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20073051769	"Background: Although AIDS is less frequent following HIV-2 than HIV-1 infection, it is unclear whether the clinical picture and clinical course of AIDS are similar in the two infections. Objectives: To compare the pattern of AIDS-defining events, CD4 cell count at the time of AIDS diagnosis, survival from time of AIDS, and CD4 cell count near time of death in HIV-1 and HIV-2-infected patients. Methods: Adult patients with AIDS who attended the clinics of the MRC in The Gambia were enrolled. AIDS was diagnosed according to the expanded World Health Organization case definition for AIDS surveillance (1994). Results: Three hundred and forty-one AIDS patients with HIV-1 and 87 with HIV-2 infection were enrolled. The most common AIDS-defining events in both infections were the wasting syndrome and pulmonary tuberculosis. The median CD4 cell count at AIDS was 109 cells/ micro l in HIV-1 and 176 in HIV-2 (P=0.01) and remained significantly higher in HIV-2 after adjustment for age and sex (P=0.03). The median time to death was 6.3 months in HIV-1 and 12.6 months in HIV-2-infected patients (P=0.03). In a multivariable analysis adjusting for age, sex and CD4 cell count, the mortality rates of HIV-1 and HIV-2-infected patients were similar (P=0.25). The median CD4 cell count near time of death was 62 and 120 cells/ micro l in HIV-1 and HIV-2-infected patients, respectively (P=0.02). Conclusions: HIV-2 patients have a higher CD4 cell count at the time of AIDS, and a longer survival after AIDS. The mortality after an AIDS diagnosis is more influenced by CD4 cell count than HIV type."									
368	Gastric and intestinal barrier impairment in tropical enteropathy and HIV: limited impact of micronutrient supplementation during a randomised controlled trial.	"Kelly P, Shawa T, Mwanamakondo S, Soko R, Smith G, Barclay GR, Sanderson IR."	BMC Gastroenterology. 2010;10:72.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=20604937	"BACKGROUND: Although micronutrient supplementation can reduce morbidity and mortality due to diarrhoea, nutritional influences on intestinal host defence are poorly understood. We tested the hypothesis that micronutrient supplementation can enhance barrier function of the gut."	"METHODS: We carried out two sub-studies nested within a randomised, double-blind placebo-controlled trial of daily micronutrient supplementation in an urban community in Lusaka, Zambia. In the first sub-study, gastric pH was measured in 203 participants. In the second sub-study, mucosal permeability, lipopolysaccharide (LPS) and anti-LPS antibodies, and serum soluble tumour necrosis factor receptor p55 (sTNFR55) concentrations were measured in 87 participants. Up to three stool samples were also analysed microbiologically for detection of asymptomatic intestinal infection. Gastric histology was subsequently analysed in a third subset (n = 37) to assist in interpretation of the pH data. Informed consent was obtained from all participants after a three-stage information and consent process."	"RESULTS: Hypochlorhydria (fasting gastric pH > 4.0) was present in 75 (37%) of participants. In multivariate analysis, HIV infection (OR 4.1; 95%CI 2.2-7.8; P < 0.001) was associated with hypochlorhydria, but taking anti-retroviral treatment (OR 0.16; 0.04-0.67; P = 0.01) and allocation to micronutrient supplementation (OR 0.53; 0.28-0.99; P < 0.05) were protective. Hypochlorhydria was associated with increased risk of salmonellosis. Mild (grade 1) gastric atrophy was found in 5 participants, irrespective of Helicobacter pylori or HIV status. Intestinal permeability, LPS concentrations in serum, anti-LPS IgG, and sTNFR55 concentrations did not differ significantly between micronutrient and placebo groups. Anti-LPS IgM was reduced in the micronutrient recipients (P <0.05)."	CONCLUSIONS: We found evidence of a specific effect of HIV on gastric pH which was readily reversed by anti-retroviral therapy and not mediated by gastric atrophy. Micronutrients had a modest impact on gastric pH and one marker of bacterial translocation.	TRIAL REGISTRATION: Current Controlled Trials ISRCTN31173864.					
1601	Incidence of Treatment-Limiting toxicity with Stavudine-Based antiretroviral therapy in Cambodia: A retrospective cohort study.	"Phan V, Thai S, Choun K, Lynen L, van Griensven J."	PLoS ONE. 2012 27 Jan;7(1).		"Background: Although stavudine (D4T) remains frequently used in low-income countries in Asia, associated long-term toxicity data are scarce. The aim of this study was to determine the long-term incidence of severe D4T-toxicity (requiring drug substitution) and associated risk factors in HIV-infected Cambodians up to six years on antiretroviral treatment (ART). Methodology/Principal Findings: This is a retrospective analysis of an observational cohort, using data from an ART program with systematic monitoring for D4T-toxicity. Probabilities of time to D4T substitution due to suspected D4T toxicity (treatment-limiting D4T toxicity) were calculated, a risk factor analysis was performed using multivariate Cox regression modelling. Out of 2581 adults initiating a D4T-containing regimen, D4T was replaced in 276 (10.7%) patients for neuropathy, 14 (0.5%) for lactic acidosis and 957 (37.1%) for lipoatrophy. The main early side effect was peripheral neuropathy (7.0% by 1 year). After the first year, lipoatrophy became predominant, with a cumulative incidence of 56.1% and 72.4% by 3 and 6 years respectively. Older age (aHR 1.8; 95%CI: 1.4-2.3) and lower baseline haemoglobin (aHR 1.7; 95%CI: 1.4-2.2) were associated with the occurrence of neuropathy. Being female (aHR 3.8; 95%CI: 1.1-12.5), a higher baseline BMI (aHR 12.6; 95%CI: 3.7-43.1), and TB treatment at ART initiation (aHR 8.6; 95%CI: 2.7-27.5) increased the likelihood of lactic acidosis. Lipoatrophy was positively associated with female gender (aHR 2.3; 95%CI: 2.0-2.6), an older age (aHR 1.3; 95%CI: 1.1-1.4), and a CD4 count <200 cells/muL (aHR 1.3; 95%CI: 1.1-1.5). Conclusions: Stavudine-based treatment regimens in low-income countries are associated with significant long-term toxicities, predominantly lipoatrophy. Close clinical monitoring for toxicity with timely D4T substitution is recommended. Phasing-out of stavudine should be implemented, as costs allows. 2012 Phan et al."									
1603	Outcomes of Multidrug-Resistant Tuberculosis Treatment with Early Initiation of Antiretroviral Therapy for HIV Co-Infected Patients in Lesotho.	"Satti H, McLaughlin MM, Hedt-Gauthier B, Atwood SS, Omotayo DB, Ntlamelle L, Seung KJ."	PLoS ONE. 2012 24 Oct;7(10).		"Background: Although the importance of concurrent treatment for multidrug-resistant tuberculosis (MDR-TB) and HIV co-infection has been increasingly recognized, there have been few studies reporting outcomes of MDR-TB and HIV co-treatment. We report final outcomes of comprehensive, integrated MDR-TB and HIV treatment in Lesotho and examine factors associated with death or treatment failure. Methods: We reviewed clinical charts of all adult patients who initiated MDR-TB treatment in Lesotho between January 2008 and September 2009. We calculated hazard ratios (HR) and used multivariable Cox proportional hazards regression to identify predictors of poor outcomes. Results: Of 134 confirmed MDR-TB patients, 83 (62%) were cured or completed treatment, 46 (34%) died, 3 (2%) transferred, 1 (1%) defaulted, and 1 (1%) failed treatment. Treatment outcomes did not differ significantly by HIV status. Among the 94 (70%) patients with HIV co-infection, 53% were already on antiretroviral therapy (ART) before MDR-TB treatment initiation, and 43% started ART a median of 16 days after the start of the MDR-TB regimen. Among HIV co-infected patients who died, those who had not started ART before MDR-TB treatment had a shorter median time to death (80 days vs. 138 days, p = 0.065). In multivariable analysis, predictors of increased hazard of failure or death were low and severely low body mass index (HR 2.75, 95% confidence interval [CI] 1.27-5.93; HR 5.50, 95% CI 2.38-12.69), and a history of working in South Africa (HR 2.37, 95% CI 1.24-4.52). Conclusions: Favorable outcomes can be achieved in co-infected patients using a community-based treatment model when both MDR-TB and HIV disease are treated concurrently and treatment is initiated promptly. 2012 Satti et al."									
404	"Risk factors in hospital deaths in severely malnourished children in Kampala, Uganda."	"Bachou H, Tumwine JK, Mwadime RK, Tylleskar T."	BMC Pediatrics. 2006;6:7.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medc&AN=16542415	"BACKGROUND: Although the risk factors for increased fatality among severely malnourished children have been reported, recent information from Africa, during a period of HIV pandemic and constrained health services, remains sketchy. The aim of this study has been to establish the risk factors for excess deaths among hospitalized severely malnourished children of below five years of age."	"METHOD: In 2003, two hundred and twenty consecutively admitted, severely malnourished children were followed in the paediatric wards of Mulago, Uganda's national referral and teaching hospital. The children's baseline health conditions were established by physical examination, along with haematological, biochemical, microbiological and immunological indices."	"RESULTS: Of the 220 children, 52 (24%) died, with over 70% of the deaths occurring in the first week of admission. There was no significant difference by sex or age group. The presence of oedema increased the adjusted odds-ratio, but did not reach significance (OR = 2.0; 95% CI = 0.8 - 4.7), similarly for a positive HIV status (OR = 2.6, 95% CI = 0.8 - 8.6). Twenty four out of 52 children who received blood transfusion died (OR = 5.0, 95% CI = 2 - 12); while, 26 out of 62 children who received intravenous infusion died (OR = 4.8, 95% CI = 2 - 12). The outcome of children who received blood or intravenous fluids was less favourable than of children who did not receive them. Adjustment for severity of disease did not change this."	CONCLUSION: The main risk factors for excess hospital deaths among severely malnourished children in Mulago hospital include blood transfusion and intravenous infusion. An intervention to reduce deaths needs to focus on guideline compliance with respect to blood transfusions/infusions.						
414	Predictors of mortality in HIV-1 infected children on antiretroviral therapy in Kenya: a prospective cohort.	"Wamalwa DC, Obimbo EM, Farquhar C, Richardson BA, Mbori-Ngacha DA, Inwani I, Benki-Nugent S, et al."	BMC pediatrics. 2010;10:33.		"BACKGROUND: Among children, early mortality following highly active antiretroviral therapy (HAART) remains high. It is important to define correlates of mortality in order to improve outcome. METHODS: HIV-1-infected children aged 18 months-12 years were followed up at Kenyatta National Hospital, Nairobi after initiating NNRTI-based HAART. Cofactors for mortality were determined using multivariate Cox regression models. RESULTS: Between August 2004 and November 2008, 149 children were initiated on HAART of whom 135 were followed for a total of 238 child-years (median 21 months) after HAART initiation. Baseline median CD4% was 6.8% and median HIV-1-RNA was 5.98-log10 copies/ml. Twenty children (13.4%) died at a median of 35 days post-HAART initiation. Mortality during the entire follow-up period was 8.4 deaths per 100 child-years (46 deaths/100 child-years in first 4 months and 1.0 deaths/100 child-years after 4 months post-HAART initiation). On univariate Cox regression, baseline hemoglobin (Hb) <9 g/dl, weight-for-height z-score (WHZ) < -2, and WHO clinical stage 4 were associated with increased risk of death (Hb <9 g/dl HR 3.00 [95% C.I. 1.21-7.39], p = 0.02, WHZ < -2 HR 3.41 [95% C.I. 1.28-9.08], p = 0.01, and WHO clinical stage 4, HR 3.08 [1.17-8.12], p = 0.02). On multivariate analysis Hb < 9 g/dl remained predictive of mortality after controlling for age, baseline CD4%, WHO clinical stage and weight-for-height z-score (HR 2.95 (95% C.I. 1.04-8.35) p = 0.04). CONCLUSION: High early mortality was observed in this cohort of Kenyan children receiving HAART, and low baseline hemoglobin was an independent risk factor for death."									
1214	Nutrition outcomes of HIV-infected malnourished adults treated with ready-to-use therapeutic food in sub-Saharan Africa: a longitudinal study.	"Ahoua L, Umutoni C, Huerga H, Minetti A, Szumilin E, Balkan S, Olson DM, et al."	Journal of the International AIDS Society. 2011;14:2.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=21219607	"BACKGROUND: Among people living with HIV/AIDS, nutritional support is increasingly recognized as a critical part of the essential package of care, especially for patients in sub-Saharan Africa. The objectives of the study were to evaluate the outcomes of HIV-positive malnourished adults treated with ready-to-use therapeutic food and to identify factors associated with nutrition programme failure."	"METHODS: We present results from a retrospective cohort analysis of patients aged 15 years or older with a body mass index of less than 17 kg/m2 enrolled in three HIV/AIDS care programmes in Africa between March 2006 and August 2008. Factors associated with nutrition programme failure (patients discharged uncured after six or more months of nutritional care, defaulting from nutritional care, remaining in nutritional care for six or more months, or dead) were investigated using multiple logistic regression."	"RESULTS: Overall, 1340 of 8685 (15.4%) HIV-positive adults were enrolled in the nutrition programme. At admission, median body mass index was 15.8 kg/m2 (IQR 14.9-16.4) and 12% received combination antiretroviral therapy (ART). After a median of four months of follow up (IQR 2.2-6.1), 524 of 1106 (47.4%) patients were considered cured. An overall total of 531 of 1106 (48.0%) patients failed nutrition therapy, 132 (11.9%) of whom died and 250 (22.6%) defaulted from care. Men (OR = 1.5, 95% CI 1.2-2.0), patients with severe malnutrition at nutrition programme enrolment (OR = 2.2, 95% CI 1.7-2.8), and those never started on ART (OR = 4.5, 95% CI 2.7-7.7 for those eligible; OR = 1.6, 95% CI 1.0-2.5 for those ineligible for ART at enrolment) were at increased risk of nutrition programme failure. Diagnosed tuberculosis at nutrition programme admission or during follow up, and presence of diarrhoeal disease or extensive candidiasis at admission, were unrelated to nutrition programme failure."	"CONCLUSIONS: Concomitant administration of ART and ready-to-use therapeutic food increases the chances of nutritional recovery in these high-risk patients. While adequate nutrition is necessary to treat malnourished HIV patients, development of improved strategies for the management of severely malnourished patients with HIV/AIDS are urgently needed."						
415	Reducing stillbirths: prevention and management of medical disorders and infections during pregnancy.	"Menezes EV, Yakoob MY, Soomro T, Haws RA, Darmstadt GL, Bhutta ZA."	BMC Pregnancy & Childbirth. 2009;9 Suppl 1:S4.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=19426467	"BACKGROUND: An estimated two-thirds of the world's 3.2 million stillbirths occur antenatally, prior to labour, and are often overlooked in policy and programs. Poorly recognised, untreated or inadequately treated maternal infections such as syphilis and malaria, and maternal conditions including hypertensive disorders, are known risk factors for stillbirth."	"METHODS: We undertook a systematic review of the evidence for 16 antenatal interventions with the potential to prevent stillbirths. We searched a range of sources including PubMed and the Cochrane Library. For interventions with prior Cochrane reviews, we conducted additional meta-analyses including eligible newer randomised controlled trials following the Cochrane protocol. We focused on interventions deliverable at the community level in low-/middle-income countries, where the burden of stillbirths is greatest."	"RESULTS: Few of the studies we included reported stillbirth as an outcome; most that did were underpowered to assess this outcome. While Cochrane reviews or meta-analyses were available for many interventions, few focused on stillbirth or perinatal mortality as outcomes, and evidence was frequently conflicting. Several interventions showed clear evidence of impact on stillbirths, including heparin therapy for certain maternal indications; syphilis screening and treatment; and insecticide-treated bed nets for prevention of malaria. Other interventions, such as management of obstetric intrahepatic cholestasis, maternal anti-helminthic treatment, and intermittent preventive treatment of malaria, showed promising impact on stillbirth rates but require confirmatory studies. Several interventions reduced known risk factors for stillbirth (e.g., anti-hypertensive drugs for chronic hypertension), yet failed to show statistically significant impact on stillbirth or perinatal mortality rates. Periodontal disease emerged as a clear risk factor for stillbirth but no interventions have reduced stillbirth rates."	"CONCLUSION: Evidence for some newly recognised risk factors for stillbirth, including periodontal disease, suggests the need for large, appropriately designed randomised trials to test whether intervention can minimise these risks and prevent stillbirths. Existing evidence strongly supports infection control measures, including syphilis screening and treatment and malaria prophylaxis in endemic areas, for preventing antepartum stillbirths. These interventions should be incorporated into antenatal care programs based on attributable risks and burden of disease."						
1182	Predictors of postoperative complications in HIV-infected children undergoing surgery.	"Karpelowsky JS, Zar HJ, van Bogerijen G, van der Graaf N, Millar AJ."	Journal of Pediatric Surgery. 2011;46(4):674-8.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=21496536	BACKGROUND: An increasing number of HIV-infected children require a surgical procedure. The aim of this study was to investigate factors associated with the development of complications in HIV-infected children undergoing surgery.	"METHODS: A prospective study of HIV-infected children younger than 60 months undergoing surgery at a tertiary referral pediatric hospital from July 2004 to July 2008 was performed. Children were followed postoperatively for the development of complications, length of stay, and mortality."	"RESULTS: Eighty-two HIV-infected children, with a median age of 11.5 months (interquartile range, 6-24 months), were enrolled. Most (68; 82.9%) had World Health Organization stage 3 or 4 HIV disease, 72 (88%) had Centers for Disease Control and Prevention stage 2 or 3 disease, and 60 (73%) were taking highly active antiretroviral therapy. Half (41; 50%) were underweight, 37 (45.1%) underwent emergency surgery, 28 (34.2%) required major surgery, and 40 (48.7%) had surgical site contamination at the time of surgery. The median length of hospital stay was 4 days (interquartile range, 2-14 days), and in-hospital mortality was 6 (7%). Thirty-four (42%) children developed 37 complications. On univariate analysis, malnutrition, HIV stage, or type of surgery was not associated with development of complications. In contrast, young age (6 vs 13.5 months; P = .0004), low hemoglobin (9.6 vs 10.5 g/dL; P = .04), or having a major procedure (14 [42%] vs 9 [18%]; P = .03; relative risk, 2.2 [1.2-4.8]) was associated with complications. On logistic regression, younger age (odds ratio = 4.3; P = .004; 95% confidence interval, 1.6-11.9) and major surgery (odds ratio = 6.8; P = .001; 95% confidence interval, 1.5-31.4) were associated with development of a complication."	CONCLUSION: Young age and major surgery were the main predicators of complications in HIV-infected children undergoing surgery. Copyright 2011 Elsevier Inc. All rights reserved.						
1181	Predictors of postoperative complications in HIV-infected children undergoing surgery.	"Karpelowsky JS, Zar HJ, Bogerijen Gv, Graaf Nvd, Millar AJW."	Journal of Pediatric Surgery. 2011;46(4):674-8.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20113152349	"Background: An increasing number of HIV-infected children require a surgical procedure. The aim of this study was to investigate factors associated with the development of complications in HIV-infected children undergoing surgery. Methods: A prospective study of HIV-infected children younger than 60 months undergoing surgery at a tertiary referral pediatric hospital from July 2004 to July 2008 was performed. Children were followed postoperatively for the development of complications, length of stay, and mortality. Results: Eighty-two HIV-infected children, with a median age of 11.5 months (interquartile range, 6-24 months), were enrolled. Most (68; 82.9%) had World Health Organization stage 3 or 4 HIV disease, 72 (88%) had Centers for Disease Control and Prevention stage 2 or 3 disease, and 60 (73%) were taking highly active antiretroviral therapy. Half (41; 50%) were underweight, 37 (45.1%) underwent emergency surgery, 28 (34.2%) required major surgery, and 40 (48.7%) had surgical site contamination at the time of surgery. The median length of hospital stay was 4 days (interquartile range, 2-14 days), and in-hospital mortality was 6 (7%). Thirty-four (42%) children developed 37 complications. On univariate analysis, malnutrition, HIV stage, or type of surgery was not associated with development of complications. In contrast, young age (6 vs 13.5 months; P=.0004), low hemoglobin (9.6 vs 10.5 g/dL; P=.04), or having a major procedure (14 [42%] vs 9 [18%]; P=.03; relative risk, 2.2 [1.2-4.8]) was associated with complications. On logistic regression, younger age (odds ratio=4.3; P=.004; 95% confidence interval, 1.6-11.9) and major surgery (odds ratio=6.8; P=.001; 95% confidence interval, 1.5-31.4) were associated with development of a complication. Conclusion: Young age and major surgery were the main predicators of complications in HIV-infected children undergoing surgery."									
612	"Anaemia in women of reproductive age in Dar-es-Salaam, Tanzania."	"Massawe SN, Urassa EN, Nystrom L, Lindmark G."	East African medical journal. 2002 Sep;79(9):461-6.		"BACKGROUND: Anaemia is among the greatest health problems in reproductive age women in developing countries. OBJECTIVES: To estimate the prevalence of anaemia among non-pregnant parous women, and to investigate the main underlying cause for the anaemia. SETTING: A sub-urban Maternal and Child Health Clinic (MCH) in Dar es Salaam. DESIGN: Cross-sectional. METHODS: Consecutive parous non-pregnant women who had brought their children for vaccination and/or had come for family planning to Mbagala MCH clinic were invited to participate in the study. Obstetric and social history was recorded, and their height and weight were checked. Haemoglobin was measured using HemoCue hemoglobinometer. Anaemic women were further investigated to determine the cause of anaemia by haematological and biochemical tests. RESULTS: Five hundred and four parous non-pregnant women were screened, 49% were anaemic (Hb <12 g/dl) and 1.6% severely anaemic (Hb <7 g/dl). Anaemia was not related to socio-demographic and obstetric history characteristics, but decreased significantly with increasing Body Mass Index (BMI) (p=0.042). The prevalence of anaemia was significantly lower in women using hormonal contraceptives, compared to non-users (36% vs 54%) (p=0.04). Eighty-seven percent of the anaemic women were iron deficient and 8.7% had elevated serum C-reactive protein indicating undiagnosed infections. CONCLUSION: Nutritional deficiencies in women have to be corrected before and between pregnancies and all contacts women have with the health system should be utilised for anaemia control interventions, in addition to long-term community approaches. To improve maternal health calls for a broader agenda and a change of approach in the MCH-clinics."									
1792	"Iron status and anaemia of chronic disease in HIV-infected African women in Mangaung, Bloemfontein."	"Walsh CM, Hattingh Z, Veldman FJ, Bester CJ."	South African Family Practice. 2010 January/February;52(1):55-9.		"Background: Anaemia occurs widely among people living with HIV/AIDS. The aim of this study was to investigate the effect of HIV status on iron status, more specifically to investigate the nutritional health of women between 25 and 44 years of age. Methods: An epidemiological study was undertaken in Mangaung, a black residential community of Bloemfontein in the Free State (South Africa). A random sample consisted of 500 women in two age groups (25-34 [n = 273] and 35-44 years [n = 215]). Blood specimens were collected in ethyldimethylacetic acid collection tubes according to standard procedures. Respondents fasted overnight, abstained from exercise and avoided consuming alcohol and caffeine for 24 hours prior to collection of the blood specimens. All specimens were taken in the morning. A full blood count was performed using a Coulter Microdiff 18 Cell Counter. The metabolic variables haematocrit (Hct), haemoglobin (Hb), serum iron, ferritin and transferrin were determined. The red blood cell count was performed to calculate the mean corpuscular volume (MCV), mean corpuscular haemoglobin (MCH) and mean corpuscular haemoglobin concentration (MCHC). Age and HIV-status groups were described and compared by nonparametric methods. A p-value lower than 0.05 was considered significant. HIV-infected and -uninfected groups were compared by 95% confidence intervals for the difference in the percentage of women with parameters below or above the normal range. Results: Sixty-one per cent of the younger women and 38% of the older women were HIV infected. The percentage with serum ferritin levels below 20 mug/L was higher in HIV-uninfected women, ranging from 0% in older HIV-infected women to 10.4% in younger HIV-uninfected women. A large percentage of women had elevated transferrin values, ranging from 23.9% in older HIV-infected women to 44.8% in older HIV-uninfected women. A large percentage of women had anaemia of chronic disease, with HIV-infected women afflicted more often. Conclusion: The results of the study indicate that prevalence of HIV infection in Mangaung is high, especially among women between 25 and 34 years of age. Although the parameters of iron status on average did not indicate iron deficiency in the different age and HIV-status groups, a large percentage of women did have anaemia of chronic disease, with HIV-infected women afflicted more often. Knowledge of the HIV status of a patient is of paramount importance in evaluating laboratory results of iron levels to determine future treatment or nutritional recommendations. HIV-infected and -uninfected individuals might not be comparable regarding their laboratory results to interpret iron store depletion, with consequences for further therapeutic actions in these two groups. The progression rate to AIDS might also be enhanced by certain interventions. SAAFP."									
413	Anemia and growth failure among HIV-infected children in India: a retrospective analysis.	"Shet A, Mehta S, Rajagopalan N, Dinakar C, Ramesh E, Samuel NM, Indumathi CK, et al."	BMC Pediatrics. 2009;9:37.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=19531242	"BACKGROUND: Anemia and poor nutrition have been previously described as independent risk factors for death among HIV-infected children. We sought to describe nutritional status, anemia burden and HIV disease correlates among infected children in India."	"METHODS: We analyzed retrospective data from 248 HIV-infected children aged 1-12 years attending three outpatient clinics in South India (2004-2006). Standard WHO definitions were used for anemia, HIV staging and growth parameters. Statistical analysis included chi square, t tests, univariate and multivariate logistic regression analyses."	"RESULTS: The overall prevalence of anemia (defined as hemoglobin < 11 gm/dL) was 66%, and 8% had severe anemia (Hb < 7 gm/dL). The proportion of underweight and stunted children in the population was 55% and 46% respectively. Independent risk factors of anemia by multivariate analysis included the pre-school age group (age younger than 6 years) (OR: 2.87; 95% CI: 1.45, 5.70; p < 0.01), rural residence (OR: 12.04; 95% CI: 5.64, 26.00; p < 0.01), advanced HIV disease stage (OR: 6.95; 95% CI: 3.06, 15.79; p < 0.01) and presence of stunting (Height-for-age Z Score < -2) (OR: 3.24; 95% CI: 1.65, 6.35; p < 0.01). Use of iron/multivitamin supplementation was protective against risk of anemia (OR: 0.44; 95% CI: 0.22, 0.90; p = 0.03). Pulmonary tuberculosis was an independent risk factor in multivariate analysis (OR: 3.36; 95% CI: 1.43, 7.89; p < 0.01) when correlated variables such as HIV disease stage and severe immunodeficiency, and nutritional supplement use were not included. Use of antiretroviral therapy (ART) was associated with a reduced risk of anemia (OR: 0.29; 95% CI: 0.16, 0.53; p < 0.01). No significant association was found between anemia and gender, cotrimoxazole, or ART type (zidovudine versus stavudine)."	"CONCLUSION: The high prevalence and strong interrelationship of anemia and poor nutrition among HIV-infected children in India, particularly those living in rural areas underscores the need for incorporating targeted nutritional interventions during national scale up of care, support and treatment among HIV-infected children."						
403	Anemia and growth failure among HIV-infected children in India: a retrospective analysis.	"Anita S, Mehta S, Nirmala R, Chitra D, Elango R, Samuel NM, Indumathi CK, et al."	BMC Pediatrics. 2009;9(37).	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20093213758	"Background: Anemia and poor nutrition have been previously described as independent risk factors for death among HIV-infected children. We sought to describe nutritional status, anemia burden and HIV disease correlates among infected children in India. Methods: We analyzed retrospective data from 248 HIV-infected children aged 1-12 years attending three outpatient clinics in South India (2004-2006). Standard WHO definitions were used for anemia, HIV staging and growth parameters. Statistical analysis included chi square, t tests, univariate and multivariate logistic regression analyses. Results: The overall prevalence of anemia (defined as hemoglobin <11 gm/dL) was 66%, and 8% had severe anemia (Hb<7 gm/dL). The proportion of underweight and stunted children in the population was 55% and 46% respectively. Independent risk factors of anemia by multivariate analysis included the pre-school age group (age younger than 6 years) (OR: 2.87; 95% CI: 1.45, 5.70; p<0.01), rural residence (OR: 12.04; 95% CI: 5.64, 26.00; p<0.01), advanced HIV disease stage (OR: 6.95; 95% CI: 3.06, 15.79; p<0.01) and presence of stunting (Height-for-age Z Score <-2) (OR: 3.24; 95% CI: 1.65, 6.35; p<0.01). Use of iron/multivitamin supplementation was protective against risk of anemia (OR: 0.44; 95% CI: 0.22, 0.90; p=0.03). Pulmonary tuberculosis was an independent risk factor in multivariate analysis (OR: 3.36; 95% CI: 1.43, 7.89; p<0.01) when correlated variables such as HIV disease stage and severe immunodeficiency, and nutritional supplement use were not included. Use of antiretroviral therapy (ART) was associated with a reduced risk of anemia (OR: 0.29; 95% CI: 0.16, 0.53; p<0.01). No significant association was found between anemia and gender, cotrimoxazole, or ART type (zidovudine versus stavudine). Conclusion: The high prevalence and strong interrelationship of anemia and poor nutrition among HIV-infected children in India, particularly those living in rural areas underscores the need for incorporating targeted nutritional interventions during national scale up of care, support and treatment among HIV-infected children."									
212	Etiology of anemia in pregnancy in south Malawi.	"van den Broek NR, Letsky EA."	American Journal of Clinical Nutrition. 2000;72(1 Suppl):247S-56S.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=10871590	"BACKGROUND: Anemia in pregnancy is a major public health problem in developing countries. In sub-Saharan Africa, such anemia is generally accepted as resulting from nutritional deficiencies, particularly iron deficiency."	OBJECTIVE: We comprehensively assessed the full spectrum of nutritional and nonnutritional factors associated with pregnancy anemia.	"DESIGN: Iron, folate, vitamin B-12, and vitamin A were measured in serum in a cross-sectional study of 150 pregnant women in Blantyre, Malawi. Bone marrow aspirates were evaluated, peripheral blood films were examined for malaria parasites, stool and urine samples were examined for helminthic infection, and tests were done for genetic disorders and for HIV infection. C-reactive protein (CRP) concentrations and erythrocyte sedimentation rates were measured as markers of inflammation."	"RESULTS: Of the 150 anemic women, 23% were iron deficient with no evidence of folate, vitamin B-12, or vitamin A deficiencies; 32% were deficient in iron and one or more of the other micronutrients; 26% were not iron deficient but had evidence of one of the other micronutrient deficiencies, most often vitamin A; and 19% were not deficient in any of the micronutrients studied. CRP concentrations were notably high in 54% of the anemic women with no nutritional deficiencies and in 73.5% of the anemic women who were iron replete by bone marrow assessment."	CONCLUSION: The role of chronic inflammation as a possible contributing factor to anemia in pregnancy has important implications for the clinical evaluation and treatment of women. [References: 56]					
182	Multivitamin supplementation improves hematologic status in HIV-infected women and their children in Tanzania.	"Fawzi WW, Msamanga GI, Kupka R, Spiegelman D, Villamor E, Mugusi F, Wei R, et al."	American Journal of Clinical Nutrition. 2007;85(5):1335-43.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=17490971	BACKGROUND: Anemia is a frequent complication among HIV-infected persons and is associated with faster disease progression and mortality.	OBJECTIVE: We examined the effect of multivitamin supplementation on hemoglobin concentrations and the risk of anemia among HIV-infected pregnant women and their children.	"DESIGN: HIV-1-infected pregnant women (n = 1078) from Dar es Salaam, Tanzania, were enrolled in a double-blind trial and provided daily supplements of preformed vitamin A and beta-carotene, multivitamins (vitamins B, C, and E), preformed vitamin A and beta-carotene + multivitamins, or placebo. All women received iron and folate supplements only during pregnancy according to local standard of care. The median follow-up time for hemoglobin measurement for mothers was 57.3 mo [interquartile range (IQR): 28.6-66.8] and for children it was 28.0 mo (IQR: 5.3-41.7)."	"RESULTS: During the whole period, hemoglobin concentrations among women who received multivitamins were 0.33 g/dL higher than among women who did not receive multivitamins (P=0.07). Compared with placebo, multivitamin supplementation resulted in a hemoglobin increase of 0.59 g/dL during the first 2 y after enrollment (P=0.0002). Compared with placebo, the children born to mothers who received multivitamins had a reduced risk of anemia. In this group, the risk of macrocytic anemia was 63% lower than in the placebo group (relative risk: 0.37: 95% CI: 0.18, 0.79; P=0.01)."	"CONCLUSION: Multivitamin supplementation provided during pregnancy and in the postpartum period resulted in significant improvements in hematologic status among HIV-infected women and their children, which provides further support for the value of multivitamin supplementation in HIV-infected adults."					
202	"Effect of maternal and neonatal vitamin A supplementation and other postnatal factors on anemia in Zimbabwean infants: a prospective, randomized study."	"Miller MF, Stoltzfus RJ, Iliff PJ, Malaba LC, Mbuya NV, Zimbabwe Vitamin AfM, Babies Project Study G, et al."	American Journal of Clinical Nutrition. 2006;84(1):212-22.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=16825698	BACKGROUND: Anemia is prevalent in infants in developing countries. Its etiology is multifactorial and includes vitamin A deficiency.	OBJECTIVE: Our primary aim was to measure the effect of maternal or neonatal vitamin A supplementation (or both) on hemoglobin and anemia in Zimbabwean infants. Our secondary aim was to identify the underlying causes of postnatal anemia.	"DESIGN: A randomized, placebo-controlled trial was conducted in 14 110 mothers and their infants; 2854 infants were randomly selected for the anemia substudy, of whom 1592 were successfully observed for 8-14 mo and formed the study sample. Infants were randomly assigned within 96 h of delivery to 1 of 4 treatment groups: mothers and infants received vitamin A; mothers received vitamin A and infants received placebo; mothers received placebo and infants received vitamin A; and mothers and infants received placebo. The vitamin A doses were 400,000 and 50,000 IU in the mothers and infants, respectively."	"RESULTS: Vitamin A supplementation had no effect on hemoglobin or anemia (hemoglobin <105 g/L) in unadjusted or adjusted analyses. Infant HIV infection independently increased anemia risk >6-fold. Additional predictors of anemia in HIV-negative and -positive infants were male sex and lower total body iron at birth. In addition, in HIV-positive infants, the risk of anemia increased with early infection, low maternal CD4+ lymphocyte count at recruitment, and frequent morbidity. Six-month plasma ferritin concentrations <12 microg/L were a risk factor in HIV-negative but not in HIV-positive infants. Maternal HIV infection alone did not cause anemia."	CONCLUSION: Prevention of infantile anemia should include efforts to increase the birth endowment of iron and prevent HIV infection.					
201	"Effect of maternal and neonatal vitamin A supplementation and other postnatal factors on anemia in Zimbabwean infants: a prospective, randomized study."	"Miller MF, Stoltzfus RJ, Iliff PJ, Malaba LC, Mbuya NV, Humphrey JH."	American Journal of Clinical Nutrition. 2006;84(1):212-22.	http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=2009228984&site=ehost-live	"BACKGROUND: Anemia is prevalent in infants in developing countries. Its etiology is multifactorial and includes vitamin A deficiency. OBJECTIVE: Our primary aim was to measure the effect of maternal or neonatal vitamin A supplementation (or both) on hemoglobin and anemia in Zimbabwean infants. Our secondary aim was to identify the underlying causes of postnatal anemia. DESIGN: A randomized, placebo-controlled trial was conducted in 14 110 mothers and their infants; 2854 infants were randomly selected for the anemia substudy, of whom 1592 were successfully observed for 8-14 mo and formed the study sample. Infants were randomly assigned within 96 h of delivery to 1 of 4 treatment groups: mothers and infants received vitamin A; mothers received vitamin A and infants received placebo; mothers received placebo and infants received vitamin A; and mothers and infants received placebo. The vitamin A doses were 400 000 and 50 000 IU in the mothers and infants, respectively. RESULTS: Vitamin A supplementation had no effect on hemoglobin or anemia (hemoglobin <105 g/L) in unadjusted or adjusted analyses. Infant HIV infection independently increased anemia risk >6-fold. Additional predictors of anemia in HIV-negative and -positive infants were male sex and lower total body iron at birth. In addition, in HIV-positive infants, the risk of anemia increased with early infection, low maternal CD4(+) lymphocyte count at recruitment, and frequent morbidity. Six-month plasma ferritin concentrations <12 microg/L were a risk factor in HIV-negative but not in HIV-positive infants. Maternal HIV infection alone did not cause anemia. CONCLUSION: Prevention of infantile anemia should include efforts to increase the birth endowment of iron and prevent HIV infection. Copyright © 2006 American Society for Nutrition"									
399	Reliability of anthropometric measures in a longitudinal cohort of patients initiating ART in West Africa.	"Sicotte M, Ledoux M, Zunzunegui MV, Ag Aboubacrine S, Nguyen VK, group A."	BMC Medical Research Methodology. 2010;10:102.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=20969785	"BACKGROUND: Anthropometric measurements are a non invasive, inexpensive, and suitable method for evaluating the nutritional status in population studies with relatively large sample sizes. However, anthropometric techniques are prone to errors that could arise, for example, from the inadequate training of personnel. Despite these concerns, anthropometrical measurement error is seldom assessed in cohort studies. We describe the reliability and challenges associated with measurement of longitudinal anthropometric data in a cohort of West African HIV+ adults ."	"METHODS: In a cohort of patients initiating antiretroviral treatment in Mali, we evaluated nutritional status using anthropometric measurements(weight, height, mid-upper arm circumference, waist circumference and triceps skinfold). Observers with no prior experience in the field of anthropometry were trained to perform anthropometrical measurements. To assess the intra- and inter-observer variability of the measurements taken in the course of the study, two sub-studies were carried out: one at the beginning and one at the end of the prospective study. Twelve patients were measured twice on two consecutive days by the same observer on both study occasions. The technical error of measurement (TEM) (absolute and relative value), and the coefficient of reliability (R) were calculated and compared across reliability studies."	"RESULTS: According to the R and relative TEM, inter-observer reliabilities were only acceptable for height and weight. In terms of intra-observer precision, while the first and second anthropometrists demonstrated better reliability than the third, only height and weight measurements were reliable. Looking at total TEM, we observed that while measurements remained stable between studies for height and weight, circumferences and skinfolds lost precision from one occasion to the next."	"CONCLUSIONS: Height and weight were the most reliable measurements under the study's conditions. Circumferences and skinfolds demonstrated less reliability and lost precision over time, probably as a result of insufficient supervision over the entire length of the study. Our results underline the importance of a careful observer's selection, good initial preparation, as well as the necessity of ongoing training and supervision over the entire course of a longitudinal nutritional study. Failure to do so could have major repercussions on data reliability and jeopardize its utilization."						
879	Antioxidant nutritional status and superoxide dismutase (SOD) levels in school-aged children infected with human immunodeficiency virus.	"Vega Patin R, Ceragioli Oliveira FL, De Menezes Succi RC, Silverio Amancio OM, Thome Barbosa Gouvea ADF, Zanin Palchetti C, MacHado DM, et al."	International Journal of Infectious Diseases. 2010 March;14:e72.		"Background: Antioxidant micronutrients play an important role in HIV infection. Deficiencies of micronutrients are associated with immune deficiency, rapid disease progression and mortality. The aim of the study was evaluate antioxidant nutritional status in prepubertal school-aged children in two situations: HIV exposure and the control group. Methods: Prospective transversal study including 51 HIV-infected children attended at the Pediatric Infectious Disease Clinic - Universidade Federal de Sao Paulo, Sao Paulo city, Brazil and their respective exposed siblings not infected by HIV (n = 31) and the ones not exposed to HIV (n = 32). Antioxidant substances related to the clinical, dietary and biochemical variables in the groups were evaluated. Results: Vitamin A, C, E, beta-carotene, licopene, zinc and copper intake and plasma levels of vitamins A, C, E, beta-carotene, serum copper and superoxide dismutase (SOD) and protein C reactive, did not significantly differ in the groups. Major probability of vitamin A inadequacy was identified in the HIV-infected group (43.1%) as well as in the exposed but non-infected by HIV (48.4%), when compared to the non-exposed to HIV (37.5%) (P > 0.05). Lower rates of dietary vitamin E in HIV-infected children with inadequate trans fatty acid intake (P < 0.005) were verified. In the three studied groups, vitamin E correlated to the dietary saturated and polyunsaturated fatty acid (P < 0.007). Lower rates of the erythrocyte and serum zinc (P < 0.02) were verified in the HIV-infected children, when compared to the other groups. In the same group, correlation between dietary and biochemical values for vitamin C (r = 0.34; P = 0.01) and serum zinc (r = 0.37; P = 0.008); serum copper with SOD (r = 0.30) and with serum zinc (r = 0.43) and an inverse correlation of the erythrocyte zinc with the serum copper (r = -0.31) and with SOD (r = -0.50) were found. Plasma levels of vitamin E, licopene and betacarotene were related to CD4 count (P < 0.05) but negatively to the viral load (P < 0.02). Conclusion: HIV-infected school-aged children without severe infectious processes in the last year presented oxidative stress by the chronic viral infection, allied to infectious processes, promoting increase in the demand of antioxidant. Interdisciplinary accompaniment has become essential, emphasizing adequate dietary in antioxidant micronutrient intake by HIV-infected children."									
1480	"Very early anthropometric changes after antiretroviral therapy predict subsequent survival, in Karonga, Malawi."	"Maman D, Glynn JR, Crampin AC, Kranzer K, Saul J, Jahn A, Mwinuka V, et al."	Open AIDS Journal. 2012;6(1):36-44.		"Background: Antiretroviral (ART) scale-up in Malawi has been achieved on a large scale based mainly on clinical criteria. Simple markers of prognosis are useful, and we investigated the value of very early anthropometric changes in predicting mortality. Methods: Principal findings: Adult patients who initiated ART in Karonga District, northern Malawi, between September 2005 and August 2006 were included in a prospective cohort study, and followed for up to one year. We used Cox regression to examine the association between anthropometric changes at 2 and 6 weeks and deaths within the first year. 573 patients were included, of whom 59% were women; the median age at initiation was 37 and 64% were in WHO stage 4. Both body mass index (BMI) and mid-upper arm circumference (MUAC) increased linearly with increased time on ART, and were closely correlated with each other. There were 118 deaths. After 2 weeks on ART, a BMI increase of <0.5 kg/m<sup>2</sup> (HR 2.47, 95%CI 1.24-4.94, p=0.005) or a MUAC increase of <0.5cm (HR 2.79, 95%CI 1.19-6.55, p=0.008) were strong predictors of death, and these associations were stronger after adjusting for baseline charactertistics. Similar results were found after 6 weeks on ART. Conclusions: Very early anthropometric changes, after 2 and 6 weeks on ART, are strong predictors of survival, independent of baseline characteristics. This should help identify patients requiring more detailed assessment where facilities are limited. MUAC is particularly valuable, requiring the simplest equipment and being appropriate for patients who have problems standing. Maman et al."									
955	Treatment outcomes from the largest antiretroviral treatment program in Myanmar (Burma): a cohort analysis of retention after scale-up.	"Sabapathy K, Ford N, Khin Nyein C, Moe Kyaw K, Elema R, Smithuis F, Floyd S."	"JAIDS, Journal of Acquired Immune Deficiency Syndromes. 2012;60(2):e53-e62."	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20123198179	"Background: Antiretroviral treatment (ART) coverage in Myanmar is well below average. This study describes retention and baseline predictors of prognosis from the largest ART program in the country. Methods: A cohort analysis of adult patients who initiated ART during 2003-2007 was conducted, with follow-up until the end of 2009. The primary outcome was attrition [death plus losses to follow-up (LTF)]. Baseline variables were assessed as potential risk factors. The cumulative probabilities of death, LTF, and attrition up to 5 years were described using Kaplan-Meier estimates. Cox regression was used to calculate hazard ratios of attrition, overall and separately for 2 time periods on ART: 1-6 and 7-36 months. Results: A total of 5963 adults enrolled in the program, providing 17,581 person-years of follow-up. Median age at baseline was 33 years [interquartile range (IQR): 28-38], 61% were men, 45% were in World Health Organization stage IV, and the median CD4 count was 71 cells per cubic millimeter (IQR: 29-164). There were 821 (13.8%) deaths and 389 (6.5%) LTF over the study period, with a 72% probability of being retained in care in the 5-year cohort. Double the rate of loss was contributed by death compared with LTF, and attrition was almost 4 times higher in the period 1-6 months compared with 7-36 months. In the multivariable analyses of the program overall, older age [adjusted hazard ratio (aHR): 1.56, 95% confidence interval (CI): 1.25 to 1.94], being male (aHR: 1.52, 95% CI: 1.25 to 1.85), World Health Organization stage IV (aHR: 1.44, 95% CI: 1.19 to 1.74), and body mass index <16 kg/m<sup>2</sup> (aHR: 2.13, 95% CI: 1.71 to 2.66) were independently predictive of attrition. Conclusions: The excellent retention over >6 years in this large cohort demonstrates that ART delivery at the primary care level in Myanmar is feasible and should encourage support for further ART expansion in the country."									
1602	Predictors of Change in CD4 Lymphocyte Count and Weight among HIV Infected Patients on Anti-Retroviral Treatment in Ethiopia: A Retrospective Longitudinal Study.	"Reda AA, Biadgilign S, Deribew A, Gebre B, Deribe K."	PLoS ONE. 2013 03 Apr;8(4).		"Background: Antiretroviral treatment (ART) has been introduced in Ethiopia a decade ago and continues to be scaled up. However, there is dearth of literature on the impact of ART on changes in CD4 lymphocyte count and weight among patients on treatment. Objective: To determine the predictors of change in CD4 lymphocyte count and weight among HIV/AIDS infected patients taking antiretroviral treatment in eastern Ethiopia. Methods: A retrospective cohort study was conducted among HIV/AIDS patients taking ART from 2005 to 2010. A sample of 1540 HIV infected adult patients who started antiretroviral therapy in hospitals located in eastern Ethiopia were included in the study. The primary outcomes of interest were changes in CD4 count and weight. Descriptive statistics and multivariable regression analyses were performed to examine the outcomes among the cohort. Results: Both the median CD4 lymphocyte counts and weight showed improvements in the follow up periods. The multivariate analysis shows that the duration of ART was an important predictor of improvements in CD4 lymphocyte count (beta 7.91; 95% CI 7.48-8.34; p 0.000) and weight (beta 0.15; 95% CI 0.13-0.18; p 0.000). Advanced WHO clinical stage, lower baseline CD4 cell count, and baseline hemoglobin levels were factors associated with decline in weight. Actively working patients had higher CD4 lymphocyte count and weight compared to those that were ambulatory (p<0.05). Conclusion: We detected a substantial increment in weight and CD4 lymphocyte count among the patients who were taking ART in eastern Ethiopia. Patients who are of older age, with low initial CD4 lymphocyte count, late stage of the WHO clinical stages and lower hemoglobin level may need special attention. The reasons for the improved findings on CD4 count and weight throughout the five years of follow up merit further investigation. 2013 Reda et al."									
1040	"HIV lipodystrophy more prevalent in women than men in Tamil Nadu, India."	"Jacob SM, Kalyanasunderam AP, Kumar ER, Anitha D, Hemalatha R, Sivakumar MR."	Journal of AIDS and Clinical Research. 2012;3(3).	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20133136878	"Background: As antiretroviral therapy (ART) becomes more available to the HIV infected population in rural areas in India, it is important to determine the prevalence of its long term complications. Therefore, it was proposed to find out the prevalence of lipodystrophy in patients receiving ART and compare the gender differences. Material and methods: In this cross sectional study, consenting HIV-infected patients on ART visiting Namakkal District Head Quarters Hospital, Tamil Nadu, India, were recruited. They were on generic first-line fixed dose combinations of ART. Sociodemographics, anthropometric measurements, ART regimens and duration of treatment were recorded. Patients' self-perception of lipodystrophy was obtained using standardized questionnaires and clinically confirmed by the physician. An overnight fasting blood was drawn to determine serum lipids levels. Statistical analysis included Chi-square test, student t-test and Mann Whitney U test. Results: There were 145 HIV-infected subjects (46.9% males, 53.1% females) receiving ART for a mean 29.4 months. Mean age of the males were 38.18+or-8.85 and for the females, it was 33.34+or-6.20. The mean body mass index (BMI) for the males was 21.95+or-3.94 kg/m<sup>2</sup> while for the females it was 21.14+or-3.54 kg/m<sup>2</sup>. The overall prevalence of lipodystrophy was 60.69%; 22.72% with lipohypertrophy, 51.14% with lipoatrophy, and 22.72% with mixed pattern. Women had a higher prevalence of lipodystrophy than men (p=0.004). Lipoatrophy was higher in females (p=0.015) and mixed pattern (p=0.015). There was a higher prevalence of facial atrophy, fat loss in arms, fat loss in legs and fat loss in buttocks among women compared to men. Women with lipodystrophy had higher BMI, CD4 counts, VLDL cholesterol and triglycerides. Conclusion: Women had significantly higher rates of generalized lipodystrophy and particularly lipoatrophy when compared with men taking first-line antiretroviral regimen. Compared with women without lipodystrophy, those with lipodystrophy had lipid abnormalities."									
719	"Illness, death, and macronutrients: adequacy of rural Mozambican household production of macronutrients in the face of HIV/AIDS."	"Donovan C, Massingue J."	Food & Nutrition Bulletin. 2007;28(2 Suppl):S331-8.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=17658079	"BACKGROUND: As the public sector and civil society develop intervention programs to deal with the HIV/ AIDS epidemic, there has been an increasing emphasis on the relationship between nutrition and the disease. Drug interventions may be ineffective, and the progression from HIV infection to full-blown AIDS may be accelerated without adequate nutrition. Mozambique is still fighting an increasing prevalence rate of HIV including in rural areas. Rural households in Mozambique rely heavily on their own agricultural production for the basic macronutrients."	"OBJECTIVES: To evaluate the extent to which household agricultural production of basic staples meets overall household needs for major macronutrients, comparing households affected and not directly affected by HIV/ AIDS and other major illnesses over two time periods. Methods. This research analyzes nationally representative panel data from rural household surveys conducted in 2002 and 2005 to evaluate whether households that have suffered the chronic illness or illness-related death of prime-age adult members (15 to 49 years of age) are more vulnerable to macronutrient gaps."	RESULTS: Households in the South and in the North with a male illness or death in 2002 produced significantly less macronutrients from crops in 2005 than nonaffected households. These households also had significantly lower income per adult equivalent.	"CONCLUSIONS: Mortality or illness from HIV/AIDS affects the ability of agricultural households dependent on own-food production to produce macronutrients. Interventions to improve access to food may be needed for affected households, particularly in light of their inability to recover over time. More analysis is needed to understand income sources, crop diversification, and access to macronutrients through the market."						
1554	"Effects of caffeine supplementation on oxidative stress, exercise-induced muscle damage and leukocytosis."	"Mahdavi R, Daneghian S, Homayouni A, Jafari A."	Pharmaceutical Sciences. 2012;18(3):177-82.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20133206126	"Background: Athletes use variety of ergogenic aids such as caffeine to improve their performance. Many factors such as oxidative stress, muscular-damage and decreased immune function may have negative effect on athletic performance. However effects of caffeine on mentioned factors in female athletes after supramaximal exercise are rare and obscure. Methods: In this double-blind, cross-over study, 26 female basketball players supplemented with 5 mg.kg<sup>-1</sup> caffeine or dextrose as a placebo followed by Wingate test. Blood samples were obtained before and 5 minutes post-exercise for determining the serum malondialdehyde (MDA), total antioxidant capacity (TAC), creatine kinase (CK) activity and blood's white blood cells (WBC). Kolmogrov-smirnov statistic test and paired t-test were used to analyze data. Results: After the Wingate test, WBC, lymphocyte, granulocyte count and serum MDA levels, were increased significantly in both groups (P<0.001). No significant differences were observed in increased levels between caffeine supplemented and placebo groups (P>0.05). Furthermore the changes in CK activity and TAC levels were not statistically significant in any of the groups (P>0.05). Conclusion: The findings indicated that 5 mg.kg<sup>-1</sup> caffeine supplementation did not have significant adverse effect on oxidative stress, exercise-induced muscle damage and leukocytosis after Wingate test."									
771	"Infant-feeding practices of mothers of known HIV status in Lusaka, Zambia."	"Omari AAA, Luo C, Kankasa C, Bhat GJ, Bunn J."	Health Policy and Planning. 2003;18(2):156-62.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh3&AN=20033096028	"Background: Between 25 and 44% of mother-to-child transmission (MTCT) of the human immunodeficiency virus (HIV) occurs through breastfeeding. As a result, feeding guidelines for infants of HIV-infected mothers are being formulated in many resource-poor countries. The impact of introducing these guidelines on mothers' actual feeding practices has not previously been examined. Infant-feeding practices of mothers of known HIV status who should have received advice during pre- and post-test HIV counselling were assessed and compared with those of uninfected mothers. Methods: Mothers of infants aged 2-12 months, 55 HIV-infected and 85 HIV-uninfected, were recruited from the HIV Family Support Unit in Lusaka, Zambia. HIV status was known to 121 of these mothers, who had all received pre- and post-test HIV counselling. Feeding practices were determined by verbal questionnaire. Results: All mothers breastfed but only 35% of infants below 4 months were exclusively breastfed (received breast milk only). HIV-infected mothers introduced fluids and weaned their infants significantly earlier than HIV-uninfected mothers (p=0.03 and p=0.002, respectively). Infants of HIV-infected mothers had significantly lower weight for age Z (WAZ) scores indicating poorer nutritional or health status (p=0.004). Commercial formula milk and cow's milk were used by 36 mothers as breast milk substitutes, and were introduced at a median age of 2.5 months. Thirteen mothers gave cow's milk, and no mother added water to cow's milk (as recommended), with two adding sugar and four adding salt. Conclusion: Infant-feeding practices of HIV-infected mothers differed significantly from HIV-uninfected mothers, and this may contribute to their poorer growth. Paradoxically these mothers feeding practice could be putting these infants at greater risk of both non-HIV-related morbidity and HIV transmission, as early introduction of foods other than breast milk may increase MTCT."									
790	The sexual health behaviour of HIV positive patients in an urban UK cohort.	"Pugh E, Pakianathan M, McCormick C, Webb H, Korley K, Patel S."	HIV Medicine. 2012 April;13:17.		"Background: BHIVA guidelines recommend a full sexual health screen upon diagnosis of HIV infection followed by yearly unless indicated by sexual practice. Each patient attending our service is offered an annual health check which currently covers body mass index calculation, smoking and alcohol history, cardiovascular and fracture risk, hepatitis screening and sexual health assessment. Methods: Annual health assessments were offered to all patients attending the outpatient clinic (n = 1199), and data were compiled onto a database. Sexual health data were further analysed. Results: 918/1199 (544, 59% male) were included: median age 44, median CD4 count 541/mm<sup>3</sup>, 91% on HAART. Ethnicity: 327 (36%) white, 426 (46%) black African, 79 (9%) black Caribbean/other, 86 (9%) other. Route of infection: 576 (63%) heterosexual, 311 (34%) MSM, 31 (3%) other. 709 (77%) were non-smokers and 536 (58%) did not drink alcohol. 71 reported oral sex only (66/71 male, 63/66 (95%) MSM). Condom use: 578/833 (69%) always, 183 (22%) sometimes, 72 (9%) never. Only 45/346 women < 55 yrs (13%) were using long acting contraception - IUD (33/346, 10%), depoprovera (7/ 346, 2%), sterilisation (5/346, 1%). Only 438/918 (48%) were aware of post exposure prophylaxis (PEP). 249 (27%) accepted a sexual health screen. 3% (7/ 249: all male, 5 MSM, 2 heterosexual) were identified with a new sexually transmitted infection (Chlamydia trachomatis n = 4, Gonorrhoea n = 4). Syphilis screening identified 10 cases (all MSM) of previously unknown infection. (Table Presented) Conclusion: Our nurse led annual health screen (uptake rate 77%, 918/1199) is an effective way to screen HIV positive patients allowing focussed targeted healthcare interventions. Understanding the sexual behaviour of our cohort ensures we individualise care and consider appropriate services that may be beneficial such as specialist contraceptive services, PEP awareness and risk reduction strategies."									
375	Antimicrobial resistance predicts death in Tanzanian children with bloodstream infections: a prospective cohort study.	"Blomberg B, Manji KP, Urassa WK, Tamim BS, Mwakagile DS, Jureen R, Msangi V, et al."	BMC Infectious Diseases. 2007;7:43.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=17519011	"BACKGROUND: Bloodstream infection is a common cause of hospitalization, morbidity and death in children. The impact of antimicrobial resistance and HIV infection on outcome is not firmly established."	"METHODS: We assessed the incidence of bloodstream infection and risk factors for fatal outcome in a prospective cohort study of 1828 consecutive admissions of children aged zero to seven years with signs of systemic infection. Blood was obtained for culture, malaria microscopy, HIV antibody test and, when necessary, HIV PCR. We recorded data on clinical features, underlying diseases, antimicrobial drug use and patients' outcome."	"RESULTS: The incidence of laboratory-confirmed bloodstream infection was 13.9% (255/1828) of admissions, despite two thirds of the study population having received antimicrobial therapy prior to blood culture. The most frequent isolates were klebsiella, salmonellae, Escherichia coli, enterococci and Staphylococcus aureus. Furthermore, 21.6% had malaria and 16.8% HIV infection. One third (34.9%) of the children with laboratory-confirmed bloodstream infection died. The mortality rate from Gram-negative bloodstream infection (43.5%) was more than double that of malaria (20.2%) and Gram-positive bloodstream infection (16.7%). Significant risk factors for death by logistic regression modeling were inappropriate treatment due to antimicrobial resistance, HIV infection, other underlying infectious diseases, malnutrition and bloodstream infection caused by Enterobacteriaceae, other Gram-negatives and candida."	"CONCLUSION: Bloodstream infection was less common than malaria, but caused more deaths. The frequent use of antimicrobials prior to blood culture may have hampered the detection of organisms susceptible to commonly used antimicrobials, including pneumococci, and thus the study probably underestimates the incidence of bloodstream infection. The finding that antimicrobial resistance, HIV-infection and malnutrition predict fatal outcome calls for renewed efforts to curb the further emergence of resistance, improve HIV care and nutrition for children."						
1611	"Association of pre-treatment nutritional status with change in CD4 count after antiretroviral therapy at 6, 12, and 24 months in Rwandan women."	"Kiefer E, Hoover DR, Shi Q, Dusingize JC, Cohen M, Mutimura E, Anastos K."	PLoS ONE [Electronic Resource]. 2011;6(12):e29625.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=22216334	BACKGROUND: Body mass index (BMI) independently predicts mortality in studies of HIV infected patients initiating antiretroviral therapy (ART). We hypothesized that poorer nutritional status would be associated with smaller gains in CD4 count in Rwandan women initiating ART.	"METHODS AND FINDINGS: The Rwandan Women's Interassociation Study and Assessment, enrolled 710 ART-naive HIV-positive and 226 HIV-negative women in 2005 with follow-up every 6 months. The outcome assessed in this study was change in CD4 count at 6, 12, and 24 months after ART initiation. Nutritional status measures taken prior to ART initiation were BMI; height adjusted fat free mass (FFMI); height adjusted fat mass (FMI), and sum of skinfold measurements. 475 women initiated ART. Mean (within 6 months) pre-ART CD4 count was 216 cells/L. Prior to ART initiation, the mean (+/-SD) BMI was 21.6 (+/-3.78) kg/m(2) (18.3% malnourished with BMI<18.5); and among women for whom the following were measured, mean FFMI was 17.10 (+/-1.76) kg/m(2); FMI 4.7 (+/-3.5) kg/m(2) and sum of skinfold measurements 4.9 (+/-2.7) cm. FFMI was significantly associated with a smaller change in CD4 count at 6 months in univariate analysis (-6.7 cells/uL per kg/m(2), p=0.03) only. In multivariate analysis after adjustment for covariates, no nutritional variable was associated with change in CD4 count at any follow up visit."	"CONCLUSION: In this cohort of African women initiating ART, no measure of malnutrition prior to ART was consistently associated with change in CD4 count at 6, 12, and 24 months of follow up, suggesting that poorer pre-treatment nutritional status does not prevent an excellent response to ART. 2011 Kiefer et al."							
1588	"Association of pre-treatment nutritional status with change in CD4 count after antiretroviral therapy at 6, 12, and 24 months in Rwandan women."	"Kiefer E, Hoover DR, Shi QH, Dusingize JC, Cohen M, Mutimura E, Anastos K."	PLoS ONE. 2011;27.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20123052240	"Background: Body mass index (BMI) independently predicts mortality in studies of HIV infected patients initiating antiretroviral therapy (ART). We hypothesized that poorer nutritional status would be associated with smaller gains in CD4 count in Rwandan women initiating ART. Methods and Findings The Rwandan Women's Interassociation Study and Assessment, enrolled 710 ART-naive HIV-positive and 226 HIV-negative women in 2005 with follow-up every 6 months. The outcome assessed in this study was change in CD4 count at 6, 12, and 24 months after ART initiation. Nutritional status measures taken prior to ART initiation were BMI; height adjusted fat free mass (FFMI); height adjusted fat mass (FMI), and sum of skinfold measurements. 475 women initiated ART. Mean (within 6 months) pre-ART CD4 count was 216 cells/ micro L. Prior to ART initiation, the mean (+or-SD) BMI was 21.6 (+or-3.78) kg/m<sup>2</sup> (18.3% malnourished with BMI<18.5); and among women for whom the following were measured, mean FFMI was 17.10 (+or-1.76) kg/m<sup>2</sup>; FMI 4.7 (+or-3.5) kg/m<sup>2</sup> and sum of skinfold measurements 4.9 (+or-2.7) cm. FFMI was significantly associated with a smaller change in CD4 count at 6 months in univariate analysis (-6.7 cells/uL per kg/m<sup>2</sup>, p=0.03) only. In multivariate analysis after adjustment for covariates, no nutritional variable was associated with change in CD4 count at any follow up visit. Conclusion: In this cohort of African women initiating ART, no measure of malnutrition prior to ART was consistently associated with change in CD4 count at 6, 12, and 24 months of follow up, suggesting that poorer pre-treatment nutritional status does not prevent an excellent response to ART."									
1778	Calculating BMI in HIV+ female adolescents: A case of shaping the health of adolescents in Zimbabwe: SHAZ! plus project.	Nhamo D.	Sexually Transmitted Infections. 2011 July;87:A311.		"Background: Body Mass Index (BMI) is a statistical measure which compares a person's weight and height. It is used to estimate a healthy body weight based on a person's height. This measure is pertinent to use in HIV positives since weight loss is used as a proxy measure for clinical progression of HIV disease in that more weight loss is associated with advancing disease and often precedes clinical symptoms. We sought to measure BMI among HIV+ female adolescents to see if this is the best tool to use in immunecompromised populations. Methods: Data were pulled out from an ongoing RCT entitled SHAZ! Plus. (N=650). It enrols HIV +ive female adolescents who are out of school. Data were collected at baseline, 6, 12 and 18- month follow-up visits, with the project facilitating ongoing care, ART and support to those in need of it. BMI was calculated using Adolphe Quetelet BMI calculator of weight in kg over height in m<sup>2</sup> (kg/m<sup>2</sup>). BMI prime 25 was also calculated and used to compare the BMI results. Sample of xx used. Results: 64.5% of the cohort had BMIs falling within normal ranges 18.5 to 25. 33.8% had BMIs of <18.5 and 0.16% had a BMI of >25. 64.5% had BMI prime that fell within normal ranges of 0.74 and 0.99. 33.8% had BMI prime of <0.74 and 0.16% had a BMI prime of >1.00. The average BMI at baseline was 19.35 Weight ranged from 25 to 70 at baseline, average was 47.71. Conclusion Results call for the need to come up with an adjusted BMI index for female adolescents who are immuno-compromised to use as a standard measure for optimal health. BMI however has it's shortcomings since it does not measure the actual body fat. In resource poor settings, a simple tool like weight lost or gained over time might be a good indicator of clinical progression of HIV as opposed to validated tools like the BMI."									
1575	Reduced quantitative ultrasound bone mineral density in HIV-infected patients on antiretroviral therapy in Senegal.	"Cournil A, Eymard-Duvernay S, Diouf A, Moquet C, Coutherut J, Gueye NFN, Cames C, et al."	PLoS ONE. 2012;7(2).	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20123110783	"Background: Bone status in HIV-infected patients on antiretroviral treatment (ART) is poorly documented in resource-limited settings. We compared bone mineral density between HIV-infected patients and control subjects from Dakar, Senegal. Methods: A total of 207 (134 women and 73 men) HIV-infected patients from an observational cohort in Dakar (ANRS 1215) and 207 age- and sex-matched controls from the general population were enrolled. Bone mineral density was assessed by quantitative ultrasound (QUS) at the calcaneus, an alternative to the reference method (i.e. dual X-absorptiometry), often not available in resource-limited countries. Results: Mean age was 47.0 (+or-8.5) years. Patients had received ART for a median duration of 8.8 years; 45% received a protease inhibitor and 27% tenofovir; 84% had undetectable viral load. Patients had lower body mass index (BMI) than controls (23 versus 26 kg/m<sup>2</sup>, P<0.001). In unadjusted analysis, QUS bone mineral density was lower in HIV-infected patients than in controls (difference: -0.36 standard deviation, 95% confidence interval (CI): -0.59;-0.12, P=0.003). Adjusting for BMI, physical activity, smoking and calcium intake attenuated the difference (-0.27, CI: -0.53;-0.002, P=0.05). Differences in BMI between patients and controls explained a third of the difference in QUS bone mineral density. Among patients, BMI was independently associated with QUS bone mineral density (P<0.001). An association between undetectable viral load and QUS bone density was also suggested ( beta =0.48, CI: 0.02;0.93; P=0.04). No association between protease inhibitor or tenofovir use and QUS bone mineral density was found. Conclusion: Senegalese HIV-infected patients had reduced QUS bone mineral density in comparison with control subjects, in part related to their lower BMI. Further investigation is needed to clarify the clinical significance of these observations."									
1564	Food insufficiency is associated with high-risk sexual behavior among women in Botswana and Swaziland.	"Weiser SD, Leiter K, Bangsberg DR, Butler LM, Percy-de Korte F, Hlanze Z, Phaladze N, et al."	PLoS Medicine / Public Library of Science. 2007;4(10):1589-97; discussion 98.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medc&AN=17958460	"BACKGROUND: Both food insufficiency and HIV infection are major public health problems in sub-Saharan Africa, yet the impact of food insufficiency on HIV risk behavior has not been systematically investigated. We tested the hypothesis that food insufficiency is associated with HIV transmission behavior."	"METHODS AND FINDINGS: We studied the association between food insufficiency (not having enough food to eat over the previous 12 months) and inconsistent condom use, sex exchange, and other measures of risky sex in a cross-sectional population-based study of 1,255 adults in Botswana and 796 adults in Swaziland using a stratified two-stage probability design. Associations were examined using multivariable logistic regression analyses, clustered by country and stratified by gender. Food insufficiency was reported by 32% of women and 22% of men over the previous 12 months. Among 1,050 women in both countries, after controlling for respondent characteristics including income and education, HIV knowledge, and alcohol use, food insufficiency was associated with inconsistent condom use with a nonprimary partner (adjusted odds ratio [AOR] 1.73, 95% confidence interval [CI] 1.27-2.36), sex exchange (AOR 1.84, 95% CI 1.74-1.93), intergenerational sexual relationships (AOR 1.46, 95% CI 1.03-2.08), and lack of control in sexual relationships (AOR 1.68, 95% CI 1.24-2.28). Associations between food insufficiency and risky sex were much attenuated among men."	CONCLUSIONS: Food insufficiency is an important risk factor for increased sexual risk-taking among women in Botswana and Swaziland. Targeted food assistance and income generation programs in conjunction with efforts to enhance women's legal and social rights may play an important role in decreasing HIV transmission risk for women.							
1607	Prevalence and characteristics associated with malnutrition at hospitalization among patients with acquired immunodeficiency syndrome in Brazil.	"Andrade CS, Jesus RP, Andrade TB, Oliveira NS, Nabity SA, Ribeiro GS."	PLoS ONE [Electronic Resource]. 2012;7(11):e48717.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=23144941	"BACKGROUND: Brazil's National STD/AIDS Program is considered a model of success worldwide. However, AIDS-associated malnutrition continues in subgroups of Brazilian patients despite access to free highly active antiretroviral therapy (HAART). We aimed to identify the prevalence of malnutrition and associated factors among patients hospitalized with AIDS."	"METHODS: We conducted a cross-sectional nutritional assessment among 127 adults hospitalized with AIDS in Brazil's third largest city. Using anthropometric measurements, we determined the prevalence of malnutrition (body mass index <18.5 kg/m2) at hospitalization. Prevalence ratios of malnutrition by demographic, socioeconomic, and clinical conditions were estimated using log-binomial regression."	"RESULTS: One-third of participants were first informed of their HIV disease during the current hospitalization and recent treatment interruption was common (71%) among those on HAART. Forty-three percent were malnourished and 35% had severe weight loss at admission. Patient characteristics independently associated with malnutrition were older age (2% increased prevalence for each year; 95% confidence interval [CI] 0-4%) and very low daily per capita household income. Living on <USD 2.00, USD 2.00-4.99 or USD 5.00-9.99 increased the prevalence of malnutrition by 2.01 (95% CI 1.06-3.81), 1.75 (95% CI 0.92-3.35) and 1.42 (95% CI 0.76-2.65) times, respectively, compared to >=USD 10.00 per day. Chronic diarrhea was marginally associated with malnutrition (RR 1.42; 95% CI 0.99-2.04). Overall, 16% of the patients died during hospitalization. We observed a trend toward higher in-hospital case fatality among malnourished patients (22% vs. 12% for patients with and without malnutrition, respectively; chi square P=0.14)."	"CONCLUSIONS: Unacceptably high rates of malnutrition persist in Brazilians hospitalized with AIDS and our results reinforce the importance of nutritional evaluations in these patients. Improved early testing and treatment adherence strategies may continue to help reduce AIDS-related morbidity and mortality in Brazil, yet novel interventions to disrupt the cycle of poverty, HIV, and malnutrition are also urgently needed."						
190	A lipid-based nutrient supplement mitigates weight loss among HIV-infected women in a factorial randomized trial to prevent mother-to-child transmission during exclusive breastfeeding.	"Kayira D, Bentley ME, Wiener J, Mkhomawanthu C, King CC, Chitsulo P, Chigwenembe M, et al."	American Journal of Clinical Nutrition. 2012;95(3):759-65.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=22258269	"BACKGROUND: Breastfeeding increases metabolic demands on the mother, and excessive postnatal weight loss increases maternal mortality."	"OBJECTIVE: We evaluated the efficacy of a lipid-based nutrient supplement (LNS) for prevention of excess weight loss in breastfeeding, HIV-infected women."	"DESIGN: The BAN (Breastfeeding, Antiretrovirals, and Nutrition) Study was a randomized controlled trial in Lilongwe, Malawi. At delivery, HIV-infected mothers and their infants were randomly assigned according to a 2-arm (with and without LNS) by 3-arm (maternal triple-antiretroviral prophylaxis, infant-nevirapine prophylaxis, or neither) factorial design. The 28-wk LNS intervention provided daily energy (700 kcal), protein (20 g), and micronutrients (except for vitamin A) to meet lactation needs. Women were counseled to breastfeed exclusively for 24 wk and to wean by 28 wk. Weight change (0-28 wk) was tested in an intent-to-treat analysis by using 2-factor ANOVA and with longitudinal mixed-effects models."	"RESULTS: At delivery, the LNS (n = 1184) and control (n = 1185) groups had similar mean weights and BMIs. Women receiving the LNS had less 0-28-wk weight loss (-1.97 compared with -2.56 kg, P = 0.003). This difference remained significant after adjustment for maternal antiretroviral drug therapy and baseline BMI. Women receiving antiretroviral drugs had more weight loss than did those not receiving antiretroviral drugs (-2.93 compared with -1.90 kg, P < 0.001). The benefit of the LNS for reducing weight loss was observed both in those receiving antiretroviral drugs (-2.56 compared with -3.32 kg, P = 0.019) and in those not receiving antiretroviral drugs (-1.63 compared with -2.16 kg, P = 0.034)."	"CONCLUSIONS: The LNS reduced weight loss among HIV-infected, breastfeeding women, both in those taking maternal antiretroviral prophylaxis to prevent postnatal HIV transmission and in those not receiving antiretroviral prophylaxis. Provision of an LNS may benefit HIV-infected, breastfeeding women in resource-limited settings. This trial was registered at clinicaltrials.gov as NCT00164762."					
189	A lipid-based nutrient supplement mitigates weight loss among HIV-infected women in a factorial randomized trial to prevent mother-to-child transmission during exclusive breastfeeding.	"Kayira D, Bentley ME, Wiener J, Mkhomawanthu C, King CC, Chitsulo P, Chigwenembe M, et al."	American Journal of Clinical Nutrition. 2012 01 Mar;95(3):759-65.		"Background: Breastfeeding increases metabolic demands on the mother, and excessive postnatal weight loss increases maternal mortality. Objective: We evaluated the efficacy of a lipid-based nutrient supplement (LNS) for prevention of excess weight loss in breastfeeding, HIV-infected women. Design: The BAN (Breastfeeding, Antiretrovirals, and Nutrition) Study was a randomized controlled trial in Lilongwe, Malawi. At delivery, HIV-infected mothers and their infants were randomly assigned according to a 2-arm (with and without LNS) by 3-arm (maternal triple-antiretroviral prophylaxis, infant-nevirapine prophylaxis, or neither) factorial design. The 28-wk LNS intervention provided daily energy (700 kcal), protein (20 g), and micronutrients (except for vitamin A) to meet lactation needs. Women were counseled to breastfeed exclusively for 24 wk and to wean by 28 wk. Weight change (0-28 wk) was tested in an intent-to-treat analysis by using 2-factor ANOVA and with longitudinal mixed-effects models. Results: At delivery, the LNS (n = 1184) and control (n = 1185) groups had similar mean weights and BMIs. Women receiving the LNS had less 0-28-wk weight loss (-1.97 compared with -2.56 kg, P = 0.003). This difference remained significant after adjustment for maternal antiretroviral drug therapy and baseline BMI. Women receiving antiretroviral drugs had more weight loss than did those not receiving antiretroviral drugs (-2.93 compared with -1.90 kg, P < 0.001). The benefit of the LNS for reducing weight loss was observed both in those receiving antiretroviral drugs (-2.56 compared with -3.32 kg, P = 0.019) and in those not receiving antiretroviral drugs (-1.63 compared with -2.16 kg, P = 0.034). Conclusions: The LNS reduced weight loss among HIV-infected, breastfeeding women, both in those taking maternal antiretroviral prophylaxis to prevent postnatal HIV transmission and in those not receiving antiretroviral prophylaxis. Provision of an LNS may benefit HIV-infected, breastfeeding women in resource-limited settings. This trial was registered at clinicaltrials.gov as NCT00164762. 2012 American Society for Nutrition."									
188	A lipid-based nutrient supplement mitigates weight loss among HIV-infected women in a factorial randomized trial to prevent mother-to-child transmission during exclusive breastfeeding.	"Kayira D, Bentley ME, Wiener J, Mkhomawanthu C, King CC, Chitsulo P, Chigwenembe M, et al."	American Journal of Clinical Nutrition. 2012;95(3):759-65.	http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=2011471779&site=ehost-live	"Background: Breastfeeding increases metabolic demands on the mother, and excessive postnatal weight loss increases maternal mortality. Objective: We evaluated the efficacy of a lipid-based nutrient supplement (LNS) for prevention of excess weight loss in breastfeeding, HIV-infected women. Design: The BAN (Breastfeeding, Antiretrovirals, and Nutrition) Study was a randomized controlled trial in Lilongwe, Malawi. At delivery, HIV-infected mothers and their infants were randomly assigned according to a 2-arm (with and without LNS) by 3-arm (maternal triple-antiretroviral prophylaxis, infant-nevirapine prophylaxis, or neither) factorial design. The 28-wk LNS intervention provided daily energy (700 kcal), protein (20 g), and micronutrients (except for vitamin A) to meet lactation needs. Women were counseled to breastfeed exclusively for 24 wk and to wean by 28 wk. Weight change (0-28 wk) was tested in an intent-to-treat analysis by using 2-factor ANOVA and with longitudinal mixed-effects models. Results: At delivery, the LNS (n = 1184) and control (n = 1185) groups had similar mean weights and BMIs. Women receiving the LNS had less 0-28-wk weight loss (-1.97 compared with -2.56 kg, P = 0.003). This difference remained significant after adjustment for maternal antiretroviral drug therapy and baseline BMI. Women receiving antiretroviral drugs had more weight loss than did those not receiving antiretroviral drugs (-2.93 compared with -1.90 kg, P < 0:001). The benefit of the LNS for reducing weight loss was observed both in those receiving antiretroviral drugs (-2.56 compared with -3.32 kg, P = 0.019) and in those not receiving antiretroviral drugs (-1.63 compared with -2.16 kg, P = 0.034). Conclusions: The LNS reduced weight loss among HIV-infected, breastfeeding women, both in those taking maternal antiretroviral prophylaxis to prevent postnatal HIV transmission and in those not receiving antiretroviral prophylaxis. Provision of an LNS may benefit HIV-infected, breastfeeding women in resource-limited settings. This trial was registered at clinicaltrials.gov as NCT00164762."									
406	Early cessation of breastfeeding amongst women in South Africa: an area needing urgent attention to improve child health.	"Doherty T, Sanders D, Jackson D, Swanevelder S, Lombard C, Zembe W, Chopra M, et al."	BMC Pediatrics. 2012;12:105.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=22827969	BACKGROUND: Breastfeeding is a critical component of interventions to reduce child mortality. Exclusive breastfeeding practice is extremely low in South Africa and there has been no improvement in this over the past ten years largely due to fears of HIV transmission. Early cessation of breastfeeding has been found to have negative effects on child morbidity and survival in several studies in Africa. This paper reports on determinants of early breastfeeding cessation among women in South Africa.	"METHODS: This is a sub group analysis of a community-based cluster-randomized trial (PROMISE EBF) promoting exclusive breastfeeding in three South African sites (Paarl in the Western Cape Province, and Umlazi and Rietvlei in KwaZulu-Natal) between 2006 and 2008 (ClinicalTrials.gov no: NCT00397150). Infant feeding recall of 22 food and fluid items was collected at 3, 6, 12 and 24 weeks postpartum. Women's experiences of breast health problems were also collected at the same time points. 999 women who ever breastfed were included in the analysis. Univariable and multivariable logistic regression analysis adjusting for site, arm and cluster, was performed to determine predictors of stopping breastfeeding by 12 weeks postpartum."	"RESULTS: By 12 weeks postpartum, 20% of HIV-negative women and 40% of HIV-positive women had stopped all breastfeeding. About a third of women introduced other fluids, most commonly formula milk, within the first 3 days after birth. Antenatal intention not to breastfeed and being undecided about how to feed were most strongly associated with stopping breastfeeding by 12 weeks (Adjusted odds ratio, AOR 5.6, 95% CI 3.4 - 9.5 and AOR 4.1, 95% CI 1.6 - 10.8, respectively). Also important was self-reported breast health problems associated with a 3-fold risk of stopping breastfeeding (AOR 3.1, 95%CI 1.7 - 5.7) and the mother having her own income doubled the risk of stopping breastfeeding (AOR 1.9, 95% CI 1.3 - 2.8)."	CONCLUSION: Early cessation of breastfeeding is common amongst both HIV-negative and positive women in South Africa. There is an urgent need to improve antenatal breastfeeding counselling taking into account the challenges faced by working women as well as early postnatal lactation support to prevent breast health problems.						
881	The prevalence and characteristics of metabolic syndrome in urban Malaysian HIV-infected patients.	"Yuhana MY, Kamarulzaman A, Pendek R, Ismail N."	International Journal of Infectious Diseases. 2012 June;16:e195.		"Background: Cardiovascular disease (CVD) and metabolic syndrome (MS) have become more prevalent among the HIV-infected patients. The purpose of this study is to describe the prevalence and characteristics of MS among the HIV-infected patients. Methods: All patients attending the HIV clinic in University of Malaya Medical Centre from July 2011until January 2012 were included. Patients with symptomatic HIV, established coronary heart disease, hypertension, dyslipidaemia and diabetes mellitus were excluded from the study. Patients were examined for blood pressure and anthropometric measurements. History of tobacco consumption, family history of CVD and history of exposure to highly active antiretroviral treatment (HAART) were also obtained. Biochemical analysis comprises oral glucose tolerance test, full lipid profiles (after a 10-hour fasting), CD4 cell counts and HIV RNA viral load. MS was confirmed using the Harmonized criteria (2009). Results: 126 patients were enrolled in this study. 109 (86.5%) were on HAART and 17 (13.5%) were HAART-naive. Prevalence of MS observed among the HIV-infected patients was 32.5%. The prevalence increased from 19.4% among the HIV-infected patients under age 40 years to 43.8% for those aged more than 40 (p = 0.02). HIV-infected patients with MS were more likely to be male (OR = 3.1; 95% CI:1.2-8.2) and have higher mean body mass index (BMI) (26.3 + 5.0 kg/m2; p < 0.05). Higher prevalence of MS observed in patients on HAART than HAART-naive, 33% and 29% respectively. Patients on HAART with MS were noted to have higher mean age (42.5 + 8.5, p < 0.05) and lower BMI (mean = 23.3 + 3.1 kg/m2; p < 0.05) compared to HAART-naive with MS. Total cholesterol and HDL-c were (5.3 + 1.0 mmol/L) and (1.3 + 0.3 mmol/L) respectively (p < 0.05). Duration of HAART was not a significant factor for MS. When individual HAART was analyzed Ritonavir contributes to MS (OR = 3.2; p = 0.045). Conclusion: There is high prevalence ofMSamong HIV-infected patients in Malaysia. Exposure to Ritonavir may increase the risk of developing MS. These study findings highlight the importance of implementing targeted measures in preventing CVD among HIVinfected patients."									
878	Risk of acute myocardial infarction predicted by RAMA-EGAT score among HIV-infected Thai patients.	"Suppadungsuk S, Yamwong S, Sungkanuparph S."	International Journal of Infectious Diseases. 2012 June;16:e192.		"Background: Cardiovascular disease has become important cause of death among HIV-infected patients. The risk of acute myocardial infarction (AMI) in HIV-infected Thai patients has never been evaluated. This study aimed to evaluate the risk of AMI using RAMA-EGAT score among HIV-infected patients in Ramathibodi Hospital. Methods: A cross-sectional study was carried out in HIVinfected patients who visited Infectious Disease Clinic at Ramathibodi Hospital, Mahidol University, Bangkok, Thailand between August and December 2011. The risk of AMI was determined using RAMA-EGAT risk in all patients. Patients were categorized into two groups according to the score: high risk (RAMA-EGAT score >=6) and low risk (RAMA-EGAT score < 6). Results: A total of 109 HIV-infected patients were studied. The mean age was 47.3 years old and 67% of patients were male. Mean duration of HIV infection was 8.5 years. Mean CD4 cell count was 485 cell/mm3. Twenty (18%) patients had hypertension and use antihypertensive drugs; 14 (13%) patients had diabetes mellitus. Almost all patients (99.1%) had received antiretroviral therapy (ART). Twenty (18%) patients had lipodystrophy as adverse drug effect. Mean body weight and body mass index (BMI) were 61.2 kg and 22.5 kg/M2, respectively. Of all, 12 (11%) patients had high risk. When patients were categorized into high and risk group, patients with high risk had older age (65.1vs45.6 years, p < 0.001), higher waist circumference (87.2vs80.2 cm, p = 0.006), higher systolic blood pressure (144vs130mmHg, p = 0.008). Hypertension (67%vs12%, p < 0.001) and diabetes (58%vs7%, p < 0.001) are also more common in high risk group. HDL had a trend toward lower in high risk group (40.3vs48.1 mg/dL, p = 0.075). In multivariate analysis, age [OR (per 5 yrs increased) 8.6; p = 0.005], diabetes [OR 63.1; p = 0.020] and HDL [OR (per 5mg/dl increased) 0.2, p = 0.020] were factors significantly associated with high EGAT risk score. Conclusion: Using RAMA-EGAT score, 11% of HIV-infected patients have high risk for AMI. Older age, presence of diabetes and low HDL level significantly predict the high risk for AMI. Early screening for diabetes and HDL level, as well as appropriate glycemic control and regular exercise intervention are crucial for preventing AMI in HIV-infected patients receiving ART in Thailand."									
1776	"A community LED decentralised and integrated approach for personalised prevention and care services to PLHIV in Karnataka, South India."	"Manish Kumar P, Jayanna K."	Sexually Transmitted Infections. 2011 July;87:A341.		"Background: Care and support for People living with HIV (PLHIV) is often limited to institutional settings with considerable time lag between diagnoses and access to care, and poor linkages with other social support services. The USAID supported Samastha project aimed to address the gaps through an innovative approach. Method Drop-in centres (DIC) were set up within the PLHIV networks as a hub of decentralised care and support. They offered psychosocial, outpatient medical care, positive prevention and nutritional services. To increase accessibility to general medical care, outreach clinics were clubbed with support group meetings and held in local government hospitals. The linkages to treatment, testing, screening for TB and institutional care were strengthened through referral systems, including accompaniment by outreach workers and coordination meetings at district level. All outreach workers were trained on government sponsored social entitlements and schemes for PLHIV and methods of assessing and addressing these needs. Results: By the fourth year of the project, 45 009 PLHIVs (53% female) had availed services of which 52% received clinical care, 99% of clinical visits screened for TB and 4% of PLHIV were treated for TB. 51% received positive prevention services, including treatment adherence counselling while 39% received treatment for minor OI and general ailments. 85% are registered at ARTcenter and 44% are on ART. 91% were provided with psychosocial support, 81% received nutritional support and 51% attended support group meetings. Nutrition and livelihood support were leveraged from other sources. Lessons Learned The Drop-in centre run by people living with HIV makes a continuum of care possible. In resource poor settings, DICs helps in early enrolment of PLHIVs into care, thereby resulting in timely initiation of treatment for HIV and TB and a qualitative improvement in the life of a PLHIV."									
984	Predictors of mortality in a cohort of HIV-1-infected adults in rural Africa.	"Erikstrup C, Kallestrup P, Zinyama R, Gomo E, Mudenge B, Gerstoft J, Ullum H."	Journal of Acquired Immune Deficiency Syndromes. 2007 April;44(4):478-83.		"BACKGROUND: CD4 cell count and plasma HIV RNA level are used to monitor HIV-infected patients in high-income countries, but the applicability in an African context with frequent concomitant infections has only been studied sparsely. Moreover, alternative inexpensive markers are needed in the attempts to roll out antiretroviral treatment in the region. We explored the prognostic strengths of classic and alternative progression markers in this study set in rural Zimbabwe. METHODS: We followed 196 treatment-naive HIV-1-infected patients from the Mupfure Schistosomiasis and HIV Cohort, Zimbabwe. CD4 cell count, HIV RNA level, hemoglobin (HB), total lymphocyte count (TLC), body mass index, clinical staging (Centers for Disease Control and Prevention [CDC] classification), and self-reported level of function (Karnofsky Performance Scale score) were assessed at baseline; participants were followed until death or last follow-up (3-4.3 years). RESULTS: All parameters except TLC predicted survival in univariate Cox models. HIV RNA level (P = 0.001), HB (P = 0.018), CD4 cell count (P = 0.047), and CDC category C (P = 0.007) remained significant in multivariate analysis. CONCLUSIONS: We found HIV RNA level and CD4 cell count to predict mortality with prognostic capabilities similar to findings from high-income countries. HB and clinical staging were strong independent predictors and might be considered candidates for alternative HIV progression markers. 2007 Lippincott Williams & Wilkins, Inc."									
1535	"Impact of human immunodeficiency virus 1 infection on clinical presentation, treatment outcome and survival in a cohort of Ethiopian children with tuberculosis."	"Palme IB, Gudetta B, Bruchfeld J, Muhe L, Giesecke J."	Pediatric Infectious Disease Journal. 2002;21(11):1053-61.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=12442029	"BACKGROUND: Childhood tuberculosis (TB) is difficult to diagnose reliably because signs and symptoms are nonspecific and sputum for direct microscopy is difficult to obtain, especially in very young children. This diagnostic dilemma is thought to have increased with the HIV pandemic. Few studies on treatment outcome of dually infected children in high endemic countries have been reported. This study examines the impact of HIV infection on clinical presentation, diagnostic criteria and treatment outcome of TB in Ethiopian children."	"METHODS: A prospective cohort study of children with TB diagnosed in Addis Ababa from December 1995 to January 1997 in which HIV-positive children were compared with HIV-negative children with regard to medical history, signs and symptoms, nutritional status, chest radiography, tuberculin skin test, response to TB treatment and final outcome. Mycobacterium tuberculosis was cultured in children with pulmonary manifestations."	"RESULTS: HIV-positive children were younger, were underweight and had a 6-fold higher mortality than HIV-negative children. The tuberculin skin test was less sensitive and chest radiography was less specific in HIV-infected patients. Adherence to treatment was high (96%), and the cure rate was 58% for HIV-positive and 89% for HIV-negative TB patients."	CONCLUSION: HIV-positive children are at risk of diagnostic error as well as delayed diagnosis of TB. TB manifestations are more severe and progression to death is more rapid than in HIV-negative children. Weight for age may be used to identify children at high risk of a fatal outcome.						
1460	A randomized trial of multivitamin supplementation in children with tuberculosis in Tanzania.	"Mehta S, Mugusi FM, Bosch RJ, Aboud S, Chatterjee A, Finkelstein JL, Fataki M, et al."	Nutrition Journal. 2011;10:120.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=22039966	"BACKGROUND: Children with tuberculosis often have underlying nutritional deficiencies. Multivitamin supplementation has been proposed as a means to enhance the health of these children; however, the efficacy of such an intervention has not been examined adequately."	"METHODS: 255 children, aged six weeks to five years, with tuberculosis were randomized to receive either a daily multivitamin supplement or a placebo in the first eight weeks of anti-tuberculous therapy in Tanzania. This was only 64% of the proposed sample size as the trial had to be terminated prematurely due to funding constraints. They were followed up for the duration of supplementation through clinic and home visits to assess anthropometric indices and laboratory parameters, including hemoglobin and albumin."	"RESULTS: There was no significant effect of multivitamin supplementation on the primary endpoint of the trial: weight gain after eight weeks. However, significant differences in weight gain were observed among children aged six weeks to six months in subgroup analyses (n=22; 1.08 kg, compared to 0.46 kg in the placebo group; 95% CI=0.12, 1.10; p=0.01). Supplementation resulted in significant improvement in hemoglobin levels at the end of follow-up in children of all age groups; the median increase in children receiving multivitamins was 1.0 g/dL, compared to 0.4 g/dL in children receiving placebo (p<0.01). HIV-infected children between six months and three years of age had a significantly higher gain in height if they received multivitamins (n=48; 2 cm, compared to 1 cm in the placebo group; 95% CI=0.20, 1.70; p=0.01; p for interaction by age group=0.01)."	"CONCLUSIONS: Multivitamin supplementation for a short duration of eight weeks improved the hematological profile of children with tuberculosis, though it didn't have any effect on weight gain, the primary outcome of the trial. Larger studies with a longer period of supplementation are needed to confirm these findings and assess the effect of multivitamins on clinical outcomes including treatment success and growth failure. CLINICALTRIALS.GOV IDENTIFIER: NCT00145184."						
783	Clinical outcomes of HIV-infected patients with Kaposi's sarcoma receiving nonnucleoside reverse transcriptase inhibitor-based antiretroviral therapy in Uganda.	"Asiimwe FM, Moore DM, Were W, Nakityo R, Campbell J, Barasa A, Mermin J, et al."	HIV Medicine. 2012 March;13(3):166-71.		"Background: Clinical outcomes for patients with Kaposi's sarcoma (KS) using nonnucleoside reverse transcriptase inhibitor (NNRTI)-based highly active antiretroviral therapy (HAART) in resource-limited settings have not previously been described. Methods: We evaluated HIV-infected patients aged >=18 years, who initiated HAART in the Home-Based AIDS Care (HBAC) project in Tororo, Uganda, between May 2003 and February 2008 and were diagnosed with KS at baseline or during follow-up. We examined independent risk factors for having either prevalent or incident KS and risk factors for death among patients with KS. Results: Of 1121 study subjects, 17 (1.5%) were diagnosed with prevalent KS and 18 (1.6%) with incident KS over a median of 56.1 months of follow-up. KS was associated with male sex [adjusted odds ratio (AOR) 2.41; 95% confidence interval (CI) 1.20-4.86] and baseline CD4 cell count <50 cells/muL (AOR 3.25; 95% CI 1.03-10.3). Eleven (65%) of 17 patients with prevalent KS and 13 (72%) of 18 patients with incident KS experienced complete regression (P=0.137). Eighteen (64%) of 28 patients who remained on NNRTI-based HAART experienced regression of their KS and six (86%) of seven patients who were switched to protease inhibitor-containing HAART regimens had regression of their KS (P=0.23). Mortality among those with KS was significantly associated with visceral disease (hazard ratio 19.22; 95% CI 2.42-152). Conclusion: Prevalent or incident KS was associated with 30% mortality. The resolution of KS lesions among individuals who initiated HAART with NNRTI-based regimens was similar to that found in studies using only protease inhibitor-based HAART. 2011 British HIV Association."									
1307	Daily co-trimoxazole prophylaxis in severely immunosuppressed HIV-infected adults in Africa started on combination antiretroviral therapy: an observational analysis of the DART cohort.	"Walker AS, Ford D, Gilks CF, Munderi P, Ssali F, Reid A, Katabira E, et al."	The Lancet. 2010;375(9722):1278-86.		"Background: Co-trimoxazole prophylaxis can reduce mortality from untreated HIV infection in Africa; whether benefits occur alongside combination antiretroviral therapy (ART) is unclear. We estimated the effect of prophylaxis after ART initiation in adults. Methods: Participants in our observational analysis were from the DART randomised trial of management strategies in HIV-infected, symptomatic, previously untreated African adults starting triple-drug ART with CD4 counts lower than 200 cells per muL. Co-trimoxazole prophylaxis was not routinely used or randomly allocated, but was variably prescribed by clinicians. We estimated effects on clinical outcomes, CD4 cell count, and body-mass index (BMI) using marginal structural models to adjust for time-dependent confounding by indication. DART was registered, number ISRCTN13968779. Findings: 3179 participants contributed 14 214 years of follow-up (8128 [57%] person-years on co-trimoxazole). Time-dependent predictors of co-trimoxazole use were current CD4 cell count, haemoglobin concentration, BMI, and previous WHO stage 3 or 4 events on ART. Present prophylaxis significantly reduced mortality (odds ratio 065, 95% CI 050-085; p=0001). Mortality risk reduction on ART was substantial to 12 weeks (041, 027-065), sustained from 12-72 weeks (056, 037-086), but not evident subsequently (096, 063-145; heterogeneity p=002). Variation in mortality reduction was not accounted for by time on co-trimoxazole or current CD4 cell count. Prophylaxis reduced frequency of malaria (074, 063-088; p=00005), an effect that was maintained with time, but we observed no effect on new WHO stage 4 events (086, 069-107; p=017), CD4 cell count (difference vs non-users, -3 cells per muL [-12 to 6]; p=050), or BMI (difference vs non-users, -004 kg/m<sup>2</sup> [-020 to 013); p=068]. Interpretation: Our results reinforce WHO guidelines and provide strong motivation for provision of co-trimoxazole prophylaxis for at least 72 weeks for all adults starting combination ART in Africa. Funding: UK Medical Research Council, the UK Department for International Development, the Rockefeller Foundation, GlaxoSmithKline, Gilead Sciences, Boehringer-Ingelheim, and Abbott Laboratories. 2010 Elsevier Ltd. All rights reserved."									
304	Estimating glomerular filtration rate in HIV-infected adults in Africa: comparison of Cockcroft-Gault and Modification of Diet in Renal Disease formulae.	"Stohr W, Walker AS, Munderi P, Tugume S, Gilks CF, Darbyshire JH, Hakim J, et al."	Antiviral Therapy. 2008;13(6):761-70.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=18839777	"BACKGROUND: Cockcroft-Gault (CG) and Modification of Diet in Renal Disease (MDRD) formulae are recommended for glomerular filtration rate (GFR) estimation, but neither has been validated or directly compared longitudinally in HIV-infected patients or in Africa."	"METHODS: We investigated differences between formulae in baseline GFR, GFR changes and incidence of impaired GFR after initiation of antiretroviral therapy (ART) in 3,316 HIV-infected adults in Africa, considering sex, age, body mass index and baseline laboratory parameters as predictors."	"RESULTS: Participants were 65% women, median age 36.8 years, median weight 56.7 kg. Baseline GFR was lower using CG (median 89 ml/min/1.73 m2, 7.4% <60 ml/min/1.73 m2) versus MDRD (103 ml/min/1.73 m2, 3.1% <60 ml/min/1.73 m2). At 36 weeks, median CG-GFR increased (92 ml/min/1.73 m2), whereas MDRD-GFR decreased (96 ml/min/1.73 m2). Weight (explicitly a factor in CG only) concurrently increased to 62.0 kg. GFR changes from weeks 36-96 (after weight stabilization) were similar across formulae. By 96 weeks, 56 patients developed severe GFR impairment (<30 ml/min/1.73 m2) using one or both formulae (both n=45, CG n=7, MDRD n=4) compared with only 24 by serum creatinine alone. Multivariate models identified different sets of predictors for each formula."	"CONCLUSIONS: Although severe GFR impairments are similarly classified by different formulae, moderate impairments were more frequently identified using CG-GFR versus MDRD-GFR (with Black ethnicity correction factor 1.21), and creatinine alone had low sensitivity. Given overestimation in underweight patients and sensitivity to weight changes, this MDRD formula might not necessarily be superior for monitoring ART in African HIV-infected adults."						
303	Estimating glomerular filtration rate in HIV-infected adults in Africa: Comparison of Cockcroft-gault and modification of diet in renal disease formulae.	"Stohr W, Walker AS, Munderi P, Tugume S, Gilks CF, Darbyshire JH, Hakim J."	Antiviral Therapy. 2008;13(6):761-70.		"Background: Cockcroft-Gault (CG) and Modification of Diet in Renal Disease (MDRD) formulae are recommended for glomerular filtration rate (GFR) estimation, but neither has been validated or directly compared longitudinally in HIV-infected patients or in Africa. Methods: We investigated differences between formulae in baseline GFR, GFR changes and incidence of impaired GFR after initiation of antiretroviral therapy (ART) in 3,316 HIV-infected adults in Africa, considering sex, age, body mass index and baseline laboratory parameters as predictors. Results: Participants were 65% women, median age 36.8 years, median weight 56.7 kg. Baseline GFR was lower using CG (median 89 ml/min/1.73 m<sup>2</sup>, 7.4% <60 ml/min/1.73 m<sup>2</sup>) versus MDRD (103 ml/min/1.73 m<sup>2</sup> , 3.1% <60 ml/min/1.73 m<sup>2</sup>). At 36 weeks, median CG-GFR increased (92 ml/min/ 1.73 m<sup>2</sup>), whereas MDRD-GFR decreased (96 ml/min/1.73 m<sup>2</sup>). Weight (explicitly a factor in CG only) concurrently increased to 62.0 kg. GFR changes from weeks 36-96 (after weight stabilization) were similar across formulae. By 96 weeks, 56 patients developed severe GFR impairment (<30 ml/min/1.73 m<sup>2</sup>) using one or both formulae (both n=45, CG n=7, MDRD n=4) compared with only 24 by serum creatinine alone. Multivariate models identified different sets of predictors for each formula. Conclusions: Although severe GFR impairments are similarly classified by different formulae, moderate impairments were more frequently identified using CG-GFR versus MDRD-GFR (with Black ethnicity correction factor 1.21), and creatinine alone had low sensitivity. Given overestimation in underweight patients and sensitivity to weight changes, this MDRD formula might not necessarily be superior for monitoring ART in African HIV-infected adults. 2008 International Medical Press."									
1781	Common mental disorder and associated factors amongst women with young infants in rural Malawi.	"Stewart RC, Bunn J, Vokhiwa M, Umar E, Kauye F, Fitzgerald M, Tomenson B, et al."	Social Psychiatry & Psychiatric Epidemiology. 2010;45(5):551-9.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=19609476	BACKGROUND: Common mental disorder (CMD) affecting women during the childbearing years is an important health problem in low and middle income countries. This study investigates CMD and associated factors amongst women with young infants in rural Malawi.	"METHODS: In this cross-sectional study, mothers of infants due for measles vaccination were recruited from a district hospital child health clinic. Maternal CMD was measured using a Chichewa version of the Self-Reporting Questionnaire (SRQ). DSM-IV diagnoses of major and minor depressive disorder were made using the structured clinical interview for DSM-IV (SCID). Socio-demographic, maternal and infant variables were measured and associations with CMD were determined."	"RESULTS: Of 519 eligible women, 501 were included in the analysis. Mean age was 24.4 years and median infant age was 9.9 months. The weighted prevalence of any current depressive episode (minor or major) was 30.4% (95% CI 22.8-38.1%). The weighted prevalence of current major depressive episode was 13.9% (95% CI 8.2-19.5%). Mean SRQ score for the total sample was 5.71 (SD 4.42). On multivariate analysis, SRQ score was significantly associated with lower socioeconomic status, lack of a confiding relationship with partner or relative, and recent infant illness. Amongst the women who knew their HIV status (n = 314), SRQ score was also associated with HIV infection."	"CONCLUSIONS: This study demonstrates that CMD is a significant health burden among women with infants in rural Malawi, and is associated with poverty, relationship difficulties, HIV infection and infant health problems."						
1222	Prevalence and factors associated with cryptococcal antigenemia among severely immunosuppressed HIV-infected adults in Uganda: A cross-sectional study.	"Oyella J, Meya D, Bajunirwe F, Kamya MR."	Journal of the International AIDS Society. 2012;15(1).		"Background: Cryptococcal infection is a common opportunistic infection among severely immunosuppressed HIV patients and is associated with high mortality. Positive cryptococcal antigenemia is an independent predictor of cryptococcal meningitis and death in patients with severe immunosuppression. We evaluated the prevalence and factors associated with cryptococcal antigenemia among patients with CD4 counts of 100 cells/mm<sup>3</sup> or less in Mulago Hospital, Kampala, Uganda. Screening of a targeted group of HIV patients may enable early detection of cryptococcal infection and intervention before initiating antiretroviral therapy. Factors associated with cryptococcal antigenemia may be used subsequently in resource-limited settings in screening for cryptococcal infection, and this data may also inform policy for HIV care. Methods. In this cross-sectional study, HIV-infected patients aged 18 years and older with CD4 counts of up to 100 cells/mm<sup>3</sup> were enrolled between December 2009 and March 2010. Data on socio-demographics, physical examinations and laboratory tests were collected. Factors associated with cryptococcal antigenemia were analyzed using multiple logistic regression. Results: We enrolled 367 participants and the median CD4 count was 23 (IQR 9-51) cells/mm<sup>3</sup>. Sixty-nine (19%) of the 367 participants had cryptococcal antigenemia. Twenty-four patients (6.5%) had cryptococcal meningitis on cerebrospinal fluid analysis and three had isolated cryptococcal antigenemia. Factors associated with cryptococcal antigenemia included: low body mass index of 15.4 kg/m<sup>2</sup> or less (adjusted odds ratio, AOR = 0.5; 95% CI 0.3-1.0), a CD4+ T cell count of less than 50 cells/mm<sup>3</sup> (AOR = 2.7; 95% CI1.2-6.1), neck pain (AOR = 2.3; 95% CI 1.2-4.6), recent diagnosis of HIV infection (AOR = 1.9; 95% CI 1.1-3.6), and meningeal signs (AOR = 7.9; 95% CI 2.9-22.1). However, at sub-analysis of asymptomatic patients, absence of neck pain (AOR = 0.5), photophobia (AOR = 0.5) and meningeal signs (AOR = 0.1) were protective against cryptococcal infection. Conclusions: Cryptococcal antigenemia is common among severely immunosuppressed HIV patients in Mulago Hospital, Kampala, Uganda. Independent predictors of positive serum cryptococcal antigenemia were CD4<sup>+</sup> T cell counts of less than 50 cells/mm, low body mass index, neck pain, signs of meningeal irritation, and a recent diagnosis of HIV infection. Routine screening of this category of patients may detect cryptococcosis, and hence provide an opportunity for early intervention. Absence of neck pain, photophobia and meningeal signs were protective against cryptococcal infection compared with symptomatic patients. 2012 Oyella et al; licensee BioMed Central Ltd."									
1278	Effect of nitazoxanide on morbidity and mortality in Zambian children with cryptosporidiosis: a randomised controlled trial.	"Amadi B, Mwiya M, Musuku J, Watuka A, Sianongo S, Ayoub A, Kelly P."	Lancet. 2002;360(9343):1375-80.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=12423984	"BACKGROUND: Cryptosporidiosis in children in developing countries causes persistent diarrhoea and malnutrition and is associated with increased mortality, but there is no effective treatment. We aimed to assess the effect of nitazoxanide-a new broad-spectrum antiparasitic drug-on morbidity and mortality in Zambian children with diarrhoea due to Cryptosporidium parvum."	"METHODS: Children with cryptosporidial diarrhoea who were admitted to the University Teaching Hospital, Lusaka, Zambia, between November, 2000, and July, 2001, and whose parents consented to their having an HIV test were randomly assigned nitazoxanide (100 mg twice daily orally for 3 days) or placebo. The primary endpoint was clinical response on day 7 after the start of treatment. Secondary endpoints included parasitological response by day 10 and mortality at day 8. Analysis was by intention to treat, with exclusion of patients subsequently found to be negative for C parvum or co-infected at baseline. The trial was stratified by HIV serology."	"FINDINGS: 50 HIV-seropositive and 50 HIV-seronegative children were recruited for the study, four of whom were subsequently excluded. In HIV-seronegative children, diarrhoea resolved in 14 (56%) of 25 receiving nitazoxanide and 5 (23%) of 22 receiving placebo (difference 33%, 95% CI 7-59; p=0.037). C parvum was eradicated from stool in 13 (52%) of 25 receiving nitazoxanide and three (14%) of 22 receiving placebo (38%, 95% CI 14-63; p=0.007). Four children (18%) of 22 in the placebo group had died by day 8, compared with none of 25 in the nitazoxanide group (-18%, -34 to 2; p=0.041). HIV-seropositive children did not benefit from nitazoxanide. Nitazoxanide was not significantly associated with adverse events in either stratum."	"INTERPRETATION: A 3-day course of nitazoxanide significantly improved the resolution of diarrhoea, parasitological eradication, and mortality in HIV-seronegative, but not HIV-seropositive, children."						
371	Involving expert patients in antiretroviral treatment provision in a tertiary referral hospital HIV clinic in Malawi.	"Tenthani L, Cataldo F, Chan AK, Bedell R, Martiniuk AL, van Lettow M."	BMC Health Services Research. 2012;12:140.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=22681872	"BACKGROUND: Current antiretroviral treatment (ART) models in Africa are labour intensive and require a high number of skilled staff. In the context of constraints in human resources for health, task shifting is considered a feasible alternative for ART service delivery. In 2006, Dignitas International in partnership with the Malawi Ministry of Health trained a cadre of expert patients at the HIV Clinic at a tertiary referral hospital in Zomba, Malawi. Expert patients were trained to assist with clinic tasks including measurement of vital signs, anthropometry and counseling."	"METHODS: A descriptive observational study using mixed methods was conducted two years after the start of program implementation. Semi-structured interviews were conducted with 20 patients, seven expert patients and six formal health care providers to explore perceptions towards the expert patients' contributions in the clinic. Structured exit interviews with 81 patients, assessed whether essential ART information was conveyed during counseling sessions. Vital signs and anthropometry measurements performed by expert patients were repeated by a nurse to assess accuracy of measurements. Direct observations quantified the time spent with each patient."	"RESULTS: There were minor differences in measurement of patients' weight, height and temperature between the expert patients and the nurse. The majority of patients exiting a counseling session reported, without prompting, at least three side effects of ART, correct actions to be taken on observing a side-effect, and correct consequences of non-adherence to ART. Expert patients carried out 368 hours of nurse tasks each month, saving two and a half full-time nurse equivalents per month. Formal health care workers and patients accept and value expert patients' involvement in ART provision and care. Expert patients felt valued by patients for being a 'role model', or a 'model of hope', promoting positive living and adherence to ART."	"CONCLUSIONS: Expert patients add value to the ART services at a tertiary referral HIV clinic in Malawi. Expert patients carry out shifted tasks acceptably, saving formal health staff time, and also act as 'living testimonies' of the benefits of ART and can be a means of achieving greater involvement of People Living with HIV in HIV treatment programs."						
372	Involving expert patients in antiretroviral treatment provision in a tertiary referral hospital HIV clinic in Malawi.	"Tenthani L, Cataldo F, Chan AK, Bedell R, Martiniuk ALC, Lettow Mv."	BMC Health Services Research. 2012;12(140).	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20123232964	"Background: Current antiretroviral treatment (ART) models in Africa are labour intensive and require a high number of skilled staff. In the context of constraints in human resources for health, task shifting is considered a feasible alternative for ART service delivery. In 2006, Dignitas International in partnership with the Malawi Ministry of Health trained a cadre of expert patients at the HIV Clinic at a tertiary referral hospital in Zomba, Malawi. Expert patients were trained to assist with clinic tasks including measurement of vital signs, anthropometry and counseling. Methods: A descriptive observational study using mixed methods was conducted two years after the start of program implementation. Semi-structured interviews were conducted with 20 patients, seven expert patients and six formal health care providers to explore perceptions towards the expert patients' contributions in the clinic. Structured exit interviews with 81 patients, assessed whether essential ART information was conveyed during counseling sessions. Vital signs and anthropometry measurements performed by expert patients were repeated by a nurse to assess accuracy of measurements. Direct observations quantified the time spent with each patient. Results: There were minor differences in measurement of patients' weight, height and temperature between the expert patients and the nurse. The majority of patients exiting a counseling session reported, without prompting, at least three side effects of ART, correct actions to be taken on observing a side-effect, and correct consequences of non-adherence to ART. Expert patients carried out 368 hours of nurse tasks each month, saving two and a half full-time nurse equivalents per month. Formal health care workers and patients accept and value expert patients' involvement in ART provision and care. Expert patients felt valued by patients for being a 'role model', or a 'model of hope', promoting positive living and adherence to ART. Conclusions: Expert patients add value to the ART services at a tertiary referral HIV clinic in Malawi. Expert patients carry out shifted tasks acceptably, saving formal health staff time, and also act as 'living testimonies' of the benefits of ART and can be a means of achieving greater involvement of People Living with HIV in HIV treatment programs."									
835	Nutritional status impairments in HIV-infected patients are associated with increased TNF- alpha and IL-6 serum levels but not with viral load.	"Galhardo MCG, Carvalho MGCd, Georg I, Perez M, Morgado MG, Azevedo LMSd, Sampaio EP, et al."	Infection. 2001;29(5):257-61.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh3&AN=20013146015	"Background: Cytokines may alter metabolic pathways and contribute to malnutrition among human immunodeficiency virus (HIV)-positive individuals. Patients and Methods: Tumour necrosis factor- alpha (TNF- alpha ), interleukin-6 (IL-6), soluble IL-2 receptors (sIL-2R), beta <sub>2</sub>-microglobulin serum levels and plasma viral load of 45 HIV-positive patients (27 females, 18 females; age range: 25-50 years) from the Evandro Chagas Hospital in Rio de Janeiro, Brazil, were determined and correlated to nutritional status impairment [date not given]. Patients were grouped by CD4 counts into categories I (<200/ micro l), II (200-499/ micro l), or III (>=500/ micro l). There were 15 healthy controls. A nutritional grading system, based on anthropometric and laboratory data, was devised. Scores ranged from 0 to 5 (eutrophic to malnutrition). Results: AIDS patients' cytokines and immune marker levels were significantly higher than those of the controls, but not always higher than those of other categories. AIDS patients had higher nutritional deficit grades than category III (P<0.05) or the controls (P<0.02) which, except for viral load, correlated with the parameters studied. Conclusion: Nutritional status impairments in HIV-positive individuals are associated with immune activation but not with viral load."									
165	First-line antiretroviral therapy and dyslipidemia in people living with HIV-1 in Cameroon: A cross-sectional study.	"Pefura Yone EW, Betyoumin AF, Kengne AP, Kaze Folefack FJ, Ngogang J."	AIDS Research and Therapy. 2011 26 Sep;8(33).		"Background: Data on lipid profile derangements induced by antiretroviral treatment in Africa are scarce. The aim of this study was to determine the prevalence and characteristics of lipid profile derangements associated with first-line highly active antiretroviral therapy (ART) among Cameroonians living with human immunodeficiency virus (HIV) infection.Methods: This cross-sectional study was conducted between November 2009 and January 2010, and involved 138 HIV patients who had never received ART (ART-naive group) and 138 others treated for at least 12 months with first line triple ART regimens that included nevirapine or efavirenz (ART group). Lipid profile was determined after overnight fast and dyslipidemia diagnosed according to the US National Cholesterol Education Program III criteria. Data comparison used chi-square test, Student t-test and logistic regressions.Results: The prevalence of total cholesterol >= 200 mg/dl was 37.6% and 24.6% respectively in ART group and ART-naive groups (p = 0.019). The equivalents for LDL-cholesterol >= 130 mg/dl were 46.4% and 21% (p <= 0.001). Proportions of patients with total cholesterol/HDL-cholesterol ratio >= 5 was 35.5% in ART group and 18.6% in ART-naive group (p <= 0.001). The distribution of HDL-cholesterol and triglycerides was similar between the two groups. In multivariable analysis adjusted for age, sex, body mass index, CD4 count and co-infection with tuberculosis, being on ART was significantly and positively associated with raised total cholesterol, LDL-cholesterol and TC/HDL cholesterol. The adjusted odd ratios (95% confidence interval, p-value) ART-treated vs. ART-naive was 1.82 (1.06-1.12, p = 0.02) for TC >= 200 mg/dl; 2.99 (1.74-5.15), p < 0.0001) for LDL-cholesterol >= 130 mg/dl and 1.73 (1.04-2.89, p = 0.03) for TC/HDL-cholesterol >= 5.Conclusions: First-line antiretroviral therapy that includes nonnucleoside reverse transcriptase inhibitors is associated with pro-atherogenic adverse lipid profile in people with HIV-1 infection compared to untreated HIV-infected subjects in Yaounde. Lipid profile and other cardiovascular risk factors should be monitored in patients on such therapy so that any untoward effects of treatments can be optimally managed. 2011 Yone et al; licensee BioMed Central Ltd."									
1488	Distribution of haematological and chemical pathology values among infants in Malawi and Uganda.	"Kumwenda NI, Khonje T, Mipando L, Nkanaunena K, Katundu P, Lubega I, Elbireer A, et al."	Paediatrics & international Child Health. 2012;32(4):213-27.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=23164296	BACKGROUND: Data on paediatric reference laboratory values are limited for sub-Saharan Africa.	OBJECTIVE: To describe the distribution of haematological and chemical pathology values among healthy infants from Malawi and Uganda.	"METHODS: A cross-sectional study was conducted among healthy infants, 0-6 months old, born to HIV-uninfected mothers recruited from two settings in Blantyre, Malawi and Kampala, Uganda. Chemical pathology and haematology parameters were determined using standard methods on blood samples. Descriptive analyses by age-group were performed based on 2004 Division of AIDS Toxicity Table age categories. Mean values and interquartile ranges were compared by site and age-group."	"RESULTS: A total of 541 infants were included altogether, 294 from Malawi and 247 from Uganda. Overall, the mean laboratory values were comparable between the two sites. Mean alkaline phosphatase levels were lower among infants aged <=21 days while aspartate aminotransferase, creatinine, total bilirubin and gamma-glutamyl transferase were higher in those aged 0-7 days than in older infants. Mean haematocrit, haemoglobin and neutrophil counts were higher in the younger age-groups (<35 days) and overall were lower than US norms. Red and white blood cell counts tended to decrease after birth but increased after ~2 months of age. Mean basophil counts were higher in Malawi than in Uganda in infants aged 0-1 and 2-7 days; mean counts for eosinophils (for age groups 8-21 or older) and platelets (for all age groups) were higher in Ugandan than in Malawian infants. Absolute lymphocyte counts increased with infant age."	CONCLUSION: The chemical pathology and haematological values in healthy infants born to HIV-uninfected mothers were comparable in Malawi and Uganda and can serve as useful reference values in these settings.					
1018	Effect of nonnucleoside reverse transcriptase inhibitor-based antiretroviral therapy on dysglycemia and insulin sensitivity in South African HIV-infected patients.	"Dave JA, Lambert EV, Badri M, West S, Maartens G, Levitt NS."	Journal of Acquired Immune Deficiency Syndromes: JAIDS. 2011;57(4):284-9.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=21602696	"BACKGROUND: Data on the prevalence of the complications of antiretroviral therapy (ART) (diabetes, central fat accumulation, peripheral fat wasting, and dyslipidemia) in sub-Saharan Africa are sparse. We examined the prevalence and associated risk factors of dysglycemia and insulin sensitivity in HIV-infected South Africans."	"METHODS: HIV-infected patients, on nonnucleoside reverse transcriptase inhibitor-based ART or ART-naive, had oral glucose tolerance tests and clinical anthropometry. Insulin sensitivity and -cell function were assessed."	"RESULTS: The prevalence of dysglycemia in 406 ART-naive patients and 443 patients on ART was 25.7% and 21.9% (P = 0.193), respectively. Dysglycemic patients on ART had a similar body mass index (P = 0.440), greater waist circumference (P = 0.047), and smaller calf skinfold thickness (P = 0.015) than dysglycemic ART-naive patients but no difference in -cell function or insulin sensitivity. Normoglycemic patients on ART had a greater body mass index (P = 0.0009), waist circumference (P = 0.0001), and abdominal skinfold thickness (P = 0.040), similar calf skinfold thickness (P = 0.079), and reduced -cell function [lower insulinogenic index (P = 0.027) and oral disposition index (D(o), P = 0.020)] compared with normoglycemic ART-naive patients. In multivariate analysis, older age [odds ratio (OR): 1.04, 95% confidence interval (CI): 1.02 to 1.06], male gender (OR: 1.96, 95% CI: 1.28 to 2.99), higher CD4 count (OR: 1.0, 95% CI: 1.00 to 1.02) and use of efavirenz (OR: 1.70, 95% CI: 1.19 to 2.45) were associated with dysglycemia."	"CONCLUSIONS: The prevalence of dysglycemia in ART-naive and ART patients was similar. Peripheral fat wasting was more common in dysglycemic patients on ART. The association of efavirenz with dysglycemia is important because first-line ART regimens in the developing world include nonnucleoside reverse transcriptase inhibitors, and increasingly, efavirenz is selected because of its perceived lower toxicity than nevirapine."						
442	Assessment of simple risk markers for early mortality among HIV-infected patients in Guinea-Bissau: A cohort study.	"Oliveira I, Andersen A, Furtado A, Medina C, Da Silva D, Da Silva ZJ, Aaby P, et al."	BMJ Open. 2012;2(6).		"Background: Decisions about when to start an antiretroviral therapy (ART) are normally based on CD4 cell counts and viral load (VL). However, these measurements require equipment beyond the capacity of most laboratories in low-income and middle-income settings. Thus, there is an urgent need to identify and test simple markers to guide the optimal time for starting and for monitoring the effect of ART in developing countries. Objectives: (1) To evaluate anthropometric measurements and measurement of plasma-soluble form of the urokinase plasminogen activator receptor (suPAR) levels as potential risk factors for early mortality among HIV-infected patients; (2) to assess whether these markers could help identify patients to whom ART should be prioritised and (3) to determine if these markers may add information to CD4 cell count when VL is not available. Design: An observational study. Setting: The largest ART centre in Bissau, Guinea- Bissau. Participants: 1083 ART-naive HIV-infected patients. Outcome measures: Associations between baseline anthropometric measurements, CD4 cell counts, plasma suPAR levels and survival were examined using Cox proportional hazards models. Results: Low body mass index (BMI<=18.5 kg/m<sup>2</sup>), low mid-upper-arm-circumference (MUAC<=250 mm), low CD4 cell count (<=350 cells/mul) and high suPAR plasma levels (>5.3 ng/ml) were independent predictors of death. Furthermore, mortality among patients with low CD4 cell count, low MUAC or low BMI was concentrated in the highest suPAR quartile. Conclusions: Irrespective of ART initiation and baseline CD4 count, MUAC and suPAR plasma levels were independent predictors of early mortality in this urban cohort. These markers could be useful in identifying patients at the highest risk of short-term mortality and may aid triage for ART when CD4 cell count is not available or when there is shortness of antiretroviral drugs."									
563	Vitamin D status in young HIV infected women of various ethnic origins: incidence of vitamin D deficiency and possible impact on bone density.	"Shahar E, Segal E, Rozen GS, Shen-Orr Z, Hassoun G, Kedem E, Pollack S, et al."	Clinical Nutrition. 2013;32(1):83-7.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=22732141	BACKGROUND: Decreased bone mineral density (BMD) was reported in HIV infected patients. Mechanisms leading to this decrease are poorly understood.	AIMS: To assess factors relating to BMD in young HIV infected Israeli women of Ethiopian and Caucasian origin.	"PATIENTS AND METHODS: 75 young HIV infected women aged 34.5 +/- 8.5 followed up at the Institute of Allergy, Clinical Immunology & AIDS filled a questionnaire about sun exposure, daily calcium intake and dress habits. Data about HIV status and treatment regimens were collected from the patients' charts. Serum hydroxyvitamin D [25(OH)D] levels, bone turnover markers and bone densitometry were evaluated."	"RESULTS: 28 (65%) of Ethiopians and 2 (6.25%) of Caucasians had 25(OH)D serum levels <10 ng/ml (vitamin D deficiency), p = 0.001. 21 (67.7%) Ethiopians and 16 (39%) Caucasians avoided sun exposure, p = 0.019. Mean daily calcium intake was 491 +/- 268.6 mg and 279 +/- 252.6 mg, respectively, p = 0.001. Z scores < -1 found at Lumbar spine in 26 (89.7%), at Femoral neck in 20 (69%) at Total hip in 17 (58.6%) of vitamin D deficient patients compared to 20 (48.8%), 17 (41.5%), 9 (22%), in patients with 25(OH)D > 10 ng/ml, p < 0.01, <0.03, <0.001, respectively. Significantly more Ethiopian than Caucasian women covered their face (32.3% and 9.5%, p = 0.003) and hands (58.1% and 30.9%, p = 0.03). There was no difference in bone turnover markers levels."	CONCLUSION: Poorer vitamin D status was observed in Ethiopian women might be one of the important factors related to lower BMD in this group. Copyright 2012 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.					
392	Weight and height z-scores improve after initiating ART among HIV-infected children in rural Zambia: a cohort study.	"Sutcliffe CG, Dijk JHv, Munsanje B, Hamangaba F, Sinywimaanzi P, Thuma PE, Moss WJ."	BMC Infectious Diseases. 2011;11(54).	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20113101506	"Background: Deficits in growth observed in HIV-infected children in resource-poor settings can be reversed with antiretroviral treatment (ART). However, many of the studies have been conducted in urban areas with older pediatric populations. This study was undertaken to evaluate growth patterns after ART initiation in a young pediatric population in rural Zambia with a high prevalence of undernutrition. Methods: Between 2007 and 2009, 193 HIV-infected children were enrolled in a cohort study in Macha, Zambia. Children were evaluated every 3 months, at which time a questionnaire was administered, height and weight were measured, and blood specimens were collected. Weight- and height-for-age z-scores were constructed from WHO growth standards. All children receiving ART at enrollment or initiating ART during the study were included in this analysis. Linear mixed effects models were used to model trajectories of weight and height-for-age z-scores. Results: A high proportion of study children were underweight (59%) and stunted (72%) at treatment initiation. Improvements in both weight- and height-for-age z-scores were observed, with weight-for-age z-scores increasing during the first 6 months of treatment and then stabilizing, and height-for-age z-scores increasing consistently over time. Trajectories of weight-for-age z-scores differed by underweight status at treatment initiation, with children who were underweight experiencing greater increases in z-scores in the first 6 months of treatment. Trajectories of height-for-age z-scores differed by age, with children older than 5 years of age experiencing smaller increases over time. Conclusions: Some of the effects of HIV on growth were reversed with ART initiation, although a high proportion of children remained underweight and stunted after two years of treatment. Partnerships between treatment and nutrition programs should be explored so that HIV-infected children can receive optimal nutritional support."									
393	Weight and height z-scores improve after initiating ART among HIV-infected children in rural Zambia: a cohort study.	"Sutcliffe CG, van Dijk JH, Munsanje B, Hamangaba F, Sinywimaanzi P, Thuma PE, Moss WJ."	BMC Infectious Diseases. 2011;11:54.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=21362177	"BACKGROUND: Deficits in growth observed in HIV-infected children in resource-poor settings can be reversed with antiretroviral treatment (ART). However, many of the studies have been conducted in urban areas with older pediatric populations. This study was undertaken to evaluate growth patterns after ART initiation in a young pediatric population in rural Zambia with a high prevalence of undernutrition."	"METHODS: Between 2007 and 2009, 193 HIV-infected children were enrolled in a cohort study in Macha, Zambia. Children were evaluated every 3 months, at which time a questionnaire was administered, height and weight were measured, and blood specimens were collected. Weight- and height-for-age z-scores were constructed from WHO growth standards. All children receiving ART at enrollment or initiating ART during the study were included in this analysis. Linear mixed effects models were used to model trajectories of weight and height-for-age z-scores."	"RESULTS: A high proportion of study children were underweight (59%) and stunted (72%) at treatment initiation. Improvements in both weight- and height-for-age z-scores were observed, with weight-for-age z-scores increasing during the first 6 months of treatment and then stabilizing, and height-for-age z-scores increasing consistently over time. Trajectories of weight-for-age z-scores differed by underweight status at treatment initiation, with children who were underweight experiencing greater increases in z-scores in the first 6 months of treatment. Trajectories of height-for-age z-scores differed by age, with children older than 5 years of age experiencing smaller increases over time."	"CONCLUSIONS: Some of the effects of HIV on growth were reversed with ART initiation, although a high proportion of children remained underweight and stunted after two years of treatment. Partnerships between treatment and nutrition programs should be explored so that HIV-infected children can receive optimal nutritional support."						
1477	Effectiveness of group weight loss visits in a federally qualified health center.	"Raube E, Conrad J, Rozwadowski J, Tsai AG."	Obesity. 2011 November;19:S97.		"Background: Denver Health is an integrated system serving a low income patient population. Obesity and its co-morbidities are extremely common, and patients have limited access to nutrition counseling. We established group visits for weight loss. The goal was to offer a service that cannot be feasibly provided in the context of routine primary care visits. Methods: Materials used were from the National Institutes of Health and the American Dietetic Association. These were supplemented with visual aids to teach portion size and calorie counting. Groups were conducted 4 times per year, for 5 weeks each time. Classes were co-led by a registered nurse and either a nurse practitioner or a primary care physician. Results: A total of 180 patients registered for 7 groups. Of these, 58 patients attended at least 1 class, and 47 completed the class. Patients lost an average of 2.9 pounds between week 1 and week 5. At an average follow-up of 22 weeks, they had regained 1.7 pounds. Patients that registered but did not attend identified the following barriers: transportation, work and child care conflicts, co-pays, and motivation. Participants that completed the group gave highly positive feedback about the content. Conclusions: Weight losses of nearly 1 pound per week can be achieved in a low income patient population with a high percentage of ethnic minorities. However, attrition among registered participants was very high, illustrating the challenge of intensive behavioral interventions in a low income population."									
407	High prevalence of lipoatrophy in pre-pubertal South African children on antiretroviral therapy: a cross-sectional study.	"Innes S, Cotton MF, Haubrich R, Conradie MM, Niekerk Mv, Edson C, Rabie H, et al."	BMC Pediatrics. 2012;12(183).	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20133003238	"Background: Despite changes in WHO guidelines, stavudine is still used extensively for treatment of pediatric HIV in the developing world. Lipoatrophy in sub-Saharan African children can be stigmatizing and have far-reaching consequences. The severity and extent of lipoatrophy in pre-pubertal children living in sub-Saharan Africa is unknown. Methods: In this cross-sectional study, children who were 3-12years old, on antiretroviral therapy and pre-pubertal were recruited from a Family HIV Clinic in South Africa. Lipoatrophy was identified and graded by consensus between two HIV pediatricians using a standardized grading scale. A professional dietician performed formal dietary assessment and anthropometric measurements of trunk and limb fat. Previous antiretroviral exposures were recorded. In a Dual-Energy X-ray Absorbtiometry (DXA) substudy body composition was determined in 42 participants. Results: Among 100 recruits, the prevalence of visually obvious lipoatrophy was 36% (95% CI: 27%-45%). Anthropometry and DXA measurements corroborated the clinical diagnosis of lipoatrophy: Both confirmed significant, substantial extremity fat loss in children with visually obvious lipoatrophy, when adjusted for age and sex. Adjusted odds ratio for developing lipoatrophy was 1.9 (95% CI: 1.3-2.9) for each additional year of accumulated exposure to standard dose stavudine. Cumulative time on standard dose stavudine was significantly associated with reductions in biceps and triceps skin-fold thickness (p=0.008). Conclusions: The prevalence of visually obvious lipoatrophy in pre-pubertal South African children on antiretroviral therapy is high. The amount of stavudine that children are exposed to needs review. Resources are needed to enable low-and-middle-income countries to provide suitable pediatric-formulated alternatives to stavudine-based pediatric regimens. The standard stavudine dose for children may need to be reduced. Diagnosis of lipoatrophy at an early stage is important to allow timeous antiretroviral switching to arrest progression and avoid stigmatization. Diagnosis using visual grading requires training and experience, and DXA and comprehensive anthropometry are not commonly available. A simple objective screening tool is needed to identify early lipoatrophy in resource-limited settings where specialized skills and equipment are not available."									
408	High prevalence of lipoatrophy in pre-pubertal South African children on antiretroviral therapy: a cross-sectional study.	"Innes S, Cotton MF, Haubrich R, Conradie MM, van Niekerk M, Edson C, Rabie H, et al."	BMC Pediatrics. 2012;12:183.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=23176441	"BACKGROUND: Despite changes in WHO guidelines, stavudine is still used extensively for treatment of pediatric HIV in the developing world. Lipoatrophy in sub-Saharan African children can be stigmatizing and have far-reaching consequences. The severity and extent of lipoatrophy in pre-pubertal children living in sub-Saharan Africa is unknown."	"METHODS: In this cross-sectional study, children who were 3-12 years old, on antiretroviral therapy and pre-pubertal were recruited from a Family HIV Clinic in South Africa. Lipoatrophy was identified and graded by consensus between two HIV pediatricians using a standardized grading scale. A professional dietician performed formal dietary assessment and anthropometric measurements of trunk and limb fat. Previous antiretroviral exposures were recorded. In a Dual-Energy X-ray Absorbtiometry (DXA) substudy body composition was determined in 42 participants."	"RESULTS: Among 100 recruits, the prevalence of visually obvious lipoatrophy was 36% (95% CI: 27%-45%). Anthropometry and DXA measurements corroborated the clinical diagnosis of lipoatrophy: Both confirmed significant, substantial extremity fat loss in children with visually obvious lipoatrophy, when adjusted for age and sex. Adjusted odds ratio for developing lipoatrophy was 1.9 (95% CI: 1.3 - 2.9) for each additional year of accumulated exposure to standard dose stavudine. Cumulative time on standard dose stavudine was significantly associated with reductions in biceps and triceps skin-fold thickness (p=0.008)."	"CONCLUSIONS: The prevalence of visually obvious lipoatrophy in pre-pubertal South African children on antiretroviral therapy is high. The amount of stavudine that children are exposed to needs review. Resources are needed to enable low-and-middle-income countries to provide suitable pediatric-formulated alternatives to stavudine-based pediatric regimens. The standard stavudine dose for children may need to be reduced. Diagnosis of lipoatrophy at an early stage is important to allow timeous antiretroviral switching to arrest progression and avoid stigmatization. Diagnosis using visual grading requires training and experience, and DXA and comprehensive anthropometry are not commonly available. A simple objective screening tool is needed to identify early lipoatrophy in resource-limited settings where specialized skills and equipment are not available."						
1228	Use of the exercise treadmill test for the assessment of cardiac risk markers in adults infected with HIV.	"Lorenzo Ad, Meirelles V, Vilela F, Souza FCC."	Journal of the International Association of Physicians in AIDS Care. 2013;12(2):110-6.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20133126210	"Background: Despite the association between HIV and coronary artery disease (CAD), there are no specific recommendations for the cardiovascular evaluation of the HIV-infected population. Besides being a tool for the evaluation of CAD, the exercise treadmill test (ETT) provides insights into functional capacity and autonomic function, which have been frequently affected in HIV infection, and thus may be useful in this setting. Methods: Forty-nine HIV-infected individuals without known CAD underwent ETT. Peak oxygen consumption during exercise (VO2 peak), functional capacity (in metabolic equivalents [METs]), exercise-induced ischemia, chronotropic incompetence (CI) and abnormal heart rate recovery (HRR) after exercise were studied. Results: VO2 peak was 31.4+4.8 mL/kg/min and functional capacity was 9.2+1.6 MET. CI was observed in 30.6%, and 10.2% had abnormal HRR. VO2 peak was lower in women and inversely correlated with age and body mass index. None of the patients displayed ischemic changes. Conclusion: Although functional capacity was good, risk markers such as CI and abnormal HRR were not infrequent. This study identifies a subgroup of HIV-infected patients-the older, overweight, or obese-who may have higher risk and deserve cardiovascular screening with the ETT."									
204	Exclusive breastfeeding reduces risk of mortality in infants up to 6 mo of age born to HIV-positive Tanzanian women.	"Natchu UCM, Liu E, Duggan C, Msamanga G, Peterson K, Aboud S, Spiegelman D, et al."	American Journal of Clinical Nutrition. 2012 November;96(5):1071-8.		"Background: Despite the benefits of exclusive breastfeeding (EBF), exposure to HIV from breast milk has relegated EBF to an option only when formula feeding is not affordable, feasible, safe, and sustainable. Mixed feeding remains the norm in sub-Saharan Africa. Objective: We evaluated whether the duration of EBF was associated with mortality and HIV infection in children followed to <=5 y of age. Methods: A total of 690 mother-infant pairs from the Trial of Vitamins with information on infant feeding, HIV status, and at least one visit in the first year were included in the analysis. The duration of EBF was defined in months as a time-varying covariate at each follow-up visit. Associations of the duration of EBF with mortality, HIV infection, and HIV infection or death were estimated by using Cox proportional hazards models and Kaplan-Meier survival curves. Results: A 1-mo increase in EBF was associated with a 49% reduction in early infant mortality in the first 6 mo of life (RR: 0.51; 95% CI: 0.28, 0.93) and a nonsignificant 15% reduction in risk of HIV infection or death (RR: 0.85; 95% CI: 0.71, 1.01; P = 0.07) over the first 5 y of life. EBF was not associated with HIV infection (RR: 0.93; 95% CI: 0.76, 1.15). Conclusion: Longer EBF by HIV-positive mothers was associated with reduced mortality in the first 6 mo of life without increased HIV infection, which makes EBF the best option for women who cannot sustain exclusive formula feeding. This trial was registered at clinicaltrials.gov as NCT00197743. 2012 American Society for Nutrition."									
1573	"Factors associated with HIV/AIDS diagnostic disclosure to HIV infected children receiving HAART: A multi-center study in Addis Ababa, Ethiopia."	"Biadgilign S, Deribew A, Amberbir A, Escudero HR, Deribe K."	PLoS ONE. 2011;6(3).		"Background: Diagnostic disclosure of HIV/AIDS to a child is becoming an increasingly common issue in clinical practice. Nevertheless, some parents and health care professionals are reluctant to inform children about their HIV infection status. The objective of this study was to identify the proportion of children who have knowledge of their serostatus and factors associated with disclosure in HIV-infected children receiving HAART in Addis Ababa, Ethiopia. Methods: A cross-sectional study was conducted in five hospitals in Addis Ababa from February 18, 2008-April 28, 2008. The study populations were parents/caretakers and children living with HIV/AIDS who were receiving Highly Active Antiretroviral Therapy (HAART) in selected hospitals in Addis Ababa. Univariate and multivariate logistic regression analysis were carried out using SPSS 12.0.1 statistical software. Results: A total of 390 children/caretaker pairs were included in the study. Two hundred forty three children (62.3%) were between 6-9 years of age. HIV/AIDS status was known by 68 (17.4%) children, 93 (29%) caretakers reported knowing the child's serostatus two years prior to our survey, 180 (46.2%) respondents said that the child should be told about his/her HIV/AIDS status when he/she is older than 14 years of age. Children less than 9 years of age and those living with educated caregivers are less likely to know their results than their counterparts. Children referred from hospital's in-patient ward before attending the HIV clinic and private clinic were more likely to know their results than those from community clinic. Conclusion: The proportion of disclosure of HIV/AIDS diagnosis to HIV-infected children is low. Strengthening referral linkage and health education tailored to educated caregivers are recommended to increase the rate of disclosure. 2011 Biadgilign et al."									
191	Micronutrient supplementation has limited effects on intestinal infectious disease and mortality in a Zambian population of mixed HIV status: a cluster randomized trial.	"Kelly P, Katubulushi M, Todd J, Banda R, Yambayamba V, Fwoloshi M, Zulu I, et al."	American Journal of Clinical Nutrition. 2008;88(4):1010-7.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medc&AN=18842788	"BACKGROUND: Diarrheal disease remains a major contributor to morbidity and mortality in Africa, but host defense against intestinal infection is poorly understood and may depend on nutritional status."	"OBJECTIVE: To test the hypothesis that defense against intestinal infection depends on micronutrient status, we undertook a randomized controlled trial of multiple micronutrient supplementation in a population where there is borderline micronutrient deficiency."	"DESIGN: All consenting adults (> or =18 y) living in a carefully defined sector of Misisi, Lusaka, Zambia, were included in a cluster-randomized (by household), double-blind, placebo-controlled trial with a midpoint crossover. There were no exclusion criteria. Participants were given a daily tablet containing 15 micronutrients at just above the recommended nutrient intake or placebo. The primary endpoint was the incidence of diarrhea; secondary endpoints were severe episodes of diarrhea, respiratory infection, nutritional status, CD4 count, and mortality."	"RESULTS: Five hundred participants were recruited and followed up for 3.3 y (10,846 person-months). The primary endpoint, incidence of diarrhea (1.4 episodes/y per person), did not differ with treatment allocation. However, severe episodes of diarrhea were reduced in the supplementation group (odds ratio: 0.50; 95% CI: 0.26, 0.92; P = 0.017). Mortality was reduced in HIV-positive participants from 12 with placebo to 4 with supplementation (P = 0.029 by log-rank test), but this was not due to changes in CD4 count or nutritional status."	CONCLUSION: Micronutrient supplementation with this formulation resulted in only modest reductions in severe diarrhea and reduced mortality in HIV-positive participants. The trial was registered as ISRCTN31173864.					
377	"Digital clubbing in tuberculosis--relationship to HIV infection, extent of disease and hypoalbuminemia."	"Ddungu H, Johnson JL, Smieja M, Mayanja-Kizza H."	BMC Infectious Diseases. 2006;6:45.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=16529654	"BACKGROUND: Digital clubbing is a sign of chest disease known since the time of Hippocrates. Its association with tuberculosis (TB) has not been well studied, particularly in Africa where TB is common. The prevalence of clubbing in patients with pulmonary TB and its association with Human Immunodeficiency Virus (HIV), severity of disease, and nutritional status was assessed."	"METHODS: A cross-sectional study was carried out among patients with smear-positive TB recruited consecutively from the medical and TB wards and outpatient clinics at a public hospital in Uganda. The presence of clubbing was assessed by clinical signs and measurement of the ratio of the distal and inter-phalangeal diameters (DPD/IPD) of both index fingers. Clubbing was defined as a ratio > 1.0. Chest radiograph, serum albumin and HIV testing were done."	"RESULTS: Two hundred patients (82% HIV-infected) participated; 34% had clubbing by clinical criteria whilst 30% had clubbing based on DPD/IPD ratio. Smear grade, extensive or cavitary disease, early versus late HIV disease, and hypoalbuminemia were not associated with clubbing. Clubbing was more common among patients with a lower Karnofsky performance scale score or with prior TB."	"CONCLUSION: Clubbing occurs in up to one-third of Ugandan patients with pulmonary TB. Clubbing was not associated with stage of HIV infection, extensive disease or hypoalbuminemia."						
378	"Digital clubbing in tuberculosis - relationship to HIV infection, extent of disease and hypoalbuminemia."	"Ddungu H, Johnson JL, Smieja M, Mayanja-Kizza H."	BMC Infectious Diseases. 2006;6(45).	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20073013487	"Background: Digital clubbing is a sign of chest disease known since the time of Hippocrates. Its association with tuberculosis (TB) has not been well studied, particularly in Africa where TB is common. The prevalence of clubbing in patients with pulmonary TB and its association with human immunodeficiency virus (HIV), severity of disease, and nutritional status was assessed. Methods: A cross-sectional study was carried out among patients with smear-positive TB recruited consecutively from the medical and TB wards and outpatient clinics at a public hospital in Uganda. The presence of clubbing was assessed by clinical signs and measurement of the ratio of the distal and inter-phalangeal diameters (DPD/IPD) of both index fingers. Clubbing was defined as a ratio >1.0. Chest radiograph, serum albumin and HIV testing were done. Results: Two hundred patients (82% HIV-infected) participated; 34% had clubbing by clinical criteria whilst 30% had clubbing based on DPD/IPD ratio. Smear grade, extensive or cavitary disease, early versus late HIV disease, and hypoalbuminaemia were not associated with clubbing. Clubbing was more common among patients with a lower Karnofsky performance scale score or with prior TB. Conclusion: Clubbing occurs in up to one-third of Ugandan patients with pulmonary TB. Clubbing was not associated with stage of HIV infection, extensive disease or hypoalbuminaemia."									
381	"The role of diabetes co-morbidity for tuberculosis treatment outcomes: a prospective cohort study from Mwanza, Tanzania."	"Faurholt-Jepsen D, Range N, Praygod G, Kidola J, Faurholt-Jepsen M, Aabye MG, Changalucha J, et al."	BMC Infectious Diseases. 2012 27 Jul;12(165).		"Background: Due to the association between diabetes and pulmonary tuberculosis (TB), diabetes may threaten the control of TB. In a prospective cohort study nested in a nutrition trial, we investigated the role of diabetes on changes in anthropometry, grip strength, and clinical parameters over a five months follow-up period.Methods: Among pulmonary TB patients with known diabetes status, we assessed anthropometry and clinical parameters (e.g. haemoglobin) at baseline and after two and five months of TB treatment. A linear mixed-effects model (repeated measurements) was used to investigate the role of diabetes during recovery.Results: Of 1205 TB patients, the mean (standard deviation) age was 36.6 (13.0) years, 40.9% were females, 48.9% were HIV co-infected, and 16.3% had diabetes. TB patients with diabetes co-morbidity experienced a lower weight gain at two (1.3 kg, CI95% 0.5; 2.0, p = 0.001) and five months (1.0 kg, CI95% 0.3; 1.7, p = 0.007). Similarly, the increase in the level of haemoglobin was lower among TB patients with diabetes co-morbidity after two ( 0.6 g/dL, CI95% 0.3; 0.9 p < 0.001) and five months ( 0.5 g/dL, CI95% 0.2; 0.9 p = 0.004) of TB treatment, respectively.Conclusion: TB patients initiating TB treatment with diabetes co-morbidity experience delayed recovery of body mass and haemoglobin, which are important for the functional recovery from disease. 2012 Faurholt-Jepsen et al.; licensee BioMed Central Ltd."									
380	"The role of diabetes co-morbidity for tuberculosis treatment outcomes: a prospective cohort study from Mwanza, Tanzania."	"Faurholt-Jepsen D, Range N, Praygod G, Kidola J, Faurholt-Jepsen M, Aabye MG, Changalucha J, et al."	BMC Infectious Diseases. 2012;12:165.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=22839693	"BACKGROUND: Due to the association between diabetes and pulmonary tuberculosis (TB), diabetes may threaten the control of TB. In a prospective cohort study nested in a nutrition trial, we investigated the role of diabetes on changes in anthropometry, grip strength, and clinical parameters over a five months follow-up period."	"METHODS: Among pulmonary TB patients with known diabetes status, we assessed anthropometry and clinical parameters (e.g. haemoglobin) at baseline and after two and five months of TB treatment. A linear mixed-effects model (repeated measurements) was used to investigate the role of diabetes during recovery."	"RESULTS: Of 1205 TB patients, the mean (standard deviation) age was 36.6 (13.0) years, 40.9% were females, 48.9% were HIV co-infected, and 16.3% had diabetes. TB patients with diabetes co-morbidity experienced a lower weight gain at two (1.3 kg, CI95% 0.5; 2.0, p = 0.001) and five months (1.0 kg, CI95% 0.3; 1.7, p = 0.007). Similarly, the increase in the level of haemoglobin was lower among TB patients with diabetes co-morbidity after two ( 0.6 g/dL, CI95% 0.3; 0.9 p < 0.001) and five months ( 0.5 g/dL, CI95% 0.2; 0.9 p = 0.004) of TB treatment, respectively."	"CONCLUSION: TB patients initiating TB treatment with diabetes co-morbidity experience delayed recovery of body mass and haemoglobin, which are important for the functional recovery from disease."						
166	Association of lopinavir concentrations with plasma lipid or glucose concentrations in HIV-infected South Africans: A cross sectional study.	"Sinxadi PZ, McIlleron HM, Dave JA, Smith PJ, Levitt NS, Maartens G."	AIDS Research and Therapy. 2012 26 Oct;9(32).		"Background: Dyslipidaemia and dysglycaemia have been associated with exposure to ritonavir-boosted protease inhibitors. Lopinavir/ritonavir, the most commonly used protease inhibitor in resource-limited settings, often causes dyslipidaemia. There are contradictory data regarding the association between lopinavir concentrations and changes in lipids.Aim: To investigate associations between plasma lopinavir concentrations and lipid and glucose concentrations in HIV-infected South African adults.Methods: Participants stable on lopinavir-based antiretroviral therapy were enrolled into a cross-sectional study. After an overnight fast, total cholesterol, triglycerides, and lopinavir concentrations were measured and an oral glucose tolerance test was performed. Regression analyses were used to determine associations between plasma lopinavir concentrations and fasting and 2 hour plasma glucose, fasting cholesterol, and triglycerides concentrations.Results: There were 84 participants (72 women) with a median age of 36 years. The median blood pressure, body mass index and waist: hip ratio were 108/72 mmHg, 26 kg/m<sup>2</sup> and 0.89 respectively. The median CD4 count was 478 cells/mm<sup>3</sup>. Median duration on lopinavir was 18.5 months. The median (interquartile range) lopinavir concentration was 8.0 (5.2 to 12.8) mug/mL. Regression analyses showed no significant association between lopinavir pre-dose concentrations and fasting cholesterol (beta-coefficient -0.04 (95% CI -0.07 to 0.00)), triglycerides (beta-coefficient -0.01 (95% CI -0.04 to 0.02)), fasting glucose (beta-coefficient -0.01 (95% CI -0.04 to 0.02)), or 2-hour glucose concentrations (beta-coefficient -0.02 (95% CI -0.09 to 0.06)). Lopinavir concentrations above the median were not associated with presence of dyslipidaemia or dysglycaemia.Conclusions: There was no association between lopinavir plasma concentrations and plasma lipid and glucose concentrations. 2012 Sinxadi et al.; licensee BioMed Central Ltd."									
1049	Plasma concentrations of efavirenz are associated with body weight in HIV-positive individuals.	"Poeta J, Linden R, Antunes MV, Real L, Menezes AM, Ribeiro JP, Sprinz E."	Journal of Antimicrobial Chemotherapy. 2011 November;66(11):2601-4.		"Background: Efavirenz is among the most widely used antiretroviral drugs. Increased efavirenz exposure has been associated with CNS side effects and also with the chance of emergence of resistance upon treatment interruptions. The objective of this study was to evaluate factors associated with efavirenz plasma concentrations in a cohort of HIV-infected individuals. Methods: From July 2009 to March 2010, HIV-infected patients with efavirenz as part of antiretroviral therapy (600 mg at night), undetectable viral load for at least 1 year and CD4 cell count .200 cells/mm3 were consecutively enrolled at the HIV/AIDS ambulatory care unit in southern Brazil. Plasma samples were taken 18-23 h after efavirenz last dose and analysed by validated ultra-performance liquid chromatography. Results: Forty-one subjects were included (21 females). Mean age and weight were 45.4 years and 70.9 kg, respectively. Mean efavirenz plasma concentration was 2.20+2.17 mg/L. Most plasma concentrations (73%) were within the therapeutic window (1-4 mg/L); 17% were below and 10% above the limits. There were no significant associations between efavirenz concentration and age, CD4 cell count, time on antiretroviral treatment and gender. There was significant and inverse correlation between efavirenz concentrations and body weight (P=0.013) and body mass index (P=0.001). Conclusions: In this cohort of well-controlled HIV-positive individuals, patients with lower weight or body mass index had a higher chance of presenting elevated plasma concentrations of efavirenz. Therapeutic drug monitoring to adjust dose might be a helpful tool to decrease efavirenz dose in order to minimize costs and adverse effects. The Author 2011. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved."									
754	Ethnic minority health in Vietnam: a review exposing horizontal inequity.	"Malqvist M, Hoa DT, Liem NT, Thorson A, Thomsen S."	Glob Health Action. 2013;6:1-19.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=23462107	"BACKGROUND: Equity in health is a pressing concern and reaching disadvantaged populations is necessary to close the inequity gap. To date, the discourse has predominately focussed on reaching the poor. At the same time and in addition to wealth, other structural determinants that influence health outcomes exist, one of which is ethnicity. Inequities based on group belongings are recognised as 'horizontal', as opposed to the more commonly used notion of 'vertical' inequity based on individual characteristics."	OBJECTIVE: The aim of the present review is to highlight ethnicity as a source of horizontal inequity in health and to expose mechanisms that cause and maintain this inequity in Vietnam.	"DESIGN: Through a systematic search of available academic and grey literature, 49 publications were selected for review. Information was extracted on: a) quantitative measures of health inequities based on ethnicity and b) qualitative descriptions explaining potential reasons for ethnicity-based health inequities."	"RESULTS: Five main areas were identified: health-care-seeking and utilization, maternal and child health, nutrition, infectious diseases, and oral health and hygiene. Evidence suggests the presence of severe health inequity in health along ethnic lines in all these areas. Research evidence also offers explanations derived from both external and internal group dynamics to this inequity. It is reported that government policies and programs appear to be lacking in culturally adaptation and sensitivity, and examples of bad attitudes and discrimination from health staff toward minority persons were identified. In addition, traditions and patriarchal structures within ethnic minority groups were seen to contribute to the maintenance of harmful health behaviors within these groups."	"CONCLUSION: Better understandings of the scope and pathways of horizontal inequities are required to address ethnic inequities in health. Awareness of ethnicity as a determinant of health, not only as a covariate of poverty or living area, needs to be improved, and research needs to be designed with this in mind."					
747	"Risk factors for esophageal cancer in zambia, southern africa: An exploratory case control study."	"Asombang AW, Kayamba VJ, Lisulo MM, Trinkaus K, Mudenda V, Sinkala E, Mwanamakondo SB, et al."	Gastrointestinal Endoscopy. 2013 May;1):AB338-AB9.		"Background: Esophageal cancer is the 5th leading cause of cancer mortality in Zambia, Southern Africa, yet only one study (from 1969) has evaluated risk factors. We sought to identify factors associated with esophageal cancer in Zambia. Methods: Patients presenting for upper endoscopy at the University Teaching Hospital (UTH), the Zambian national referral hospital, were eligible for this prospective, case-control study. Cases with histopathologically proven esophageal cancer were compared to age and gender matched controls with normal endoscopy. Demographics, alcohol consumption, smoking status and body mass index (BMI) were recorded. A detailed food frequency questionnaire created for this study was administered. Frequency of intake of standard portions of food categories (fruits, vegetables, foods of animal origin, insects, fish) was determined. Blood samples were collected for human immunodeficiency virus (HIV) testing. Fasting spot urine samples were collected for isoprostane (8-iso PGF2=) measurement. Data are reported as mean [s.d.]. Conditional logistic regression was used to estimate risk ratio (RR), 95% confidence interval (CI), and p-value (<0.05 statistically significant). Results: There were 27 cases (mean age 54.67 years [16.4], 17 males) and 45 controls (mean 54.2 years [15.3], 31 males). The median BMI for cases (16.8) and controls (23.2) differed significantly, p=0.014. Histopathologically, 25/27 (93%) were squamous cell carcinoma and 2/27 (7%) adenocarcinoma. Significantly more cases smoked cigarettes, RR 11.24, 95% CI 1.37-92.4, p=0.024, but alcohol consumption and HIV seropositivity did not differ significantly (both p=0.14). The total fruit, vegetables and fish consumption did not differ significantly between groups, p=0.11, 0.12, and 0.10 respectively. The mean isoprostane level was significantly higher in cases (0.03 ng/mg creatinine) than controls (0.01 ng/mg creatinine), RR 2.35, 95% CI 1.19- 4.65, p=0.014. Conclusion: In this exploratory study, we found that smoking and isoprostane levels (a marker of oxidative stress) were significantly associated with esophageal cancer in Zambians, but diet composition, HIV status, and alcohol consumption were not. We speculate that an increase in isoprostanes would most likely indicate an increase in oxidative stress and thus an increase in cell damage leading to an increase risk factor for development of esophageal cancer. Further studies are needed to evaluate the role of isoprostanes in identifying individuals at risk for esophageal cancer."									
1876	[Nutritional situation for mothers and children in South Africa].	Iversen PO.	Tidsskrift for Den Norske Laegeforening. 2009;129(13):1362-5.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=19561683	"BACKGROUND: Even 15 years after the downfall of the apartheid regime, there are significant inequalities regarding resources, welfare and social benefits among the people of South Africa. Poverty prevails and conditions are bad with respect to sanitation, health and living conditions; a situation which is likely to affect nutritional health. We have reviewed the nutritional status in South Africa."	"MATERIAL AND METHODS: This article is based on literature retrieved from non-systematic reviews of the databases PubMed and High Wire Press, in addition to information from official documents and African journals. The author's recent field work in South Africa was also a source of information."	"RESULTS: Nationwide surveys, as well as smaller studies have documented high rates of stunting, malnutrition and deficiency of micronutrients among South African children. Daily hunger is reported from more than half of South African households. There is also a rise in the number of overweight and obese children and mothers. HIV/aids is highly prevalent and often coexists with tuberculosis. Many of these patients have a poor nutritional status, which in turn reduces the effect of antiviral treatment."	INTERPRETATION: The high rate of malnutrition and HIV/aids among mothers and children in South Africa will delay improvement of general health in this population with generations. [References: 42]						
500	"Epidemiology of lung cancer: Diagnosis and management of lung cancer, 3rd ed: American college of chest physicians evidence-based clinical practice guidelines."	"Alberg AJ, Brock MV, Ford JG, Samet JM, Spivack SD."	Chest. 2013 May;143(5 SUPPL):e1S-e29S.		"Background: Ever since a lung cancer epidemic emerged in the mid-1900s, the epidemiology of lung cancer has been intensively investigated to characterize its causes and patterns of occurrence. This report summarizes the key findings of this research. Methods: A detailed literature search provided the basis for a narrative review, identifying and summarizing key reports on population patterns and factors that affect lung cancer risk. Results: Established environmental risk factors for lung cancer include smoking cigarettes and other tobacco products and exposure to secondhand tobacco smoke, occupational lung carcinogens, radiation, and indoor and outdoor air pollution. Cigarette smoking is the predominant cause of lung cancer and the leading worldwide cause of cancer death. Smoking prevalence in developing nations has increased, starting new lung cancer epidemics in these nations. A positive family history and acquired lung disease are examples of host factors that are clinically useful risk indicators. Risk prediction models based on lung cancer risk factors have been developed, but further refinement is needed to provide clinically useful risk stratification. Promising biomarkers of lung cancer risk and early detection have been identified, but none are ready for broad clinical application. Conclusions: Almost all lung cancer deaths are caused by cigarette smoking, underscoring the need for ongoing efforts at tobacco control throughout the world. Further research is needed into the reasons underlying lung cancer disparities, the causes of lung cancer in never smokers, the potential role of HIV in lung carcinogenesis, and the development of biomarkers. Copyright by the American College of Chest Physicians 2013."									
222	Sex differences in responses to antiretroviral treatment in south african HIV-infected children on ritonavir-boosted lopinavir-based and nevirapinebased treatment.	"Shiau S, Arpadi S, Strehlau R, Martens L, Patel F, Coovadia A, Abrams EJ, et al."	American Journal of Epidemiology. 2013 15 Jun;177:S66.		"Background: Evidence in HIV-infected adults shows higher rates of antiretroviral treatment (ART) complications in women compared to men. However, few studies have assessed sex differences in children. Here we investigate if there are differences in responses to two ART regimens between young HIV-infected boys and girls. Methods: This secondary analysis compares ART outcomes in HIV-infected boys and girls who initiated ritonavir-boosted lopinavir (LPV/r)- based ART before 24 months of age in Johannesburg, South Africa from 2005-2007 and were randomized to remain on LPV/r or switch to nevirapine (NVP)-based ART. HIV-1 viral load (VL), CD4 count, total cholesterol (TC), HDL, LDL, triglycerides, and anthropometrics were measured at regular follow up visits. Outcomes were compared between sexes within treatment strata as well as between treatment groups within sex strata. Results: A total of 323 children (median age 8.8 months, IQR 5.1-13.5) including 168 boys and 155 girls were initiated on LPV/r-based ART. 195 children were randomized and 156 children completed long-term follow up. No sex differences in virological failure (confirmed VL > 1000 copies/mL) by 156 weeks post randomization were observed within treatment groups. Girls who switched to NVP had a significantly greater mean CD4 response than boys switched to NVP as well as compared to girls continuing on LPV/r at 24, 64, and 100 weeks post randomization. Upon exit from the study, girls on LPV/r had a higher TC:HDL ratio and lower mean HDL concentration than boys on LPV/r, as well as compared to girls switched to NVP. Conclusions: Immunologic response to ART was strongest for girls who switched to NVP. Sex differences were also noted in lipid profiles, with a less favorable outcome for girls who remained on LPV/r. Future studies are warranted to determine the biological mechanisms and clinical significance of these differences."									
299	Is the paradise in the Caribbean? Prevalence of hypovitaminosis D in HIV+ patients treated at a clinic in Puerto Rico.	"Mele Kn-RI, Ayala."	Antiviral Therapy. 2011;16:A49.		"Background: Existent studies have demonstrated that HIV+ population suffer from low bone density, increasing their risk of fractures, which has been linked to the use of highly active antiretroviral therapy (HAART) and even HIV itself. Currently, there aren't studies published regarding vitamin D deficiency and insufficiency in HIV+ patients in the Caribbean (latitude 18degree00N 66degree37W). Our hypothesis is that HIV+ patients with or without HAART who live in the Caribbean have 25-hydroxyvitamin D severe deficiency (<=25 nmol/l), deficiency (<=50 nmol/l) or insufficiency (>50 nmol/l <=75 nmol/l). Methodology: A retrospective chart review was conducted among files from HIV+ adults >49 year managed at private clinic. A data collection tool was designed to gather demographic characteristics (age, gender, race/ethnicity), vitamin D levels, height, weight, body mass index (BMI), viral load, CD4 cell count, 25-OHD levels, time with HIV infection (date of diagnosis), AIDS defining illness, current or former IVDU, tobacco use, current ARV therapy (PI or NNRTI based), time on ARV (number of years since first ARV regimen), co-morbid conditions, multivitamin use, vitamin D supplementation used and dose, and other medications. Results: All patients were Hispanic, 62.8% men, and mean age was 57 years. Twenty-two patients (51%) had deficient/insufficient vitamin D levels vs 21 patients (49%) who had normal vitamin D levels. Among patients with vitamin D deficiency/insufficiency, 95.5% were taking ART; 68% were on a PI based regimen, and 32% on a non-PI based regimen. Eighteen patients (82%) with deficient/insufficient vitamin D levels had a BMI<30 vs 4 patients (18%) with a BMI>30. Ten patients (46%) with deficient/insufficient levels had a total daily intake of <=800 IU of vitamin D vs 6 patients (27%) which were taking a total daily intake of >800 IU of vitamin D; 6 (27%) patients with deficient/ insufficient levels were not taking any vitamin D supplementation. Four patients (18%) with deficiency/ insufficiency were currently smokers. Fifteen patients (68%) with deficiency/insufficiency had been infected for 1-10 years, 7 patients (32%) had been infected for more than 11 years. Conclusion: Inadequate vitamin D levels were highly prevalent among HIV+ patients treated at a clinic in the Caribbean. Although, location of the population is in the Caribbean, were there is no difference in the solar radiation between seasons, less than 50% of the HIV population had the sufficient vitamin D levels. Even in patients using more than 400 IU of vitamin D level per day, more than 50% of them had inadequate vitamin D levels. Additional studies in this area are needed to determine the necessary amount of vitamin D for the HIV infected patients to maintain sufficient vitamin D levels."									
1422	Comprehensive treatment of extensively drug-resistant tuberculosis.	"Mitnick CD, Shin SS, Seung KJ, Rich ML, Atwood SS, Furin JJ, Fitzmaurice GM, et al."	New England Journal of Medicine. 2008 07 Aug;359(6):563-74.		"BACKGROUND: Extensively drug-resistant tuberculosis has been reported in 45 countries, including countries with limited resources and a high burden of tuberculosis. We describe the management of extensively drug-resistant tuberculosis and treatment outcomes among patients who were referred for individualized outpatient therapy in Peru. METHODS: A total of 810 patients were referred for free individualized therapy, including drug treatment, resective surgery, adverse-event management, and nutritional and psychosocial support. We tested isolates from 651 patients for extensively drug-resistant tuberculosis and developed regimens that included five or more drugs to which the infecting isolate was not resistant. RESULTS: Of the 651 patients tested, 48 (7.4%) had extensively drug-resistant tuberculosis; the remaining 603 patients had multidrug-resistant tuberculosis. The patients with extensively drug-resistant tuberculosis had undergone more treatment than the other patients (mean [+/-SD] number of regimens, 4.2+/-1.9 vs. 3.2+/-1.6; P<0.001) and had isolates that were resistant to more drugs (number of drugs, 8.4+/-1.1 vs. 5.3+/-1.5; P<0.001). None of the patients with extensively drug-resistant tuberculosis were coinfected with the human immunodeficiency virus (HIV). Patients with extensively drug-resistant tuberculosis received daily, supervised therapy with an average of 5.3+/-1.3 drugs, including cycloserine, an injectable drug, and a fluoroquinolone. Twenty-nine of these patients (60.4%) completed treatment or were cured, as compared with 400 patients (66.3%) with multidrug-resistant tuberculosis (P = 0.36). CONCLUSIONS: Extensively drug-resistant tuberculosis can be cured in HIV-negative patients through outpatient treatment, even in those who have received multiple prior courses of therapy for tuberculosis. Copyright 2008 Massachusetts Medical Society."									
1872	BCG vaccination status may predict sputum conversion in patients with pulmonary tuberculosis: A new consideration for an old vaccine?	"Jeremiah K, PrayGod G, Faurholt-Jepsen D, Range N, Andersen AB, Grewal HMS, Friis H."	Thorax. 2010 December;65(12):1072-6.		"Background: Failure to convert (persistent sputum and/or culture positivity) while on antituberculosis (anti-TB) treatment at the end of the second month of anti-TB therapy has been reported to be a predictor of treatment failure. Factors that could be associated with persistent bacillary positivity at the end of the second month after initiation of anti-TB treatment were assessed. Methods: A prospective cohort study was conducted in 754 patients with sputum culture positive pulmonary TB in Mwanza, Tanzania. Information on social demographic characteristics, anthropometric measurements, BCG scar status, HIV status, CD4+ count, white blood cell count, haemoglobin and sputum culture status was obtained. Results: Factors associated with sputum culture non-conversion at the end of the second month of anti-TB treatment were initial acid-fast bacilli (AFB) culture grading of 3+ (OR 5.70, 95% CI 1.34 to 24.31, p=0.02) and absence of a BCG scar (OR 3.35, 95% CI 1.48 to 7.58, p=0.004). Conclusion: Patients with pulmonary TB with no BCG scar and high initial AFB sputum intensity are at risk of remaining sputum culture positive at the end of the second month of anti-TB treatment. These findings reflect a beneficial role for BCG vaccination on sputum conversion which should also be examined in large studies in other areas. The finding of a beneficial role for BCG vaccination on the treatment of pulmonary TB is important for TB control and vaccination programmes."									
1265	"The first 5 years of the family clinic for HIV at Tygerberg Hospital: family demographics, survival of children and early impact of antiretroviral therapy."	"van Kooten Niekerk NK, Knies MM, Howard J, Rabie H, Zeier M, van Rensburg A, Frans N, et al."	Journal of Tropical Pediatrics. 2006;52(1):3-11.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=15947012	BACKGROUND: Family clinics address the problems of HIV-infected children and their families. The aims were to document demographics of the children and caregivers attending the Family Clinic for HIV at Tygerberg Academic Hospital (TAH) and to investigate factors affecting disease progression in children.	"METHODS: A retrospective folder review of children and parents attending the Family Clinic at TAH between January 1997 and December 2001, a period noted for its lack of antiretroviral treatment."	"RESULTS: Of 432 children seen for testing, 274 children, median age 16.9 months, were HIV-infected. During follow-up, 46 children died (median age 23 months) and 113 were lost to follow-up. The majority of children were malnourished. Those <2 years of age had lower weight for age Z-scores (WAZ) than older children (p<0.001). At presentation, 47 per cent were in clinical stage B and two-thirds had moderate or severe CD4+ T cell depletion. Seventeen children had received highly active antiretroviral therapy (HAART), 12 dual and 31 monotherapy. HAART was associated with improved survival compared to dual or monotherapy. Risk of death was reduced from eleven-fold for a WAZ <-4 to four-fold between -2 and -3. There was no association with immunological and clinical classification at entry and risk of mortality. Only 18 per cent of parents were evaluated in the clinic. Non-parental care was documented for 25 per cent of families."	"CONCLUSIONS: A low WAZ is associated with poor survival in children. Nutritional status should receive more attention in HIV disease classification in children. Parent utilization of the clinic was inadequate. Even in the absence of HAART, extended survival in children is possible."						
163	"Food assistance is associated with improved body mass index, food security and attendance at clinic in an HIV program in central Haiti: A prospective observational cohort study."	"Ivers LC, Chang Y, Gregory Jerome J, Freedberg KA."	AIDS Research and Therapy. 2010 26 Aug;7(33).		"Background: Few data are available to guide programmatic solutions to the overlapping problems of undernutrition and HIV infection. We evaluated the impact of food assistance on patient outcomes in a comprehensive HIV program in central Haiti in a prospective observational cohort study.Methods: Adults with HIV infection were eligible for monthly food rations if they had any one of: tuberculosis, body mass index (BMI) <18.5kg/m<sup>2</sup>, CD4 cell count <350/mm<sup>3 </sup>(in the prior 3 months) or severe socio-economic conditions. A total of 600 individuals (300 eligible and 300 ineligible for food assistance) were interviewed before rations were distributed, at 6 months and at 12 months. Data collected included demographics, BMI and food insecurity score (range 0 - 20).Results: At 6- and 12-month time-points, 488 and 340 subjects were eligible for analysis. Multivariable analysis demonstrated that at 6 months, food security significantly improved in those who received food assistance versus who did not (-3.55 vs -0.16; P < 0.0001); BMI decreased significantly less in the food assistance group than in the non-food group (-0.20 vs -0.66; P = 0.020). At 12 months, food assistance was associated with improved food security (-3.49 vs -1.89, P = 0.011) and BMI (0.22 vs -0.67, P = 0.036). Food assistance was associated with improved adherence to monthly clinic visits at both 6 (P < 0.001) and 12 months (P = 0.033).Conclusions: Food assistance was associated with improved food security, increased BMI, and improved adherence to clinic visits at 6 and 12 months among people living with HIV in Haiti and should be part of routine care where HIV and food insecurity overlap. 2010 Ivers et al; licensee BioMed Central Ltd."									
989	"Differences in factors associated with initial growth, CD4, and viral load responses to ART in HIV-infected children in Kampala, Uganda, and the United Kingdom/Ireland."	"Kekitiinwa A, Lee KJ, Walker AS, Maganda A, Doerholt K, Kitaka SB, Asiimwe A, et al."	Journal of Acquired Immune Deficiency Syndromes. 2008 01 Dec;49(4):384-92.		"Background: Few studies have directly compared response to antiretroviral therapy (ART) between children living in well-resourced and resource-limited settings. In resource-limited settings non-HIV contributors could reduce the beneficial effects of ART. We compare predictors of short-term immunological, virological, and growth response to ART in HIV-infected children in the United Kingdom/Ireland and Kampala. Methods: We analyzed prospective cohort data from 54 UK/Irish hospitals (the Collaborative HIV Paediatric Study) and Mulago Hospital, Kampala, Uganda. Six- and 12-month responses are described among children initiating combination ART (>=3 drugs, >=2 classes). Six months post-ART, predictors of viral load (VL) suppression <400 copies/mL, CD4% increases >10%, and height-and weight-for-age z-score increases >=+0.5 were investigated using logistic regression. Results: In all, 582 UK/Irish children (76% black African) were younger than 876 Kampala children at ART initiation (median 5.0 vs 7.6 years), with higher CD4% (14%, 8%), lower VL (172,491 and 346,809 copies/mL), and less stunting (-0.8, -2.8) and wasting (-0.6, -2.8). Post-ART, median 12-month changes in the United Kingdom/Ireland and Kampala in CD4% (+12%, +13%) and weight (+0.4, +0.5) were similar, but growth was less in Kampala (+0.20, +0.06, P < 0.001). Younger children in both cohorts had better immunological, weight, and growth responses (all P < 0.001). However, lower pre-ART CD4% predicted better immunological response in the United Kingdom/Ireland but poorer response in Kampala (heterogeneity P = 0.004). Although 70% children in both cohorts had suppressed <400 copies/mL at 6 months, adolescents starting ART in the United Kingdom/Ireland had somewhat poorer VL responses than those in Kampala (P = 0.15). Conclusions: Overall immunological and virologic ART responses were similar in children in both cohorts. Poorer CD4 recovery in more immunosuppressed Kampala children and blunted growth responses likely reflect higher background malnutrition and infection rates in Uganda, suggesting the need for earlier HIV diagnosis, nutritional support, cotrimoxazole prophylaxis, and ART. Copyright 2008 by Lippincott Williams & Wilkins."									
425	"Factors associated with prenatal folic acid and iron supplementation among 21,889 pregnant women in Northern Tanzania: a cross-sectional hospital-based study."	"Ogundipe O, Hoyo C, Ostbye T, Oneko O, Manongi R, Lie RT, Daltveit AK."	BMC Public Health. 2012;12:481.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=22734580	"BACKGROUND: Folate and iron deficiency during pregnancy are risk factors for anaemia, preterm delivery, and low birth weight, and may contribute to poor neonatal health and increased maternal mortality. The World Health Organization recommends supplementation of folic acid (FA) and iron for all pregnant women at risk of malnutrition to prevent anaemia. We assessed the use of prenatal folic acid and iron supplementation among women in a geographical area with a high prevalence of anaemia, in relation to socio-demographic, morbidity and health services utilization factors."	"METHODS: We analysed a cohort of 21,889 women who delivered at Kilimanjaro Christian Medical Centre (KCMC), Moshi, Tanzania, between 1999 and 2008. Logistic regression models were used to describe patterns of reported intake of prenatal FA and iron supplements."	"RESULTS: Prenatal intake of FA and iron supplements was reported by 17.2% and 22.3% of pregnant women, respectively. Sixteen percent of women reported intake of both FA and iron. Factors positively associated with FA supplementation were advanced maternal age (OR = 1.17, 1.02-1.34), unknown HIV status (OR = 1.54, 1.42-1.67), a diagnosis of anaemia during pregnancy (OR = 12.03, 9.66-14.98) and indicators of lower socioeconomic status. Women were less likely to take these supplements if they reported having had a malaria episode before (OR = 0.57, 0.53-0.62) or during pregnancy (OR = 0.45, 0.41-0.51), reported having contracted other infectious diseases (OR = 0.45, 0.42-0.49), were multiparous (OR = 0.73, 0.66-0.80), had preeclampsia/eclampsia (OR = 0.48, 0.38-0.61), or other diseases (OR = 0.55, 0.44-0.69) during pregnancy. Similar patterns of association emerged when iron supplementation alone and supplementation with both iron and FA were evaluated."	"CONCLUSIONS: FA and iron supplementation are low among pregnant women in Northern Tanzania, in particular among women with co-morbidities before or during pregnancy. Attempts should be made to increase supplementation both in general and among women with pregnancy complications."						
1423	Early versus standard antiretroviral therapy for HIV-infected adults in Haiti.	"Severe P, Juste MAJ, Ambroise A, Eliacin L, Marchand C, Apollon S, Edwards A, et al."	New England Journal of Medicine. 2010 15 Jul;363(3):257-65.		"BACKGROUND: For adults with human immunodeficiency virus (HIV) infection who have CD4+ T-cell counts that are greater than 200 and less than 350 per cubic millimeter and who live in areas with limited resources, the optimal time to initiate antiretroviral therapy remains uncertain. METHODS: We conducted a randomized, open-label trial of early initiation of antiretroviral therapy, as compared with the standard timing for initiation of therapy, among HIV-infected adults in Haiti who had a confirmed CD4+ T-cell count that was greater than 200 and less than 350 per cubic millimeter at baseline and no history of an acquired immunodeficiency syndrome (AIDS) illness. The primary study end point was survival. The early-treatment group began taking zidovudine, lamivudine, and efavirenz therapy within 2 weeks after enrollment. The standard-treatment group started the same regimen of antiretroviral therapy when their CD4+ T-cell count fell to 200 per cubic millimeter or less or when clinical AIDS developed. Participants in both groups underwent monthly follow-up assessments and received isoniazid and trimethoprim-sulfamethoxazole prophylaxis with nutritional support. RESULTS: Between 2005 and 2008, a total of 816 participants - 408 per group - were enrolled and were followed for a median of 21 months. The CD4+ T-cell count at enrollment was approximately 280 per cubic millimeter in both groups. There were 23 deaths in the standard-treatment group, as compared with 6 in the early-treatment group (hazard ratio with standard treatment, 4.0; 95% confidence interval [CI], 1.6 to 9.8; P = 0.001). There were 36 incident cases of tuberculosis in the standard-treatment group, as compared with 18 in the early-treatment group (hazard ratio, 2.0; 95% CI, 1.2 to 3.6; P = 0.01). CONCLUSIONS: Early initiation of antiretroviral therapy decreased the rates of death and incident tuberculosis. Access to antiretroviral therapy should be expanded to include all HIVinfected adults who have CD4+ T-cell counts of less than 350 per cubic millimeter, including those who live in areas with limited resources. (ClinicalTrials.gov number, NCT00120510.) Copyright 2010 Massachusetts Medical Society. All rights reserved."									
1490	"The use of a validated dietar y diversity questionnaire to ases dietar y inta ke and habits of orphaned youth in kampala, uganda."	"Sanghera M, Roccamatisi D, Wang Y, Jang W, McLean J, Cannon WG, Kagoda M, et al."	Paediatrics and Child Health. 2010 May-June;15:43A.		"Background: For more than 4 years, since 2007, The Brighter Smiles Africa Program has partnered with the African Hearts Community Organization (AfriHCO) in Kampala, Uganda. AfriHCO provides accommodation, food, schooling and a stable environment for more than 60 male street youth/AIDS orphans between 6 and 19 years of age. Nutrition education for the youth was requested as part of our 2009 project in Uganda. Our purpose was to evaluate the youth's current food intake and dietary habits, to collect baseline information and to provide nutrition education. Methods: A 24 hour validated dietary recall instrument was used. The questionnaire collects information on nutritional adequacy by asking about dietary diversity. We consulted with AfriHCO's director to include local Ugandan foods in our survey instrument. Boys interested in participation were interviewed individually after providing written informed consent. Results: 41 boys participated in this study. Of 16 boys living at AfriHCO's Kampala home (KH), 11 residents were interviewed. The remaining 30 participants receive assistance from AfriHCO but live in the surrounding area. The reported intake reflected a usual day in terms of the type and quantity of food consumed by 78.0% of participants. Each individual's dietary diversity score was calculated based on suggested food groupings, with a maximum score of 14. The average dietary diversity score was 5.6, with KH residents having a slightly higher score than nonresidents (6.2 vs. 5.4). Common foods consumed included rice, bread, matoke (green plantain), beans, added oils, fats and sweets. Food group analysis showed that 65.9% of the boys consumed either plant or animalbased food groups high in vitamin A. Only 48.8% of boys reported consumption of iron-rich food groups. Education on how to improve nutrition was provided while in Uganda and a summary document was prepared upon return to Canada. Recommendations included an increase in the variety of foods consumed and the consideration of creating household garden projects. Conclusions: Energy intake among the boys interviewed did not seem to pose a serious concern in terms of weight status. However, a lack of dietary diversity could place them at risk of nutrient deficiencies. The dietary diversity questionnaire acted as a quick, easy and objective way of identifying potential nutritional concerns. Our findings helped guide nutrition education and have the potential to evaluate changes over time."									
176	Gastric cancer in Zambian adults: a prospective case-control study that assessed dietary intake and antioxidant status by using urinary isoprostane excretion.	"Asombang AW, Kayamba V, Mwanza-Lisulo M, Colditz G, Mudenda V, Yarasheski K, Chott R, et al."	American Journal of Clinical Nutrition. 2013;97(5):1029-35.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=23535107	"BACKGROUND: Gastric cancer is increasingly recognized in Zambia. Although nutritional factors contribute to gastric cancer risk, their effect in Zambia is unknown."	"OBJECTIVE: The objective was to investigate the association between intake of dietary antioxidants, urinary 8-iso prostaglandin F2 (8-iso PGF2) as a marker of oxidative stress, and gastric cancer."	"DESIGN: This was a case-control study at the University Teaching Hospital in Zambia. Gastric cancer cases were compared with age- and sex-matched controls. Urine 8-iso PGF2 was measured primarily by ELISA, and by gas chromatography-mass spectrometry in a subset, expressed as a ratio to creatinine. Blood was collected for Helicobacter pylori, HIV serology, gastrin-17, and pepsinogen 1 and 2 concentrations. Clinical and dietary data were collected by using questionnaires. Food items were broadly classified into 7 major categories (fruit, vegetables, fish, meat, insects, cereals, and starches)."	"RESULTS: Fifty cases with gastric cancer (mean age: 61 y; n = 31 males) and 90 controls (mean age: 54 y; n = 41 males) were enrolled. Median urinary 8-iso PGF2 excretion was higher in cases (0.014; IQR: 0.008-0.021) than in controls (0.011; IQR: 0.006-0.018; P = 0.039). On univariate analysis, habitual fruit intake was lower in cases than in controls during the dry season (P = 0.02). On multivariate analysis, smoking (OR: 7.22; IQR: 1.38-37.9) and gastric atrophy (OR: 2.43; IQR: 1.12-5.13) were independently associated with cancer, and higher fruit intake was protective (OR: 0.44; IQR: 0.20-0.95). Isoprostane excretion was inversely correlated with total fruit intake ( = -0.23; n = 140; P = 0.006)."	"CONCLUSION: Urinary 8-iso PGF2 excretion was associated with the risk of gastric cancer, as were smoking and gastric atrophy, but increased fruit intake conferred protection. This trial was registered at www.pactr.org as ISRCTN52971746."					
1890	Incidence and risk factors for tuberculosis in HIV-infected patients while on antiretroviral treatment in Cambodia.	"Choun K, Thai S, Pe R, Lorent N, Lynen L, Griensven Jv."	Transactions of the Royal Society of Tropical Medicine and Hygiene. 2013;107(4):235-42.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20133119140	"Background: Given the lack of detailed studies on tuberculosis (TB) in patients on antiretroviral treatment (ART) in South-East Asia, we aimed to determine the incidence and risk factors for early (after <=6 months of ART) and late (after >6 months of ART) incident TB in Cambodia. Methods: We conducted a retrospective analysis of all patients started on ART at a non-governmental hospital in Phnom Penh (March 2003-December 2010). TB diagnosis was performed according to WHO algorithms. Risk factor analysis was performed using multivariate Cox regression modeling. Results: Overall, 2984 patients started ART. The median baseline CD4 count was 89 cells micro l<sup>-1</sup> (IQR 25-209), median age 34 years (IQR 29-40). Fifty-three percent of the patients were female. Median follow-up time on ART was 2.4 years. In addition to 932 (31.2%) patients already on TB treatment at ART initiation, 313 (10.5%) developed TB, with an overall incidence rate of 3.9/100 patient-years. Of those developing TB, 179 (6.0%) patients were diagnosed with early TB and 134 (4.5%) with late TB, corresponding with a rate of 13.5 and 2.0 per 100 patient-years respectively. Risk factors for early TB included low body mass index, low baseline CD4 count and low hemoglobin levels. Low on-treatment CD4 counts and hemoglobin levels, being underweight while on ART and prevalent TB were identified as risk factors for late TB. Conclusion: The incidence of early TB was high, and predominantly associated with advanced HIV progression markers. Earlier ART initiation and enhanced TB screening prior to and after ART initiation is warranted. Late TB amounts to almost half of the total TB burden, meriting specific preventive and diagnostic approaches."									
1881	Incidence and risk factors for tuberculosis in HIV-infected patients while on antiretroviral treatment in Cambodia.	"Choun K, Thai S, Pe R, Lorent N, Lynen L, van Griensven J."	Transactions of the Royal Society of Tropical Medicine & Hygiene. 2013;107(4):235-42.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=23324313	"BACKGROUND: Given the lack of detailed studies on tuberculosis (TB) in patients on antiretroviral treatment (ART) in South-East Asia, we aimed to determine the incidence and risk factors for early (after <=6 months of ART) and late (after >6 months of ART) incident TB in Cambodia."	METHODS: We conducted a retrospective analysis of all patients started on ART at a non-governmental hospital in Phnom Penh (March 2003-December 2010). TB diagnosis was performed according to WHO algorithms. Risk factor analysis was performed using multivariate Cox regression modeling.	"RESULTS: Overall, 2984 patients started ART. The median baseline CD4 count was 89 cells l(-1) (IQR 25-209), median age 34 years (IQR 29-40). Fifty-three percent of the patients were female. Median follow-up time on ART was 2.4 years. In addition to 932 (31.2%) patients already on TB treatment at ART initiation, 313 (10.5%) developed TB, with an overall incidence rate of 3.9/100 patient-years. Of those developing TB, 179 (6.0%) patients were diagnosed with early TB and 134 (4.5%) with late TB, corresponding with a rate of 13.5 and 2.0 per 100 patient-years respectively. Risk factors for early TB included low body mass index, low baseline CD4 count and low hemoglobin levels. Low on-treatment CD4 counts and hemoglobin levels, being underweight while on ART and prevalent TB were identified as risk factors for late TB."	"CONCLUSION: The incidence of early TB was high, and predominantly associated with advanced HIV progression markers. Earlier ART initiation and enhanced TB screening prior to and after ART initiation is warranted. Late TB amounts to almost half of the total TB burden, meriting specific preventive and diagnostic approaches."						
1560	Projections of global mortality and burden of disease from 2002 to 2030.	"Mathers CD, Loncar D."	PLoS Medicine. 2006 November;3(11):2011-30.		"Background: Global and regional projections of mortality and burden of disease by cause for the years 2000, 2010, and 2030 were published by Murray and Lopez in 1996 as part of the Global Burden of Disease project. These projections, which are based on 1990 data, continue to be widely quoted, although they are substantially outdated; in particular, they substantially underestimated the spread of HIV/AIDS. To address the widespread demand for information on likely future trends in global health, and thereby to support international health policy and priority setting, we have prepared new projections of mortality and burden of disease to 2030 starting from World Health Organization estimates of mortality and burden of disease for 2002. This paper describes the methods, assumptions, input data, and results. Methods and Findings: Relatively simple models were used to project future health trends under three scenarios - baseline, optimistic, and pessimistic - based largely on projections of economic and social development, and using the historically observed relationships of these with cause-specific mortality rates. Data inputs have been updated to take account of the greater availability of death registration data and the latest available projections for HIV/AIDS, income, human capital, tobacco smoking, body mass index, and other inputs. In all three scenarios there is a dramatic shift in the distribution of deaths from younger to older ages and from communicable, maternal, perinatal, and nutritional causes to noncommunicable disease causes. The risk of death for children younger than 5 y is projected to fall by nearly 50% in the baseline scenario between 2002 and 2030. The proportion of deaths due to noncommunicable disease is projected to rise from 59% in 2002 to 69% in 2030. Global HIV/AIDS deaths are projected to rise from 2.8 million in 2002 to 6.5 million in 2030 under the baseline scenario, which assumes coverage with antiretroviral drugs reaches 80% by 2012. Under the optimistic scenario, which also assumes increased prevention activity, HIV/AIDS deaths are projected to drop to 3.7 million in 2030. Total tobacco-attributable deaths are projected to rise from 5.4 million in 2005 to 6.4 million in 2015 and 8.3 million in 2030 under our baseline scenario. Tobacco is projected to kill 50% more people in 2015 than HIV/AIDS, and to be responsible for 10% of all deaths globally. The three leading causes of burden of disease in 2030 are projected to include HIV/AIDS, unipolar depressive disorders, and ischaemic heart disease in the baseline and pessimistic scenarios. Road traffic accidents are the fourth leading cause in the baseline scenario, and the third leading cause ahead of ischaemic heart disease in the optimistic scenario. Under the baseline scenario, HIV/AIDS becomes the leading cause of burden of disease in middle- and low-income countries by 2015. Conclusions: These projections represent a set of three visions of the future for population health, based on certain explicit assumptions. Despite the wide uncertainty ranges around future projections, they enable us to appreciate better the implications for health and health policy of currently observed trends, and the likely impact of fairly certain future trends, such as the ageing of the population, the continued spread of HIV/AIDS in many regions, and the continuation of the epidemiological transition in developing countries. The results depend strongly on the assumption that future mortality trends in poor countries will have a relationship to economic and social development similar to those that have occurred in the higher-income countries. 2006 Mathers and Loncar."									
1021	Effect of baseline immune suppression on growth recovery in HIV positive South African children receiving antiretroviral treatment.	"Feinstein L, Yotebieng M, Moultrie H, Meyers T, Van Rie A."	Journal of Acquired Immune Deficiency Syndromes: JAIDS. 2012;61(2):235-42.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=22743597	BACKGROUND: Growth failure is common among children infected with HIV. The degree of growth recovery and its determinants in children initiating combination antiretroviral therapy (cART) are not well understood.	"METHODS: We conducted a cohort study of children who initiated cART between 2004 and 2008 at a pediatric HIV clinic in Johannesburg, South Africa. To determine the effect of severe immunodeficiency at cART initiation on growth recovery (defined as attaining a z-score > -2), we generated Kaplan-Meier survival functions and fit a Cox proportional hazards model. In sensitivity analyses, we assessed selection bias due to loss to follow-up or death."	"RESULTS: Of the 2399 children who initiated cART, 71% presented with growth failure. Within 2 years of cART, only 81% of underweight children achieved normal weight, and 64% of stunted children achieved length/height recovery. Severe immunodeficiency at cART initiation was not associated with weight recovery [hazards ratio: 1.05, 95% CI: 0.83 to 1.32] or length/height recovery (hazards ratio: 1.06, 95% CI: 0.83 to 1.34) in overall analyses, and modification by baseline growth failure and age were modest. Older children and those with severe growth failure were less likely to achieve growth recovery, regardless of baseline immunodeficiency status."	"CONCLUSIONS: A substantial proportion of children fail to achieve growth recovery despite 2 years of cART. Our analysis did not support an association between baseline immunodeficiency and growth recovery. Younger age and less-severe growth failure at cART initiation are strong predictors of achieving growth recovery. These findings support early initiation of cART, before the presence of growth failure, and independent of level of immunodeficiency."						
949	Effect of baseline immune suppression on growth recovery in HIV positive South African children receiving antiretroviral treatment.	"Feinstein L, Yotebieng M, Moultrie H, Meyers T, Rie Av."	"JAIDS, Journal of Acquired Immune Deficiency Syndromes. 2012;61(2):235-42."	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20123329659	"Background: Growth failure is common among children infected with HIV. The degree of growth recovery and its determinants in children initiating combination antiretroviral therapy (cART) are not well understood. Methods: We conducted a cohort study of children who initiated cART between 2004 and 2008 at a pediatric HIV clinic in Johannesburg, South Africa. To determine the effect of severe immunodeficiency at cART initiation on growth recovery (defined as attaining a z-score >-2), we generated Kaplan-Meier survival functions and fit a Cox proportional hazards model. In sensitivity analyses, we assessed selection bias due to loss to follow-up or death. Results: Of the 2399 children who initiated cART, 71% presented with growth failure. Within 2 years of cART, only 81% of underweight children achieved normal weight, and 64% of stunted children achieved length/height recovery. Severe immunodeficiency at cART initiation was not associated with weight recovery [hazards ratio: 1.05, 95% CI: 0.83 to 1.32] or length/height recovery (hazards ratio: 1.06, 95% CI: 0.83 to 1.34) in overall analyses, and modification by baseline growth failure and age were modest. Older children and those with severe growth failure were less likely to achieve growth recovery, regardless of baseline immunodeficiency status. Conclusions: A substantial proportion of children fail to achieve growth recovery despite 2 years of cART. Our analysis did not support an association between baseline immunodeficiency and growth recovery. Younger age and less-severe growth failure at cART initiation are strong predictors of achieving growth recovery. These findings support early initiation of cART, before the presence of growth failure, and independent of level of immunodeficiency."									
1501	The frequency and magnitude of growth failure in a group of HIV-infected children in Cameroon.	"Chiabi A, Lebela J, Kobela M, Mbuagbaw L, Obama MT, Ekoe T."	The Pan African medical journal. 2012;11:15.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=22368758	"BACKGROUND: Growth impairment is a major manifestation of HIV infection in children and has been implicated as a major contributor to both morbidity and mortality. This study the first to be done in this setting, was aimed at comparing the growth of HIV infected children to that of non-infected children in two referral health facilities in Yaounde, Cameroon."	METHODS: A prospective case control study was carried out on 39 HIV infected children in two referral hospitals and followed up for a period of 12 months. Anthropometric measurements were taken and the sociodemographic variables of mothers and infants noted. Thirty nine infected children (mean age 45.3 months +/- 41.6 SD) were age and sex matched with 39 non-infected children (mean age 44.4 +/- 40.7 months).	"RESULTS: Out of the 39 infected children, 26 (66.7%) had at least one of the three anthropometric indices (weight for height, weight for age, height for age) Z scores less than -2. Throughout follow-up, 20.5% of the infected children were wasted (weight to height Z score < -2) versus none in the control group, 56.4% underweight (weight for age Z score < -2) in the infected versus 2.6% in the control group, and 51.3% stunted (height for age Z score < -2) in contrast to 5.1% in the control group."	"CONCLUSION: This study demonstrated that wasting; underweight and stunting are common findings in HIV- infected children, thus stressing the importance of anthropometry in the routine care of these children."						
84	Response to highly active antiretroviral therapy among severely immuno-compromised HIV-infected patients in Cambodia.	"Madec Y, Laureillard D, Pinoges L, Fernandez M, Prak N, Ngeth C, Moeung S, et al."	Aids. 2007 January;21(3):351-9.		"BACKGROUND: HAART efficacy was evaluated in a real-life setting in Phnom Penh (Medecins Sans Frontieres programme) among severely immuno-compromised patients. METHODS: Factors associated with mortality and immune reconstitution were identified using Cox proportional hazards and logistic regression models, respectively. RESULTS: From July 2001 to April 2005, 1735 patients initiated HAART, with median CD4 cell count of 20 (inter-quartile range, 6-78) cells/mul. Mortality at 2 years increased as the CD4 cell count at HAART initiation decreased, (4.4, 4.5, 7.5 and 24.7% in patients with CD4 cell count > 100, 51-100, 21-50 and <=20 cells/mul, respectively; P < 10<sup>-4</sup>). Cotrimoxazole and fluconazole prophylaxis were protective against mortality as long as CD4 cell counts remained <= 200 and >= 100 cells/mul, respectively. The proportion of patients with successful immune reconstitution (CD4 cell gain > 100 cells/mul at 6 months) was 46.3%; it was lower in patients with previous ART exposure [odds ratio (OR), 0.16; 95% confidence interval (CI), 0.05-0.45] and patients developing a new opportunistic infection/immune reconstitution infection syndromes (OR, 0.71; 95% CI, 0.52-0.98). Similar efficacy was found between the stavudineg-lamivudineg- nevirapine fixed dose combination and the combination stavudineg-lamivudineg- efavirenz in terms of mortality and successful immune reconstitution. No surrogate markers for CD4 cell change could be identified among total lymphocyte count, haemoglobin, weight and body mass index. CONCLUSION: Although CD4 cell count-stratified mortality rates were similar to those observed in industrialized countries for patients with CD4 cell count > 50 cells/mul, patients with CD4 cell count <= 20 cells/mul posed a real challenge to clinicians. Widespread voluntary HIV testing and counselling should be encouraged to allow HAART initiation before the development of severe immuno-suppression. 2007 Lippincott Williams & Wilkins."									
383	Predictors of early death in a cohort of Ethiopian patients treated with HAART.	"Jerene D, Endale A, Hailu Y, Lindtjoorn B."	BMC Infectious Diseases. 2006 01 Sep;6(136).		"Background: HAART has improved the survival of HIV infected patients. However, compared to patients in high-income countries, patients in resource-poor countries have higher mortality rates. Our objective was to identify independent risk factors for death in Ethiopian patients treated with HAART. Methods: In a district hospital in Ethiopia, we treated adult HIV infected patients with HAART based on clinical and total lymphocyte count (TLC) criteria. We measured body weight and complete blood cell count at baseline, 4 weeks later, then repeated weight every month and complete blood cell count every 12 weeks. Time to death was the main outcome variable. We used the Kaplan Meier and Cox regression survival analyses to identify prognostic markers. Also, we calculated mortality rates for the different phases of the follow-up. Results: Out of 162 recruited, 152 treatment-naive patients contributed 144.1 person-years of observation (PYO). 86 (57%) of them were men and their median age was 32 years. 24 patients died, making the overall mortality rate 16.7 per 100 PYO. The highest death rate occurred in the first month of treatment. Compared to the first month, mortality declined by 9-fold after the 18th week of follow-up. Being in WHO clinical stage IV and having TLC<= 750/mcL were independent predictors of death. Haemoglobin (HGB) <= 10 g/dl and TLC<= 1200/mcL at baseline were not associated with increased mortality. Body mass index (BMI) <= 18.5 kg/m2 at baseline was associated with death in univariate analysis. Weight loss was seen in about a third of patients who survived up to the fourth week, and it was associated with increased death. Decline in TLC, HGB and BMI was associated with death in univariate analysis only. Conclusion: The high mortality rate seen in this cohort was associated with advanced disease stage and very low TLC at presentation. Patients should be identified and treated before they progress to advanced stages. The underlying causes for early death in patients presenting at late stages should be investigated. 2006 Jerene et al; licensee BioMed Central Ltd."									
369	Infant feeding counselling in Uganda in a changing environment with focus on the general population and HIV-positive mothers - a mixed method approach.	"Fadnes LT, Engebretsen IM, Moland KM, Nankunda J, Tumwine JK, Tylleskar T."	BMC Health Services Research. 2010;10:260.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=20815932	BACKGROUND: Health workers' counselling practices are essential to improve infant feeding practices. This paper will assess how infant feeding counselling was done and experienced by counsellors and mothers in Eastern Uganda in the context of previous guidelines. This has implications for implementation of the new infant feeding guidelines from 2009.	"METHODS: This paper combines qualitative and quantitative data from Mbale District in Eastern Uganda. Data was collected from 2003 to 2005 in a mixed methods approach. This includes: key-informant interviews among eighteen health workers in the public hospital, health clinics and non-governmental organisations working with people living with HIV, fifteen focus group discussions in the general population and among clients from an HIV clinic, two cross-sectional surveys including 727 mothers from the general population and 235 HIV-positive mothers."	"RESULTS: The counselling sessions were often improvised. Health workers frequently had pragmatic approaches to infant feeding as many clients struggled with poverty, stigma and non-disclosure of HIV. The feasibility of the infant feeding recommendations was perceived as challenging among health workers, both for HIV-positive mothers and in the general population. Group counselling with large groups was common in the public health service. Some extra infant feeding teaching capacities were mobilised for care-takers of undernourished children. A tendency to simplify messages giving one-sided information was seen. Different health workers presented contradicting simplified perspectives in some cases. Outdated training was a common concern with many health workers not being given courses or seminars on infant feeding since professional graduation. Other problems were minimal staffing, lack of resources, and programs being started and subsequently stopped abruptly. Many of the HIV-counsellors in the non-governmental organisations got extended training in counselling which seemed to be beneficial."	"CONCLUSIONS: Health workers were faced with challenges related to workload, resources, scientific updating, and also a need to adjust to frequent changes in programs, recommendations and guidelines. The clients were faced with difficult choices, poverty, lack of education and stigma. Feasibility of the recommendations was a major concern. Systematic approaches to update health workers should be a priority."						
370	Infant feeding counselling in Uganda in a changing environment with focus on the general population and HIV-positive mothers - a mixed method approach.	"Fadnes LT, Engebretsen IMS, Moland KM, Nankunda J, Tumwine JK, Tylleska T."	BMC Health Services Research. 2010;10(260).	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20103299934	"Background: Health workers' counselling practices are essential to improve infant feeding practices. This paper will assess how infant feeding counselling was done and experienced by counsellors and mothers in Eastern Uganda in the context of previous guidelines. This has implications for implementation of the new infant feeding guidelines from 2009. Methods: This paper combines qualitative and quantitative data from Mbale District in Eastern Uganda. Data was collected from 2003 to 2005 in a mixed methods approach. This includes: key-informant interviews among eighteen health workers in the public hospital, health clinics and non-governmental organisations working with people living with HIV, fifteen focus group discussions in the general population and among clients from an HIV clinic, two cross-sectional surveys including 727 mothers from the general population and 235 HIV-positive mothers. Results: The counselling sessions were often improvised. Health workers frequently had pragmatic approaches to infant feeding as many clients struggled with poverty, stigma and non-disclosure of HIV. The feasibility of the infant feeding recommendations was perceived as challenging among health workers, both for HIV-positive mothers and in the general population. Group counselling with large groups was common in the public health service. Some extra infant feeding teaching capacities were mobilised for care-takers of undernourished children. A tendency to simplify messages giving one-sided information was seen. Different health workers presented contradicting simplified perspectives in some cases. Outdated training was a common concern with many health workers not being given courses or seminars on infant feeding since professional graduation. Other problems were minimal staffing, lack of resources, and programs being started and subsequently stopped abruptly. Many of the HIV-counsellors in the non-governmental organisations got extended training in counselling which seemed to be beneficial. Conclusions: Health workers were faced with challenges related to workload, resources, scientific updating, and also a need to adjust to frequent changes in programs, recommendations and guidelines. The clients were faced with difficult choices, poverty, lack of education and stigma. Feasibility of the recommendations was a major concern. Systematic approaches to update health workers should be a priority."									
777	Steatohepatitis and fibrosis in chronic hepatitis C patients: Is there any association?	"Hasmoni MH, Salleh R, Jaafar KA, Jaafar MH, Abas A."	Hepatology International. 2011 March;5 (1):312-3.		"Background: Hepatic steatosis and disturbances in lipid metabolism has been identified as one of the metabolic disorders in hepatitis C (HCV) infection. This study was to examine the possible association of steatohepatitis with the degree of fibrosis in chronic HCV patients. Methods: Retrospective analysis of data from 72 patients with chronic HCV who underwent liver biopsy from January 2008 to March 2010 in two tertiary hospitals in Malaysia was performed. Patients' demographic data and their body mass index (BMI), liver function tests and lipid profiles, histological findings of steatosis, staging and grading of biopsy specimen were made. Staging and grading of liver disease was done using modified histological activity index staging (score 0-6) and grading (score 0-18) respectively. Univariate analysis was done to assess the association between the degree of fibrosis and steatohepatitis. Results: 79.2% were males and the mean age for the study population was 40.7 +/- 12.0 years. There were 13.9 and 9.7% cases of coinfection with HIV and hepatitis B respectively, while 76.4% patients were infected with HCV alone. The table showed the superimposed steatohepatitis that was present with severe fibrosis and mild or no fibrosis in the two different groups. However, the univariate analysis assessing the association between the degree of fibrosis and the presence of steatohepatitis in both the two groups could not find any significant result. Conclusion: There was no significant association between steatohepatitis and the degree of fibrosis in patients with chronic HCV infection, either co-infection with other viruses or HCV infection alone. (Table presented)."									
687	Risk factors for hepatotoxicity after introduction of highly active antiretroviral therapy.	"Ugiagbe RA, Malu AO, Bojuwoye BJ, Onunu AN."	Experimental and Clinical Hepatology. 2011;7(1-2):49-56.		"Background: Hepatotoxicity in patients with HIV may be caused by multiple factors in addition to ARVs. These include HIV itself, HBV, HCV, systemic opportunistic infections, malignancies and other hepatotoxic drugs. Others are alcohol consumption and abnormal body mass index. The aim of this study was to identify risk factors for hepatotoxicity of HAART in HIV infected patients. Material/Methods: This study was carried out on patients with HIV on HAART attending infectious disease clinic, gastroenterology clinic or admitted into the medical wards of University of Benin Teaching Hospital. HAART-naive patients were used as controls. A clinical evaluation and relevant laboratory investigations were done. Hepatotoxicity was defined using a standardized toxicity grade scale. Results: A total of 84 cases and 42 controls were studied. The mean ages were 35.2+/-9.9 years and 35.5+/-9.0 years for the cases and the controls respectively. Over 70% of the study population and controls were females. The overall incidence of hepatotoxicity was 17.9% and severe hepatotoxicity occurred in 10.7% of the patients. Alcohol use and being underweight were independent risk factors for hepatotoxicity. Conclusions: This study clearly identifies use of alcohol and being under weight as risk factors for hepatotoxicity in HIV patients on HAART as found in other parts of the world. Careful selection of less hepatotoxic regimens in patients with identifiable risk factors and counseling against use of alcohol should be encouraged. E&C Hepatology, 2011."									
77	Body mass index and risk of tuberculosis and death.	"Hanrahan CF, Golub JE, Mohapi L, Tshabangu N, Modisenyane T, Chaisson RE, Gray GE, et al."	AIDS. 2010;24(10):1501-8.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=20505496	"BACKGROUND: High BMI has been shown to be protective against tuberculosis (TB) among HIV-uninfected individuals, as well as against disease progression and mortality among those with HIV. We examined the effect of BMI on all-cause mortality and TB incidence among a cohort of HIV-infected adults in Soweto, South Africa."	METHODS: A clinical cohort of 3456 HIV-infected adults from South Africa was prospectively followed from 2003 to 2008 with regular monitoring. The primary exposure was BMI and the outcomes of interest were all-cause mortality and a newly diagnosed episode of TB. Cox proportional hazard models assessed associations with risk of mortality or incident TB.	"RESULTS: Incidence rates of mortality were 10.4/100 person-years for baseline BMI of 18.5 or less, 3.6/100 person-years for baseline BMI 18.6-25, 1.7/100 person-years for baseline BMI 25.1-30, and 1.6/100 person-years for baseline BMI more than 30. Compared to those with normal BMI, overweight and obese participants had a significantly reduced risk of mortality [adjusted hazard ratio 0.59 (95% confidence interval, CI 0.40-0.87) and 0.48 (95% CI 0.29-0.80), respectively]. Incidence rates of TB by baseline BMI were 7.3/100 person-years for underweight, 6.0/100 person-years for normal, 3.2/100 person-years for overweight, and 1.9/100 person-years for obese. Compared to those with normal BMI, those with overweight and obese BMI were at a significantly reduced risk of developing TB [adjusted hazard ratio 0.56 (95% CI 0.38-0.83) and 0.33 (95% CI 0.19-0.55), respectively]."	"CONCLUSION: HIV-infected individuals with obese and overweight BMI have a significantly reduced risk of both mortality and TB, after adjusting for HAART use and CD4 cell count."						
787	Low prevalence of insulin resistance among HIV-infected children receiving nonnucleoside reverse transcriptase inhibitor-based highly active antiretroviral therapy in Thailand.	"Lee B, Aurpibul L, Sirisanthana V, Mangklabruks A, Sirisanthana T, Puthanakit T."	HIV Medicine. 2009;10(2):72-8.		"Background: Highly active antiretroviral therapy (HAART) is reported to cause insulin resistance among adults, but effects on children are less clear. We attempted to describe the prevalence of insulin resistance among HIV-infected children receiving HAART. Methods: Insulin resistance was assessed at 96 weeks of treatment with nonnucleoside reverse transcriptase inhibitor (NNRTI)-based HAART (nevirapine or efavirenz with stavudine and lamivudine) among children in Chiang Mai, Thailand. Insulin resistance was defined as homeostasis model assessment for insulin resistance (HOMA-IR) >= 3.16, fasting c-peptide >= 4.40ng/mL or fasting insulin >= 25.0muU/mL. Impaired fasting glucose (IFG) was defined as glucose >=110mg/dL. Measurements were analysed for associations with age, lipodystrophy, treatment regimen and clinical data. Results: The prevalence of insulin resistance was 6.5% no child had IFG. Those with insulin resistance were older with higher body mass index. Children >= 10 years had higher HOMA-IR, c-peptide and insulin, but no difference was seen in the frequency of insulin resistance. No associations between insulin resistance and lipodystrophy or treatment regimen were detected. Conclusions: Insulin resistance is uncommon among children receiving NNRTI-based HAART and is unrelated to lipodystrophy. 2009 British HIV Association."									
1790	Focus group discussion with private sector doctors in the eThekwini metro of KwaZulu-Natal on the management of HIV/AIDS patients.	Naidoo P.	South African Family Practice. 2011 March/April;53(2):176-81.		"Background: Highly active antiretroviral treatment (HAART) is essential in the treatment of HIV/AIDS; however, a holistic approach to HIV/AIDS management is important. This study was done to confirm the findings of two studies done previously in the eThekwini Metro of KwaZulu-Natal on private sector doctors' management of HIV-infected patients and to obtain more in-depth information about their nonpharmacological management of HIV-infected patients. Methods: Two focus group discussions were conducted amongst private sector doctors in the eThekwini Metro, after obtaining their consent. The focus group sessions were scripted, audio-taped and transcribed verbatim. Prevalent themes were identified and reported. Results: Eight doctors participated. Of the total patient population seen annually by the majority of the doctors, an average of 43.8% was HIV infected. Doctors in this study managed their patients both pharmacologically and nonpharmacologically. Seventy-five per cent of doctors indicated that the taste of medicine played an important role in nonadherence to treatment, but all agreed that cultural beliefs also influenced the patient's adherence to medication. Theft of medicines and the outof- stock situation prevented antiretroviral drug access, which impacted negatively on adherence. Five doctors mentioned that depressed patients abused alcohol, resulting in nonadherence. One doctor reported that he used the biopsychosocial approach to improve adherence in his patients. Doctors indicated that the disability grant given by the South African Government caused patients not to adhere to treatment in order to maintain a CD4 count of 200 or less so as to qualify for the grant. Conclusions: The study confirmed the previous study findings in that it showed that private sector doctors manage their HIV-infected patients both pharmacologically and nonpharmacologically. It further provided new and interesting information with regard to the nonpharmacological methods employed in HIV/AIDS management, that is the incorporation of cultural beliefs in the management of HIV-infected patients to improve adherence to treatment, and the role of the disability grant and pharmaceutical formulations in contributing to nonadherence by HIV-infected patients. SAAFP."									
423	Factors associated with mortality in HIV-infected and uninfected patients with pulmonary tuberculosis.	"Mugusi FM, Mehta S, Villamor E, Urassa W, Saathoff E, Bosch RJ, Fawzi WW."	BMC Public Health. 2009;9:409.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=19909501	"BACKGROUND: HIV has fuelled the TB epidemic in sub-Saharan Africa. Mortality in patients co-infected with TB and HIV is high. Managing factors influencing mortality in TB patients might help reducing it. This study investigates factors associated with mortality including patients' HIV sero-status, CD4 cell count, laboratory, nutritional and demographic characteristics in AFB smear positive pulmonary TB patients."	"METHODS: We studied 887 sputum smear positive PTB patients, between 18 and 65 years of age receiving standard 8 months anti-TB treatment. Demographic, anthropometric and laboratory data including HIV, CD4 and other tests were collected at baseline and at regular intervals. Patients were followed for a median period of 2.5 years."	"RESULTS: Of the 887 participants, 155 (17.5%) died, of whom 90.3% (140/155) were HIV-infected, a fatality of 29.7% (140/471) compared to 3.6% (15/416) among HIV-uninfected. HIV infection, age, low Karnofsky score, CD4 cell counts and hemoglobin, high viral load, and oral thrush were significantly associated with high mortality in all patients."	"CONCLUSION: Mortality among HIV-infected TB patients is high despite the use of effective anti-TB therapy. Most deaths occur after successful completion of therapy, an indication that patients die from causes other than TB. HIV infection is the strongest independent predictor of mortality in this cohort."						
488	"Increased subclinical atherosclerosis in HIV-infected children and adolescents: Relations with cardiovascular biomarkers, immune activation/senescence and HIV-related variables."	"Alvarez Fuente M, Sainz Costa T, Diaz L, Navarro ML, Medrano C, Blazquez D, De Jose MI, et al."	Cardiology in the Young. 2013 May;23:S7.		"Background: HIV infection accelerates cardiovascular disease (CVD). The study of subclinical atherosclerosis in subjects without traditional CVD risk factors, such as children and adolescents, may help clarify the role of HIV infection, antiretroviral treatment (ART) and immune activation on the atherogenic process. Methods: These are the definitive baseline results of the prospective CaroVIH Study. Carotid intima-media thickness (IMT) was measured with a portable echo-device (Phillips CX50) in a group of HIV-infected children and young adults and in a group of healthy subjects of similar sex and age. Cardiovascular biomarkers (hsCRP, IL-6, IL-8, MPO, VCAM, MCP-1, tPA, CD40L) in a random subgroup of 64 HIV1 and 30 HIV- subjects, and T-cell activation (CD381HLADR1)/ senescence (CD27-CD581) in a random subgroup of 37 HIV1 and 11 HIV- subjects were determined. Results: 300 subjects were included, 150 HIV-infected patients (97% vertical transmission, 76% on viral suppression, 97% on stable ART) and 150 healthy subjects. Mean age was 14.8+/-4.9 years, 62% were female. Age, gender, body-mass index (BMI), smoking status, frequency of hypertension or hypercholesterolemia were similar in both groups. IMT was thicker in HIV-infected subjects compared to healthy individuals (mm) (0.434+/-0.025 vs 0.424+/-0.018, respectively, p<0.001). After adjustment by age, sex, BMI, smoking status, triglycerides and non-HDL cholesterol, HIV infection remained independently associated with thicker IMT (.p=0 [0.42 mm], OR, 2.3; 95% CI: 1.3-4.1; p=0.007). Among HIVinfected patients, in a multivariate analysis including time with detectable viral load, cumulative ART exposure, CD4 nadir, lipodystrophy, CD4 and CD8 counts, only CD4 nadir remained independently associated to increased IMT (.100 cells/mL, OR, 0.8, 95% CI, 0.7-0.9, p=0.033). Regarding cardiovascular biomarkers, only t-PA and CD-40L were elevated in the HIV-infected patients (p<0.05). HIV-infected subjects presented higher frequencies of activated CD4 T-cells (p=0.016). Viremic patients showed higher frequencies of senescent CD8 T-cells compared to healthy subjects (p<0.001) and aviremic patients (p=0.02). Conclusions: Structural changes of the vasculature present early in vertically HIV-infected subjects, as well as immune activation and senescence. These patients should be carefully monitored for the prompt detection and early treatment, in order to prevent cardiovascular disease."									
1082	"Association of pre-treatment nutritional status with change in CD4 count after initiation of antiretroviral therapy at 6, 12, and 24 months in Rwandan women."	"Kiefer E, Hoover D, Shi Q, Dusingize JC, Cohen M, Mutimura E, Anastos K."	Journal of General Internal Medicine. 2011 May;26:S119-S20.		"BACKGROUND: HIV infection and malnutrition are prevalent in Africa. Rwandan women share a greater burden of HIV than men, and malnutrition (using World Health Organization definition of body mass index (BMI) < 18.5 kg/m2) is common (approximately 19%) in our preliminary studies of HIV-positive Rwandan women. Low serum albumin and BMI have been shown to independently predict increased mortality in several African studies. However, macro-and micro-nutrient supplementation have failed to consistently show reductions in HIV mortality. It is thus unclear whether these malnutrition measures simply mark more advanced HIV disease, and there are scant data on the effect of nutritional status on response to antiretroviral therapy (ART). As ART becomes more available in the low income countries, it is crucial to understand the association between poor nutrition and response to ART. We hypothesized that poorer nutritional status would be associated with poorer gains in CD4 count after ART initiation. METHODS: This analysis was done on 537 Rwandan Women's Interassociation Study and Assessment (RWISA) participants who initiated ART after study entry and had at least six subsequent months of follow up. RWISA is a population-based observational cohort study of 710 ART-naive HIV + and 226 HIV-negative women who enrolled in 2005 and seen at six-month visits. At these visits, health and health behavior data were collected, including whether women initiated ART (exact dates of ART initiation and medication regimen were determined), physical exams performed, and biologic specimens collected and stored. Medical care was provided by non-governmental and national health organizations, separately from the RWISA study. Following World Health Organization (WHO) and Rwandan guidelines, women were eligible for ART if they had; WHO Stage IV disease, irrespective of the CD4 cell count; WHO Stage III disease with CD4 cell counts <350 cells/muL, or CD4 <200/muL regardless of clinical stage. The study outcomes were changes in CD4 count at follow up visits 6+/-3, 12+/-3, and 24+/-3 months after ART initiation. Indicators of nutritional status collected from the study visit prior to ART initiation that were used in these analyses included BMI, albumin, fat adjusted for (height)2, fat free mass (FFM) adjusted for (height)2, and sum of skinfold measurements at the thigh, triceps and subscapular muscles. Resistance and reactance obtained frombioelectric impedancemeasurements wereused in standard formulae to calculate FFM and fat. Other covariates used included age, income in Rwandan Francs (FRW), education, pre-ART CD4 count (per 100 cells/ <sup>1/4</sup>L) and history of AIDS defining illness (ADI) prior to ART initiation. Nutritional variables were examined in univariate linear regression models of CD4 change. Multivariate linear regression models of change for each nutritional variable were fit using backwards selection. RESULTS: 537 women initiated ART at a mean age of 35 years. Mean (within 6 months) preART CD4 count was 216 cells/ <sup>1/4</sup>L. Prior to ART, the mean BMI was 21.6 kg/m2 (18.3% of the women classified as malnourished), mean albumin 3.4 g/dL; mean adjusted fat 4.70 kg/m2, mean adjusted FFM 17.1 kg/m2; and mean sum of skinfold measurements 0.495 cm. The mean change in CD4 count from pre-ART to 6+/-3, 12+/-3, and 24+/-3 months was 71, 89 and 153 cells/ <sup>1/4</sup>L, respectively. In univariate analysis, higher albumin was associated with a smaller increase in CD4 count from pre-ART to 6 months post-ART (estimate -17.8 cells/ <sup>1/4</sup>L per g/dL, p=0.03), but not at 12 or 24 months post-ART. Thus for example, those with 4.0 g/dL albumin gained on average 17.8 fewer CD4 cells/uL compared to those with 3.0 g/dL of albumin. FFM was also inversely associated with change in CD4 count at 6 months (-6.7 cells/ <sup>1/4</sup>L per kg/m2, p=0.03, respectively), but not at 12 or 24 months. For example, those with an adjusted FFM of 18.1 kg/ m2 gained 6.7 fewer CD4 cells/uL from pre-ART to 6 months post-ART compared to those with 17.1 k"									
72	Randomized trial of vitamin supplements in relation to transmission of HIV-1 through breastfeeding and early child mortality.	"Fawzi WW, Msamanga GI, Hunter D, Renjifo B, Antelman G, Bang H, Manji K, et al."	AIDS. 2002;16(14):1935-44.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=12351954	BACKGROUND: HIV-1 transmission through breastfeeding is a global problem and has been associated with poor maternal micronutrient status.	METHODS: A total of 1078 HIV-infected pregnant women from Tanzania were randomly assigned to vitamin A or multivitamins excluding A from approximately 20 weeks' gestation and throughout lactation.	"RESULTS: Multivitamins excluding A had no effect on the total risk of HIV-1 transmission (RR 1.04, 95% CI 0.82-1.32, P= 0.76). Vitamin A increased the risk of transmission (RR 1.38, 95% CI 1.09-1.76, P = 0.009). Multivitamins were associated with non-statistically significant reductions in transmission through breastfeeding, and mortality by 24 months among those alive and not infected at 6 weeks. Multivitamins significantly reduced breastfeeding transmission in infants of mothers with low baseline lymphocyte counts (RR 0.37; 95% CI 0.16-0.85, P = 0.02) compared with infants of mothers with higher counts (RR 0.99, 95% CI 0.68-1.45, P = 0.97; -for-interaction 0.03). Multivitamins also protected against transmission among mothers with a high erythrocyte sedimentation rate (P-for-interaction 0.06), low hemoglobin (P-for-interaction 0.06), and low birthweight babies (P-for-interaction 0.04). Multivitamins reduced death and prolonged HIV-free survival significantly among children born to women with low maternal immunological or nutritional status. Vitamin A alone increased breastfeeding transmission but had no effect on mortality by 24 months."	"CONCLUSION: Vitamin A increased the risk of HIV-1 transmission. Multivitamin (B, C, and E) supplementation of breastfeeding mothers reduced child mortality and HIV-1 transmission through breastfeeding among immunologically and nutritionally compromised women. The provision of these supplements to HIV-infected lactating women should be considered."						
1039	Characteristics associated to lipodystrophy syndrome among HIV-infected patients naive and on antiretroviral treatment.	"Alencastro PR, Wolff FH, Schuelter-Treviso F, Ikeda ML, Brandao ABM, Barcellos NT, Fuchs SC."	Journal of AIDS and Clinical Research. 2012;3(9).	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20133136912	"Background: HIV-associated lipodystrophy involves changes in complex metabolic networks that are associated with increased cardiovascular risk. It has been associated with the use of combined antiretroviral treatment (cART), particularly Protease Inhibitors (PI) and thymidine analogs. This study aims to evaluate characteristics and use of ART associated with lipodystrophy, lipohypertrophy, and lipoatrophy among HIV-infected patients. Methods: A cross-sectional study was conducted in HIV-infected patients of both genders, aged 18 years or older, who sought care at an HIV/AIDS referral service for diagnostic confirmation or treatment between June 2006 and December 2008. Results: 1240 out of 1295 patients with HIV infection were included. Among patients on cART, women had a higher risk of lipohypertrophy than men, as well as a time since diagnosis of HIV greater than 6 years (versus <3 years). For lipoatrophy, age, education, lifestyle, and body mass index were associated with increased risk. Metabolic parameters were higher among patients on ART; and cART and PI use were independently associated with lipohypertrophy, lipoatrophy and lipodystrophy. The use of IPs can be regarded as responsible for 13% of the association of ART and lipodystrophy, and of 11.5% for the thymidine analogs use, independent of gender, skin color, smoking, CD4, and BMI. Conclusions: Risk factors for lipodystrophy, lipoatrophy and lipohypertrophy are marked among ART users, but also among ART naive patients."									
410	Outcome of HIV-exposed uninfected children undergoing surgery.	"Karpelowsky JS, Millar AJ, van der Graaf N, van Bogerijen G, Zar HJ."	BMC Pediatrics. 2011;11:69.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=21801358	BACKGROUND: HIV-exposed uninfected (HIVe) children are a rapidly growing population that may be at an increased risk of illness compared to HIV-unexposed children (HIVn). The aim of this study was to investigate the morbidity and mortality of HIVe compared to both HIVn and HIV-infected (HIVi) children after a general surgical procedure.	"METHODS: A prospective study of children less than 60 months of age undergoing general surgery at a paediatric referral hospital from July 2004 to July 2008 inclusive. Children underwent age-definitive HIV testing and were followed up post operatively for the development of complications, length of stay and mortality."	"RESULTS: Three hundred and eighty children were enrolled; 4 died and 11 were lost to follow up prior to HIV testing, thus 365 children were included. Of these, 38(10.4%) were HIVe, 245(67.1%) were HIVn and 82(22.5%) were HIVi children.The overall mortality was low, with 2(5.2%) deaths in the HIVe group, 0 in the HIVn group and 6(7.3%) in the HIVi group (p = 0.0003). HIVe had a longer stay than HIVn children (3 (2-7) vs. 2 (1-4) days p = 0.02). There was no significant difference in length of stay between the HIVe and HIVi groups. HIVe children had a higher rate of complications compared to HIVn children, (9 (23.7%) vs. 14(5.7%) (RR 3.8(2.1-7) p < 0.0001) but a similar rate of complications compared to HIVi children 34 (41.5%) (RR = 0.6 (0.3-1.1) p = 0.06)."	"CONCLUSION: HIVe children have a higher risk of developing complications and mortality after surgery compared to HIVn children. However, the risk of complications is lower than that of HIVi children."						
1022	Provision of micronutrient-fortified food from 6 months of age does not permit HIV-exposed uninfected Zambian children to catch up in growth to HIV-unexposed children: a randomized controlled trial.	"Filteau S, Baisley K, Chisenga M, Kasonka L, Gibson RS, Team CS."	Journal of Acquired Immune Deficiency Syndromes: JAIDS. 2011;56(2):166-75.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=21119523	"BACKGROUND: HIV-exposed, uninfected (HIV-EU) children represent a large proportion of children in southern Africa. The reasons for their poorer growth and higher morbidity and mortality than their HIV-unexposed peers are unclear."	OBJECTIVE: We compared anthropometry of 125 HIV-EU with 382 HIV-unexposed young Zambian children participating in a trial of micronutrient-fortified complementary/replacement food.	DESIGN: The randomized controlled trial provided children from age 6 to 18 months with a porridge flour containing either a basal or a rich level of micronutrients. Weight and length were measured 3 monthly and head and arm circumferences and triceps and subscapular skinfolds 6 monthly.	"RESULTS: There were no significant anthropometric differences between the 2 treatment groups. In unadjusted analyses, most anthropometric Z scores of HIV-EU children were lower than those of HIV-unexposed children; after adjustment for treatment arm, socioeconomic factors, breastfeeding and sex, head and arm circumference Z scores remained lower. Subscapular skinfold Z scores were lower among HIV-EU than HIV-unexposed children at 6 months but not 18 months."	CONCLUSIONS: Socioeconomic factors accounted for some but not all of the impaired growth of HIV-EU children. Micronutrient malnutrition may not be the socioeconomic factor responsible for the growth faltering. Factors acting earlier in life had irreversible effects.					
985	Provision of micronutrient-fortified food from 6 months of age does not permit HIV-exposed uninfected Zambian children to catch up in growth to HIV-unexposed children: A randomized controlled trial.	"Filteau S, Baisley K, Chisenga M, Kasonka L, Gibson RS."	Journal of Acquired Immune Deficiency Syndromes. 2011 01 Feb;56(2):166-75.		"Background: HIV-exposed, uninfected (HIV-EU) children represent a large proportion of children in southern Africa. The reasons for their poorer growth and higher morbidity and mortality than their HIV-unexposed peers are unclear. Objective: We compared anthropometry of 125 HIV-EU with 382 HIV-unexposed young Zambian children participating in a trial of micronutrient-fortified complementary/replacement food. Design: The randomized controlled trial provided children from age 6 to 18 months with a porridge flour containing either a basal or a rich level of micronutrients. Weight and length were measured 3 monthly and head and arm circumferences and triceps and subscapular skinfolds 6 monthly. Results: There were no significant anthropometric differences between the 2 treatment groups. In unadjusted analyses, most anthropometric Z scores of HIV-EU children were lower than those of HIV-unexposed children; after adjustment for treatment arm, socioeconomic factors, breastfeeding and sex, head and arm circumference Z scores remained lower. Subscapular skinfold Z scores were lower among HIV-EU than HIV-unexposed children at 6 months but not 18 months. Conclusions: Socioeconomic factors accounted for some but not all of the impaired growth of HIV-EU children. Micronutrient malnutrition may not be the socioeconomic factor responsible for the growth faltering. Factors acting earlier in life had irreversible effects. 2011 Lippincott Williams & Wilkins."									
1457	Synbiotic therapy decreases microbial translocation and inflammation and improves immunological status in HIV-infected patients: a double-blind randomized controlled pilot trial.	"Gonzalez-Hernandez LA, Jave-Suarez LF, Fafutis-Morris M, Montes-Salcedo KE, Valle-Gutierrez LG, Campos-Loza AE, Enciso-Gomez LF, et al."	Nutrition Journal. 2012;11:90.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=23101545	"BACKGROUND: HIV-infection results in damage and dysfunction of the gastrointestinal system. HIV enteropathy includes pronounced CD4+ T-cell loss, increased intestinal permeability, and microbial translocation that promotes systemic immune activation, which is implicated in disease progression. A synbiotic is the combination of probiotics and prebiotics that could improve gut barrier function. Our study goal was to determine whether the use of a synbiotic, probiotics or a prebiotic can recover immunological parameters in HIV-infected subjects through of a reduction of microbial translocation and pro-inflammatory cytokine production."	"METHODS: A randomized, double-blind controlled study was performed; twenty Antiretroviral treatment-naive HIV-infected subjects were subgrouped and assigned to receive a synbiotic, probiotics, a prebiotic, or a placebo throughout 16 weeks."	"RESULTS: We had no reports of serious adverse-events. From baseline to week 16, the synbiotic group showed a reduction in bacterial DNA concentrations in plasma (p = 0.048). Moreover, the probiotic and synbiotic groups demonstrated a decrease in total bacterial load in feces (p = 0.05). The probiotic group exhibited a significant increment of beneficial bacteria load (such as Bifidobacterium; p = 0.05) and a decrease in harmful bacteria load (such as Clostridium; p = 0.063). In the synbiotic group, the CD4+ T-cells count increased (median: +102 cells/uL; p = 0.05) and the level of Interleukin 6 cytokine decreased significantly (p = 0.016)."	"CONCLUSIONS: Our study showed a significant increase in CD4+ T lymphocyte levels in the synbiotic group, which could delay the initiation of antiretroviral therapy and decrease costs in countries with limited resources."						
1462	"Ready to Use Therapeutic Foods (RUTF) improves undernutrition among ART-treated, HIV-positive children in Dar es Salaam, Tanzania."	"Sunguya BF, Poudel KC, Mlunde LB, Otsuka K, Yasuoka J, Urassa DP, Mkopi NP, et al."	Nutrition Journal. 2012;11:60.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=22931107	"BACKGROUND: HIV/AIDS is associated with an increased burden of undernutrition among children even under antiretroviral therapy (ART). To treat undernutrition, WHO endorsed the use of Ready to Use Therapeutic Foods (RUTF) that can reduce case fatality and undernutrition among ART-naive HIV-positive children. However, its effects are not studied among ART-treated, HIV-positive children. Therefore, we examined the association between RUTF use with underweight, wasting, and stunting statuses among ART-treated HIV-positive children in Dar es Salaam, Tanzania."	"METHODS: This cross-sectional study was conducted from September-October 2010. The target population was 219 ART-treated, HIV-positive children and the same number of their caregivers. We used questionnaires to measure socio-economic factors, food security, RUTF-use, and ART-duration. Our outcome variables were underweight, wasting, and stunting statuses."	"RESULTS: Of 219 ART-treated, HIV-positive children, 140 (63.9%) had received RUTF intervention prior to the interview. The percentages of underweight and wasting among non-RUTF-receivers were 12.4% and 16.5%; whereas those of RUTF-receivers were 3.0% (P = 0.006) and 2.8% (P = 0.001), respectively. RUTF-receivers were less likely to have underweight (Adjusted Odd Ratio (AOR) =0.19, CI: 0.04, 0.78), and wasting (AOR = 0.24, CI: 0.07, 0.81), compared to non RUTF-receivers. Among RUTF receivers, children treated for at least four months (n = 84) were less likely to have underweight (P = 0.049), wasting (P = 0.049) and stunting (P < 0.001)."	"CONCLUSIONS: Among HIV-positive children under ART, the provision of RUTF for at least four months was associated with low proportions of undernutrition status. RUTF has a potential to improve undernutrition among HIV-positive children under ART in the clinical settings in Dar es Salaam, Tanzania."						
164	"Virologic and immunologic outcome of HAART in Human Immunodeficiency Virus (HIV)-1 infected patients with and without tuberculosis (TB) and latent TB infection (LTBI) in Addis Ababa, Ethiopia."	"Kassa D, Gebremichael G, Alemayehu Y, Wolday D, Messele T, van Baarle D."	AIDS Research and Therapy. 2013 10 Jul;10(1).		"Background: HIV/TB coinfection remains a major challenge even after the initiation of HAART. Little is known about Mycobacterium tuberculosis (Mtb) specific immune restoration in relation to immunologic and virologic outcomes after long-term HAART during co-infections with latent and active TB.Methods: A total of 232 adults, including 59 HIV patients with clinical TB (HIV + TB+), 125 HIV patients without clinical TB (HIV + TB-), 13 HIV negative active TB patients (HIV-TB+), and 10 HIV negative Tuberculin Skin TST positive (HIV-TST+), and 25 HIV-TST- individuals were recruited. HAART was initiated in 113 HIV + patients (28 TB + and 85 TB-), and anti-TB treatment for all TB cases. CD4+ T-cell count, HIV RNA load, and IFN- responses to ESAT-6/CFP-10 were measured at baseline, 6 months (M6), 18 months (M18) and 24 months (M24) after HAART initiation.Results: The majority of HIV + TB- (70%, 81%, 84%) as well as HIV + TB + patients (60%, 77%, 80%) had virologic success (HIV RNA < 50 copies/ml) by M6, M18 and M24, respectively. HAART also significantly increased CD4+ T-cell counts at 2 years in HIV + TB + (from 110.3 to 289.9 cells/mul), HIV + TB- patients (197.8 to 332.3 cells/mul), HIV + TST- (199 to 347 cells/mul) and HIV + TST + individuals (195 to 319 cells/mul). Overall, there was no significant difference in the percentage of patients that achieved virologic success and in total CD4+ counts increased between HIV patients with and without TB or LTBI. The Mtb specific IFN- response at baseline was significantly lower in HIV + TB + (3.6 pg/ml) compared to HIV-TB + patients (34.4 pg/ml) and HIV + TST + (46.3 pg/ml) individuals; and in HIV-TB + patients compared to HIV-TST + individuals (491.2 pg/ml). By M18 on HAART, the IFN- response remained impaired in HIV + TB + patients (18.1 pg/ml) while it normalized in HIV + TST + individuals (from 46.3 to 414.2 pg/ml).Conclusions: Our data show that clinical and latent TB infections do not influence virologic and immunologic outcomes of ART in HIV patients. Despite this, HAART was unable to restore optimal TB responsiveness as measured by Mtb specific IFN- response in HIV/TB patients. Improvement of Mtb-specific immune restoration should be the focus of future therapeutic strategies. 2013 Kassa et al.; licensee BioMed Central Ltd."									
724	Nutritional status of under-five children in HIV-affected households in western Kenya.	"Ndirangu M, Wariero JO, Sachs SE, Masibo P, Deckelbaum RJ."	Food & Nutrition Bulletin. 2011;32(2):159-67.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=22164976	"BACKGROUND: Households affected by HIV/AIDS are at an increased risk for food insecurity and malnutrition. Poor nutrition contributes to more than a third of all deaths associated with infectious diseases among children under 5 years of age in developing countries. With increased household food insecurity, and a greater disease burden associated with HIV/AIDS, the growth of children under five could be impacted, resulting in increased malnutrition for this vulnerable group."	OBJECTIVE: To determine whether there is an association between the type of household (HIV-affected compared with HIV-unaffected) and the nutritional status of children under 5 years of age residing in these households.	"METHODS: The study was set in a Millennium Village Project site in western Kenya and used a cross-sectional design to compare the stunting, wasting, and underweight status among 102 and 99 under-five children living in HIV-affected and -unaffected households, respectively. Height-for-age, weight-for-age, and weight-for-age z-scores were calculated based on the World Health Organization growth standards and compared. Proportions, means, and standard deviations were used to describe the data. The data were analyzed with the use of the chi-square test for comparison of proportions and the independent t-test for comparison of means."	"RESULTS: Children in HIV-affected households had a significantly higher degree of stunting (height-for-age < -2 SD) than children in unaffected households (25.5% vs. 9.1%, p = .002). The degree of wasting and underweight did not differ significantly between HIV-affected and -unaffected households."	CONCLUSIONS: Residing in HIV-affected households is associated with stunting in children under 5 years of age.					
171	"Policosanol for managing human immunodeficiency virus-related dyslipidemia in a medically underserved population: a randomized, controlled clinical trial."	"Swanson B, Keithley JK, Sha BE, Fogg L, Nerad J, Novak RM, Adeyemi O, et al."	Alternative Therapies in Health & Medicine. 2011;17(2):30-5.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=21717822	"BACKGROUND: Human immunodeficiency virus (HIV) infection is associated with dyslipidemia and increased risk for cardiovascular events; however, the use ofstatins in HIV-infected people is complicated by pharmacokinetic interactions and overlapping toxicities with antiretroviral medications. Policosanol is a dietary supplement derived from sugar cane that is widely used as a statin alternative in Latin America."	PRIMARY STUDY OBJECTIVE: To collect feasibility data on sugar cane-derived policosanol to normalize dyslipidemic profiles in a sample of medically underserved HIV-infected people.	"METHODS/DESIGN: Randomized, controlled, double-blind clinical trial. Setting: Two infectious disease outpatient clinics located in a Health Resources Service Administration-designated medically underserved neighborhood in Chicago, Illinois."	PARTICIPANTS: Fifty-four clinically stable HIV-infected people (91% black) with at least one lipid abnormality that warranted dietary modifications and/or drug therapy.	"INTERVENTION: Participants received either 20 mg/day of policosanol or placebo for 12 weeks, followed by a 4-week washout and crossover to the other arm."	"PRIMARY OUTCOME MEASURES: Efficacy measures included the standard lipid panel (low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglycerides) and nuclear magnetic resonance (NMR)-derived lipoprotein particle profiles. Safety measures included CD4+ T lymphocyte counts, plasma HIV ribonucleic acid levels, serum creatinine, and liver function tests."	RESULTS: Policosanol supplementation was not associated with normalization of any dyslipidemic parameters as measured by the standard lipid panel or NMR spectroscopy-measured lipoprotein size or concentration. The supplement was well tolerated and was not associated with any changes in parameters of HIV disease progression.	CONCLUSIONS: Our findings corroborate recent studies conducted outside Cuba that have failed to find any lipid modulatory effects for policosanol.		
515	"HIV infection, malnutrition, and invasive bacterial infection among children with severe malaria."	"Berkley JA, Bejon P, Mwangi T, Gwer S, Maitland K, Williams TN, Mohammed S, et al."	Clinical Infectious Diseases. 2009;49(3):336-43.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=19548833	"BACKGROUND: Human immunodeficiency virus (HIV) infection, malnutrition, and invasive bacterial infection (IBI) are reported among children with severe malaria. However, it is unclear whether their cooccurrence with falciparum parasitization and severe disease happens by chance or by association among children in areas where malaria is endemic."	"METHODS: We examined 3068 consecutive children admitted to a Kenyan district hospital with clinical features of severe malaria and 592 control subjects from the community. We performed multivariable regression analysis, with each case weighted for its probability of being due to falciparum malaria, using estimates of the fraction of severe disease attributable to malaria at different parasite densities derived from cross-sectional parasitological surveys of healthy children from the same community."	"RESULTS: HIV infection was present in 133 (12%) of 1071 consecutive parasitemic admitted children (95% confidence interval [CI], 11%-15%). Parasite densities were higher in HIV-infected children. The odds ratio for admission associated with HIV infection for admission with true severe falciparum malaria was 9.6 (95% CI, 4.9-19); however, this effect was restricted to children aged 1 year. Malnutrition was present in 507 (25%) of 2048 consecutive parasitemic admitted children (95% CI, 23%-27%). The odd ratio associated with malnutrition for admission with true severe falciparum malaria was 4.0 (95% CI, 2.9-5.5). IBI was detected in 127 (6%) of 2048 consecutive parasitemic admitted children (95% CI, 5.2%-7.3%). All 3 comorbidities were associated with increased case fatality."	"CONCLUSIONS: HIV, malnutrition and IBI are biologically associated with severe disease due to falciparum malaria rather than being simply alternative diagnoses in co-incidentally parasitized children in an endemic area."						
385	Nutritional status and serum zinc and selenium levels in Iranian HIV infected individuals.	"Khalili H, Soudbakhsh A, Hajiabdolbaghi M, Dashti-Khavidaki S, Poorzare A, Saeedi AA, Sharififar R."	BMC Infectious Diseases. 2008 09 Dec;8(165).		"Background: Human immunodeficiency virus infected individuals are prone to malnutrition due to increased energy requirements, enteropathy and increased catabolism. Trace elements such as zinc and selenium have major role in maintaining a healthy immune system. This study was designed to evaluate the nutritional status of Iranian subjects who were newly diagnosed with human immunodeficiency virus infection and to compare serum level of zinc and selenium in these patients with those of the sex and aged match healthy subjects. Methods: After an interview and physical examination, nutritional assessment was done based on clinical and anthropometric parameters. Body mass index (normal range 18.5-27 kg/m2 based on age) of less than 16, 16-16.9 and 17-18.4 kg/m2 were considered as severe, moderate and mild malnutrition respectively. Serum level of zinc and selenium were measured by graphite furnace atomic absorption. Results: Severe, moderate and mild malnutrition were detected in 15%, 38% and 24% of human immunodeficiency virus infected individuals respectively. Compared with the healthy control group, serum level of zinc and selenium in the human immunodeficiency virus infected subjects were significantly lower (P = 0.01 and P = 0.02 respectively). Conclusion: Malnutrition found to be prevalent in Iranian human immunodeficiency virus infected individuals and low serum zinc and selenium levels are common in this population. 2008 Khalili et al; licensee BioMed Central Ltd."									
957	Body mass index at time of HIV diagnosis: a strong and independent predictor of survival.	"Sande MABvd, Loeff MFSvd, Aveika AA, Sabally S, Togun T, Sarge-Njie R, Alabi AS, et al."	"JAIDS, Journal of Acquired Immune Deficiency Syndromes. 2004;37(2):1288-94."	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh3&AN=20043179447	"Background: Identification of basic prognostic indicators of HIV infection is essential before widespread antiretroviral therapy can be implemented in low-technology settings. This study assessed how well body mass index (BMI:kg/m<sup>2</sup>) predicts survival. Methods: BMI within 3 months of HIV diagnosis was obtained from 1657 patients aged >=15 years, recruited in a seroprevalent clinical cohort in The Gambia since 1992 and followed up at least once. Baseline CD4<sup>+</sup> counts and clinical assessment at time of diagnosis were done. Results: The mortality hazard ratio (HR) of those with a baseline BMI<18 compared with those with a baseline BMI>=18 was 3.4 (95% CI, 3.0-3.9). The median survival time of those presenting with a BMI<16 was 0.8 years, in contrast to a median survival of 8.9 years for those with a baseline BMI>=22. Baseline BMI<18 remained a highly significant independent predictor of mortality after adjustment for age, sex, co-trimoxazole prophylaxis, tuberculosis, reported wasting at diagnosis, and baseline CD4<sup>+</sup> cell count (adjusted HR=2.5, 95% CI 2.0-3.0). Sensitivity and specificity of baseline BMI<18 was comparable to that of a CD4<sup>+</sup> count <200 in predicting mortality within 6 months of diagnosis. Discussion: BMI at diagnosis is a strong, independent predictor of survival in HIV-infected patients in West Africa. In the absence of sophisticated clinical and laboratory support, BMI may also prove a useful guide for deciding when to initiate antiretroviral therapy."									
1005	Body mass index at time of HIV diagnosis: A strong and independent predictor of survival.	"Van Der Sande MAB, Shim Van Der Loeff MF, Aveika AA, Sabally S, Togun T, Sarge-Njie R, Alabi AS, et al."	Journal of Acquired Immune Deficiency Syndromes. 2004 01 Oct;37(2):1288-94.		"Background: Identification of basic prognostic indicators of HIV infection is essential before widespread antiretroviral therapy can be implemented in low-technology settings. This study assessed how well body mass index (BMI:kg/m<sup>2</sup>) predicts survival. Methods: BMI within 3 months of HIV diagnosis was obtained from 1657 patients aged >=15 years, recruited in a seroprevalent clinical cohort in The Gambia since 1992 and followed up at least once. Baseline CD4<sup>+</sup> counts and clinical assessment at time of diagnosis were done. Results: The mortality hazard ratio (HR) of those with a baseline BMI <18 compared with those with a baseline BMI >=18 was 3.4 (95% CI, 3.0-3.9). The median survival time of those presenting with a BMI <16 was 0.8 years, in contrast to a median survival of 8.9 years for those with a baseline BMI >=22. Baseline BMI <18 remained a highly significant independent predictor of mortality after adjustment for age, sex, co-trimoxazole prophylaxis, tuberculosis, reported wasting at diagnosis, and baseline CD4 <sup>+</sup> cell count (adjusted HR = 2.5, 95% CI 2.0-3.0). Sensitivity and specificity of baseline BMI <18 was comparable to that of a CD4<sup>+</sup> count <200 in predicting mortality within 6 months of diagnosis. Discussion: BMI at diagnosis is a strong, independent predictor of survival in HIV-infected patients in West Africa. In the absence of sophisticated clinical and laboratory support, BMI may also prove a useful guide for deciding when to initiate antiretroviral therapy."									
1032	Body mass index at time of HIV diagnosis: a strong and independent predictor of survival.	"van der Sande MA, Schim van der Loeff MF, Aveika AA, Sabally S, Togun T, Sarge-Njie R, Alabi AS, et al."	Journal of Acquired Immune Deficiency Syndromes: JAIDS. 2004;37(2):1288-94.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=15385737	BACKGROUND: Identification of basic prognostic indicators of HIV infection is essential before widespread antiretroviral therapy can be implemented in low-technology settings. This study assessed how well body mass index (BMI:kg/m2) predicts survival.	"METHODS: BMI within 3 months of HIV diagnosis was obtained from 1657 patients aged > or = 15 years, recruited in a seroprevalent clinical cohort in The Gambia since 1992 and followed up at least once. Baseline CD4+ counts and clinical assessment at time of diagnosis were done."	"RESULTS: The mortality hazard ratio (HR) of those with a baseline BMI <18 compared with those with a baseline BMI > or = 18 was 3.4 (95% CI, 3.0-3.9). The median survival time of those presenting with a BMI <16 was 0.8 years, in contrast to a median survival of 8.9 years for those with a baseline BMI > or = 22. Baseline BMI <18 remained a highly significant independent predictor of mortality after adjustment for age, sex, co-trimoxazole prophylaxis, tuberculosis, reported wasting at diagnosis, and baseline CD4+ cell count (adjusted HR = 2.5, 95% CI 2.0-3.0). Sensitivity and specificity of baseline BMI <18 was comparable to that of a CD4+ count <200 in predicting mortality within 6 months of diagnosis."	"DISCUSSION: BMI at diagnosis is a strong, independent predictor of survival in HIV-infected patients in West Africa. In the absence of sophisticated clinical and laboratory support, BMI may also prove a useful guide for deciding when to initiate antiretroviral therapy."						
1539	Immune reconstitution inflammatory syndrome in human immunodeficiency virus-infected children in Peru.	"Wang ME, Castillo ME, Montano SM, Zunt JR."	Pediatric Infectious Disease Journal. 2009 October;28(10):900-3.		"Background: Immune reconstitution inflammatory syndrome (IRIS) after initiating highly active antiretroviral therapy (HAART) has not been widely studied in children, especially in resource-poor settings. Methods: Retrospective cohort study of HIV-infected children initiating HAART between 2001 and 2006 at a tertiary pediatric hospital in Lima, Peru. Charts were reviewed for 1 year after HAART initiation. IRIS was defined as a HAART-associated adverse event caused by an infectious or inflammatory condition in patients with documented virologic or immunologic success. Results: Ninety-one children (52% female) received HAART for at least 1 year. Median age at initiation was 5.7 years; 91% were ART naive and 73% had CDC stage C disease. The incidence of IRIS was 19.8 events per 100 person years (95% CI: 11.5-28.0). Median time to IRIS was 6.6 weeks after HAART initiation (range: 2-32 weeks). There were 18 IRIS events, 11 unmasking and 7 paradoxical. These included associations with Mycobacterium tuberculosis in 4 cases, Bacillus Calmette Guerin lymphadenitis in 1 case, varicella zoster virus in 6 cases and herpes simplex labialis in 6 cases. Children who developed IRIS had a higher baseline HIV viral load (P = 0.02) and an indicator of malnutrition (P = 0.007) before HAART initiation. Conclusion: IRIS occurred in 20% of HIV-infected children starting HAART in Peru and was associated with more advanced disease and malnutrition. Future research is needed to examine specific risk factors associated with pediatric IRIS to allow prompt identification and treatment of IRIS. Copyright 2009 by Lippincott Williams & Wilkins."									
1948	Suboptimal CD4 restitution in patients on concurrent ATT-ART.	"Sashindran VK, Pramanik SK, Kumar A."	Tropical Medicine and International Health. 2011 October;16:62.		"Background: Immunosuppressive effects of TB should ad- versely affect the immune restitution in patients of HIV-TB being put on therapy. This study was done to study the prevalence of suboptimal CD4 response (SO-CD4) in patients of HIV-TB being put on concurrent ATT and ART. Methods: This prospective cohort study was carried out in a tertiary care hospital over 5 years. HIV patients with TB being put on ATT and ART concurrently were enrolled as subjects. They were followed up for a minimum of 12 months (m) after initiating ATT-ART. SO-CD4 was defines as a CD4 count rise of < 100/mm<sup>3</sup> from baseline at 12 m after starting ATT-ART. Statistical analysis was done using R 2. 11-1. Fischer's exact; Rank sum and Chi squared tests were used as required. Results: One hundred and thirty subjects on concurrent ATT- ART with median age of 35 years (IQR 31, 40) and median CD4 count of 107. 5 cells/mm<sup>3</sup> (IQR 58, 156. 5) were enrolled. SO-CD4 was seen in 66. 20% cases (significantly higher than that in HIV-TB cohort study in Africa and non-TB Western HIV cohorts, P < 0. 0001). Higher baseline CD4 cell count was more common in those with SO-CD4 than those with normal immune restitution (median CD4 count 102 and 130/mm<sup>3</sup>respectively, P = 0. 016). Lower percentage change in body mass index (BMI) and shorter ATT regimen (6 m vs. > 9 m) were associated with SO-CD4 (P = 0. 018 and 0. 016 respectively). Occurrence of adverse effects to ATT/ART or IRIS did not correlate with SO-CD4. Subsequent survival at 24 m and occurrence of ART failure were not significantly linked to SO-CD4."									
1592	Analysis of factors lowering sensitivity of interferon- release assay for tuberculosis.	"Le Hang NT, Lien LT, Kobayashi N, Shimbo T, Sakurada S, Thuong PH, Hong LT, et al."	PLoS ONE. 2011;6(8).		"Background: Imperfect sensitivity of interferon- release assay (IGRA) is a potential problem to detect tuberculosis. We made a thorough investigation of the factors that can lead to false negativity of IGRA. Methods: We recruited 543 patients with new smear-positive pulmonary tuberculosis in Hanoi, Viet Nam. At diagnosis, peripheral blood was collected and IGRA (QuantiFERON-TB Gold In-Tube) was performed. Clinical and epidemiological information of the host and pathogen was collected. The test sensitivity was calculated and factors negatively influencing IGRA results were evaluated using a logistic regression model in 504 patients with culture-confirmed pulmonary tuberculosis. Results: The overall sensitivity of IGRA was 92.3% (95% CI, 89.6%-94.4%). The proportions of IGRA-negative and -indeterminate results were 4.8% (95% CI, 3.1%-7.0%) and 3.0% (95% CI, 1.7%-4.9%). Age increased by year, body mass index <16.0, HIV co-infection and the increased number of HLA-DRB1*0701 allele that patients bear showed significant associations with IGRA negativity (OR = 1.04 [95% CI, 1.01-1.07], 5.42 [1.48-19.79], 6.38 [1.78-22.92] and 5.09 [2.31-11.22], respectively). HIV co-infection and the same HLA allele were also associated with indeterminate results (OR = 99.59 [95% CI, 15.58-625.61] and 4.25 [1.27-14.16]). Conclusions: Aging, emaciation, HIV co-infection and HLA genotype affected IGRA results. Assessment of these factors might contribute to a better understanding of the assay. 2011 Hang et al."									
675	Change over time of mortality predictors after HAART initiation in a Senegalese cohort.	"Beaudrap Pd, Etard JF, Ecochard R, Diouf A, Dieng AB, Cilote V, Ndiaye I, et al."	European Journal of Epidemiology. 2008;23(3):227-34.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20083111353	"Background: In 1998, Senegal was among the first sub-Saharan African countries to launch a Highly active anti-retroviral therapy (HAART) access program. Initial studies have demonstrated the feasibility and efficacy of this initiative. Analyses showed a peak of mortality short after starting HAART warranting an investigation of early and late mortality predictors. Methods: 404 HIV-1-infected Senegalese adult patients were enrolled and data censored as of September 2005. Predictor effects on mortality were first examined over the whole follow-up period (median 46 months) using a Cox model and Shoenfeld residuals. Then, changes of these effects were examined separately over the early and late treatment periods; i.e., less and more than 6-month follow-up. Results: During the early period, baseline body mass index and baseline total lymphocyte count were significant predictors of mortality (Hazard Ratios 0.82 [0.72-0.93] and 0.80 [0.69-0.92] per 200 cell/mm<sup>3</sup>, respectively) while baseline viral load was not significantly associated with mortality. During the late period, viro-immunological markers (baseline CD4-cell count and 6-month viral load) had the highest impact. In addition, the viral load at 6-month was a significant predictor (HR=1.42 [1.20-1.66]). Conclusion: In this cohort, impaired clinical status could explain the high early mortality rate while viro-immunological markers were rather predictors of late mortality."									
676	Change over time of mortality predictors after HAART initiation in a Senegalese cohort.	"De Beaudrap P, Etard JF, Ecochard R, Diouf A, Dieng AB, Cilote V, Ndiaye I, et al."	European Journal of Epidemiology. 2008 March;23(3):227-34.		"Background: In 1998, Senegal was among the first sub-Saharan African countries to launch a Highly active anti-retroviral therapy (HAART) access program. Initial studies have demonstrated the feasibility and efficacy of this initiative. Analyses showed a peak of mortality short after starting HAART warranting an investigation of early and late mortality predictors. Methods: 404 HIV-1-infected Senegalese adult patients were enrolled and data censored as of September 2005. Predictor effects on mortality were first examined over the whole follow-up period (median 46 months) using a Cox model and Shoenfeld residuals. Then, changes of these effects were examined separately over the early and late treatment periods; i.e., less and more than 6-month follow-up. Results: During the early period, baseline body mass index and baseline total lymphocyte count were significant predictors of mortality (Hazard Ratios 0.82 [0.72-0.93] and 0.80 [0.69-0.92] per 200 cell/mm<sup>3</sup>, respectively) while baseline viral load was not significantly associated with mortality. During the late period, viro-immunological markers (baseline CD4-cell count and 6-month viral load) had the highest impact. In addition, the viral load at 6-month was a significant predictor (HR = 1.42 [1.20-1.66]). Conclusion: In this cohort, impaired clinical status could explain the high early mortality rate while viro-immunological markers were rather predictors of late mortality. 2008 Springer Science+Business Media B.V."									
32	"Clinical predictors of HIV infection in hospitalized children aged 2-18 months in Harare, Zimbabwe."	"Nathoo KJ, Rusakaniko S, Tobaiwa O, Mujuru HA, Ticklay I, Zijenah L."	African Health Sciences. 2012;12(3):259-67.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20133061303	"Background: In Africa without antiretroviral treatment more than half of the HIV infected children die by 2 years. The recommended HIV virological testing for early infant diagnosis is not widely available in developing countries therefore a presumptive diagnosis is made in infants presenting with symptoms suggestive of HIV disease. Objectives: To identify presenting signs and symptoms predictive of HIV infection in hospitalized children aged between 2-18 months at Harare Hospital, Zimbabwe. Methods: In a cross sectional study the baseline clinical information was collected and HIV infection confirmed using DNA PCR. Multiple logistic regression analysis was used to identify significant predictors of symptomatic HIV infection. Diagnostic parameters (sensitivity, specificity) and their 95% confidence intervals were calculated. Results: 355 children with an overall median age of 6 months (IQR: 3, 10.5 months) of whom 203 (57.2%) were HIV DNA PCR positive. Clinical signs independently predictive of HIV infection were cyanosis, generalized lymphadenopathy, oral thrush, weight for age z-score <-2 and splenomegaly. The sensitivity of these signs ranged from 43-49% with a higher specificity (ranging from 72.3-89.5%). Conclusion: Clinical identification using individual signs for probable HIV infection in hospitalized children below 18 months would provide an opportunity for early diagnosis, treatment."									
725	Impact of orphanhood on underweight prevalence in sub-Saharan Africa.	"Rivers J, Mason J, Silvestre E, Gillespie S, Mahy M, Monasch R."	Food & Nutrition Bulletin. 2008;29(1):32-42.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=18510203	"BACKGROUND: In Africa, approximately 25 million people live with HIV/AIDS and 12 million children are orphaned. Although evidence indicates that orphans risk losing opportunities for adequate education, health care, and future employment, the immediate effects of orphanhood on child nutritional status remain poorly understood."	"OBJECTIVE: This paper assesses the nutritional impact of orphanhood, with particular emphasis on taking account of various factors potentially confounding or masking these impacts."	"METHODS: Child anthropometry and orphan status were examined in 23 Multiple Indicator Cluster Surveys and Demographic and Health Surveys throughout sub-Saharan Africa, which were subsequently merged into larger, region-specific datasets (East, West, and Southern Africa). To compare orphans and nonorphans, linear regression and probit models were developed, taking account of orphan status and type, presence of a surviving parent in the household, household structure, child age and sex, urban versus rural residence, and current wealth status."	"RESULTS: Few differences emerged between orphans and nonorphans in controlled and uncontrolled comparisons, regardless of orphan type, presence of surviving parent, or household structure. Age differentials did confound nutritional comparisons, although in the counterintuitive direction, with orphans (who were 8 months older on average) becoming less malnourished when age differences were taken into account. Wealth did appear to be associated with orphanhood status, although it did not significantly confound nutritional comparisons."	"CONCLUSIONS: Orphans were not consistently more malnourished than nonorphans, even when potential confounding variables were examined. Since household wealth status is likely to change after becoming affected by HIV ruling out wealth as a potential confounder would require more detailed, prospective studies."					
692	Relationship between protein intake and body composition in HIV positive adults in Botswana.	"Berg MV, Baum MK, Martinez SS, Li Y, Tsalaile L, Oropeza M, Moyo S, et al."	FASEB Journal. 2011 April;25.		"Background: In asymptomatic HIV infection weight reduction and loss of lean body mass is a predisposing factor for disease progression. Adequate protein and calorie intake is needed to maintain optimal LBM in healthy populations. The aim of this study was to investigate the relationship between protein intake and body composition in early stages of HIV infection in Botswana. Methods: After consenting 528 HIV+ adults, nutritional assessments using 24-hour recalls and body composition were conducted. For analyses, protein adequacy was considered >40 g/day for women and >60g/day for men. Body cell mass (BCM), lean body mass (LBM) and body mass index (BMI) were measured using bioelectrical impedance and compared among those with adequate and inadequate protein intake. Linear regression models and t-test were used. Results: Mean CD4 cell count in the cohort was 461.81+/-179.92 cells/mm3. Those with adequate protein intake had significantly greater BMI (beta=1.42, p=0.0007) compared to those with inadequate intake after adjusting for caloric intake, CD4 cell count, and age. Protein intake was related to increased LBM (beta=0.01, p=0.007) and BCM (beta=0.007, p=0.007). Conclusion: Protein intake was associated with greater BMI, LBM and BCM indicating that in HIV infected adults early in the disease adequate dietary protein and calorie intake is needed to maintain optimal body composition."									
1015	Randomized controlled trial of zinc supplementation for persistent diarrhea in adults with HIV-1 infection.	"Carcamo C, Hooton T, Weiss NS, Gilman R, Wener MH, Chavez V, Meneses R, et al."	Journal of Acquired Immune Deficiency Syndromes: JAIDS. 2006;43(2):197-201.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=16940855	"BACKGROUND: In children, zinc supplementation reduces the incidence and severity of diarrhea."	"METHODS: HIV-infected adults with > or =7 days of diarrhea recruited at 3 tertiary hospitals in Lima, Peru, received a zinc sulfate capsule containing 50 mg of elemental zinc twice daily or an identical placebo for 14 days. Outcomes included persistence of diarrhea at day 14 and time until cessation of diarrhea."	"RESULTS: The 81 subjects randomized to zinc and 78 randomized to placebo were comparable at baseline, except for higher prevalences of certain enteric pathogens in the zinc group; complete follow-up rates were 62% and 69%, respectively. Zinc concentrations were consistent with zinc deficiency at follow-up in 94% of placebo recipients and 66% of zinc recipients (P = 0.01). Persistence of diarrhea at day 14 according to follow-up interview (60% for zinc-treated patients and 57.4% for placebo-treated patients) or to patient diary (42.2% vs. 31.9%) did not differ significantly. Adjusting for enteric pathogens and CD4 count, the hazard ratio (HR) for zinc supplementation and cessation of diarrhea (according to the diaries) was 0.91 (95% confidence interval [CI]: 0.50 to 1.64)."	CONCLUSION: Supplemental zinc had no significant effect on the duration or remission of diarrhea in HIV-infected adults.						
85	Weight gain at 3 months of antiretroviral therapy is strongly associated with survival: Evidence from two developing countries.	"Madec Y, Szumilin E, Genevier C, Ferradini L, Balkan S, Pujades M, Fontanet A."	Aids. 2009 27 Apr;23(7):853-61.		"Background: In developing countries, access to laboratory tests remains limited, and the use of simple tools such as weight to monitor HIV-infected patients treated with antiretroviral therapy should be evaluated. Methods: Cohort study of 2451 Cambodian and 2618 Kenyan adults who initiated antiretroviral therapy between 2001 and 2007. The prognostic value of weight gain at 3 months of antiretroviral therapy on 3-6 months mortality, and at 6 months on 6-12 months mortality, was investigated using Poisson regression. Results: Mortality rates [95% confidence interval (CI)] between 3 and 6 months of antiretroviral therapy were 9.9 (7.6-12.7) and 13.5 (11.0-16.7) per 100 person-years in Cambodia and Kenya, respectively. At 3 months, among patients with initial body mass index less than or equal to 18.5 kg/m2 (43% of the study population), mortality rate ratios (95% CI) were 6.3 (3.0-13.1) and 3.4 (1.4-8.3) for those with weight gain less than or equal to 5 and 5-10%, respectively, compared with those with weight gain of more than 10%. At 6 months, weight gain was also predictive of subsequent mortality: mortality rate ratio (95% CI) was 7.3 (4.0-13.3) for those with weight gain less than or equal to 5% compared with those with weight gain of more than 10%. Conclusion: Weight gain at 3 months is strongly associated with survival. Poor compliance or undiagnosed opportunistic infections should be investigated in patients with initial body mass index less than or equal to 18.5 and achieving weight gain less than or equal to 10%. 2009 Wolters Kluwer Health | Lippincott Williams &Wilkins."									
1613	HIV prevalence and impact on renutrition in children hospitalised for severe malnutrition in Niger: an argument for more systematic screening.	"Madec Y, Germanaud D, Moya-Alvarez V, Alkassoum W, Issa A, Amadou M, Tchiombiano S, et al."	PLoS ONE [Electronic Resource]. 2011;6(7):e22787.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=21829514	"BACKGROUND: In developing countries, malnutrition is a contributing factor in over 50% of child deaths. Mortality rates are higher in underweight children, and HIV-infection is known to increase underweight. Our goals were to evaluate the prevalence of HIV among children hospitalised for severe malnutrition (SM) at the Niamey national hospital (Niger), and to compare renutrition and mortality by HIV-status."	METHODS: Retrospective study based on all children <5 years hospitalised for SM between January 1(st) 2008 and July 1(st) 2009. HIV-prevalence was the ratio of HIV+ children on the number of children tested. Duration of renutrition and mortality were described using survival curves.	"RESULTS: During the study period, 477 children were hospitalised for SM. HIV testing was accepted in 470 (98.5%), of which 40 were HIV+ (HIV prevalence (95% confidence interval) of 8.6% (6.2-11.5)). Duration of renutrition was longer in HIV+ than HIV- children (mean: 22 vs. 15 days; p=0.003). During renutrition, 8 (20%) and 61 (14%) HIV+ and HIV- children died, respectively (p=0.81)."	"CONCLUSION: Around 9% of children hospitalised for severe malnutrition were HIV infected, while in Niger HIV prevalence in adults is estimated at 0.8%. This pleads for wider access to HIV testing in this population."						
1290	Randomised trial of effects of vitamin supplements on pregnancy outcomes and T cell counts in HIV-1-infected women in Tanzania.	"Fawzi WW, Msamanga GI, Spiegelman D, Urassa EJ, McGrath N, Mwakagile D, Antelman G, et al."	Lancet. 1998;351(9114):1477-82.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=9605804	"BACKGROUND: In HIV-1-infected women, poor micronutrient status has been associated with faster progression of HIV-1 disease and adverse birth outcomes. We assessed the effects of vitamin A and multivitamins on birth outcomes in such women."	"METHODS: In Tanzania, 1075 HIV-1-infected pregnant women at between 12 and 27 weeks' gestation received placebo (n=267), vitamin A (n=269), multivitamins excluding vitamin A (n=269), or multivitamins including vitamin A (n=270) in a randomised, double-blind, placebo-controlled trial with a 2x2 factorial design. We measured the effects of multivitamins and vitamin A on birth outcomes and counts of T lymphocyte subsets. We did analyses by intention to treat."	"RESULTS: 30 fetal deaths occurred among women assigned multivitamins compared with 49 among those not on multivitamins (relative risk 0.61 [95% CI 0.39-0.94] p=0.02). Multivitamin supplementation decreased the risk of low birthweight (<2500 g) by 44% (0.56 [0.38-0.82] p=0.003), severe preterm birth (<34 weeks of gestation) by 39% (0.61 [0.38-0.96] p=0.03), and small size for gestational age at birth by 43% (0.57 [0.39-0.82] p=0.002). Vitamin A supplementation had no significant effect on these variables. Multivitamins, but not vitamin A, resulted in a significant increase in CD4, CD8, and CD3 counts."	INTERPRETATION: Multivitamin supplementation is a low-cost way of substantially decreasing adverse pregnancy outcomes and increasing T-cell counts in HIV-1-infected women. The clinical relevance of our findings for vertical transmission and clinical progression of HIV-1 disease is yet to be ascertained.						
637	"Evaluation of adherence to national guideline for clinical follow up of HIV infected children using the proxy hematological, biochemical and anthropometric indicators of care."	Berhan Y.	Ethiopian Medical Journal. 2011;49(3):199-209.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=21991753	"BACKGROUND: In HIV-infected children, assessment of liver and renal functions, growth pattern, hematologic and immunologic profiles is highly recommended. However, no study has evaluated the regularity of these kinds of assessment in hospital population."	"OBJECTIVE: The objective of this study was to evaluate the regularity of selected haematological, biochemical and anthropometric monitoring"	"METHODS: A Multi-Centre Retrospective Cohort Study was done to analyze 1163 HIV-infected children who had follow up in seven public hospitals in Ethiopia. The frequency of the following measures was used as a proxy indicator of the quality of assessment: weight & height measurement, absolute CD4 count, haemoglobin level and Serum glutamic oxaloacetic transaminase (SGOT). Paired sample t-test was done to evaluate the change in weight, haemoglobin and SGOT levels."	"RESULTS: Initially, for all children CD4 and haemoglobin levels were assessed. At 6 and 24 months after start of ART the proportion of children with a CD4 assessment was 68% and 37% respectively; 55% and 28% for haemoglobin; 62.7% and 6.4% for weight; and, 47% and 23% for SGOT. Mean weight for children age ten years and above, and mean height for children age two years and above was below the 5th percentile. Initially and at 24 months, the prevalence of all types of anemia was about 50% and 7%, respectively. There were no children with severe hepatotoxicity."	"CONCLUSION: The proportion of children being assessed for CD4, haemoglobin, SGOT and weight measures were initially two-third and markedly declined as the cohort progressed. The prevalence of anemia after two years follow up reduced by about 8-fold, growth appears to be poor in older children while hepatotoxicity is observed to be a rare phenomenon."					
373	Uptake of HIV testing and outcomes within a Community-based Therapeutic Care (CTC) programme to treat severe acute malnutrition in Malawi: a descriptive study.	"Bahwere P, Piwoz E, Joshua MC, Sadler K, Grobler-Tanner CH, Guerrero S, Collins S."	BMC Infectious Diseases. 2008;8:106.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=18671876	"BACKGROUND: In Malawi and other high HIV prevalence countries, studies suggest that more than 30% of all severely malnourished children admitted to inpatient nutrition rehabilitation units are HIV-infected. However, clinical algorithms designed to diagnose paediatric HIV are neither sensitive nor specific in severely malnourished children. The present study was conducted to assess : i) whether HIV testing can be integrated into Community-based Therapeutic Care (CTC); ii) to determine if CTC can improve the identification of HIV infected children; and iii) to assess the impact of CTC programmes on the rehabilitation of HIV-infected children with Severe Acute Malnutrition (SAM)."	"METHODS: This community-based cohort study was conducted in Dowa District, Central Malawi, a rural area 50 km from the capital, Lilongwe. Caregivers and children admitted in the Dowa CTC programme were prospectively (Prospective Cohort = PC) and retrospectively (Retrospective Cohort = RC) admitted into the study and offered HIV testing and counseling. Basic medical care and community nutrition rehabilitation was provided for children with SAM. The outcomes of interest were uptake of HIV testing, and recovery, relapse, and growth rates of HIV-positive and uninfected children in the CTC programme. Student's t-test and analysis of variance were used to compare means and Kruskall Wallis tests were used to compare medians. Dichotomous variables were compared using Chi2 analyses and Fisher's exact test. Stepwise logistic regression with backward elimination was used to identify predictors of HIV infection (alpha = 0.05)."	"RESULTS: 1273 and 735 children were enrolled in the RC and PC. For the RC, the average age (SD) at CTC admission was 30.0 (17.2) months. For the PC, the average age at admission was 26.5 (13.7) months. Overall uptake of HIV testing was 60.7% for parents and 94% for children. HIV prevalence in severely malnourished children was 3%, much lower than anticipated. 59% of HIV-positive and 83% of HIV-negative children achieved discharge Weight-For-Height (WFH) > or = 80% of the NCHS reference median (p = 0.003). Clinical algorithms for diagnosing HIV in SAM children had poor sensitivity and specificity."	CONCLUSION: CTC is a potentially valuable entry point for providing HIV testing and care in the community to HIV infected children with SAM.						
196	"Randomized, double-blind, placebo-controlled trial of selenium supplements among HIV-infected pregnant women in Tanzania: effects on maternal and child outcomes."	"Kupka R, Mugusi F, Aboud S, Msamanga GI, Finkelstein JL, Spiegelman D, Fawzi WW."	American Journal of Clinical Nutrition. 2008;87(6):1802-8.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medc&AN=18541571	"BACKGROUND: In observational studies, adequate selenium status has been associated with better pregnancy outcomes and slowed HIV disease progression."	"OBJECTIVE: We investigated the effects of daily selenium supplements on CD4 cell counts, viral load, pregnancy outcomes, and maternal and infant mortality among 913 HIV-infected pregnant women."	"DESIGN: In this randomized, double-blind, placebo-controlled trial, eligible women between 12 and 27 wk of gestation were given daily selenium (200 mug as selenomethionine) or placebo as supplements from recruitment until 6 mo after delivery. All women received prenatal iron, folic acid, and multivitamin supplements irrespective of experimental assignment."	"RESULTS: The selenium regimen had no significant effect on maternal CD4 cell counts or viral load. Selenium was marginally associated with a reduced risk of low birth weight [relative risk (RR) = 0.71; 95% CI: 0.49, 1.05; P = 0.09] and increased risk of fetal death (RR = 1.58; 95% CI = 0.95, 2.63; P = 0.08), but had no effect on risk of prematurity or small-for-gestational age birth. The regimen had no significant effect on maternal mortality (RR = 1.02; 95% CI = 0.51, 2.04; P = 0.96). There was no significant effect on neonatal or overall child mortality, but selenium reduced the risk of child mortality after 6 wk (RR = 0.43; 95% CI = 0.19, 0.99; P = 0.048)."	"CONCLUSION: Among HIV-infected women from Dar es Salaam, Tanzania, selenium supplements given during and after pregnancy did not improve HIV disease progression or pregnancy outcomes, but may improve child survival. This trial was registered at clinicaltrials.gov as NCT00197561."					
277	"Impact of HAART on survival, weight gain and resting energy expenditure in HIV-1-infected children in India."	"Banerjee T, Pensi T, Banerjee D, Grover G."	Annals of Tropical Paediatrics. 2010;30(1):27-37.		"Background: In resource-limited countries, use of highly active antiretroviral therapy (HAART) in HIV-infected children is still poorly documented in terms of impact on survival, the immune system and growth. Since the availability of HAART, nutrition of HIV-infected children has been neglected. Aim: To evaluate the effect of HAART on survival and immune response in HIV-infected children and to investigate the response to nutritional support. Methods: In December, 2002 a cohort study was carried out on vertically HIV-1-infected children and was observed longitudinally for CD4<sup>+</sup> T-cell count, antiretroviral treatment and weight until 31 December 2007. Z-scores were calculated for CD4<sup>+</sup> T-cell count to account for age-related differences. Nutritional supplementation was given to all the HIV-infected children and resting energy expenditure (REE) was calculated. Mortality rates were also calculated for the perinatally infected children followed up at the HIV clinic. Results: A total of 180 children were assessed, 100 (56%) of whom were on HAART. Baseline body mass index was lower in the HAART group (p<0.05). Median duration of survival from date of diagnosis was 15.1 years. Those who received HAART survived significantly longer. The average annual mortality rate was 1.2% during 2005-2006. During HAART, a CD4 Z-score increase of 1 SD was associated with a 0.35 increase in body weight Z-score (p<0.001). The increase in daily energy intake owing to nutritional supplementation was associated with increase in weight Z-score in both the no-HAART and HAART group. REE was independently associated with weight change in the models which tested association of changes in CD4<sup>+</sup> T-cell Z-score and daily REE/kg body weight with changes in body weight Z-score in both the HAART and no-HAART group and then separately in the two groups (p<0.001). Conclusion: Survival rates of children improved which correlated with an increase in CD4<sup>+</sup> T-cell count concurrent with the expanded use of HAART. HAART had a positive effect on growth in HIV-1-infected children. Nutrition supplementation improved the health of children in both the no-HAART and HAART groups. 2010 The Liverpool School of Tropical Medicine."									
1581	"Evaluation of Clinical and Immunological Markers for Predicting Virological Failure in a HIV/AIDS Treatment Cohort in Busia, Kenya."	"Ferreyra C, Yun O, Eisenberg N, Alonso E, Khamadi AS, Mwau M, Mugendi MK, et al."	PLoS ONE. 2012 21 Nov;7(11).		"Background: In resource-limited settings where viral load (VL) monitoring is scarce or unavailable, clinicians must use immunological and clinical criteria to define HIV virological treatment failure. This study examined the performance of World Health Organization (WHO) clinical and immunological failure criteria in predicting virological failure in HIV patients receiving antiretroviral therapy (ART). Methods: In a HIV/AIDS program in Busia District Hospital, Kenya, a retrospective, cross-sectional cohort analysis was performed in April 2008 for all adult patients (>18 years old) on ART for >=12 months, treatment-naive at ART start, attending the clinic at least once in last 6 months, and who had given informed consent. Treatment failure was assessed per WHO clinical (disease stage 3 or 4) and immunological (CD4 cell count) criteria, and compared with virological failure (VL >5,000 copies/mL). Results: Of 926 patients, 123 (13.3%) had clinically defined treatment failure, 53 (5.7%) immunologically defined failure, and 55 (6.0%) virological failure. Sensitivity, specificity, positive predictive value, and negative predictive value of both clinical and immunological criteria (combined) in predicting virological failure were 36.4%, 83.5%, 12.3%, and 95.4%, respectively. Conclusions: In this analysis, clinical and immunological criteria were found to perform relatively poorly in predicting virological failure of ART. VL monitoring and new algorithms for assessing clinical or immunological treatment failure, as well as improved adherence strategies, are required in ART programs in resource-limited settings. 2012 Ferreyra et al."									
925	Incidence of and risk factors for active tuberculosis in human immunodeficiency virus-infected patients in South Korea.	"Ku NS, Choi YH, Kim YK, Choi JP, Kim JM, Choi JY."	International Journal of Tuberculosis and Lung Disease. 2013 01 Jun;17(6):777-81.		"BACKGROUND: In South Korea, a high-income country with an intermediate tuberculosis (TB) burden and low human immunodeficiency virus (HIV) prevalence, studies on incidence and risk factors of TB in HIV-infected persons have rarely been reported. OBJECTIVE: To investigate the incidence of and risk factors for active TB in HIV-infected persons in South Korea. METHODS: A retrospective analysis was conducted of 1265 HIV-1 infected patients who visited four hospitals in South Korea between 1985 and 2012. We analysed the incidence of TB during the follow-up period. To investigate risk factors associated with active TB, we conducted a 1:2 matched case-control study of HIV-infected patients with newly active TB and controls without active TB who had similar CD4<sup>+</sup> T-cell counts and dates of first visit. RESULTS: Over a total of 4457 person-years (py), 185 (14.6%) subjects were diagnosed with active TB; the incidence was 4.2 cases/100 py. In multivariate analysis, low body mass index (P = 0.033) and current smoking (P = 0.003) were independent risk factors for TB in HIV-infected patients. CONCLUSION: Further strategies on prevention and treatment of active TB among HIV-infected patients should be implemented in South Korea. Encouraging smoking cessation and supporting good nutrition may be ways to reduce the incidence of active TB in HIV-infected patients. 2013 The Union."									
1617	"Six-month mortality among HIV-infected adults presenting for antiretroviral therapy with unexplained weight loss, chronic fever or chronic diarrhea in Malawi."	"van Lettow M, Akesson A, Martiniuk AL, Ramsay A, Chan AK, Anderson ST, Harries AD, et al."	PLoS ONE [Electronic Resource]. 2012;7(11):e48856.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=23185278	"BACKGROUND: In sub-Saharan Africa, early mortality is high following initiation of antiretroviral therapy (ART). We investigated 6-month outcomes and factors associated with mortality in HIV-infected adults being assessed for ART initiation and presenting with weight loss, chronic fever or diarrhea, and with negative TB sputum microscopy."	"METHODS: A prospective cohort study was conducted in Malawi, investigating mortality in relation to ART uptake, microbiological findings and treatment of opportunistic infection (OIs), 6 months after meeting ART eligibility criteria."	"RESULTS: Of 469 consecutive adults eligible for ART, 74(16%) died within 6 months of enrolment, at a median of 41 days (IQR 20-81). 370(79%) started ART at a median time of 18 days (IQR 7-40) after enrolment. Six-month case-fatality rates were higher in patients with OIs; 25/121(21%) in confirmed/clinical TB and 10/50(20%) with blood stream infection (BSI) compared to 41/308(13%) in patients with no infection identified. Median TB treatment start was 27 days (IQR 17-65) after enrolment and mortality [8 deaths (44%)] was significantly higher among 18 culture-positive patients with delayed TB diagnosis compared to patients diagnosed clinically and treated promptly with subsequent culture confirmation [6/34 (18%);p = 0.04]. Adjusted multivariable analysis, excluding deaths in the first 21 days, showed weight loss >10%, low CD4 count, severe anemia, laboratory-only TB diagnosis, and not initiating ART to be independently associated with increased risk of death."	CONCLUSIONS: Mortality remains high among chronically ill patients eligible for ART. Prompt initiation of ART is vital: more than half of deaths were among patients who never started ART. Diagnostic and treatment delay for TB was strongly associated with risk of death. More than half of deaths occurred without identification of a specific infection. ART programmes need access to rapid point-of-care-diagnostic tools for OIs. The role of early empiric OI treatment in this population requires further evaluation in clinical trials.						
428	Health and functional status among older people with HIV/AIDS in Uganda.	"Scholten F, Mugisha J, Seeley J, Kinyanda E, Nakubulwa S, Kowal P, Naidoo N, et al."	BMC Public Health. 2011;11(886).	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20113389809	"Background: In sub-Saharan Africa, little is known about the health and functional status of older people who either themselves are HIV infected or are affected by HIV and AIDS in the family. This aim of this study was to describe health among older people in association with the HIV epidemic. Methods: The cross-sectional survey consisted of 510 participants aged 50 years and older, equally divided into five study groups including; (1) HIV infected and on antiretroviral therapy (ART) for at least 1 year; (2) HIV infected and not yet eligible for ART; (3) older people who had lost a child due to HIV/AIDS; (4) older people who have an adult child with HIV/AIDS; (5) older people not known to be infected or affected by HIV in the family. The participants were randomly selected from ongoing studies in a rural and peri-urban area in Uganda. Data were collected using a WHO standard questionnaire and performance tests. Eight indicators of health and functioning were examined in an age-adjusted bivariate and multivariate analyses. Results: In total, 198 men and 312 women participated. The overall mean age was 65.8 and 64.5 years for men and women respectively. Men had better self-reported health and functional status than women, as well as lower self-reported prevalence of chronic diseases. In general, health problems were common: 35% of respondents were diagnosed with at least one of the five chronic conditions, including 15% with depression, based on algorithms; 31% of men and 35% of women had measured hypertension; 25% of men and 21% of women had poor vision test results. HIV-positive older people, irrespective of being on ART, and HIV-negative older people in the other study groups had very similar results for most health status and functioning indicators. The main difference was a significantly lower BMI among HIV-infected older people. Conclusion: The systematic exploration of health and well being among older people, using eight self-reported and objective health indicators, showed that basic health problems are very common at older ages and poorly addressed by existing health services. HIV-infected older people, however, whether on ART or not yet on ART, had a similar health and functional status as other older people."									
1321	The association between malnutrition and the incidence of malaria among young HIV-infected and -uninfected Ugandan children: a prospective study.	"Arinaitwe E, Gasasira A, Verret W, Homsy J, Wanzira H, Kakuru A, Sandison TG, et al."	Malaria Journal. 2012;11:90.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=22453048	"BACKGROUND: In sub-Saharan Africa, malnutrition and malaria remain major causes of morbidity and mortality in young children. There are conflicting data as to whether malnutrition is associated with an increased or decreased risk of malaria. In addition, data are limited on the potential interaction between HIV infection and the association between malnutrition and the risk of malaria."	"METHODS: A cohort of 100 HIV-unexposed, 203 HIV-exposed (HIV negative children born to HIV-infected mothers) and 48 HIV-infected children aged 6 weeks to 1 year were recruited from an area of high malaria transmission intensity in rural Uganda and followed until the age of 2.5 years. All children were provided with insecticide-treated bed nets at enrolment and daily trimethoprim-sulphamethoxazole prophylaxis (TS) was prescribed for HIV-exposed breastfeeding and HIV-infected children. Monthly routine assessments, including measurement of height and weight, were conducted at the study clinic. Nutritional outcomes including stunting (low height-for-age) and underweight (low weight-for-age), classified as mild (mean z-scores between -1 and -2 during follow-up) and moderate-severe (mean z-scores < -2 during follow-up) were considered. Malaria was diagnosed when a child presented with fever and a positive blood smear. The incidence of malaria was compared using negative binomial regression controlling for potential confounders with measures of association expressed as an incidence rate ratio (IRR)."	"RESULTS: The overall incidence of malaria was 3.64 cases per person year. Mild stunting (IRR = 1.24, 95% CI 1.06-1.46, p = 0.008) and moderate-severe stunting (IRR = 1.24, 95% CI 1.03-1.48, p = 0.02) were associated with a similarly increased incidence of malaria compared to non-stunted children. Being mildly underweight (IRR = 1.09, 95% CI 0.95-1.25, p = 0.24) and moderate-severe underweight (IRR = 1.12, 95% CI 0.86-1.46, p = 0.39) were not associated with a significant difference in the incidence of malaria compared to children who were not underweight. There were no significant interactions between HIV-infected, HIV-exposed children taking TS and the associations between malnutrition and the incidence of malaria."	"CONCLUSIONS: Stunting, indicative of chronic malnutrition, was associated with an increased incidence of malaria among a cohort of HIV-infected and -uninfected young children living in an area of high malaria transmission intensity. However, caution should be made when making causal inferences given the observational study design and inability to disentangle the temporal relationship between malnutrition and the incidence of malaria."	TRIAL REGISTRATION: ClinicalTrials.gov: NCT00527800.					
65	"Effect of early chemoprophylaxis with co-trimoxazole on nutritional status evolution in HIV-1-infected adults in Abidjan, Cote d'Ivoire."	"Castetbon K, Anglaret X, Attia A, Toure S, Dakoury-Dogbo N, Messou E, N'Dri-Yoman T, et al."	AIDS. 2001;15(7):869-76.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=11399959	"BACKGROUND: In sub-Saharan Africa, malnutrition is a major complication of HIV disease. Measuring accurately the nutritional benefits of a therapeutic intervention could be an easy-to-monitor secondary outcome."	"METHODS: Anthropometric data were analysed from patients participating in a placebo-controlled trial of co-trimoxazole prophylaxis in adults recruited at early stages of HIV-1 infection in Cote d'Ivoire (COTRIMO-CI ANRS 059 trial). Body mass index (BMI), arm muscle circumference (AMC) and percentage of fat mass (FM) were measured at baseline and quarterly during the follow up. Percentage of variation from the baseline value was compared between treatment groups and within the groups using Student t-test."	"RESULTS: An improvement of all anthropometric indicators was observed in the first 3 months of follow up in both treatment groups, significant in the co-trimoxazole group (P < or = 0.0006) but not in the placebo group (P > or = 0.06). In the co-trimoxazole group, this improvement was maintained for up to 24 months for BMI (P = 0.007), 21 months for AMC (P = 0.02) and only up to 12 months for FM (P = 0.04). The placebo group had a stable anthropometric status up to the end of the trial. Differences between treatment groups were significant for up to 15 months for BMI and AMC and 12 months for FM."	"CONCLUSION: As co-trimoxazole prophylaxis is now recommended in Africa as part of a minimum package of care for HIV-infected symptomatic subjects, the short-term improvement of these anthropometric indicators in adults who start co-trimoxazole prophylaxis should be considered as an effective clinical outcome."						
64	"Effect of early chemoprophylaxis with co-trimoxazole on nutritional status evolution in HIV-1-infected adults in Abidjan, Cote d'Ivoire."	"Castetbon K, Anglaret X, Attia A, Toure S, Dakoury-Dogbo N, Messou E, N'Dri-Yoman T, et al."	Aids. 2001 04 May;15(7):869-76.		"Background: In sub-Saharan Africa, malnutrition is a major complication of HIV disease. Measuring accurately the nutritional benefits of a therapeutic intervention could be an easy-to-monitor secondary outcome. Methods: Anthropometric data were analysed from patients participating in a placebo-controlled trial of co-trimoxazole prophylaxis in adults recruited at early stages of HIV-1 infection in Cote d'Ivoire (COTRIMO-CI ANRS 059 trial). Body mass index (BMI), arm muscle circumference (AMC) and percentage of fat mass (FM) were measured at baseline and quarterly during the follow up. Percentage of variation from the baseline value was compared between treatment groups and within the groups using Student t-test. Results: An improvement of all anthropometric indicators was observed in the first 3 months of follow up in both treatment groups, significant in the co-trimoxazole group (P <= 0.0006) but not in the placebo group (P >= 0.06). In the co-trimoxazole group, this improvement was maintained for up to 24 months for BMI (P = 0.007), 21 months for AMC (P = 0.02) and only up to 12 months for FM (P = 0.04). The placebo group had a stable anthropometric status up to the end of the trial. Differences between treatment groups were significant for up to 15 months for BMI and AMC and 12 months for FM. Conclusion: As co-trimoxazole prophylaxis is now recommended in Africa as part of a minimum package of care for HIV-infected symptomatic subjects, the short-term improvement of these anthropometric indicators in adults who start co-trimoxazole prophylaxis should be considered as an effective clinical outcome. 2001 Lippincott Williams & Wilkins."									
857	The intergenerational impact of the African orphans crisis: a cohort study from an HIV/AIDS affected area.	"Beegle K, De Weerdt J, Dercon S."	International Journal of Epidemiology. 2009;38(2):561-8.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=18796480	"BACKGROUND: In sub-Saharan Africa, the prevalence of orphanhood among children has been greatly exacerbated by the HIV/AIDS pandemic. If orphanhood harms a child's development and these effects perpetuate into adult life, then the African orphan crisis could seriously jeopardize the continent's future generations. Whether or not there exists an adverse, causal and intergenerational effect of HIV/AIDS on development is of crucial importance for setting medical priorities. This study is the first to empirically investigate the impact of orphanhood on health and schooling using long-term longitudinal data following children into adulthood."	METHODS: We examined a cohort of 718 children interviewed in the early 1990s and again in 2004. Detailed survey questionnaires and anthropometric measurements were administered at baseline and during a follow-up survey. Final attained height and education (at adulthood) between children who lost a parent before the age of 15 and those who did not were compared.	"RESULTS: On average, children who lose their mother before the age of 15 suffer a deficit of around 2 cm in final attained height (mean 1.96; 95% CI 0.06-3.77) and 1 year of final attained schooling (mean 1.01; 95% CI 0.39-1.81). This effect is permanent and the hypothesis that it is causal cannot be rejected by our study. Although father's death is a predictor of lower height and schooling as well, we reject the hypothesis of a causal link."	"CONCLUSIONS: The African orphan crisis, exacerbated by the HIV/AIDS epidemic will have important negative intergenerational effects."						
859	HIV-1 subtype E progression among northern Thai couples: Traditional and non-traditional predictors of survival.	"Costello C, Nelson KE, Suriyanon V, Sennun S, Tovanabutra S, Heilig CM, Shiboski S, et al."	International Journal of Epidemiology. 2005 June;34(3):577-84.		"Background: In the continuing effort to introduce antiretroviral therapy in resource-limited settings, there is a need to understand differences between natural history of HIV in different populations and to identify feasible clinical measures predictive of survival. Methods: We examined predictors of survival among 836 heterosexuals who were infected with HIV subtype CRF01-AE in Thailand. Results: From 1993 to 1999, 269 (49.4%) men and 65 (25.7 %) women died. The median time from the estimated seroconversion to death was 7.8 years (95% confidence interval 7.0-9.1). Men and women with enrolment CD4 counts <200 cells/mul had about 2 and 11 times greater risk of death than those with CD4 counts of 200-500 and >500, respectively. Measurements available in resource-limited settings, including total lymphocyte count (TLC), anaemia, and low body mass index (BMI), also predicted survival. Men with two or more of these predictors had a median survival of 0.8 (0.5-1.8) years, compared with 2.7 (1.9-3.3) years for one predictor and 4.9 (4.1-5.2) years for no predictors. Conclusions: The time from HIV infection to death appears shorter among this Thai population than among antiretroviral naive Western populations. CD4 count and viral load (VL) were strong, independent predictors of survival. When CD4 count and VL are unavailable, individuals at high risk for shortened HIV survival may be identified by a combination of low TLC, anaemia, and low BMI. This combination of accessible clinical measures of the disease stage may be useful for medical management in resource-limited settings. The Author 2005; all rights reserved."									
721	"Nutritional and immunological status and their associations among HIV-infected adults in Addis Ababa, Ethiopia."	"Fufa H, Umeta M, Taffesse S, Mokhtar N, Aguenaou H."	Food & Nutrition Bulletin. 2009;30(3):227-32.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=19927602	"BACKGROUND: In the search for cost-effective interventions to reduce morbidity and mortality in HIV disease, the identification of nutritional status and levels of micronutrients is very important."	"OBJECTIVE: To generate information on the level of energy malnutrition and on vitamin A, zinc, and hemoglobin levels and their relationships with disease status in HIV-infected adults in Addis Ababa, Ethiopia."	"METHODS: A cross-sectional study was carried out on 153 HIV-positive adults (19% male, 81%female) living in Addis Ababa. The nutritional status and the levels of zinc, retinol, and hemoglobin were determined by anthropometric and biochemical methods. CD4+ counts and C-reactive protein levels were measured by standard methods."	"RESULTS: Of the patients, 18% were chronically energy deficient, 71% were normal, and 11% were overweight. Serum zinc levels were low (< 10.7 micromol/L) in 53% of subjects, and serum retinol levels were low (< 30 microg/dL) in 47% of subjects. Low hemoglobin levels (< 12 g/dL) were observed in only 4.72% of the study population. CD4+ counts under 200/mm3 and elevated C-reactive protein levels were both found in 21% of the subjects. CD4+ counts were positively and significantly correlated with hemoglobin (r = 0.271, p < .001), zinc (r = 0.180, p < .033), and body mass index (r = 0.194, p < .017). There were significant negative associations between levels of C-reactive protein and levels of zinc (r = -0.178, p < 0.036 and hemoglobin (r = -0.253, p < .002)."	"CONCLUSIONS: Our results provide evidence that compromised nutritional and micronutrient status begins early in the course of HIV-1 infection. Low serum zinc and vitamin A levels were observed in almost half of the subjects. The clinical significance of low serum zinc and vitamin A levels is unclear, and more research is required."					
1058	Morphologic and body composition changes are different in men and women on generic combination antiretroviral therapy - an observational study.	"Padmapriyadarsini C, Swaminathan S, Karthipriya MJ, Narendran G, Menon PA, Thomas BE."	Journal of Association of Physicians of India. 2010 June;58(6):375-7.		"Background: Increasingly effective therapies for HIV infection, combination antiretroviral therapy, are now widely available in developing countries. A range of metabolic complications presenting as abnormalities of body-fat mass distribution in association with dyslipidemia and glucose homeostasis dysregulation, have been recognized as important toxicities in patients treated with these drugs. With increasing use of antiretroviral therapy in India, we examined the association between gender and body shape and composition, one year after initiating combination antiretroviral therapy and attempted to identify simple clinical markers to detect and monitor these changes. Methods: Patients on combination antiretroviral therapy (2 nRTIs + 1 nnRTI), attending a HIV clinic between July 2005 and December 2006 had anthropometry clinical examination and bioelectric impedance analysis (BIA) performed along with blood tests at baseline and after 1 year. Results: Of the 34 patients on combination antiretroviral therapy, 5 males and 12 females had noticeable changes in their body shape. Significant decrease in triceps skin fold thickness, an increase in waist circumference and waist: hip ratio was observed in females. BIA did not show any change in total body fat in either sex. Conclusions: Since the presence and severity of fat redistribution could affect adherence as well as the success of antiretroviral therapy, close monitoring is required to detect and prevent this complication early. JAPI."									
1208	Morphologic and body composition changes are different in men and women on generic combination antiretroviral therapy--an observational study.	"Padmapriyadarsini C, Swaminathan S, Karthipriya MJ, Narendran G, Menon PA, Thomas BE."	Journal of the Association of Physicians of India. 2010;58:375-7.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=21125779	"BACKGROUND: Increasingly effective therapies for HIV infection, combination antiretroviral therapy, are now widely available in developing countries. A range of metabolic complications presenting as abnormalities of body-fat mass distribution in association with dyslipidemia and glucose homeostasis dysregulation, have been recognized as important toxicities in patients treated with these drugs. With increasing use of antiretroviral therapy in India, we examined the association between gender and body shape and composition, one year after initiating combination antiretroviral therapy and attempted to identify simple clinical markers to detect and monitor these changes."	"METHODS: Patients on combination antiretroviral therapy (2 NRTIs + 1 NNRTI), attending a HIV clinic between July 2005 and December 2006 had anthropometry clinical examination and bioelectric impedance analysis (BIA) performed along with blood tests at baseline and after 1 year."	"RESULTS: Of the 34 patients on combination antiretroviral therapy, 5 males and 12 females had noticeable changes in their body shape. Significant decrease in triceps skin fold thickness, an increase in waist circumference and waist: hip ratio was observed in females. BIA did not show any change in total body fat in either sex."	"CONCLUSIONS: Since the presence and severity of fat redistribution could affect adherence as well as the success of antiretroviral therapy, close monitoring is required to detect and prevent this complication early."						
389	"Growth patterns among HIV-exposed infants receiving nevirapine prophylaxis in Pune, India."	"Ram M, Gupte N, Nayak U, Kinikar AA, Khandave M, Shankar AV, Sastry J, et al."	BMC Infectious Diseases. 2012;12:282.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=23114104	BACKGROUND: India has among the highest rates of infant malnutrition. Few studies investigating the growth patterns of HIV-exposed infants in India or the impact of timing of HIV infection on growth in settings such as India exist.	"METHODS: We used data from the Six Week Extended Nevirapine (SWEN) trial to compare the growth patterns of HIV-infected and HIV-exposed but uninfected infants accounting for timing of HIV infection, and to identify risk factors for stunting, underweight and wasting. Growth and timing of HIV infection were assessed at weeks 1, 2, 4, 6, 10, 14 weeks and 6, 9, 12 months of life. Random effects multivariable logistic regression method was used to assess factors associated with stunting, underweight and wasting."	"RESULTS: Among 737 HIV-exposed infants, 93 (13%) were HIV-infected by 12 months of age. Among HIV-infected and uninfected infants, baseline prevalence of stunting (48% vs. 46%), underweight (27% vs. 26%) and wasting (7% vs. 11%) was similar (p>0.29), but by 12 months stunting and underweight, but not wasting, were significantly higher in HIV-infected infants (80% vs. 56%, 52% vs. 29%, p< 0.0001; 5% vs. 6%, p=0.65, respectively). These differences rapidly manifested within 4-6 weeks of birth. Infants infected in utero had the worst growth outcomes during the follow-up period. SWEN was associated with non-significant reductions in stunting and underweight among HIV-infected infants and significantly less wasting in HIV-uninfected infants. In multivariate analysis, maternal CD4 < 250, infant HIV status, less breastfeeding, low birth weight, non-vaginal delivery, and infant gestational age were significant risk factors for underweight and stunting."	CONCLUSION: Baseline stunting and underweight was high in both HIV-infected and uninfected infants; growth indices diverged early and were impacted by timing of infection and SWEN prophylaxis. Early growth monitoring of all HIV-exposed infants is an important low-cost strategy for improving health and survival outcomes of these infants.	Trial registration: nct00061321.					
388	"Growth patterns among HIV-exposed infants receiving nevirapine prophylaxis in Pune, India."	"Ram M, Gupte N, Nayak U, Kinikar AA, Khandave M, Shankar AV, Sastry J, et al."	BMC Infectious Diseases. 2012 31 Oct;12(282).		"Background: India has among the highest rates of infant malnutrition. Few studies investigating the growth patterns of HIV-exposed infants in India or the impact of timing of HIV infection on growth in settings such as India exist. Methods: We used data from the Six Week Extended Nevirapine (SWEN) trial to compare the growth patterns of HIV-infected and HIV-exposed but uninfected infants accounting for timing of HIV infection, and to identify risk factors for stunting, underweight and wasting. Growth and timing of HIV infection were assessed at weeks 1, 2, 4, 6, 10, 14 weeks and 6, 9, 12 months of life. Random effects multivariable logistic regression method was used to assess factors associated with stunting, underweight and wasting.Results: Among 737 HIV-exposed infants, 93 (13%) were HIV-infected by 12 months of age. Among HIV-infected and uninfected infants, baseline prevalence of stunting (48% vs. 46%), underweight (27% vs. 26%) and wasting (7% vs. 11%) was similar (p>0.29), but by 12 months stunting and underweight, but not wasting, were significantly higher in HIV-infected infants (80% vs. 56%, 52% vs. 29%, p< 0.0001; 5% vs. 6%, p=0.65, respectively). These differences rapidly manifested within 4-6 weeks of birth. Infants infected in utero had the worst growth outcomes during the follow-up period. SWEN was associated with non-significant reductions in stunting and underweight among HIV-infected infants and significantly less wasting in HIV-uninfected infants. In multivariate analysis, maternal CD4 < 250, infant HIV status, less breastfeeding, low birth weight, non-vaginal delivery, and infant gestational age were significant risk factors for underweight and stunting.Conclusion: Baseline stunting and underweight was high in both HIV-infected and uninfected infants; growth indices diverged early and were impacted by timing of infection and SWEN prophylaxis. Early growth monitoring of all HIV-exposed infants is an important low-cost strategy for improving health and survival outcomes of these infants.Trial Registration: NCT00061321. 2012 Ram et al.; licensee BioMed Central Ltd."									
390	"Growth patterns among HIV-exposed infants receiving nevirapine prophylaxis in Pune, India."	"Ram M, Nikhil G, Nayak U, Kinikar AA, Mangesh K, Shankar AV, Jayagowri S, et al."	BMC Infectious Diseases. 2012;12(282).	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20123390400	"Background: India has among the highest rates of infant malnutrition. Few studies investigating the growth patterns of HIV-exposed infants in India or the impact of timing of HIV infection on growth in settings such as India exist. Methods: We used data from the Six Week Extended Nevirapine (SWEN) trial to compare the growth patterns of HIV-infected and HIV-exposed but uninfected infants accounting for timing of HIV infection, and to identify risk factors for stunting, underweight and wasting. Growth and timing of HIV infection were assessed at weeks 1, 2, 4, 6, 10, 14 weeks and 6, 9, 12 months of life. Random effects multivariable logistic regression method was used to assess factors associated with stunting, underweight and wasting. Results: Among 737 HIV-exposed infants, 93 (13%) were HIV-infected by 12 months of age. Among HIV-infected and uninfected infants, baseline prevalence of stunting (48% vs. 46%), underweight (27% vs. 26%) and wasting (7% vs. 11%) was similar (p>0.29), but by 12 months stunting and underweight, but not wasting, were significantly higher in HIV-infected infants (80% vs. 56%, 52% vs. 29%, p<0.0001; 5% vs. 6%, p=0.65, respectively). These differences rapidly manifested within 4-6 weeks of birth. Infants infected in utero had the worst growth outcomes during the follow-up period. SWEN was associated with nonsignificant reductions in stunting and underweight among HIV-infected infants and significantly less wasting in HIV-uninfected infants. In multivariate analysis, maternal CD4 <250, infant HIV status, less breastfeeding, low birth weight, non-vaginal delivery, and infant gestational age were significant risk factors for underweight and stunting. Conclusion: Baseline stunting and underweight was high in both HIV-infected and uninfected infants; growth indices diverged early and were impacted by timing of infection and SWEN prophylaxis. Early growth monitoring of all HIV-exposed infants is an important low-cost strategy for improving health and survival outcomes of these infants."									
1514	Malnutrition and neutropenia in children treated for Burkitt lymphoma in Malawi.	"Israels T, van de Wetering MD, Hesseling P, van Geloven N, Caron HN, Molyneux EM."	Pediatric Blood & Cancer. 2009;53(1):47-52.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=19338050	"BACKGROUND: Infection in neutropenic children is a major cause of morbidity and mortality in children treated for cancer. In developing countries, children with cancer are often malnourished at diagnosis. In Blantyre, Malawi, children with Burkitt lymphoma are treated with a local protocol with limited toxicity. The aim of this study was to evaluate the incidence and outcome of febrile neutropenia during this treatment and the association with malnutrition at diagnosis."	"METHODS: We documented nutritional status, febrile and/or neutropenic episodes, antibiotic therapy and short term outcome of all children with Burkitt lymphoma treated according to the local protocol and admitted from January 2007 to March 2008."	"RESULTS: Fifty eight (69%) of 84 patients were acutely malnourished at diagnosis with an arm muscle area (AMA) below the 5(th) percentile. Malnutrition at diagnosis was associated with a significantly higher rate of profound neutropenia. This association remained significant (OR 12; 95% C.I. 1.5 - infinitely; P = 0.012) after control for clinical stage of disease, bone marrow involvement and HIV infection which are possible confounders. All patients with profound neutropenia, prolonged neutropenia and treatment related deaths were malnourished at diagnosis. Four (4.9%) of 81 patients died of treatment related causes; three of them due to a Gram negative septicaemia."	"CONCLUSION: Acute malnutrition at diagnosis is associated with significantly more treatment related profound neutropenia. The intensity of chemotherapeutic regimens has to be adapted to the level of available supportive care and patients' nutritional status and tolerance to avoid unacceptable morbidity and mortality. This local treatment protocol for Burkitt lymphoma has a treatment related mortality of 5% in patients in Malawi. Copyright 2009 Wiley-Liss, Inc."						
1515	Malnutrition and neutropenia in children treated for Burkitt lymphoma in Malawi.	"Israels T, Wetering MDvd, Hesseling P, Geloven Nv, Caron HN, Molyneux EM."	Pediatric Blood & Cancer. 2009;53(1):47-52.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20093159894	"Background: Infection in neutropenic children is a major cause of morbidity and mortality in children treated for cancer. In developing countries, children with cancer are often malnourished at diagnosis. In Blantyre, Malawi, children with Burkitt lymphoma are treated with a local protocol with limited toxicity. The aim of this study was to evaluate the incidence and outcome of febrile neutropenia during this treatment and the association with malnutrition at diagnosis. Methods: We documented nutritional status, febrile and/or neutropenic episodes, antibiotic therapy and short term outcome of all children with Burkitt lymphoma treated according to the local protocol and admitted from January 2007 to March 2008. Results: Fifty eight (69%) of 84 patients were acutely malnourished at diagnosis with an arm muscle area (AMA) below the 5th percentile. Malnutrition at diagnosis was associated with a significantly higher rate of profound neutropenia. This association remained significant (OR 12; 95% C.I. 1.5 - infinitely; P=0.012) after control for clinical stage of disease, bone marrow involvement and HIV infection which are possible confounders. All patients with profound neutropenia, prolonged neutropenia and treatment related deaths were malnourished at diagnosis. Four (4.9%) of 81 patients died of treatment related causes; three of them due to a Gram negative septicaemia. Conclusion: Acute malnutrition at diagnosis is associated with significantly more treatment related profound neutropenia. The intensity of chemotherapeutic regimens has to be adapted to the level of available supportive care and patients' nutritional status and tolerance to avoid unacceptable morbidity and mortality. This local treatment protocol for Burkitt lymphoma has a treatment related mortality of 5% in patients in Malawi."									
1529	Effect of human immunodeficiency virus infection on episodes of diarrhea among children in South Africa.	"Johnson S, Hendson W, Crewe-Brown H, Dini L, Frean J, Perovic O, Vardas E."	Pediatric Infectious Disease Journal. 2000;19(10):972-9.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=11055599	"BACKGROUND: Infection with HIV is increasing among children in South Africa. Diarrhea is a common cause of morbidity and mortality in Africa, and some studies have shown that HIV-infected children have episodes of severe diarrhea with higher mortality than HIV-uninfected children."	"OBJECTIVES: To compare the severity, pathogens and outcome of diarrhea in HIV-infected and uninfected children."	"METHODS: We studied 181 children ages 3 months to 4 years admitted for gastroenteritis to the Chris Hani Baragwanath Hospital in Soweto, South Africa. Demographic details of the children were recorded, as were the details of the episode of diarrhea. Stools specimens were collected and sent for microbiologic evaluation. The clinical course of the child's admission was recorded. Children were diagnosed as being infected with HIV if they tested positive by HIV enzyme-linked immunosorbent assay (ELISA) and were >15 months of age, or if they were ELISA-positive, were < 15 months of age and had clinical signs of HIV infection."	"RESULTS: Of the 176 children with an HIV ELISA result, 31 (17.6%) were classified as HIV-infected. More HIV-infected children were malnourished (80.6% vs. 39.5%, P < 0.001) and more likely to have had prolonged diarrhea (16.1% vs. 5.9%, P = 0.07) compared with HIV-uninfected children. HIV-infected children had a higher rate of a codiagnosis of pneumonia (43.3% vs. 9.2%, P < 0.0001) and were more likely to require a hospital stay of >4 days (prevalence odds ratio, 5.11; 95% confidence interval, CI 1.49 to 17.52). There were no significant differences in stool pathogens or in the level of dehydration on admission between the HIV-infected and uninfected children."	CONCLUSION: HIV-infected children have the same spectrum of enteric pathogens as uninfected children but require more attention because of malnutrition and comorbidity.					
598	Infections in children with prolonged acute convulsions in Malawi.	"Jefferis OH, Lissauer S, Kenny J, Wingfield T, Miller A, Chagaluka G, Khalilani-Phiri L, et al."	Developmental Medicine and Child Neurology. 2012 January;54:60.		"Background: Infections are a common cause of prolonged convulsions, particularly in resource poor countries. Knowledge of the frequency of different infections among children with prolonged convulsions is important. Method: Between July 2006 and January 2008 data were collected from 671 children with prolonged convulsions who were enrolled in a randomized controlled trial comparing treatments. Data were analysed post-hoc to determine the frequency of certain serious, treatable infections and explore some of the subsets of children most at risk. Results: Meningitis was found in 14% of children and was more common in children under a year, with a negative malaria slide, with longer convulsions (more than 30min) or who were HIV positive. Cerebral malaria was found in 28% of children and was no more common in longer convulsions. Cerebral malaria was found less commonly in severely underweight and HIV seronegative children. Bacteraemia was found in 4% of children, mainly in association with meningitis. Malarial parasites were found on thick blood film in 50% of children. Children with meningitis, bacteraemia, and HIV had a higher rate of death or new neurological deficit. Conclusions: A quarter of children with prolonged convulsions in this setting have adverse outcomes, and this study highlights some of the children most at risk."									
424	Low nutrient intake among adult women and patients with severe tuberculosis disease in Uganda: a cross-sectional study.	"Mupere E, Parraga IM, Tisch DJ, Mayanja HK, Whalen CC."	BMC Public Health. 2012;12:1050.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=23217171	BACKGROUND: Information regarding dietary nutrient intake during tuberculosis disease is lacking. We established the relationship between disease severity or wasting during pulmonary tuberculosis and nutrient intake.	"METHODS: In a cross-sectional study of 131 adults with or without pulmonary tuberculosis were screened for human immune-deficiency virus (HIV), wasting, disease severity using 13 item validated clinical TBscore, and 24-hour dietary intake recall."	"RESULTS: Of the 131 participants, 61 were males and 70 females. Overall men and women had similar age. In average 24-hour nutrient intake, the following nutrients: energy, protein, total fat, carbohydrate, calcium, vitamin A, and folate were low among patients with severe tuberculosis disease. Patients with moderate-to-severe clinical TBscore had lower average energy intake than patients with mild TBscores (6.11 vs. 9.27 MJ, respectively) (p<0.05). The average 24-hour nutrient intakes between wasted and non-wasted tuberculosis patients were comparable. Nutrient intake among men was higher when compared to women regardless of wasting and severity of tuberculosis. Among those with wasting, men had higher average energy intake than women (8.87 vs. 5.81 MJ, respectively) (p<0.05). Among patients with mild disease, men had higher average energy intake than women with mild disease (12.83 vs. 7.49 kcal, respectively) (p<0.001)."	CONCLUSIONS: Findings suggest that severity of pulmonary tuberculosis and female gender had reduced nutrient intake. Early tuberculosis diagnosis and nutritional support may be important in management of tuberculosis patients.						
722	Impact of drought and HIV on child nutrition in Eastern and Southern Africa.	"Mason JB, Chotard S, Bailes A, Mebrahtu S, Hailey P."	Food & Nutrition Bulletin. 2010;31(3 Suppl):S209-18.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=21049842	"BACKGROUND: Intermittent food insecurity due to drought and the effects of HIV/AIDS affect child nutritional status in sub-Saharan Africa. In Southern Africa in 2001-3 drought and HIV were previously shown to interact to cause substantial deterioration in child nutrition. With additional data available from Southern and Eastern Africa, the size of the effects of drought and HIV on child underweight up to 2006 were estimated."	OBJECTIVE: To determine short- and long-term trends in child malnutrition in Eastern and Southern Africa and how these are affected by drought and HIV.	"METHODS: A secondary epidemiologic analysis was conducted of area-level data derived from national surveys, generally from the mid-1990s to the mid-2000s. Data from countries in the Horn of Africa (Ethiopia, Kenya, and Uganda) and Southern Africa (Lesotho, Malawi, Mozambique, Swaziland, Zambia, and Zimbabwe) were compiled from available survey results. Secondary data were obtained on weight-for-age for preschool children, HIV prevalence data were derived from antenatal clinic surveillance, and food security data were obtained from United Nations sources (Food and Agriculture Organization, International Labour Office, and others)."	"RESULTS: Overall trends in child nutrition are improving as national averages; the improvement is slowed but not stopped by the effects of intermittent droughts. In Southern Africa, the prevalence rates of underweight showed signs of recovery from the 2001-03 crisis. As expected, food production and price indicators were related (although weakly) to changes in malnutrition prevalence; the association was strongest between changes in food production and price indicators and changes in malnutrition prevalence in the following year. Areas of higher HIV prevalence had better nutrition (in both country groups), but this counterintuitive association is removed after controlling for socioeconomic status. In low-HIV areas in Eastern Africa, nutrition deteriorates during drought, with prevalence rates of underweight 5 to 12 percentage points higher than in nondrought periods; less difference was seen in high-HIV areas, in contrast to Southern Africa, where drought and HIV together interact to produce higher prevalence rates of underweight."	"CONCLUSIONS: Despite severe intermittent droughts and the HIV/AIDS epidemic (now declining but still with very high prevalence rates), underlying trends in child underweight are improving when drought is absent: resilience may be better than feared. Preventing effects of drought and HIV could release potential for improvement and, when supported by national nutrition programs, help to accelerate the rates of improvement, now generally averaging around 0.3 percentage points per year, to those needed to meet Millennium Development Goals (0.4 to 0.9 percentage points per year)."					
817	"Feasibility of ""directly observed home-based twice-daily iron therapy"" (DOHBIT) for management of anemia in rural patients: a pilot study."	Bharti S.	Indian Journal of Medical Sciences. 2004;58(10):431-8.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=15523164	"BACKGROUND: Iron deficiency anemia (IDA) is a significant public health challenge in resource-poor settings, despite strong evidence for efficacy of iron supplementation. We hypothesized, modeled on the successful initiatives in disorders like tuberculosis or HIV, that directly observed therapy is an effective and practical strategy for control of IDA in such settings."	"OBJECTIVE: To overcome practical constraints and optimize compliance and effectiveness of iron supplementation by ""Directly Observed Home-Based twice daily Iron Therapy"" (DOHBIT) through village youth volunteers."	DESIGN: Prospective longitudinal evaluation of DOHBIT.	SETTING: A remote rural hilly hamlet with 25 families.	"METHODS AND MATERIAL: 100 mg elemental iron was administered twice daily under direct supervision to 33 anemic patients at home for 90 days. Outcome measures included hemoglobin rise, weight gain and side-effects."	STATISTICS: Pre- and post-intervention weight and hemoglobin values were compared using paired t-test.	"RESULTS: 29 patients completed 3-months twice-daily iron therapy without interruption (compliance 87%). There was significant increase in mean weight (43.3 +/- 6.8 kg vs. 45.1+/- 6.9 kg; P < 0.0001) as well mean hemoglobin concentration (9.5 +/- 0.9 gm% vs. 11.7 +/- 0.7 gm%; P < 0.0001) and prevalence of anemia decreased by 40% from recruitment through the 3-months therapy. In terms of side effects, occasional constipation was stated by 3 patients, transient heartburn by two and diarrhea by none. Vomiting prompted withdrawal of iron therapy in one patient."	CONCLUSIONS: Providing iron supplementation as directly observed home based therapy is feasible and successful in decreasing the prevalence of anemia in resource-poor settings.		
288	Soluble transferrin receptor as an indicator of iron deficiency in HIV-infected infants.	"Ray A, Ndugwa C, Mmirot F, Ricks MO, Semba RD."	Annals of Tropical Paediatrics. 2007;27(1):11-6.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medc&AN=17469727	BACKGROUND: Iron deficiency is common in human immunodeficiency virus (HIV)-infected infants in sub-Saharan Africa. It is not known whether soluble transferrin receptor (sTfR) is a good indicator of iron deficiency in infants with HIV.	"METHODS: We evaluated sTfR as an indicator of iron deficiency in 134 HIV-infected 9-month-old infants in Kampala, Uganda. Ferritin <12 microg/L and microcytic, hypochromic anaemia were used as indicators of iron deficiency, respectively. The presence of inflammation was indicated by C-reactive protein >5 mg/L or alpha1-acid glycoprotein >1 g/L."	"RESULTS: Receiver operator characteristic curves showed that the area under the curve was 0.67 when sTfR receptor was compared with low ferritin and 0.71 when sTfR was compared with microcytic, hypochromic anaemia. The appropriate calculated cut-offs of sTfR >3.74 microg/mL (43.98 nmol/L) and >3.53 microg/mL (41.55 nmol/L) show adequate specificities of 60% and sensitivities of 63% and 69% for low ferritin and microcytic, hypochromic anaemia, respectively. C-reactive protein and alpha 1-acid glycoprotein were strongly correlated with serum ferritin (r=0.371 and r=0.458, respectively, both p<0.0001) but were not correlated with sTfR (r=0.009 and r= -0.003, respectively, both p=0.9). In all, 78.6% of infants had alpha l-acid glycoprotein >1 g/L and 54.7% had C-reactive protein >5 g/L."	CONCLUSIONS: Soluble TfR appears to be an adequate indicator of iron deficiency in HIV-infected infants.						
421	Effect of nutritional supplementation of breastfeeding HIV positive mothers on maternal and child health: findings from a randomized controlled clinical trial.	"Kindra G, Coutsoudis A, Esposito F."	BMC Public Health. 2011;11:946.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=22192583	"BACKGROUND: It has been well established that breastfeeding is beneficial for child health, however there has been debate regarding the effect of lactation on maternal health in the presence of HIV infection and the need for nutritional supplementation in HIV positive lactating mothers."	AIMS: To assess the effect of nutritional supplementation to HIV infected lactating mothers on nutritional and health status of mothers and their infants.	"METHODS: A randomized controlled clinical trial to study the impact of nutritional supplementation on breastfeeding mothers. Measurements included anthropometry; body composition indicators; CD4 count, haemoglobin and albumin; as well as incidence rates of opportunistic infections; depression and quality of life scores. Infant measurements included anthropometry, development and rates of infections."	"RESULTS: The supplement made no significant impact on any maternal or infant outcomes. However in the small group of mothers with low BMI, the intake of supplement was significantly associated with preventing loss of lean body mass (1.32 kg vs. 3.17 kg; p = 0.026). There was no significant impact of supplementation on the infants."	CONCLUSIONS: A 50 g daily nutritional supplement to breastfeeding mothers had no or limited effect on mother and child health outcomes.	CLINICAL TRIAL REGISTRATION: ISRCTN68128332 (http://www.controlled-trials.com/ISRCTN68128332).				
435	Effects of vitamin D supplementation on the bone specific biomarkers in HIV infected individuals under treatment with efavirenz.	"Etminani-Esfahani M, Khalili H, Jafari S, Abdollahi A, Dashti-Khavidaki S."	BMC Research Notes. 2012;5:204.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=22537736	BACKGROUND: It was reported that antiretroviral drugs such as efavirenz can increase the catabolism of vitamin D in HIV infected individuals. We have not found any study that evaluated effects of vitamin D supplementation on the bone specific biomarkers in HIV positive patients under treatment with antiretroviral regimen containing efavirenz.	"FINDINGS: Vitamin D deficiency was detected in 88.4% of included patients. Baseline osteocalcin, but not collagen telopeptidase, serum levels were lower than normal range in all of these individuals. Both bone biomarkers' concentrations increased significantly (p<0.001 for both of them) after supplementation of vitamin D and it was more predominant for osteocalcin."	"CONCLUSION: In the HIV-infected patients under treatment with efavirenz, vitamin D deficiency is prevalent. After supplementation with single dose of 300,000IU vitamin D in this population, the activation of osteoblasts and osteoclasts stimulates bone formation and resorption respectively with favorable bone formation without any adverse event. Significant percent of HIV infected individuals are vitamin d deficient that could benefit from vitamin D supplementation."							
837	"Prevalence and predictors of kaposi sarcoma herpes virus seropositivity: A cross-sectional analysis of HIV-infected adults initiating ART in Johannesburg, South Africa."	"Maskew M, MacPhail A, Whitby D, Egger M, Wallis CL, Fox MP."	Infectious Agents and Cancer. 2011;6(1).		"Background: Kaposi sarcoma (KS) is the most common AIDS-defining tumour in HIV-infected individuals in Africa. Kaposi sarcoma herpes virus (KSHV) infection precedes development of KS. KSHV co-infection may be associated with worse outcomes in HIV disease and elevated KSHV viral load may be an early marker for advanced HIV disease among untreated patients. We examined the prevalence of KSHV among adults initiating antiretroviral therapy (ART) and compared immunological, demographic and clinical factors between patients seropositive and seronegative for KSHV. Results: We analyzed cross-sectional data collected from 404 HIV-infected treatment-nave adults initiating ART at the Themba Lethu Clinic, Johannesburg, South Africa between November 2008 and March 2009. Subjects were screened at ART initiation for antibodies to KSHV lytic K8.1 and latent Orf73 antigens. Seropositivity to KSHV was defined as positive to either lytic KSHV K8.1 or latent KSHV Orf73 antibodies. KSHV viremia was determined by quantitative PCR and CD3, 4 and 8 lymphocyte counts were determined with flow cytometry. Of the 404 participants, 193 (48%) tested positive for KSHV at ART initiation; with 76 (39%) reactive to lytic K8.1, 35 (18%) to latent Orf73 and 82 (42%) to both. One individual presented with clinical KS at ART initiation. The KSHV infected group was similar to those without KSHV in terms of age, race, gender, ethnicity, smoking and alcohol use. KSHV infected individuals presented with slightly higher median CD3 (817 vs. 726 cells/mm<sup>3</sup>) and CD4 (90 vs. 80 cells/mm<sup>3</sup>) counts than KSHV negative subjects. We found no associations between KSHV seropositivity and body mass index, tuberculosis status, WHO stage, HIV RNA levels, full blood count or liver function tests at initiation. Those with detectable KSHV viremia (n = 19), however, appeared to present with signs of more advanced HIV disease including anemia and WHO stage 3 or 4 defining conditions compared to those in whom the virus was undetectable. Conclusions: We demonstrate a high prevalence of KSHV among HIV-infected adults initiating ART in a large urban public-sector HIV clinic. KSHV viremia but not KSHV seropositivity may be associated with markers of advanced HIV disease. 2011 Maskew et al; licensee BioMed Central Ltd."									
197	Circulating antioxidants and lipid peroxidation products in untreated tuberculosis patients in Ethiopia.	"Madebo T, Lindtjorn B, Aukrust P, Berge RK."	American Journal of Clinical Nutrition. 2003;78(1):117-22.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=12816780	"BACKGROUND: Knowledge of the antioxidant profile and its relation to lipid peroxidation in tuberculosis patients with or without accompanying HIV infection is scarce, particularly in developing countries."	"OBJECTIVE: The objective was to further investigate the interaction between HIV, tuberculosis, and antioxidants and their relations with markers of oxidative stress in a large population of Ethiopians."	"DESIGN: In a cross-sectional study, we evaluated antioxidants and markers of oxidative stress in Ethiopian tuberculosis patients with (n = 25) and without (n = 100) HIV infection and in Ethiopian (n = 45) and Norwegian (n = 25) healthy control subjects."	"RESULTS: Concentrations of the antioxidant vitamins C and E and of vitamin A were significantly lower in tuberculosis patients than in healthy Ethiopians. Tuberculosis patients also had significantly lower thiol concentrations, particularly of the reduced forms. Tuberculosis patients, particularly those who were co-infected with HIV, had higher malondialdehyde concentrations than did control subjects. High malondialdehyde concentrations were associated with clinical severity as measured by the Karnofsky Performance Status Index and anthropometric scores. Ethiopian control subjects had lower concentrations of vitamin E and higher concentrations of malondialdehyde than did Norwegian control subjects."	"CONCLUSIONS: Our findings further support a link between oxidative stress, tuberculosis, and HIV infection. However, whether antioxidant supplementation will improve tuberculosis outcome or is of importance for its prevention should be further examined in future prospective studies."					
198	Circulating antioxidants and lipid peroxidation products in untreated tuberculosis patients in Ethiopia.	"Madebo T, LindtjÀrn B, Aukrust P, Berge RK."	American Journal of Clinical Nutrition. 2003;78(1):117-22.	http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=2004049343&site=ehost-live	"BACKGROUND: Knowledge of the antioxidant profile and its relation to lipid peroxidation in tuberculosis patients with or without accompanying HIV infection is scarce, particularly in developing countries. OBJECTIVE: The objective was to further investigate the interaction between HIV, tuberculosis, and antioxidants and their relations with markers of oxidative stress in a large population of Ethiopians. DESIGN: In a cross-sectional study, we evaluated antioxidants and markers of oxidative stress in Ethiopian tuberculosis patients with (n = 25) and without (n = 100) HIV infection and in Ethiopian (n = 45) and Norwegian (n = 25) healthy control subjects. RESULTS: Concentrations of the antioxidant vitamins C and E and of vitamin A were significantly lower in tuberculosis patients than in healthy Ethiopians. Tuberculosis patients also had significantly lower thiol concentrations, particularly of the reduced forms. Tuberculosis patients, particularly those who were co-infected with HIV, had higher malondialdehyde concentrations than did control subjects. High malondialdehyde concentrations were associated with clinical severity as measured by the Karnofsky Performance Status Index and anthropometric scores. Ethiopian control subjects had lower concentrations of vitamin E and higher concentrations of malondialdehyde than did Norwegian control subjects. CONCLUSIONS: Our findings further support a link between oxidative stress, tuberculosis, and HIV infection. However, whether antioxidant supplementation will improve tuberculosis outcome or is of importance for its prevention should be further examined in future prospective studies. Copyright © 2003 American Society for Clinical Nutrition"									
294	Lactic acidosis and symptomatic hyperlactataemia in a randomized trial of first-line therapy in HIV-infected adults in South Africa.	"Dlamini J, Ledwaba L, Mokwena N, Mokhathi T, Orsega S, Tsoku M, Kowo H, et al."	Antiviral Therapy. 2011;16(4):605-9.		"Background: Lactic acidosis (LA) is a potentially life-threatening complication of antiretroviral (ARV) therapy. Few randomized prospective studies have compared LA between different ARV regimens. Methods: Characterization of cases of LA (serum lactate >5 mmol/l and arterial pH<7.35 or bicarbonate <20 mmol/l) and symptomatic hyperlactataemia (SH; serum lactate >2.2 mmol/l and symptoms) was made in a randomized open-label 2x2 factorial study of stavudine/lamivudine (d4T/3TC)-based versus didanosine/zidovudine-based therapy and lopinavir/ritonavir-based versus efavirenz (EFV)-based therapy in 1,771 HIV-infected adults initiating therapy between 2004 and 2008. Results: The LA incident rate was 3.5/1,000 person-years (95% CI 1.8-5.9), and for combined LA/SH was 11.0/1,000 person-years (95% CI 7.9-14.9). There were two deaths (15% mortality) among 13 LA cases; all 11 survivors experienced symptom resolution and started new ARV regimens. LA cases were more likely to be female (OR 7.19, 95% CI 1.84-40.75; P=0.001) and had a higher body mass index (BMI; P<0.0001) compared with non-cases. There was no increase in LA according to ARV regimen, age or CD4<sup>+</sup> T-cell count at randomization. When combined, LA/SH cases (n=41) were more often female (OR 4.76, 95% CI 2.36-10.08; P<0.0001), had increased BMI (P<0.0001), were more likely to be assigned d4T/3TC (OR 3.17, 95% CI 1.50-7.28; P=0.001) and were more likely to be assigned EFV (OR 2.18, 95% CI 1.08-4.61; P=0.026). Conclusions: Female sex and increased BMI were associated with severe LA in this large randomized trial of first-line ARV in South Africa. While female sex, increased BMI and d4T are previously described risk factors for the development of clinically significant lactate elevations, the independent risk associated with EFV is a novel observation warranting further investigation. 2011 International Medical Press."									
1580	"Who Starts? Factors Associated with Starting Antiretroviral Therapy among Eligible Patients in Two, Public HIV Clinics in Lilongwe, Malawi."	"Feldacker C, Johnson D, Hosseinipour M, Phiri S, Tweya H."	PLoS ONE. 2012 30 Nov;7(11).		"Background: Lighthouse Trust operates two, public, integrated HIV clinics, Lighthouse (LH) and Martin Preuss Center (MPC), in Lilongwe, Malawi. Approximately 20% of patients eligible for antiretroviral therapy (ART) do not start ART. We explore individual and geographic factors that influence whether ART-eligible patients initiate ART. Methods: Adult patients eligible for ART between 2008-2011 were included. Analysis was stratified by clinic. Using logistic regression, we evaluated factors associated with initiating ART including gender, age, body mass index (BMI), employment, tuberculosis (TB), eligible at initial registration, WHO stage, CD4, months in pre-ART care (from initial registration to eligibility date), and patient neighborhood distance to clinic. Results: Of 14,216 study patients, 4841 were from LH; 9285 were from MPC. At LH and MPC, respectively, median age was 34.2 and 33.8 years; median BMI was 22.0 and 20.6; and median distance was 5.6 and 4.9 Km. In multivariate models, odds of starting ART was highest among those older than 35 years and those eligible for ART based on WHO stages 3-4 vs. those in WHO stages 1-2 with CD4<250. Patients with 1-12 months in pre-ART were at least 11 times more likely to start ART than peers with less pre-ART time. At LH, living 2.5-5 Km from the clinic increased the likelihood of starting ART over patients living closer. Conclusions: Length of the pre-ART period is the most significant predictor of starting ART among eligible patients. Better understanding of motivation for retention in pre-ART care may reduce attrition along the treatment cascade. 2012 Feldacker et al."									
215	Vitamin supplementation of HIV-infected women improves postnatal child growth.	"Villamor E, Saathoff E, Bosch RJ, Hertzmark E, Baylin A, Manji K, Msamanga G, et al."	American Journal of Clinical Nutrition. 2005;81(4):880-8.		"Background: Linear growth retardation and wasting are common in children born to HIV-infected women. Inexpensive interventions that could improve the postnatal growth pattern of such children are needed. Objective: The objective was to examine the effect of supplementing HIV-infected women with multivitamins or vitamin A and beta-carotene, during and after pregnancy, on the growth of their children during the first 2 y of life. Design: We conducted a randomized placebo-controlled trial in 886 mother-infant pairs in Tanzania. At the first prenatal visit, HIV-infected women were randomly assigned to 1 of 4 daily oral regimens in a 2 x 2 factorial fashion: multivitamins (MV: thiamine, riboflavin, vitamin B-6, niacin, vitamin B-12, vitamin C, vitamin E, and folic acid), preformed vitamin A + beta-carotene (VA/BC), MV including VA/BC, or placebo. Supplementation continued during the first 2 y postpartum and thereafter. Children were weighed and measured monthly, and all received vitamin A supplements after 6 mo of age per the standard of care. Results: Multivitamins had a significant positive effect on attained weight (459 g; 95% CI: 35, 882; P = 0.03) and on weight-for-age (0.42; 95% CI: 0.07, 0.77; P = 0.02) and weight-for-length (0.38; 95% CI: 0.07, 0.68; P = 0.01) z scores at 24 mo. VA/BC seemed to reduce the benefits of MV on these outcomes. No significant effects were observed on length, midupper arm circumference, or head circumference. Conclusion: Supplementation of HIV-infected women with multivitamins (vitamin B complex, vitamin C, and vitamin E) during pregnancy and lactation is an effective intervention for improving ponderal growth in children. 2005 American Society for Clinical Nutrition."									
297	"Prevalence, DEXA differences and risk factors for lipoatrophy among pre-pubertal African children on HAART."	"Innes S, Eagar R, Edson C, Rabie H, Hough S, Haubrich R, Cotto SnMF, et al."	Antiviral Therapy. 2011;16:A61-A2.		"Background: Lipoatrophy amongst children on HAART in Africa has not previously been investigated. Method: We performed a cross-sectional study to determine the prevalence, DEXA differences and risk factors for lipoatrophy among pre-pubertal African children. The first 100 of 300 eligible (on HAART, 3-11 years old) clinic attendees were recruited. Lipoatrophy was graded by an expert HIV paediatrician using the European Paediatric Lipodystrophy Group classification. Durations of previous antiretroviral exposures were recorded. Dual Emission X-ray Absorbiometry (DEXA) was performed on 42 recruits and 34 HIV-uninfected controls. Results: All 100 recruits and 34 controls were Tanner stage 1 or 2 (i.e. pre-pubertal). Lipoatrophy prevalence was 37% (27.5-46.5%). Children with and without lipoatrophy had similar gender distribution (43% versus 52% female; P=0.41), ethnic distribution (49% versus 57% black; P=0.53), body mass index (15 versus 16; P=0.21), viral load (1.98 versus 2.23 log10 copies/ml; P=0.29) and mean CD4 (1,296 versus 1,223; P=0.48). Greater age (83 versus 66 months; P=0.002) and overall time on HAART (56 versus 43 months; P=0.004) were associated with lipoatrophy. The effect of specific antiretroviral exposures is shown in Table 1. A multivariable logistic regression model controlling for age and CD4% found that stavudine duration (OR=1.7 per 12 months; P=0.003) was independently associated with lipoatrophy. Fifteen (36%) of the 42 recruits with DEXA scans, had lipoatrophy. There were statistically significant differences between children with and without lipoatrophy, as well as between children with lipoatrophy and HIVuninfected children, in the following variables: limbfat- mass-to-limb-lean-mass ratio (overall P=0.004); total extremity fat (P=0.005); limb-fat-mass-to-totallean- mass ratio (P=0.001); limb-fat-mass-to-total-mass ratio (P<0.0001); limb-fat-mass-to-body-mass-index ratio (P=0.002). There were no statistically significant differences between HIV-infected children without lipoatrophy, and HIV-uninfected children. Groups were well matched with regard to age, sex and ethnicity (P=0.24, 0.88, and 0.96, respectively). Table 2 shows the between-groups P-values for the limb-fat-mass-tolimb- lean-mass ratio. Conclusion: Lipoatrophy was as common in pre-pubertal African children as reported among adults. Efavirenz may be associated with lipoatrophy in African children. (Table presented) HIV-infected children with and without lipoatrophy can be clearly differentiated by DEXA scanning. Children without lipoatrophy and HIV-uninfected children have indistinguishable DEXA findings."									
162	Lipoprotein levels and cardiovascular risk in HIV-infected and uninfected Rwandan women.	"Anastos K, Ndamage F, Lu D, Cohen MH, Shi Q, Lazar J, Bigirimana V, et al."	AIDS Research and Therapy. 2010 26 Aug;7(34).		"Background: Lipoprotein profiles in HIV-infected African women have not been well described. We assessed associations of lipoprotein levels and cardiovascular risk with HIV-infection and CD4 count in Rwandan women.Methods: Cross-sectional study of 824 (218 HIV-negative, 606 HIV+) Rwandan women. Body composition by body impedance analysis, CD4 count, and fasting serum total cholesterol (total-C), triglycerides (TG) and high-density lipoprotein (HDL) levels were measured. Low-density lipoprotein (LDL) was calculated from Friedewald equation if TG < 400 and measured directly if TG >= 400 mg/dl.Results: BMI was similar in HIV+ and -negative women, < 1% were diabetic, and HIV+ women were younger. In multivariate models LDL was not associated with HIV-serostatus. HDL was lower in HIV+ women (44 vs. 54 mg/dL, p < 0.0001) with no significant difference by CD4 count (p = 0.13). HIV serostatus (p = 0.005) and among HIV+ women lower CD4 count (p = 0.04) were associated with higher TG. BMI was independently associated with higher LDL (p = 0.01), and higher total body fat was strongly associated with higher total-C and LDL. Framingham risk scores were < 2% in both groups.Conclusions: In this cohort of non-obese African women HDL and TG, but not LDL, were adversely associated with HIV infection. As HDL is a strong predictor of cardiovascular (CV) events in women, this HIV-associated difference may confer increased risk for CV disease in HIV-infected women. 2010 Anastos et al; licensee BioMed Central Ltd."									
639	"Changes in nutritional, functional and immunological status of HIV-infected adults with antiretroviral therapy."	"Tafese Z, Berhan Y, Abebe H."	Ethiopian Medical Journal. 2012;50(1):75-87.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=22519164	"BACKGROUND: Literature has shown that there is vicious cycle between malnutrition and HIV infection. In Ethiopia, antiretroviral therapy (ART) was started about eight years back but, to the best of authors' knowledge, there was no published study that assessed treatment outcome indicators."	"OBJECTIVE: To assess the outcomes of ART from the perspective of nutritional, clinical, functional and immunological status."	METHODS: A retrospective recored review was used to assess the nutritional status of adults before and after ART in Hawassa University referral hospital. This analysis included 358 living HIV positive adults who were on ART for 3 - 96 months.	"RESULTS: The mean age of the study participants was 33.75 +/- 9.12 years and the median duration of ART was 24 months (Inter-quartile range: 12, 36). After ART, cases with body mass index (BMI) < 18.5 kg/m2 dropped from 38% to about 20% and cases with CD4 count < 200/mm3 dropped from about 73% to about 9% (P < 0.0001 for each). However, there were 58 and 14 cases whose BMI and CD4 count were even below the Pre-ART levels, respectively. The regression line demonstrating an overall change in CD4 count showed a positive linear trend as the duration of ART increases but the change in BMI was a downward linear trend. In multiple linear regression, current nutritional status was found to have significant association with baseline low CD4 count, clinical stage III/ IV, low BMI and low meal frequency. Multiple logistic regression also demonstrated a significant association of low BMI after ART with low CD4 count before ART. With ART, decreased frequency of illness, baseline WHO clinical stage I/II and high BMI were independent predictors of improvement in functional status."	"CONCLUSION: Patients started on ART with low BMI, severely immunosuppressed and clinical stage III/IV illnesses were found to have poorer nutritional, functional and immunological response. This study provided another evidence to support the WHO recommendation on initiating ART before patients' nutritional, clinical and immunological statuses deteriorate. The nutritional care needs to be given more emphasis since the ART response was found to be unsatisfactory."					
642	"Changes in nutritional, functional and immunological status of HIV-infected adults with antiretroviral therapy."	"Zelalem T, Yifru B, Hiwot A."	Ethiopian Medical Journal. 2012;50(1):75-87.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20123151544	"Background: Literature has shown that there is vicious cycle between malnutrition and HIV infection. In Ethiopia, antiretroviral therapy (ART) was started about eight years back but, to the best of authors' knowledge, there was no published study that assessed treatment outcome indicators. Objective: To assess the outcomes of ART from the perspective of nutritional, clinical, functional and immunological status. Methods: A mixed study design (retrospective record review and cross-sectional) was used to assess the nutritional status of adults before and after ART in Hawassa University referral hospital. This analysis included 358 living HIV positive adults who were on ART for 3-96 months. Results: The mean age of the study participants was 33.75+or-9.12 years and the median duration of ART was 24 months (Inter-quartile range: 12, 36). After ART, cases with body mass index (BMI) <18.5 kg/m<sup>2</sup> dropped from 38% to about 20% and cases with CD4 count <200/mm<sup>3</sup> dropped from about 73% to about 9% (P<0.0001 for each). However, there were 58 and 14 cases whose BMI and CD4 count were even below the Pre-ART levels, respectively. The regression line demonstrating an overall change in CD4 count showed a positive linear trend as the duration of ART increases but the change in BMI was a downward linear trend. In multiple linear regression, current nutritional status was found to have significant association with baseline low CD4 count, clinical stage III/IV, low BMI and low meal frequency. Multiple logistic regressions also demonstrated a significant association of low BMI after ART with low CD4 count before ART. In Whisker and Box plots, the current CD4 count plots were found to be the mirror reflection of the baseline plots. With ART, decreased frequency of illness, baseline WHO clinical stage I/II and high BMI were independent predictors of improvement in functional status. Conclusion: Patients started on ART with low BMI, severely immunosuppressed and clinical stage III/IV illnesses were found to have poorer nutritional, functional and immunological response. This study provided another evidence to support the WHO recommendation on initiating ART before patients' nutritional, clinical and immunological statuses deteriorate. The nutritional care needs to be given more emphasis since the ART response was found to be unsatisfactory."									
332	"Malnutrition: prevalence and its associated factors in people living with HIV/AIDS, in Dilla University Referral Hospital."	"Solomon H, Bune GT, Ayele HT."	Archives of Public Health. 2013;71(13).	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20133221823	"Background: Literatures on prevalence and factors associated with malnutrition among peoples living with HIV/AIDS are limited in Ethiopia and not well documented either. The proper implementation of nutritional support and its integration with the routine highly active antiretroviral therapy package demands a clear picture of the magnitude and associated factors of malnutrition. The objective of this study is, therefore, to assess the prevalence and factors associated with malnutrition among peoples living with HIV/AIDS. Methods: Institution based cross sectional study was conducted in Dilla University referral Hospital including adult HIV patients who were in highly active anti retroviral therapy. Interview administered questionnaires were used to collect data on socio demographic factors. Besides, HIV related clinical information was extracted from anti retro viral therapy data base and clinical charts. The nutritional status of the patients was determined by Body Mass Index (BMI) where BMI<18 kg/m<sup>2</sup> was defined as malnutrition according to World Health Organization (WHO). Binary logistic regression was used to assess association between different risk factors and malnutrition. Confidence interval of 95% was considered to see the precision of the study and the level of significance was taken at alpha <0.05. Results: A total of 520 patients were included in the analysis. The overall prevalence of malnutrition was 12.3% (95% CI 9.5-15.0). After full control of all variables; unemployment (OR=3.61, 95% CI: 3.6-7.76), WHO clinical stage four (OR=12.9, 95% CI: 2.49-15.25), gastrointestinal symptoms (OR=5.3, 95% CI: 2.56-10.78) and previous (one) opportunistic infection (OR=3.1, 95% CI 2.06-5.46), and two & above previous opportunistic infections (OR=4.5, 95% CI: 3.38-10.57) were significantly associated with malnutrition. However, moderately poor economic condition was found to be protective factor for malnutrition (OR=0.4, 95% CI: 0.14-0.95). Conclusion: Unemployment, WHO clinical AIDS stage four, one & more number of previous opportunistic infections and gastrointestinal symptoms were found to be important risk factors for malnutrition among People Living with HIV/AIDS. From this study it has been learnt that nutritional programs should be an integral part of HIV/AIDS continuum of care. Furthermore, it needs to improve household income of PLHIV with employment opportunity and to engage them in income generating activities as well."									
207	Micronutrient status during lactation in HIV-infected and HIV-uninfected South African women during the first 6 mo after delivery.	"Papathakis PC, Rollins NC, Chantry CJ, Bennish ML, Brown KH."	American Journal of Clinical Nutrition. 2007;85(1):182-92.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20073047058	"Background: Little information on the micronutrient status of HIV-infected (HIV-positive) breastfeeding women is available. Objective: The objective was to compare the protein and micronutrient status of South African breastfeeding women by HIV status. Design: Serum albumin, prealbumin, vitamin B-12, folate, retinol, alpha -tocopherol, hemoglobin, ferritin, and zinc concentrations were compared between 92 HIV-positive and 52 HIV-uninfected (HIV-negative) mothers 6, 14, and 24 wk after delivery. C-reactive protein and alpha <sub>1</sub>-acid glycoprotein were used as proxy indicators of an inflammatory process. Results: Mean albumin and prealbumin were significantly lower in HIV-positive mothers, and a higher proportion of HIV-positive mothers had low albumin concentrations (<35 g/L). Less than 45% of the mothers were vitamin B-12 or folate sufficient. Significantly more HIV-positive (70.5%) than HIV-negative (46.2%) mothers had marginal vitamin B-12 status (P<0.05), and mean folate concentrations were lower in HIV-positive mothers (P=0.05). Mean serum retinol was significantly lower in HIV-positive mothers, even after control for the acute phase response. At 24 wk, 70% of both groups had an -tocopherol deficiency (<11.6 micro mol/L), but no significant difference by HIV status was observed. More HIV-positive (33.3%) than HIV-negative (8.7%) mothers had anemia (P=0.018), whereas 25% of all mothers had low serum ferritin concentrations. After the acute phase response was controlled for, zinc deficiency was more common in HIV-positive (45.0%) than in HIV-negative (25.0%) mothers (P=0.05). Conclusions:Deficiencies in vitamins B-12, folate, alpha -tocopherol, ferritin, and zinc are common in South African breastfeeding mothers. HIV-positive mothers had lower mean serum concentrations of albumin, prealbumin, folate, retinol, and hemoglobin than did HIV-negative mothers."									
866	Are behavioural risk factors to be blamed for the conversion from optimal blood pressure to hypertensive status in Black South Africans? A 5-year prospective study.	"Schutte AE, Schutte R, Huisman HW, van Rooyen JM, Fourie CM, Malan NT, Malan L, et al."	International Journal of Epidemiology. 2012;41(4):1114-23.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=22825590	"BACKGROUND: Longitudinal cohort studies in sub-Saharan Africa are urgently needed to understand cardiovascular disease development. We, therefore, explored health behaviours and conventional risk factors of African individuals with optimal blood pressure (BP) (<= 120/80 mm Hg), and their 5-year prediction for the development of hypertension."	"METHODS: The Prospective Urban Rural Epidemiology study in the North West Province, South Africa, started in 2005 and included African volunteers (n = 1994; aged > 30 years) from a sample of 6000 randomly selected households in rural and urban areas."	"RESULTS: At baseline, 48% of the participants were hypertensive (>= 140/90 mmHg). Those with optimal BP (n = 478) were followed at a success rate of 70% for 5 years (213 normotensive, 68 hypertensive, 57 deceased). Africans that became hypertensive smoked more than the normotensive individuals (68.2% vs 49.8%), and they also had a greater waist circumference [ratio of geometric means of 0.94 cm (95% CI: 0.86-0.99)] and greater amount of -glutamyltransferase [0.74 U/l (95% CI: 0.62-0.88)] at baseline. The 5-year change in BP was independently explained by baseline -glutamyltransferase [R(2) = 0.23, = 0.13 U/l (95% CI: 0.01-0.19)]. Alcohol intake also predicted central systolic BP and carotid cross-sectional wall area (CSWA) at follow-up. Waist circumference was another predictor of BP changes [ = 0.18 cm (95% CI: 0.05-0.24)] and CSWA. HIV infection was inversely associated with increased BP."	"CONCLUSIONS: During the 5 years, 24% of Africans with optimal BP developed hypertension. The surge in hypertension in Africa is largely explained by modifiable risk factors. Public health strategies should focus aggressively on lifestyle to prevent a catastrophic burden on the national health system."						
867	Are behavioural risk factors to be blamed for the conversion from optimal blood pressure to hypertensive status in black South Africans? A 5-year prospective study.	"Schutte AE, Schutte R, Huisman HW, Van rooyen JM, Fourie CMT, Malan NT, Malan L, et al."	International Journal of Epidemiology. 2012 August;41(4):1114-23.		"Background: Longitudinal cohort studies in sub-Saharan Africa are urgently needed to understand cardiovascular disease development. We, therefore, explored health behaviours and conventional risk factors of African individuals with optimal blood pressure (BP) (<=120/80 mm Hg), and their 5-year prediction for the development of hypertension. Methods: The Prospective Urban Rural Epidemiology study in the North West Province, South Africa, started in 2005 and included African volunteers (n = 1994; aged > 30 years) from a sample of 6000 randomly selected households in rural and urban areas. Results: At baseline, 48% of the participants were hypertensive (>=140/90 mmHg). Those with optimal BP (n = 478) were followed at a success rate of 70% for 5 years (213 normotensive, 68 hypertensive, 57 deceased). Africans that became hypertensive smoked more than the normotensive individuals (68.2% vs 49.8%), and they also had a greater waist circumference [ratio of geometric means of 0.94 cm (95% CI: 0.86-0.99)] and greater amount of -glutamyltransferase [0.74 U/l (95% CI: 0.62-0.88)] at baseline. The 5-year change in BP was independently explained by baseline -glutamyltransferase [R<sup>2 </sup> = 0.23, beta = 0.13 U/l (95% CI: 0.01-0.19)]. Alcohol intake also predicted central systolic BP and carotid cross-sectional wall area (CSWA) at follow-up. Waist circumference was another predictor of BP changes [beta = 0.18 cm (95% CI: 0.05-0.24)] and CSWA. HIV infection was inversely associated with increased BP. Conclusions: During the 5 years, 24% of Africans with optimal BP developed hypertension. The surge in hypertension in Africa is largely explained by modifiable risk factors. Public health strategies should focus aggressively on lifestyle to prevent a catastrophic burden on the national health system. Published by Oxford University Press on behalf of the International Epidemiological Association The Author 2012; all rights reserved."									
298	Low dose lopinavir/ritonavir tablet achieves adequate pharmacokinetic parameters in HIV-infected Thai adolescents.	"Klinklom A, Puthanakit T, Gorowara M, Phasomsap C, Kerr S, Sriheara C, Ananworanich J, et al."	Antiviral Therapy. 2012;17(2):283-9.		"Background: Lopinavir/ritonavir (LPV/r) is an effective and commonly used protease inhibitor in HIV-infected adolescents. Previous data showed high plasma concentrations of LPV in Thai patients. This study determined the pharmacokinetic (PK) parameters of a low-dose LPV/r tablet (70% of standard dose) in HIV-infected Thai adolescents. Methods: A total of 24 adolescents on LPV/r-containing HAART regimens with HIV RNA<50 copies/ml were included. Standard and low doses for two different weight bands using LPV/r 100/25 mg tablet formulation twice daily were prescribed as follows: 3 and 2 tablets for adolescents weighing 25-35 kg, and 4 and 3 tablets for those weighing >35 kg, respectively. On the fourth week of treatment, PK was performed for all doses at 0 (predose), 2, 4, 6, 8, 10 and 12 h. LPV and ritonavir concentrations were measured using the HPLC method. Results: The median (IQR) age was 13.5 (12-15) years. The median LPV doses of standard and low doses were 290 and 208 mg/m <sup>2</sup>. The mean (sd) area under the concentration-time curve at 0-12 h, maximum concentration and plasma concentration at 12 h for the standard dose were 97.6 (25.7) mg*h/l, 11.1 (2.6) mg/l and 4.1 (2.0) mg/l, and for the low dose were 87.4 (29.0) mg*h/l, 11.0 (3.1) mg/l and 3.2 (1.9) mg/l, respectively. No significant differences were detected between the groups. One child had plasma concentration at 12 h <1.0 mg/l while on low-dose LPV/r but HIV RNA was undetectable. Conclusions: The low-dose LPV/r tablet provides adequate PK parameters in HIV-infected Thai adolescents. A randomized study to assess the efficacy of low and standard doses of LPV/r among Thai HIV-infected adolescents should be explored. 2012 International Medical Press."									
1604	Estimating loss to follow-up in HIV-infected patients on antiretroviral therapy: The effect of the competing risk of death in Zambia and Switzerland.	"Schoni-Affolter F, Keiser O, Mwango A, Stringer J, Ledergerber B, Mulenga L, Bucher HC, et al."	PLoS ONE. 2011 19 Dec;6(12).		"Background: Loss to follow-up (LTFU) is common in antiretroviral therapy (ART) programmes. Mortality is a competing risk (CR) for LTFU; however, it is often overlooked in cohort analyses. We examined how the CR of death affected LTFU estimates in Zambia and Switzerland. Methods and Findings: HIV-infected patients aged >=18 years who started ART 2004-2008 in observational cohorts in Zambia and Switzerland were included. We compared standard Kaplan-Meier curves with CR cumulative incidence. We calculated hazard ratios for LTFU across CD4 cell count strata using cause-specific Cox models, or Fine and Gray subdistribution models, adjusting for age, gender, body mass index and clinical stage. 89,339 patients from Zambia and 1,860 patients from Switzerland were included. 12,237 patients (13.7%) in Zambia and 129 patients (6.9%) in Switzerland were LTFU and 8,498 (9.5%) and 29 patients (1.6%), respectively, died. In Zambia, the probability of LTFU was overestimated in Kaplan-Meier curves: estimates at 3.5 years were 29.3% for patients starting ART with CD4 cells &100 cells/mul and 15.4% among patients starting with >=350 cells/muL. The estimates from CR cumulative incidence were 22.9% and 13.6%, respectively. Little difference was found between naive and CR analyses in Switzerland since only few patients died. The results from Cox and Fine and Gray models were similar: in Zambia the risk of loss to follow-up and death increased with decreasing CD4 counts at the start of ART, whereas in Switzerland there was a trend in the opposite direction, with patients with higher CD4 cell counts more likely to be lost to follow-up. Conclusions: In ART programmes in low-income settings the competing risk of death can substantially bias standard analyses of LTFU. The CD4 cell count and other prognostic factors may be differentially associated with LTFU in low-income and high-income settings. 2011 Schoni-Affolter et al."									
180	Determinants of low birth weight among HIV-infected pregnant women in Tanzania.	"Dreyfuss ML, Msamanga GI, Spiegelman D, Hunter DJ, Urassa EJN, Hertzmark E, Fawzi WW."	American Journal of Clinical Nutrition. 2001;74(6):814-26.		"Background: Low birth weight (LBW) increases the risk of infant death, but little is known about its causes among HIV-infected populations in sub-Saharan Africa. Objective: We assessed sociodemographic, nutritional, immunologic, parasitic, and infant risk factors for birth weight, LBW, and small-for-gestational-age (SGA) status in a cohort of 822 HIV-positive women enrolled in a clinical trial of vitamin supplementation and pregnancy outcomes in Dar es Salaam, Tanzania. Design: Women were enrolled at prenatal care clinics during their second trimester, at which time blood, stool, urine, and genital specimens were collected, and anthropometric measurements and sociodemographic data were recorded. Birth weight was measured at hospital delivery. Results: The mean (+/-SD) birth weight was 3015+/-508 g, 11.1% of newborns weighed <2500 g (LBW), and 11.5% were SGA. In multivariate analyses, maternal weight at enrollment and a low CD8 cell count were inversely associated with LBW. Advanced-stage HIV disease, previous history of preterm birth, Plasmodium falciparum malaria, and any helmintic infection were associated with higher risk of LBW. The intestinal parasites Entamoeba histolytica and Strongyloides stercoralis were predictors of LBW despite their low prevalence in the cohort. In a multivariate-adjusted linear regression model, BMI, midupper arm circumference, a CD4 cell count <200 x 10<sup>6</sup> cells/L (200 cells/mm<sup>3</sup>), primiparity, maternal literacy, and infant HIV infection at birth were significantly associated with birth weight in addition to risk factors included in the LBW model. Determinants of SGA included maternal weight, low serum vitamin E concentration, candidiasis, malaria, and infant HIV infection at birth. Conclusion: Prevention of HIV disease progression and vertical transmission, improved nutritional status, and better management of malaria and intestinal parasitic infections are likely to reduce the incidence of LBW in Tanzania."									
1968	"Maternal HIV infection and intrauterine growth: a prospective study in Lagos, Nigeria."	"Iroha EO, Ezeaka VC, Akinsulie AO, Temiye EO, Adetifa IM."	West African Journal of Medicine. 2007;26(2):121-5.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=17939313	BACKGROUND: Low birth weight (LBW) is the most important cause of perinatal mortality and morbidity worldwide and particularly so in developing countries. Maternal HIV (Human Immunodeficiency Virus) infection has been identified as one of the risk factors to the development of low birth weight babies.	OBJECTIVE: To evaluate the effect of maternal HIV infection on the birth weight of the newborn at tertiary hospital in West Africa.	METHODS: The anthropometry of all HIV seropositive women who delivered in LUTH as well as that of their babies was determined using standard methods. Controls consisted of HIV seronegative women and their babies matched for age and parity with the above subjects.	"RESULTS: There were a total of 262 subjects of whom 132 (50.4%) were HIV seropositive and 130 (49.6%) were HIV seronegative controls. There were five times more low birth weight (LBW) infants in the HIV seropositive group than in the controls (OR 5.77, CI=2.19-16.80; p=0.000075). The mean maternal body mass index, BMI (p=0.0003), mean maternal weight (p=0.0004) and mean birth weight of newborns (p=0.0002) were significantly lower in the HIV seropositive group than in the controls. Maternal weight and gestational age were significantly associated with low birth weight (OR 15.3, CI=2.6-316.0; p=0.002) and (OR 3.78, CI=1.37-10.9; p=0.007) respectively."	CONCLUSION: Maternal HIV infection is strongly associated with low maternal BMI and low birth weight in their offspring.					
1969	"Maternal HIV infection and intrauterine growth: A prospective study in Lagos, Nigeria."	"Iroha EO, Ezeaka VC, Akinsulie AO, Temiye EO, Adetifa IMO."	West African Journal of Medicine. 2007 April/June;26(2):121-5.		"Background: Low birth weight (LBW) is the most important cause of perinatal mortality and morbidity worldwide and particularly so in developing countries. Maternal HIV (Human Immunodeficiency Virus) infection has been identified as one of the risk factors to the development of low birth weight babies. Objective: To evaluate the effect of maternal HIV infection on the birth weight of the newborn at tertiary hospital in West Africa. Methods: The anthropometry of all HIV seropositive women who delivered in LUTH as well as that of their babies was determined using standard methods. Controls consisted of HIV seronegative women and their babies matched for age and parity with the above subjects. Results: There were a total of 262 subjects of whom 132 (50.4%) were HIV seropositive and 130 (49.6%) were HIV seronegative controls. There were five times more low birth weight (LBW) infants in the HIV seropositive group than in the controls (OR 5.77, CI= 2.19-16.80; p=0.000075). The mean maternal body mass index, BMI (p=0.0003), mean maternal weight (p=0.0004) and mean birth weight of newborns (p=0.0002) were significantly lower in the HIV seropositive group than in the controls. Maternal weight and gestational age were significantly associated with low birth weight (OR 15.3, CI=2.6-316.0; p=0.002) and (OR 3.78, CI=1.37-10.9; p=0.007) respectively. Conclusion: Maternal HIV infection is strongly associated with low maternal BMI and low birth weight in their offspring."									
929	Low BMI and falling BMI predict HIV-associated tuberculosis: A prospective study in Tanzania.	"Maro I, Lahey T, MacKenzie T, Mtei L, Bakari M, Matee M, Pallangyo K, et al."	International Journal of Tuberculosis and Lung Disease. 2010 November;14(11):1447-53.		"BACKGROUND: Low body mass index (BMI) is a known risk factor for tuberculosis (TB) in people without human immunodeficiency virus (HIV), but there are no prospective studies linking BMI to the risk of HIV-associated TB. DESIGN: In HIV-infected adults with CD4 counts >= 200 cells/mul receiving placebo in a TB booster vaccine trial in Dar es Salaam, Tanzania, we measured BMI at baseline and Year 1, and related baseline BMI and change in BMI to the risk of developing TB. RESULTS: We documented 92 cases of TB among 979 subjects followed for a mean of 3.2 years. Compared to subjects who did not develop TB, subjects who developed TB had a lower baseline BMI (23.2 vs. 24.6 kg/m <sup>2</sup>, P = 0.006), and a greater BMI decline from baseline to Year 1 (-0.4 vs. 0.6 kg/m<sup>2</sup>, P < 0.001). In multivariate analyses, baseline BMI was associated with the risk of developing TB (hazard ratio [HR] per kg/m<sup>2</sup> 0.94, 95%CI 0.90-0.99, P = 0.028), as was the change in BMI from baseline to Year 1 (HR per kg/m<sup>2</sup> 0.79, 95%CI 0.71-0.87, P < 0.001). Subjects with a baseline BMI < 17 kg/m<sup>2</sup> were more likely to develop TB (HR 3.72, 95%CI 1.16-12.0, P = 0.028). CONCLUSION: Low BMI and falling BMI predict HIV-associated TB. 2010 The Union."									
928	Low BMI and falling BMI predict HIV-associated tuberculosis: a prospective study in Tanzania.	"Maro I, Lahey T, MacKenzie T, Mtei L, Bakari M, Matee M, Pallangyo K, et al."	International Journal of Tuberculosis and Lung Disease. 2010;14(11):1447-53.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20103357883	"BACKGROUND: Low body mass index (BMI) is a known risk factor for tuberculosis (TB) in people without human immunodeficiency virus (HIV), but there are no prospective studies linking BMI to the risk of HIV-associated TB. DESIGN: In HIV-infected adults with CD4 counts >=200 cells/ micro l receiving placebo in a TB booster vaccine trial in Dar es Salaam, Tanzania, we measured BMI at baseline and Year 1, and related baseline BMI and change in BMI to the risk of developing TB. RESULTS: We documented 92 cases of TB among 979 subjects followed for a mean of 3.2 years. Compared to subjects who did not develop TB, subjects who developed TB had a lower baseline BMI (23.2 vs. 24.6 kg/m<sup>2</sup>, P=0.006), and a greater BMI decline from baseline to Year 1 (-0.4 vs. 0.6 kg/m<sup>2</sup>, P<0.001). In multivariate analyses, baseline BMI was associated with the risk of developing TB (hazard ratio [HR] per kg/m<sup>2</sup> 0.94, 95%CI 0.90-0.99, P=0.028), as was the change in BMI from baseline to Year 1 (HR per kg/m<sup>2</sup> 0.79, 95%CI 0.71-0.87, P<0.001). Subjects with a baseline BMI<17 kg/m<sup>2</sup> were more likely to develop TB (HR 3.72, 95%CI 1.16-12.0, P=0.028). CONCLUSION: Low and falling BMI predict HIV-associated TB."									
1003	Prevalence and risk factors of low bone mineral density among perinatally HIV-infected thai adolescents receiving antiretroviral therapy.	"Puthanakit T, Saksawad R, Bunupuradah T, Wittawatmongkol O, Chuanjaroen T, Ubolyam S, Chaiwatanarat T, et al."	Journal of Acquired Immune Deficiency Syndromes. 2012 01 Dec;61(4):477-83.		"BACKGROUND: Low bone mineral density (BMD) has been reported among 10%-54% of HIV-infected adolescents in developed countries. We studied the prevalence and predictors of low BMD among HIV-infected Thai adolescents receiving antiretroviral therapy. METHODS: A cross-sectional study of lumbar spine (L2-L4) BMD as measured by dual-energy X-ray absorptiometry in Thai HIV-infected adolescents aged 12-20 years was performed. The BMD Z score was analyzed using age-matched healthy Thai children as a reference. Serum 25-hydroxyvitamin D was performed. Osteopenia was defined as BMD Z score <= -2. RESULTS: From October 2010 to February 2011, 101 adolescents, 50% male, with a median age of 14.3 (range: 13.0-15.7) years were enrolled. The median [interquartile range (IQR)] current CD4 T-cell count was 646 (506-796) cells per cubic millimeter and 90% had plasma HIV-1 RNA <50 copies per milliliter. The mean BMD among HIV-infected adolescents and controls were 0.855 and 0.980 g/cm (P < 0.001). The median (IQR) L2-L4 spine BMD Z score was -1.0 (-1.9 to -0.1), of which 24% had BMD Z score <= -2.0. The median (IQR) of 25-hydroxyvitamin D level was 24.8 (20.0-31.4) ng/mL, of which 25% had vitamin D level < 20 ng/mL. In multivariate analysis, the height for age Z score < -1.5 (adjusted odds ratio: 6.2; 95% confidence interval: 2.2 to 17.7) and history of World Health Organization clinical stage 4 before antiretroviral therapy (adjusted odds ratio: 3.7; 95% confidence interval: 1.3 to 10.7) were significantly associated with osteopenia. CONCLUSION: One fourth of HIV-infected Thai adolescents have osteopenia. Children with history of advanced-staging or having low height for age are at risk of osteopenia. Preventive measures to prevent osteopenia should be incorporated in routine care for these adolescents. Copyright 2012 by Lippincott Williams & Wilkins."									
1899	"Effect of selenium supplementation on CD4 T-cell recovery, viral suppression, morbidity and quality of life of HIV-infected patients in Rwanda: study protocol for a randomized controlled trial."	"Kamwesiga J, Mutabazi V, Kayumba J, Tayari JC, Smyth R, Fay H, Umurerwa A, et al."	Trials [Electronic Resource]. 2011;12:192.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=21838913	"BACKGROUND: Low levels of serum selenium are associated with increased risk of mortality among HIV+ patients in East Africa. We aim to assess the effect of selenium supplementation on CD4 cell count, HIV viral load, opportunistic infections, and quality of life in HIV-infected patients in Rwanda."	"METHODS AND DESIGN: A 24-month, multi-centre, patient and provider-blinded, randomized, placebo-controlled clinical trial involving 300 pre-antiretroviral therapy (ART) HIV-infected patients will be carried out at two sites in Rwanda. Patients >= 21 years of age with documented HIV infection, CD4 cell count of 400-650 cells/mm3, and not yet on ART will be recruited. Patients will be randomized at each study site using a randomized block design to receive either the selenium micronutrient supplement or an identically appearing placebo taken once daily. The primary outcome is a composite of time from baseline to reduction of CD4 T lymphocyte count below 350 cells/mm3 (confirmed by two measures at least one week apart), or start of ART, or the emergence of a documented CDC-defined AIDS-defining illness. An intention-to-treat analysis will be conducted using stepwise regression and structural equation modeling."	"DISCUSSION: Micronutrient interventions that aim to improve CD4 cell count, decrease opportunistic infections, decrease HIV viral load, and ultimately delay initiation of more costly ART may be beneficial, particularly in resource-constrained settings, such as sub-Saharan Africa. Additional trials are needed to determine if micro-supplementation can delay the need for more costly ART among HIV-infected patients. If shown to be effective, selenium supplementation may be of public health importance to HIV-infected populations, particularly in sub-Saharan Africa and other resource-constrained settings."							
217	The effect of vitamin A and zinc supplementation on treatment outcomes in pulmonary tuberculosis: a randomized controlled trial.	"Visser ME, Grewal HM, Swart EC, Dhansay MA, Walzl G, Swanevelder S, Lombard C, et al."	American Journal of Clinical Nutrition. 2011;93(1):93-100.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=21068353	BACKGROUND: Low serum concentrations of vitamin A and zinc are common in tuberculosis and may have an adverse effect on host cell-mediated responses. The role of adjunctive micronutrient supplementation on treatment outcomes is uncertain.	OBJECTIVE: The objective was to assess the efficacy of vitamin A and zinc supplementation on sputum smear and culture conversion and time to culture detection in adults with sputum smear-positive pulmonary tuberculosis.	"DESIGN: Participants attending a primary care tuberculosis clinic in Cape Town, South Africa, were randomly assigned to receive micronutrients (single dose of 200,000 IU retinyl palmitate plus 15 mg Zn/d for 8 wk) or matching placebo. Sputum was collected weekly for 8 wk for auramine staining and culture on liquid media (BACTEC MGIT 960; Becton Dickinson, Sparks, MD). Performance status, chest radiographs, and anthropometric measures were assessed at baseline and again at 8 wk."	"RESULTS: The participants (n = 154) were randomly assigned to the micronutrient (n = 77) or placebo (n = 77) group. Twenty participants were HIV infected (13%), and 12 participants had an unknown HIV status (8%). No differences in time to smear or culture conversion were observed between the treatment groups by Kaplan-Meier analysis (P = 0.15 and P = 0.38, respectively; log-rank test). Log-logistic regression analysis found no significant group interaction effect in time to culture detection over the 8-wk period (P = 0.32). No significant differences in weight gain (2.3 +/- 3.5 compared with 2.2 +/- 2.4 kg, P = 0.68) or radiologic resolution were observed between the treatment groups."	CONCLUSION: Supplementation with vitamin A and zinc did not affect treatment outcomes in participants with pulmonary tuberculosis at 8 wk. This trial was registered at controlled-trials.com as ISRCTN80852505.					
218	The effect of vitamin A and zinc supplementation on treatment outcomes in pulmonary tuberculosis: A randomized controlled trial.	"Visser ME, Grewal HMS, Swart EC, Dhansay MA, Walzl G, Swanevelder S, Lombard C, et al."	American Journal of Clinical Nutrition. 2011 01 Jan;93(1):93-100.		"Background: Low serum concentrations of vitamin A and zinc are common in tuberculosis and may have an adverse effect on host cell-mediated responses. The role of adjunctive micronutrient supplementation on treatment outcomes is uncertain. Objective: The objective was to assess the efficacy of vitamin A and zinc supplementation on sputum smear and culture conversion and time to culture detection in adults with sputum smear-positive pulmonary tuberculosis. Design: Participants attending a primary care tuberculosis clinic in Cape Town, South Africa, were randomly assigned to receive micro-nutrients (single dose of 200,000 IU retinyl palmitate plus 15 mg Zn/d for 8 wk) or matching placebo. Sputum was collected weekly for 8 wk for auramine staining and culture on liquid media (BACTEC MGIT 960; Becton Dickinson, Sparks, MD). Performance status, chest radiographs, and anthropometric measures were assessed at baseline and again at 8 wk. Results: The participants (n = 154) were randomly assigned to the micronutrient (n = 77) or placebo (n = 77) group. Twenty participants were HIV infected (13%), and 12 participants had an unknown HIV status (8%). No differences in time to smear or culture conversion were observed between the treatment groups by Kaplan-Meier analysis (P = 0.15 and P = 0.38, respectively; log-rank test). Log-logistic regression analysis found no significant group interaction effect in time to culture detection over the 8-wk period (P = 0.32). No significant differences in weight gain (2.3 +/- 3.5 compared with 2.2 +/- 2.4 kg, P = 0.68) or radiologic resolution were observed between the treatment groups. Conclusion: Supplementation with vitamin A and zinc did not affect treatment outcomes in participants with pulmonary tuberculosis at 8 wk. This trial was registered at controlled-trials.com as ISRCTN80852505. 2011 American Society for Nutrition."									
1112	"Vitamin D status and incidence of pulmonary tuberculosis, opportunistic infections, and wasting among HIV-infected Tanzanian adults initiating antiretroviral therapy."	"Sudfeld CR, Giovannucci EL, Isanaka S, Aboud S, Mugusi FM, Wang M, Chalamilla G, et al."	Journal of Infectious Diseases. 2013;207(3):378-85.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=23162137	BACKGROUND: Maintaining vitamin D sufficiency may decrease the incidence of pulmonary tuberculosis and other infectious diseases. We present the first prospective study of vitamin D among human immunodeficiency virus (HIV)-infected adults receiving antiretrovirals in sub-Saharan Africa.	METHODS: Serum 25-hydroxyvitamin D (25(OH)D) level was assessed at antiretroviral therapy (ART) initiation for 1103 HIV-infected adults enrolled in a trial of multivitamins (not including vitamin D) in Tanzania. Participants were prospectively followed at monthly visits at which trained physicians performed a clinical examination and nurses took anthropometric measurements and assessed self-reported symptoms. Cox proportional hazards models estimated hazard ratios (HRs) of morbidity outcomes.	"RESULTS: After multivariate adjustment, vitamin D deficiency (defined as a concentration of <20 ng/mL) had a significantly greater association with incident pulmonary tuberculosis, compared with vitamin D sufficiency (HR, 2.89; 95% confidence interval [CI], 1.31-7.41; P = .027), but no association was found for vitamin D insufficiency (defined as a concentration of 20-30 ng/mL; P = .687). Deficiency was also significantly associated with incident oral thrush (HR, 1.96; 95% CI, 1.01-3.81; P = .046), wasting (HR, 3.10; 95% CI, 1.33-7.24; P = .009), and >10% weight loss (HR, 2.10; 95% CI, 1.13-3.91; P = .019). Wasting results were robust to exclusion of individuals experiencing pulmonary tuberculosis. Vitamin D status was not associated with incident malaria, pneumonia, or anemia."	CONCLUSIONS: Vitamin D supplementation trials for adults receiving ART appear to be warranted.						
1322	"Factors associated with malaria parasitaemia, malnutrition, and anaemia among HIV-exposed and unexposed Ugandan infants: a cross-sectional survey."	"Osterbauer B, Kapisi J, Bigira V, Mwangwa F, Kinara S, Kamya MR, Dorsey G."	Malaria Journal. 2012;11:432.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=23270614	"BACKGROUND: Malaria, malnutrition and anaemia are major causes of morbidity and mortality in African children. The interplay between these conditions is complex and limited data exist on factors associated with these conditions among infants born to HIV-uninfected and infected women."	"METHODS: Two hundred HIV-exposed (HIV-uninfected infants born to HIV-infected mothers) and 400 HIV-unexposed infants were recruited from an area of high malaria transmission in rural Uganda. A cross-sectional survey was performed at enrolment to measure the prevalence of malaria parasitaemia, measures of malnutrition (z-scores <2 standard deviations below mean) and anaemia (haemoglobin <8 gm/dL). Multivariate logistic regression was used to measure associations between these conditions and risk factors of interest including household demographics, malaria prevention practices, breastfeeding practices, household structure and wealth index."	"RESULTS: The prevalence of malaria parasitaemia was 20%. Factors protective against parasitaemia included female gender (OR=0.66, p=0.047), mother's age (OR=0.81 per five-year increase, p=0.01), reported bed net use (OR=0.63, p=0.03) and living in a well-constructed house (OR=0.25, p=0.01). Although HIV-unexposed infants had a higher risk of parasitaemia compared to HIV-exposed infants (24% vs 14%, p=0.004), there was no significant association between HIV-exposure status and parasitaemia after controlling for the use of malaria preventative measures including bed net use and trimethoprim-sulphamethoxazole prophylaxis. The prevalence of stunting, underweight, and wasting were 10%, 7%, and 3%, respectively. HIV-exposed infants had a higher odds of stunting (OR=2.23, p=0.005), underweight (OR=1.73, p=0.09) and wasting (OR=3.29, p=0.02). The prevalence of anaemia was 12%. Risk factors for anaemia included older infant age (OR=2.05 per one month increase, p=0.003) and having malaria parasitaemia (OR=5.74, p<0.001)."	"CONCLUSIONS: Compared to HIV-unexposed infants, HIV-exposed infants had a higher use of malaria preventative measures and lower odds of malaria parasitaemia. Having a better constructed house was also protective against malaria parasitaemia. HIV-exposure was the primary risk factor for measures of malnutrition. The primary risk factor for anaemia was malaria parasitaemia. These findings suggest the need to better target existing interventions for malaria, malnutrition and anaemia as well as the need to explore further the mechanisms behind the observed associations."						
568	Ready-to-use therapeutic food for home-based treatment of severe acute malnutrition in children from six months to five years of age.	"Schoonees A, Lombard M, Musekiwa A, Nel E, Volmink J."	Cochrane Database of Systematic Reviews. 2013;6:CD009000.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=23744450	"BACKGROUND: Malnourished children have a higher risk of death and illness. Treating severe acute malnourished children in hospitals is not always desirable or practical in rural settings, and home treatment may be better. Home treatment can be food prepared by the carer, such as flour porridge, or commercially manufactured food such as ready-to-use therapeutic food (RUTF). RUTF is made according to a standard, energy-rich composition defined by the World Health Organization (WHO). The benefits of RUTF include a low moisture content, long shelf life without needing refrigeration and that it requires no preparation."	"OBJECTIVES: To assess the effects of home-based RUTF on recovery, relapse and mortality in children with severe acute malnutrition."	"SEARCH METHODS: We searched the following electronic databases up to April 2013: Cochrane Central Register of Clinical Trials (CENTRAL), MEDLINE, MEDLINE In-process, EMBASE, CINAHL, Science Citation Index, African Index Medicus, LILACS, ZETOC and three trials registers. We also contacted researchers and clinicians in the field and handsearched bibliographies of included studies and relevant reviews."	"SELECTION CRITERIA: We included randomised and quasi-randomised controlled trials where children between six months and five years of age with severe acute malnutrition were treated at home with RUTF compared to a standard diet, or different regimens and formulations of RUTFs compared to each other. We assessed recovery, relapse and mortality as primary outcomes, and anthropometrical changes, time to recovery and adverse outcomes as secondary outcomes."	"DATA COLLECTION AND ANALYSIS: Two review authors independently assessed trial eligibility using prespecified criteria, and three review authors independently extracted data and assessed trial risk of bias."	"MAIN RESULTS: We included four trials (three having a high risk of bias), all conducted in Malawi with the same contact author. One small trial included children infected with human immunodeficiency virus (HIV). We found the risk of bias to be high for the three quasi-randomised trials while the fourth trial had a low to moderate risk of bias. Because of the sparse data for HIV, we reported below the main results for all children together. RUTF meeting total daily requirements versus standard dietWhen comparing RUTF with standard diet (flour porridge), we found three quasi-randomised cluster trials (n = 599). RUTF may improve recovery slightly (risk ratio (RR) 1.32; 95% confidence interval (CI) 1.16 to 1.50; low quality evidence), but we do not know whether RUTF improves relapse, mortality or weight gain (very low quality evidence). RUTF supplement versus RUTF meeting total daily requirementsWhen comparing RUTF supplement with RUTF that meets total daily nutritional requirements, we found two quasi-randomised cluster trials (n = 210). For recovery, relapse, mortality and weight gain the quality of evidence was very low; therefore, the effects of RUTF are unknown. RUTF containing less milk powder versus standard RUTFWhen comparing a cheaper RUTF containing less milk powder (10%) versus standard RUTF (25% milk powder), we found one trial that randomised 1874 children. For recovery, there was probably little or no difference between the groups (RR 0.97; 95% CI 0.93 to 1.01; moderate quality evidence). RUTF containing less milk powder may lead to slightly more children relapsing (RR 1.33; 95% CI 1.03 to 1.72; low quality evidence) and to less weight gain (mean difference (MD) -0.5 g/kg/day; 95% CI -0.75 to -0.25; low-quality evidence) than standard RUTF. We do not know whether the cheaper RUTF improved mortality (very low quality evidence)."	"AUTHORS' CONCLUSIONS: Given the limited evidence base currently available, it is not possible to reach definitive conclusions regarding differences in clinical outcomes in children with severe acute malnutrition who were given home-based ready-to-use therapeutic food (RUTF) compared to the standard diet, or who were treated with RUTF in different daily amounts or formulations. For this reason, either RUTF or flour porridge can be used to treat children at home depending on availability, affordability and practicality. Well-designed, adequately powered pragmatic randomised controlled trials of HIV-uninfected and HIV-infected children with severe acute malnutrition are needed."			
1513	Nutritional status at admission of children with cancer in Malawi.	"Israels T, Chirambo C, Caron HN, Molyneux EM."	Pediatric Blood & Cancer. 2008;51(5):626-8.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=18668514	BACKGROUND: Malnutrition at diagnosis is found in 10-50% of children with cancer in industrialized countries. In developing countries a large proportion of the normal paediatric population is undernourished and children with cancer often present late with advanced disease. Therefore it would be expected that many children with cancer are malnourished at admission. Malnutrition is associated with more severe chemotherapy toxicity and infectious complications.	"METHODS: All new paediatric oncology patients admitted in the Queen Elizabeth Central Hospital, Blantyre, Malawi between 1, January 2007 and 1, January 2008 were included. We documented age, clinical diagnosis, HIV status, weight, height, mid-upper-arm-circumference (MUAC) and triceps skinfold (TSF), and calculated arm muscle area (AMA). Nutritional data were compared with the 1978 NCHS growth curves."	"RESULTS: Of 128 children, 70 (55.1%) had an AMA for age <5th percentile and 76 (59.3%) had a TSF and MUAC below the 5th percentile, both parameters indicating acute malnutrition. Fifty seven patients (44.5%) had a height for age <-2 SD (indicative of stunting), and 22 patients (17.2%) had a weight for height (WFH) <-2 SD."	"CONCLUSION: Arm anthropometry shows that more than half of Malawian children with cancer are severely acutely malnourished at diagnosis. WFH, in children with large tumour masses, is less sensitive than arm anthropometry in detecting acute malnutrition. Forty-five percent of paediatric oncology patients in Malawi are stunted, making interpretation of weight for age (WFA) very difficult. (c) 2008 Wiley-Liss, Inc."						
550	Nutritional supplementation in HIV-infected individuals in South India: a prospective interventional study.	"Swaminathan S, Padmapriyadarsini C, Yoojin L, Sukumar B, Iliayas S, Karthipriya J, Sakthivel R, et al."	Clinical Infectious Diseases. 2010;51(1):51-7.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=20509768	"BACKGROUND: Malnutrition in human immunodeficiency virus (HIV)-infected individuals is associated with faster disease progression, higher mortality rates, and suboptimal response to antiretroviral therapy (ART)."	"METHODS: We conducted a prospective interventional study to evaluate the effects of an oral macronutrient supplement among HIV-infected adults in South India. Patients attending Tuberculosis Research Centre clinics from June 2005 through December 2007 had baseline nutritional assessment and laboratory investigations performed. Patients at 1 center received nutritional counseling and standard care, whereas patients at 2 centers additionally received a macronutrient providing 400 cal and 15 g of protein daily. Study outcomes were changes in anthropometry, body composition, blood chemistry, and immune status at 6 months."	"RESULTS: In total, 636 ART-naive patients were enrolled in the study; 361 completed 6 months of follow-up (282 received supplements and 79 received standard care). Mean age +/- standard deviation (SD) was 31 +/- 7 years, mean weight +/- SD was 50 +/- 10 kg, and 42% were male. Significant increases in body weight, body mass index, midarm circumference, fat-free mass, and body cell mass were observed in the supplement group but not in the control group at 6 months; gains were greater in patients with CD4 cell counts <200 cells/microL. No changes were observed in lipid levels, whereas the CD4 cell count decreased in the control group. However, after adjusting for baseline differences, these changes were not statistically significantly different between the groups."	CONCLUSIONS: Macronutrient supplementation did not result in significantly increased weight gain compared with standard care (including nutritional counseling) among patients with moderately advanced HIV disease. The effect of supplementation on specific subsets of patients and on preserving immune function needs further research.						
638	The impact of malnutrition in survival of HIV infected children after initiation of antiretroviral treatment (ART).	"Bineyam T, Solomon S, Fikre E."	Ethiopian Medical Journal. 2010;48(1):1-10.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20103207055	"Background: Malnutrition is a common condition in HIV-infected children; however, its impact in survival of HIV infected children after initiation of antiretroviral therapy is not well understood. Objective: To assess the impact of malnutrition in survival of HIV infected children after initiation of antiretroviral treatment. Methods: A retrospective cohort study was conducted in HIV infected children starting antiretroviral treatment at Zewditu memorial hospital, Addis Ababa, Ethiopia. Demographic, nutritional, clinical and immunological data were carefully extracted from the existing ART logbook and patient follow up cards. Accordingly, nutritional status were defined with stunting (height for age Z score <-2), Wasting (weight for height Z score -2) and under weight (weight for age Z score <-2). Survival was defined as the time from nutritional and immunologic evaluation to death. Data were analyzed for univariate and multivariate analysis using Cox regression proportional hazard model. Survival rate was calculated and compare with the Kaplan Meier and log rank tests. Results: A total of 475 HIV infected children starting antiretroviral treatment (ART) from March 21 2005 to 30 April 2008 were included in the study. Of whom 42 (8.8%) died during a median study follow up of 12 months. The average survival time for the entire cohort was 27.9 months. Independent baseline predictors of mortality were severe wasting (Hazard ratio (HR)=4.99, 95% CI 2.4-10.2, P<0.00), absolute CD4 below the threshold for severe immunodeficiency (HR=3.02, 95% CI 1.02-8.96, P=0.04) and low hemoglobin value (HR=2.92, 95% CI 1.3-6.7, P=0.001 for those hemoglobin value <7.0 gm/dl). The probability of surviving for wasted children declines sharply starting from 6th months and reach 76% in 12th months. Conclusion: Despite the apparent benefit of ART use on HIV related survival, severe wasting (WHZ<-3) appear to be strong independent predictor of survival in HIV infected children receiving ART."									
640	The impact of malnutrition in survival of HIV infected children after initiation of antiretroviral treatment (ART).	"Taye B, Shiferaw S, Enquselassie F."	Ethiopian Medical Journal. 2010;48(1):1-10.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=20607992	"BACKGROUND: Malnutrition is a common condition in HIV-infected children; however, its impact in survival of HIV infected children after initiation ofantiretroviral therapy is not well understood."	OBJECTIVE: To assess the impact of malnutrition in survival of HIV infected children after initiation of antiretroviral treatment.	"METHODS: A retrospective cohort study was conducted in HIV infected children starting antiretroviral treatment at Zewditu memorial hospital, Addis Ababa, Ethiopia. Demographic, nutritional, clinical and immunological data were carefully extracted from the existing ART logbook and patient follow up cards. Accordingly, nutritional status were defined with stunting (height for age Z score < -2), Wasting (weight for height Z score -2) and under weight (weight for age Z score < -2). Survival was defined as the tidne from nutritional and immunologic evaluation to death. Data were analyzed for univariate and multivariate analysis using Cox regression proportional hazard model. Survival rate was calculated and compare with the Kaplan Meier and log rank tests."	"RESULTS: A total of 475 HIV infected children starting antiretroviral treatment (ART) from March 21 2005 to 30 April 2008 were included in the study. Of whom 42 (8.8%) died during a median study follow up of 12 months. The average survival time for the entire cohort was 27.9 months. Independent baseline predictors of mortality were severe wasting (Hazard ratio (HR) = 4.99, 95% CI 2.4-10.2, P < 0.00), absolute CD4 below the threshold for severe immunodeficiency (HR = 3.02, 95% CI 1.02-8.96, P = 0.04) and low hemoglobin value (HR = 2.92, 95% CI 1.3-6.7, P = 0.001 for those hemoglobin value < 7.0 gm/dl). The probability of surviving for wasted children declines sharply starting from 6th months and reach 76% in 12th months."	"CONCLUSION: Despite the apparent benefit of ART use HIV related survival, severe wasting (WHZ < -3) appear to be strong independent predictor of survival in HIV infected children receiving ART."					
1451	"Potential of spirulina platensis as a nutritional supplement in malnourished HIV-infected adults in Sub-Saharan Africa: a randomised, single-blind study."	"Azabji-Kenfack M, Dikosso SE, Loni EG, Onana EA, Sobngwi E, Gbaguidi E, Kana ALN, et al."	Nutrition and Metabolic Insights. 2010;3:29-37.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20113263694	"Background: Malnutrition is a major global public health issue and its impact on communities and individuals is more dramatic in Sub-Saharan Africa, where it is compounded by widespread poverty and generalized high prevalence of human immunodeficiency virus (HIV). Therefore, malnutrition should be addressed through a multisectorial approach, and malnourished individuals should have access to nutritional rehabilitation molecules that are affordable, accessible, rich in nutrient and efficient. We thus assessed the efficacy of two affordable and accessible nutritional supplements, spirulina platensis versus soya beans among malnourished HIV-infected adults. Methods: Undernourished patients, naive of, but eligible to antiretroviral treatment (ART), aged 18 to 35 years were enrolled and randomly assigned to two groups. The first group received spirulina (Group A) as food supplement and the second received soya beans (Group B). Patients were initiated ART simultaneously with supplements. Food supplements were auto-administered daily, the quantity being calculated according to weight to provide 1.5 g/kg body weight of proteins with 25% from supplements (spirulina and soya beans). Patients were monitored at baseline and followed-up during twelve weeks for anthropometric parameters, body composition, haemoglobin and serum albumin, CD4 count and viral load. Results: Fifty-two patients were enrolled (Group A: 26 and Group B: 26). The mean age was 26.4+or-4.9 years (Group A) and 28.7+or-4.8 (Group B) with no significant difference between groups (P=0.10). After 12 weeks, weight and BMI significantly improved in both groups (P<0.001 within each group). The mean gain in weight and BMI in Group A and B were 4.8 vs. 6.5kg, (P=0.68) and 1.3 vs. 1.90 Kg/m<sup>2</sup>, (P=0.82) respectively. In terms of body composition, fat free mass (FFM) did not significantly increase within each group (40.5 vs. 42.2 Kg, P=0.56 for Group A; 39.2 vs. 39.0 Kg, P=0.22 for Group B). But when compared between the two groups at the end of the trial, FFM was significantly higher in the spirulina group (42.2 vs. 39.0 Kg, P=0.01). The haemoglobin level rose significantly within groups (P<0.001 for each group) with no difference between groups (P=0.77). Serum albumin level did not increase significantly within groups (P<0.90 vs. P<0.82) with no difference between groups (P=0.39). The increase in CD4 cell count within groups was significant (P<0.01 in both groups), with a significantly higher CD4 count in the spirulina group compared to subjects on soya beans at the end of the study (P=0.02). Within each group, HIV viral load significantly reduced at the end of the study (P<0.001 and P=0.04 for spirulina and soya beans groups respectively). Between the groups, the viral load was similar at baseline but significantly reduced in the spirulina group at the end of the study (P=0.02). Conclusion: We therefore conclude in this preliminary study, firstly, that both spirulina and soja improve on nutritional status of malnourished HIV-infected patients but in terms of quality of nutritional improvement, subjects on spirulina were better off than subjects on soya beans. Secondly, nutritional rehabilitation improves on immune status with a consequent drop in viral load but further investigations on the antiviral effects of this alga and its clinical implications are strongly needed."									
1450	"Potential of Spirulina platensis as a nutritional supplement in malnourished HIV-Infected adults in Sub-Saharan Africa: a randomised, single-blind study."	"Azabji-Kenfack M, Dikosso SE, Loni EG, Onana EA, Sobngwi E, Gbaguidi E, Kana ALN, et al."	Nutrition and Metabolic Insights. 2011;4:29-37.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20123050992	"Background: Malnutrition is a major global public health issue and its impact on communities and individuals is more dramatic in Sub-Saharan Africa, where it is compounded by widespread poverty and generalized high prevalence of human immunodeficiency virus (HIV). Therefore, malnutrition should be addressed through a multisectorial approach, and malnourished individuals should have access to nutritional rehabilitation molecules that are affordable, accessible, rich in nutrient and efficient. We thus assessed the efficacy of two affordable and accessible nutritional supplements, spirulina platensis versus soya beans among malnourished HIV-infected adults. Methods: Undernourished patients, naive of, but eligible to antiretroviral treatment (ART), aged 18 to 35 years were enrolled and randomly assigned to two groups. The first group received spirulina (Group A) as food supplement and the second received soya beans (Group B). Patients were initiated ART simultaneously with supplements. Food supplements were auto-administered daily, the quantity being calculated according to weight to provide 1.5 g/kg body weight of proteins with 25% from supplements (spirulina and soya beans). Patients were monitored at baseline and followed-up during twelve weeks for anthropometric parameters, body composition, haemoglobin and serum albumin, CD4 count and viral load. Results: Fifty-two patients were enrolled (Group A: 26 and Group B: 26). The mean age was 26.4+or-4.9 years (Group A) and 28.7+or-4.8 (Group B) with no significant difference between groups (P=0.10). After 12 weeks, weight and BMI significantly improved in both groups (P<0.001 within each group). The mean gain in weight and BMI in Group A and B were 4.8 vs. 6.5 kg, (P=0.68) and 1.3 vs. 1.90 Kg/m, (P=0.82) respectively. In terms of body composition, fat free mass (FFM) did not significantly increase within each group (40.5 vs. 42.2 Kg, P=0.56 for Group A; 39.2 vs. 39.0 Kg, P=0.22 for Group B). But when compared between the two groups at the end of the trial, FFM was significantly higher in the spirulina group (42.2 vs. 39.0 Kg, P=0.01). The haemoglobin level rose significantly within groups (P<0.001 for each group) with no difference between groups (P=0.77). Serum albumin level did not increase significantly within groups (P<0.90 vs. P<0.82) with no difference between groups (P=0.39). The increase in CD4 cell count within groups was significant (P<0.01 in both groups), with a significantly higher CD4 count in the spirulina group compared to subjects on soya beans at the end of the study (P=0.02). Within each group, HIV viral load significantly reduced at the end of the study (P<0.001 and P=0.04 for spirulina and soya beans groups respectively). Between the groups, the viral load was similar at baseline but significantly reduced in the spirulina group at the end of the study (P=0.02). Conclusion: We therefore conclude in this preliminary study, firstly, that both spirulina and soja improve on nutritional status of malnourished HIV-infected patients but in terms of quality of nutritional improvement, subjects on spirulina were better off than subjects on soya beans. Secondly, nutritional rehabilitation improves on immune status with a consequent drop in viral load but further investigations on the antiviral effects of this alga and its clinical implications are strongly needed."									
1123	"Severe acute malnutrition in a tertiary hospital in north-central Nigeria, a review of hospitalized cases."	"John C, Abdu H, Ukata P."	Journal of Medicine in the Tropics. 2012;14(2):142-6.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20123300776	"Background: Malnutrition is a major public-health problem throughout the developing world and is an underlying factor in over 50% of the 10-11 million children dying before 5 years of age The objective of this article was to document the outcome of treatment of Severe Acute Malnutrition using F75 and F100 milk based nutritional packs. Methodology: All consecutively admitted patients with diagnosis of Severe Acute Malnutrition were recruited into the study. Data retrieved and reviewed were weight, height, presence or absence of oedema, clinical diagnosis, and admission outcomes, discharged or otherwise. All the subjects had received F75 and F100 milk based nutrition formula, amongst other treatment administered. Results: Total of 135 (10.6%) patients were seen, females 56 (41.5%) and males 79 (58.5%). Mean age was 18.8+or-14 months, females 20+or-16.7 months and males 17.9+11.94 months, (p=0.38); 36 (26.7%) had oedema. Mean admission weight was 5.87+or-1.8 kg. Mean admission weight, non-oedema cases, 5.5+1.6 kg and 6.76+or-2.1 kg in oedematous patients, p=0.0006. Overall mean discharge weight 6.4+or-1.8 kg p=0.0144; mean discharge weight non-oedematous patient 6.2+or-1.8 kg, and 6.9+or-1.8 kg oedematous patients, p=0.057. Septicemia was reported in 71.8%, Pulmonary Tb in 10.3% and severe anemia was found 12%. In all 21.5% were HIV cases. Diarrhea was a feature in 60% of the SAM cases, 6% had eye-signs suggestive of Vitamin A deficiency. Overall 62.6% were discharged, 16.8% absconded, 7.6% left against advice while 13% died (10.1% of unit deaths). Death was higher in HIV cases 17.2%, than in the others. Mean duration of hospital stay was 13+or-7 days. Conclusion: While significant improvement in weight and clinical condition occurred using the feeds, many absconded or left against advice. Further evaluation of impact is still needed. We encourage the use of F75 and F100 in management."									
1098	The effects of Spiruline on the immune functions of HIV-infected undernourished children. (Special Issue: Global theme issue on poverty and human development.).	"Simpore J, Pignatelli S, Musumeci S."	Journal of Infection in Developing Countries. 2007;1(2):112-7.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20083064881	"Background: Malnutrition is a public health problem in the entire world, particularly in the developing countries. The effect of Spiruline supplement in the weight recovery of HIV-negative and HIV-infected undernourished children has been largely demonstrated. The aim of this study is to determine the effect of Spiruline on the immune status of 46 HIV-infected undernourished children, aged 15+or-5 months, and of 23 undernourished HIV-negative children, aged 14+or-6 months. Methodology: The duration of this study was eight weeks. To assess immune functions a count of CD4 lymphocyte subpopulation was performed before and after introducing the Spiruline supplement. Results: The degree of anemia improved in all the children, but the effect was less evident among HIV-infected children; in fact, 81% of HIV-negative versus 62% of HIV-infected children showed signs of improvement. The mean values of CD4 lymphocyte subpopulation showed a consistent increment in HIV-negative children [from 1257 (range 531-2301) to 1562 (range 798-2552) mm<sup>3</sup>] while they showed an irregular increase in HIV-infected children [from 1339 (152-4000) to 2088 (244-4214) mm<sup>3</sup>]. Conclusions: The improvement of the immunological status due to Spiruline treatment might represent an effective barrier against infectious diseases, which both cause and result from malnutrition in underdeveloped countries."									
602	"Malnutrition in a population of HIV-positive and HIV-negative drug users living in Chennai, South India."	"Tang AM, Bhatnagar T, Ramachandran R, Dong K, Skinner S, Kumar MS, Wanke CA."	Drug & Alcohol Dependence. 2011;118(1):73-7.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=21420798	BACKGROUND: Malnutrition is a strong predictor of poor outcomes in people living with HIV (PLHIV). Drug users are at increased risk of malnutrition regardless of whether or not they are infected with HIV. Little data exists on the nutritional status of drug users (with or without HIV infection) in India.	"METHODS: We describe and compare the nutrition and metabolic status of 107 HIV-positive and 193 HIV-negative male clients of a community-based drop-in center for injection drug users in Chennai, India. Measures of nutrition and metabolic status include body composition, dietary intake, food insecurity, and serum lipid levels."	"RESULTS: We found poor overall nutritional status in both the HIV-positive and HIV-negative clients, with HIV-positive men faring worse on some parameters. Both groups had extremely low percent body fat, but levels in HIV-positive participants were significantly lower (6.5% versus 7.9%, p=.01). HIV-positive men also had significantly lower total caloric and fat intakes compared to HIV-negative men. A considerable proportion (70%) of both HIV-positive and HIV-negative drug users were food insecure. HDL cholesterol levels were significantly lower and below normal range in the HIV-positive compared to HIV-negative men."	"CONCLUSIONS: The high levels of food insecurity and poor nutritional status in this population, regardless of HIV status, indicates critical need for intervention. Improving nutritional status in those who are infected with HIV prior to initiation of antiretroviral treatment may help patients to reap the full benefits of therapy. Copyright 2011 Elsevier Ireland Ltd. All rights reserved."						
178	Fraction of all hospital admissions and deaths attributable to malnutrition among children in rural Kenya.	"Bejon P, Mohammed S, Mwangi I, Atkinson SH, Osier F, Peshu N, Newton CR, et al."	American Journal of Clinical Nutrition. 2008;88(6):1626-31.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medc&AN=19064524	"BACKGROUND: Malnutrition is common in the developing world and associated with disease and mortality. Because malnutrition frequently occurs among children in the community as well as those with acute illness, and because anthropometric indicators of nutritional status are continuous variables that preclude a single definition of malnutrition, malnutrition-attributable fractions of admissions and deaths cannot be calculated by simply enumerating individual children."	"OBJECTIVE: We determined the malnutrition-attributable fractions among children admitted to a rural district hospital in Kenya, among inpatient deaths and among children with the major causes of severe disease."	"DESIGN: We analyzed data from children between 6 and 60 mo of age, comprising 13,307 admissions, 674 deaths, 3068 admissions with severe disease, and 562 community controls by logistic regression, using anthropometric z scores as the independent variable and admission or death as the outcome, to calculate the probability of admission as a result of ""true malnutrition"" for individual cases. Probabilities were averaged to calculate attributable fractions."	"RESULTS: Z scores < -3 were insensitive for malnutrition-attributable deaths and admissions, and no single threshold was both specific and sensitive. The overall malnutrition-attributable fraction for in-hospital deaths was 51% (95% CI: 42%, 61%) with midupper arm circumference. Similar malnutrition-attributable fractions were seen for the major causes of severe disease (severe malaria, gastroenteritis, lower respiratory tract infection, HIV, and invasive bacterial disease)."	"CONCLUSIONS: Despite global improvements, malnutrition still underlies half of the inpatient morbidity and mortality rates among children in rural Kenya. This contribution is underestimated by using conventional clinical definitions of severe malnutrition."					
1119	Anthropometric indices and dietary intake in HIV-infected patients. [Arabic].	"Karimi I, Kasaeeian N, Atayi B, Tayeri K, Zare M, Azadbakht L."	Journal of Isfahan Medical School. 2010;28(107):238-47.		"Background: Malnutrition is one of the most important complication in Human Immonodeficiency Virus (HIV)-infected patients. So, it is better to consider the nutrition status and food intake of these patients. There are not numerous studies in this field in Iran. Therefore, this study was conducted to assess the anthropometric indice and nutritional intake of HIV-infected patients in Isfahan. Methods: This was a cross-sectional study on 48 HIV-infected patients in Isfahan. Anthropometric measurments were done according to the standard method and food intake was assessed using a validated food-frequency questionnaire. Nutrients intakes of the patients was compared with the recommended dietary allowances (RDA), and the dietary intakes of sociodemographic matched group of healthy Isfahanian population. Findings: Mean of body mass index in men and women was 24 and 22 kg/m<sup>2</sup>, respectively. Mid arm circumference in men and women was 28 and 29 cm and the body fat percent was 21 and 31% respectively. Low nutrient intake was not seen in men however, women had low intake of vitamin B<sub>12</sub>, folate and vitamin E compared to RDA. However, the amount of vitamin B<sub>12</sub> among infected men and energy intake among infected women were lower than Isfahanian healthy population's intake. Conclusion: Although the body mass index of the patients was in the normal range but their body fat percentage was higher than standard and their lean body mass was lower than standard. Low intake of some nutrients shows the nessecity of the nutrition intervention."									
316	Pericardial effusions in children with severe protein energy malnutrition resolve with therapeutic feeding: a prospective cohort study.	"Ahmad S, Ellis J, Nesbitt A, Molyneux E."	Archives of Disease in Childhood. 2008;93(12):1033-6.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=18499774	"BACKGROUND: Malnutrition underlies 50% of paediatric morbidity and mortality in sub-Saharan Africa. It is important to look for the underlying causes of the malnutrition, and some clinicians have assumed that the presence of a pericardial effusion indicates underlying tuberculosis (TB). We wished to see how common pericardial effusions are in malnourished children and how their presence or size is related to peripheral oedema or the type of malnutrition of the child, HIV status or to underlying TB."	"METHODS: We prospectively studied a cohort of children at a regional nutritional rehabilitation unit in Malawi. Echocardiography on admission and follow-up 4 weeks later was performed. During this interval children received therapeutic feeding and any other required medical care. The children were grouped into group 1 (marasmus), group 2 (marasmus with TB), group 3 (marasmic kwashiorkor), group 4 (marasmic kwashiorkor with TB), group 5 (kwashiorkor) and group 6 (kwashiorkor with TB)."	"RESULTS: Of the 89 children who were enrolled, 28 were marasmic (eight also had TB), 29 had marasmic kwashiorkor (six with TB) and 32 had kwashiorkor (four with TB). In all the children who had a pericardial effusion, its size was greatest at presentation. The overall reduction in pericardial effusion size after 4 weeks of nutritional therapy was significant (2.9 mm change, range 0 to 8.4 mm, p = 0.002). The greatest change in pericardial effusion size was in the children with most peripheral oedema compared with those with no oedema (2.7 mm versus 1.0 mm, p = 0.017)."	"CONCLUSIONS: In severely malnourished children pericardial effusions are common, larger in children with peripheral oedema and respond to nutritional therapy alone."						
195	Synergy between mannose-binding lectin gene polymorphisms and supplementation with vitamin A influences susceptibility to HIV infection in infants born to HIV-positive mothers.	"Kuhn L, Coutsoudis A, Trabattoni D, Archary D, Rossi T, Segat L, Clerici M, et al."	American Journal of Clinical Nutrition. 2006;84(3):610-5.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=16960176	BACKGROUND: Mannose-binding lectin (MBL-2) allele variants are associated with deficiencies in innate immunity and have been found to be correlated with HIV infection in adults and children.	OBJECTIVE: We tested whether MBL-2 variants among infants born to HIV-positive mothers have an increased susceptibility to HIV.	"DESIGN: MBL-2 allele variants were measured among 225 infants born to HIV-positive mothers enrolled in a trial in Durban, South Africa. Mothers of 108 infants were randomly assigned to receive vitamin A and beta-carotene supplementation and 117 to receive placebo. Infants were followed with regular HIV tests to determine rates of mother-to-child HIV transmission."	"RESULTS: A high proportion of infants were either homozygous (10.7%) or heterozygous (32.4%) for MBL-2 variants. MBL-2 variants within the placebo arm were associated with an increased risk of HIV transmission (odds ratio: 3.09; 95% CI: 1.21, 7.86); however, MBL-2 variants within the supplementation arm were not associated with an increased risk of transmission (P = 0.04; test of interaction). Among infants with MBL-2 variants, supplementation was associated with a decreased risk of HIV transmission (odds ratio: 0.37; 95% CI: 0.15, 0.91)."	CONCLUSION: We observed what appears to be a gene-environment interaction between MBL-2 variants and an intervention with vitamin A plus beta-carotene that is relevant to mother-to-child HIV transmission.					
214	"Trends in obesity, underweight, and wasting among women attending prenatal clinics in urban Tanzania, 1995-2004."	"Villamor E, Msamanga G, Urassa W, Petraro P, Spiegelman D, Hunter DJ, Fawzi WW."	American Journal of Clinical Nutrition. 2006;83(6):1387-94.	http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=2009205675&site=ehost-live	"BACKGROUND: Many developing countries are currently burdened by both undernutrition and increasing rates of overweight and obesity. Scarce data are available from population studies on the recent trends and current epidemiology of obesity in African settings. OBJECTIVES: The objectives were to evaluate changes in the prevalence of obesity, underweight, and wasting in women of reproductive age from Dar es Salaam, Tanzania, during the past 10 y and to identify contemporary sociodemographic correlates of these indicators. DESIGN: We estimated the prevalence of obesity [body mass index (BMI; in kg/m(2)) >/= 30], underweight (BMI < 18.5), and wasting (midupper arm circumference <22 cm) in 73 689 women aged 14-52 y who attended antenatal care clinics in the city of Dar es Salaam, Tanzania, between 1995 and 2004. RESULTS: The prevalence of obesity rose steadily and progressively from 3.6% in 1995 to 9.1% in 2004 [adjusted prevalence ratio (PR): 1.97; 95% CI: 1.66, 2.33; P for trend for year < 0.0001]. Underweight showed only a modest decline from 3.3% in 1995 to 2.6% in 2004 (adjusted PR: 0.91; 95% CI: 0.75, 1.10; P for trend for year = 0.003), whereas no change was observed in the prevalence of wasting. In the most recent years (2003 and 2004), obesity was positively associated with age, parity, and socioeconomic status and inversely with HIV infection. Underweight was inversely related to socioeconomic status and positively to HIV status. CONCLUSION: The recent, rapid, and large increase in the prevalence of obesity in women represents a new competing public health priority in urban Tanzania, where underweight and wasting have not decreased substantially. Copyright © 2006 American Society for Nutrition"									
422	"'Rumours' and clinical trials: a retrospective examination of a paediatric malnutrition study in Zambia, southern Africa."	"Kingori P, Muchimba M, Sikateyo B, Amadi B, Kelly P."	BMC Public Health. 2010;10:556.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=20849580	"BACKGROUND: Many public health researchers conducting studies in resource-constrained settings have experienced negative 'rumours' about their work; in some cases they have been reported to create serious challenges and derail studies. However, what may appear superficially as 'gossip' or 'rumours' can also be regarded and understood as metaphors which represent local concerns. For researchers unaccustomed to having concerns expressed from participants in this manner, possible reactions can be to be unduly perturbed or conversely dismissive.This paper represents a retrospective examination of a malnutrition study conducted by an international team of researchers in Zambia, Southern Africa. The fears of mothers whose children were involved in the study and some of the concerns which were expressed as rumours are also presented. This paper argues that there is an underlying logic to these anxieties and to dismiss them simply as 'rumours' or 'gossip' would be to overlook the historic and socio-economic factors which have contributed to their production."	"METHODS: Qualitative interviews were conducted with the mothers whose children were involved in the study and with the research nurses. Twenty five face-to-face interviews and 2 focus group discussions (FGDs) were conducted with mothers. In addition, face-to-face interviews were conducted with research nurses participating in the trial."	"RESULTS: A prominent anxiety expressed as rumours by the mothers whose children were involved in the study was that recruitment into the trial was an indicator that the child was HIV-infected. Other anxieties included that the trial was a disguise for witchcraft or Satanism and that the children's body parts would be removed and sold. In addition, the liquid, milk-based food given to the children to improve their nutrition was suspected of being insufficiently nutritious, thus worsening their condition.The form which these anxieties took, such as rumours related to the stealing of body parts and other anxieties about a stigmatised condition, provide an insight into the historical, socio-economic and cultural influences in such settings."	"CONCLUSIONS: Employing strategies to understand local concerns should accompany research aims to achieve optimal success. The concerns raised by the participants we interviewed are not unique to this study. They are produced in countries where the historic, socio-economic and cultural settings communicate anxieties in this format. By examining this study we have shown that by contextualizing these 'rumours', the concerns they express can be constructively addressed and in turn result in the successful conduct of research aims."						
1590	"Mortality and Health Outcomes in HIV-Infected and HIV-Uninfected Mothers at 18-20 Months Postpartum in Zomba District, Malawi."	"Landes M, van Lettow M, Bedell R, Mayuni I, Chan AK, Tenthani L, Schouten E."	PLoS ONE. 2012 04 Sep;7(9).		"Background: Maternal morbidity and mortality among HIV-infected women is a global concern. This study compared mortality and health outcomes of HIV-infected and HIV-uninfected mothers at 18-20 months postpartum within routine prevention of mother-to-child transmission of HIV (PMTCT) services in a rural district in Malawi. Methods: A retrospective cohort study of mother-child dyads at 18-20 months postpartum in Zomba District. Data on socio-demographic characteristics, service uptake, maternal health outcomes and biometric parameters were collected. Results: 173 HIV-infected and 214 HIV-uninfected mothers were included. HIV-specific cohort mortality at 18-20 months postpartum was 42.4 deaths/1000 person-years; no deaths occurred among HIV-uninfected women. Median time to death was 11 months post-partum (range 3-19). Women ranked their health on a comparative qualitative scale; HIV-infected women perceived their health to be poorer than did HIV-uninfected women (RR 2.4; 95% CI 1.6-3.7). Perceived maternal health status was well correlated with an objective measure of functional status (Karnofsky scale; p<0.001). HIV-infected women were more likely to report minor (RR 3.8; 95% CI 2.3-6.4) and major (RR 6.2; 95% CI 2.2-17.7) signs or symptoms of disease. In multivariable analysis, HIV-infected women remained twice as likely to report poorer health [adjusted OR (aOR) 2.3; 95% CI 1.4-3.6], as did women with low BMI (aOR 2.1; 95% CI 1.1-4.0) and scoring lowest on the welfare scale (aOR 2.0; 95% CI 1.1-3.8). Conclusions: HIV-infected women show increased mortality and morbidity at 18-20 months postpartum. In our rural Malawian operational setting, where there is documented under-application of ART and poor adherence to PMTCT services, these results support attention to optimizing maternal participation in PMTCT programs. 2012 Landes et al."									
161	"Metabolic syndrome and population attributable risk among HIV/AIDS patients: comparison between NCEP-ATPIII, IDF and AHA/NHLBI definitions."	"Alencastro PR, Wollf FH, Oliveira RR, Ikeda MLR, Barcellos NT, Brandao ABM, Fuchs SC."	AIDS Research and Therapy. 2012;9(29).	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20123368952	"Background: Metabolic Syndrome (MetS) is based on the same individual components, but has received several amendments to the original definition. In this study, we verified the prevalence of metabolic syndrome according to different criteria, and the impact of each component on the diagnostic. Methods: This cross-sectional study enrolled HIV infected patients from a HIV/AIDS reference Center in southern Brazil. Metabolic syndrome was identified according to the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (NCEP-ATPIII), the International Diabetes Federation (IDF) and the American Heart Association/National Heart, Lung and Blood Institute (AHA/NHLBI) criteria, and using a standardized questionnaire and blood testing. Results: A sample of 1240, out of 1295, HIV-infected patients was enrolled. Males were on average older, more educated, and had shorter time since the HIV diagnosis. The population attributable risk (PAR) for waist circumference explained 80% of the prevalence among men and women (AHA/NHLBI criteria). Triglycerides had the highest impact on prevalence of metabolic syndrome according to all criteria, independently of age, skin color and HAART use, among men. Conclusions: In this large sample of HIV infected patients, the overall prevalence of metabolic syndrome, under either classification, was noticeable and the AHA/NHLBI definition accounted for the highest prevalence."									
265	The Efficacy of Micronutrient-Fortified Sorghum Meal in Improving the Immune Status of HIV-Positive Adults.	"Motswagole BS, Mongwaketse TC, Mokotedi M, Kobue-Lekalake RI, Bulawayo BT, Thomas TS, Kurpad AV, et al."	Annals of Nutrition & Metabolism. 2013;62(4):323-30.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=23796693	"Background: Micronutrient deficiencies are common and compound the effects of human immunodeficiency virus (HIV) infection in Africa. Nutritional interventions, particularly vitamin A supplementation, may improve immune functioning and delay disease progression. Aim: To investigate the effect of fortified sorghum meal provided for 12 months on the immune status of adults with HIV. Methods: HIV-infected men and women were enrolled in a double-blind randomized placebo-controlled trial in Kanye, Botswana, to receive either sorghum meal fortified with micronutrients including vitamin A (n = 67) or control (n = 65). Serum retinol, iron, zinc, albumin, CD4 cell count and HIV viral load were assessed at baseline and every 3 months. Results: Baseline serum retinol levels were 1.6 mol/l in both groups and no significant difference was observed at the end of the intervention (control group: 1.5 mol/l; experimental group: 1.6 mol/l). In addition, there was no significant difference in the mean (Q1, Q3) CD4 cell count; 348 (220, 456) cells/mm(3) for the control group versus 338 (228, 426) cells/mm(3) in the experimental group after intervention. Conclusion: In this study, fortified sorghum meal did not influence serum retinol, CD4 cell count and HIV viral load. Future intervention studies should carefully consider the composition and dosing of food supplements needed to improve immune status and delay disease progression. Copyright 2013 S. Karger AG, Basel."									
567	Micronutrient supplementation in children and adults with HIV infection.	"Irlam JH, Visser MM, Rollins NN, Siegfried N."	Cochrane Database of Systematic Reviews. 2010(12):CD003650.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=21154354	BACKGROUND: Micronutrient deficiencies are widespread and compound the effects of HIV disease; micronutrient supplements may be effective and safe in reducing this burden.	OBJECTIVES: To assess whether micronutrient supplements are effective and safe in reducing mortality and morbidity in adults and children with HIV infection.	"SEARCH STRATEGY: The CENTRAL, EMBASE, PubMed, and GATEWAY databases were searched for randomised controlled trials of micronutrient supplements using the search methods of the Cochrane HIV/AIDS Group."	"SELECTION CRITERIA: Randomised controlled trials were selected that compared the effects of micronutrient supplements (vitamins, trace elements, and combinations of these) with other supplements, placebo or no treatment on mortality, morbidity, pregnancy outcomes, immunologic indicators, and anthropometric measures in HIV-infected adults and children. Any adverse effects of supplementation were recorded."	"DATA COLLECTION AND ANALYSIS: Two reviewers independently selected trials, appraised trial quality for risk of bias using standardised criteria, and extracted data using standardised forms."	"MAIN RESULTS: Sixteen additional trials are included in this update to the original Cochrane review (Irlam 2005). Overall, 30 trials involving 22 120 participants are reviewed: 20 trials of single supplements (vitamin A, vitamin D, zinc, selenium) and 10 of multiple micronutrients. Eight trials were undertaken in child populations.None of the six trials of vitamin A or beta-carotene supplementation in adults demonstrated any significant reduction in HIV disease progression. Vitamin A halved all-cause mortality in a meta-analysis of three trials in African children, had inconsistent impacts on diarrhoeal and respiratory morbidity, and improved short-term growth in one trial. No significant adverse effects of vitamin A in adults or children have been reported.Zinc supplements reduced diarrhoeal morbidity and had no adverse effects on disease progression in a single safety trial in South African children. No significant clinical benefits were found from zinc supplementation of pregnant Tanzanian women or Peruvian adults with persistent diarrhoea.Selenium reduced diarrhoeal morbidity in pregnant women in Tanzania, and reduced viral load in two separate small trials in American adults.Single trials of vitamin D supplements in adults, and in adolescents and children, demonstrated safety but no clinical benefits.Multiple micronutrient supplements conferred multiple clinical benefits to pregnant women and their offspring in a large Tanzanian trial. Supplementation in another Tanzanian trial reduced the recurrence of pulmonary TB and increased weight gain in co-infected patients. No significant adverse effects were reported."	"AUTHORS' CONCLUSIONS: Multiple micronutrient supplements reduced morbidity and mortality in HIV-infected pregnant women and their offspring and also improved early child growth in one large randomised controlled trial in Africa. Additional research is needed to determine if these are generalisable findings. Vitamin A supplementation is beneficial and safe in HIV-infected children, but further evidence is needed to establish if supplementation confers similar benefits in HIV-infected adults. Zinc is safe in HIV-infected adults and children. It may have similar benefits in HIV-infected children and adults, and uninfected children with diarrhoea, as it does in HIV-uninfected children.Further trials of single supplements (vitamin D, zinc, and selenium) are required to build the evidence base. The long-term clinical benefits, adverse effects, and optimal formulation of multiple micronutrient supplements require further investigation in individuals with diverse disease status."			
1221	"Effect of multiple micronutrient supplementation on survival of HIV-infected children in Uganda: a randomized, controlled trial."	"Ndeezi G, Tylleskar T, Ndugwa CM, Tumwine JK."	Journal of the International AIDS Society. 2010;13:18.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=20525230	BACKGROUND: Micronutrient deficiencies compromise the survival of HIV-infected children in low-income countries. We assessed the effect of multiple micronutrient supplementation on the mortality of HIV-infected children in Uganda.	"METHODS: In a randomized, controlled trial, 847 children aged one to five years and attending HIV clinics in Uganda were stratified by antiretroviral therapy (ART, n = 85 versus no ART, n = 762). The children were randomized to six months of either: twice the recommended dietary allowance of 14 micronutrients as the intervention arm (vitamins A, B1, B2, niacin, B6, B12, C, D and E, folate, zinc, copper, iodine and selenium); or the standard recommended dietary allowance of six multivitamins (vitamins A, D2, B1, B2, C and niacin) as a comparative ""standard-of-care"" arm. Mortality was analyzed at 12 months of follow up using Kaplan Meier curves and the log rank test."	"RESULTS: Mortality at 12 months was 25 out of 426 (5.9%) children in the intervention arm and 28 out of 421 (6.7%) in the comparative arms: risk ratio 0.9 (95% CI 0.5 - 1.5). Two out of 85 (2.4%) children in the ART stratum died compared with 51 out of 762 (6.7%) in the non-ART stratum. Of those who died in the non-ART stratum, 25 of 383 (6.5%) were in the intervention arm and 26 of 379 (6.9%) in the comparative arm; risk ratio 1.0 (95% CI 0.6 - 1.6). There was no significant difference in survival at 12 months (p = 0.64, log rank test). In addition, there was no significant difference in mean weight-for-height at 12 months; 0.70 +/- 1.43 (95% CI 0.52 - 0.88) for the intervention versus 0.59 +/- 1.15 (95% CI 0.45 - 0.75) in the comparative arm. The mean CD4 cell count; 1024 +/- 592 (95% CI 942 - 1107) versus 1060 +/- 553 (95% CI 985 - 1136) was also similar between the two groups."	"CONCLUSIONS: Twice the recommended dietary allowance of 14 micronutrients compared with a standard recommended dietary allowance of six multivitamins for six months was well tolerated, but it did not significantly alter mortality, growth or CD4 counts. Future intervention studies should carefully consider: (1) the composition and dosing of the supplements; and (2) the power needed to detect a difference between arms."	TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT00122941.					
1716	Genital microsporidiosis in women with AIDS: a post-mortem study.	"Torres G, Izquierdo F, Capo V, Lopez LX, Lopez MC, Limonta D, Fenoy S, et al."	Revista Iberoamericana de Micologia. 2013;30(1):47-50.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20133101237	"Background: Microsporidiosis is a life threatening opportunistic infection of AIDS patients. The infection is usually restricted to specific anatomical areas, but could become systemic depending on the involved species. Genital microsporidiosis in female patients is rare. Objective: To report genital microsporidiosis in female AIDS patients. Methods: Tissues samples from the genital tract (ovary, fallopian tubes and uterus) of eight deceased women who died of wasting syndrome associated to AIDS and disseminated microsporidiosis at the Institute of Tropical Medicine Pedro Kouri were collected between 1997 and 2005. Using an indirect immunohistochemistry assay the microsporidia species involved in those cases were identified. Results: We report several cases of microsporidial infection of the female genital tract. Six out of eight women with the disseminated form of the disease showed the presence of microsporidia in the genital tract. Encephalitozoon cuniculi and Encephalitozoon hellem were identified in the internal lining epithelium of the fallopian tubes and endometrium. Conclusions: Microsporidia species could disseminate to other organs and become systemic in severe immunocompromised cases. To our knowledge this is the greatest number of female genital tract microsporidiosis cases so far reported in humans."									
1597	The Cameroon Mobile Phone SMS (CAMPS) Trial: A Randomized Trial of Text Messaging versus Usual Care for Adherence to Antiretroviral Therapy.	"Mbuagbaw L, Thabane L, Ongolo-Zogo P, Lester RT, Mills EJ, Smieja M, Dolovich L, et al."	PLoS ONE. 2012 06 Dec;7(12).		"Background: Mobile phone technology is a novel way of delivering health care and improving health outcomes. This trial investigates the use of motivational mobile phone text messages (SMS) to improve adherence to antiretroviral therapy (ART) over six months. Methodology/Principal Findings: CAMPS was a single-site randomized two-arm parallel design trial in Yaounde, Cameroon. We enrolled and randomized HIV-positive adults on ART, aged 21 years and above to receive a weekly standardized motivational text message versus usual care alone. The primary outcome was adherence measured using a visual analogue scale (VAS), number of doses missed (in the week preceding the interview) and pharmacy refill data. Outcomes were measured at 3 and 6 months. Service providers and outcome assessors were blinded to allocation. Analysis was by intention-to-treat. Between November and December 2010, 200 participants were randomized, with 101 in the intervention group and 99 in the control group. At 6 months, overall retention was 81.5%. We found no significant effect on adherence by VAS>95% (risk ratio [RR] 1.06, 95% confidence interval [CI] 0.89, 1.29; p = 0.542; reported missed doses (RR 1.01, 95% CI 0.87, 1.16; p>0.999) or number of pharmacy refills (mean difference [MD] 0.1, 95% CI: 0.23, 0.43; p = 0.617. One participant in the intervention arm reported a possible disclosure of status. Conclusions/Significance: Standardized motivational mobile phone text messages did not significantly improve adherence to ART in this study. Other types of messaging or longer term studies are recommended. Registration: 1. Pan-African Clinical Trials Registry; PACTR201011000261458 2. Clinicaltrials.gov; NCT01247181. 2012 Mbuagbaw et al."									
1591	Mortality and Health Outcomes of HIV-Exposed and Unexposed Children in a PMTCT Cohort in Malawi.	"Landes M, van Lettow M, Chan AK, Mayuni I, Schouten EJ, Bedell RA."	PLoS ONE. 2012 17 Oct;7(10).		"Background: Mortality and morbidity among HIV-exposed children are thought to be high in Malawi. We sought to determine mortality and health outcomes of HIV-exposed and unexposed infants within a PMTCT program. Method: Data were collected as part of a retrospective cohort study in Zomba District, Malawi. HIV-infected mothers were identified via antenatal, delivery and postpartum records with a delivery date 18-20 months prior; the next registered HIV-uninfected mother was identified as a control. By interview and health record review, data on socio-demographic characteristics, service uptake, and health outcomes were collected. HIV-testing was offered to all exposed children. Results: 173 HIV-infected and 214 uninfected mothers were included. 4 stillbirths (1.0%) occurred; among the 383 livebirths, 41 (10.7%) children died by 20 months (32 (18.7%) HIV-exposed and 9 unexposed children (4.3%; p<0.0001)). Risk factors for child death included: HIV-exposure [adjOR2.9(95%CI 1.1-7.2)], low birthweight [adjOR2.5(1.0-6.3)], previous child death (adjOR25.1(6.5-97.5)] and maternal death [adjOR5.3(11.4-20.5)]. At 20 months, HIV-infected children had significantly poorer health outcomes than HIV-unexposed children and HIV-exposed but uninfected children (HIV-EU), including: hospital admissions, delayed development, undernutrition and restrictions in function (Lansky scale); no significant differences were seen between HIV-EU and HIV-unexposed children. Overall, no difference was seen at 20 months among HIV-infected, HIV-EU and HIV-unexposed groups in Z-scores (%<-2.0) for weight, height and BMI. Risk factors for poor functional health status at 20 months included: HIV-infection [adjOR8.9(2.4-32.6)], maternal illness [adjOR2.8(1.5-5.0)] and low birthweight [adjOR2.0(1.0-4.1)]. Conclusion: Child mortality remains high within this context and could be reduced through more effective PMTCT including prioritizing the treatment of maternal HIV infection to address the effect of maternal health and survival on infant health and survival. HIV-infected children demonstrated developmental delays, functional health and nutritional deficits that underscore the need for increased uptake of early infant diagnosis and institution of ART for all infected infants. 2012 Landes et al."									
396	Cytokine activation is predictive of mortality in Zambian patients with AIDS-related diarrhoea.	"Zulu I, Hassan G, Lungowe Njobvu RN, Dhaliwal W, Sianongo S, Kelly P."	BMC Infectious Diseases. 2008;8(156).	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20093047642	"Background: Mortality in Zambian AIDS patients is high, especially in patients with diarrhoea, and there is still unacceptably high mortality in Zambian patients just starting anti-retroviral therapy. We set out to determine if high concentrations of serum cytokines correlate with mortality. Methods: Serum samples from 30 healthy controls (HIV seropositive and seronegative) and 50 patients with diarrhoea (20 of whom died within 6 weeks) were analysed. Concentrations of tumour necrosis factor receptor p55 (TNFR p55), macrophage migration inhibitory factor (MIF), interleukin (IL)-6, IL-12, interferon (IFN)- gamma and C-reactive protein (CRP) were measured by ELISA, and correlated with mortality after 6 weeks follow-up. Results: Apart from IL-12, concentrations of all cytokines, TNFR p55 and CRP increased with worsening severity of disease, showing highly statistically significant trends. In a multivariable analysis high TNFR p55, IFN- gamma , CRP and low CD4 count (CD4 count <100) were predictive of mortality. Although nutritional status (assessed by body mass index, BMI) was predictive in univariate analysis, it was not an independent predictor in multivariate analysis. Conclusion: High serum concentrations of TNFR p55, IFN- gamma , CRP and low CD4 count correlated with disease severity and short-term mortality in HIV-infected Zambian adults with diarrhoea. These factors were better predictors of survival than BMI. Understanding the cause of TNFR p55, IFN- gamma and CRP elevation may be useful in development of interventions to reduce mortality in AIDS patients with chronic diarrhoea in Africa."									
397	Cytokine activation is predictive of mortality in Zambian patients with AIDS-related diarrhoea.	"Zulu I, Hassan G, Njobvu RN, Dhaliwal W, Sianongo S, Kelly P."	BMC Infectious Diseases. 2008 13 Nov;8(156).		"Background: Mortality in Zambian AIDS patients is high, especially in patients with diarrhoea, and there is still unacceptably high mortality in Zambian patients just starting anti-retroviral therapy. We set out to determine if high concentrations of serum cytokines correlate with mortality. Methods: Serum samples from 30 healthy controls (HIV seropositive and seronegative) and 50 patients with diarrhoea (20 of whom died within 6 weeks) were analysed. Concentrations of tumour necrosis factor receptor p55 (TNFR p55), macrophage migration inhibitory factor (MIF), interleukin (IL)-6, IL-12, interferon (IFN)- and C-reactive protein (CRP) were measured by ELISA, and correlated with mortality after 6 weeks follow-up. Results: Apart from IL-12, concentrations of all cytokines, TNFR p55 and CRP increased with worsening severity of disease, showing highly statistically significant trends. In a multivariable analysis high TNFR p55, IFN-, CRP and low CD4 count (CD4 count <100) were predictive of mortality. Although nutritional status (assessed by body mass index, BMI) was predictive in univariate analysis, it was not an independent predictor in multivariate analysis. Conclusion: High serum concentrations of TNFR p55, IFN-, CRP and low CD4 count correlated with disease severity and short-term mortality in HIV-infected Zambian adults with diarrhoea. These factors were better predictors of survival than BMI. Understanding the cause of TNFR p55, IFN- and CRP elevation may be useful in development of interventions to reduce mortality in AIDS patients with chronic diarrhoea in Africa. 2008 Zulu et al; licensee BioMed Central Ltd."									
855	"Growth of children according to maternal and child HIV, immunological and disease characteristics: a prospective cohort study in Kinshasa, Democratic Republic of Congo."	"Bailey RC, Kamenga MC, Nsuami MJ, Nieburg P, St Louis ME."	International Journal of Epidemiology. 1999;28(3):532-40.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=10405861	"BACKGROUND: Most HIV-infection in children occurs in sub-Saharan Africa where antiretroviral therapy is seldom available. This study compares the growth progression and retardation of HIV-infected and uninfected children in the Democratic Republic of Congo (formerly Zaire). It estimates the risk for child growth retardation according to child and maternal immunological factors, severity of maternal and child illness, and maternal socioeconomic and marital status."	"METHODS: In a prospective cohort study of 258 children born to HIV seropositive mothers and 256 children of seronegative mothers in Kinshasa, Congo, the growth in length, weight, and weight-for-length of infected children (n = 68), uninfected children born to seropositive mothers (n = 190), and uninfected children born to uninfected mothers (n = 256) was compared. Serological, anthropometric and other clinical measures were collected monthly from 3-12 months and bi-monthly during the second year of life. Polymerase chain reaction for HIV was performed on bloods drawn at 2 days and 3 months post partum. Length-for-age, weight-for-age, and weight-for-length mean z-scores against National Center for Health Statistics (NCHS) reference data were calculated, and Cox proportional hazards models were used to estimate the risk of falling below -2.00 z-scores as a function of child and maternal immunological, clinical and sociodemographic variables."	"RESULTS: There was no difference in mean length-for-age at birth between HIV-infected (Group 1) children, uninfected children of infected mothers (Group 2) or Control children, but by 3 months old, HIV-infected children were shorter than both Group 2 and Controls. In weight-for-age and weight-for-length, Group 1 infants were lighter and more wasted at birth and onwards. Group 2 newborns were lighter than Controls at birth, but by three months they had caught up to Controls in both length and weight and remained the same as Controls thereafter. The odds of falling below -2.00 z-scores by 20 months for length, weight, and weight-for-length for HIV-infected children compared to uninfected children were 2.10, 2.84, and 2.56 respectively. Both HIV-infection and associated illnesses were factors associated with child stunting, underweight and wasting. The mother's age, socioeconomic status, presence of father, stage of illness and immune status had no detectable effect on the child's growth in the first two years of life."	"CONCLUSION: The HIV-infected children in Congo with no access to antiretroviral therapy were stunted, underweight, and wasted compared to same age uninfected children. Both HIV infection and HIV-associated signs and symptoms, not maternal immunological or socioeconomic circumstances, placed children at risk for growth retardation."						
523	Undiagnosed HIV infection among adolescents seeking primary health care in Zimbabwe.	"Ferrand RA, Munaiwa L, Matsekete J, Bandason T, Nathoo K, Ndhlovu CE, Munyati S, et al."	Clinical Infectious Diseases. 2010;51(7):844-51.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=20804412	"BACKGROUND: Mother-to-child transmission of human immunodeficiency virus (HIV) infection was extremely common in southern Africa during the 1990s, and a substantial minority of infected infants have survived to reach adolescence undiagnosed. Studies have shown a high prevalence of HIV infection in hospitalized adolescents who have features associated with long-standing HIV infection, including stunting and frequent minor illnesses. We therefore investigated the epidemiology of HIV infection at the primary care level."	"METHODS: Adolescents (aged 10-18 years) attending two primary care clinics underwent HIV and Herpes simplex virus-2 (HSV-2) serological testing, clinical examination, and anthropometry. All were offered routine HIV counseling and testing. Patients attending for acute primary care (APC) who were HIV infected were asked about their risk factors."	"RESULTS: Five hundred ninety-four participants were systematically recruited (97% participation), of whom 88 (15%) were attending for antenatal care. HIV infection prevalence was higher among APC attendees than among antenatal care attendees (17% vs 6%; P < .007), but for the prevalence of HSV-2 infection, a marker of sexually acquired HIV, the converse was true (4% vs 14%; P < .002). Seventy (81%) of 86 HIV-positive APC attendees were previously undiagnosed. They had a broad range of presenting complaints, with a median CD4 cell count of 329 cells/microL (interquartile range, 176-485 cells/microL) and a high prevalence of stunting, compared with the corresponding prevalence among HIV-negative attendees (40% vs 12%; P < .001). Maternal transmission was considered to be likely by 69 (80%) of the 86 HIV-positive APC attendees, only one of whom was HSV-2 positive."	CONCLUSIONS: Unrecognized HIV infection was a common cause of primary care attendance. Routine HIV counseling and testing implemented at the primary care level may provide a simple and effective way of identifying older long-term survivors of mother-to-child transmission before the onset of severe immunosuppression and irreversible complications.						
720	Multiple micronutrient supplementation during pregnancy in low-income countries: a meta-analysis of effects on birth size and length of gestation.	"Fall CH, Fisher DJ, Osmond C, Margetts BM, Maternal Micronutrient Supplementation Study G."	Food & Nutrition Bulletin. 2009;30(4 Suppl):S533-46.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=20120795	BACKGROUND: Multiple micronutrient deficiencies are common among women in low-income countries and may adversely affect pregnancy outcomes.	"OBJECTIVE: This meta-analysis reports the effects on newborn size and duration of gestation of multiple micronutrient supplementation mainly compared with iron plus folic acid during pregnancy in recent randomized, controlled trials."	"METHODS: Original data from 12 randomized, controlled trials in Bangladesh, Burkina Faso, China, Guinea-Bissau, Indonesia, Mexico, Nepal, Niger, Pakistan, and Zimbabwe, all providing approximately 1 recommended dietary allowance (RDA) of multiple micronutrients to presumed HIV-negative women, were included. Outcomes included birthweight, other birth measurements, gestation, and incidence of low birthweight (LBW) (< 2500 g), small-for-gestational age birth (SGA, birthweight below the within-each-population 10th percentile), large-for-gestational age birth (LGA, birthweight above the within-each-population 90th percentile), and preterm delivery (< 37 weeks)."	"RESULTS: Compared with control supplementation (mainly with iron-folic acid), multiple micronutrient supplementation was associated with an increase in mean birthweight (pooled estimate: +22.4 g [95% CI, 8.3 to 36.4 g]; p = .002), a reduction in the prevalence of LBW (pooled OR = 0.89 [95% CI, 0.81 to 0.97]; p = .01) and SGA birth (pooled OR = 0.90 [95% CI, 0.82 to 0.99]; p = .03), and an increase in the prevalence of LGA birth (pooled OR = 1.13 [95% CI, 1.00 to 1.28]; p = .04). In most studies, the effects on birthweight were greater in mothers with higher body mass index (BMI). In the pooled analysis, the positive effect of multiple micronutrients on birthweight increased by 7.6 g (95% CI, 1.9 to 13.3 g) per unit increase in maternal BMI (p for interaction = .009). The intervention effect relative to the control group was + 39.0 g (95% CI, +22.0 to +56.1 g) in mothers with BMI of 20 kg/m2 or higher compared with -6.0 g (95% CI, -8.8 to +16.8 g) in mothers with BMI under 20 kg/m2. There were no significant effects of multiple micronutrient supplementation on birth length or head circumference nor on the duration of gestation (pooled effect: +0.17 day [95% CI, -0.35 to +0.70 day]; p = .51) or the incidence of preterm birth (pooled OR = 1.00 [95% CI, 0.93 to 1.09]; p = .92)."	"CONCLUSIONS: Compared with iron-folic acid supplementation alone, maternal supplementation with multiple micronutrients during pregnancy in low-income countries resulted in a small increase in birthweight and a reduction in the prevalence of LBW of about 10%. The effect was greater among women with higher BMI."					
726	Multiple micronutrient supplementation during pregnancy in low-income countries: a meta-analysis of effects on stillbirths and on early and late neonatal mortality.	"Ronsmans C, Fisher DJ, Osmond C, Margetts BM, Fall CH, Maternal Micronutrient Supplementation Study G."	Food & Nutrition Bulletin. 2009;30(4 Suppl):S547-55.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=20120796	BACKGROUND: Multiple micronutrient deficiencies are common among women in low-income countries and may adversely affect pregnancy outcomes.	"OBJECTIVE: To conduct a meta-analysis of the effects on stillbirths and on early and late neonatal mortality of supplementation during pregnancy with multiple micronutrients compared with iron-folic acid in recent randomized, controlled trials."	"METHODS: Twelve randomized, controlled trials were included in the analysis (Bangladesh; Burkina Faso; China; Guinea-Bissau; Indramayu and Lombok, Indonesia; Mexico; Sarlahi and Janakur, Nepal; Niger; Pakistan; and Zimbabwe), all providing approximately 1 recommended dietary allowance (RDA) of multiple micronutrients or iron-folic acid to presumed HIV-negative women."	"RESULTS: Supplementation providing approximately I RDA of multiple micronutrients did not decrease the risk of stillbirth (OR = 1.01; 95% CI, 0.88 to 1.16), early neonatal mortality (OR = 1.23; 95% CI, 0.95 to 1.59), late neonatal mortality (OR = 0.94; 95% CI, 0.73 to 1.23), or perinatal mortality (OR = 1.11; 95% CI, 0.93 to 1.33)."	CONCLUSIONS: Our meta-analysis provides consistent evidence that supplementation providing approximately 1 RDA of multiple micronutrients during pregnancy does not result in any reduction in stillbirths or in early or late neonatal deaths compared with iron-folic acid alone.					
183	"Effect of multimicronutrient supplementation on gestational length and birth size: a randomized, placebo-controlled, double-blind effectiveness trial in Zimbabwe."	"Friis H, Gomo E, Nyazema N, Ndhlovu P, Krarup H, Kaestel P, Michaelsen KF."	American Journal of Clinical Nutrition. 2004;80(1):178-84.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=15213046	"BACKGROUND: Multiple micronutrient deficiencies may contribute to low birth weight, which is a major global determinant of mortality."	OBJECTIVE: We assessed the effect of prenatal multimicronutrient supplementation on gestational length and birth size.	"DESIGN: We conducted a randomized, placebo-controlled, double-blind effectiveness trial among antenatal care attendees in Harare, Zimbabwe. Pregnant women (22-35 wk of gestation) were randomly allocated to receive a multimicronutrient or placebo supplement daily until delivery. Supplementation with iron and folic acid was part of antenatal care."	"RESULTS: Of 1669 women, birth data were available from 1106 (66%), of whom 360 (33%) had HIV infection. The mean gestational length was 39.1 wk, and 16.6% of the women had a gestational length < 37 wk. The mean birth weight was 3030 g, and 10.5% of the infants had a birth weight < 2500 g. Multimicronutrient supplementation was associated with tendencies for increased gestational length (0.3 wk; 95% CI: -0.04, 0.6 wk; P = 0.06), birth weight (49 g; -6, 104 g; P = 0.08), and head circumference (0.2 cm; -0.02, 0.4 cm; P = 0.07) but was not associated with low birth weight (birth weight < 2500 g) (relative risk: 0.84; 0.59, 1.18; P = 0.31). The effect of multimicronutrient supplementation on birth weight was not significantly different between HIV-uninfected (26 g; -38, 91 g) and HIV-infected (101 g; -3, 205 g) subjects (interaction, P > 0.10)."	CONCLUSION: Antenatal multimicronutrient supplementation may be one strategy to increase birth size.					
181	"Multiple micronutrient supplementation in Tanzanian infants born to HIV-infected mothers: a randomized, double-blind, placebo-controlled clinical trial."	"Duggan C, Manji KP, Kupka R, Bosch RJ, Aboud S, Kisenge R, Okuma J, et al."	American Journal of Clinical Nutrition. 2012;96(6):1437-46.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=23134887	"BACKGROUND: Multiple micronutrients (vitamin B complex and vitamins C and E) were effective at reducing infectious disease morbidity, HIV disease progression, and poor pregnancy outcomes in HIV-infected women."	OBJECTIVE: The objective was to evaluate whether direct supplementation of these micronutrients to HIV-exposed infants reduces mortality and morbidity.	"DESIGN: Infants born to HIV-infected women from Dar es Salaam, Tanzania, were randomly assigned to receive daily oral supplementation of multiple multivitamins (vitamin B complex and vitamins C and E) or placebo from age 6 wk for 24 mo. All-cause mortality, hospitalizations, and unscheduled clinic visits were recorded. Morbidities were recorded during monthly follow-up visits. All mothers received multiple micronutrients throughout the study."	"RESULTS: A total of 1193 infants were randomly assigned to receive micronutrients and 1194 to receive placebo. There were 138 child deaths in the multivitamin group and 124 deaths in the placebo group (HR: 1.13; 95% CI: 0.88, 1.44; P = 0.33). Hospitalizations (RR: 0.83; 95% CI: 0.62, 1.13; P = 0.23), unscheduled clinic visits (RR: 0.97; 95% CI: 0.85, 1.10; P = 0.59), and maternal reports of diarrhea (RR: 0.97; 0.87, 1.10; P = 0.64) were not significantly different between the 2 groups. Fever (P = 0.02) and vomiting (P = 0.007) were significantly lower in the multivitamin group. Among 429 children whose mothers received antiretroviral (ARV) therapy, multivitamin use had no effect on mortality but was associated with a significant reduction in hospitalizations (P = 0.035), episodes of fever (P = 0.005), and episodes of fever and cough (P = 0.019)."	"CONCLUSIONS: In the setting of maternal micronutrient supplementation, supplementation of HIV-exposed infants with vitamin B and vitamins C and E does not reduce mortality. Studies of nutrition supplementation in ARV-exposed infants may be warranted."					
707	A randomized trial of multivitamin supplementation in children with tuberculosis in tanzania.	"Mehta S, Mugusi FM, Bosch RJ, Aboud S, Chatterjee A, Finkelstein JL, Fataki M, et al."	FASEB Journal. 2010 April;24.		"Background: Multivitamin supplementation may enhance the health of children with tuberculosis (TB); however, its efficacy as an intervention has not been examined. Methods: 255 children with TB were randomized to receive either a daily multivitamin supplement or placebo in the first eight weeks of anti-TB therapy. They were followed up for the duration of supplementation through clinic and home visits to assess anthropometric indices and laboratory parameters, including hemoglobin and albumin. Results: Multivitamin supplementation resulted in a significant improvement in hemoglobin levels at the end of follow-up; the median increase in children receiving multivitamins was 1.0 g/dL, compared to 0.4 g/dL in children who were given placebo (p<0.01). No significant differences were observed in growth indices, including height and weight gain. Among children who were also co-infected with HIV (n=87; 34%), daily multivitamins had a smaller but statistically significant increase in albumin levels compared with placebo. Conclusions: Multivitamin supplementation for eight weeks improved the hematological profile of children with TB. Larger studies with a longer period of supplementation are needed to confirm these findings and assess the effect of multivitamins on clinical outcomes including treatment success and growth failure."									
1051	Factors influencing plasma nevirapine levels: a study in HIV-infected children on generic antiretroviral treatment in India.	"Soumya S, Geetha R, Kupparam HKA, Vasantha M, Lakshmi S, Kannabiran BP, Navaneethapandian PGD, et al."	Journal of Antimicrobial Chemotherapy. 2011;66(6):1354-9.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20113171064	"Background: Nevirapine is an important component of paediatric combination HIV therapy. Adequate drug exposure is necessary in order to achieve long-lasting viral suppression. Objectives: To study the influence of age, drug dose and formulation type, nutritional status and CYP2B6 516G > T polymorphism on blood concentrations of nevirapine in children treated with generic antiretroviral drugs. Methods: A multicentre study was conducted at four sites in India. HIV-infected children receiving generic nevirapine-based fixed-dose combinations were recruited. Trough and 2 h nevirapine plasma concentrations were determined by HPLC. Characterization of the CYP2B6 gene polymorphism was performed using direct sequencing. Clinical and nutritional status was recorded. Groups were compared using the Mann-Whitney U-test and multivariable logistic regression analysis was performed to identify factors contributing to low drug levels. Results: Ninety-four children of median age 78 months were studied; 60% were undernourished or stunted. Stunted children had a significantly lower 2 h nevirapine concentration compared with non-stunted children (P<0.05); there were no significant differences in trough concentrations between different nutritional groups. Nevirapine levels were significantly higher in children with TT compared with GG and GT CYP2B6 genotypes (P<0.01). Children <=3 years had a 3.2 (95% confidence interval 1.07-9.45) times higher risk of having sub-therapeutic nevirapine concentrations. Conclusions: Nevirapine blood concentrations are affected by many factors, most notably age <=3 years; a combination of young age, stunting and CYP2B6 GG or GT genotype could potentially result in sub-therapeutic nevirapine concentrations. Dosing recommendations for children should be reviewed in the light of these findings."									
755	"Predictors of loss to follow-up among children in the first and second years of antiretroviral treatment in Johannesburg, South Africa."	"Sengayi M, Dwane N, Marinda E, Sipambo N, Fairlie L, Moultrie H."	Glob Health Action. 2013;6:19248.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=23364098	"BACKGROUND: Ninety percent of the world's 2.1 million HIV-infected children live in sub-Saharan Africa, and 2.5% of South African children live with HIV. As HIV care and treatment programmes are scaled-up, a rise in loss to follow-up (LTFU) has been observed."	OBJECTIVE: The aim of the study was to determine the rate of LTFU in children receiving antiretroviral treatment (ART) and to identify baseline characteristics associated with LTFU in the first year of treatment. We also explored the effect of patient characteristics at 12 months treatment on LTFU in the second year.	"METHODS: The study is an analysis of prospectively collected routine data of HIV-infected children at the Harriet Shezi Children's Clinic (HSCC) in Soweto, Johannesburg. Cox proportional hazards models were fitted to investigate associations between baseline characteristics and 12-month characteristics with LTFU in the first and second year on ART, respectively."	"RESULTS: The cumulative probability of LTFU at 12 months was 7.3% (95% CI 7.1-8.8). In the first 12 months on ART, independent predictors of LTFU were age <1 year at initiation, recent year of ART start, mother as a primary caregiver, and being underweight (WAZ <= -2). Among children still on treatment at 1 year from ART initiation, characteristics that predicted LTFU within the second year were recent year of ART start, mother as a primary caregiver, being underweight (WAZ <= -2), and low CD4 cell percentage."	"CONCLUSIONS: There are similarities between the known predictors of death and the predictors of LTFU in the first and second years of ART. Knowing the vital status of children is important to determine LTFU. Although HIV-positive children cared for by their mothers appear to be at greater risk of becoming LTFU, further research is needed to explore the challenges faced by mothers and other caregivers and their impact on long-term HIV care. There is also a need to investigate the effects of differential access to ART between mothers and children and its impact on ART outcomes in children."					
417	"Prevalence and risk factors of major depressive disorder in HIV/AIDS as seen in semi-urban Entebbe district, Uganda."	"Kinyanda E, Hoskins S, Nakku J, Nawaz S, Patel V."	BMC Psychiatry. 2011 30 Dec;11(205).		"Background: Not much is known about the risk factors of major depressive disorder (MDD) in HIV/AIDS in the African socio-cultural context. Therefore a study was undertaken to examine the prevalence and risk factors of MDD in HIV/AIDS in semi-urban Uganda.Methods: A cross-sectional study was undertaken among 618 respondents attending two HIV clinics in Uganda.Results: Prevalence of MDD was 8.1%. Factors associated with MDD at univariate analysis only were female gender, family history of mental illness, negative coping style, alcohol dependency disorder, food insecurity and stress; not associated with MDD were social support, neurocognitive impairment, CD4 counts and BMI. Factors independently associated with MDD were psychosocial impairment, adverse life events, post traumatic stress disorder, generalised anxiety disorder and life-time attempted suicide.Conclusion: Psychological and social factors were the main risk factors of MDD among ambulatory HIV positive persons with no evidence for the role of the neurotoxic effects of HIV. Treatment approaches for MDD in this patient group should be modeled on those used among non-HIV groups. 2011 Kinyanda et al; licensee BioMed Central Ltd."									
1788	"Anthropometric profile of HIV-uninfected and HIV-infected women aged 25-44 years in Mangaung, Free State."	"Hattingh Z, Walsh C, Bester CJ."	South African Family Practice. 2011;53(5):474-80.		"Background: Obesity and human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) affect significant numbers of black women in South Africa. Method: Using township maps, a random sample of 500 black women residing in Mangaung in the Free State was selected to participate in this study in the year 2000. The women were divided into two age groups, namely 25-34 years (n = 273) and 35-44 years (n = 215). Anthropometric measurements, including height, weight [to calculate the body mass index (BMI)] and waist circumference (WC) were taken. Fat percentage was measured with bioelectrical impedance. HIV status was determined using a microparticle enzyme immunoassay method. Socio-demographic status, health status, dietary intake, level of physical activity, body perception and attitude toward weight control, as well as prevalence and risk of lifestyle diseases were determined as part of the larger study. Results: Sixty-one per cent of younger women (25-34 years) and 38% of older women (35-44 years) were infected with HIV. In younger HIV-infected women, median BMI, WC and fat percentage were significantly lower than in HIV-uninfected women. Conclusions: HIV infection rates were found to be higher among younger than older women. The prevalence of obesity was high overall. Median BMI values ranged between 24.4 kg/m<sup>2</sup> and 27.6 kg/m<sup>2</sup>. A large percentage of all women fell in the unhealthy fat percentage category (excessive body fat), ranging between 65.9% of HIV-infected young women and 79.3% of older HIV-infected women. HIV, even in the asymptomatic stage, influences anthropometric indicators. SAAFP."									
1020	Randomized trial of vitamin supplements in relation to vertical transmission of HIV-1 in Tanzania.	"Fawzi WW, Msamanga G, Hunter D, Urassa E, Renjifo B, Mwakagile D, Hertzmark E, et al."	Journal of Acquired Immune Deficiency Syndromes: JAIDS. 2000;23(3):246-54.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=10839660	BACKGROUND: Observational studies suggest that poor nutritional status among HIV-infected pregnant women is associated with a higher risk of vertical transmission of HIV.	"METHODS: We randomized 1083 pregnant women infected with HIV-1 in a double-blind, placebo-controlled trial to examine the effects of supplements of vitamin A and/or multivitamins (excluding vitamin A) using a 2-x-2 factorial design. We report the effects of the supplements on HIV infection defined using polymerase chain reaction (PCR), or death up to 6 weeks postpartum."	"RESULTS: Of babies in the multivitamin arm 38, (10.1%) were HIV-positive at birth compared with 24 (6.6%) in the no-multivitamin arm (relative risk [RR] = 1.54; 95% CI, 0.94-2.51; p = .08). Of babies born to mothers in the vitamin A arm, 38 (10.0%) were HIV-positive at birth compared with 24 (6.7%) in the no-vitamin A arm (RR, 1.49; 95% CI, 0.91-2.43; p = 0.11). Neither multivitamins nor vitamin A had an effect on HIV status at 6 weeks among those who were HIV-negative at birth (RR = 1.04; 95% CI, 0.65-1.66; p = 0.88) and (RR = 1.30; 95% CI, 0.80-2.09; p = .29, respectively). Similarly, neither supplement was associated with being either HIV-infected or dead at birth (RR, 0.98; 95% CI, 0.76-1.27; p = .89 and RR, 1.01; 95% CI, 0.78-1.31; p = .95, respectively. A beneficial effect of multivitamins on birth weight was limited to babies who were HIV-negative at birth; babies in the multivitamin arm weighed +94 g more compared with those in the no-multivitamin arm (p = .02). Among babies who were HIV-positive at birth, the corresponding difference was -31 g (p = .82)."	CONCLUSIONS: Vitamin A and multivitamins did not affect the risk of vertical transmission of HIV in utero nor during the intrapartum and early breastfeeding periods. Multivitamins resulted in a significant improvement in birth weight of babies who were HIV-negative at birth but had no effect among those who were HIV-positive. The effect of vitamin supplements on HIV transmission through breastfeeding and on clinical progression of HIV disease is yet to be ascertained.						
1619	"HIV/AIDS, food supplementation and livelihood programs in Uganda: a way forward?"	"Yager JE, Kadiyala S, Weiser SD."	PLoS ONE [Electronic Resource]. 2011;6(10):e26117.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=22022530	"BACKGROUND: Over the last decade, health, nutrition and policy experts have become increasingly aware of the many ways in which food insecurity and HIV infection negatively impact and reinforce one another. In response, many organizations providing HIV care began supplying food aid to clients in need. Food supplementation, however, was quickly recognized as an unsustainable and incomplete intervention. Many HIV care organizations therefore developed integrated HIV and livelihood programs (IHLPs) to target the root causes of food insecurity."	"METHODS AND FINDINGS: We conducted a qualitative study using in-depth interviews with 21 key informants who worked at seven organizations providing HIV care, food aid, or IHLPs in Kampala, Uganda in 2007-2008 to better understand the impact of IHLPs on the well-being of people living with HIV and AIDS (PLWHAs) and the challenges in transitioning clients from food aid to IHLPs. There was strong consensus among those interviewed that IHLPs are an important intervention in addressing food insecurity and its adverse health consequences among PLWHAs. Key informants identified three main challenges in transitioning PLWHAs from food supplementation programs to IHLPs: (1) lack of resources (2) timing of the transition and (3) logistical considerations including geography and weather. Factors seen as contributing to the success of programs included: (1) close involvement of community leaders (2) close ties with local and national government (3) diversification of IHLP activities and (4) close integration with food supplementation programs, all linked through a central program of HIV care."	"CONCLUSION: Health, policy and development experts should continue to strengthen IHLPs for participants in need. Further research is needed to determine when and how participants should be transitioned from food supplementation to IHLPs, and to determine how to better correlate measures of food insecurity with objective clinical outcomes so as to better evaluate program results."							
910	Predictors of change in nutritional and hemoglobin status among adults treated for tuberculosis in Tanzania.	"Kawai K, Villamor E, Mugusi FM, Saathoff E, Urassa W, Bosch RJ, Spiegelman D, et al."	International Journal of Tuberculosis & Lung Disease. 2011;15(10):1380-9.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=22283899	BACKGROUND: Patients with tuberculosis (TB) often suffer from profound malnutrition.	OBJECTIVE: To examine the patterns and predictors of change in nutritional and hemoglobin status during and after TB treatment.	"METHODS: A total of 471 human immunodeficiency virus (HIV) positive and 416 HIV-negative adults with pulmonary TB were prospectively followed in Dar es Salaam, Tanzania. All patients received 8 months' TB treatment following enrollment."	"RESULTS: About 40% of HIV-positive and 47% of HIV-negative TB patients had body mass index (BMI) < 18.5 kg/m 2 at baseline, while about 94% of HIV-positive and 84% of HIV-negative participants were anemic at baseline. Both HIV-positive and HIV-negative patients experienced increases in BMI and hemoglobin concentrations over the course of TB treatment. Among HIV- positive patients, older age, low CD4 cell counts, and high viral load were independently associated with a smaller increase in BMI from baseline to 8 months. Fe- male sex, older age, low CD4 cell counts, previous TB infection and less money spent on food were independently associated with a smaller improvement in hemoglobin levels among HIV-positive patients during treatment."	"CONCLUSION: HIV-positive TB patients, especially those with low CD4 cell counts, showed poor nutritional recovery during TB treatment. Adequate nutritional support should be considered during TB treatment."					
386	"Prevalence of smear positive pulmonary tuberculosis among prisoners in North Gondar Zone Prison, northwest Ethiopia."	"Moges B, Amare B, Asfaw F, Tesfaye W, Tiruneh M, Belyhun Y, Mulu A, et al."	BMC Infectious Diseases. 2012 15 Dec;12(352).		"Background: People concentrated in congregated systems, such as prisons, are important but often neglected reservoirs for TB transmission, and threaten those in the outside community. Therefore, this study was conducted to determine the prevalence of tuberculosis in a prison system of North Gondar Zone.Methods: An active case-finding survey in North Gondar Prison was carried out from March to May 2011. All prison inmates who had history of cough for at least a week were included in the study. Three morning sputum samples were collected from suspected inmates and examined through fluorescence microscopy. Fine needle aspiration cytology was done for those having significant lymphadenopathy. Pre and post HIV test counseling was provided after written consent. Binary logistic and multivariable analysis was performed using SPSS version 16.Results: A total of 250 prisoners were included in the survey. Among these, 26 (10.4%) prisoners were found to have TB giving a point prevalence of 1482.3 per 100,000 populations of smear positive TB among the TB suspects. All the inmates who participated in the study volunteered for HIV testing and a total of 19(7.6%) inmates were found to be reactive for the HIV antibody test amongst of which 9(47.4%) had TB co-infection. The prevalence of HIV infection in the TB infected inmates was found to be 34.6% (9/26). From the 26 TB cases identified 12 (46.2%) were having under nutrition (BMI < 18.5kg/m<sup>2</sup>).Conclusions: There is high prevalence of TB in North Gondar Prison with possible active transmission of TB within the prison. There was a high prevalence of HIV among the TB suspects. Strong cooperation between prison authorities and the national tuberculosis control programmes is urgently required to develop locally appropriate interventions to reduce transmission. The determinants for poor nutrition in the prison need also further investigation. 2012 Moges et al.; licensee BioMed Central Ltd."									
1524	Growth of human immunodeficiency virus-uninfected children exposed to perinatal zidovudine for the prevention of mother-to-child human immunodeficiency virus transmission.	"Briand N, Le Coeur S, Traisathit P, Karnchanamayul V, Hansudewechakul R, Ngampiyasakul C, Bhakeecheep S, et al."	Pediatric Infectious Disease Journal. 2006 April;25(4):325-32.		"Background: Perinatal human immunodeficiency virus (HIV) prevention programs have been implemented in several countries, and many children have been or will be exposed to antiretrovirals in utero and during their first weeks of life. Although reducing substantially the number of infected children, the potential adverse consequences of these treatments on the health of HIV-uninfected children need to be assessed. Objective: To investigate the impact of in utero and postnatal zidovudine exposure on the growth of HIV-uninfected children born to HIV-infected women. Methods: We used data prospectively collected in 1408 live born children participating in a clinical trial comparing zidovudine regimens of different durations to prevent perinatal transmission in Thailand (PHPT-I). We used a linear mixed model to analyze the anthropometric measurements (weight for age, height for age and weight for height Z-scores) until 18 months of age according to zidovudine treatment duration (mothers, <7.5 weeks versus more; infants, 3 days versus >4 weeks). Results: Children exposed in utero for >7.5 weeks had a slightly lower birth weight (Z-score difference, 0.08; P = 0.003). However, zidovudine exposure had no effect on the evolution of Z-scores from 6 weeks to 18 months of age. Conclusions: Although a longer in utero zidovudine exposure may have had a negative impact on birth weight, the magnitude of this effect was small and faded over time. Neither the total nor the postnatal duration of exposure was associated with changes in infant Z-scores from 6 weeks to 18 months of age. Copyright 2006 by Lippincott Williams & Wilkins."									
535	Sex differences in the incidence of peripheral neuropathy among Kenyans initiating antiretroviral therapy.	"Mehta SA, Ahmed A, Laverty M, Holzman RS, Valentine F, Sivapalasingam S."	Clinical Infectious Diseases. 2011 01 Sep;53(5):490-6.		"Background: Peripheral neuropathy (PN) is common among patients receiving antiretroviral therapy (ART) in resource-limited settings. We report the incidence of and risk factors for PN among human immunodeficiency virus (HIV)-infected Kenyan adults initiating ART. Methods: An inception cohort was formed of adults initiating ART. They were screened for PN at baseline and every 3 months for 1 year. We used the validated Brief Peripheral Neuropathy Screen (BPNS) that includes symptoms and signs (vibration perception and ankle reflexes) of PN. Results: Twenty-two (11%) of 199 patients had PN at baseline screening. One hundred fifty patients without evidence of PN at baseline were followed for a median of 366 days (interquartile range, 351-399). The incidence of PN was 11.9 per 100 person-years (95% confidence interval [CI], 6.9-19.1) and was higher in women than men (17.7 vs 1.9 per 100 person-years; rate ratio, 9.6; 95% CI, 1.27-72, P = .03). In stratified analyses, female sex remained statistically significant after adjustment for each of the following variables: age, CD4 cell count, body mass index, ART regimen, and tuberculosis treatment. Stratifying hemoglobin levels decreased the hazard ratio from 9.6 to 7.40 (P = .05), with higher levels corresponding to a lower risk of PN. Conclusions: HIV-infected Kenyan women were almost 10 times more likely than men to develop PN in the first year of ART. The risk decreased slightly at higher hemoglobin levels. Preventing or treating anemia in women before ART initiation and implementing BPNS during the first year of ART, the period of highest risk, could ameliorate the risk of PN. The Author 2011."									
1547	Variability of growth in children starting antiretroviral treatment in southern Africa.	"Gsponer T, Weigel R, Davies MA, Bolton C, Moultrie H, Vaz P, Rabie H, et al."	Pediatrics. 2012;130(4):e966-77.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=22987878	"BACKGROUND: Poor growth is an indication for antiretroviral therapy (ART) and a criterion for treatment failure. We examined variability in growth response to ART in 12 programs in Malawi, Zambia, Zimbabwe, Mozambique, and South Africa."	"METHODS: Treatment naive children aged <10 years were included. We calculated weight for age z scores (WAZs), height for age z scores (HAZs), and weight for height z scores (WHZs) up to 3 years after starting ART, by using the World Health Organization standards. Multilevel regression models were used."	"RESULTS: A total of 17990 children (range, 238-8975) were followed for 36181 person-years. At ART initiation, most children were underweight (50%) and stunted (66%). Lower baseline WAZ, HAZ, and WHZ were the most important determinants of faster catch-up growth on ART. WAZ and WHZ increased rapidly in the first year and stagnated or reversed thereafter, whereas HAZ increased continuously over time. Three years after starting ART, WAZ ranged from -2.80 (95% confidence interval [CI]: -3.66 to -2.02) to -1.98 (95% CI: -2.41 to -1.48) in children with a baseline z score < -3 and from -0.79 (95% CI: -1.62 to 0.02) to 0.05 (95% CI: -0.42 to 0.51) in children with a baseline WAZ >= -1. For HAZ, the corresponding range was -2.33 (95% CI: -2.62 to -2.02) to -1.27 (95% CI: -1.58 to -1.00) for baseline HAZ < -3 and -0.24 (95% CI: -0.56 to 0.15) to 0.84 (95% CI: 0.53 to 1.16) for HAZ >= -1."	"CONCLUSIONS: Despite a sustained growth response and catch-up growth in children with advanced HIV disease treated with ART, normal weights and heights are not achieved over 3 years of ART."						
1546	Variability of growth in children starting antiretroviral treatment in Southern Africa.	"Gsponer T, Weigel R, Davies MA, Bolton C, Moultrie H, Vaz P, Rabie H, et al."	Pediatrics. 2012 October;130(4):e966-e77.		"BACKGROUND: Poor growth is an indication for antiretroviral therapy (ART) and a criterion for treatment failure. We examined variability in growth response to ART in 12 programs in Malawi, Zambia, Zimbabwe, Mozambique, and South Africa. METHODS: Treatment naive children aged <10 years were included. We calculated weight for age z scores (WAZs), height for age z scores (HAZs), and weight for height z scores (WHZs) up to 3 years after starting ART, by using the World Health Organization standards. Multilevel regression models were used. RESULTS: A total of 17 990 children (range, 238-8975) were followed for 36 181 person-years. At ART initiation, most children were underweight (50%) and stunted (66%). Lower baseline WAZ, HAZ, and WHZ were the most important determinants of faster catch-up growth on ART. WAZ and WHZ increased rapidly in the first year and stagnated or reversed thereafter, whereas HAZ increased continuously over time. Three years after starting ART, WAZ ranged from-2.80 (95% confidence interval [CI]:-3.66 to-2.02) to-1.98 (95% CI:-2.41 to 2 1.48) in children with a baseline z score <-3 and from-0.79 (95% CI:-1.62 to 0.02) to 0.05 (95% CI:-0.42 to 0.51) in children with a baseline WAZ >=-1. For HAZ, the corresponding range was-2.33 (95% CI:-2.62 to-2.02) to-1.27 (95% CI:-1.58 to-1.00) for baseline HAZ <-3 and 20.24 (95% CI:-0.56 to 0.15) to 0.84 (95% CI: 0.53 to 1.16) for HAZ >= 21. CONCLUSIONS: Despite a sustained growth response and catch-up growth in children with advanced HIV disease treated with ART, normal weights and heights are not achieved over 3 years of ART. Copyright 2012 by the American Academy of Pediatrics."									
200	Nutritional indicators of adverse pregnancy outcomes and mother-to-child transmission of HIV among HIV-infected women.	"Mehta S, Manji KP, Young AM, Brown ER, Chasela C, Taha TE, Read JS, et al."	American Journal of Clinical Nutrition. 2008;87(6):1639-49.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medc&AN=18541551	BACKGROUND: Poor nutrition may be associated with mother-to-child transmission (MTCT) of HIV and other adverse pregnancy outcomes.	"OBJECTIVE: The objective was to examine the relation of nutritional indicators with adverse pregnancy outcomes among HIV-infected women in Tanzania, Zambia, and Malawi."	"DESIGN: Body mass index (BMI; in kg/m(2)) and hemoglobin concentrations at enrollment and weight change during pregnancy were prospectively related to fetal loss, neonatal death, low birth weight, preterm birth, and MTCT of HIV."	"RESULTS: In a multivariate analysis, having a BMI < 21.8 was significantly associated with preterm birth [odds ratio (OR): 1.82; 95% CI: 1.34, 2.46] and low birth weight (OR: 2.09; 95% CI: 1.41, 3.08). A U-shaped relation between weight change during pregnancy and preterm birth was observed. Severe anemia was significantly associated with fetal loss or stillbirth (OR: 3.67; 95% CI: 1.16, 11.66), preterm birth (OR: 2.08; 95% CI: 1.39, 3.10), low birth weight (OR: 1.76; 95% CI: 1.07, 2.90), and MTCT of HIV by the time of birth (OR: 2.26; 95% CI: 1.18, 4.34) and by 4-6 wk among those negative at birth (OR: 2.33; 95% CI: 1.15, 4.73)."	"CONCLUSIONS: Anemia, poor weight gain during pregnancy, and low BMI in HIV-infected pregnant women are associated with increased risks of adverse infant outcomes and MTCT of HIV. Interventions that reduce the risk of wasting or anemia during pregnancy should be evaluated to determine their possible effect on the incidence of adverse pregnancy outcomes and MTCT of HIV."					
1106	Nutritional status and mortality among HIV-infected patients receiving antiretroviral therapy in Tanzania.	"Liu E, Spiegelman D, Semu H, Hawkins C, Chalamilla G, Aveika A, Nyamsangia S, et al."	Journal of Infectious Diseases. 2011;204(2):282-90.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=21673040	BACKGROUND: Poor nutritional status is associated with immunologic impairment and adverse health outcomes among adults infected with human immunodeficiency virus (HIV).	"METHODS: We investigated body mass index (BMI), middle upper arm circumference (MUAC), and hemoglobin (Hgb) concentrations at initiation of antiretroviral therapy (ART) in 18,271 HIV-infected Tanzanian adults and their changes in the first 3 months of ART, in relation to the subsequent risk of death."	"RESULTS: Lower BMI, MUAC, and Hgb concentrations at ART initiation were strongly associated with a higher risk of death within 3 months. Among patients who survived >3 months after ART initiation, those with a decrease in weight, MUAC, or Hgb concentrations by 3 months had a higher risk of death during the first year. After 1 year, only a decrease in MUAC by 3 months after ART initiation was associated with a higher risk of death. Weight loss was associated with a higher risk of death across all levels of baseline BMI, with the highest risk observed among patients with BMI <17 kg/m(2) (relative risk, 7.9; 95% confidence interval, 4.4-14.4)."	CONCLUSIONS: Poor nutritional status at ART initiation and decreased nutritional status in the first 3 months of ART were strong independent predictors of mortality. The role of nutritional interventions as adjunct therapies to ART merits further investigation.						
1090	Portion size estimation aids for Asian foods.	"Thoradeniya T, de Silva A, Arambepola C, Atukorala S, Lanerolle P."	Journal of Human Nutrition & Dietetics. 2012;25(5):497-504.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=22500981	"BACKGROUND: Portion size estimation is fundamental to the accuracy of dietary recall, as well as interventions in obesity. Data on portion size estimation aids (PSEA) for Asian foods are limited. PSEA for Asian foods were developed and their accuracy and precision were tested for inclusion in a food atlas."	"METHODS: Sixteen food items were selected to represent all food groups. Small and life size photographs were developed, and line diagrams were drawn. These, together with household utensils, were tested among a random sample of 80 schoolchildren (aged 10-16 years). A total of 3180 estimations were made: 876 for small photographs (n = 11 foods), 558 for life size photographs (n = 7 foods), 1271 for line diagrams (n = 16 foods) and 475 for household utensils (n = 6 foods)."	"RESULTS: Line diagrams had a high percentage (63.9%) of correct estimations and a low percentage of over estimations (18.0%) and under estimations (18.1%), whereas household utensils performed poorly with 0.6% correct estimations. Greater accuracy and precision were obtained for amorphous foods with small photographs and for non-amorphous foods with line diagrams. The combination of small photographs (for vegetables) and line diagrams (for other foods) achieved a high correlation (r = 0.959, P <= 0.001), percentage correct estimations (68.3%) and low under estimations (19.9%) and over estimations (11.8%). Food texture, but not age or sex, was associated with correct estimations in all of the PSEA, except household utensils."	"CONCLUSIONS: Accuracy and precision of a combination PSEA is convincing, enabling inclusion into an Asian food atlas for dietary assessment and intervention. 2012 The Authors Journal of Human Nutrition and Dietetics 2012 The British Dietetic Association Ltd."						
1584	Effects of PPAR gamma and RBP4 gene variants on metabolic syndrome in HIV-infected patients with anti-retroviral therapy.	"Hung Y, Lee N, Lin S, Chang H, Wu C, Chang C, Chen P, et al."	PLoS ONE. 2012;7(11).	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20133018965	"Background: PPAR gamma and RBP4 are known to regulate lipid and glucose metabolism and insulin resistance. The influences of PPAR gamma (C1431T and Pro12Ala) and RBP4 (-803GA) polymorphisms on metabolic syndrome in HIV-infected patients receiving anti-retroviral therapy were examined in this study. Materials and Methods: A cross-sectional study of HIV-1 infected adults with antiretroviral therapy for more than one year in the National Cheng Kung University Hospital was conducted. The gene polymorphisms were determined by quantitative PCR. Results: Ninety-one patients were included in the study. Eighty-two (90.1%) patients were males with a mean age of 44.4 years. For the C1431T polymorphism in PPAR gamma , while patients with the T allele (48.4%) had trends toward lower rate of hypertriglyceridemia, the borderline significance together with insignificant power did not support the protective effect of the T allele against development of hypertriglyceridemia. For the Pro12Ala polymorphism in PPAR gamma , although patients with the Pro/Ala genotype (8.8%) had a higher level of serum LDL (138.0 vs. 111.5 mg/dl, P=0.04) and trends toward higher rates of hypercholesterolemia and serum LDL>110 mg/dl, these variables were found to be independent of the Pro/Ala genotype in the multivariate analysis. For the -803GA polymorphism in RBP4, patients with the A allele (23.1%) more often had insulin resistance (HOMA>3.8; 33.3 vs. 8.7%, P=0.01) and more often received anti-hypoglycemic drugs (14.3 vs. 1.4%, P=0.04). The detrimental effect of the A allele in RBP4 -803GA polymorphism on development of insulin resistance was supported by the multivariate analysis adjusting for covariates. Conclusion: The impacts of PPAR gamma C1431T and Pro12Ala polymorphisms on metabolism in HIV-infected patients are not significant. RBP4 -803GA polymorphism has increased risk of insulin resistance in HIV-infected patients with anti-retroviral therapy."									
1555	Baseline predictors of efavirenz-related symptoms during the first six months of therapy.	"Sonenthal PD, Ratshaa B, Chimbengo G, Thero M, Rantleru T, Barenbaum S, Steenhoff A, et al."	Pharmacoepidemiology and Drug Safety. 2011 August;20:S141-S2.		"Background: Pre-treatment prediction of drug toxicity may help target interventions to improve tolerability of antiretroviral therapy (ART) and add to understanding of mechanisms of toxicity. Objectives: Evaluate the determinants of efavirenz (EFV)- associated CNS symptoms in Botswana. Methods: We enrolled a prospective cohort of HIV+ patients initiating EFV in Botswana. Demographics, height, weight, CD4+ count, alcohol use (using a modified AUDIT), and a nine item mood inventory were recorded at baseline. EFV-related side effects, the primary outcome, were measured at months 1 and 6 using an AIDS Clinical Trials Group checklist. We used multivariable linear regression to assess predictors of EFV checklist score. Results: We enrolled 151 patients with median age of 40 (range: 23 to 65); 96 (64%) were male. Median month 1 EFV score was 9 (IQR: 4 to 19). Median baseline weight was 60 kg (IQR: 54 to 70). EFV score was associated with baseline weight (-2.28 points per 10 kg increase (95% CI -3.7 to -0.87)), AUDIT score (-0.20 points per point increase (-0.38 to -0.03)) and mood score (1.67 points per point increase (0.66 to 2.67)). The adjusted R2 was 0.14. No confounders were identified. At month 6, median EFV score was 4 (IQR: 1 to 7). In the regression model of the 77 patients to date who completed month 6 visits, weight was the only variable to significantly predict month 6 EFV score with a point estimate of -1.44 points per 10 kg increase (-2.54 to -0.35). The adjusted R2 value was 0.07. No confounders were identified. Conclusions: While alcohol use and mood predicted EFV score at month 1, baseline weight predicted it at both months 1 and 6 of therapy. At month 1, a 20 kg decrease in baseline weight was comparable to the impact of slow EFV metabolism genotype, which has been associated with increased CNS side effects. Since all patients take the same dose of EFV, those with greater body mass may have lower EFV plasma concentrations. Further investigations which include CYP2B6 genotype as part of the predictive model are warranted. Clinicians should consider patients' weight, alcohol use, and mood when prescribing efavirenz to plan for better side effect education and management."									
71	"Antiretroviral therapy in pregnant women with advanced HIV disease and pregnancy outcomes in Abidjan, Cote d'Ivoire."	"Ekouevi DK, Coffie PA, Becquet R, Tonwe-Gold B, Horo A, Thiebaut R, Leroy V, et al."	Aids. 2008 12 Sep;22(14):1815-20.		"BACKGROUND: Pregnancy outcomes in women receiving highly active antiretroviral treatment (HAART) in Africa are not well described. METHODS: HIV-1-infected pregnant women in the ANRS Ditrame Plus and the MTCT-Plus projects were included. Between March 2001 and July 2003, when HAART was not yet available, women eligible for HAART received a short-course antiretroviral regimen, zidovudine (ZDV) or (ZDV + lamivudine) and single dose of nevirapine for preventing mother-to-child transmission (PMTCT group). Between August 2003 and August 2007, eligible women for HAART received it (HAART group). The frequencies of low birth weight (LBW) (<2500 g), stillbirth and infant mortality are reported. Risk factors associated with LBW were investigated using a logistic regression model. RESULTS: Of the 326 HIV-infected pregnant women, 175 women received short-course antiretroviral (median CD4 cell count 177 cells/mul) and 151 received HAART (median CD4 cell count 182 cells/mul). At 12 months, three paediatric infections (2.3%) occurred in the HAART group vs. 25 (16.1%) in the PMTCT group (P < 0.001). The rate of LBW was 22.3% in the HAART group and 12.4% in the PMTCT group (P <= 0.02). In multivariable analysis (n <= 309), after adjustment on maternal CD4 cell count, WHO stage, age and maternal BMI, HAART initiated before pregnancy [adjusted odds ratio (OR) 2.88, 95% confidence interval (CI) 1.10-7.51] and during pregnancy (adjusted OR 2.12, 95% CI 1.15-4.65) and maternal BMI at delivery (adjusted OR 2.43, 95% CI 1.20-4.91) were associated with LBW. CONCLUSION: HAART in pregnant African women with advanced HIV disease substantially reduced mother-to-child transmission, but was associated with LBW. 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins."									
952	Clinical outcomes of a comprehensive integrated program for HIV-exposed infants: a 3-year experience promoting HIV-free survival in rural Rwanda.	"Neil G, Cyamatare FR, Niyigena P, Niyigena JW, Stulac S, Mugwaneza P, Drobac P, et al."	"JAIDS, Journal of Acquired Immune Deficiency Syndromes. 2013;62(4):e109-e14."	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20133115687	"Background: Prevention of mother-to-child transmission of HIV services are often inadequate in promoting HIV-free child survival in rural areas with limited resources. An integrated comprehensive child survival program in rural Rwanda with special emphasis on HIV-exposed infants was established in 2005 and scaled-up. The objective of this study was to report program outcomes and identify predictors of program retention. Methods: We conducted a retrospective study of infants born to HIV-infected women enrolled in the program at or before birth from March 1, 2007, to February 28, 2010, in Eastern Rwanda. Key program elements included improved access to health care, antiretroviral prophylaxis for prevention of mother-to-child transmission of HIV, clean water sources and replacement feeding, home visits by community health workers, prevention and treatment of childhood illness, nutritional support, family planning, and socioeconomic support for the extremely vulnerable. Results: Overall,1038 infants enrolled in the program in the study period during which time there was a 4-fold increase in the number of current participants. Uptake of contraception and treatment for diarrheal disease were high. The 18-month survival probability and retention probability were 0.93 (95% confidence interval: 0.91 to 0.94) and 0.88 (95% confidence interval: 0.86 to 0.90), respectively. Twenty-seven (2.6%) children tested positive for HIV, of which 1 died and none were lost-to-follow-up at 18 months. No statistically significant predictors of retention were identified. Conclusions: Our findings demonstrate that a comprehensive integrated program to promote HIV-free survival can achieve high rates of retention and survival in a highly vulnerable population, even during a period of rapid growth."									
1612	Zinc or multiple micronutrient supplementation to reduce diarrhea and respiratory disease in South African children: a randomized controlled trial.	"Luabeya KK, Mpontshane N, Mackay M, Ward H, Elson I, Chhagan M, Tomkins A, et al."	PLoS ONE [Electronic Resource]. 2007;2(6):e541.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=17593956	"BACKGROUND: Prophylactic zinc supplementation has been shown to reduce diarrhea and respiratory illness in children in many developing countries, but its efficacy in children in Africa is uncertain."	"OBJECTIVE: To determine if zinc, or zinc plus multiple micronutrients, reduces diarrhea and respiratory disease prevalence."	"DESIGN: Randomized, double-blind, controlled trial."	SETTING: Rural community in South Africa.	PARTICIPANTS: THREE COHORTS: 32 HIV-infected children; 154 HIV-uninfected children born to HIV-infected mothers; and 187 HIV-uninfected children born to HIV-uninfected mothers.	"INTERVENTIONS: Children received either 1250 IU of vitamin A; vitamin A and 10 mg of zinc; or vitamin A, zinc, vitamins B1, B2, B6, B12, C, D, E, and K and copper, iodine, iron, and niacin starting at 6 months and continuing to 24 months of age. Homes were visited weekly."	"OUTCOME MEASURES: Primary outcome was percentage of days of diarrhea per child by study arm within each of the three cohorts. Secondary outcomes were prevalence of upper respiratory symptoms and percentage of children who ever had pneumonia by maternal report, or confirmed by the field worker."	"RESULTS: Among HIV-uninfected children born to HIV-infected mothers, median percentage of days with diarrhea was 2.3% for 49 children allocated to vitamin A; 2.5% in 47 children allocated to receive vitamin A and zinc; and 2.2% for 46 children allocated to multiple micronutrients (P = 0.852). Among HIV-uninfected children born to HIV-uninfected mothers, median percentage of days of diarrhea was 2.4% in 56 children in the vitamin A group; 1.8% in 57 children in the vitamin A and zinc group; and 2.7% in 52 children in the multiple micronutrient group (P = 0.857). Only 32 HIV-infected children were enrolled, and there were no differences between treatment arms in the prevalence of diarrhea. The prevalence of upper respiratory symptoms or incidence of pneumonia did not differ by treatment arms in any of the cohorts."	"CONCLUSION: When compared with vitamin A alone, supplementation with zinc, or with zinc and multiple micronutrients, did not reduce diarrhea and respiratory morbidity in rural South African children."	TRIAL REGISTRATION: ClinicalTrials.gov NCT00156832.
801	Background morbidity in HIV vaccine trial participants from various geographic regions as assessed by unsolicited adverse events.	"Schmidt C, Smith C, Barin B, Bakhtyari A, Bart PA, Bekker LG, Chomba E, et al."	Human Vaccines and Immunotherapeutics. 2012 May;8(5):630-8.		"Background: Recently, more clinical trials are being conducted in Africa and Asia, therefore, background morbidity in the respective populations is of interest. Between 2000 and 2007, the International AIDS Vaccine Initiative sponsored 19 Phase 1 or 2A preventive HIV vaccine trials in the US, Europe, Sub-Saharan Africa and India, enrolling 900 healthy HIV-1 uninfected volunteers. Objective:To assess background morbidity as reflected by unsolicited adverse events (AEs), unrelated to study vaccine, reported in clinical trials from four continents. Methods:All but three clinical trials were double-blind, randomized, and placebo-controlled. Study procedures and data collection methods were standardized. The frequency and severity of AEs reported during the first year of the trials were analyzed. To avoid confounding by vaccine-related events, solicited reactogenicity and other AEs occurring within 28 d after any vaccination were excluded. Results:In total, 2134 AEs were reported by 76% of all participants; 73% of all events were mild. The rate of AEs did not differ between placebo and vaccine recipients. Overall, the percentage of participants with any AE was higher in Africa (83%) compared with Europe (71%), US (74%) and India (65%), while the percentage of participants with AEs of moderate or greater severity was similar in all regions except India. In all regions, the most frequently reported AEs were infectious diseases, followed by gastrointestinal disorders. Conclusions:Despite some regional differences, in these healthy participants selected for low risk of HIV infection, background morbidity posed no obstacle to clinical trial conduct and interpretation. Data from controlled clinical trials of preventive interventions can offer valuable insights into the health of the eligible population."									
1420	A randomized trial of multivitamin supplements and HIV disease progression and mortality.	"Fawzi WW, Msamanga GI, Spiegelman D, Wei R, Kapiga S, Villamor E, Mwakagile D, et al."	New England Journal of Medicine. 2004;351(1):23-32.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=15229304	BACKGROUND: Results from observational studies suggest that micronutrient status is a determinant of the progression of human immunodeficiency virus (HIV) disease.	"METHODS: We enrolled 1078 pregnant women infected with HIV in a double-blind, placebo-controlled trial in Dar es Salaam, Tanzania, to examine the effects of daily supplements of vitamin A (preformed vitamin A and beta carotene), multivitamins (vitamins B, C, and E), or both on progression of HIV disease, using survival models. The median follow-up with respect to survival was 71 months (interquartile range, 46 to 80)."	"RESULTS: Of 271 women who received multivitamins, 67 had progression to World Health Organization (WHO) stage 4 disease or died--the primary outcome--as compared with 83 of 267 women who received placebo (24.7 percent vs. 31.1 percent; relative risk, 0.71; 95 percent confidence interval, 0.51 to 0.98; P=0.04). This regimen was also associated with reductions in the relative risk of death related to the acquired immunodeficiency syndrome (0.73; 95 percent confidence interval, 0.51 to 1.04; P=0.09), progression to WHO stage 4 (0.50; 95 percent confidence interval, 0.28 to 0.90; P=0.02), or progression to stage 3 or higher (0.72; 95 percent confidence interval, 0.58 to 0.90; P=0.003). Multivitamins also resulted in significantly higher CD4+ and CD8+ cell counts and significantly lower viral loads. The effects of receiving vitamin A alone were smaller and for the most part not significantly different from those produced by placebo. Adding vitamin A to the multivitamin regimen reduced the benefit with regard to some of the end points examined."	"CONCLUSIONS: Multivitamin supplements delay the progression of HIV disease and provide an effective, low-cost means of delaying the initiation of antiretroviral therapy in HIV-infected women. Copyright 2004 Massachusetts Medical Society"						
412	"Growth, immune and viral responses in HIV infected African children receiving highly active antiretroviral therapy: A prospective cohort study."	"Musoke PM, Mudiope P, Barlow-Mosha LN, Ajuna P, Bagenda D, Mubiru MM, Tylleskar T, et al."	BMC Pediatrics. 2010 06 Aug;10(56).		"Background: Scale up of paediatric antiretroviral therapy in resource limited settings continues despite limited access to routine laboratory monitoring. We documented the weight and height responses in HIV infected Ugandan children on highly active antiretroviral therapy and determined clinical factors associated with successful treatment outcomes.Methods: A prospective cohort of HIV infected children were initiated on HAART and followed for 48 weeks. Body mass index for age z scores(BAZ), weight and height-for-age z scores (WAZ & HAZ) were calculated: CD4 cell % and HIV-1 RNA were measured at baseline and every 12 weeks. Treatment outcomes were classified according to; both virological and immunological success (VS/IS), virological failure and immunological success (VF/IS). virological success and immunological failure (VS/IF) and both virological and immunological failure (VF/IF).Results: From March 2004 until May 2006, 124 HIV infected children were initiated on HAART. The median age (IQR) was 5.0 years (2.1 - 7.0) and 49% (61/124) were female. The median [95% confidence interval (CI)] BAZ, WAZ and HAZ at baseline were 0.29 (-2.9, -1.2), -1.2 (-2.1, -0.5) and -2.06 (-2.9, -1.2) respectively. Baseline median CD4 cell % and log10 HIV-1 RNA were; 11.8% (7.5-18.0) and 5.6 (5.2-5.8) copies/ml. By 48 weeks, mean WAZ and HAZ in the VF/IS group, which was younger, increased from - 0.98 (SD 1.7) to + 1.22 (SD 1.2) and from -1.99 (1.7) to + 0.76 (2.4) respectively. Mean increase in WAZ and HAZ in the VS/IF group, an older group was modest, from -1.84 (1.3) to - 0.41 (1.2) and -2.25 (1.2) to -1.16 (1.3) respectively. Baseline CD4 cell % [OR 6.97 95% CI (2.6 -18.6)], age [OR 4.6 95% CI (1.14 -19.1)] and WHO clinical stage [OR 3.5 95%CI (1.05 -12.7)] were associated with successful treatment outcome.Conclusions: HIV infected Ugandan children demonstrated a robust increase in height and weight z scores during the first 48 weeks of HAART, including those who failed to completely suppress virus. Older children initiating HAART with severe immune suppression were less likely to achieve a successful treatment outcome. These data emphasize the importance of initiating HAART early to ensure adequate immune and growth responses. 2010 Musoke et al; licensee BioMed Central Ltd."									
177	"Use of serum retinol-binding protein for prediction of vitamin A deficiency: effects of HIV-1 infection, protein malnutrition, and the acute phase response."	"Baeten JM, Richardson BA, Bankson DD, Wener MH, Kreiss JK, Lavreys L, Mandaliya K, et al."	American Journal of Clinical Nutrition. 2004;79(2):218-25.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=14749226	"BACKGROUND: Serum retinol is the most commonly used indicator of vitamin A status. Retinol is transported in a 1-to-1 complex with retinol-binding protein (RBP). RBP is easy and inexpensive to measure, and studies have shown a high correlation between concentrations of RBP and concentrations of retinol. The performance of RBP in the context of infection or protein malnutrition, however, has not been evaluated."	"OBJECTIVE: Our aim was to determine whether RBP is a good surrogate measure for retinol in the context of HIV-1 infection, protein malnutrition, and the acute phase response."	DESIGN: The relation between RBP and retinol was examined in a cross-sectional study of 600 Kenyan women.	"RESULTS: There was a high correlation between concentrations of RBP and those of retinol (r = 0.88). When equimolar cutoffs were used, RBP predicted marginal vitamin A status (retinol < 1.05 micro mol/L) with 93% sensitivity and 75% specificity and vitamin A deficiency (retinol < 0.70 micro mol/L) with 91% sensitivity and 94% specificity. Similarly high sensitivities and specificities were found among subgroups with HIV-1 infection, a positive acute phase response, and protein malnutrition. Protein malnutrition and a positive acute phase response were common, especially among HIV-1-infected women, and were independently and synergistically associated with lower RBP concentrations."	"CONCLUSIONS: Equimolar RBP cutoffs predict vitamin A deficiency with high sensitivity and specificity, even in the context of infection and protein malnutrition. Like retinol, RBP may not accurately identify true vitamin A status under all conditions, because the acute phase response and protein malnutrition depress RBP concentrations. However, RBP may be a simple, inexpensive tool for assessment of vitamin A deficiency in population studies."					
1874	[Malnutrition and infections in children--a destructive interplay with global dimensions].	"Bohler E, Wathne KO."	Tidsskrift for Den Norske Laegeforening. 2000;120(15):1740-5.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=10904660	"BACKGROUND: Seven out of ten deaths among the world's children are caused by infectious diseases. Malnutrition is a contributing cause in more than half of the children's deaths. At present, interventions against such diseases in children are the most cost-effective way of reducing the world's morbidity and mortality."	"MATERIAL AND METHODS: This paper discusses how nutritional status affects the immune defence, and vice versa. General protein and energy malnutrition and some specific nutrients are discussed. The paper is based on review of recent literature found in Medline, and key references in the papers identified."	"RESULTS: Malnutrition is the most common cause of acquired immune deficiency in children. Malnourished children are especially prone to develop persistent diarrhoea, which in turn aggravates the nutritional status. Iron deficiency may be caused or worsened by hookworm and a number of other gastrointestinal infections. There are indications that iron deficiency in itself reduces the immune defence. Vitamin A supplements have reduced the mortality of measles and other infectious diseases. Some studies have shown reduced vertical transmission of HIV when pregnant women get vitamin A supplements. Chronic diarrhoea may cause zinc deficiency which may aggravate the diarrhoea. In areas where the general population's zinc status is marginal, zinc supplementation has reduced the incidence and duration of persistent diarrhoea."	"INTERPRETATION: The interaction between malnutrition and common infections in children causes a considerable fraction of the global burden of disease, yet so far this is not reflected in research, which mainly targets the diseases of the rich. [References: 91]"						
1616	Diarrhoea complicating severe acute malnutrition in Kenyan children: a prospective descriptive study of risk factors and outcome.	"Talbert A, Thuo N, Karisa J, Chesaro C, Ohuma E, Ignas J, Berkley JA, et al."	PLoS ONE [Electronic Resource]. 2012;7(6):e38321.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=22675542	"BACKGROUND: Severe acute malnutrition (SAM) accounts for two million deaths worldwide annually. In those hospitalised with SAM, concomitant infections and diarrhoea are frequent complications resulting in adverse outcome. We examined the clinical and laboratory features on admission and outcome of children with SAM and diarrhoea at a Kenyan district hospital."	"METHODS: A 4-year prospective descriptive study involving 1,206 children aged 6 months to 12 years, hospitalized with SAM and managed in accordance with WHO guidelines. Data on clinical features, haematological, biochemical and microbiological findings for children with diarrhoea (>= 3 watery stools/day) were systematically collected and analyzed to identify risk factors associated with poor outcome."	"RESULTS: At admission 592 children (49%) had diarrhoea of which 122 (21%) died compared to 72/614 (12%) deaths in those without diarrhoea at admission (X(2) = 17.6 p<0.001). A further 187 (16%) children developed diarrhoea after 48 hours of admission and 33 died (18%). Any diarrhoea during admission resulted in a significantly higher mortality 161/852 (19%) than those uncomplicated by diarrhoea 33/351 (9%) (X(2) = 16.6 p<0.001). Features associated with a fatal outcome in children presenting with diarrhoea included bacteraemia, hyponatraemia, low mid-upper arm circumference <10 cm, hypoxia, hypokalaemia and oedema. Bacteraemia had the highest risk of death (adjusted OR 6.1; 95% C.I 2.3, 16.3 p<0.001); and complicated 24 (20%) of fatalities. Positive HIV antibody status was more frequent in cases with diarrhoea at admission (23%) than those without (15%, X(2) = 12.0 p = 0.001) but did not increase the risk of death in diarrhoea cases."	CONCLUSION: Children with SAM complicated by diarrhoea had a higher risk of death than those who did not have diarrhoea during their hospital stay. Further operational and clinical research is needed to reduce mortality in children with SAM in the given setting.						
1296	Probiotics and prebiotics for severe acute malnutrition (PRONUT study): a double-blind efficacy randomised controlled trial in Malawi.	"Kerac M, Bunn J, Seal A, Thindwa M, Tomkins A, Sadler K, Bahwere P, et al."	Lancet. 2009;374(9684):136-44.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=19595348	BACKGROUND: Severe acute malnutrition affects 13 million children worldwide and causes 1-2 million deaths every year. Our aim was to assess the clinical and nutritional efficacy of a probiotic and prebiotic functional food for the treatment of severe acute malnutrition in a HIV-prevalent setting.	"METHODS: We recruited 795 Malawian children (age range 5 to 168 months [median 22, IQR 15 to 32]) from July 12, 2006, to March 7, 2007, into a double-blind, randomised, placebo-controlled efficacy trial. For generalisability, all admissions for severe acute malnutrition treatment were eligible for recruitment. After stabilisation with milk feeds, children were randomly assigned to ready-to-use therapeutic food either with (n=399) or without (n=396) Synbiotic2000 Forte. Average prescribed Synbiotic dose was 10(10) colony-forming units or more of lactic acid bacteria per day for the duration of treatment (median 33 days). Primary outcome was nutritional cure (weight-for-height >80% of National Center for Health Statistics median on two consecutive outpatient visits). Secondary outcomes included death, weight gain, time to cure, and prevalence of clinical symptoms (diarrhoea, fever, and respiratory problems). Analysis was on an intention-to-treat basis. This trial is registered as an International Standard Randomised Controlled Trial, number ISRCTN19364765."	"FINDINGS: Nutritional cure was similar in both Synbiotic and control groups (53.9% [215 of 399] and 51.3% [203 of 396]; p=0.40). Secondary outcomes were also similar between groups. HIV seropositivity was associated with worse outcomes overall, but did not modify or confound the negative results. Subgroup analyses showed possible trends towards reduced outpatient mortality in the Synbiotic group (p=0.06)."	"INTERPRETATION: In Malawi, Synbiotic2000 Forte did not improve severe acute malnutrition outcomes. The observation of reduced outpatient mortality might be caused by bias, confounding, or chance, but is biologically plausible, has potential for public health impact, and should be explored in future studies."	FUNDING: Department for International Development (DfID).					
1303	The effect of an integrated multisector model for achieving the Millennium Development Goals and improving child survival in rural sub-Saharan Africa: A non-randomised controlled assessment.	"Pronyk PM, Muniz M, Nemser B, Somers MA, McClellan L, Palm CA, Huynh UK, et al."	The Lancet. 2012 June;379(9832):2179-88.		"Background: Simultaneously addressing multiple Millennium Development Goals (MDGs) has the potential to complement essential health interventions to accelerate gains in child survival. The Millennium Villages project is an integrated multisector approach to rural development operating across diverse sub-Saharan African sites. Our aim was to assess the effects of the project on MDG-related outcomes including child mortality 3 years after implementation and compare these changes to local comparison data. Methods: Village sites averaging 35 000 people were selected from rural areas across diverse agroecological zones with high baseline levels of poverty and undernutrition. Starting in 2006, simultaneous investments were made in agriculture, the environment, business development, education, infrastructure, and health in partnership with communities and local governments at an annual projected cost of US$120 per person. We assessed MDG-related progress by monitoring changes 3 years after implementation across Millenium Village sites in nine countries. The primary outcome was the mortality rate of children younger than 5 years of age. To assess plausibility and attribution, we compared changes to reference data gathered from matched randomly selected comparison sites for the mortality rate of children younger than 5 years of age. Analyses were done on a per-protocol basis. This trial is registered with ClinicalTrials.gov, number NCT01125618. Findings: Baseline levels of MDG-related spending averaged $27 per head, increasing to $116 by year 3 of which $25 was spent on health. After 3 years, reductions in poverty, food insecurity, stunting, and malaria parasitaemia were reported across nine Millennium Village sites. Access to improved water and sanitation increased, along with coverage for many maternal-child health interventions. Mortality rates in children younger than 5 years of age decreased by 22 in Millennium Village sites relative to baseline (absolute decrease 25 deaths per 1000 livebirths, p=0015) and 32 relative to matched comparison sites (30 deaths per 1000 livebirths, p=0033). Interpretation: An integrated multisector approach for addressing the MDGs can produce rapid declines in child mortality in the first 3 years of a long-term effort in rural sub-Saharan Africa. Funding: UN Human Security Trust Fund, the Lenfest Foundation, Bill & Melinda Gates Foundation, and Becton Dickinson. 2012 Elsevier Ltd."									
400	Prevalence of chronic kidney disease among people living with HIV/AIDS in Burundi: A cross-sectional study.	"Cailhol J, Nkurunziza B, Izzedine H, Nindagiye E, Munyana L, Baramperanye E, Nzorijana J, et al."	BMC Nephrology. 2011;12(1).		"Background: Since little is known about chronic kidney disease (CKD) among people living with HIV/AIDS (PLWHA) in Sub-Saharan Africa, the prevalence and nature of CKD were assessed in Burundi through a multicenter cross-sectional study. Methods. Patients underwent assessments at baseline and 3 months later. Glomerular Filtration Rate (GFR) was estimated using abbreviated 4-variable Modification of Diet in Renal Diseases (MDRD) and Cockroft-Gault estimation methods. Patients were classified at month 3 into various CKD stages using the National Kidney Foundation (NKF) definition, which combines GFR and urinary abnormalities. Risk factors for presence of proteinuria (PRO) and aseptic leukocyturia (LEU) were further analyzed using multiple logistic regression. Results: Median age of the patients in the study (N = 300) was 40 years, 70.3% were female and 71.7% were on highly active antiretroviral therapy. Using the MDRD method, CKD prevalence in patients was 45.7%, 30.2% of whom being classified as stage 1 according to the NKF classification, 13.5% as stage 2 and 2% as stage 3. No patient was classified as stage 4 or 5. Among CKD patients with urinary abnormality, PRO accounted for 6.1% and LEU for 18.4%. Significant associations were found between LEU and non-steroidal anti-inflammatory drug (NSAID) use, previous history of tuberculosis, low body mass index and female gender and between PRO and high viral load. Conclusion: Our study, using a very sensitive definition for CKD evaluation, suggests a potentially high prevalence of CKD among PLWHA in Burundi. Patients should be regularly monitored and preventative measures implemented, such as monitoring NSAID use and adjustment of drug dosages according to body weight. Urine dipsticks could be used as a screening tool to detect patients at risk of renal impairment. 2011 Cailhol et al; licensee BioMed Central Ltd."									
793	High incidence of overweight and obesity in a South London HIV clinic.	"Tate H, McCormick C."	HIV Medicine. 2012 April;13:57.		"Background: Since the advent of HAART malnutrition has receded, and a problem of overweight and obesity is emerging amongst the HIV positive. There is little UK data on the true extent of the problem. Better understanding of obesity in the HIV positive population could lead to better health promotion strategies. Method: Body Mass Index was collected on all clinic attenders in 2010. BMI data were analysed by gender and ethnicity. Here we present data for the clinic's 3 major ethnic groups as numbers in other groups were too small to be significant. A statistical analysis (independent t test) was also carried out to determine whether those on ART had higher BMIs than those not on treatment. Results: A total of 1040 measurements are presented. High levels of overweight and obesity were found using WHO BMI classification. Obesity rates were higher in women overall, and highest in Caribbean women (although total number was small for this group). Black African women had an obesity rate of 41%, similar to the level of obesity of 38% in general female African population in England (Health Survey for England 2004). Rates of underweight (BMI< 18.5) are not presented, but accounted for less than 2% in all groups except white women (8.5%). Independent T test showed no statistical difference between those on ART and those not on ART, once those with CD4< 200 were excluded from both groups (as more likely to be unwell and have suppressed appetite). P value was 0.7096 for women and 0.8956 for men. However numbers not on ART were much lower than numbers on ART (n=407 vs n=39 in women, and n= 490 vs n=99 in men). (Table Presented) Conclusion: In a sample of 1040 patients, high rates of overweight and obesity were detected. Incidence was highest amongst African and Caribbean women. There was no statistical difference in BMI between those on, or not on ART."									
489	CaroVIH study: Cardiovascular risk and ventricular function evaluation in HIV-infected children and young adults.	"Alvarez Fuente M, Sainz Costa T, Rodriguez Lopez A, Diaz L, Medrano C, Navarro ML, Ramos JT, et al."	Cardiology in the Young. 2013 May;23:S18.		"Background: Since the introduction of antiretroviral therapy (ART) HIV-infected patients have a higher rate of agingrelated diseases, including cardiovascular disease (CVD). Studies in HIV-infected adults have evidenced the presence of premature atherosclerosis and ventricular dysfunction, due to the virus and prolonged ART. Ultrasound techniques, like carotid intima-media thickness (IMT) measurement and Speckle Tracking Echocardiography (STE) could serve as early markers of CVD. Methods: Multicentre study including vertically HIVinfected children and young adults matched with controls by age and sex. Clinical and analytical variables were recorded. A portable echo-device (Philips CX50) was used during the complete study to measure IMT and to perform a complete echocardiography: M-Mode (shortening fraction (SF) and ejection fraction (EF)), 2D-echo, Doppler, tissue Doppler and STE. Results: 300 subjects were included (150 HIV-infected and 150 controls). Mean age was 14.8+/-4.9 years, 62% were female. Age, gender, body-mass index, smoking status, hypertension and hypercholesterolemia was similar in both groups. IMT was thicker in HIV-infected subjects compared to healthy individuals (mm) (0.434+/-0.025 vs 0.424+/-0.018, respectively, p<0.001). A complete echocardiographic study was done in148 participants, 77cases and 71 controls: HIV-infected subjects showed a lower systolic function (SF 36,3% (SD 6,41) and EF 66,2% (SD 8,39)) versus (SF 40,6% (SD 6,88) and EF 71,3% (SD 7,51)) (p<0.001) (all values within normal ranges). No differences were found in diastolic function and tissue Doppler examination. Ventricular torsion was greater in HIVinfected: 6,068 (SD 2,25) versus 5,498 (SD 1,97) (p=0.09). Longitudinal strain was analyzed in 54 subjects (28 cases and 24 controls), being -21,54% in HIV-infected and 222,29% in cases (p=0.299). Conclusion: Since childhood, cardiovascular risk, determined by IMT, is increased in HIV-infected subjects. Also EF and SF are lower in comparison to controls. Longitudinal strain impairment, which correlates with atherosclerosis, is not present in our cohort. Ventricular torsion is increased, in accordance with a senescent myocardium. Our results suggest that at adolescent age, HIV-infected patients have a premature myocardial tissue aging and not yet affection in tissue perfusion even though higher cardiovascular risk is present."									
752	Self-reported health and health care use in an ageing population in the Agincourt sub-district of rural South Africa.	"Gomez-Olive FX, Thorogood M, Clark B, Kahn K, Tollman S."	Glob Health Action. 2013;6:19305.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=23364087	"BACKGROUND: South Africa is experiencing a demographic and epidemiological transition with an increase in population aged 50 years and older and rising prevalence of non-communicable diseases. This, coupled with high HIV and tuberculosis prevalence, puts an already weak health service under greater strain."	"OBJECTIVE: To measure self-reported chronic health conditions and chronic disease risk factors, including smoking and alcohol use, and to establish their association with health care use in a rural South African population aged 50 years or older."	"METHODS: The Study on Global Ageing and Adult Health (SAGE), in collaboration with the INDEPTH Network and the World Health Organization, was implemented in the Agincourt sub-district in rural northeast South Africa where there is a long-standing health and socio-demographic surveillance system. Household-based interviews were conducted in a random sample of people aged 50 years and older. The interview included questions on self-reported health and health care use, and some physical measurements, including blood pressure and anthropometry."	"RESULTS: Four hundred and twenty-five individuals aged 50 years or older participated in the study. Musculoskeletal pain was the most prevalent self-reported condition (41.7%; 95% Confidence Interval [CI] 37.0-46.6) followed by hypertension (31.2%; 95% CI 26.8-35.9) and diabetes (6.1%; 95% CI 4.1-8.9). All self-reported conditions were significantly associated with low self-reported functionality and quality of life, 57% of participants had hypertension, including 44% of those who reported normal blood pressure. A large waist circumference and current alcohol consumption were associated with high risk of hypertension in men, whereas in women, old age, high waist-hip ratio, and less than 6 years of formal education were associated with high risk of hypertension. Only 45% of all participants reported accessing health care in the last 12 months. Those who reported higher use of the health facilities also reported lower levels of functioning and quality of life."	"CONCLUSIONS: Self-reported chronic health conditions, especially hypertension, had a high prevalence in this population and were strongly associated with higher levels of health care use. The primary health care system in South Africa will need to provide care for people with non-communicable diseases."					
33	Tuberculosis in rural Uganda.	Olle-Goig JE.	African Health Sciences. 2010;10(3):226-9.		"Background: St Francis Hospital, a health facility in the rural district of Mayuge, Uganda. Objectives: To evaluate the presentation, course and outcome of patients with tuberculosis hospitalized to receive the intensive phase of treatment. Method: Observational analytical study of all patients admitted during June 2002-March 2005. Results: There were 680 patients. Their median age was 31 years (range 2-75); 364 (54 %) were male. There were 564 (83 %) new patients; 60 (9 %) defaulters; 35 (5 %) relapses; 14 (2 %) transfers; four chronic patients; and three treatment failures. Three hundred and thirteen patients (58 %) had moderate or severe malnutrition on admission. Among 102 patients tested for the human immunodeficiency virus, 68 (67 %) were positive. At the end of hospitalization 593 patients (87 %) were to be followed-up at St Francis Hospital or were transferred to another health facility, 31 (5 %) had absconded and 56 (8 %) had died. Conclusion: The severely limited resources of our patients and the human immunodeficiency virus co-infection are likely factors contributing to their late presentation and the severity of the disease. It is doubtful that in our setting tuberculosis can be effectively controlled without addressing and correcting these factors."									
1080	Steatosis in chronic hepatitis C: Relationship to the virus and host risk factors.	"Matos CAL, Perez RM, Pacheco MS, Figueiredo-Mendes CG, Lopes-Neto E, Oliveira Jr EB, Lanzoni VP, et al."	Journal of Gastroenterology and Hepatology. 2006 August;21(8):1236-9.		"Background: Steatosis occurs frequently in hepatitis C. However, the mechanisms leading to this lesion are still unknown, and the role of steatosis in the progression of the disease remains controversial. The aim of the present paper was to determine the prevalence of steatosis in hepatitis C and its association with hepatitis C virus (HCV) genotype, viral load and the presence of risk factors for steatosis, and to analyze the association between steatosis and the intensity of liver disease. Methods: Patients infected with HCV who underwent liver biopsy were included. Patients coinfected with hepatitis B virus and/or human immunodeficiency virus and those previously treated for hepatitis C were excluded. The following risk factors for steatosis were investigated: obesity (body mass index [BMI] > 25 kg/m<sup>2</sup>), diabetes mellitus, hyperlipidemia, alcoholism, and use of potential steatosis-inducing drugs. Histological analysis evaluated the presence of steatosis, the degree of periportal activity and staging. Patients with and without steatosis were compared regarding demographic, epidemiological, laboratory and histological characteristics. Logistic regression analysis was applied to identify variables that were independently associated with the presence of steatosis. Results: Ninety patients (55 men, 35 women) with a mean age of 45 +/- 13 years were included. The prevalence of steatosis was 67%. Variables that remained independently associated with steatosis were age, female gender, obesity and genotype 3. Conclusions: The prevalence of steatosis in hepatitis C was high. Risk factors usually related to steatosis such as age, female gender and obesity, as well as genotype 3, were independently associated with the presence of steatosis. Steatosis was not independently associated with the intensity of histological liver disease. 2006 Journal of Gastroenterology and Hepatology Foundation and Blackwell Publishing Asia Pty Ltd."									
1083	"Food insecurity, BMI and dietary diversity in rwandan HIV + women."	"Sirotin N, Hoover D, Segal-Isaacson CJ, Shi Q, Mutimura E, Cohen M, Anastos K."	Journal of General Internal Medicine. 2011 May;26:S300-S1.		"BACKGROUND: Structural determinants, including poverty, low literacy levels and lack of access to electricity, are increasingly identified as important for health outcomes. Also important are nutrition-related determinants of health, including food insecurity, low BMI and low dietary diversity, which are common in areas with high HIV prevalence. Food insecurity, defined as ""the limited availability of nutritionally adequate foods or inability to acquire acceptable foods in socially acceptable ways,"" was found to be associated with low CD4 counts, virologic failure and mortality in HIV + patients. Low BMI (<18.5 kg/m2) is a strong predictor for mortality in HIV + patients starting ART, with higher mortality in patients who are both food insecure and underweight versus underweight but food secure. In addition, consuming fewer distinct food groups (low dietary diversity) has been found to contribute to poor health outcomes in African women. In order to elucidate potential interventions to prevent food insecurity and malnutrition in persons with HIV infection, we examined the prevalence and sociodemographic associations of food insecurity, BMI, and household dietary diversity in HIV + women in Kigali, Rwanda. We also examined the correlation between food insecurity, low BMI and low dietary diversity in these women. METHODS: The Rwanda Women's Interassociation Study and Assessment (RWISA, initiated in 2005) is a prospective observational cohort study designed to assess the effectiveness and toxicity of antiretroviral therapy (ART) in HIV-infected Rwandan women. From July to December 2007, sociodemographic data and BMI were obtained for 622 HIV + women enrolled in RWISA. The Household Dietary Diversity Score (HDDS), a validated survey, measures household food consumption over the previous 24 hours, giving one point for each food class (total 12 possible), with <3 classes defined as low dietary diversity. Food insecurity was assessed using a single question, ""Do you have enough food?"" Logistic regression identified factors associated with food insecurity, low dietary diversity and low BMI. Spearman correlation assessed relationships between food insecurity, BMI and dietary diversity. RESULTS: Prevalence of poverty was high [35% reporting monthly income <10 K Rwandan Francs (FRW) ($US 17)], as was illiteracy (23%), and 22% of women reported no formal education. 53% had CD4 counts <350 cells/mul and 70% were taking antiretroviral therapy. Food insecurity was reported by 44% and low dietary diversity by 43%. The mean BMI was 22.4 kg/m2 and 12% of women had BMI < 18.5 kg/m2. Food insecurity (answering ""usually not or never"" to ""Do you have enough food?"") was inversely associated with high monthly income (>35 K FRW, $US 58 vs. <10 K FRW ) (Odds ratio (OR)=0.43; 95% CI 0.23-0.80), employment (OR=0.51; CI 0.29-0.91) and higher literacy (answering ""can read some or all"" to ""How well are you able to read?"", measured at study entry) (OR=0.59; CI 0.36-0.96). Alcohol use was positively associated with being food insecure (OR=4.79; CI 2.52-9.09). Factors inversely associated with low dietary diversity included high monthly income (OR=0.11; CI 0.06-0.24) and higher literacy level (OR= 0.49; CI 0.30- 0.80). BMI was associated with income (I<sup>2</sup>=1.39 kg/m2, p =0.008), and electricity (I<sup>2</sup>=1.70 kg/m2, p<0.001). Correlations were not significant between self-reported food insecurity and BMI (r=-0.05, p=0.29), or dietary diversity and BMI (r=0.10, p=0.03). Weak correlations were found between food insecurity and dietary diversity (r=-0.14, p=0.001). CONCLUSION: These HIV + Rwandan women experienced high rates of food insecurity, low BMI and low dietary diversity, which may have adverse effects on their health. Socioeconomic factors, including low income, illiteracy and lack of electricity, which is often used as a proxy for disposable income, and behavioral factors such as alcohol use, were associated with food insecurity, low BMI and low dietary diversity. HIV + treatment programs in developing countries should consider t"									
150	Predictors of mortality among HIV infected patients taking antiretroviral treatment in Ethiopia: a retrospective cohort study.	"Biadgilign S, Reda AA, Digaffe T."	AIDS Research & Therapy [Electronic Resource]. 2012;9(1):15.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=22606951	"BACKGROUND: Studies indicate that there is high early mortality among patients starting antiretroviral treatment in sub-Saharan Africa. However, there is paucity of evidence on long term survival of patients on anti-retroviral treatment in the region. The objective of this study is to examine mortality and its predictors among a cohort of HIV infected patients on anti-retroviral treatment retrospectively followed for five years."	METHODS: A retrospective cohort study was conducted among HIV infected patients on ART in eastern Ethiopia. Cox regression and Kaplan-Meier analyses were performed to investigate factors that influence time to death and survival over time.	"RESULT: A total of 1540 study participants were included in the study. From the registered patients in the cohort, the outcome of patients as active, deceased, lost to follow up and transfer out was 1005 (67.2%), 86 (5.9%), 210 (14.0%) and 192 (12.8%) respectively. The overall mortality rate provides an incidence density of 2.03 deaths per 100 person years (95% CI 1.64 - 2.50). Out of a total of 86 deaths over 60month period; 63 (73.3%) died during the first 12months, 10 (11.6%) during the second year, and 10 (11.6%) in the third year of follow up. In multivariate analysis, the independent predictors for mortality were loss of more 10% weight loss, bedridden functional status at baseline, <= 200 CD4 cell count/ml, and advanced WHO stage patients."	"CONCLUSION: A lower level of mortality was detected among the cohort of patients on antiretroviral treatment in eastern Ethiopia. Previous history of weight loss, bedridden functional status at baseline, low CD4 cell count and advanced WHO status patients had a higher risk of death. Early initiation of ART, provision of nutritional support and strengthening of the food by prescription initiative, and counseling of patients for early presentation to treatment is recommended."						
384	Predictors of mortality in HIV-infected patients starting antiretroviral therapy in a rural hospital in Tanzania.	"Johannessen A, Naman E, Ngowi BJ, Sandvik L, Matee MI, Aglen HE, Gundersen SG, et al."	BMC Infectious Diseases. 2008 22 Apr;8(52).		"Background: Studies of antiretroviral therapy (ART) programs in Africa have shown high initial mortality. Factors contributing to this high mortality are poorly described. The aim of the present study was to assess mortality and to identify predictors of mortality in HIV-infected patients starting ART in a rural hospital in Tanzania. Methods: This was a cohort study of 320 treatment-naive adults who started ART between October 2003 and November 2006. Reliable CD4 cell counts were not available, thus ART initiation was based on clinical criteria in accordance with WHO and Tanzanian guidelines. Kaplan-Meier models were used to estimate mortality and Cox proportional hazards models to identify predictors of mortality. Results: Patients were followed for a median of 10.9 months (IQR 2.9-19.5). Overall, 95 patients died, among whom 59 died within 3 months of starting ART. Estimated mortality was 19.2, 29.0 and 40.7% at 3, 12 and 36 months, respectively. Independent predictors of mortality were severe anemia (hemoglobin <8 g/dL; adjusted hazard ratio [AHR] 9.20; 95% CI 2.05-41.3), moderate anemia (hemoglobin 8-9.9 g/dL; AHR 7.50; 95% CI 1.77-31.9), thrombocytopenia (platelet count <150 x 109/L; AHR 2.30; 95% CI 1.33-3.99) and severe malnutrition (body mass index <16 kg/m<sup>2</sup>; AHR 2.12; 95% CI 1.06-4.24). Estimated one year mortality was 55.2% in patients with severe anemia, compared to 3.7% in patients without anemia (P < 0.001). Conclusion: Mortality was foundto be high, with the majority of deaths occurring within 3 months of starting ART. Anemia, thrombocytopenia and severe malnutrition were strong independent predictors of mortality. A prognostic model based on hemoglobin level appears to be a useful tool for initial risk assessment in resource-limited settings. 2008 Johannessen et al; licensee BioMed Central Ltd."									
1795	"Household market participation and stunting in preschool children in Lilongwe, Malawi."	"Howard AL, Komwa MK, Yohane R, Jacobsen KH."	South African Journal of Clinical Nutrition. 2011;24(4):202-4.		"Background: Stunting among Malawian preschool children continues to be a concern. Method: A cross-sectional survey of 251 semi-urban households, who participated in a community-supported preschool programme, was conducted. Results: Of the 433 participating two- to five-year-old children, 34.4% had stunting. Children from families who grow tobacco were less likely than other children to have stunting (27.0% vs. 37.3%, p-value = 0.04). In contrast, children from families who grow a local type of cowpea (khobwe) had a higher rate of stunting than other children (46.8% vs. 32.9%, p-value = 0.01). Conclusion: The study suggests that the increased income associated with household participation in the growing of globally marketable cash crops, as compared to the growing of local crops, may lead to increased nutritional benefits for children. SAJCN."									
1400	Prevalence and clinical correlates of metabolic syndrome in Nigerians living with human immunodeficiency virus/acquired immunodeficiency syndrome.	"Ayodele OE, Akinboro AO, Akinyemi SO, Adepeju AA, Akinremi OA, Alao CA, Popoola AA."	Metabolic Syndrome & Related Disorders. 2012;10(5):373-9.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=22799758	"BACKGROUND: Sub-Saharan Africa bears an inordinate burden of human immunodeficiency virus (HIV) infection/acquired immune deficiency syndrome (AIDS). Reports have shown increased prevalence of clustering of cardiovascular risk factors referred to as metabolic syndrome in treatment-naive patients and patients on highly active antiretroviral therapy (HAART). In view of the fact that metabolic syndrome is a heterogeneous disorder with substantial variability in the prevalence and component traits within and across populations and the dearth of publications on the prevalence and clinical correlates of metabolic syndrome in people living with HIV/AIDS (PLWHA) in Nigeria, this study was carried out to determine the prevalence and clinical correlates of metabolic syndrome among an HIV-infected outpatient population using the National Cholesterol Education Adult Treatment Panel III (NCEP ATP III), the International Diabetes Federation (IDF), and the Joint Interim Statement (JIS) definitions. We also sought to determine if HAART use and CD4 count level were associated with metabolic syndrome."	"METHODS: This cross-sectional study involved 291 (95 men, 196 women) consecutive PLWHA. Anthropometry, blood pressure, fasting plasma glucose, and lipid profile values were determined."	"RESULTS: The prevalence rates of metabolic syndrome according to the ATP III, IDF, and JIS criteria were 12.7%, 17.2%, and 21.0%, respectively. Metabolic syndrome was significantly associated with female gender (all definitions), body mass index (all definitions), increasing age, and CD4 count (IDF definition). There was no significant association between metabolic syndrome and HAART. The concordance [kappa coefficient (k)] between the definitions of metabolic syndrome varied between 0.583 and 0.878."	CONCLUSIONS: The prevalence of metabolic syndrome varied with the criteria used and metabolic syndrome correlates with traditional cardiovascular risk factors rather than HAART-related factors.						
379	Barriers to the care of HIV-infected children in rural Zambia: a cross-sectional analysis.	"Dijk JHv, Sutcliffe CG, Munsanje B, Hamangaba F, Thuma PE, Moss WJ."	BMC Infectious Diseases. 2009;9(169).	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20093340719	"Background: Successful antiretroviral treatment programs in rural sub-Saharan Africa may face different challenges than programs in urban areas. The objective of this study was to identify patient characteristics, barriers to care, and treatment responses of HIV-infected children seeking care in rural Zambia. Methods: Cross-sectional analysis of HIV-infected children seeking care at Macha Hospital in rural southern Zambia. Information was collected from caretakers and medical records. Results: 192 HIV-infected children were enrolled from September 2007 through September 2008, 28% of whom were receiving antiretroviral therapy (ART) at enrollment. The median age was 3.3 years for children not receiving ART (IQR 1.8, 6.7) and 4.5 years for children receiving ART (IQR 2.7, 8.6). 91% travelled more than one hour to the clinic and 26% travelled more than 5 hours. Most participants (73%) reported difficulties accessing the clinic, including insufficient money (60%), lack of transportation (54%) and roads in poor condition (32%). The 54 children who were receiving ART at study enrollment had been on ART a median of 8.6 months (IQR: 2.7, 19.5). The median percentage of CD4<sup>+</sup> T cells was 12.4 (IQR: 9.2, 18.6) at the start of ART, and increased to 28.6 (IQR: 23.5, 36.1) at the initial study visit. However, the proportion of children who were underweight decreased only slightly, from 70% at initiation of ART to 61% at the initial study visit. Conclusion: HIV-infected children in rural southern Zambia have long travel times to access care and may have poorer weight gain on ART than children in urban areas. Despite these barriers, these children had a substantial rise in CD4<sup>+</sup> T cell counts in the first year of ART although longer follow-up may indicate these gains are not sustained."									
394	Barriers to the care of HIV-infected children in rural Zambia: a cross-sectional analysis.	"van Dijk JH, Sutcliffe CG, Munsanje B, Hamangaba F, Thuma PE, Moss WJ."	BMC Infectious Diseases. 2009;9:169.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=19835604	"BACKGROUND: Successful antiretroviral treatment programs in rural sub-Saharan Africa may face different challenges than programs in urban areas. The objective of this study was to identify patient characteristics, barriers to care, and treatment responses of HIV-infected children seeking care in rural Zambia."	METHODS: Cross-sectional analysis of HIV-infected children seeking care at Macha Hospital in rural southern Zambia. Information was collected from caretakers and medical records.	"RESULTS: 192 HIV-infected children were enrolled from September 2007 through September 2008, 28% of whom were receiving antiretroviral therapy (ART) at enrollment. The median age was 3.3 years for children not receiving ART (IQR 1.8, 6.7) and 4.5 years for children receiving ART (IQR 2.7, 8.6). 91% travelled more than one hour to the clinic and 26% travelled more than 5 hours. Most participants (73%) reported difficulties accessing the clinic, including insufficient money (60%), lack of transportation (54%) and roads in poor condition (32%). The 54 children who were receiving ART at study enrollment had been on ART a median of 8.6 months (IQR: 2.7, 19.5). The median percentage of CD4+ T cells was 12.4 (IQR: 9.2, 18.6) at the start of ART, and increased to 28.6 (IQR: 23.5, 36.1) at the initial study visit. However, the proportion of children who were underweight decreased only slightly, from 70% at initiation of ART to 61% at the initial study visit."	"CONCLUSION: HIV-infected children in rural southern Zambia have long travel times to access care and may have poorer weight gain on ART than children in urban areas. Despite these barriers, these children had a substantial rise in CD4+ T cell counts in the first year of ART although longer follow-up may indicate these gains are not sustained."						
213	Effect of vitamin supplements on HIV shedding in breast milk.	"Villamor E, Koulinska IN, Aboud S, Murrin C, Bosch RJ, Manji KP, Fawzi WW."	American Journal of Clinical Nutrition. 2010;92(4):881-6.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=20739426	BACKGROUND: Supplementation in lactating HIV-1-infected women with preformed vitamin A and -carotene (VA/BC) increases the risk of mother-to-child transmission of HIV through breastfeeding. Identifying a biological mechanism to explain this unexpected finding would lend support to a causal effect.	"OBJECTIVE: The aim of the study was to evaluate the effect of VA/BC or multivitamin (B complex, vitamin C, and vitamin E) supplementation of HIV-infected women on HIV shedding in breast milk during the first 2 y postpartum."	"DESIGN: We quantified viral (cell-free) and proviral (cell-associated) HIV loads in breast-milk samples collected <=15 d after delivery and every 3 mo thereafter from 594 Tanzanian HIV-1-infected women who participated in a randomized trial. Women received 1 of the following 4 daily oral regimens in a 2 x 2 factorial fashion during pregnancy and throughout the first 2 y postpartum: multivitamin, VA/BC, multivitamin including VA/BC, or placebo."	"RESULTS: The proportion of breast-milk samples with detectable viral load was significantly higher in women who received VA/BC (51.3%) than in women who were not assigned to VA/BC (44.8%; P = 0.02). The effect was apparent >=6 mo postpartum (relative risk: 1.34; 95% CI: 1.04, 1.73). No associations with proviral load were observed. The multivitamin had no effects. In observational analyses, -carotene but not retinol breast-milk concentrations were significantly associated with an increased viral load in milk."	"CONCLUSIONS: VA/BC supplementation in lactating women increases the HIV load in breast milk. This finding contributes to explaining the adverse effect of VA/BC on mother-to-child transmission. -Carotene appears to have an effect on breast-milk viral load, independent of preformed vitamin A. This trial was registered at clinicaltrials.gov as NCT00197756."					
1624	"Mortality rates, prevalence of malnutrition, and prevalence of lost pregnancies among the drought-ravaged population of Tete Province, Mozambique."	Renzaho AM.	Prehospital & Disaster Medicine. 2007;22(1):26-34.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=17484360	"BACKGROUND: Tete Province, Mozambique has experienced chronic food insecurity and a dramatic fall in livestock numbers due to the cyclic problems characterized by the floods in 2000 and severe droughts in 2002 and 2003. The Province has been a beneficiary of emergency relief programs, which have assisted > 22% of the population. However, these programs were not based on sound epidemiological data, and they have not established baseline data against which to assess the impact of the programs."	"OBJECTIVE: The objective of this study was to document mortality rates, causes of death, the prevalence of malnutrition, and the prevalence of lost pregnancies after 2.5 years of humanitarian response to the crisis."	"METHODS: A two-stage, 30-cluster household survey was conducted in the Cahora Bassa and Changara districts from 22 October to 08 November 2004. A total of 838 households were surveyed, with a population size of 4,688 people."	"RESULTS: Anthropometric data were collected among children 6-59 months of age. In addition, crude mortality rates (CMRs), under five mortality rates (U5MRs), causes of deaths, and prevalence of lost pregnancies were determined among the sample population. The prevalence of malnutrition was 8.0% (95% confidence interval (CI) = 6.2-9.8%) for acute malnutrition, 26.9% (95% CI = 24.0-29.9%) for being underweight, and 37.0% (95% CI = 33.8-40.2%) for chronic malnutrition. Boys were more likely to be underweight than were girls (odds ratio (OR) = 1.34; 95% CI = 1.00, 1.82; p < 0.05) after controlling for age, household size, and food aid beneficiary status. Similarly, children 30-59 months of age were significantly less likely to suffer from acute malnutrition (OR = 0.45; 95% CI = 0.26, 0.79; p < 0.01) and less likely to be underweight (OR = 0.37; 95% CI = 0.27, 0.51; p < 0.01) than children 6-29 months of age, after adjusting for the other, aforementioned factors. The proportion of lost pregnancies was estimated at 7.7% (95% CI = 4.5-11.0%). A total of 215 deaths were reported during the year preceding the survey. Thirty-nine (18.1%) children < 5 years of age died. The CMR was 1.23/10,000/day (95% CI = 1.08-1.38), and an U5MR was 1.03/10,000/day (95% CI = 0.71-1.35). Diarrheal diseases, malaria, tuberculosis, and human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) accounted for more than two-thirds of all deaths."	"CONCLUSIONS: The observed CMR in Tete Province, Mozambique is three times higher than the baseline rate for sub-Saharan Africa and 1.4 times higher than the CMR cut-off point used to define excess mortality in emergencies. The current humanitarian response in Tete Province would benefit from an improved alignment of food aid programming in conjunction with diarrheal disease control, HIV/AIDS, and malaria prevention and treatment programs. The impact of the food programs would be improved if mutually acceptable food aid program objectives, verifiable indicators relevant to each objective, and beneficiary targets and selection criteria are developed. Periodic re-assessments and evaluations of the impact of the program and evidenced-based decision-making urgently are needed to avert a chronic dependency on food aid."					
1625	"Mortality rates, prevalence of malnutrition, and prevalence of lost pregnancies among the drought-ravaged population of Tete Province, Mozambique."	Renzaho AMN.	Prehospital and Disaster Medicine. 2007;22(1):26-34.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20073213098	"Background: Tete Province, Mozambique has experienced chronic food insecurity and a dramatic fall in livestock numbers due to the cyclic problems characterized by the floods in 2000 and severe droughts in 2002 and 2003. The Province has been a beneficiary of emergency relief programs, which have assisted >22% of the population. However, these programs were not based on sound epidemiological data, and they have not established baseline data against which to assess the impact of the programs. Objective: The objective of this study was to document mortality rates, causes of death, the prevalence of malnutrition, and the prevalence of lost pregnancies after 2.5 years of humanitarian response to the crisis. Methods: A two-stage, 30-cluster household survey was conducted in the Cahora Bassa and Changara districts from 22 October to 08 November 2004. A total of 838 households were surveyed, with a population size of 4,688 people. Results: Anthropometric data were collected among children 6-59 months of age. In addition, crude mortality rates (CMRs), under five mortality rates (U5MRs), causes of deaths, and prevalence of lost pregnancies were determined among the sample population. The prevalence of malnutrition was 8.0% (95% confidence interval (CI)=6.2-9.8%) for acute malnutrition, 26.9% (95% CI=24.0-29.9%) for being underweight, and 37.0% (95% CI=33.8-40.2%) for chronic malnutrition. Boys were more likely to be underweight than were girls (odds ratio (OR)=1.34; 95% CI=1.00, 1.82; p<0.05) after controlling for age, household size, and food aid beneficiary status. Similarly, children 30-59 months of age were significantly less likely to suffer from acute malnutrition (OR=0.45; 95% CI=0.26, 0.79; p<0.01) and less likely to be underweight (OR=0.37; 95% CI=0.27, 0.51; p<0.01) than children 6-29 months of age, after adjusting for the other, aforementioned factors. The proportion of lost pregnancies was estimated at 7.7% (95% CI=4.5-11.0%). A total of 215 deaths were reported during the year preceding the survey. Thirty-nine (18.1%) children <5 years of age died. The CMR was 1.23/10 000/day (95% CI=1.08-1.38), and an U5MR was 1.03/10 000/day (95% CI=0.71-1.35). Diarrheal diseases, malaria, tuberculosis, and human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) accounted for more than two-thirds of all deaths. Conclusions: The observed CMR in Tete Province, Mozambique is three times higher than the baseline rate for sub-Saharan Africa and 1.4 times higher than the CMR cut-off point used to define excess mortality in emergencies. The current humanitarian response in Tete Province would benefit from an improved alignment of food aid programming in conjunction with diarrheal disease control, HIV/AIDS, and malaria prevention and treatment programs. The impact of the food programs would be improved if mutually acceptable food aid programme objectives, verifiable indicators relevant to each objective, and beneficiary targets and selection criteria are developed. Periodic re-assessments and evaluations of the impact of the program and evidenced-based decision-making urgently are needed to avert a chronic dependency on food aid."									
1008	Higher-than-expected rates of lactic acidosis among highly active antiretroviral therapy-treated women in Botswana: Preliminary results from a large randomized clinical trial.	"Wester CW, Okezie OA, Thomas AM, Bussmann H, Moyo S, Muzenda T, Makhema J, et al."	Journal of Acquired Immune Deficiency Syndromes. 2007 November;46(3):318-22.		"BACKGROUND: The ability of nucleoside reverse transcriptase inhibitors (NRTIs) to inhibit human mitochondrial polymerase- results in impaired synthesis of mitochondrial enzymes that generate adenosine triphosphate (ATP) by oxidative phosphorylation. This has been associated with several long-term mitochondrial toxicities, which include lactic acidosis and pancreatitis, peripheral neuropathy, and lipoatrophy. METHODS: Enrolled highly active antiretroviral therapy (HAART)-treated adults have completed nearly 2 years of follow-up as part of the ongoing randomized clinical trial Adult Antiretroviral Treatment and Drug Resistance (Tshepo) study. All patients were intensively screened for the presence of ARV-related toxicities. RESULTS: Six hundred fifty adults (69% female) were initiated on NRTI-based HAART. Overall, 2.0% of patients developed moderate to severe symptomatic hyperlactatemia, with 7 (1.0%), all female, diagnosed with lactic acidosis. Female gender (P = 0.008) and being overweight, namely having a body mass index (BMI) of greater than 25 (P = 0.001), were predictive for the development of moderate to severe symptomatic hyperlactatemia or lactic acidosis. Older age (age >40 years) showed a statistical trend (P = 0.053) as a predictor for the development of toxicity, whereas exposure to d4T and/or ddI for 6 or more months was not predictive (P = 0.102). Those diagnosed with lactic acidosis had a mean BMI of 32.38 (interquartile range [IQR] = 29.4 to 35) at the time of toxicity and had been receiving HAART for a mean of 12.1 months (IQR = 7 to 20.8). Four of the 7 (57%) died of lactic acidosis and/or hemorrhagic pancreatitis; these 4 patients also had a comorbid diagnosis of severe clinical pancreatitis with grade 3/4 lipase elevations and abdominal symptoms at the time of their demise. CONCLUSIONS: Rates of lactic acidosis appear to be higher in southern Africa when compared with rates previously described elsewhere. Risk factors for the development of moderate to severe symptomatic hyperlactatemia or lactic acidosis appear to be multifactorial but include female gender and having a BMI of greater than 25. Additional studies are ongoing to evaluate for other possible risk factors, such as host genetic differences. 2007 Lippincott Williams & Wilkins, Inc."									
959	Higher-than-expected rates of lactic acidosis among highly active antiretroviral therapy-treated women in Botswana: preliminary results from a large randomized clinical trial.	"Wester CW, Okezie OA, Thomas AM, Bussmann H, Moyo S, Muzenda T, Makhema J, et al."	"JAIDS, Journal of Acquired Immune Deficiency Syndromes. 2007;46(3):318-22."	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20083145384	"Background: The ability of nucleoside reverse transcriptase inhibitors (NRTIs) to inhibit human mitochondrial polymerase-[gamma] results in impaired synthesis of mitochondrial enzymes that generate adenosine triphosphate (ATP) by oxidative phosphorylation. This has been associated with several long-term mitochondrial toxicities, which include lactic acidosis and pancreatitis, peripheral neuropathy, and lipoatrophy. Methods: Enrolled highly active antiretroviral therapy (HAART)-treated adults have completed nearly 2 years of follow-up as part of the ongoing randomized clinical trial Adult Antiretroviral Treatment and Drug Resistance (Tshepo) study. All patients were intensively screened for the presence of ARV-related toxicities. Results: Six hundred fifty adults (69% female) were initiated on NRTI-based HAART. Overall, 2.0% of patients developed moderate to severe symptomatic hyperlactatemia, with 7 (1.0%), all female, diagnosed with lactic acidosis. Female gender (P=0.008) and being overweight, namely having a body mass index (BMI) of greater than 25 (P=0.001), were predictive for the development of moderate to severe symptomatic hyperlactatemia or lactic acidosis. Older age (age >40 years) showed a statistical trend (P=0.053) as a predictor for the development of toxicity, whereas exposure to d4T and/or ddI for 6 or more months was not predictive (P=0.102). Those diagnosed with lactic acidosis had a mean BMI of 32.38 (interquartile range [IQR]=29.4 to 35) at the time of toxicity and had been receiving HAART for a mean of 12.1 months (IQR=7 to 20.8). Four of the 7 (57%) died of lactic acidosis and/or hemorrhagic pancreatitis; these 4 patients also had a comorbid diagnosis of severe clinical pancreatitis with grade 3/4 lipase elevations and abdominal symptoms at the time of their demise. Conclusions: Rates of lactic acidosis appear to be higher in southern Africa when compared with rates previously described elsewhere. Risk factors for the development of moderate to severe symptomatic hyperlactatemia or lactic acidosis appear to be multifactorial but include female gender and having a BMI of greater than 25. Additional studies are ongoing to evaluate for other possible risk factors, such as host genetic differences."									
409	The motor development of orphaned children with and without HIV: Pilot exploration of foster care and residential placement.	"Jelsma J, Davids N, Ferguson G."	BMC Pediatrics. 2011;11:11.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=21299864	"BACKGROUND: The AIDS epidemic has lead to an increase in orphaned children who need residential care. It is known that HIV leads to delayed motor development. However, the impact of place of residence on motor function has not been investigated in the South African context. The aim of the study was therefore to establish if children in institutionalised settings performed better or worse in terms of gross motor function than their counterparts in foster care. A secondary objective was to compare the performance of children with HIV in these two settings with those of children who were HIV negative."	"METHODS: Forty-four children both with and without HIV, were recruited from institutions and foster care families in Cape Town. The Peabody Development Motor Scale (PDMS II) was used to calculate the total motor quotient (TMQ) at baseline and six months later. Comparisons of TMQ were made between residential settings and between children with and without HIV."	RESULTS: Twenty-one children were infected with HIV and were significantly delayed compared to their healthy counterparts. Antiretroviral therapy was well managed among the group but did not appear to result in restoration of TMQ to normal over the study period. HIV status and place of residence emerged as a predictor of TMQ with children in residential care performing better than their counterparts in foster care. All children showed improvement over the six months of study.	CONCLUSIONS: Foster parents were well supported administratively in the community by social welfare services but their children might have lacked stimulation in comparison to those in institutional settings. This could have been due to a lack of resources and knowledge regarding child development. The assumption that foster homes provide a better alternative to institutions may not be correct in a resource poor community and needs to be examined further.						
1407	"Body composition in prepubertal, HIV-infected children: a comparison of bioelectrical impedance analysis and dual-energy X-ray absorptiometry."	"Palchetti CZ, Patin RV, Machado DM, Szejnfeld VL, Succi RCdM, Oliveira FLC."	NCP Nutrition in Clinical Practice. 2013;28(2):247-52.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20133120375	"Background: The aim of this study was to compare bioelectrical impedance analysis (BIA) equations developed for healthy pediatric populations and for HIV-infected children using dual-energy X-ray absorptiometry (DXA) as the gold standard. Materials and Methods: A cross-sectional study was carried out with 40 prepubertal, HIV-infected children who regularly attended the Pediatric Infectious Disease Clinic at the Universidade Federal de Sao Paulo, Sao Paulo, Brazil. The study was conducted from August to November 2008. Demographic data, clinical parameters, immunological status, and use of antiretroviral therapy were obtained from the patients' medical records. We performed anthropometric parameters and body composition analyses, analyzed body composition by BIA and DXA, and compared the results obtained from BIA through using equations for both healthy and HIV-infected populations. Results: The mean+or-SD age of the study population was 9.8+or-1.2 years. Half of the population were females, and 82.5% of the children were clinically classified as B and C. Total body fat, by both absolute mass and by percentage, exhibited high homogeneity between the results obtained from BIA and DXA. However, there was no concordance in fat-free mass. The equation for healthy children showed good sensitivity and specificity when comparing the percentage of total body fat measured by DXA. Conclusion: BIA provides reliable data on total body fat but not fat-free mass when compared with DXA. The BIA equation developed for healthy pediatric populations can be used to determine total body fat in HIV-infected children."									
300	"Risk factors for mortality among HIV-positive patients with and without active tuberculosis in Dar es Salaam, Tanzania."	"Mugusi SF, Ngaimisi E, Janabi MY, Mugusi FM, Minzi OMS, Sasi PG, Bakari M, et al."	Antiviral Therapy. 2012;17(2):265-74.		"Background: The aim of this study was to describe risk factors for mortality and clinical characteristics of HIV-infected patients with and without tuberculosis (TB) coinfection. Methods: A cohort of HIV-infected patients with CD4<sup>+</sup> T-cell counts of <=200 cells/ml was recruited, consisting of 255 HIV-infected patients without active TB and 231 patients with active TB. All received a well-supervised treatment with an efavirenz-based HAART, and those coinfected with TB received appropriate anti-TB treatment. They were followed up for 48 weeks after HAART initiation. Results: Common presenting symptoms in HIV-only patients were fever (36.5%), headache (34.5%), skin rash (34.5%) and weight loss (32%), while in HIV-TB patients the symptoms were weight loss (58%), cough (57.6%), night sweats (44.6%) and fever (34.2%). HIV-TB patients had significantly lower body mass index, Karnofsky scores and haemoglobin levels compared to those infected with HIV only, despite similar baseline CD4 <sup>+</sup> T-cell counts. Overall, 12 (4.7%) HIV patients developed TB and 7 (3%) HIV-TB patients had worsening of their TB symptoms during the study period. Mortality was similar in the two groups, being 10.9% (16 deaths per 100 person years) and 11.3% (17 deaths per 100 person years) in HIV-only and HIV-TB patients, respectively. Overall, more males (13.1%) died compared to females (9.6%). Predictors of mortality were presence of oral candidiasis, Kaposi's sarcoma, low Karnofsky score, and low baseline white blood cell and CD4 <sup>+</sup> T-cell counts. Conclusions: The outcomes following well-supervised treatment of HIV-TB patients are similar to those in patients with HIV alone. Predictors of mortality were those of advanced disease. 2012 International Medical Press."									
1455	"Severe malnutrition with and without HIV-1 infection in hospitalised children in Kampala, Uganda: differences in clinical features, haematological findings and CD4+ cell counts."	"Bachou H, Tylleskar T, Downing R, Tumwine JK."	Nutrition Journal. 2006;5:27.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medc&AN=17042940	"BACKGROUND: The aim of this study was to describe the clinical features, haematological findings and CD4+ and CD8+ cell counts of severely malnourished children in relation to human immunodeficiency virus (HIV) infection."	"METHODS: The study was conducted in the paediatric wards of Mulago hospital, which is Uganda's national referral and teaching hospital. We studied 315 severely malnourished children (presence of oedema and/or weight-for-height: z-score < -3) and have presented our findings. At admission, the CD4+ and CD8+ cells were measured by the flow cytometry and HIV serology was confirmed by Enzyme linked Immunoassay for children >18 months of age, and RNA PCR was performed for those < or =18 months. Complete blood count, including differential counts, was determined using a Beckman Coulter counter."	"RESULTS: Among the 315 children, 119 (38%) were female; the median age of these children was 17 months (Interquartile range 12-24 months), and no difference was observed in the HIV status with regard to gender or age. The children showed a high prevalence of infections: pneumonia (68%), diarrhoea (38%), urinary tract infection (26%) and bacteraemia (18%), with no significant difference with regard to the HIV status (HIV-positive versus HIV-negative children). However, the HIV-positive children were more likely to have persistent diarrhoea than the HIV-uninfected severely malnourished children (odds ratio (OR) 2.0, 95% confidence interval (CI) 1.2-3.6). When compared with the HIV-negative children, the HIV-positive children showed a significantly lower median white blood cell count (10700 versus 8700) and lymphocyte count (4033 versus 2687). The CD4+ cell percentages were more likely to be lower in children with non-oedematous malnutrition than in those with oedematous malnutrition even after controlling for the HIV infection. The novel observation of this study is that the CD4+ percentages in both HIV-positive and HIV-negative children without oedema were lower that those in children with oedema. These observations appear to imply that the development of oedema requires a certain degree of immunocompetence, which is an interesting clue to the pathophysiology of oedema in severe malnutrition."							
868	"Child mortality in relation to HIV infection, nutritional status, and socio-economic background."	"Villamor E, Misegades L, Fataki MR, Mbise RL, Fawzi WW."	International Journal of Epidemiology. 2005;34(1):61-8.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=15649965	BACKGROUND: The aims of this study were to examine the impact of child HIV infection on mortality and to identify nutritional and sociodemographic factors that increase the risk of child mortality independent of human immunodeficiency virus (HIV) infection.	"METHODS: We conducted a prospective study in Dar es Salaam, Tanzania, among 687 children 6-60 months of age who were admitted to hospital with pneumonia. After discharge, children were followed up every 2 weeks during the first year and every 4 months thereafter. Sociodemographic characteristics were determined at baseline, and HIV status, haemoglobin, and malaria infection were assessed from a blood sample. During the first year of follow-up, we measured height, weight, and mid-upper arm circumference (MUAC) monthly. We estimated the risk of mortality according to HIV status and socio-economic characteristics using Cox proportional hazards models. Nutritional status variables (wasting and stunting) were examined as time-varying risk factors."	"RESULTS: Mean age at enrollment was 18 months. A total of 90 children died during an average 24.7 months of follow-up. HIV infection was associated with an adjusted 4-fold higher risk of mortality [relative risk (RR) = 3.92, 95% confidence interval (CI) 2.34-6.55, P < 0.0001]. Other risk factors included child's age < 24 months, stunting, low MUAC, anaemia, and lack of water supply in the household. In models with time-varying covariates, stunting and wasting during the previous month were both significant and independently related to increased risk of death. HIV infection appeared to be a stronger predictor of mortality among children who were wasted than among those who were not (P for interaction = 0.05)."	"CONCLUSIONS: HIV infection is a strong predictor of death among children who have been hospitalized with pneumonia. Preventable conditions including inadequate water supply, child undernutrition, and anaemia contribute significantly to infant and child mortality independent of HIV infection."						
1492	"Nutritional status and its response to treatment of children, with and without HIV infection, hospitalized for the management of tuberculosis."	"Schaaf HS, Cilliers K, Willemse M, Labadarios D, Kidd M, Donald PR."	Paediatrics and International Child Health. 2012;32(2):74-81.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20123183929	"Background: The association of childhood tuberculosis (TB) and malnutrition is known, but treatment response, the influence of the acute-phase response (APR) and concomitant HIV infection are not well documented. Aim: To evaluate the nutritional response and APR in HIV-infected and uninfected children hospitalised for the treatment of TB and receiving standard anti-tuberculosis chemotherapy. Methods: During a study of the pharmacokinetics of standard anti-tuberculosis agents, anthropometric parameters were measured and blood concentrations of nutrients and C-reactive protein (CRP) determined at 1 and 4 months after initiation of chemotherapy. Results: 24 HIV-infected and 34 HIV-uninfected children were studied. On enrolment, 31.6% of HIV-infected and 2.9% of HIV-uninfected children were underweight, and 31.6% and 14.7%, respectively, were stunted. Mean values of weight, height/length, head circumference and mid-upper-arm circumference on enrolment and at 4-month assessment in HIV-infected and uninfected children did not differ. Mean triceps skinfold (TSF) (8.17 and 9.73 cm) and subscapular skinfold (SSF) thicknesses (5.75 and 7.5 cm) on enrolment differed significantly (P=0.03 and P=0.003); by 4 months, TSF had declined to 5.97 cm (P<0.001) and 8.87 cm (P=0.05), respectively, and SSF to 5.57 cm (P=0.79) and 6.73 cm (P=0.04); the arm muscle area (AMA) was low in a majority of children on enrolment and remained so at the second assessment. CRP was raised in 66.6% and 53.3% of HIV-infected and -uninfected children on enrolment, but at 4-month assessment was raised in 63.2% and 15.2%, respectively. Other micronutrient and haematological findings probably reflect an APR, but no children had sub-normal zinc or magnesium values; most selenium and vitamin C and E values were normal. An elevated platelet count (>420x10<sup>9</sup>/L) was significantly more common in HIV-uninfected children, and was still raised in 39% at 4 months. Conclusion: A majority of HIV-infected and uninfected children had an APR but it had resolved by 4 months in most HIV-uninfected children. In both groups, low and declining skinfolds and a persistently low AMA indicate a persistent disturbance of fat and protein metabolism, despite successful chemotherapy."									
419	Effect on longitudinal growth and anemia of zinc or multiple micronutrients added to vitamin A: a randomized controlled trial in children aged 6-24 months.	"Chhagan MK, Van den Broeck J, Luabeya KK, Mpontshane N, Tomkins A, Bennish ML."	BMC Public Health. 2010;10:145.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=20298571	"BACKGROUND: The benefits of zinc or multiple micronutrient supplementations in African children are uncertain. African children may differ from other populations of children in developing countries because of differences in the prevalence of zinc deficiency, low birth weight and preterm delivery, recurrent or chronic infections such as HIV, or the quality of complementary diets and genetic polymorphisms affecting iron metabolism.The aim of this study was to ascertain whether adding zinc or multiple micronutrients to vitamin A supplementation improves longitudinal growth or reduces prevalence of anemia in children aged 6-24 months."	"METHODS: Randomized, controlled double-blinded trial of prophylactic micronutrient supplementation to children aged 6-24 months. Children in three cohorts - 32 HIV-infected children, 154 HIV-uninfected children born to HIV-infected mothers, and 187 uninfected children born to HIV-uninfected mothers - were separately randomly assigned to receive daily vitamin A (VA) [n = 124], vitamin A plus zinc (VAZ) [n = 123], or multiple micronutrients that included vitamin A and zinc (MM) [n = 126]."	"RESULTS: Among all children there were no significant differences between intervention arms in length-for-age Z scores (LAZ) changes over 18 months. Among stunted children (LAZ below -2) [n = 62], those receiving MM had a 0.7 Z-score improvement in LAZ versus declines of 0.3 in VAZ and 0.2 in VA (P = 0.029 when comparing effects of treatment over time). In the 154 HIV-uninfected children, MM ameliorated the effect of repeated diarrhea on growth. Among those experiencing more than six episodes, those receiving MM had no decline in LAZ compared to 0.5 and 0.6 Z-score declines in children receiving VAZ and VA respectively (P = 0.06 for treatment by time interaction). After 12 months, there was 24% reduction in proportion of children with anemia (hemoglobin below 11 g/dL) in MM arm (P = 0.001), 11% in VAZ (P = 0.131) and 18% in VA (P = 0.019). Although the within arm changes were significant; the between-group differences were not significant."	"CONCLUSIONS: Daily multiple micronutrient supplementation combined with vitamin A was beneficial in improving growth among children with stunting, compared to vitamin A alone or to vitamin A plus zinc. Effects on anemia require further study."	"TRIAL REGISTRATION: This study is registered with ClinicalTrials.gov, number. NCT00156832."					
1272	"Efficacy of first-line, WHO recommended generic HAART regimens in Indian children."	"Parakh A, Dubey AP, Kumar A, Maheshwari A, Saxena R."	Kathmandu University Medical Journal. 2009 July-September;7(27):220-5.		"Background: The clinical efficacy of highly active antiretroviral therapy (HAART) in children has been well documented in the developed countries, although most of the regimens are Protease Inhibitor (PI) based which are too expensive. To circumvent this problem World Health Organization (WHO) has recommended Non- Nucleotide Reverse Transcriptase Inhibitor (NNRTI) based regimen for resource-limited countries. Aim: To assess the long-term efficacy of first line World Health Organization (WHO)-recommended generic highly active antiretroviral therapy (HAART) regimens in treatment -naive children. Materials and methods: Observational retrospective analysis was done. Thirty patients on HAART for > 6 months were included (27 on Stavudine; three on Zidovudine with Lamivudine/ Nevirapine). No protease inhibitors were used. Results: median age was seven years (Interquartile [IQR]: 5.62-8.50) and median duration on HAART was 18 months (IQR: 6-24). No new staging events were observed after six months of initiation of HAART. The median CD4% increased from 6.0 % at baseline to 15.5% at six months, 21.7% at 12 months, 25.4% at 18 months, 24.6 % at 24 months 25.3% at 30 months and 23.7% at 36 months. There was only one case of immunological failure. Stratified analysis based on baseline CD4 % show that even patients with a baseline CD4 % of <5% achieved percentage of >25% at 18-24 months and maintained it subsequently. Significant increase in the weight and body mass index Z scores was observed but significant fall in the height Z scores were observed. This sub group of patients with poor linear height velocity would require detailed endocrine evaluation after testing for viral loads. Conclusions: Non- Nucleotide Reverse Transcriptase Inhibitor based HAART regi mens are feasible and effective in long term in resource-limited setting despite initiation of treatment in advanced stages. These can be continued in NACO/WHO scale up programmes at present for children."									
376	Associated factors for treatment delay in pulmonary tuberculosis in HIV-infected individuals: a nested case-control study.	"Coimbra I, Maruza M, Militao-Albuquerque MDFP, Moura LV, Diniz GTN, Miranda-Filho DDB, Lacerda HR, et al."	BMC Infectious Diseases. 2012 07 Sep;12(208).		"Background: The delay in initiating treatment for tuberculosis (TB) in HIV-infected individuals may lead to the development of a more severe form of the disease, with higher rates of morbidity, mortality and transmissibility. The aim of the present study was to estimate the time interval between the onset of symptoms and initiating treatment for TB in HIV-infected individuals, and to identify the factors associated to this delay.Methods: A nested case-control study was undertaken within a cohort of HIV-infected individuals, attended at two HIV referral centers, in the state of Pernambuco, Brazil. Delay in initiating treatment for TB was defined as the period of time, in days, which was greater than the median value between the onset of cough and initiating treatment for TB. The study analyzed biological, clinical, socioeconomic, and lifestyle factors as well as those related to HIV and TB infection, potentially associated to delay. The odds ratios were estimated with the respective confidence intervals and p-values.Results: From a cohort of 2365 HIV-infected adults, 274 presented pulmonary TB and of these, 242 participated in the study. Patients were already attending 2 health services at the time they developed a cough (period range: 1 - 552 days), with a median value of 41 days. Factors associated to delay were: systemic symptoms asthenia, chest pain, use of illicit drugs and sputum smear-negative.Conclusion: The present study indirectly showed the difficulty of diagnosing TB in HIV-infected individuals and indicated the need for a better assessment of asthenia and chest pain as factors that may be present in co-infected patients. It is also necessary to discuss the role played by negative sputum smear results in diagnosing TB/HIV co-infection as well as the need to assess the best approach for drug users with TB/HIV. 2012 Coimbra et al.; licensee BioMed Central Ltd."									
211	"Weight change at 1 mo of antiretroviral therapy and its association with subsequent mortality, morbidity, and CD4 T cell reconstitution in a Tanzanian HIV-infected adult cohort."	"Sudfeld CR, Isanaka S, Mugusi FM, Aboud S, Wang M, Chalamilla GE, Giovannucci EL, et al."	American Journal of Clinical Nutrition. 2013;97(6):1278-87.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=23636235	BACKGROUND: The development of low-cost point-of-care technologies to improve HIV treatment is a major focus of current research in resource-limited settings.	"OBJECTIVE: We assessed associations of body mass index (BMI; in kg/m(2)) at antiretroviral therapy (ART) initiation and weight change after 1 mo of treatment with mortality, morbidity, and CD4 T cell reconstitution."	"DESIGN: A prospective cohort of 3389 Tanzanian adults initiating ART enrolled in a multivitamin trial was followed at monthly clinic visits (median: 19.7 mo). Proportional hazard models were used to analyze mortality and morbidity associations, whereas generalized estimating equations were used for CD4 T cell counts."	"RESULTS: The median weight change at 1 mo of ART was +2.0% (IQR: -0.4% to +4.6%). The association of weight loss at 1 mo with subsequent mortality varied significantly by baseline BMI (P = 0.011). Participants with >=2.5% weight loss had 6.43 times (95% CI: 3.78, 10.93 times) the hazard of mortality compared with that of participants with weight gains >=2.5%, if their baseline BMI was <18.5 but only 2.73 times (95% CI: 1.49, 5.00 times) the hazard of mortality if their baseline BMI was >=18.5 and <25.0. Weight loss at 1 mo was also associated with incident pneumonia (P = 0.002), oral thrush (P = 0.007), and pulmonary tuberculosis (P < 0.001) but not change in CD4 T cell counts (P > 0.05)."	"CONCLUSIONS: Weight loss as early as 1 mo after ART initiation can identify adults at high risk of adverse outcomes. Studies identifying reasons for and managing early weight loss are needed to improve HIV treatment, with particular urgency for malnourished adults initiating ART. The parent trial was registered at clinicaltrials.gov as NCT00383669."					
210	"Weight change at 1 mo of antiretroviral therapy and its association with subsequent mortality, morbidity, and CD4 T cell reconstitution in a Tanzanian HIV-infected adult cohort."	"Sudfeld CR, Isanaka S, Mugusi FM, Aboud S, Molin W, Chalamilla GE, Giovannucci EL, et al."	American Journal of Clinical Nutrition. 2013;97(6):1278-87.	http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=2012127490&site=ehost-live	"Background: The development of low-cost point-of-care technologies to improve HIV treatment is a major focus of current research in resource-limited settings. Objective: We assessed associations of body mass index (BMI; in kg/m?) at antiretroviral therapy (ART) initiation and weight change after 1 mo of treatment with mortality, morbidity, and CD4 T cell reconstitution. Design: A prospective cohort of 3389 Tanzanian adults initiating ART enrolled in a multivitamin trial was followed at monthly clinic visits (median: 19.7 mo). Proportional hazard models were used to analyze mortality and morbidity associations, whereas generalized estimating equations were used for CD4 T cell counts. Results: The median weight change at 1 mo of ART was +2.0% (IQR: -0.4% to +4.6%). The association of weight loss at 1 mo with subsequent mortality varied significantly by baseline BMI (P = 0.011). Participants with _2.5% weight loss had 6.43 times (95% CI: 3.78, 10.93 times) the hazard of mortality compared with that of participants with weight gains _2.5%, if their baseline BMI was <18.5 but only 2.73 times (95% CI: 1.49, 5.00 times) the hazard of mortality if their baseline BMI was _18.5 and <25.0. Weight loss at 1 mo was also associated with incident pneumonia (P = 0.002), oral thrush (P = 0.007), and pulmonary tuberculosis (P < 0.001) but not change in CD4 T cell counts (P > 0.05). Conclusions: Weight loss as early as 1 mo after ART initiation can identify adults at high risk of adverse outcomes. Studies identifying reasons for and managing early weight loss are needed to improve HIV treatment, with particular urgency for malnourished adults initiating ART. The parent trial was registered at clinicaltrials.gov as NCT00383669."									
30	"Tuberculosis in children at Mbarara University Teaching Hospital, Uganda: diagnosis and outcome of treatment."	Kiwanuka JP.	African Health Sciences. 2002;2(3):82-8.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medc&AN=12789090	"BACKGROUND: The diagnosis of tuberculosis in children is difficult particularly in HIV infected children. The poor outcome following antituberculosis treatment usually reported in HIV infected children might be due, in part, to other HIV-related chronic diseases wrongly diagnosed as TB."	OBJECTIVE: The study examines the impact of HIV infection on the clinical features and diagnosis of children presenting with suspected tuberculosis in Mbarara University Teaching Hospital. It also examines the effect of various factors on the outcome of anti-TB treatment.	"METHODS: Children presenting with suspected TB were prospectively enrolled. Clinical data were recorded and investigations included Mantoux test, chest X-ray, HIV test and Z-N staining of various specimens for AAFBs where available. Patients were treated with standard, short-course anti-TB therapy, and followed-up for six months. They were then classified as ""good outcome"" if they improved and ""poor outcome"" if they deteriorated or died whilst on treatment."	"RESULTS: A total of 128 children were enrolled over an 18-month period. Four patients (3.1%) had a diagnosis of confirmed TB, 82 (64.1%) with ""probable TB"" and 42 (32.8%) with ""suspected TB"". Of 88 patients tested 43 (48.9%) were HIV positive. HIV positive patients had a higher frequency of failure to thrive, digital clubbing, enlarged lymph nodes and hepatomegaly; and a lower frequency of positive Mantoux tests. HIV positive patients were less likely to be classified as ""confirmed or probable TB"" (chi2 = 5.02, p = 0.025). Fifty six patients had a good outcome, 12 had a poor outcome and 60 defaulted before completing six months of treatment. HIV positive children were more likely to have a poor outcome (relative risk = 9.58, 95% CI 1.32 - 69.46). A diagnosis of ""confirmed or probable TB"" was associated with a good outcome (relative risk for poor outcome = 0.14, 95% CI 0.05 - 0.36)."	"CONCLUSION: HIV positive children with suspected TB frequently have signs that suggest the presence of other diseases such as Lymphocystic Interstitial Pneumonitis (LIP) and chronic bronchiectasis; and are less likely to have a diagnosis of ""probable or confirmed TB"" after investigations. Patients with an uncertain diagnosis of TB are less likely to improve on anti-TB therapy."					
205	Comparison of isotope dilution with bioimpedance spectroscopy and anthropometry for assessment of body composition in asymptomatic HIV-infected and HIV-uninfected breastfeeding mothers.	"Papathakis PC, Rollins NC, Brown KH, Bennish ML, Loan MDv."	American Journal of Clinical Nutrition. 2005;82(3):538-46.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh3&AN=20053193471	"Background: The effect of breast feeding on the nutrition of HIV-infected (HIV+) mothers is unknown. Simple, valid methods are needed for body-composition assessment of HIV+ women. Objective: We compared the ability of bioimpedance spectroscopy (BIS) and anthropometry with that of isotope dilution (<sup>2</sup>H<sub>2</sub>O) to measure fat-free mass (FFM) and fat mass (FM) in HIV+ and HIV-uninfected (HIV-) breast feeding South African mothers. Design: Total body water (TBW) content of 68 lactating mothers (20 HIV+, 48 HIV-) was measured 10 wk after delivery by using BIS and <sup>2</sup>H<sub>2</sub>O to measure FFM and FM. Anthropometric measurements included body mass index (BMI; in kg/m<sup>2</sup>), midupper arm circumference (MUAC), and 4 skinfold thicknesses. Results: TBW, FFM, and FM measurements determined by BIS were correlated with <sup>2</sup>H<sub>2</sub>O measurements in HIV+ (r=0.664, 0.621, and 0.872, respectively; P<0.01) and HIV- (r=0.876, 0.868, and 0.932, respectively; P<0.001) mothers. TBW measured by BIS was greater than that measured by the <sup>2</sup>H<sub>2</sub>O method in both HIV+ (1.8 L) and HIV- (1.5 L) women; FM or FFM did not differ significantly by method. BMI, MUAC, and all skinfold-thickness measurements correlated strongly (r>0.62, P<0.001) with FM measured by <sup>2</sup>H<sub>2</sub>O in both groups. BMI and MUAC correlated (r>0.64, P<0.001) with FFM in HIV- mothers but not in HIV+ mothers. Conclusions: In HIV+ and HIV- breastfeeding mothers, BIS provides an estimate of body composition comparable to that obtained with the <sup>2</sup>H<sub>2</sub>O method. BMI and MUAC are useful in predicting FM in both groups but are not valid measures of FFM in HIV+ mothers."									
175	Growth faltering due to breastfeeding cessation in uninfected children born to HIV-infected mothers in Zambia.	"Arpadi S, Fawzy A, Aldrovandi GM, Kankasa C, Sinkala M, Mwiya M, Thea DM, et al."	American Journal of Clinical Nutrition. 2009;90(2):344-53.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=19553300	BACKGROUND: The effect of breastfeeding on growth in HIV-exposed infants is not well described.	OBJECTIVE: The objective was to evaluate the effect of early breastfeeding cessation on growth.	"DESIGN: In a trial conducted in Lusaka, Zambia, HIV-infected mothers were randomly assigned to exclusive breastfeeding for 4 mo followed by rapid weaning to replacement foods or exclusive breastfeeding for 6 mo followed by introduction of complementary foods and continued breastfeeding for a duration of the mother's choice. Weight-for-age z score (WAZ), length-for-age z score (LAZ), and weight-for-length z score (WLZ) and the self-reported breastfeeding practices of 593 HIV-uninfected singletons were analyzed. Generalized estimating equations were used to adjust for confounders."	"RESULTS: WAZ scores declined precipitously between 4.5 and 15 mo. The decline was slower in the breastfed infants. At 9, 12, and 15 mo, mean WAZs were, respectively, -0.74, -0.92, and -1.06 in infants who were reportedly breastfed and were -1.07, -1.20, and -1.31 in the weaned infants (P = 0.003, 0.007, and 0.02, respectively). No differences were observed past 15 mo. Breastfeeding practice was not associated with LAZ, which declined from -0.98 to -2.24 from 1 to 24 mo. After adjustment for birth weight, maternal viral load, body mass index, education, season, and marital and socioeconomic status, not breastfeeding was associated with a 0.28 decline in WAZ between 4.5 and 15 mo (P < 0.0001). During the rainy season, not breastfeeding was associated with a larger WAZ decline (0.33) than during the dry season (0.22; P for interaction = 0.02)."	CONCLUSIONS: Early growth is compromised in uninfected children born to HIV-infected Zambian mothers. Continued breastfeeding partially mitigates this effect through 15 mo. Nutritional interventions to complement breastfeeding after 6 mo are urgently needed. This trial was registered at clinicaltrials.gov as NCT00310726.					
206	Comparison of isotope dilution with bioimpedance spectroscopy and anthropometry for assessment of body composition in asymptomatic HIV-infected and HIV-uninfected breastfeeding mothers.	"Papathakis PC, Rollins NC, Brown KH, Bennish ML, Van Loan M."	American Journal of Clinical Nutrition. 2005;82(3):538-46.		"Background: The effect of breastfeeding on the nutrition of HIV-infected (HIV+) mothers is unknown. Simple, valid methods are needed for body-composition assessment of HIV+ women. Objective: We compared the ability of bioimpedance spectroscopy (BIS) and anthropometry with that of isotope dilution ( <sup>2</sup>H<sub>2</sub>O) to measure fat-free mass (FFM) and fat mass (FM) in HIV+ and HIV-uninfected (HIV-) breastfeeding South African mothers. Design: Total body water (TBW) content of 68 lactating mothers (20 HIV+, 48 HIV-) was measured 10 wk after delivery by using BIS and <sup>2</sup>H<sub>2</sub>O to measure FFM and FM. Anthropometric measurements included body mass index (BMI; in kg/m<sup>2</sup>), midupper arm circumference (MUAC), and 4 skinfold thicknesses. Results: TBW, FFM, and FM measurements determined by BIS were correlated with <sup>2</sup>H<sub>2</sub>O measurements in HIV+ (r = 0.664, 0.621, and 0.872, respectively; P < 0.01) and HIV- (r = 0.876, 0.868, and 0.932, respectively; P < 0.001) mothers. TBW measured by BIS was greater than that measured by the <sup>2</sup>H<sub>2</sub>O method in both HIV+ (1.8 L) and HIV- (1.5 L) women; FM or FFM did not differ significantly by method. BMI, MUAC, and all skinfold-thickness measurements correlated strongly (r > 0.62, P < 0.001) with FM measured by <sup>2</sup>H<sub>2</sub>O in both groups. BMI and MUAC correlated (r > 0.64, P < 0.001) with FFM in HIV- mothers but not in HIV+ mothers. Conclusions: In HIV+ and HIV- breastfeeding mothers, BIS provides an estimate of body composition comparable to that obtained with the <sup>2</sup>H<sub>2</sub>O method. BMI and MUAC are useful in predicting FM in both groups but are not valid measures of FFM in HIV+ mothers. 2005 American Society for Clinical Nutrition."									
1456	"An assessment of food supplementation to chronically sick patients receiving home based care in Bangwe, Malawi: a descriptive study."	"Bowie C, Kalilani L, Marsh R, Misiri H, Cleary P, Bowie C."	Nutrition Journal. 2005;4:12.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=15777483	BACKGROUND: The effect of food supplementation provided by the World Food Programme to patients and their families enrolled in a predominantly HIV/AIDS home based care programme in Bangwe Malawi is assessed.	METHODS: The survival and nutritional status of patients and the nutritional status of their families recruited up to six months before a food supplementation programme started are compared to subsequent patients and their families over a further 12 months.	"RESULTS: 360 patients, of whom 199 died, were studied. Food supplementation did not improve survival but had an effect (not statistically significant) on nutritional status. Additional oil was given to some families; it may have improved survival but not nutritional status."	CONCLUSION: Food supplementation to HIV/AIDS home based care patients and their families does not work well. This may be because the intervention is too late to affect the course of disease or insufficiently targeted perhaps due to problems of distribution in an urban setting. The World Food Programme's emphasis on supplementary feeding for these families needs to be reviewed.						
1459	"An assessment of food supplementation to chronically sick patients receiving home based care in Bangwe, Malawi: A descriptive study."	"Kalilani L, Marsh R, Misiri H, Cleary P, Bowie C."	Nutrition Journal. 2005 21 Mar;4(12).		"Background: The effect of food supplementation provided by the World Food Programme to patients and their families enrolled in a predominantly HIV/AIDS home based care programme in Bangwe Malawi is assessed. Methods: The survival and nutritional status of patients and the nutritional status of their families recruited up to six months before a food supplementation programme started are compared to subsequent patients and their families over a further 12 months. Results: 360 patients, of whom 199 died, were studied. Food supplementation did not improve survival but had an effect (not statistically significant) on nutritional status. Additional oil was given to some families; it may have improved survival but not nutritional status. Conclusion: Food supplementation to HIV/AIDS home based care patients and their families does not work well. This may be because the intervention is too late to affect the course of disease or insufficiently targeted perhaps due to problems of distribution in an urban setting. The World Food Programme's emphasis on supplementary feeding for these families needs to be reviewed. 2005 Bowie et al; licensee BioMed Central Ltd."									
1461	Multiple micronutrient supplementation improves vitamin B12 and folate concentrations of HIV infected children in Uganda: a randomized controlled trial.	"Ndeezi G, Tumwine JK, Ndugwa CM, Bolann BJ, Tylleskar T."	Nutrition Journal. 2011;10:56.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=21600005	BACKGROUND: The effect of multiple micronutrient supplementation on vitamin B12 and folate has hither to not been reported in African HIV infected children. This paper describes vitamin B12 and folate status of Ugandan HIV infected children aged 1-5 years and reports the effect of multiple micronutrient supplementation on serum vitamin B12 and folate concentrations.	"METHODS: Of 847 children who participated in a multiple micronutrient supplementation trial, 214 were assessed for vitamin B12 and folate concentrations pre and post supplementation. One hundred and four children were randomised to two times the recommended dietary allowance (RDA) of a 14 multiple micronutrient supplement (MMS) and 114 to a 'standard of care' supplement of 6 multivitamins (MV). Serum vitamin B12 was measured by an electrochemiluminescence immunoassay and folate by a competitive protein-binding assay using Modular E (Roche) automatic analyzer. Vitamin B12 concentrations were considered low if less than 221 picomoles per litre (pmol/L) and folate if < 13.4 nanomoles per litre (nmol/L). The Wilcoxon Signed Ranks test was used to measure the difference between pre and post supplementation concentrations."	"RESULTS: Vitamin B12 was low in 60/214 (28%) and folate in 62/214 (29.0%) children. In the MMS group, the median concentration (IQR) of vitamin B12 at 6 months was 401.5 (264.3 - 518.8) pmol/L compared to the baseline of 285.5 (216.5 - 371.8) pmol/L, p < 0.001. The median (IQR) folate concentrations increased from 17.3 (13.5-26.6) nmol/L to 27.7 (21.1-33.4) nmol/L, p < 0.001. In the 'standard of care' MV supplemented group, the median concentration (IQR) of vitamin B12 at 6 months was 288.5 (198.8-391.0) pmol/L compared to the baseline of 280.0 (211.5-386.3) pmol/L while the median (IQR) folate concentrations at 6 months were 16.5 (11.7-22.1) nmol/L compared to 15.7 (11.9-22.1) nmol/L at baseline. There was a significant difference in the MMS group in both vitamin B12 and folate concentrations but no difference in the MV group."	CONCLUSIONS: Almost a third of the HIV infected Ugandan children aged 1-5 years had low serum concentrations of vitamin B12 and folate. Multiple micronutrient supplementation compared to the 'standard of care' supplement of 6 multivitamins improved the vitamin B12 and folate status of HIV infected children in Uganda.	TRIAL REGISTRATION: http://ClinicalTrials.govNCT00122941).					
1323	Zinc erythrocyte protoporphyrin as marker of malaria risk in pregnancy - A retrospective cross-sectional and longitudinal study.	"Senga EL, Koshy G, Brabin BJ."	Malaria Journal. 2012;11(249).		"Background: The effects of iron interventions and host iron status on infection risk have been a recurrent clinical concern, although there has been little research on this interaction in pregnant women. Methods: Cross-sectional and longitudinal analyses were undertaken to determine the association of whole blood zinc erythrocyte protoporphyrin (ZPP) with malaria parasitaemia in pregnant women attending antenatal and delivery care at Montfort and Chikwawa Hospitals, Shire Valley, Malawi. Prevalence of antenatal, delivery and placental malaria was assessed in relation to maternal ZPP levels. The main outcome measures were prevalence of peripheral and placental Plasmodium falciparum parasitaemia and odds ratios of malaria risk. Results: A total of 4,103 women were evaluated at first antenatal visit, of whom at delivery 1327 were screened for peripheral and 1285 for placental parasitaemia. Risk of malaria at delivery (peripheral or placental) was higher in primigravidae (p<0.001), and lower (peripheral) with use of intermittent preventive anti-malarials during pregnancy (p<0.001). HIV infection was associated with increased malaria parasitaemia (p<0.02, peripheral or placental). Parasitaemia prevalence was lower in women with normal ZPP levels compared to those with raised concentrations at both first antenatal visit (all gravidae, p = 0.048, and at delivery (all gravidae, p<0.001; primigravidae, p = 0.056). Between first antenatal visit and delivery women who transitioned from raised (at first antenatal visit) to normal ZPP values (at delivery) had lower peripheral parasitaemia prevalence at delivery compared to those who maintained normal ZPP values at both these visits (all gravidae: 0.70, 95%CI 0.4-1.1; primigravidae: 0.3, 0.1-0.8). In regression analysis this difference was lost with inclusion of HIV infection in the model. Conclusions: Raised ZPP concentrations in pregnancy were positively associated with P. falciparum parasitaemia and were probably secondary to malaria inflammation, rather than indicating an increased malaria risk with iron deficiency. It was not possible from ZPP measurements alone to determine whether iron deficiency or repletion alters malaria susceptibility in pregnancy. 2012 Senga et al.; licensee BioMed Central Ltd."									
1319	Normal enhanced liver fibrosis (ELF) values in apparently healthy subjects undergoing a health check-up and in living liver donors in South Korea.	"Yoo EJ, Kim BK, Kim SU, Park JY, Kim DY, Ahn SH, Han KH, et al."	Liver International. 2013 May;33(5):706-13.		"Background: The enhanced liver fibrosis (ELF) value is a non-invasive serum marker used for assessing liver fibrosis in chronic liver disease. To use the ELF value for the purpose of screening the general population and selecting subpopulations at high risk, it is important to know the normal range of ELF values as a prerequisite. Aims: We aimed to define the normal range of ELF values by recruiting apparently healthy subjects and investigating factors influencing ELF values in subjects with minimal fibrotic burden. Methods: ELF values were determined in a cohort of healthy subjects who underwent a health check-up and in healthy living liver donors who were screened for transplantation. None of subjects suffered from chronic heart disease, diabetes mellitus, metabolic syndrome, hepatitis B, hepatitis C, or human immunodeficiency virus infection, systemic autoimmune disease or liver dysfunction. Results: Among 183 subjects analyzed, the normal ELF 5th through 95th percentile range was 5.95-8.73. Body mass index (P = 0.014) and male gender (P = 0.015) showed significant positive correlations with ELF value, whereas age did not. In multivariate linear regression analysis, platelet count was identified as the only independent factor influencing the ELF value (beta=-0.006, P = 0.016). When considering the difference in ELF values between genders, the normal range of men was defined to be 6.72-8.93, this was slightly higher than that of women, 5.69-8.67. Conclusions: We identified the normal range of ELF values and found that it can be significantly influenced by platelet count even in the healthy population. 2013 John Wiley & Sons A/S."									
426	The impact of food assistance on weight gain and disease progression among HIV-infected individuals accessing AIDS care and treatment services in Uganda.	"Rawat R, Kadiyala S, McNamara PE."	BMC Public Health. 2010;10:316.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=20529283	"BACKGROUND: The evidence evaluating the benefits of programmatic nutrition interventions to HIV-infected individuals in developing countries, where there is a large overlap between HIV prevalence and malnutrition, is limited. This study evaluates the impact of food assistance (FA) on change in weight and disease progression as measured by WHO staging."	"METHODS: We utilize program data from The AIDS Support Organization (TASO) in Uganda to compare outcomes among FA recipients to a control group, using propensity score matching (PSM) methods among 14,481 HIV-infected TASO clients."	RESULTS: FA resulted in a significant mean weight gain of 0.36 kg over one year period. This impact was conditional on anti-retroviral therapy (ART) receipt and disease stage at baseline. FA resulted in mean weight gain of 0.36 kg among individuals not receiving ART compared to their matched controls. HIV-infected individuals receiving FA with baseline WHO stage II and III had a significant weight gain (0.26 kg and 0.2 kg respectively) compared to their matched controls. Individuals with the most advanced disease at baseline (WHO stage IV) had the highest weight gain of 1.9 kg. The impact on disease progression was minimal. Individuals receiving FA were 2 percentage points less likely to progress by one or more WHO stage compared to their matched controls. There were no significant impacts on either outcome among individuals receiving ART.	"CONCLUSIONS: Given the widespread overlap of HIV and malnutrition in sub-Saharan Africa, FA programs have the potential to improve weight and delay disease progression, especially among HIV-infected individuals not yet on ART. Additional well designed prospective studies evaluating the impact of FA are urgently needed."						
194	"Relative influences of sex, race, environment, and HIV infection on body composition in adults."	"Kotler DP, Thea DM, Heo M, Allison DB, Engelson ES, Wang J, Pierson RN, Jr., et al."	American Journal of Clinical Nutrition. 1999;69(3):432-9.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=10075327	BACKGROUND: The factors that control body composition in disease are uncertain.	"OBJECTIVE: We planned to compare the relative influences of HIV infection, sex, race, and environment on body composition."	"METHODS: We analyzed results of body composition studies performed by bioelectrical impedance analysis in 1415 adults from 2 cohorts: white and African American men and women from the United States, and African men and women (279 HIV-infected and 1136 control). The effects of sex and HIV infection on weight, body cell mass, and fat-free mass were analyzed by using both unadjusted and age-, weight-, and height-adjusted data."	"RESULTS: Control men weighed more and had more body cell mass and fat-free mass than did control women, although control women had more fat. The strongest correlates with body composition were height and weight, followed by sex. HIV infection, age, environment, and race. Control men and women weighed more and had more body cell mass, fat-free mass, and fat than did HIV-infected men. However, differences in body composition between HIV-infected and control groups were strongly influenced by sex. Of the differences in weight between HIV-infected and uninfected subjects, fat-free mass accounted for 51% in men but only 18% in women, in whom the remainder was fat. Sex effects were similar in African and American groups."	"CONCLUSIONS: Sex has a marked effect on the changes in body composition during HIV infection, with women losing disproportionately more fat than men. Sex-related differences in body composition were narrower in the HIV-infected groups. Race and environment had smaller effects than sex and HIV infection."					
1589	"Implementing the global plan to stop TB, 2011-2015 - optimizing allocations and the global fund's contribution: A scenario projections study."	"Korenromp EL, Glaziou P, Fitzpatrick C, Floyd K, Hosseini M, Raviglione M, Atun R, et al."	PLoS ONE. 2012 18 Jun;7(6).		"Background: The Global Plan to Stop TB estimates funding required in low- and middle-income countries to achieve TB control targets set by the Stop TB Partnership within the context of the Millennium Development Goals. We estimate the contribution and impact of Global Fund investments under various scenarios of allocations across interventions and regions. Methodology/Principal Findings: Using Global Plan assumptions on expected cases and mortality, we estimate treatment costs and mortality impact for diagnosis and treatment for drug-sensitive and multidrug-resistant TB (MDR-TB), including antiretroviral treatment (ART) during DOTS for HIV-co-infected patients, for four country groups, overall and for the Global Fund investments. In 2015, China and India account for 24% of funding need, Eastern Europe and Central Asia (EECA) for 33%, sub-Saharan Africa (SSA) for 20%, and other low- and middle-income countries for 24%. Scale-up of MDR-TB treatment, especially in EECA, drives an increasing global TB funding need - an essential investment to contain the mortality burden associated with MDR-TB and future disease costs. Funding needs rise fastest in SSA, reflecting increasing coverage need of improved TB/HIV management, which saves most lives per dollar spent in the short term. The Global Fund is expected to finance 8-12% of Global Plan implementation costs annually. Lives saved through Global Fund TB support within the available funding envelope could increase 37% if allocations shifted from current regional demand patterns to a prioritized scale-up of improved TB/HIV treatment and secondly DOTS, both mainly in Africa - with EECA region, which has disproportionately high per-patient costs, funded from alternative resources. Conclusions/Significance: These findings, alongside country funding gaps, domestic funding and implementation capacity and equity considerations, should inform strategies and policies for international donors, national governments and disease control programs to implement a more optimal investment approach focusing on highest-impact populations and interventions. 2012 Korenromp et al."									
398	Health and human rights of women imprisoned in Zambia.	"Todrys KW, Amon JJ."	BMC International Health and Human Rights. 2011;11(1).		"Background: The healthcare needs and general experience of women in detention in sub-Saharan Africa are rarely studied and poorly understood. Methods. A mixed-methods study was conducted including in-depth interviews with 38 adult female prisoners and 21 prison officers in four Zambian prisons to assess the health and human rights concerns of female detainees. Key informant interviews with 46 officials from government and non-governmental organizations and a legal and policy review were also conducted. Results: Despite special protection under international and regional law, incarcerated women's health needs-including prenatal care, prevention of mother-to-child transmission of HIV, and nutritional support during pregnancy and breastfeeding-are not being adequately met in Zambian prisons. Women are underserved by general healthcare programs including those offering tuberculosis and HIV testing, and reported physical and sexual abuse conducted by police and prison officers that could amount to torture under international law. Conclusions: There is an urgent need for women's healthcare services to be expanded, and for general prison health campaigns, including HIV and tuberculosis testing and treatment, to ensure the inclusion of female inmates. Abuses against women in Zambian police and prison custody, which violate their rights and compromise their health, must be halted immediately. 2011 Todrys and Amon; licensee BioMed Central Ltd."									
1171	Oral manifestations in 101 Cambodian patients with HIV infection and AIDS.	"Bendick C, Scheifele C, Reichart PA."	Journal of Oral Pathology & Medicine. 2002;31(1):1-4.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh3&AN=20023166793	"Background: The HIV/AIDS epidemic in Cambodia has become a major problem in the last 7-8 years, mainly because in this formerly war-stricken country the socioeconomic situation is only slowly improving. Since only very few studies have been published to date on the oral health status of Cambodian HIV/AIDS patients, it was the purpose of the present investigation to study oral manifestations in Cambodian patients with HIV disease. Methods: One hundred one Cambodian patients with HIV infection or AIDS were examined for the presence of oral manifestations in one medical centre in Phnom Penh, Cambodia. Results: Sixty-three men and 38 women with a median age of 32 years were examined (age range 7.5-63.5 years). Of these patients, 42.6% were smokers, 46.5% of men were heavy drinkers and 90.5% of men were promiscuous compared with 5.3% of women. The most frequent AIDS-defining diseases were wasting syndrome (54.5%), Pneumocystis carinii pneumonia (PcP) (19.8%) and tuberculosis (18.8%). Puritic papular eruption, a common cutaneous manifestation in HIV-infected patients, was seen in 17.8% of patients. Candida-associated infections of the oral cavity were most common. Among the patients, 52.5% revealed pseudomembranous candidosis and 35.6% had bilateral hairy leukoplakia. Only 10% of patients had no oral lesions. Also common were necrotising ulcerative gingivo-periodontal diseases (27.7%). Conclusions: The general health status of 101 Cambodian patients with HIV infection and AIDS is poor, and they demonstrate a large number of oral manifestations. Antiretroviral therapy is presently not available and only a fraction of patients receives antimycotic treatment (25.7%). HIV infection and the AIDS epidemic in Cambodia have become a serious problem and patients urgently need adequate diagnosis and antiretroviral therapies."									
418	Prevalence and factors associated with probable HIV dementia in an African population: A cross-sectional study of an HIV/AIDS clinic population.	"Nakku J, Kinyanda E, Hoskins S."	BMC Psychiatry. 2013 03 May;13(126).		"Background: The HIV/AIDS infection is common in sub-Saharan Africa and is associated with psychological and neuro- cognitive impairment. These conditions, however, remain largely unrecognized. In this study we aimed to determine the prevalence of probable HIV dementia (PHD) in an HIV clinic population in Uganda and to delineate the factors associated with such impairment in these HIV positive individuals.Methods: Six hundred eighty HIV clinic attendees were surveyed in a cross sectional study. PHD was assessed using the International Dementia Scale (IHDS). Standardized measures were also used to assess clinical, psychological, social and demographic variables. Respondents were aged 18 years and above and did not have severe physical or mental health conditions. Multivariate analysis was conducted to identify associations between PHD and various factors.Results: The prevalence of probable HIV dementia was 64.4%. PHD was significantly associated with increasing stress scores and psychosocial impairment but not with age, BMI, CD4 count, use of HAART, or a diagnosis of depression or alcohol dependence.Conclusion: The prevalence of probable HIV dementia in an ambulatory adult HIV positive population in Uganda was 64.4%. Increasing stress scores and psychosocial impairment were significant contributing factors. Clinicians need to be aware of this and to make efforts to identify neuro-cognitive impairment. Secondly there is need for more studies to better understand the relationship between PHD and stress in HIV populations so as to inform patient care. 2013 Nakku et al.; licensee BioMed Central Ltd."									
261	Caregiving and cardiovascular disease risk factors in male and female Luo elders from Kenya.	"Horwitz S, Yogo J, Juma E, Ice GH."	Annals of Human Biology. 2009;36(4):400-10.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20093182836	"Background: The HIV/AIDS pandemic has created over 11 million orphans, who are primarily being cared for by grandparents. It has been suggested that this renewed parenting responsibility presents elders with added stressors. Few studies have systematically examined the impact of caregiving on health outcomes. Aim: The aim of this study was to examine the impact of caregiving on cardiovascular risk. It was hypothesized that caregiving would increase cardiovascular disease risk as measured by Framingham risk scores. Subjects and method: 386 Luo elders (age=73+or-8), divided into caregiving and non-caregiving groups, were recruited from the Nyanza Province, Kenya. Data were obtained from the participants including: Total cholesterol, HDL cholesterol, glucose, blood pressure, age, sex and smoking status. Results: No significant difference was found between the Framingham risk scores of caregivers and non-caregivers. Among women increased BMI was positively associated with Framingham score (p=0.017), and among men increased waist circumference was positively associated with the score (p<0.001). Among women, the number of orphans under one's care lowered the risk of falling into the top quartile of the Framingham score while being a caregiver increased the risk of falling into the top quartile. Conclusion: This study demonstrates that there is not a simple relationship between caregiving and cardiovascular risk."									
1030	Effects of in utero antiretroviral exposure on longitudinal growth of HIV-exposed uninfected infants in Botswana.	"Powis KM, Smeaton L, Ogwu A, Lockman S, Dryden-Peterson S, van Widenfelt E, Leidner J, et al."	Journal of Acquired Immune Deficiency Syndromes: JAIDS. 2011;56(2):131-8.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=21124227	BACKGROUND: The impact of in utero exposure to highly active antiretroviral therapy (HAART) on longitudinal growth of HIV-uninfected infants is unknown.	"METHODS: The Mashi and Mma Bana PMTCT intervention trials enrolled HIV-infected pregnant women at four sites in Botswana. Breast-fed (BF), HIV-uninfected infants born at 37 weeks or greater were included in this analysis. Weight-for-age (WAZ), length-for-age (LAZ), and weight-for-length (WLZ) z-scores were calculated using World Health Organization Child Growth Standards. Mean z-scores were compared between in utero antiretroviral exposure groups using Student t test, response profiles analysis, and general linear mixed effects modeling."	"RESULTS: Growth of 619 HAART-exposed and 440 zidovudine-exposed, HIV-uninfected infants was evaluated. Mean birth weights were 3.01 kg for HAART and 3.15 kg for zidovudine-exposed infants (P < 0.001) with lower mean birth WAZ, length-for-age (LAZ), and weight-for-length (WLZ) among HAART-exposed infants (all P < 0.001). HAART-exposed infants had greater improvement in WAZ and weight-for-length (WLZ) from birth through 2 months (P = 0.03, P < 0.001, respectively). The WAZ did not differ between groups from 3 through 6 months (P = 0.26). Length-for-age (LAZ) remained lower in HAART-exposed infants but the incidence of wasting or stunting did not differ between exposure groups."	CONCLUSIONS: Lower weights in HAART-exposed uninfected infants at birth were rapidly corrected during the first 6 months of life.						
301	Impact of tenofovir-associated renal dysfunction among HIV-infected patients with low bodyweight: A retrospective cohort study of the Japanese patients.	"Nishijima T, Komatsu H, Gatanaga H, Aoki T, Watanabe K, Kinai E, Honda H, et al."	Antiviral Therapy. 2011;16:A16-A7.		"Background: The impact of tenofovir-associated renal dysfunction has hardly been evaluated among patients with low body weight, a possible high-risk group, although tenofovir use will spread rapidly in Asia and Africa, where patients are likely to be smaller. Method: In a single-center cohort, Japanese patients with HIV infection who started tenofovir-containing antiretroviral therapy were retrospectively analyzed. Incidence rate of tenofovir-associated renal dysfunction, defined as more than 25% of decrement of estimated glomerular filtration rate (eGFR) from the baseline, was calculated. Impact of being lower weight and smaller body mass index (BMI) for tenofovir-associated renal dysfunction were estimated in univariate and multivariate Cox hazards model as a primary exposure. Other possible risk factors were evaluated in univariate analysis and were added in the multivariate analysis for adjustment if they were statistically significant. Results: Median weight of 495 patients in the analysis was 63 kg. Tenofovir-associated renal dysfunction occurred to 97 patients (19.6%) with incidence rate of 10.5 per 100 person-years. In univariate analysis, every 5 kg decrement and smaller BMI had a significant impact on the incidence of tenofovir-associated renal dysfunction (HR=1.23; 95% CI, 1.10-1.37; P<0.001, HR=1.14; 95% CI, 1.05-1.23; P=0.001, respectively). Older age, higher eGFR, lower serum creatinine, lower CD4 counts, higher HIV viral load, concurrent nephrotoxic drug, hepatitis C infection, and a current smoker were also identified as risks. Every 5 kg decrement persisted to be a risk with statistical significance in multivariate analysis, (adjusted HR=1.13; 95% CI, 1.01-1.27; P=0.039) but not smaller BMI (adjusted HR=1.07; 95% CI 1.00-1.16; P=0.058). Conclusion: Incidence rate of tenofovir-associated renal dysfunction among the Japanese patients was high. Lower body weight was identified as a risk for tenofovir-associated renal dysfunction in a model designed to evaluate lower body weight as primary exposure. (Table Presented)."									
789	The impact of malnutrition on survival and the CD4 count response in HIV-infected patients starting antiretroviral therapy.	"Paton NI, Sangeetha S, Earnest A, Bellamy R."	HIV Medicine. 2006;7(5):323-30.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=16945078	BACKGROUND: The impact that malnutrition at the time of starting antiretroviral therapy (ART) has on survival and the CD4 count response is not known.	METHODS: A retrospective cohort study of patients attending the national HIV referral centre in Singapore who had a CD4 count less than 250 cells/microL and a measurement of body weight performed at the time of starting ART was carried out. Demographic and clinical variables were extracted from an existing database. Body mass index (BMI) was calculated from the weight in kilograms divided by the square of the height in metres. Moderate to severe malnutrition was defined as BMI less than 17 kg/m(2). Intent-to-treat Cox models were used to determine the predictors of survival.	"RESULTS: A total of 394 patients were included in the analysis, of whom 79 died during a median study follow-up of 2.4 years. Moderate to severe malnutrition was present in 16% of patients at the time of starting ART, and was found to be a significant independent predictor of death [hazard ratio (HR) 2.19, 95% confidence interval (CI) 1.29-3.73, P=0.004 for those with BMI<17 compared with those with BMI>18.5] as were stage of disease (HR 2.47, 95% CI 1.20-5.07, P=0.014 for those who were at stage C compared with those at stage A) and the type of ART [HR 0.50, 95% CI 0.27-0.93, P=0.03 for highly active antiretroviral therapy (HAART) compared with non-HAART treatment]. Malnutrition did not impair the magnitude of the increase in CD4 count at 6 or 12 months."	"CONCLUSIONS: Malnutrition at the time of starting ART was significantly associated with decreased survival, but the effect appeared not to be mediated by impaired immune reconstitution. Given the increasing access to ART in developing countries and the high frequency of HIV-associated wasting, studies of nutritional therapy as an adjunct to the initiation of HAART are urgently needed."						
305	Incidence of lipodystrophy and metabolic disorders in patients starting non-nucleoside reverse transcriptase inhibitors in Benin.	"Zannou DM, Denoeud L, Lacombe K, Amoussou-Guenou D, Bashi J, Akakpo J, Gougounon A, et al."	Antiviral Therapy. 2009;14(3):371-80.		"Background: The incidence and risk factors for lipodystrophy and metabolic disorders among patients in Africa on first-line combined antiretroviral treatment (cART) mostly containing non-nucleoside reverse transcriptase inhibitors is poorly documented. Methods: This prospective cohort study recruited 88 HIV-infected patients initiating cART between October 2004 and June 2005 in Cotonou, Benin. Patients were followed for 24 months. The main outcomes were incidence of lipodystrophy and metabolic disorders. Multivariate Cox proportional hazards regression models were used to describe factors associated with progression to lipodystrophy. Results: After a median follow-up of 23.2 months (inter-quartile range 22.3-23.7), 24 (30%) patients developed lipodystrophy (lipoatrophy 9%, lipohypertrophy 24% and mixed pattern 2.5%). The incidence rate for lipodystrophy was estimated to 1.72 per person-month (95% confidence interval [CI] 1.15-2.56) occurring after a median time of 11 months on cART. Metabolic syndrome (International Diabetes Federation definition) appeared in 10 (13%) patients after a median of 15 months with an estimated incidence rate of 0.62 per person-month (95% CI 0.33-1.16). It was more common in women (19.2% versus 3.1% in men; P=0.043). Diabetes (8%) and hypercholesterolaemia (35%) were also observed. After adjustment, gender, young age (hazard ratio [HR] 0.45 [95% CI 0.22-0.90]; P=0.025), high BMI at inclusion (HR 1.53 [95% CI 1.28-1.83]; P<0.0001) and smoking (HR 28.0 [95% CI 2.5-307.4]; P=0.006) were significantly associated with lipohypertrophy. Conclusions: Lipodystrophy and metabolic syndrome were commonly and rapidly observed in this cohort of sub-Saharan patients initiating cART. 2009 International Medical Press."									
718	Integrating nutrition security with treatment of people living with HIV: lessons from Kenya.	"Byron E, Gillespie S, Nangami M."	Food & Nutrition Bulletin. 2008;29(2):87-97.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=18693472	"BACKGROUND: The increased caloric requirements of HIV-positive individuals, undesirable side effects of treatment that may be worsened by malnutrition (but alleviated by nutritional support), and associated declines in adherence and possible increased drug resistance are all justifications for developing better interventions to strengthen the nutrition security of individuals receiving antiretroviral treatment."	OBJECTIVE: To highlight key benefits and challenges relating to interventions aimed at strengthening the nutrition security of people living with HIV who are receiving antiretroviral treatment.	METHODS: Qualitative research was undertaken on a short-term nutrition intervention linked to the provision of free antiretroviral treatment for people living with HIV in western Kenya in late 2005 and early 2006.	"RESULTS: Patients enrolled in the food program while on treatment regimens self-reported greater adherence to their medication, fewer side effects, and a greater ability to satisfy increased appetite. Most clients self-reported weight gain, recovery of physical strength, and the resumption of labor activities while enrolled in dual (food supplementation and treatment) programs. Such improvements were seen to catalyze increased support from family and community."	CONCLUSIONS: These findings provide further empirical support to calls for a more holistic and comprehensive response to the coexistence of AIDS epidemics with chronic nutrition insecurity. Future work is needed to clarify ways of bridging the gap between short-term nutritional support to individuals and longer-term livelihood security programming for communities affected by AIDS. Such interdisciplinary research will need to be matched by intersectoral action on the part of the agriculture and health sectors in such environments.					
1955	Treatment outcomes and prognostic factors in patients with multidrug-resistant tuberculosis in Korean private hospitals. [Korean].	"Park JK, Koh WJ, Kim DK, Kim EK, Kim YI, Kim HJ, Kim TH, et al."	Tuberculosis and Respiratory Diseases. 2010 August;69(2):95-102.		"Background: The increasing rate of drug-resistant tuberculosis (TB) is a threat to the public health and TB control. In Korea, about 75-80% of TB patients are treated in private hospitals and the rate has been continuously increasing since 2000. Methods: On a retrospective basis, we enrolled 170 newly diagnosed with or retreated for multidrug-resistant TB (MDR-TB) in 2004 from 21 private hospitals. We extracted the following demographics and treatment history from patient medical records: initial treatment outcomes, cumulative survival rates, treatment outcomes, and prognostic factors. Results: Of the 170 patients, the majority were male (64.1%), the mean age was 44.5 years old, and mean body-mass-index was 20.2 kg/m<sup>2</sup>. None of the patients tested positive for HIV. Eleven (6.5%) were confirmed to have extensively drug-resistant TB (XDR-TB) at treatment initiation. Treatment success rates were not different between XDR-TB (36.4%, 4/11) and non-XDR MDR-TB (51.6%, 82/159). Default rate was high, 21.8% (37/170). Far advanced disease on X-ray was a significant negative predictor of treatment success; advanced disease and low BMI were risk factors for all-cause mortality. Conclusion: In private hospitals in Korea, the proportion of XDR-TB in MDR-TB was comparable to previous data. The treatment success rate of MDR-/XDR-TB remains poor and the failure rate was quite high. Adequate TB control policies should be strengthened to prevent the further development and spread of MDR-/XDR-TB in Korea. Copyright2010. The Korean Academy of Tuberculosis and Respiratory Diseases. All rights reserved."									
629	Changes in retinol-binding protein concentrations and thyroid homeostasis with nonoccupational exposure to DDT.	"Delport R, Bornman R, MacIntyre UE, Oosthuizen NM, Becker PJ, Aneck-Hahn NH, de Jager C."	Environmental Health Perspectives. 2011 May;119(5):647-51.		"Background: The insecticide dichlorodiphenyltrichloroethane (DDT) has been used for malaria vector control in the northern and eastern parts of the Vhembe District of Limpopo Province, South Africa, since 1945. Bioaccumulation of DDT raises concern because it reportedly affects thyroid function.Objective: Our objective was to investigate the association between DDT uptake (as reflected in plasma concentrations) and thyroid homeostasis while considering related factors. Methods: We compared dietary intake, serum retinol-binding protein (RBP), transthyretin (TTR) and albumin concentrations, and liver and thyroid function between cases with evidence of a body burden of DDT in the circulation (concentration of any DDT isomer >= 0.02 mug/g lipid; n = 278) and controls (concentration of all DDT isomers < 0.02 mug/g lipid; n = 40) in a cross-sectional study. Further analyses were performed to assess the relevance of changes in RBP status associated with DDT uptake.Results: RBP concentrations below the reference range were more prevalent in cases (54% vs. 10% in controls; chi<sup>2</sup> = 27.4; p < 0.001), which could not be explained by nutrient intake. We observed significantly lower thyroid hormone concentrations among cases (p <= 0.01). We also observed a significant linear trend for serum concentrations of free thyroxine and free triiodothyronine (p < 0.001) and a significant quadratic trend for serum thyroid-stimulating hormone (p = 0.025) and TTR (p < 0.001) across the control group and case groups with normal and relatively low RBP concentrations. Relatively low RBP concentrations were associated with significantly higher DDT and 1,1-dichloro-2,2-bis(p-chlorophenyl) ethylene (DDE) isomer concentrations and with a higher DDE/DDT ratio (p <= 0.01), which signifies long-term exposure. Inadequate intake of vitamin A and zinc were observed in 84% and 58%, respectively, of the total study population. Conclusion: RBP concentrations appear to decrease in the presence of long-term DDT uptake, which may have deleterious effects on thyroid function and vitamin A nutritional status. This is of major concern in a population with poor vitamin A and zinc intake."									
1216	Salvage therapy with raltegravir in a 3-month-old infant.	"Brolund AB, Ilchmann C, Ganschow R, Degen O."	Journal of the International AIDS Society. 2010 08 Nov;13.		"Background: The integrase inhibitor raltegravir (RAL) is widely used in adults. Only limited data are available for children and no data for infants. We describe the case of a threemonth- old infant treated with RAL in combination with lopinavir/r (LPV/r) and lamivudine (3TC). Methods: The mother emigrated from Ghana several years before and was insufficiently treated in a local hospital with AZT, 3TC and nevirapine (NVP) with constantly high plasma viral load (VL). At admission to the external birth clinic her VL was 160,000 copies/ml, the CD4 count 146/ml. The infant had a gestational age of 35 weeks with a birth weight of 1940g. A high-risk chemoprophylaxis with AZT, 3CT and NVP was given until the confirmation of a HIV1 infection three weeks later. The infant was then referred to our university hospital in an underweight state. His VL was 2.5Mio copies/ml, the CD4 count was 37% (2110c/ml). The genotypic resistance profile showed full resistance for all NRTIs and NNRTIs. We started an off-label therapy including RAL at 6mg/kg BID. The dosage was extrapolated from smaller trials in children =6 years of age. RAL is only available in 400mg tablets, so we pestled the tablet, attenuated the powder and distributed the required amount of mixture into a capsule. The content was then solved in water and administered by the mother. We combined RAL with LPV/r and 3CT BID which were dosed according to paediatric recommendations and adjusted monthly due to weight gain in closed cooperation with the pharmacologist. Results The therapy was well tolerated, no clinical or laboratory adverse events have occurred yet. The boy showed a catch-up growth and weight gain from <3rd percentile to >25th percentile at week 16 of therapy. In the same period his VL decreased from 1.8Mio copies/ml to 164 copies/ml and his CD4 count increased to 39% (3357c/ ml). We performed a PK-profile and measured sufficient drug levels of RAL and LPV/r, comparable to the limited data of PK-studies conducted in older children. RAL Cmin: 146ng/ml, Cmax: 1960ng/ml, Tmax: 2h. Conclusions: Due to the widely use of NNRTIs in developing countries an increasing number of mother-to-child transmissions of HIV with multi resistances can be expected in the near future. We describe a successful salvage therapy including RAL in a three-month-old infant."									
405	Adherence to highly active antiretroviral therapy and its correlates among HIV infected pediatric patients in Ethiopia.	"Biadgilign S, Deribew A, Amberbir A, Deribe K."	BMC Pediatrics. 2008;8(53).		"Background: The introduction of combination antiretroviral therapy (ART) has resulted in striking reductions in HIV-related mortality. Despite increased availability of ART, children remain a neglected population. This may be due to concerns that failure to adhere appears to be related to continued viral replication, treatment failure and the emergence of drug-resistant strains of HIV. This study determines the rates and factors associated with adherence to Antiretroviral (ARV) Drug therapy in HIV-infected children who were receiving Highly Active Antiretroviral Therapy (HAART) in Addis Ababa, Ethiopia in 2008. Methods: A cross-sectional study was conducted in five hospitals in Addis Ababa from February 18 - April 28, 2008. The study population entailed parents/caretaker and index children who were following ART in the health facilities. A structured questionnaire was used for data collection. Results: A total of 390 children respondents were included in the study with a response rate of 91%. The majority, equaling 205 (52.6%) of the children, were greater than 9 years of age. Fifty five percent of the children were girls. A total of 339 children (86.9%) as reported by caregivers were adherent to antiretroviral drugs for the past 7 days before the interview. Numerous variables were found to be significantly associated with adherence: children whose parents did not pay a fee for treatment [OR = 0.39 (95%CI: 0.16, 0.92)], children who had ever received any nutritional support from the clinic [OR = 0.34 (95%CI: 0.14, 0.79)] were less likely to adhere. Whereas children who took co-trimoxazole medication/syrup besides ARVs [OR = 3.65 (95%CI: 1.24, 10.74)], children who did not know their sero-status [OR = 2.53 (95%CI: 1.24, 5.19)] and children who were not aware of their caregiver's health problem [OR = 2.45 (95%CI: 1.25, 4.81)] were more likely to adhere than their counterparts. Conclusion: Adherence to HAART in children in Addis Ababa was higher than other similar setups. However, there are still significant numbers of children who are non-adherent to HAART. 2008 Biadgilign et al; licensee BioMed Central Ltd."									
1553	Maternal factors in the etiology of fetal malnutrition in Nigeria.	"Adebami OJ, Oyedeji GA, Owa JA, Oyelami OA."	Pediatrics International. 2007;49(2):150-5.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=17445030	"BACKGROUND: The main objective of the study was to determine the role of maternal factors in the etiology of fetal malnutrition (FM) in Nigeria. Neonatal and Maternity Units of the Wesley Guild Hospital Ilesa, Nigeria, a unit of the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife was the setting for the study."	"METHODS: This was a prospective study of consecutive, singleton, term live babies delivered between January and August 2001. Fetal malnutrition was diagnosed using Clinical Assessment of Fetal Nutritional Status (CANS) and the score (CANSCORE) adapted by Metcoff. The maternal prenatal record was checked and additional history was obtained from the mother. This included history of maternal illness and drugs taken during pregnancy. The socioeconomic class of the parents was also documented. Nutritional status of the mother was determined using mid arm circumference (MAC) and the body mass index (BMI). Babies were stratified into babies with FM and babies without FM. The two groups of babies were compared."	"RESULTS: Of the 473 studied, 89 [18.8%] had FM. Maternal factors found associated with FM were: lack of antenatal care, young mother (<18 years), primiparity, maternal undernutrition (BMI < 18.5 kg/m(2) and MAC < 23.5 cm), low socioeconomic status, pregnancy-induced hypertension, antepatum hemorrhage, and maternal infections especially malaria, urinary tract infections and HIV (P < 0.05)."	"CONCLUSION: Improvement in the socioeconomic status of women and good antenatal care will reduce most of the maternal factors associated with FM in Nigeria. Therefore, antenatal should be made cheap and accessible to all pregnant mothers."						
1586	"Tenofovir use and renal insufficiency among pregnant and general adult population of HIV-infected, ART-naive individuals in Lilongwe, Malawi."	"Johnson DC, Chasela C, Maliwichi M, Mwafongo A, Akinkuotu A, Moses A, Jamieson DJ, et al."	PLoS ONE. 2012 27 Jul;7(7).		"Background: The Malawian government recently changed its prevention of mother-to-child transmission (PMTCT) regimen and plans to change its first-line antiretroviral therapy (ART) regimen to Tenofovir(TDF)/Lamivudine/Efavirenz as a fixed-dose combination tablet. Implementation could be challenging if baseline creatinine clearance (CrCl) screening were required to assess renal function prior to TDF therapy. Our goal is to determine predictors of CrCl<50 ml/min among HIV-infected, ART-naive individuals. Methodology: Data on HIV-infected, ART-naive adults screened for enrollment into 5 HIV clinical trials in Lilongwe, Malawi were combined for a pooled analysis of predictors for CrCl<50 ml/min. CrCl was derived from the Cockroft-Gault equation. Multivariable logistic regression modeled the association of age, body mass index (BMI), hemoglobin, CD4 cell count <350 cells/mm<sup>3</sup>, gender, and pregnancy with CrCl<50 ml/min. Results: The analysis included 3508 patients with values for creatinine clearance. Most subjects were female (90.6%) with a median age of 26 years (IQR 22-29). The median CD4 cell count was 444 (IQR 298.0-561.0), and 85.2% percent of women in our study were pregnant. Few patients had CrCl<50 ml/min (n = 38, 1.1%). A BMI less than 18.5 in non-pregnant females (OR = 8.87, 95% CI = 2.45-32.09)) was associated with CrCl<50 ml/min. Hemoglobin level higher than 10 g/dL in males (OR = 0.69, 95% CI = 0.56-0.86) and non-pregnant females (OR = 0.21, 95% CI = 0.04-0.97) was protective against CrCl<50 ml/min. Discussion: Our findings indicate few patients would be excluded from a TDF-based antiretroviral regimen, suggesting baseline creatinine clearance assessment may not be necessary for implementation. However, in ART settings individuals with low BMI or anemia could potentially be at increased risk for lower CrCl. 2012 Johnson et al."									
312	[Children of foreign origin adopted in France. Analysis of 68 cases during l2 years at the University Hospital Center of Tours].	"Bureau JJ, Maurage C, Bremond M, Despert F, Rolland JC."	Archives de Pediatrie. 1999;6(10):1053-8.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=10544779	BACKGROUND: The number of children of foreign origin adopted in France has increased in the past 15 years. The aim of this study was to analyse distinctive features and medical problems associated with international adoption.	"PATIENTS AND METHODS: The files of 68 foreign-origin adopted children who attended or were admitted to the Medical and Nutrition Unit of the Pediatric Hospital in Tours between January 1st 1986 and December 31st 1997, were studied retrospectively. Various parameters were analysed: age at first consultation, age at adoption, country of origin and health problems, especially nutritional status, infectious diseases, growth and development."	"RESULTS: In the majority of cases, children were adopted before 12 months of age (61.2%), particularly before six months of age (49.3%). The children came mainly from Africa and countries in the Indian Ocean (48.5%), and from Southeastern Asia (33.9%). Malnutrition was frequent in children from Africa. Twenty-one children (30.9%) presented with severe malnutrition characterized by weight less than the mean-2SD for height and required hospitalization. No children had congenital hypothyroidism, hyperphenylalaninemia, nor were HIV positive. Some patients had infectious diseases: 11 Hepatitis B, four congenital syphilis and six tuberculosis, with favorable outcomes after treatment. The other most frequent diseases were acute diarrhea, chronic diarrhea, intestinal parasites, and scabies, varying according to countries. Three girls adopted from southern Asia developed precocious puberty. Growth and psychomotor development were satisfactory overall, but abnormalities were observed in 15 children (22.1%), which is higher than in the general population."	"CONCLUSION: The expansion of international adoption with distinctive diseases proves the importance of a checkup as soon as possible after the arrival of these children in France. This checkup has to include nutritional and general evaluation and supplementary tests, especially for specific serology and vaccination status. Following this, it would be possible to propose a suitable follow-up to the adoptive parents."						
542	Weight and body shape changes in a treatment-naive population after 6 months of nevirapine-based generic highly active antiretroviral therapy in South India.	"Saghayam S, Kumarasamy N, Cecelia AJ, Solomon S, Mayer K, Wanke C."	Clinical Infectious Diseases. 2007;44(2):295-300.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=17173234	"BACKGROUND: The nutritional and body shape response after the initiation of highly active antiretroviral therapy (HAART) in resource-limited environments has not been documented. In this environment, nutritional compromise is a common complication of human immunodeficiency virus (HIV) infection."	"METHODS: We conducted a prospective study of 190 HIV-infected patients who initiated a nevirapine-based HAART regimen. CD4+ T cell count, body weight, body mass index, anthropometry, and bioelectrical impedance data were collected prior to initiation of therapy and after 6 months of therapy."	"RESULTS: The mean age of participants was 35 years, 85% of participants were male, and 59% received stavudine as 1 of the nucleosides in their initial HAART regimen. The members of the cohort were malnourished before the initiation of therapy and had a mean body mass index of 20.1 (calculated as weight in kilograms divided by the square of height in meters). Overall, body weight increased a mean of 2.8 kg (range, -12.5 to 22.5 kg), and CD4+ T cell counts increased by a mean of 140 cells/mm3. Patients were stratified into those who lost weight (loss of >1 kg, 22%; n=41), those whose weight remained stable (19%; n=37), and those who gained weight (gain of >1 kg, 59%; n=112). Patients in all groups retained body shape symmetry and experienced no change in waist-to-hip ratio or regional body shape by anthropometry."	"CONCLUSIONS: The group that lost weight and the group whose weight remained stable experienced significant CD4+ T cell count increases at 6 months. Although the majority of HIV-infected patients who received nevirapine-based HAART gained weight, there were participants who lost weight despite initiating their first HAART therapy."						
1002	Body composition changes during lactation in HIV-infected and HIV-uninfected South African women.	"Papathakis PC, Loan MDV, Rollins NC, Chantry CJ, Bennish ML, Brown KH."	Journal of Acquired Immune Deficiency Syndromes. 2006 December;43(4):467-74.		"BACKGROUND: The nutritional consequences of HIV infection in lactating women are unknown. OBJECTIVE: To measure the body composition of South African lactating women in relation to HIV status. METHODS: Fat-free mass (FFM) and fat mass (FM) using bioimpedance spectrometry (BIS) and anthropometric measurements were obtained at 8 and 24 weeks postpartum in 92 HIV-infected (HIVpos) and 50 HIV-uninfected (HIVneg) lactating mothers. RESULTS: At 8 weeks, HIVpos and HIVneg mothers were not significantly different in height (159.7 vs. 158.9 cm), weight (62.7 vs. 63.9 kg), body mass index (BMI; 24.6 vs. 25.3 kg/m), FFM (40.7 vs. 42.8 kg), or FM (21.6 vs. 22.0 kg), respectively. In HIVpos women, the median CD4 count was 621 (range: 101-1585) cells/muL; 95% had CD4 counts >200 cells/muL. Between 8 and 24 weeks, HIVpos mothers had a mean weight loss of 1.4 kg in contrast to a 0.4-kg weight gain in HIVneg mothers (P < 0.01). There were no significant group differences with regard to change in FFM (0.3 vs. 0.1 kg; P = 0.9) and FM (-1.5 vs. -0.3 kg; P = 0.2). CONCLUSION: HIVpos South African breast-feeding mothers without severe immune suppression lost weight and subcutaneous fat between 8 and 24 weeks postpartum, whereas HIVneg mothers gained weight. FFM was maintained postpartum in HIVpos and HIVneg mothers. 2006 Lippincott Williams & Wilkins, Inc."									
1609	Micronutrient fortification to improve growth and health of maternally HIV-unexposed and exposed Zambian infants: a randomised controlled trial.	"Chilenje Infant Growth N, Infection Study T."	PLoS ONE [Electronic Resource]. 2010;5(6):e11165.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=20567511	"BACKGROUND: The period of complementary feeding, starting around 6 months of age, is a time of high risk for growth faltering and morbidity. Low micronutrient density of locally available foods is a common problem in low income countries. Children of HIV-infected women are especially vulnerable. Although antiretroviral prophylaxis can reduce breast milk HIV transmission in early infancy, there are no clear feeding guidelines for after 6 months. There is a need for acceptable, feasible, affordable, sustainable and safe (AFASS by WHO terminology) foods for both HIV-exposed and unexposed children after 6 months of age."	"METHODS AND FINDINGS: We conducted in Lusaka, Zambia, a randomised double-blind trial of two locally made infant foods: porridges made of flour composed of maize, beans, bambaranuts and groundnuts. One flour contained a basal and the other a rich level of micronutrient fortification. Infants (n = 743) aged 6 months were randomised to receive either regime for 12 months. The primary outcome was stunting (length-for-age Z<-2) at age 18 months. No significant differences were seen between trial arms overall in proportion stunted at 18 months (adjusted odds ratio 0.87; 95% CI 0.50, 1.53; P = 0.63), mean length-for-age Z score, or rate of hospital referral or death. Among children of HIV-infected mothers who breastfed <6 months (53% of HIV-infected mothers), the richly-fortified porridge increased length-for-age and reduced stunting (adjusted odds ratio 0.17; 95% CI 0.04, 0.84; P = 0.03). Rich fortification improved iron status at 18 months as measured by hemoglobin, ferritin and serum transferrin receptors."	"CONCLUSIONS: In the whole study population, the rich micronutrient fortification did not reduce stunting or hospital referral but did improve iron status and reduce anemia. Importantly, in the infants of HIV-infected mothers who stopped breastfeeding before 6 months, the rich fortification improved linear growth. Provision of such fortified foods may benefit health of these high risk infants."	TRIAL REGISTRATION: Controlled-Trials.com ISRCTN37460449.						
1568	Micronutrient fortification to improve growth and health of maternally HIV-unexposed and exposed Zambian infants: a randomised controlled trial.		PLos One. 2008;39.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20103217865	"Background: The period of complementary feeding, starting around 6 months of age, is a time of high risk for growth faltering and morbidity. Low micronutrient density of locally available foods is a common problem in low income countries. Children of HIV-infected women are especially vulnerable. Although antiretroviral prophylaxis can reduce breast milk HIV transmission in early infancy, there are no clear feeding guidelines for after 6 months. There is a need for acceptable, feasible, affordable, sustainable and safe (AFASS by WHO terminology) foods for both HIV-exposed and unexposed children after 6 months of age. Methods and Findings: We conducted in Lusaka, Zambia, a randomised double-blind trial of two locally made infant foods: porridges made of flour composed of maize, beans, bambaranuts and groundnuts. One flour contained a basal and the other a rich level of micronutrient fortification. Infants (n=743) aged 6 months were randomised to receive either regime for 12 months. The primary outcome was stunting (length-for-age Z<-2) at age 18 months. No significant differences were seen between trial arms overall in proportion stunted at 18 months (adjusted odds ratio 0.87; 95% CI 0.50, 1.53; P=0.63), mean length-for-age Z score, or rate of hospital referral or death. Among children of HIV-infected mothers who breastfed <6 months (53% of HIV-infected mothers), the richly-fortified porridge increased length-for-age and reduced stunting (adjusted odds ratio 0.17; 95% CI 0.04, 0.84; P=0.03). Rich fortification improved iron status at 18 months as measured by hemoglobin, ferritin and serum transferrin receptors. Conclusions: In the whole study population, the rich micronutrient fortification did not reduce stunting or hospital referral but did improve iron status and reduce anemia. Importantly, in the infants of HIV-infected mothers who stopped breastfeeding before 6 months, the rich fortification improved linear growth. Provision of such fortified foods may benefit health of these high risk infants."									
1242	Risk factors for HIV-associated neurocognitive disorders (HAND) in sub-Saharan Africa: The case of Yaounde-Cameroon.	"Njamnshi AK, Zoung-Kanyi Bissek AC, Ongolo-Zogo P, Tabah EN, Lekoubou AZ, Yepnjio FN, Fonsah JY, et al."	Journal of the Neurological Sciences. 2009 15 Oct;285(1-2):149-53.		"Background: The prevalence of HIV-associated neurocognitive disorders (HAND), especially HIV-associated dementia (HAD) is influenced by several risk factors. The prevalence as well as risk factors for HAD are not well known in sub-Saharan Africa (SSA). We have shown that the International HIV Dementia Scale (IHDS) is a useful screening tool for HAND in Yaounde [Njamnshi AK, Djientcheu VdP, Fonsah JY, Yepnjio FN, Njamnshi DM, Muna WFT. The IHDS is a useful screening tool for HAD/Cognitive Impairment in HIV-infected adults in Yaounde-Cameroon. Journal of Acquired Immune Deficiency Syndromes 2008;49(4):393-397], but no study in Cameroon has yet investigated the risk factors for HAND or HAD. Patients and methods: A cross-sectional study was conducted in Yaounde, the capital of Cameroon from September to December 2006. One hundred and eighty-five HIV-positive subjects were included. Diagnosis of HAND was done using the IHDS with a score <= 10 considered as abnormal. Age, sex, level of education, IV drug use, body mass index (BMI), CDC clinical stage, CD4 counts, hemoglobin levels, administration of highly active antiretroviral therapy (HAART) and type of regimen used, were considered in univariate analysis, with level of significance set at P <= 0.05. A binary logistic regression was used to determine independent risk factors. Results: The following factors were independent predictors of HAND: advanced clinical stage (OR = 7.43, P = 0.001), low CD4 count especially CD4 <= 200 cells/muL (OR = 4.88, P = 0.045) and low hemoglobin concentration (OR = 1.16, P = 0.048). Conclusion: This first study of the risk factors for HAND in Yaounde-Cameroon shows findings similar to those described in other studies. These results call for rapid action by policy makers to include HAND prevention strategies such as providing early universal access to HAART based on these risk factors, in the management of HIV patients at risk of HAND in resource-limited settings of SSA like ours. 2009 Elsevier B.V. All rights reserved."									
429	"Undernutrition among HIV-positive children in Dar es Salaam, Tanzania: antiretroviral therapy alone is not enough."	"Sunguya BF, Poudel KC, Otsuka K, Yasuoka J, Mlunde LB, Urassa DP, Mkopi NP, et al."	BMC Public Health. 2011;11:869.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=22087543	"BACKGROUND: The prevalence of HIV/AIDS has exacerbated the impact of childhood undernutrition in many developing countries, including Tanzania. Even with the provision of antiretroviral therapy, undernutrition among HIV-positive children remains a serious problem. Most studies to examine risk factors for undernutrition have been limited to the general population and ART-naive HIV-positive children, making it difficult to generalize findings to ART-treated HIV-positive children. The objectives of this study were thus to compare the proportions of undernutrition among ART-treated HIV-positive and HIV-negative children and to examine factors associated with undernutrition among ART-treated HIV-positive children in Dar es Salaam, Tanzania."	"METHODS: From September to October 2010, we conducted a cross-sectional survey among 213 ART-treated HIV-positive and 202 HIV-negative children in Dar es Salaam, Tanzania. We measured the children's anthropometrics, socio-demographic factors, food security, dietary habits, diarrhea episodes, economic status, and HIV clinical stage. Data were analyzed using both univariate and multivariate methods."	"RESULTS: ART-treated HIV-positive children had higher rates of undernutrition than their HIV-negative counterparts. Among the ART-treated HIV-positive children, 78 (36.6%) were stunted, 47 (22.1%) were underweight, and 29 (13.6%) were wasted. Households of ART-treated HIV-positive children exhibited lower economic status, lower levels of education, and higher percentages of unmarried caregivers with higher unemployment rates. Food insecurity was prevalent in over half of ART-treated HIV-positive children's households. Furthermore, ART-treated HIV-positive children were more likely to be orphaned, to be fed less frequently, and to have lower body weight at birth compared to HIV-negative children.In the multivariate analysis, child's HIV-positive status was associated with being underweight (AOR = 4.61, 95% CI 1.38-15.36 P = 0.013) and wasting (AOR = 9.62, 95% CI 1.72-54.02, P = 0.010) but not with stunting (AOR = 0.68, 95% CI 0.26-1.77, P = 0.428). Important factors associated with underweight status among ART-treated HIV-positive children included hunger (AOR = 9.90, P = 0.022), feeding frequency (AOR = 0.02, p < 0.001), and low birth weight (AOR = 5.13, P = 0.039). Factors associated with wasting among ART-treated HIV-positive children were diarrhea (AOR = 22.49, P = 0.001) and feeding frequency (AOR = 0.03, p < 0.001)."	"CONCLUSION: HIV/AIDS is associated with an increased burden of child underweight status and wasting, even among ART-treated children, in Dar es Salaam, Tanzania. In addition to increasing coverage of ART among HIV-positive children, interventions to ameliorate poor nutrition status may be necessary in this and similar settings. Such interventions should aim at promoting adequate feeding patterns, as well as preventing and treating diarrhea."						
430	"Undernutrition among HIV positive children in Dar es Salaam, Tanzania: antiretroviral therapy alone is not enough."	"Sunguya BF, Poudel KC, Otsuka K, Yasuoka J, Mlunde LB, Urassa DP, Mkopi NP, et al."	BMC Public Health. 2011;11(869).	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20113384444	"Background: The prevalence of HIV/AIDS has exacerbated the impact of childhood undernutrition in many developing countries, including Tanzania. Even with the provision of antiretroviral therapy, undernutrition among HIV-positive children remains a serious problem. Most studies to examine risk factors for undernutrition have been limited to the general population and ARTnaive HIV-positive children, making it difficult to generalize findings to ART-treated HIVpositive children. The objectives of this study were thus to compare the proportions of undernutrition among ART-treated HIV-positive and HIV-negative children and to examine factors associated with undernutrition among ART-treated HIV-positive children in Dar es Salaam, Tanzania. Methods: From September to October 2010, we conducted a cross-sectional survey among 213 ART-treated HIV-positive and 202 HIV-negative children in Dar es Salaam, Tanzania. We measured the children's anthropometrics, socio-demographic factors, food security, dietary habits, diarrhea episodes, economic status, and HIV clinical stage. Data were analyzed using both univariate and multivariate methods. Results: ART-treated HIV-positive children had higher rates of undernutrition than their HIVnegative counterparts. Among the ART-treated HIV-positive children, 78 (36.6%) were stunted, 47 (22.1%) were underweight, and 29 (13.6%) were wasted. Households of ART-treated HIVpositive children exhibited lower economic status, l wer levels of education, and higher percentages of unmarried caregivers with higher unemployment rates. Food insecurity was prevalent in over half of ART-treated HIV-positive children's households. Furthermore, ARTtreated HIV-positive children were more likely to be orphaned, to be fed less frequently, and to have lower body weight at birth compared to HIV-negative children. In the multivariate analysis, child's HIV-positive status was associated with being underweight (AOR=4.61, 95% CI 1.38-15.36 P=0.013) and wasting (AOR=9.62, 95% CI 1.72-54.02, P=0.010) but not with stunting (AOR=0.68, 95% CI 0.26-1.77, P=0.428). Important factors associated with underweight status among ART-treated HIV-positive children included hunger (AOR=9.90, P=0.022), feeding frequency (AOR=0.02, P<0.001), and low birth weight (AOR=5.13, P=0.039). Factors associated with wasting among ART-treated HIV-positive children were diarrhea (AOR=22.49, P=0.001) and feeding frequency (AOR=0.03, P<0.001). Conclusion: HIV/AIDS is associated with an increased burden of child underweight status and wasting, even among ART-treated children, in Dar es Salaam, Tanzania. In addition to increasing coverage of ART among HIV-positive children, interventions to ameliorate poor nutrition status may be necessary in this and similar settings. Such interventions should aim at promoting adequate feeding patterns, as well as preventing and treating diarrhea."									
1528	Biceps skin-fold thickness may detect and predict early lipoatrophy in HIV-infected children.	"Innes S, Schulte-Kemna E, Cotton MF, Zollner EW, Haubrich R, Klinker H, Sun X, et al."	Pediatric Infectious Disease Journal. 2013 June;32(6):e254-e62.		"Background: The prevalence of potentially stigmatizing lipoatrophy in children receiving antiretroviral therapy in Southern Africa is high, affecting around a third of children. Early diagnosis of lipoatrophy is essential for effective intervention to arrest progression. Methods: Prepubertal children receiving antiretroviral therapy were recruited from a hospital-based family HIV clinic in Cape Town and followed up prospectively. Lipoatrophy was identified and graded by consensus between 2 HIV pediatricians. A dietician performed anthropometric measurements of trunk and limb fat. Anthropometric measurements in children with and without lipoatrophy were compared using multivariable linear regression adjusting for age and gender. The most discerning anthropometric indicators of lipoatrophy underwent receiver operating characteristic curve analysis. The precision of anthropometric measurements performed by an inexperienced healthcare worker was compared with that of a research dietician. Results: Of 100 recruits, 36 had lipoatrophy at baseline and a further 9 developed lipoatrophy by 15-month follow-up. Annual incidence of lipoatrophy was 12% (confidence interval [CI]: 5-20%) per person-year of follow-up. A biceps skin-fold thickness <5 mm at baseline had a sensitivity of 89% (CI: 67-100%) and a specificity of 60% (CI: 46-75%) for predicting development of lipoatrophy by 15-month follow-up. Negative and positive predictive values were 97% (CI: 91-100%) and 32% (CI: 14-50%). Conclusion: Biceps skin-fold thickness <5 mm in prepubertal children exposed to thymidine analogue-based antiretroviral therapy may be a useful screening tool to identify children who are likely to develop lipoatrophy. The variation in precision of measurements performed by an inexperienced healthcare worker only marginally impacted performance. Copyright 2013 by Lippincott Williams & Wilkins."									
1014	"A pilot study of food supplementation to improve adherence to antiretroviral therapy among food-insecure adults in Lusaka, Zambia."	"Cantrell RA, Sinkala M, Megazinni K, Lawson-Marriott S, Washington S, Chi BH, Tambatamba-Chapula B, et al."	Journal of Acquired Immune Deficiency Syndromes: JAIDS. 2008;49(2):190-5.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=18769349	BACKGROUND: The provision of food supplementation to food-insecure patients initiating antiretroviral therapy (ART) may improve adherence to medications.	"METHODS: A home-based adherence support program at 8 government clinics assessed patients for food insecurity. Four clinics provided food supplementation, and 4 acted as controls. The analysis compared adherence (assessed by medication possession ratio), CD4, and weight gain outcomes among food-insecure patients enrolled at the food clinics with those enrolled at the control clinics."	"RESULTS: Between May 1, 2004, and March 31, 2005, 636 food- insecure adults were enrolled. Food supplementation was associated with better adherence to therapy. Two hundred fifty-eight of 366 (70%) patients in the food group achieved a medication possession ratio of 95% or greater versus 79 of 166 (48%) among controls (relative risk = 1.5; 95% confidence interval: 1.2 to 1.8). This finding was unchanged after adjustment for sex, age, baseline CD4 count, baseline World Health Organization stage, and baseline hemoglobin. We did not observe a significant effect of food supplementation on weight gain or CD4 cell response."	CONCLUSIONS: This analysis suggests that providing food to food-insecure patients initiating ART is feasible and may improve adherence to medication. A large randomized study of the clinical benefits of food supplementation to ART patients is urgently needed to inform international policy.						
979	"A pilot study of food supplementation to improve adherence to antiretroviral therapy among food-insecure adults in Lusaka, Zambia."	"Cantrell RA, Sinkala M, Megazinni K, Lawson-Marriott S, Washington S, Chi BH, Tambatamba-Chapula B, et al."	Journal of Acquired Immune Deficiency Syndromes. 2008 October;49(2):190-5.		"Background: The provision of food supplementation to foodinsecure patients initiating antiretroviral therapy (ART) may improve adherence to medications. Methods: A home-based adherence support program at 8 government clinics assessed patients for food insecurity. Four clinics provided food supplementation, and 4 acted as controls. The analysis compared adherence (assessed by medication possession ratio), CD4, and weight gain outcomes among food-insecure patients enrolled at the food clinics with those enrolled at the control clinics. Results: Between May 1, 2004, and March 31, 2005, 636 foodinsecure adults were enrolled. Food, supplementation was associated with better adherence to therapy. Two hundred fifty-eight of 366 (70%) patients in the food group achieved a medication possession ratio of 95% or greater versus 79 of 166 (48%) among controls (relative risk = 1.5; 95% confidence interval: 1.2 to 1.8). This finding was unchanged after adjustment for sex, age, baseline CD4 count, baseline World Health Organization stage, and baseline hemoglobin. We did not observe a significant effect of food supplementation on weight gain or CD4 cell response. Conclusions: This analysis suggests that providing food to foodinsecure patients initiating ART is feasible and may improveadherence to medication. A large randomized study of the clinical benefits of food supplementation to ART patients is urgently needed to inform international policy. Copyright 2008 by Lippincott Williams & Wilkins."									
416	Intraclass correlation coefficients in the Brazilian network for surveillance of severe maternal morbidity study.	"Haddad SM, Sousa MH, Cecatti JG, Parpinelli MA, Costa ML, Souza JP."	BMC Pregnancy and Childbirth. 2012 21 Sep;12(101).		"Background: The purpose of the study was to evaluate intraclass correlation coefficients (ICC) of variables concerning personal characteristics, structure, outcome and process in the Brazilian Network for Surveillance of Severe Maternal Morbidity study conducted to identify severe maternal morbidity/near miss cases using the World Health Organization criteria.Method: It was a cross-sectional, multicenter study involving 27 hospitals providing care for pregnant women in Brazil. Cluster size and the mean size of the primary sampling unit were described. Estimated prevalence rates, ICC, their respective 95% confidence intervals, the design effect and the mean cluster size were presented for each variable.Results: Overall, 9,555 cases of severe maternal morbidity (woman admitted with potentially life-threatening conditions, near miss events or death) were included in the study. ICC ranged from < 0.001 to 0.508, with a median of 0.035. ICC was < 0.1 for approximately 75% of the variables. For process-related variables, median ICC was 0.09, with 0.021 for those related to outcome. These findings confirm data from previous studies. Homogeneity may be considered minor, thus increasing reliability of these findings.Conclusions: These results may be used to design new cluster trials in maternal and perinatal health and to help calculate sample sizes. 2012 Haddad et al.; licensee BioMed Central Ltd."									
1291	Scaling up of highly active antiretroviral therapy in a rural district of Malawi: an effectiveness assessment.	"Ferradini L, Jeannin A, Pinoges L, Izopet J, Odhiambo D, Mankhambo L, Karungi G, et al."	Lancet. 2006 22 Apr;367(9519):1335-42.		"Background: The recording of outcomes from large-scale, simplified HAART (highly active antiretroviral therapy) programmes in sub-Saharan Africa is critical. We aimed to assess the effectiveness of such a programme held by Medecins Sans Frontieres (MSF) in the Chiradzulu district, Malawi. Methods: We scaled up and simplified HAART in this programme since August, 2002. We analysed survival indicators, CD4 count evolution, virological response, and adherence to treatment. We included adults who all started HAART 6 months or more before the analysis. HIV-1 RNA plasma viral load and self-reported adherence were assessed on a subsample of patients, and antiretroviral resistance mutations were analysed in plasma with viral loads greater than 1000 copies per mL. Analysis was by intention to treat. Findings: Of the 1308 patients who were eligible, 827 (64%) were female, the median age was 349 years (IQR 299-410), and 1023 (78%) received d4T/3TC/NVP (stavudine, lamivudine, and nevirapine) as a fixed-dose combination. At baseline, 1266 individuals (97%) were HAART-naive, 357 (27%) were at WHO stage IV, 311 (33%) had a body-mass index of less than 185 kg/m<sup>2</sup>, and 208 (21%) had a CD4 count lower than 50 cells per muL. At follow-up (median 83 months, IQR 55-131), 967 (74%) were still on HAART, 243 (19%) had died, 91 (7%) were lost to follow-up, and seven (05%) discontinued treatment. Low body-mass index, WHO stage IV, male sex, and baseline CD4 count lower than 50 cells per muL were independent determinants of death in the first 6 months. At 12 months, the probability of individuals still in care was 076 (95% CI 073-078) and the median CD4 gain was 165 (IQR 67-259) cells per muL. In the cross-sectional survey (n=398), 334 (84%) had a viral load of less than 400 copies per mL. Of several indicators measuring adherence, self-reported poor adherence (<80%) in the past 4 days was the best predictor of detectable viral load (odds ratio 54, 95% CI 19-156). Interpretation: These data show that large numbers of people can rapidly benefit from antiretroviral therapy in rural resource-poor settings and strongly supports the implementation of such large-scale simplified programmes in Africa. 2006 Elsevier Ltd. All rights reserved."									
293	Immune deficiency could be an early risk factor for altered insulin sensitivity in antiretroviral-naive HIV-1-infected patients: The ANRS COPANA cohort.	"Boufassa F, Goujard C, Viard JP, Carlier R, Lefebvre B, Yeni P, Bouchaud O, et al."	Antiviral Therapy. 2012;17(1):91-100.		"Background: The relationships between immunovirological status, inflammatory markers, insulin resistance and fat distribution have not been studied in recently diagnosed (<1 year) antiretroviral-naive HIV-1-infected patients. Methods: We studied 214 antiretroviral-naive patients at enrolment in the metabolic substudy of the ANRS COPANA cohort. We measured clinical, immunovirological and inflammatory parameters, glucose/insulin during oral glucose tolerance test (OGTT), adipokines, subcutaneous and visceral fat surfaces (subcutaneous adipose tissue [SAT] and visceral adipose tissue [VAT], assessed by computed tomography) and the body fat distribution based on dual-energy X-ray absorptiometry (DEXA). Results: Median age was 36 years; 28% of the patients were female and 35% of sub-Saharan origin; 20% had low CD4 <sup>+</sup> T-cell counts (<=200/mm<sup>3</sup>). Patients with low CD4 <sup>+</sup> T-cell counts were older and more frequently of sub-Saharan Africa origin, had lower body mass index (BMI) but no different SAT/VAT ratio and fat distribution than other patients. They also had lower total, low-density lipoprotein and high-density lipoprotein cholesterolaemia, higher triglyceridaemia and post-OGTT glycaemia, higher markers of insulin resistance (insulin during OGTT and homeostasis model assessment of insulin resistance) and of inflammation (high-sensitivity C-reactive protein, IL-6, tumour necrosis factor (TNF)-alpha, sTNFR1 and sTNFR2). After adjustment for age, sex, geographic origin, BMI and waist circumference, increased insulin resistance was not related to any inflammatory marker. In multivariate analysis, low CD4 <sup>+</sup>T-cell count was an independent risk factor for altered insulin sensitivity (beta-coefficient for HOMA-IR: +0.90; P=0.001; CD4<sup>+</sup> T-cell count >500/mm<sup>3</sup> as the reference), in addition to older age (beta: +0.26 for a 10-year increase; P=0.01) and higher BMI (beta: +0.07 for a 1-kg/m<sup>2</sup> increase; P=0.003). Conclusions: In ART-naive patients, severe immune deficiency but not inflammation could be an early risk factor for altered insulin sensitivity. 2012 International Medical Press."									
1537	The effect of human immunodeficiency virus and breastfeeding on the nutritional status of African children.	"Taha T, Nour S, Li Q, Kumwenda N, Kafulafula G, Nkhoma C, Broadhead R."	Pediatric Infectious Disease Journal. 2010;29(6):514-8.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=20054287	BACKGROUND: The risk of HIV-1 infection is high among breast-fed children in sub-Saharan Africa. Monitoring the nutritional status can provide useful information to determine the effect of HIV infection and breast-feeding on child growth and development. We longitudinally assessed the nutritional status and determined its association with HIV infection and breast-feeding among Malawian children.	"METHODS: We analyzed data from 2 clinical trials to prevent mother-to-child transmission of HIV in Malawi. These trials were conducted during 2000-2003 before the current guidelines were implemented to breast-feed exclusively during the first 6 months and wean thereafter. The nutritional status of children was measured up to age 24 months, using z-scores. Age-specific differences in length-for-age (L/A), weight-for-age (W/A), and weight-for-length (W/L) were compared stratifying by gender and HIV infection status. Multivariable models examined the mean change in z-scores controlling for breast-feeding and other factors."	"RESULTS: In this analysis, 1589 children were included. Boys had significantly lower L/A scores and became stunted (z-score -<2 standard deviations) earlier than girls. HIV-infected children had significantly lower mean L/A and W/A z-scores than HIV-uninfected children and became stunted and underweight at an earlier age. In multivariable analysis not being breast-fed and being HIV infected were significantly (P < 0.001) associated with decreases in mean L/A, W/A, and W/L z-scores."	CONCLUSIONS: This study shows the impact of infant HIV infection on growth and supports the critical importance of breast-feeding. Mother-to-child transmission of HIV programs should endeavor to preserve breast-feeding and find alternative measures to prevent postnatal HIV transmission.						
780	Peginterferon alfa-2a plus ribavirin for HIV-HCV genotype 1 coinfected patients: A randomized international trial.	"Rodriguez-Torres M, Slim J, Bhatti L, Sterling R, Sulkowski M, Hassanein T, Serrao R, et al."	HIV Clinical Trials. 2012 01 Jan;13(3):142-52.		"Background: The safety and efficacy of weight-based ribavirin (RBV) dosing regimens in patients with HIV-HCV coinfection has not been demonstrated in randomized clinical trials. Objective: This randomized, double-blind, international, parallel-group study in specialist outpatient clinics in the United States, Spain, and Portugal compares the efficacy and safety of 2 RBV dose regimens (800 mg/day and 1000/1200 mg/day) combined with peginterferon alfa-2a (40KD) in patients with HIV-HCV (genotype 1) coinfection. Methods: Patients with HIV-HCV coinfec-tion, quantifiable HCV RNA in serum, HCV genotype-1 infection, compensated liver disease, and stable HIV disease (CD4+ count >=100 cells/muL) with or without ongoing antiretroviral therapy were randomized to 48 weeks' treatment with RBV at standard dose (800 mg/day) or weight-based dose (1000 mg/day for patients weighing <75 kg; 1200 mg/day for patients weighing >=75 kg) in combination with peginterferon alfa-2a (40KD) 180 mug once a week. Planned enrollment was 400 patients with >=100 non-Latino African Americans. The primary endpoint was sustained virological response (SVR) (undetectable HCV RNA [<20 IU/mL] at the end of a 24-week untreated follow-up period [week 72]). Results: SVR rates were 19% (26/135) and 22% (60/275) in patients randomized to RBV 800 mg/day and 1000/1200 mg/day, respectively (odds ratio, 1.15; 95% CI, 0.68-1.93; P = .6119). In the 1000/1200 mg/day RBV dose group, the incidence of hemoglobin reductions <100 g/L and anaemia reported as an adverse event were higher versus the standard 800 mg/day RBV dose group. Conclusions: Compared with the standard RBV dose (800 mg/day), weight-based RBV dosing (1000/1200 mg/day) did not significantly increase SVR rates, but did increase the incidence of anemia in HIV-HCV (genotype 1) coinfected patients. 2012 Thomas Land Publishers, Inc."									
327	Home based therapy for severe malnutrition with ready-to-use food.	"Manary MJ, Ndkeha MJ, Ashorn P, Maleta K, Briend A."	Archives of Disease in Childhood. 2004;89(6):557-61.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=15155403	"BACKGROUND: The standard treatment of severe malnutrition in Malawi often utilises prolonged inpatient care, and after discharge results in high rates of relapse."	"AIMS: To test the hypothesis that the recovery rate, defined as catch-up growth such that weight-for-height z score >0 (WHZ, based on initial height) for ready-to-use food (RTUF) is greater than two other home based dietary regimens in the treatment of malnutrition."	"METHODS: HIV negative children >1 year old discharged from the nutrition unit in Blantyre, Malawi were systematically allocated to one of three dietary regimens: RTUF, RTUF supplement, or blended maize/soy flour. RTUF and maize/soy flour provided 730 kJ/kg/day, while the RTUF supplement provided a fixed amount of energy, 2100 kJ/day. Children were followed fortnightly. Children completed the study when they reached WHZ >0, relapsed, or died. Outcomes were compared using a time-event model."	"RESULTS: A total of 282 children were enrolled. Children receiving RTUF were more likely to reach WHZ >0 than those receiving RTUF supplement or maize/soy flour (95% v 78%, RR 1.2, 95% CI 1.1 to 1.3). The average weight gain was 5.2 g/kg/day in the RTUF group compared to 3.1 g/kg/day for the maize/soy and RTUF supplement groups. Six months later, 96% of all children that reached WHZ >0 were not wasted."	CONCLUSIONS: Home based therapy of malnutrition with RTUF was successful; further operational work is needed to implement this promising therapy.					
326	Home based therapy for severe malnutrition with ready-to-use food.	"Manary MJ, Ndekha MJ, Ashorn P, Maleta K, Briend A."	Archives of Disease in Childhood. 2004;89(6):557-61.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh3&AN=20043092256	"Background: The standard treatment of severe malnutrition in Malawi often utilises prolonged inpatient care, and after discharge results in high rates of relapse. Aims: To test the hypothesis that the recovery rate, defined as catch-up growth such that weight-for-height z score >0 (WHZ, based on initial height) for ready-to-use food (RTUF) is greater than two other home based dietary regimens in the treatment of malnutrition. Methods: HIV negative children >1 year old discharged from the nutrition unit in Blantyre, Malawi were systematically allocated to one of three dietary regimens: RTUF, RTUF supplement, or blended maize/soy flour. RTUF and maize/soy flour provided 730 kJ/kg/day, while the RTUF supplement provided a fixed amount of energy, 2100 kJ/day. Children were followed fortnightly. Children completed the study when they reached WHZ>0, relapsed, or died. Outcomes were compared using a time-event model. Results: A total of 282 children were enrolled. Children receiving RTUF were more likely to reach WHZ>0 than those receiving RTUF supplement or maize/soy flour (95% v 78%, RR 1.2, 95% CI 1.1 to 1.3). The average weight gain was 5.2 g/kg/day in the RTUF group compared to 3.1 g/kg/day for the maize/soy and RTUF supplement groups. Six months later, 96% of all children that reached WHZ>0 were not wasted. Conclusions: Home based therapy of malnutrition with RTUF was successful; further operational work is needed to implement this promising therapy."									
657	"Serum vitamin E, C and A status of the drug addicts undergoing detoxification: influence of drug habit, sexual practice and lifestyle factors."	"Islam SKN, Hossain KJ, Ahsan M."	European Journal of Clinical Nutrition. 2001;55(11):1022-7.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh3&AN=20013146588	"Background: The study was carried out on the hypothesis that drug addicts would have reduced vitamin E, C and A status which could be influenced by drug habit, sexual practice and lifestyle factors. Method: Serum concentrations of Vitamin E, C and A of male drug addicts and cohort controls were analysed, and influence of drug habit, sexual practice and lifestyle factors of the addicts on the vitamin status was assessed. The study was conducted among 253 drug addicts who sought detoxification voluntarily during the period of June 1997 to July 1998 at the Central Drug Addiction Treatment Hospital, Dhaka, Bangladesh, and 100 cohort control men. Research instruments were questionnaire and blood specimens. HPLC and spectrophotometric methods were used to determine the vitamin levels in sera of drug addicts. Results: alpha -Tocopherol (12.60+or-3.73 compared with 16.3+or-3.37 micro mol/litre; t=8.6, P=0.05), ascorbic acid (21.59+or-10.5 compared with 38.3+or-13.62 micro mol/litre; t=10.93, P=0.003) and retinol (1.15+or-0.39 compared with 1.33+or-0.30 micro mol/litre; t=5.28, P=0.048) in the drug addicts were significantly low as compared to those in the cohort controls. Use of multiple illicit drugs for a longer period of time did result in reduced levels of these vitamins. A significant reduction in retinol concentration was noted among the multiple drug users (F(2250)=3.23, P=0.041). Duration of addiction had a significant linear correlation with the level of reduction in retinol (F(2250)=3.23, P=0.041) and alpha -tocopherol (F(2,250)=3.06, P=0.049). Apart from having a significant negative correlation between number of sexual partners and retinol level (F(3247)=2.65, P=0.049), sexual practice did not have any influence on the vitamin status of the addicts. Occupation did have a significant effect on the ascorbic acid level (F(4248)=2.46, P=0.046), but other socioeconomic factors like income, age etc did not influence the vitamin E, C and A levels. Body mass index had a positive linear correlation with the vitamins, but it was significant only with vitamin C (F(2250)=7.06, P=0.001). Conclusions: These results could have important implications for providing an antioxidant therapy to drug addicts and thus rehabilitating them into normal life. Risk of HIV infection and transmission (if any) could be reduced or inhibited."									
667	"Serum vitamin E, C and A status of the drug addicts undergoing detoxification: Influence of drug habit, sexual practice and lifestyle factors."	"Nazrul Islam SK, Jahangir Hossain K, Ahsan M."	European Journal of Clinical Nutrition. 2001;55(11):1022-7.		"Background: The study was carried out on the hypothesis that drug addicts would have reduced vitamin E, C and A status which could be influenced by drug habit, sexual practice and lifestyle factors. Method: Serum concentrations of Vitamin E, C and A of male drug addicts and cohort controls were analysed, and influence of drug habit, sexual practice and lifestyle factors of the addicts on the vitamin status was assessed. The study was conducted among 253 drug addicts who sought detoxification voluntarily during the period of June 1997 to July 1998 at the Central Drug Addiction Treatment Hospital, Dhaka, and 100 cohort control men. Research instruments were questionnaire and blood specimens. HPLC and spectrophotometric methods were used to determine the vitamin levels in sera of drug addicts. Results: alpha-Tocopherol (12.60 +/- 3.73 compared with 16.3 +/- 3.37 mol/l; t = 8.6, P = 0.05), ascorbic acid (21.59 +/- 10.5 compared with 38.3 +/- 13.62 mol/l; t = 10.93, P = 0.003) and retinol (1.15 +/- 0.39 compared with 1.33 +/- 0.30 mol/l; t = 5.28, P = 0.048) in the drug addicts were significantly low as compared to those in the cohort controls. Use of multiple illicit drugs for a longer period of time did result in reduced levels of these vitamins. A significant reduction in retinol concentration was noted among the multiple drug users (F(2,250) = 3.23, P = 0.041). Duration of addiction had a significant linear correlation with the level of reduction in retinol (F(2,250) = 3.23, P = 0.041) and alpha-tocopherol (F(2,250) = 3.06, P = 0.049). Apart from having a significant negative correlation between number of sexual partners and retinol level (F(3,247) = 2.65, P = 0.049), sexual practice did not have any influence on the vitamin status of the addicts. Occupation did have a significant effect on the ascorbic acid level (F(4,248) = 2.46, P = 0.046), but other socioeconomic factors like income, age etc did not influence the vitamin E, C and A levels. Body mass index had a positive linear correlation with the vitamins, but it was significant only with vitamin C (F(2,250) = 7.06, P = 0.001). Conclusions: These results could have important implications for providing an antioxidant therapy to drug addicts and thus rehabilitating them into normal life. Risk of HIV infection and transmission (if any) could be reduced or inhibited."									
63	Generic fixed-dose combination antiretroviral treatment in resource-poor settings: Multicentric observational cohort.	"Calmy A, Pinoges L, Szumilin E, Zachariah R, Ford N, Ferradini L."	Aids. 2006 May;20(8):1163-9.		"Background: The use fixed-dose combination (FDC) is a critical tool in improving HAART. Studies on the effectiveness of combined lamivudine, stavudine and nevirapine (3TC/d4T/NVP) are scarce. Objective: To analyse 6861 patients in a large observational cohort from 21 Medecins Sans Frontieres (MSF) HIV/AIDS programmes taking 3TC/d4T/NVP, with subcohort analyses of patients at 12 and 18 months of treatment. Methods: Survival was analysed using Kaplan-Meier method and factors associated with progression to death with Cox proportional hazard ratio. Results: Median baseline CD4 cell count at initiating of FDC was 89 cells/mul [interquartile range (IQR), 33-158]. The median follow-up time was 4.1 months (IQR, 1.9-7.3). The incidence rate of death during follow-up was 14.2/100 person-years [95% confidence interval (CI), 13.8-14.5]. Estimates of survival (excluding those lost to follow-up) were 0.93 (95% CI, 92-94) at 6 months (n = 2,231) and 0.90 (95% CI, 89-91) at 12 months (n = 472). Using a Cox model, the following factors were associated with death: male gender, symptomatic infection, body mass index < 18 kg/m<sup>2</sup> and CD4 cell count 15-50 cells/mul or < 15 cells/mul. Subcohort analysis of 655 patients after 1 year of follow-up (M12 FDC cohort) revealed that 77% remained on HAART, 91% of these still on the FDC regimen; 5% discontinued the FDC because of drug intolerance. At 18 months, 77% of the patients remained on HAART. Conclusions: Positive outcomes for d4T/3TC/NVP are reported for up to 18 months in terms of efficacy and safety. 2006 Lippincott Williams & Wilkins."									
871	No impact of TangHerb on the efavirenz plasma concentration among HIV-infected patients in China.	"Chen J, Lu HZ, Zhang LJ, Yao YM."	International Journal of Infectious Diseases. 2010 July;14:S75.		"Background: The use of traditional Chinese medicine is widespread in China, even among HIV-infected patients. However, the potential drug interaction has not been well studied. We evaluate the impact of TangHerb (a proprietary Chinese medicine for AIDS treatment) on the efavirenz plasma concentration and the safety and efficacy of efavirenz when be used in combined with TangHerb. Methods: Fifty HIV-infected patients taking efavirenz containing antiretroviral regimens were enrolled. Twenty of them were taking TangHerb (eight capsules 3 times per day) together while 30 of them were not. Steady-state plasma concentrations of efavirenz were determined using HPLC-MS detection. Efavirenz associated central nervous system side effects and the frequency of viralogic failure was observed. Results: No significant difference of the efavirenz concentration between these two groups was found (2765 ng/ml vs 2325 ng/ml, P = 0.25). No factors including age, gender, body mass index, alanine transaminase and CD4 cell count were associated with efavirenz concentration in multi-regression analysis. The frequency of efavirenz associated central nervous system side effects and viralogic failure were also comparable among these two populations. Conclusion: TangHerb does not impact the EFV steady plasma concentration and its efficacy. It could be used safely together with EFV.(Table presented)."									
76	"Isoniazid preventive therapy, HAART and tuberculosis risk in HIV-infected adults in South Africa: A prospective cohort."	"Golub JE, Pronyk P, Mohapi L, Thsabangu N, Moshabela M, Struthers H, Gray GE, et al."	Aids. 2009 13 Mar;23(5):631-6.		"Background: The World Health Organization recommends isoniazid preventive therapy (IPT) for preventing tuberculosis in HIV-infected adults, although few countries have instituted this policy. Both IPT and highly active antiretroviral therapy (HAART) used separately result in reductions in tuberculosis risk. There is less information on the combined effect of IPT and HAART. We assessed the effect of IPT, HAART or both IPT and HAART on tuberculosis incidence in HIV-infected adults in South Africa. Methods: Two clinical cohorts of HIV-infected patients were studied. Primary exposures were receipt of IPT and/or HAART and the primary outcome was incident tuberculosis. Crude incident rates and incident rate ratios were calculated and Cox proportional hazards models investigated associations with tuberculosis risk. Results: Among 2778 HIV-infected patients followed for 4287 person-years, 267 incident tuberculosis cases were diagnosed [incidence rate ratio (IRR) = 6.2/100 person-years; 95% CI 5.5-7.0]. For person-time without IPT or HAART, the IRR was 7.1/100 person-years (95% CI 6.2-8.2); for person-time receiving HAART but without IPT, the IRR was 4.6/100 person-years (95% CI 3.4-6.2); for person-time after IPT but prior to HAART, the IRR was 5.2/100 person-years (95% CI 3.4-7.8); during follow-up in patients treated with HAART after receiving IPT the IRR was 1.1/100 person-years (95% CI 0.02-7.6). Compared to treatment-naive patients, HAART-only patients had a 64% decreased hazard for tuberculosis [adjusted hazard ratio (aHR) = 0.36; 95% CI 0.25-0.51], and patients receiving HAART after IPT had a 89% reduced hazard (aHR = 0.11; 95% CI 0.02-0.78). Conclusion: Tuberculosis risk is significantly reduced by IPT in HAART-treated adults in a high-incidence operational setting in South Africa. IPT is an inexpensive and cost- effective strategy and our data strengthen calls for the implementation of IPT in conjunction with the roll-out of HAART. 2009 Wolters Kluwer Health."									
1223	"Development of an algorithmic tool to guide routine HIV testing of hospitalized pediatric patients in Papua New Guinea (PNG), a resource-limited setting with moderate HIV prevalence."	"Allison W, Kiromat M, Vince J, Wand H, Cunningham P, Kaldor J."	Journal of the International Association of Physicians in AIDS Care. 2010;9 (1):56.		"Background: The World Health Organization recommends provider initiated counseling and testing for all patient groups in resource limited settings including pediatric patients. This study aimed to develop an algorithmic tool to define clinical presentations for which HIV testing should be routine at Port Moresby General Hospital (PMGH). PMGH is a tertiary referral hospital in the capital city of PNG admitting approximately 5000 children per annum. With an HIV prevalence of 2% in a population of approximately 6.2 million, PNG is one of the worst affected countries in the region. Methods: In a prospective cross-sectional study of a successive cohort of pediatric patients at PMGH, carers of inpatients were offered HIV testing and counseling for their children. Recruited patients were tested for HIV antibodies and HIV DNA and standardized clinical information was collected for each patient. Results: From September 2007 to October 2008, 487 patients were enrolled. Overall, 55 (11%) of patients were HIV-infected with a median age of 7 months (range 1-80 months). On multivariate regression analysis, persistent fever (odds ratio [OR] = 2.05 [95% confidence interval = 1.11-4.68]), lymphadenopathy (OR = 2.29 [1.12-4.68]), oral candidiasis (OR = 3.94 [2.17-7.14]) and being underweight for age (OR = 2.03 [1.03-3.99]) were found to be independent predictors of HIV infection. Based on this analysis an algorithmic tool was developed with a sensitivity of 96% in detecting HIV infection if any one of these clinical features were present in a patient. This tool was projected to increase the proportion of admitted children tested each year from 4% to 41%. Conclusions: A clinical algorithmic tool to guide routine provider initiated testing in hospitalized children in PNG increased testing of hospitalized pediatric patients ten fold thereby facilitating early detection of HIV positive children in a moderate prevalence setting."									
431	Prevalence and pattern of HIV-related malnutrition among women in sub-Saharan Africa: a meta-analysis of demographic health surveys.	Uthman OA.	BMC Public Health. 2008;8:226.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=18597680	"BACKGROUND: The world's highest HIV infection rates are found in Sub-Saharan Africa (SSA), where adult prevalence in most countries exceeds 25%. Food shortages and malnutrition have combined with HIV/AIDS to bring some countries to the brink of crisis. The aim of this study was to describe prevalence of malnutrition among HIV-infected women and variations across socioeconomic status using data from 11 countries in SSA."	METHODS: This study uses meta-analytic procedures to synthesize the results of most recent data sets available from Demographic and Health Surveys of 11 countries in SSA. Pooled prevalence estimates and 95% confidence intervals were calculated using random-and fixed-effects models. Subgroup and leave-one-country-out sensitivity analyses were also carried out.	"RESULTS: Pooling the prevalence estimates of HIV-related malnutrition yielded an overall prevalence of 10.3% (95% CI 7.4% to 14.1%) with no statistically significant heterogeneity (I2 = 0.0%, p = .903). The prevalence estimates decreased with increasing wealth index and education attainment. The pooled prevalence of HIV-related malnutrition was higher among women residing in rural areas than among women residing in urban areas; and lower among women that were professionally employed than unemployed or women in agricultural or manual work."	"CONCLUSION: Prevalence of HIV-related malnutrition among women varies by wealth status, education attainment, occupation, and type of residence (rural/urban). The observed socioeconomic disparities can help provide more information about population subgroups in particular need and high risk groups, which may in turn lead to the development and implementation of more effective intervention programs."						
1869	Designs in AT research: Usefulness for therapists in clinical practice.	"Vincent C, Routhier F."	Technology and Disability. 2012 2012;24(1):49-58.	http://search.proquest.com/docview/922884943?accountid=26724	"Background: Therapists need information about assistive technology (AT) outcomes linked to life habits (activities in real life). However, the scientific literature seems to be almost non-existent in many life habit domains, and when it does exist, it may not be relevant to clinics because of the characteristics of the research designs.Objective: To examine what kinds of research designs are used to assess outcomes of AT use in real life situation and to discuss the usefulness of different designs for therapists in clinical practice.Method: A limited search in PubMed and OT Seeker was performed in June 2010 using the keywords ""assistive AND technology AND device AND outcome"".Results: Of the 499 references found, 19 studies met our inclusion criteria. Six of the research designs were experimental (randomized controlled trial: n=6), four were quasi-experimental (longitudinal: n=2, multiple baseline: n=2) and nine were non-experimental (survey and follow-up: n=4, case study: n=1, case report: n=2, correlational research: n=1, multiple cohort: n=1). Eleven types of AT were assessed.Discussion and conclusion: We found that the studies that give more useful information for therapists in clinics include research designs with short and long term effects of AT, use of standardized tools that point out the possible life habits where AT should be helpful, and a strategy to control confounders (group comparison, alternative condition for AT use, repetitive measures)."									
864	Lactation-associated postpartum weight changes among HIV-infected women in Zambia.	"Murnane PM, Arpadi SM, Sinkala M, Kankasa C, Mwiya M, Kasonde P, Thea DM, et al."	International Journal of Epidemiology. 2010;39(5):1299-310.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=20484334	BACKGROUND: There are concerns about effects of lactation on postpartum weight changes among HIV-infected women because low weight may increase risks of HIV-related disease progression.	"METHODS: This analysis of postpartum maternal weight change is based on a trial evaluating the effects of shortened breastfeeding on postpartum mother-to-child transmission of HIV in Lusaka, Zambia, in which 958 HIV-infected women were randomized to breastfeed for a short duration (4 months) or for a duration of their own informed choosing (median 16 months). Among 768 women who met inclusion criteria, we compared across the two groups change in weight (kg) and the percent underweight [body mass index (BMI) <18.5] through 24 months. We also examined the effect of breastfeeding in two high-risk groups: those with low BMI and those with low CD4 counts."	"RESULTS: Overall, women in the long-duration group gained less weight compared with those in the short-duration group from 4-24 months "	"1.0 kg [95% confidence interval (CI): 0.3-1.7] vs 2.3 kg (95% CI: 1.6-2.9), P = 0.01}. No association was found between longer breastfeeding and being underweight (odds ratio 1.1; 95% CI: 0.8-1.6; P = 0.40). Effects of lactation in underweight women and women with low CD4 counts were similar to the effects in women with higher BMI and higher CD4 counts. Women with low baseline BMI tended to gain more weight from 4 to 24 months than those with higher BMI, regardless of breastfeeding duration (2.1 kg, 95% CI: 1.3-2.9; P < 0.01)."	"CONCLUSIONS: In this study of HIV-infected breastfeeding women in a low-resource setting, the average change in weight from 4 to 24 months postpartum was a net gain rather than loss. Although longer duration breastfeeding was associated with less weight gain, breastfeeding duration was not associated with being underweight (BMI < 18.5). Weight change associated with longer breastfeeding may be metabolically regulated so that women with low BMI and at risk of wasting are protected from excess weight loss."					
1102	"Comparison of CD4 cell count, viral load, and other markers for the prediction of mortality among HIV-1-infected Kenyan pregnant women."	"Brown ER, Otieno P, Mbori-Ngacha DA, Farquhar C, Obimbo EM, Nduati R, Overbaugh J, et al."	Journal of Infectious Diseases. 2009;199(9):1292-300.	http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=2010289165&site=ehost-live	"BACKGROUND: There are limited data regarding the relative merits of biomarkers as predictors of mortality or time to initiation of antiretroviral therapy (ART). METHODS: We evaluated the usefulness of the CD4 cell count, CD4 cell percentage (CD4%), human immunodeficiency virus type 1 (HIV-1) load, total lymphocyte count (TLC), body mass index (BMI), and hemoglobin measured at 32 weeks' gestation as predictors of mortality in a cohort of HIV-1-infected women in Nairobi, Kenya. Sensitivity, specificity, positive predictive value (PPV), and area under the receiver operating characteristic (ROC) curve (AUC) were determined for each biomarker separately, as well as for the CD4 cell count and the HIV-1 load combined. RESULTS: Among 489 women with 10,150 person-months of follow-up, mortality rates at 1 and 2 years postpartum were 2.1% (95% confidence interval [CI], 0.7%-3.4%) and 5.5% (95% CI, 3.0%-8.0%), respectively. CD4 cell count and CD4% had the highest AUC value (>0.9). BMI, TLC, and hemoglobin were each associated with but poorly predictive of mortality (PPV, <7%). The HIV-1 load did not predict mortality beyond the CD4 cell count. CONCLUSIONS: The CD4 cell count and CD4% measured during pregnancy were both useful predictors of mortality among pregnant women. TLC, BMI, and hemoglobin had a limited predictive value, and the HIV-1 load did not predict mortality any better than did the CD4 cell count alone. Copyright © 2009 Infectious Diseases Society of America"									
1041	Clinic-based food assistance is associated with increased medication adherence among HIV-infected adults on long-term Antiretroviral Therapy in Zambia.	"Tirivayi N, Koethe JR, Groot W."	Journal of AIDS and Clinical Research. 2012;3(7).	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20133136901	"Background: There has been limited research to date on the effects of food assistance provided to HIV-infected adults in resource-constrained settings with a high prevalence of malnutrition and chronic food insecurity. We compare Antiretroviral Therapy (ART) adherence, weight gain, and CD4+ lymphocyte change among HIV-infected adult enrolled in a clinic-based food assistance program in Lusaka, Zambia versus a control group of non-recipients. Methods: We conducted a cohort study incorporating interviewer-administered surveys and retrospective clinical data to compare ART patients receiving food assistance with a control group of non-recipients. Medication adherence was assessed using pharmacy dispensation records. We use propensity score matching to assess the effect of food assistance on outcome measures. Results: After 6 months, food assistance recipients (n=145) had higher ART adherence compared to nonrecipients (n=147, 98.3% versus 88.8%, respectively; p<0.01), but no significant effects were observed for weight or CD4+ lymphocyte count change. The improvement in adherence rates was greater for participants on ART for less than 230 days, and those with BMI<18.5 kg/m<sup>2</sup>, a higher HIV disease stage, or a CD4+ lymphocyte count <=350 cells/ micro l. Conclusions: Promoting optimal medication adherence among persons on ART is relevant to public health and the success of HIV control efforts. The provision of food assistance to HIV-infected adults on ART may have an incentivizing effect which can improve medication adherence, particularly among patients recently initiated on treatment and those with poor nutrition or advanced disease. The effects on body weight and immune reconstitution appear minimal."									
1763	Survival and causes of death among HIV-infected patients starting antiretroviral therapy in north-eastern Vietnam.	"Cuong DD, Thorson A, Sonnerborg A, Hoa NP, Chuc NTK, Phuc HD, Larsson M."	Scandinavian Journal of Infectious Diseases. 2012 March;44(3):201-8.		"Background: There is a lack of knowledge on mortality and causes of death among human immunodeficiency virus (HIV)-infected patients after initiation of antiretroviral therapy (ART) in Vietnam. We investigated the mortality rate, risk factors, causes of death, and impact of enhanced adherence support on survival among 640 Vietnamese treatment-nave HIV-infected patients receiving ART in a cluster randomized controlled trial. Methods: Patients in the intervention group received enhanced adherence from peer-supporters. Data were collected through medical records and a verbal autopsy questionnaire. We used KaplanMeier analysis to describe the survival trends and the Cox proportional hazard model to identify predictors of acquired immune deficiency syndrome (AIDS)-related deaths. Results: After a median follow-up of 15.2 months, there were 60 deaths, 73% of which occurred within 6 months. The mortality rate was 7.4/100 person-y and survival probability was 91% after 1 y. There was no significant difference in mortality rate between the intervention and the control groups. At baseline, the predictive factors for AIDS-related death were age >35 y, clinical stage 3 or 4, body mass index (BMI) <18 kg/m<sup>2</sup>, CD4 count <100/mul, haemoglobin level <100 g/l, and plasma viral load >100,000 copies/ml. Tuberculosis (TB) was the most common cause of death (40%). Conclusions: Early deaths occurred after ART, and delay of ART caused a significant decrease in CD4 count and a high mortality. Adherence support had no impact on survival at the early stage of ART. Early ART initiation and intensive follow-up of patients during the first 6 months of ART are therefore necessary to reduce AIDS-related mortality. 2012 Informa Healthcare."									
1764	Survival and causes of death among HIV-infected patients starting antiretroviral therapy in north-eastern Vietnam.	"Do Duy C, Thorson A, Sonnerborg A, Nguyen Phuong H, Nguyen Thi Kim C, Ho Dang P, Larsson M."	Scandinavian Journal of Infectious Diseases. 2012;44(3):201-8.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20123091255	"Background: There is a lack of knowledge on mortality and causes of death among human immunodeficiency virus (HIV)-infected patients after initiation of antiretroviral therapy (ART) in Vietnam. We investigated the mortality rate, risk factors, causes of death, and impact of enhanced adherence support on survival among 640 Vietnamese treatment-naive HIV-infected patients receiving ART in a cluster randomized controlled trial. Methods: Patients in the intervention group received enhanced adherence from peer-supporters. Data were collected through medical records and a verbal autopsy questionnaire. We used Kaplan-Meier analysis to describe the survival trends and the Cox proportional hazard model to identify predictors of acquired immune deficiency syndrome (AIDS)-related deaths. Results: After a median follow-up of 15.2 months, there were 60 deaths, 73% of which occurred within 6 months. The mortality rate was 7.4/100 person-y and survival probability was 91% after 1 y. There was no significant difference in mortality rate between the intervention and the control groups. At baseline, the predictive factors for AIDS-related death were age >35 y, clinical stage 3 or 4, body mass index (BMI) <18 kg/m<sup>2</sup>, CD4 count <100/ micro l, haemoglobin level <100 g/l, and plasma viral load >100,000 copies/ml. Tuberculosis (TB) was the most common cause of death (40%). Conclusions: Early deaths occurred after ART, and delay of ART caused a significant decrease in CD4 count and a high mortality. Adherence support had no impact on survival at the early stage of ART. Early ART initiation and intensive follow-up of patients during the first 6 months of ART are therefore necessary to reduce AIDS-related mortality."									
1606	Vitamin D and HIV progression among Tanzanian adults initiating antiretroviral therapy.	"Sudfeld CR, Wang M, Aboud S, Giovannucci EL, Mugusi FM, Fawzi WW."	PLoS ONE. 2012 29 Jun;7(6).		"Background: There is growing evidence of an association between low vitamin D and HIV disease progression; however, no prospective studies have been conducted among adults receiving antiretroviral therapy (ART) in sub-Saharan Africa. Methods: Serum 25-hydroxyvitamin D (25(OH)D) levels were assessed at ART initiation for a randomly selected cohort of HIV-infected adults enrolled in a trial of multivitamins (not including vitamin D) in Tanzania during 2006-2010. Participants were prospectively followed at monthly clinic visits for a median of 20.6 months. CD4 T-cell measurements were obtained every 4 months. Proportional hazard models were utilized for mortality analyses while generalized estimating equations were used for CD4 T-cell counts. Results: Serum 25(OH)D was measured in 1103 adults 9.2% were classified as vitamin D deficient (<20 ng/ml), 43.6% insufficient (20-30 ng/mL), and 47.2% as sufficient (>30 ng/mL). After multivariate adjustment, vitamin D deficiency was significantly associated with increased mortality as compared to vitamin D sufficiency (HR: 2.00; 95% CI: 1.19-3.37; p = 0.009), whereas no significant association was found for vitamin D insufficiency (HR: 1.24; 95% CI: 0.87-1.78; p = 0.24). No effect modification by ART regimen or change in the associations over time was detected. Vitamin D status was not associated with change in CD4 T-cell count after ART initiation. Conclusions: Deficient vitamin D levels may lead to increased mortality in individuals receiving ART and this relationship does not appear to be due to impaired CD4 T-cell reconstitution. Randomized controlled trials are needed to determine the safety and efficacy of vitamin D supplementation for individuals receiving ART. 2012 Sudfeld et al."									
1574	Hypertension and obesity as cardiovascular risk factors among HIV seropositive patients in Western Kenya.	"Bloomfield GS, Hogan JW, Keter A, Sang E, Carter EJ, Velazquez EJ, Kimaiyo S."	PLoS ONE. 2011;6(7).		"Background: There is increased risk of cardiovascular disease among HIV seropositive individuals. The prevalence of HIV is highest in sub-Saharan Africa; however, HIV-related cardiovascular risk research is largely derived from developed country settings. Herein, we describe the prevalence of hypertension and obesity in a large HIV treatment program in Kenya. Methods: We performed a retrospective analysis of the electronic medical records of a large HIV treatment program in Western Kenya between 2006 and 2009. We calculated the prevalence of hypertension and obesity among HIV+ adults as well as utilized multiple logistic regression analyses to examine the relationship between clinical characteristics, HIV-related characteristics, and hypertension. Results: Our final sample size was 12,194. The median systolic/diastolic blood pressures were similar for both sexes (male: 110/70 mmHg, female: 110/70 mmHg). The prevalence of hypertension among men and women were 11.2% and 7.4%, respectively. Eleven percent of men and 22.6% of women were overweight/obese (body mass index >=25 kg/m<sup>2</sup>). Ordinal logistic regression analyses showed that overweight/obesity was more strongly associated with hypertension among HIV+ men (OR 2.41, 95% CI 1.88-3.09) than a higher successive age category (OR 1.62, 95% CI 1.40-1.87 comparing 16-35, 36-45 and >45 years categories). Among women, higher age category and overweight/obesity were most strongly associated with hypertension (age category: OR 2.21, 95% CI 1.95-2.50, overweight/obesity: OR 1.80, 95% CI 1.50-2.16). Length of time on protease inhibitors was not found to be related to hypertension for men (OR 1.62, 95% CI 0.42-6.20) or women (OR 1.17, 95% CI 0.37-2.65) after adjustment for CD4 count, age and BMI. Conclusion: In Western Kenya, there is a high prevalence of hypertension and overweight/obesity among HIV+ patients with differences observed between men and women. The care of HIV+ patients in sub-Saharan Africa should also include both identification and management of associated cardiovascular risk factors. 2011 Bloomfield et al."									
1593	Incidence and predictors of immune reconstitution inflammatory syndrome in a rural area of Mozambique.	"Letang E, Miro JM, Nhampossa T, Ayala E, Gascon J, Menendez C, Alonso PL, et al."	PLoS ONE. 2011;6(2).		"Background: There is limited data on the epidemiology of Immune Reconstitution Inflammatory Syndrome (IRIS) in rural sub-Saharan Africa. A prospective observational cohort study was conducted to assess the incidence, clinical characteristics, outcome and predictors of IRIS in rural Mozambique. Methods: One hundred and thirty-six consecutive antiretroviral treatment (ART)-naive HIV-1-infected patients initiating ART at the Manhica district hospital were prospectively followed for development of IRIS over 16 months. Survival analysis by Cox regression was performed to identify pre-ART predictors of IRIS development. Results: Thirty-six patients developed IRIS [26.5%, incidence rate 3.1 cases/100 persons-month of ART (95% CI 2.2-4.3)]. Median time to IRIS onset was 62 days from ART initiation (IQR 35.5-93.5). Twenty-five cases (69.4%) were ""unmasking"", 10 (27.8%) were ""paradoxical"", and 1 (2.8%) developed a paradoxical worsening followed by the unmasking of another condition. Systemic OI (OI-IRIS) accounted for 47% (17/36) of IRIS cases, predominantly of KS (8 cases) and TB (6 cases) IRIS. Mucocutaneous IRIS manifestations (MC-IRIS) accounted for 53% (19/36) of IRIS events, mostly tinea (9 cases) and herpes simplex infection (3 cases). Multivariate analysis identified two independent predictors of IRIS development: pre-ART CD4 count <50 cells/mul (HR 2.3, 95% CI 1.19-4.44, p = 0.01) and body mass index (BMI) <18.5 (HR 2.15, 95% CI 1.07-4.3, p = 0.03). The pre-cART proportion of activated T-cells, as well as the immunologic and virologic response to ART were not associated with IRIS development. All patients continued on ART, 7 (19.4%) required hospitalization and there were 3 deaths (8.3%) attributable to IRIS. Conclusions: IRIS is common in patients initiating ART in rural Mozambique. Pre-ART CD4 counts and BMI can easily be assessed at ART initiation in rural sub-Saharan Africa to identify patients at high risk of IRIS, for whom close supervision is warranted. 2011 Letang et al."									
753	Exploring the paradox: double burden of malnutrition in rural South Africa.	Kimani-Murage EW.	Glob Health Action. 2013;6:19249.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=23364082	"BACKGROUND: This article is a review of the PhD thesis by Elizabeth Kimani-Murage that explores the double burden of malnutrition in rural South Africa. This is in the context of a worryingly rapid increase in obesity and obesity-related diseases in low- and middle-income countries (LMICs) including South Africa, and in the wake of on-going nutrition transition and lifestyle changes in these countries."	"OBJECTIVE: To understand the profiles of malnutrition among children and adolescents in a poor, high HIV prevalent, transitional society in a middle-income country."	"METHODS: A cross-sectional growth survey was conducted in 2007 targeting 4,000 children and adolescents aged 1-20 years. In addition, HIV testing was carried out on children aged 1-5 years and Tanner pubertal assessment among adolescents aged 9-20 years."	"RESULTS: The study shows stunting at an early age and adolescent obesity, particularly among girls, that co-exists in the same socio-geographic population. The study also shows that HIV is an independent modifiable risk factor for poor nutritional outcomes in children and makes a significant contribution to nutritional outcomes at the individual level. Significant predictors of undernutrition at an early age, documented at individual, household, and community levels, include child's HIV status, age and birth weight, maternal age, age of household head, and area of residence. Significant predictors of overweight/obesity and risk for metabolic disease during adolescence, documented at individual and household levels include child's age, sex, and pubertal development, household-level food security, socio-economic status, and household head's highest education level."	"CONCLUSIONS: The combination of early stunting and adolescent obesity raises critical concerns in the wake of the rising public health importance of metabolic diseases in LMICs. This is because, both paediatric obesity and adult short stature are risk factors for metabolic syndrome and metabolic diseases in adulthood. Clearly, policies and interventions to address malnutrition in this and other transitional societies need to be double-pronged and gender-sensitive."					
842	Oral manifestations among people living with HIV/AIDS in Tanzania.	"Fabian FM, Kahabuka FK, Petersen PE, Shubi FM, Jurgensen N."	International Dental Journal. 2009;59(4):187-91.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20093264503	"Background: This study aimed to determine the prevalence of various oral and peri-oral manifestations in people living with HIV/AIDS in Tanzania. Methods: A cross sectional study. A total of 187 persons with HIV infection were recruited from non-governmental organisations serving people living with HIV/AIDS, 16.6% were males and females 83.4%. Information on weight and height, as well as extra oral and intra oral examinations for different manifestations were gathered. Treatment and referral for special care were offered. Results: At least one oral lesion was present in 45% of the participants. Candidiasis (28.9%) and non-tender lymphadenopathy (11.8%) were the most common lesions. Candidiasis occurred most frequently on lips/mucosa, and the tongue, and pseudomembranous candidiasis was the most frequent type. Candidiasis occurred with several other conditions and was statistically significantly associated with low body mass index (BMI). Conclusion: This community survey carried out in an African sub-Saharan country showed that oral lesions are frequent among people living with HIV/AIDS. As emphasised by the World Health Organization Global Oral Health Programme, national HIV/AIDS programmes should incorporate oral health components."									
1089	Diet quality of persons living with HIV/AIDS on highly active antiretroviral therapy.[Erratum appears in J Hum Nutr Diet. 2009 Apr;22(2):184].	"Duran AC, Almeida LB, Segurado AA, Jaime PC."	Journal of Human Nutrition & Dietetics. 2008;21(4):346-50.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=18721401	"BACKGROUND: This study sought to assess the diet quality of individuals living with HIV/AIDS who were receiving antiretroviral therapy in Sao Paulo, Brazil."	"METHODS: This cross-sectional study involved 56 HIV-infected adults. Demographic and anthropometric data were collected, and diet quality was measured using the Healthy Eating Index (HEI), modified for Brazilians, which included ten components: adequacy of intake of six different food groups, total fat, cholesterol, dietary fibre and dietary variety."	"RESULTS: Among the individuals assessed, 64.3% of the participants had a diet needing improvement, while 8.7% had a poor diet. The overall HEI score was 68.3 points (SD = 14.9). Mean scores were low for fruits, vegetables, dairy products and dietary fibre; and high for meats and eggs, total fat and cholesterol. The overall HEI score was higher among individuals who were not overweight (P = 0.003), who were also more likely to achieve dietary goals for dairy products (P = 0.039) and grains (P = 0.005)."	"CONCLUSION: Most of these adults living with HIV/AIDS had diets that required improvement, and being overweight was associated with poorer diet quality. Nutritional interventions aimed at maintaining healthy body weight and diet should be taken into account in caring for HIV-infected people."						
1092	Diet quality of persons living with HIV/AIDS on highly active antiretroviral therapy.	"Duran ACFL, Almeida LB, Segurado AAC, Jaime PC."	Journal of Human Nutrition and Dietetics. 2008 August;21(4):346-50.		"Background: This study sought to assess the diet quality of individuals living with HIV/AIDS who were receiving antiretroviral therapy in Sao Paulo, Brazil. Methods: This cross-sectional study involved 56 HIV-infected adults. Demographic and anthropometric data were collected, and diet quality was measured using the Healthy Eating Index (HEI), modified for Brazilians, which included ten components: adequacy of intake of six different food groups, total fat, cholesterol, dietary fibre and dietary variety. Results: Among the individuals assessed, 64.3% of the participants had a diet needing improvement, while 8.7% had a poor diet. The overall HEI score was 68.3 points (SD = 14.9). Mean scores were low for fruits, vegetables, dairy products and dietary fibre; and high for meats and eggs, total fat and cholesterol. The overall HEI score was higher among individuals who were not overweight (P = 0.003), who were also more likely to achieve dietary goals for dairy products (P = 0.039) and grains (P = 0.005). Conclusion: Most of these adults living with HIV/AIDS had diets that required improvement, and being overweight was associated with poorer diet quality. Nutritional interventions aimed at maintaining healthy body weight and diet should be taken into account in caring for HIV-infected people. 2008 The British Dietetic Association."									
1898	The cameroon mobile phone sms (CAMPS) trial: A protocol for a randomized controlled trial of mobile phone text messaging versus usual care for improving adherence to highly active anti-retroviral therapy.	"Mbuagbaw L, Thabane L, Ongolo-Zogo P, Lester RT, Mills E, Volmink J, Yondo D, et al."	Trials. 2011 07 Jan;12(5).		"Background: This trial aims at testing the efficacy of weekly reminder and motivational text messages, compared to usual care in improving adherence to Highly Active Antiretroviral Treatment in patients attending a clinic in Yaounde, Cameroon.Methods and Design: This is a single-centered randomized controlled single-blinded trial. A central computer generated randomization list will be generated using random block sizes. Allocation will be determined by sequentially numbered sealed opaque envelopes. 198 participants will either receive the mobile phone text message or usual care. Our hypothesis is that weekly motivational text messages can improve adherence to Highly Active Antiretroviral Treatment and other clinical outcomes in the control group by acting as a reminder, a cue to action and opening communication channels. Data will be collected at baseline, three months and six months. A blinded program secretary will send out text messages and record delivery.Our primary outcomes are adherence measured by the visual analogue scale, self report, and pharmacy refill data. Our secondary outcomes are clinical: weight, body mass index, opportunistic infections, all cause mortality and retention; biological: Cluster Designation 4 count and viral load; and quality of life. Analysis will be by intention-to-treat. Covariates and subgroups will be taken into account.Discussion: This trial investigates the potential of SMS motivational reminders to improve adherence to Highly Active Antiretroviral Treatment in Cameroon. The intervention targets non-adherence due to forgetfulness and other forms of non-adherence.Trial Registration: Pan-African Clinical Trials Registry PACTR201011000261458. http://clinicaltrials.gov/NCT01247181. 2011 Mbuagbaw et al; licensee BioMed Central Ltd."									
1618	"Baseline predictors of sputum culture conversion in pulmonary tuberculosis: importance of cavities, smoking, time to detection and W-Beijing genotype."	"Visser ME, Stead MC, Walzl G, Warren R, Schomaker M, Grewal HM, Swart EC, et al."	PLoS ONE [Electronic Resource]. 2012;7(1):e29588.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=22238625	"BACKGROUND: Time to detection (TTD) on automated liquid mycobacterial cultures is an emerging biomarker of tuberculosis outcomes. The M. tuberculosis W-Beijing genotype is spreading globally, indicating a selective advantage. There is a paucity of data on the association between baseline TTD and W-Beijing genotype and tuberculosis outcomes."	"AIM: To assess baseline predictors of failure of sputum culture conversion, within the first 2 months of antitubercular therapy, in participants with pulmonary tuberculosis."	"DESIGN: Between May 2005 and August 2008 we conducted a prospective cohort study of time to sputum culture conversion in ambulatory participants with first episodes of smear and culture positive pulmonary tuberculosis attending two primary care clinics in Cape Town, South Africa. Rifampicin resistance (diagnosed on phenotypic susceptibility testing) was an exclusion criterion. Sputum was collected weekly for 8 weeks for mycobacterial culture on liquid media (BACTEC MGIT 960). Due to missing data, multiple imputation was performed. Time to sputum culture conversion was analysed using a Cox-proportional hazards model. Bayesian model averaging determined the posterior effect probability for each variable."	"RESULTS: 113 participants were enrolled (30.1% female, 10.5% HIV-infected, 44.2% W-Beijing genotype, and 89% cavities). On Kaplan Meier analysis 50.4% of participants underwent sputum culture conversion by 8 weeks. The following baseline factors were associated with slower sputum culture conversion: TTD (adjusted hazard ratio (aHR)=1.11, 95% CI 1.02; 1.2), lung cavities (aHR=0.13, 95% CI 0.02; 0.95), ever smoking (aHR=0.32, 95% CI 0.1; 1.02) and the W-Beijing genotype (aHR=0.51, 95% CI 0.25; 1.07). On Bayesian model averaging, posterior probability effects were strong for TTD, lung cavitation and smoking and moderate for W-Beijing genotype."	"CONCLUSION: We found that baseline TTD, smoking, cavities and W-Beijing genotype were associated with delayed 2 month sputum culture. Larger studies are needed to confirm the relationship between the W-Beijing genotype and sputum culture conversion."					
880	"Survival, clinical, immunological and hematological outcomes of antiretroviral therapy among HIV-infected children attending a public clinic in Kinshasa, Democratic Republic of Congo."	"Yotebieng M, Van Rie A, Luisiama J, Kitetele F, Edmonds A, Behets Fg."	International Journal of Infectious Diseases. 2010 March;14:e247.		"Background: To assess the mortality, immunological, hematological, and clinical outcomes of children initiating antiretroviral therapy (ART) during the first 5 years (November 2004 - October 2009) of a standardized HIV care and treatment program at the Kalembe-Lembe pediatric hospital in Kinshasa, DRC. Methods: Retrospective analysis of routine clinical data from a cohort of 603 HIV-infected children) 17 years of age at ART initiation. Results: Children initiated ART at a median age of 6.4 [interquartile range 3.2-10.5] years. At ART initiation, 27.1% were on treatment for tuberculosis, 54.6% were in WHO stage III&IV, 52.8% had < 10 g/dL hemoglobin, 63.0% had a CD4%) 15% (severe immunosuppression), 39.6% had a weight-for-age Z score (WAZ)) -3 (severe underweight), and 9.8% had previously received antiretrovirals. The first line regimens included stavudine or zidovudine, lamuvidine, and nevirapine or efavirenz. During 1409.8 child-years of follow-up (median follow-up, 28.7 months), 61 children died: 38 during the first 90 days of treatment (early mortality rate, 28.0/100 child-years; 95% Confidence Interval (CI), 20.4-38.4) and 23 after 90 days (late mortality rate, 1.6/100 child-years; 95% CI, 1.9-2.5). The mean CD4% and WAZ rose rapidly from 11.6% and -2.57 at baseline to 25.0% and -1.92 at 12 months before stabilizing above 28.0% and around - 1.80 between 18 and 48 months, respectively. The mean height-for-age Z scores (HAZ) and hemoglobin increased almost linearly from -2.23 and 9.8 g/dL at baseline to -1.78 and 10.8 g/dL at 12 months to -1.23 and 12.0 g/dL at 48 months, respectively. Children under two years of age at ART initiation had greater and more sustained gains in weight, height, CD4% and hemoglobin compared to children who started ART when at least two years of age (p < 0.01, p < 0.01, p = 0.01, p < 0.01, respectively). Conclusion: Despite late presentation in our clinic, good clinical, immunological, and hematologic outcomes were obtained within the first 12 months and maintained through 48 months of ART among children who survived the first three months. The high early mortality rate reflects obstacles to health seeking behavior, early HIV diagnosis, and access to timely ART initiation in Kinshasa."									
295	"Living with HIV, antiretroviral treatment experience and tobacco smoking: results from a multisite cross-sectional study."	"Duval X, Baron G, Garelik D, Villes V, Dupre T, Leport C, Lert F, et al."	Antiviral therapy. 2008;13(3):389-97.		"BACKGROUND: To assess the prevalence of and factors associated with tobacco smoking and dependence in HIV patients. METHODS: In a one-day cross-sectional national survey of a representative sample of 82 French units specialized in HIV-infected patient care, 727 consecutive outpatients were asked to complete a self-administered questionnaire, assessing smoking habits, dependence, cessation motivation, other substance abuse, sociocultural characteristics, life with HIV and its treatment. Smoking prevalence and dependence were assessed and compared with a representative sample of the general French population. RESULTS: The questionnaire was completed by 593 (82%) patients: 12% were active or ex-intravenous drug users, 37% were homosexual men, and 43% were active smokers (compared with 31% in the French population) of whom 56% were classified as moderately or highly dependent. Fourteen percent of smokers were highly motivated and free of other substance abuse and of depressive symptoms. Smoking was independently associated with male sex (odds ratio [OR] = 2.38; 95% confidence interval [CI] 0.99-1.11), lower body mass index (OR 1.08; 95% Cl 1.14-1.03), smoking environment (OR 4.75; 95% Cl 3.02-7.49), excessive alcohol consumption (OR 2.50; 95% CI 1.20-5.23), illicit drug use (OR 2.43; 95% CI 1.41-4.19), HIV status disclosure to family (OR 1.81; 95% CI 1.16-2.85) and experience of rejection due to disclosure (OR 1.90; 95% CI 1.14-3.17). Disclosure and drug substitute usage were associated with high tobacco dependence. CONCLUSIONS: Very few HIV smokers seem to be good candidates for a standard tobacco cessation program. Tobacco reduction or cessation strategies should be adapted to this population."									
982	"Low risk of death, but substantial program attrition, in pediatric HIV treatment cohorts in sub-saharan Africa."	"Dabis F, Mbori-Ngacha D, Arrive E, Kyabayinze D, Marquis B, Namale L, Olet S, et al."	Journal of Acquired Immune Deficiency Syndromes. 2008 December;49(5):523-31.		"Background: To date, an estimated 10% of children eligible for antiretroviral treatment (ART) receive it, and the frequency of retention in programs is unknown. We evaluated the 2-year risks of death and loss to follow-up (LTFU) of children after ART initiation in a multicenter study in sub-Saharan Africa. Methods: Pooled analysis of routine individual data from 16 participating clinics produced overall Kaplan-Meier estimates of the probabilities of death or LTFU after ART initiation. Risk factors analysis used Weibull regression, accounting for between-cohort heterogeneity. Results: The median age of 2405 children at ART initiation was 4.9 years (12%, younger than 12 months), 52% were male, 70% had severe immunodeficiency, and 59% started ART with a nonnucleoside reverse transcriptase inhibitor. The 2-year risk of death after ART initiation was 6.9% (95% confidence interval [CI]: 5.9 to 8.1), independently associated with baseline severe anemia (adjusted hazard ratio [aHR]: 4.10 [CI: 2.36 to 7.13]), immunodeficiency (adjusted aHR: 2.95 [CI: 1.49 to 5.82]), and severe clinical status (adjusted aHR: 3.64 [CI: 1.95 to 6.81]); the 2-year risk of LTFU was 10.3% (CI: 8.9 to 11.9), higher in children with severe clinical status. Conclusions: Once on treatment, the 2-year risk of death is low but the LTFU risk is substantial. ART is still mainly initiated at advanced disease stage in African children, reinforcing the need for early HIV diagnosis, early initiation of ART, and procedures to increase program retention. Copyright 2008 Lippincott Williams & Wilkins."									
1911	Retention of HIV-infected and HIV-exposed children in a comprehensive HIV clinical care programme in Western Kenya.	"Braitstein P, Katshcke A, Shen C, Sang E, Nyandiko W, Ochieng VO, Vreeman R, et al."	Tropical Medicine & International Health. 2010;15(7):833-41.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=20487430	BACKGROUND: To describe incidence rates (IR) and risk factors for loss-to-follow-up (LTFU) among HIV-infected and HIV-exposed children in a large HIV treatment programme in Western Kenya.	"METHODS: The USAID-AMPATH Partnership has enrolled >100,000 patients (20% children) at 23 clinic sites throughout western Kenya. LTFU is defined as being absent from the clinic for >3 months if on combination antiretroviral treatment (cART) and >6 months if not. Included in this analysis were children aged <14 years, HIV exposed or infected at enrollment, and enrolled between April 2002 and March 2009. The IR for LTFU are presented per 100 child-years (CY) of follow-up. Proportional hazards models with time-independent and time-dependent covariates were used to model factors associated with LTFU. Weight for height Z-scores were calculated using EpiInfo, with severe malnutrition being defined as a Z-score <or=-3.0. Immune suppression was defined as per WHO age-specific categories."	"RESULTS: There were 13,510 children eligible for analysis, comprising 3106 children who at enrollment were HIV infected and 10,404 children who were HIV exposed. The overall IR of LTFU was 18.4 (17.8-18.9) per 100 CY. Among HIV-infected children, 15.2 (13.8-16.7) and 14.1 (13.1-15.8) per 100 CY became LTFU, pre- and post-cART initiation, respectively. The only independent risk factor for becoming LTFU among the HIV-infected children was severe immune suppression (AHR: 2.17, 95% CI: 1.51-3.12). Among the HIV-exposed children, 20.1 per 100 (19.4-20.7) became LTFU. Independent risk factors for LTFU among them were being severely low weight for height (AHR: 1.69, 95% CI: 1.25-2.28), being orphaned at enrollment (AHR: 1.57, 95% CI: 1.23-1.64), being CDC Class B or C (AHR: 1.41, 95% CI: 1.14-1.74), and having received cART (AHR: 1.56, 95% CI: 1.23-1.99). Protective against becoming LTFU among the HIV exposed were testing HIV positive (AHR: 0.26, 95% CI: 0.21-0.32), older age (AHR: 0.90, 95% CI: 0.85-0.96), enrolling in later time periods, and receiving food supplementation (AHR: 0.58, 95% CI: 0.32-1.04)."	"CONCLUSIONS: There is a high rate of LTFU among these highly vulnerable children, particularly among the HIV exposed. These data suggest that HIV-infected and HIV-exposed children are at especially high risk for LTFU if they are sick or malnourished."						
1028	Transmission of cell-free and cell-associated HIV-1 through breast-feeding.[Erratum appears in J Acquir Immune Defic Syndr. 2006 Aug 15;42(5):650].	"Koulinska IN, Villamor E, Chaplin B, Msamanga G, Fawzi W, Renjifo B, Essex M."	Journal of Acquired Immune Deficiency Syndromes: JAIDS. 2006;41(1):93-9.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=16340480	"BACKGROUND: Transmission through breast-feeding is an important cause of infant HIV-1 infections in developing countries; however, its mechanism remains largely unknown. We have explored the association between cell-free virus (CFV) and cell-associated virus (CAV) levels in breast milk (BM), as reflected by viral RNA and proviral DNA, respectively, and the risk of infant HIV-1 infection after 6 weeks postpartum."	METHODS: Sixty-one HIV-positive mothers who transmitted HIV-1 by BM were matched to 61 HIV-positive nontransmitting mothers based on their infant's age at sample collection. CFV and CAV were quantified in a single milk specimen per mother preceding the infant's first HIV-positive result.	"RESULTS: After adjusting for maternal CD4 cell counts and disease stage, each 10-fold increase in CFV or CAV load was associated with an almost 3-fold increase in BM transmission. Whereas CAV load was predictive of transmission before and after 9 months postpartum, CFV was a significant predictor of transmission occurring only after 9 months. Phylogenetic analyses of the C2 to C5 env region showed that 85% of infants (11 of 13 infants) harboring viruses that clustered with CFV in their mother's milk were infected after 9 months postpartum."	CONCLUSION: A reduction in milk CAV and CFV loads might significantly decrease HIV-1 transmission by breast-feeding.						
1269	Gender differences in mortality and CD4 count response among virally suppressed HIV-positive patients.	"Maskew M, Brennan AT, Westreich D, McNamara L, MacPhail AP, Fox MP."	Journal of Women's Health. 2013 01 Feb;22(2):113-20.		"Background: Treatment outcomes for antiretroviral therapy (ART) patients may vary by gender, but estimates from current evidence may be confounded by disease stage and adherence. We investigated the gender differences in treatment response among HIV-positive patients virally suppressed within 6 months of treatment initiation. Methods: We analyzed data from 7,354 patients initiating ART between April 2004 and April 2010 at Themba Lethu Clinic, a large urban public sector treatment facility in South Africa. We estimated the relations among gender, mortality, and mean CD4 response in HIV-infected adults virally suppressed within 6 months of treatment initiation and used inverse probability of treatment weights to correct estimates for loss to follow-up. Results: Male patients had a 20% greater risk of death at both 24 months and 36 months of follow-up compared to females. Older patients and those with a low hemoglobin level or low body mass index (BMI) were at increased risk of mortality throughout follow-up. Men gained fewer CD4 cells after treatment initiation than did women. The mean differences in CD4 count gains made by women and men between baseline and 12, 24, and 36 months were 28.2 cells/mm<sup>3</sup> (95% confidence interval [CI] 22.2-34.3), 60.8 cells/mm<sup>3</sup> (95% CI 71.1-50.5 cells/mm<sup>3</sup>), and 83.0 cells/mm<sup>3</sup> (95% CI 97.1-68.8 cells/mm<sup>3</sup>), respectively. Additionally, patients with a current detectable viral load (>400 copies/mL) and older patients had a lower mean CD4 increase at the same time points. Conclusions: In this initially virally suppressed population, women showed consistently better immune response to treatment than did men. Promoting earlier uptake of HIV treatment among men may improve their immunologic outcomes. Copyright 2013, Mary Ann Liebert, Inc."									
1598	Impact of small body weight on Tenofovir-Associated renal dysfunction in HIV-infected patients: A retrospective cohort study of Japanese patients.	"Nishijima T, Komatsu H, Gatanaga H, Aoki T, Watanabe K, Kinai E, Honda H, et al."	PLoS ONE. 2011;6(7).		"Background: Treatment with tenofovir is sometimes associated with renal dysfunction. Limited information is available on this side effect in patients with small body weight, although the use of tenofovir will spread rapidly in Asia and Africa, where patients are likely to be of smaller body weight. Methods: In a single-center cohort, Japanese patients with HIV infection who started tenofovir-containing antiretroviral therapy were retrospectively analyzed. The incidence of tenofovir-associated renal dysfunction, defined as more than 25% decrement of estimated glomerular filtration rate (eGFR) from the baseline, was determined. The effects of small body weight and body mass index (BMI) on tenofovir-associated renal dysfunction, respectively, were estimated in univariate and multivariate Cox hazards models as the primary exposure. Other possible risk factors were evaluated by univariate analysis and those found significant were entered into the multivariate analysis. Results: The median weight of 495 patients was 63 kg. Tenofovir-related renal dysfunction occurred in 97 (19.6%) patients (incidence: 10.5 per 100 person-years). Univariate analysis showed that the incidence of tenofovir-related renal dysfunction was significantly associated with smaller body weight and BMI, respectively (per 5 kg decrement, HR = 1.23; 95% CI, 1.10-1.37; p<0.001)(per 1 kg/m<sup>2</sup> decrement, HR = 1.14; 95% CI, 1.05-1.23; p = 0.001). Old age, high baseline eGFR, low serum creatinine, low CD4 count, high HIV viral load, concurrent nephrotoxic drugs, hepatitis C infection, and current smoking were also associated with tenofovir-related renal dysfunction. Multivariate analysis identified small body weight as a significant risk (adjusted HR = 1.13; 95% CI, 1.01-1.27; p = 0.039), while small BMI had marginal significance (adjusted HR = 1.07; 95% CI 1.00-1.16; p = 0.058). Conclusion: The incidence of tenofovir-associated renal dysfunction in Japanese patients was high. Small body weight was identified as an independent risk factor for tenofovir-associated renal dysfunction. Close monitoring of renal function is advocated for patients with small body weight treated with tenofovir. 2011 Nishijima et al."									
1571	High prevalence of tuberculosis and serious bloodstream infections in ambulatory individuals presenting for antiretroviral therapy in Malawi.	"Bedell RA, Anderson STB, van Lettow M, Akesson A, Corbett EL, Kumwenda M, Chan AK, et al."	PLoS ONE. 2012 22 Jun;7(6).		"Background: Tuberculosis (TB) and serious bloodstream infections (BSI) may contribute to the high early mortality observed among patients qualifying for antiretroviral therapy (ART) with unexplained weight loss, chronic fever or chronic diarrhea. Methods and Findings: A prospective cohort study determined the prevalence of undiagnosed TB or BSI among ambulatory HIV-infected adults with unexplained weight loss and/or chronic fever, or diarrhea in two routine program settings in Malawi. Subjects with positive expectorated sputum smears for AFB were excluded. Investigations Bacterial and mycobacterial blood cultures, cryptococcal antigen test (CrAg), induced sputum (IS) for TB microscopy and solid culture, full blood count and CD4 lymphocyte count. Among 469 subjects, 52 (11%) had microbiological evidence of TB; 50 (11%) had a positive (non-TB) blood culture and/or positive CrAg. Sixty-five additional TB cases were diagnosed on clinical and radiological grounds. Nontyphoidal Salmonellae (NTS) were the most common blood culture pathogens (29 cases; 6% of participants and 52% of bloodstream isolates). Multivariate analysis of baseline clinical and hematological characteristics found significant independent associations between oral candidiasis or lymphadenopathy and TB, marked CD4 lymphopenia and NTS infection, and severe anemia and either infection, but low positive likelihood ratios (<2 for all combinations). Conclusions: We observed a high prevalence of TB and serious BSI, particularly NTS, in a program cohort of chronically ill HIV-infected outpatients. Baseline clinical and hematological characteristics were inadequate predictors of infection. HIV clinics need better rapid screening tools for TB and BSI. Clinical trials to evaluate empiric TB or NTS treatment are required in similar populations. 2012 Bedell et al."									
934	Controlling tuberculosis in prisons against confinement conditions: A lost case? Experience from Cameroon.	"Noeske J, Ndi N, Mbondi S."	International Journal of Tuberculosis and Lung Disease. 2011 February;15(2):223-7.		"BACKGROUND: Tuberculosis (TB) is recognised as a major public health problem in the prisons of sub-Saharan Africa. In Cameroon, the main prisons have created diagnostic and treatment units linked to the National Tuberculosis Programme (NTP). OBJECTIVE: To assess the effectiveness of routine TB control activities in a prison population by determining the prevalence of undetected pulmonary tuberculosis (PTB). METHODS: In 2009, a PTB case-finding survey was under taken at the Central Prison of Yaounde (CPY), Cam eroon. All prisoners with cough of >=1 week's duration were screened by sputum smear microscopy. Smears were sent to the national reference laboratory for culture and drug susceptibility testing (DST). Voluntary testing for human immunodeficiency virus (HIV) was offered to all inmates. RESULTS: Among 3219 inmates screened, 40 (1.2%) identified with PTB had been missed by the prison TB control programme. Missed PTB was positively associated with severe crowding, low body mass index and previous TB treatment. Of the 40 inmates, four (10%) were TB-HIV co-infected. The DST of three inmates revealed resistance to anti-tuberculosis drugs. CONCLUSION: Despite a well-performing TB control programme in the CPY, the number of undetected PTB cases remains unacceptably high. It is doubtful whether TB transmission can be controlled under conditions of confinement, such as the CPY."									
93	"Prevalence, incidence and mortality associated with tuberculosis in HIV-infected patients initiating antiretroviral therapy in rural Uganda."	"Moore D, Liechty C, Ekwaru P, Were W, Mwima G, Solberg P, Rutherford G, et al."	Aids. 2007 March;21(6):713-9.		"BACKGROUND: Tuberculosis (TB) is the leading cause of death among people with HIV in sub-Saharan Africa. Expanding access to antiretroviral therapy (ART) may reduce the burden of TB, but to what extent is unknown. METHODS: In a study of 1044 adults who initiated home-based ART in Tororo, Uganda between 1 May 2003 and 30 June 2005, participants were screened for active TB at baseline and then monitored at weekly home visits. Participants with TB at baseline or follow-up were compared with those without TB to determine factors associated with mortality in those with TB. RESULTS: At baseline, 75 (7.2%) subjects had TB and a total of 53 (5.5%) were diagnosed with TB over a median of 1.4 years of follow-up (3.90 cases/100 person years). Cumulative mortality was 17.9/100 person-years for those with TB and 3.8/100 person-years for those without TB (P < 0.001). Mortality was associated with low baseline CD4 cell counts [relative hazard (RH), 0.99 per 1 cell/mul increase; P = 0.03] and marginally associated with a body mass index <= 18 (RH, 2.04; P = 0.10) and increasing age (RH, 1.04 per year; P = 0.11). TB incidence and TB-associated mortality were highest within the first 6 months of ART and declined to 52% and 61% of expected values, respectively, from months 7 to 18 after ART initiation. CONCLUSION: TB remains an important cause of illness and death in patients receiving ART in Uganda. However, both appear to decline markedly, after 6 months of ART. 2007 Lippincott Williams & Wilkins, Inc."									
1231	Integrating tuberculosis (TB) screening and HIV/AIDS care improves diagnosis of TB-HIV coinfections at an Urban Public HIV Clinic in Uganda.	"Nakanjako D, Mayanja-Kizza H, Ouma J, Wanyenze R, Mwesigire D, Namale A, Ssempira J, et al."	Journal of the International Association of Physicians in AIDS Care. 2010;9 (1):51.		"Background: Tuberculosis (TB) remains an important cause of illness and death in patients receiving antiretroviral therapy (ART) particularly in Africa, where patients typically present with advanced HIV disease at enrolment into HIV care. We integrated routine TB screening into an urban hospitalbased HIV/AIDS care program and evaluated the burden of TB. Methods: Clinicians screened all patients for previous and current TB treatment as well as presence of symptoms and signs of active TB at enrolment and throughout follow up. Results: Overall, 10 908 patients were enrolled into HIV/ AIDS care between 08-05 and 02-09. The median age was 32 (interquartile range [IQR] 27-38 years) and 7364 (68%) were female. Prevalent TB at enrolment was 156/10 908 (1.4%) of whom 65/156 (42%) had suspected TB at enrolment that was confirmed during follow up. A total of 707/10 908 (6.5%) were diagnosed with incident TB at a rate of 7 cases per 100 person years of follow up (PYO). Of these, 491/707 (69%) had initiated ART and the median time between ART initiation and TB diagnosis was 14 (IQR 0-41) months. Incident TB rates were significantly higher among ART patients (8 [95% CI 8-9])/100 PYO than among non-ART patients (5 [95% CI 5-6])/100 PYO; log rank P < .001. Male gender, body mass index (BMI) <=20 and WHO clinical stage 3 and 4 were significant predictors of prevalent TB at enrolment (adjusted odds ratio [aOR] 2.0 [95% CI 1.4-2.9]), aOR 2.5 (95% 1.7-3.3), and aOR 7.7 (95% CI 4.8-12.2), respectively, and incident TB (hazard ratio [HR]) 1.4 [95% CI 1.2-1.6]), HR 1.7 (95% CI 1.4-2.0) and HR 2.1 (95% CI 1.8-2.5), respectively. Conclusion: Integration of TB screening in HIV testing and treatment programs is feasible, identifies a significant number of TB-HIV coinfections thus a potential strategy to improve HIV treatment outcomes in resource limited settings."									
569	Nutritional supplements for people being treated for active tuberculosis.	"Sinclair D, Abba K, Grobler L, Sudarsanam TD."	Cochrane Database of Systematic Reviews. 2011(11):CD006086.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=22071828	"BACKGROUND: Tuberculosis and malnutrition are linked in a complex relationship. The infection may cause undernutrition through increased metabolic demands and decreased intake, and nutritional deficiencies may worsen the disease, or delay recovery by depressing important immune functions. At present, there are no evidence-based nutritional guidance for adults and children being treated for tuberculosis."	"OBJECTIVES: To assess the effects of oral nutritional supplements (food, protein/energy supplements or micronutrients) on tuberculosis treatment outcomes and recovery in people on antituberculous drug therapy for active tuberculosis."	"SEARCH METHODS: We searched the Cochrane Infectious Disease Group Specialized Register, CENTRAL (The Cochrane Library), MEDLINE, EMBASE, LILACS, mRCT, and the Indian Journal of Tuberculosis to July 2011, and checked the reference lists of all included studies."	"SELECTION CRITERIA: Randomized controlled trials comparing any oral nutritional supplement given for at least four weeks with no nutritional intervention, placebo, or dietary advice only for people being treated for active tuberculosis."	"DATA COLLECTION AND ANALYSIS: Two authors independently selected trials, extracted data, and assessed the risk of bias. Results are presented as risk ratios (RR) for dichotomous variables, and mean differences (MD) for continuous variables, with 95% confidence intervals (CI). Where appropriate, data from trials with similar interventions and outcomes have been pooled. The quality of evidence was assessed using the GRADE methods."	"MAIN RESULTS: Twenty-three trials, with 6842 participants, were included. Macronutrient supplementation Five trials assessed the provision of free food, or high energy supplements, although none were shown to provide a total daily kilocalorie intake above the current daily recommended intake for the non-infected population.The available trials were too small to reliably prove or exclude clinically important benefits on mortality, cure, or treatment completion. One small trial from India did find a statistically significant benefit on treatment completion, and clearance of the bacteria from the sputum, but these findings have not been confirmed in larger trials elsewhere (VERY LOW quality evidence).The provision of free food or high-energy nutritional products probably does produce a modest increase in weight gain during treatment for active tuberculosis (MODERATE quality evidence). Two small studies provide some evidence that physical function and quality of life may also be improved but the trials were too small to have much confidence in the result (LOW quality evidence). These effects were not seen in the one trial which included only human immunodeficiency virus (HIV)-positive patients.Micronutrient supplementation Five trials assessed multi-micronutrient supplementation in doses up to ten times the dietary reference intake, and 12 trials assessed single or dual micronutrient supplementation.There is insufficient evidence to judge whether multi-micronutrients have a beneficial effect on mortality in HIV- negative patients with tuberculosis (VERY LOW quality evidence), but the available studies show that multi-micronutrients probably have little or no effect on mortality in HIV-positive patients with tuberculosis (MODERATE quality evidence). No studies have assessed the effects of multi-micronutrients on cure, or treatment completion.Multi-micronutrient supplements may have little or no effect on the proportion of tuberculosis patients remaining sputum positive during the first eight weeks (LOW quality evidence), and probably have no effect on weight gain during treatment (MODERATE quality evidence). No studies have assessed quality of life.Plasma levels of vitamin A appear to increase following initiation of tuberculosis treatment regardless of supplementation. In contrast, plasma levels of zinc, vitamin D and E, and selenium may be improved by supplementation during the early stages of tuberculosis treatment, but a consistent benefit on tuberculosis treatment outcomes or nutritional recovery has not been demonstrated."	"AUTHORS' CONCLUSIONS: There is insufficient research to know whether routinely providing free food or energy supplements results in better tuberculosis treatment outcomes, or improved quality of life. Further trials, particularly from food insecure settings, should have adequate sample sizes to identify, or exclude, clinically important benefits.Although blood levels of some vitamins may be low in patients starting treatment for active tuberculosis, there is currently no reliable evidence that routinely supplementing at or above recommended daily amounts has clinical benefits."			
434	Gender and HIV-associated pulmonary tuberculosis: Presentation and outcome at one year after beginning antituberculosis treatment in Uganda.	"Nsubuga P, Johnson JL, Okwera A, Mugerwa RD, Ellner JJ, Whalen CC."	BMC Pulmonary Medicine. 2002 11 Sep;2(4).		"Background: Tuberculosis is responsible for more female deaths around the earth than any other infectious disease. Reports have suggested that responses to tuberculosis may differ between men and women. We investigated gender related differences in the presentation and one year outcomes of HIV-infected adults with initial episodes of pulmonary tuberculosis in Uganda. Methods: We enrolled and followed up a cohort of 105 male and 109 female HIV-infected adults on treatment for initial episodes of culture-confirmed pulmonary tuberculosis between March 1993 and March 1995. A favorable outcome was defined as being cured and alive at one year while an unfavorable outcome was not being cured or dead. Subjects were followed-up by serial medical examinations, complete blood counts, serum beta<sub>2</sub> microglobulin, CD4+ cell counts, sputum examinations, and chest x-rays. Results: Male patients were older, had higher body mass indices, and lower serum beta<sub>2</sub> microglobulin levels than female patients at presentation. At one year, there was no difference between male and female patients in the likelihood of experiencing a favorable outcome (RR 1.02, 95% Cl 0.89-1.17). This effect persisted after controlling for symptoms, serum beta<sub>2</sub> microglobulin, CD4+ cell count, and severity of disease on chest x-ray (OR 1.07, 95% Cl 0.54-2.13) with a repeated measures model. Conclusions: While differences existed between males and females with HIV-associated pulmonary tuberculosis at presentation, the outcomes at one year after the initiation of tuberculosis treatment were similar in Uganda. Women in areas with a high HIV and tuberculosis prevalence should be encuraged to present for screening at the first sign of tuberculosis symptoms. 2002 Nsubuga et al; licensee BioMed Central Ltd."									
727	Addressing tuberculosis in the context of malnutrition and HIV coinfection.	"Semba RD, Darnton-Hill I, de Pee S."	Food & Nutrition Bulletin. 2010;31(4):S345-64.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=21214037	"BACKGROUND: Tuberculosis is the second leading cause of infectious disease mortality (1.8 million/year), after HIV/AIDS. There are more than 9 million new cases each year. One-third of the world's population, and 50% of adults in sub-Saharan Africa, South Asia, and SouthEast Asia, are infected, representing an enormous pool of individuals at risk for developing the disease. The situation is complicated by the HIV/AIDS pandemic, widespread undernutrition, smoking, diabetes, increased mobility, and emergence of multi- and extensively drug-resistant tuberculosis."	"OBJECTIVE: To review the scientific evidence about the interactions among tuberculosis, nutrition, and HIV coinfection."	"RESULTS: HIV infection and malnutrition lower immunity, increasing the risk of reactivation tuberculosis and primary progressive disease. Having either tuberculosis or HIV infection causes weight loss. Malnutrition markedly increases mortality among both tuberculosis and HIV/AIDS patients and should be treated concurrently with treatment of the infections. Tuberculosis treatment is a prerequisite for nutritional recovery, in addition to intake of nutrients required for rebuilding tissues, which is constrained in food-insecure households. Additional pharmaceutical treatment to reduce the catabolic impact of inflammation or promote growth may be needed. Specific nutrients can contribute to faster sputum smear clearance, which is important for reducing transmission, as well as faster weight gain when combined with an adequate diet. Adequate nutrition and weight gain in undernourished populations might reduce the incidence of tuberculosis."	"CONCLUSIONS: The many risk factors for the development of tuberculosis need to be addressed simultaneously, especially HIV/AIDS and food insecurity and undernutrition. For stronger evidence-based guidelines, existing recommendations and clinical applications need to be more widely applied and evaluated."						
1563	Is food insecurity associated with HIV risk? Cross-sectional evidence from sexually active women in Brazil.	"Tsai AC, Hung KJ, Weiser SD."	PLoS Medicine / Public Library of Science. 2012;9(4):e1001203.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=22505852	"BACKGROUND: Understanding how food insecurity among women gives rise to differential patterning in HIV risks is critical for policy and programming in resource-limited settings. This is particularly the case in Brazil, which has undergone successive changes in the gender and socio-geographic composition of its complex epidemic over the past three decades. We used data from a national survey of Brazilian women to estimate the relationship between food insecurity and HIV risk."	"METHODS AND FINDINGS: We used data on 12,684 sexually active women from a national survey conducted in Brazil in 2006-2007. Self-reported outcomes were (a) consistent condom use, defined as using a condom at each occasion of sexual intercourse in the previous 12 mo; (b) recent condom use, less stringently defined as using a condom with the most recent sexual partner; and (c) itchy vaginal discharge in the previous 30 d, possibly indicating presence of a sexually transmitted infection. The primary explanatory variable of interest was food insecurity, measured using the culturally adapted and validated Escala Brasiliera de Seguranca Alimentar. In multivariable logistic regression models, severe food insecurity with hunger was associated with a reduced odds of consistent condom use in the past 12 mo (adjusted odds ratio [AOR] = 0.67; 95% CI, 0.48-0.92) and condom use at last sexual intercourse (AOR = 0.75; 95% CI, 0.57-0.98). Self-reported itchy vaginal discharge was associated with all categories of food insecurity (with AORs ranging from 1.46 to 1.94). In absolute terms, the effect sizes were large in magnitude across all outcomes. Underweight and/or lack of control in sexual relations did not appear to mediate the observed associations."	"CONCLUSIONS: Severe food insecurity with hunger was associated with reduced odds of condom use and increased odds of itchy vaginal discharge, which is potentially indicative of sexually transmitted infection, among sexually active women in Brazil. Interventions targeting food insecurity may have beneficial implications for HIV prevention in resource-limited settings."							
1091	Effect of nutritional education and dietary counselling on body weight in HIV-seropositive South Africans not receiving antiretroviral therapy.	"van Niekerk C, Smego RA, Jr., Sanne I."	Journal of Human Nutrition & Dietetics. 2000;13(6):407-12.	http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=2001026481&site=ehost-live	"Background: Unintentional weight loss of > 10% contributes to morbidity and mortality in HIV-infected patients. In poorer developing countries, cost-effective options to promote weight gain are extremely limited."	"Methods: We conducted a pilot study of the effect of nutritional education and dietary counselling on body weight in 90 HIV/AIDS patients. Education entailed principles of healthy eating, socioeconomics of nutrition, food safety, and symptom-related dietary guidelines. Other clinical parameters examined for potential impact on body weight included age, sex, CD4+ lymphocyte count, presence of complicating infections, concomitant medications, vitamin use, and nutritional supplementation. No patients received antiretroviral therapy."	"Results: At study end (mean follow-up, 4.2 months) body weight compared to baseline was greater in study subjects than in controls (P < 0.01); stable or increasing weight was seen in 73% of study patients. Weight gain (>/= 1 kg) occurred in 53% of counselled patients (mean = 3.5 kg; range 1-11 kg) vs. 21% of matched controls (mean = 2.0 kg; range 1-3 kg) (P < 0.03). Nutritional counselling was found to offset the adverse effects of gastrointestinal tract or systemic infection (especially in patients with CD4+ counts < 200 cells mm[-3])."	"Conclusion: In low-resource areas, culturally and economically relevant nutritional education and dietary counselling are simple yet effective means of stabilizing or increasing body weight in HIV-infected patients."						
391	Latent tuberculosis among pregnant mothers in a resource poor setting in Northern Tanzania: a cross-sectional study.	"Sheriff FG, Manji KP, Manji MP, Chagani MM, Mpembeni RM, Jusabani AM, Alwani ZR, et al."	BMC Infectious Diseases. 2010;10(52).	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20103128425	"Background: Untreated latent TB infection (LTBI) is a significant risk factor for active pulmonary tuberculosis, hence predisposing to adverse pregnancy outcomes and mother to child transmission. The prevalence of latent tuberculosis in pregnancy and its association, if any, with various socio-demographic, obstetric and clinical characteristics was evaluated. Methods: Northern Tanzania was chosen as the study site. In a cross-sectional study, a total of 286 pregnant women from 12 weeks gestational age to term were assessed. Screening was undertaken using an algorithm involving tuberculin skin testing, symptom screening in the form of a questionnaire, sputum testing for acid fast bacilli followed by shielded chest X-rays if indicated. HIV serology was also performed on consenting participants. Results: Prevalence of latent infection ranged between 26.2% and 37.4% while HIV sero prevalence was 4.5%. After multivariate logistic analysis it was found that age, parity, body mass index, gestational age, and HIV sero status did not have any significant association with tuberculin skin test results. However certain ethnic groups were found to be less vulnerable to LTBI as compared to others (Chi square=10.55, p=0.03). All sputum smears for acid fast bacilli were negative. Conclusion: The prevalence of latent tuberculosis in pregnant women was found to be relatively high compared to that of the general population. In endemic areas, socio-demographic parameters alone are rarely adequate in identifying women susceptible to TB infection; therefore targeted screening should be conducted for all pregnant women at high risk for activation (especially HIV positive women). As opposed to the current policy of passive case detection, there appears to be an imminent need to move towards active screening. Ethnicity may provide important clues into genetic and cultural differences which predispose to latent tuberculosis, and is worth exploring further."									
996	Determinants of early and late mortality among HIV-infected individuals receiving home-based antiretroviral therapy in rural Uganda.	"Moore DM, Yiannoutsos CT, Musick BS, Tappero J, Degerman R, Campbell J, Were W, et al."	Journal of Acquired Immune Deficiency Syndromes. 2011 01 Nov;58(3):289-96.		"Background: Up to 20% of people initiating antiretroviral therapy (ART) in sub-Saharan Africa die during the first year of treatment. Understanding the clinical conditions associated with mortality could potentially lead to effective interventions to prevent these deaths. Methods: We examined data from participants aged 18 years in the Home-Based AIDS Care project in Tororo, Uganda, to describe mortality over time and to determine clinical conditions associated with death. Survival analysis was used to examine variables associated with mortality at baseline and during follow-up. Results: A total of 112 (9.4%) deaths occurred in 1132 subjects (73% women) during a median of 3.0 years of ART. Mortality was 15.9 per 100 person-years during the first 3 months and declined to 0.3 per 100 person-years beyond 24 months after ART initiation. Tuberculosis (TB) was the most common condition associated with death (21% of deaths), followed by Candida disease (15%). In 43% of deaths, no specific clinical diagnosis was identified. Deaths within 3 months after ART initiation were associated with World Health Organization clinical stage III or IV at baseline, diagnosis of TB at baseline, a diagnosis of a non-TB opportunistic infection in follow-up and a body mass index <=17 kg/m during follow-up. Mortality after 3 months of ART was associated with CD4 cell counts <200 cells per microliter, a diagnosis of TB or other opportunistic infection, adherence to therapy <95%, and low hemoglobin levels during follow-up. CONCLUSION: Potentially remediable conditions and preventable infections were associated with mortality while receiving ART in Uganda. 2011 Lippincott Williams & Wilkins."									
977	Changes in lipid profile over 24 months among adults on first-line highly active antiretroviral therapy in the Home-Based AIDS Care Program in Rural Uganda.	"Buchacz K, Weidle PJ, Moore D, Were W, Mermin J, Downing R, Kigozi A, et al."	Journal of Acquired Immune Deficiency Syndromes. 2008 March;47(3):304-11.		"BACKGROUND: Use of highly active antiretroviral therapy (HAART) has been linked to dyslipidemia and increased risk of cardiovascular disease (CVD) in HIV-infected patients in industrialized countries. The effects of HAART on lipid metabolism among sub-Saharan Africans, for whom access to antiretroviral therapy is expanding, remain largely unknown. METHODS: From July 2003 to May 2004, 987 antiretroviral-naive patients with symptomatic HIV disease or a CD4 count <250 cells/mm were started on HAART in the Home-Based AIDS Care (HBAC) Program in Tororo, Uganda. The HBAC Program provided weekly drug delivery and field-based clinical monitoring. Nonfasting repository sera from a subset of 374 patients were analyzed for levels of total cholesterol (TC), direct low-density lipoprotein cholesterol (LDL-c), direct high-density lipoprotein cholesterol (HDL-c), and triglycerides (TG) at baseline (before HAART) and after 12 and 24 months of HAART using Randox enzymatic kits (Crumlin, United Kingdom). RESULTS: The 374 patients evaluated (49% women, mean age = 39 years, CD4 count = 124 cells/mm, body mass index = 19.7 kg/m) received initial HAART composed of stavudine, lamivudine, and either nevirapine (365 patients [98%]) or efavirenz (9 patients [2%]). During 24 months, 99 (26%) patients had single drug substitutions from stavudine to zidovudine and 27 (7%) had single drug substitutions from nevirapine to efavirenz. At baseline, the mean serum lipid concentrations were 120 mg/dL for TC, 53 mg/dL for LDL-c, 29 mg/dL for HDL-c, and 123 mg/dL for TG; values were generally comparable for men and women. During 24 months of treatment, TC increased by a mean of 31 mg/dL, LDL-c by a mean of 26 mg/dL, and HDL-c by a mean of 19 mg/dL, whereas the TC/HDL-c ratio decreased from a mean of 4.6 to 3.4 (all changes, P < 0.001). TG levels initially decreased and then returned to baseline levels by 24 months. At baseline and 24 months, respectively, TC was >=200 mg/dL for 2% and 10% of patients, LDL-c was >=130 mg/dL for 1% and 6%, HDL-c was <40 mg/dL for 88% and 41%, and TG were >=150 mg/dL for 23% and 20%. CONCLUSIONS: Rural Ugandans with advanced HIV disease initiating nevirapine- or efavirenz-based HAART experienced infrequent elevations in TC, LDL-c, and TG at baseline and after 24 months of therapy. Increases in HDL-c levels were substantial and proportionally greater than increases in TC or LDL-c levels. The risk of CVD and how it is affected by lipid changes in this rural African population are unknown. However, the changes we observed after 24 months of HAART seem unlikely to increase the risk of CVD. 2008 Lippincott Williams & Wilkins, Inc."									
382	Multivitamin supplementation in HIV infected adults initiating antiretroviral therapy in Uganda: The protocol for a randomized double blinded placebo controlled efficacy trial.	"Guwatudde D, Ezeamama AE, Bagenda D, Kyeyune R, Wabwire-Mangen F, Wamani H, Mugusi F, et al."	BMC Infectious Diseases. 2012 15 Nov;12(304).		"Background: Use of multivitamin supplements during the pre-HAART era has been found to reduce viral load, enhance immune response, and generally improve clinical outcomes among HIV-infected adults. However, immune reconstitution is incomplete and significant mortality and opportunistic infections occur in spite of HAART. There is insufficient research information on whether multivitamin supplementation may be beneficial as adjunct therapy for HIV-infected individuals taking HAART. We propose to evaluate the efficacy of a single recommended daily allowance (RDA) of micronutrients (including vitamins B-complex, C, and E) in slowing disease progression among HIV-infected adults receiving HAART in Uganda.Methods/Design: We are using a randomized, double-blind, placebo-controlled trial study design. Eligible patients are HIV-positive adults aged at least 18 years, and are randomized to receive either a placebo; or multivitamins that include a single RDA of the following vitamins: 1.4 mg B1, 1.4 mg B2, 1.9 mg B6, 2.6 mcg B12, 18 mg niacin, 70 mg C, 10 mg E, and 0.4 mg folic acid. Participants are followed for up to 18 months with evaluations at baseline, 6, 12 and 18 months. The study is primarily powered to examine the effects on immune reconstitution, weight gain, and quality of life. In addition, we will examine the effects on other secondary outcomes including the risks of development of new or recurrent disease progression event, including all-cause mortality; ARV regimen change from first- to second-line therapy; and other adverse events as indicated by incident peripheral neuropathy, severe anemia, or diarrhea.Discussions: The conduct of this trial provides an opportunity to evaluate the potential benefits of this affordable adjunct therapy (multivitamin supplementation) among HIV-infected adults receiving HAART in a developing country setting.Trial registration: Clinical Trial Registration-URL: http://www.clinicaltrials.gov. Unique identifier: NCT01228578. 2012 Guwatudde et al.; licensee BioMed Central Ltd."									
1565	Arginase Activity in the Blood of Patients with Visceral Leishmaniasis and HIV Infection.	"Takele Y, Abebe T, Weldegebreal T, Hailu A, Hailu W, Hurissa Z, Ali J, et al."	PLoS Neglected Tropical Diseases. 2013 January;7(1).		"Background: Visceral leishmaniasis is a parasitic disease associated with high mortality. The most important foci of visceral leishmaniasis in Ethiopia are in the Northwest and are predominantly associated with high rates of HIV co-infection. Co-infection of visceral leishmaniasis patients with HIV results in higher mortality, treatment failure and relapse. We have previously shown that arginase, an enzyme associated with immunosuppression, was increased in patients with visceral leishmaniasis and in HIV seropositive patients; further our results showed that high arginase activity is a marker of disease severity. Here, we tested the hypothesis that increased arginase activities associated with visceral leishmaniasis and HIV infections synergize in patients co-infected with both pathogens. Methodology/Principal Findings: We recruited a cohort of patients with visceral leishmaniasis and a cohort of patients with visceral leishmaniasis and HIV infection from Gondar, Northwest Ethiopia, and recorded and compared their clinical data. Further, we measured the levels of arginase activity in the blood of these patients and identified the phenotype of arginase-expressing cells. Our results show that CD4<sup>+</sup> T cell counts were significantly lower and the parasite load in the spleen was significantly higher in co-infected patients. Moreover, our results demonstrate that arginase activity was significantly higher in peripheral blood mononuclear cells and plasma of co-infected patients. Finally, we identified the cells-expressing arginase in the PBMCs as low-density granulocytes. Conclusion: Our results suggest that increased arginase might contribute to the poor disease outcome characteristic of patients with visceral leishmaniasis and HIV co-infection. 2013 Takele et al."									
1036	"Mortality and morbidity among postpartum HIV-positive and HIV-negative women in Zimbabwe: risk factors, causes, and impact of single-dose postpartum vitamin A supplementation."	"Zvandasara P, Hargrove JW, Ntozini R, Chidawanyika H, Mutasa K, Iliff PJ, Moulton LH, et al."	Journal of Acquired Immune Deficiency Syndromes: JAIDS. 2006;43(1):107-16.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=16885772	BACKGROUND: Vitamin A deficiency is common among women in resource-poor countries and is associated with greater mortality during HIV.	"METHODS: Fourteen thousand one hundred ten mothers were tested for HIV and randomly administered 400,000 IU vitamin A or placebo at less than 96 hours postpartum. The effects of vitamin A and HIV status on mortality, health care utilization, and serum retinol were evaluated."	"RESULTS: Four thousand four hundred ninety-five (31.9%) mothers tested HIV positive. Mortality at 24 months was 2.3 per 1000 person-years and 38.3 per 1000 person-years in HIV-negative and HIV-positive women, respectively. Vitamin A had no effect on mortality. Tuberculosis was the most common cause of death, and nearly all tuberculosis-associated deaths were among HIV-positive women. Among HIV-positive women, vitamin A had no effect on rates of hospitalization or overall sick clinic visits, but did reduce clinic visits for malaria, cracked and bleeding nipples, pelvic inflammatory disease, and vaginal infection. Among HIV-negative women, serum retinol was responsive to vitamin A, but low serum retinol was rare. Among HIV-positive women, serum retinol was largely unresponsive to vitamin A, and regardless of treatment group, the entire serum retinol distribution was shifted 25% less than that of HIV-negative women 6 weeks after dosing."	"CONCLUSIONS: Single-dose postpartum vitamin A supplementation had no effect on maternal mortality, perhaps because vitamin A status was adequate in HIV-negative women and apparently unresponsive to supplementation in HIV-positive women."						
1174	The effect of antenatal vitamin A and beta-carotene supplementation on gut integrity of infants of HIV-infected South African women.	"Filteau SM, Rollins NC, Coutsoudis A, Sullivan KR, Willumsen JF, Tomkins AM."	Journal of Pediatric Gastroenterology & Nutrition. 2001;32(4):464-70.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=11396815	"BACKGROUND: Vitamin A is important for protection against diarrhea, and supplements may benefit gut function of infants of HIV-infected mothers."	"METHODS: We studied 238 infants of HIV-infected South African women participating in a randomized, double-blind, placebo-controlled trial of vitamin A during pregnancy (1.5 mg retinyl palmitate and 30 mg beta-carotene daily) plus 60 mg retinyl palmitate at delivery. The placebo group received identical placebo capsules at the same times. When infants were 1, 6, and 14 weeks of age, lactulose/mannitol dual sugar intestinal permeability tests were performed."	"RESULTS: Maternal vitamin A supplementation did not significantly affect infant gut permeability in the group as a whole at any time. By multiple regression analysis, HIV infection of the infant by 14 weeks was significantly associated with increased gut permeability at both 6 and 14 weeks. After controlling for birth weight, gestational age, current weight, feeding mode and recent morbidity, there was a trend toward an interaction between vitamin A supplementation and HIV infection (P = 0.086) at 14 weeks. Vitamin A made no difference to gut permeability of uninfected infants (lactulose/mannitol ratio for vitamin A group: 0.11, 95% confidence interval [CI] 0.08, 0.15, n = 73 and for placebo group: 0.09, 95% CI 0.06, 0.12, n = 76), but largely prevented the increase in the ratio of HIV-infected infants (vitamin A group: 0.17, 95% CI 0.13, 0.23, n = 23; placebo group: 0.50, 95% CI 0.37, 0.68, n = 20). The effects on the lactulose/mannitol ratio were related to changes in lactulose, not mannitol, excretion. Vitamin A supplementation was associated with significantly lower lactulose excretion at 1 and 14 weeks, suggesting the major effect of vitamin A was on maintaining the integrity of gut tight junctions."	CONCLUSIONS: Vitamin A supplementation of HIV-infected pregnant women may prevent the deterioration in gut integrity in the subgroup of their infants who themselves become infected. Improving vitamin A status of HIV-infected infants may decrease their gastrointestinal morbidity.						
933	Vitamin D and calcium levels in Ugandan adults with human immunodeficiency virus and tuberculosis.	"Nansera D, Graziano FM, Friedman DJ, Bobbs MK, Jones AN, Hansen KE."	International Journal of Tuberculosis and Lung Disease. 2011 November;15(11):1522-7.		"BACKGROUND: Vitamin D increases cathelicidin production, and might alter mortality due to tuberculosis (TB) in human immunodeficiency virus (HIV) coinfection. However, due to abundant sun exposure, vita min D levels might be excellent among Ugandans with HIV and TB. METHODS: We measured 25(OH)D and calcium levels in 50 HIV-negative, 50 HIV-infected and 50 TB-HIV coinfected Ugandan adults. RESULTS: Mean +/- standard deviation 25(OH)D levels were 26 +/- 7 ng/ml in HIV-negative, 28 +/- 11 ng/ml in HIV-infected and 24 +/- 11 ng/ml in TB-HIV co-infected adults (P > 0.05 all comparisons). Vitamin D deficiency (<12 ng/ml) was present in 10% of the HIV-infected subjects, 12% of the TB-HIV co-infected and none of the healthy controls (P = 0.03 for healthy vs. TB, P > 0.05 for other comparisons); 20% of the healthy controls, 22% of the HIV-positive and 38% of the TB-HIV co-infected subjects (P = 0.047 for healthy vs. TB, P > 0.05 for other comparisons) had suboptimal vitamin D levels (<20 ng/ml). No participant had hypercalcemia. Serum 25(OH)D levels correlated positively with body mass index (r = 0.22, P = 0.03) and serum calcium levels (r = 0.18, P = 0.03). CONCLUSIONS: Ugandan HIV-infected adults with and without TB commonly had suboptimal vitamin D levels. Clinical trials are needed to evaluate the effect of vitamin D on health outcomes in HIV-infected patients with low vitamin D levels. 2011 The Union."									
1527	"Maternal vitamin D status and child morbidity, anemia, and growth in human immunodeficiency virus-exposed children in Tanzania."	"Finkelstein JL, Mehta S, Duggan C, Manji KP, Mugusi FM, Aboud S, Spiegelman D, et al."	Pediatric Infectious Disease Journal. 2012;31(2):171-5.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=22252204	"BACKGROUND: Vitamin D may help prevent adverse pediatric outcomes, including infectious diseases and growth failure, based on its role in immune and metabolic functions. We examined the association of maternal vitamin D status and pediatric health outcomes in children born to human immunodeficiency virus (HIV)-infected women."	"METHODS: Vitamin D status was determined in 884 HIV-infected pregnant women at 12 to 27 weeks of gestation in a trial of vitamin supplementation (not excluding vitamin D) in Tanzania. Information on child morbidities, anemia and hypochromic microcytosis, and anthropometry was recorded through monthly clinic visits. Generalized estimating equations and Cox proportional hazards models were used to assess the relationships of outcomes with maternal vitamin D status."	"RESULTS: A total of 39% of women had low vitamin D levels (<32 ng/mL). Children born to women with low vitamin D status were 1.11 times more likely to report cough during follow-up (relative risk [RR], 1.11; 95% confidence interval [CI], 1.02-1.21). No significant associations were noted for other respiratory symptoms, diarrhea, or anemia outcomes. Low maternal vitamin D status was associated with significantly increased risk of stunting (height-for-age z score, <-2; RR, 1.29; 95% CI, 1.05-1.59) and being underweight (weight-for-age z score, <-2; RR, 1.33; 95% CI, 1.03-1.71)."	CONCLUSIONS: Maternal vitamin D status may be important for preventing respiratory infections and ensuring optimal growth in HIV-exposed children.						
395	Micronutrient malnutrition and wasting in adults with pulmonary tuberculosis with and without HIV co-infection in Malawi.	"van Lettow M, Harries AD, Kumwenda JJ, Zijlstra EE, Clark TD, Taha TE, Semba RD."	BMC Infectious Diseases. 2004;4(1):61.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medc&AN=15613232	BACKGROUND: Wasting and micronutrient malnutrition have not been well characterized in adults with pulmonary tuberculosis. We hypothesized that micronutrient malnutrition is associated with wasting and higher plasma human immunodeficiency virus (HIV) load in adults with pulmonary tuberculosis.	"METHODS: In a cross-sectional study involving 579 HIV-positive and 222 HIV-negative adults with pulmonary tuberculosis in Zomba, Malawi, anthropometry, plasma HIV load and plasma micronutrient concentrations (retinol, alpha-tocopherol, carotenoids, zinc, and selenium) were measured. The risk of micronutrient deficiencies was examined at different severity levels of wasting."	"RESULTS: Body mass index (BMI), plasma retinol, carotenoid and selenium concentrations significantly decreased by increasing tertile of plasma HIV load. There were no significant differences in plasma micronutrient concentrations between HIV-negative individuals and HIV-positive individuals who were in the lowest tertile of plasma HIV load. Plasma vitamin A concentrations <0.70 micromol/L occurred in 61%, and zinc and selenium deficiency occurred in 85% and 87% respectively. Wasting, defined as BMI<18.5 was present in 59% of study participants and was independently associated with a higher risk of low carotenoids, and vitamin A and selenium deficiency. Severe wasting, defined as BMI<16.0 showed the strongest associations with deficiencies in vitamin A, selenium and plasma carotenoids."	CONCLUSIONS: These data demonstrate that wasting and higher HIV load in pulmonary tuberculosis are associated with micronutrient malnutrition.						
1062	"Interleukin-6 and human immunodeficiency virus load, but not plasma leptin concentration, predict anorexia and wasting in adults with pulmonary tuberculosis in Malawi."	"Lettow Mv, Meer JWMvd, West CE, Crevel Rv, Semba RD."	Journal of Clinical Endocrinology & Metabolism. 2005;90(8):4771-6.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh3&AN=20053152492	"Background: Wasting is a prominent feature of tuberculosis and may be more severe among individuals with HIV coinfection. It is likely that several biological mechanisms, including the anorexia of infection, are contributing to wasting. Objective: The purpose of this study was to determine whether leptin concentrations, in relation to the inflammatory cytokine response and level of HIV infection, are contributing to loss of appetite and wasting in adults with pulmonary tuberculosis and HIV infection. Design: We characterized plasma leptin concentrations in relationship with self-reported loss of appetite, body mass index, fat mass (FM), IL-6, and HIV load in a cross-sectional study of 500 adults who presented with pulmonary tuberculosis in Zomba, Malawi. Results: Plasma leptin concentrations, associated with FM, significantly decreased by increasing tertile of plasma HIV load (P=0.0001). Leptin concentrations were inversely associated with plasma IL-6 concentrations after adjusting for sex, age, FM, and HIV load. Plasma leptin concentrations were associated with neither loss of appetite nor wasting. Inflammation, reflected by increased IL-6 concentrations, was associated with loss of appetite (odds ratio, 3.41; 95% confidence interval, 1.91-6.09), when adjusted for sex, age, FM, leptin concentrations, and HIV load. A high plasma HIV load was associated with severe wasting, defined as body mass index less than 16.0 kg/m<sup>2</sup> (odds ratio, 2.14; 95% confidence interval, 1.09-4.19) when adjusted for sex, age, IL-6, FM, and leptin concentrations. Conclusion: This study suggests that the anorexia and wasting seem primarily determined by the level of inflammation and the level of HIV infection in patients with tuberculosis and HIV coinfection."									
1064	"Interleukin-6 and human immunodeficiency virus load, but not plasma leptin concentration, predict anorexia and wasting in adults with pulmonary tuberculosis in Malawi."	"Van Lettow M, Van Der Meer JWM, West CE, Van Crevel R, Semba RD."	Journal of Clinical Endocrinology and Metabolism. 2005 August;90(8):4771-6.		"Background: Wasting is a prominent feature of tuberculosis and may be more severe among individuals with HIV coinfection. It is likely that several biological mechanisms, including the anorexia of infection, are contributing to wasting. Objective: The purpose of this study was to determine whether leptin concentrations, in relation to the inflammatory cytokine response and level of HIV infection, are contributing to loss of appetite and wasting in adults with pulmonary tuberculosis and HIV infection. Design: We characterized plasma leptin concentrations in relationship with self-reported loss of appetite, body mass index, fat mass (FM), IL-6, and HIV load in a cross-sectional study of 500 adults who presented with pulmonary tuberculosis in Zomba, Malawi. Results: Plasma leptin concentrations, associated with FM, significantly decreased by increasing tertile of plasma HIV load (P = 0.0001). Leptin concentrations were inversely associated with plasma IL-6 concentrations after adjusting for sex, age, FM, and HIV load. Plasma leptin concentrations were associated with neither loss of appetite nor wasting. Inflammation, reflected by increased IL-6 concentrations, was associated with loss of appetite (odds ratio, 3.41; 95% confidence interval, 1.91-6.09), when adjusted for sex, age, FM, leptin concentrations, and HIV load. A high plasma HIV load was associated with severe wasting, defined as body mass index less than 16.0 kg/m<sup>2</sup> (odds ratio, 2.14; 95% confidence interval, 1.09-4.19) when adjusted for sex, age, IL-6, FM, and leptin concentrations. Conclusion: This study suggests that the anorexia and wasting seem primarily determined by the level of inflammation and the level of HIV infection in patients with tuberculosis and HIV coinfection. Copyright 2005 by The Endocrine Society."									
216	"Vitamin supplements, socioeconomic status, and morbidity events as predictors of wasting in HIV-infected women from Tanzania."	"Villamor E, Saathoff E, Manji K, Msamanga G, Hunter DJ, Fawzi WW."	American Journal of Clinical Nutrition. 2005;82(4):857-65.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=16210717	"BACKGROUND: Wasting is a strong independent predictor of mortality in HIV-infected persons. Vitamin supplements delay the disease progression, but their effect on wasting is not known. Data are lacking on the risk factors for wasting in African HIV-infected persons."	"OBJECTIVES: The objectives were to examine the effect of vitamin supplements on wasting in HIV-infected women and to assess the effects of sociodemographic characteristics, morbidity events, and immunologic progression on the risk of wasting."	"DESIGN: HIV-infected women (n = 1078) from Tanzania were randomly assigned to receive 1 of 4 daily oral regimens: multivitamins (B complex, C, and E), vitamin A plus beta-carotene, multivitamins that included vitamin A plus beta-carotene, or placebo. The endpoints of the study included first episodes of a midupper arm circumference <22 cm or a body mass index (BMI; in kg/m2) <18 and the incidence of weight loss episodes during a median 5.3 y of follow-up."	"RESULTS: Multivitamins alone significantly reduced the risk of a first episode of a midupper arm circumference <22 cm (relative risk: 0.66; 95% CI: 0.47, 0.94; P = 0.02). In multivariate-adjusted Cox models, the woman's age, education level, and height were inversely related to the incidence of wasting. Episodes of diarrhea, nausea or vomiting, lower respiratory tract infections, oral ulcers, thrush, severe anemia, and low CD4+ cell counts were each significantly related to an increased risk of wasting."	"CONCLUSIONS: Vitamins C and E and the vitamin B complex have a protective effect on wasting in HIV-infected women. Prevention of diarrhea, severe respiratory tract infections, and anemia are likely to decrease the burden of wasting."					
1579	Availability of Volunteer-Led Home-Based Care System and Baseline Factors as Predictors of Clinical Outcomes in HIV-Infected Patients in Rural Zambia.	"Estopinal CB, van Dijk JH, Sitali S, Stewart H, Davidson MA, Spurrier J, Vermund SH."	PLoS ONE. 2012 07 Dec;7(12).		"Background: We assessed the impact of home-based care (HBC) for HIV+ patients, comparing outcomes between two groups of Zambians receiving antiretroviral therapy (ART) who lived in villages with and without HBC teams. Methods: We conducted a retrospective cohort study using medical charts from Macha Mission Hospital, a hospital providing HIV care in Zambia's rural Southern Province. Date of birth, date of ART initiation, place of residence, sex, body mass index (BMI), CD4+ cell count, and hemoglobin (Hgb) were abstracted. Logistic regression was used to test our hypothesis that HBC was associated with treatment outcomes. Results: Of 655 patients, 523 (80%) were eligible and included in the study. There were 428 patients (82%) with favorable outcomes (alive and on ART) and 95 patients (18%) with unfavorable outcomes (died, lost to follow-up, or stopped treatment). A minority of the 523 eligible patients (n = 84, 16%) lived in villages with HBC available. Living in a village with HBC was not significantly associated with treatment outcomes; 80% of patients in a village with HBC had favorable outcomes, compared to 82% of patients in a village without HBC (P = 0.6 by chi<sup>2</sup>). In bivariable analysis, lower BMI (P<0.001), low CD4+ cell count (P = 0.02), low Hgb concentration (P = 0.02), and older age at ART initiation (P = 0.047) were associated with unfavorable outcomes. In multivariable analysis, low BMI remained associated with unfavorable outcomes (P<0.001). Conclusions: We did not find that living in a village with HBC available was associated with improved treatment outcomes. We speculate that the ART clinic's rigorous treatment preparation before ART initiation and continuous adherence counseling during ART create a motivated group of patients whose outcomes did not improve with additional HBC support. An alternative explanation is that the quality of the HBC program is suboptimal. 2012 Estopinal et al."									
1688	Reproductive health issues in rural Western Kenya.	"van Eijk AM, Lindblade KA, Odhiambo F, Peterson E, Sikuku E, Ayisi JG, Ouma P, et al."	Reproductive Health. 2008;5:1.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=18348726	BACKGROUND: We describe reproductive health issues among pregnant women in a rural area of Kenya with a high coverage of insecticide treated nets (ITNs) and high prevalence of HIV (15%).	"METHODS: We conducted a community-based cross-sectional survey among rural pregnant women in western Kenya. A medical, obstetric and reproductive history was obtained. Blood was obtained for a malaria smear and haemoglobin level, and stool was examined for geohelminths. Height and weight were measured."	"RESULTS: Of 673 participants, 87% were multigravidae and 50% were in their third trimester; 41% had started antenatal clinic visits at the time of interview and 69% reported ITN-use. Malaria parasitemia and anaemia (haemoglobin < 11 g/dl) were detected among 36% and 53% of the women, respectively. Geohelminth infections were detected among 76% of the 390 women who gave a stool sample. Twenty percent of women were underweight, and sixteen percent reported symptoms of herpes zoster or oral thrush in the last two months. Nineteen percent of all women reported using a contraceptive method to delay or prevent pregnancy before the current pregnancy (injection 10%, pill 8%, condom 0.4%). Twenty-three percent of multigravidae conceived their current pregnancy within a year of the previous pregnancy. More than half of the multigravidae (55%) had ever lost a live born child and 21% had lost their last singleton live born child at the time of interview."	"CONCLUSION: In this rural area with a high HIV prevalence, the reported use of condoms before pregnancy was extremely low. Pregnancy health was not optimal with a high prevalence of malaria, geohelminth infections, anaemia and underweight. Chances of losing a child after birth were high. Multiple interventions are needed to improve reproductive health in this area."						
932	Mortality and loss to follow-up among tuberculosis and HIV co-infected patients in rural southwestern Uganda.	"Nansera D, Bajunirwe F, Elyanu P, Asiimwe C, Amanyire G, Graziano FM."	International Journal of Tuberculosis and Lung Disease. 2012;16(10):1371-6.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20123392601	"BACKGROUND: We describe the presentation and outcome of care among patients with tuberculosis (TB) and human immunodeficiency virus (HIV) co-infection from a prospective observational cohort in Uganda. METHODS: We analysed basic demographics, CD4+ counts, time of initiating antiretroviral therapy (ART), clinical and haematological parameters and outcome of care of 386 patients enrolled between February 2007 and March 2010. RESULTS: At presentation, 56.7% of the patients were sputum-positive, 89.9% had new TB infection, 62.7% had wasting, 78.7% were anaemic, 72.1% had a CD4+ count of <200 cells/mm<sup>3</sup>, 20.2% had pneumonia, 50.3% had oral thrush and 1.3% had Kaposi's sarcoma. Patients developing TB within 3 months of starting ART were less likely to have wasting, to be anaemic or to have a CD4+ count of <100 cells/mm<sup>3</sup>. The cure, default and death rates were respectively 54.3%, 24% and 16%. At 8 months, 53 (13.7%) were confirmed dead, 119 (30.8%) were lost to follow-up, 28 (7.3%) were transferred out and 1 (0.3%) had treatment failure. Mortality and loss to follow-up were associated with failure to start ART and having a CD4+ count of <200 cells/mm<sup>3</sup>. CONCLUSION: In Uganda, TB-HIV patients present with severe immune suppression and are at increased risk of death and loss to follow-up, particularly those not on ART. There is need for early identification and improved follow-up of TB-HIV co-infected patients."									
578	The cost of antiretroviral therapy in Haiti.	"Koenig SP, Riviere C, Leger P, Severe P, Atwood S, Fitzgerald DW, Pape JW, et al."	Cost Effectiveness and Resource Allocation. 2008 14 Feb;6(3).		"Background: We determined direct medical costs, overhead costs, societal costs, and personnel requirements for the provision of antiretroviral therapy (ART) to patients with AIDS in Haiti. Methods: We examined datafrom 218 treatment-naive adults who were consecutively initiated on ART at the GHESKIO Center in Port-au-Prince, Haiti between December 23, 2003 and May 20, 2004 and calculated costs and personnel requirements for the first year of ART. Results: The mean total cost of treatment per patient was $US 982 including $US 846 in direct costs, $US 114 for overhead, and $US 22 for societal costs. The direct cost per patient included generic ART medications $US 355, lab tests $US 130, nutrition $US 117, hospitalizations $US 62, pre-ART evaluation $US 58, labor $US 51, non-ART medications $US 39, outside referrals $US 31, and telephone cards for patient retention $US 3. Higher treatment costs were associated with hospitalization, change in ART regimen, TB treatment, and survival for one year. We estimate that 1.5 doctors and 2.5 nurses are required to treat 1000 patients in the first year after initiating ART. Conclusion: Initial ART treatment in Haiti costs approximately $US 1,000 per patient per year. With generic first-line antiretroviral drugs, only 36% of the cost is for medications. Patients who change regimens are significantly more expensive to treat, highlighting the need for less-expensive second-line drugs. There may be sufficient health care personnel to treat all HIV-infected patients in urban areas of Haiti, but not in rural areas. New models of HIV care are needed for rural areas using assistant medical officers and community health workers. 2008 Koenig et al; licensee BioMed Central Ltd."									
90	Simple markers for initiating antiretroviral therapy among HIV-infected Ethiopians.	"Mekonnen Y, Dukers NHTM, Sanders E, Dorigo W, Wolday D, Schaap A, Geskus RB, et al."	Aids. 2003 11 Apr;17(6):815-9.		"Background: We explored the relevance of simple markers (clinical or laboratory markers not requiring sophisticated laboratories) in the decision of initiation of therapy in resource-poor settings. Methods: Among HIV-infected Ethiopian cohort participants, simple markers predicting short-term death were examined using time-dependent Cox proportional hazards models. Timing of hypothetical treatment was compared between guidelines using the simple markers (based on presence of at least one marker), guidelines recommended by the United States Department of Health and Human Services (based on CD4 cell count and viral load), and guidelines for resource-limited settings recommended by the World Health Organization (WHO). Results: From February 1997 to August 2001, 35 deaths were recorded among 155 HIV-positive participants. Simple independent predictors of death were low body mass index, HIV-related conditions, anaemia, and lymphocyte count < 1500 x 10<sup>6</sup>/l. In such time as was covered by our study, 135 (87%) of 155 cohort participants would have had the same management under both the simple markers and the DHHS guidelines, i.e., would have been treated (n = 114, 74%) or not treated (n = 21, 14%). Of the 114 participants hypothetically treated under either set of guidelines, 91 (80%) would have started treatment at the same time. Application of the WHO guidelines for resource-limited settings (without CD4 cell counts) would have resulted in 11 participants dying without ever meeting a treatment indication during regular follow-up visits. Conclusion: Simple markers for the initiation of highly active antiretroviral therapy were identified among HIV-infected Ethiopian patients. The validity of these markers for monitoring patients' improvement following therapy remains to be evaluated. 2003 Lippincott Williams & Wilkins."									
641	Simple markers for initiating antiretroviral therapy among HIV-infected Ethiopians. (Special issue on HIV/AIDS in Ethiopia in collaboration with the Ethio-Netherlands AIDS Research Project).	"Yared M, Dukers NHTM, Sanders E, Dorigo W, Wolday D, Ab S, Geskus RB, et al."	Ethiopian Medical Journal. 2003;41(Suppl.1):61-5.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh3&AN=20043028927	"Background: We explored the relevance of simple markers (clinical or laboratory markers not requiring sophisticated laboratories) in the decision of initiation of therapy in resource-poor settings. Methods: Among HIV-infected Ethiopian cohort participants, simple markers predicting short-term death were examined using time-dependent Cox proportional hazards models. Timing of hypothetical treatment was compared between guidelines using the simple markers (based on presence of at least one marker), guidelines recommended by the United States Department of Health and Human Services (based on CD4 cell count and viral load), and guidelines for resource-limited settings recommended by the World Health Organization (WHO). Results: From February 1997 to August 2001, 35 deaths were recorded among 155 HIV-positive participants. Simple independent predictors of death were low body mass index, HIV-related conditions, anaemia, and lymphocyte count <1500x10<sup>6</sup>/litre. In such time as was covered by our study, 135 (87%) of 155 cohort participants would have had the same management under both the simple markers and the DHHS guidelines, i.e., would have been treated (n=114, 74%) or not treated (n=21, 14%). Of the 114 participants hypothetically treated under either set of guidelines, 91 (80%) would have started treatment at the same time. Application of the WHO guidelines for resource-limited settings (without CD4 cell counts) would have resulted in 11 participants dying without ever meeting a treatment indication during regular follow-up visits. Conclusion: Simple markers for the initiation of highly active antiretroviral therapy were identified among HIV-infected Ethiopian patients. The validity of these markers for monitoring patients' improvement following therapy remains to be evaluated."									
170	Impaired bioavailability of vitamin A in adults and children with persistent diarrhoea in Zambia.	"Kelly P, Musuku J, Kafwembe E, Libby G, Zulu I, Murphy J, Farthing MJ."	Alimentary Pharmacology & Therapeutics. 2001;15(7):973-9.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=11421872	"BACKGROUND: We have previously demonstrated a strong relationship between low serum retinol concentration and mortality in Zambian AIDS patients with diarrhoea, but were unable to detect any benefit from oral micronutrient supplementation."	"AIM: To test the hypothesis that this is related to impaired availability of vitamin A, we analysed serum retinol concentration changes over 6 h following oral mega-dose therapy (60, 120 or 180 mg retinol)."	"METHODS: Twenty-four men without diarrhoea, 15 adults with persistent diarrhoea and 11 children (six girls, five boys) with persistent diarrhoea were studied."	"RESULTS: Men with persistent diarrhoea had lower baseline serum retinol concentrations (median 0.39 micromol/L, interquartile range 0.21-0.56) than controls (median 1.16 micromol/L, interquartile range 0.84-1.47; P=0.0003). After 60 mg retinol, the rise in serum retinol in HIV seropositive controls (median 0.63 micromol/L, interquartile range 0.35-0.77) did not differ significantly from that observed in HIV seronegative controls (median 0.35 micromol/L, interquartile range - 0.04-0.56; P=0.20). Increasing the dose to 120 mg or 180 mg retinol did not enhance the increase in serum retinol concentration. The increase in serum retinol was less in adults with persistent diarrhoea (median 0.25 micromol/L, interquartile range 0.04-0.35) and in children (median 0.11 micromol/L, interquartile range 0.04-0.46) than in men without diarrhoea (median 0.44 micromol/L, interquartile range 0.26-0.74; P=0.03). Adults and children with diarrhoea had greater losses of retinol in urine over a 24-h period than controls, but less than 1% of the ingested dose was excreted."	CONCLUSIONS: These results suggest that persistent diarrhoea in this population is associated with reduced bioavailability of retinol. Further work is required to determine the metabolic fate of therapeutic doses of retinol and to determine appropriate replacement strategies for HIV infected individuals.					
187	A randomized trial to determine the optimal dosage of multivitamin supplements to reduce adverse pregnancy outcomes among HIV-infected women in Tanzania.	"Kawai K, Kupka R, Mugusi F, Aboud S, Okuma J, Villamor E, Spiegelman D, et al."	American Journal of Clinical Nutrition. 2010;91(2):391-7.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=19939985	"BACKGROUND: We previously reported that supplementation with multivitamins (vitamin B complex, vitamin C, and vitamin E) at multiples of the Recommended Dietary Allowance (RDA) significantly decreased the risk of adverse pregnancy outcomes among HIV-infected women. The minimum dosage of multivitamins necessary for optimal benefits is unknown."	OBJECTIVE: We investigated the efficacy of multivitamin supplements at single compared with multiple RDAs on decreasing the risk of adverse pregnancy outcomes among HIV-infected women.	"DESIGN: We conducted a double-blind, randomized controlled trial among 1129 HIV-infected pregnant women in Tanzania. Eligible women between 12 and 27 gestational weeks were randomly assigned to receive daily oral supplements of either single or multiple RDA multivitamins from enrollment until 6 wk after delivery."	"RESULTS: Multivitamins at multiple and single doses of the RDA had similar effects on the risk of low birth weight (11.6% and 10.2%, respectively; P = 0.75). We found no difference between the 2 groups in the risk of preterm birth (19.3% and 18.4%, respectively; P = 0.73) or small-for-gestational-age (14.8% and 12.0%, respectively; P = 0.18). The mean birth weights were similar in the multiple RDA (3045 + or - 549 g) and single RDA multivitamins group (3052 + or - 534 g; P = 0.83). There were no significant differences between the 2 groups in the risk of fetal death (P = 0.99) or early infant death (P = 0.19)."	CONCLUSION: Multivitamin supplements at a single dose of the RDA may be as efficacious as multiple doses of the RDA in decreasing the risk of adverse pregnancy outcomes among HIV-infected women. This trial was registered at clinicaltrials.gov as NCT00197678.					
1582	Early mortality in adults initiating antiretroviral therapy (ART) in low- and middle-income countries (LMIC): A systematic review and meta-analysis.	"Gupta A, Nadkarni G, Yang WT, Chandrasekhar A, Gupte N, Bisson GP, Hosseinipour M, et al."	PLoS ONE. 2011 29 Dec;6(12).		"Background: We systematically reviewed observational studies of early mortality post-antiretroviral therapy (ART) initiation in low- and middle-income countries (LMIC) in Asia, Africa, and Central and South America, as defined by the World Bank, to summarize what is known. Methods and Findings: Studies published in English between January 1996 and December 2010 were searched in Medline and EMBASE. Three independent reviewers examined studies of mortality within one year post-ART. An article was included if the study was conducted in a LMIC, participants were initiating ART in a non-clinical trial setting and were >=15 years. Fifty studies were included; 38 (76%) from sub-Saharan Africa (SSA), 5 (10%) from Asia, 2 (4%) from the Americas, and 5 (10%) were multi-regional. Median follow-up time and pre-ART CD4 cell count ranged from 3-55 months and 11-192 cells/mm<sup>3</sup>, respectively. Loss-to-follow-up, reported in 40 (80%) studies, ranged from 0.3%-27%. Overall, SSA had the highest pooled 12-month mortality probability of 0.17 (95% CI 0.11-0.24) versus 0.11 (95% CI 0.10-0.13) for Asia, and 0.07 (95% CI 0.007-0.20) for the Americas. Of 14 (28%) studies reporting cause-specific mortality, tuberculosis (TB) (5%-44%), wasting (5%-53%), advanced HIV (20%-37%), and chronic diarrhea (10%-25%) were most common. Independent factors associated with early mortality in 30 (60%) studies included: low baseline CD4 cell count, male sex, advanced World Health Organization clinical stage, low body mass index, anemia, age greater than 40 years, and pre-ART quantitative HIV RNA. Conclusions: Significant heterogeneity in outcomes and in methods of reporting outcomes exist among published studies evaluating mortality in the first year after ART initiation in LMIC. Early mortality rates are highest in SSA, and opportunistic illnesses such as TB and wasting syndrome are the most common reported causes of death. Strategies addressing modifiable risk factors associated with early death are urgently needed. 2011 Gupta et al."									
1533	The influence of nutritional status on the response to HAART in HIV-infected children in South Africa.	"Naidoo R, Rennert W, Lung A, Naidoo K, McKerrow N."	Pediatric Infectious Disease Journal. 2010;29(6):511-3.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=20179664	"BACKGROUND: While the impact of HAART on growth in children is well established, the influence of prior nutritional status on the response to HAART is not well known."	"METHODS: A retrospective study was conducted on 120 children in South Africa. Patients were divided into 3 groups (normal, moderately underweight, and severely underweight) based on weight-for-age z-scores (WAZ). Age, weight, height, CD4 cell percentage, and viral load were recorded at initiation of HAART and after 24 months of therapy. Data were analyzed using t-tests, chi tests, and one-way ANOVA."	"RESULTS: At baseline, 58% of children were normal weight, 18% moderately underweight, and 23% severely underweight. After 24 months of HAART, WAZ improved significantly in moderately and severely underweight patient groups compared with the normal group. Height-for-age z-scores (HAZ) increased in all 3 groups with severely underweight children gaining more height than normal weight counterparts. Weight-for-height z-scores (WHZ) normalized in the severely underweight group. Mean CD4 cell percentages increased significantly in all 3 groups while viral loads decreased significantly in all groups with no differences among the groups at the end of 24 months of therapy. Of the entire cohort, 75% achieved undetectable HIV RNA viral loads."	"CONCLUSIONS: Underlying malnutrition does not adversely affect growth, immunologic or virologic response to HAART in HIV-infected children. Underweight children exhibit an equally robust response to treatment as their well-nourished peers."						
420	Socio-economic factors explain differences in public health-related variables among women in Bangladesh: a cross-sectional study.	"Khan MM, Kraemer A."	BMC public health. 2008;8:254.		"BACKGROUND: Worldwide one billion people are living in slum communities and experts projected that this number would double by 2030. Slum populations, which are increasing at an alarming rate in Bangladesh mainly due to rural-urban migration, are often neglected and characterized by poverty, poor housing, overcrowding, poor environment, and high prevalence of communicable diseases. Unfortunately, comparisons between women living in slums and those not living in slums are very limited in Bangladesh. The objectives of the study were to examine the association of living in slums (dichotomized as slum versus non-slum) with selected public health-related variables among women, first without adjusting for the influence of other factors and then in the presence of socio-economic variables. METHODS: Secondary data was used in this study. 120 women living in slums (as cases) and 480 age-matched women living in other areas (as controls) were extracted from the Bangladesh Demographic and Health Survey 2004. Many socio-economic and demographic variables were analysed. SPSS was used to perform simple as well as multiple analyses. P-values based on t-test and Wald test were also reported to show the significance level. RESULTS: Unadjusted results indicated that a significantly higher percent of women living in slums came from country side, had a poorer status by household characteristics, had less access to mass media, and had less education than women not living in slums. Mean BMI, knowledge of AIDS indicated by ever heard about AIDS, knowledge of avoiding AIDS by condom use, receiving adequate antenatal visits (4 or more) during the last pregnancy, and safe delivery practices assisted by skilled sources were significantly lower among women living in slums than those women living in other areas. However, all the unadjusted significant associations with the variable slum were greatly attenuated and became insignificant (expect safe delivery practices) when some socio-economic variables namely childhood place of residence, a composite variable of household characteristics, a composite variable of mass media access, and education were inserted into the multiple regression models. Taken together, childhood place of residence, the composite variable of mass media access, and education were the strongest predictors for the health related outcomes. CONCLUSION: Reporting unadjusted findings of public health variables in women from slums versus non-slums can be misleading due to confounding factors. Our findings suggest that an association of childhood place of residence, mass media access and public health education should be considered before making any inference based on slum versus non-slum comparisons."									
199	Effect of postpartum maternal or neonatal vitamin A supplementation on infant mortality among infants born to HIV-negative mothers in Zimbabwe.	"Malaba LC, Iliff PJ, Nathoo KJ, Marinda E, Moulton LH, Zijenah LS, Zvandasara P, et al."	American Journal of Clinical Nutrition. 2005;81(2):454-60.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=15699235	"BACKGROUND: Young infants are at risk of vitamin A deficiency. Supplementation of breastfeeding mothers improves the vitamin A status of their infants, but there are no data regarding its effect on infant mortality, and data on the effect of directly supplementing infants during the first few weeks of life are conflicting."	"OBJECTIVE: The objective was to measure the effect on infant mortality of supplementing neonates and their HIV-negative mothers with single, large doses of vitamin A during the immediate postpartum period."	"DESIGN: A randomized, placebo-controlled, 2-by-2 factorial design trial was conducted in 14,110 mothers and their infants; 9208 of the mothers were HIV-negative at delivery, remained such during the postpartum year, and were retained in the current analysis. The infants were randomly assigned within 96 h of delivery to 1 of 4 treatment groups: mothers and infants received vitamin A (Aa), mothers received vitamin A and infants received placebo (Ap), mothers received placebo and infants received vitamin A (Pa), and both mothers and infants received placebo (Pp). The vitamin A dose in the mothers was 400,000 IU and in the infants was 50,000 IU. The mother-infant pairs were followed to 12 mo."	"RESULTS: Hazard ratios (95% CI) for 12 mo mortality among infants in the maternal-supplemented and infant-supplemented groups were 1.17 (0.87, 1.58) and 1.08 (0.80, 1.46), respectively. Hazard ratios (95% CI) for the Aa, Ap, and Pa groups compared with the Pp group were 1.28 (0.83, 1.98), 1.27 (0.82, 1.97), and 1.18 (0.76, 1.83), respectively. These data indicate no overall effect. Serum retinol concentrations among a subsample of women were similar to reference norms."	CONCLUSION: Postpartum maternal or neonatal vitamin A supplementation may not reduce infant mortality in infants of HIV-negative women with an apparently adequate vitamin A status.					
433	Assessing the impact of a food supplement on the nutritional status and body composition of HIV-infected Zambian women on ARVs.	"Zulu RM, Byrne NM, Munthali GK, Chipeta J, Handema R, Musonda M, Hills AP."	BMC Public Health. 2011;11:714.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=21936938	"BACKGROUND: Zambia is a sub-Saharan country with one of the highest prevalence rates of HIV, currently estimated at 14%. Poor nutritional status due to both protein-energy and micronutrient malnutrition has worsened this situation. In an attempt to address this combined problem, the government has instigated a number of strategies, including the provision of antiretroviral (ARV) treatment coupled with the promotion of good nutrition. High-energy protein supplement (HEPS) is particularly promoted; however, the impact of this food supplement on the nutritional status of people living with HIV/AIDS (PLHA) beyond weight gain has not been assessed. Techniques for the assessment of nutritional status utilising objective measures of body composition are not commonly available in Zambia. The aim of this study is therefore to assess the impact of a food supplement on nutritional status using a comprehensive anthropometric protocol including measures of skinfold thickness and circumferences, plus the criterion deuterium dilution technique to assess total body water (TBW) and derive fat-free mass (FFM) and fat mass (FM)."	"METHODS/DESIGN: This community-based controlled and longitudinal study aims to recruit 200 HIV-infected females commencing ARV treatment at two clinics in Lusaka, Zambia. Data will be collected at four time points: baseline, 4-month, 8-month and 12-month follow-up visits. Outcome measures to be assessed include body height and weight, body mass index (BMI), body composition, CD4, viral load and micronutrient status."	DISCUSSION: This protocol describes a study that will provide a longitudinal assessment of the impact of a food supplement on the nutritional status of HIV-infected females initiating ARVs using a range of anthropometric and body composition assessment techniques.	TRIAL REGISTRATION: Pan African Clinical Trial Registry PACTR201108000303396.						
992	Kaposi sarcoma-associated herpes virus and response to antiretroviral therapy: A prospective study of HIV-infected adults.	"Maskew M, Macphail AP, Whitby D, Egger M, Fox MP."	Journal of Acquired Immune Deficiency Syndromes. 2013 August 1;63(4):442-8.		"Background:: The possible impact of coinfection with the Kaposi sarcoma-associated herpes virus (KSHV) on the response to antiretroviral therapy (ART) is unknown. Prospective studies are rare, particularly in Africa. METHODS:: We enrolled a prospective cohort of HIV-infected adults initiating ART in Johannesburg, South Africa. The subjects were defined as seropositive to KSHV if they were reactive to either KSHV lytic K8.1 or latent Orf73 antigen or to both. The subjects were followed from ART initiation until 18 months of treatment. HIV viral load and CD4 counts were tested 6 monthly. Linear generalized estimating and log-binomial regression models were used to estimate the effect of KSHV infection on immunologic recovery and response and HIV viral load suppression within 18 months after ART initiation. RESULTS:: Three hundred eighty-five subjects initiating ART from November 2008 to March 2009 were considered to be eligible including 184 (48%) KSHV+. The KSHV+ group was similar to the KSHV- in terms of age, gender, initiating CD4 count, body mass index, tuberculosis, and hemoglobin levels. The KSHV+ group gained a similar number of cells at 6 [difference of 10 cells per cubic millimeter, 95% confidence interval (CI): -11 to 31], 12 (3 cells per cubic millimeter, 95% CI: -19 to 25), and 18 months (24 cells per cubic millimeter, 95% CI: -13 to 61) compared with that gained by the KSHV- group. Adjusted relative risk of failure to suppress viral load to <400 copies per milliliter (1.03; 95% CI: 0.90 to 1.17) were similar for KSHV+ and KSHV- by 6 months on treatment. CONCLUSIONS:: In a population with a high KSHV prevalence, HIV-positive adults coinfected with KSHV achieved similar immunologic and virologic responses to ART early after treatment initiation compared with those with KSHV-. 2013 by Lippincott Williams & Wilkins."									
1599	Food Access and Diet Quality Are Associated with Quality of Life Outcomes among HIV-Infected Individuals in Uganda.	"Palermo T, Rawat R, Weiser SD, Kadiyala S."	PLoS ONE. 2013 18 Apr;8(4).		"Background:Food insecurity is associated with poor nutritional and clinical outcomes among people living with HIV/AIDS. Few studies investigate the link between food insecurity, dietary diversity and health-related quality of life among people living with HIV/AIDS.Objective:We investigated whether household food access and individual dietary diversity are associated with health-related quality of life among people living with HIV/AIDS in Uganda.Methods:We surveyed 902 people living with HIV/AIDS and their households from two clinics in Northern Uganda. Health-related quality of life outcomes were assessed using the Medical Outcomes Study (MOS)-HIV Survey. We performed multivariate regressions to investigate the relationship between health-related quality of life, household food insecurity and individual dietary diversity.Results:People living with HIV/AIDS from severe food insecurity households have mean mental health status scores that are 1.7 points lower (p<.001) and physical health status scores that are 1.5 points lower (p<.01). Individuals with high dietary diversity have mean mental health status scores that were 3.6 points higher (p<.001) and physical health status scores that were 2.8 points higher (p<.05).Conclusions:Food access and diet quality are associated with health-related quality of life and may be considered as part of comprehensive interventions designed to mitigate psychosocial consequences of HIV. 2013 Palermo et al."									
1569	Prevalence of Non-Tuberculous Mycobacterial Infections among Tuberculosis Suspects in Nigeria.	"Aliyu G, El-Kamary SS, Abimiku A, Brown C, Tracy K, Hungerford L, Blattner W."	PLoS ONE. 2013 09 May;8(5).		"Background:Nigeria is ranked in the top five countries for tuberculosis deaths worldwide. This study investigated the mycobacterial agents associated with presumptive clinical pulmonary tuberculosis (TB) in Nigeria and evaluated the pattern and frequency of mycobacterial infections over twelve calendar months period.Methods:Sputum samples from 1,603 consecutive new cases with presumptive diagnosis of TB were collected from August 2010 to July 2011. All sputum samples were incubated for detection of mycobacterial growth and those with positive acid fast bacilli (AFB) growth were tested to detect mycobacterium tuberculosis (MTB) complex and characterized to differentiate between MTB complex species. Cultures suggestive of Non-tuberculous mycobacterial infections (NTM) were sub-cultured and characterized.Results:Of the 1,603 patients screened, 444 (28%) culture-positive cases of pulmonary tuberculosis were identified. Of these, 375 (85%) were due to strains of MTB complex (354 cases of M. tuberculosis, 20 M. africanum and one case of M. bovis) and 69 (15%) were due to infection with NTM. In contrast to the MTB complex cases, the NTM cases were more likely to have been diagnosed during the calendar months of the Harmattan dust season (OR = 2.34, 1.28-4.29; p = 0.01), and aged older than 35 years (OR = 2.77, 1.52-5.02, p = 0.0007), but less likely to have AFB identified on their sputum smear (OR = 0.06, 0.02-0.14, p<0.0001). Among those with NTM infection, cases 35 years or younger were more likely to have co-infection with HIV (3.76, 1.72-8.22; p = 0.0009) compared to those older than 35 years.Interpretation:The high proportion of younger patients with clinical pulmonary TB due to NTM and co-infection with HIV and the likely role of the seasonal dust exposure in the occurrence of the disease, present novel public health challenges for prevention and treatment. 2013 Aliyu et al."									
1583	"Anti-Tuberculosis Drug Induced Hepatotoxicity among TB/HIV Co-Infected Patients at Jimma University Hospital, Ethiopia: Nested Case-Control Study."	"Hassen Ali A, Belachew T, Yami A, Ayen WY."	PLoS ONE. 2013 16 May;8(5).		"Background:This study was carried out to determine the incidence and predictors of anti-tuberculosis drug induced hepatotoxicity among TB/HIV co-infected patients at Jimma University Hospital, Ethiopia.Methods/Principal Findings:A nested case-control study was conducted by reviewing charts of all TB/HIV co-infected patients who commenced anti-TB treatment from January 2008 to December 2011 at Jimma University Hospital. Patients who had developed hepatotoxicity after at least 5 days of standard doses of anti-TB drug therapy were labeled as ""cases"" and those without hepatotoxicity were ""controls"". Each case with anti-TB drug induced hepatotoxicity was compared with 3 controls selected randomly from the cohort. From a cohort of 296 TB/HIV co-infected patients 8 were excluded from the study as the causality between anti-TB drugs and hepatotoxicity was not confirmed, 33 had developed hepatotoxicity. On bivariate logistic regression analysis, body mass index (BMI) <18.5 Kg/m<sup>2</sup> [P = 0.01; OR (95%CI): 3.6 (1.4-9.5)], disseminated pulmonary TB [P = 0.00; OR (95%CI): 5.6 (2.2-14.6)], CD4 count <=50 [P = 0.016; OR (95%CI): 3.6(1.27-10.23)] and WHO stage 4 [P = 0.004, OR (95%CI): 3.8 (1.68-8.77)] were significantly associated with anti-TB drug induced hepatotoxicity. Predictor variables with p-value <0.05 by bivariate analysis were analyzed using multivariable logistic regression analysis and identified disseminated pulmonary TB [P = 0.001; AOR (95%CI) = 5.6 (2.1-15.0)] and BMI <18.5 [P = 0.014; AOR (95%CI) = 3.6 (1.3-10.1)] as independent predictors of anti-TB drug induced hepatotoxicity.Conclusions:The incidence of anti-TB drug induced hepatotoxicity was 11.5%. The results suggest that in the presence of disseminated pulmonary TB and/or BMI <18.5 Kg/m<sup>2</sup>, TB/HIV co-infected patients should be closely followed for the occurrence of hepatotoxicity during the intensive phase of TB treatment to prevent morbidity and mortality. 2013 Hassen Ali et al."									
532	Characteristics and early outcomes of patients with xpert MTB/RIF-negative pulmonary tuberculosis diagnosed during screening before antiretroviral therapy.	"Lawn SD, Kerkhoff AD, Vogt M, Ghebrekristos Y, Whitelaw A, Wood R."	Clinical Infectious Diseases. 2012 15 Apr;54(8):1071-9.		"Background. A proportion of patients with tuberculosis diagnosed by sputum culture during screening before antiretroviral therapy (ART) have false-negative Xpert MTB/RIF assay results (Xpert-negative tuberculosis). We determined the characteristics and early ART program outcomes of such patients.Methods.Adult patients who enrolled in a South African township ART service were systematically screened for pulmonary tuberculosis regardless of symptoms by testing paired sputum samples with Xpert MTB/RIF and liquid culture. The ART service provided follow-up for all patients, and early (90-day) programmatic outcomes were determined. Results. Among 602 patients screened, 523 had >=1 Xpert and culture result, yielding 89 culture-positive tuberculosis diagnoses. Of these, 37 (42%) of the patients with tuberculosis were Xpert-negative when a single sputum sample was tested, compared with 25 (28%) when 2 samples were tested. Compared with patients with Xpert-positive tuberculosis, those with Xpert-negative tuberculosis (using either definition) had substantially higher CD4 cell counts, lower plasma viral loads, higher hemoglobin concentrations, and higher body mass index. Their tuberculosis was also less advanced, with a lower frequency of prolonged cough (>=2 weeks), less extensive radiographic abnormalities, and a lower frequency of detectable lipoarabinomannan antigenuria and mycobacteriuria. Xpert-negative cases were all sputum smear negative with prolonged time to culture positivity (median, 21 days). Despite greater delays in starting tuberculosis treatment, Xpert-negative patients were less likely to die during follow-up.Conclusions.Compared to patients with Xpert-positive tuberculosis diagnosed during pre-ART screening, Xpert-negative cases had less advanced immunosuppression and less advanced tuberculosis and did not have adverse outcomes despite substantial delays in starting tuberculosis treatment. 2012 The Author."									
846	Body composition of HIV-infected adults in Ethiopia: validation of bioelectrical impedance analysis.	"Fufa H, Umeta M, Akalu G, Taffesse S, Ketema L, Messele T, Slater C, et al."	International Journal of Body Composition Research. 2007;5(2):65-71.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20093316084	"Background. Accurate methods of measuring body composition are important for nutritional assessment of HIV-infected individuals, particularly in developing nations. In HIV-infected individuals, it is important to know whether changes in body weight are due to changes in body fatness or in fat-free mass. Bioelectrical impedance analysis (BIA) is a non-invasive method of estimating body composition. However, equations for predicting body composition from impedance are population-specific. Objective. The present study set out to develop and validate BIA prediction equations for measuring body composition in Ethiopian adults living with HIV/AIDS using deuterium dilution as the criterion method. Design. Impedance was measured using BIA at 50 kHz and deuterium dilution was used as the criterion method. TBW was measured in 138 adults (31 males and 107 females) with HIV. The study group was randomly divided into model (n=73 females and 19 males) and validation (n=34 females and 12 males) subgroups. Predictive equations were derived in the model group and validated with validation subgroup using multiple regression analysis for TBW from impedance. Results. TBW is best predicted from BIA and weight (R=0.91, SEE=1.4 kg for females and R=0.87, SEE=1.7 kg for males). The regression coefficients did not differ significantly between model and validation subgroups for both females and males. These equations can be used to predict body composition from BIA at 50 kHz in HIV infected Ethiopians. Conclusion. The predictive equations derived specifically from this population are validated and can be useful in assessing body composition of people living with HIV/AIDS. There is a need to assess whether the equations can accurately detect changes in TBW."									
764	Bone status of children with hemophilia a assessed with dual energy X-ray Absorptiometry and Quantitative ultrasonography: Comparisons and Correlations.	"Economou M, Christoforides A, Papadopoulou E, Gompakis N, Athanassiou-Metaxa M."	Haematologica. 2009 June;94:44-5.		"Background. Adult patients with hemophilia A are known to be at risk for developing osteopenia or osteoporosis due to multiple factors, the main cause being recurrent hemarthrosis and subsequent reduced physical activity. Recent reports have demonstrated decreased bone mineral density (BMD) values even to younger hemophilic patients. Aims.To evaluate bone status of hemophilic children using two different Methods. Dual Energy X-ray Absorptiometry (DXA) and Quantitative Ultra-Sonography (QUS) and to determine the degree of correlation between these two techniques. Methods. Seventeen patients with hemophilia A, aged 11.87+/-4.91 years (range: 4.94-17.62 years) participated in the study. The majority of patients had a severe bleeding phenotype and were receiving either primary or secondary prophylaxis. Patients were HCV and HIV negative. With regards to study methods, weight and height were measured using standard techniques. Pubertal status was determined according to Tanner staging. Body Mass Index (BMI) was calculated as the ratio weight/height2 (kg/m<sup>2</sup>). For every auxological parameter, Standard Deviation Scores (SDS's) were calculated according to sex-and age-matched normal greek population. BMD at lumbar spine (L2-L4 vertebrae) was determined by DXA technique using Cronos' bone densitometer (DMS, France). Results were expressed as grams per centimetre squared (g/cm<sup>2</sup>), whereas Z-scores were calculated based on BMD measurements of normal sex-and age-matched Caucasian population, provided by the DXA device's manufacturer. QUS measurements (Speed Of Sound, SOS) were performed using Omnisense 7000 P (Sunlight Medical Ltd, Israel) at two peripheral sites: distal third of the radius (SOSR) and midshaft tibia (SOST), both at the patient's non-dominant and dominant side. Z-scores were calculated according to normative data derived from sex-and age-matched Greek population. Levels of intact parathormone (iPTH), fT4, fT3, TSH, calcium (Ca), phosphate (P) and alkaline phosphatase (ALP) were evaluated using commercial assays. Finally, joint evaluation was performed using the Hemophilia Joint Health Score (HJHS), a validated 11-item scoring tool scale assessing six index joints (elbows, knees and ankles). table present Results. All patients had normal pubertal development for age whereas biochemical profile, intact PTH concentrations and thyroid function tests were normal. Mean BMD Z-score was -0.12+/-1.08 g/cm<sup>2</sup>, whereas 3 and 2 patients were classified as having osteopenia and osteoporosis respectively. Mean SOSR Z-score and mean SOST Z-score were -0.08+/-0.83 m/sec and -0.10+/-1.6 m/sec, respectively. No correlation was observed between DXA values and QUS-derived measurements. No agreement was recorded between the two methods in identifying hemophilic patients at risk for osteoporosis (kappa value = -0.25, p=0.17). SOS values at the dominant side were significantly correlated to SOS values at the non-dominant side both at radius (r=-0.541, p=0.01) and at tibia (r=0.45, p=0.04). Finally, the HJHS was negatively correlated with the SOST Z-scores (r= -0.541, p=0.023), whereas it was, surprisingly, positively correlated to BMD Z-scores (r=0.473, p=0.044). Correlations between studied parameters are demonstrated in Table 1. Conclusions. DXA detected a significant number of hemophilic children with impaired bone status; however, these findings were not confirmed by QUS measurements."									
1732	The clinical and anthropometric profile of undernourished children aged under 5 admitted to Nyangabgwe referral hospital in Botswana.	"Madondo A, Macintyre UE, Ntuli B."	SAJCH South African Journal of Child Health. 2012;6(4):123-7.		"Background. Although Botswana is a middle-income country, undernutrition among children younger than 5 years of age is still seen in various parts of the country. There is little information on the clinical and anthropometric profile of undernourished children in this age group admitted to hospitals in Francistown, Botswana. Purpose. To determine the clinical profile and the severity of anthropometric failure of undernourished children aged under 5 admitted to Nyangabgwe Referral Hospital in Francistown. Method. Data were collected from 113 caregiver-child pairs using a researcher-administered questionnaire targeting caregivers together with the children's hospital records. The children's anthropometric measurements were taken. Data were analysed using the WHO Anthro 2006 software and Stata 10. Proportions were then calculated. Results. The median age of the children was 14 months and 55% were boys. The majority of the caregivers were single, younger than 30 years and lived in rural villages. The most common symptoms on admission were oedema (50%) and coughing (35%). Ten per cent of the children were HIV-infected and the HIV status of half the children was unknown. The majority (87%) did not present with secondary diagnoses. Severe wasting (<-3 standard deviations (SD)) (73%) was found in all age groups. Stunting (<-2 SD) was prevalent in 68% of the boys, and 95% of the children were severely underweight (<-3 SD). Conclusion. Oedematous undernutrition was common and 73% of the children presented with severe wasting (<-3 SD). In order to prevent severe forms of undernutrition, avoid the necessity for complicated care and improve the chances of survival, health education to caregivers on various forms of undernutrition is crucial."									
538	"Incidence and predictors of death, retention, and switch to second-line regimens in antiretroviral-treated patients in sub-Saharan African sites with comprehensive monitoring availability."	"Palombi L, Marazzi MC, Guidotti G, Germano P, Buonomo E, Scarcella P, Altan AD, et al."	Clinical Infectious Diseases. 2009 01 Jan;48(1):115-22.		"Background. Antiretroviral treatment programs in sub-Saharan Africa have high rates of early mortality and loss to follow-up. Switching to second-line regimens is often delayed because of limited access to laboratory monitoring. Methods. Retrospective analysis was performed of a cohort of adults who initiated a standard first-line antiretroviral treatment at 5 public sector sites in 3 African countries. Monitoring included routine CD4 cell counts, human immunodeficiency virus RNA measures, and records of whether appointments were kept. Incidence and predictors of death, loss to follow-up, and switch to second-line regimens were analyzed by time-to-event approaches. Results. A total of 3749 patients were analyzed; at baseline, 37.1% were classified as having World Health Organization disease stage 3 or 4, and the median CD4 cell count was 192 cells/muL. First-line regimens were nevirapine based in 96.5% of patients; 17.7% of patients attended <95% of their drug pickup appointments. During 4545 person-years of follow-up, mortality was 8.6 deaths per 100 person-years and was predicted by lower baseline CD4 cell count, lower hemoglobin level, and lower body mass index (calculated as weight in kilograms divided by the square of height in meters); more-advanced clinical stage of infection; male sex; and more missed drug pickup appointments. Dropouts (which accrued at a rate of 2.1 dropouts per 100 person-years) were predicted by a lower body mass index, more missed visits and missed drug pickup appointments, and later calendar year. Incidence of switches to second-line regimens was 4.9 per 100 person-years; increased hazards were observed with lower CD4 cell count and earlier calendar year at baseline. In patients who switched, virological failure was predicted by combined clinical and CD4 criteria with 74% sensitivity and 30% specificity. Conclusions. In an antiretroviral treatment program employing comprehensive monitoring, the probability of switching to second-line therapy was limited. Regular pickup of medication was a predictor of survival and was also strongly predictive of patient retention. 2008 by the Infectious Diseases Society of America. All rights reserved."									
537	"Incidence and predictors of death, retention, and switch to second-line regimens in antiretroviral-treated patients in sub-Saharan African sites with comprehensive monitoring availability."	"Palombi L, Marazzi MC, Guidotti G, Germano P, Buonomo E, Scarcella P, Altan AD, et al."	Clinical Infectious Diseases. 2009;48(1):115-22.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20093014382	"Background. Antiretroviral treatment programs in sub-Saharan Africa have high rates of early mortality and loss to follow-up. Switching to second-line regimens is often delayed because of limited access to laboratory monitoring. Methods. Retrospective analysis was performed of a cohort of adults who initiated a standard first-line antiretroviral treatment at 5 public sector sites in 3 African countries. Monitoring included routine CD4 cell counts, human immunodeficiency virus RNA measures, and records of whether appointments were kept. Incidence and predictors of death, loss to follow-up, and switch to second-line regimens were analyzed by time-to-event approaches. Results. A total of 3749 patients were analyzed; at baseline, 37.1% were classified as having World Health Organization disease stage 3 or 4, and the median CD4 cell count was 192 cells/ micro L. First-line regimens were nevirapine based in 96.5% of patients; 17.7% of patients attended <95% of their drug pickup appointments. During 4545 person-years of follow-up, mortality was 8.6 deaths per 100 person-years and was predicted by lower baseline CD4 cell count, lower hemoglobin level, and lower body mass index (calculated as weight in kilograms divided by the square of height in meters); more-advanced clinical stage of infection; male sex; and more missed drug pickup appointments. Dropouts (which accrued at a rate of 2.1 dropouts per 100 person-years) were predicted by a lower body mass index, more missed visits and missed drug pickup appointments, and later calendar year. Incidence of switches to second-line regimens was 4.9 per 100 person-years; increased hazards were observed with lower CD4 cell count and earlier calendar year at baseline. In patients who switched, virological failure was predicted by combined clinical and CD4 criteria with 74% sensitivity and 30% specificity. Conclusions. In an antiretroviral treatment program employing comprehensive monitoring, the probability of switching to second-line therapy was limited. Regular pickup of medication was a predictor of survival and was also strongly predictive of patient retention."									
729	"Illness, death, and macronutrients: adequacy of rural Mozambican household production of macronutrients in the face of HIV/AIDS. (Special issue: Linkages between agriculture and health in science, policy, and practice.)."	"Donovan C, Massingue J."	Food and Nutrition Bulletin. 2007;28(2(Supplement):S331-S8.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20073140031	"Background. As the public sector and civil society develop intervention programs to deal with the HIV/AIDS epidemic, there has been an increasing emphasis on the relationship between nutrition and the disease. Drug interventions may be ineffective, and the progression from HIV infection to full-blown AIDS may be accelerated without adequate nutrition. Mozambique is still fighting an increasing prevalence rate of HIV, including in rural areas. Rural households in Mozambique rely heavily on their own agricultural production for the basic macronutrients. Objectives. To evaluate the extent to which household agricultural production of basic staples meets overall household needs for major macronutrients, comparing households affected and not directly affected by HIV/AIDS and other major illnesses over two time periods. Methods. This research analyzes nationally representative panel data from rural household surveys conducted in 2002 and 2005 to evaluate whether households that have suffered the chronic illness or illness-related death of prime-age adult members (15 to 49 years of age) are more vulnerable to macronutrient gaps. Results. Households in the South and in the North with a male illness or death in 2002 produced significantly less macronutrients from crops in 2005 than nonaffected households. These households also had significantly lower income per adult equivalent. Conclusions. Mortality or illness from HIV/AIDS affects the ability of agricultural households dependent on own-food production to produce macronutrients. Interventions to improve access to food may be needed for affected households, particularly in light of their inability to recover over time. More analysis is needed to understand income sources, crop diversification, and access to macronutrients through the market."									
728	"AIDS and agriculture in Zambia. (Special issue: Linkages between agriculture and health in science, policy, and practice.)."	"Byron E, Chapoto A, Drinkwater M, Gillespie S, Hamazakaza P, Jayne T, Kadiyala S, et al."	Food and Nutrition Bulletin. 2007;28(2(Supplement):S339-S44.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20073140032	"Background. Because agriculture is the livelihood base for the majority of people affected by AIDS in sub-Saharan Africa, the interactions between AIDS and agriculture, and their implications for policy and programming, are of fundamental importance. Objective. This paper summarizes evidence from three RENEWAL (Regional Network on AIDS, Livelihoods, and Food Security) research studies and one policy review on the interactions between AIDS and agriculture in Zambia and their implications for future policy and programming. Methods. The unit of analysis adopted for each study varies, spanning the individual, household, cluster, and community levels, drawing attention to the wider socio-economic landscape within which households operate. Results. This paper identifies the ways in which livelihood activities, within the prevailing norms of gender, sexuality, and perceptions of risk in rural Zambia, can influence susceptibility to HIV, and how the nature and severity of the subsequent impacts of AIDS are modified by the specific characteristics and initial conditions of households, clusters, and communities. Conclusions. The findings demonstrate the importance of studying the risks, vulnerabilities, and impacts of the AIDS epidemic in the context of multiple resource flows and relationships between and within households - and in the context of other drivers of vulnerability, some of which interact with HIV and AIDS. The paper addresses several factors that enable or hinder access to formal support programs, and concludes by highlighting the particular importance of engaging communities proactively in the response to HIV and AIDS, to ensure relevance, sustainability, and scale."									
1749	Diagnosis and management of community-acquired pneumonia in childhood - South African Thoracic Society Guidelines.	"Zar HJ, Jeena P, Argent A, Gie R, Madhi SA."	SAMJ South African Medical Journal. 2005;95(12(2):977-90.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20063005622	"Background. Community-acquired pneumonia (CAP) is a major cause of morbidity and mortality in South African children. The incidence, severity and spectrum of childhood pneumonia have changed owing to the HIV epidemic. Increasing emergence of antimicrobial resistance necessitates a rational approach to the use of antibiotics in pneumonia management. Objective. To develop guidelines for the diagnosis, management and prevention of CAP in South African children. Methods. The Paediatric Assembly of the South African Thoracic Society established five expert subgroups to address: (i) epidemiology and aetiology; (ii) diagnosis; (iii) antibiotic treatment; (iv) supportive therapy; and (v) prevention of CAP. Each subgroup developed a position paper based on the available published evidence; in the absence of evidence, expert opinion was accepted. After peer review and revision, the position papers were synthesised into an overall guideline which was further reviewed and revised. Recommendations. Recommendations based on epidemiological factors include a diagnostic approach, investigations, supportive therapy, appropriate antibiotic treatment and preventive strategies. Specific recommendations for HIV-infected children are provided. Validation. These guidelines are based on the available evidence supplemented by the consensus opinion of South African experts in paediatrics, paediatric pulmonology, radiology, infectious diseases and microbiology. Published international guidelines have also been consulted."									
539	Effect of antiretroviral therapy on the diagnostic accuracy of symptom screening for intensified tuberculosis case finding in a South African HIV clinic.	"Rangaka MX, Wilkinson RJ, Glynn JR, Boulle A, Cutsem Gv, Goliath R, Mathee S, et al."	Clinical Infectious Diseases. 2012;55(12):1698-706.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20123402849	"Background. Current symptom screening algorithms for intensified tuberculosis case finding or prior to isoniazid preventive therapy (IPT) in patients infected with human immunodeficiency virus (HIV) were derived from antiretroviral-naive cohorts. There is a need to validate screening algorithms in patients on antiretroviral therapy (ART). Methods. We performed cross-sectional evaluation of the diagnostic accuracy of symptom screening, including the World Health Organization (WHO) algorithm, to rule out tuberculosis in HIV-infected individuals pre-ART and on ART undergoing screening prior to IPT. Results. A total of 1429 participants, 54% on ART, had symptom screening and a sputum culture result available. Culture-positive tuberculosis was diagnosed in 126 patients (8.8%, 95% confidence interval [CI], 7.4%-10.4%). The WHO symptom screen in the on-ART compared with the pre-ART group had a lower sensitivity (23.8% vs 47.6%), but higher specificity (94.4% vs 79.8%). The effect of ART was independent of CD4<sup>+</sup> count in multivariable analyses. The posttest probability of tuberculosis following a negative WHO screen was 8.9% (95% CI, 7.4%-10.8%) and 4.4% (95% CI, 3.7%-5.2%) for the pre-ART and on-ART groups, respectively. Addition of body mass index to the WHO screen significantly improved discriminatory ability in both ART groups, which was further improved by adding CD4 count and ART duration. Conclusions. The WHO symptom screen has poor sensitivity, especially among patients on ART, in a clinic where regular tuberculosis screening is practiced. Consequently, a significant proportion of individuals with tuberculosis would inadvertently be placed on isoniazid monotherapy despite high negative predictive values. Until more sensitive methods of ruling out tuberculosis are established, it would be prudent to do a sputum culture prior to IPT where this is feasible."									
540	Effect of antiretroviral therapy on the diagnostic accuracy of symptom screening for intensified tuberculosis case finding in a South African HIV clinic.	"Rangaka MX, Wilkinson RJ, Glynn JR, Boulle A, Van Cutsem G, Goliath R, Mathee S, et al."	Clinical Infectious Diseases. 2012 15 Dec;55(12):1698-706.		"Background. Current symptom screening algorithms for intensified tuberculosis case finding or prior to isoniazid preventive therapy (IPT) in patients infected with human immunodeficiency virus (HIV) were derived from antiretroviral-naive cohorts. There is a need to validate screening algorithms in patients on antiretroviral therapy (ART).Methods. We performed cross-sectional evaluation of the diagnostic accuracy of symptom screening, including the World Health Organization (WHO) algorithm, to rule out tuberculosis in HIV-infected individuals pre-ART and on ART undergoing screening prior to IPT.Results. A total of 1429 participants, 54% on ART, had symptom screening and a sputum culture result available. Culture-positive tuberculosis was diagnosed in 126 patients (8.8%, 95% confidence interval [CI], 7.4%-10.4%). The WHO symptom screen in the on-ART compared with the pre-ART group had a lower sensitivity (23.8% vs 47.6%), but higher specificity (94.4% vs 79.8%). The effect of ART was independent of CD4<sup>+</sup> count in multivariable analyses. The posttest probability of tuberculosis following a negative WHO screen was 8.9% (95% CI, 7.4%-10.8%) and 4.4% (95% CI, 3.7%-5.2%) for the pre-ART and on-ART groups, respectively. Addition of body mass index to the WHO screen significantly improved discriminatory ability in both ART groups, which was further improved by adding CD4 count and ART duration.Conclusions. The WHO symptom screen has poor sensitivity, especially among patients on ART, in a clinic where regular tuberculosis screening is practiced. Consequently, a significant proportion of individuals with tuberculosis would inadvertently be placed on isoniazid monotherapy despite high negative predictive values. Until more sensitive methods of ruling out tuberculosis are established, it would be prudent to do a sputum culture prior to IPT where this is feasible. The Author 2012. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved."									
529	The Global Enteric Multicenter Study (GEMS) of diarrheal disease in infants and young children in developing countries: Epidemiologic and clinical methods of the case/control study.	"Kotloff KL, Blackwelder WC, Nasrin D, Nataro JP, Farag TH, Van Eijk A, Adegbola RA, et al."	Clinical Infectious Diseases. 2012 15 Dec;55(SUPPL. 4):S232-S45.		"Background. Diarrhea is a leading cause of illness and death among children aged <5 years in developing countries. This paper describes the clinical and epidemiological methods used to conduct the Global Enteric Multicenter Study (GEMS), a 3-year, prospective, age-stratified, case/control study to estimate the population-based burden, microbiologic etiology, and adverse clinical consequences of acute moderate-to-severe diarrhea (MSD) among a censused population of children aged 0-59 months seeking care at health centers in sub-Saharan Africa and South Asia.Methods. GEMS was conducted at 7 field sites, each serving a population whose demography and healthcare utilization practices for childhood diarrhea were documented. We aimed to enroll 220 MSD cases per year from selected health centers serving each site in each of 3 age strata (0-11, 12-23, and 24-59 months), along with 1-3 matched community controls. Cases and controls supplied clinical, epidemiologic, and anthropometric data at enrollment and again approximately 60 days later, and provided enrollment stool specimens for identification and characterization of potential diarrheal pathogens. Verbal autopsy was performed if a child died. Analytic strategies will calculate the fraction of MSD attributable to each pathogen and the incidence, financial costs, nutritional consequences, and case fatality overall and by pathogen.Conclusions. When completed, GEMS will provide estimates of the incidence, etiology, and outcomes of MSD among infants and young children in sub-Saharan Africa and South Asia. This information can guide development and implementation of public health interventions to diminish morbidity and mortality from diarrheal diseases. 2012 The Author 2012. Published by Oxford University Press on behalf of the Infectious Diseases Society of America."									
1105	Marked reduction in prevalence of malaria parasitemia and anemia in HIV-infected pregnant women taking cotrimoxazole with or without sulfadoxine-pyrimethamine intermittent preventive therapy during pregnancy in Malawi.	"Kapito-Tembo A, Meshnick SR, Van Hensbroek MB, Phiri K, Fitzgerald M, Mwapasa V."	Journal of Infectious Diseases. 2011 15 Feb;203(4):464-72.		"Background. Effectiveness of cotrimoxazole (CTX) compared with sulfadoxine-pyrimethamine (SP) intermittent-preventive-therapy (IPTp) for malaria in HIV-infected pregnant women is unknown. We examined effectiveness of CTX with or without SP-IPTp versus SP-IPTp at reducing malaria parasitemia and anemia. Methods. From 2005 to 2009, we conducted a cross-sectional study of HIV-infected pregnant women at Thyolo Hospital, Malawi. Blood was tested for malaria parasitemia and anemia (hemoglobin<11g/dl). Data were collected on use of anti-malaria interventions and other risk factors. CTX prophylaxis policy for HIV-infected pregnant women was introduced in 2007, but implementation problems resulted in some women receiving both CTX and SP-IPTp. Findings. We enrolled 1,142 women, of whom 1,121 had data on CTX and/or SP-IPTp intake. Of these, 49.7%, 29.8%, and 15.4% reported taking SP-IPTp only, CTX only and SP-IPTp plus CTX, respectively. Compared with women taking SP-IPTp, those taking SP-IPTp plus CTX and CTX were less likely to have malaria parasitemia (OR, [95%CI]: 0.09, [0.01-0.66] and 0.43, [0.19-0.97], respectively) or anemia (PR, [95% CI]: 0.67, [0.54-0.83] and 0.72, [0.61-0.83], respectively). Conclusion. In HIV-infected pregnant women, daily CTX was associated with reduced malaria parasitemia and anemia compared with SP-IPTp. CTX plus SP-IPTp was associated with further reduction in malaria parasitemia but toxicity was not fully assessed. The Author 2011. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved."									
888	"Prevalence of Underweight, Stunting, and Wasting among Children Infected with Human Immunodeficiency Virus in South India."	"Padmapriyadarsini C, Pooranagangadevi N, Chandrasekaran K, Subramanyan S, Thiruvalluvan C, Bhavani PK, Swaminathan S."	International Journal of Pediatrics. 2009;2009:837627.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=20041007	"Background. Growth failure is a common feature of children with human immunodeficiency virus (HIV) infection. Malnutrition increases mortality and may impair the response to antiretroviral treatment. Objective. Our objective was to describe the prevalence of stunting, underweight, and wasting in HIV-infected children in south India and to assess the utility of these parameters in predicting immune status. Methodology. In this cross-sectional study, anthropometric measurements and CD4 counts were performed on 231 HIV-infected children. Z scores for height for age, weight for age, and weight for height were correlated with CD4 cell counts and receiver operating characteristic curves plotted. Results. Prevalence of underweight was 63%, stunting 58%, and wasting 16%, respectively. 33-45% of children were moderately or severely malnourished even at CD4 >25%; sensitivity and specificity of stunting or underweight to predict HIV disease severity was low. Conclusions. Undernutrition and stunting are common among HIV-infected children at all stages of the disease in India. Early and aggressive nutritional intervention is required, if long-term outcomes are to be improved."									
889	"Prevalence of underweight, stunting, and wasting among children infected with human immunodeficiency virus in south India."	"Padmapriyadarsini C, Pooranagangadevi N, Chandrasekaran K, Sudha S, Thiruvalluvan C, Bhavani PK, Soumya S."	International Journal of Pediatrics. 2009;837627(17).	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20103216939	"Background. Growth failure is a common feature of children with human immunodeficiency virus (HIV) infection. Malnutrition increases mortality and may impair the response to antiretroviral treatment. Objective. Our objective was to describe the prevalence of stunting, underweight, and wasting in HIV-infected children in south India and to assess the utility of these parameters in predicting immune status. Methodology. In this cross-sectional study, anthropometric measurements and CD4 counts were performed on 231 HIV-infected children. Z scores for height for age, weight for age, and weight for height were correlated with CD4 cell counts and receiver operating characteristic curves plotted. Results. Prevalence of underweight was 63%, stunting 58%, and wasting 16%, respectively. 33-45% of children were moderately or severely malnourished even at CD4 >25%; sensitivity and specificity of stunting or underweight to predict HIV disease severity was low. Conclusions. Undernutrition and stunting are common among HIV-infected children at all stages of the disease in India. Early and aggressive nutritional intervention is required, if long-term outcomes are to be improved."									
1103	Immune response to hepatitis B virus vaccination among HIV-1 infected and uninfected adults in Kenya.	"Irungu E, Mugo N, Ngure K, Njuguna R, Celum C, Farquhar C, Dhanireddy S, et al."	Journal of Infectious Diseases. 2013 01 Feb;207(3):402-10.		"Background. In studies from high-income countries, human immunodeficiency virus type 1 (HIV-1)-infected persons have diminished responses to hepatitis B virus (HBV) vaccination, compared with HIV-1-uninfected persons, but data from other settings are limited.Methods. We compared the immune response to HBV vaccination among HIV-1-infected and HIV-1-uninfected Kenyan adults and assessed the response of HIV-1-infected initial nonresponders to revaccination with a standard HBV vaccine series.Results. Of 603 participants, 310 (51.4%) were HIV-1-infected, for whom the median CD4<sup>+</sup> T-cell count was 557 cells/muL (interquartile range, 428-725 cells/muL); none were receiving antiretroviral therapy. Nonresponse to HBV vaccine was higher among HIV-1-infected participants, compared with HIV-1-uninfected participants (35.8% vs 14.3%; odds ratio, 3.33; P <. 001). Of 102 HIV-1-infected initial nonresponders, 88 (86.3%) responded to revaccination, for an overall response, including to revaccination, of 94.9%. Among HIV-1-infected individuals, lower CD4<sup>+</sup> T-cell counts and male sex were independent predictors of nonresponse to initial vaccination, and lower body mass index, higher plasma HIV-1 RNA levels, and longer time to revaccination predicted nonresponse to revaccination.Conclusions. Kenyan adults had similar HBV vaccination responses as persons from high-income countries. Timely revaccination of HIV-1-infected nonresponders increased response to the vaccine to 95%. 2012 The Author."									
1104	Immune response to hepatitis B virus vaccination among HIV-1 infected and uninfected adults in Kenya.	"Irungu E, Mugo N, Ngure K, Njuguna R, Celum C, Farquhar C, Shireesha D, et al."	Journal of Infectious Diseases. 2013;207(3):402-10.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20133027342	"Background. In studies from high-income countries, human immunodeficiency virus type 1 (HIV-1)-infected persons have diminished responses to hepatitis B virus (HBV) vaccination, compared with HIV-1-uninfected persons, but data from other settings are limited. Methods. We compared the immune response to HBV vaccination among HIV-1-infected and HIV-1-uninfected Kenyan adults and assessed the response of HIV-1-infected initial nonresponders to revaccination with a standard HBV vaccine series. Results. Of 603 participants, 310 (51.4%) were HIV-1-infected, for whom the median CD4<sup>+</sup> T-cell count was 557 cells/ micro L (interquartile range, 428-725 cells/ micro L); none were receiving antiretroviral therapy. Nonresponse to HBV vaccine was higher among HIV-1-infected participants, compared with HIV-1-uninfected participants (35.8% vs 14.3%; odds ratio, 3.33; P<.001). Of 102 HIV-1-infected initial nonresponders, 88 (86.3%) responded to revaccination, for an overall response, including to revaccination, of 94.9%. Among HIV-1-infected individuals, lower CD4<sup>+</sup> T-cell counts and male sex were independent predictors of nonresponse to initial vaccination, and lower body mass index, higher plasma HIV-1 RNA levels, and longer time to revaccination predicted nonresponse to revaccination. Conclusions. Kenyan adults had similar HBV vaccination responses as persons from high-income countries. Timely revaccination of HIV-1-infected nonresponders increased response to the vaccine to 95%."									
732	"Nutritional and immunological status and their associations among HIV-infected adults in Addis Ababa, Ethiopia."	"Habtamu F, Melaku U, Samson T, Mokhtar N, Aguenaou H."	Food and Nutrition Bulletin. 2009;30(3):227-32.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20093323030	"Background. In the search for cost-effective interventions to reduce morbidity and mortality in HIV disease, the identification of nutritional status and levels of micronutrients is very important. Objective. To generate information on the level of energy malnutrition and on vitamin A, zinc, and hemoglobin levels and their relationships with disease status in HIV-infected adults in Addis Ababa, Ethiopia. Methods. A cross-sectional study was carried out on 153 HIV-positive adults (19% male, 81% female) living in Addis Ababa. The nutritional status and the levels of zinc, retinol, and hemoglobin were determined by anthropometric and biochemical methods. CD<sub>4</sub><sup>+</sup> counts and C-reactive protein levels were measured by standard methods. Results. Of the patients, 18% were chronically energy deficient, 71% were normal, and 11% were overweight Serum zinc levels were low (<10.7 micro mol/L) in 53% of subjects, and serum retinol levels were low (<30 micro g/dL) in 47% of subjects. Low hemoglobin levels (<12 g/dL) were observed in only 4.72% of the study population. CD<sub>4</sub><sup>+</sup> counts under 200/mm<sup>3</sup> and elevated C-reactive protein levels were both found in 21% of the subjects. CD<sub>4</sub><sup>+</sup> counts were positively and significantly correlated with hemoglobin (r=0.271, p<.001), zinc (r=0.180, p<.033), and body mass index (r=0.194, p<.017). There were significant negative associations between levels of C-reactive protein and levels of zinc (r=-0.178, p<0.036) and hemoglobin (r=-0.253, p<.002). Conclusions. Our results provide evidence that compromised nutritional and micronutrient status begins early in the course of HIV-1 infection. Low serum zinc and vitamin A levels were observed in almost half of the subjects. The clinical significance of low serum zinc and vitamin A levels is unclear, and more research is required."									
734	"Impact of drought and HIV on child nutrition in Eastern and Southern Africa. (Special Issue: Child nutrition in vulnerable populations in Eastern and Southern Africa, 2000-2006.)."	"Mason JB, Chotard S, Bailes A, Mebrahtu S, Hailey P."	Food and Nutrition Bulletin. 2010;31(3):S209-S18.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20103335496	"Background. Intermittent food insecurity due to drought and the effects of HIV/AIDS affect child nutritional status in sub-Saharan Africa. In Southern Africa in 2001-3 drought and HIV were previously shown to interact to cause substantial deterioration in child nutrition. With additional data available from Southern and Eastern Africa, the size of the effects of drought and HIV on child underweight up to 2006 were estimated. Objective. To determine short- and long-term trends in child malnutrition in Eastern and Southern Africa and how these are affected by drought and HIV. Methods. A secondary epidemiologic analysis was conducted of area-level data derived from national surveys, generally from the mid-1990s to the mid-2000s. Data from countries in the Horn of Africa (Ethiopia, Kenya, and Uganda) and Southern Africa (Lesotho, Malawi, Mozambique, Swaziland, Zambia, and Zimbabwe) were compiled from available survey results. Secondary data were obtained on weight-for-age for preschool children, HIV prevalence data were derived from antenatal clinic surveillance, and food security data were obtained from United Nations sources (Food and Agriculture Organization, International Labour Office, and others). Results. Overall trends in child nutrition are improving as national averages; the improvement is slowed but not stopped by the effects of intermittent droughts. In Southern Africa, the prevalence rates of underweight showed signs of recovery from the 2001-03 crisis. As expected, food production and price indicators were related (although weakly) to changes in malnutrition prevalence; the association was strongest between changes in food production and price indicators and changes in malnutrition prevalence in the following year. Areas of higher HIV prevalence had better nutrition (in both country groups), but this counterintuitive association is removed after controlling for socioeconomic status. In low-HIV areas in Eastern Africa, nutrition deteriorates during drought, with prevalence rates of underweight 5 to 12 percentage points higher than in nondrought periods; less difference was seen in high-HIV areas, in contrast to Southern Africa, where drought and HIV together interact to produce higher prevalence rates of underweight. Conclusions. Despite severe intermittent droughts and the HIV/AIDS epidemic (now declining but still with very high prevalence rates), underlying trends in child underweight are improving when drought is absent: resilience may be better than feared. Preventing effects of drought and HIV could release potential for improvement and, when supported by national nutrition programs, help to accelerate the rates of improvement, now generally averaging around 0.3 percentage points per year, to those needed to meet Millennium Development Goals (0.4 to 0.9 percentage points per year)."									
516	"A high incidence of lactic acidosis and symptomatic hyperlactatemia in women receiving highly active antiretroviral therapy in Soweto, South Africa."	"Bolhaar MG, Karstaedt AS."	Clinical Infectious Diseases. 2007 15 Jul;45(2):254-60.		"Background. Lactic acidosis and symptomatic hyperlactatemia may complicate nucleoside reverse-transcriptase inhibitor use. Females may be at increased risk for such complications. Our study evaluated the incidence of lactic acidosis and symptomatic hyperlactatemia by sex, analyzed clinical features, and described the safety of reintroducing highly active antiretroviral therapy (HAART) with zidovudine replacing stavudine. Methods. A retrospective cohort analysis was performed for 1735 adults (63% of whom were female) who initiated HAART from April 2004 through August 2005 in Soweto, South Africa, with follow-up until February 2006. Patients with lactate levels >=4.5 mmol/L and no potential cause of elevated lactic acidosis other than receipt of HAART were included in the study. Results. A total of 23 patients (22 of whom were female) experienced lactic acidosis. The overall incidence was 10.6 cases per 1000 patient-years; the incidence was 16.1 cases per 1000 patient-years in female patients and 1.2 cases per 1000 patient-years in male patients. Seven (30.4%) of the patients died. Eight (34.8%) of the patients were obese (body mass index [calculated as weight in kilograms divided by the square of height in meters], >30) at HAART initiation. Forty-four patients (37 of whom were female) had symptomatic hyperlactatemia. The overall incidence was 20.2 cases per 1000 patient-years, with an incidence of 27.0 cases per 1000 patient-years in female patients and 8.7 cases per 1000 patient-years in male patients. None of the patients died. Nine (20.4%) of the patients were obese at HAART initiation. Sixty-six of 67 patients were receiving stavudine, and 5 patients were receiving didanosine. Among 56 patients who restarted HAART with zidovudine for a cumulative nucleoside reverse-transcriptase inhibitor reexposure of 44.6 patient-years - including 41 patients who received treatment for >=9 months - there were no relapses. Conclusion. Women in Soweto, South Africa, have a higher frequency of symptomatic hyperlactatemia and lactic acidosis than has been reported for patients in other study groups. In cases associated with stavudine use, restarting HAART with zidovudine seemed to be safe and effective for patients with limited nucleoside reverse-transcriptase inhibitor alternatives. 2007 by the Infectious Diseases Society of America. All rights reserved."									
1164	Serum Phosphate Predicts Early Mortality among Underweight Adults Starting ART in Zambia: A Novel Context for Refeeding Syndrome?	"Koethe JR, Blevins M, Nyirenda CK, Kabagambe EK, Chiasera JM, Shepherd BE, Zulu I, et al."	Journal of Nutrition and Metabolism. 2013;2013:545439.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=23691292	"Background. Low body mass index (BMI) at antiretroviral therapy (ART) initiation is associated with early mortality, but the etiology is not well understood. We hypothesized that low pretreatment serum phosphate, a critical cellular metabolism intermediate primarily stored in skeletal muscle, may predict mortality within the first 12 weeks of ART. Methods. We prospectively studied 352 HIV-infected adults initiating ART in Lusaka, Zambia to estimate the odds of death for each 0.1mmol/L decrease in baseline phosphate after adjusting for established predictors of mortality. Results. The distribution of phosphate values was similar across BMI categories (median value 1.2mmol/L). Among the 145 participants with BMI <18.5kg/m(2), 28 (19%) died within 12 weeks. Lower pretreatment serum phosphate was associated with increased mortality (odds ratio (OR) 1.24 per 0.1mmol/L decrement, 95% CI: 1.05 to 1.47; P = 0.01) after adjusting for sex, age, and CD4(+) lymphocyte count. A similar relationship was not observed among participants with BMI >=18.5kg/m(2) (OR 0.96, 95% CI: 0.76 to 1.21; P = 0.74). Conclusions. The association of low pretreatment serum phosphate level and early ART mortality among undernourished individuals may represent a variant of the refeeding syndrome. Further studies of cellular metabolism in this population are needed."									
553	Treatment outcomes for HIV-uninfected patients with multidrug-resistant and extensively drug-resistant tuberculosis.	"Yong SK, Yee HK, Gee YS, Man PC, Kim H, O JK, Yong SC, et al."	Clinical Infectious Diseases. 2008 15 Aug;47(4):496-502.		"Background. Multidrug-resistant (MDR) tuberculosis (TB) is more difficult to treat than is drug-susceptible TB. To elucidate the optimal therapy for MDR TB, we assessed the treatment outcomes and prognostic factors for patients with MDR TB. Methods. This study included patients who received an individualized treatment regimen for MDR TB at Samsung Medical Center, a tertiary referral hospital in Seoul, Korea, from January 1995 through December 2004. To identify the prognostic factors related to favorable treatment outcomes, univariate comparison and multiple logistic regression were performed. Results. Of 155 patients, 18 (12%) had newly diagnosed MDR TB, 81 (52%) had previously received treatment with first-line drugs, and 56 (36%) had received treatment with second-line drugs. The isolated strains were resistant to a median of 5 drugs. Twenty-seven patients (17%) had extensively drug-resistant (XDR) TB at the start of treatment. Outcome assessment revealed that 102 patients (66%) were cured or completed therapy. The treatment success rates did not differ significantly between patients with non-XDR MDR TB and those with XDR TB (66% vs. 67%). Surgical resection was performed more frequently for patients with XDR TB than for those with non-XDR MDR TB (48% vs. 17%). Combined surgical resection, body mass index >=18.5 (calculated as the weight in kilograms divided by the square of the height in meters), use of >4 effective drugs, and a negative sputum smear result were independent predictors of a favorable outcome. Conclusions. Early aggressive treatment comprising at least 4 effective drugs and surgical resection, when indicated, may improve the outcome for patients with MDR TB or XDR TB. 2008 by the Infectious Diseases Society of America. All rights reserved."									
737	Multiple micronutrient supplementation during pregnancy in low-income countries: a meta-analysis of effects on stillbirths and on early and late neonatal mortality. (Special Issue: Multiple micronutrient supplementation during pregnancy in developing country settings.).	"Ronsmans C, Fisher DJ, Osmond C, Margetts BM, Fall CHD."	Food and Nutrition Bulletin. 2009;30(4 (Supplement):S547-S55.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20103048419	"Background. Multiple micronutrient deficiencies are common among women in low-income countries and may adversely affect pregnancy outcomes Objective. To conduct a meta-analysis of the effects on stillbirths and on early and late neonatal mortality of supplementation during pregnancy with multiple micronutrients compared with iron-folic acid in recent randomized, controlled trials. Methods. Twelve randomized, controlled trials were included in the analysis (Bangladesh; Burkina Faso; China; Guinea-Bissau; Indramayu and Lombok, Indonesia; Mexico; Sarlahi and Janakur, Nepal; Niger; Pakistan; and Zimbabwe), all providing approximately 1 recommended dietary allowance (RDA) of multiple micronutrients or iron-folic acid to presumed HIV-negative women. Results. Supplementation providing approximately 1 RDA of multiple micronutrients did not decrease the risk of stillbirth (OR=1.01; 95% CI 0.88 to 1.16), early neonatal mortality (OR=1.23; 95% CI, 0.95 to 1.59), late neonatal mortality (OR=0.94; 95% CI, 0.73 to 1.23), or perinatal mortality (OR=1.11; 95% CI, 0.93 to 1.33). Conclusions. Our meta-analysis provides consistent evidence that supplementation providing approximately 1 RDA of multiple micronutrients during pregnancy does not result in any reduction in stillbirths or in early or late neonatal deaths compared with iron-folic acid alone."									
731	Multiple micronutrient supplementation during pregnancy in low-income countries: a meta-analysis of effects on birth size and length of gestation. (Special Issue: Multiple micronutrient supplementation during pregnancy in developing country settings.).	"Fall CHD, Fisher DJ, Osmond C, Margetts BM."	Food and Nutrition Bulletin. 2009;30(4 (Supplement):S533-S46.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20103048415	"Background. Multiple micronutrient deficiencies are common among women in low-income countries and may adversely affect pregnancy outcomes. Objective. This meta-analysis reports the effects on newborn size and duration of gestation of multiple micronutrient supplementation mainly compared with iron plus folic acid during pregnancy in recent randomized, controlled trials. Methods. Original data from 12 randomized, controlled trials in Bangladesh, Burkina Faso, China, Guinea-Bissau, Indonesia, Mexico, Nepal, Niger, Pakistan, and Zimbabwe, all providing approximately 1 recommended dietary allowance (RDA) of multiple micronutrients to presumed HIV-negative women, were included. Outcomes included birthweight, other birth measurements, gestation, and incidence of low birthweight (LBW) (<2,500 g), small-for-gestational age birth (SGA, birthweight below the within-each-population 10th percentile), large-for-gestational age birth (LGA, birthweight above the within-each-population 90th percentile), and preterm delivery (<37 weeks). Results. Compared with control supplementation (mainly with iron-folic acid), multiple micronutrient supplementation was associated with an increase in mean birthweight (pooled estimate: +22.4 g [95% CI, 8.3 to 36.4 g]; p=.002), a reduction in the prevalence of LBW (pooled OR=0.89 [95% CI, 0.81 to 0.97]; p=.01) and SGA birth (pooled OR=0.90 [95% CI, 0.82 to 0.99]; p=.03), and an increase in the prevalence of LGA birth (pooled OR=1.13 [95% CI, 1.00 to 1.28]; p=.04). In most studies, the effects on birthweight were greater in mothers with higher body mass index (BMI). In the pooled analysis, the positive effect of multiple micronutrients on birthweight increased by 7.6 g (95% CI, 1.9 to 13.3 g) per unit increase in maternal BMI (p for interaction=.009). The intervention effect relative to the control group was +39.0 g (95% CI, +22.0 to +56.1 g) in mothers with BMI of 20 kg/m<sup>2</sup> or higher compared with -6.0 g (95% CI, -8.8 to +16.8 g) in mothers with BMI under 20 kg/m<sup>2</sup>. There were no significant effects of multiple micronutrient supplementation on birth length or head circumference nor on the duration of gestation (pooled effect: +0.17 day [95% CI, -0.35 to +0.70 day]; p=.51) or the incidence of preterm birth (pooled OR=1.00 [95% CI, 0.93 to 1.09]; p=.92). Conclusions. Compared with iron-folic acid supplementation alone, maternal supplementation with multiple micronutrients during pregnancy in low-income countries resulted in a small increase in birthweight and a reduction in the prevalence of LBW of about 10%. The effect was greater among women with higher BMI."									
1165	"Assessing nutrient intake and nutrient status of HIV seropositive patients attending clinic at Chulaimbo Sub-District Hospital, Kenya."	"Onyango AC, Walingo MK, Mbagaya G, Kakai R."	Journal of Nutrition and Metabolism. 2012;306530(22).	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20133082481	"Background. Nutritional status is an important determinant of HIV outcomes. Objective. To assess the nutrient intake and nutrient status of HIV seropositive patients attending an AIDS outpatient clinic, to improve the nutritional management of HIV-infected patients. Design. Prospective cohort study. Setting. Comprehensive care clinic in Chulaimbo Sub-District Hospital, Kenya. Subjects. 497 HIV sero-positive adults attending the clinic. Main Outcome Measures. Evaluation of nutrient intake using 24-hour recall, food frequency checklist, and nutrient status using biochemical assessment indicators (haemoglobin, creatinine, serum glutamate pyruvate (SGPT) and mean corpuscular volume (MCV)). Results. Among the 497 patients recruited (M:F sex ratio: 1.4, mean age: 39 years+or-10.5 y), Generally there was inadequate nutrient intake reported among the HIV patients, except iron (10.49+or-3.49 mg). All the biochemical assessment indicators were within normal range except for haemoglobin 11.2 g/dL (11.4+or-2.60 male and 11.2+or-4.25 female). Conclusions. Given its high frequency, malnutrition should be prevented, detected, monitored, and treated from the early stages of HIV infection among patients attending AIDS clinics in order to improve survival and quality of life."									
1107	Nutritional status and mortality among HIV-infected patients receiving antiretroviral therapy in Tanzania.	"Liu EJ, Spiegelman D, Semu H, Hawkins C, Chalamilla G, Aveika A, Nyamsangia S, et al."	Journal of Infectious Diseases. 2011;204(2):282-90.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20113237173	"Background. Poor nutritional status is associated with immunologic impairment and adverse health outcomes among adults infected with human immunodeficiency virus (HIV). Methods. We investigated body mass index (BMI), middle upper arm circumference (MUAC), and hemoglobin (Hgb) concentrations at initiation of antiretroviral therapy (ART) in 18,271 HIV-infected Tanzanian adults and their changes in the first 3 months of ART, in relation to the subsequent risk of death. Results. Lower BMI, MUAC, and Hgb concentrations at ART initiation were strongly associated with a higher risk of death within 3 months. Among patients who survived >3 months after ART initiation, those with a decrease in weight, MUAC, or Hgb concentrations by 3 months had a higher risk of death during the first year. After 1 year, only a decrease in MUAC by 3 months after ART initiation was associated with a higher risk of death. Weight loss was associated with a higher risk of death across all levels of baseline BMI, with the highest risk observed among patients with BMI<17 kg/m<sup>2</sup> (relative risk, 7.9; 95% confidence interval, 4.4-14.4). Conclusions. Poor nutritional status at ART initiation and decreased nutritional status in the first 3 months of ART were strong independent predictors of mortality. The role of nutritional interventions as adjunct therapies to ART merits further investigation."									
1113	"Association of serum albumin concentration with mortality, morbidity, CD4 T-cell reconstitution among tanzanians initiating antiretroviral therapy."	"Sudfeld CR, Isanaka S, Aboud S, Mugusi FM, Wang M, Chalamilla GE, Fawzi WW."	Journal of Infectious Diseases. 2013 01 May;207(9):1370-8.		"Background. Prospective studies of serum albumin concentration measurement as a low-cost predictor of human immunodeficiency virus (HIV) disease progression are needed for individuals initiating antiretroviral therapy (ART) in resource-limited settings.Methods. Serum albumin concentration was measured at ART initiation for 2145 adults in Tanzania who were enrolled in a trial examining the effect of multivitamins on HIV disease progression. Participants were prospectively followed for mortality, morbidity, and anthropometric outcomes at monthly visits (median follow-up duration, 21.2 months). Proportional hazard models were used to analyze mortality, morbidity, and nutritional outcomes, while generalized estimating equations were used to analyze CD4<sup>+</sup> T-cell counts.Results. Individuals with hypoalbuminemia (defined as a serum albumin concentration of <35 g/L) at ART initiation had a hazard of death that was 4.52 times (95% confidence interval, 3.37-6.07; P <. 001) that of individuals with serum albumin concentrations of >=35 g/L, after multivariate adjustment. Hypoalbuminemia was also independently associated with the incidence of pulmonary tuberculosis (P <. 001), severe anemia (P <. 001), wasting (P =. 002), and >10% weight loss (P =. 012). Secondary analyses suggested that serum albumin concentrations of <38 g/L were associated with increased mortality and incident pulmonary tuberculosis. There was no association between serum albumin concentration and changes in CD4 <sup>+</sup> T-cell counts (P =. 121).Conclusions. Serum albumin concentrations can identify adults initiating ART who are at high risk for mortality and selected morbidities. Future research is needed to identify and manage conditions that reduce the serum albumin concentration. 2013 The Author."									
1109	Increased risk of preterm delivery among HIV-infected women randomized to protease versus nucleoside reverse transcriptase inhibitor-based HAART during pregnancy.	"Powis KM, Kitch D, Ogwu A, Hughes MD, Lockman S, Leidner J, Widenfelt Ev, et al."	Journal of Infectious Diseases. 2011;204(4):506-14.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20113304883	"Background. Protease inhibitor (PI)-based highly active antiretroviral therapy (HAART) use in pregnancy has been associated with preterm deliveries in some observational studies. Methods. HIV-infected, HAART-naive pregnant women with CD4+ counts >=200 cells/mm<sup>3</sup> were randomized between 26 and 34 weeks gestation to lopinavir/ritonavir/zidovudine/lamivudine (PI group) or abacavir/zidovudine/lamivudine (NRTI group) in a clinical trial to prevent mother-to-child HIV transmission. Risk factors for preterm delivery (<37 weeks) and differences by randomization arm were evaluated for live infants by logistic regression. Results. Preterm delivery rates were higher among 267 women in the PI group than 263 women in the NRTI group (21.4% vs 11.8%, P=.003). PI-based HAART was the most significant risk factor for preterm delivery [odds ratio=2.03, 95% confidence interval 1.26-3.27, P=.004]. Mean change in maternal body mass index (BMI) 1 month after HAART initiation was lower in the PI group (P< .001); however, this was not significantly associated with preterm delivery. Neither infant hospitalizations nor mortality through 6 months of life differed by maternal regimen. Conclusions. PI-based HAART was associated with increased preterm delivery but not increased infant hospitalizations or mortality in a clinical trial setting. The association between PI use and lower increase in BMI in late pregnancy warrants further study."									
534	"Effect of reducing the dose of stavudine on body composition, bone density, and markers of mitochondrial toxicity in HIV-infected subjects: a randomized, controlled study."	"McComsey GA, Lo Re V, III, O'Riordan M, Walker UA, Lebrecht D, Baron E, Mounzer K, et al."	Clinical Infectious Diseases. 2008;46(8):1290-6.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20083152331	"Background. Stavudine is widely used in developing countries. Lipoatrophy and mitochondrial toxicity have been linked to stavudine use, but it is unclear whether switching to a lower dose can reduce these toxicities while maintaining human immunodeficiency virus (HIV) suppression. Methods. HIV-infected subjects receiving standard-dose stavudine with undetectable HIV type 1 RNA for >=6 months were randomized (ratio, 3:2) to receive one-half of the stavudine dose (switch arm) or to maintain the dose (continuation arm) while continuing to receive all other prescribed antiretrovirals. The following measurements were obtained at baseline and week 48: fasting lactate, pyruvate, and lipid levels; results of whole-body dual-energy x-ray absorptiometry; and mitochondrial DNA (mtDNA) measurements in fat and peripheral blood mononuclear cells. Change from baseline to week 48 was compared within and between groups. Results. Twenty-four patients (79% of whom were men and 79% of whom were African American; median age, 45 years) were enrolled in the study, 15 were enrolled in the switch arm, and 9 were enrolled in the continuation arm. The median duration of stavudine treatment was 55 months (range, 21-126 months). The median CD4 cell count was 558 cells/mm<sup>3</sup> (range, 207-1698 cells/mm<sup>3</sup>). At baseline, the study arms had similar demographic characteristics and laboratory indices, except for body mass index, total lean body mass, and triglyceride levels (all of which were higher in the switch arm). Three patients (2 in the switch arm) discontinued the study because of study-unrelated reasons. CD4 cell counts remained unchanged. At 48 weeks, 6 patients (4 [27%] in the switch arm and 2 [22%] in the continuation arm) had detectable HIV RNA levels (median, 972 copies/mL; range, 60-49,400 copies/mL). All patients with detectable HIV RNA levels reported significant lapses in treatment adherence; none exhibited mutations in HIV genotype. After the treatment switch, significant changes from study entry to week 48 were noted only for lactate level (median change, -0.27 mmol/L; range, -1.2 to 0.25 mmol/L; P=.02) and fat mtDNA (median change, 40 copies/cell; range, -49 to 261 copies/cell; P=.02). In the continuation arm, a significant loss of bone mineral density was seen at week 48 (median change, -1.7%; range, -6.3% to 0.8%; P=.02). The only significant between-group difference was the change in bone mineral density from baseline (P=.003). Conclusions. Reducing stavudine dose by one-half increased fat mtDNA and decreased lactate levels, suggesting improvement in mitochondrial indices while preserving HIV suppression in subjects who maintained adherence. A significant loss of bone mineral density was seen in patients receiving standard-dose stavudine but not in those receiving low-dose stavudine. These results suggest that switching to low-dose stavudine may improve mitochondrial indices while maintaining virological suppression."									
552	Association between HLA-4001 and lipodystrophy among HIV-infected patients from Thailand who received a stavudine-containing antiretroviral regimen.	"Wangsomboonsiri W, Mahasirimongkol S, Chantarangsu S, Kiertiburanakul S, Charoenyingwattana A, Komindr S, Thongnak C, et al."	Clinical Infectious Diseases. 2010;50(4):597-604.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20103046276	"Background. Stavudine-containing antiretroviral regimens are widely used in developing countries. Stavudine-associated lipodystrophy commonly occurs, without a clear predictable pattern owing to the unknown interaction between stavudine and the host, among patients who received this regimen. The aim of this study was to determine the clinical risk factors and human leukocyte antigen (HLA) alleles associated with stavudine-associated lipodystrophy. Methods. A case-control, cross-sectional study was conducted for HIV-infected patients receiving stavudine-containing antiretroviral regimens. Clinical assessments for lipodystrophy by physical examination, anthropometry, and dual-energy X-ray absorptiometry were obtained. On the basis of their clinical assessment, the patients were classified into 2 groups: the case group (moderated to severe lipodystrophy) and the control group (absent to mild lipodystrophy). The clinical characteristics and allelic distribution of HLA-A, HLA-B, HLA-C, HLA-DRB1, HLA-DQB1, and HLA-DPB1 were compared between the case group and the control group, to determine the possible association with stavudine-associated lipodystrophy. Results. There were 103 patients; 55 patients were in the case group, and 48 patients were in the control group. By use of forward stepwise logistic regression, the presence of HLA-B*4001 (odds ratio [OR], 14.05; 95% confidence interval [CI], 2.57-76.59; P=.002) and a longer duration of stavudine treatment (OR, 1.02; 95% CI, 1.00-1.04; P=.02) were significantly associated with stavudine-associated lipodystrophy, whereas a higher body mass index during treatment (OR, 0.73; 95% CI, 0.61-0.86; P<.001) was associated with a lower risk for lipodystrophy. HLA-B*4001 has a high specificity (95.8%) and a positive predictive value (88.9%) for lipodystrophy. Conclusions. HLA-B*4001 is a strong genetic risk factor for stavudine-associated lipodystrophy in HIV-infected patients in Thailand. HLA-B*4001 may be used as a genetic marker to predict which patients will develop stavudine-associated lipodystrophy, to avoid or shorten the duration of stavudine use. This finding needs to be confirmed in further replication studies."									
1381	Neuropathic pain during tuberculosis treatment in Bamako (Mali).	"Maiga Y, Toloba Y, M'Belesso P, Daniele R, Cissoko Y, Illiassou S, Maiga MY, et al."	Medecine et Sante Tropicales. 2012;22(3):312-6.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20133051835	"Background. The incidence of tuberculosis is high in Africa. It is treated with medications that can trigger neuropathic pain and thus negatively affect patients', quality of life and treatment compliance. The aim of this study was to investigate neuropathic pain due to antituberculosis drugs in patients without HIV infection. Methods. This prospective study, conducted in the pulmonology department of the University Hospital of Point G, Mali, included patients taking antituberculosis drugs who had negative HIV tests and no other potential cause of neuropathic pain. Diagnosis of neuropathic pain relied on the DN4 questionnaire (4 questions for neuropathic pain) and its assessment on a visual analog scale (VAS) and the Lattinen test. Results. During the study period, 423 subjects were admitted to our department, 103 (24.4%) with tuberculosis. Eighty met the inclusion criteria. The sex ratio (male to female) was 2.5 Their mean age was 39 years (range: 13-80). In all, 13 (16.25%) reported neuropathic pain. Burning sensations in the plantar region, with or without paresthesia, were the presenting symptoms in 10 of them. All patients began a treatment based on amitriptyline, vitamin B6, and physical therapy and all reported improvement within 2 months. Conclusion. Neuropathic pain occurs independently of age, sex or the specific antituberculosis regimen, as long as it includes isoniazid. Stopping or modifying the treatment regimen is not necessary. In our context, in view of the difficulties in identifying slow acetylators, the routine addition of vitamin B6 to all treatment protocols should be discussed."									
548	Weight and body shape changes in a treatment-naive population after 6 months of nevirapine-based generic highly active antiretroviral therapy in South India.	"Suneeta S, Kumarasamy N, Cecelia AJ, Suniti S, Mayer K, Wanke C."	Clinical Infectious Diseases. 2007;44(2):295-300.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20073047005	"Background. The nutritional and body shape response after the initiation of highly active antiretroviral therapy (HAART) in resource-limited environments has not been documented. In this environment, nutritional compromise is a common complication of human immunodeficiency virus (HIV) infection. Methods. We conducted a prospective study of 190 HIV-infected patients who initiated a nevirapine-based HAART regimen. CD4<sup>+</sup> T cell count, body weight, body mass index, anthropometry, and bioelectrical impedance data were collected prior to initiation of therapy and after 6 months of therapy. Results. The mean age of participants was 35 years, 85% of participants were male, and 59% received stavudine as 1 of the nucleosides in their initial HAART regimen. The members of the cohort were malnourished before the initiation of therapy and had a mean body mass index of 20.1 (calculated as weight in kilograms divided by the square of height in meters). Overall, body weight increased a mean of 2.8 kg (range, -12.5 to 22.5 kg), and CD4<sup>+</sup> T cell counts increased by a mean of 140 cells/mm<sup>3</sup>. Patients were stratified into those who lost weight (loss of >1 kg, 22%; n=41), those whose weight remained stable (19%; n=37), and those who gained weight (gain of >1 kg, 59%; n=112). Patients in all groups retained body shape symmetry and experienced no change in waist-to-hip ratio or regional body shape by anthropometry. Conclusions. The group that lost weight and the group whose weight remained stable experienced significant CD4<sup>+</sup> T cell count increases at 6 months. Although the majority of HIV-infected patients who received nevirapine-based HAART gained weight, there were participants who lost weight despite initiating their first HAART therapy."									
1108	"HIV-1 disease progression in breast-feeding and formula-feeding mothers: a prospective 2-year comparison of T cell subsets, HIV-1 RNA levels, and mortality."	"Otieno PA, Brown ER, Mbori-Ngacha DA, Nduati RW, Farquhar C, Obimbo EM, Bosire RK, et al."	Journal of Infectious Diseases. 2007;195(2):220-9.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20073031060	"Background. There is conflicting evidence regarding the effects of breast-feeding on maternal mortality from human immunodeficiency virus type 1 (HIV-1) infection, and little is known about the effects of breast-feeding on markers of HIV-1 disease progression. Methods. HIV-1-seropositive women were enrolled during pregnancy and received short-course zidovudine. HIV-1 RNA levels and CD4 cell counts were determined at baseline and at months 1, 3, 6, 12, 18, and 24 postpartum and were compared between breast-feeding and formula-feeding mothers. Results. Of 296 women, 98 formula fed and 198 breast-fed. At baseline, formula-feeding women had a higher education level and prevalence of HIV-1-related illness than did breast-feeding women; however, the groups did not differ with respect to CD4 cell counts and HIV-1 RNA levels. Between months 1 and 24 postpartum, CD4 cell counts decreased 3.9 cells/ micro L/month (P<.001), HIV-1 RNA levels increased 0.005 log<sub>10</sub> copies/mL/month (P=.03), and body mass index (BMI) decreased 0.03 kg/m<sup>2</sup>/month (P<.001). The rate of CD4 cell count decline was higher in breast-feeding mothers (7.2 cells/ micro L/month) than in mothers who never breast-fed (4.0 cells/ micro L/month) (P=.01). BMI decreased more rapidly in breast-feeding women (P=.04), whereas HIV-1 RNA levels and mortality did not differ significantly between breast-feeding and formula-feeding women. Conclusions. Breast-feeding was associated with significant decreases in CD4 cell counts and BMI. HIV-1 RNA levels and mortality were not increased, suggesting a limited adverse impact of breast-feeding in mothers receiving extended care for HIV-1 infection."									
401	"High prevalence of undiagnosed chronic kidney disease among at-risk population in Kinshasa, the Democratic Republic of Congo."	"Sumaili EK, Cohen EP, Zinga CV, Krzesinski JM, Pakasa NM, Nseka NM."	BMC Nephrology. 2009;10(1).		"Background. There is limited knowledge of Chronic Kidney Disease (CKD) among high risk populations, especially in the developing countries. We report our study of testing for CKD in at-risk subjects. Methods. In a cross-sectional study, 527 people from primary and secondary health care areas in the city of Kinshasa were studied from a random sample of at-risk out-patients with hypertension, diabetes, obesity, or HIV+. We measured blood pressure (BP), blood glucose level, proteinuria, body mass index, and estimated glomerular filtration rate (eGFR by MDRD equation) using calibrated creatinine levels based on one random measurement. The associations between health characteristics, indicators of kidney damage (proteinuria) and kidney function (<60 ml/min/1.73 m<sup>2</sup>) were also examined. Results. The prevalence of CKD in this study was 36%, but only 12% were aware of their condition. 4% of patients had stage 1 CKD, 6% stage 2, 18% stage 3, 2% stage 4, and 6% had stage 5. 24 hour quantitative proteinuria (>300 mg/day) was found in 19%. In those with the at-risk conditions, the % of CKD was: 44% in patients with hypertension, 39% in those with diabetes; 16% in the obese and 12% in those who were HIV+. 82% of those with a history of diabetes had elevated serum glucose levels at screening (>= 126 mg/dl). Only 6% of individuals with hypertension having CKD had reduced BP to lower than 130/80 mmHg. In multivariate analysis, diabetes, proteinuria and hypertension were the strongest determinants of CKD 3+. Conclusion. It appears that one out of three people in this at-risk population has undiagnosed CKD and poorly controlled CKD risk factors. This growing problem poses clear challenges to this developing country. Therefore, CKD should be addressed through the development of multidisciplinary teams and improved communication between traditional health care givers and nephrology services. Attention to CKD risk factors must become a priority. 2009 Sumaili et al; licensee BioMed Central Ltd."									
738	Addressing tuberculosis in the context of malnutrition and HIV coinfection. (Special issue: Nutrition and food insecurity in relation to HIV and AIDS and tuberculosis).	"Semba RD, Darnton-Hill I, Pee Sd."	Food and Nutrition Bulletin. 2010;31(4 (Supplement):S345-S64.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20113049439	"Background. Tuberculosis is the second leading cause of infectious disease mortality (1.8 million/year), after HIV/AIDS. There are more than 9 million new cases each year. One-third of the worlds population, and 50% of adults in sub-Saharan Africa, South Asia, and Southeast Asia, are infected, representing an enormous pool of individuals at risk for developing the disease. The situation is complicated by the HIV/AIDS pandemic, widespread undernutrition, smoking, diabetes, increased mobility, and emergence of multi- and extensively drug-resistant tuberculosis. Objective. To review the scientific evidence about the interactions among tuberculosis, nutrition, and HIV coinfection. Results. HIV infection and malnutrition lower immunity, increasing the risk of reactivation tuberculosis and primary progressive disease. Having either tuberculosis or HIV infection causes weight loss. Malnutrition markedly increases mortality among both tuberculosis and HIV/AIDS patients and should be treated concurrently with treatment of the infections. Tuberculosis treatment is a prerequisite for nutritional recovery, in addition to intake of nutrients required for rebuilding tissues, which is constrained in food-insecure households. Additional pharmaceutical treatment to reduce the catabolic impact of inflammation or promote growth may be needed. Specific nutrients can contribute to faster sputum smear clearance, which is important for reducing transmission, as well as faster weight gain when combined with an adequate diet. Adequate nutrition and weight gain in undernourished populations might reduce the incidence of tuberculosis. Conclusions. The many risk factors for the development of tuberculosis need to be addressed simultaneously, especially HIV/AIDS and food insecurity and undernutrition. For stronger evidence-based guidelines, existing recommendations and clinical applications need to be more widely applied and evaluated."									
519	"Corticosteroid therapy, vitamin D status, and inflammatory cytokine profile in the HIV-tuberculosis immune reconstitution inflammatory syndrome."	"Conesa-Botella A, Meintjes G, Coussens AK, Plas Hvd, Goliath R, Schutz C, Moreno-Reyes R, et al."	Clinical Infectious Diseases. 2012;55(7):1004-11.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20123313259	"Background. Tuberculosis-immune reconstitution inflammatory syndrome (TB-IRIS) in patients coinfected with human immunodeficiency virus (HIV) and tuberculosis starting antiretroviral therapy (ART) is associated with hypercytokinemia. As adjunctive corticosteroid therapy and vitamin D have immunomodulatory properties, we investigated the relationship between cytokine/chemokine profiles, corticosteroid use, and vitamin D deficiency in TB-IRIS patients. Methods. Plasma from 39 TB-IRIS and 42 non-IRIS patients was collected during a prospective study of HIV-associated tuberculosis patients starting ART. In total, 26% of patients received corticosteroid (CTC) therapy pre-ART for severe tuberculosis. Concentrations of total 25-hydroxyvitamin D (25(OH)D) and 14 cytokines/chemokines were determined at ART initiation and 2 weeks later. Results. Patients prescribed concurrent CTC had lower interferon gamma (IFN- gamma ), IP-10, tumor necrosis factor (TNF), interleukin (IL)-6, IL-8, IL-10, IL-12p40, and IL-18 pre-ART (P<.02). TB-IRIS presented at 12 days (median) of ART, irrespective of CTC use. In patients who developed TB-IRIS (not on CTC) IL-6, IL-8, IL-12p40, IL-18, IP-10, and TNF increased during 2 weeks (P<=.04) of ART. Vitamin D deficiency (total 25(OH)D <75 nmol/L) was highly prevalent (89%) at baseline. Although vitamin D deficiency at either baseline or 2 weeks was not associated with TB-IRIS, in those not on CTC the median 25(OH)D decreased during 2 weeks (P=.004) of ART. Severe vitamin D deficiency (total 25(OH)D <25 nmol/L) was associated with higher baseline TNF, IL-6, and IL-8 irrespective of IRIS status. Conclusions. CTC modifies the inflammatory profile of those who develop TB-IRIS. The association between severe vitamin D deficiency and elevated proinflammatory cytokines support a study of vitamin D supplementation in HIV-TB co-infected patients starting ART."									
551	"Effects of cessation of breastfeeding in HIV-1-exposed, uninfected children in Malawi."	"Taha TE, Hoover DR, Chen S, Kumwenda NI, Mipando L, Nkanaunena K, Thigpen MC, et al."	Clinical Infectious Diseases. 2011 15 Aug;53(4):388-95.		"Background. We assessed morbidity rates during short intervals that accompanied weaning and cumulative mortality among HIV-exposed, uninfected infants enrolled in the postexposure prophylaxis of infants in Malawi (PEPI-Malawi) trial. Methods. Women were counseled to stop breastfeeding (BF) by 6 months in the PEPI-Malawi trial. HIV-uninfected infants were included in this analysis starting at age 6 months. Breastfeeding and morbidity (illness and/or hospital admission and malnutrition [weight-for-age Z-score, <=2]) were assessed during age intervals of 6-9, 9-12, and 12-15 months. BF was defined as any BF at the start and end of the interval and no breastfeeding (NBF) was defined as NBF at any time during the interval. The association of NBF with morbidity at each mutually exclusive interval was assessed using Poisson regression models controlling for other factors. Cumulative mortality among infants aged 6-15 months with BF and NBF was assessed using an extended Kaplan-Meier method. Results. At age 6 months, 1761 HIV-uninfected infants were included in the study. The adjusted rate ratios for illnesses and/or hospital admission for NBF, compared with BF, was 1.7 (P,<.0001) at 6-9months, 1.66 (P=.0001) at 9-12 months, and 1.75 (P = .0008) at 12-15 months. The rates of morbidity were consistently higher among NBF infants during each age interval, compared with BF infants. The 15 months cumulative mortality among BF and NBF children was 3.5% and 6.4% (P = .03), respectively. Conclusions. Cessation of BF is associated with acute morbidity events and cumulative mortality. Prolonged BF should be encouraged, in addition to close monitoring of infant health and provision of support services. The Author 2011. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved."									
541	Severe renal dysfunction and risk factors associated with renal impairment in HIV-infected adults in Africa initiating antiretroviral therapy.	"Reid A, Stohr W, Walker AS, Williams IG, Kityo C, Hughes P, Kambugu A, et al."	Clinical Infectious Diseases. 2008 15 Apr;46(8):1271-81.		"Background. We sought to investigate renal function in previously untreated symptomatic human immunodeficiency virus (HIV)-infected adults with CD4 <sup>+</sup> cell counts of <200 cells/mm<sup>3</sup> who were undergoing antiretroviral therapy (ART) in Africa. Methods. The study was an observational analysis within a randomized trial of ART management strategies that included 3316 participants with baseline serum creatinine levels of <=360 mumol/L. Creatinine levels were measured before ART initiation, at weeks 4 and 12 of therapy, and every 12 weeks thereafter. We calculated estimated glomerular filtration rate (eGFR) using the Cockcroft-Gault formula. We analyzed the incidence of severely decreased eGFR (<30 mL/min/1.73 m<sup>2</sup>) and changes in eGFR to 96 weeks, considering demographic data, type of ART, and baseline biochemical and hematological characteristics as predictors, using random-effects models. Results. Sixty-five percent of the participants were women. Median values at baseline were as follows: age, 37 years; weight, 57 kg; CD4<sup>+</sup> cell count, 86 cells/mm<sup>3</sup>; and eGFR, 89 mL/min/1.73 m<sup>2</sup>. Of the participants, 1492 (45%) had mild (>=60 but <90 mL/min/1.73 m<sup>2</sup>) and 237 (7%) had moderate (>=30 but <60 mL/min/1.73 m<sup>2</sup>) impairments in eGFR. First-line ART regimens included zidovudine-lamivudine plus tenofovir disoproxil fumarate (for 74% of patients), nevirapine (16%), and abacavir (9%) (mostly nonrandomized allocation). After ART initiation, the median eGFR was 89-91 mL/min/1.73 m<sup>2</sup> for the period from week 4 through week 96. Fifty-two participants (1.6%) developed severe reductions in eGFR by week 96; there was no statistically significant difference between these patients and others with respect to first-line ART regimen received (P = .94). Lower baseline eGFR or hemoglobin level, lower body mass index, younger age, higher baseline CD4<sup>+</sup> cell count, and female sex were associated with greater increases in eGFR over baseline, with small but statistically significant differences between regimens (P < .001 for all). Conclusions. Despite screening, mild-to-moderate baseline renal impairment was relatively common, but these participants had greatest increases in eGFR after starting ART. Severe eGFR impairment was infrequent regardless of ART regimen and was generally related to intercurrent disease. Differences between ART regimens with respect to changes in eGFR through 96 weeks were of marginal clinical relevance, but investigating longer-term nephrotoxicity remains important. 2008 by the Infectious Diseases Society of America. All rights reserved."									
1318	Peginterferon alpha -2a and ribavirin treatment of patients with haemophilia and hepatitis C virus infection: a single-centre study of 367 cases.	"Alavian SM, Tabatabaei SV, Keshvari M, Behnava B, Miri SM, Elizee PK, Lankarani KB."	Liver International. 2010;30(8):1173-80.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20103273689	"Background/aims: Chronic hepatitis C virus infection (HCV) is a major comorbidity in patients with haemophilia. Peginterferon alpha and ribavirin is current standard anti-HCV therapy but there is little information about safety and efficacy of peginterferon alpha -2a and ribavirin combination therapy in these patients. Material and methods: In an open-label single-treatment arm cohort study, 367 haemophilia patients seronegative for hepatitis B and human immunodeficiency virus markers and chronically infected with HCV (HCV RNA>50 IU/ml for at least 6 months) received 180 micro g of PegasysReg. and 800-1200 mg of ribavirin according to body weight. Genotypes 1 and 4, mixed and untypable infections were treated for 48 weeks, while genotypes 2 and 3 were treated for 24 weeks. The efficacy of therapy was expressed as sustained virological response (SVR). Results: Two hundred and twenty-five subjects [61%, 95% confidence interval (CI) 56-66] achieved SVR, 66 patients relapsed and 30 subjects did not respond and nine patients developed breakthrough during treatment. In a multivariate logistic regression model, age <24 odds ratio (OR)=1.8 (95% CI 1.1-3.1), genotype non-1 OR=1.8 (95% CI 1.1-3.2), BMI<25 OR=2.1 (95% CI 1.3-3.3) and HCV RNA<600 000 IU/ml OR=1.7 (95% CI 1.1-3.2) were independent predictors of SVR. Eight patients discontinued the treatment because of persistent neutropaenia and 22 subjects were dropped out because of intractable side effects. Furthermore, two patients died during treatment and five were lost to follow-up after treatment cessation. Conclusions: Peginterferon alpha-2a in combination with weight-based ribavirin has SVR rate of 51% for genotype 1 and 71% for genotype non-1 infections in haemophilia patients. Age <24, BMI<25, viral load <600 000 IU/ml and genotype non-1 are the major determinants of SVR achievement in these patients."									
980	Predictors of adherence to antiretroviral therapy in rural Zambia.	"Carlucci JG, Kamanga A, Sheneberger R, Shepherd BE, Jenkins CA, Spurrier J, Vermund SH."	Journal of Acquired Immune Deficiency Syndromes. 2008 April;47(5):615-22.		"BACKGROUND/OBJECTIVE: Antiretroviral therapy (ART) adherence levels of >=95% optimize outcomes and minimize HIV drug resistance. As such, identifying barriers to adherence is essential. We sought to assess travel to point-of-care for ART as a potential barrier to adherence in rural Zambia, within the context of patient demographics, perceived stigma, and selected clinical indices. METHODS: We studied 424 patients receiving ART from the Macha Mission Hospital (MMH). Interviews ascertained age, gender, education, perceived stigma, nearest rural health facility (RHF), and mode/cost/time of transport for each study participant. Motorcycle odometer and global positioning system way-points measured distance from the MMH to each of the RHFs, estimating patients' home-to-MMH travel distances. Body mass index, World Health Organization HIV/AIDS stage, and pill counts were assessed from review of patients' medical and pharmacy records. RESULTS: At least 95% adherence was documented for 83.7% of the patients in their first months of ART. Travel-related factors did not predict adherence. Adherence was higher for those on ART for a longer time (odds ratio = 1.04 per day; P = 0.002). CONCLUSIONS: Patients in rural Zambia can achieve adherence rates compatible with good clinical outcomes despite long travel distances. The MMH was able to provide quality HIV/AIDS care by implementing programmatic features selecting for a highly adherent population in this resource-limited setting. 2008 Lippincott Williams & Wilkins, Inc."									
674	"Effect of vitamin supplementation on breast milk concentrations of retinol, carotenoids and tocopherols in HIV-infected Tanzanian women."	"Webb AL, Aboud S, Furtado J, Murrin C, Campos H, Fawzi WW, Villamor E."	European Journal of Clinical Nutrition. 2009;63(3):332-9.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=17940544	"BACKGROUND/OBJECTIVE: The effect of daily prenatal and postnatal vitamin supplementation on concentrations of breast milk nutrients is not well characterized in HIV-infected women. We examined the impact of vitamin supplementation during pregnancy and lactation on breast milk concentrations of retinol, carotenoids and tocopherols during the first year postpartum among 626 HIV-infected Tanzanian women."	"SUBJECTS/METHODS: We conducted a randomized, double-blind, placebo-controlled trial. Women were assigned to one of four daily oral supplements: vitamin A+beta-carotene (VA+BC); multivitamins (MV; B, C and E); MV+VA+BC or placebo. Concentrations of breast milk nutrients were determined by high-performance liquid chromatography at birth and every 3 months thereafter."	"RESULTS: Supplementation with VA+BC increased concentrations of retinol, beta-carotene and alpha-carotene at delivery by 4799, 1791 and 84 nmol l(-1), respectively, compared to no VA+BC (all P<0.0001). MV supplementation did not increase concentrations of alpha-tocopherol or delta-tocopherol at delivery but significantly decreased concentrations of breast milk gamma-tocopherol and retinol. Although concentrations of all nutrients decreased significantly by 3 months postpartum, retinol, alpha-carotene and beta-carotene concentrations were significantly higher among those receiving VA+BC at 3, 6 and 12 months compared to no VA+BC. alpha-Tocopherol was significantly higher, while gamma-tocopherol concentrations were significantly lower, among women receiving MV compared to no MV at 3, 6 and 12 months postpartum."	CONCLUSIONS: Sustained supplementation of HIV-infected breastfeeding mothers with MV could be a safe and effective intervention to improve vitamin E concentrations in breast milk. VA+BC supplementation increases concentrations of breast milk retinol but it is not recommended in HIV-infected mothers due to the elevated risk of vertical transmission.						
651	Effect of micronutrient supplementation on diarrhoeal disease among stunted children in rural South Africa.	"Chhagan MK, Broeck Jvd, Luabeya KKA, Mpontshane N, Tucker KL, Bennish ML."	European Journal of Clinical Nutrition. 2009;63(7):850-7.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20093221809	"Background/Objective: The efficacy of zinc combined with vitamin A or multiple micronutrients in preventing diarrhoea is unclear in African countries with high prevalence of human immunodeficiency virus (HIV)-exposed children. Potential modifying factors, such as stunting, need to be addressed. The objective of this study was to determine whether adding zinc or zinc plus multiple micronutrients to vitamin A reduces diarrhoea incidence, and whether this differs between the strata of stunted or HIV-infected children. Methods: We analyzed data from a randomized, controlled, double-blinded trial (ClinicalTrials.gov NCT00156832) of prophylactic micronutrient supplementation to children aged 6-24 months. Three cohorts of children: 32 HIV-infected children, 154 HIV-uninfected children born to HIV-infected mothers and 187 uninfected children born to HIV-uninfected mothers, received vitamin A, vitamin A plus zinc or multiple micronutrients, which included vitamin A and zinc. The main outcome was incidence of diarrhoea. Poisson regression was used in intent-to-treat analyses. Stratified analyses followed testing for statistical interaction between intervention and stunting. Results: We observed no significant differences in overall diarrhoea incidence among treatment arms. Stunting modified this effect with stunted HIV-uninfected children having significantly lower diarrhoea incidence when supplemented with zinc or multiple micronutrients compared with vitamin A alone (2.04 and 2.23 vs 3.92 episodes/year, respectively, P=0.024). No meaningful subgroup analyses could be done in the cohort of HIV-infected children. Conclusions: Compared with vitamin A alone, supplementation with zinc and with zinc and multiple micronutrients, reduced diarrhoea morbidity in stunted rural South African children. Efficacy of zinc supplementation in HIV-infected children needs confirmation in studies that represent the spectrum of disease severity and age groups."									
652	Effect of micronutrient supplementation on diarrhoeal disease among stunted children in rural South Africa.	"Chhagan MK, Van den Broeck J, Luabeya KK, Mpontshane N, Tucker KL, Bennish ML."	European Journal of Clinical Nutrition. 2009;63(7):850-7.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=19174830	"BACKGROUND/OBJECTIVE: The efficacy of zinc combined with vitamin A or multiple micronutrients in preventing diarrhoea is unclear in African countries with high prevalence of human immunodeficiency virus (HIV)-exposed children. Potential modifying factors, such as stunting, need to be addressed. The objective of this study was to determine whether adding zinc or zinc plus multiple micronutrients to vitamin A reduces diarrhoea incidence, and whether this differs between the strata of stunted or HIV-infected children."	"METHODS: We analyzed data from a randomized, controlled, double-blinded trial (ClinicalTrials.gov NCT00156832) of prophylactic micronutrient supplementation to children aged 6-24 months. Three cohorts of children: 32 HIV-infected children, 154 HIV-uninfected children born to HIV-infected mothers and 187 uninfected children born to HIV-uninfected mothers, received vitamin A, vitamin A plus zinc or multiple micronutrients, which included vitamin A and zinc. The main outcome was incidence of diarrhoea. Poisson regression was used in intent-to-treat analyses. Stratified analyses followed testing for statistical interaction between intervention and stunting."	"RESULTS: We observed no significant differences in overall diarrhoea incidence among treatment arms. Stunting modified this effect with stunted HIV-uninfected children having significantly lower diarrhoea incidence when supplemented with zinc or multiple micronutrients compared with vitamin A alone (2.04 and 2.23 vs 3.92 episodes/year, respectively, P=0.024). No meaningful subgroup analyses could be done in the cohort of HIV-infected children."	"CONCLUSIONS: Compared with vitamin A alone, supplementation with zinc and with zinc and multiple micronutrients, reduced diarrhoea morbidity in stunted rural South African children. Efficacy of zinc supplementation in HIV-infected children needs confirmation in studies that represent the spectrum of disease severity and age groups."						
653	Effect of micronutrient supplementation on diarrhoeal disease among stunted children in rural South Africa.	"Chhagan MK, Van den Broeck J, Luabeya KKA, Mpontshane N, Tucker KL, Bennish ML."	European Journal of Clinical Nutrition. 2009;63(7):850-7.		"Background/Objective: The efficacy of zinc combined with vitamin A or multiple micronutrients in preventing diarrhoea is unclear in African countries with high prevalence of human immunodeficiency virus (HIV)-exposed children. Potential modifying factors, such as stunting, need to be addressed. The objective of this study was to determine whether adding zinc or zinc plus multiple micronutrients to vitamin A reduces diarrhoea incidence, and whether this differs between the strata of stunted or HIV-infected children. Methods: We analyzed data from a randomized, controlled, double-blinded trial (ClinicalTrials.gov NCT00156832) of prophylactic micronutrient supplementation to children aged 6-24 months. Three cohorts of children: 32 HIV-infected children, 154 HIV-uninfected children born to HIV-infected mothers and 187 uninfected children born to HIV-uninfected mothers, received vitamin A, vitamin A plus zinc or multiple micronutrients, which included vitamin A and zinc. The main outcome was incidence of diarrhoea. Poisson regression was used in intent-to-treat analyses. Stratified analyses followed testing for statistical interaction between intervention and stunting. Results: We observed no significant differences in overall diarrhoea incidence among treatment arms. Stunting modified this effect with stunted HIV-uninfected children having significantly lower diarrhoea incidence when supplemented with zinc or multiple micronutrients compared with vitamin A alone (2.04 and 2.23 vs 3.92 episodes/year, respectively, P=0.024). No meaningful subgroup analyses could be done in the cohort of HIV-infected children. Conclusions: Compared with vitamin A alone, supplementation with zinc and with zinc and multiple micronutrients, reduced diarrhoea morbidity in stunted rural South African children. Efficacy of zinc supplementation in HIV-infected children needs confirmation in studies that represent the spectrum of disease severity and age groups. 2009 Macmillan Publishers Limited. All rights reserved."									
665	"Predictors of stunting, wasting and underweight among Tanzanian children born to HIV-infected women."	"McDonald CM, Kupka R, Manji KP, Okuma J, Bosch RJ, Aboud S, Kisenge R, et al."	European Journal of Clinical Nutrition. 2012;66(11):1265-76.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=23031850	"BACKGROUND/OBJECTIVES: Children born to human immunodeficiency virus (HIV)-infected women are susceptible to undernutrition, but modifiable risk factors and the time course of the development of undernutrition have not been well characterized. The objective of this study was to identify maternal, socioeconomic and child characteristics that are associated with stunting, wasting and underweight among Tanzanian children born to HIV-infected mothers, followed from 6 weeks of age for 24 months."	"SUBJECTS/METHODS: Maternal and socioeconomic characteristics were recorded during pregnancy, data pertaining to the infant's birth were collected immediately after delivery, morbidity histories and anthropometric measurements were performed monthly. Multivariate Cox proportional hazards methods were used to assess the association between potential predictors and the time to first episode of stunting, wasting and underweight."	"RESULTS: A total of 2387 infants (54.0% male) were enrolled and followed for a median duration of 21.2 months. The respective prevalence of prematurity (<37 weeks) and low birth weight (<2500 g) was 15.2% and 7.0%; 11.3% of infants were HIV-positive at 6 weeks. Median time to first episode of stunting, wasting and underweight was 8.7, 7.2 and 7.0 months, respectively. Low maternal education, few household possessions, low infant birth weight, child HIV infection and male sex were all independent predictors of stunting, wasting and underweight. In addition, preterm infants were more likely to become wasted and underweight, whereas those with a low Apgar score at birth were more likely to become stunted."	"CONCLUSIONS: Interventions to improve maternal education and nutritional status, reduce mother-to-child transmission of HIV, and increase birth weight may lower the risk of undernutrition among children born to HIV-infected women."						
662	"The influence of inflammation on plasma zinc concentration in apparently healthy, HIV+ Kenyan adults and zinc responses after a multi-micronutrient supplement."	"Mburu AS, Thurnham DI, Mwaniki DL, Muniu EM, Alumasa FM."	European Journal of Clinical Nutrition. 2010;64(5):510-7.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=20216563	"BACKGROUND/OBJECTIVES: Plasma zinc is an important biomarker of zinc status, but the concentration is depressed by inflammation."	"SUBJECTS/METHODS: Apparently healthy adults, who tested positive twice for human immunodeficiency virus (HIV) but who had not reached stage IV or clinical AIDS, were randomly allocated to receive a food supplement (n=17 and 21) or the food plus a micronutrient capsule (MN; n=10 men and n=33 women) containing 15 mg zinc/day. We used the inflammation biomarkers, C-reactive protein (CRP) and alpha1-acid glycoprotein (AGP), to identify subjects with and without inflammation and determine the effect of inflammation on the response of plasma zinc concentrations to the MN and food supplements."	"RESULTS: There were no differences between men and women either in plasma zinc or in the responses to the supplements and their data were combined. Plasma zinc was lower in those with inflammation than without. Repeated measures analysis of variance (ANOVA) showed that inflammation blocked increases in plasma zinc, and there was an approximate 10% increase in plasma zinc concentration in response to the MN supplement (P=0.023) in those without inflammation. Subgroup analysis showed mean changes in plasma zinc of 0.95 and -0.83 micromol/l (P=0.031) in response to the MN and food treatments, respectively, in those without inflammation at both time points."	CONCLUSIONS: Inflammation seems to block any increase in plasma zinc after MN supplement and it is important to identify those without inflammation to determine the effectiveness of a zinc supplementation program.						
663	"The influence of inflammation on plasma zinc concentration in apparently healthy, HIV Kenyan adults and zinc responses after a multi-micronutrient supplement."	"Mburu ASW, Thurnham DI, Mwaniki DL, Muniu EM, Alumasa FM."	European Journal of Clinical Nutrition. 2010 May;64(5):510-7.		"Background/Objectives: Plasma zinc is an important biomarker of zinc status, but the concentration is depressed by inflammation. Subjects/Methods: Apparently healthy adults, who tested positive twice for human immunodeficiency virus (HIV) but who had not reached stage IV or clinical AIDS, were randomly allocated to receive a food supplement (n=17 and 21) or the food plus a micronutrient capsule (MN; n=10 men and n=33 women) containing 15 mg zinc/day. We used the inflammation biomarkers, C-reactive protein (CRP) and alpha1-acid glycoprotein (AGP), to identify subjects with and without inflammation and determine the effect of inflammation on the response of plasma zinc concentrations to the MN and food supplements. Results: There were no differences between men and women either in plasma zinc or in the responses to the supplements and their data were combined. Plasma zinc was lower in those with inflammation than without. Repeated measures analysis of variance (ANOVA) showed that inflammation blocked increases in plasma zinc, and there was an approximate 10% increase in plasma zinc concentration in response to the MN supplement (P=0.023) in those without inflammation. Subgroup analysis showed mean changes in plasma zinc of 0.95 and -0.83 mumol/l (P=0.031) in response to the MN and food treatments, respectively, in those without inflammation at both time points. Conclusions: Inflammation seems to block any increase in plasma zinc after MN supplement and it is important to identify those without inflammation to determine the effectiveness of a zinc supplementation program. 2010 Macmillan Publishers Limited All rights reserved."									
664	"The influence of inflammation on plasma zinc concentration in apparently healthy, HIV+ Kenyan adults and zinc responses after a multi-micronutrient supplement."	"Mburu ASW, Thurnham DI, Mwaniki DL, Muniu EM, Alumasa FM."	European Journal of Clinical Nutrition. 2010;64(5):510-7.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20103187356	"Background/Objectives: Plasma zinc is an important biomarker of zinc status, but the concentration is depressed by inflammation. Subjects/Methods: Apparently healthy adults, who tested positive twice for human immunodeficiency virus (HIV) but who had not reached stage IV or clinical AIDS, were randomly allocated to receive a food supplement (n=17 and 21) or the food plus a micronutrient capsule (MN; n=10 men and n=33 women) containing 15 mg zinc/day. We used the inflammation biomarkers, C-reactive protein (CRP) and alpha 1-acid glycoprotein (AGP), to identify subjects with and without inflammation and determine the effect of inflammation on the response of plasma zinc concentrations to the MN and food supplements. Results: There were no differences between men and women either in plasma zinc or in the responses to the supplements and their data were combined. Plasma zinc was lower in those with inflammation than without. Repeated measures analysis of variance (ANOVA) showed that inflammation blocked increases in plasma zinc, and there was an approximate 10% increase in plasma zinc concentration in response to the MN supplement (P=0.023) in those without inflammation. Subgroup analysis showed mean changes in plasma zinc of 0.95 and -0.83 micro mol/l (P=0.031) in response to the MN and food treatments, respectively, in those without inflammation at both time points. Conclusions: Inflammation seems to block any increase in plasma zinc after MN supplement and it is important to identify those without inflammation to determine the effectiveness of a zinc supplementation program."									
666	"Lipid-soluble vitamins A, D, and E in HIV-infected pregnant women in Tanzania."	"Mehta S, Spiegelman D, Aboud S, Giovannucci EL, Msamanga GI, Hertzmark E, Mugusi FM, et al."	European Journal of Clinical Nutrition. 2010;64(8):808-17.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=20517330	"BACKGROUND/OBJECTIVES: There is limited published research examining lipid-soluble vitamins in human immunodeficiency virus (HIV)-infected pregnant women, particularly in resource-limited settings."	"SUBJECTS/METHODS: This is an observational analysis of 1078 HIV-infected pregnant women enrolled in a trial of vitamin supplementation in Tanzania. Baseline data on sociodemographic and anthropometric characteristics, clinical signs and symptoms, and laboratory parameters were used to identify correlates of low plasma vitamin A (<0.7 micromol/l), vitamin D (<80 nmol/l) and vitamin E (<9.7 micromol/l) status. Binomial regression was used to estimate risk ratios and 95% confidence intervals."	"RESULTS: Approximately 35, 39 and 51% of the women had low levels of vitamins A, D and E, respectively. Severe anemia (hemoglobin <85 g/l; P<0.01), plasma vitamin E (P=0.02), selenium (P=0.01) and vitamin D (P=0.02) concentrations were significant correlates of low vitamin A status in multivariate models. Erythrocyte Sedimentation Rate (ESR) was independently related to low vitamin A status in a nonlinear manner (P=0.01). The correlates of low vitamin D status were CD8 cell count (P=0.01), high ESR (ESR >81 mm/h; P<0.01), gestational age at enrollment (nonlinear; P=0.03) and plasma vitamins A (P=0.02) and E (P=0.01). For low vitamin E status, the correlates were money spent on food per household per day (P<0.01), plasma vitamin A concentration (nonlinear; P<0.01) and a gestational age <16 weeks at enrollment (P<0.01)."	CONCLUSIONS: Low concentrations of lipid-soluble vitamins are widely prevalent among HIV-infected women in Tanzania and are correlated with other nutritional insufficiencies. Identifying HIV-infected persons at greater risk of poor nutritional status and infections may help inform design and implementation of appropriate interventions.						
1817	Weight evolution and perceptions of adults living with HIV following initiation of antiretroviral therapy in a South African urban setting.	"Hurley E, Coutsoudis A, Giddy J, Knight SE, Loots E, Esterhuizen TM."	South African Medical Journal. 2011 September;101(9):645-50.		"BackgroundObesity and undernutrition are common in South Africa and influence the health outcomes of people living with the human immunodeficiency virus (PLHIV). Aim. To describe the anthropometric changes and perceptions of body weight in adults initiated on antiretroviral therapy (ART). Methods. A cohort of 230 PLHIV was enrolled at an HIV clinic I Durban. Changes in their body mass index, and waist and hip girth were measured 6-monthly in the 12 months following initiation of ART. Data on demographic and socio-economic variables, CD4 counts, opportunistic infections and drug regimens used were recorded. Perceptions of body weight and desire to change these were ascertained. Results. Weight perceptions of respondents were incongruent with their body mass index, with the trend being to judge themselves as weighing less than their actual weight. Those wanting to gain weight gained an average of 7.8 kg - 2.8 times more than those satisfied with their weight (p<0.001). After 12 months on ART, there was a statistically significant increase in anthropometric measurements (p<0.001) with 43 of the 110 women having waist circumferences that increased their risk of cardiovascular disease; the incidence of lipodystrophy was 35% (62/177) (95% confidence interval 27 - 42%), 36% (64/177) were overweight and 22% (39/177) were obese, compared with 21% (49/230) and 12% (28/230) respectively at baseline (p=0.002). Conclusion. There is a strong association between PLHIV's perception of body weight, their desire to gain weight and their actual weight gain on ART. Lipodystrophy, weight gain and truncal obesity are common among PLHIV after initiating ART."									
356	The action of HIV infection on the height-weight development of children infected postnatally. [Romanian]	Actiunea infectiei cu HIV asupra dezvoltarii staturo-ponderale a copiilor infectati postnatal.	"Cojocaru S, Cojocaru R."		"Bacteriologia, virusologia, parazitologia, epidemiologia (Bucharest, Romania : 1990). 1998 1998;43(1-2):39-42."									
723	A high prevalence of biochemical evidence of vitamin B12 or folate deficiency does not translate into a comparable prevalence of anemia.	Metz J.	Food & Nutrition Bulletin. 2008;29(2 Suppl):S74-85.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=18709883	"Based on biochemical evidence, a high prevalence of biochemical evidence of vitamin B12 or folate deficiency has been reported in a number of areas in the world. The evidence that these biochemical abnormalities lead to a comparable prevalence of anemia is reviewed. The overall contribution of vitamin B12 deficiency to the global burden of anemia is probably not significant, except perhaps in women and their infants and children in vegetarian communities. In developed countries, folate-deficiency anemia is uncommon. In some developing countries, this anemia is still seen, but there are no comprehensive data on the relative prevalence compared with anemia due to malaria, iron-deficiency, hemoglobinopathy, and HIV disease. It seems unlikely that folate deficiency makes a major contribution to the burden of anemia in developing countries. Iron-deficiency anemia may coexist with vitamin B12 and especially folate deficiency, and may confound the hematological features of the vitamin deficiencies whose prevalence would then be underestimated. Supplementation of the diet of pregnant women with folic acid can virtually eliminate folate-deficiency anemia in these women. There are very few data on the hematological effect of vitamin B12 supplementation or fortification at the population level. The addition of vitamin B12 to the supplementation of the diet of pregnant women with iron and folic acid does not produce an increased hematological response, at least in nonvegetarian populations. There are numerous reports of the effect of folic acid fortification of food on tests of folate status, but only a single published report on the hematological response was found. [References: 107]"									
1300	"Hormonal contraception, vitamin A deficiency, and other risk factors for shedding of HIV-1 infected cells from the cervix and vagina."	"Mostad SB, Overbaugh J, DeVange DM, Welch MJ, Chohan B, Mandaliya K, Nyange P, et al."	Lancet. 1997;350(9082):922-7.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh2&AN=19972009609	"Between December, 1994, and April, 1996, women who attended a municipal STD clinic in Mombasa, Kenya, and had previously tested positive for HIV-1, were invited to take part in this cross-sectional study. Cervical and vaginal secretions from 318 women were evaluated for the presence of HIV-1 infected cells by PCR amplification of gag DNA sequences. HIV-1 infected cells were detected in 51% of endocervical and 14% of vaginal-swab specimens. Both cervical and vaginal shedding of HIV-1 infected cells were highly associated with CD4 lymphocyte depletion (P=0.00001 and P=0.003, respectively). After adjustment for CD4 count, cervical proviral shedding was significantly associated with use of depot medroxyprogesterone acetate (odds ratio 2.9, 95% CI 1.5-5.7), and with use of low-dose and high-dose oral contraceptive pills (3.8, 1.4-9.9 and 12.3, 1.5-101, respectively). Vitamin A deficiency was highly predictive of vaginal HIV-1 DNA shedding. After adjustment for CD4 count, severe vitamin A deficiency, moderate deficiency, and low normal vitamin A status were associated with 12.9, 8.0, and 4.9-fold increased odds of vaginal shedding, respectively. Gonococcal cervicitis (3.1, 1.1-9.8) and vaginal candidosis (2.6, 1.2-5.4) were also correlated with significant increases in HIV-1 DNA detection, but Chlamydia trachomatis and Trichomonas vaginalis were not."									
1199	A validation study of body composition by bioelectrical impedance analysis in human immunodeficiency virus (HIV)-positive and HIV-negative Hispanic men and women.	"Forrester JE, Sheehan HM, Joffe TH."	Journal of the American Dietetic Association. 2008;108(3):534-8.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=18313436	"Bioelectrical impedance analysis (BIA) is a potentially useful tool for measuring body composition in people with human immunodeficiency virus (HIV). However, it is not clear that equations derived in healthy non-Hispanic whites can be applied to people who are of other races or ethnicities and who are infected with HIV. Body composition measures done by BIA, using the equations of Lukaski, were compared to measures of body composition derived from dual-energy x-ray absorptiometry (DXA) in Hispanic men and women of Caribbean origin (predominantly Puerto Rican) with and without HIV infection. In cross-sectional analyses, body composition was measured by BIA and DXA in four groups of Hispanics: 97 HIV-positive men, 70 HIV-negative men, 38 HIV-positive women, and 14 HIV-negative women. The method of Bland and Altman was used to evaluate the validity of BIA compared to DXA. Compared to DXA, BIA provided accurate measures of fat-free mass in HIV-positive and HIV-negative Hispanic men. Fat-free mass by BIA compared to DXA was overestimated by 2.7 kg (standard deviation=2.5; P<0.0001) in the HIV-positive Hispanic women and by 3.4 kg (standard deviation=2.6; P<0.01) in the HIV-negative women. The magnitude of the bias in fat-free mass was dependent on fat mass in both the men and the women. BIA, using the equations of Lukaski, appears to be useful in this Hispanic population of Caribbean origin with and without HIV, for whom it provided reasonable estimates of body composition. Fat mass affects the accuracy of estimates."									
1200	A Validation Study of Body Composition by Bioelectrical Impedance Analysis in Human Immunodeficiency Virus (HIV)-Positive and HIV-Negative Hispanic Men and Women.	"Forrester JE, Sheehan HMB, Joffe TH."	Journal of the American Dietetic Association. 2008 March;108(3):534-8.		"Bioelectrical impedance analysis (BIA) is a potentially useful tool for measuring body composition in people with human immunodeficiency virus (HIV). However, it is not clear that equations derived in healthy non-Hispanic whites can be applied to people who are of other races or ethnicities and who are infected with HIV. Body composition measures done by BIA, using the equations of Lukaski, were compared to measures of body composition derived from dual-energy x-ray absorptiometry (DXA) in Hispanic men and women of Caribbean origin (predominantly Puerto Rican) with and without HIV infection. In cross-sectional analyses, body composition was measured by BIA and DXA in four groups of Hispanics: 97 HIV-positive men, 70 HIV-negative men, 38 HIV-positive women, and 14 HIV-negative women. The method of Bland and Altman was used to evaluate the validity of BIA compared to DXA. Compared to DXA, BIA provided accurate measures of fat-free mass in HIV-positive and HIV-negative Hispanic men. Fat-free mass by BIA compared to DXA was overestimated by 2.7 kg (standard deviation=2.5; P<0.0001) in the HIV-positive Hispanic women and by 3.4 kg (standard deviation=2.6; P<0.01) in the HIV-negative women. The magnitude of the bias in fat-free mass was dependent on fat mass in both the men and the women. BIA, using the equations of Lukaski, appears to be useful in this Hispanic population of Caribbean origin with and without HIV, for whom it provided reasonable estimates of body composition. Fat mass affects the accuracy of estimates. 2008 American Dietetic Association."									
1384	[Aspects of blood transfusion in Djibouti].	"Massenet D, Bouh A."	Medecine Tropicale. 1997;57(2):202-5.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=9304018	"Blood transfusion in Djibouti is organized with reference to relevant French regulation and the recommendations of the World Health Organization. The system is basically family donor system operating on the principle of one tested unit of blood for every two untested units donated. Spontaneous donations mainly from the police and army personnel account for only 20% of the 2500 units collected each year. The principle blood products are adult whole blood, adult red cells, and fresh frozen plasma. Products are distributed after viral and microbial testing for infectious disease. Overall the percentage of blood products that are not released due to detection of infectious agents is 17.5%. This rate is well correlated with the incidence of hepatitis B (15.5%), HIV infection (3.4%), hepatitis C (1.5%) and syphilis (0.4%) in Djibouti. The greatest demand for whole blood comes from medical departments where indigent people are treated for anemia due to dietary deficiency. Contamination by HIV present at undetectable levels at the time of testing is a serious problem. Measures should be taken to prevent anemia due to dietary deficiency and develop the use of autologous transfusion."									
107	Impact of protein supplementation and care and support on body composition and CD4 count among HIV-infected women living in rural India: results from a randomized pilot clinical trial.	"Nyamathi A, Sinha S, Ganguly KK, Ramakrishna P, Suresh P, Carpenter CL."	AIDS & Behavior. 2013;17(6):2011-21.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=23370835	"Body composition in HIV-infected individuals is subject to many influences. We conducted a pilot 6-month randomized trial of 68 women living with AIDS (WLA) from rural India. High protein intervention combined with education and supportive care delivered by HIV-trained village women (activated social health activist [Asha] life [AL]) was compared to standard protein with usual care delivered by village community assistants (usual care [UC]). Measurements included CD4 counts, ART adherence, socio-demographics, disease characteristics (questionnaires); and anthropometry (bioimpedance analyzer). Repeated measures analysis of variance modeled associations. AL significantly gained in BMI, muscle mass, fat mass, ART adherence, and CD4 counts compared to UC, with higher weight and muscle mass gains among ART adherent (>=66%) participants who had healthier immunity (CD4 >=450). BMI of WLA improved through high protein supplementation combined with education and supportive care. Future research is needed to determine which intervention aspect was most responsible."									
1060	Prevalence of low bone mineral density in a low-income inner-city population.	"El-Maouche D, Xu XQ, Cofrancesco J, Jr., Dobs AS, Brown TT."	Journal of Bone and Mineral Research. 2011;26(2):388-96.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20113070107	"Bone mineral density (BMD) is an important factor linked to bone health. Little is known of the prevalence of low BMD and its associated risk factors in an urban underserved population. Between 2001 and 2004, we recruited 338 subjects who completed drug use and medical history questionnaires, underwent hormonal measurements, and underwent whole-body dual-energy X-ray absorptiometry (DXA) for evaluation of BMD and body composition. Of these, 132 subjects had site-specific DXA (lumbar spine and hip) performed. Osteoporosis was defined as a T-score of -2.5 or less for men 50 years of age and older and postmenopausal women and a Z-score of -2.0 or less in men younger than 50 years of age and premenopausal women at either the lumbar spine, total hip, or femoral neck, according to National Osteoporosis Foundation (NOF) guidelines. The cohort consisted of mostly African-American, middle-aged people with a high prevalence of illicit drug use, 50% HIV<sup>+</sup>, and 39% hepatitis C<sup>+</sup>. Osteoporosis was identified in 22% of subjects (24 men, 5 women), with the majority of cases (90%) attributable to osteoporosis at the lumbar spine. Osteoporosis was more common in men than in women. Lower whole-body BMD among women was associated with multiple risk factors, but only with lower lean mass among men. Osteoporosis was highly prevalent in men, mainly at the spine. The risk factors for bone loss in this population need to be further clarified. Screening men for osteoporosis starting at age 50 might be warranted in this population given the multiple risk factors and the unexpectedly high prevalence of low BMD."									
1576	Reduced quantitative ultrasound bone mineral density in HIV-infected patients on antiretroviral therapy in Senegal.	"Cournil A, Eymard-Duvernay S, Diouf A, Moquet C, Coutherut J, Ngom Gueye NF, Cames C, et al."	PloS one. 2012;7(2):e31726.		"Bone status in HIV-infected patients on antiretroviral treatment (ART) is poorly documented in resource-limited settings. We compared bone mineral density between HIV-infected patients and control subjects from Dakar, Senegal. A total of 207 (134 women and 73 men) HIV-infected patients from an observational cohort in Dakar (ANRS 1215) and 207 age- and sex-matched controls from the general population were enrolled. Bone mineral density was assessed by quantitative ultrasound (QUS) at the calcaneus, an alternative to the reference method (i.e. dual X-absorptiometry), often not available in resource-limited countries. Mean age was 47.0 (+/-8.5) years. Patients had received ART for a median duration of 8.8 years; 45% received a protease inhibitor and 27% tenofovir; 84% had undetectable viral load. Patients had lower body mass index (BMI) than controls (23 versus 26 kg/m(2), P<0.001). In unadjusted analysis, QUS bone mineral density was lower in HIV-infected patients than in controls (difference: -0.36 standard deviation, 95% confidence interval (CI): -0.59;-0.12, P = 0.003). Adjusting for BMI, physical activity, smoking and calcium intake attenuated the difference (-0.27, CI: -0.53;-0.002, P = 0.05). Differences in BMI between patients and controls explained a third of the difference in QUS bone mineral density. Among patients, BMI was independently associated with QUS bone mineral density (P<0.001). An association between undetectable viral load and QUS bone density was also suggested (beta = 0.48, CI: 0.02;0.93; P = 0.04). No association between protease inhibitor or tenofovir use and QUS bone mineral density was found. Senegalese HIV-infected patients had reduced QUS bone mineral density in comparison with control subjects, in part related to their lower BMI. Further investigation is needed to clarify the clinical significance of these observations."									
1784	Emerging health disparities in Botswana: examining the situation of orphans during the AIDS epidemic.	"Miller CM, Gruskin S, Subramanian SV, Heymann J."	Social Science & Medicine. 2007;64(12):2476-86.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=17442471	"Botswana has the second highest HIV prevalence rate and highest rate of orphanhood in the world. Although child mortality rates have doubled in 15 years, the extent to which health disparities are connected to orphan status remains unclear. We conducted an analysis of the 2000 Botswana Multiple Indicator Cluster Survey to examine whether orphan-based health disparities exist. We measured health inequalities using anthropometric data among 2723 under-five year olds, nested in 1854 households, and 208 communities. We calculated multilevel logistic regression models to estimate the child, household, and regional determinants of growth failure. We found that orphaned children aged 0-4 are 49% more likely to be underweight than nonorphans (p<0.05) controlling for household poverty and other factors; and orphans disproportionately live in the poorest households. Throughout sub-Saharan Africa (SSA), Botswana is a leader in responding to the AIDS epidemic, in particular as one of the first countries to offer universal antiretroviral treatment. However, orphan-based health disparities confirm that the orphan response is still insufficient. Better data are needed to fully understand the mechanisms that lead to these disparities, and the public sector needs an increased capacity to fully implement the policies and programs designed to meet the needs of orphans. Findings from this study have important implications for countries throughout SSA, and Southern Africa in particular, where the number of orphans has doubled to tripled over the past 15 years."									
444	"Effects of the flood regime on the body condition of fish of different trophic guilds in the Upper Parana River floodplain, Brazil"	"Influencia do regime de cheias na condicao corporal de peixes de diferentes guildas troficas na planicie de inundacao do Alto Rio Parana, Brazil."	"Abujanra F, Agostinho AA, Hahn NS."		Brazilian Journal of Biology. 2009 June;69(SUPPL. 2):469-79.									
286	Breastfeeding practices and attitudes relevant to the vertical transmission of HIV in rural south-west Uganda.	"Pool R, Nyanzi S, Whitworth JA."	Annals of Tropical Paediatrics. 2001;21(2):119-25.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=11471254	"Breastfeeding has been associated with a doubling of the risk of HIV transmission. In developed countries, it is recommended that HIV-positive women do not breastfeed, but this is not a feasible option in most of Africa. It is therefore important to know the extent to which breastfeeding practices are amenable to change. To study this, we carried out 24 focus group discussions with 208 women attending maternity clinics in three rural sites in rural south-west Uganda. Breastfeeding starts from a few minutes to a few days after delivery; most women reported starting after 2 days. The main reason for delay is lack of milk or that the breasts are 'blocked'. Most women thought that this delay was good for the baby, or at least not harmful. Almost all women reported giving the child a soup made of boiled mushrooms before starting to breastfeed. Once they have started breastfeeding, various supplementary foods are gradually introduced at 4-6 months. Women thought that ideally breastfeeding should last for 2-3 years, but in practice most stopped after 18 months. The father and his female relatives generally decide when the child should be weaned. The women thought that commercial milk formula foods were good but could not use them because they are too expensive and anyway unavailable in rural areas. Most women were unaware that HIV could be passed to the child through breastfeeding. Various practices identified as potentially risky are common in this population. Artificial feeding is not a viable option in this area, and although women were prepared to make sacrifices to prevent vertical transmission of HIV, practices are deeply ingrained in traditional culture and will need to be addressed in future interventions. Male partners will also need to be involved."									
287	Breastfeeding practices and attitudes relevant to the vertical transmission of HIV in rural south-west Uganda.	"Pool R, Nyanzi S, Whitworth JAG."	Annals of Tropical Paediatrics. 2001;21(2):119-25.		"Breastfeeding has been associated with a doubling of the risk of HIV transmission. In developed countries, it is recommended that HIV-positive women do not breastfeed, but this is not a feasible option in most of Africa. It is therefore important to know the extent to which breastfeeding practices are amenable to change. To study this, we carried out 24 focus group discussions with 208 women attending maternity clinics in three rural sites in rural south-west Uganda. Breastfeeding starts from a few minutes to a few days after delivery; most women reported starting after 2 days. The main reason for delay is lack of milk or that the breasts are 'blocked'. Most women thought that this delay was good for the baby, or at least not harmful. Almost all women reported giving the child a soup made of boiled mushrooms before starting to breastfeed. Once they have started breastfeeding, various supplementary foods are gradually introduced at 4-6 months. Women thought that ideally breastfeeding should last for 2-3 years, but in practice most stopped after 18 months. The father and his female relatives generally decide when the child should be weaned. The women thought that commercial milk formula foods were good but could not use them because they are too expensive and anyway unavailable in rural areas. Most women were unaware that HIV could be passed to the child through breastfeeding. Various practices identified as potentially risky are common in this population. Artificial feeding is not a viable option in this area, and although women were prepared to make sacrifices to prevent vertical transmission of HIV, practices are deeply ingrained in traditional culture and will need to be addressed in future interventions. Male partners will also need to be involved."									
1336	Breastfeeding in HIV exposed infants significantly improves child health: a prospective study.	"Kindra G, Coutsoudis A, Esposito F, Esterhuizen T."	Maternal & Child Health Journal. 2012;16(3):632-40.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=21505776	"Breastfeeding has been shown to benefit both maternal and child immune status. The impact of exclusive breastfeeding in the presence of HIV infection on maternal and child health is still unclear. Socio-economic factors make breast-feeding an important source of nutrition for an infant 6months and under in the developing world. A prospective study was conducted to examine the impact of feeding mode on various maternal indices including anthropometry; body composition indicators (using FTIR); haematology and biochemical markers; as well as incidence rates of opportunistic infections and clinical disease progression. In infants we examined the impact on growth, development and morbidity. AFASS criteria (affordable, feasible, accessible, sustainable and safe) were fulfilled by 38.7% of the formula feeding mothers. No significant differences between the formula feeding and breastfeeding groups in terms of haematological, immunological and body composition changes were seen. Breastfeeding mothers had significantly lower events with high depression scores (P=0.043). Breastfeeding infants had a significantly lower risk of diarrhoea and hospitalisation at 3months (P=0.006 and 0.014 respectively). Breastfeeding was significantly associated with better development scores and growth parameters. Breastfeeding is not harmful to the mother in the presence of HIV infection. Mothers are still choosing formula feeding inappropriately despite counselling about the AFASS criteria. Breastfeeding is beneficial to the infants especially in the first 3months of life."									
467	"Zidovudine-associated mitochondriopathy: Three possible observations in Abidjan, Cote d'Ivoire. [French]"	"Mitochondriopathie associee a la zidovudine. A propos de 3 cas possibles a Abidjan, Cote d'Ivoire."	"Elenga N, Msellati P, Fassinou P, Viho I, Dabis F."		Bulletin de la Societe de Pathologie Exotique. 2004 November;97(4):253-6.									
471	"Trends in sociodemographic and health-related indicators in bangladesh, 1993-2007: Will inequities persist?"	"Evolutions des indicateurs sociodemographiques et sanitaires au bangladesh, 1993-2007: Les inegalites persisteront-elles?"	"Khan MMH, Kramer A, Khandoker A, Prufer-Kramer L, Islam A."		Bulletin of the World Health Organization. 2011 August;89(8):583-93.									
685	"Sixteen days of activism against gender-based violence in Burkina Faso. (Gender violence, HIV and AIDS.)."	"Ilse J, Simon S."	"Exchange on HIV/AIDS, Sexuality and Gender. 2008;3:14-5."	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20093096989	"Burkina Faso is one of the poorest countries in the world with 70 out of 100 people living on less than US$2 a day. Women are particularly affected by poverty as they are generally more vulnerable both economically and socially due to illiteracy. The 2007 and 2008 Human Development Report states that in Burkina Faso, 38% of the children under five years are underweight. The report further states that literacy among the 15-24 year youth category stands at 33% for boys and 27% for girls. Primary school enrolment stands at 51% but with a very low secondary and tertiary enrolment rate for girls."									
480	Mixed linear regression model for longitudinal data: Application to an unbalanced anthropometric data set. [Portuguese]	O modelo de regressao linear misto para dados longitudinais: Uma aplicacao na analise de dados antropometricos desbalanceados.	"Fausto MA, Carneiro M, Antunes CMDF, Pinto JA, Colosimo EA."		Cadernos de Saude Publica. 2008 March;24(3):513-24.									
481	Body mass index in individuals with HIV infection and factors associated with thinness and overweight/obesity	Indice de massa corporal em individuos com infeccao pelo HIV e fatores associados com magreza e sobrepeso/obesidade.	"Mariz CA, de Albuquerque MFPM, Ximenes RAA, de Melo HRL, Bandeira F, e Oliveira TGB, de Carvalho EH, et al."		Cadernos de Saude Publica. 2011 October;27(10):1997-2008.									
486	"The effect of nutritional management on the mortality of malnourished children, uninfected and infected with the human immunodeficiency virus. [French]"	Impact d'une prise en charge nutritionnelle sur la mortalite d'enfants malnutris infectes ou non par le virus de l'immunodeficience humaine.	"Beau JP, Imboua-Coulibaly L, Desgrees Du Lou A."		Cahiers Sante. 1999 May/June;9(3):163-7.									
487	Maternal HIV infection and the anthropometric characteristics of children at birth in Burkina Faso. [French]	Infection maternelle par le VIH et parametres anthropometriques de l'enfant a la naissance au Burkina Faso.	"Sombie I, Nacro B, Tiendrebeogo S, Dao B, Cartoux M, Meda N, Ky-Zerbo O, et al."		Cahiers Sante. 1999 May/June;9(3):173-7.									
680	Cancrum oris (noma) in children.	"Valadas G, Leal MJ."	European Journal of Pediatric Surgery. 1998;8(1):47-51.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=9550277	"Cancrum oris, noma or gangrenous stomatitis is a disease which affects primarily undernourished and immunosuppressed young children. Frequent in underdeveloped countries, it also is seen in rare cases of patients with AIDS and leukemia in America and in Europe. Once fatal, the disease is now better understood and today the repair of its terrible sequels is looked upon as a great surgical challenge. This paper reports a case of noma in a 3-year-old black African female admitted to this Service. In an already advanced stage of this illness with severe sequelae, she presented with partial amputation of the lips (upper and lower), right cheek, right side of the nose and maxilla. The choice of treatment of the infected area and eventual reconstruction is discussed. [References: 21]"									
1117	An atypical case of laryngitis: Laryngeal tuberculosis in the first world traveler.	"Austin CA, Beahm D, Broering GH, St.Cyr S, Lopez FA."	Journal of Investigative Medicine. 2012 January;60 (1):362-3.		"Case Report: Case: A 47 year-old male with no significant past medical history presented to an outpatient otolaryngology clinic with a three month history of sore throat. Upon further questioning, he also related a one year history of hoarseness that preceded his recent sore throat. After a detailed review of systems, the patient revealed other symptoms, including a ten pound weight loss, night sweats, chills, easy fatigability, and non-productive cough of two months duration. His social history was significant for extensive travel to India, Southeastern Asia, and Haiti over the past twenty years, as well as an extensive smoking history of twenty-eight pack years. He also had been incarcerated multiple times over the past five years for three to four days at a time. His physical exam revealed a thin man with tachycardia to the 110s and a body mass index (BMI) of 18. He had bilateral temporal wasting, decreased muscle mass, submandibular lypmhadenopathy (largest measuring 1.5 cm) and hoarseness upon speaking. Labs revealed a total WBC count of 14.3 x103/uL, with 91% segmented neutrophils, hemoglobin of 10.2 g/dL, hematocrit of 32.1%, MCVof 78.8 FL, and an albumin of 2.6g/dL. The final diagnosis made via direct laryngoscopy, which revealed granulomatous disease that had destroyed the larynx and some of the surrounding structures, was consistent with laryngeal tuberculosis. Discussion: A century ago, laryngeal tuberculosis was the most common chronic infection of the larynx. In the following decades the incidence of laryngeal involvement of TB decreased, and several papers published in the 1960's and 1970's labeled the condition a Wforgotten diagnosisW by physicians working in developed countries. Following the emergence of HIV and the dissemination of multi-drug resistant tuberculosis during the 1980's, the disease underwent a world-wide resurgence. Since, there has been a renewed interest in the various expressions of TB including laryngeal tuberculosis, highlighted by several papers that demonstrate changing trends in the epidemiology and presentation of upper airway tuberculosis. Currently, tuberculosis of the upper airway is found in approximately 1% of patients infected with TB."									
1512	Protecting child health worldwide.	"Staton DM, Harding MH."	Pediatric Annals. 2004 October;33(10):647-55.		"Children in developing countries bear most of the burden of childhood death and disease. Because decades of technical and medical research have produced solutions to most of the serious health problems affecting such children, the main challenge ahead remains one of implementation. Achieving this goal will almost certainly require significantly greater commitment by the nations, organizations, and individuals who have the ability to help."									
1342	Determinants of infant feeding choices by Zambian mothers: a mixed quantitative and qualitative study.	"Chisenga M, Siame J, Baisley K, Kasonka L, Filteau S."	Maternal & Child Nutrition. 2011;7(2):148-59.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=21410882	"Choosing an infant feeding mode is complex for human immunodeficiency virus (HIV)-infected African women. We documented infant feeding choices by 811 mothers of infants aged less than 18 months enrolled in the Chilenje Infant Growth, Nutrition and Infection Study of fortified complementary or replacement foods. We also conducted 20 interviews and 4 focus group discussions among women and nurses to explore the issues in depth. Practices of most HIV-infected women did not closely follow national or international guidelines: 26% never initiated breastfeeding, and 55% were not breastfeeding by 6 months post partum. Women of lower socio-economic status and those not meeting criteria for safe replacement feeding were more likely to initiate breastfeeding, to continue longer and to stop at 6 months when provided with free food within the trial. Most HIV-negative women and women of unknown HIV status continued breastfeeding into the infant's second year, indicating limited 'spillover' of infant feeding messages designed for HIV-infected women into the uninfected population. Qualitative work indicated that the main factors affecting HIV-infected women's infant feeding decisions were the cost of formula, the advice of health workers, influence of relatives, stigma and difficulties with using an exclusive feeding mode. Rapidly changing international recommendations confused both mothers and nurses. Many HIV-infected women chose replacement feeding without meeting criteria to do this safely. Women were influenced by health workers but, for several reasons, found it difficult to follow their advice. The recently revised international HIV and infant feeding recommendations may make the counselling process simpler for health workers and makes following their advice easier for HIV-infected women. 2010 Blackwell Publishing Ltd."									
148	Predicting CD4 lymphocyte count <200 cells/mm(3) in an HIV type 1-infected African population.	"Morpeth SC, Crump JA, Shao HJ, Ramadhani HO, Kisenge PR, Moylan CA, Naggie S, et al."	AIDS Research & Human Retroviruses. 2007;23(10):1230-6.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=17961109	"Clinical criteria are recommended to select HIV-infected patients for initiation of antiretroviral therapy when CD4 lymphocyte testing is unavailable. We evaluated the performance characteristics of WHO staging criteria, anthropometrics, and simple laboratory measurements for predicting CD4 lymphocyte count (CD4 count) <200 cells/mm(3) among HIV-infected patients in Tanzania. A total of 202 adults, diagnosed with HIV infection through community-based testing, underwent a detailed evaluation including staging history and examination, anthropometry, complete blood count, erythrocyte sedimentation rate (ESR), and CD4 count. Univariable analysis and recursive partitioning were used to identify characteristics associated with CD4 count 200 cells/mm(3). Of 202 participants 109 (54%) had a CD4 count <200 cells/mm(3). Characteristics most strongly associated with CD4 count <200 cells/mm(3) (p-value <0.0001) were the presence of mucocutaneous manifestations (72% vs. 28%), lower total lymphocyte count (TLC) (median 1,450 vs. 2,200 cells/mm(3)), lower total white blood cell count (median 4,200 vs. 5,500 cells/mm(3)), and higher ESR (median 95 vs. 53 mm/h). In a partition tree model, TLC <1,200 cells/mm(3), ESR >or=120 mm/h, or the presence of mucocutaneous manifestations yielded a sensitivity of 0.85 and specificity of 0.63 for predicting CD4 count <200 cells/mm(3). The sensitivity of the 2006 WHO Staging system improved from 0.75 to 0.93 with inclusion of these parameters, at the expense of specificity (0.36 to 0.26). The presence of mucocutaneous manifestations, TLC <1,200 cells/mm(3), or ESR >or=120 mm/h was a strong predictor of CD4 count <200 cells/mm(3) and enhanced the sensitivity of the 2006 WHO staging criteria for identifying patients likely to benefit from antiretrovirals."									
159	Predicting CD4 lymphocyte count <200 cells/mm<sup>3</sup> in an HIV type 1-infected African population.	"Morpeth SC, Crump JA, Shao HJ, Ramadhani HO, Kisenge PR, Moylan CA, Naggie S, et al."	AIDS Research and Human Retroviruses. 2007;23(10):1230-6.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20073298620	"Clinical criteria are recommended to select HIV-infected patients for initiation of antiretroviral therapy when CD4 lymphocyte testing is unavailable. We evaluated the performance characteristics of WHO staging criteria, anthropometrics, and simple laboratory measurements for predicting CD4 lymphocyte count (CD4 count) <200 cells/mm<sup>3</sup> among HIV-infected patients in Tanzania. A total of 202 adults, diagnosed with HIV infection through community-based testing, underwent a detailed evaluation including staging history and examination, anthropometry, complete blood count, erythrocyte sedimentation rate (ESR), and CD4 count. Univariable analysis and recursive partitioning were used to identify characteristics associated with CD4 count <200 cells/mm<sup>3</sup>. Of 202 participants 109 (54%) had a CD4 count <200 cells/mm<sup>3</sup>. Characteristics most strongly associated with CD4 count <200 cells/mm<sup>3</sup> (p-value <0.0001) were the presence of mucocutaneous manifestations (72% vs. 28%), lower total lymphocyte count (TLC) (median 1450 vs. 2200 cells/mm<sup>3</sup>), lower total white blood cell count (median 4200 vs. 5500 cells/mm<sup>3</sup>), and higher ESR (median 95 vs. 53 mm/h). In a partition tree model, TLC<1200 cells/mm<sup>3</sup>, ESR>=120 mm/h, or the presence of mucocutaneous manifestations yielded a sensitivity of 0.85 and specificity of 0.63 for predicting CD4 count <200 cells/mm<sup>3</sup>. The sensitivity of the 2006 WHO Staging system improved from 0.75 to 0.93 with inclusion of these parameters, at the expense of specificity (0.36 to 0.26). The presence of mucocutaneous manifestations, TLC<1200 cells/mm<sup>3</sup>, or ESR>=120 mm/h was a strong predictor of CD4 count <200 cells/mm<sup>3</sup> and enhanced the sensitivity of the 2006 WHO staging criteria for identifying patients likely to benefit from antiretrovirals."									
158	"Predictors of HIV serostatus among HIV discordant couples in Lusaka, Zambia and female antenatal clinic attendants in Kigali, Rwanda."	"Modjarrad K, Zulu I, Karita E, Kancheya N, Funkhouser E, Allen S."	AIDS Research and Human Retroviruses. 2005;21(1):5-12.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20083064658	"Clinical manifestations of HIV disease in Africa are nonspecific and easily confused with other endemic diseases. Several studies have compared the prevalence of HIV-related signs and symptoms in infected versus uninfected populations, but little is known about differences in HIV disease manifestations between African men and women across geographic areas. We conducted a cross-sectional study to define predictors of HIV status and assess their differences by gender and country in two African cohorts: 1351 heterosexual couples recruited from a voluntary HIV counseling and testing center in Lusaka, Zambia, and 1458 women recruited from antenatal and pediatric clinics in Kigali, Rwanda. HIV-positive Zambian men and women differed most with respect to prevalence of wasting syndrome (48.1% vs. 35.5%, p<0.01). Zambian women were more likely to have a disseminated adenopathy than Rwandan women (33.2% vs. 7.8%, p<0.01) and had a much higher median erythrocyte sedimentation rate (ESR) than either of the two other groups (78 mm/hr vs. 47 mm/hr, p<0.01). Multivariable logistic regression modeling showed a history of tuberculosis [odds ratio (OR): 2.8-20.7], adenopathy on examination (OR: 4.0-6.3), and an ESR of >65 mm/hr (OR: 3.1-5.9) to be strongly predictive of HIV status in all groups. These screening tools, though highly predictive of HIV infection, were insensitive, as most infected persons were asymptomatic. Given these differences in HIV disease manifestation, screening tools based on signs and symptoms should be adapted accordingly. Additional studies are required to evaluate clinical markers as predictors of HIV disease progression and adjust them according to regional and gender differences."									
870	Fetal alcohol syndrome: A South African epidemic.	Viljoen D.	International Journal of Gynecology and Obstetrics. 2009 October;107:S89-S90.		"Clinical Manifestations: Fetal alcohol spectrum disorder (FASD) is the most common cause of preventable mental handicap in the world. It is caused by (usually) heavy alcohol ingestion during pregnancy and results in pre-and post-natal growth retardation, characteristic facies, microcephaly, mental retardation, behavioural abnormalities eg. hyperactivity, school learning difficulties, poor concentration span, inappropriate socio-cultural behaviours and occasional organ system damage eg: cardiac lesions, deafness, optic hypopasia. Prevalence: In South Africa, several communities have been extensively evaluated and found to have very high prevalences of FASD. In the Western Cape, rates of 40-88 per 1000 schoolentry children have been ascertained in 3 evaluations of a single population. In the Northern, Cape Province, the highest reported prevalence of FASD was recorded, namely 119/1000 school-entry children. A further evaluation of school children in Gauteng Province demonstrated rates of 22/1000 amongst black children in Soweto. All these communities far exceeded previous FAS prevalence figures recorded in Europe and the United States where 0.1-12 per 1000 children were estimated to have FASD. Risk Factors: Common to the South African populations studied, mothers at risk of having a child with FASD were found to have poor socio-economic circumstances (R200/week), limited education (<8 years schooling), low BMI (Body Mass Indices) (<22), and low religiosity and to be cigarette smokers (>60%), binge-drinkers (>60 g of absolute alcohol/occasion), and frequently were infected with tuberculosis or HIV/AIDS virus. There was some indication of a genetic predilection for FASD when enzyme/polymorphisms of alcohol metabolism were studied. Prevention: Rates of FASD have been dramatically reduced by brief motivational interventions during pregnancy, and an intensive holistic prevention campaign in the highest-prevalence population in the Northern Cape Province reduced the rates from 119 to 48 per 1000 of the population."									
623	"Nontuberculous mycobacteria, zambia."	"Buijtels PC, van-der-Sande MA, de-Graaff CS, Parkinson S, Verbrugh HA, Petit PL, van-Soolingen D."	Emerging Infectious Diseases. 2009;15(2):242-9.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=19193268	"Clinical relevance of nontuberculous mycobacteria (NTM) isolated from 180 chronically ill patients and 385 healthy controls in Zambia was evaluated to examine the contribution of these isolates to tuberculosis (TB)-like disease. The proportion of NTM-positive sputum samples was significantly higher in the patient group than in controls; 11% and 6%, respectively (p<0.05). NTM-associated lung disease was diagnosed for 1 patient, and a probable diagnosis was made for 3 patients. NTM-positive patients and controls were more likely to report vomiting and diarrhea and were more frequently underweight than the NTM-negative patients and controls. Chest radiographs of NTM-positive patients showed deviations consistent with TB more frequently than those of controls. The most frequently isolated NTM was Mycobacterium avium complex. Multiple, not previously identified mycobacteria (55 of 171 NTM) were isolated from both groups. NTM probably play an important role in the etiology of TB-like diseases in Zambia."									
624	"Nontuberculous mycobacteria, Zambia."	"Buijtels PCAM, Van Der Sande MAB, De Graaff CS, Parkinson S, Verbrugh HA, Petit PLC, Van Soolingen D."	Emerging Infectious Diseases. 2009 February;15(2):242-9.		"Clinical relevance of nontuberculous mycobacteria (NTM) isolated from 180 chronically ill patients and 385 healthy controls in Zambia was evaluated to examine the contribution of these isolates to tuberculosis (TB)-like disease. The proportion of NTM-positive sputum samples was significantly higher in the patient group than in controls; 11% and 6%, respectively (p<0.05). NTM-associated lung disease was diagnosed for 1 patient, and a probable diagnosis was made for 3 patients. NTM-positive patients and controls were more likely to report vomiting and diarrhea and were more frequently underweight than the NTM-negative patients and controls. Chest radiographs of NTM-positive patients showed deviations consistent with TB more frequently than those of controls. The most frequently isolated NTM was Mycobacterium avium complex. Multiple, not previously identified mycobacteria (55 of 171 NTM) were isolated from both groups. NTM probably play an important role in the etiology of TB-like diseases in Zambia."									
512	Antiretroviral treatment-associated tuberculosis in a prospective cohort of HIV-infected patients starting ART.	"Worodria W, Massinga-Loembe M, Mayanja-Kizza H, Namaganda J, Kambugu A, Manabe YC, Kestens L, et al."	Clinical & developmental immunology. 2011;2011:758350.		"Commencement of antiretroviral treatment (ART) in severely immunosuppressed HIV-infected persons is associated with unmasking of subclinical disease. The subset of patients that are diagnosed with tuberculosis (TB) disease while on ART have been classified as ART-associated TB. Few studies have reported the incidence of ART-associated TB and unmasking TB-IRIS according to the International Network for the Study of HIV-Associated IRIS (INSHI) consensus definition. To determine the incidence and predictors of ART-associated TB, we screened 219 patients commencing ART at the Infectious Diseases Clinic in Kampala, Uganda for TB by symptoms, sputum microscopy, and chest X-rays and followed them for one year. Fourteen (6.4%) patients were diagnosed with TB during followup. Eight (3.8%) patients had ART-associated TB (incidence rate of 4.3 per 100 person years); of these, three patients fulfilled INSHI criteria for unmasking TB-associated IRIS (incidence rate of 1.6 per 100 person years). A body mass index of less than 18.5kg/m(2) BMI (HR 5.85 95% CI 1.24-27.46, P = .025) and a C-reactive protein greater than 5mg/L (HR 8.23 95% CI 1.36-38.33, P = .020) were risk factors for ART-associated TB at multivariate analysis. In conclusion, with systematic TB screening (including culture and chest X-ray), the incidence of ART-associated TB is relatively low in settings with high HIV and TB prevalence."									
41	Farming for balanced nutrition: an agricultural approach to addressing micronutrient deficiency among the vulnerable poor in Africa.	Hillocks RJ.	"African Journal of Food, Agriculture, Nutrition and Development. 2011;11(2):4688-707."	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20113132565	"Concepts on malnutrition have evolved from an emphasis on protein deficiency through energy deficit, to the realization that food quality in general and an adequate supply of micronutrients in particular, is often more of a problem than food quantity. Throughout the developing world, micronutrient deficiency is one of the most important factors influencing human health, being directly responsible for conditions such as xeropthalmia, associated with vitamin A deficiency and anaemia, due to iron deficiency. In addition, micronutrient deficiency predisposes children to infection and retards recovery from common infections such as malaria, measles and diarrhoea. The groups most at risk from micronutrient deficiency are usually children and those for whom labour for food production is limited by ill health (HIV sufferers), advanced age or intense social commitments (single mothers, for example). There have been numerous health projects in sub-Saharan Africa and elsewhere in the developing world, to address micronutrient deficiency through the distribution of vitamin and mineral supplements, which usually have to be imported. An alternative (or complementary) approach is to promote the inclusion of high quality food crops in the farming system to enrich the diet with essential vitamins and minerals. This agricultural approach to the problem of micronutrient deficiency can provide sustainable solutions, which improve diet quality. An increase in the cultivation of high quality foods such as legumes, fruits and green vegetables, may be able to deliver a balanced diet to households, without necessarily requiring additional land and labour. Agricultural approaches to enhance dietary intake of vitamins and minerals have the additional advantage that they foster community self-reliance, they are sustainable in the absence of external funding, and, offer the opportunity for enhanced income by marketing surplus production. Diet diversification through better use of existing biodiversity offers an immediate means to address poor diet quality and can also include the use of presently available nutritionally enhanced crops, such as orange-fleshed sweet potato."									
1758	Lack of association between nutritional status and change in clinical category among HIV-infected children in Brazil.	"Centeville M, Morcillo AM, Barros Filho Ade A, Silva MT, Toro AA, Vilela MM."	Sao Paulo Medical Journal = Revista Paulista de Medicina. 2005;123(2):62-6.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=15947832	CONTEXT AND OBJECTIVE: Malnutrition is common among HIV-infected children. Our objective was to study the occurrence of malnutrition and its relationship with changes in clinical category among HIV-infected children.	"DESIGN AND SETTING: Longitudinal study, at the Pediatrics Department and Pediatrics Investigation Center (CIPED), Faculdade de Ciencias Medicas da Universidade Estadual de Campinas (Unicamp)."	"METHODS: We reviewed the hospital records of 127 vertically HIV-infected children. Anthropometric measurements were obtained at the beginning of follow-up, at clinical category change and five months later. These were converted to z-scores of weight/age, height/age and weight/height. Data were presented as means, standard deviations, frequency counts and percentages. The Wilcoxon and Kruskal-Wallis tests and odds ratios were used in the analysis."	"RESULTS: We found that 51 (40.2%) were undernourished and 40 (31.5%) were stunted, with higher risk of being included in clinical category C. There was an association between nutritional condition and the clinical categories of the Centers for Disease Control classification (1994), and with age at symptom onset (except for height z-score). During follow-up, 36 patients (28.4%) changed their clinical category, which occurred early among the undernourished patients. The group that changed its clinical category maintained the same z-score distribution for weight, height and weight/height throughout follow-up."	"CONCLUSION: Aids manifestation severity was associated with nutritional status and with age at symptom onset, but change in clinical category was not followed by worsening of nutritional status."					
1756	Lack of association between nutritional status and change in clinical category among HIV-infected children in Brazil.	"Centeville M, Morcillo AM, Barros Filho AdA, Silva MTNd, Toro AADC, Vilela MMdS."	Sao Paulo Medical Journal. 2005;123(2):62-5.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20073170361	"CONTEXT AND OBJECTIVE: Malnutrition is common among HIV-infected children. Our objective was to study the occurrence of malnutrition and its relationship with changes in clinical category among HIV-infected children. DESIGN AND SETTING: Longitudinal study, at the paediatrics Department and paediatrics Investigation centre (CIPED), Faculdade de Ciencias Medicas da Universidade Estadual de Campinas (Unicamp). METHODS: We reviewed the hospital records of 127 vertically HIV-infected children. Anthropometric measurements were obtained at the beginning of follow-up, at clinical category change and five months later. These were converted to z-scores of weight/age, height/age and weight/height. Data were presented as means, standard deviations, frequency counts and percentages. The Wilcoxon and Kruskal-Wallis tests and odds ratios were used in the analysis. RESULTS: We found that 51 (40.2%) were undernourished and 40 (31.5%) were stunted, with higher risk of being included in clinical category C. There was an association between nutritional condition and the clinical categories of the centres for Disease Control classification (1994), and with age at symptom onset (except for height z-score). During follow-up, 36 patients (28.4%) changed their clinical category, which occurred early among the undernourished patients. The group that changed its clinical category maintained the same z-score distribution for weight, height and weight/height throughout follow-up. CONCLUSION: Aids manifestation severity was associated with nutritional status and with age at symptom onset, but change in clinical category was not followed by worsening of nutritional status."									
1757	Lack of association between nutritional status and change in clinical category among HIV-infected children in Brazil.	"Centeville M, Moreno Morcillo A, de Azevedo Barros Filho A, Nolasco da Silva MT, Dalbo Contrera Toro AA, dos Santos Vilela MM."	Sao Paulo Medical Journal. 2005 02 Mar;123(2):62-5.		"Context and objective: Malnutrition is common among HIV-infected children. Our objective was to study the occurrence of malnutrition and its relationship with changes in clinical category among HIV-infected children. Design and setting: Longitudinal study, at the Pediatrics Department and Pediatrics Investigation Center (CIPED), Faculdade de Ciencias Medicas da Universidade Estadual de Campinas (Unicamp). Methods: We reviewed the hospital records of 127 vertically HIV-infected children. Anthropometric measurements were obtained at the beginning of follow-up, at clinical category change and five months later. These were converted to z-scores of weight/age, height/age and weight/height. Data were presented as means, standard deviations, frequency counts and percentages. The Wilcoxon and Kruskal-Wallis tests and odds ratios were used in the analysis. Results: We found that 51 (40.2%) were undernourished and 40 (31.5%) were stunted, with higher risk of being included in clinical category C. There was an association between nutritional condition and the clinical categories of the Centers for Disease Control classification (1994), and with age at symptom onset (except for height z-score). During follow-up, 36 patients (28.4%) changed their clinical category, which occurred early among the undernourished patients. The group that changed its clinical category maintained the same z-score distribution for weight, height and weight/height throughout follow-up. Conclusion: Aids manifestation severity was associated with nutritional status and with age at symptom onset, but change in clinical category was not followed by worsening of nutritional status."									
961	Morbidity and mortality in breastfed and formula-fed infants of HIV-1-infected women: A randomized clinical trial.	"Mbori-Ngacha D, Nduati R, John G, Reilly M, Richardson B, Mwatha A, Ndinya-Achola J, et al."	JAMA. 2001;286(19):2413-20.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medc&AN=11712936	"CONTEXT: Breastfeeding among women infected with human immunodeficiency virus type 1 (HIV-1) is associated with substantial risk of HIV-1 transmission, but little is known about the morbidity risks associated with formula feeding in infants of HIV-1-infected women in resource-poor settings."	"OBJECTIVE: To compare morbidity, nutritional status, mortality adjusted for HIV-1 status, and cause of death among formula-fed and breastfed infants of HIV-1-infected women."	DESIGN: Randomized clinical trial conducted between 1992 and 1998.	"SETTING: Four antenatal clinics in Nairobi, Kenya."	"PARTICIPANTS: Of 401 live-born, singleton, or first-born twin infants of randomized HIV-1-seropositive mothers, 371 were included in the analysis of morbidity and mortality."	INTERVENTIONS: Mothers were randomly assigned either to use formula (n = 186) or to breastfeed (n = 185) their infants.	"MAIN OUTCOME MEASURES: Mortality rates, adjusted for HIV-1 infection status; morbidity; and nutritional status during the first 2 years of life."	"RESULTS: Two-year estimated mortality rates among infants were similar in the formula-feeding and breastfeeding arms (20.0% vs 24.4%; hazard ratio [HR], 0.8; 95% confidence interval [CI], 0.5-1.3), even after adjusting for HIV-1 infection status (HR, 1.1; 95% CI, 0.7-1.7). Infection with HIV-1 was associated with a 9.0-fold increased mortality risk (95% CI, 5.3-15.3). The incidence of diarrhea during the 2 years of follow-up was similar in formula and breastfeeding arms (155 vs 149 per 100 person-years, respectively). The incidence of pneumonia was identical in the 2 groups (62 per 100 person-years), and there were no significant differences in incidence of other recorded illnesses. Infants in the breastfeeding arm tended to have better nutritional status, significantly so during the first 6 months of life."	"CONCLUSIONS: In this randomized clinical trial, infants assigned to be formula fed or breastfed had similar mortality rates and incidence of diarrhea and pneumonia during the first 2 years of life. However, HIV-1-free survival at 2 years was significantly higher in the formula arm. With appropriate education and access to clean water, formula feeding can be a safe alternative to breastfeeding for infants of HIV-1-infected mothers in a resource-poor setting."	
1205	Efficacy and safety of emtricitabine vs stavudine in combination therapy in antiretroviral-naive patients: A randomized trial.	"Saag MS, Cahn P, Raffi F, Wolff M, Pearce D, Molina JM, Powderly W, et al."	Journal of the American Medical Association. 2004 14 Jul;292(2):180-90.		"Context: Emtricitabine is a new, once-daily nucleoside reverse transcriptase inhibitor (NRTI) with potent activity against human immunodeficiency virus (HIV). Objective: To assess the efficacy and safety of emtricitabine as compared with stavudine when used with a background regimen of didanosine and efavirenz. Design, Setting, and Patients: Randomized, double-blind, double-dummy study conducted at 101 research clinics in North America, Latin America, and Europe. The first patient was enrolled on August 21, 2000; no investigator or patient was unblinded until the last patient randomized completed the week 48 visit on October 24, 2002. Analyses were based on data collected in a double-blind setting with a median follow-up of 60 weeks. Patients were 571 antiretroviral-naive, HIV-1-infected adults aged 18 years or older with viral load levels greater than or equal to 5000 copies/mL. Interventions: Receipt of either 200 mg of emtricitabine once daily (plus stavudine placebo twice daily) (n=286) or stavudine at standard doses twice daily (plus emtricitabine placebo once daily) (n=285) plus open-label didanosine and efavirenz, once daily. Main Outcome Measure: Persistent virological response, defined as achieving and maintaining viral load at or below the limit of assay quantification (<=400 or 50 copies/mL). Results: At the interim analysis on June 14, 2002, when the last patient randomized completed 24 weeks of double-blind treatment (median follow-up time of 42 weeks), patients in the emtricitabine group had a higher probability of a persistent virological response <=50 copies/mL vs the stavudine group (85% vs 76%, P=.005). This was associated with a higher mean CD4 cell count change from baseline for the emtricitabine group (156 cells/muL vs 119 cells/muL, P=.01 [of note, there was no statistical difference at 48 weeks "	"P=.02}]). The independent data and safety monitoring board recommended offering open-label emtricitabine based on the interim analysis. The probability of persistent virological response <=50 copies/mL through week 60 was 76% for the emtricitabine group vs 54% for the stavudine group (P<.001). The probability of virological failure through week 60 was 4% in the emtricitabine group and 12% in the stavudine group (P<.001). Patients in the stavudine group had a greater probability of an adverse event that led to study drug discontinuation through week 60 than did those in the emtricitabine group (15% vs 7%, P=.005). Conclusion: Once-daily emtricitabine appeared to demonstrate greater virological efficacy, durability of response, and tolerability compared with twice-daily stavudine when used with once-daily didanosine and efavirenz."								
1172	HIV neuropathy risk factors and symptom characterization in stavudine-exposed South Africans.	"Wadley AL, Cherry CL, Price P, Kamerman PR."	Journal of Pain and Symptom Management. 2011 April;41(4):700-6.		"Context: HIV-associated sensory neuropathy (HIV-SN) is a frequent complication of both HIV and neurotoxic antiretroviral medications such as stavudine. Objectives: To determine the prevalence, risk factors, and clinical characteristics of symptomatic HIV-SN in a Black South African cohort of patients exposed to stavudine. Methods: HIV-positive Black South Africans (n = 395) who had received stavudine for at least six months were recruited at the Virology Clinic of the Charlotte Maxeke Academic Johannesburg Hospital, South Africa, and screened for neuropathy using the AIDS Clinical Trials Group neuropathy screening tool. HIV-SN was defined as present if the patient had both symptoms and signs of peripheral neuropathy. If present, the distribution and intensity of symptoms were recorded. In addition, anthropomorphic, demographic, and clinical information were recorded and analyzed as risk factors. Results: The prevalence of symptomatic HIV-SN was 57% (226 of 395). Increasing age and height were independently associated with the development of SN among patients who had used stavudine. Pain was the primary symptom reported by participants with HIV-SN (76%, 172 of 226), followed by numbness (48%, 108 of 226), and pins and needles (46%, 105 of 226). About three-quarters of participants rated their symptoms as being of moderate to severe intensity. Symptoms were always present in the feet and only 23% experienced symptoms proximal to the feet. Conclusion: HIV-SN was common in this population and frequently associated with moderate to severe pain in the feet. HIV-SN was significantly associated with increasing age and height, factors that could be measured at no added cost prior to stavudine prescription, allowing higher risk patients to be offered priority access to nonneurotoxic drugs. 2011 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved."									
807	Assessment of quality of life of HIV-positive people receiving art: an Indian perspective.	"Deepika A, Seema P, Mathew M."	Indian Journal of Community Medicine. 2012;37(3):165-9.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20123313221	"Context: HIV/AIDS is known to affect an individual not only physically but also mentally, socially, and financially. It is a syndrome that builds a vacuum in a person affecting his/her life as a whole. Aims: The purpose of the present study is to evaluate the quality of life (QOL) of people living with HIV/AIDS (PLHIV) receiving ART and its association with Body mass index (BMI) and CD4 count. Study Design: An observational study was performed on PLHIV receiving ART in Orissa, India. Materials and Methods: Data on sociodemographic profile, BMI, and CD4 were gathered from 153 HIV-positive subjects. QOL was assessed using WHOQOL-HIV BREF scale. Results: The overall QOL score of the subjects was moderate; PLHIV with lower BMI also had poorer QOL (P<0.05). Employment affected only the social health domain of the subjects. Men reported poorer level of independence and physical health while women reported poorer social relationships and environment. All the six domains correlated significantly with the overall QOL indicated by the G-facet. Conclusion: Attention toward improving the nutritional status of PLHIV should be accorded high priority to ensure improvement in the overall QOL of PLHIV."									
1063	"Vitamin D toxicity due to a commonly available ""over the counter"" remedy from the Dominican Republic."	"Lowe H, Cusano NE, Binkley N, Blaner WS, Bilezikian JP."	Journal of Clinical Endocrinology & Metabolism. 2011;96(2):291-5.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=21123442	CONTEXT: Hypercalcemia in ambulatory patients is occasionally caused by vitamin D toxicity.	OBJECTIVE: We report nine patients presenting to Columbia University Medical Center with hypercalcemia due to a supplement from the Dominican Republic containing massive amounts of vitamin D.	"METHODS: Case histories and laboratory evaluation (calcium, PTH, vitamin D metabolites) are discussed in the context of other published cases of vitamin D toxicity. The supplement was analyzed by HPLC to quantitate vitamin D and A content."	"RESULTS: Nine patients presented with hypercalcemia (range, 10.8-17.2 mg/dl; normal, 8.4-9.8 mg/dl), suppressed PTH (range, <3 to 11 pg/ml), and elevated 25-hydroxyvitamin D (range, 94-525 ng/ml; normal, 30-80 ng/ml) levels. All reported recently taking an over-the-counter vitamin supplement called Soladek readily available in the Dominican Republic and in Upper Manhattan. Although serum calcium values before the ingestion of Soladek were not elevated (baseline serum calcium range, 8.7-9.2 mg/dl), most had a disorder that can be associated with hypercalcemia [squamous cell cancer (n = 1), Pneumocystis or mycobacterial infection (n = 3), lymphoma (n = 1), granulomatous disease (n = 1), hyperthyroidism (n = 2)]. According to the manufacturer's label, each 5-ml vial of Soladek contains vitamin D (600,000 IU), vitamin A (120,000 IU), and vitamin E (5 mg). Laboratory analysis by HPLC revealed that the supplement actually contained vitamin D(3) (864,000 IU) and vitamin A (predominantly retinyl palmitate 123,500 IU) per vial."	"CONCLUSION: Although hypercalcemia due to exogenous use of vitamin D is unusual, it is important to consider it in the differential diagnosis, particularly among individuals with access to Soladek."					
960	Effect of high-dose vs standard-dose multivitamin supplementation at the initiation of HAART on HIV disease progression and mortality in Tanzania: a randomized controlled trial.	"Isanaka S, Mugusi F, Hawkins C, Spiegelman D, Okuma J, Aboud S, Guerino C, et al."	JAMA. 2012;308(15):1535-44.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=23073950	"CONTEXT: Large randomized trials have previously shown that high-dose micronutrient supplementation can increase CD4 counts and reduce human immunodeficiency virus (HIV) disease progression and mortality among individuals not receiving highly active antiretroviral therapy (HAART); however, the safety and efficacy of such supplementation has not been established in the context of HAART."	"OBJECTIVE: To test the hypothesis that high-dose multivitamin supplementation vs standard-dose multivitamin supplementation decreases the risk of HIV disease progression or death and improves immunological, virological, and nutritional parameters in patients with HIV initiating HAART."	"DESIGN, SETTING, AND PARTICIPANTS: A randomized, double-blind, controlled trial of high-dose vs standard-dose multivitamin supplementation for 24 months in 3418 patients with HIV initiating HAART between November 2006 and November 2008 in 7 clinics in Dar es Salaam, Tanzania. INTERVENTION The provision of daily oral supplements of vitamin B complex, vitamin C, and vitamin E at high levels or standard levels of the recommended dietary allowance."	MAIN OUTCOME MEASURE: The composite of HIV disease progression or death from any cause.	"RESULTS: The study was stopped early in March 2009 because of evidence of increased levels of alanine transaminase (ALT) in patients receiving the high-dose multivitamin supplement. At the time of stopping, 3418 patients were enrolled (median follow-up, 15 months), and there were 2374 HIV disease progression events and 453 observed deaths (2460 total combined events). Compared with standard-dose multivitamin supplementation, high-dose supplementation did not reduce the risk of HIV disease progression or death. The absolute risk of HIV progression or death was 72% in the high-dose group vs 72% in the standard-dose group (risk ratio [RR], 1.00; 95% CI, 0.96-1.04). High-dose supplementation had no effect on CD4 count, plasma viral load, body mass index, or hemoglobin level concentration, but increased the risk of ALT elevations (1239 events per 1215 person-years vs 879 events per 1236 person-years; RR, 1.44; 95% CI, 1.11-1.87) vs standard-dose supplementation. CONCLUSION In adults receiving HAART, use of high-dose multivitamin supplements compared with standard-dose multivitamin supplements did not result in a decrease in HIV disease progression or death but may have resulted in an increase in ALT levels."	TRIAL REGISTRATION: Clinicaltrials.gov Identifier: NCT00383669.				
1523	The clinical burden of tuberculosis among human immunodeficiency virus-infected children in Western Kenya and the impact of combination antiretroviral treatment.	"Braitstein P, Nyandiko W, Vreeman R, Wools-Kaloustian K, Sang E, Musick B, Sidle J, et al."	Pediatric Infectious Disease Journal. 2009;28(7):626-32.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20093227167	"Context: The burden of tuberculosis (TB) disease in children, particularly in HIV-infected children, is poorly described because of a lack of effective diagnostic tests and the emphasis of public health programs on transmissible TB. Objectives: The objectives of this study were to describe the observed incidence of and risk factors for TB diagnosis among HIV-infected children enrolled in a large network of HIV clinics in western Kenya. Design: Retrospective observational study. Setting: The USAID-Academic Model Providing Access to Healthcare (AMPATH) Partnership is Kenya's largest HIV/AIDS care system. Since 2001, the program has enrolled over 70,000 HIV-infected patients in 18 clinics throughout Western Kenya. Patients: This analysis included all HIV-infected children aged 0 to 13 years attending an AMPATH clinic. Main Outcome Measure: The primary outcome was a diagnosis of any TB, defined either by a recorded diagnosis or by the initiation of anti-TB treatment. Diagnosis of TB is based on a modified Kenneth Jones scoring system and is consistent with WHO case definitions. Results: There were 6535 HIV-infected children aged 0 to 13 years, eligible for analysis, 50.1% were female. Of these, 234 (3.6%) were diagnosed with TB at enrollment. There were subsequently 765 new TB diagnoses in 4368.0 child-years of follow-up for an incidence rate of 17.5 diagnoses (16.3-18.8) per 100 child-years. The majority of these occurred in the first 6 months after enrollment (IR: 106.8 per 100 CY, 98.4-115.8). In multivariable analysis, being severely immune-suppressed at enrollment (Adjusted Hazard Ratio [AHR]: 4.44, 95% CI: 3.62-5.44), having ever attended school (AHR: 2.65, 95% CI: 2.15-3.25), being an orphan (AHR: 1.57, 95% CI: 1.28-1.92), being severely low weight-for-height at enrollment (AHR: 1.46, 95% CI: 1.32-1.62), and attending an urban clinic (AHR: 1.39, 95% CI: 1.16-1.67) were all independent risk factors for having an incident TB diagnosis. Children receiving combination antiretroviral treatment were dramatically less likely to be diagnosed with incident TB (AHR: 0.15, 95% CI: 0.12-0.20). Conclusions: These data suggest a high rate of TB diagnosis among HIV-infected children, with severe immune suppression, school attendance, orphan status, very low weight-for-height, and attending an urban clinic being key risk factors. The use of combination antiretroviral treatment reduced the probability of an HIV-infected child being diagnosed with incident TB by 85%."									
1206	Rapid scale-up of antiretroviral therapy at primary care sites in Zambia: Feasibility and early outcomes.	"Stringer JSA, Zulu I, Levy J, Stringer EM, Mwango A, Chi BH, Mtonga V, et al."	Journal of the American Medical Association. 2006 16 Aug;296(7):782-93.		"Context: The Zambian Ministry of Health has scaled-up human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) care and treatment services at primary care clinics in Lusaka, using predominately nonphysician clinicians. Objective: To report on the feasibility and early outcomes of the program. Design, Setting, and Patients: Open cohort evaluation of antiretroviral-naive adults treated at 18 primary care facilities between April 26, 2004, and November 5, 2005. Data were entered in real time into an electronic patient tracking system. Intervention: Those meeting criteria for antiretroviral therapy (ART) received drugs according to Zambian national guidelines. Main Outcome Measures: Survival, regimen failure rates, and CD4 cell response. Results: We enrolled 21 755 adults into HIV care, and 16 198 (75%) started ART. Among those starting ART, 9864 (61%) were women. Of 15 866 patients with documented World Health Organization (WHO) staging, 11 573 (73%) were stage III or IV, and the mean (SD) entry CD4 cell count among the 15 336 patients with a baseline result was 143/muL (123/muL). Of 1142 patients receiving ART who died, 1120 had a reliable date of death. Of these patients, 792 (71%) died within 90 days of starting therapy (early mortality rate: 26 per 100 patient-years), and 328 (29%) died after 90 days (post-90-day mortality rate: 5.0 per 100 patient-years). In multivariable analysis, mortality was strongly associated with CD4 cell count between 50/muL and 199/muL (adjusted hazard ratio [AHR], 1.4; 95% confidence interval [CI], 1.0-2.0), CD4 cell count less than 50/muL (AHR, 2.2; 95% CI, 1.5-3.1), WHO stage III disease (AHR, 1.8; 95% CI, 1.3-2.4), WHO stage IV disease (AHR, 2.9; 95% CI, 2.0-4.3), low body mass index (<16; AHR,2.4; 95% CI, 1.8-3.2), severe anemia (<8.0 g/dL; AHR, 3.1; 95% CI, 2.3-4.0), and poor adherence to therapy (AHR, 2.9; 95% CI, 2.2-3.9). Of 11 714 patients at risk, 861 failed therapy by clinical criteria (rate, 13 per 100 patient-years). The mean (SD) CD4 cell count increase was 175/muL (174/muL) in 1361 of 1519 patients (90%) receiving treatment long enough to have a 12-month repeat. Conclusion: Massive scale-up of HIV and AIDS treatment services with good clinical outcomes is feasible in primary care settings in sub-Saharan Africa. Most mortality occurs early, suggesting that earlier diagnosis and treatment may improve outcomes. 2006 American Medical Association. All rights reserved."									
1759	Evolution of nutritional status of infants infected with the human immunodeficiency virus.	"Leandro-Merhi VA, Vilela MM, Silva MN, Lopez FA, Barros Filho A."	Sao Paulo medical journal = Revista paulista de medicina. 2000 7 Sep;118(5):148-53.		"CONTEXT: There are today only a limited number of studies defining growth parameters and nutritional status for HIV children. OBJECTIVE: To study the nutritional status of infants infected with the human immunodeficiency virus. TYPE OF STUDY: Longitudinal study. SETTING: Department of Pediatrics, Faculty of Medical Sciences, UNICAMP, Campinas, Brazil. PARTICIPANTS: One hundred and twenty-four children born to HIV infected mothers were evaluated from birth until the age of two years. They were subdivided into two groups: 71 infected children and 53 non-infected children. MAIN MEASUREMENTS: Growth was evaluated in both groups by comparing Z-scores for weight/age (w/a), length/age (H/a) and weight/length (w/H) (using the NCHS curves as reference). RESULTS: The Z-score analyses showed that there was a significant difference between the two groups for all the variables studied, except for the H/a value at 3 months of age and the W/H value at 21 months of age, which showed P > 0.05. CONCLUSIONS: The growth of infected infants was observed to be severely affected in comparison with that of seroreversed infants in the same age groups. Although clinical manifestations may take time to appear, the onset of growth changes begin soon after birth."									
1669	"Food insecurity, malnutrition and mortality in Maewo and Ambae islands, Vanuatu."	Renzaho AMN.	Public Health Nutrition. 2006;9(6):798-807.		"Context: This paper reports on findings from the ex-post evaluation of the Maewo Capacity Building project in Maewo Island, Vanuatu, which was funded by World Vision Australia. Objectives: To examine the extent to which the infrastructure and systems left behind by the project contributed to the improvement of household food security and health and nutritional outcomes in Maewo Island, using Ambae Island as a comparator. Setting: Two-stage cluster survey conducted from 6 to 20 July 2004, which included anthropometric measures and 4.5-year retrospective mortality data collection. Participants: A total of 406 households in Maewo comprising 1623 people and 411 households in Ambae comprising 1799 people. Main outcome measures: Household food insecurity, crude mortality rate (CMR), under-five mortality rate (U5MR) and malnutrition prevalence among children. Results: The prevalence of food insecurity without hunger was estimated at 15.3% (95% confidence interval (CI): 12.1, 19.2%) in Maewo versus 38.2% (95% CI: 33.6, 43.0%) in Ambae, while food insecurity with hunger in children did not vary by location. After controlling for the child's age and gender, children in Maewo had higher weight-for-age and height-for-age Z-scores than children of the same age in Ambae. The CMR was lower in Maewo (CMR = 0.47/10 000 per day, 95% CI: 0.39, 0.55) than in Ambae (CMR = 0.59/10 000 per day, 95% CI: 0.51, 0.67) but no difference existed in U5MR. The major causes of death were similar in both locations, with frequently reported causes being malaria, acute respiratory infection and diarrhoeal disease. Conclusions: Project initiatives in Maewo Island have reduced the risks of mortality and malnutrition. Using a cross-sectional 'external control group' design, this paper demonstrates that it is possible to draw conclusions about project effectiveness where baseline data are incomplete or absent. Shifting from donor-driven evaluations to impact evaluations has greater learning value for the organisation, and greater value when reporting back to the beneficiaries about project impact and transformational development in their community. Public health nutritionists working in the field are well versed in the collection and interpretation of anthropometric data for evaluation of nutritional interventions such as emergency feeding programmes. These same skills can be used to conduct impact evaluations, even some time after project completion, and elucidate lessons to be learned and shared. These skills can also be applied more widely to projects which impact on the longer-term nutritional status of communities and their food security. The Authors 2006."									
518	"Cryptosporidium, Enterocytozoon, and Cyclospora infections in pediatric and adult patients with diarrhea in Tanzania."	"Cegielski JP, Ortega YR, McKee S, Madden JF, Gaido L, Schwartz DA, Manji K, et al."	Clinical Infectious Diseases. 1999;28(2):314-21.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh2&AN=19990802943	"Cryptosporidiosis, microsporidiosis and cyclosporiasis were studied in 4 groups of Tanzanian inpatients: adults with AIDS-associated diarrhoea (n=86), children with chronic diarrhoea (n=59, of whom 23 were HIV<sup>+</sup>), children with acute diarrhoea (n=55, of whom 15 were HIV<sup>+</sup>), and HIV<sup>-</sup> control children without diarrhoea (n=20). Cryptosporidium was identified in specimens from 6 of the adults, 5 of the children with chronic diarrhoea (3 were HIV<sup>+</sup>), 7 of the children with acute diarrhoea (0 were HIV<sup>+</sup>), and 0 of the control children. Among children with acute diarrhoea, 7 of 7 with cryptosporidiosis were malnourished, compared with 10 of 48 without cryptosporidiosis (P<0.01). Enterocytozoon was identified in specimens from 3 of the adults, 2 of the children with chronic diarrhoea (1 was HIV<sup>+</sup>), 0 of the children with acute diarrhoea, and 4 of the control children: all 4 controls were underweight (P<0.01). Cyclospora was identified in specimens from one adult and one child with acute diarrhoea (HIV<sup>-</sup>). Thus, Cryptosporidium was the most frequent and Cyclospora the least frequent pathogen identified. Cryptosporidium and Enterocytozoon were associated with malnutrition. Asymptomatic faecal shedding of Enterocytozoon in otherwise healthy, HIV<sup>-</sup> children has not been described previously."									
253	Cryptosporidiosis and microsporidiosis in Ugandan children with persistent diarrhea with and without concurrent infection with the human immunodeficiency virus.	"Tumwine JK, Kekitiinwa A, Bakeera-Kitaka S, Ndeezi G, Downing R, Feng X, Akiyoshi DE, et al."	American Journal of Tropical Medicine and Hygiene. 2005 November;73(5):921-5.		"Cryptosporidium spp. and Enterocytozoon bieneusi are enteric pathogens that have emerged as significant causes of persistent diarrhea (PD) in immunologically compromised individuals particularly in association with HIV/ AIDS. We conducted a cross-sectional study on the clinical epidemiology of E. bieneusi and Cryptosporidium in children with PD, with and without HIV/AIDS, attending Uganda's Mulago National Referral Hospital. Two hundred forty-three children aged < 60 months, admitted between November 2002 and May 2003 with PD (> 14 days), were analyzed for HIV status and CD4 lymphocyte counts, and stools were screened for the presence of E. bieneusi and Cryptosporidium by microscopy and positive samples genotyped by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) analysis. Eighty (32.9%) of the children were excreting E. bieneusi, and 76 (31.3%) were excreting Cryptosporidium. Ninety-one of the 243 children had HIV. of who 70 (76.9%) had E. bieneusi, versus 10 (6.6%) of the 152 without (odds ratio = 47.33; 95% CI = 19.88 to 115.97). while 67 (73.6%) had Cryptosporidium, versus 9 (5.9%) without (odds ratio = 44.36; 95% CI = 18.39 to 110.40). Children with counts < 25% CD4 cells were more likely to have either E. bieneusi (odds ratio = 7.42; 95% CI = 3.77 to 14.69) or Cryptosporidium (odds ratio = 6.45; 95% CI = 3.28 to 12.76) than those with higher CD4 percentages. However, only HIV status was independently associated with either Cryptosporidium or E. bieneusi. Among the 243 children with PD. 67 (27.8%) were infected with both enteric pathogens, with HIV being the only independent predictor of coinfection. Finally, some 81% of HIV-infected children with PD excreted one or both organisms, compared with only 10% of children with PD testing negative for HIV. Seventy-four percent of isolates were C. hominis, the anthroponotic species. 17% were C. parvum, the zoonotic species, and 8% were a mixture of the two or others. Copyright 2005 by The American Society of Tropical Medicine and Hygiene."									
1918	"Developing an evidence-based, preventive care package for persons with HIV in Africa."	"Mermin J, Bunnell R, Lule J, Opio A, Gibbons A, Dybul M, Kaplan J."	Tropical Medicine & International Health. 2005;10(10):961-70.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=16185230	"Currently, 95% of the 40 million persons with HIV live in low and middle income countries; 27 million in sub-Saharan Africa. HIV/AIDS is a leading cause of death in the region, yet access to care and treatment considered standard-of-care in the industrialized world is extremely limited. There is a need for standardized, evidence-based recommendations on preventive measures. We developed a list of potential interventions based, when possible, on documented efficacy in reducing morbidity or mortality among persons with HIV in Africa. We considered the accessibility, affordability, and potential for implementation using existing health care infrastructure. Potential components included cotrimoxazole prophylaxis, safe drinking water, isoniazid prophylaxis, insecticide-treated bed nets, micronutrients, and provision of HIV counseling and testing and condoms to family members of persons with HIV. There are several additional interventions for which further evaluation would be useful before inclusion in a standard package of care, including acyclovir prophylaxis, food supplementation, hand washing, and fluconazole prophylaxis. The provision of a basic care package could be an important step toward reducing health care disparities and gaining more control of the global HIV/AIDS epidemic."									
1122	Morphological changes in HIV-1 infected patients on antiretroviral therapy without protease inhibitors in Cameroon: A prospective cohort study.	"Nguemaim NF, Mbuagbaw J, Teto G, Nkoa T, Same-Ekobo A, Asonganyi T."	Journal of Medical Sciences (Faisalabad). 2012;12(5):131-40.		"Data on morphological derangements induced by antiretroviral treatment in Cameroon are scarce. The aim of this study was to determine the effect of HIV infection and of antiretroviral therapy on lipid metabolism in order to help the clinicians to improve the management of HIV-infected patients. The lipid profile of 700 subjects of which 272 HIV-negative persons and 428 HIV-infected, treatment-Naive patients were evaluated. Blood was collected from the participants when they came for specialised consultation in the University Teaching Hospital of Yaounde. Biometric (body mass index, waist and hip circumference) and clinical (opportunistic infections) parameters were determined for each subject enrolled for the study. The 428 patients were put on 4 different antiretroviral (ARV) drugs as follows: 201 patients on triple association Nevirapine (NVP)/Stavudine (d4T)/Lamivudine (3TC), 177 on tritherapy Efavirenz (EFV)/Stavudine/Lamivudine, 34 on combination Lamivudine/Zidovudine (AZT)/Efavirenz and 16 on association Zidovudine/Lamivudine/Nevirapine. The bodily changes of patients were measured during a period of two years of follow up. The overall prevalence of lipodystrophy increased significantly with the Lamivudine/Stavudine/Efavirenz ARV regimen, with breast lipodystrophy being the most frequent (15.92%; p = 0.038). In general, the lipodystrophy was more prevalent in: (1) HIV-infected, treatment-Naive patients with a CD<sub>4</sub> count less than 200 cells mm<sup>-3</sup> and a Viral Load (VL) more than 10000 copies mL<sup>-1</sup> and (2) female patients above 31 years old on ARV with CD4 count more than 350 cells muL and viral load less than 50 copies mL<sup>-1</sup>. The waist and hip circumference of patients on ARV therapy were significantly higher than those of HIV-infected, treatment-Naive patients, irrespective of treatment regimen. There seems to be a high risk of developing lipodystrophy by HIV-infected patients during ARV therapy. Further, in the treatment regimen that contains d4T and EFV, the risk of developing metabolic disorders seems to be high."									
366	Prolonged survival of end-stage AIDS patients immunized with therapeutic HIV vaccine V-1 Immunitor.	"Metadilogkul O, Jirathitikal V, Bourinbaiar AS."	Biomedicine & Pharmacotherapy. 2005;59(8):469-73.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=16126364	"Death, rather than surrogate markers, is a single and most straightforward clinical endpoint, defining unequivocally the merit of a therapeutic intervention. As there is still neither a cure for AIDS nor a vaccine to prevent HIV infection, an AIDS diagnosis remains associated with a death sentence. V-1 Immunitor (V1) is an experimental, oral, therapeutic AIDS vaccine licensed as a dietary supplement. As part of a charity program V1 has been offered at Wat Phra Baht Nam Phu--a Buddhist hospice for end-stage AIDS patients. Out of 117 approached individuals, 53 decided to take V1 and 64 declined the treatment. Patients in both groups did not differ in age, gender, or severity of disease. All patients were in WHO terminal stage 4 at study entry and had received similar palliative care. None of the patients had received conventional antiviral drugs. At 9 weeks the last two patients in the non-V1 group died. In contrast, 56.6% (30/53) in the V1 group remained alive. Kaplan-Meier survival analysis showed that median short-term survival time for non-treated and treated patients was 4 and 10 weeks, respectively. The difference was statistically significant by Wilcoxon signed rank test (P=0.000089). Patients who remained alive were followed until the last patient died at 142 weeks. Based on the main outcome, i.e. time to death, patients on V1 had a 15.8 times longer life expectancy than the control group (P<0.000001). Observed results are encouraging and V1 needs to be tested in controlled clinical trials as a life-saving immunotherapy."									
1126	Provision of multiple rather than two or fewer micronutrients more effectively improves growth and other outcomes in micronutrient-deficient children and adults.	"Allen LH, Peerson JM, Olney DK."	Journal of Nutrition. 2009;139(5):1022-30.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=19321586	"Deficiencies of multiple micronutrients (MMN) usually coexist in developing countries, but supplements have usually provided only 1 or 2 micronutrients (MN). To inform policy, in this article we compared the relative benefits of supplying MMN vs. a placebo or 1 or 2 MN on the following: children's growth, health, and development; pregnancy outcome; nutritional status; and HIV/AIDS mortality and morbidity in adults. Sufficient data were available to perform random-effects meta-analyses of randomized controlled trials (RCT) for the effects of MMN on child growth and nutritional status. Results for other outcomes are presented as effect sizes (ES) when available. In children, MMN interventions resulted in small but significantly greater improvements in length or height (ES = 0.13; 95% CI: 0.055, 0.21) and weight (ES = 0.14; 95% CI: 0.029, 0.25), hemoglobin (ES = 0.39; 95% CI: 0.25, 0.53), serum zinc (ES = 0.23; 95% CI: 0.18, 0.43), serum retinol (ES = 0.33; 95% CI: 0.050, 0.61), and motor development. A Cochrane review reported that compared with no supplementation or a placebo, MMN supplementation during pregnancy reduced the relative risk of low birth weight (0.83), small-for-gestational age (0.92), and anemia (0.61); however, MMN were not more effective than iron + folic acid alone. There is some evidence that MMN supplementation improves CD4 counts and HIV-related morbidity and mortality in adults. The efficacy of MMN varies across trials, but overall there is evidence that outcomes are better than when providing < or =2 MN. The policy implications of these studies are discussed. [References: 63]"									
689	Maternal mineral and vitamin supplementation in pregnancy.	"Yakoob MY, Khan YP, Bhutta ZA."	Expert Review of Obstetrics and Gynecology. 2010 March;5(2):241-56.		"Deficiency of vitamins and minerals, collectively known as micronutrients, during pregnancy can have important adverse effects on maternal and birth outcomes. Evidence-based nutrition interventions can make a difference and potentially avert these outcomes. Iron supplementation has been shown to improve maternal mean hemoglobin concentration at term and reduce the risk of anemia. Zinc supplementation has been shown to result in a small but significant reduction in preterm births. A cluster-randomized study in Nepal showed a 40% reduction in maternal mortality up to 12 weeks postpartum with weekly vitamin A and 49% biweekly-carotene supplementation but subsequent large studies in Bangladesh and Ghana have failed to demonstrate any impact on mortality. Maternal vitamin A supplementation has no role in preventing mother-to-child transmission of HIV in HIV-infected pregnant women. Periconceptional folic acid supplementation reduces the risk of neural tube defects, while supplementation with vitamin D reduces the incidence of neonatal hypocalcemia with no impact on craniotabes. Iodine supplementation during pregnancy has also been suggested to reduce the risk of perinatal and infant mortality, and the risk of endemic cretinism at 4 years of age. Calcium supplementation reduced the risk of preeclampsia in women with low baseline calcium dietary intake, while magnesium supplementation has been associated with a lower frequency of preterm births and adverse neurodevelopmental outcomes in childhood. Other vitamins and minerals, such as vitamins B, C and E, copper and selenium, have been associated with fetal development, but their impact on pregnancy outcomes is not clear. Given such widespread maternal vitamin and mineral deficiencies, it is logical to consider supplementation with multiple micronutrient preparations in pregnancy. The clinical benefits of such an approach over single-nutrient supplements are unclear, and this article explores the current concepts, evidence and limitations of maternal multiple-micronutrient supplementation. 2010 Expert Reviews Ltd."									
858	Demographic and health surveys: A profile.	"Corsi DJ, Neuman M, Finlay JE, Subramanian SV."	International Journal of Epidemiology. 2012 December;41(6):1602-13.		"Demographic and Health Surveys (DHS) are comparable nationally representative household surveys that have been conducted in more than 85 countries worldwide since 1984. The DHS were initially designed to expand on demographic, fertility and family planning data collected in the World Fertility Surveys and Contraceptive Prevalence Surveys, and continue to provide an important resource for the monitoring of vital statistics and population health indicators in low- and middle-income countries. The DHS collect a wide range of objective and self-reported data with a strong focus on indicators of fertility, reproductive health, maternal and child health, mortality, nutrition and self-reported health behaviours among adults. Key advantages of the DHS include high response rates, national coverage, high quality interviewer training, standardized data collection procedures across countries and consistent content over time, allowing comparability across populations cross-sectionally and over time. Data from DHS facilitate epidemiological research focused on monitoring of prevalence, trends and inequalities. A variety of robust observational data analysis methods have been used, including cross-sectional designs, repeated cross-sectional designs, spatial and multilevel analyses, intra-household designs and cross-comparative analyses. In this profile, we present an overview of the DHS along with an introduction to the potential scope for these data in contributing to the field of micro- and macro-epidemiology. DHS datasets are available for researchers through MEASURE DHS at. www.measuredhs.com. Published by Oxford University Press on behalf of the International Epidemiological Association The Author 2012; all rights reserved."									
334	Evaluation of the maternal perception of her child's weight and Body Mass Index heritability in mestizas dyads in Southeastern Mexico.	"Flores-Pena Y, Camal-Rios NY, Cerda-Flores RM."	Archivos Latinoamericanos de Nutricion. 2011;61(4):389-95.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20123149142	"Descriptive correlational study. The objectives were the following: (1) evaluate maternal perception of her child's weight through two test, Word-perception (WP) test and the Body mass index (BMI) of the child as perceived by the mother (Body weight index perception [BWIP]); (2) evaluate the sensitivity and specificity of the tests, and (3) quantify BMI heritability (h<sup>2</sup>) in 173 mother-child dyads. WP was assessed by asking the question, How do you think your child is? For assessing BWIP, the mother referred the child's weight and height, and we calculated the child's BMI as perceived by the mother. The weight and height of the mothers and their children were measured. We found that 10.3% of mothers of children with Overweight (OW) and 1.8% of mothers of children with Obesity (OB) perceived their children adequately by means of WP; by means of the BWIP test, 38.5 and 67.3% of mothers of children with OW and OB, respectively, exhibited adequate perception. BWIP sensitivity was 55.3% and specificity was 54.4%. BWI h<sup>2</sup> was 15%. We was concluded that mothers did not perceive the OW-OB of their children, and that asking the mother for the weight and height of the child (BMIP) will aids her to perceive the OW-OB of her child. The BWI h<sup>2</sup> indicate that the lifestyle factors of this population contribute to OW-OB. Given the broad socioeconomic and cultural diversity, these results of the southeastern Mexican state of Campeche should be evaluated with similar study designs."									
1175	Effect of infections and environmental factors on growth and nutritional status in developing countries.	Bhutta ZA.	Journal of Pediatric Gastroenterology and Nutrition. 2006 December;43(SUPPL. 3):S13-S21.		"Despite numerous advances and improvements in child health globally, malnutrition remains a major problem and underlies a significant proportion of child deaths. A large proportion of the hidden burden of malnutrition is represented by widespread single and multiple micronutrient deficiencies. A number of factors may influence micronutrient deficiencies in developing countries, including poor body stores at birth, dietary deficiencies and high intake of inhibitors of absorption such as phytates and increased losses from the body. Although the effects of poor intake and increased micronutrient demands are well described, the potential effects of acute and chronic infections on the body's micronutrient status are less well appreciated. Even more obscure is the potential effect of immunostimulation and intercurrent infections on the micronutrient distribution and homeostasis. The association therefore of relatively higher rates of micronutrient deficiencies with infectious diseases may be reflective of both increased predisposition to infections in deficient populations as well as a direct effect of the infection itself on micronutrient status indicators. Recently the association of increased micronutrient losses such as those of zinc and copper with acute diarrhea has been recognized and a net negative balance of zinc has been shown in zinc metabolic studies in children with persistent diarrhea. It is also recognized that children with shigellosis can lose a significant amount of vitamin A in the urine, thus further aggravating preexisting subclinical vitamin A deficiency. Given the epidemiological association between micronutrient deficiencies and diarrhea, supplementation strategies in endemic areas are logical. The growing body of evidence on the key role of zinc supplementation in accelerating recovery from diarrheal illnesses in developing countries supports its use in public health strategies. 2006 Lippincott Williams & Wilkins, Inc."									
137	Barriers to and Facilitators of Adherence to Pediatric Antiretroviral Therapy in a Sub-Saharan Setting: Insights from a Qualitative Study.	"Fetzer BC, Mupenda B, Lusiama J, Kitetele F, Golin C, Behets F."	AIDS Patient Care & STDs. 2011;25(10):611-21.	http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=2011291612&site=ehost-live	"Despite the need for HIV-positive children to adhere effectively to antiretroviral treatment (ART), a guiding theory for pediatric ART in resource-limited settings is still missing. Understanding factors that influence pediatric ART adherence is critical to developing adequate strategies. In-depth qualitative interviews were undertaken in Kinshasa, Democratic Republic of the Congo, with 20 sets of HIV disclosed and nondisclosed children along with respective caregivers to better characterize barriers, facilitators, and adherence experiences in children taking ART. Commonly cited barriers included lack of food or nutritional support, lack of assistance or supervision for children, lack of assistance for caregivers, and being unable to remember to take medicines on a consistent basis. Facilitators included having a strong caregiver-child relationship and support system along with strategies for maintaining adherence. Similar themes arose within the child-caregiver sets, but were often characterized differently between the two. Children who were aware of their HIV status displayed fewer instances of frustration and conflict concerning taking medicines and within the child-caregiver relationship. Continued study on pediatric ART adherence should account for differing perspectives of children and caregivers, as well as between status disclosed and nondisclosed children. Areas of future intervention should focus on child-caregiver relationships, disclosure of HIV status, and available nutritional and psychosocial support for children and their caregivers."									
146	The paradox of family support: Concerns of tuberculosis-infected hiv patients about involving family and friends in their treatment.	"Ushie BA, Jegede AS."	AIDS Patient Care and STDs. 2012 01 Nov;26(11):674-80.		"Despite the widely documented evidence that family support improves adherence to HIV treatment, some studies have reported no benefit or even a negative association between family support and adherence. This study reexamined the role of family support in treatment adherence to find out the circumstances under which family support for HIV and tuberculosis coinfected patients promotes or hinders treatment adherence in Cross River State, Nigeria. We conducted eight focus group discussions (FGDs) and four case histories with coinfected patients. In addition, 21 in-depth interviews (IDIs) were conducted with: 8 family members, 6 friends, and 7 care providers. Data were analyzed in a thematic format with the aid of NVIVO software. Overall, family support promotes adherence in coinfected patients. Family support may, however, have a negative effect on adherence when the recipient perceives that the support is given with ulterior motives (e.g., gossiping about them and becoming indebted to the support givers) and when the recipient is the primary breadwinner and feels that this role is being undermined. Family support is useful as a tool for scaling up adherence but the usefulness is context-specific and mediated by the patient's subjective interpretation of the support givers' motives. 2012 Copyright, Mary Ann Liebert, Inc."									
526	"HIV/AIDS, undernutrition, and food insecurity."	"Ivers LC, Cullen KA, Freedberg KA, Block S, Coates J, Webb P."	Clinical Infectious Diseases. 2009;49(7):1096-102.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=19725790	"Despite tremendous advances in care for human immunodeficiency virus (HIV) infection and increased funding for treatment, morbidity and mortality due to HIV/AIDS in developing countries remains unacceptably high. A major contributing factor is that >800 million people remain chronically undernourished globally, and the HIV epidemic largely overlaps with populations already experiencing low diet quality and quantity. Here, we present an updated review of the relationship between HIV infection, nutritional deficiencies, and food insecurity and consider efforts to interrupt this cycle at a programmatic level. As HIV infection progresses, it causes a catabolic state and increased susceptibility to other infections, which are compounded by a lack of caloric and other nutrient intake, leading to progressive worsening of malnutrition. Despite calls from national and international organizations to integrate HIV and nutritional programs, data are lacking on how such programs can be effectively implemented in resource-poor settings, on the optimum content and duration of nutritional support, and on ideal target recipients. [References: 107]"									
533	"HIV/AIDS, undernutrition, and food insecurity."	"Lvers LC, Cullen KA, Freedberg KA, Block S, Coates J, Webb P."	Clinical Infectious Diseases. 2009 01 Oct;49(7):1096-102.		"Despite tremendous advances in care for human immunodeficiency virus (HIV) infection and increased funding for treatment, morbidity and mortality due to HIV/AIDS in developing countries remains unacceptably high. A major contributing factor is that >800 million people remain chronically undernourished globally, and the HIV epidemic largely overlaps with populations already experiencing low diet quality and quantity. Here, we present an updated review of the relationship between HIV infection, nutritional deficiencies, and food insecurity and consider efforts to interrupt this cycle at a programmatic level. As HIV infection progresses, it causes a catabolic state and increased susceptibility to other infections, which are compounded by a lack of caloric and other nutrient intake, leading to progressive worsening of malnutrition. Despite calls from national and international organizations to integrate HIV and nutritional programs, data are lacking on how such programs can be effectively implemented in resource-poor settings, on the optimum content and duration of nutritional support, and on ideal target recipients. 2009 by the Infectious Diseases Society of America. All rights reserved."									
1340	Addressing malnutrition in young children in South Africa. Setting the national context for paediatric food-based dietary guidelines.	"Bourne LT, Hendricks MK, Marais D, Eley B."	Maternal & Child Nutrition. 2007;3(4):230-8.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=17824851	"Despite various national nutrition and primary healthcare programmes being initiated in South Africa over the last decade, child health has deteriorated. This is seen by the rise in infant and child mortality rates, the high prevalence of preventable childhood diseases, e.g. diarrhoea and lower respiratory tract infections, and the coexistence of under-nutrition along with HIV/AIDS. Poor dietary intake, food insecurity and poor quality of basic services prevail within this precarious causal web. The national Integrated Nutrition Programme is a comprehensive nutrition strategy that focuses on children below 6 years old, at-risk pregnant and lactating women, and those affected by communicable and non-communicable diseases. Focus areas relevant to pre-school children include disease-specific nutrition treatment, support and counselling; growth monitoring and promotion (GMP); micronutrient malnutrition control; breastfeeding promotion, protection and support; contributions to household food security; nutrition interventions among HIV-infected children; and nutrition promotion, education and advocacy. Progress towards this includes the Baby-Friendly Hospital Initiative; mandatory fortification of maize meal and wheat flour with multiple micronutrients; vitamin A supplementation coverage and mandatory iodization of salt by legislation; the provision of free road-to-health charts for GMP; and the National School Nutrition Programme. Since 2003, the basis of the nutrition education strategy has been the locally developed food-based dietary guidelines (FBDGs), directed at adults and school-going children. This review sketches the backdrop to and motivation for the introduction of specifically targeted paediatric FBDGs, for mothers and caregivers of children from birth to age 7 years, as a national initiative. [References: 33]"									
600	Anthropometric characteristics and cardiometabolic risk factors in a sample of urban-dwelling adults in Senegal. [French]	Caracteristiques anthropometriques et facteurs de risque cardiometabolique en milieu urbain au Senegal.	"Fontbonne A, Cournil A, Cames C, Mercier S, Ndiaye Coly A, Lacroux A, Dupuy AM, et al."		Diabetes and Metabolism. 2011 February;37(1):52-8.									
773	"Diabetes in Africa: Epidemiology, management and healthcare challenges."	Levitt NS.	Heart. 2008 November;94(11):1376-82.		"Diabetes is an increasing problem in sub-Saharan Africa. Type 2 diabetes, the most common form, is becoming more prevalent owing to rising rates of obesity, physical inactivity and urbanisation. Type 1 diabetes exists in two major forms in the region: type 1A or autoimmune and type 1B or ketosis-prone type 2 diabetes. At present there are scanty epidemiological data on either. The current morbidity of diabetes is primarily due to the high rates of microvascular complications, while macrovascular complications, once rare, are becoming more common, particularly in the urban setting. Further, despite the HIV epidemic, the total number of people with diabetes in the region is expected to grow because of changing demography. A concerted multisectoral effort will be critical to ensuring improvement in healthcare delivery for people with diabetes in the region."									
251	Moderate-to-severe diarrhea among children less than five years old with HIV infected mothers in rural western Kenya.	"O'Reilly CE, Omore R, Moke F, Ondeng A, Hukumu E, Ibworo V, Rajasingham A, et al."	American Journal of Tropical Medicine and Hygiene. 2011 December;1):6.		"Diarrhea causes substantial morbidity and mortality among people living with HIV. Data on diarrhea among HIV-infected children are limited. We examined the outcome and etiology of moderate-to-severe diarrhea in Kenyan children <5 years old participating in the Global Enterics Multicenter Study (GEMS) who were HIV-infected (HIV+), HIV-uninfected, but potentially HIV-exposed (HIV-infected mother) (HIV-/+), and HIV-uninfected and HIV-unexposed (HIV-uninfected mother) (HIV-/-). Stool specimens were collected at enrollment. We abstracted HIV test results for enrolled children and their biological mothers. HIV infection was determined by PCR for children <18 months old, and by rapid antibody test for those >18 months. From Jan 25, 2010 to Feb 6, 2011, 206 (67%) of the 309 children with moderate-to-severe diarrhea had an HIV test at GEMS enrollment; 9 (4%) were HIV+, 45 (22%) HIV-/+, and 152 (74%) HIV-/-. Median age was 15, 11 and 13 months for the three groups, respectively. For HIV-infected mothers of HIV+ and HIV-/+ children respectively, the median CD4 count was 331 cells/mu L and 451 cells/mu L; 2 (22%) and 12 (27%) were on antiretroviral therapy. Five (56%) HIV+, 27 (60%) HIV-/+, and 115 (76%) HIV-/- children were currently breastfeeding. On enrollment, for HIV+, HIV-/+, and HIV-/- children respectively, 75%, 31%, and 27% were stunted (height-for-age z-score <-2), and 13%, 23%, and 10% were underweight (weight-for-age z-score <-2). Two (22%) HIV+, four (9%) HIV-/+, and 20 (13%) HIV-/- children were hospitalized for diarrhea. ETEC (33%), Cryptosporidium (25%), EPEC (22%), and astrovirus (14%), were more commonly found in stools from HIV+ children, than in stools from HIV-/+ and HIV-/- children (ETEC 16% and 19%; Cryptosporidium7% and 12%; EPEC 16% and 7%; astrovirus 0% and <1%). Death within 60 days of enrollment was more common among HIV-/+ children (4.4%) than among HIV-/- (0.7%) or HIV+ children (0%). These limited preliminary data suggest that being a child of an HIV-infected mother, regardless of the child's HIV status, adversely impacts outcome of diarrheal illness."									
875	Epidemiology and management of diarrheal disease in HIV-infected patients.	Katabira ET.	International Journal of Infectious Diseases. 1999;3(3):164-7.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=10460930	"Diarrhea is the most common gastrointestinal symptom in human immunodeficiency virus (HIV) infection. It affects up to 90% of patients, becoming more frequent and severe as the immune system deteriorates. It often is associated with significant morbidity and mortality particularly in the developing countries. Gastrointestinal infections, some of which are attributable to inadequate sanitation and poor hygiene are the predominant cause of diarrhea, although multiple medications, including traditional herbs, also may be causes. The basic principles of management include detection of treatable causes, relief of symptoms, prevention of malnutrition, and psychosocial support. In up to 60% of cases, no cause can be identified, partly because of inadequate investigative facilities. Symptomatic treatment is the mainstay of management particularly when no cause can be identified. Unfortunately this can be extremely difficult when the patient is severely immune-suppressed. There is poor response to motility control drugs, such as loperamide, and others, such as octreotide, are too expensive. Fluid replacement should be started early to prevent excessive dehydration. This should be combined with nutritional support to prevent malnutrition. Psychosocial support, including counselling, for both the patient and the caring relatives, is required to alleviate anxiety, particularly when the diarrhea becomes intractable. [References: 14]"									
241	"Diarrheal disease in patients infected with human immunodeficiency virus in Bangkok, Thailand."	"Wanke CA, Cohan D, Thummakul T, Jongwuitiwes S, Grayson ML, Hammer SM, Hanvanich M."	American Journal of Tropical Medicine & Hygiene. 1999;60(5):871-4.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=10344668	"Diarrheal disease and its associated morbidities occur frequently in patients infected with human immunodeficiency virus (HIV) and may be associated with a decreased quality of life. We studied the spectrum of symptoms, measures of nutritional status, and the enteric pathogens associated with diarrheal disease in a group of 24 patients infected with HIV in Bangkok, Thailand compared with a group of 19 patients infected with HIV without diarrhea cared for at the same clinic. Patients with diarrhea appeared to have more advanced disease by CD4 cell counts and complained more frequently of symptoms such as anorexia, gas, and bloating than patients without diarrhea. Patients with diarrhea had a tendency toward a lower nutritional status, as measured by body mass index and mid arm circumference. Stool culture and examination revealed that enteric pathogens including Salmonella species and Cryptosporidium parvum sporidia were recovered at equal frequencies in patients with and without diarrhea (27% of the patients with diarrhea and 25% of the patients without diarrhea). Microsporidia was identified in one patient with diarrhea. It was not possible to identify a pathogen in 73% of the patients with diarrhea and 75% of the patients without diarrhea, suggesting that additional agents or factors may be responsible for the diarrheal symptoms in the patients with diarrhea. More extensive studies to identify potentially treatable pathogens in HIV-infected patients with diarrhea in Thailand are warranted and further attempts to better define the syndrome of pathogen-negative diarrheal disease in patients infected with HIV might result in the development of more targeted interventions in these patients."									
1417	Chronic enteropathy: clinical aspects.	"Gibbons T, Fuchs GJ."	Nestle Nutrition Workshop Series Paediatric Programme. 2007;59:89-101; discussion 2-4.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=17245093	"Diarrheal disease is a major cause of childhood morbidity and mortality worldwide. Chronic enteropathy with subsequent persistent diarrhea and associated vicious cycles of malnutrition, increased gut permeability and secondary immunodeficiency are particularly devastating in the childhood population. The major causes of chronic enteropathy differ significantly between developed countries and developing countries. In developed countries, infectious and postinfectious diarrhea as well as abnormalities in immune response including celiac disease, food-induced allergic enteropathy and idiopathic inflammatory bowel disease account for most cases of chronic enteropathy. In developing countries, syndromic persistent diarrhea associated with malnutrition and secondary immunodeficiency due to human immunodeficiency virus (HIV) infection predominate as the major causes of chronic enteropathy. These latter two causes account for a disproportionate share of the more than 2.5 million deaths of children under 5 years of age due to diarrhea each year worldwide. From a practical perspective, diagnostic evaluation of chronic enteropathy in developing countries is often limited to identifying potential causative enteropathogens and antimicrobial treatment. Proper management with an emphasis on fluid homeostasis and protocolized nutritional therapy and rehabilitation is essential to successful treatment of syndromic persistent diarrhea. [References: 31]"									
1195	"Lactose maldigestion, calcium intake and osteoporosis in African-, Asian-, and Hispanic-Americans."	"Jackson KA, Savaiano DA."	Journal of the American College of Nutrition. 2001;20(2 Suppl):198S-207S.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=11349943	"Dietary calcium is critical for the development of the human skeleton and likely plays an important role in the prevention of osteoporosis. Dairy products provide approximately three-fourths of calcium consumed in the diet and are the most concentrated sources of this essential nutrient. One obstacle that likely interferes with calcium consumption among many ethnic groups is lactose maldigestion. The real or perceived occurrence of intolerance symptoms after dairy food consumption may cause maldigesters to avoid dairy products. Several investigators have observed a relationship between lactose maldigestion, dietary calcium and osteoporosis in Caucasian populations. Research on ethnically diverse populations is necessary to better understand how lactose maldigestion influences the risk for osteoporosis. Low calcium intakes, a greater than previously thought potential for low bone density and extensive lactose maldigestion among Hispanic-American and Asian-American populations may create an elevated risk for osteoporosis. Dietary management strategies for lactose maldigesters to increase calcium consumption include consuming (1) dairy foods with meals, (2) yogurts, (3) calcium-fortified foods, (4) using lactose digestive aids and (5) including dairy foods daily in the diet to enhance colonic metabolism of lactose. [References: 87]"									
496	HCV genotype analysis in HCV-HIV-co-infected Puerto Ricans who are injecting drug users: undetermined and mixed infections.	"Rios-Olivares E, Yamamura Y, Gomez MA, Guzman L, Rodriguez N, Fernandez D, Hunter Mellado R."	Cellular and Molecular Biology. 2001;47(6):1017-24.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh3&AN=20023001450	"Direct percutaneous exposure is the main route of HCV transmission. In Puerto Rico, half of people infected with HIV use illicit drugs. The effects of HCV in the course of HIV infection and vice versa have been extensively studied, but remain highly controversial. This may be due to HCV genetic heterogeneity. Therefore, a complex classification into genotypes has emerged that prompted us to determine how this impacts a population of intravenous drug users (IDUs) coinfected with HIV-1. Using Inno-LiPa II technique, we analysed samples from 171 HCV-HIV-1-coinfected IDUs and 375 from a general HCV population of unknown HIV or source of infection status. Similar HCV genotype distribution was detected in these populations. HCV genotype 1a was the most frequently in IDUs-coinfected with HIV-1, followed by 1b and 3a. Twenty mixed infections and 5 undetermined genotypes were reported. A reduced HCV viral load was observed in HIV-1 positives with wasting syndrome. Individuals with a high HIV-1 viral load presented a low HCV viral load. There were no correlation between HCV genotypes and AIDS-related event. Patients with genotype 1b showed a higher HCV viral load. Males presented higher HCV viral load than females. Females were predominantly affected by genotype 1a and men by 1a and 1b. Neither the HCV viral load nor the frequency of genotypes were influenced by the antiretroviral modality. The importance of continuous genotype monitoring is stressed."									
795	Home parenteral nutrition in Europe.	Gossum Av.	Home parenteral nutrition. 2006.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20063180889	"Discussions on the history of the use of home parenteral nutrition (HPN) in Europe and its current incidence in various European countries, viz. France, Denmark, Belgium, UK, Poland and Spain, are presented. Also, data on the different diseases that require HPN are presented on a per disease and per country basis; examples of these diseases include Crohn's disease, vascular diseases, cancer, radiation complications and AIDS. Moreover, discussions on the different practical aspects of HPN, which include the route of administration of the nutritional solutions, training, prognosis and HPN-related complications are presented as well."									
802	"The impact of integrating food supplementation, nutritional education and HAART (Highly Active Antiretroviral Therapy) on the nutritional status of patients living with HIV/AIDS in Mozambique: results from the DREAM Programme."	"Scarcella P, Buonomo E, Zimba I, Doro Altan AM, Germano P, Palombi L, Marazzi MC."	Igiene e Sanita Pubblica. 2011;67(1):41-52.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=21468153	"DREAM (Drug Resources Enhancement against AIDS and Malnutrition) is a multiregional health program active in Mozambique since 2002 and provides free of charge an integrating package of care consisting of peer to peer nutritional and health education, food supplementation, voluntary counseling and testing, immunological, virological, clinical assessment and HAART (Highly Active AntiRetroviral Treatment). The main goals of this paper are to describe the state of health and nutrition and the adequacy of the diet of a sample of HIV/AIDS patients in Mozambique on HAART and not. A single-arm retrospective cohort study was conducted. 106 HIV/AIDS adult patients (84 in HAART), all receiving food supplementation and peer-to-peer nutritional education, were randomly recruited in Mozambique in two public health centres where DREAM is running. The programme is characterized by: provision of HAART, clinical and laboratory monitoring, peer to peer health and nutritional education and food supplementation. We measured BMI, haemoglobin, viral load, CD4 count at baseline (T0) and after at least 1 year (T1). Dietary intake was estimated using 24h food recall and dietary diversity was assessed by using the Dietary Diversity Score (DDS) at T1. Overall, the patients'diet appeared to be quite balanced in nutrients. In the cohort not in HAART the mean BMI values showed an increases but not significant (initial value: 21.9 +/- 2.9; final value: 22.5 +/- 3.3 ) and the mean haemoglobin values (g/dl) showed a significant increases (initial value: 10.5+ 2.1; final value: 11.5 +/- 1.7 p< 0.024) . In the cohort in HAART, both the mean of BMI value (initial value: 20.7 +/- 3.9; final value: 21.9 +/- 3.3 p< 0.001) and of haemoglobin (initial value: 9.9 +/- 2.2; final value: 10.8 +/- 1.7 p< 0.001) showed a higher significant increase. The increase in BMI was statistically associated with the DDS in HAART patients. In conclusion nutritional status improvement was observed in both cohorts. The improvement in BMI was significant and substantially higher in HAART patients because of the impact of HAART on nutritional status of AIDS patients. Subjects on HAART and with a DDS > 5, showed a substantial BMI gain. This association showed an additional expression of the synergic effect of integrating food supplementation, nutritional education and HAART on the nutritional status of African AIDS patients and also highlights the complementary role of an adequate and diversified diet in persons living with HIV/AIDS in resources limited settings."									
1352	Situational analysis of infant and young child nutrition policies and programmatic activities in Niger.	"Wuehler SE, Biga Hassoumi A."	Maternal & Child Nutrition. 2011;7 Suppl 1:133-56.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=21410893	"Due to limited progress towards reducing mortality and malnutrition among children <5 years of age, an alliance of international agencies joined to 'Reposition children's right to adequate nutrition in the Sahel,' starting with a situational analysis of current activities related to infant and young child nutrition (IYCN). The main objectives of this analysis are to compile, analyse, and interpret available information on infant and child feeding and the nutrition situation of children <2 years of age in Niger, as one of the six targeted countries. Between August and November 2008, key informants responsible for conducting IYCN-related activities in Niger were interviewed, and 90 documents were examined on: optimal breastfeeding and complementary feeding practices, prevention of micronutrient deficiencies, prevention of mother-to-child transmission of HIV, management of acute malnutrition, food security, and hygienic practices. The results reported are limited by the availability of documents for review. Mortality rates are on track to reaching the Millennium Development Goal to reduce mortality among young children by two-thirds by 2015, but there has been no change in undernutrition, and total mortality rates are still high among young children. Nearly all of the key IYCN topics were addressed, specifically or generally, in national policy documents, training materials, and programmes. A national nutrition council meets regularly to coordinate programme activities nationally. Many of the IYCN-related programmes are intended for national coverage, but few reach this coverage. Monitoring and impact evaluations were conducted on some programmes, but few of these reported on whether the specific IYCN components of the programme were implemented as designed or compared outcomes with non-intervention sites. Human resources have been identified as inadequate to fully carry out nutrition programmes in Niger. Due to these limitations, we could not confirm whether the lack of progress in reducing malnutrition was due to ineffective or inadequately implemented programmes, though both of these were likely contributors. The policy framework is well established for the promotion of optimal IYCN practices, but greater resources and capacity building are needed to: (i) increase human capacities to carry out nutrition programmes; (ii) expand and track the implementation of evidence-based programmes nationally; (iii) improve and carry out monitoring and evaluation that identify effective and ineffective programmes; and (iv) apply these findings in developing, expanding, and improving effective programmes. 2011 Blackwell Publishing Ltd."									
1369	Situational analysis of infant and young child nutrition policies and programmatic activities in Niger. (Special Issue: Repositioning children's right to adequate nutrition in the Sahel - situational analysis.).	"Wuehler SE, Hassoumi AB."	Maternal and Child Nutrition. 2011;7(s1):133-56.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20113110909	"Due to limited progress towards reducing mortality and malnutrition among children <5 years of age, an alliance of international agencies joined to 'Reposition children's right to adequate nutrition in the Sahel,' starting with a situational analysis of current activities related to infant and young child nutrition (IYCN). The main objectives of this analysis are to compile, analyse, and interpret available information on infant and child feeding and the nutrition situation of children <2 years of age in Niger, as one of the six targeted countries. Between August and November 2008, key informants responsible for conducting IYCN-related activities in Niger were interviewed, and 90 documents were examined on: optimal breastfeeding and complementary feeding practices, prevention of micronutrient deficiencies, prevention of mother-to-child transmission of HIV, management of acute malnutrition, food security, and hygienic practices. The results reported are limited by the availability of documents for review. Mortality rates are on track to reaching the Millennium Development Goal to reduce mortality among young children by two-thirds by 2015, but there has been no change in undernutrition, and total mortality rates are still high among young children. Nearly all of the key IYCN topics were addressed, specifically or generally, in national policy documents, training materials, and programmes. A national nutrition council meets regularly to coordinate programme activities nationally. Many of the IYCN-related programmes are intended for national coverage, but few reach this coverage. Monitoring and impact evaluations were conducted on some programmes, but few of these reported on whether the specific IYCN components of the programme were implemented as designed or compared outcomes with non-intervention sites. Human resources have been identified as inadequate to fully carry out nutrition programmes in Niger. Due to these limitations, we could not confirm whether the lack of progress in reducing malnutrition was due to ineffective or inadequately implemented programmes, though both of these were likely contributors. The policy framework is well established for the promotion of optimal IYCN practices, but greater resources and capacity building are needed to: (i) increase human capacities to carry out nutrition programmes; (ii) expand and track the implementation of evidence-based programmes nationally; (iii) improve and carry out monitoring and evaluation that identify effective and ineffective programmes; and (iv) apply these findings in developing, expanding, and improving effective programmes."									
1470	Maternal nutrition - effect on fetal growth and outcome of pregnancy.	Prema R.	Nutrition Reviews. 2002;60(5(2):S26-S34.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh3&AN=20023080569	"During the first half of the 20th century, chronic energy undernutrition due to low dietary intake, repeated infections, and rapid succession of pregnancy were the factors most responsible for maternal undernutrition and consequent adverse outcomes of pregnancy. Efforts to improve dietary intake, treatment of infections, and provision of contraceptive care were the major focuses of intervention from 1950-1990. These interventions resulted in reduction in severe grades of undernutrition. However, there was no reduction in mild and moderate degrees of undernutrition and anaemia during pregnancy and there was no significant improvement in the course and outcome of pregnancy, or in birth weight. During the 1990s, among the middle- and upper-income groups, there has been a progressive rise in obesity and consequent adverse effects. The advent of human immunodeficiency virus (HIV) infection in India in the 1980s will inevitably lead to increases in severe undernutrition associated with HIV infection in pregnancy and an adverse impact of maternal HIV infection on the fetus. Practicing physicians and nutritionists in the new millennium will therefore have to assess each person individually and provide appropriate advice regarding diet, exercise, fertility, and infection prevention and control in order to achieve optimum health and nutrition status during pregnancy and to prevent adverse pregnancy outcomes."									
1471	Maternal nutrition--effect on fetal growth and outcome of pregnancy.	Ramachandran P.	Nutrition Reviews. 2002;60(5 Pt 2):S26-34.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=12035855	"During the first half of the 20th century, chronic energy undernutrition due to low dietary intake, repeated infections, and rapid succession of pregnancy were the factors most responsible for maternal undernutrition and consequent adverse outcomes of pregnancy. Efforts to improve dietary intake, treatment of infections, and provision of contraceptive care were the major focuses of intervention from 1950 to 1990. These interventions resulted in reduction in severe grades of undernutrition. However, there was no reduction in mild and moderate degrees of undernutrition and anemia during pregnancy and there was no significant improvement in the course and outcome of pregnancy, or in birth weight. During the 1990s, among the middle- and upper-income groups, there has been a progressive rise in obesity and consequent adverse effects. The advent of HIV infection in India in the 1980s will inevitably lead to increases in severe undernutrition associated with HIV infection in pregnancy and an adverse impact of maternal HIV infection on the fetus. Practicing physicians and nutritionists in the new millennium will therefore have to assess each person individually and provide appropriate advice regarding diet, exercise, fertility, and infection prevention and control in order to achieve optimum health and nutrition status during pregnancy and to prevent adverse pregnancy outcomes. [References: 14]"									
325	Self-assessment of appearance and using of Slimming supplements and ergogenic AIDs among polish students from junior high schools.	"Kolarzyk E, Jos'ko J, Kasperczyk J, Ostachowska-Gasior A."	Archives of Disease in Childhood. 2012 October;97:A134.		"Dynamic physical and psychological changes connected with adolescence are associated with focusing on appearance. The difference between the imagine figure and real appearance can become a source of frustration and dissatisfaction. The aim Assessment of body weight acceptance and different actions aiming at appearance improvement among Polish students from junior high schools. Methods The examinations included 986 students from junior high schools (551girls and 435 boys) at the mean age 13 years and BMI 19.28+/-2.85 (girls) and 19.90+/-4.51 (boys). An anonymous standardized questionnaire concerning nutritional behaviors was used. Results Dissatisfaction with body mass and general appearance was declared by 31.4% boys and 40. 6% girls. The majority of these girls used different weight-loss diets (reduction, low-carbohydrate, protein, yoghurt and fruit diets) and nonconventional diets such dr Atkins' and South Beach. Supplements which stimulate fat tissue burn, metabolic process and thermogenesis and such products as Alli, Bio CLA, Linea and Therm Line II were the most popular. The boys declared taking the ergogenic aids (vitamin and mineral preparations) and supplementation with protein or carbohydrate. The reduction of body mass was the goal for 8% of boys and they also decided to start a weight-loss diet. Conclusions Low level of self-assessment and lack of appearance acceptance may lead to disturbances with physical and mental health. In Poland dietary supplements and nutrients are sold without prescription even in filling stations and supermarkets and we afraid that young people will abuse them to create their figure according to their imagine."									
1317	Lipid abnormalities in a never-treated HIV-1 subtype C-infected African population.	"Fourie CMT, Van Rooyen JM, Kruger A, Schutte AE."	Lipids. 2010 January;45(1):73-80.		"Dyslipidemia has been documented worldwide among human immunodeficiency virus-infected (HIV) individuals and these changes are reminiscent of the metabolic syndrome (MetS). In South Africa, with the highest number of HIV infections worldwide, HIV-1 subtype C is prevalent, while HIV-1 subtype B (genetically different from C) prevails in Europe and the United States. We aimed to evaluate if HIV infection (subtype C) is associated with dyslipidemia, inflammation and the occurrence of the MetS in Africans. Three hundred newly diagnosed HIV-infected participants were compared to 300 age, gender, body mass index and locality matched uninfected controls. MetS was defined according to the Adult Treatment Panel III (ATP III) and International Diabetes Federation (IDF) criteria. The HIV-infected group showed lower high density lipoprotein cholesterol (1.23 vs. 1.70 mmol/L) and low density lipoprotein cholesterol (2.60 vs. 2.80 mmol/L) and higher triglycerides (1.29 vs. 1.15 mmol/L), C-reactive protein (3.31 vs. 2.13 mg/L) and interleukin 6 (4.70 vs. 3.72 pg/L) levels compared to the uninfected group. No difference in the prevalence of the MetS was seen between the two groups (ATP III, 15.2 vs. 11.5%; IDF, 21.1 vs. 22.6%). This study shows that HIV-1 subtype C is associated with dyslipidemia, but not with a higher incidence of MetS in never antiretroviral-treated HIV-infected Africans. 2009 AOCS."									
151	"Hyponatremia, hypochloremia, and hypoalbuminemia predict an increased risk of mortality during the first year of antiretroviral therapy among HIV-infected Zambian and Kenyan women."	"Dao CN, Peters PJ, Kiarie JN, Zulu I, Muiruri P, Ong'Ech J, Mutsotso W, et al."	AIDS Research and Human Retroviruses. 2011 01 Nov;27(11):1149-55.		"Early mortality rates after initiating antiretroviral therapy (ART) are high in sub-Saharan Africa. We examined whether serum chemistries at ART initiation predicted mortality among HIV-infected women. From May 2005 to January 2007, we enrolled women initiating ART in a prospective cohort study in Zambia and Kenya. We used Cox proportional hazards models to identify risk factors associated with mortality. Among 661 HIV-infected women, 53 (8%) died during the first year of ART, and tuberculosis was the most common cause of death (32%). Women were more likely to die if they were both hyponatremic (sodium <135mmol/liter) and hypochloremic (chloride <95mmol/liter) (37% vs. 6%) or hypoalbuminemic (albumin <34g/liter, 13% vs. 4%) when initiating ART. A body mass index <18kg/m<sup>2</sup> [adjusted hazard ratio (aHR) 5.3, 95% confidence interval (CI) 2.6-10.6] and hyponatremia with hypochloremia (aHR 4.5, 95% CI 2.2-9.4) were associated with 1-year mortality after adjusting for country, CD4 cell count, WHO clinical stage, hemoglobin, and albumin. Among women with a CD4 cell count >50 cells/mul, hypoalbuminemia was also a significant predictor of mortality (aHR=3.7, 95% CI 1.4-9.8). Baseline hyponatremia with hypochloremia and hypoalbuminemia predicted mortality in the first year of initiating ART, and these abnormalities might reflect opportunistic infections (e.g., tuberculosis) or advanced HIV disease. Assessment of serum sodium, chloride, and albumin can identify HIV-infected patients at highest risk for mortality who may benefit from more intensive medical management during the first year of ART. 2011, Mary Ann Liebert, Inc."									
617	Pilot study of antiretroviral therapy in Djibouti. [French]	Etude pilote de la therapie antiretrovirale a Djibouti.	"Ahmed AA, Latoundji S, Ghosn J, Guiguet M, Costagliola D."		Eastern Mediterranean Health Journal. 2007 November/December;13(6):1274-85.									
1085	Effects of vitamin A supplementation during pregnancy and early lactation on body weight of South African HIV-infected women.	"Kennedy-Oji C, Coutsoudis A, Kuhn L, Pillay K, Mburu A, Stein Z, Coovadia H."	"Journal of Health, Population & Nutrition. 2001;19(3):167-76."	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=11761770	"Effects of vitamin A supplementation during pregnancy and early lactation on maternal weight among HIV-1-seropositive South African women were examined. Three hundred twelve HIV-seropositive pregnant women between 28 and 32 weeks gestation were studied as part of a randomized, double-blind, placebo-controlled trial at the King Edward VIII Hospital in Durban, South Africa. Patients were randomized to receive placebo or 5,000 IU of retinyl palmitate and 30 mg of beta-carotene daily during pregnancy. At delivery, patients received placebo or 200,000 IU of retinyl palmitate. The main outcome measures were prenatal and postnatal maternal weight and weight loss at three months after delivery as measured in body mass index (BMI). Supplementation of vitamin A was not associated with improvements in prepartum weight gain but was significantly associated with improved weight retention three to six months after delivery (p = 0.02). The benefit of vitamin A supplementation appeared to be confined to subgroups with baseline CD4+ count < 200 cells/microL and serum retinol 0-20 micrograms/dL. Similar trends were observed in maintenance of postpartum BMI. However, no statistically significant associations were observed. Although there was no benefit of vitamin A supplementation on prepartum weight gain, a benefit on maintenance of postnatal weight was observed. The benefit was highest among those who were vitamin A-deficient or whose CD4+ count was < 200 cells/microL presupplementation. In populations for whom antiretroviral therapy is not readily available or accessible, the finding that vitamin A may improve postpartum weight lends some hope to a relatively inexpensive treatment which could be used for helping ameliorate some weight loss which is common during HIV infection."									
156	Persistently elevated serum interleukin-6 predicts mortality among adults receiving combination antiretroviral therapy in Botswana: Results from a clinical trial.	"McDonald B, Moyo S, Gabaitiri L, Gaseitsiwe S, Bussmann H, Koethe JR, Musonda R, et al."	AIDS Research and Human Retroviruses. 2013 01 Jul;29(7):993-9.		"Elevated serum levels of inflammatory biomarkers have been associated with increased mortality and morbidity among HIV-infected individuals receiving combination antiretroviral therapy (cART) in European and U.S. cohorts. Few similar data are available from sub-Saharan Africa, where most cART-treated adults reside and the prevalence of advanced immunosuppression and opportunistic infections (OIs) at cART initiation is higher. This was a retrospective nested case-control analysis of clinical trial data from the completed Adult Antiretroviral Treatment and Drug Resistance (""Tshepo"") study, 2002-2007, Gaborone, Botswana. We measured pretreatment serum levels of interleukin-6 (IL-6), high sensitivity C-reactive protein, and D-dimer in stored plasma samples from 32 deceased participants (cases) and 64 survivors (controls), matched for age, sex, baseline CD4<sup>+</sup> cell count, and plasma HIV-1 RNA. Multivariate conditional logistic regression analyses were used to compare inflammatory biomarker levels, adjusting for pretreatment body mass index (BMI) and the presence of OIs. A total of 37 (5.7%) of 650 patients died on study, for a crude mortality rate of 20.6/1,000 person-years. Of 37 (86%) study participants who died on study 32 were included in this analysis. Causes of death (n=32) included non-AIDS-defining events (31.3%), HIV-related OIs (28.1%), cART/toxicity-related (21.9%), other infectious etiologies (15.6%), and unknown (3.1%). Median time to death was 31 weeks [interquartile range (IQR) 14-64]. Median baseline levels of all three biomarkers were higher in cases compared to matched controls. After adjusting for BMI and the presence of OIs, only baseline and most recent (near time of event) levels of IL-6 remained as significant predictors of all-cause mortality [adjusted OR (aOR)=1.25, 95% CI (1.05-1.48); p=0.012; and aOR=1.48 (1.05-2.09); p=0.027, respectively]. Serum IL-6 levels are important predictors of all-cause mortality in this adult urban sub-Saharan African cART-treated population. Future translational studies are warranted to better elucidate pathophysiology and inform the design of novel interventions to ameliorate the risk of death among these ""at-risk"" individuals. 2013, Mary Ann Liebert, Inc."									
774	"Quality of care assessment and adherence to the international guidelines considering dialysis, water treatment, and protection against transmission of infections in university hospital-based dialysis units in Cairo, Egypt."	Ibrahim S.	Hemodialysis International. 2010;14(1):61-7.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=19758297	"End-stage renal disease has emerged as a major public health problem around the world. In recent decades, several important advances have been made in the therapy of hemodialysis (HD) with the introduction of international guidelines to ensure the delivery of optimum care to HD patients. An increased mortality risk in HD patients unable to meet six targets in different areas of HD practice has been reported by the Dialysis Outcomes and Practice Patterns Study investigators. In this retrospective study, we assessed the current practice patterns of care for HD patients in the Kaser El-Aini Nephrology and Dialysis Center in comparison with Dialysis Outcomes Quality Initiative Guidelines, European Best Practice Guidelines, Centers for Disease Control and Prevention guidelines for prevention of transmission of infections among HD patients, and American Association for Medical Instrumentation (AAMI) standards for dialysis water quality. The mean percent of urea reduction was 63 +/- 8.8% in prevalent HD patients. An arteriovenous fistula was the vascular access in 91% of prevalent HD patients, whereas a temporary catheter was used in 9% of cases mostly as a bridge till arteriovenous fistula creation/maturation. Bicarbonate was the base used in 80% of the cases. Ninty-seven percent patients had thrice-weekly sessions and 3% had two dialysis sessions/wk. The mean serum albumin was 4.19 +/- 0.39 g/dL; 66.66% of prevalent patients had serum albumin level >4 g/dL. The mean serum calcium was 8.66 +/- 1.4 mg/dL, phosphorus was 6.26 +/- 2.54 mg/dL, and approximately 60% of patients had a serum phosphorus level >5.5 mg/dL. The CaxPi product was higher than 55 in around 40% of the cases, and the parathyroid hormone level was in the range of 150 to 300 pg/mL in around 10% of prevalent patients. The mean hemoglobin was 9.23 +/- 7.18 g/dL in prevalent cases; around 70% of cases had a hemoglobin level <11 g/dL. Iron deficiency was prevalent as 18% of patients, with serum ferritin <200 ng/L, and 34% had total serum test <20%. Seventy percent of the patients were hepatitis C virus positive and 4% were hepatitis B surface antigen positive, and all were negative for the human immunodeficiency virus serological test. Dialysis water was monitored regularly for chemical and bacterial contamination as recommended by the American Association for Medical Instrumentation, but an endotoxin assay is currently not included in the monitoring checklist. The annual mortality rate was 8% in 2007. The current audit revealed a reasonable quality of care for HD patients in the fields of vascular access care, dialysis adequacy, and nutrition areas. It also reveals the need for improving anemia management and control of hyperphosphatemia with dietary counseling and more frequent dialysis. To fully meet the guideline targets, each patient should be treated in an individualized way with more counseling, nutritional education, and individualized dialysis prescription. Besides, the unit needs to adopt primary and secondary intervention strategies to prevent and promptly correct any deviation from the desired targets."									
193	Energy expenditure in HIV infection.	Kosmiski L.	American Journal of Clinical Nutrition. 2011 01 Dec;94(6):1677S-82S.		"Energy intake recommendations for adults should be based preferably on direct measurements of total daily energy expenditure (TDEE) in corresponding populations who are maintaining healthy body weight and satisfactory physical activity levels. During adolescence, pregnancy, and lactation, energy requirements should be based on TDEE plus the additional energy required to advance these physiologic states. With illness, energy expenditure and energy intake change, but nutritional intervention is not necessarily beneficial. This article reviews data on energy expenditure in HIV infection with a focus on adults, adolescents aged >=14 y, and pregnant and lactating women. Resting energy expenditure (REE) in adults with untreated asymptomatic HIV is ~10% higher than in healthy control subjects. In asymptomatic adults receiving antiretroviral therapy, REE may be similarly increased. HIV wasting and secondary infections are also associated with increased REE. In contrast, TDEE is typically normal in asymptomatic HIV and decreased in HIV wasting and secondary infection. No direct measurements of REE or TDEE are available in adolescents or in pregnant or lactating women with HIV. On the basis of current data, energy intake may need to increase by ;10% in adults with asymptomatic HIV to maintain body weight. In adolescents and in pregnant and lactating women with asymptomatic HIV, energy requirements should approximate recommendations for their uninfected counterparts until further data are available. In the resource-rich world, the energy expenditure changes associated with HIV are unlikely to contribute to significant weight loss. More data are needed on energy expenditure in HIV-infected populations from developing nations, where concurrent malnutrition and coinfections are common. 2011 American Society for Nutrition."									
365	"Serum protein, albumin, globulin levels, and A/G ratio in HIV positive patients."	"Ranjit P, Uplabdhi R."	Biomedical & Pharmacology Journal. 2009;2(2):321-5.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20103075279	"Estimating serum total protein & serum albumin level assesses the nutritional status of the patient. Malnutrition is an important complication of HIV infection. Opportunistic infections not only cause altered body metabolism but are also associated with reduced oral intake, which seems to be the most important determinant of weight loss. The present study attempts to assess the following: - 1. The protein status in HIV positive patients. 2. If it is useful as a prognostic tool. The study demonstrates a significant increase (p<0.01) in serum total protein in morbid group as compared to controls. The mean serum total protein level in HIV positive patients was 7.43+or-0.43 gm% (control group=7.07+or-0.22 gm%). The serum albumin levels (mean=2.67+or-0.34 gm%) were decreased in morbid group as compared to control (4.45+or-0.26 gm %), which was found to be statistically highly significant (p<0.001). The serum globulin levels (mean=4.76+or-0.41 gm %) were increased in HIV positive patients as compared to controls (2.6+or-0.29 gm %). This increase was statistically highly significant (p<0.001). The mean serum A:G ratio in the control group was found to be 1.7+or-0.26 whereas in HIV positive patients it was reversed (0.56+or-0.1), which was statistically highly significant (p<0.001), according to the present study. The serum albumin level (<3 gm%) can be used as a prognostic indicator."									
1076	Towards realizing the health-related millennium development goals for migrants from Burma in Thailand.	"Ditton MJ, Lehane L."	Journal of Empirical Research on Human Research Ethics. 2009;4(3):37-48.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=19754234	"ETHICAL ISSUES IN HEALTH-RELATED research on politically oppressed migrant populations differ in significant ways from community health research in other contexts. The United Nations has set goals for such research. The health-related Millennium Development Goals (MDGs) were investigated in communities (""clusters"") of migrants from Burma living in villages in the Sangkhlaburi District of Thailand, adjacent to the Thai-Burma border. Hunger was experienced regularly in 70% of the households, and 26% of children under 5 years were underweight. Malaria, tuberculosis, and HIV/AIDS were prevalent. Few households took part in family planning, and there were many large families and disabled children. The health of the migrant populations was compromised by poverty, social exclusion, and under- or unemployment. Stakeholders in discussion groups concurred with the authors that tuberculosis detection and treatment and food production activities were important issues to address in developing projects to improve migrant health. This case study illustrates how the MDGs can be operationally defined."									
117	Demotivating infant feeding counselling encounters in southern Africa: do counsellors need more or different training?	"Buskens I, Jaffe A."	AIDS Care. 2008;20(3):337-45.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=18351482	"Ethnographic research was conducted in eleven low-resource settings across Swaziland, Namibia and South Africa to explore how the perceptions and experiences of counselling health workers, pregnant women and recent mothers could be used to improve infant feeding counselling in the context of mother to child transmission (MTCT) of HIV. We found many counselling encounters to be demotivating. Mothers often reported feeling judged, stigmatised and shamed. Counsellors complained of mothers' poor compliance and passive resistance and reported suffering from stress, depression and burnout. We observed a rift between the mothers and counselling nurses, with both parties holding opposing agendas grounded in conflicting realities, expectations, experiences and needs. While the clients framed the visit as a consultation, counsellors framed it as health education, towards one exclusive purpose; to save the baby. Two communication modes prevailed in the counselling encounter: in theory, the counselling format was non-directive and client-centred but, in practice, most encounters reverted to information-based health education. Neither counselling format enabled the counsellors to acknowledge the reality of the two opposing agendas in the conversation and manage its dynamics. In order to achieve success - which, for the health service, is framed as persuading mothers to test for HIV and disclose the result - counsellors often felt compelled to be prescriptive and authoritative and reverted at times to confronting, judging and shaming mothers. Yet to adhere to their feeding choice consistently, mothers need to be motivated towards the significant behaviour change that this implies: to change their traditional roles and identities as women. For infant feeding counselling in the context of HIV/AIDS to become effective in southern Africa, a different format is therefore required; one that can acknowledge and manage these opposing agendas and conflicting realities and also enable counsellors to motivate mothers to make significant behaviour change."									
15	Food security in Central Asia and Eastern Europe and possible solutions for hunger and malnutrition in these regions.	"Kadlecikova M, Filo M."	Acta Oeconomica et Informatica. 2011;14(1):5-8.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20113121993	"Even at the beginning of the 21th century, hunger and malnutrition are still serious problems for many countries in the world. It is estimated that every three and a half seconds a person dies because of insufficient amount of food. There are as much as 925 million undernourished people on our planet. Hunger and malnutrition present in fact a great risk to the health worldwide, even greater than AIDS, malaria and tuberculosis altogether. Eastern Europe and Central Asia are both regions with specific conditions and issues related to the poorer part of the population. The goal of this paper is to point out possible solutions for eradication of extreme poverty with specific focus on these two regions and to highlight the most important factors that have had an influence on the development of the agricultural sector in these regions."									
1066	Probiotics for the developing world.	"Reid G, Anand S, Bingham MO, Mbugua G, Wadstrom T, Fuller R, Anukam K, et al."	Journal of Clinical Gastroenterology. 2005;39(6):485-8.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=15942433	"Every minute of every day more and more children die of diarrheal diseases and women, and girls become infected by HIV. An estimated 7,000 women become infected each day. While many valiant efforts are being made to address these issues, until now they have proved to be markedly ineffective. The notion that lactic acid bacteria, formulated into food or dietary supplements, could have a role to play in slowing the morbidity and mortality associated with HIV/AIDS and gastroenteritis, is built upon sound clinical findings and scientific investigations, yet no international efforts have been placed in this approach, to date. We hereby summarize the reasons why such efforts should be made, provide an example of one model being set up in sub-Saharan Africa, and challenge the international community to consider the potential benefits of probiotics, especially for communities not reached by governmental and nongovernmental agencies. [References: 33]"									
1031	"Feeding mode, intestinal permeability, and neopterin excretion: a longitudinal study in infants of HIV-infected South African women."	"Rollins NC, Filteau SM, Coutsoudis A, Tomkins AM."	Journal of Acquired Immune Deficiency Syndromes: JAIDS. 2001;28(2):132-9.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=11588506	"Exclusive breast feeding has been associated with a lower rate of mother-to-child HIV transmission than breast feeding plus other foods. To obtain further information on biologic outcomes of different feeding modes, we examined 272 infants of HIV-infected South African women at ages 1, 6, and 14 weeks. At each visit information about infant diet and morbidity was collected and infants underwent a lactulose/mannitol dual sugar intestinal permeability test. In a subset of infants, urinary neopterin excretion was measured as an indicator of immune system activation. Infants who had themselves become HIV-infected by 14 weeks had higher ( p <.01) intestinal permeability at 6 and 14 weeks and slightly (.05 < p <.1) higher neopterin excretion at all times than uninfected infants. At 1 week infants given no breast milk had higher ( p <.05) intestinal permeability than infants given breast milk exclusively or with other foods. Intestinal permeability in infants fed breast milk plus other foods was never increased relative to that of exclusively breastfed infants. Feeding mode had no effect on neopterin excretion. Thus, infant HIV infection induces changes in gut permeability and possibly immune system activation before clinical symptoms become apparent. The effects of feeding mode on infant intestinal permeability or urinary neopterin excretion do not explain a possible protective effect of exclusive breast feeding on mother-to-child transmission of HIV."									
1363	Establishing individual peer counselling for exclusive breastfeeding in Uganda: Implications for scaling-up.	"Nankunda J, Tylleskar T, Ndeezi G, Semiyaga N, Tumwine JK."	Maternal and Child Nutrition. 2010 January;6(1):53-66.		"Exclusive breastfeeding remains critical for child survival, potentially reducing childhood morbidity and mortality. In Uganda, 98% of children are ever breastfed, but exclusive breastfeeding levels remain low. Supporting mothers in breastfeeding exclusively can improve breastfeeding practices. This paper describes experiences of establishing individual peer counselling for exclusive breastfeeding in the Uganda site of the Promoting Infant Health and Nutrition in Sub-Saharan Africa: Safety and Efficacy of Exclusive Breastfeeding Promotion in the Era of HIV trial, and highlights some implications for scaling-up. Twelve women were identified by their communities, one from each of 12 clusters. They were trained for 6 days and followed up for 1 year while they counselled mothers. Their knowledge and attitudes towards exclusive breastfeeding were assessed before and immediately after training, and also 10 months into peer counselling. Observations, field notes and records of interactions with peer counsellors were used to record experiences from this intervention. The communities were receptive to peer counselling and women participated willingly. After training and 10 months' follow-up, their knowledge and attitude to exclusive breastfeeding improved. All were retained in the study, and mothers accepted them in their homes. They checked for mothers several times if they missed them on the first attempt. Husbands and grandmothers played key roles in infant feeding decisions. Involving the communities in selection helped to identify reliable breastfeeding peer counsellors who were acceptable to mothers and were retained in the study. Other key issues to consider for scaling-up such interventions include training and follow up of peer counsellors, which led to improved knowledge and attitudes towards exclusive breastfeeding. 2009 Blackwell Publishing Ltd."									
1347	Food-based dietary guidelines and nutrition interventions for children at primary healthcare facilities in South Africa.	"Hendricks MK, Goeiman H, Dhansay A."	Maternal & Child Nutrition. 2007;3(4):251-8.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=17824853	"Existing dietary recommendations and nutrition counselling provided to mothers/caregivers at primary healthcare (PHC) facilities are reviewed and analysed to be consistent with food-based dietary guidelines (FBDGs) that are being developed for preschool children. Recommendations provided by the Integrated Management of Childhood Illness and the provincial Paediatric Case Management Guidelines, which are currently implemented at PHC facilities were reviewed. For FBDGs to be consistent with nutrition counselling that is provided to mothers/caregivers at these facilities, various principles need to be promoted. These include among others, exclusive and on-demand breastfeeding in the HIV-negative mother; exclusive breastfeeding with abrupt cessation preferably at 6 months or exclusive, safe and adequate formula feeding in the HIV-infected mother; the introduction of complementary feeds in all infants at 6 months; the provision of energy-dense and micronutrient-enriched (particularly, iron, zinc, calcium and vitamin A) complementary feeds; frequent visits to the healthcare facility; and physical activity aimed at encouraging a healthy lifestyle and preventing overweight and obesity in childhood. The FBDGs should be incorporated into nutrition and child health programmes and be reviewed and modified regularly. [References: 29]"									
1587	Factors predicting discordant virological and immunological responses to antiretroviral therapy in HIV-1 clade C infected zulu/xhosa in South Africa.	"Julg B, Poole D, Ghebremichael M, Castilla C, Altfeld M, Sunpath H, Murphy RA, et al."	PLoS ONE. 2012 14 Feb;7(2).		"Factors predicting suboptimal CD4 cell recovery have been studied in HIV clade-B infected US and European populations. It is, however, uncertain to what extent these results are applicable to HIV clade-C infected African populations. Multivariate analysis using logistic regression and longitudinal analyses using mixed models were employed to assess the impact of age, gender, baseline CD4 cell count, hemoglobin, body mass index (BMI), tuberculosis and other opportunistic co-infections, and frequencies of regimen change on CD4 cell recovery at 12 and 30 months and on overtime change in CD4 cells among 442 virologically suppressed South Africans. Despite adequate virological response 37% (95% CI:32%-42%) and 83% (95% CI:79%-86%) of patients on antiretroviral therapy failed to restore CD4 cell counts >=200 cells/mm<sup>3</sup> after 12 and >=500 cells/mm<sup>3</sup> after 30 months, respectively, in this South African cohort. Critical risk factors for inadequate recovery were older age (p = 0.001) and nadir CD4 cell count at ART initiation (p&0.0001), while concurrent TB co-infection, BMI, baseline hemoglobin, gender and antiretroviral regimen were not significant risk factors. These data suggest that greater efforts are needed to identify and treat HAART-eligible patients prior to severe CD4 cell decline or achievement of advanced age. 2012 Julg et al."									
710	"Maternal awareness of the WHO guidelines on infant feeding is related to HIV status, feeding practices, and stunting in Andhra Pradesh, India."	"Singh A, Ramakrishna GS, Grizas AP, Humphries D."	FASEB Journal. 2010 April;24.		"Family Health International's Balasahyoga program provides child growth monitoring and nutrition counseling to HIV/AIDS affected households in Andhra Pradesh. Objectives: To assess awareness of the WHO guidelines on infant feeding among HIV+ and HIV- mothers, and to determine whether awareness of the guidelines is related to feeding practices and infant nutritional status. Methods: A cross-sectional assessment of Balasahyoga program participants (HIV+ N=44) and neighborhood controls (HIV- N=41), with infants 6-12 months of age, was conducted in Guntur and West Godavari districts of Andhra Pradesh. The mothers were interviewed regarding feeding practices and anthropometric measurements were taken of mothers and infants. Results: HIV+ mothers were 3.23 times more likely to be aware of the WHO guidelines than HIV- mothers (unadjusted, p=0.02). Infants of HIV+ mothers were 5.88 times more likely to be stunted than infants of HIV- mothers (unadjusted, p=0.01). Guideline-aware HIV+ mothers were more likely to have ever breastfed (p=0.003) and less likely to have stunted infants (p=0.01) than guideline-unaware HIV+ mothers. Conclusion: Among the HIV+ mothers, awareness of the WHO guidelines is positively associated with breastfeeding and infant nutritional status. This initial finding emphasizes the importance of guideline implementation and evaluation of further educational interventions for HIV+ mothers."									
456	"Acute- phase response and iron status markers among pulmonary tuberculosis patients: a cross-sectional study in Mwanza, Tanzania."	"Friis H, Range N, Braendgaard Kristensen C, Kaestel P, Changalucha J, Malenganisho W, Krarup H, et al."	British Journal of Nutrition. 2009;102(2):310-7.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=19175946	"Fe status is difficult to assess in the presence of infections. To assess the role of the acute- phase response (APR) and other predictors of serum ferritin and transferrin receptor, we conducted a cross-sectional study among pulmonary tuberculosis (PTB) patients in Mwanza, Tanzania. The acute- (serum ferritin) phase protein, serum alpha1-antichymotrypsin (ACT) and serum ferritin and serum soluble transferrin receptor (sTfR) were measured, and data on smoking, soil and alcohol intake, and infection status were collected. Linear regression analysis was used to assess the role of elevated serum ACT and other predictors of serum ferritin and serum sTfR. Of 655 patients, 81.2 % were sputum positive (PTB+) and 47.2 % HIV+. Mean serum ACT was 0.72 g/l, with 91.1 % above 0.4 g/l. Among females and males, respectively, geometric mean serum ferritin was 140.9 and 269.1 microg/l (P < 0.001), and mean serum sTfR 4.3 and 3.8 mg/l (P < 0.001). Serum sTfR was increased 0.5 mg/l and log serum ferritin increased linearly with serum ACT >0.4 g/l. PTB+ and HIV infection, alcohol drinking and smoking were the positive predictors of serum ferritin, and female sex, soil eating, Schistosoma mansoni and hookworm infection were the negative predictors. Similarly, smoking and HIV infection were the negative predictors of serum sTfR, and female sex, soil eating and PTB+ were the positive predictors. Serum ferritin and serum sTfR are affected by the APR, but may still provide information about Fe status. It may be possible to develop algorithms, based on the markers of the APR and Fe status, to assess the Fe status among the patients with tuberculosis or other infections eliciting an APR."									
1958	Pathological manifestations of feline immunodeficiency virus (FIV) infection in wild African lions.	"Roelke ME, Brown MA, Troyer JL, Winterbach H, Winterbach C, Hemson G, Smith D, et al."	Virology. 2009 20 Jul;390(1):1-12.		"Feline immunodeficiency virus (FIV) causes AIDS in the domestic cat (Felis catus) but has not been explicitly associated with AIDS pathology in any of the eight free-ranging species of Felidae that are endemic with circulating FIV strains. African lion (Panthera leo) populations are infected with lion-specific FIV strains (FIVple), yet there remains uncertainty about the degree to which FIV infection impacts their health. Reported CD4+ T-lymphocyte depletion in FIVple-infected lions and anecdotal reports of lion morbidity associated with FIV seroprevalence emphasize the concern as to whether FIVple is innocuous or pathogenic. Here we monitored clinical, biochemical, histological and serological parameters among FIVple-positive (N = 47) as compared to FIVple-negative (N = 17) lions anesthetized and sampled on multiple occasions between 1999 and 2006 in Botswana. Relative to uninfected lions, FIVple-infected lions displayed a significant elevation in the prevalence of AIDS-defining conditions: lymphadenopathy, gingivitis, tongue papillomas, dehydration, and poor coat condition, as well as displaying abnormal red blood cell parameters, depressed serum albumin, and elevated liver enzymes and gamma globulin. Spleen and lymph node biopsies from free-ranging FIVple-infected lions (N = 9) revealed evidence of lymphoid depletion, the hallmark pathology documented in immunodeficiency virus infections of humans (HIV-1), macaques, and domestic cats. We conclude that over time FIVple infections in free-ranging lions can lead to adverse clinical, immunological, and pathological outcomes in some individuals that parallel sequelae caused by lentivirus infection in humans (HIV), Asian macaques (SIV) and domestic cats (FIVfca). 2009 Elsevier Inc."									
1135	Micronutrients and fetal growth.	"Fall CH, Yajnik CS, Rao S, Davies AA, Brown N, Farrant HJ."	Journal of Nutrition. 2003;133(5 Suppl 2):1747S-56S.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=12730494	"Fetal undernutrition affects large numbers of infants in developing countries, with adverse consequences for their immediate survival and lifelong health. It manifests as intrauterine growth retardation (IUGR), defined as birth weight <10th percentile, which probably underestimates the number failing to achieve full growth potential. Birth weight is a crude measure of the dynamic process of fetal growth and does not capture effects of fetal undernutrition on body composition and the development of specific tissues. The link between maternal nutrition and fetal nutrition is indirect. The fetus is nourished by a complex supply line that includes the mother's diet and absorption, endocrine status and metabolism, cardiovascular adaptations to pregnancy and placental function. Micronutrients are essential for growth, and maternal micronutrient deficiency, frequently multiple in developing countries, may be an important cause of IUGR. Supplementation of undernourished mothers with micronutrients has several benefits but there is little hard evidence of improved fetal growth. However, this has been inadequately tested. Most trials have only used single micronutrients and many were inconclusive because of methodological problems. Several food-based studies (some uncontrolled) suggest benefits from improving maternal dietary quality with micronutrient-dense foods. One trial of a multivitamin supplement (HIV-positive mothers, Tanzania) showed increased birth weight and fewer fetal deaths. Well-conducted randomized controlled trials of adequate sample size and including measures of effectiveness are needed in populations at high risk of micronutrient deficiency and IUGR and should include food-based interventions and better measurements of fetal growth, maternal metabolism, and long-term outcomes in the offspring. [References: 104]"									
1136	Micronutrients and fetal growth.	"Fall CHD, Yajnik CS, Shobha R, Davies AA, Brown N, Farrant HJW."	"Journal of Nutrition. 2003;133(5, Supplement2)."	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh3&AN=20033110390	"Fetal undernutrition affects large numbers of infants in Developing Countries, with adverse consequences for their immediate survival and lifelong health. It manifests as intrauterine growth retardation (IUGR), defined as birth weight <10th percentile, which probably underestimates the number failing to achieve full growth potential. Birth weight is a crude measure of the dynamic process of fetal growth and does not capture effects of fetal undernutrition on body composition and the development of specific tissues. The link between maternal nutrition and fetal nutrition is indirect. The fetus is nourished by a complex supply line that includes the mother's diet and absorption, endocrine status and metabolism, cardiovascular adaptations to pregnancy and placental function. Micronutrients are essential for growth, and maternal micronutrient deficiency, frequently multiple in Developing Countries, may be an important cause of IUGR. Supplementation of undernourished mothers with micronutrients has several benefits, but there is little hard evidence of improved fetal growth. However, this has been inadequately tested. Most trials have only used single micronutrients and many were inconclusive because of methodological problems. Several food-based studies (some uncontrolled) suggest benefits from improving maternal dietary quality with micronutrient-dense foods. One trial of a multivitamin supplement (HIV-positive mothers, Tanzania) showed increased birth weight and fewer fetal deaths. Well-conducted randomized controlled trials of adequate sample size and including measures of effectiveness are needed in populations at high risk of micronutrient deficiency and IUGR and should include food-based interventions and better measurements of fetal growth, maternal metabolism and long-term outcomes in the offspring."									
39	Nutritional status of children (6-59 months) among HIV-positive mothers/caregivers living in an urban setting of Uganda.	"Bukusuba J, Kikafunda JK, Whitehead RG."	"African Journal of Food, Agriculture, Nutrition and Development. 2009;9(6):1345-64."	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20093320701	"Few studies have attempted to establish the burden of childhood malnutrition and the associated factors among households of HIV-positive mothers/caregivers particularly in urban settings. There is also no satisfactory evidence of health and nutritional benefits of food aid in this particular group where options to attain a balanced diet are generally minimal. A cross-sectional survey was therefore organized to assess the prevalence of malnutrition and establish the contributory factors that would be vital in design of interventions. The target group was children under five years of age (6-59 months) of HIV-positive mothers/caregivers residing in an urban setting of Uganda. Interviews were conducted with a random sample of 144 households of HIV-positive mothers/caregivers of children under the age of five years in Jinja municipality in Eastern Uganda. Nutritional status was determined on every randomly selected index child from sampled households. Epi-Info 2002 was used for calculation of z-scores and Nutrisurvey for SMART (2005) for drawing anthropometric charts. SPSS version 12 was then used for descriptive statistics, bivariate and multivariate analyses. For all the statistical tests, P<=0.05 was considered significant. The proportion of stunted children (23%) among study households was nearly 12 times higher, underweight (11%) more than five times higher and wasting (3.5%) about two times higher than the level expected in a healthy, well-nourished population. Malnutrition among children under five years of age in households of mothers/caregivers living with HIV/AIDS in Ugandan urban settings is therefore of public health concern. The identified causative factors include high malaria and fever episodes, high dependency ratio, low food access, low Socio-Economic Status (SES) and low education level of mother/caregiver. Interventions to address malnutrition in this vulnerable group should therefore aim at addressing the identified contributory factors. Use of insecticide-treated mosquito nets (ITNs) and campaigns to ensure their proper use, income generating activities, and kitchen gardening are some of the targeted interventions that could contribute to alleviation of the problem. Food aid to supplement the diet contributes to daily energy requirements."									
1244	"Impact of HIV/aids on child mortality before the highly active antiretroviral therapy era: a study in Pointe-Noire, Republic of Congo."	"Lallemant C, Halembokaka G, Baty G, Ngo-Giang-Huong N, Barin F, Coeur Sl."	Journal of Tropical Medicine. 2010;897176(24).	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20113024063	"Few studies have documented the contribution of HIV/AIDS to mortality among children under 15 years. From June 30 to October 19, 2001, all child deaths (n=588) registered to the morgue and/or hospitals of the city of Pointe-Noire, Congo, were investigated using a combined approach including an interview of relatives and postmortem clinical and biological HIV diagnosis. Twenty-one percent of children were HIV positive, while 10.5% of deaths were attributed to AIDS. The most common causes of death in HIV-infected children were pneumonia (30%), pyrexia (22%), diarrhoea (16%) and wasting syndrome (16%). Infant mortality rate was estimated 6.3 times higher in children born to HIV-infected mothers compared to HIV-uninfected mothers. This study provides a direct measure of HIV/AIDS as impact on child mortality using a rapid and reliable method. A significant number of deaths could be prevented if HIV infection was diagnosed earlier and infants were provided with antiretroviral treatments."									
694	Supply and demand constraints in the delivery of a national food by prescription program for HIV+ individuals in Ethiopia.	"Coates J, Stobaugh H, Bontrager E."	FASEB Journal. 2012 April;26.		"Few studies have examined the effect on health and nutrition outcomes of food offered ""by prescription"" to people living with HIV/AIDS. Likewise, the implementation processes conducive to achieving significant impacts and constraints to program effectiveness are not well documented. This study examines the delivery and utilization of a therapeutic Plumpy'nut ration as part of the Ethiopia National Food by Prescription (FBP) Program. Quantitative monitoring data from FBP clinic sites were analyzed to examine the proportion of patients attending ART and FBP appointments and receiving drugs and nutrition rations. 130 male and female FBP participants and medical staff were engaged in focus group discussions using participatory methods at 8 FBP program health facilities to examine factors related to program participation, adherence, and perceived changes in health and nutrition status. Approximately 50% of rations were reportedly consumed by the HIV+ index patient. Pressure to sell and share rations, negative ration side-effects, transportation difficulties, stigma, and additional burden on health workers emerged as constraints to efficient implementation. Attention to often under-utilized monitoring data can enable the timely resolution of critical implementation bottlenecks, leading to greater program effectiveness."									
941	The Impact of HIV and AIDS on Lesotho Primary School Children.	Ntaote GM.	International Perspectives on Education and Society. 2012 2012;18:161-85.	http://search.proquest.com/docview/1315599768?accountid=26724	"Fifty-one orphans from five primary schools in the Maseru District, whose parents died of HIV- and AIDS-related illnesses, were interviewed for their experiences of HIV and AIDS. They were interviewed with regard to their psychosocial problems, their attendance at school, stigma and discrimination, nutrition and career aspirations. The interview schedule comprised of 37 items developed and validated by the researcher. Sixty-four per cent of the orphans lived with maternal grandmothers, 8% with maternal aunts, 8% with the elder sisters, 12% with elder brothers and 8% lived on their own, including looking after younger siblings. The orphans do not only have unmet basic or material needs but also have markedly increased psychosocial problems, exacerbated by their inability to access essential services such as healthcare due to poverty. Thus, their long-term psychological health, resilience, self-worth and self-esteem are in jeopardy. There is an urgent need to enhance and expand all current community and school intervention programmes not only to meet the basic needs of orphans but also to include psychosocial support (PSS), improved counselling services and training of caregivers and teachers in critical areas of care and support for the orphans. Adapted from the source document."									
775	"Viral dynamics of hepatitis B virus DNA in human immunodeficiency virus-1-hepatitis B virus coinfected individuals: Similar effectiveness of lamivudine, tenofovir, or combination therapy."	"Lewin SR, Ribiero RM, Avihingsanon A, Bowden S, Matthews G, Marks P, Locarnini SA, et al."	Hepatology. 2009;49(4):1113-21.		"Following treatment of hepatitis B virus (HBV) infection with nucleos(t)ide reverse transcriptase inhibitors (NRTIs), there is a biphasic clearance of HBV, similar to that seen following treatment of human immunodeficiency virus-1 (HIV-1) and hepatitis C virus. Little is known about the impact of combination NRTIs and HIV-1 coinfection on HBV viral kinetic parameters following the initiation of HBV-active highly active antiretroviral therapy (HAART). HIV-1-HBV coinfected patients (n=21) were enrolled in a viral kinetics substudy of the Tenofovir in HIV-1-HBV Coinfection study (TICO). TICO was a randomized (1:1:1) trial of tenofovir disoproxil fumarate (TDF, 300 mg) versus lamivudine (LMV, 300 mg) versus TDF/LMV within an efavirenz based HAART regimen initiated in HIV-1-HBV coinfected antiretroviral naive individuals in Thailand. HBV DNA was measured frequently over the first 56 days. To fit the viral load data, we used a model of HBV kinetics that allows the estimation of treatment effectiveness, viral clearance and infected cell loss. We observed a biphasic decline in HBV DNA in almost all patients. We did not observe any significant differences in HBV viral dynamic parameters between the three treatments groups. Overall, median (interquartile range) HBV treatment effectiveness was 98% (95%-99%), median HBV virion half-life was 1.2 days (0.5-1.4 days), and median infected cell half-life was 7.9 days (6.3-11.0 days). When we compared hepatitis B e antigen (HBeAg)-positive and HBeAg-negative individuals, we found a significantly longer infected cell half-life in HBeAg-positive individuals (6.2 versus 9.0 days, P = 0.02). Conclusion: HBV viral dynamic parameters are similar following anti-HBV NRTI monotherapy and dual combination therapy in the setting of HIV-1-HBV coinfection. HIV-1 coinfection has minimal effect on HBV viral dynamics, even in the setting of advanced HIV-1-related immunosuppression."									
1193	Food Demand in Northern Nigeria: Implications for Food Policy.	Akinleye SO.	Journal of Social Sciences. 2009 Mar 2009;18(3):209-15.	http://search.proquest.com/docview/61769427?accountid=26724	"Food calorie intake has been found to have a strong empirical linkage with both human health and productivity. This study sets out to determine the probable influence of price and income changes on the availability of food nutrients to households in Northern Nigeria. Demand elasticities were obtained for survey respondents and the nutritional effects of changes arising from changes in income and prices were computed using both the AIDS methodology and a technique developed by Huang. The findings show that yam, maize and guinea corns are the foods that would have the greatest implications for the nutrient status of the households. The study concludes with the likely applications of the methodology used to derive nutrient elasticities. Adapted from the source document."									
120	The benefit of supplementary feeding for wasted Malawian adults initiating ART.	"Oosterhout JJv, Ndekha M, Moore E, Kumwenda JJ, Zijlstra EE, Manary M."	AIDS Care. 2010;22(6):737-42.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20103228400	"Food insecurity is considered to be an important contributor to HIV associated wasting in sub-Saharan Africa. Low body mass index (BMI) is a strong risk factor for early mortality during antiretroviral therapy (ART). Nutritional supplementation has become standard of care in wasted patients starting ART in many countries in the region, but there is no unequivocal evidence base for this intervention. Against this background, we performed a retrospective study to compare food supplementation versus no nutritional intervention in wasted adults starting ART in Blantyre, Malawi. All patients received free nevirapine, lamivudine, and stavudine. Participants in an effectiveness trial of two food supplements received either corn-soy blend (CSB) or ready-to-use food spread (RUFS) during the first 14 weeks of ART. Results were compared with a historical control group receiving no food supplement that was part of an observational cohort study of outcomes of the same ART regimen. Characteristics on initiation of ART were similar in the three groups, except the use of cotrimoxazole prophylaxis which was more frequent in the food-supplemented groups. Linear regression analysis showed that increase in BMI was greatest in the RUFS group and better in the CSB group than in those receiving no food supplementation at 14 weeks. These differences were no longer significant at 26 weeks. Lower BMI, CD4 count and hemoglobin, WHO clinical stage IV, male gender, and not receiving cotrimoxazole prophylaxis were independent risk factors for mortality at 14 and 26 weeks in the logistic regression analysis. Supplementary food use was not directly associated with improved survival."									
124	The benefit of supplementary feeding for wasted Malawian adults initiating ART.	"van Oosterhout JJ, Ndekha M, Moore E, Kumwenda JJ, Zijlstra EE, Manary M."	AIDS Care. 2010;22(6):737-42.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=20467944	"Food insecurity is considered to be an important contributor to HIV associated wasting in sub-Saharan Africa. Low body mass index (BMI) is a strong risk factor for early mortality during antiretroviral therapy (ART). Nutritional supplementation has become standard of care in wasted patients starting ART in many countries in the region, but there is no unequivocal evidence base for this intervention. Against this background, we performed a retrospective study to compare food supplementation versus no nutritional intervention in wasted adults starting ART in Blantyre, Malawi. All patients received free nevirapine, lamivudine, and stavudine. Participants in an effectiveness trial of two food supplements received either corn-soy blend (CSB) or ready-to-use food spread (RUFS) during the first 14 weeks of ART. Results were compared with a historical control group receiving no food supplement that was part of an observational cohort study of outcomes of the same ART regimen. Characteristics on initiation of ART were similar in the three groups, except the use of cotrimoxazole prophylaxis which was more frequent in the food-supplemented groups. Linear regression analysis showed that increase in BMI was greatest in the RUFS group and better in the CSB group than in those receiving no food supplementation at 14 weeks. These differences were no longer significant at 26 weeks. Lower BMI, CD4 count and hemoglobin, WHO clinical stage IV, male gender, and not receiving cotrimoxazole prophylaxis were independent risk factors for mortality at 14 and 26 weeks in the logistic regression analysis. Supplementary food use was not directly associated with improved survival."									
1642	The food multimix concept: new innovative approach to meeting nutritional challenges in Sub-Saharan Africa.	"Zotor FB, Amuna P."	Proceedings of the Nutrition Society. 2008;67(1):98-104.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=18234137	"Food insecurity, chronic hunger, starvation and malnutrition continue to affect millions of individuals throughout the developing world, especially Sub-Saharan Africa. Various initiatives by African governments and International Agencies such as the UN, the industrial nations, the International Monetary Fund, the World Bank and the World Trade Organisation to boost economic development, have failed to provide the much-needed solution to these challenges. The impact of these economic shifts and the failures of structural adjustment programmes on the nutritional well-being and health of the most vulnerable members of poor communities cannot be over-emphasised. The use of ad hoc measures as an adjunct to community-based rural integrated projects have provided little success and will be unsustainable unless they are linked to harnessing available local resources. The present paper therefore focuses on exploring alternative ways of harnessing the scant agricultural resources by employing a scientific approach to food-related problem-solving. The food multimix (FMM) concept offers a scientific contribution alongside other attempts currently in use by the World Food Programme, WHO and FAO to meet the food insecurity challenges that confront most of the developing world in the twenty-first century. It is an innovative approach that makes better use of traditional food sources as a tool for meeting community nutritional needs. The FMM concept employs a food-based approach using traditional methods of food preparation and locally-available, cheap and affordable staples (fruits, pulses, vegetables and legumes) in the formulation of nutrient-enriched multimixes. Developed recipes can provide > or =40% of the daily nutritional requirements of vulnerable groups, including patients with HIV/AIDS and children undergoing nutrition rehabilitation. The FMM approach can also be used as a medium- to long-term adjunct to community-based rural integration projects aimed at health improvement and economic empowerment in Sub-Saharan Africa."									
364	Current food and nutrition situation in south Asian and south-east Asian countries.	Gopalan C.	Biomedical & Environmental Sciences. 1996;9(2-3):102-16.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=8886320	"Food production in the countries of South and South-East Asia has shown a general upward trend during the last decade. Despite the considerable increase in population in many of these countries, food production per capita in 1988-90 was significantly higher as compared to 1979-81 figures, the increase being specially marked in such countries as Vietnam, Cambodia, Indonesia, and Malaysia. Available daily calorie supply was adequate to meet the requirement. The overall pattern of food production however has shown little change, with cereal production continuing to account for a predominant part of food production. There is no evidence of a significant uptrend with respect to production of pulses, milk, horticultural products, poultry or meat production in most countries. A unique and unfortunate feature of the nutrition situation in South-Asian countries is that the incidence of low birth weight deliveries is as high as 34% (1990), ranging from 25% in Sri Lanka to 50% in Bangladesh (as against less than 7% in the countries of Europe and North America). Even in countries of Africa where the overall food and nutrition situation is worse than in South Asia, the incidence is well below 20%. This is a reflection of the poor state of maternal nutrition in pregnancy. Florid nutritional deficiency diseases have shown a steep decline over the last two decades, but goitre and iron deficiency anaemia continue to be major public health problems, though some headway has been made with regard to the control of the former. Severe forms of growth retardation in children have declined but the majority suffer from mild and moderate forms of growth retardation. Countries of the Region are in varying stages of developmental transition. Among the burgeoning middle classes in some of these countries there are evidences of escalation of degenerative diseases such as diabetes and coronary heart disease. With increasing life expectancy, geriatric nutritional problems will demand increasing attention. [References: 15]"									
186	Food insecurity: special considerations for women.	"Ivers LC, Cullen KA."	American Journal of Clinical Nutrition. 2011;94(6):1740S-4.	http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=2011386351&site=ehost-live	"Food security exists when all people, at all times, have physical, social, and economic access to sufficient, safe, and nutritious food that meets their dietary needs and food preferences for an active and healthy life. Food insecurity is the converse state, is often associated with poverty and low income, and has important implications for the health and nutrition of individuals. Given their contribution to food production and preparation, their role in society as child bearers and caregivers, the increasing number of female-headed households worldwide, and their disproportionately poor economic status, women need special consideration in discussions of food insecurity and its effect on health, nutrition, and behavior. This article reviews the scientific literature on issues related to women and food insecurity. Food insecurity is associated with obesity, anxiety, and depressive symptoms; risky sexual behavior; poor coping strategies; and negative pregnancy outcomes in women, although evidence about the direction and causality of associations is unclear. There is a lack of evidence and understanding of the effects of food insecurity in resource-poor settings, including its effect on weight, nutritional outcomes, and pregnancy outcomes, as well as its effect on progression of diseases such as HIV infection. More research is needed to guide efficient interventions that address food insecurity among women. However, practical experience suggests that both short-term assistance and longer-term strategies that improve livelihoods, address behavioral and coping strategies, acknowledge the mental health components of food insecurity, and attempt to ensure that women have the same economic opportunities, access to land, and economic power as men are important."									
1192	Impact of pregnancy on maternal AIDS.	"Kumar RM, Uduman SA, Khurrana AK."	Journal of Reproductive Medicine. 1997;42(7):429-34.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh2&AN=19972008550	"From February 1992 to February 1996, 71 tribal women from Manipur, India, with AIDS (CDC stage III/IV), matched for age, parity, CD4<sup>+</sup> lymphocyte count and demographic characteristics, were recruited into a prospective study. 32 (49%) of these women were pregnant (8-10 weeks) (group A) and 38 (51%) non-pregnant (group B). Pneumocystis carinii pneumonia followed by miliary tuberculosis and wasting disease were the most common AIDS-defining illness and cause of maternal death in both groups. A total of 28 (39%) women died as a direct result of their AIDS-defining illness; 10 (27%) of them were among the non-pregnant women as compared to 18 (56%) deaths among the pregnant women (P=0.17, odds ratio 3.7, 95% CI 1.23, 11.58). 3 (16%) of these 18 deaths occurred within 14 weeks of an uneventful first-trimester medical termination of pregnancy. 13 women (41%) died undelivered at 30-34 weeks' gestation, and 2 died within 3 weeks of delivery. 14 (144%) women vaginally delivered 14 preterm infants, between 28 and 35 weeks' gestation. 11 of these infants died within 6 weeks; 9 deaths were a direct result of prematurity and clinical diagnosis of an AIDS-defining illness. The mean survival time was 9.72 months for the pregnant women and 22.6 months for the non-pregnant women (P=0.066)."									
1376	Late development kwashiorkor: a consequence of family disintegration.	"Mayanda H, Moubouh I, Nkoua JL, Nzingoula S."	Medecine d'Afrique Noire. 1996;43(2):79-81.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh2&AN=19971404449	"From January 1989 to September 1994, 8 girls and 6 boys 4 to 15 years old with kwashiorkor of late development were admitted to the paediatric department of a hospital in Brazzaville, Congo. Of the children, 5 were from families with both parents present, both parents of 4 were dead, 1 parent of 2 was dead and the parents of 3 were divorced. None of the mothers and 9 of the fathers were in employment. All the children were underweight and 3 of 8 tested were positive for human immunodeficiency virus. After treatment for a period of 10 to 60 days, 13 were discharged as cured. One died as a result of peritoneal tuberculosis. All the cases were related to poverty resulting from the disintegration of the traditional family unit."									
683	Effect of nutritional and HIV status on bacteraemia in Zimbabwean children who died at home.	"Wolf BHM, Ikeogu MO, Vos ET."	European Journal of Pediatrics. 1995;154(4):299-303.		"From July 1992 to May 1993 a study was performed of the relationship between bacteraemia, nutritional status and HIV status in 212 out of 334 consecutive infants and children aged 0-5 years, who had died at home in Bulawayo, Zimbabwe. The remaining 122 children were excluded because the time period between death and arrival at the hospital was over 3 h. A pathogen was isolated from 92 (43%) children and Klebsiella species were most commonly isolated. A positive HIV serology was found in 122 (58%) children and 110 (52%) children were malnourished. Malnutrition was significantly associated with bacteraemia at death after adjustment for the confounding effect of age and HIV status (odds ratio 4.28; 95% CI 2.27-8.07; P < 0.001). No association was found between either HIV serostatus or proven HIV infection and bacteraemia, which could not be attributed to nutritional status. Conclusion. Bacteraemia, in particular with Gram-negative bacteria, is an important cause of death in malnourished children in Zimbabwe regardless of their HIV-1 antibody status."									
130	Challenges faced by elderly guardians in sustaining the adherence to antiretroviral therapy in HIV-infected children in Zimbabwe.	"Skovdal M, Campbell C, Madanhire C, Nyamukapa C, Gregson S."	AIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV. 2011 August;23(8):957-64.		"Grandparents throughout sub-Saharan Africa have shown immense courage and fortitude in providing care and support for AIDS-affected children. However, growing old comes with a number of challenges which can compromise the quality of care and support they are able to provide, particularly for children infected by HIV and enrolled on antiretroviral therapy (ART) programmes. For ART to be effective, and for infected children not to develop drug-resistance, a complex treatment regimen must be followed. Drawing on the perspectives of 25 nurses and eight grandparents of HIV-infected children in Manicaland, eastern Zimbabwe, we explore some of the challenges faced by grandparents in sustaining children's adherence to ART. These challenges, serving as barriers to paediatric ART, are poverty, immobility, deteriorating memory and poor comprehension of complex treatments. Although older HIV-infected children were found to play an active role in sustaining the adherence to their programme of treatment by contributing to income and food generating activities and reminding their guardians about check-ups and drug administration, such contribution was not available from younger children. There is therefore an urgent need to develop ART services that both take into consideration the needs of elderly guardians and acknowledge and enhance the agency of older children as active and responsible contributors to ART adherence. 2011 Taylor & Francis."									
645	Strategies to improve care for children with cancer in Sub-Saharan Africa.	"Israels T, Ribeiro RC, Molyneux EM."	European Journal of Cancer. 2010;46(11):1960-6.	http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=2010732450&site=ehost-live	"Great progress has been made in the care of children with cancer in recent decades. Worldwide, more than 80% of children with cancer live in resource-limited countries where access to care is poor. Sub-Saharan Africa is the world's poorest region. Child mortality is high, caused by largely preventable and treatable conditions. Paediatric cancer accounts for only a small fraction of deaths and understandably receives little attention from local policy makers or global health agencies. The survival of children with cancer is very poor. Challenges to improving survival include advanced-stage disease at presentation, failure to start or complete treatment (abandonment), inadequate hospital infrastructure and medications, lack of trained health care providers, lack of cancer registration and follow-up and lack of treatment guidelines adapted to local medical facilities. We propose a stepwise approach that integrates paediatric cancer treatment with existing general paediatric care. Priority is given to interventions (improvement of supportive care, diagnostic facilities) that also improve general paediatric care. Minimal requirements for diagnostic procedures include complete blood counts, HIV and malaria tests, blood cultures, histopathology and simple imaging (X-ray and ultrasonography). Feasible interventions include adequate palliative care, curative treatment for Burkitt lymphoma and Wilms tumour and symptomatic treatment for Kaposi sarcoma."									
1142	Multivitamin supplements have no effect on growth of Tanzanian children born to HIV-infected mothers.	"Kupka R, Manji KP, Bosch RJ, Aboud S, Kisenge R, Okuma J, Fawzi WW, et al."	Journal of Nutrition. 2013;143(5):722-7.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=23514773	"Growth faltering and micronutrient deficiencies commonly coexist in HIV-exposed children in sub-Saharan Africa, and correcting deficiencies, such as those of vitamins B-complex, C, and E, may improve HIV-related endpoints and child growth. We therefore examined the effect of daily oral supplementation of vitamins B-complex, C, and E on growth among 2341 children born to HIV-infected mothers in Tanzania. HIV-infected women pregnant at <=32 wk of gestation were enrolled in the study. Children were randomized at age 6 wk to receive multivitamins or placebo until age 104 wk. All women received the same types of vitamins pre- and postnatally. At 6 wk, 256 children (11.1%) were HIV infected and the mean (SD) Z-scores for length for age (LAZ), weight for length (WLZ), and weight for age (WAZ) were -0.39 +/- 1.20, -0.21 +/- 1.23, and -0.52 +/- 1.11, respectively. There was no overall treatment effect on LAZ, WLZ, or WAZ profiles during the follow-up (P >= 0.15). There was no treatment effect from 6 to 104 wk on LAZ [(95% CI: -0.14, 0.13); P = 0.94], WLZ [(95% CI: -0.17, 0.13); P = 0.78], or WAZ [(95% CI: -0.15, 0.16); P = 0.97] or on the incidence of growth failure, defined as respective Z-scores < -2 (P >= 0.29). Among the subgroup of HIV-uninfected children, there was no treatment effect from 6 to 104 wk on LAZ, WLZ, and WAZ (P >= 0.71) or on the incidence of growth failure (P >= 0.16). Multivitamin supplements had no effect on growth among children born to HIV-infected women who were themselves receiving multivitamins."									
272	An analysis of the determinants of anaemia in pregnant women in rural Malawi--a basis for action.	"Verhoeff FH, Brabin BJ, Chimsuku L, Kazembe P, Broadhead RL."	Annals of Tropical Medicine & Parasitology. 1999;93(2):119-33.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=10474637	"Haematological data are presented on 4104 pregnant women attending the antenatal-care facilities of two hospitals in a rural area in southern Malawi. In this area, malaria transmission is perennial and there is a high prevalence of HIV infection. The local women are exposed to drought and food shortages but experience high fertility rates. Mean (S.D.) haemoglobin (Hb) concentration was significantly lower in the primigravidae [8.7 (1.60 g/dl] than in the secundigravidae [9.1 (1.5) g/dl; P < 0.0001] or multigravidae [9.2 (1.5) g/dl; P < 0.0001]. Primigravidae also experienced significantly more iron deficiency and malaria than secundi- or multi-gravidae. For all parity groups, the lowest mean Hb levels were observed between 26-30 weeks' gestation. In primigravidae peak prevalence of malaria occurred between 16-20 weeks' gestation (38.6%) and peak prevalence of moderately severe anaemia (< 8 g Hb/dl) between 26-30 weeks' (35.7%). Multigravidae showed little variation in the prevalence of anaemia, iron deficiency and malaria with gestational age. Peak prevalences of malaria were observed in April, in the post-rainy season, with values of 51.4%, 56.0% and 25.3% for primi-, secundi- and multi-gravidae, respectively. Peak prevalences of iron deficiency occurred between April and May and those of moderately severe anaemia between May and June. Mean Hb was lower in adolescent primigravidae than in any other group of pregnant women [8.6 (1.5) g/dl], including the non-adolescent primigravidae [8.9 (1.6) g/dl; P = 0.008]. Other factors significantly associated with increased risk of moderately severe anaemia in primigravidae were illiteracy and poor nutritional status (i.e. body mass index < 18.5 kg/m2 and mid-upper-arm circumference < 23 cm). After forward, step-wise, regression analysis of relative risk (RR) factors and their 95% confidence intervals (CI), variables associated with an increased risk for moderately severe anaemia were iron deficiency (RR = 4.2; CI = 3.0-6.0) and malaria parasitaemia (RR = 1.9; CI = 1.3-2.7) in primigravidae, iron deficiency (RR = 4.1; CI = 2.7-6.3) and mid-upper-arm-circumference < 23 cm (RR = 1.8; CI = 1.1-3.0) in secundigravidae, and iron deficiency in multigravidae (RR = 3.1; CI = 4.3-6.9)."									
274	An analysis of the determinants of anaemia in pregnant women in rural Malawi - A basis for action.	"Verhoeff FH, Brabin BJ, Chimsuku L, Kazembe P, Broadhead RL."	Annals of Tropical Medicine and Parasitology. 1999;93(2):119-33.		"Haematological data are presented on 4104 pregnant women attending the antenatal-care facilities of two hospitals in a rural area in southern Malawi. In this area, malaria transmission is perennial and there is a high prevalence of HIV infection. The local women are exposed to drought and food shortages but experience high fertility rates. Mean (S.D.) haemoglobin (Hb) concentration was significantly lower in the primigravidae [8.7 (1.6) g/dl] than in the secundigravidae [9.1 (1.5) g/dl; P < 0.0001] or multigravidae [9.2 (1.5) g/dl; P < 0.0001]. Primigravidae also experienced significantly more iron deficiency and malaria than secundi -or multi-gravidae. For all parity groups, the lowest mean Hb levels were observed between 26-30 weeks' gestation. In primigravidae peak prevalence of malaria occurred between 16-20 weeks' gestation (38.6%) and peak prevalence of moderately severe anaemia (< 8 Hb/dl) between 26-30 weeks' (35.7%). Multigravidae showed little variation in the prevalence of anaemia, iron deficiency and malaria with gestational age. Peak prevalences of malaria were observed in April, in the post-rainy season, with values of 51.4%, 56.0% and 25.3% for primi-, secundi- and multi-gravidae, respectively. Peak prevalences of iron deficiency occurred between April and May and those of moderately severe anaemia between May and June. Mean Hb was lower in adolescent primigravidae than in any other group of pregnant women [8.6 (1.5) g/dl], including the non-adolescent primigravidae [8.9 (1.6) g/dl; P = 0.008]. Other factors significantly associated with increased risk of moderately severe anaemia in primigravidae were illiteracy and poor nutritional status (i.e. body mass index < 18.5 kg/m<sup>2</sup> and mid-upper-arm circumference < 23 cm). After forward, step-wise, regression analysis of relative risk (RR) factors and their 95% confidence intervals (CI), variables associated with an increased risk for moderately severe anaemia were iron deficiency (RR = 4.2; CI = 3.0-6.0) and malaria parasitaemia (RR = 1.9; CI = 1.3-2.7) in primigravidae, iron deficiency (RR = 4.1; CI = 2.7-6.3) and mid-upper-arm-circumference < 23 cm (RR 1.8; CI = 1.1-3.0) in secundigravidae, and iron deficiency in multigravidae (RR = 3.1; CI = 4.3-6.9). The basis of anaemia prevention in this population of pregnant women is malaria control and haematinic supplementation, one of the most serious drawbacks being non-compliance. Although the present data are presented according to the World Health Organization's definitions of anaemia, the corresponding cut-off values for Hb (< 11 or < 7 g/dl) were not associated with malaria, suggesting that these Hb levels would be less useful indicators in malaria interventions. It is argued that an Hb value of < 8 g/dl might be considered for identifying the pregnant women at highest risk, for selective health education to reduce non-compliance."									
1120	Establishing a head and neck unit in a developing country.	"Aswani J, Baidoo K, Otiti J."	Journal of Laryngology and Otology. 2012 June;126(6):552-5.		"Head and neck cancers pose an especially serious problem in developing countries due to late presentation requiring complex surgical intervention. These countries are faced with many challenges, ranging from insufficient health care staff to problems with peri-operative requirements, diagnostic facilities, chemoradiation services and research funding. These challenges can be addressed through the training of head and neck surgeons and support personnel, the improvement of cancer awareness in local communities, and the establishment of dedicated head and neck institutes which focus on the special needs of head and neck cancer patients. All these changes can best be achieved through collaborative efforts with external partners. The Karl Storz Fellowship in Advanced Head and Neck Cancer, enabling training at the University of Cape Town, South Africa, has served as a springboard towards establishing head and neck services in developing sub-Saharan African countries. JLO (1984) Limited 2012."									
1150	"The influence and benefits of controlling for inflammation on plasma ferritin and hemoglobin responses following a multi-micronutrient supplement in apparently healthy, HIV+ Kenyan adults."	"Mburu ASW, Thurnham DI, Mwaniki DL, Muniu EM, Alumasa F, Wagt Ad."	Journal of Nutrition. 2008;138(3):613-9.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20103009490	"Hemoglobin and ferritin are important biomarkers of iron status but are both altered by inflammation. We used the inflammation biomarkers C-reactive protein (CRP) and alpha 1-acid glycoprotein (AGP) to adjust hemoglobin and ferritin concentrations to clarify interpretation of iron status. Apparently healthy adults who tested positive twice for HIV but who had not reached stage IV or clinical AIDS were randomly allocated to receive a food supplement (n=17 and 21) or the food plus a micronutrient capsule (MN; 10 men and 34 women, respectively) containing 30 mg iron/d. Hemoglobin, ferritin, CRP, and AGP concentrations were measured at baseline and 3 mo and subjects were divided into 4 groups (reference, no inflammation; incubating, raised CRP; early convalescence, raised AGP and CRP; and late convalescence, raised AGP). Correction factors (the ratios of the median for the reference group over each inflammatory group) improved the consistency of the ferritin but not the hemoglobin results. After correction, ferritin (but not hemoglobin) increased in both men (48 micro g/L; P=0.02) and women (12 micro g/L; P=0.04) who received MN but not in the food-only group. However, hemoglobin did improve in subjects who showed no inflammation both at baseline and mo 3 (P=0.019), but ferritin did not increase in this group. In conclusion, ferritin concentrations were more closely linked to current inflammation than hemoglobin; hence, correction by inflammation biomarkers improved data consistency. However, low hemoglobin concentrations were the consequence of long-term chronic inflammation and improvements in response to MN supplements were only detected in subjects with no inflammation."									
1149	"The influence and benefits of controlling for inflammation on plasma ferritin and hemoglobin responses following a multi-micronutrient supplement in apparently healthy, HIV+ Kenyan adults."	"Mburu ASW, Thurnham DI, Mwaniki DL, Muniu EM, Alumasa F, De Wagt A."	Journal of Nutrition. 2008 March;138(3):613-9.		"Hemoglobin and ferritin are important biomarkers of iron status but are both altered by inflammation. We used the inflammation biomarkers C-reactive protein (CRP) and alpha1-acid glycoprotein (AGP) to adjust hemoglobin and ferritin concentrations to clarify interpretation of iron status. Apparently healthy adults who tested positive twice for HIV but who had not reached stage IV or clinical AIDS were randomly allocated to receive a food supplement (n = 17 and 21) or the food plus a micronutrient capsule (MN; 10 men and 34 women, respectively) containing 30 mg iron/d. Hemoglobin, ferritin, CRP, and AGP concentrations were measured at baseline and 3 mo and subjects were divided into 4 groups (reference, no inflammation; incubating, raised CRP; early convalescence, raised AGP and CRP; and late convalescence, raised AGP). Correction factors (the ratios of the median for the reference group over each inflammatory group) improved the consistency of the ferritin but not the hemoglobin results. After correction, ferritin (but not hemoglobin) increased in both men (48 mug/L; P = 0.02) and women (12 mug/L; P = 0.04) who received MN but not in the food-only group. However, hemoglobin did improve in subjects who showed no inflammation both at baseline and mo 3 (P = 0.019), but ferritin did not increase in this group. In conclusion, ferritin concentrations were more closely linked to current inflammation than hemoglobin; hence, correction by inflammation biomarkers improved data consistency. However, low hemoglobin concentrations were the consequence of long-term chronic inflammation and improvements in response to MN supplements were only detected in subjects with no inflammation. 2008 American Society for Nutrition."									
765	Clinical outcome of interferon and ribavirin combination treatment in hepatitis C virus infected patients with congenital bleeding disorders in Iran.	"Rahmani M, Toosi MN, Ghannadi K, Lari GR, Jazebi M, Rasoulzadegan M, Ala F."	Haemophilia. 2009;15(5):1097-103.		"Hepatitis C virus (HCV) infection is a major cause of morbidity and mortality in patients with inherited bleeding disorders. The results of interferon and ribavirin combination therapy have been reported in a limited number of clinical trials on these patients. Peginterferon is a costly treatment. Conventional interferon and ribavirin therapy is still the main available and affordable antiviral therapy in some countries. The goal of this study was to assess the effectiveness and safety of interferon alfa-2b plus ribavirin in HIV seronegative, non-alcoholic, non-cirrhotic, naive subjects with congenital coagulopathy. Between May 2003 and August 2007, 103 haemophiliacs were treated consecutively with standard inclusion and exclusion criteria, with interferon alfa-2b (PDferon B) 3MIU three times a week subcutaneously plus ribavirin, for 24-48 weeks, with appropriate dose adjustments. They were all scheduled to have serial visits and laboratory tests. Among 7(6.8%) female and 96(93.2%) male haemophiliacs, 11(10.68%) cases did not complete the study because of psychological side effects. With intent-to-treat analysis, end-of-treatment response was 63.1%, and sustained virological response (SVR) was 56.3%. There was a significant correlation between SVR and genotype, baseline HCV viral load, rapid virological response, early virological response and BMI. A decrease in the haemoglobin level of two patients required ribavirin dose reduction. One developed thrombocytopenia at the end of treatment, but none had neutropenia. Hypothyroidism was observed in two patients. Interferon plus ribavirin combination therapy in HCV-infected haemophilic patients is well tolerated and treatment outcomes appear to be similar to those seen in the general population. 2009 Blackwell Publishing Ltd."									
1879	Peculiarities of some biochemical parameters for HCV patients living in selenium-deficiency region.	"Skesters A, Silova A, Rozentale B, Petukhov V, Rusakova N, Ivanchenko L, Larmane L."	Trace elements in the food chain. 2006(2006.):30-4. 7 ref.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20073222280	"Hepatitis C virus (HCV) infection is a major public health problem. Up to 3% of the world's population is infected with HCV, and at least aproximally 80 000 citizens in the Latvia carry the virus. Of those exposed to HCV, 70%-80% become chronically infected, and at least 20%-30% of carries develop chronic liver disease, including cirrhosis and hepatocellular carcinoma. This paper present antioxidant status and prooxidants of different HCV patients groups."									
1345	Maternal nutrition in rural Kenya: health and socio-demographic determinants and its association with child nutrition.	"Gewa CA, Oguttu M, Yandell NS."	Maternal & Child Nutrition. 2012;8(3):275-86.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=21624050	"High levels of food insecurity and human immunodeficiency virus (HIV) infection place most breastfeeding mothers in Kenya at high risk of malnutrition. We examined the role of selected socio-economic, demographic and health factors as determinants of nutritional status among HIV-infected and HIV-uninfected mothers in rural Kenya and further examined the interrelationship between maternal nutritional and child nutritional status within this population. A cross-sectional design was used to collect data from non-pregnant mothers with children ages 4-24 months in Kisumu District, Kenya. Over 80% of the mothers were breastfeeding at the time of the study. Mean maternal body mass index (BMI) (21.60 +/- 3.15) and percent body fat (22.29 +/- 4.86) values were lower than among lactating mothers in other Sub-Sahara African countries. Maternal HIV status was not significantly associated with any of the maternal nutritional indicators assessed in the study. Breastfeeding, recent severe illness and having multiple children below 2 years of age were negatively associated with maternal nutritional status, while higher maternal age, socio-economic status and household food security were each positively associated with maternal nutritional status. Significant positive association was reported between maternal weight, height, BMI, mid-upper arm circumference (MUAC), body fat and fat-free mass estimates, and children's height-for-age, weight-for-age, weight-for-height and MUAC-for-age z-score. This analysis identifies determinants of maternal nutritional status in rural Kenya and highlights the importance of interventions that address malnutrition in both HIV-infected and HIV-uninfected mothers in rural Kenya. Significant association between maternal and child nutritional status stresses the importance of addressing maternal and young child nutritional status as interrelated factors. 2011 Blackwell Publishing Ltd."									
832	Antiretroviral therapy in HIV-1 infected children.	"Lodha R, Upadhyay A, Kabra SK."	Indian Pediatrics. 2005 August;42(8):789-96.		"Highly active antiretroviral therapy is beyond reach of most HIV-infected children in developing countries. There is paucity of data on more affordable regimens such as ones based on nevirapine and 2 nucleoside reverse transcriptase inhibitors. We report our experience with the use of antiretroviral therapy in children with HIV-1 infection at a tertiary care hospital in north India. The study subjects were HIV-1 infected children, who were receiving 3-drug antiretroviral therapy for a period of three or more months. The children were regularly followed up for any complications, changes in anthropometry, and changes in CD4 counts. The mean age of children at diagnosis (n=26; 22 boys) was 68.5 +/- 33.4 months. These children were followed up for a mean of 19.7 +/- 18.7 months. Twenty four children received nevirapine based regimen. There was statistically significant improvement in weight for height and body mass index on follow up. The mean CD4 count changed from baseline (n=24) of 584.3 +/- 685.9/mm<sup>3</sup> to 614.4 +/- 455.7/mm<sup>3</sup> (n=15) at last follow up. One child developed minor skin rash in the initial two weeks of starting nevirapine. One child developed pancreatitis. We conclude that administration of nevirapine based ART for HIV-1 infected children is feasible in resource poor setting. There is improvement in growth parameters with use of this therapy."									
833	Antiretroviral therapy in HIV-1 infected children.	"Rakesh L, Amit U, Kabra SK."	Indian Pediatrics. 2005;42(8):789-96.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh3&AN=20053150567	"Highly active antiretroviral therapy is beyond reach of most HIV-infected children in developing countries. There is paucity of data on more affordable regimens such as ones based on nevirapine and 2 nucleoside reverse transcriptase inhibitors. We report our experience with the use of antiretroviral therapy in children with HIV-1 infection at a tertiary care hospital in north India. The study subjects were HIV-1 infected children, who were receiving 3-drug antiretroviral therapy for a period of three or more months. The children were regularly followed up for any complications, changes in anthropometry, and changes in CD4 counts. The mean age of children at diagnosis (n=26; 22 boys) was 68.5+or-33.4 months. These children were followed up for a mean of 19.7+or-18.7 months. 24 children received nevirapine based regimen. There was statistically significant improvement in weight for height and body mass index on follow up. The mean CD4 count changed from baseline (n=24) of 584.3+or-685.9/mm<sup>3</sup> to 614.4+or-455.7/mm<sup>3</sup> (n=15) at last follow up. One child developed minor skin rash in the initial two weeks of starting nevirapine. One child developed pancreatitis. We conclude that administration of nevirapine based ART for HIV-1 infected children is feasible in resource poor setting. There is improvement in growth parameters with use of this therapy."									
632	Implementation of nutritional recommendations for HIV-infected individuals in black Africa.	"Nguewo EA, Winkler G, Kaptue L."	Ernahrungs Umschau. 2008;55(6):334-9.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20083179673	"HIV infection affects the economic strength of many countries, predominantly of those in Africa. Besides the prevention of new infections, it is essential to ensure the quality of life and work capacity of HIV-infected individuals for the longest possible period. To prevent food-related infections, practical recommendations for drinking water, food and kitchen hygiene have been developed. In this paper, the development and implementation of nutritional recommendations for HIV-infected individuals in Africa are described."									
1452	Nutrition and HIV in the international setting.	Wanke C.	Nutrition in Clinical Care. 2005;8(1):44-8.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=15850234	"HIV infection has become increasingly prevalent globally, with more than 40 million infected individuals worldwide, the majority of whom live in the resource-limited world, especially sub-Saharan Africa and Asia. There are nutritional and metabolic issues that significantly impact morbidity and mortality in HIV-infected populations. In addition, malnutrition has been associated with an increased risk of transmission of HIV from infected mothers to infants, and malnutrition may further compromise HIV-infected individuals who have tuberculosis or persistent diarrheal disease. The introduction of highly active antiretroviral therapy will have a significant impact on the mortality of HIV, but will not completely alleviate the malnutrition associated with HIV infection in the global setting. [References: 31]"									
1468	Micronutrients and adverse pregnancy outcomes in the context of HIV infection.	"Fawzi W, Msamanga G."	Nutrition Reviews. 2004;62(7 Pt 1):269-75.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=15384917	"HIV infection is a global public health problem, particularly in Africa. Concurrently, micronutrient deficiencies and adverse pregnancy outcomes are prevalent in the same settings. Supplements containing B complex and vitamins C and E were efficacious in reducing adverse pregnancy outcomes, including fetal loss, low birth weight, and prematurity among HIV-infected women; the generalizability of this finding to uninfected women is being examined. There is little encouragement from published studies to provide prenatal vitamin A supplements in HIV infection, particularly in light of significantly higher risk of mother-to-child transmission observed in one trial. The efficacy and safety of prenatal zinc and selenium supplements on these outcomes need to be examined in randomized trials. [References: 46]"									
1255	Features of whey protein concentrate supplementation in children with rapidly progressive HIV infection.	"Moreno YF, Sgarbieri VC, da Silva MN, Toro AA, Vilela MM."	Journal of Tropical Pediatrics. 2006;52(1):34-8.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=16014759	"HIV infection is associated with subnormal GSH levels. An increase in glutathione levels has been observed in HIV-infected adults under oral whey protein supplementation. We studied the features associated with a whey protein concentrate supplementation in children with rapidly progressive AIDS. A prospective double-blind clinical trial was carried out for 4 months with 18 vertically HIV-infected children (1.98-6.37 years), under antiretroviral therapy, who had received whey protein, maltodextrin (placebo) or none. Erythrocyte glutathione concentration, T lymphocyte counts (CD4+ and CD8+) and occurrence of associated co-infections were evaluated. Wilcoxon's and Fischer's Exact tests were used to assess differences between whey protein-supplemented and control (placebo and non-supplemented) groups. A significant median increase of 16.14 mg/dl (p = 0.018) in erythrocyte glutathione levels was observed in the whey protein-supplemented group; the TCD4/CD8 lymphocyte ratio showed a non significant increase and lower occurrence of associated co-infections was also observed. In conclusion, whey protein concentrate supplementation can stimulate glutathione synthesis and, possibly, decrease the occurrence of associated co-infections."									
1256	Features of whey protein concentrate supplementation in children with rapidly progressive HIV infection.	"Moreno YF, Sgarbieri VC, Silva MNd, Toro AADC, Vilela MMS."	Journal of Tropical Pediatrics. 2006;52(1):34-8.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20063043059	"HIV infection is associated with subnormal GSH levels. An increase in glutathione levels has been observed in HIV-infected adults under oral whey protein supplementation. We studied the features associated with a whey protein concentrate supplementation in children with rapidly progressive AIDS. A prospective double-blind clinical trial was carried out for 4 months with 18 vertically HIV-infected children (1.98-6.37 years), under antiretroviral therapy, who had received whey protein, maltodextrin (placebo) or none. Erythrocyte glutathione concentration, T lymphocyte counts (CD4<sup>+</sup> and CD8<sup>+</sup>) and occurrence of associated co-infections were evaluated. Wilcoxon's and Fischer's Exact tests were used to assess differences between whey protein-supplemented and control (placebo and non-supplemented) groups. A significant median increase of 16.14 mg/dl (p=0.018) in erythrocyte glutathione levels was observed in the whey protein-supplemented group; the TCD4/CD8 lymphocyte ratio showed a non significant increase and lower occurrence of associated co-infections was also observed. In conclusion, whey protein concentrate supplementation can stimulate glutathione synthesis and, possibly, decrease the occurrence of associated co-infections."									
794	Severe acute malnutrition and HIV in African children.	Bunn JEG.	HIV Therapy. 2009;3(6):595-611.		"HIV is a significant cause of severe acute malnutrition (SAM) in Africa, which radically alters its epidemiology and clinical presentation. Clinical diagnosis of HIV is difficult: marasmus, oral candidiasis and persistent diarrhea are associated with HIV, but are also commonly observed in SAM. The same pathogens have been identified in HIV-infected and -uninfected children with SAM, but the former respond less well to treatment. HIV also affects children's nutrition through food insecurity and infant feeding practice. A threefold greater mortality (30%) occurs in children living with HIV during nutrition program admission and continues after discharge. Nutrition interventions alone are able to achieve a nutritional cure in most HIV-infected children, including those with severe immunodeficiency, although weight gain is slower. Nonresponse to nutritional therapy is a defining WHO clinical criteria for initiating antiretroviral treatment, and malnutrition is the strongest predictor of death after starting antiretrovirals. Few studies have addressed whether initial management of SAM in HIV infection should be modified from the standard protocol for HIV-uninfected SAM, but the high excess mortality suggests important differences in pathophysiology. Prophylactic cotrimoxazole reduces mortality, but for most HIV-infected children antiretrovirals are needed to achieve long-term survival. It remains unclear when antiretroviral treatment should be initiated. Pharmacokinetic and safety data are limited in SAM and immune reconstitution inflammatory syndromes may occur early during treatment. A better implementation of, and linkage between, nutrition, HIV counseling and testing, prevention of mother-child transmission, cotrimoxazole and antiretroviral services will be critical to improving the outcome in those children living with HIV and their families. 2009 Future Medicine Ltd."									
1393	How HIV-1 causes AIDS: implications for prevention and treatment.	Foster HD.	Medical Hypotheses. 2004;62(4):549-53.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=15050105	"HIV-1 encodes for one of the human glutathione peroxidases. As a consequence, as it is replicated, its genetic needs cause it to deprive HIV-1 seropositive individuals not only of glutathione peroxidase, but also of the four basic components of this selenoenzyme, namely selenium, cysteine, glutamine, and tryptophan. Eventually this depletion process causes severe deficiencies of all these substances. These, in turn, are responsible for the major symptoms of AIDS which include immune system collapse, greater susceptibility to cancer and myocardial infarction, muscle wasting, depression, diarrhea, psychosis and dementia. As the immune system fails, associated pathogenic cofactors become responsible for a variety of their own unique symptoms. Any treatment for HIV/AIDS must, therefore, include normalization of body levels of glutathione, glutathione peroxidase, selenium, cysteine, glutamine, and tryptophan. Although various clinical trials have improved the health of AIDS patients by correcting one or more of these nutritional deficiencies, they have not, until the present, been addressed together. Physicians involved in a selenium and amino-acid field trial in Botswana, however, are reporting that this nutritional protocol reverses AIDS in 99% of patients receiving it, usually within three weeks."									
14	Using underutilised food crops to strengthen the food and nutritional status of an HIV-impacted community in the Uzumba-Maramba-Pfungwe district of Zimbabwe.	"Nyamupingidza T, Breton Gl, MacHivenyika L."	Acta Horticulturae. 2013;979:195-202.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20133138489	"HIV-AIDS is a disease that is exacerbated by poor nutrition. Underutilised crops that are nutritionally and chemically diverse are a basis for improving the nutrition and antioxidant status of foods within the community. CADS, a local NGO, introduced a programme to help a community in the Uzumba-Maramba-Pfungwe district of Zimbabwe to use available underutilised crop resources to combat the effects of HIV-AIDS. This was done by increasing the community's awareness, knowledge, understanding, production, harvesting and use of underutilised crops found within their communities. This paper describes the impacts on household nutrition and health status of people in about 300 households involved in this programme in rural Zimbabwe and draws some general lessons about opportunities for using underutilised food crops to strengthen the nutritional status of an HIV-impacted community."									
114	Characterization of HIV-Associated Neurocognitive Disorders Among Individuals Starting Antiretroviral Therapy in South Africa.	"Joska JA, Westgarth-Taylor J, Myer L, Hoare J, Thomas KGF, Combrinck M, Paul RH, et al."	AIDS and Behavior. 2011 Aug 2011;15(6):1197-203.	http://search.proquest.com/docview/886254348?accountid=26724	"HIV-Associated Neurocognitive Disorders (HAND) exert an impact on everyday functions, including adherence. The prevalence of and risk factors for HAND in patients commencing anti-retroviral therapy in Southern Africa are unknown. Participants from primary care clinics in Cape Town, South Africa underwent detailed neuropsychological, neuropsychiatric, and neuromedical evaluation. Using the updated American Academy of Neurology (AAN) criteria, participants were classified into categories of HAND, and demographic and clinical risk factors for HIV-dementia (HIV-D) were assessed. The prevalence of mild neurocognitive disorder (MND) and HIV-D were 42.4 and 25.4%, respectively. There were significant associations between lower levels of education and older age with HIV-D, and a trend to association with HIV-D and lower CD4 count. In a regression model, a lower level of education and male gender were predictive of HIV-D. These findings suggest that HAND are highly prevalent in primary care settings in South Africa where clade C HIV is predominant."									
1262	HIV-exposed uninfected infants are at increased risk for severe infections in the first year of life.	"Slogrove A, Reikie B, Naidoo S, De Beer C, Ho K, Cotton M, Bettinger J, et al."	Journal of Tropical Pediatrics. 2012 December;58(6):505-8.		"HIV-exposed uninfected (HEU) infants have higher infectious morbidity than HIV-unexposed uninfected (HUU) infants. We present the clinical outcomes from a pilot cohort study of 27 HEU and 28 HUU infants. In the absence of infant malnutrition or advanced maternal HIV, HEU infants experienced a 2.74 (0.85-8.78) times greater risk of hospitalization in the first year. The Author [2012]. Published by Oxford University Press. All rights reserved."									
1538	Mortality after the first year of life among human immunodeficiency virus type 1-infected and uninfected children.	"Taha TE, Kumwenda NI, Broadhead RL, Hoover DR, Graham SM, Hoven Lvd, Markakis D, et al."	Pediatric Infectious Disease Journal. 1999;18(8):689-94.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh2&AN=19992010962	"HIV-infected and uninfected children who survived their first year of life were prospectively followed in Malawi to assess levels of mortality and related risk factors during the second and third years of life. Children with known HIV status from an earlier perinatal intervention trial were enrolled between May and October 1995. These children (HIV-infected (group A); HIV-uninfected but born to HIV-seropositive mothers (group B); and children born to HIV-seronegative mothers (group C)) were followed every 3 months until 36 months of age. Mortality data were collected at each visit. Immunological data (CD4<sup>+</sup> percent) were collected at or immediately after enrolment. Overall, 702 children were enrolled and 83 children died during follow-up. The mortality rate per 1000 person years of observation was 339.3 among group A children, 46.3 among group B children and 35.7 among group C children. Among HIV-infected children the cumulative proportion surviving to age 24 months was 70% and those surviving to age 36 months was 55%. By age 32 months none of the severely immunosuppressed (CD4%<15%) children had survived. The mortality differentials between HIV-infected and uninfected children persisted after adjusting for several risk factors. The major causes of death among infected children (n=52) were wasting and respiratory conditions. Although all HIV-infected children had received childhood immunizations, mortality was high. It is concluded that management of these children should include aggressive antimicrobial treatment, and evaluation of prophylactic regimens should be considered."									
905	Immune response to hepatitis A vaccination in HIV-infected men in Greece.	"Kourkounti S, Mavrianou N, V AP, Kyriakis K, Hatzivassiliou M, Kordosis T, Katsambas A."	International Journal of STD and AIDS. 2012 July;23(7):464-7.		"HIV-infected patients are at increased risk for acquiring hepatitis A virus (HAV) infection. We evaluated the seroconversion rate (anti-HAV antibodies >=20 mIU/ml) and the geometric mean antibody titres (GMTs) in a group of 351 HIV infected men, who had received two doses of a hepatitis A vaccine. We analysed blood samples collected at one, six, 12 and 18 months following the administration of the second dose of the vaccine. The seroconversion rate one month after the second dose of the vaccine was 74.4% (260/351). At month 18 after the end of vaccination, 56.1% of the subjects remained seropositive. GMTs were 315, 203, 153 and 126 mIU/ml at months 1, 6, 12, and 18, respectively. Logistic regression revealed that the CD4 count is the only factor affecting response to vaccination (P=0.019). A higher response rate and higher GMTs were observed in patients with CD4 counts >=500 cells/mm<sup>3</sup> (76.6%) than in patients with CD4 counts 200-499 cells/mm<sup>3</sup>. In conclusion, even in patients with near-normal CD4 counts, the response to the hepatitis A vaccine is impaired."									
1427	The effect of Spirulina platensis versus soybean on insulin resistance in HIV-infected patients: a randomized pilot study.	"Marcel AK, Ekali LG, Eugene S, Arnold OE, Sandrine ED, von der Weid D, Gbaguidi E, et al."	Nutrients. 2011;3(7):712-24.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=22254118	"HIV-infected patients develop abnormalities of glucose metabolism due to the virus and antiretroviral drugs. Spirulina and soybean are nutritional supplements that are cheap, accessible in our community and affect glucose metabolism. We carried out a randomized study to assess the effect of Spirulina platensis versus soybean as a food supplement on HIV/HAART-associated insulin resistance (IR) in 33 insulin-resistant HIV-infected patients. The study lasted for two months at the National Obesity Centre of Cameroon. Insulin resistance was measured using the short insulin tolerance test. Physical activity and diet did not change over the study duration. On-treatment analysis was used to analyze data. The Mann-Whitney U test, the Students T test and the Chi square test were used as appropriate. Curve gradients were analyzed using ANCOVA. Seventeen subjects were randomized to spirulina and 16 to soybean. Each received 19 g of supplement daily. The follow up rate was 65% vs. 100% for spirulina and soybean groups, respectively, and both groups were comparable at baseline. After eight weeks, insulin sensitivity (IS) increased by 224.7% vs. 60% in the spirulina and soybean groups respectively (p < 0.001). One hundred per cent vs. 69% of subjects on spirulina versus soybean, respectively, improved their IS (p = 0.049) with a 1.45 (1.05-2.02) chance of improving insulin sensitivity on spirulina. This pilot study suggests that insulin sensitivity in HIV patients improves more when spirulina rather than soybean is used as a nutritional supplement. Trial registration: ClinicalTrials.gov identifier NCT01141777."									
1428	The effect of Spirulina platensis versus soybean on insulin resistance in HIV-infected patients: A randomized pilot study.	"Marcel AK, Ekali LG, Eugene S, Arnold OE, Sandrine ED, vor der Weid D, Gbaguidi E, et al."	Nutrients. 2011 July;3(7):712-24.		"HIV-infected patients develop abnormalities of glucose metabolism due to the virus and antiretroviral drugs. Spirulina and soybean are nutritional supplements that are cheap, accessible in our community and affect glucose metabolism. We carried out a randomized study to assess the effect of Spirulina platensis versus soybean as a food supplement on HIV/HAART-associated insulin resistance (IR) in 33 insulin-resistant HIV-infected patients. The study lasted for two months at the National Obesity Centre of Cameroon. Insulin resistance was measured using the short insulin tolerance test. Physical activity and diet did not change over the study duration. On-treatment analysis was used to analyze data. The Mann-Whitney U test, the Students T test and the Chi square test were used as appropriate. Curve gradients were analyzed using ANCOVA. Seventeen subjects were randomized to spirulina and 16 to soybean. Each received 19 g of supplement daily. The follow up rate was 65% vs. 100% for spirulina and soybean groups, respectively, and both groups were comparable at baseline. After eight weeks, insulin sensitivity (IS) increased by 224.7% vs. 60% in the spirulina and soybean groups respectively (p < 0.001). One hundred per cent vs. 69% of subjects on spirulina versus soybean, respectively, improved their IS (p = 0.049) with a 1.45 (1.05-2.02) chance of improving insulin sensitivity on spirulina. This pilot study suggests that insulin sensitivity in HIV patients improves more when spirulina rather than soybean is used as a nutritional supplement. Trial registration: ClinicalTrials.gov identifier NCT01141777."									
1429	The effect of Spirulina platensis versus soybean on insulin resistance in HIV-infected patients: a randomized pilot study.	"Marcel AK, Ekali LG, Eugene S, Arnold OE, Sandrine ED, Weid Dvd, Gbaguidi E, et al."	Nutrients. 2011;3(7):712-24.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20113255587	"HIV-infected patients develop abnormalities of glucose metabolism due to the virus and antiretroviral drugs. Spirulina and soybean are nutritional supplements that are cheap, accessible in our community and affect glucose metabolism. We carried out a randomized study to assess the effect of Spirulina platensis versus soybean as a food supplement on HIV/HAART-associated insulin resistance (IR) in 33 insulin-resistant HIV-infected patients. The study lasted for two months at the National Obesity Centre of Cameroon. Insulin resistance was measured using the short insulin tolerance test. Physical activity and diet did not change over the study duration. On-treatment analysis was used to analyze data. The Mann-Whitney U test, the Students T test and the Chi square test were used as appropriate. Curve gradients were analyzed using ANCOVA. Seventeen subjects were randomized to spirulina and 16 to soybean. Each received 19 g of supplement daily. The follow up rate was 65% vs. 100% for spirulina and soybean groups, respectively, and both groups were comparable at baseline. After eight weeks, insulin sensitivity (IS) increased by 224.7% vs. 60% in the spirulina and soybean groups respectively (p<0.001). One hundred per cent vs. 69% of subjects on spirulina versus soybean, respectively, improved their IS (p=0.049) with a 1.45 (1.05-2.02) chance of improving insulin sensitivity on spirulina. This pilot study suggests that insulin sensitivity in HIV patients improves more when spirulina rather than soybean is used as a nutritional supplement."									
154	Predictive value of weight loss on mortality of HIV-positive mothers in a prolonged breastfeeding setting.	"Koyanagi A, Humphrey JH, Moulton LH, Ntozini R, Mutasa K, Iliff P, Ruff AJ."	AIDS Research and Human Retroviruses. 2011;27(11):1141-8.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20113374060	"HIV-positive lactating women may be at high risk of weight loss due to increased caloric requirements and postpartum physiological weight loss. Ten percent weight loss is associated with a higher risk of mortality in HIV-positive patients and this alone is a criterion for highly active antiretroviral therapy (HAART) initiation where CD4 counts are not available. However, no study has investigated this association in lactating postpartum women. We investigated whether 10% weight loss predicts death in postpartum HIV-positive women. A total of 9207 HIV-negative and 4495 HIV-positive mothers were recruited at delivery. Women were weighed at 6 weeks, 3 months, and every 3 months thereafter for up to 24 months postpartum and data on mortality up to 2 years were collected. The median duration of breastfeeding was longer than 18 months. Among HIV-positive women, the independent predictors of >=10% weight loss were CD4 cell count, body mass index, and household income. Mortality was up to 7.12 (95% CI 3.47-14.61) times higher in HIV-positive women with >=10% weight loss than those without weight loss. Ten percent weight loss in postpartum lactating HIV-positive women was significantly predictive of death. Our findings suggest that 10% weight loss is an appropriate criterion for HAART initiation among postpartum breastfeeding women."									
111	"Researchers seek solutions to diarrhea, wasting. Research takes several different twists and turns."	Anonymous.	AIDS Alert. 2001;16(3):38-9.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=15446234	"HIV-related diarrhea and cachexia are tremendously serious problems in developing countries where there is little access to antiretroviral medications. They also remain a concern for many AIDS patients in the United States, yet much needs to be proved with regard to treatments."									
1965	Children's body mass index and nutrition intake in HIV/AIDS.	"Lin CQ, Li L, Ji G, Wu S, Semaan A."	Vulnerable Children and Youth Studies. 2008;3(1):16-23.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20093112102	"HIV/AIDS in China poses many challenges for caregivers and their children. A total of 154 caregivers of HIV/AIDS-affected families were interviewed to examine the children's nutrition intake and body mass index (BMI) in the context of HIV/AIDS in the family. The results showed that 25% of children in HIV/AIDS-affected families were underweight or at risk of being underweight according to US criteria. More than half the children reported that their consumption of protein such as meat, eggs or milk ranged from not at all to two times during the past month. About 40% of the children sometimes or often went hungry due to insufficient food. The study findings underscore the need to improve the nutrition and general health of children of people living with HIV/AIDS."									
1630	HIV/AIDS: nutritional implications and impact on human development.	Colecraft E.	Proceedings of the Nutrition Society. 2008;67(1):109-13.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=18234139	"HIV/AIDS is associated with biological and social factors that affect the individual's ability to consume and utilize food and to acquire food. These biological and social factors lead to poor nutritional status and weight loss, which are an important cause of morbidity in individuals infected with HIV, resulting in a poor quality of life; weight loss is an important predictor of death from AIDS. The links between nutrition and HIV/AIDS amplify the negative effects of HIV infection on human development at individual, household, community and national levels. For many developing countries the incidence of HIV/AIDS and malnutrition is impeding progress towards achieving the UN millennium development goals. Aggressive interventions to curb the spread of HIV continue to be needed. Concurrent efforts to improve nutrition for populations living with HIV/AIDS should also be given priority. [References: 43]"									
1065	Yogurt containing probiotic Lactobacillus rhamnosus GR-1 and L. reuteri RC-14 helps resolve moderate diarrhea and increases CD4 count in HIV/AIDS patients.	"Anukam KC, Osazuwa EO, Osadolor HB, Bruce AW, Reid G."	Journal of Clinical Gastroenterology. 2008;42(3):239-43.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=18223503	"HIV/AIDS is changing the human landscape in sub-Saharan Africa. Relatively few patients receive antiretroviral therapy, and many suffer from debilitating diarrhea that affects their quality of life. Given the track record of probiotics to alleviate diarrhea, conventional yogurt fermented with Lactobacillus delbruekii var bulgaricus and Streptococcus thermophilus was supplemented with probiotic Lactobacillus rhamnosus GR-1 and L. reuteri RC-14. Twenty-four HIV/AIDS adult female patients (18 to 44 y) with clinical signs of moderate diarrhea, CD4 counts over 200, and not receiving antiretrovirals or dietary supplements, consumed either 100 mL supplemented or unsupplemented yogurt per day for 15 days. Hematologic profiles, CD4 cell counts, and quality of life was evaluated at baseline, 15 and 30 days postprobiotic-yogurt feeding. There was no significant alteration in the hematologic parameters of both groups before and after the probiotic-yogurt feeding. The probiotic yogurt group at baseline, 15 and 30 days had a mean WBC count of 5.8+/-0.76 x 10(9)/L, 6.0+/-1.02 x 10(9)/L, and 5.4+/-0.14 x 10(9)/L, respectively. However, the mean CD4 cell count remained the same or increased at 15 and 30 days in 11/12 probiotic-treated subjects compared to 3/12 in the control. Diarrhea, flatulence, and nausea resolved in 12/12 probiotic-treated subjects within 2 days, compared to 2/12 receiving yogurt for 15 days. This is the first study to show the benefits of probiotic yogurt on quality of life of women in Nigeria with HIV/AIDS, and suggests that perhaps a simple fermented food can provide some relief in the management of the AIDS epidemic in Africa."									
1431	Nutrition and HIV/AIDS in sub-Saharan Africa: an overview.	"Anabwani G, Navario P."	Nutrition. 2005;21(1):96-9.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=15661483	"HIV/AIDS is most prevalent in Sub-Saharan Africa where, exacerbated by the presence of other common conditions such as malnutrition and opportunistic infections, it is wreaking devastation on families, communities, and nations. Just as epidemics vary by country, so do national responses to this complex emergency. This is illustrated by the cases of Botswana, South Africa, and Uganda. Nutritional and micronutrient deficiencies play an important additive role in immune degradation and impaired development in children. Careful implementation of antiretroviral drugs, complemented by simultaneous efforts to ensure proper nutrition among HIV-infected children and adults are essential components of an effective response to the HIV/AIDS pandemic in Africa and elsewhere. [References: 36]"									
1084	"Broadening psychology's contribution to addressing issues of HIV/AIDS, poverty and nutrition: structural issues as constraints and opportunities."	"Tomlinson M, Rohleder P, Swartz L, Drimie S, Kagee A."	Journal of Health Psychology. 2010;15(7):972-81.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=20631038	"HIV/AIDS, more than any other public health problem, challenges dominant models of the role of psychology in health promotion and prevention. This paper focuses on poverty and resulting food insecurity as a structural risk factor for HIV infection. The paper considers the role of health psychology in global health concerns and argues that, while individual-based interventions are important, health psychology needs to shift to playing a proper role in broader level initiatives. Health psychology, in thinking about global health concerns such as HIV, needs to view an understanding of health, education and nutrition delivery programmes in low resourced contexts as at the core of the discipline."									
1362	A large-scale operational study of home-based therapy with ready-to-use therapeutic food in childhood malnutrition in Malawi.	"Linneman Z, Matilsky D, Ndekha M, Maleta K, Manary MJ."	Maternal and Child Nutrition. 2007 July;3(3):206-15.		"Home-based therapy with ready-to-use therapeutic food (RUTF) for the treatment of malnutrition has better outcomes in the research setting than standard therapy. This study examined outcomes of malnourished children aged 6-60 months enrolled in operational home-based therapy with RUTF. Children enrolled in 12 rural centres in southern Malawi were diagnosed with moderate or severe malnutrition according to the World Health Organization guidelines. They were treated with 733 kJ kg<sup>-1</sup> day <sup>-1</sup> of RUTF and followed fortnightly for up to 8 weeks. Staff at each centre followed one of three models: Medical professionals administered treatment (5 centres), patients were referred by medical professionals and treated by community health aids (4 centres), or community health aids administered treatment (3 centres). The primary outcome of the study was clinical status, defined as recovered, failed, died or dropped out. Regression modelling was conducted to determine what aspects of the centre (formal training of staff, location along a main road) contributed to the outcome. Of 2131 severely malnourished children and 806 moderately malnourished, 89% and 85% recovered, respectively. Thirty-four (4%) of the moderately malnourished children failed, with 20 (2%) deaths, and 61 (3%) of the severely malnourished children failed, with 29 (1%) deaths. Centre location along a road was associated with a poor outcome. Outcomes for severely malnourished children were acceptable with respect to both the Sphere guidelines and the Prudhon case fatality index. Home-based therapy with RUTF yields acceptable results without requiring formally medically trained personnel; further implementation in comparable settings should be considered. 2007 The Authors. Journal compilation 2007 Blackwell Publishing Ltd."									
1348	A large-scale operational study of home-based therapy with ready-to-use therapeutic food in childhood malnutrition in Malawi.	"Linneman Z, Matilsky D, Ndekha M, Manary MJ, Maleta K, Manary MJ."	Maternal & Child Nutrition. 2007;3(3):206-15.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=17539889	"Home-based therapy with ready-to-use therapeutic food (RUTF) for the treatment of malnutrition has better outcomes in the research setting than standard therapy. This study examined outcomes of malnourished children aged 6-60 months enrolled in operational home-based therapy with RUTF. Children enrolled in 12 rural centres in southern Malawi were diagnosed with moderate or severe malnutrition according to the World Health Organization guidelines. They were treated with 733 kJ kg(-1) day(-1) of RUTF and followed fortnightly for up to 8 weeks. Staff at each centre followed one of three models: medical professionals administered treatment (5 centres), patients were referred by medical professionals and treated by community health aids (4 centres), or community health aids administered treatment (3 centres). The primary outcome of the study was clinical status, defined as recovered, failed, died or dropped out. Regression modelling was conducted to determine what aspects of the centre (formal training of staff, location along a main road) contributed to the outcome. Of 2131 severely malnourished children and 806 moderately malnourished, 89% and 85% recovered, respectively. Thirty-four (4%) of the moderately malnourished children failed, with 20 (2%) deaths, and 61 (3%) of the severely malnourished children failed, with 29 (1%) deaths. Centre location along a road was associated with a poor outcome. Outcomes for severely malnourished children were acceptable with respect to both the Sphere guidelines and the Prudhon case fatality index. Home-based therapy with RUTF yields acceptable results without requiring formally medically trained personnel; further implementation in comparable settings should be considered."									
890	Has the natural raw honey any effect on HIV infection?	"Heidari A, Sheikholeslam NZ, Amiri GH, Afsahi SH, Sarahroodi S."	International Journal of Pharmaceutical Research and Bio Science. 2012;1(5):205-10.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20123390769	"Honey stimulates B and T lymphocytes proliferation in cell cultures and is an old medicine in Middle East. CD4 has an important role in progression of HIV/AIDS. The aim of this study was assessment of the natural honey on CD4 count in a 30 year-Old Iranian HIV positive man. In this study he treated with 80 g natural honey every day for three months. The CD4 counted in day 0 and 30 days after consumption of honey. Results revealed that honey elevated CD4, CD8, platelet, lymphocyte, Neutrophil, RBC and WBC counts and hemoglobuline level in HIV positive patient. Also CD25 was decreased after consumption of honey. It seems that natural raw honey may improve the immune system function in HIV positive patients."									
13	Towards Conceptual Clarity of Incarceration and Rehabilitation within the South African Criminal Justice System.	Singh S.	Acta Criminologica. 2008 2008;21(special edition 2):59-77.	http://search.proquest.com/docview/61745430?accountid=26724	http://journals.sabinet.co.za/crim/	"This article is based on research that was started in February 2006 in the Westville Medium B prison near Durban, KwaZulu-Natal. The research was based on interviews with prison officials, prison inmates & medical & auxiliary staff that worked in the prison. After matching some of the official statements with the literature on prisons in South Africa & my personal experiences through visits & interviews in the prisons I considered it necessary to review two widely used concepts that are often spoken about, namely: 'rehabilitation' & 'incarceration'. Both these concepts are predicated upon the notions of conviction & imprisonment. There is an entrenched perception that the three-fold process viz. conviction-imprisonment/incarceration-rehabilitation that offenders undergo prepares them for the return to normal civilian life. However, this article takes the position that against the background of overcrowded conditions, the violence that emerges from it as a result of this, sexual molestation & relationships that lead to the spread of HIV/AIDS, the poor nutrition that inmates receive & the lack of adequate support that is necessary to change inmates' attitudes, incarceration is a more real condition in prison than rehabilitation in that the confinement they experience is more inhibitive than rehabilitation suggests. Adapted from the source document."								
1075	HIV/AIDS in Africa: Fertile Terrain.	Stillwaggon E.	The Journal of Development Studies. 2002 Aug 2002;38(6):1-22.	http://search.proquest.com/docview/60452066?accountid=26724	http://sfxhosted.exlibrisgroup.com/cdc?url_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&genre=article&sid=ProQ:ProQ%3Asocabsshell&atitle=HIV%2FAIDS+in+Africa%3A+Fertile+Terrain&title=The+Journal+of+Development+Studies&issn=00220388&date=2002-08-01&volume=38&issue=6&spage=1&au=Stillwaggon%2C+Eileen&isbn=&jtitle=The+Journal+of+Development+Studies&btitle=&rft_id=info:eric/	"An interdisciplinary approach that incorporates biomedical data into an economic analysis provides the necessary foundation for human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) policy in poor countries. This article examines the biomedical effects of economic conditions in sub-Saharan Africa that contribute to high rates of HIV transmission. The results of statistical analysis show the correlation of economic & epidemiological variables (nutrition, distribution of income, & urbanization) with rates of HIV. The economic/biomedical hypothesis implies a broad policy response for confronting HIV/AIDS in Africa & in Asia & Latin America. 1 Table, 73 References. Adapted from the source document."								
402	"The pattern of symptoms in patients receiving home based care in Bangwe, Malawi: a descriptive study."	"Bowie C, Kalilane L, Cleary P, Bowie C."	BMC Palliative Care. 2006 2006;5(1).	http://search.proquest.com/docview/289095531?accountid=26724	http://www.biomedcentral.com/1472-684X/5/1	"Home based care of HIV/AIDS patients is a health need recommended but not often available in Africa. Population based assessment helps to identify unmet health needs to plan services. Careful assessment and follow up of patients receiving home based care in a defined population of Bangwe, Malawi provides details of the frequency and severity of common symptoms. Mortality and the incidence, duration and severity of common symptoms of patients in a defined population receiving home based care were measured over an eighteen month period. 358 patients, of whom 199 died, were studied. A third of patients died within 4 months of being first seen. About half the patients were unable to care for themselves on first assessment. Half were malnourished with a Body Mass Index (BMI) < 18.5 kg/m super(2)u. Most patients had a mixture of symptoms at presentation. These symptoms responded to treatment usually within a fortnight. However a small proportion (5%) of patients suffered repeated episodes often as many as 6-9 times a year. Incidence rates are estimated. Symptoms which are alleviated by simple treatments are common. The patients in whom symptoms recur need a responsive home based care service. Population based estimates of incidence and duration of disease and the visit work load allow an assessment of home based care needs in an urban setting in Africa."								
1682	"African American Women: The Face of HIV/AIDS in Washington, DC."	Amutah NN.	Qualitative Report. 2012 2012;17(92):1-15.	http://search.proquest.com/docview/1373426891?accountid=26724	http://www.nova.edu/ssss/QR/index.html	"In 2007, the estimated HIV and AIDS case rates among adult and adolescent African-American females in the United States was 60.6 per 100,000, as compared to 3.3 per 100,000 for adult and adolescent white American females. Women living with HIV or AIDS often face complex social problems that may inhibit them from accessing resources and healthcare services to assist them in coping with the disease. In-depth interviews and direct observations utilizing open-ended note taking were conducted at an HIV service provider's office to determine the unique needs that develop because of these complex social issues, specifically among HIV positive women of color in Washington, DC. Ethnographic methods were used to address the study's research questions among 10 women of different ages and backgrounds in group settings at a non-profit organization in Washington, DC. The qualitative results of the study indicate that the women dealt with a myriad of social and mental issues related to their diagnosis, such as fear of disclosure to family and friends. The study also revealed that the women were in dire need of mental health services to address their unresolved issues regarding their diagnosis. The implications of this research add to the growing body of literature on the mental and social health needs of women of color who are HIV positive. Adapted from the source document."								
536	Value of mandatory testing for human immunodeficiency virus in a sub-Saharan hospital population.	"Palmer DL, Mason PR, Pasi C, Tobiwa O."	Clinical Infectious Diseases. 2000;31(5):1258-65.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=11073761	"Human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) are currently hyperendemic in sub-Saharan Africa. HIV and AIDS have a special impact on working-age populations, economic resources, certain illnesses, and health care facilities. Assessment of HIV serostatus of hospitalized patients is rarely performed, however, because of a reluctance to intrude on patient confidentiality, a perceived lack of benefit (no antiretroviral therapy is available), and societal denial. We evaluated the effect on health care of HIV testing of patients routinely admitted to medical wards in the 2 major city hospitals in Harare, Zimbabwe. Of 196 patients tested, 58% were HIV positive with strong associations with infectious diseases, and with youth and weight loss, but not with cardiac, pulmonary, endocrinologic, or renal diagnoses, and not with rural versus urban location, occupation, sex, mortality, or cost of hospitalization. The clinical estimate of patients' HIV serostatus was largely inaccurate. Mandatory HIV testing of all hospitalized patients would improve diagnosis of infectious diseases, clarify patient prognosis, allow for individual counseling with regard to HIV prevention, and focus national health efforts by providing alarming, realistic statistics."									
587	Serum vitamin D concentration and potential risk factors for its deficiency in HIV positive individuals.	"Etminani-Esfahani M, Khalili H, Soleimani N, Jafari S, Abdollahi A, Khazaeipour Z, Gholami K."	Current HIV Research. 2012 March;10(2):165-70.		"Human immunodeficiency virus (HIV) infected individuals are prone to malnutrition, and deficiencies of some minerals and vitamins. The aim of this study is to evaluate the frequency of vitamin D deficiency and determine the possible risk factors associated with this problem in HIV-infected individuals. This cross-sectional study was performed on 98 adult patients referred to the Emam Khomeini Hospital Complex, Tehran, Iran. The patients' serum vitamin D concentration was determined using radioimmunoassay method. The possible correlations between demographic and clinical data with the level of vitamin D were evaluated. Vitamin D levels less than 35 nmol/l were considered as deficient in this study. Eighty-five (86.7%) of the patients had serum vitamin D deficiency (concentrations less than 35 nmol/l) in this study. Coinfection with hepatitis C virus (HCV) was present in 54 (55.1%) of the patients. Only daily intake of vitamin D (r=0.304, p=0.002), duration of sun exposure (r=0.268, p=0.009), the level of PTH (r=-0.459, p<0.001), daily intake of calcium (r=0.239, p=0.018) and GFR of more than 90 ml/min (OR=1.208, CI 95%= 1.080-1.350, p=0.033) had a correlation with serum vitamin D concentration. Being female (OR=7.224, CI 95%= 3.640-14.335, p<0.001), unemployed (OR= 1.627, CI 95%=1.209-2.190, p<0.001) and infected with HCV (OR= 1.811, CI 95%= 1.331-2.465, p<0.001) were related to the severe serum vitamin D deficiency. Vitamin D deficiency is a common problem in Iranian HIV-infected patients and with concern of this vitamin's important role in health issues, early evaluation of its status and providing appropriate nutritional support seems to be important. 2012 Bentham Science Publishers."									
1138	HIV-1 viral load and elevated serum alpha1-antichymotrypsin are independent predictors of body composition in pregnant Zimbabwean women.	"Friis H, Gomo E, Nyazema N, Ndhlovu P, Kaestel P, Krarup H, Michaelsen KF."	Journal of Nutrition. 2002 01 Dec;132(12):3747-53.		"Human immunodeficiency virus (HIV) infection affects body composition, but their relationship has not been studied in pregnant women. We conducted a cross-sectional study among 1669 women receiving antenatal care between 22 and 35 wk of gestation in Harare, Zimbabwe. The role of HIV-1 status and viral load, malaria and elevated serum alpha<sub>1</sub>-antichymotrypsin (ACT, an acute phase protein) in weight, body mass index (BMI), arm circumference (AC), triceps skinfold thickness (TSF), and arm muscle (AMA) and fat (AFA) area were assessed using multiple linear regression analysis. The mean (range) age was 24.4 (14-45) y and gestational age 29 (22-35) wk. HIV infection was present in 31.5% of the women, malaria parasitemia in 0.4% and 11.4% had serum ACT >0.4 g/L. There was no difference in any anthropometric variable between HIV-infected and uninfected women. However, women with viral loads (genome equivalents/mL) between 4 and 5 and >5log<sub>10</sub> had 1.1 [95% confidence interval (Cl): -0.3, 2.3] and 2.5 (95% Cl: 0.1, 5.1) kg lower weights compared with uninfected women; this was explained by losses of both AFA and AMA. Malaria parasitemia was associated with 6 cm<sup>2</sup> (95% Cl: 0.4; 11.8) or 25% lower AMA. Elevated serum ACT was a negative predictor of all anthropometric variables, i.e., levels between 0.3 and 0.4, 0.4 and 0.5 and >0.5 g/L were associated with 1, 2 and 6 kg lower mean body weights, respectively. Despite the limitations of a cross-sectional design, we conclude that arm fat and muscle areas, reflecting body fat and lean body mass, seem to be unaffected in the majority of HIV-infected pregnant women, but decline with increasing viral loads. The effects of viral load are not explained by elevated serum ACT, which is a strong independent predictor of all anthropometric variables."									
479	Integration of nutritional support with paediatric HIV care in developing countries.	"Semba RD, Pee Sd, Bloem MW."	CAB Reviews. 2012;7(057):1-14.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20123334743	"Human immunodeficiency virus (HIV) infection and malnutrition remain major causes of morbidity and mortality among children in developing countries. Malnutrition also exacerbates the clinical course of HIV-infected children by further compromising immunity and increasing the severity of opportunistic infections. This review summarizes current scientific knowledge regarding the role of nutrition in the pathophysiology of HIV infection in children and presents the perspective of integrating nutritional interventions with programmes in resource-limited settings to increase survival of HIV-exposed and -infected children. The three major programming areas for identifying and caring for HIV-infected and HIV-exposed children are: (1) prevention of mother-to-child transmission (PMTCT) of HIV, which is the earliest possible detection of HIV-exposure of the child, (2) care for HIV-infected children and (3) treatment of malnourished children, as for many children whose HIV exposure is unknown, malnutrition can be a first sign of HIV infection. Care for HIV-exposed and -infected infants and children requires early diagnosis of HIV exposure and status, especially through PMTCT services, availability of antiretrovirals (ARVs) and nutritional services including growth monitoring, use of specially formulated foods, micronutrient supplementation, vitamin A supplementation, zinc therapy and micronutrient supplementation for the treatment of diarrhoea, use of iodized salt and exclusive breastfeeding according to national guidelines. Given that the scale-up of PMTCT is expected to accelerate in the next several years, basic nutritional interventions should be part of the standard of care of these programmes."									
630	Vitamins in HIV disease progression and vertical transmission.	"Fawzi WW, Hunter DJ."	Epidemiology. 1998;9(4):457-66.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=9647913	"Human immunodeficiency virus (HIV) infection is a major public health problem worldwide, but particularly in subsaharan Africa and Asia. Numerous observational studies report inverse associations between vitamin status, measured biochemically or as levels of dietary intake, and the risk of disease progression or vertical transmission. Evidence to support these findings has been obtained from a few randomized placebo-controlled trials. In this paper, we review studies that examined the role of vitamins A, B, C, D, and E in HIV disease progression and transmission, and we discuss the potential mechanisms of action of these vitamins. Adequate vitamin intake leads to enhancement of epithelial integrity and systemic immunity and could contribute to improved clinical condition among HIV-infected subjects and reduce vertical transmission by reducing the risk and severity of opportunistic infection and reducing viral load in blood. Adequate vitamin status may also reduce vertical transmission through the intrapartum and breastfeeding routes by reducing HIV viral load in lower genital secretions and breast milk, respectively. Vitamin supplements may be one of a few potential treatments that are inexpensive enough to be made available to HIV-infected persons in developing countries. [References: 91]"									
7	Barriers to nutrition management among people living with HIV on antiretroviral therapy.	Maertens JA. 			"Human Immunodeficiency Virus (HIV) is a virus that attacks and impairs the body's natural defense system against disease and infection, in part through depletion of nutrients that are implicated in malnutrition and weight loss. Many nutritional problems among people living with HIV can be managed via nutrition intervention. No wide scale evaluation of HIV patient access or adherence to comprehensive nutrition intervention exists; however, there are potential barriers among patients to following nutrition advice from healthcare providers even when delivered. An online questionnaire among healthcare providers, along with focus groups and semi-structured interviews among patients living with HIV at three healthcare settings in Colorado were utilized in the current study in an effort to identify the barriers to nutrition management among people living with HIV. Healthcare providers reported being limited in the amount of nutrition intervention they could provide based on a lack of time and in-house referral services, and the co-occurrence of multiple illnesses among patients that demanded time and energy during appointments. Patients were limited in their ability to optimally manage their diet based on finances and transportation available for acquiring food, side effects associated with ARV (antiretroviral) medications, and their own cooking and meal planning skills. The nature of the barriers identified in the current study suggested a systems approach to optimizing nutrition management among HIV-positive patients may be an appropriate future direction of action. Copies of dissertations may be obtained by addressing your request to ProQuest, 789 E. Eisenhower Parkway, P.O. Box 1346, Ann Arbor, MI 48106-1346. Telephone 1-800-521-3042; e-mail: disspub@umi.com"									
1338	Food insecurity and perceived stress but not HIV infection are independently associated with lower energy intakes among lactating Ghanaian women.	"Addo AA, Marquis GS, Lartey AA, Perez-Escamilla R, Mazur RE, Harding KB."	Maternal & Child Nutrition. 2011;7(1):80-91.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=21143587	"Human immunodeficiency virus (HIV) seropositive women living in low-income communities may have difficulty meeting the increased energy requirements that are associated with both lactation and HIV infection. Data on household food security and maternal socio-demographic characteristics, perceived stress, anthropometry, reported illness, dietary intakes and preferences, and exposure to nutrition education were collected from 70 lactating women [16 seropositive (HP), 27 seronegative (HN), and 27 who refused to be tested and had unknown HIV status (HU)]. Diet was assessed with three 24-h recalls (one market day, one weekend day, and one non-market weekday). Data were collected at 8.4 (SD = 4.7) months postpartum. Most women (74.3%) reported being in good health at the time of study. Three-day mean energy intakes did not differ by HIV status [HP: 12,000 kJ (SD = 3600), HN: 12,600 kJ (SD = 5100), and HU: 12,300 kJ (SD = 4800); P = 0.94]. Protein, fat, vitamin A, thiamin, riboflavin, niacin, vitamin C, calcium, iron, and zinc intakes also did not differ by group (P > 0.10). There was a higher proportion of women with high stress levels in food insecure households compared with food secure households (55.6% vs. 26.5%; P = 0.01). Energy intake was independently negatively associated with food insecurity [high: 11,300 kJ (SD = 3500) vs. low: 13,400 kJ (SD = 5400), respectively; P = 0.050] and stress [high: 10,800 kJ (SD = 2800) vs. low: 13,400 kJ (SD = 5300), P = 0.021]. These results suggest the need to integrate multi-dimensional interventions that address economic and mental health constraints which may limit some women's ability to meet their dietary needs. 2010 Blackwell Publishing Ltd."									
1349	Duration of hospitalization and appetite of HIV-infected South African children.	"Mda S, van Raaij JM, MacIntyre UE, de Villiers FP, Kok FJ."	Maternal & Child Nutrition. 2011;7(2):175-87.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=21410883	"Human immunodeficiency virus (HIV)-infected children generally show poor growth. Episodes of diarrhoea and pneumonia in HIV-infected children are thought to be more severe than in HIV-uninfected children. The objective of this study was to compare duration of hospitalization, appetite and nutritional status of HIV-infected children with that of uninfected children. A cross-sectional study was performed on children (2-24 months) admitted with diarrhoea or pneumonia to the university hospital. Children were tested for HIV, and the duration of hospitalization was noted for 189 children. Follow-up for blood analysis (n=154) and appetite measurement (n=48) was performed 4-8 weeks after discharge. Appetite was measured as ad libitum intake of a commercial infant cereal using highly standardized procedures. Hospitalization (in days) was significantly longer in HIV-infected children; among children admitted with diarrhoea (5.9 +/- 1.9 vs. 3.8 +/- 1.5) (mean +/- standard deviation) and with pneumonia (9.0 +/- 2.5 vs. 5.9 +/- 1.9). Serum zinc, iron and transferrin concentrations, and haemoglobin levels were significantly lower in HIV-infected children compared with uninfected children. Appetites [amounts eaten (g) per kg body weight] of HIV-infected children were significantly poorer than those of HIV-uninfected children (18.6 +/- 5.8 vs. 25.2 +/- 7.4). The eating rates (g min(-1) ) of HIV-infected children were also slower (17.6 +/- 6.2 vs. 10.1 +/- 3.7) Mean Z-scores for length-for-age were significantly lower among HIV-infected children compared with HIV-uninfected children. Weight-for-length Z-scores were not significantly different. In summary, HIV-infected children had a 55% longer duration of hospitalization and a 21% lower appetite. 2010 Blackwell Publishing Ltd."									
1110	Severe hepatotoxicity associated with nevirapine use in HIV-infected subjects.	"Sanne I, Mommeja-Marin H, Hinkle J, Bartlett JA, Lederman MM, Maartens G, Wakeford C, et al."	Journal of Infectious Diseases. 2005 15 Mar;191(6):825-9.		"Human immunodeficiency virus (HIV)-infected South African patients (n = 468) received blinded lamivudine or emtricitabine, stavudine, and either nevirapine or efavirenz (based on screening viral load). Baseline characteristics were analyzed in univariate and multivariate regression, to identify risk factors for hepatotoxicity (grade 3 or greater increase in serum aminotransferase levels). The occurrence of early hepatotoxicity was 17% in the nevirapine group and 0% in the efavirenz group and was balanced between the lamivudine and emtricitabine arms. Two subjects died of hepatic failure. Independent risk factors were body-mass index (BMI) <18.5, female sex, serum albumin level <35 g/L, mean corpuscular volume >85 fL, plasma HIV-1 RNA load <20,000 copies/mL, aspartate aminotransferase level <75 IU/L, and lactate dehydrogenase level <164 IU/L. The use of nevirapine in female patients with a low BMI should be discouraged. 2005 by the Infectious Diseases Society of America. All rights reserved."									
1476	Lipodystrophy and human immunodeficiency virus infection. [Chinese].	Lan SJ.	Nutritional Sciences Journal. 2002 September;27(3):118-28.		"Human immunodeficiency virus (HIV)/acquired human immunodeficiency syndrome (AIDS) is a major public health problem worldwide, since it is the number one leading cause of death in certain underdeveloped countries. Although many anti-HIV drugs, which dramatically decrease morbidity and mortality associated with HIV/AIDS, are available in developed countries, long-term use of these drugs has been associated with the undesirable side effect of lipodystrophy, a very hot issue over the past 2-3 years in those countries. This review includes the following: 1) a review of the epidemic of HIV/AIDS in Taiwan as well as worldwide; 2) a definition, classification, and the characteristics of lipodystrophy; 3) the prevalence of lipodystrophy in people living with HIV (PLWH); 4) factors associated with lipodystrophy in PLWH such as HIV, antiretroviral drugs including protease inhibitors (PI), nucleoside reverse transcriptase inhibitors (NRTIs), non nucleoside reverse transcriptase inhibitors (NNRTIs), and other drugs; the duration of drug therapy and drug tolerability, gender, body mass index (BMI) and body composition, age, immunity, hormones, diet/nutrition, and exercise; 5) the influence of lipodystrophy on PLWH; and 6) treatments for lipodystrophy including switching therapies or stopping drugs, diet/nutrition therapies, exercise, drug therapies to lower blood lipid or glucose, hormonal therapy, and plastic surgery such as liposuction, lipectomy or fat grafts. For those with dyslipidemia, hyperglycemia, insulin resistance, or diabetes mellitus, in addition to the therapies of diet/nutrition and exercise, blood lipid- or glucose-lowering drugs can be used."									
1394	"Host-pathogen evolution: Implications for the prevention and treatment of malaria, myocardial infarction and AIDS."	Foster HD.	Medical Hypotheses. 2008;70(1):21-5.		"Humans have evolved complex immune systems to protect against infection by pathogens. However, pathogens possess a remarkable genetic versatility that allows them to gain new vigour and so escape such population immunity. Conflicting pathogen-host objectives, therefore, lead to the evolutionary equivalent of an ""arms race"". Typically, in this struggle, pathogens attempt to deplete their host of specific nutrients that are essential for immune system function. After infection, the resulting deficiency of nutrient(s) may cause many of the disease symptoms and sequela. In malaria, Plasmodium falciparum, for example, depletes its host of Vitamin A, possibly resulting in blindness in some cases. However, 200,000 International Units of Vitamin A, given to children every three months can reduce significantly their susceptibility to malaria. This would seem to be a minimum child dosage for the treatment of the disease. In contrast, the Coxsackie B virus causes a selenium deficiency that may result in myocardial infarction or Keshan disease. However, table salt fortified with 15 ppm anhydrous sodium selenite can cause dramatic drops in the incidence of Keshan disease, while selenium supplementation also reduces re-infarction rates. HIV-1 depletes its host of four nutrients: selenium, cysteine, glutamine and tryptophan, resulting in symptoms known as AIDS. Open and closed clinical trials in South Africa, Zambia and Uganda, involving daily adult doses of 600 mcg l-selenomethione, and some 500 mg l-glutamine, hydroxytryptophan and N-acetyl cysteine, however, have shown that such supplementation can reverse the symptoms of AIDS and prevent HIV-1 infected patients declining into this disease. It is obvious, therefore, that supplementation of diet with specific nutrients can reduce infection by particular pathogens. In addition, if infection still occurs, their use as a treatment may prevent many of the symptoms and sequela commonly associated with diseases such as malaria, myocardial infarction and AIDS. 2007 Elsevier Ltd. All rights reserved."									
1595	Hypertension and Obesity in Adults Living in a High HIV Prevalence Rural Area in South Africa.	"Malaza A, Mossong J, Barnighausen T, Newell ML."	PLoS ONE. 2012 17 Oct;7(10).		"Hypertension and excess body weight are major risk factors of cardiovascular morbidity and mortality in developing countries. In countries with a high HIV prevalence, it is unknown how increased antiretroviral treatment and care (ART) coverage has affected the prevalence of overweight, obesity, and hypertension. We conducted a health survey in 2010 based on the WHO STEPwise approach in 14,198 adult resident participants of a demographic surveillance area in rural South Africa to investigate factors associated with hypertension and excess weight including HIV infection and ART status. Women had a significantly higher median body mass index (BMI) than men (26.4 vs. 21.2 kg/m<sup>2</sup>, p<0.001). The prevalence of obesity (BMI>=30 kg/m<sup>2</sup>) in women (31.3%, 95% confidence interval (CI) 30.2-32.4) was 6.5 times higher than in men (4.9%, 95% CI 4.1-5.7), whereas prevalence of hypertension (systolic or diastolic blood pressure>=140 or 90 mm Hg, respectively) was 1.4 times higher in women than in men (28.5% vs 20.8%, p<0.001). In multivariable regression analysis, both hypertension and obesity were significantly associated with sex, age, HIV and ART status. The BMI of women and men on ART was on average 3.8 (95% CI 3.2-3.8) and 1.7 (95% CI 0.9-2.5) kg/m<sup>2</sup> lower than of HIV-negative women and men, respectively. The BMI of HIV-infected women and men not on ART was on average 1.2 (95% CI 0.8-1.6) and 0.4 (95% CI -0.1-0.9) kg/m<sup>2</sup> lower than of HIV-negative women and men, respectively. Obesity was a bigger risk factor for hypertension in men (adjusted odds ratio (aOR) 2.99, 95% CI 2.00-4.48) than in women (aOR 1.64, 95% CI 1.39-1.92) and overweight (25<=BMI<30) was a significant risk factor for men only (aOR 1.53 95% CI 1.14-2.06). Our study suggests that, cardiovascular risk factors of hypertension and obesity differ substantially between women and men in rural South Africa. 2012 Malaza et al."									
1154	Multivitamin supplementation of HIV-positive women during pregnancy reduces hypertension.	"Merchant AT, Msamanga G, Villamor E, Saathoff E, O'Brien M, Hertzmark E, Hunter DJ, et al."	Journal of Nutrition. 2005;135(7):1776-81.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=15987864	"Hypertension during pregnancy increases fetal growth retardation, preterm deliveries, and perinatal deaths, and yet its causes remain unclear. In HIV-infected women, preterm birth additionally increases the risk of HIV transmission to the infant. Oxidative stress and endothelial cell dysfunction of the placenta have been implicated in the development of hypertension during pregnancy. Vitamin intake can reduce oxidative stress and improve endothelial function. We therefore evaluated the effect of multivitamin (20 mg thiamine, 20 mg riboflavin, 25 mg B-6, 50 microg B-12, 500 mg C, 30 mg E, and 0.8 mg folic acid) and vitamin A supplements (30 mg beta-carotene plus 5000 IU preformed vitamin A) in relation to hypertension during pregnancy (systolic blood pressure > or = 140 mm Hg or diastolic blood pressure > or = 90 mm Hg at any time during pregnancy). In a double-blind, placebo-controlled, randomized, clinical trial, conducted among 1078 HIV-positive pregnant Tanzanian women, those who received multivitamins were 38% less likely to develop hypertension during pregnancy than those who did not [relative risk (RR) = 0.62, 95% CI 0.40-0.94, P = 0.03]. There was no overall effect of vitamin A on hypertension during pregnancy (RR = 1.00, 95% CI 0.66-1.51, P = 0.98). Hypertension during pregnancy was more likely in women with high baseline systolic blood pressure (>120 vs. < or = 120 mm Hg) (RR = 6.02, 95%CI 2.59-13.97, P < 0.001), and those with higher mid-upper arm circumference (RR = 1.12, 95% CI 1.04-1.19, P = 0.002). Taking multivitamins containing vitamins B, C, and E during pregnancy may be an inexpensive and effective strategy to improve the health of the mother and baby."									
230	Two-step tuberculin skin testing in HIV-infected persons in Uganda.	"Hecker MT, Johnson JL, Whalen CC, Nyole S, Mugerwa RD, Ellner JJ."	American Journal of Respiratory and Critical Care Medicine. 1997;155(1):81-6.		"Identifying persons infected with both human immunodeficiency virus (HIV) and Mycobacterium tuberculosis (MTB) is often difficult because of the reduced sensitivity of tuberculin skin testing in HIV-infected persons. To determine the value of two-step tuberculin skin testing (TTST) as a method of increasing the sensitivity of tuberculin skin testing in HIV-infected persons, a consecutive sample of 58 HIV-infected persons being screened for a TB preventive therapy trial in Uganda with an initial purified protein derivative (PPD) response < 5 mm completed two-step tuberculin and candida skin testing. The mean change in PPD size between the two tests, placed a mean of 8 d apart, was +2.1 mm (SD 4.4 mm, range -4 to +16 mm). Seventeen subjects (29%) had a boosted response (PPD<sub>1</sub> < 5 and PPD<sub>2</sub> <= 5). In a multiple logistic regression model, boosted responses were independently associated with a CD4 count between 200 and 500 mul<sup>-1</sup> (p = 0.02) and a higher body mass index (p = 0.05). TTST may be valuable in identifying MTB infection and in preventing misclassification of boosted responses as skin test conversions in HIV-infected persons, especially persons with CD4 counts between 200 and 500 mul<sup>-1</sup> from areas with a high prevalence of MTB infection or from areas with a low prevalence of MTB infection who have other risk factors for MTB infection."									
776	Global challenges in liver disease.	Williams R.	Hepatology. 2006 September;44(3):521-6.		"Immigration, cheap air travel, and globalization are all factors contributing to a worldwide spread of hepatitis B virus (HBV) and hepatitis C virus (HCV) infection. End-stage chronic liver disease (ESLD) as a result of co-infection with HBV/HCV is now the major cause of death for individuals who have been infected with the HIV virus. The high incidence of HCV infection in Egypt-the legacy left from the mass use of tartar emetic to eradicate schistosomiasis, as in other high prevalence areas-will take years to reduce. Steatohepatitis due to non-alcoholic fatty liver disease is developing into a new and major health problem as a result of rising levels of obesity in populations worldwide. Hepatic steatosis also has an adverse influence on the progression of other liver diseases including chronic HCV infection and alcoholic liver disease. In many countries, considerable public concern is on the rise due to increased levels of alcohol consumption adversely affecting younger and affluent age groups. With the rising prevalence of cirrhosis, primary hepatocellular carcinoma (HCC) is increasing in frequency as is that of primary intrahepatic cholangiocarcinoma. Finally, despite the successes of liver transplantation, many deserving patients are not getting transplants due to low levels of cadaver organ donation in many countries, thereby increasing pressures on the use of living donor liver transplantation. Only through a concerted effort from governments, health agencies, healthcare professionals at all levels, and the pharmaceutical industry can this grim outlook for liver disease worldwide be reversed. Copyright 2006 by the American Association for the Study of Liver Diseases."									
1059	"The chemical bases of the various AIDS epidemics: recreational drugs, anti-viral chemotherapy and malnutrition."	"Duesberg P, Koehnlein C, Rasnick D."	Journal of Biosciences. 2003;28(4):383-412.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=12799487	"In 1981 a new epidemic of about two-dozen heterogeneous diseases began to strike non-randomly growing numbers of male homosexuals and mostly male intravenous drug users in the US and Europe. Assuming immunodeficiency as the common denominator the US Centers for Disease Control (CDC) termed the epidemic, AIDS, for acquired immunodeficiency syndrome. From 1981-1984 leading researchers including those from the CDC proposed that recreational drug use was the cause of AIDS, because of exact correlations and of drug-specific diseases. However, in 1984 US government researchers proposed that a virus, now termed human immunodeficiency virus (HIV), is the cause of the non-random epidemics of the US and Europe but also of a new, sexually random epidemic in Africa. The virus-AIDS hypothesis was instantly accepted, but it is burdened with numerous paradoxes, none of which could be resolved by 2003: Why is there no HIV in most AIDS patients, only antibodies against it? Why would HIV take 10 years from infection to AIDS? Why is AIDS not self-limiting via antiviral immunity? Why is there no vaccine against AIDS? Why is AIDS in the US and Europe not random like other viral epidemics? Why did AIDS not rise and then decline exponentially owing to antiviral immunity like all other viral epidemics? Why is AIDS not contagious? Why would only HIV carriers get AIDS who use either recreational or anti-HIV drugs or are subject to malnutrition? Why is the mortality of HIV-antibody-positives treated with anti-HIV drugs 7-9%, but that of all (mostly untreated) HIV-positives globally is only 1.4%? Here we propose that AIDS is a collection of chemical epidemics, caused by recreational drugs, anti-HIV drugs, and malnutrition. According to this hypothesis AIDS is not contagious, not immunogenic, not treatable by vaccines or antiviral drugs, and HIV is just a passenger virus. The hypothesis explains why AIDS epidemics strike non-randomly if caused by drugs and randomly if caused by malnutrition, why they manifest in drug- and malnutrition-specific diseases, and why they are not self-limiting via anti-viral immunity. The hypothesis predicts AIDS prevention by adequate nutrition and abstaining from drugs, and even cures by treating AIDS diseases with proven medications."									
1341	The process followed in the development of the paediatric food-based dietary guidelines for South Africa.	"Bourne LT, Marais D, Love P."	Maternal & Child Nutrition. 2007;3(4):239-50.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=17824852	"In 1996, a Food and Agricultural Organization/World Health Organization expert panel proposed the development of food-based dietary guidelines (FBDGs) that would be unique and specific to the needs of the populations of different countries. In 1997, a South African FBDG Working Group was initiated to develop a single set of FBDGs aimed at optimal nutrition for all South Africans older than 5 years. Thereafter, additional working groups investigated the development of FBDGs for specific priority groups including HIV/AIDS sufferers, the elderly, pregnant and lactating women and children under 5 years. This resulted in the formation of an expert paediatric FBDG Working Group in 2000, in Cape Town with the task to develop paediatric FBDGs (PFBDGs) for children younger than 5 years. However, it was decided to raise the 5-year-age limit to 7 years, which corresponds to one of the recommended dietary allowance (RDA) cut-offs for both genders and that would cover most pre-schoolers. Ultimately, three age subcategories were identified for developing specific PFBDGs, i.e. 0-6 months, 6-12 months and 12-84 months. In May 2003, after thorough review of the relevant literature, discussions with various stakeholders and pre-testing for comprehensibility, a set of preliminary PFBDGs for each of the subcategories was approved by the Working Group to be subjected to consumer testing. The proposed guidelines were considered to be the most appropriate ones for each age group, based on scientific and local evidence, and were evaluated utilizing qualitative methodologies. The results of these data are presented and discussed below. However, further testing is required for the diverse groups in the country. [References: 11]"									
581	Risks and benefits of genetically modified maize donations to southern Africa: views from Malawi.	"Muula AS, Mfutso-Bengo JM."	Croatian Medical Journal. 2003;44(1):102-6.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=12590438	"In 2001 and 2002, many countries in the Southern African Development Community (SADC) have suffered from severe food shortages resulting in an estimated 14 million people facing starvation due to inadequate quantities of the staple maize. The international community's response has been the donation of foodstuffs, including genetically modified maize. Reactions of the recipient countries of Zambia, Zimbabwe, and Malawi have been different. Zambia appealed to the donors not to send genetically modified maize, whereas Malawi accepted the maize donations. Malawi is currently facing many public health challenges because 10% of its 10-million population is HIV-positive, maternal mortality rate has almost doubled between 1992 and 2000, and there are also an estimated 1 million orphans due to HIV/AIDS. In the European Union, genetically modified maize falls under ""Novel Foods"" and its marketing and distribution are strictly regulated by law. This has never been the case in the southern African countries. In this article, we discuss the ethical challenges associated with genetically modified maize donations to southern Africa. Although genetically modified food offers a way to avoid many adverse effects of food shortages, we believe that some of the ethical questions of genetically modified food donations should be solved first, under the leadership of the donor countries and partnership of the developing countries. There are fears that consummation of genetically modified maize could have adverse health effects. These fears must be addressed if the confidence of developing countries in the donor community is to be maintained."									
140	Survival and quality of life among HIV-positive people on antiretroviral therapy in Cambodia.	"Morineau G, Vun MC, Barennes H, Wolf RC, Song N, Prybylski D, Chawalit N."	AIDS Patient Care & STDs. 2009;23(8):669-77.	http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=2010378049&site=ehost-live	"In 2004, Cambodia, a low-income country, undertook a rapid scale-up of free antiretroviral therapy (ART) through the public sector in order to respond to the need for treatment for those living with HIV/AIDS. A cohort of patients initiating ART in a provincial national hospital was set up at the beginning of the program to monitor the impact of treatment on patients. Patients provided information on behaviors through face-to-face interviews. Medical data were obtained from clinical files. Health-related quality of life (HRQOL) was assessed using the Medical Outcomes Study 21-Items Short Form (MOS SF-21). Patients were interviewed when initiating ART and followed up at 3 months, 6 months, and each consecutive 6 months thereafter. From March 2005 through January 2008, the cohort included 549 patients followed for a total of 645 person-years. The 4.0% of patients lost to follow-up were considered dead in the analysis. Incidence of mortality was 9.1 per 100 person-years, which is comparable to international standards. HRQOL subscale scores increased dramatically in the first year after initiating ART. The mean of overall HRQOL score rose from 63.0 at baseline to 81.1 at 1 year and 89.9 at 30 months of follow-up (chi(2) for trends p < 0.001). Simultaneously, the proportion of patients with full-time employment increased from 48.8% to 95.7%.We conclude that the rapid scaling-up of ART delivery in a resource poor Asian setting dramatically improved the survival and well-being of its beneficiaries, who in turn resumed productive lives within their communities."									
856	"Growth of children according to maternal and child HIV, immunological and disease characteristics: a prospective cohort study in Kinshasa, Democratic Republic of Congo."	"Bailey RC, Kamenga MC, Nsuami MJ, Nieburg P, St. Louis ME."	International Journal of Epidemiology. 1999;28(3):532-40.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh3&AN=20002006678	"In a prospective cohort study of 258 children born to HIV seropositive mothers and 256 children of seronegative mothers in Kinshasa during October 1989-April 1990 the growth in length, weight, and weight-for-length of infected children (n=68), uninfected children born to seropositive mothers (n=190), and uninfected children born to uninfected mothers (n=256) was compared. Serological, anthropometric and other clinical measures were collected monthly from 3-12 months and bi-monthly during the second year of life. Polymerase chain reaction for HIV was performed on blood drawn at 2 days and 3 months post partum. Length-for-age, weight-for-age, and weight-for-length mean z-scores against National Center for Health Statistics (NCHS) reference data were calculated, and Cox proportional hazards models were used to estimate the risk of falling below -2.00 z-scores as a function of child and maternal immunological, clinical and sociodemographic variables. There was no difference in mean length-for-age at birth between HIV-infected (Group 1) children, uninfected children of infected mothers (Group 2) or Control children, but by 3 months old, HIV-infected children were shorter than both Group 2 and Controls. In weight-for-age and weight-for-length, Group 1 infants were lighter and more wasted at birth and onwards. Group 2 newborns were lighter than Controls at birth, but by 3 months they had caught up to Controls in both length and weight and remained the same as Controls thereafter. The odds of falling below -2.00 z-scores by 20 months for length, weight, and weight-for-length for HIV-infected children compared to uninfected children were 2.10, 2.84, and 2.56 respectively. Both HIV-infection and associated illnesses were factors associated with child stunting, underweight and wasting. The mother's age, socioeconomic status, presence of father, stage of illness and immune status had no detectable effect on the child's growth in the first 2 years of life. The HIV-infected children in Congo with no access to antiretroviral therapy were stunted, underweight, and wasted compared to same age uninfected children. Both HIV infection and HIV-associated signs and symptoms were important, but not maternal factors."									
1161	Weight loss during pregnancy is associated with adverse pregnancy outcomes among HIV-1 infected women.	"Villamor E, Dreyfuss ML, Baylin A, Msamanga G, Fawzi WW."	Journal of Nutrition. 2004;134(6):1424-31.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh3&AN=20043133076	"In a prospective study of 1002 pregnant, HIV-1 infected Tanzanian women, we examined the incidence of fetal death, preterm delivery, low birth weight (LBW), and small for gestational age (SGA) births in relation to maternal anthropometry at the first prenatal visit, weight loss, and low weight gain during pregnancy. Anthropometric measurements were obtained monthly during the 2nd and 3rd trimesters. Low maternal height and weight at the first visit were significantly related to lower mean birth weight and increased risk of SGA, but not to preterm delivery. Maternal stature <150 cm was significantly related to fetal death. Weight loss during pregnancy, defined as a negative slope of the regression of weight measurements on the week of gestation, occurred in 10% of the women. It was related to increased relative risk (RR) of fetal death (RR=1.83, 95% CI=0.93, 3.57), preterm delivery (RR=1.85, 95% CI=1.40, 2.44), and LBW (RR=2.85, 95% CI=1.69, 4.79) after adjusting for multivitamin supplementation, height, primiparity, baseline weight, malaria, CD4 cell count, HIV disease stage, and intestinal parasitoses. The significant association with fetal death was stronger for weight loss during the 2nd trimester, whereas increased risks of preterm delivery and LBW were higher for weight loss during the 3rd. Similar but weaker associations were found with low weight gain during pregnancy (slope <25th percentile). We conclude that poor anthropometric status at the first prenatal visit and weight loss during pregnancy among HIV-1 infected women are strong risk factors for adverse pregnancy outcomes."									
1133	Nonbreast-fed HIV-1-exposed Burkinabe infants have low energy intake between 6 and 11 months of age despite free access to infant food aid.	"Cames C, Cassard F, Cournil A, Mouquet-Rivier C, Ayassou K, Meda N, Bork K."	Journal of Nutrition. 2011;141(4):674-9.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=21325474	"In a WHO-coordinated, mother-to-child HIV transmission (MTCT) prevention trial in Burkina Faso, HIV-1-infected mothers were advised to either stop breast-feeding by 6 mo or totally avoid it. Participants were provided with cereal-based, infant fortified mix (IFM) from 6 to 12 mo postpartum along with infant feeding counseling. Our objective was to describe nonbreast-fed infants' food consumption and adequacy of nutrient intake. A 1-d weighed food record and one 24-h dietary recall were performed in 68 nonbreast-fed, non-HIV-infected 6- to 11-mo-old infants. Mean food energy density and feeding frequency were satisfactory in 6-8 mo olds [0.8 +/- 0.2 kcal/g (3.3 +/- 0.9 kJ/g) and 7.2 +/- 1.6 times/d] and in 9-11 mo olds [0.9 +/- 0.2 kcal/g (3.6 +/- 0.8 kJ/g) and 7.7 +/- 2.1 times/d]. Median energy intake was 523 kcal [range: 82-1053 (2187 kJ, range: 345-4401)] in 6-8- and 811 kcal [range: 34-1543 (3392 kJ, range: 144-6452)] in 9-11-mo-old infants, respectively. Approximately 75% of their energy intake was provided by subsidized foods (milk that mothers obtained from support networks and IFM). One-half of the infants had intakes < 80 kcal/kg (<334 kJ/kg) on the day of the survey, mainly because IFM and milk were consumed in amounts that were too low. Thus, coverage of energy needs required a diet with sufficient amounts of both IFM and milk in these vulnerable infants. These findings argue for the development of adequate, sustainable infant fortified foods and their rapid integration into MTCT prevention services. They also lend support to the recent revision of WHO infant feeding guidance for future MTCT prevention programming that recommends breast-feeding up to 12 mo postpartum (under cover of antiretroviral prophylaxis) as the safest feeding option for infants of HIV-infected mothers."									
730	Vitamin E deficiency in developing countries.	"Dror DK, Allen LH."	Food and Nutrition Bulletin. 2011;32(2):124-43.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20113249284	"In addition to its role as a potent antioxidant, vitamin E is involved in a wide range of physiological processes, ranging from immune function and control of inflammation to regulation of gene expression and cognitive performance. Results from multiple studies suggest that poor nutritional status and higher prevalence of other oxidative stressors such as malaria and HIV infection predispose populations in developing countries for vitamin E deficiency. Although direct comparison between study outcomes is complicated by varied definitions of vitamin E deficiency, data trends indicate that children and the elderly are more vulnerable age groups and that men may be at higher risk for deficiency than women. Public health initiatives aimed at improving the vitamin E status of high-risk populations in developing countries would be prudent to counteract oxidative stress, improve immune function, and protect against neurologic and cognitive deficits. Additional research is needed to estabish dose-response relationships of various interventions and to develop cost-effective, culturally-appropriate, and targeted programs."									
1204	"An exploratory investigation of dietary intake and weight in human immunodeficiency virus-seropositive individuals in Accra, Ghana."	"Wiig K, Smith C."	Journal of the American Dietetic Association. 2007;107(6):1008-13.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=17524722	"In Africa, the human immunodeficiency virus and acquired immunodeficiency syndrome (HIV/AIDS) complex is commonly referred to as ""slim disease"" because, as the disease progresses, food intake and metabolism are altered, leading to visible body weight loss. In this descriptive, cross-sectional pilot study, 50 HIV-seropositive adults attending the Korle Bu Teaching Hospital in Accra, Ghana, were interviewed during the late spring of 2003. Demographics, medical HIV history and current status of their HIV disease, food safety, and food security information were collected. One 24-hour dietary recall was completed, height and weight were measured, and body mass index (BMI) was calculated for each participant. Results show that women participants had a higher mean BMI and maintained it through disease progression compared with men (P<0.02). The majority of the participants cited cost as a barrier in purchasing adequate amounts of food (92%). Fruit and vegetable intake was low overall (<three servings/day). The foods contributing most to daily energy intake were fried fish, white rice, kenkey, white bread, and fufu. In fighting the global HIV/AIDS epidemic, registered dietitians must consider barriers to achieving optimal nutritional status in a cultural context to enhance feasibility and ensure the effectiveness of dietary interventions."									
1158	Recommendations for vitamin A supplementation.	Ross DA.	Journal of Nutrition. 2002;132(9 Suppl):2902S-6S.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=12221268	"In all populations where vitamin A deficiency is an important public health problem, prophylactic vitamin A supplements should be given to all infants and young children (0-59 mo), pregnant women and postpartum women within 6 wk after delivery. The efficacy of vitamin A supplementation of young children is one of the best-proven, safest and most cost-effective interventions in international public health. The International Vitamin A Consultative Group (IVACG) also recommends that three 50,000-international unit (IU) doses of vitamin A should be given at the same time as infant vaccines during the first 6 mo of life. Recent kinetic studies have indicated that this regimen will be safe and is necessary to maintain the infant's vitamin A stores, even when the mother is also given 400,000 IU within the first 6 wk after delivery. IVACG will make a decision on whether to recommend prophylactic supplementation of all women of childbearing age when the results of two large trials in Ghana and Bangladesh are available. Active corneal xerophthalmia is always a medical emergency that should be treated with immediate high-dose vitamin A. High-dose vitamin A treatment is also recommended for infants and young children with xerophthalmia, severe malnutrition or measles. Low-dose vitamin A treatment is recommended for women with night blindness and/or Bitot's spots. Given the evidence of the cost-effectiveness of vitamin A supplementation, it is essential that effective vitamin A supplementation programs are made universally available to all populations where vitamin A deficiency is an important public health problem."									
763	Low birth weight and genital infections. An incident case-referent study.	"Osman NB, Folgosa E, Gonzalez C, Bergstrom S."	Gynecologic and Obstetric Investigation. 1995;40(3):183-9.		"In an attempt to elucidate the potential association between genital infections and low birth weight (LBW) births, 51 women with LBW neonates were identified and compared to 51 women with normal birthweight (NEW) neonates. Both groups were matched according to age and parity. All women were subjected to interviews regarding socioeconomic background and obstetric history. They were examined clinically and tested regarding serum haemoglobin, malaria parasitaemia, syphilis and HIV serology. Cultures were taken from the vagina, endocervix, amniotic fluid and from various sites of newborn, including the conjunctivae and the stomach and from the interior of the placenta. Whilst socioeconomic background factors did not differ among cases and referents, previous neonatal death did. Significant differences were also found in mid-upper-arm circumference (OR 3.08) and body mass index (OR 6.00). The prevalence of alleged risk factors according to the antenatal card was similar among cases and referents. Birthweight < 2,000 g was significantly more often associated with chorioamnionitis than birthweight between 2,000 and 2,499 g (OR 5.46). Bacteriological findings did not show significant differences in cases and referents. Haemoglobin values and prevalence of malaria parasitaemia were similar as was the neonatal mortality. It is concluded that LBW births is difficult to predict by use of alleged risk factors in existing antenatal cards."									
1246	Body mass index: A prognosis factor among HIV seropositive malnourished children.	"Beau JP, Imboua-Coulibaly L."	Journal of Tropical Pediatrics. 1997 October;43(5):301-3.		"In both adults and children, weight loss is one of the major complications of HIV infection and constitutes a factor of bad prognosis. Among children, anthropometry constitutes the most convenient method for assessing nutritional status and the aim of this study was to assess the prognosis value of various anthropometric indicators among seropositive malnourished children. This retrospective analysis was conducted on 101 children suffering from marasmus, monitored in 1994 at an infant home in Cote d'Ivoire. The percentage of seropositive children was 51 per cent and the mortality rate was significantly higher in this group (23 deaths out of 52 (44 per cent) for seropositive children, and five deaths out of 49 (10 per cent) for seronegative ones; P < 0.001). Among the anthropometric indicators studied, only the body mass index (BMI) could be significantly related to the vital prognosis among seropositive children (deceased: BMI = 10.5 +/- 1.1 kg/m<sup>2</sup>; living: BMI = 11.3 +/- 1.2 kg/m<sup>2</sup>; P < 0.05). Determining this index in seropositive malnourished children could constitute an objective and quick method for assessing the prognosis in these children."									
1498	"Body composition and CD4 cell count of HIV sero-positive adults attending out-patient clinic in Chulaimbo sub-district hospital, Kenya."	"Onyango AC, Walingo MK, Mbagaya G, Kakai R."	Pakistan Journal of Nutrition. 2011;10(6):582-8.		"In both adults and children, weight loss is one of the major complications of HIV infection and constitutes a factor of bad prognosis. The aim of this study was to assess the prognosis value of Body Mass Index and CD4 cell count among HIV sero-positive adults attending Academic Model for Prevention and Treatment of HIV/AIDS (AMPATH) outpatient clinic, to improve the nutritional management of HIV-infected patients. A prospective cohort study of 497 patients infected with human immunodeficiency virus in Chulaimbo hospital, Kenya assessed the nutritional status. Evaluation of nutritional status was done using anthropometry and immune integrity by use of CD4 cell count. Among the 497 patients recruited the Male: Female sex ratio was 1:4 and mean age: 39.0+/-10.5 years). The men were leaner (BMI = 20.5kg/m<sup>2</sup> in men) than the women (BMI = 21.7kg/m<sup>2</sup>) and patients with a CD4+ T cell count < 200 cells/mm<sup>3</sup>(category three) tended to have the lowest mean values for all anthropometric measurements. 79.7% had normal nutritional status with a mean CD4 cell count of 431 cells/mm<sup>3</sup>. Malnutrition was observed among patients in all the three categories (mild, 20.8%, moderate, 43.6% and severe, 35.6%). Determining the BMI in HIV seropositive adults could constitute an objective and quick method for assessing the prognosis of malnutrition. Given its high frequency, malnutrition should be prevented, detected, monitored and treated from the early stages of HIV infection among patients attending AIDS clinics in order to improve survival and quality of life. Insights were gained about relative value of using various measurements to assess nutritional status of HIV-infected populations. Asian Network for Scientific Information, 2011."									
882	New dietary supplements from medicinal mushrooms: Dr Myko San--a registration report.	Jakopovich I.	International Journal of Medicinal Mushrooms. 2011;13(3):307-13.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=22135883	"In December 2010 the Ministry of Health and Social Welfare of the Republic of Croatia registered tablet preparations AGARIKON. 1 and MYKOPROTECT. 1, developed by Dr Myko San-Health From Mushrooms Co., as dietary supplements. This may be the first time for a European manufacturer to successfully register its own medicinal mushroom products in a European country. As a product with a very broad spectrum of action, officially described as a preparation for immunity strengthening and general health improvement, AGARIKON.1 is a result of 20 years of research and practice, and is based on the formulation that has achieved the best tumor growth inhibition rates-above 90% on tumor cell lines of mouse squamous cell carcinoma and fibrosarcoma. Since the usage of massive dosages of proprietary blended liquid mushroom extracts in patients with breast, colorectal, lung, and other cancers significantly improved their survival rates, alleviated side effects of standard oncological therapies, improved their quality of life, and resulted in life prolongation-the very idea is that scientifically verified medicinal mushroom products can be used as powerful biological weapons to fight human malignancies. If progressive modem medicine were redefined in a more effective and humane way, cancer mycotherapy should be a part of a broad concept of biological prevention and therapy of cancer. Also, with a very broad spectrum of action, generally formulated as ""to strengthen immunity,"" MYKOPROTECT. 1 is intended as an important element in the prevention and fighting of serious viral infections, whether they are caused by well-known viruses (hepatitis, HIV, etc.) or newly emerging ones."									
883	New dietary supplements from medicinal mushrooms: Dr Myko San - a registration report.	Jakopovich I.	International Journal of Medicinal Mushrooms. 2011;13(3):307-13.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20113231932	"In December 2010 the Ministry of Health and Social Welfare of the Republic of Croatia registered tablet preparations AGARIKON.1 and MYKOPROTECT.1, developed by Dr Myko San-Health From Mushrooms Co., as dietary supplements. This may be the first time for a European manufacturer to successfully register its own medicinal mushroom products in a European country. As a product with a very broad spectrum of action, officially described as a preparation for immunity strengthening and general health improvement, AGARIKON.1 is a result of 20 years of research and practice, and is based on the formulation that has achieved the best tumor growth inhibition rates - above 90% on tumor cell lines of mouse squamous cell carcinoma and fibrosarcoma. Since the usage of massive dosages of proprietary blended liquid mushroom extracts in patients with breast, colorectal, lung, and other cancers significantly improved their survival rates, alleviated side effects of standard oncological therapies, improved their quality of life, and resulted in life prolongation - the very idea is that scientifically verified medicinal mushroom products can be used as powerful biological weapons to fight human malignancies. If progressive modern medicine were redefined in a more effective and humane way, cancer mycotherapy should be a part of a broad concept of biological prevention and therapy of cancer. Also, with a very broad spectrum of action, generally formulated as ""to strengthen immunity,"" MYKOPROTECT.1 is intended as an important element in the prevention and fighting of serious viral infections, whether they are caused by well-known viruses (hepatitis, HIV, etc.) or newly emerging ones."									
762	The potential role for probiotic yogurt for people living with HIV/AIDS.	Reid G.	Gut Microbes. 2010;1(6).		"In demonstrating that it is feasible to create a community-run kitchen that produces probiotic yogurt, and that this can contribute to the health of people with HIV/AIDS, we embellished the 2001 Food and Agriculture Organization (FAO) and World Health Organization (WHO) Report on Probiotics that recommended efforts be made to take probiotics to developing countries. We proved that driven by humanitarian goals not profit, probiotic yogurt can be produced in the world's poor regions. This food can be safely consumed by HIV/AIDS subjects, and in many of them benefits can be accrued in gut health, nutritional and potentially immune status. Such outcomes have a scientific rationale, many social implications, and perhaps most importantly raise the question, why have developed countries not tried harder to bring nutrition-based probiotics to people in need?. 2010 Landes Bioscience."									
343	"Family nutritional support improves survival, immune restoration and adherence in HIV patients receiving ART in developing country."	"Serrano C, Laporte R, Ide M, Nouhou Y, de Truchis P, Rouveix E, Adamou A, et al."	Asia Pacific Journal of Clinical Nutrition. 2010;19(1):68-75.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=20199989	"In developing countries, access to antiretroviral treatment for persons living with HIV is still in progress. Malnutrition represents another cause of acquired immunodeficiency and premature death. This evaluation program estimated the impact of family nutritional support during the first year of antiretroviral treatment in West Africa's sub-Sahara region. Family nutritional support was proposed to patients with CD-4 cell count <200 /mm3 and/or developing a WHO stage III/IV or with body mass index <18.5 kg/m2 and receiving antiretroviral treatment. Follow-up of 62 patients receiving support was compared to 118 patients who had only received antiretroviral treatment the year before. Average body mass index, CD-4 cell count were 20.7 and 20.5, 217 and 191/mm3 respectively in supported and control groups (NS). Twenty-two (36%) and 56 (48%) were WHO stage III/IV (NS) respectively in supported and control groups. One patient who received support and twelve controls died (Mortality Ratio=0.19; p<0.05). Increase in CD-4 cell count was around 1.7 times higher (+ 114 vs. + 68 CD-4 cells/mm3 respectively in supported and control groups; p<0.05) and observance was improved in supported group (p<0.005). The evolutions of WHO stage and body mass index were not different but the study period was short. Family nutritional support for persons living with HIV initiating antiretroviral treatment in a developing country showed a positive impact after six months. This family intervention could be integrated into AIDS interventions as an effective and comprehensive community-based primary care."									
344	"Family nutritional support improves survival, immune restoration and adherence in HIV patients receiving ART in developing country."	"Serrano C, Laporte R, Ide M, Nouhou Y, Truchis Pd, Rouveix E, Adamou A, et al."	Asia Pacific Journal of Clinical Nutrition. 2010;19(1):68-75.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20103113909	"In developing countries, access to antiretroviral treatment for persons living with HIV is still in progress. Malnutrition represents another cause of acquired immunodeficiency and premature death. This evaluation program estimated the impact of family nutritional support during the first year of antiretroviral treatment in West Africa's sub-Sahara region. Family nutritional support was proposed to patients with CD-4 cell count <200/mm<sup>3</sup> and/or developing a WHO stage III/IV or with body mass index <18.5 kg/m<sup>2</sup> and receiving antiretroviral treatment. Follow-up of 62 patients receiving support was compared to 118 patients who had only received antiretroviral treatment the year before. Average body mass index, CD-4 cell count were 20.7 and 20.5, 217 and 191/mm<sup>3</sup> respectively in supported and control groups (NS). Twenty-two (36%) and 56 (48%) were WHO stage III/IV (NS) respectively in supported and control groups. One patient who received support and twelve controls died (Mortality Ratio=0.19; p<0.05). Increase in CD-4 cell count was around 1.7 times higher (+114 vs. +68 CD-4 cells/mm<sup>3</sup> respectively in supported and control groups; p<0.05) and observance was improved in supported group (p<0.005). The evolutions of WHO stage and body mass index were not different but the study period was short. Family nutritional support for persons living with HIV initiating antiretroviral treatment in a developing country showed a positive impact after six months. This family intervention could be integrated into AIDS interventions as an effective and comprehensive community-based primary care."									
249	"Population-based study of a widespread outbreak of diarrhea associated with increased mortality and malnutrition in Botswana, January-March, 2006."	"Mach O, Lu L, Creek T, Bowen A, Arvelo W, Smit M, Masunge J, et al."	American Journal of Tropical Medicine and Hygiene. 2009 May;80(5):812-8.		"In early 2006, coinciding with heavy rains, Botswana health facilities reported increases in diarrhea, mortal-ity, and acute malnutrition among young children. Data on diarrhea, human immunodeficiency virus, feeding, mortality, and water/sanitation were collected by random cluster survey. Anthropometric data were measured and drinking water samples were tested. Of 537 surveyed children less than five years of age, one-third experienced >= 1 episode of diarrhea. Prevalence of acute malnutrition was 7.9%, and the mortality rate for children less than five years of age was 2.6/10,000/day during the outbreak. Significant risk factors for diarrhea included an age less than two years; breastfeeding was pro-tective. Diarrhea lasting for more than 14 days and failure to thrive were risk factors for acute malnutrition. Prevalence of acute malnutrition was higher than previously documented and the mortality rate in children less than five years of age during the outbreak was above the international threshold for emergency action with an estimated 547 excess deaths. This survey highlights the need for safe infant feeding and effective treatment of malnutrition and diarrhea in young children. Copyright 2009 by The American Society of Tropical Medicine and Hygiene."									
1143	Iron status is an important cause of anemia in HIV-infected Tanzanian women but is not related to accelerated HIV disease progression.	"Kupka R, Msamanga GI, Mugusi F, Petraro P, Hunter DJ, Fawzi WW."	Journal of Nutrition. 2007;137(10):2317-23.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=17885017	"In HIV-infected populations from developing countries, it is unclear what proportion of anemia is attributable to iron deficiency (ID) and whether high body iron stores worsen HIV disease progression. We therefore evaluated these research questions in 584 HIV-infected Tanzanian women. Hemoglobin (Hb), serum ferritin (SF), serum transferrin receptor (sTfR), and C-reactive protein (CRP) concentrations were evaluated between 13 and 43 wk after women gave birth. ID was defined as SF or sTfR outside normal ranges, and ID anemia (IDA) as ID plus low Hb. In multivariate Cox regression models, the association between SF and HIV disease progression was assessed. Participants received iron + folate supplements during pregnancy. Hb (r = -0.159; P = 0.0001), SF (r = 0.355; P < 0.0001), and sTfR/log SF index (r = -0.119; P = 0.004) were related to CRP, whereas sTfR (r = 0.029; P = 0.48) was not. Prevalence estimates were 39.7% for ID and 23.6% for IDA. ID was associated with 48.9% of anemia cases. Categories of SF were not significantly associated with HIV-related mortality or progression to stage 4. Nevertheless, SF > 150.0 microg/L was related to a nonsignificantly elevated risk of progression to stage 4 (rate ratio = 1.78; 95% CI = 0.68-4.64; P = 0.24) compared with SF < 12.0 microg/L. In HIV-infected, parous women from sub-Saharan Africa, ID is of moderately high prevalence and is an important underlying cause of anemia. High storage iron does not appear to be related to HIV disease progression in this population, but more research on the role of iron during HIV disease is needed."									
1878	Tumour necrosis factor haplotypes associated with sensory neuropathy in Asian and Caucasian human immunodeficiency virus patients.	"Chew CS, Cherry CL, Imran D, Yunihastuti E, Kamarulzaman A, Varna S, Ismail R, et al."	Tissue Antigens. 2011;77(2):126-30.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=20887379	"In human immunodeficiency virus (HIV) patients, neuropathy is a common adverse side effect to some antiretroviral treatments, particularly stavudine. As stavudine is cheap, it is widely used in Asia and Africa. We showed that increasing age and height moderately predict the development of neuropathy. This was improved by the inclusion of tumour necrosis factor (TNF)-1031 (rs1799964). To investigate this association, Malay (n = 64), Chinese (n = 74) and Caucasian patients (n = 37) exposed to stavudine were screened for neuropathy. DNA samples were genotyped for polymorphisms in the central major histocompatibility complex (MHC) near TNF, and haplotypes were derived. The haplotype group FVa6,7,8 (incorporating TNF-1031) was found to be associated with neuropathy in Chinese patients in bivariate analyses (P = 0.03), and in Malays and Chinese in a multivariate analysis correcting for age and height (P = 0.02, P = 0.03, respectively). This trend was also confirmed in Caucasians. 2010 John Wiley & Sons A/S."									
1893	"A simple clinical and paraclinical score predictive of CD4 cell counts below 400/mm3 in HIV-infected adults in Dakar University Hospital, Senegal."	"Pistone T, Kony S, Faye-Niang MA, Ndour CT, Gueye PM, Henzel D, Delaporte E, et al."	Transactions of the Royal Society of Tropical Medicine and Hygiene. 2002;96(2):167-72.		"In industrialized countries the decision to start co-trimoxazole (CMX) prophylaxis of HIV-related opportunistic infections is based on the CD4+ cell count. The value of CMX prophylaxis has also been demonstrated in Africa, where CD4+ cell counts are rarely available. We therefore developed a simple score predictive of a threshold CD4+ cell count (400/mm<sup>3</sup>) below which CMX prophylaxis is indicated. In a retrospective cross-sectional study, we collected clinical and biological data on 211 HIV-infected patients recruited from January 1996 through January 1998 at Fann University Hospital in Dakar, Senegal. Several variables were identified as being predictive of a CD4+ cell count below 400/mm<sup>3</sup> by stepwise logistic regression. Each variable was weighted according to its regression coefficient, as follows: male sex (+1), weight loss (+2), body mass index <22 (+2), herpes zoster (+4), tuberculin induration <5 mm (+3) and haemoglobin <=10 g/dL (+1). A score of >=4 (sum of weights) selected patients with CD4+ cell counts below 400/mm<sup>3</sup> with a sensitivity of 98% and a negative predictive value of 83%. Such a score should be applicable in the African context and should facilitate the management of HIV-infected patients, especially the prescription of CMX prophylaxis."									
1344	Quality of care in nutritional rehabilitation in HIV-endemic Malawi: caregiver perspectives.	"Fergusson P, Chikaphupha K, Bongololo G, Makwiza I, Nyirenda L, Chinkhumba J, Aslam A, et al."	Maternal & Child Nutrition. 2010;6(1):89-100.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=20055932	"In Malawi, HIV and malnutrition are two of the most common causes of childhood morbidity and mortality. This qualitative study based in Nutrition Rehabilitation Units (NRU) in HIV-endemic Malawi explores caregiver's (staff and family) perspectives on quality of care for severely malnourished children. Three carer focus groups and 30 carer and staff in-depth interviews were conducted in two NRUs. The interviews and data analysis used a grounded theory approach, using both male and female Malawian researchers. Trustworthiness was enhanced through the researchers' prolonged engagement with the study setting and participants. The use of multiple methods - interviews, focus groups and observation - allowed for triangulation of the data. Data was then cross-referenced between staff and family caregiver reports. The analysis generated five themes. 'We have different blood' referring to staff attitudes and underperformance, 'What wrong did I do to God?' referring to stigma and chronic illness, 'My other children back home' referring to the carer's multiple responsibilities and challenges, 'Always in short supply' referring to resources available in the NRU (milk, medicine, space, hygiene) and 'you are always lagging behind' referring to the need for change and participants recommendations. Quality of care is a complex issue, bound by resources and capacity, influenced by stigma and hierarchy and limited by caregivers' conflicting responsibilities. Valuing and involving caregivers is essential in improving quality of care. Care should be patient and family centred and HIV services should be integrated into malnutrition care at the hospital and community level."									
1472	"Breast-feeding, mastitis, and HIV transmission: nutritional implications."	"Semba RD, Neville MC."	Nutrition Reviews. 1999;57(5 Pt 1):146-53.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=10391017	"In many developing countries, transmission of the human immunodeficiency virus (HIV) from mother to infant occurs through breast-feeding. Mastitis, an inflammatory process in the breast, may be common in lactating women in Africa and is associated with both higher HIV load in breast milk and mother-to-child transmission of HIV. Antioxidant micronutrient deficiencies may increase the risk of mastitis. Whether prevention, early diagnosis, and prompt treatment of mastitis will help reduce mother-to-child transmission of HIV in breast-feeding women needs further study. [References: 100]"									
1444	Variations in occurrences of nutrition-related diseases in Sub-Saharan Africans in stages of transition: what of the future?	"Walker AR, Walker BF, Sci DD, Adam F."	Nutrition. 2002;18(1):71-4.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=11827769	"In many Sub-Saharan African populations, in particular urban dwellers, there have been marked rises in the prevalences of obesity in women, hypertension, diabetes, and cerebral vascular disease. Yet there have been only slight rises in coronary heart disease. To learn more of the roles of the various influencing factors in the puzzling situations described, some aspects of the past and present occurrences of these diseases are described and discussed, with comparisons being made with corresponding situations in African Americans, as well as in certain white populations. Despite increases in the knowledge of influencing factors, such fail to explain fully the epidemiologic situations described. As to the future, judging from the experiences of other populations, despite continuing indigence, within the next generation significant rises in coronary heart disease in certain African populations seem to be inevitable. However, in many of those populations, in particular those in the South, the extent of changes, apart from those linked with level of socioeconomic state, will be strongly affected by the rising epidemic of human immunodeficiency virus and acquired immunodeficiency syndrome. [References: 71]"									
446	Hepatitis C as a risk factor for diabetes type 2: Lack of evidence in a hospital in Central-West Brazil.	"Correada Costa LMF, Mussi ADH, Brianeze MR, Souto FJD."	Brazilian Journal of Infectious Diseases. 2008 February;12(1):24-6.		"In order to assess the importance of HCV infection as a possible risk factor for type 2 diabetes mellitus, a case-control study was conducted, comparing the prevalence of HCV infection among diabetic and non-diabetic patients. Diabetic outpatients attending to a University Hospital in Central-West Brazil were evaluated between April and October 2005. A control group composed by patients from the same institution was matched by gender and age. Candidates to control group were included only if fasting glucose measures were under 100 mg/dL. Diabetics and controls had blood samples taken in order to test for antibodies against HCV (anti-HCV) by enzyme-immunoassay. Polymerase chain reaction and immunoblot were performed to confirm the anti-HCV status. Each group included 206 participants. Despite of the groups were in general comparable. The diabetics had a greater body mass average and smaller family income. The prevalence of confirmed anti-HCV in the diabetic group was of 1.4%, which was similar to the controls (1%). FInding statistical difference may have been hampered by the low frequencyof HCV infection in both groups. It was not possible to demonstrate a role of HCV as an etiologic factor in type 2 diabetes, since HCV infected patients represented a small portion of the overall diabetes cases. This finding does not allow to recommend regular screening for HCV infection in type 2 diabetics in this region. 2008 by The Brazilian Journal of Infectious Diseases and Contexto Publishing. All rights reserved."									
34	"Aerobic capacity, muscle strength and physical activity levels in a group of HIV positive females."	"Kinsey K, Chantler I, McVeigh J, Jordaan DP, Nowak I."	"African Journal for Physical, Health Education, Recreation and Dance. 2007;13(4):414-29."	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20083037526	"In order to assess whether HIV has negatively impacted on the muscle strength and aerobic capacity of infected individuals, ten healthy, Black, HIV positive women (32+or-6 years, median CD4<sup>+</sup> cell count=230 cells/mm<sup>3</sup>), all taking antiretroviral (ARV) medication, completed an exercise testing session consisting of a submaximal bicycle ergometer protocol, a lower-limb isokinetic dynamometry test and a hand-grip dynamometer test. Ten healthy, Black, age-matched HIV negative women (34+or-6 years) completed the same exercise session. All the women wore an activity monitor, a subjective measure of physical activity, for seven days. There were no significant differences in the predicted aerobic capacity (p>0.05), hamstring (p>0.05) and quadriceps (p>0.05) peak torque, hand-grip strength (p>0.05), and seven day physical activity counts (p>0.05) between the HIV positive and negative women. There was no significant difference in the body mass index (p>0.05) of the two groups. We have shown that the aerobic capacity, muscle strength and measured physical activity counts of HIV positive women, despite their lower CD4 counts, were not significantly less than their HIV negative counterparts. The use of antiretroviral medication, despite reported side-effects, has not negatively impacted on their physical performance. We recommend that these HIV positive women participate in a structured exercise program to help maintain or even improve their current muscular strength and aerobic capacity; both essential for functional independence and quality of life."									
1441	"Tuberculosis, human immunodeficiency virus infection, and malnutrition in Burundi."	"Niyongabo T, Henzel D, Idi M, Nimubona S, Gikoro E, Melchior JC, Matheron S, et al."	Nutrition. 1999;15(4):289-93.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=10319361	"In order to compare the nutritional status of tuberculosis (TB) patients who were human immunodeficiency virus (HIV)-seropositive with those who were seronegative, we carried out a cross-sectional anthropometric and biochemical assessment, together with bioelectrical impedance analysis (BIA) of the nutritional status of TB patients hospitalized in the Department of Internal Medicine, Bujumbura University Hospital, Burundi, East Africa. Of the 65 TB patients (33 pulmonary, 6 extrapulmonary, and 26 disseminated TB), 50 (76.9%) were HIV-seropositive (HIV+). When assessed according to anthropometric, BIA, and biochemical variables, HIV+ TB patients had more pronounced malnutrition than HIV- patients. Similar results were obtained when the comparison was restricted to patients with only pulmonary TB: HIV+ patients were more malnourished than HIV- patients. The results according to anthropometric measurements were: weight loss (13.5% of HIV- patients versus 26.4% of HIV+ patients, P = 0.005), body mass index (18.6 versus 15.1, P = 0.003), fat free mass (FFM) (13.9 versus 11.9, P < 0.01), and body fat (BF) (4.55 versus 3.71, P = 0.03) expressed per unit height2. BIA showed that the difference in FFM between HIV- and HIV+ TB pulmonary patients was mostly due to a decrease in body cellular mass. Measurements of albumin, prealbumin, and transferrin showed a marked decrease in all three markers in HIV+ TB pulmonary patients. The nutritional status of HIV+ patients with disseminated versus pulmonary TB was similar. The nutritional status of HIV+ TB patients is far worse than that of HIV- TB patients. In such patients, anthropometry underestimates the degree of malnutrition because it does not account for the water component of FFM. Nutritional status should be assessed and nutritional intervention should be provided in an attempt to improve the prognosis of TB patients, especially those who are infected by HIV."									
1413	"Renal disease in HIV-seropositive patients in Nigeria: an assessment of prevalence, clinical features and risk factors."	"Emem CP, Arogundade F, Sanusi A, Adelusola K, Wokoma F, Akinsola A."	Nephrology Dialysis Transplantation. 2008;23(2):741-6.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20083075196	"In order to determine the pattern of renal disease and risk factors for renal disease in HIV-infected Nigerians, we studied 400 consecutive HIV/AIDS patients (210 males, 190 females) aged between 18 and 65 years (mean+or-SD; 34.6+or-9.4 years), and examined renal disease factors attributable to the infection. Diagnosis of renal disease was based on the consistent presence of at least 1+ albuminuria and/or elevated serum creatinine (>132 micro mol/l) as well as the absence of other identifiable causes of chronic kidney disease (CKD). We determined socio-demography and clinical findings, as well as full laboratory work-ups including haemogram, CD4+ cell count, serum electrolytes, urea, creatinine, protein, cholesterol and urine analysis. Renal biopsies were taken in 10 patients who had moderate to massive proteinuria and had consented to the procedure. Finally, we compared HIV/AIDS cases with and without renal disease to determine the risk factors for nephropathy. We observed a high prevalence of renal disease (proteinuria and/or elevated serum creatinine), which was present in 152 (38%) of the patients. This subgroup included 74 males and 78 females with a M:F ratio of 1:1. The mean age (+or-SD) was 35.8 (+or-10.01) years. Systolic and/or diastolic hypertension was seen in 13.2% of these patients while the mean (+or-SD) body mass index (BMI) and packed cell volume (PCV) were 18.5 (+or-3.1) kg/m<sup>2</sup> and 25.26 (+or-6.81)%, respectively. The mean (+or-SD) CD4+ count was 246.49 (+or-192.8) cells/ micro l, while the mean (+or-SD) serum creatinine and 24-h urine protein excretion rates were 210.11 (+or-337.8) micro mol/l and 2.57 (+or-2.42) g/day, respectively. In subjects with and without nephropathy, there were significant differences in age, BMI, serum cholesterol, serum albumin and CD4+ counts, suggesting that these parameters may be risk factors for nephropathy. Histology revealed mainly focal glomerulosclerosis (FGS) with glomerular collapse. We conclude that the prevalence of proteinuria in HIV-seropositive patients is high in Nigeria. Such subjects show an equal male:female distribution, and glomerular histology revealed that a majority of biopsied patients had the collapsing FSGS variant. The risk factors for renal disease included severity of the HIV infection (inferred from the generally low CD4+ count), anaemia, malnutrition and increasing age."									
576	"Modifications of a large HIV prevention clinical trial to fit changing realities: A case study of the Breastfeeding, Antiretroviral, and Nutrition (BAN) protocol in Lilongwe, Malawi."	"van der Horst C, Chasela C, Ahmed Y, Hoffman I, Hosseinipour M, Knight R, Fiscus S, et al."	Contemporary Clinical Trials. 2009 January;30(1):24-33.		"In order to evaluate strategies to reduce HIV transmission through breast milk and optimize both maternal and infant health among HIV-infected women and their infants, we designed and implemented a large, randomized clinical trial in Lilongwe, Malawi. The development of protocols for large, randomized clinical trials is a complicated and lengthy process often requiring alterations to the original research design. Many factors lead to delays and changes, including study site-specific priorities, new scientific information becoming available, the involvement of national and international human subject committees and monitoring boards, and alterations in medical practice and guidance at local, national, and international levels. When planning and implementing a clinical study in a resource-limited setting, additional factors must be taken into account, including local customs and program needs, language and socio-cultural barriers, high background rates of malnutrition and endemic diseases, extreme poverty, lack of personnel, and limited infrastructure. Investigators must be prepared to modify the protocol as necessary in order to ensure participant safety and successful implementation of study procedures. This paper describes the process of designing, implementing, and subsequently modifying the Breastfeeding, Antiretrovirals, and Nutrition, (BAN) Study, a large, on-going, randomized breastfeeding intervention trial of HIV-infected women and their infants conducted at a single-site in Lilongwe, Malawi. We highlight some of the successes, challenges, and lessons learned at different stages during the conduct of the trial. 2008 Elsevier Inc."									
577	"Modifications of a large HIV prevention clinical trial to fit changing realities: a case study of the Breastfeeding, Antiretroviral, and Nutrition (BAN) protocol in Lilongwe, Malawi."	"van der Horst C, Chasela C, Ahmed Y, Hoffman I, Hosseinipour M, Knight R, Fiscus S, et al."	Contemporary Clinical Trials. 2009;30(1):24-33.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=18805510	"In order to evaluate strategies to reduce HIV transmission through breast milk and optimize both maternal and infant health among HIV-infected women and their infants, we designed and implemented a large, randomized clinical trial in Lilongwe, Malawi. The development of protocols for large, randomized clinical trials is a complicated and lengthy process often requiring alterations to the original research design. Many factors lead to delays and changes, including study site-specific priorities, new scientific information becoming available, the involvement of national and international human subject committees and monitoring boards, and alterations in medical practice and guidance at local, national, and international levels. When planning and implementing a clinical study in a resource-limited setting, additional factors must be taken into account, including local customs and program needs, language and socio-cultural barriers, high background rates of malnutrition and endemic diseases, extreme poverty, lack of personnel, and limited infrastructure. Investigators must be prepared to modify the protocol as necessary in order to ensure participant safety and successful implementation of study procedures. This paper describes the process of designing, implementing, and subsequently modifying the Breastfeeding, Antiretrovirals, and Nutrition, (BAN) Study, a large, on-going, randomized breastfeeding intervention trial of HIV-infected women and their infants conducted at a single-site in Lilongwe, Malawi. We highlight some of the successes, challenges, and lessons learned at different stages during the conduct of the trial."									
271	Failure of twice-weekly iron supplementation to increase blood haemoglobin and serum ferritin concentrations: results of a randomized controlled trial.	"Olsen A, Nawiri J, Magnussen P, Krarup H, Friis H."	Annals of Tropical Medicine & Parasitology. 2006;100(3):251-63.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=16630383	"In order to increase the intestinal absorption of iron whilst simultaneously minimising the side-effects and thus increasing compliance, once- or twice-weekly, instead of daily, iron supplementation has been widely recommended. In a randomized, placebo-controlled, double-blind study in western Kenya, a tablet of ferrous dextran (containing 60 mg elemental iron) or an identical-looking placebo tablet was provided twice-weekly for 12 months to each child or adult investigated. At baseline each subject had a moderately low blood concentration of haemoglobin (Hb). Initial Hb and serum ferritin (SF) concentrations were determined and each subject was tested for malarial and helminth infection and treated, if necessary, with the appropriate anthelminthic drug(s). Overall, 200 children (aged 4-15 years) and 129 adults (aged 16-63 years) completed the 12-month study. At baseline, 47.5% of the children and 58.1% of the adults were anaemic, hookworm (detected in 60.0% of the children and 69.9% of the adults) was the most common helminth infection, and malaria was endemic. The results of bivariate analyses indicated that twice-weekly iron supplementation had no significant effect on blood Hb or SF concentrations, either in the children or the adults investigated. The results were confirmed in multiple linear-regression analyses, which revealed that the predictors of the final Hb concentration in the children investigated were age and infection, after enrollment, with Ascaris lumbricoides. Gender and the serum concentration of alpha-1-antichymotrypsin (ACT) at final follow-up were predictors of the final SF concentration in the children. In adults, the predictors of the final Hb concentration were gender and HIV infection, and the predictors of the final SF concentration were age and the serum concentration of ACT at the final follow-up. Twice-weekly iron supplementation did not increase Hb or iron stores in children or adults. Since compliance appeared to be high, this lack of effect may be the result of an inadequate dose of iron or of subjects who have deficiencies in micronutrients other than iron."									
1704	[Understanding current practice of clinical medicine in the tropics (II). Bacterial and viral diseases. Malnutrition].	"Ramos JM, de Gorgolas M, Cuadros J, Fanjul E, Profesores del Curso de Patologia Tropical en Madrid y E."	Revista Clinica Espanola. 2012;212(7):347-58.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=22425146	"In recent years, a significant number of physicians want to spend part of their medical training in health facilities in developing countries. In this setting, clinical skills are extremely important due to the limited available diagnostic resources. Bacterial diseases are common, but bacterial cultures are rarely accessible. In Africa, tuberculosis affects over 200 cases per 100,000 persons, and more than 22 million people live with HIV infection; both diseases are a serious public health problem. Malnutrition is endemic in many countries in Africa and is compounded by the continuous humanitarian and food crisis. In this paper, basic concepts of epidemiology, clinical features, diagnosis and treatment of major diseases that can be found in a rural health post in the tropics are discussed. Copyright 2011 Elsevier Espana, S.L. All rights reserved."									
788	Metabolic patterns of HIV-infected young adults undergoing highly active antiretroviral therapy.	"Munteanu DI, Streinu Cercel A, Arama V, Benea O, Mardarescu M, Costinescu C, Mihailescu R, et al."	HIV Medicine. 2009 October;10:124.		"In Romania, the majority of HIV seropositive patients is made of young adults who were parenterally infected, in the childhood, before 1990. Objective: To define the metabolic patterns and the cardiovascular risk of HIV infected young adults undergoing highly active antiretroviral therapy (HAART), a population group without enough data in the literature. Methods: We present the preliminary data of an ongoing prospective Romanian research grant (SLD-ART) on HIV infected patients with HAART, in INBIMB, between Nov/2008-Nov/2011. The patients are examined every 6 months and the performed laboratory assays are: CD4 cell count, HIV viremia, lipidogram, glicemia, insulinemia, leptine, adiponectine, resistine, tumoral necrosis factor alpha (TNFa), interleukin6 (IL6). Results: Up to date (Jan-May/2009) we included 32 patients in the study with median age of 24 years and M:F ratio=1,66:1, with median CD4 cell count of 596/mmc and >65% of patients with undetectable HIV viremia. Over 80% of patients received a protease inhibitor (PI). Of all patients 75% were multiexperienced. The estimation of the body mass index showed that 7% of patients were underweight and 25% overweight or obese. Although the majority of patients had total cholesterol < 200mg/dl, the lipidogram showed that 40% had HDLcholesterol < 55mg/dl and LDL >100mg/dl, in the same time. Of all the patients 65% had triglicerides >150mg/dl. Over 90% of patients had fasting glucose < 100mg/dl; however 40% of patients presented high insulin and 63% insulin-resistance according to the Quiki score. Values of leptine were low and those of TNFa high in 42% and respectively 65% of patients. Framingham cardiac risk score >15% was found in 10% of patients. Conclusions: Despite the young age of the patients, we noticed that they presented dislipidemia and insulin-resistance and some of them a high 10-year cardiovascular disease risk, probably because the patients were multiexperienced and under PI medication."									
1862	[The characteristics of diagnosing homosexuality in examining a special population contingent].	"Bardenshtein LM, Ermolaev VS, Ovchinnikov VI, Ponomarev GN."	Sudebno-Meditsinskaia Ekspertiza. 1995;38(2):13-6.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med3&AN=7638881	"In social terms homosexuality is one of the most dangerous sexual perversions, for it is subject to a strong social disapproval, affects the personality core, leads to social disadaptation, growth of anxiety, development of neurotic and depressive states, suicidal inclination, is conducive to the spread of syphilis and AIDS, forms the basis for numerous crimes (violence, aggression, murder). Homosexuality virtually cannot be corrected and is carefully concealed. In single-sex groups (soldiers, students of military schools, convicts) the prevalence of homosexuality may be as high as 30 to 50%. The proposed complex method for the diagnosis of homosexuality in men has been developed on the basis of methods of sexology, anthropometry, verbal and nonverbal psychodiagnosis, multidimensional mathematical statistics. The method consists of several independent blocks representing different aspects of sexuality. It is conductive to a flexible and rapid solution of numerous practical problems from singling out a risk group in screening examinations to full expert evaluation of the sexual sphere with a resulting differential diagnosis."									
432	"High prevalence of obesity among women who enrolled in HIV prevention trials in KwaZulu-Natal, South Africa: healthy diet and life style messages should be integrated into HIV prevention programs."	"Wand H, Ramjee G."	BMC public health. 2013;13:159.		"In South Africa, poverty and the dual epidemics of HIV and tuberculosis underscore the need for prevention efforts for obesity. The aim of this study was to describe the prevalence of obesity in a cohort of South African women and discuss the implications for public health practices. A total of 5,495 HIV-negative women from KwaZulu-Natal, South Africa enrolled in three microbicide trials during the period of 2002-2008 were categorised as normal weight (body mass index (BMI: 18.6-<25), overweight (BMI: 25-<30) or obese (BMI: 30+). Incidence of HIV and other sexually transmitted infections such as Chlamydia and gonorrhoea were also estimated and compared by BMI groups. Combined data was analysed using STATA 10.0. Approximately 70% of the sample population was classified as being overweight or obese. Older age and lack of education were determined to be significant predictors of obesity. Women who were 35 years or older were more than three times as likely to be overweight and more than 12 times as likely to be obese compared to the youngest group. The highest HIV and STI incidence rates were observed among those with BMI <25 kg/m(2) (normal weight) compared to women with BMI more than 25 kg/m2 (8.1 and 19.8 per 100 person-year respectively, P<0.001, both). Effective obesity prevention strategies are needed to re-formulate HIV prevention programmes by incorporating healthy diet and life style messages to target those who are at highest risk not just for HIV infection but also for non-communicable diseases."									
607	Severe malnutrition due to subtle neurologic deficits and epilepsy: report of three cases.	Dike GL.	East African Medical Journal. 1999;76(10):597-8.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=10734515	"In southern and eastern Africa, where approximately eight per cent of households lack access to adequate food, children suffering from chronic infections such as tuberculosis, gastrointestinal parasites and human immunodeficiency virus, often present with severe protein energy malnutrition. Three cases are described of children presenting to Chikankata Salvation Army Hospital who required hospitalization and urgent feeding due to PEM. No underlying aetiology for their life-threatening PEM could initially be identified and they were all observed to gain weight while in the intensive feeding unit. After discharge, each re-presented with recurrent failure-to-thrive and were found to have subtle neurologic deficits and underlying epilepsy. Epilepsy and developmental disabilities should be considered in patients with PEM for whom other aetiologies cannot be identified."									
844	Effects of antioxidants on CD4 and viral load in HIV-infected women in sub-Saharan Africa - dietary supplements vs. local diet.	"Nkengfack GN, Torimiro JN, Englert H."	International Journal for Vitamin & Nutrition Research. 2012;82(1):63-72.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=22811378	"In sub-Sahara Africa, micronutrient deficiency, especially of antioxidant micronutrients including vitamins A, C, and E, beta-carotene, selenium, zinc, and polyphenols is very common in HIV-positive patients. Amongst adults, women are the most vulnerable. Antioxidants are known to play a vital role in the immune system, reducing oxidative stress. Oxidative stress is induced by excess production of reactive oxygen species (ROS), due to the HIV infection. Such damage may be prevented or moderated through adequate oral intake of antioxidants, scavenging ROS, as well as protecting cells and tissues against oxidative stress. Antioxidants can be provided to the body through locally available antioxidant rich-diets such as fruit-and-vegetable-based diets and/or dietary supplements. Provision of antioxidants through local diets or dietary supplements exercise beneficial effects on biological markers of the immune system (CD4 and viral load). However, while dietary supplements represent a costly and short-term strategy to limiting antioxidant deficiency, local diets, combined with adequate nutritional education, can provide a low-cost and long-term strategy to reduce oxidative stress, prevent micronutrient deficiency, and slow down HIV disease progression. The former can be applicable in countries around the West, Central, and South coast of Africa, which are rich in natural food resources. In contrast with significant evidence that dietary supplements confer benefits in HIV patients, fewer data are available relating to the benefits of local diets. Thus the need to do more research in this area arises. This review compares available data on effects of antioxidants on CD4 and viral load in HIV-positive women noneligible for antiretroviral therapy. Intake of antioxidants though dietary supplements and local diet, associated with nutritional education, is compared. Studies conducted in sub-Sahara Africa are considered."									
220	"Prognostic value of cross-sectional anthropometric indices on short-term risk of mortality in human immunodeficiency virus-infected adults in Abidjan, Cote d'Ivoire."	"Castetbon K, Anglaret X, Toure S, Chene G, Ouassa T, Attia A, N'Dri-Yoman T, et al."	American Journal of Epidemiology. 2001 01 Jul;154(1):75-84.		"In sub-Saharan Africa where weight loss is very difficult to estimate, cross-sectional anthropometric indicators could be useful to predict human immunodeficiency virus (HIV)-associated mortality. The study objective was to look for threshold values of baseline body mass index, arm muscle circumference, and fat mass to predict the risk of death in HIV-infected adults included in a 1996-1998 trial of early cotrimoxazole chemoprophylaxis in Abidjan, Cote d'Ivoire (COTRIMO-CI-ANRS 059 trial). The authors graphically determined if consecutive anthropometric categories with the closest hazards ratios of the risk of death could be clustered to obtain a unique threshold that distinctly separated two categories. When the threshold values were determined, the authors estimated the hazards ratio of mortality of this two-category model. A significant increase of mortality was observed for a body mass index of <=20.3 in men (hazards ratio = 2.6; 95% confidence interval (CI): 1.4, 5.0) and of <=18.5 in women (hazards ratio = 2.2; 95% CI: 1,05, 4.5) and for a fat mass of <=6% in men (hazards ratio = 4,6; 95% CI: 2.3, 9.4) and of <=18% in women (hazards ratio = 2.4; 95% CI: 1.2, 4.9). No simple threshold could be identified for arm muscle circumference. In Cote d'Ivoire where chemoprophylaxis of opportunistic infections has recently been recommended to be widely initiated on clinical criteria, such thresholds may help to screen patients with higher risks of mortality."									
221	"Prognostic value of cross-sectional anthropometric indices on short-term risk of mortality in human immunodeficiency virus-infected adults in Abidjan, Cote d'Ivoire."	"Castetbon K, Anglaret X, Toure S, Chene G, Ouassa T, Attia A, N'Dri-Yoman T, et al."	American Journal of Epidemiology. 2001;154(1):75-84.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=11427407	"In sub-Saharan Africa where weight loss is very difficult to estimate, cross-sectional anthropometric indicators could be useful to predict human immunodeficiency virus (HIV)-associated mortality. The study objective was to look for threshold values of baseline body mass index, arm muscle circumference, and fat mass to predict the risk of death in HIV-infected adults included in a 1996-1998 trial of early cotrimoxazole chemoprophylaxis in Abidjan, Cote d'Ivoire (COTRIMO-CI-ANRS 059 trial). The authors graphically determined if consecutive anthropometric categories with the closest hazards ratios of the risk of death could be clustered to obtain a unique threshold that distinctly separated two categories. When the threshold values were determined, the authors estimated the hazards ratio of mortality of this two-category model. A significant increase of mortality was observed for a body mass index of < or =20.3 in men (hazards ratio = 2.6; 95% confidence interval (CI): 1.4, 5.0) and of < or =18.5 in women (hazards ratio = 2.2; 95% CI: 1.05, 4.5) and for a fat mass of < or =6% in men (hazards ratio = 4.6; 95% CI: 2.3, 9.4) and of < or =18% in women (hazards ratio = 2.4; 95% CI: 1.2, 4.9). No simple threshold could be identified for arm muscle circumference. In Cote d'Ivoire where chemoprophylaxis of opportunistic infections has recently been recommended to be widely initiated on clinical criteria, such thresholds may help to screen patients with higher risks of mortality."									
1983	Barriers to referral in Swaziland: Perceptions from providers and clients of a system under stress.	"Macintyre KCE, Littrell M, Hotchkiss DR, Mndzebele S, Nkambule R, Malima B, Gumbi S, et al."	World Medical and Health Policy. 2011 01 Dec;3(4).		"In Swaziland, where one in four adults is HIV positive, identifying and addressing barriers to a strong referral system is critical to ensure continuity of care for HIV positive individuals. This study examines the referral system from the perspectives of health providers, community health workers, traditional healers, clients seeking facility-based care, and managers of private health organizations. Structured and semi-structured questionnaires were administered to 52 senior providers, 161 providers, and 307 clients in 52 health facilities. In 82 randomly selected communities, 81 traditional healers and 247 CHWs also participated. Staff from private health agencies providing HIV-related care were also interviewed. Referral is commonly understood as sending clients to seek care at higher level facilities and is an individualized process dependent on various factors. Providers sending clients rarely hear back on any regular basis about those clients. Referrals and linkages for certain services are particularly weak including nutrition support, psychosocial support, palliative care and homebased care. Many providers recommended that referral protocols with improved communication tools are needed and said referred clients should be given priority at referral-receiving sites. Policy recommendations include: referral form redesign; formalizing or reforming the referral protocol; strengthening communication and linkages between community-and facility-based providers; and improving patient-flow at referral sites. 2011 Policy Studies Organization."									
1057	Regional health sector performances in Tanzania: a comparison of various aggregating schemes.	Mduma JK.	Journal of Applied Sciences. 2007;7(3):356-61.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20073049510	"In Tanzania, the Ministry of Health publishes the Heath Statistics Abstract, which contains several indicators of health performance disaggregated on regional level. For policy intervention at the regional level, it is necessary to have an indicator which is able to consistently rank the performance of each region. Given that there are several indicators which show the performance of each region, such comparison is not straight forward. One option is to create an aggregated index/indicator from the given standard indicators. We developed such Unified Health Performance Index (UHPI) based on several performance indicators collected in the 1990s. In the construction of the UHPI, the weights of different standard health performance indicators were statistically derived by applying the benefit-of-the-doubt weighting method, which gave regions some freedom to emphasize and prioritize some aspects of indicators that they perform best over others. The health indicators considered were: percentages of family and institutional blood donors who tested HIV positive in 1996; cumulative rate of HIV positive per 100 000 population during 1992-96; number of death due to dysentery in 1995; percentage of underweight children aged less than 5 years in 1997; infant and under 5 child mortality in 1995; and maternal mortality in 1995. The results of our index were compared with those based on simple average ranking. Their policy implications are discussed."									
1650	Responding to the crisis in sub-Saharan Africa: the role of nutrition.	"Chopra M, Darnton-Hill I."	Public Health Nutrition. 2006;9(5):544-50.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=16923284	"In the chapter dealing with education and health, the report of the influential Commission for Africa prioritises basic health systems, HIV/AIDS, malaria and tuberculosis. In contrast, nutrition is given less than half a page and is reduced to parasite control and micronutrient support. Such neglect of nutrition is hard to understand in the context of increasing hunger and malnutrition across the continent. Sub-Saharan Africa is the only region in the world where the proportion of underweight children has stagnated and the absolute numbers have actually increased in the last decade. It has been pointed out that if current trends continue sub-Saharan Africa will achieve the Millennium Development Goal for child mortality around 2115 - one century after the target date. Quite clearly those concerned with nutrition need to more powerfully advocate the role of nutrition in lifting Africa out of the spiral of poverty. The present paper argues that to achieve this requires an understanding not just of the critical role of nutrition for health and development (both individual and national), but also of how recent global changes are interacting with changes in food production and supply, other determinants of maternal and child health, and the role and capacity of the state to tackle malnutrition in Africa. It concludes by suggesting some responses that nutritionists could now be making."									
1151	"Heat treatment of expressed breast milk is a feasible option for feeding HIV-exposed, uninfected children after 6 months of age in rural Zimbabwe."	"Mbuya MNN, Humphrey JH, Majo F, Chasekwa B, Jenkins A, Israel-Ballard K, Muti M, et al."	Journal of Nutrition. 2010 August;140(8):1481-8.		"In the context of a prevention of mother to child transmission of HIV program promoting exclusive breast-feeding (EBF) to 6 mo and offering HIV-PCR testing at ~6 mo, we ascertained the feasibility of expressing and heat-treating (EHT) all breast milk fed to HIV-exposed, uninfected infants following 6 mo of EBF. Twenty mother-baby pairs were enrolled from a hospital in rural Zimbabwe. Research nurses provided lactation, EHT, and complementary feeding counseling through 21 home visits conducted over an 8-wk period and collected quantitative and qualitative data on the mothers' EHT experiences, children's diets, and anthropometric measurements. Mothers kept daily logs of EHT volumes and direct breast-feeding episodes. Mothers successfully initiated and sustained EHT for 4.5 mo (range, 1-11 mo), feeding 426 +/- 227 mL/d (mean +/- SD). By wk 2 of follow-up, children were receiving EHT and Nutributter-enriched complementary foods that satisfied 100% of their energy requirements. During the 8-wk follow-up period, no growth faltering was experienced [changes in weight-for-age, weight-for-length, and length-for-age Z scores = +0.03 +/- 0.50; +0.77 +/- 1.59; and +0.02 +/- 0.85 (mean +/- SD), respectively]. Stigma was not a major deterrent, likely due to a social marketing campaign for EBF that promoted EHT as a practice to sustain breast-feeding for all women. This study provides evidence that resource-poor rural women can initiate and sustain EHT given family and health systems support. EHT provides a strategy for improving the diets of HIV-exposed but uninfected children after direct breast-feeding has ceased. 2010 American Society for Nutrition."									
1848	Nigeria 2003: results from the demographic and health survey.		Studies in Family Planning. 2008;39(1):79-84.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20083064562	"In the demographic and health survey carried out in Nigeria between March and August 2003, data were collected from 7225 households and complete interviews were conducted with 7620 women aged 15-49 years and 2346 men aged 15-59 years. Data on fertility (fertility preference, contraception, marital status, assistance during childbirth, postpartum variables), infant mortality, disease prevention and treatment, nutritional status and knowledge of human immunodeficiency virus and acquired immune deficiency syndrome were presented."									
1684	Expanding global HIV treatment: Case studies from the field.	"Furin JJ, Behforouz HL, Shin SS, Mukherjee JS, Bayona J, Farmer PE, Kim JY, et al."	Reducing the Impact of Poverty on Health and Human Development: Scientific Approaches. 2008 June;Annals of the New York Academy of Sciences. 1136:12-20.		"In the last 25 years, human immunodeficiency virus (HIV) has become the leading infectious killer of adults globally, with an estimated 44 million people infected with the virus worldwide. Most of these individuals live in poor regions of the world, particularly sub-Saharan Africa. Although a great deal of work has been done in identifying and treating individuals with the disease, there has been little action to date to address the complex socioeconomic factors that lie at the heart of this global pandemic. Understanding and responding to such factors is of paramount importance if HIV infection is to be managed in a meaningful way. This article explores the social context of people living with HIV in three different geographic and epidemiologic settings and highlights the social factors that shape and define an individual's risk of acquiring HIV. It also discusses unique programs aimed at addressing the complex realities of the world in which HIV thrives. These programs can act as models of HIV prevention and treatment. 2008 New York Academy of Sciences."									
1639	Micronutrients in childhood and the influence of subclinical inflammation.	"Thurnham DI, Mburu ASW, Mwaniki DL, De Wagt A."	Proceedings of the Nutrition Society. 2005 November;64(4):502-9.		"In the present paper biomarkers of micronutrient status in childhood and some of the factors influencing them, mainly dietary intake, requirements and inflammation will be examined. On a body-weight basis the micronutrient requirements of children are mostly higher than those of an adult, but most biomarkers of status are not age-related. A major factor that is often overlooked in assessing status is the influence of subclinical inflammation on micronutrient biomarkers. In younger children particularly the immune system is still developing and there is a higher frequency of sickness than in adults. The inflammatory response rapidly influences the concentration in the blood of several important micronutrients such as vitamin A, Fe and Zn, even in the first 24 h, whereas dietary deficiencies can be envisaged as having a more gradual effect on biomarkers of nutritional status. The rapid response to infection may be for protective reasons, i.e. conservation of reserves, or by placing demands on those reserves to mount an effective immune response. However, because there is a high prevalence of disease in many developing countries, an apparently-healthy child may well be at the incubation stage or convalescing when blood is taken for nutritional assessment and the concentration of certain micronutrient biomarkers will not give a true indication of status. Most biomarkers influenced by inflammation are known, but often they are used because they are convenient or cheap and the influence of subclinical inflammation is either ignored or overlooked. The objective of the present paper is to discuss: (1) some of the important micronutrient deficiencies in childhood influenced by inflammation; (2) ways of correcting the interference from inflammation. The Authors 2005."									
1640	Micronutrients in childhood and the influence of subclinical inflammation.	"Thurnham DI, Mburu ASW, Mwaniki DL, Wagt Ad."	Proceedings of the Nutrition Society. 2005;64(4):502-9.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh3&AN=20053200050	"In the present paper biomarkers of micronutrient status in childhood and some of the factors influencing them, mainly dietary intake, requirements and inflammation will be examined. On a body-weight basis the micronutrient requirements of children are mostly higher than those of an adult, but most biomarkers of status are not age-related. A major factor that is often overlooked in assessing status is the influence of subclinical inflammation on micronutrient biomarkers. In younger children particularly the immune system is still developing and there is a higher frequency of sickness than in adults. The inflammatory response rapidly influences the concentration in the blood of several important micronutrients such as vitamin A, Fe and Zn, even in the first 24 h, whereas dietary deficiencies can be envisaged as having a more gradual effect on biomarkers of nutritional status. The rapid response to infection may be for protective reasons, i.e. conservation of reserves, or by placing demands on those reserves to mount an effective immune response. However, because there is a high prevalence of disease in many developing countries, an apparently-healthy child may well be at the incubation stage or convalescing when blood is taken for nutritional assessment and the concentration of certain micronutrient biomarkers will not give a true indication of status. Most biomarkers influenced by inflammation are known, but often they are used because they are convenient or cheap and the influence of subclinical inflammation is either ignored or overlooked. The objective of the present paper is to discuss: (1) some of the important micronutrient deficiencies in childhood influenced by inflammation; (2) ways of correcting the interference from inflammation."									
681	The prevalence and etiology of anemia among HIV-infected children in India.	"Anita S, Karthika A, Nirmala R, Chitra D, Shubha K, Mehta S, Shet AS."	European Journal of Pediatrics. 2012;171(3):531-40.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20123109984	"In this report, the prevalence and multifactorial etiology of anemia among Indian human immunodeficiency virus (HIV)-infected children are described. HIV-infected children aged 2-12 years were prospectively enrolled in 2007-2008. Measured parameters included serum ferritin, vitamin B<sub>12</sub>, red-cell folate, soluble transferrin receptor, and C-reactive protein. Children received antiretroviral therapy (ART), iron and, folate supplements as per standard of care. Among 80 enrolled HIV-infected children (mean age 6.8 years), the prevalence of anemia was 52.5%. Etiology of anemia was found to be iron deficiency alone in 38.1%, anemia of inflammation alone in 38.1%, combined iron deficiency and anemia of inflammation alone in 7.1%, vitamin B<sub>12</sub> deficiency in 7.1%, and others in 9.5%. Median iron intake was 5.7 mg/day (recommended dietary allowance 18-26 mg/day). Compared to nonanemic children, anemic children were more likely to be underweight (weight Z-score -2.5 vs. -1.9), stunted (height Z-score -2.6 vs. -1.9), with lower CD4 counts (18% vs. 24%, p<0.01), and higher log viral load (11.1 vs. 7.1, p<0.01). Hemoglobin (Hb) improved significantly among those who started ART (baseline Hb 11.6 g/dl, 6-month Hb 12.2 g/dl, p=0.03). Children taking ART combined with iron supplements experienced a larger increase in Hb compared to those receiving neither ART nor iron supplements (mean Hb change 1.5 g/dl, p<0.01). Conclusion: Anemia, particularly iron deficiency anemia and anemia of inflammation, is highly prevalent among children with HIV infection. Micronutrient supplements combined with ART improved anemia in HIV-infected children."									
682	The prevalence and etiology of anemia among HIV-infected children in India.	"Shet A, Arumugam K, Rajagopalan N, Dinakar C, Krishnamurthy S, Mehta S, Shet AS."	European Journal of Pediatrics. 2012;171(3):531-40.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=22009132	"In this report, the prevalence and multifactorial etiology of anemia among Indian human immunodeficiency virus (HIV)-infected children are described. HIV-infected children aged 2-12 years were prospectively enrolled in 2007-2008. Measured parameters included serum ferritin, vitamin B(12), red-cell folate, soluble transferrin receptor, and C-reactive protein. Children received antiretroviral therapy (ART), iron and, folate supplements as per standard of care. Among 80 enrolled HIV-infected children (mean age 6.8 years), the prevalence of anemia was 52.5%. Etiology of anemia was found to be iron deficiency alone in 38.1%, anemia of inflammation alone in 38.1%, combined iron deficiency and anemia of inflammation alone in 7.1%, vitamin B(12) deficiency in 7.1%, and others in 9.5%. Median iron intake was 5.7 mg/day (recommended dietary allowance 18-26 mg/day). Compared to nonanemic children, anemic children were more likely to be underweight (weight Z-score -2.5 vs. -1.9), stunted (height Z-score -2.6 vs. -1.9), with lower CD4 counts (18% vs. 24%, p<0.01), and higher log viral load (11.1 vs. 7.1, p<0.01). Hemoglobin (Hb) improved significantly among those who started ART (baseline Hb 11.6 g/dl, 6-month Hb 12.2 g/dl, p=0.03). Children taking ART combined with iron supplements experienced a larger increase in Hb compared to those receiving neither ART nor iron supplements (mean Hb change 1.5 g/dl, p<0.01). CONCLUSION: Anemia, particularly iron deficiency anemia and anemia of inflammation, is highly prevalent among children with HIV infection. Micronutrient supplements combined with ART improved anemia in HIV-infected children."									
29	Nutritional update: relevance to maternal and child health in East Africa.	Duggan MB.	African Health Sciences. 2003;3(3):136-43.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medc&AN=14676720	"In this review of recent advances in nutrition, we shall follow the 'life cycle' with special attention to maternal and foetal nutrition, linear growth, and nutritional assessment. We also consider nutrition, infection and micronutrients, and recent concepts of the pathophysiology and management of protein energy malnutrition PEM. [References: 49]"									
1478	Analysis on 617 cases of HIV and HCV infection among patients in methadone maintenance treatment clinics.	"Xing X, Wang Z, Peng X."	Occupation and Health. 2011;27(12):1381-3.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20113265362	"In this study, a questionnaire survey for drug use behaviour, liver function, nutritional status and complications was conducted among 617 drug addicts reporting in methadone maintenance treatment clinics in Jingzhou City, Hubei Province, China. Also, blood samples were collected from all patients for HIV and HCV antibody testing. Of the 617 drug addicts evaluated, infection rates with HIV and HCV were 2.1% and 70.5%, respectively, with the HCV infection directly correlated with the duration of drug use. A significant difference in age of first drug use and duration of drug abuse was noted between male and female drug addicts (P<0.01 and P<0.05). However, no significant difference in average frequency of drug use and average amount of drug use was observed between male and female drug addicts (P>0.05). Incidence of complications among female drug addicts (21.43%) was significantly higher than that among male drug addicts (12.83%; P<0.01). There was no significant difference in HCV infection rate among the drug addicts with different nutritional state (P>0.05). However, significant differences in the incidence of abnormal liver function and complications were seen among drug addicts of different nutritional status (P<0.01). Multiple logistic regression analysis showed that the main influencing factors for HCV infection were age of first drug use, amount of drug use, liver function, complications and age, while age of first drug use was negatively correlated with HCV infection. Thus, intervention measures to address high risk behaviours among drug addicts should be carried out."									
128	Determinants and causes of mortality in HIV-infected patients receiving antiretroviral therapy in Burkina Faso: A five-year retrospective cohort study.	"Kouanda S, Meda IB, Nikiema L, Tiendrebeogo S, Doulougou B, Kabore I, Sanou MJ, et al."	AIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV. 2012 01 Apr;24(4):478-90.		"In this study, we investigated the causes of death and the factors associated with mortality in a cohort of patients receiving highly active antiretroviral therapy (HAART) in Burkina Faso, an African country with limited resources. This retrospective cohort study included patients aged 15 years and older who started HAART for the first time between January 2003 and December 2008 in 14 health districts. We used survival analyses, including the Kaplan-Meier method, to examine potential predictors of death and two Cox proportional hazard models to estimate hazard ratios for death, first from baseline covariates and then from time-dependent covariates. A total of 6641 patients initiated HAART during this period; of these, 5608 were included in the analysis. By the end of the study period, 4310 of those patients were still receiving HAART, 690 had died, 207 had been transferred and 401 were lost to follow-up. The median duration of follow-up was 23.2 months [interquartile range (IQR): 12.4-36.9], and the overall incidence of mortality was 6 per 100 person-years. The clinical stage, CD4 count, body mass index (BMI), haemoglobin level, HAART regimen, gender, age, profession and year of initiation were the primary risk factors associated with death. In the multivariate analysis, BMI, clinical stage, treatment regimen and CD4 count remained significantly associated with death. The most frequent causes of death were wasting syndrome, tuberculosis and anaemia. This result highlights the already advanced stage of immunodeficiency among patients in Burkina Faso when they start HAART. Testing patients for HIV and starting antiretroviral therapy earlier are necessary to further reduce the mortality of patients living with HIV. This study provides a solid evidence base with which future evaluations of HAART in Burkina Faso can be compared. 2012 Copyright Taylor and Francis Group, LLC."									
1954	Effects of a food supplement rich in arginine in patients with smear positive pulmonary tuberculosis - A randomised trial.	"Schon T, Idh J, Westman A, Elias D, Abate E, Diro E, Moges F, et al."	Tuberculosis. 2011 September;91(5):370-7.		"In tuberculosis (TB), the production of nitric oxide (NO) is confirmed but its importance in host defense is debated. Our aim was to investigate whether a food supplement rich in arginine could enhance clinical improvement in TB patients by increased NO production. Smear positive TB patients from Gondar, Ethiopia (n = 180) were randomized to a food supplementation rich in arginine (peanuts, equivalent to 1 g of arginine/day) or with a low arginine content (wheat crackers, locally called daboqolo) during four weeks. The primary outcome was cure rate according to the WHO classification and secondary outcomes were sputum smear conversion, weight gain, sedimentation rate, reduction of cough and chest X-ray improvement as well as levels of NO in urine (uNO) or exhaled air (eNO) at two months. There was no effect of the intervention on the primary outcome (OR 1.44, 95% CI: 0.69-3.0, p = 0.39) or secondary outcomes. In the subgroup analysis according to HIV status, peanut supplemented HIV+/TB patients showed increased cure rate (83.8% (31/37) vs 53.1% (17/32), p < 0.01). A low baseline eNO (<10 ppb) in HIV+/TB patients was associated with a decreased cure rate. We conclude that nutritional supplementation with a food supplement rich in arginine did not have any overall clinical effect. In the subgroup of HIV positive TB patients, it significantly increased the cure rate and as an additional finding in this subgroup, low initial levels of NO in exhaled air were associated with a poor clinical outcome but this needs to be confirmed in further studies. 2011 Elsevier Ltd. All rights reserved."									
1953	Effects of a food supplement rich in arginine in patients with smear positive pulmonary tuberculosis--a randomised trial.	"Schon T, Idh J, Westman A, Elias D, Abate E, Diro E, Moges F, et al."	Tuberculosis. 2011;91(5):370-7.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=21813328	"In tuberculosis (TB), the production of nitric oxide (NO) is confirmed but its importance in host defense is debated. Our aim was to investigate whether a food supplement rich in arginine could enhance clinical improvement in TB patients by increased NO production. Smear positive TB patients from Gondar, Ethiopia (n = 180) were randomized to a food supplementation rich in arginine (peanuts, equivalent to 1 g of arginine/day) or with a low arginine content (wheat crackers, locally called daboqolo) during four weeks. The primary outcome was cure rate according to the WHO classification and secondary outcomes were sputum smear conversion, weight gain, sedimentation rate, reduction of cough and chest X-ray improvement as well as levels of NO in urine (uNO) or exhaled air (eNO) at two months. There was no effect of the intervention on the primary outcome (OR 1.44, 95% CI: 0.69-3.0, p = 0.39) or secondary outcomes. In the subgroup analysis according to HIV status, peanut supplemented HIV+/TB patients showed increased cure rate (83.8% (31/37) vs 53.1% (17/32), p < 0.01). A low baseline eNO (<10 ppb) in HIV+/TB patients was associated with a decreased cure rate. We conclude that nutritional supplementation with a food supplement rich in arginine did not have any overall clinical effect. In the subgroup of HIV positive TB patients, it significantly increased the cure rate and as an additional finding in this subgroup, low initial levels of NO in exhaled air were associated with a poor clinical outcome but this needs to be confirmed in further studies. Copyright 2011 Elsevier Ltd. All rights reserved."									
11	"An assessment of the nutritional status of orphaned adolescents living in Nyanza Province, Kenya."	Rodriguez S. 			"Increasing numbers of children and adolescents are becoming vulnerable or orphaned due to the HIV/AIDS epidemic in Nyanza Province, Kenya. Research indicates food security remains a top concern for those caring for these children or adolescents. This study was a examined thinness, stunting, and perceptions about food availability in adolescents ages 10-17 years in Nyanza Province. No evidence was found suggesting orphaned adolescents experience greater amounts of stunting or thinness over non-orphaned adolescents in the province. Orphans did not perceive less available food in their households. Instead, predictors of thinness, stunting, or low perceptions of food availability included age, household facilities, perceptions of equal or unequal treatment in the household, and perceptions about the household's ability to provide them with basic needs. Findings suggest interventions aimed at decreasing malnutrition focus less on orphaned versus non-orphaned adolescents, but they should focus on adolescents made vulnerable due to lower socioeconomic status. Copies of dissertations may be obtained by addressing your request to ProQuest, 789 E. Eisenhower Parkway, P.O. Box 1346, Ann Arbor, MI 48106-1346. Telephone 1-800-521-3042; email: disspub@umi.com"									
1124	Research issues in perinatal HIV.	"Balakrishna H, Nanavati RN, Mondkar JA, Kabra N."	Journal of Neonatology. 2009 October-December;23(4):337-43.		"India has a huge burden of maternally transmitted HIV. There are unique socio-cultural, economic, nutritional and system issues which require different approaches and solutions. This article summarizes the major research issues and gaps in knowledge in the Indian set-up."									
108	Sexual relationship power and malnutrition among HIV-positive women in rural Uganda.	"Siedner MJ, Tsai AC, Dworkin S, Mukiibi NF, Emenyonu NI, Hunt PW, Haberer JE, et al."	AIDS & Behavior. 2012;16(6):1542-8.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=22382629	"Inequality within partner relationships is associated with HIV acquisition and gender violence, but little is known about more pervasive effects on women's health. We performed a cross-sectional analysis of associations between sexual relationship power and nutritional status among women in Uganda. Participants completed questionnaires and anthropometric measurements. We assessed sexual relationship power using the Sexual Relationship Power Scale (SRPS). We performed logistic regression to test for associations between sexual relationship power and poor nutritional status including body mass index, body fat percentage, and mid-upper arm circumference. Women with higher sexual relationship power scores had decreased odds of low body mass index (OR 0.29, p = 0.01), low body fat percentage (OR 0.54, p = 0.04), and low mid-upper arm circumference (OR 0.22, p = 0.01). These relationships persisted in multivariable models adjusted for potential confounders. Targeted interventions to improve intimate partner relationship equality should be explored to improve health status among women living with HIV in rural Africa."									
853	Nutritional rehabilitation of HIV-exposed infants in Malawi: Results from the drug resources enhancement against AIDS and malnutrition program.	"Buonomo E, de Luca S, Tembo D, Scarcella P, Germano P, Altan AMD, Palombi L, et al."	International Journal of Environmental Research and Public Health. 2012 February;9(2):421-34.		"Infant malnutrition in sub-Saharan Africa is a public health priority and a challenge in high HIV prevalence areas. The Drug Resources Enhancement Against AIDS and Malnutrition program, with multiple medical centers in Sub-Saharan Africa, developed an innovative intervention for the surveillance and control of malnutrition. In a pilot initiative, 36 HIV-exposed children were evaluated at baseline upon presentation for malnutrition and at six months post- treatment. Parameters included HIV-free survival, nutritional status and change in diet. Food diary data was entered and processed using the Nutrisurvey (WHO) software. At 6 months post-intervention, a significant improvement in anthropometric parameters was noted. Slowing of linear growth was observed in patients with malaria with a mean gain in centimetres of 4.4 +/- 1.7 as compared to 5.6 +/- 1.7 in children with no malaria, p < 0.048 (CL 95%: -2.32, -0.01). Dietary diversity scores increased from 5.3 +/- 1.9 to 6.5 +/- 1.3, p < 0.01 at 6 months. A significant increase (+25%, p < 0.02) in the number of children eating fish meals was noted. Our pilot data describes positive outcomes from a rehabilitative nutritional approach based on use of local foods, peer education, anthropometric and clinical monitoring in areas of high food insecurity. The relationship between malaria and linear growth retardation requires further investigation. 2012 by the authors; licensee MDPI, Basel, Switzerland."									
851	Nutritional rehabilitation of HIV-exposed infants in Malawi: results from the drug resources enhancement against AIDS and malnutrition program.	"Buonomo E, de Luca S, Tembo D, Scarcella P, Germano P, Doro Altan AM, Palombi L, et al."	International Journal of Environmental Research & Public Health [Electronic Resource]. 2012;9(2):421-34.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=22470301	"Infant malnutrition in sub-Saharan Africa is a public health priority and a challenge in high HIV prevalence areas. The Drug Resources Enhancement Against AIDS and Malnutrition program, with multiple medical centers in Sub-Saharan Africa, developed an innovative intervention for the surveillance and control of malnutrition. In a pilot initiative, 36 HIV-exposed children were evaluated at baseline upon presentation for malnutrition and at six months post- treatment. Parameters included HIV-free survival, nutritional status and change in diet. Food diary data was entered and processed using the Nutrisurvey (WHO) software. At 6 months post-intervention, a significant improvement in anthropometric parameters was noted. Slowing of linear growth was observed in patients with malaria with a mean gain in centimetres of 4.4 +/- 1.7 as compared to 5.6 +/- 1.7 in children with no malaria, p < 0.048 (CL 95%: -2.32, -0.01). Dietary diversity scores increased from 5.3 +/- 1.9 to 6.5 +/- 1.3, p < 0.01 at 6 months. A significant increase (+25%, p < 0.02) in the number of children eating fish meals was noted. Our pilot data describes positive outcomes from a rehabilitative nutritional approach based on use of local foods, peer education, anthropometric and clinical monitoring in areas of high food insecurity. The relationship between malaria and linear growth retardation requires further investigation."									
1152	Stunting and wasting are associated with poorer psychomotor and mental development in HIV-exposed tanzanian infants.	"McDonald CM, Manji KP, Kupka R, Bellinger DC, Spiegelman D, Kisenge R, Msamanga G, et al."	Journal of Nutrition. 2013 February;143(2):204-14.		"Infants born to HIV-infected women are at increased risk of impaired neurodevelopment, but little research has attempted to identifymodifiable risk factors. The objective of this prospective cohort analysiswas to identify maternal, socioeconomic, and child correlates of psychomotor and mental development in the first 18 mo of life among Tanzanian infants born to HIVinfected women. We hypothesized that child HIV infection, morbidity, and undernutrition would be associated with lower developmental status when taking into consideration maternal health and socioeconomic factors. Baseline maternal characteristics were recorded during pregnancy, birth characteristics were collected immediately after delivery, infant micronutrient status was measured at 6 wk and 6 mo, and anthropometric measurements and morbidity histories were performed at monthly follow-up visits. The Psychomotor Development Index (PDI) andMental Development Index (MDI) of the Bayley Scales of Infant Development, 2nd edition (BSID-II) were used to assess developmental functioning at 6, 12, and 18 mo of age. Multivariate repeated regression models with time-varying covariates were used to estimate adjusted mean MDI and PDI scores for each level of the variables. A total of 311 infants contributed>=1 BSID-II assessments for 657 PDI and 655 MDI measurements. Of infants, 51% were male, 23% were born preterm, 7% were low birth weight, and 10% were HIV-positive at 6 wk. Preterm birth, child HIV infection, stunting, and wasting were independently associated with lower PDI and MDI scores. Strategies to lower mother-to-child transmission of HIV, prevent preterm birth, and enhance child growth could contribute to improved child psychomotor and mental development. 2013 American Society for Nutrition."									
1905	Assessment of nutritional status of HIV-infected patients at a tertiary centre in North India.	"Malhotra S, Wanchu A, Khurana S."	Tropical Doctor. 2007;37(3):167-9.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=17716508	"Infection with HIV has an adverse effect on nutritional status, and can result in progressive involuntary weight loss. We assessed the nutritional status of our patients with HIV infection and found that HIV-infected patients had significantly low nutrient intake and body mass index as compared with controls. Involuntary weight loss, altered body composition and reduced nutritional status were present throughout the stages of HIV infection."									
1907	Assessment of nutritional status of HIV-infected patients at a tertiary centre in North India.	"Sunita M, Ajay W, Sudha K."	Tropical Doctor. 2007;37(3):167-9.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20073218414	"Infection with HIV has an adverse effect on nutritional status, and can result in progressive involuntary weight loss. We assessed the nutritional status of our patients with HIV infection and found that HIV-infected patients had significantly low nutrient intake and body mass index as compared with controls. Involuntary weight loss, altered body composition and reduced nutritional status were present throughout the stages of HIV infection."									
760	Probiotics and prebiotics to combat enteric infections and HIV in the developing world: a consensus report.	"Monachese M, Cunningham-Rundles S, Diaz M, Guerrant R, Hummelen R, Kemperman R, Kerac M, et al."	Gut Microbes. 2011;2(3):198-207.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20113352954	"Infectious disease in the developing world continues to represent one of the greatest challenges facing humanity. Every year over a million children suffer and die from the sequela of enteric infections, while in 2008 it is estimated almost 2.7 million (UNAIDS 2009 update) adults and children became infected with human immunodeficiency virus (HIV). While oral rehydration therapy for diarrhea, and antiretrovirals (ARV) for HIV are critical, there is a place for adjunctive therapies to improve quality of life. The importance of the human microbiota in retaining health is now recognized, as is the concept of replenishing beneficial microbes through probiotic treatments. Studies have shown that probiotics can reduce the duration of diarrhea, improve gut barrier function, help prevent bacterial vaginosis (BV), and enhance immunity even in HIV-infected subjects. However, many issues remain before the extent of probiotic benefits can be verified, and their application to the developing world realised. This consensus report outlines the potential probiotic, and to a lesser extent prebiotic, applications in resource disadvantages settings, and recommends steps that could bring tangible relief to millions of people. The challenges to both efficacy and effectiveness studies in these settings include a lack of infrastructure and funding for scientists, students and research projects in developing countries; making available clinically proven probiotic and prebiotic products at affordable prices; and undertaking appropriately designed clinical trials. We present a roadmap on how efficacy studies may be conducted in a resource disadvantages setting among persons with chronic diarrhea and HIV. These examples and the translation of efficacy into effectiveness are described."									
761	Probiotics and prebiotics to combat enteric infections and HIV in the developing world: a consensus report.	"Monachese M, Cunningham-Rundles S, Diaz MA, Guerrant R, Hummelen R, Kemperman R, Kerac M, et al."	Gut Microbes. 2011;2(3):198-207.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=21804356	"Infectious disease in the developing world continues to represent one of the greatest challenges facing humanity. Every year over a million children suffer and die from the sequela of enteric infections, while in 2008 it is estimated almost 2.7 million (UNAIDS 2009 update) adults and children became infected with human immunodeficiency virus (HIV). While oral rehydration therapy for diarrhea, and antiretrovirals (ARV) for HIV are critical, there is a place for adjunctive therapies to improve quality of life. The importance of the human microbiota in retaining health is now recognized, as is the concept of replenishing beneficial microbes through probiotic treatments. Studies have shown that probiotics can reduce the duration of diarrhea, improve gut barrier function, help prevent bacterial vaginosis (BV), and enhance immunity even in HIV-infected subjects. However, many issues remain before the extent of probiotic benefits can be verified, and their application to the developing world realised. This consensus report outlines the potential probiotic, and to a lesser extent prebiotic, applications in resource disadvantages settings, and recommends steps that could bring tangible relief to millions of people. The challenges to both efficacy and effectiveness studies in these settings include a lack of infrastructure and funding for scientists, students and research projects in developing countries; making available clinically proven probiotic and prebiotic products at affordable prices; and undertaking appropriately designed clinical trials. We present a roadmap on how efficacy studies may be conducted in a resource disadvantages setting among persons with chronic diarrhea and HIV. These examples and the translation of efficacy into effectiveness are described."									
1115	"Analysis of causes of death in Nakhon Sawan Province, with emphasis on infectious diseases."	"Santibhavank P, Sawasdivorn V."	Journal of Infectious Diseases and Antimicrobial Agents. 2001;18(1):1-7.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh3&AN=20013042032	"Infectious disease was the second common cause of death in Nakhon Sawan Province, Thailand during the period 1 July 1997-30 June 1998. It was the important leading cause of mortality, representing 14.2 percent of total causes of death or 51.6 per 100 000 population. Most of the infectious diseases were not preventable by vaccines. HIV/AIDS was the most common infectious diseases, counting for 361 out of 596 (60.6%). The most common HIV affected age group was 25-44 years and males were significantly affected more than female (p<0.05), followed by age group of 15-24 and 45-59 years (11 females in each group; 24 and 26 males respectively). When compared by age group, the deceased persons in age group <1 year were affected by infectious disease (50% of total mortality in this age group in both genders) more than others, and were due to dengue infection and pneumonia. Deceased persons who were 25-44 years old (36.5% in females and 38.1% in males) were affected mostly by HIV/AIDS. Wasting syndrome was the most common HIV-related disease in both genders (38.0 and 39.8% in females and males respectively). Health education especially in mothers, good health care and sanitation, early seeking for health care, and early diagnosis with prompt and proper treatment should decrease mortality due to infectious diseases in children. In adults, intensive interventions to prevent HIV and related diseases are the most important strategies, including consistent condom use, reducing alcoholic drinking, avoiding drug abuse, safe sexual behaviour, chemotherapy to prevent opportunistic infections and preventing HIV transmission from mother to child."									
688	Nutrition and infectious diseases in developing countries and problems of acquired immunodeficiency syndrome.	"Ambrus JL, Sr., Ambrus JL, Jr."	Experimental Biology and Medicine. 2004;229(6):464-72.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh3&AN=20043109569	"Infectious diseases are the major causes of death and morbidity in Developing Countries, particularly in children. Increasing evidence suggests that malnutrition (protein energy malnutrition (PEM) and essential micronutrient (vitamins, trace minerals, essential amino acids, polyunsaturated fatty acids) deficiency) is the underlying reason for increased susceptibility to infections. On the other hand, certain infectious diseases also cause malnutrition, which results in a vicious cycle. Before its viral origin was known, acquired immunodeficiency syndrome (AIDS) was termed as thin disease because cachexia was AIDS' main clinical manifestation. The relationship between infection and malnutrition is well documented in the literature. Our experience supports this. Preventive and therapeutic measures are suggested."									
463	Using plasma acute-phase protein concentrations to interpret nutritional biomarkers in apparently healthy HIV-1-seropositive Kenyan adults.	"Thurnham DI, Mburu ASW, Mwaniki DI, Muniu EM, Alumasa F, De Wagt A."	British Journal of Nutrition. 2008;100(1):174-82.		"Inflammation influences the assessment of nutritional status. For example, inflammation reduces plasma retinol concentrations and vitamin A deficiency is overestimated. Conversely inflammation increases plasma ferritin concentrations and Fe deficiency is underestimated. Blood samples were obtained from 163 free-living HIV-1-infected adults, not on continuous medication, anti-retroviral drugs or micronutrients, not unwell and who had not reached WHO stage IV of HIV/AIDS. We used four markers of inflammation, C-reactive protein (CRP), alpha1-acid glycoprotein (AGP), alpha1-antichymotrypsin and erythrocyte sedimentation rate but mainly CRP and AGP were used to separate the subjects into four groups: 'healthy' where both CRP and AGP were normal; 'incubation phase' where CRP was elevated; 'early convalescence' where AGP and CRP were elevated and 'late convalescence' where only AGP was elevated. Correction factors were calculated to remove the influence of inflammation from each biomarker and group where inflammation was present and the data are shown before and after recalculation. The correction increased median plasma retinol concentrations of the whole group from 1.16 to 1.33 mumol/l, comparable with values (mean 1.29 mumol/l) in HIV-negative Kenyan women. Median ferritin concentrations fell by about 50 % in both sexes and the number of women with plasma ferritin concentrations <=12 mug/l increased from eleven to twenty. The correction also increased plasma carotenoids and Hb but not alpha-tocopherol concentrations. We suggest that the method described to remove the influence of inflammation from nutritional biomarkers should be generally applicable in apparently healthy people and prevents discarding valuable data because of mild inflammation. The method does now need to be tested in other populations. The Authors 2008."									
464	Using plasma acute-phase protein concentrations to interpret nutritional biomarkers in apparently healthy HIV-1-seropositive Kenyan adults.	"Thurnham DI, Mburu ASW, Mwaniki DL, Muniu EM, Alumasa F, Wagt Ad."	British Journal of Nutrition. 2008;100(1):174-82.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20083282979	"Inflammation influences the assessment of nutritional status. For example, inflammation reduces plasma retinol concentrations and vitamin A deficiency is overestimated. Conversely inflammation increases plasma ferritin concentrations and Fe deficiency is underestimated. Blood samples were obtained from 163 free-living HIV-1-infected adults, not on continuous medication, anti-retroviral drugs or micronutrients, not unwell and who had not reached WHO stage IV of HIV/AIDS. We used four markers of inflammation, C-reactive protein (CRP), alpha 1-acid glycoprotein (AGP), alpha 1-antichymotrypsin and erythrocyte sedimentation rate but mainly CRP and AGP were used to separate the subjects into four groups: 'healthy' where both CRP and AGP were normal; 'incubation phase' where CRP was elevated; 'early convalescence' where AGP and CRP were elevated and 'late convalescence' where only AGP was elevated. Correction factors were calculated to remove the influence of inflammation from each biomarker and group where inflammation was present and the data are shown before and after recalculation. The correction increased median plasma retinol concentrations of the whole group from 1.16 to 1.33 micro mol/l, comparable with values (mean 1.29 micro mol/l) in HIV-negative Kenyan women. Median ferritin concentrations fell by about 50% in both sexes and the number of women with plasma ferritin concentrations <=12 micro g/l increased from eleven to twenty. The correction also increased plasma carotenoids and Hb but not alpha -tocopherol concentrations. We suggest that the method described to remove the influence of inflammation from nutritional biomarkers should be generally applicable in apparently healthy people and prevents discarding valuable data because of mild inflammation. The method does now need to be tested in other populations."									
351	Effects of Information and Communication Technology on Youth's Health Knowledge.	"Ghorbani NR, Heidari RN."	Asia-Pacific Journal of Public Health. 2011 May 2011;23(3):363-8.	http://search.proquest.com/docview/876668326?accountid=26724	"Information technology (IT) has produced a deep impact on human lives, and the most important aspect of its effect is on education and learning. This study was done for the purpose of evaluating the effectiveness of electronic health information on our Web site http://www.teen.hbi.ir in the promotion of health education and in increasing the capabilities of the students in the use of the Internet. This study was performed on the basis of the information obtained from the questionnaires on selected health issues from 649 students from 3 high schools. Information was collected in 2 steps (pretest and posttest). The t test and Leven's test were used in the statistical analysis of data. Results of the t test showed that educating students through health information Web sites has increased their knowledge by at least 14.5% on environmental health and 48.9% on nutrition and was statistically meaningful in all fields (P = .000) with the exception of mental health. The fact is that the use of IT has become a part of our society and is perhaps the most promising medium for achieving health promotion initiatives."									
133	"The acceptance and feasibility of replacement feeding at 6 months as an HIV prevention method in Lilongwe, Malawi: results from the BAN study."	"Parker ME, Bentley ME, Chasela C, Adair L, Piwoz EG, Jamieson DJ, Ellington S, et al."	AIDS Education and Prevention. 2011;23(3):281-95.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20113232820	"International guidelines recommend EBF to age 6 months among HIV-infected mothers choosing to breast-feed and cessation thereafter if replacement feeding is acceptable, feasible, affordable, sustainable, and safe. When mothers wean, they are challenged to provide an adequate replacement diet. This study investigates the use and acceptability of a lipid-based nutrient supplement (LNS) as a breast-milk substitute when provided to infants (6-12 mo) of HIV-positive mothers, as part of the Breast-feeding, Antiretroviral, and Nutrition (BAN) Study. A sub-sample of mothers (n=45) participated in interviews that explored EBF, weaning, and strategies to feed LNS. Mothers reported several weaning strategies, including gradual reduction of breast-feeding, expressing breast-milk into a cup, and separation of mother and child. LNS, a peanut-based micronutrient fortified paste, was highly accepted and incorporated into the traditional diet. Weaning is a feasible HIV prevention method among this population in Malawi when supported by the provision of LNS as a breast-milk substitute."									
1339	Mainstreaming nutrition into maternal and child health programmes: scaling up of exclusive breastfeeding.	"Bhandari N, Kabir AK, Salam MA."	Maternal & Child Nutrition. 2008;4 Suppl 1:5-23.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=18289156	"Interventions to promote exclusive breastfeeding have been estimated to have the potential to prevent 13% of all under-5 deaths in developing countries and are the single most important preventive intervention against child mortality. According to World Health Organization and United Nations Children Funds (UNICEF), only 39% infants are exclusively breastfed for less than 4 months. This review examines programme efforts to scale up exclusive breastfeeding in different countries and draws lesson for successful scale-up. Opportunities and challenges in scaling up of exclusive breastfeeding into Maternal and Child Health programmes are identified. The key processes required for exclusive breastfeeding scale-up are: (1) an evidence-based policy and science-driven technical guidelines; and (2) an implementation strategy and plan for achieving high exclusive breastfeeding rates in all strata of society, on a sustainable basis. Factors related to success include political will, strong advocacy, enabling policies, well-defined short- and long-term programme strategy, sustained financial support, clear definition of roles of multiple stakeholders and emphasis on delivery at the community level. Effective use of antenatal, birth and post-natal contacts at homes and through community mobilization efforts is emphasized. Formative research to ensure appropriate intervention design and delivery is critical particularly in areas with high HIV prevalence. Strong communication strategy and support, quality trainers and training contributed significantly to programme success. Monitoring and evaluation with feedback systems that allow for periodic programme corrections and continued innovation are central to very high coverage. Legal framework must make it possible for mothers to exclusively breastfeed for at least 4 months. Sustained programme efforts are critical to achieve high coverage and this requires strong national- and state-level leadership. [References: 68]"									
1217	The association between metabolic syndrome and the occurrence of nephrolithiasis in HIVinfected patients.	"Dumitru IM, Rugina S, Sotila G, Dumitru E, Rugina CN."	Journal of the International AIDS Society. 2010 08 Nov;13.		"Introduction Although HAART therapy has radically changed the prognosis of HIV infected patients, decreasing their morbidity and mortality, the ARV medication produced other clinical manifestations due to their toxicity. For many years there was no data in the literature attesting link between metabolic syndrome and renal disease development. Recent epidemiological studies have found that patients with metabolic syndrome have a high risk of developing chronic kidney disease: chronic renal failure and nephrolithiasis. Purpose: of the study Evaluation of the relationship between metabolic syndrome and the occurrence of nephrolithiasis in HIV infected patients. Methods: The study involved 112 patients with known HIV-AIDS infection and metabolic syndrome in the evidence of the Regional HIV Centre Constanta, Romania which were compared with 100 matched control group. The parameters analyzed were: demographic characteristics, weight, height, body mass index, blood pressure, medical history, examination of urine, urea, creatinine, Na, K, Cl, Mg, P, total serum calcium, glucose, serum triglycerides, LDH cholesterol, HDL cholesterol, CD4+ lymphocytes, HIV-RNA. Nephrolithiasis was diagnosed by ultrasound examination. No patient had a history of treatment with Indinavir. Results Of the 112 patients studied, 67 patients developed nephrolithiasis (59.82%) in comparison with only 24% in the control group (p < 0.01). The age of these patients was between 20 and 67 years, with a mean age of 43.5, sex ratio F:M = 1.09. The predominant form was bilateral (69%) and asymptomatic (58%). The analysis of kidney stones revealed that the major component was uric acid (48%). Ultrasound revealed hydronephrosis in 18 patients (26.8%). Urinary tract infection was diagnosed in 23 patients (34.3%); the most common etiology was E. coli (39%). PCR HIV-RNA was undetectable in 90 patients (80.3%), and 46 patients had a CD4+ cell count > 500 cells/mm<sup>3</sup> and only 10 patients CD4+ < 200 cells/ Mm<sup>3</sup>. The majority of patients (55.3%) received 2INRT and PI/r as ARV treatment. Conclusions: In HIV infected patients with metabolic syndrome under ARV treatment, nephrolithiasis is 2.5 times more frequent compared to general population. The presence of kidney stones is a risk factor for developing hydronephrosis and urinary tract infection. Because patients with HIV infection and chronic renal failure have a decreased survival, the screening for nephrolithiasis is mandatory in these patients."									
1414	New biomarkers for early detection on renal injury in HIV infected patients.	"Sotila GG, Sorin R, Magdalena DI, Roxana C, Claudia R."	Nephrology Dialysis Transplantation. 2012 May;27:ii119.		"Introduction and Aims: HIV-infected patients have a known increasd risk of kidney disease. In the last years, Cistatin C has been referenced in several studies as a more sensitive marker of kidney function that could replace creatinine. This study aimed to evaluate serum Cystatin C was a better marker than serum creatinine in a HIV -infected cohort. Methods: This was a prospectiv, cross sectional study of 150 HIV infected patients that attend The Infectious Hospital Constanta, Centre of excellence of HIV, Romania, during one year (2009- 2010). Patients with known kidney disease, HIV 2 infection, thyroid disfunction or corticosteroids therapy were excluded. Clinical and demographic data was colected, and serum creatinine, glomerular filtration rate (GFR) by MDRD ecuation and Cystatine C levels were determined. Results: Cystatin C is an independent factor of age, gender, ethnicity and body mass index. Of the 12 patients with elevated levels of cystatin C but with an estimated creatinine clearance within normal range, 7 patients were on antiretroviral therapy with tenofovir and/or atazanavir, 5 patients had detectable plasma HIV-RNA and elevated microalbuminuria, 5 patients had hepatitis c virus co-infection, 2 patients had tuberculosis, 1 patient had hepatitis b virus co- infection, 6 patients were smokers, , which are known causes of inflammation. Mean CD4 cell count was 470 cell/mm3, 60% were male, all of patients were caucasian, the median age of the patients was 49 years old. 65 HIV infected patients (43,3%) had a creatinine level greater than 1,2 mg/ dl.Using the CKD stages guidelines and eGFR reduction, we found that 3% had moderate GFR reduction, 0,4% had severe GFR reduction and 0,9% had kidney failure. Conclusions: In what concerns to nephrotoxicity, it was found that patients on tenofovir had higher levels of Cystatin C. Cystatin C may be considered as an alternative and more accurate serum marker than creatinine in discriminating renal injury in HIV patients with reduced GFR from those with normal GFR. Renal dysfunction was common despite the widespred use of antiretroviral therapy."									
1937	"Prevalence and risk factors of major depressive disorders in HIV/AIDS as seen in semi-urban Entebbe District, Uganda."	Kinyanda E.	Tropical Medicine and International Health. 2012 June;17:9.		"Introduction Better access to highly effective antiretroviral therapy for people living with HIV even in low income countries including in sub-Saharan Africa has delayed HIV disease progression and prolonged survival. This brings into sharp focus issues of quality of life including mental wellbeing. A major cause of psychiatric morbidity in HIV/AIDS is major depressive disorder. Not much is known about the risk factors of major depressive disorder in HIV/AIDS in the African socio-cultural context. The aim of this study was to examine the prevalence and risk factors of major depressive disorder in HIV/AIDS in semi-urban Uganda. Methods A cross-sectional study was undertaken among 618 respondents attending two HIV clinics in Uganda. Results Prevalence of major depressive disorder in this study was 8.1% (95% CI, 5.9-10.2%). Factors associated with major depressive disorder at univariate analysis only were female gender, family history of mental illness, negative coping style, alcohol dependency disorder, food insecurity and stress. Factors independently associated with major depressive disorder were psychosocial impairment, adverse life events, post traumatic stress disorder, generalised anxiety disorder and life-time attempted suicide. Not associated with major depressive disorder were social support, neurocognitive impairment, CD4 counts and body mass index. Conclusion Psychological and social factors were the main risk factors of major depressive disorder among ambulatory HIVpositive persons with no evidence for the role of the neurotoxic effects of HIV. Treatment approaches for major depressive disorder among these patients should be modelled on those used among non-HIV patient groups."									
1099	"Biomarkers in sepsis at time zero: Intensive care unit scores, plasma measurements and polymorphisms in Argentina."	"Wingeyer SP, Cunto E, Nogueras C, Juan JS, Norberto G, de Larranaga G."	Journal of Infection in Developing Countries. 2012 July;6(7):555-62.		"Introduction: A patient's response to sepsis is influenced by their genetic background. Our objective was to use plasma markers, such as protein C (PC), D-dimer, Plasminogen Activator Inhibitor-1 (PAI-1) levels, and the PAI-1 rs1799889 4G/5G and Tumor Necrosis Factor-alpha rs1800629 G/A polymorphisms to improve classical intensive care unit (ICU) scores. Methodology: We studied 380 subjects, 166 with sepsis. We performed coagulation tests: plasma PAI-1 and PC levels were evaluated by chromogenic methods; and D-dimer was evaluated by immunoturbidimetric assay. Polymorphisms were performed using for polymerase chain reactions followed by digest with specific restriction enzyme. We acquired the APACHE and SOFA scores (time zero), sex, age, body mass index, associated co-morbidities, length of ICU stay (days), the severity of sepsis (sepsis, severe sepsis or septic shock), the HIV status and the ICU outcome (survival or death). Results: We found significant differences between patients who died (n=80) and those who survived (n=86) in terms of the ICU length of stay (6 vs. 10 days), septic shock (64 versus 24%), age (51 versus 38 years old), HIV+ condition (34 versus 16%), SOFA (7 versus 4), APACHE (19 versus 13), D-dimer (4.32 versus 2.88 ng/ml), PC (46.0 versus 63.5%) and PAI-1 (33.0 versus 16.5 UA/l). When we used a regression analysis with dichotomized variables, only the SOFA<sup>4</sup>, PAI-1<sup>16</sup>, HIV status and the PAI-1 4G allele proved to be predictors of death at time zero. Conclusions: In the future, ICU scores may be further improved by adding certain genomic or plasma data. 2012 Peres et al."									
1614	Validation of 2006 WHO prediction scores for true HIV infection in children less than 18 months with a positive serological HIV test.	"Peltier CA, Omes C, Ndimubanzi PC, Ndayisaba GF, Stulac S, Arendt V, Courteille O, et al."	PLoS ONE [Electronic Resource]. 2009;4(4):e5312.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=19390690	"INTRODUCTION: All infants born to HIV-positive mothers have maternal HIV antibodies, sometimes persistent for 18 months. When Polymerase Chain Reaction (PCR) is not available, August 2006 World Health Organization (WHO) recommendations suggest that clinical criteria may be used for starting antiretroviral treatment (ART) in HIV seropositive children <18 months. Predictors are at least two out of sepsis, severe pneumonia and thrush, or any stage 4 defining clinical finding according to the WHO staging system."	"METHODS AND RESULTS: From January 2005 to October 2006, we conducted a prospective study on 236 hospitalized children <18 months old with a positive HIV serological test at the national reference hospital in Kigali. The following data were collected: PCR, clinical signs and CD4 cell count. Current proposed clinical criteria were present in 148 of 236 children (62.7%) and in 95 of 124 infected children, resulting in 76.6% sensitivity and 52.7% specificity. For 87 children (59.0%), clinical diagnosis was made based on severe unexplained malnutrition (stage 4 clinical WHO classification), of whom only 44 (50.5%) were PCR positive. Low CD4 count had a sensitivity of 55.6% and a specificity of 78.5%."	"CONCLUSION: As PCR is not yet widely available, clinical diagnosis is often necessary, but these criteria have poor specificity and therefore have limited use for HIV diagnosis. Unexplained malnutrition is not clearly enough defined in WHO recommendations. Extra pulmonary tuberculosis (TB), almost impossible to prove in young children, may often be the cause of malnutrition, especially in HIV-affected families more often exposed to TB. Food supplementation and TB treatment should be initiated before starting ART in children who are staged based only on severe malnutrition."							
1600	Validation of 2006 WHO prediction scores for true HIV infection in children less than 18 months with a positive serological HIV test.	"Peltier CA, Omes C, Ndimubanzi PC, Ndayisaba GF, Stulac S, Arendt V, Courteille O, et al."	PLoS ONE. 2009;32.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20103247779	"Introduction: All infants born to HIV-positive mothers have maternal HIV antibodies, sometimes persistent for 18 months. When Polymerase Chain Reaction (PCR) is not available, August 2006 World Health Organization (WHO) recommendations suggest that clinical criteria may be used for starting antiretroviral treatment (ART) in HIV seropositive children <18 months. Predictors are at least two out of sepsis, severe pneumonia and thrush, or any stage 4 defining clinical finding according to the WHO staging system. Methods and Results: From January 2005 to October 2006, we conducted a prospective study on 236 hospitalized children <18 months old with a positive HIV serological test at the national reference hospital in Kigali. The following data were collected: PCR, clinical signs and CD4 cell count. Current proposed clinical criteria were present in 148 of 236 children (62.7%) and in 95 of 124 infected children, resulting in 76.6% sensitivity and 52.7% specificity. For 87 children (59.0%), clinical diagnosis was made based on severe unexplained malnutrition (stage 4 clinical WHO classification), of whom only 44 (50.5%) were PCR positive. Low CD4 count had a sensitivity of 55.6% and a specificity of 78.5%. Conclusion: As PCR is not yet widely available, clinical diagnosis is often necessary, but these criteria have poor specificity and therefore have limited use for HIV diagnosis. Unexplained malnutrition is not clearly enough defined in WHO recommendations. Extra pulmonary tuberculosis (TB), almost impossible to prove in young children, may often be the cause of malnutrition, especially in HIV-affected families more often exposed to TB. Food supplementation and TB treatment should be initiated before starting ART in children who are staged based only on severe malnutrition."									
1946	Insights into the impact of malaria in pregnant women and their infants Maternal anaemia at first antenatal visit: Prevalence and aetiology in a West African malaria endemic area.	"Ouedraogo S, Koura GK, M AC, Massougbodji A, Cot M."	Tropical Medicine and International Health. 2011 October;16:86.		"Introduction: Anaemia in pregnancy remains a public health concern in developing countries . This multifactorial syndrome involves micronutrient deficiencies, infections and hemoglobinopathies although their respective contributions are unclear. In this study, we investigated the relationship between micronutrients, mainly iron, and maternal anaemia in Beninese pregnant women, before the administration of haematinics or antimalarials. Material and Methods Study design: A cross-sectional survey was carried out at enrolment from January 2010 to May 2011 as part of a cohort study of pregnant women and their babies to assess the aetiologies of anaemia in pregnancy and its consequences in infants up to the age of 1 year. This cohort survey is an ancillary study to a multi-centre randomized trial of IPTp (MiPPAD) procedures: For each participant, socio-socioeconomic and demographic data, parity, gestational age, anthropometric measurements and medical history were recorded. Malaria, iron, folate and vitamin B12 deficiencies, inflammation, syphilis, hemoglobin rate and genotype, HIV status and intestinal helminths were also checked. Statistical analysis: multiple logistic regression was used to study the relationships between anaemia and risk factors. A P value 0.05 was considered statistically significant. Results: Of 1005 pregnant women were analysed. Anaemia (Hb < 110 g/l) was found in 68.3% and severe anaemia (Hb < 70 g/l) in 0.7%. Malaria parasitaemia, low body mass index, gestational age over 16 weeks, rainy season, iron, folate and vitamin B12 deficiencies and helminth infestation increased the risk of anaemia with respective adjusted odds ratios of 2.4 (1.5- 3.8), 1.6 (1.2-2.1), 1.7 (1.1-2.7), 1.6 ( 1.2-2.2), 1.5 ( 1.1-2.1), 1.4 (1.01-1.7), 2.3 (1.01-6.3) and 1.6 (1.02-2.7). Conclusion: Malaria, helminths and micronutrient deficiencies are the commonest aetiologies of anaemia in this area, suggesting the necessity of improving malaria and helminth control, and to reinforce iron and folate supplementations."									
1828	"Prevalence and morphological types of anaemia and hookworm infestation in the medical emergency ward, Mulago Hospital, Uganda."	"Mukaya JE, Ddungu H, Ssali F, O'Shea T, Crowther MA."	South African Medical Journal Suid-Afrikaanse Tydskrif Vir Geneeskunde. 2009;99(12):881-6.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=20459999	"INTRODUCTION: Anaemia is common worldwide, although the burden is highest in developing countries where nutrient deficiencies and chronic infections are prevalent."	"OBJECTIVE: To determine the prevalence and morphological types of anaemia and assess the hookworm burden among patients in the medical emergency ward at Mulago national referral hospital, Uganda."	METHODS: In a cross-sectional descriptive study 395 patients were recruited by systematic random sampling and their socio-demographic characteristics and clinical details collected. A complete blood count and peripheral film examination were done and stool examined for hookworm ova.	STATISTICAL ANALYSIS: Data were processed using Epi-Info version 6 and Stata version 9. The chi-square test was used for categorical variables and Student's t-test for non-categorical variables. Multiple logistic regression was used to determine factors predictive of anaemia.	"RESULTS: Of the patients 255 (64.6%) had anaemia. The prevalence was higher among males (65.8%) than females (63.7%). Fatigue (odds ratio (OR) 2.1, confidence interval (CI) 1.37 - 3.24), dizziness (OR 1.64, CI 1.07 - 2.44), previous blood transfusion (OR 2.83, CI 1.32 - 6.06), lymphadenopathy (OR 2.99, CI 1.34 - 6.66) and splenomegaly (OR 5.22, CI 1.78 - 15.28) were significantly associated with anaemia. Splenomegaly, low body mass index (BMI) (<19) and being HIV positive were independently associated with anaemia. The commonest type of anaemia was hypochromic microcytic (34.1%). Only 10.6% of anaemic patients had hookworm infestation."	"CONCLUSIONS: In our study the prevalence of anaemia (64.6%) was very high. Splenomegaly, HIV infection and low BMI were independently associated with anaemia. The commonest type of anaemia was microcytic hypochromic (34.1%). There was a low prevalence of hookworm infestation."				
492	"Echocardiographic patterns in treatment-naive HIV-positive patients in Lagos, south-west Nigeria."	"Olusegun-Joseph DA, Ajuluchukwu JNA, Okany CC, Mbakwem AC, Oke DA, Okubadejo NU."	Cardiovascular Journal of Africa. 2012 September;23(8):e1-e6.		"Introduction: Cardiovascular abnormalities are common in HIV-infected patients, although often clinically quiescent. This study sought to identify by echocardiography early abnormalities in treatment-naive patients. Methods: One hundred patients and 50 controls with no known traditional risk factors for cardiovascular disease were recruited for the study. The cases and controls were matched for age, gender and body mass index. Both groups had clinical and echocardiographic evaluation for cardiac abnormalities, and CD<sub>4</sub> count was measured in all patients. Results: The cases comprised 57 females (57.0%) and 43 males (43.0%), while the controls were 28 females (56.0%) and 22 males (44.0%) (chi<sup>2</sup> = 0.01; p = 0.913). The mean age of the cases was 33.2 +/- 7.7, while that of the controls was 31.7 +/- 9.7 (t = 1.02; p = 0.31). Echocardiographic abnormalities were significantly more common in the cases than the controls (78 vs 16%; p = 0.000), including systolic dysfunction (30 vs 8%; p = 0.024) and diastolic dysfunction (32 vs 8%; p = 0.002). Other abnormalities noted in the cases were pericardial effusion in 47% (chi<sup>2</sup> = 32.10; p = 0.000) and dilated cardiomyopathy in 5% (five); none of the controls had either complication. One patient each had aortic root dilatation, mitral valve prolapse and isolated right heart dilatation and dysfunction. Conclusion: Cardiac abnormalities are more common in HIV-infected people than in normal controls. A careful initial and periodic cardiac evaluation to detect early involvement of the heart in the HIV disease is recommended."									
758	Expression of small intestinal antimicrobial genes in Zambian adults: A randomised controlled trial of micronutrient supplementation.	"Kelly P, Dhaliwal W, Shawa T, Sanderson I."	Gut. 2009 April;58:A118-A9.		"Introduction: Diarrhoeal disease remains a major contributor to morbidity and mortality in Africa, and evidence suggests that micronutrient supplementation confers protection. In order to test the hypothesis that one mechanism of an effect could be on innate immunity in the gut, we carried out a randomised controlled trial of multiple micronutrient supplementation in adults living in a population in which there is evidence of borderline micronutrient deficiency. Aims and Methods: All consenting adults living in a carefully defined residential area in Lusaka, Zambia, were included. There were no exclusion criteria. Participants were cluster-randomly assigned to a supplement containing 15 micronutrients at around the recommended nutrient intake in the form of a daily tablet, or placebo. Treatment allocation was crossed over at the mid-point. Small intestinal biopsies were taken at approximately annual intervals and messenger RNA of the intestinal Paneth cell defensins HD5 and HD6, epithelial human beta defensins 1 and 2 (hBD1, hBD2) and the cathelicidin LL-37 were quantified by real-time reverse transcriptase PCR. In addition, mRNA was compared during diarrhoea episodes and after convalescence. Results: mRNA was quantified in 511 biopsies from 287 participants. There was no difference in mRNA transcripts for any of the five genes between micronutrient supplementation and placebo groups. However, in malnourished adults (body mass index ,18.5 kg/m<sup>2</sup>), HD5 mRNA was increased from 3.0 log transcripts/ mg total RNA in placebo recipients to 3.8 log transcripts (p=0.007) and hBD1 was increased in HIV-negative participants only (p=0.01). During diarrhoea, HD5 expression was reduced by 0.8 log transcripts/mg total RNA in placebo recipients (p=0.02), but this effect was not seen in supplement recipients, nor was it seen after the cross-over. In further exploratory analysis, sexspecific correlations between HD5 and nutritional status were found that included serum leptin. Conclusion: Although the trial showed no benefit overall, micronutrient supplementation was associated with the upregulation solely of HD5 in malnourished adults. We also found sex-dependent interactions between antimicrobial gene expression and nutritional status, which could be of wider interest in understanding innate immunity in the gut, especially as leptin has recently been identified as a Paneth cell product upregulated by the Crohn's disease mutation in the gene ATG16L1."									
1807	Food insecure and HIV affected Indian families: A double burden for the HIV infected child.	"Van Der Hoeven M, Van Elsland SL, Joshi S, Doak CM."	South African Journal of Clinical Nutrition. 2010;2):S13.		"Introduction: Growth failure is a common feature of children infected with human inmmunodeficiency virus (HIV). Food security plays a crucial role in maintaining quality of life and improving survival through nutrition for children infected with HIV. Aim: This study explored associations between child nutritional status and household food security in HIV affected families living in Aurangabad, Maharasthra. Methods: Households with children belonging to a network of people living with HIV/AIDS were confidentially invited by the network to participate. Anthropometric measurements were used to collect data on 55 HIV-infected and 80 non-infected children. A total of 135 households (85.6%) participated in this study. Caretakers consenting to participation were interviewed to assess household food security. Logistic analysis was used to test associations, controlling for socio-economic confounders. Results: HIV-infected children had, compared to non-infected children, a significantly higher prevalence of stunting (respectively 64.2% and 36.7%. p=0.002) and significantly higher prevalence of underweight (respectively 67.9% and 41.8% p=0.003). The child's HIV-status was associated with stunting (OR=0.29; CI:0.13-0.65) and with household food insecurity (OR=3.96; CI:1.76-8.89). Conclusions: Further research is needed to investigate causal relationships. These findings show a high level of food insecurity in HIV/AIDS affected households with children. The association between household level determinants, such as food insecurity, and child nutrition indicate the need for intervention at the household level to improve food security and thereby diminish the risk of undernutrition among children."									
510	Quantification of high blood pressure in a general population cohort in a rural setting.	"Nsubuga RN, Murphy G, Asiki G, Waswa L, Seeley J, Young E, Sandhu M, et al."	Circulation. 2012 15 May;125 (19):e729.		"Introduction: High blood pressure (HBP) defined as >= 140/90 mmHg, if uncontrolled could lead to several health problems such as coronary heart disease, heart and kidney failure. In Uganda, the prevalence of HBP is not readily available, particularly for the rural setting. The Medical Research Council Research/Uganda Virus Research Institute, Uganda Research Unit on AIDS has a General Population Cohort (GPC) in rural south west Uganda which provides an ideal setting for quantifying HBP in a rural setting. Objectives: We aim to establish the state of blood pressure in a rural population in south west Uganda. Methods: The GPC has been followed for 22 years through annual medical surveys conducted by trained field staff. This year's survey is ongoing; data on 5931 people aged 13 years or more have been collected. Lifestyle and anthropometric data are being collected; BP is being measured and history of treatment for HBP recorded. BP was measured three times with resting intervals of 3-5 minutes, using the Omron M6. BP was taken as the mean of the second and third reading. We report the distribution of BP and estimate the prevalence of HBP by age and gender. We also assess the association between BP and tobacco and alcohol intake and body mass index (BMI). Results: We report preliminary results on 5931 participants (43% men, 57% women) who had BP measurement. Systolic and diastolic BP respectively ranged between 74.5-232 and 45-150.5 mmHg, with respective means (SD) of 122.6 (17.15) and 74.1 (10.38) mmHg. The prevalence of reported current treatment for HBP was 4%, majority being women. There was a 16% prevalence of HBP for both sexes. HBP prevalence varied by age: 6% among the 13-24 year olds, 10.5% for 25-40 and 34.5% among those over 40 years. There was a significant difference in BP by gender among the 25-40 year olds with men having a higher HBP prevalence (13.4%) compared to women (8.8%) (P=0.004). Tobacco and alcohol intake and BMI were significantly associated with BP (all P<0.01). Conclusion: Results indicated a high prevalence of HBP in this population, especially among those aged above 40 years (34%) but also with a substantial prevalence among the 25-40 year olds (10%). These results highlight that this is a potentially hidden public health problem. It is therefore important to design appropriate health education targeting rural populations, addressing both the treatment seeking behaviours as well as risk factors."									
268	Nutrient intakes and nutritional status of people living with HIV in Ghana.	"Nti C, Hayford J, Opare-Obisaw C."	Annals of Nutrition and Metabolism. 2011 October;58:413.		"Introduction: HIV causes changes in nutritional status, including loss of appetite, weight loss, and malnutrition. HIV can therefore compromise the nutritional status of infected individuals and consequently worsen the effects of the disease. To maintain good nutrition, an adequate intake of energy-giving foods, proteins, vitamins and minerals, fibre and water are vital Objectives: The study investigated dietary practices, nutrient intakes and nutritional status of people living with HIV (PLHIV). Method/Design: The study design was a cross-sectional survey. One hundred and ten adults infected with HIV, who were receiving treatment at the Koforidua Central Hospital, were purposively selected for the study. Structured interviews, diet assessment methods and anthropometry were used to collect information on respondents' dietary practices, energy and nutrient intakes and nutritional status. The data collected were analyzed using the SPSS program version 11. The Chi-squared test and regression analysis were used to determine the relationships between dietary practices, nutrient intakes and nutritional status of respondents. Results: A high proportion (86%) of respondents ate three times a day. The qualities of diet of 92% were rated poor to fair and lacked variety. The diets of the respondents were low in calories, iron and folate, thiamine, riboflavin and niacin and nearly one third (31%) were underweight. A significant relationship existed between the frequency of access to nutrition information and the number of times respondents ate per day. But there was no relationship between the number of times eaten daily and nutritional status of respondents. A significant relationship (r= 0.24; p=0.011) existed between the quality of diet and nutritional status, suggesting that the quality of diets of respondents somehow determined their nutritional status. Conclusions: Respondents' dietary practices were generally poor, reflecting negatively on their nutrient intakes and nutritional status. The findings are significant for the operations of both governmental and non-governmental organizations working on HIV and nutrition issues in Ghana."									
270	Effect of nutritional status on the immune system in patients living with HIV.	"Zapata L, Cossio M, Mancera G."	Annals of Nutrition and Metabolism. 2011 October;58:94.		"Introduction: HIV infection destroys CD4+ lymphocytes, whose blood count is a predicting factor of survival in patients living with HIV. Deficient dietary supply of nutrients is a known cause for impaired immune response. Adequate nutritional status improves overall health and has a well stablished effect on the immune system as well. Objectives: Method/Design: 89 HIV files of patients attending the nutrition service of the CAPASITS (HIV and Sexually Transmitted Diseases Ambulatory Care and Prevention Clinics) in Chihuahua, Mexico were revised, to obtain data on nutritional status and immune system. Results: 78.65% (70) were male and 21.35% (19) were women. The average age is 40.87 years is a +9.91 DS, with an average initial weight of 66.37 +14.57 kg, while the average height was 1.66 meters with a DS plus or minus 0,091. According to BMI, we found that 52.81% had a normal weight, in a range for BMI of 24.88 +4.18. The average CD4 levels were 381.84 +272.46 DS, We found 19 (21.35 %) subjects whose CD4+ count was under 200/ml3, 45 subjects (55.56%) from 200-499/ml3 and 25 subjects 28.09% had CD4+ counts over 500/ml3. Lymphocytes ranged from 0.1 to 5.5, with an average of 2.11 +1.11 DS. The multiple linear regression model, with r2 = 0.3571, resulted in statistically significant for lymphocytes, albumin, glucose and sex. Conclusions: The relationship is positive in the first variables and involves a possibility of increased risk in women. Thus we can observe the importance of nutrition intervention as a part of treatment for people living with HIV to promote an improvement in their immune system."									
1097	Nutritional status of HIV-positive individuals on free HAART treatment in a developing nation.	"Obi SN, Ifebunandu NA, Onyebuchi AK."	Journal of Infection in Developing Countries. 2010;4(11):745-9.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20103373419	"Introduction: HIV positive individuals are prone to malnutrition due to inadequate dietary intake. Additionally, in low-income countries, including Nigeria, stigmatization and discrimination result in a lack of support for HIV-positive individuals ultimately contributing to even further reduced food availability and inadequate dietary intake. This study aimed to determine the nutrirional status of HIV-positive individuals on free, highly active antiretroviral therapy (HAART) in Abakaliki, southeast Nigeria. Methodology: Subjective global assessment (SGA) technique was used to survey the nutritional status of 120 HIV-positive individuals and a control group over a one-year period. Results: All the HIV-positive individuals and their control group were physically active, with a third of them belonging to the lower socioeconomic status. There were significantly more malnourished individuals among the HIV-positive group than in the control group (P<0.05). Conclusion: Malnutrition is common among HIV-positive patients in southeast Nigeria."									
1707	Nutritional assessment and lipid profile in HIV-infected children and adolescents treated with highly active antiretroviral therapy.	"Tremeschin MH, Sartorelli DS, Cervi MC, Negrini BVdM, Salomao RG, Monteiro JP."	Revista da Sociedade Brasileira de Medicina Tropical. 2011;44(3):274-81.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20113284198	"Introduction: HIV-infected children and adolescents treated with highly active antiretroviral therapy (HAART) regimens that include a protease inhibitor (PI) can show significant improvements in clinical outcomes, nutritional status and quality of life. The study aimed to report nutritional and metabolic alterations for pediatric patients continuously exposed to HAART and for healthy controls for up to 1 year. Methods: Clinical, anthropometric, lipid profile and food intake data were collected prospectively over approximately 12-months for each patient. Results: Fifty-one individuals were studied, of these, 16 were healthy. After 12 months follow-up, HIV-positive individuals remained below the healthy control group parameters. No change was observed concerning food intake. Triglyceride serum levels were higher in patients using protease inhibitor at the onset of the study [PI groups: 114 (43-336), and 136 (63-271) versus control group: 54.5 (20-162); p=0.003], but after twelve months follow-up, only the group using protease inhibitor for up to two months presented higher values [140 (73-273) versus 67.5 (33-117); p=0.004]. HDL-cholesterol was lower in HIV-positive individuals [HIV-positive groups: 36 (27-58) and 36 (23-43); control 49.5 (34-69); p=0.004]. Conclusions: HIV-infected children and adolescents treated with highly active antiretroviral therapy showed compromised nutritional parameters compared to a paired healthy control group. Individuals using protease inhibitor presented worse triglyceride serum levels compared to their healthy counterparts."									
267	High prevalences of hypertriglyceridemia and stunting in HIV infected children from El Salvador.	"Custodio E, Escobar G, Rivas E, Sagrado M, Sonego M, Perez E, Ayala S, et al."	Annals of Nutrition and Metabolism. 2011 October;58:41-2.		Introduction: Hypercholesterolemia and hypertryglideridemia in healthy childhood and adolescence may result in an increased risk of cardiovascular disease in adulthood. The HIV infected children and adolescents are at particular risk because the virus itself and the antiretroviral treatment (ARV) can cause such metabolic disorders. However. epidemiological studies on this particular population are very scarce. Objectives: To describe the nutritional status and prevalence of dyslipidemias in the children infected by VIH-1 in El Salvador. and to identify the associated risk factors. Method/Design: Fasting triglycerides. cholesterol and glucose tests as well as anthropometric assessments were performed to the 339 children (0-18 years old) infected by HIV-1 attended at the children HIV reference center in El Salvador (CENID). Dislypidemias and nutritional status were defined according to international references. Logistic regression models were used for the identification of associated risk factors. Results: Cholesterol results were obtained in 301 patients. triglycerides in 262 and glucose in 295. Mean age was 9.3 years (3.7 SD) and sex distribution even. 26.3% of the children were identified as being stunted. 2.9% as being wasted. 8% as being overweight and 2.4% as being obese. Hypertrygliceridemia was diagnosed in 50.4% of the children. hypercholesterolemia in 11.2% and hyperglycemia in 2.1%. Associated factors with hypertriglyceridemia were increasing Body Mass Index for Age Z Score (BMAZ) [odds ratios (95% CI): 1.36 (1.03. 1.80)] and being treated with protease inhibitors [odds ratios (95% CI): 7.77 (4.00. 15.07]. This last factor was the only one found to be associated with hypercholesterolemia [odds ratios (95% CI): 2.72. 11.92]. No significant association was found with age. gender. duration of treatment. or being overweight or obese. Conclusions: More than 50% of the HIV infected children analyzed present hypertriglyceridemia. Treatment with protease inhibitors seems to be the most important risk factor although nutrition may also be playing an important role. Further research on the subject is encouraged in order to understand the etiology of the problem and to propose effective treatment and prevention strategies for its management.									
283	Experience of anti-retroviral treatment for HIV-infected children in Malawi: the 1st 12 months.	"Ellis J, Molyneux EM."	Annals of Tropical Paediatrics. 2007;27(4):261-7.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=18053342	"INTRODUCTION: Malawi is a resource-poor country in central southern Africa with an estimated 91,000 HIV-infected children. A national public sector antiretroviral treatment (ART) scale-up programme was commenced in 2004."	AIM: The experience and results of the 1st 12 months of free ART for HIV-infected children from a public sector hospital in Malawi is reported.	"METHODS: Demographic and clinical data were collected at the commencement of ART and during treatment of all children who attended the clinic at Queen Elizabeth Central Hospital, Blantyre from 1 August 2004 to 31 July 2005."	"RESULTS: ART was prescribed for 238 children during the 1st 12-month period. Of these, 196 were ART-naive and 42 had previously begun ART elsewhere. There were 128 (53.8%) males. Median age of the 196 ART-naive children was 87 months (range 7-212); 173 (88.3%) had WHO clinical stage III disease and 23 (11.7%) had WHO clinical stage I or II disease. Weight-for-age and weight-for-height Z-scores improved significantly with treatment. By 31 July 2005, 194 (81.5%) of the 238 children who attended the clinic were alive and on treatment, 20 (8.4%) had died, 19 (8.0%) were lost to follow-up and 5 (2.1%) had been transferred to other health facilities."	"CONCLUSIONS: In a resource-poor setting with only clinical monitoring available, children can feasibly and effectively be treated with ART. Lack of appropriate laboratory facilities, extra staff and paediatric drug formulations, although not ideal, should not prevent commencement of ART for children in such a setting."					
1458	"Diarrhea is a major killer of children with severe acute malnutrition admitted to inpatient set-up in Lusaka, Zambia."	"Irena AH, Mwambazi M, Mulenga V."	Nutrition Journal. 2011;10:110.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=21989455	INTRODUCTION: Mortality of children with Severe Acute Malnutrition (SAM) in inpatient set-ups in sub-Saharan Africa still remains unacceptably high. We investigated the prevalence and effect of diarrhea and HIV infection on inpatient treatment outcome of children with complicated SAM receiving treatment in inpatient units.	"METHOD: A cohort of 430 children aged 6-59 months old with complicated SAM admitted to Zambia University Teaching Hospital's stabilization centre from August to December 2009 were followed. Data on nutritional status, socio-demographic factors, and admission medical conditions were collected up on enrollment. T-test and chi-square tests were used to compare difference in mean or percentage values. Logistic regression was used to assess risk of mortality by admission characteristics."	"RESULTS: Majority, 55.3% (238/430) were boys. The median age of the cohort was 17 months (inter-quartile range, IQR 12-22). Among the children, 68.9% (295/428) had edema at admission. The majority of the children, 67.3% (261/388), presented with diarrhea; 38.9% (162/420) tested HIV positive; and 40.5% (174/430) of the children died. The median Length of stay of the cohort was 9 days (IQR, 5-14 days); 30.6% (53/173) of the death occurred within 48 hours of admission. Children with diarrhea on admission had two and half times higher odds of mortality than those without diarrhea; Adjusted OR = 2.5 (95% CI 1.50-4.09, P < 0.001). The odds of mortality for children with HIV infection was higher than children without HIV infection; Adjusted OR = 1.6 (95% CI 0.99-2.48 P = 0.5)."	"CONCLUSION: Diarrhea is a major cause of complication in children with severe acute malnutrition. Under the current standard management approach, diarrhea in children with SAM was found to increase their odds of death substantially irrespective of other factors."						
643	The morbidity and mortality associated with kidney disease in an HIV-infected cohort in Puerto Rico.	"Mayor AM, Dworkin M, Quesada L, Rios-Olivares E, Hunter-Mellado RF."	Ethnicity & Disease. 2010;20(1 Suppl 1):S1-163-7.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=20521408	"INTRODUCTION: Nephropathy in HIV-infected patients has been associated with progression to AIDS and death. The virus, several comorbid conditions and certain medications may contribute to the development and progression of kidney disease."	"METHODS: This study analyzed data collected from HIV-infected persons enrolled in a HIV registry in Puerto Rico during January 1998 through September 2006. Demographic factors, clinical manifestations, laboratory findings at enrollment, and antiretroviral therapy (ART) prescriptions were compared between patients with and without kidney disease. Death status and cause of death by December 2006 were also evaluated and compared."	"RESULTS: The study included 1,283 subjects, 69.0% male, 39.7% injecting drug users, 19.5% hepatitis C infected, 6.5% with diabetes mellitus (DM-2), 11.6% had hypertension (HTN) and 9.0% had kidney disease. Patients with kidney disease had significantly higher (P < .05) HIV viral load mean (273,499 vs. 202,858 copies/mL), CD4 T-cell count < 200 (57.0% vs. 44.4%), underweight (22.9% vs. 10.9%), DM-2 (13.9% vs. 5.8%), HTN (27.8% vs 10.0%) and mortality (15.9 vs 5.7 deaths per 100 years of follow-up) than those without it. Cox proportional hazard analysis showed that patients with kidney disease had a higher mortality risk (2.1) after controlling for age, sex, HIV risk factor, ART prescription in the last year and HIV disease duration."	"CONCLUSIONS: This study demonstrated a substantial disparity in mortality for Puerto Rican HIV-infected patients with nephropathy. Kidney disease preventive strategies that include aggressive control of HIV-infection and chronic medical conditions, such as hypertension and diabetes, are recommend as an approach to reduce this health disparity."						
1721	[HIV and noma in Burkina Faso].	"Millogo M, Konsem T, Ouedraogo D, Ouoba K, Zwetyenga N."	Revue de Stomatologie et de Chirurgie Maxillo-Faciale. 2012;113(6):433-6.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=22981207	"INTRODUCTION: Noma is a ""gangrenous"" disease beginning in gums and spreading to other parts of the face. It usually occurs in undernourished children with bad orodental hygiene. Its incidence in adults is increasing. HIV infection is very common in African countries. We had for objective to compare noma characteristics in patients with, or without, HIV."	"MATERIAL AND METHODS: This retrospective and descriptive study included patients managed for noma in our unit from January 1988 to December 2007. The clinical, epidemiological, and outcome data of patients treated for noma were compared according to HIV infection status."	"RESULTS: Two hundred and twelve patients were included and 14 (6.6%) among them were HIV positive. In the HIV positive group, there were a male predominance and patients were older (mean age 15.3 vs. 4.7 years in the other group). HIV positive patients were less frequently operated (35.7% vs. 76.3%) and their death rate was higher (37.5% vs. 5.6%)."	DISCUSSION: HIV infection during the course of noma impacts the clinical and epidemiological features of this condition. It worsens the prognosis. Noma could be considered as an opportunistic infection in the WHO disease staging system. Copyright 2012 Elsevier Masson SAS. All rights reserved.						
1333	"Nutritional status of children living with HIV and receiving antiretroviral (ARV) medication in the Klang Valley, Malaysia."	"Mohd. Nasir MT, Yeo J, Huang MSL, Kamarul Azahar MR, Koh MT, Khor GL."	Malaysian Journal of Nutrition. 2011;17(1):19-30.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20113189807	"Introduction: Nutrition and HIV are closely related. Any immune impairment as a result of HIV leads to malnutrition, which in turn, can also lead to reduced immunity, thus contributing to a more rapid progression to AIDS. Methods:This cross-sectional study determined the nutritional status of children living with HIV and are receiving antiretroviral medication in the Klang Valley. A total of 95 children aged one to eighteen years old were recruited between September 2008 and February 2009. Data collected included socio-economic status, anthropometric measurements, dietary intake, medical history and serum levels of selected micronutrients specific for immunity. Results: The mean age of the children was 8.4+or-3.9 years and the mean duration on antiretroviral medications was 68.3+or-38.3 months. Anthropometric assessment found that 9.5% of the children were underweight and 31.6% were overweight. In contrast, 20.8% were stunted and 14.6% severely stunted. Biochemical indicators showed that 10.4% had deficiency in vitamin A while 12.5% had deficiency in selenium. Total cholesterol and HDL-C levels were found to be low in 30.5% and 10.5% of the children respectively. Conclusion: Dietary assessment showed almost all the children did not achieve the recommended energy intake for their age groups and almost half of the children did not achieve the RNI for selenium and vitamin A. This study provides an insight on the nutritional status of children living with HIV."									
1700	"Nutritional and clinical status, and dietary patterns of people living with HIV/AIDS in ambulatory care in Sao Paulo, Brazil."	"Silva EF, Lewi DS, Vedovato GM, Garcia VR, Tenore SB, Bassichetto KC."	Revista Brasileira de Epidemiologia. 2010;13(4):677-88.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=21180856	"INTRODUCTION: Nutrition currently plays a key role in the treatment of people living with HIV/AIDS (PLHA), especially in the case of metabolic alterations due to highly active antiretroviral therapy (HAART), which could be related to cardiovascular diseases (CD)."	"OBJECTIVE: to describe the nutritional and clinical status, and the quality of diet of PLHA."	"METHODS: It is a cross-sectional study involving a network of ambulatory care facilities for PLHA in the city of Sao Paulo, Brazil. Patients, in use of HAART or not, were selected from December 2004 to may 2006, through routine clinic visits. We collected: socio-demographic, clinical, biochemical, anthropometric measures and dietary data. Diet quality was evaluated according to a ""protecting"" or ""non-protecting"" pattern of consumption scores for CD."	"RESULTS: The sample had 238 patients on HAART and 76 without treatment. Mean serum levels of total cholesterol, triglycerides and glucose were higher in the HAART group (p < 0.001). The majority of patients of both the treated and untreated group were eutrophic with a mean body mass index (BMI) of 24.4 (+/- 4.3) kg/m2 and 24.3 (+/- 3.5), respectively. The waist-hip ratio was higher among men on HAART (0.90 +/- 0.06 versus 0.87 +/- 0.05) (p < 0.001). The HAART group showed a mean food pattern score indicating a higher consumption of ""non-protecting"" foods for CD (p = 0.001)."	CONCLUSION: The results showed undesired nutritional and metabolic conditions among patients on HAART associated with CD. It is necessary to manage health intervention programs for PLHA in order to control cardiovascular risk factors before final outcomes.					
1701	"Nutritional and clinical status, and dietary patterns of people living with HIV/AIDS in ambulatory care in Sao Paulo, Brazil."	"Silva EFR, Lewi DS, Vedovato GM, Garcia VRS, Tenore SB, Bassichetto KC."	Revista Brasileira de Epidemiologia. 2010;13(4):677-88.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20113010411	"INTRODUCTION: Nutrition currently plays a key role in the treatment of people living with HIV/AIDS (PLHA), especially in the case of metabolic alterations due to highly active antiretroviral therapy (HAART), which could be related to cardiovascular diseases (CD). OBJECTIVE: to describe the nutritional and clinical status, and the quality of diet of PLHA. METHODS: It is a cross-sectional study involving a network of ambulatory care facilities for PLHA in the city of Sao Paulo, Brazil. Patients, in use of HAART or not, were selected from December 2004 to may 2006, through routine clinic visits. We collected: socio-demographic, clinical, biochemical, anthropometric measures and dietary data. Diet quality was evaluated according to a ""protecting"" or ""non-protecting"" pattern of consumption scores for CD. RESULTS: The sample had 238 patients on HAART and 76 without treatment. Mean serum levels of total cholesterol, triglycerides and glucose were higher in the HAART group (p<0.001). The majority of patients of both the treated and untreated group were eutrophic with a mean body mass index (BMI) of 24.4 (+or-4.3) and 24.3 (+or-3.5) kg/m<sup>2</sup>, respectively. The waist-hip ratio was higher among men on HAART (0.90+or-0.06 versus 0.87+or-0.05) (p<0.001). The HAART group showed a mean food pattern score indicating a higher consumption of ""non-protecting"" foods for CD (p=0.001). CONCLUSION: The results showed undesired nutritional and metabolic conditions among patients on HAART associated with CD. It is necessary to manage health intervention programs for PLHA in order to control cardiovascular risk factors before final outcomes."									
1780	Nutritional supplement use among university athletes in Singapore.	"Tian HH, Ong WS, Tan CL."	Singapore Medical Journal. 2009;50(2):165-72.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20093088321	"Introduction: Nutritional supplements used by athletes can be classified as sports food, dietary supplements and ergogenic aids. The aim of this study was to examine the use of such supplements among university athletes in Singapore. Methods: 82 athletes from 16 sport disciplines completed a questionnaire which sought information on demographical parameters, type of supplements, frequency of use, motivations, knowledge, expenditure and side effects. Results: The prevalence of supplement use was 76.8 percent and 20 different products were used. Each individual consumed a mean and standard deviation of 3.18+or-1.7 products over a 12-month period. The mean number of products consumed daily was 2.1+or-1.2. Popular products included sports drinks, vitamin C, multivitamins and traditional/herbal preparations such as essence of chicken, bird's nest and ginseng. Before using a product, 65.9 percent sought information, usually from the media, the Internet, coaches and fellow athletes. However, many did not know where to obtain reliable information and 86.4 percent were also unaware that supplementation can have adverse effects. Conclusion: Although there is a high prevalence of supplement use in our study population, many do not have accurate information about these products. Hence, there is an urgent need to provide athletes with education and access to scientific and unbiased information."									
1717	"Oxygen reactive species and anti-oxidant response in HIV positive patients and volunteer blood donors, Pereira, Colombia, 2007-2009."	"Lagos Grisales G, Cediel Collazos V, Villegas Rojas S."	Revista Medica de Risaralda. 2012;18(1):54-64.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20133199937	"Introduction: Oxidative stress is caused by imbalance between the production of Reactive Oxygen Species (ROS) and cellular antioxidant capacity (CAC). Mitochondrial ROS production is constant. Between 2% and 5% of oxygen to the respiratory chain is reduced to generate superoxide anion, . O<sup>2-</sup>, from this there are other molecules and free radicals potentially harmful to the cell. Acquired Immunodeficiency Syndrome (AIDS) is characterized by persistent oxidative stress. The objective of this study was to measure the redox status in HIV+AIDS program of the ESE Salud Pereira and redox status of people volunteer blood donors medicine program of the Technological University of Pereira years 2007 to 2009 to verify the condition of oxidative stress by spectrophotometric quantification of markers associated with oxidant-antioxidant cell system. Materials and methods: Cross-sectional study with a group of HIV-AIDS and other blood donors, the redox state was measured and correlated with other parameters: age, gender, clinical status, socioeconomic status, diet, nutritional status, immunological stressor consumption, personal history and epidemiologists. Results: Total antioxidant response (TAR), peroxide plasma (PP), oxidative stress index (IEO), carbonyl index (CI), malondialdehyde (MDA) were significantly different in the groups studied. Discussion: In HIV+ there were no significant differences in oxidative stress tests among those who consume and consume no antiretrovirals. Population studies are required to obtain reference values of oxidative stress tests tested here."									
501	Worsening pulmonary infiltrates during anti-TB Therapy in a Non-HIV patient in absence of secondary causes-a paradoxical response?	"Kommuri A, Madan N, Mangione S, Kavuru M."	Chest. 2012 October;1).		"INTRODUCTION: Patients can develop clinical or radiological worsening of pre-existing tuberculous lesion or develop new lesions during anti- tuberculosis therapy (ATT). Such a paradoxical response is well reported in HIV patients. We report a case of paradoxical response in a non-HIV patient during therapy for pulmonary tuberculosis CASE PRESENTATION: A 68 year old Vietnamese female presented with a 2 month history of low grade fever, night sweats, pleuritic chest pain, dry cough and progressive dyspnea. Past history included asthma, a positive tuberculin skin test since 2001. She denied exposure to active TB patients or contacts; no recent travel abroad. She emigrated to US (1996) and last visited Vietnam in 2007. On examination she is afebrile, with decreased air entry in right anterior chest. Her blood counts, metabolic panel and office spirometry were normal. HIV was negative. A computed Tomogram (CT) of chest showed a right upper lobe cavity with surrounding consolidation. A bronchoalveolar lavage (BAL) fluid showed neutrophilia (N 64%), smear negative for acid fast bacilli (AFB), fungi and malignant cells. She was treated for pulmonary tuberculosis due to high clinical probability pending cultures, which subsequently grew pan susceptible mycobacterium tuberculosis (MTB). she remained symptomatic (chest pain , dry cough) despite therapy. Repeat imaging at 1 and 2 month intervals showed new subpleural pulmonary nodules with resolution of the cavitary lesion. Multiple CT guided biopsies of these nodules showed pneumonitis and did not grow MTB A right lower lobe wedge resection inclusive of nodules confirmed granulomatous inflammation, fibrosis and organizing pneumonia with cytology and cultures negative for MTB. She was continued on ATT with a regimen change and clinically improved. DISCUSSION: A diagnosis of paradoxical response warrants exclusion of secondary infection, treatment failure (drug resistance, poor compliance) and drug reaction. Paradoxical response has been reported more often in extra-pulmonary disease( CNS) with median onset time of 60 days. Risk factors include anemia, hypoalbuminemia, lymphopenia, greater % increase in lymphocyte count and a low body mass index (BMI) Our patient had low BMI (17.5) as a risk factor; all other causes of worsening infiltrates were excluded. A complete recovery was noted to occur in 78% of cases CONCLUSIONS: A clinical or radiological worsening during Tb therapy occurs in 6-30 % cases.A Paradoxical response should be considered in the differential diagnosis of worsening infiltrates during TB therapy in HIV negative patients after excluding other causes."									
447	Risk factors related to hypertension among patients in a cohort living with HIV/AIDS.	"de Arruda Jr ER, Lacerda HR, Moura LCRV, de Albuquerque MFPM, de Barros Miranda Filho D, Diniz GTN, de Albuquerque VMG, et al."	Brazilian Journal of Infectious Diseases. 2010 May/June;14(3):281-7.		"Introduction: Studies disagree as to whether there is a greater prevalence of hypertension among HIV/AIDS patients and the role of antiretroviral therapy. Objective: Evaluate the prevalence of hypertension and risk factors in a cohort of HIV-infected patients, with emphasis on antiretroviral therapy. Method: Case-control study conducted at baseline of a cohort, between June/2007 and December/2008 in Pernambuco/Brazil. Blood pressure was classified as normal, prehypertension, and hypertension. Results: Of 958 patients, 245 (25.6%) had hypertension (cases), 325 (33.9%) had prehypertension, and 388 (40.5%) were normotensive (controls). Comparison between hypertensive and normotensive patients showed that traditional factors, such as age > 40 (OR = 3.06, CI = 1.91- 4.97), male gender (OR = 1.85, CI = 1.15-3.01), BMI > 25 (OR = 5.51, CI = 3.36-9.17), and triglycerides > 150 mg/dL (OR = 1.69, CI = 1.05-2.71), were independently associated with hypertension. Duration of antiretroviral therapy and CD4 > 200 cells/mm3 were associated with hypertension in univariate analysis, but did not remain in final model. Type of antiretroviral schema and lipodystrophy showed no association with hypertension. Conclusion: Hypertension in HIV/AIDS patients is partially linked to invariable factors, such as age and sex. Efforts should be directed toward controlling reversible factors, particularly excessive weight gain and unsuitable diet. Elsevier Editora Ltda."									
491	HIV cardiomyopathy is associated with a low body mass index: Evidence from a case-comparison study.	"Lemmer CE, Badri M, Visser M, Mayosi BM."	Cardiovascular Journal of Africa. 2011 May-June;1):S11.		"Introduction: The cause of cardiomyopathy in patients infected with human immunodeficiency virus (HIV) remains largely unknown, although a number of predisposing factors have been identified. Malnutrition has been postulated as a contributory factor but the connection of malnutrition with HIV-associated cardiomyopathy has not been established in prospective studies. Methods: We prospectively investigated the association between nutritional state measured by anthropometric measures of lean body mass and HIV-positive individuals with and without cardiomyopathy. Results: Seventeen cases of HIV-associated cardiomyopathy (HIVAC) and a comparison group of 18 HIV-positive patients without heart disease were recruited. There were no significant differences in age, CD4 cell count, HIV RNA viral load and WHO clinical stage of HIV disease between the two groups. HIVAC cases had evidence of malnutrition compared to those without cardiomyopathy: a significantly lower body mass index (cases: 20.9 kg/m<sup>2</sup>; controls: 27.0 kg/m<sup>2</sup>; p = 0.02), mid-upper arm circumference (cases: 26.2 cm; controls: 27.3 cm; p = 0.02), and bone-free arm muscle area (cases: 26.7 cm2; controls: 32.8 cm2; p = 0.02). However, in a multi-variate step-wise logistic regression model, body mass index (BMI) was the only independent anthropometric risk factor for cardiomyopathy (odds ratio = 0.73; 95% CI: 0.64-0.97, p = 0.02). Conclusion: Cardiomyopathy is associated with a lower BMI in people who are living with HIV."									
449	Angina pectoris in patients with HIV/AIDS: Prevalence and risk factors.	"Zirpoli JC, Lacerda HR, De Albuquerque VMG, Militao de Albuquerque MDFP, Miranda Filho DDB, Monteiro VS, De Barros IL, et al."	Brazilian Journal of Infectious Diseases. 2012 January;16(1):1-8.		"Introduction: The incidence of ischemic heart disease is higher in patients with HIV/AIDS. However, the frequency of angina pectoris in these patients is still not known. Literature about this subject is still scarce. Objective: To evaluate the prevalence of angina pectoris and risk factors for coronary disease and to examine the association between traditional risk factors and HIV-related risk factors and angina pectoris. Method: An epidemiological cross-sectional study, analyzed as case-control study, involving 584 patients with HIV/AIDS. Angina pectoris was identified by Rose questionnaire, classified as definite or possible. Information regarding risk factors was obtained through a questionnaire, biochemical laboratory tests, medical records and anthropometric measures taken during consultations at AIDS treatment clinics in Pernambuco, Brazil, from June 2007 to February 2008. To adjust the effect of each factor in relation to others, multiple logistic regression was used. Results: There was a preponderance of men (63.2%); mean ages were 39.8 years for men, 36.8 years for women. The prevalence of definite and possible angina were 11% and 9.4%, respectively, totaling 20.4%, with independent associations between angina and smoking (OR = 2.88; 95% CI: 1.69-4.90), obesity (OR = 1.62; 95% CI: 0.97-2.70), family history of heart attack (OR = 1.70; 95% CI: 1.00-2.88), low schooling (OR = 2.11; 95% CI: 1.24-3.59), and low monthly income (OR = 2.93; 95% CI: 1.18-7.22), even after adjustment for age. Conclusion: This study suggests that angina pectoris is underdiagnosed, even in patients with medical monitoring, revealing lost opportunities in identification and prevention of cardiovascular morbidity. 2011 Elsevier Editora Ltda."									
1610	Association of serum albumin with markers of nutritional status among HIV-infected and uninfected Rwandan women.	"Dusingize JC, Hoover DR, Shi Q, Mutimura E, Kiefer E, Cohen M, Anastos K."	PLoS ONE [Electronic Resource]. 2012;7(4):e35079.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=22532840	INTRODUCTION: The objectives of this study are to address if and how albumin can be used as an indication of malnutrition in HIV infected and uninfected Africans.	"METHODS: In 2005, 710 HIV-infected and 226 HIV-uninfected women enrolled in a cohort study. Clinical/demographic parameters, CD4 count, albumin, liver transaminases; anthropometric measurements and Bioelectrical Impedance Analysis (BIA) were performed. Malnutrition outcomes were defined as body mass index (BMI), Fat-free mass index (FFMI) and Fat mass index (FMI). Separate linear predictive models including albumin were fit to these outcomes in HIV negative and HIV positive women by CD4 strata (CD4>350,200-350 and <200 cells/l)."	"RESULTS: In unadjusted models for each outcome in HIV-negative and HIV positive women with CD4>350 cells/l, serum albumin was not significantly associated with BMI, FFMI or FMI. Albumin was significantly associated with all three outcomes (p<0.05) in HIV+ women with CD4 200-350 cells/l, and highly significant in HIV+ women with CD4<200 cells/l (P<0.001). In multivariable linear regression, albumin remained associated with FFMI in women with CD4 count<200 cells/l (p<0.01) but not in HIV+ women with CD4>200."	DISCUSSION: While serum albumin is widely used to indicate nutritional status it did not consistently predict malnutrition outcomes in HIV- women or HIV+ women with higher CD4. This result suggests that albumin may measure end stage disease as well as malnutrition and should not be used as a proxy for nutritional status without further study of its association with validated measures.						
1519	[Differences in nutrition manners among short-statured and tall-statured girls and boys from Swietokrzyskie Voivodeship].	Suliga E.	"Pediatric endocrinology, diabetes, & metabolism. 2009;15(3):183-7."	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=20384180	"INTRODUCTION: The problem of body height deficiency, being an effect of undernutrition of children in developing countries, is widely described in the literature, whereas very little attention is devoted to the estimation of the nourishment of children and adolescents with body height deficiency in developed countries. The aim of the study is the quality and quantity assessment of nutrition manners among short-statured and tall-statured girls and boys."	MATERIAL AND METHODS: The study was conducted in a group of 86 short-statured girls and 113 short-statured boys (of a body height lower than 10th percentile) as well as 45 tall-statured girls and 44 tall-statured boys (of a body height higher than 90th percentile) aged 7-16 years. 24-hour dietary recall has been applied to assess nutrition manner.	"RESULTS: Daily food rations of the subjects in both groups did not differ markedly in terms of the content of energy, protein, polyunsaturated fatty aids as well as fat-soluble vitamins, that is vitamins D and E, and among boys also vitamin A. However, diets of tall-statured children and youth were characterized by a higher percent of energy coming from protein, a higher content of animal protein, mineral ingredients and some vitamins. Quality analysis has indicated that menu of 65% of short-statured children and youth was drawn up at variance with the rules of a well-balanced diet, and among over 40% of the subjects milk and dairy products were lacked in the diet."	"CONCLUSIONS: Deficiency of some nutritional ingredients as well as improper combination of food rations in terms of quality, stated in the group of short-statured girls and boys, could cause a worse use of developmental potential."						
1685	"Evaluation of quality of care in a large Saudi Hemodialysis Center (Prince Salman Center for Kidney Diseases, Riyadh, KSA)."	"Al Saran K, Sabry A, Hassan AH, Al Halawany Z."	Renal Failure. 2011;33(6):555-61.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=21663385	"INTRODUCTION: The quality of care provided to dialysis patients is under increasing scrutiny and systematic measurements of clinical performance, relying on indicators such as levels of Kt/V, hemoglobin, and serum albumin, have been implemented."	"METHODS: In this retrospective study we revised clinical and laboratory data of 146 chronic hemodialysis (HD) patients who met our inclusion criteria in the dialysis unit at Prince Salman Center for Kidney Diseases for a whole year - 2009. This study looked at the extent of adherence to the kidney diseases outcome quality initiative kidney diseases outcome quality initiative (K/DOQI), Centers for Disease Control and Prevention guidelines for prevention of transmission of infections among HD patients, and American Association of Medical Instrumentation standards for dialysis water quality."	"RESULTS: A total of 146 HD patients (54.8% males and 45.2% females) were included in this study with mean age 51.21 +/- 15.33 years. About 97.94% of cases had thrice-weekly sessions. An arteriovenous fistula was the vascular access in 78.1% of cases, and a permanent catheter was used in 21.9%. The mean predialysis blood pressure was <=140/90 in 91.8% of cases. The mean hemoglobin level was 11.44 +/- 1.46 g/dL in prevalent HD patients; 79.45% of cases had a hemoglobin level >=11 g/dL. The mean serum albumin level was 33.53 +/- 4.02 g/L; only 31.33% of cases had serum albumin >=35 g/L. The mean parathormone level was 34.35 +/- 28.70 pmol/L; 43.0% of patients had the target range (16.5-33 pmol/L), and the mean calcium level was 2.17 mmol/L; 89.73% of cases had the target range (2.12-2.52 mmol/L) while the mean serum phosphorus level was 1.46 mmol/L; 83.56% of patients had the target range (0.81-1.78 mmol/L). The Ca x Pi product was <=4.5 in 83.56% of cases. The mean Kt/V value was 1.45 +/- 0.18 in prevalent HD patients (98.63% and 60.96% of cases had Kt/V >=1.2 and >= 1.4, respectively). All patients were negative for HIV serology test while the prevalence of hepatitis C virus-positive and hepatitis B virus-positive patients was 24.7% and 4.1%, respectively. All patients (except hepatitis B virus positive) were vaccinated against hepatitis B virus. The annual mortality rate was 5.67%."	"CONCLUSION: Our study revealed an excellent quality of care for HD patients in the field of vascular access care, hemoglobin level, blood pressure control, and dialysis adequacy. On the other hand, this study showed the need for improving the nutritional status of patients through more dietary counseling, nutritional education, and early management for nutritional problems."						
1687	"Evaluation of quality of care in a large Saudi hemodialysis center (Prince Salman Center for Kidney Diseases, Riyadh, KSA)."	"Saran KA, Sabry A, Hassan AH, Halawany ZA."	Renal Failure. 2011 July;33(6):555-61.		"Introduction: The quality of care provided to dialysis patients is under increasing scrutiny and systematic measurements of clinical performance, relying on indicators such as levels of Kt/V, hemoglobin, and serum albumin, have been implemented. Methods: In this retrospective study we revised clinical and laboratory data of 146 chronic hemodialysis (HD) patients who met our inclusion criteria in the dialysis unit at Prince Salman Center for Kidney Diseases for a whole year - 2009. This study looked at the extent of adherence to the kidney diseases outcome quality initiative kidney diseases outcome quality initiative (K/DOQI), Centers for Disease Control and Prevention guidelines for prevention of transmission of infections among HD patients, and American Association of Medical Instrumentation standards for dialysis water quality. Results: A total of 146 HD patients (54.8% males and 45.2% females) were included in this study with mean age 51.21 +/- 15.33 years. About 97.94% of cases had thrice-weekly sessions. An arteriovenous fistula was the vascular access in 78.1% of cases, and a permanent catheter was used in 21.9%. The mean predialysis blood pressure was <=140/90 in 91.8% of cases. The mean hemoglobin level was 11.44 +/- 1.46 g/dL in prevalent HD patients; 79.45% of cases had a hemoglobin level >=11 g/dL. The mean serum albumin level was 33.53 +/- 4.02 g/L; only 31.33% of cases had serum albumin >=35 g/L. The mean parathormone level was 34.35 +/- 28.70 pmol/L; 43.0% of patients had the target range (16.5-33 pmol/L), and the mean calcium level was 2.17 mmol/L; 89.73% of cases had the target range (2.12-2.52 mmol/L) while the mean serum phosphorus level was 1.46 mmol/L; 83.56% of patients had the target range (0.81-1.78 mmol/L). The Ca x Pi product was <=4.5 in 83.56% of cases. The mean Kt/V value was 1.45 +/- 0.18 in prevalent HD patients (98.63% and 60.96% of cases had Kt/V >=1.2 and >= 1.4, respectively). All patients were negative for HIV serology test while the prevalence of hepatitis C virus-positive and hepatitis B virus-positive patients was 24.7% and 4.1%, respectively. All patients (except hepatitis B virus positive) were vaccinated against hepatitis B virus. The annual mortality rate was 5.67%. Conclusion: Our study revealed an excellent quality of care for HD patients in the field of vascular access care, hemoglobin level, blood pressure control, and dialysis adequacy. On the other hand, this study showed the need for improving the nutritional status of patients through more dietary counseling, nutritional education, and early management for nutritional problems. 2011 Informa Healthcare USA, Inc."									
1325	Features associated with underlying HIV infection in severe acute childhood malnutrition: a cross sectional study.	"Bunn J, Thindwa M, Kerac M."	Malawi Medical Journal. 2009;21(3):108-12.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20093329038	"Introduction: Up to half of all children presenting to Nutrition Rehabilitation Units (NRUs) in Malawi with severe acute malnutrition (SAM) are infected with HIV. There are many similarities in the clinical presentation of SAM and HIV. It is important to identify HIV infected children, in order to improve case management. This study aims to identify features suggestive of HIV in children with SAM. Methods: All 1024 children admitted to the Blantyre NRU between July 2006 and March 2007 had demographic, anthropometric and clinical characteristics documented on admission. HIV status was known for 904 children, with 445 (43%) seropositive and 459 (45%) seronegative. Features associated with HIV were determined. Results: Associations were found for the following signs: chronic ear discharge (OR 14.6, 95% CI 5.8-36.7), lymphadenopathy (6.4, 3.5-11.7), clubbing (4.9, 2.6-9.4), marasmus (4.9, 3.5- 6.8), hepato-splenomegally (3.2, 1.8-5.6), and oral candida (2.4, 1.8-3.27). Any one of these signs was present in 74% of the HIV seropositive, and 38% of HIV uninfected children. A history of recurrent respiratory infection (OR 9.6, 4.8-18.6), persistent fever, recent outpatient attendance, or hospital admission were also associated with HIV. Persistent diarrhoea was no more frequent in HIV (OR 1.1). Orphaning (OR 2.1, 1.4-3.3) or a household contact with TB (OR 1.7, 1.1-2.6), were more common in HIV. Each of these features were present in >10% of seropositive children. HIV infected children were more stunted, wasted, and anaemic than uninfected children. Conclusions: Features commonly associated with HIV were often present in uninfected children with SAM, and HIV could neither be diagnosed, nor excluded using these. We recommend HIV testing be offered to all children with SAM where HIV is prevalent."									
1585	"The Prevalence of Latent Mycobacterium tuberculosis Infection Based on an Interferon- Release Assay: A Cross-Sectional Survey among Urban Adults in Mwanza, Tanzania."	"Jensen AV, Jensen L, Faurholt-Jepsen D, Aabye MG, Praygod G, Kidola J, Faurholt-Jepsen M, et al."	PLoS ONE. 2013 21 May;8(5).		"Introduction:One third of the world's population is estimated to be latently infected with Mycobacterium tuberculosis (LTBI). Surveys of LTBI are rarely performed in resource poor TB high endemic countries like Tanzania although low-income countries harbor the largest burden of the worlds LTBI. The primary objective was to estimate the prevalence of LTBI in household contacts of pulmonary TB cases and a group of apparently healthy neighborhood controls in an urban setting of such a country. Secondly we assessed potential impact of LTBI on inflammation by quantitating circulating levels of an acute phase reactant: alpha-1-acid glycoprotein (AGP) in neighborhood controls.Methods:The study was nested within the framework of two nutrition studies among TB patients in Mwanza, Tanzania. Household contacts- and neighborhood controls were invited to participate. The study involved a questionnaire, BMI determination and blood samples to measure AGP, HIV testing and a Quantiferon Gold In tube (QFN-IT) test to detect signs of LTBI.Results:245 household contacts and 192 neighborhood controls had available QFN-IT data. Among household contacts, the proportion of QFT-IT positive was 59% compared to 41% in the neighborhood controls (p = 0.001). In a linear regression model adjusted for sex, age, CD4 and HIV, a QFT-IT positive test was associated with a 10% higher level of alpha-1-acid glycoprotein(AGP) (10<sup>B</sup> 1.10, 95% CI 1.01; 1.20, p = 0.03), compared to individuals with a QFT-IT negative test.Conclusion:LTBI is highly prevalent among apparently healthy urban Tanzanians even without known exposure to TB in the household. LTBI was found to be associated with elevated levels of AGP. The implications of this observation merit further studies. 2013 Jensen et al."									
1745	"Anaemia prevalence and morphologic types and hookworm infestation: medical emergency ward, Mulago Hospital, Uganda."	"Mukaya JE, Ddungu H, Ssali F, Crowther M."	SAMJ South African Medical Journal. 2009;99(12):881-6.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20103023093	"Introduction. Anaemia is common worldwide, although the burden is highest in developing countries where nutrient deficiencies and chronic infections are prevalent. Objective. To determine the prevalence and morphological types of anaemia and assess the hookworm burden among patients in the medical emergency ward at Mulago national referral hospital, Uganda. Methods. In a cross-sectional descriptive study 395 patients were recruited by systematic random sampling and their socio-demographic characteristics and clinical details collected. A complete blood count and peripheral film examination were done and stool examined for hookworm ova. Statistical analysis. Data were processed using Epi-Info version 6 and Stata version 9. The chi-square test was used for categorical variables and Student's t-test for non-categorical variables. Multiple logistic regression was used to determine factors predictive of anaemia. Results. Of the patients 255 (64.6%) had anaemia. The prevalence was higher among males (65.8%) than females (63.7%). Fatigue (odds ratio (OR) 2.1, confidence interval (CI) 1.37-3.24), dizziness (OR 1.64, CI 1.07-2.44), previous blood transfusion (OR 2.83, CI 1.32-6.06), lymphadenopathy (OR 2.99, CI 1.34-6.66) and splenomegaly (OR 5.22, CI 1.78-15.28) were significantly associated with anaemia. Splenomegaly, low body mass index (BMI) (<19) and being HIV positive were independently associated with anaemia. The commonest type of anaemia was hypochromic microcytic (34.1%). Only 10.6% of anaemic patients had hookworm infestation. Conclusions. In our study the prevalence of anaemia (64.6%) was very high. Splenomegaly, HIV infection and low BMI were independently associated with anaemia. The commonest type of anaemia was microcytic hypochromic (34.1%). There was a low prevalence of hookworm infestation."									
1734	Neurodevelopmental status of HIV-exposed but uninfected children: A pilot study.	"Springer P, Laughton B, Tomlinson M, Harvey J, Esser M."	SAJCH South African Journal of Child Health. 2012;6(2):51-5.		"Introduction. HIV affects children both directly and indirectly, with evidence of increased infectious mortality and morbidity in the HIV-exposed but uninfected (HEU) infant. There is little published research on neurodevelopmental outcome of HEU infants in Africa. Following the introduction of successful prevention of mother-to-child transmission programmes, it has become important to determine whether differences exist between HEU infants and infants born to HIV-negative mothers in order to guide current management policies of this rapidly growing group of infants. Objectives. To compare the developmental outcome of infants exposed to HIV in utero who remained uninfected (HEU) with that of infants unexposed to HIV in utero (HUU). Methodology. This was a prospective, blinded, hospital-based study. Infants aged between 17 and 19 months were assessed on the Griffiths Mental Developmental Scales (GMDS). Birth history, previous hospitalisation, maternal and infant characteristics, antiretroviral exposure, anthropometric measurements and abnormal clinical findings were documented. Results. Of the original 55 infants enrolled at 2 weeks of age, 37 (17 HEU and 20 HUU) underwent neurological and developmental assessment. There were no significant differences between the groups with regard to the GMDS general quotient or other subscales, apart from the Personal/social subscale, where the HEU group performed significantly more poorly than the HUU participants (p=0.026). This difference is probably a result of cultural differences between the groups, as 76% of HEU and only 15% of HUU participants were of Xhosa origin. Discussion. There was no difference in neurodevelopmental outcome at 18 months between the HEU and HUU groups."									
839	Tuberculosis in the intensive care unit in paris area in the xxi century.	"Valade S, Megarbane B, Raskine L, Deye N, Baud FJ."	Intensive Care Medicine. 2010 September;36:S252.		"INTRODUCTION. Tuberculosis remains a major concern worldwide in the XXI century. OBJECTIVES. We aimed to know the circumstances of admission and outcome of patients for whom a diagnosis of tuberculosis was assessed in the intensive care unit (ICU). METHODS. Retrospective one-centre study including all patients with a microbiological diagnosis of tuberculosis in the ICU during 2000-2009; results were expressed as median [25- 75% percentiles]; univariate comparisons using Chi-square and Mann-Whitney tests; multivariate analysis using ascendant logistic regression with determination of Odds ratio (OR) and 95%-confidence intervals. RESULTS. Forty-eight patients (35 M/13 F, 41 years [31-52], body mass index: 20.6 kg/m2 [17.0-24.2], HIV+: 29%, homeless: 33%, SAPS2: 31 [22-50]) were included. Patients were originated from Africa (42%), Asia (19%), and Europe (39%). The reasons for ICU admission were respiratory (63%), neurological (33%), and cardiovascular (8%) failure. Features included significant weight loss (84%), fever (80%), conscious loss (54%), meningeal syndrome (19%), and hemoptysis (9%). Chest X-rays were abnormal (89%), showing alveolar condensations (52%), miliary (18%), pleurisy (28%), caverna (26%), and mediastinal lymph nodes (26%). Meningeal localization (21%, leucocytes: 336/mm<sup>3</sup> [216-372], lymphocytes: 91% [86-97], glucose: 1.6 mM[1.3-2.1], protein: 3.0 g/l [2.3-3.3], and positive Mycobacterium tuberculosis Polymerase Chain Reaction (50%) in the CSF) was accompanied by hydrocephalus in third of the cases. Diagnosis was based on direct examination (59%) and culture (100%) with a delay of 19 days [11-30]. Two strains were rifampicin-resistant. Supportive treatments included intubation (52%, duration: 8 days [3-21]), non-invasive ventilation (14%), and vaopressor infusion (norepinephrine, 33% and epinephrine, 25%). Mycobacterium tuberculosis quadritherapy was started in the ICU in only 70% of the patients, while diagnosis was assessed after ICU discharge in 30%of the cases. In these cases, patients were diagnosed with a community pneumonia (8/14), pleurisy (3/14), pneumocystis infection (1/14), acute pulmonary edema (1/14) and renal failure (1/ 14). Seventeen patients (35%)died in the ICUin relation to refractory hypoxemia (35%) and shock (65%). In a multivariate analysis, two independent variables were associated with tuberculosisrelated death in the ICU (p<0.001): vasopressor administration during 24 h (OR: 20.7 [3.7-116.7]) and increased respiratory rate >=40/min on ICU admission (OR: 5.8 [1.2-28.0]). CONCLUSIONS. Tuberculosis may still require ICU admission in the XXI Century in France leading to an elevated mortality rate (35%). Patient histories and clinical features are variable. Diagnosis is diffICUlt and may only be assessed after ICU discharge (30%). On ICU admission, increased respiratory rate and cardiovascular failure requiring catecholamines are predictive of death."									
1111	Neonatal measles immunity in rural Kenya: The influence of HIV and placental malaria infections on placental transfer of antibodies and levels of antibody in maternal and cord serum samples.	"Scott S, Cumberland P, Shulman CE, Cousens S, Cohen BJ, Brown DWG, Bulmer JN, et al."	Journal of Infectious Diseases. 2005 01 Jun;191(11):1854-60.		"Introduction. Young infants are protected from measles infection by maternal measles antibodies. The level of these antibodies at birth depends on the level of antibodies in the mother and the extent of placental transfer. We investigated predictors of levels of measles antibodies in newborns in rural Kenya. Methods. A total of 747 paired maternal-cord serum samples (91 from human immunodeficiency virus [HIV]-infected and 656 from HIV-uninfected mothers) were tested for measles immunoglobulin G antibodies. Placental malaria infection was determined by biopsy. Data on pregnancy history, gestational age, and anthropometric and socioeconomic status were collected. Results. Infants born to HIV-infected mothers were more likely (odds ratio, 4.6 [95% confidence interval "									
256	[Carotenoids: 2. Diseases and supplementation studies].	"Faure H, Fayol V, Galabert C, Grolier P, Moel GL, Stephens J, Nabet F."	Annales de Biologie Clinique. 1999;57(3):273-82.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=10377477	"Inverse correlations have been found in most studies on the relationship between dietary intake and plasma concentrations of carotenoids on one side and degenerative diseases such as cancer and cardiovascular diseases on the other side. Protective effects of carotenoids have been found for pathologies of the retina and the skin. Concentrations of these molecules in blood are lower in digestive pathologies and HIV. Short- and long-term toxicity of carotenoids was found to be low. In combination with the beneficial effects found for diets rich in carotenoids, this has initiated trials with relatively high doses of carotenoid supplements. In the study in Linxian (China) in a rural population with poor nutritional status, supplementation with beta-carotene, zinc, selenium and vitamin E lowered total mortality and mortality from stomach cancer. Other studies (ATBC, Caret.) on well-fed subjects did not show beneficial effects on mortality from cancer and cardiovascular diseases. On the contrary, higher mortality and lung cancer incidence was found in supplemented subjects that were also exposed to asbestos and cigarette smoke. In these studies, doses of supplemental beta-carotene were high and varied from 20 to 50 mg/day. One still ongoing study, called Suvimax, doses subjects for eight years with a cocktail of vitamins and minerals including 6 mg per day of beta-carotene. This supplementation with physiologically seen more ""normal"" doses might give clarity on the question if beta-carotene is the protective factor in fruits and vegetables. [References: 77]"									
115	"Social protection to support vulnerable children and families: the potential of cash transfers to protect education, health and nutrition."	"Adato M, Bassett L."	AIDS Care. 2009;21 Suppl 1:60-75.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=22380980	"Investing in social protection in sub-Saharan Africa has taken on a new urgency as HIV and AIDS interact with other drivers of poverty to simultaneously destabilise livelihoods systems and family and community safety nets. Cash transfer programmes already reach millions of people in South Africa, and in other countries in southern and East Africa plans are underway to reach tens and eventually hundreds of thousands more. Cash transfers worldwide have demonstrated large impacts on the education, health and nutrition of children. While the strongest evidence is from conditional cash transfer evaluations in Latin America and Asia, important results are emerging in the newer African programmes. Cash transfers can be implemented in conjunction with other services involving education, health, nutrition, social welfare and others, including those related to HIV and AIDS. HIV/AIDS-affected families are diverse with respect to household structure, ability to work and access to assets, arguing for a mix of approaches, including food assistance and income-generation programmes. However, cash transfers appear to offer the best strategy for scaling up to a national system of social protection, by reaching families who are the most capacity constrained, in large numbers, relatively quickly. These are important considerations for communities hard-hit by HIV and AIDS, given the extent and nature of deprivation, the long-term risk to human capital and the current political willingness to act."									
1148	Intake of alcoholic beverages is a predictor of iron status and hemoglobin in adult tanzanians.	"Malenganisho W, Magnussen P, Vennervald BJ, Krarup H, Kaestel P, Siza J, Kaatano G, et al."	Journal of Nutrition. 2007 September;137(9):2140-6.		"Iron deficiency is widespread in sub-Saharan Africa, but its predictors are not fully understood. We conducted a cross-sectional study among adults around Lake Victoria to describe iron status and asses the role of dietary and infectious predictors. Linear regression analyses were used to assess the role of infections and intake of meat, fish, fruit/vegetables, alcoholic beverages, and soil on hemoglobin and serum ferritin, while controlling for elevated serum alpha<sub>1</sub>-antichymotrypsin (ACT). Among 1498 participants, the mean age was 33.3 (14-87) y with 53.9% females. More than one-half ate fish daily, 6% ate fruit/vegetables daily, and only 11% ate meat weekly. One-third consumed alcoholic beverages and one-fifth of females consumed soil. Hookworm (80.3%), Schistosoma mansoni (64.7%), and HIV (7.3%) infection were common. Anemia was found in 48.2% of females (<120 g/L hemoglobin) and 40.1% of males (<130 g/L hemoglobin), and 22.3% of females and 7.0% of males had depleted iron stores (serum ferritin <12 mug/L). In multivariate analyses, alcoholic beverage consumption and HIV were positive, whereas soil eating and hookworm infection were negative predictors of serum ferritin. Alcoholic beverage consumption was a positive predictor of hemoglobin, and soil eating, HIV, and hookworm infection were negative predictors. Intakes of meat, fish, and fruit or vegetables were not predictors. Elevated serum ACT was a predictor of both hemoglobin and serum ferritin. Anemia and depleted iron stores were common, whereas iron overload was rare. In conclusion, the associations between alcoholic beverage intake and hemoglobin and iron status suggest that alcoholic beverages may contain micronutrients essential to erythropoiesis. The role of alcoholic beverage intake and other determinants of hemoglobin and iron status in low-income populations needs to be better elucidated. 2007 American Society for Nutrition."									
1727	The role of nutrition and micronutrients in paediatric HIV infection.	"Buys H, Hendricks M, Eley B, Hussey G."	SADJ. 2002;57(11):454-6.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=12674865	"It has been postulated that micronutrients play a role in the pathogenesis of HIV disease. Though data are sparse, there is evidence that HIV-infected adults and children have a range of micronutrient deficiencies with increasing severity in advanced disease and in the presence of malnutrition. It appears that micronutrient deficiencies contribute to immune dysfunction, infectious morbidity and disease progression. Limited interventive studies suggest that vitamin and mineral supplementation is beneficial to HIV-infected adults and children; however, current, regimens are not evidence-based and there are no randomised controlled trials in children. There are a number of African studies under way addressing these issues. [References: 55]"									
759	Gastrointestinal complications of HIV infection: Changing priorities in the HAART era.	"Wilcox CM, Saag MS."	Gut. 2008 June;57(6):861-70.		"It has now been some 25 years since the initial description of AIDS. Following these observations, the epidemiology, natural history and manifestations of this disease have been well characterised. Intense investigation has better characterised HIV, resulting in the development of effective drug therapies to arrest disease progression. These multidrug combinations, termed highly active antiretroviral therapy or HAART, can suppress the viral load to the undetectable range and secondarily halt the destruction of CD4 T lymphocytes. This virological response is associated with a marked improvement in survival and absence of the many complications related to immunodeficiency. For patients who respond to HAART, the current emphasis is on treating side effects from the medications as well as treating other non-AIDS-related disorders. However, given the cost and complexities of these regimens, there are many patients who continue to present with the classic manifestations of AIDS, and, especially in the developing world, we will continue to see these patients for years to come."									
458	Rich micronutrient fortification of locally produced infant food does not improve mental and motor development of Zambian infants: a randomised controlled trial.	"Manno D, Kowa PK, Bwalya HK, Siame J, Grantham-McGregor S, Baisley K, De Stavola BL, et al."	British Journal of Nutrition. 2012;107(4):556-66.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=21733297	"It is uncertain whether multiple micronutrients benefit the mental and psychomotor development of young children in developing countries. We conducted a randomised double-blind controlled trial to evaluate the effect of a richly micronutrient-fortified v. a basal fortified porridge on mental and psychomotor development in Zambian infants. Infants (n 743) were randomised at age 6 months to receive either the richly fortified or the basal fortified infant food and were followed up until 18 months of age. All the infants were evaluated monthly for achievement of a series of developmental milestones. The Bayley scales of infant development II were administered to a subsample of 502 infants at 6, 12 and 18 months. Rich micronutrient fortification had no significant benefit on the following: (a) number of developmental milestones achieved (rate ratio at 12 months=1.00; 95% CI 0.96, 1.05; P=0.81, adjusted for sex, socio-economic status and maternal education, with similar results at 15 and 18 months); (b) ages of walking unsupported (hazard ratio (HR) 1.04; 95% CI 0.88, 1.24; P=0.63, adjusted for the above covariates) and of speaking three or four clear words (HR 1.01; 95% CI 0.84, 1.20; P=0.94, adjusted for the above covariates); (c) mental development index (MDI) and psychomotor development index (PDI) of the Bayley scales (scores difference adjusted for baseline scores, age at the assessment, sex, socio-economic status, maternal education, language, age and HIV status: MDI 0.3 (95% CI -0.5, 1.1), P=0.43; PDI -0.1 (95% CI -0.9, 0.7), P=0.78). In conclusion, the results do not support the hypothesis that rich micronutrient fortification improves Zambian infants' mental and motor development."									
972	Influence of HIV-1 and placental malaria co-infection on newborn biometry and Apgar scores in Kinshasa Democratic Republic of Congo. [French]	"Influence de la co-infection paludeenne placentaire et VIH sur la biometrie et l'indice d'Apgar du nouveau-ne a Kinshasa, Republique democratique du Congo."	"Modia O'Yandjo A, Foidart JM, Rigo J."		Journal de Gynecologie Obstetrique et Biologie de la Reproduction. 2011 September;40(5):460-4.									
973	Disseminated histoplasmosis due to Histoplasma capsulatum var. duboisii in Senegal. A case in HIV-infected patient. [French]	Histoplasmose disseminee a Histoplasma capsulatumvar. duboisii au Senegal. A propos d'un cas chez unpatient VIH positif.	"Ndiaye D, Diallo M, Sene PD, Ndiaye M, Ndir O."		Journal de Mycologie Medicale. 2011 March;21(1):60-4.									
826	Infant and young child feeding guidelines: 2010.		Indian Pediatrics. 2010;47(12):995-1004.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20113052702	"Justification: The first National Guidelines on Infant and Young Child Feeding (IYCF) were formulated by Ministry of Women and Child Development (Food & Nutrition Board) in 2004, and the same guidelines were revised in 2006. India is committed to halving the prevalence of under weight children by 2015 as one of the key indicators of progress towards the Millennium Development Goals (MDG). By the end of 2009 nutritional achievement goals did not make for happy reading. So there was need to revise the existing guidelines and to have more viable and scientifically accepted national guidelines on Infant and Young child feeding. Process: A National Consultative Meet was organized by Indian Academy of Pediatrics at Gurgaon in 2009 where members of IYCF and Nutrition Chapters of IAP, BPNI, WHO, UNICEF, USAID, WFP were present. Each group made detailed presentations after reviewing recent literature on the subject. After extensive discussions a consensus was reached and the guidelines were formulated. Objectives: To formulate, endorse, adopt and disseminate guidelines related to Infant & Young Child feeding from an Indian perspective (including infant feeding in the context of HIV infection). Recommendations: Optimal infant and young child feeding: Early initiation of breastfeeding, exclusive breastfeeding for the first six month of life followed by continued breastfeeding for up to two years and beyond with adequate complementary foods is the most appropriate feeding strategy for infants and young children. Adequate nutrition and anemia control for adolescent girls, pregnant and lactating mother is also advocated."									
1517	The management of children with Kaposi sarcoma in resource limited settings.	"Molyneux E, Davidson A, Orem J, Hesseling P, Balagadde-Kambugu J, Githanga J, Israels T."	Pediatric Blood and Cancer. 2013 April;60(4):538-42.		"Kaposi sarcoma (KS) is common where HIV infection is endemic. Antiretroviral therapy (ART) has reduced the incidence in well-resourced settings but in some parts of the world access to ART is delayed. These recommendations are for use where only minimal requirements for treatment are available. Consensus was sought for the management of childhood HIV-associated KS in this setting. There are no randomised controlled studies of chemotherapy for KS in children and these recommendations have drawn on consensus of a group of experts and published reports from studies in adults. 2012 Wiley Periodicals, Inc."									
136	Growth patterns reflect response to antiretroviral therapy in HIV-positive infants: potential utility in resource-poor settings.	"Benjamin DK, Jr., Miller WC, Ryder RW, Weber DJ, Walter E, McKinney RE, Jr."	AIDS Patient Care & Stds. 2004;18(1):35-43.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=15006193	"Laboratory monitoring of HIV-infected children is the current standard of care in the United States to guide the appropriate use of antiretroviral therapy (ART). Although ART is becoming a reality in some developing countries, laboratory monitoring of ART is costly, necessitating creative approaches to monitoring. As an initial step to guide monitoring of HIV progression in low resource settings, we assessed the utility of the physical examination to predict clinical progression of HIV. We conducted a retrospective cohort study of HIV-infected children using data from Pediatric AIDS Clinical Trials Group Protocol 300. We developed a clinical predictive model, and compared the utility of the clinical model to the change in HIV RNA viral load as diagnostic tests of ART failure. The clinical model incorporated treatment regimen, age, and height velocity: a three-level clinical predictive model provided likelihood ratios of 0.3, 3.9, and 14. For decline in RNA the likelihood ratios were 0.2 (> 1 log decline), 1.4, and 3.5 (> log increase). We developed a simple clinical predictive model that was able to predict clinical progression of HIV after initiation of new ART. The clinical model performed similarly to using changes in HIV RNA viral load. These data should be validated internationally and prospectively, because the test subjects were from a resource rich environment and growth patterns in undernourished children may be impacted differently by HIV and its treatment. The model was most pertinent to children 36 months of age or younger, and was conducted in children receiving monotherapy and dual therapy."									
898	Fatal lactic acidosis associated with highly active antiretroviral therapy in patients with advanced human immunodeficiency virus infection in Taiwan.	"Sheng WH, Hsieh SM, Lee SC, Chen MY, Wang JT, Hung CC, Chang SC."	International Journal of STD & AIDS. 2004;15(4):249-53.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh3&AN=20043068692	"Lactic acidosis (LA), a rare but life-threatening adverse effect associated with antiretroviral therapy, has been reported with an increasing frequency since the mid-1990s. From June 1994 to June 2002, a total of six patients, four males and two females with a median age of 43 years (range, 30 to 74 years), had been diagnosed with LA at the national Taiwan University Hospital in Taiwan. The estimated incidence of LA was 5.1 per 1000 patient-years (PYs) on highly active antiretroviral therapy (HAART) (95% confidence interval, 95% CI, 4.5-5.5 per 1000 PYs) and 4.4 per 1000 PY on nucleoside analogues (NAs) (95% CI, 3.9-4.7 per 1000 PYs). Their median body mass index at diagnosis of LA was 17.6 kg/m<sup>2</sup> (range 16.3 to 22.6 kg/m<sup>2</sup>). The median CD4+ lymphocyte count at the initial diagnosis of HIV infection and at the onset of LA was 38 cells/ micro l (range, 4 to 103 cells/ micro l) and 108 cells/ micro l (range, 79 to 224 cells/ micro l), respectively. The most common symptoms were nausea, vomiting, and dyspnoea. All of the patients had findings suggestive of NA-related mitochondrial toxicity, such as myositis, pancreatitis, fatty hepatitis, peripheral neuropathy or lipodystrophy. The prescribed NA related to LA were stavudine (six patients), lamivudine (five), and didanosine (one). Despite treatment, all patients died of persistent circulatory collapse following LA. The median duration from diagnosis to death was eight days (range, 4-17 days). Our report highlights that clinicians caring for patients with AIDS should be alerted to the potentially fatal LA associated with antiretroviral therapy when patients present with low body mass index, lipodystrophy, unexplained abdominal symptoms, dyspnoea, or elevated aminotransferases."									
1068	New challenges in studying nutrition-disease interactions in the developing world.	"Prentice AM, Gershwin ME, Schaible UE, Keusch GT, Victora CG, Gordon JI."	Journal of Clinical Investigation. 2008;118(4):1322-9.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20083186020	"Latest estimates indicate that nutritional deficiencies account for 3 million child deaths each year in less-developed countries. Targeted nutritional interventions could therefore save millions of lives. However, such interventions require careful optimization to maximize benefit and avoid harm. This paper reviews the global burden of childhood malnutrition, the complexities of nutritional metabolism, and the problems in assessing nutritional status. The conundrum of distinguishing cause from effect in studies of diet and infectious disease, and the intersection between host nutrition and the immune system are described. The host-pathogen competition for nutrients and the contributions of gut microbiota to nutrition are discussed. Four case studies providing examples of past deficiencies and future opportunities are presented: (1) universal vitamin A supplementation; (2) iron supplementation; (3) nutrition and tuberculosis; and (4) nutritional modulation of viral pathogenicity (e.g., HIV, influenza)."									
965	Serum zinc and albumin levels in pulmonary tuberculosis patients with and without HIV.	"Kuppamuthu R, Rajaiah S, Karuppusamy K, Alagappa U, Ramakrishnan B, Ponniah T."	Japanese Journal of Infectious Diseases. 2008;61(3):202-4.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20083200721	"Limited data are available on the relationship between nutritional status and pulmonary tuberculosis (PTB). Zinc plays a vital role in the immune status of the individual. The present study was carried out to estimate serum zinc and albumin levels in newly detected adult active PTB patients with (n=20) and without (n=20) HIV, and to compare them with the levels in controls (healthy family members; n=20) who satisfied rigid selection criteria. Standard methods were adopted to collect an early morning fasting blood sample for zinc (by Atomic Absorption Spectrometer) and albumin (estimated by the bromocresol green method). The mean+or-SD for BMI, zinc and albumin among the controls, HIV positive and HIV negative patients were 19.6+or-0.6, 18+or-0.4 and 18.5+or-0.6 kg/m<sup>2</sup>; 117.13+or-4.2, 53.9+or-8 and 65.5+or-9.8 micro g/dL; and 4.1+or-0.6, 2.9+or-0.4 and 3.6+or-0.7 g/dL, respectively. All three parameters were significantly low in active PTB patients irrespective of HIV status, but more so in HIV-positive individuals. These changes may be attributable to nutritional factors, enteropathy and acute phase reactant proteins. Hence, the National AIDS Control Organization (NACO) in India is providing nutritional supplements to those HIV-infected cases inducted for antiretroviral therapy and nutritional counselling for others as a part of a national policy."									
966	Serum zinc and albumin levels in pulmonary tuberculosis patients with and without HIV.	"Ramakrishnan K, Shenbagarathai R, Kavitha K, Uma A, Balasubramaniam R, Thirumalaikolundusubramanian P."	Japanese Journal of Infectious Diseases. 2008;61(3):202-4.		"Limited data are available on the relationship between nutritional status and pulmonary tuberculosis (PTB). Zinc plays a vital role in the immune status of the individual. The present study was carried out to estimate serum zinc and albumin levels in newly detected adult active PTB patients with (n = 20) and without (n = 20) HIV, and to compare them with the levels in controls (healthy family members; n = 20) who satisfied rigid selection criteria. Standard methods were adopted to collect an early morning fasting blood sample for zinc (by Atomic Absorption Spectrometer) and albumin (estimated by the bromocresol green method). The mean +/- SD for BMI, zinc and albumin among the controls, HIV positive and HIV negative patients were 19.6 +/- 0.6,18 +/- 0.4 and 18.5 +/- 0.6 kg/m<sub>2</sub>; 117.13 +/- 4.2, 53.9 +/- 8 and 65.5 +/- 9.8 mug/dL; and 4.1 +/- 0.6, 2.9 +/- 0.4 and 3.6 +/- 0.7 g/dL, respectively. All three parameters were significantly low in active PTB patients irrespective of HIV status, but more so in HIV-positive individuals. These changes may be attributable to nutritional factors, enteropathy and acute phase reactant proteins. Hence, the National AIDS Control Organization (NACO) in India is providing nutritional supplements to those HIV-infected cases inducted for antiretroviral therapy and nutritional counseling for others as a part of a national policy."									
337	Prevalence of HIV-associated lipodystrophy in Brazilian outpatients: relation with metabolic syndrome and cardiovascular risk factors.	"Diehl LA, Dias JR, Paes ACS, Thomazini MC, Garcia LR, Cinagawa E, Wiechmann SL, et al."	Arquivos Brasileiros de Endocrinologia e Metabologia. 2008;52(4):658-67.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20093017132	"Lipodystrophy in HIV-infected patients (LDHIV) affects 40-50%, but there are no data on its prevalence in Brazil. The aim of this study is to assess the LDHIV prevalence among HIV-infected adult Brazilian individuals, as well as to evaluate LDHIV association with cardiovascular risk factors and the metabolic syndrome (MS). Subjects included 180 adult HIV-infected outpatients consecutively seen in the Infectology Clinic of Universidade Estadual de Londrina. Anthropometric and clinical data (blood pressure, family and personal comorbidities, duration of HIV infection/AIDS, antiretroviral drugs used, CD4+ cells, viral load, fasting glycaemia and plasma lipids) were obtained both from a clinical interview as well as from medical charts. LDHIV was defined as the presence of body changes self-reported by the patients and confirmed by clinical exam. MS was defined using the NCEP-ATPIII criteria, reviewed and modified by AHA/NHLBI. A 55% prevalence of LDHIV was found. Individuals with LDHIV presented a longer infection period since HIV infection, longer AIDS duration, and longer use of antiretroviral drugs. In multivariate analysis, women (p=0.006) and AIDS duration >=8 years (p<0.001) were independently associated with LDHIV. Concerning MS diagnostic criteria, high blood pressure was found in 32%, low HDL-cholesterol in 68%, hypertriglyceridaemia in 55%, altered waist circumference in 17%, and altered glycaemia and/or diabetes in 23% of individuals. Abnormal waist and hypertriglyceridaemia were more common in LDHIV-affected individuals. MS was diagnosed in 36%. In multivariate analysis, the factors associated with MS were BMI>=25 Kg/m<sup>2</sup> (p<0.001), family history of obesity (p=0.01), indinavir (p=0.001), and age >=40 years on HIV first detection (p=0.002). There was a trend towards higher frequency of LDHIV among patients with MS (65% versus 50%, p=0.051). LDHIV prevalence among our patients (55%) was similar to previous reports from other countries. MS prevalence in these HIV-infected individuals seems to be similar to the prevalence reported on Brazilian non-HIV-infected adults."									
149	"Regional anthropometry changes in antiretroviral-naive persons initiating a Zidovudine-containing regimen in Mbarara, Uganda."	"Thompson V, Medard B, Taseera K, Chakera AJ, Andia I, Emenyonu N, Hunt PW, et al."	AIDS Research & Human Retroviruses. 2011;27(7):785-91.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=21128866	"Lipodystrophy is commonly reported in Africa after antiretroviral therapy (ART) is initiated, but few studies have objectively measured changes in body composition. Body composition was determined in 76 HIV-infected participants from Mbarara, Uganda after starting a thymidine-analog regimen, and annual change was determined using repeated measures analysis. We measured skinfolds (tricep, thigh, subscapular, and abdomen), circumferences (arm, hip, thigh, waist), and total lean and fat mass (using bioelectric impedance analysis). A cross-sectional sample of 49 HIV-uninfected participants was studied for comparison. At baseline, most body composition measures were lower in HIV-infected than uninfected participants, but waist circumference was similar. After 12 months on ART, there was little difference in body composition measures between HIV-infected and uninfected participants; median waist circumference appeared higher in HIV-infected participants (79 vs. 75 cm; p = 0.090). Among HIV-infected participants, increases were observed in total lean and fat mass, circumference, and skinfold measures; only the increase in tricep skinfold did not reach statistical significance (+1.05 mm; 95% confidence interval: -0.24, 2.34; p = 0.11). Regional anthropometry in peripheral and central body sites increased over 12 months after ART initiation in HIV-infected persons from southwestern Uganda, suggesting a restoration to health. Gains in the tricep skinfold, a reliable marker of subcutaneous fat, appeared blunted, which could indicate an inhibitory effect of zidovudine on peripheral subcutaneous fat recovery."									
1146	HIV-positive poor women may stop breast-feeding early to protect their infants from HIV infection although available replacement diets are grossly inadequate.	"Lunney KM, Jenkins AL, Tavengwa NV, Majo F, Chidhanguro D, Iliff P, Strickland GT, et al."	Journal of Nutrition. 2008;138(2):351-7.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=18203903	"Little is known about mothers' perspectives and experiences of early breast-feeding cessation as a strategy to reduce postnatal HIV transmission in rural, resource-constrained settings. We conducted in-depth interviews (IDI) with 15 HIV-positive breast-feeding mothers of infants aged 3-5 mo about their plans for feeding their infants after age 6 mo. We also conducted IDI with 12 HIV-positive mothers who intended to stop breast-feeding after receiving their infant's HIV-PCR negative test result at age 6 mo. Twenty-four-hour dietary recalls were conducted with the same 12 mothers and 16 HIV-negative or status unknown mothers who were breast-feeding their 6- to 9-mo-old infants. Of the 12 mothers who intended to stop breast-feeding, 11 did so by 9 mo. Median energy intake (percent requirement) was 1382 kJ (54%) among weaned infants compared with 2234 kJ (87%) among breast-feeding infants. Median intakes were <67% of the recommended levels for 9 and 7 of the 12 micronutrients assessed for weaned and breast-feeding infants, respectively. Factors facilitating early breast-feeding cessation were mothers' knowledge about HIV transmission, family support, and disclosure of their HIV status; food unavailability was the primary barrier. HIV-positive mothers in resource-constrained settings may be so motivated to protect their child from HIV that they stop breast-feeding early even when they cannot provide an adequate replacement diet. As reflected in the new World Health Organization guidance, HIV-positive mothers should continue breastfeeding their infants beyond 6 mo if replacement feeding is still not acceptable, feasible, affordable, sustainable, and safe."									
360	New-Fill to treat facial wasting.	Cheonis N.	Beta Bulletin of Experimental Treatments for Aids: a Publication of the San Francisco AIDS Foundation. 2002;15(2):10-5.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=12064301	"Looking in the mirror can be a humbling experience. For HIV positive people with facial wasting, or lipoatropy, the experience can be traumatic. Facial lipoatropy refers to subcutaneous fat loss in the cheeks and temples resulting in a bony, emaciated appearance. The condition may mild to severe. As with other symptoms of lipodystrophy, or body fat abnormality syndrome (such as fat loss in the limbs and buttocks, and fat accumulation in the abdomen), the only thing known for certain about facial wasting is that it exists; precise causes have not been identified and successful strategies to prevent the condition remain elusive. A recently developed cosmetic treatment for facial wasting, polylactic acid (PLA) or New-Fill, appears to be well tolerated in European clinical trials and anecdotal reports. Although the treatment has been approved in Europe and Mexico, the future of PLA access in the U.S. remains uncertain."									
698	Dietary intake and appetite predict early treatment outcome among low-BMI adults initiating antiretroviral therapy for HIV in Sub-Saharan Africa.	"Heimburger DC, Koethe JR, Bosire C, Blevins M, Nyirenda C, Kabagambe EK, Zulu I, et al."	FASEB Journal. 2012 April;26.		"Low body mass index (BMI), common in patients with HIV in sub-Saharan Africa, is a risk factor for early mortality on antiretroviral therapy (ART). Many persons in the region believe that ART produces hunger, and this compromises ART adherence. We measured dietary intake (24-hour recall) & appetite (ordinal scale) in 142 adults starting ART in Lusaka, Zambia with very low BMI (<16 kg/m<sup>2</sup>) and/or advanced immunosuppression (CD4+ lymphocyte count <50 cells/muL). Relationships with 12-week outcomes were analyzed with Cox models. Median age, BMI, & CD4+ count were 32 y, 16 kg/m<sup>2</sup>, & 34 cells/muL. Twenty-five participants (18%) died before 12 weeks, and 33 (23%) were lost to care. A 100 kcal/day higher energy intake at any time after ART initiation was associated with 14% lower hazard of death (AHR=0.86, p=0.01); similar relationships were observed for higher intakes of protein (5 g/day, AHR=0.81, P=0.01) and fat (5 g/day, AHR=0.80, P<0.01), while that for carbohydrate fell short of significance (25 g/day, AHR=0.85, P=0.09). Higher energy intake was marginally associated with a reduction in the combined endpoint of mortality or loss to care (p=0.07). Among survivors, appetite tended to normalize gradually, and hunger was rarely reported. Intervention trials are needed to test the impact of dietary supplementation on early ART outcomes."									
1061	"Low Bone Mass Prevalence, Therapy Type, and Clinical Risk Factors in an HIV-Infected Brazilian Population."	"Pinto Neto LFS, Ragi-Eis S, Vieira NFR, Soprani M, Neves MB, Ribeiro-Rodrigues R, Miranda AE."	Journal of Clinical Densitometry. 2011 October;14(4):434-9.		"Low bone mineral density (BMD) has been described in human immunodeficiency virus (HIV)-infected patients, but data on associated factors are still unclear, and to our knowledge, no reports are available in Brazil. Our goal was to evaluate BMD in HIV patients attending an outpatient clinic in Vitoria, Brazil. A sectional study was performed in 300 HIV-infected patients to measure BMD by dual-energy X-ray absorptiometry (DXA). Age, gender, anthropometric parameters, nadir and current CD4 cell count, HIV viral load, smoking habit, and current antiretroviral therapy (ART) associations were investigated by multivariable analysis. Based on World Health Organization T-score ranges, low BMD (T-score <-1.0 standard deviation [SD] in postmenopausal women and men aged 50 and older or Z-score <- 2.0 SD in premenopausal women and men below the age of 50) was detected in 54.7% (95% confidence interval: 49.1-60.3%) of the 300 enrolled patients. The observed median age was 46 yr (interquartile range: 39-52), 58% were male, 88.5% were on ART, and 21.4% smoked. The following factors were identified, by multiple logistic modeling, as being independently associated with low BMD: (1) male gender (4.6 [1.28-16.39]), (2) body mass index lower than 25 kg/m<sup>2</sup> (2.9 [1.31-6.49]), (3) menopause (13.4 [2.53-71.12]), and (4) HIV-1 undetectable viral load (7.9 [1.96-32.25]). Conversely, zidovudine (0.2 [0.04-0.85]) and nevirapine (0.1 [0.02-0.38]) use were inversely associated with low BMD. Low BMD was frequently found in our cohort of about 300 Brazilian HIV-infected subjects. This study upports the need for periodic DXA testing in HIV outpatient clinics. Using a sample of 300 HIV-infected patients, BMD by DXA, age, gender, anthropometrics, CD4 cell count, HIV viral load, smoking habit, and current antiretroviral therapy associations were investigated. Low BMD was frequently found among HIV-infected patients. This study supports the need for BMD screening in HIV-infected population. 2011 The International Society for Clinical Densitometry."									
1304	Lessons learned from complex emergencies over past decade.	"Salama P, Spiegel P, Talley L, Waldman R."	Lancet. 2004;364(9447):1801-13.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=15541455	"Major advances have been made during the past decade in the way the international community responds to the health and nutrition consequences of complex emergencies. The public health and clinical response to diseases of acute epidemic potential has improved, especially in camps. Case-fatality rates for severely malnourished children have plummeted because of better protocols and products. Renewed focus is required on the major causes of death in conflict-affected societies--particularly acute respiratory infections, diarrhoea, malaria, measles, neonatal causes, and malnutrition--outside camps and often across regions and even political boundaries. In emergencies in sub-Saharan Africa, particularly southern Africa, HIV/AIDS is also an important cause of morbidity and mortality. Stronger coordination, increased accountability, and a more strategic positioning of non-governmental organisations and UN agencies are crucial to achieving lower maternal and child morbidity and mortality rates in complex emergencies and therefore for reaching the UN's Millennium Development Goals."									
167	Prevention of HIV mother to child transmission: A review.	"Musoke PM, Mmiro FA."	AIDS Reviews. 2000;2(4):263-70.		"Major advances have been made in the prevention of HIV mother to child transmission (MTCT) including shorter, less expensive, antiretroviral (ARV) regimens for the developing world. In 1994, ACTG 076 using long course AZT during pregnancy reduced MTCT by 68%. Subsequently oral AZT regimens starting at 35-36 weeks gestations have also reduced transmission by 50% in non-breast feeding populations and 40% in breast feeding cohorts. Combination therapy is more effective than monotherapy and pregnant women on HAART with an undetectable viral load have vertical transmission rates less than two percent. Elective caesarian section reduces vertical transmission rates independent of ARV therapy. However the risk of surgery in HIV-infected pregnant women must be weighed against the benefit of caesarian section. Vaginal antiseptic cleansing and nutritional interventions have not been shown to reduce MTCT, but are reported to reduce maternal and neonatal morbidity and mortality. Single dose NVP at the onset of labor and a single dose to the infant (HIVNET 012) led to a 47% reduction in transmission, providing the developing world with a simple and cheap regimen. However, most developing countries are not able to implement prevention programs on a large scale because of inadequate infrastructure, limited access to voluntary counselling and testing (VCT), insufficient community involvement and lack of infant feeding options. Exclusive breast-feeding may provide protection against acquisition of HIV through breast milk in these populations. Despite these advances in prevention of perinatal transmission there is still a need for further research, including operational research to improve implementation of successful interventions."									
246	Anemia and malaria in the Democratic Republic of Congo.	"Hand CC, Taylor S, Mwandagalirwa K, Muwonga J, Okenge A, Matindii A, Tshefu AK, et al."	American Journal of Tropical Medicine and Hygiene. 2010 November;1):171.		"Malaria and anemia are both highly prevalent in the Democratic Republic of Congo; however there are many causes of anemia and the importance of malaria remains unclear. We used molecular results from the 2007 Demographic and Health Survey to assess the relationship between malaria and anemia in 4,574 women throughout the country. Blood was collected for on-site hemoglobin testing and stored as dried blood spots, from which genomic DNA was extracted for testing in real-time PCR assays for Plasmodium falciparum, P. malariae, and P. ovale. The prevalence of parasitemia was 28.5% (n=1303). The prevalence of mild (hemoglobin [Hgb] < 11.5 g/dL), moderate (Hgb < 9g/dL), and severe anemia (Hgb<7g/ dL) was 33.95%, 14.9% and 1.2% respectively. In bivariate analyses, anemia (defined as Hgb <11 g/dL ) was more prevalent in patients living in rural settings compared with urban (32% v. 26%), in poorer compared with wealthier patients (31% v. 26%), in patients with lower body mass indices, in pregnant compared with non-pregnant patients (44% v. 27%), and in patients infected with HIV (47% v. 29% uninfected) or with malaria parasites (32% v. 28% uninfected; all p < 0.01). In a logistic regression model, malaria parasitemia (OR 1.2; 95% C.I. 1.03 - 1.38), HIV infection (OR 2.7; 95% C.I. 1.69 - 4.31), pregnancy (OR 2.3; 95% C.I. 1.91 - 2.66), rural residence (OR 1.4; 95% C.I. 1.13 - 1.62), and low BMI were independently associated with anemia (all p<0.02). Among multi- and mono-species infection, only P. falciparum monoinfection was independently associated with anemia (OR 1.2; 95% C.I. 1.05 - 1.42; p < 0.01); combination or monoinfections with P. malariae or P. ovale were not significantly associated with anemia. Independent of other measured correlates, P. falciparum is an important contributor to anemia in women the Democratic Republic of Congo."									
24	Anemia and malaria at different altitudes in the western highlands of Kenya.	"Akhwale WS, Lum JK, Kaneko A, Eto H, Obonyo C, Bjorkman A, Kobayakawa T."	Acta Tropica. 2004 July;91(2):167-75.		"Malaria associated severe anemia in children is the most important complication of Plasmodium falciparum infection in sub-Saharan Africa. To evaluate anemia and malaria in an area with recurrent malaria epidemics in the western highlands of Kenya, we conducted cross-sectional surveys in four ""lowland"" (1440-1660 m) and two ""highland"" (1960 and 2040 m) villages in 2002. Among 1314 subjects randomly selected from all age groups, the overall prevalence of anemia (hemoglobin, Hb<11 g/dl) was 14% and P. falciparum infection 17%. In children <=5 years, anemia prevalence ranged from 57% at 1440 m to 11% at 2040 m and correlated with altitude (r=-0.88, P<0.05). Similarly, P. falciparum prevalence ranged from 31 to 0% and correlated with altitude (r=-0.93, P<0.01). Malnutrition defined by a body mass index <15th percentile characterized 39% of the population and the hookworm prevalence was 3.9%. In the lowland villages, anemia was most common in children <=5 years of age (34%) followed by women of childbearing age (16%). A similar pattern was also observed in the highland villages. In these vulnerable populations, hemoglobin concentration was significantly associated with malaria infection, but not with malnutrition or hookworm infestation and comparisons of anemia prevalence between highland and lowland villages revealed that two-thirds of anemia could be attributed to malaria infection. The prevalence of severe anemia (Hb<8 g/dl) was 1.5%; of these, 90% resided in lowland villages, 70% were under-fives, while 20% were women of childbearing age. In severely anemic subjects, the Hb concentration decreased further with malnutrition (P<0.05). Anemia was more prevalent in the lowland villages characterized by high prevalence of P. falciparum infection. We conclude that malaria may also be the main cause of anemia in the highland fringe areas of sub-Saharan Africa. Measures that reduce the prevalence of malaria will consequently reduce anemia in both, young children and adult women and the need for blood transfusions associated with the risk of HIV-transmission. 2004 Elsevier B.V. All rights reserved."									
239	Adverse perinatal outcomes of HIV-1-infected women in relation to malaria parasitemia in maternal and umbilical cord blood.	"Villamor E, Msamanga G, Aboud S, Urassa W, Hunter DJ, Fawzi WW."	American Journal of Tropical Medicine & Hygiene. 2005;73(4):694-7.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=16222011	"Malaria infection during pregnancy increases the risk of adverse birth outcomes among HIV-infected women. The role of umbilical cord parasitemia is not well characterized. We examined the risk of adverse perinatal outcomes in relation to maternal or umbilical cord Plasmodium falciparum parasitemia among 275 HIV-infected women from Tanzania, who participated in a randomized trial of zinc supplementation during pregnancy. Maternal parasitemia (> or = 1/microL) at the first antenatal visit was associated with increased risk of low birth weight < 2,500 g (adjusted relative risk [ARR] = 2.66; P = 0.01) and preterm delivery < 37 weeks (ARR = 1.87; P = 0.06). Maternal parasitemia at delivery was associated with preterm delivery (ARR = 2.27; P = 0.008), intrauterine growth retardation (ARR = 1.92; P = 0.03), and neonatal death (ARR = 3.22; P = 0.07). Cord parasitemia was associated with a large and significant increase in the risk of neonatal death (ARR = 8.75; P = 0.003). Maternal parasitemia at the first antenatal visit was strongly related to parasitemia at delivery, and the latter was associated with cord blood parasitemia. CD4 cell counts, parity, or assignment to the zinc arm (25 mg daily) were not associated with parasitemia in maternal or cord blood at delivery. Successful treatment of HIV-infected women who present to the first prenatal visit with malaria parasitemia and avoidance of reinfection are likely to decrease the risk of adverse outcomes during pregnancy and the early postpartum period. Cord blood parasitemia is a strong predictor of neonatal death. The potential effect of zinc supplementation on clinical malaria outcomes deserves future investigation."									
1505	New approaches to pathogenesis of malaria in pregnancy.	"Rogerson SJ, Boeuf P."	Parasitology. 2007 December;134(13):1883-93.		"Malaria infection during pregnancy is associated with poor maternal and foetal outcomes including low birth weight. In malaria-endemic areas, low birth weight is primarily a consequence of foetal growth restriction. Little is known on the pathogenesis of foetal growth restriction and our understanding of the relationship between epidemiological observations and the pathogenesis or consequences of disease is incomplete. In this review, we describe these gaps in our knowledge and also try to identify goals for future research into malaria in pregnancy. Foetal growth restriction results from a complex four-dimensional interaction between the foetus, the mother and the malaria parasite over gestation, and research into its pathogenesis may be advanced by combining longitudinal studies with techniques and approaches new to the field of malaria in pregnancy. Such approaches would greatly increase our knowledge on the pathogenesis of this disease and may provide new avenues for intervention strategies. 2007 Cambridge University Press."									
1312	Reducing the burden of malaria in pregnancy by preventive strategies.	"Menendez C, D'Alessandro U, Kuile FOt."	Lancet Infectious Diseases. 2007;7(2):126-35.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20073039920	"Malaria is one of the most common and preventable causes of adverse birth outcomes. In Africa, important progress has been made in the past decade with the introduction of a preventive strategy for malaria in pregnancy consisting of intermittent preventive treatment in pregnancy (IPTp) and insecticide-treated nets, yet their coverage is still unacceptably low and malaria continues to demand a huge toll on pregnant women and their newborn babies. Increasing the frequency of dosing of IPTp with sulfadoxine-pyrimethamine might provide temporary respite, but increasing resistance to sulfadoxine-pyrimethamine makes research into safe, efficacious, and affordable alternatives for IPTp one of the highest priorities for the control of malaria in pregnancy. A number of promising alternatives are, or will soon be, available that need to be evaluated as IPTp after their safety and pharmacokinetics in pregnancy have first been assessed in parasitaemic women. Little is known about appropriate control strategies in Asia and Latin America for Plasmodium falciparum and Plasmodium vivax malaria in pregnancy, which in most countries rely on responsive case management approaches. The role of case management based on proactive screening for malaria infection of women attending antenatal care or preventive approaches with insecticide-treated nets or IPTp are urgently needed. To achieve these objectives, multicentre and multidisciplinary approaches are required across the range of malaria transmission settings that include assessment of immunological effect of successful preventions, the perceptions and acceptability of different preventive approaches, and their cost-effectiveness."									
943	HIV Prevention and Mitigation in Southern Africa through the Rural Livelihoods Project.  	"Linn JG, Champeau D, Maritz J, McNamara M, Osborne K. "	International Sociological Association; 20062006.		"Malawi in southern Africa is afflicted with both high rates of malnutrition & of HIV. Antiretroviral treatment of HIV/AIDS remains economically out of reach of most rural families in Malawi. Consequently, special efforts need to be made to extend HIV prevention programs to farm households & to adapt agriculture to the HIV epidemic so that vulnerable individuals & families can improve their nutrition to better maintain their immune systems. This paper describes the strategy & pilot programs of the Rural Livelihoods Project, which has addressed problems of food insecurity, & HIV in Malawi, Zambia, & Mozambique. The implementation of an HIV prevention & mitigation program is discussed. Novel approaches to AIDS education, combined with the implementation of micro irrigation technologies, labor saving agricultural practices, & new crops are described. The importance of the interface between physical & mental health & agriculture for rural development in Africa is explored."									
1897	"Targeting CD4 testing to a clinical subgroup of patients could limit unnecessary CD4 measurements, premature antiretroviral treatment and costs in Thyolo District, Malawi."	"Zachariah R, Teck R, Ascurra O, Humblet P, Harries AD."	Transactions of the Royal Society of Tropical Medicine and Hygiene. 2006 January;100(1):24-31.		"Malawi offers antiretroviral treatment (ART) to all HIV-positive adults who are clinically classified as being in WHO clinical stage III or IV without 'universal' CD4 testing. This study was conducted among such adults attending a rural district hospital HIV/AIDS clinic (a) to determine the proportion who have CD4 counts >=350 cells/mul, (b) to identify risk factors associated with such CD4 counts and (c) to assess the validity and predictive values of possible clinical markers for CD4 counts >=350 cells/mul. A CD4 count >=350 cells/mul was found in 36 (9%) of 401 individuals who are thus at risk of being placed prematurely on ART. A body mass index (BMI) >22 kg/m<sup>2</sup>, the absence of an active WHO indicator disease at the time of presentation for ART, and a total lymphocyte count >1200 cells/mul were significantly associated with such a CD4 count. The first two of these variables could serve as clinical markers for selecting subgroups of patients who should undergo CD4 testing. In a resource-limited district setting, assessing the BMI and checking for active opportunistic infections are routine clinical procedures that could be used to target CD4 measurements, thereby minimising unnecessary CD4 measurements, unnecessary (too early) treatment and costs. 2005 Royal Society of Tropical Medicine and Hygiene. Published by Elsevier Ltd. All rights reserved."									
1439	Nutritional assessment of vitamin E in malnourished patients with AIDS.	"Monteiro JP, Cunha DFd, Cunha SFC, Santos VMd, Jordao AA, Correia D, Silva-Vergara ML, et al."	Nutrition. 2000;16(5):339-43.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh3&AN=20001417563	"Malnourished patients with acquired immunodeficiency syndrome (AIDS) may have low serum levels and reduced intake of alpha -tocopherol, mainly in the presence of acute-phase response. The aims of this study were to compare intake and serum levels of alpha -tocopherol between malnourished (MN) and non-malnourished (NMN) AIDS patients and to correlate alpha -tocopherol intake and serum levels. Undernutrition was defined as having a body mass index lower than 18.5 kg/msuperscript 2 or a height-creatinine index lower than 70%. A semiquantitative food frequency questionnaire assessed alpha -tocopherol intake. High-performance liquid chromatography determined vitamin serum levels. The patients were divided into MN (n=14) and NMN (n=15) groups. There were no statistical differences in relation to clinical findings between MN and NMN, respectively, including moniliasis (7/14 versus 4/15), neurocryptoccocosis and neurotoxoplasmosis (6/14 versus 6/15), pulmonary tuberculosis (4/14 versus 2/15), and fever (1/14 versus 3/15). MN and NMN groups had similar peripheral blood CD<sub>4</sub> levels (111.4+or-87.1 versus 124.4+or-90.9 cells/mmsuperscript 3), and both groups had similar and adequate alpha -tocopherol intake (MN=50.0+or-11.0 versus NMN=47.2+or-16.5 mg) and serum levels (MN=17.8+or-7.2 versus NMN=19.8+or-6.3 micro mol/L). Vitamin E intake and serum levels did not show a significant correlation (r=-0.22, P>0.05). Protein-energy nutrition status and acute-phase response were not factors determining vitamin status among AIDS patients."									
1320	Tuberculosis and nutrition.	"Gupta K, Gupta R, Atreja A, Verma M, Vishvkarma S."	Lung India. 2009 01 Jan;26(1):9-16.		"Malnutrition and tuberculosis are both problems of considerable magnitude in most of the underdeveloped regions of the world. These two problems tend to interact with each other. Tuberculosis mortality rates in different economic groups in a community tend to vary inversely with their economic levels. Similarly, nutritional status is significantly lower in patients with active tuberculosis compared with healthy controls. Malnutrition can lead to secondary immunodeficiency that increases the host's susceptibility to infection. In patients with tuberculosis, it leads to reduction in appetite, nutrient malabsorption, micronutrient malabsorption, and altered metabolism leading to wasting. Both, protein-energy malnutrition and micronutrients deficiencies increase the risk of tuberculosis. It has been found that malnourished tuberculosis patients have delayed recovery and higher mortality rates than well-nourished patients. Nutritional status of patients improves during tuberculosis chemotherapy. High prevalence of human immunodeficiency (HIV) infection in the underdeveloped countries further aggravates the problem of malnutrition and tuberculosis. Effect of malnutrition on childhood tuberculosis and tuberculin skin test are other important considerations. Nutritional supplementation may represent a novel approach for fast recovery in tuberculosis patients. In addition, raising nutritional status of population may prove to be an effective measure to control tuberculosis in underdeveloped areas of world."									
693	Nutrition education for HIV-infected women in Ghana.	"Chehayber H, Marquis G, Lartey A."	FASEB Journal. 2011 April;25.		"Malnutrition exacerbates symptom severity and worsens prognosis among HIV patients. We examined 1) nutrition education offered by health services and HIV-service organizations for HIV-infected women and 2) its relationship with knowledge and reported practices. Six focus group discussions included HIV-infected women (n=38) recruited from 2 HIV-service organizations and 4 outpatient clinics. Semi-structured interviews were conducted with health workers (n=12), non-governmental and governmental personnel (n=5) and one community leader. HIV-infected women cited health professionals as their primary source of nutrition education. Additional sources included the church, prayer camps and mass media. Nutrition messages were provided via group health education talks and private counseling sessions; none were based on patient assessment. Only one of the 6 sites visited had nutrition counseling materials. Health workers had good knowledge about healthy eating and management of HIV symptoms; however, barriers to nutrition education included lack of audience-appropriate materials and in-service training, limited space for counseling, and heavy workloads. Women reported barriers to following recommendations, including poverty, inconsistent messages, and low support from health services. Practical nutrition advice should be integrated and reinforced throughout the health system."									
1504	Zinc in human health.	"Temple VJ, Masta A."	Papua New Guinea Medical Journal. 2004;47(3-4):146-58.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=16862939	"Malnutrition is a contributing cause of about half of the 10 million deaths annually worldwide, and contributes to a substantial proportion of the infectious disease morbidity among children in developing countries. Recent epidemiological and clinical evidence has shown that in most developing countries deficiencies of specific micronutrients are partly responsible for the severity of infectious disease morbidity and mortality in malnourished children. Efforts to improve micronutrient status have focused on iron, vitamin A and iodine. Supplementation with iron and vitamin A significantly reduces child mortality, while implementation of the universal salt iodization strategy reduces the incidence of iodine deficiency disorders. These strategies are considered to be among the most cost-effective health interventions in developing countries. A number of recent zinc supplementation studies in developing countries suggest that greater priority should also be given to the correction of mild to moderate zinc deficiency in children, pregnant women and lactating mothers. Some of these studies showed that zinc supplementation reduces the duration of malaria, and the severity of diarrhoea and respiratory infections (including pneumonia), and improves immunocompetence in susceptible children. The results of these studies indicate that zinc may be another specific micronutrient in which there is widespread deficiency in developing countries and that great benefits can be achieved by its supplementation. [References: 87]"									
44	"Child malnutrition and mortality in Swaziland: situation analysis of the immediate, underlying and basic causes."	"Masuku-Maseko S, Owaga EE."	"African Journal of Food, Agriculture, Nutrition and Development. 2012;12(2):5994-6006."	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20123142070	"Malnutrition is a major confounding factor for child morbidity and mortality in developing countries. In Swaziland, about 31% of the under-five children are stunted in growth, where-as 1% and 6% are wasted and underweight, respectively. Hhohho region has the highest prevalence of underweight children (8.2%) relative to other regions such as Shiselweni (7.3%), Lubombo (6.7%) and Manzini (6.4%). The prevalence of infant and under-five children mortality rate (per 1,000 live births) are 85 and 102 deaths, respectively. Lubombo region has the highest cases of under-five mortality rate (deaths per 1,000 live births) of 115 when compared to rates in other regions, namely; Manzini (112), Shiselweni (100) and Hhohho (96). Despite the several child healthcare programmes, the problem of high child malnutrition places a significant hindrance towards the attainment of the Millennium Development Goals (MDG) 4 on reduction of child mortality. Potential determinants of childhood malnutrition and mortality in Swaziland can be categorized into three levels, namely: (a) immediate causes (inadequate dietary intake of protein, energy and micronutrients; diseases such as pneumonia, diarrhoeal diseases and HIV/AIDS), (b) underlying causes (inadequate access to food due to poverty and decline in food production; inadequate care of children and women, insufficient health services and unhealthy environment), and (c) basic causes (inadequate mother's education and nutrition knowledge, insufficient human resources in child health care; inadequate policies on child nutrition and health care; inequitable distribution of household and national socioeconomic resources). This paper presents an in-depth analysis of the causal factors of childhood malnutrition and mortality in Swaziland, and further explores opportunities that could be adopted to address the malnutrition and mortality problem. It also aims to reinforce that in order to ensure effectiveness and sustainability of intervention programmes, there is need for multi-dimensional strategies and collaboration between all the stakeholders concerned with child nutrition, health and socio-economic development. However, the interventions must recognize the existing socio-economic differentials between the rural and urban areas, and the administrative regions."									
1605	Sub-optimal vitamin B-12 levels among ART-naive HIV-positive individuals in an urban cohort in uganda.	"Semeere AS, Nakanjako D, Ddungu H, Kambugu A, Manabe YC, Colebunders R."	PLoS ONE. 2012 02 Jul;7(7).		"Malnutrition is common among HIV-infected individuals and is often accompanied by low serum levels of micronutrients. Vitamin B-12 deficiency has been associated with various factors including faster HIV disease progression and CD4 depletion in resource-rich settings. To describe prevalence and factors associated with sub-optimal vitamin B-12 levels among HIV-infected antiretroviral therapy (ART) naive adults in a resource-poor setting, we performed a cross-sectional study with a retrospective chart review among individuals attending either the Mulago-Mbarara teaching hospitals' Joint AIDS Program (MJAP) or the Infectious Diseases Institute (IDI) clinics, in Kampala, Uganda. Logistic regression was used to determine factors associated with sub-optimal vitamin B-12. The mean vitamin B-12 level was 384 pg/ml, normal range (200-900). Sub-optimal vitamin B-12 levels (<300 pg/ml) were found in 75/204 (36.8%). Twenty-one of 204 (10.3%) had vitamin B-12 deficiency (<200 pg/ml) while 54/204 (26.5%) had marginal depletion (200-300 pg/ml). Irritable mood was observed more among individuals with sub-optimal vitamin B-12 levels (OR 2.5, 95% CI; 1.1-5.6, P = 0.03). Increasing MCV was associated with decreasing serum B-12 category; 86.9 fl (+/-5.1) vs. 83 fl (+/-8.4) vs. 82 fl (+/-8.4) for B-12 deficiency, marginal and normal B-12 categories respectively (test for trend, P = 0.017). Compared to normal B-12, individuals with vitamin B-12 deficiency had a longer known duration of HIV infection: 42.2 months (+/-27.1) vs. 29.4 months (+/-23.8; P = 0.02). Participants eligible for ART (CD4<350 cells/mul) with sub-optimal B-12 had a higher mean rate of CD4 decline compared to counterparts with normal B-12; 118 (+/-145) vs. 22 (+/-115) cells/mul/year, P = 0.01 respectively. The prevalence of a sub-optimal vitamin B-12 was high in this HIV-infected, ART-naive adult clinic population in urban Uganda. We recommend prospective studies to further clarify the causal relationships of sub-optimal vitamin B-12, and explore the role of vitamin B-12 supplementation in immune recovery. 2012 Semeere et al."									
461	"The effect of multi-vitamin/mineral supplementation on mortality during treatment of pulmonary tuberculosis: a randomised two-by-two factorial trial in Mwanza, Tanzania."	"Range N, Changalucha J, Krarup H, Magnussen P, Andersen AB, Friis H."	British Journal of Nutrition. 2006;95(4):762-70.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=16571156	"Malnutrition is common in pulmonary tuberculosis (TB), and may impair survival. The objective of this study was to assess effects of multi-vitamin/mineral (MVM) and zinc (Zn) supplementation during TB treatment on mortality. Patients diagnosed with sputum-positive pulmonary TB in Mwanza, Tanzania, were randomised, using a two-by-two factorial design, to Zn (45 mg) or placebo, and MVM (vitamins A, B, C, D, E, and selenium and copper) or placebo. Survival status was ascertained at the end of the 8-month TB treatment and supplementation period. Of 499 TB patients, 213 (43 %) had HIV. The mean weight gain at 7 months was 6.88 kg (95 % CI 6.36, 7.41). Zn and MVM combined, but neither alone (interaction, P=0.03), increased weight gain by 2.37 kg (95 % CI 0.91, 3.83), irrespective of HIV status. Survival status at 8 months was determined for 422 patients (84.6 %), of which fifty-two (12.3 %) had died. Among fifty-two deaths, there were no effects of MVM (relative risk (RR) 0.73; 95 % CI 0.43, 1.23) and Zn (RR 0.76; 95 % CI 0.46, 1.28). However, among HIV co-infected patients, marginally significant effects of both MVM (RR 0.60; 95 % CI 0.34, 1.05) and Zn (RR 0.63, 95 % CI 0.37, 1.08) were seen, and MVM and Zn combined reduced mortality (RR 0.29; 95 % CI 0.10, 0.80; interaction ratio 0.52). In conclusion, supplementation with MVM, including Zn, during treatment of pulmonary TB may reduce mortality in those co-infected with HIV. A randomised trial of the effect of the combined intervention used in this study should be conducted in a different setting to confirm the finding."									
125	Dietary adequacy in Asian Indians with HIV.	"Wig N, Bhatt SP, Sakhuja A, Srivastava S, Agarwal S."	AIDS Care. 2008;20(3):370-5.	http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=2009880517&site=ehost-live	"Malnutrition is endemic in developing countries, which also bear the brunt of the human immunodeficiency virus (HIV) pandemic. HIV and its complications have a significant impact on nutritional status. Malnutrition and HIV have deleterious interactions. Dietary inadequacy is a major cause of malnutrition and few studies have been done to assess dietary adequacy in HIV-infected individuals and the factors affecting intake. Dietary intake of 71 consecutive patients was determined using 24-hour dietary recall, with the help of a questionnaire and a structured interview, and then compared with the recommended dietary allowances (RDA). The dietary intake of energy, total fat, fibre, vitamin C and iron were significantly less than the recommended RDA. There was no difference in protein intake. Only 5.7% of males and 16.7% of females reached the recommended energy allowance. The recommended protein allowance was reached by 43.4% males and 44.4% females and 41.5% males and 38.9% females consumed more than the upper limit of the recommended fat intake. Intake of major nutrients was also significantly less when compared to the national average intake. On bivariate analysis, the factors affecting these inadequacies were found to be annual per-capita income, dependency on another for livelihood, CD4 counts more than 200/cubic millimeter and absence of antiretroviral therapy. On multivariate analysis, only dependency on another was found to significantly influence energy intake. Dietary intake of many food constituents is significantly less in HIV patients than that recommended. Dietary counselling and efforts to improve food security are important in management of these patients."									
1247	"Nutritional and clinical status of children admitted to the malnutrition ward, Maputo central hospital: a comparison of data from 2001 and 1983."	"Cartmell E, Natalal H, Francois I, Ferreira MH, Grahnquist L."	Journal of Tropical Pediatrics. 2005;51(2):102-5.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=15677369	"Malnutrition is the fourth commonest reason for hospital admission to the paediatric department of the Central Hospital, Maputo and has the second highest death rate (20 per cent). A study from 1995 into mortality at this paediatric department, suggested an increase in severe malnutrition. Recent studies have shown that the global burden of undernutrition in the world is declining; however, data for Eastern Africa shows a deterioration. The current study was aimed at describing and comparing the patients on the malnutrition ward, in 2001 and 1983. The study gathered indices of nutritional status and secondary diagnoses from the notes of all children (aged between 6 months and 5 years) discharged from the malnutrition ward for a period of l year (January-December 2001), and from data (collected in January-December 1983) for the malnutrition ward. Data was entered and analysed using Epi-Info 6 and SPSS statistics package. The ethics committee of the hospital approved the study. Data was collected for 558 children in 2001 and 833 in 1983. There was no gender difference, average age was 21.7 months in 2001 and 23.8 months in 1983 and the average hospital stay was 13.1 and 14.3 days, respectively. In 2001, 33 per cent had kwashiorkor, 26 per cent marasmus, and 28 per cent marasmic kwashiorkor. Three hundred and twenty children (82 per cent) were <2 Z-scores below the median weight-for-age and 252 children (65 per cent) were <3 Z-scores. Forty per cent had malaria, 65 per cent anaemia, 53 per cent bronchopneumonia, 14 per cent TB, 36 per cent diarrhoea, and 12 per cent HIV/AIDS. In 1983, 49 per cent had kwashiorkor, 17 per cent marasmus, and 11 per cent had marasmic kwashiorkor. A total of 494 children (81 per cent) were <2 Z-scores below the median weight-for-age and 335 children (55 per cent) were <3 Z-scores. Eighteen per cent had malaria, 37 per cent anaemia, 28 per cent bronchopneumonia, 6 per cent TB, 8 per cent diarrhoea, and 4.4 per cent measles/post-measles. A comparison between the clinical status of 1983 with that of 2001 shows little difference in age, gender or length of stay. There were fewer admissions in 2001, although a higher percentage of severely underweight children and the 2001 group had more secondary infections, especially malaria, bronchopneumonia and anaemia. Clinical malnutrition at a referral hospital level, in spite of the remarkable Mozambican economic growth, shows signs of following the depressing pattern for much of Eastern Africa. A prospective study including HIV tests and anthropometric data for this and the city's other hospitals is warranted. Discussion needs to be prompted on a local level about malnutrition and the use of guidelines."									
1511	Child nutrition in developing countries.	"Neumann CG, Gewa C, Bwibo NO."	Pediatric Annals. 2004 October;33(10):658-74.		"Malnutrition permeates all aspects of health, growth, cognition, motor and social development of young children in developing countries. More than 50% of deaths in these children can be attributed to malnutrition, most often in conjunction with serious infection. Irreversible and lifelong sequelae prevent children from reaching their full potential. Child survival initiatives and programs have accomplished much to save the lives of children from common and preventable illnesses, but the quality of the survivors' health needs to be improved, with much more attention paid to nutrition of the preschool and school child. Promotion of nutritional health must become an integral part of primary health services, especially for infants, preschoolers, schoolchildren, and women. Promotion of exclusive breast-feeding and appropriate complementary feeding and weaning are essential inputs. A daunting challenge is to improve diet quality through the raising and consumption of small animals by rural subsistence households to enhance maternal and child nutrition. School feeding from preschool onward must be an integral part of education so children are in a condition to learn. An excellent example of such programs is the WHO initiated Integrated Management of Childhood Illness, which integrates nutrition into the care of both sick and well children. The Early Child Development Program initiated by the World Bank and UNICEF has taken hold in many countries. Nutrition outcomes are closely linked with health and education activities starting in the preconception period through pregnancy, lactation, and childhood. Investment in human capital early in life will optimize the growth and social and economic development of children, families, and communities."									
1095	Dendritic cell anergy results from endotoxemia in severe malnutrition.	"Hughes SM, Amadi B, Mwiya M, Nkamba H, Tomkins A, Goldblatt D."	Journal of Immunology. 2009;183(4):2818-26.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=19625645	"Malnutrition predicts an increased risk of morbidity and mortality from infection. Defects in cell-mediated immunity, such as thymic atrophy, impaired cutaneous tuberculin responses, and reduced T cell mitogenesis in vitro, are well characterized. There has been no convincing mechanism proposed for these T cell defects. However, as T cell responses rely on signals received from APCs, this study evaluates dendritic cell (DC) function in children with severe malnutrition. Repeated sampling of peripheral blood from 81 severely malnourished children at the University Teaching Hospital, Lusaka, Zambia, demonstrated for the first time a defect in DC numbers in children with malnutrition (28 per microliter) and a recovery in cell number (48 per microliter; p < 0.01) with standard treatment. We describe normal DC maturation in the majority of malnourished children. However, in 17% of our study patients, in association with endotoxemia we describe the novel finding of DC maturation failure (down-regulation rather than up-regulation of HLA-DR). There was a strong correlation between the strength of HLA-DR up or down-regulation and the generation of IL-10 (r = -0.481; p = 0.003). These ""anergic"" DCs failed to support T cell proliferation. Defects in DC number and the immunosuppressive phenotype of DCs from severely malnourished children with endotoxemia provide a rational basis for the anergy found in severe malnutrition."									
1416	The clinical challenge of preventing and treating malnutrition.	Cooper PA.	Nestle Nutrition Workshop Series Paediatric Programme. 2010;66:31-40.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=20664214	"Malnutrition remains a major problem in children in large parts of the developing world. About 150 million young children in the developing world are either wasted or stunted, and it has been estimated that over half of childhood deaths are attributable to the potentiating effects of malnutrition. Thus, tackling both mild-moderate and severe malnutrition effectively is essential if the millennium development goals are to be achieved. Intervention strategies to promote exclusive breastfeeding for about 6 months in the absence of maternal HIV infection will result in significant improvements in nutrition, and are key to prevention strategies for malnutrition. Careful evaluation and effective counseling of HIV-positive mothers regarding feeding choices is essential. Evidence from a number of randomized controlled trials shows that ready to use foods have an important role to play in the prevention and treatment of both outpatient and inpatient malnutrition. Such foods were initially produced commercially, but it has been shown, particularly in Malawi, that such foods can be locally produced at low cost. In some parts of the world, HIV is a major underlying cause of malnutrition in children and is associated with high mortality rates in those with severe malnutrition. Strategies for the prevention and treatment of children with HIV need to be escalated. Copyright 2010 S. Karger AG, Basel."									
1988	Medical nutrition treatment for people living with HIV/AIDS.	Jiang H.	Zhongguo Shiyong Neike Zazhi / Chinese Journal of Practical Internal Medicine. 2011;31(3):184-7.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20113129001	"Malnutrition, a major factor for poor prognosis, has been found to be prevalent in AIDS patients or people living with HIV/AIDS (PLWHA) by some domestic studies. For patients undergoing anti-retroviral treatment (ART), routinal screening of malnutrition should be performed so as to identify the condition at an early stage. Nutrition counseling lays fundamental to medical nutrition treatment (MNT) and appears effective in promoting calorie/protein intake to meet daily standards. For those whose calorie/protein intake can not reach the standards after nutrition counseling, enteral nutrition (EA) should be given as a first-line option. Blood lipids should be monitored for those who are receiving ART. Dyslipidemia can be addressed by adjustment of dietary structure. In conclusion, malnutrition has been a major challenge for PLWHA in China. Calorie and protein intake should be a focus in HIV/AIDS caring programs. Furthermore, MNT should be incorporated in national or community guidelines for treatment of HIV/AIDS."									
119	"A ""planting and eating soybean"" project for people living with HIV/AIDS in rural Anhui - a pilot study in China."	"Ji G, Qi R, Wang H, Feng C, Leng J."	AIDS Care. 2010;22(1):126-32.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=20390490	"Many people living with HIV/AIDS (PLWHA) in rural Anhui, China are poor and lack sufficient protein in their diet. This project was to increase soybean protein in the diet of PLWHAs in a resource limited area in rural Anhui. A community intervention was implemented, by providing soybean seeds and a series of training courses on planting soybean, nutrition and preparing for soy food to PLWHA families in two villages in North Anhui. Participants were encouraged to eat soy food everyday after harvest. Among the 47 PLWHA participants in the assessment, 60% were females, 38% were illiterate, the average household income was 5323 Yuan ($760) per year. In 2006, they received soybean seeds of 320.5 kg and the harvest was 3465 kg four months later. In the past three months of the assessment, 94% had eaten soy food at least three times a week and 96% of them ate 100 g each time. After eating soy food, 93% felt better, 86% reported less sickness, 61.3% had higher total blood protein and blood white protein, 58.1% had higher blood hemoglobin, and 54.8% had higher CD(4) count. All participants liked the project and all hoped to continue the project. The preliminary data suggested that the pilot ""planting and eating soybean"" project was effective and sustainable for PLWHAs living in resource limited rural areas in Anhui, China."									
838	The development of micronutrient supplemented probiotic yogurt for people living with HIV: laboratory testing and sensory evaluation.	"Hemsworth J, Hekmat S, Reid G."	Innovative Food Science & Emerging Technologies. 2011;12(1):79-84.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20113101956	"Many probiotic organisms, including Lactobacillus rhamnosus GR-1 have shown significant promise in supporting the immune function of people living with HIV. Moreover, certain micronutrients have also demonstrated the ability to improve immune function and delay disease progression. A micronutrient supplemented probiotic (L. rhamnosus CAN-1) yogurt was developed by first preparing a mother culture of the probiotic species and adding them to 2% milk that was supplemented with micronutrients at 25% DRI and incubating the mixture at 37 degrees C for 5 h. A sensory evaluation was performed to assess consumer acceptance of the products as 1: 12.5% DRI and standard cultures; 2: 25% DRI and standard cultures; 3: 12.5% DRI and probiotic cultures; 4: 25% DRI and probiotic cultures. Micronutrients slightly inhibited the viable counts of L. rhamnosus CAN-1; however, the colony forming units remained above what is considered the therapeutic level (WHO, 2001) at the end of the shelf life (21 days) Consumers preferred product 3 over the others, suggesting yogurt is a suitable carrier for L. rhamnosus CAN-1 and micronutrients. Industrial Relevance: This study is highly relevant to industry as it is a new development of a functional food for use in a clinical population. While yogurt itself has increased in popularity, so has the demand for functional foods. In addition, yogurt is a relatively simple and low-maintenance technology, which can be easily transferred to diverse settings such as Sub-Saharan Africa, where the need for strategies to alleviate suffering from malnutrition and HIV are urgently needed. Yogurt has also been shown to be an inhospitable environment for pathogenic bacteria, thus this technology would be suitable for small-scale social businesses in developing countries where electricity and hygiene are more challenging than larger industry. These products were well accepted by consumers, suggesting its potential viability in North American markets, but more specifically for patient populations in hospital. Nutrition and immune function are closely linked, which suggests that other populations suffering from nutrition and immune disorders such as inflammatory bowel disease, cancer, and aging populations may also benefit from a product that combines the immunostimulatory potential of probiotics with a nutritious medium of micronutrient supplemented yogurt."									
1141	Iron deficiency and anemia predict mortality in patients with tuberculosis.	"Isanaka S, Mugusi F, Urassa W, Willett WC, Bosch RJ, Villamor E, Spiegelman D, et al."	Journal of Nutrition. 2012;142(2):350-7.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=22190024	"Many studies have documented a high prevalence of anemia among tuberculosis (TB) patients and anemia at TB diagnosis has been associated with an increased risk of death. However, little is known about the factors contributing to the development of TB-associated anemia and their importance in TB disease progression. Data from a randomized clinical trial of micronutrient supplementation in patients with pulmonary TB in Tanzania were analyzed. Repeated measures of anemia with iron deficiency, anemia without iron deficiency, and iron deficiency without anemia were assessed as risk factors for treatment failure, TB recurrence, and mortality. The prevalence of anemia (hemoglobin < 110 g/L) at baseline was 64%, more than one-half of which was related to iron deficiency (mean corpuscular volume , 80 fL). We found no evidence of an association between anemia (with or without iron deficiency) or iron deficiency without anemia at baseline and the risk of treatment failure at 1 mo after initiation. Anemia without iron deficiency was associated with an independent, 4-fold increased risk of TB recurrence [adjusted RR = 4.10 (95% CI = 1.88, 8.91); P < 0.001]. Iron deficiency and anemia (with and without iron deficiency) were associated with a 2- to nearly 3-fold independent increase in the risk of death [adjusted RR for iron deficiency without anemia = 2.89 (95% CI = 1.53, 5.47); P = 0.001; anemia without iron deficiency = 2.72 (95% CI = 1.50, 4.93); P = 0.001; iron deficiency anemia = 2.13 (95% CI = 1.10, 4.11); P = 0.02]. Efforts to identify and address the conditions contributing to TB-associated anemia, including iron deficiency, could play an important role in reducing morbidity and mortality in areas heavily affected by TB."									
1335	"An investigation into the influence of socioeconomic variables on gestational body mass index in pregnant women living in a peri-urban settlement, South Africa."	"Davies HR, Visser J, Tomlinson M, Rotherham-Borus MJ, LeRoux I, Gissane C."	Maternal & Child Health Journal. 2012;16(8):1732-41.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=21894501	"Maternal and child mortality rates are still unacceptably high in South Africa. The health status of women in peri-urban areas has been influenced by political and socio-economic factors. Examining socio-economic variables (SEV) in a population aids in the explanation of the impact of social structures on an individual. Risk factors can then be established and pregnant women in these higher risk groups can be identified and given additional support during pregnancy. The aim of this study was to investigate the association between SEV and gestational Body Mass Index (GBMI) in a peri-urban settlement, South Africa. This was a sub-study of the Philani Mentor Mothers' Study (2009-2010). Maternal anthropometry and SEV were obtained from 1,145 participants. Multinomial regression was used to analyse the data. Household income was the only SEV that was significantly associated with GBMI. The odds of being underweight rather than normal weight during pregnancy increase by a factor of 2.145 (P<0.05) for those who had a household income lower than R2000 per month. All other SEV were not significant. Logistic regression was therefore not carried out. Women who had a lower income were at risk of having a lower GBMI during pregnancy. This can lead to adverse birth outcomes such as premature birth, low birth weight, height and head circumference. Public health policy needs to be developed to include optimal nutrition health promotion strategies targeting women with a low income ante and post-natally. Once implemented, they need to be evaluated to assess the impact on maternal and child mortality."									
631	Impact of maternal malaria and under-nutrition on intrauterine growth restriction: a prospective ultrasound study in Democratic Republic of Congo.	"Landis SH, Lokomba V, Ananth CV, Atibu J, Ryder RW, Hartmann KE, Thorp JM, et al."	Epidemiology & Infection. 2009;137(2):294-304.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=18588723	"Maternal malaria and under-nutrition are established risk factors for small-for-gestational-age (SGA) births; however, whether malaria is associated with intrauterine growth restriction (IUGR) is unknown. We investigated IUGR risk among 177 HIV-negative pregnant women enrolled in a longitudinal ultrasound study conducted in Democratic Republic of Congo from May 2005 to May 2006. Malaria infection, maternal anthropometrics, and ultrasound estimated fetal weight were measured monthly. All positive malaria cases were treated and intermittent presumptive therapy (IPTp) provided. Log-binomial regression models for IUGR were fitted using generalized estimating equations to account for statistical clustering of repeat IUGR measurements. Twenty-nine percent of fetuses experienced an episode of IUGR with the majority occurring in the third trimester. The risk of IUGR associated with malaria was greatest after three or more cumulative infections (RR 3.3, 95% CI 1.3-8.2) and was two- to eight-fold higher among women with evidence of under-nutrition. Receiving antimalarial treatment in the previous month (for IPTp or treatment) was significantly protective against IUGR (RR 0.5, 95% CI 0.3-0.7). The interaction observed between malaria and under-nutrition suggests that antenatal programmes in malaria endemic areas should incorporate nutritional screening and supplementation in addition to IPTp."									
359	Changing patterns of maternal mortality (HIV/AIDS related) in poor countries.	"Sebitloane HM, Mhlanga RE."	Best Practice & Research in Clinical Obstetrics & Gynaecology. 2008;22(3):489-99.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=18248773	"Maternal mortality is greatest in poor countries and it is in exactly these countries that the human immunodeficiency virus (HIV) poses an added challenge in attaining the Millennium Development Goals. The prevalence of HIV infection in many poor countries continues to rise. South Africa is an example of how some of the challenges can be addressed. Recommendations by the South African National Committee on the Confidential Enquiry into Maternal Deaths stressed the importance of addressing the antenatal, intrapartum and postpartum care of women, laying emphasis on the need for societal support, including nutritional and emotional support, reproductive health services including contraception, provider-initiated counselling and testing (PICT) and prevention. Antenatal care needs to be targeted for support and early intervention when abnormalities are detected, including the initiation of highly active antiretroviral therapy when necessary. Intrapartum care needs to be conducted in a hygienic environment with access to operative delivery. More attention needs to be paid to postpartum care because most women tend to succumb to puerperal sepsis. Ethical principles must be upheld when managing women with HIV infection."									
1343	Applying a knowledge-to-action framework for primary prevention of spina bifida in tropical Africa.	"Claude KM, Juvenal KL, Hawkes M."	Maternal & Child Nutrition. 2012;8(2):174-84.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=21062419	"Maternal periconceptual folate supplementation reduces the incidence of neural tube defects; however, in settings where population-level food fortification is not available, it is not clear how best to promote this prevention strategy. Guided by a knowledge-to-action methodology, we used mixed quantitative and qualitative methods to define the local disease burden, then designed, implemented and evaluated a culturally tailored educational intervention in eastern Democratic Republic of Congo, where resource limitations and threats to human security contribute to restricted capacity for the prevention and management of congenital malformations. A descriptive case series of 27 patients undergoing surgery for spina bifida demonstrated a short-term mortality of 15% and long-term disability in survivors. A survey of knowledge, attitudes and practices demonstrated a low level of folate awareness (53%) among women of reproductive age. Focus group discussions revealed exotic aetiologic views, significant gender issues and several barriers to folate use. A culturally tailored radio broadcast and an educational video were designed and produced locally based on qualitative and quantitative findings. Evaluation of the video documented high levels of viewer satisfaction and unequivocal knowledge gain (P <= 0.001). We conclude that spina bifida poses a significant burden on affected patients and their families in the African context, but folate is underutilized as a prevention strategy. Patient education through video media results in increased awareness and understanding of spina bifida and folate, a first step in empowering women to reduce the risk of spina bifida in their children in the absence of population-wide food fortification. 2010 Blackwell Publishing Ltd."									
1163	Maternal weight loss during exclusive breastfeeding is associated with reduced weight and length gain in daughters of hiv-infected malawian women.	"Widen EM, Bentley ME, Kayira D, Chasela CS, Jamieson DJ, Tembo M, Soko A, et al."	Journal of Nutrition. 2013 01 Jul;143(7):1168-75.		"Maternal weight loss during exclusive breastfeeding may influence the growth of exclusively breast-fed infants through impaired quality or quantity of breast milk. This study evaluated how maternal weight loss from 2 to 24 wk postpartum was related to infant weight and length gain in 1309 lactating HIV-infected mothers and their exclusively breast-fed infants. Malawian mother-infant pairs in the Breastfeeding, Antiretrovirals, and Nutrition Study were randomized with a 2x3 factorial design to a 2-arm nutritional intervention with a lipid-based nutrient supplement (LNS), meeting nutritional needs of lactation,or no LNS and a 3-arm antiretroviral (ARV) intervention (maternal, infant, or no ARV regimen). Linear regression models were used to relate maternal weight loss (weight loss vs. no weight loss) to infant weight and length gain from birth to 24 mo, stratifying by gender and controlling for maternal BMI at 2 wk (mean+/-SD: 23.2+/-3.0 kg/m<sup>2</sup>) and interactingmaternal BMI with weight loss. In adjusted models, compared with daughters of women who did not lose weight, length and weight gain were lower in daughters whose mothers had a lower BMI at 2 wk postpartum coupled with the weight loss. For example, amongmothers with an initial BMI of 18 kg/m<sup>2</sup>, daughters of those who lost weight gained less weight [beta = -0.29 kg (95% CI: 20.53, 20.06)] and length [beta = -0.88 cm (95% CI: 21.52, 20.23)] from birth to 24 wk than daughters of those who gained weight. Though effects were only observed in girls, suggesting possible gender differences in suckling and feeding behavior, these findings indicate that maternal weight loss with low energy reserves represents a riskfactor for poor infant growth outcomes. 2013 American Society for Nutrition."									
1162	Maternal weight loss during exclusive breastfeeding is associated with reduced weight and length gain in daughters of HIV-infected Malawian women.	"Widen EM, Bentley ME, Kayira D, Chasela CS, Jamieson DJ, Tembo M, Soko A, et al."	Journal of Nutrition. 2013;143(7):1168-75.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20133239084	"Maternal weight loss during exclusive breastfeeding may influence the growth of exclusively breast-fed infants through impaired quality or quantity of breast milk. This study evaluated how maternal weight loss from 2 to 24 wk postpartum was related to infant weight and length gain in 1309 lactating HIV-infected mothers and their exclusively breast-fed infants. Malawian mother-infant pairs in the Breastfeeding, Antiretrovirals, and Nutrition Study were randomized with a 2x3 factorial design to a 2-arm nutritional intervention with a lipid-based nutrient supplement (LNS), meeting nutritional needs of lactation, or no LNS and a 3-arm antiretroviral (ARV) intervention (maternal, infant, or no ARV regimen). Linear regression models were used to relate maternal weight loss (weight loss vs. no weight loss) to infant weight and length gain from birth to 24 mo, stratifying by gender and controlling for maternal BMI at 2 wk (mean+or-SD: 23.2+or-3.0 kg/m<sup>2</sup>) and interacting maternal BMI with weight loss. In adjusted models, compared with daughters of women who did not lose weight, length and weight gain were lower in daughters whose mothers had a lower BMI at 2 wk postpartum coupled with the weight loss. For example, among mothers with an initial BMI of 18 kg/m<sup>2</sup>, daughters of those who lost weight gained less weight [ beta =-0.29 kg (95% CI: -0.53, -0.06)] and length [ beta =-0.88 cm (95% CI: -1.52, -0.23)] from birth to 24 wk than daughters of those who gained weight. Though effects were only observed in girls, suggesting possible gender differences in suckling and feeding behavior, these findings indicate that maternal weight loss with low energy reserves represents a risk factor for poor infant growth outcomes."									
284	"Serum levels of measles IgG antibody activity in children under 5 years in Dar-es-Salaam, Tanzania."	"Lyamuya EF, Matee MIN, Aaby P, Scheutz F."	Annals of Tropical Paediatrics. 1999 June;19(2):175-83.		"Measles IgG antibody levels were estimated in sera from 685 Tanzanian children, 374 (54.6%) boys and 311 (45.4%) girls aged 18 months to 5 years, using an enzyme-linked immunosorbent assay (ELISA). The children were screened for HIV-1 and 2 antibodies using ELISA, and reactive sera were confirmed by Western blot. Nutritional status was assessed by anthropometry. Overall measles vaccination coverage was 98.8%. Measles antibody activity was not detected in 41 (6.0%) children, and ten (1.5%) had antibody levels below 200 mIU/ml, the cut-off level considered to be protective. The non-reactive samples were from one unvaccinated child, one child with unknown vaccination status and 39 vaccinated children. Measles IgG antibody levels were higher in girls (3452.1 mIU/ml) than in boys (2928.2 mIU/ml) (p = 0.02). Higher mean levels were found in children with a history of low birthweight (< 2.5kg) (p = 0.03). There were no significant differences in measles antibody levels with regard to variations in nutritional status. No correlation (r<sup>2</sup> = 0.002) was found between antibody levels and time elapsed since vaccination. In a multivariable logistic regression analysis, children who were HIV-seropositive (n = 9) were more likely to have non-protective antibody levels < 200 mIU/ml (OR = 5.85; 95% CI: 1.37-24.93)."									
453	Validity of impedance-based predictions of total body water as measured by 2H dilution in African HIV/AIDS outpatients.	"Diouf A, Gartner A, Dossou NI, Sanon DA, Bluck L, Wright A, Wade S."	British Journal of Nutrition. 2009;101(9):1369-77.		"Measurements of body composition are crucial in identifying HIV-infected patients at risk of malnutrition. No information is available on the validity of indirect body composition methods in African HIV-infected outpatients. Our first aim was to test the validity of fifteen published equations, developed in whites, African-Americans and/or Africans who were or not HIV-infected, for predicting total body water (TBW) from bioelectrical impedance analysis (BIA) in HIV-infected patients. The second aim was to develop specific predictive equations. Thirty-four HIV-infected patients without antiretroviral treatment and oedema at the beginning of the study (age 39 (sd 7) years, BMI 18.7 (sd 3.7) kg/m<sup>2</sup>, TBW 30.4 (sd 7.2) kg) were measured at inclusion then 3 and 6 months later. In the resulting eighty-eight measurements, we compared TBW values predicted from BIA to those measured by <sup>2</sup>H dilution. Range of bias values was 0.1-4.3 kg, and errors showed acceptable values (2.2-3.4 kg) for fourteen equations and a high value (10.4) for one equation. Two equations developed in non-HIV-infected subjects showed non-significant bias and could be used in African HIV-infected patients. In the other cases, poor agreement indicated a lack of validity. Specific equations developed from our sample showed a higher precision of TBW prediction when using resistance at 1000 kHz (1.7 kg) than at 50 kHz (2.3 kg), this latter precision being similar to that of the valid published equations (2.3 and 2.8 kg). The valid published or developed predictive equations should be cross-validated in large independent samples of African HIV-infected patients."									
1389	Aspects of blood transfusion in Djibouti. [French]	Aspects de la transfusion sanguine a Djibouti.	"Massenet D, Bouh A."		Medecine tropicale : revue du Corps de sante colonial. 1997;57(2):202-5.									
1388	Reduction of mother-child transmission of HIV infection in Africa: from clinical research to public health programs. [French]	Reduction de la transmission mere-enfant du VIH en Afrique: de la recherche clinique aux programmes de sante publique.	"Leroy V, Dabis F."		Medecine tropicale : revue du Corps de sante colonial. 1999;59(4 Pt 2):456-64.									
1375	Medical conditions in pregnancy.	"Webber R, McCaw-Binns A, Hussein J."	Maternal and perinatal health in developing countries. 2012.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20123188920	"Medical conditions can have a major effect on the woman before, during and after pregnancy, some of which have particular importance to her offspring. The conditions are often exacerbated by pregnancy. Infectious conditions are common in developing country settings, with antenatal care providing an opportunity for detection of many conditions: * Human immunodeficiency virus (HIV) infection affects a woman's chance of surviving pregnancy. The condition can be transmitted to her offspring. * Sexually transmissible infections cause infertility and damage to the fetus. * While the mother's immunity is compromised during pregnancy, she is at risk from varicella, influenza and malaria and may transmit congenital infections to the fetus - syphilis, genital herpes, rubella, toxoplasmosis, cytomegalovirus, listerosis and parvovirus B19. Chronic and non-communicable medical conditions may be identified for the first time in pregnancy and include: * Nutritional deficiencies such as anaemia, other micronutrients and caloric restrictions. * Circulatory disorders, such as heart disease, chronic hypertension. * Gestational, Type I or Type II diabetes. * Haematological conditions such as sickle cell anaemia and thalassaemia, which have implications for the long-term health of offspring if both parents carry the trait and for the health of the mother if she is homozygous for the condition. The management of medical conditions in pregnancy can be categorized in the following stages: * Preconceptually, couples planning to have children should be educated about immunization, improving diet and general health. * Antenatal care provides the opportunity to diagnose, manage and treat HIV, sexually transmitted infections, anaemia and other pre-existing medical conditions such as sickle cell disease, thalassaemia, heart disease and diabetes, to limit the effect of these problems. * Childbirth can be stressful physiologically. Acute management of conditions such as anaemia, diabetes and heart conditions may be necessary. Hygienic practices and HIV prophylaxis are also important. * Postpartum management of infant feeding will reduce HIV transmission, and use of insecticidetreated nets by the mother and child will contribute to preventing the consequences of malaria. Longterm management of medical conditions after pregnancy and planning for the next pregnancy are necessary."									
1396	Lipodystrophy syndrome in HIV-infected patients with antirretroviral therapy. [Spanish]	Sindrome de lipodistrofia en pacientes con infeccion por VIH que reciben tratamiento antirretroviral.	"Castro Sansores C, Rivero AS, Rendon JCS, Rodriguez ID, Biachi RG, Martinez PG."		Medicina Interna de Mexico. 2008 January/February;24(1):8-15.									
143	Independent predictors of metabolic syndrome in HIV-infected patients.	"Alencastro PR, Fuchs SC, Wolff FH, Ikeda ML, Brandao ABM, Barcellos NT."	AIDS Patient Care and STDs. 2011 01 Nov;25(11):627-34.		"Metabolic syndrome (MetS) is associated with development of type 2 diabetes mellitus and increased risk for cardiovascular disease. However, a few studies have assessed its prevalence and risk factors among HIV patients from developing countries. The aim of this study was to identify independent risk factors for metabolic syndrome by the criteria of the American Heart Association/National Heart, Lung, and Blood Institute (AHA/NHLBI) among HIV-infected men and women. A cross-sectional study enrolled patients, aged 18 years or older, who sought to confirm the diagnosis or sought treatment in the outpatient service of a public health care center in southern Brazil. From June 2006 to December 2008, certified research assistants conducted interviews using standardized questionnaires and anthropometric measurements. Fasting blood sample was collected, use of highly active antiretroviral therapy (HAART) was ascertained, and MetS was characterized by AHA/NHLBI criteria. In the total, 1240 of 1295 HIV-infected patients were included. MetS prevalence was 24.7% and was similar among men and women. Among men, age, education, physical activity, body mass index (BMI), and HAART use were independently associated with MetS, while among women, there were associations with age, BMI, and use of protease inhibitors. In conclusion, high prevalence of MetS was detected in HIV-infected men and women. In both genders, age and BMI were directly and independently associated with MetS. The association between the use of HAART and MetS was confirmed among men but not among women. 2011, Mary Ann Liebert, Inc."									
135	Independent Predictors of Metabolic Syndrome in HIV-Infected Patients.	"Alencastro PR, Fuchs SC, Wolff FH, Ikeda ML, M, Barcellos NT."	AIDS Patient Care & STDs. 2011;25(11):627-34.	http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=2011324963&site=ehost-live	"Metabolic syndrome (MetS) is associated with development of type 2 diabetes mellitus and increased risk for cardiovascular disease. However, a few studies have assessed its prevalence and risk factors among HIV patients from developing countries. The aim of this study was to identify independent risk factors for metabolic syndrome by the criteria of the American Heart Association/National Heart, Lung, and Blood Institute (AHA/NHLBI) among HIV-infected men and women. A cross-sectional study enrolled patients, aged 18 years or older, who sought to confirm the diagnosis or sought treatment in the outpatient service of a public health care center in southern Brazil. From June 2006 to December 2008, certified research assistants conducted interviews using standardized questionnaires and anthropometric measurements. Fasting blood sample was collected, use of highly active antiretroviral therapy (HAART) was ascertained, and MetS was characterized by AHA/NHLBI criteria. In the total, 1240 of 1295 HIV-infected patients were included. MetS prevalence was 24.7% and was similar among men and women. Among men, age, education, physical activity, body mass index (BMI), and HAART use were independently associated with MetS, while among women, there were associations with age, BMI, and use of protease inhibitors. In conclusion, high prevalence of MetS was detected in HIV-infected men and women. In both genders, age and BMI were directly and independently associated with MetS. The association between the use of HAART and MetS was confirmed among men but not among women."									
1986	Serum retinol-binding protein-4 levels are increased in HIV-infected subjects with metabolic syndrome receiving highly active antiretroviral therapy.	"Jeong S, Chin B, Chae Y, Jin S, Ku N, Baek J, Han S, et al."	Yonsei Medical Journal. 2012;53(6):1211-5.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20123383356	"Metabolic syndrome is an important long term complication in chronic asymptomatic HIV-infected subjects under highly active antiretroviral therapy (HAART), because it can contribute to morbidity and mortality via cardiovascular disease (CVD). Therefore, a predictive marker for early detection of metabolic syndrome may be necessary to prevent CVD in HIV-infected subjects. Retinol-binding protein-4 (RBP-4) has been shown to be associated with metabolic syndrome in various non-HIV-infected populations. We performed a cross-sectional study to evaluate whether serum RBP-4 levels are correlated with metabolic syndrome in HIV-infected subjects receiving HAART. In total, 98 HIV-infected Koreans who had been receiving HAART for at least 6 months were prospectively enrolled. Metabolic syndrome was diagnosed according to the Adult Treatment Panel III criteria, and serum RBP-4 concentrations were measured using human RBP-4 sandwich enzyme-linked immunosorbent assay. Serum RBP-4 levels were significantly higher in HIV-infected subjects receiving HAART with metabolic syndrome (n=33, 33.9+or-7.7 micro g/mL) than in those without it (n=65, 29.9+or-7.2 micro g/mL) (p=0.012). In multivariate linear regression analysis, the number of components of metabolic syndrome presented and waist circumference were independently, significantly correlated with RBP-4 (p=0.018 and 0.030, respectively). In conclusion, we revealed a strong correlation between RBP-4 and the number of components of metabolic syndrome in HIV-infected subjects receiving HAART."									
1383	[Reduction of mother-child transmission of HIV infection in Africa: from clinical research to public health programs].	"Leroy V, Dabis F."	Medecine Tropicale. 1999;59(4 Pt 2):456-64.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=10901847	"More and more African women are infected by HIV. As a result the mother-to-child transmission (MCT) rate is rising. Various prevention techniques have been assessed in randomized clinical trials in Africa but results need to be discussed to understand the full implications for prevention programs. To gain insight into this issue, we reviewed 11 randomized trials conducted in Africa and several other studies from developed countries. Trials using antiretroviral (ARV) drugs demonstrated good results for prevention of MCT in the first six months of life using abbreviated regimens involving either zidovudine (with or without lamivudine) or nevirapine alone. Preliminary results suggest long-term effectiveness of zidovudine. Antiseptic and nutritional interventions have demonstrated some efficacy in reducing maternal and newborn morbidity and mortality but have no effect on MCT rate. Confidential, voluntary HIV screening and counseling of pregnant women and short-course ARV treatment during the perinatal period associated with alternatives to breast-feeding such as early weaning or replacement of breast milk at birth are now the best methods to reduce MCT. Prevention of postnatal transmission will require further study in particular with regard to effects of different methods of feeding and post-exposure prophylaxis using ARV drugs in newborns. Management of HIV-infected children must remain a high priority. Implementation of currently available strategies is now under discussion. [References: 66]"									
1280	Where and why are 10 million children dying every year?	"Black RE, Morris SS, Bryce J."	Lancet. 2003 28 Jun;361(9376):2226-34.		"More than 10 million children die each year, most from preventable causes and almost all in poor countries. Six countries account for 50% of worldwide deaths in children younger than 5 years, and 42 countries for 90%. The causes of death differ substantially from one country to another, highlighting the need to expand understanding of child health epidemiology at a country level rather than in geopolitical regions. Other key issues include the importance of undernutrition as an underlying cause of child deaths associated with infectious diseases, the effects of multiple concurrent illnesses, and recognition that pneumonia and diarrhoea remain the diseases that are most often associated with child deaths. A better understanding of child health epidemiology could contribute to more effective approaches to saving children's lives."									
203	Severe malnutrition and metabolic complications of HIV-infected children in the antiretroviral era: clinical care and management in resource-limited settings.	"Musoke PM, Fergusson P."	American Journal of Clinical Nutrition. 2011;94(6):1716S-20.	http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=2011386348&site=ehost-live	"More than 2 million children globally are living with HIV infection and >90% of these reside in sub-Saharan Africa. Severe acute malnutrition (SAM) remains a major problem for HIV-infected children who live in resource-limited settings (RLS), and SAM is an important risk factor for mortality. SAM in HIV-infected children is associated with complications including electrolyte disorders, micronutrient deficiencies, and severe infections, which contribute to the high mortality. Access to antiretroviral therapy (ART) has significantly improved the survival of HIV-infected children, although the response to ART of children with SAM remains undocumented in the literature. Immune and virologic responses to ART in RLS are similar to those of infected children in resource-rich settings, but delays in initiation of therapy have led to a high early mortality. Antiretroviral drug toxicities have been described in children who receive therapy and may affect their quality of life and long-term survival. Metabolic complications of ART include lipodystrophy, dyslipidemia, lactic acidosis, insulin resistance, and osteopenia. These complications have been well described in adults and children from developed countries, but data from RLS are limited, and these complications may be compounded by SAM. In this article we review the epidemiology, clinical presentation, and complications of SAM in HIV-infected children and the metabolic complications of HIV-infected children in the era of ART, and discuss future research priorities for RLS."									
1522	Care and treatment of HIV-infected children in Africa: issues and challenges at the district hospital level.	"Baets AJd, Bulterys M, Abrams EJ, Kankassa C, Pazvakavambwa IE."	Pediatric Infectious Disease Journal. 2007;26(2):163-73.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20073066202	"More than 90% of paediatric HIV infection occurs in sub-Saharan Africa and 75% of these children currently die before their fifth birthday. Most HIV-infected children in Africa rely on district hospitals for HIV treatment, but insufficient attention has been paid to improving HIV/AIDS care at this level. Considerable confusion exists about optimal use of combination antiretroviral treatment, prophylaxis for opportunistic infections and other rational healthcare interventions that can greatly improve the quality of life for these children. A simple and inexpensive infant HIV diagnostic assay and alternative laboratory markers of paediatric HIV disease progression would be highly beneficial. Routine anthropometric and neurodevelopmental assessments could help guide initiation and monitoring of antiretroviral therapy. Even in the absence of antiretroviral therapy, interventions such as immunizations, provision of micronutrients and nutrition counselling, prevention and treatment of opportunistic as well as endemic infections (such as helminths and malaria) can substantially reduce paediatric HIV-related morbidity and mortality. The need for pain relief, palliative care, counselling and emotional support is often underestimated. Surmounting the sense of hopelessness by providing district healthcare workers with training in basic paediatric HIV/AIDS care is an urgent priority."									
1525	Care and treatment of HIV-infected children in Africa: issues and challenges at the district hospital level.	"De Baets AJ, Bulterys M, Abrams EJ, Kankassa C, Pazvakavambwa IE."	Pediatric Infectious Disease Journal. 2007;26(2):163-73.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=17259881	"More than 90% of pediatric HIV infection occurs in sub-Saharan Africa and 75% of these children currently die before their fifth birthday. Most HIV-infected children in Africa rely on district hospitals for HIV treatment, but insufficient attention has been paid to improving HIV/AIDS care at this level. Considerable confusion exists about optimal use of combination antiretroviral treatment, prophylaxis for opportunistic infections and other rational healthcare interventions that can greatly improve the quality of life for these children. A simple and inexpensive infant HIV diagnostic assay and alternative laboratory markers of pediatric HIV disease progression would be highly beneficial. Routine anthropometric and neurodevelopmental assessments could help guide initiation and monitoring of antiretroviral therapy. Even in the absence of antiretroviral therapy, interventions such as immunizations, provision of micronutrients and nutrition counseling, prevention and treatment of opportunistic as well as endemic infections (such as helminths and malaria) can substantially reduce pediatric HIV-related morbidity and mortality. The need for pain relief, palliative care, counseling and emotional support is often underestimated. Surmounting the sense of hopelessness by providing district healthcare workers with training in basic pediatric HIV/AIDS care is an urgent priority. [References: 108]"									
47	Effect of Moringa oleifera Lam. leaves powder on the evolution of hemogram profile in Togolese undernourished children: evaluation on HIV-positive patients.	"Tete-Benissan A, Lawson-Evi KA, Kokou K, Gbeassor M."	"African Journal of Food, Agriculture, Nutrition and Development. 2012;12(2):6007-26."	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20123142071	"Moringa oleifera Lam. (Moringaceae) leaves have exceptional nutritional qualities and they are used against malnutrition in Africa and Asia. The deficiency corrected by M. oleifera leaves powder administration into daily meal of HIV positive and negative patients has been determined during 14 weeks nutritional recovery by measuring their weight, height and carried hemogram analysis. The study population included infants (20 HIV-positive and 21 HIV-negative) aged from 12 to 30 months and children (26 HIV-positive and 20 HIV-negative) aged 30 months to 9 years. The patients, male and female had anemia or low BMI (body mass index). Results showed that M. oleifera use increased significantly BMI (p<0,0001). Weight varied from 1,5 to 2kg and height from 1,8 to 4 cm on the patients. On pilot subjects, variations were very low (p<0,05). The increase in BMI was significantly different for patients on antiretroviral (ARV) therapy (p<0,0001) compared to patients without ARV (p<.0,001). Hemogram analysis revealed that M. oleifera consumption allowed significant increase (p<=0,001) of red blood cell (RBC), hemoglobin (HB), hematocrit (HCT) mean cell volume (MCV), mean cell hemoglobin concentration (MCHC) and (p<=0,01) for mean cellular hemoglobin concentration (CHCM) values. On the other hand, white blood cell parameters were not significantly modified. Hypochromic anemia decreased from 40% to 84% while microcytic anemia decreased from 30% to 84%. On pilot subjects, hemogram parameters did not significantly vary. M. oleifera leaf powder would correct moderate hypochromic anemia better than normochromic anemia whose etiology is folate and vitamin B12 deficit. In addition, these results showed that using M. oleifera alone could not correct inflammatory status by reduction of infections on patients. Despite phytates in their leaves, M. oleifera powder can be regarded as nutritional supplement and would allow improvement of nutritional status, accelerate immunological recovery and also reinforce the effectiveness of antiretroviral (ARV) drugs on HIV/AIDS patients. Consuming only M. oleifera leaves powder, despite its exceptional nutritional benefit, is not a miracle cure. These leaves are neither a drug nor a substitute for antiretroviral drugs."									
1134	Nutrition among older adults in Africa: the situation at the beginning of the millenium.	"Charlton KE, Rose D."	Journal of Nutrition. 2001;131(9):2424S-8S.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=11533288	"Most Africans enter old age after a lifetime of poverty and deprivation, poor access to health care and a diet that is usually inadequate in quantity and quality. However, nutrition interventions in African countries are directed primarily toward infants and young children, as well as pregnant and lactating women. This situational analysis focuses on two key areas to identify priorities for future research and policy development: the nutritional status of older Africans and determinants of undernutrition. Based on the scant evidence available, the prevalence of undernutrition is high in older African men (9.5-36.1%) and women (13.1-27%); however, in some urban areas there is evidence that older adults are experiencing the nutrition transition. Information on micronutrient status is sparse, yet it appears that anemia related to suboptimal folate status is a particular problem. Important determinants of poor nutritional status in the elderly in the African context include inadequate household food security, war and famine, and the indirect impact of HIV infection and AIDS. The rapidly increasing size of the older population, combined with their increased burden of care-giving responsibilities and severe socioeconomic hardship, indicates an urgent need for increased attention to this group, including applied research on nutrition problems and the development and evaluation of nutrition interventions. [References: 33]"									
1885	Antenatal and perinatal strategies to prevent mother-to-child transmission of HIV infection.	Newell ML.	Transactions of the Royal Society of Tropical Medicine & Hygiene. 2003;97(1):22-4.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=12886799	"Mother-to-child transmission (MTCT) is the dominant mode of acquisition of HIV infection for children. Each day an estimated 1600 children born to HIV-infected mothers become infected, 1500 of whom are in sub-Saharan Africa. Mother-to-child transmission can occur before, during and after delivery; overall rates of MTCT range from 15 to 35%. Risk factors for MTCT include maternal viral load levels, vaginal delivery, prematurity and breastfeeding. Approaches to reduce the risk of MTCT include reduction of maternal viral load through antiretroviral prophylaxis, avoidance of exposure through birth canal cleansing or elective caesarean section delivery and refraining from breastfeeding, and boosting the host immune system through nutritional supplementation or immunization. Substantial reductions in the risk of MTCT can be achieved with antiretroviral prophylaxis during pregnancy, delivery and in the neonatal period, both in settings with and without breastfeeding. Elective caesarean section independently decreases the risk, but is not a safe and feasible option in most high prevalence areas. Birth canal cleansing with chlorhexidine does not reduce the rate overall, but may be beneficial in a subgroup of women with prolonged duration of ruptured membranes. Micronutrient supplementation, including vitamin A, does not reduce MTCT of HIV, but may improve pregnancy outcome generally."									
4	"Culture-specific influences on exclusive breastfeeding among HIV-positive mothers in Blantyre, Malawi."	Kafulafula UK. 			"Mother-to-child transmission (MTCT) of HIV accounts for 90% of all HIV infections in children in Malawi. Replacement feeding (feeding a breast milk substitute to an infant who is not receiving any breast milk) is not an option for most of the HIV-positive mothers in Malawi because of poverty. For those who might access infant formula, the risk of infant morbidity and mortality from diarrhea and other infections is high owing to inadequate availability of safe water and containers for feeding the infants that are easily contaminated. Although not the norm in Malawi, exclusive breastfeeding (EBF) is a better and safer option for infants and is recommended by World Health Organization (WHO). This mixed methods study sought to explore salient culture-specific external influences on EBF, EBF beliefs, intentions and behaviors among HIV-positive mothers in Blantyre, Malawi. Framed within the Theory of Planned Behavior (TPB), (1) The qualitative component utilizing focus group discussions and in-depth interviews with a purposive sample consisting of 16 HIV-positive mothers (18-35 years old), 5 nurse-midwives (25-55 years old), and 11 adult women (30-55 years old). Semi-structured and piloted focus group and in-depth interview guides were used to collect data which were analyzed through thematic content analysis. The identified themes were organized according to the main concepts of the Theory of Planned Behavior to identify key behavioral, normative and control beliefs associated with exclusive breastfeeding. (2) The quantitative component utilized face-to-face surveys to collect data at baseline and at 12 weeks postnatal from a convenience sample of 110 HIV-positive women (18-41 years) who were at least 36 weeks pregnant at baseline. The adapted and piloted Breastfeeding Attrition Prediction Tool (BAPT) was used to measure the participants' culture-specific EBF beliefs, intentions and external salient influences at baseline. Actual duration of EBF was measured at the 12-week postnatal follow-up. Descriptive and association statistics were used to analyze data. Additionally, multiple regressions were used to determine significant predictors of EBF prenatal intentions and the actual EBF duration at 12 weeks postnatal. The findings revealed high EBF prenatal intentions among HIV-positive mothers. Among others, lack of money for purchasing baby formula, promoting the well-being of the baby, preventing MTCT of HIV, being expected to do so and concealing one's HIV status were reasons for intending to breastfeed the baby. More positive than negative EBF beliefs emerged from the study. Key normative referents of EBF included husbands, mothers, mothers-in-law, sisters, doctors and nurses. Maternal diet, maternal health, and postnatal sex and sexual abstinence were some of the themes of factors that would make EBF easier or harder for HIV-positive mothers. EBF prenatal intentions were positively associated with parity (p < .05), normative (p < .05) and control beliefs (p < .01), and negatively associated with high maternal education (p < .001), disclosure of HIV status (p <.05) and positive EBF beliefs (p < .05). Actual EBF duration at 12 weeks postnatal was positively associated with parity (p < .05) and previous experience of EBF (p < .05), and negatively associated with high maternal education (p < .01) and late timing of decision to breastfeed (p <.05). High maternal education (p <.001), positive EBF beliefs (p < .01) and EBF control beliefs (p < .001) were significant predictors of EBF prenatal intentions, while parity (p < .05), previous EBF experience (p < .05) and maternal education (p < .05) were significant predictors of actual EBF duration at 12 weeks postnatal. The rate of EBF at 12 weeks postnatal was 83.6%. Copies of dissertations may be obtained by addressing your request to ProQuest, 789 E. Eisenhower Parkway, P.O. Box 1346, Ann Arbor, MI 48106-1346. Telephone 1-800-521-3042; e-mail: disspub@umi.com"									
5	"Culture-specific influences on exclusive breastfeeding among HIV-positive mothers in Blantyre, Malawi."	Kafulafula UK. 			"Mother-to-child transmission (MTCT) of HIV accounts for 90% of all HIV infections in children in Malawi. Replacement feeding (feeding a breast milk substitute to an infant who is not receiving any breast milk) is not an option for most of the HIV-positive mothers in Malawi because of poverty. For those who might access infant formula, the risk of infant morbidity and mortality from diarrhea and other infections is high owing to inadequate availability of safe water and containers for feeding the infants that are easily contaminated. Although not the norm in Malawi, exclusive breastfeeding (EBF) is a better and safer option for infants and is recommended by World Health Organization (WHO). This mixed methods study sought to explore salient culture-specific external influences on EBF, EBF beliefs, intentions and behaviors among HIV-positive mothers in Blantyre, Malawi. Framed within the Theory of Planned Behavior (TPB), (1) The qualitative component utilizing focus group discussions and in-depth interviews with a purposive sample consisting of 16 HIV-positive mothers (18-35 years old), 5 nurse-midwives (25-55 years old), and 11 adult women (30-55 years old). Semi-structured and piloted focus group and in-depth interview guides were used to collect data which were analyzed through thematic content analysis. The identified themes were organized according to the main concepts of the Theory of Planned Behavior to identify key behavioral, normative and control beliefs associated with exclusive breastfeeding. (2) The quantitative component utilized face-to-face surveys to collect data at baseline and at 12 weeks postnatal from a convenience sample of 110 HIV-positive women (18-41 years) who were at least 36 weeks pregnant at baseline. The adapted and piloted Breastfeeding Attrition Prediction Tool (BAPT) was used to measure the participants' culture-specific EBF beliefs, intentions and external salient influences at baseline. Actual duration of EBF was measured at the 12-week postnatal follow-up. Descriptive and association statistics were used to analyze data. Additionally, multiple regressions were used to determine significant predictors of EBF prenatal intentions and the actual EBF duration at 12 weeks postnatal. The findings revealed high EBF prenatal intentions among HIV-positive mothers. Among others, lack of money for purchasing baby formula, promoting the well-being of the baby, preventing MTCT of HIV, being expected to do so and concealing one's HIV status were reasons for intending to breastfeed the baby. More positive than negative EBF beliefs emerged from the study. Key normative referents of EBF included husbands, mothers, mothers-in-law, sisters, doctors and nurses. Maternal diet, maternal health, and postnatal sex and sexual abstinence were some of the themes of factors that would make EBF easier or harder for HIV-positive mothers. EBF prenatal intentions were positively associated with parity (p < .05), normative (p < .05) and control beliefs (p < .01), and negatively associated with high maternal education (p < .001), disclosure of HIV status (p <.05) and positive EBF beliefs (p < .05). Actual EBF duration at 12 weeks postnatal was positively associated with parity (p < .05) and previous experience of EBF (p < .05), and negatively associated with high maternal education (p < .01) and late timing of decision to breastfeed (p <.05). High maternal education (p <.001), positive EBF beliefs (p < .01) and EBF control beliefs (p < .001) were significant predictors of EBF prenatal intentions, while parity (p < .05), previous EBF experience (p < .05) and maternal education (p < .05) were significant predictors of actual EBF duration at 12 weeks postnatal. The rate of EBF at 12 weeks postnatal was 83.6%. Copies of dissertations may be obtained by addressing your request to ProQuest, 789 E. Eisenhower Parkway, P.O. Box 1346, Ann Arbor, MI 48106-1346. Telephone 1-800-521-3042; e-mail: disspub@umi.com"									
113	"Stress Biomarkers as Outcomes for HIV+ Prevention: Participation, Feasibility and Findings Among HIV+ Latina and African American Mothers."	"Glover DA, Garcia-Aracena EF, Lester P, Rice E, Rothram-Borus MJ."	AIDS and Behavior. 2010 Apr 2010;14(2):339-50.	http://search.proquest.com/docview/809576276?accountid=26724	"Mothers living with HIV (MLH) are at high risk for acute and chronic stress, given challenges related to their HIV status, ethnicity, economic and urban living conditions. Biomarkers combined into a composite index show promise in quantifying psychosocial stress in healthy people, but have not yet been examined among MLH. According, we examined potential biomarker correlates of stress [cortisol and catecholamines from home-collected urine and basic health indicators (blood pressure, height and weight, waist-to-hip ratio) measured during an interview] among 100 poor African American and Latina mothers MLH and demographic-matched control mothers without HIV (n=50). Participants had been enrolled in a randomized controlled trial about 18months earlier and had either received (MLH-I) or were awaiting (MLH-W) the psychosocial intervention. Participation was high, biomarkers were correctly collected for 93% of cases, and a complete composite biomarker index (CBI) calculated for 133 mothers (mean age=42). As predicted, MLH had a significantly higher CBI than controls, but there was no CBI difference across ethnicity or intervention group. CBI predicted CD4 counts independently after controlling for age, years since diagnosis, prior CD4 counts, medication adherence, and depression symptoms. The study demonstrates acceptability, feasibility and potential utility of community-based biomarker collections in evaluating individual differences in psychosocial stress."									
35	Poor-quality health services and lack of programme support leads to low uptake of HIV testing in rural Mozambique.	"Audet CM, Groh K, Moon TD, Vermund SH, Sidat M."	African Journal of AIDS Research. 2012;11(4):327-35.		"Mozambique has one of the world's highest burdens of HIV infection. Despite the increase in HIV-testing services throughout the country, the uptake has been low. To identify barriers to HIV testing we conducted a study in six rural districts in Zambezia Province. We recruited a total of 124 men and women from the community through purposeful sampling to participate in gender-specific focus group discussions about barriers to HIV testing. The participants noted three main barriers to HIV testing: 1) poor conduct by clinicians, including intentional disclosure of patients' HIV status to other community members; 2) unintentional disclosure of patients' HIV status through clinical practices; and, 3) a widespread fatalistic belief that HIV infection will result in death, particularly given poor access to adequate food. Improving quality and confidentiality within clinical service delivery, coupled with the introduction of food-supplement programmes should increase people's willingness to test and remain in care for HIV disease. Copyright NISC (Pty) Ltd."									
1398	Aspects of gastrointestinal immunology and nutrition in human immunodeficiency virus-1 infection in Brazil.	"Castello-Branco LR, Ortigao-de-Sampaio MB."	Memorias do Instituto Oswaldo Cruz. 2000;95 Suppl 1:171-3.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=11142709	"Mucosal surfaces have a fundamental participation in many aspects of the human immunodeficiency virus (HIV) infection pathogenesis. In Brazilian HIV-1 infected subjects, loss of weight and appetite are among the most debilitating symptoms. In this review we describe a defined mucosal immunogen that has profound but transient effects on HIV viral load, and we suggest that gut associated lymphoid tissue under constant immunostimulation is likely to provide a major contribution to the total levels of HIV. We also show that hypermetabolism appears to play a role in the wasting process in Brazilian patients coinfected with HIV and tuberculosis. [References: 19]"									
1406	Multidrug-resistant tuberculosis in an HIV-infected girl.	"Shah I, Mohanty S."	National Medical Journal of India. 2012 July/August;25(4):210-1.		"Multidrug-resistant tuberculosis (MDR-TB) in patients with human immunodeficiency virus (HIV) infection poses multiple challenges for treatment, and has a high mortality. MDR-TB coinfection with HIV has been reported in African children. In India, we did not come across any report of HIV and MDR-TB coinfection in children, though such coinfection has been reported in adults. A 9-year-old HIV-infected girl requiring antiretroviral therapy (ART) developed MDR-TB and responded to second-line antituberculous therapy. The National Medical Journal of India 2012."									
1236	Use of Dual-Energy X-Ray Absorptiometry (DXA) Scans in HIV-Infected Patients.	"Dickinson SA, Fantry LE."	Journal of the International Association of Physicians in AIDS Care (JIAPAC). 2012 Aug 2012;11(4):239-44.	http://search.proquest.com/docview/1222846097?accountid=26724	"Multiple studies have demonstrated increased rates of osteopenia and osteoporosis in HIV-infected patients but there have been no published studies on current screening practices. We conducted a retrospective chart review of 2924 patients attending an urban HIV clinic. Thirty patients (1%) had dual-energy x-ray absorptiometry (DXA) scans. Patients undergoing DXA scans were more likely to be older, women, and have nondetectable HIV viral load and CD4 count greater than or equal to 200. The most frequently cited indications for screening were perimenopausal or postmenopausal status and HIV infection. Of the patients screened, 96% had osteopenia or osteoporosis with a median T-score of -1.9 and a median of 3.8 osteoporosis risk factors in addition to HIV. Of the 20 practitioners in the clinic, only 7 had patients with screening DXA scans. DXA scans are underutilized in the HIV population given the high rate of osteopenia and osteoporosis detected in this study."									
713	"Differences between tuberculosis cases infected with Mycobacterium africanum, West African type 2, relative to Euro-American Mycobacterium tuberculosis: an update."	"de Jong BC, Adetifa I, Walther B, Hill PC, Antonio M, Ota M, Adegbola RA."	FEMS Immunology & Medical Microbiology. 2010;58(1):102-5.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=20002176	"Mycobacterium africanum (MAF) is a common cause of human pulmonary tuberculosis in West Africa. We previously described phenotypic differences between MAF and Mycobacterium tuberculosis (MTB) among 290 patients. In the present analysis, we compared 692 tuberculosis patients infected with the two most common lineages within the (MTB) complex found in the Gambia, namely MAF West African type 2 (39% prevalence) and Euro-American MTB (55% prevalence). We identified additional phenotypic differences between infections with these two organisms. MAF patients were more likely to be older and HIV infected. In addition, they had worse disease on chest X-ray, despite complaining of cough for an equal duration, and were more likely severely malnourished. In this cohort, the prevalence of MAF did not change significantly over a 7-year period."									
52	People living with HIV/AIDS and the utilization of home-based care services.	"Oguntibeju OO, Ndalambo KT, Mokgatle-Nthabu M."	African Journal of Microbiology Research. 2011;5(20):3166-74.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20123058562	"Namibia is one of the most affected countries by human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) epidemic in the world and in the sub-Saharan Africa with an adult prevalence of 19.7%. The health care services are overstrained with patients and home-based care (HBC) is seen as a possible solution to the overstrained health care services in Namibia and this challenge impact on the quality of care on people living with HIV/AIDS (PLWHA) receive. This study assessed the utilization of HBC service, knowledge and perceptions of PLWHA toward HBC services. This is a qualitative study that utilized focus group discussions (FGDs) for the home-based caregivers of the HBC and in-depth interview with HIV/AIDS patients accessing antiretroviral treatment (ART) at Katima State Hospital, Namibia. A total of 4 FGDs were organized with caregivers comprising 31 adult participants (15 male and 16 female) and 18 in-depth interviews were conducted for PLWHA patients ART at Katima State Hospital. All FGDs were tape recorded and one-to-one interview was hand-written. The study demonstrates that most of the participants have positive attitudes toward utilization of HBC service. However, few participants are still afraid to disclose their health status. In general, the community participation has tremendously reduced stigmatization. The access by HBC to nutrition support possibly played a role in reducing the stigma associated with HIV and has increased the number of people utilizing the HBC service. The HIV-positive participants valued the assistance received from the HBC volunteer caregivers and dressing code of volunteers did not influence participant's attitude to access the HBC service. Knowledge about HIV and HBC service enhanced the positive attitude towards the utilization of HBC service which consequently reduced the stigma associated with HIV infection."									
465	Nutrition and maternal morbidity and mortality.	Tomkins A.	British Journal of Nutrition. 2001;85 Suppl 2:S93-9.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=11509096	"Nearly 600 000 women die every year from pregnancy related conditions and the maternal mortality rates (MMR = deaths per 100 000 live births) in developing countries may be as high as 1000 compared with less than ten in industrialised countries. In the light of the striking impact of deficiencies of micronutrients such as vitamin A and zinc on immune function, morbidity and mortality in children it seems reasonable to suggest that such deficiencies might play a contributing role in the high rates of morbidity and mortality in mothers. Hitherto, there has been rather little published on the contribution of malnutrition to maternal morbidity or mortality but recent results of micronutrient supplementation show a major effect of vitamin A or beta carotene supplementation on maternal mortality in Nepal and an impressive effect of a multiple micronutrient mixture on pregnancy outcome in Tanzania. There is now data showing that subclinical mastitis, a potential risk factor for mother to child transmission of HIV by increasing levels of virus in breast milk, is influenced by maternal diet in Tanzania and feeding patterns in South Africa. Considering the massive tragedy of maternal mortality the recent data provides opportunities for new, innovative nutritional interventions for the reduction of the global burden of maternal morbidity and mortality. [References: 57]"									
1411	"[Epidemiology of chronic kidney disease in the Democratic Republic of Congo: review of cross-sectional studies from Kinshasa, the capital]. [French]"	"Epidemiologie de la maladie renale chronique en Republique democratique du Congo : une revue synthetique des etudes de Kinshasa, la capitale."	"Sumaili EK, Krzesinski JM, Cohen EP, Nseka NM."		Nephrologie & therapeutique. 2010 Jul;6(4):232-9.									
23	Mini mental state Examination and evaluation of factors associated with cognitive decline in HIV/AIDS-infected people	"Sereia AL, Junior MS, Domiciano TP, Shimauti E, Pupulin ART."	Acta Scientiarum - Health Sciences. 2012;34(2):193-8.		"Neuropsychiatric complications are present in almost one third of patients diagnosed with AIDS who show wide variations in their clinical symptoms, featuring a spectrum of disorders ranging from minor cognitive-motor impairments to profound dementia. The Mini Mental State Examination (MMSE) is one of the most used and studied cognitive tests around the world and evaluates cognitive function and screening of dementia. Current experiment applies the MMSE to HIV/AIDS patients to screen possible dementia factors in the sample and to evaluate the association of scores that are positively associated with the emergence of cognitive impairment and possible dementia. The study population consisted of 100 HIV/AIDS patients attended at the 15<sup>th</sup> and 17<sup>th</sup> Regional Health Centers covering 50 municipalities in the northwestern region of the state of Parana, Brazil. Whereas patients were classified with cognitive impairment and patients without cognitive impairment, the factors assessed included depression, body mass index, haematocrit, hemoglobin levels, rate of lymphocytes T CD4+, viral load and gender. Twenty-seven (27%) patients had scores lower than expected and were considered cognitively impaired. There was a significant positive association between cognitive impairment and changes in blood hemoglobin and haematocrit, age and depression."									
147	Effect of different antiretroviral drug regimens on body fat distribution of HIV-infected South African women.	"Goedecke JH, Micklesfield LK, Levitt NS, Lambert EV, West S, Maartens G, Dave JA."	AIDS Research & Human Retroviruses. 2013;29(3):557-63.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=mesx&AN=23330599	"No African studies have examined the effect of first-line nonnucleoside reverse transcriptase inhibitor (NNRTI)-based and second-line protease inhibitor (PI)-based antiretroviral therapy (ART) on body composition. We compared body composition in HIV-infected black South African women receiving NNRTI-based ART (ART1, n=344), PI-based ART (ART2, n=91), and those not on ART (ART-naive, n=309). Accordingly, body composition was measured using dual energy x-ray absorptiometry (DXA) and anthropometry in a cross-sectional study. Despite similar body mass index (BMI), ART1 and ART2 had greater central fat mass (FM) [median (IQR): 44.2 (39.4-50.1) and 46.9 (39.3-52.8) vs. 41.1 (36.3-45.2) %FM, p<0.01] and less leg FM [41.2 (34.8-45.8) and 40.2 (32.9-45.7) vs. 43.9 (39.3-48.1) %FM, p<0.01] than ART-naive women. Within ART1, waist:hip was greater [0.87 (0.81-0.92) vs. 0.84 (0.78-0.89), p=0.006], while calf skinfold was lower [15.2 (9.4-21.5) vs. 17.4 (12.0-23.6) mm, p=0.033] in women receiving efavirenz compared to nevirapine. ART2 had a greater waist:hip, and abdominal, subscapular, and suprailiac skinfolds than ART1 (p<0.05). After adjusting for time on d4T (stavudine), ART2 had greater body fat than ART1 (p<0.05). With increasing time on d4T, the decrease in leg fat (%FM) was higher in ART1 than ART2 (p=0.012, for timextreatment effect). A similar interaction was reported for total time on ART treatment (p=0.002 for timextreatment effect). In conclusion, ART was associated with increased central fat and reduced peripheral fat. Changing to a PI-based regimen in ART2, which also substitutes stavudine with zidovudine, partially reversed the peripheral fat loss observed on ART1."									
1909	Frequency and determinants of the metabolic syndrome in apparently healthy adult Nigerians.	"Wahab KW, Sani M, Gbadamosi M, Yandutse M."	Tropical doctor. 2008 Oct;38(4):224-6.		"Non-communicable disease conditions such as the metabolic syndrome further strain the already insufficient health resources in Africa, where communicable diseases such as malaria and HIV/AIDS are still causing significant morbidity and mortality. We studied the frequency and determinants of the syndrome in apparently healthy Nigerian volunteers in order to provide a basis for the establishment of a prevention programme."									
1871	Secondary causes of nonalcoholic fatty liver disease.	"Kneeman JM, Misdraji J, Corey KE."	Therapeutic Advances in Gastroenterology. 2012;5(3):199-207.		"Nonalcoholic fatty liver disease (NAFLD) is becoming the most common cause of chronic liver disease in the developing world, found in 17-30% of the population in Western countries and 2-4% worldwide. Defined as the accumulation of fatty acid content greater than 5% of liver weight, NAFLD is a spectrum of disease ranging from simple steatosis to nonalcoholic steatohepatitis. The pathophysiology of NAFLD involves increased de novo synthesis of fatty acids in hepatocytes, the retention of lipids due to impaired hepatocyte apolipoprotein secretion or beta-oxidation. The well-known primary causes of NAFLD are obesity, type II diabetes, dyslipidemia, and insulin resistance. However, other less common conditions can cause a similar clinical and histologic picture, and should be considered in patients who present with NAFLD but do not have traditional risk factors. In this review, we discuss uncommon but important causes of NAFLD, including inborn errors of metabolism, iatrogenic causes, viral hepatitis, and nutritional disorders to provide practicing clinicians with an understanding of the less well recognized causes of NAFLD. The Author(s) 2011."									
717	Efficacy of herbal supplements containing Citrus aurantium and synephrine alkaloids for the management of overweight and obesity: a systematic review. (Special issue: Caribbean herbal medicine.).	"Onakpoya I, Davies L, Ernst E."	Focus on Alternative and Complementary Therapies. 2011;16(4):254-60.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20113401098	"Numerous herbal supplements are presently marketed as weight-loss aids, but the efficacy of most is not proven. One such supplement is the extract of Citrus aurantium (bitter orange). The objective of this systematic review is to critically evaluate the evidence of efficacy for C. aurantium and weight management. Electronic databases, conference proceedings and pertinent journals were searched for relevant RCTs. Bibliographies and our departmental files were searched also. No restrictions on date or language of publication, age of participants or duration of treatment were imposed. Two reviewers independently determined the eligibility of studies, extracted data and evaluated the methodological quality of included studies. Seven studies were identified, of which four met the inclusion criteria. All RCTs had major methodological flaws. Two RCTs reported a marginal to statistically significant reduction in body weight and body fat in participants treated with C. aurantium-containing supplements, when compared to placebo. One trial reported a statistically significant reduction in body fat only, while the other reported a statistically significant increase in body weight. Adverse events included anxiety, elevated heart rate and musculoskeletal complaints. The evidence of efficacy for C. aurantium and weight management is contradictory and methodologically weak. Until more rigorous RCTs emerge, C. aurantium cannot be recommended as a treatment for weight loss."									
1168	The effect of multiple micronutrient supplementation on mortality and morbidity of HIV-infected adults: a meta-analysis of randomized controlled trials.	"Jiang S, He J, Zhao X, Li H."	Journal of Nutritional Science & Vitaminology. 2012;58(2):105-12.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=22790568	"Numerous preclinical studies have suggested that micronutrient status is associated with the progression of human immunodeficiency virus (HIV) disease, but results from observational studies are still controversial. The objective was to systematically review the efficacy of multiple micronutrient supplementation on mortality and morbidity in HIV-infected adults. A comprehensive search of the PubMed/MEDLINE, EMBASE and Cochrane Library was performed. Six randomized controlled trials assessing the effect of multiple micronutrient supplementation on HIV-infected adults were included. Relative risk was used as an effect measure to compare the intervention and control groups with fixed-effects or random effects models. Sensitivity analyses were applied to further evaluate heterogeneity. Multiple micronutrient supplementation decreased the mortality and morbidity of HIV-infected adults nonstatistically significantly (RR=0.90; 95% CI, 0.80 to 1.02; p=0.09). Sensitivity analyses revealed that multiple micronutrient supplementation decreased the mortality and morbidity of adults infected with HIV alone statistically significantly (RR=0.75; 95% CI, 0.58 to 0.95; p=0.02), but not adults infected with both HIV and pulmonary tuberculosis (RR=0.97; 95% CI, 0.84 to 1.11; p=0.65). Multiple micronutrient consumption was correlated with reduction of the mortality and morbidity of HIV-infected adults, at least those in developing countries and infected with HIV alone, and should be prescribed by local doctors for those in earlier stages especially.Numerous preclinical studies have suggested that micronutrient status is associated with the progression of human immunodeficiency virus (HIV) disease, but results from observational studies are still controversial. The objective was to systematically review the efficacy of multiple micronutrient supplementation on mortality and morbidity in HIV-infected adults. A comprehensive search of the PubMed/MEDLINE, EMBASE and Cochrane Library was performed. Six randomized controlled trials assessing the effect of multiple micronutrient supplementation on HIV-infected adults were included. Relative risk was used as an effect measure to compare the intervention and control groups with fixed-effects or random effects models. Sensitivity analyses were applied to further evaluate heterogeneity. Multiple micronutrient supplementation decreased the mortality and morbidity of HIV-infected adults nonstatistically significantly (RR=0.90; 95% CI, 0.80 to 1.02; p=0.09). Sensitivity analyses revealed that multiple micronutrient supplementation decreased the mortality and morbidity of adults infected with HIV alone statistically significantly (RR=0.75; 95% CI, 0.58 to 0.95; p=0.02), but not adults infected with both HIV and pulmonary tuberculosis (RR=0.97; 95% CI, 0.84 to 1.11; p=0.65). Multiple micronutrient consumption was correlated with reduction of the mortality and morbidity of HIV-infected adults, at least those in developing countries and infected with HIV alone, and should be prescribed by local doctors for those in earlier stages especially."									
904	"Anthropometric indices of infants born to HIV-1-infected mothers: A prospective cohort study in Lagos, Nigeria."	"Ezeaka VC, Iroha EO, Akinsulie AO, Temiye EO, Adetifa IMO."	International Journal of STD and AIDS. 2009 August;20(8):545-8.		"Numerous studies have reported that HIV-infected pregnant women are at increased risk of delivery of low birth weight (LBW) infants, of preterm deliveries and of intrauterine growth restriction. The objective of the study was to determine the effect of maternal HIV infection on the anthropometric characteristics of the babies at birth. A prospective study was carried out at the Lagos University Teaching Hospital, Nigeria. There were three times more LBW babies in the HIV-positive group than in the uninfected mothers (odds ratio = 3.47, 95% confidence interval = 1.69, 7.27; chi<sup>2</sup> = 12.99, P = 0.0003).The maternal weight (t = 15.85; P = 0.0001), maternal body mass index (BMI) (t = 15.07; P = 0.0003), birth weight of infants (t = 27.17; P = 0.0001) and birth length (t = 31.20; P = 0.001) were significantly less in HIV-positive mothers than in controls. In conclusion, poor maternal bodyweight and low BMI are significant contributors to LBW in HIV-infected women. Nutritional counselling, dietary intake and weight monitoring during pregnancy should be emphasized to improve pregnancy outcome in HIV-infected women."									
1432	Global issues in pediatric nutrition: AIDS.	Ball CS.	Nutrition. 1998;14(10):767-70.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=9785358	"Nutrition is a final common pathway in chronic disease, and weight loss is a major manifestation of acquired immunodeficiency syndrome (AIDS). In sub-Saharan Africa, studies have shown that 25% of children with malnutrition have human immunodeficiency virus (HIV) infection, although patterns of malnutrition are indistinguishable from those who are HIV negative. Breast-feeding increases the risk of vertical transmission, and the overall risk versus benefit needs continuing careful consideration in relation to local mortality from gastroenteritis and malnutrition. Chronic diarrhea is much more common in HIV-infected children in Africa and may have a multiplicity of causes, including infection with adherent forms of Escherichia coli, protozoa, and even direct HIV infection of intestinal mucosal cells. The HIV wasting syndrome produces reduction in bioelectrical impedence, fat, lean body mass, and body cell mass, but the changes can be predicted from equations used in starvation states. Micronutrients may be important, but observed changes may be due to immune mediator activation, rather than malnutrition. Calorie supplementation is beneficial when delivered by any route, but is likely to produce the greatest positive change when CD4 counts are highest in relation to calorie intake. Paradoxically, HIV-infected children may be obese early in the disease until AIDS develops. There is an inextricable link between disease and nutritional status. In children with AIDS wasting syndrome, a low CD4 count and high viral load are likely so that effective antiviral treatment may ultimately produce the greatest improvement in health, including nutritional status. [References: 31]"									
255	Nutritional state in HIV infected patients.	"Luis DAd, Bachiller P, Izaola O, Eiros Bouza JM, Aller R."	Anales de Medicina Interna. 2001;18(12):619-23.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh3&AN=20023021458	"Nutritional assessment is an important part of the treatment of HIV infected patients. The aim of this work was to study the nutritional status of a group of HIV infected patients using biochemical and anthropometrical parameters. A total of 119 patients were assessed for the following parameters: age, sex, treatment with anti-retroviral drugs, anthropometric evaluation (weight, height, triceps skinfold, arm circumference, arm muscular circumference and body mass index) and biochemical evaluation (albumin, pre-albumin, transferrin, total proteins, triglycerides, cholesterol, lymphocytes and count of CD4). Patients had an average age of 37.9+or-9.9 years, weight 64.5+or-13.2 kg and body mass index 22.5+or-3.5. The values for total protein, albumin, prealbumin and transferrin were all normal, except for patients with AIDS who had low levels of transferrin (262.5+or-49.2 mg/dl vs 277.8+or-87.5; p<0.05). Percentile distribution of anthropometric parameters showed a major depletion of muscle protein: 53.1% of patients had skinfold under P 50, 91.8% had arm circunference under P 50, and 91.8% arm muscular circunference under P 50. High levels of triglycerides were detected in 30.5%: these levels were related to the HIV phase and the number of antiretroviral drugs. It is concluded that the overall nutritional status of HIV infected patients in Mexico is good with only depletion in muscle protein being detected."									
347	Nutrition problems of hospitalised children in a developing country: Thailand.	Tienboon P.	Asia Pacific Journal of Clinical Nutrition. 2002;11(4):258-62.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=12495256	"Nutritional assessment reveals the nutritional status of a patient. It thereby helps identify each patient's need for specific nutritional care and facilitates early intervention. Generally, the common nutrition and nutrition-related problems in hospitalised paediatric patients are: protein energy malnutrition in various degrees; vitamin deficiencies such as A, B1, B2, niacin, folic acid, K and E; mineral deficiencies such as Zn, Fe, Ca, Mg, P, K and Na; essential fatty acid deficiencies; carbohydrate intolerance; maldigestion and malabsorption; and overweight and obesity. However, there is limited information about nutritional status of hospitalised patients in some countries, especially in developing countries. In Thailand, it was found that the prevalence of hospital malnutrition in children aged 1-15 years in the paediatric ward was similar (50-60%) to that of a study conducted 10 years earlier. In another study of micronutrients in 45 paediatric AIDS patients (aged 3-46 months), high prevalences of malnutrition, anaemia and mineral deficiencies were found. For convenience in clinical practice, body mass index (BMI) values for use as an indicator in the assessment of undernutrition in children whose heights are less than 145 cm have been published. These BMI values have been tested and retested using normal children and patients with various degrees of undernutrition and were found to be reliable and valid. Therefore, nutritional status must be assessed in all hospitalised patients. At the very least, weight and height (length) should be obtained."									
1873	Nutritional status influences plasma fibrinogen concentration: evidence from the THUSA survey.	"James S, Vorster HH, Venter CS, Kruger HS, Nell TA, Veldman FJ, Ubbink JB."	Thrombosis Research. 2000;98(5):383-94.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=10828478	"Nutritional status and risk factors for chronic diseases, including plasma fibrinogen and its determinants, of Africans in the Northwest Province of South Africa, have been studied in a cross-sectional survey. A representative sample of 1854 ""apparently healthy"" African men and women volunteers aged 15 years and older was recruited from 37 randomly selected sites throughout the Province and stratified for level of urbanisation. Information was collected using validated and culture-sensitive questionnaires. Fasting blood samples were drawn, and all measurements were done with standardised methodology using appropriate equipment, procedures, and controls. Fibrinogen concentration was measured in citrated plasma with the method of Clauss, using the ACL200 automated system and the international fibrinogen standard. The results revealed a population with a high mean plasma fibrinogen (3.17+/-1.10 g/L for HIV-negative men and 3. 64+/-1.12 g/L for HIV-negative women). Factors known to influence plasma fibrinogen, such as age, gender, smoking habit, and physical activity, were also observed in this population. Young rural men and women had the lowest fibrinogen level. Nasal snuff taking and HIV infection did not influence fibrinogen concentration. Multivariate analyses revealed that lower plasma fibrinogen was associated with low to normal body mass index in women, and with dietary intakes compatible with prudent dietary guidelines in men and women (low intakes of animal protein; trans fatty acids and higher intakes of plant protein; dietary fibre, vitamin E, and iron, and a high dietary P/S ratio). Subjects in the higher quartiles of plasma fibrinogen had significantly lower iron, vitamin E, and vitamin B6 (women) status. Increases in fibrinogen were associated with significant increases in serum lipids. Both under- and overnutrition seem to be associated with high plasma fibrinogen. It is concluded that overall nutritional status, possibly in addition to specific nutrients (and foods), influences plasma fibrinogen."									
1705	"Iron status, malnutrition and acute phase response in HIV-positive patients."	"Monteiro JP, Cunha DFd, Cunha SFdCd, Santos VMd, Silva-Vergara ML, Correia D, Bianchi MLPd."	Revista da Sociedade Brasileira de Medicina Tropical. 2000;33(2):175-80.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh3&AN=20001415248	"Nutritional status and some iron metabolism parameters of acute phase response (APR) positive and APR-negative AIDS patients were studied. 29 AIDS patients were submitted to 24-h food intake recall, anthropometry, and albumin, C-reactive protein (CRP), haemoglobin, ferritin, and total iron binding capacity (TIBC) measurements. Infection plus serum CRP>7 mg/dl were criteria for APR presence. Protein-energy malnutrition (PEM) was ascertained by body mass index (BMI) lower than 18.5 kg/msuperscript 2 and height-creatinine index (HCl<70%). PEM (77.8 vs. 40%) and pulmonary tuberculosis (44.4 vs. 9.5%) were more frequent in APR-positive patients, which also had lower serum albumin (3.7+or-0.9 vs. 4.3+or-0.9 g/dl), TIBC (165.8+or-110.7 vs. 265.9+or-74.6 mg/dl) and blood haemoglobin (10.5+or-1.8 vs. 12.6+or-2.3 g/dl). Iron intake was similar between groups; however, serum ferritin levels (median, range) were higher among APR-positive (568, 45.3-1814 vs. 246, 18.4-1577 ng/ml) patients. HIV-positive adults with systemic response to invading pathogens showed worse nutritional status than those APR-negative. In APR-positive AIDS patients, anaemia appears to be unrelated to recent iron intake."									
1892	Nutritional status and weight gain in patients with pulmonary tuberculosis in Tanzania.	"Kennedy N, Ramsay A, Uiso L, Gutmann J, Ngowi FI, Gillespie SH."	Transactions of the Royal Society of Tropical Medicine and Hygiene. 1996;90(2):162-6.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh2&AN=19962006447	"Nutritional status was assessed in 200 adult Tanzanian patients with smear-positive pulmonary tuberculosis before, during, and after 6 months of tuberculosis treatment; 148 patients (74%) were successfully followed for 12 months. Marked nutritional impairment was present on admission: 77% of males and 58% of females had a body mass index (BMI) below 18.5; approximately one-fifth had BMI <16.0. The length of hospital stay and gender, rather than microbiological response, were the major determinants of weight gain during treatment. Patients infected with human immunodeficiency virus (HIV) gained more weight than uninfected patients. Most patients lost weight after completing treatment and returning home. At 12 months 32% of male and 19% of female patients considered cured of tuberculosis had BMI <18.5. It is concluded that patients with tuberculosis from this area of Tanzania frequently have evidence of malnutrition both before and after treatment for tuberculosis. Weight gain during therapy appeared to be an unreliable indicator of overall treatment response. However, the results also demonstrated that nutritional rehabilitation can be successfully achieved even in HIV-positive tuberculosis patients and in patients with a suboptimal response to therapy."									
546	Short-term clinical disease progression in hiv-infected patients receiving combination antiretroviral therapy: results from the TREAT Asia HIV Observational database.	"Srasuebkul P, Lim PL, Lee MP, Kumarasamy N, Zhou J, Sirisanthana T, Li PCK, et al."	Clinical Infectious Diseases. 2009 01 Apr;48(7):940-50.		"Object The aim of our study was to develop, on the basis of simple clinical data, predictive short-term risk equations for AIDS or death in Asian patients infected with human immunodeficiency virus (HIV) who were included in the TREAT Asia HIV Observational Database. Methods. Inclusion criteria were highly active antiretroviral therapy initiation and completion of required laboratory tests. Predictors of short-term AIDS or death were assessed using Poisson regression. Three different models were developed: a clinical model, a CD4 cell count model, and a CD4 cell count and HIV RNA level model. We separated patients into low-risk, high-risk, and very high-risk groups according to the key risk factors identified. Results. In the clinical model, patients with severe anemia or a body mass index (BMI; calculated as the weight in kilograms divided by the square of the height in meters) <=18 were at very high risk, and patients who were aged <40 years or were male and had mild anemia were at high risk. In the CD4 cell count model, patients with a CD4 cell count <50 cells/muL, severe anemia, or a BMI <=18 were at very high risk, and patients who had a CD4 cell count of 51-200 celW/muL, were aged <40 years, or were male and had mild anemia were at high risk. In the CD4 cell count and HIV RNA level model, patients with a CD4 cell count <50 cells/muL, a detectable viral load, severe anemia, or a BMI <=18 were at very high risk, and patients with a CD4 cell count of 51-200 cells/muL and mild anemia were at high risk. The incidence of new AIDS or death in the clinical model was 1.3, 4.9, and 15.6 events per 100 person-years in the low-risk, high-risk, and very high-risk groups, respectively. In the CD4 cell count model the respective incidences were 0.9, 2.7, and 16.02 events per 100 person-years; in the CD4 cell count and HIV RNA level model, the respective incidences were 0.8, 1.8, and 6.2 events per 100 person-years. Conclusions. These models are simple enough for widespread use in busy clinics and should allow clinicians to identify patients who are at high risk of AIDS or death in Asia and the Pacific region and in resource-poor settings."									
746	Effect of a healthcare gender gap on progression of HIV/AIDS defined by clinical-biological criteria among adults from Cordoba City (Argentina) from 1995 to 2005.	"Soria EA, Nores ML, Diaz MdP, Kremer LE."	Gaceta Sanitaria. 2010;24(3):204-8.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20103217644	"Objective - To establish the influence of clinical status at diagnosis and of gender on progression of HIV/AIDS determined by clinical-biological factors in patients from Cordoba City (Argentina) from (1995 to 2005). Methods - Gender and clinical and laboratory data were evaluated by descriptive statistics, non-parametric survival analysis, and generalized linear models at the beginning of the study (diagnosis) and at the end (hospital records, n=209). Results - At diagnosis, women (n=28, 13.4%) had a higher probability of being asymptomatic than men (n=181, 86.6%). High viremia was associated with advanced clinical stages, but was inversely related to CD4 count. Truncated Kaplan-Meier curves were similar for both sexes. The probability of not having AIDS criteria at the end of the study was higher in patients without these criteria at diagnosis. Women had a higher probability of having AIDS at the end of the follow-up than men. In contrast, men had a higher prevalence of venereal diseases (n=38, 21%), dysmetabolic profile (n=14, 7.7%) and positive serology for opportunists (n=31, 17.1%). Marker diseases were mainly represented by internal mycosis and waste syndrome, although less specific findings (anemia, oral lesions) were also associated with progression. Conclusions - Using an integrative approach, high viremia was critically linked to clinical and lymphocyte impairment. Early diagnosis was a major determinant of clinical course, with women having a worse prognosis. However, men were diagnosed in clinically advanced stages and with other non-HIV-related entities, which could affect progression. These findings should be integrated into the planning of preventive strategies."									
1949	"Determinants of survival in AIDS patients on antiretroviral therapy in a rural centre in the Far-North Province, Cameroon."	"Sieleunou I, Souleymanou M, Schonenberger AM, Menten J, Boelaert M."	Tropical Medicine and International Health. 2009 January;14(1):36-43.		"Objective To analyse the outcomes of antiretroviral therapy (ART) in routine conditions in a rural hospital in the Far-North province of Cameroon. Method Retrospective cohort study of 1187 patients >15 years who started ART between July 2001 and December 2006. The survival time was estimated by Kaplan-Meier analysis and Cox proportional hazard models were fitted to explain survival. Results Upon enrolment, 90.4% patients were in WHO stage III or IV and 56.1% had a BMI <18.5. Median CD4 count was 105 cells/mm<sup>3</sup> (IQR 40-173). At the end of the study period, 338/1187 had died and 59/1187 were lost to follow-up. The survival probability was 77% at 1 year [95% CI: 75-80] and 47% at 5 years [95% CI: 40-55]. The median survival time was 58 months. CD4 count, haemoglobin, BMI, sex and clinical stage at enrolment were independent predictors of mortality. Conclusion This study confirms the clinical benefit of ART programs in a remote and resource-constrained setting operating in routine conditions. The challenge ahead is to secure earlier access to ART and to maintain its longer-term benefit. 2008 Blackwell Publishing Ltd."									
1951	Growth of infants born to HIV-infected women in South Africa according to maternal and infant characteristics.	"Venkatesh KK, Lurie MN, Triche EW, De Bruyn G, Harwell JI, McGarvey ST, Gray GE."	Tropical Medicine and International Health. 2010 November;15(11):1364-74.		"Objective To evaluate growth parameters assessed by weight and length in HIV-infected and HIV-uninfected infants born to HIV-infected mothers in South Africa from birth to 6months of age. Methods We calculated z-scores for weight-for-age (WAZ), length-for-age (LAZ) and weight-for-length (WLZ) among a cohort of 840 mother-infant dyads. Multivariable Cox proportional hazards models with time-varying covariates were used to estimate the risk of falling <-2 z-scores for WAZ, LAZ, and WLZ as a function of infant and maternal characteristics. Results By 6months after birth, a fifth of infants had WAZ<-2, 19% had an LAZ<-2, and 29% had a WLZ<-2. WLZ and WAZ were significantly lower in HIV-infected infants than in uninfected infants by 3months of age and LAZ by 6months of age (P<0.001). The risk of WAZ falling <-2 was associated with decreasing maternal CD4 cell count (adj. HR for CD4 cell count <200cells/mul: 1.64; 95% CI: 1.10-2.43), premature birth (adj. HR: 2.82; 95% CI: 2.06-3.86) and formula feeding (adj. HR: 3.35; 95% CI: 1.64-6.85). The risk of LAZ falling <-2 was associated with increasingly lower maternal age (adj. HR for<20years: 0.54; 95% CI: 0.31-0.96), lower maternal CD4 cell count (adj. HR for CD4 cell count <200cells/mul: 1.72; 95% CI: 1.14-2.59), premature birth (adj. HR: 2.37; 95% CI: 1.70-3.30) and formula feeding (adj. HR: 4.22; 95% CI: 1.85-9.62). The risk of WLZ falling <-2 was significantly associated with infant HIV infection (adj. HR: 1.64; 95% CI: 1.16-2.32) and formula feeding (adj. HR: 1.78; 95% CI: 1.11-2.83). The risk of WAZ and LAZ falling <-2 was more than two times greater for HIV-infected infants than for uninfected infants with gastrointestinal infections. Conclusions HIV-infected infants were more likely to be stunted and wasted than uninfected infants, which often occurred within 3months after birth. Infants who were born to mothers with advanced HIV disease, formula-fed and co-infected with HIV and gastrointestinal infections were at greater risk for growth disturbances. Further interventions are needed to promptly initiate both HIV-infected mothers and infants on appropriate antiretroviral therapy and nutritional supplementation. 2010 Blackwell Publishing Ltd."									
1936	Growth patterns and anaemia status of HIV-infected children living in an institutional facility in India.	"Kapavarapu PK, Bari O, Perumpil M, Duggan C, Dinakar C, Krishnamurthy S, Arumugam K, et al."	Tropical Medicine and International Health. 2012 August;17(8):962-71.		"Objective To understand the health status of HIV orphans in a well-structured institutional facility in India. Method Prospective longitudinal analysis of growth and anaemia prevalence among these children, between June 2008 and May 2011. Results A total of 85 HIV-infected orphan children residing at Sneha Care Home, Bangalore, for at least 1year, were included in the analysis. Prevalence of anaemia at entry into the home was 40%, with the cumulative incidence of anaemia during the study period being 85%. At baseline, 79% were underweight and 72% were stunted. All children, irrespective of their antiretroviral therapy (ART) status, showed an improvement in nutritional status over time as demonstrated by a significant increase in weight (median weight-for-age Z-score: -2.75 to -1.74, P<0.001) and height Z-scores (median height-for-age Z-score: -2.69 to -1.63, P<0.001). Conclusion These findings suggest that good nutrition even in the absence of ART can bring about improvement in growth. The Sneha Care Home model indicates that the holistic approach used in the Home may have been helpful in combating HIV and poor nutritional status in severely malnourished orphaned children. 2012 Blackwell Publishing Ltd."									
670	An analysis of intra-uterine growth retardation in rural Malawi.	"Verhoeff FH, Brabin BJ, van Buuren S, Chimsuku L, Kazembe P, Wit JM, Broadhead RL."	European Journal of Clinical Nutrition. 2001;55(8):682-9.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=11477467	"OBJECTIVE: (1) To describe the sex-specific, birth weight distribution by gestational age of babies born in a malaria endemic, rural area with high maternal HIV prevalence; (2) to assess the contribution of maternal health, nutritional status and obstetric history on intra-uterine growth retardation (IUGR) and prematurity."	"METHODS: Information was collected on all women attending antenatal services in two hospitals in Chikwawa District, Malawi, and at delivery if at the hospital facilities. Newborns were weighed and gestational age was assessed through post-natal examination (modified Ballard). Sex-specific growth curves were calculated using the LMS method and compared with international reference curves."	"RESULTS: A total of 1423 live-born singleton babies were enrolled; 14.9% had a birth weight <2500 g, 17.3% were premature (<37 weeks) and 20.3% had IUGR. A fall-off in Malawian growth percentile values occurred between 34 and 37 weeks gestation. Significantly associated with increased IUGR risk were primiparity relative risk (RR) 1.9; 95% CI 1.4--2.6), short maternal stature (RR 1.6; 95% CI 1.0--2.4), anaemia (Hb<8 g/dl) at first antenatal visit (RR 1.6; 95% CI 1.2--2.2) and malaria at delivery (RR 1.4; 95% CI 1.0--1.9). Prematurity risk was associated with primiparity (RR 1.7; 95% CI 1.3--2.4), number of antenatal visits (RR 2.2; 95% CI 1.6--2.9) and arm circumference <23 cm (RR 1.9; 95% CI 1.4--2.5). HIV infection was not associated with IUGR or prematurity."	"CONCLUSION: The birth-weight-for-gestational-age, sex-specific growth curves should facilitate improved growth monitoring of newborns in African areas where low birth weight and IUGR are common. The prevention of IUGR requires improved malaria control, possibly until late in pregnancy, and reduction of anaemia."						
885	Validation of bioimpedance against isotope techniques for determination of body composition in HIV-infected children.	"Sewnath A, Chhagan MK, Arpadi S, Ahdikari M."	International Journal of Obesity. 2011 May;35:S56.		"Objective: 1) To establish whether BIA equations currently used for deriving total body water (TBW) and Fat Free Mass (FFM) in Nigerian and HIV-infected American children are precise to be applied to HIV-infected children in South Africa. 2) To determine feasibility of blood and saliva specimens in isotope studies. 3) To compare performance of blood and saliva using the isotope dilution method in children aged 3 to 6 years. Methods: Anthropometry and Bioelectric impedance measurements were performed on 42 HIV-infected children using a 50-kHz tetrapolar BIA device. TBW was measured by deuterium oxide (D2O) dilution. TBW enrichment in blood and saliva was assessed using a Fourier-Transfer Infrared Spectrometer. ECW was measured by sodium bromide dilution and assessed using HPLC. Results: Good correlations were seen between measured and predicted values for TBW and FFM, and between saliva and blood assays of TBW. Bland-Altman plots showed poor agreement between measured and predicted values of TBW. Bland-Altman plots also showed saliva over estimated TBW. Conclusion: Co-morbidities included oral problems coupled with opportunistic diseases may have caused measurement variation in salivary samples. Altered mucosal permeability may have affected results by altering absorption and/or equilibration time of the isotope. Addition of variables such as reactance improved TBW."									
1507	Acceptability and effectiveness of chickpea sesame-based ready-to-use therapeutic food in malnourished HIV-positive adults.	"Bahwere P, Sadler K, Collins S."	Patient preference & adherence. 2009;3:67-75.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=19936147	OBJECTIVE: A prospective descriptive study to assess acceptability and effectiveness of a locally made ready-to-use therapeutic food (RUTF) in HIV-infected chronically sick adults (CSA) with mid-upper-arm circumference (MUAC) <210 mm or pitting edema.	"METHODS: Sixty-three wasted AIDS adults were prescribed 500 g representing ~2600 kcal/day of locally made RUTF for three months and routine cotrimoxazole. Weight, height, MUAC, Karnofsky score and morbidity were measured at admission and at monthly intervals. The amount of RUTF intake and acceptability were assessed monthly."	"RESULTS: Ninety-five percent (60/63) of the CSA that were invited to join the study agreed to participate. Mean daily intake in these 60 patients was 300 g/person/day (~1590 Kcal and 40 g of protein). Overall, 73.3% (44/60) gained weight, BMI, and MUAC. The median weight, MUAC and BMI gains after three months were 3.0 kg, 25.4 mm, and 1.1 kg/m(2), respectively. The intervention improved the physical activity performance of participants and 78.3% (47/60) regained sufficient strength to walk to the nearest health facility. Mortality at three months was 18.3% (11/60)."	CONCLUSION: Locally made RUTF was acceptable to patients and was associated with a rapid weight gain and physical activity performance. The intervention is likely to be more cost effective than nutritional support using usual food-aid commodities.						
1660	Food access and diet quality independently predict nutritional status among people living with HIV in Uganda.	"Kadiyala S, Rawat R."	Public Health Nutrition. 2013;16(1):164-70.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=22348289	"OBJECTIVE: Although undernutrition is recognized as a risk factor for mortality among people living with HIV (PLWHIV), even among those initiating antiretroviral therapy, few studies have explored the underlying determinants of undernutrition. The objectives of the present study were to: (i) examine the independent association between household food security, individual diet quality and nutritional status; and (ii) determine if any association between food security and nutritional status is mediated through diet quality."	DESIGN: Cross-sectional baseline survey.	"SETTING: Gulu and Soroti districts, Uganda."	SUBJECTS: Nine hundred and two PLWHIV recruited into a study evaluating the impact of a food assistance programme supported by the World Food Programme.	"RESULTS: Food security and diet quality were measured using the Household Food Insecurity Access Scale (HFIAS) and the Individual Dietary Diversity Score (IDDS), respectively. Multivariate regression results demonstrated that HFIAS and IDDS independently predict BMI (P < 0.01) and mid upper-arm circumference (P < 0.05). The adjusted odds ratio of being underweight (BMI < 18.5 kg/m2) among individuals living in severely food-insecure households was 1.92 (P < 0.0 0 1); individuals consuming a highly diverse diet had an adjusted odds ratio of being underweight of 0.56 (P < 0.05) compared with those consuming a diet of low diversity. Similar results were observed when mid upper-arm circumference and wasting were modelled as outcomes. Using path analysis, we observed that the indirect effect of food insecurity on BMI mediated through dietary diversity is negligible, and mostly a result of the direct effect of food insecurity on BMI."	CONCLUSIONS: Our results provide an empirical basis for focused efforts on improving food access and diet quality among PLWHIV. Addressing the broader structural determinants of food security of people infected and affected by HIV is crucial.				
1655	Predictors of anaemia and iron deficiency in HIV-infected pregnant women in Tanzania: a potential role for vitamin D and parasitic infections.	"Finkelstein JL, Mehta S, Duggan CP, Spiegelman D, Aboud S, Kupka R, Msamanga GI, et al."	Public Health Nutrition. 2012;15(5):928-37.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=22014374	"OBJECTIVE: Anaemia is common during pregnancy, and prenatal Fe supplementation is the standard of care. However, the persistence of anaemia despite Fe supplementation, particularly in HIV infection, suggests that its aetiology may be more complex and warrants further investigation. The present study was conducted to examine predictors of incident haematological outcomes in HIV-infected pregnant women in Tanzania."	"DESIGN: Prospective cohort study. Cox proportional hazards and binomial regression models were used to identify predictors of incident haematological outcomes: anaemia (Hb < 110 g/l), severe anaemia (Hb < 85 g/l) and hypochromic microcytosis, during the follow-up period."	"SETTING: Antenatal clinics in Dar es Salaam, Tanzania."	SUBJECTS: Participants were 904 HIV-infected pregnant women enrolled in a randomized trial of vitamins (1995-1997).	"RESULTS: Malaria, pathogenic protozoan and hookworm infections at baseline were associated with a two-fold increase in the risk of anaemia and hypochromic microcytosis during follow-up. Higher baseline erythrocyte sedimentation rate and CD8 T-cell concentrations, and lower Hb concentrations and CD4 T-cell counts, were independent predictors of incident anaemia and Fe deficiency. Low baseline vitamin D (<32 ng/ml) concentrations predicted a 1.4 and 2.3 times greater risk of severe anaemia and hypochromic microcytosis, respectively, during the follow-up period."	"CONCLUSIONS: Parasitic infections, vitamin D insufficiency, low CD4 T-cell count and high erythrocyte sedimentation rate were the main predictors of anaemia and Fe deficiency in pregnancy and the postpartum period in this population. A comprehensive approach to prevent and manage anaemia, including micronutrient supplementation and infectious disease control, is warranted in HIV-infected women in resource-limited settings - particularly during the pre- and postpartum periods."				
554	Risk factors of atherosclerotic plaque measured by carotid Doppler ultrasonography in HIV-infected Koreans receiving antiretroviral treatment.	"Baek J, Han S, Chin B, Choi HK, Shin SY, Chae Y, Jin S, et al."	Clinical Microbiology and Infection. 2010 April;16:S332.		"Objective: Antiretroviral therapy (ART) in HIV infection produces a spectrum of metabolic complications, including dyslipidemia, insulin resistance, lipodystrophy. It has been reported that ART is independently associated with the increase in the rate of myocardial infarction. We examined the risk factors for the existence of plaque in carotid artery, which are predisposing conditions of cardiovascular disease, in HIV- infected Koreans receiving ART. Methods: Total 137 HIV-infected Koreans who have been treated with ART during more than 6 months were examined the carotid intima media thickness (IMT) and plaque existence by carotid doppler ultrasonography from August 2007 to March 2008 at Severance Hospital, a 2,000-bed tertiary care university hospital and referral center in Seoul, Korea. Anthropometric parameters were examined by bioelectrical impedance analysis and physical examination. The mean of the bilateral maximal common carotid artery (CCA) IMT was used as the carotid IMT values in our analyses, because it has been shown to have the strongest association with cardiovascular risk factors. The atherosclerotic plaques were defined as localized echo structures protruding from the vessel lumen. Only lesions for which the thickness was >1 mm at either the right or left CCA were considered as carotid plaques. Results: Total duration of ART in total participants was 26.9 months. Carotid plaque was observed in 33 (24.1%) patients. Carotid IMT values in total patients had significantly positive correlations with waist-to-hip ratio (r = 0.190, p = 0.027), body mass index (r=0.235, p = 0.00<sup>6</sup>), total cholesterol (r=0.201, p = 0.019) LDL cholesterol (r = 0.269, p = 0.00<sup>5</sup>), total exposed duration of zidovudine (r = 0.247, p = 0.017) after the adjusting for age. In multivariate logistic regression model, age and history of hypertension were significantly associated with the existence of plaque (OR 1.09, 95%CI 1.02-1.17, p = 0.018, and OR 10.75, 95% CI 2.0<sup>6</sup>-56.14, respectively). The total duration of HAART or total exposed duration of each antiretroviral drug did not show any association with the existence of plaque. Conclusion: The increased carotid IMT and plaque existence in HIV- infected Koreans receiving ART were associated with the traditional risk factors of atherosclerosis known in non-HIV-infected individuals. The carotid IMT and plaque measurement should be regularly examined especially in the HIV-infected patients receiving ART with older age to prevent cardiovascular disease."									
892	Concurrent use of complementary and alternative medicine with antiretroviral therapy reduces adherence to HIV medications.	"Ekwunife OI, Oreh C, Ubaka CM."	International Journal of Pharmacy Practice. 2012;20(5):340-3.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=22953773	OBJECTIVE: Antiretroviral therapy requires strict adherence to ensure therapeutic success. Concurrent use of complementary and alternative medicine (CAM) could alter the adherence to and thereby effectiveness of antiretroviral drugs. This study examined the association of CAM use with adherence to antiretroviral therapy (ART) and CD4 count.	"METHODS: The study was conducted in two HIV clinics: one in a semi-urban, the other in a rural area. Adherence to ART was assessed using the Morisky Medication Adherence Scale (MMAS). Data on type of CAM used and MMAS adherence were collected by patient interview and demographic; clinical data were collected from hospital records."	"RESULTS: Altogether 212 HIV patients participated in the exit study conducted over 3 months. Almost half (47.9%) used CAM concurrently with antiretroviral drugs. Dietary supplements (40.3%), healing systems (36.5%) and exercise (23.2%) were mainly used. The use of CAM significantly lowered adherence to ART (89.4% in non-CAM users versus 82.5% in CAM users, P = 0.01). Improvement in CD4 count was less in patients using CAM compared to non-CAM users although the difference was not statistically significant (310.5 +/- 294.0 cells/L in CAM users versus 224.5 +/- 220.0 cells/L in non-CAM users, P = 0.13). Patients attending the rural HIV clinic were more likely to use CAM compared to patients attending semi-urban hospital ((2) test = 7.0; P < 0.01)."	CONCLUSION: Use of CAM could lower adherence to antiretroviral therapy. There is need to develop protocol which could help in monitoring CAM use in HIV patients especially those from rural settings. 2012 The Authors. IJPP 2012 Royal Pharmaceutical Society.						
999	"Growth, morbidity, and mortality in a cohort of institutionalized HIV-1-infected African children."	"Nathan LM, Nerlander LM, Dixon JR, Ripley RM, Barnabas R, Wholeben BE, Musoke R, et al."	Journal of Acquired Immune Deficiency Syndromes. 2003 01 Oct;34(2):237-41.		"Objective: As a result of the HIV epidemic in Africa, much debate exists on whether institutionalized compared with community-based care provides optimum management of infected children. Previous reports calculated 89% mortality by age 3 years among outpatients in Malawi. No similar data are available for infected children in institutionalized care. We characterized patterns of morbidity and mortality among HIV-1-infected children residing at an orphanage in Nairobi. Methods: Medical records for 174 children followed over 5 years were reviewed. Mortality was analyzed by Kaplan-Meier methods with adjustment to account for survival in the community before admission. Anthropometric indices were calculated to include mean z scores for weight for length and length for age. Low indices reflected wasting and stunting. Opportunistic infections were documented. Results: Of 174 children, 64 had died. Survival was 70% at age 3 years. Morbidity included recurrent respiratory tract infections, gastroenteritis, parotitis, and lymphoid interstitial pneumonitis. No new cases of tuberculosis disease were noted after admission. Mean z scores for length for age suggested overall stunting (z = -1.65). Wasting was not observed (z = -0.39). Conclusion: The optimal form of care for HIV-infected children in resource-poor settings may be the development of similar homes. Absence of tuberculosis disease in long-standing residents may have contributed to improved survival. Stunting in the absence of wasting implied that growth was compromised by opportunistic infections and other cofactors."									
79	Micronutrient supplementation in the AIDS diarrhoea-wasting syndrome in Zambia: a randomized controlled trial.	"Kelly P, Musonda R, Kafwembe E, Kaetano L, Keane E, Farthing M."	AIDS. 1999;13(4):495-500.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=10197378	"OBJECTIVE: As HIV has spread through sub-Saharan Africa, persistent diarrhoea has emerged as a major problem in hospitals and in the community in severely affected areas. We have previously demonstrated that antiprotozoal therapy with albendazole reduces diarrhoea in AIDS patients in urban Zambia. This trial was designed to test the hypothesis that the clinical response to albendazole might be improved by oral micronutrient supplementation."	"DESIGN: Randomized, placebo-controlled trial."	"SETTING: Home care service of Ndola Central Hospital, Zambia."	PATIENTS: HIV-seropositive patients with persistent diarrhoea.	"INTERVENTION: Patients were randomized to albendazole plus vitamins A, C and E, selenium and zinc orally or albendazole plus placebo, for 2 weeks."	MAIN OUTCOME MEASURES: Time with diarrhoea following completion of treatment; mortality; adverse events.	"RESULTS: Serum vitamin A and E concentrations before treatment were powerful predictors of early mortality, but supplementation did not reduce time with diarrhoea or mortality during the first month, even after taking into account initial vitamin A or E concentrations, CD4 cell count or clinical markers of illness severity. Serum concentrations of vitamins A and E did not increase significantly in supplemented patients compared with those given placebo, and there were no changes in CD4 cell count or haematological parameters. No adverse events were detected except those attributable to underlying disease."	"CONCLUSIONS: Although micronutrient deficiency is predictive of early death in Zambian patients with the diarrhoea-wasting syndrome, short-term oral supplementation does not overcome it nor influence morbidity or mortality."		
820	Clinical profile and natural history of children with HIV infection.	"Lodha R, Upadhyay A, Kapoor V, Kabra SK."	Indian Journal of Pediatrics. 2006;73(3):201-4.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=16567911	"OBJECTIVE: As the HIV infection spreads in India, increasing number of children are affected. We report the clinical manifestations, the laboratory parameters and follow up of these children."	"METHODS: We reviewed case records of all children diagnosed as pediatric HIV infection since 1995 in our department at a tertiary care hospital in north India. Since September 1999, all children with HIV infection registered in our clinic were prospectively followed up. Complete clinical and laboratory evaluation was performed at baseline and thereafter children were followed up. The children were managed according to standard treatment guidelines."	"RESULTS: 109 children (82 boys, 27 girls) were diagnosed to have HIV infection. The median (range) age at presentation was 48 months (range: 0.75 months-180 months). Eighty one (74.3%) children acquired the infection vertically. Ninety-one (83.5%) children were symptomatic at time of presentation. The common symptoms in the former were failure to thrive (81.3%), recurrent fever (73.6%), diarrhea (50.5%) and recurrent or persistent pneumonia (44%). All children had poor nutritional status at baseline. Of the 67 children who followed up, 36 were receiving antiretroviral drugs (32 received 3 drugs), while families of 31 children did not opt for antiretroviral therapy. Children receiving antiretroviral therapy showed improvement in nutritional parameters."	"CONCLUSION: Majority of children with HIV infection presented with various clinical manifestations, poor nutritional status and immunosuppression. Administration of nevirapine based antiretroviral therapy leads to improvement in growth and immune restoration."						
1794	Relationships of alcohol intake with biological health outcomes in an African population in transition: The Transition and Health during Urbanisation in South Africa (THUSA) study.	"Gopane RE, Pisa PT, Vorster HH, Kruger A, Margetts BM."	South African Journal of Clinical Nutrition. 2010;23(3 SUPPL. 1):S16-S21.		"Objective: Because present recommendations on alcohol intake are based mainly on evidence of beneficial effects in populations of developed countries, this study examines biological effects of alcohol consumption in an African population in transition to assess whether these recommendations are also valid for Africans. Design: A cross-sectional, comparative, population-based study. Setting: Thirty-seven randomly selected sites in the North West province of South Africa, representing both rural and urban areas. Subjects: A total of 1 854 apparently healthy men and women older than 15 years volunteered to participate. Complete data of 1 757 participants were available for analysis. Pregnant and lactating women as well as subjects taking any form of chronic medication, those with oral temperatures above 37 degreeC and those who were inebriated were excluded. Outcome measures: A validated, quantitative food frequency questionnaire was used to measure dietary intake, including alcoholic beverages, expressed as absolute alcohol in grams per day. Anthropometric measurements and blood pressure were taken in triplicate using standardised equipment and procedures. Fasting blood samples were used to determine biochemical variables related to nutritional status and health. Serum gamma glutamyl transferase was used to examine the reliability of reported alcohol intake. The SPSS package was used to relate alcohol intake to blood pressure and biochemical variables, controlling for age, body mass index and blood glucose. Data from men and women, as well as drinkers and non-drinkers, were analysed separately and compared. Results: In total, 61.5% of the men and 25.2% of the women reported that they consumed alcoholic beverages. The mean alcohol intake of men (30.2 +/- 47.8 g/day) exceeded the recommend value of 21 g/day. The women had a mean intake of 11.4 +/- 18.8 g/day, falling within the 12 to 15 g/day recommendation. Older drinkers (> 40 years) and those infected with HIV drank more. The level of urbanisation had little effect on amounts consumed. Drinkers had significantly higher HDL cholesterol (HDL-C), serum triglycerides, blood pressure and iron status variables than non-drinkers. These effects represent some beneficial but mostly detrimental consequences of alcohol consumption. When serum ferritin was used to classify subjects into those in negative iron balance (< 12 mug/L), 'normal' iron balance (12-150 mug/L) and positive iron balance (> 150 mug/L), it became evident that alcohol intake almost doubled the proportion of subjects in positive iron balance (in men from 25 to 46%; in women from 11 to 23%). Conclusion: Although the beneficial effect of alcohol consumption on HDL-C was seen in this population, the effects on iron status and balance are of concern and should be researched in more detail. SAJCN."									
696	Estimates of body composition in drug naive asymptomatic HIV-infected rural kenyan women.	"Ernst JA, Ettyang G, Katschke A, Lewis B, Neumann C."	FASEB Journal. 2010 April;24.		"Objective: Bioelectrical impedance analysis (BIA), as a method to estimate fat free mass (FFM) and % body fat (%BF), is compared to the anthropometric (Anthro) method using skinfold (SF) and body circumference (BC) measures in HIV-infected women in rural Kenya. Methods: In 138 women, (WHO Stage 1 or 2; CD4 > 250 cells/uL), height, weight, SF, BC and BIA were obtained with standardized procedures. Fat area of the arm (MAFA), muscle area of the arm (MAMA), thigh (MTMA), calf (MCMA) and sum of SF were calculated from standard equations using BC and SF. Estimates of FFM, %BF and total body water (TBW) from BIA measures of resistance were calculated with standard equations. Results: The mean (SD) for age, BMI and CD4 was 36.4(7.5) yrs, 22.3(3.6); 11% < 18.5, and 492(191) cells/uL, respectively. Conclusions: BIA, when compared to the method using anthropometry measures, has a strong relationship to fat and lean mass, at baseline, in drug naive asymptomatic HIV-infected rural Kenyan women enrolled in an 18 month randomized controlled field trial that measures the impact of added protein and energy on body composition."									
1865	Long-chain polyunsaturated fatty acids as anti-HIV supplementation during breastfeeding.	Hsu K.	Taiwanese Journal of Obstetrics & Gynecology. 2009;48(1):65-8.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=19346195	"OBJECTIVE: Breastfeeding by human immunodeficiency virus (HIV)-positive mothers is an unavoidable practice in some very poor countries. It has been suggested that long-chain polyunsaturated fatty acids (LC-PUFAs) in breast milk, such as arachidonic acid, act as natural, protective ingredients against HIV transmission. The objective of this study was to identify the protective mechanism of LC-PUFAs in cells susceptible to HIV infection (e.g. human CD4+ T cells, HeLa cells)."	"RESULTS: LC-PUFAs are bioactive molecules capable of activating the cellular protective machinery via modulation of endogenous background K+ or KCNK channels. KCNK channel expression contributes significantly to the stability of the cell membrane potential. During HIV-1 infection, degradation of the KCNK channel is accelerated, and the cell membrane potential becomes pathologically depolarized. From studying functionally distinct KCNK mutants, we found that the degree of membrane potential depolarization was directly proportional to the release efficiency of HIV-1 virions. On the other hand, supplementation of KCNK channel modulators such as arachidonic acid (AA) and docosahexaenoic acid (DHA) at micromolar doses could restore hyperpolarization and stability of the cell membrane potential when endogenous KCNK channels are partially knocked down (mimicking the depolarized state of an HIV-1-infected cell)."	"CONCLUSION: The protective mechanism of LC-PUFAs against HIV spread involves stimulation of the endogenous KCNK channels. Our work suggests that supplementation with AA and DHA may be beneficial in reducing the risk of HIV-1 transmission, particularly during the period of breastfeeding."							
1173	Solutions to nutrition-related health problems of preschool children: education and nutritional policies for children.	"Darnton-Hill I, Kennedy E, Cogill B, Hossain SM."	Journal of Pediatric Gastroenterology & Nutrition. 2006;43 Suppl 3:S54-65.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=17204980	"OBJECTIVE: By reviewing the literature, lessons learned and experience regarding the nutrition-related health problems of preschool children, draw conclusions and make recommendations on education and nutrition policies for young children."	"RESULTS: The most common causes of under-5 mortality in low-income countries have been identified as neonatal disorders, diarrhoea, respiratory infections, malaria, measles, and in some developing countries, AIDS. More than half (56%) of all child deaths have underlying malnutrition and undernutrition as a contributing factor. Children must have optimal growth and physical and intellectual development to learn and achieve their potential in society. Solutions include both preventive and curative interventions at all levels and include both improved health and education systems. Recent focus has been on health systems interventions that address averting deaths by cause for the 42 countries that account for 90% of worldwide under-5 deaths (the majority in sub-Saharan Africa). However, parallel or multisectoral interventions must be addressed to all children at risk for death, poor health and compromised growth and development. Adequate health care and nutrition is a human right, legally established in the Convention on the Rights of the Child."	"CONCLUSIONS: Improved health and nutrition will lead to enhanced economic development, but having a poverty focus appears to be essential, if poor people are not to be marginalized further. The HIV/AIDS pandemic illustrates this challenge clearly. The role of education, especially girls' education, in improved health and nutrition status of children and birth-spacing is now clear, as is improving women's status. Increases in female status and education have been estimated to account for half of the reduction in child malnutrition rates during the past 25 years."							
1176	Solutions to nutrition-related health problems of preschool children: education and nutritional policies for children.	"Darnton-Hill I, Kennedy E, Cogill B, Hossain SMM."	Journal of Pediatric Gastroenterology and Nutrition. 2006;43(Supplement 3):S54-S65.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20073173066	"Objective: By reviewing the literature, lessons learned and experience regarding the nutrition-related health problems of preschool children, draw conclusions and make recommendations on education and nutrition policies for young children. Results: The most common causes of under-5 mortality in low-income countries have been identified as neonatal disorders, diarrhoea, respiratory infections, malaria, measles, and in some developing countries, AIDS. More than half (56%) of all child deaths have underlying malnutrition and undernutrition as a contributing factor. Children must have optimal growth and physical and intellectual development to learn and achieve their potential in society. Solutions include both preventive and curative interventions at all levels and include both improved health and education systems. Recent focus has been on health systems interventions that address averting deaths by cause for the 42 countries that account for 90% of worldwide under-5 deaths (the majority in sub-Saharan Africa). However, parallel or multisectoral interventions must be addressed to all children at risk for death, poor health and compromised growth and development. Adequate health care and nutrition is a human right, legally established in the Convention on the Rights of the Child. Conclusions: Improved health and nutrition will lead to enhanced economic development, but having a poverty focus appears to be essential, if poor people are not to be marginalized further. The HIV/AIDS pandemic illustrates this challenge clearly. The role of education, especially girls' education, in improved health and nutrition status of children and birth-spacing is now clear, as is improving women's status. Increases in female status and education have been estimated to account for half of the reduction in child malnutrition rates during the past 25 years."									
319	Clinical outcomes of severe malnutrition in a high tuberculosis and HIV setting.	"De Maayer T, Saloojee H."	Archives of Disease in Childhood. 2011;96(6):560-4.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=21310895	"OBJECTIVE: Case death rates for severe childhood malnutrition remain stubbornly elevated in high HIV prevalence settings, despite the implementation of WHO guidelines. This study examined case death and other clinical outcomes in malnourished children with and without HIV infection."	"METHODS: A prospective, observational study was undertaken at three tertiary hospitals in Johannesburg, South Africa. All severely malnourished children had their HIV status established, and anthropometric, clinical and diagnostic findings and admission outcomes were analysed."	"FINDINGS: Just over half (51%) of the 113 severely malnourished children were HIV infected, but 31/58 (54%) of these children had their positive status diagnosed only after admission. Marasmic children were significantly more likely to be HIV infected (OR 9.7, 95% CI 3.5 to 29.1). Tuberculosis (TB) was strongly suspected and treated in 27 children (24%) although confirmed in only five (4%). The overall case death rate was 11.5%. HIV infection, pallor and shock were significant predictors of death. HIV-infected children were six times more likely to die compared with HIV-negative children (19% vs 3.6%, OR 6.2, 95% CI 1.2 to 59). HIV-'affected' children (HIV negative but exposed) and HIV-negative children had similar outcomes."	CONCLUSION: HIV infection significantly increases severe malnutrition case death. WHO guidelines for the management of severe malnutrition in high HIV prevalence settings need to be modified to include routine HIV and TB testing and offer guidance on the criteria and timing of TB treatment and highly active antiretroviral therapy initiation.						
354	Low plasma levels of the soluble receptor for advanced glycation end products in HIV-infected patients with subclinical carotid atherosclerosis receiving combined antiretroviral therapy.	"Jeong S, Kim C, Song Y, Baek J, Kim S, Jin S, Ku N, et al."	Atherosclerosis. 2011;219(2):778-83.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20123006604	"Objective: Combined antiretroviral therapy (cART) has significantly improved the survival rate and quality of life for HIV-infected subjects, but it contributes to the development of metabolic complications including coronary artery disease (CAD). Recent studies have reported that high plasma levels of the soluble receptor for advanced glycation end products (sRAGE) were associated with a lower incidence of CAD in non-HIV infected patients. However, there has been no report of an association of sRAGE and subclinical carotid atherosclerosis in HIV-infected patients receiving cART. Methods: We examined the association of circulating sRAGE in HIV-infected patients with carotid intima-media thickness (IMT) and other metabolic variables. We prospectively enrolled 76 HIV-infected patients receiving cART for >=6 months. Results: sRAGE had a significantly negative correlation with body mass index (r=-0.324, p=0.005), waist-to-hip ratio (r=-0.335, p=0.003), systolic blood pressure (BP) (r=-0.359, p=0.002), diastolic BP (r=-0.343, p=0.004), total cholesterol (r=-0.240, p=0.037), low-density lipoprotein-cholesterol (r=-0.284, p=0.024), log(homeostasis model assessment of insulin resistance [HOMA-IR]) (r=-0.380, p=0.002) and carotid IMT including max-IMT and mean-IMT (r=-0.358, p=0.001 and r=-0.329, p=0.004, respectively). By the use of multiple stepwise regression analyses, systolic BP (p=0.001) and log[HOMA-IR] (p=0.001) remained significant independently. Conclusions: These results suggest that sRAGE may have a protective effect against subclinical atherosclerosis by preventing inflammatory responses mediated by the activation of cell surface RAGE in HIV-infected patients receiving cART."									
769	"Too little, too late: comparison of nutritional status and quality of life of nutrition care and support recipient and non-recipients among HIV-positive adults in KwaZulu-Natal, South Africa."	"Oketch JA, Paterson M, Maunder EW, Rollins NC."	Health Policy. 2011;99(3):267-76.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=20884072	"OBJECTIVE: Compare the nutritional vulnerability, risk of malnutrition, nutritional status and quality of life (QoL) between recipients and non-recipients of nutrition care and support (NCS) of HIV-positive adults."	"METHODS: In 2009, a household-based cross-sectional study of HIV-positive adults, NCS recipients (n=97) and non-NCS recipients (n=203) from KwaZulu-Natal was conducted. Nutritional vulnerability (socio-economic status; food security; self-reported health status; nutritional knowledge and attitude), risk of malnutrition (nutrition assessment screening tool), anthropometry (body mass index; mid-upper arm circumference; waist-to-hip ratio) and QoL (general health; self-care; physical functioning) were compared between the two groups."	"RESULT: Although the result suggests a modest impairment of QoL, NCS recipients were twice as likely to have severe impairment of general health; self-care functioning and QoL. Overweight and obesity were common despite indications of high prevalence of food insecurity, possible-risk of malnutrition and diets predominantly of cereals. NCS recipients were more frequently taking anti-retroviral drugs, receiving social grants, reporting good eating plans and owning kitchen gardens. Non-NCS recipients had been generally sick, reported fatigue, nausea, appetite loss and diarrhoea. NCS recipients were twice as likely to experience oral thrush."	CONCLUSION: Contextual factors such as low dietary diversity and household food insecurity that exacerbates nutritional vulnerability and malnutrition should be considered when providing NCS to fully achieve nutritional recovery and QoL of HIV-positive adults. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.						
1271	Prevalence of enteroparasites in immunocompromised and immunocompetent children.	"Chourio-Lozano G, Diaz I, Rivero-Rodriguez Z, Pena C, Cuenca E, Calchi M, Molero E."	Kasmera. 2002;30(2):156-73.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh3&AN=20033116971	"Objective: Determine the enteroparasite prevalence in immunocompromised and immunocompetent children in Zulia State, Venezuela. Materials and methods: Faecal samples from 78 children of both sexes, between the ages of 2 months and 12 years were distributed in 4 groups and analysed: undernourished (20), oncological (20), with HIV/AIDS infection (18) and a control group (20); the copro-parasitology test, Lugol, Nair and Kinyoun stains, Ritchie concentration technique and Arakaki technique (agar in plaque) were used. Results: 29 (37.2%) children had one or several kinds of enteroparasites distributed as follows: 7/20 (35.0%) for the undernourished and control group, 8/20 (40.0%) for oncology and 7/18 (38.9%) for children with HIV/AIDS infection. Children aged 2 years or younger had more parasites, which also occurred in undernourished children, children aged 3 to 6 years for the oncology group and children aged 7 to 12 years with HIV/AIDS infection. The prevalent parasites were: Ascaris lumbricoides (14.3%) and Blastocystis hominis (24.5%). Conclusions: The immunocompromised condition of the children under study (undernourishment, cancer and HIV/AIDS) was not significant for enteroparasite presence. Monoparasitism was prevalent in undernourished, oncology and control groups and polyparasitism was prevalent in children with HIV/AIDS infection."									
978	Association of low CD4 cell count and intrauterine growth retardation in Thailand.	"Cailhol J, Jourdain G, Le Coeur S, Traisathit P, Boonrod K, Prommas S, Putiyanun C, et al."	Journal of Acquired Immune Deficiency Syndromes. 2009 April;50(4):409-13.		"Objective: Each year, intrauterine growth retardation (IUGR) affects 20-30 million neonates worldwide, mostly in resource-limited settings. Increased perinatal and infant mortality has been associated with IUGR. Some studies have suggested that HIV infection could increase the risk of IUGR. To confirm this hypothesis, we examined the association between HIV-related factors and the risk of IUGR in Thailand. Patients and Methods: Data from a cohort of 1436 HIV-infected pregnant women enrolled in the ""Perinatal HIV Prevention Trial-1"", a clinical trial conducted from 1997 to 1999 in Thailand, were analyzed using a logistic regression, adjusting for risk factors usually associated with IUGR. Results: The rate of IUGR was 7.6%. Adjusting for a short maternal height, low body mass index, small weight gain during pregnancy, and infant female sex, a low maternal CD4 percentage was independently associated with IUGR (odds ratio 0.96, per 1% increment, 95% confidence interval 0.93 to 0.99, P = 0.03). Conclusions: The current World Health Organization recommendation to initiate combination antiretroviral therapy for immunocompromised women as early as possible during pregnancy for their own health and for the prevention of HIV mother-to-child transmission is likely to also decrease the incidence of IUGR. Encouraging immunocompromised HIV-infected women who plan to become pregnant to wait until immune restoration has been achieved may help to reduce the risk of IUGR. Copyright 2009 by Lippincott Williams & Wilkins."									
31	"Reliability of scored patient generated subjective global assessment for nutritional status among HIV infected adults in TASO, Kampala."	"Mokori A, Kabehenda MK, Nabiryo C, Wamuyu MG."	African Health Sciences. 2011;11 Suppl 1:S86-92.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=22135651	OBJECTIVE: Establish the reliability of the scored Patient Generated-Subjective Global Assessment (PG-SGA) in determining nutritional status among Antiretroviral Therapy (ART) naive HIV-infected adults.	"METHODS: A descriptive, cross sectional study among outpatient medical clinics, in The AIDS Support Organization (TASO), Mulago Centre, Kampala, Uganda. The study group (n=217) consisted of male (n=60) and female (n=157) HIV patients (18-67 years). Purposive sampling was used. Anthropometry (weight, height, BMI), nutritional history (body weight, dietary intake, gastrointestinal symptoms, functional capacity and infections), and clinical status were assessed. Sensitivity and specificity of PG-SGA were determined using Receiver Operating Characteristic (ROC) curve. Data collection was done from April-May 2008."	RESULTS: Only 12% of the subjects were underweight and over half (58.2%) had normal weight. The PG-SGA had low sensitivity (69.2%) and specificity (57.1%) at categorizing the risk for malnutrition indicated by BMI< 18.5.	"CONCLUSION: There was a high prevalence of malnutrition among the study group. Overall, this study indicated the PG-SGA could not adequately discriminate between underweight and normal patients. The tool was not reliable enough for determining nutritional status in this population."						
320	Nutritional recovery in HIV-infected and HIV-uninfected children with severe acute malnutrition.	"Fergusson P, Chinkhumba J, Grijalva-Eternod C, Banda T, Mkangama C, Tomkins A."	Archives of Disease in Childhood. 2009;94(7):512-6.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=18977785	"OBJECTIVE: Few studies have reported on nutritional recovery, survival and growth among severely malnourished children with HIV. This study explores nutritional recovery in HIV-infected and HIV-uninfected children during inpatient nutrition rehabilitation and 4 months of follow-up."	DESIGN: Prospective cohort study.	"SETTING: Lilongwe district, Malawi."	"MAIN OUTCOME MEASURES: Weight gain, anthropometrics."	"RESULTS: In our sample of 454 children with severe acute malnutrition (SAM), 17.4% (n = 79) of children were HIV infected. None of the children were on antiretroviral therapy upon admission. Among the HIV-infected children, 35.4% (28/79) died, compared with 10.4% (39/375) in HIV-uninfected children (p<0.001). All children who survived achieved nutritional recovery (>85% weight for height and no oedema), regardless of HIV status. HIV-infected children had similar weight gain to HIV-uninfected children (8.9 vs 8.0 g/kg/d, not significant (NS)). Mean increases in z-scores for both subscapular (2.72 vs 2.69, NS) and triceps (1.26 vs 1.48, NS) skinfolds were similar between HIV-infected and HIV-uninfected children, respectively, during nutrition rehabilitation. 362 children were followed for 4 months, at which time mean weight for height z-score was similar in HIV-infected and HIV-uninfected children (-0.85 vs -0.64, NS)."	"CONCLUSIONS: HIV-infected children with SAM have higher mortality rates than HIV-uninfected children. Among those who survive, however, nutritional recovery is similar in HIV-infected and HIV-uninfected children."				
1659	Development of a nutrient-dense food supplement for HIV-infected women in rural Kenya using qualitative and quantitative research methods.	"Hong SY, Hendricks KM, Wanke C, Omosa G, Patta S, Mwero B, Mjomba I, et al."	Public Health Nutrition. 2013;16(4):721-9.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=22974548	"OBJECTIVE: Formative research to facilitate the development, packaging and delivery of a culturally acceptable nutrition intervention for HIV-infected women in rural Kenya for an intervention trial."	"DESIGN: Focus group discussion on three areas: (i) ingredients and form of the nutrition intervention, (ii) packaging and delivery and (iii) monitoring of adherence. Two single-blind taste tests with eleven different porridge formulations of various combinations of maize flour, soyabeans, peanuts, sorghum, mung beans, dried fish, raisins and dried whole milk. Follow-up acceptability focus group discussion was also conducted."	"SETTING: Voi, Kenya, community based."	SUBJECTS: Focus group discussion and two taste tests (twenty-one women aged 16-55 years). Follow-up acceptability focus group discussion (four women enrolled in intervention trial).	"RESULTS: The preferred porridge for taste consisted of maize, soyabeans and peanuts. For animal protein, dried whole milk and dried fish were used. Although the women disliked the taste of dried fish, it was acceptable if added in small undetectable quantities. Sugar over lime was favoured for taste. Women believed they could consume at least two cups of porridge per day without displacing their usual meals. The optimal delivery interval was believed to be every two weeks in individual serving packages. Women who had been consuming porridge for several weeks felt the taste was acceptable for long-term consumption."	"CONCLUSIONS: This formative research resulted in the development, packaging and delivery of a nutrient-dense food supplement using local ingredients to meet the dietary needs of the population and acceptable for daily consumption by women in Kenya for evaluation in an intervention trial."				
1016	"Feasibility of using flash-heated breastmilk as an infant feeding option for HIV-exposed, uninfected infants after 6 months of age in urban Tanzania."	"Chantry CJ, Young SL, Rennie W, Ngonyani M, Mashio C, Israel-Ballard K, Peerson J, et al."	Journal of Acquired Immune Deficiency Syndromes: JAIDS. 2012;60(1):43-50.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=22362154	"OBJECTIVE: Heat-treating expressed breastmilk is recommended as an interim feeding strategy for HIV-exposed infants in resource-poor countries, but data on its feasibility are minimal. Flash-heating (FH) is a simple in-home technique for heating breastmilk that inactivates HIV although preserving its nutritional and anti-infective properties. Our primary objective was to determine, among HIV-infected mothers, the feasibility and protocol adherence of FH expressed breastmilk after 6 months of exclusive breastfeeding."	DESIGN: Prospective longitudinal.	PARTICIPANTS: One hundred one HIV-infected breastfeeding mothers.	"SETTING: Dar es Salaam, Tanzania."	"INTERVENTION: Peer counselors provided in-home counseling and support on infant feeding from 2 to 9 months postpartum. Mothers were encouraged to exclusively breastfeed for 6 months followed by FH expressed breastmilk if her infant was HIV negative. Clinic-based staff measured infant growth and morbidity monthly, and mothers kept daily logs of infant morbidity. FH behavior was tracked until 9 months postpartum using daily logs, in-home observations, and clinic-based and home-based surveys. Bacterial cultures of unheated and heated milk samples were performed."	RESULTS: Thirty-seven of 72 eligible mothers (51.4%) chose to flash-heat. Median (range) frequency of milk expression was 3 (1-6) times daily and duration of method use on-study was 9.7 (0.1-15.6) weeks. Mean (SD) daily milk volume was 322 (201) mL (range 25-1120). No heated and 32 (30.5%) unheated samples contained bacterial pathogens.	"CONCLUSIONS: FH is a simple technology that many HIV-positive women can successfully use after exclusive breastfeeding to continue to provide the benefits of breastmilk while avoiding maternal-to-child transmission associated with nonexclusive breastfeeding. Based on these feasibility data, a clinical trial of the effects of FH breastmilk on infant health outcomes is warranted."			
1530	Prevalence of lipodystrophy in HIV-infected children in Tanzania on highly active antiretroviral therapy.	"Kinabo GD, Sprengers M, Msuya LJ, Shayo AM, Asten Hv, Dolmans WMV, Ven AJAMvd, et al."	Pediatric Infectious Disease Journal. 2013;32(1):39-44.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20133023340	"Objective: Highly active antiretroviral therapy (HAART) has been associated with lipodystrophy (LD) in adults but data are more limited for children. The purpose of this study was to determine the prevalence of and risk factors for LD in Tanzanian children receiving HAART by clinical assessment and to compare the results with anthropometric data. Design and Methods: A cross-sectional study was performed in a cohort of HIV-infected children aged 1-18 years receiving HAART in a single center in Moshi, Tanzania. Age, gender, past and current medication regimens and anthropometric measurements were recorded. A clinical scoring method was used to assess LD. Backward binary multivariate logistic regression was used to determine relationships between anthropometric measurements and the presence of clinical LD. Results: Among 210 HIV-infected children, the prevalence of LD was 30% (95% confidence interval [CI]: 23.8-36.2) overall, 19% (95% CI: 13.7-24.3) for lipoatrophy only, 3.8% (95% CI: 1.2-6.4) for lipohypertrophy only and 7.1% (95% CI: 3.6-10.6) for the mixed type. Most cases were mild. Older age and use of stavudine increased the risk of LD. Overall, the study population was stunted but not underweight. In children with relatively lower weight-for-height (<1), only the mid-upper arm circumference was found to be associated with lipoatrophy, while nearly all anthropometric measurements were associated with lipoatrophy in the well-nourished (weight-for-height >=1) children. Conclusions: Our findings demonstrate that LD is a significant problem among Tanzanian HIV-infected children receiving HAART. Anthropometric measurements predicted LD in well-nourished children but generally failed to do so in relatively wasted children. Our findings support current efforts to avoid stavudine use in children."									
1531	Prevalence of lipodystrophy in HIV-infected children in Tanzania on highly active antiretroviral therapy.	"Kinabo GD, Sprengers M, Msuya LJ, Shayo AM, Van Asten H, Dolmans WMV, Van Der Ven AJAM, et al."	Pediatric Infectious Disease Journal. 2013 January;32(1):39-44.		"Objective: Highly active antiretroviral therapy (HAART) has been associated with lipodystrophy (LD) in adults but data are more limited for children. The purpose of this study was to determine the prevalence of and risk factors for LD in Tanzanian children receiving HAART by clinical assessment and to compare the results with anthropometric data. DESIGN AND Methods: A cross-sectional study was performed in a cohort of HIV-infected children aged 1-18 years receiving HAART in a single center in Moshi, Tanzania. Age, gender, past and current medication regimens and anthropometric measurements were recorded. A clinical scoring method was used to assess LD. Backward binary multivariate logistic regression was used to determine relationships between anthropometric measurements and the presence of clinical LD. Results: Among 210 HIV-infected children, the prevalence of LD was 30% (95% confidence interval [CI]: 23.8-36.2) overall, 19% (95% CI: 13.7-24.3) for lipoatrophy only, 3.8% (95% CI: 1.2-6.4) for lipohypertrophy only and 7.1% (95% CI: 3.6-10.6) for the mixed type. Most cases were mild. Older age and use of stavudine increased the risk of LD. Overall, the study population was stunted but not underweight. In children with relatively lower weight-for-height (<1), only the mid-upper arm circumference was found to be associated with lipoatrophy, while nearly all anthropometric measurements were associated with lipoatrophy in the well-nourished (weight-for-height 1) children. Conclusions: Our findings demonstrate that LD is a significant problem among Tanzanian HIV-infected children receiving HAART. Anthropometric measurements predicted LD in well-nourished children but generally failed to do so in relatively wasted children. Our findings support current efforts to avoid stavudine use in children. 2012 Lippincott Williams & Wilkins."									
644	Prevalence of cardiometabolic risk factors in hispanics living with HIV.	"Ramirez-Marrero FA, De Jesus E, Santana-Bagur J, Hunter R, Frontera W, Joyner MJ."	Ethnicity and Disease. 2010 Autumn;20(4):423-8.		"Objective: Human immunodeficiency virus (HIV) infection and antiretroviral treatment are associated with metabolic and cardiovascular complications that resemble metabolic syndrome (MetS) and potentially increase the risk of diabetes and cardiovascular disease in this population. The purpose of this study was to determine the prevalence of MetS and its individual components among Hispanics living with HIV in Puerto Rico. Methods: Data from 909 clinical records were extracted and the prevalence of MetS determined using the NCEP-ATPIII criteria. Fisher's exact test was used to detect sex differences, and logistic regression to examine the effect of age, sex, smoking, years of HIV infection, antiretroviral therapy, and Hepatitis C coinfection. Results: The prevalence of MetS in our study group (35.4%) was higher than previously reported in the United States, but not higher than in the general population in Puerto Rico. Females had a higher prevalence of MetS (44.2%) than males (30.5%); mostly explained by high body mass index and waist circumference. Age and sex were associated with the presence of MetS. Conclusion: Understanding ethnic and sex differences in the prevalence of metabolic risk factors is essential for the implementation of specific targeted interventions to prevent subsequent vascular morbidity and mortality in this population."									
1542	"Complementary feeding adequacy in relation to nutritional status among early weaned breastfed children who are born to HIV-infected mothers: ANRS 1201/1202 Ditrame Plus, Abidjan, Cote d'Ivoire."	"Becquet R, Leroy V, Ekouevi DK, Viho I, Castetbon K, Fassinou P, Dabis F, et al."	Pediatrics. 2006 Apr;117(4):e701-10.		"OBJECTIVE: In high HIV prevalence resource-constrained settings, exclusive breastfeeding with early cessation is one of the conceivable interventions aimed at the prevention of HIV through breast milk. Nevertheless, this intervention has potential adverse effects, such as the inappropriateness of complementary feeding to take over breast milk. The purpose of our study first was to describe the nature and the ages of introduction of complementary feeding among early weaned breastfed infants up to their first birthday and second was to assess the nutritional adequacy of these complementary foods by creating a child feeding index and to investigate its association with child nutritional status. METHODS: A prospective cohort study in Abidjan, Cote d'Ivoire, was conducted in HIV-infected pregnant women who were willing to breastfeed and had received a perinatal antiretroviral prophylaxis. They were requested to practice exclusive breastfeeding and initiate early cessation of breastfeeding from the fourth month to reduce breast milk HIV transmission. Nature and ages of introductory complementary feeding were described in infants up to their first birthday by longitudinal compilation of 24-hour and 7-day recall histories. These recalls were done weekly until 6 weeks of age, monthly until 9 months of age, and then quarterly. We created an index to synthesize the nutritional adequacy of infant feeding practices (in terms of quality of the source of milk, dietary diversity, food, and meal frequencies) ranging from 0 to 12. The association of this feeding index with growth outcomes in children was investigated. RESULTS: Among the 262 breastfed children included, complete cessation of breastfeeding occurred in 77% by their first birthday, with a median duration of 4 months. Most of the complementary foods were introduced within the seventh month of life, except for infant food and infant formula that were introduced at age 4 months. The feeding index was relatively low (5 of 12) at age 6 months, mainly as a result of insufficient dietary diversity, but was improved in the next 6 months (8.5 of 12 at 12 months of age). Inadequate complementary feeding at age 6 months was associated with impaired growth during the next 12 months, with a 37% increased probability of stunting. CONCLUSION: Adequate feeding practices around the weaning period are crucial to achieving optimal child growth. HIV-infected women should turn to early cessation of breastfeeding only when they are counseled properly to provide adequate complementary feeding to take over breast milk. Our child feeding index could contribute to the assessment of the nutritional adequacy of complementary feeding around the weaning period and therefore help to detect children who are at risk for malnutrition."									
1543	"Complementary feeding adequacy in relation to nutritional status among early weaned breastfed children who are born to HIV-infected mothers: ANRS 1201/1202 Ditrame Plus, Abidjan, Cote d'Ivoire."	"Becquet R, Leroy V, Ekouevi DK, Viho I, Castetbon K, Fassinou P, Dabis F, et al."	Pediatrics. 2006;117(4):e701-10.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medc&AN=16585284	"OBJECTIVE: In high HIV prevalence resource-constrained settings, exclusive breastfeeding with early cessation is one of the conceivable interventions aimed at the prevention of HIV through breast milk. Nevertheless, this intervention has potential adverse effects, such as the inappropriateness of complementary feeding to take over breast milk. The purpose of our study first was to describe the nature and the ages of introduction of complementary feeding among early weaned breastfed infants up to their first birthday and second was to assess the nutritional adequacy of these complementary foods by creating a child feeding index and to investigate its association with child nutritional status."	"METHODS: A prospective cohort study in Abidjan, Cote d'Ivoire, was conducted in HIV-infected pregnant women who were willing to breastfeed and had received a perinatal antiretroviral prophylaxis. They were requested to practice exclusive breastfeeding and initiate early cessation of breastfeeding from the fourth month to reduce breast milk HIV transmission. Nature and ages of introductory complementary feeding were described in infants up to their first birthday by longitudinal compilation of 24-hour and 7-day recall histories. These recalls were done weekly until 6 weeks of age, monthly until 9 months of age, and then quarterly. We created an index to synthesize the nutritional adequacy of infant feeding practices (in terms of quality of the source of milk, dietary diversity, food, and meal frequencies) ranging from 0 to 12. The association of this feeding index with growth outcomes in children was investigated."	"RESULTS: Among the 262 breastfed children included, complete cessation of breastfeeding occurred in 77% by their first birthday, with a median duration of 4 months. Most of the complementary foods were introduced within the seventh month of life, except for infant food and infant formula that were introduced at age 4 months. The feeding index was relatively low (5 of 12) at age 6 months, mainly as a result of insufficient dietary diversity, but was improved in the next 6 months (8.5 of 12 at 12 months of age). Inadequate complementary feeding at age 6 months was associated with impaired growth during the next 12 months, with a 37% increased probability of stunting."	CONCLUSION: Adequate feeding practices around the weaning period are crucial to achieving optimal child growth. HIV-infected women should turn to early cessation of breastfeeding only when they are counseled properly to provide adequate complementary feeding to take over breast milk. Our child feeding index could contribute to the assessment of the nutritional adequacy of complementary feeding around the weaning period and therefore help to detect children who are at risk for malnutrition.						
1541	"Complementary feeding adequacy in relation to nutritional status among early weaned breastfed children who are born to HIV-infected mothers: ANRS 1201/1202 Ditrame Plus, Abidjan, Cªte d'Ivoire."	"Becquet R, Leroy V, Ekouevi DK, Viho I, Castetbon K, Fassinou P, Dabis F, et al."	Pediatrics. 2006;117(4):e701-10.	http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=2009170711&site=ehost-live	"OBJECTIVE: In high HIV prevalence resource-constrained settings, exclusive breastfeeding with early cessation is one of the conceivable interventions aimed at the prevention of HIV through breast milk. Nevertheless, this intervention has potential adverse effects, such as the inappropriateness of complementary feeding to take over breast milk. The purpose of our study first was to describe the nature and the ages of introduction of complementary feeding among early weaned breastfed infants up to their first birthday and second was to assess the nutritional adequacy of these complementary foods by creating a child feeding index and to investigate its association with child nutritional status. METHODS: A prospective cohort study in Abidjan, Cªte d'Ivoire, was conducted in HIV-infected pregnant women who were willing to breastfeed and had received a perinatal antiretroviral prophylaxis. They were requested to practice exclusive breastfeeding and initiate early cessation of breastfeeding from the fourth month to reduce breast milk HIV transmission. Nature and ages of introductory complementary feeding were described in infants up to their first birthday by longitudinal compilation of 24-hour and 7-day recall histories. These recalls were done weekly until 6 weeks of age, monthly until 9 months of age, and then quarterly. We created an index to synthesize the nutritional adequacy of infant feeding practices (in terms of quality of the source of milk, dietary diversity, food, and meal frequencies) ranging from 0 to 12. The association of this feeding index with growth outcomes in children was investigated. RESULTS: Among the 262 breastfed children included, complete cessation of breastfeeding occurred in 77% by their first birthday, with a median duration of 4 months. Most of the complementary foods were introduced within the seventh month of life, except for infant food and infant formula that were introduced at age 4 months. The feeding index was relatively low (5 of 12) at age 6 months, mainly as a result of insufficient dietary diversity, but was improved in the next 6 months (8.5 of 12 at 12 months of age). Inadequate complementary feeding at age 6 months was associated with impaired growth during the next 12 months, with a 37% increased probability of stunting. CONCLUSION: Adequate feeding practices around the weaning period are crucial to achieving optimal child growth. HIV-infected women should turn to early cessation of breastfeeding only when they are counseled properly to provide adequate complementary feeding to take over breast milk. Our child feeding index could contribute to the assessment of the nutritional adequacy of complementary feeding around the weaning period and therefore help to detect children who are at risk for malnutrition."									
1661	Self-reported dietary intake and appetite predict early treatment outcome among low-BMI adults initiating HIV treatment in sub-Saharan Africa.	"Koethe JR, Blevins M, Bosire C, Nyirenda C, Kabagambe EK, Mwango A, Kasongo W, et al."	Public Health Nutrition. 2013;16(3):549-58.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=22691872	"OBJECTIVE: Low BMI is a major risk factor for early mortality among HIV-infected persons starting antiretrovial therapy (ART) in sub-Saharan Africa and the common patient belief that antiretroviral medications produce distressing levels of hunger is a barrier to treatment adherence. We assessed relationships between appetite, dietary intake and treatment outcome 12 weeks after ART initiation among HIV-infected adults with advanced malnutrition and immunosuppression."	"DESIGN: A prospective, observational cohort study. Dietary intake was assessed using a 24 h recall survey. The relationships of appetite, intake and treatment outcome were analysed using time-varying Cox models."	"SETTING: A public-sector HIV clinic in Lusaka, Zambia."	SUBJECTS: One hundred and forty-two HIV-infected adults starting ART with BMI <16 kg/m2 and/or CD4+ lymphocyte count <50 cells/ul.	"RESULTS: Median age, BMI and CD4+ lymphocyte count were 32 years, 16 kg/m2 and 34 cells/ul, respectively. Twenty-five participants (18%) died before 12 weeks and another thirty-three (23%) were lost to care. A 500 kJ/d higher energy intake at any time after ART initiation was associated with an approximate 16% reduction in the hazard of death (adjusted hazard ratio = 0.84; P = 0.01), but the relative contribution of carbohydrate, protein or fat to total energy was not a significant predictor of outcome. Appetite normalized gradually among survivors and hunger was rarely reported."	CONCLUSIONS: Poor early ART outcomes were strikingly high in a cohort of HIV-infected adults with advanced malnutrition and mortality was predicted by lower dietary intake. Intervention trials to promote post-ART intake in this population may benefit survival and are warranted.				
1925	"Growth response to antiretroviral treatment in HIV-infected children: a cohort study from Lilongwe, Malawi."	"Weigel R, Phiri S, Chiputula F, Gumulira J, Brinkhof M, Gsponer T, Tweya H, et al."	Tropical Medicine & International Health. 2010;15(8):934-44.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=20561308	OBJECTIVE: Malnutrition is common in HIV-infected children in Africa and an indication for antiretroviral treatment (ART). We examined anthropometric status and response to ART in children treated at a large public-sector clinic in Malawi.	METHODS: All children aged <15 years who started ART between January 2001 and December 2006 were included and followed until March 2008. Weight and height were measured at regular intervals from 1 year before to 2 years after the start of ART. Sex- and age-standardized z-scores were calculated for weight-for-age (WAZ) and height-for-age (HAZ). Predictors of growth were identified in multivariable mixed-effect models.	"RESULTS: A total of 497 children started ART and were followed for 972 person-years. Median age (interquartile range; IQR) was 8 years (4-11 years). Most children were underweight (52% of children), stunted (69%), in advanced clinical stages (94% in WHO stages 3 or 4) and had severe immunodeficiency (77%). After starting ART, median (IQR) WAZ and HAZ increased from -2.1 (-2.7 to -1.3) and -2.6 (-3.6 to -1.8) to -1.4 (-2.1 to -0.8) and -1.8 (-2.4 to -1.1) at 24 months, respectively (P < 0.001). In multivariable models, baseline WAZ and HAZ scores were the most important determinants of growth trajectories on ART."	"CONCLUSIONS: Despite a sustained growth response to ART among children remaining on therapy, normal values were not reached. Interventions leading to earlier HIV diagnosis and initiation of treatment could improve growth response."						
1620	Maternal nutritional status predicts adverse birth outcomes among HIV-infected rural Ugandan women receiving combination antiretroviral therapy.	"Young S, Murray K, Mwesigwa J, Natureeba P, Osterbauer B, Achan J, Arinaitwe E, et al."	PLoS ONE [Electronic Resource]. 2012;7(8):e41934.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=22879899	"OBJECTIVE: Maternal nutritional status is an important predictor of birth outcomes, yet little is known about the nutritional status of HIV-infected pregnant women treated with combination antiretroviral therapy (cART). We therefore examined the relationship between maternal BMI at study enrollment, gestational weight gain (GWG), and hemoglobin concentration (Hb) among 166 women initiating cART in rural Uganda."	DESIGN: Prospective cohort.	"METHODS: HIV-infected, ART-naive pregnant women were enrolled between 12 and 28 weeks gestation and treated with a protease inhibitor or non-nucleoside reverse transcriptase inhibitor-based combination regimen. Nutritional status was assessed monthly. Neonatal anthropometry was examined at birth. Outcomes were evaluated using multivariate analysis."	"RESULTS: Mean GWG was 0.17 kg/week, 14.6% of women experienced weight loss during pregnancy, and 44.9% were anemic. Adverse fetal outcomes included low birth weight (LBW) (19.6%), preterm delivery (17.7%), fetal death (3.9%), stunting (21.1%), small-for-gestational age (15.1%), and head-sparing growth restriction (26%). No infants were HIV-infected. Gaining <0.1 kg/week was associated with LBW, preterm delivery, and a composite adverse obstetric/fetal outcome. Maternal weight at 7 months gestation predicted LBW. For each g/dL higher mean Hb, the odds of small-for-gestational age decreased by 52%."	"CONCLUSIONS: In our cohort of HIV-infected women initiating cART during pregnancy, grossly inadequate GWG was common. Infants whose mothers gained <0.1 kg/week were at increased risk for LBW, preterm delivery, and composite adverse birth outcomes. cART by itself may not be sufficient for decreasing the burden of adverse birth outcomes among HIV-infected women."	TRIAL REGISTRATION: Clinicaltrials.gov NCT00993031.				
1054	"Serum zinc levels of school children on a corn-soy blend feeding trial in primary schools in Suba district, Kenya."	"Ohiokpehai O, David DM, Kamau J."	Journal of Applied Biosciences. 2009;17:904-12.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20093217843	"Objective: Micronutrient deficiencies are among the top 10 leading causes of death in Sub-Saharan Africa. In Suba district of Kenya, the problem is compounded by high poverty levels and a high prevalence of HIV and AIDS. This study determined the effect of corn soya fortified complementary food on serum zinc levels among primary school pupils in Suba district. Methodology and results: An experimental study was conducted on children recruited from 2 schools (Mbita and Sindo). They were fed with corn soya blend for 3 months. Children recruited from the 3rd school (Ong'ayo primary) were used as controls and were not fed with the corn-soya blend. Blood samples at baseline were drawn from 156 school children aged 6-9 years from the 3 schools (Mbita, n=55; Sindo, n=52; and Ong'ayo, n=49) through systematic sampling while blood samples at follow-up were drawn from 138 children (Mbita, n=49; Sindo, n=46; and Ong'ayo, n=43). Assessments of serum zinc were done before and after 3 months of feeding. SPSS and Nutri-survey software packages were used to analyze data into descriptive and inferential statistics. At baseline, nearly all (95.7%) the pupils were found to be deficient, with low serum zinc (<10.7 micro m/litre). There was a significant reduction (P=0.0421) in the number of zinc-deficient cases to 70.2% after feeding for 3 months on corn soya blend with the mean serum zinc having improved from 8.4 to 10.2 micro m/litre (P=0.002). Although not significantly different, girls had higher serum zinc levels than boys before feeding trials, while the opposite was observed after the feeding trials. Conclusion and potential application of findings: The fortified complementary food significantly improved serum zinc levels and reduced the level of absenteeism from school. Parents are therefore encouraged to introduce and ensure families consume more of corn soya blended foods at home. It would also be valuable for schools with feeding programmes to introduce corn soya blends or products as part of school meals. The findings can also be used by policy makers to promote production and consumption of soya beans. Authors recommend a similar study be conducted in a different area among the same age group and results compared to validate the findings of this study."									
677	High prevalence of elevated liver enzymes in blood donors: associations with male gender and central adiposity.	"Papatheodoridis GV, Goulis J, Christodoulou D, Manolakopoulos S, Raptopoulou M, Andrioti E, Alexandropoulos N, et al."	European Journal of Gastroenterology & Hepatology. 2007;19(4):281-7.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20073251730	"Objective: Nonalcoholic fatty liver disease is an increasingly recognized condition, but its exact prevalence is unknown. In this prospective, multicenter study, we evaluated the prevalence of elevated alanine aminotransferase, aspartate aminotransferase, and [gamma]-glutamyl-transpeptidase levels as indirect markers of nonalcoholic fatty liver disease in volunteer blood donors as well as their associations with epidemiological and anthropometrical characteristics. Methods: Alanine aminotransferase, aspartate aminotransferase and [gamma]-glutamyl-transpeptidase levels were determined in blood donors from four transfusion centers during the morning sessions of a 3-month period. Cases with positive hepatitis B surface antigen, anti-hepatitis C virus, anti-HIV or elevated liver enzymes and alcohol abuse were excluded. Results: Abnormal liver enzymes were found in 17.6% of 3063 participants (alanine aminotransferase: 14.5%, aspartate aminotransferase: 4.6%, [gamma]-glutamyl-transpeptidase: 4.7%). Individuals with abnormal compared with those with normal liver enzymes or alanine aminotransferase values were more frequently men and had higher weight, body mass index, waist, hip and neck circumference (P<0.001 for all comparisons). The prevalence of abnormal liver enzymes was also associated with the transfusion center ranging between 8.8 and 22.1% (P<0.001) and alcohol consumption (P=0.001). In multivariate analysis, presence of elevated enzymes was independently associated with male sex, higher weight or body mass index, higher waist circumference and transfusion center. Conclusions: More than 15% of Greek blood donors exhibit elevated liver enzymes, most likely as a result of unrecognized nonalcoholic fatty liver disease. The prevalence of nonalcoholic fatty liver disease is mainly associated with male sex, obesity and waist circumference, but it may range significantly among different population groups."									
1683	The effects of exercise training on quality of life in HAART-treated HIV-positive Rwandan subjects with body fat redistribution.	"Mutimura E, Stewart A, Crowther NJ, Yarasheski KE, Cade WT."	Quality of Life Research. 2008;17(3):377-85.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medc&AN=18320351	OBJECTIVE: Our objective was to examine the effects of exercise training (EXS) on quality of life (QoL) in highly active antiretroviral therapy (HAART)-treated HIV-positive (HIV+) subjects with body fat redistribution (BFR) in Rwanda.	METHODS: The effects of a randomised controlled trial of EXS on QoL were measured using World Health Organisation Quality of Life (WHOQOL)-BREF in HIV+ subjects with BFR randomised to EXS (n = 50; BFR + EXS) or no exercise training (n = 50; BFR + noEXS).	"RESULTS: At 6 months, scores on the psychological [1.3 (0.3) vs. 0.5 (0.1); P < 0.0001], independence [0.6 (0.1) vs. 0.0 (0.0); P < 0.0001], social relationships [0.6 (0.2) vs. 0.0 (0.0); P < 0.0001] and HIV HAART-specific QoL domains [1.4 (0.2) vs. -0.1 (0.2); P < 0.0001] improved more in BFR + EXS than BFR + noEXS group, respectively. Self-esteem [1.3 (0.8) vs. 0.1 (0.6); P < 0.001], body image [1.5 (0.6) vs. 0.0 (0.5); P < 0.001] and emotional stress [1.6 (0.7) vs. 0.2 (0.5); P < 0.001] improved more in the BFR + EXS group than BFR + noEXS group, respectively. Psychological [1.5 (0.2) vs. 1.1 (0.3); P < 0.0001], social relationship [0.8 (0.2) vs. 0.4 (0.2); P < 0.0001], and HIV HAART-specific well-being [1.8 (0.2) vs. 1.0 (0.0); P < 0.0001] improved more in BFR + EXS female than male subjects."	"CONCLUSIONS: Exercise training improved several components of QoL in HAART-treated HIV+ African subjects with BFR. Exercise training is an inexpensive and efficacious strategy for improving QoL in HIV+ African subjects, which may improve HAART adherence and treatment initiatives in resource-limited areas of sub-Saharan Africa."						
67	"Randomized trial testing the effect of vitamin A supplementation on pregnancy outcomes and early mother-to-child HIV-1 transmission in Durban, South Africa. South African Vitamin A Study Group."	"Coutsoudis A, Pillay K, Spooner E, Kuhn L, Coovadia HM."	AIDS. 1999;13(12):1517-24.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=10465076	OBJECTIVE: Poor vitamin A status has been associated with a higher risk for mother-to-child transmission of HIV-1 and there is contradictory evidence on the impact of vitamin A on perinatal outcome. We therefore assessed the effect of vitamin A supplementation to mothers on birth outcome and mother-to-child transmission of HIV-1.	"DESIGN AND METHODS: In Durban, South Africa 728 pregnant HIV infected women received either vitamin A (368) or placebo (360) in a randomized, double-blind trial. The vitamin A treatment consisted of a daily dose of 5000 IU retinyl palmitate and 30 mg beta-carotene during the third trimester of pregnancy and 200000 IU retinyl palmitate at delivery. HIV infection results were available on 632 children who were included in the Kaplan-Meier transmission analysis. Results are reported on mother-to-child transmission rates up to 3 months of age."	"RESULTS: There was no difference in the risk of HIV infection by 3 months of age between the vitamin A [20.3%; 95% confidence interval (CI), 15.7-24.9] and placebo groups (22.3%; 95% CI, 17.5-27.1), nor were there differences in foetal or infant mortality rates between the two groups. Women receiving vitamin A supplement were, however, less likely to have a preterm delivery (11.4% in the vitamin A and 17.4% in the placebo group; P = 0.03) and among the 80 preterm deliveries, those assigned to the vitamin A group were less likely to be infected (17.9%; 95% CI, 3.5-32.2) than those assigned to the placebo group (33.8%; 95% CI, 19.8-47.8)."	"CONCLUSION: Vitamin A supplementation, a low-cost intervention, does not appear to be effective in reducing overall mother-to-child transmission of HIV; however, its potential for reducing the incidence of preterm births, and the risk of mother-to-child transmission of HIV in these infants needs further investigation."						
1094	Epidemiology of hypertension in low-income countries: A cross-sectional population-based survey in rural Uganda.	"Maher D, Waswa L, Baisley K, Karabarinde A, Unwin N."	Journal of Hypertension. 2011 June;29(6):1061-8.		"Objective: Population-based data on burden of hypertension are crucial for planning and implementation of prevention and control strategies but are often limited in developing countries in Africa. We assessed the prevalence of hypertension and related risk factors in a population cohort in rural Uganda initially established for HIV surveys. Methods: In a cross-sectional population-based survey of hypertension and related risk factors in 2009, trained field staff administered a questionnaire and obtained a single measurement of blood pressure, BMI, waist and hip circumference, waist/hip ratio (WHR) and random plasma glucose. All members of the population cohort aged 13 years and above were eligible for survey participation. Logistic regression was used to evaluate factors associated with high blood pressure, defined as SBP (mmHg) a1 140 or DBP a1 90. Results: Of the 4801 men and 5372 women who were eligible, 2719 (56.6%) men and 3959 (73.7%) women participated in the survey. The prevalence of high blood pressure was 22.0%, age standardized to the local population. Factors that were independently associated with high blood pressure were increasing age, BMI and elevated glucose in both sexes, extremes of education level (none and secondary or above) among men, and being unmarried and waist circumference a1 80 cm among women. Levels of reported hypertension were very low, with nine out 10 people unaware of their condition. Conclusion: The use of established research infrastructure, for example, community HIV surveys, can help to generate the population-based data on the prevalence of hypertension and related risk factors needed to inform planning and implementation of effective prevention and control strategies in low-income countries. There is an urgent need to strengthen health services in responding effectively to the large burden of undetected hypertension. 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins."									
1009	"Prevalent pregnancy, biological sex, and virologic response to antiretroviral therapy."	"Westreich D, Evans D, Firnhaber C, Majuba P, Maskew M."	Journal of Acquired Immune Deficiency Syndromes. 2012 15 Aug;60(5):489-94.		"Objective: Pregnancy is a common indication for initiation of highly active antiretroviral therapy (HAART) in sub-Saharan Africa. Our objective was to evaluate how pregnancy at treatment initiation predicts virologic response to HAART. Methods: We evaluated an open cohort of 9173 patients who initiated HAART between April 2004 and September 2009 in the Themba Lethu Clinic in Johannesburg, South Africa. Risk ratios were estimated using log-binomial regression; hazard ratios were estimated using Cox proportional hazards models; time ratios were estimated using accelerated failure time models. We controlled for calendar date, age, ethnicity, employment status, history of smoking, tuberculosis, WHO stage, weight, body mass index, hemoglobin, CD4 count and CD4 percent, and whether clinical care was free. Extensive sensitivity and secondary analyses were performed. Results: During follow-up, 822 nonpregnant women and 70 pregnant women experienced virologic failure. In adjusted analyses, pregnancy at baseline was associated with reduced risk of virologic failure by 6 months [risk ratio 0.66, 95% confidence limits (CL): 0.35 to 1.22] and with reduced hazard of virologic failure over follow-up (hazard ratio: 0.69, 95% CL: 0.50 to 0.95). The adjusted time ratio for failure was 1.44 (95% CL: 1.13 to 1.84), indicating 44% longer time to event among women pregnant at baseline. Sensitivity analyses generally confirmed main findings. Conclusions: Pregnancy at HAART initiation is not associated with increased risk of virologic failure at 6 months or during longer follow-up. 2012 by Lippincott Williams & Wilkins."									
1440	Recommended dose for repair of serum vitamin A levels in patients with HIV infection/AIDS may be insufficient because of high urinary losses.	"Neves FF, Vannucchi H, Jordao Junior AA, Figueiredo JFC."	Nutrition. 2006;22(5):483-9.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20063126472	"Objective: Retinol deficiency is quite frequent in the population of human immunodeficiency virus (HIV)-infected individuals. Serum retinol levels of less than 1.05 micro mol/L determine a 3.5 to five times higher death risk. However, studies evaluating the efficacy of retinol supplementation in HIV-seropositive individuals have reported conflicting results. The World Health Organization recommends the treatment of vitamin A deficiency in seropositive individuals in the same manner as for seronegative individuals, but clinical studies proving the efficacy of this scheme are lacking. The proposal of the present study was to assess the efficacy of supplementation with high retinol doses in HIV-infected patients with vitamin A deficiency. Methods: Twenty-five adult HIV-seropositive individuals were monitored over a period of 9 months, with determination of serum and urinary retinol every 3 months. The subjects received retinol palmitate doses ranging from 300 000 IU to 600 000 IU. Patients whose retinol levels were higher than 1.60 micro mol/L were only observed. Results: Eighteen patients received supplementation during clinical monitoring. The dose of 600 000 IU induced a significant mean increase in serum levels of 0.47 micro mol/L (P=0.049) within a period of three months. Those who received 300 000 IU presented a mean increase of 0.29 micro mol/L. In contrast, the patients who did not receive replacement therapy presented a significant decrease (P=0.017) in serum retinol levels, with initial and final values of 1.77 micro mol/L and 1.55 micro mol/L. The individuals with the worst response to supplementation presented a higher urinary loss of retinol at the beginning of the study. Even with a mean retinol supplementation of 771 428 IU during the study period, six patients had marginal serum retinol levels at the end of the study. Conclusion: We conclude that, in view of the high urinary loss of this nutrient, there is the need to redefine the ideal dose for the treatment of HIV-infected individuals."									
1419	Age and height predict neuropathy risk in patients with HIV prescribed stavudine.	"Cherry CL, Affandi JS, Imran D, Yunihastuti E, Smyth K, Vanar S, Kamarulzaman A, et al."	Neurology. 2009;73(4):315-20.	http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=2010354950&site=ehost-live	"OBJECTIVE: Sensory neuropathy is a common problem in HIV-infected patients and is the dose-limiting toxicity of stavudine. Affordable methods of predicting neuropathy risk are needed to guide prescribing in countries where some use of stavudine remains an economic necessity. We therefore aimed to identify factors predictive of neuropathy risk before antiretroviral use. METHODS: A total of 294 patients attending clinics in Melbourne, Kuala Lumpur, and Jakarta were enrolled in a cross-sectional neuropathy screening program in 2006. Neuropathy was defined by the presence of symptoms and signs on the AIDS Clinical Trials Group Brief Peripheral Neuropathy Screen. Demographic, laboratory, and treatment details were considered as possible risk factors for neuropathy. The role of patient demographics in predicting stavudine neuropathy were then assessed in 181 patients who reported that they were free of neuropathy symptoms when first prescribed this drug. RESULTS: The prevalence of neuropathy was 42% in Melbourne (n = 100), 19% in Kuala Lumpur (n = 98), and 34% in Jakarta (n = 96). In addition to treatment exposures, increasing age (p = 0.002) and height (p = 0.001) were independently associated with neuropathy. Age and height cutoffs of >/=170 cm or >/=40 years predicted neuropathy. Among 181 patients who were asymptomatic before stavudine exposure, the risk of neuropathy following stavudine was 20% in younger, shorter patients, compared with 66% in older, taller individuals. CONCLUSIONS: Stavudine neuropathy risk increases with patient age and height. Prioritizing older and taller patients for alternative agents would be an inexpensive strategy to reduce neuropathy rates in countries where the burden of HIV disease limits treatment options."									
603	"Social factors and lifestyle attributes associated with nutritional status of people living with HIV/AIDS attending care and treatment clinics in Ilala District, Dar Es Salaam."	"Ritte SA, Kessy AT."	East African Journal of Public Health. 2012;9(1):33-8.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=23120947	"OBJECTIVE: Tanzania is one of the countries that suffer huge burden of malnutrition and food poverty with over two million people living with HIV/AIDS. Despite ongoing nutritional interventions in care and treatment clinics for people living with HIV/AIDS (PLWHA), a high proportion of them still face nutritional problems, with about 29% being underweight. This study therefore aimed assessing social factors and lifestyle attributes associated with nutritional status among adults living with HIV/AIDS and attending care and treatment clinics (CTCs) in an urban district in Tanzania."	METHODS: An interview schedule was administered to 412 randomly selected adult male and female clients attending different CTCs in Ilala district. Their anthropometric measurements i.e. body weights and heights were also taken.	"RESULTS: Findings revealed that 18.4% of males and females were underweight according to their body mass indices. The risk of being underweight was higher among respondents who were young; who had never married; had no formal education as well as those who reported to be living with their families or friends, although these associations were not statistically significant. On the other hand, factors which had statistically significant association with nutritional status included the type of persons the client was living with and the habit of drinking alcohol."	"CONCLUSION: From the findings we conclude that PLWHA attending Care and Treatment Clinics in Ilala district, Dar es Salaam have problems with their nutrition with underweight being common among them. This suggests that the existing care and treatment clinics that provide nutritional support to PLWHA do not appear to address these issues in their totality. There is therefore, need to ensure that more efforts are geared towards providing nutritional counseling, support and encouragement of these clients within social contexts of their lives so in order for the current efforts to give best results."						
472	Anthropometric and immunological success of antiretroviral therapy and prediction of virological success in west African adults.	"Messou E, Gabillard D, Moh R, Inwoley A, Sorho S, Eholie S, Rouet F, et al."	Bulletin of the World Health Organization. 2008;86(6):435-42.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medc&AN=18568272	"OBJECTIVE: The 6 month assessment of the response to antiretroviral therapy (ART) is a critical step. In sub-Saharan Africa, few people have access to plasma viral-load measurement. We assessed the gain or loss in body mass index (BMI), alone or in combination with the gain or loss in CD4+ T-cell count (CD4), as a tool for predicting the response to ART."	"METHODS: In a cohort of 622 adults in Abidjan, Cote d'Ivoire, we calculated the sensitivity, specificity and predictive values of BMI and CD4 for treatment success defined as viral-load undetectability (< 300 copies/ml) as gold standard."	"FINDINGS: After 6 months of ART, the median change in BMI was an increase of 1.0 kg/m(2) (interquartile range, IQR: 0.0-2.1), the median change in CD4 an increase of 148/ml (IQR: 54-230) and 84% of patients reached viral-load undetectability. The distribution of change in BMI was similar among patients who reached undetectability and those who did not (increases of 1.06 kg/m(2) versus 0.99 kg/m(2), P = 0.51). With larger changes in BMI, the specificity for treatment success increased but its sensitivity decreased and its positive predictive value was stable around 85%. All results remained similar when combining changes in BMI with those in CD4 and when stratifying by groups of baseline BMI or CD4."	"CONCLUSION: In settings where viral-load measurement is not available, a high BMI gain does not reflect virological success, even when combined with a high CD4 gain. In our population, most patients with detectable viral-load had probably adhered to the drug regimen sufficiently to reach significant gains in body mass and CD4 count but had adhered insufficiently to reach viral suppression."						
1922	"The effect of micronutrient supplementation on treatment outcome in patients with pulmonary tuberculosis: a randomized controlled trial in Mwanza, Tanzania."	"Range N, Andersen AB, Magnussen P, Mugomela A, Friis H."	Tropical Medicine & International Health. 2005;10(9):826-32.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=16135188	OBJECTIVE: The aim of the study was to assess the effects of micronutrient supplementation on culture conversion in tuberculosis (TB) patients.	"DESIGN: The study was a randomized, double-blind placebo-controlled 2 x 2 trial of zinc and multi-micronutrient (MMN) supplementation in pulmonary TB patients in Tanzania."	"RESULTS: A total of 499 pulmonary TB patients were included in the trial after being confirmed sputum-positive by microscopy or culture. At 8 weeks, 25% were sputum-smear positive but only 11% were culture-positive (P<0.0001). No significant differences were observed in culture conversion rate among those allocated to MMN or placebo (89.5 vs. 86.2%, P=0.29) at 8 weeks, although at week 4 those allocated to MMN had a slightly reduced culture conversion rate (42.8 vs. 52.8%, P=0.058). Zinc had no effects on culture conversion. MMN increased weight gain by 0.78 kg [95% confidence interval (CI): 0.12--1.43] at week 8, while zinc supplementation had no effect. The effects of MMN and zinc did not interact and neither MMN nor zinc interacted with human immunodeficiency virus status, sex and culture-intensity at baseline."	"CONCLUSION: Neither zinc nor MMN supplementation had significant effects on culture conversion, but MMN supplementation increased weight gain in TB patients."						
784	Hyperlactataemia in HIV-infected subjects initiating antiretroviral therapy in a large randomized study (a substudy of the INITIO trial).	"Feeney ER, Chazallon C, O'Brien N, Meiffredy V, Goodall RL, Aboulker JP, Cooper DA, et al."	HIV Medicine. 2011;12(10):602-9.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=21599820	"OBJECTIVE: The aim of the study was to evaluate the predictive value of clinical and molecular risk factors, including peripheral blood mononuclear cell (PBMC) mitochondrial DNA (mtDNA) and mitochondrial RNA (mtRNA), for the development of lactic acidosis (LA) and symptomatic hyperlactataemia (SHL)."	"METHODS: In a substudy of a large multicentre, randomized trial of three antiretroviral regimens, all containing didanosine (ddI) and stavudine (d4T), in antiretroviralnaive, HIV-1-infected patients, patients with LA/SHL ('cases') were compared with those without LA/SHL in a univariate analysis, with significant parameters analysed in a multivariate model. In a molecular substudy, PBMC mtDNA and mtRNA from cases and matched controls at baseline and time of event were examined."	"RESULTS: In 911 subjects followed for a median of 192 weeks, 24 cases were identified (14 SHL and 10 LA). In univariate analysis, cases were more likely to be female (P=0.05) and to have a high body mass index (BMI) (P=0.02). In multivariate analyses, only BMI remained an independent predictor of the development of LA/SHL (P=0.03). Between cases and controls there was no significant difference in mtDNA copy number at baseline (389 vs. 411 copies/cell, respectively; P=0.60) or at time of event (329 vs. 474 copies/cell, respectively; P=0.21), in the change in mtDNA copy number from baseline to event (-65 vs. +113 copies/cell, respectively; P=0.12), in mtRNA expression at baseline or time of event, or in the change in mtRNA expression from baseline to event."	"CONCLUSION: The development of LA/SHL was associated with increased BMI, but PBMC mtDNA and mtRNA did not predict LA/SHL. This demonstrates the ineffectiveness of routine measurement of PBMC mtDNA in patients on ddI and d4T as a means of predicting development of LA/SHL. 2011 British HIV Association."						
223	Diarrhea and abnormalities of gastrointestinal function in a cohort of men and women with HIV infection.	"Knox TA, Spiegelman D, Skinner SC, Gorbach S."	American Journal of Gastroenterology. 2000;95(12):3482-9.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=11151881	OBJECTIVE: The aim of this study was to determine the prevalence of gastrointestinal dysfunction in the era of improved treatment of HIV infection.	"METHODS: Gastrointestinal function was studied cross-sectionally in 671 persons with HIV. Absorptive function was measured by a 25-g D-xylose test, a Sudan-III stain for fecal fat on a 100-g fat diet, and serum levels of micronutrients."	"RESULTS: Eighty-eight percent had at least one abnormality of gastrointestinal function: 47.7% had low D-xylose absorption; 40.3% had a history of liver disease; 38.9% had diarrhea; 28.3% had chronic diarrhea; 22.5% had borderline or low serum vitamin B12 levels; 12.2% had stool pathogens; and 7.2% were hypoalbuminemic. Men were more likely to have low D-xylose absorption, diarrhea, and stool pathogens than women. Intravenous drug users (IVDUs) were more likely to have a history of liver disease and hypoalbuminemia. However, borderline or low vitamin B12 levels were less frequent in IVDUs; they tended to have less diarrhea and a lower prevalence of stool pathogens. Despite less history of liver disease, 14.1% of women were hypoalbuminemic. Differences in patterns of gastrointestinal dysfunction are unlikely to be due to severity of immunosuppression as abnormalities were seen in all risk groups with CD4 >200 cells/mm3. D-xylose absorption below 30 mg/dl, current diarrhea, and borderline levels of vitamin B12 were associated with advanced immunosuppression."	"CONCLUSIONS: Abnormalities of gastrointestinal function are common in the current era of HIV treatment, appear early in the course of HIV infection, and in the absence of diarrhea. Gender and IVDU are important determinants of the type and frequency of gastrointestinal abnormalities."						
338	"Prevalence of obesity and cardiovascular risk in patients with HIV/AIDS in Porto Alegre, Brazil."	"Kroll AF, Sprinz E, Leal SC, Labrea Mda G, Setubal S."	Arquivos Brasileiros de Endocrinologia e Metabologia. 2012;56(2):137-41.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=22584567	"OBJECTIVE: The aim of this study was to discover the prevalence of overweight, obesity and cardiovascular risk in our HIV/AIDS outpatients according to sex, antiretroviral therapy and other variables."	SUBJECTS AND METHODS: Patients underwent an anthropometric assessment. Body mass index and waist circumference were used to classify their nutritional status and their cardiovascular risk.	"RESULTS: The majority of the 345 patients (58.8%) were males. Obesity was detected in 8.3% of them; 34.2% were overweight, and 5.2% malnourished. Near half of them (51.3%) had some cardiovascular risk, with increased risk in 24.6% of them, and substantially increased risk in 26.7% of them."	"CONCLUSIONS: Overweight and obesity were highly prevalent. Women were more frequently obese (OR = 3.53; IC 95%, 1.47 < OR < 8.69), and their cardiovascular risk was often higher (OR = 6.97; IC 95%, 4.16 < OR < 11.76). The prevalence of obesity and cardiovascular risk did not change according to antiretroviral therapy or other variables."						
1201	"Selective underreporting of energy intake in women: magnitude, determinants, and effect of training."	"Scagliusi FB, Polacow VO, Artioli GG, Benatti FB, Lancha AH, Jr."	Journal of the American Dietetic Association. 2003;103(10):1306-13.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=14520248	"OBJECTIVE: The aim of this study was to quantify underreporting of energy intake in Brazilian women; identify underreporting determinants; find out if underreporting was selective and; test if a motivational multimethod training, in combination with providing the subjects some results from the prior recording period, was able to reduce underreporting."	"DESIGN: Energy intake (EI) was assessed by a 7-day diet record. Energy expenditure (EE) was calculated by heart rate monitoring. EI:EE ratio lower than one in subjects who did not lose weight in one month was considered underreporting. Underreporting was correlated with anthropometric, behavioral, and psychological parameters. Food and nutrient consumption was compared between underreporters and non-underreporters. A focus group investigated the main causes of underreporting. Subjects were told that the earlier food records' results were unrealistic and submitted to a motivational training. Then, they were reevaluated for underreporting."	"SUBJECTS: Subjects were recruited by advertisements for a physical activity program. Thirty-eight healthy women, 13 normal-weight (34%), 13 overweight (34%), and 12 obese (32%), enrolled in the study. Three subjects (2 normal-weight and 1 obese) (8%) withdrew."	"STATISTICAL ANALYSIS PERFORMED: Analysis of variance, paired t tests, and simple linear regression."	"RESULTS: Seventeen women (49%) underreported their EI by 21%. A significant negative correlation was found between social desirability and EI:EE. Undereating, errors in portion sizes estimation and the inconvenience of having to record everything that was eaten seemed to explain underreporting. Mean portion sizes did not differ for underreporters and non-underreporters. Fewer self-reported years of education was correlated with underreporting only among normal-weight women. Training and confrontation with earlier results reduced underreporting rate to 33%, but did not affect macronutrient densities. Applications/conclusions Subjects tended to report their intake in a socially desirable way, by eating or reporting less frequently foods considered unhealthful or fattening, like sweets and fried foods. Inclusion of social desirability score as a covariate in studies that rely on self-reports of food intake may be useful. A motivational training program, developed in such a way that subjects are comfortable reporting intake of foods considered socially undesirable, in combination with confrontation with earlier results of dietary assessment and use of portion size measurement aids, can be used to attenuate underreporting."					
1202	"Selective underreporting of energy intake in women: magnitude, determinants, and effect of training."	"Scagliusi FB, Polacow VO, Artioli GG, Benatti FB, Lancha Jr AH."	Journal of the American Dietetic Association. 2003 Oct;103(10):1306-13.		"OBJECTIVE: The aim of this study was to quantify underreporting of energy intake in Brazilian women; identify underreporting determinants; find out if underreporting was selective and; test if a motivational multimethod training, in combination with providing the subjects some results from the prior recording period, was able to reduce underreporting. DESIGN: Energy intake (EI) was assessed by a 7-day diet record. Energy expenditure (EE) was calculated by heart rate monitoring. EI:EE ratio lower than one in subjects who did not lose weight in one month was considered underreporting. Underreporting was correlated with anthropometric, behavioral, and psychological parameters. Food and nutrient consumption was compared between underreporters and non-underreporters. A focus group investigated the main causes of underreporting. Subjects were told that the earlier food records' results were unrealistic and submitted to a motivational training. Then, they were reevaluated for underreporting. SUBJECTS: Subjects were recruited by advertisements for a physical activity program. Thirty-eight healthy women, 13 normal-weight (34%), 13 overweight (34%), and 12 obese (32%), enrolled in the study. Three subjects (2 normal-weight and 1 obese) (8%) withdrew. STATISTICAL ANALYSIS PERFORMED: Analysis of variance, paired t tests, and simple linear regression. RESULTS: Seventeen women (49%) underreported their EI by 21%. A significant negative correlation was found between social desirability and EI:EE. Undereating, errors in portion sizes estimation and the inconvenience of having to record everything that was eaten seemed to explain underreporting. Mean portion sizes did not differ for underreporters and non-underreporters. Fewer self-reported years of education was correlated with underreporting only among normal-weight women. Training and confrontation with earlier results reduced underreporting rate to 33%, but did not affect macronutrient densities. Applications/conclusions Subjects tended to report their intake in a socially desirable way, by eating or reporting less frequently foods considered unhealthful or fattening, like sweets and fried foods. Inclusion of social desirability score as a covariate in studies that rely on self-reports of food intake may be useful. A motivational training program, developed in such a way that subjects are comfortable reporting intake of foods considered socially undesirable, in combination with confrontation with earlier results of dietary assessment and use of portion size measurement aids, can be used to attenuate underreporting."									
1203	"Selective underreporting of energy intake in women: magnitude, determinants, and effect of training."	"Scagliusi FB, Polacow VO, Artioli GG, Benatti FB, Lancha Junior AH."	Journal of the American Dietetic Association. 2003;103(10):1306-13.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh3&AN=20033177846	"Objective: The aim of this study was to quantify underreporting of energy intake in Brazilian women; identify underreporting determinants; find out if underreporting was selective and; test if a motivational multimethod training, in combination with providing the subjects some results from the prior recording period, was able to reduce underreporting. Design: Energy intake (EI) was assessed by a 7-day diet record. Energy expenditure (EE) was calculated by heart rate monitoring. EI:EE ratio lower than one in subjects who did not lose weight in one month was considered underreporting. Underreporting was correlated with anthropometric, behavioural, and psychological parameters. Food and nutrient consumption was compared between underreporters and non-underreporters. A focus group investigated the main causes of underreporting. Subjects were told that the earlier food records' results were unrealistic and submitted to a motivational training. Then, they were reevaluated for underreporting. Subjects: Subjects from Brazil were recruited by advertisements for a physical activity programme [date not given]. Thirty-eight healthy women, 13 normal-weight (34%), 13 overweight (34%), and 12 obese (32%), enrolled in the study. Three subjects (2 normal-weight and 1 obese) (8%) withdrew. Statistical analyses performed: Analysis of variance, paired t tests, and simple linear regression. Results: Seventeen women (49%) underreported their EI by 21%. A significant negative correlation was found between social desirability and EI:EE. Undereating, errors in portion sizes estimation and the inconvenience of having to record everything that was eaten seemed to explain underreporting. Mean portion sizes did not differ for underreporters and non-underreporters. Fewer self-reported years of education was correlated with underreporting only among normal-weight women. Training and confrontation with earlier results reduced underreporting rate to 33%, but did not affect macronutrient densities. Applications/conclusions: Subjects tended to report their intake in a socially desirable way, by eating or reporting less frequently foods considered unhealthful or fattening, like sweets and fried foods. Inclusion of social desirability score as a covariate in studies that rely on self-reports of food intake may be useful. A motivational training programme, developed in such a way that subjects are comfortable reporting intake of foods considered socially undesirable, in combination with confrontation with earlier results of dietary assessment and use of portion size measurement aids, can be used to attenuate underreporting."									
1207	The AMPATH Nutritional Information System: designing a food distribution electronic record system in rural Kenya.	"Lim JL, Yih Y, Gichunge C, Tierney WM, Le TH, Zhang J, Lawley MA, et al."	Journal of the American Medical Informatics Association. 2009;16(6):882-8.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=19717795	"OBJECTIVE: The AMPATH program is a leading initiative in rural Kenya providing healthcare services to combat HIV. Malnutrition and food insecurity are common among AMPATH patients and the Nutritional Information System (NIS) was designed, with cross-functional collaboration between engineering and medical communities, as a comprehensive electronic system to record and assist in effective food distribution in a region with poor infrastructure."	"DESIGN: The NIS was designed modularly to support the urgent need of a system for the growing food distribution program. The system manages the ordering, storage, packing, shipping, and distribution of fresh produce from AMPATH farms and dry food supplements from the World Food Programme (WFP) and U.S. Agency for International Development (USAID) based on nutritionists' prescriptions for food supplements. Additionally, the system also records details of food distributed to support future studies."	"MEASUREMENTS: Patients fed weekly, patient visits per month."	"RESULTS: With inception of the NIS, the AMPATH food distribution program was able to support 30,000 persons fed weekly, up from 2,000 persons. Patient visits per month also saw a marked increase."	"CONCLUSION: The NIS' modular design and frequent, effective interactions between developers and users has positively affected the design, implementation, support, and modifications of the NIS. It demonstrates the success of collaboration between engineering and medical communities, and more importantly the feasibility for technology readily available in a modern country to contribute to healthcare delivery in developing countries like Kenya and other parts of sub-Saharan Africa."					
1608	Association of BMI category change with TB treatment mortality in HIV-positive smear-negative and extrapulmonary TB patients in Myanmar and Zimbabwe.	"Benova L, Fielding K, Greig J, Nyang'wa BT, Casas EC, da Fonseca MS, du Cros P."	PLoS ONE [Electronic Resource]. 2012;7(4):e35948.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=22545150	"OBJECTIVE: The HIV epidemic has increased the proportion of patients with smear-negative and extrapulmonary tuberculosis (TB) diagnoses, with related higher rates of poor TB treatment outcomes. Unlike in smear-positive pulmonary TB, no interim markers of TB treatment progress are systematically used to identify individuals most at risk of mortality. The objective of this study was to assess the association of body mass index (BMI) change at 1 month (+/-15 days) from TB treatment start with mortality among HIV-positive individuals with smear-negative and extrapulmonary TB."	"METHODS AND FINDINGS: A retrospective cohort study of adult HIV-positive new TB patients in Medecins Sans Frontieres (MSF) treatment programmes in Myanmar and Zimbabwe was conducted using Cox proportional hazards regression to estimate the association between BMI category change and mortality. A cohort of 1090 TB patients (605 smear-negative and 485 extrapulmonary) was followed during TB treatment with mortality rate of 28.9 per 100 person-years. In multivariable analyses, remaining severely underweight or moving to a lower BMI category increased mortality (adjusted hazard ratio 4.05, 95% confidence interval 2.77-5.91, p<0.001) compared with remaining in the same or moving to a higher BMI category."	CONCLUSIONS: We found a strong association between BMI category change during the first month of TB treatment and mortality. BMI category change could be used to identify individuals most at risk of mortality during TB treatment among smear-negative and extrapulmonary patients.							
1572	Association of BMI category change with TB treatment mortality in HIV-positive smear-negative and extrapulmonary TB patients in Myanmar and Zimbabwe.	"Benova L, Fielding K, Greig J, Nyang'wa BT, Casas EC, Fonseca MSd, Cros Pd."	PLoS ONE. 2012;7(4).	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20123190889	"Objective: The HIV epidemic has increased the proportion of patients with smear-negative and extrapulmonary tuberculosis (TB) diagnoses, with related higher rates of poor TB treatment outcomes. Unlike in smear-positive pulmonary TB, no interim markers of TB treatment progress are systematically used to identify individuals most at risk of mortality. The objective of this study was to assess the association of body mass index (BMI) change at 1 month (+or-15 days) from TB treatment start with mortality among HIV-positive individuals with smear-negative and extrapulmonary TB. Methods and Findings: A retrospective cohort study of adult HIV-positive new TB patients in Medecins Sans Frontieres (MSF) treatment programmes in Myanmar and Zimbabwe was conducted using Cox proportional hazards regression to estimate the association between BMI category change and mortality. A cohort of 1090 TB patients (605 smear-negative and 485 extrapulmonary) was followed during TB treatment with mortality rate of 28.9 per 100 person-years. In multivariable analyses, remaining severely underweight or moving to a lower BMI category increased mortality (adjusted hazard ratio 4.05, 95% confidence interval 2.77-5.91, p<0.001) compared with remaining in the same or moving to a higher BMI category. Conclusions: We found a strong association between BMI category change during the first month of TB treatment and mortality. BMI category change could be used to identify individuals most at risk of mortality during TB treatment among smear-negative and extrapulmonary patients."									
1847	"Antiretroviral therapy in a South African public health care setting - facilitating and constraining factors. (Special issue on access to medicines, pricing and generics)."	"Ruud KW, Srinivas SC, Toverud EL."	Southern Med Review. 2009;2(2):29-34.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20093306481	"Objective: The objective of the study was to identify and document facilitating and constraining factors in the antiretroviral therapy (ART) programme in a public health care setting in the Eastern Cape, South Africa. Method: Observations for the study were carried out in a district hospital and two down-referral clinics in Makana Local Services Area in the Eastern Cape Province. Two discussion groups with key stakeholders were conducted to gather information about opinions and experiences among the health care providers (HCPs). Results: It was found that the operating ART programme in this setting has been integrated in the existing down-referral health care system, based on follow-up in primary health care (PHC) clinics. Treatment is provided free of charge. The treatment programme provides the patients with access to counselling, nutritional assistance, psychosocial support and social welfare evaluation. However, increasing patient numbers and lack of human resources leads to a heavy workload for the HCPs involved with the ART programme. The need for additional, educated health workers is a major constraint for progress in provision of health care to patients who have accepted their HIV status, and are enrolled, or waiting to be enrolled, on the ART. However, delegation of work tasks among available HCPs and good communication between HCPs in the different clinics is a facilitating factor that ensures efficient use of the human resources available. Conclusion: Taking into account the challenges in a resource-constrained setting, this programme shows potential for functioning well as a provider of ART for those who are able and willing to access it. Considering an already heavy workload for HCPs, limitations and challenges still exist in reaching out with adequate treatment to a greater number of people who need ART."									
1708	Changes in the anthropometric parameters of patients with the Human Immunodeficiency virus or Acquired Immunodeficiency Syndrome: a prospective study.	"Curti MLR, Almeida LB, Jaime PC."	Revista de Nutricao. 2010;23(1):57-64.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20103178736	"Objective: The objective of this study was to assess the nutritional status and changes in the anthropometric indicators of patients with the human Immunodeficiency virus or acquired immunodeficiency syndrome using the highly active antiretroviral therapy. Methods: This is a 12-month prospective cohort study of adult males and females who recently started antiretroviral therapy. The anthropometric indicators studied were body mass index, waist circumference and subscapular, biceps and triceps skinfold thicknesses, taken 4 times during the year in 3-month intervals. The variables were described according to medians and 25 and 75 percentiles and analyzed by ANOVA for repeated measurements. Results: The studied population consisted of 53 patients, mostly males (81%) aged 30 to 39 years. Only subscapular skinfold thickness changed significantly over time (T1=13.70 vs T4=16.00, p<0.001), indicating cervical lipohypertrophy (buffalo hump). Conclusion: The findings of this study, although limited, show the need to monitor anthropometric parameters associated with morphological changes, especially those used in the diagnosis of abdominal and dorsocervical fat accumulation."									
1548	CD4 counts decline despite nutritional recovery in HIV-infected Zambian children with severe malnutrition.	"Hughes SM, Amadi B, Mwiya M, Nkamba H, Mulundu G, Tomkins A, Goldblatt D."	Pediatrics. 2009;123(2):e347-51.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=19124582	OBJECTIVE: The objective of this study was to establish the contribution that severe malnutrition makes to CD4 lymphopenia in HIV-infected and uninfected children and to determine the changes in CD4 count during nutritional rehabilitation.	"METHODS: Fifty-six children with severe malnutrition and with and without HIV infection were recruited from a pediatric ward in Lusaka for measurement of CD4 counts on admission, on discharge, and at final nutritional recovery."	"RESULTS: HIV-uninfected children with severe malnutrition had normal CD4 counts. In contrast, CD4 counts in HIV-infected children with severe malnutrition were reduced, more so in those without edema compared with those with edema. Mean CD4 count of HIV-infected SM children fell despite nutritional recovery so that at the time of full nutritional recovery, >85% of HIV-infected children required antiretroviral therapy."	"CONCLUSIONS: Severe malnutrition did not reduce the CD4 counts of children without HIV. HIV-infected children with severe malnutrition may respond well to nutritional rehabilitation, despite low CD4 counts, but nearly all require early antiretroviral therapy to prevent disease progression."						
1719	Predictive factors for repetition of the tuberculin test after a nonreactive test in patients with HIV/AIDS.	"Moura LCRV, Ximenes RAdA, Lacerda HR, Miranda Filho DB, Barbosa MT, Byington MR, Albuquerque MdFPM."	Revista Panamericana de Salud Publica/Pan American Journal of Public Health. 2012;31(2):121-8.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20123149490	"OBJECTIVE: The outcome of interest was repetition of the tuberculin skin test (TST) and the objectives were to estimate the rate of TST repetition, the probability of no TST repetition after 1 year, and the probability of no TST repetition at the end of the follow-up period in patients whose initial test was nonreactive. The study also set out to analyze factors associated with the time until TST repetition at two HIV/AIDS referral services that carry out the TST on a routine basis in Recife, Pernambuco, Brazil. METHODS: A cohort of HIV-positive patients who initially tested nonreactive on the TST were followed from November 2007 to February 2010. The Kaplan-Meier method was used to estimate the probability of not repeating the TST, and Cox's regression analysis was used to analyze the factors associated with time until repeating the TST. Cox's multivariate analysis was stratified according to each hospital where patients were followed, because this variable did not respect the principle of proportionality of risk. RESULTS: The probability of not repeating the TST for 1 year was 80.0% and at the end of the follow-up period it was 42.0%. The variables that remained associated with TST repetition in the final Cox multivariate model were an age of 40 years or older, body mass index between 18.0 and 24.9, being female, and years of schooling. CONCLUSIONS: This study encountered a very low TST repetition rate after 1 year of follow-up and identified groups of individuals who should be the target of interventions aimed at repeating the TST."									
1651	"Rapid assessment of infant feeding support to HIV-positive women accessing prevention of mother-to-child transmission services in Kenya, Malawi and Zambia."	"Chopra M, Doherty T, Mehatru S, Tomlinson M."	Public Health Nutrition. 2009;12(12):2323-8.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=19402947	"OBJECTIVE: The possibility of mother-to-child transmission (MTCT) of HIV through breast-feeding has focused attention on how best to support optimal feeding practices especially in low-resource and high-HIV settings, which characterizes most of sub-Saharan Africa. To identify strategic opportunities to minimize late postnatal HIV transmission, we undertook a review of selected country experiences on HIV and infant feeding, with the aims of documenting progress over the last few years and determining the main challenges and constraints."	"DESIGN: Field teams conducted national-level interviews with key informants and visited a total of thirty-six facilities in twenty-one sites across the three countries--eighteen facilities in Malawi, eleven in Kenya and seven in Zambia. During these visits interviews were undertaken with key informants such as the district and facility management teams, programme coordinators and health workers."	"SETTING: A rapid assessment of HIV and infant feeding counselling in Kenya, Malawi and Zambia, undertaken from February to May 2007."	"RESULTS: Infant feeding counselling has, until now, been given low priority within programmes aimed at prevention of MTCT (PMTCT) of HIV. This is manifest in the lack of resources - human, financial and time--for infant feeding counselling, leading to widespread misunderstanding of the HIV transmission risks from breast-feeding. It has also resulted in lack of space and time for proper counselling, poor support and supervision, and very weak monitoring and evaluation of infant feeding. Finally, there are very few examples of linkages with community-based infant feeding interventions. However, all three countries have started to revise their feeding policies and strategies and there are signs of increased resources."	CONCLUSIONS: In order to sustain this momentum it will be necessary to continue the advocacy with the HIV community and stress the importance of child survival--not just minimization of HIV transmission - and hence the need for integrating MTCT prevention.					
840	Prognostic factors in 194 patients with chronic necrotizing pulmonary aspergillosis.	"Nakamoto K, Takayanagi N, Kanauchi T, Ishiguro T, Yanagisawa T, Sugita Y."	Internal Medicine. 2013;52(7):727-34.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20133216097	"Objective: The prognostic factors of chronic necrotizing pulmonary aspergillosis remain unclear. We assessed the prognostic factors of all-cause mortality in patients with chronic necrotizing pulmonary aspergillosis, focusing especially on underlying pulmonary disease, first-line treatment and host predisposition. Methods: We retrospectively analyzed the medical records of 194 patients negative for HIV who had chronic necrotizing pulmonary aspergillosis treated at our institution in Saitama, Japan. Results: The patients (median age, 68.5 years) were followed over a median follow-up time of 2.6 years. The underlying pulmonary diseases consisted of previous pulmonary tuberculosis in 59 (30.4%) patients, emphysema in 39 (20.1%) patients, interstitial lung disease in 32 (16.5%) patients, nontuberculous mycobacteriosis in 29 (14.9%) patients and other diseases in 35 (18%) patients. The first-line treatments included observation in 65 (33.5%) patients, itraconazole in 56 (28.9%) patients, micafungin in 46 (23.7%) patients, voriconazole in 22 (11.3%) patients and amphotericin B (including liposomal amphotericin B) in five (2.6%) patients. The overall cumulative mortality rate was 50.2% at five years and 67.4% at 10 years. Multivariate Cox proportional hazard modeling found an older age, the presence of systemic comorbidities, baseline corticosteroid use, a body mass index of <18.5 kg/m<sup>2</sup> and a C-reactive protein level of >=5.0 mg/dL to be negative prognostic factors for all-cause mortality. Conclusion: The 5-year mortality rate of chronic necrotizing pulmonary aspergillosis was 50.2%. When clinical trials are designed and implemented to test effective drug therapies in patients with chronic necrotizing pulmonary aspergillosis, the trial patients should be stratified according to these prognostic factors prior to randomization."									
1540	"Association between socioeconomic status indicators and obesity in adolescent students in Botswana, an African country in rapid nutrition transition."	"Wrotniak BH, Malete L, Maruapula SD, Jackson J, Shaibu S, Ratcliffe S, Stettler N, et al."	Pediatric Obesity. 2012;7(2):e9-e13.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=22434762	"OBJECTIVE: The purpose of this study was to examine two separate socioeconomic status (SES) indicators of obesity in Botswana, an African country that has experienced rapid economic development and where the prevalence of human immunodeficiency virus/acquired immune deficiency syndrome is high."	"METHODS: We conducted a nationally representative, cross-sectional study of 707 adolescent secondary school students in Botswana. Measured height and weight were used to compute World Health Organization age- and sex-specific body mass index z-scores. SES was described by private vs. public school attendance and a survey of assets/facilities within the home."	"RESULTS: Overall, private school students and those with more assets had a higher prevalence of overweight and obesity than public school students (private: 27.1%, 95% confidence interval [CI]: 20.4-34.5; public: 13.1%, 95% CI: 9.8-16.8) and those with fewer assets (more assets: 20.0%, 95% CI: 16.0-24.4; fewer assets: 11.2%, 95% CI: 6.6-16.9)."	CONCLUSIONS: Public health interventions in developing countries may need to be targeted differently to low or high SES individuals in order to treat already high obesity rates in higher SES groups and to prevent the development of obesity in lower SES communities undergoing economic transition. 2012 The Authors. Pediatric Obesity 2012 International Association for the Study of Obesity.						
1399	Age at menopause and menopause-related symptoms in human immunodeficiency virus-infected Thai women.	"Boonyanurak P, Bunupuradah T, Wilawan K, Lueanyod A, Thongpaeng P, Chatvong D, Sophonphan J, et al."	Menopause. 2012 July;19(7):820-4.		"Objective: There are limited data for age at menopause (AM) and menopause-related symptoms in human immunodeficiency virus (HIV)-infected Asian women. We investigated AM and menopause-related symptoms in HIV-infected Thai women. Methods: HIV-infected Thai women 40 years or older who did not receive any hormone therapy in the 8-week period preceding the study were enrolled. Participants completed the Menopause-Specific Quality of Life survey for their symptoms in the past 30 days. Menopause was defined as having the last menstrual period more than 1 year ago. Multivariate Cox proportional hazard regression analysis was used to identify factors associated with menopause. Results: Two hundred sixty-eight HIV-infected women were enrolled; their median age was 44.6 (41.8-48.7) years, and the ratio of their Centers for Disease Control and Prevention clinical classifications (A:B:C) was 53%:34%:13%; 95% were using highly active antiretroviral therapy. The median (interquartile range [IQR]) CD4 count was 575 (437-758) cells/muL, and 93% had HIV-RNA of less than 1.7log10 copies/mL. Among the 55 women who had reached menopause, the mean (SD) AM was 47.3 (5.1) years. The mean (SD) AM in our study was earlier than the previous report of 49.5 (3.6) years in non-HIV-infected Thai women (difference,-2.2 y; 95% CI,-3.2 to-1.2, P < 0.01). Postmenopausal women had more symptoms, including night sweats (P = 0.03), change in sexual desire (P = 0.01), and avoiding intimacy (P = 0.01), compared with nonpostmenopausal women. No differences in psychosocial or physical domains between groups were found. Factors associated with menopause were Centers for Disease Control and Prevention clinical classification B or C (hazard ratio, 1.7; 95% CI, 1.0-3.03, P = 0.04), and no sexual act in the past month (hazard ratio, 4.9; 95% CI, 1.5-16.0, P = 0.01). No associations of later age of menarche, parity, marital status, educational level, income, body mass index, CD4 count, and HIV-RNA with menopause were found. Conclusions: AM in HIV-infected Thai women was 47.3 years, which is significantly earlier than the findings of a previous AM report on non-HIV-infected women. Postmenopausal HIV-infected women had more vasomotor and sexual symptoms. More studies are needed to investigate the cause and appropriate interventions for accelerated menopause in HIV-infected women. 2012 by The North American Menopause Society."									
478	Setting the stage for equity-sensitive monitoring of the maternal and child health Millennium Development Goals.	"Wirth ME, Balk D, Delamonica E, Storeygard A, Sacks E, Minujin A."	Bulletin of the World Health Organization. 2006;84(7):519-27.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20063148275	"Objective: This analysis seeks to set the stage for equity-sensitive monitoring of the health-related Millennium Development Goals (MDGs). Methods: We use data from international household-level surveys (Demographic and Health Surveys (DHS) and Multiple Indicator Cluster Surveys (MICS)) to demonstrate that establishing an equity baseline is necessary and feasible, even in low-income and data-poor countries. We assess data from six countries using 11 health indicators and six social stratifiers. Simple bivariate stratification is complemented by simultaneous stratification to expose the compound effect of multiple forms of vulnerability. Findings: The data reveal that inequities are complex and interactive: inferences cannot be drawn about the nature or extent of inequities in health outcomes from a single stratifier or indicator. Conclusion: The MDGs and other development initiatives must become more comprehensive and explicit in their analysis and tracking of inequities. The design of policies to narrow health gaps must take into account country-specific inequities."									
1709	Body image dissatisfaction and adherence to antiretroviral therapy in people with HIV/AIDS.	"Leite LHM, Papa A, Valentini RC."	Revista de Nutricao. 2011;24(6):873-81.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20123149920	"Objective: This study assessed the association between body image dissatisfaction and adherence to antiretroviral therapy. Methods: Eighty individuals with Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome participated in the study. A self-report inventory on adherence to therapy and figure rating scales were used to assess body image dissatisfaction. Statistical treatment included descriptive statistics, Student's t-test, chi-square test and estimation of odds ratio. Results: The results showed that body image dissatisfaction was high in men and women (75.0%). Body image dissatisfaction was more likely to be present in overweight individuals (40.0% vs 15.0%; p=0.041) and individuals with symptoms of depression, but these differences were not significant (28.3% vs 15.0%; p=0.233). Sixty-two percent of the women with body image dissatisfaction were overweight and 58.0% of the men were normal weight. Men were more likely to adhere to treatment than women (52.3% vs 22.2%; p=0.006). There was a positive and significant association between body image dissatisfaction and low adherence to antiretroviral therapy (OR=4.69 CI: 1.491-17.792; p=0.003). Conclusion: This study found that body image dissatisfaction is associated with excess weight and low adherence to antiretroviral therapy. Thus, interventions to reduce body image dissatisfaction in people undergoing antiretroviral therapy for Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome are recommended."									
1053	"Effect of soybean (Glycine max) supplementation on nutritional status of school children aged 6-9 years from HIV affected households in Suba District, Kenya."	"Kamau J, Ohiokpehai O, Mbithe D, Kimiywe J, Oteba L, Were G, King'olla B."	Journal of Applied Biosciences. 2008;4:94-102.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20093214429	"Objective: This study investigated the effect of soyabean supplementation on the nutritional status of school children from HIV affected households in western Kenya. Methodology and results: A research design was used with 54 and 56 randomly selected subjects in the experimental and control groups, respectively. The experimental group received corn-soya blend porridge for 3 months at school. A structured questionnaire and anthropometry were used to collect data. Malnutrition levels among the experimental group reduced from 10.2, 28.9 and 5.6% for underweight, stunting and wasting, respectively, to 6.2, 16.7 and 3.4%, respectively. The control group registered 11.4, 28.5 and 8.7% underweight, stunting and wasting, respectively, at baseline. Underweight and wasting rose to 14.3 and 9.5%, respectively, while stunting dropped to 21.5%, which were insignificant changes. Conclusion and application of findings: The feeding trial using corn-soya blend improved the nutritional status of school children in Suba District. It is likely that significant improvement of the pupils' nutritional status would be realized with extended feeding periods. Soyabean has potential to curb protein energy malnutrition and its utilization should be promoted in HIV and AIDS affected areas to alleviate malnutrition."									
969	"Evaluation of hematological, virologic and anthropometric parameters as progression markers in HIV-1 infected children."	"Carvalho IR, Pinto JA, Cardoso CAA, Candiani TMS, Kakehasi FM."	Jornal de Pediatria. 2009;85(2):149-56.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20093141469	"Objective: To analyse total lymphocyte count, total leukocyte count, haemoglobin levels, nutritional status, CD4+ T-lymphocyte count and viral load as markers of disease progression and/or death in HIV-infected children. Methods: This retrospective cohort study was conducted at the Center of Training and Reference in Infectious and Parasitic Diseases Orestes Diniz, Belo Horizonte, Minas Gerais, Brazil, and assessed antiretroviral naive HIV-infected children who were asymptomatic or had mild and/or moderate symptoms. The events of interest were: progression to clinical category C (according to the classification of the Centers for Disease Control and Prevention - CDC, 1994) or death. Values of total leukocyte count, total lymphocyte count, haemoglobin, weight-for-age z score, CD4+ T-lymphocyte count and plasma viral load obtained at admission were considered in the risk analysis of events of interest. The population was stratified into age groups: <12, >=12 to <36, >=36 to <60 months. Results: 120 patients, admitted between 1997 and 2003, met the inclusion criteria. The total median follow-up duration was 7.4 months (25-75% interquartile range=3.8-21.1). In the multivariate analysis, only CD4+ T-lymphocyte count, according to the categories of the World Health Organization, and weight-for-age z score <=-2 were predictors of risk for disease progression in children older than 12 months. In children younger than 12 months, none of the variables was associated with risk of progression. Conclusion: Nutritional status is an important aspect in the assessment of risk of disease progression in HIV-infected children older than 12 months."									
975	"CD4 cell response before and after HAART initiation according to viral load and growth indicators in HIV-1-infected children in abidjan, cote d'ivoire."	"Beaudrap PD, Rouet F, Fassinou P, Kouakoussui A, Mercier S, Ecochard R, Msellati P."	Journal of Acquired Immune Deficiency Syndromes. 2008 01 Sep;49(1):70-6.		"OBJECTIVE: To analyze the determinants of CD4 change in children during 3 periods: before highly active antiretroviral therapy (HAART), during the first year after HAART initiation, and past 1 year after HAART initiation. METHODS: One hundred seventy-seven children enrolled in a prospective cohort in Abidjan received HAART during a mean follow-up of 30 months. A linear mixed-effects model was used for the first period, a mixed-effects piecewise model for the second period, and an asymptotic mixed-effects model for long-term CD4 dynamics. RESULTS: Before HAART initiation, CD4 percentage decreased along time [beta = -0.59 (-0.92 to -0.26)] was positively associated with body mass index for age [beta = 0.47 (0.22 to 0.72)] and negatively associated with viral load [beta = -1.01 (-1.90 to -0.13)]. During the first year of treatment, the CD4 decrease reverted to a steep increase that was negatively associated with age at HAART initiation [beta = -0.24 (-0.4 to -0.07)] and with the mean viral load under HAART [beta = -1.51 (-2.21 to -0.81)]. The long-term CD4 percentage was also negatively associated with the mean viral load under HAART [beta = -4.97 (-6.22 to -3.72)] and age at HAART initiation [beta = -0.82 (-1.12 to -0.51)]. CONCLUSIONS: Before HAART initiation, the CD4 cell percentage was associated with growth indicators whereas, after HAART, an early increase and a long-term plateau were negatively associated with the viral load and age at HAART initiation. 2008 Lippincott Williams & Wilkins."									
1011	"CD4 cell response before and after HAART initiation according to viral load and growth indicators in HIV-1-infected children in Abidjan, Cote d'Ivoire."	"De Beaudrap P, Rouet F, Fassinou P, Kouakoussui A, Mercier S, Ecochard R, Msellati P."	Journal of acquired immune deficiency syndromes (1999). 2008 1 Sep;49(1):70-6.		"OBJECTIVE: To analyze the determinants of CD4 change in children during 3 periods: before highly active antiretroviral therapy (HAART), during the first year after HAART initiation, and past 1 year after HAART initiation. METHODS: One hundred seventy-seven children enrolled in a prospective cohort in Abidjan received HAART during a mean follow-up of 30 months. A linear mixed-effects model was used for the first period, a mixed-effects piecewise model for the second period, and an asymptotic mixed-effects model for long-term CD4 dynamics. RESULTS: Before HAART initiation, CD4 percentage decreased along time [beta = -0.59 (-0.92 to -0.26)] was positively associated with body mass index for age [beta = 0.47 (0.22 to 0.72)] and negatively associated with viral load [beta = -1.01 (-1.90 to -0.13)]. During the first year of treatment, the CD4 decrease reverted to a steep increase that was negatively associated with age at HAART initiation [beta = -0.24 (-0.4 to -0.07)] and with the mean viral load under HAART [beta = -1.51 (-2.21 to -0.81)]. The long-term CD4 percentage was also negatively associated with the mean viral load under HAART [beta = -4.97 (-6.22 to -3.72)] and age at HAART initiation [beta = -0.82 (-1.12 to -0.51)]. CONCLUSIONS: Before HAART initiation, the CD4 cell percentage was associated with growth indicators whereas, after HAART, an early increase and a long-term plateau were negatively associated with the viral load and age at HAART initiation."									
948	Lipodystrophy and metabolic disorders in HIV-1-infected adults on 4- to 9-year antiretroviral therapy in Senegal: a case-control study.	"Delaporte E, Simondon KB, Mercier S, Gueye NFN, Cournil A, Fontbonne A, Copin N, et al."	"JAIDS, Journal of Acquired Immune Deficiency Syndromes. 2009;51(2):224-30."	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20093164201	"Objective: To assess adverse effects of long-term highly active antiretroviral therapy (HAART), that is, lipodystrophy and metabolic disorders, in a cohort of African patients. Methods: One hundred eighty HIV-1-infected patients treated with HAART for 4-9 years in Dakar and 180 age-matched and sex-matched controls were enrolled. Regional subcutaneous fat changes were assessed by physicians, and fasting blood samples were drawn. Centralization of body fat was estimated using skinfold ratio, waist circumference, and waist to hip ratio (WHR). Results: Mean duration of HAART was 5.4 years. Main drugs received were zidovudine, stavudine, and protease inhibitors. The prevalence of moderate-severe lipodystrophy was 31.1% (95% confidence interval: 24.3 to 37.9), with 13.3%, 14.5%, and 3.3% for lipoatrophy, lipohypertrophy, and mixed forms, respectively. Mild-severe lipodystrophy affected 65.0% (58.0; 72.0) of patients. Stavudine was the only independent risk factor (any vs. none: odds ratio=2.8; 1.4 to 5.5). Patients had lower body mass index and skinfolds but greater centralization of body fat (WHR, P<0.0001 and skinfold ratio, P<0.001), fasting glucose (P<0.0001), homeostasis model assessment insulin resistance, and triglyceride levels (P<0.01 for both) than controls. Moderately-severely lipodystrophic patients had higher triglyceride and low-density lipoprotein cholesterol than other patients (P<0.001 and P<0.05, respectively). Conclusions: Moderate-severe lipodystrophy affected one third of West African patients on long-term HAART and was associated with a less favorable metabolic profile."									
994	Lipodystrophy and metabolic disorders in HIV-1-infected adults on 4- to 9-year antiretroviral therapy in senegal: A case-control study.	"Mercier S, Gueye NFN, Cournil A, Fontbonne A, Copin N, Ndiaye I, Dupuy AM, et al."	Journal of Acquired Immune Deficiency Syndromes. 2009 June;51(2):224-30.		"OBJECTIVE: To assess adverse effects of long-term highly active antiretroviral therapy (HAART), that is, lipodystrophy and metabolic disorders, in a cohort of African patients. METHODS: One hundred eighty HIV-1-infected patients treated with HAART for 4-9 years in Dakar and 180 age-matched and sex-matched controls were enrolled. Regional subcutaneous fat changes were assessed by physicians, and fasting blood samples were drawn. Centralization of body fat was estimated using skinfold ratio, waist circumference, and waist to hip ratio (WHR). RESULTS: Mean duration of HAART was 5.4 years. Main drugs received were zidovudine, stavudine, and protease inhibitors. The prevalence of moderate-severe lipodystrophy was 31.1% (95% confidence interval: 24.3 to 37.9), with 13.3%, 14.5%, and 3.3% for lipoatrophy, lipohypertrophy, and mixed forms, respectively. Mild-severe lipodystrophy affected 65.0% (58.0; 72.0) of patients. Stavudine was the only independent risk factor (any vs. none: odds ratio = 2.8; 1.4 to 5.5). Patients had lower body mass index and skinfolds but greater centralization of body fat (WHR, P < 0.0001 and skinfold ratio, P < 0.001), fasting glucose (P < 0.0001), homeostasis model assessment insulin resistance, and triglyceride levels (P < 0.01 for both) than controls. Moderately-severely lipodystrophic patients had higher triglyceride and low-density lipoprotein cholesterol than other patients (P < 0.001 and P < 0.05, respectively). CONCLUSIONS: Moderate-severe lipodystrophy affected one third of West African patients on long-term HAART and was associated with a less favorable metabolic profile. 2009 by Lippincott Williams & Wilkins."									
1825	Differences in access and patient outcomes across antiretroviral treatment clinics in the Free State province: a prospective cohort study.	"Ingle SM, May M, Uebel K, Timmerman V, Kotze E, Bachmann M, Sterne JA, et al."	South African Medical Journal Suid-Afrikaanse Tydskrif Vir Geneeskunde. 2010;100(10):675-81.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=21080999	"OBJECTIVE: To assess differences in access to antiretroviral treatment (ART) and patient outcomes across public sector treatment facilities in the Free State province, South Africa."	"DESIGN: Prospective cohort study with retrospective database linkage. We analysed data on patients enrolled in the treatment programme across 36 facilities between May 2004 and December 2007, and assessed percentage initiating ART and percentage dead at 1 year after enrolment. Multivariable logistic regression was used to estimate associations of facility-level and patient-level characteristics with both mortality and treatment status."	"RESULTS: Of 44 866 patients enrolled, 15 219 initiated treatment within 1 year; 8 778 died within 1 year, 7 286 before accessing ART. Outcomes at 1 year varied greatly across facilities and more variability was explained by facility-level factors than by patient-level factors. The odds of starting treatment within 1 year improved over calendar time. Patients enrolled in facilities with treatment initiation available on site had higher odds of starting treatment and lower odds of death at 1 year compared with those enrolled in facilities that did not offer treatment initiation. Patients were less likely to start treatment if they were male, severely immunosuppressed (CD4 count <=50 cells/l), or underweight (<50 kg). Men were also more likely to die in the first year after enrolment."	"CONCLUSIONS: Although increasing numbers of patients started ART between 2004 and 2007, many patients died before accessing ART. Patient outcomes could be improved by decentralisation of treatment services, fast-tracking the most immunodeficient patients and improving access, especially for men."						
1818	Differences in access and patient outcomes across antiretroviral treatment clinics in the Free State Province: A prospective cohort study.	"Ingle SM, May M, Uebel K, Timmerman V, Kotze E, Bachmann M, Sterne JAC, et al."	South African Medical Journal. 2010;100(10):675-81.		"Objective: To assess differences in access to antiretroviral treatment (ART) and patient outcomes across public sector treatment facilities in the Free State province, South Africa. Design: Prospective cohort study with retrospective database linkage. We analysed data on patients enrolled in the treatment programme across 36 facilities between May 2004 and December 2007, and assessed percentage initiating ART and percentage dead at 1 year after enrolment. Multivariable logistic regression was used to estimate associations of facility-level and patient-level characteristics with both mortality and treatment status. Results: Of 44 866 patients enrolled, 15 219 initiated treatment within 1 year; 8 778 died within 1 year, 7 286 before accessing ART. Outcomes at 1 year varied greatly across facilities and more variability was explained by facility-level factors than by patient-level factors. The odds of starting treatment within 1 year improved over calendar time. Patients enrolled in facilities with treatment initiation available on site had higher odds of starting treatment and lower odds of death at 1 year compared with those enrolled in facilities that did not offer treatment initiation. Patients were less likely to start treatment if they were male, severely immunosuppressed (CD4 count <=50 cells/mul), or underweight (<50 kg). Men were also more likely to die in the first year after enrolment. Conclusions: Although increasing numbers of patients started ART between 2004 and 2007, many patients died before accessing ART. Patient outcomes could be improved by decentralisation of treatment services, fast-tracking the most immunodeficient patients and improving access, especially for men."									
469	"Trends in sociodemographic and health-related indicators in Bangladesh, 1993-2007: will inequities persist?"	"Khan MM, Kramer A, Khandoker A, Prufer-Kramer L, Islam A."	Bulletin of the World Health Organization. 2011;89(8):583-93.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=21836757	"OBJECTIVE: To assess levels, trends and gaps between the poorest and the richest in selected health and human development indicators in Bangladesh."	"METHODS: Data for selected indicators associated with sociodemographic characteristics among ever-married women, contraception use, child vaccination, antenatal care practices and health conditions were extracted from the Bangladesh Demographic and Health Surveys conducted in 1993-94, 1996-1997, 1999-2000, 2004 and 2007. Results for the whole sample and for the poorest and the richest wealth quintiles are presented."	"FINDINGS: Positive trends were noted in urbanization, availability of electricity, age at first marriage, use of modern contraception, access to skilled antenatal care, child vaccination, knowledge of human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome and overweight and obesity. In contrast, negative trends were seen in factors such as literacy, infant and child mortality, fertility rate, home delivery and malnutrition and underweight. However, changes in these indicators differed between the poorest and richest quintiles. For instance, only the richest quintile experienced rapid urbanization, whereas illiteracy declined more among the poorest. Noteworthy gaps were found in almost all factors. Rich-poor gaps in urbanization, age at marriage, fertility, condom use, home delivery and overweight increased; in contrast, gaps in education, water and sanitation, use of contraception (except condoms) and child vaccination declined."	CONCLUSION: Persistent inequities in Bangladesh endanger equitable and sustainable human development in the country. Pro-poor development strategies based on the principles of equity and quality should be implemented to narrow existing gaps and further promote holistic and equitable human development.						
470	"Trends in sociodemographic and health-related indicators in Bangladesh, 1993-2007: will inequities persist?"	"Khan MMH, Kramer A, Khandoker A, Prufer-Kramer L, Anwar I."	Bulletin of the World Health Organization. 2011;89(8):583-92.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20113300460	"Objective: To assess levels, trends and gaps between the poorest and the richest in selected health and human development indicators in Bangladesh. Methods: Data for selected indicators associated with sociodemographic characteristics among ever-married women, contraception use, child vaccination, antenatal care practices and health conditions were extracted from the Bangladesh Demographic and Health Surveys conducted in 1993-94, 1996-1997, 1999-2000, 2004 and 2007. Results for the whole sample and for the poorest and the richest wealth quintiles are presented. Findings: Positive trends were noted in urbanization, availability of electricity, age at first marriage, use of modern contraception, access to skilled antenatal care, child vaccination, knowledge of human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome and overweight and obesity. In contrast, negative trends were seen in factors such as literacy, infant and child mortality, fertility rate, home delivery and malnutrition and underweight. However, changes in these indicators differed between the poorest and richest quintiles. For instance, only the richest quintile experienced rapid urbanization, whereas illiteracy declined more among the poorest. Noteworthy gaps were found in almost all factors. Rich-poor gaps in urbanization, age at marriage, fertility, condom use, home delivery and overweight increased; in contrast, gaps in education, water and sanitation, use of contraception (except condoms) and child vaccination declined. Conclusion: Persistent inequities in Bangladesh endanger equitable and sustainable human development in the country. Pro-poor development strategies based on the principles of equity and quality should be implemented to narrow existing gaps and further promote holistic and equitable human development."									
1714	Central obesity and dietary intake in HIV/AIDS patients.	"Jaime PC, Florindo AA, Latorre MdRDdO, Segurado AAC."	Revista de Saude Publica. 2006 August;40(4):634-40.		"Objective: To assess the association between dietary intake and central obesity among people living with HIV/AIDS and receiving highly active antiretroviral therapy. Methods: A cross-sectional study was conducted involving 223 adult individuals in the city of Sao Paulo city in 2002. The study population was classified according to central obesity, defined as waist-to-hip ratio >0.95 for men and >0.85 for women. The dietary variables studied were energy consumption (in calories and calories/kilo of body weight), macronutrients (in grams and % of energy intake), total fiber (grams) and fruit and vegetables intake (grams). The potential confounders examined were sex, skin color, age, schooling, income, body mass index, physical activity, smoking habits, peripheral CD4+ T lymphocyte count and length of protease inhibitor use. The multiple logistic regression model was performed in order to evaluate the association between central obesity and dietary intake. Results: The prevalence of central obesity was 45.7% and it was associated with greater consumption of lipids: for every increase of 10g of lipid intake the odds of central obesity increased 1.28 times. Carbohydrate consumption showed negative association (OR=0.93) with central obesity after adjustment for control variables. Conclusions: The results suggest that the amount of carbohydrates and lipids in the diet, regardless of total energy intake, may modify the chance of developing central obesity in the studied population. Nutritional interventions maybe beneficial for preventing central obesity among HIV/AIDS patients. 2007 Faculdade de Saude Publica da Universidade de Sao Paulo."									
1238	Effect of HIV infection on body composition and fat distribution in Rwandan women.	"Mutimura E, Anastos K, Zheng L, Cohen M, Binagwaho A, Kotler DP."	Journal of the International Association of Physicians in AIDS Care: JIAPAC. 2010;9(3):173-8.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=20530472	OBJECTIVE: To assess the association of HIV infection with body weight and composition in Rwandan women.	"DESIGN: Body weight and composition, the latter determined by bioelectrical impedance analysis (BIA) and by anthropometry, were compared in 620 HIV-positive and 211 HIV-negative participants. Associations of HIV with body composition were assessed, and t tests compared the groups."	"RESULTS: HIV-positive women were younger (-7.0 years, P < .001) and shorter (-2.1 cm, P < .001). Mean body weight, body mass index (BMI), total body fat, and waist-to-hip ratio (WHR) were similar. Mean fat-free mass was 2.5% greater in HIV-negative participants, and 19% of HIV-positive group had BMI <18.5 kg/m(2) versus 26% of the HIV-negative group (P < .05). CD4 counts and body composition were not associated."	"CONCLUSIONS: Malnutrition was common in this cohort of Rwandan women. However, HIV infection was not associated with nutritional status. Factors other than malnutrition may influence quality-of-life outcomes in HIV-infected Rwandan women. Initiatives to improve nutritional status should be population-wide and not restricted to the HIV-infected population."						
1230	Effect of HIV infection on body composition and fat distribution in rwandan women.	"Mutimura E, Anastos K, Lin Z, Cohen M, Binagwaho A, Kotler DP."	Journal of the International Association of Physicians in AIDS Care. 2010 May-June;9(3):173-8.		"Objective: To assess the association of HIV infection with body weight and composition in Rwandan women. Design: Body weight and composition, the latter determined by bioelectrical impedance analysis (BIA) and by anthropometry, were compared in 620 HIV-positive and 211 HIV-negative participants. Associations of HIV with body composition were assessed, and t tests compared the groups. Results: HIV-positive women were younger (-7.0 years, P < .001) and shorter (-2.1 cm, P < .001). Mean body weight, body mass index (BMI), total body fat, and waist-to-hip ratio (WHR) were similar. Mean fat-free mass was 2.5% greater in HIV-negative participants, and 19% of HIV-positive group had BMI <18.5 kg/m2 versus 26% of the HIV-negative group (P < .05). CD4 counts and body composition were not associated. Conclusions: Malnutrition was common in this cohort of Rwandan women. However, HIV infection was not associated with nutritional status. Factors other than malnutrition may influence quality-of-life outcomes in HIV-infected Rwandan women. Initiatives to improve nutritional status should be population-wide and not restricted to the HIV-infected population. The Author(s) 2010."									
986	Diagnostic accuracy of a urine lipoarabinomannan enzyme-linked immunosorbent assay for screening ambulatory HIV-infected persons for tuberculosis.	"Gounder CR, Kufa T, Wada NI, Mngomezulu V, Charalambous S, Hanifa Y, Fielding K, et al."	Journal of Acquired Immune Deficiency Syndromes. 2011 01 Oct;58(2):219-23.		"Objective: To assess the diagnostic accuracy of the urine lipoarabinomannan (LAM) test among ambulatory HIV-infected persons. Design: Cross-sectional. Methods: HIV-infected persons consecutively presenting to the HIV Clinic at Tembisa Main Clinic in Ekhuruleni, South Africa, were screened for symptoms of tuberculosis (TB) and asked to provide sputum and blood samples for smears for acid-fast bacilli and mycobacterial culture and a urine specimen for a LAM enzyme-linked immunosorbent assay. Fine needle aspirates were obtained from participants with enlarged lymph nodes and sent for histopathology. Nonpregnant participants underwent chest X-ray. Results: Four hundred twenty-two HIV-infected participants were enrolled with median age 37 years (interquartile range: 31-44 years), median CD4+ T-cell count 215 cells per microliter (interquartile range: 107-347 cells/muL), and 212 (50%) receiving antiretroviral therapy. Thirty (7%) had active TB: 18 with only pulmonary TB, 5 with only extrapulmonary TB, and 7 with both pulmonary TB and extrapulmonary TB. Twenty-seven percent [95% confidence interval (CI): 12% to 48%] of TB cases were sputum acid-fast bacilli positive. The sensitivity and specificity of the urine LAM compared with the gold standard of positive bacteriology or histopathology were 32% (95% CI: 16% to 52%) and 98% (95% CI: 96% to 99%), respectively. Urine LAM had higher sensitivity in TB cases with higher bacillary burdens, though these differences were not statistically significant. Conclusions: The sensitivity of urine LAM testing is inadequate to replace mycobacterial culture. In contrast to prior research on the urine LAM, this study was conducted among less sick, ambulatory HIV-infected patients presenting for routine care. 2011 by Lippincott Williams & Wilkins."									
1916	Randomized controlled trial of zinc and vitamin A as co-adjuvants for the treatment of pulmonary tuberculosis.	"Lawson L, Thacher TD, Yassin MA, Onuoha NA, Usman A, Emenyonu NE, Shenkin A, et al."	Tropical Medicine & International Health. 2010;15(12):1481-90.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=20958890	OBJECTIVE: To assess the efficacy of weekly zinc or zinc plus retinol as adjuncts for the treatment of pulmonary tuberculosis.	"METHODS: Double-blind, randomized, placebo-controlled trial in 350 patients >15 years old with smear-positive tuberculosis in Nigeria (ISRCTN36636609). In addition to antituberculous treatment, patients were randomly allocated to weekly supplements of zinc (90 mg), zinc plus retinol (5000 IU) or placebos for 6 months. Primary outcomes were time to sputum smear conversion and resolution of radiographic abnormalities."	"RESULTS: After 8 weeks of treatment, 68% had achieved sputum smear conversion, and the median conversion time was 6.5 weeks. Hazard ratios (HR, 95%CI) for sputum conversion relative to the placebo group were not significant for zinc (1.07, 0.92-1.29) or zinc plus retinol (0.89, 0.76-1.07). Significant predictors of time to sputum conversion were lung abnormality score, sputum smear grade, age and serum C-reactive protein. HIV co-infection and gender were not independent predictors of time to sputum conversion. There were no significant differences between supplement groups in clinical, radiological or laboratory outcomes at 2 months or 6 months. There were 9, 9 and 2 deaths in patients receiving zinc, zinc plus retinol or placebos, respectively. Mortality in those who received zinc (HR 1.71, 0.88-3.58) or zinc plus retinol (HR 1.54, 0.78-3.26) did not differ significantly from those who received placebos. Most deaths occurred in patients co-infected with HIV."	"CONCLUSIONS: Supplementation with zinc or zinc plus retinol did not lead to better outcomes than placebos, and caution is warranted regarding routine micronutrient supplementation, particularly in patients co-infected with HIV. 2010 Blackwell Publishing Ltd."						
318	Infant feeding in the time of HIV: rapid assessment of infant feeding policy and programmes in four African countries scaling up prevention of mother to child transmission programmes.	"Chopra M, Rollins N."	Archives of Disease in Childhood. 2008;93(4):288-91.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20083273343	"Objective: To assess the infant feeding components of prevention of mother to child HIV transmission (PMTCT) programmes. Methods: Assessments were performed across Botswana, Kenya, Malawi and Uganda. 29 districts offering PMTCT were selected by stratified random sampling with rural and urban strata. All health facilities in the selected PMTCT district were assessed. The facility level manager and the senior nurse in charge of maternal care were interviewed. 334 randomly selected health workers involved in the PMTCT programme completed self-administered questionnaires. 640 PMTCT counselling observations were carried out and 34 focus groups were conducted amongst men and women. Results: Most health workers (234/334, 70%) were unable to correctly estimate the transmission risks of breastfeeding irrespective of exposure to PMTCT training. Infant feeding options were mentioned in 307 of 640 (48%) observations of PMTCT counselling sessions, and in only 35 (5.5%) were infant feeding issues discussed in any depth; of these 19 (54.3%) were rated as poor. Several health workers also reported receiving free samples of infant formula in contravention of the International Code on Breastmilk Substitutes. National HIV managers stated they were unsure about infant feeding policy in the context of HIV. Finally, there was an almost universal belief that an HIV positive mother who breastfeeds her child will always infect the child and intentional avoidance of breastfeeding by the mother indicates that she is HIV positive. Conclusion: These findings underline the need to implement and support systematic infant feeding policies and programme responses in the context of HIV programmes."									
1914	"Nutritional status, psychological well-being and the quality of life of AIDS orphans in rural Henan Province, China."	"He Z, Ji C."	Tropical Medicine & International Health. 2007;12(10):1180-90.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=17956500	"OBJECTIVE: To assess the influence of orphanhood due to AIDS on children's nutritional status, psychological well-being and life quality, and to explore appropriate intervention strategies in China."	"METHODS: In 2005, 186 children aged 8-15 years (93 AIDS orphans and 93 non-orphans) from a rural area of Henan Province were surveyed in a cross-sectional and matched pairs study on nutritional status, psychological health and life quality."	"RESULTS: We found no compelling evidence for poorer nutritional status in orphans. The nutritional status of both orphans and non-orphans was extremely poor according to the prevalence of stunting, underweight, wasting and anaemia. Depression, low self-esteem and lower quality of life were more frequent in orphans. These differences mainly existed in boys' groups. No significant differences were found between paternal, maternal and double orphans, or orphans in orphanages or extended families. Regression analysis revealed that orphanhood leads to low self-esteem and more depression which contributes to lower quality of life and mediates the association between orphanhood and quality of life."	"CONCLUSION: The high prevalence of poor nutritional status indicates that basic material needs of children, including AIDS orphans, are not met in rural China. Psychological problems were prominent among orphans and had become the most important contributor of lower life quality. Boys were at least as vulnerable as girls. The living conditions of all children in rural China must be improved; school-based care and support are crucial and would be a cost-effective way to improve the overall life quality of AIDS orphans."						
821	Lipodystrophy and metabolic complications of highly active antiretroviral therapy.	"Parakh A, Dubey AP, Kumar A, Maheshwari A."	Indian Journal of Pediatrics. 2009 October;76(10):1017-21.		"Objective: To assess the metabolic drug toxicities of first-line, World Health Organization (WHO)-recommended generic highly active antiretroviral therapy (HAART) regimens, to estimate the prevalence of body fat redistribution and to identify associated risk factors. Methods: Cross-sectional observational study. During 3 month period, 52 HIV infected children (25 on HAART; 27 not on HAART) were assessed. Their sociodemographic, clinical, and immunological data was recorded. Children were examined or the signs of fat redistribution (peripheral lipoatrophy and central lipohypertrophy). Liver function tests, fasting blood sugar, lipid profile, serum amylase, serum lactate, blood pH and bicarbonate levels were done in all patients. Results: Twenty-two patients were on stavudine and three on zidovudine based HAART. None of the patients ever received any protease inhibitor. There were no cases of clinical or immunological failure. Children on HAART had significantly lower weight for age and body mass index but the mean height for age was similar between study groups. Only two cases of peripheral lipoatrophy were observed. Hypercholesterolemia was observed in four children on HAART but none without therapy. Hypertriglyceridemia was observed in three children on HAART and seven without therapy. Four cases of asymptomatic mild hyperlactatemia were observed. No case of any hyperglycemia or liver impairment was observed. Conclusion: Metabolic abnormalities and lipodystrophy are emerging complications of HAART in Indian children and needs very close follow up. Future studies with larger sample size and longitudinal model are recommended. 2009 Dr. K C Chaudhuri Foundation."									
1644	A needs assessment of clients with HIV in a home-based care program in Guyana.	"Boryc K, Anastario MP, Dann G, Chi B, Cicatelli B, Steilen M, Gordon-Boyle K, et al."	Public Health Nursing. 2010;27(6):482-91.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=21087301	"OBJECTIVE: To assess the needs of clients in a home-based care (HBC) program aimed at improving the quality of lives of people living with HIV in Region 4 of Guyana (Demerara-Mahaica region) following their involvement with the HBC program, volunteers, and nurse providers."	DESIGN AND SAMPLE: A cross-sectional analysis of a needs assessment conducted through a verbally administered questionnaire. We collected a cross-sectional sample of 84 HBC clients living with HIV from Region 4 in Guyana.	MEASURES: Respondents were administered a questionnaire that asked questions regarding the demographics; services received; quality of service delivery; and mental health and substance abuse.	"RESULTS: The services most commonly received by respondents included nutritional assessment and counseling, HIV prevention education, emotional support, hygiene education, support for antiretroviral adherence, and support for HIV disclosure. Respondents reported further need of referrals to income-generation opportunities, food and nutritional supplement support, and support for children. Forty-two percent of the respondents screened positive for probable depression, and 37% of respondents screened positive for being at risk for a drinking problem."	"CONCLUSIONS: While a substantial portion of needs were addressed by the HBC program, outstanding needs included linking people living with HIV to income-generation opportunities, food support, mental health, and services for children. We suggest that mental health and substance use services be factored into HIV programming and that referral systems be strengthened to ensure access to support services for people living with HIV. 2010 Wiley Periodicals, Inc."					
1645	A needs assessment of clients with HIV in a home-based care program in Guyana.	"Boryc K, Anastario MP, Dann G, Chi BH, Cicatelli B, Steilen M, Gordon-Boyle K, et al."	Public Health Nursing. 2010;27(6):482-91.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20103364617	"Objective: To assess the needs of clients in a home-based care (HBC) program aimed at improving the quality of lives of people living with HIV in Region 4 of Guyana (Demerara-Mahaica region) following their involvement with the HBC program, volunteers, and nurse providers. Design and Sample: A cross-sectional analysis of a needs assessment conducted through a verbally administered questionnaire. We collected a cross-sectional sample of 84 HBC clients living with HIV from Region 4 in Guyana. Measures: Respondents were administered a questionnaire that asked questions regarding the demographics; services received; quality of service delivery; and mental health and substance abuse. Results: The services most commonly received by respondents included nutritional assessment and counseling, HIV prevention education, emotional support, hygiene education, support for antiretroviral adherence, and support for HIV disclosure. Respondents reported further need of referrals to income-generation opportunities, food and nutritional supplement support, and support for children. Forty-two percent of the respondents screened positive for probable depression, and 37% of respondents screened positive for being at risk for a drinking problem. Conclusions: While a substantial portion of needs were addressed by the HBC program, outstanding needs included linking people living with HIV to income-generation opportunities, food support, mental health, and services for children. We suggest that mental health and substance use services be factored into HIV programming and that referral systems be strengthened to ensure access to support services for people living with HIV."									
877	Factors associated with low bone mineral density in a Brazilian cohort of vertically HIV-infected adolescents.	"Schtscherbyna A, Pinheiro MFMC, Mendonca LMCd, Gouveia C, Luiz RR, Machado ES, Farias MLFd."	International Journal of Infectious Diseases. 2012;16(12):e872-e8.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20123387114	"Objective: To assess the prevalence and factors associated with low bone mineral density (BMD) in HIV-infected adolescents. Methods: This was a cross-sectional study of a Brazilian cohort of vertically HIV-infected adolescents. Body composition and lumbar spine (LS) and total body (TB) BMD were estimated by dual-energy X-ray absorptiometry (DXA). Low BMD was considered for a Z-score <=-2 standard deviations. Pubertal development, anthropometric data, laboratory measurements, antiretroviral regimen, and time of immunological and virological recovery were evaluated as factors associated with a low BMD. Results: Seventy-four adolescents aged 17.3+or-1.8 years were studied. Low BMD was present in 32.4% of them. LS and TB BMD Z-scores were positively correlated with weight, body mass index (BMI), BMI Z-score, total body fat, and nutritional status. Patients on tenofovir had lower LS and TB BMD Z-scores. Time on tenofovir was indirectly correlated with LS and TB BMD Z-scores. No difference was found regarding levels of calcium, parathyroid hormone, or 25-hydroxyvitamin D according to BMD status. Conclusions: Control of the HIV infection, especially before the initiation of puberty, might have a positive influence on bone gain. Body composition and nutritional status had a positive influence on BMD that was more evident in females, suggesting that nutritional intervention may have a positive impact on BMD."									
1699	"Anemia in recyclable waste pickers using human driven pushcarts in the city of Santos, southeastern Brazil."	"Rozman MA, Azevedo CHd, Jesus RRCd, Moldero Filho R, Perez Junior V."	Revista Brasileira de Epidemiologia. 2010;13(2):326-36.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20103265976	"OBJECTIVE: To assess the prevalence of anemia and describe associated risk factors in recyclable waste pickers using human-driven pushcarts in the city of Santos. METHODS: A cross-sectional study including 253 recyclable waste pickers was conducted in the city of Santos, southeastern Brazil, in July 2005. A questionnaire was used to collect information about individual, occupational, and dietary factors. All subjects underwent an anthropometric evaluation and venous blood was drawn for complete blood count and serological testing for HIV, HCV, HBV, and syphilis. Statistical analysis included univariate and multivariate (logistic regression) analyses testing for the association between anemia and risk factors. RESULTS: The prevalence of anemia was 38.3%. Variables independently associated with anemia in the multivariate model were: gender (OR 2.8; 95% CI: 1.25-6.5), HIV infection (OR 6.45; 95% CI: 2.11-21.06), BMI ( chi <sup>2</sup> for trend, p<0.01), length of time working as a picker ( chi <sup>2</sup> for trend, p<0.01), and consumption of milk ( chi <sup>2</sup> for trend, p<0.01) and animal protein (OR 0.30; 95% CI: 0.13-0.68). CONCLUSIONS: The prevalence of anemia among recyclable waste pickers is high even after the compulsory addition of iron to wheat and corn flours. Waste pickers have not benefited from the actions for workers' health protection established by law. Health actions targeting this occupational category should be implemented to ensure their access to health services."									
1715	Factors associated with cesarean sections in Brazilian hospitals.	"Padua KSd, Osis MJD, Faundes A, Barbosa AH, Moraes Filho OB."	Revista de Saude Publica. 2010;44(1):70-9.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20103122968	"OBJECTIVE: To assess the prevalence of cesarean sections in Brazilian hospitals. METHODS: A cross-sectional study was carried out with data from the World Health Organization's Global Data System for Maternal and Perinatal Health, for the Brazilian states of Sao Paulo, Pernambuco and the Federal District. Data relating to 15,354 women who gave birth between September/2004 and March/2005 were analyzed, according to sociodemographic, reproductive, and hospital-related characteristics. Bivariate analyses - with calculations of the prevalence ratios and respective confidence intervals - and multivariate Poisson regression analyses were performed. RESULTS: The prevalence ratio of cesarean sections was significantly higher among older women, who were married/living with a partner and with higher body mass index. The following conditions during pregnancy or birth were associated with higher cesarean section prevalence ratio: parturient being diagnosed as HIV-positive, heavier weight and greater head circumference of the newborn, and more prenatal consultations. In regression analysis, the following variables showed direct association with the outcome: parturient being older and with higher schooling level, presence of hypertension/eclampsia, chronic condition or some other medical condition, newborn's greater head circumference, being primiparous, having had a cesarean in the last pregnancy and having received an epidural block or rachidian analgesic during labor. Although the proportion of cesareans was higher in hospitals with a high complexity index, the difference was not statistically significant, as well as for other characteristics of hospitals. CONCLUSIONS: The conditions of the pregnancy, newborn and the sociodemographic and reproductive characteristics of the parturient were independently associated with cesarean delivery. The hospital complexity index was not associated with cesarean delivery, probably due to the homogeneity of the hospital sample."									
1824	Paediatric admissions to a rural South African hospital: value of hospital data in helping to define intervention priorities and allocate district resources.	"Chopra M, Stirling S, Wilkinson D, Connolly C, McCoy D."	South African Medical Journal Suid-Afrikaanse Tydskrif Vir Geneeskunde. 1998;88(6 Suppl):785-8.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=20593621	OBJECTIVE: To audit paediatric medical admissions to a rural district hospital in order to help define intervention priorities and allocate district resources.	"DESIGN: Prospective audit of consecutive admissions to the paediatric medical service of Hlabisa Hospital, KwaZulu-Natal, between March 1995 and February 1996."	"MAIN OUTCOME MEASURES: Number of admissions, month of admission, age, sex, diagnosis, nutritional status, HIV status, outcome and length of stay."	"RESULTS: Of 1,364 children admitted, 995 (73%) were aged under 24 months and 584 (43%) were either underweight for age or severely malnourished. Acute respiratory tract infection (384, 28%), acute diarrhoea (200, 15%), dysentery (168, 12%) and severe malnutrition (149, 11%) were the major causes for admission and were responsible for most deaths (113, 75%). The overall case fatality rate was 11% and most (90, 60%) died within 48 hours of admission. Forty-five per cent of the 332 children tested were HIV-positive."	"CONCLUSION: Most severe morbidity and mortality result from four common conditions, reflecting poor socioeconomic conditions in the area. Opportunities for clincial intervention to reduce their impact include identification of 'at risk' children, focusing care early in admissions, use of standardised protocols of care, and integrated management of the sick child."					
1678	Pneumocystis carinii pneumonia versus wasting syndrome among AIDS cases in Puerto Rico: a survival analysis.	"Mayor Becerra AM, Suarez E, Morales Bedoya A."	Puerto Rico Health Sciences Journal. 1996;15(4):257-60.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=9097342	"OBJECTIVE: To compare mortality of wasting syndrome (WS) versus Pneumocystis carinii pneumonia (PCP) in AIDS patients reported in Puerto Rico after controlling for gender, age, and CD4 levels."	"METHODS: AIDS patients for which a diagnosis of WS (n = 1,180) or PCP (n = 765), who were reported to the AIDS Surveillance System of Puerto Rico between 1989 and 1992, were used to analyze the mortality risk among these diagnoses using a Cox's proportional hazard regression model."	"RESULTS: Cox model showed that WS patients had a 14% to 33% reduction in mortality risk compared with PCP patients after adjusting for gender and age (95% confidence level). Mortality risks for males were 18% (95% CI: 1%, 39%) higher than females risk after adjusting for AIDS defining condition and age. It was shown that a decrease in 100 CD4 cells increased the mortality by 37% (95% CI: 16%, 62%) after adjusting for AIDS defining conditions, gender, and age."							
1240	D-xylose absorption in non-chronic diarrhea AIDS patients with the wasting syndrome.	"Luangjaru S, Wisedopas N, Ruxrungtham K, Mahachai V."	Journal of the Medical Association of Thailand. 2003 01 Jun;86(SUPPL. 2):S477-S83.		"Objective: To compare the intestinal absorptive capacity, permeability function and duodenal histopathology in human immunodeficiency virus (HIV) patients with or without wasting syndrome who had not suffered from chronic diarrhea. Method: Adult HIV patients who attended Chulalongkorn Hospital were included. The subjects were classified into wasting and non-wasting groups (group I and group II). 25 g oral D-xylose test, oral phenolsulfonephthalein test and duodenal histopathology were performed. Results: Of thirty-two HIV patients, aged between 25-50 years enrolled, there were 18 and 14 patients in group I and group II, respectively. In both groups, the baseline data, permeability function and histopathology were similar. Intestinal absorptive capacity was statistically different, i.e. 5-hour urine D-xylose was 3.96 +/- 2.81 g and 5.95 +/- 2.47 g in group I and group II respectively (p < 0.05). Conclusion: This study demonstrated that D-xylose absorption was decreased in non-diarrheal, wasting HIV infected patients. Abnormal absorptive capacity is a common phenomenon found in HIV patients with wasting syndrome as determined by standard 25 g oral D-xylose test."									
1672	The nutritional status of asymptomatic HIV-infected Africans: directions for dietary intervention?	"Vorster HH, Kruger A, Margetts BM, Venter CS, Kruger HS, Veldman FJ, Macintyre UE."	Public Health Nutrition. 2004;7(8):1055-64.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=15548344	"OBJECTIVE: To compare the relationships between food (nutrient) intakes and biochemical markers of nutritional status of asymptomatic HIV-infected with HIV-uninfected subjects, to gain more information on the appropriate diet for HIV-infected persons at an early stage of infection."	DESIGN: Cross-sectional population-based survey.	"SETTING: North West Province, South Africa."	"SUBJECTS: Two hundred and sixteen asymptomatic HIV-infected and 1550 HIV-uninfected men and women volunteers aged 15 years and older, recruited as 'apparently healthy' subjects from 37 randomly selected sites."	"OUTCOME MEASURES: Food and nutrient intakes, measured with a validated food-frequency questionnaire, and nutritional status indicated by anthropometric and biochemical variables, measured by a standardised methodology."	"RESULTS: The prevalence of HIV infection in the study population was 11.9%. The anthropometric indices and nutrient intakes of HIV-infected and uninfected subjects did not differ significantly, indicating that these 216 HIV-infected subjects were at an early stage of infection. Of the biochemical nutritional status variables, high-density lipoprotein cholesterol and total cholesterol, haemoglobin, albumin and triglycerides were significantly lower in infected subjects. They also had higher globulin and liver enzyme levels than uninfected subjects. In infected subjects, serum albumin correlated significantly with serum lipids, serum vitamin A, serum vitamin E, serum iron, total iron-binding capacity and haemoglobin. The significant positive correlations of the liver enzymes with serum lipids, albumin, vitamin A and iron, observed in HIV-uninfected subjects, disappeared in the infected subjects. Polyunsaturated fat intake showed significant positive correlations with the increased liver enzymes in infected subjects. A principal components analysis indicated that, in infected subjects, increased liver enzymes correlated with higher consumption of maize meal and lower consumption of meat and vegetables."	"CONCLUSIONS AND RECOMMENDATIONS: This survey indicated that asymptomatic HIV-infected subjects who followed a diet rich in animal foods had smaller decreases in serum albumin, haemoglobin and lipid variables, and smaller increases in liver enzymes, than those who consumed a diet based on staple foods. This suggests that animal foods are associated with improved nutritional status in HIV-infected persons. These results should be confirmed with intervention studies before dietary recommendations for asymptomatic HIV-infected individuals can be made."			
1056	"Safety and efficacy of two preparations of megestrol acetate in HIV-infected individuals with weight loss in Africa, India, and the United States."	"Wanke C, Gutierrez J, Kristensen A, MacEarchern L."	Journal of Applied Research. 2007;7(3):206-16.		"Objective: To compare the safety and efficacy of a concentrated megestrol acetate oral suspension and traditional megestrol acetate in a randomized, controlled trial in HIV-infected patients with weight loss. Materials and Methods: The efficacy and safety of a new formulation of megestrol acetate concentrated suspension (575 mg/5 mL; MA-CS) was compared with traditional megestrol acetate oral suspension (800 mg/20 mL; MA-OS) in 63 HIV-infected adults with weight loss in South Africa, India, and the United States. Safety monitoring included measures of serum cortisol and adrenocorticotropic hormone stimulation testing, liver function, lipid panel, fasting glucose, and hemoglobin A1c prior to and after the 12-week trial. To assess the efficacy of the medication, patients' dietary intake, and body weight and composition were monitored during the trial. Quality of life, including appetite, was also assessed by visual analogue scales. Results: Body weight in the concentrated suspension group increased significantly more (5.4 kg) than in the in the traditional group (3.5 kg, P = 0.024). Body mass index (BMI) was <21 kg/m<sup>2</sup> in both groups after intervention. Weight increased earlier in the concentrated suspension group. Bioelectrical impedance analysis showed that 37%-40% of the weight increase was lean and 60%-63% was fat. Baseline and stimulated serum cortisol were normal; levels in both groups were low at 12 weeks (122 mug/dL and 302 mug/dL in the concentrated group and 120 mug/dL and 334 mug/dL in the traditional group). Cortisol levels 30 days after the trial were normal in both groups. Quality of life, including appetite, was assessed by the Bristol-Myers Anorexia/Cachexia Recovery Instrument. Conclusions: Both formulations of megestrol acetate improved BMI; weight gain was significantly more rapid and substantial with the concentrated suspension. Both treatment groups had compromised adrenal function, which normalized within 30 days of completing the trial."									
993	Elevated iron status strongly predicts mortality in west African adults with HIV infection.	"McDermid JM, Jaye A, Schim Van Der Loeff MF, Todd J, Bates C, Austin S, Jeffries D, et al."	Journal of Acquired Immune Deficiency Syndromes. 2007 December;46(4):498-507.		"OBJECTIVE: To comprehensively assess iron status and determine whether elevated iron status, like anemia, predicts mortality. METHODS: We followed 1362 Gambian adults (53% female) in an HIV-seroprevalent clinic-based cohort over 11.5 years to ascertain all-cause mortality. Baseline iron status (iron, soluble transferrin receptor [sTfR], transferrin, ferritin, transferrin saturation, log [transferrin receptor: ferritin]), age, gender, ethnicity, hemoglobin, body mass index, HIV type, absolute CD4 count, malaria status, and alpha-1-antichymotrypsin were measured. RESULTS: The mortality rate was 25.9/100 person-years. Elevated iron universally predicted greater mortality compared to normal iron status for all iron status indices, with the exception of sTfR in unadjusted models. In fully adjusted models, transferrin (elevated vs. normal, hazard ratio [HR]: 1.77; 95% confidence interval [CI]: 1.30 to 2.42; P < 0.001), ferritin (elevated vs. normal, HR: 1.40; 95% CI: 1.07 to 1.83; P = 0.014), and the combined iron status index (highly elevated vs. normal, HR: 2.20; 95% CI: 1.16 to 4.18; P = 0.016) remained significant predictors. As expected, hemoglobin (Hb) concentration and absolute CD4 counts were each inversely associated with mortality. CONCLUSIONS: Elevated iron status predicts mortality in HIV infection, even after adjustment for immunosuppression and other confounders. This finding has implications in the clinical monitoring of disease progression and for iron-supplementation practices in areas of high HIV prevalence. 2007 Lippincott Williams & Wilkins, Inc."									
1673	Integrated nutrition science: from theory to practice in South Africa.	"Vorster HH, Margetts BM, Venter CS, Wissing MP."	Public Health Nutrition. 2005;8(6A):760-5.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=16236213	"OBJECTIVE: To describe an integrated, holistic conceptual framework and research paradigm for a better understanding of the nutrition transition in middle- and low-income countries."	"MOTIVATION: Current inability effectively to prevent the increasing burden related to changes in food consumption patterns and other health behaviours of populations in transition motivates a new approach for nutrition research and practice. In this proposed approach, broader and integrated dimensions of science and practice may be applied for a better understanding of this complex phenomenon."	"RESULT: Examples from our own studies are given and quoted to illustrate how results from transdisciplinary studies were used to design an integrated, holistic programme to improve quality of life of people infected with HIV."	"CONCLUSION: Based on these experiences it is argued that the more holistic and integrated approach should and could lead to more effective and sustainable interventions to prevent the adverse health consequences of the nutrition transition. At the same time such an approach will contribute to efforts to conserve the environment and also human, living and natural resources. [References: 24]"						
98	Hospitalization for severe malnutrition among HIV-infected children starting antiretroviral therapy.	"Prendergast A, Bwakura-Dangarembizi MF, Cook AD, Bakeera-Kitaka S, Natukunda E, Nahirya Ntege P, Nathoo KJ, et al."	AIDS. 2011;25(7):951-6.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=21487251	OBJECTIVE: To describe early hospitalization for severe malnutrition in HIV-infected children initiating antiretroviral therapy (ART).	DESIGN: Randomized trial of induction-maintenance and monitoring strategies in HIV-infected children.	SETTING: Three tertiary hospitals in Uganda and one in Zimbabwe.	"PARTICIPANTS: 1207 HIV-infected children, median age 6 years (range, 3 months to 17 years)."	"INTERVENTION: Abacavir, lamivudine and nevirapine or efavirenz were given; children in induction-maintenance arms also received zidovudine to week 36. Pre-ART inpatient/outpatient nutritional rehabilitation for children with baseline severe malnutrition."	MAIN OUTCOME MEASURES: : Hospitalization for severe malnutrition and change in CD4 cell percentage by week 12 after ART. Mortality and change in weight-for-age Z-score (WAZ) by week 24 after ART.	"RESULTS: Thirty-nine of 1207 (3.2%) children were hospitalized for severe malnutrition (20 with oedema), median 28 days [interquartile range (IQR) 14, 36] after ART for marasmus and 26 days (IQR 14, 56) after ART for kwashiorkor. Hospitalized children had lower baseline and greater 24-week rise in WAZ than nonhospitalized children (P < 0.001). Twenty-nine of 39 (74%) children admitted for severe malnutrition had underlying infections. Of 220 children with advanced disease (baseline WAZ and CD4 cell Z-scores both <-3), 7.3% [95% confidence interval (CI) 3.8, 10.7] developed kwashiorkor and 3.6% (95% CI 1.2, 6.1) developed marasmus by week 12. CD4 cell percentage rise was similar among groups (P = 0.37). Twenty-four-week mortality was 32, 20 and 1.7% among children hospitalized with marasmus, kwashiorkor and not hospitalized, respectively, (P < 0.001)."	"CONCLUSION: One in nine children with advanced HIV required early hospitalization for severe malnutrition after ART, with a 15-fold increase in 6-month mortality compared with nonhospitalized children. Integration of HIV/malnutrition services and further research to determine optimal ART timing, role of supplementary feeding and antimicrobial prophylaxis are urgently required."		
329	Anthropometry of fetal growth in rural Malawi in relation to maternal malaria and HIV status.	"Kalanda BF, van Buuren S, Verhoeff FH, Brabin BJ."	Archives of Disease in Childhood -- Fetal & Neonatal Edition. 2005;90(2):F161-5.	http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=2009109549&site=ehost-live	"OBJECTIVE: To describe fetal growth centiles in relation to maternal malaria and HIV status, using cross sectional measurements at birth. DESIGN: A cross sectional study of pregnant women and their babies. Data on maternal socioeconomic status and current pregnancy, including HIV status and newborn anthropometry, were collected. Malaria parasitaemia was assessed in maternal peripheral and placental blood, fetal haemoglobin was measured in cord blood, and maternal HIV status was determined. SETTING: Two district hospitals in rural southern Malawi, between March 1993 and July 1994. OUTCOME VARIABLES: Newborn weight, length, Rohrer's ponderal index. RESULTS: Maternal HIV (adjusted odds ratio (AOR) 1.76 (95% confidence interval 1.04 to 2.98)) and first pregnancy (AOR 1.83 (1.10 to 3.05)) were independently associated with low weight for age. Placental or peripheral parasitaemia at delivery (AOR 1.73 (1.02 to 2.88)) and primigravidae (AOR 2.13 (1.27 to 3.59)) were independently associated with low length for age. Maternal malaria at delivery and primiparity were associated with reduced newborn weight and length but not with disproportionate growth. Maternal HIV infection was associated only with reduced birth weight. The malaria and parity effect occurred throughout gestational weeks 30-40, but the HIV effect primarily after 38 weeks gestation. CONCLUSION: Fetal growth retardation in weight and length commonly occurs in this highly malarious area and is present from 30 weeks gestation. A maternal HIV effect on fetal weight occurred after 38 weeks gestation."									
323	Anthropometry of fetal growth in rural Malawi in relation to maternal malaria and HIV status.	"Kalanda BF, Buuren Sv, Verhoeff FH, Brabin BJ."	Archives of Disease in Childhood. 2005;90(2):F161-F5.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh3&AN=20053127269	"Objective: To describe fetal growth centiles in relation to maternal malaria and HIV status, using cross sectional measurements at birth. Design: A cross sectional study of pregnant women and their babies. The study was conducted during March 1993-July 1994 in Chikwawa District, Shire Valey, Malawi. Data on maternal socioeconomic status and current pregnancy, including HIV status and newborn anthropometry, were collected. Malaria parasitaemia was assessed in maternal peripheral and placental blood, fetal haemoglobin was measured in cord blood, and maternal HIV status was determined. Setting: Two district hospitals in rural southern Malawi, between March 1993 and July 1994. Outcome variables: Newborn weight, length, Rohrer's ponderal index. Results: Maternal HIV (adjusted odds ratio (AOR) 1.76 (95% confidence interval 1.04 to 2.98)) and first pregnancy (AOR 1.83 (1.10 to 3.05)) were independently associated with low weight for age. Placental or peripheral parasitaemia at delivery (AOR 1.73 (1.02 to 2.88)) and primigravidae (AOR 2.13 (1.27 to 3.59)) were independently associated with low length for age. Maternal malaria at delivery and primiparity were associated with reduced newborn weight and length but not with disproportionate growth. Maternal HIV infection was associated only with reduced birth weight. The malaria and parity effect occurred throughout gestational weeks 30-40, but the HIV effect primarily after 38 weeks gestation. Conclusion: Fetal growth retardation in weight and length commonly occurs in this highly malarious area and is present from 30 weeks gestation. A maternal HIV effect on fetal weight occurred after 38 weeks gestation."									
1270	Gender-based differences in treatment and outcome among HIV patients in South India.	"Kumarasamy N, Venkatesh KK, Cecelia AJ, Devaleenol B, Saghayam S, Yepthomi T, Balakrishnan P, et al."	Journal of Women's Health (15409996). 2008;17(9):1471-5.	http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=2010103751&site=ehost-live	"Objective: To describe gender-based differences in disease progression, treatment, and outcome among patientsreceiving highly active antiretroviral therapy (HAART) in South India.Methods: Therapy-na¥ve patients initiating HAART between February 1996 and June 2006 at a tertiary HIV referralcenter in Chennai, South India, were analyzed using the YRG CARE HIV Observational Database. Patientswith 1 year of follow-up after initiating HAART were examined to investigate immunological and clinicaloutcomes, including the development of adverse events to therapy and opportunistic infections.Results: All previously therapy-na¥ve patients who initiated HAART with at least 1 year of follow-up (n \'021972) were analyzed. At enrollment into care, women had higher CD4 counts, lower hemoglobin, and higherbody mass index (BMI) than their male counterparts (p \'03 0.05). At the time of initiating therapy, women hadhigher CD4 counts and lower hemoglobin (p \'03 0.05); women continued to have higher CD4 counts at 12 months(p \'03 0.05). After 1 year following HAART initiation, significantly more men developed tuberculosis and Pneumocystisjiroveci pneumonia (p \'03 0.05), more women experienced lactic acidosis and nausea, and more men developedimmune reconstitution syndrome (p \'03 0.05).Conclusions: Significant physiological, immunological, and clinical differences exist between men and womeninitiating HAART in a resource-limited setting in South India. Future studies should examine whether clinicalmanagement strategies should be different for men and women in resource-limited settings."									
1674	The nutrition and health transition in the North West Province of South Africa: a review of the THUSA (Transition and Health during Urbanisation of South Africans) study.	"Vorster HH, Venter CS, Wissing MP, Margetts BM."	Public Health Nutrition. 2005;8(5):480-90.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=16153329	OBJECTIVE: To describe how urbanisation influences the nutrition and health transition in South Africa by using data from the THUSA (Transition and Health during Urbanisation of South Africans) study.	"DESIGN: The THUSA study was a cross-sectional, comparative, population-based survey."	SETTING: The North West Province of South Africa.	"SUBJECTS: In total, 1854 apparently healthy volunteers, men and women aged 15 years and older, from 37 randomly selected sites. Pregnant and lactating women, those with diagnosed chronic diseases and taking medication, with acute infections or inebriated were excluded but screened for hypertension and diabetes mellitus. Subjects were stratified into five groups representing different levels of urbanisation in rural and urban areas: namely, deep rural, farms, squatter camps, townships and towns/cities. OUTCOME MEASURES AND METHODS: Socio-economic and education profiles, dietary patterns, nutrient intakes, anthropometric and biochemical nutrition status, physical and mental health indicators, and risk factors for non-communicable diseases (NCDs) were measured using questionnaires developed or adapted and validated for this population, as well as appropriate, standardised methods for the biochemical analyses of biological samples."	"RESULTS: Subjects from the rural groups had lower household incomes, less formal education, were shorter and had lower body mass indices than those in the urban groups. Urban subjects consumed less maize porridge but more fruits, vegetables, animal-derived foods and fats and oils than rural subjects. Comparing women from rural group 1 with the urban group 5, the following shifts in nutrient intakes were observed: % energy from carbohydrates, 67.4 to 57.3; from fats, 23.6 to 31.8; from protein, 11.4 to 13.4 (with an increase in animal protein from 22.2 to 42.6 g day(-1)); dietary fibre, 15.8 to 17.7 g day(-1); calcium, 348 to 512 mg day(-1); iron from 8.4 to 10.4 mg day(-1); vitamin A from 573 to 1246 mug retinol equivalents day(-1); and ascorbic acid from 30 to 83 mg day(-1). Serum total cholesterol, low-density lipoprotein cholesterol and plasma fibrinogen increased significantly across groups; systolic blood pressure >140 mmHg was observed in 10.4-34.8% of subjects in different groups and diabetes mellitus in 0.8-6.0% of subjects. Women in groups 1 to 5 had overweight plus obesity rates of 48, 53, 47, 61 and 61%, showing an increase with urbanisation. Subjects from group 2 (farm dwellers) showed the highest scores of psychopathology and the lowest scores of psychological well-being. The same subjects consistently showed the lowest nutrition status."	"CONCLUSIONS: Urbanisation of Africans in the North West Province is accompanied by an improvement in micronutrient intakes and status, but also by increases in overweight, obesity and several risk factors for NCDs. It is recommended that intervention programmes to promote nutritional health should aim to improve micronutrient status further without leading to obesity. The role of psychological strengths in preventing the adverse effects of urbanisation on health needs to be examined in more detail."				
1187	Effect of maternal HIV status on infant mortality: Evidence from a 9-month follow-up of mothers and their infants in Zimbabwe.	"Kurewa EN, Gumbo FZ, Munjoma MW, Mapingure MP, Chirenje MZ, Rusakaniko S, Stray-Pedersen B."	Journal of Perinatology. 2010 February;30(2):88-92.		"Objective: To describe infant mortality trends and associated factors among infants born to mothers enrolled in a prevention of mother-to-child transmission (PMTCT) program. Study Design: A nested case-control study of human immunodeficiency virus (HIV)-positive and-negative pregnant women enrolled from the national PMTCT program at 36 weeks of gestation attending three peri-urban clinics in Zimbabwe offering maternal and child health care. Mother-infant pairs were followed up from delivery, and at 6 weeks, 4 months and 9 months. Results: A total of 1045 mother and singleton infant pairs, 474 HIV-positive and 571 HIV-negative mothers, delivered 469 and 569 live infants, respectively. Differences in mortality were at 6 weeks and 4 months, RR (95% CI) 9.71 (1.22 to 77.32) and 21.84 (2.93 to 162.98), respectively. Overall, 9-month mortality rates were 150 and 47 per 1000 person-years for infants born to HIV-positive and HIV-negative mothers, respectively. Proportional hazard ratio of mortality for children born to HIV-positive mothers was 3.21 (1.91 to 5.38) when compared with that for children born to HIV-negative mothers. Conclusion: Maternal HIV exposure was associated with higher mortality in the first 4 months of life. Infant's HIV status was the strongest predictor of infant mortality. There is a need to screen infants for HIV from delivery and throughout breastfeeding. 2010 Nature Publishing Group All rights reserved."									
1027	"Association between weight gain and clinical outcomes among malnourished adults initiating antiretroviral therapy in Lusaka, Zambia."	"Koethe JR, Lukusa A, Giganti MJ, Chi BH, Nyirenda CK, Limbada MI, Banda Y, et al."	Journal of Acquired Immune Deficiency Syndromes: JAIDS. 2010;53(4):507-13.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=19730111	OBJECTIVE: To describe the association between 6-month weight gain on antiretroviral therapy (ART) and subsequent clinical outcomes.	"DESIGN: A retrospective analysis of a large programmatic cohort in Lusaka, Zambia."	"METHODS: Using Kaplan-Meier analysis and Cox proportional hazards models, we examined the association between 6-month weight gain and the risk of subsequent death and clinical treatment failure. Because it is a known effect modifier, we stratified our analysis according to body mass index (BMI)."	"RESULTS: Twenty-seven thousand nine hundred fifteen adults initiating ART were included in the analysis. Patients in the lower BMI categories demonstrated greater weight gain. In the post 6-month analysis, absolute weight loss was strongly associated with mortality across all BMI strata, with the highest risk observed among those with BMI <16 kg/m (adjusted hazard ratio 9.7; 95% CI: 4.7 to 20.0). There seemed to be an inverse relationship between weight gain and mortality among patients with BMI <16 kg/m. Similar trends were observed with clinical treatment failure."	"CONCLUSIONS: Weight gain after ART initiation is associated with improved survival and decreased risk for clinical failure, especially in the lower BMI strata. Prospective trials to promote weight gain after ART initiation among malnourished patients in resource-constrained settings are warranted."					
990	"Association between weight gain and clinical outcomes among malnourished adults initiating antiretroviral therapy in Lusaka, Zambia."	"Koethe JR, Lukusa A, Giganti MJ, Chi BH, Nyirenda CK, Limbada MI, Banda Y, et al."	Journal of Acquired Immune Deficiency Syndromes. 2010 April;53(4):507-13.		"OBJECTIVE: To describe the association between 6-month weight gain on antiretroviral therapy (ART) and subsequent clinical outcomes. DESIGN: A retrospective analysis of a large programmatic cohort in Lusaka, Zambia. METHODS: Using Kaplan-Meier analysis and Cox proportional hazards models, we examined the association between 6-month weight gain and the risk of subsequent death and clinical treatment failure. Because it is a known effect modifier, we stratified our analysis according to body mass index (BMI). RESULTS: Twenty-seven thousand nine hundred fifteen adults initiating ART were included in the analysis. Patients in the lower BMI categories demonstrated greater weight gain. In the post 6-month analysis, absolute weight loss was strongly associated with mortality across all BMI strata, with the highest risk observed among those with BMI <16 kg/m<sup>2</sup> (adjusted hazard ratio 9.7; 95% CI: 4.7 to 20.0). There seemed to be an inverse relationship between weight gain and mortality among patients with BMI <16 kg/m.<sup>2</sup> Similar trends were observed with clinical treatment failure. CONCLUSIONS: Weight gain after ART initiation is associated with improved survival and decreased risk for clinical failure, especially in the lower BMI strata. Prospective trials to promote weight gain after ART initiation among malnourished patients in resource-constrained settings are warranted. Copyright 2010 by Lippincott Williams & Wilkins."									
956	"Clinical and biological evolution of HIV-1 seroconverters in Abidjan, Cote d'Ivoire, 1997-2000."	"Salamon R, Marimoutou C, Ekra D, Minga A, Nerrienet E, Huet C, Gourvellec G, et al."	"JAIDS, Journal of Acquired Immune Deficiency Syndromes. 2002;29(2):149-57."	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh3&AN=20023100664	"Objective: To describe the clinical and biological evolution of HIV-1 infection in Africa. Methods: 104 HIV-1-infected individuals were identified prospectively from regular blood donors in Abidjan, Cote d'Ivoire (1997-2000). The date of seroconversion was estimated from results of sequential serological tests. Biological and clinical follow-up were performed every 6 months, starting as early as possible after seroconversion. Case management followed national guidelines. Results: The median interval between estimated seroconversion and study inclusion was 9.7 months, and the median window of seroconversion was 2.8 months. At baseline, all but 2 patients were asymptomatic; the median CD4<sup>+</sup> cell count was 527/mm<sup>3</sup> (interquartile range (IR), 395-684), and the median plasma HIV RNA level was 4.6 log<sub>10</sub> copies/ml (IR, 3.8-4.9). The median follow-up was 23.9 months, and 95% of the patients received primary prophylaxis with co-trimoxazole for opportunistic infections. Of the patients, one presented with wasting syndrome, 3 developed tuberculosis and 17 had a Centers for Disease Control and Prevention category B-defining event. The 3-year AIDS-free and symptom-free probabilities were 96.7% (95% confidence interval (CI), 87.0-99.2) and 79.3% (95% CI, 67.5-87.2), respectively. During the first 3 years of follow-up, we observed that the median plasma viral load stabilized at >4 log<sub>10</sub> copies/ml and that the median CD4<sup>+</sup> cell count declined by 20 to 25/mm<sup>3</sup> per year. Conclusion: These African seroconverters were moderately immunosuppressed. The median HIV RNA level was high and varied very little during the first 3 years, and there were few clinical events."									
1185	Initiation of antiretroviral therapy before 6 months of age is associated with faster growth recovery in South African children perinatally infected with human immunodeficiency virus.	"Shiau S, Arpadi S, Strehlau R, Martens L, Patel F, Coovadia A, Abrams EJ, et al."	"Journal of Pediatrics. 2013;162(6):1138-45, 45.e1-2."	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=mesx&AN=23312691	OBJECTIVE: To describe the effects of age at antiretroviral therapy (ART) initiation on growth outcomes among children infected with HIV followed for 48 months after treatment initiation.	"STUDY DESIGN: This secondary analysis describes anthropometric changes in children infected with HIV in Johannesburg, South Africa who initiated ritonavir-boosted lopinavir-based ART before 24 months of age and were randomized to continue ritonavir-boosted lopinavir or to receive nevirapine after achieving and maintaining virologic suppression. Weight, height, and head circumference were measured at visits over 48 months post-ART initiation. Growth patterns including weight-for-age z-scores (WAZs), height-for-age z-scores, body mass index-for-age z-scores, and head circumference for age z-score were compared between children initiating ART<6 months, 6-12 months, and 12-24 months of age."	"RESULTS: A total of 195 children (mean+/-SD age 10.7+/-5.9 months), including 54 (27.7%)<6 months, 69 (35.4%) 6-12 months, and 72 (36.9%) 12-24 months of age at ART initiation, were evaluated. In the first 12 months on treatment, children<6 months of age at ART initiation experienced more rapid improvement in WAZ (1.98 vs 1.44, P=.084) and head circumference for age z-score (1.24 vs 0.45, P=.004) than children who initiated ART between 12-24 months of age. By 48 months on ART, growth outcomes were similar, regardless of age at ART initiation. WAZ approached population norms by 12 months on ART. Although improving, height-for-age z-scores remained on average 1.0 z-score below population norms at 48 months of therapy."	"CONCLUSIONS: Initiation of ART before 6 months of age results in more rapid growth recovery in children infected with HIV. These data provide further evidence for the importance of prompt diagnosis and early initiation of ART for infants infected with HIV. Copyright 2013 Mosby, Inc. All rights reserved."						
971	Lipodystrophy syndrome and cardiovascular risk factors in children and adolescents infected with HIV/AIDS receiving highly active antiretroviral therapy.	"Werner MLF, Pone MVdS, Fonseca VM, Chaves CRMdM."	Jornal de Pediatria. 2010;86(1):27-32.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20103135491	"Objective: To describe the lipid profile, body shape changes, and cardiovascular risk factors in children and adolescents infected with Human immunodeficiency virus (HIV) infection/acquired immune deficiency syndrome (AIDS) receiving highly active antiretroviral therapy. Methods: We investigated 43 children and adolescents being treated with this therapy at the outpatient clinic of paediatric infectious diseases of Instituto Fernandes Figueira/Fundacao Oswaldo Cruz, Rio de Janeiro, Brazil. Values of total cholesterol, high density lipoprotein, low density lipoprotein, and triglycerides were determined. We also performed glucose tolerance tests and analysed body fat distribution, nutritional status, dietary intake, and family history of cardiovascular risk. The statistical analysis was performed using Student's t test. Significance level of the p-value was lower than 0.05. Results: We found lipid abnormality in 88.3% and body shape change in 13.9% of the cases. Nutritional status was adequate (81.3%) in most of the study population. Cholesterol intake in children older than 9 years was above the recommended value. Conclusion: The prevalence of dyslipidaemia and, therefore, the risk for cardiovascular diseases were high during the use of highly active antiretroviral therapy."									
1915	Disease profile of children under 5 years attending primary health care clinics in a high HIV prevalence setting in South Africa.	"Horwood C, Butler LM, Vermaak K, Rollins N, Haskins L, Nkosi P, Neilands TB, et al."	Tropical Medicine & International Health. 2011;16(1):42-52.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=21091856	OBJECTIVE: To describe the presenting complaints and disease profile of children attending primary health care (PHC) clinics in two provinces of South Africa.	METHODS: Participants were sick children 2-59 months old presenting for care at PHC clinics in KwaZulu-Natal (KZN) and Limpopo provinces from 2006-2007. Children were assessed by an expert Integrated Management of Childhood Illnesses (IMCI) practitioner. Children for whom parental/guardian consent was obtained were tested for HIV.	"RESULTS: A total of 1357 children attending one of 74 clinics were assessed. HIV seroprevalence overall was 7.1%, but was significantly higher in KZN than Limpopo (7.5 vs. 2.4%; OR = 3.3, 95%CI 1.9-5.8%). Commonest presenting complaints were cough (72%), skin conditions (22%) and diarrhoea (19%). Of 1349 children, 120 (8.9%) had a weight below the third percentile; 108/1357 (8.0%) children required urgent referral, most commonly for severe pneumonia (53.7%) and severe malnutrition (16.7%). In multivariate analyses, severe pneumonia, growth faltering and urgent referral were independently associated with younger age, residence in KZN and HIV infection (P < 0.05)."	"CONCLUSIONS: Many children with severe illnesses and undiagnosed HIV infection present to PHC facilities. PHC staff require skills to correctly manage these conditions and undertake HIV testing. Although IMCI provides evidence-based guidelines, implementation must be improved to achieve adequate coverage of life-saving interventions. 2010 Blackwell Publishing Ltd."						
302	"Prevalence, incidence and predictors of severe anaemia with zidovudine-containing regimens in African adults with HIV infection within the DART trial."	"Ssali F, Stohr W, Munderi P, Reid A, Walker AS, Gibb DM, Mugyenyi P, et al."	Antiviral Therapy. 2006;11(6):741-9.		"Objective: To describe the prevalence, incidence and predictors of severe anaemia in previously untreated symptomatic HIV-infected adults with CD4 <sup>+</sup> T-cells <200 cells/mm<sup>3</sup> initiating zidovudine-containing regimens in Africa. Design: DART is a randomized trial comparing two strategies for HIV/AIDS management in Uganda and Zimbabwe. Methods: We analysed the occurrence of anaemia at weeks 4 and 12, and then every 12 weeks. We also evaluated sex, age, WHO stage, body mass index (BMI), baseline laboratory measurements and first regimen as predictors of developing grade 4 anaemia (<6.5 mg/dl) by week 48 using logistic regression. Results: To May 2005, 3,314 participants (65% women, 23% at WHO stage 4, median age=37 years, baseline CD4<sup>+</sup> T-cell=86 cells/mm<sup>3</sup> and median baseline haemoglobin =11.4 g/dl) had a median 72 weeks follow-up. Prevalence of grade 4 anaemia was 0.7%, 2.0%, 0.5% and <0.5% at weeks 4, 12, 24 and >=36, respectively. Overall, 219 (6.6%) participants developed grade 4 anaemia by week 48; women and those with lower haemoglobin, CD4<sup>+</sup> T-cell count and BMI at baseline were at significantly higher risk (P<0.05), but not those with lower neutrophils or receiving cotrimoxazole at baseline. Conclusions: We observed a higher incidence of grade 4 anaemia than in studies from industrialized countries, which is likely to be due in part to population characteristics and in part to a higher rate of concurrent HIV-related clinical events. Clinical vigilance and haemoglobin measurements 4, 8 and 12 weeks after starting zidovudine could help to manage serious anaemia. 2006 International Medical Press."									
1710	Metabolic abnormalities and overweight in HIV/AIDS persons-treated with antiretroviral therapy.	"Leite LHM, Sampaio ABdMM."	Revista de Nutricao. 2008;21(3):277-83.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20083218861	"Objective: To describe the proportion of overweight among patients with human immunodeficiency virus/Acquired Immune Deficiency Syndrome and correlate overweight and highly active antiretroviral therapy with metabolic complications. Methods: A cross-sectional study was conducted among human immunodeficiency virus/Acquired Immune Deficiency Syndrome outpatients undergoing nutritional therapy from 2000 to 2006 in a University Health Center. The sample consisted of 393 human immunodeficiency virus/Acquired Immune Deficiency Syndrome patients. Nutritional and medical records were used as a source of data on personal, clinical and biochemical information. Data analysis included descriptive statistics and the Chi-square test. Results: Sixty-nine percent of the patients were males aging from 26 to 49 years. Overweight and obesity were identified in 49% of this population. The most important metabolic complications were low levels of high-density lipoprotein (70%) and high levels of triglycerides (48%) and cholesterol (40%). Higher body mass index was associated with higher lipid levels and more evidence of insulin resistance. Conclusion: This study demonstrated an important proportion of overweight and obesity among human immunodeficiency virus/Acquired Immune Deficiency Syndrome patients. These results suggest that nutritional interventions and lifestyle modifications may be useful strategies to decrease the cardiovascular risk in this population."									
1025	"Infant feeding practices of women in a perinatal HIV-1 prevention study in Nairobi, Kenya."	"Kiarie JN, Richardson BA, Mbori-Ngacha D, Nduati RW, John-Stewart GC."	Journal of Acquired Immune Deficiency Syndromes: JAIDS. 2004;35(1):75-81.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=14707796	OBJECTIVE: To determine feeding practices and nutritional status of infants born to HIV-1-infected women.	METHODS: Feeding plans and practices were evaluated by questionnaires and focus group discussions. Infants were weighed at 1 and 6 weeks and tested for HIV-1 at 6 weeks.	"RESULTS: Of 128 women seen after delivery, 111 completed the study. Mothers who planned to breast feed were more likely to feed their infants as planned (86% vs. 55%; P < 0.001). Women opted to breast feed due to financial constraints, partner influence, and fear of losing confidentiality. Women who reported that their partners were willing to have HIV-1 testing were less likely to be breast feeding at 6 weeks (odds ratio [OR] = 0.3, 95% confidence interval [CI]: 0.1-0.8; P = 0.01). At 6 weeks, more infants were mixed fed (31% vs. 21%; P = 0.05) than at 1 week. Lower infant weight at 6 weeks was associated with not breast feeding (P = 0.001), HIV-1 infection (P = 0.05), birth weight <3000 g (P = 0.01), maternal employment (P = 0.02), and paying <$12.5 per month in house rent (among infants not breast fed; P = 0.05)."	"CONCLUSIONS: Replacement feeding was difficult, particularly without partner support in HIV-1 testing. Mixed feeding was common and increased by 6 weeks. Mothers of low socioeconomic status who opt not to breast feed require support to avoid nutritional compromise of infants."						
1743	"Nutritional status, quality of life and CD4 cell count of adults living with HIV/AIDS in the Ga-Rankuwa area (South Africa)."	"Venter E, Gericke GJ, Bekker PJ."	SAJCN South African Journal of Clinical Nutrition. 2009;22(3):124-9.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20103090070	"Objective: To determine if there was a relationship between CD4 cell count, nutritional status and self-reported quality of life (QoL) in HIV-infected adults. Design: Descriptive study in the quantitative research domain. Setting: The out-patient antiretroviral (ARV) clinic at Dr George Mukhari Hospital (Ga-Rankuwa) (institutional). Subjects: The study group (n=90) consisted of male (n=34) and female patients (18-50 years) diagnosed with HIV/AIDS. Convenience sampling was used. Outcome measures: Anthropometry (weight, height, BMI, MUAC, TSF), dietary intake (habitual food intake recall) and QoL (WHOQoL-HIV questionnaire) were assessed. Data collection was done from January-April 2007. Results: Significant, but poor, positive correlation was found for the following anthropometrical parameters and the CD4 cell count: weight (r=0.37; rho =0.00), BMI (r=0.39; rho =0.00), and MUAC (r=0.36; rho =0.00). The study group had a poor dietary quality. Significant correlation with the CD4 cell count was found for the following domains of the QoL: physical activity (r=0.27; rho =0.01), psychological (r=0.27; rho =0.01), level of independence (r=0.36; rho =0.00), and environmental (r=0.27; rho =0.01). The overall QoL assessment was average, according to the WHOQoL-HIV questionnaire score. Conclusion: Significant positive relationships existed between specific anthropometry and the CD4 cell count, and also between certain QoL domains and the CD4 cell count. Strategies for increasing dietary diversity and QoL ought to be identified and implemented in communities."									
1808	"Nutritional status, quality of life and CD4 cell count of adults living with HIV/AIDS in the Ga-Rankuwa area (South Africa)."	"Venter ME, Gericke GJ, Bekker PJ."	South African Journal of Clinical Nutrition. 2009;22(3):124-9.		"Objective: To determine if there was a relationship between CD4 cell count, nutritional status and self-reported quality of life (QoL) in HIV-infected adults. Design: Descriptive study in the quantitative research domain. Setting: The out-patient antiretroviral (ARV) clinic at Dr George Mukhari Hospital (Ga-Rankuwa) (institutional). Subjects: The study group (n = 90) consisted of male (n = 34) and female patients (18-50 years) diagnosed with HIV/AIDS. Convenience sampling was used. Outcome measures: Anthropometry (weight, height, BMI, MUAC, TSF), dietary intake (habitual food intake recall) and QoL (WHOQoL-HIV questionnaire) were assessed. Data collection was done from January-April 2007. Results: Significant, but poor, positive correlation was found for the following anthropometrical parameters and the CD4 cell count: weight (r = 0.37; = 0.00), BMI (r=0.39; = 0.00), and MUAC (r = 0.36; = 0.00). The study group had a poor dietary quality. Significant correlation with the CD4 cell count was found for the following domains of the QoL: physical activity (r = 0.27; = 0.01), psychological (r = 0.27; = 0.01), level of independence (r = 0.36; = 0.00), and environmental (r = 0.27; = 0.01). The overall QoL assessment was average, according to the WHOQoL-HIV questionnaire score. Conclusion: Significant positive relationships existed between specific anthropometry and the CD4 cell count, and also between certain QoL domains and the CD4 cell count. Strategies for increasing dietary diversity and QoL ought to be identified and implemented in communities. Recommendation: A longitudinal study would give better understanding of the relationship between nutritional status, the CD4 cell count and QoL."									
350	Hypercalcemia in patients with tuberculosis and HIV infections in Northwest Ethiopia.	"Amare B, Meseret S, Yabutani T, Moges B, Kassu A."	Asian Pacific Journal of Tropical Disease. 2012;2(SUPPL2):S629-S34.		"Objective: To determine incidence of hypercalcemia among TB patients with and without HIV infection before and after anti-TB chemotherapy in tropical settings of Northwest Ethiopia. Methods: Serum levels of calcium were determined using an inductively coupled plasma mass spectrometer from all subjects at baseline and from 60 TB patients (34 with HIV co-infection) at the end of an intensive phase of anti-TB chemotherapy. Results: At baseline, significant difference was found between the mean albumin-adjusted calcium levels in TB patients with HIV (11.95+/-3.72) and controls (9.81+/-1.59) (P=0.03). Hypercalcemia (serum calcium of > 10.5 mg/dL) was observed in 62.2% and 43.2% of TB patients with and without HIV co-infection, respectively. The serum levels of calcium did not significantly change after anti-TB chemotherapy both in patients with (n = 34) and without (n = 26) HIV co-infection. Conclusions: The present study suggests that TB itself appears not to be responsible for hypercalcemia; however, rates of hypercalcemia are high in TB and HIV co-infected patients in the tropical settings of Northwest Ethiopia, of rarely symptomatic. Anti-TB chemotherapy does not improve the incidence of hypercalcemia in both groups with HIV co-infection and without. 2012 Asian Pacific Tropical Medicine Press."									
1549	"Mortality and clinical outcomes in HIV-infected children on antiretroviral therapy in Malawi, Lesotho, and Swaziland."	"Kabue MM, Buck WC, Wanless SR, Cox CM, McCollum ED, Caviness AC, Ahmed S, et al."	Pediatrics. 2012;130(3):e591-9.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=22891234	"OBJECTIVE: To determine mortality and immune status improvement in HIV-infected pediatric patients on antiretroviral treatment (ART) in Malawi, Lesotho, and Swaziland."	"METHODS: We conducted a retrospective cohort study of patients aged <12 years at ART initiation at 3 sites in sub-Saharan Africa between 2004 and 2009. Twelve-month and overall mortality were estimated, and factors associated with mortality and immune status improvement were evaluated."	"RESULTS: Included in the study were 2306 patients with an average follow-up time on ART of 2.3 years (interquartile range 1.5-3.1 years). One hundred four patients (4.5%) died, 9.0% were lost to follow-up, and 1.3% discontinued ART. Of the 104 deaths, 77.9% occurred in the first year of treatment with a 12-month mortality rate of 3.5%. The overall mortality rate was 2.25 deaths/100 person-years (95% confidence interval [CI] 1.84-2.71). Increased 12-month mortality was associated with younger age; <6 months (hazard ratio [HR] = 8.11, CI 4.51-14.58), 6 to <12 months (HR = 3.43, CI 1.96-6.02), and 12 to <36 months (HR = 1.92, CI 1.16-3.19), and World Health Organization stage IV (HR = 4.35, CI 2.19-8.67). Immune status improvement at 12 months was less likely in patients with advanced disease and age <12 months."	"CONCLUSIONS: Despite challenges associated with pediatric ART in developing countries, low mortality and good treatment outcomes can be achieved. However, outcomes are worse in younger patients and those with advanced disease at the time of ART initiation, highlighting the importance of early diagnosis and treatment."						
987	Changing predictors of mortality over time from cART start: Implications for care.	"Hoffmann CJ, Fielding KL, Johnston V, Charalambous S, Innes C, Moore RD, Chaisson RE, et al."	Journal of Acquired Immune Deficiency Syndromes. 2011 01 Nov;58(3):269-73.		"Objective: To determine predictors of mortality and changes in those predictors over time on combination antiretroviral therapy (cART) in South Africa. Design: A cohort study. Methods: Using routine clinic data with up to 4 years follow-up after antiretroviral therapy initiation and with death ascertainment from a national vital statistics register, we used proportional hazards modeling to assess baseline and time-updated predictors of mortality and changes in strength of those predictors over time on cART. Furthermore, we compared CD4 count among individuals who died by duration on cART. Results: Fifteen thousand sixty subjects (64% men, median CD4 count 127 cells/mm) started antiretroviral therapy between January 2003 and January 2008. Over a median follow-up of 1.8 years, 2658 subjects died. The baseline characteristics of WHO stage, hemoglobin, CD4 count, HIV RNA level, and symptoms were all associated with mortality during the first 12 months of cART but lost association thereafter. However, time-updated factors of CD4 count, body mass index, symptoms, anemia, and HIV RNA suppression remained strong predictors of death. Most recent CD4 count before death rose from 71 during the first 3 months of cART to 175 cells per cubic millimeter after >3 years of cART. CONCLUSION: Over 4 years of cART, risk of death declined and associations with mortality changed. An increase in CD4 count at death and changing associations with mortality may suggest a shift in causes of death, possibly from opportunistic infections to other infections and chronic illnesses. 2011 Lippincott Williams & Wilkins."									
1741	"The metabolic profiles of HIV-infected and non-infected women in Mangaung, South Africa."	"Hattingh Z, Walsh C, Veldman FJ, Bester CJ."	SAJCN South African Journal of Clinical Nutrition. 2009;22(1):23-8.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20103089898	"Objective: To determine the biochemical nutritional status of HIV-infected women in Mangaung. Design: Cross-sectional. Setting: The community of Mangaung, Free State, South Africa. Subjects: A representative group of 500 black women (25-44 years) was selected randomly to participate. Outcome measures: Biochemical analyses were performed for total lymphocytes, serum protein, serum albumin, plasma fibrinogen, serum insulin, serum glucose, serum triglycerides and serum cholesterol using standard methodology. Values were compared to standard references, and between HIV-infected and HIV-uninfected women. Results: After screening for eligibility, 488 women qualified. Sixty-one per cent of the younger women (25-34 years) and 38% of the older women (35-44 years) were HIV-infected. HIV-infected women had significantly lower median blood values for total lymphocytes (p=0.0001 and p=0.02 for younger and older group respectively) and serum albumin (p=0.0001 for both age groups), but significantly higher median concentrations of serum protein (p=0.0001 for both age groups) than uninfected women. Plasma fibrinogen and serum insulin concentrations were significantly lower in HIV-infected younger women than in their uninfected counterparts (p=0.002 for both parameters). Older HIV-infected women had significantly lower total serum cholesterol values (p=0.01) than older HIV-uninfected women. Serum glucose and serum triglycerides did not differ significantly between HIV-infected and HIV-uninfected women. Conclusions: The results indicate a possible impact of HIV infection on serum protein and serum albumin, which may adversely affect biochemical nutritional status and the course of HIV progression. Future research into the causes and possible treatment of metabolic changes in women in this community should be prioritised."									
616	"Morbidity and mortality amongst southern Sudanese in Koboko refugee camps, Arua District, Uganda."	Orach CG.	East African Medical Journal. 1999;76(4):195-9.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=10442100	"OBJECTIVE: To determine the causes of morbidity, mortality and assess the nutritional status of children under five years, in Koboko refugee camps, Arua District, Uganda."	DESIGN: Review and analysis of refugee treatment records between 1992 and 1994 from Maracha and Koboko hospitals and cross sectional nutritional survey of children under five years in camps.	"SETTING: Between June 1992 and March 1994, an estimated 70,000 Sudanese refugees were encamped in five transit camps in Koboko county, Arua district. Koboko field hospital was immediately established and Maracha hospital designated the referral hospital for refugees."	PARTICIPANTS: Hospitalised refugees between 1992 and 1994 in Koboko and Maracha hospitals and children under five years in the camps formed the study populations.	INTERVENTIONS: Health facilities and therapeutic nutrition centres were established in the camps. Fortnightly general food distribution and therapeutic feeding programmes were instituted. Severe medical and surgical conditions were referred to Maracha hospital.	"MAIN OUTCOME MEASURES: Outcome variables considered were morbidity, mortality, case fatality rates; weight/height, weight/age and height/age."	"RESULTS: Out of 1476 refugees hospitalised in Koboko and Maracha hospitals, 267 died giving a case fatality rate of 18%. The leading causes of morbidity were diarrhoeal diseases (26.9%), ARI (13.6%), malaria (10.2%), trauma (7.6%) and malnutrition (5.0%). The main causes of mortality were similar, that is, diarrhoeal diseases (35.9%), ARI (23.9%), anaemia (7.2%) and HIV/AIDS (6.8%). Conditions associated with high overall case fatality rates were ARI (31.3%), HIV/AIDS (30.0%) and cardiac failure (29.3%) respectively. Nearly half of the children (48.6%), H/A -2SD were stunted, over a third (36.7%), W/A -2SD were underweight and (8.5%), W/H -2SD wasted."	"CONCLUSION: Communicable diseases are the predominant causes of morbidity and mortality during the emergency phase of encampment. Timely and effective management of communicable diseases including malnutrition and trauma are crucial to avoid high mortality amongst refugees, coupled with the provision of essential requirements and services such as water, sanitation, food, shelter and immunisation."		
473	Diagnostic performance of visible severe wasting for identifying severe acute malnutrition in children admitted to hospital in Kenya.	"Mogeni P, Twahir H, Bandika V, Mwalekwa L, Thitiri J, Ngari M, Toromo C, et al."	Bulletin of the World Health Organization. 2011;89(12):900-6.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=22271947	OBJECTIVE: To determine the diagnostic value of visible severe wasting in identifying severe acute malnutrition at two public hospitals in Kenya.	"METHODS: This was a cross-sectional study of children aged 6 to 59.9 months admitted to one rural and one urban hospital. On admission, mid-upper arm circumference (MUAC), weight and height were measured and the presence of visible severe wasting was assessed. The diagnostic performance of visible severe wasting was evaluated against anthropometric criteria."	"FINDINGS: Of 11,166 children admitted, 563 (5%) had kwashiorkor and 1406 (12.5%) were severely wasted (MUAC <11.5 cm). The combined sensitivity and specificity of visible severe wasting at the two hospitals, as assessed against a MUAC <11.5 cm, were 54% (95% confidence interval, CI: 51-56) and 96% (95% CI: 96-97), respectively; at one hospital, its sensitivity and specificity against a weight-for-height z-score below -3 were 44.7% (95% CI: 42-48) and 96.5% (95% CI: 96-97), respectively. Severely wasted children who were correctly identified by visible severe wasting were consistently older, more severely wasted, more often having kwashiorkor, more often positive to the human immunodeficiency virus, ill for a longer period and at greater risk of death. Visible severe wasting had lower sensitivity for determining the risk of death than the anthropometric measures. There was no evidence to support measuring both MUAC and weight-for-height z-score."	"CONCLUSION: Visible severe wasting failed to detect approximately half of the children admitted to hospital with severe acute malnutrition diagnosed anthropometrically. Routine screening by MUAC is quick, simple and inexpensive and should be part of the standard assessment of all paediatric hospital admissions in the study setting."						
1183	"Vitamin A supplements and diarrheal and respiratory tract infections among children in Dar es Salaam, Tanzania."	"Fawzi WW, Mbise R, Spiegelman D, Fataki M, Hertzmark E, Ndossi G."	Journal of Pediatrics. 2000;137(5):660-7.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=11060532	OBJECTIVE: To determine the effect of vitamin A supplementation on the risk of diarrhea and of acute respiratory infection.	"DESIGN: Double-blind, randomized, placebo-controlled trial."	"SETTING: Dar-es-Salaam, Tanzania."	"SUBJECTS: Six hundred eighty-seven children, 6 to 60 months old, hospitalized with pneumonia, who received vitamin A or placebo at baseline and at 4 and 8 months after discharge from hospital. Main outcome variables: Incidence and duration of episodes of diarrhea and respiratory tract infections during the year after discharge from the hospital."	"RESULTS: Relative to those receiving placebo, children receiving vitamin A had a significantly smaller risk of severe watery diarrhea (multivariate odds ratio = 0.56, 95% CI = 0.32-0.99, P =.04) but a higher risk of cough and rapid respiratory rate (multivariate odds ratio = 1.67, 95% CI = 1.17-2.36, P =.004). Vitamin A supplementation was also associated with increased risk of acute diarrhea among normally nourished children or children with stunted growth but was relatively protective among children with wasting disease (P value for interaction =.01). The apparently increased risk of respiratory tract infection was limited to children who were seronegative for human immunodeficiency virus (HIV) (P value for interaction =.07)."	CONCLUSIONS: Vitamin A supplements provide a low-cost intervention against morbidity in HIV-infected and undernourished children. Supplements may also have serious non-lethal adverse outcomes in well-nourished individuals. Whether these apparent detrimental effects of vitamin A are transient or long-term needs to be examined.				
869	Resumption of sexual activity and regular menses after childbirth among women infected with HIV in Malawi.	"Makanani B, Kumwenda J, Kumwenda N, Chen S, Tsui A, Taha TE."	International Journal of Gynecology and Obstetrics. 2010 January;108(1):26-30.		"Objective: To determine the factors associated with resumption of sexual activity and regular menses after childbirth among women infected with HIV-1. Methods: Information on sociodemographic, behavioral, and clinical factors was obtained from 2 HIV perinatal studies (NVAZ and PEPI trials) conducted in Malawi, 2000-2009. Factors associated with resumption of sexual activity and menses were analyzed using Cox proportional hazard models. Results: A total of 1838 women from the NVAZ study and 2982 women from the PEPI study were included in the analysis. Resumption of sexual activity was primarily associated with sociodemographic factors (e.g. in the PEPI study, marital status [adjusted hazard ratio (aHR) 0.56, P < 0.001], use of contraceptive method [aHR 8.0, P < 0.001], and breastfeeding [aHR 0.52, P < 0.001]), whereas resumption of regular menses in the PEPI study was primarily associated with biological factors (e.g. plasma viral load [aHR 0.89, P < 0.006], and breastfeeding [aHR 0.23, P < 0.001). Conclusion: HIV-infected women need adequate counseling to take into account their HIV infection status before resuming sexual activity after childbirth. 2009 International Federation of Gynecology and Obstetrics."									
57	Increased regression and decreased incidence of human papillomavirus- related cervical lesions among HIV-infected women on HAART.	"Adler DH, Kakinami L, Modisenyane T, Tshabangu N, Mohapi L, De Bruyn G, Martinson NA, et al."	Aids. 2012 24 Aug;26(13):1645-52.		"Objective: To determine the impact of HAART on incidence, regression, and progression of cytopathological abnormalities in HIV-infected women. Design: Prospective cohort. Methods: HIV-infected women (N=1123) from Soweto, South Africa underwent serial cervical smears that were analyzed and reported using the Bethesda System. The results of HAART and non-HAART users were compared using two statistical approaches: a survival analysis assessing risk of incident smear abnormality among women with baseline normal smear results; and analysis with marginal models assessing for an association between HAART use and likelihood of regression/progression in consecutive smears. Results: After multivariate survival analysis, women using HAART with a normal baseline smear were 38% less likely to have an incident smear abnormality during follow-up than nonusers [confidence interval (CI) 0.42-0.91; P=0.01]. Multivariate marginal models analysis identified a significantly increased likelihood (odds ratio 2.61; CI 1.75-3.89; P<0.0001) of regression of cervical lesions among women on HAART. Conclusion: Our large prospective cohort study adds significant weight to the side of the balance of clinical research supporting the positive impact of HAART on the natural history of human papillomavirus-related cervical disease in HIV-infected women. 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins."									
923	Incidence of tuberculosis after HAART initiation in a cohort of HIV-positive patients in Burkina Faso.	"Dembele M, Saleri N, Carvalho ACC, Saouadogo T, Hien AD, Zabsonre I, Koala ST, et al."	International Journal of Tuberculosis and Lung Disease. 2010 March;14(3):318-23.		"OBJECTIVE: To determine the incidence rates of tuberculosis (TB) after the initiation of highly active antiretroviral treatment (HAART). METHODS: We conducted a retrospective cohort study on four human immunodeficiency virus (HIV) treatment centres in Ouagadougou, Burkina Faso. TB incidence was measured at different intervals after HAART initiation. Cox regression models were used to identify factors associated with TB incidence. RESULTS: We analysed a cohort of 2383 subjects with a mean follow-up period of 836 days (standard deviation +/- 443.4). TB incidence rate was highest during the first trimester of HAART; after 3 months of treatment, the total TB case incidence dropped by 60% from 5.77/100 person-years (py) to 2.23/100 py. World Health Organization clinical Stage III or IV, CD4+ T-cell count < 50 cells/mul and body mass index (BMI) < 18.5 were associated with increased risk of TB on univariate analysis. In the Cox regression, BMI < 18.5 and CD4+ T-cell count < 50 cells/mul at HAART initiation were independently associated with a two-fold higher risk of TB. CONCLUSIONS: Delaying HAART initiation until the CD4+ T-cell count drops to <50 cells/mul significantly increases TB incidence in the first 3 months after HAART initiation. Active case finding for TB is an essential element of standard clinical care in HIV-positive patients during the initial period of HAART. 2010 The Union."									
285	"Micronutrients and T-cell subsets: a comparison between HIV-infected and uninfected, severely malnourished Rwandan children."	"Ndagije F, Baribwira C, Coulter JBS."	Annals of Tropical Paediatrics. 2007;27(4):269-75.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20073290938	"Objective: To determine the levels of CD4+ cells and micronutrients in HIV-infected and uninfected severely malnourished children. Design: Cross-sectional study in two centres. Setting: Children admitted to the malnutrition units in Kigali and Butare, Rwanda. Patients: A total of 112 children aged 2 months to 5 years presenting with severe malnutrition (weight for height Z- score -3 SD+/- oedema). Fifty-two (46.4%) were HIV-infected. Methods: CD4+ counts, selenium, zinc and copper levels were measured. The percentage of CD4 cells was calculated as a proportion of total lymphocyte count. Results: The mean age of the 52 HIV-infected children (18 months) was lower than of the 60 uninfected children (26 months) (p=0.01). Six (11.5%) of the HIV-infected had oedematous malnutrition compared with 50% of the uninfected group. The mean (SD) CD4+ count was 1054 (780) in the HIV-infected and 1579 (721) in the uninfected group (p=0.001). The CD4+ count was also significantly lower in the HIV-infected group than in the uninfected group for the ages <12 mths (p=0.09), 12-24 mths (p=0.045) and >36 mths (p=0.001). In HIV-infected children, 17% had severe immunosuppression (<15% CD4+ cells), 33% moderate (15-24%) and 50% had none (>25%) compared with 9%, 12% and 80% in the HIV-uninfected group, respectively (p<0.001). Approximately one-third in both groups had low levels of selenium and zinc and 77% had raised levels of copper. In multivariate analysis there was significant correlation between selenium and CD4+ (r=0.36, p<0.001) in HIV-infected children and no correlation of zinc and copper to CD4+ %. In HIV uninfected children, CD4+ % was related to selenium (r=0.282, p=0.03) and to zinc (r=0.264, p=0.047) but not to copper. Conclusions: In severely malnourished children with HIV infection, low CD4+ levels are associated mainly with HIV infection. There was no significant difference in levels of selenium, zinc and copper between HIV-infected and uninfected children."									
704	Overweight in early HIV predicts slower disease progression in HIV+ Adults in Botswana.	"Martinez SS, Campa A, Makhema J, Burns P, Farahani M, Bussmann H, Dusara P, et al."	FASEB Journal. 2012 April;26.		"Objective: To determine the predictive value of higher BMI on HIV disease progression in asymptomatic, ART naive HIV+ adults. Methods: After consenting 218 participants, blood was drawn for measures of HIV disease progression (CD4 cell count, CD4 cell % and HIV viral load) at baseline and every 6 months for 24 months. Height, and weight were obtained and BMI calculated. BMI was categorized as underweight (<18.5 kg/m<sup>2</sup>), normal weight (18.5-24.9 kg/m<sup>2</sup>), overweight (25.0-29.9 kg/m<sup>2</sup>), and obese (>30 kg/m<sup>2</sup>). Results: The mean age was 34.21+/-8.33 years, 76.04% were female and the mean CD4 cell count was 468.26+/-161.21 cells/muL. The mean BMI was 24.07+/-4.64 kg/m<sup>2</sup>. The prevalence of overweight and obesity was 26.42% (N=56) and 9.91% (N=21), respectively, similar to that in the general population of Botswana. Using mixed models, higher levels of BMI were predictive of higher levels of CD4 cell % over time after controlling for age (beta=0.914, p=0.001). BMI category 25-29.9 kg/m<sup>2</sup> was significantly predictive of lower HIV viral load log10 over time (beta= -0.145, p=0.0295) after controlling for age and gender. Conclusions: In this HIV+ ART naive cohort, being overweight predicted a slower HIV disease progression. Mechanistic studies on the relationship between higher BMI and HIV disease progression are needed to support recommendations for HIV care in developing countries."									
668	"Nutritional status of adult inpatients in Bujumbura, Burundi (impact of HIV infection)."	"Niyongabo T, Henzel D, Ndayishimyie JM, Melchior JC, Ndayiragije A, Ndihokubwayo JB, Nikoyagize E, et al."	European Journal of Clinical Nutrition. 1999;53(7):579-82.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=10452413	OBJECTIVE: To determine the prevalence and analyse the characteristics and causes of malnutrition among inpatients in an HIV highly endemic area.	DESIGN: Prospective cross-sectional study.	"SETTING: Department of Internal Medicine, University Hospital, Bujumbura, Burundi."	SUBJECTS: 226 adult inpatients.	"MAIN OUTCOMES MEASURES: Evaluation of nutritional status using anthropometry. Degree of malnutrition defined by the percentage of body weight loss (BWL), calculated by reference to the usual body weight."	"RESULTS: Among the 226 patients recruited (mean age: 34.4 +/- 11.9 y, M:F sex ratio: 1.72), 102 (45.1%) were HIV seropositive. 62 (60.8%) of these HIV seropositive were AIDS cases. The AIDS defining criterion was 'wasting syndrome' for 25 (40.3%) and opportunistic infection (OI) for 37 (59.7%) including 34 cases of tuberculosis (TB). The nutritional status of 119/226 patients (52.7%) was normal (BWL < or = 10%). Moderate malnutrition (10% < or = BWL < or = 20%) was observed in 47 (20.8%) and severe malnutrition (BWL > 20%) was observed in 60 (26.5%). HIV seroprevalence and, among HIV seropositive subjects, the percentage of AIDS cases increased according to decreasing level of nutrition (Chi2 for trends: P < 0.001 in both instances). The fat free mass mass of malnourished subjects was lower and the fat body mass was higher among HIV seropositive subjects than HIV seronegative subjects. Among HIV seropositive subjects, malnutrition was associated with TB (P < 0.001) and dysphagia (P < 0.05). Among HIV seronegative subjects, malnutrition was associated with decreased food availability (P < 0.003) and TB (P < 0.05). One week after admission, the mortality rate was higher among HIV seropositive subjects (10.8%) than seronegative subjects (2.4%, P=0.009). Other factors associated with death were decreased fat free mass (P < 0.01) and tricipital skinfold thickness (P < 0.04)."	"CONCLUSIONS: The prevalence of malnutrition is high among the inpatients investigated. Main factors are HIV infection and TB. Strategies adapted to the African context should be developed to prevent, detect and treat malnutrition and associated factors, particularly among HIV seropositive subjects."			
709	"Metabolic syndrome in HIV+ asymptomatic adults in Botswana, Africa."	"Sales S, Campa A, Makhema J, Dusara P, Tsalaile L, Burns PJ, Baum MK, et al."	The FASEB Journal. 2009;23 (S1).		"Objective: To determine the prevalence of metabolic syndrome (MS) in a cohort of asymptomatic and antiretrovirally naive HIV+ adults in Botswana, and its association with other risk factors for cardiovascular disease (CVD). Methods: After consenting, socio-demographic and medical questionnaires were completed, blood pressure and anthropometries taken. Fasting blood was drawn for total blood cholesterol, HDL cholesterol, triglycerides, and glucose. MS was defined according to NCEP ATP III guidelines. Results: Of the 402 participants, 69.4% were female and the mean age was 33.7+/-8.1 years. The prevalence of MS in this cohort was 7.7% (n=31), 32.8% were overweight (BMI >25 kg/m<sup>2</sup>), 11.6% were obese (BMI >30 kg/m<sup>2</sup>), 21.9% had hypertenstion, 31.9% reported alcohol use and 19.5% tobacco use. Only 5.1% had high cholesterol and 14.3% high LDL levels. Risk factors significantly associated with MS were age (OR=1.10, 95% CI: 1.04, 1.16, p<0.01) and BMI (OR=1.26, 95% CI: 1.16, 1.36, p<0.01) after adjusting for age and gender. Conclusions: The prevalence of MS in this cohort is similar to other sub-Saharan African HIV+ cohorts, but low compared to that in developed countries. Preventive interventions should be implemented to reduce the future impact of MS on HIV-related CVD risk, especially when these patients start their antiretroviral treatment."									
604	"Seroprevalence of varicella zoster antibodies among children with malnutrition, malignancies and HIV infection."	"Admani B, Macharia WM, Were F."	East African Medical Journal. 2008;85(10):480-6.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=19537424	OBJECTIVE: To determine the seroprevalence of varicella zoster in paediatric patients at a high risk of developing complications.	DESIGN: A cross-sectional study.	SETTING: Paediatric general wards at Kenyatta National Hospital.	"SUBJECTS: Children with malignancies, severe malnutrition and were HIV positive."	"INTERVENTIONS: The sample size was calculated at 147 subjects. Venous samples were tested for varicella zoster virus (VZV) antibodies using enzyme immunosorbent assay (ELISA) technique at Kenya Medical Research Institute (KEMRI) laboratories, The data were analysed using the SPSS software and presented in form of tables and graphs. The prevalence of VZV antibodies was determined and 95% confidence interval computed."	"RESULTS: The overall seroprevalence of VZV antibodies in the three groups of children studied was 23.6% (95% CI = 17.4, 29.8). The seroprevalence of VZV antibodies in those with malignancies and severe malnutrition was 24.1 and 25.0% respectively. About 22% of HIV positive children had protective levels of VZV antibodies. Though the seroprevalence increased with age, it was not significantly associated with area of residence, size of residence, family size or income."	"CONCLUSIONS: The low prevalence of protective VZV antibodies among children with severe malnutrition, malignancies and HIV infection children at Kenyatta National Hospital warrants routine immunisation of the high-risk population."			
954	"Tuberculosis in patients receiving antiretroviral treatment: incidence, risk factors, and prevention strategies."	"Rie Av, Westreich D, Sanne I."	"JAIDS, Journal of Acquired Immune Deficiency Syndromes. 2011;56(4):349-55."	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20113088916	"Objective: To determine tuberculosis (TB) incidence rates and risk factors among individuals receiving antiretroviral treatment (ART). Design: Observational cohort in Johannesburg, South Africa. Methods: Incident TB was classified as early (less than 6 months of ART) or late (greater than 6 months of ART) incident TB. CD4 cell counts, viral load, body mass index, and hemoglobin were measured 6-monthly. Hazard ratios for factors associated with early and late incident TB were assessed using Cox proportional hazards regression. Results: During 13,416 person-years of follow-up, 501 TB cases occurred among 7536 individuals, corresponding to a 10% risk in the first 4 years of ART and an overall incidence rate of 4.2 cases/100 person-years. The highest incidence rate (21.7 per 100 person-years) was observed in the first 3 months of ART among people with CD4 count below 50 cells/mm3. Low baseline CD4 count, anemia, and low body mass index were the strongest risk factors for early incident TB. Low updated CD4 count, low updated body mass index, anemia, and high viral load on ART were strong risk factors for late incident TB. Conclusions: Severity of HIV disease and unfavorable response to ART are associated with early and late incident TB, respectively. Early ART initiation and intensified TB screening at ART initiation are crucial to reduce incident TB."									
1006	"Tuberculosis in patients receiving antiretroviral treatment: Incidence, risk factors, and prevention strategies."	"Van Rie A, Westreich D, Sanne I."	Journal of Acquired Immune Deficiency Syndromes. 2011 01 Apr;56(4):349-55.		"Objective: To determine tuberculosis (TB) incidence rates and risk factors among individuals receiving antiretroviral treatment (ART). Design: Observational cohort in Johannesburg, South Africa. Methods: Incident TB was classified as early (less than 6 months of ART) or late (greater than 6 months of ART) incident TB. CD4 cell counts, viral load, body mass index, and hemoglobin were measured 6-monthly. Hazard ratios for factors associated with early and late incident TB were assessed using Cox proportional hazards regression. Results: During 13,416 person-years of follow-up, 501 TB cases occurred among 7536 individuals, corresponding to a 10% risk in the first 4 years of ART and an overall incidence rate of 4.2 cases/100 person-years. The highest incidence rate (21.7 per 100 person-years) was observed in the first 3 months of ART among people with CD4 count below 50 cells/mm. Low baseline CD4 count, anemia, and low body mass index were the strongest risk factors for early incident TB. Low updated CD4 count, low updated body mass index, anemia, and high viral load on ART were strong risk factors for late incident TB. Conclusions: Severity of HIV disease and unfavorable response to ART are associated with early and late incident TB, respectively. Early ART initiation and intensified TB screening at ART initiation are crucial to reduce incident TB. 2011 Lippincott Williams & Wilkins."									
97	"Exploring the Cinderella myth: Intrahousehold differences in child wellbeing between orphans and non-orphans in Amajuba District, South Africa."	"Parikh A, DeSilva MB, Cakwe M, Quinlan T, Simon JL, Skalicky A, Zhuwau T."	Aids. 2007 November;21(SUPPL. 7):S95-S103.		"OBJECTIVE: To determine whether differences in wellbeing (defined by a variety of education and health outcomes) exist between recent school-aged orphans and non-orphans who live in the same household in a context of high HIV/AIDS mortality in KwaZulu Natal, South Africa. DESIGN: The data come from the first 2 years (2004-2006) of an ongoing 3-year longitudinal cohort study in a district in KwaZulu-Natal, the Amajuba Child Health and Well-being Research Project. Using stratified cluster sampling based on school and age, we constructed a cohort of 197 recent orphans and 528 non-orphans aged 9-16 years and their households and caregivers. Household heads, caregivers, and children were interviewed regarding five domains of child wellbeing: demographic, economic, educational, health/nutrition/lifestyle, and psychosocial status. METHODS: The analytical sample consists of 174 children (87 orphans and 87 comparable non-orphans who live together) at baseline and 124 children in round 2. We estimated a linear regression model using household fixed effects for continuous outcomes (grade adjusted for age, annual expenditure on schooling and body mass index) and a logit model using household fixed effects for categorical variables (malnutrition) to compare co-resident orphans and non-orphans. RESULTS: We found no statistically significant differences in most education, health and labour outcomes between orphans and the non-orphans with whom they live. Paternal orphans are more likely to be behind in school, and recent mobility has a positive effect on schooling outcomes. 2007 Lippincott Williams & Wilkins, Inc."									
317	Development of a clinical algorithm to prioritise HIV testing of hospitalised paediatric patients in a low resource moderate prevalence setting.	"Allison WE, Kiromat M, Vince J, Wand H, Cunningham P, Graham SM, Kaldor J."	Archives of Disease in Childhood. 2011;96(1):67-72.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=21047830	OBJECTIVE: To develop a clinical algorithm to identify paediatric patients who should be offered HIV testing in a setting of moderate HIV prevalence and limited resources.	"METHODS: In a prospective cross-sectional study at Port Moresby General Hospital, Papua New Guinea, carers of inpatients were offered HIV testing and counselling for their children. Recruited children were tested for HIV antibodies and DNA. Standardised clinical information was collected. Multivariate regression analysis was used to ascertain independent predictors of HIV infection and these were used to develop a predictive algorithm."	"RESULTS: From September 2007 to October 2008, 487 children were enrolled. Overall, 55 (11%) with a median age of 7 months were found to be HIV-infected. In multivariate analysis, independent predictors of HIV infection were: persistent fever (OR = 2.05 (95% CI 1.11 to 4.68)), lymphadenopathy (OR = 2.29 (1.12 to 4.68)), oral candidiasis (OR = 3.94 (2.17 to 7.14)) and being underweight for age (OR = 2.03 (1.03 to 3.99)). The presence of any one of these conditions had a sensitivity of 96% in detecting a child with HIV infection. Using an algorithm based on the presence of at least one of these conditions would result in around 40% of hospitalised children being offered testing."	"CONCLUSIONS: This clinical algorithm may be a useful screening tool for HIV infection in hospitalised children in situations where it is not feasible to offer universal HIV testing, providing guidance for HIV testing practices for increased identification and management of HIV-infected children in Papua New Guinea."						
262	Classification of HIV infection and disease in women from Rwanda. Evaluation of the World Health Organization HIV staging system and recommended modifications.	"Lifson AR, Allen S, Wolf W, Serufilira A, Kantarama G, Lindan CP, Hudes ES, et al."	Annals of Internal Medicine. 1995;122(4):262-70.	http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=2009785492&site=ehost-live	"OBJECTIVE: To develop a human immunodeficiency virus (HIV) staging system for sub-Saharan Africa on the basis of an evaluation of the World Health Organization (WHO) system and predictors of mortality. DESIGN: Prospective cohort study with 4 years of follow-up. SETTING: Kigali, Rwanda. PATIENTS: 412 HIV-infected women recruited from prenatal and pediatric clinics. MEASUREMENTS: Clinical signs and symptoms of HIV disease, laboratory assays (including complete blood count and erythrocyte sedimentation rate), and cumulative mortality. RESULTS: The WHO staging system includes a clinical and a laboratory axis. The clinical axis was revised by inclusion of oral candidiasis, chronic oral or genital ulcers, and pulmonary tuberculosis as ""severe"" disease (clinical stage IV); in addition, body mass index was substituted for weight loss in the definition for the wasting syndrome. The 36-month cumulative mortality was 7% for women in modified clinical stage I (""asymptomatic""), 15% for those in stage II, 19% for those in stage III, and 36% for those in stage IV (P < 0.001). The laboratory axis was revised by replacing lymphocyte count with hematocrit and erythrocyte sedimentation rate. The 36-month mortality was 10% for women in modified stage A (""normal"" laboratory results) and 33% for those in stage B (erythrocyte sedimentation rate > 65 mm/h or hematocrit < 0.38) (P < 0.001). A single staging system combining clinical and laboratory criteria is proposed, with a 36-month mortality of 7% for women in combined stage I, 10% for those in stage II, 29% for those in stage III, and 62% for those in stage IV (P < 0.001). CONCLUSIONS: On the basis of this analysis, a staging system relevant for sub-Saharan Africa is proposed that reflects the range of HIV-related outcomes, has strong prognostic significance, includes inexpensive and available laboratory tests, and can be used by both clinicians and researchers."									
1433	Development of a cross-over randomized trial method to determine the acceptability and safety of novel ready-to-use therapeutic foods.	"Dibari F, Bahwere P, Huerga H, Irena AH, Owino V, Collins S, Seal A."	Nutrition. 2013;29(1):107-12.	http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=2012027867&site=ehost-live	"Objective: To develop a method for determining the acceptability and safety of ready-to-use therapeutic foods (RUTF) before clinical trialing. Acceptability was defined using a combination of three consumption, nine safety, and six preference criteria. These were used to compare a soy/maize/sorghum RUTF (SMS-RUTFh), designed for the rehabilitation of human immunodeficiency virus/tuberculosis (HIV/TB) wasted adults, with a peanut-butter/milk-powder paste (P-RUTF; brand: Plumpy'nut) designed for pediatric treatment. Methods: A cross-over, randomized, controlled trial was conducted in Kenya. Ten days of repeated measures of product intake by 41 HIV/TB patients, >18 y old, body mass index (BMI) 18-24 kg ‡ m<sup>-2</sup>, 250 g were offered daily under direct observation as a replacement lunch meal. Consumption, comorbidity, and preferences were recorded. Results: The study arms had similar age, sex, marital status, initial BMI, and middle upper-arm circumference. No carryover effect or serious adverse events were found. SMS-RUTFh energy intake was not statistically different from the control, when adjusted for BMI on day 1, and the presence of throat sores. General preference, taste, and sweetness scores were higher for SMS-RUTFh compared to the control (P < 0.05). Most consumption, safety, and preference criteria for SMS-RUTFh were satisfied except for the average number of days of nausea (0.16 versus 0.09 d) and vomiting (0.04 versus 0.02 d), which occurred with a higher frequency (P < 0.05). Conclusion: SMS-RUTFh appears to be acceptable and can be safely clinically trialed, if close monitoring of vomiting and nausea is included. The method reported here is a useful and feasible approach for testing the acceptability of ready-to-use foods in low income countries."									
626	Human immunodeficiency virus-associated lipodystrophy: an objective definition based on dual-energy x-ray absorptiometry-derived regional fat ratios in a South Asian population.	"Asha HS, Seshadri MS, Paul TV, Abraham OC, Rupali P, Thomas N."	Endocrine Practice. 2012;18(2):158-69.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=21856599	OBJECTIVE: To develop an objective definition of human immunodeficiency virus (HIV)-associated lipodystrophy by using regional fat mass ratios and to assess the utility of anthropometric and skinfold measurements in the initial screening for lipodystrophy.	"METHODS: Male patients between 25 and 50 years old with proven HIV infection (highly active antiretroviral therapy [HAART]-naive subjects and those receiving successful HAART) were studied and compared with body mass index (BMI)-matched HIV-negative control subjects. Anthropometric variables, body composition, dual-energy x-ray absorptiometry findings, and metabolic variables were compared among the 3 study groups and between those patients with and those without lipodystrophy."	"RESULTS: Trunk fat/lower limb fat mass ratio >2.28 identified 54.3% of patients with HIV receiving HAART as having lipodystrophy and had the highest odds ratio for predicting metabolic syndrome. The ""clinical diagnosis of lipodystrophy"" and the ""clinical scoring system"" had too many false-positive and false-negative results. Triceps skinfold thickness (SFT)/BMI ratio <=0.49 and abdominal SFT/triceps SFT ratio >1.385 have good sensitivity but poor specificity in identifying lipodystrophy. In comparison with HAART-naive patients with HIV, those receiving HAART had significantly higher insulin resistance, and a significantly greater proportion had impaired glucose tolerance and dyslipidemia. Among patients receiving HAART, those with lipodystrophy had a greater degree of insulin resistance, higher triglyceride levels, and lower levels of high-density lipoprotein cholesterol."	CONCLUSION: The trunk fat/lower limb fat mass ratio in BMI-matched normal subjects can be used to derive cutoff values to define lipodystrophy objectively in HIV-infected patients. Defining lipodystrophy in this way is better than other methods of identifying those patients with increased cardiovascular risk. Triceps SFT/BMI and abdominal SFT/triceps SFT ratios may be useful as screening tools in resource-poor settings.						
498	"Pattern of admissions to the paediatric medical wards (1995 to 1996) at Harare Hospital, Zimbabwe."	"Nathoo KJ, Bannerman CH, Pirie DJ."	Central African Journal of Medicine. 1999;45(10):258-63.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=10823229	OBJECTIVE: To document the pattern of disease and outcome of medical paediatric admissions at Harare hospital.	DESIGN: Cross sectional study from 1 June 1995 to 30th May 1996.	"SETTING: Medical paediatric wards, Harare Central Hospital."	SUBJECTS: All admissions below the age of nine years.	"MAIN OUTCOME MEASURES: Socio-demographic features, nutritional status, clinical diagnoses, duration of hospital stay and mortality."	"RESULTS: A total of 8,826(90.0%) of the admissions were assessed. The majority(51.8%) of the patients were one year and below. ""Road to Health"" cards, available for 94.4% children, showed 88.0% had appropriate immunizations for age. Forty nine percent had lower respiratory tract infection either as only, or concurrent with other diagnoses, with an overall fatality rate of 16.2%. Acute diarrhoea was the second most frequent condition (21.0%) with an associated case fatality rate of 11.3%. Mortality rates for neonatal sepsis and bacterial meningitis were 12.3% and 32.8% respectively. Severe malnutrition defined as less than 60% of the expected weight for age, was present in 12.5% with an associated fatality rate of 28.7%. Based on clinical suspicion 23.2% of the total children were tested for HIV antibodies and 82.0% were positive. Overall case fatality among the inpatients was 17.8% and 36.7% of the total deaths occurred within 24 hours of admission."	CONCLUSION: There is a need to re-evaluate our management strategies for common conditions including those with HIV infection. Standardization of case management is an important and essential step towards reduction in mortality both at the primary and referral health institutions.			
608	Contextualising the paediatric HIV epidemic: a review.	"Eley BS, Tindyebwa D, Kayita J, Kieffer MP, Nduati R, Mwansambo C, Musoke P, et al."	East African Medical Journal. 2006;83(12):684-8.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20073264214	"Objective: To draw attention to the sub-optimal care that HIV-infected children are receiving in Africa. Data sources: Relevant published literature. Data synthesis: Sub-optimal response to paediatric HIV infection has aggravated the negative impact that the epidemic has had on child health in Africa. Recently the African Network for the Care of Children Affected by HIV/AIDS (ANNECA) released an advocacy statement that called for the optimisation of prevention, diagnosis, treatment and care for children affected by the AIDS pandemic. Effective prevention strategies if comprehensively implemented, could prevent more than 500 000 paediatric infections per annum at current antenatal HIV prevalence rates. Improved care that includes universal utilisation of early diagnostic testing systems, cotrimoxazole prophylaxis, nutritional support and the timely introduction of antiretroviral therapy could improve the quality of life and lifespan of most infected children. Conclusion: Political leaders, public health officials and fellow child health professionals are urged to redouble their efforts to reverse the magnitude of the paediatric epidemic in Africa."									
1662	"Food consumption and nutritional status of people living with HIV/AIDS (PLWHA): a case of Thika and Bungoma Districts, Kenya."	Kuria EN.	Public Health Nutrition. 2010;13(4):475-9.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=19758480	"OBJECTIVE: To establish the food consumption, dietary habits and nutritional status of people living with HIV/AIDS (PLWHA) and adults whose HIV status is not established."	DESIGN: Cross-sectional descriptive survey.	"SETTING: Thika and Bungoma Districts, Kenya."	SUBJECTS: A random sample of 439 adults; 174 adults living with HIV/AIDS and 265 adults whose HIV/AIDS status was not established in Thika and Bungoma Districts.	"RESULTS: Majority of PLWHA consume foods that are low in nutrients to build up the immune system and help maintain adequate weight, and there is little variety in the foods they consume. More adults who are HIV-positive are undernourished than those whose status is not established. Of the HIV-positive adults, those with a BMI of <or=18.5 kg/m2 were 23.6 % (Thika 20.0 % and Bungoma 25.7 %) while of the adults whose status is not established those with BMI <or= 18.5 kg/m2 were 13.9 % (Thika 9.3 % and Bungoma 16.7 %)."	"CONCLUSIONS: Adults who are HIV-positive are more likely to be undernourished than those whose status is not established, as there is a significant difference (P = 0.000) between the nutritional status (BMI) of PLWHA and those whose HIV/AIDS status is not established. PLWHA consume foods that are low in nutrients to promote their nutritional well-being and health."				
92	Incidence and determinants of mortality and morbidity following early antiretroviral therapy initiation in HIV-infected adults in West Africa.	"Moh R, Danel C, Messou E, Ouassa T, Gabillard D, Anzian A, Abo Y, et al."	Aids. 2007 December;21(18):2483-91.		"OBJECTIVE: To estimate the incidence and risk factors of mortality and severe morbidity during the first months following antiretroviral therapy (ART) initiation in West African adults. METHODS: A cohort study in Abidjan in which 792 adults started ART with a median CD4 cell count of 252 cells/mul and were followed for a median of 8 months. Severe morbidity was defined as all World Health Organization stage 3 or 4-defining morbidity events other than oral candidiasis. RESULTS: In patients with pre-ART CD4 cell count < 200, at 200-350 and > 350 cells/mul, incidence of mortality was 5.0 [95% confidence interval (CI), 2.6-8.7], 1.7 (95% CI, 0.6-3.8) and 0.0 (95% CI, 0.0-3.4]/100 person-years, and incidence of severe morbidity was 13.3 (95% CI, 9.0-19.1), 9.5 (95% CI, 6.2-12.9) and 7.9 (95% CI, 3.4-15.5)/100 person-years, respectively. The most frequent diseases were invasive bacterial diseases (32/65 episodes, 49%) and tuberculosis (25/65 episodes, 38%). Both diseases followed the same curve of decreasing incidence over time. Patients who experienced severe morbidity had higher risks of mortality, virological failure and immunological failure. Other independent risk factors for mortality and/or severe morbidity were: at baseline, high viral load, advanced clinical stage, past history of tuberculosis, low BMI, low haemoglobin and low CD4 cell count; during follow-up: low CD4 cell count and persistently detectable viral load. CONCLUSION: These data give new arguments to reinforce the hypothesis that, in this region, ART should be started before the CD4 cell count drops below 350 cells/mul. Further studies should assess whether patients with low BMI, low haemoglobin, high viral load or past history of tuberculosis should start ART earlier. 2007 Lippincott Williams & Wilkins, Inc."									
477	"Evidence-based reproductive health care in Cameroon: population-based study of awareness, use and barriers."	"Tita AT, Selwyn BJ, Waller DK, Kapadia AS, Dongmo S."	Bulletin of the World Health Organization. 2005;83(12):895-903.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=16462981	OBJECTIVE: To estimate the prevalence of awareness and use of evidence-based reproductive health interventions and to describe the barriers associated with the use of evidence-based interventions among health providers in north-west Cameroon.	"METHODS: In February 2004, a population-based descriptive study of the awareness and use of 13 evidence-based interventions targeted health workers providing reproductive health care. Their awareness and use of a composite of four vital interventions was also evaluated. These were peripartum use of antiretrovirals to prevent transmission of HIV, antenatal corticosteroid administration, magnesium sulfate prophylaxis and active management of placental delivery with uterotonics. In-depth interviews with key informants were conducted as part of a qualitative substudy to discover the barriers to the use of evidence-based interventions."	"FINDINGS: Overall, 91.4% (328/359) of reproductive health workers were surveyed. Their awareness of evidence-based interventions varied from 29% for the use of antenatal corticosteroids to 97% for the use of iron and folic acid supplementation during pregnancy. Their use of these interventions ranged from 10.2% for antenatal corticosteroids to 94.8% for iron and folic acid supplementation. Only 50/322 (15.5%; 95% confidence interval (CI)=11.8-20.0) of health workers were aware of all four vital interventions, and only 12/312 (3.8%; 95% CI=2.0- 6.6) reported using all of them regularly. A total of 26 key informants participated in the qualitative substudy. A deficiency in the education and training of health workers, especially a lack of continuing education, was commonly identified as the most important barrier to their awareness of evidence-based practices. A lack of awareness and a lack of supplies and materials were the main barriers to practice."	"CONCLUSION: The awareness and practice of important evidence-based reproductive health interventions were less than optimal. To improve maternal and perinatal outcomes both remedial programmes to enhance awareness, including continuing education for health workers, and the provision of necessary supplies are needed."						
1012	Evaluation of a systematic substitution of zidovudine for stavudine-based HAART in a program setting in rural Cambodia.	"Isaakidis P, Raguenaud ME, Phe T, Khim SA, Kuoch S, Khem S, Reid T, et al."	Journal of acquired immune deficiency syndromes (1999). 2008 1 Sep;49(1):48-54.		"OBJECTIVE: To evaluate a treatment strategy of substituting zidovudine (ZDV) for stavudine (d4T)-based highly active antiretroviral therapy (HAART), aimed at preventing d4T-associated toxicity, in a programmatic setting in rural Cambodia. METHODS: Survival probability, CD4 gain, anemia incidence, and factors associated with severe anemia were analyzed in a cohort of adult patients switched from d4T- to ZDV-containing regimens from March 2006 to March 2007. RESULTS: Among 527 patients systematically switched to ZDV after d4T-based HAART for a median of 18 months, 4 (0.8%) patients died, 2 (0.4%) were lost to follow-up, 18 (3.4%) were transferred out, and 503 (95.4%) remained on HAART. Median CD4 gain was +263.5 cells/microL (interquartile range: 89.25-369.5) at 24 months. Within 1 year after the switch, 21.9% and 7.1% of patients developed anemia (grades 1-4) and severe anemia (grades 3-4), respectively. Low body mass index (< or =18) and low CD4 count (<200 cells/microL) at the time of switch were factors associated with severe anemia. Additional follow-up visits for laboratory monitoring and adherence counseling, increased absenteeism from work, and transportation costs for the patients were noted. CONCLUSIONS: The switch strategy of substituting ZDV for d4T-based HAART led to satisfactory overall clinical outcomes. However, it resulted in a relatively high incidence of mild to severe anemia and increased burden for the program and the patients."									
68	Detection of tuberculosis in HIV-infected children using an enzyme-linked immunospot assay.	"Davies MA, Connell T, Johannisen C, Wood K, Pienaar S, Wilkinson KA, Wilkinson RJ, et al."	AIDS. 2009;23(8):961-9.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=19287300	OBJECTIVE: To evaluate an enzyme-linked immunospot assay (ELISPOT) for the diagnosis of tuberculosis (TB) in HIV-infected children with suspected TB and to compare the performance of ELISPOT with the tuberculin skin test (TST).	METHODS: Interferon-gamma responses to Mycobacterium tuberculosis-specific antigens were measured by ELISPOT in HIV-infected children with suspected TB. HIV-infected and HIV-uninfected children without TB were taken for comparison.	"RESULTS: Results were available for 188 children, of whom 139 (74%) were HIV-infected. Of these, 22 were classified as having definite TB: 24 probable TB, 14 possible TB and 128 not having TB. The median (range) age of patients was 20 (10-54.1) months. Median interferon-gamma responses to early-secreted antigenic target-6 and culture filtrate protein-10 were higher in children with definite or probable TB compared with children without TB (P < 0.002). In HIV-infected children with an interpretable ELISPOT result, the ELISPOT was positive in 14/21 (66%) with definite TB. A significantly higher proportion of HIV-infected children with definite or probable TB had a positive ELISPOT compared with a positive TST [25/39 (64%) vs. 10/34 (29%), P = 0.005]. In contrast to TST, results from ELISPOT were not affected by young age or severe immunosuppression. In HIV-infected children without active TB disease, 27% had a positive ELISPOT, suggesting latent TB infection."	"CONCLUSION: ELISPOT is more sensitive than TST for the detection of active TB in HIV-infected children. However, the sensitivity of current ELISPOT assays is not sufficiently high to be used as a rule out test for TB."						
649	"Nutritional status and dietary intakes in human immunodeficiency virus (HIV)-infected outpatients in Abidjan, Cote D'Ivoire, 1995."	"Castetbon K, Kadio A, Bondurand A, Boka Yao A, Barouan C, Coulibaly Y, Anglaret X, et al."	European Journal of Clinical Nutrition. 1997;51(2):81-6.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=9049565	"OBJECTIVE: To evaluate nutritional status and dietary intakes in HIV-outpatients in Abidjan, Cote d'Ivoire."	DESIGN: Cross-sectional study.	"SETTING: In the Outpatients and Counselling Unit in the University Hospital in Treichville, and in the follow-up Unit of Blood Donors."	SUBJECTS: 100 HIV-infected patients at different stages of the infection recruited consecutively in the two consultation services.	"MAIN OUTCOME MEASURES: Clinical, biological and anthropometric data were collected: weight, baseline weight, height, triceps skinfold (TS), arm circumference (AC), body mass index (BMI), muscular circumference (MC) and weight loss (WL). Dietary intake was estimated by the 24 h recall method."	"RESULTS: The M:F sex ratio was 1.1:1. Mean age was 32.5 y (30.7-34.4); 64% of the patients were symptomatic (S+). Mean weight was 58.7 kg (56.8-60.6) and mean BMI, 20.9 k/m2 (20.7-21.1); 67% of the patients had a BMI < 21.5 kg/m2. S+ patients had mean weight, BMI, AC and MC significantly lower than asymptomatic patients (P < 0.0001 = 0.001, 0.0003 and 0.004 respectively) and had suffered a more important WL (P < 0.0001). Immunodepressed patients had mean weight, AC and MC significantly lower than patients with a CD4 count > or = 200/mm3 (P = 0.04, 0.005 and 0.04 respectively). WL was independent of CD4 count. Protein, carbohydrate and fat intakes were respectively 59 g/24 h (52-66), 266 g/24 h (240-292) and 59 g/24 h (51-66). Energy mean intake was 7.6 MJ/24 h (6.9-8.4) and lower than WHO recommended intakes."	"CONCLUSIONS: In Abidjan, anthropometric parameters and dietary intakes of HIV-infected patients are worsened by clinical events. Nutritional intakes are generally lower than recommendations. Further studies are needed to determine if, in the African context, a causal relationship could exist between dietary intakes and nutritional status in HIV-infected patients."			
650	"Nutritional status and dietary intakes in human immunodeficiency virus (HIV)-infected outpatients in Abidjan, Cote D'Ivoire, 1995."	"Castetbon K, Kadio A, Bondurand A, Yao AB, Barouan C, Coulibaly Y, Anglaret X, et al."	European Journal of Clinical Nutrition. 1997 February;51(2):81-6.		"Objective: To evaluate nutritional status and dietary intakes in HIV-outpatients in Abidjan, Cote d'Ivoire. Design: Cross-sectional study. Setting: In the Outpatients and Counselling Unit in the University Hospital in Treichville, and in the follow-up Unit of Blood Donors. Subjects: 100 HIV-infected patients at different stages of the infection recruited consecutively in the two consultation services. Main outcome measures: Clinical, biological and anthropometric data were collected: weight, baseline weight, height, triceps skinfold (TS), arm circumference (AC), body mass index (BMI), muscular circumference (MC) and weight loss (WL). Dietary intake was estimated by the 24 h recall method. Results: The M:F sex ratio was 1.1:1. Mean age was 32.5 y (30.7-34.4); 64% of the patients were symptomatic (S+). Mean weight was 58.7 kg (56.8-60.6) and mean BMI, 20.9 k/m<sup>2</sup> (20.7-21.1); 67% of the patients had a BMI < 21.5 kg/m<sup>2</sup>. S+ patients had mean weight, BMI, AC and MC significantly lower than asymptomatic patients (P < 0.0001 = 0.001, 0.0003 and 0.004 respectively) and had suffered a more important WL (P < 0.0001). Immunodepressed patients had mean weight, AC and MC significantly lower than patients with a CD4 count <= 200/mm<sup>3</sup> (P = 0.04, 0.005 and 0.04 respectively). WL was independent of CD4 count. Protein, carbohydrate and fat intakes were respectively 59 g/24 h (52-66), 266 g/24 h (240-292) and 59 g/24 h (51-66). Energy mean intake was 7.6 MJ/24 h (6.9-8.4) and lower than WHO recommended intakes. Conclusions: In Abidjan, anthropometric parameters and dietary intakes of HIV-infected patients are worsened by clinical events. Nutritional intakes are generally lower than recommendations. Further studies are needed to determine if, in the African context, a causal relationship could exist between dietary intakes and nutritional status in HIV-infected patients. Sponsorship: This study has been presented in part at the IXth International Conference on AIDS and STD in Africa, Kampala, Ouganda, December 10-14, 1995 (Abstract no. Tu B123), and was supported in part by the Universite de Bordeaux II, Bordeaux (France) and the Centre ORSTOM Petit-Bassam, Abidjan, Cote d'Ivoire."									
511	Clinical and fiberoptic endoscopic evaluation of swallowing in Robin sequence treated with nasopharyngeal intubation: the importance of feeding facilitating techniques.	"Marques IL, Prado-Oliveira R, Leiriao VHV, Jorge JC, Souza Ld."	Cleft Palate Craniofacial Journal. 2010;47(5):523-9.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20103299789	"Objective: To evaluate oral feeding capacity, the swallowing process, and risk for aspiration, both clinically and during fiberoptic endoscopic evaluation of swallowing, in infants with isolated Robin sequence treated exclusively with nasopharyngeal intubation and feeding facilitating techniques. Design: Longitudinal and prospective study. Setting: Hospital de Reabilitacao de Anomalias Craniofaciais, University of Sao Paulo, Bauru, Brazil. Patients: Eleven infants with isolated Robin sequence, under 2 months of age, treated with nasopharyngeal intubation. Interventions: Feeding facilitating techniques were applied in all infants throughout the study period. The infants were evaluated clinically and through fiberoptic endoscopic evaluation of swallowing at first, second, and, if necessary, third week of hospitalization (T1, T2, T3). The mean volume of ingested milk was registered during clinical evaluation, and events were registered during feeding. Results: The respiratory status of all infants was improved after nasopharyngeal intubation; 72% of them presented risk for aspiration during fiberoptic endoscopic evaluation of swallowing at T1. This risk was less frequent when thickened milk was given to the infants and at subsequent evaluations (T2 and T3). Conclusions: Nasopharyngeal intubation aids in stabilizing the airway in isolated Robin sequence, but it does not relate directly to feeding. The risk for aspiration was present in most of the infants, mainly during the first week of hospitalization, and improved within a few weeks, after the use of feeding facilitating techniques."									
87	Extended antenatal use of triple antiretroviral therapy for prevention of mother-to-child transmission of HIV-1 correlates with favorable pregnancy outcomes.	"Marazzi MC, Palombi L, Nielsen-Saines K, Haswell J, Zimba I, Magid NA, Buonomo E, et al."	Aids. 2011 24 Aug;25(13):1611-8.		"Objective: To evaluate pregnancy outcomes in a cohort of HIV-infected women receiving triple antiretroviral therapy (ART) for prevention of mother-to-child-transmission. Methods: A retrospective cohort study with review of records of 3273 HIV-positive women receiving prenatal care in Malawi and Mozambique from July 2005 to December 2009 was conducted in Drug Resource Enhancement Against AIDS and Malnutrition (DREAM) centers. Patients were offered nevirapine-based triple ART initiated in pregnancy until 6 months postpartum. Main outcome measures were maternal mortality, abortion/stillbirth, prematurity, and low birth weight. Results: Maternal mortality was 1.2% (42/3273): 7.4% in 68 women with no antenatal ART and 0.7% in 1370 with at least 90 days of antenatal ART [P < 0.001; odds ratio (OR) 0.29 (95% confidence interval [CI] 0.14-0.96]. Abortion/stillbirth was 5.2% (169/3273): 26.5% in 68 women with no ART and 5.0% in 1370 women with at least 90 days of antenatal ART [P < 0.001; OR 0.39 (95% CI 0.27-0.57)]. Prematurity was 19.1%: 70% in 10 women with no antenatal ART and 8.5% in 1330 women with at least 90 days of antenatal ART [P < 0.001; OR 0.15 (95% CI 0.14-0.19)]. Low birth weight was 11.5% (57/496) and not associated with ART duration. The protective effect of antenatal ART against mortality, fetal demise, and prematurity was independent of CD4 strata. Multivariate analysis for BMI, CD4 cell count, virus load, days in care, predelivery length of ART, and hemoglobin demonstrated an independent association between predelivery length of ART and CD4 with maternal mortality, abortion/stillbirth, and prematurity. ART toxicities were infrequent (5.2%). Conclusion: Antenatal triple ART reduces adverse pregnancy outcomes in HIV-infected women. 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins."									
1938	Asymptomatic serum cryptococcal antigenemia and early mortality during antiretroviral therapy in rural Uganda.	"Liechty CA, Solberg P, Were W, Ekwaru JP, Ransom RL, Weidle PJ, Downing R, et al."	Tropical Medicine and International Health. 2007 August;12(8):929-35.		"Objective: To evaluate the association between a positive serum cryptococcal antigen (CRAG) test at baseline and mortality during the first 12 weeks on antiretroviral therapy (ART). Cryptococcal meningitis is a leading cause of HIV-related mortality in Africa, but current guidelines do not advocate CRAG testing as a screening tool. Methods: Between May 2003 and December 2004, we enrolled HIV-1 infected individuals into a study of ART monitoring in rural Uganda. CRAG testing was conducted retrospectively on stored pre-ART serum samples of participants whose baseline CD4 cell count was <100 cells/mul and who were without symptoms suggestive of disseminated cryptococcal disease at enrolment. Results: Of 377 participants, 5.8% had serum CRAG titre >=1:2. Of these, 23% died during follow-up. Controlling for CD4 cell count, HIV-1 viral load, anaemia, active tuberculosis and body mass index, relative risk of death during follow-up among those with asymptomatic cryptococcal antigenemia at baseline was 6.6 [95% confidence interval (CI) 1.86-23.61, P = 0.0036]. The population attributable risk for mortality associated with a positive CRAG at baseline was 18% (CI 2-33%), similar to that associated with active tuberculosis (19%, CI 1-36%). Conclusion: Asymptomatic cryptococcal antigenemia independently predicts death during the first 12 weeks of ART among individuals with advanced HIV disease in rural Uganda. Routine screening and provision of azole antifungal therapy prior to or simultaneous with the start of ART should be evaluated for the potential to prevent mortality in this population. 2007 Blackwell Publishing Ltd."									
1934	Effect of haematinic supplementation and malaria prevention on maternal anaemia and malaria in western Kenya.	"Eijk AMv, Ayisi JG, Slutsker L, Kuile FOt, Rosen DH, Otieno JA, Shi YP, et al."	Tropical Medicine and International Health. 2007;12(3):342-52.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20073061680	"OBJECTIVE: To evaluate the effect of routine antenatal haematinic supplementation programmes and intermittent preventive treatment (IPT) with sulphadoxine-pyrimethamine (SP) in Kenya. METHODS: Anaemia (haemoglobin (Hb)<11 g/dl), severe anaemia (Hb<8 g/dl) and placental malaria were compared among women with known HIV status who delivered at a provincial hospital after study enrolment in the third trimester during three consecutive periods: period 1, no routine intervention (reference); period 2, routine haematinic supplementation (60 mg elementary iron three times/day, folic acid 5 mg once daily) and period 3, haematinics and IPT with SP. RESULTS: Among 3108 participants, prevalence of placental malaria, anaemia and severe anaemia postpartum was 16.7%, 53.6% and 12.7%, respectively. Compared with period 1, women in period 2 were less anaemic [adjusted odds ratio (AOR), 95% confidence interval anaemia: 0.56, 0.47-0.67; severe anaemia 0.37, 0.28-0.49] and shared a similar prevalence of placental malaria (AOR 1.07, 0.86-1.32). Women in period 3 were also less anaemic (AOR anaemia: 0.43, 0.35-0.53 and severe anaemia: 0.43, 0.31-0.59), and had less placental malaria (AOR 0.56, 0.42-0.73). The effect of intervention did not differ significantly by HIV status. CONCLUSION: The haematinic supplementation programme was associated with significant reductions in anaemia in HIV-seropositive and HIV-seronegative women. The subsequent introduction of IPT was associated with halving of malaria, but no additional haematological benefit over haematinics."									
1711	"Longitudinal anthropometric assessment of infants born to HIV-1-infected mothers, Belo Horizonte, Southeastern Brazil."	"Fausto MA, Carneiro M, Antunes CM, Colosimo EA, Pinto JA."	Revista de Saude Publica. 2011;45(4):652-60.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=21670861	OBJECTIVE: To evaluate the growth parameters in infants who were born to HIV-1-infected mothers.	"METHODS: The study was a longitudinal evaluation of the z-scores for the weight-for-age (WAZ), weight-for-length (WLZ) and length-for-age (LAZ) data collected from a cohort. A total of 97 non-infected and 33 HIV-infected infants born to HIV-1-infected mothers in Belo Horizonte, Southeastern Brazil, between 1995 and 2003 was studied. The average follow-up period for the infected and non-infected children was 15.8 months (variation: 6.8 to 18.0 months) and 14.3 months (variation: 6.3 to 18.6 months), respectively. A mixed-effects linear regression model was used and was fitted using a restricted maximum likelihood."	"RESULTS: There was an observed decrease over time in the WAZ, LAZ and WLZ among the infected infants. At six months of age, the mean differences in the WAZ, LAZ and WLZ between the HIV-infected and non-infected infants were 1.02, 0.59, and 0.63 standard deviations, respectively. At 12 months, the mean differences in the WAZ, LAZ and WLZ between the HIV-infected and non-infected infants were 1.15, 1.01, and 0.87 standard deviations, respectively."	CONCLUSIONS: The precocious and increasing deterioration of the HIV-infected infants' anthropometric indicators demonstrates the importance of the early identification of HIV-infected infants who are at nutritional risk and the importance of the continuous assessment of nutritional interventions for these infants.						
1712	"Longitudinal anthropometric assessment of infants born to HIV-1-infected mothers, Belo Horizonte, Southeastern Brazil."	"Fausto MA, Carneiro M, Antunes CMF, Colosimo EA, Pinto JA."	Revista de Saude Publica. 2011 August;45(4):652-60.		"OBJECTIVE: To evaluate the growth parameters in infants who were born to HIV-1-infected mothers. METHODS: The study was a longitudinal evaluation of the z-scores for the weight-for-age (WAZ), weight-for-length (WLZ) and length-for-age (LAZ) data collected from a cohort. A total of 97 non-infected and 33 HIV-infected infants born to HIV-1-infected mothers in Belo Horizonte, Southeastern Brazil, between 1995 and 2003 was studied. The average follow-up period for the infected and non-infected children was 15.8 months (variation: 6.8 to 18.0 months) and 14.3 months (variation: 6.3 to 18.6 months), respectively. A mixed-effects linear regression model was used and was fitted using a restricted maximum likelihood. RESULTS: There was an observed decrease over time in the WAZ, LAZ and WLZ among the infected infants. At six months of age, the mean differences in the WAZ, LAZ and WLZ between the HIV-infected and non-infected infants were 1.02,0.59, and 0.63 standard deviations, respectively. At 12 months, the mean differences in the WAZ, LAZ and WLZ between the HIV-infected and non-infected infants were 1.15,1.01, and 0.87 standard deviations, respectively. CONCLUSIONS: The precocious and increasing deterioration of the HIV-infected infants' anthropometric indicators demonstrates the importance of the early identification of HIV-infected infants who are at nutritional risk and the importance of the continuous assessment of nutritional interventions for these infants."									
1250	Food supplementation as an incentive to improve pre-antiretroviral therapy clinic adherence in HIV-positive children--experience from eastern India.	"Kundu CK, Samanta M, Sarkar M, Bhattacharyya S, Chatterjee S."	Journal of Tropical Pediatrics. 2012;58(1):31-7.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=21421550	"OBJECTIVE: To evaluate the importance of food supplementation as incentive in improving preantiretroviral therapy (pre-ART) adherence, and second its impact on health of HIV-infected children by a clinic-based observational study."	"METHODS: HIV-seropositive children aged between 2 and 12 years were followed-up sequentially for 2 years without and with food supplementation, respectively, with monitoring of disease parameters. The outcome morbidity parameters were compared and correlated."	"RESULT: Study showed significant improvement in clinic adherence (r=0.165, p=0.027) along with increased mean clinic visit (6.65+/-1.43 vs. 8.01+/-1.52, p=0.000) and mean CD4 count (p=0.028) with incentive. Provision of incentive correlated well (Pearson's r=0.345) with number of visits which in turn had strong correlation with weight gain (r=0.548), episodes of AIDS-defining illnesses (r=-0.412), hospitalization (r=-0.279)."	"CONCLUSION: Food incentive could enhance pre-ART phase clinic adherence that decreases disease-related morbidities, setting the stage for improved treatment and care of seropositive children in future."						
1249	Food supplementation as an incentive to improve pre-antiretroviral therapy clinic adherence in HIV-positive children - experience from eastern India.	"Kundu CK, Moumita S, Mihir S, Subhasish B, Sukanta C."	Journal of Tropical Pediatrics. 2012;58(1):31-7.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20123061823	"Objective: To evaluate the importance of food supplementation as incentive in improving preantiretroviral therapy (pre-ART) adherence, and second its impact on health of HIV-infected children by a clinic-based observational study. Methods: HIV-seropositive children aged between 2 and 12 years were followed-up sequentially for 2 years without and with food supplementation, respectively, with monitoring of disease parameters. The outcome morbidity parameters were compared and correlated. Result: Study showed significant improvement in clinic adherence (r=0.165, p=0.027) along with increased mean clinic visit (6.65+or-1.43 vs. 8.01+or-1.52, p=0.000) and mean CD4 count (p=0.028) with incentive. Provision of incentive correlated well (Pearson's r=0.345) with number of visits which in turn had strong correlation with weight gain (r=0.548), episodes of AIDS-defining illnesses (r=-0.412), hospitalization (r=-0.279). Conclusion: Food incentive could enhance pre-ART phase clinic adherence that decreases disease-related morbidities, setting the stage for improved treatment and care of seropositive children in future."									
1251	Food supplementation as an incentive to improve pre-antiretroviral therapy clinic adherence in HIV-positive children-experience from Eastern India.	"Kundu CK, Samanta M, Sarkar M, Bhattacharyya S, Chatterjee S."	Journal of Tropical Pediatrics. 2012 February;58(1):31-7.		"Objective: To evaluate the importance of food supplementation as incentive in improving preantiretroviral therapy (pre-ART) adherence, and second its impact on health of HIV-infected children by a clinic-based observational study. Methods: HIV-seropositive children aged between 2 and 12 years were followed-up sequentially for 2 years without and with food supplementation, respectively, with monitoring of disease parameters. The outcome morbidity parameters were compared and correlated. Result: Study showed significant improvement in clinic adherence (r = 0.165, p = 0.027) along with increased mean clinic visit (6.65 +/- 1.43 vs. 8.01 +/- 1.52, p = 0.000) and mean CD4 count (p = 0.028) with incentive. Provision of incentive correlated well (Pearson's r = 0.345) with number of visits which in turn had strong correlation with weight gain (r = 0.548), episodes of AIDS-defining illnesses (r = -0.412), hospitalization (r = -0.279). Conclusion: Food incentive could enhance pre-ART phase clinic adherence that decreases disease-related morbidities, setting the stage for improved treatment and care of seropositive children in future. The Author [2011]. Published by Oxford University Press. All rights reserved."									
911	Serum procalcitonin in pulmonary tuberculosis.	"Rasmussen TA, Sogaard OS, Camara C, Andersen PL, Wejse C."	"International Journal of Tuberculosis & Lung Disease. 2011;15(2):251-6, i."	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=21219690	OBJECTIVE: To evaluate the level and prognostic value of procalcitonin (PCT) in a West African out-patient cohort with pulmonary tuberculosis (PTB).	"METHOD: Patients were clinically scored (TB score), grouped into severity classes (SCs) upon diagnosis and followed for 12 months. Patients were categorised by comparisons of severity class (SC I+II or SC III) and levels of PCT and C-reactive protein (CRP) at diagnosis. Fifty healthy volunteers from the study area were used as controls. The association with TB score was explored using Spearman's rank correlation test. Survival curves stratified after baseline levels of PCT and CRP were compared using the log-rank test."	"RESULTS: We included 218 patients in the study. PCT and CRP levels were low, but were significantly higher in patients than in controls (P < 0.001), and were higher for SC III compared to SC I+II patients (P = 0.021 for PCT, P < 0.001 for CRP). Human immunodeficiency virus (HIV) status did not influence results. We found positive correlations between both PCT and CRP and TB score. There was a significantly increased risk of mortality with increasing baseline PCT (P = 0.01), whereas high CRP did not predict mortality rate (P = 0.887)."	"CONCLUSION: In West African PTB patients, PCT levels were low but increased significantly with increasing severity of disease, and can predict mortality risk."						
655	Nutritional status of HIV-1 seropositive patients in the Free State Province of South Africa: anthropometric and dietary profile.	"Dannhauser A, van Staden AM, van der Ryst E, Nel M, Marais N, Erasmus E, Attwood EM, et al."	European Journal of Clinical Nutrition. 1999;53(3):165-73.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=10201796	"OBJECTIVE: To evaluate the nutritional intake and status of HIV-1 seropositive patients, as well as the relationship between malnutrition and disease stage."	DESIGN: A cross-sectional study.	"SETTINGS: The Immunology Clinic at the Pelonomi Hospital in Bloemfontein, South Africa."	SUBJECTS: Eighty-one HIV/AIDS patients in different stages of disease were recruited consecutively from January to May 1995. Eleven of these patients were followed in 1997.	"MAIN OUTCOME MEASURES: Anthropometric data including current weight, height, triceps skinfold thickness, mid-upper-arm circumference, body mass index and bone-free arm muscle area were collected. Nutrient intake was estimated using a diet history in combination with a standardised food frequency questionnaire. The patients were divided into 3 groups according to their CD4+ T cell counts."	"RESULTS: The men were leaner (BMI = 18.9) than the women (BMI = 22.7) and patients with a CD4+ T cell count < 200 (stage III) tended to have the lowest median values for all anthropometric measurements. More than half the patients had a low intake (< 67% of the recommended dietary allowances) of vitamin C, vitamin B6, vitamin D, vitamin A, calcium, iron and zinc."	"CONCLUSIONS: The results confirms that HIV/AIDS patients from this population are malnourished. There was, however, no association between disease stage and nutritional status. Nutritional supplementation of HIV/AIDS patients should be considered, as this might lead to improved immune function in these patients."			
499	Nutritional status of HIV-1 seropositive patients in the Free State Province of South Africa--laboratory parameters.	"van Staden AM, Barnard HC, Nel M, Attwood EM, Oosthuizen GM, Dannhauser A, van der Ryst E, et al."	Central African Journal of Medicine. 1998;44(10):246-50.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=10101433	"OBJECTIVE: To evaluate the nutritional status of HIV-1 seropositive patients with regards to laboratory parameters; the correlation between nutrient intake and actual values of nutrients, as well as the relationship between malnutrition and disease progression."	DESIGN: A cross sectional study.	"SETTING: The Immunology Clinic at the Pelonomi Hospital in Bloemfontein, South Africa."	SUBJECTS: 90 HIV/AIDS patients in different stages of disease were recruited consecutively from January to May 1995. Sixteen patients were followed up in 1997.	"MAIN OUTCOME MEASURES: The patients were divided into three groups according to their CD4+ T-cell counts, and blood levels of protein, albumin, cholesterol, ferritin, vitamin B12, magnesium, and phosphorus, as well as several micronutrients including vitamin E, vitamin C, beta-carotene and retinol which were determined using standard methods. These values were compared with the normal reference values used in the laboratory, and we tried to correlate these parameters with disease stage, as well as recorded nutrient intake in a subgroup of 35 patients."	"RESULTS: Abnormal values for several parameters, including plasma-retinol and serum-protein were found, but no correlation between more advanced disease and micronutrient deficiencies could be demonstrated."	"CONCLUSIONS: HIV/AIDS patients from this population are deficient in several micronutrients, and for some patients this is mirrored by a low intake. Multivitamin/anti-oxidant supplementation of HIV/AIDS patients should be considered, as this could lead to improved immune function in these patients."			
80	Early immunologic response and subsequent survival among malnourished adults receiving antiretroviral therapy in Urban Zambia.	"Koethe JR, Limbada MI, Giganti MJ, Nyirenda CK, Mulenga L, Wester CW, Chi BH, et al."	AIDS. 2010;24(13):2117-21.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=20543657	OBJECTIVE: To evaluate the relationship between early CD4(+) lymphocyte recovery on antiretroviral therapy (ART) and subsequent survival among low body mass index (BMI) HIV-1-infected adults.	"DESIGN: Retrospective analysis of a large programmatic cohort in Lusaka, Zambia."	"METHODS: We evaluated ART-treated adults enrolled in care for more than 6 months. We stratified this study population according to World Health Organization (WHO) malnutrition criteria: normal (BMI >or=18.5 kg/m(2)), mild (17.00-18.49), moderate (16.00-16.99), and severe (<16.0). We used Cox proportional hazards regression to estimate the subsequent risk of death associated with absolute CD4(+) cell count change over the first 6 months on ART. To account for effect modification associated with baseline CD4(+) cell count, a weighted summary measure was calculated."	"RESULTS: From May 2004 to February 2009, 56,612 patients initiated ART at Lusaka district clinics; of these, 33 097 (58%) were included in this analysis. The median change in 0-6 month CD4(+) cell count in each baseline BMI strata varied from 127 to 131 cells/microl. There was a statistically significant, inverse association between baseline BMI and the post 6-month hazard for mortality only among those patients with less than 100 cells/microl increase in the first 6 months of ART. A CD4(+) cell count increase of at least 100 cells/microl over the first 6 months of ART was not associated with a higher hazard for mortality, regardless of baseline BMI."	"CONCLUSIONS: Low baseline BMI and attenuated CD4(+) cell count response at 6 months had a compounding, negative impact on post 6-month survival. Specific guidelines for monitoring ART response using immunologic criteria may be warranted for low BMI patients."					
441	"Utility of routine viral load, CD4 cell count, and clinical monitoring among adults with HIV receiving antiretroviral therapy in Uganda: Randomised trial."	"Mermin J, Ekwaru JP, Were W, Degerman R, Bunnell R, Kaharuza F, Downing R, et al."	BMJ (Online). 2011 03 Dec;343(7834):1134.		"Objective: To evaluate the use of routine laboratory monitoring in terms of clinical outcomes among patients receiving antiretroviral therapy (ART) in Uganda. Design: Randomised clinical trial Setting: A home based ART programme in rural Uganda. Participants: All participants were people with HIV who were members of the AIDS Support Organisation. Participants had CD4 cell counts <250 cells x 10<sup>6</sup>/L or World Health Organization stage 3 or 4 disease. Interventions: Participants were randomised to one of three different monitoring arms: a viral load arm (clinical monitoring, quarterly CD4 counts, and viral load measurements), CD4 arm (clinical monitoring and CD4 counts), or clinical arm (clinical monitoring alone). Main outcome measures: Serious morbidity (newly diagnosed AIDS defining illness) and mortality. Results: 1094 participants started ART; median CD4 count at baseline was 129 cells x 10<sup>6</sup>/L. Median follow-up was three years. In total, 126 participants died (12%), 148 (14%) experienced new AIDS defining illnesses, and 61(6%) experienced virological failure, defined as two consecutive viral loads >500 copies/mL occurring more than three months after the start of ART. After adjustment for age, sex, baseline CD4 count, viral load, and body mass index, the rate of new AIDS defining events or death was higher in the clinical arm than the viral load arm (adjusted hazard ratio 1.83, P=0.002) or the CD4 arm (1.49, P=0.032). There was no significant difference between the CD4 arm and the viral load arm (1.23, P=0.31). Conclusion: In patients receiving ART for HIV infection in Uganda, routine laboratory monitoring is associated with improved health and survival compared with clinical monitoring alone. Trial registration: Clinical Trials NCT00119093."									
988	"Management of HIV-1 infection with a combination of nevirapine, stavudine, and lamivudine: A preliminary report on the Nigerian antiretroviral program."	"Idigbe EO, Adewole TA, Eisen G, Kanki P, Odunukwe NN, Onwujekwe DI, Audu RA, et al."	Journal of Acquired Immune Deficiency Syndromes. 2005 01 Sep;40(1):65-9.		"Objective: To evaluate treatment outcome in the first 12 months among HIV-positive patients managed with a combination of nevirapine + stavudine + lamivudine under the current national antiretroviral (ARV) program in Nigeria. Design: This was a prospective observational, cohort study on 50 ARV-naive patients who met the inclusion criteria for the program and had given informed consent. All patients were in stage 2 or stage 3 periods of infection based on World Health Organization clinical classification. The patients were treated with the generic brands of ARVs and treatment consisted of oral nevirapine (Nevimal, Cipla, Mumbai, India), 200 mg daily, lamivudine (Lamivir, Cipla), 150 mg twice daily, and stavudine (Stavir, Cipla), 40 mg twice daily. Prior to initiation of treatment, the clinical history and baseline data for each patient were documented. The levels of plasma HIV-1 RNA, CD4<sup>+</sup> cell counts, frequency of opportunistic infections, and estimated body mass index were recorded at baseline and subsequently at intervals during treatment. Data obtained at the various sampling times for each parameter were compared against their baseline values. Results: Data on the plasma HIV-1 RNA levels indicated that between baseline and week 24, the median viral load of the patients decreased by 1.79 logic copies/mL. Equally between baseline and week 48 the median CD4<sup>+</sup> cell counts increased by 186 x 10<sup>6</sup> cells/L, the frequency of opportunistic infections decreased by 82%, the median body mass index increased by 4.8 kg/m<sup>2</sup>, and 36% experienced side effects, which were minor and transient. The most prevalent side effect recorded was skin rash associated with nevirapine. Good adherence to this triple regimen was recorded in >85% of the patients. Conclusions: The overall results within the 12-month treatment period indicated an effective suppression of viral replication, the re-constitution of the immune system, and improvement of the physical well-being of the study population. Though there may be differences in global distribution of the infecting HIV-1 subtypes, the clinical and biologic results of this study compared favorably to those documented in cohorts treated with branded and generic ARV drugs in some developed and developing countries. The cumulative data in this study further confirmed that the correct use of generic brands of ARVs is a feasible option in HIV care and support programs in resource-poor countries. Copyright 2005 by Lippincott Williams & Wilkins."									
1940	Evaluation of affordable screening markers to detect CD4+ T-cell counts below 200 cells/mul among HIV-1-infected Ugandan adults.	"Miiro G, Nakubulwa S, Watera C, Munderi P, Floyd S, Grosskurth H."	Tropical Medicine and International Health. 2010 April;15(4):396-404.		"Objective: To evaluate validity of WHO staging, low body mass index (BMI) and anaemia in detecting HIV-infected adults with CD4+ T-cell counts < 200 cells/mul. Methods: Between October 1995 and April 2006, we screened Ugandans aged 16 or older at enrolment into an open cohort. We analysed highly active anti-retroviral therapy (HAART)-naive HIV-infected patients with WHO stages 1-3 and complete data in a secondary cross-sectional study. Low BMI was a BMI < 18.5 kg/m<sup>2</sup>. Anaemia was a haemoglobin level < 11 or 12 g/dl among women and men respectively. Results: Among 2892 HAART-naive patients, the median age was 32 years. 71% were women, 54% had WHO stage 3 AIDS, 34% had anaemia, 16% had a low BMI and 43% had CD4+ T-cell counts < 200 cells/mul. WHO stage 3 compared to combined WHO stages 1 and 2 had a sensitivity (95% CI) of 70% (67, 72) and a specificity of 57% (55, 60) respectively to detect CD4+ T-cell counts < 200 cells/mul. Anaemia compared to normal haemoglobin had sensitivity (95% CI) of 47% (44, 50) and a specificity of 76% (74, 78). Low BMI compared to normal BMI had sensitivity (95% CI) of 23% (20, 25) and a specificity of 89% (87, 90) against CD4+ T-cell counts < 200 cells/mul. Conclusion: Only WHO stage 3 had reasonably high sensitivity in detecting CD4+ T-cell counts below 200 cells/mul in this setting. Targeted low-cost CD4 testing strategies are urgently needed to detect patients eligible for HAART in rural Africa and other resource-limited settings. 2010 Blackwell Publishing Ltd."									
1941	Evaluation of affordable screening markers to detect CD4+ T-cell counts below 200 cells/ micro l among HIV-1-infected Ugandan adults.	"Miiro G, Nakubulwa S, Watera C, Munderi P, Floyd S, Grosskurth H."	Tropical Medicine and International Health. 2010;15(4):396-404.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20103125759	"OBJECTIVE: To evaluate validity of WHO staging, low body mass index (BMI) and anaemia in detecting HIV-infected adults with CD4+ T-cell counts <200 cells/ micro l. METHODS: Between October 1995 and April 2006, we screened Ugandans aged 16 or older at enrolment into an open cohort. We analysed highly active anti-retroviral therapy (HAART)-naive HIV-infected patients with WHO stages 1-3 and complete data in a secondary cross-sectional study. Low BMI was a BMI<18.5 kg/m<sup>2</sup>. Anaemia was a haemoglobin level <11 or 12 g/dl among women and men respectively. RESULTS: Among 2892 HAART-naive patients, the median age was 32 years. 71% were women, 54% had WHO stage 3 AIDS, 34% had anaemia, 16% had a low BMI and 43% had CD4+ T-cell counts <200 cells/ micro l. WHO stage 3 compared to combined WHO stages 1 and 2 had a sensitivity (95% CI) of 70% (67, 72) and a specificity of 57% (55, 60) respectively to detect CD4+ T-cell counts <200 cells/ micro l. Anaemia compared to normal haemoglobin had sensitivity (95% CI) of 47% (44, 50) and a specificity of 76% (74, 78). Low BMI compared to normal BMI had sensitivity (95% CI) of 23% (20, 25) and a specificity of 89% (87, 90) against CD4+ T-cell counts <200 cells/ micro l. CONCLUSION: Only WHO stage 3 had reasonably high sensitivity in detecting CD4+ T-cell counts below 200 cells/ micro l in this setting. Targeted low-cost CD4 testing strategies are urgently needed to detect patients eligible for HAART in rural Africa and other resource-limited settings."									
615	Complementary factors contributing to the rapid spread of HIV-I in sub-Saharan Africa: a review.	Nyindo M.	East African Medical Journal. 2005;82(1):40-6.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=16122111	OBJECTIVE: To examine and establish complementary factors that contribute to the alarmingly high prevalence of HIV-1 in sub-Saharan Africa (SSA) in order to create awareness and suggest possible measures to avert the spread of the pandemic.	"DATA SOURCES: Review of literature via Medline, the Internet, articles in refereed journals, and un-refereed features from the East Africa media houses and personal communications."	"DATA SELECTION: Most published data from 1981 to September 2004 found to have revealed an impact on the spread of HIV-1 in SSA were included in the review. Therefore, all selected articles were read and critically evaluated. Where possible the number of citations articles which had been received were sought to established the degree of impact."	"DATA EXTRACTION: Abstracts of all articles identified were accessed, read and analysed to determined possible relevance to the spread of HIV-1. When relevance was established from the abstract the entire paper was read and important points were included in the review."	"DATA SYNTHESIS: A matrix was drawn to include all subtitles (e.g. polygamy, circumcision, poverty, etc). Below each subtitle all published works were included and prioritised. Published works that were found to have impact were included in the review. Finally a percent composite picture of all factors was drawn in an attempt to prioritise the factors, not withstanding the fact that most factors are interrelated and complementary."	"CONCLUSIONS: There are many reasons why the spread of HIV-1 in SSA has not been declining over the years. Main risk factors for HIV-1 infection and AIDS disease in SSA were found to include poverty, famine, low status of women in society, corruption, naive risk taking perception, resistance to sexual behaviour change, high prevalence of sexually transmitted infections (STI), internal conflicts and refugee status, antiquated beliefs, lack of recreational facilities, ignorance of individual's HIV status, child and adult prostitution, uncertainty of safety of blood intended for transfusion, widow inheritance, circumcision, illiteracy and female genital cutting and polygamy. It is suggested that control programmes both local and donor-driven seeking to mitigate the spread of HIV-1 in SSA should take into account the apparent multiplicity of sub-Saharan African cultures and beliefs, some of which augment the spread of HIV-1. [References: 39]"				
1506	Public understanding of growth charts: a review of the literature.	"Ben-Joseph EP, Dowshen SA, Izenberg N."	Patient Education & Counseling. 2007;65(3):288-95.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=17081719	OBJECTIVE: To examine current knowledge about the general public's comprehension of growth charts.	METHODS: A literature search was carried out to identify and analyze the findings of studies that have examined the extent to which non-healthcare professionals comprehend the information presented by growth charts.	RESULTS: Few studies have examined how well parents understand growth charts. These studies have mostly been conducted in developing countries and have yielded inconclusive results.	"CONCLUSION: Growth charts can be useful for such purposes as growth monitoring and public health education, but their effectiveness as an educational tool depends on whether parents and caregivers comprehend the information they offer. The literature has not clearly proven that growth charts are easily understood by the general population."	PRACTICE IMPLICATIONS: Further studies of the public's understanding of growth charts are needed to help guide health care providers in their use of growth charts as educational tools. [References: 35]					
672	HIV status and sociodemographic correlates of maternal body size and wasting during pregnancy.	"Villamor E, Msamanga G, Spiegelman D, Coley J, Hunter DJ, Peterson KE, Fawzi WW."	European Journal of Clinical Nutrition. 2002;56(5):415-24.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=12001012	"OBJECTIVE: To examine HIV status and sociodemographic variables as correlates of body size (height, body mass index (BMI), and mid-upper-arm circumference (MUAC)) and wasting (MUAC <22 cm) in pregnant women."	DESIGN: Cross-sectional study.	"SETTING: Four antenatal clinics in Dar es Salaam, Tanzania."	"SUBJECTS: Women presenting for first prenatal visit before the 23rd week of gestation, between April 1995 and July 1997 (n=13 760)."	"RESULTS: Mean MUAC, BMI and height were 25.5 cm, 23.5 kg/m(2) and 155.1 cm, respectively. The prevalence of HIV infection was 13.1% and the overall prevalence of wasting was 4.7%. Wasting was 34% (95% CI=3%, 73%) more prevalent among HIV-infected than in uninfected mothers, after adjusting for week of gestation, height and sociodemographic indicators. The risk of wasting associated with HIV infection was highest among women with low level of education or unable to contribute to the household income. From a multiple linear regression model, BMI was positively associated with mother's age, level of education and money spent on food, but not with HIV infection, after adjusting for week of gestation. In multivariate analysis, height increased monotonically by categories of maternal age and level of education, and was also positively correlated with the ability to contribute to household income, the amount of money spent on food per person per day, and having a professional partner."	"CONCLUSION: HIV infection is a significant risk factor for wasting among pregnant women, particularly in groups of low socioeconomic status (SES). SES indicators are strongly correlated with maternal height and with BMI during the first and second trimesters of pregnancy independently of HIV status."	"SPONSORSHIP: The National Institute of Child Health and Human Development (NICHD R01 32257), and the Fogarty International Center (NIH D43 TW00004)."			
1239	Denver Developmental Screening Test (DDST) survey and degree of malnutrition among children born to HIV infected mothers under the Prevention of Mother to-Child-Transmission (PMTCT) Program.	"Hokjindee U, Chongsuvivatwong V, Lim A, Pruphetkaew N."	Journal of the Medical Association of Thailand. 2010;93(12):1458-62.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=21344810	"OBJECTIVE: To examine morbidity experience, pattern of nutrition status and development of the children born to HIV infected mothers under the Prevention of Mother to Child Transmission (PMTCT) Program compared to the national standard."	"MATERIAL AND METHOD: In 2008, births given by mothers under PMTCT in five selected hospitals of Health Region 4 of Thailand between 2002 and 2006 were identified from the registered data and the medical records, were reviewed. Their homes were visited to collect the data."	"RESULTS: Among 138 mothers and 143 children studied, nobody died. Forty-four were healthy 91 experienced mild episode of various infections and allergy within the past three months, one was admitted for pneumonia, two were HIV-positive, 53 were negative and the other 88 had no final blood tested In the Denver Developmental Screening Test (DDST), all parameters were minimal, less than 5%. Overall, the suspected delay development is around 15.4%. For nutritional status assessment by height for age (HFA), weight for age (WFA) and weight for height (WFH) reported a quarter (23.1%) was stunting whereas 12.6% were thin and 5.6% were wasting, respectively."	"CONCLUSION: Among the study PMTCT children, serious morbidity was rare. Nutritional deficiency was more common than delayed development."						
1646	Availability of nutritional support services in HIV care and treatment sites in sub-Saharan African countries.	"Anema A, Zhang W, Wu Y, Elul B, Weiser SD, Hogg RS, Montaner JS, et al."	Public Health Nutrition. 2012;15(5):938-47.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=21806867	OBJECTIVE: To examine the availability of nutritional support services in HIV care and treatment sites across sub-Saharan Africa.	"DESIGN: In 2008, we conducted a cross-sectional survey of sites providing antiretroviral therapy (ART) in nine sub-Saharan African countries. Outcomes included availability of: (i) nutritional counselling; (ii) micronutrient supplementation; (iii) treatment for severe malnutrition; and (iv) food rations. Associations with health system indicators were explored using bivariate and multivariate methods."	SETTING: President's Emergency Plan for AIDS Relief-supported HIV treatment and care sites across nine sub-Saharan African countries.	"SUBJECTS: A total of 336 HIV care and treatment sites, serving 467 175 enrolled patients."	"RESULTS: Of the sites under study, 303 (90 %) offered some form of nutritional support service. Nutritional counselling, micronutrient supplementation, treatment for severe acute malnutrition and food rations were available at 98 %, 64 %, 36 % and 31 % of sites, respectively. In multivariate analysis, secondary or tertiary care sites were more likely to offer nutritional counselling (adjusted OR (AOR): 2.2, 95 % CI 1.1, 4.5). Rural sites (AOR: 2.3, 95 % CI 1.4, 3.8) had increased odds of micronutrient supplementation availability. Sites providing ART for >2 years had higher odds of availability of treatment for severe malnutrition (AOR: 2.4, 95 % CI 1.4, 4.1). Sites providing ART for >2 years (AOR: 1.6, 95 % CI 1.3, 1.9) and rural sites (AOR: 2.4, 95 % CI 1.4, 4.4) had greater odds of food ration availability."	"CONCLUSIONS: Availability of nutritional support services was high in this large sample of HIV care and treatment sites in sub-Saharan Africa. Further efforts are needed to determine the uptake, quality and effectiveness of these services and their impact on patient and programme outcomes."				
1647	Availability of nutritional support services in HIV care and treatment sites in sub-Saharan African countries.	"Anema A, Zhang W, Wu YF, Elul B, Weiser SD, Hogg RS, Montaner JSG, et al."	Public Health Nutrition. 2012;15(5):938-47.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20123146589	"Objective: To examine the availability of nutritional support services in HIV care and treatment sites across sub-Saharan Africa. Design: In 2008, we conducted a cross-sectional survey of sites providing antiretroviral therapy (ART) in nine sub-Saharan African countries. Outcomes included availability of: (i) nutritional counselling; (ii) micronutrient supplementation; (iii) treatment for severe malnutrition; and (iv) food rations. Associations with health system indicators were explored using bivariate and multivariate methods. Setting: President's Emergency Plan for AIDS Relief-supported HIV treatment and care sites across nine sub-Saharan African countries. Subjects: A total of 336 HIV care and treatment sites, serving 467 175 enrolled patients. Results: Of the sites under study, 303 (90%) offered some form of nutritional support service. Nutritional counselling, micronutrient supplementation, treatment for severe acute malnutrition and food rations were available at 98%, 64%, 36% and 31% of sites, respectively. In multivariate analysis, secondary or tertiary care sites were more likely to offer nutritional counselling (adjusted OR (AOR): 2.2, 95% CI 1.1, 4.5). Rural sites (AOR: 2.3, 95% CI 1.4, 3.8) had increased odds of micronutrient supplementation availability. Sites providing ART for >2 years had higher odds of availability of treatment for severe malnutrition (AOR: 2.4, 95% CI 1.4, 4.1). Sites providing ART for >2 years (AOR: 1.6, 95% CI 1.3, 1.9) and rural sites (AOR: 2.4, 95% CI 1.4, 4.4) had greater odds of food ration availability. Conclusions: Availability of nutritional support services was high in this large sample of HIV care and treatment sites in sub-Saharan Africa. Further efforts are needed to determine the uptake, quality and effectiveness of these services and their impact on patient and programme outcomes."									
671	"Zinc supplementation to HIV-1-infected pregnant women: effects on maternal anthropometry, viral load, and early mother-to-child transmission."	"Villamor E, Aboud S, Koulinska IN, Kupka R, Urassa W, Chaplin B, Msamanga G, et al."	European Journal of Clinical Nutrition. 2006;60(7):862-9.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=16452912	"OBJECTIVE: To examine the effect of zinc supplementation to HIV-1-infected pregnant women on viral load, early mother-to-child transmission of HIV (MTCT), and wasting."	DESIGN: Double-blind placebo-controlled randomized clinical trial.	"SETTING: Antenatal clinic in Dar es Salaam, Tanzania."	SUBJECTS: Four hundred HIV-1-infected pregnant women.	METHODS: Women 12-27 weeks of gestation were randomly assigned to receive a daily oral dose of 25 mg zinc or placebo from the day of the first prenatal visit until 6 weeks postdelivery. Weight and mid-upper arm circumference (MUAC) were measured monthly. HIV status of the babies was assessed at birth and at 6 weeks postpartum. Viral load was assessed in a random sample of 100 women at baseline and at the end of the study.	"RESULTS: Zinc had no effects on maternal viral load or early MTCT. Supplementation was related to a significant threefold increase in the risk of wasting (reaching a MUAC value <22 cm) during an average 22 weeks of observation (RR=2.7, 95%CI=1.1, 6.4, P=0.03), and to a 4 mm decline in MUAC during the second trimester (P=0.02)."	CONCLUSIONS: Zinc supplementation to HIV-infected pregnant women offers no benefits on viral load or MTCT. The clinical relevance of an apparent decrease in MUAC associated with zinc supplementation is yet to be ascertained. These findings together with the lack of effect on fetal outcomes (reported previously) do not provide support for the addition of zinc supplements to the standard of prenatal care among HIV-infected women.			
673	"Wasting and body composition of adults with pulmonary tuberculosis in relation to HIV-1 coinfection, socioeconomic status, and severity of tuberculosis."	"Villamor E, Saathoff E, Mugusi F, Bosch RJ, Urassa W, Fawzi WW."	European Journal of Clinical Nutrition. 2006;60(2):163-71.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=16234841	"OBJECTIVE: To examine the impact of HIV coinfection, socioeconomic status (SES) and severity of tuberculosis (TB) on the body composition and anthropometric status of adults with pulmonary TB."	DESIGN: Cross-sectional study.	"SETTING: Five TB clinics in Dar es Salaam, Tanzania."	"SUBJECTS: A total of 2231 adult men and women diagnosed with pulmonary TB, prior to the initiation of anti-TB therapy."	"METHODS: We compared the distribution of anthropometric characteristics including body mass index (BMI), mid-upper arm circumference (MUAC), triceps skin-fold (TSF), and arm muscle circumference (AMC) by HIV status, SES characteristics, and indicators of TB severity (bacillary density in sputum and Karnofsky performance score). Similar comparisons were carried out with body composition variables from bioelectrical impedance analysis and albumin concentrations, in a subsample of 731 subjects."	"RESULTS: In multivariate analysis, HIV infection was significantly associated with lower MUAC and AMC in both men and women, but not with BMI or TSF. Compared to HIV-uninfected women, those who were HIV infected had lower body cell mass (BCM) (adjusted difference = -0.85 kg, P = 0.04), intracellular water (-0.68 l, P = 0.04), and phase angle (-0.52, P = 0.02). Albumin concentrations were significantly lower in both men and women infected with HIV. Among HIV-infected men, CD4 cell counts <200/mm(3) were related to lower intracellular water, BCM, fat-free mass and phase angle. Independent of HIV infection, BMI and MUAC were positively related to SES indicators and the Karnofsky performance score; and inversely related to bacillary density."	"CONCLUSIONS: HIV infection is associated with indicators of low lean body mass in adults with TB; socioeconomic factors and TB severity are important correlates of wasting, independent of HIV."	SPONSORSHIP: The National Institute of Allergy and Infectious Diseases (UO1 AI 45441-01).		
1747	Impact of urbanisation on serum lipid profiles - the THUSA survey.	"Oosthuizen W, Vorster HH, Kruger A, Venter CS, Kruger HS, Ridder JHd."	SAMJ South African Medical Journal. 2002;92(9):723-8.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh3&AN=20023144225	"Objective: To examine the impact of urbanization on lipid profiles of black South Africans, stratified for human immunodeficiency virus (HIV) status. Design: Cross-sectional population-based survey. Setting: North West province of South Africa. Subjects: A representative sample of 1854 apparently healthy volunteers aged >=15 years, was recruited from 37 randomly selected sites throughout the province. Subjects were stratified into 5 urbanization strata (S): S1 rural villages, S2 farms, S3 informal housing or 'squatter camps', S4 urban townships, and S5 suburban housing. Outcome measures: Demographical, physical activity and dietary intake information was collected using validated and culture-sensitive questionnaires. Anthropometric measurements and lipid analyses were determined using standardized methodology. Results: The results revealed significantly lower mean (95% confidence interval) total serum cholesterol (TC) levels in HIV-negative men in S1-S4 compared with S5 (S1 3.91 (3.77-4.05) vs. S5 4.79 (4.54-5.04) mmol/litre). In HIV-negative women, TC levels were significantly lower in S1-S3 than in S4 and S5 (S1 4.05 (3.94-4.17) vs. S5 4.79 (4.59-5.00) mmol/litre). The same trends were seen for serum low-density lipoprotein cholesterol (LDLC) and triglycerides and in HIV-positive subjects. Binary logistical analysis indicated that the main factor responsible for the increased TC levels seemed to be increased body mass index (BMI) due to decreased physical activity. Conclusions: Serum lipid levels increased with urbanization although they remained within levels recommended for other populations. This may, however, become an important health problem in the future if preventive strategies are not implemented. Culturally sensitive physical activity programmes to decrease BMI, targeted at professional men and women, and women in urban townships, seem to constitute the most appropriate intervention."									
331	"Association between steatorrhea, growth, and immunologic status in children with perinatally acquired HIV infection."	"Sentongo TA, Rutstein RM, Stettler N, Stallings VA, Rudy B, Mulberg AE."	Archives of Pediatrics and Adolescent Medicine. 2001;155(2):149-53.		"Objective: To examine the prevalence of steatorrhea and exocrine pancreatic insufficiency (EPI) and their association with growth and immune status variables in children with perinatally acquired human immunodeficiency virus (HIV) infection. Design: Cross-sectional study. Setting: Tertiary care HIV subspecialty practice. Participants: Children with perinatally acquired HIV infection. Exclusion criteria included being younger than 1 year and receiving mineral oil as a medication. Methods: Weight, height, and upper arm anthropometric variables were measured. Spot stool samples were analyzed for steatorrhea using the Sudan III qualitative test and for EPI using fecal elastase-1 enzyme assay. Hormone-stimulated pancreatic function testing and 72-hour stool and dietary fat sample collection were performed when fecal elastase-1 enzyme was in the range of EPI, defined as less than 200 mug/g. HIV RNA viral load, CD4 status, type of antiretroviral therapy, and biochemical evidence of hepatobiliary disease were measured within 3 months of stool sample collection, z Scores were computed for height, weight, triceps skinfold, and upper arm muscle area. Results: We enrolled 44 patients (23 girls [52%]) with a mean +/- SD age of 7.4 +/- 3.1 years. None had hepatobiliary disease. The prevalence of steatorrhea was 39% (95% confidence interval, 23%-56%). The prevalence of EPI was 0% (95% confidence interval, 0%-9%). There were no associations between steatorrhea and EPI, growth, HIV RNA viral load, CD4 status, or type of antiretroviral therapy. Older children had decreased z scores for height (r=-0.42; P=.006). Conclusions: The clinical significance of steatorrhea in children with HIV infection is unclear. Furthermore, its evaluation should focus on nonpancreas-based conditions. Continual close monitoring of growth is essential in children with HIV infection."									
660	Selenium levels in relation to morbidity and mortality among children born to HIV-infected mothers.	"Kupka R, Msamanga GI, Spiegelman D, Rifai N, Hunter DJ, Fawzi WW."	European Journal of Clinical Nutrition. 2005;59(11):1250-8.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=16015252	OBJECTIVE: To examine the relation between selenium status and child mortality and morbidity among children born to HIV-infected mothers.	DESIGN: Prospective cohort study.	"METHODS: Study participants were originally part of a trial to study the effect of maternal vitamin supplements on maternal and child health outcomes. Morbidity information was collected during monthly clinic visits until the child reached 24 months of age. Out of 984 livebirths, 806 had morbidity information, and 610 also had data on plasma selenium levels available."	"SETTING: A study clinic at Muhimbili National Hospital, Dar es Salaam, Tanzania, a tertiary-care hospital."	"RESULTS: The median age at baseline was 10.5 weeks. A total of 117 (19%) of the 610 study children died during follow-up. In a multivariate model, child plasma selenium levels were inversely associated with risk of all-cause mortality (P-value, test for trend=0.05). Plasma selenium levels were not significantly associated with risk of diarrhea or respiratory outcomes."	"CONCLUSIONS: Among infants born to HIV-infected women in sub-Saharan Africa, selenium status may be important to prevent child mortality. These preliminary findings warrant future reexamination."				
661	Relationship between plasma selenium concentrations and lower genital tract levels of HIV-1 RNA and interleukin type 1beta.	"Kupka R, Msamanga GI, Xu C, Anderson D, Hunter D, Fawzi WW."	European Journal of Clinical Nutrition. 2007;61(4):542-7.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=17151590	OBJECTIVE: To examine the relationship between selenium nutritional status and intermediates of human immunodeficiency virus (HIV)-1 transmission.	DESIGN: Prospective cohort study.	"SETTING: A study clinic at Muhimbili National Hospital, Dar es Salaam, Tanzania."	SUBJECTS: A total of 340 HIV-1-infected pregnant women with gestational ages 12-27 weeks.	"METHODS: Women's plasma selenium concentrations were determined at enrollment and modeled as tertiles (tertile 1: <114 microg/l (reference); tertile 2: 114-131 microg/l; tertile 3: >131 microg/l). Cervicovaginal lavage specimens were obtained at 36 weeks of gestation to determine HIV-1 RNA and interleukin-1beta (IL-1beta) levels. In subgroup analyses, 123 women with genital tract infections at enrollment were excluded."	"RESULTS: Plasma selenium concentrations >or=114 microg/l were related to increased risk of lower-genital shedding of HIV-1 RNA. Excluding women with genital tract infections strengthened the associations (relative risk (RR) tertile 2: 1.46, 95% confidence interval (CI)=1.10, 1.92; RR tertile 3: 1.39, 95% CI=1.05, 1.84). There was evidence for an association between plasma selenium concentrations >or=114 microg/l and increased HIV-1 RNA levels among the entire cohort and after excluding women with genital tract infections. There was no association between plasma selenium and IL-1beta concentrations."	"CONCLUSIONS: High selenium status may lead to increased risk of genital HIV-1 shedding, but data from other studies indicate that the evidence is mixed. Results from ongoing selenium trials are awaited to clarify the impact of selenium on HIV-1-related transmission endpoints. Sponsorship: National Institute of Child Health and Human Development (NICHD R01 32257) and the Fogarty International Center (NIH D43 TW00004)."			
1017	Maternal disease stage and child undernutrition in relation to mortality among children born to HIV-infected women in Tanzania.	"Chatterjee A, Bosch RJ, Hunter DJ, Fataki MR, Msamanga GI, Fawzi WW."	Journal of Acquired Immune Deficiency Syndromes: JAIDS. 2007;46(5):599-606.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=18043314	OBJECTIVE: To examine whether maternal HIV disease stage during pregnancy and child malnutrition are associated with child mortality.	DESIGN: Prospective cohort study in Tanzania.	"METHODS: Indicators of disease stage were assessed for 939 HIV-infected women during pregnancy and at delivery, and children's anthropometric status was obtained at scheduled monthly clinic visits after delivery. Children were followed up for survival status until 24 months after birth."	"RESULTS: Advanced maternal HIV disease during pregnancy (CD4 count <350 vs. >or=350 cells/mm) was associated with increased risk of child mortality through 24 months of age (hazard ratio [HR] = 1.74, 95% confidence interval [CI]: 1.32 to 2.30). CD4 count <350 cells/mm was also associated with an increased risk of death among children who remained HIV-negative during follow-up (HR = 2.00, 95% CI: 1.36 to 2.94). Low maternal hemoglobin concentration and child undernutrition were related to an increased risk of mortality in this cohort of children."	"CONCLUSIONS: Low maternal CD4 cell count during pregnancy is related to increased risk of mortality in children born to HIV-infected women. Care and treatment for HIV disease, including highly active antiretroviral therapy to pregnant women, could improve child survival. Prevention and treatment of undernutrition in children remain critical interventions in settings with high HIV prevalence."					
1671	"Pressure cooker ownership and food security in Aurangabad, India."	"van Elsland SL, van der Hoeven M, Joshi S, Doak CM, Ponce MC."	Public Health Nutrition. 2012;15(5):818-26.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=22017820	"OBJECTIVE: To explore associations between household food security and home gardening, use of soya and pressure cooker ownership in low-income households affected by HIV/AIDS in Aurangabad, India."	"DESIGN: Cross-sectional pilot study which assessed household food security using the validated US Department of Agriculture's food security core-module questionnaire. Questions were added to explore household environment, education, occupation, home gardening, use of soya and pressure cooker ownership. Households with very low v. low food security were compared using logistic regression analysis, controlling for confounding by socio-economic status."	"SETTING: Aurangabad is an urban setting situated in a primarily agricultural dependent area. The study was carried out in 2008, at the peak of the global food crisis."	SUBJECTS: Adult caregivers of children affiliated with the Network of People Living with HIV/AIDS in Aurangabad.	"RESULTS: All except for one of 133 households were identified as food insecure (99.2 %). Of these households, 35.6 % had to cut size or skip a meal in the past 30 d. Households that cut meal size due to cooking fuel shortages were more likely to have very low food security (OR = 4.67; 95 % CI 1.62, 13.44) compared with households having no cooking fuel shortages. Owning a pressure cooker was shown to be protective against very low food security after controlling for confounding by socio-economic status (OR = 0.27; 95 % CI 0.11, 0.64)."	"CONCLUSIONS: Only pressure cooker ownership showed a protective association with low household food security. Pressure cookers save household fuel costs. Therefore, future interventions should explore pressure cookers as a sustainable means of improving household food security."				
574	Quality of STIs and HIV/AIDS care as perceived by biomedical and traditional health care providers in Zambia: Are there common grounds for collaboration?	"Kaboru BB, Muchimba M, Falkenberg T, Hojer B, Faxelid E."	Complementary Therapies in Medicine. 2008 June;16(3):155-62.		"Objective: To explore biomedical and traditional health care providers' (BHPs and THPs, respectively) perceptions of good quality of care and opinions on weaknesses in the services they provide to patients with STIs and HIV/AIDS. Methods: Using data from a cross-sectional survey, we post-coded two open-ended questions related to THPs' and BHPs' perceptions on good quality of care and on provided care. The post-coding was done following Donabedian's framework of assessment of quality of care, and allowed transformation of qualitative data into quantitative. The analysis is based on comparison of frequencies, proportions and subsequent chi-square tests and odds ratios. Setting: Ndola and Kabwe, Zambia Main measures: Proportions of responses from 152 BHPs and 144 THPs. Results: Substantial proportions of providers from both sectors perceived drugs availability (63% of BHPs and 70% of THPs) and welcoming attitude (73% of BHPs and 64% of THPs) as important components of good quality care. BHPs were more likely than THPs to mention proper examination, medical management (provider's technical ability) and explanation of causes and prognosis of the disease as important. More THPs than BHPs cited short waiting time and cost of care. A majority of BHPs (87%) and of THPs (80%) reported deficiencies in their STIs and HIV/AIDS-related services. Both groups regarded training of providers and nutritional support and health education to patients as lacking. None of the THPs alluded to voluntary counselling and testing (VCT) or supportive/home-based care as aspects needing improvement. Conclusion: Drugs availability and welcoming attitude were two aspects of quality highly valued by THPs and BHPs. Future collaborative interventions need to respond to aspects of joint concern including training of providers, nutritional support and health education to patients. Further, there is an imperative of expanding and adapting VCT, home-based care and palliative care to THPs for better care of STIs and HIV/AIDS. 2008 Elsevier Ltd. All rights reserved."									
1359	Emotional development and nutritional status of HIV/AIDS orphaned children aged 6-12 years old in Thailand.	"Isaranurug S, Chompikul J."	Maternal and Child Health Journal. 2009;13(1):138-43.		"Objective: To explore the emotional development and nutritional status of HIV/AIDS orphans by their infection status. Methods: A community-based cross-sectional survey was conducted during January and December 2005 in four provinces and Bangkok Metropolis where the prevalence of HIV/AIDS among pregnant women was high. The study population consisted of 388 HIV/AIDS orphans who were maternal or paternal or double orphans aged 6-12 years old. The orphans' main caregivers gave informed consent to the project and assessed the emotional development of their orphaned children. The children were measured for weight, height, and emotional development by standard instruments. They were divided into three groups regarding their HIV/AIDS infection status reported by their caregivers: infected, non-infected, and unknown. The chi<sup>2</sup> test was used to determine the association between nutritional status and infection status. Results: Regarding HIV/AIDS infected children, 19.1% were infected, 57.5% were not infected, and 23.4% were unknown. The main caregivers of all types of orphans were grandparents. Only 13.7% of infected orphans lived with their mothers. Most caregivers were females and more than 40 years old. Infected orphans had mean scores of overall emotional development and for each domain less than other groups. The mean scores of self-control and quick recovery were significantly different between infected and non-infected groups (P-value < 0.05). Nearly 50% of infected orphans were rather short and approximately 42% were under weight and light. The findings revealed a significant association between height for age, weight for age and infection status of orphans at a P-value of <0.001. Conclusions: Orphanhood itself is a vulnerable status and HIV/AIDS infected orphans are most vulnerable. Acceptable and friendly services for orphans and their families are crucial. The services should continue and protect stigmatization. Springer Science+Business Media, LLC 2008."									
1913	Nutritional supplementation: the additional costs of managing children infected with HIV in resource-constrained settings.	"Cobb G, Bland RM."	Tropical Medicine & International Health. 2013;18(1):45-52.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=23107420	OBJECTIVE: To explore the financial implications of applying the WHO guidelines for the nutritional management of HIV-infected children in a rural South African HIV programme.	"METHODS: WHO guidelines describe Nutritional Care Plans (NCPs) for three categories of HIV-infected children: NCP-A: growing adequately; NCP-B: weight-for-age z-score (WAZ) <=-2 but no evidence of severe acute malnutrition (SAM), confirmed weight loss/growth curve flattening, or condition with increased nutritional needs (e.g. tuberculosis); NCP-C: SAM. In resource-constrained settings, children requiring NCP-B or NCP-C usually need supplementation to achieve the additional energy recommendation. We estimated the proportion of children initiating antiretroviral treatment (ART) in the Hlabisa HIV Programme who would have been eligible for supplementation in 2010. The cost of supplying 26-weeks supplementation as a proportion of the cost of supplying ART to the same group was calculated."	"RESULTS: A total of 251 children aged 6 months to 14 years initiated ART. Eighty-eight required 6-month NCP-B, including 41 with a WAZ <=-2 (no evidence of SAM) and 47 with a WAZ >-2 with co-existent morbidities including tuberculosis. Additionally, 25 children had SAM and required 10-weeks NCP-C followed by 16-weeks NCP-B. Thus, 113 of 251 (45%) children were eligible for nutritional supplementation at an estimated overall cost of $11 136, using 2010 exchange rates. These costs are an estimated additional 11.6% to that of supplying 26-week ART to the 251 children initiated."	"CONCLUSIONS: It is essential to address nutritional needs of HIV-infected children to optimise their health outcomes. Nutritional supplementation should be integral to, and budgeted for, in HIV programmes. 2012 Blackwell Publishing Ltd."						
1802	Perceptions of body size and its association with HIV/AIDS.	"Matoti-Mvalo T, Puoane T."	South African Journal of Clinical Nutrition. 2011;24(1):40-5.		"Objective: To explore the perception among black South African women that people who are thin are infected with HIV or have AIDS. Setting: Khayelitsha, an urban township in Cape Town. Subjects: 513 women aged 18-65 years. Methods: This was an exploratory study employing both quantitative and qualitative research methodology. Data were collected in two phases. The first phase involved collecting quantitative data among 513 participants. During the second phase, qualitative data were collected in a purposely selected sub-sample of 20 women. For the qualitative data collection, participants were shown eight body figures, ranging from thin to obese, and asked to choose a figure representing the ideal figure, a preferred figure and a figure thought to symbolise health. They were also invited to choose a figure that they thought represented a person infected with HIV or who had AIDS. They had the option of saying that they did not associate any of the figures with people infected with HIV or who had AIDS. Weight and height measurements were also taken. After the quantitative analysis was completed, focus group discussions explored perceptions about body image and the relation to HIV among purposely selected participants. Data were summarised by content based on questions discussed. Results: Sixty-nine per cent of the participants associated a thin figure with a person infected with HIV, or who had AIDS. Only 10.2% thought the thin figure symbolised health. Fifty per cent preferred a normal-weight figure, while 34.2% thought that normal weight symbolised health. Only 2% thought that people in the normal-weight category were infected with HIV or had AIDS. Thirty-four per cent preferred to be overweight and 31% thought that being overweight symbolised health. None of the participants thought the overweight figure represented people infected with HIV or who had AIDS. Only 8% preferred the obese figure. The results of the qualitative data analysis suggested that participants preferred to be overweight and at risk of acquiring cardiovascular diseases, rather than being thin and stigmatised as a person infected with HIV or who had AIDS. Conclusion: This study revealed that the stigma associated with HIV and AIDS may undermine strategies for prevention of chronic noncommunicable diseases among urban black South African women. SAJCN."									
82	Predictors of weight loss after HAART initiation among HIV-infected adults in Tanzania.	"Li N, Spiegelman D, Drain P, Mwiru RS, Mugusi F, Chalamilla G, Fawzi WW."	AIDS. 2012;26(5):577-85.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=22156968	"OBJECTIVE: To explore the predictors of weight loss after highly active antiretroviral therapy (HAART) initiation in a large cohort of HIV-infected adults living in Dar es Salaam, Tanzania."	DESIGN: Cross-sectional and longitudinal analysis of a cohort of HIV-infected adults on HAART.	"METHODS: HIV-infected adults (n = 18 965) were enrolled between November 2004 to December 2009 in Dar es Salaam, Tanzania. Log-binomial regression and Cox proportional hazard regression were used to explore the predictors of short-term (3 months) and long-term significant weight loss (>= 5%) after HAART initiation."	"RESULTS: At 3 months after HAART initiation, 8% patients lost greater than or equal to 5% weight. Underweight patients at initiation gained more weight than other body mass index (BMI) groups. Younger or older than age group 30-39, lower socioeconomic status (SES), higher BMI, lower hemoglobin, difficulty breathing, loss of appetite, nausea/vomiting at baseline were associated with the risk of significant weight loss at 3 months after initiation. During a median follow-up period of 10 months [interquartile range (IQR) 4-20 months], 31% patients had experienced an initial significant weight loss after HAART initiation. In addition to time-varying CD4 cell count and hemoglobin level, age, sex, baseline BMI and having loss of appetite, and nausea/vomiting at baseline were associated with the risk of long-term significant weight loss."	"CONCLUSION: Our study suggested that a significant percentage of patients continue to lose weight after HAART initiation. Our findings on the effect of socio-demographics, symptoms and diseases, biomedical indicators in relation to weight loss provide important information that has significant practical implications."					
705	"Predictors of stunting, wasting, and underweight among infants born to HIV-infected women in Tanzania."	"McDonald C, Kupka R, Manji KP, Okuma J, Bosch RJ, Fawzi WW, Duggan C."	FASEB Journal. 2011 April;25.		"Objective: To identify child, maternal, and socioeconomic (SES) predictors of stunting, wasting, and underweight among 2387 Tanzanian infants born to HIV-infected women using sdNVP. Methods: Maternal and SES data were recorded on enrollment, birth data were collected immediately after delivery, HIV test and morbidity history were performed at 6 wks, anthropometrics were measured monthly until age 24 mo. Results: The respective prevalence of prematurity (< 37 wks) and low birthweight (LBW) (<2500 g) was 52% and 7%; 12% of infants tested HIV-positive at 6 wks. Median time to first episode of stunting, wasting, and underweight was 26.4, 28.9, and 25.7 wks, respectively. The risk of each outcome was increased among male, premature, and LBW infants. HIV-positive infants were 2.45 (95% CI 2.01, 2.99), 2.42 (1.97, 2.98), and 3.31 (2.74, 4.01) times more likely to become stunted, wasted, and underweight, respectively. Cough and fever predicted wasting, whereas household possessions were inversely associated with stunting and underweight. As maternal education rose from 0 to 1-4, 5-8, and >8 yrs, the respective risk of stunting fell by 5%, 9%, and 34% (p=.01). Conclusions: Knowledge that male sex, prematurity, LBW, child HIV infection, and low maternal education are predictors of undernutrition can guide the design and targeting of interventions for HIV-exposed children."									
1184	Pneumonia and malnutrition are highly predictive of mortality among African children hospitalized with human immunodeficiency virus infection or exposure in the era of antiretroviral therapy.	"Preidis GA, McCollum ED, Mwansambo C, Kazembe PN, Schutze GE, Kline MW."	Journal of Pediatrics. 2011;159(3):484-9.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=21489553	OBJECTIVE: To identify clinical characteristics predicting death among inpatients who are infected with or exposed to human immunodeficiency virus (HIV) during a period of pediatric antiretroviral therapy scale-up in sub-Saharan Africa.	"STUDY DESIGN: Retrospective review of medical records from every child with HIV infection (n = 834) or exposure (n = 351) identified by routine inpatient testing in Kamuzu Central Hospital, Lilongwe, Malawi, September 2007 through December 2008."	"RESULTS: The inpatient mortality rate was high among children with HIV infection (16.6%) and exposure (13.4%). Clinically diagnosed Pneumocystis pneumonia or very severe pneumonia independently predicted death in inpatients with HIV infection (OR 14; 95% CI 8.2 to 23) or exposure (OR 21; CI 8.4 to 50). Severe acute malnutrition independently predicted death in children who are HIV infected (OR 2.2; CI 1.7 to 3.9) or exposed (OR 5.1; CI 2.3 to 11). Other independent predictors of death were septicemia, Kaposi sarcoma, meningitis, and esophageal candidiasis for children infected with HIV, and meningitis and severe anemia for inpatients exposed to HIV."	"CONCLUSIONS: Severe respiratory tract infections and malnutrition are both highly prevalent and strongly associated with death among hospitalized children who are HIV infected or exposed. Novel programmatic and therapeutic strategies are urgently needed to reduce the high mortality rate among inpatients with HIV infection and HIV exposure in African pediatric hospitals. Copyright 2011 Mosby, Inc. All rights reserved."						
872	Clinical predictors cannot replace biological predictors in HIV-2 infection in a community setting in West Africa.	"Gourlay AJ, Tienen Cv, Dave SS, Vincent T, Rowland-Jones SL, Glynn JR, Whittle HC, et al."	International Journal of Infectious Diseases. 2012;16(5):e337-e43.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20123141957	"Objective: To identify clinical predictors of mortality in HIV-2-infected individuals that may be used in place of CD4 count or plasma viral load (PVL) to guide treatment management in resource-limited settings. Methods: A prospective community cohort study of HIV-infected and HIV-negative individuals in a rural area of Guinea-Bissau has been ongoing since 1989. In 2003 participants were invited for a clinical examination and blood tests. They were followed-up for vital status until 2010. Antiretroviral treatment (ART) became available in 2007. Cox regression was used to examine the association of clinical measures (World Health Organization (WHO) stage, body mass index (BMI), mid-upper arm circumference (MUAC), and WHO performance scale) measured in 2003 with subsequent mortality. Results: In 2003, 146 HIV-2-infected individuals (68% women; mean age 56 years) were examined. Over the next 7 years, 44 (30%) died. BMI <18.5 kg/m<sup>2</sup> was associated with a crude mortality hazard ratio (HR) of 1.9 (95% confidence interval (CI) 1.0-3.9, p=0.08); adjusted for age and sex, HR 1.8 (95% CI 0.9-3.8, p=0.1). MUAC <230 mm in women and <240 mm in men was also associated with an elevated mortality HR, though statistical evidence was weak (crude HR 2.2, 95% CI 0.9-5.3, p=0.1). WHO clinical stage and WHO performance scale were not associated with mortality (p=0.6 and p=0.2, respectively, for crude associations). Conclusions: Baseline BMI, MUAC, WHO stage, and WHO performance scale were not strong or statistically significant predictors of mortality among HIV-2-infected individuals. CD4 count and PVL are more reliable tools, when available, for the management of HIV-2-infected patients in the community setting."									
873	Clinical predictors cannot replace biological predictors in HIV-2 infection in a community setting in West Africa.	"Gourlay AJ, van Tienen C, Dave SS, Vincent T, Rowland-Jones SL, Glynn JR, Whittle HC, et al."	International Journal of Infectious Diseases. 2012 May;16(5):e337-e43.		"Objective: To identify clinical predictors of mortality in HIV-2-infected individuals that may be used in place of CD4 count or plasma viral load (PVL) to guide treatment management in resource-limited settings. Methods: A prospective community cohort study of HIV-infected and HIV-negative individuals in a rural area of Guinea-Bissau has been ongoing since 1989. In 2003 participants were invited for a clinical examination and blood tests. They were followed-up for vital status until 2010. Antiretroviral treatment (ART) became available in 2007. Cox regression was used to examine the association of clinical measures (World Health Organization (WHO) stage, body mass index (BMI), mid-upper arm circumference (MUAC), and WHO performance scale) measured in 2003 with subsequent mortality. Results: In 2003, 146 HIV-2-infected individuals (68% women; mean age 56 years) were examined. Over the next 7 years, 44 (30%) died. BMI<18.5kg/m<sup>2</sup> was associated with a crude mortality hazard ratio (HR) of 1.9 (95% confidence interval (CI) 1.0-3.9, p=0.08); adjusted for age and sex, HR 1.8 (95% CI 0.9-3.8, p=0.1). MUAC <230mm in women and <240mm in men was also associated with an elevated mortality HR, though statistical evidence was weak (crude HR 2.2, 95% CI 0.9-5.3, p=0.1). WHO clinical stage and WHO performance scale were not associated with mortality (p=0.6 and p=0.2, respectively, for crude associations). Conclusions: Baseline BMI, MUAC, WHO stage, and WHO performance scale were not strong or statistically significant predictors of mortality among HIV-2-infected individuals. CD4 count and PVL are more reliable tools, when available, for the management of HIV-2-infected patients in the community setting. 2012 International Society for Infectious Diseases."									
448	Body composition and lipodystrophy in prepubertal HIV-infected children.	"Palchetti CZ, Patin RV, Gouvea ADFTB, Szejnfeld VL, Succi RCDM, Oliveira FLC."	Brazilian Journal of Infectious Diseases. 2013 January;17(1):1-6.		"Objective: To identify lipodystrophy in prepubertal HIV-infected children using anthropometric parameters and body composition assessment. Methods: Cross-sectional study including 40 prepubertal HIV-infected children of both genders seen at the Care Center of the Division of Pediatric Infectious Diseases - Universidade Federal de Sao Paulo, Sao Paulo city, Brazil, was carried out from August to December 2008. Age, clinical and immunological status, prophylaxis, transmission and highly active antiretroviral therapy were recorded. Body mass index z-score and height-for-age z-score were calculated to characterize the nutritional status. Circumferences were measured with flexible tape and skinfolds were assessed by an adipometry. Fat mass and lean mass were determined by dual-energy X-ray absorptiometry. Presence of clinical signs of lipodystrophy was assessed by a trained clinician. Data were analyzed using SPSS 12.0 software. Results: The mean age and standard deviation were 9.8 (1.2) years, 50% were girls and 82.5% children from B and C categories. Clinical lipodystrophy and dislypidemia were present in 27.5% and 70%, respectively. The trunk to arm ratio and the limb to trunk ratio had positive association with lipodystrophy. Patients with lipodystrophy had short stature, higher triglycerides values and lower HDL-cholesterol. Conclusion: The ratios obtained by skinfolds and dual-energy X-ray absorptiometry measurements can be considered as indicators of preclinical lipodystrophy. The cutoff points have not been determined yet; however, continuous assessment may be useful to identify early body composition changes. 2013 Elsevier Editora Ltda."									
706	Morbidity and undernutrition are associated with impaired neurodevelopment among HIV-exposed infants in Tanzania.	"McDonald C, Manji K, Spiegelman D, Bellinger D, Kisenge R, Msamanga G, Fawzi W, et al."	FASEB Journal. 2012 April;26.		"Objective: To identify maternal, socioeconomic (SES), and child predictors of neurodevelopmental status among 311 Tanzanian infants born to HIV-infected women. Methods: Maternal and SES data were recorded during pregnancy, HIV status was assessed at 6 weeks then every 3 months, morbidity and anthropometrics were assessed monthly, and the Bayley Scales of Infant Development-II were administered at 6, 12, and 18 months. Results: 10.3% of infants were HIV-positive at 6 wks. Mean Psychomotor Development Index (PDI) and Mental Development Index (MDI) scores were 94.0 +/- 14.7 and 93.6 +/- 16.1, respectively. In multivariate analyses, having 3 episodes of cough and fever, stunting, or underweight lowered PDI scores by 5.82 (95% CI -9.89, -1.74), 6.26 (-11.22, -1.18), and 6.33 (-11.03, -1.63) and MDI scores by 8.77 (-12.37, -5.16), 4.78 (-8.99, -0.57), and 6.43 (-11.27, -1.60), respectively. Mean PDI scores were higher among infants whose mothers had elevated depressive symptoms, preterm and HIV-negative infants; MDI scores were higher among infants whose mothers had a low mid-upper arm circumference, those born preterm, with a low birthweight, low vitamin B12 levels, and few episodes of diarrhea. Conclusions: Preventing and treating child illnesses and undernutrition could improve the neurodevelopment of HIV-exposed infants."									
1921	Micronutrient status indicators in individuals single- or double-infected with HIV and Wuchereria bancrofti before and after DEC treatment.	"Nielsen NO, Simonsen PE, Kaestel P, Krarup H, Magnussen P, Magesa S, Friis H."	Tropical Medicine & International Health. 2009;14(1):44-53.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=19017312	"OBJECTIVE: To identify possible associations between selected micronutrient status indicators (serum ferritin, retinol, beta-carotene, alpha-tocopherol, and the acute phase reactant alpha-1 antichymotrypsin) and infection with human immunodeficiency virus (HIV) or Wuchereria bancrofti, and to assess the effect of the antifilarial drug diethylcarbamazine (DEC) on the micronutrient status indicators in individuals positive for one or both of the two infections."	"METHODS: Serum concentrations of ferritin, retinol, beta-carotene, alpha-tocopherol and the acute phase reactant alpha-1 antichymotrypsin were examined in 59 individuals with HIV, W. bancrofti infection, or both, in Tanga Region, Tanzania, before and 12 weeks after treatment with DEC."	"RESULTS: HIV infection, but not W. bancrofti infection, was associated with higher serum ferritin concentrations and lower beta-carotene and alpha-tocopherol. Neither HIV infection nor W. bancrofti infection was associated with serum retinol. The four micronutrient status indicators and alpha-1 antichymotrypsin were generally lower at 12 weeks after treatment both in the DEC and the placebo groups."	"CONCLUSIONS: The negative association between HIV infection and the antioxidant vitamins beta-carotene and alpha-tocopherol may be due to infection-induced oxidative stress, whereas W. bancrofti infection seemed not to be associated with oxidative stress. The drop in antioxidant vitamin concentrations after treatment may be due to oxidative stress induced by HIV progression (HIV infected) and inflammation around dead adult worms and microfilariae (W. bancrofti infected) rather than to an effect of DEC."						
264	"Recombinant human growth hormone, insulin-like growth factor 1, and combination therapy in AIDS-associated wasting. A randomized, double-blind, placebo-controlled trial."	"Waters D, Danska J, Hardy K, Koster F, Qualls C, Nickell D, Nightingale S, et al."	Annals of Internal Medicine. 1996;125(11):865-72.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=8967666	"OBJECTIVE: To increase lean body mass and improve health status in patients with wasting associated with the acquired immunodeficiency syndrome (AIDS) by treatment with recombinant human growth hormone (rhGH), recombinant human insulin-like growth factor 1 (rhIGF-1), or both."	"DESIGN: Randomized, double-blind, placebo-controlled clinical trial."	SETTING: University of New Mexico Clinical Research Center and University of Texas Southwestern Medical Center.	PATIENTS: 60 patients with AIDS and wasting as defined by the Centers for Disease Control and Prevention. Patients were divided into four groups of 15 patients each.	INTERVENTION: Group 1 received 1.4 mg of rhGH once daily plus placebo twice daily; group 2 received 5 mg of rhIGF-1 twice daily plus placebo once daily; group 3 received 5 mg of rhIGF-1 twice daily plus 1.4 mg of rhGH once daily; and group 4 received placebo three times daily.	"MEASUREMENTS: Body weight, body composition, muscle strength, protein catabolism, quality of life, and immune status were assessed at baseline, and changes in these variables were measured at 6 and 12 weeks."	"RESULTS: At 6 weeks, lean body mass had increased and total fat mass had decreased in the groups receiving rhGH, rhIGF-1, or both. Group 3 had the greatest changes in lean body mass (mean +/- SE, 3.2 +/- 0.59 kg; P < 0.001); only in this group were changes in body mass maintained at 12 weeks. Only patients in group 1 had improvement in muscular strength of the knees and upper body (P = 0.04) and quality of life (P = 0.01). Immunologic function did not improve in any group."	"CONCLUSIONS: Growth factor therapy had significantly increased lean body mass and decreased fat mass by 6 weeks, but these improvements persisted for 12 weeks only in group 3. Growth factor therapy at the dosages used in this study is not recommended because the magnitude of weight gain was modest and improvements in quality-of-life measures varied."		
884	Changes in body mass index in rural and urban black adults in South Africa.	"Salome Kruger H, Moss SJ, Vorster HH, Wentzel-Viljoen E, Kruger A."	International Journal of Obesity. 2011 May;35:S20-S1.		"Objective: To investigate changes in body composition over 5 years in rural and urban black South African adults and predictors of change in body mass index (BMI). Methods: Longitudinal study of 848 women and 432 men, aged >35 y at baseline. Anthropometric measurements were done at baseline and after 5 years and HIV status was measured. Dietary intakes were measured by quantitative food frequency questionnaire and physical activity (PA) by Baecke questionnaire. Results: BMI and waist circumference (WC) increased signifi cantly over 5 years in urban and rural men and women. Effect sizes were small, with the greatest increase in BMI in rural women. Prevalence of overweight/obesity increased in both men (14-18%) and women (53-60%). Prevalence of underweight remained stable among men, but declined in women (12-9%). HIV infected persons showed no change in BMI over the 5 years. There were no significant differences between body composition of rural and urban men, but urban women had a significantly greater BMI and WC than rural women and were significantly less active. The most significant predictor of change in BMI in both men and women were age. Conclusion: Overweight/obesity is high among African women and increase further with age, especially in rural areas."									
74	Genetic polymorphisms in estrogen receptors and sexual dimorphism in fat redistribution in HIV-infected patients on HAART.	"Gasparotto AS, Sprinz E, Lazzaretti RK, Kuhmmer R, Silveira JM, Basso RP, Pinheiro CAT, et al."	Aids. 2012 02 Jan;26(1):19-26.		"Objective: To investigate genetic single nucleotide polymorphisms (SNPs) in estrogen receptor-alpha (ERalpha) (ESR1, rs2234693, rs1801132, rs7757956 and rs2813544) and ERbeta (ESR2, rs3020450, rs7154455 and rs4986938) genes and relate them to the adverse effects lipodystrophy, dyslipidemia and metabolic syndrome as well as to differences in their prevalence between sexes in HIV-infected individuals on HAART. Design: Cross-sectional study. Methods: Blood samples and anthropometric measurements were collected from 614 patients at reference services in the cities of Porto Alegre, Pelotas and Rio Grande in Brazil. The SNPs were genotyped by real-time PCR. Results: The lipodystrophy subtype frequencies in patients of different sexes showed statistically significant differences; the atrophic pattern was more prevalent in men, and the hypertrophic pattern was more prevalent in women. Furthermore, metabolic syndrome prevalence was higher in women than in men. The ESR1 rs2813544 G-allele was associated with higher measurements of several anthropometric variables in women: BMI, total subcutaneous fat and subcutaneous fat of limbs. Additionally, patients who were AA homozygous for ESR2 rs3020450 presented an increased risk for developing lipoatrophy (prevalence ratio 1.37, 95% confidence interval 1.09-1.73, P=0.007). Conclusion: Significant differences in lipodystrophy and metabolic syndrome prevalence were detected between sexes. Moreover, the ESR1 gene (rs2813544) presented significant sex-specific associations with anthropometric variables, and the ESR2 gene (rs3020450) was associated with an increased risk of developing lipoatrophy. Our results suggest that these genes are in part responsible for the sexual dimorphism in fat tissue redistribution and patterns of lipodystrophy. 2011 Wolters Kluwer Health."									
296	Nevirapine concentrations in HIV-infected children treated with divided fixed-dose combination antiretroviral tablets in Malawi and Zambia.	"Ellis JC, L'Homme R FA, Ewings FM, Mulenga V, Bell F, Chileshe R, Molyneux E, et al."	Antiviral Therapy. 2007;12(2):253-60.		"Objective: To investigate nevirapine concentrations in African HIV-infected children receiving divided Triomune tablets (stavudine+lamivudine+nevirapine). Design: Cross-sectional study. Methods: Steady-state plasma nevirapine concentrations were determined in Malawian and Zambian children aged 8 months to 18 years receiving Triomune in routine outpatient settings. Predictors from height-for-age, body mass index (BMI)-for-age, age, sex, post-dose sampling time and dose/m<sup>2</sup>/day were investigated using centrestratified regression with backwards elimination (P<0.1). Results: Of the 71 Malawian and 56 Zambian children (median age 8.4 vs 8.5 years, height-for-age -3.15 vs -1.84, respectively), only 1 (3%) of those prescribed 2300 mg/m<sup>2</sup>/day nevirapine had subtherapeutic concentrations (<3mg/l) compared with 22 (23%) of those prescribed <300 mg/m<sup>2</sup>/day; most children with subtherapeutic nevirapine concentrations were taking half or quarter Triomune tablets. Lower nevirapine concentrations were independently associated with lower height-for-age (indicating stunting) (0.37 mg/l per unit higher [95% confidence interval (CI): -0.003, +0.74]; P=0.05), lower prescribed dose/m <sup>2</sup> (+0.89 mg/l per 50mg/m<sup>2</sup> higher [95% CI: 0.32, 1.46]; P=0.002) and higher BMI-for-age (indicating lack of wasting) (-0.42mg/l per unit higher [95% CI: -0.80, -0.04]; P=0.03). Conclusions: Currently available adult fixed-dose combination tablets are not well suited to children, particularly at younger ages: Triomune 30 is preferable to Triomune 40 because of the higher dose of nevirapine relative to stavudine. Further research is required to confirm that concentrations are reduced in stunted children but increased in wasted children. Development of appropriate paediatric fixed-dose combination tablets is essential if antiretroviral therapy is to be made widely available to children in resource-limited settings. 2007 International Medical Press."									
1930	Increased mortality of male adults with AIDS related to poor compliance to antiretroviral therapy in Malawi.	"Chen C, Yu K, Harries AD, Bong C, Kolola-Dzimadzi R, Tok T, King C, et al."	Tropical Medicine and International Health. 2008;13(4):513-9.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20083143942	"OBJECTIVE: To investigate the effect of gender on mortality of HIV-infected adults receiving antiretroviral therapy (ART) and its possible reasons. METHODS: A retrospective study to review the records for outcomes of adult cases receiving ART at Mzuzu Central Hospital, Malawi, between July 2004 and December 2006. RESULTS: Over the study period, 2838 adult AIDS patients received ART. Of these, 2029 (71.5%) were alive and still on ART, 376 (13.2%) were dead and 433 (15.3%) were lost to follow-up. Survival analysis with Kaplan-Meier estimator showed significantly higher survival rates among females than males in WHO stage 1, 2 and 3 (both P<0.0001) and borderline in stage 4 (P=0.076). The Cox model revealed a death hazard ratio (males vs. females) of 1.70 (95% confidence interval 1.35-2.15) after controlling for WHO clinical stages, body mass index and age. More men than women were lost to follow-up in all occupations except health workers. CONCLUSIONS: The most important reasons for a higher mortality in male patients starting ART may relate to their seeking medical care at a more advanced stage of immunodeficiency and poorer compliance with therapy. The issue needs to be addressed in scaling up ART programmes in Africa."									
1931	Increased mortality of male adults with AIDS related to poor compliance to antiretroviral therapy in Malawi.	"Chen SCC, Yu JKL, Harries AD, Bong CN, Kolola-Dzimadzi R, Tok TS, King CC, et al."	Tropical Medicine and International Health. 2008 April;13(4):513-9.		"Objective: To investigate the effect of gender on mortality of HIV-infected adults receiving antiretroviral therapy (ART) and its possible reasons. Methods: A retrospective study to review the records for outcomes of adult cases receiving ART at Mzuzu Central Hospital, Malawi, between July 2004 and December 2006. Results: Over the study period, 2838 adult AIDS patients received ART. Of these, 2029 (71.5%) were alive and still on ART, 376 (13.2%) were dead and 433 (15.3%) were lost to follow-up. Survival analysis with Kaplan-Meier estimator showed significantly higher survival rates among females than males in WHO stage 1, 2 and 3 (both P < 0.0001) and borderline in stage 4 (P = 0.076). The Cox model revealed a death hazard ratio (males vs. females) of 1.70 (95% confidence interval 1.35-2.15) after controlling for WHO clinical stages, body mass index and age. More men than women were lost to follow-up in all occupations except health workers. Conclusions: The most important reasons for a higher mortality in male patients starting ART may relate to their seeking medical care at a more advanced stage of immunodeficiency and poorer compliance with therapy. The issue needs to be addressed in scaling up ART programmes in Africa. 2008 Blackwell Publishing Ltd."									
439	"Supplementary feeding with either ready-to-use fortified spread or corn-soy blend in wasted adults starting antiretroviral therapy in Malawi: randomised, investigator blinded, controlled trial."	"Ndekha MJ, van Oosterhout JJ, Zijlstra EE, Manary M, Saloojee H, Manary MJ."	BMJ. 2009;338:b1867.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=19465470	OBJECTIVE: To investigate the effect of two different food supplements on body mass index (BMI) in wasted Malawian adults with HIV who were starting antiretroviral therapy.	"DESIGN: Randomised, investigator blinded, controlled trial."	"SETTING: Large, public clinic associated with a referral hospital in Blantyre, Malawi."	PARTICIPANTS: 491 adults with BMI <18.5.	INTERVENTIONS: Ready-to-use fortified spread (n=245) or corn-soy blend (n=246).	"MAIN OUTCOME MEASURES: Primary outcomes: changes in BMI and fat-free body mass after 3.5 months. Secondary outcomes: survival, CD4 count, HIV viral load, quality of life, and adherence to antiretroviral therapy."	"RESULTS: The mean BMI at enrolment was 16.5. After 14 weeks, patients receiving fortified spread had a greater increase in BMI and fat-free body mass than those receiving corn-soy blend: 2.2 (SD 1.9) v 1.7 (SD 1.6) (difference 0.5, 95% confidence interval 0.2 to 0.8), and 2.9 (SD 3.2) v 2.2 (SD 3.0) kg (difference 0.7 kg, 0.2 to 1.2 kg), respectively. The mortality rate was 27% for those receiving fortified spread and 26% for those receiving corn-soy blend. No significant differences in the CD4 count, HIV viral load, assessment of quality of life, or adherence to antiretroviral therapy were noted between the two groups."	CONCLUSION: Supplementary feeding with fortified spread resulted in a greater increase in BMI and lean body mass than feeding with corn-soy blend.	TRIAL REGISTRATION: Current Controlled Trials ISRCTN67515515.	
438	"Supplementary feeding with either ready-to-use fortified spread or corn-soy blend in wasted adults starting antiretroviral therapy in Malawi: randomised, investigator blinded, controlled trial."	"Ndekha MJ, Oosterhout JJGv, Zijlstra EE, Manary M, Saloojee H, Manary MJ."	Bmj. 2009;338(b1867).	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20093200698	"Objective: To investigate the effect of two different food supplements on body mass index (BMI) in wasted Malawian adults with HIV who were starting antiretroviral therapy. Design: Randomised, investigator blinded, controlled trial. Setting: Large, public clinic associated with a referral hospital in Blantyre, Malawi. Participants: 491 adults with BMI<18.5. Interventions: Ready-to-use fortified spread (n=245) or corn-soy blend (n=246). Main outcome measures: Primary outcomes: changes in BMI and fat-free body mass after 3.5 months. Secondary outcomes: survival, CD4 count, HIV viral load, quality of life, and adherence to antiretroviral therapy. Results: The mean BMI at enrolment was 16.5. After 14 weeks, patients receiving fortified spread had a greater increase in BMI and fat-free body mass than those receiving corn-soy blend: 2.2 (SD 1.9) v 1.7 (SD 1.6) (difference 0.5, 95% confidence interval 0.2 to 0.8), and 2.9 (SD 3.2) v 2.2 (SD 3.0) kg (difference 0.7 kg, 0.2 to 1.2 kg), respectively. The mortality rate was 27% for those receiving fortified spread and 26% for those receiving corn-soy blend. No significant differences in the CD4 count, HIV viral load, assessment of quality of life, or adherence to antiretroviral therapy were noted between the two groups. Conclusion: Supplementary feeding with fortified spread resulted in a greater increase in BMI and lean body mass than feeding with corn-soy blend."									
440	"Supplementary feeding with either ready-to-use fortified spread or corn-soy blend in wasted adults starting antiretroviral therapy in Malawi: Randomised, investigator blinded, controlled trial."	"Ndekha MJ, Van Oosterhout JJG, Zijlstra EE, Manary M, Saloojee H, Manary MJ."	Bmj. 2009 30 May;338(7706):1309-11.		"Objective: To investigate the effect of two different food supplements on body mass index (BMI) in wasted Malawian adults with HIV who were starting antiretroviral therapy. Design: Randomised, investigator blinded, controlled trial. Setting: Large, public clinic associated with a referral hospital in Blantyre, Malawi. Participants: 491 adults with BMI <18.5. Interventions: Ready-to-use fortified spread (n=245) or corn-soy blend (n=246). Main outcome measures: Primary outcomes: changes in BMI and fat-free body mass after 3.5 months. Secondary outcomes: survival, CD4 count, HIV viral load, quality of life, and adherence to antiretroviral therapy. Results: The mean BMI at enrolment was 16.5. After 14 weeks, patients receiving fortified spread had a greater increase in BMI and fat-free body mass than those receiving corn-soy blend: 2.2 (SD 1.9) v 1.7 (SD 1.6) (difference 0.5, 95% confidence interval 0.2 to 0.8), and 2.9 (SD 3.2) v 2.2 (SD 3.0) kg (difference 0.7 kg, 0.2 to 1.2 kg), respectively. The mortality rate was 27% for those receiving fortified spread and 26% for those receiving corn-soy blend. No significant differences in the CD4 count, HIV viral load, assessment of quality of life, or adherence to antiretroviral therapy were noted between the two groups. Conclusion: Supplementary feeding with fortified spread resulted in a greater increase in BMI and lean body mass than feeding with corn-soy blend. Trial registration: Current Controlled Trials ISRCTN67515515."									
1656	Maternal micronutrient status and decreased growth of Zambian infants born during and after the maize price increases resulting from the southern African drought of 2001-2002.	"Gitau R, Makasa M, Kasonka L, Sinkala M, Chintu C, Tomkins A, Filteau S."	Public Health Nutrition. 2005;8(7):837-43.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=16277799	OBJECTIVE: To investigate the effects on maternal micronutrient status and infant growth of the increased maize prices that resulted from the southern African drought of 2001-2002.	DESIGN: Longitudinal cohort study.	"SETTING: A maternal and child health clinic in Lusaka, Zambia."	"SUBJECTS: Maternal and infant health and nutrition data and maternal plasma were being collected for a study of breast-feeding and postpartum health. Samples and data were analysed according to whether they were collected before (June to December 2001), during (January 2002 to April 2003) or after (May 2003 to January 2004) the period of increased maize price. Season and maternal HIV status were controlled for in analyses."	"RESULTS: Maize price increases were associated with decreased maternal plasma vitamin A during pregnancy (P = 0.028) and vitamin E postpartum (P = 0.042), with the lowest values among samples collected after May 2003 (vitamin A: 0.96 micromol l(-1), 95% confidence interval (CI) 0.84-1.09, n = 38; vitamin E: 30.8 micromol mmol(-1) triglycerides, 95% CI 27.2-34.8, n = 64) compared with before January 2002 (vitamin A: 1.03 micromol l(-1), 95% CI 0.93-1.12, n = 104; vitamin E: 38.9 micromol mmol(-1) triglycerides, 95% CI 34.5-43.8, n = 47). There were no significant effects of sampling date on maternal weight, haemoglobin or acute-phase proteins and only marginal effects on infant weight. Infant length at 6 and 16 weeks of age decreased progressively throughout the study (P-values for time of data collection were 0.51 at birth, 0.051 at 6 weeks and 0.026 at 16 weeks)."	CONCLUSIONS: The results show modest effects of the maize price increases on maternal micronutrient status. The most serious consequence of the price increases is likely to be the increased stunting among infants whose mothers experienced high maize prices while pregnant. During periods of food shortages it might be advisable to provide micronutrient supplements even to those who are less food-insecure.				
1666	"Food fortification improves the intake of all fortified nutrients, but fails to meet the estimated dietary requirements for vitamins A and B6, riboflavin and zinc, in lactating South African women."	"Papathakis PC, Pearson KE."	Public Health Nutrition. 2012;15(10):1810-7.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=22874138	OBJECTIVE: To investigate the impact of fortification by comparing food records and selected biochemical indicators of nutritional status pre- and post-fortification.	"DESIGN: Mean intake from 24 h recalls (n 142) was compared with the Estimated Average Requirement (EAR) to determine the proportion with inadequate intake. In a subsample (n 34), diet and serum retinol, folate, ferritin and Zn were compared pre- and post-fortification for fortified nutrients vitamin A, thiamin, riboflavin, niacin, folic acid, Fe and Zn."	SETTING: South Africa.	"SUBJECTS: Breast-feeding women (ninety-four HIV-infected, forty eight HIV-uninfected) measured at ~6, 14, 24 weeks, and 9 and 12 months postpartum."	"RESULTS: Pre-fortification, >80 % of women did not meet the EAR for vitamins A, C, D, thiamin, riboflavin, niacin, B6, B12 and folate and minerals Zn, iodine and Ca. Dietary intake post-fortification increased for all fortified nutrients. In post-fortification food records, >70 % did not meet the EAR for Zn and vitamins A, riboflavin and B6. Serum folate and Zn increased significantly post-fortification (P < 0.001 for both), with no change in ferritin and a reduction in retinol. Post-fortification marginal/deficient folate status was reduced (73.5 % pre v. 3.0 % post; P < 0.001), as was Zn deficiency (26.5 % pre v. 5.9 % post; P < 0.05). Pre- and post-fortification, >93 % were retinol replete. There was no change in Fe deficiency (16.7 % pre v. 19.4 % post; P = 0.728)."	"CONCLUSIONS: Micronutrient intake improved with fortification, but >70 % of lactating women did not meet the EAR for Zn, vitamins A, riboflavin and B6. Although 100 % exceeded the EAR for Fe after fortification, Fe status did not improve."				
1667	"Food fortification improves the intake of all fortified nutrients, but fails to meet the estimated dietary requirements for vitamins A and B<sub>6</sub>, riboflavin and zinc, in lactating South African women."	"Papathakis PC, Pearson KE."	Public Health Nutrition. 2012;15(10):1810-7.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20123320768	"Objective: To investigate the impact of fortification by comparing food records and selected biochemical indicators of nutritional status pre- and post-fortification. Design: Mean intake from 24 h recalls (n 142) was compared with the Estimated Average Requirement (EAR) to determine the proportion with inadequate intake. In a subsample (n 34), diet and serum retinol, folate, ferritin and Zn were compared pre- and post-fortification for fortified nutrients vitamin A, thiamin, riboflavin, niacin, folic acid, Fe and Zn. Setting: South Africa. Subjects: Breast-feeding women (ninety-four HIV-infected, forty eight HIV-uninfected) measured at ~6, 14, 24 weeks, and 9 and 12 months postpartum. Results: Pre-fortification, >80% of women did not meet the EAR for vitamins A, C, D, thiamin, riboflavin, niacin, B<sub>6</sub>, B<sub>12</sub> and folate and minerals Zn, iodine and Ca. Dietary intake post-fortification increased for all fortified nutrients. In post-fortification food records, >70% did not meet the EAR for Zn and vitamins A, riboflavin and B<sub>6</sub>. Serum folate and Zn increased significantly post-fortification (P<0.001 for both), with no change in ferritin and a reduction in retinol. Post-fortification marginal/deficient folate status was reduced (73.5% pre v. 3.0% post; P<0.001), as was Zn deficiency (26.5% pre v. 5.9% post; P<0.05). Pre- and post-fortification, >93% were retinol replete. There was no change in Fe deficiency (16.7% pre v. 19.4% post; P=0.728). Conclusions: Micronutrient intake improved with fortification, but >70% of lactating women did not meet the EAR for Zn, vitamins A, riboflavin and B<sub>6</sub>. Although 100% exceeded the EAR for Fe after fortification, Fe status did not improve."									
507	A clinical investigation of persons with at least 10 years untreated HIV infection.	"Zhu X, Xue X, Cui W, Sun G, Liu J, Tian S, Zhu Q, et al."	Chinese Journal of Viral Diseases. 2011;1(3):197-9.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20123026126	"Objective: To investigate the status of residents with at least ten years untreated HIV infection. Methods: A cross-sectional questionnaire survey was performed to investigate untreated HIV infected residents in 7 counties, Henan province. We collected the information of infection routes, infection time, the status of spouse, income and perceived social cognition and etc. All participants had medical examination and were tested for CD4<sup>+</sup> T cell counts, viral loads and HCV co-infection. Results: The study had 101 persons with at least 10 years untreated HIV infection. HCV co-infection was confirmed in 84 (83.17%) participants. The majority (67.33%) of the HIV infected persons were between 36 and 45 years old. Body mass index (BMI) was above 18.5 for the most of the HIV infected persons (97%) and was 24.25 on average. The average CD4<sup>+</sup> T cell count was 530.50 (444.75-686.75) cells/ micro l. Nineteen (18.8%) HIV infected participants had long-term non-progressive disease development. The proportion of CD4<sup>+</sup>/CD8<sup>+</sup> was significantly higher in the group with long-term non-progressive disease development than in the group with progressive disease development (z=1.860, P=0.002). Conclusions: A decent proportion of at least 10 years HIV infected persons were still in good physical condition without any antiviral treatment. It is important to improve the physical fitness and the life quality of HIV infected persons."									
1663	"AIDS, drought, and child malnutrition in southern Africa."	"Mason JB, Bailes A, Mason KE, Yambi O, Jonsson U, Hudspeth C, Hailey P, et al."	Public Health Nutrition. 2005;8(6):551-63.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=16236184	"OBJECTIVE: To investigate trends in child malnutrition in six countries in southern Africa, in relation to the HIV epidemic and drought in crop years 2001/2 and 2002/3."	"DESIGN: Epidemiological analysis of sub-national and national surveys with related data.Setting: Data from Lesotho, Malawi, Mozambique, Swaziland, Zambia and Zimbabwe, compiled and analysed under UNICEF auspices."	SUBJECTS: Secondary data: children 0-5 years for weight-for-age; HIV prevalence data from various sources especially antenatal clinic surveillance.	"RESULTS: Child nutritional status as measured by prevalence of underweight deteriorated from 2001 onwards in all countries except Lesotho, with very substantial increases in some provinces/districts (e.g. from 5 to 20% in Maputo (Mozambique, 1997-2002), 17 to 32% in Copperbelt (Zambia, 1999-2001/2) and 11 to 26% in Midlands province (Zimbabwe, 1999-2002)). Greater deterioration in underweight occurred in better-off areas. Areas with higher HIV/AIDS prevalences had (so far) lower malnutrition rates (and infant mortality rates), presumably because more modern areas--with greater reliance on trade and wage employment--have more HIV/AIDS. Areas with higher HIV/AIDS showed more deterioration in child nutrition. A significant area-level interaction was found of HIV/AIDS with the drought period, associated with particularly rapid deterioration in nutritional status."	"CONCLUSIONS: First, the most vulnerable may be households in more modern areas, nearer towns, to whom resources need to be directed. Second, the causes of this vulnerability need to be investigated. Third, HIV/AIDS amplifies the effect of drought on nutrition, so rapid and effective response will be crucial if drought strikes again. Fourth, expanded nutritional surveillance is now needed to monitor and respond to deteriorating trends. Finally, with or without drought, new means are needed of bringing help, comfort and assistance to the child population."					
1035	"Changes in food insecurity, nutritional status, and physical health status after antiretroviral therapy initiation in rural Uganda."	"Weiser SD, Gupta R, Tsai AC, Frongillo EA, Grede N, Kumbakumba E, Kawuma A, et al."	Journal of Acquired Immune Deficiency Syndromes: JAIDS. 2012;61(2):179-86.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=22692093	"OBJECTIVE: To investigate whether time on antiretroviral therapy (ART) is associated with improvements in food security and nutritional status, and the extent to which associations are mediated by improved physical health status."	"DESIGN: The Uganda AIDS Rural Treatment Outcomes study, a prospective cohort of HIV-infected adults newly initiating ART in Mbarara, Uganda."	"METHODS: Participants initiating ART underwent quarterly structured interview and blood draws. The primary explanatory variable was time on ART, constructed as a set of binary variables for each 3-month period. Outcomes were food insecurity, nutritional status, and PHS. We fit multiple regression models with cluster-correlated robust estimates of variance to account for within-person dependence of observations over time, and analyses were adjusted for clinical and sociodemographic characteristics."	"RESULTS: Two hundred twenty-eight ART-naive participants were followed for up to 3 years, and 41% were severely food insecure at baseline. The mean food insecurity score progressively declined (test for linear trend P < 0.0001), beginning with the second quarter (b = -1.6; 95% confidence interval: -2.7 to -0.45) and ending with the final quarter (b = -6.4; 95% confidence interval: -10.3 to -2.5). PHS and nutritional status improved in a linear fashion over study follow-up (P < 0.001). Inclusion of PHS in the regression model attenuated the relationship between ART duration and food security."	"CONCLUSIONS: Among HIV-infected individuals in Uganda, food insecurity decreased and nutritional status and PHS improved over time after initiation of ART. Changes in food insecurity were partially explained by improvements in PHS. These data support early initiation of ART in resource-poor settings before decline in functional status to prevent worsening food insecurity and its detrimental effects on HIV treatment outcomes."					
575	"Involving communities in the design of clinical trial protocols: the BAN Study in Lilongwe, Malawi."	"Corneli AL, Piwoz EG, Bentley ME, Moses A, Nkhoma JR, Tohill BC, Adair L, et al."	Contemporary Clinical Trials. 2007;28(1):59-67.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=17000137	"OBJECTIVE: To learn the attitudes and concerns of the local community on participating in research, infant feeding practices, and maternal nutrition in order to inform the design of a clinical trial in Lilongwe, Malawi on the safety and efficacy of antiretroviral and nutrition interventions to reduce postnatal transmission of HIV."	"DESIGN: Formative research methods were used, including semi-structured interviews, focus group discussions, home observations, and taste trials. Data were collected, analyzed, and incorporated into the protocol within 3 months."	"RESULTS: Participants were supportive of the clinical trial, although their overall understanding of research was limited. Mothers agreed that infants' blood could be drawn by venipuncture, yet concern was raised about the amount of blood proposed to be collected from both infants and mothers. Data demonstrated that rapid breastfeeding cessation would be difficult and malnutrition could be a risk if infants were weaned early. Mothers selected a maternal supplement suitable for use in the clinical trial."	"CONCLUSIONS: The protocol was rapidly modified to achieve cultural acceptability while maintaining study objectives. Without the formative research, several significant areas would have been undetected and may have jeopardized the implementation of the trial. Additional research was carried out to develop a meaningful informed consent process, the amount of blood collected was reduced to acceptable levels, and the protocol was modified to reduce the risk of malnutrition. Researchers who conduct clinical trials are encouraged to incorporate formative research into their protocol design to ensure participant understanding of the research, to safeguard participants, and to increase feasibility and acceptance of the clinical research in the community."						
1649	A sustainable food support for non-breastfed infants: implementation and acceptability within a WHO mother-to-child HIV transmission prevention trial in Burkina Faso.	"Cames C, Mouquet-Rivier C, Traore T, Ayassou KA, Kabore C, Bruyeron O, Simondon KB."	Public Health Nutrition. 2010;13(6):779-86.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=20188009	OBJECTIVE: To provide HIV-positive mothers who opted for exclusive breastfeeding or formula feeding from birth to 6 months postpartum as a means of prevention of mother-to-child transmission (PMTCT) of HIV with a sustainable infant food support programme (FSP) from 6 to 12 months postpartum. We describe the implementation and assessment of this pilot initiative.	DESIGN: The FSP included a 6-month provision of locally produced infant fortified mix (IFM; 418 kJ/100 g of gruel) for non-breastfed infants coupled with infant-feeding and psychosocial counselling and support. Acceptability and feasibility were assessed in a subsample of sixty-eight mother-infant pairs.	SETTING: The FSP was developed in collaboration with local partners to support participants in a PMTCT prevention study. Formula was provided for free from 0 to 6 months postpartum. Cessation by 6 months was recommended for breastfeeding mothers.	"RESULTS: The FSP was positively received and greatly encouraged breastfeeding mothers to cease by 6 months. As recommended, most infants were given milk as an additional replacement food, mainly formula subsidised by safety networks. Among daily IFM consumers, feeding practices were satisfactory overall; however, the IFM was shared within the family by more than one-third of the mothers. Cessation of IFM consumption was observed among twenty-two infants, seventeen of whom were fed milk and five neither of these."	CONCLUSIONS: Without any food support most mothers would have been unable to provide appropriate replacement feeding. The food security of non-breastfed infants urgently needs to be addressed in HIV PMTCT programmes. Our findings on a simple cost-effective pioneer intervention provide an important foundation for this process.					
907	Cash transfer and microfinance interventions for tuberculosis control: review of the impact evidence and policy implications.	"Boccia D, Hargreaves J, Lonnroth K, Jaramillo E, Weiss J, Uplekar M, Porter JD, et al."	International Journal of Tuberculosis & Lung Disease. 2011;15 Suppl 2:S37-49.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=21740658	OBJECTIVE: To quantify the impact of cash transfer and microfinance interventions on a selected list of tuberculosis (TB) risk factors and assess their potential role in supporting TB control.	"DATA SOURCE: Published and unpublished references identified from clinical and social electronic databases, grey literature and web sites."	"METHODS: Eligible interventions had to be conducted in middle- or low-income countries and document an impact evaluation on any of the following outcomes: 1) TB or other respiratory infections; 2) household socio-economic position; and 3) factors mediating the association between low household socio-economic position and TB, including inadequate health-seeking behaviours, food insecurity and biological TB risk factors such as human immunodeficiency virus (HIV) and adult malnutrition. Interventions targeting special populations were excluded."	"RESULTS: Fifteen cash transfer schemes (four unconditional and 11 conditional) and seven microfinance programmes met the eligibility criteria. No intervention addressed TB or any other respiratory infection. Of 11 cash transfer and four microfinance interventions, respectively seven and four reported a positive impact on indicators of economic well-being. A positive impact on household food security was documented in respectively eight of nine and three of five cash transfer and microfinance interventions. Improved health care access was documented respectively in 10 of 12 cash transfer and four of five microfinance interventions. The only intervention evaluating impact on HIV incidence was a microfinance project that found no effect. No cash transfer or microfinance interventions had an impact on adult malnutrition."	CONCLUSIONS: Cash transfer and microfinance interventions can positively impact TB risk factors. Evaluation studies are urgently needed to assess the impact of these social protection interventions on actual TB indicators.					
919	Cash transfer and microfinance interventions for tuberculosis control: Review of the impact evidence and policy implications.	"Boccia D, Hargreaves J, Lonnroth K, Jaramillo E, Weiss J, Uplekar M, Porter JDH, et al."	International Journal of Tuberculosis and Lung Disease. 2011 June;15(SUPPL. 2):S37-S49.		"OBJECTIVE: To quantify the impact of cash transfer and microfinance interventions on a selected list of tuberculosis (TB) risk factors and assess their potential role in supporting TB control. DATA SOURCE: Published and unpublished references identified from clinical and social electronic databases, grey literature and web sites. METHODS: Eligible interventions had to be conducted in middle- or low-income countries and document an impact evaluation on any of the following outcomes: 1) TB or other respiratory infections; 2) household socioeconomic position; and 3) factors mediating the association between low household socio-economic position and TB, including inadequate health-seeking behaviours, food insecurity and biological TB risk factors such as human immunodeficiency virus (HIV) and adult malnutrition. Interventions targeting special populations were excluded. RESULTS: Fifteen cash transfer schemes (four unconditional and 11 conditional) and seven microfinance programmes met the eligibility criteria. No intervention addressed TB or any other respiratory infection. Of 11 cash transfer and four microfinance interventions, respectively seven and four reported a positive impact on indicators of economic well-being. A positive impact on household food security was documented in respectively eight of nine and three of five cash transfer and microfi nance interventions. Improved health care access was documented respectively in 10 of 12 cash transfer and four of five microfinance interventions. The only intervention evaluating impact on HIV incidence was a microfi nance project that found no effect. No cash transfer or microfinance interventions had an impact on adult malnutrition. CONCLUSIONS: Cash transfer and microfinance interventions can positively impact TB risk factors. Evaluation studies are urgently needed to assess the impact of these social protection interventions on actual TB indicators. 2011 The Union."									
1777	Survival by AIDS defining condition in rural Uganda.	"Morgan D, Malamba SS, Orem J, Mayanja B, Okongo M, Whitworth JAG."	Sexually Transmitted Infections. 2000;76(3):193-7.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh3&AN=20013040190	"Objective: To report the initial AIDS defining conditions, CD4 lymphocyte counts around the time of AIDS diagnosis, and survival by AIDS defining condition in a population based cohort in rural Uganda. Methods: Participants in an HIV natural history cohort in rural Uganda were reviewed every 3 months at routine visits and at other times when they were ill. The date and nature of the first AIDS defining condition in participants developing AIDS during follow up between the start of the cohort in 1990 and the end of 1998 were noted. The CD4 count at, or within, 3 months of this time was recorded for those participants who developed AIDS (WHO stage 4) after 1993. Results: The median survival from developing AIDS to death was 9.3 months and the median CD4 lymphocyte count around the time of developing AIDS was 150 cellsx10<sup>6</sup>/1. The most frequent AIDS defining conditions were wasting syndrome, oesophageal candidosis, and mucocutaneous herpes simplex virus infection (HSV) for more than 1 month. The median survival with wasting syndrome, Kaposi's sarcoma, and oesophageal candidosis was less than 3.5 months; however, survival with cryptosporidial diarrhoea, chronic HSV, and extrapulmonary tuberculosis was greater than 20 months. There was little relation between CD4 count around the time of development of the AIDS defining condition and the median survival with that condition. Conclusions: The survival for most AIDS defining conditions was generally shorter and the median CD4 lymphocyte count higher than studies reported from developed countries. However, the conditions with the longest survival (cryptosporidial diarrhoea, chronic HSV, and extrapulmonary tuberculosis) had a similar survival to that in developed countries and these conditions have a high background level in this population."									
1648	Where does the black population of South Africa stand on the nutrition transition?	"Bourne LT, Lambert EV, Steyn K."	Public Health Nutrition. 2002;5(1 A):157-62.		"Objective: To review data on selected risk factors related to the emergence of non-communicable diseases (NCDs) in the black population of South Africa. Methods: Data from existing literature on South African blacks were reviewed with an emphasis placed on changes in diet and the emergence of obesity and related NCDs. Design: Review and analysis of secondary data over time relating to diet, physical activity and obesity and relevant to nutrition-related NCDs. Settings: Urban, peri-urban and rural areas of South Africa. National prevalence data are also included. Subjects: Black adults over the age of 15 years were examined. Results: Shifts in dietary intake, to a less prudent pattern, are occurring with apparent increasing momentum, particularly among blacks, who constitute three-quarters of the population. Data have shown that among urban blacks, fat intakes have increased from 16.4% to 26.2% of total energy (a relative increase of 59-7%), while carbohydrate intakes have decreased from 69.3% to 61.7% of total energy (a relative decrease of 10.9%) in the past 50 years. Shifts towards the Western diet are apparent among rural African dwellers as well. The South African Demographic and Health Survey conducted in 1998 revealed that 31-8% of African women (over the age of 15 years) were obese (body mass index (BMI) >= 30 kg m<sup>-2</sup>) and that a further 26.7% were overweight (BMI >= 25 to < 30 kg m<sup>-2</sup>). The obesity prevalence among men of the same age was 6.0%, with 19.4% being overweight. The national prevalence of hypertension in blacks was 24.4%, using the cut-off point of 140/90 mmHg. There are limited data on the population's physical activity patterns. However, the effects of the HIV/AIDS epidemic will become increasingly important. Conclusions: The increasing emergence of NCDs in black South Africans, compounded by the HIV/AIDS pandemic, presents a complex picture for health workers and policy makers. Increasing emphasis needs to be placed on healthy lifestyles. The Authors 2002."									
1552	"Perinatal human immunodeficiency virus-1 transmission and intrauterine growth: a cohort study in Butare, Rwanda."	"Weng S, Bulterys M, Chao A, Stidley CA, Dushimimana A, Mbarutso E, Saah A."	Pediatrics. 1998;102(2):e24.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=9685470	"OBJECTIVE: To study the association of perinatal human immunodeficiency virus (HIV)-1 transmission with birth outcomes, including birth weight, gestational age, ponderal index, head circumference, and weight/head ratio."	"METHODS: Data from a prospective cohort study of 627 pregnant women and their infants in Butare, Rwanda, from October 1989 until April 1994 were analyzed. A total of 318 HIV-1-infected and 309 seronegative women were enrolled during pregnancy and gave birth to 590 live singletons. Multiple linear regression modeling was used to assess the association of mother-child HIV status with several birth outcome measures."	"RESULTS: Unadjusted mean birth weight of HIV- infected infants was 235 g (95% confidence interval [CI] = 94 to 376 g) less than that of HIV-uninfected infants born to HIV-positive mothers (the reference group). After adjustment for gestational age, socioeconomic factors, maternal age, parity, hematocrit, and anthropomorphic measures, mean birth weight of HIV-infected infants was 154 g (95% CI = 38 to 271 g) lower than that of the reference group. When infants born to HIV-seronegative mothers were compared with the reference group, mean birth weights did not differ. Adjusted models resulted in estimates of mean head circumference 0.6 cm smaller (95% CI = 0.2 to 1.1 cm), ponderal index 0.14 lower (95% CI = 0.05 to 0.23), weight/head ratio 3.5 lower (95% CI = 0.5 to 6.4), and gestational age 0.5 weeks shorter (95% CI = 0.1 to 0.9 weeks) for HIV-infected infants than for the reference group."	"CONCLUSIONS: After adjustment for potential confounding variables, this study showed statistically significant differences in birth weight, gestational age, ponderal index, and weight/head ratio when HIV-infected infants were compared with noninfected infants born to HIV-positive mothers. HIV-1, mother-to-child transmission, Africa, intrauterine growth, birth weight, gestational age, ponderal index."						
778	CD4+ T-lymphocytes natural decrease in HAART-naive HIV-infected adults in Abidjan.	"Duvignac J, Anglaret X, Kpozehouen A, Inwoley A, Seyler C, Toure S, Gourvellec G, et al."	HIV Clinical Trials. 2008 January/February;9(1):26-35.		"Objective: To study the CD4 natural decrease and its determinants in sub-Saharan African HIV-infected adults. Method: We performed a 7-year prospective cohort study, with biannual CD4 measurement. Follow-up was censored at the first severe morbidity event or at HAART initiation. Changes in CD4 values were studied by jointly modelling (a) the correlation between repeated measures through a linear mixed model and (b) the time to drop-out through a survival model. Results: 690 patients were followed up during 1,382 person-years. Contrasting with the baseline CD4 count and percentage, which were associated with numerous variables, the slopes of both CD4 count and CD4 percentage in the absence of severe morbidity episode were only associated with the follow-up time and with the baseline body mass index (BMI). The mean annual natural decrease in CD4 count (CD4%) was estimated at -81/mm<sup>3</sup> (-2.2%), -69/mrm<sup>3</sup> (-1.7%), and -55/mm<sup>3</sup> (-1.2%) for patients with baseline BMI at 16 kg/m<sup>2</sup>, 20.4 kg/m<sup>2</sup>, and 25 kg/m<sup>2</sup>, respectively (p < .001). A steeper decline in the CD4 count was independently associated with a shorter event-free follow-up time. Conclusion: These estimates of the CD4 natural decrease in sub-Saharan African patients, while they did not experience any episode of severe morbidity and before they initiate HAART, are in the bracket of those previously reported in industrialized countries. In sub-Saharan African settings with CD4 count being measured less frequently than in industrialized countries, the CD4 should be monitored more closely among adults with low BMI. 2008 Thomas Land Publishers, Inc."									
609	Vitamin A levels in HIV/AIDS.	"Kafwembe EM, Kelly P, Ngalande P."	East African Medical Journal. 2001;78(9):451-3.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh3&AN=20013169843	"Objective: To study the correlation of vitamin A concentrations in patients with AIDS, HIV positive symptom free and HIV negative symptom free men and women. Design: A cross-sectional study. Subjects: Male and female volunteers aged between 15 and 60 years willing to undergo an HIV-test. Setting: Participants came from different backgrounds within the city of Ndola, Zambia. Some were urban while others were peri-urban dwellers. They were included in the study only if they were willing to undergo the HIV test regardless of their place of residence. Main outcome measures: After obtaining consent blood samples were taken from the participants using needle and syringe. Whole blood was used to measure haematological indices while serum was used to measure vitamin A concentrations and HIV status. Results: One hundred and thirty five participants were recruited for the study. Vitamin A was analysed in 87 HIV-negative symptom free, 41 HIV-positive symptom free and 7 AIDS cases. There was a significant difference (P<0.05) in the variance of vitamin A levels in the three groups. Vitamin A deficiency was defined as blood concentrations below 30 micro g/dl. Using this cut-off point, the odds ratio for deficiency if HIV-positive was found to be 6.3 (95% confidence interval (CI), 2.5-16.7; P<0.0001). The odds ratio for HIV and serum vitamin A deficiency was approximately the same for males and females. There was a modest correlation between vitamin A concentrations and haemoglobin (r=0.34; 95% CI, 0.18-0.48; P<0.0001). Conclusion: Vitamin A concentration is lowered in HIV infection. The depletion of vitamin A seems to increase with progression of the infection leading to AIDS disease. Whether regular supplementation of vitamin A to the HIV-infected individual can lead to a delayed progression to AIDS needs to be explored."									
1545	Growth failure as a prognostic indicator of mortality in pediatric HIV infection.	"Berhane R, Bagenda D, Marum L, Aceng E, Ndugwa C, Bosch RJ, Olness K."	Pediatrics. 1997;100(1):E7.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=9200381	OBJECTIVE: To study the effect of perinatally acquired human immunodeficiency virus (HIV) on somatic growth and examine the relationship of nutritional status to mortality in HIV-infected infants.	"METHOD: Pregnant women attending the antenatal clinic at Mulago hospital in Kampala, Uganda, were enrolled. All live-born babies born to HIV-1 seropositive (HIV+) women, and to every fourth age-matched HIV-1 seronegative (HIV-) woman, were followed for 25 months."	"RESULTS: The mean weight-for-age and length-for-age curves of HIV+ children were significantly lower than those of HIV- controls and seroeverters. Forty-five (54%) of the 84 HIV+ infants died before their second birthday, as compared with a 1.6% and 5.6% mortality in HIV- and seroeverters. HIV+ infants with an average weight-for-age Z-score below -1.5 in the first year of life have a nearly fivefold risk of dying before 25 months of age compared with noninfected controls."	"CONCLUSION: Perinatally acquired HIV infection is associated with early and progressive growth failure. The severity of growth failure is associated with an increased risk of mortality. The effect of early, aggressive nutritional intervention in delaying HIV progression and mortality should be evaluated by controlled intervention studies."						
862	"Pregnancy, body weight and human immunodeficiency virus infection in African women: a prospective cohort study in Kigali (Rwanda), 1992-1994. Pregnancy and HIV Study Group (EGE)."	"Ladner J, Castetbon K, Leroy V, Nyiraziraje M, Chauliac M, Karita E, De Clercq A, et al."	International Journal of Epidemiology. 1998;27(6):1072-7.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=10024206	OBJECTIVE: To study the relationship between human immunodeficiency virus (HIV) infection and body weight in African women during and after pregnancy.	"METHODS: A prospective cohort study was initiated at the Centre Hospitalier de Kigali in July 1992. Every woman seen at the antenatal clinic and with a gestational age of <28 weeks was offered HIV-1 antibody testing. Comparable numbers of HIV-infected (HIV+) and uninfected (HIV-) women were recruited. At inclusion, socio-demographic characteristics and self-reported pre-pregnancy weight were recorded; height and weight were measured. Each woman enrolled had a monthly follow-up until 9 months after delivery, with a clinical examination including weighing. Three anthropometric indices were used to answer the study objectives: weight, body mass index (BMI), and pregnancy balance."	"RESULTS: As of April 1994, 101 HIV+ and 106 HIV- women were followed until 5 months after delivery. Weight and BMI during pregnancy were lower in HIV+ women than in HIV- women. After delivery, weight and BMI gains were significantly lower in HIV+ women. Until 5 months after delivery, the mean weight variation was -2.2 kg (standard deviation [SD] = 5.9 kg) in HIV+ women and +0.2 kg (SD = 6.6 kg) in HIV- women (P = 0.007) in comparison to pre-pregnancy weight. Comparisons of the slopes of the weight curves did not show statistical differences throughout the pregnancy, but it did during the post-partum period (P = 0.02)."	"CONCLUSIONS: Our study suggests that HIV infection could impair nutritional status in pregnant women, especially during the post-partum period. Family planning and maternal and child health services including HIV testing and counselling, should consider a nutritional assessment and intervention programme targeted to HIV+ pregnant women."						
627	"Hypovitaminosis D and bone mineral density in human immunodeficiency virus-infected men from India, with or without antiretroviral therapy."	"Paul TV, Asha HS, Thomas N, Seshadri MS, Rupali P, Abraham OC, Pulimood SA, et al."	Endocrine Practice. 2010;16(4):547-53.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=20150027	OBJECTIVE: To study the vitamin D status and bone mineral density (BMD) in men infected with human immunodeficiency virus (HIV) in a tertiary care center from southern India.	METHODS: We conducted a cross-sectional study of 35 HIV-infected men (between 20 and 50 years old) receiving highly active antiretroviral therapy (HAART) (group 1) in comparison with 35 age- and body mass index-matched HIV-positive antiretroviral therapy-naive men (group 2) and 35 HIV-negative healthy control subjects (group 3).	"RESULTS: A significantly greater proportion (P = .002) of patients (74%) in the HAART group had vitamin D deficiency (<20 ng/mL) in comparison with the other 2 groups (37% in each group). The mean intact parathyroid hormone level was higher (P<.001) and the mean duration of exposure to sunlight was lower (P = .001) in the HAART group than in the other 2 groups. By logistic regression analysis, HAART was found to be significantly associated with vitamin D deficiency. The BMD in the femoral neck was significantly lower in men with HIV infection who were receiving HAART in comparison with the other 2 groups (P = .006). On multivariate logistic regression, older age, low body mass index, and high parathyroid hormone levels emerged as factors significantly associated with decreased BMD at the femoral neck."	"CONCLUSION: A significant proportion of patients receiving HAART had vitamin D deficiency. The secondary hyperparathyroidism probably due to vitamin D deficiency is an important contributing factor for the observed changes in BMD. Vitamin D deficiency noted in this group is probably multifactorial, and further research is needed to determine whether the effect of HAART on vitamin D metabolism is an additional causative factor and what benefit vitamin D supplementation might confer in these patients."						
1943	Nutritional status of Malawian adults on antiretroviral therapy 1 year after supplementary feeding in the first 3 months of therapy.	"Ndekha M, Oosterhout JJGv, Saloojee H, Pettifor J, Manary M."	Tropical Medicine and International Health. 2009;14(9):1059-63.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20093269548	"OBJECTIVE: To test the hypothesis that individuals on antiretroviral therapy (ART) for 3 months with a greater body mass index (BMI) as a result of supplementary feeding with ready-to-use fortified spread would maintain a higher BMI 9 months after the feeding ended. METHODS: Two cohorts of wasted adults with AIDS, after 12 months of ART and 3 months of supplementary feeding with either ready-to-use fortified spread, an energy dense lipid paste; or corn/soy blended flour, were assessed for clinical and anthropometric status, quality of life, and ART adherence after 3 and 9 months. RESULTS: 336 ART patients participated: 162 who had received ready-to-use fortified spread and 174 who had received corn/soy blended flour. 9 months after stopping food supplements, both groups had a similar BMI, fat-free body mass, hospitalization rate and mortality. Binary logistic regression modelling showed that lower BMI, lower CD4 count, and older age at baseline were associated with a higher risk of death (odds ratio for BMI=0.63, 95% CI 0.47-0.79). Adherence to the ART regimen and quality of life were similar in both cohorts. CONCLUSION: While supplementary feeding with ready-to-use fortified spread can ameliorate the BMI, an established risk factor for mortality, this effect is sustained only during the time of the intervention. Supplementary feeding of wasted patients for longer than 3 months should be investigated."									
1920	Nutritional status of Malawian adults on antiretroviral therapy 1 year after supplementary feeding in the first 3 months of therapy.	"Ndekha M, van Oosterhout JJ, Saloojee H, Pettifor J, Manary M."	Tropical Medicine & International Health. 2009;14(9):1059-63.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=19552659	OBJECTIVE: To test the hypothesis that individuals on antiretroviral therapy (ART) for 3 months with a greater body mass index (BMI) as a result of supplementary feeding with ready-to-use fortified spread would maintain a higher BMI 9 months after the feeding ended.	"METHODS: Two cohorts of wasted adults with AIDS, after 12 months of ART and 3 months of supplementary feeding with either ready-to-use fortified spread, an energy dense lipid paste; or corn/soy blended flour, were assessed for clinical and anthropometric status, quality of life, and ART adherence after 3 and 9 months."	"RESULTS: 336 ART patients participated: 162 who had received ready-to-use fortified spread and 174 who had received corn/soy blended flour. 9 months after stopping food supplements, both groups had a similar BMI, fat-free body mass, hospitalization rate and mortality. Binary logistic regression modelling showed that lower BMI, lower CD4 count, and older age at baseline were associated with a higher risk of death (odds ratio for BMI = 0.63, 95% CI 0.47-0.79). Adherence to the ART regimen and quality of life were similar in both cohorts."	"CONCLUSION: While supplementary feeding with ready-to-use fortified spread can ameliorate the BMI, an established risk factor for mortality, this effect is sustained only during the time of the intervention. Supplementary feeding of wasted patients for longer than 3 months should be investigated."						
1654	A qualitative investigation of adherence to nutritional therapy in malnourished adult AIDS patients in Kenya.	"Dibari F, Bahwere P, Le Gall I, Guerrero S, Mwaniki D, Seal A."	Public Health Nutrition. 2012;15(2):316-23.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=21294939	"OBJECTIVE: To understand factors affecting the compliance of malnourished, HIV-positive adults with a nutritional protocol using ready-to-use therapeutic food (RUTF; Plumpy'nut)."	"DESIGN: Qualitative study using key informant interviews, focus group discussions and direct observations."	"SETTING: Ministry of Health HIV/programme supported by Medecins Sans Frontiers (MSF) in Nyanza Province, Kenya."	"SUBJECTS: Adult patients (n 46) currently or previously affected by HIV-associated wasting and receiving anti-retroviral therapy, their caregivers (n 2) and MoH/MSF medical employees (n 8)."	"RESULTS: Thirty-four out of forty-six patients were receiving RUTF (8360 kJ/d) at the time of the study and nineteen of them were wasted (BMI < 17 kg/m2). Six of the thirteen wasted out-patients came to the clinic without a caregiver and were unable to carry their monthly provision (12 kg) of RUTF home because of physical frailty. Despite the patients' enthusiasm about their weight gain and rapid resumption of labour activities, the taste of the product, diet monotony and clinical conditions associated with HIV made it impossible for half of them to consume the daily prescription. Sharing the RUTF with other household members and mixing with other foods were common. Staff training did not include therapeutic dietetic counselling."	"CONCLUSIONS: The level of reported compliance with the prescribed dose of RUTF was low. An improved approach to treating malnourished HIV-positive adults in limited resource contexts is needed and must consider strategies to support patients without a caregiver, development of therapeutic foods more suited to adult taste, specific dietetic training for health staff and the provision of liquid therapeutic foods for severely ill patients."				
1653	A qualitative investigation of adherence to nutritional therapy in malnourished adult AIDS patients in Kenya.	"Dibari F, Bahwere P, Gall Il, Guerrero S, Mwaniki D, Seal A."	Public Health Nutrition. 2012;15(2):316-23.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20123020789	"Objective: To understand factors affecting the compliance of malnourished, HIV-positive adults with a nutritional protocol using ready-to-use therapeutic food (RUTF; Plumpy'nutReg.). Design: Qualitative study using key informant interviews, focus group discussions and direct observations. Setting: Ministry of Health HIV/programme supported by Medecins Sans Frontiers (MSF) in Nyanza Province, Kenya. Subjects: Adult patients (n 46) currently or previously affected by HIV-associated wasting and receiving anti-retroviral therapy, their caregivers (n 2) and MoH/MSF medical employees (n 8). Results: Thirty-four out of forty-six patients were receiving RUTF (8360 kJ/d) at the time of the study and nineteen of them were wasted (BMI <17 kg/m<sup>2</sup>). Six of the thirteen wasted out-patients came to the clinic without a caregiver and were unable to carry their monthly provision (12 kg) of RUTF home because of physical frailty. Despite the patients' enthusiasm about their weight gain and rapid resumption of labour activities, the taste of the product, diet monotony and clinical conditions associated with HIV made it impossible for half of them to consume the daily prescription. Sharing the RUTF with other household members and mixing with other foods were common. Staff training did not include therapeutic dietetic counselling. Conclusions: The level of reported compliance with the prescribed dose of RUTF was low. An improved approach to treating malnourished HIV-positive adults in limited resource contexts is needed and must consider strategies to support patients without a caregiver, development of therapeutic foods more suited to adult taste, specific dietetic training for health staff and the provision of liquid therapeutic foods for severely ill patients."									
1935	Growth patterns and anaemia status of HIV-infected children living in an institutional facility in India.	"Kapavarapu PK, Bari O, Mathew P, Duggan C, Chitra D, Shubha K, Karthika A, et al."	Tropical Medicine and International Health. 2012;17(8):962-71.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20123275139	"Objective: To understand the health status of HIV orphans in a well-structured institutional facility in India. Method: Prospective longitudinal analysis of growth and anaemia prevalence among these children, between June 2008 and May 2011. Results: A total of 85 HIV-infected orphan children residing at Sneha Care Home, Bangalore, for at least 1 year, were included in the analysis. Prevalence of anaemia at entry into the home was 40%, with the cumulative incidence of anaemia during the study period being 85%. At baseline, 79% were underweight and 72% were stunted. All children, irrespective of their antiretroviral therapy (ART) status, showed an improvement in nutritional status over time as demonstrated by a significant increase in weight (median weight-for-age Z-score: -2.75 to -1.74, P<0.001) and height Z-scores (median height-for-age Z-score: -2.69 to -1.63, P<0.001). Conclusion: These findings suggest that good nutrition even in the absence of ART can bring about improvement in growth. The Sneha Care Home model indicates that the holistic approach used in the Home may have been helpful in combating HIV and poor nutritional status in severely malnourished orphaned children."									
104	Characterization of HIV-HBV coinfection in a multinational HIV-infected cohort.	"Thio CL, Smeaton L, Saulynas M, Hwang H, Saravan S, Kulkarni S, Hakim J, et al."	Aids. 2013;27(2):191-201.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20133046938	"Objective: To understand the HIV-hepatitis B virus (HBV) epidemic from a global perspective by clinically and virologically characterizing these viruses at the time of antiretroviral therapy (ART) initiation in a multinational cohort. Methods and design: HIV-infected patients enrolled in two international studies were classified as HIV-HBV coinfected or HIV monoinfected prior to ART. HIV-HBV coinfected patients were tested for HBV characteristics, hepatitis D virus (HDV), a novel noninvasive marker of liver disease, and drug-resistant HBV. Comparisons between discrete covariates used chi <sup>2</sup> or Fisher's exact tests (and Jonchkheere-Terpstra for trend tests), whereas continuous covariates were compared using Wilcoxon Rank-Sum Test. Results: Of the 2105 HIV-infected patients from 11 countries, the median age was 34 years and 63% were black. The 115 HIV-HBV coinfected patients had significantly higher alanine aminotransferase and aspartate aminotransferase values, lower BMI, and lower CD4<sup>+</sup> T-cell counts than HIV monoinfected patients (median 159 and 137 cells/ micro l, respectively, P=0.04). In the coinfected patients, 49.6% had HBeAg-negative HBV, 60.2% had genotype A HBV, and 13% were HDV positive. Of the HBeAg-negative patients, 66% had HBV DNA 2000IU/ml or less compared to 5.2% of the HBeAg-positive individuals. Drug-resistant HBV was not detected. Conclusion: Screening for HBV in HIV-infected patients in resource-limited settings is important because it is associated with lower CD4<sup>+</sup> T-cell counts. In settings in which HBV DNA is not available, HBeAg may be useful to assess the need for HBV treatment. Screening for drug-resistant HBV is not needed prior to starting ART in settings in which this study was conducted."									
1010	Impact of tuberculosis on the body composition of HIV-infected men in Brazil.	"Paton NI, Castello-Branco LR, Jennings G, Ortigao-de-Sampaio MB, Elia M, Costa S, Griffin GE."	Journal of Acquired Immune Deficiency Syndromes & Human Retrovirology. 1999;20(3):265-71.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=10077175	OBJECTIVE: Tuberculosis (TB) is the commonest HIV-related opportunistic infection in many developing countries and is thought to be a frequent underlying cause of HIV-associated wasting. We have used reference water dilution methods to examine the body composition changes associated with TB and to assess the severity and pattern of wasting.	"METHODS: The study was conducted at a charitable support house for poor and homeless HIV-infected people in Rio de Janeiro, Brazil. Male patients who were HIV-positive and receiving treatment for active TB (HIVTB+) and HIV-infected controls without TB (HIVTB-) were studied. Total body water (TBW) and extracellular water (ECW) were measured by giving oral doses of deuterium oxide and sodium bromide, respectively, and determining enrichment in plasma after 4 hours. Intracellular water (ICW), body cell mass (BCM), lean body mass (LBM) and fat mass were calculated from these parameters using standard equations."	"RESULTS: HIVTB+ (n = 11) and HIVTB- (n = 12) groups were similar in age, height, CD4 count and HIV risk factors. HIVTB+ men had significantly lower mean ICW (13.2 versus 16.6 kg; p = .02) and BCM (18.4 versus 23.0 kg; p = .02), a relative expansion of ECW (35.0 versus 30.0 L/kg body weight; p = .04), and small and nonsignificant reductions in total body weight (58.0 versus 62.1 kg; p = .26), LBM (45.5 versus 47.7 kg; p = .33) and fat mass (12.5 versus 14.4 kg; p = .51) compared with HIVTB- controls. BCM in the HIVTB+ group was similar to reference values for severe malnutrition. The relative depletion of BCM appeared excessive in comparison with reference values for uncomplicated starvation."	"CONCLUSION: The nutritional status of HIVTB+ patients was significantly worse than HIVTB- patients. Body weight and LBM underestimated the nutritional deficit, and measurement of BCM is therefore necessary to appreciate the extent of malnutrition in such patients. Malnutrition in HIVTB+ patients is severe and may therefore contribute to decreased survival. Hypermetabolism appears to play a role in the wasting process in patients coinfected with HIV and TB."						
105	"A study of the safety, immunology, virology, and microbiology of adjunctive etanercept in HIV-1-associated tuberculosis."	"Wallis RS, Kyambadde P, Johnson JL, Horter L, Kittle R, Pohle M, Ducar C, et al."	Aids. 2004 23 Jan;18(2):257-64.		"Objective: Tumor necrosis factor (TNF), an important inflammatory mediator in tuberculosis, has been implicated in causing accelerated HIV disease progression in HIV-associated tuberculosis. However, TNF blockade, particularly by monoclonal antibody, has been associated with the reactivation of latent Mycobacterium tuberculosis infection by the impairment of mycobacterial immunity. This phase 1 study examined the safety, microbiology, immunology, and virology of TNF blockade using etanercept (soluble TNF receptor, Enbrel) during the initial treatment of HIV-associated tuberculosis. Design: A single-arm trial, with key endpoints compared with historical controls, conducted in Mulago Hospital, Kampala, Uganda. Subjects: Sixteen HIV-1-infected patients and 42 CD4-frequency-matched controls with sputum smear-positive tuberculosis and CD4 cell counts > 200 cells/mul. Intervention: Etanercept 25 mg, eight doses administered subcutaneously twice weekly beginning on day 4 of tuberculosis therapy. Main outcome measures: Serial examination, radiography, sputum culture, CD4 T-cell counts, plasma log<sub>10</sub> HIV-RNA copy numbers. Results: Trends towards superior responses to tuberculosis treatment were evident in etanercept-treated subjects in body mass, performance score, number of involved lung zones, cavitary closure, and time to sputum culture conversion. Etanercept treatment resulted in a 25% increase in CD4 cells by week 4 (P = 0. 1 compared with controls). The change in CD4 cell count was inversely related to the change in serum neopterin, a marker of macrophage activation. There was no effect on plasma HIV RNA. Conclusion: Etanercept can be safely administered during the initial treatment of pulmonary tuberculosis. Further studies are warranted to examine the effects of etanercept on T-cell numbers, activation and apoptosis in AIDS and tuberculosis. 2004 Lippincott Williams & Wilkins."									
1536	Morbidity and mortality during the first two years of life among uninfected children born to human immunodeficiency virus type 1-infected women: the women and infants transmission study.	"Paul ME, Chantry CJ, Read JS, Frederick MM, Lu M, Pitt J, Turpin DB, et al."	Pediatric Infectious Disease Journal. 2005;24(1):46-56.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh3&AN=20053093902	"Objective: We evaluated morbidity and mortality during the first 2 years of life among children born to human immunodeficiency virus-(HIV) type 1-infected women enrolled in the Women and Infants Transmission Study (WITS) during an 11-year period (1990-2001). Design and Methods: As part of WITS, evaluations were performed at birth and at 1, 2, 4, 6, 9, 12, 18 and 24 months of age. Growth, hospitalization and the incidence of clinical disease were assessed regularly. Results: Data regarding 1118 children born to HIV-infected women (955 HIV-uninfected children and 163 HIV-infected children) were analysed. Fewer changes in the caretaker of the child and fewer in utero exposures to drugs, tobacco and alcohol occurred in the latter periods of the study (all P values for time trend analyses <0.01). The percentages of HIV-uninfected children with poor weight gain (44 of 767; 5.7%), short stature (32 of 703; 4.5%) and wasting (27 of 792; 3.4%) were higher than expected for the general population. Two or more changes in caretaker were associated with all growth deficiencies except wasting, and fetal exposure to tobacco was associated with height abnormalities. Anemia was common and was associated with receipt of zidovudine prophylaxis. Morbidity and mortality decreased during the study period. For the uninfected children, a decrease in class A events (Kaplan-Meier rates: group 1, 22.3%; group 2, 6.8%; group 3, 4.2%; P<0.001) and class C events and death (Kaplan-Meier event rates: group 1, 2.0%; group 2, 1.7%; group 3, 0.2%; P=0.062) during the first 2 years of life account for the differences in the curves over time. Conclusions: During an 11-year period, morbidity and mortality during the first 24 months of life decreased substantially for children born to HIV-infected women."									
1664	Relationship of exclusive breast-feeding to infections and growth of Tanzanian children born to HIV-infected women.	"Mwiru RS, Spiegelman D, Duggan C, Peterson K, Liu E, Msamanga G, Aboud S, et al."	Public Health Nutrition. 2011;14(7):1251-8.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=21324223	"OBJECTIVE: We examined the relationships between exclusive breast-feeding and the risks of respiratory, diarrhoea and nutritional morbidities during the first 2 years of life among children born to women infected with HIV-1."	"DESIGN: We prospectively determined the incidence of respiratory illnesses, diarrhoea, fever, hospitalizations, outpatient visits and nutritional morbidities. Generalized estimating equations were used to estimate the relative risks for morbidity episodes and Cox proportional hazards models to estimate the incidence rate ratios of nutritional morbidities."	"SETTING: Dar es Salaam, Tanzania."	SUBJECTS: The sample consisted of 666 children born to HIV-infected women.	"RESULTS: The 666 children were followed for 2 years. Exclusive breast-feeding was associated with lower risk for cough (rate ratio (RR) = 0.49, 95 % CI 0.41, 0.60, P < 0.0001), cough and fever (RR = 0.44, 95 % CI 0.32, 0.60, P < 0.0001) and cough and difficulty breathing or refusal to feed (RR = 0.31, 95 % CI 0.18, 0.55, P < 0.0001). Exclusive breast-feeding was also associated with lower risk of acute diarrhoea, watery diarrhoea, dysentery, fever and outpatient visits during the first 6 months of life, but showed no effect at 6-24 months of life. Exclusive breast-feeding did not significantly reduce the risks of nutritional morbidities during the first 2 years of life."	CONCLUSIONS: Exclusive breast-feeding is strongly associated with reductions in the risk of respiratory and diarrhoea morbidities during the first 6 months of life among children born to HIV-infected women.				
647	Effect of vitamin supplementation to HIV-infected pregnant women on the micronutrient status of their infants.	"Baylin A, Villamor E, Rifai N, Msamanga G, Fawzi WW."	European Journal of Clinical Nutrition. 2005;59(8):960-8.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=15956998	"OBJECTIVE: We examined whether supplementation with vitamin A and/or vitamins B, C, and E to HIV-infected women during pregnancy and lactation is related to increased concentrations of vitamins A, B12, and E in their infants during the first 6 months of life."	"DESIGN: We carried out a randomized clinical trial among 716 mother-infant pairs in Dar-es-Salaam, Tanzania. Women were randomly allocated to receive a daily oral dose of one of four regimens: vitamin A, multivitamins (B, C, and E), multivitamins including A, or placebo. Supplementation started at first prenatal visit and continued after delivery throughout the breastfeeding period. The serum concentration of vitamins A, E and B12 was measured in infants at 6 weeks and 6 months postpartum."	"RESULTS: Maternal vitamin A supplementation increased serum retinol in the infants at 6 weeks (mean difference=0.09 micromol/l, P<0.0001) and 6 months (mean difference=0.06 micromol/l, P=0.0002), and decreased the prevalence of vitamin A deficiency, but had no impact on serum vitamins E or B12. Multivitamins increased serum vitamin B12 at 6 weeks and 6 months (mean differences=176 pmol/l, P<0.0001 and 127 pmol/l, P<0.0001, respectively) and vitamin E (mean differences=1.8 micromol/l, P=0.0008 and 1.1 micromol/l, P=0.004, respectively) and decreased the prevalence of vitamin B12 deficiency."	CONCLUSIONS: Vitamin supplementation to HIV-1-infected women is effective in improving the vitamin status of infants during the first 6 months of age.						
86	Response to antiretroviral therapy: Improved survival associated with CD4 above 500 cells/mul.	"Maman D, Pujades-Rodriguez M, Nicholas S, McGuire M, Szumilin E, Ecochard R, Etard JF."	Aids. 2012 17 Jul;26(11):1393-8.		"Objective: We investigated the association between immune response and mortality in four HIV African programs supported by Medecins Sans Frontieres. Design: Multicentric retrospective cohort study. Methods: All antiretroviral therapy (ART) naive adults (>15 years) who initiated therapy between March 2001 and November 2010 and receiving therapy for 9 months or more were included. We described the evolution of mortality over time. Mixed Poisson models were used to assess the effect of updated CD4 cell counts and other potential risk factors on mortality. Findings: A total of 24 037 patients, of which 68% were women, contributed 69 516.2 person-years of follow-up. At ART initiation, 5718 patients (23.7%) were classified as WHO clinical stage 4, 1587 (6.6%) had a BMI below 16 kg/m and 2568 (10.7%) had CD4 cell count below 50 cells/mul. A total of 568 (2.4%) deaths were recorded during the study period. In the CD4 response categories 500 cells/mul or more, 350-499, 200-349, 50-199 cells/mul and less than 50 cells/mul, unadjusted mortality rates were 0.36; 0.58; 0.88; 1.91 and 7.43 per 100 person-years, respectively. In multivariate analysis, higher mortality was observed in patients with CD4 response levels 350-499 cells/mul [adjusted hazard ratio (aHR) 1.70, 95% confidence interval (CI) 1.26-2.30] and for those between 200-349 (aHR 2.56; 95% CI 1.93-3.38), compared to those with 500 cells/mul or more. Interpretation: The observed higher survival of patients with a CD4 response to ART higher than 500 cells/mul supports the need of further research to evaluate the individual benefit of initiating ART at higher CD4 levels in sub-Saharan Africa. 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins."									
1481	"Increased risk of mortality and loss to follow-up among HIV-positive patients with oropharyngeal candidiasis and malnutrition before antiretroviral therapy initiation: a retrospective analysis from a large urban cohort in Johannesburg, South Africa."	"Evans D, Maskew M, Sanne I."	"Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology. 2012;113(3):362-72."	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=22669142	OBJECTIVE: We investigated the effect of oropharyngeal candidiasis (OC) and body mass index (BMI) before antiretroviral therapy (ART) initiation on treatment outcomes of human immunodeficiency virus (HIV)-positive patients.	"STUDY DESIGN: Treatment outcomes included failure to increase CD4 count by >=50 or >=100 cells/uL or failure to suppress viral load (<400 copies/mL) at 6 or 12 months in addition to loss to follow-up (LTFU) and mortality by 12 months. Risk and hazard ratios (HRs) were estimated with the use of log-binomial regression and Cox proportional hazards models, respectively."	"RESULTS: Baseline CD4 <100 cells/uL, low BMI (<18.5 kg/m(2)), low hemoglobin, and elevated aspartate transaminase were associated with OC at ART initiation. Patients with low BMI with and without, respectively, OC were at risk of mortality (HR 2.42, 95% CI 1.88-3.12; HR 1.87, 95% CI 1.54-2.28) and LTFU (HR 1.36, 95% CI 1.02-1.82; HR 1.55, 95% CI 1.30-1.85)."	"CONCLUSIONS: Low BMI (with/without OC) at ART initiation was associated with poor treatment outcomes. Conversely, normal BMI with OC was associated with adequate CD4 response and reduced LTFU compared with without OC. Copyright 2012 Elsevier Inc. All rights reserved."						
1443	Effect of periodic vitamin A supplementation on mortality and morbidity of human immunodeficiency virus-infected children in Uganda: A controlled clinical trial.[Erratum appears in Nutrition. 2005 Feb;21(2):287].	"Semba RD, Ndugwa C, Perry RT, Clark TD, Jackson JB, Melikian G, Tielsch J, et al."	Nutrition. 2005;21(1):25-31.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medc&AN=15661475	OBJECTIVE: We investigated whether vitamin A supplementation would decrease mortality and morbidity rates in children infected with the human immunodeficiency virus (HIV).	"METHODS: We conducted a randomized, double-blind, placebo-controlled clinical trial at Mulago Hospital, a large hospital that serves the urban and semiurban populations of Kampala, Uganda. One hundred eighty-one HIV-infected children were enrolled at 6 mo and randomized to receive vitamin A supplementation, 60 mg retinol equivalent, or placebo every 3 mo from ages 15 to 36 mo. Morbidity was assessed through a 7-d morbidity history every 3 mo, and vital events were measured. Children received daily trimethoprim-sulfamethoxazole prophylactic therapy."	"RESULTS: After age 15 mo, children were followed for a median of 17.8 mo (interquartile range = 11.1 to 21.0 mo). The trial was stopped when there was a new policy to implement a program of mass supplementation of vitamin A in the country. Mortality rates among 87 children in the vitamin A group and 94 children in the control group were 20.6% and 32.9%, respectively, yielding a relative risk of 0.54 (95% confidence interval, 0.30 to 0.98; P = 0.044) after adjusting for baseline weight-for-height Z score. Children who received vitamin A had lower modified point prevalences of persistent cough (odds ratio, 0.47; 95% confidence interval, 0.23 to 0.96; P = 0.038) and chronic diarrhea (odds ratio, 0.48; 95% confidence interval, 0.19 to 1.18; P = 0.11) and a shorter duration of ear discharge (P = 0.03). Vitamin A supplementation had no significant effect on modified point prevalences of fever, ear discharge, bloody stools, or hospitalizations."	CONCLUSIONS: Vitamin A supplementation decreases mortality rate in HIV-infected children and should be considered in the care for these children in developing countries.						
1177	Randomized controlled trial of feeding a concentrated formula to infants born to women infected by human immunodeficiency virus.	"Winter HS, Oleske JM, Hughes MD, McKinney RE, Jr., Elgie C, Powell C, Purdue L, et al."	Journal of Pediatric Gastroenterology and Nutrition. 2009;49(2):222-32.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20093274400	"Objective: We tested the hypothesis that concentrated formula (CF) begun within the first 2 weeks of life increases growth in infants born to human immunodeficiency virus (HIV)-infected mothers. Materials and Methods: HIV-exposed infants from the United States, the Bahamas, and Brazil were randomized in a double-blind, controlled trial to receive either a CF (87 kcal/100 mL [26 kcal/oz]) or a standard formula (SF; 67 kcal/100 mL [20 kcal/oz]) for 8 weeks. This article presents results for infants who were not determined to be HIV infected based on testing at 4 weeks. Primary outcomes were safety, tolerability, and growth in weight and length. Results: Two thousand ninety-seven infants were enrolled, of whom 1998 were uninfected and had study formula dispensed. At weeks 4 and 8, uninfected infants receiving CF showed higher energy intake than those who were receiving SF (P<0.001). By week 8, uninfected infants assigned to CF weighed more than infants receiving SF. There were no consistent differences in measures of tolerability, and rates of discontinuation or perceived formula intolerance were similar between treatment groups. Conclusions: A CF is well tolerated and results in increased weight gain compared with SF. Until the HIV status of an infant is reliably determined, early introduction of a CF in HIV-exposed children may have beneficial effects on growth. The role of early nutritional intervention remains to be determined for individuals living in countries with endemic malnutrition for whom formula feeding is a viable option."									
1570	"Incidence and Risk Factors for Tuberculosis in People Living with HIV: Cohort from HIV Referral Health Centers in Recife, Brazil."	"Batista JL, de Albuquerque MFPM, Maruza M, Ximenes RAA, Santos ML, Montarroyos UR, de Barros Miranda-Filho D, et al."	PLoS ONE. 2013 10 May;8(5).		"Objective:To identify the incidence of and risk factors for tuberculosis in people living with HIV (PLHIV).Design:Observational, prospective cohort study.Methods:A total of 2069 HIV-infected patients was observed between July 2007 and December 2010. The Kaplan-Meier method was used to estimate the probability of survival free of tuberculosis, and Cox regression analysis to identify risk factors associated with the development of tuberculosis.Results:Survival free of tuberculosis (TB) was 91%. The incidence rate of tuberculosis was 2.8 per 100 persons/years. Incidence of tuberculosis was higher when subjects had CD4 cell count <200 cells/mm<sup>3</sup>; were not on antiretroviral therapy; in those who had, a body mass index <18.5 kg/m<sup>2</sup>, anemia (or were not tested for it), were illiterate or referred previous tuberculosis treatment at entry into the cohort. Those not treated for latent TB infection had a much higher risk (HR = 7.9) of tuberculosis than those with a negative tuberculin skin test (TST). Having a TST>=5 mm but not being treated for latent TB infection increased the risk of incident tuberculosis even in those with a history of previous tuberculosis.Conclusions:Preventive actions to reduce the risk of TB in people living with HIV should include an appropriate HAART and treatment for latent TB infection in those with TST>=5 mm. The actions towards enabling rigorous implementation of treatment of latent TB infection and targeting of PLHIV drug users both at the individual and in public health level can reduce substantially the incidence of TB in PLHIV. 2013 Batista et al."									
1551	Immune function in young children with previous pulmonary or miliary/meningeal tuberculosis and impact of BCG vaccination.	"Sterling TR, Martire T, De Almeida AS, Ding L, Greenberg DE, Moreira LA, Elloumi H, et al."	Pediatrics. 2007 October;120(4):e912-e21.		"OBJECTIVE. Children <5 years old are at increased risk of miliary/meningeal tuberculosis, but the immunologic factors that place them at risk are unknown. BCG vaccine protects against miliary/meningeal tuberculosis, but the mechanism of protection is unknown. We assessed for abnormalities in immune response associated with miliary/meningeal or pulmonary tuberculosis in young children. PATIENTS AND METHODS. We conducted a case-control study among HIV-seronegative Brazilian children who were <5 years old. Case subjects had previous culture-confirmed or clinical miliary/meningeal tuberculosis. There were 2 sets of control subjects: those with culture-confirmed pulmonary tuberculosis and purified protein derivative-positive household contacts. All of the children had completed treatment. Peripheral blood mononuclear cells were stimulated (phytohemagglutinin, phytohemagglutinin + interleukin 12, lipopolysaccharide, lipopolysaccharide + interferon-, and purified protein derivative), and cytokine responses (interleukin 1beta, interleukin-4, interleukin-6, interleukin-8, interleukin 10, interleukin 12, interferon-, tumor necrosis factor-alpha, and monocyte chemoattractant protein 1) were quantified by bead-based assay. Median cytokine responses were compared by the Kruskal-Wallis test. Multivariate analysis of variance accounted for multiple comparisons. RESULTS. There were 18 case subjects with miliary/meningeal tuberculosis, 28 pulmonary control subjects, and 29 purified protein derivative-positive control subjects. The median age was 4.2 years. There was no difference in case and control subjects by age, gender, race, BMI, or median CD4 count. Twelve (67%) of 18 case subjects, 26 (93%) of 28 pulmonary control subjects, and 28 (97%) of 29 purified protein derivative-positive subjects had received BCG vaccine. No cytokine defects were identified in case subjects with miliary/meningeal tuberculosis compared with either set of control subjects. Pulmonary control subjects had uniformly higher monocyte chemoattractant protein 1 levels than case subjects with miliary/meningeal tuberculosis and purified protein derivative-positive control subjects, both at rest and with lipopolysaccharide, lipopolysaccharide + interferon-, and purified protein derivative stimulation. Pulmonary control subjects did not have a higher frequency of allele G in the -2518 monocyte chemoattractant protein 1 promoter polymorphism. Case subjects with miliary/meningeal tuberculosis who had received BCG vaccine (n = 12) had lower stimulated interleukin 8 production than children who did not receive BCG vaccine (n = 6). CONCLUSIONS. Children with previous miliary/meningeal tuberculosis did not have a major defect in the cytokine pathways studied. Increased monocyte chemoattractant protein 1 levels were associated with pulmonary disease, occurred despite BCG vaccination, and were not associated with a polymorphism in the monocyte chemoattractant protein 1 promoter. Copyright 2007 by the American Academy of Pediatrics."									
1544	"Complementary feeding adequacy in relation to nutritional status among early weaned breastfed children who are born to HIV-infected mothers: ANRS 1201/1202 Ditrame Plus, Abidjan, Cote d'Ivoire."	"Becquet R, Leroy V, Ekouevi DK, Viho I, Castetbon K, Fassinou P, Dabis F, et al."	Pediatrics. 2006;117(4):e701-e10.		"OBJECTIVE. In high HIV prevalence resource- constrained settings, exclusive breastfeeding with early cessation is one of the conceivable interventions aimed at the prevention of HIV through breast milk. Nevertheless, this intervention has potential adverse effects, such as the inappropriateness of complementary feeding to take over breast milk. The purpose of our study first was to describe the nature and the ages of introduction of complementary feeding among early weaned breastfed infants up to their first birthday and second was to assess the nutritional adequacy of these complementary foods by creating a child feeding index and to investigate its association with child nutritional status. METHODS. A prospective cohort study in Abidjan, Cote d'Ivoire, was conducted in HIV-infected pregnant women who were willing to breastfeed and had received a perinatal antiretroviral prophylaxis. They were requested to practice exclusive breastfeeding and initiate early cessation of breastfeeding from the fourth month to reduce breast milk HIV transmission. Nature and ages of introductory complementary feeding were described in infants up to their first birthday by longitudinal compilation of 24-hour and 7-day recall histories. These recalls were done weekly until 6 weeks of age, monthly until 9 months of age, and then quarterly. We created an index to synthesize the nutritional adequacy of infant feeding practices (in terms of quality of the source of milk, dietary diversity, food, and meal frequencies) ranging from 0 to 12. The association of this feeding index with growth outcomes in children was investigated. RESULTS. Among the 262 breastfed children included, complete cessation of breastfeeding occurred in 77% by their first birthday, with a median duration of 4 months. Most of the complementary foods were introduced within the seventh month of life, except for infant food and infant formula that were introduced at age 4 months. The feeding index was relatively low (5 of 12) at age 6 months, mainly as a result of insufficient dietary diversity, but was improved in the next 6 months (8.5 of 12 at 12 months of age). Inadequate complementary feeding at age 6 months was associated with impaired growth during the next 12 months, with a 37% increased probability of stunting. CONCLUSION. Adequate feeding practices around the weaning period are crucial to achieving optimal child growth. HIV-infected women should turn to early cessation of breastfeeding only when they are counseled properly to provide adequate complementary feeding to take over breast milk. Our child feeding index could contribute to the assessment of the nutritional adequacy of complementary feeding around the weaning period and therefore help to detect children who are at risk for malnutrition. Copyright 2006 by the American Academy of Pediatrics."									
545	Short-term clinical disease progression in HIV-infected patients receiving combination antiretroviral therapy: results from the TREAT Asia HIV Observational Database.	"Srasuebkul P, Lim P, Lee M, Nagalingeswaran K, Zhou J, Sirisanthana T, Li PCK, et al."	Clinical Infectious Diseases. 2009;48(7):940-50.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20093122647	"Objective. The aim of our study was to develop, on the basis of simple clinical data, predictive short-term risk equations for AIDS or death in Asian patients infected with human immunodeficiency virus (HIV) who were included in the TREAT Asia HIV Observational Database. Methods. Inclusion criteria were highly active antiretroviral therapy initiation and completion of required laboratory tests. Predictors of short-term AIDS or death were assessed using Poisson regression. Three different models were developed: a clinical model, a CD4 cell count model, and a CD4 cell count and HIV RNA level model. We separated patients into low-risk, high-risk, and very high-risk groups according to the key risk factors identified. Results. In the clinical model, patients with severe anemia or a body mass index (BMI; calculated as the weight in kilograms divided by the square of the height in meters) <=18 were at very high risk, and patients who were aged <40 years or were male and had mild anemia were at high risk. In the CD4 cell count model, patients with a CD4 cell count <50 cells/ micro L, severe anemia, or a BMI <=18 were at very high risk, and patients who had a CD4 cell count of 51-200 cells/ micro L, were aged <40 years, or were male and had mild anemia were at high risk. In the CD4 cell count and HIV RNA level model, patients with a CD4 cell count <50 cells/ micro L, a detectable viral load, severe anemia, or a BMI<=18 were at very high risk, and patients with a CD4 cell count of 51-200 cells/ micro L and mild anemia were at high risk. The incidence of new AIDS or death in the clinical model was 1.3, 4.9, and 15.6 events per 100 person-years in the low-risk, high-risk, and very high-risk groups, respectively. In the CD4 cell count model the respective incidences were 0.9, 2.7, and 16.02 events per 100 person-years; in the CD4 cell count and HIV RNA level model, the respective incidences were 0.8, 1.8, and 6.2 events per 100 person-years. Conclusions. These models are simple enough for widespread use in busy clinics and should allow clinicians to identify patients who are at high risk of AIDS or death in Asia and the Pacific region and in resource-poor settings."									
1744	The influence of pre-pregnancy BMI and weight gain during pregnancy on pregnancy outcomes.	"Ward E, Kruger HS, Graan Av."	SAJCN South African Journal of Clinical Nutrition. 2007;20(3):112-7.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20083046287	"Objective. The purpose of this study was to evaluate the association between pre-pregnancy body mass index (BMI) and maternal pregnancy weight gain and pregnancy outcomes. Methods. Ninety-eight pregnant black women were followed up during pregnancy. Pre-pregnancy weight was recorded or calculated by regression analysis, and weekly weight gain was calculated. The correlation between pre-pregnancy BMI, weekly weight gain, blood pressure, and the infants' birth weight, length and head circumference was assessed, adjusting for gestational age and smoking. Adjustment for HIV status was also done in subjects with known status. Participants were categorised into three groups: pre-pregnancy BMI<19.8, BMI 19.8-26, and BMI>26. Results. According to the Institute of Medicine (IOM)'s weight gain recommendations, women in all BMI categories tended to gain excessive weight. Pregnancy weight gain was significantly associated with infant birth weight ( chi <sup>2</sup>=6.25, p=0.04), although no significant correlations were found between weekly weight gain or mothers' pre-pregnancy BMI, respectively, and birth outcomes. Pre-pregnancy BMI correlated significantly with blood pressure at the second clinic visit. Age and parity correlated significantly with pre-pregnancy BMI; and household income correlated with mothers' weekly weight gain. Conclusion. Inadequate weight gain was associated with a significantly lower infant birth weight. No correlation was found between infant birth weight and mother's pre-pregnancy BMI."									
1735	Quality of care offered to children attending primary health care clinics in Johannesburg.	"Thandrayen K, Saloojee H."	SAJCH South African Journal of Child Health. 2010;4(3):73-7.		"Objective. To assess the quality of child health services provided at primary health care (PHC) facilities in Johannesburg, South Africa. Design. Observational study conducted at 16 PHC clinics. A researcher-developed structured checklist, based on national guidelines and protocols, was utilised. Results. The majority of facilities were adequately equipped and well stocked with drugs. A total of 141 sick child and 149 well child visits were observed. Caregivers experienced long waiting times (mean 135 (standard deviation 72) minutes). Many routine examination procedures were poorly performed, with an adequate diagnosis established in 108 of 141 consultations (77%), even though health professionals were experienced and well trained. Triage and attention to danger signs were poor. An antibiotic was prescribed in almost half (65/141) of the consultations, but antibiotic use was unwarranted in one-third of these cases. Health promotion activities (such as growth monitoring) were consistently ignored during sick child visits. HIV status was seldom asked about or investigated, for the mother or for the child. Growth monitoring and nutritional counselling at well child visits was generally inadequate, with not one of 11 children who qualified for food supplementation receiving it. Conclusion. The poor quality of PHC offered to children in the richest city in Africa is a sad indictment of the inability of health service providers to address children's health needs meaningfully. A deliberate and radical restructuring of PHC for children, with clearly defined and monitored standard clinical practice routines and norms, is required to change the status quo."									
1532	"Growth of human immunodeficiency type 1-infected and uninfected children: A prospective cohort study in Kigali, Rwanda, 1988 to 1993."	"Lepage P, Msellati P, Hitimana DG, Bazubagira A, Van Goethem C, Simonon A, Karita E, et al."	Pediatric Infectious Disease Journal. 1996;15(6):479-85.		"Objective. To compare the anthropometric characteristics of children with and without HIV-1 infection. Methods. In a prospective cohort study of 218 children born to HIV-1 seropositive mothers and 218 children born to HIV-1 seronegative mothers in Kigali, Rwanda, 3 groups were compared: infected children (n = 46); uninfected children born to seropositive mothers (n = 140); and uninfected children born to seronegative mothers (n = 207). Weight, height and head circumference were measured at birth, every 3 months during the first year of life and every 6 months thereafter. The weight-for-age, height-for-age, weight-for-height and head circumference-for-age mean z scores were calculated. Results. The weight-for-age, height-for-age and head circumference-for-age mean z scores were lower among HIV-infected children than among uninfected ones at each time period. The reduction in the weight- for-age mean z score was the greatest between 12 and 36 months. The reduction in the height-for-age mean z score of HIV-infected children was persistently below 2 so after 9 months of age. On the other hand the weight-for-height mean z score was not consistently lower in HIV-infected children when compared with uninfected ones. The anthropometric characteristics of uninfected children born to seropositive mothers were similar to those of children born to seronegative mothers. Conclusions. In this study HIV- infected children were more frequently stunted (low height-for-age) than uninfected ones. Wasting (low weight-for-height) was not common among HIV- infected children."									
1822	Impact of urbanisation on serum lipid profiles - The THUSA survey.	"Oosthuizen W, Vorster HH, Kruger A, Venter CS, Kruger HS, de Ridder JH."	South African Medical Journal. 2002 September;92(9):723-8.		"Objective. To examine the impact of urbanisation on lipid profiles of black South Africans, stratified for HIV status. Design. Cross-sectional population-based survey. Setting. North West province of South Africa. Subjects. A representative sample of 1 854 apparently healthy volunteers aged >= 15 years, was recruited from 37 randomly selected sites throughout the province. Subjects were stratified into five urbanisation strata (S): S1 rural villages, S2 farms, S3 informal housing or 'squatter camps', S4 urban townships, and S5 surburban housing. Outcome measures. Demographic, physical activity and dietary intake information was collected using validated and culture-sensitive questionnaires. Anthropometric measurements and lipid analyses were determined using standardised methodology. Results. The results revealed significantly lower mean (95% confidence interval) total serum cholesterol (TC) levels in HIV-negative men in S1 - S4 compared with S5 (S1 3.91 (3.77 - 4.05) v. S5 4.79 (4.54 - 5.04) mmol/l). In HIV-negative women, TC levels were significantly lower in S1 - S3 than in S4 and S5 (S1 4.05 (3.94 - 4.17) v. S5 4.79 (4.59 - 5.00) mmol/l). The same trends were seen for serum low-density lipoprotein cholesterol (LDLC) and triglycerides and in HIV-positive subjects. Binary logistical analysis indicated that the main factor responsible for the increased TC levels seemed to be increased body mass index (BMI) due to decreased physical activity. Conclusions. Serum lipid levels increased with urbanisation although they remained within levels recommended for other populations. This may, however, become an important health problem in future if preventive strategies are not implemented. Culturally sensitive physical activity programmes to decrease BMI, targeted at professional men and women, and women in urban townships, seem to constitute the most appropriate intervention."									
863	"Pregnancy, body weight and human immunodeficiency virus infection in African women: A prospective cohort study in Kigali (Rwanda), 1992-1994."	"Ladner J, Castetbon K, Leroy V, Nyiraziraje M, Chauliac M, Karita E, De Clercq A, et al."	International Journal of Epidemiology. 1998;27(6):1072-7.		"Objective. To study the relationship between human immunodeficiency virus (HIV) infection and body weight in African women during and after pregnancy. Methods. A prospective cohort study was initiated at the Centre Hospitalier de Kigali in July 1992. Every woman seen at the antenatal clinic and with a gestational age of < 28 weeks was offered HIV-1 antibody testing. Comparable numbers of HIV-infected (HIV+) and uninfected (HIV-) women were recruited. At inclusion, socio-demographic characteristics and self-reported pre-pregnancy weight were recorded; height and weight were measured. Each woman enrolled had a monthly follow-up until 9 months after delivery, with a clinical examination including weighing. Three anthropometric indices were used to answer the study objectives: weight, body mass index (BMI), and pregnancy balance. Results. As of April 1994, 101 HIV+ and 106 HIV- women were followed until 5 months after delivery. Weight and BMI during pregnancy were lower in HIV+ women than in HIV- women. After delivery, weight and BMI gains were significantly lower in HIV+ women. Until 5 months after delivery, the mean weight variation was -2.2 kg (standard deviation [SD] = 5.9 kg) in HIV+ women and +0.2 kg (SD = 6.6 kg in HIV- women (P = 0.007) in comparison to pre-pregnancy weight. Comparisons of the slopes of the weight curves did not show statistical differences throughout the pregnancy, but it did during the post-partum period (P = 0.02). Conclusions. Our study suggests that HIV infection could impair nutritional status in pregnant women, especially during the post-partum period. Family planning and maternal and child health services including HIV testing and counselling, should consider a nutritional assessment and intervention programme targeted to HIV+ pregnant women."									
1482	"Increased risk of mortality and loss to follow-up among HIVpositive patients with oropharyngeal candidiasis and malnutrition before antiretroviral therapy initiation: A retrospective analysis from a large urban cohort in Johannesburg, South Africa."	"Evans D, Maskew M, Sanne I."	"Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology. 2012 March;113(3):362-72."		"Objective. We investigated the effect of oropharyngeal candidiasis (OC) and body mass index (BMI) before antiretroviral therapy (ART) initiation on treatment outcomes of human immunodeficiency virus (HIV)-positive patients. Study Design. Treatment outcomes included failure to increase CD4 count by <=50 or <=100 cells/muL or failure to suppress viral load (<400 copies/mL) at 6 or 12 months in addition to loss to follow-up (LTFU) and mortality by 12 months. Risk and hazard ratios (HRs) were estimated with the use of log-binomial regression and Cox proportional hazards models, respectively. Results. Baseline CD4 <100 cells/muL, low BMI (=18.5 kg/m2), low hemoglobin, and elevated aspartate transaminase were associated with OC at ART initiation. Patients with low BMI with and without, respectively, OC were at risk of mortality (HR 2.42, 95%CI 1.88-3.12; HR 1.87, 95%CI 1.54-2.28) and LTFU (HR 1.36, 95%CI 1.02-1.82; HR 1.55, 95%CI 1.30-1.85). Conclusions. Low BMI (with/without OC) at ART initiation was associated with poor treatment outcomes. Conversely, normal BMI with OC was associated with adequate CD4 response and reduced LTFU compared with without OC. 2012 Elsevier Inc. All rights reserved."									
1950	"Implementing family-focused HIV care and treatment: The first 2 years' experience of the mother-to-child transmission -plus program in Abidjan, Cote d'Ivoire."	"Tonwe-Gold B, Ekouevi DK, Bosse CA, Toure S, Kone M, Becquet R, Leroy V, et al."	Tropical Medicine and International Health. 2009 February;14(2):204-12.		"Objectives : To describe a family-focused approach to HIV care and treatment and report on the first 2 years experience of implementing the mother-to-child transmission (MTCT)-plus program in Abidjan, Cote d'Ivoire. Program : The MTCT-plus initiative aims to enrol HIV-infected pregnant and postpartum women in comprehensive HIV care and treatment for themselves and their families. Main outcomes : Between August 2003 and August 2005, 605 HIV-infected pregnant or postpartum women and 582 HIV-exposed infants enrolled. Of their 568 male partners reported alive, 52% were aware of their wife's HIV status and 30% were tested for HIV; 53% of these tested partners were found to be HIV-infected and 78% enrolled into the program. Overall only 10% of the women enrolled together with their infected partner. On the other hand, the program involved half of the seronegative men who came for voluntary counselling and testing (VCT) in the care of their families. Of 1624 children <15 years reported alive by their mothers (excluding the last newborn infants of the most recent pregnancy systematically screened for HIV), only 10.8% were brought in for HIV testing, of whom 12.3% were found to be HIV-infected. Lessons learned and challenges : The family-focused model of HIV care pays attention to the needs of families and household members. The program was successful in enrolling HIV women, their partners and infants in continuous follow-up. However engaging partners and family members of newly enrolled women into care involves numerous challenges such as disclosure of HIV status by women to their partners and family members. Further efforts are required to understand barriers for families accessing HIV services as strategies to improve partner involvement and provide access to care for other children in the households are needed in this West African urban setting. 2009 Blackwell Publishing Ltd."									
1237	Antiretroviral Therapy Initiation in France: Adherence to National Guidelines and Outcome.	"Latthaphasavang V, Bouldouyre M-A, Rachline A, Ponscarme D, Rozenbaum W, Mary J-Y, Delaugerre C, et al."	Journal of the International Association of Physicians in AIDS Care (JIAPAC). 2012 Feb 2012;11(1):40-6.	http://search.proquest.com/docview/925148121?accountid=26724	"Objectives and Methods: Retrospective study of all patients who started antiretroviral therapy (ART) in 2007 in a single center in Paris, with baseline characteristics and 1-year outcome, to assess adherence to national guidelines. Results: We analyzed 118 patients. Time of ART initiation was in agreement with the guidelines for only 64 (54.2%) patients. Fifty patients (42%) started ART with AIDS or a CD4 count <200 cells/mm3. In all, 62 (52%) and 47 patients (40%) received a combination of 2 nucleoside analogues with efavirenz (EFV) and 1 ritonavir-boosted protease inhibitor (PI/r), respectively. Treatment regimens were in accordance with the guidelines for 114 patients (97%). At 1 year, 16 patients (13.5%) were lost to follow-up, only 5 (4.9%) experienced HIV disease progression or death, but 19 (18.6%) required hospitalization. Antiretroviral therapy was changed in 21 patients (21%). Ten patients (8.4%) experienced virologic failure. Conclusion: Antiretroviral therapy was in agreement with guidelines for the choice of combination but was often initiated too late."									
1944	Total lymphocyte count is a good marker for HIV-related mortality and can be used as a tool for starting HIV treatment in a resource-limited setting.	"Oudenhoven HPW, Meijerink H, Wisaksana R, Oetojo S, Indrati A, van der Ven AJAM, van Asten HAGH, et al."	Tropical Medicine and International Health. 2011 November;16(11):1372-9.		"Objectives Total lymphocyte counts (TLC) may be used as an alternative for CD4 cell counts to monitor HIV infection in resource-limited settings, where CD4 cell counts are too expensive or not available. Methods We used prospectively collected patient data from an urban HIV clinic in Indonesia. Predictors of mortality were identified via Cox regression, and the relation between TLC and CD4 cell counts was calculated by linear regression. Receiver operating characteristics (ROC) curves were used to choose the cut-off values of TLC corresponding with CD4 cell counts <200 and <=350cells/mul. Based on these analyses, we designed TLC-based treatment algorithms. Results Of 889 antiretroviral treatment (ART)-naive subjects included, 66% had CD4 cell counts <200 and 81% had 350<=cells/mul at baseline. TLC and CD4 cell count were equally strong predictors of mortality in our population, where ART was started based on CD4 cell count criteria. The correlation coefficient (R) between TLC and CD4 was 0.70. Optimal cut-off values for TLC to identify patients with CD4 cell counts <200 and <=350cells/mul were 1500 and 1700cells/mul, respectively. Treatment algorithms based on a combination of TLC, gender, oral thrush, anaemia and body mass index performed better in terms of predictive value than WHO staging or TLC alone. In our cohort, such an algorithm would on average have saved $14.05 per patient. Conclusion Total lymphocyte counts is a good marker for HIV-associated mortality. Simple algorithms including TLC can prioritize patients for HIV treatment in a resource-limited setting, until affordable CD4 cell counts will be universally available. 2011 Blackwell Publishing Ltd."									
648	Case management of kwashiorkor: an intervention project at seven nutrition rehabilitation centres in Malawi.	"Brewster DR, Manary MJ, Graham SM."	European Journal of Clinical Nutrition. 1997;51(3):139-47.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=9076403	OBJECTIVES: (1) To improve case management of kwashiorkor at seven Nutritional Rehabilitation Centres (NRCs) through 2-4 weekly paediatric supervisory visits. (2) To evaluate the impact of the use of routine tube-feeding and a micronutrient supplement (Nutriset).	"DESIGN: An intervention project with descriptive clinical data in which Nutriset was introduced halfway through the project, and routine tube-feeding at one NRC was compared to no tube-feeding at a similar one."	"SETTING: NRCs located at two central hospitals, two district hospitals and three rural clinics in southern Malawi."	SUBJECTS: 1625 consecutive kwashiorkor admissions from January-December 1995.	"RESULTS: The overall case-fatality rate was 24.2% (393/1625), varying by facility level (central 30.5%, district 25.8% and rural 7.5%), reflecting different severity of cases. From ELISA testing and a clinical protocol, we estimate that 21.7% (353/1625) of these kwashiorkor cases were HIV-infected, including 121 breastfed children. Routine tube-feeding was associated with better weight gain (8.24 g/kg/d) than no tube-feeding (4.51 g/kg/d) at central NRCs, but with no reduction in mortality (31.4% vs 30.3%). The introduction of Nutriset was associated with improved weight gain (6.06 vs 4.66 g/kg/d) and a lower mortality (20.8 vs 25.8%), but was confounded by seasonal factors."	"CONCLUSIONS: From a clinical perspective, HIV infection has transformed kwashiorkor in this part of Africa. Routine tube-feeding was associated with improved body weight gain in the treatment of kwashiorkor. The benefit of paediatric supervision was limited by the infrequency of visits, by constraints of health worker motivation, by a lack of resources and by the severity of disease. Efforts need to focus-not just on case management protocols-but on how to actually improve clinical practice in this setting."				
829	Profile of HIV infected children from Delhi and their response to antiretroviral treatment.	"Gomber S, Kaushik JS, Chandra J, Anand R."	Indian Pediatrics. 2011 September;48(9):703-7.		"Objectives: (i) To study the clinical and immunological profile of HIV infected children attending the ART centre; (ii) To correlate CD4 count with clinical staging at diagnosis; and, iii) To study the clinical and immunological response to antiretroviral treatment. Setting: Antiretroviral therapy (ART) centres of two tertiary care hospitals of Delhi. Patients: 100 children attending the centres between December 2008 to June 2009. Methods: The clinical features, immunological profile (CD4 count) and response to ART were recorded in a structured proforma. Design: Prospective follow-up. Results: Average age of enrolled children was 6.24 y (range 1-14 years) and mode of transmission was parent to child in 92%. Most common clinical presentation was fever (83%), cough (50.8%) and diarrhea (38.9%). Tuberculosis was the most common opportunistic infection seen in 11% of children. 59% of enrolled children were malnourished. Antiretroviral treatment (ART) was initiated in 33 children. Children who were initiated on ART had a significant improvement in both clinical and immunological staging at the 6 months follow up. Immunological response (rise in CD4 count) to ART was better in children with lesser degree of immunosuppression. The measure of agreement between the clinical and immunological stage at presentation was poor. Conclusions: Baseline CD4 counts rather than clinical staging can be a primary determinant for initiation of antiretroviral treatment in HIV infected children. 2011 Indian Academy of Pediatrics."									
503	A prospective study of psychological distress among mothers of children admitted to a nutritional rehabilitation unit in Malawi.	"Stewart RC, Bunn J, Vokhiwa M, Umar E, Kauye F, Tomenson B, Rahman A, et al."	"Child: Care, Health & Development. 2011;37(1):55-63."	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=20645996	OBJECTIVES: Accompanying guardians (usually the mother) have a pivotal role in promoting recovery from childhood severe acute malnutrition on Nutritional Rehabilitation Units (NRUs). We describe the prevalence of maternal distress at an NRU in Malawi and identify factors associated with this. We tested the hypothesis that maternal distress during admission would be associated with reduced child weight gain over the 4-week post-discharge period.	"METHODS: Maternal distress was measured using the Self Reporting Questionnaire (SRQ) administered to mothers of consecutive children during NRU admission. Repeat SRQ was administered to mothers attending a follow-up clinic 4 weeks post discharge. Maternal, child and psychosocial variables were also measured. Child weight change from discharge to follow-up was compared between children of mothers scoring SRQ >= 8 and those scoring SRQ < 8."	"FINDINGS: A total of 244 mothers and their children were recruited. In total, 71% of mothers scored SRQ >= 8 during admission. In all, 155 of 222 mothers eligible to complete repeat SRQ did so, and 33.5% scored SRQ >= 8. Maternal distress at recruitment was associated with older child age, no confiding relationship with spouse, having had a previous child die, and the child having diarrhoea. Maternal distress at follow-up was associated with older child age, the child having diarrhoea or fever since discharge, and the child being HIV sero-positive. Maternal distress during admission was not associated with child weight gain at 4-week post-discharge follow-up."	CONCLUSION: Levels of maternal distress are very high during child admission to an NRU. Persistent distress is associated with child health factors including HIV. Nutritional rehabilitation programmes should pay increased attention to carer psychological wellbeing using targeted evidence-based interventions. 2010 Blackwell Publishing Ltd.						
73	Positive outcomes of HAART at 24 months in HIV-infected patients in Cambodia.	"Ferradini L, Laureillard D, Prak N, Ngeth C, Fernandez M, Pinoges L, Puertas G, et al."	Aids. 2007 November;21(17):2293-301.		"OBJECTIVES: African and Asian cohort studies have demonstrated the feasibility and efficacy of HAART in resource-poor settings. The long-term virological outcome and clinico-immunological criteria of success remain important questions. We report the outcomes at 24 months of antiretroviral therapy (ART) in patients treated in a Medecins Sans Frontieres/ Ministry of Health programme in Cambodia. METHODS: Adults who started HAART 24 +/- 2 months ago were included. Plasma HIV-RNA levels were assessed by real-time polymerase chain reaction. Factors associated with virological failure were analysed using logistic regression. RESULTS: Of 416 patients, 59.2% were men; the median age was 33.6 years. At baseline, 95.2% were ART naive, 48.9% were at WHO stage IV, and 41.6% had a body mass index less than 18 kg/m. The median CD4 cell count was 11 cells/mul. A stavudine-lamivudine-efavirenz- containing regimen was initiated predominantly (81.0%). At follow-up (median 23.8 months), 350 (84.1%) were still on HAART, 53 (12.7%) had died, six (1.4%) were transferred, and seven (1.7%) were lost to follow-up. Estimates of survival were 85.5% at 24 months. Of 346 tested patients, 259 (74.1%) had CD4 cell counts greater than 200 cells/mul and 306 (88.4%) had viral loads of less than 400 copies/ml. Factors associated with virological failure at 24 months were non-antiretroviral naive, an insufficient CD4 cell gain of less than 350 cells/mul or a low trough plasma ART concentration. In an intention-to-treat analysis, 73.6% of patients were successfully treated. CONCLUSION: Positive results after 2 years of advanced HIV further demonstrate the efficacy of HAART in the medium term in resource-limited settings. 2007 Lippincott Williams & Wilkins, Inc."									
106	Risk factors for high early mortality in patients on antiretroviral treatment in a rural district of Malawi.	"Zachariah R, Fitzgerald M, Massaquoi M, Pasulani O, Arnould L, Makombe S, Harries AD."	Aids. 2006 November;20(18):2355-60.		"OBJECTIVES: Among adults started on antiretroviral treatment (ART) in a rural district hospital (a) to determine the cumulative proportion of deaths that occur within 3 and 6 months of starting ART, and (b) to identify risk factors that may be associated with such mortality. DESIGN AND SETTING: A cross-sectional analytical study set in Thyolo district, Malawi. METHODS: Over a 2-year period (April 2003 to April 2005) mortality within the first 3 and 6 months of starting ART was determined and risk factors were examined. RESULTS: A total of 1507 individuals (517 men and 990 women), whose median age was 35 years were included in the study. There were a total of 190 (12.6%) deaths on ART of which 116 (61%) occurred within the first 3 months (very early mortality) and 150 (79%) during the first 6 months of initiating ART. Significant risk factors associated with such mortality included WHO stage IV disease, a baseline CD4 cell count under 50 cells/mul and increasing grades of malnutrition. A linear trend in mortality was observed with increasing grades of malnutrition (chi for trend = 96.1, P <= 0.001) and decreasing CD4 cell counts (chi for trend = 72.4, P <= 0.001). Individuals who were severely malnourished [body mass index (BMI) < 16.0 kg/m] had a six times higher risk of dying in the first 3 months than those with a normal nutritional status. CONCLUSIONS: Among individuals starting ART, the BMI and clinical staging could be important screening tools for use to identify and target individuals who, despite ART, are still at a high risk of early death. 2006 Lippincott Williams & Wilkins, Inc."									
699	Serum phosphate predicts early mortality in HIV patients on ART in Zambia.	"Heimburger DC, Nyirenda C, Kabagambe EK, Potter D, Bosire C, Zulu I, Chisembele-Taylor A."	The FASEB Journal. 2009;23 (S1).		"Objectives: Antiretroviral therapy (ART) programs in developing countries report high mortality rates in the first 90 days of ART. We hypothesize that acute hypophosphatemia, analogous to refeeding syndrome, occurs & is a risk factor for mortality. Methods: We enrolled 148 adults with BMI <16 kg/m<sup>2</sup> or CD4 <50/muL at ART initiation in Lusaka, Zambia. Serum phosphate, diet and anthropometrics were recorded 6 times in 12 weeks of ART. Results: 2.4% of participants had serum phosphate <0.65 mmol/L (<2 mg/dL) at baseline; this increased to 10.9% after 1 week but decreased again after another week. Mean phosphate dropped -0.16+/-0.33 mmol/L (p<0.001) between weeks 0 & 1. In median 86 days of follow-up, 28 participants died (93/100 person-yr). Higher baseline phosphate predicted improved survival (HR 0.15; 95% CI: 0.04-0.56). This remained significant after adjustment for sex, BMI, & CD4 (HR 0.21; 0.06-0.82). Sex(HR men vs. women 2.54; 1.05-6.16) & BMI (HR/unit in BMI 0.74; 0.59-0.93) also significantly predicted early mortality, but CD4 count did not. Baseline serum phosphate correlated with CD4 & intakes of protein & fat but not with sex, BMI, appetite, or intakes of energy or carbohydrate. Conclusions: Hypophosphatemia occurs in persons with HIV/AIDS in Zambia and may worsen early in ART. Higher phosphate concentrations at ART initiation strongly predict improved survival during ART."									
58	Impact of malnutrition and social determinants on survival of HIV-infected adults starting antiretroviral therapy in resource-limited settings.	"Argemi X, Dara S, You S, Mattei JF, Courpotin C, Simon B, Hansmann Y, et al."	AIDS. 2012;26(9):1161-6.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=22472856	"OBJECTIVES: Determining the impact of malnutrition, anaemia and social determinants on survival once starting antiretroviral therapy (ART) in a cohort of HIV-infected adults in a rural HIV care centre in Sihanoukville, Cambodia."	METHODS: Retrospective and descriptive cohort study of adults starting ART between December 2004 and July 2009. We used the Kaplan-Meier and Cox regression survival analyses to identify predictors of death.	"RESULTS: Out of 1002 patients, 49.7% were men; median age was 40; median time of follow-up was 2.4 years and 10.4% died during the follow-up. At baseline, median CD4 cell count was 83 cells/ul, 79.9% were at WHO stage III or IV. In multivariate analysis, malnutrition appeared to be a strong and independent risk factor of death; 11.2% had a BMI less than 16 kg/m and hazard ratio was 6.97 [95% confidence interval (CI), 3.51-13.89], 21.5% had a BMI between 16 and 18 kg/m and hazard ratio was 2.88 (95% CI, 1.42-5.82), 30.8% had a BMI between 18 and 20 kg/m and hazard ratio was 2.18 (95% CI, 1.09-4.36). Severe anaemia (haemoglobin<=8.4 g/dl) and CD4 cell count below 100 cells/ul also predicted mortality, hazard ratio were 2.25 (95% CI, 1.02-4.34) and 2.29 (95% CI, 1.01-2.97), respectively. Social determinants were not significantly associated with death in univariate analysis."	CONCLUSION: Malnutrition and anaemia are strong and independent prognostic factors at the time of starting ART. Nutritional cares are essential for the clinical success of HIV programs started in developing countries.						
658	Increased body weight and improved quality of life in AIDS patients following V-1 Immunitor administration.	"Jirathitikal V, Metadilogkul O, Bourinbaiar AS."	European Journal of Clinical Nutrition. 2004;58(1):110-5.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=14679375	OBJECTIVES: Development of affordable and safe therapy to reverse the loss of body mass is of critical importance since AIDS-related wasting is associated with increased mortality.	"METHOD: We have demonstrated earlier that oral therapeutic HIV vaccine, V-1 Immunitor (V1), tested in a small group of AIDS patients in Thailand not only increases T-cell counts and decreases the viral load but also results in weight gain and prolonged survival. To further expand this observation, we retrospectively analyzed 650 HIV-positive patients who were followed for an average of 23 weeks."	"RESULTS: The treatment with V1 resulted in a sustained and statistically significant increase in body mass across the whole population (mean+/-s.e.; 1.5+/-0.4 kg; P=6.5E-015). Among them, 384 (59%) patients gained an average of 4.2+/-0.2 kg; 107 (17%) had unchanged weight; and 159 (24%) had lost 3.8+/-0.3 kg. Thus, the prevailing majority of patients (76%) were able to gain or maintain weight. Treatment was well tolerated; in a survey of health status in a comparable but separate group of 382 patients, about 85% reported subjective improvement after V1 treatment, 6% reported no difference, and 9% of the patients reported minor adverse reactions, which did not last more than 1 week. Subjective improvement coincides with the reduction or clearance of oral thrush or mucocutaneous candidiasis in 87.5% of the patients."	"CONCLUSIONS: In an open label setting, V1 increases body weight, subjective assessment of quality of life, and is safe and effective for HIV patients with weight loss. These data provide the impetus of using V-1 Immunitor as an affordable and easy-to-administer means of treating AIDS-associated wasting and opportunistic infections."						
659	Increased body weight and improved quality of life in AIDS patients following V-1 immunitor admimnistration.	"Jirathitikal V, Metadilogkul O, Bourinbaiar AS."	European Journal of Clinical Nutrition. 2004 January;58(1):110-5.		"Objectives: Development of affordable and safe therapy to reverse the loss of body mass is of critical importance since AIDS-related wasting is associated with increased mortality. Method: We have demonstrated earlier that oral therapeutic HIV vaccine, V-1 Immunitor (V1), tested in a small group of AIDS patients in Thailand not only increases T-cell counts and decreases the viral load but also results in weight gain and prolonged survival. To further expand this observation, we retrospectively analyzed 650 HIV-positive patients who were followed for an average of 23 weeks. Results: The treatment with V1 resulted in a sustained and statistically significant increase in body mass across the whole population (mean +/- s.e.; 1.5 +/- 0.4 kg; P = 6.5E-015). Among them, 384 (59%) patients gained an average of 4.2 +/- 0.2 kg; 107 (17%) had unchanged weight; and 159 (24%) had lost 3.8 +/- 0.3 kg. Thus, the prevailing majority of patients (76%) were able to gain or maintain weight. Treatment was well tolerated; in a survey of health status in a comparable but separate group of 382 patients, about 85% reported subjective improvement after V1 treatment, 6% reported no difference, and 9% of the patients reported minor adverse reactions, which did not last more than 1 week. Subjective improvement coincides with the reduction or clearance of oral thrush or mucocutaneous candidiasis in 87.5% of the patients. Conclusions: In an open label setting, V1 increases body weight, subjective assessment of quality of life, and is safe and effective for HIV patients with weight loss. These data provide the impetus of using V-1 Immunitor as an affordable and easy-to-administer means of treating AIDS-associated wasting and opportunistic infections."									
1046	Interindividual variability of once-daily ritonavir boosted saquinavir pharmacokinetics in Thai and UK patients.	"Autar RS, Boffito M, Hassink E, Wit FWNM, Ananworanich J, Siangphoe U, Pozniak A, et al."	Journal of Antimicrobial Chemotherapy. 2005 November;56(5):908-13.		"Objectives: Differential exposure to saquinavir/ritonavir may lead to therapy failure. The objective was to identify factors that influence variability of saquinavir/ritonavir plasma concentrations. Methods: Saquinavir/ritonavir data, dosed as 1600/100 mg once daily, from three separate pharmacokinetic studies, in 45 patients from Thailand and the UK, were pooled. Pharmacokinetic parameters were based on non-compartmental analysis. Univariate analysis was performed with saquinavir as the dependent variable, and ritonavir area under the curve (AUC), gender, body weight, body mass index (BMI) and study site as independent variables. Variables with a P value <0.10 were included in a multivariate linear regression analysis. Results: Higher saquinavir AUCs, maximum concentrations (C<sub>max</sub>) and minimum concentrations (C<sub>min</sub>) were seen in Thai patients than in UK patients. Univariate analysis showed associations between body weight, gender, study site and ritonavir AUC and saquinavir AUC (P < 0.05), whereas BMI (P = 0.13) did not. In the multivariate analysis, ritonavir AUC (P = 0.0001) and study site (P = 0.0021) were significantly related to saquinavir AUC (R<sup>2</sup> = 0.50). Conclusions: The ritonavir AUC and study site appeared to be related to exposure of saquinavir. Study site should be viewed as the total of country- and study-specific differences-such as differences in lifestyle, environment, genetic background and dietary composition-between the analysed studies. The Author 2005. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved."									
791	Determinants of epidermal nerve fibre density in antiretroviral-naive HIV-infected individuals.	"Shikuma CM, Gerschenson M, Ananworanich J, Valcour VG, Teeratakulpisarn N, Jadwattanakul T, DeGruttola V, et al."	HIV Medicine. 2012;13(10):602-8.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20123345733	"Objectives: Distal leg epidermal nerve fibre density (ENFD) is a validated predictor of small unmyelinated nerve fibre damage and neuropathy risk in HIV infection. As pre-existing damage may increase the risk of neuropathy following antiretroviral (ARV) therapy, particularly when the regimen contains stavudine (d4T), we assessed the relationship between ENFD and various parameters including mitochondrial factors in HIV-infected Thai individuals naive to ARV therapy. Methods: Distal leg and proximal thigh ENFDs were quantified in HIV-infected Thai individuals without neuropathy prior to randomization to a HIV clinical trial that focused on mitochondrial toxicity issues. We assessed their association with various clinical and immunovirological parameters as well as with peripheral blood mononuclear cell (PBMC) mitochondrial (mt) DNA copies/cell, oxidative phosphorylation (OXPHOS) complex I (CI) and complex IV (CIV) enzyme activities, and mt 8-oxo-deoxyguanine (8-oxo-dG) break frequencies. Results: In 132 subjects, the median (interquartile range) ENFD (fibres/mm) values were 21.0 (16.2-26.6) for the distal leg and 31.7 (26.2-40.0) for the proximal thigh. By linear regression, lower CD4 count (P<0.01), older age (P<0.01), increased body mass index (BMI) (P=0.04), increased height (P=0.02), and higher PBMC OXPHOS activity as measured by CIV activity (P=0.02) were associated with lower distal leg ENFD. Conclusions: Older age, increased height, higher BMI, poorer immunological status and higher PBMC OXPHOS activity are associated with lower distal leg ENFD in HIV-infected subjects free of neuropathy prior to initiation of first-time ARV therapy."									
1048	Outcomes of starting first-line antiretroviral therapy in hepatitis B virus/HIV-coinfected patients in Ghana.	"Chadwick D, Ankcorn M, Sarfo F, Phillips R, Fox Z, Garcia A, Appiah L, et al."	Journal of Antimicrobial Chemotherapy. 2012 December;67(12):2939-42.		"Objectives: HIV/hepatitis B virus (HBV) coinfection is common in Ghana, where first-line antiretroviral therapy (ART) comprises lamivudine with zidovudine or stavudine and nevirapine or efavirenz. Little is known about ART outcomes in the context of coinfection. This study evaluated outcomes of ART among HIV/HBV-coinfected Ghanaians, focusing on locally available parameters. Patients and methods: An observational study comparing clinical and virological outcomes in HIV-infected individuals who were either hepatitis B surface antigen (HBsAg) positive or HBsAg negative was conducted over 36 months. Clinical events, hepatic transaminases, CD4 count and body mass index (BMI) were evaluated among 143 HBsAg-positive and 228 HBsAg-negative patients. In a random subset of HBsAg-positive patients, HBV-DNA levels and polymerase sequences were analysed. Results: Comparing HBsAg-positive and HBsAg-negative patients, 44/143 (30.8%) and 83/228 (36.4%) defaulted follow-up, 15/143 (10.5%) and 30/228 (13.2%) experienced a new clinical event, and 8/143 (5.6%) and 11/228 (4.8%) discontinued their initial regimen, respectively. Transaminase levels were higher in HBsAg-positive patients, although elevations were low grade. HBV coinfection was associated with an adjusted 2.04 (95% CI 0.59-3.49) cells/mm. <sup>3</sup>/month smaller CD4 cell increase; there was no significant effect on BMI changes. After a median of 9 months of ART, 64/66 (97.0%) patients showed detectable HBV-DNA (median 3.3 log. <sub>10</sub> IU/mL; IQR 2.6-6.2); 12/53 (22.6%) of these showed lamivudine-associated resistance mutations. Conclusions: HIV/HBV-coinfected Ghanaians tolerated first-line ART well, but experienced blunted CD4 cell responses. There was evidence of ongoing HBV replication, mild but persistent transaminase elevations and emerging lamivudine resistance in a proportion of treated patients, indicating the potential for progressive liver damage. The Author 2012. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved."									
60	Risk factors for early mortality in children on adult fixed-dose combination antiretroviral treatment in a central hospital in Malawi.	"Bong C, Yu K, Chiang H, Huang W, Hsieh T, Schouten EJ, Makombe SD, et al."	Aids. 2007;21(13):1805-10.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20073218463	"Objectives: In children aged less than 15 years, to determine the cumulative proportion of deaths occurring within 3 and 6 months of starting split-tablet adult fixed-dose combination antiretroviral therapy (ART) and to identify risk factors associated with early deaths. Design: A retrospective cohort analysis. Methods: Data were collected and analysed from ART patient master cards and the ART register of all children registered for treatment between July 2004 and September 2006 in the ART clinic at Mzuzu Central Hospital, northern Malawi. Results: A total of 439 children started on ART, of whom 220 (50%) were male; 37 (8%) were aged less than 18 months, 172 (39%) 18 months to 5 years, and 230 (52%) were 6-14 years. By September 2006, 49 children (11%) had died, of whom 35 (71%) died by 3 months and 44 (89%) by 6 months. The cumulative incidence of death at 3, 6, 12 and 24 months after ART was 8, 12, 13 and 15%, respectively. After multivariate analysis, being in World Health Organization clinical stage 4, having severe wasting and severe immunodeficiency were factors significantly associated with 3-month mortality and 6-month mortality, respectively. Conclusion: Although children do well on ART, there is high early mortality. Scaling up HIV testing and simple diagnostic tests for infants and children, expanding routine provision of cotrimoxazole prophylaxis, and investigating the role of nutritional interventions are three measures that, if implemented and expanded countrywide, may improve ART outcomes."									
61	Risk factors for early mortality in children on adult fixed-dose combination antiretroviral treatment in a central hospital in Malawi.	"Bong CN, Yu JK, Chiang HC, Huang WL, Hsieh TC, Schouten EJ, Makombe SD, et al."	AIDS. 2007;21(13):1805-10.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=17690580	"OBJECTIVES: In children aged less than 15 years, to determine the cumulative proportion of deaths occurring within 3 and 6 months of starting split-tablet adult fixed-dose combination antiretroviral therapy (ART) and to identify risk factors associated with early deaths."	DESIGN: A retrospective cohort analysis.	"METHODS: Data were collected and analysed from ART patient master cards and the ART register of all children registered for treatment between July 2004 and September 2006 in the ART clinic at Mzuzu Central Hospital, northern Malawi."	"RESULTS: A total of 439 children started on ART, of whom 220 (50%) were male; 37 (8%) were aged less than 18 months, 172 (39%) 18 months to 5 years, and 230 (52%) were 6-14 years. By September 2006, 49 children (11%) had died, of whom 35 (71%) died by 3 months and 44 (89%) by 6 months. The cumulative incidence of death at 3, 6, 12 and 24 months after ART was 8, 12, 13 and 15%, respectively. After multivariate analysis, being in World Health Organization clinical stage 4, having severe wasting and severe immunodeficiency were factors significantly associated with 3-month mortality and 6-month mortality, respectively."	"CONCLUSION: Although children do well on ART, there is high early mortality. Scaling up HIV testing and simple diagnostic tests for infants and children, expanding routine provision of cotrimoxazole prophylaxis, and investigating the role of nutritional interventions are three measures that, if implemented and expanded countrywide, may improve ART outcomes."					
443	"Structural determinants of food insufficiency, low dietary diversity and BMI: A cross-sectional study of HIV-infected and HIV-negative Rwandan women."	"Sirotin N, Hoover D, Segal-Isaacson CJ, Shi Q, Adedimeji A, Mutimura E, Cohen M, et al."	BMJ Open. 2012;2(2).		"Objectives: In Sub-Saharan Africa, the overlapping epidemics of undernutrition and HIV infection affect over 200 and 23 million people, respectively, and little is known about the combined prevalence and nutritional effects. The authors sought to determine which structural factors are associated with food insufficiency, low dietary diversity and low body mass index (BMI) in HIV-negative and HIV-infected Sub-Saharan women. Study design: Cross-sectional analysis of a longitudinal cohort. Setting: Community-based women's organisations. Participants: 161 HIV-negative and 514 HIV-infected Rwandan women. Primary and secondary outcome measures: Primary outcomes included food insufficiency (reporting 'usually not' or 'never' to 'Do you have enough food?'), low household dietary diversity (Household Dietary Diversity Score <=3) and BMI <18.5 (kg/m<sup>2</sup>). The authors also measured structural and behavioural factors including: income, household size, literacy and alcohol use. Results: Food insufficiency was prevalent (46%) as was low dietary diversity (43%) and low BMI (15%). Food insufficiency and dietary diversity were associated with low income (adjusted odds ratio (aOR)=2.14 (95% CI 1.30 to 3.52) p<0.01), (aOR=6.51 (95% CI 3.66 to 11.57) p<0.001), respectfully and illiteracy (aOR=2.00 (95% CI 1.31 to 3.04) p<0.01), (aOR=2.10 (95% CI 1.37 to 3.23) p<0.001), respectfully and were not associated with HIV infection. Alcohol use was strongly associated with food insufficiency (aOR=3.23 (95% CI 1.99 to 5.24) p<0.001). Low BMI was inversely associated with HIV infection (aORz0.5) and was not correlated with food insufficiency or dietary diversity. Conclusions: Rwandan women experienced high rates of food insufficiency and low dietary diversity. Extreme poverty, illiteracy and alcohol use, not HIV infection alone, may contribute to food insufficiency in Rwandan women. Food insufficiency, dietary diversity and low BMI do not correlate with one another; therefore, low BMI may not be an adequate screening tool for food insufficiency. Further studies are needed to understand the health effects of not having enough food, low food diversity and low weight in both HIVnegative and HIV-infected women."									
834	Assessment of the factors involving in the development of hypothyroidism in HIV-infected patients: A case-control study.	"Afhami S, Haghpanah V, Heshmat R, Rasoulinejad M, Izadi M, Lashkari A, Tavangar SM, et al."	Infection. 2007 October;35(5):334-8.		"Objectives: Increased prevalence of thyroid dysfunction has been reported in HIV-infected patients, and recent studies have shown hypothyroidism as the most common thyroid function abnormality in this population, especially after treatment with antiretroviral drugs (HAART). The aim of this study is to assess risk factors of hypothyroidism in HIVinfected patients in Iran. Design: This case-control study was conducted among 15 hypothyroid (cases) and 70 euthyroid (control group) HIV-infected outpatients. Serum Free T4, Free T3, and TSH levels were measured, and data on age, sex, body mass index, opium addiction or injection of illicit drugs, duration of HIV infection and HAART, disease stage, CD4-cell count, opportunistic infection (OI) or malignancy, HCV co-infection, and drug use were collected. Results: We found no association between hypothyroidism in HIV-infected patients and any parameters measured, and P value was not significant for receipt of HAART (0.141), CD4-cell count (0.094), duration of HIV infection (0.474), duration of HAART (0.418), HCV co-infection (0.146), OI (0.566), or receipt of rifampin (0.816). Conclusion: In this study, age, sex, HAART, mean CD4- cell count, duration of HIV infection, HCV co-infection, and OI were not significant risk factors of hypothyroidism in HIV-infected patients. The occurrence of hypothyroidism may be related to other factors or HIV infection itself. Therefore, hypothyroidism should be considered in all HIV-infected patients. 2007 Urban & Vogel."									
1047	The use of pharmacokinetically guided indinavir dose reductions in the management of indinavir-associated renal toxicity.	"Boyd MA, Siangphoe U, Ruxrungtham K, Reiss P, Mahanontharit A, Lange JMA, Phanuphak P, et al."	Journal of Antimicrobial Chemotherapy. 2006 June;57(6):1161-7.		"Objectives: Indinavir is associated with nephrotoxicity. Therapeutic drug monitoring of indinavir improves clinical outcome, but there is little data regarding therapeutic drug monitoring for patients with established indinavir-associated renal impairment. We prospectively studied the use of therapeutic drug monitoring in patients with virological success but established nephrotoxicity on an indinavir-containing regimen. Methods: We measured indinavir C<sub>trough</sub>/C<sub>2</sub>h, serum creatinine, pyuria, blood pressure (BP), weight and HIV RNA. The major endpoint of interest was the number of patients achieving a normal creatinine level 20 weeks following final indinavir dose adjustment. Primary analysis was by intention to treat (ITT). Results: A total of 35 patients were enrolled; mean (SD) age 40.3 (5.8) years; mean (SD) BMI 21.5 (2.8) kg/m<sup>2</sup>. At baseline 6/35 (17%) had a serum creatinine concentration within normal limits, but were offered enrolment because of previous nephrotoxicity (nephrolithiasis and/or abnormal serum creatinine), and a screening pharmacokinetic profile associated with increased nephrotoxicity risk. By ITT analysis 11/35 (31%) had normal creatinine at study end (P = 0.18). Of the 29 patients with abnormal creatinine at baseline, 7/29 (24.1%) had normal creatinine at study end (P = 0.016). Patients had a median (IQR) indinavir per dose adjustment over the study of 400 (400-800) mg. We observed improvements in estimated creatinine clearance, pyuria, resting BP and indinavir pharmacokinetic profile. HIV RNA control was maintained with continued immune recovery despite lower indinavir doses. Conclusions: Patients experiencing nephrotoxicity on an indinavir-containing regimen were safely maintained on indinavir by means of therapeutic drug monitoring. Parameters of renal function improved but did not return to baseline values, at least in the short-term. 2006 Oxford University Press."									
95	Prevalence of HIV and chronic comorbidities among older adults.	"Negin J, Martiniuk A, Cumming RG, Naidoo N, Phaswana-Mafuya N, Madurai L, Williams S, et al."	Aids. 2012 31 Jul;26(SUPPL.1):S55-S63.		"Objectives: Limited evidence is available on HIV, aging and comorbidities in sub-Saharan Africa. This article describes the prevalence of HIV and chronic comorbidities among those aged 50 years and older in South Africa using nationally representative data. Design: The WHO's Study of global AGEing and adult health (SAGE) was conducted in South Africa in 2007-2008. SAGE includes nationally representative cohorts of persons aged 50 years and older, with comparison samples of those aged 18-49 years, which aims to study health and its determinants. Methods: Logistic and linear regression models were applied to data from respondents aged 50 years and older to determine associations between age, sex and HIV status and various outcome variables including prevalence of seven chronic conditions. Results: HIV prevalence among adults aged 50 and older in South Africa was 6.4% and was particularly elevated among Africans, women aged 50-59 and those living in rural areas. Rates of chronic disease were higher among all older adults compared with those aged 18-49. Of those aged 50 years and older, 29.6% had two or more of the seven chronic conditions compared with 8.8% of those aged 18-49 years (P < 0.0001). When controlling for age and sex among those aged 50 and older, BMI was lower among HIV-infected older adults aged 50 and older (27.5 kg/m) than in HIV-uninfected individuals of the same age (30.6) (P < 0.0001). Grip strength among HIV-infected older adults was significantly (P=0.004) weaker than among similarly-aged HIV-uninfected individuals. Conclusion: HIV-infected older adults in South Africa have high rates of chronic disease and weakness. Studies are required to examine HIV diagnostics and treatment instigation rates among older adults to ensure equity of access to quality care, as the number and percentage of older adults living with HIV is likely to increase. 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins."									
1224	"Mortality and treatment failure among HIV-infected adults in Dar Es Salaam, Tanzania."	"Chalamilla G, Hawkins C, Okuma J, Spiegelman D, Aveika A, Christian B, Koda H, et al."	Journal of the International Association of Physicians in AIDS Care. 2012 September-October;11(5):296-304.		"Objectives: Monitoring antiretroviral treatment (ART) outcomes is essential for assessing the success of HIV care and treatment programs in resource-limited settings (RLS). Methods: Longitudinal analyses of clinical and immunologic parameters in HIVinfected adults initiated on ART between November 2004 and June 2008 at Management and Development for Health (MDH)-Presidents Emergency Plan For AIDS Relief PEPFAR supported HIV care and treatment clinics in Tanzania. Results: A total of 12 842 patients were analyzed (65.9% female, median baseline CD4 count, 106 cells/mm<sup>3</sup>). Significant improvements in immunologic status were observed with an increase in CD4 count to 298 (interquartile range [IQR] 199-416), 372 (256-490) and 427 (314-580) cells/mm3, at 1, 2, and 3 years, respectively. Overall mortality was 13.1% (1682 of 12 842). Male sex, World Health Organization (WHO) stage III/IV, CD4 <200 cells/mm<sup>3</sup>, hemoglobin (Hgb) <8.5 g/dL, and stavudine (d4T)-containing regimens were independently associated with early and overall mortality. Conclusions: Closer monitoring of males and patients with advanced HIV disease following ART initiation may improve clinical and immunologic outcomes in these individuals. The Author(s) 2012."									
341	"Malnutrition in hospitalized people living with HIV/AIDS: evidence from a cross-sectional study from Chengdu, China."	"Hu W, Jiang H, Chen W, He SH, Deng B, Wang WY, Wang Y, et al."	Asia Pacific Journal of Clinical Nutrition. 2011;20(4):544-50.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=22094839	"OBJECTIVES: Nutrition support has long been ignored in China's HIV/AIDS treatment and care. The objectives of this project were to evaluate the prevalence of malnutrition among Chengdu urban HIV positive patients, and to provide evidence for further nutritional intervention."	"MATERIALS AND METHODS: HIV-infected adults admitted to an infectious diseases inpatient unit were eligible for this study. Nutritional status was evaluated using Subject Global Assessment (SGA), Malnutrition Universal Screening Tool (MUST), body mass index (BMI), food frequency questionnaire and dietary records."	"RESULTS: 94 hospitalized HIV positive patients were enrolled from April 2009 to May 2010. The median CD4 T cell count was 44.0/mm3. The prevalence of malnutrition is measured by three tools and ranged from 37.2% (by BMI) to 77.2% (by SGA class B/C or MUST scores >= 2). Chi-square test showed significant relationship between opportunistic infections and MUST score (OR=5.67, p<0.005, 95% CI=1.96-16.4). Of patients, 59.6% had insufficient total energy intake; while 54.3% had insufficient protein intake."	CONCLUSIONS: Malnutrition is highly prevalent among Chengdu urban HIV/AIDS patients who underwent inpatient treatment. Calorie and protein deficiency should be given more attention in HIV/AIDS care programs. Nutrition evaluation and support should be considered an integral parts of national and community HIV/AIDS treatment and care guidelines.						
89	Younger age at HAART initiation is associated with more rapid growth reconstitution.	"McGrath CJ, Chung MH, Richardson BA, Benki-Nugent S, Warui D, John-Stewart GC."	AIDS. 2011;25(3):345-55.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=21102302	OBJECTIVES: Patterns of growth following highly active antiretroviral therapy (HAART) administration among children are not well defined. The objective of this study was to determine rates and predictors of growth reconstitution among children on HAART.	METHODS: A study was conducted among HIV-1-infected children initiating HAART at an HIV treatment clinic in Kenya. Kaplan-Meier survival curves and Cox proportional hazards regression models compared catch-up growth (Z-score >= 0) at 12 months post-HAART. Multivariate linear mixed-effects models determined rates and predictors of growth following HAART.	"RESULTS: One hundred and seventy-three HIV-1-infected children initiated HAART with a median age of 4.7 years [interquartile range (IQR) 2.4, 7.0]. At baseline, children below 3 years had lower weight-for-age (WAZ) and weight-for-height (WHZ) Z-scores than children 3-5 and 6-10 years (WAZ: P = 0.03; WHZ: P = 0.006). Adjusting for baseline growth, children below 3 years were two to three-fold more likely to attain population age-norms (Z-score = 0) than 6-10 years (WAZ: P = 0.055; WHZ: P = 0.005) at 12 months post-HAART. After adjustment, children below 3 years had higher increases in WAZ and WHZ following HAART than 6-10 years (WAZ: P = 0.006; WHZ: P = 0.005). Children at WHO stage at least 3 at baseline experienced more rapid WHZ reconstitution (P = 0.002). Food supplementation while on HAART was associated with increased monthly gains in weight indices (WAZ: P = 0.001; WHZ: P = 0.005), and multivitamins were associated with greater increases in height (P < 0.01)."	"CONCLUSION: Following HAART initiation, younger children had more rapid catch-up to the population-average weight of their peers than older children, demonstrating growth benefit of earlier HAART. In addition to HAART, food supplementation and multivitamins may also accelerate growth reconstitution."						
1508	"Use, perceptions, and acceptability of a ready-to-use supplementary food among adult HIV patients initiating antiretroviral treatment: a qualitative study in Ethiopia."	"Olsen MF, Tesfaye M, Kaestel P, Friis H, Holm L."	Patient preference & adherence. 2013;7:481-8.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=23766634	"OBJECTIVES: Ready-to-use supplementary foods (RUSF) are used increasingly in human immunodeficiency virus (HIV) programs, but little is known about how it is used and viewed by patients. We used qualitative methods to explore the use, perceptions, and acceptability of RUSF among adult HIV patients in Jimma, Ethiopia."	METHODS: The study obtained data from direct observations and 24 in-depth interviews with HIV patients receiving RUSF.	"RESULTS: Participants were generally very motivated to take RUSF and viewed it as beneficial. RUSF was described as a means to fill a nutritional gap, to ""rebuild the body,"" and protect it from harmful effects of antiretroviral treatment (ART). Many experienced nausea and vomiting when starting the supplement. This caused some to stop supplementation, but the majority adapted to RUSF. The supplement was eaten separately from meal situations and only had a little influence on household food practices. RUSF was described as food with ""medicinal qualities,"" which meant that many social and religious conventions related to food did not apply to it. The main concerns about RUSF related to the risk of HIV disclosure and its social consequences."	"CONCLUSION: HIV patients view RUSF in a context of competing livelihood needs. RUSF intake was motivated by a strong wish to get well, while the risk of HIV disclosure caused concerns. Despite the motivation for improving health, the preservation of social networks was prioritized, and nondisclosure was often a necessary strategy. Food sharing and religious fasting practices were not barriers to the acceptability of RUSF. This study highlights the importance of ensuring that supplementation strategies, like other HIV services, are compatible with the sociocultural context of patients."						
669	Influence of inflammation as measured by alpha-1-acid glycoprotein on iron status indicators among HIV-positive postpartum Zimbabwean women.	"Rawat R, Stoltzfus RJ, Ntozini R, Mutasa K, Iliff PJ, Humphrey JH."	European Journal of Clinical Nutrition. 2009;63(6):787-93.		"Objectives: The acute phase response (APR) influences indicators of iron status. A recent WHO/CDC consultation recommended concurrent measurement of alpha-1-acid-glycoprotein (AGP) in surveys to control for the APR, and aid in interpreting iron status. They proposed further exploratory analyses using AGP. We examined whether the APR (measured by AGP) influences the expected relationships between iron status indicators in an HIV-infected population. Subjects: We measured hemoglobin (Hb), serum ferritin (SF), transferrin receptor (TfR), erythropoietin (EPO) and AGP in a cross-sectional survey of 643 HIV-positive Zimbabwean women. Results: SF was significantly higher in APR-positive (AGP > 1 g/l) women (P < 0.001), in whom there was no association between SF and Hb. TfR was inversely associated with Hb, in both APR-positive and APR-negative women (P < 0.001). However, among anemic women (Hb < 110 g/l), APR-positive women had marginally lower TfR concentrations (P = 0.053). There was no difference in EPO response to decreasing Hb among APR-positive and APR-negative women. Conclusions: AGP captured the influence of the APR on iron indicators and their relationships with each other. The APR influenced SF and its relationship with Hb as expected. TfR behaved unexpectedly. Although TfR has been promoted as an iron indicator that is uninfluenced by the APR, TfR concentrations were depressed among anemic APR-positive women. Because TfR reflects iron deficiency and erythropoietic activity, pro-inflammatory cytokines associated with the APR may be inhibiting erythropoeisis, which is reflected by lower TfR concentrations. We support the WHO/CDC recommendation that AGP is a useful indicator to assess the influence of the APR on iron status indicators."									
1397	Dietary habits and oral health related behaviors in relation to DMFT indexes of a group of young adult patients attending a dental school.	"Akarslan ZZ, Sadik B, Sadik E, Erten H."	"Medicina Oral, Patologia Oral y Cirugia Bucal. 2008 01 Dec;13(12):E800-E7."		"Objectives: The aim of the present study was to investigate the dietary habits and oral health related behaviors in relation to the dental health status in terms of decayed, missing and filled teeth (DMFT index) of a group of young adults attending to a dental school located in a major city in Turkey. Study Design: A total of 416 young adults (247 females and 169 males) with an age range of 18-25 (Mean 23.2 sd 0.97) attending the Oral Diagnosis department participated in the study. The patients completed a questionnaire including questions about demographic factors, dietary habits and oral health related behaviors. Subsequently, the DMFT index and plaque index was calculated. Descriptive statistics, Mann Whitney U/ Kruskal Wallis Variance analysis, Chi-square/ Fisher's Exact tests and multiple linear regression analysis were used for statistical analysis of the data when applicable. Results: According to the results of the study, approximately 70% of the patients had regular main meals and a very high snacking rate (76.9%) was present. Although not at a high rate, most of the patients brushed their teeth regularly twice a day (44.2%) and approximately half used other hygiene aids in addition to brushing (43.8%). The median of the DMFT index was 5 and a majority of the patients had moderate plaque accumulation which could be seen with the naked eye (45.0%). Dental plaque had the most significant effect on the DMFT index. Conclusion: In conclusion, advice, including importance of regularity of main meals, decrease in snacking frequency, regular brushing twice a day and the use of other oral hygiene aids for the elimination of dental plaque would be helpful to enhance the dietary habits and oral health related behaviors of young adult Turkish patients. Medicina Oral S. L. C.I.F."									
606	Nutritional status and food consumption patterns of young children living in Western Uganda.	"Bridge A, Kipp W, Raine K, Konde-Lule J."	East African Medical Journal. 2006;83(11):619-25.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=17455451	OBJECTIVES: The aim of this pilot study was to compare the nutritional status and food consumption patterns of children under five years.	"DESIGN: Quantitative, exploratory, cross sectional study."	"SETTING: Kabarole district, western Uganda. Kabarole district is a rural district with subsistence farming as the main income."	SUBJECTS: Two hundred and five children between 12 and 72 months of age living in AIDS affected homes versus children living in non-AIDS affected homes were examined.	"RESULTS: Fifty-five percent of all children were stunted and 20.5% were underweight. There was no difference in the prevalence of malnutrition between children living in AIDS affected homes versus non-AIDS affected homes. Only children between 12-35 months suffered from a daily deficit in caloric intake. The older children consumed the basic recommended daily intake (RDI) for protein, fat, iron and vitamin A. Due to frequent disease episodes and limitations in the estimations of individual total energy expenditure, the results are likely underestimations of the children's true nutritional requirements. The type of foods given to children in AIDS affected homes and controls were quite similar."	"CONCLUSION: Young children in Kabarole district suffer from severe chronic malnutrition rates, but rates and feeding patterns are not different in AIDS affected versus non AIDS affected homes."				
1052	"A comparative study on dietary practices, morbidity patterns and nutrition status of HIV/AIDS infected and non-infected pre-school children in Kibera slum, Kenya."	"Chege P, Kuria E, Kimiywe J."	Journal of Applied Biosciences. 2010;32:2008-14.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20113087881	"Objectives: The impact of HIV and associated opportunistic infections compounded by inappropriate dietary practices among children leads to under nutrition and micronutrient deficiencies associated with high morbidity and mortality rates. This study determined the dietary practices, morbidity patterns and nutrition status of HIV/AIDS infected and non-infected pre-school children in Kibera slums. Methodology and results: A comparative descriptive design was used to conduct a study in May 2005 among 64 HIV/AIDS infected and 64 non-infected pre-school children in Kibera slum. Data was obtained a researcher administered questionnaire and focus group discussion guides. Results indicated that the average number of meals consumed per day was 3.4. The consumption of cereals, vegetables, fruits and animal products were irregular. Except for fat, intake of macronutrients and micronutrients were inadequate. The main illnesses were malaria, cold, cough and pneumonia which manifested as fever, diarrhea, vomiting and loss of appetite. A total of 44, 33 and 52% of the infected children were stunted, wasted and underweight as compared to 22, 21 and 17%, respectively, for the non-infected group. The education level of the caregiver, amount of kilocalories taken, and number of meals taken per day, household size and morbidity patterns of the children significantly affected the nutrition status. The children's poor nutrition status was due to poor dietary practices. This was compounded by the effect of the manifestations of various infections like diarrhea, vomiting, fever and loss of appetite which deteriorated the nutrition status. There was no significant difference between the number of meals per day (p=0.061), amount of kilocalories taken per day (p=0.093) for the two groups. However, there was a significance difference in the number of sick (p=0.048), wasted (p=0.043), stunted (p=0.035) and underweight (p=0.028) children for the two groups. The significant difference in morbidity patterns and nutrition status was due to opportunistic infections which increases nutrient needs. The infected children were frequently ill with the manifestations of the infections lasting longer. Conclusions and application of the findings: The study recommends the use of nutrient dense products to provide more nutrients as needed, educating caregivers on nutritional management of HIV patients and initiating income generating activities to improve food security in the study areas."									
786	"Second-line treatment in the Malawi antiretroviral programme: high early mortality, but good outcomes in survivors, despite extensive drug resistance at baseline."	"Hosseinipour MC, Kumwenda JJ, Weigel R, Brown LB, Mzinganjira D, Mhango B, Eron JJ, et al."	HIV Medicine. 2010 September;11(8):510-8.		"Objectives: The Malawi antiretroviral therapy (ART) programme uses the public health approach to identify ART failure. Advanced disease progression may occur before switching to second-line ART. We report outcomes for patients evaluated and initiated on second-line treatment in Malawi. Methods: Patients meeting Malawi immunological or clinical criteria for ART failure in two large urban ART clinics were evaluated for virological failure (viral load >400 HIV-1 RNA copies/mL) and, if failure was confirmed, initiated on second-line ART (zidovudine/lamivudine/tenofovir/lopinavir/ritonavir). Patients were seen monthly and laboratory evaluations were performed quarterly and as needed. We performed logistic regression modelling to identify factors associated with mortality, mortality or new HIV illnesses, and virological suppression at 12 months. Results: Of the 109 patients with confirmed virological failure, five patients died prior to initiation, three declined switching and 101 patients initiated second-line treatment. Over 12 months, 10 additional patients died, 34 patients experienced 45 HIV-related events, and 19 patients experienced grade 3 or 4 toxicities. Among survivors, 85.2% had HIV-1 RNA<400 copies/mL at 12 months. While power to distinguish differences was limited, response rates were similar regardless of baseline resistance level. The median CD4 count increase was 142 cells/muL. World Health Organization clinical failure at baseline [odds ratio (OR) 3.47; 95% confidence interval (CI) 1.14-10.59] and body mass index <18.5 (OR 4.43; 95% CI 1.15-17.12) were risk factors for death. Baseline CD4 count <50 cells/muL was associated with increased risk for death or morbidity at 12 months (OR 2.57; 95% CI 1.01-6.52). Conclusions: Second-line treatment in Malawi was associated with substantial mortality, morbidity and toxicity but, among survivors, virological outcomes were favourable. 2010 British HIV Association."									
785	"Second-line treatment in the Malawi antiretroviral programme: high early mortality, but good outcomes in survivors, despite extensive drug resistance at baseline."	"Hosseinipour MC, Kumwenda JJ, Weigel R, Brown LB, Mzinganjira D, Mhango B, Eron JJ, et al."	HIV Medicine. 2010;11(8):510-8.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20103257478	"Objectives: The Malawi antiretroviral therapy (ART) programme uses the public health approach to identify ART failure. Advanced disease progression may occur before switching to second-line ART. We report outcomes for patients evaluated and initiated on second-line treatment in Malawi. Methods: Patients meeting Malawi immunological or clinical criteria for ART failure in two large urban ART clinics were evaluated for virological failure (viral load >400 HIV-1 RNA copies/mL) and, if failure was confirmed, initiated on second-line ART (zidovudine/lamivudine/tenofovir/lopinavir/ritonavir). Patients were seen monthly and laboratory evaluations were performed quarterly and as needed. We performed logistic regression modelling to identify factors associated with mortality, mortality or new HIV illnesses, and virological suppression at 12 months. Results: Of the 109 patients with confirmed virological failure, five patients died prior to initiation, three declined switching and 101 patients initiated second-line treatment. Over 12 months, 10 additional patients died, 34 patients experienced 45 HIV-related events, and 19 patients experienced grade 3 or 4 toxicities. Among survivors, 85.2% had HIV-1 RNA<400 copies/mL at 12 months. While power to distinguish differences was limited, response rates were similar regardless of baseline resistance level. The median CD4 count increase was 142 cells/ micro L. World Health Organization clinical failure at baseline [odds ratio (OR) 3.47; 95% confidence interval (CI) 1.14-10.59] and body mass index <18.5 (OR 4.43; 95% CI 1.15-17.12) were risk factors for death. Baseline CD4 count <50 cells/ micro L was associated with increased risk for death or morbidity at 12 months (OR 2.57; 95% CI 1.01-6.52). Conclusions: Second-line treatment in Malawi was associated with substantial mortality, morbidity and toxicity but, among survivors, virological outcomes were favourable."									
1803	The risk of developing malnutrition in people living with HIV/AIDS: Observations from six support groups in Botswana.	Nnyepi MS.	South African Journal of Clinical Nutrition. 2009;22(2):89-93.		"Objectives: The objectives of this study were 1) to determine the proportion of people living with HIV/AIDS (PLWHA) at risk of developingmalnutrition, 2) to determine the prevalence of malnutrition (BMI 18.5 kg/m2), and 3) to describe the dietary intake and other nutritionparameters of PLWHA with membership in support groups.Design: Descriptive cross-sectional study.Setting: Six support groups in Gaborone and neighbouring locations.Subjects: Consenting, free-living HIV-positive adults 20 to 50 years of age with membership in support groups for PLWHA.Outcome measures: The subjectsf risk of developing malnutrition was established using a modified subjective global assessment (SGA)screening tool. Subjects with an SGA score . 4 were classified as being at high risk of developing malnutrition.Results: From 145 PLWHA screened, 47.5% (n = 69) were found to be at high risk of developing malnutrition (SGA score . 4) and 28.5%(n = 41) were malnourished (BMI 18.5 kg/m2). In the sample with SGA scores . 4, 52.2% (n = 35) presented with a BMI 18.5 kg/ m2.These two groups also reported more unintentional weight loss, gastrointestinal symptoms, and other conditions commonly associatedwith a high risk of developing malnutrition. PLWHA with membership in support groups also had low educational attainment and highunemployment rates. A total of 47% of subjects with an SGA score . 4 needed food assistance.Conclusions: Almost 50% of PLWHA with membership in support groups for PLWHA are at risk of developing malnutrition, while about 30%have a BMI 18.5kg/m2. Nutrition screening can also help to identify those PLWHA with a BMI 18.5 kg/m2 who are still at high risk ofdeveloping malnutrition. Timely nutrition interventions can therefore be instituted in order to prevent deterioration in nutritional status."									
1670	Workforce development in South Africa with a focus on public health nutrition.	"Steyn NP, Mbhenyane XG."	Public Health Nutrition. 2008;11(8):792-800.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=18346310	"OBJECTIVES: The present paper aims to review and report on the current and predicted future public health nutrition workforce in South Africa. Additionally, it examines ways in which the Department of Health (DOH) is striving to meet the increasing burden of nutrition-related diseases in South Africa."	"METHODS: The primary sources of data used for the review were reports from the Census office, South African health reviews, mortality and morbidity statistics, and documents from the Health Professions Council of South Africa."	"RESULTS: There are fewer than 2000 registered dietitians in South Africa and fewer than 600 of them work in the public health sector. Furthermore, professional nurses - who are the backbone of the primary health-care system and deliver the rudiments of basic nutritional care - are not being trained in sufficient numbers to meet population growth; in 2004 there was only one nurse per 4000 persons. This situation is aggravated by the growing burden of conditions associated with both overnutrition and undernutrition, as well as the enormous demands of the HIV/AIDS epidemic. The DOH is striving to meet these increasing needs by means of the Integrated Nutrition Programme as well as a National Human Resources Plan which includes numerous strategies to improve the quantity and quality of health professionals' training, including dietitians and nutritionists. This plan includes the objective of increasing the public health nutrition workforce to more than 250 newly trained dietitians and nutritionists per annum by 2010."							
744	Effect of body weight and body composition on plasma concentrations of efavirenz and atazanavir in HIV-positive patients.	"Lloret-Linares C, Rahmoun Y, Lopes A, Delhotal B, Magnier JD, Mouly S, Bergmanna JF, et al."	Fundamental and Clinical Pharmacology. 2013 June;27:72.		"Objectives: The prevalence of overweight increases in developed countries, irrespective of HIV status. The consequences of the overweight on plasma concentrations of NNRTIs and PIs have been poorly studied Efavirenz, atazanavir are among the most used 'third agent' in HAART in HIV-infected patients. The objective was to compare their plasma concentrations according to the body mass index (BMI < 25 and BMI > 25 kg/m<sup>2</sup>) and to describe their relationship with body composition. Methods: From September 2011 to August 2012, HIV-infected patients with efavirenz 600 mg/day, 'boosted'-atazanavir 300 mg/day as part of HAART were enrolled. Body composition was assessed using bioelectrical impedance. Plasma samples were taken 12 h after the last dose of EFV or 24 h after last dose of atazanavir or darunavir. Concentrations were measured by ultra-performance liquid chromatography. Viral load and CD4 cell count were assessed while treatment tolerance was assessed by a validated auto-questionnary. Results: Eighty-nine patients were enrolled. Their mean age was 46.5 +/- 10 years, 56% were male, 57% were from sub-Saharan Africa and their mean was BMI 26 +/- 5 kg/m<sup>2</sup>. Mean drug plasma concentrations were similar according to the BMI whatever the drug. Concentrations were not correlated with anthropometric parameters, including body composition, neither with viral load nor CD4 count. They did not differ according to the ethnic origin of patients. Discussion: The large interindividual variability of drug concentrations is not explained by body weight or body composition but probably results from multiple factors (ethnic, pharmacokinetic,.), eventually conflicting with each other."									
1042	"Reasons, perceived efficacy, and factors associated with complementary and alternative medicine use among Malaysian patients with HIV/AIDS."	"Hasan SS, See CK, Choong CL, Ahmed SI, Ahmadi K, Anwar M."	Journal of Alternative & Complementary Medicine. 2010;16(11):1171-6.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=20973734	"OBJECTIVES: The primary objective of this study was to evaluate the pattern of use, reasons for use, and perceived effect of complementary and alternative medicine (CAM), accompanied by identification and comparison of the factors that are potentially associated with CAM use."	"DESIGN: This cross-sectional study was carried out in 325 randomly sampled patients with human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS), at HIV/AIDS referral clinics in the Hospital Sungai Buloh, Malaysia. Simple random sampling was used, where randomization was done using patients' medical record numbers."	"SUBJECTS AND METHODS: Semistructured face-to-face interviews were conducted using 38 questions pertaining to type, pattern, perceived efficacy, adverse effects, and influential factors associated with CAM use. In addition, CD4 count and viral load readings were recorded."	"RESULTS: Of 325 randomly sampled patients with HIV/AIDS, 254 of them were using some forms of CAM, resulting in a utilization rate of 78.2%. Vitamins and supplements (52.6%), herbal products (33.8%), and massage (16.6%) were the top three most frequently used CAM modalities. Sociodemographic factors including education level (p=0.021, r(s)=0.148), monthly income (p=0.001, r(s)=0.260), and family history of CAM use (p=0.001, r(s)=0.231) were significantly associated and positively correlated with CAM use. However, the majority of these patients (68%) did not disclose CAM use to health care professionals. About half of those who rated their health as good or very good perceived it as a result of CAM use."	"CONCLUSIONS: This study confirmed the range of 30%-100% CAM use among individuals infected with HIV/AIDS. Although, on the one hand some types of CAM reduced viral load and enhanced the immune system, on the other hand some forms of CAM produced a detrimental effect on the virological suppression, opening this platform to more research and investigation in order to optimize the use of CAM among patients with HIV/AIDS."					
1044	"Reasons, perceived efficacy, and factors associated with complementary and alternative medicine use among Malaysian patients with HIV/AIDS."	"Syed Shahzad H, See C, Choong L, Syed Imran A, Keivan A, Mudassir A."	Journal of Alternative and Complementary Medicine. 2010;16(11):1171-6.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20113034037	"Objectives: The primary objective of this study was to evaluate the pattern of use, reasons for use, and perceived effect of complementary and alternative medicine (CAM), accompanied by identification and comparison of the factors that are potentially associated with CAM use. Design: This cross-sectional study was carried out in 325 randomly sampled patients with human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS), at HIV/AIDS referral clinics in the Hospital Sungai Buloh, Malaysia. Simple random sampling was used, where randomization was done using patients' medical record numbers. Subjects and methods: Semistructured face-to-face interviews were conducted using 38 questions pertaining to type, pattern, perceived efficacy, adverse effects, and influential factors associated with CAM use. In addition, CD4 count and viral load readings were recorded. Results: Of 325 randomly sampled patients with HIV/AIDS, 254 of them were using some forms of CAM, resulting in a utilization rate of 78.2%. Vitamins and supplements (52.6%), herbal products (33.8%), and massage (16.6%) were the top three most frequently used CAM modalities. Sociodemographic factors including education level (p=0.021, r<sub>s</sub>=0.148), monthly income (p=0.001, r<sub>s</sub>=0.260), and family history of CAM use (p=0.001, r<sub>s</sub>=0.231) were significantly associated and positively correlated with CAM use. However, the majority of these patients (68%) did not disclose CAM use to health care professionals. About half of those who rated their health as good or very good perceived it as a result of CAM use. Conclusions: This study confirmed the range of 30%-100% CAM use among individuals infected with HIV/AIDS. Although, on the one hand some types of CAM reduced viral load and enhanced the immune system, on the other hand some forms of CAM produced a detrimental effect on the virological suppression, opening this platform to more research and investigation in order to optimize the use of CAM among patients with HIV/AIDS."									
792	Multivitamin supplementation in HIV-positive pregnant women: impact on depression and quality of life in a resource-poor setting.	"Smith Fawzi MC, Kaaya SF, Mbwambo J, Msamanga GI, Antelman G, Wei R, Hunter DJ, et al."	HIV Medicine. 2007;8(4):203-12.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=17461847	"OBJECTIVES: The primary objective of this study was to examine the effect of vitamin supplementation on health-related quality of life and the risk of elevated depressive symptoms comparable to major depressive disorder (MDD) in HIV-positive pregnant women in Dar es Salaam, Tanzania."	"METHODS: From April 1995 to July 1997, 1078 HIV-positive pregnant women were enrolled in a randomized controlled trial. We examined the effects of vitamin supplementation on quality of life and the risk of elevated depressive symptoms, assessed longitudinally every 6-12 months."	"RESULTS: A substantial prevalence of elevated depressive symptoms (42%) was observed in HIV-positive pregnant women. Multivitamin supplementation (B-complex, C and E) demonstrated a protective effect on depression [relative risk (RR)=0.78; P=0.005] and quality of life [RR=0.72 for social functioning (P=0.001) and vitality (P=0.0001); RR=0.70 for role-physical (P=0.002)]; however, vitamin A showed no effect on these outcomes."	"CONCLUSIONS: Multivitamin supplementation (B-complex, C and E) resulted in a reduction in risk of elevated depressive symptoms comparable to MDD and improvement in quality of life in HIV-positive pregnant women in Tanzania."						
1972	The nutritional status of clinic attendees living with HIV/AIDS in St Vincent and the Grenadines.	"Burgin J, Nichols S, Dalrymple N."	West Indian Medical Journal. 2008;57(5):438-43.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=19565972	OBJECTIVES: The purpose of this study was to assess nutritional status and dietary practices in persons living with HIV/AIDS (PLWHA).	"METHODS: A case-control design was used. Cases consisted of 36 PLWHA. Controls consisted of 37 persons within the same age range from the general population. Participants filled out a questionnaire consisting of sociodemographic, dietary and health history items. In addition, they had weight, height, upper mid-arm circumference and triceps skinfold measured using standard procedure. Biochemical and clinical data for cases were extracted from their clinic file."	"RESULTS: HIV-positive persons had significantly lower mean weight, BMI, upper mid-arm circumferences, arm muscle area and arm fat area than persons in the control group. They were also less likely to use multivitamins, dietary supplements, fruit and vegetables than persons in the control group. Correlation coefficients between corrected arm muscle area (CAMA) and BMI and weight ranged from 0.67 to 0.74 in cases and 0.41 to 0.68 for the control group, respectively. Screening for depleted CD4 counts using gender specific CAMA cut-offs indicative of depleted arm muscle reserves resulted in 48% sensitivity and 100% specificity in identifying PLWHA with CD4 counts < 200 cells/microL."	"CONCLUSION: The findings suggest that PLWHA are at increased risk for poor intakes of fruits and vegetables and depleted lean body mass. In addition, CAMA along with other clinic measures might be useful in the identification of PLWHA who might be responding adequately to treatment."						
1668	Elevated iron stores are associated with HIV disease severity and mortality among postpartum women in Zimbabwe.	"Rawat R, Humphrey JH, Ntozini R, Mutasa K, Iliff PJ, Stoltzfus RJ."	Public Health Nutrition. 2009;12(9):1321-9.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=19000344	"OBJECTIVES: The relationship between Fe status and HIV infection is complex and poorly understood. While anaemia is a major complication of HIV infection, higher Fe stores may be associated with disease progression. There is limited and conflicting data available from Africa."	"DESIGN: Cross-sectional and prospective cohort study. SETTING, SUBJECTS AND METHODS: We examined the association between postpartum Fe status (Hb, serum ferritin (SF) and transferrin receptor (TfR)) and viral load (VL) and HIV-related mortality in 643 HIV-positive Zimbabwean women over a period of 12 months."	"RESULTS: In non-anaemic women a log10 increase in SF was associated with a 2.3-fold increase in VL (P = 0.019); this association was absent in anaemic women. In prospective analyses, a log10 increase in SF was associated with a 4-fold increase in mortality by 12 months (P = 0.002). Hb was negatively associated with VL (P = 0.001) and mortality (P = 0.047). The adverse associations between SF and both VL and mortality were found at SF concentrations > 45 microg/l (P < 0.05). Controlling for alpha1 acid glycoprotein, a marker of inflammation, attenuated the association between both SF and VL and mortality, but these remained significant."	"CONCLUSIONS: These results are consistent with the hypothesis that high Fe stores have adverse consequences in HIV infection. If adverse consequences are real, our data suggest that they occur at SF concentrations exceeding those consistent with adequate Fe nutriture."						
1798	Development of predictive equations for total body water using the deuterium-dilution method as the gold standard in a population of asymptomatic HIV-positive Zulu women in South Africa.	"Kindra G, Coutsoudis A, Pillay L, Kindness A."	South African Journal of Clinical Nutrition. 2012;25(4):186-91.		Objectives: The study aimed to derive predictive equations for total body water determinations with bioelectrical impedance and anthropometric measurements in a population of asymptomatic human immunodeficiency virus (HIV) -positive Zulu women. Design: Cross-sectional data from within an ongoing prospective study that observed the effect of infant feeding mode on maternal and child health in a cohort of asymptomatic HIV-positive women were used for this objective. Setting: A community health centre in Durban. Subjects: Asymptomatic HIV-infected women who were not eligible for antiretroviral therapy. They were resident in the area and were of Zulu ethnicity. Outcome measures: Development of predictive equations for total body water. Results: Success was achieved in developing predictive equations for total body water using bioelectrical impedance analysis and anthropometric measurements that were specific to the HIV-positive female Zulu population. These equations were developed using the total body water that was obtained from deuterium-dilution method as a gold standard. Conclusion: These predictive equations are likely to be more valid for the HIV-positive female African populations of similar build than the current predictive equations that derive from the Western population. SAJCN.									
1742	"Nutritional status of HIV-infected adults on antiretroviral therapy and the impact of nutritional supplementation in the Northern Cape Province, South Africa."	"Lategan R, Steenkamp L, Joubert G, Roux Ml."	SAJCN South African Journal of Clinical Nutrition. 2010;23(4):197-201.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20113038140	"Objectives: The study aimed to describe the nutritional status and determine the impact of current nutrition intervention strategies on weight changes in adult HIV-infected patients on antiretroviral (ARV) therapy. Design: A descriptive, prospective trial was performed. Setting: The investigation was conducted at ARV roll-out centres in Kimberley, Upington, Kuruman, Prieska and Springbok in the Northern Cape Province of South Africa. Subjects: Adult HIV-infected patients receiving ARV therapy were included in the study. Outcome measures: Each participants's body mass index (BMI) was determined before and after a four-month intervention period of nutritional supplementation with an instant, enriched maize product. Results: Data from 98 patients (mean age 39.7 years; standard deviation 8.9 years) were assessed. Prior to intervention, the median BMI was 20 kg/m<sup>2</sup> (range 12.6-29.7 kg/m<sup>2</sup>); the patients from Kuruman had a greater incidence of underweight compared to the other towns, with a median BMI of 17.9 kg/m<sup>2</sup>. Of the 87 patients assessed during the final week, 49.4% experienced weight gain and 40.2% lost weight. Eighteen (20.7%) patients gained more than 5% of their baseline weight, which was significant. Only eight (9.2%) patients lost more than 5% of their baseline weight. Twenty-two patients who presented with a BMI<18.5 kg/m<sup>2</sup> at baseline had a median weight gain of 1.13 kg during the intervention period, while the group with a BMI>18.5 kg/m<sup>2</sup> presented with no change in median weight. Conclusions: Nutritional supplementation, provided according to provincial policy and combined with ARVs, nutritionally benefitted about half of the patients in the ARV programme in the Northern Cape."									
1830	Clinical predictors of low CD4 count among HIV infected pulmonary tuberculosis clients: a health facility-based survey.	"Nzou C, Kambarami RA, Onyango FE, Ndhlovu CE, Chikwasha V."	South African Medical Journal Suid-Afrikaanse Tydskrif Vir Geneeskunde. 2010;100(9):602-5.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=20822651	OBJECTIVES: The study aimed to determine the clinical and laboratory predictors of a low CD4+ cell count (<200 cells/microl) in HIV-infected patients with pulmonary tuberculosis (PTB).	DESIGN AND SETTING: A prospective cohort study on HIV-positive patients with smear-positive PTB attending an outpatient clinic in Zimbabwe.	"PARTICIPANTS: Consecutively consenting HIV-positive adults, aged 18 years and over, who had positive sputum smears for acid-fast bacilli and were naive to both antituberculosis drugs and ART."	"INTERVENTIONS: Baseline CD4+ cell count, full blood count, functional status using the Karnofsky Performance Status (KPS) score and body mass index (BMI, kg/m2) were determined for all participants. Univariate and multiple logistic regression analyses of the data were done."	"RESULTS: Of the 97 participants recruited, 59 (61%) were females. The overall mean age was 34 years (standard deviation (SD) 8). The median CD4+ cell count was 104.5 cells/microl (intraquartile range (IQR) 41-213 cells/microl). Patients with pleuritic chest pain were less likely to have a low CD4+ cell count than patients who did not (odds ratio (OR) 0.2; confidence interval (CI) 0.03-0.8). The following were statistically significant predictors of a CD4+ cell count of <200 cells /microl: BMI<18 kg/m2 (OR 3.8; CI 1.2-12), KPS<54.4 (OR 3; CI 1.1-12) and haemoglobin concentration<8 g/dl (OR 13; CI 1.8 - 533)."	"CONCLUSIONS: HIV-infected sputum-positive PTB patients presenting with a BMI<18, KPS<54.4% and haemoglobin concentration<8 g/dl should have early initiation of ART since they are more likely to have a low CD4+ cell count, whereas those presenting with pleuritic pain are less likely to have a low CD4+ cell count."				
1821	Clinical predictors of low CD4 count among HIV-infected pulmonary tuberculosis clients: A health facility-based survey.	"Nzou C, Kambarami RA, Onyango FE, Ndhlovu CE, Chikwasha V."	South African Medical Journal. 2010;100(9):602-5.		"Objectives: The study aimed to determine the clinical and laboratory predictors of a low CD4+ cell count (<200 cells/mul) in HIV-infected patients with pulmonary tuberculosis (PTB). Design and setting: A prospective cohort study on HIV-positive patients with smear-positive PTB attending an outpatient clinic in Zimbabwe. Participants: Consecutively consenting HIV-positive adults, aged 18 years and over, who had positive sputum smears for acid-fast bacilli and were naive to both antituberculosis drugs and ART. Interventions: Baseline CD4+ cell count, full blood count, functional status using the Karnofsky Performance Status (KPS) score and body mass index (BMI, kg/m<sup>2</sup>) were determined for all participants. Univariate and multiple logistic regression analyses of the data were done. Results: Of the 97 participants recruited, 59 (61%) were females. The overall mean age was 34 years (standard deviation (SD) 8). The median CD4+ cell count was 104.5 cells/mul (intraquartile range (IQR) 41 - 213 cells/mul). Patients with pleuritic chest pain were less likely to have a low CD4+ cell count than patients who did not (odds ratio (OR) 0.2; confidence interval (CI) 0.03 - 0.8). The following were statistically significant predictors of a CD4+ cell count of <200 cells/ mul: BMI <18 kg/m<sup>2</sup> (OR 3.8; CI 1.2 - 12), KPS <54.4 (OR 3; CI 1.1 - 12) and haemoglobin concentration <8 g/dl (OR 13; CI 1.8 - 533). Conclusions: HIV-infected sputum-positive PTB patients presenting with a BMI <18, KPS <54.4% and haemoglobin concentration <8 g/dl should have early initiation of ART since they are more likely to have a low CD4+ cell count, whereas those presenting with pleuritic pain are less likely to have a low CD4+ cell count."									
782	Determinants of antiretroviral therapy initiation and treatment outcomes for people living with HIV in Vietnam.	"Tran D, Shakeshaft A, Ngo A, Mallitt KA, Wilson D, Doran C, Zhang L."	HIV Clinical Trials. 2013 01 Jan;14(1):21-33.		"Objectives: This study explores patient characteristics that are significantly associated with very late combination antiretroviral therapy (cART) initiation (CD4 count a100 cells/mm<sup>3</ sup>) and examines the association between patient characteristics and treatment outcomes, CD4 recovery, and mortality. Design: Data were obtained from the clinical records of 2,198 HIV/AIDS patients in 13 outpatient clinics across 6 provinces in Vietnam. Methods: Multivariate logistic regression and Cox proportional hazards regression were used to identify patient characteristics that are significantly associated with very late cART initiation and to measure relationships between patient characteristics and treatment outcomes. Results: Very late cART initiation was significantly associated with being male compared with female (odds ratio [OR], 0.36; 95% CI, 0.23-0.58), becoming HIV infected through injecting drugs (OR, 2.13; 95% CI, 1.09-4.14), and having opportunistic infections at cART initiation (OR, 1.69; 95% CI, 1.02-2.86). Being male (female vs male: hazard ratio [HR], 0.45; 95% CI, 0.20-0.98), very late cART initiation (timely vs late: HR, 0.18; 95% CI, 0.04-0.72), low baseline body mass index (BMI) (HR, 0.95; 95% CI, 0.92-0.98), and later baseline WHO clinical stage (WHO clinical stage IV vs combined group of stage I and II: HR, 5.70; 95% CI, 3.90-7.80) were significantly associated with death, whereas being female compared with male (HR, 1.51; 95% CI, 1.14-1.99) and timely cART initiation (HR, 35.45; 95% CI, 13.67-91.91) were significant predictors of CD4 recovery. Conclusions: Timely testing of patients for HIV, increasing use of CD4 count testing services, and starting cART earlier are essential to reduce mortality and improve treatment outcomes. 2013 Thomas Land Publishers, Inc."									
847	Ocular and other comorbidities in HIV positive orphans in Myanmar.	"Kaythi M, May Thet Hnin A, Soe M, Soe K."	International Journal of Collaborative Research on Internal Medicine and Public Health. 2012;4(6):1245-56.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20123257320	"Objectives: This study is to explore the ocular manifestations, nutritional status and other concurrent comorbidities of the HIV positive orphan in relation to gender. Method: It is a cross sectional study done in one orphanage home in Yangon, Myanamr. 60 children included in the study. Data collection methods are record review, interview and physical, anthropometric and ophthalmic examination. Pretested precoded profoma is used for record review and record of examination findings. WHO BMI and MAC standard are used for assessment of Nutritional status. Results: 28 boys and 32 girls included in this study. Age ranged from 2 years to 15 years. 36 children are HIV stage 1, 16 in stage 2 and 7 in stage 3 and only one in stage 4. Nutritional problem is seen in 60% of the children. Ocular morbidity is seen in only 3 children (5.1%). Other systemic comorbidities were seen in 23 children (37.7%). There are no significant differences in CD4 count, HIV status and provision of ART among male and female children. Conclusions: This study showed ocular manifestations in paediatric HIV population is low. Majority of children had nutritional problems. Tuberculosis and otitis media were seen in small proportion."									
848	Ocular and other comorbidities in HIV positive orphans in Myanmar.	"Myint K, Aye MTH, Moe S, Kyaw S."	International Journal of Collaborative Research on Internal Medicine and Public Health. 2012 June;4(6):1245-56.		"Objectives: This study is to explore the ocular manifestations, nutritional status and other concurrent comorbidities of the HIV positive orphan in relation to gender. Method: It is a cross sectional study done in one orphanage home in Yangon, Myanamr. 60 children included in the study. Data collection methods are record review, interview and physical, anthropometric and ophthalmic examination. Pretested precoded profoma is used for record review and record of examination findings. WHO BMI and MAC standard are used for assessment of Nutritional status. Results: 28 boys and 32 girls included in this study. Age ranged from 2 years to 15 years. 36 children are HIV stage 1, 16 in stage 2 and 7 in stage 3 and only one in stage 4. Nutritional problem is seen in 60% of the children. Ocular morbidity is seen in only 3children (5.1%). Other systemic comorbidities were seen in 23 children (37.7%). There are no significant differences in CD4 count, HIV status and provision of ART among male and female children. Conclusions: This study showed ocular manifestations in paediatric HIV population is low. Majority of children had nutritional problems. Tuberculosis and otitis media were seen in small proportion."									
1483	Prevalence of low bone mineral density in Brazilian HIV-infected patients and associated factors.	"Ragi-Eis S, Neto LP, Vieira N, Soprani M, Neves M, Ribeiro-Rodrigues R, Miranda A."	Osteoporosis International. 2011 March;22:S347-S8.		"Objectives: This study was designed to evaluate the prevalence of Low Bone Density in a sample of HIV infected adults being followed by a State reference center for HIV in the city of Vitoria-ES, Brazil Materials/Methods: A cross-sectional study was performed in 300 HIV-infected patients to measure BMD by DXA. Age, gender, anthropometric parameters, nadir and current CD4 cell count, HIV viral load, smoking habit and current antiretroviral therapy (AT) associations were investigated by multivariable analysis. Results: Based on WHO/ISCD T-score criteria, low BMD was detected in 54.7% out of the 300 enrolled patients. The observed median age was 46 years (interquartile range: 39- 52), 58% were male, 88.5% were on AT, and 21.4% smoked. The following factors were identified by multiple logistic modeling, as being independently associated with low BMD (T-score <-1.0 or Z-score <-2.0 in premenopausal women and men below the age of 50): a) male gender [4.6 (1.28- 16.39)], b) body mass index lower than 25 [2.9 (1.31-6.49)], c) menopause [13.4 (2.53-71.12)] and d) HIV-1 undetectable viral load [7.9 (1.96-32.25)]. Conversely, zidovudine [0.2 (0.04-0.85)] and nevirapine [0.1 (0.02-0.38)] use were inversely associated with low BMD. Conclusions: Low BMD was frequently found among our cohort of 300 Brazilian HIV-infected subjects. This study supports the need for constant screening and availability of DXA evaluation for HIV patient."									
1924	Malaria parasitaemia in relation to HIV status and vitamin A supplementation among pre-school children.	"Villamor E, Fataki MR, Mbise RL, Fawzi WW."	Tropical Medicine & International Health. 2003;8(12):1051-61.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=14641839	OBJECTIVES: To ascertain whether malaria parasitaemia in children is associated with HIV status. To examine the effect of vitamin A supplementation on malaria parasitaemia in children.	"METHODS: We studied the cross-sectional associations between HIV status and malaria parasitaemia among 546 children 6-60 months of age who participated in a double-blind, randomized clinical trial of vitamin A supplementation. Prevalence ratios and 95% confidence intervals (CI) were estimated for the presence of malaria parasites at baseline by HIV status in uni- and multivariate models that adjusted for sociodemographic and environmental variables. Among children with malaria, correlates of high parasite loads were identified. Next, we examined the effect of vitamin A supplementation on the risk of malaria parasitaemia and high parasite density at 4-8 months of the first dose in a subset of children."	"RESULTS: The prevalence of malaria parasitaemia was 11.4% among HIV-infected children, compared with 27.6% among uninfected. After adjusting for season, anaemia, use of bednets, maternal education and indicators of socioeconomic status, we found some evidence for lower prevalence of parasitaemia among HIV positive compared with HIV-negative children (prevalence ratio=0.56; 95% CI=0.29, 1.09; P=0.09). Other important correlates of malaria parasitaemia at baseline included low level of maternal education, poor quality of water supply, and the presence of animals at home. Vitamin A supplementation did not have a significant effect on malaria parasitaemia at 4-8 months of follow-up, overall or within levels of potential effect modifiers."	CONCLUSION: HIV infection appears to be negatively correlated with malaria parasitaemia in this group of children. Investing in women's education is likely to decrease the prevalence of malaria parasitaemia in children. Vitamin A supplementation does not seem to have an effect on malaria parasitaemia in this population; possible benefits against clinical episodes and severe malaria deserve further examination.						
970	Analysis of serum and supplemented vitamin C and oxidative stress in HIV-infected children and adolescents.	"Oliveira KFd, Cunha DFd, Weffort VRS."	Jornal de Pediatria. 2011;87(6):517-22.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20123086492	"OBJECTIVES: To assess adequacy of vitamin C intake in HIV-infected children and adolescents; to evaluate serum levels of vitamin C and indicators of oxidative stress; to compare with the uninfected group; to correlate serum vitamin C with oxidative stress and associate them according to the reference values. METHODS: Comparative cross-sectional study. Two groups of 27 children and adolescents each, aged between 3 to 19 years. Group 1 (G1) comprised individuals vertically infected with HIV seen at a regional outpatient clinic. Group 2 (G2) comprised invited individuals without history of HIV infection. The groups were matched for age, sex, and socioeconomic status. The following variables were analyzed: body mass index for age; micronutrient intake and consumption; and serum vitamin C, C-reactive protein (CRP), and albumin. RESULTS: The mean age was 12 years old. Most subjects were female (17, 63%), and there was prevalence of the economic class C (27, 50%). The most prevalent nutritional status was normal weight in 20 individuals (74.1%) in G1 and 21 (77.8%) in G2. The intake of vitamin C was significantly higher in G1 (p=0.006; t=2.987) according to the 24-hour dietary recall method. There were significant differences in serum vitamin C concentration between the groups, with a lower level in G1 (p=0.000; t=-7.309). In relation to oxidative stress, values of CRP in G1 were significantly higher (p=0.007; t=2.958). There was no association between deficiency of vitamin, CRP, and albumin. CONCLUSION: Our findings show that HIV-infected individuals have low levels of vitamin C; however, this deficiency is not related to eating habits, since the intake of this nutrient was higher in this group than in the control group. HIV-infected individuals have specific characteristics that increase their oxidative stress, which is evidenced by increased CRP."									
62	HIV-associated anemia in children: a systematic review from a global perspective.	"Calis JCJ, Hensbroek MBv, Haan RJd, Moons P, Brabin BJ, Bates I."	Aids. 2008;22(10):1099-112.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20083173220	"Objectives: To assess the importance of anemia in HIV-infected children in western and tropical settings. Design: A systematic review with a descriptive component. Methods: Four databases were searched and reference lists of pertinent articles were checked. Studies that reported data on anemia or hemoglobin levels in HIV-infected children were selected and grouped according to the location and the definition of anemia. Results: Thirty-six studies met the inclusion criteria. Mild (hemoglobin <11 g/dl) and moderate (hemoglobin <9 g/dl) anemia were more prevalent with HIV infection (odds ratio 4.5; 95% confidence interval 2.5-8.3 and odds ratio 4.5; 95% confidence interval 2.0-10.3, respectively). Mean hemoglobin levels were lower (standardized mean difference; 0.79; 95% confidence interval 0.47-1.10). These differences were observed in both western and tropical settings. Anemia incidence ranged from 0.41 to 0.44 per person-year. There was limited data on more severe anemia (hemoglobin <7 or <5 g/dl). As anemia was frequently identified as an independent risk factor for disease progression and death, we next reviewed the limited data to formulate better strategies. Failure of erythropoiesis was the most important mechanism for anemia in HIV-infected children. Therapeutic options include highly active antiretroviral therapy and prevention or treatment of secondary infections. Erythropoietin can improve anemia in children, but it has not been evaluated in developing countries. Micronutrient supplementation may be helpful in individual children. The potential benefits or risks of iron supplementation in HIV-infected children require evaluation. Conclusion: Anemia is a very common complication of pediatric HIV infection, associated with a poor prognosis. With the increasing global availability of highly active antiretroviral therapy, more data on the safety and efficacy of possible interventions in children are urgently needed."									
1919	Nutritional status of children living in a community with high HIV prevalence in rural Uganda: a cross-sectional population-based survey.	"Nalwoga A, Maher D, Todd J, Karabarinde A, Biraro S, Grosskurth H."	Tropical Medicine & International Health. 2010;15(4):414-22.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=20180934	"OBJECTIVES: To assess the nutritional status of children in a rural community with high HIV prevalence in rural Uganda and to examine the impact of HIV infection at the individual and population level. Methods Cross-sectional population-based survey of children aged 0-12 in a cohort comprising the residents of 25 neighbouring villages in rural southwest Uganda. Anthropometric indicators of nutritional status (height for age, weight for age and weight for height) were assessed in relation to children's HIV serostatus, maternal HIV serostatus and maternal vital status. Children with a Z score of <-2 were defined as undernourished, with a Z score <-2 for weight for age defining underweight, for height for age defining stunting and for weight for height defining wasting."	"RESULTS: Of 5951 children surveyed, 91% underwent anthropometric measurement: 30% were underweight, 42% stunted and 10% wasted. HIV seroprevalence among children aged 2-12 was 0.7%. The prevalence of underweight was significantly higher in HIV-positive than in HIV-negative children (52%vs. 30%), as was the prevalence of stunting (68%vs. 42%), but there was no significant difference in the prevalence of wasting (4%vs. 9%). There were no significant differences in the prevalences of indicators of undernutrition in children classified by maternal HIV and vital status."	"CONCLUSIONS: Chronic childhood undernutrition is common in this rural community. HIV infection had a direct effect in worsening children's nutritional status, but no indirect effect in terms of maternal HIV infection or maternal death. The population-level impact of childhood HIV infection on nutritional status is limited on account of the low HIV prevalence in children. The response to undernutrition in children in Africa requires action on many fronts: not only delivering community-wide HIV and nutritional interventions but also addressing the many interacting factors that contributed to childhood undernutrition before the HIV era and still do so now."							
656	An interactive 24-h recall technique for assessing the adequacy of trace mineral intakes of rural Malawian women; its advantages and limitations.	"Ferguson EL, Gadowsky SL, Huddle JM, Cullinan TR, Lehrfeld J, Gibson RS."	European Journal of Clinical Nutrition. 1995;49(8):565-78.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med3&AN=7588507	OBJECTIVES: To assess the relative validity of an interactive 24-h recall for estimating mineral intakes of rural Malawian women.	"DESIGN: Repeated interactive 24-h recalls were compared with weighed records collected for the same 2 days of food intake, and for 2 days 1-2 weeks prior and subsequent to the weighed record data collection period."	"SETTING: Three villages in traditional authority Jalasi, Mangochi District, Malawi."	SUBJECTS: 60 rural pregnant women.	"RESULTS: Median daily intakes of most minerals (Ca, Fe, Zn, Mn) were comparable for the two methods, but slightly overestimated for recalled (R) intakes expressed per MJ (mg/MJ) compared to weighed (W) (R vs W = Ca, 48 vs 38; Fe, 2.1 vs 1.9; Zn, 0.9 vs 0.8; Mn, 0.40 vs 0.38; P < or = 0.05). By contrast, recalled median daily intakes of energy (kJ), protein (g) fat (g) and Cu (mg) were slightly underestimated (R vs W = 6588 vs 7824; 51 vs 57; 14 vs 15; 1.3 vs 1.6, respectively; P < or = 0.05). Discrepancies were attributed primarily to inaccurate estimates of main meal food portions [R vs W = nsima (the main meal cereal style) 475 vs 557; and legume relish 171 vs 118 P < or = 0.001]. For classifying intakes into tertiles, agreement between the two methods was poor for daily intakes (Cohen's kappa < 0.40), but fair when expressed per MJ, and as a percentage of energy from food groups (Cohen's kappa > or = 0.40). Variance ratios for recall data were higher than corresponding ratios for the weighed intakes (R vs W = for energy, 4.87 vs 0.87), indicating poorer recall measurement precision."	"CONCLUSION: Results emphasise the importance of selecting the dietary method according to the study objectives, and the nutrients required."				
1253	Feeding and nutritional characteristics of infants on PMTCT programs.	"Magezi SR, Kikafunda J, Whitehead R."	Journal of Tropical Pediatrics. 2009;55(1):32-5.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=18755710	OBJECTIVES: To compare feeding and nutritional characteristics of infants born to mothers on the prevention of mother to child transmission (PMTCT) programs with infants not in the program.	DESIGN: A hospital-based case-control study was used.	"SETTING: The study was conducted in Nsambya hospital, Kampala, Uganda."	SUBJECTS: A total of 176 mother/baby pairs were included in the study with 88 from each group. Infants were aged from 3 to 12 months.	"RESULTS: The percentage of mothers exclusively breastfeeding was lower in PMTCT mothers (65%) compared to the 98% in non-PMTCT mothers (p < 0.01). The mean duration of breastfeeding was 2.5 months among PMTCT mothers compared to 4.1 months in non-PMTCT mothers (p < 0.01). Dietary diversity score (DDS) was higher among PMTCT babies (4.3) compared to 3.7 among non-PMTCT babies (p < 0.05). The percentage of babies reported ill in the previous month was much higher among the PMTCT infants (79%) compared to the non-PMTCT infants (69%) and the incidence of diarrhoea was almost twice as high among the PMTCT infants (18.1%) compared to the 9.3% in non-PMTCT infants [risk ratio (RR) = 1.94]. In addition, the incidence of respiratory infections was higher among the PMTCT infants (47.7%) compared to 39.5% in the non-PMTCT infants (RR = 1.2). The mean z-scores: [Weight for age z-score (WAZ)] [height for age z-score (HAZ)] and [weight for height z-score (WHZ)] were significantly lower (p < 0.01) for PMTCT infants. The incidence of stunting among PMTCT infants (11.8%) was twice that of the non-PMTCT ones (5.2%) and incidence of underweight was 8.4% in the PMTCT infants compared to 1.2% in the non-PMTCT ones."	CONCLUSIONS: The feeding patterns of the PMTCT infants were significantly different from the non-PMTCT ones both in terms of breastfeeding and DDS. Although DDS was higher among the PMTCT infants it did not translate into better nutritional status. The higher incidence of morbidity combined with the lower incidence of breastfeeding among the PMTCT infants are some of the contributing factors to significantly higher levels of malnutrition.				
1912	Clinical and contextual determinants of anthropometric failure at baseline and longitudinal improvements after starting antiretroviral treatment among South African children.	"Chhagan MK, Kauchali S, Van den Broeck J."	Tropical Medicine & International Health. 2012;17(9):1092-9.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=22686572	"OBJECTIVES: To describe baseline nutritional anthropometry and its determinants in a cohort of children commencing HAART, and subsequent longitudinal anthropometric trajectories over 2 years."	"METHODS: Prospective observational study in a prepubertal cohort of children commencing HAART in Durban, South Africa."	"RESULTS: Among 151 children with a median baseline age of 61.3 months (IQR 29.6, 90.1), prevalence of stunting was 54% (95% CI 46, 62) and of underweight, 37% (95% CI 29, 45). There was high prevalence of preceding respiratory and diarrhoeal comorbidities, which were associated with poorer anthropometry. There were significant improvements in height, weight and mid-upper-arm circumference z-scores after initiation of HAART regardless of preceding comorbidities. Stunted children remained shorter on average after 24 months, but younger children had better catch-up. Children who eventually died had persistently worse anthropometry. Children who were exposed to improved programs for prevention of mother-to-child transmission (PMTCT) were younger and had more severe growth impairments at baseline."	"CONCLUSION: Anthropometric status of children on HAART is influenced by age, preceding comorbidities, and by programmatic factors. With improved PMTCT programs, infants who would previously have died in infancy are now surviving to commence HAART. Poor outcomes are preceded by persistent anthropometric failure on HAART reaffirming the need for growth velocity monitoring. 2012 Blackwell Publishing Ltd."						
1932	Clinical and contextual determinants of anthropometric failure at baseline and longitudinal improvements after starting antiretroviral treatment among South African children.	"Chhagan MK, Kauchali S, Broeck Jvd."	Tropical Medicine and International Health. 2012;17(9):1092-9.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20123298081	"Objectives: To describe baseline nutritional anthropometry and its determinants in a cohort of children commencing HAART, and subsequent longitudinal anthropometric trajectories over 2 years. Methods: Prospective observational study in a prepubertal cohort of children commencing HAART in Durban, South Africa. Results: Among 151 children with a median baseline age of 61.3 months (IQR 29.6, 90.1), prevalence of stunting was 54% (95% CI 46, 62) and of underweight, 37% (95% CI 29, 45). There was high prevalence of preceding respiratory and diarrhoeal comorbidities, which were associated with poorer anthropometry. There were significant improvements in height, weight and mid-upper-arm circumference z-scores after initiation of HAART regardless of preceding comorbidities. Stunted children remained shorter on average after 24 months, but younger children had better catch-up. Children who eventually died had persistently worse anthropometry. Children who were exposed to improved programs for prevention of mother-to-child transmission (PMTCT) were younger and had more severe growth impairments at baseline. Conclusion: Anthropometric status of children on HAART is influenced by age, preceding comorbidities, and by programmatic factors. With improved PMTCT programs, infants who would previously have died in infancy are now surviving to commence HAART. Poor outcomes are preceded by persistent anthropometric failure on HAART reaffirming the need for growth velocity monitoring."									
1007	Early response to highly active antiretroviral therapy in HIV-1-infected Kenyan children.	"Wamalwa DC, Farquhar C, Obimbo EM, Selig S, Mbori-Ngacha DA, Richardson BA, Overbaugh J, et al."	Journal of Acquired Immune Deficiency Syndromes. 2007 July;45(3):311-7.		"OBJECTIVES: To describe the early response to World Health Organization (WHO)-recommended nonnucleoside reverse transcriptase inhibitor (NNRTI)-based first-line highly active antiretroviral therapy (HAART) in HIV-1-infected Kenyan children unexposed to nevirapine. DESIGN: Observational prospective cohort. METHODS: HIV-1 RNA level, CD4 lymphocyte count, weight for age z score, and height for age z score were measured before the initiation of HAART and every 3 to 6 months thereafter. Children received no nutritional supplements. RESULTS: Sixty-seven HIV-1-infected children were followed for a median of 9 months between August 2004 and November 2005. Forty-seven (70%) used zidovudine, lamivudine (3TC), and an NNRTI (nevirapine or efavirenz), whereas 25% used stavudine (d4T), 3TC, and an NNRTI. Nevirapine was used as the NNRTI by 46 (69%) children, and individual antiretroviral drug formulations were used by 63 (94%), with only 4 (6%) using a fixed-dose combination of d4T, 3TC, and nevirapine (Triomune; Cipla, Mumbai, India). In 52 children, the median height for age z score and weight for age z score rose from -2.54 to -2.17 (P < 0.001) and from -2.30 to -1.67 (P = 0.001), respectively, after 6 months of HAART. Hospitalization rates were significantly reduced after 6 months of HAART (17% vs. 58%; P < 0.001). The median absolute CD4 count increased from 326 to 536 cells/muL (P < 0.001), the median CD4 lymphocyte percentage rose from 5.8% before treatment to 15.4% (P < 0.001), and the median viral load fell from 5.9 to 2.2 log10 copies/mL after 6 months of HAART (P < 0.001). Among 43 infants, 47% and 67% achieved viral suppression to less than 100 copies/mL and 400 copies/mL, respectively, after 6 months of HAART. CONCLUSION: Good early clinical and virologic response to NNRTI-based HAART was observed in HIV-1-infected Kenyan children with advanced HIV-1 disease. 2007 Lippincott Williams & Wilkins, Inc."									
1096	Treatment of cryptococcal meningitis in Peruvian AIDS Patients using amphotericin B and fluconazole.	"Dammert P, Bustamante B, Ticona E, Llanos-Cuentas A, Huaroto L, Chavez VM, Campos PE."	Journal of Infection. 2008 September;57(3):260-5.		"Objectives: To describe the mycologic and clinical outcomes and factors associated with failure in Peruvian patients with AIDS-associated cryptococcal meningitis (CM) treated with amphotericin B deoxycholate (Amph B) followed by fluconazole. Methods: Patients were treated with intravenous Amph B 0.7 mg/kg/day for 2 or 3 weeks followed by oral fluconazole 400 mg/day for 7 or 8 weeks. Clinical and laboratory evaluations including cerebrospinal fluid (CSF) studies were performed at baseline and at weeks 2 and 10. Results: The CSF cultures were negative in 25% and 68% of 47 patients at weeks 2 and 10, respectively. In the univariate analysis, baseline low body mass index (BMI), hyponatremia, low serum albumin, positive blood culture and CSF antigen titers >=1024 were associated with a positive CSF culture at week 2. Baseline positive urine culture, positive blood culture, any positive extraneural culture and CSF opening pressure at week 2 >=300 mm H2O were associated with a positive CSF culture at week 10. In the multivariate analysis no association was found. Conclusions: Therapy with Amph B and fluconazole, combined with aggressive management of elevated intracranial pressure (ICP), results in low CSF sterilization rates at week 2 and acceptable CSF sterilization rates at week 10 when compared with other series. 2008 The British Infection Society."									
1657	Are opportunities for vitamin A supplementation being utilised at primary health-care clinics in the Western Cape Province of South Africa?	"Hendricks M, Beardsley J, Bourne L, Mzamo B, Golden B."	Public Health Nutrition. 2007;10(10):1082-8.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=17381904	"OBJECTIVES: To determine missed opportunities and problems relating to implementation of the Vitamin A Supplementation Programme in urban and rural regions of the Western Cape Province of South Africa.MethodA cross-sectional survey was conducted at primary health-care (PHC) clinics in Cape Metropole, an urban region, and West Coast Winelands, a rural region, of the Western Cape. A purposive sample of clinics where more than 30 children were seen per day was drawn from 10 of the 11 districts in the Cape Metropole region and the two districts of the West Coast Winelands region. The number of children selected from each district was weighted in terms of population size for the two regions. At each clinic visited, the first five to 10 children seen on a day, and meeting the inclusion criteria for vitamin A supplementation (VAS) based on the vitamin A provincial policy guidelines, were selected. These included children with low birth weight (LBW), growth faltering, underweight and severe undernutrition, recurrent diarrhoea and lower respiratory tract infection (LRTI), tuberculosis, measles, HIV/AIDS and eye signs of vitamin A deficiency. Clinic records were reviewed following consultation with the PHC nurse to identify if the child required vitamin A, exit interviews were conducted with mothers/caregivers, and Road to Health Charts (RTHCs) were reviewed. At the end of the study, PHC managers were interviewed to determine if problems could be identified with the Programme."	"RESULTS: Forty-three of 123 (35%) and 13 of 40 (33%) of the fixed PHC clinics in the Cape Metropole and West Coast Winelands regions were visited, and a total of 300 children (234 from Cape Metropole, 66 from West Coast Winelands) with a mean (standard deviation) age of 24.3 (16.3) months and who met the inclusion criteria for VAS were selected. Of the total sample of children, 198 (66%) had multiple (i.e. more than one) indication and 102 (34%) had a single indication for VAS. There were a total of 617 indications for VAS in the two regions; 238 (39%) for growth faltering, 119 (19%) for underweight, 98 (16%) for LBW, 70 (11%) for LRTI, 51 (8%) for diarrhoea, 21 (3%) for HIV/AIDS and 20 (3%) for tuberculosis. A total of 102 (34%) of the children in the two regions received vitamin A supplements (Cape Metropole 29%; West Coast Winelands 52%). A record was made on the RTHC of 79 (77%) of the children who received VAS (Cape Metropole 76%; West Coast Winelands 79%). Twenty-four per cent of the mothers knew why their child had been given vitamin A (Cape Metropole 29%; West Coast Winelands 12%). Eleven per cent of the mothers had previously heard about the Vitamin A Supplementation Programme (Cape Metropole 12%; West Coast Winelands 6%). More than 81% of PHC managers indicated that health staff had been trained to implement the Vitamin A Supplementation Programme. The main problems identified by health staff in the two regions were lack of vitamin A capsules, inadequate training and difficulties in implementing the Programme."	CONCLUSIONS: Opportunities to administer vitamin A were underutilised in both regions. Recommendations such as improving mothers' awareness of the benefits of vitamin A and training of PHC nurses were made to the provincial Department of Health and are being implemented to improve the effectiveness of the Programme.							
1550	Effect of maternal multivitamin supplementation on the mental and psychomotor development of children who are born to HIV-1-infected mothers in Tanzania.	"McGrath N, Bellinger D, Robins J, Msamanga GI, Tronick E, Fawzi WW."	Pediatrics. 2006;117(2):e216-25.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=16452331	"OBJECTIVES: To determine the association between maternal multivitamin supplementation and the mental and psychomotor development of children who are born to HIV-1-infected mothers in Tanzania, as secondary endpoints in a randomized trial that investigated the effect of maternal multivitamin supplementation on HIV-1 vertical transmission and progression."	"METHODS: The Bayley Scales of Infant Development, 2nd Edition, were administered at 6, 12, and 18 months of age to a subset of children (N = 327). We assessed the effect of vitamin A and multivitamin (vitamins B, C, and E) supplementation using linear regression models and Cox proportional hazard models for the Mental Development Index, the Psychomotor Development Index, and raw scores separately."	RESULTS: Multivitamin supplementation was associated significantly with a mean increase in Psychomotor Development Index score of 2.6 (95% confidence interval: 0.1-5.1). Multivitamins were also significantly protective against the risk for developmental delay on the motor scale (relative risk: 0.4; 95% confidence interval: 0.2-0.7) but not on the Mental Development Index. Vitamin A supplementation had no significant effect on these outcomes.	CONCLUSIONS: Maternal multivitamin supplements provide a low-cost intervention to reduce the risk for developmental delays among infants who are born to HIV-positive mothers in developing countries.						
1489	Multiple micronutrient supplementation does not reduce diarrhoea morbidity in Ugandan HIV-infected children: a randomised controlled trial.	"Ndeezi G, Tylleskar T, Ndugwa CM, Tumwine JK."	Paediatrics & international Child Health. 2012;32(1):14-21.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=22525443	OBJECTIVES: To determine the effect of multiple micronutrient supplementation on the incidence and prevalence of diarrhoea in Ugandan HIV-infected children aged 1-5 years.	"METHODS: We enrolled 847 HIV-infected Ugandan children in a randomised trial of a supplement containing 14 micronutrients (MMS) given at twice the recommended dietary allowance (RDA) versus a six-multivitamin (MV) supplement given in one RDA as the 'standard of care'. The participants were stratified into a highly active antiretroviral therapy (HAART) group of 85/847 (10%) and a non-HAART group of 762/847 (90%) participants. The supplements were given daily for 6 months. Episodes of diarrhoea assessed at routine visits, sick visits and those reported within 2 weeks before the routine visit were counted against weeks of observation for each participant. Diarrhoea incidence per child was calculated as the number of episodes per child year. Rate ratios were used to compare person-time rates in the two groups."	"RESULTS: The incidence of diarrhoea was 3.8 (95% CI 3.4-4.3) in the MMS and 3.5 (95% CI 3.1-4.0) in the MV group per child year. The rate ratio was 1.1 (0.9-1.3), similar in both strata, except that HAART-treated children had a lower incidence rate of diarrhoea. The prevalence of diarrhoea at 6 months was also similar in the two groups."	CONCLUSION: The 14-multiple-micronutrient supplement given in two RDA doses compared with a six-multivitamin 'standard of care' supplement given in one RDA dose did not reduce the incidence or prevalence of diarrhoea in HIV-infected children aged 1-5 years.						
1577	Incidence of WHO stage 3 and 4 conditions following initiation of anti-retroviral therapy in resource limited settings.	"Curtis AJ, Marshall CS, Spelman T, Greig J, Elliot JH, Shanks L, Cros Pd, et al."	PLoS ONE. 2012;7(12).	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20133043868	"Objectives: To determine the incidence of WHO clinical stage 3 and 4 conditions during early anti-retroviral therapy (ART) in resource limited settings (RLS). Design/Setting A descriptive analysis of routine program data collected prospectively from 25 Medecins Sans Frontieres supported HIV treatment programs in eight countries between 2002 and 2010. Subjects/Participants 35,349 study participants with median follow-up on ART of 1.33 years (IQR 0.51-2.41). Outcome Measures Incidence in 100 person-years of WHO stage 3 or 4 conditions during 5 periods after ART initiation. Diagnoses of conditions were made according to WHO criteria and relied upon clinical assessments supported by basic laboratory investigations. Results: The incidence of any WHO clinical stage 3 or 4 condition over 3 years was 40.02 per 100 person-years (31.77 for stage 3 and 8.25 for stage 4). The incidence of stage 3 and 4 conditions fell by over 97% between months 0-3 and months 25-36 (77.81 to 2.40 for stage 3 and 28.70 to 0.64 for stage 4). During months 0-3 pulmonary tuberculosis was the most common condition diagnosed in adults (incidence 22.24 per 100 person-years) and children aged 5-14 years (25.76) and oral candidiasis was the most common in children <5 years (25.79). Overall incidences were higher in Africa compared with Asia (43.98 versus 12.97 for stage 3 and 8.98 versus 7.05 for stage 4 conditions, p<0.001). Pulmonary tuberculosis, weight loss, oral and oesophageal candidiasis, chronic diarrhoea, HIV wasting syndrome and severe bacterial infections were more common in Africa. Extra-pulmonary tuberculosis, non-tuberculous mycobacterial infection, cryptococcosis, penicilliosis and toxoplasmosis were more common in Asia. Conclusions: The incidence of WHO stage 3 and 4 conditions during the early period after ART initiation in RLS is high, but greatly reduces over time. This is likely due to both the benefits of ART and deaths of the sickest patients occurring shortly after ART initiation. Access to appropriate disease prevention tools prior to ART, and early initiation of ART, are important for their prevention."									
1232	Stavudine-induced hyperlactatemia/lactic acidosis at a tertiary communicable diseases clinic in South Africa.	"Perez EH, Dawood H."	Journal of the International Association of Physicians in AIDS Care. 2010 March-April;9(2):109-12.		"Objectives: To determine the incidence, presentation, and outcome of hyperlactatemia and lactic acidosis. Design and Methods Setting: Grey's Hospital, a tertiary level referral institution. Study Population: A chart review of 1719 patients commenced on highly active antiretroviral therapy (HAART) between August 1, 2004, and July 31, 2006. A total of 1000 patients (615 females) received stavudine (d4T)/lamivudine (3TC)/efavirenz (EFV), 719 patients (598 females) received d4T/ 3TC/nevirapine (NVP). Results: Of the 1719 patients, 152 (8.84%) had an elevated plasma venous lactate (>2.2 mmol/L), 45 patients required admission for lactic acidosis. The overall incidence rate was 13.5 cases per 1000 patient years. The most common presenting symptoms were loss of weight (95%), abdominal pain (78.9%), loss of appetite, and paresthesias (63.8%). The median body mass index (BMI) at commencement of HAART and at onset of symptoms was 24.5 and 26, respectively. A median serum lactate level of 6.08 mmol/L (range 2.3-19.7 mmol/L) was observed at the onset of symptoms. Conclusions: High BMI at treatment initiation did not always predict hyperlactatemia. All patients who died had a baseline CD4 count <I0 cells/mm<sup>3</sup> at HAART initiation. The Author(s) 2010."									
1910	Influence of body mass index on pregnancy outcomes among HIV-infected and HIV-uninfected Zambian women.	"Banda Y, Chapman V, Goldenberg RL, Chi BH, Vermund SH, Stringer JS."	Tropical Medicine & International Health. 2007;12(7):856-61.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medc&AN=17596253	OBJECTIVES: To determine the influence of body mass index (BMI) on pregnancy outcomes of HIV-infected and HIV-uninfected Zambian women and to assess the possible role of BMI on mother-to-child transmission rate of HIV.	"METHODS: We analysed data from a clinical trial on nevirapine administration for the prevention of mother-to-child transmission of HIV in Lusaka, Zambia. Demographic characteristics, medical information and pregnancy outcomes were used in this secondary analysis."	"RESULTS: A total of 1211 women were included in this analysis and 36% were HIV-infected. Among HIV-infected women, maternal parity and prior stillbirths increased with increasing BMI in univariate analysis. Mean birth weight rose as well at 28.3 g [95% confidence interval (CI)=14.0-42.6] of infant weight per BMI unit. Transmission of HIV from mother to child appeared inversely related to BMI when compared according to BMI quartile (P for trend=0.07). In the HIV-uninfected group, infant birth weight increased with increasing BMI, at 32.7 g (95% CI=23.5-41.9) of infant weight per BMI unit."	"CONCLUSION: Birth weight increased alongside BMI in both HIV-infected and HIV-uninfected women. There is a suggestion that women with lower BMI have a greater risk of perinatal HIV transmission, even after adjustments for HIV viral load and CD4 count."						
1929	Influence of body mass index on pregnancy outcomes among HIV-infected and HIV-uninfected Zambian women.	"Banda Y, Chapman V, Goldenberg RL, Chi BH, Vermund SH, Stringer JSA."	Tropical Medicine and International Health. 2007 July;12(7):856-61.		"Objectives: To determine the influence of body mass index (BMI) on pregnancy outcomes of HIV-infected and HIV-uninfected Zambian women and to assess the possible role of BMI on mother-to-child transmission rate of HIV. Methods: We analysed data from a clinical trial on nevirapine administration for the prevention of mother-to-child transmission of HIV in Lusaka, Zambia. Demographic characteristics, medical information and pregnancy outcomes were used in this secondary analysis. Results: A total of 1211 women were included in this analysis and 36% were HIV-infected. Among HIV-infected women, maternal parity and prior stillbirths increased with increasing BMI in univariate analysis. Mean birth weight rose as well at 28.3 g [95% confidence interval (CI) = 14.0-42.6] of infant weight per BMI unit. Transmission of HIV from mother to child appeared inversely related to BMI when compared according to BMI quartile (P for trend = 0.07). In the HIV-uninfected group, infant birth weight increased with increasing BMI, at 32.7 g (95% CI = 23.5-41.9) of infant weight per BMI unit. Conclusion: Birth weight increased alongside BMI in both HIV-infected and HIV-uninfected women. There is a suggestion that women with lower BMI have a greater risk of perinatal HIV transmission, even after adjustments for HIV viral load and CD4 count. 2007 Blackwell Publishing Ltd."									
1942	"Anaemia in a rural Ugandan HIV cohort: prevalence at enrolment, incidence, diagnosis and associated factors."	"Mugisha JO, Shafer LA, Paal Lvd, Mayanja BN, Eotu H, Hughes P, Whitworth JAG, et al."	Tropical Medicine and International Health. 2008;13(6):788-94.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20083160344	"OBJECTIVES: To determine the prevalence and incidence of anaemia in HIV-positive and negative individuals; to identify risk factors for anaemia, prior to the introduction of HAART; and to determine the validity of the clinical diagnosis of anaemia. METHODS: Between 1990 and 2003, we followed a rural population based cohort of HIV-infected and uninfected participants. Prevalence and incidence of anaemia were determined clinically and by laboratory measurements. The sensitivity, specificity and predictive values of clinical diagnosis were calculated. RESULTS: The prevalence of anaemia at enrolment was 18.9% among HIV-positive and 12.9% among HIV-negative participants (P=0.065). Incidence of anaemia increased with HIV disease progression, from 103 per 1000 person-years of observation among those with CD4 counts >500 to 289 per 1000 person-years of observation among those with CD4 counts <200. Compared to laboratory diagnosis, the clinical diagnosis of anaemia had a sensitivity of 17.8%, specificity of 96.8%, a positive predictive value of 50.6% and a negative predictive value of 86.4%. Being female, low CD4 cell counts, HIV-positive, wasting syndrome, WHO stage 3 or 4, malaria, fever, pneumonia and oral candidiasis were associated with prevalent anaemia. CONCLUSIONS: Anaemia prevalence and incidence were higher among HIV-positive than negative participants. Compared to laboratory diagnosis, clinical detection of anaemia had a low sensitivity. Clinicians working in settings with limited laboratory support must be conscious of the risk of anaemia when managing HIV/AIDS patients, particularly when using antiretroviral drugs which by themselves may cause anaemia as a side effect. We recommend that haemoglobin should be measured before starting ART and monthly for the first three months."									
497	The levels of malnutrition and risk factors for mortality at Harare Central Hospital-Zimbabwe: an observation study.	"Chimhuya S, Kambarami RA, Mujuru H."	Central African Journal of Medicine. 2007;53(5-8):30-4.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=20355679	"OBJECTIVES: To determine the prevalence of malnutrition, and identify risk factors associated with mortality in acute severe malnutrition in a major referral hospital in Harare."	DESIGN: Cross sectional analytical study.	"SETTING: Harare Central Hospital, paediatric wards."	SUBJECTS: All children admitted to the general paediatric medical wards between 12 October 2003 and 19 January 2004 were surveyed.	MAIN OUTCOME MEASURES: Prevalence and mortality in hospitalized children with acute severe malnutrition.	"STUDY FACTORS: Patient's age, sex, vaccination status, type of malnutrition, weight-for-height, breast feeding status (age <24 months), care giver details, orphanage, area of residence, new or re-admission, time of admission, admission temperature, co-morbidity conditions, HIV status and selected laboratory tests."	"RESULTS: A total of 784 infants and children were admitted during the study period, of whom 619 were eligible for the study. Of the 619 children, 259 (41.8%) had acute severe malnutrition, 79 (12.8%) moderate malnutrition and 281 (45.5%) had no malnutrition. Fatality rates were 42.9% (acute severe malnutrition), 32.9% (moderate malnutrition), and 21% (no malnutrition) respectively. Factors predictive of mortality by multivariate analysis were age <18 months (O.R=2.27; 95% CI 1.20-4.29), weight-for-height <70% (O.R=2.63; 95% CI=1.24-5.56), acute diarrhoea (O.R=3.42; 95% CI=1.53-7.65), persistent diarrhoea (O.R=2.67; 95% CI= 1.26-5.66), and pneumonia (O.R=2.21; 95% CI= 1.08-4.52)."	"CONCLUSION: Mortality among children with acute severe malnutrition at this institution was unacceptably high. Case management needs strengthening particularly for malnutrition, diarrhoea and pneumonia. The role of high HIV prevalence rates on mortality in this population needs evaluating."		
1596	Vitamin D Deficiency in Medical Patients at a Central Hospital in Malawi: A Comparison with TB Patients from a Previous Study.	"Mastala Y, Nyangulu P, Banda RV, Mhemedi B, White SA, Allain TJ."	PLoS ONE. 2013 28 Mar;8(3).		"Objectives: To determine the prevalence of vitamin D deficiency (VDD) in adult medical, non-tuberculous (non-TB) patients. To investigate associations with VDD. To compare the results with a similar study in TB patients at the same hospital. Design: Cross-sectional sample. Setting: Central hospital in Malawi. Participants: Adult non-TB patients (n = 157), inpatients and outpatients. Outcome Measures: The primary outcome was the prevalence of VDD. Potentially causal associations sought included nutritional status, in/outpatient status, HIV status, anti-retroviral therapy (ART) and, by comparison with a previous study, a diagnosis of tuberculosis (TB). Results: Hypovitaminosis D (<=75 nmol/L) occurred in 47.8% (75/157) of patients, 16.6% (26/157) of whom had VDD (<=50 nmol/L). None had severe VDD (<=25 nmol/L). VDD was found in 22.8% (23/101) of in-patients and 5.4% (3/56) of out-patients. In univariable analysis in-patient status, ART use and low dietary vitamin D were significant predictors of VDD. VDD was less prevalent than in previously studied TB patients in the same hospital (68/161 = 42%). In multivariate analysis of the combined data set from both studies, having TB (OR 3.61, 95%CI 2.02-6.43) and being an in-patient (OR 2.70, 95%CI 1.46-5.01) were significant independent predictors of VDD. Conclusions: About half of adult medical patients without TB have suboptimal vitamin D status, which is more common in in-patients. VDD is much more common in TB patients than non-TB patients, even when other variables are controlled for, suggesting that vitamin D deficiency is associated with TB. 2013 Mastala et al."									
995	"Prevalence, determinants of positivity, and clinical utility of cryptococcal antigenemia in Cambodian HIV-infected patients."	"Micol R, Lortholary O, Sar B, Laureillard D, Ngeth C, Dousset JP, Chanroeun H, et al."	Journal of Acquired Immune Deficiency Syndromes. 2007 August;45(5):555-9.		"OBJECTIVES: To determine the prevalence, determinants of positivity, and clinical utility of serum cryptococcal polysaccharide (CPS) antigen testing among HIV-infected patients in 2004 in Cambodia, an area highly endemic for cryptococcosis. METHODS: All HIV-infected patients with a CD4 count <200 cells/mm attending 1 of 2 Phnom Penh hospitals for the first time were systematically screened for serum CPS. Patients with positive test results were further investigated to identify those with cryptococcal meningitis (CM), pulmonary cryptococcosis, or isolated positive cryptococcal antigenemia (IPCA). RESULTS: The median (interquartile range [IQR]) CD4 count of 327 enrolled patients was 24 (IQR: 8 to 65) cells/mm. The prevalence of cryptococcal infection was 59 (18.0%) of 327 cases, of which 41 were CM and 10 were IPCA. In the absence of serum CPS detection, 17 (28.8%) of 59 cryptococcal infections would have been missed on the day of consultation. In patients with no specific symptoms of meningoencephalitis, the prevalence of positive serum CPS detection was 32 (10.8%) of 295 cases. Countryside residence (adjusted odds ratio [AOR] = 3.6), headache (AOR = 3.2), body mass index <15.4 kg/m (AOR = 3.4), CD4 count <50 cells/mm (AOR = 4.0), and male gender (marginally, AOR = 2.1) were all independently associated with a positive test result. CONCLUSION: Serum CPS screening among AIDS patients with a CD4 count <100 cells/mm is useful in areas highly endemic for cryptococcosis, allowing early diagnosis and treatment of this opportunistic infection. 2007 Lippincott Williams & Wilkins, Inc."									
1050	Pharmacokinetics of nevirapine in HIV-infected children with and without malnutrition receiving divided adult fixed-dose combination tablets.	"Pollock L, Else L, Poerksen G, Molyneux E, Moons P, Walker S, Fraser W, et al."	Journal of Antimicrobial Chemotherapy. 2009;64(6):1251-9.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=19812065	OBJECTIVES: To determine the relationship between nutritional status and nevirapine exposure by comparing the pharmacokinetics of nevirapine in HIV-infected children of different ages with and without malnutrition receiving divided tablets of Triomune 30 (stavudine + lamivudine + nevirapine) in accordance with Malawi National Guidelines.	"METHODS: Children were recruited in weight-based dosage bands and nutritional status classified according to weight for height. Total and unbound plasma nevirapine concentrations were measured over a full dosing interval. Multivariate linear and logistic regression analyses were performed to determine the effects of malnutrition, age, dose and other factors on nevirapine exposure and likelihood of achieving therapeutic nevirapine trough concentrations."	"RESULTS: Forty-three children were recruited (37 included for analysis). Mild to moderate malnutrition was present in 12 (32%) children; 25 (68%) were of normal nutritional status. There was no effect of malnutrition on any measure of total drug exposure or on the unbound fraction of nevirapine. Nevirapine exposure was strongly related to dose administered (P = 0.039) and to age (for every yearly increase in age there was an approximately 88% increase in the odds of achieving a therapeutic nevirapine concentration; P = 0.056, 95% confidence interval 0.983-3.585)."	CONCLUSIONS: Use of divided adult Triomune 30 tablets in treating young children results in significant underdosing. No independent effect of malnutrition on total and unbound nevirapine exposures was observed. These data support the use of bespoke paediatric antiretroviral formulations.						
605	"Infant feeding practices among HIV infected women receiving prevention of mother-to-child transmission services at Kitale District Hospital, Kenya."	"Bii SC, Otieno-Nyunya B, Siika A, Rotich JK."	East African Medical Journal. 2008;85(4):156-61.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=18700348	"OBJECTIVES: To determine the types and modes of infant feeding practices among the HIV infected mothers on prevention of mother-to-child transmission (PMTCT) and attending MCH-FP clinic at Kitale District Hospital, Kenya."	DESIGN: Descriptive cross-sectional study.	SETTING: Kitale District Hospital in Western Kenya within the maternal and child health and family planning (MCH-FP) and comprehensive care clinics.	SUBJECTS: A total of 146 respondents who had delivered 150 babies were recruited for this study.	RESULTS: Thirty five percent (52/150) of the babies were exclusively breastfed while 50% (75/150) were not breastfed at all and 14% (21/150) of the babies received mixed feeding. The length of exclusive breastfeeding ranged from 1-6 months with most (53%) women exclusively breastfeeding for two to three months. Only 13% of the women exclusively breastfed for five to six months. There was a strong relationship between mode of infant feeding and spouse's awareness of HIV status. Mothers who had disclosed their HIV status to their spouses were more likely not to breastfeed than mothers who had not disclosed their status (p < 0.05%). The choice of infant feeding method was also influenced by the socio-economic status of the mothers and nevirapine uptake. The level of education did not influence the mode of infant feeding.	"CONCLUSION: Infant feeding decisions were mainly influenced by the male partner's involvement and the socio economic status of the mother. Half of the respondents did not breastfeed at all. The duration of exclusive breastfeeding rarely reached six months. To encourage women to adhere to good infant feeding practices, involvement of their partners, family members as well as the community for support should be encouraged."				
1829	Estimating the burden of disease attributable to childhood and maternal undernutrition in South Africa in 2000.	"Nannan N, Norman R, Hendricks M, Dhansay MA, Bradshaw D, South African Comparative Risk Assessment Collaborating G."	South African Medical Journal Suid-Afrikaanse Tydskrif Vir Geneeskunde. 2007;97(8 Pt 2):733-9.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=17952231	OBJECTIVES: To estimate the disease burden attributable to being underweight as an indicator of undernutrition in children under 5 years of age and in pregnant women for the year 2000.	"DESIGN: World Health Organization comparative risk assessment (CRA) methodology was followed. The 1999 National Food Consumption Survey prevalence of underweight classified in three low weight-for-age categories was compared with standard growth charts to estimate population-attributable fractions for mortality and morbidity outcomes, based on increased risk for each category and applied to revised burden of disease estimates for South Africa in 2000. Maternal underweight, leading to an increased risk of intra-uterine growth retardation and further risk of low birth weight (LBW), was also assessed using the approach adopted by the global assessment. Monte Carlo simulation-modeling techniques were used for the uncertainty analysis."	SETTING: South Africa.	SUBJECTS: Children under 5 years of age and pregnant women.	"OUTCOME MEASURES: Mortality and disability-adjusted life years (DALYs) from protein- energy malnutrition and a fraction of those from diarrhoeal disease, pneumonia, malaria, other non- HIV/AIDS infectious and parasitic conditions in children aged 0 - 4 years, and LBW."	"RESULTS: Among children under 5 years, 11.8% were underweight. In the same age group, 11,808 deaths (95% uncertainty interval 11,100 - 12,642) or 12.3% (95% uncertainty interval 11.5 - 13.1%) were attributable to being underweight. Protein-energy malnutrition contributed 44.7% and diarrhoeal disease 29.6% of the total attributable burden. Childhood and maternal underweight accounted for 2.7% (95% uncertainty interval 2.6 - 2.9%) of all DALYs in South Africa in 2000 and 10.8% (95% uncertainty interval 10.2 - 11.5%) of DALYs in children under 5."	"CONCLUSIONS: The study shows that reduction of the occurrence of underweight would have a substantial impact on child mortality, and also highlights the need to monitor this important indicator of child health."			
974	Body fat abnormality in HIV-infected children and adolescents living in europe: Prevalence and risk factors.	"Alam N, Cortina-Borja M, Goetghebuer T, Marczynska M, Vigano A, Thorne C."	Journal of Acquired Immune Deficiency Syndromes. 2012 01 Mar;59(3):314-24.		"Objectives: To estimate the prevalence of and identify risk factors for lipodystrophy syndrome (LS) and body fat abnormality in a population of HIV-infected children and adolescents. Design: Cross-sectional observational study. Methods: HIV-infected subjects aged 2-18 years were recruited from 15 HIV centers in Belgium Italy, and Poland between January 2007 and December 2008. Standardized assessments by the patient's long-term clinician were performed to establish the presence of abnormality. Risk factors were explored in logistic regression models for fat abnormality outcomes and LS (abnormality plus dyslipidemia). Results: Among 426 subjects (70% white), median age was 12.2 years (interquartile range: 9.0-15.0 years) and median duration of antiretroviral therapy was 5.2 years (interquartile range: 2.2-8.8 years). Prevalence was 57% (n = 235) for LS and 42% (n =176) for fat abnormality; 90 subjects with abnormality were affected in >=3 locations. Lipoatrophy occurred in 28% (n =117) of subjects and lipohypertrophy in 27% (n = 115), most commonly in the face and trunk, respectively. In multivariable analysis, white ethnicity, body mass index, ritonavir/lopinavir, and nonnucleoside reverse transcriptase inhibitors were each associated with an increased risk of LS (P <0.05). White ethnicity, history of Centers for Disease Control and Prevention-defined disease, and stavudine were associated with risk of lipoatrophy (P <0.05). Increased risk of lipohypertrophy was associated with body mass index and prior HIV disease. Conclusions: Fat abnormality was prevalent in close to half of children and adolescents, who had accumulated long treatment durations. Risk of fat abnormality was associated with specific drugs, including stavudine and ritonavir, and other variables. Our results underline the importance of continued surveillance of children treated with antiretroviral therapy. Copyright 2012 by Lippincott Williams & Wilkins."									
611	"Food insufficiency in rural Kilimanjaro, Tanzania."	"Leyna GH, Mnyika KS, Mmbaga EJ, Hussain A, Klouman E, Holm-Hansen C, Klepp KI."	East African Medical Journal. 2007;84(4):163-71.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=17894250	OBJECTIVES: To estimate the prevalence of reported food insufficiency associated socio-demographic factors and health indicators in rural Tanzania.	DESIGN: A cross-sectional study.	"SETTING: A rural community in Kilimanjaro, Tanzania."	"SUBJECTS: Eight hundred and ninety nine individuals aged 15-36 years. A structured questionnaire was administered to collect information on socio-demographic factors, health indicators and food insufficiency. Participants were tested for HIV-1 using saliva samples."	"RESULTS: The prevalence of food insufficiency was 25.3% with no sex difference. After controlling for potential confounders age (Adjusted Odds Ratio [AOR] = 1.05; 95% Confidence Interval [CI]: 1.02-1.08), low education level (AOR = 4.73; CI: 1.30-17.11), being a peasant (AOR = 2.29; CI: 1.04-5.04), poor self-rated health status (AOR = 4.35; CI: 1.71-11.00) and having health problems (AOR = 2.23; CI: 1.21-4.08) were associated with food insufficiency among women but not men. In unadjusted analysis, women with food insufficiency had over twice the odds of testing HIV positive although the association did not reach statistical significance (AOR = 2.12; CI: 0.87-5.19) in adjusted analysis."	CONCLUSIONS: Food insufficiency was prevalent in rural Tanzania. It was associated with sociodemographic factors and health indicators among women but not men. Our findings suggest that food insufficiency may play a role in increasing vulnerability to HIV infection particularly among women however; more research is needed to explore further this relationship.				
1534	Immunologic outcomes of antiretroviral therapy among HIV-infected Nigerian children and its association with early infant feeding and nutritional status at treatment initiation.	"Omoni AO, Christian PS, Sadoh WE, Okechukwu A, Olateju E, Omoigberale A, Blattner W, et al."	Pediatric Infectious Disease Journal. 2013;32(7):e291-e7.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20133239384	"Objectives: To evaluate immunologic response to antiretroviral treatment (ART) among HIV-infected Nigerian children (<36 months old) and to assess its association with early infant feeding pattern and nutritional status at treatment initiation. Design: Mixed prospective and retrospective cohort study. Methods: One hundred fifty HIV-infected children were followed for 12 months from initiation of ART. CD4 count/CD4% was assessed at baseline and every 4-6 months. Nutritional status was assessed by height-for-age, weight-for-age and weight-for-height Z scores using the 2006 World Health Organization growth reference. Children were classified into 4 feeding groups - exclusively breast-fed, predominantly breast-fed, mixed fed and exclusively formula fed. Logistic regression was used to model odds of failure to reach CD4% of >=25% at the 12-month follow-up. Linear random effects models were used to model the longitudinal change in CD4%. Results: There was a significant increase in CD4% for all children from 13.8% at baseline to 28.5% after 12 months ( Delta CD4%=14.7%, 95% confidence interval: 12.1%-17.4%). There was no association of feeding pattern with immunologic outcomes. In adjusted analyses, children who were underweight (weight-for-age < -2.0) or with CD4% <15% at baseline were 4.30 (95% confidence interval: 1.16, 15.87; P<0.05) times and 3.41 (95% confidence interval: 1.10, 10.52; P<0.05) times, respectively, more likely not to attain CD4% of >=25% at 12 months. Conclusion: Baseline nutritional status and CD4% were independently associated with failure to reach CD4% >=25% at 12 months among HIV-infected Nigerian children on ART. These results emphasize the importance of early screening and initiation of ART among children in resource-poor settings before malnutrition and severe immunosuppression sets in."									
75	Markers for predicting mortality in untreated HIV-infected children in resource-limited settings: A meta-analysis.	"Gibb DM, Dunn D, Chintu C, Mulenga V, Cotton M, Eley B, Zar H, et al."	Aids. 2008 January;22(1):97-105.		"OBJECTIVES: To evaluate the prognostic value of selected laboratory and growth markers on the short-term risk of mortality in untreated HIV-infected children in resource-limited settings. DESIGN: A meta-analysis of individual longitudinal data on children aged 12 months onwards from 10 studies (nine African, one Brazilian in the 3Cs4kids collaboration). METHODS: The risk of death within 12 months based on age and the most recent measurements of laboratory and growth markers was estimated using Poisson regression models, adjusted for cotrimoxazole prophylaxis use and study effects. RESULTS: A total of 2510 children contributed 357 deaths during 3769 child-years-at-risk, with 81% follow-up occurring after start of cotrimoxazole. At first measurement, median age was 4.0 years (interquartile range, 2.2-7.0 years), median CD4% was 15% and weight-for-age z-score -1.9. CD4% and CD4 cell count were the strongest predictors of mortality, followed by weight-for-age and haemoglobin. After adjusting for these markers, the effects of total lymphocyte count and BMI-for-age were relatively small. Young children who were both severely malnourished and anaemic had high mortality regardless of CD4 values, particularly those aged 1-2 years. By contrast, high CD4% or CD4 cell count values predicted low mortality level amongst either children older than 5 years or those younger with neither severe malnutrition nor anaemia. CONCLUSIONS: CD4 measurements are the most important indicator of mortality and wider access to affordable tests is needed in resource-limited settings. Evaluation of antiretroviral initiation in children also needs to consider weight-for-age and haemoglobin. Prevention and treatment of malnutrition and anaemia is integral to HIV paediatric care and could improve survival. 2008 Lippincott Williams & Wilkins, Inc."									
822	Effect of nutritional status on tuberculin skin testing.	"Pineiro R, Cilleruelo MJ, Garcia-Hortelano M, Garcia-Ascaso M, Medina-Claros A, Mellado MJ."	Indian Journal of Pediatrics. 2013 April;80(4):271-5.		"Objectives: To evaluate Tuberculin skin test (TST) results in a population of immigrants and internationally adopted children from several geographical areas; to analyze whether nutritional status can modify TST results. Methods: This cross-sectional observational study included adopted children and immigrants evaluated in the authors' unit between January 2003 and December 2008. Children diagnosed with tuberculosis, or vaccinated with live attenuated virus 2 mo earlier, HIV-infected, chronically ill or under treatment with immunosuppressive agents were excluded. TST was considered as dependent variable. Independent variables were gender, age, geographical origin, BCG scar, nutritional status, immune status and intestinal parasitism. Results: One thousand seventy four children were included; 69.6 % were girls. There was a BCG scar in 79 % of children. Mantoux = 0 mm was found in 84.4 %, <10 mm in 4.1 %, and >=10 mm in 11.4 % of children. Nutrition (McLaren's classification) was normal (>=90 %) in 26.7 % of the subjects, with mild malnutrition (80-89 %) in 36 %, moderate (70-79 %) in 23.2 % and severe (<=69 %) in 14.1 %. There was no difference in TST results among different nutritional status children. Conclusions: The nutritional status, measured by McLaren's classification, does not changes the results of TST. McLaren's classification only grades protein-caloric malnutrition, so in authors' experience this type of malnutrition does not interfere with TST results. Implementing other nutritional parameters could help to determine whether nutritional status should be taken into account when interpreting TST results. 2012 Dr. K C Chaudhuri Foundation."									
1001	Anemia is an independent predictor of mortality and immunologic progression of disease among women with HIV in Tanzania.	"O'Brien ME, Kupka R, Msamanga GI, Saathoff E, Hunter DJ, Fawzi WW."	Journal of Acquired Immune Deficiency Syndromes. 2005 01 Oct;40(2):219-25.		"Objectives: To examine the association of anemia with mortality and disease progression among a cohort of women with HIV in Dar es Salaam, Tanzania. Methods: Time to all-cause death, AIDS-related death, and a 50% decrease in CD4 cell count among 1078 HIV-positive pregnant women enrolled in a clinical trial of vitamin supplementation from 1995-2003. Results: Adjusted models showed that anemia was associated with an increased risk of all-cause mortality (relative hazard [RH]: 2.06, 95% CI: 1.52 to 2.79 for moderate anemia and RH: 3.19, 95% CI: 2.23 to 4.56 for severe anemia) and AIDS-related mortality (RH: 2.21, 95% CI: 1.53 to 3.19 for moderate anemia and RH: 3.47, 95% CI: 2.25 to 5.33 for severe anemia), independent of CD4 cell count, World Health Organization clinical stage, age, pregnancy, vitamin supplementation, and body mass index. Anemia was also associated with a more rapid decline in CD4 counts, measured as time to a 50% drop in CD4 cell count from baseline. Erythrocyte characteristics suggestive of iron deficiency were also associated with all-cause and AIDS-related death and a 50% decline in CD4 cell count. Conclusions: Anemia is an independent predictor of mortality and disease progression in this cohort. Screening for anemia, coupled with prevention and treatment efforts, should be included in HIV care initiatives, particularly those that target women. Copyright 2005 by Lippincott Williams & Wilkins."									
78	A randomized trial of the impact of multiple micronutrient supplementation on mortality among HIV-infected individuals living in Bangkok.	"Jiamton S, Pepin J, Suttent R, Filteau S, Mahakkanukrauh B, Hanshaoworakul W, Chaisilwattana P, et al."	AIDS. 2003;17(17):2461-9.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=14600517	OBJECTIVES: To examine the impact of high-dose multiple micronutrient supplementation on survival and disease progression among HIV-infected individuals in Thailand.	DESIGN: Randomized placebo-controlled trial.	METHODS: Four-hundred and eighty-one HIV-infected men and women living in and around Bangkok with CD4 cell counts in the range 50 x 10(6)- 550 x 10(6)/l were randomized to receive micronutrients or placebo for a period of 48 weeks. Trial participants were examined clinically 12-weekly and tested for CD4 cell count 24-weekly. A subset were tested for HIV plasma viral load at 48 weeks.	RESULTS: Seventy-nine (16%) trial participants were lost to follow-up and 23 (5%) died. The death rate was lower in the micronutrients arm with the mortality hazard ratios [95% confidence interval (CI)] of 0.53 (0.22-1.25; P = 0.1) overall and 0.37 (0.13-1.06; P = 0.052) and 0.26 (0.07-0.97; P = 0.03) among those with CD4 cell counts < 200 x 10(6)/l and < 100 x 10(6)/l respectively. There was no impact on CD4 cell count or plasma viral load.	"CONCLUSIONS: Multiple micronutrient supplementation may enhance the survival of HIV-infected individuals with CD4 cell counts < 200 x 10(6)/l. This could have important public health implications in the developing world where access to antiretrovirals remains poor. The clinical findings need to be reproduced in other settings and the mechanism, which appears to be independent of change in CD4 cell count, merits further investigation."					
263	"Plasma cytokines, cytokine antagonists, and disease progression in African women infected with HIV-1."	"Thea DM, Porat R, Nagimbi K, Baangi M, St Louis ME, Kaplan G, Dinarello CA, et al."	Annals of Internal Medicine. 1996;124(8):757-62.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=8633837	OBJECTIVES: To examine the relation of circulating cytokines and cytokine antagonists to the progression of human immunodeficiency virus type 1 (HIV-1) disease.	DESIGN: Cross-sectional analysis.	"SETTING: An ambulatory acquired immunodeficiency syndrome (AIDS) research clinic in Kinshasa, Zaire."	"PATIENTS: 48 women with AIDS, 51 women with HIV infection who were clinically asymptomatic, and 11 female controls who did not have HIV infection, all from Zaire."	"MEASUREMENTS: Plasma levels of interleukin-1beta, tumor necrosis factor-alpha (TNF-alpha), interleukin-6, interleukin-8, interferon-gamma, interleukin-1beta receptor antagonist (interleukin-1Ra), and TNF soluble receptor p55 (TNFsRp55) were assayed by specific radioimmunoassays. Plasma levels of interferon-gamma were assayed by commercial enzyme-linked immunosorbent assay. The Wilcoxon rank-sum test was used to assess the significance of mean and median differences between groups."	"RESULTS: Of the 48 patients with AIDS, circulating interleukin-1beta was detected in 2, TNF-alpha in 4, interleukin-6 in 3, and interleukin-8 in 12. None of these factors were seen in any of the 11 controls. Median values of interleukin-1beta (320 pg/mL), TNF-alpha (210 pg/mL), and interleukin-8 (750 pg/mL) were elevated in HIV-infected asymptomatic patients compared with patients with AIDS (2-, 2.6-, and 18.7-fold higher, respectively; P < 0.001). Interleukin-1Ra and TNFsRp55 levels were substantially higher than interleukin-1beta and TNF-alpha levels in HIV-infected asymptomatic patients (73- and 14-fold, respectively) and were higher than those in patients with AIDS (17.8- and 1.74-fold, respectively)."	"CONCLUSION: High circulating levels of the proinflammatory cytokines interleukin-1beta and TNF-alpha, combined with an excess of their natural inhibitors interleukin-1Ra and TNF-sRp55, were seen in clinically asymptomatic HIV-1-positive African women but not in African women with AIDS or in HIV-negative controls. Circulating cytokine antagonists may play a clinical role in modulating cytokine-associated symptoms in the early phases of HIV infection."			
1034	Wasting during pregnancy increases the risk of mother-to-child HIV-1 transmission.	"Villamor E, Saathoff E, Msamanga G, O'Brien ME, Manji K, Fawzi WW."	Journal of Acquired Immune Deficiency Syndromes: JAIDS. 2005;38(5):622-6.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=15793376	"OBJECTIVES: To examine whether wasting during pregnancy, as measured by weight loss and low weight gain, is associated with increased mother-to-child transmission (MTCT) of HIV-1."	"METHODS: This was a cohort study in Dar es Salaam, Tanzania, among 957 HIV-1-infected pregnant women. Weight was measured at the first prenatal visit and every month thereafter until delivery. Weight loss was defined as a weekly rate of weight gain </=0 and low weight gain as a weekly rate >0 and </=166 g/wk. The incidences of presumptive intrauterine transmission (HIV status at birth) and presumptive intrapartum and early breast-feeding transmission (HIV status at 6 weeks) were examined in relation to baseline anthropometric characteristics and weight change during pregnancy using 2xn tables and multivariable binomial regression."	"RESULTS: Compared with women who gained >/=167 g/wk, weight loss during pregnancy was related to higher risk of intrauterine MTCT (adjusted relative risk [RR] = 2.32, 95% CI = 1.23-4.36, P = 0.009), HIV positive at birth or fetal death (RR = 2.13, 95% CI = 1.40-3.24, P = 0.0004), and HIV positive at birth or early neonatal death (RR = 1.96, 95% CI = 1.26-3.07, P = 0.003). The rate of weight gain during the 3rd trimester was inversely related to the risk of intrapartum/early breast-feeding transmission (adjusted P value, test for trend = 0.05)."	CONCLUSIONS: Weight loss during pregnancy increases the risk of early MTCT. Identifying causes of wasting during pregnancy may provide clues for new strategies to prevent MTCT.						
951	Long-term antiretroviral treatment outcomes in seven countries in the Caribbean.	"Koenig SP, Rodriguez LA, Bartholomew C, Edwards A, Carmichael TE, Barrow G, Cabie A, et al."	"JAIDS, Journal of Acquired Immune Deficiency Syndromes. 2012;59(4):e60-e71."	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20123113910	"Objectives: To report long-term HIV treatment outcomes in 7 Caribbean countries. Design: Observational cohort study. Methods: We report outcomes for all antiretroviral therapy (ART) naive adult patients enrolled on ART from program inception until study closing for cohorts in Barbados, the Dominican Republic, Haiti, Jamaica, Martinique, Trinidad, and Puerto Rico. Incidence and predictors of mortality were analyzed by time-to-event approaches. Results: A total of 8203 patients were on ART from 1998 to 2008. Median follow-up time was 31 months (interquartile range: 14-50 months). The overall mortality was 13%: 6% in Martinique, 8% in Jamaica, 11% in Trinidad, 13% in Haiti, 15% in the Dominican Republic, 15% in Barbados, and 24% in Puerto Rico. Mortality was associated with male gender [hazard ratio (HR), 1.58; 95% confidence interval (CI): 1.33 to 1.87], body weight (HR, 0.85 per 10 pounds; 95% CI: 0.82 to 0.89), hemoglobin (HR, 0.84 per g/dL; 95% CI: 0.80 to 0.88), CD4 cell count (0.90 per 50 CD4 cells; 95% CI: 0.86 to 0.93), concurrent tuberculosis (HR, 1.58; 95% CI: 1.25 to 2.01) and age (HR, 1.19 per 10 years; 95% CI: 1.11 to 1.28). After controlling for these variables, mortality in Martinique, Jamaica, Trinidad, and Haiti was not significantly different. A total of 75% of patients remained alive and in care at the end of the study period. Conclusions: Long-term mortality rates vary widely across the Caribbean countries. Much of the difference can be explained by disease severity at ART initiation, nutritional status, and concurrent tuberculosis. Earlier ART initiation will be critical to improve the outcomes."									
1927	Very early mortality in patients starting antiretroviral treatment at primary health centres in rural Malawi.	"Zachariah R, Harries K, Moses M, Manzi M, Line A, Mwagomba B, Harries AD."	Tropical Medicine & International Health. 2009;14(7):713-21.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=19497082	"OBJECTIVES: To report on the cumulative proportion of deaths occurring within 3 months of starting antiretroviral treatment (ART) and to identify factors associated with such deaths, among adults at primary health centres in a rural district of Malawi."	"METHODS: Retrospective cohort study: from June 2006 to April 2008, deaths occurring over a 3-month period were determined and risk factors examined."	"RESULTS: A total of 2316 adults (706 men and 1610 women; median age 35 years) were included in the analysis and followed up for a total of 1588 person-years (PY); 277 (12%) people died, of whom 206 (74%) people died within 3 months of initiating ART (cumulative incidence: 13.0; 95% confidence interval: 11.3-14.8 per 100 PY of follow-up). Significant risk factors associated with early deaths included male sex, WHO stage 4 disease, oesophageal or persistent oral candidiasis and unexplained presumed or measured weight loss >10%. One in every 3 patients who either died or was lost to follow up had unexplained weight loss >10%, and survival in this group was significantly different from patients without this condition."	"CONCLUSIONS: Seven in 10 individuals initiating ART at primary health centres die early. Specific groups of patients are at higher risk of such mortality and should receive priority attention, care and support."						
94	What are the essential components of HIV treatment and care services in low and middle-income countries: An overview by settings and levels of the health system?	"Munderi P, Grosskurth H, Droti B, Ross DA."	Aids. 2012 December;26(SUPPL.2):S97-S103.		"OBJECTIVES: To review and summarize the essential components of HIV treatment and care services in low and middle-income countries (LMICs). METHODS: Literature review and reflection on programmatic experience. FINDINGS: There is increasing recognition that the essential 'package' of HIV care must include early identification of HIV-positive people in need of care, appropriate initial and continued counselling, assessment of HIV disease stage, treatment with HAART for those who need it, monitoring while on treatment for efficacy, adherence and side-effects, detection and management of other complications of HIV infection, provision of sexual and reproductive health services as well as careful record-keeping.The impressive scale-up of HIV treatment and care services has required decentralization of service provision linked to task-shifting. But the future holds even greater challenges, as the number of people in need of HIV care continues to rise at a time when many traditional donors and governments in the most-affected regions have reduced budgets. CONCLUSION: In the long-term, the increased demand for HIV-care services can only be satisfied through increased decentralisation to peripheral health units, with the role of each type of unit being appropriate to the human and material resources available to it.HIV-care services can also naturally integrate with the care of chronic noncommunicable diseases and with closely related services like mother and child health, and thus should promote a shift from vertical to integrated programming. Staff training and support around a set of evidence-based policies and guidelines and a reliable supply of essential medicines and supplies are further essential components for a successful programme. 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins."									
1652	Clinico-immunological profile and outcome of antiretroviral therapy in HIV-positive children.	"Choudhary N, Gomber S, Narang M."	Public Health Nutrition. 2012;15(8):1442-5.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=22717053	"OBJECTIVES: To study the clinico-immunological, nutritional and growth characteristics of HIV-infected children and the impact of antiretroviral therapy (ART) on these parameters."	DESIGN: Retrospective study.	"SETTING: Out-patient department of a paediatric ART centre, Delhi, India."	SUBJECTS: HIV-positive children registered at the paediatric ART centre of the hospital were enrolled (n 130). Anthropometric measurements were used to classify children into the type of malnutrition according to definitions of the WHO and US Centers for Disease Control and Prevention. Clinical and immunological status of the children was recorded as per WHO guidelines. First-line ART was started based on guidelines of the National AIDS Control Organization. Nutritional status and clinico-immunological characteristics were followed up annually in children receiving ART.	"RESULTS: Of children <=5 years of age (n 54), stunting was noted in 42.5 % contrary to wasting seen in only 12.9 %. In children >5 years of age (n 76), short stature (40.7 %) and underweight (39.4 %) were seen in almost equal proportions. Asymptomatic presentation was noted in 60.0 %. Following ART, a reduction in wasting was noted in 75.0 % of children <=5 years of age, whereas only 44.4 % of underweight children >5 years of age showed an improvement after therapy. Stunting and short stature continued to persist in all in children (<=5 years and >5 years, respectively). Clinico-immunologically, 67.5 % improved in clinical status and 62.5 % showed immunological improvement."	CONCLUSIONS: ART improves the acute parameters of nutritional status like wasting. It also improves the clinical outcome and restores the immune system. At present first-line ART is effective in HIV-positive children.				
1665	Clinico-immunological profile and outcome of antiretroviral therapy in HIV-positive children.	"Nidhi C, Sunil G, Manish N."	Public Health Nutrition. 2012;15(8):1442-5.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20123259521	"Objectives: To study the clinico-immunological, nutritional and growth characteristics of HIV-infected children and the impact of antiretroviral therapy (ART) on these parameters. Design: Retrospective study. Setting: Out-patient department of a paediatric ART centre, Delhi, India. Subjects: HIV-positive children registered at the paediatric ART centre of the hospital were enrolled (n 130). Anthropometric measurements were used to classify children into the type of malnutrition according to definitions of the WHO and US Centers for Disease Control and Prevention. Clinical and immunological status of the children was recorded as per WHO guidelines. First-line ART was started based on guidelines of the National AIDS Control Organization. Nutritional status and clinico-immunological characteristics were followed up annually in children receiving ART. Results: Of children <=5 years of age (n 54), stunting was noted in 42.5% contrary to wasting seen in only 12.9%. In children >5 years of age (n 76), short stature (40.7%) and underweight (39.4%) were seen in almost equal proportions. Asymptomatic presentation was noted in 60.0%. Following ART, a reduction in wasting was noted in 75.0% of children <=5 years of age, whereas only 44.4% of underweight children >5 years of age showed an improvement after therapy. Stunting and short stature continued to persist in all in children (<=5 years and >5 years, respectively). Clinico-immunologically, 67.5% improved in clinical status and 62.5% showed immunological improvement. Conclusions: ART improves the acute parameters of nutritional status like wasting. It also improves the clinical outcome and restores the immune system. At present first-line ART is effective in HIV-positive children."									
1945	Total lymphocyte count is a good marker for HIV-related mortality and can be used as a tool for starting HIV treatment in a resource-limited setting.	"Oudenhoven HPW, Meijerink H, Wisaksana R, Oetojo S, Indrati A, Ven AJAMvd, Asten HAGHv, et al."	Tropical Medicine and International Health. 2011;16(11):1372-9.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20113355484	"Objectives: Total lymphocyte counts (TLC) may be used as an alternative for CD4 cell counts to monitor HIV infection in resource-limited settings, where CD4 cell counts are too expensive or not available. Methods: We used prospectively collected patient data from an urban HIV clinic in Indonesia. Predictors of mortality were identified via Cox regression, and the relation between TLC and CD4 cell counts was calculated by linear regression. Receiver operating characteristics (ROC) curves were used to choose the cut-off values of TLC corresponding with CD4 cell counts <200 and <=350 cells/ micro l. Based on these analyses, we designed TLC-based treatment algorithms. Results: Of 889 antiretroviral treatment (ART)-naive subjects included, 66% had CD4 cell counts <200 and 81% had 350 <= cells/ micro l at baseline. TLC and CD4 cell count were equally strong predictors of mortality in our population, where ART was started based on CD4 cell count criteria. The correlation coefficient (R) between TLC and root CD4 was 0.70. Optimal cut-off values for TLC to identify patients with CD4 cell counts <200 and <=350 cells/ micro l were 1500 and 1700 cells/ micro l, respectively. Treatment algorithms based on a combination of TLC, gender, oral thrush, anaemia and body mass index performed better in terms of predictive value than WHO staging or TLC alone. In our cohort, such an algorithm would on average have saved $14.05 per patient. Conclusion: Total lymphocyte counts is a good marker for HIV-associated mortality. Simple algorithms including TLC can prioritize patients for HIV treatment in a resource-limited setting, until affordable CD4 cell counts will be universally available."									
586	Incidence and risk factors for tenofovir-associated renal function decline among Thai HIV-infected patients with low body weight.	"Chaisiri K, Bowonwatanuwong C, Kasettratat N, Kiertiburanakul S."	Current HIV Research. 2010;8(7):504-9.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20113026120	"Objectives: We aimed at determining the incidence and factors for tenofovir disoproxil fumarate (TDF)-associated renal function decline among Thai HIV-infected patients. Methods: Retrospective and prospective cohort studies were conducted. We enrolled HIV-infected adults who had initiated TDF. Renal function decline was defined by a decrease of 25% in glomerular filtration rate (GFR) from the baseline. Factors associated with the renal function decline were determined. Results: A total of 405 patients with a median (interquartile range, IQR) body weight of 56.5 (50.5-65.0) kg were enrolled. All but four (99%) were antiretroviral treatment-experience patients. A median (IQR) duration of receiving TDF was 16 (8-21) months. Of these, 78 (19.3%) patients had a 25% decrease in GFR with the incidence rate of 16.2 per 100 person-years. By Kaplan-Meier survival analysis, median time to a 25% decrease in GFR was 28 [95% confidence interval (CI) 25.2-30.8] months. By multiple logistic regression, lower body weight [odds ratio (OR) 1.15 per 5 kg, 95% CI 1.00-1.33], lower body mass index (BMI) (OR 2.26 per 1 kg/m<sup>2</sup>, 95% CI 1.74-2.94), baseline GFR (OR 1.62 per 10 ml/min/1.73m<sup>2</sup>, 95% CI 1.39-1.88), protease inhibitor (OR 2.12, 95% CI 1.15-3.92), and nephrotoxic drug (OR 3.16, 95% CI 1.44-6.98) were statistically significant factors associated with a 25% decrease in GFR. Conclusions: The study revealed high incidence of TDF-associated renal function decline among patients with low-body weight and BMI. Additional risk factors were baseline GFR, receiving protease inhibitor, and nephrotoxic drugs. Close monitoring of renal function is warranted among patients with these risk factors."									
259	Lean tissue mass wasting is associated with increased risk of mortality among women with pulmonary tuberculosis in urban Uganda.	"Mupere E, Malone L, Zalwango S, Chiunda A, Okwera A, Parraga I, Stein CM, et al."	Annals of Epidemiology. 2012;22(7):466-73.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=22575813	OBJECTIVES: We assessed the impact of wasting on survival in patients with tuberculosis by using a precise height-normalized lean tissue mass index (LMI) estimated by bioelectrical impedance analysis and body mass index (BMI).	"METHODS: In a retrospective cohort study, 747 adult pulmonary patients with tuberculosis who were screened for HIV and nutritional status were followed for survival."	"RESULTS: Of 747 patients, 310 had baseline wasting by BMI (kg/m(2)) and 103 by LMI (kg/m(2)). Total deaths were 105. Among men with reduced BMI, risk of death was 70% greater (hazard ratio [HR] 1.7, 95% confidence interval [95% CI] 1.03-2.81) than in men with normal BMI. Survival did not differ by LMI among men (HR 1.1; 95% CI 0.5-2.9). In women, both the BMI and LMI were associated with survival. Among women with reduced BMI, risk of death was 80% greater (HR 1.8; 95% CI 0.9-3.5) than in women with normal BMI; risk of death was 5-fold greater (HR 5.0; 95% CI 1.6-15.9) for women with low LMI compared with women with normal LMI."	CONCLUSIONS: Wasting assessed by reduced BMI is associated with an increased risk for death among both men and women whereas reduced LMI is among women with tuberculosis. Copyright 2012 Elsevier Inc. All rights reserved.						
1004	"Short- and long-term efficacy of modified directly observed antiretroviral treatment in Mombasa, Kenya: A randomized trial."	"Sarna A, Luchters S, Geibel S, Chersich MF, Munyao P, Kaai S, Mandaliya KN, et al."	Journal of Acquired Immune Deficiency Syndromes. 2008 15 Aug;48(5):611-9.		"OBJECTIVES:: To determine short- and long-term efficacy of modified directly observed therapy (m-DOT) on antiretroviral adherence. DESIGN:: Randomized controlled trial. SETTING AND ANALYTIC APPROACH:: From September 2003 to November 2004, 234 HIV-infected adults were assigned m-DOT (24 weeks of twice weekly health center visits for nurse-observed pill ingestion, adherence support, and medication collection) or standard care. Follow-up continued until week 72. Self-reported and pill-count adherence and, secondarily, viral suppression and body mass index measures are reported. Generalized estimating equations adjusted for intraclient clustering and covariates were used. RESULTS:: During weeks 1-24, 9.1% (9/99) of m-DOT participants reported missing doses compared with 19.1% (20/105) of controls (P = 0.04) and 96.5% (517/571) of m-DOT pill-count measures were >=95% compared with 86.1% (445/517) in controls [adjusted odds ratio = 4.4; 95% confidence interval (CI) = 2.6 to 7.5; P < 0.001. Adherence with m-DOT was 4.8 times greater (95% CI = 2.7 to 8.6; P < 0.001) with adjustment for depression and HIV-related hospitalization. In weeks 25-48, adherence with m-DOT (488/589) was similar to controls (507/630). Viral suppression at 48 weeks was 2.0 times (95% CI = 0.8 to 5.2; P = 0.13) as likely in m-DOT participants as controls. M-DOT patients had larger body mass index increases at 24 weeks (2.2 vs 1.4 kg/m; P = 0.014). Viral suppression was more likely at week 48 (21/25 vs 13/22; P = 0.057) and week 72 (27/30 vs 15/23; P = 0.027) among depressed participants receiving m-DOT. CONCLUSIONS:: M-DOT increased adherence, most notably among depressed participants. 2008 by Lippincott Williams & Wilkins."									
1379	"Clinical and immunological profile of HIV infected patients in Cotonou, Benin."	"Zannou DM, Kinde-Gazard D, Vigan J, Ade G, Sehonou JJ, Atadokpede F, Azondekon A, et al."	Medecine et Maladies Infectieuses. 2004;34(5):225-8.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh3&AN=20043109664	"Objectives. - This study had for aim to identify the clinical status and the level of immuno-deficiency of HIV-infected patients on their first visit. Methods. - 136 HIV+patients were prospectively evaluated from 1 November 2001 to 31 May 2002. Results. - 134 were infected with HIV-1 and two with HIV-2. The mean age on the first consultation was 37+or-2 years. The m/w sex ratio was 0.9. Stage C was observed in 46.3%. The main clinical symptoms were: weight loss (88%), fever (80%), cough (71%), diarrhoea (51%). Body mass index was normal in 70% and KI>=80% in 57% of the cases but immuno-deficiency was severe with CD4 cells count <200 per mm<sup>3</sup> in 69%. The main diseases were digestive candidosis (53%), pneumonia (18%), tuberculosis (12%), non-determined pneumonia (29%), prurigo (20%), zona (16%), cryptosporidiosis (4%), cerebral toxoplasmosis (3%), and Kaposi's sarcoma (1%)."									
1731	Nutritional health of young children in South Africa over the first 16 years of democracy.	"Iversen PO, du Plessis L, Marais D, Morseth M, Hoisaether EA, Herselman M."	SAJCH South African Journal of Child Health. 2011;5(3):72-7.		"Objectives. Malnutrition among young children is a major health problem in post-apartheid South Africa. Despite implementation of numerous health and nutrition programmes, these extensive efforts to alleviate the situation have not been adequately reviewed. Methods. We provide an overview of various aspects of the current nutritional health status of young children. The reviewed data are from the time period 1994 - 2010, and were collected from literature databases and official reports, as well as our own experience with field research in various urban and rural parts of the country. Results. Both smaller province-based studies as well as three large nationwide surveys conclude that many young South African children have inadequate nutritional status. Rates of stunting, micronutrient deficiencies and hunger and food insecurity are all unacceptably high. Coexisting HIV/AIDS and tuberculosis add to this burden. A gradual transition to a westernized diet characterized by energy-dense food has led to a worrying increase in overweight and obesity. Conclusion. A major challenge for the South African health authorities is still the fight against childhood under nutrition and hunger, which in turn are rooted in poverty and social inequalities. The double burden of disease adds to the scale and complexity of this challenge."									
1733	"Indications, medical conditions and services related to gastrostomy placement in infants and children at a tertiary hospital in South Africa."	"Norman V, Singh SA, Hittler T, Jones N, Kenny N, Mann R, McFarlane S, et al."	SAJCH South African Journal of Child Health. 2011;5(3):86-9.		"Objectives. To describe South African infants and children requiring gastrostomies in a tertiary hospital, including the indications, medical conditions and health services, during a 5-year period (2005 - 2009). Design. The research design was a retrospective descriptive survey of medical records. Setting. A tertiary paediatric state hospital in South Africa. Subjects. One hundred and forty-two patients between the ages of 0 and 17 years. Results. Dysphagia (N=80, 56%), aspiration (N=70, 49%) and need for nutritional support (N=63, 44%) were the most common indicators for gastrostomy placement. Most participants (N=85, 75% of the subset of 114 with feeding and swallowing difficulties) presented with multiple medical conditions, and neurological impairment (N=94, 82%) and gastro-intestinal problems (N=96, 84%) were the most prominent. Services were required from a variety of health care professionals for a period ranging from 6 to 103 months (mean 18 months). The speech-language therapist was consulted most frequently before gastrostomy placement (85%), while the stoma sister (97%) and dietician (97%) were consulted after placement. Conclusions. South African infants and children requiring gastrostomies frequently present with multiple medical conditions and dysphagia. These children are likely to benefit from extended services provided by a specialised team of health care professionals."									
1746	Estimating the burden of disease attributable to childhood and maternal undernutrition in South Africa in 2000. (Special issue: South African comparative risk assessment.).	"Nannan N, Norman R, Hendricks M, Dhansay MA, Bradshaw D."	SAMJ South African Medical Journal. 2007;97(8(2):733-9.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20073199773	"Objectives. To estimate the disease burden attributable to being underweight as an indicator of undernutrition in children under 5 years of age and in pregnant women for the year 2000. Design. World Health Organization comparative risk assessment (CRA) methodology was followed. The 1999 National Food Consumption Survey prevalence of underweight classified in three low weight-for-age categories was compared with standard growth charts to estimate population-attributable fractions for mortality and morbidity outcomes, based on increased risk for each category and applied to revised burden of disease estimates for South Africa in 2000. Maternal underweight, leading to an increased risk of intra-uterine growth retardation and further risk of low birth weight (LBW), was also assessed using the approach adopted by the global assessment. Monte Carlo simulation-modelling techniques were used for the uncertainty analysis. Setting. South Africa. Subjects. Children under 5 years of age and pregnant women. Outcome measures. Mortality and disability-adjusted life years (DALYs) from protein-energy malnutrition and a fraction of those from diarrhoeal disease, pneumonia, malaria, other non-HIV/AIDS infectious and parasitic conditions in children aged 0-4 years, and LBW. Results. Among children under 5 years, 11.8% were underweight. In the same age group, 11 808 deaths (95% uncertainty interval 11 100-12 642) or 12.3% (95% uncertainty interval 11.5-13.1%) were attributable to being underweight. Protein-energy malnutrition contributed 44.7% and diarrhoeal disease 29.6% of the total attributable burden. Childhood and maternal underweight accounted for 2.7% (95% uncertainty interval 2.6-2.9%) of all DALYs in South Africa in 2000 and 10.8% (95% uncertainty interval 10.2-11.5%) of DALYs in children under 5. Conclusions. The study shows that reduction of the occurrence of underweight would have a substantial impact on child mortality, and also highlights the need to monitor this important indicator of child health."									
1820	Estimating the burden of disease attributable to childhood and maternal undernutrition in South Africa in 2000.	"Nannan N, Norman R, Hendricks M, Dhansay MA, Bradshaw D."	South African Medical Journal. 2007 August;97(8):733-9.		"Objectives. To estimate the disease burden attributable to being underweight as an indicator of undernutrition in children under 5 years of age and in pregnant women for the year 2000. Design. World Health Organization comparative risk assessment (CRA) methodology was followed. The 1999 National Food Consumption Survey prevalence of underweight classified in three low weight-for-age categories was compared with standard growth charts to estimate population-attributable fractions for mortality and morbidity outcomes, based on increased risk for each category and applied to revised burden of disease estimates for South Africa in 2000. Maternal underweight, leading to an increased risk of intra-uterine growth retardation and further risk of low birth weight (LBW), was also assessed using the approach adopted by the global assessment. Monte Carlo simulation-modelling techniques were used for the uncertainty analysis. Setting. South Africa. Subjects. Children under 5 years of age and pregnant women. Outcome measures. Mortality and disability-adjusted life years (DALYs) from protein- energy malnutrition and a fraction of those from diarrhoeal disease, pneumonia, malaria, other non-HIV/AIDS infectious and parasitic conditions in children aged 0 - 4 years, and LBW. Results. Among children under 5 years, 11.8% were underweight. In the same age group, 11 808 deaths (95% uncertainty interval 11 100 - 12 642) or 12.3% (95% uncertainty interval 11.5 - 13.1%) were attributable to being underweight. Protein-energy malnutrition contributed 44.7% and diarrhoeal disease 29.6% of the total attributable burden. Childhood and maternal underweight accounted for 2.7% (95% uncertainty interval 2.6 - 2.9%) of all DALYs in South Africa in 2000 and 10.8% (95% uncertainty interval 10.2 - 11.5%) of DALYs in children under 5. Conclusions. The study shows that reduction of the occurrence of underweight would have a substantial impact on child mortality, and also highlights the need to monitor this important indicator of child health."									
1101	Vitamin A supplementation and human immunodeficiency virus type 1 shedding in women: results of a randomized clinical trial.	"Baeten JM, McClelland RS, Overbaugh J, Richardson BA, Emery S, Lavreys L, Mandaliya K, et al."	Journal of Infectious Diseases. 2002;185(8):1187-91.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=11930332	"Observational studies have associated vitamin A deficiency with vaginal shedding of human immunodeficiency virus (HIV) type 1-infected cells and mother-to-child HIV-1 transmission. To assess the effect of vitamin A supplementation on vaginal shedding of HIV-1, a randomized, double-blind, placebo-controlled trial of 6 weeks of daily oral vitamin A (10,000 IU of retinyl palmitate) was conducted among 400 HIV-1-infected women in Mombasa, Kenya. At follow-up, there was no statistically significant difference in the prevalence of HIV-1 DNA (18% vs. 21%, P=.4) or the quantity of HIV-1 RNA (3.12 vs. 3.00 log(10) copies/swab, P=1.0) in vaginal secretions of women receiving vitamin A, compared with women receiving placebo. No significant effect of supplementation on plasma HIV-1 load or CD4 or CD8 cell counts was observed, and no effect was seen among women who were vitamin A deficient at baseline. Vitamin A supplementation is unlikely to decrease the infectivity of women infected with HIV-1."									
903	Relationship between markers of HIV-1 disease progression and serum beta-carotene concentrations in Kenyan women.	"Baeten JM, McClelland RS, Wener MH, Bankson DD, Lavreys L, Mandaliya K, Bwayo JJ, et al."	International Journal of STD and AIDS. 2007 March;18(3):202-6.		"Observational studies have suggested that low serum beta-carotene concentrations may influence HIV-1 disease progression. However, randomized trials have not demonstrated beneficial effects of beta-carotene supplementation. To understand this discrepancy, we conducted a cross-sectional study among 400 HIV-1-seropositive women in Mombasa, Kenya, to correlate serum beta-carotene concentrations with several measures of HIV-1 disease severity. beta-Carotene concentrations were significantly associated with biologic markers of HIV-1 disease progression (CD4 count, HIV-1 plasma viral load, serum C-reactive protein [CRP] concentration, and serum albumin level). In multivariate analysis, beta-carotene concentrations below the median were associated with elevated CRP (>10 mg/l, adjusted odds ratio [aOR] 3.32, 95% confidence interval [CI] 1.99-5.53, P < 0.001) and higher HIV-1 plasma viral load (for each log<sub>10</sub> copies/mL increase, aOR 1.38, 95% CI 1.01-1.88, P = 0.04). In the context of negative findings from randomized trials of beta-carotene supplementation in HIV-1-seropositive individuals, these results suggest that low beta-carotene concentrations primarily reflect more active HIV-1 infection rather than a deficiency amenable to intervention."									
819	Study on the nutritional status of HIV/AIDS patients.	"Priyadharsini VP, Kumari HN."	Indian Journal of Nutrition and Dietetics. 2009;46(11):440-6.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20103039697	"Of the selected 202 HIV-positive cases from Manipur State and Coimbatore City, Tamil Nadu State, India, 114 were men and 88 were women. The incidence of HIV infection was high among the married subjects. Except for protein, a significant difference for the rest of nutrients between the recommended dietary allowance (RDA) and actual mean nutrient intake was observed at 1% level of significance for male drug users. Except for protein and thiamine, a significant difference in the nutrient intake between the RDA and the actual nutrient intake was observed among female non-drug users at 1% level of significance. The results also revealed that although the nutrient requirements of HIV patients is very high, the drug users and non-drug users, irrespective of gender, met only the RDA for a sedentary worker, inferring poor nutrient intake in general."									
1069	Prevalence of HIV infection and AIDS symptomatology in malnourished children--a hospital based study.	"Angami K, Reddy SV, Singh Kh I, Singh NB, Singh PI."	Journal of Communicable Diseases. 2004;36(1):45-52.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=16295686	"One hundred and seventy five malnourished children aged between 1(1/2) and 12 years attending pediatric department of Regional Institute of Medical Sciences Hospital, Imphal from January 2001 to June 2002 were screened for human immunodeficiency virus (HIV) infection along with their biological mothers after pretest counselling and informed consent. The prevalence rate of HIV seropositivity among malnourished children was 21.7%. Children aged between 1(1/2) and 3 years had the highest seroprevalence (47.4%) and male to female ratio was 1.5: 1. Underweight children showed the highest seroprevalence (47.4%) and children with kwashiorkor showed least seroprevalence (10.5%). Mode of HIV transmission was vertical in 94.7%. The causative agent was HIV-I in all the cases. AIDS defining children features were seen more frequently among HIV seropositive malnourished children as compared to the seronegative children. Prolonged fever (p 0.001), oropharyngeal candidiasis (p<0.001), generalised lymphadenopathy (p<0.001) and disseminated maculopapular dermatitis (p<0.001) were significantly related to HIV infection. Among seronegative children 18.2% fulfilled the clinical criteria for AIDS and among seropositive children 94.7% had AIDS. The total mortality encountered among seropositive children was 34.2%. It is suggested to confirm findings based on larger community based data before recommending mandatory HIV testing in all malnourished children. Specific guidelines on the nutritional management of children with HIV/AIDS is needed in Manipur where HIV is spreading rapidly."									
1070	Prevalence of HIV infection and AIDS symptomatology in malnourished children - A hospital based study.	"Angami K, Sudha Reddy VR, Singh Kh I, Singh Ng B, Singh PI."	Journal of Communicable Diseases. 2004 March;36(1):45-52.		"One hundred and seventy five malnourished children aged between 11/2 and 12 years attending pediatric department of Regional Institute of Medical Sciences Hospital, Imphal from January 2001 to June 2002 were screened for human immunodeficiency virus (HIV) infection along with their biological mothers after pretest counselling and informed consent. The prevalence rate of HIV seropositivity among malnourished children was 21.7%. Children aged between 1<sub>1/2</sub> and 3 years had the highest seroprevalence (47.4%) and male to female ratio was 1.5: 1. Underweight children showed the highest seroprevalence (47.4%) and children with kwashiorkor showed least seroprevalence (10.5%). Mode of HIV transmission was vertical in 94.7%. The causative agent was HIV-I in all the cases. AIDS defining children features were seen more frequently among HIV seropositive malnourished children as compared to the seronegative children. Prolonged fever (p 0.001), oropharyngeal candidiasis (p<0.001), generalised lymphadenopathy (p<0.001) and disseminated maculopapular dermatitis (p<0.001) were significantly related to HIV infection. Among seronegative children 18.2% fulfilled the clinical criteria for AIDS and among seropositive children 94.7% had AIDS. The total mortality encountered among seropositive children was 34.2%. It is suggested to confirm findings based on larger community based data before recommending mandatory HIV testing in all malnourished children. Specific guidelines on the nutritional management of children with HIV/AIDS is needed in Manipur where HIV is spreading rapidly."									
1917	Health and nutritional status of orphans <6 years old cared for by relatives in western Kenya.	"Lindblade KA, Odhiambo F, Rosen DH, DeCock KM."	Tropical Medicine & International Health. 2003;8(1):67-72.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=12535253	"One of the consequences of the HIV/AIDS epidemic in sub-Saharan Africa is the increase in the number of orphans, estimated to have reached 6-11% of children <15 years old in 2000. Orphans who stay in their communities may be at increased risk for poor health due to reduced circumstances and loss of parental care. We have used data from a population-based study in rural western Kenya to compare basic health and nutritional indicators between non-orphaned children <6 years old and children who lost either or both of their parents. In June 2000, all children <6 years old who had been recruited for a cross-sectional survey in 60 villages of Rarieda Division, western Kenya, in June 1999 were invited to return for a follow-up survey. Basic demographic characteristics, including the vital status of the child's parents, and health histories were requested from all 1190 participants of the follow-up survey, along with a finger-prick blood sample for determination of malaria parasite status and haemoglobin (Hb) levels. Height-for-age (H/A) and weight-for-height (W/H) Z-scores were also calculated from anthropometric measurements. Overall, 7.9% of the children had lost one or both their parents (6.4% had lost their father, 0.8% had lost their mother and 0.7% had lost both parents). While there was no difference between orphans and non-orphans regarding most of the key health indicators (prevalence of fever and malaria parasitaemia, history of illness, Hb levels, H/A Z scores), W/H Z-scores in orphans were almost 0.3 standard deviations lower than those of non-orphans. This association was more pronounced among paternal orphans and those who had lost a parent more than 1 year ago. These results suggest that the health status of surviving orphans living in their community is similar to that of the non-orphan population, but longitudinal cohort studies should be conducted to determine better the overall impact of orphanhood on child health."									
593	"The double burden: The role of diabetes for tuberculosis risk, manifestations, treatment outcomes and survival."	Faurholt-Jepsen D.	Danish Medical Journal. 2013 July;60(7):18.		"One third of the world's population is latently infected with Mycobacterium tuberculosis, and with the lifestyle changes succeeding the on-going urbanization, populations already burdened by tuberculosis are experiencing a dramatic increase in chronic diseases, with diabetes being a serious challenge. Tuberculosis and diabetes are not only becoming co-existing diseases. In fact, the diseases interact, and there is evidence to suggest that especially diabetes disease increases the susceptibility for developing active tuberculosis disease. Furthermore, it is plausible that tuberculosis leads to, either transient or permanent, impairment of the glucose metabolism, which ultimately will turn into diabetes. A number of studies from the Americas, Europe, Asia, and, most lately, from sub-Saharan Africa have reported strong association between tuberculosis and diabetes; on average, the estimated risk of active tuberculosis is thrice as high among people with diabetes. The study from sub-Saharan Africa was conducted in Tanzania and is the basis of this thesis. Based on available evidence on the association between tuberculosis and diabetes, the primary aim of the study was to assess the role of diabetes for tuberculosis risk, manifestations, treatment outcomes and survival in a Tanzanian population of tuberculosis patients and non-tuberculosis neighbourhood controls. The study was conducted in Mwanza City in northern Tanzania, with a population exceeding half a million inhabitants, with tuberculosis and HIV being common infections in the region, but with little knowledge about the prevalence of diabetes. We recruited newly diagnosed pulmonary tuberculosis patients from spring 2006 and continuously till the fall 2009, with all participating in a nutritional intervention running in parallel with the medical tuberculosis treatment. All participants underwent diabetes and HIV testing as well as a series of measurements such as anthropometric, clinical and paraclinical parameters. The population was followed up during treatment (2 and 5 months) to assess treatment outcome as well as after one year to assess their survival status. Based on data from 1250 tuberculosis patients and 350 neighbourhood controls, we found that 38 and 21%, respectively, had impaired glycaemia, and that the prevalence of diabetes was 17 and 9% among tuberculosis patients and controls, respectively. This difference in prevalence between patients and controls was equivalent to an adjusted odds ratio of more than four, indicating a strong association between tuberculosis and diabetes. Furthermore, we found that diabetes was associated with tuberculosis among both participants with or without HIV co-infection. Despite the strong association, diabetes had only moderate clinical implications when the tuberculosis patients initiated the tuberculosis treatment; the patients with diabetes co-morbidity had a minor elevation in the immune response and more frequently reported to have fever. Furthermore, diabetes did not seem to delay time to sputum conversion during treatment. Nevertheless, diabetes co-morbidity led to impaired treatment outcome with slower recovery of weight and haemoglobin and a more than four times higher mortality rate within the initial phase of tuberculosis treatment. In conclusion, in the African region, the double burden of tuberculosis and diabetes is becoming a major health problem. Although the tuberculosis incidence has stabilized during the last decade, the increasing incidence of diabetes will possibly interfere with tuberculosis control and may, consequently, make the tuberculosis incidence increase again. Future research strategies should focus on enhanced diagnostic tools to identify tuberculosis patients with diabetes co-morbidity, and on the role of disease-disease, drug-disease and drug-drug interactions between tuberculosis and diabetes diseases and treatments."									
823	Opportunistic infections in pediatric HIV disease.	"Agarwal R, Tullu MS, Bavdekar SB."	Indian Journal of Practical Pediatrics. 2003 October/December;5(4):314-24.		"Opportunistic infections (OI) are the hallmark of the immunodeficiency associated with HIV infection in children. As HIV infection affects the cellular as well as the humoral arms of the immune system all types of organisms, viruses, bacteria, fungi, protozoa and mycobacteria, are responsible for OI. The pattern of OI in children differs from that in adults. The type of OI encountered in children is dependent upon the patient's age as well as on the degree of immunosuppression. Opportunistic infections should be managed with vigor. Efforts should be made to identify the causative organism, so that early treatment can be instituted. Prophylactic regimens, both primary and secondary, are available for most OI. They have decreased the morbidity and mortality associated with HIV infection and have improved the quality of life of HIV infected children. Prophylaxis does not mean prescribing medications alone. The pediatrician has a much wider role in prevention of OI that includes giving counseling regarding hygienic practices, offering appropriate vaccinations and giving advice regarding maintenance of nutrition and avoiding infections. Effective anti-retroviral therapy (ART) helps arrest to immune function deterioration and may even lead to improvement in immune function; thereby decreasing the incidence and severity of OI. The diagnosis, prophylaxis and treatment of OI are an integral component of comprehensive HIV care. Given the wide spectrum of health services available in the developing countries, including India, there is a need to evolve standard protocols for management of OI taking into consideration the facilities available at different grades of healthcare system."									
1147	"Food insecurity among volunteer AIDS caregivers in Addis Ababa, Ethiopia was highly prevalent but buffered from the 2008 food crisis."	"Maes KC, Hadley C, Tesfaye F, Shifferaw S, Tesfaye YA."	Journal of Nutrition. 2009;139(9):1758-64.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=19640968	"Our objective in this study was to assess the validity and dependability of the Household Food Insecurity Access Scale (HFIAS), which was developed for international use, among community health volunteers in Addis Ababa, Ethiopia. The HFIAS was translated into Amharic and subsequently tested for content and face validity. This was followed by a quantitative validation study based on a representative sample (n = 99) of female community volunteers (HIV/AIDS home-based caregivers), with whom the HFIAS was administered at 3 time points over the course of 2008, in the context of the local and global ""food crisis."" By pooling observations across data collection rounds and accounting for intra-individual correlation in repeated measures, we found that the HFIAS performed well according to standards in the field. We also observed slight amelioration in reported food insecurity (FI) status over time, which seems paradoxical given the increasing inaccessibility of food over the same time period due to inflating prices and disappearing food aid. We attempted to resolve this paradox by appealing to self-report-related phenomena that arise in the context of longitudinal study designs: 1) observation bias, in which respondents change their reports according to changing expectations of the observer-respondent relationship or change their behavior in ways that ameliorate FI after baseline self-reports; and 2) ""response shift,"" in which respondents change their reports according to reassessment of internal standards of FI. Our results are important for the validation of FI tools and for the sustainability of community health programs reliant on volunteerism in sub-Saharan Africa."									
1301	Health of Indigenous people in Africa.	"Ohenjo N, Willis R, Jackson D, Nettleton C, Good K, Mugarura B."	Lancet. 2006 10 Jun;367(9526):1937-46.		"Our paper is part of a series focusing on Indigenous peoples' health in different world regions. Indigenous peoples worldwide are subject to marginalisation and discrimination, systematically experiencing poorer health than do majority groups. In Africa, poor health in the general population is widely recognised, but the consistently lower health position and social status of Indigenous peoples are rarely noted. Disputed conceptual understandings of indigeneity, a history of discriminatory colonial and post-colonial policies, and non-recognition of Indigenous groups by some governments complicate the situation. We discuss two case studies, of the central African Pygmy peoples and the San of southern Africa, to illustrate recurring issues in Indigenous health in the continent. We make recommendations for the recognition of Indigenous peoples in Africa and improvements needed in the collection of health data and the provision of services. Finally, we argue that wider changes are needed to address the social determinants of Indigenous peoples' health. 2006 Elsevier Ltd. All rights reserved."									
322	Pulmonary manifestations in HIV seropositivity and malnutrition in Zimbabwe.	"Ikeogu MO, Wolf B, Mathe S."	Archives of Disease in Childhood. 1997;76(2):124-8.	http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=2009792670&site=ehost-live	"Over a 10 month period 184 children, aged 5 years or less, who died at home had their nutritional status and HIV serostatus established; necropsies were also carried out. The HIV antibody test was positive in 122/184 (66%). Of the HIV seropositive children Pneumocystis carinii pneumonia was present in 19 (16%), cytomegalovirus pneumonia in nine (7%), and lymphoid interstitial pneumonitis in 11 (9%). Opportunistic infection was therefore seen in 28/122 (23%) of the seropositive cases but in none of the seronegative cases. Tuberculosis was present in 8/184 (4%): 6/122 (5%) in HIV seropositive and 2/62 (3%) in seronegative children. Lung aspirate showed positive bacterial isolates in 106/ 122 (86%) of HIV seropositive and 46/62 (74%) of seronegative children with Gram negative organisms predominating in both groups. Malnutrition was common and affected 106/184 (58%); positive growth was obtained in 98 (92%) of the malnourished children irrespective of their HIV serostatus. Malnutrition was significantly associated with bacterial lung infection after adjustment for the confounding effect of HIV status. No association was found between HIV serostatus and bacterial lung infection that could not be attributed to malnutrition at the time of death. The importance of adequate nutrition in reducing the risk of bacterial infection in HIV infected children is apparent."									
328	Transmission of tuberculosis to contacts of sputum positive adults in Malawi.	"Topley JM, Maher D, Mbewe LN."	Archives of Disease in Childhood. 1996;74(2):140-3.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=8660077	"Over a period of one year from June 1993 to May 1994, 282 children under 6 years old who were household contacts of sputum positive adults with tuberculosis were evaluated in a screening clinic. Of these, 180 (63.8%) had evidence of tuberculosis, a much higher transmission rate than reported elsewhere. HIV seropositivity was 77.4% in the adult index cases and 18% in the contact children. No increased infectivity to household contacts was detected in HIV seropositive index adults compared with those who were seronegative. Child tuberculosis contact tracing is essential in these families, where transmission of disease is higher than reported elsewhere, and attention to the health needs of the children may be diminished by the high morbidity and mortality among adult family members."									
1773	Structural Renal Changes in Obesity and Diabetes.	"Amann K, Benz K."	Seminars in Nephrology. 2013 January;33(1):23-33.		"Overweight, obesity, and associated diseases represent an emerging problem, not only in Western countries but also in the developing world. They are now characterized as epidemic diseases. Obesity is particularly serious because its incidence in children and adolescents increased dramatically: it is estimated that in the United States every eighth adolescent suffers from obesity, which in the long run may reduce life expectancy in the population. Apart from cardiovascular disease (ie, blood pressure, stroke, and coronary heart disease), kidney diseases also have been shown to be associated with obesity. Epidemiologic studies have indicated that obesity can be a risk factor of chronic kidney disease irrespective of the presence or absence of diabetes, arterial hypertension, and other comorbidities. More evidence is accumulated on the link between chronic kidney disease in obesity and abnormalities in adipokine secretion (hyperleptinemia, lack of adiponectin), activation of the renin-angiotensin system, chronic inflammation, endothelial dysfunction, lipid accumulation, impaired renal hemodynamics, and diminished nephron number related to body mass. In general, obesity is known to aggravate the course of many primary renal diseases such as glomerulonephritides, but also impairs renal function after kidney transplantation. Microalbuminuria, proteinuria, hyperfiltration, and impaired renal function are associated with obesity. Histologically, secondary focal segmental sclerosis has been shown to be caused particularly by obesity. Of practical purpose for clinical nephrology, loss of body weight either by lifestyle modification or bariatric surgery improves albuminuria and hyperfiltration in obese patients, making renal disease in obesity accessible for prevention programs. This review specifically addresses the pathogenesis and morphology of renal functional and particularly structural changes in obesity and associated renal disease such as diabetic nephropathy. 2013 ."									
953	"A randomized, clinical trial to evaluate the impact of regular physical activity on the quality of life, body morphology and metabolic parameters of patients with AIDS in Salvador, Brazil. (AIDS research in Brazil.)."	"Ogalha C, Luz E, Sampaio E, Souza R, Zarife A, Gomes Neto M, Netto E, et al."	"JAIDS, Journal of Acquired Immune Deficiency Syndromes. 2011;57(Suppl. 3):S179-S85."	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20113239132	"Patients with AIDS under antiretroviral therapy often present with metabolic problems associated with HIV infection and its therapy, which can affect their quality of life. The knowledge on the potential benefits of regular physical exercises for HIV-infected patients is limited. Objective: We conducted a clinical trial to evaluate the impact of regular physical activity on quality of life, anatomic disturbances, and/or metabolic changes in patients with AIDS in the city of Salvador, Brazil. Methods: Patients were randomly assigned in monthly workshops (1-hour duration) to discuss the importance of physical activity and receive nutritional counseling (control group) or to receive a 1-hour supervised gym class three times a week plus monthly nutritional counseling (intervention group). Before and after intervention, body composition, maximum oxygen consumption, metabolic equivalent, blood count, fasting total cholesterol, high-density lipoprotein, triglycerides, glucose, HIV viral load and CD4/CD8 counts, and resting heart rate were measured. Quality of life was evaluated at baseline and after 24 weeks. Results: The domains of quality of life, general health, vitality and mental health increased in the exercise group (P<0.05) compared with the control group. In the exercise group, fat mass (P=0.04), the resting heart rate (P=0.001), waist circumference (P=0.002), and glucose (P=0.003) decreased. Muscle mass (P=0.002), CD4 <sup>+</sup> T cells (P=0.002), metabolic equivalent (P=0.014), and maximum oxygen consumption (P=0.05) increased. Conclusion: The practice of regular exercise, coupled with nutritional guidance, in individuals with HIV/AIDS significantly improves the quality of life."									
1520	Differences in nutrition manners among short-statured and tall-statured girls and boys from Swietokrzyskie Voivodeship. [Polish]	Zroznicowanie sposobu zywienia niskoroslych i wysokoroslych dziewczat i chlopcow z wojewodztwa swietokrzyskiego.	Suliga E.		"Pediatric endocrinology, diabetes, and metabolism. 2009;15(3):183-7."									
1386	[Prevalence of HIV infection in patients with pellagra and pellagra-like erythemas].	"Pitche P, Kombate K, Tchangai-Walla K."	Medecine Tropicale. 1999;59(4):365-7.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=10816749	"Pellagra is a systemic disorder caused by severe niacin deficiency. While uncommon in Europe and North America, pellagra and pellagra-like erythema are frequently encountered in undernourished adults in poor African countries. The purpose of this three-year prospective study was to determine the prevalence of HIV infection in patients with pellagra. Between 1996 and 1998, all documented cases of pellagra and pellagra-like erythema diagnosed in the Dermatology Department and Internal Medicine Department of the Teaching Hospital in Lome, Togo were included. Patients underwent screening tests for HIV infection. During the study period, pellagra or pellagra-like erythema was diagnosed in a total of 108 patients (59 women and 49 men) with a mean age of 41 +/- 3.5 years (range, 18 to 68 years). Serology tests for HIV were positive in 6 of these patients (5.5 p. 100; mean age 35 years). In four asymptomatic patients with no opportunistic infection, detection of HIV was an incidental discovery. The other two patients had AIDS symptoms. The principal causes of pellagra were malnutrition (n = 30), alcoholism (n = 15), and combined malnutrition and alcoholism (n = 60). The findings of this study suggest that the incidence of HIV infection in patients with pellagra and pellagra-like erythema is low, i.e., not higher than in the general population. This study also confirms previous etiologic and epidemiological data concerning pellagra in poor countries, i.e., the preponderant role of nutritional deficiency."									
1556	"Bombax ceiba Linn.: pharmacognosy, ethnobotany and phyto-pharmacology."	"Chaudhary PH, Khadabadi SS."	Pharmacognosy Communications. 2012;2(3):2-9.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20123412760	"Plants have been an important source of medicines since the beginning of cultivation. There is a growing demand for plant-based medicines, health products, pharmaceuticals, food supplements, cosmetics etc. Bombax ceiba Linn. (Bombacaceae) is a tall tree buttressed at the base that is widely distributed throughout India, Ceylon and Malaya, upto 1500 m of altitude. Many parts of the plant (root, stem bark, gum, leaf, prickles, flower, fruit, seed and heartwood) are used by various tribal communities and forest dwellers for the treatment of a variety of ailments. The plant literature survey shows the plant possesses astringent, cooling, stimulant, diuretic, aphrodisiac, demulcent, and tonic effects and also helps in dysentery. It also possesses important pharmacological activity such as aphrodisiac, anti-inflammatory and hepatoprotective activity in addition to anticancer and anti-HIV activity, anti-Helicobacter pylori, antiangiogenic, analgesic and antioxidant activity and hypotensive, hypoglycemic and antimicrobial activity. It is reported to contain important phytoconstituents such as naphthol, naphthoquinones, polysaccharides, anthocyanins, shamimin and lupeol."									
1761	Evaluation of plasma retinol-binding protein as a surrogate measure for plasma retinol concentrations.	"Almekinder J, Manda W, Soko D, Lan Y, Hoover DR, Semba RD."	Scandinavian Journal of Clinical & Laboratory Investigation. 2000;60(3):199-203.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=10885491	"Plasma retinol-binding protein (RBP) concentrations have been suggested as surrogate indicators for plasma retinol concentrations in the assessment of vitamin A status in less technologically developed settings. Plasma RBP was measured by radial immunodiffusion and plasma retinol by high performance liquid chromatography in a cross-sectional study of 900 pregnant women at the Queen Elizabeth Central Hospital, Blantyre, Malawi. The Spearman correlation coefficient between plasma RBP and retinol concentrations was 0.95 (p<0.0001). By linear regression, 0.70 micromol l(-1) retinol was equivalent to 21.1 mg l(-1) RBP. With these cut-off points for defining vitamin A deficiency, there was high concordance between categorical descriptions of deficiency using retinol and RBP by chi-square analysis (p<0.001). Measurement of plasma RBP by radial immunodiffusion is simple, inexpensive, and does not require expensive instrumentation. Plasma RBP concentrations measured by radial immunodiffusion are highly correlated with plasma retinol and can be used as a simple surrogate measure for vitamin A concentrations in large field studies."									
1521	Progress on developing a global action plan for pneumonia prevention and control.	"Qazi S, Weber M, Cherian T."	Pediatric Health. 2008;2(5):571-81.		"Pneumonia remains the biggest killer of children, particularly in the least developed countries with the highest child mortality, accounting for over 2 million deaths in those under 5 years of age annually. This is a greater number than deaths due to HIV, tuberculosis and malaria together in this age group. Control of pneumonia mortality is key to achieving the fourth millennium development goal. Even though effective interventions for reducing pneumonia mortality exist, they have not been systematically implemented in most developing countries. The Global Action Plan for Pneumonia prevention and control aims to advocate for a concerted action to control pneumonia mortality through the scaling up of known effective interventions, and proposes a set of strategies to achieve this. 2008 Future Medicine Ltd."									
1088	Food insecurity and nutritional barriers to antiretroviral therapy: lessons from Latin America and the Caribbean.	"Martin A, Palar K, Derose KP, Adams J."	Journal of HIV/AIDS & Social Services. 2011;10(2):194-214.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20113250581	"Poor nutrition and food insecurity are emerging as important barriers to antiretroviral therapy access and adherence in low-resource settings, yet little is known about these barriers in Latin America and Caribbean. This qualitative study used community expert interviews to explore the links between food insecurity, undernutrition, and HIV/AIDS treatment in the region. Results indicate that food insecurity and undernutrition are closely linked to quality of life, health status, and access and adherence to antiretroviral therapy in the region. Social services, such as food assistance and nutrition counseling, and access to social protection networks are needed for people with HIV infection who are economically vulnerable so that the full advantages of antiretroviral therapy can be realized."									
1861	Empowered Women and the Need to Empower Men: Gender Relations and Food Security in Black South African Households.	Lemke S.	Studies of Tribes and Tribals. 2003 Jul 2003;1(1):59-67.	http://search.proquest.com/docview/60470594?accountid=26724	"Poverty, food insecurity, & the high incidence of HIV/AIDS are among the most pressing issues in South Africa. Many families are disrupted, due to continuous migration, poverty, & increasing societal violence, leading to the re-organization of households & changing intra-household relationships. The article investigates gender & power relations within households & their effect on the food & nutrition situation. It is shown that certain female-headed households & also households based on partnership relationships, despite more limited resources, often achieve a better or an equal situation than households headed by men. Women increasingly prefer to be independent from men, whom they often consider an economic liability. Households headed by women have several ways of closing the gap between their income levels & that of more privileged household categories, such as social networks of kin & neighbors, using credit at local shops, & engaging in occasional jobs. It is concluded that families, whatever their state, continue to make use of their kinship links, which is also one of the most important coping strategies for survival. With regard to development, it is suggested that men need to be empowered & reaffirmed as men, to give them the means to change wrong perceptions of their role as men in the household. 4 Tables, 33 References. Adapted from the source document."									
1977	Community approaches to women's health: delivering preconception care in a Community Health Center model.	"Wilensky S, Proser M."	Womens Health Issues. 2008;18(6 Suppl):S52-60.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=18948019	"Preconception care has been recognized as an important set of interventions necessary to improve pregnancy outcomes and the overall health of women of childbearing age. Traditionally underserved populations such as the low income, uninsured, racial and ethnic minorities, homeless, and migrant farmworkers have less access to a usual source of primary care and therefore are more at risk for adverse health outcomes. The national network of Community Health Centers was created to break down compounding barriers to care that leads to poor health. Health centers are a vital source of care for low-income women. Almost 60% of health center patients are women, about half of whom are women of childbearing age. In addition, health centers provide care for > 17% of low-income births in the United States. Most health centers offer their patients preconception services, such as HIV/AIDS screening and treatment, weight management, nutrition counseling, and smoking cessation programs, in addition to comprehensive primary care services. Three quarters of health centers provide mental health services and half provide substance abuse treatment services onsite; the rest provide these services in partnership with other providers. Health centers also participate in a number of community-based programs focused on improving women's health and providing preconception care services. As policymakers and public health planners consider options for enhancing the utilization of preconception care, they must also consider options for expanding access to health centers nationwide."									
361	"Serum zinc, copper, selenium, calcium, and magnesium levels in pregnant and non-pregnant women in Gondar, Northwest Ethiopia."	"Kassu A, Yabutani T, Mulu A, Tessema B, Ota F."	Biological Trace Element Research. 2008 May;122(2):97-106.		"Pregnant women in developing countries are vulnerable to multiple micronutrient deficiencies. Studies assessing serum levels of the micronutrients and magnitude of their deficiencies are very scarce in African subjects. This study was aimed at determining serum levels of micronutrients in 375 pregnant (42 HIV seropositive) and 76 non-pregnant women (20 HIV seropositive) who visited the University of Gondar Hospital, Gondar, Ethiopia. Serum concentrations of zinc,\ copper, selenium, calcium, and magnesium were determined using an inductively coupled plasma mass spectrometer. Irrespective of HIV serostatus, pregnant women had significantly higher serum concentrations of copper and copper/zinc ratio and significantly lower magnesium compared to those in non-pregnant women (P<0.05). Except for selenium, which was significantly lower in HIV-seropositive pregnant women (P<0. 05), the mean serum concentrations of zinc, copper, calcium, and magnesium were not significantly different between pregnant women by HIV serostatus. The prevalence of deficiency in zinc, magnesium, selenium, and calcium in the pregnant women, irrespective of their HIV serostatus, was 66.7%, 25.6%, 21.9%, and 9.3%, respectively. The magnitude of deficiency in zinc, magnesium, and selenium was significantly higher in HIV seropositive pregnant women (76.2%, 52.4%, and 45.2%) than that in HIV-seronegative pregnant women (65.5%, 22.2%, and 18.9%) and in HIV-seronegative non-pregnant women (42.9%, 8.1%, and 30.4%; P<0.05). Deficiency in one, two, three, or four mineral elements was observed in 44.8%, 14.4%, 9.9%, and 5.1% of the pregnant women, respectively. Only 25.9% of the pregnant women and 44.7% of the non-pregnant women were not deficient in any of the micronutrients. The high prevalence of micronutrient deficiencies in pregnant and non-pregnant women in Gondar, Ethiopia warrants the need for strategies on prevention and control of the deficiencies. 2007 Humana Press Inc."									
1366	Premastication: The second arm of infant and young child feeding for health and survival?	"Pelto GH, Zhang Y, Habicht JP."	Maternal and Child Nutrition. 2010 January;6(1):4-18.		"Premastication of foods for infants was a crucial behavioural adaptation to neoteny that ensured nutritional adequacy during the period of complementary feeding throughout the course of human evolution until recent times. While the paps and gruels of agricultural systems provided an alternative and modern food technology appears to make it unnecessary, we argue that, in addition to its role in nutrition, premastication also played a crucial role in supporting infant health. Its abandonment, particularly in poor communities, has placed children at increased risk of inadequate nutrition and decreased ability to confront infections associated with the introduction of complementary foods. We present two empirical studies. Section I is a cross-cultural study of the ethnographic literature in order to estimate prevalence in non-Western societies. One-third of ethnographies in the worldwide sample with data on infant feeding report premastication. Section II presents the results of a qualitative study in China, conducted in order to provide data on the likelihood that this percent is incorrect due to under-reporting. The finding that 63% of Chinese university students received premasticated food as infants, whereas none of eight ethnographic studies performed in Han China identified premastication in their reports, provides support for the conclusion that the cross-cultural study grossly underestimates its prevalence in non-Western societies. Section III is a discussion of potential benefits and risks of infant exposure to maternal saliva. We conclude with the argument for a concerted research effort to determine whether premastication can solve not only the 'weanling dilemma' in poor countries but also some of the health problems among the better-off. 2009 Blackwell Publishing Ltd."									
1437	Review of the South African nutrition policy 1994-2002 and targets for 2007: Achievements and challenges.	"Labadarios D, Steyn NP, Mgijima C, Daldla N."	Nutrition. 2005 January;21(1):100-8.		"Primary and secondary nutrition interventions are essential in South Africa, a country with mortality rates of 45.2 deaths per 1000 live births and 61 per 1000 for children younger than 5 y and an estimated prevalence of 8.3% for low birth weight. In addition, the National Food Consumption Survey has recently reported that approximately one in five children 1 to 9 y of age in South Africa are stunted (21.6%) and 1 in 10 (10.3%) is underweight for age. The prevalence of stunting was highest in children 1 to 3 y old (25.5%) and lowest in those 7 to 9 y old (13%). In terms of overnutrition, the survey also reported overweight and obesity in 17.1% of the sample at the national level. In this overview, the focus areas of the Integrated Nutrition Program are examined and critically discussed to determine whether targets planned for 2002 were met and how they are envisioned to change by 2007. 2005 Elsevier Inc. All rights reserved."									
1190	Alternatives to current HIV/AIDS policies and practices in South African prisons.	"Goyer KC, Gow J."	Journal of Public Health Policy. 2002;23(3):307-23.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=12325288	"Prisoners in South Africa face problems of overcrowding, violence and poor nutrition. Added to this burden in recent times is the increased threat from HIV. The HIV epidemic has been relatively late in coming to South Africa but infection rates are now 20% in the adult population. However, there is no data available on the level of HIV infection in the prison population. Overseas studies suggest that the characteristics of prisoners place them at much greater risk of HIV infection. Factors which contribute to increased levels of HIV infection include poor health care facilities, lack of condoms and lack of disinfectants. Current policies and practices on HIV in prison attempt to balance the constraints of limited resources with the need to preserve prisoner human rights. The outcomes include: mass testing not freely available, HIV education is limited, and early release of prisoners with advanced AIDS is not allowed. Constraints on the implementation of effective HIV prevention strategies include: bureaucratic inefficiency, lack of resources, and a reluctance by prison authorities to address the issue of HIV in prison. These problems can possibly be overcome by addressing the issue from both management and prisoner perspectives. On the management side, increased resources, increased training of prison officials, and increased political commitment to address the issue are required. Outside partnerships are probably required for an effective response. Prisoners require better nutrition, better living conditions, better health care, freely available condoms and disinfectants."									
475	Outcomes of antiretroviral therapy in a northern Indian urban clinic.	"Sharma SK, Dhooria S, Prasad KT, George N, Ranjan S, Gupta D, Sreenivas V, et al."	Bulletin of the World Health Organization. 2010;88(3):222-6.	http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=2010601391&site=ehost-live	"Problem Antiretroviral therapy (ART) programmes have been successful in several countries. However, whether they would succeed as part of a national programme in a resource-constrained setting such as India is not clear. The outcomes and specific problems encountered in such a setting have not been adequately studied. Approach We assessed the efficacy and functioning of India's national ART programme in a tertiary care centre in northern India. All ART-naive patients started on ART between May 2005 and October 2006 were included in the study and were followed until 31 April 2008. Periodic clinical and laboratory evaluations were carried out in accordance with national guidelines. Changes in CD4+ lymphocyte count, body weight and body mass index were assessed at follow-up, and the operational problems analysed. Local setting The setting was a tertiary care centre in northern India with a mixed population of patients, mostly of low socioeconomic status. The centre is reasonably well resourced but faces constraints in health-care delivery, such as lack of adequate human resources and a high patient load. Relevant changes The response to ART in the cohort studied was comparable to that reported from other countries. However, the programme had a high attrition rate, possibly due to patient-related factors and operational constraints. Lessons learnt A high rate of attrition can affect the overall efficacy and functioning of an ART programme. Addressing the issues causing attrition might improve patient outcomes in India and in other resource-constrained countries. © World Health Organization 2010. All rights reserved."									
476	Outcomes of antiretroviral therapy in a northern Indian urban clinic.	"Sharma SK, Sahajal D, Prasad KT, George N, Sanjay R, Deepak G, Vishnubhatla S, et al."	Bulletin of the World Health Organization. 2010;88(3):222-6.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20103117427	"Problem: Antiretroviral therapy (ART) programmes have been successful in several countries. However, whether they would succeed as part of a national programme in a resource-constrained setting such as India is not clear. The outcomes and specific problems encountered in such a setting have not been adequately studied. Approach: We assessed the efficacy and functioning of India's national ART programme in a tertiary care centre in northern India. All ART-naive patients started on ART between May 2005 and October 2006 were included in the study and were followed until 31 April 2008. Periodic clinical and laboratory evaluations were carried out in accordance with national guidelines. Changes in CD4+ lymphocyte count, body weight and body mass index were assessed at follow-up, and the operational problems analysed. Local setting: The setting was a tertiary care centre in northern India with a mixed population of patients, mostly of low socioeconomic status. The centre is reasonably well resourced but faces constraints in health-care delivery, such as lack of adequate human resources and a high patient load. Relevant changes: The response to ART in the cohort studied was comparable to that reported from other countries. However, the programme had a high attrition rate, possibly due to patient-related factors and operational constraints. Lessons learnt: A high rate of attrition can affect the overall efficacy and functioning of an ART programme. Addressing the issues causing attrition might improve patient outcomes in India and in other resource-constrained countries."									
1368	Situational analysis of infant and young child nutrition policies and programmatic activities in the Islamic Republic of Mauritania. (Special Issue: Repositioning children's right to adequate nutrition in the Sahel - situational analysis.).	"Wuehler SE, Dehah CMEO."	Maternal and Child Nutrition. 2011;7(s1):113-32.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20113110908	"Progress towards reducing mortality and malnutrition among children <5 years of age has been less than needed to achieve related Millennium Development Goals (MDGs), so several international agencies joined to 'reposition children's right to adequate nutrition in the Sahel', starting with an analysis of current activities related to infant and young child nutrition (IYCN). The main objectives of the situational analysis are to compile, analyse, and interpret available information on infant and child feeding, and the nutrition and health situation of children <2 years of age in Mauritania as one of the six target countries (Burkina Faso, Chad, Mali, Mauritania, Niger, Senegal). These findings are available to assist countries in identifying inconsistencies and filling gaps in current programming. Between August and November of 2008, key informants responsible for conducting IYCN-related activities in Mauritania were interviewed, and 46 documents were examined on the following themes: optimal breastfeeding and complementary feeding practices, prevention of micronutrient deficiencies, prevention of mother-to-child transmission of human immunodeficiency virus (HIV), management of acute malnutrition, food security, and hygienic practices. Mauritania is on track to reaching the MDG of halving undernutrition among children <5 years of age by 2015. National policy documents, training guides, and programmes address nearly all of the key IYCN topics, specifically or generally. Exceptions are the use of zinc supplements in diarrhoea treatment, prevention of zinc deficiency, and dietary guidelines for preventing mother-to-child transmission of HIV. Substantial infrastructure capacity building was also recently implemented in nutritionally high-risk regions, and increases were reported in exclusive breastfeeding rates among children <6 months. The recent National Behaviour Change Communication Strategy is intended to address the needs of adapting programme activities to local needs. Despite these noteworthy accomplishments, the prevalence of acute malnutrition remains high, mortality rates did not decrease as malnutrition rates decreased, the overall prevalence of desirable nutrition-related practices is low, and human resources are reportedly insufficient to carry out all nutrition-related programme activities. Very little nutrition research has been conducted in Mauritania, and key informants identified gaps in adapting international programmes to local needs. Monitoring and evaluation reports have not been rigorous enough to identify which programme activities were implemented as designed or whether programmes were effective at improving nutritional and health status of young children. Therefore, we could not confirm which programmes might have been responsible for the reported improvements, or if other population-wide changes contributed to these changes. The policy framework is supportive of optimal IYCN practices, but greater resources and capacity building are needed to (i) support activities to adapt training materials and programme protocols to fit local needs, (ii) expand and track the implementation of evidence-based programmes nationally, (iii) improve and carry out monitoring and evaluation that identify effective and ineffective programmes, and (iv) apply these findings in developing, disseminating, and improving effective programmes."									
1354	Situational analysis of infant and young child nutrition policies and programmatic activities in the Islamic Republic of Mauritania.	"Wuehler SE, El Hafed Ould Dehah CM."	Maternal & Child Nutrition. 2011;7 Suppl 1:113-32.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=21410892	"Progress towards reducing mortality and malnutrition among children <5 years of age has been less than needed to achieve related Millennium Development Goals (MDGs), so several international agencies joined to 'reposition children's right to adequate nutrition in the Sahel', starting with an analysis of current activities related to infant and young child nutrition (IYCN). The main objectives of the situational analysis are to compile, analyse, and interpret available information on infant and child feeding, and the nutrition and health situation of children <2 years of age in Mauritania as one of the six target countries (Burkina Faso, Chad, Mali, Mauritania, Niger, Senegal). These findings are available to assist countries in identifying inconsistencies and filling gaps in current programming. Between August and November of 2008, key informants responsible for conducting IYCN-related activities in Mauritania were interviewed, and 46 documents were examined on the following themes: optimal breastfeeding and complementary feeding practices, prevention of micronutrient deficiencies, prevention of mother-to-child transmission of human immunodeficiency virus (HIV), management of acute malnutrition, food security, and hygienic practices. Mauritania is on track to reaching the MDG of halving undernutrition among children <5 years of age by 2015. National policy documents, training guides, and programmes address nearly all of the key IYCN topics, specifically or generally. Exceptions are the use of zinc supplements in diarrhoea treatment, prevention of zinc deficiency, and dietary guidelines for preventing mother-to-child transmission of HIV. Substantial infrastructure capacity building was also recently implemented in nutritionally high-risk regions, and increases were reported in exclusive breastfeeding rates among children <6 months. The recent National Behaviour Change Communication Strategy is intended to address the needs of adapting programme activities to local needs. Despite these noteworthy accomplishments, the prevalence of acute malnutrition remains high, mortality rates did not decrease as malnutrition rates decreased, the overall prevalence of desirable nutrition-related practices is low, and human resources are reportedly insufficient to carry out all nutrition-related programme activities. Very little nutrition research has been conducted in Mauritania, and key informants identified gaps in adapting international programmes to local needs. Monitoring and evaluation reports have not been rigorous enough to identify which programme activities were implemented as designed or whether programmes were effective at improving nutritional and health status of young children. Therefore, we could not confirm which programmes might have been responsible for the reported improvements, or if other population-wide changes contributed to these changes. The policy framework is supportive of optimal IYCN practices, but greater resources and capacity building are needed to (i) support activities to adapt training materials and programme protocols to fit local needs, (ii) expand and track the implementation of evidence-based programmes nationally, (iii) improve and carry out monitoring and evaluation that identify effective and ineffective programmes, and (iv) apply these findings in developing, disseminating, and improving effective programmes. 2011 Blackwell Publishing Ltd."									
1356	Situational analysis of infant and young child nutrition policies and programmatic activities in Senegal.	"Wuehler SE, Ly Wane CT."	Maternal & Child Nutrition. 2011;7 Suppl 1:157-81.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=21410894	"Progress towards reducing mortality and malnutrition among children <5 years of age has been less than needed to achieve related Millennium Development Goals (MDGs). Therefore, several international agencies joined to 'Reposition children's right to adequate nutrition in the Sahel', starting with an analysis of current activities related to infant and young child nutrition (IYCN). The main objectives of the situational analysis are to compile, analyse and interpret available information on infant and child feeding and the nutrition situation of children <2 years of age in Senegal, as one of the six targeted countries. These findings will be used to assist in identifying inconsistencies and filling gaps in current programming. Between August and December 2008, key informants responsible for conducting IYCN-related activities in Senegal were interviewed, and 157 documents were examined on the following themes: optimal breastfeeding and complementary feeding practices, prevention of micronutrient deficiencies, prevention of mother-to-child transmission of HIV, management of acute malnutrition, food security and hygienic practices. Nearly all of the key IYCN topics were addressed, specifically or generally, in national policy documents. Senegal reported substantial improvements since the 1990s towards reducing infant and young child mortality and underweight, and increasing exclusive breastfeeding among infants <6 months of age (34%). Senegal is one of the few countries in the region that is nearly on track for reaching related MDGs. Notable activities that may have played a role include: (1) vitamin A supplementation was expanded to nearly semi-annual national campaigns starting in 1994; (2) the Ministry of Health partnered with several national and international agencies to scale up child survival activities under the umbrella of the Basic Support for Institutionalizing Child Survival (1994-2006); (3) a national nutrition division was developed to support a national nutrition strengthening programme; (4) the national nutrition counsel was organized to coordinate nutritional activities across various organizations and governmental sectors, involving representatives from health, agriculture and surveillance; and (5) an integrated communications programme was developed to support harmonized behaviour change communication tools for the health and nutrition sectors. Along with these activities, a number of programme evaluations were conducted to ensure that programmes obtain desired results. Although useful, these evaluations were not rigorous enough to identify effective programmes that contributed to the mentioned reductions in the prevalence of underweight and mortality, and increases in exclusive breastfeeding. The policy and programme framework is well established for support of optimal IYCN practices in Senegal. Despite the recent improvements in infant and young child nutritional status indicators, there is still much to do. Greater resources and continued capacity building are needed to: (1) conduct necessary research for adapting training materials and programme protocols to programmatic needs; (2) improve and carry out monitoring and evaluation that identify effective programme components; and (3) apply these findings in developing, expanding and improving effective programmes. 2011 Blackwell Publishing Ltd."									
1357	Situational analysis of infant and young child nutrition policies and programmatic activities in Chad.	"Wuehler SE, Nadjilem D."	Maternal & Child Nutrition. 2011;7 Suppl 1:63-82.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=21410890	"Progress towards reducing mortality and malnutrition among children <5 years of age has been less than needed to achieve related Millennium Development Goals (MDGs). Therefore, several international agencies joined to 'reposition children's right to adequate nutrition in the Sahel', starting with an analysis of current activities related to infant and young child nutrition (IYCN). The main objectives of the situational analysis are to compile, analyse, and interpret available information on infant and child feeding, and the nutrition situation of children <2 years of age in Chad, as one of the six targeted countries. These findings are available to assist in identifying inconsistencies and filling gaps in current programming. Between June and October of 2008, key informants responsible for IYCN-related activities in Chad were interviewed, and 53 documents were examined on the following themes: the promotion of optimal breastfeeding and complementary feeding practices, prevention of micronutrient deficiencies, management of acute malnutrition, prevention of mother-to-child transmission of human immunodeficiency virus (HIV), food security, and promotion of good hygienic practices. Chad is not on track to reaching the MDGs of reducing mortality by two-thirds and malnutrition by half among children <5 years of age between 1990 and 2015. Most of the key IYCN topics were addressed in a national policy to combat malnutrition and micronutrient deficiencies. No national nutrition policy was yet ratified in Chad, so the target of many documents reviewed was the malnourished child. Researchers have identified some barriers to optimal feeding practices. However, the majority of these surveys were small scale, so they do not necessarily provide information relevant to the general population. Expanded surveys would be needed for developing evidence-based educational messages targeted to local needs. Reviewed training materials and related programmes being implemented in Chad provide specific guidance for nearly all of the key IYCN topics, except for appropriate feeding choices for the prevention of mother-to-child transmission of HIV. Some of the programmes were intended for national coverage, but we could not confirm whether these programmes were actually implemented nationally. Monitoring and evaluation reports were available for some small-scale programmes, but few of these evaluated whether IYCN-specific programme components were implemented as designed and none evaluated whether participants adopted the promoted feeding practices. Establishment of the policy and programme framework has commenced for improving IYCN practices. Formative research is needed to guide the development of evidence-based training materials and programmes to address the nutritional needs of infants and children. Once more directed programmes are established, there is a further need for rigorous monitoring and evaluation to ensure that training is adequate, programmes are implemented as designed, and effective programmes are identified for expansion nationally. Evaluations are also needed to determine where human and institutional capacity building is needed to carry out these activities as they are implemented. National and international support will be required to complete these enhancements, and thus improve the health and nutritional status of infants and young children in Chad. 2011 Blackwell Publishing Ltd."									
1372	Situational analysis of infant and young child nutrition policies and programmatic activities in Chad. (Special Issue: Repositioning children's right to adequate nutrition in the Sahel - situational analysis.).	"Wuehler SE, Nadjilem D."	Maternal and Child Nutrition. 2011;7(s1):63-82.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20113110906	"Progress towards reducing mortality and malnutrition among children <5 years of age has been less than needed to achieve related Millennium Development Goals (MDGs). Therefore, several international agencies joined to 'reposition children's right to adequate nutrition in the Sahel', starting with an analysis of current activities related to infant and young child nutrition (IYCN). The main objectives of the situational analysis are to compile, analyse, and interpret available information on infant and child feeding, and the nutrition situation of children <2 years of age in Chad, as one of the six targeted countries. These findings are available to assist in identifying inconsistencies and filling gaps in current programming. Between June and October of 2008, key informants responsible for IYCN-related activities in Chad were interviewed, and 53 documents were examined on the following themes: the promotion of optimal breastfeeding and complementary feeding practices, prevention of micronutrient deficiencies, management of acute malnutrition, prevention of mother-to-child transmission of human immunodeficiency virus (HIV), food security, and promotion of good hygienic practices. Chad is not on track to reaching the MDGs of reducing mortality by two-thirds and malnutrition by half among children <5 years of age between 1990 and 2015. Most of the key IYCN topics were addressed in a national policy to combat malnutrition and micronutrient deficiencies. No national nutrition policy was yet ratified in Chad, so the target of many documents reviewed was the malnourished child. Researchers have identified some barriers to optimal feeding practices. However, the majority of these surveys were small scale, so they do not necessarily provide information relevant to the general population. Expanded surveys would be needed for developing evidence-based educational messages targeted to local needs. Reviewed training materials and related programmes being implemented in Chad provide specific guidance for nearly all of the key IYCN topics, except for appropriate feeding choices for the prevention of mother-to-child transmission of HIV. Some of the programmes were intended for national coverage, but we could not confirm whether these programmes were actually implemented nationally. Monitoring and evaluation reports were available for some small-scale programmes, but few of these evaluated whether IYCN-specific programme components were implemented as designed and none evaluated whether participants adopted the promoted feeding practices. Establishment of the policy and programme framework has commenced for improving IYCN practices. Formative research is needed to guide the development of evidence-based training materials and programmes to address the nutritional needs of infants and children. Once more directed programmes are established, there is a further need for rigorous monitoring and evaluation to ensure that training is adequate, programmes are implemented as designed, and effective programmes are identified for expansion nationally. Evaluations are also needed to determine where human and institutional capacity building is needed to carry out these activities as they are implemented. National and international support will be required to complete these enhancements, and thus improve the health and nutritional status of infants and young children in Chad."									
1374	Situational analysis of infant and young child nutrition policies and programmatic activities in Senegal. (Special Issue: Repositioning children's right to adequate nutrition in the Sahel - situational analysis.).	"Wuehler SE, Wane CTL."	Maternal and Child Nutrition. 2011;7(s1):157-81.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20113110910	"Progress towards reducing mortality and malnutrition among children <5 years of age has been less than needed to achieve related Millennium Development Goals (MDGs). Therefore, several international agencies joined to 'Reposition children's right to adequate nutrition in the Sahel', starting with an analysis of current activities related to infant and young child nutrition (IYCN). The main objectives of the situational analysis are to compile, analyse and interpret available information on infant and child feeding and the nutrition situation of children <2 years of age in Senegal, as one of the six targeted countries. These findings will be used to assist in identifying inconsistencies and filling gaps in current programming. Between August and December 2008, key informants responsible for conducting IYCN-related activities in Senegal were interviewed, and 157 documents were examined on the following themes: optimal breastfeeding and complementary feeding practices, prevention of micronutrient deficiencies, prevention of mother-to-child transmission of HIV, management of acute malnutrition, food security and hygienic practices. Nearly all of the key IYCN topics were addressed, specifically or generally, in national policy documents. Senegal reported substantial improvements since the 1990s towards reducing infant and young child mortality and underweight, and increasing exclusive breastfeeding among infants <6 months of age (34%). Senegal is one of the few countries in the region that is nearly on track for reaching related MDGs. Notable activities that may have played a role include: (1) vitamin A supplementation was expanded to nearly semi-annual national campaigns starting in 1994; (2) the Ministry of Health partnered with several national and international agencies to scale up child survival activities under the umbrella of the Basic Support for Institutionalizing Child Survival (1994-2006); (3) a national nutrition division was developed to support a national nutrition strengthening programme; (4) the national nutrition counsel was organized to coordinate nutritional activities across various organizations and governmental sectors, involving representatives from health, agriculture and surveillance; and (5) an integrated communications programme was developed to support harmonized behaviour change communication tools for the health and nutrition sectors. Along with these activities, a number of programme evaluations were conducted to ensure that programmes obtain desired results. Although useful, these evaluations were not rigorous enough to identify effective programmes that contributed to the mentioned reductions in the prevalence of underweight and mortality, and increases in exclusive breastfeeding. The policy and programme framework is well established for support of optimal IYCN practices in Senegal. Despite the recent improvements in infant and young child nutritional status indicators, there is still much to do. Greater resources and continued capacity building are needed to: (1) conduct necessary research for adapting training materials and programme protocols to programmatic needs; (2) improve and carry out monitoring and evaluation that identify effective programme components; and (3) apply these findings in developing, expanding and improving effective programmes."									
1353	Situational analysis of infant and young child nutrition policies and programmatic activities in Mali.	"Wuehler SE, Coulibaly M."	Maternal & Child Nutrition. 2011;7 Suppl 1:83-112.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=21410891	"Progress towards reducing mortality and malnutrition among children <5 years of age has been less than needed to achieve related Millennium Development Goals. Therefore, several international agencies joined to 'Reposition children's right to adequate nutrition in the Sahel', starting with a situational analysis of current activities related to infant and young child nutrition (IYCN). The main objectives of the situational analysis are to compile, analyse and interpret available information on infant and young child feeding, and the nutrition situation of children <2 years of age in Mali, as one of the six targeted countries. Between June and September 2008, key informants responsible for conducting IYCN-related activities in Mali were interviewed, and 117 documents were examined on the following themes: optimal breastfeeding and complementary feeding practices, prevention of micronutrient deficiencies, screening and management of acute malnutrition, prevention of mother-to-child transmission of HIV, food security, and hygienic practices. Most of the key IYCN topics were addressed in national policies, training materials, and programme documents. Information on the national coverage and impact of these programmes is generally not available. Exclusive breastfeeding (<6 months) has increased in Mali, but no studies identified the contributors to this increase. Despite improvements in breastfeeding practices, optimal infant, and young child feeding is still practiced among too few young children in Mali. Several research articles were identified, but few of these were linked to programme development. Some programme monitoring and evaluation reports were available, but few of these were rigorous enough to identify whether IYCN-specific programme components were implemented as designed or were achieving desired outcomes. Therefore, we could not confirm which programmes contributed to reported improvements. Monitoring of programmes managing malnutrition identified gaps in human and institutional capacities to fully carry out intended interventions and the government has recognized the overall lack of adequate numbers of health care providers to carry out necessary programmes in Mali, of which nutrition programmes are a part. The policy and programme framework is well established for support of optimal IYCN practices, but greater resources and capacity building are needed to: (i) conduct necessary research to adapt training materials and programme protocols to programmatic needs; (ii) implement rigorous monitoring and evaluation that identify effective programme components; and (iii) apply these findings in developing, expanding, and improving effective programmes. 2011 Blackwell Publishing Ltd."									
1367	Situational analysis of infant and young child nutrition policies and programmatic activities in Mali. (Special Issue: Repositioning children's right to adequate nutrition in the Sahel - situational analysis.).	"Wuehler SE, Coulibaly M."	Maternal and Child Nutrition. 2011;7(s1):83-112.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20113110907	"Progress towards reducing mortality and malnutrition among children <5 years of age has been less than needed to achieve related Millennium Development Goals. Therefore, several international agencies joined to 'Reposition children's right to adequate nutrition in the Sahel', starting with a situational analysis of current activities related to infant and young child nutrition (IYCN). The main objectives of the situational analysis are to compile, analyse and interpret available information on infant and young child feeding, and the nutrition situation of children <2 years of age in Mali, as one of the six targeted countries. Between June and September 2008, key informants responsible for conducting IYCN-related activities in Mali were interviewed, and 117 documents were examined on the following themes: optimal breastfeeding and complementary feeding practices, prevention of micronutrient deficiencies, screening and management of acute malnutrition, prevention of mother-to-child transmission of HIV, food security, and hygienic practices. Most of the key IYCN topics were addressed in national policies, training materials, and programme documents. Information on the national coverage and impact of these programmes is generally not available. Exclusive breastfeeding (<6 months) has increased in Mali, but no studies identified the contributors to this increase. Despite improvements in breastfeeding practices, optimal infant, and young child feeding is still practiced among too few young children in Mali. Several research articles were identified, but few of these were linked to programme development. Some programme monitoring and evaluation reports were available, but few of these were rigorous enough to identify whether IYCN-specific programme components were implemented as designed or were achieving desired outcomes. Therefore, we could not confirm which programmes contributed to reported improvements. Monitoring of programmes managing malnutrition identified gaps in human and institutional capacities to fully carry out intended interventions and the government has recognized the overall lack of adequate numbers of health care providers to carry out necessary programmes in Mali, of which nutrition programmes are a part. The policy and programme framework is well established for support of optimal IYCN practices, but greater resources and capacity building are needed to: (i) conduct necessary research to adapt training materials and programme protocols to programmatic needs; (ii) implement rigorous monitoring and evaluation that identify effective programme components; and (iii) apply these findings in developing, expanding, and improving effective programmes."									
1373	Situational analysis of infant and young child nutrition policies and programmatic activities in Burkina Faso. (Special Issue: Repositioning children's right to adequate nutrition in the Sahel - situational analysis.).	"Wuehler SE, Ouedraogo AW."	Maternal and Child Nutrition. 2011;7(s1):35-62.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20113110905	"Progress towards reducing mortality and malnutrition among children <5 years of age has been less than needed to achieve related Millennium Development Goals. Therefore, several international agencies joined to 'Reposition children's right to adequate nutrition in the Sahel', starting with an analysis of current activities related to infant and young child nutrition (IYCN). The objectives of the present paper are to compare relevant national policies, training materials, programmes, and monitoring and evaluation activities with internationally accepted IYCN recommendations. These findings are available to assist countries in identifying inconsistencies and filling gaps in current programming. Between August and November 2008, key informants responsible for conducting IYCN-related activities in Burkina Faso were interviewed, and 153 documents were examined on the following themes: optimal breastfeeding and complementary feeding practices, prevention of micronutrient deficiencies, screening and treatment of acute malnutrition, prevention of mother-to-child transmission of HIV, food security and hygienic practices. National policy documents addressed nearly all of the key IYCN topics, specifically or generally. Formative research has identified some local barriers and beliefs related to general breastfeeding and complementary feeding practices, and other formative research addressed about half of the IYCN topics included in this review. However, there was little evidence that this formative research was being utilized in developing training materials and designing programme interventions. Nevertheless, the training materials that were reviewed do provide specific guidance for nearly all of the key IYCN topics. Although many of the IYCN programmes are intended for national coverage, we could only confirm with available reports that programme coverage extended to certain regions. Some programme monitoring and evaluation were conducted, but few of these provided information on whether the specific IYCN programme components were implemented as designed. Most surveys that were identified reported on general nutrition status indicators, but did not provide the detail necessary for programme impact evaluations. The policy framework is well established for optimal IYCN practices, but greater resources and capacity building are needed to: (i) conduct necessary research and adapt training materials and programme protocols to local needs; (ii) improve, carry out, and document monitoring and evaluation that highlight effective and ineffective programme components; and (iii) apply these findings in developing, expanding, and improving effective programmes."									
1358	Situational analysis of infant and young child nutrition policies and programmatic activities in Burkina Faso.	"Wuehler SE, Ouedraogo AW."	Maternal & Child Nutrition. 2011;7 Suppl 1:35-62.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=21410889	"Progress towards reducing mortality and malnutrition among children<5 years of age has been less than needed to achieve related Millennium Development Goals. Therefore, several international agencies joined to 'Reposition children's right to adequate nutrition in the Sahel', starting with an analysis of current activities related to infant and young child nutrition (IYCN). The objectives of the present paper are to compare relevant national policies, training materials, programmes, and monitoring and evaluation activities with internationally accepted IYCN recommendations. These findings are available to assist countries in identifying inconsistencies and filling gaps in current programming. Between August and November 2008, key informants responsible for conducting IYCN-related activities in Burkina Faso were interviewed, and 153 documents were examined on the following themes: optimal breastfeeding and complementary feeding practices, prevention of micronutrient deficiencies, screening and treatment of acute malnutrition, prevention of mother-to-child transmission of HIV, food security and hygienic practices. National policy documents addressed nearly all of the key IYCN topics, specifically or generally. Formative research has identified some local barriers and beliefs related to general breastfeeding and complementary feeding practices, and other formative research addressed about half of the IYCN topics included in this review. However, there was little evidence that this formative research was being utilized in developing training materials and designing programme interventions. Nevertheless, the training materials that were reviewed do provide specific guidance for nearly all of the key IYCN topics. Although many of the IYCN programmes are intended for national coverage, we could only confirm with available reports that programme coverage extended to certain regions. Some programme monitoring and evaluation were conducted, but few of these provided information on whether the specific IYCN programme components were implemented as designed. Most surveys that were identified reported on general nutrition status indicators, but did not provide the detail necessary for programme impact evaluations. The policy framework is well established for optimal IYCN practices, but greater resources and capacity building are needed to: (i) conduct necessary research and adapt training materials and programme protocols to local needs; (ii) improve, carry out, and document monitoring and evaluation that highlight effective and ineffective programme components; and (iii) apply these findings in developing, expanding, and improving effective programmes. 2011 Blackwell Publishing Ltd."									
1033	Pattern and predictors of weight gain during pregnancy among HIV-1-infected women from Tanzania.	"Villamor E, Msamanga G, Spiegelman D, Peterson KE, Antelman G, Fawzi WW."	Journal of Acquired Immune Deficiency Syndromes: JAIDS. 2003;32(5):560-9.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=12679710	"Progression of HIV disease is often accompanied by weight loss and wasting. Gestational weight gain is a strong determinant of maternal and neonatal outcomes; however, the pattern and predictors of weight gain during pregnancy among HIV-positive women are unknown. We obtained monthly anthropometric measurements in a cohort of 957 pregnant women from Tanzania who were HIV infected. We estimated the weekly rate of weight gain at various points during the second and third trimesters of pregnancy and computed rate differences between levels of sociodemographic, nutritional, immunologic, and parasitic variables at the first prenatal visit. The change in mid-upper arm circumference (MUAC) from baseline to delivery was also examined. The rate of weight gain decreased progressively during pregnancy. There was an average decline of 1 cm in MUAC between weeks 12 and 38. Lower level of education and helminthic infections at first visit were associated with decreased adjusted rates of weight gain during the third trimester. High baseline MUAC, not contributing to household income, lower serum retinol and selenium concentrations, advanced clinical stage of HIV disease, and malaria infection were related to decreased rates of weight gain during the second trimester. Low baseline CD4 T-cell counts were related to a poorer pattern of weight gain throughout pregnancy. Prevention and treatment of parasitic infections and improvement of nutritional status are likely to enhance the pattern of gestational weight gain among HIV-infected women."									
524	Integration of tuberculosis and HIV services in sub-Saharan Africa: Lessons learned.	"Howard AA, El-Sadr WM."	Clinical Infectious Diseases. 2010 15 May;50(SUPPL. 3):S238-S44.		"Promoting linkages between tuberculosis (TB) and human immunodeficiency virus (HIV) treatment and prevention programs in resource-constrained environments where both diseases are prevalent is essential to improve the diagnosis, treatment, and outcomes for patients affected by both diseases. In this article, we share insights based on our experiences supporting integrated TB and HIV service delivery programs, including intensified TB case finding, isoniazid preventive therapy, infection control, and initiation of antiretroviral therapy. Our experience indicates that successful integration of TB and HIV services in resource-constrained environments is feasible, although programmatic, infrastructure, and staffing challenges remain. Successful implementation of TB and HIV collaborative activities requires consideration of the realities that exist on the ground and the importance of tailoring interventions in a manner that enables their seamless introduction into existing programs that are often overwhelmed with large numbers of patients and a paucity of human and other resources. 2010 by the Infectious Diseases Society of America. All rights reserved."									
686	Metabolic syndrome indicators and target organ damage in urban active coping African and caucasian men: The SABPA study.	"De Kock A, Malan L, Potgieter JC, Steenekamp W, Van Der Merwe MT."	Experimental and Clinical Endocrinology and Diabetes. 2012;120(5):282-7.		"Psychosocial stress relating to an urban environment or acculturation increases the prevalence of metabolic syndrome (MetS). The objectives of this study were firstly to indicate and compare differences regarding appraisal of stress or active coping responses in urban African (n=88) and Caucasian (n=101) male teachers of South Africa, in accord with the prevalence of MetS indicators. And secondly to investigate the extent to which utilisation of active coping responses, together with MetS indicators, predict target organ damage, in these men. The Coping Strategy Indicator determined high and low active coping responses in male teachers from the Sympathetic Activity and Ambulatory Blood Pressure in Africans (SABPA) study. SABPA inclusion and exclusion criteria were used. Additionally, diabetic medication users (n=8), and participants with renal impairment (n=2) or HIV positive (n=13), were excluded. MetS indicators included glucose, triglyceride, high-density lipoprotein cholesterol, blood pressure, and waist circumference, independent of confounders (age, physical activity, gamma glutamyl transferase). Microalbuminuria and carotid intima-media thickness indicated target organ damage. More MetS indicators exceeded the IDF cut-off points in high active coping African men (14.71%) than in their Caucasian counterparts (3.33%), as determined from analyses. Furthermore, stepwise regressions indicated that more MetS indicators predicted endothelial dysfunction, especially in the high active coping African men. High active coping African men showed more manifestation of MetS, compared to their Caucasian counterparts, and revealed progress towards endothelial dysfunction. Georg Thieme Verlag KG Stuttgart New York."									
10	uerto Rican young women's substance abuse: A qualitative study of young female cocaine and heroin drug users ages 18 to 35 from San Juan Metropolitan Area.	Rivera-Oquendo WJ. 			"PThe purpose of this qualitative study was to obtain a deeper understanding of Puerto Rican women between the ages of 18-35 with a cocaine and heroin problem. This study was designed to identify and describe common issues (specific problems, and personal/social characteristics, factors contributing to drug use) in the lives of these young women, their backgrounds, and life experiences, and to examine the social problems that these young women face as a result of their involvement with cocaine and heroin. Literature on drug use reveals that females are especially vulnerable to the physical and social consequences of drugs dependence and abuse. General health consequences of drug use in women are poor nutrition, low-self stem, depression and physical abuse. In Puerto Rico, female drug users were studied in the context of HIV risk and prostitution activities. Some important research findings related to prostitution and drugs were: in comparison to New York, in Puerto Rico gender was significantly associated with gallery drug use and female paid sex (Andia, Bearsley, & Cant, 2000). It is quite common to find that females over 25, who are working in the sex trade describe themselves as addicted to drugs (Alegria, et al., 1994). Cocaine and heroin were ordinarily used drugs among this population (Hansen, Lopez-Iftikhar, & Alegria, 2002). Specifically, the study employed a grounded theory methodology in which fifteen formerly cocaine and/or heroine drug users were interviewed. The method of constant comparative analysis was used to analyze the interview transcripts. The grounded theory derived from this analysis was expressed in the form of the following congruencies about the life of the participants. The congruencies were: (1)Dysfunctional family of origin. (2)The majority of the participants came from communities in which there were complex problems, few opportunities, and a high exposure to drugs. (3)Drug-using friends and/or sexual/romantic partners. (4)Developing a criminal life linked to addiction. (5)Poor governmental support for attacking the drug addiction problem. (6)Hispanic cultural values positively and negatively affect the rehabilitation of the women [in the study]. Copies of dissertations may be obtained by addressing your request to ProQuest, 789 E. Eisenhower Parkway, P.O. Box 1346, Ann Arbor, MI 48106-1346. Telephone 1-800-521-3042; email: disspub@umi.com"									
1310	Public nutrition in complex emergencies.	"Young H, Borrel A, Holland D, Salama P."	Lancet. 2004;364(9448):1899-909.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=15555671	"Public nutrition is a broad-based, problem-solving approach to addressing malnutrition in complex emergencies that combines analysis of nutritional risk and vulnerability with action-oriented strategies, including policies, programmes, and capacity development. This paper focuses on six broad areas: nutritional assessment, distribution of a general food ration, prevention and treatment of moderate malnutrition, treatment of severe malnutrition in children and adults, prevention and treatment of micronutrient deficiency diseases, and nutritional support for at-risk groups, including infants, pregnant and lactating women, elderly people, and people living with HIV. Learning and documenting good practice from previous emergencies, the promotion of good practice in current emergencies, and adherence to international standards and guidelines have contributed to establishing the field of public nutrition. However, many practical challenges reduce the effectiveness of nutritional interventions in complex emergencies, and important research and programmatic questions remain. [References: 136]"									
494	Pulmonary tuberculosis mortality risks in a cohort of HIV/AIDS patients in Puerto Rico. (Biomedicl research on health diaprities. Part II.).	"Mayor AM, Gomez MA, Otero JF, Vila S, Hunter RF."	Cellular and Molecular Biology. 2001;47(7):1143-8.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh3&AN=20023018389	"Pulmonary tuberculosis (TB) has re-emerged in relation to the HIV epidemic. To gain knowledge of TB infection in HIV-infected patients, we studied 106 HIV-TB cases in a cohort of 2646 patients in Puerto Rico between January 1992 and September 1999. The TB prevalence was 4%; 82% were males and 73.6% were injecting drug users (IDU). At the time of TB diagnosis, the mean CD4<sup>+</sup> T-cell count was 174/mm<sup>3</sup>, 35% were in antiretroviral treatment and 42.5% had another AIDS related condition. Only 9% received two or more antiretroviral medications. The death rate in the first year after the TB diagnosis was 55%. A Cox proportional hazard analysis showed that CD4<sup>+</sup> T-cells <200/mrn<sup>3</sup> (P<0.01), history of toxoplasmosis (P<0.01), wasting syndrome (P<0.01) and lack of antiretroviral treatment (P=0.12) increased their mortality risk. The studied patients had a highly compromised immune system at the time of TB diagnosis. Low CD4<sup>+</sup> T-cells (essential to control the TB infection) significantly increased the hazard and mortality risk of the cases studied. Early antiretroviral therapy in combination is recommended in HIV-infected patients, particularly in those with IDU, TB history and low CD4<sup>+</sup> T-cell levels, to ensure an optimal immune system function that limits the pulmonary TB morbidity and mortality."									
1623	Predictors of outcome in routine care for Cryptococcal meningitis in Western Kenya: Lessons for HIV outpatient care in resource-limited settings.	"Kendi C, Penner J, Koech J, Nyonda M, Cohen CR, Bukusi EA, Ngugi E, et al."	Postgraduate Medical Journal. 2013;89(1048):73-7.		"Purpose Cryptococcal meningitis is a leading cause of mortality among HIV-infected individuals in sub-Saharan Africa but little is known about its treatment and outcomes in decentralised HIV outpatient settings. We assessed adherence to treatment guidelines and determined predictors of survival. Design A computerised laboratory database identified HIV-infected adults with cryptococcal meningitis at Family AIDS Care and Education Services in Nyanza Province, Kenya, between 2005-2009. Medical records were reviewed. Kaplan-Meier survival curves were generated. Bivariate and multivariate Cox proportional hazards models were used to determine associations between key clinical characteristics and survival. Results Medical records were located for 79% (71/90). Mortality was 38% (27/71) over a median follow-up period of 201 days (IQR: 10-705 days). Adherence to local guidelines for treatment of cryptococcal meningitis was 48% (34/71). Higher body mass index was associated with improved survival (HR: 0.82, 95% CI (0.68 to 0.99)) even after controlling for factors such as age, CD4 cell count, receipt of highly active antiretroviral therapy, and treatment with any anti-fungal therapy. Conclusions Cryptococcal meningitis diagnosed in routine HIV outpatient settings is largely treated as an outpatient and adherence to treatment guidelines is poor. Body mass index is a critical independent predictor of outcome. Additional research to determine the most effective strategies to reduce premature mortality is urgently needed."									
589	Evidence-based prevention of childhood malnutrition.	"Imdad A, Sadiq K, Bhutta ZA."	Current Opinion in Clinical Nutrition & Metabolic Care. 2011;14(3):276-85.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=21415736	PURPOSE OF REVIEW: Childhood malnutrition is prevalent in developing countries and contributes to one-third of all deaths in these countries. There have been advances in prevention of childhood malnutrition and the purpose of this article was to review the current evidence in the field.	"RECENT FINDINGS: Multiple micronutrient (MMN) supplements during pregnancy reduce the incidence of maternal anemia and small for gestational-age babies. Recent evidence suggest that combined supplementation of MMNs with protein energy supplement is more effective than MMN supplementation alone. It is now recommended that HIV-infected mothers can exclusively breast-feed their infants for 6 months when the mother or infant is on effective antiretroviral therapy. Home fortification of complementary foods reduces the prevalence of anemia in infancy and combined supplementation of MMNs with lipid-based supplements improves growth in young children. Ready-to-use therapeutic foods have been successfully used to manage severe acute malnutrition in the community. Zinc supplementation is associated with a reduction in diarrhea and respiratory disease morbidity and improves linear growth. Vitamin A supplementation decreases the incidence of diarrhea and measles. Water supply, sanitation, and hygiene are important for the prevention of malnutrition because of their direct impact on infectious disease."	"SUMMARY: There is clear evidence on the causes and consequences of malnutrition as well as effective interventions to prevent undernutrition. The next step is to implement these packages of interventions at large scale. A global effort is required that should entail unified and compelling advocacy among governments, lead organizations, and institutions."							
590	Strategies to reduce early morbidity and mortality in adults receiving antiretroviral therapy in resource-limited settings.	"Lawn SD, Harries AD, Wood R."	Current Opinion in HIV and AIDS. 2010;5(1):18-26.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20103002614	"Purpose of review: We review recently published literature concerning early morbidity and mortality during antiretroviral therapy (ART) among patients in resource-limited settings. We focus on articles providing insights into this burden of disease and strategies to address it. Recent findings: In sub-Saharan Africa, mortality rates during the first year of ART are very high (8-26%), with most deaths occurring in the first few months. This figure compares with 3-13% in programmes in Latin America and the Caribbean and 11-13% in south-east Asia. Risk factors generally reflect late presentation with advanced symptomatic disease. Key causes of morbidity and mortality include tuberculosis (TB), acute sepsis, cryptococcal meningitis, malignancy and wasting syndrome/chronic diarrhoea. Current literature shows that the fundamental need is for much earlier HIV diagnosis and initiation of ART. In addition, further studies provide data on the role of screening and prophylaxis against opportunistic diseases (particularly TB, bacterial sepsis and cryptococcal disease) and the management of specific opportunistic diseases and complications of ART. Effective and sustainable delivery of these interventions requires strengthening of programmes. Summary: Strategies to address this disease burden should include earlier HIV diagnosis and ART initiation, screening and prophylaxis for opportunistic infections, optimized management of specific diseases and treatment complications, and programme strengthening."									
1118	Evaluation of dietary intake amongst disadvantaged African youth.	"Sanghera M, Roccamatisi D, Wang Y, Jang W, McLean J, Cannon W, Kagoda M, et al."	Journal of Investigative Medicine. 2010 January;58 (1):128.		"Purpose of Study: Brighter Smiles Africa, a global-health education partnership between our University and Makerere University includes the African Hearts Community (AfriHCO) in Kampala, Uganda. AfriHCO provides accommodation, food, schooling and a stable environment for 60 male street youth/AIDS orphans aged 6-19 yrs. Their director requested inclusion of dietary assessment and nutrition education in our 2009 program. This project evaluated current food intake. Methods Used: A 24 hour validated dietary recall instrument was used. 1. The questionnaire allows investigation of dietary diversity as a proxy measure of nutritional adequacy. The tool was modified to incorporate local Ugandan foods. Boys interested in participation were interviewed individually after providing informed consent. Summary of Results: 41 boys were involved (11 residents of AfriHCO's Kampala House (KH) and 30 living in local homes). The reported intake reflected a usual day in terms of the type and quantity of food consumed by 78.0% of participants. Each individual's dietary diversity score was calculated based on suggested food groupings1, with a maximum score of 14. The average dietary diversity score was 5.6, with KH residents having a slightly higher score than non-residents (6.2 vs. 5.4). Common foods consumed included rice, bread, matoke (green plantain), beans, added oils, fats and sweets. Food group analysis showed that 65.9% of the boys consumed either plant or animal-based food groups high in vitamin A. Only 48.8% of boys reported consumption of iron-rich food groups. Education on how to improve nutrition was provided while in Uganda and a summary document for the Director was prepared on return to Canada. Conclusions: While energy intake amongst these boys may be adequate, a lack of dietary diversity could place them at risk of nutrient deficiencies .The use of a dietary diversity questionnaire provides a quick, easy and objective way of identifying potential nutritional concerns. Results can guide nutrition education and evaluate changes over time."									
1220	Adiponectin and leptin levels in HIV-infected patients with lipodystrophy in Southern India.	"Mini Jacob S, Annie Phoebe K, Hemalatha R, Sivakumar MR, Ravindran MP, Natarajan MV."	Journal of the International AIDS Society. 2010 08 Nov;13.		"Purpose: of the study Evidence suggests that the level of adipokines (adiponectin and leptin) may be altered in lipodystrophy related to the long-term use of antiretroviral therapy (ART). The purpose of this study was to estimate the levels of adiponectin and leptin in HIV infected patients with lipodystrophy and to correlate them to metabolic parameters. Methods: In this cross sectional study, consenting 79 HIV+ve patients on antiretroviral therapy (for more than six months) visiting the Namakkal Government Hospital were recruited. Demography, anthropometry and ART regimens were collected. Patients' self-perception of lipodystrophy was determined using standardized questionnaires and clinically confirmed. An overnight fasting blood was drawn to determine serum adiponectin (Ray Biotech ELISA), serum leptin (DRG International ELISA) and insulin. Statistical analysis included analysis of variance and Pearson's correlation. Summary of results Men and women on ART with lipodystrophy (60.8%) when compared to those without lipodystrophy (30.2%) had similar mean adiponectin (p=0.842) moderately lower leptin (p=0.133), and higher insulin resistance (p= 0.031). Patients with lipodystrophy had lower BMI than those without lipodystrophy (p=0.02) and similar WHR (p=0.174). Among the total study population stavudine usage was associated with lower adiponectin (p=0.018) but not leptin whereas insulin (p=0.007) and insulin resistance (p=0.00) positively correlated with leptin and not adiponectin. In lipodystrophic patients, adiponectin had positive correlation with BMI (p=0.014) and had no correlation with insulin (0.304), and insulin resistance (0.250) whereas leptin had positive correlations with insulin (p= 0.00) and insulin resistance (p=0.001). Among patients without lipodystrophy, adiponectin levels had negative correlation with stavudine usage (p=0.018) while leptin had no significant correlation. Conclusions: Patients with lipodystrophy had moderately lower leptin and higher insulin resistance compared to those without lipodystrophy. Leptin seemed to have influence on insulin and insulin resistance while adiponectin did not influence insulin levels in this study population. Stavudine usage influenced adiponectin but not leptin levels."									
1241	Risk factors for possible HIV-associated dementia (HAD) in Sub-Saharan Africa: The case of Yaounde - Cameroon.	"Njamnshi AK, Zoung Kanyi Bissek AC, Ongolo-Zogo P, Tabah EN, Lekoubou AZ, Yepnjio FN, Fonsah JY, et al."	Journal of the Neurological Sciences. 2009 October;285:S136.		"Purpose: The prevalence of HIV-associated dementia (HAD) is influenced by several risk factors. The prevalence as well as risk factors for HAD are not well known in Sub Saharan Africa (SSA). We have shown that the International HIV Dementia Scale (IHDS) is a useful screening tool for possible HAD in Yaoundeacute; [2], but no study in Cameroon has yet investigated the risk factors for HAD.We hypothesized that the risk factors for HAD in Yaounde-Cameroon are similar to those described in the literature. Patients and Methods: A cross-sectional study was conducted in Yaoundeacute;, the capital of Cameroon from September to December 2006. One hundred and eighty-five HIV-positive subjects were included. Diagnosis of possible HIV-Associated Dementia was done using the International HIV-Dementia Scale with a score <=10 considered as abnormal. Age, sex, level of education, IV drug use, body mass index (BMI), CDC clinical stage, CD4 counts, hemoglobin levels, administration of highly active antiretroviral therapy (HAART) and type of regimen used, were considered in univariate analysis, with level of significance set at P <= 0.05. A binary logistic regression was used to determine independent risk factors. Results: The following factors were independent predictors of possible HAD: advanced clinical stage (OR = 7.43, P = 0.001), low CD4 count especially CD4 <= 200/mL (OR = 4.88, P = 0.045) and low Hemoglobin concentration (OR = 1.16, P = 0.048). Conclusion: This first study of the risk factors for possible HAD in Yaoundeacute; -Cameroon, reports findings similar to those described in other studies. These results call for rapid action by policy makers to include HAD prevention strategies such as providing early universal access to HAART based on these risk factors, in the management of HIV patients at risk of HAD in resource-limited settings of SSA like ours."									
513	Diagnostic value of an immunochromatographic test over clinical predictors for tuberculosis in HIV patients.	"Nanta S, Kantipong P, Pathipvanich P, Ruengorn C, Tawichasri C, Patumanond J."	Clinical Epidemiology. 2011 12 Sep;3(1):237-44.		"Purpose: The value of an immunochromatographic test for tuberculosis (ICT-TB) combined with clinical predictors has yet to be evaluated in Thailand. This study aimed to assess any additional diagnostic value of an ICT-TB test over that of clinical predictors in a group of human immunodeficiency virus (HIV) patients as well as in subgroups of HIV patients classified by clinical risk scores. Patients and methods: An extended cross-sectional study was conducted at a community hospital in Chiang Rai and a general hospital in Lampang. HIV patients registered between April 2009 and May 2010 were screened by a locally made ICT-TB test, including 38, 16, and 6 kD Microbacterium tuberculosis antigens, as well as by routine evaluations for TB diagnosis. Demographic data, medical history, signs, and symptoms were recorded. Participants were followed up for 2 months for final ascertainment of TB diagnosis. Results: Of 206 patients, 37 (18%) had TB. Four clinical predictors were identified: low body mass index (< 19 kg/m<sup>2</sup>), prolonged cough (duration. > 2 weeks), shaking chills (>= 1 week), and no use of antiretrovirals. The area under the receiver operating curve was 90.2%; adding the ICT-TB test result increased the area nonsignificantly to 91.6% (P =0.40). When patients were categorized by risk scores derived from selected clinical predictors into low (scores <= 7) and high (scores. > 7) TB risk groups, a positive ICT-TB test increased the positive predictive value nonsignificantly in the low risk group (from 12.5% to 27.3%, P =0.17) and the high risk group (from 78.6% to 80.8%, P =0.73). Conclusion: In this study setting, the ICT-TB test did not enhance TB diagnosis over the four clinical predictors in the overall group or any subgroups of HIV patients classified by clinical risk scores. 2011 Nanta et al."									
1179	"Is the risk of mother-to-child transmission of HIV higher among female compared with male infants? A case of Rakai, Uganda."	"Brahmbhatt H, Kigozi G, Serwadda D, Wabwire-Mangen F, Sewankambo N, Wawer M, Gray R."	Journal of Pediatric Infectious Diseases. 2009;4(3):275-9.		"Purpose: To assess gender differences in the risk of mother-to-child transmission (MTCT) of human immunodeficiency virus (HIV). HIV-positive mothers were identified from a population cohort followed from 1994 to 2000. HIV infection in mothers was detected using two independent enzyme immunoassays and infant HIV infection was diagnosed using RNA- polymerase chain reaction. Birth weight was determined by anthropometry. Logistic regression was used to assess the univariate and multivariate risk factors of MTCT. Approximately 16% of 371 infants were HIV-positive in the in-utero and intrapartum periods and an additional 16% were infected via breastfeeding. Female infants were significantly more likely to be HIV infected perinatally compared with male infants (20.8% vs. 12.4%, respectively, P = 0.035), but there was no significant sex differences in postnatal risk of MTCT. In adjusted analyses, among mothers with higher than median HIV viral loads, there was no significant difference in the risk of MTCT by gender, but among mothers with lower than median HIV viral loads, female infants were significantly more likely to be HIV infected (odds ratio = 4.1, confidence interval = 1.04-16.1). Low birth weight was more frequent in female than male infants born to HIV-positive mothers. Female infants could be more susceptible to HIV infection in the in-utero and peripartum period compared with male infants. Alternatively, this sex association could be due to higher in-utero mortality rates of male infants or to increased susceptibility of female infants. 2009 IOS Press. All rights reserved."									
1702	Epidemiological and nutritional characteristics of pregnant HIV-infected women.	"Brandao T, Silva KSd, Sally EFdO, Dias MA, Silva CVCd, Fonseca VM."	Revista Brasileira de Ginecologia e Obstetricia. 2011;33(8):189-95.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20123001643	"PURPOSE: To describe the epidemiological profile and nutritional status of pregnant women infected with human immunodeficiency virus (HIV) and its effect on the nutritional status of these women during pregnancy. METHODS: A retrospective cohort study was conducted on 121 pregnant women with HIV infection, single fetus pregnancies, who received prenatal care and delivered at a referral unit for HIV-infected pregnant women during the period from 1997 to 2007. Outcomes of the study were the initial and final nutritional status as measured by body mass index, weight gain, anemia (hemoglobin <11 g/dL) and low birth weight. Bivariate analysis investigated the association of these outcomes with socio-demographic, clinical-care and dietary characteristics. We estimated the relative risks (RR) with 95% confidence intervals (CI). RESULTS: At the beginning of pregnancy, 11.0% of the women were underweight, and in late pregnancy, the prevalence was 29.3%. Low educational level, urinary infection and worm infestation were associated with low gestational weight in late pregnancy. The percentage of insufficient weight gain was 47.5%, with well-nourished pregnant women (RR=3.3 95%CI 1.3-8.1) and women with no companion (RR=1.5 95%CI 1.1-2.2) having a higher risk for this outcome. The prevalences of overweight at the beginning and at the end of pregnancy were 26.8 and 29.4, respectively. There was a significant prevalence of anemia (61.0%). CONCLUSIONS: The high percentage of negative nutritional outcomes identified at this referral service with multidisciplinary care for pregnant women living with HIV reveals the need to establish more effective strategies to deal with the complex context of HIV."									
1266	Penile measurements in tanzanian males: Guiding circumcision device design and supply forecasting.	"Chrouser K, Bazant E, Jin L, Kileo B, Plotkin M, Adamu T, Curran K, et al."	Journal of Urology. 2013 August;190(2):544-50.		"Purpose: Voluntary medical male circumcision decreases the risk in males of HIV infection through heterosexual intercourse by about 60% in clinical trials and 73% at post-trial followup. In 2007 WHO and the Joint United Nations Programme on HIV/AIDS (UNAIDS) recommended that countries with a low circumcision rate and high HIV prevalence expand voluntary medical male circumcision programs as part of a national HIV prevention strategy. Devices for adult/adolescent male circumcision could accelerate the pace of scaling up voluntary medical male circumcision. Detailed penile measurements of African males are required for device development and supply size forecasting. Materials and Methods: Consenting males undergoing voluntary medical male circumcision at 3 health facilities in the Iringa region, Tanzania, underwent measurement of the penile glans, shaft and foreskin. Age, Tanner stage, height and weight were recorded. Measurements were analyzed by age categories. Correlations of penile parameters with height, weight and body mass index were calculated. Results: In 253 Tanzanian males 10 to 47 years old mean +/- SD penile length in adults was 11.5 +/- 1.6 cm, mean shaft circumference was 8.7 +/- 0.9 cm and mean glans circumference was 8.8 +/- 0.9 cm. As expected, given the variability of puberty, measurements in younger males varied significantly. Glans circumference highly correlated with height (r = 0.80) and weight (r = 0.81, each p <0.001). Stretched foreskin diameter moderately correlated with height (r = 0.68) and weight (r = 0.71, each p <0.001). Conclusions: Our descriptive study provides penile measurements of males who sought voluntary medical male circumcision services in Iringa, Tanzania. To our knowledge this is the first study in a sub-Saharan African population that provides sufficiently detailed glans and foreskin dimensions to inform voluntary medical male circumcision device development and size forecasting. 2013 American Urological Association Education and Research, Inc."									
781	"Therapeutic effects of nandrolone and testosterone in adult male HIV patients with AIDS wasting syndrome (AWS): A randomized, double-blind, placebo-controlled trial."	"Sardar P, Jha A, Roy D, Majumdar U, Guha P, Roy S, Banerjee R, et al."	HIV Clinical Trials. 2010 01 Jan;11(4):220-9.		"Purpose: We aimed to compare therapeutic effects of intramuscular (IM) nandrolone decanoate and IM testosterone enanthate in male HIV patients with AIDS wasting syndrome (AWS) with placebo control. Methods: In this randomized, double-blind, placebo-controlled, 12-week trial, 104 patients with AWS who satisfied our inclusion criteria were randomly allotted in a 2:2:1 ratio to the 3 intervention groups: nandrolone, testosterone, and placebo. We administered 150 mg nandrolone and 250 mg testosterone (both IM, biweekly). The primary outcome measure was a comparison of absolute change in weight at 12 weeks between the nandrolone decanoate, testosterone, and placebo groups. Results: Intent-to-treat analysis was done. The nandrolone group recorded maximum mean increase in weight (3.20 kg; post hoc P <.01 compared to placebo). Body mass index (BMI) of subjects in the nandrolone group had a significantly greater increase (mean = 1.28) compared to both testosterone (post hoc P <.05) and placebo (post hoc P <.01). Waist circumference and triceps skinfold thickness of patients on nandrolone showed similar results. Nandrolone also ensured a better quality of life. Patients with low testosterone level (<3 ng/mL) benefited immensely from nandrolone therapy, which increased their weight and BMI significantly compared to placebo (P <.05). Conclusion: Our trial demonstrates the superior therapeutic effects of nandrolone in male AWS patients, including the androgen deficient. 2010 Thomas Land Publishers, Inc."									
260	Body composition among HIV-seropositive and HIV-seronegative adult patients with pulmonary tuberculosis in Uganda.	"Mupere E, Zalwango S, Chiunda A, Okwera A, Mugerwa R, Whalen C."	Annals of Epidemiology. 2010;20(3):210-6.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20103101408	"PURPOSE: We determined whether human immunodeficiency virus (HIV) infection affects body cell mass and fat mass wasting among adults with pulmonary tuberculosis (PTB). METHODS: We screened 967 Ugandan adults for PTB and HIV infection in a cross-sectional study. We compared anthropometric and bioelectric impedance analysis (BIA) body composition parameters among HIV-seropositive and HIV-seronegative men and women with or without PTB by using a non-parametric test. RESULTS: We found that poor nutritional status associated with TB differed among men and women. Anthropometric and BIA body composition did not differ between HIV-seropositive and HIV-seronegative patients regardless of gender. Average weight group difference in men consisted of body cell mass and fat mass in equal proportions of 43%. In women, average weight group difference consisted predominantly of fat mass of 73% and body cell mass of 13%. Compared to individuals without TB, patients with TB had lower body mass index, weight, body cell mass, and fat mass regardless of gender and HIV status. CONCLUSIONS: Gender, but not HIV status, was associated with body composition changes in TB. TB appears to be the dominant factor driving the wasting process among co-infected patients."									
231	Development of extensively drug-resistant tuberculosis during multidrug-resistant tuberculosis treatment.	"Shin SS, Keshavjee S, Gelmanova IY, Atwood S, Franke MF, Mishustin SP, Strelis AK, et al."	American Journal of Respiratory and Critical Care Medicine. 2010 01 Aug;182(3):426-32.		"Rationale: Extensively drug-resistant (XDR) tuberculosis (TB) may arise in individuals on treatment for multidrug-resistant (MDR) TB. Preventing this amplification of resistance will likely improve clinical outcomes and delay the secondary spread of XDR-TB. Objectives: To measure the proportion of individuals that develops XDR-TB during the course of MDR-TB treatment, and to identify those factors associated with the development of XDR. Methods: We performed a retrospective analysis of 608 consecutive patients with documented MDR-TB who were started on MDR-TB treatment between September 10, 2000 and November 1, 2004 in the Tomsk Oblast TB Treatment Services in Western Siberia, Russian Federation. Measurements and Main Results: A total of 6% of patients were observed to develop XDR-TB while on MDR-TB treatment. These patients were significantly less likely to be cured or to complete treatment. Using Cox proportional hazardmodels,we found that the presenceof bilateral andcavitary lesionswas associatedwithagreater than threefold increase in hazard (adjusted hazard ratio [HR], 3.47; 95%confidence interval [CI], 1.32-9.14). Prior exposure to a secondline injectable antibiotic was associatedwith a greater than threefold increase in hazard (adjusted HR, 3.65; 95% CI, 1.81-7.37), and each additionalmonth inwhich a patient failed to take at least 80%of their prescribeddrugswasassociatedwithnearlyanadditional20%hazard of developing XDR-TB (adjusted HR, 1.17; 95%CI, 1.01-1.35). Conclusions: Early and rapid diagnosis, timely initiation of appropriate therapy, and programmatic efforts to optimize treatment adherence during MDR-TB therapy are crucial to avoiding the generation of excess XDR-TB in MDR-TB treatment programs."									
547	Adverse effects of highly active antiretroviral therapy in developing countries.	"Subbaraman R, Chaguturu SK, Mayer KH, Flanigan TP, Kumarasamy N."	Clinical Infectious Diseases. 2007;45(8):1093-101.		"Recent increases in access to highly active antiretroviral therapy (HAART) have made the management of drug toxicities an increasingly crucial component of human immunodeficiency virus (HIV) care in developing countries. The spectrum of adverse effects related to HAART in developing countries may differ from that in developed countries because of the high prevalence of conditions such as anemia, malnutrition, and tuberculosis and frequent initial presentation with advanced HIV disease. The severity of adverse effects may vary as a result of host genetics and diagnostic delays attributable to inadequate laboratory monitoring. This article reviews current knowledge about toxicities related to HAART in resource-limited regions, which are in the process of rapid treatment scale-up. We conclude that initiating HAART before advanced immunosuppression, titrating doses in single-pill drug combinations to differences in patients' body weights, providing more intensive laboratory monitoring during the initial months of therapy, and providing access to less-toxic nucleoside reverse-transcriptase inhibitors may decrease the incidence of toxicities related to HAART in resource-limited regions. 2007 by the Infectious Diseases Society of America. All rights reserved."									
290	"Low levels of pyrazinamide and ethambutol in children with tuberculosis and impact of age, nutritional status, and human immunodeficiency virus infection."	"Graham SM, Bell DJ, Nyirongo S, Hartkoorn R, Ward SA, Molyneux EM."	Antimicrobial Agents and Chemotherapy. 2006;50(2):407-13.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20063040353	"Recent pharmacokinetic studies that included children found that serum drug levels were low compared to those of adults for whom the same dosages were used. This study aimed to characterize the pharmacokinetics of pyrazinamide and ethambutol in Malawian children and to examine the impact of age, nutritional status, and human immunodeficiency virus (HIV) infection. We conducted a pharmacokinetic study of children treated for tuberculosis with thrice-weekly pyrazinamide (n=27; mean age, 5.7 years) and of a separate group of children treated with thrice-weekly ethambutol (n=18; mean age, 5.5 years) as portions of tablets according to national guidelines. Malnutrition and HIV infection were common in both groups. Blood samples were taken just prior to oral administration of the first dose, and subsequent samples were taken at intervals of 2, 3, 4, 7, 24, and 48 h after drug administration. Serum drug levels were low in all children for both drugs; in almost all cases, the maximum concentration of the drug in serum (C<sub>max</sub>) failed to reach the MIC for Mycobacterium tuberculosis. The C<sub>max</sub> of pyrazinamide was significantly lower in younger children (<5 years) than in older children. The C<sub>max</sub> of pyrazinamide was also lower for HIV-infected children and children with severe malnutrition, but these differences did not reach statistical significance. No differences were found for ethambutol in relation to age, HIV infection, or malnutrition, but the C<sub>max</sub> was <2 mg/liter in all cases. Studies of pharmacokinetic parameters and clinical outcomes obtained by using higher dosages of drugs for treatment of childhood tuberculosis are needed, and recommended dosages may need to be increased."									
1212	Beneficial effects of nandrolone decanoate in wasting associated with HIV.	"Bibhuti S, Rajadhyaksha GC, Ray SK."	Journal of the Indian Medical Association. 2009;107(5):295-9.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20093270414	"Recent studies have demonstrated the role of nandrolone decanoate (ND) in reversal of wasting associated with HIV infection. However, such studies in Indian scenario are lacking. Hence, the present study was planned with an objective to assess the effect of ND in patients of HIV-associated wasting in Indian subjects. The study was a prospective, randomised, multicentric, open labelled and comparative one in male HIV-infected subjects, aged between 18 and 65 years with involuntary weight loss of 10% over 12 months or 7.5% over 6 months or 5% over 3 months. The subjects were on stable antiretroviral therapy including at least 2 agents with CD<sub>4</sub> count >=50 cells/ micro l. In the treatment group, ND (150 mg) intramuscularly every 2 weeks for 12 weeks was administered according to randomisation. Fat-free mass (FFM), body weight, CD<sub>4</sub> count, and patient perception of treatment were the main outcomes measures. Of the 73 enrolled subjects, 69 completed study duration of 12 weeks. Compared to baseline, ND treated group demonstrated significant increase in FFM (0.49+or-1.26 kg; p<0.01) and body weight (1.31+or-1.87 kg; p<0.01) and control group demonstrated significant increase in body weight (0.99+or-1.48 kg; p<0.01) at the end of treatment period. Compared to control group, patient perception of benefit and subjective recovery of symptoms was significantly (p<.0001) greater in the ND group. None of the patients had any clinically significant deterioration of biochemical as well as laboratory safety parameters. Nandrolone was well tolerated with few reported adverse events of mild and non-serious in nature. Nandrolone improved patient perception of benefit and subjective recovery of symptoms in wasting associated HIV. Nandrolone therapy may prove to be effective and safe in reversing wasting associated with Indian HIV patients on antiretroviral therapy (ART) and nutritional replacement."									
1213	Beneficial effects of nandrolone decanoate in wasting associated with HIV.	"Saha B, Rajadhyaksha GC, Ray SK."	Journal of the Indian Medical Association. 2009;107(5):295-9.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=19886384	"Recent studies have demonstrated the role of nandrolone decanoate (ND) in reversal of wasting associated with HIV infection. However, such studies in Indian scenario are lacking. Hence, the present study was planned with an objective to assess the effect of ND in patients of HIV-associated wasting in Indian subjects. The study was a prospective, randomised, multicentric, open labelled and comparative one in male HIV-infected subjects, aged between 18 and 65 years with involuntary weight loss of 10% over 12 months or 7.5% over 6 months or 5% over 3 months. The subjects were on stable antiretroviral therapy including at least 2 agents with CD, count > or =50 cells/microl. In the treatment group, ND (150 mg) intramuscularly every 2 weeks for 12 weeks was administered according to randomisation. Fat-free mass (FFM), body weight, CD4 count, and patient perception of treatment were the main outcomes measures. Of the 73 enrolled subjects, 69 completed study duration of 12 weeks. Compared to baseline, ND treated group demonstrated significant increase in FFM (0.49 +/- 1.26 kg; p < 0.01) and body weight (1.31 +/- 1.87 kg; p < 0.01) and control group demonstrated significant increase in body weight (0.99 +/- 1.48 kg; p < 0.01) at the end of treatment period. Compared to control group, patient perception of benefit and subjective recovery of symptoms was significantly (p < .0001) greater in the ND group. None of the patients had any clinically significant deterioration of biochemical as well as laboratory safety parameters. Nandrolone was well tolerated with few reported adverse events of mild and non-serious in nature. Nandrolone improved patient perception of benefit and subjective recovery of symptoms in wasting associated HIV. Nandrolone therapy may prove to be effective and safe in reversing wasting associated with Indian HIV patients on antiretroviral therapy (ART) and nutritional replacement."									
53	Possible benefits of micronutrient supplementation in the treatment and management of HIV infection and AIDS.	"Oguntibeju OO, Esterhuyse AJ, Truter EJ."	African Journal of Pharmacy and Pharmacology. 2009 September;3(9):404-12.		"Recently, several reports have indicated that individuals living with HIV/AIDS undergo a condition of chronic oxidative stress with a resultant decline in nutritional antioxidants and other micronutrients. It has also been reported that these micronutrient deficiencies interfere with immune functions, weaken epithelial integrity, contribute to oxidative stress and enhance HIV disease progression. Reports from observational studies have led to an increasing interest in the possible benefits of micronutrient supplementation as a cost-effective strategy for improving oxidative and nutritional status. Micronutrient supplementation may also assist in the possible prevention of vertical transmission of HIV from mother to child especially in low-income countries where antiretroviral therapy and prophylactic drugs are not readily available. However, there are conflicting reports from other observational studies as to the usefulness or benefits of micronutrient supplementation in the treatment and management of HIV/AIDS. In this review we examine possible benefits of micronutrient supplementation in the treatment and management of HIV infection and AIDS. 2009 Academic Journals."									
1087	"Perceptions about probiotic yogurt for health and nutrition in the context of HIV/AIDS in Mwanza, Tanzania."	"Whaling MA, Luginaah I, Reid G, Hekmat S, Thind A, Mwanga J, Changalucha J."	"Journal of Health, Population & Nutrition. 2012;30(1):31-40."	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=22524117	"Recently, the food and malnutrition issues have taken centre stage within the arena of HIV/AIDS epidemic, with several calls being made for context-specific health and nutrition interventions to deal with the emerging food insecurity and malnutrition issues in settings with high burdens of HIV/AIDS. The use of probiotics as nutritional supplements in HIV/AIDS-affected and resource-poor settings has also been advocated. This paper presents the results of a qualitative study on community knowledge and perceptions about probiotics and their potential impact on people's everyday life in the context of the HIV/AIDS epidemic. In-depth interviews (n=26) were conducted with residents in Mwanza, Tanzania. The results showed that people living with HIV/AIDS, who were using probiotic yogurt produced through a joint partnership of Western Heads East, Tanzania Medical Research Institute and the Tukwamune Women's Group, reported perceived beneficial effects, such as gain in weight and improved health and well-being. Yet, these beneficial effects might be resulting in growing misconceptions about probiotic yogurt being 'medicine' for the treatment of HIV/AIDS; this is leading some people living with HIV/AIDS to abandon taking their antiretroviral medications based on the view that the probiotic yogurt is making them feel much better. The findings illustrate the potential challenges with regard to the introduction of nutritional food supplements into new contexts plagued by malnutrition and infectious diseases. Public-health education and awareness programmes are needed when introducing novel foods into such contexts."									
495	Recurrent pneumonia mortality risk in a HIV/AIDS Puerto Rican cohort. (Special issue. Biomedical research on health disparities. Part IV).	"Mayor AM, Gomez MA, Rios E, Hunter RF."	Cellular and Molecular Biology. 2003;49(8):1199-204.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh3&AN=20043030369	"Recurrent pneumonia (RP) within 12 months is one of the AIDS diagnosis criteria. To gain knowledge of RP infection in HIV-infected patients, we studied 145 RP cases detected in a cohort of 2,996 HIV patients in Puerto Rico between Jan. 1992-Dec. 2001. The RP prevalence was 4.8%; 77.2% were males and 62.1% were injecting drug users (IDU). At the time of RP diagnosis, the mean CD4<sup>+</sup> T cell count was 93.8 cells/mm<sup>3</sup>, 59.3% were in antiretroviral treatment, 13% had received the pneumococcal vaccine and 84.8% had another AIDS related condition. Over 37% received two or more antiretroviral medications. The death rate in the first year after the RP diagnosis was 63.4%. A Cox proportional hazard analysis showed that CD4<sup>+</sup> T cells <200/mm<sup>3</sup> (p<0.05), history of toxoplasmosis (p<0.01), wasting syndrome (p<0.01), esophageal candidiasis (p<0.05) and lower number of antiretroviral medications (p<0.05) increased their mortality risk. The studied patients had a highly compromised immune system and a very low pneumococcal vaccination percent at the time of RP diagnosis. Low CD4<sup>+</sup> T cells significantly increased the hazard and mortality risk of the cases studied. Antecedents of antiretroviral therapy in these patients ensure a better outcome with lower mortality. Efforts to increase the vaccination rate should reduce the RP incidence in our HIV-infected population."									
915	Prevention of HIV-associated respiratory illness in children in developing countries: potential benefits.	Zar HJ.	International Journal of Tuberculosis & Lung Disease. 2003;7(9):820-7.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=12971664	"Respiratory disease accounts for a substantial proportion of illness in human immunodeficiency virus-infected children. A number of interventions are available to prevent respiratory complications; these interventions may be beneficial especially in low-income countries where the burden of human immunodeficiency virus and infectious diseases are high and where antiretroviral therapy is unavailable or unaffordable. This article reviews the potential benefits and risks for interventions that are available to prevent respiratory complications including chemoprophylaxis for Pneumocystis carinii pneumonia and tuberculosis, use of immunisation for prevention of specific respiratory infections and non-specific measures including nutrition and micronutrient supplementation. [References: 68]"									
1703	"Factors associated with survival of patients with tuberculosis in Lima, Peru. [Spanish]"	"Factores asociados a supervivencia en pacientes con tuberculosis en Lima, Peru."	Bernabe-Ortiz A.		Revista Chilena de Infectologia. 2008 April;25(2):104-7.									
1713	Validation of methods for estimating HIV/AIDS patients' body fat. [Portuguese]	Validaccao de metodos de estimativa da gordura corporal em portadores do HIV/Aids.	"Florindo AA, de Oliveira Latorre MdD, Morandi dos Santos EC, Borelli A, de Souza Rocha M, Segurado AAC."		Revista de Saude Publica. 2004 October;38(5):643-9.									
1720	Mechanisms and causes of death in 143 vietnamese VIH-infected patients hospitalized for tuberculosis. [French]	Evolutions fatales chez les patients vietnamiens co-infectes par le virus VIH et la tuberculose BAAR (+) au cours ou au decours immediat de leur hospitalisation.	"Ngo AT, Duc NH, Lan NH, Maynart M, Mayaud C, Quy TH."		Revue de Pneumologie Clinique. 2007 June;63(3):139-46.									
1722	Aetiology of AFB negative pneumonias in hospitalized HIV patients in Dakar. [French]	Etiologie des pneumonies BAAR negatives chez les patients infectes par le VIH hospitalises a Dakar (etude ANRS 1260).	"Sire JM, Sow PS, Chartier L, Ndiaye B, Ndaye M, Sarr FD, Vray M, et al."		Revue des Maladies Respiratoires. 2010 November;27(9):1015-21.									
1724	Nutritional supplementation in children and adolescents practicing fencing. [Polish]	Wspomaganie zywieniowe wsrod dzieci i mlodziezy uprawiajacych szermierke.	"Chalcarz W, Radzimirska-Graczyk M."		Roczniki Panstwowego Zakladu Higieny. 2009;60(4):357-60.									
145	"Safer sexual behaviors after 12 months of antiretroviral treatment in Mombasa, Kenya: A prospective cohort."	"Luchters S, Sarna A, Geibel S, Chersich MF, Munyao P, Kaai S, Mandaliya KN, et al."	AIDS Patient Care and STDs. 2008 01 Jul;22(7):587-94.		"Roll-out of antiretroviral treatment (ART) raises concerns about the potential for unprotected sex if sexual activity increases with well-being, resulting in continued HIV spread. Beliefs about reduced risk for HIV transmission with ART may also influence behavior. From September 2003 to November 2004, 234 adults enrolled in a trial assessing the efficacy of modified directly observed therapy in improving adherence to ART. Unsafe sexual behavior (unprotected sex with an HIV-negative or unknown status partner) before starting ART and 12 months thereafter was compared. Participants were a mean 37.2 years (standard deviation [SD} = 7.9 years) and 64% (149/234) were female. Nearly half (107/225) were sexually active in the 12 months prior to ART, the majority (96/107) reporting one sexual partner. Unsafe sex was reported by half of those sexually active in the 12 months before ART (54/107), while after 12 months ART, this reduced to 28% (30/107). Unsafe sex was associated with nondisclosure of HIV status to partner; recent HIV diagnosis; not being married or cohabiting; stigma; depression and body mass index <18.5kg/m<sup>2</sup>. ART beliefs, adherence, and viral suppression were not associated with unsafe sex. After adjusting for gender and stigma, unsafe sex was 0.59 times less likely after 12 months ART than before initiation (95% confidence interval [CI] = 0.37-0.94; p = 0.026). In conclusion, although risky sexual behaviors had decreased, a considerable portion do not practice safe sex. Beliefs about ART's effect on transmission, viral load, and adherence appear not to influence sexual behavior but require long-term surveillance. Positive prevention interventions for those receiving ART must reinforce safer sex practices and partner disclosure. 2008 Mary Ann Liebert, Inc."									
620	"Dietary patterns, nutrient intake, and sociodemographic characteristics in HIV-infected Tanzanian pregnant women.[Erratum appears in Ecol Food Nutr. 2013;52(3):266 Note: Spiegleman, Donna [corrected to Spiegelman, Donna]]."	"Lukmanji Z, Hertzmark E, Spiegelman D, Fawzi WW."	Ecology of Food & Nutrition. 2013;52(1):34-62.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medc&AN=23282190	"Routinely collected dietary intakes were available for 925 HIV-infected pregnant women participating in a longitudinal clinical trial of vitamin supplementation in Dar es Salaam, Tanzania. Information on sociodemographic and economic characteristics was recorded. Dietary macronutrient intakes were computed and analyzed using the Tanzania Food Composition Tables. Women's age, parity, education level, and economic independence were positively related to diet intake. Women younger than 25 years were at highest risk of inadequate food and nutrient intake. By World Health Organization recommendations, almost two-thirds of the participants were energy deficient, and nearly half were protein deficient."									
621	"Dietary patterns, nutrient intake, and sociodemographic characteristics in HIV-infected Tanzanian pregnant women."	"Lukmanji Z, Hertzmark E, Spiegleman D, Fawzi WW."	Ecology of Food & Nutrition. 2013;52(1):34-62.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=23282190	"Routinely collected dietary intakes were available for 925 HIV-infected pregnant women participating in a longitudinal clinical trial of vitamin supplementation in Dar es Salaam, Tanzania. Information on sociodemographic and economic characteristics was recorded. Dietary macronutrient intakes were computed and analyzed using the Tanzania Food Composition Tables. Women's age, parity, education level, and economic independence were positively related to diet intake. Women younger than 25 years were at highest risk of inadequate food and nutrient intake. By World Health Organization recommendations, almost two-thirds of the participants were energy deficient, and nearly half were protein deficient."									
1754	Vitamin A deficiency: epidemiological aspects and control methods. [French]	Le deficit en vitamine A: aspects epidemiologiques et methodes de controle.	"Ag Bendech M, Malvy DJ, Chauliac M."		"Sante (Montrouge, France). 1997 1997;7(5):309-16."									
1755	Prevention of wasting and opportunistic infections in HIV-infected patients in West Africa: a realistic and necessary strategy before antiretroviral treatment. [French]	"Prevention de la denutrition et des infections opportunistes chez lespatients infectes par le VIH en Afrique de l'Ouest: une demarche realiste, necessaire, prealabe aux antiretroviraux."	"Ledru e, Sanou PT, Dembele M, Dahourou H, Zoubga A, Durand G."		"Sante (Montrouge, France). 1999 1999;9(5):293-300."									
254	Expanding an electronic medical record to support community health worker and nutritional support programs in rural Rwanda.	"Allen C, Manyika P, Ufitamahoro E, Musabende A, Rich M, Jazayeri D, Fraser H."	AMIA 2007;Annual Symposium Proceedings/AMIA Symposium.:860.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=18693962	"Scaling up HIV and TB treatment rapidly in a resource poor setting is greatly facilitated when community health workers can monitor patient well-being and ensure that patients adhere to medication. In addition, it is almost essential that patients receive a food package while being treated for HIV and TB, since medication can be ineffective if patient is undernourished. However,a community health worker program and food program can add significant administrative overhead,particularly if reporting or evaluation is required. By expanding an Electronic Medical Record to cover these programs in addition to treatment programs, it becomes easier to administer them and combine interesting data from different sources."									
1768	"Inguinal swelling: Pressure-dolent, overheated - A case report. [German]"	"Inguinale schwellung: Druckdolent, uberwarmt - 66-Jahriger patient, rentner in Portugal."	"V VO, Hess C."		Schweizerische Rundschau fur Medizin - Praxis. 2006 22 Nov;95(47):1845-7.									
1144	Selenium status is associated with accelerated HIV disease progression among HIV-1-infected pregnant women in Tanzania.	"Kupka R, Msamanga GI, Spiegelman D, Morris S, Mugusi F, Hunter DJ, Fawzi WW."	Journal of Nutrition. 2004 October;134(10):2556-60.		"Selenium deficiency has been implicated in accelerated disease progression and poorer survival among populations infected with HIV in developed countries, yet these associations remain unexamined in developing countries. Among 949 HIV-1-infected Tanzanian women who were pregnant, we prospectively examined the association between plasma selenium levels and survival and CD4 counts over time. Over the 5.7-y median follow-up time, 306 of 949 women died. In a Cox multivariate model, lower plasma selenium levels were significantly associated with an increased risk of mortality (P-value, test for trend = 0.01). Each 0.1 mumol/L increase in plasma selenium levels was related to a 5% (95% Cl = 0%-9%) decreased risk of mortality. Plasma selenium levels were not associated with time to progression to CD4 cell count < 200 cells/mm<sup>3</sup> but were weakly and positively related to CD4 cell count in the first years of follow up. Selenium status may be important for clinical outcomes related to HIV disease in sub-Saharan Africa."									
17	"Selenium status, kwashiorkor and congestive heart failure."	"Manary MJ, MacPherson GD, McArdle F, Jackson MJ, Hart CA."	Acta Paediatrica. 2001;90(8):950-2.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh3&AN=20013115028	"Selenium deficiency is associated with congestive heart failure (CHF) in geographic areas where dietary selenium intake is low and in individuals receiving total parenteral nutrition. In Malawi, among 66 children with kwashiorkor (including marasmic-kwashiorkor), those who developed CHF had lower serum selenium concentrations than those who did not (32.9+or-8.3 vs 41.1+or-11.9 micro g/litre, mean +or-SD, p=0.03). This association was independent of serum albumin and selenium status was not associated with severity of symptoms, anthropometric indices or HIV infection. This association raises the possibility that selenium may contribute to CHF in kwashiorkor."									
531	Effect of selenium supplements on hemoglobin concentration and morbidity among HIV-1-infected Tanzanian women.	"Kupka R, Mugusi F, Aboud S, Hertzmark E, Spiegelman D, Fawzi WW."	Clinical Infectious Diseases. 2009;48(10):1475-8.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=19368503	"Selenium deficiency may increase risks of anemia and morbidity among people with human immunodeficiency virus infection. We therefore investigated the effect of selenium supplements (200 microg of selenomethionine) on these end points among 915 pregnant Tanzanian women. Hemoglobin concentration was measured at baseline (at 12-27 weeks of gestation) and at 6 weeks and 6 months postpartum, and morbidity data were collected during monthly visits to the clinic. Selenium supplements had no effect on hemoglobin concentrations during follow-up (mean difference, 0.05 g/dL; 95% confidence interval, -0.07 to 0.16 g/dL) but reduced diarrheal morbidity risk by 40% (relative risk, 0.60; 95% confidence interval, 0.42-0.84). There was no effect on the other morbidity end points."									
22	The facts and controversies about selenium.	"Dodig S, Cepelak I."	Acta Pharmaceutica. 2004;54(4):261-76.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=15634611	"Selenium is a trace element, essential in small amounts, but it can be toxic in larger amounts. Levels in the body are mainly dependent on the amount of selenium in the diet, which is a function of the selenium content of the soil. Humans and animals require selenium for normal functioning of more than about 30 known selenoproteins, of which approximately 15 have been purified to allow characterisation of their biological functions. Selenoproteins are comprised of four glutathione peroxidases, three iodothyronine deiodinases, three thioredoxin reductases, selenoprotein P, selenoprotein W and selenophosphate synthetase. Selenium is essential for normal functioning of the immune system and thyroid gland, making selenium an essential element for normal development, growth, metabolism, and defense of the body. Supportive function of selenium in health and disease (male infertility, viral infections, including HIV, cancer, cardiovascular and autoimmune diseases) is documented in great number of clinical examinations. A great number of studies confirm that selenium supplementation plays a preventive and therapeutical role in different diseases. Definitive evidence regarding the preventive and therapeutical role of selenium as well as the exact mechanism of its action should be investigated in further studies. Investigations in Croatia indicate a possibility of inadequate selenium status of people in the area. [References: 88]"									
930	"Vitamin A status of patients presenting with pulmonary tuberculosis and asymptomatic HIV-infected individuals, Dar es Salaam, Tanzania."	"Mugusi FM, Rusizoka O, Habib N, Fawzi W."	International Journal of Tuberculosis and Lung Disease. 2003;7(8):804-7.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh3&AN=20033146584	"Serum vitamin A was determined in a cross-sectional study of 100 HIV-positive and -negative tuberculosis patients and 144 blood donors. The study was conducted at Muhimbili Medical Centre, Tanzania during July-December 1997. Tuberculosis patients were seen again after 2 months of treatment. Mean vitamin A was lowest among tuberculosis patients co-infected with HIV, and was lower among HIV-positive than -negative donors. Mean vitamin A rose significantly at 2 months in HIV-negative patients, and not in -positive patients. HIV infection was the strongest predictor of low vitamin A. Vitamin A deficiency is common in tuberculosis and HIV infection, particularly in those patients who are dually infected, and nutritional supplementation may be beneficial."									
922	Clinical presentation and outcome of tuberculosis patients infected by M. africanum versus M. tuberculosis.	"De Jong BC, Hill PC, Aiken A, Jeffries DJ, Onipede A, Small PM, Adegbola RA, et al."	International Journal of Tuberculosis and Lung Disease. 2007 April;11(4):450-6.		"SETTING: A tuberculosis (TB) case contact study in the Gambia. OBJECTIVE: To test whether Mycobacterium africanum, which has lost around 68 kb compared with M. tuberculosis sensu stricto, causes less severe TB disease. DESIGN: We genotyped mycobacterial isolates and compared clinical and radiological characteristics as well as outcome data of M. africanum-infected TB patients with those infected with M. tuberculosis. RESULTS: Of 317 index cases, 301 had a mycobacterial isolate available, 290 of which had an interpretable spoligotype pattern. Of these, 110 isolates (38%) were M. africanum and 180 (62%) were M. tuberculosis. M. africanum cases had lower body mass indices (17 vs. 17.45 for M. tuberculosis-infected patients, P = 0.029) and their radiographic disease was more extensive (96% vs. 89% had at least moderately severe radiographic changes, P = 0.031). Outcome on treatment was similar (2.8% of human immunodeficiency virus [HIV] negative M. africanum patients died on treatment vs. 3.0% of M. tuberculosis patients, P = 0.95). CONCLUSION: M. africanum causes sputum smear-positive tuberculosis disease that is at least as severe as that caused by M. tuberculosis sensu stricto. Further clinical comparisons may be helpful in smear-negative patients and HIV-TB co-infected patients, and to identify whether there is any difference in time to develop disease. 2007 The Union."									
917	Tuberculosis and nutrition: Disease perceptions and health seeking behavior of household contacts in the Peruvian Amazon.	"Baldwin MR, Yori PP, Ford C, Moored DAJ, Gilman RH, Vidal C, Ticona E, et al."	International Journal of Tuberculosis and Lung Disease. 2004 December;8(12):1484-91.		"SETTING: Households of TB patients in the Peruvian Amazon. OBJECTIVE: To investigate how knowledge and beliefs of household contacts about TB affected health seeking behavior. DESIGN: Interviews with 73 patients finishing treatment and 79 of their adult household contacts. RESULTS: Contacts were knowledgeable about free screening and treatment, but contacts who noted weight loss, not cough, were more likely to be screened for TB (P = 0.03). Forty-two per cent reported that TB was prevented by nutrition, 28% by separating eating utensils, and only 19% by avoiding a coughing patient. Only one household contact reported being stigmatized. Stigma centered upon nutrition, and only 12% knew of the association between TB and HIV. Only 14% had a BMI <20, yet 30% reported regularly going to sleep hungry. Free food packages were reported to be the most important reason for treatment adherence by 33% of patients. CONCLUSION: Contacts misperceived TB as a nutritional disease and did not fear airborne transmission, which should be corrected by public health education. Weight loss, and not cough, led to screening. Stigma appeared to be minimized because risk was perceived as personal, through malnutrition, rather than exposure-based. Nutritional incentives that utilize these beliefs may reduce diagnostic delay and enhance treatment adherence."									
916	Tuberculosis and nutrition: disease perceptions and health seeking behavior of household contacts in the Peruvian Amazon.	"Baldwin MR, Yori PP, Ford C, Moore DAJ, Gilman RH, Vidal C, Ticona E, et al."	International Journal of Tuberculosis and Lung Disease. 2004;8(12):1484-91.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh3&AN=20053019023	"Setting: Households of tuberculosis (TB) patients in the Peruvian Amazon. Objective: To investigate how knowledge and beliefs of household contacts about TB affected health seeking behaviour. Design: Interviews with 73 patients finishing treatment and 79 of their adult household contacts. Results: Contacts were knowledgeable about free screening and treatment, but contacts who noted weight loss, not cough, were more likely to be screened for TB (P=0.03). 42% reported that TB was prevented by nutrition, 28% by separating eating utensils, and only 19% by avoiding a coughing patient. Only one household contact reported being stigmatized. Stigma centred upon nutrition, and only 12% knew of the association between TB and HIV. Only 14% had a BMI<20, yet 30% reported regularly going to sleep hungry. Free food packages were reported to be the most important reason for treatment adherence by 33% of patients. Conclusion: Contacts misperceived TB as a nutritional disease and did not fear airborne transmission, which should be corrected by public health education. Weight loss, and not cough, led to screening. Stigma appeared to be minimized because risk was perceived as personal, through malnutrition, rather than exposure-based. Nutritional incentives that utilize these beliefs may reduce diagnostic delay and enhance treatment adherence."									
931	Tuberculosis and human immunodeficiency virus co-infections and their predictors at a hospital-based HIV/AIDS clinic in Uganda.	"Nakanjako D, Mayanja-Kizza H, Ouma J, Wanyenze R, Mwesigire D, Namale A, Ssempiira J, et al."	International Journal of Tuberculosis and Lung Disease. 2010 December;14(12):1621-8.		"SETTING: Mulago Hospital, Uganda. OBJECTIVE: To evaluate the burden of TB-HIV (tuberculosis-human immunodeficiency virus) co-infections and their predictors in an urban hospital-based HIV programme. DESIGN: Prospective observational study. METHODS: Clinicians screened all patients with HIV/ AIDS (acquired immune-deficiency syndrome) for previous and current TB treatment at enrolment and throughout follow-up. RESULTS: Of 10 924 patients enrolled between August 2005 and February 2009, co-prevalent TB was 157/10 924 (1.4%), which included 88/157 (56%) with TB confirmed at enrolment and 65/157 (41%) with TB diagnoses established during follow-up in whom symptoms were present at enrolment. Male sex (adjusted odds ratio [aOR] 2.3, 95%CI 1.6-3.2) and body mass index (BMI) <=20 kg/m<sup>2</sup> (aOR 3.8, 95%CI 2.5-5.4) were associated with co-prevalent TB. Overall, 749/10 767 (7%) were diagnosed with incident TB at a higher rate among antiretroviral treatment (ART) patients (8/100 patient years of observation [PYO]) than non-ART patients (5/100 PYO, log rank P < 0.001). Female sex (adjusted hazard ratio [aHR] 1.4, 95%CI 1.2-1.7) and baseline BMI <= 20 (aHR 1.9, 95%CI 1.6-2.2) predicted incident TB. CONCLUSION: Routine TB screening in the HIV/AIDS care programme identified a significant number of TBHIV co-infections among patients with and without ART, and is therefore a potential strategy to improve HIV treatment outcomes in resource-limited settings. 2010 The Union."									
939	A simple screening tool for active tuberculosis in HIV-infected adults receiving antiretroviral treatment in Uganda.	"Were W, Moore D, Ekwaru P, Mwima G, Bunnell R, Kaharuza F, Rutherford G, et al."	International Journal of Tuberculosis and Lung Disease. 2009 January;13(1):47-53.		"SETTING: Reliable clinical algorithms that screen for active tuberculosis (TB) in human immunodeficiency virus (HIV) infected people initiating or receiving antiretroviral treatment (ART) in sub-Saharan Africa could reduce the need for diagnostic procedures. METHODS: We estimated the utility of six TB-related signs and symptoms, alone or in combination, compared with the Uganda Ministry of Health diagnostic guidelines for participants with prevalent (baseline), early ART (<=3 months on ART) and incident TB (>3 months on ART). RESULTS: Of 1995 participants screened for ART eligibility, 71 (3.6%) had prevalent TB. The presence of any one of the following: cough >=3 weeks, fever >=4 weeks, lymphadenopathy or baseline body mass index <=18 kg/m <sup>2</sup> had a sensitivity of 99% (95% CI 96-100), a specificity of 66% (95% CI 64-68) and a negative predictive value (NPV) of 100% (95% CI 99-100) for predicting active TB. During ART follow-up, TB incidence was 2.4 (95% CI 1.6-3.4)/100 person-years. The presence of cough >=3 weeks or general weakness was 100% sensitive (95% CI 99-100), 66% specific (95% CI 59-74) and had an NPV of 100% (95% CI 99-100). CONCLUSION: Use of a simple TB screening algorithm can accurately identify, in a resource-poor African setting, HIV-infected individuals who require further procedures to diagnose active TB. 2009 The Union."									
935	"Age, nutritional status and INH acetylator status affect pharmacokinetics of anti-tuberculosis drugs in children."	"Ramachandran G, Hemanth Kumar AK, Bhavani PK, Poorana Gangadevi N, Sekar L, Vijayasekaran D, Banu Rekha VV, et al."	International Journal of Tuberculosis and Lung Disease. 2013 01 Jun;17(6):800-6.		"SETTING: The currently recommended dosages of rifampicin (RMP), isoniazid (INH), pyrazinamide (PZA) and ethambutol in children are extrapolated from adult pharmacokinetic studies, and have not been adequately evaluated in children. OBJECTIVE: To describe the pharmacokinetics of RMP, INH and PZA given thrice weekly in children with tuberculosis (TB), and to relate pharmacokinetics to treatment outcomes. METHODS: Eighty-four human immunodeficiency virus negative children with TB aged 1-12 years in Chennai and Madurai, India, were recruited. Phenotypic INH acetylator status was determined. Nutritional status was assessed using Z scores. During the intensive phase of anti-tuberculosis treatment, a complete pharmacokinetic study was performed after directly observed administration of drugs. At 2 and 6 months, drug levels were measured 2 h post-dose. Drug concentrations were measured using high performance liquid chromatography and pharmacokinetic variables were calculated. Multi-variable regression analysis was performed to explore factors impacting drug levels and treatment outcomes. RESULTS AND CONCLUSIONS: Children aged <3 years had significantly lower RMP, INH and PZA concentrations than older children, and 90% of all children had sub-therapeutic RMP C<sub>max</sub> (<8 mug/ml). Age, nutritional status and INH acetylator status influenced drug levels. Peak RMP and INH concentrations were important determinants of treatment outcome. Recommendations for anti-tuberculosis treatment in children should take these factors into consideration. 2013 The Union."									
936	"Age, nutritional status and INH acetylator status affect pharmacokinetics of anti-tuberculosis drugs in children."	"Ramachandran G, Kumar AKH, Bhavani PK, Gangadevi NP, Sekar L, Vijayasekaran D, Rekha VVB, et al."	International Journal of Tuberculosis and Lung Disease. 2013;17(6):800-6.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20133229169	"SETTING: The currently recommended dosages of rifampicin (RMP), isoniazid (INH), pyrazinamide (PZA) and ethambutol in children are extrapolated from adult pharmacokinetic studies, and have not been adequately evaluated in children. OBJECTIVE: To describe the pharmacokinetics of RMP, INH and PZA given thrice weekly in children with tuberculosis (TB), and to relate pharmacokinetics to treatment outcomes. METHODS: Eighty-four human immunodeficiency virus negative children with TB aged 1-12 years in Chennai and Madurai, India, were recruited. Phenotypic INH acetylator status was determined. Nutritional status was assessed using Z scores. During the intensive phase of anti-tuberculosis treatment, a complete pharmacokinetic study was performed after directly observed administration of drugs. At 2 and 6 months, drug levels were measured 2 h post-dose. Drug concentrations were measured using high performance liquid chromatography and pharmacokinetic variables were calculated. Multivariable regression analysis was performed to explore factors impacting drug levels and treatment outcomes. RESULTS AND CONCLUSIONS: Children aged <3 years had significantly lower RMP, INH and PZA concentrations than older children, and 90% of all children had sub-therapeutic RMP C<sub>max</sub> (<8 micro g/ml). Age, nutritional status and INH acetylator status influenced drug levels. Peak RMP and INH concentrations were important determinants of treatment outcome. Recommendations for anti-tuberculosis treatment in children should take these factors into consideration."									
909	A critical review of diagnostic approaches used in the diagnosis of childhood tuberculosis.	"Hesseling AC, Schaaf HS, Gie RP, Starke JR, Beyers N."	International Journal of Tuberculosis & Lung Disease. 2002;6(12):1038-45.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=12546110	"SETTING: The diagnosis of tuberculosis (TB) in children is seldom confirmed, and is based mainly on clinical signs, symptoms and special investigations. Various attempts in the form of diagnostic approaches have been made to rationalise this diagnostic process."	AIMS: To review and describe published diagnostic approaches aimed at diagnosing mainly intrathoracic tuberculosis in children in developing countries; to compare diagnostic approaches with each other and with bacteriologically confirmed TB; and to describe modifications to the diagnosis of TB in HIV-infected or malnourished children.	"METHODS: Literature review classified into 1) diagnostic approaches, 2) characteristics used in diagnostic approaches, and 3) studies done to validate diagnostic approaches."	"RESULTS: Sixteen systems were analysed. Comparison of systems is difficult because characteristic definitions and the ranking of characteristics are not standardised, few studies have been performed to validate these diagnostic approaches, and the gold standard of diagnosis is not practicable in most settings. The minority of systems are adapted for HIV-infected and malnourished patients."	"RECOMMENDATIONS: Characteristic definitions and ranking of characteristics should be standardised. Any new diagnostic approaches developed should be relevant to developing countries with limited resources, a high burden of tuberculosis, malnutrition and HIV/AIDS and a young population. Studies done to validate diagnostic approaches should be conducted scientifically. [References: 46]"					
924	A randomised controlled trial of oral zinc on the immune response to tuberculosis in HIV-infected patients.	"Green JA, Lewin SR, Wightman F, Lee M, Ravindran S, Paton NI."	International Journal of Tuberculosis and Lung Disease. 2005;9(12):1378-84.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20063060557	"SETTING: The National HIV Unit, Singapore. OBJECTIVE: To test whether zinc supplementation improves the immune response to tuberculosis in HIV-positive patients. DESIGN: A double-blind, randomised, placebo-controlled trial of 28 days of oral zinc sulphate (50 mg of elemental zinc) or placebo in stable adult HIV-positive patients receiving antiretroviral therapy with a CD4 count <200 cells/ micro l. METHODS: IFN- gamma response to mycobacterial antigen stimulation, CD4/8 cell count, lymphocyte subsets, T-cell receptor excision circle (TREC) levels and viral load were measured at baseline and day 28. RESULTS: Thirty-two patients received zinc and 34 placebo. There was no significant change in the IFN- gamma response to human PPD stimulation in the zinc or placebo groups (placebo baseline: 0.42+or-1.03, day 28: 0.84+or-1.21 IU/ml, zinc baseline: 1.26+or-2.41, day 28: 1.39+or-1.88 IU/ml, P=0.31 between groups), nor any of the other mycobacterial antigens tested. There were no changes in absolute CD4/8 cell levels or other lymphocyte subsets, TREC or viral load. Baseline zinc levels were normal in 62/66 (93.9%) patients. CONCLUSIONS: We found no evidence for recommending pharmacological supplementation with oral zinc in HIV-positive patients without zinc deficiency."									
912	The Innovative Socio-economic Interventions Against Tuberculosis (ISIAT) project: an operational assessment.	"Rocha C, Montoya R, Zevallos K, Curatola A, Ynga W, Franco J, Fernandez F, et al."	International Journal of Tuberculosis & Lung Disease. 2011;15 Suppl 2:S50-7.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=21740659	"SETTING: Tuberculosis (TB) affected households in impoverished shantytowns, Lima, Peru."	OBJECTIVE: To evaluate socio-economic interventions for strengthening TB control by improving uptake of TB care and prevention services.	"DESIGN: Barriers to TB control were characterised by interviews with TB-affected families. To reduce these barriers, a multidisciplinary team offered integrated community and household socio-economic interventions aiming to: 1) enhance uptake of TB care by education, community mobilisation and psychosocial support; and 2) reduce poverty through food and cash transfers, microcredit, microenterprise and vocational training. An interim analysis was performed after the socio-economic interventions had been provided for 2078 people in 311 households of newly diagnosed TB patients for up to 34 months."	"RESULTS: Poverty (46% earned <US$1 per day), depression (40%), stigmatisation (77%), and perceived isolation (39%) were common among TB patients (all P < 0.05 vs. non-patients). The project had 100% recruitment, and involved 97% of TB-affected households in regular visits, 71% in community groups, 78% in psychosocial support and 77% in poverty-reduction interventions. The socio-economic interventions were associated with increases in household contact TB screening (from 82% to 96%); successful TB treatment completion (from 91% to 97%); patient human immunodeficiency virus testing (from 31% to 97%); and completion of preventive therapy (from 27% to 87%; all P < 0.0001)."	CONCLUSIONS: Socio-economic interventions can strengthen TB control activities.	KEYWORDS: tuberculosis; control; microcredit; poverty;social determinants.				
913	"Anemia in adults with tuberculosis is associated with HIV and anthropometric status in Dar es Salaam, Tanzania."	"Saathoff E, Villamor E, Mugusi F, Bosch RJ, Urassa W, Fawzi WW."	International Journal of Tuberculosis & Lung Disease. 2011;15(7):925-32.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=21682966	"SETTING: Tuberculosis (TB) infected adults attending out-patient TB clinics in Dar es Salaam, Tanzania."	"OBJECTIVE: To examine the association of anemia with human immunodeficiency virus (HIV) co-infection, indicators of socio-economic status (SES) and anthropometric status in TB-infected adults."	DESIGN: Cross-sectional data collection during screening for a clinical trial.	"RESULTS: Overall, 750 females and 1693 males participated in this study, of whom respectively 49% and 24% were co-infected with HIV-1. Hemoglobin levels were significantly lower in females than in males and in HIV-positive than in HIV-negative participants. HIV co-infection in this antiretroviral-naive population was also associated with severe anemia (hemoglobin < 85 g/l) in both women (prevalence ratio [PR] = 2.07, 95%CI 1.65-2.59) and men (PR 3.45, 95%CI 2.66-4.47). Although severe anemia was negatively associated with indicators of SES, especially in males, adjustment for SES indicators only marginally changed its association with HIV co-infection. In both sexes, anemia was inversely associated with anthropometric status, independently of HIV infection and SES."	"CONCLUSION: Among TB-infected adults, anemia is strongly associated with HIV co-infection and anthropometric status, independently of SES indicators. As anemia is a risk factor for morbidity and mortality in both infections, the management of anemia in TB-HIV co-infected patients warrants special attention."					
908	"Pulmonary tuberculosis among patients visiting a voluntary confidential counseling and testing center, Cambodia."	"Chheng P, Tamhane A, Natpratan C, Tan V, Lay V, Sar B, Kimerling ME."	International Journal of Tuberculosis & Lung Disease. 2008;12(3 Suppl 1):54-62.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=18302824	"SETTING: Voluntary counseling and confidential testing center (VCCT), Battambang District, Cambodia."	"OBJECTIVES: To determine newly diagnosed pulmonary tuberculosis (PTB) prevalence and predicting factors, and assess the utility of TB-related symptoms and yield of sputum microscopy and culture."	"DESIGN: Cross-sectional survey using interview, sputum smears and cultures and human immunodeficiency virus (HIV) testing."	"RESULTS: Of 496 participants, 29 (5.8%) had culture-confirmed PTB while 19 (65.5%) were acid-fast bacilli (AFB) smear-positive. PTB prevalence was higher (P < 0.001) in HIV-positives (20/124, 16.1%) than in HIV-negatives (9/372, 2.4%). On multivariable analysis, being HIV-positive, underweight (body mass index <18.5 kg/m(2)), rapid weight loss and age > or =35 years were predictors of PTB. Fever (93%) and hemoptysis (86%) had the highest sensitivity and specificity, respectively. The symptom complex of rapid weight loss, fever and hemoptysis detected all PTB cases (sensitivity 100%). Examination of three sputum smears with culture of the first sample detected 95% (19/20) of the HIV-associated PTB cases and 90% (26/29) overall."	"CONCLUSIONS: TB is common in the VCCT setting, regardless of HIV status. The high prevalence of HIV and PTB among the participants warrants consideration of TB screening for all HIV suspects. Such screening through VCCT is feasible. Adding a single culture test to the evaluation of an initial sputum sample set will substantially increase case detection."					
921	"Pulmonary tuberculosis among patients visiting a voluntary confidential counseling and testing center, Cambodia. (Special Issue: Monitoring and evaluation of TB-HIV collaboration.)."	"Chheng P, Tamhane A, Natpratan C, Tan V, Lay V, Sar B, Kimerling ME."	International Journal of Tuberculosis and Lung Disease. 2008;12(3 Suppl.1):S54-S62.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20083082391	"SETTING: Voluntary counseling and confidential testing center (VCCT), Battambang District, Cambodia. OBJECTIVES: To determine newly diagnosed pulmonary tuberculosis (PTB) prevalence and predicting factors, and assess the utility of TB-related symptoms and yield of sputum microscopy and culture. DESIGN: Cross-sectional survey using interview, sputum smears and cultures and human immunodeficiency virus (HIV) testing. RESULTS: Of 496 participants, 29 (5.8%) had culture-confirmed PTB while 19 (65.5%) were acid-fast bacilli (AFB) smear-positive. PTB prevalence was higher (P<0.001) in HIV-positives (20/124, 16.1%) than in HIV-negatives (9/372, 2.4%). On multivariable analysis, being HIV-positive, underweight (body mass index <18.5 kg/m<sup>2</sup>), rapid weight loss and age >=35 years were predictors of PTB. Fever (93%) and hemoptysis (86%) had the highest sensitivity and specificity, respectively. The symptom complex of rapid weight loss, fever and hemoptysis detected all PTB cases (sensitivity 100%). Examination of three sputum smears with culture of the first sample detected 95% (19/20) of the HIV-associated PTB cases and 90% (26/29) overall. CONCLUSIONS: TB is common in the VCCT setting, regardless of HIV status. The high prevalence of HIV and PTB among the participants warrants consideration of TB screening for all HIV suspects. Such screening through VCCT is feasible. Adding a single culture test to the evaluation of an initial sputum sample set will substantially increase case detection."									
938	Micronutrient supplements and mortality of HIV-infected adults with pulmonary TB: a controlled clinical trial.	"Semba RD, Kumwenda J, Zijlstra E, Ricks MO, Lettow Mv, Whalen C, Clark TD, et al."	International Journal of Tuberculosis and Lung Disease. 2007;11(8):854-9.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20073211932	"SETTING: Zomba and Blantyre, Malawi, Africa. OBJECTIVES: To determine whether daily micronutrient supplementation reduces the mortality of human immunodeficiency virus (HIV) infected adults with pulmonary tuberculosis (TB). DESIGN: A randomized, controlled clinical trial of micronutrient supplementation for HIV-positive and HIV-negative adults with pulmonary TB. Participants were enrolled at the commencement of chemotherapy for sputum smear-positive pulmonary TB and followed up for 24 months. RESULTS: A total of 829 HIV-positive and 573 HIV-negative adults were enrolled. During follow-up, 328 HIV-positive and 17 HIV-negative participants died. The proportion of HIV-positive participants who died in the micronutrient and placebo groups was 38.7% and 40.4%, respectively (P=0.49). Micronutrient supplementation did not reduce mortality (hazard ratio [HR] 0.93, 95%CI 0.75-1.15) among HIV-positive adults. CONCLUSIONS: Micronutrient supplementation at the doses used in this study does not reduce mortality in HIV-positive adults with pulmonary TB in Malawi."									
914	Malnutrition and the severity of lung disease in adults with pulmonary tuberculosis in Malawi.	"Van Lettow M, Kumwenda JJ, Harries AD, Whalen CC, Taha TE, Kumwenda N, Kang'ombe C, et al."	International Journal of Tuberculosis & Lung Disease. 2004;8(2):211-7.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=15139450	"SETTING: Zomba Central Hospital, Zomba, Malawi."	OBJECTIVE: To examine the relationship between malnutrition and the severity of lung disease in human immunodeficiency virus (HIV) positive and negative adults with pulmonary tuberculosis (PTB).	DESIGN: Cross-sectional study.	"METHODS: Chest radiographs and anthropometric measurements were obtained and bioelectrical impedance analysis was conducted in sputum-positive patients with pulmonary tuberculosis. Lung disease in chest radiographs was graded as normal, minimal, moderately advanced and far advanced according to a conventional classification system."	"RESULTS: Among 319 adults with PTB with or without HIV co-infection, body mass index (BMI), fat mass and phase angle were independently associated with increasing severity of lung disease. Multiple logistic regression analyses showed that BMI, fat mass and phase angle were associated with increasing severity of lung disease among 236 HIV-positive adults, when adjusted for sex, age, and plasma HIV load."	"CONCLUSION: The severity of lung disease in adults with PTB is associated with the extent of malnutrition, as reflected by BMI and body composition studies using bioelectrical impedance analysis."				
926	Malnutrition and the severity of lung disease in adults with pulmonary tuberculosis in Malawi.	"Lettow Mv, Kumwenda JJ, Harries AD, Whalen CC, Taha TE, Kumwenda N, Kang'ombe C, et al."	International Journal of Tuberculosis and Lung Disease. 2004;8(2):211-7.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh3&AN=20043081322	"SETTING: Zomba Central Hospital, Zomba, Malawi. OBJECTIVE: To examine the relationship between malnutrition and the severity of lung disease in human immunodeficiency virus (HIV) positive and negative adults with pulmonary tuberculosis (PTB). DESIGN: Cross-sectional study. METHODS: Chest radiographs and anthropometric measurements were obtained and bioelectrical impedance analysis was conducted in sputum-positive patients with pulmonary tuberculosis who presented between July 1999 and December 2000. Lung disease in chest radiographs was graded as normal, minimal, moderately advanced, and far advanced according to a conventional classification system. RESULTS: Among 319 adults with PTB with or without HIV coinfection, body mass index (BMI), fat mass, and phase angle were independently associated with increasing severity of lung disease. Multiple logistic regression analyses showed that BMI, fat mass, and phase angle were associated with increasing severity of lung disease among 236 HIV-positive adults, when adjusted for sex, age, and plasma HIV load. CONCLUSION: The severity of lung disease in adults with PTB is associated with the extent of malnutrition, as reflected by BMI and body composition studies using bioelectrical impedance analysis."									
1000	Incidence of tuberculosis in HIV-infected patients before and after starting combined antiretroviral therapy in 8 Sub-Saharan African HIV Programs.	"Nicholas S, Sabapathy K, Ferreyra C, Varaine F, Pujades-Rodriguez M."	Journal of Acquired Immune Deficiency Syndromes. 2011 01 Aug;57(4):311-8.		"SETTING:: Eight HIV programs in sub-Saharan Africa. OBJECTIVE:: To describe the incidence of pulmonary and extrapulmonary tuberculosis before and after the start of combined antiretroviral therapy (ART) and investigate associated risk factors. DESIGN:: Multicohort study. Adults enrolled between January 2006 and September 2008. Results: A total of 30,134 patients contributed 25,916 person-years of follow-up. The incidence of tuberculosis was 10.5 per 100 person-years during the pre-ART and 5.4 during the ART period. For all types of tuberculosis, incidence was similar in the pre-ART period and initial 3 months of ART but declined over time receiving ART (from 13 per 100 person-years in the first 3 months to 1.5 per 100 person-years after 12 months of therapy). Throughout follow-up, rates of pulmonary tuberculosis remained 2-fold to 3-fold higher than extrapulmonary tuberculosis rates. Smear-negative pulmonary tuberculosis was higher than smear-positive incidence and varied greatly across sites during the pre-ART period. Incidence was lower in rural sites, women, patients without prior history of tuberculosis, body mass index a 18.5 kg/m, and 200 nadir CD4 cells per microliter. Recurrence rate was 1.7 per 100 person-years (95% confidence interval: 1.0 to 2.8). Conclusions: Our findings show the high burden that tuberculosis represents for HIV programs and highlight the importance of earlier ART start and the need to implement intensified tuberculosis finding, isoniazide prophylaxis, and infection control. 2011 by Lippincott Williams & Wilkins."									
564	A low dose of ritonavir-boosted atazanavir provides adequate pharmacokinetic parameters in HIV-1-infected Thai adults.	"Avihingsanon A, Van Der Lugt J, Kerr SJ, Gorowara M, Chanmano S, Ohata P, Lange J, et al."	Clinical Pharmacology and Therapeutics. 2009 April;85(4):402-8.		"Several dose-finding studies of boosted protease inhibitors have demonstrated that doses lower than those recommended in Caucasian populations exhibit in the Thai population similar pharmacokinetic (PK) properties with sustained virological suppression but reduced toxicity. We therefore evaluated the PK profiles of lower than the standard doses of atazanavir/ritonavir (ATV/RTV) in 22 adult Thai patients with well-suppressed human immunodeficiency virus 1 (HIV-1) infection. The PK parameters of ATV/RTV at a dosage of 200/100 mg once daily, plus two nucleoside reverse transcriptase inhibitors, were significantly lower than those associated with a dosage of 300/100 mg once daily in the same patients. In addition, the PK parameters for the lower dosage in these Thai patients were comparable to historical data from Caucasian cohorts who received the standard dose of ATV/RTV (300/100 mg). None of the patients showed subtherapeutic values of <0.15 mg/l at any time point. Bilirubin concentration decreased significantly after dose reduction, and viral load remained at <50 copies/ml in all subjects. Therefore, ATV/RTV at a dose of 200/100 mg once daily (plus appropriate backbone medication) warrants further long-term efficacy studies, particularly in patients of Thai and other Asian ethnicities. 2009 American Society for Clinical Pharmacology and Therapeutics."									
1693	Universal antiretroviral therapy for pregnant and breastfeeding HIV-infected women: Towards the elimination of mother-to-child transmission of HIV-1 in resource-limited settings?	Becquet R.	Retrovirology. 2009 22 Jul;6.		"Several unmet scientific needs that account for the partial failure of MTCT prevention efforts in resource-constrained settings, particularly in Africa. Single-dose and short-course antiretroviral (ARV) regimens are only partially effective and have failed to achieve wide coverage despite their apparent simplicity. More potent ARV combinations are restricted to pregnant women who need treatment for themselves but are also infrequently used. Furthermore, postnatal transmission via breastfeeding is a serious additional threat. Modifications of infant feeding practices aim to reduce breast-milk HIV transmission: replacement feeding is neither affordable nor safe for the majority of African women, and early breastfeeding cessation (e.g. prior to 6 months of life) requires substantial care and nutritional counselling to be practised safely. We argue that the recent roll out of highly active ARV treatment (HAART) has changed the paradigm of prevention of MTCT. To date, postnatal ARV interventions that have been evaluated target either maternal ARV treatment to selected breastfeeding women, with good efficacy, or single- drug post-exposure prophylaxis for short periods of time to their neonates, with a partial efficacy and at the expense of acquisition of drug-related viral resistance. We hypothesize that a viable solution to eliminate paediatric AIDS lies in the universal provision of HAART to all HIVinfected women through pregnancy, delivery, and covering the entire breastfeeding period. We suggest the active promotion of the universal maternal HAART approach as a way towards elimination of MTCT in resource-limited settings. We argue that HAART should be made available to all HIV-infected pregnant women in resource-limited settings, irrespective of their CD4 count or clinical stage, and even to those who present late in pregnancy. This universal ARV-based strategy will be accompanied by proper pharmacovigilance systems. It should consider the breastfeeding cessation around six months of age, which implies the need for a proper and systematic nutritional support. Continuing investigations will compare the safety, acceptability, feasibility and efficiency of various maternal HAART regimens for preventing MTCT throughout the entire exposure period in order to rank them according to the best risk-benefit balance."									
1285	Management of severe acute malnutrition in children.	"Collins S, Dent N, Binns P, Bahwere P, Sadler K, Hallam A."	Lancet. 2006 02 Dec;368(9551):1992-2000.		"Severe acute malnutrition (SAM) is defined as a weight-for-height measurement of 70% or less below the median, or three SD or more below the mean National Centre for Health Statistics reference values, the presence of bilateral pitting oedema of nutritional origin, or a mid-upper-arm circumference of less than 110 mm in children age 1-5 years. 13 million children under age 5 years have SAM, and the disorder is associated with 1 million to 2 million preventable child deaths each year. Despite this global importance, child-survival programmes have ignored SAM, and WHO does not recognise the term ""acute malnutrition"". Inpatient treatment is resource intensive and requires many skilled and motivated staff. Where SAM is common, the number of cases exceeds available inpatient capacity, which limits the effect of treatment; case-fatality rates are 20-30% and coverage is commonly under 10%. Programmes of community-based therapeutic care substantially reduce case-fatality rates and increase coverage rates. These programmes use new, ready-to-use, therapeutic foods and are designed to increase access to services, reduce opportunity costs, encourage early presentation and compliance, and thereby increase coverage and recovery rates. In community-based therapeutic care, all patients with SAM without complications are treated as outpatients. This approach promises to be a successful and cost-effective treatment strategy. 2006 Elsevier Ltd. All rights reserved."									
1866	Infections associated with severe malnutrition among hospitalised children in East Africa.	"Sunguya BF, Koola JI, Atkinson S."	Tanzania Health Research Bulletin. 2006;8(3):189-92.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=18254514	"Severe protein-energy malnutrition (PEM) predisposes affected children to various infections, which either worsens their nutritional status or causes malnutrition, hence complicating their management and outcome. This study was carried out to determine the infections associated with severe malnutrition among children admitted at Kilifi District Hospital (KDH) in Kenya and Muhimbili National Hospital (MNH) in Dar es Salaam, Tanzania. Data was collected from hospital register books and online system database. A total of 1121 children with severe malnutrition were admitted during a period of one year (2004-2005) (MNH = 781; KDH = 340). The proportion of male children with malnutrition was higher than that of female children. Non-oedematous malnutrition was more prevalent at MNH (N = 504; 64%) than KDH (N = 130; 38%). Conversely, oedematous was more prevalence than non-oedematous malnutrition among children admitted at KDH (N = 2 10; 61.7%). More than 75% of all patients with severe PEM were children < 2 years old. Thirty-six per cent of all severe PEM cases had malaria in both hospitals. Forty-five per cent of all admitted patients with severe PEM at KDH had diarrhoea. Two hundred twenty two (28%) and 64 (19%) of the children with severe malnutrition died at MNH and KDH, respectively. Oedematous PEM was associated with a higher case fatality rate than non-oedematous one (P < 0.05). At MNH, 86% of the patients who died with severe malnutrition had other co-morbidities. More (46%) oedematous malnourished patients with co-infections died at MNH than non-oedematous malnourished patients (19%). At KDH, septicaemia was the leading cause of death (55%) among severely malnourished patients. In conclusion, coinfections complicate the management of severe malnutrition and are associated with higher death rate. Management of such infections is of paramount importance to reduce case fatality rates."									
582	"'They don't just come for Machu Picchu': locals' views of tourist-local sexual relationships in Cuzco, Peru."	Bauer I.	"Culture, Health & Sexuality. 2008 Aug 2008;10(6):611-24."	http://search.proquest.com/docview/61744381?accountid=26724	"Sexual and romantic relationships between local people and tourists have long taken place. Such encounters are not a modern phenomenon, but the potential of sexually transmitted infections (STIs), including HIV/AIDS, warrants greater research into the issue. This paper analyses local people' s views of local-tourist relationships in Cuzco/Peru. Data were obtained through in-depth interviews, participant and non-participant observation and informal discussions. Attraction based on physical difference was reportedly the main trigger for such relationships. Emerging themes discussed include issues of self-esteem, strategies of approach, tourists' motives, emotional involvement and expectations from such encounters. Levels of unprotected sexual behaviour and lack of STI awareness are of sufficient concern to recommend urgent action. Suggestions for sexual health education are made with particular emphasis on targeting local people involved in the tourism and hospitality industries. Adapted from the source document."									
1518	Medical management of HIV disease in children.	"Laufer M, Scott GB."	Pediatric Clinics of North America. 2000;47(1):127-53.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=10697645	"Significant advances have been made in the understanding of the pathophysiology of HIV infection since the beginning of the epidemic. This knowledge has translated into the development of new therapies for HIV and opportunistic infections, laboratory advances in monitoring viral and immune status, and a better understanding of factors affecting patient outcome. Concomitantly, significant progress has been made in the medical management of children with HIV infection in the past 5 years. The number of children reported with AIDS in the United States is decreasing, and efforts are shifting from caring for children with advanced immunosuppression and severe opportunistic infections to early HAART, maintenance of the immune system, and prevention of opportunistic infections. Primary care physicians are now more involved and informed in the care of HIV-infected patients. Although published data are limited, physicians who have been working with this population have observed a dramatic improvement in the quality of life and length of survival of these patients. Unfortunately, this progress is not shared by developing countries where resources are minimal and antiretroviral agents are commonly unavailable. Although efforts to develop a vaccine to prevent HIV infection are ongoing, progress has been slow. Education and awareness continue to be the most powerful weapons against HIV. [References: 75]"									
1933	Access to care and quality of services for plwha in Benin: What options are viable and sustainable?	"Dieudonne ESG, Lambert MR."	Tropical Medicine and International Health. 2011 October;16:156.		"Since 2002, Benin has adopted a global care approach for people living with HIV/AIDS (PLWHA). Healthcare services are delivered both by public and private as well as associative health centers. This communication analyzes the demand profile of three healthcare centers located in Cotonou, one public (CTA/CNHU) and two private (NGO RACINES and NGO Arc en ciel), in relation to delivery costs, quality of care and approach to medical care. The methodological approach is based on the comparison of data collected from the healthcare structures (03), patients (32) and prescribers (12) through questionnaires, guided interviews and participant observations. For cost analysis, a specific algorithm was designed that takes account of free ARVs, main activities and available statistics. The three studied centers reported strong demand. All active files exceed 1200 patients. However, that demand reflects different realities. At CTA/CNHU, the average cost of care is the highest against an average quality of service. But its care approach is non global. However, its attractiveness is linked to the nutritional support provided and to social networks. 'Arc-en-ciel' also offers partial support but virtually no direct cost and therefore increases access to car to poor PLWHA, with an average quality of service. At the NGO Racine, support is indeed comprehensive and extends to the family of PLWHAs at low cost. However, that centre denies entry of new people into its active file to ensure the quality and completeness of care to the initial registered patients. The patient flow towards the various centers is indicative of the social profile of patients and the degree of discrimination in the system. Universal access to quality services and care for PLWHA is primarily a question of approach, organization and policy option whose sustainability must be rethought."									
997	Antiretroviral therapy in resource-poor settings: Decreasing barriers to access and promoting adherence.	"Mukherjee JS, Ivers L, Leandre F, Farmer P, Behforouz H."	Journal of Acquired Immune Deficiency Syndromes. 2006 December;43(SUPPL. 1):S123-S6.		"Since 2002, the HIV Equity Initiative of the nongovernmental organization Partners in Health has been expanded in conjunction with the Haitian MOH to cover 7 public clinics. More than 8000 HIV-positive persons, 2300 of whom are on antiretroviral therapy (ART) are now followed. This article describes the interventions to promote access to care and adherence to ART developed in reference to the specific context of poverty in rural Haiti. User fees for clinic attendance have been waived for all patients with HIV and tuberculosis and for women presenting for prenatal services. Additionally, HIV testing has been integrated into the provision of primary care services to increase HIV case finding among those presenting to clinic because of illness, rather than solely focusing on those who present for voluntary counseling and testing (VCT). Once a patient is diagnosed with HIV, medications and monitoring tests are provided free of charge and transportation costs for follow-up appointments are covered to defray patients' out-of-pocket expenses. Patients are given home-based adherence support from a network of health workers who provide psychosocial support and directly observed therapy. In addition, the neediest patients receive nutritional support. Following the description of the program is an approximation of the costs of these interventions and a discussion of their impact. 2006 Lippincott Williams & Wilkins, Inc."									
1766	The unfinished child survival revolution: the role of nutrition.	Persson LA.	Scandinavian Journal of Nutrition. 2005;49(4):146-50.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20063205906	"Since an impressive reduction in child mortality in the 1970s to early 1990s improvements have slowed down, and more than 10 million children die annually under the age of 5 years. Most of these deaths occur in relatively few countries, mainly in South Asia and Africa south of the Sahara. Given the causal links between nutrition and mortality in infancy and childhood it is of great importance to assess the role of nutrition in further improvements in global child survival. This study assessed what proportion of global under-five deaths could be prevented by available and efficacious nutrition interventions, through a review of recent papers of child survival and the role of nutrition in the prevention under-five deaths in a global perspective. It was found that undernutrition is an underlying cause in more than half of global under-five deaths. Most deaths are caused directly by bronchopneumonia, diarrhoeal diseases, diseases of the newborn, malaria, measles and HIV/AIDS. Specific and proven efficacious nutrition interventions could prevent more than one-third of the current 10 million child deaths. The most important nutrition-related interventions are exclusive breast-feeding, zinc supplements for treatment and prevention, complementary feeding, vitamin A supplementation and oral rehydration therapy. The coverage of many of these efficacious interventions is usually low. The potential role of nutrition interventions to promote global child survival is great. Child survival issues and the role of nutrition in preventing child deaths must be reintroduced on international health agendas. This is a prerequisite for reaching the fourth Millennium Development Goal, a reduction in child deaths by two-thirds before 2015."									
357	Diarrhoea due to small bowel diseases. (Special Issue: Chronic diarrhea.).	"Murray JA, Rubio-Tapia A."	Best Practice & Research Clinical Gastroenterology. 2012;26(5):581-600.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20133116056	"Small intestinal diseases are a common, though often overlooked cause of diarrhoeal illness. Fully 1% of the Caucasian population are affected by coeliac disease and a substantial portion of children living in poverty in the developing world are affected by environmental enteropathy. These are but two examples of the many diseases that cause mucosal injury to the primary digestive and absorptive organ in our body. While diarrhoea may be a common, though not universally seen symptom of small bowel mucosal disease, the consequent malabsorption can lead to substantial malnutrition and nutrient deficiencies. The small intestine, unlike the colon, has been relatively inaccessible, and systematic evaluation is often necessary to identify and treat small intestinal mucosal diseases that lead to diarrhoea. Immunodeficiency states, including HIV enteropathy, adult autoimmune enteropathy, drug-associated enteropathy, and tropical sprue continue to occur and require specific therapy. All patients with severe diarrhoea or diarrhoea associated with features suggestive of malabsorption may have a disease of the small intestinal mucosa that requires careful evaluation and targeted management."									
358	Diarrhoea due to small bowel diseases.	"Murray JA, Rubio-Tapia A."	Best Practice & Research in Clinical Gastroenterology. 2012;26(5):581-600.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=23384804	"Small intestinal diseases are a common, though often overlooked cause of diarrhoeal illness. Fully 1% of the Caucasian population are affected by coeliac disease and a substantial portion of children living in poverty in the developing world are affected by environmental enteropathy. These are but two examples of the many diseases that cause mucosal injury to the primary digestive and absorptive organ in our body. While diarrhoea may be a common, though not universally seen symptom of small bowel mucosal disease, the consequent malabsorption can lead to substantial malnutrition and nutrient deficiencies. The small intestine, unlike the colon, has been relatively inaccessible, and systematic evaluation is often necessary to identify and treat small intestinal mucosal diseases that lead to diarrhoea. Immunodeficiency states, including HIV enteropathy, adult autoimmune enteropathy, drug-associated enteropathy, and tropical sprue continue to occur and require specific therapy. All patients with severe diarrhoea or diarrhoea associated with features suggestive of malabsorption may have a disease of the small intestinal mucosa that requires careful evaluation and targeted management. Copyright 2012 Elsevier Ltd. All rights reserved."									
967	Trends in international nutrition policy.	Rikimaru T.	Japanese Journal of Nutrition and Dietetics. 2004;62(4):199-210.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh3&AN=20043151078	"Some of the most influential bodies for the direction of international nutrition policies are the United Nations System Standing Committee on Nutrition (SCN), the international conferences and summits related to nutritional matters, the general assembly of the United Nations and the guidelines on nutrition by United Nations organizations or authorized academic associations. SCN promotes cooperation amongst UN agencies to strengthen the coherence and the impact of actions against malnutrition with other partner organizations. The International Conference on Nutrition and the World Food Summit were held in the 1990s, and the objectives that were established were to halve the number of food-insecure and malnourished people by the 21st century, although these objectives are still far from being met. Millennium Development Goals established at the UN General Assembly in 2000 with the declared intent of radicating extreme poverty and hunger, reducing child mortality and improving maternal health, with emphasis placed on nutrition activities for achieving these goals. WHO has reported that child and maternal underweight are the leading global risk to disease, disability and death in the world today. Many guidelines have been developed by such responsible organizations, as WHO and UNICEF, and by academic associations to share a common understanding for combating global malnutrition, including PEM, iron deficiency anaemia, vitamin A deficiency and iodine deficiency. Although governments of developing countries and donors follow these guidelines, effective measures for nutrition related to HIV/AIDS, life-style related diseases, and anaemia have yet to be sufficiently implemented, and measures for developing the international growth standards and food/nutrition aid in an emergency and during war are still challenging issues. Since poverty, hunger, conflict, population growth, food insecurity, infectious diseases, gender issues and environmental problems are strongly associated with human nutrition, we have to widen the scope of nutrition science to adopt these challenging issues so that we can develop international nutrition as an applied science and contribute to combating global nutritional problems."									
1845	The South African national strategic plan: What does it mean for our health system?	Venter WDF.	Southern African Journal of HIV Medicine. 2007 June(27):8+10-1.		"South Africa has a new and highly ambitious guiding document to comprehensively deal with HIV over the next 5 years, the National Strategic Plan (NSP) (Table I). The country has an HIV problem resulting in huge mortality and morbidity, with an associated tuberculosis crisis, a growing orphan population, and a range of well-documented adverse social and economic impacts. In 2000 the South African government, under siege internationally for its denialist President and combative Health Minister, hurriedly unveiled its 5-year programme for HIV. The plan was vague and committed the government to very little of substance, and its soft wording contrasted with the strong and clearly defined advocacy campaigns around prevention of mother-to-child transmission (PMTCT) and antiretroviral therapy (ART) provision, nutrition and unscientific supplements. In 2003, the release of the ART component of the Operational Plan for Comprehensive HIV and AIDS Care, Management, and Treatment resulted in the provision of antiretroviral treatment throughout the country over the next 4 years. The original Plan expired in 2005, but it was only when the absence of an updated version was highlighted in the media, that the Department of Health began responding by drawing up a new Plan. An initial very rough draft, released after some consultation with special interest groups in the middle of 2006, rapidly attracted civil society interest and mobilisation, as well as strong media interest."									
1287	New variant famine: AIDS and food crisis in southern Africa.	"de Waal A, Whiteside A."	Lancet. 2003;362(9391):1234-7.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=14568749	"Southern Africa is undergoing a food crisis of surprising scale and novelty. The familiar culprits of drought and mismanagement of national strategies are implicated. However, this crisis is distinct from conventional drought-induced food shortages with respect to those vulnerable to starvation, and the course of impoverishment and recovery. We propose that these new aspects to the food crisis can be attributed largely to the HIV/AIDS epidemic in the region. We present evidence that we are facing a new variant famine. We have used frameworks drawn from famine theory to examine the implications. HIV/AIDS has created a new category of highly vulnerable households--namely, those with ill adults or those whose adults have died. The general burden of care in both AIDS-affected and non-AIDS-affected households has reduced the viability of farming livelihoods. The sensitivity of rural communities to external shocks such as drought has increased, and their resilience has declined. The prospects for a sharp decline into severe famine are increased, and possibilities for recovery reduced."									
1306	New variant famine: AIDS and food crisis in southern Africa.	"Waal Ad, Whiteside A."	Lancet. 2003;362(9391):1234-7.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh3&AN=20033174833	"Southern Africa is undergoing a food crisis of surprising scale and novelty. The familiar culprits of drought and mismanagement of national strategies are implicated. However, this crisis is distinct from conventional drought-induced food shortages with respect to those vulnerable to starvation, and the course of impoverishment and recovery. We propose that these new aspects to the food crisis can be attributed largely to the HIV/AIDS epidemic in the region. We present evidence that we are facing a new variant famine. We have used frameworks drawn from famine theory to examine the implications. HIV/AIDS has created a new category of highly vulnerable households - namely, those with ill adults or those whose adults have died. The general burden of care in both AIDS-affected and non-AIDS-affected households has reduced the viability of farming livelihoods. The sensitivity of rural communities to external shocks such as drought has increased, and their resilience has declined. The prospects for a sharp decline into severe famine are increased, and possibilities for recovery reduced."									
1852	Colombia 2005: results from the Demographic and Health Survey.		Studies in Family Planning. 2007;38(1):55-60.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20073108943	"Statistical data on the various aspects of reproductive health in Colombia during 2005 are presented in graphs and tables. The specific areas where data have been provided include the general characteristics of the country's demography and socioeconomics, fertility rates among women, contraception, assistance during pregnancy and delivery, maternal and infant nutrition, infant morbidity and mortality and HIV/AIDS epidemiology."									
1851	Malawi 2004: results from the Demographic and Health Survey.		Studies in Family Planning. 2007;38(1):61-6.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20073108944	"Statistical data on the varius aspects of reproductive health in Malawi during 2004 are presented in graphs and tables. The specific areas where data have been provided include the general characteristics of the country's demography and socioeconomics, fertility rates among women, contraception, assistance during pregnancy and delivery, maternal and infant nutrition, infant morbidity and mortality and HIV/AIDS epidemiology."									
157	Short communication: Severe symptomatic hyperlactatemia among HIV type 1-infected adults on antiretroviral therapy in Cote d'Ivoire.	"Minga A, Lewden C, Dohoun L, Abo Y, Emieme A, Coulibaly A, Salamon R, et al."	AIDS Research and Human Retroviruses. 2010 01 Sep;26(9):991-5.		"Stavudine is no longer recommended for use in first-line antiretroviral therapy (ART), but it remains in high demand worldwide because it is affordable. We report the clinical presentation and incidence of severe hyperlactatemia (SL) in HIV-infected adults who initiated ART between April 2005 and May 2009 in Cote d'Ivoire, West Africa. In a prospective cohort study at the HIV care center affiliated with the National Centre for Blood Transfusion, we used standardized forms to record baseline and follow-up data. We measured serum lactate levels for all adults on ART who showed signs of hyperlactatemia. SL was defined as serum lactate >2.5 mmol/liter. Overall, 806 adults initiated ART. Among the 591 patients (73%) on stavudine-containing regimens, 394 were women (67%); the median pre-ART CD4 count was 150 /mm<sup>3</sup> and the median body mass index was 20.9 kg/m<sup>2</sup>. These patients were followed for a median of 28 months. We detected SL only among patients taking stavudine. The incidence of SL was 0.55/100 person-years (PY) (95% CI 0.47-0.63) overall and 0.85/100 PY among women (95% CI 0.75-0.95). Among the eight patients with SL, 100% lost >9% of body weight before diagnosis, 100% had serum lactate >4 mmol/liter (range 4.2-12.1), 50% had pre-ART BMI >25 kg/m<sup>2</sup>, and three patients died (38%), accounting for 6.4% of deaths among patients taking stavudine. As long as HIV clinicians continue to use stavudine in sub-Saharan Africa, they should watch out for acute unexplained weight loss in patients taking ART, particularly among women and patients with high pre-ART BMI. 2010, Mary Ann Liebert, Inc."									
1578	Plasma Clot Lysis Time and Its Association with Cardiovascular Risk Factors in Black Africans.	"de Lange Z, Pieters M, Jerling JC, Kruger A, Rijken DC."	PLoS ONE. 2012 08 Nov;7(11).		"Studies in populations of European descent show longer plasma clot lysis times (CLT) in patients with cardiovascular disease (CVD) than in controls. No data are available on the association between CVD risk factors and fibrinolytic potential in black Africans, a group undergoing rapid urbanisation with increased CVD prevalence. We investigated associations between known CVD risk factors and CLT in black Africans and whether CLTs differ between rural and urban participants in light of differences in CVD risk. Data from 1000 rural and 1000 urban apparently healthy black South Africans (35-60 years) were cross-sectionally analysed. Increased PAI-1<sub>act</sub>, BMI, HbA1c, triglycerides, the metabolic syndrome, fibrinogen concentration, CRP, female sex and positive HIV status were associated with increased CLTs, while habitual alcohol consumption associated with decreased CLT. No differences in CLT were found between age and smoking categories, contraceptive use or hyper- and normotensive participants. Urban women had longer CLT than rural women while no differences were observed for men. CLT was associated with many known CVD risk factors in black Africans. Differences were however observed, compared to data from populations of European descent available in the literature, suggesting possible ethnic differences. The effect of urbanisation on CLT is influenced by traditional CVD risk factors and their prevalence in urban and rural communities. 2012 de Lange et al."									
1128	Vitamin supplementation increases risk of subclinical mastitis in HIV-infected women.	"Arsenault JE, Aboud S, Manji KP, Fawzi WW, Villamor E."	Journal of Nutrition. 2010;140(10):1788-92.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=20739447	"Subclinical mastitis is common in HIV-infected women and is a risk factor for mother-to-child transmission of HIV. The purpose of this study was to examine the effect of vitamin supplementation [vitamin A + -carotene, multivitamins (B complex, C, and E), or multivitamins, including vitamin A + -carotene] on the risk of subclinical mastitis during the first 2 y postpartum among HIV-infected women. The study was a randomized, placebo-controlled, clinical trial including 674 HIV-infected, antiretroviral naive Tanzanian women who were recruited during pregnancy and followed-up after delivery. Breast milk samples were obtained approximately every 3 mo. Any subclinical mastitis was defined as a ratio of the sodium to potassium (Na:K) breast milk concentrations > 0.6 and further classified as either moderate (Na:K >= 0.6 and <= 1) or severe (Na:K > 1.0). Fifty-eight percent of women had at least 1 episode of any subclinical mastitis. Women assigned to multivitamins (B complex, C, and E) had a 33% greater risk of any subclinical mastitis (P = 0.005) and a 75% greater risk of severe subclinical mastitis (P = 0.0006) than women who received the placebo. Vitamin A + -carotene also increased the risk of severe subclinical mastitis by 45% (P = 0.03). Among women with CD4+ T-cell counts >= 350 cells/uL, multivitamin intake resulted in a 49% increased risk of any subclinical mastitis (P = 0.006); by contrast, there were no treatment effects among women with CD4+ T-cell counts < 350 cells/uL (P- interaction for treatment x CD4+ T-cell count = 0.10). Supplementation of HIV-infected women with vitamins increased the risk of subclinical mastitis."									
1884	Subclinical mastitis among HIV-infected and uninfected Zimbabwean women participating in a multimicronutrient supplementation trial.	"Gomo E, Filteau SM, Tomkins AM, Ndhlovu P, Michaelsen KF, Friis H."	Transactions of the Royal Society of Tropical Medicine & Hygiene. 2003;97(2):212-6.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=14584380	"Subclinical mastitis, defined as raised milk sodium/potassium (Na/K) ratio is common and associated with poor infant growth and increased mother-to-child HIV transmission. In 1996-97, we conducted a randomized controlled trial of multiple micronutrient supplementation, at recommended daily allowance levels, from 22 to 35 weeks gestation until 3 months post-partum, on the prevalence and severity of subclinical mastitis among 84 HIV-infected and 83 HIV-uninfected lactating Zimbabwean women and on their infants' growth. Spot milk samples collected before 4.5 months post-partum were analysed for Na/K ratio by flame photometry. There was no significant difference in prevalence of subclinical mastitis between HIV-infected and HIV-uninfected women. After controlling for infant age at time of sampling, micronutrient-supplemented HIV-infected women had non-significantly (P = 0.08) lower geometric mean Na/K ratio (0.43, 95% CI 0.35-0.51) than HIV-infected women given placebo (0.51, 95% CI 0.42-0.61). Micronutrient supplementation had no effect on the prevalence of subclinical mastitis among HIV-uninfected women (odds ratio [OR] = 1.26, 95% CI 0.45-3.51, P = 0.80) but induced a borderline decrease in prevalence (OR = 2.82, 95% CI 0.96-8.26, P = 0.07) among HIV-infected women. Infant weight between 1.5 and 4.5 months was lower in women with higher milk Na/K ratio. Thus, the importance of subclinical mastitis for infant growth suggests that further investigations to decrease the condition, perhaps using higher micronutrient doses, are warranted."									
1484	"Risk factors for subclinical mastitis among HIV-infected and uninfected women in Lusaka, Zambia."	"Kasonka L, Makasa M, Marshall T, Chisenga M, Sinkala M, Chintu C, Kaseba C, et al."	Paediatric and Perinatal Epidemiology. 2006 September;20(5):379-91.		"Subclinical mastitis, defined as raised milk sodium/potassium (Na/K) ratio, is associated with poor infant growth and, among HIV-infected women, with increased milk HIV viral load. We conducted a longitudinal cohort study in Lusaka, Zambia, in order to investigate the relative importance of several potential causes of subclinical mastitis: maternal infection, micronutrient deficiencies and poor lactation practice. Women (198 HIV-infected, 189 HIV-uninfected) were recruited at 34 weeks' gestation and followed up to 16 weeks postpartum for collection of information on their health, their infant's health, infant growth and infant feeding practices. Milk samples were collected from each breast at 11 postpartum visits and blood at recruitment and 6 weeks postpartum. The geometric mean milk Na/K ratio and the proportion of women with Na/K ratio > 1.0 in one or both breasts were significantly higher among HIV-infected than among uninfected women. Other factors associated with the higher mean Na/K ratio in univariable analyses were primiparity, high maternal alpha1-acid glycoprotein (AGP) at 6 weeks, maternal overall morbidity and specific breast symptoms, preterm delivery, low infant weight or length, infant thrush and non-exclusive breast feeding. In multivariable analyses, primiparity, preterm delivery, breast symptoms, HIV status and raised AGP were associated with the raised Na/K ratio. Thus the main factors associated with subclinical mastitis that are amenable to intervention are poor maternal overall health and breast health. The impact of improved postpartum health care, especially management of maternal infections and especially in primiparous women, on the prevalence of subclinical mastitis and its consequences requires investigation. 2006 The Authors."									
1863	The characteristics of diagnosing homosexuality in examining a special population contingent. [Russian]	Osobennosti diagnostiki gomoseksualizma pri obsledovanii spetskontigenta.	"Bardenshtein LM, Ermolaev VS, Ovchinnikov VI, Ponomarev GN."		Sudebno-meditsinskaia ekspertiza. 1995 1995;38(2):13-6.									
825	"Summaries of papers presented at the 53rd national conference on tuberculosis and chest diseases - Bhubaneswar (Orissa) - 27-30 December, 1998."		Indian Journal of Tuberculosis. 1999;46(3):206-11.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh2&AN=19992012346	"Summaries of 20 papers are given. The papers are titled: profile of DOTS providers in Orissa; training activities in Revised National Tuberculosis Control Programme in Orissa; a study of morphological, histological and diagnostic correlation in endoscopical visible bronchogenic carcinoma; comparative analysis of cytodiagnosis of spontaneous and aerosol induced sputum in bronchogenic carcinoma; the progress of FIV [HIV] +ve in comparison with HIV -ve tuberculosis patients treated under the National Tuberculosis Programme; a one-year controlled study of TB and HIV coinfection in a 11 bed state TB hospital, Iymphal, Manipur; aetiological diagnosis of pleural effusion using pleural fluid bilirubin to serum bilirubin ratio; clinical profile of Pneumocystis carinii pneumonia in HIV cases; influence of pulmonary tuberculosis on nutritional status; anti-tuberculosis drug resistance in Cuttack; pleural fluid cholesterol and serum cholesterol ratio as parameter to differentiate between pleural transudate and exudate; evaluation of multi-drug resistance in tuberculosis patients diagnosed at State TB Center, Irramnuma, Hyderabad; trans-thoracic fine needle aspiration biopsy in sputum negative suspected cases of pulmonary tuberculosis; study on correlation of the different blood groups with various parameters in pulmonary tuberculosis; cor-pulmonale in pulmonary tuberculosis; cough variant asthma in persistent cough presentation; genital tuberculosis, infertility and outcome; experience of multi-drug resistance tuberculosis in an ESI hospital in West Bengal (1991-97); study of respiratory morbidity among employees of Railway Workshop, South Eastern Railway, Kharagpur; mortality in pulmonary tuberculosis."									
1926	"Use of nutritional and water hygiene packages for diarrhoeal prevention among HIV-exposed infants in Lilongwe, Malawi: an evaluation of a pilot prevention of mother-to-child transmission post-natal care service."	"Xue J, Mhango Z, Hoffman IF, Mofolo I, Kamanga E, Campbell J, Allgood G, et al."	Tropical Medicine & International Health. 2010;15(10):1156-62.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=20701728	"SUMMARY OBJECTIVE: To evaluate a pilot prevention of mother-to-child transmission post-natal programme in Lilongwe, Malawi, through observed retention and infant diarrhoeal rates."	METHODS: Free fortified porridge and water hygiene packages were offered to mothers to encourage frequent post-natal visits and to reduce diarrhoeal rates in infants on replacement feeding. Participant retention and infant health outcome were assessed.	"RESULTS: Of 474 patients enrolled, 357 (75.3%) completed 3-month follow-up visits. Ninety-nine percent of women reported hygiene package use, and only 17.7% (95% CI 13.8-22.0%) of the infants had diarrhoea at least once over the 3-month period. Being 12 months or younger, confirmed HIV positive, access to tap water, and having a mother with diarrhoea were all associated with increased risk of infant diarrhoea."	"CONCLUSION: The majority of participants adhered to their scheduled visits and retention was favourable, possibly because of the introduction of hygiene and nutrition incentives. The infant diarrhoeal rate was low, suggesting benefits of regular medical care with hygiene package usage and reliable replacement feeding options. Continuation and expansion of the programme would allow further studies and improve the post-natal care of HIV-exposed infants in Malawi and in other resource-constrained countries. 2010 Blackwell Publishing Ltd."						
964	"Immune reconstitution inflammatory syndrome among HIV/AIDS patients during highly active antiretroviral therapy in Addis Ababa, Ethiopia."	"Huruy K, Mulu A, Mengistu G, Shewa-Amare A, Akalu A, Kassu A, Andargie G, et al."	Japanese Journal of Infectious Diseases. 2008;61(3):205-9.		"Suppression of viral replication is followed by increases in CD4<sup>+</sup> lymphocytes, and this has been shown to result in decreased susceptibility to opportunists after initiation of highly active antiretroviral therapy (HAART). However, clinical aggravations after the initiation of HAART have been thought to be due to the restored ability to mount an inflammatory response, or the immune reconstitution inflammatory syndrome (IRIS). The degree of IRIS observed in human immunodeficiency virus (HIV)-infected patients following initiation of HAART is variable This prospective study was aimed at determining the proportion of IRIS and the pattern of opportunistic infections among 196 HIV/AIDS patients receiving HAART between December 2006 and July 2007 at Zewditu Memorial Hospital, Addis Ababa, Ethiopia The proportion of IRIS was 17.2% (32/186). The mean number of days of IRIS occurrence for each disease ranged from 26 to 122 days with a mean of 80. Opportunistic diseases associatedwith IRIS were tuberculosis (68.8%,22/32), herpes zoster rash (12.5%,4/32), cryptococcosis (94%, 3/ 32), toxoplasmosis (63%, 2/32) and bacterial pneumonia (31%, 1/32). Compared to baseline readings there were significant increases in CD4 count, aspartate aminotransferase and alanine aminotransferase levels while hemoglobin values decreased during the development of IRIS. In summary, the proportion of IRIS and the pattern of opportunistic infections in HAART-treated patients in Ethiopia mirrored those reported in other countries. Further prospective surveys on epidemiological, immunological, microbial and clinical studies are imperative to assess the proportion and pattern of IRIS and effect of HAART in Ethiopia."									
291	"Pharmacokinetics and pharmacodynamics of TBR-652, a novel CCR5 antagonist, in HIV-1-infected, antiretroviral treatment-experienced, CCR5 antagonist-naive patients."	"Marier JF, Trinh M, Pheng LH, Palleja SM, Martin DE."	Antimicrobial Agents and Chemotherapy. 2011 June;55(6):2768-74.		"TBR-652 is a novel CCR5 antagonist with potent in vitro anti-HIV activity. The objective of this study was to determine the pharmacokinetics (PK) and pharmacodynamics (PD) of TBR-652 in HIV-1-infected, antiretroviral treatment-experienced, CCR5 antagonist-naive patients. A double-blind, placebo-controlled, randomized, dose-escalating study of TBR-652 monotherapy given once daily orally for 10 days was performed, followed by a 40-day follow-up period. Approximately 10 patients/dose level received 25, 50, 75, 100, and 150 mg TBR-652 or placebo (4:1). Blood was collected at different intervals for PK and HIV-1 RNA assessments. PK analysis of TBR-652 was performed using noncompartmental methods. PK/PD was modeled using a maximum inhibitory effect model (E<sub>max</sub>) and 50% inhibitory concentrations (IC<sub>50</sub>). TBR-652 was well absorbed in the systemic circulation. TBR-652 concentration levels declined slowly, with mean elimination half-lives ranging from 22.5 to 47.62 h across dose levels. TBR-652 treatment resulted in potent, dose-dependent decreases in viral load, with statistically significant decreases in nadir HIV-1 RNA compared to baseline for all dose levels. Suppression of HIV-1 RNA persisted over the 40-day follow-up period. A steep exposure-effect relationship was observed, with an E<sub>max</sub> of -1.43 log<sub>10</sub> copies/ml and IC<sub>50</sub> of 13.1 ng/ml. TBR-652 was generally safe and well tolerated at all dose levels studied. Short-term monotherapy treatments of TBR-652 in HIV-1-infected patients resulted in promising PK and PD results, with a clear exposure-response relationship at the current dose levels studied. Data from this study support further development of TBR-652 in HIV-infected patients. Copyright 2011, American Society for Microbiology. All Rights Reserved."									
474	Factors associated with trends in infant and child mortality in developing countries during the 1990s. (Special issue: child mortality.).	Rutstein SO.	Bulletin of the World Health Organization. 2000;78(10):1256-70.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh3&AN=20003014448	"The 1990s have seen a remarkable decrease in mortality among infants and children in most developing countries. In some countries, particularly in sub-Saharan Africa, these declines in mortality among children have slowed and are now increasing again. Internationally comparable data derived from survey programmes, such as the Demographic and Health Survey (DHS) programme, are available both to document the changes that have occurred in mortality and to provide insight into some of the factors that may explain these trends in mortality. The factors found in repeated DHS programmes that explain these trends fall into five categories: fertility behaviour; nutritional status, breastfeeding, and infant feeding; the use of health services by mothers and for children; environmental health conditions; and socioeconomic status. Both simple analyses and multivariate analyses of changes in these factors between surveys indicate that all factors affected the mortality trends. However, to explain trends in mortality, the variables themselves had to have changed over time. During the 1990s fertility behaviour, breastfeeding, and infant feeding have changed less than other factors and so would seem to have played a smaller role in mortality trends. This study confirms that trends in mortality during the 1990s were related to more than just a handful of variables. It would, therefore, be a mistake to concentrate policy actions on one or a few of these while forsaking others. Countries with the largest decreases in mortality have had substantial improvements in most of the factors that might be used to explain these changes. In some countries mortality has risen. In part these increases can be explained by the factors included in this study, such as deterioration in seeking medical care for children with fever. Other factors that were not measured, such as the increasing resistance of malaria to drug treatment and the increased prevalence of parental HIV/AIDS, may be contributing to the increases noted."									
1967	"Demographic and Health Survey in Kenya, 1993. Maternal and child health."		Weekly Epidemiological Record. 1995;70(42):297-303.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh2&AN=19962002531	"The 1993 Kenya Demographic and Health Survey (KDHS) was conducted by the National Council for Population and Development (Kenya) and the Central Bureau of Statistics (Kenya) with technical assistance from Macro International as part of the worldwide Demographic and Health Surveys Programme of the United States Agency for International Development. Field work took place from February to August 1993. The sample was nationally representative, with the exception of 7 northern districts comprising less than 4% of the total population."									
1738	"Plenary presentations, 18th IUNS Congress of Nutrition, Durban, South Africa, 19-23 September 2005."		SAJCN South African Journal of Clinical Nutrition. 2005;18(2):98-201.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh3&AN=20053195327	"The 20 papers presented at the conference deal with the following topics: health claims on food; global strategies to prevent chronic diseases; solutions to nutritional issues in Asia; WHO's views on the possible action of Codex Alimentarius to support the implementation of the global strategy on diet, physical activity and health; nutrigenomics in human nutrition; triple burden of malnutrition in the developing world; principles and practice of the new nutrition science; relationship between dietary flavonoid intake and cardiovascular diseases; role of women in agriculture and food security in Africa; factors affecting food security among urban poor in Thailand; global dimensions and dynamics of nutrition transition; relationship between poverty and nutrition; relationship between maternal care behaviours and nutritional status of children; evidence-based nutrition intervention for the control of human immunodeficiency virus/acquired immune deficiency syndrome; lessons learned from Clive West; and nutrition transformation in India."									
712	A dietary analysis of haitian infants and a critical analysis of dietary quality using IYCF standards.	"Webster LE, Heidkamp R, Stoltzfus R, Fitzgerald D, Pape JW."	FASEB Journal. 2012 April;26.		"The 2008 Lancet Series on Maternal and Child Undernutrition identifies infant feeding education with food supplementation as an effective strategy to reduce child undernutrition by improving overall nutrient intake. We assessed the impact of an intervention providing infant feeding education and a lipid-based nutrient supplement (LNS) on the overall dietary quality of non-breastfed HIV-exposed uninfected infants in urban Haiti. Dietary intake data was collected in intervention (n=77) and control (n=36) infants at age 9 mo using 24-hr recalls with caregivers. Diet quality was assessed using the WHO Infant and Young Child Feeding (IYCF) indicators. Intervention participants were more likely to meet the minimum dietary diversity indicator compared to the control group both with (63.6% vs 33.3%, p=0.003) and without (53.9% vs 33.3%, p=0.048) including the contribution of the LNS to the diet. In addition, intervention infants were more likely to consume iron-rich foods only when the LNS was included in the analysis (89.5% vs 69.4%, p=0.008). Though differences in the infants' diets do exist with and without the lipid-based supplementation, findings suggest that both of the intervention components (education and LNS) improved the infant diets."									
1989	Zimbabwe: demographic and health survey 2010-11.		Zimbabwe: demographic and health survey. 2010;11(450).	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20123263554	"The 2010-2011 Zimbabwe Demographic and Health Survey (2010-11 ZDHS) is one of a series of surveys of a large, nationally representative sample of nearly 11 000 households. This survey was conducted by the Zimbabwe National Statistics Agency (ZIMSTAT) from late September 2010 through March 2011. It is a follow-up to the 1988, 1994, 1999, and 2005-06 ZDHS surveys. In contrast to the earlier surveys, the 2010-11 ZDHS was carried out using electronic personal digital assistants (PDAs) rather than paper questionnaires for recording responses during interviews. The primary objective of the 2010-11 ZDHS is to provide up-to-date information on basic demographic and health indicators, including fertility levels; nuptiality; sexual activity; fertility preferences; knowledge and use of family planning methods; breastfeeding practices; nutritional status of mothers and young children; early childhood mortality and maternal mortality; maternal and child health; malaria prevention and treatment; awareness and behaviour regarding HIV and other sexually transmitted infections; and domestic violence. Additionally, the 2010-11 ZDHS provides population-based prevalence estimates for anaemia among men, women, and young children and for HIV among women aged 15-49 years and men aged 15-54 years."									
228	Integrating nutrition support for food-insecure patients and their dependents into an HIV care and treatment program in western Kenya.	"Mamlin J, Kimaiyo S, Lewis S, Tadayo H, Jerop FK, Gichunge C, Petersen T, et al."	American Journal of Public Health. 2009;99(2):215-20.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20093244635	"The Academic Model Providing Access to Healthcare (AMPATH) is a partnership between Moi Teaching and Referral Hospital, Moi University School of Medicine, and a consortium of universities led by Indiana University. AMPATH has over 50 000 patients in active care in 17 main clinics around western Kenya. Despite antiretroviral therapy, many patients were not recovering their health because of food insecurity. AMPATH therefore established partnerships with the World Food Program and United States Agency for International Development and began high-production farms to complement food support. Today, nutritionists assess all AMPATH patients and dependents for food security and refer those in need to the food program. We describe the implementation, challenges, and successes of this program."									
227	Integrating nutrition support for food-insecure patients and their dependents into an HIV care and treatment program in Western Kenya.	"Mamlin J, Kimaiyo S, Lewis S, Tadayo H, Jerop FK, Gichunge C, Petersen T, et al."	American Journal of Public Health. 2009;99(2):215-21.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=19059851	"The Academic Model Providing Access to Healthcare (AMPATH) is a partnership between Moi Teaching and Referral Hospital, Moi University School of Medicine, and a consortium of universities led by Indiana University. AMPATH has over 50,000 patients in active care in 17 main clinics around western Kenya. Despite antiretroviral therapy, many patients were not recovering their health because of food insecurity. AMPATH therefore established partnerships with the World Food Program and United States Agency for International Development and began high-production farms to complement food support. Today, nutritionists assess all AMPATH patients and dependents for food security and refer those in need to the food program. We describe the implementation, challenges, and successes of this program."									
1209	The human immunodeficiency virus and the cardiometabolic syndrome in the developing world: an African perspective.	"Mutimura E, Crowther NJ, Stewart A, Cade WT."	Journal of the CardioMetabolic Syndrome. 2008;3(2):106-10.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=18453811	"The advent of highly active antiretroviral therapy (HAART) has transformed human immunodeficiency virus (HIV)/AIDS into a manageable chronic disorder. Clinical care, however, needs to address the metabolic, anthropometric, and cardiovascular changes associated with HIV infection and HAART. Studies in developing countries suggest an increasing incidence of HIV-associated cardiometabolic syndrome (CMS), especially in urban settings. Predictions indicate that the greatest increase in the prevalence of diabetes will occur in Africa over the next 2 decades due to lifestyle changes. This, coupled with increased access to HAART, may exponentially increase the prevalence of CMS in developing countries, where HIV infection is prevalent. Appropriate evaluation and intervention programs need to be implemented in the developing world, especially sub-Saharan Africa, to curtail HIV-related CMS. This should include routine cardiovascular risk assessments, management of HIV infection with more ""metabolically friendly"" HAART, and encouragement of lifestyle modifications, particularly smoking cessation, weight management, regular exercise, and adherence to a healthy diet."									
116	Impact of a nutritional counseling program on prevention of HAART-related metabolic and morphologic abnormalities.	"Almeida LB, Segurado AC, Duran AC, Jaime PC."	AIDS Care. 2011;23(6):755-63.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=21287417	"The advent of highly active antiretroviral therapy (HAART) improved HIV infection prognosis. However, adverse metabolic and morphologic effects emerged, highlighting a lack of investigation into the role of nutritional interventions among this population. The present study evaluated the impact of a nutritional counseling program on prevention of morphologic and metabolic changes in patients living with HIV/AIDS receiving HAART. A 12-month randomized clinical trial was conducted with 53 adults of both genders in use of HAART. Subjects were allocated to either an intervention group (IG) or a control group (CG). Nutritional counseling was based on the promotion of a healthy diet pattern. Anthropometrical, biochemical, blood pressure, and food intake variables were assessed on four separate occasions. Sub scapular skin-fold results showed a significant tendency for increase between time 1 (Mean IG = 14.9 mm; CG = 13.6 mm), time 3 (Mean IG = 16.7 mm; CG = 18.2 mm), and time 4 (Mean IG = 16.4 mm; CG = 17.7 mm). Lipid percentage intake presented a greater increase among controls (time 1 mean = 26.3%, time 4 mean = 29.6%) than among IG subjects (time 1 mean = 29.1%, time 4 mean = 28.9%). Moreover, participants allocated to the IG presented an increase in dietetic fiber intake of almost 10 grams. The proposed nutritional counseling program proved to be effective in improving diet by reducing fat consumption and increasing fiber intake."									
824	General management of HIV in children.	"Mathur YC, Mathur RC."	Indian Journal of Practical Pediatrics. 2003;5(4):303-5.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh3&AN=20043038880	"The advent of potent antiretroviral therapy has enabled the transformation of HIV infection from a fatal to chronic disease in developed countries. However, supportive care, appropriate prophylaxis and management of infections are equally important. In fact, they are the mainstay of therapy in developing countries like India, where antiretroviral therapy is not affordable by most patients. This article discusses the role of breast feeding in the maternal transmission of HIV, the importance of adequate nutrition among HIV-infected children, and management of opportunistic infections (drug therapy and chemoprophylaxis). Guidelines on monitoring the growth and development of HIV-infected children, and on the immunization of this population are provided."									
126	Overlooked potential: older-age parents in the era of ART.	"Williams N, Knodel J, Kim SK, Puch S, Saengtienchai C."	AIDS Care. 2008 Nov 2008;20(10):1169-76.	http://search.proquest.com/docview/61706512?accountid=26724	"The advent of widespread ART provision in low- and middle-income countries requires not just medical attention, but also social and psychological support to encourage and monitor strict adherence to drug regimens. Developing innovative approaches to providing this broad support is a major challenge, especially within the financial constraints of resource-limited countries hardest hit by the epidemic. In this study, we examine the role of older-age parents in monitoring ART treatment and caring for their HIV-infected children and grandchildren in Cambodia. Our results are based on 25 open-ended interviews with older-age parents of people with AIDS (PWHA). A high level of co-residence when PWHA become ill and a sense of parental responsibility and emotional attachment facilitate high parental involvement in their children's and grandchildren's illness, care and treatment. Our interviews indicate that parents play an important role in encouraging their children to get tested and to access treatment if they test positive. They consistently monitor antiretroviral therapy (ART) adherence and opportunistic infections and remind PWHA to attend medical appointments and support-group meetings. Parents also provide for the nutrition and hygiene of PWHA essential to the success of ART treatments. We find that despite low levels of education, older parents were able to express clear, correct and detailed knowledge of complicated ART treatment regimens, nutrition and hygiene. Overall, our findings show that older parents play a pivotal role in care and treatment if they are provided with proper resources and training and have the ability to understand the necessity and details of ensuring strict adherence to medications. Based on these results, we suggest that explicitly including older parents in policy and programs for care and treatment would allow Cambodia and other countries to take advantage of this unique and effective but overlooked asset in AIDS care and treatment. Adapted from the source document."									
306	Improved appetite after multi-micronutrient supplementation for six months in HIV-infected South African children.	"Mda S, Raaij JMAv, MacIntyre UE, Villiers FPRd, Kok FJ."	Appetite. 2010;54(1):150-5.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20103056320	"The aim of the study was to assess the effect of multi-micronutrient supplementation on the appetite of HIV-infected children. HIV-infected children (6-24 months) who had previously been hospitalized were enrolled into a double-blind randomized trial, and given daily multi-micronutrient supplements or placebos for six months. Appetite tests were performed at enrolment and after three and six months. Appetite was measured as ad libitum intake of a commercial cereal test food served after an overnight fast according to standardized procedures. Body weights and total amount of test food eaten were measured. In total, 99 children completed the study (50 on supplements and 49 on placebos). Amounts eaten per kilogram body weight in the supplement group at enrolment and after six months were 36.7+or-17.7 g/kg (mean+or-SD) and 41.3+or-15.0 g/kg respectively, while the amounts in the placebo group were 47.1+or-14.9 g/kg and 45.7+or-13.1 g/kg respectively. The change in amount eaten per kilogram body weight over six months was significantly higher in the supplement group (4.7+or-14.7 g/kg) than in the placebo group (-1.4+or-15.1 g/kg). Multi-micronutrient supplementation for six months seems to significantly improve the appetite of HIV-infected children."									
307	Improved appetite after multi-micronutrient supplementation for six months in HIV-infected South African children.	"Mda S, van Raaij JM, Macintyre UE, de Villiers FP, Kok FJ."	Appetite. 2010;54(1):150-5.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=19815042	"The aim of the study was to assess the effect of multi-micronutrient supplementation on the appetite of HIV-infected children. HIV-infected children (6-24 months) who had previously been hospitalized were enrolled into a double-blind randomized trial, and given daily multi-micronutrient supplements or placebos for six months. Appetite tests were performed at enrollment and after three and six months. Appetite was measured as ad libitum intake of a commercial cereal test food served after an overnight fast according to standardized procedures. Body weights and total amount of test food eaten were measured. In total, 99 children completed the study (50 on supplements and 49 on placebos). Amounts eaten per kilogram body weight in the supplement group at enrollment and after six months were 36.7+/-17.7 g/kg (mean+/-SD) and 41.3+/-15.0 g/kg respectively, while the amounts in the placebo group were 47.1+/-14.9 g/kg and 45.7+/-13.1g/kg respectively. The change in amount eaten per kilogram body weight over six months was significantly higher in the supplement group (4.7+/-14.7 g/kg) than in the placebo group (-1.4+/-15.1g/kg). Multi-micronutrient supplementation for six months seems to significantly improve the appetite of HIV-infected children. 2009 Elsevier Ltd. All rights reserved."									
308	Improved appetite after multi-micronutrient supplementation for six months in HIV-infected South African children.	"Mda S, van Raaij JMA, MacIntyre UE, de Villiers FPR, Kok FJ."	Appetite. 2010 February;54(1):150-5.		"The aim of the study was to assess the effect of multi-micronutrient supplementation on the appetite of HIV-infected children. HIV-infected children (6-24 months) who had previously been hospitalized were enrolled into a double-blind randomized trial, and given daily multi-micronutrient supplements or placebos for six months. Appetite tests were performed at enrolment and after three and six months. Appetite was measured as ad libitum intake of a commercial cereal test food served after an overnight fast according to standardized procedures. Body weights and total amount of test food eaten were measured. In total, 99 children completed the study (50 on supplements and 49 on placebos). Amounts eaten per kilogram body weight in the supplement group at enrolment and after six months were 36.7 +/- 17.7 g/kg (mean +/- SD) and 41.3 +/- 15.0 g/kg respectively, while the amounts in the placebo group were 47.1 +/- 14.9 g/kg and 45.7 +/- 13.1 g/kg respectively. The change in amount eaten per kilogram body weight over six months was significantly higher in the supplement group (4.7 +/- 14.7 g/kg) than in the placebo group (-1.4 +/- 15.1 g/kg). Multi-micronutrient supplementation for six months seems to significantly improve the appetite of HIV-infected children. 2009 Elsevier Ltd. All rights reserved."									
1261	Breastfeeding knowledge among health workers in rural South Africa.	"Shah S, Rollins NC, Bland RM, Bennish M, Coutsoudis A, Coovadia HM, Goga A, et al."	Journal of Tropical Pediatrics. 2005 February;51(1):33-8.		"The aim of the study was to conduct a rapid assessment of breastfeeding knowledge amongst health workers in an area of high HIV prevalence. A cross-sectional survey using semi-structured questionnaires and problem-based scenarios was carried out. Responses were compared to those recommended in the World Health Organization (WHO) Breastfeeding Counselling Course. The setting was a rural area of KwaZulu Natal, with a population of 220 000 people. At the time of the study approximately 36 per cent of pregnant women were HIV-infected and no programme to prevent mother-to-child transmission was in place. A convenient sample of 71 healthcare workers (14 doctors, 25 professional nurses, 16 staff nurses, and 16 community health workers) were included in the study. Over 50% of respondents had given breastfeeding advice to clients over the previous month. However, there were significant discrepancies in breastfeeding knowledge compared to WHO recommendations. Ninety-three per cent (n = 13) of doctors knew that breastfeeding should be initiated within 30 min of delivery, but 71 per cent (n = 10) would recommend water, and 50 per cent (n = 7) solids to breastfed infants under 6 months of age. Fifty-seven per cent (n = 8) considered glucose water necessary for neonatal jaundice, constipation, and for infants immediately after delivery. Only 44 per cent (n = 7) of staff nurses and 56 per cent (n = 14) of professional nurses knew that breastfeeding should be on demand. The majority would recommend water, formula milk, and solids to breastfed infants under 6 months of age, and glucose water for neonatal jaundice and immediately after delivery. Knowledge of community health workers differed most from WHO recommendations: only 37 per cent (n = 6) knew that breastfeeding should be initiated within 30 min of delivery, 68 per cent (n = 11) thought breastfeeding should be on schedule and not on demand, and the majority would recommend supplements to infants under 6 months of age. Few respondents suggested taking a feeding history or observing a breastfeed in response to the problem scenarios. The most commonly given responses to problems of babies who were perceived to be thirsty, unsatisfied, or crying after feeds was to supplement with other fluids or feeds. There is a need for systematic and ongoing training in breastfeeding and infant feeding counselling in the context of HIV, so that breastfeeding is not undermined by the current HIV pandemic, and exclusive breastfeeding continues to be promoted for all HIV-uninfected women, women of unknown status, and HIV-infected women who choose to breastfeed. Oxford University Press 2005; all rights reserved."									
1800	Validation of a method for dietary assessment: 24-hour recall supported by photographs for application in rural areas.	"Lazarte Pardo C, Encinas ME, Granfeldt Y."	South African Journal of Clinical Nutrition. 2010;2):S33.		"The aim of the study was to improve the twenty four hour recall method to measure food consumption of individuals, and also to adjust the method for measurement of dietary intake in poor rural areas. The 24-h recall method was improved to increase accuracy of dietary intake by addition of two visual aids namely 1) digital photos taken by the subjects on all food consumed during the days in question and 2) a photo album with servings, of the most consumed food in the area, in different sizes. The purpose of the photos taken by the subjects was to simplify the recall, during the interview, of everything consumed the previous day. The purpose of the photo album was to assist the validation of the amount of food that was eaten. The present study was carried out in a rural area in the tropical region of Bolivia, South America on 45 women that participated as volunteers. The validation of the developed method was made by comparing the result (recalled amount of food intake) with results from a more precise method (weighed food record) used in parallel. The nutritional assessment according to the evaluated food intake with the two methods was calculated using the Bolivian food composition tables. There were no significant differences between the results from the two methods regarding most of the nutrients studied."									
484	[Evidence of the impact of vitamin A supplementation on maternal and child health].	"Oliveira JM, Rondo PH."	Cadernos de Saude Publica. 2007;23(11):2565-75.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medc&AN=17952249	"The aim of this article was to collect the results of systematic reviews and meta-analyses that evaluated the effect of vitamin A supplementation on child growth and maternal, fetal, and child morbidity and mortality. A detailed search was performed in PubMed, Cochrane Library, LILACS, PAHO, CAPES, USP Digital Thesis Library, and UNIFESP Collection Database. A total of 14 studies published from 1993 to 2006 were included in the review. There is evidence that vitamin A supplementation in children is associated with a reduction of 23% to 30% in mortality risk and attenuation in the severity of measles and diarrhea. There is no evidence of the intervention's impact on pneumonia incidence or mortality in children without measles. Vitamin A also appears to be protective in children and pregnant women with HIV/AIDS, with a positive effect on child morbidity and mortality and birth weight. There is no evidence that supplementation in pregnant and lactating women reduces infant morbidity and mortality, but there is an indication that vitamin A protects against maternal morbidity. [References: 76]"									
583	Maternal anthropometry and pregnancy outcomes: a proposal for the monitoring of pregnancy weight gain in outpatient clinics in South Africa.	Kruger HS.	Curationis. 2005;28(4):40-9.	http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=2009111686&site=ehost-live	"The aim of this review was to develop a framework for the monitoring of pregnancy weight gain in South African outpatient clinics. Studies showed that intrauterine malnutrition have more serious consequences for children than postnatal malnutrition. Undernutrition, as well as overnutrition during pregnancy, was associated with adverse pregnancy outcomes. The IOM published recommended weight gains by pre-pregnancy body mass index (BMI). Wasting in pregnant women can be defined as a mid-upperarm circumference (MUAC) < 22cm. Low prepregnancy BMI is considered a risk factor for preterm birth and intra-uterine growth retardation. Pregnant women in developing countries start to attend antenatal clinics late in pregnancy, so that prepregnancy BMI may be unknown and antenatal care can be based on pregnancy weight gain only. A framework is proposed that identifies the critical points for action during pregnancy to improve birth outcomes. Health care providers should measure height, weight and MUAC and try to classify pregnant women according to weight status, set weight gain goals and monitor gestational weight gain between follow-up visits. Women with short stature (< 145cm), low body weight (< 45kg), and/or MUAC < 22cm are considered to be at risk of adverse pregnancy outcomes. Weekly weight gains should range from 0.3kg for overweight women to 0.5kg or more for underweight women from the second trimester. Genetic background, age, general health, HIV and educational status, cigarette smoking, past nutritional status of the mother, parity, multiple pregnancies, climate, socioeconomic conditions and the availability of health services should be adjusted for in statistical analyses."									
570	The physique of young males in East Africa from the biosocial point of view.	Rebacz E.	Collegium Antropologicum. 2006 June;30(2):259-64.		"The aim of this study is to show the correlation between the physique of Africans from Kenya, Tanzania, Sudan and the conditions of their biosocial environment. All the young men examined were from Kenya (N=423), Tanzania (N= 153) and Sudan (N=154) aged 18 to 30. Based on the taken measurements (height, weight, sitting height, physiognomic leg length and chest, waist, hip, left thigh and left arm circumferences) the following indices were calculated: Body Mass Index (BMI), Rohrer's index and skelic index. The birth date, the number of children per menage (in family), and the birth sequence of the examined subject were inquired. The measurement results were elaborated (worked out) statistically in accordance with commonly accepted standards. All the information contained in the collected material within the analysed countries was compared. On the basis of the measured traits and calculated indices it was found that the morphological constitution of the men from Sudan differed. Typical for this group are the largest stature length and the lowest weight and waist measurements. Kenyans are similar to Tanzanians, although the latter have higher weight, hip and thigh measurements and lower chest circumference. The characteristics of the examined Africans' morphological structure were analysed in comparison with the data available in literature and relating to the number of children in family, population density, illiteracy and the growth of income and of the HIV/AIDS problem."									
313	Children of foreign origin adopted in France. Analysis of 68 cases over 12 years at the University Hospital in Tours.	"Bureau JJ, Maurage C, Bremond M, Despert F, Rolland JC."	Archives de Pediatrie. 1999;6(10):1053-8.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh3&AN=20001406223	"The aim of this study was to analyse distinctive features and medical problems associated with international adoption. The files of 68 foreign-origin adopted children who attended or were admitted to the Medical and Nutrition Unit of the Pediatric Hospital in Tours between 1st January 1986 and 31st December 1997, were studied retrospectively. Age at first consultation, age at adoption, country of origin, health problems (especially nutritional status), infectious diseases, growth and development were analysed. In the majority of cases, children were adopted before 12 months of age (61.2%), particularly before 6 months of age (49.3%). The children came mainly from Africa and countries in the Indian Ocean (48.5%), and from Southeastern Asia (33.9%). Malnutrition was frequent in children from Africa. 21 children (30.9%) presented with severe malnutrition characterized by weight <mean-2 s.d. for height, and required hospitalization. No children had congenital hypothyroidism, hyperphenylalaninaemia nor were HIV positive. Some patients had infectious diseases; 11, 4 and 6 had hepatitis B, congenital syphilis and tuberculosis, respectively, with favourable outcomes after treatment. The other most frequent diseases were acute diarrhoea, chronic diarrhoea, intestinal parasites and scabies [Sarcoptes scabiei infection]. Three girls adopted from southern Asia developed precocious puberty. Growth and psychomotor development were satisfactory overall, but abnormalities were observed in 15 children (22.1%), which is higher than in the general population. It is concluded that the expansion of international adoption proves the importance of a check-up as soon as possible after the arrival of children in France. This check-up has to include nutritional and general evaluation and supplementary tests, especially for specific serology and vaccination status. Following this, it would be possible to propose a suitable follow-up to the adoptive parents."									
893	Reasons for complementary therapies and characteristics of users among HIV-infected people.	"Agnoletto V, Chiaffarino F, Nasta P, Rossi R, Parazzini F."	International Journal of STD & AIDS. 2003;14(7):482-6.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh3&AN=20033114873	"The aim of this study was to analyse in a large sample of HIV-infected subjects the expectations toward complementary therapies (CT) and the characteristics of users. Self-administered anonymous questionnaires were distributed in seven European countries (Italy, Belgium, France, Germany, Greece, Spain, UK) among HIV-infected subjects consecutively attending the offices of AIDS organizations during April-June 2000. Among 632 ever CT users, nutritional supplements (124 subjects) and psycho-physiological approaches (116 subjects) were the most frequent CT used: 61.4% used CT to improve energy. Half the CT users wanted to prevent or alleviate the highly active antiretroviral therapy (HAART) side effects. General malaise and neuropathy were the most common HAART side effects, where CT users found improvement (62.0% and 54.7%, respectively). Acupuncture improved neuropathy in a high proportion of subjects (87.5%); whereas for others CT were considered less effective (range 20.0%-36.4%). The most common expectations from CT were to improve energy and to prevent or alleviate the HAART side effects. This suggests that HIV-infected people expect not so much specific help as general support from CT."									
310	"Nutritional supplement use among fitness club participants in Tehran, Iran."	"Pouya S, Mohd Taib MN, Abu Saad H, Vafa MR, Foroushani AR."	Appetite. 2013;60:20-6.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20123415143	"The aim of this study was to assess nutritional supplement use among fitness club participants in Tehran, Iran. A cross sectional study was conducted in 24 fitness clubs throughout the city of Tehran, Iran. A total of 1625 fitness club participants were recruited to participate in this study. They were asked to complete a self-administered pre-tested questionnaire. Descriptive statistics and chi-square test were performed to determine the characteristics of participants, reasons for supplement use, sources of information and also the influential advisors regarding nutritional supplement use. A high prevalence rate of nutritional supplement use (66.7%) was reported. Overall, multivitamin-mineral (43.8%) and iron tablets (30.5%) were the common nutritional supplements used and only a small number of participants used illegal substances (0.5%). Younger participants were more likely to use ergogenic aids, whereas, older participants were more likely to use vitamin D. Males were more likely than females to use creatine and amino acids, whereas, iron tablets and mint water were more common among females. Also, males were more likely to use nutritional supplements for increasing energy, whereas, females were more likely to use nutritional supplements for nutritional deficiencies. In conclusion, a high prevalence rate of nutritional supplement use was seen among participants."									
311	"Nutritional supplement use among fitness club participants in Tehran, Iran."	"Saeedi P, Mohd Nasir MT, Hazizi AS, Vafa MR, Rahimi Foroushani A."	Appetite. 2013;60(1):20-6.		"The aim of this study was to assess nutritional supplement use among fitness club participants in Tehran, Iran. A cross sectional study was conducted in 24 fitness clubs throughout the city of Tehran, Iran. A total of 1625 fitness club participants were recruited to participate in this study. They were asked to complete a self-administered pre-tested questionnaire. Descriptive statistics and chi-square test were performed to determine the characteristics of participants, reasons for supplement use, sources of information and also the influential advisors regarding nutritional supplement use. A high prevalence rate of nutritional supplement use (66.7%) was reported. Overall, multivitamin-mineral (43.8%) and iron tablets (30.5%) were the common nutritional supplements used and only a small number of participants used illegal substances (0.5%). Younger participants were more likely to use ergogenic aids, whereas, older participants were more likely to use vitamin D. Males were more likely than females to use creatine and amino acids, whereas, iron tablets and mint water were more common among females. Also, males were more likely to use nutritional supplements for increasing energy, whereas, females were more likely to use nutritional supplements for nutritional deficiencies. In conclusion, a high prevalence rate of nutritional supplement use was seen among participants. 2012 Elsevier Ltd."									
1723	[Nutritional supplementation in children and adolescents practicing fencing].	"Chalcarz W, Radzimirska-Graczyk M."	Roczniki Panstwowego Zakladu Higieny. 2009;60(4):357-60.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=20361564	"The aim of this study was to assess the use of nutritional supplementation during the days of training and the days free of training in children and adolescents who attend sports schools, Questionnaires on the use of nutritional supplementation were filled in by 141 children and adolescents who practice fencing. The factor gender-age had statistically significant impact only on using mineral supplementation by the studied students. Using ergogenic aids as well as using vitamin and mineral supplements or other kind of supplementation was rare in the studied population, but was more frequent during the days of training. Nutritional supplementation was always used by higher percentage of boys than girls."									
1329	Maternal anthropometry and weight gain as risk factors for poor pregnancy outcomes in a rural area of Southern Malawi.	Kalanda BF.	Malawi Medical Journal. 2007;19(4):149-53.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20083269333	"The aim of this study was to determine the anthropometric risk factors for pregnancy outcomes, the risk factors for pregnancy weight gain, and the effect of weight gain on pregnancy outcomes in the rural district of Chikwawa, Lower Shire Walley, Malawi, between March 1993 and July 1995. The study recruited 4104 women, of whom 38.3% (n=1571) delivered in the study hospitals. Demographic, nutritional and anthropometric data were obtained and statistically analysed. Univariate analysis showed that low birth weight (LBW) was associated with low maternal height and low mid-upper arm circumference (MUAC). Preterm delivery was associated with low MUAC. Intrauterine growth retardation (IUGR) was associated with low height and low MUAC. In a multivariate analysis, LBW was independently associated with low height and low MUAC, and IUGR was independently associated with low height. There were 991 women recruited before or at 18 weeks gestation. Their mean height, MUAC, Fep and MCHC were not different at recruitment from those recruited after 18 weeks gestation. Their haemoglobin and haematocrit were significantly higher at recruitment. Of these 991 women, 335 delivered in study hospitals. The average weight gain was 685+or-3.8 g. Weight gain was independently associated with maternal weight, MUAC and age. Mothers with placental or peripheral malaria at delivery or HIV infection had lower mean weight gain in pregnancy. Mothers with low weight or height or were primigravidae had lower mean weight gain in pregnancy. Mothers who delivered preterm or had LBW babies had lower mean weight gain in pregnancy. LBW and preterm delivery were associated with weight gain. It is suggested that maternal nutrition should be improved to reduce adverse pregnancy outcomes. On a long-term basis, interventions should aim at improving maternal height so that birth outcomes in subsequent generations should not be affected by maternal short stature. On a short-term basis, interventions should improve pre-pregnancy weights, MUAC and malaria in pregnancy, which in turn affect maternal weight gain and pregnancy outcomes."									
1121	"Changes in lipid profiles in two groups of HIV-1 infected patients in cameroon on two treatment regimens with either efavirenz or nevirapine, in association with reverse transcriptase inhibitors."	"Nguemaim NF, Mbuagbaw J, Nkoa T, Teto G, Njitchouang GR, Pouomogne DJ, Same-Ekobo A, et al."	Journal of Medical Sciences. 2010;10(2):25-33.		"The aim of this study was to determine the effect of two antiretroviral therapy regimens on lipid profiles. Patients were allocated to two treatment regimens: Nevirapine (NVP) + Stavudine (d4T) + Lamivudine (3TC) (n = 197) or Efavirenz (EFV) + Stavudine (d4T) + Lamivudine (3TC) (n = 181). Serum was prepared from blood samples collected before the start of treatment (Month 0) and at 24 months. Lipids and lipoproteins were measured using colorimetric enzyme assays or by calculation. Overall, there was an increase in all lipid parameters in patients on both treatment regimens at 24 months, although there were individual differences with respect to each lipid parameter that affected the atherogenicity indices for both regimens. Increase of high density lipoprotein cholesterol (HDLC) (42.82%) was significantly larger in patients on the NVP than on EFV (24.03%) (p<0.001), as opposed to Total Cholesterol (TC), triglycerides (TG) And Low Density Lipoprotein Cholesterol (LDLC) that were significantly lower in patient on NVP than on EFV; TG, Very Low Density Lipoproteins (VLDL) and LDLC increased in both regimens. These changes were not much affected by changes in viral load and CD<sub>4</sub> cell levels. The changes in the atherogenicity indices showed that the regimen with NVP seems to have less risk of coronary heart disease compared to EFV."									
940	Nutritional status of children with an intellectual disability.	"Sari HY, Bahceci B."	International Journal on Disability and Human Development. 2012 March;11(1):17-21.		"The aim of this study was to determine the nutritional status of economically disadvantaged 7- to 18-year-old children with mild or moderate intellectual disability in Turkey. The research was conducted in Izmir. Children with mild or moderate intellectual disability with poor socioeconomic status and their families who applied to the Counseling Research Center between May 15, 2010 and June 15, 2010 constituted the sample. The sample consisted of 70 families. The data were collected by fi lling out questionnaires through face-to-face interviews, and height and weight measurements were also taken. Body mass index (BMI) was calculated. BMI percentile values were determined according to the curves used for Turkish children. Of the children, 70 % (n = 49) had normal weight, 5.7 % (n = 4) were underweight, 17.1 % (n = 12) were overweight, and 7.1 % (n = 5) were obese. Of the children, 61.4 % consumed milk and milk products, 2.9 % meat products, 34.3 % eggs, 58.6 % dry legumes, 61.4 % vegetables, 62.9 % fruits, 98.6 % bread and cereal food group, 100 % oil, and 11.4 % oil seeds every day. A total of 42.9 % (n = 30) of the mothers stated that they use foods as a reward. In this study, we found that children did not consume enough animal protein sources, such as meat, fi sh, and chicken. Multifaceted studies should be undertaken to prevent obesity in children with intellectual disabilities. Planning social aids to the nutrition of economically disadvantaged children may be benefi cial for the health of those children. 2012 by Walter de Gruyter Berlin Boston."									
152	A longitudinal study of the changes in body fat and metabolic parameters in a South African population of HIV-positive patients receiving an antiretroviral therapeutic regimen containing stavudine.	"George JA, Venter WDF, Deventer HEv, Crowther NJ."	AIDS Research and Human Retroviruses. 2009;25(8):771-81.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20093243679	"The aim of this study was to determine the patterns of change in body fat and metabolic parameters in a South African cohort on a first line ART regimen containing stavudine. Fasting lipogram, blood glucose and insulin levels, CD4 cell count, viral load, BMI, waist-to-hip ratio (WHR), and skinfold thickness at the triceps, scapula, and iliac crest were measured before starting ART in 42 (27 female) subjects. Repeat measurements were performed at four monthly intervals for 2 years. Lipodystrophy was diagnosed using patient perception and assessment by a physician. At baseline, subjects who went on to develop lipodystrophy (LD group) were fatter and had higher skinfold thickness at all three sites and higher insulin levels than subjects who never developed lipodystrophy (NLD group). The WHR increased to a greater extent while hip circumference and tricep skinfolds fell more significantly in the LD than NLD group. Triglyceride and cholesterol levels increased significantly in both groups while lactate and glucose levels increased more and insulin levels increased less in the LD than the NLD group. Neither viral load nor CD4 count differed between the groups during the study. Viral load correlated positively with insulin levels at baseline. Thus, lipodystrophy in the South African population is characterized by a higher BMI before initiation of ART and lipoatrophy of the arms and hips, lipohypertrophy of the waist, and increased lactate production. When compared to the NLD group, the LD subjects display attenuated insulin secretory output in response to a higher weight gain."									
1765	"Prevalence of HIV type 1 infection, associated clinical features and mortality among hospitalized children in Dar es Salaam, Tanzania."	"Kawo G, Karlsson K, Lyamuya E, Kalokola F, Fataki M, Kazimoto T, Kitundu J, et al."	Scandinavian Journal of Infectious Diseases. 2000;32(4):357-63.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh3&AN=20002015411	"The aim of this study was to determine the prevalence of HIV-1 infection, the clinical spectrum of HIV-1-associated conditions and HIV-1-associated mortality among children hospitalized in the medical paediatric wards at Muhimbili Medical Centre (MMC), Dar es Salaam, Tanzania. All children admitted to the medical paediatric wards of MMC between August 1995 and January 1996 were eligible for the study. Testing for HIV antibodies was done using 2 consecutive enzyme linked immunosorbent assays (ELISAs). ELISA-reactive samples from children aged 18 months and below were further tested by a recently developed heat-denatured p24 antigen assay. The prevalence of HIV-1 infection among the 2015 children studied was 19.2%. When present for 14 days or more, fever, cough, diarrhoea, ear discharge, oral ulcers and skin rash were all significantly more common in HIV-1-infected than in HIV-uninfected children (p < 0.001). In the multivariate analysis cough, ear discharge, oropharyngeal ulcers and skin rash were found to be the most important symptoms. Clinical signs found to be significantly associated with HIV-1 infection in the univariate analysis were wasting, stunting, hair changes, oral thrush, oropharyngeal ulcers, lymphadenopathy, lung consolidation and lung crepitations (p < 0.001). In the multivariate analysis, oral thrush, lung crepitations, cervical lymphadenopathy, wasting and inguinal lymphadenopathy were found to be the most important signs. The 3 most common diagnoses in HIV-1-infected children were acute respiratory infection (ARI) (39.4%), malnutrition (38.1%) and tuberculosis (19.3%), while in HIV-uninfected children they were malaria (47.0%), ARI (25.0%) and malnutrition (16.1%). The mortality rate was 21.4% in HIV-1-infected children and 8.4% in HIV-uninfected children (p < 0.001). In conclusion, the prevalence of HIV-1 infection among hospitalized children at the main hospital in Dar es Salaam was high and associated with high mortality. Many symptoms and signs are indicative of HIV-1 infection, but appropriate laboratory testing is required for diagnosis."									
462	Nutritional status in patients with HIV infection and AIDS.	"Stambullian M, Feliu S, Slobodianik NH."	British Journal of Nutrition. 2007;98(Suppl.1):S140-S3.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20073253364	"The aim of this study was to evaluate the nutritional status of adults with HIV infection or with AIDS through the use of biochemical parameters. The study was performed on 43 patients (19 HIV+ and 24 AIDS patients), between 26 and 44 years of age, from low and medium socioeconomic status, with access to health care services; 35 patients were under highly active antiretroviral therapy (HAART) treatment. Body weight and height were determined, and the Body Mass Index calculated (kg/m<sup>2</sup>). Blood samples were collected from fasting patients. Plasma cholesterol (total, HDL and LDL), triacylglycerol, total protein, apolipoproteins A-I and B, albumin, transthyretin, retinol binding protein, and ceruloplasmin concentrations were determined. Plasma levels of zinc, copper, and selenium were determined in a haemolysis-free sample by flame atomic absorption spectrometry. Statistical analyses were performed with the Student's t-test. AIDS patients showed changes in biochemical parameters, particularly an increase in fibrinogen and a trend to decreased transthyretin levels. These findings stress the importance of the inclusion of functional biochemical parameters in the periodic evaluation of these patients. This would allow an early assessment of the need for appropriate nutritional support, implemented along with the specific retroviral treatment. This would aim at delaying the progression of the disease, and might improve the prospects of survival and quality of life."									
1725	[The estimation of weight-loss programmes and using of slimming preparations among young women].	"Sadowska J, Szuber M."	Roczniki Panstwowego Zakladu Higieny. 2011;62(3):343-9.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=22171527	"The aim of this study was to evaluate the range of weight-loss programmes and behaviours associated with the use of slimming supplements observed among young women. The study in the form of questionnaire survey was carried out among 300 female students of the West Pomeranian University of Technology in Szczecin during late autumn 2009. Analysis of the responses revealed that most of the women had tried to lose weight ever during their lives, many of them within the past six months. The respondents undertook weight-loss programmes regardless of their BMI, which may imply a disturbed perception of one's own body. In order to reduce body weight, the women applied various methods, usually modified diet and use slimming preparations. Among the preparations, the women most frequently mentioned appetite inhibitors or fat burning and thermogenesis enhancers. During the use of slimming enhancers, many women also changed their dietary patterns; such alterations were not necessarily nutritionally correct, due to either lack of knowledge on the principles of proper nutrition (which apply also during a weight-loss action) or due to abandoning these rules when applying the slimming aids. The observed dietary behaviours of the women may underlie serious nutrition-related health problems when they reach their middle age, but can also result in nutritional disorders in the near future."									
1391	Growth and development of children with HIV/AIDS.	Kim O.	Medical and Health Sciences Journal. 2011;8:16-20.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20113385699	"The aim of this study was to investigate physical development (PD) disturbances in 241 HIV-infected children, taking into consideration disease stage, viral replication, and severity of immunodeficiency. The children were divided into 3 age groups, i.e. <12 months (n=19), 12-35 months (n=107), and 36-59 months (n=115). PD was assessed based on the following indices: weight-to-growth, height-for-age, weight-for-age, and BMI-for-age. It was revealed that the PD indexes of children aged <12 months may not be used as predictors of HIV severity and progression rate. The prediction of severity and progression rate based on PD indices is possible only in children older than one year."									
1698	Does orphanhood by aids or by homicide effect nutritional status of children? [Portuguese].	"Bronhara B, Franca Junior I, Conde WL."	Revista Brasileira de Epidemiologia. 2012;15(3):548-59.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20123363538	"The aims of this paper were to evaluate the nutritional status of children orphaned by aids or homicides in the city of Sao Paulo and to estimate the association of nutritional indexes with orphanhood-related variables. The study was a household survey carried out between 2006 and 2007. We sampled 484 children representative of Sao Paulo, 5-14 years old who lost either or both of their parents from aids or homicides between 2000 and 2004. We selected body-mass-index-for-age (BMI) and height-for-age (height) as outcomes for analysis. Multiple linear regression in the light of a conceptual hierarchical approach was used for estimating BMI-for-age and height-for-age associated factors. Children from aids and homicides groups differed in terms of orphanhood-related variables and age. Economic, household, health and nutritional conditions were similar between groups. Underweight accounted for 1.3% and 2.1% of children under the age of 10 and adolescents, respectively. Stunting accounted for 0.7% and 4.0% of children and adolescents, respectively. Overweight accounted for 19% and 20% of children and adolescents, respectively. BMI and height were unaffected by orphanhood-related variables after adjusting for selected classical determinants of nutritional status in the hierarchical model. Economic status was the main determinant of the nutritional profile. Nutritional status of children orphaned by aids or homicides in Sao Paulo was similar and mainly influenced by economic status. The nutritional profile, characterized by being overweight, suggests that these orphans have not shown additional risks due to those orphanhood-related variables."									
238	"Vitamin A supplementation and other predictors of anemia among children from Dar Es Salaam, Tanzania."	"Villamor E, Mbise R, Spiegelman D, Ndossi G, Fawzi WW."	American Journal of Tropical Medicine & Hygiene. 2000;62(5):590-7.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=11289670	"The associations of hemoglobin, hematocrit, and packed cell volume with socioeconomic factors, malaria, human immunodeficiency virus (HIV) infection, and nutritional status were examined among 687 children admitted to hospital with pneumonia participating in a double blind, placebo-controlled trial of vitamin A supplementation. Children were randomized to receive 2 doses of vitamin A (200,000 IU) or placebo at baseline, and additional doses at 4 and 8 months after discharge from hospital. Hemoglobin levels were measured at enrollment and, on a subset of 161 children, during follow-up. At baseline, hemoglobin concentration was positively associated with the number of possessions in the household, maternal level of education and quality of water supply, and inversely related to malaria infection after controlling for potential confounding variables. Children infected with HIV experienced a significant fall in mean hemoglobin levels over time. The risk of developing severe anemia (< 7 g/dL) during follow-up was lower for children who were breastfed for longer than 18 months as compared to those with less than 6 months of breastfeeding (adjusted prevalence ratio = 0.14, 95% confidence interval [CI] = 0.02, 0.93; P = 0.04), and higher for children over two years of age as compared to 6 to 11 months-old infants (adjusted prevalence ratio = 8.11, 95% CI = 1.2, 55.8; P = 0.03). Children with repeated diagnoses of malaria had 4.1 times the risk of developing severe anemia than did children without the diagnosis (95% CI = 1.3, 13.5; P = 0.02). Vitamin A supplements were associated with an overall nonsignificant reduction of 14% in the risk of developing severe anemia (adjusted prevalence ratio = 0.86, 95% CI = 0.37, 1.99; P = 0.73). We conclude that malaria, HIV infection, low socioeconomic status, and short duration of breastfeeding are strong and independent determinants of adverse hematologic profiles in this population."									
1408	Maternal mid-upper arm circumference is associated with birth weight among HIV-infected Malawians.	"Ramlal RT, Tembo M, Soko A, Chigwenembe M, Ellington S, Kayira D, King CC, et al."	NCP Nutrition in Clinical Practice. 2012;27(3):416-21.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20123186971	"The authors examined the relationship of maternal anthropometry to fetal growth and birth weight among 1005 human immunodeficiency virus (HIV)-infected women in Lilongwe, Malawi, who consented to enrollment in the Breastfeeding, Antiretrovirals, and Nutrition Study (www.thebanstudy.org). Anthropometric assessments of mid-upper arm circumference (MUAC), arm muscle area (AMA), and arm fat area (AFA) were collected at the baseline visit between 12 and 30 weeks' gestation and in up to 4 follow-up prenatal visits. In longitudinal analysis, fundal height increased monotonically at an estimated rate of 0.92 cm/wk and was positively and negatively associated with AMA and AFA, respectively. These latter relationships varied over weeks of follow-up. Baseline MUAC, AMA, and AFA were positively associated with birth weight (MUAC: 31.84 g/cm<sup>2</sup>, 95% confidence interval [CI], 22.18-41.49 [P<.01]; AMA: 6.88 g/cm<sup>2</sup>, 95% CI, 2.51-11.26 [P<.01]; AFA: 6.97 g/cm<sup>2</sup>, 95% CI, 3.53-10.41 [P<.01]). In addition, MUAC and AMA were both associated with decreased odds for low birth weight (LBW; <2500 g) (MUAC: odds ratio [OR]=0.85, 95% CI, 0.77-0.94 [P<.01]; AMA: OR=0.95, 95% CI, 0.91-0.99 [P<.05]). These findings support the use of MUAC as an efficient, cost-effective screening tool for LBW in HIV-infected women, as in HIV-uninfected women."									
1453	Maternal mid-upper arm circumference is associated with birth weight among HIV-infected Malawians.	"Ramlal RT, Tembo M, Soko A, Chigwenembe M, Ellington S, Kayira D, King CC, et al."	Nutrition in Clinical Practice. 2012 June;27(3):416-21.		"The authors examined the relationship of maternal anthropometry to fetal growth and birth weight among 1005 human immunodeficiency virus (HIV)-infected women in Lilongwe, Malawi, who consented to enrollment in the Breastfeeding, Antiretrovirals, and Nutrition Study (www.thebanstudy.org). Anthropometric assessments of mid-upper arm circumference (MUAC), arm muscle area (AMA), and arm fat area (AFA) were collected at the baseline visit between 12 and 30 weeks' gestation and in up to 4 follow-up prenatal visits. In longitudinal analysis, fundal height increased monotonically at an estimated rate of 0.92 cm/wk and was positively and negatively associated with AMA and AFA, respectively. These latter relationships varied over weeks of follow-up. Baseline MUAC, AMA, and AFA were positively associated with birth weight (MUAC: 31.84 g/cm2, 95% confidence interval [CI], 22.18-41.49 [P <.01]; AMA: 6.88 g/cm2, 95% CI, 2.51-11.26 [P <.01]; AFA: 6.97 g/cm2, 95% CI, 3.53-10.41 [P <.01]). In addition, MUAC and AMA were both associated with decreased odds for low birth weight (LBW; <2500 g) (MUAC: odds ratio [OR] = 0.85, 95% CI, 0.77-0.94 [P <.01]; AMA: OR = 0.95, 95% CI, 0.91-0.99 [P <.05]). These findings support the use of MUAC as an efficient, cost-effective screening tool for LBW in HIV-infected women, as in HIV-uninfected women. 2012 American Society for Parenteral and Enteral Nutrition."									
1454	Maternal mid-upper arm circumference is associated with birth weight among HIV-infected Malawians.	"Ramlal RT, Tembo M, Soko A, Chigwenembe M, Ellington S, Kayira D, King CC, et al."	Nutrition in Clinical Practice. 2012;27(3):416-21.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=22511656	"The authors examined the relationship of maternal anthropometry to fetal growth and birth weight among 1005 human immunodeficiency virus (HIV)-infected women in Lilongwe, Malawi, who consented to enrollment in the Breastfeeding, Antiretrovirals, and Nutrition Study (www.thebanstudy.org). Anthropometric assessments of mid-upper arm circumference (MUAC), arm muscle area (AMA), and arm fat area (AFA) were collected at the baseline visit between 12 and 30 weeks' gestation and in up to 4 follow-up prenatal visits. In longitudinal analysis, fundal height increased monotonically at an estimated rate of 0.92 cm/wk and was positively and negatively associated with AMA and AFA, respectively. These latter relationships varied over weeks of follow-up. Baseline MUAC, AMA, and AFA were positively associated with birth weight (MUAC: 31.84 g/cm(2), 95% confidence interval [CI], 22.18-41.49 [P < .01]; AMA: 6.88 g/cm(2), 95% CI, 2.51-11.26 [P < .01]; AFA: 6.97 g/cm(2), 95% CI, 3.53-10.41 [P < .01]). In addition, MUAC and AMA were both associated with decreased odds for low birth weight (LBW; <2500 g) (MUAC: odds ratio [OR] = 0.85, 95% CI, 0.77-0.94 [P < .01]; AMA: OR = 0.95, 95% CI, 0.91-0.99 [P < .05]). These findings support the use of MUAC as an efficient, cost-effective screening tool for LBW in HIV-infected women, as in HIV-uninfected women."									
592	Metabolic parameters and cellular activation are determinant of immune reconstitution in ARV-treated HIV-1-infected South Africans.	"Azzoni L, Firnhaber C, Yin X, Foulkes A, Glencross D, Stevens W, Crowther N, et al."	Cytokine. 2009 October-November;48 (1-2):99.		"The balance between caloric metabolism and HIV replication is poorly understood. Antiretroviral drugs (ART) have been shown to alter lipid and glucose metabolism, leading to increased risk of cardiovascular disease; in addition, prior studies indicated that excess of adiposity might be beneficial for HIV-infected individuals, as it correlates with slower disease progression(8, 9), suggesting a relationship between the metabolic status of the subject and the progression of HIV infection. In this study, we sought to determine if the degree of immune reconstitution attained by therapy-naive HIV-1 infected subjects achieving viral suppression (viral load <50 copies/ml) on ART was related to baseline values of metabolic markers or adiposity. Methods: Study subjects: we assessed 85 ART-naive HIV-infected subjects initiating ART at the Clinical HIV Research Unit of the Themba Lethu Clinic, Johannesburg, South Africa [24 males, 61 females, age 34.84 years (8.31) CD4 = 257.435 (+/-62.676)]. The main endpoint was the CD4 count measured at approximately 36 weeks (range 220-259 days; CD4<sub>END</sub>). Statistical analysis: we used a linear modeling approach. The variables included in the model [CD4 count, viral load (Log<sub>10</sub>VL), waist/hip ratio (W:H), LDL cholesterol/HDL cholesterol ratio (LDL:HDL), and % of CD8<sup>+</sup> T cells expressing CD95] were selected based on log likelihood comparisons (alpha < 0.10). Other variables considered (gender, Dexa scan-based total fat mass, MRI-based L4-L5 fat, waist circumference, BMI and fasting glucose) were not significant as single predictors. Results: Both baseline CD4 (CD4<sub>BL</sub>) count and VL had a positive effect on CD4<sub>END</sub> (estimate = 2.73 and 170.03, respectively), suggesting that subjects with high VL pressure might benefit most from viral suppression in terms of CD4 recovery. When the absolute change in CD4 count from baseline to endpoint (CD4) was used as an alternate endpoint, CD4<sub>Bl</sub> had a negative predictive value, confirming prior observations that subjects with low CD4<sub>BL</sub> have steeper rates of CD4 recovery upon ART initiation. Both W:H and LDL:HDL (high values of which are associated with obesity) had a negative effect on endpoint CD4 count (estimates = -13.69 and -261.48, respectively). Importantly, adding the two metabolic terms to the model improved the adjusted R<sup>2</sup> from 0.074 to 0.162, indicating that metabolic variables may play a relevant role in determining immune reconstitution outcomes. However, the rates of viral suppression in normal/underweight subjects vs. overweight/obese subjects were similar, as assessed by survival curves, indicating that adiposity did not affected ART efficacy (e.g. by decreasing drug bioavailability). To assess the effects of cellular activation, in a subset of subjects (n = 69) we also modeled baseline % of CD8+/CD95<sup>+</sup> T cells; this variable had a positive effect on CD4<sub>END</sub> (estimate = 2.23), and its inclusion resulted in an adjusted R<sup>2</sup> of 0.295 (as compared to 0.241 for the model excluding % of CD8<sup>+</sup>/ CD95<sup>+</sup> T cells). Conclusions: By including both activation and metabolic parameters, we have developed a model based on pre-ART baseline measurements that accounts for 30% of the CD4<sub>END</sub> variability in otherwise equally virally suppressed individuals. Our analysis strongly suggests that adiposity and lipid metabolism may play a role in modulating the degree of immune reconstitution in response to ART."									
1137	Use of lipid-based nutrient supplements by HIV-infected Malawian women during lactation has no effect on infant growth from 0 to 24 weeks.	"Flax VL, Bentley ME, Chasela CS, Kayira D, Hudgens MG, Knight RJ, Soko A, et al."	Journal of Nutrition. 2012;142(7):1350-6.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=22649265	"The Breastfeeding, Antiretrovirals, and Nutrition Study evaluated the effect of daily consumption of lipid-based nutrient supplements (LNS) by 2121 lactating, HIV-infected mothers on the growth of their exclusively breast-fed, HIV-uninfected infants from 0 to 24 wk. The study had a 2 x 3 factorial design. Malawian mothers with CD4(+) >=250 cells/mm(3), hemoglobin >=70 g/L, and BMI >=17 kg/m(2) were randomized within 36 h of delivery to receive either no LNS or 140 g/d of LNS to meet lactation energy and protein needs, and mother-infant pairs were assigned to maternal antiretroviral drugs (ARV), infant ARV, or no ARV. Sex-stratified, longitudinal, random effects models were used to estimate the effect of the 6 study arms on infant weight, length, and BMI. Logistic regression models were used to calculate the odds of growth faltering [decline in weight-for-age Z-score (WAZ) or length-for-age Z-score (LAZ) >0.67] using the control arm as the reference. Although some differences between study arms emerged with increasing infant age in boys, there were no consistent effects of the maternal supplement across the 3 growth outcomes in longitudinal models. At the ages where differences were observed, the effects on weight and BMI were quite small (<=200 g and <=0.4 kg/m(2)) and unlikely to be of clinical importance. Overall, 21 and 34% of infants faltered in WAZ and LAZ, respectively. Maternal supplementation did not reduce the odds of infant weight or length faltering from 0 to 24 wk in any arm. These results indicate that blanket supplementation of HIV-infected lactating women may have little impact on infant growth."									
1957	HIV vasculopathy of the renal artery manifesting as severe hypertension in a young female: Case report and review.	"Nel D, Rayner B."	Vascular Disease Management. 2011 February;8(2):E40-E4.		"The burden of HIV infection, particularly in Sub-Saharan Africa, is well documented. The consequences are far-reaching and go beyond those of opportunistic infection and malignancy and into the realm of chronic diseases of lifestyle, with an increasing risk of cardiovascular disease in HIV-positive individuals. In this report we explore the case of a young black female with HIV who was referred with severe early-onset hypertension and was found, on further investigation, to have unilateral renal artery stenosis and bilateral renal artery aneurysms. We will also look at the clinicopathological entity of large- and medium-vessel vasculopathy associated with HIV."									
1445	The elimination of child poverty and the pivotal significance of the mother.	Crawford MA.	Nutrition & Health. 2008;19(3):175-86.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=19009739	"The child poverty not an independent condition: it is intimately related to the ecology of the family. It elimination will involve the elimination poor maternal nutrition, low birthweight and its life long consequences in chronic ill health and poor learning. Maternal nutrition and health is a prime determinant of the future of the child and also of her own health, mental state and ability to manage child care. Maternal nutrition and health is also relevant to the future employment opportunities, health, skills and literacy and social behaviour of the new born. Poor maternal nutrition and adverse outcomes conspire to maintain the state of poverty. Children need to be empowered by knowledge. Nutrition, health and home economics should be introduced from pre-school to advanced levels in the school curriculum. It makes little sense to educate children with everything they need to know except how to take charge of their own health, reproductive capacity, cognitive development and that of their own children that they are likely bear. Today non-communicable diseases account for more deaths than all the HIV-AIDS, Malaria, and Tuberculosis combined. The Global Forum for Health predicts that the top three burdens of ill health world-wide will by 2020 be heart disease, perinatal conditions (adverse pregnancy outcomes) and mental ill-health. Unfavourable nutritional conditions contribute substantially to the cause of these three conditions and other non-communicable diseases. Yet children today grow up in ignorance of the science of nutrition and health and become leaders in industry and government with little understanding of nutritional science which could, if taught properly, lead to large scale reductions in chronic disorders, substantial cost savings in the health services and especially in the enhancement of population skills and prosperity. It is also evident that education alone will not suffice. The priority in human development is vested in the brain. Nutrition and food policies last century were based on protein and growth. This century they should be re-aligned to take the human priority of the brain nutrition into account. [References: 27]"									
555	"Mycobacterial bacteraemia in patients infected and not infected with human immunodeficiency virus, Taiwan."	"Tan CK, Lai CC, Liao CH, Chou CH, Hsu HL, Huang YT, Hsueh PR."	Clinical Microbiology and Infection. 2010;16(6):627-30.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20103163534	"The clinical characteristics and outcomes of 71 patients with mycobacterial bacteraemia, infected with human immunodeficiency virus (HIV) (n=47) and not infected with HIV (n=24) are described. Mycobacterium avium complex (MAC) (54.9%) constituted the most frequently isolated mycobacterium, followed by Mycobacterium tuberculosis (MTB) (38.0%), Mycobacterium kansasii (4.2%), and Mycobacterium abscessus (2.8%). The Beijing family genotype was the most common type in MTB, and Mycobacterium intracellulare was the most common species in MAC. The overall mortality rate was 33.8%; it was lower in HIV-infected than in non-HIV-infected patients. HIV-infected patients were younger, had fewer underlying diseases and better nutritional status, and were more likely to have MAC bacteraemia than MTB bacteraemia."									
243	Malnutrition is associated with increased mortality in adult medical inpatients at a regional referral hospital in southwestern uganda.	"Asiimwe SB, Moore CC."	American Journal of Tropical Medicine and Hygiene. 2012 November;1):79-80.		"The contribution of malnutrition to the course of acute illness and hospital-based mortality in adults in sub-Saharan Africa (SSA) is not fully described. To determine if malnutrition is associated with increased mortality in hospitalized patients in SSA we conducted a prospective observational study of 318 adult (age >= 18 years) medical inpatients admitted to the Mbarara Regional Referral Hospital in southwestern Uganda. For each patient, we calculated body mass index (BMI) and a mini-nutritional assessment short form (MNA-SF) score. We followed patients until death or 30 days from admission. The cohort included 152 (48%) women and the mean (+/- SD) age was 42 (+/- 8) years. There were 144 (45%) HIV infected patients and 132 (42%) had suspected tuberculosis (TB). Other diagnoses included severe anemia with HB <= 7 g/ dl (89, 28%), diarrhea (52, 16%), pneumonia (44, 14%), kidney disease (24, 8%) and stroke (11, 4%). Malnutrition (MNA-SF <= 7) occurred in 187 (59%) patients and 149 (47%) patients had a BMI of <18.5 kg/m2. The inhospital mortality was 18% (57 of 318). Of the 261 patients discharged, only 27 (10%) were lost to 30 day follow-up. The 30 day mortality was 40% (117 of 291). In the univariate analysis, malnutrition, an abnormal temperature (>=38 degreeC or <36 degreeC), HIV infection, and presence of suspected TB were significantly associated with mortality (p < 0.05). In the multivariate analysis, only malnutrition (adjusted OR 3.7, 95% CI 1.6-8.6, p = 0.002) and abnormal temperature (adjusted OR 2.0, 95% CI 1.0-3.9, p = 0.04) remained independently associated with mortality. Our findings indicate that malnutrition contributes strongly to mortality in acutely ill hospitalized adults in SSA. Additional research is urgently needed to better understand the pathophysiology of malnutrition in acutely ill hospitalized adults in SSA and ways to mitigate its effect."									
579	"Countdown to 2015 decade report (2000-2010) with country profiles: taking stock of maternal, newborn and child survival."		"Countdown to. 2015 decade report (2000-2010) with country profiles: taking stock of maternal, newborn and child survival(2010.):53 pp."	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20103308518	"The Countdown collects and analyses data from 68 countries that account for at least 95% of maternal and child deaths. This 2010 report reviews the progress over 2000-10 towards Millennium Development Goals (MDGs) 4 (reduce child mortality) and 5 (improve maternal health) and discusses the causes of maternal and child mortality, social determinants of and financing for maternal, newborn and child health, coverage of interventions along the continuum of care, health systems and policies for survival of women, newborns and children, and equal care for every mother and child. The success in reducing inequities in Brazil and narrowing gender differentials in Bangladesh are described. The country profiles of the 68 countries (Afghanistan, Angola, Azerbaijan, Bangladesh, Benin, Bolivia, Botswana, Brazil, Burkina Faso, Burundi, Cambodia, Cameroon, Central African Republic, Chad, China, Congo, Congo Democratic Republic, Cote d'Ivoire, Djibouti, Egypt, Equatorial Guinea, Eritrea, Ethiopia, Gabon, Gambia, Ghana, Guatemala, Guinea, Guinea-Bissau, Haiti, India, Indonesia, Iraq, Kenya, Korea Democratic People's Republic, Laos, Lesotho, Liberia, Madagascar, Malawi, Mali, Mauritania, Mexico, Morocco, Mozambique, Myanmar, Nepal, Niger, Nigeria, Pakistan, Papua New Guinea, Peru, Philippines, Rwanda, Senegal, Sierra Leone, Somalia, South Africa, Sudan, Swaziland, Tajikistan, Tanzania, Togo, Turkmenistan, Uganda, Yemen, Zambia and Zimbabwe) covering the following indicators are presented: demographics; nutrition (underweight prevalence, exclusive breastfeeding and vitamin A supplementation); child health (immunization, malaria prevention and treatment, prevention of maternal HIV transmission, diarrhoeal disease treatment and pneumonia treatment); maternal and newborn health (causes of maternal mortality, contraceptive use, antenatal care, skilled attendant at delivery, and neonatal tetanus protection); water and sanitation; financial investments in maternal, newborn and child health; and equity of access, health systems and policy."									
1038	Environmental health impacts of dispersed mineralisation in South Africa.	"Davies TC, Mundalamo HR."	Journal of African Earth Sciences. 2010;58(4):652-66.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20103347173	"The crust of South Africa has undergone various episodes and styles of mineralisation, dating as far back as the Archaean. The suite of minerals produced is diverse and includes metals, non-metals and industrial minerals. Since the Pleistocene, substantial quantities of elements, both nutritional and toxic, that were involved in ore forming processes, have been remobilised and redistributed by surficial processes of intense tropical weathering, leaching, eluviation, podsolisation and gleying; and more recently, by mining and related processes, as well as by other urban and industrial activities. As a result of this ""dispersion"" it is not uncommon to find large tracts of the country containing anomalous trace element contents or deficiencies in essential micro-nutrient elements. Through water and food crops, extremes in trace element variation in soils are transmitted into the food chain, with often undesirable consequences for human and animal health. But the known variations are not as yet adequately documented. Nor is there sufficient knowledge on the implications of these variations for the health of the environment and its ecosystems. Nutrient deficient soils may be the principal causative factor in the devastating endemic osteoarthritic disease that afflicts two-thirds of the women in Maputaland, for instance. The generally low Se status of agricultural soils could represent an important co-factor in the relatively high diffusion rates of HIV-AIDS in the country. The impact of geology on animal health also remains an area of critical concern to both farmers and managers of the hugely important wildlife game reserves. This paper discusses a few known relationships between trace element excess/deficiency stemming originally from mineralisation processes, and the local and regional distribution of diseases in man and animals in South Africa. It is submitted that the challenge for future research in medical geology would lie in an organised effort aimed at detecting, verifying and documenting such relationships. This would help greatly in broadening the diagnostic spectrum and therapy for a number of environmental diseases in the country."									
450	HIV and infant feeding: to breastfeed or not to breastfeed: the dilemma of competing risks. Part 1.	Morrison P.	Breastfeeding Review. 1999;7(2):5-13.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=10453705	"The discovery of the human immunodeficiency virus (HIV) in breastmilk in 1985, and subsequent research, supports the hypothesis that breastfeeding provides a route of transmission to the nursing baby. Various routes of infection and relative rates of transmission have been studied in many parts of the world, leading to the blanket guideline that babies of HIV-infected mothers should not be breastfed, if a safe alternative can be provided. However, due to the limits inherent in various studies and various testing methods, the exact frequency of breastmilk transmission of HIV during the course of lactation remains unknown, and the conclusions drawn are thus conflicting and confusing. Replacement feeding of young babies with non-human milks and other foods may be hazardous in poverty-stricken populations in Africa and elsewhere, and still more research suggests that there are several properties in human milk that may provide specific protection to the baby of an infected mother. The possibility of providing the mother's own treated expressed breastmilk to the baby at risk of HIV infection via breastfeeding is an alternative which has yet to be fully explored and ways that this could be accomplished are examined. Those of us working with mothers and babies need more information before we can assist mothers living with HIV to make truly informed decisions about the safest way to feed their babies. Topics requiring urgent further attention are outlined. [References: 89]"									
1785	Health impacts of rapid economic changes in Thailand.	"Tangcharoensathien V, Harnvoravongchai P, Pitayarangsarit S, Kasemsup V."	Social Science & Medicine. 2000;51(6):789-807.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=10972425	"The economic crisis in Thailand in July 1997 had major social implications for unemployment, under employment, household income contraction, changing expenditure patterns, and child abandonment. The crisis increased poverty incidence by 1 million, of whom 54% were the ultra-poor. This paper explores and explains the short-term health impact of the crisis, using existing data and some special surveys and interviews for 2 years during 1998-99. The health impacts of the crisis are mixed, some being negative and some being positive. Household health expenditure reduced by 24% in real terms; among the poorer households, institutional care was replaced by self-medication. The pre-crisis rising trend in expenditure on alcohol and tobacco consumption was reversed. Immunization spending and coverage were sustained at a very high level after the crisis, but reports of increases in diphtheria and pertussis indicate declining programme quality. An increase in malaria, despite budget increases, had many causes but was mainly due to reduced programme effectiveness. STD incidence continued the pre-crisis downward trend. Rates of HIV risky sexual behaviour were higher among conscripts than other male workers, but in both groups there was lower condom use with casual partners. HIV serosurveillance showed a continuation of the pre-crisis downward trend among commercial sex workers (CSW, both brothel and non-brothel based), pregnant women and donated blood; this trend was slightly reversed among male STD patients and more among intravenous drug users. Condom coverage among brothel based CSW continued to increase to 97.5%, despite a 72% budget cut in free condom distribution. Poverty and lack of insurance coverage are two major determinants of absence of or inadequate antenatal care, and low birthweight. The Low Income Scheme could not adequately cover the poor but the voluntary Health Card Scheme played a health safety net role for maternal and child health. Low birthweight and underweight among school children were observed during the crisis. The impact of the crisis on health was minimal in some sectors but not in the others if the pre-crisis condition is efficient and healthy and vice versa. We demonstrated some key health status parameters during the 2-year period after the 1997 crisis but do not have firm conclusions on the impact of the economic crisis on health status, as our observation is too short and there is uncertainty on how long the crisis will last."									
1947	Dyslipidaemia in patients on first-line ART in India - A prospective cohort study.	"Sashindran VK, Kumar S, Kumar A, Namgyal K, Dabas R."	Tropical Medicine and International Health. 2009 September;14:34.		"The effect of first line ART on the lipid profile of Indians who are, as it is, at increased risk for cardiovascular disease has not been studied. This study was planned with the hypothesis that combination antiretroviral therapy (cART), even without protease inhibitors, will significantly increase the occurrence of proatherogenic yslipidaemia in Indians, and aimed to study the prevalence and pattern of dyslipidaemia in patients being put on ART and the factors affecting it. Volunteering adult HIV patients initiating first line ART were recruited as subjects in this prospective cohort study. Patients with pre-existing diabetes, chronic kidney/liver disease were excluded. They were followed up with serial weight recordings, CD4 cell count estimation and lipid profiles for a minimum of 12 months. The National Cholesterol Education Program-Adult Treatment Panel-III (NCEP - ATP III) recommendations were used to define dyslipidaemia. Statistical analysis was done using R 2.7.2 (R Development Core Team (2008). URL http://www.R-project.org). Analyses were done with ANOVA and Kruskal Wallis test, paired t test, chi square test and Fisher's exact test and multiple linear regression analysis (LRA). Seventy subjects were enrolled of which 87% were male with a mean age of 38.7 years and a mean body mass index of 20.5. They were followed up for an average of 18.1 months. Prevalence of dyslipidaemia before ART was 0.75 (95%CI 0.58-0.79) and 0.90 after ART (95% CI 0.81-0.95). Prevalence of different types of dyslipidaemia before and after ART was: high TC 4.3, 27.3%, high Tg 22.9, 30%, high LDL 35.7, 54.3% and low HDL 45.7, 78.5% respectively. Paired t-test for effect of treatment showed significant changes in lipid values after treatment: TC 4.3-22.9 (P = 0.005), Tg 1.9-32 (P = 0.03), LDL 4.2-25.8 (P = 0.007), HDL (-6.2)-(-1.9) (P = 0.0003). Linear regression analysis showed that confounding factors such as age, opportunistic infections, BMI and CD4 cell count did not significantly affect lipid levels. Only Tg levels were directly influenced by rise in CD4 count (P = 0.04). Analysis of temporal trends showed a consistent fall in HDL (P = 0.0001), and rise in Tg (P = 0.051). Dyslipidaemia is very common both before and after ART (0.75, 0.9) - commonest abnormalities being low HDL and high LDL. The treatment regimen did not influence dyslipidaemia but larger studies are required to conclusively exclude it. Temporal worsening of Tg and HDL values was seen. Only Tg values worsen with rise in CD4 count with treatment. The high prevalence of dyslipidaemia in AIDS patients in India necessitates further research into causes and preventive methods."									
827	Persistence of stunting after highly active antiretroviral therapy in HIV-infected children in South India.	"Devi NPG, Chandrasekaran K, Bhavani PK, Thiruvalluvan C, Soumya S."	Indian Pediatrics. 2011;48(4):333-4.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20113192174	"The effect of highly active antiretroviral treatment (HAART) on growth and immunologic parameters was investigated in HIV-infected children, in Tamil Nadu, India, over a period of one year [date not given]. The impact of baseline immune status on post-HAART improvement in underweight, stunting and wasting was also determined. A cohort of HIV-infected children was followed at the Tuberculosis Research Centre clinic, Madurai, every three months with clinical monitoring and every 6 months with laboratory investigations. Nutritional counselling, iron, folic acid and multivitamin supplements and co-trimoxazole prophylaxis were provided to all children. Children were referred to the nearest government antiretroviral treatment centre, where they were initiated on treatment as per NACO guidelines. Of 102 children, 49 were started on treatment (HAART group) after assessment at the ART centre while 53 were considered not to require ART (non HAART group). The prevalence of underweight and wasting at baseline in the HAART group (81% and 56%) was significantly higher than in the non-HAART group (59% and 29%) while rates of stunting were not different (52% and 50%, respectively). ART eligible children had lower baseline median CD4% and CD4 counts indicating their worse immune status. There was an overall beneficial effect of HAART on growth and immunologic parameters. However, a substantial proportion of children were undernourished even at the end of one year and stunting persisted. Strategies to prevent irreversible stunting such as earlier initiation of HAART and/or nutritional supplementation are warranted."									
28	"Effect of nutritional supplement on the CD4 T-lymphocyte counts of treatment naive asymptomatic HIV patients in Benin City, Nigeria."	"Okorie EN, Ophori EA."	Advances in Bio Research. 2013;4(2):106-8.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20133257066	"The effect of nutritional supplementation with haematinics and multivitamins on CD4<sup>+</sup> T-lymphocyte counts of 30 diagnosed anti-retreoviral therapy naive asymptomatic human immunodeficiency virus (HIV) patients was investigated retrospectively from November 2005 to April 2006. Twenty-five sero-negative subjects were used as control. All the subjects were above the age of 18 years. The HIV patients were counseled on good nutrition and placed on haematinics and multivitamins three dose daily for six months. The CD4<sup>+</sup> T-lymphocytes count of all subjects were determined at baseline, 3 and 6 months. Results showed that the CD4<sup>+</sup> T-lymphocytes count of HIV subjects was not statistically different from that of control subjects throughout the study period (P>0.05). Also, baseline, 3 and 6 months CD4<sup>+</sup> T-lymphocytes values did not differ from each other significantly in both HIV patients and control (P>0.05). Although the number of HIV subjects with CD4<sup>+</sup> T-lymphocytes count of >500 cells/ micro l reduced during the study period, none had a value of <200 cells/ micro l. This study suggests that nutritional supplements may maintain the CD4<sup>+</sup> T-lymphocytes levels for 6 months in HIV seropositive individuals, we recommend that appropriate timing of nutritional intervention be advocated and further encouraged."									
1079	"The effects of soybean (Glycine max) and pigeon pea (Cajanus cajan) food mixtures on the nutritional status of school children in Suba District, Kenya."	"Ohiokpehai O, David DM, Kamau J."	"Journal of Food, Agriculture and Environment. 2009 April;7(2):59-63."		"The effects of HIV and AIDS are reversing the developmental gains on malnutrition in Africa. It is important to reposition nutrition for development that is sustainable, especially in resource poor areas, an example which is Suba District in Nyanza province. Suba District has the highest prevalence of HIV and AIDS which is currently 31%. This has resulted in inadequate food at the household level leading to macro and micronutrient deficiencies. The objective of the work was to establish the effect of corn-soy and corn-pigeon pea blends on nutritional status of school children aged 6-9 years in Suba District, Kenya. An experimental research design was adopted that would enable the data to be analyzed statistically. Two primary schools were purposively selected followed by a systematic sampling of the pupils leading to the selection of 49 pupils from Mbita and 52 pupils from Ong'ayo schools. The children were purposely chosen to be affected by HIV and known to be vulnerable in the community. Soybean or pigeon peacorn mixtures were commercially prepared at NUTRO EPZ, Athi River, Kenya, to give 14% protein of roasted flour. The children were fed at midday in school and a take home ration was prepared to serve a family of five during the weekend to ensure that the index child was allowed to eat his/ her portion. Anthropometric techniques were used for data collection. Pupils from Mbita were fed on corn-soy while those from Ong'ayo were fed on corn-pigeon pea blends for five months. Nutrisurvey and SPSS were used for data analysis. Descriptive and inferential statistics were used to interpret results at p<0.05 confidence interval. Stunting level in Mbita decreased from 21.6 to 16.4% and in Ong'ayo from 21.5 to 18.8%. Underweight and wasting decreased significantly (p<0.05). Grain legumes can improve nutritional status of children; however, a longer feeding (intervention) period and a more dense food type are needed to allow for a better impact. Grain legumes, especially soybeans, contain genistein and immune-boosting substances that can improve growth and could decrease the use of nutritional intervention."									
1225	Vitamin D deficiency in HIV-infected women on antiretroviral therapy living in the tropics.	"Conrado T, De Barros Miranda-Filho D, De Alencar Ximenes RA, De Fatima Albuquerque M, Lacerda HR, Ramos RCF, De Araujo PSR, et al."	Journal of the International Association of Physicians in AIDS Care. 2011 August;10(4):239-45.		"The effects of HIV/AIDS and antiretroviral drugs on vitamin D metabolism are still mostly unknown. This was a cross-sectional study to estimate the prevalence of vitamin D deficiency and identify its association with the clinical and metabolic parameters among 214 HIV-positive female patients on antiretroviral therapy (ART) in Brazil. The prevalence of vitamin D deficiency (< 30 ng/ml) was 40.65% (87/214). Hypercholesterolemia, high LDL-c, duration of use of current antiretroviral regimen, hypertriglyceridemia, body mass index, age, hypertension, time with AIDS >= 10 years and hyperglycemia were selected for multivariate analysis (p < 0.20). After this analysis, hypercholesterolemia and use of current antiretroviral regimen >= 3 years remained independently associated with vitamin D deficiency. There was an inverse statistically significant correlation between total cholesterol and serum 25(OH)D levels. High prevalence of vitamin D deficiency was found among HIV-positive women on ART and was independently associated with its prolonged use and with hypercholesterolemia."									
1226	Vitamin D deficiency in HIV-infected women on antiretroviral therapy living in the tropics.	"Conrado T, Miranda Filho DdB, Ximenes RAdA, Albuquerque MdF, Lacerda HR, Ramos RCF, Araujo PSRd, et al."	Journal of the International Association of Physicians in AIDS Care. 2011;10(4):239-45.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20113261888	"The effects of HIV/AIDS and antiretroviral drugs on vitamin D metabolism are still mostly unknown. This was a cross-sectional study to estimate the prevalence of vitamin D deficiency and identify its association with the clinical and metabolic parameters among 214 HIV-positive female patients on antiretroviral therapy (ART) in Brazil. The prevalence of vitamin D deficiency (<30 ng/ml) was 40.65% (87/214). Hypercholesterolemia, high LDL-c, duration of use of current antiretroviral regimen, hypertriglyceridemia, body mass index, age, hypertension, time with AIDS >=10 years and hyperglycemia were selected for multivariate analysis (p<0.20). After this analysis, hypercholesterolemia and use of current antiretroviral regimen >=3 years remained independently associated with vitamin D deficiency. There was an inverse statistically significant correlation between total cholesterol and serum 25(OH)D levels. High prevalence of vitamin D deficiency was found among HIV-positive women on ART and was independently associated with its prolonged use and with hypercholesterolemia."									
1235	Vitamin D Deficiency in HIV-Infected Women on Antiretroviral Therapy Living in the Tropics.	"Conrado T, Miranda-Filho DdB, Ximenes RAdA, Albuquerque MdF, Lacerda HR, Ramos RCF, Araujo PSRd, et al."	Journal of the International Association of Physicians in AIDS Care (JIAPAC). 2011 Aug 2011;10(4):239-45.	http://search.proquest.com/docview/885996501?accountid=26724	"The effects of HIV/AIDS and antiretroviral drugs on vitamin D metabolism are still mostly unknown. This was a cross-sectional study to estimate the prevalence of vitamin D deficiency and identify its association with the clinical and metabolic parameters among 214 HIV-positive female patients on antiretroviral therapy (ART) in Brazil. The prevalence of vitamin D deficiency (< 30 ng/ml) was 40.65% (87/214). Hypercholesterolemia, high LDL-c, duration of use of current antiretroviral regimen, hypertriglyceridemia, body mass index, age, hypertension, time with AIDS greater than or equal to 10 years and hyperglycemia were selected for multivariate analysis (p < 0.20). After this analysis, hypercholesterolemia and use of current antiretroviral regimen greater than or equal to 3 years remained independently associated with vitamin D deficiency. There was an inverse statistically significant correlation between total cholesterol and serum 25(OH)D levels. High prevalence of vitamin D deficiency was found among HIV-positive women on ART and was independently associated with its prolonged use and with hypercholesterolemia."									
517	Diarrhea and reduced levels of antiretroviral drugs: improvement with glutamine or alanyl-glutamine in a randomized controlled trial in northeast Brazil.[Erratum appears in Clin Infect Dis. 2004 Aug 15;39(4):607].	"Bushen OY, Davenport JA, Lima AB, Piscitelli SC, Uzgiris AJ, Silva TM, Leite R, et al."	Clinical Infectious Diseases. 2004;38(12):1764-70.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medc&AN=15227625	"The effects of therapy with glutamine and alanyl-glutamine on diarrhea and antiretroviral drug levels in patients with acquired immune deficiency syndrome (AIDS) were examined in a randomized, double-blinded, placebo-controlled study in northeast Brazil. Patients with AIDS and with diarrhea and/or wasting were randomized into 4 groups to determine the efficacy of glutamine or high- or low-dose alanyl-glutamine given for 7 days, compared with isonitrogenous glycine given to control subjects. All patients in whom baseline antiretroviral drug levels were determined had low levels 2 h after dosing. Gastrointestinal symptom scores improved with receipt of high-dose alanyl-glutamine (P<.05) or glutamine (P<.01). Antiretroviral drug levels increased in patients given alanyl-glutamine (P=.02) or glutamine (P=.03) by 113% (P=.02) and 14% (P=.01), respectively. Antiretroviral drug resistance mutations were common in all groups. The dose-related efficacy of alanyl-glutamine and glutamine in treating diarrhea and in increasing antiretroviral drug levels shows that these supplements may help to improve therapy for patients with AIDS who have diarrhea and/or wasting in developing, tropical areas."									
1782	The Elderly and AIDS: Coping with the Impact of Adult Death in Tanzania.	"Dayton J, Ainsworth M."	Social Science & Medicine. 2004 Nov 2004;59(10):2161-72.	http://search.proquest.com/docview/60518043?accountid=26724	"The elderly are one of the key groups of survivors who may be adversely affected by the death of prime-age adults from AIDS. We use a longitudinal survey of households from Northwestern Tanzania in 1991-94 to compare the activities & welfare of the elderly in households before & after the death of a prime-age adult with that of the elderly in households that did not have an adult death. The elderly in households that had an adult death were more educated, more likely to engage in wage employment & spent less time farming than the elderly in households that did not have a death during the survey. Time spent by the elderly in household chores rose following an adult death & participation in wage employment fell; there was no evidence of increased participation in farm work. The physical well-being of the elderly, as measured by body mass index (BMI), was lower prior to an adult death & higher afterward. Finally, the elderly with the lowest BMI are those in poor households that did not have an adult death during the survey. Thus, policymakers should be concerned about the adverse impacts of adult deaths on the physical well-being of the elderly -- primarily during the period of illness prior to a prime-age adult death -- but they should also focus on the larger groups of poor elderly with much lower physical health status. 6 Tables, 1 Figure, 30 References. [Copyright 2004 Elsevier Ltd.]"									
309	Bilateral parotid enlargement due to malnutrition under the influence of the media in an adolescent in Lithuania.	"Mieliauskaite D, Venalis A, Graziene V, Kirdaite G."	Appetite. 2007;49(1):260-2.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=17198741	"The elimination of censorship for the media in post-communist countries in transition has contributed to increases in the prevalence of several medical problems. Children and adolescents are particularly vulnerable to the messages conveyed through the media, which influence their perceptions and behaviour. We describe a case of bilateral parotid enlargement due to malnutrition under the influence of self-prescribed diet in an adolescent. A 15-year-old girl reported to our institution under suspicion of Sjogren's syndrome for medical advice. Two months ago she developed persistent bilateral parotid enlargement and a dry mouth. Her medical history revealed a weight loss due to ""self-prescribed"" reduce diet. Social questioning clarified high use of the media and influence on the body concept and self image. On extra oral examination, a diffuse parotid enlargement was seen bilaterally. The examination of the mouth showed a low moisture level of the intraoral mucosa. The unstimulated whole salivary flow rate was 2 ml in 15 min. Laboratory findings evidenced anemia (107 g/l). The serum albumin concentration indicated a reduced level (28 g/l). Search for antinuclear antibodies, anti-SSA antibodies, anti-SSB, -Sm, -RNP and anti-double-stranded DNA antibodies was negative. Evaluation for antibodies against hepatitis C, cytomegalovirus and Epstein-Barr virus infection and HIV rendered negative results. A histopathologic examination of labial salivary gland biopsy revealed a picture of sialoadenosis. From the above investigations, a diagnosis of sialoadenosis due to malnutrition was made."									
805	Endoplasmic reticulum stress in diabetes: New insights of clinical relevance.	"Balasubramanyam M, Lenin R, Monickaraj F."	Indian Journal of Clinical Biochemistry. 2010 April;25(2):111-8.		"The endoplasmic reticulum (ER) is a cellular compartment responsible for multiple important cellular functions including the biosynthesis and folding of newly synthesized proteins destined for secretion, such as insulin. A myriad of pathological and physiological factors perturb ER function and cause dysregulation of ER homeostasis, leading to ER stress. Accumulating evidence suggests that ER stress plays a role in the pathogenesis of diabetes, contributing to pancreatic beta-cell loss and insulin resistance. ER stress may also link obesity, inflammation and insulin resistance in type 2 diabetes. In this review, we address the transition from physiology to pathology, namely how and why the physiological UPR evolves to a proapoptotic ER stress response in diabetes and its complications. Special attention was given to elucidate how ER stress could explain some of the 'clinical paradoxes' such as secondary sulfonylurea failure, initial worsening of retinopathy during tight glycemic control, insulin resistance induced by protease inhibitors and other clinically relevant observations. 2010 Association of Clinical Biochemists of India."									
1430	Food and nutritional profile of HIV-positive patients assisted in a public health service of Porto Alegre/RS.	"Rocha PB, Schuch I."	Nutrire Revista da Sociedade Brasileira de Alimentacao e Nutricao. 2009;34(3):1-15.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20103081774	"The evolution of Highly Active Antiretroviral Therapy (HAART) has provided HIV/AIDS patients with a significant reduction in the incidence of opportunistic infections, making this disease chronic and controllable. The main problems related to nutritional status in these patients are redistribution of body fat, obesity or malnutrition. The objective of this study was determining the diet and nutritional profile of HIV-positive patients in the asymptomatic phase at the first consultation in a public health service in Porto Alegre/Rio Grande do Sul, Brazil. We studied a total of 128 patients. The results showed that 65% of them were aged 31 to 50 years and the most prevalent education levels corresponded to those who had finished elementary school and high school (28.3% for both). Around 60% of them had incomes from 1 to 2.9 minimum wages. Regarding nutritional status, about 40% of the participants presented overweight or obesity. There was a higher prevalence of eutrophic men and women presenting grade I obesity. Approximately 59% of the patients said that they did not have any kind of physical activity. The evaluation of the diet nutritional composition, made from the 24-h record, showed an average distribution of macronutrients comprising 53-6% carbohydrates, 16.09% proteins and 30.64% lipids. Smoking was found among 30.6% of the subjects and 32.3% of them have alcoholic drinks at least once a week. The prevalence of overweight and obesity is important, indicating the need for monitoring nutritional status and nutritional interventions targeted at this group."									
1636	Achieving the goal of halving global hunger by 2015.	Prakash S.	Proceedings of the Nutrition Society. 2006;65(1):7-18.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20063030763	"The FAO World Food Summit (WFS) in 1996 set the goal of halving the numbers of the global population suffering hunger by the year 2015, which was later incorporated into the UN Millennium Development Goals (MDG) that commit the international community to an expanded vision of development, and one that vigorously promotes human development as the key to sustaining social and economic progress in all countries. The two targets under the first MDG goal to eradicate poverty and hunger call for halving the proportion of individuals who suffer from poverty and from hunger by 2015. This commitment is another instance of the international community through the UN system yet again renewing its efforts and setting a target and a time frame to deal with the global problem of hunger, poverty and malnutrition. To date, the efforts to reduce global hunger in the developing world have fallen far short of the pace required to meet these targets. There has no doubt been some progress and several countries in the developing world have proved that success is possible. The economic and societal costs to developing countries of not taking decisive action, and thus failing to achieve a reduction in hunger and undernutrition, including micronutrient malnutrition costs, are that every year five million children lose their lives, 220 million disability-adjusted life years are lost as a result of childhood and maternal undernutrition and billions of dollars are lost in productivity and incomes in these countries. Alongside this perennial problem in developing societies are emerging new epidemics of diet-related diseases resulting from the profound demographic changes, urbanization and the economic transition that is transforming and globalizing the food systems in these countries. Thus, many developing countries are facing new and additional challenges of co-existing hunger alongside the emergence of other forms of malnutrition. Meeting the WFS and MDG targets of achieving the goal of halving global hunger is urgent, and the question that needs to be addressed is not whether the international community can achieve this goal in time but whether it can afford not to."									
1378	Tuberculosis and AIDS in an antituberculosis centre in Bouake (Ivory Coast).	"Eholie SP, Ehui E, Domoua K, Kakou A, Diarrassouba M, Mobio N, Bissagnene E, et al."	Medecine et Maladies Infectieuses. 1999;29(2):99-104.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh2&AN=19992008963	"The features of tuberculosis in 327 patients (187 men, 140 women) treated in Bouake Antituberculosis Centre, Bouake, Cote d'Ivoire, during April-December 1996. Among the 327 patients, 133 (38%) were HIV-positive and 194 (62%) were HIV-negative. They were treated with short therapy isoniazid-rifampicin-pyrazinamide for 2 months then isoniazid-rifampicin for 4 months. In HIV-positive patients, there was a higher probability of wasting syndrome (P=0.05), multifocal extrapulmonary tuberculosis (P=0.002), negative microscopy tuberculosis (P=0.005), mortality (P=0.05) and drug related side events (P=0.01)."									
852	Guidelines for environmental health management in children's homes in sub-Sahara Africa.	"Muruka C, Muruka A."	International Journal of Environmental Research & Public Health [Electronic Resource]. 2007;4(4):319-31.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=18180543	"The field of environmental health focuses on the relationships between human health and well being and the influence of the physical, social and societal environments. Our understanding of the environment-health interface has progressed because of two relatively recent insights: First, the recognition that the unprecedented environmental changes of the last half-century are affecting global population health. Secondly, the recognition that children have greater vulnerability to environmental hazards and are inadequately protected by current regulatory standards. Efforts to redress this situation have shaped the current thrust in environmental health research toward preventing further harm to children's health. The disproportionate vulnerability of children to environmental hazards can be explained by several reasons. Children are not ""little adults."" It is known that children have greater risk of exposure and greater risk of harm compared to adults for many reasons that are unique to each developmental stage. Their behaviour and activity patterns bring them into greater contact with toxins. Children have important biological differences. Immature developing organs and tissues are more vulnerable to harm from toxic exposures. Immature metabolic and physiological systems less effectively protect the child from toxic exposure and effects. In addition, children have additional pathways of exposure that are not applicable to adults, e.g., in utero, via breast milk and via products such as toys, clothing, etc. Children also have a longer ""shelf life."" They have much more of their life ahead of them during which time they will be exposed and may develop health problems as a result. Finally, children are more often involuntarily exposed and unable to avoid exposures of their own accord [1]. Due to the AIDS catastrophe in Sub- Saharan Africa, the numbers of children in difficult circumstances have increased. To mitigate the effects of the catastrophe, charitable organizations have sprung up to establish homes for such children, especially those orphaned by AIDS or those infected with HIV. It is important to ensure that environmental health hazards and risks are minimized in these children's homes. By use of a conceptual synthesis approach, the authors attempt to generate guidelines from literature for environmental health management in children's homes in sub-Saharan Africa."									
1526	Visceral leishmaniasis in a Brazilian child infected perinatally with human immunodeficiency virus.	"Ferreira E, Lucena S, Fonseca G, Barbosa TCM, Aquino RB, Lambert JS, Nogueira SA."	Pediatric Infectious Disease Journal. 2001;20(2):224-6.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh3&AN=20013029736	"The first Brazilian case of visceral leishmaniasis (VL) is described in a young perinatally infected child from Rio de Janeiro with human immunodeficiency virus type 1 (HIV-1) infection. At the time of admission to the hospital on 3 March 1997, the child was one year and 7 months old and was referred from a county hospital with high fever, cough, dyspnoea and recurrent diarrhoea for 2 months. Physical examination revealed that the child was undernourished (second degree; weight=8.6 kg and height=77 cm), hypoactive and anaemic. She had oral candidosis, generalized lymph node enlargement, disseminated scabies, hepatomegaly and splenomegaly. She was dyspnoeic with rales auscultated in both lungs. Nervous system examination detected retarded neurodevelopment. She was unable to walk. Anti-HIV ELISA and Western blot were positive at a titre of 1/45 and bone marrow aspirate revealed an amastigote form of Leishmania. The mother's serology was positive for HIV. One brother (age=7 years old) was positive for Leishmania (titre=1/360) but had no clinical signs of the disease. Treatment for HIV infection included didanosine and zidovudine. To treat VL, meglumine antimonate (Glucantime; 20/mg/kg) was administered intravenously for 30 days. The child responded well to Glucantime, with reduction in hepatosplenomegaly, anaemia and fever. After 55 days of hospitalization, she was discharged to receive zidovudine-didanosine and trimethoprim-sulfamethoxazole. She had no relapse of VL during the first year. The following year, she was less adherent to clinic appointments and died in 1999, with sepsis and strongyloidiasis during a short period of hospitalization."									
1631	Zinc: the missing link in combating micronutrient malnutrition in developing countries.	Gibson RS.	Proceedings of the Nutrition Society. 2006;65(1):51-60.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=16441944	"The first cases of human Zn deficiency were described in the 1960s in the Middle East. Nevertheless, it was not until 2002 that Zn deficiency was included as a major risk factor in the global burden of disease, and only in 2004 did WHO/UNICEF include Zn supplements in the treatment of acute diarrhoea. Despite this recognition Zn is still not included in the UN micronutrient priority list, an omission that will continue to hinder efforts to reduce child and maternal mortality, combat HIV/AIDS, malaria and other diseases and achieve the UN Millennium Development Goals for improved nutrition in developing countries. Reasons for this omission include a lack of awareness of the importance of Zn in human nutrition, paucity of Zn and phytate food composition values and difficulties in identifying Zn deficiency. Major factors associated with the aetiology of Zn deficiency include dietary inadequacies, disease states inducing excessive losses or impairing utilization and physiological states increasing Zn requirements. To categorize countries according to likely risk of Zn deficiency the International Zinc Nutrition Consultative Group has developed indirect indicators based on the adequacy of Zn in the national food supplies and/or prevalence of childhood growth stunting. For countries identified as at risk confirmation is required through direct measurements of dietary Zn intake and/or serum Zn in a representative sample. Finally, in at risk countries either national or targeted Zn interventions such as supplementation, fortification, dietary diversification or modification, or biofortification should be implemented, where appropriate, by incorporating them into pre-existing micronutrient intervention programmes."									
1502	Nutritional recommendations with practical examples of menus for people living with HIV/AIDS in Black Africa.	"Nguewo EA, Winkler G."	Pan African Medical Journal. 2008;1(1).	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20103265631	"The following article provides detailed recommendations on dietary recommended intakes of nutrients (macro-and micronutrients) for people living with HIV/AIDS. This work also offers practical advice in case of power problems and examples of menus adapted to the African context. Dietary advice presented are for all those concerned about a healthy diet, not only for persons living with HIV/AIDS. The evolution of HIV infection is described. The influence of infection on nutrition, the most frequent causes of malnutrition among people infected with HIV, influence of drugs on nutrition, nutritional recommendations, purpose of nutrition therapy, recommendations for hygiene and recommendations for food and water are discussed. Sample menus (adapted to eating habits in black Africa) for people infected with HIV/AIDS; examples of antiretroviral drugs and thjeir influence on nutrition; and comparisons of some daily nutrient recommendations for health people in Germany, Austria and Switzerland, and for people infected with HIV are given. As a result of different causes of involuntary weight loss and food preferences of different people, it is recommended that the advice and nutritional monitoring of patients should be individualized."									
690	Hospice and Hope in South Africa.	Tick E.	Explore: The Journal of Science and Healing. 2007 July;3(4):407-9.		"The front lines of health and healing today are everywhere around our country and the world where individuals, societies, and ecosystems are at risk. On these lines and often unheralded, courageous healers and communities utilize traditional, scientific, humanistic, communal, holistic, and spiritual resources to address our most pressing global health issues. Field Reports offers reports from these front lines about significant health crises, concerns, and healing approaches that occur beyond our usual horizon of vision. Our concern is for world health. We seek to hoist flags of hope. 2007 Elsevier Inc. All rights reserved."									
1077	"Feeding patterns and practices among households with children aged 6-59 months in Mbita Division, Suba District, Kenya."	"Ohiokpehai O, Kimiywe J, Naidoo P, Adesina A, Sanginga N."	"Journal of Food, Agriculture & Environment. 2007;5(2):17-23."	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20073113386	"The growth patterns of children are reflective of community nutritional status and food security, which is measured in terms of food consumption patterns and practices, availability and accessibility. Vital statistics from Suba District indicate high mortality rates of 146.9/1000 and 247/1000 for infants and under fives respectively. The expected HIV cases are also estimated at 41% of the reproductive population. The purpose of this study therefore was to conduct a baseline survey on the nutrition and health situation in Mbita Division, Suba District, with the aim of developing a comprehensive programme for intervention using soybean-enriched diets in the management of HIV/AIDS. To achieve this, the following objectives were formulated; to establish the food consumption and utilization practices in the households; determine food production patterns and practices; determine food accessibility and availability, and to investigate the morbidity patterns of households and children. The survey was conducted in three locations, namely Gembe West, Gembe East and Rusinga West, and 265 households, 162 from township, 50 from Kayanja and 53 from Kaswanga were interviewed. Food frequency and 24-hour recall were used to collect data on household and children's food consumption patterns and practices. A structured questionnaire was used to collect data on feeding and childcare practices and household morbidity patterns. To access food availability and accessibility, respondents were asked questions on methods of food acquisition and production patterns. The study findings were verified by information from key informant focus group discussions and from observational checklist. Results indicated that the diets were inadequate for the majority of the households. Most households depended on fishing and very few practiced subsistence farming, most of the foods consumed were therefore purchased. Some families resorted to food for work and donations because of insufficient incomes. There was also a high prevalence of diseases among the children and in the households in general. The common illnesses reported were malaria, upper respiratory tract infections, stomachache and diarrhea/typhoid among others. An in-depth study should be conducted in Suba District in order to determine the magnitude of malnutrition and rate of morbidity and its relationship to the prevalence of HIV/AIDS, and the causes and consequences of these on the socio-economic status of the individuals in the community. This will facilitate in the planning of viable intervention programmes, which should involve all the relevant stakeholders."									
1970	Guidelines for young child feeding in the Caribbean--Part I. Caribbean Food and Nutrition Institute.	Anonymous.	West Indian Medical Journal. 2000;49(1):3-8.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=10786441	"The guidelines for young child feeding have been developed and prepared as a supportive-tool primarily for health personnel involved in the care of infants and children in Caribbean countries. The recommendations address some practical aspects of nutrition before, during and after pregnancy. These are: The benefits of breastfeeding and strategies for its promotion, protection and support; review of infant feeding options for mothers with HIV and other infections; nutrition of the newborn; feeding of low birth weight infants and those with special requirements; replacement feeding for infants who are not breastfed; complementary feeding with emphasis on the continuation of breastfeeding for two years and beyond; guidelines on vitamin and mineral supplementation; management of feeding-related problems in early childhood; policy issues and nutrition education in relation to the promotion of adequate nutrition in early childhood."									
1464	"Probiotic yogurt consumption may improve gastrointestinal symptoms, productivity, and nutritional intake of people living with human immunodeficiency virus in Mwanza, Tanzania."	"Irvine SL, Hummelen R, Hekmat S."	Nutrition Research. 2011;31(12):875-81.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=22153512	"The gut-associated lymphoid tissue is a major site of human immunodeficiency virus (HIV) activity and significantly influences disease prognosis. Reducing immune activation due to gastroenteritis may thus help slow disease progression. Probiotic microorganisms have considerable immunomodulatory effects at the level of the gut-associated lymphoid tissue. A probiotic yogurt initiative was thus established in Mwanza, Tanzania, to improve gastrointestinal (GI) integrity and reduce the incidence and severity of opportunistic infections among people with HIV. The research objective was to retrospectively evaluate the effects of yogurt supplemented with Lactobacillus rhamnosus as an adjunct to the diet of people living with HIV on systemic and GI symptoms, daily routine activities, and nutritional intake. Eighty-five people with HIV consuming probiotic yogurt and 86 controls were interviewed. Demographics and HIV disease stage were comparable between groups. Probiotic yogurt consumers reported an ability to work a median of 2 hours more daily (P = .01), experienced a lower fever incidence (P = .01), and were more likely to achieve daily nutrient requirements for vitamin A, several B complex vitamins, and calcium (P = .02). Antiretroviral users experienced less drug-induced stomach pain (P = .02) and a lower overall impact of GI symptoms on routine activities (P = .03). The results of this study need be further substantiated because of limits imposed by the observational, retrospective study design; however, results suggest that yogurt supplemented with L rhamnosus may effectively alleviate GI symptoms and improve productivity, nutritional intake, and tolerance to antiretroviral treatment among people with HIV in Mwanza. Copyright 2011 Elsevier Inc. All rights reserved."									
1243	Is breast best? Is early solid feeding harmful?	MacDonald A.	Journal of the Royal Society for the Promotion of Health. 2003;123(3):169-74.	http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=2003139402&site=ehost-live	"The health benefits of breastfeeding for babies and mothers have long been recognised and it is now globally recommended that it be continued exclusively for six months. Although there are few controlled trials to support this recommendation, the most important advantage is less morbidity from gastrointestinal infection in developing countries. There is also evidence that respiratory tract infections and atopic dermatitis is reduced, and the maternal risk of breast cancer decreases, particularly with a longer duration of breastfeeding and a high parity. There is little to suggest that exclusive breastfeeding for six months adversely affects infant growth, nutritional status or infant feeding skills, but more studies are needed. Equally, there is no evidence that introduction of solids from 17 weeks is harmful in developed countries. However, in the UK breastfeeding prevalence is low and solids are introduced early for the majority of infants and much can be done to positively encourage and support all mothers to continue breastfeeding for a longer period."									
321	Urbanisation and child health in resource poor settings with special reference to under-five mortality in Africa.	Garenne M.	Archives of Disease in Childhood. 2010;95(6):464-8.	http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=2010673389&site=ehost-live	"The health of children improved dramatically worldwide during the 20th century, although with major contrasts between developed and developing countries, and urban and rural areas. The quantitative evidence on urban child health from a broad historical and comparative perspective is briefly reviewed here. Before the sanitary revolution, urban mortality tended to be higher than rural mortality. However, after World War I, improvements in water, sanitation, hygiene, nutrition and child care resulted in lower urban child mortality in Europe. Despite a similar mortality decline, urban mortality in developing countries since World War II has been generally lower than rural mortality, probably because of better medical care, higher socio-economic status and better nutrition in urban areas. However, higher urban mortality has recently been seen in the slums of large cities in developing countries as a result of extreme poverty, family disintegration, lack of hygiene, sanitation and medical care, low nutritional status, emerging diseases (HIV/AIDS and tuberculosis) and other health hazards (environmental hazards, accidents, violence). These emerging threats need to be addressed by appropriate policies and programmes."									
49	"Soybean (Glycine max) complementation and the zinc status of HIV and AIDS affected children in Suba District, Kenya. (Special Issue: Diversity of research.)."	"Were GM, Ohiokpehai O, Okeyo-Owuor JB, Mbagaya GM, Kimiywe J, Mbithe D, Okello MM."	"African Journal of Food, Agriculture, Nutrition and Development. 2010;10(3):2187-202."	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20103323789	"The HIV and AIDS pandemic continues to ravage families and communities throughout the world particularly Sub-Saharan Africa. The scourge is associated with malnutrition specifically underweight, stunting and wasting among school children most of whom are orphaned by HIV. Subsequently, inadequate food supply at the household level has led to micronutrient deficiencies especially zinc. The purpose of this study was to assess the nutritional status of children aged 6-9 years in HIV and AIDS affected households in Suba District and to determine the effect of soybean complementation on zinc status of the children. Suba District, Kenya is resource-poor with high levels of food insecurity and lack of diet diversification. Experimental study design was employed in this study. Multi-stage, stratified and simple random sampling strategies were used to identify a total of 158 HIV and AIDS affected children from rural communities of Suba District who formed the study sample. Of these, one-hundred and six (106) children from both Sindo and Lambwe primary schools were put on a feeding trial; they were fed on corn-soy blend daily for three months. Fifty-two (52) children selected from Ong'ayo Primary School formed the control group and were not put on the feeding trial. Structured questionnaires were used to gather demographic and socio-economic data from mothers or guardians of the children. Anthropometric measurements (weight and height) were used to assess the nutritional status of children at baseline. Biochemical tests were carried out to determine serum zinc levels of the children between baseline and three months. These tests were analyzed at Kenya Medical Research Institute (KEMRI) Laboratories in Nairobi. Data were analyzed using the Statistical Package for Social Sciences (SPSS) version 11.5 and the Nutri-Survey computer soft ware. A probability value of <0.05 was considered significant. Results showed that out of the 158 children, 48 (29.8%) were malnourished; 43.7% were stunted, 22.9% were underweight while 33.3% were wasted. Nearly all (95.7%) the children were deficient in zinc at baseline. There was a significant (p<0.05) reduction in zinc deficiency from 95.7% (mean 8.41 micro m/l) to 70.2% (mean 10.2 micro m/l) between baseline and three months of the feeding trial. Children in HIV-affected households in Suba District showed signs of underweight, stunting and wasting. Soybean complementation improved zinc status of the children and should therefore be promoted in the entire community to alleviate malnutrition."									
27	Morbidity and nutritional impairment in relation to CD4 count in a Zambian population with high HIV prevalence.	"Kelly P, Zulu I, Amadi B, Munkanta M, Banda J, Rodrigues LC, Mabey D, et al."	Acta Tropica. 2002;83(2):151-8.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh3&AN=20023108520	"The HIV epidemic has greatly increased morbidity in many African cities and severe undernutrition is a prominent feature of the clinical presentation. However, there is little information about the relationship of morbidity or nutritional status to immune damage at a population level. We report a cross-sectional study of morbidity and nutritional status in relation to CD4 count in an impoverished urban community in Lusaka, Zambia, at enrollment into a longitudinal study. Over a 2-month period (March-May) in 1999, two hundred and sixty-one (52%) of 506 adults resident in one area were interviewed and examined. Of 186 adults who consented to testing, 33 (51%) of 65 who were HIV seropositive reported symptoms of disease compared to 39 (32%) of 121 who were HIV seronegative (OR 2.2, 95% CI 1.1-4.2; P=0.02). Peripheral blood CD4 counts in HIV seronegative individuals were broadly similar to norms in developed countries, but 8 (7%) had CD4 counts below 500 cells/ micro l. Morbidity in HIV seropositive adults was dominated by tuberculosis (n=11), other respiratory infections (5) or persistent diarrhoea (4), and affected individuals had a wide range of CD4 counts. Nutritional impairment was evident in HIV seropositive adults with clinical evidence of opportunistic infection (OI), not those with asymptomatic HIV infection. Unexpectedly, we also noted that systolic blood pressure was reduced progressively in HIV infection and in those with OI. In conclusion, HIV-related morbidity was dominated by a small number of treatable infectious diseases occurring over a wide range of CD4 count. Nutritional impairment was associated with OI."									
26	Morbidity and nutritional impairment in relation to CD4 count in a Zambian population with high HIV prevalence.	"Kelly P, Zulu I, Amadi B, Munkanta M, Banda J, Rodrigues LC, Mabey D, et al."	Acta Tropica. 2002;83(2):151-8.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=12088856	"The HIV epidemic has greatly increased morbidity in many African cities and severe undernutrition is a prominent feature of the clinical presentation. However, there is little information about the relationship of morbidity or nutritional status to immune damage at a population level. We report a cross-sectional study of morbidity and nutritional status in relation to CD4 count in an impoverished urban community in Lusaka, Zambia, at enrollment into a longitudinal study. Over a 2 month period in 1999, 261 (52%) of 506 adults resident in one area were interviewed and examined. Of 186 adults who consented to testing, 33 (51%) of 65 who were HIV seropositive reported symptoms of disease compared to 39 (32%) of 121 who were HIV seronegative (OR 2.2, 95%CI 1.1-4.2; P=0.02). Peripheral blood CD4 counts in HIV seronegative individuals were broadly similar to norms in developed countries, but 8 (7%) had CD4 counts below 500 cells/microl. Morbidity in HIV seropositive adults was dominated by tuberculosis (n=11), other respiratory infections (5) or persistent diarrhoea (4), and affected individuals had a wide range of CD4 counts. Nutritional impairment was evident in HIV seropositive adults with clinical evidence of opportunistic infection (OI), not those with asymptomatic HIV infection. Unexpectedly, we also noted that systolic blood pressure was reduced progressively in HIV infection and in those with OI. In conclusion, HIV-related morbidity was dominated by a small number of treatable infectious diseases occurring over a wide range of CD4 count. Nutritional impairment was associated with OI."									
896	"Opportunistic infections in hospitalized HIV-infected adults in Ho Chi Minh City, Vietnam: a cross-sectional study."	"Louie JK, Nguyen Huu C, Le Thi Thu T, Vo Minh Q, Campbell J, Nguyen Van Vinh C, Rutherford GW, et al."	International Journal of STD & AIDS. 2004;15(11):758-61.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh3&AN=20043198492	"The HIV epidemic is emerging rapidly in Vietnam. Between July and September 2000, we studied the prevalence of opportunistic infections by performing clinical and microbiological investigations among 100 hospitalized HIV-infected adults in Ho Cho Minh City, Vietnam. The median CD4 count was 20 cells/mm<sup>3</sup>, and in-hospital mortality was 28%. The most frequent diagnoses were oral candidosis (n=54), tuberculosis (n=37), wasting syndrome (n=34), lower respiratory tract infection (n=13), cryptococcosis (n=9), and penicilliosis (n=7). Bacterial (other than tuberculosis) and protozoal infections were uncommon. Regional differences should be considered when deciding which diagnostic procedures and prophylactic measures to implement. In Vietnam, routine mycobacterial blood cultures do not provide greater yield than chest radiography and sputum and lymph node aspirate smears. Prophylactic trimethoprim/sulphamethoxazole against Pneumocystis jiroveci (carinii) pneumonia may confer little benefit, and high rates of isoniazid resistance may affect the efficacy and feasibility of tuberculosis chemoprophylaxis. However, the usefulness of itraconazole prophylaxis for cryptococcosis and penicilliosis merits further consideration."									
209	"Executive summary-nutritional care of HIV-infected adolescents and adults, including pregnant and lactating women: What do we know, what can we do, and where do we go from here?"	"Raiten DJ, Mulligan K, Papathakis P, Wanke C."	American Journal of Clinical Nutrition. 2011 01 Dec;94(6):1667S-76S.		"The HIV pandemic continues to place an unbearable burden on the international community, with disease prevalence remaining highest in resource-limited settings in Africa, Asia, and the Americas. HIV is most often imposed on conditions of food insecurity and consequent malnutrition, poor sanitation, and chronic exposure to a myriad of infectious (eg, malaria, tuberculosis, and diarrheal) and noncommunicable (eg, obesity, diabetes, cancer, and cardiovascular) diseases. Women and children continue to bear the greatest burden. Two essential tenets underpin our approach to HIV: 1) antiretroviral drugs (ARVs) are essential to prolong lives and to halt the spread of HIV and AIDS and 2) food and sound nutrition are essential to human health. The challenge is to apply sound principles of clinical care and nutrition science to the safe and efficacious implementation of ARVs and for long-term care for people living with HIV and AIDS. The WHO has played a leading role in developing guidelines to support this goal with the generation of general recommendations regarding nutritional needs of people living with HIVand AIDS and specific guidelines for the nutritional care of HIV-infected infants and children (<14 y of age). These proceedings represent a summary of the work accomplished at a workshop sponsored by the NIH to review the existing evidence to support changes in the recommendations regarding nutrient requirements for people living with HIV and AIDS; to support development of new WHO guidelines for adolescents and adults, including for pregnant and lactating women; and to identify a research agenda to address outstanding knowledge gaps. 2011 American Society for Nutrition."									
208	"Executive summary--nutritional care of HIV-infected adolescents and adults, including pregnant and lactating women: what do we know, what can we do, and where do we go from here?"	"Raiten DJ, Mulligan K, Papathakis P, Wanke C."	American Journal of Clinical Nutrition. 2011;94(6):1667S-76S.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=22089438	"The HIV pandemic continues to place an unbearable burden on the international community, with disease prevalence remaining highest in resource-limited settings in Africa, Asia, and the Americas. HIV is most often imposed on conditions of food insecurity and consequent malnutrition, poor sanitation, and chronic exposure to a myriad of infectious (eg, malaria, tuberculosis, and diarrheal) and noncommunicable (eg, obesity, diabetes, cancer, and cardiovascular) diseases. Women and children continue to bear the greatest burden. Two essential tenets underpin our approach to HIV: 1) antiretroviral drugs (ARVs) are essential to prolong lives and to halt the spread of HIV and AIDS and 2) food and sound nutrition are essential to human health. The challenge is to apply sound principles of clinical care and nutrition science to the safe and efficacious implementation of ARVs and for long-term care for people living with HIV and AIDS. The WHO has played a leading role in developing guidelines to support this goal with the generation of general recommendations regarding nutritional needs of people living with HIV and AIDS and specific guidelines for the nutritional care of HIV-infected infants and children (<14 y of age). These proceedings represent a summary of the work accomplished at a workshop sponsored by the NIH to review the existing evidence to support changes in the recommendations regarding nutrient requirements for people living with HIV and AIDS; to support development of new WHO guidelines for adolescents and adults, including for pregnant and lactating women; and to identify a research agenda to address outstanding knowledge gaps."									
1078	"Nutritional status and morbidity among HIV/AIDS-affected children aged 6-9 years in Suba district, Kenya."	"Were GM, Ohiokpehai O, Kimiywe J, Mbagaya GM, Okeyo-Owuor JB, Kamau J, Mbithe D."	"Journal of Food, Agriculture & Environment. 2008;6(2):68-73."	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20083123739	"The HIV/AIDS pandemic continues to claim lives and render many children orphans. More than 3 million people died from AIDS including half a million children. In Sub-Saharan Africa, it is estimated that 12 million children have been orphaned by HIV and this number is set to increase. HIV/AIDS orphaned children suffer malnutrition which adversely affects their health. Objective of this study was to establish the magnitude of underweight, stunting and wasting as indicators of malnutrition among HIV/AIDS-affected school children aged 6-9 years in Suba district. A cross-sectional research design was used and setting included Lambwe, Sindo and Ong'ayo primary schools in Suba district. A total of 150 children were sampled from HIV/AIDS-affected households. Anthropometric measurements and guided questionnaires were the main tools of data collection. Data was analyzed using SPSS and the Nutri-survey computer software programs. Of the children 8.8% were underweight, 13.3% stunted and 7.6% wasted. Cereals formed the main part of the childrens' diet, fish was the most consumed protein and vegetable and fruit consumption was low. Total kilocalories taken were 41% of the Recommended Dietary Allowance. The most reported illnesses which were also confirmed by the doctor's clinical assessment were malaria (16%), upper respiratory infections (6.1%) and skin infections (8.0%). Primary education was completed by 67.4% of mothers, while only 1.2% had post secondary education. The average monthly maternal income was Ksh 1,550 ($ 24.2). Food security was reported to be low as 64.6% of the households purchased food three months after harvest. HIV/AIDS-affected children suffered underweight, stunting and wasting with morbidity, poverty, low educational and occupational status of the parents/guardians cited as probable determinants. Interventions should therefore focus on improved agricultural production, innovative poverty alleviation methods and education."									
226	Does being an orphan decrease the nutritional status of Luo children?	"Zidron AM, Juma E, Ice GH."	American Journal of Human Biology. 2009;21(6):844-51.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=19309681	"The HIV/AIDS pandemic is creating a generation of orphaned children in Africa. The number of orphans will continue to increase long after the HIV/AIDS crisis has peaked; therefore, it is important to determine how best to assist these children. Current studies investigating the impact of orphanhood have conflicting results and conclusions. Several studies report that orphans are at a disadvantage and are more likely to suffer from malnutrition, whereas other studies report no difference between the nutritional status of orphans and nonorphans. Four hundred eleven Luo children (mean age 9 +/- 1 years) were recruited to participate in a study investigating the impact of orphanhood on nutritional status. Participants underwent an interview, anthropometric measurements, testing for anemia, a clinical history, and a physical exam. Anthropometric variables and hemoglobin level were compared across groups using a t-test. The reference population used for comparison of anthropometric variables is the 2000 CDC growth reference data. All analyses were gender specific, and the effect of length of orphanhood was also investigated. The data presented here suggest that there is no significant difference between the nutritional status of orphaned and nonorphaned Luo children. This study supports research indicating there is little, if any, difference in nutritional indicators between orphans and nonorphans. Orphans may live in households with higher socioeconomic statuses than nonorphans. Luo orphans may not be at higher risk for poor nutritional status than nonorphans; therefore, interventions targeted at this age group should include both orphaned and nonorphaned children."									
1901	"Increase in hospital mortality from non-communicable disease and HIV-related conditions in Bulawayo, Zimbabwe, between 1992 and 2000."	"Bardgett HP, Dixon M, Beeching NJ."	Tropical Doctor. 2006;36(3):129-31.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20063160054	"The HIV/AIDS pandemic is creating a strain on health care services in the developing world, with knock-on consequences for HIV negative patients. We looked for possible changes over time in the patterns of illness and outcomes of admission to an adult medical unit in Zimbabwe. We performed a prospective descriptive study of discharge diagnoses and causes of in-hospital mortality for all medical patients under the care of one consultant at Mpilo Central Hospital, Bulawayo, Zimbabwe. Two similar 7-month periods were compared in 1992 and 2000. Data recorded included: initials, sex, alive or dead status, diagnosis and HIV/AIDS status. Similar numbers of patients were admitted in 1992 and 2000 (1305 and 1369), but in-hospital mortality increased from 13.3% to 28.6% (P<0.001), especially in male patients (13.1% to 33.9% P<0.001). Mortality rates increased for both infectious and non-communicable diseases such as cardiac failure, stroke and diabetes. The 10 most common diagnoses were similar, apart from Pneumocystis carinii pneumonia (PCP) cases, which increased from 18 to 90. The proportion of patients clinically or serologically positive for HIV/AIDS rose from 13.9% to 51.1% (P<0.001), but the number of cases of the HIV wasting syndrome (SLIM)/chronic gastroenteritis did not change significantly. In 1992 there happened to be a large number of cases of malaria transmission. Mortality related to both communicable and non-communicable diseases increased, confirming that HIV negative patients are also being affected by the strain on health services. Although based on clinical and radiological diagnosis, PCP pneumonia appears to be increasingly common in this area."									
1923	"Assessing the health status of young AIDS and other orphans in Kampala, Uganda."	"Sarker M, Neckermann C, Muller O."	Tropical Medicine & International Health. 2005;10(3):210-5.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=15730503	"The huge number of human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) orphans is an important feature of the epidemic in sub-Saharan Africa. There are few and conflicting data on the effects of being orphaned on health and nutrition in the highly affected HIV endemic areas of Africa. This study reports findings from a cross-sectional survey on associations between orphan status and health and nutrition parameters in young children of urban Uganda. A high prevalence of orphans was reported from a central Kampala community, with 41% being attributed to HIV/AIDS. Although there was a higher prevalence of self-reported morbidity in orphans than non-orphans, there were no differences in reported treatment seeking behaviour and measured anthropometric parameters. Hence it seems that the extended family system still manages to care for young orphans. Paying school fees for older children should be the primary target for HIV/AIDS impact mitigation programs in urban Uganda."									
1169	"Invasive cervical cancer and human immunodeficiency virus (HIV) infection in KwaZulu-Natal, South Africa."	"Moodley M, Mould S."	Journal of Obstetrics and Gynaecology. 2005 01 Oct;25(7):706-10.		"The human immunodeficiency virus (HIV) can be expected to influence the course of disease and response to treatment of invasive carcinoma of the cervix. The extent and nature of this influence, however remains largely unknown. We therefore undertook a retrospective analysis of patients with carcinoma of the cervix at a tertiary referral centre in an African setting where HIV prevalence is high. There were 271 patients seen during a period of 1 year. Of these, 45 of the 206 tested were HIV infected (21.8%). The corresponding HIV prevalence for antenatal attendees was 38.7% in the region. The HIV-infected patients had lower mean haemoglobin levels and body mass indices than the HIV-non-infected women and were on average 13 years younger (p < 0.001), but otherwise did not differ with respect to demographics or disease parameters. They were, however, less likely to complete planned treatment. CD4 counts were below 200 in only 6 (21%) of 29 women tested. HIV-infected women in the African setting present with carcinoma of the cervix at a younger age, but the same disease stage as HIV-non-infected women, and without evidence of advanced immunocompromise. Circumstantial evidence is put forward by the study to suggest a more rapid decline in health and earlier demise for HIV-infected women with carcinoma of the cervix. 2005 Taylor & Francis."									
1963	"Impairment of nutritional, educational status and quality of life among children infected with and belonging to families affected by human immunodeficiency virus/acquired immune deficiency syndrome."	"Bele SD, Sameer V, Bodhare TN."	Vulnerable Children and Youth Studies. 2011;6(4):284-92.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20123077626	"The human immunodeficiency virus (HIV) epidemic has ramified impact on family members of people living with the disease, especially in vulnerable groups such as children, which has been neglected while addressing the overt burden in infected individuals. The objectives of this study were to evaluate the impact of HIV on the nutritional and educational status in HIV-infected and -affected children and to compare quality of life (QoL) in these children with controls. A cross-sectional controlled study was conducted among children aged 5-11 years. HIV-infected children and children accompanying parents seeking treatment in an antiretroviral treatment (ART) centre were sampled. Controls were obtained from the field practice area of a teaching hospital. A semi-structured questionnaire and anthropometric measures were used to evaluate the impact on the nutritional and educational status. The General Health Assessment for Children (GHAC) instrument was used to measure QoL. Thirty-eight infected children, 149 children living with family members infected with HIV and 200 controls were sampled. The mean age was 8.55+or-1.78, with 203 male children and 184 female children. The mean nutritional Z-scores were impacted in the affected and infected groups and significant differences were obtained on the domains of educational status on a proportions test. Most QoL domains were affected and the significance was retained in multivariate regression analysis after controlling for sociodemographic factors. HIV-infected and -affected children have poorer outcome on nutritional and educational indicators with impaired QoL. Identifying and defining vulnerability in these children can help mitigate the wider impact of HIV."									
1487	Infections and other causes of death in HIV-infected children in Africa.	Chakraborty R.	Paediatric Respiratory Reviews. 2004;5(2):132-9.		"The human immunodeficiency virus (HIV) pandemic has dramatically reversed improvements in infant mortality and child survival in sub-Saharan Africa. However, accurate information on the specific causes of HIV-related morbidity and mortality arising from vertical transmission is infrequent and is constrained in resource-poor settings by infrastructure and local access to health care. Such knowledge is essential to improve clinical management of HIV-infected children in Africa. In this review, a global overview of the clinical aspects of HIV infection in children is given. Factors influencing HIV disease progression, morbidity and mortality are discussed from studies on a cohort of HIV-infected children that were followed at an orphanage in Nairobi between 1999 and 2001. These parameters are contrasted with available data on HIV-infected children residing in community settings in Africa. 2004 Elsevier Ltd. All rights reserved."									
679	Hyper-IgE syndrome. A study involving 30 children from Makkah - Saudi Arabia.	Tonsi A.	European Journal of Pediatric Dermatology. 2004;14(4):209-14.		"The hyperimmunoglobulin E syndrome is a primary immunodeficiency state with elevated immunoglobulin E, eosinophilia, skin, skeletal and dental defects. The aim of this study was to determine the frequency of these abnormalities in children with Hyper IgE syndrome. This would enable in apprising clinicians of the importance of early recognition and management of this condition. This study was conducted at Alawi Tonsi Hospital, Makkah, Saudi-Arabia, from February 2001 to April 2004. We evaluated 30 human immunodeficiency virus-seronegative children from consanguineous -19- and non-consanguineous -11- families with hyperimmunoglobulin E syndrome. All the cases were new, aged 10 years or less and reported either directly to the dermatology outpatients or from other units of the same hospital. Their detailed histories were taken. Besides anthropometric measurements, physical and dental examinations were done and laboratory tests were performed. The classical findings of hyperimmunoglobulin E syndrome were put in evidence. 26 patients (86.66%) presented recurrent skin infections including bacterial, viral and fungal infections. 22 patients (73.33%) had respiratory tract infection with half of them suffering from bronchial asthma. 6 (20%) of the children had skeletal abnormalities such as scoliosis, repeated fractures and osteopenia. 16 (53.33%) children had dental abnormalities, while only 5 (16.66%) children had eye and 4 (13.33%) ear infections. Elevated serum immunoglobulin E levels were observed in 28 cases (93.33%), while hypereosinophilia was seen in 29 (96.66%) children. In conclusion, the hyperimmunoglobulin E syndrome is a multi-system immunodeficiency disorder involving cutaneous, skeletal, connective tissue, and dental abnormalities. This condition must be borne in mind when children with repeated skin and chest infections are encountered."									
1903	Sustainable decline in mortality among severely malnourished children with local resources.	"Daga SR, Bela V, Abhijit M."	Tropical Doctor. 2007;37(4):247-8.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20073268590	"The impact of dietary and medical treatment of patients with protein energy malnutrition (PEM) at the Cama and Albless Hospital, Mumbai, Maharashtra, India, was investigated. Patients admitted during 2000-03 were studied. Linear by linear association revealed a significant decline in mortality. It decreased from 17% in 2000 to 13.5% in 2001, 9.5% in 2002, and 6.7% in 2003. The risk of death was higher in infancy, PEM grade IV, weight less than 5 kg, bacteraemia, pneumonia and HIV infection. In conclusion, a significant decline in mortality was achieved over a period of 4 years using locally available food, medicines and simple protocols."									
25	Malaria and helminthic co-infection among HIV-positive pregnant women: Prevalence and effects of antiretroviral therapy.	"Ivan E, Crowther NJ, Rucogoza AT, Osuwat LO, Munyazesa E, Mutimura E, Njunwa KJ, et al."	Acta Tropica. 2012 December;124(3):179-84.		"The impact of malaria on anemia and the interplay with helminths underline the importance of addressing the interactions between HIV/AIDS, malaria and intestinal helminth infections in pregnancy. The aim of this study was to determine the prevalence of malaria-helminth dual infections among HIV positive pregnant mothers after 12 months of ART. A cross sectional study was conducted on intestinal helminths and malaria dual infections among HIV-positive pregnant women attending antenatal health centers in Rwanda. Stool and malaria blood slide examinations were performed on 328 women residing in rural (n= 166) and peri-urban locations (n= 162). BMI, CD4 cell count, hemoglobin levels, type of ART and viral load of participants were assessed. Within the study group, 38% of individuals harbored helminths, 21% had malaria and 10% were infected with both. The most prevalent helminth species were Ascaris lumbricoides (20.7%), followed by Trichuris trichiura (9.2%), and Ancylostoma duodenale and Necator americanus (1.2%). Helminth infections were characterized by low hemoglobin and CD4 counts. Subjects treated with a d4T, 3TC, NVP regimen had a reduced risk of T. trichiura infection (OR, 0.27; 95% CIs, 0.10-0.76; p< 0.05) and malaria-helminth dual infection (OR, 0.29; 95% CI, 0.11-0.75; p< 0.05) compared to those receiving AZT, 3TC, NVP. This study shows a high prevalence of malaria and helminth infection among HIV-positive pregnant women in Rwanda. The differential effect of ARTs on the risk of helminth infection is of interest and should be examined prospectively in larger patient groups. 2012 Elsevier B.V."									
1346	Nutrition and HIV/AIDS in infants and children in South Africa: implications for food-based dietary guidelines.	"Hendricks MK, Eley B, Bourne LT."	Maternal & Child Nutrition. 2007;3(4):322-33.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=17824860	"The implications for food-based dietary guidelines (FBDGs) that are being developed in South Africa are reviewed in relation to HIV-exposed and -infected children. The nutritional consequences of HIV infection and nutritional requirements along with programmes and guidelines to address undernutrition and micronutrient deficiency in these children are also investigated. Based on studies for HIV-infected children in South Africa, more than 50% are underweight and stunted, while more than 60% have multiple micronutrient deficiencies. Nutritional problems in these children are currently addressed through the Prevention-of-Mother-to-Child Transmission Programme (PMTCT), the Integrated Nutrition Programme and Guidelines for the Management of HIV-infected Children which include antiretroviral (ARV) therapy in South Africa. Evaluations relating to the implementation of these programmes and guidelines have not been conducted nationally, although certain studies show that coverage of the PMTCT and the ARV therapy programmes was low. FBDGs for infants and young children could complement and strengthen the implementation of these programmes and guidelines. However, FBDGs must be in line with national and international guidelines and address key nutritional issues in these infants and young children. These issues and various recommendations are discussed in detail in this review. [References: 77]"									
1361	Nutrition and HIV/AIDS in infants and children in South Africa: implications for food-based dietary guidelines. (Special Issue: Food-based dietary guidelines for infants and children: the South African experience.).	"Hendricks MK, Eley B, Bourne LT."	Maternal and Child Nutrition. 2007;3(4):322-33.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20073240733	"The implications for food-based dietary guidelines (FBDGs) that are being developed in South Africa are reviewed in relation to HIV-exposed and -infected children. The nutritional consequences of HIV infection and nutritional requirements along with programmes and guidelines to address undernutrition and micronutrient deficiency in these children are also investigated. Based on studies for HIV-infected children in South Africa, more than 50% are underweight and stunted, while more than 60% have multiple micronutrient deficiencies. Nutritional problems in these children are currently addressed through the Prevention-of-Mother-to-Child Transmission Programme (PMTCT), the Integrated Nutrition Programme and Guidelines for the Management of HIV-infected Children which include antiretroviral (ARV) therapy in South Africa. Evaluations relating to the implementation of these programmes and guidelines have not been conducted nationally, although certain studies show that coverage of the PMTCT and the ARV therapy programmes was low. FBDGs for infants and young children could complement and strengthen the implementation of these programmes and guidelines. However, FBDGs must be in line with national and international guidelines and address key nutritional issues in these infants and young children. These issues and various recommendations are discussed in detail in this review."									
1467	Zinc and human immunodeficiency virus infection.	"Siberry GK, Ruff AJ, Black R."	Nutrition Research. 2002;22(4):527-38.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh3&AN=20023060439	"The importance of zinc in normal immune function - and of its deficiency in immune dysfunction - has led to increased interest in its role in nutrition and immunity in human immunodeficiency virus type 1 (HIV) infection. Zinc deficiency produces reversible immune dysfunction, particularly of T-lymphocyte cell-mediated immunity. In developing countries where zinc deficiency is prevalent, zinc supplementation has been shown to reduce morbidity from respiratory and diarrhoeal illnesses. The relationship between zinc and HIV infection has not been well delineated. Malabsorption, repeated concurrent infections and increased losses probably increase zinc requirements in HIV infection. In some studies, low plasma zinc levels occur frequently in HIV infection and have predicted disease progression and mortality, suggesting supplementation might be beneficial. However, the finding that zinc binding to specific HIV proteins is essential for HIV function and replication and the association in one observational study of zinc intake with higher rates of HIV progression have raised questions regarding the safety of zinc supplementation among HIV-infected individuals. To date, no randomized, placebo-controlled study of moderate zinc supplementation in HIV infection has been published. We believe that available evidence supports the need for and acceptability of such a trial."									
1140	Growth in late infancy among HIV-exposed children in urban Haiti is associated with participation in a clinic-based infant feeding support intervention.	"Heidkamp RA, Stoltzfus RJ, Fitzgerald DW, Pape JW."	Journal of Nutrition. 2012;142(4):774-80.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=22378328	"The integration of nutrition support for infants of HIV-infected mothers is a recognized need; however, the evidence for effective programmatic solutions is weak. The objective of our study was to implement and evaluate a new infant feeding support intervention for HIV-exposed, uninfected, non-breast-fed infants 6-12 mo of age attending the Groupe Haitien d'Etude du Sarcome de Kaposi et des Infections Opportunistes (GHESKIO) pediatric clinic in Port-au-Prince, Haiti. The 24-wk intervention included a lipid-based nutrient supplement, education, promotion of existing clinical services, and social support. We compared growth outcomes among intervention participants (n = 73) at start (wk 0) and end (wk 24) of intervention to a historical control group of HIV-exposed infants seen at the GHESKIO in the year prior to the intervention who would have met the intervention entrance criteria (n = 294). The intervention and historical control groups did not differ significantly at age 6 mo (wk 0). At age 12 mo (wk 24), the intervention group had a lower prevalence of underweight and stunting than the historical control group (weight-for-age Z-score < -2 SD: 6.8 vs. 20.8%, P = 0.007; length-for-age Z-score < -2 SD: 9.6 vs. 21.2%, P = 0.029). Wasting tended to be lower in the intervention group than the historical control (weight-for-length Z-score < -2 SD: 2.9 vs. 8.9%, P = 0.11). Implementation of the intervention was associated with reduced risk of growth faltering in HIV-exposed uninfected children from 6 to 12 mo of age. This is a promising intervention model that can be adapted and scaled-up to other HIV care contexts."									
1045	Nutritional recovery of HIV positive and HIV negative undernourished patients utilizing Moringa oleifera leaves.	"Tete-Benissan A, Quashie MLA, Lawson-Evi K, Kokou K, Gbeassor M."	Journal of Animal and Plant Sciences. 2012;15(2):2184-99.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20123379676	"The leaves of Moringa oleifera Lam (Moringaceae) a plant with many uses, are used in the fight against malnutrition in Africa and Asia because of their exceptional nutritional qualities. The objective of this study is to evaluate the influence of consumption of leaf powder on the evolution of serum proteins during nutritional recovery in malnourished subjects. Infants (29 HIV negative and 26 HIV positive) and children (27 HIV negative and 32 HIV positive) of both sexes aged 12 months to 8 years were compared. After 16 weeks of use of M. oleifera, anthropometric parameters were measured, assays of total protein, creatinine, AST, ALT, and a proteinogramme was performed. Nutritional recovery with M. oleifera showed that BMI was significantly increased in HIV-negative than in HIV positive (p<=0.001). The significant increase in concentrations of albumin is correlated with significant decrease in total protein, alpha 1, alpha 2, beta , gamma , fractions globulins, creatinine, AST, ALT and GT after use of the dietary supplement. The results of the study also showed that the improvement of the nutritional status of the inflammatory and immune status is higher among HIV negative and HIV positive patients. This study confirms the nutritional and pharmacological properties of M. oleifera leaves in the fight against the protein-energy malnutrition and micronutrient deficiencies. However, despite the profound metabolic disturbances caused by viral infection M. oleifera to effectively reduce the inflammatory state among HIV positive."									
36	"HIV/AIDS Policies, Practices and Conditions in South African Prisons: Criticism and Alternatives. Towards a Research Agenda."	"Goyer KC, Gow J."	African Journal of AIDS Research. 2002 May 2002;1(1):69-74.	http://search.proquest.com/docview/60442587?accountid=26724	"The level of HIV infection in South African prisoners is unknown. However, given that 4.2 million citizens (20% of the adult population) are infected by HIV, the problem of infection within the prison system would seem to be a significant management issue. Policies to treat HIV+ prisoners & prevent HIV transmission have been developed. However, the efficacy of programs implemented to prevent HIV transmission is questionable. The reasons for this situation include lack of such resources as condoms, lubricants, & disinfectants; & availability of testing. Prison conditions also militate against success, especially overcrowding & poor health care & nutrition. Little research has been undertaken into HIV in the prison system & the lack of transparency in management of the system is a major hindrance in achieving better public policy outcomes. The issues of importance to policy research on HIV/AIDS in prison, which should receive early attention, include (1) prevalence rate determination; (2) treatment of HIV+ prisoners; (3) education programs; & (4) early release policy & practices. 3 Tables, 21 References. Adapted from the source document."									
345	Diet and long-term health: an African Diaspora perspective.	Solomons NW.	Asia Pacific Journal of Clinical Nutrition. 2003;12(3):313-30.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=14505996	"The life-stage approach, which views the behaviours and exposures of an individual from the preconceptual situation of the parent through pregnancy, infancy, childhood and adolescence, and into the advancing years through adulthood, is the basis of analysis of strategies to improve long-term health. Among the behaviours of note is the dietary selection pattern, conditioning our exposure to nutrients and dietary constituents that influences growth, nutriture, cognitive and physical performance, and disease resistance and susceptibility. The African Diaspora created a population displaced from Africa to the Western Hemisphere as part of the African slave trade from the 16th to 18th centuries. It continues to manifest distinct dietary and lifestyle practices in the context of a health experience that is different both from the population in their African countries of origin and from the other ethnicities in their countries of displacement and current residence. Afro-Americans are more susceptible to a series of diseases and conditions including low birth weight, violence, and HIV/AIDS, as well as the non-communicable diseases: obesity, diabetes mellitus, cardiovascular disease, hypertension, stroke, renal failure, breast cancer, prostate cancer and lead poisoning. The differential nature of dietary practices are conditioned at times by the poverty and marginalisation of the populace, resulting in either disadvantageous or beneficial outcomes relative to others' eating habits. Serious consideration must be given to the possibility that ethnic difference give rise to different requirements and tolerances for essential nutrients and distinct protective or adverse responses to foods and dietary substances. The major challenges to health improvement for the African Diaspora is coming to grips with the policy and programmatic nuances of differential treatment and the effecting the behavioural changes that would be needed in a population skeptical of the motives of media and of the power elites of their societies. [References: 141]"									
678	Influence of mineral and vitamin supplements on pregnancy outcome.	"Hovdenak N, Haram K."	"European Journal of Obstetrics, Gynecology, & Reproductive Biology. 2012;164(2):127-32."	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=22771225	"The literature was searched for publications on minerals and vitamins during pregnancy and the possible influence of supplements on pregnancy outcome. Maternal iron (Fe) deficiency has a direct impact on neonatal Fe stores and birth weight, and may cause cognitive and behavioural problems in childhood. Fe supplementation is recommended to low-income pregnant women, to pregnant women in developing countries, and in documented deficiency, but overtreatment should be avoided. Calcium (Ca) deficiency is associated with pre-eclampsia and intra-uterine growth restriction. Supplementation may reduce both the risk of low birth weight and the severity of pre-eclampsia. Gestational magnesium (Mg) deficiency may cause hematological and teratogenic damage. A Cochrane review showed a significant low birth weight risk reduction in Mg supplemented individuals. Intake of cereal-based diets rich in phytate, high intakes of supplemental Fe, or any gastrointestinal disease, may interfere with zinc (Zn) absorption. Zn deficiency in pregnant animals may limit fetal growth. Supplemental Zn may be prudent for women with poor gastrointestinal function, and in Zn deficient women, increasing birth weight and head circumference, but no evidence was found for beneficial effects of general Zn supplementation during pregnancy. Selenium (Se) is an antioxidant supporting humoral and cell-mediated immunity. Low Se status is associated with recurrent abortion, pre-eclampsia and IUGR, and although beneficial effects are suggested there is no evidence-based recommendation for supplementation. An average of 20-30% of pregnant women suffer from any vitamin deficiency, and without prophylaxis, about 75% of these would show a deficit of at least one vitamin. Vitamin B6 deficiency is associated with pre-eclampsia, gestational carbohydrate intolerance, hyperemesis gravidarum, and neurologic disease of infants. About 25% of pregnant women in India are folate deficient. Folate deficiency may lead to congenital malformations (neural tube damage, orofacial clefts, cardiac anomalies), anaemia and spontaneous abortions, and pre-eclampsia, IUGR and abruption placentae. Pregestational supplementation of folate prevents neural tube defects. A daily supplemental dose of 400 ug/day of folate is recommended when planning pregnancy. In developing countries diets are generally low in animal products and consequently in vitamin B12 content. An insufficient supply may cause reduced fetal growth. In vegetarian women, supplementation of vitamin B12 may be needed. Vitamin A deficiency is prevalent in the developing world, impairing Fe status and resistance to infections. The recommended upper limit for retinol supplements is 3000 IU/day. Vitamin A supplementation enhances birth weight and growth in infants born to HIV-infected women. Overdosing should be avoided. Low concentrations of vitamin C seem to increase the development of pre-eclampsia, and supplementation may be beneficial. Supplementation with vitamin D in the third trimester in vitamin D deficient women seems to be beneficial. The use of vitamins E, although generally considered ""healthy"", may be harmful to the pregnancy outcome by disrupting a physiologic oxidative gestational state and is consequently not recommended to prevent pre-eclampsia. Further studies on specific substances are needed as the basis for stratified, placebo-controlled analyses. Copyright 2012 Elsevier Ireland Ltd. All rights reserved."									
1418	Cardiovascular disease in sub-Saharan Africa: A disaster waiting to happen.	van der Sande MAB.	Netherlands Journal of Medicine. 2003 February;61(2):32-6.		"The looming threat posed by the emergence of cardiovascular disease (CVD) in sub-Saharan Africa (sSA) is underestimated and often denied. The health services and societies struggle to cope with the direct effects of poverty, war, fragile social and economic structures and AIDS. The threat of CVD seems less direct and few reliable data are available. This has resulted in neglecting serious warning signs on the emergence of CVD in sSA. This short review deals with the strong increase in a number of risk factors for CVD in certain areas, necessitating preventive measures to lighten the 'double burden of disease' in this part of the world. 2003 Van Zuiden Communications B.V. All rights reserved."									
1833	"Low birth weight infants born to HIV-seropositive mothers and HIV-seronegative mothers in Chiang Rai, Thailand."	"Mitgitti R, Seanchaisuriya P, Schelp FP, Marui E, Yanai H."	Southeast Asian Journal of Tropical Medicine & Public Health. 2008;39(2):273-8.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=18564713	"The low birth weight (LBW) infant has a much higher risk of mortality and morbidity in infancy and early childhood. This study examined the effects of maternal HIV infection and other risk factors for LBW (< 2,500 g). A retrospective study of mothers who delivered at Mae Chan Hospital from 1997 to 2002 was conducted. Logistic regression was used to adjust for confounding factors. There were 266 infants born to HIV-seropositive mothers and 5,872 infants born to HIV-negative mothers. Low birth weight was significantly associated with maternal HIV status, gestational age, antenatal care, maternal age less than 20 years, and > 35 years. Maternal HIV positive status, young maternal age and gestational age were significant factors after adjusting for potential confounders. No significant effect of hilltribe on LBW was found. The results underline the need for nutritional surveillance and dietary counseling. HIV-seropositive women must receive early and continuing antenatal care for good pregnancy outcomes."									
1836	"Low birth weight infants born to HIV-seropositive mothers and HIV-seronegative mothers in Chiang Rai, Thailand."	"Mitgitti R, Seanchaisuriya P, Schelp FP, Marui EJ, Yanai H."	Southeast Asian Journal of Tropical Medicine and Public Health. 2008 March;39(2):273-8.		"The low birth weight (LBW) infant has a much higher risk of mortality and morbidity in infancy and early childhood. This study examined the effects of maternal HIV infection and other risk factors for LBW (<2,500 g). A retrospective study of mothers who delivered at Mae Chan Hospital from 1997 to 2002 was conducted. Logistic regression was used to adjust for confounding factors. There were 266 infants born to HIV-seropositive mothers and 5,872 infants born to HIV-negative mothers. Low birth weight was significantly associated with maternal HIV status, gestational age, antenatal care, maternal age less than 20 years, and >35 years. Maternal HIV positive status, young maternal age and gestational age were significant factors after adjusting for potential confounders. No significant effect of hilltribe on LBW was found. The results underline the need for nutritional surveillance and dietary counseling. HIV-seropositive women must receive early and continuing antenatal care for good pregnancy outcomes."									
363	Influence of HIV/AIDS infection on some nutritional state biochemical markers.	"Linares ME, Bencomo JF, Perez LE, Torrez O, Barrera O."	Biomedica. 2002;22(2):116-22.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh3&AN=20023117094	"The main objective of this study was to analyse the influence of nutritional state among HIV-1 infected people, according to the different clinical stages referred by the CDC (Control Disease Center of the United States) in 1987, as well as the changes in the concentrations of some biochemical markers linked to nutritional state in Cuba (1999). A similar study was carried out in a control group with UltramicroELISA non-reagent healthy individuals, anthropometrically classified. Concentrations of total proteins, albumin, cholesterol, three-glycerides, urea, uric acid and creatinine were analysed by sex and clinical group, comparing the levels obtained through a variance study. When comparing HIV-1 asymptomatic infected patients to HIV-1 and HIV-2 noninfected people, the results showed a nonsignificant increase in the level of total proteins with a significant decrease of albumin and creatinine, the latter observed only in male patients. In stage IV patients, an important decrease of cholesterol and a significant increase of the three-glycerides were found, as well as the lowest albumin levels. Urea and uric acid levels did not experience statistically significant changes. It is concluded that the study of biochemical markers is advisable, since it contributes to the detection by default of malnutrition marginal states in infected individuals."									
610	Carotenoid status of pregnant women with and without HIV infection in Malawi.	"Lan Y, Kumwenda N, Taha TE, Chiphangwi JD, Miotti PG, Mtimavalye L, Broadhead R, et al."	East African Medical Journal. 1999;76(3):133-7.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh3&AN=20001406855	"The major plasma carotenoids in 900 pregnant women with (697) and without (203) human immunodeficiency virus (HIV) infection attending an antenatal clinic in Blantyre, Malawi between November 1995 and December 1996 were characterized in a cross sectional study. There were no differences in plasma carotenoid levels between HIV-positive and HIV-negative women. Median (25th, 75th percentiles) plasma levels of carotenoids for all women in the study were alpha -carotene, 0.04 (0.23, 0.071) micro mol/litre; beta -carotene, 0.35 (0.192, 0.595) micro mol/litre; beta -cryptoxanthin, 0.05 (0.029, 0.091) micro mol/litre; lutein/zeaxanthin 0.646 (0.426, 0.976) micro mol/litre; lycopene, 0.088 (0.055, 0.138) micro mol/litre, and total carotenoids 1.321 (0.884, 1.874) micro mol/litre. Mothers had higher mean plasma concentrations of alpha -carotene (P<0.04), beta -carotene (P<0.0001), lutein/zeaxanthin (P<0.0001), and total carotenoids (P<0.0001) in the wet season than the dry season. No seasonality was observed for beta -cryptoxanthin, lycopene, or retinol. It is concluded that pregnant women with and without HIV infection in Blantyre, Malawi have low plasma carotenoids levels and poor dietary intake of provitamin A carotenoids."									
1752	[Prevention of wasting and opportunistic infections in HIV-infected patients in West Africa: a realistic and necessary strategy before antiretroviral treatment].	"Ledru e, Sanou PT, Dembele M, Dahourou H, Zoubga A, Durand G."	Sante. 1999;9(5):293-300.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=10657773	"The medical inequalities between countries of the North and South (infrastructure, drug availability, medical techniques) are particularly marked in terms of the challenge posed by HIV infection. We propose a strategy for monitoring adult patients in West Africa that is appropriate to the situation in the field and to economic constraints. The aim of this strategy is to increase the quality of life and the life expectancy of HIV-infected adults and to prevent the overcrowding of hospital departments with patients in the terminal phase of AIDS. We analyzed the biological and clinical spectrum of HIV infection before the onset of the diseases that define AIDS (excluding pulmonary tuberculosis). We found that it was particularly important to diagnose B-stage diseases early, especially atypical chronic cutaneous and mucous diseases. Careful analysis of data from a routine hemogram (total lymphocyte count 2500/ml; paradoxical eosinopenia), even in the absence of a CD4 lymphocyte count, should also enable clinicians from a wide variety of health structures to identify the HIV-infected patients most likely to benefit from more detailed clinical follow up, prophylaxis of opportunistic infections using cotrimoxazole, nutritional checkups and prevention of wasting. Cachexia is the most common AIDS-associated disease in West African patients. It involves an overall decrease in calorific intake, diarrhea, immune system activation, an increase in TNFalpha production and greater energy expenditure when resting. Recent nutritional studies have shown that it is vital to optimize the calorific intake of HIV-infected patients presenting with chronic diarrhea, before the onset of severe immune deficiency, to prevent wasting. So, spontaneous calorific intake should de routinely determined in HIV-infected patients and an optimal diet provided. Specific training in nutrition is required for doctors and nurses, as is consideration of the logistic organization required to provide nutritional support to HIV-infected adults. Despite the large number of individuals infected and the lack of sophisticated paraclinical facilities, we feel that it is possible to establish rational management ""a minima"" of HIV infection in West Africa, whilst waiting for antiretroviral drugs to become more widely available. This strategy could be of direct benefit to patients without swallowing up the financial resources of the health system in expensive biological follow up. Such basic management is also required before the new antiretroviral drugs become widely available. Research should be carried out in parallel in several reference centers in West Africa to determine the most effective associations of antiretroviral drugs and the optimal timing of treatment during the course of infection and to assess the potential side effects of these drugs in HIV patients exposed to recurrent antigenic stimulation by a wide diversity of pathogens."									
845	Frequency of deficiencies in trace elements and correlations with the degree of immunosuppression in people living with HIV in Cotonou (Benin).	"Aissi AK, Hounto-Ogouyemi A, Lozes E, Johnson CR, Kplakatcha S, Dougnon V, Tchiakpe E, et al."	International Journal of Biosciences. 2013;3(4):58-67.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20133186969	"The micronutrient deficiencies are a form of malnutrition detrimental to the success of antiretroviral therapy. In order to assess the frequency of deficiencies in some trace elements among People Living with HIV (PLHIV) in Cotonou and their correlation with the degree of immunosuppression, a cross-sectional study was conducted from January to April 2012. 93 patients aged of 37.56 years were interviewed and subjected to laboratory analysis. Chi2 test allowed the statistical comparison of frequencies at significance level of 5%. The results showed 31.87% of low zinc content, 26.37% of hypo plasma copper and 46.43% deficit in serum iron. Zinc deficiency has been accompanied in 65.55% of cases of copper deficiency. Unlike iron, zinc and copper deficiency have not varied by gender. HIV positive with a CD4 count <=200 cells/ micro L (group G4) are significantly affected by zinc deficiency (p=0.008) and copper (p=0.043) compared to those with CD4> 200 cells/uL (G3). Indeed, 51.85% of low zinc content in G4 against 23.44% in G3 was noted while 40.74% in plasma copper (G4) was noted against 20.31% in G3. But these correlations proved with a threshold of 200 CD4/ micro L were not observed when considering the reference of 350 CD4/ micro L. For iron, the differences observed between G4 (53.84%) and G3 (41.37%), and between G2 (51.11%) and G1 (38.46%) were not statistically significant (p=0.245 and 0.289 respectively). These results suggest that it is imperative to improve the nutritional status of PLHIV including food supplements rich in trace elements."									
51	"Acute phase proteins, trace elements in asymptomatic human immunodeficiency virus infection in Nigerians."	"Arinola OG, Adedapo KS, Kehinde AO, Olaniyi JA, Akiibinu MO."	African Journal of Medicine & Medical Sciences. 2004;33(4):317-22.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=15977438	"The natural history of Human Immunodeficiency Virus (HIV) infection is incompletely understood. Factors other than HIV infection alone may be required for the development of the profound immunosuppression that characterizes advanced HIV disease. Nutritional status plays an important role in maintaining normal immunity and thus may be one of these factors. The plasma concentrations of C-reactive protein, transferrin, selected trace elements (Mg, Zn, Fe, Cu, Cd, Se and Cr,), total protein and albumin were determined in 25 asymptomatic HIV-infected Nigerian subjects and 30 age matched HIV-seronegative controls using single radial immunodiffusion and spectrophotometric methods. The mean values of Cu (73.2 + 23.9 microg/dl), Mg (9.83 + 5.5 mg/dl), Fe (126 + 21 microg/L), Cd (24.6 + 7.2 microg/L), Se (22.0 + 12.2 microg/dl) and Cr (19.0 + 5.2 microg/L) were low in asymptomatic HIV-positive subjects when compared with the controls (Cu = 119.3 + 30.8 microg/dl; Mg = 14.5 + 4.6 mg/L; Fe = 155 + 8.8 microg/ dl; Cd = 33. 1 + 8.3 microg/L; Se = 30.9 + 8.3 microg/dl; Cr = 32.1 + 7.8 microg/ L). The level of Zn was similar in asymptomatic HIV-positive subjects (5.1 + 1.9 mg/dl) and the controls (4.6 + 1.7mg/dl). The value of albumin in asymptomatic HIV-positive subjects (3.43 + 0.7 g/dl) was significantly low when compared with the controls (4.04 + 0.52 g/dl). Significant correlation existed between albumin and Mg in asymptomatic HIV subjects (r = + 0.758, p < 0.001). The mean value of C-reactive protein was significantly higher in HIV-infected subjects compared with the controls while the level of transferrin in HIV-infected subjects (92.86 + 26.3 mg/dl) did not show any significant difference when compared with the controls (84.36 + 16.9 mg/dl). This study revealed the deficiencies of trace elements in asymptomatic HIV infection and therefore suggests dietary supplementation of these trace elements in the infected subjects."									
1982	Women and migration: a public health issue.	"Carballo M, Grocutt M, Hadzihasanovic A."	World Health Statistics Quarterly - Rapport Trimestriel de Statistiques Sanitaires Mondiales. 1996;49(2):158-64.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=9050196	"The need to migrate is usually a function of the complex interaction of economic, social, familial and political factors. Among the most important, however, are the denial of access to education, employment, goods and services and the lack of respect for basic human rights. Because in many societies women are marginalized from these rights, migration to more economically and educationally open societies can often help improve their personal situation and their professional opportunities. On the other hand, because the status of women is usually linked to their role and status within the family and is defined in relationship to their male partners, migration can place women in situations where they experience stress and anxiety due to the loss of their traditional social entourage and environment. Their social integration in new settings may be equally limited by their initial lack of education and occupational experience. The higher vulnerability of women to sexual abuse and violence also places them at risk of STDs, including HIV, and a range of post-traumatic stress disorders associated with sexual violence. Their reproductive health needs often go unnoticed and unprotected even in well organized refugee and migrant situations, and the insensitivity of health staff to the needs of women is often more pronounced in refugee and migrant contexts than it is in general. Health monitoring of women in all migration-related situations has to be given greater priority. Similarly, much more attention at a health policy level is called for if the rights of women refugees and migrants are to be protected, and their contribution to health and social development is to be acknowledged and promoted."									
1566	The neglected tropical diseases of Latin America and the Caribbean: a review of disease burden and distribution and a roadmap for control and elimination.	"Hotez PJ, Bottazzi ME, Franco-Paredes C, Ault SK, Periago MR."	PLoS Neglected Tropical Diseases [electronic resource]. 2008;2(9):e300.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=18820747	"The neglected tropical diseases (NTDs) represent some of the most common infections of the poorest people living in the Latin American and Caribbean region (LAC). Because they primarily afflict the disenfranchised poor as well as selected indigenous populations and people of African descent, the NTDs in LAC are largely forgotten diseases even though their collective disease burden may exceed better known conditions such as of HIV/AIDS, tuberculosis, or malaria. Based on their prevalence and healthy life years lost from disability, hookworm infection, other soil-transmitted helminth infections, and Chagas disease are the most important NTDs in LAC, followed by dengue, schistosomiasis, leishmaniasis, trachoma, leprosy, and lymphatic filariasis. On the other hand, for some important NTDs, such as leptospirosis and cysticercosis, complete disease burden estimates are not available. The NTDs in LAC geographically concentrate in 11 different sub-regions, each with a distinctive human and environmental ecology. In the coming years, schistosomiasis could be eliminated in the Caribbean and transmission of lymphatic filariasis and onchocerciasis could be eliminated in Latin America. However, the highest disease burden NTDs, such as Chagas disease, soil-transmitted helminth infections, and hookworm and schistosomiasis co-infections, may first require scale-up of existing resources or the development of new control tools in order to achieve control or elimination. Ultimately, the roadmap for the control and elimination of the more widespread NTDs will require an inter-sectoral approach that bridges public health, social services, and environmental interventions."									
1635	Nutrition in paediatric human immunodeficiency virus infection.	Miller TL.	Proceedings of the Nutrition Society. 2000;59(1):155-62.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=10828185	"The nutritional condition of children with human immunodeficiency virus (HIV) infection continues to be a problem both in developed and developing countries. HIV-infected children grow below normal standards in both height and weight when compared with HIV-exposed non-infected children. These patterns persist over time. It is possible that acute infectious episodes and increased HIV viral burden contribute to decrements in all growth variables. Potential aetiologies for abnormal growth include inadequate dietary intake, gastrointestinal malabsorption, increased energy utilization and psycho-social problems. It is likely that all these factors contribute to the growth problems of these children to some extent. With the development of protease inhibitor anti-retroviral therapy and highly-active anti-retroviral treatment regimens, children with HIV infection in developed countries are living longer with a chronic illness. New nutritional problems have arisen with the development of the fat redistribution syndrome or lipodystrophy. Emerging problems are now being recognized, with the development of insulin resistance and truncal obesity which may potentially lead to premature cardiovascular disease. [References: 51]"									
1500	"Effects of nutritional counseling and micronutrient supplementation on some biochemical parameters of persons living with HIV and AIDS in Uyo, Nigeria."	"Opara DC, Umoh IB, John M."	Pakistan Journal of Nutrition. 2007;6(3):220-7.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20083068906	"The nutritional status of 290 randomly selected persons living with HIV and AIDS, who reported for anti retro viral therapy at the University of Uyo Teaching Hospital was evaluated. The study participants were randomly assigned subjects (78 females and 66 males), who received nutritional counseling and free daily micronutrient supplements and controls (76 females and 70 males), who did not receive. Their biochemical parameters (Serum albumin, packed cell volume, serum retinol and serum Vitamin C) were assessed at recruitment and the end of the four month study period. The results showed that there was significant difference (p<0.05) in the mean gain in packed cell volume between the subjects and their control. There was no significant difference (P>0.05) in the mean gain in total serum protein between male subjects and control, however there was a significant difference (p<0.05) in mean gain in serum protein between female subjects and female controls. The study also observed a significant difference (p<0.05) in the mean gains in serum albumin; serum retinol and serum vitamin c levels respectively between subjects and their controls. It is recommended that in resource-limited settings all PLWHA should be given individualized nutritional counseling and micronutrient supplementation, when undergoing anti-retro viral therapy."									
818	Nutritional status of HIV positive children.	"Kaveri R, Jacob KRS."	Indian Journal of Nutrition and Dietetics. 2011;48(3):99-105.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20113375702	"The nutritional status of HIV-positive children in Tamil Nadu, India, was assessed. 75 HIV-positive children and 75 normal children matched for age, gender and socioeconomic status participated in the study. Demographic data were obtained through interview, anthropometric measurements were performed, clinical assessment of nutrient deficiency was performed, and dietary assessment was carried out using 24-h recall method. The children were divided into 3 age groups (3-6, 7-9 and 10-14 years). Majority of the HIV-positive and normal children were in the 7-9 and 10-14 years age groups. About 50% of the families had income of Rs 2000-5000 and 80% belonged to small families. Among HIV-positive children, 96% of them had parents who were both HIV-positive. The occurrence of nutritional problems was high and much evident in HIV-positive children compared with control children. The height and weight of HIV-positive children were below the NCHS standards and about 29% of them showed delayed milestones in 6 key motor developmental stages and 60% had poor nutritional status according to Waterlow classification. Significant difference in height was observed between male HIV-positive and normal children among 3-6 and 10-14 years age groups. Clinical assessment showed significant difference between HIV-positive and normal children. HIV-positive children had significantly more clinical signs and symptoms of malnutrition than normal children. Food availability was similar in both groups but the food consumption of HIV-positive children was less because of frequent illnesses. Majority of the HIV-positive and normal children consumed rice while other food groups were not matched for daily consumption. About 90% of both groups had the practice of buying foods from outside. Both groups had similar monthly expenditure pattern for cereals but expenditure for other food groups varied. Less than 50% of food adequacy was observed for many of the food groups among all age groups of HIV-positive children except 3-6 years age group. Regarding nutrient intake, significant difference was observed between male HIV-positive and normal children aged 10-14 years and between HIV-positive and normal children aged 7-9 years. Nutrient intake was quite below the RDA except in children aged 3-6 years. Significant difference was observed for haemoglobin values between HIV-positive children who were receiving and not receiving antiretroviral therapy. It is suggested that nutritional assessment could be part of clinical evaluation of HIV-positive children to slow down their progression to AIDS and have a better quality of life."									
1497	Nutrition rehabilitation of the HIV-infected and negative undernourished children utilizing spiruline.	"Simpore J, Zongo F, Ouattara Y, Kabore F, Dansou D, Bere A, Nikiema JB, et al."	Pakistan Journal of Biological Sciences. 2005;8(4):589-95.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh3&AN=20053117639	"The objective of the study was to assess the impact of an alimentary integrator composed by Spiruline (Spirulina platensis), produced at the Centre Medical St Camille (CMSC) of Ouagadougou, Burkina Faso, on the nutritional status of undernourished HIV-infected and HIV negative children. We compared two groups of children: 84 children HIV-infected and 86 HIV-negative. The duration of this study was eight weeks. Anthropometrics and haematological parameters allowed us to appreciate both the nutritional and biological effects of Spiruline supplement to traditional meals. The rehabilitation with Spiruline shows on average a weight gain of 15 and 25 g/day in HIV-infected and in HIV negative children, respectively. The level of anaemia decreased during the study in all the children, but the recuperation was less efficient among the HIV-infected children, in fact, 81.8% of HIV negative undernourished children recuperated against 63.6% of HIV-infected children (Z: 1.70 (95% CI: -0.366, -0.002, p=0.088)). Present results allow to confirm that Spiruline is a good food supplement for undernourished children. In particular the rehabilitation by Spiruline seems to correct the anaemia and the weight loss also in HIV-infected, but more quickly in HIV negative undernourished children."									
1952	Predictors of poor outcomes among patients treated for multidrug-resistant tuberculosis at DOTS-plus projects.	"Kurbatova EV, Taylor A, Gammino VM, Bayona J, Becerra M, Danilovitz M, Falzon D, et al."	Tuberculosis. 2012 September;92(5):397-403.		"The Objective of this analysis was to identify predictors of death, failure, and default among MDR-TB patients treated with second-line drugs in DOTS-plus projects in Estonia, Latvia, Philippines, Russia, and Peru, 2000-2004. Risk ratios (RR) with 95% confidence intervals (CI) were calculated using multivariable regression. Of 1768 patients, treatment outcomes were: cure/completed - 1156 (65%), died - 200 (11%), default - 241 (14%), failure - 118 (7%). Independent predictors of death included: age>45 years (RR = 1.90 (95%CI 1.29-2.80), HIV infection (RR = 4.22 (2.65-6.72)), extrapulmonary disease (RR = 1.54 (1.04-2.26)), BMI<18.5 (RR = 2.71 (1.91-3.85)), previous use of fluoroquinolones (RR = 1.91 (1.31-2.78)), resistance to any thioamide (RR = 1.59 (1.14-2.22)), baseline positive smear (RR = 2.22 (1.60-3.10)), no culture conversion by 3rd month of treatment (RR = 1.69 (1.19-2.41)); failure: cavitary disease (RR = 1.73 (1.07-2.80)), resistance to any fluoroquinolone (RR = 2.73 (1.71-4.37)) and any thioamide (RR = 1.62 (1.12-2.34)), and no culture conversion by 3rd month (RR = 5.84 (3.02-11.27)); default: unemployment (RR = 1.50 (1.12-2.01)), homelessness (RR = 1.52 (1.00-2.31)), imprisonment (RR = 1.86 (1.42-2.45)), alcohol abuse (RR = 1.60 (1.18-2.16)), and baseline positive smear (RR = 1.35 (1.07-1.71)). Patients with biomedical risk factors for treatment failure or death should receive heightened medical attention. To prevent treatment default, management of patients who are unemployed, homeless, alcoholic, or have a prison history requires extra measures to insure treatment completion. 2012 Elsevier Ltd. All rights reserved."									
1263	The nutritional status of children and adolescents with HIV/AIDS on antiretroviral therapy.	"Souza DT, Rondo PHC, Reis LC."	Journal of Tropical Pediatrics. 2011 February;57(1):65-8.		"The objective of this cross-sectional study was to assess the nutritional status of children and adolescents with human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) receiving highly active antiretroviral therapy (HAART). One hundred and eighteen subjects aged 6-19 years attending an outpatient clinic in Sao Paulo city were involved in the study. The following anthropometric measurements were assessed: weight, height, waist circumference and triceps and subscapular skinfold thickness. One (0.9%) adolescent was diagnosed with abdominal obesity based on waist circumference measurement; three (2.5%) adolescents were obese based on subscapular skinfold thickness. According to the body mass index, the population studied was mainly eutrophic. The prevalence of fat redistribution, a characteristic of patients with HIV/AIDS under HAART, was low. We advise the development of further studies to assess the nutritional status of children and adolescents with HIV/AIDS using anthropometric measurements as well as computed tomography to detect fat redistribution. The Author [2010]. Published by Oxford University Press. All rights reserved."									
1127	"Nutritional factors, and infectious, disease contribute to anemia among pregnant women with human immunodeficiency virus in Tanzania."	"Antelman G, Msamanga GI, Spiegelman D, Urassa EJN, Narh R, Hunter DJ, Fawzi WW."	Journal of Nutrition. 2000;130(8):1950-7.		"The objective of this cross-sectional study was to identify risk factors for anemia among human immunodeficiency virus (HIV)-positive pregnant women in Dar es Salaam, Tanzania. Baseline data from 1064 women enrolled in a clinical trial on the effect of vitamin supplementation in HIV infection were examined to identify potential determinants of anemia. The mean hemoglobin (Hb) level was 94 g/L, and the prevalence of severe anemia (Hb < 85 g/L) was 28%; 83% of the women had Hb < 110 g/L. Iron deficiency and infectious disease appeared to be the predominant causes of anemia. Significant independent associations with severe anemia were observed for women with body mass index (BMI) < 19 kg/m<sup>2</sup> compared with women with BMI > 24 kg/m<sup>2</sup> (odds ratio (OR) 3.13, 95% confidence interval (Cl): 1.37-7.14); malaria parasite densities > 1000/mm<sup>3</sup> (OR 2.70, Cl:1.58-4.61) compared with women with no parasites; eating soil during early pregnancy (OR 2.47, Cl: 1.66-3.69); CD4+ cell count < 200/muL compared with CD4+ count > 500/muL (OR 2.70, Cl: 1.42- 5.12); and serum retinol levels < 70 mumol/L (OR 2.45, Cl: 1.44-4.17) compared with women with retinol levels > 1.05 mumol/L. The most significant risk factors associated with severe anemia in this population are preventable. Public health recommendations include increasing the effectiveness of iron supplementation and malaria management during pregnancy, and providing health education messages that increase awareness of the potentially adverse nutritional consequences of eating soil during pregnancy."									
266	Nutrition rehabilitation of HIV-infected and HIV-negative undernourished children utilizing spirulina.	"Simpore J, Zongo F, Kabore F, Dansou D, Bere A, Nikiema JB, Pignatelli S, et al."	Annals of Nutrition & Metabolism. 2005;49(6):373-80.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=16219988	"The objective of this study was to assess the impact of an alimentary integrator composed of spirulina (Spirulina platensis; SP), produced at the Centre Medical St Camille of Ouagadougou, Burkina Faso, on the nutritional status of undernourished HIV-infected and HIV-negative children. We compared two groups of children: 84 were HIV-infected and 86 were HIV-negative. The duration of the study was 8 weeks. Anthropometric and haematological parameters allowed us to appreciate both the nutritional and biological effect of SP supplement to traditional meals. Rehabilitation with SP shows on average a weight gain of 15 and 25 g/day in HIV-infected and HIV-negative children, respectively. The level of anaemia decreased during the study in all children, but recuperation was less efficient among HIV-infected children. In fact 81.8% of HIV-negative undernourished children recuperated as opposed to 63.6% of HIV-infected children (Z: 1.70 (95% CI -0.366, -0.002, p = 0.088)). Our results confirm that SP is a good food supplement for undernourished children. In particular, rehabilitation with SP also seems to correct anaemia and weight loss in HIV-infected children, and even more quickly in HIV-negative undernourished children."									
1837	Screening scheme development for active TB prediction among HIV-infected patients.	"Nanta S, Kantipong P, Pathipvanich P, Ruengorn C, Tawichasri C, Patumanond J."	Southeast Asian Journal of Tropical Medicine and Public Health. 2011 July;42(4):867-75.		"The objective of this study was to develop and evaluate a simple scoring scheme to screen for active tuberculosis (TB) among HIV-infected patients. Two hundred fifty-seven HIV-infected patients were enrolled in the study between April 2009 and May 2010 from Mae Sai District Hospital and Lampang Regional Hospital. Participants underwent routine evaluations to diagnose TB. Data collection included demographics, medical history, signs and symptoms and laboratory results. Of the 257 HIV-infected patients enrolled, 66 (25.7%) were diagnosed with active TB. Six variables were statistically significant predictors of active TB (p<0.05): BMI <=19 kg/m2, cough >2 weeks, shaking chills >=1 week, not taking antiretroviral drugs, a CD4+ cell count level <=200 cells/mul, and had a history of TB. A risk score (ranging from 0 to 16) gave a 92.1% sensitivity of being associated with active TB. A low risk score (<= 2.0), a moderate risk score (3.0-7.0), and a high risk score (>7.0) gave positive likelihood ratios (LHR+) of 0.04 (95%CI 0.01-0.24), 2.56 (95%CI 1.71-3.85), and 11.72 (95%CI 4.91-27.96), respectively. This screening tool may be useful to identify patients who should have further diagnostic testing for TB, but requires further validation before adoption due to the variability of predicting factors and the prevalence of TB in the target population."									
1870	The effect of food supplementation for HIV/AIDS persons.	"Tawichasri C, Patumanond J, Kiattipornsakda A."	Thai AIDS Journal. 1999;11(1):9-20.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh2&AN=19991409776	"The objective of this study was to evaluate the potential benefit of food supplementation for HIV/AIDS persons in a community intervention study in Mae Jan District, Chiang Rai, Thailand. Subjects included 173 HIV/AIDS persons, 103 in the intervention group and 70 in the control. Information was collected regarding demographic characteristics, history of illnesses, daily food intake, an ability to work, results of a physical check up which grouped them into ""HIV infection without symptom"", ""HIV infection with symptoms"" and ""definite AIDS"", body weight and height measurements A blood sample wasn taken for total lymphocyte count, and an evaluation of mental feeling. The number of deaths and losses to follow up were recorded. All subjects were encouraged to form weekly activity groups, at which time the health team visited, to give advice and health education. Subjects in the intervention group were additionally provided with food supplements. After 3 and 6 months of intervention, the proportion of subjects who lost weight in the intervention group was less than the control group. Although the mean total lymphocyte counts were decreased in both groups, it was obvious that the reduction of the proportion of subjects whose total lymphocyte counts were maintained or increased, was less than the control group. Food supplementation for HIV/AIDS persons resulted in increasing dietary intake, deceleration of body weight and total lymphocyte count reductionr."									
573	"Association between carriage of oral yeasts, malnutrition and HIV-1 infection among Tanzanian children aged 18 months to 5 years."	"Scheutz F, Matee MI, Simon E, Mwinula JH, Lyamuya EF, Msengi AE, Samaranayake LP."	Community Dentistry & Oral Epidemiology. 1997;25(3):193-8.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=9192146	"The objective was to determine whether there is an association between carriage of oral yeasts, malnutrition and HIV-1 infection among Tanzanian children. A case-control study design within a cross-sectional study was used, and the outcome was carriage of oral yeasts. The exposure variables were malnutrition and HIV-1 antibody, and confounders to be adjusted for were age, sex, and breastfeeding. The study was carried out in Dar-es-Salaam, Tanzania, in two maternal and child health (MCH) clinics that offer routine medical checkups to all expectant mothers and children aged between 0 and 5 years in the catchment area. A total of 882 children aged between 18 months and 5 years participated. Smears from the tongue and buccal mucosa were examined for oral yeasts. Malnutrition was categorized according to standards on the MCH chart and World Health Organization/Centers for Disease Control (WHO/CDC) standards as weight-for-height (wasted), weight-for-age (underweight), and height-for-age (stunted). HIV-1 infection was determined by an enzyme-linked immunosorbent assay. Reactive sera were confirmed by Western Blot. About 27% of the children were slightly or severely malnourished according to standards on the MCH chart. According to WHO/CDC standards, 2.6% were wasted, 16.3% were underweight, and 29.6% were stunted. Fourteen (1.6%) were seropositive for HIV-1 antibody. Hyphal forms and blastospores were much more frequent among children infected with HIV-1 with odds ratios ranging from 3.8 (95% CI: 1.3;11.2) to 6.2 (95% CI: 2.1;18.4) depending on categorization of malnutrition. Malnutrition was a risk factor, too, albeit to a much lesser and insignificant degree. The study supports our previous findings that malnutrition may predispose to carriage of oral yeasts and subsequent infection. However, in this study population HIV infection was clearly the predominant risk factor."									
1985	"Baseline study: nutritional status, food security and fish consumption among people living with HIV/AIDS in Zambia."	"Nyirenda DB, Sampa M, Husken SMC."	WorldFish Center Project Report. 2010;63(18).	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20123059877	"The overall objective of this study is to establish a baseline of the nutritional status, food security and fish consumption levels of people living with HIV/AIDS in selected rural and peri-urban sites in Lusaka and Central Provinces, Zambia. A total of 145 respondents were interviewed over a period of ten days. The results of the baseline study demonstrated that household income and social support from family and relatives seemed to be important factors to ensure household food security. Female headed households were more likely to be vulnerable to food insecurity, and households that were able to cope better were households with children or relatives who sent help or came to look after them. However, such households were in the minority. Kapenta (Rastreneobola argentea) was the most commonly consumed animal source food. Fish in general turned out to be the most preferred source of animal foods, however, its access depends on availability of cash to the household and most PLHIV are the poorest of the poor, without regular income to afford frequent consumption of fish. Kapenta was found to be the most accessible fish due to its availability and low cost, and also the divisibility; small quantities of the small dried fish can be bought and shared as is or combined with vegetables. However, actual quantitative intake per person appeared to be low due to small purchases and sharing among household members. The respondents' food intake was low as seen by their low Body Mass Index (BMI) and low weight, which is an indication for increased vulnerability to opportunistic infections."									
751	Medical and prophylactic nutrition in workers under harmful conditions. [Russian].	"Pilat TL, Tychinin MV."	Gigiena i sanitariia. 2009 2009(6):57-9.		"The paper assesses the traditional and current methods in the organization of providing workers with medical and prophylactic products. It raises the question as to the value of milk as a detoxicant, an antidote, that aids in eliminating harmful substances from the organism of workers who are in contact with noxious occupational factors. Consideration of this issue may be presently regarded as actually urgent and timely since present-day developments in preventive nutrition of the population provide a possibility of using foods (beverages) that are of great rational benefit to the health of the persons exposed to poor industrial factors."									
750	[Medical and prophylactic nutrition in workers under harmful conditions].	"Pilat TL, Tychinin MV."	Gigiena i Sanitariia. 2009(6):57-9.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=20135870	"The paper assesses the traditional and current methods in the organization of providing workers with medical and prophylactic products. It raises the question as to the value of milk as a detoxicant, an antidote, that aids in eliminating harmful substances from the organism of workers who are in contact with noxious occupational factors. Consideration of this issue may be presently regarded as actually urgent and timely since present-day developments in preventive nutrition of the population provide a possibility of using foods (beverages) that are of great rational benefit to the health of the persons exposed to poor industrial factors."									
1245	Improved nutritional recovery on an elemental diet in Zambian children with persistent diarrhoea and malnutrition.	"Amadi B, Mwiya M, Chomba E, Thomson M, Chintu C, Kelly P, Walker-Smith J."	Journal of Tropical Pediatrics. 2005;51(1):5-10.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=15601655	"The persistent diarrhoea-malnutrition syndrome (PDM) remains a leading cause of morbidity and mortality in hospitals in resource-poor countries. In view of the benefits of elemental or oligomeric feeds in inflammatory bowel diseases, we performed a randomized controlled trial of an exclusive diet of amino acid-based elemental feed (AAF) compared with standard nutritional rehabilitation (based on skimmed milk and then soya) for PDM. Treatment was given for 4 weeks in the malnutrition ward of the University Teaching Hospital, Lusaka, in a single-blind study. Intestinal and systemic infections were treated with routine therapies. The main outcome measures were weight gain, recovery from diarrhoea, and mortality. Two hundred children (106 HIV seropositive, 90 HIV seronegative) were randomized; 155 children completed therapy, 39 died, and six were lost to follow-up. At randomization, they were severely malnourished: median baseline weight-for-age z-score was -4.0 (interquartile range, IQR -4.4, -3.5); 9 per cent were underweight, 23 per cent had marasmus, 47 per cent had kwashiorkor, and 21 per cent had marasmic-kwashiorkor. Weight gain was greater in the AAF group (median gain in weight-for-age z-score was 1.23, IQR 0.89-1.57) compared with the control group (0.87, IQR 0.47-1.25; p=0.002), although calorie intakes were higher in the control group. The increase in haemoglobin concentration was also greater in the AAF group (0.8 g/dl, IQR 0-1.8) than in the control group (0.3, IQR -0.6, -1.6; p=0.04). Diarrhoea frequency and global recovery scores improved equally in both treatment groups and mortality did not differ. A diet of reduced molecular complexity was associated with significantly improved weight gain."									
459	The effects of micronutrient-fortified complementary/replacement food on intestinal permeability and systemic markers of inflammation among maternally HIV-exposed and unexposed Zambian infants.	"Mullen A, Gosset L, Larke N, Manno D, Chisenga M, Kasonka L, Filteau S."	British Journal of Nutrition. 2012;107(6):893-902.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=21899803	"The present randomised trial investigated the effects of feeding Zambian infants from 6 to 18 months old either a richly or basal micronutrient-fortified complementary/replacement food on gut integrity and systemic inflammation. Blood samples were obtained from all infants (n 743) at 6 and 18 months for the assessment of serum C-reactive protein (CRP) and 1-acid glycoprotein (AGP). A subsample of 502 infants, selected from the main cohort to include a larger proportion of infants with HIV-positive mothers, was assigned to lactulose/mannitol gut permeability tests. Lactulose:mannitol (L:M) ratio analyses were adjusted for baseline urinary L:M ratio, socio-economic status, mother's education, season of birth and baseline stunting, and stratified by maternal antenatal HIV status, child's sex, concurrent breast-feeding status and anaemia at baseline. There was no significant difference in geometric mean L:M ratio between the richly fortified and basal-fortified porridge arms at 12 months (0.47 (95 % CI 0.41, 0.55) v. 0.41 (95 % CI 0.34, 0.49); P = 0.16 adjusted). At 18 months, the richly fortified porridge group had a significantly higher geometric mean L:M ratio than the basal-fortified group (0.23 (95 % CI 0.19, 0.28) v. 0.15 (95 % CI 0.12, 0.19); P = 0.02 adjusted). This effect was evident for all stratifications, significantly among boys (P = 0.04), among the infants of HIV-negative mothers (P = 0.01), among the infants of HIV-negative mothers not concurrently breast-fed (P = 0.01) and among those who were not anaemic at baseline (P = 0.03). CRP, but not AGP, was positively associated with L:M ratio, but there were no significant effects of the diet on either CRP or AGP. In conclusion, a richly fortified complementary/replacement food did not benefit and may have worsened intestinal permeability."									
342	"Interaction among body composition, self-rated health and functional status of the elderly in an Indian population."	"Reddy KKR, Reddy BK, Rao AP."	Asia Pacific Journal of Clinical Nutrition. 2004;13(1):78-85.		"The present study examined the relationship among body composition, measures of self-rated health and activities of daily living in a group of free living poor elderly aged >=60 years with a sample size of 147 subjects (82 males, 65 females) from Tirupati suburbs of Andhra Pradesh, India. The subjects were divided into three age groups i.e. 60-69, 70-79 and >= 80 years for comparison. Mean height, weight, circumferences of waist and hip and waist hip ratio (WHR) were higher in males than females with no difference in body mass index (BMI). However, none of the anthropometric variables showed significant association with age. The majority of the subjects rated themselves as 'poor' or 'fair' self-rated health and this corresponds well with the lower mean values of anthropometry as well as activities of daily living, well-being and memory and cognitive function, impaired health aids and in general health. Polytomous logistic regression showed that subjects with the highest score on well-being compared to the lowest score rated 0.325 times (CI: 0.124, 0.851; P<0.05) good vs fair. The odds ratio was 0.519 times (CI: 0.206, 1.306) between good vs poor. Regarding BMI, subjects who rated their health as good/fair tended to have BMI in the normal range. In the poor self-rated health group a maximum of 55% of males and 47% of females were below 19 units of BMI, which was reflected in the increase in odds ratio of 1.361 in males and 1.134 in females between good vs poor health ratings. The findings reveal that well-being and BMI are related to self-reported health status."									
91	Nutritional aspects of HIV-infected children receiving highly active antiretroviral therapy.	Miller TL.	Aids. 2003 April;17(SUPPL. 1):S130-S40.		"The presentation of the nutritional problems of HIV-infected children is changing over time with improved antiretroviral regimens. Early reports of HIV infection in the 1980s, included such problems as malnutrition and wasting. However, as treatment and prophylactic regimens improve, the current nutritional problems of HIV-infected children in developed countries include truncal obesity and insulin resistance in addition to malnutrition. Background data on the wasting syndrome, etiology of malnutrition, nutritional effects of highly active antiretroviral therapies, and nutritional intervention strategies for HIV-infected children will be presented. 2003 Lippincott Williams & Wilkins."									
1254	"Pediatric admissions with human immunodeficiency virus infection at a regional hospital in Soweto, South Africa."	"Meyers TM, Pettifor JM, Gray GE, Crewe-Brown H, Galpin JS."	Journal of Tropical Pediatrics. 2000;46(4):224-30.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=10996984	"The prevalence and clinical spectrum of HIV disease in hospitalized African children has not been adequately characterized in Southern Africa. This study aimed to determine the prevalence and disease profile of HIV infected children under 5 years of age admitted to a tertiary care hospital in Soweto, South Africa and to assess the impact of pediatric HIV on health services. Over a 6-month period, serial pediatric admissions to one of the children's wards were screened for HIV. Data on demographics and disease profile were recorded for all patients. A total of 549 patients were admitted, of whom 507 were tested for HIV; 29.2 per cent were considered to be truly infected. Previous admissions to hospital were more frequent in the HIV infected group, 48 per cent compared with 20.4 per cent of HIV uninfected children (p < 0.01), with a median length of stay of 8 days compared with 6 days (p < 0.01). There were more malnourished children in the HIV infected group (65.8 per cent compared with 33.1 per cent) (p < 0.01) and more died (17 per cent compared with 4.6 per cent) (p < 0.01). The most common reasons for admission in all children were infectious diseases such as pneumonia and gastroenteritis (85 and 31.9 per cent compared with 51 and 22.5 per cent, respectively in the HIV infected and uninfected groups, p < 0.01 and p < 0.03). It was concluded that pediatric HIV infection accounts for almost a third of childhood admissions to this hospital and has become a significant burden on the health service."									
237	Enterocytozoon bieneusi among children with diarrhea attending Mulago Hospital in Uganda.	"Tumwine JK, Kekitiinwa A, Nabukeera N, Akiyoshi DE, Buckholt MA, Tzipori S."	American Journal of Tropical Medicine & Hygiene. 2002;67(3):299-303.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=12408671	"The prevalence of Enterocytozoon bieneusi in the general population is unknown. Using genetic tools, we investigated its prevalence and contribution to diarrhea and malnutrition in hospitalized children in Uganda. A cross-sectional, case-control study involving diarrheic children who were matched for age and sex (3:1) with control children. Measurements included anthropometry and clinical assessment. A total of 17.4% of 1,779 children with diarrhea were infected with E. bieneusi compared with 16.8% of 667 control children (CHI2 = 0.137, P = 0.712). Prevalence was highest during the rainy seasons. There was no significant relationship between infection with E. bieneusi and stunting, being underweight, wasting, or acute diarrhea. However, children who were E. bieneusi-positive by a polymerase chain reaction (PCR) had diarrhea for a longer period (15.15 versus 9.67 days; F = 12.02; P = 0.001) compared with children who were either uninfected or were E. bieneusi-positive by a nested PCR. We conclude that E. bieneusi is widespread among children 3-36 months of age in Uganda, and that in a cross-sectional study, there was no clear association of E. bieneusi with poor nutrition or diarrhea. Since E. bieneusi is closely linked with persistent diarrhea and wasting in adults who are positive for human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS), the outcome of follow-up studies involving children who are HIV/AIDS-positive and severely malnourished children may be entirely different and warrants further study."									
48	"Nutrient-enhancement of matooke banana for improved nutrient intake of people living with HIV/AIDS in Rakai district, Uganda."	"Wamono EBK, Kaaya AN, Ng'ang'a Z, Wamue G, Manyama A, Mwangi M, Muyonga JH."	"African Journal of Food, Agriculture, Nutrition and Development. 2011;11(4):5018-34."	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20113273676	"The prevalence of HIV in Rakai district is estimated at 12.7%, which is approximately double the national prevalence. It is well established that HIV and AIDS affect nutritional status and food security of populations. The aim of this study was to assess the food and nutrition security of people living with HIV (PLHIV) and the potential of banana nutrient enhancement to improve nutrient intake. A total of 173 PLHIV registered with Rakai Health Science Project were chosen and interviewed using structured questionnaires to determine the current contribution of banana to the household food security. Nutrient intake data were collected using Gibson's 24-hour recall method and food frequency questionnaires. Key informants' interviews with agricultural extension staff and focus group discussions with PLHIV and support group personnel were used to collect qualitative and quantitative information. Experiments were conducted to determine the suitability of banana as a food vehicle to boost the energy and nutrient intake of PLHIV. A product was made by blending banana flour with soybean flour and multi-nutrient fortificant premix. The formulation was reached using the Pearson's square method, with a target protein content of 15%. To pilot test the product, the nutrient-enhanced banana powder was distributed to15 PLHIV and data on acceptability and the contribution of the product to nutrient intake were assessed. It was found that the majority of PLHIV (88%) in Rakai district consumed banana at least 3 times a week. The baseline daily intake was found to be 1676.2 kcal, 0.8 mg, 0.8 mg, 249.6 mcg, 259.4 mg and 12.9 mg for energy, vitamin B<sub>1</sub>, vitamin B<sub>2</sub>, folate, calcium and iron respectively, which was below the recommended daily allowances (RDA) for PLHIV. The formulated banana product was found to supply 459.7 kcal and contained 15% protein. The product was well accepted by the PLHIV and its average level of consumption was 67 g per day. At this intake level of the product, study households intake of energy, vitamin B<sub>2</sub>, folate and calcium increased to 1732.89 kcal, 1.09 mg, 277.8 mcg and 300.79 mg respectively while iron and vitamin B<sub>1</sub> intakes were not significantly different from the baseline values. It can be concluded that supplementation of diet of PLHIV in Rakai with nutrient-enhanced flour can raise nutrient intake of PLHIV to recommended levels for improved nutritional and health status."									
185	Iron supplementation in early childhood: health benefits and risks.	"Iannotti LL, Tielsch JM, Black MM, Black RE."	American Journal of Clinical Nutrition. 2006;84(6):1261-76.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medc&AN=17158406	"The prevalence of iron deficiency among infants and young children living in developing countries is high. Because of its chemical properties--namely, its oxidative potential--iron functions in several biological systems that are crucial to human health. Iron, which is not easily eliminated from the body, can also cause harm through oxidative stress, interference with the absorption or metabolism of other nutrients, and suppression of critical enzymatic activities. We reviewed 26 randomized controlled trials of preventive, oral iron supplementation in young children (aged 0-59 mo) living in developing countries to ascertain the associated health benefits and risks. The outcomes investigated were anemia, development, growth, morbidity, and mortality. Initial hemoglobin concentrations and iron status were considered as effect modifiers, although few studies included such subgroup analyses. Among iron-deficient or anemic children, hemoglobin concentrations were improved with iron supplementation. Reductions in cognitive and motor development deficits were observed in iron-deficient or anemic children, particularly with longer-duration, lower-dose regimens. With iron supplementation, weight gains were adversely affected in iron-replete children; the effects on height were inconclusive. Most studies found no effect on morbidity, although few had sample sizes or study designs that were adequate for drawing conclusions. In a malaria-endemic population of Zanzibar, significant increases in serious adverse events were associated with iron supplementation, whereas, in Nepal, no effects on mortality in young children were found. More research is needed in populations affected by HIV and tuberculosis. Iron supplementation in preventive programs may need to be targeted through identification of iron-deficient children. [References: 74]"									
1801	Development of a cultural specific dietary assessment tool for people in the Eastern Cape province.	"Lombard M, Burger HM, Steyn NP, Charlton KE, Senekal M."	South African Journal of Clinical Nutrition. 2010;2):S39.		"The prevalence of oesophageal cancer in rural areas of the Eastern Cape Province is high. Because of cultural diversity a culturally specific dietary assessment tool was developed to determine the maize consumption and therefore fumonisin exposure. The SFFQ was developed with focus groups and in-depth interviews. Participants mix maize meal porridge and vegetables in combined dishes. The ratio of the combined dishes varies according to availability. The photographic set includes three portion sizes per dish and three ratio photographs per dish. Portion sizes were estimated during cooking sessions. Small, medium and large portions were determined by using the 25th, 50th and 75th quartiles of portion weight. A local resident prepared the dishes according to the traditional manner. The RAPP tool therefore comprises a SFFQ with photographic aids representing different dishes. The FFQ has 33 food items, with frequencies ranging from once a month to number of times per day. The food photographs include portion sizes of all food items and ratio photographs for 11 dishes. The RAPP tool is a culturally specific dietary assessment tool, which can be used in rural areas of the Eastern Cape Province in South Africa."									
276	"Pneumocystis carinii in children with severe pneumonia at Mulago Hospital, Uganda."	"Bakeera-Kitaka S, Musoke P, Downing R, Tumwine JK."	Annals of Tropical Paediatrics. 2004;24(3):227-35.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=15479572	"The prevalence of Pneumocystis carinii pneumonia (PCP), its clinical and radiological features and the outcome in 121 children aged 2-60 months presenting with severe pneumonia over a 2-month period at Mulago Hospital, Kampala are described. Children presenting with severe pneumonia had sputum induction using 3% hypertonic saline. The sputum was stained using PCP monoclonal antibodies and viewed with fluorescent microscopy. Twenty children with confirmed PCP were compared with 101 without PCP. The prevalence of PCP was 16.5%, and 12 (60%) were < 6 months of age. Eighteen (42%) of 43 children infected with HIV had PCP and two of 78 not infected with HIV. The outcome in children with PCP was poor with a case fatality rate of 40% compared with 20% in those without HIV. Radiological findings were non-specific. Clinical features associated with PCP included: HIV-positive infants with a small head circumference, AIDS, a clear chest on auscultation and elevated LDH levels. PCP occurs in one in six children < 5 years with severe pneumonia in Mulago Hospital. In developing countries where investigations for PCP are not routinely available, infants suspected of PCP should be treated as an emergency. Copyright 2004 Liverpool School of Tropical Medicine"									
1198	Prevalence of malnutrition in human immunodeficiency virus/acquired immunodeficiency syndrome orphans in the Nyanza province of Kenya: a comparison of conventional indexes with a composite index of anthropometric failure.	"Berger MR, Fields-Gardner C, Wagle A, Hollenbeck CB."	Journal of the American Dietetic Association. 2008;108(6):1014-7.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=18502236	"The prevalence of undernutrition in children is commonly reported using a conventional index, which identifies three conventional categories: stunting, underweight, and wasting. Recently, a composite index of anthropometric failure was developed to categorize undernutrition into seven mutually exclusive categories, including single failures (stunting, underweight, or wasting) and multiple failures (stunting and underweight, stunting and wasting, underweight and wasting, and stunting and underweight and wasting). This cross-sectional study used baseline data gathered during a feeding program targeting orphans and vulnerable children impacted by human immunodeficiency virus and/or acquired immunodeficiency syndrome (HIV/AIDS) in Kenya to compare the conventional index with the composite index of anthropometric failure. Children younger than 5 years of age who participated in the feeding trial were included in the analysis (n=170). The conventional index found that the prevalence of undernutrition included 31.2% stunted, 14.1% underweight, and 5.9% wasted children, whereas the composite index of anthropometric failure estimated a more severe overall prevalence rate (38.2%); thus, the conventional index did not uncover the complexity of malnutrition experienced. Of the 53 children classified as stunted by the conventional index, the composite index of anthropometric failure identified 36 (67.9%) as stunted and 17 (32.1%) as stunted and underweight. Thus, the composite index of anthropometric failure was able to distinguish children with multiple anthropometric failures. In total, multiple anthropometric failures were found in 22 of the 65 children with anthropometric failure. These data suggest that the complexity and prevalence of undernutrition may be underestimated using the conventional index because it does not identify children experiencing multiple anthropometric failures. The ability of the composite index of anthropometric failure to identify children with multiple anthropometric failures may have profound implications for prioritizing, designing, and targeting nutritional interventions."									
1273	Resituating the principle of equipoise: justice and access to care in non-ideal conditions.	Kukla R.	Kennedy Institute of Ethics Journal. 2007;17(3):171-202.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=18210980	"The principle of equipoise traditionally is grounded in the special obligations of physician-investigators to provide research participants with optimal care. This grounding makes the principle hard to apply in contexts with limited health resources, to research that is not directed by physicians, or to nontherapeutic research. I propose a different version of the principle of equipoise that does not depend upon an appeal to the Hippocratic duties of physicians and that is designed to be applicable within a wider range of research contexts and types, including health services research and research on social interventions. I consider three examples of ethically contentious research trials conducted in three different social settings. I argue that in each case my version of the principle of equipoise provides more plausible and helpful guidance than does the traditional version of the principle."									
1308	Primary health care: making Alma-Ata a reality.	"Walley J, Lawn JE, Tinker A, de Francisco A, Chopra M, Rudan I, Bhutta ZA, et al."	The Lancet. 2008;372(9642):1001-7.		"The principles agreed at Alma-Ata 30 years ago apply just as much now as they did then. ""Health for all"" by the year 2000 was not achieved, and the Millennium Development Goals (MDGs) for 2015 will not be met in most low-income countries without substantial acceleration of primary health care. Factors have included insufficient political prioritisation of health, structural adjustment policies, poor governance, population growth, inadequate health systems, and scarce research and assessment on primary health care. We propose the following priorities for revitalising primary health care. Health-service infrastructure, including human resources and essential drugs, needs strengthening, and user fees should be removed for primary health-care services to improve use. A continuum of care for maternal, newborn, and child health services, including family planning, is needed. Evidence-based, integrated packages of community and primary curative and preventive care should be adapted to country contexts, assessed, and scaled up. Community participation and community health workers linked to strengthened primary-care facilities and first-referral services are needed. Furthermore, intersectoral action linking health and development is necessary, including that for better water, sanitation, nutrition, food security, and HIV control. Chronic diseases, mental health, and child development should be addressed. Progress should be measured and accountability assured. We prioritise research questions and suggest actions and measures for stakeholders both locally and globally, which are required to revitalise primary health care. 2008 Elsevier Ltd. All rights reserved."									
224	Predictors of South African male testosterone levels: the THUSA study.	"Gray PB, Kruger A, Huisman HW, Wissing MP, Vorster HH."	American Journal of Human Biology. 2006;18(1):123-32.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=16378346	"The process of urbanization occurring in many developing countries may have consequences for reproductive endocrine function. Here, we test predictions concerning variation in South African male testosterone levels among subgroups across an urbanization gradient representing differences in both geography and socioeconomic status. Subjects included 364 males aged between 20 and 82 comprising a cross-sectional study conducted between 1996 and 1998. Testosterone levels were measured from serum samples obtained between 08:00 and 11:00. In ANCOVA analysis, male testosterone levels differed significantly along this rural-to-urban gradient, with members of the most urban group having higher testosterone levels than groups of farmers and inhabitants of informal housing areas adjacent to towns. Testosterone levels declined with age and were negatively related to body mass index (BMI). Testosterone levels did not differ according to HIV status. Further exploratory ANCOVA analyses revealed that physical activity levels, depression, affect, and hostility were not significantly associated with variation in testosterone levels. These data help document causes of variation in male testosterone levels in a context of urbanization and may have implications for clinical outcomes such as the development of a male hormonal contraceptive or prostate cancer. Am. J. Hum. Biol. 18:123-132, 2006. (c) 2005 Wiley-Liss, Inc."									
1469	"Nutrition, health, and aging in sub-Saharan Africa."	"Kimokoti RW, Hamer DH."	Nutrition Reviews. 2008;66(11):611-23.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=19019023	"The proportion of the population that is > or = 60 years of age in sub-Saharan Africa (SSA) is increasing rapidly and is likely to constrain healthcare systems in the future. Nevertheless, the elderly are not a health policy priority for African countries. This paper reviews the nutritional and health status of older adults in SSA and their determinants. Literature was abstracted through the Medline, Google Scholar, and Dogpile databases using the following search terms: sub-Saharan Africa, older adults, nutrition, health. Findings showed that up to half (6-48%) of elderly Africans in SSA are underweight and almost a quarter (2.5-21%) are overweight, while 56% of older South Africans are obese. Low-quality diets contribute to poor nutritional status. Poverty, HIV/AIDS, and complex humanitarian emergencies are major determinants of undernutrition. Effective interventions need to consider socioeconomic, health, and demographic factors; social pensions may be the most cost-effective option for improving the health and nutritional status of the elderly in SSA. [References: 88]"									
355	[The action of HIV infection on the height-weight development of children infected postnatally].	"Cojocaru S, Cojocaru R."	"Bacteriologia, Virusologia, Parazitologia, Epidemiologia. 1998;43(1-2):39-42."	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=9718747	"The purpose of the recent research was to evaluate the influence of HIV infection on the weight-growth deficiency of nonmaternally infected children. The retrospective and prospective study was done on 141 children who died of AIDS in 1990-1997 (inclusive) in Colentina Hospital of Infectious Diseases, Bucharest. The mean of weight and growth deficiency in the total group was accordingly 50.7% and 20.4% with a statistically significant differences in organized children 54.3% and 21.3% in comparison with those of family 46.4% and 18.5%. The evaluation of the anthropometry data estimates a relationship of middle strength between weight and growth deficiency. The obtained data reveal the importance of nutrition and hygiene care factors in the degree of wasting syndrome and mortality-rate, especially in the first two years of life, and demonstrate the necessity of anthropometry measures of children in AIDS."									
1475	Nutritional assessment of 15 HIV-infected male adults.	Lan S.	Nutritional Sciences Journal. 2002;27(1):45-55.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh3&AN=20023070863	"The purpose of the study was to assess the nutritional status of 15 HIV-infected male adults by anthropometric measurements, biochemical tests, cell counts and dietary evaluation. Anthropometric measurements included height and weight. Body mass index (BMI) was calculated as weight (kg) divided by height square (m<sub>2</sub>). Biochemical tests covered serum total protein, albumin, globulin, triglycerides, cholesterol, glucose, haemoglobin (Hb), haematocrit (Hct), RBC, WBC, CD4+, and CD8+. Two-day dietary records were used to analyse the mean intake of energy, macronutrients, crude fibre, cholesterol, 6 vitamins, and 4 minerals. Eight subjects had BMI<22, including 4 with BMI<20. Based on biochemical tests, overall protein and cholesterol metabolism was good, although 4 subjects had low protein intake and 9 subjects had a cholesterol intake > 400 mg/day. Three subjects had hypertriglyceridaemia and another 3 had hyperglycaemia. The means of RBC and Hct were below reference values and 8 subjects had anaemia. Energy intake was 1891+or-323 kcal, equivalent to 90% of RDNA; protein intake was 74+or-18 g, fat was 55+or-15 g, and carbohydrate 275+or-64 g. These nutrients contributed 15.6%+or-2.7%, 26.4%+or-6.9% and 58%+or-7.6% to total calories, respectively. Crude fibre intake was 5.00+or-3.81 g, and cholesterol was 396+or-181 mg. Except for vitamin C, the intake of vitamins A, B<sub>1</sub>, B<sub>2</sub>, and niacin was inadequate, and was equivalent to 76%, 80%, 78%, and 75% of the RDNA. Mineral intake for Ca was 347+or-138 mg, 58% RDNA; P was 889+or-260 mg, 145% RDNA; Fe was 14+or-6.6 mg, and Na was 1166+or-479 mg."									
1976	Lipodystrophy and metabolic abnormalities in Slovenian HIV-infected patients.	"Tomazic J, Silic A, Karner P, Vidmar L, Maticic M, Poljak M, Ihan A, et al."	Wiener Klinische Wochenschrift. 2004 30 Nov;116(21-22):755-9.		"The purpose of this cross-sectional survey was to estimate the prevalence of lipodystrophy (LD) and metabolic abnormalities in Slovenian patients with HIV infection. All patients receiving highly active antiretroviral therapy (HAART) for more than six months (treated group) and all known antiretroviral-naive patients (control group) were consecutively evaluated between October and December 2003. Eighty-one treated patients (81% male, 19% female), and 18 controls (83% male, 17% female) were included in the study. In the treated group, the duration of HAART at the time of evaluation was 3.7 +/- 2.3 years. Twenty-nine treated patients (36%) had at least one sign of LD: isolated peripheral atrophy was present in nine (31%), isolated fat accumulation in four (14%) and a mixed syndrome in 16 (55%). Patients with evidence of LD were older than those without LD and had a higher prevalence of AIDS and a longer duration of HAART, but there were no differences in HIV transmission categories, plasma RNA level, CD4+ count, HAART regimens or BMI. Insulin resistance was observed in 31 treated patients (38%), of whom 22 (27%) had impaired glucose tolerance and six (7%) had diabetes mellitus. Dyslipidemia was the predominant metabolic abnormality in the treated group, observed in 58 patients (72%). Levels of total cholesterol were increased in 43 patients (53%), and hypertriglyceridemia was noted in 40 (49%). The duration of HAART in patients with metabolic syndrome was longer than in patients without the syndrome. Lipid- and glucose-related abnormalities were more frequent in patients with LD than in those without. A total of 60 treated patients (74%) had at least one sign of LD and/or one metabolic alteration at the time of evaluation. In the control group, none of the patients showed evidence of LD, and metabolic abnormalities were less common than in the treated group: six patients (33%) had one or more metabolic abnormalities. HIV-related LD syndrome includes a variety of clinical and biological manifestations, which can be included in a case definition. The metabolic effects of HAART could lead to an increase in cardiovascular disease. The patient's metabolic parameters should be evaluated before starting treatment, and appropriate management of LD and glucose- or lipid-related metabolic changes is essential."									
131	Impact of an Asha intervention on depressive symptoms among rural women living with AIDS in India: comparison of the Asha-Life and Usual Care program.[Erratum appears in AIDS Educ Prev. 2012 Aug;24(4):388].	"Nyamathi A, Salem BE, Meyer V, Ganguly KK, Sinha S, Ramakrishnan P."	AIDS Education & Prevention. 2012;24(3):280-93.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=22676466	"The purpose of this randomized pilot study is to conduct an intervention with 68 rural women living with AIDS to compare the effectiveness of two different programs on depressive symptoms. The trial was designed to assess the impact of the Asha-Life intervention engaging with an HIV-trained village woman, Asha (Accredited Social Health Activist), to participate in the care of women living with AIDS (WLA), along with other health care providers compared to a Usual Care group. Two high prevalence HIV/AIDS villages in rural Andhra Pradesh, which were demographically alike and served by distinct Public Health Centers, were selected randomly from a total of 16 villages. The findings of this study demonstrated that the Asha-Life participants significantly reduced their depressive symptom scores compared to the Usual Care participants. Moreover, women living with AIDS who demonstrated higher depressive symptom scores at baseline had greater reduction in their depressive symptoms than women with lower scores."									
123	The Effect of Weight Loss on Body Image in HIV-Positive Gay Men.	"Tate H, George R."	AIDS Care. 2001 Apr 2001;13(2):163-9.	http://search.proquest.com/docview/60394581?accountid=26724	"The purpose of this study was to assess how body image may be affected by HIV-related weight loss. Qualitative methodology was used: eight gay men with weight loss of at least 10% self-completed a brief, tailor-made questionnaire & then participated singly in semistructured audiotaped interviews. Questionnaire analysis showed all but one had avoided social activities in the last two months due to self-consciousness over their emaciated appearance; family visits, meeting new people & meeting up again with people after weight loss were most problematic. Interview analysis revealed that in addition to social considerations, bodily comfort & effectiveness were affected, & participants identified weight loss as a clear sign of disease progression. Weight regain was problematic & food had become a difficult issue for most. These results suggest that in gay men, HIV-related weight loss causes significant emotional & physical problems. 1 Table, 16 References. Adapted from the source document."									
646	Effectiveness of highly active antiretroviral therapy administered by general practitioners in rural South Africa.	"Barth RE, Van Der Meer JTM, Hoepelman AIM, Schrooders PA, Van De Vijver DA, Geelen SPM, Tempelman HA."	European Journal of Clinical Microbiology and Infectious Diseases. 2008 October;27(10):977-84.		"The purpose of this study was to assess the one-year efficacy of highly active antiretroviral therapy (HAART) administered by general practitioners in a primary care community clinic in rural South Africa. We performed an observational cohort study of 675 treatment-naive human immunodeficiency virus (HIV)-infected patients (including 66 children) who began HAART at least 12 months prior to the data analyses. Throughout treatment, the CD4+ T-cell count (percentage of CD4+ T-cells in children) and plasma HIV-RNA level were determined and the patient's weight was recorded. The primary outcome was mortality. Secondary outcomes were viral suppression, immunological response, and weight gain. One year after the start of HAART, 100 of the 675 (15%) patients were lost to follow-up and 119 patients (18%), including six children, died. Mortality was highest during the first few months of treatment. Based on an on-treatment analysis at one year after the start of therapy, 83% of adults and 71% of children had a viral load <400 copies/ml; the viral load was <50 copies/ml in 70% of adults and 61% of children. At one year, the mean CD4+ T-cell count in adults had increased by 236/mm<sup>3</sup>, and the mean body mass index (BMI) had increased by 3.5 kg/m<sup>2</sup>. In children, the mean CD4% had increased by 17.6. A low Karnofsky score and a low baseline CD4+ T-cell count were independently associated with death. In addition to these factors, a low baseline BMI and gender were predictive of a poor immunological outcome. Our study shows that adequately monitored HIV/acquired immunodeficiency syndrome (AIDS) care administered by general practitioners and their staff is feasible and leads to good results in a rural, primary care center in sub-Saharan Africa. In order to achieve even better results, early mortality should be reduced and efforts should be made to start HAART earlier. 2008 The Author(s)."									
1677	Pneumocystis carinii pneumonia versus wasting syndrome among AIDS cases in Puerto Rico: a survival analysis.	"Becerra AMM, Suarez E, Morales Bedoya A."	Puerto Rico Health Sciences Journal. 1996;15(4):257-60.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh2&AN=19972005116	"The purpose of this study was to compare mortality of wasting syndrome (WS) versus P. carinii pneumonia (PCP) in AIDS patients reported in Puerto Rico after controlling for gender, age and CD4<sup>+</sup> levels. AIDS patients for which a diagnosis of WS (n=1180) or PCP (n=765), who were reported to the AIDS Surveillance System of Puerto Rico during 1989-92, were used to analyse the mortality risk among these diagnoses using a Cox's proportional hazard regression model. The Cox model showed that WS patients had 14% to 33% reduction in mortality risk compared with PCP patients after adjusting for gender and age (95% CI). Mortality risks for males were 18%, (95% CI:1%, 39%) higher than females risk after adjusting for AIDS defining condition and age. It was shown that a decrease in 100 CD4<sup>+</sup> cells increased the mortality by 37% (95% CI: 16%, 62%) after adjusting for AIDS defining conditions, gender and age."									
950	Survival in children with perinatal HIV infection and very low CD4 lymphocyte counts.	"Hsu H, Pelton S, Williamson JM, Thomas P, Mascola L, Ortiz I, Rakusan T, et al."	"JAIDS, Journal of Acquired Immune Deficiency Syndromes. 2000;25(3):269-75."	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh3&AN=20013002881	"The purpose of this study was to evaluate clinical conditions associated with mortality in HIV-infected children with CD4<sup>+</sup> counts <100 cells/ micro l. The Pediatric Spectrum of HIV Disease Project is a longitudinal medical record review study with eight study sites in the USA (Los Angeles, California; Massachusetts; New York City, New York; San Francisco, California; District of Columbia; Puerto Rico; and North Carolina), which have been enrolling children since 1989. Survival time from baseline very low CD4 count (<100 cells/ micro l) to death was estimated using the Kaplan-Meier method. Cox proportional hazards models were used to evaluate the effect of clinical variables on mortality. Of 522 children (>=1 year of age) with serial CD4<sup>+</sup> T-lymphocyte measurements, the median age at the first very low CD4 count was 4.8 years. The estimated median survival following the first very low CD4 count was 36 months. The following factors present at the first very low CD4 count were independently associated with a higher risk of death: younger age, weight-for-age, >2 standard deviations below the mean, and previously diagnosed AIDS. The subsequent development of cytomegalovirus (CMV)-associated disease, Mycobacterium avium intracellulare (MAI) infection, wasting syndrome, or oesophageal candidiasis was also independently associated with a higher risk of death. Survival in HIV-infected children with very low CD4 counts before introduction of highly active antiretroviral therapy was highly variable. Poor nutritional status and the development of CMV disease or MAI infection were associated with the shortest survival times."									
735	Nutrition education in Chilean primary schools.	"Olivares S, Zacarias I, Andrade M, Kain J, Lera L, Vio F, Moron C."	Food and Nutrition Bulletin. 2005;26(Suppl. 2):S179-S85.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh3&AN=20053116522	"The purpose of this study was to incorporate nutrition education in Chilean primary schools. The baseline information included nutritional status, food consumption and physical activity of 1701 children from 3rd to 7th grade in ten urban and rural schools. Main results showed a high prevalence of obesity (15.4%) and overweight (19.6%), low consumption of vegetables, fruits, and dairy products, high intake of snacks and a low level of physical activity, especially in girls. Because the Ministry of Education does not allow the incorporation of new programmes into the curriculum, the educational strategy was based on the development of a text book, a teacher's guide, five practical guides for students from third to eighth grade and a CD-ROM. These materials were validated by 36 teachers in six schools through an educational intervention. Teachers and students considered the educational materials useful, motivational and easy to understand. This programme is being implemented in 57 schools."									
1404	"HIV neuropathy in South Africans: Frequency, characteristics, and risk factors."	"Maritz J, Benatar M, Dave JA, Harrison TB, Badri M, Levitt NS, Heckmann JM."	Muscle and Nerve. 2010 May;41(5):599-606.		"The purpose was to estimate the frequency, characteristics, and risk factors of HIV-associated distal sensory polyneuropathy (DSP) among South Africans who attend an urban community-based clinic. In a cross-sectional study, neuropathy status was determined in 598 HIV-infected adults using validated tools (Brief Peripheral Neuropathy Screen and a modified version of the Total Neuropathy Score) to categorize subjects as DSP versus no DSP. Symptomatic DSP (SDSP) required the presence of at least two neuropathic signs together with symptoms. Clinical, anthropometric, and laboratory evaluations were prospectively performed. CD4 counts, antiretroviral therapy (ART), and questionnaires regarding previous tuberculosis (TB) and alcohol exposure were collected retrospectively. Approximately half (49%) of the study population were diagnosed with DSP, and 30% of the study population were diagnosed with SDSP. In multivariate analyses the odds ratio (OR) (95% confidence interval) of DSP were independently associated with ART use (OR 1.7, 1.0-2.9), age (per 10 year increment) (OR 1.7, 1.4-2.2), and prior TB (OR 2.0, 1.3-3.0). Pain or paresthesias were reported as moderately severe by 70% of those with SDSP. Stavudine use was significantly associated with DSP. DSP is a clinically significant problem in urban HIV-infected Africans. Our findings raise the possibility that the incidence of DSP may be reduced with avoidance of stavudine-containing regimens in older subjects, especially with a history of prior TB infection. 2010 Wiley Periodicals, Inc."									
841	Role of anesthesiologists in global health: Can one volunteer make a difference?	Bridenbaugh PO.	International Anesthesiology Clinics. 2010;48(2):165-75.		"The question in the title of this chapter is ""Can one volunteer make a difference?"" As the review of volunteer opportunities for physicians has been presented here, and in most of the other chapters of this book, it might seem that there are too many organizations and people from all walks of life trying to make a difference in helping the needy folks of the world. Living in the developed countries shelters us from appreciating the magnitude of need in the underdeveloped regions of the world. One of the greatest needs is the resources to fight disease and starvation. Let there be no doubt that every physician in the developed world could volunteer their services in some way with some volunteer organization in many parts of the world today and make a difference. Equally important, every place where people volunteer will, in turn, make a life-time difference in the volunteer who shared their need. 2010, Lippincott Williams & Wilkins."									
1129	HIV-1 infection alters the retinol-binding protein:transthyretin ratio even in the absence of the acute phase response.	"Baeten JM, Wener MH, Bankson DD, Lavreys L, Richardson BA, Mandaliya K, Bwayo JJ, et al."	Journal of Nutrition. 2006;136(6):1624-9.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20063147881	"The ratio of retinol-binding protein (RBP) to transthyretin (TTR) has been proposed as an indirect method with which to assess vitamin A status in the context of inflammation. Few studies have been conducted among adults, and none examined the effect of HIV-1 infection. Our goal was to assess the RBP:TTR ratio among adults, including the effects of HIV-1 and the acute phase response. We used data from a cross-sectional study of 600 Kenyan women, of whom 400 had HIV-1. The effect of vitamin A supplementation among the HIV-1-infected participants was subsequently assessed in a randomized trial. Among HIV-1-uninfected women without an acute phase response, a RBP:TTR cut-off value of 0.25 had ~80% sensitivity and specificity to detect vitamin A deficiency (retinol <0.70 micro mol/L). No RBP:TTR cut-off value demonstrated both high sensitivity and specificity among HIV-1 infected women without evidence of inflammation. HIV-1 infection and advanced HIV-1 disease were associated with higher RBP:TTR ratios. The effect of HIV-1 was independent of the acute phase response, which also increased the RBP:TTR ratio. Serum retinol increased with vitamin A supplementation among those with a low RBP:TTR ratio, although the effect was small and was not present among those with concurrent inflammation. Thus, the RBP:TTR ratio has modest ability to predict vitamin A deficiency among healthy adults, but HIV-1 infection alters the ratio, even in the absence of the acute phase response. Our results raise questions about the utility of this measurement given the high prevalence of HIV-1 infection in areas where vitamin A deficiency is common."									
1775	Knowing a sexual partner is HIV-1-uninfected is associated with higher condom use among HIV-1-infected adults in Kenya.	"Benki-Nugent S, Chung MH, Ackers M, Richardson BA, McGrath CJ, Kohler P, Thiga J, et al."	Sexually Transmitted Diseases. 2011 September;38(9):808-10.		The relation between awareness of sexual partner's HIV serostatus and unprotected sex was examined in HIV clinic enrollees. Increased condom use was associated with knowing that a partner was HIV-negative (adjusted odds ratio = 5.99; P < 0.001) versus not knowing partner's status. Partner testing may increase condom use in discordant couples. Copyright 2011 American Sexually Transmitted Diseases Association. All rights reserved.									
55	Nutritional content and a Phase-I safety clinical trial of a herbal-nutritional supplement (IMUNITI) with putative immune-modulating properties.	"Matsabisa MG, Sekhoacha MP, Ibrahim O, Moodley P, Faber M."	"African Journal of Traditional, Complementary and Alternative Medicines. 2012;9(3S):19-23."	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20123094004	"The relationship between HIV and AIDS and poor nutrition has been well established. Poor nutrition hastens the progression of HIV infection to AIDS. The rising pandemic of HIV and AIDS and high toxicity associated with anti-retroviral use are major factors that have compelled research to explore traditional herbal medicines as potential alternatives or supplements to anti-retroviral agents. A Phase I clinical trial was conducted on IMUNITI Wellness Pack, a herbal product with putative immune-modulating properties. The product is a combination of 7 herbal preparations, minerals, vitamins, and a specially formulated soya-maize meal porridge and a bottle of water purifier. The aim was to evaluate the safety and tolerability of IMUNITI, with a purpose of developing it for use in HIV-infected patients. The phase I study was conducted at the MRC clinic in Botha's hill and the study lasted 5 weeks from date of participant dosing. The study was a randomised blinded placebo-controlled phase I clinical trial conducted on 48 healthy males. The participants were randomly divided into 4 groups of 12. The 3 groups received different escalating doses of IMUNITI while the forth group received placebo tablets. Participants consumed IMUNITI daily for a period of 5 weeks. Assessments were done at baseline, week 1 and week 5 to determine the safety parameters in all participants. In this study, IMUNITI did not show any safety concerns. In all study participants, there were no significant changes above the upper limit of the reference ranges of the laboratory tests for full blood count, INR, renal and biochemical safety parameters. IMUNITI was well tolerated. Furthermore, the nutritional content analysis of IMUNITI showed that it is a high kilojoule, high protein content product which contains a mixture of sugars, vitamins, traces of calcium, phosphorus and minerals."									
861	"Pregnancy, body weight and human immunodeficiency virus infection in African women: a prospective cohort study in Kigali (Rwanda), 1992-1994."	"Ladner J, Castetbon K, Leroy V, Nyiraziraje M, Chauliac M, Karita E, Clercq Ad, et al."	International Journal of Epidemiology. 1998;27(6):1072-7.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh2&AN=19992003644	"The relationship between human immunodeficiency virus (HIV) infection and body weight was studied in African women during and after pregnancy. A prospective cohort study was initiated at the Centre Hospitalier de Kigali in July 1992. Every woman seen at the antenatal clinic and with a gestational age of <28 weeks was offered HIV-1 antibody testing. Comparable numbers of HIV-infected (HIV+) and uninfected (HIV-) women were recruited. At inclusion, sociodemographic characteristics and self-reported pre-pregnancy weight were recorded; height and weight were measured. Each woman enrolled had a monthly follow-up until 9 months after delivery, with a clinical examination including weighing. Three anthropometric indices were used to answer the study objectives: weight, body mass index (BMI) and pregnancy balance. As of April 1994, 101 HIV+ and 106 HIV- women were followed until 5 months after delivery. Weight and BMI during pregnancy were lower in HIV+ women than in HIV- women. After delivery, weight and BMI gains were significantly lower in HIV+ women. Until 5 months after delivery, the mean weight variation was -2.2 kg (standard deviation (SD)=5.9 kg) in HIV+ women and +0.2 kg (SD=6.6 kg) in HIV- women (P=0.007) in comparison to pre-pregnancy weight. Comparisons of the slopes of the weight curves did not show statistical differences throughout the pregnancy, but it did during the post-partum period (P=0.02). It is suggested that HIV infection could impair nutritional status in pregnant women, especially during the post-partum period. Family planning and maternal and child health services including HIV testing and counselling, should consider a nutritional assessment and intervention programme targeted to HIV+ pregnant women."									
292	Effect of nutritional status on response to treatment with artemisinin-based combination therapy in young Ugandan children with malaria.	"Verret WJ, Arinaitwe E, Wanzira H, Bigira V, Kakuru A, Kamya M, Tappero JW, et al."	Antimicrobial Agents and Chemotherapy. 2011;55(6):2629-35.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20113189904	"The relationship between malnutrition and malaria in young children is under debate, and no studies evaluating the association between malnutrition and response to artemisinin-based combination therapies (ACTs) have been published. We evaluated the association between malnutrition and response to antimalarial therapy in Ugandan children treated with ACTs for repeated episodes of malaria. Children aged 4 to 12 months diagnosed with uncomplicated malaria were randomized to dihydroartemisinin-piperaquine (DP) or artemether-lumefantrine (AL) and followed for up to 2 years. All HIV-exposed and HIV-infected children received trimethoprim-sulfamethoxazole prophylaxis (TS). The primary exposure variables included height-for-age and weight-for-age z scores. Outcomes included parasite clearance at days 2 and 3 and risk of recurrent parasitemia after 42 days of follow-up. Two hundred ninety-two children were randomized to DP or AL, resulting in 2,013 malaria treatments. Fewer than 1% of patients had a positive blood smear by day 3 (DP, 0.2%; AL, 0.6% [P=0.18]). There was no significant association between height-for-age or weight-for-age z scores and a positive blood smear 2 days following treatment. For children treated with DP but not on TS, decreasing height-for-age z scores of <-1 were associated with a higher risk of recurrent parasitemia than a height-for-age z score of >0 (hazard ratio [HR] for height-for-age z score of <-1 and >=-2=2.89 [P=0.039]; HR for height-for-age z score of <-2=3.18 [P=0.022]). DP and AL are effective antimalarial therapies in chronically malnourished children in a high-transmission setting. However, children with mild to moderate chronic malnutrition not taking TS are at higher risk for recurrent parasitemia and may be considered a target for chemoprevention."									
543	Iron status and indicators of human immunodeficiency virus disease severity among pregnant women in Malawi.	"Semba RD, Taha TE, Kumwenda N, Mtimavalye L, Broadhead R, Miotti PG, Chiphangwi JD."	Clinical Infectious Diseases. 2001;32(10):1496-9.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh3&AN=20013157240	"The relationships among haemoglobin, ferritin, and transferrin receptor levels and 2 markers of human immunodeficiency virus (HIV) disease severity - HIV load and CD4<sup>+</sup> lymphocyte count - were characterized among 483 pregnant women seen at an antenatal clinic in Malawi, Africa between November 1995 and December 1996. The only significant correlation was an inverse correlation between haemoglobin level and plasma HIV load (r=-.104; P<0.03). The prevalence of iron deficiency anaemia was not significantly different across quartiles of HIV load or CD4<sup>+</sup> lymphocyte count. In contrast to previous studies, these data suggest that iron status is not related to markers of HIV disease severity in pregnant women in Africa."									
700	Maternal HIV is associated with reduced growth in the first year of life among infants in the Eastern region of Ghana.	"Lartey A, Marquis GS, Perez-Escamilla R, Mazur R, Brakohiapa L, Ampofo W, Sellen D."	FASEB Journal. 2011 April;25.		"The Research to Improve Infant Nutrition and Growth Project used a longitudinal study design to investigate the association between maternal HIV status and growth among Ghanaian infants. Pregnant women in their third trimester were recruited into one of three groups after voluntary counseling and testing: HIV Negative (HIV-N, n=167) HIV-positive (HIV-P, n=147) and HIV status unknown, due to refusal to test (HIV-U, n= 160). Anthropometric measurements were taken at birth and every month until 12 months of age. Differences in weight-for-age (WAZ), length-for-age (LAZ) and weight-for-length (WLZ) z-scores from 1-12 month of age were assessed using mixed model repeated measures analysis, controlling for various socioeconomic variables. Adjusted mean WAZ and LAZ at birth were significantly lower for infants of HIV-P compared to infants of HIV-N mothers. By 12 months of age, the adjusted mean (+/-SE) LAZ for infants of HIV-N vs HIV-P mothers were -0.23+/-0.06 vs -0.62 +/-0.09 (p=0.001) respectively. The prevalence of stunting (26% vs 6%) and underweight (28% vs 7%) was higher among infants of HIV-P mothers than infants of HIV-N mothers. Growth of infants of HIV-U mothers was between the HIV-N and HIV-P groups. Children of HIV-P mothers living in deprived communities need special support to mitigate the negative effect of maternal HIV infection."									
155	Excessive early mortality in the first year of treatment in HIV type 1-infected patients initiating antiretroviral therapy in resource-limited settings.	"Marazzi MC, Liotta G, Germano P, Guidotti G, Altan AD, Ceffa S, San Lio MM, et al."	AIDS Research and Human Retroviruses. 2008 01 Apr;24(4):555-60.		"The response to treatment and risk factors for early mortality following initiation of combination antiretrovirals (ARVs) in a cohort of African patients are described in a retrospective cohort design. Medical history, laboratory parameters, and mortality data were reviewed for patients initiating ARVs in 12 clinical centers in Mozambique, Tanzania, and Malawi. Among 3456 HIV-1-infected patients who received ARVs for more than 6 months, at baseline 72% had WHO clinical stages 3/4, 7% had a viral load <400 copies/ml, and 38% had a CD4 cell count >200/mul. One year later, 78% had undetectable virus loads and 79% had CD4 cell counts >200 cells/mm<sup>3</sup>. In the first year of HAART 260 deaths occurred (97 per 1000 person/years) with mortality peaking in the first 3 months. The highest mortality was observed in patients with low BMI, low hemoglobin levels, and CD4 values <200 cells/mul at baseline. Mortality rates following initiation of HAART are higher in patients in resource-limited areas, particularly in the first 90 days following treatment initiation. HAART initiated at higher CD4 cell count levels, especially among malnourished and/or anemic patients, will carry significant public health impact. 2008 Mary Ann Liebert, Inc."									
520	Micronutrients and human immunodeficiency virus type 1 disease progression among adults and children.	Fawzi W.	Clinical Infectious Diseases. 2003;37 Suppl 2:S112-6.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=12942384	"The results of randomized trials among men and nonpregnant women have confirmed the potential benefits of vitamins B, C, and E supplements on the immune status of human immunodeficiency virus (HIV)-infected individuals. Larger trials are needed to ascertain whether these benefits are sustained and to examine the effect of supplementation on clinical outcomes. Among pregnant women, vitamin A supplements increase the risk of mother-to-child transmission. Supplementation with vitamins B, C, and E during prenatal and breastfeeding periods should be encouraged, in light of the protective effects on adverse pregnancy and child outcomes. In children aged >6 months, vitamin A supplements are beneficial for reducing morbidity and mortality in developing countries, including among HIV-infected children. There are no data on the relationships of other micronutrients and child health. For adults and children, more research is warranted on the role of selenium, zinc, and other trace elements on various measures of health among HIV-infected individuals. [References: 46]"									
40	"The effect of integrated nutrition care intervention on the nutritional status of HIV/AIDS children in Kilifi District, Kenya."	"Chesire EJ, Makokha A, Kombe YY, Mwangi M."	"African Journal of Food, Agriculture, Nutrition and Development. 2012;12(6):6593-613."	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20123373607	"The right to adequate nutrition in children is essential for the attainment of high standards of health. The health and nutritional status of orphans and vulnerable children is important as it affects their growth, health and mental development. However, these children suffer from malnutrition as they have limited access to adequate food and proper health care. The objective of this study was to assess the effect of an integrated nutrition care intervention in improving the nutritional status of children aged 6-14 years orphaned and made vulnerable by HIV and AIDS in Kilifi District, Kenya. A longitudinal quasi-experimental study was carried out in selected households of two divisions of Kilifi District. Two-stage sampling was used to identify the target households. Random sampling was used to identify the study subjects. A sample of 276 children was included in the study for experimental (138) and control (138) groups drawn from 153 households. The data collected included anthropometry measurements, dietary intake and socio-demographic characteristics of the study children. The intervention measures of the study were food rations, health and nutrition education, Vitamin A supplementation and de-worming. The experimental group was put on all the intervention measures, whereas the control group was given Vitamin A supplements and de-worming tablets, given in all the three phases. Epi-Info Anthro' software package was used to analyze anthropometry data. Nutri-survey package was used to compute the nutrient content of the children's meals. In both study areas, 26.1% of the children were underweight and 17.8% were wasted at baseline. In the control group at baseline, underweight was 29.7% and 18.8% were wasted, whereas in the experimental group, underweight was 22.5% and wasting was 16.7%. At endline evaluation, the proportion of underweight children in the control group reduced insignificantly (p=0.203) from 29.7% to 22.6% and wasting reduced insignificantly (p=0.295) from 18.8% to 13.9%. Among the experimental group, there was significant reduction (p=0.007) of underweight children from 22.5% to 9.4%, and wasting reduced significantly (p=0.031) from 16.7% to 7.7%. There was significant reduction (p<0.05) in malnutrition among the children in the experimental group but no significant reduction (p>0.05) in the control group. There is need for food rations and nutrition education among orphans and vulnerable children to improve their nutritional status. These results can be used by policy makers to modify programmes targeting orphans and vulnerable children to assure their nutrition security and improve their quality of life."									
1643	Assessment of palliative care needs for people living with HIV/AIDS in Rwanda.	"Uwimana J, Struthers P."	Progress in Palliative Care. 2008;16(3):119-28.		"The rising number of people living with HIV/AIDS (PLWHA) world-wide has made healthcare professionals and policy makers search for accessible healthcare that will meet the needs of people who are suffering from the disease and enhance their quality of life (QoL). This Study investigated met and unmet palliative care needs of PLWHA in selected areas in Rwanda. The study sample included 306 participants: PLWHA, healthcare professionals and co-ordinators of HIV/AIDS units. Quantitative and qualitative methodologies were used. The data were analysed separately and then triangulated. In the findings, over 50% of PLWHA had symptoms related to HIV/AIDS most of the time, with the most common symptom being pain. Participation in activities of daily living was associated with the health status of PLWHA (P < 0.001). The most common perceived palliative care needs of PLWHA were: (i) medical needs, psychosocial needs and the need for financial assistance (77%); (ii) home-based care (47%); (iii) nutritional support (44%); and (iv) pain relief and management of other symptoms (43%). Most PLWHA indicated these palliative care needs were unmet, in particular, the need for pain relief, symptom management, financial assistance and nutritional support. Over 50% of healthcare professionals reported they were not trained in palliative care. They indicated that inadequate policy and resources were the main obstacles to the provision af optimal palliative care. Addressing unmet palliative care needs would enhance the QoL of PLWHA. In addition, developing policy related to the provision of palliative care and building the capacity of healthcare providers is essential for the provision of adequate palliative care services in Rwanda. 2008 W. S. Maney and Son Ltd."									
1728	Met and unmet palliative care needs of people living with HIV/AIDS in Rwanda.	"Uwimana J, Struthers P."	SAHARA J: Journal of Social Aspects of HIV/AIDS Research Alliance. 2007;4(1):575-85.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=18040536	"The rising number of people living with HIV/AIDS (PLWHA) worldwide has made health care professionals and policy makers search for accessible health care that will meet the needs of people who are suffering from the disease and enhance their quality of life (QoL). This study investigated met and unmet palliative care needs of PLWHA in selected areas in Rwanda. The study sample included 306 participants: PLWHA, health care professionals and coordinators of HIV/AIDS units. Quantitative and qualitative methodologies were used. The data were analysed separately and then triangulated. In the findings, over 50% of PLWHA had symptoms related to HIV/AIDS most of the time, with the most common symptom being pain. Participation in activities of daily living was significantly associated with the health status of PLWHA (p<0.001). The most common perceived palliative care needs of PLWHA were medical needs, psychosocial needs and the need for financial assistance (77%); home-based care (47%); nutritional support (44%); and pain relief and management of other symptoms (43%). Most PLWHA indicated these palliative care needs were unmet, in particular the need for pain relief, symptom management, financial assistance and nutritional support. Over 50% of health care professionals reported they were not trained in palliative care. They indicated that inadequate policy and resources were the main obstacles to the provision of optimal palliative care. Addressing unmet palliative care needs would enhance the QoL of PLWHA. In addition, developing policy related to the provision of palliative care and building the capacity of health care providers is essential for the provision of adequate palliative care services in Rwanda."									
236	Maternal anemia at first antenatal visit: prevalence and risk factors in a malaria-endemic area in Benin.	"Ouedraogo S, Koura GK, Accrombessi MM, Bodeau-Livinec F, Massougbodji A, Cot M."	American Journal of Tropical Medicine & Hygiene. 2012;87(3):418-24.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=22826498	"The risk factors for maternal anemia (hemoglobin level less than 110 g/L) were studied in human immunodeficiency virus-negative pregnant women in Benin at the time of first antenatal visit and prior to any prevention. Data for the first 1,005 pregnant women included in a multicentre randomized controlled trial were analyzed. Anemia was common (68.3%), and malaria and helminth infestations were prevalent in 15.2% and 11.1% of the women. A total of 33.3%, 31.3% and 3.6% of the women were iron, folic acid and vitamin B12 deficient, respectively. These parasitic infections and nutrient deficiencies were associated with a high risk of anemia. Twenty-one percent, 15%, 12%, 11% and 7% of anemia were attributable to malnutrition, malaria, iron, folic acid deficiencies, and helminth infestations, respectively. Most anemia was caused by factors that could be prevented by available tools, stressing the need to reinforce their implementation and to evaluate their effectiveness throughout the course of the pregnancy."									
252	Maternal anemia at first antenatal visit: Prevalence and risk factors in a malaria-endemic area in Benin.	"Ouedraogo S, Koura GK, Accrombessi MMK, Bodeau-Livinec F, Massougbodji A, Cot M."	American Journal of Tropical Medicine and Hygiene. 2012 September;87(3):418-24.		"The risk factors for maternal anemia (hemoglobin level less than 110 g/L) were studied in human immunodeficiency virus-negative pregnant women in Benin at the time of first antenatal visit and prior to any prevention. Data for the first 1,005 pregnant women included in a multicentre randomized controlled trial were analyzed. Anemia was common (68.3%), and malaria and helminth infestations were prevalent in 15.2% and 11.1% of the women. A total of 33.3%, 31.3% and 3.6% of the women were iron, folic acid and vitamin B12 deficient, respectively. These parasitic infections and nutrient deficiencies were associated with a high risk of anemia. Twenty-one percent, 15%, 12%, 11% and 7% of anemia were attributable to malnutrition, malaria, iron, folic acid deficiencies, and helminth infestations, respectively. Most anemia was caused by factors that could be prevented by available tools, stressing the need to reinforce their implementation and to evaluate their effectiveness throughout the course of the pregnancy. Copyright 2012 by The American Society of Tropical Medicine and Hygiene."									
900	"Treatment outcome, mortality and their predictors among HIV-associated tuberculosis patients."	"Tabarsi P, Chitsaz E, Moradi A, Baghaei P, Farnia P, Marjani M, Shamai M, et al."	International Journal of STD & AIDS. 2012;23(9):e1-e4.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20123367271	"The risk of death is significantly higher in HIV-infected patients with tuberculosis (TB). This study aims to evaluate the impact of demographic, clinical and laboratory characteristics on the treatment outcome and mortality of TB/HIV co-infected patients in a tertiary TB centre in Iran. In total, 111 patients were recruited from 2004 to 2007. Mycobacteriological studies and demographic, clinical, and laboratory data from all patients were analysed and predictors of unsuccessful outcomes as well as mortality were determined. The mean age for all 111 TB-HIV patients was 38+or-9 years (range 22-70) and 107 (96.3%) were men; 104 (93.7%) had a history of drug abuse and 96 (86.4%) had a history of imprisonment. The method of HIV transmission was intravenous drug use in 88 (79.3%). Twenty-three (20.7%) had a history of Category 1 (CAT I) TB treatment and six (5.4%) Category 2 (CAT II) treatment. Combination antiretroviral therapy (cART) was given to 48 (43.2%). No significant associations were found between treatment outcomes or mortality and gender, smoking, drug and alcohol abuse, imprisonment, method of transmission, history of CAT I and CAT II treatments, CD4 counts or adverse effects (P>0.05). Administration of cART led to significantly better outcomes (P<0.001). Lower serum albumin levels and low body weight were significantly associated with mortality."									
1145	Nutrition in pediatric HIV infection: setting the research agenda. Nutrition and immune function II: maternal factors influencing transmission.	Landers DV.	Journal of Nutrition. 1996;126(10 Suppl):2637S-40S.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=8861927	"The risk of mother-to-child transmission of HIV ranges from 15-35 percent depending on the population under study (Fowler and Rogers 1996, Peckham and Gibb 1995). The recent finding that zidovudine treatment during pregnancy can reduce the risk of mother-to-child transmission of HIV by as much as two-thirds in some populations (CDC 1994, Connor et al. 1994), raises the question of which maternal, fetal, viral, immunologic, and placental factors play the greatest role in vertical transmission. It is clear that not only does the transmission rate vary dramatically by geographical distribution, but both the prevalence of infection and susceptibility of the uninfected may be higher in parts of the developing world. The transmission rate is significantly higher in the developing world presumably due to numerous factors including coinfection with other STD's, very little economic support for prevention, education, health maintenance or improving nutritional contributions to curb the spread of HIV. Furthermore, the strategies to reduce vertical transmission in industrialized countries are often not feasible in the developing world. Providing widescale availability of antivirals may not be feasible in areas where, to date, vitamin deficiencies often still exist. The healthcare budget in many of these developing countries cannot even pay for basic medical or prenatal services. The future directions in reducing the rate of mother-to-infant transmission must focus on strategies applicable to the developing world as well as industrialized countries. The vast majority of HIV in the pediatric age group is the result of vertical transmission of the virus. A number of maternal immunologic factors have been associated with vertical transmission. This paper offers a brief review of the extant knowledge with regard to the role of maternal factors in vertical transmission of HIV infection. [References: 23]"									
455	"Maternal body composition, HIV infection and other predictors of gestation length and birth size in Zimbabwe."	"Friis H, Gomo E, Nyazema N, Ndhlovu P, Krarup H, Kaestel P, Michaelsen KF."	British Journal of Nutrition. 2004;92(5):833-40.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=15533273	"The role of maternal infections, nutritional status and obstetric history in low birth weight is not clear. Thus, the objective of the present study was to assess the effects of maternal HIV infection, nutritional status and obstetric history, and season of birth on gestation length and birth size. The study population was 1669 antenatal care attendees in Harare, Zimbabwe. A prospective cohort study was conducted as part of a randomised, controlled trial. Maternal anthropometry, age, gravidity, and HIV status and load were assessed in 22nd-35th weeks gestation. Outcomes were gestation length and birth size. Birth data were available from 1106 (66.3%) women, of which 360 (32.5%) had HIV infection. Mean gestation length was 39.1 weeks with 16.6% <37 weeks, mean birth weight was 3030 g with 10.5% <2500 g. Gestation length increased with age in primigravidae, but not multigravidae (interaction, P=0.005), and birth in the early dry season, low arm fat area, multiple pregnancies and maternal HIV load were negative predictors. Birth weight increased with maternal height, and birth in the late rainy and early dry season; primi-secundigravidity, low arm fat area, HIV load, multiple pregnancies and female sex were negative predictors. In conclusion, gestation length and birth weight decline with increasing maternal HIV load. In addition, season of birth, gravidity, maternal height and body fat mass, and infant sex are predictors of birth weight."									
1473	"Vitamin A, beta-carotene, and mother-to-child transmission of HIV."	Stephensen CB.	Nutrition Reviews. 2003;61(8):280-4.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=13677590	"The role of maternal vitamin A supplements in decreasing the risk of mother-to-child HIV transmission has been examined in sub-Saharan Africa. Overall, there is no reduction in either mortality or HIV transmission in two recent studies. Contrary to expectations, one study reported an increased risk of transmission using vitamin A plus beta-carotene supplements. [References: 13]"									
509	"Factors associated with the use of supplements among newborns in communal wards in Rio de Janeiro, 2009."	"Lopes FdO, Oliveira MICd, Brito AdS, Fonseca VM."	Ciencia & Saude Coletiva. 2013;18(2):431-9.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20133067425	"The scope of this study was to estimate the prevalence of the use of supplements among newborns and analyze the factors associated with their use. A cross-sectional study was conducted in 2009 with a representative sample of 687 mothers interviewed in 15 communal wards in hospitals of the Unified Health System in the city of Rio de Janeiro. Prevalence ratios (PR) of supplement use were obtained by Poisson Regression with robust variance, using a hierarchical model. The prevalence of supplement use was 49.8%. Factors associated with supplement use were: being submitted to the rapid HIV test (PR=1.37; CI95%:1.18-1.58); cesarean delivery (PR=1.57; CI95%:1.38-1.79); not being helped to breastfeed in the delivery room (PR=1.60; CI95%:1.29-1.99); mother-child separation (PR=1.24; CI95%:1.05-1.46); pacifier use (PR=1.31; CI95%:1.08-1.58); maternal or neonatal interventions (PR=1.56; CI95%:1.34-1.82); BFH certification (PR=0.52; CI95%:0.44-0.61); and not receiving help to breastfeed in the communal ward (PR=0.78; CI95%:0.66-0.92). Supplements to breast milk are being widely used. Hospital routines should be reviewed, so that exclusive breastfeeding becomes the norm."									
1155	"Women's voices, women's choices: The challenge of nutrition and HIV/AIDS."	"Piwoz EG, Bentley ME."	Journal of Nutrition. 2005 April;135(4):933-7.		"The Society for International Nutrition Research sponsored a Symposium titled ""Women's Voices, Women's Choices: The Challenge of Nutrition and HIV/AIDS in Asia and Africa"" at Experimental Biology 2004 to highlight the challenges facing HIV-positive women living in resource-poor settings of Asia and Africa, when it comes to the everyday decisions they are forced to make about their own health and nutrition, and the health and the nutrition of their children. This introductory paper summarizes the rationale for this session, including a summary of the evidence for women's increased vulnerability to HIV, the nutritional impacts of HIV infection, and the special infant feeding and nutritional concerns facing HIV-positive pregnant and lactating mothers in Africa and Asia. The issue of nutrition and HIV/AIDS is addressed here from an intergenerational perspective, using new data from qualitative research, clinical trials, and behavioral interventions in India, Malawi, South Africa, Tanzania, and Zimbabwe, to illustrate important concerns, using study participants' own words to convey key messages. The focus is on women, because they are shouldering much of the burden of HIV infection in terms of their numbers and in their responsibilities for providing food and care for orphans and HIV-affected family members. Infant feeding choices are also considered in this review, because of the vast implications that not breast-feeding at all and stopping breast-feeding early have on the nutritional well-being of HIV-exposed children, as well as the positive contribution of breast-feeding to child nutrition and survival worldwide. 2005 American Society for Nutritional Sciences."									
1499	"Socio-demographic and anthropometric variables of persons living with HIV and AIDS in Uyo, South Eastern Nigeria."	"Opara DC, Umoh IB, John M."	Pakistan Journal of Nutrition. 2007;6(6):547-57.		"The socio-demographic-and anthropometric characteristics of 290 (154 females and 136 males) Persons Living with HIV and AIDS (PLWHA) has been assessed. They were randomly selected from a total of 1280 infected persons who registered for anti retroviral therapy at the University of Uyo Teaching Hospital, Uyo, South Eastern Nigeria. The results revealed that the age group 31-43 years were the most affected, females (53.1%) were significantly (p<0.05) more affected than males (46.9%). The married and the tertiary educated persons were more affected than single and less educated persons. The low income earners were also more affected. The most common opportunistic infections were fever, loss of appetite and diarrhea. Most (98.2%) respondents recorded low CD<sub>4</sub> counts, it was lower in females (190.1+/-32.5) than males (205.7+/-47.2). This difference was statistically significant (p<0.05). The 24-hour dietary intake of nutrients (Vitamin C, Fat, protein and calories) was inadequate to meet the increased nutrient needs of PLWHA. Their anthropometric parameters did not reflect the clinical status of the respondents. Almost all male respondents (99.3%) and 96.8%) of females recorded normal MUAC values, while 92.6% of males and 91.3% of female respondents recorded normal BMI values. There was no statistically significant difference (p>0.05) in the BMI values of both males and females and MUAC values of females of the different age groups. The difference in MUAC values of males of the different age groups was statistically significant (p<0.05). It was concluded that anthropometric parameters alone were not a good index of the health Status of PLWHA. It is recommended that effective health education programmes be instituted in tertiary institutions. Voluntary counseling and testing and antiretroviral treatment centers should be readily available and easily accessible to facilitate prompt intervention. Food supplementation programmes should be urgently incorporated into the national effort to curb the impact of the HIV and AIDS pandemic. Asian Network for Scientific Information, 2007."									
1615	A pilot study assessing the impact of a fortified supplementary food on the health and well-being of creche children and adult TB patients in South Africa.	"Rudolph M, Kroll F, Beery M, Marinda E, Sobiecki JF, Douglas G, Orr G."	PLoS ONE [Electronic Resource]. 2013;8(1):e55544.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=23383220	"The South African population faces many of the global concerns relating to micronutrient deficiency and the impact this has on health and well-being. Moreover, there is a high prevalence of HIV infection, compounded by a high level of co-infection with TB.This pilot study evaluates the impact of a fortified supplementary food on the health and well-being of a cohort of creche children, aged 3 to 6, and adult TB patients drawn from the Presidential Node of Alexandra, Johannesburg, South Africa. A further aim of this study was to evaluate the sensitivity and validity of non-invasive indicators of nutritional status in a field-based population sample.The investigational product, e'Pap, is supported by extensive anecdotal evidence that whole grain cereals with food-style nutrients constitute an effective supplementary food for those suffering from the effects of food insecurity, poor health and well-being, and coping with TB and HIV infection.The results indicate a beneficial effect of e'Pap for both study populations, and particularly for adult TB patients, whose baseline data reflected severe food insecurity and malnutrition in the majority of cases. There is evidence to suggest statistically significant improvements in key micronutrient levels, well-being and energy, hand-grip strength, the Bioelectrical Impedance Analysis (BIA) Illness Marker, and certain clinical indicators. Although Body Mass Index (BMI) and Mid Upper Arm Circumference (MUAC) are frequently used as standard measures to evaluate the efficacy of nutritional interventions, these indicators were not sufficiently sensitive in this study. Nor does weight gain necessarily indicate improved nutritional status. Hand-grip strength, lean body mass, and the BIA Illness Marker seem to be more useful indicators of change in nutritional status."									
1466	Vitamin A deficiency and increased mortality among human immunodeficiency virus-infected adults in Uganda.	"Langi P, Semba RD, Mugerwa RD, Whalen CC."	Nutrition Research. 2003 01 May;23(5):595-605.		"The specific aims of the study were to determine the prevalence of vitamin A deficiency and to examine the relationship between vitamin A deficiency and mortality among human immunodeficiency virus (HIV)-infected adults in sub-Saharan Africa. A prospective cohort study was conducted at the outpatient clinic of Mulago Hospital, Kampala, Uganda, among HIV-infected adults enrolled in the placebo arms of a randomized clinical trial to prevent Mycobacterium tuberculosis infection. Of 519 subjects at enrollment, 186 (36%) had serum vitamin A concentrations consistent with deficiency (<1.05 mumol/L). During follow-up (median 17 months), the mortality among subjects with and without vitamin A deficiency at enrollment was 30% and 17%, respectively (P = 0.01). In a multivariate model adjusting for CD4<sup>+</sup> lymphocyte count, age, sex, anergy status, body mass index, and diarrhea, vitamin A deficiency was associated with a significantly elevated risk of death [relative risk (RR) = 1.78, 95% confidence interval (CI) 1.2-2.6]. Vitamin A deficiency is common among HIV-infected adults in this sub-Saharan population and is associated with higher mortality. 2003 Elsevier Inc. All rights reserved."									
1839	Spectrum of HIV-related disease in rural South Africa.	"Wilkinson D, Habgood LC."	Southern African Journal of Epidemiology & Infection. 1997;12(2):45-8.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh2&AN=19982002127	"The spectrum of HIV-related disease diagnosed in a rural district hospital in South Africa is described. A cross-sectional study in Hlabisa Hospital, KwaZulu-Natal, South Africa was undertaken. All 290 patients who tested HIV positive between 1989 and 1992 and a random sample of 210 who tested HIV positive in 1993 were studied. The main outcome measures were number of patients HIV positive per year, age, sex, World Health Organization clinical staging, primary diagnosis, AIDS and type of tuberculosis. The number of patients testing HIV positive increased from six in 1989 to 451 in 1993; the sex ratio was one male to 1.4 females and the highest prevalence of infection was in the 20-29-year age group. Seventy-six (15%) of the cases were aged less than 13 years. Most adults (275; 65%) presented with intermediate (stage 3) or advanced (stage 4) disease, and 160 (38%) had AIDS at their initial presentation. Most of the patients with AIDS had tuberculosis (110; 69%) or HIV wasting syndrome (43; 27%). Sixty-three (15%) adults died during their initial admission compared with 34 of the 76 (45%) children (p<0.0001). A broad spectrum of HIV-related disease was diagnosed in this rural hospital. Most patients presented with disease of intermediate or advanced severity, but more than a quarter were asymptomatic or only mildy ill. Tuberculosis dominated the clinical presentation. The added burden of HIV-related disease is increasing substantially the workload in this hospital. A more detailed study is needed of the spectrum of HIV-related disease, its natural history, and its impact on the health system, in order to plan for coping strategies."									
1403	"Multi-micronutrient supplementation in HIV-infected South African children: effect on nutritional status, diarrhoea and respiratory infections."	Mda S.	"Multi micronutrient supplementation in HIV infected South African children: effect on nutritional status, diarrhoea and respiratory infections. 2011;168."	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20113188135	"The studies in this thesis had two main objectives (1) to evaluate the effect of short-term (during hospitalization) and long-term (6 months) multi-micronutrient supplementation on episodes of diarrhoea and respiratory infections in HIV-infected children who are not yet on antiretroviral therapy (ART), and (2) to assess the effects of long-term multi-micronutrient supplementation on appetite and growth performance of HIV-infected who are not on ART. Four studies were conducted. Long-term multi -micronutrient supplementation improved the weight-for-age and weight-for-height Z-scores of HIV-infected children aged 4-24 months by 0.4 over the 6-month period. There was no improvement in stunting. It is concluded that multi-micronutrient supplementation reduces the duration of diarrhoea and of pneumonia and incidence of diarrhoea and of respiratory symptoms in HIV-infected children who are not yet on ART. Multi-micronutrient supplementation also improves appetite and weight in these children but not height. The results of these studies indicate that multi-micronutrient supplementation should be considered in IIIV-infected infant and young children who have not commenced ART."									
739	"Nutrition knowledge, diet quality and nutritional status of people living with HIV (PLHIV) in Ghana."	"Nti CA, Hayford J, Opare-Obisaw C."	Food and Public Health. 2012;2(6):219-27.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20133180974	"The study aimed at investigating the influence of nutrition knowledge and dietary practices on the nutritional status of people living with HIV (PLHIV). In a cross-sectional survey, one hundred and ten adults, comprising 60 females and 50 males infected with HIV were purposively selected and studied using a combination of methods. The study was conducted at the Koforidua Central Hospital in Ghana. The instruments used for data collection included a standardized questionnaire close and open-ended questions, a Food Frequency Questionnaire and a 24-hour-recall dietary assessment method. Weights and heights measurements were used to derive BMIs to assess the nutritional status of the respondents. The Statistical Package for Social Sciences (version 11) and ESHA-FPRO software (version 6.2) were used to analyze the data. The results showed that most of the respondents (91%) had fair to adequate knowledge of nutrition. Ninety-five percent (95%) of the respondents ate three or more times a day and most (85%) of them were not on any special diet. The diet quality of most (91.8%) respondents was rated fair to poor, with 50% having poor diets. The diets of the respondents were generally low in calories and folate. Two-thirds of the respondents had normal BMIs. A negative correlation, although not statistically significant, existed between nutrition knowledge and diet quality. There was also a positive correlation between nutrition knowledge and nutritional status. A significant negative correlation was observed between the quality of diets of respondents and their nutritional status. Based on the findings, it was concluded that nutrition knowledge did not influence the quality of respondents' diets to a large extent but diet quality determined nutritional status."									
1233	A comparison of sonographic assessments and clinical questionnaire in the diagnosis of HIV-associated lipodystrophy.	"Signorini DJHP, Netto AMSdO, Gabbay S, Monteiro MCM, Signorini DH, Andrade MdFCd, Bastos FI, et al."	Journal of the International Association of Physicians in AIDS Care. 2011;10(6):351-6.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20123014472	"The study evaluated the use of sonographic measurements as an alternative to assessments based on clinical or other imaging techniques for the diagnosis of body-fat abnormalities. The study enrolled 179 HIV-infected patients, 81 (45.3%) of them diagnosed as lipodystrophy (LD)-positive based on a clinical standard questionnaire. Association between clinical LD and sonographic measurements of face, right upper limb, subcutaneous abdomen, and visceral compartments was evaluated by multiple logistic regression. The predicted probability of the logistic model was 0.64, corresponding to a maximum sensitivity of 69.1% (58%-79%), a specificity of 94.9% (88%-98%), and to positive and negative predictive values of 92% (82%-97%) and 79% (70%-86%), respectively. Kappa measure of concordance was 65% (54%-77%). Low sensitivity poses a problem for the use of sonography to detect LD in the clinical routine as a single exam, speaking in favor of the combined use of clinical and sonographic measurements over time."									
1377	Aspects of nutritional assessment in AIDS.	"Ngangoue N, Parra HJ, Itouga-Ngaporo A."	Medecine d'Afrique Noire. 1995;42(1):5-7.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh2&AN=19951413192	"The study involved 200 men and women (23 to 54 years old) with acquired immune deficiency syndrome (AIDS) and hospitalised at Brazzaville University Hospital Center, Congo. Anthropometric parameters, proteins and lipids (body mass index, albumin, transferrin, retinol-binding protein, transthyretin, apolipoprotein A1, apolipoprotein B, total cholesterol, HDL-cholesterol, LDL-cholesterol, phospholipids, triacylglycerols) were assessed. Data were compared with those of 70 blood donors. The results showed a decrease of all parameters in AIDS, except for serum triacylglycerols and apolipoprotein B. Increasing triacylglycerols and apolipoprotein B may be linked to immune system activity."									
346	Nutritional status and food security in Sub-Saharan Africa: predictions for 2020.	"Steyn NP, Walker ARP."	Asia Pacific Journal of Clinical Nutrition. 2000;9(1):1-6.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh3&AN=20001412695	"The subject of the future regarding nutritional status and food security, and of their ramifications in terms of nutrition-related disorders/diseases in Sub-Saharan African (SSA) populations, is a complex one. As well as social unrest, a country's socioeconomic situation may affect food availability and, crucially, influence the generally low proportions of the Gross National Product devoted to health services. Additional determinants include changes in the roles of non-dietary adverse factors (i.e. smoking practice, alcohol consumption, physical inactivity) and of infections (i.e. gastroenteritis, malaria, tuberculosis and, particularly, HIV). As to future health in 2020, major increases in socioeconomic status are very unlikely; in fact, there has been a deterioration in some countries with food shortages affecting nutrition status and food security. However, with some measures of prosperity there are likely to be decreases in family size and falls in the proportions of children born with low birthweights or with protein-energy-malnutrition (PEM), and of children lying under the 5th percentile of growth reference standards. Simultaneously, though, there will be variable rises, especially in urban dwellers, in the occurrence of hypertension, diabetes, cardiovascular disease and certain cancers. Improvements in the health status of both children and adults are likely to be strongly affected by whether HIV infection can be controlled or whether it becomes rampant."									
1939	Vertically acquired paediatric HIV infection: The challenges of providing comprehensive packages of care in resource-limited settings.	"Little KE, Bland RM, Newell ML."	Tropical Medicine and International Health. 2008 September;13(9):1098-110.		"The successes achieved in paediatric disease management in well-resourced countries in recent years highlight the vast divide between the care options, and ultimately survival, between developed and developing areas of the world. Using an extensive literature review, we quantify recent achievements in terms of improved survival and quality of life, and examine current evidence of the effects of treatment on the survival and morbidity of HIV-infected children in developing countries. When provided with the same care as their counterparts in developed countries, children in developing countries show similar improvements in survival and general health, with 1-year survival rates exceeding 90% in many African settings. Despite the challenges of providing comprehensive packages of care in resource-limited settings, there is an urgent need to scale up prevention and treatment of HIV infections in children, focussing on strengthening Prevention of Mother-to-Child Transmission programmes in order to reduce the numbers of infants who are infected in addition to reducing morbidity and mortality among their mothers. 2008 Blackwell Publishing Ltd."									
1638	Nutritional imbalances and infections affect the thymus: consequences on T-cell-mediated immune responses.	"Savino W, Dardenne M."	Proceedings of the Nutrition Society. 2010;69(4):636-43.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20103366088	"The thymus gland, where T lymphocyte development occurs, is targeted in malnutrition secondary to protein energy deficiency. There is a severe thymic atrophy, resulting from massive thymocyte apoptosis (particularly affecting the immature CD4<sup>+</sup>CD8<sup>+</sup> cell subset) and decrease in cell proliferation. The thymic microenvironment (the non-lymphoid compartment that drives intrathymic T-cell development) is also affected in malnutrition: morphological changes in thymic epithelial cells were found, together with a decrease of thymic hormone production, as well as an increase of intrathymic contents of extracellular proteins. Profound changes in the thymus can also be seen in deficiencies of vitamins and trace elements. Taking Zn deficiency as an example, there is a substantial thymic atrophy. Importantly, marginal Zn deficiency in AIDS subjects, children with diarrhoea and elderly persons, significantly impairs the host's immunity, resulting in an increased risk of opportunistic infections and mortality; effects that are reversed by Zn supplementation. Thymic changes also occur in acute infectious diseases, including a severe thymic atrophy, mainly due to the depletion of CD4<sup>+</sup>CD8<sup>+</sup> thymocytes, decrease in thymocyte proliferation, in parallel to densification of the epithelial network and increase in the extracellular matrix contents, with consequent disturbances in thymocyte migration and export. In conclusion, the thymus is targeted in several conditions of malnutrition as well as in acute infections. These changes are related to the impaired peripheral immune response seen in malnourished and infected individuals. Thus, strategies inducing thymus replenishment should be considered as adjuvant therapeutics to improve immunity in malnutrition and/or acute infectious diseases."									
1634	Nutrition and immune function in human immunodeficiency virus infection.	Macallan DC.	Proceedings of the Nutrition Society. 1999;58(3):743-8.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=10604211	"The triad of human immunodeficiency virus (HIV) infection, nutritional status and immune function are intimately related, each factor having effects on the others. The dominant effect in this three-way relationship is the effect of HIV infection on nutritional status, an effect which, until the advent of potent anti-retroviral drugs, has been manifest primarily as wasting. Recently, more complex metabolic abnormalities have become apparent, particularly fat redistribution syndromes, hyperlipidaemia and hypercholesterolaemia. For the converse effect, the effect of nutritional state on HIV disease progression, there is good evidence that clinical outcome is poorer in individuals with compromised nutrition. However, the beneficial effects of nutritional support have been more difficult to demonstrate. For macronutrients, effective macronutrient supply improves survival in severely-malnourished individuals and may have beneficial effects in less-severely-affected individuals. Micronutrient deficiencies appear to be involved in modifying clinical HIV disease and may also be associated with enhanced mother-to-child transmission of virus, particularly in developing countries. Intervention trials in this setting are currently under way. In conclusion, the interaction of HIV infection and nutrition is of great importance not just because of the major impact that HIV infection has on nutritional state, but also because strategies to improve nutritional status, both quantitatively and qualitatively, may have a beneficial effect on the clinical and immunological course of the disease. [References: 38]"									
192	Nutritional aspects of HIV-associated wasting in sub-Saharan Africa.	"Koethe JR, Heimburger DC."	American Journal of Clinical Nutrition. 2010;91(4):1138S-42S.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=20147470	"The twin global epidemics of HIV infection and food scarcity disproportionately affect sub-Saharan Africa, and a significant proportion of patients who require antiretroviral therapy (ART) are malnourished because of a combination of HIV-associated wasting and inadequate nutrient intake. Protein-calorie malnutrition, the most common form of adult malnutrition in the region, is associated with significant morbidity and compounds the immunosuppressive effects of HIV. A low body mass index (BMI), a sign of advanced malnutrition, is an independent predictor of early mortality (<6 mo) after ART initiation in several analyses, and recent studies show an association between early weight gain when receiving ART and improved treatment outcomes. The cause of the observed increase in mortality is uncertain, but it is likely due in part to malnutrition-induced immune system dysfunction, a higher burden of opportunistic infections, and metabolic derangements. In this article, we describe the epidemiology of HIV infection and malnutrition in sub-Saharan Africa, potential causes of increased mortality after ART initiation among patients with a low BMI, recent studies on post-ART weight gain and treatment outcome, and trials of macronutrient supplementation from the region. We close by highlighting priority areas for future research."									
1194	Evidence for extended age dependent maternal immunity in infected children: Mother to child transmission of HIV infection and potential interventions including sulfatides of the human fetal Adnexa and complementary or alternative medicines.	"Bhargav H, Huilgol V, Metri K, Sundell IB, Tripathi S, Ramagouda N, Jadhav M, et al."	Journal of Stem Cells. 2012;7(3):127-53.		"The two neighboring southwestern states of India, Karnataka and Maharashtra, have high incidence of HIV/AIDS and are among the six most high prevalence HIV infected states. In Karnataka state, the northern districts of Bagalkot, Belgaum and Bijapur (the three Bs) and in Maharashtra state, the southern districts of Sangli, Satara, and Solapur (the three Ss) are the areas with the highest incidence of HIV/AIDS. We have evaluated the incidence of maternal to child transmission (MTCT) of HIV-1 infection in Belgaum District which is more than 500 kilometers distance by road from the campus in greater Bangalore (Karnataka State). We have obtained the prenatal CD4 counts of HIV infected pregnant mothers. We have also screened the HIV infected children in two orphanages (rehabilitation centres for HIV infected children) in Belgaum District. The clinical conditions of these infected children were assessed for their CD4 counts, anti-retroviral therapy (ART) intake status, outpatient illnesses and body composition. We have observed that there is an influence of the age factor on the CD4 counts of the HIV infected children. Further, in view of the role of our recently found involvement of sulfatide, 3-O- galactosylceramide, in inhibition of HIV-1 replication and enhancement of hematopoiesis which is otherwise inhibited due to such infection, we have discussed the possible role of sulfatides that biologically occur in the fetal adnexa (placenta-trophoblasts /amnion/chorion-umbilical cord), in containing HIV infection as a potential safer alternative to the ART regimens currently approved to be clinically practiced. Lastly, we have discussed the complementary and alternative medicine (CAM) therapies such as evidence based yoga and ayurveda as add-on to ART in potential elimination of MTCT of HIV infection. Out of a total of 150 children delivered by HIV infected mothers, 13 children were found to be positive as determined by the dried blood smear (DBS) for virological testing, giving an incidence of about 8.66% in the Belgaum district during the last two years, in spite of the prescription of currently available ART regimens. All the 13 HIV-transmitting mothers had normal vaginal deliveries. Though 12% of the total 150 deliveries required lower segment caesarean section (LSCS), none among them resulted in MTCT of HIV. Comparison of the prenatal CD4 counts between transmitting and non-transmitting mothers did not show significant differences (p=0.25) thus suggesting indirectly that HIV-1 proviral loads (undetermined/unavailable) need not necessarily determine the fate of incidence of vertical transmission. The mean age of 44 HIV infected children (14 females, 30 males) that were screened in two orphanages was 10.8+/-3.1 years. Out of these 44 children, 27 were taking ART (61.36%) with mean duration of consumption being 2.8+/-2.28 years. Fifty percent (n=22) of the children were suffering from at least one outpatient illness, out of which 13 were taking ART. Their mean basal metabolic rate (BMR), body mass index (BMI), muscle mass, fat mass and fat % were 795.45+/-106.9, 14.55+/-1.9 kg/m<sup>2</sup>, 9.54+/-3.4 kg, 3.69+/-2.24 kg and 15.04+/-7.8% respectively. Comparison between the children taking ART (on-ART, n=27) and those not taking ART (non-ART, n= 17) showed that though there was no significant difference in the average age of the two groups, on-ART children had significantly higher BMR (p=0.05), and muscle mass (p=0.004), than non-ART. The CD4 counts, BMI, fat mass and fat percentage did not show significant statistical differences between the two groups. The CD4 counts of the children (both on-ART and non-ART) of age 8 years and below (n=12) were found to be significantly higher (p=0.04) than those of age 14 and above (n=10). All the children in age group of 14 years and above (n=10) except one child were on ART, whereas 7 out of 12 children in age group of 8 years and below were on-ART. In one of the rehabilitation centers called Aadhar, among non-ART children, a significant correlation was observed between the age of th"									
1355	Accelerating improvements in nutritional and health status of young children in the Sahel region of Sub-Saharan Africa: review of international guidelines on infant and young child feeding and nutrition.	"Wuehler SE, Hess SY, Brown KH."	Maternal & Child Nutrition. 2011;7 Suppl 1:6-34.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=21410888	"The United Nations Convention on the Rights of the Child holds governments responsible to ensure children's right to the highest attainable standard of health by providing breastfeeding support, and access to nutritious foods, appropriate health care, and clean drinking water. International experts have identified key child care practices and programmatic activities that are proven to be effective at reducing infant and young child undernutrition, morbidity, and mortality. Nevertheless, progress towards reducing the prevalence of undernutrition has been sporadic across countries of the Sahel sub-region of Sub-Saharan Africa. In view of this uneven progress, a working group of international agencies was convened to 'Reposition children's right to adequate nutrition in the Sahel.' The first step towards this goal was to organize a situational analysis of the legislative, research, and programmatic activities related to infant and young child nutrition (IYCN) in six countries of the sub-region: Burkina Faso, Chad, Mali, Mauritania, Niger, and Senegal. The purposes of this introductory paper are to review current information concerning the nutritional and health status of infants and young children in the Sahel and to summarize international guidelines on optimal IYCN practices. These guidelines were used in completing the above-mentioned situational analyses and encompass specific recommendations on: (i) breastfeeding (introduction within the first hour after birth, exclusivity to 6 months, continuation to at least 24 months); (ii) complementary feeding (introduction at 6 months, use of nutrient dense foods, adequate frequency and consistency, and responsive feeding); (iii) prevention and/or treatment of micronutrient deficiencies (vitamin A, zinc, iron and anaemia, and iodine); (iv) prevention and/or treatment of acute malnutrition; (v) feeding practices adapted to the maternal situation to reduce mother-to-child transmission of HIV; (vi) activities to ensure food security; and (vii) the promotion of hygienic practices concerning food preparation and storage and environmental sanitation. The following papers in this issue will present results of the situational analyses for the individual countries. 2011 Blackwell Publishing Ltd."									
1370	Accelerating improvements in nutritional and health status of young children in the Sahel region of Sub-Saharan Africa: review of international guidelines on infant and young child feeding and nutrition. (Special Issue: Repositioning children's right to adequate nutrition in the Sahel - situational analysis.).	"Wuehler SE, Hess SY, Brown KH."	Maternal and Child Nutrition. 2011;7(s1):6-34.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20113110904	"The United Nations Convention on the Rights of the Child holds governments responsible to ensure children's right to the highest attainable standard of health by providing breastfeeding support, and access to nutritious foods, appropriate health care, and clean drinking water. International experts have identified key child care practices and programmatic activities that are proven to be effective at reducing infant and young child undernutrition, morbidity, and mortality. Nevertheless, progress towards reducing the prevalence of undernutrition has been sporadic across countries of the Sahel sub-region of Sub-Saharan Africa. In view of this uneven progress, a working group of international agencies was convened to 'Reposition children's right to adequate nutrition in the Sahel.' The first step towards this goal was to organize a situational analysis of the legislative, research, and programmatic activities related to infant and young child nutrition (IYCN) in six countries of the sub-region: Burkina Faso, Chad, Mali, Mauritania, Niger, and Senegal. The purposes of this introductory paper are to review current information concerning the nutritional and health status of infants and young children in the Sahel and to summarize international guidelines on optimal IYCN practices. These guidelines were used in completing the above-mentioned situational analyses and encompass specific recommendations on: (i) breastfeeding (introduction within the first hour after birth, exclusivity to 6 months, continuation to at least 24 months); (ii) complementary feeding (introduction at 6 months, use of nutrient dense foods, adequate frequency and consistency, and responsive feeding); (iii) prevention and/or treatment of micronutrient deficiencies (vitamin A, zinc, iron and anaemia, and iodine); (iv) prevention and/or treatment of acute malnutrition; (v) feeding practices adapted to the maternal situation to reduce mother-to-child transmission of HIV; (vi) activities to ensure food security; and (vii) the promotion of hygienic practices concerning food preparation and storage and environmental sanitation. The following papers in this issue will present results of the situational analyses for the individual countries."									
127	Barriers and outcomes: TB patients co-infected with HIV accessing antiretroviral therapy in rural Zambia.	"Chileshe M, Bond VA."	AIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV. 2010;22(SUPPL. 1):51-9.		"The vulnerabilities that underlie barriers faced by the rural poor whilst trying to access and adhere to free antiretroviral treatment (ART) demand more attention. This paper highlights barriers that poor rural Zambians co-infected with tuberculosis (TB) and HIV and their households faced in accessing ART between September 2006 and July 2007, and accounts for patient outcomes by the end of TB treatment and (more sporadically) beyond October 2009. The analysis draws on findings from wider anthropological fieldwork on the converging impact of TB, HIV and food insecurity, focusing for the purpose of this paper on ethnographic case-studies of seven newly diagnosed TB patients co-infected with HIV and their six households (one household had two TB patients). Economic barriers included being pushed into deeper poverty by managing TB, rural location, absence of any external assistance, and mustering time and extended funds for transport and special food during and beyond the end of TB. In the case of death, funeral costs were astronomical. Social barriers included translocation, broken marriages, a sub-ordinate household position, gender relations, denial, TB/HIV stigma and the difficulty of disclosure. Health facility barriers involved understaffing, many steps, lengthy procedures and inefficiencies (lost blood samples, electricity cuts). By the end of TB treatment, outcomes were mixed; two co-infected patients had died, three had started ART and two had yet to start ART. The three on ART underwent a striking transformation in the short term. By October 2009, two more had died and three were doing well. The study advocates nutritional support and other material support (especially transport funds) for co-infected TB patients until ART is accessed and livelihood regained. More prompt diagnosis of TB and reducing steps and increasing the reach of the ART programme in rural areas are also recommended. 2010 Taylor & Francis."									
1772	The impact of HIV and/or AIDS on rural food security.	Topouzis D.	SCN News. 1998;17:20-2.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh2&AN=19991804018	"The way in which HIV/AIDS related mortality affects household food security in developing countries is documented and the scenarios that may follow are listed. Issues that need to be addressed when tackling the problem of HIV/AIDS and food security are discussed. A need is identified for: research, dissemination and promotion of labour saving technologies and improved farming practices for farmers; promotion of drought/disease resistant crop varieties; adjustment of post harvest protection measures; and information, education and communication campaigns on nutrition, diet and health. Other key issues to be addressed when assessing the impact of HIV/AIDS on rural households and their coping mechanisms are listed."									
695	Increased prevalence of high body mass index (BMI) among persons with HIV initiating antiretroviral therapy (ART) in South Africa.	"Dieterich ME, Witten C, Chopra M, Humphries D."	FASEB Journal. 2010 April;24.		"The Western Cape Provincial Department of Health provides nutritional support to underweight (BMI<18.5) HIV patients on ART. Initial evaluation suggested that patients starting ART are more often overweight than underweight. ART may worsen obesity related health conditions, such as heart disease. In turn, obesity may increase side-effects of ART. Objective: To determine the BMI distribution of patients presenting for ART, and weight change with 3 months of ART, in Mitchells Plain Community Health Center. Method: A retrospective medical record review of HIV patients ages 18-65 initiating ART between August 1-Oct 31, 2008 (n=117, 63% female, 37% male). Results: Prevalence of underweight (BMI<18.5) was 12.0%, while 32.5% were overweight (BMI>25). The prevalence of overweight was significantly higher among females than males (42% vs. 16%, p=0.016). Three-months after initiation of ART, 62% had weight gain with a mean gain of 5.37 kg. Significantly more men gained weight than women (87% vs. 48%, p=0.003). Prevalence of overweight increased to 45% after 3 months of ART with a significant increase in mean BMI from 23.2 to 24.1 (p<0.01). Prevalence of underweight decreased to 2.4%. Of patients with BMI >25, 44.2% were on an ART regime contraindicated with high BMI. Conclusion: In peri-urban African settings overweight/obesity may be an emerging issue for HIV patients on ART."									
1264	"Evaluation of the WHO clinical case definition for pediatric HIV infection in Bloemfontein, South Africa."	"van Gend CL, Haadsma ML, Sauer PJ, Schoeman CJ."	Journal of Tropical Pediatrics. 2003;49(3):143-7.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=12848202	"The WHO clinical case definition for pediatric HIV infection has been designed to be used in countries where diagnostic laboratory resources are limited. We evaluated the WHO case definition to determine whether it is a useful instrument to discriminate between HIV-positive and HIV-negative children. In addition, clinical features not included in this case definition were recorded. We recorded clinical data from 300 consecutively admitted children in a state hospital in Bloemfontein, South Africa, and tested these children for HIV infection. A total of 222 children were included in the study; 69 children (31.1 per cent) were HIV positive. The sensitivity of the WHO case definition in this study was 14.5 per cent, the specificity was 98.6 per cent. Apart from weight loss and generalized dermatitis, the signs of the WHO case definition were significantly more often seen in HIV-positive than in HIV-negative children. Of the clinical signs not included in the WHO case definition, marasmus and hepatosplenomegaly especially occurred more frequently in HIV-positive children. Based on these findings we composed a new case definition consisting of four signs: marasmus, hepatosplenomegaly, oropharyngeal candidiasis, and generalized lymphadenopathy. HIV infection is suspected in a child presenting with at least two of these four signs. The sensitivity of this case definition was 63.2 per cent, the specificity was 96.0 per cent. We conclude that in this study the WHO case definition was not a useful instrument to discriminate between HIV-positive and HIV-negative children, mainly because its sensitivity was strikingly low. The simplified case definition we propose, proved to be more sensitive than the WHO case definition (63.2 vs. 14.5 per cent), whilst its specificity remained high."									
1971	HIV serostatus and recovery from severe childhood malnutrition. A retrospective matched case-control study.	"Barker D, Younger N, MooSang M, McKenzie CA."	West Indian Medical Journal. 2004;53(2):89-94.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=15199718	"The world-wide epidemic of Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS) has led to an increase in the number of HIV positive children, mainly through perinatal transmission. HIV/AIDS can lead to severe childhood malnutrition (SCM) and has been noted as an increasingly common cause of secondary SCM. In this context, it is important to make assessments of the appropriateness of current approaches to treatment of severe malnutrition in HIV positive children. A retrospective matched case-control study of ten HIV positive children admitted to the Tropical Metabolism Research Unit (TMRU) was conducted. There were few differences between cases and matched controls on admission to the ward. Oral candidiasis and lower respiratory tract infections appeared to occur more frequently, and serum globulin concentrations were significantly higher among HIV positive cases when compared to their controls. Despite the fact that the differences between cases and controls appeared to be small, four cases died; there were no deaths among the controls. The duration of the maintenance phase was approximately five days longer (p = 0.024) among cases than controls but the time between the end of the maintenance phase and discharge from the ward was not significantly longer for the cases. The results of this matched case-control study suggest that there are likely to be important differences between HIV positive and negative patients with SCM that influence risk of mortality and morbidity, particularly in the maintenance phase of treatment. Prospective studies will be required in order to explore these differences and to develop better approaches to the care of HIV positive children with SCM."									
493	Critical care in South Africa after major injury.	"Schleicher GK, Bowley DM, Degiannis E, Boffard KD."	Care of the Critically Ill. 2003 August;19(4):112-8.		"The worldwide burden of trauma is increasing, but is unequal between nations. Trauma targets the yound and productive in society and imposes a major burden on the health infrastructure. Appropriate critical care after major injury is fundamental to survival; this review outlines the critical care priorities after major trauma in a resource-constrained environment dealing with high volumes of trauma in an emerging nation."									
1350	The health of HIV-exposed children after early weaning.	"Parker ME, Tembo M, Adair L, Chasela C, Piwoz EG, Jamieson DJ, Ellington S, et al."	Maternal & Child Nutrition. 2013;9(2):217-32.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=22099216	"There are potential health risks associated with the use of early weaning to prevent mother-to-child transmission of human immunodeficiency virus (HIV) in resource-poor settings. Our objective was to examine growth and nutrient inadequacies among a cohort of children weaned early. Children participating in the Breastfeeding Antiretrovirals and Nutrition (BAN) Study in Lilongwe, Malawi, had HIV-infected mothers, were weaned at 6 months and fed LNS until 12 months. 40 HIV-negative, BAN-exited children were compared with 40 HIV-negative, community children matched on age, gender and local health clinic. Nutrient intake was calculated from 24-h dietary recalls collected from BAN-exited children. Anthropometric measurements were collected from BAN-exited and matched community children at 15-16 months, and 2 months later. Longitudinal random effects sex-stratified models were used to evaluate anthropometric differences between the two groups. BAN-exited children consumed adequate energy, protein and carbohydrates but inadequate amounts of fat. The prevalence of inadequate micronutrient intakes were: 46% for vitamin A; 20% for vitamin B6; 69% for folate; 13% for vitamin C; 19% for iron; 23% for zinc. Regarding growth, BAN-exited girls gained weight at a significantly lower rate "	"0.02gkg(-1) per day [95% confidence interval (CI): 0.01, 0.03]} than their matched comparison [0.05gkg(-1) per day (95% CI: 0.03, 0.07)]; BAN girls grew significantly slower [0.73cm month(-1) (95% CI: 0.40,1.06)] than their matched comparison (1.55cm month(-1) [95% CI: 0.98, 2.12]). Among this sample of BAN-exited children, early weaning was associated with dietary deficiencies and girls experienced reduced growth velocity. In resource-poor settings, HIV prevention programmes must ensure that breastfeeding stop only once a nutritionally adequate and safe diet without breast milk can be provided. 2011 Blackwell Publishing Ltd."								
1365	The health of HIV-exposed children after early weaning.	"Parker ME, Tembo M, Adair L, Chasela C, Piwoz EG, Jamieson DJ, Ellington S, et al."	Maternal and Child Nutrition. 2013 April;9(2):217-32.		"There are potential health risks associated with the use of early weaning to prevent mother-to-child transmission of human immunodeficiency virus (HIV) in resource-poor settings. Our objective was to examine growth and nutrient inadequacies among a cohort of children weaned early. Children participating in the Breastfeeding Antiretrovirals and Nutrition (BAN) Study in Lilongwe, Malawi, had HIV-infected mothers, were weaned at 6 months and fed LNS until 12 months. 40 HIV-negative, BAN-exited children were compared with 40 HIV-negative, community children matched on age, gender and local health clinic. Nutrient intake was calculated from 24-h dietary recalls collected from BAN-exited children. Anthropometric measurements were collected from BAN-exited and matched community children at 15-16 months, and 2 months later. Longitudinal random effects sex-stratified models were used to evaluate anthropometric differences between the two groups. BAN-exited children consumed adequate energy, protein and carbohydrates but inadequate amounts of fat. The prevalence of inadequate micronutrient intakes were: 46% for vitamin A; 20% for vitamin B6; 69% for folate; 13% for vitamin C; 19% for iron; 23% for zinc. Regarding growth, BAN-exited girls gained weight at a significantly lower rate "									
1364	The health of HIV-exposed children after early weaning.	"Parker ME, Tembo M, Adair L, Chasela C, Piwoz EG, Jamieson DJ, Ellington S, et al."	Maternal and Child Nutrition. 2013;9(2):217-32.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20133119184	"There are potential health risks associated with the use of early weaning to prevent mother-to-child transmission of human immunodeficiency virus (HIV) in resource-poor settings. Our objective was to examine growth and nutrient inadequacies among a cohort of children weaned early. Children participating in the Breastfeeding Antiretrovirals and Nutrition (BAN) Study in Lilongwe, Malawi, had HIV-infected mothers, were weaned at 6 months and fed LNS until 12 months. 40 HIV-negative, BAN-exited children were compared with 40 HIV-negative, community children matched on age, gender and local health clinic. Nutrient intake was calculated from 24-h dietary recalls collected from BAN-exited children. Anthropometric measurements were collected from BAN-exited and matched community children at 15-16 months, and 2 months later. Longitudinal random effects sex-stratified models were used to evaluate anthropometric differences between the two groups. BAN-exited children consumed adequate energy, protein and carbohydrates but inadequate amounts of fat. The prevalence of inadequate micronutrient intakes were: 46% for vitamin A; 20% for vitamin B6; 69% for folate; 13% for vitamin C; 19% for iron; 23% for zinc. Regarding growth, BAN-exited girls gained weight at a significantly lower rate "	"0.02 g kg<sup>-1</sup> per day [95% confidence interval (CI): 0.01, 0.03]} than their matched comparison [0.05 g kg<sup>-1</sup> per day (95% CI: 0.03, 0.07)]; BAN girls grew significantly slower [0.73 cm month<sup>-1</sup> (95% CI: 0.40,1.06)] than their matched comparison (1.55 cm month<sup>-1</sup> [95% CI: 0.98, 2.12]). Among this sample of BAN-exited children, early weaning was associated with dietary deficiencies and girls experienced reduced growth velocity. In resource-poor settings, HIV prevention programmes must ensure that breastfeeding stop only once a nutritionally adequate and safe diet without breast milk can be provided."								
619	[Arabian food pyramid: unified framework for nutritional health messages].	Shokr AM.	Eastern Mediterranean Health Journal. 2008;14(6):1413-24.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=19161117	"There are several ways to present nutritional health messages, particularly pyramidic indices, but they have many deficiencies such as lack of agreement on a unified or clear methodology for food grouping and ignoring nutritional group inter-relation and integration. This causes confusion for health educators and target individuals. This paper presents an Arabian food pyramid that aims to unify the bases of nutritional health messages, bringing together the function, contents, source and nutritional group servings and indicating the inter-relation and integration of nutritional groups. This provides comprehensive, integrated, simple and flexible health messages."									
770	Successful contracting of prevention services: fighting malnutrition in Senegal and Madagascar.	"Marek T, Diallo I, Ndiaye B, Rakotosalama J."	Health Policy & Planning. 1999;14(4):382-9.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=10787654	"There are very few documented large-scale successes in nutrition in Africa, and virtually no consideration of contracting for preventive services. This paper describes two successful large-scale community nutrition projects in Africa as examples of what can be done in prevention using the contracting approach in rural as well as urban areas. The two case-studies are the Secaline project in Madagascar, and the Community Nutrition Project in Senegal. The article explains what is meant by 'success' in the context of these two projects, how these results were achieved, and how certain bottlenecks were avoided. Both projects are very similar in the type of service they provide, and in combining private administration with public finance. The article illustrates that contracting out is a feasible option to be seriously considered for organizing certain prevention programmes on a large scale. There are strong indications from these projects of success in terms of reducing malnutrition, replicability and scale, and community involvement. When choosing that option, a government can tap available private local human resources through contracting out, rather than delivering those services by the public sector. However, as was done in both projects studied, consideration needs to be given to using a contract management unit for execution and monitoring, which costs 13-17% of the total project's budget. Rigorous assessments of the cost-effectiveness of contracted services are not available, but improved health outcomes, targeting of the poor, and basic cost data suggest that the programmes may well be relatively cost-effective. Although the contracting approach is not presented as the panacea to solve the malnutrition problem faced by Africa, it can certainly provide an alternative in many countries to increase coverage and quality of services."									
42	Dietary and socio-economic correlates of nutritional status in a rural adult Kenyan population.	"Jayne J, Scrimgeour AG, Polhemus ME, Otieno L, Bovill ME."	"African Journal of Food, Agriculture, Nutrition and Development. 2011;11(4):5035-52."	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20113273677	"There is a lack of data on trends in body composition among developing countries and the distribution of malnutrition among adults is poorly understood. Thus, the objective was to establish nutritional status, demographic make-up, dietary habits, and to determine if socioeconomic variables or dietary habits are associated with nutritional status in a rural adult Kenyan population. Five hundred Kenyan adults ages 18-55 years were recruited from the Kombewa division, located 40 km west of Kisumu, Kenya. The proportion of underweight and overweight adults is consistent with developing countries in nutrition transition. Using standard body mass index (BMI) classifications, 9.8% of the study population was underweight, 76.0% were normal weight, and 14.2% were overweight or obese. Significantly more females (20.7%) were overweight or obese than males (4.1%) (P=0.001). Iron deficiency was a significant issue, with 21.4% of females classified as anemic (Hb <120 g/l). Among overweight females, anemia rates remained high (16.9%) and were greater than in underweight females (10.8%). While 20% of subjects were HIV positive, their status did not affect BMI (P=0.230). The most significant correlation between dietary data and BMI was french fry consumption (r=0.167, P=0.001). Overweight or obese subjects reported eating french fries more frequently than subjects who had an underweight or normal range BMI (64.8% vs. 43.8%, P=0.002). Several other socioeconomic and dietary variables had weak correlations with BMI. Similar to data from developing countries in nutrition transition, it appears that the nutritional status of this rural Kenyan population has been affected by shifts in dietary patterns. Based on trends in other developing countries, it is likely that the incidence of overweight will increase in Kenya while micronutrient deficiencies and underweight remain concerns. Socioeconomic variables have been correlated with nutritional status in other developing countries and should be examined further in conjunction with food insecurity, so that culturally relevant and feasible interventions can be implemented."									
1178	Antiretroviral therapy for HIV-1 infected adolescents in Uganda: Assessing the impact on growth and sexual maturation.	"Bakeera-Kitaka S, McKellar M, Snider C, Kekitiinwa A, Piloya T, Musoke P, Ronald A, et al."	Journal of Pediatric Infectious Diseases. 2008;3(2):97-104.		"There is a paucity of knowledge about perinatally infected human immunodeficiency virus (HIV) positive children surviving into their adolescent years, especially from sub-Saharan Africa. Although studies have described the effects of the disease on the physical and sexual maturation of this population, their response to highly active antiretroviral therapy has not been systematically studied. At the pediatric infectious diseases clinic in Mulago hospital, Kampala, Uganda, we evaluated the effect of antiretroviral therapy (ART) on 118 treatment-naive, perinatally-infected HIV positive adolescents between the ages of 10-19 for 12 months. We monitored physical growth using The Centers for Disease Control and Prevention and recently published World Health Organization (WHO) reference growth standards for height and weight measurements as well as sexual maturation using Tanner staging. Laboratory tests including: complete blood count, absolute CD4 cell count and percentage, and HIV-1 RNA viral load, were performed at baseline and at 3-month intervals. Of 118 children, 64% were female; the median age was 13.6 years old. At baseline, 75% were classified as WHO clinical stages III and IV, with a median CD4 count of 124 cells/ul. Apart from four adolescents, all were on first-line antiretroviral therapy with 2 nucleoside reverse transcriptase inhibitors and 1 non-nucleoside reverse transcriptase inhibitors. After 6 months, the median CD4 count was 304 cells/muL, increasing to 370 cells/muL, by 12 months. Antiretroviral therapy was virologically suppressive (HIV-1 RNA viral load <400 copies/mL) in 79% of the adolescents at 6 months and in 89% at 12 months. Six (5%) patients died during the 12-month study. The median baseline height for age Z score was -2.41 which improved to a median of -1.96 by 12 months (P < 0.0001). The median baseline weight for age Z score was -2.61 and improved to -1.26 by 12 months (P < 0.0001). The median body mass index Z score increased from -1.39 to -0.47 by 12 months (P < 0.0001). At baseline, 63% of the adolescents were noted to have delayed pubertal maturation; this only reduced slightly to 60% after 12 months. Adolescents with predominantly perinatally-acquired HIV infection and significant disease burden showed appropriate virologic and immunological response to ART in addition to having clinically significant improvements in growth and some improvement in sexual maturation. 2008 IOS Press. All rights reserved."									
1846	"Cost of inpatient care for HIV-positive patients at Red Cross Children's Hospital, Cape Town."	"Yengopal V, Naidoo S."	Southern African Journal of HIV Medicine. 2004 November(17):32-40.		"There is anecdotal evidence that certain categories of patients at Red Cross War Memorial Children's Hospital (RCH) are thought to be utilising more resources than others. Faced with an ever-increasing demand for care, shrinking budgets and tough measures by government to force health managers to operate within budget, bold decisions need to be taken regarding future admission policy. The aim of this retrospective record-based study was to assess the cost of inpatient care for paediatric HIV-positive patients at RCH over a 1-year period (January - December 2001). The objectives were (i) to determine the cost of inpatient care for paediatric HIV-positive patients; and (ii) to provide baseline data for health managers to develop future admission policy and to plan for future needs in terms of management and budgetary protocols. Methods. The study population consisted of HIV-positive inpatients admitted to RCH. Information on patients' demographic details, date and duration of admission, reason for admission, additional diagnosis, nutritional status, laboratory investigations done, surgical procedures performed and medication prescribed were obtained from the patient records. Direct costs were recorded for admissions (bed costs), X-rays, laboratory and surgical procedures. The tariff fees charged for these services were obtained in consultation with management at RCH. Results. There were 16 032 admissions to RCH in 2001. Of these patients 616 (4%) were HIV+. A 25% random sample (N = 154) with a mean age of 1.75 years was analysed. Almost 80% were admitted with diarrhoea and vomiting and/or chest problems. The mean number of previous admissions was 2.0. The most common conditions diagnosed clinically were failure to thrive (64%), pneumonia (54%), gastroenteritis (43%), oral thrush (42%) and tuberculosis (22%). Over half were found to be underweight for their age, 20% were marasmic and 87% suffered some form of malnutrition at admission. HIV+ patients were 4.7 times more likely to die in hospital than HIV-ve patients. Their average length of stay in hospital was 9 days, compared with 4 days for HIV-ve patients. HIV+ patients consumed 12%, 61% and 9% of the total budgets allocated for antibiotics, antifungals and analgesics, respectively (7% of the total budget for medicines). The average cost (direct cost) for each HIV+ inpatient amounted to R18 765.76. Admission (bed) costs formed the bulk of this amount (84%) followed by laboratory costs (9%), medication (3%), surgical (2%) and X-rays (2%). Alarmingly, HIV+ patients, who formed 4% of the total admissions, consumed 26% (R11.56 million) of the total budget for direct treatment costs (R44.65 million). Conclusion. The current admission policies regarding HIV+ patients to RCH appear unsustainable, given the continued high demand for care, an ever-increasing HIV pandemic, the non-availability of antiretroviral therapy, lower health budgets and the continued inability of these patients to pay for health services."									
697	Infant feeding support strategy reduces growth faltering in late infancy among infants of HIV-infected mothers in urban Haiti.	"Heidkamp RA, Stoltzfus RJ, Fitzgerald D, Pape JW."	FASEB Journal. 2010 April;24.		"There is growing consensus about strategies to reduce mother-to-child transmission of HIV through breastmilk during early infancy (0-5 mo) in low-income countries, but less research on feeding in late infancy (6-12 mo) when risk of growth faltering is high. We evaluated a program strategy to support infant nutrition at GHESKIO, a clinic serving poor HIV-infected mothers in Port-au-Prince, Haiti. In 2008-09, 82 six-mo-old non-breastfed HIV-exposed infants were enrolled in a 6-month intervention that included a daily ration of micronutrient-fortified ready-to-use supplementary food, monthly ""mothers club"" sessions for infant feeding education, and monthly individualized growth monitoring/counseling. Data was collected on growth, anemia, dietary intake, morbidity, compliance, caregiver knowledge, satisfaction and program feasibility. Outcomes in participants were compared to infants seen at GHESKIO in the previous year (n=174). At age 6 months, stunting (LAZ<-2 WHO 2006) prevalence was slightly higher in intervention group than in controls (NS). Among 12-mo-olds, stunting was 9.6% in the intervention cohort vs. 20.8% in controls (p<.05) and wasting (WLZ<-2) 2.7% vs. 8.7% in controls (p=.074). The program was highly acceptable to mothers and feasible to implement in the clinical context. Research support was provided by Cornell's Einaudi Center, Weill Cornell Center for Global Health, and PEFPAR."									
1516	SIOP PODC: Recommendations for supportive care of children with cancer in a low-income setting.	"Israels T, Renner L, Hendricks M, Hesseling P, Howard S, Molyneux E."	Pediatric Blood and Cancer. 2013 June;60(6):899-904.		"These supportive care recommendations were prepared to guide doctors who practice in areas with significantly limited resources but who have sufficient infrastructure and training to treat children with cancer with curative intent. The success of any cancer treatment regimen depends largely on the availability and quality of supportive care and this also determines the intensity of treatment that can be delivered. We present practical recommendations on how to prevent infections, general nursing care, management of febrile neutropenia, nutritional assessment and support, treatment of co-infections and the social support to help prevent failure to complete treatment in resource poor settings. 2013 Wiley Periodicals, Inc."									
45	Micronutrient zinc deficiency as a possible co-factor in the transmission and progression of HIV/AIDS in Kenya.	"Mbakaya CFL, Orege PA, Jumba I, Bulimo W, Kisingu W, Nyambaka H, Waudo J, et al."	"African Journal of Food, Agriculture, Nutrition and Development. 2004;4(2):9."	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh3&AN=20053143885	"Thirty-four HIV/AIDS patients at various stages of disease progression volunteered to manage their health using a nutritional supplement that contained several micronutrients that included a 15 mg daily dose of elemental zinc. This initial publication only focuses on trends in the serum zinc levels and the observed biochemical changes following intervention, considering the critical role this trace element plays in human immunity. At baseline and after 30 months of follow-up, the patients' serum zinc levels were determined as was their clinical status. Four women who were found to be HIV negative at baseline and who had lost their husbands to HIV/AIDS, yet they had regularly had un-protected sex with them, had a mean serum zinc level of 116.2+32.7 mcg/100 ml. The serum zinc levels of asymptomatic, moderately symptomatic and severely symptomatic HIV/AIDS patients in the cohort reduced from baseline to post intervention levels of 92.5+12.1 to 78.0+8.2 mcg/100 ml (P=0.056); 81.9+17.6 to 73.2+12.2 mcg/100 ml (P=0.267) and 72.7+8.0 to 66.8+14.3 mcg/100 ml (P=0.022), respectively, all being far below the mean serum zinc level of 120.0+22.0 mcg/100 ml reported in normal control subjects in Western literature. For all patients combined, the serum zinc levels fell from 79.2+14.5 to 71.0+13.0 mcg/100 ml (P=0.016) notwithstanding that the patients had used zinc supplements at recommended daily allowances (RDA) over a period of 30 months. Notably, micronutrient zinc sufficiency plays a key role in promoting cell-mediated immunity and it is probably partly due to this reason that the high-risk women in this study, who also had comparably high serum zinc levels, remained negative for HIV antibodies despite repeated exposure to the virus. Thus, from this preliminary data that shows HIV/AIDS patients to be deficient in zinc in a manner consistent with their status of disease progression and considering that this trace element is recognized to possess antiviral and antibacterial properties, it is now apparently evident that zinc supplementation may play a key role in the fight against HIV/AIDS not only in Kenya but also in other African countries where this disease has reached epidemic proportions against a background of rampant malnutrition."									
54	Hypertension in pregnancy among HIV-infected women in sub-Saharan Africa: prevalence and infant outcomes.	"Kilewo C, Natchu UC, Young A, Donnell D, Brown E, Read JS, Sharma U, et al."	African journal of reproductive health. 2009 Dec;13(4):25-36.		"This analysis was performed to determine the prevalence of hypertension and association of MAP (mean arterial pressure) with birth outcomes among HIV-infected pregnant women not taking antiretrovirals. HIV-infected pregnant women, enrolled into the HPTN024 trial in Tanzania, Malawi and Zambia were followed up at 26-30, 36 weeks, and delivery. The prevalence of hypertension was <1% at both 20-24 weeks and 26-30 weeks and 1.7% by 36 weeks. A 5 mm Hg elevation in MAP increased the risk of stillbirth at 20-24 weeks by 29% (p = 0.001), 32% (p = 0.001) at 26-30 weeks and of low birth weight (LBW) at 36 weeks by 26% (p = 0.001). MAP was not associated with stillbirth at 36 weeks, LBW prior to 36 weeks, preterm birth, neonatal mortality or the risk of maternal to child transmission (MTCT) of HIV."									
184	Update on clinical trials of growth factors and anabolic steroids in cachexia and wasting.	"Gullett NP, Hebbar G, Ziegler TR."	American Journal of Clinical Nutrition. 2010 01 Apr;91(4):1143S-7S.		"This article and others that focused on the clinical features, mechanisms, and epidemiology of skeletal muscle loss and wasting in chronic diseases, which include chronic kidney disease, cancer, and AIDS, were presented at a symposium entitled ""Cachexia and Wasting: Recent Breakthroughs in Understanding and Opportunities for Intervention,"" held at Experimental Biology 2009. The clinical and anabolic efficacy of specific growth factors and anabolic steroids (eg, growth hormone, testosterone, megestrol acetate) in malnutrition and other catabolic states has been the subject of considerable research during the past several decades. Research on the effects of these agents in cachexia or wasting conditions, characterized by progressive loss of skeletal muscle and adipose tissue, focused on patients with AIDS in the early 1990s, when the devastating effects of the loss of body weight, lean body mass, and adipose tissue were recognized as contributors to these patients' mortality. These same agents have also been studied as methods to attenuate the catabolic responses observed in cancer-induced cachexia and in wasting induced by chronic obstructive pulmonary disease, congestive heart failure, renal failure, and other conditions. This article provides an updated review of recent clinical trials that specifically examined the potential therapeutic roles of growth hormone, testosterone, oxandrolone, and megestrol acetate and emerging data on the orexigenic peptide ghrelin, in human cachexia and wasting. 2010 American Society for Nutrition."									
1779	"Interactions between multi-nutrients, vitamin A, mastitis and HIV."	Thurnham DI.	Sight and Life Magazine. 2010;3(2010):25-31.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20113071963	"This article defines subclinical mastitis, and discusses the effects of vitamin A on breast milk viral load in Tanzanian human immunodeficiency virus (HIV)-infected women, influence of vitamin supplementation on subclinical mastitis, vitamin and mineral status of Tanzanian women in randomized controlled trials, and mechanism on how vitamin and mineral supplements increase subclinical mastitis."									
1327	Wasting disease in African children: the challenges ahead.	"Heikens GT, Manary M."	Malawi Medical Journal. 2009;21(3):101-5.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20093329036	"This article describes the challenges that malnourished children face in environments with a high prevalence of human immunodeficiency virus (HIV) infection, and on the basis of the findings by the Blantyre Working Group in 2007, discusses the urgent need to reconsider the paradigm of severe acute malnutrition (SAM) care in the context of HIV to determine the best approach for immediate care and optimal nutritional rehabilitation. Important considerations for the management of diarrhoea and for the optimum timing and dosing of antiretroviral therapy in HIV-infected SAM children are also emphasized."									
571	Neglect of healthcare infrastructure: is it over?	"Madhoo P, Mehta AT."	Commodity Vision. 2010;4(3):50-4.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20103371381	"This article discusses rights to human health and the health-related Millennium Development Goals (MDGs). The MDG status in India and China in terms of underweight in children under 5 years old, infant mortality, under-five mortality, maternal mortality, births attended by skilled personnel, HIV prevalence among adults, malaria mortality, tuberculosis mortality, population using improved water sources, and population using improved sanitation facilities from 1990 to 2008, and the situation of healthcare infrastructure and introduction of cashless free health insurance to address the inadequate and poor healthcare infrastructure in India are described."									
714	Early stages of a 'Food by Prescription' programme for HIV infected adults. (Special Issue: Focus on Ethiopia.).	"Bontrager E, Sadler K."	Field Exchange Emergency Nutrition Network ENN. 2011;40:82-3.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20123109664	"This article discusses the potential of Ready-to-Use Therapeutic Foods (RUTFs) for the treatment of malnourished adults living with HIV/AIDS. The case of Ethiopia is highlighted, where the country's Ministry of Health began implementing the 'USAID/Food by Prescription' programme in the summer of 2010, with technical assistance provided by Save the Children US. This programme provides beneficiaries diagnosed with either moderate acute malnutrition (MAM) or severe acute malnutrition (SAM) with two different products for up to six months - fortified blended food (FBF) packaged in individual serving-sized sachets for MAM cases and RUTF (Plumpy'nut) for SAM. The aim of the program is to improve nutritional, clinical, and functional outcomes beyond the time period of the intervention itself. The article reviews the evidence to date in relation to the use of RUTFs, the impact of food on health and nutrition outcomes, and the challenges met during the implementation of the FBP. The FBP programme is determined to have the potential to improve both the capacity of health professionals to address the nutritional needs of PLHIV and the effectiveness of HIV care and treatment in Ethiopia."									
715	Examining the integration of food by prescription into HIV care and treatment in Zambia.	"Greenaway KA, Jere EC, Zimba ME, Masi C, Kawana BM."	Field Exchange Emergency Nutrition Network ENN. 2012;42:30-1.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20133026609	"This article evaluates a pilot programme integrating Food by Prescription (FBP) into existing HIV care and treatment in Zambia. The programme provides moderately and severely malnourished HIV-positive adults with medicalized doses of nutrition supplements through ART (antiretroviral therapy) clinics, hospices and home-based care. The improvements in weight gain, body mass index, percentage of discharges cured (i.e. nutritionally rehabilitated), activity levels and perception of wellness after the programme are described."									
1314	Fighting AIDS with traditional foods and organic practices.	"Kaschula S, Arbuckle K."	LEISA Magazine. 2007;23(3):9-11.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20073279833	"This article examines novel agricultural practices that help rural communities cope with the impact of AIDS on food security in Msunduzi district in KwaZulu-Natal, South Africa. ""African Roots"" was the initiative proposed by Children in Distress Network (CINDI) for coping with the unique flavour that AIDS has lent to food security. The project recognizes that good nutrition and food security is the foundation for good health, particularly for people affected by HIV and AIDS. The project promoted food gardens, and particularly the use of traditional crops coupled with organic farming techniques, as a way of saving labour, promoting enterprise, optimizing nutrition, and encouraging self-sufficiency. The two-year African Roots Pilot Project began in October 2003, funded by the Rockefeller Brothers Fund. The project succeeded in raising awareness about local indigenous and traditional crops, and promoting skills in organic and food garden techniques. Many local food gardens were established, and community nutrition, skills and overall food security were strengthened. A community-based farmers' organization was formed and amount of food available to the community itself was improved. The mainstreaming of traditional foods into existing agricultural projects was not, however, without its challenges. It was hoped that indigenous plants historically grown in the region by the indigenous peoples might be re-introduced, to complement other vegetables grown. However, these efforts to improve biodiversity and use less invasive, more traditional indigenous and medicinal foods met with only marginal success. No attempt was made to incorporate or investigate labour-saving but more nutritious crop varieties for those afflicted by HIV/AIDS. Despite the problems faced, the African Roots project showed that people were enthused and liberated by the idea that traditional agricultural approaches resonate appropriately with the cultural context of combating a disease which is culture-eroding."									
1324	Integration of nutrition in the antiretroviral therapy scale up plan for Malawi.	"Bisika T, Mandere G."	Malawi Medical Journal. 2008;20(3):93-8.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20093195795	This article gives an overview about HIV/AIDS in Malawi; nutrition and antiretroviral therapy; malnutrition in Malawi; ART scale up in Malawi; the link between malnutrition and AIDS; cost analysis of the nutritional support; current nutrition support (food basket and ration); and distribution points for the nutrition support.									
100	HIV treatment and care systems: The way forward.	"Ross DA, South A, Weller I, Hakim J."	Aids. 2012 December;26(SUPPL.2):S147-S52.		"This article summarizes the conclusions and recommendations from the articles in this supplement. It presents a call for greater clarity of thinking related to projections of future need for HIV treatment and care. The demands placed on HIV treatment and care services will increase for the foreseeable future while the resources available for this are likely to remain constant or to decline. This highlights the need for realistic budgeting by national governments. The key strategies that should be employed to sustain HIV treatment and care programmes in high HIV-prevalence low and middle-income countries over the coming decade include further decentralization, task shifting, and integration of HIV services with other chronic disease treatment services. At the same time, greater attention will need to be given to the provision of mental healthcare for those living with HIV; to the specific treatment needs of children, adolescents, pregnant women and older people; and to the standard collection of validated indicators of treatment outcomes within national programmes. For the considerable gains that have been achieved to be sustained, funders - both internal and external to the country concerned - need to prioritize investment in operations research to maximise the efficiency of their other investments in HIV treatment and care services. 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins."									
572	Cutaneous manifestations of HIV infection in India.	Bora PC.	A Commonwealth response to a global health challenge. 2001.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh3&AN=20023026441	"This article summarizes the predominant mucocutaneous manifestations of the various stages of human immunodeficiency virus infections and/or acquired immune deficiency syndrome (HIV/AIDS) in patients from India. Their corresponding medical treatment are briefly outlined. These include skin disorders secondary to a viral, bacterial, fungal, protozoal and/or ectoparasitic infection. Also, several papulo-squamous, vascular and neoplastic lesions, as well as skin disorders due to a nutritional deficiency, are described. Changes in hair and nails, as well as oral manifestations, are discussed. Cutaneous symptoms of adverse drug reactions are also considered."									
12	"52nd Nestle Nutrition Workshop, Micronutrient Deficiences in the First Months of Life, Dubai, United Arab Emirates, October 2002. (Nestle Nutrition Workshop Series, Pediatric Program, Vol.52)."	"Delange FM, West KP, Jr."	"52nd Nestle Nutrition Workshop, Micronutrient Deficiences in the First Months of Life, Dubai, United Arab Emirates, October. 2002;370."	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh3&AN=20033194544	"This book contains 16 papers on infantile micronutrient deficiencies presented at a conference. It is the 52nd edition in a series of publications based on the proceedings of the Nestle Nutrition Workshop Series: Pediatric Program. It starts with an assessment of the micronutrient status followed by an exploration of new dietary reference intakes for micronutrients and a primer on assuring dietary micronutrient adequacy in mothers and infants. There are also separate reviews on the epidemiology, aetiology, pathogenesis, clinical aspects, prevention and treatment of key trace element and vitamin deficiencies such as iodine, iron, zinc, selenium, and vitamins A, D and K. The effect of maternal micronutrient supplementation on neonatal health and infant survival is discussed. Special micronutrient concerns in preterm infants that have implications for enteral and parenteral intake are addressed. The pathogenesis, treatment and prevention of diseases associated with micronutrient deficiencies such as anaemia, rickets, human immunodeficiency virus infection, birth defects, and disturbed mental and psychomotor development are presented. Paediatricians, clinical investigators, health workers and nutritionists engaged in the prevention and treatment of micronutrient deficiencies will find this book very useful."									
766	Handbook of nutrition and pregnancy. (Nutrition and Health).	"Lammi-Keefe CJ, Couch SC, Philipson EH."	Handbook of nutrition and pregnancy. 2008;375.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20093155224	"This book contains 23 chapters on the latest, evidence-based approaches for managing the nutritional requirements of pregnant women in a variety of settings. This volume has been given the title of handbook because of its inclusive coverage of virtually all of the relevant topics including but not limited to, the role of nutritional status prepregnancy, during pregnancy and afterwards; body composition; usual and recommended dietary intakes and intakes in those with eating disorders; dietary components and alternative dietary patterns including vegetarianism and vegan diets; drug-nutrient and drug-supplement interactions; bariatric surgery and pregnancy outcomes; adolescent pregnancy and multifetal pregnancy; pregnancy in HIV-infected women; pregnancy complications including preeclampsia; and the nutritional needs of the lactating woman and her nutritional needs postpartum, whether or not she is breastfeeding. This text is the first to synthesize the knowledge base for the health provider who is counselling both the woman anticipating pregnancy as well as the pregnant woman concerning diet, popular diets and diet supplements, and diet components and their effects on gastrointestinal function. Likewise, this volume contains valuable information for the health provider about the nutritional requirements following pregnancy. In addition to an expected single chapter on specific nutrients such as iron and folate, these essential nutrients are discussed in two chapters from the viewpoints of pregnancy in developed compared to underdeveloped countries, and thus these contrasting chapters will be of great value to the graduate student and academic researcher as well as the practicing nutritionist. Two examples of novel chapters that are unique to this volume include a review of postpartum depression and the nutrients that may be of benefit and a chapter on the role of flavours and fragrances on the fetus and their effects on food preferences later in life. Several chapters contain extensive lists of relevant Internet resources and screening tools that could be implemented in an office setting. Thus, this volume contains valuable information for the practicing health professional as well as those professionals and students who have for an interest in the latest, up-to-date information on the full spectrum of data on nutrition and pregnancy and its implications for human health and disease."									
797	The future of breastfeeding in the face of HIV-1 infection: Science and policy.	"Bulterys M, Kourtis AP."	"Human Immunodeficiency Virus type 1 (HIV-1) and Breastfeeding: Science, Researh Advances, and Policy. 2012;Advances in Experimental Medicine and Biology. 743:301-4."		"This book presents a comprehensive and detailed overview of transmission of HIV-1 to the infant via the infected mother's breast milk. There is no question that breast milk is the ideal food for the infant-with numerous nutritional, immunologic, cognitive, and psychological benefits for the mother/infant dyad, it is a food evolutionarily designed and uniquely tailored to the needs of the developing infant. Promotion of breastfeeding is now recognized throughout the world-and especially in resource-limited settings-as one of the most critical interventions to prevent infant and young child mortality [1-4]. Derrick Jelliffe, one of the founding fathers of developing world pediatrics and child health/nutrition, aptly described the result of promotional practices of the formula industry in the 1960s and 1970s as ""commerciogenic malnutrition"" [5-7]. 2012 Springer Science+Business Media New York."									
1676	"Public health nutrition in developing countries: Part 1 and 2. (Woodhead Publishing India in Food Science, Technology and Nutrition)."	Vir SC.	Public health nutrition in developing countries: Part. 2011;1(2).	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20113266614	"This book presents an update on public health nutrition problems of developing countries along with a description of approaches used and efficacy of trials undertaken for addressing these. Additionally, it also highlights experiences emerging from up-scaling intervention trials to programme models and elaborates on the principles of public health nutrition programme planning and implementation. The book covers emerging global experiences for a wide spectrum of public health nutrition issues (nutrition epidemiology; undernutrition; overnutrition; newborn care and survival; breastfeeding; complementary feeding of infants and young children; diarrhoea; prevention and management of protein energy malnutrition, overweight, obesity; human immunodeficiency virus infection; nutrient metabolism; prevention and control of nutrient deficiencies; micronutrient supplementation; agriculture, food and nutrition security; planning, monitoring and evaluation of public health nutrition programmes; nutrition-health education; research methods in public health nutrition; Natural Rural Health Mission) and aims not only to provide an update on current knowledge but also intends to generate interest in upcoming challenges and scenarios for future programmes. This book will provide public health experts, nutrition programmers, medical and nutrition graduates, nurses, programme managers with non-government organizations, or food industry and policy makers with information on technical and programmatic aspects of public health nutrition and thereby enhance skills in formulating and implementing appropriate solutions and actions."									
1787	"Socio-economic differences in health, nutrition, and population within developing countries: an overview. (Country Reports on HNP and Poverty)."	"Gwatkin DR, Rutstein S, Johnson K, Suliman E, Wagstaff A, Amouzou A."	"Socio economic differences in health, nutrition, and population within developing countries: an overview. 2007;287."	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20093081364	"This book summarizes the data produced by a project (the PovertyNet) dealing with the socioeconomic inequalities in health, nutrition and population (HNP) within 56 developing countries. The data are intended to serve as a source of basic information for preparing analyses and for developing initiatives to benefit poor people. The major part of this book is comprised of overview tables, where each table provides figures dealing with inequalities across economically-defined quintiles of the population for a single HNP indicator for all the 56 countries covered. The 120 indicators presented are in 4 categories: health status (such as infant and child mortality, nutritional status of children and women, female circumcision, sexually transmitted diseases, and fertility); use of basic health services (such as immunization, treatment of common childhood diseases, antenatal and delivery care, and contraception); health-related behaviours (e.g., hygienic practices, breast feeding, micronutrient intake, tobacco and alcohol use, domestic violence, and sexual practices); and other health status determinants (such as education, exposure to mass media, knowledge and attitudes toward HIV/AIDS, woman's status, and orphanhood)."									
353	Assuring food and nutrition security in the time of AIDS. (2020 Africa Conference Brief 3).	"Gillespie S, Kisamba-Mugerwa W, Loevinsohn M."	Assuring food and nutrition security in the time of AIDS. 2004;6.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh3&AN=20043159442	This brief report highlights the main interactions between HIV/AIDS and food and nutrition insecurity in sub-Saharan Africa. Suggested approaches for addressing these are given.									
691	Dietary changes and the health transition in South Africa: implications for health policy.	"Steyn NP, Bradshaw D, Norman R, Joubert JD, Schneider M, Steyn K."	FAO Food and Nutrition Paper. 2006;84:259-304.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20063178923	"This case study provides data on published research of diet, dietary trends, nutritional status and diet-related chronic diseases in South Africa over recent decades. These are assessed in the context of trends in the communicable disease burden: HIV/AIDS; tuberculosis; malaria; diarrhoeal disease. The data presented show that South Africa has a quadruple burden of disease: (1) continuation of the infectious diseases associated with underdevelopment, poverty and undernutrition; (2) an emerging epidemic of chronic diseases linked to overnutrition and Western types of diet and lifestyle; (3) the explosive HIV/AIDS epidemic; and (4) the continued burden of injury-related deaths. In 2000, non-communicable diseases accounted for 37% of deaths, and HIV/AIDS and infectious diseases together for 44%. Cardiovascular diseases and diabetes together accounted for 19% of total deaths, and cancers for a further 7.5%. In contrast, nutritional deficiencies related to undernutrition accounted for 1.2% of deaths. In terms of mortality from chronic diseases, in 2000 ischaemic heart disease and stroke accounted for 123 and 124 per 100 000 deaths, respectively, and hypertensive heart disease and diabetes accounted for 68 and 54 per 100 000 deaths, respectively. Undernutrition and its associated outcomes of stunting and underweight are still prevalent in children. National dietary intake data are only available for children aged one to nine years. Many children were deficient in energy and numerous micronutrients (vitamins A and C, niacin, vitamin B6, calcium, iron and zinc), and deficiency prevalence rates were always higher in rural areas."									
340	Nutrition support in human immunodeficiency virus infection.	"Macallan DC, Cotton J, Griffin GE."	Artificial nutrition support in clinical practice. 2001;2:617-38.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh3&AN=20013112956	This chapter assesses critically the physiopathological mechanisms of weight loss in human immunodeficiency virus (HIV) infection and discusses the nutritional support of adults with HIV infection and acquired immune deficiency syndrome (AIDS). The implications of paediatric HIV infection for nutrition and the implications of AIDS for feeding and nutrition in the developing world are briefly discussed.									
1449	Nutritional effects on the pathogen genome and phenotypic expression of disease.	Beck MA.	Nutrition and immunology: principles and practice. 2000.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh3&AN=20001418552	"This chapter considers the relationship between nutrition, pathogen genome and the expression of disease. Section headings include: Malnutrition and viral disease; Keshan disease; Selenium deficiency and coxsackievirus B3 infection; Glutathione peroxidase and coxsackievirus infection; Vitamin E deficiency and coxsackievirus B3 infection; Chemokines and nutritionally induced oxidative stress; Epidemic of optic and peripheral neuropathy in Cuba; Possible mechanisms for viral genomic change in nutritionally deficient animals; Human immunodeficiency virus and antioxidant nutrients; and Potential new viral genes via selenocysteine."									
1675	"Human immunodeficiency virus (HIV) and nutrition. (Woodhead Publishing India in Food Science, Technology and Nutrition)."	Mathew M.	Public health nutrition in developing countries: Part. 2011;1(2):372-404.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20113266633	"This chapter discusses key nutrition-related issues relevant to people living with HIV infection, including HIV implications on nutritional status, nutritional requirements of HIV-infected people, and nutritional support for HIV-infected patients."									
562	Infectious diseases. (The Nutrition Society Textbook Series).	"Paton NI, Gassull MA, Cabre E."	Clinical nutrition. 2005.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh3&AN=20053107517	"This chapter focuses on HIV infection, and to a lesser extent on tuberculosis, to outline the existing knowledge about the nutritional issues accompanying chronic infections. The epidemiology and clinical features of HIV, tuberculosis, malaria, and gastrointestinal infections are discussed, as well as their pharmacological and nutritional management. The conclusions are: (1) Advanced HIV infection and tuberculosis are chronic infections that are commonly associated with wasting; (2) Reduced nutrient intake is the main cause of wasting although metabolic disturbances may promote lean tissue loss; (3) Increasing nutrient intake is the key to treatment although pharmacological management approaches may also sometimes be helpful; (4) Anti-HIV drug treatment is frequently complicated by body fat changes and metabolic disturbances; (5) Acute infections such as malaria and acute infectious diarrhoea have important effects on nutritional status, especially in children, and are an important cause of death in developing countries; (6) Malnutrition increases the risk of malaria; (7) Rehydration therapy, achieved using the WHO rehydration mixture or similar solution, is the key to management of acute infectious diarrhoea."									
168	"The ecology of poverty: nutrition, parasites, and vulnerability to HIV/AIDS."	Stillwaggon E.	"AIDS, poverty, and hunger: challenges and responses. 2005(2006.):167-80. 47 ref."	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20063180834	"This chapter integrates analysis of poverty with the epidemiology of malnutrition, parasitic diseases (such as malaria, filariasis, schistosomiasis, and other helminthoses), and HIV/AIDS. Combining medical, economic, and geographical data, it demonstrates the specific disease synergies that promote HIV transmission in poor populations."									
1401	Micronutrients and infections: an introduction. (CRC Series in Modern Nutrition).	Friis H.	Micronutrients and HIV infection. 2002.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh3&AN=20023065022	"This chapter presents an overview of the mechanisms responsible for the relationship between nutritional deficiencies and infections, and its public health implications. Micronutrient requirements (retinol, thiamin, riboflavin, niacin, pyridoxine, vitamin B12, folic acid, ascorbic acid, vitamin E, iron, zinc and selenium), and the nutritional situation in developed and developing countries are also described. The role of micronutrients in human immunodeficiency virus infection is emphasized."									
1770	Policy implications of the effects of health and nutrition on child development.	Latham MC.	Scientific Publication Pan American Health Organization. 1998;566:225-33.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh2&AN=19981415413	"This chapter proposes a rationale for addressing the health and nutritional problems of school-aged children in developing countries. It discusses the different requirements of health and nutrition intervention programmes in different countries and describes common problems at which interventions can be aimed at. The following problems are addressed: protein energy malnutrition and child hunger; micronutrient deficiencies, especially those of Fe, I and retinol; parasitic infections, especially hookworm, ascariasis, trichuriasis, schistosomiasis and malaria; other infections such as gastroenteritis, respiratory infections (including tuberculosis), measles and HIV; poor vision and hearing; trauma and simple, easily treatable diseases; school environmental problems, including sanitary facilities, water supplies and waste disposal; and health and nutrition teaching, including issues related to curriculum, teacher training, textbooks and teaching materials."									
141	"Barriers to accessing antiretroviral therapy in Kisesa, Tanzania: a qualitative study of early rural referrals to the national program."	"Mshana GH, Wamoyi J, Busza J, Zaba B, Changalucha J, Kaluvya S, Urassa M."	AIDS Patient Care & Stds. 2006;20(9):649-57.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=16987051	"This community-based, qualitative study conducted in rural Kisesa District, Tanzania, explores perceptions and experiences of barriers to accessing the national antiretroviral programme among self-identified HIV-positive persons. Part of wider operations research around local introduction of HIV therapy, the study involved consultation with villagers and documented early referrals' progress through clinical evaluation and, if eligible, further training and drug procurement. Data collection consisted of 16 participatory group discussions with community members and 18 in-depth interviews with treatment-seekers. Although participants welcomed antiretroviral therapy, they feared that transportation and supplementary food costs, the referral hospital's reputation for being unfriendly and confusing, and difficulties in sustaining long-term treatment would limit accessibility. Fear of stigma framed all concerns, posing challenges for contacting referrals who did not want their status disclosed or expressed reluctance to identify a ""treatment buddy"" as required by the programme. To mitigate logistical barriers, transportation costs were paid and hospital visits facilitated. Participants reported satisfaction with eligibility testing, finding the process easier than anticipated. Most were willing to join a support group and some changed attitudes toward disclosure. However, both experienced and anticipated discrimination continue to hinder widespread antiretroviral therapy (ART) uptake. While simple measures to reduce perceived barriers improved initial access to treatment and helped overcome anxiety among early referrals, pervasive stigma remains the most formidable barrier. Encouraging successful referrals to share their positive experiences and contribute to nascent community mobililzation could start to address this seemingly intractable problem."									
897	Abnormalities in body composition and nutritional status in HIV-infected children and adolescents on antiretroviral therapy.	"Ramalho LCdB, Goncalves EM, Carvalho WRGd, Guerra Junior G, Centeville M, Aoki FH, Morcillo AM, et al."	International Journal of STD & AIDS. 2011;22(8):453-6.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20113273982	"This cross-sectional study aimed to compare growth, nutritional status and body composition outcomes between a group of 94 HIV-infected children and adolescents on antiretroviral therapy (ART) and 364 healthy controls, and to evaluate their association with clinical and lifestyle variables within the HIV-infected group. When compared with the control group, HIV patients had higher risk of stunting (odds ratio [OR] 5.33, 95% confidence interval [CI]: 2.83-10.04) and thinness (OR 4.7, 95% CI: 2.44-9.06), higher waist-to-hip ratios (medians 0.89 versus 0.82 for boys and 0.90 versus 0.77 for girls, P<0.001), and lower prevalence of overweight or obesity (OR 0.33, 95% CI: 0.14-0.78). Protease inhibitor usage was associated with thinness (OR 3.51, 95% CI 1.07-11.44) and lipoatrophy (OR 3.5, 95% CI 1.37-8.95). HIV-infected children on ART showed significant nutritional status and body composition abnormalities, consistent with the severity of vertical HIV infection and the consequences of prolonged ART."									
3	Animals I never saw': Community-based natural resource management & health in a Game Management Area of northern Zambia.	Garoon JP. 			"This dissertation analyzes how the implementation of community-based natural resource management (CBNRM) has affected the health and well-being of people living in Mukungule, a Game Management Area (GMA) adjoining northern Zambia's North Luangwa National Park ('the Park'). The development of the Park has been billed as a successful model for integrating conservation and development initiatives. The author carried out nine months (September 2006-May 2007) of ethnographic fieldwork in Mukungule, conducting structured and semi-structured in-depth interviews and performing both direct and participant observation while living in a village in the GMA. Employing the extended case method, the author analyzed health issues as they emerged in the everyday lives of area residents -- using nutrition, violence, and HIV/AIDS as lenses through which to focus on the relationships among health, conservation, and development. These analyses highlight residents' deployment of tactics as they compete for material resources (especially cash). CBNRM in Mukungule is predicated on the idea of keeping the area 'wild,' but encouraging sufficient modernization to dissuade residents from engaging in livelihood activities deemed environmentally deleterious (such as poaching game and using 'unsustainable' agricultural techniques). While illegal wildlife offtakes have decreased dramatically in Mukungule, CBNRM has driven residents to adopt alternate forms of 'poaching' as they struggle to survive and thrive in the area. Such poaching has allowed some Mukungule residents to become quite wealthy, but has exacerbated instability, uncertainty, and inequalities within the area's population, with significant implications for health and welfare. Despite increased availability of modern material goods in the area, and improvements in overall standard of living, Mukungule residents continue to make short-term sacrifices in pursuit of longer-term gains -- often risking their health as well as that of their families and neighbors. The development of the Park has fostered conditions ripe for the annual return of seasonal hunger as well as for the eruption of violence, and it has complicated and challenged people's attempts to cope with diseases such as HIV/AIDS. These findings have critical public health significance for international efforts to integrate environmental management with development goals. Copies of dissertations may be obtained by addressing your request to ProQuest, 789 E. Eisenhower Parkway, P.O. Box 1346, Ann Arbor, MI 48106-1346. Telephone 1-800-521-3042; email: disspub@umi.com"									
625	National Demographic and Health Survey 2010.	"Ojeda G, Ordonez M, Ochoa LH."	Encuesta Nacional de Demografia y Salud. 2010;727.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20123378352	"This document provides updated information on demographics and population health in Colombia in 2010. It contains 17 chapters and 8 appendices. The first chapter provides an introduction and the following chapters cover the following: social trends (Chapter 2); general characteristics of households and population (Chapter 3); general characteristics and status of childbearing-aged women (Chapter 4); fertility (Chapter 5); knowledge and use of family planning methods (Chapter 6); marriage and pregnancy risk exposure (Chapter 7); fertility preferences and demand for family planning (Chapter 8); infant mortality and childhood (Chapter 9); maternal and child health (Chapter 10); breastfeeding and nutritional status (Chapter 11); knowledge and prevention of HIV/AIDS and other sexually transmitted infections (Chapter 12); violence against women and children (Chapter 13); affiliation, perception and use of social security services in health (Chapter 14); early detection of cervical and breast cancer (Chapter 15); perception of sex education (Chapter 16); and characteristics, health status and access to care of older adults (Chapter 17). The appendices present the design and sample coverage, sampling and nonsampling errors, and the questionnaires."									
628	A study of demography and health: Madagascar 1997.		Enquete demographique et de sante: Madagascar. 1997;264.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh2&AN=19992008215	"This document reports on the demographic characteristics of the Madagascar population. Topics studied include fertility, family planning, marriage, pregnancy, infant mortality and maternal mortality, maternal and child health, breast-feeding and nutrition in mothers and infants, sexually transmitted diseases and AIDS."									
1975	Where there is no doctor: a village health care handbook.	"Werner D, Thuman C, Maxwell J."	Where there is no doctor: a village health care handbook. 2009;446.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20093199791	"This handbook has been written primarily for those who live far from medical centres, in places where there is no doctor. It includes 23 chapters covering a wide range of topics that affect the health of the villager. Chapter 1 provides home cures and presents popular health beliefs. Chapter 2 describes the sicknesses that are often confused. Chapters 2 and 3 outline how to examine and take care of a sick person. Chapter 5 describes healing without medicines, while Chapters 6 and 7 discuss the use of modern medicines and antibiotics. Chapter 8 describes how to measure and give medicines and Chapter 9 provides instructions and precautions for injections of medicines. Chapters 10 and 11 focus on first aid and healthy eating and diet treatment, respectively. Chapter 12 covers prevention of infectious diseases through sanitation, hygiene and vaccination, as well as other ways to prevent sickness and injury, and habits that affect health. Chapters 13-18 discuss the clinical characteristics and management of some very common sickness, serious illness that need special medical attention, and diseases of the skin, eyes, teeth, gums, mouth, urinary tract and genitalia (e.g., sexually transmitted diseases). Chapter 19 provides information for mothers and midwives regarding menstrual period, menopause, pregnancy, childbirth, maternal health and neonatal care. Chapter 20 focuses on family planning. Chapters 21 and 22 cover the health and sickness of children and older adults. Chapter 23 describes the medicine kit. Aside from these chapters, sections on recommendations for village health workers (Brown Pages), and the uses, dosage and precautions for medicines (Green Pages) are provided. This new revised edition provides information about health problems of growing or special concern (Blue Pages): HIV/AIDS, genital sores, circumcision and excision, special care for small, early and underweight babies, ear wax, leishmaniasis, guinea worm, emergencies caused by cold, blood pressure measurement, pesticide poisoning, abortion complications, and drug abuse and addiction. Updated advice on topics covered in the first edition is also provided. This book is for the villager who lives far from medical centres, the village storekeeper or pharmacist, the teacher, the village health worker, and mothers and midwives."									
803	Supplementation effect on body weight and BMI of HIV-positive/AIDS patients.	"Oguntibeju OO, Heever WMJvd, Schalkwyk FEv."	IJP International Journal of Pharmacology. 2007;3(1):120-2.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20073097141	"This is the first preliminary study in the Free State Province of South Africa to have examined the possible effect of a locally produced nutritional supplement on the body weight and Body Mass Index (BMI) of HIV-positive/AIDS patients. The parameters were determined according to standard procedures in 35 HIV-positive/AIDS patients at baseline and in 28 patients at the end of the study. Twenty-four (68.8%) of the 35 patients examined at baseline had BMI within normal range while the median body weight was 57. Twenty-eight patients completed the study. The results showed that 19 (67.9%) had a BMI within the normal range after supplementation for three months. The body weight showed a slight but insignificant decline (p>0.05) at the end of the study. In general, BMI produced a trend towards an improvement. Further studies are recommended."									
891	Supplementation effect on Body Weight and BMI of HIV-positive/AIDS patients.	"Oguntibeju OO, Van den Heever WMJ, Van Schalkwyk FE."	International Journal of Pharmacology. 2007 01 Jan;3(1):120-2.		"This is the first preliminary study in the Free State Province of South Africa to have examined the possible effect of a locally produced nutritional supplement on the body weight and Body Mass Index (BMI) of HIV-positive/AIDS patients. The parameters were determined according to standard procedures in 35 HIV-positive/AIDS patients at baseline and in 28 patients at the end of the study. Twenty-four (68.8%) of the 35 patients examined at baseline had BMI within normal range while the median body weight was 57. Twenty-eight patients completed the study. The results showed that 19 (67.9%) had a BMI within the normal range after supplementation for three months. The body weight showed a slight but insignificant decline (p>0.05) at the end of the study. In general, BMI produced a trend towards an improvement. Further studies are recommended. 2007 Asian Network for Scientific Information."									
1736	"2010 Congress Supplement ""Clinical Nutrition Challenges: Evidence vs Practice"", Stellenbosch, South Africa, 3-5 March 2010."		SAJCN South African Journal of Clinical Nutrition. 2010:S3-S74.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20103102600	"This journal issue contains papers presented at the conference. These papers addressed the following topics: intestinal failure in childhood; lipid emulsions in parenteral nutrition; optimal composition of intravenous lipids; diarrhoea and malnutrition; arginine supplementation; causes and management of diarrhoea; nutritional management of different health conditions (transplant recipients, malnutrition, Crohn's disease, food allergies, gastrointestinal malignancies); metabolic syndrome; micronutrients; glucose; HIV pathogenesis; ethical approach to evidence-based medicine. Papers on the agreement between NRS-2002 and MUST nutrition risk scores and the agreement between estimated and measured heights and weights in hospitalized patients are also included."									
1116	Effective Food and Nutrition Policy Responses to HIV/AIDS: What We Know and What We Need to Know.	"Haddad L, Gillespie S."	Journal of International Development. 2001 May 2001;13(4):487-511.	http://search.proquest.com/docview/60417610?accountid=26724	"This paper addresses the broad question: How should government policies in the area of food security, nutrition, agriculture & the environment be altered to better meet the needs of the poor within the context of the HIV/AIDS pandemic? We review the literature on the impact of HIV/AIDS on livelihoods, with special reference to agriculture, food security & nutrition. We highlight public policy options for effective HIV/AIDS mitigation in the areas of agriculture & nutrition & discuss the role of research in stimulating effective action for AIDS mitigation & ultimately for HIV prevention. The review concludes with a consideration of research priorities. 2 Tables, 49 References. [Copyright 2001 John Wiley and Sons, Ltd.]"									
172	Using agricultural economics to strengthen nongovernmental organizations' food security programs for people living with HIV/AIDS: an example from Honduras.	McNamara PE.	American Journal of Agricultural Economics. 2005;87(5):1304-9.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20063062502	"This paper argues about the implications of economics for the design of effective food security programmes for families of people living with HIV/AIDS, as well as the implications of HIV/AIDS for agricultural economics research in the area of nutrition and food security. The paper uses the case of CARE-Honduras and their food security programme (the IMANAS food supplementation programme) operated with the national organization of families of persons living with HIV/AIDS and other partners. Programme impact data collected from the 2003-04 efforts are reviewed. It is concluded that NGO food assistance programmes offer an arena where agricultural economists might make a contribution to the design and implementation of more effective programmes involving food assistance to address the challenges posed by HIV/AIDS."									
1966	Baseline for the evaluation of a National Action Plan for Orphans and Other Vulnerable Children using the UNAIDS core indicators: a case study in Zimbabwe.	"Saito S, Monasch R, Keogh E, Dhlembeu N, Bergua J, Mafico M."	Vulnerable Children and Youth Studies. 2007;2(3):198-214.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20093258426	"This paper describes the experience of Zimbabwe in establishing a baseline for its National Action Plan for Orphans and Other Vulnerable Children (NAP for OVC) using the 10 core indicators developed by the UNAIDS Global Monitoring and Evaluation Reference Group in 2004. Through a population-based household survey in rural and urban high-density areas and the OVC policy and planning effort index assessment tool, a baseline was established. The survey found that 43.6% of children under 18 years were orphaned or made vulnerable by HIV/AIDS. Half of all households with children care for one or more OVC. While the large majority of OVC continued to be cared for by the extended family, its capacity to care for these children appeared to be under pressure. OVC were less likely to have their basic minimum material needs met, more likely to be underweight, less likely to be taken to an appropriate health provider when sick and less likely to attend school. Medical support to households with OVC was found to be relatively high (26%). Other support, such as psychosocial support (2%) and school assistance (12%), was lower. The OVC Effort Index assessment indicates that serious efforts are being made. The increase in the effort index between 2001 and 2004 in the areas of consultative efforts, planning and coordinating mechanisms reflects the strengthened commitment. Monitoring and evaluation and legislative review are the weakest areas of the OVC response. The findings of the baseline exercise point to the need for continued and additional efforts and resources to implement the NAP for OVC, the priorities of which were confirmed by the survey as critical to improve the welfare of the OVC in Zimbabwe."									
1328	"Paediatric oncology in the Queen Elizabeth Central Hospital, Blantyre."	"Israels T, Banda K, Molyneux EM."	Malawi Medical Journal. 2008;20(4):115-7.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20093319416	"This paper describes the paediatric cancer unit (called Sobo ward) in the Queen Elizabeth Central Hospital in Blantyre, Malawi, focusing on the nutritional and social support provided to paediatric cancer cases, and on treatment outcomes. Among the cancers commonly managed at the unit are Wilms tumour, Burkitt's lymphoma, and AIDS-related Kaposi's sarcoma. This paper is written with the intention to encourage early referral of children who need investigation for possible malignancy and to highlight what positive results can be achieved."									
485	"Large dams, health and nutrition in Africa:beyond the controversy."	"Parent G, Ouedraogo A, Zagre NM, Compaore I, Kambire R, Poda JN."	Cahiers d'Etudes et de Recherches Francophones/Sante. 1997;7(6):417-22.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh2&AN=19981415332	"This paper discusses the potential effects of large water resources projects on human health in sub-Saharan Africa. It describes the positive effects such as improved well-being of the population and increased food supply and negative effects such as increased incidence of communicable diseases associated with large volumes of water (malaria, schistosomiasis, diarrhoea and other parasitic infections) and communicable diseases associated with an influx of migrants to an irrigated area (such as sexually transmitted) and large numbers of insects attracted to the water. The effects of damming projects on the nutritional state of people is also discussed."									
1351	"Predictors of breastfeeding cessation among HIV-infected women in Dar es Salaam, Tanzania."	"Petraro P, Duggan C, Msamanga G, Peterson KE, Spiegelman D, Fawzi W."	Maternal & Child Nutrition. 2011;7(3):273-83.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=21689270	"This paper examines predictors of breastfeeding cessation among a cohort of human immunodeficiency virus (HIV)-infected women. This was a prospective follow-up study of HIV-infected women who participated in a randomized micronutrient supplementation trial conducted in Dar es Salaam, Tanzania. 795 HIV-infected Tanzanian women with singleton newborns were utilized from the cohort for this analysis. The proportion of women breastfeeding declined from 95% at 12 months to 11% at 24 months. The multivariate analysis showed breastfeeding cessation was significantly associated with increasing calendar year of delivery from 1995 to 1997 [risk ratio (RR), 1.36; 95% confidence interval (CI) 1.13-1.63], having a new pregnancy (RR 1.33; 95% CI 1.10-1.61), overweight [body mass index (BMI) >=25 kg m(-2) ; RR 1.37; 95% CI 1.07-1.75], underweight (BMI <18.5kg m(-2) ; RR 1.29; 95% CI 1.00-1.65), introduction of cow's milk at infant's age of 4 months (RR 1.30; 95% CI 1.04-1.63). Material and social support was associated with decreased likelihood of cessation (RR 0.83; 95% CI 0.68-1.02). Demographic, health and nutritional factors among women and infants are associated with decisions by HIV-infected women to cease breastfeeding. The impact of breastfeeding counselling programs for HIV-infected African women should consider individual maternal, social and health contexts. 2010 Blackwell Publishing Ltd."									
1783	Household and community HIV/AIDS status and child malnutrition in sub-Saharan Africa: Evidence from the demographic and health surveys.	Magadi MA.	Social Science & Medicine. 2011 Aug 2011;73(3):436-46.	http://search.proquest.com/docview/919902672?accountid=26724	"This paper examines the extent to which under five children in households or communities adversely affected by HIV/AIDS are disadvantaged, in comparison with other children in less affected households/communities. The study is based on secondary analysis of the Demographic and Health Survey (DHS) data collected during 2003-2008 from 18 countries in sub-Saharan Africa, where the DHS has included HIV test data for adults of reproductive age. We apply multilevel logistic regression models that take into account the effect of contextual community/country level HIV/AIDS factors on child malnutrition. The outcome variable of interest is child undernutrition: stunting, wasting and underweight. The results suggest that across countries in sub-Saharan Africa, children whose mothers are infected with HIV are significantly more likely to be stunted, wasted or underweight compared to their counterparts of similar demographic and socio-economic background whose mothers are not infected. However, the nutritional status of children who are paternal orphans or in households where other adults are HIV positive are not significantly different from non-orphaned children or those in households where no adult is infected with HIV. Other adult household members being HIV positive is, however, associated with higher malnutrition among younger children below the age of one. Further analysis reveals that the effect of mothers' HIV status on child nutritional status (underweight) varies significantly across communities within countries, the effect being lower in communities with generally higher levels of malnutrition. Overall, the findings have important implications for policy and programme efforts towards improved integration of HIV/AIDS and child nutrition services in affected communities and other sub-groups of the population made vulnerable by HIV/AIDS. In particular, children whose mothers are infected with HIV deserve special attention. [Copyright Elsevier Ltd.]"									
806	Overcoming problems in the practice of public health among tribals of India.	"Bala SM, Thiruselvakumar D."	Indian Journal of Community Medicine. 2009;34(4):283-7.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20103018124	"This paper explores the problems in delivering public health services to the tribal population of India and suggests solutions. Among the problems include maternal and child health, nutrition, disparities in public health care and public health infrastructure. The burden of diseases include respiratory tract infections, diarrhoeal disorders and other infection (falciparum malaria, intestinal helminthiasis, tinea, scabies, sexually transmitted diseases, syphilis and tuberculosis). Solutions suggested are human resources development, empowerment, aids and administrative approach."									
1448	Nutrition and the care package. (Nutrition Policy Paper No.20).	Dlamini PK.	Nutrition and HIV/AIDS. 2001(2001.):47-53. 5 ref.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh3&AN=20023000398	"This paper focuses on nutrition as a practical and affordable solution to the human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) problem in Africa. The need for programmes to promote indigenous foods rich in micronutrients and antioxidants is highlighted. Sustainable community solutions, nutrient supplementation and nutrition counselling are also discussed."									
716	Creating an enabling policy environment for effective CMAM implementation in Malawi. (Special Issue: Government experiences of CMAM scale up.).	Kathumba S.	Field Exchange Emergency Nutrition Network ENN. 2012;43:74-8.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20133026625	"This paper focuses on the Community-based Management of Acute Malnutrition (CMAM) implementation experience in Malawi. It discusses the CMAM evolution in Malawi, the vision for CMAM in Malawi, and the policy environment in which the CMAM is developed. The progress on scaling up and integrating CMAM, particularly the national scale-up, is examined. HIV linkages and moderate acute malnutrition treatment and prevention in the context of CMAM are studied. The key achievements and challenges of CMAM, and the way forward for the programme, are presented."									
1740	"Structured, holistic approach for research planning (SHARP)."	"Charlton KE, Schmidt M."	SAJCN South African Journal of Clinical Nutrition. 2000;13(1 Suppl):S45-S8.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh3&AN=20003007368	"This paper looks at the use of the Structured, Holistic Approach for Research Planning. This method was followed by group members at the Urban Nutrition Action workshop. A report of the outcomes is presented."									
1984	"The impact of nutrition and fish supplementation on the response to anti retroviral therapy, Zambia."	"Banda-Nyirenda D, Husken SMC, Kaunda W."	WorldFish Center Project Report. 2009;25.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20113341633	This paper presents the background and rationale for a study to be undertaken in selected KKCAF centers in Zambia that aims to examine the effects of nutrition and fish supplementation on the response of HIV-positive patients to antiretroviral therapy. Specific sections discuss: (1) nutrition and food security in the context of HIV/AIDS; (2) nutrition policies and interventions; (3) impact of nutrition on HIV/AIDS progression; and (4) the importance of fish as a nutrient source.									
1771	Lost youth: children and AIDS in Africa.	Gillespie S.	SCN News. 2006;31:35-9.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20063061711	"This paper provides an overview on the devastating consequences of the AIDS pandemic in African children, with emphasis on its negative effects on nutrition, food security, and overall health status of these children."									
1330	Supplementary feeding in the care of the wasted HIV infected patient.	"Manary M, Ndekha M, Oosterhout JJv."	Malawi Medical Journal. 2010;22(2):46-8.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20103335490	"This paper summarizes the results of a randomized, investigator-blinded, controlled clinical trial of two types of supplementary food, i.e., corn/soya-blended flour and a ready-to-use peanut butter-based lipid paste, in wasted HIV-positive adults in Blantyre, Malawi, as well as the course of a historical control group who did not receive any supplementary food. In general, provision of about half of the daily energy requirement as a supplementary food for 14 weeks resulted in more rapid restoration of a normal BMI in the HIV infected patients. In addition, the provision of the energy-dense, ready-to-use paste is associated with more rapid weight gain than the blended flour. However, survival is similar among the three groups of HIV patients. Further research is suggested concerning the widespread practice of supplementary feeding in HIV/AIDS care."									
1371	Situational analysis of infant and young child nutrition activities in the Sahel - executive summary. (Special Issue: Repositioning children's right to adequate nutrition in the Sahel - situational analysis.).	"Wuehler SE, Hess SY, Brown KH."	Maternal and Child Nutrition. 2011;7(s1):1-5.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20113110903	"This paper summarizes the results of situational analyses evaluating infant and young child nutrition (IYCN) activities being conducted in 6 Sahelian countries of West and Central Africa, namely Burkina Faso, Chad, Mali, Mauritania, Niger and Senegal. The national policies and strategies, research activities, training materials and curricula, programme guidelines, survey results, and monitoring and evaluation reports are described and compared with international recommendations in selected areas of IYCN: infant and young child feeding practices; prevention of micronutrient deficiencies; and other nutritional support (management of acute malnutrition, prevention of maternal transmission of HIV through feeding practices, food security and hygiene and sanitation)."									
1850	Chad 2004: results from the demographic and health survey.		Studies in Family Planning. 2006;37(2):130-5.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20073131261	"This paper summarizes the results of the Chad Demographic and Health Survey 2004, which is based on interviews of 6085 women aged 15-49 years and 1887 men aged 15-59 years conducted during 23 July-10 December 2004. The general population characteristics, fertility, fertility preferences, contraception, marital status, assistance during delivery, postpartum variables, infant mortality, vaccination against vaccine-preventable diseases (tuberculosis, diphtheria, pertussis, tetanus, poliomyelitis, measles) and oral rehydration treatment of diarrhoea in children, nutritional status and knowledge on HIV/AIDS are described."									
282	"Growth and micronutrient disturbances in stable, HIV-infected children in Cape Town."	"Eley BS, Sive AA, Abelse L, Kossew G, Cooper M, Hussey GD."	Annals of Tropical Paediatrics. 2002;22(1):19-23.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh3&AN=20023043908	"This prospective study of 60 stable, HIV-infected children in an economically deprived setting, in Cape Town, South Africa was designed to document anthropometric and micronutrient disturbances. Investigations included CD4<sup>+</sup> counts, anthropometry and plasma levels of albumin, transthyretin, retinol-binding protein (RBP), vitamins A, B<sub>6</sub>, E and B<sub>12</sub>, and folate, zinc and copper. The median age was 25 months. 32% had mild, 48% moderate and 20% severe clinical features, and 80% were moderately or severely immunosuppressed. 28% had a weight Z-score<-2.0 and 58% a height Z-score<-2.0. Many children had micronutrient deficiencies: albumin (70%), transthyretin (100%), RBP (85%), vitamins A (80%), B<sub>6</sub> (37%), E (37%) and B<sub>12</sub> (5%), zinc (20%) and copper (25%). 62% had two or more trace element or vitamin deficiencies. There was a weak association between micronutrient status and disease status. Micronutrient concentrations did not correlate with chronological age, height-for-age or weight-for-age. CRP was elevated in 53% but did not correlate with any of the micronutrient concentrations. Micronutrient deficiencies were more common and micronutrient concentrations lower in children over 24 months of age."									
804	Improving child nutrition for sustainable poverty reduction in Africa. (2020 Africa Conference Brief 2).	"Alderman H, Behrman J, Hoddinott J."	Improving child nutrition for sustainable poverty reduction in Africa. 2004;6.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh3&AN=20043159459	"This publication discusses the causes and consequences of child malnutrition in Africa. Feasible and cost-effective interventions to reduce child malnutrition (reducing the incidence of low birth weight; improving infant and child nutrition; reducing iodine, vitamin A and iron deficiencies; improving women's education and status; addressing infectious diseases such as human immunodeficiency virus infection; and improving infrastructure) are suggested. It is argued that improved child nutrition is important in sustaining poverty reduction measures as this addresses potential losses in productivity."									
1726	"Rwanda: demographic and health survey, 2010."		Rwanda: demographic and health survey. 2010;411(17).	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20123332988	"This publication presents the results of the 2010 Rwanda Demographic and Health Survey and includes relevant information on the country's demographic structure, fetility, family planning initiatives, infant and child mortality, maternal health, childhood immunization, adult and child nutrition, breast feeding, anaemia prevalence, malaria and HIV prevalence, women's health, adult and maternal mortality, and domestic violence."									
1274	"Kenya: demographic and health survey, 2008-09."		Kenya: demographic and health survey. 2008;09(430).	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20113091742	"This report presents findings of a demographic and health survey carried out in Kenya. Data presented are from 2008-09. It contains 17 chapters detailing important health indicator issues. Topics include the following: geography, history, economic profile and demography; reproductive health issues such as fertility and family planning; mortality rates for children, mothers and adults; maternal and child health; nutrition; HIV prevalence; women's health; gender-based violence; and malaria."									
1334	"Maldives: demographic and health survey, 2009."		Maldives: demographic and health survey. 2009;346(24).	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20113091741	"This report presents findings of a demographic and health survey carried out in Maldives. Data presented are from 2008-09. It contains 16 chapters detailing important health indicator issues. Topics include the following: geography, history, economic profile and demography; reproductive health issues such as fertility and family planning; mortality rates for children, mothers and adults; maternal and child health; nutrition; HIV prevalence; women's health; men's health; and youth-related issues."									
1760	Sao Tome and Principe: Demographic and Health Survey (DHS STP 2008-2009).		Sao Tome e Principe: Inquerito demografico e sanitario. 2008;303(19).	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20113091735	"This report presents findings of a health and demographic survey in Sao Tome and Principe. Data presented are from 2008-09. It is divided into 18 chapters. Topics are as follows: presentation of the country, scope and methodology of the investigation; characteristics of households; characteristics of women and men; fertility; family planning; risk exposure in pregnancy; planning and reproductive intentions of fertility; reproductive health; child health; malaria; nutritional status of children and adults; mortality of children; adult mortality and maternal mortality; knowledge, attitudes and behaviour; concerning sexually transmitted infection/AIDS; prevalence of HIV and associated factors; status of women; and domestic violence."									
1315	"Lesotho: demographic and health survey, 2009."		Lesotho: demographic and health survey. 2009;308.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20113091743	"This report presents findings of the 2009 Lesotho Demographic and Health Survey (LDHS) conducted by the Ministry of Health and Social Welfare. It contains 17 chapters detailing important health indicator data. A description of the geography, history, economic profile and demography is given. Reproductive health issues such as fertility and family planning are discussed. Mortality rates for children, mothers and adults, as well as maternal and child health topics are tackled in other chapters. Nutrition, HIV prevalence, women's health, chronic diseases in adults and tuberculosis are contained in the remaining chapters."									
1409	Nepal demographic and health survey 2011.		Nepal demographic and health survey. 2011;421.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20123263553	"This report presents the 2011 Nepal Demographic and Health Survey (NDHS), the fourth nationally representative comprehensive survey conducted as part of the worldwide Demographic and Health Surveys project in the country. The primary objective of the 2011 NDHS is to provide up-to-date and reliable data on different issues related to population and health, which provides guidance in planning, implementing, monitoring, and evaluating health programs in Nepal. The long term objective of the survey is to strengthen the technical capacity of the local institutions to plan, conduct, process and analyze data from complex national population and health surveys. The survey specifically provides data on the following: housing characteristics and household population; characteristics of respondents; marriage and sexual activity; fertility levels and determinants; fertility preferences; family planning; infant and child mortality; children and women's nutritional status; maternal and child health and the utilization of maternal and child health services; HIV/AIDS knowledge, attitudes and behaviour; women's empowerment and demographic and health outcomes; and, domestic violence in women. The survey also reports on the anaemia status of women aged 15-49 years and children aged 6-59 months. In addition to providing national estimates, the survey report also provides disaggregated data at the level of various domains such as ecological region, development regions and for urban and rural areas."									
1774	"Senegal: Demographic and Health Survey and Multiple Indicator Cluster Survey (DHS-MICS), 2010-2011: final report."		Senegal: Enquete Demographique et de Sante a Indicateurs Multiples (EDS-MICS). 2010 rapport final(2012.):xxxvi + 482 pp. 25 ref.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20123332987	"This report presents the results of the 5th Demographic Health Survey (DHS) and the 3rd Multiple Indicator Cluster Survey (MICS) in Senegal conducted during October 2010-April 2011. Using data from a nationally representative sample of 15 688 women aged 15-49 years and 4929 men aged 15-59 years from 7902 households, this report provides up-to-date information on household characteristics, characteristics of male and female respondents, marriage, fertility and fertility preferences, family planning, mortality of children under 5 years, maternal and child health, breast feeding and nutritional status, malaria, HIV/AIDS and other sexually transmitted infections, HIV prevalence and associated factors, adult and maternal mortality, gender issues, female circumcision, and situation of children."									
1834	Long term outcomes of nevirapine containing antiretroviral therapy at a center in Thailand.	"Htun WL, Bowonwatanuwong C, Phonrat B, Pitisuttithum P."	The Southeast Asian journal of tropical medicine and public health. 2012 Jul;43(4):860-70.		"This retrospective cohort study was conducted at Chon Buri Hospital, Thailand, to determine the long term outcomes of patients taking Nevirapine (NVP) containing antiretroviral therapy (ART). Patients taken NVP at least 5 years were included. Two hundred eighty-five patients met inclusion criteria and were included in the study. The median age of patients was 35 years; the median baseline CD4 was 66 cells/mm3 and the median follow-up was 7 years. Ninety-two point four percent and 90.2% of patients achieved virological success at year 5 and year 7, respectively. The median rise in CD4 count from baseline to year 5 was 354 cells/mm3 (IQR 235.5-487 cells/mm3) and at year 7 was 387 cells/mm3 (IQR 272-557 cells/mm3). Thirty-eight point eight percent of patients had a CD4 count > or = 500 cells/mm3 at year 5 and 41.6% at year 7. Rash/hypersensitivity occurred in 2 patients after 5 years and was transient. Elevated liver enzymes occurred in 5 patients after 5 years. NVP-containing ART yielded high virological-success rates. Long-term immunological response, safety and durability were also high."									
1026	Prompt initiation of ART With therapeutic food is associated with improved outcomes in HIV-infected Malawian children with malnutrition.	"Kim MH, Cox C, Dave A, Draper HR, Kabue M, Schutze GE, Ahmed S, et al."	Journal of Acquired Immune Deficiency Syndromes: JAIDS. 2012;59(2):173-6.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=22107819	"This retrospective observational study of 140 HIV-infected children with uncomplicated malnutrition in urban Malawi tested the hypothesis that initiation of antiretroviral therapy (ART) within 21 days of outpatient therapeutic feeding (prompt ART) improved clinical outcomes. Children receiving prompt ART were more likely to recover nutritionally (86% vs. 60%, P < 0.01) and had higher rates of weight gain (3.6 vs. 1.6 g/k/day; P = 0.02). Logistic regression modeling found prompt ART was associated with increased likelihood of nutritional recovery (odds ratio: 5.4, 95% confidence interval: 2.0 to 14.5). This suggests that prompt ART is associated with improved outcomes in HIV-infected Malawian children with uncomplicated malnutrition."									
122	Evidence-based gender findings for children affected by HIV and AIDS - a systematic overview.	"Sherr L, Mueller J, Varrall R."	AIDS Care. 2009;21 Suppl 1:83-97.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=22380982	"This review (under the International Joint Learning Initiative on Children and AIDS) provides a detailed evidence analysis of gender, children and AIDS. Six systematic reviews provide the most up to date evidence base on research surrounding children and HIV on key topics of treatment resistance and adherence, schooling, nutrition, cognitive development and orphaning and bereavement. Traditional systematic review techniques were used to identify all published studies on four key topics, then studies were selected according to adequacy criteria (sufficient size, control group and adequate measures). A gender analysis was performed on included studies, detailing whether gender was measured, results were analysed by gender or any gender-based findings. For family studies, both the gender of the parents and gender of the child are needed. Secondary analysis by gender was performed on existing systematic reviews for treatment resistance and adherence. Of the 12 studies on treatment resistance, 11 did not look at gender. One found boys at a seven-fold risk compared to girls. For medication adherence, gender was not significant. Of the 15 studies on schooling, 12 analysed findings by gender with an overall female disadvantage. Of the 14 studies on nutrition, nine analysed by gender with mixed findings. Of the 54 studies on cognitive development, 17 provided gender data, but only four analysed by gender with few differences established. Of the 15 studies on bereavement, seven analysed data by gender again with mixed findings. Major policies fail to provide gender data for young children. WHO, UNAIDS and the international data sets are not gathered or coded by gender for young children (generally under 15 years of age) despite well-established gender challenges in later life. This review shows that the current evidence base is inadequate. Data on gender variation and outcome are urgently needed to inform policy and research on children and HIV."									
1902	The aetiology of anaemia in pregnancy in West Africa.	Broek Nvd.	Tropical Doctor. 1996;26(1):5-7.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh2&AN=19962008616	"This review briefly discusses the consequences of anaemia in pregnancy before going on to explore its causes in women in West Africa. Nutritional anaemias, particularly iron and folate deficiency, vitamin A deficiency and vitamin B12 deficiency are discussed. Malaria, human immunodeficiency virus infections, haemoglobinopathies and other miscellaneous causes are considered."									
280	Inpatient management of severe malnutrition: time for a change in protocol and practice.	Brewster DR.	Annals of Tropical Paediatrics. 2011;31(2):97-107.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=21575313	"This review focuses on how to reduce the high mortality of severe acute malnutrition (SAM) in African hospitals. The World Health Organization's 1999 manual for physicians (protocol) has not resulted in case-fatality rates of under 5%, even in published research studies from Africa, far less in district and central hospitals which do not record case-fatality rates. It is suggested that the following eight changes to the protocol need to be considered if we are serious about reducing case-fatality rates in African hospitals: (1) use of low lactose, low osmolality milk feeds during the early stage of treatment, especially for HIV-exposed infants and diarrhoeal cases; (2) more cautious use of high carbohydrate loads (ORS, ReSoMal, sucrose and 10% dextrose) during initial stabilisation; (3) more careful grading up and down of feed volumes according the child's responses during the early rehabilitation phase; (4) rapid rehydration of children in shock with Ringer's lactate, as for well-nourished children, with closer monitoring for heart failure; (5) greater use of 3rd-generation cephalosporin and fluoroquinolone antibiotics (e.g. ceftriaxone, ciprofloxacin) to treat sepsis owing to resistant organisms; (6) consider adding glutamine-arginine supplements as gut-protective agents in addition to zinc and vitamin A; (7) the addition of phosphate to existing potassium and magnesium supplements for those at risk of the refeeding syndrome; and (8) introduce better tools for diagnosis and clearer management of combined HIV and tuberculous infections in infants. Many will argue that these suggestions are unaffordable or impractical. On the contrary, cases of SAM requiring hospital admission need to be allocated more resources, including better nursing care, better diet and better medication. Resources made available for other childhood inpatient services such as ID and HIV dwarf those for severe malnutrition. Of course, prevention is always a better investment, including improving breastfeeding rates, improving complementary feeding practices and using ready-to-use therapeutic foods (RUTF) or similar supplements for those failing to thrive in the community, but SAM is unlikely to disappear from our hospitals, and these children need to be better managed if we are serious about reducing mortality."									
258	Special Section: ACE Policy Symposium. (Special Section: ACE Policy Symposium.).		Annals of Epidemiology. 2012;22(6):413-55.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20123237112	"This section features a policy symposium, the second in a series, from the American College of Epidemiology. The 5 articles included in this section consider the policy path and implications of the following public health issues: sodium reduction; human immunodeficiency virus infection on the Mexico-U.S. border; cancer screening; and racial/ethnic health disparities."									
767	Theme Issue: Adolescent health. (Theme Issue: Adolescent health.).		Health Education & Behavior. 2010;37(1):1-154.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20103064771	"This special issue covers the following topics: effectiveness of a school-based adolescent depression education programme; athletic participation and seatbelt omission among US high school students; adapting an HIV prevention intervention for high-risk, incarcerated adolescents; relationship between health behaviours, body mass index (BMI), and self-esteem and the academic achievement of adolescents; prior victimization and sexual and contraceptive self-efficacy among adolescent females under child protective services care; evaluation of the health promotion model to predict physical activity in Iranian adolescent boys; empirical test of ecodevelopmental theory in predicting HIV risk behaviors among Hispanic youth; Project ORE: a friendship-based intervention to prevent HIV/STI in urban African American adolescent females; and self-surveillance by adolescents and young adults transitioning to self-management of a chronic genetic disorder."									
850	"Serum leptin levels in antiretroviral therapy naive HIV-1 infected patients in Zaria, Nigeria."	"Onyemelukwe GC, Ogoina D, Bakari AG."	International Journal of Endocrinology and Metabolism. 2009;7(3):162-9.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20103311037	"This study aimed at determining serum leptin levels in ART naive HIV-1 infected adults in relation to body mass index (BMI), CD4 cell count and presence or absence of symptomatic HIV disease or features of AIDS. Materials & Methods: This cross sectional study was undertaken in 2008 among patients, attending Ahmadu Bello University Teaching Hospital. Serum leptin levels by ELISA were determined in 40 consecutive sex matched, HIV infected adults (20 normal weight and 20 underweight) and 26 sex matched HIV negative, healthy, normal weight controls. Symptomatic and asymptomatic HIV infected patients as well as AIDS and non-AIDS patients with similar BMI were compared. CD4 cell counts were correlated with leptin levels. Results: The median leptin levels of healthy controls and asymptomatic normal weight patients were not significantly different. Female patients tended to have lower leptin values than male ones. Median leptin was lower in underweight patients when compared to normal weight patients (13.8 vs 39 ng/mL, p=0.009) and also lower in symptomatic patients when compared to asymptomatic patients (27.9 vs 43.9 ng/mL, p=0.038) but not significantly different between AIDS and non-AIDS cases. Among healthy controls, leptin levels positively correlated with CD4 T counts (r=0.47, p=0.04) but in HIV/AIDS patients the correlation (r=0.28, p=0.07) was not significant. Conclusion: In wasted HIV infected patients, low leptin levels were reflective of loss of adipose mass and were worse in females. It is suggested that independent of the effect of BMI, leptin secretion is down regulated in untreated symptomatic HIV/AIDS patients with secondary infections. The results also suggest that the normal leptin induced rise with CD4 T cell counts may be blunted by untreated HIV infection."									
1268	Different nutritional-state indicators of HIV-positive individuals undergoing antiretroviral therapy.	"Geraix J, Carvalhaes MABL, Pereira PCM."	Journal of Venomous Animals and Toxins including Tropical Diseases. 2008;14(2):338-56.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20083233923	"This study aimed at learning about the nutritional profile of HIV-positive individuals undergoing antiretroviral therapy and at comparing the performance of nutritional-state indicators. A transversal study was performed on 94 patients attending the Tropical Diseases Outpatient Hospital of Botucatu Medical School (FMB) - UNESP. The body mass index (BMI) and the classification by Papini-Berto (PB) were used to evaluate nutritional state, aiming at detecting malnutrition and obesity. The waist-to-hips ratio (W/HR) and waist circumference (WC) were adopted for identification of abdominal obesity and lipodystrophy. According to BMI, most of the individuals were eutrophic, followed by 30.9% overweight and 6.4% malnourished. With use of the PB classification, the frequency of malnutrition increased (22.3%). The analysis of the PB classification in relation to BMI indicated that the former presented high sensitivity and good specificity for malnutrition diagnosis, namely 100% and 83%, respectively. The prevalence of abdominal obesity was 7.44% according to WC, and a higher prevalence (38.3%) was observed when taking W/HR into account. There was significant positive association between nutritional diagnosis according to PB and T CD4<sup>+</sup> lymphocyte. The results support the use of PB classification for malnutrition detection as well as that of BMI and W/HR for overweight and fat redistribution."									
1886	"Weight, body composition and handgrip strength among pulmonary tuberculosis patients: a matched cross-sectional study in Mwanza, Tanzania."	"PrayGod G, Range N, Faurholt-Jepsen D, Jeremiah K, Faurholt-Jepsen M, Aabye MG, Jensen L, et al."	Transactions of the Royal Society of Tropical Medicine & Hygiene. 2011;105(3):140-7.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=21239027	"This study aimed to estimate deficits in weight, arm fat area (AFA), arm muscle area (AMA) and handgrip strength among smear-positive pulmonary TB (PTB+) patients starting treatment. We conducted a cross-sectional study among PTB+ patients and age- and sex-matched neighborhood controls. HIV status, anthropometric measurements and handgrip strength were determined. Deficits in weight, AFA, AMA and handgrip strength associated with PTB+ and HIV were estimated using multiple regression analysis. We recruited 355 pairs of PTB+ patients and controls. PTB+ was associated with deficits of 10.0kg (95% CI 7.3; 12.7) in weight and 6.8kg (95% CI 5.2; 8.3) in handgrip strength among females and 9.1kg (95% CI 7.3; 10.9) in weight and 6.8kg (95% CI 5.2; 8.4) in handgrip strength among males. In both sexes, PTB+ was associated with deficits in AFA and AMA. Among females, HIV was associated with deficits in AMA and handgrip strength, but the deficit in handgrip strength was larger among PTB+ patients (3.2kg 95% CI 1.3; 5.2) than controls (-1.6kg 95% CI -4.8; 1.5) (interaction, P=0.009). These findings suggest that deficits in weight and handgrip strength among patients starting TB treatment are severe. Thus, nutritional support may be necessary to ensure reversal of the deficits, and may improve treatment outcomes. Copyright 2010 Royal Society of Tropical Medicine and Hygiene. Published by Elsevier Ltd. All rights reserved."									
1894	"Weight, body composition and handgrip strength among pulmonary tuberculosis patients: A matched cross-sectional study in Mwanza, Tanzania."	"PrayGod G, Range N, Faurholt-Jepsen D, Jeremiah K, Faurholt-Jepsen M, Aabye MG, Jensen L, et al."	Transactions of the Royal Society of Tropical Medicine and Hygiene. 2011 March;105(3):140-7.		"This study aimed to estimate deficits in weight, arm fat area (AFA), arm muscle area (AMA) and handgrip strength among smear-positive pulmonary TB (PTB+) patients starting treatment. We conducted a cross-sectional study among PTB+ patients and age- and sex-matched neighborhood controls. HIV status, anthropometric measurements and handgrip strength were determined. Deficits in weight, AFA, AMA and handgrip strength associated with PTB+ and HIV were estimated using multiple regression analysis. We recruited 355 pairs of PTB+ patients and controls. PTB+ was associated with deficits of 10.0. kg (95% CI 7.3; 12.7) in weight and 6.8. kg (95% CI 5.2; 8.3) in handgrip strength among females and 9.1. kg (95% CI 7.3; 10.9) in weight and 6.8. kg (95% CI 5.2; 8.4) in handgrip strength among males. In both sexes, PTB+ was associated with deficits in AFA and AMA. Among females, HIV was associated with deficits in AMA and handgrip strength, but the deficit in handgrip strength was larger among PTB+ patients (3.2. kg 95% CI 1.3; 5.2) than controls (-1.6. kg 95% CI -4.8; 1.5) (interaction, P = 0.009).These findings suggest that deficits in weight and handgrip strength among patients starting TB treatment are severe. Thus, nutritional support may be necessary to ensure reversal of the deficits, and may improve treatment outcomes. 2010 Royal Society of Tropical Medicine and Hygiene."									
352	Health and Medical Research in Nepal: A Bibliometric Review.	"Simkhada PP, Baral YR, van Teijlingen ER."	Asia-Pacific Journal of Public Health. 2010 Oct 2010;22(4):492-500.	http://search.proquest.com/docview/852156240?accountid=26724	"This study aimed to quantify the following: (1) health research in academic journals covering Nepal, (2) location of authors, and (3) most prevalent specialties. Published health research conducted in Nepal during 1996 to May 2007 was assessed by searching from 4 electronic databases, and 631 research articles met the inclusion criteria. Only 11% was published in Nepalese journals. Most research covered urban districts. About two thirds of articles had Nepalese authors, but only 41% had a Nepalese first author. Child health and nutrition (11%), maternal health and women's health (11%), and sexual reproductive health and HIV/AIDS, and family planning (11%) were the most common topics. Most articles (78%) reported quantitative methods. The number of research articles from Nepal is fairly small and concentrated on a limited number of topics and districts. Strategic planning is required to improve the research capacity of Nepal to achieve public health improvements using locally produced evidence."									
8	The impact of HIV/AIDS on the Shona livelihood system of southeast Zimbabwe.	Mazzeo J. 			"This study aims to understand the mechanisms by which HIV/AIDS affects the means, relations and processes of rural livelihood systems practiced by the Shona living in the arid southeastern region of Zimbabwe. It shows how these households that participate in that livelihood system and respond to the shocks and stresses associated with HIV/AIDS. During fieldwork in 2004 and 2005, this region underwent a severe and prolonged drought resulting in the widespread loss of staple crops and placing the nation in a declared food emergency. Widespread poverty, stigma and an inadequate health care system further exacerbate the crisis created by HIV infection, limiting the range of household options to access care and nutrition. I propose that HIV/AIDS constitutes a shock or threat to the functioning of a livelihood system and its ability to respond to drought. The analysis investigates a set of mechanisms internal to the Shona livelihood system to show the impacts of HIV/AIDS at the household level. It presents a scenario in which the harsh synergism of drought and HIV/AIDS result in significant loss of livelihood security. Copies of dissertations may be obtained by addressing your request to ProQuest, 789 E. Eisenhower Parkway, P.O. Box 1346, Ann Arbor, MI 48106-1346. Telephone 1-800-521-3042; e-mail: disspub@umi.com"									
1267	"Intestinal parasitic infections in HIV/AIDS patients: epidemiological, nutritional and immunological aspects."	"Amancio FAM, Pascotto VM, Souza LR, Calvi SA, Pereira PCM."	Journal of Venomous Animals and Toxins including Tropical Diseases. 2012;18(2):225-35.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20123235342	"This study applied a socioeconomic questionnaire designed to evaluate the frequency of intestinal parasites and characterize epidemiological, nutritional, and immunological variables in 105 HIV/AIDS patients - with and without parasitic infections, attending the Day Hospital in Botucatu, UNESP, from 2007 to 2008. Body mass index was calculated and the following tests performed: parasitological stool examinations; eosinophil, IgE, CD4<sup>+</sup> T and CD8<sup>+</sup> T lymphocyte cell counts; albumin test; viral load measure; and TNF- alpha , IFN- gamma , IL-2, IL-5 and IL-10 cytokine levels. Results were positive for parasitic intestinal infections in 12.4% of individuals. Most patients had good socioeconomic conditions with basic sanitation, urban dwellings, treated water supply and sewage, good nutritional and immunological status and were undergoing HAART. Parasites were found at the following frequencies: Entamoeba - five patients (38.5%), Giardia lamblia - four (30.7%), Blastocystis hominis - three (23.0%), Endolimax nana - two (15.4%), and Ascaris lumbricoides - one (7.7%). There were no significant differences between the two groups for eosinophils, albumin, IgE, CD4<sup>+</sup> T and CD8<sup>+</sup> T lymphocytes, INF- gamma , IL-2, or IL-10. Most patients also showed undetectable viral load levels. Significant differences were found for TNF- alpha and IL-5. These results show the importance of new studies on immunodeficient individuals to increase understanding of such variables."									
1463	"Association of body mass index of HIV-1-infected pregnant women and infant birth weight, body mass index, length, and head circumference: the National Institute of Child Health and Human Development International Site Development Initiative Perinatal Study."	"Cruz MLS, Harris DR, Read JS, Mussi-Pinhata MM, Succi RCM."	Nutrition Research. 2007 November;27(11):685-91.		"This study assessed the relationship between the body mass index (BMI) of HIV-1-infected women and their infants' perinatal outcomes. The study population was composed of women enrolled in the National Institute of Child Health and Human Development International Site Development Initiative Perinatal Study, with data allowing calculation of their BMI adjusted for length of gestation (adjBMI), who delivered singleton infants. Outcome variables included infant growth parameters at birth (weight, BMI, length, and head circumference) and gestational age. Among the 697 women from Argentina, the Bahamas, Brazil, and Mexico who were included in the analysis, adjBMI was classified as underweight for 109 (15.6%), as normal for 418 (60.0%), as overweight for 88 (12.6%), and as obese for 82 (11.8%). Median infant birth weight, BMI, length, and head circumference differed significantly according to maternal adjBMI (P <= .0002). Mothers who were underweight gave birth to infants with lower weight, lower BMI, shorter length, and smaller head circumference, whereas infants born to mothers who were of normal weight, overweight, and obese were of similar characteristics. 2007 Elsevier Inc. All rights reserved."									
708	"Body mass index and mid upper arm circumference measurement at the HIV/AIDS clinic in Saint Peter's Hospital, Addis Ababa, Ethiopia."	"Nekatebeb H, Taffese S, Sherefa Z."	FASEB Journal. 2010 April;24.		"This study compared body mass index (BMI) with MUAC for HIV/AIDS patients attending a clinic in Addis Ababa, Ethiopia. All 157 HIV/AIDS patients attending the clinic for two weeks in June, 2008, were assessed using both BMI and MUAC. Measurements for MUAC and BMI were correlated (r: 0.62, p<0.001). However, BMI classified 79.6% of the study subjects as normal (>=18.5 kg/m<sup>2</sup>) while 90% were classified as normal (>=21 cm) by MUAC. Moreover, BMI identified 3.8% each of patients as moderately and severely malnourished while only 1.9% were classified as moderately malnourished by MUAC. No patient was classified as severely malnourished by MUAC. This shows that MUAC under classifies subjects as malnourished compared to BMI. Using MUAC alone might reduce targeting the truly malnourished cases which supposedly should receive nutritional care services. Thus, it is recommended that the current approach of using BMI for assessing nutritional status of HIV/AIDS patients be continued until the two approaches are properly validated in terms of outcomes and are perhaps adjusted for future use."									
232	Nutritional status of young children in AIDS-affected households and controls in Uganda.	"Bridge A, Kipp W, Jhangri GS, Laing L, Konde-Lule J."	American Journal of Tropical Medicine & Hygiene. 2006;74(5):926-31.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=16687705	"This study conducted in Uganda assessed the nutritional status of young children and their disease history in the 3-month period before the study. Two groups of children were randomly selected: the first group consisted of 105 children living in homes where a family member fell sick of AIDS, whereas the second group consisted of 100 children who were living in homes where nobody was affected by AIDS. Acute malnutrition (wasting) was rare. There was no difference in the severity of stunting in the two groups (Z scores, -2.1 versus -2.2, P = 0.70). In those children living in AIDS-affected homes, disease episodes were longer (15.7 versus 11.3 days, P = 0.014), but the frequency of disease occurrence was similar in both groups. Fifty-five percent of all children suffered from moderate to severe malnutrition (stunting). The high stunting rate in early childhood suggests a public nutritional intervention program is recommended."									
279	"Growth in early childhood in a cohort of children born to HIV-1-infected women from Durban, South Africa."	"Bobat R, Coovadia H, Moodley D, Coutsoudis A, Gouws E."	Annals of Tropical Paediatrics. 2001;21(3):203-10.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=11579858	"This study describes growth in a cohort of black South African children born to HIV-1-infected women in Durban. Children born to HIV-1-seropositive women were followed up from birth to early childhood. At birth and at each visit, growth parameters were measured. Mean Z-scores were calculated for weight-for-length, weight-for-age and length-for-age and, if they were low, the children were regarded as wasted, malnourished or stunted, respectively. At the end of the study, there were 48 infected and 93 uninfected children. There were no significant differences between the two groups at birth. Thereafter, the infected group was found to have early and sustained low mean Z-scores for length-for-age and weight-for-age but not for weight-for-length. The means reached significance at ages 3, 6 and 12 months for length and at 3, 6 and 9 months for weight. Infected children who died early had more severe stunting, wasting and malnutrition than infected children who survived. Infected children born to HIV-positive women have early and sustained stunting and are malnourished but not wasted. Children with rapidly progressive disease have both stunting and wasting and are more severely affected. Early nutritional intervention might help prevent early progression or death in HIV-infected children, particularly in developing countries without access to anti-retroviral therapy in state hospitals."									
1211	Factors associated with suboptimal intake of some important nutrients among HIV-positive pregnant adolescents from two Ghanaian districts.	"Laar AK, Ampofo WK, Tuakli JM, Wonodi C, Asante RK, Quakyi IA."	Journal of the Ghana Science Association. 2009;11(2).	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20133012683	"This study determined the daily intakes of some important nutrients and factors associated with the suboptimal intakes of these nutrients among young HIV-positive (HIV+) pregnant women from two Ghanaian districts. Eighty-five of such women after informed consent were recruited from three hospitals and were interviewed using a structured questionnaire. Dietary intake was quantified using the 24-hour recall technique. Total intake, calculated based on dietary recall, and adequacy of intake, calculated based on intake levels compared to the RDA, were assessed. Factors potentially associated with intake were tested using the Mann Whitney U test. The median daily intakes of the nutrients of interest were as follows: Protein (63.1 g), Vitamin C (106 mg), Zinc (11.7 mg), Iron (22.2 mg), and Selenium (1.4 micro g). The prevalence of inadequacy of these nutrients were: Vitamin C (35.3%), Protein (39.7%), Iron (72.9%), Selenium (97.6%), and Zinc (100%). HIV+women with nausea, vomiting, and oral lesions had significantly lower intakes of Protein, Iron and Zinc (p<0.05). Inadequacy of dietary intake is very prevalent among this group of pregnant women particularly among those with nausea, vomiting, and oral lesions. These conditions could be significant contributors to the burden of nutrient deficiencies among women infected with HIV in this setting. Since deficiencies of these nutrients during pregnancy could lead to adverse pregnancy outcomes, emphasis on the dietary sources of these nutrients such as fish, peas, nuts, kontomire, whole grain cereals, seafood, onions, milk, garlic, alfalfa, mushrooms, and banana should be made during antenatal counseling."									
50	"Declining frequency of blood donation among elites in Maiduguri, Nigeria."	"Ahmed SG, Gamas MG, Kagu MB."	African Journal of Medicine & Medical Sciences. 2006;35(3):359-63.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=17312745	"This study evaluated the causes of declining frequency of voluntary blood donations among educated elites as seen at the blood bank of University of Maiduguri Teaching Hospital, Maiduguri, Nigeria, over the last decade. The number of blood units received from educated elite donors during a 10-year period (1995-2004) at the blood bank were determined and expressed as percentages of total donations collected annually. The reasons for elite donor default were obtained through the use of questionnaires filled by defaulting donors. The proportion of educated elite donations steadily fell from 28% in 1995 to 7% in 2004. Reasons for defaulting from voluntary blood donations included fear for HIV screening in 86.7% of respondents, economic hardship/poor nourishment in 50.6% of respondents, changed address/logistic difficulties in 4.8% of respondents and ill health in 2.4% of respondents. Therefore, the steady fall in the proportion of elite donors over the years was mainly due to fear of HIV screening coupled with economic difficulties. Hence, there is the need to review our donor campaign strategy with respect to predonation counseling for HIV, initiate regular haematinics supplementation for donors and introduce sustainable mobile donor clinic services for distant donors. Further more, there is the need for a functional national blood transfusion service in Nigeria."									
66	Response to antiretroviral therapy in occult hepatitis B and HIV co-infection in West Africa.	"Chadwick D, Stanley A, Sarfo S, Appiah L, Ankcorn M, Foster G, Schwab U, et al."	Aids. 2013 02 Jan;27(1):139-41.		"This study evaluated the outcome of first-line antiretroviral therapy among 35 Ghanaians with occult HBV/HIV co-infection, comparing them over 2 years to 120 patients with HBsAg+ HBV/HIV co-infection and 230 patients without HBV co-infection. Increases in CD4 cell count and BMI were similar, whereas elevations of hepatic transaminases were more frequent in both the occult HBV and HBsAg+ patients. Occult HBV/HIV co-infection appears not to impact adversely on response to antiretroviral therapy in Ghana. 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins."									
1494	"The interplay between socio-demographic variables, nutritional and immune status of HIV-positive/AIDS patients."	"Oguntibeju OO, van den Heever WM, Van Schalkwyk FE."	Pakistan Journal of Biological Sciences. 2007;10(20):3592-8.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=19093467	"This study examined the association between socio-demographic factors (educational level and employment status) and the nutritional and immune status of 35 HIV-positive/AIDS patients at baseline. Assessment of selected macro-and micronutrient dietary intake was done using a validated food frequency questionnaire. Evaluation of anthropometric profiles (body mass index, waist-hip ratio and percentage of body fat) was also evaluated. A questionnaire was applied to obtain information on the educational level and employment status of the patients. The CD4+ T-cell counts and viral loads of the same patients were determined using the flow cytometry and Polymerase Chain Reaction (PCR) method respectively. An association between educational level and dietary intake was significant (p < 0.05) for total dietary fibre, selenium and vitamin C. There was no significant (p > 0.05) association between the two socio-demographic variables (education and employment) and anthropometric profiles. The association between education, employment and CD4+ T-cell count was not significant (p > 0.05). The viral load showed a significant (p < 0.05) association with employment status but not correlated with education. The sample size or certain inherent biological and social factors probably affected the outcomes of the interplay between the two selected socio-demographic factors and the nutritional and immune status. It is suggested that the results of this study should be interpreted with caution. Further studies with larger sample sizes are recommended."									
1496	"The interplay between socio-demographic variables, nutritional and immune status of HIV-positive/AIDS patients."	"Oguntibeju OO, Van Den Heever WMJ, Van Schalkwyk FE."	Pakistan Journal of Biological Sciences. 2007 15 Oct;10(20):3592-8.		"This study examined the association between socio-demographic factors (educational level and employment status) and the nutritional and immune status of 35 HIV-positive/AIDS patients at baseline. Assessment of selected macro-and micronutrient dietary intake was done using a validated food frequency questionnaire. Evaluation of anthropometric profiles (body mass index, waist-hip ratio and percentage of body fat) was also evaluated. A questionnaire was applied to obtain information on the educational level and employment status of the patients. The CD4<sup>+</sup>T-cell counts and viral loads of the same patients were determined using the flow cytometry and Polymerase Chain Reaction (PCR) method respectively. An association between educational level and dietary intake was significant (p<0.05) for total dietary fibre, selenium and vitamin C. There was no significant (p>0.05) association between the two socio-demographic variables (education and employment) and anthropometric profiles. The association between education, employment and CD4 <sup>+</sup>T-cell count was not significant (p>0.05). The viral load showed a significant (p<0.05) association with employment status but not correlated with education. The sample size or certain inherent biological and social factors probably affected the outcomes of the interplay between the two selected socio-demographic factors and the nutritional and immune status. It is suggested that the results of this study should be interpreted with caution. Further studies with larger sample sizes are recommended. 2007 Asian Network for Scientific Information."									
886	A locally produced nutritional supplement in community-based HIV and AIDS patients.	"Oguntibeju O, van den Heever WM, Van Schalkwyk FE."	International Journal of Palliative Nursing. 2007;13(4):154-62.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=17551418	"This study examined the potential effect of a nutritional supplement on the anthropometric profiles (body measurements such as body mass index [BMI], fat percentage and waist-hip ratio) of HIV-positive/AIDS patients and the correlation between anthropometric profile, CD4+T cell count and viral load. At baseline, of the 35 patients recruited into the study, 32 (94.1%) showed a fat percentage below normal range. Twenty-four of the patients (68.6%) had a BMI within normal range, while a greater percentage of the patients had a normal waist-hip ratio. Of the 28 patients that completed the study, 26 (96.3%) reported a fat percentage of below 18.5%. The results showed that 19 (67.9%) of the 28 patients had a BMI within the normal range after nutrient intervention. There was a significant positive correlation between the BMI and fat percentage. At the end of the study the CD4+T cell count showed no correlation with any of the anthropometric indices while the viral load showed a significant negative correlation with the lean body mass and BMI. The short duration of the study probably limited the positive trend of the supplement."									
800	It Really Opened My Eyes: The Effects on Youth Peer Educators of Participating in an Action Research Project.	"Goto K, Pelto GH, Pelletier DL, Tiffany JS."	Human Organization. 2010 Jul 2010;69(2):192-9.	http://search.proquest.com/docview/754040604?accountid=26724	"This study explored the effects of participating in action research on youth leaders who were already engaged in peer education activities related to HIV/AIDS. We focused particularly on effects related to their conceptualization of teaching/learning, but also cast a wider net to identify other changes. A first round of in-depth interviews was conducted with 21 youth peer educators, who led the participatory action research (PAR) in UNICEF's ""Every Adolescent Has a Right to Know""(RTK) initiative in a Caribbean setting. Some months later, follow-up interviews were used to explore specific topics as their activities progressed. Observational data were also collected. The interviews were taped, transcribed, and coded for specific themes. The study results suggest that the PAR project fostered the reconceptualization of peer education, including an appreciation for the value of local knowledge, the importance of using a needs-based approach in peer education, and the value of two-way communication in educational activities. It also documented perceived changes in self-confidence, competence, and skills. Another finding, consistently emphasized by the youth leaders, was the development of networks among themselves and their organizations and broadening of the focus of their organizational activities. Adapted from the source document."									
1188	Incidence of fungal contamination of tablets available in Dar Es Salaam market-Tanzania.	Mwambete KD.	Journal of Pharmacy Research. 2011;4(3):868-70.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20113163942	"This study intended to assess the incidence of microbial contaminants in solid dosage forms (tablets) dispensed from large container packages used in community and hospital pharmacies. The findings could provide baseline data on the common bio-degrading microorganisms associated with tablets and to highlight the health implications of such contaminants, and thus stressing on the roles of pharmacists in safe guarding the pharmaceuticals. This is a pioneer study in Tanzania, despite the presence of common predictive features in our health facilities of existence of such microbial contaminants. Because of the changes in disease patterns due to HIV/AIDS pandemic and other emerging diseases, potential health hazards to which patients are exposed, through microbial contamination of such tablets can not be overemphasized. The study involved selection of representative tablets of vitamin B complex, ascorbic acid, folic acid, quinine, ferrous sulphate and paracetamol from public hospitals and community pharmacies in Dar es Salaam City. Constitutive microorganisms were isolated and enumerated by using spread-plating count and enrichment/macrodilution techniques. A total of 67 different batches of tablets were analyzed, only 2 batches of Paracetamol were microbiologically contaminated with Aspergillus (6.05x10<sup>1</sup> cfu/ml) and Penicillium species (3.63x10<sup>1</sup> cfu/ml). Macrodilution revealed relatively higher number of contaminants than direct plating count technique. The study has revealed low incidences (2%) of fungal contamination of tablets in factory sealed containers; of which ants were intermediately susceptible to commonly used antifungal agents."									
1382	Role of vitamin deficiency in pancytopenia in Djibouti. Findings in a series of 81 consecutive patients.	"Lavigne C, Lavigne E, Massenet D, Binet C, Bremond JL, Prigent D."	Medecine Tropicale. 2005;65(1):59-63.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh3&AN=20053078137	"This study investigated the causes of pancytopenia among 81 hospitalized patients (56 men and 25 women) from Djibouti. Mean haemoglobin, leukocyte, and platelet levels were 56.5+or-22.7, 2.1+or-0.7, and 56.2+or-24.7 g/litre, respectively. Vitamin deficiency was the most common cause of pancytopenia (49%), followed by hypersplenism (9%), human immunodeficiency virus infection (6%), and leishmaniasis (6%). Patients with vitamin deficiency had significantly more severe anaemia and thrombopenia, and higher mean corpuscular volume than other pancytopenic patients. Low haemoglobin (<40 g/litre) and platelet (<35 g/litre) levels showed positive predictive values of 90 and 100%, respectively, for vitamin-deficient pancytopenia. It is concluded that immediate vitamin supplementation is an effective treatment strategy for this health problem."									
506	Study on the quality of life and its influencing factors of AIDS patients with hypohemoglobinemia caused by ARV drug.	"Liu Z, Jin Y, Liu H, Guo H, Jiang Z."	Chinese Journal of Dermatovenereology; 2012.  14 ref;26(3):226-8.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20123143550	"This study investigated the factors affecting the quality of life (QOL) of HIV/AIDS patients with hypohaemoglobinaemia caused by antiretroviral (ARV) drug therapy. The quality of life of 71 HIV/AIDS patients with hypohaemoglobinaemia from Henan Province, China was evaluated by calculating QOL scores for total and 6 domains of WHOQOL-HIV-BREF questionnaire (Chinese version). ANOVA and multiple linear regression models were used to analyse the factors influencing QOL of HIV/AIDS patients. ANOVA showed that gender, age, education, marital status, body mass index, and CD4+ T lymphocyte counts had significant influence on QOL scores. Multiple linear regression analysis showed that the score of subjective impressions correlated with gender, the score of psychological domain correlated with the age and CD4+ T lymphocyte counts, and the score of independent domain, social domain and total domains of QOL were influenced by CD4+ T lymphocyte counts (P<0.05). It is concluded that numerous factors synchronously influence the QOL of HIV/AIDS patients with ARV-related hypohaemoglobinaemia. Treatment to increase CD4+ T lymphocyte counts may be one of effective ways to improve the QOL of HIV/AIDS patients."									
56	The impact of HIV/AIDS on food security and household vulnerability in Swaziland.	"Masuku MB, Sithole MM."	Agrekon. 2009;48(2):200-21.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20093266565	"This study investigated the impact of HIV/AIDS on food security and household vulnerability in Swaziland. Personal interviews with 847 selected farming households revealed an increase in sales of crops and livestock to finance funerals and healthcare, a decrease in expenditure on agricultural inputs, and an increase in expenditure on medical bills and funerals. Most households were vulnerable to food insecurity. The affected households therefore need assistance in order to maintain food production and security, including support in the form of agricultural inputs such as fertilisers and seeds through the markets and special arrangements to allow them access to affordable inputs. Therapeutic feeding and home based care will be needed for the chronically ill in vulnerable households."									
1689	Counsellors' Perspectives on Antenatal HIV Testing and Infant Feeding Dilemmas Facing Women with HIV in Northern Tanzania.	"Manuela de Paoli M, Manongi R, Klepp K-I."	Reproductive Health Matters. 2002 Nov 2002;10(20):144-56.	http://search.proquest.com/docview/60478448?accountid=26724	"This study investigated the infant feeding advice that counselors were giving HIV-infected pregnant women in Moshi, Tanzania, the factors they thought had an impact on women's infant feeding choices, & their role in influencing these decisions. The data are drawn from in-depth interviews with 16 nurses working as counselors in their spare time in an antenatal trial of prevention of mother-to-child transmission, five local HIV/AIDS counselors & two medical doctors, whose counseling experience ranged from less than six months to nine years. Informed choice of infant feeding method by HIV-infected women, as recommended by UNAIDS/WHO/UNICEF Guidelines, was seriously compromised by the actual advice given, directive counseling, lack of time to cope with a positive HIV test result, & lack of follow-up support, regardless of socioeconomic status. Infant feeding options were not always accurately explained, but counselors believed most women had little choice but to breastfeed & were unlikely to exclusively breastfeed, despite advice. It was apparent that the risks & benefits of the options open to HIV-infected women were complicated for the counselors, not only the women. Counselors needed additional training in nondirective counseling & infant feeding options to ensure a better quality of advice-giving & support to follow-up women at home. 1 Table, 52 References. Adapted from the source document."									
1718	The shape of the HIV/AIDS epidemic in Puerto Rico.	"Gomez MA, Fernandez DM, Otero JF, Miranda S, Hunter R."	Revista Panamericana de Salud Publica/Pan American Journal of Public Health. 2000;7(6):377-83.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh3&AN=20002016975	"This study presents information on AIDS patients in Puerto Rico, including their general sociodemographic profile, some risk-related parameters, characteristics of vulnerable groups, and elements of the clinical spectrum of the disease. Data were analysed from the Puerto Rico AIDS Surveillance Program and available studies about the HIV/AIDS epidemic in Puerto Rico. A total of 23 089 AIDS cases was reported to the Puerto Rico AIDS Surveillance Program from January 1981 through February 1999. The HIV/AIDS epidemic has affected mostly males and females between the ages of 30 and 49, though cases have also been reported for other age groups. The cumulative proportion of persons with AIDS who are women has increased tremendously, from 11.4% for the 1981-1986 period to 21.6% for the entire 1981-1999 period. In Puerto Rico the category of injecting drug users (IDUs) accounts for the majority of the AIDS cases (52%), followed by heterosexual contact (22%), and men who have sex with men (17%). The three main diagnoses for AIDS on the island are wasting syndrome (30.7%); oesophageal, bronchial, and lung candidiasis (29.4%); and Pneumocystis carinii pneumonia (26.8%). According to 1994 vital statistics for Puerto Rico, AIDS was the fourth-leading cause of death. The overall reported AIDS mortality rate was 42.0 per 100 000 persons, with the rate for males, 67.8, much higher than it was for females, 17.4. AIDS is the first cause of death among persons between 30 and 39 years old. Intense efforts are needed to better understand the epidemic in Puerto Rico and its biology, social and family impacts, and financial costs."									
843	Strategies for living with the challenges of HIV and antiretroviral use in Zambia.	"Jones D, Zulu I, Mumbi M, Chitalu N, Vamos S, Gomez J, Weiss SM."	International Electronic Journal of Health Education. 2009;12:253-70.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20103080502	"This study sought to identify strategies for living with the challenges of HIV and antiretroviral (ARV) use among new medication users in urban Zambia. Participants (n=160) were recruited from urban Lusaka, Zambia. Qualitative Data was drawn from monthly ARV treatment education intervention groups addressing HIV and antiretroviral use. Themes included community stigma, nutrition, social support and HIV/ARV knowledge, concerns and beliefs. Strategies for adherence included family, friends, and community organizations that provided emotional and financial support regarding medication, feelings of depression, help with household duties, transportation and companionship at clinic visits and assistance during illness. Social support was the most frequent strategy in coping with ARV use. Challenges included learning to take medications regularly (51%), remembering information about medication (29%), clinic wait times (24%), timing of doses (28%), transportation (23%), food (23%) and lack of social support (23%). Results highlight needed programs to support nutritional supplementation and reduce stigma and the utility of support groups targeting new ARV users to enhance health and encourage sharing of challenges and solutions for consistent ARV use. Strategies for the establishment of health behaviors supporting medication use early in ARV prescription are presented as an important element in long term adherence."									
9	"Local knowledge of, and responses to, HIV-1/AIDS among the Turkana of Lodwar Township."	Owiti JA. 			"This study used a broad theoretical framework encompassing an ecosystem approach to HIV-1/AIDS that investigated: local knowledge of HIV-1/AIDS and other sexually transmitted infections (STIs); local knowledge of the nexus between HIV-1/AIDS and tuberculosis on one hand, and other STIs on the other; the factors of the ecosystem that influence the contraction and transmission of HIV-1; and the local responses to HIV-1/AIDS among the Turkana of Lodwar Township. The study found that, according to the Turkana's local knowledge of HIV-1/AIDS, other sexually transmitted infections, and tuberculosis, these infections are largely contagious, and are attributed to impersonal and natural causes. In addition, in line with biomedical knowledge, the Turkana's local knowledge emphasises a conceptual link between tuberculosis and HIV-1/AIDS. The study also demonstrates a link between other STIs and HIV-1/AIDS. This has implications for the successful control and prevention of HIV-1, as well as that of all STIs, tuberculosis, and the management of AIDS. In addition, the study demonstrates that factors of the ecosystem such as kaada, video and disco halls, unsafe medical practices, polygamy, banditry, urbanisation, migration and travel, poverty, long-distance truck drivers, military personnel, refugees, the low use of condoms, the gender-accentuated power imbalance, poverty-accentuated commercial sex work, poor sexual health and the prevalence of STIs, widow inheritance, and other sociocultural practices play an influential role in the vulnerability of the Turkana to the contraction and transmission of HIV-1/AIDS. The thesis posits an integrated approach to the prevention of HIV-1 and the management of AIDS that combines structural, public health, and biomedical approaches. In view of this integrated approach, various arenas of interventions are recommended. Some seem obvious, such as HIV-1 counselling and testing, and the development of a more durable healthcare infrastructure. Others are less obvious and concern the empowerment of women, the care of orphans, the training and use of indigenous healers and indigenous birth attendants, home-based care, the promotion of condom use, better nutrition, the provision of a safe working environment for commercial sex workers, socioeconomic development and poverty reduction, health education and mass campaigns, and, finally, the prevention and cure of prevalent, but preventable infections. Copies of dissertations may be obtained by addressing your request to ProQuest, 789 E. Eisenhower Parkway, P.O. Box 1346, Ann Arbor, MI 48106-1346. Telephone 1-800-521-3042; email: disspub@umi.com"									
1880	"Poverty, inequality and health: the challenge of the double burden of disease in a non-profit hospital in rural Ethiopia."	"Accorsi S, Kedir N, Farese P, Dhaba S, Racalbuto V, Seifu A, Manenti F."	Transactions of the Royal Society of Tropical Medicine & Hygiene. 2009;103(5):461-8.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=19157475	"This study was aimed at describing disease patterns in a rural zone of Oromiya region, Ethiopia through a retrospective analysis of discharge records for 22,377 inpatients of St. Luke Hospital, Wolisso, Ethiopia in the period 2005-2007. The leading cause of admission was childbirth, followed by injuries, malaria and pneumonia. Injuries were the leading cause of in-hospital deaths, followed by pneumonia, malaria, cardiovascular disease and AIDS. Vulnerable groups (infants, children and women) accounted for 73.3% of admissions. Most of the disease burden resulted from infectious diseases, the occurrence of which could be dramatically reduced by cost-effective preventive and curative interventions. Furthermore, a double burden of disease is already emerging at the early stage of the epidemiological transition, with a mix of persistent, emerging and re-emerging infectious diseases and increasing prevalence of chronic conditions and injuries. This will lead to fundamental changes in the volume and composition of demand for healthcare, with a more complex case mix and more costly service utilization patterns. The challenge is to address the double burden of disease, while focusing on poverty-related conditions and targeting vulnerable groups. Monitoring disease and service utilization patterns through routine hospital information systems can provide sustainable, low-cost support for evidence-based health practice."									
895	Metabolic and body composition changes after six months of highly active antiretroviral therapy in northern Indian patients.	"Gupta V, Biswas A, Sharma SK."	International Journal of STD & AIDS. 2011;22(1):46-9.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=21364067	"This study was carried out to evaluate the metabolic and body composition changes among northern Indian patients receiving combination antiretroviral therapy (cART). We prospectively studied 68 adult patients at the All India Institute of Medical Sciences hospital, New Delhi. The CD4 count, blood pressure, anthropometry, metabolic and bioelectrical impedance data were collected prior to initiation of cART and six months later. The participants had a mean age of 35.9 years and 57 (84%) were male. Hypertension developed in 10.3%. The body mass index, waist circumference, total body fat and lean body mass increased significantly. The total cholesterol, high-density lipoprotein cholesterol (HDL-c), low-density lipoprotein cholesterol, triglyceride and non-HDL-c increased significantly (P < 0.0001). Diabetes mellitus developed in 2.1%; metabolic syndrome in 19.1% (according to International Diabetes Federation criteria) and 25% (National Cholesterol Education Program--Adult Treatment Panel III criteria). Prolonged survival in the cART era may thus predispose these patients to adverse cardiovascular consequences. To the best of our knowledge, this is the first study of metabolic abnormalities in northern Indian HIV/AIDS patients receiving cART. Larger studies across India with long-term follow-up periods are required to confirm these preliminary findings. We also recommend that frequent biochemical monitoring should be performed in such patients."									
1887	"Weight loss after the first year of stavudine-containing antiretroviral therapy and its association with lipoatrophy, virological failure, adherence and CD4 counts at primary health care level in Kigali, Rwanda."	"van Griensven J, Zachariah R, Mugabo J, Reid T."	Transactions of the Royal Society of Tropical Medicine & Hygiene. 2010;104(12):751-7.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=20889179	"This study was conducted among 609 adults on stavudine-based antiretroviral treatment (ART) for at least one year at health center level in Kigali, Rwanda to (a) determine the proportion who manifest weight loss after one year of ART (b) examine the association between such weight loss and a number of variables, namely: lipoatrophy, virological failure, adherence and on-treatment CD4 count and (c) assess the validity and predictive values of weight loss to identify patients with lipoatrophy. Weight loss after the first year of ART was seen in 62% of all patients (median weight loss 3.1 kg/year). In multivariate analysis, weight loss was significantly associated with treatment-limiting lipoatrophy (adjusted effect/kg/year -2.0 kg, 95% confidence interval -0.6;-3.4 kg; P<0.01). No significant association was found with virological failure or adherence. Higher on-treatment CD4 cell counts were protective against weight loss. Weight loss that was persistent, progressive and/or chronic was predictive of lipoatrophy, with a sensitivity and specificity of 72% and 77%, and positive and negative predictive values of 30% and 95%. In low-income countries, measuring weight is a routine clinical procedure that could be used to filter out individuals with lipoatrophy on stavudine-based ART, after alternative causes of weight loss have been ruled out. Copyright 2010 Royal Society of Tropical Medicine and Hygiene. Published by Elsevier Ltd. All rights reserved."									
1895	High prevalence of lipoatrophy among patients on stavudine-containing first-line antiretroviral therapy regimens in Rwanda.	"van Griensven J, De Naeyer L, Mushi T, Ubarijoro S, Gashumba D, Gazille C, Zachariah R."	Transactions of the Royal Society of Tropical Medicine and Hygiene. 2007 August;101(8):793-8.		"This study was conducted among individuals placed on WHO-recommended first-line antiretroviral therapy (ART) at two urban health centres in Kigali, Rwanda, in order to determine (a) the overall prevalence of lipodystrophy and (b) the risk factors for lipoatropy. Consecutive individuals on ART for >1 year were systematically subjected to a standardised case definition-based questionnaire and clinical assessment. Of a total of 409 individuals, 370 (90%) were on an ART regimen containing stavudine (d4T), whilst the rest were receiving a zidovudine (AZT)-containing regimen. Lipodystrophy was apparent in 140 individuals (34%), of whom 40 (9.8%) had isolated lipoatrophy, 20 (4.9%) had isolated lipohypertrophy and 80 (19.6%) had mixed patterns. Fifty-six percent of patients reported the effects as disturbing. The prevalence of lipoatrophy was more than three times higher when taking d4T compared with AZT-containing regimens (31.4% vs. 10.3%). Being female, d4T-based ART, baseline body mass index >=25 kg/m<sup>2</sup> or baseline CD4 count >=150 cells/mul and increasing duration of ART were all significantly associated with lipoatrophy. Lipoatrophy appears to be an important long-term complication of WHO-recommended first-line ART regimens. These data highlight the urgent need for access to more affordable and less toxic ART regimens in resource-limited settings. 2007 Royal Society of Tropical Medicine and Hygiene."									
854	"Special Issue: Development and use of the Lives Saved Tool (LiST): a model to estimate the impact of scaling up proven interventions on maternal, neonatal and child mortality. (Special Issue: Development and use of the Lives Saved Tool (LiST): a model to estimate the impact of scaling up proven interventions on maternal, neonatal and child mortality.)."		International Journal of Epidemiology. 2010;39(Suppl. 1):i1-i205.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20103110277	"This supplement chronicles the development and recent use of the Lives Saved Tool (LiST), a user-friendly computer programme used to estimate the impact of childhood interventions on the survival of children younger than 5 years of age, especially in low-income countries. It includes 20 articles presenting the underlying modelling approach used to develop the LiST, reviews of specific intervention effectiveness incorporated into the programme, and examples of LiST predictions compared to observed results. The topics discussed are: linking maternal and child survival interventions with AIDS, family planning and demographic projections; neonatal mortality impacts of community-based intervention trials in South Asia; guidelines for Child Health Epidemiology Reference Group (CHERG) reviews of intervention effects on child survival; mortality reductions after an accelerated child survival programme in West Africa; LiST as a catalyst in programme planning in Burkina Faso, Ghana and Malawi; effectiveness of measles vaccination and vitamin A treatment; effect of rotavirus vaccine on diarrhoea mortality; effect of zinc treatment on diarrhoea morbidity, mortality and incidence of future episodes; antibiotic treatment of dysentery in children; effect of oral rehydration solution and recommended home fluids on diarrhoea mortality; protective efficacy of interventions for preventing malaria mortality in children in Plasmodium falciparum endemic areas; tetanus toxoid immunization to reduce mortality from neonatal tetanus; folic acid to reduce neonatal mortality from neural tube disorders; antenatal steroids in preterm labour for the prevention of neonatal deaths due to complications of preterm birth; use of antibiotics for pre-term pre-labour rupture of membranes to prevent neonatal deaths due to complications of pre-term birth and infection; 'kangaroo mother care' to prevent neonatal deaths due to preterm birth complications; effect of case management on childhood pneumonia mortality in Developing Countries; effect of Haemophilus influenzae type b and pneumococcal conjugate vaccines on childhood pneumonia incidence, severe morbidity and mortality; mortality rates among children under-five according to wealth in Bangladesh; and water, sanitation and hygiene for the prevention of diarrhoea."									
1737	"Nutrition Congress 2006: 21st Biennial Congress of the Nutrition Society of South Africa and 9th Biennial Congress of the Association of Dietetics of South Africa, Port Elizabeth, South Africa, 24-27 September, 2006."		SAJCN South African Journal of Clinical Nutrition. 2006;19(3(Supplement):S1-S28.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20063204081	This supplement contains 102 abstracts of papers presented at the congress. The topics discussed are: combating micronutrient malnutrition in South Africa; HIV and nutrition; integrated nutrition programmes; nutrition through life cycle; nutrition and human rights; dietary intake and nutrition education; evidence-based nutrition research; nutrition in transition; palliative care and ethics; antioxidants and supplementation; functional foods; nutrition and prevention/management of chronic diseases; link between cardiovascular disease (CVD) risk factors and dementia; nutritional needs and supplementation of endurance athletes; allergies; nutrigenomics and CVD; healthy lipids; hygiene HACCP; training people in the workplace; legislation and dietetics practice and services.									
1447	"Nutrition and HIV/AIDS. Report of the 29th Session Symposium, Nairobi, Kenya, 3-4 April 2001. (Nutrition Policy Paper No.20)."		Nutrition and HIV/AIDS. 2001(2001.):ii + 76 pp. many ref.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh3&AN=20023000392	This supplement contains six papers presented at a conference. Topics covered are: achievements of The AIDS Support Organization in Uganda; human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) and development as unsolved challenges in Africa; impact of food and nutrition security on HIV/AIDS; nutrition and improved care; implications of HIV/AIDS for nutrition programmes; using women's insights to guide policies on infant feeding options for mothers with HIV.									
733	"Special issue: Child nutrition in vulnerable populations in Eastern and Southern Africa, 2000-2006. (Special Issue: Child nutrition in vulnerable populations in Eastern and Southern Africa, 2000-2006.)."	"Mason J, Mebrahtu S, Horjus P."	Food and Nutrition Bulletin. 2010;31(3):S209-S86.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20103335780	"This supplement focuses on the status of and factors that affect child nutrition in Eastern and Southern Africa. Articles address drought and human immunodeficiency virus (HIV) infections, acquired immune deficiency syndrome (AIDS), wasting, mortality estimates, emergency interventions, orphanhood, food security, and nutrition information systems."									
1928	"Abstracts from 3rd Symposium on Research in International Health ""Research for Better Health"", Amsterdam, Netherlands, May 19, 2004."		Tropical Medicine and International Health. 2005;10(2):A1-A9.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh3&AN=20053023256	"This supplement presents 25 abstracts with topics on various fields of international health research from Developed and Developing Countries. The topics covered are: improvement of primary health care for youths and adults with respiratory diseases; international aid to strengthen health services; poverty reduction; risk factors, cost of treatment, disease course and maternal transmission of human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS); epidemiology and risk factors of dengue; incidence, treatment and reinfection rate after treatment of tuberculosis, as well as coinfection with HIV; undernutrition and micronutrient supplementation; diagnostic service delivery for chronic obstructive pulmonary disease; quality of life of adults with respiratory diseases; sexual and reproductive health needs and rights of women displaced by war and armed conflicts; transmission of herpes simplex virus 2; impact of changes in obstetric and neonatal care on perinatal and neonatal mortality in rural areas; relationship between umbilical cord clamping and infant anaemia; sociocultural aspects of female genital mutilation; drug therapy for Plasmodium falciparum malaria; and, diagnostic value of disease markers of leprosy."									
1114	A workshop on micronutrients and infectious diseases: cellular and molecular immunomodulatory mechanisms.	"Taylor CE, Higgs ES."	Journal of Infectious Diseases. 2000;182(Suppl. 1):0-s143.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh3&AN=20003003822	"This supplement presents the proceedings of a workshop on micronutrients and infectious diseases held on 16 and 17 September 1999 in Bethesda, Maryland, USA. Topics discussed are thoughts on integration of mechanistic approaches into micronutrient research, role of micronutrients on natural immunity, effects of lycopene and lutein supplementation on the expression of functionally associated surface molecules on blood monocytes from healthy nonsmokers, variations in the cell cycle status of lymphopoietic and myelopoietic cells created by zinc deficiency, correlation between gut integrity and vitamin A status in Gambian and Indian infants, synergistic action of retinoic acid and polyriboinosinic acid to enhance the antibody response to tetanus toxoid during vitamin A deficiency, nutritional modulation of malaria morbidity and mortality, individual effects of eicosapentaenoic acid and docosahexaenoic acid on interleukin 12 production in mice, effects of zinc deficiency on Th1 and Th2 cytokine shifts, selenium and interleukins in persons infected with human immunodeficiency virus type 1, effects of age and antioxidant supplementation on resistance to influenza infection, regulation of cysteine-rich intestinal protein by mediators of the immune response, role of intracellular zinc depletion on activation of caspase-3 and caspase-6 and the cleavage of p21 in various cell lines, host nutritional status and its effect on a viral pathogen, effects of dietary n-3 fatty acids on T cell activation and T cell receptor-mediated signalling in a murine model, phenotypic and functional considerations in the evaluation of immunity in nutritionally compromised hosts, effect of transfusional iron overload on immune response, implications of vitamin A supplementation on mortality and morbidity in children and the National Institutes of Health agenda for international research in micronutrient nutrition and infection interactions."									
1360	Special Issue: Repositioning children's right to adequate nutrition in the Sahel - situational analysis. (Special Issue: Repositioning children's right to adequate nutrition in the Sahel - situational analysis.).		Maternal and Child Nutrition. 2011;7(s1):1-185.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20113110902	"This supplement presents the situational analysis of infant and young child nutrition (IYCN) policies and programmatic activities in selected countries in the Sahel region, including Burkina Faso, Chad, Mali, Mauritania, Niger and Senegal. Following the executive summary, an introductory paper reviews current information concerning the nutritional and health status of infants and young children in the region and summarizes international guidelines on optimal IYCN practices. The next 6 papers presents the situational analysis of national policies and strategies, research activities, training materials and curricula, programme guidelines, survey results, and monitoring and evaluation reports in each of the selected countries in relation to infant and young child feeding practices, prevention of micronutrient deficiencies, and other nutritional support (management of acute malnutrition, prevention of maternal transmission of HIV through feeding practices, food security and hygiene and sanitation). The last paper discusses the notable progress and substantial gaps in existing IYCN related activities and outlines measures to ensure the success of these activities, aiming to reduce malnutrition and provide optimal nutrition in children."									
1883	HIV prevalence and mortality among children undergoing treatment for severe acute malnutrition in sub-Saharan Africa: a systematic review and meta-analysis.	"Fergusson P, Tomkins A."	Transactions of the Royal Society of Tropical Medicine & Hygiene. 2009;103(6):541-8.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=19058824	"This systematic review and meta-analysis explored HIV prevalence and mortality in children undergoing treatment for severe acute malnutrition (SAM) in sub-Saharan Africa. It included all studies reporting on HIV infection within a sample of children with SAM where HIV status was assessed using a blood test and SAM was defined using the WHO, Gomez, Wellcome or Waterlow definitions. Children from 17 studies were included in the analysis (n=4891), of whom 29.2% were HIV-infected. HIV-infected children were significantly more likely to die than HIV-uninfected children (30.4% vs. 8.4%; P<0.001; relative risk=2.81, 95% CI 2.04-3.87). HIV-negative children treated within community-based therapeutic care (CTC) programmes had lower mortality (4.3%) than those treated within an inpatient nutrition rehabilitation unit (NRU) (15.1%). There was no significant difference in mortality for HIV-infected children with SAM treated in the CTC (30.0%) or NRU (31.3%) settings. HIV prevalence is high in children with SAM in sub-Saharan Africa, and HIV-infected children are at significantly increased risk of mortality. There is an urgent need to integrate HIV testing and treatment into care for children with SAM in regions of high HIV prevalence. [References: 50]"									
2	"Harvesting health: Fertilizer, nutrition and AIDS treatment in Kenya."	Chakravarty S. 			"This thesis explores various policy options for mitigating food insecurity among patients receiving treatment for HIV/AIDS. The first chapter examines the impact of a fertilizer provision program that targets farming households in which one or more members is currently receiving treatment for AIDS. The study enrolled 540 patients, of which half were selected to receive free fertilizer for the 2007 planting season. I find that treated households planted a larger acreage and produced 350 more kilograms of maize than control households, an increase of 40% worth about 88 USD. Treated households used the increased income from crop sales to invest in livestock and purchase 80% more fertilizer than the control group in the subsequent planting season. The second chapter extends the analysis of the impact of the fertilizer program to examine health outcomes of program participants. Fertilizer recipients, who concurrently received free anti-retroviral therapy (ART), experienced significant health improvements. Fertilizer provision improved the health status of treated individuals, as measured by both body mass index (BMI) and CD4 cell count. In the third chapter, I examine the impact of direct food distribution on the clinical outcomes of patients receiving ART at one clinic within the USAID-AMPATH partnership in western Kenya. The nutrition supplementation program began in 2004 and targeted patients with low Body Mass Index (BMI) and severe immunological suppression, as measured by CD4 cell count. Of the 1977 patients who initiated ART at this clinic, 548 participated in the food supplementation program. Results indicate that while both groups respond equally well to ART, the addition of food does not appear to significantly improve the outcomes of food recipients over the first 18 months of treatment. However, these results must be interpreted with caution due to the small sample size of CD4 and BMI measurements beyond the first 6 months of treatment. More rigorous evaluation, preferably with experimental design, of the impact of nutrition programs on the health outcomes of ART patients is needed. Copies of dissertations may be obtained by addressing your request to ProQuest, 789 E. Eisenhower Parkway, P.O. Box 1346, Ann Arbor, MI 48106-1346. Telephone 1-800-521-3042; email: disspub@umi.com"									
1877	Nutritional situation for mothers and children in South Africa. [Norwegian]	Ernaeringssituasjonen for mor og barn i Sor-Afrika.	Iversen PO.		"Tidsskrift for den Norske laegeforening : tidsskrift for praktisk medicin, ny raekke. 2009 25 Jun;129(13):1362-5."									
1875	Malnutrition and infections in children--a destructive interplay with global dimensions. [Norwegian]	Underernaering og infeksjoner hos barn--et destruktivt samspill med globale dimensjoner.	"Bohler E, Wathne KO."		Tidsskrift for den Norske laegeforening. 2000 10 Jun;120(15):1740-5.									
129	"Community-based follow-up for late patients enrolled in a district-wide programme for antiretroviral therapy in Lusaka, Zambia."	"Krebs DW, Chi BH, Mulenga Y, Morris M, Cantrell RA, Mulenga L, Levy J, et al."	AIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV. 2008 March;20(3):311-7.		"Timely adherence to clinical and pharmacy appointments is well correlated with favourable patient outcomes among HIV-infected individuals on antiretroviral therapy. To date, however, there is little work exploring reasons behind missed visits or evaluating programmatic strategies to recall patients. For this study we implemented community-based follow-up of late patients as part of a large-scale programme for HIV care and treatment in Lusaka, Zambia. Through a network of local home-based care organizations, we attempted home visits to recall patients using locator information provided at time of enrolment. Between May and September 2005, home-based caregivers were dispatched to trace 1,343 patients with missed appointments. Of these, 554 (41%) were untraceable because the provided address was invalid, the patient had moved or no one was at the home. Of the remaining 789, 359 (46%) were reported to have died. Only 430 (54% of those traced, 32% overall) were contacted directly and encouraged to return for care. The likelihood of patient return was higher among traced patients in crude analysis (relative risk [RR] = 2.5; 95%CI = 1.9-3.2) and in multivariable analysis controlling for baseline body mass index, sex and CD4 + count <= 50/muL (adjusted RR = 2.3; 95%CI = 1.7-3.2). However, the process was inefficient: one late patient returned for every 18 home visits that were made. Reasons for missed visits were provided in 271 of 430 (63%) of the patients who were successfully traced. Common reasons included feeling too sick to come to the clinic, travelling away from home and being too busy. Despite the availability of free ART in Lusaka, patients face significant barriers to attending scheduled clinical visits. Cost-effective and feasible strategies are urgently needed to improve timely patient follow-up. 2008 Taylor & Francis."									
245	Modeling CD4+ cell count increase over a six-year period in HIV-1-infected patients on highly active antiretroviral therapy in Senegal.	"De Beaudrap P, Etard JF, Diouf A, Ndiaye I, Gueye NF, Gueye PM, Sow PS, et al."	American Journal of Tropical Medicine and Hygiene. 2009 June;80(6):1047-53.		"To assess the extents and determinants of long-term CD4 cell increases after initiation of antiretroviral therapy (ART), changes in CD4 cell counts were analyzed in a cohort of HIV-1-infected Senegalese using a mixed-effects model. After a median follow-up of 54 months, an average of 483 CD4 cells/mm<sup>3</sup> (95% confidence interval [CI] = 331; 680) was reached. The average asymptote level was ~421 cells/mm<sup>3</sup> (95% CI = 390; 454) in patients with < 200 cells/mm<sup>3</sup> at baseline and ~500 cells/mm<sup>3</sup> in patients with > 200 cells/mm<sup>3</sup>. The independent predictors of long-term CD4 cell reconstitution were the baseline. CD4 cell count and the monthly average viral load over the entire follow-up. This good long-term immune reconstitution, optimal in subjects with low average viral loads and > 200 CD4 cells/mm<sup>3</sup> at baseline, argues in favor of the earliest possible access to ART and underlines the importance of strict compliance with the treatment. Copyright 2009 by The American Society of Tropical Medicine and Hygiene."									
1210	Changes in causes of death and associated conditions among persons with HIV/AIDS after the introduction of highly active antiretroviral therapy in Taiwan.	"Lu T, Chang H, Chen L, Chu M, Ou N, Jen I."	Journal of the Formosan Medical Association. 2006;105(7):604-9.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20063160917	"To assess the pattern of change in the causes of death among HIV/AIDS patients in Taiwan after the introduction of highly active antiretroviral therapy (HAART), national HIV/AIDS registry data were linked with cause of death and health insurance claims data from 1994 to 2002 for analysis. Although HIV/AIDS remained the leading underlying cause of death among HIV/AIDS patients during the study period (552/752=73.4%), an increased proportion of deaths was due to non-HIV/AIDS causes (other infectious diseases, cancers, liver diseases, etc.) after the introduction of HAART in 1997. Deaths from suicide increased threefold, from three (1.5% of total) in 1994-1996 to 14 (4.8%) in 2000-2002. Most AIDS-related conditions associated with death (cryptococcosis, cachexia/wasting, dementia/encephalopathy, etc.) decreased in frequency from 1998-2000 to 2001-2002. Nonetheless, some AIDS-related conditions associated with death remained stable or increased in frequency, such as candidosis, tuberculosis, and non-Hodgkin's lymphoma. In conclusion, as the duration of survival increased, the likelihood of suicide also increased. More effort is required to address the mental health of HIV/AIDS patients as a part of therapy."									
894	Can self-reported height and weight be used among people living with HIV/AIDS?	"Duran ACFL, Florindo AA, Jaime PC."	International Journal of STD & AIDS. 2012;23(4):e1-e6.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20123206906	"To assess the reliability and validity of self-reported height and weight in adults living with HIV/AIDS (ALWHA) we assessed 508 ALWHA of both genders on antiretroviral therapy. Height and weight were directly measured in a subsample. Sensitivity and specificity analysis were performed to determine the validity of self-reported measures. Bland-Altman's method was used to calculate the limits of agreement between values while reliability was assessed using intraclass coefficients. Regression equations were devised to determine actual measures from self-reported values. Mean differences among measured and self-reported weight were -0.96 kg for men and -0.54 kg for women. Mean height differences were less than 2 cm, yielding good reliability for body mass index (BMI). Overweight (BMI>=25 kg/m<sup>2</sup>) diagnosis sensitivity was 90.6% and specificity was 81.2%. Corrected measures determined by regression equations had stronger correlation with self-reported values (r>0.980). Self-reported height and weight showed good reliability and validity compared with directly measured height and weight. However, measures should be corrected whenever possible to achieve higher accuracy."									
1385	[AIDS and malnutrition in a pediatric semi-rural milieu of Ivory Coast].	"Mutombo T, Keusse J, Sangare A."	Medecine Tropicale. 1995;55(4):357-9.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med3&AN=8830221	"To assess the role of human immunodeficiency virus (HIV) infection in malnutrition in African children, clinical examination and serologic tests were performed in 183 undernourished children at the Protestant Hospital of Dabou which is located in a semi-urban area of Cote d'Ivoire. Malnutrition was noted in 18% of children admitted to the Pediatric Department including 70.5% with marasmus. Serologic tests were positive for HIV in 46 of the 183 children, i.e. 25.1%. The type of malnutrition was not significantly different in seropositive children. Breast feeding was more common in the seropositive than seronegative group (59% vs 39%) (p<0.05). Follow-up at the nutrition center was poorer quality and less effective in seropositive than seronegative children. The results of this study demonstrate the important role of HIV infection first as a cause and second as an impediment for management of malnutrition in Black Africa."									
1086	Sex differences independent of other psycho-sociodemographic factors as a predictor of body mass index in black South African adults.	"Kruger A, Wissing MP, Towers GW, Doak CM."	"Journal of Health, Population & Nutrition. 2012;30(1):56-65."	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=22524120	"To better understand the sex differences in body mass index (BMI) observed in black South African adults in the Transition and Health during Urbanization of South Africans Study, the present study investigated whether these differences can be explained by the psycho-sociodemographic factors and/or health-related behaviours. A cross-sectional survey was undertaken among 1,842 black South African individuals from 37 study sites that represented five levels of urbanization. The behavioural factors that possibly could have an influence on the outcome of body-weight and that were explored included: diet, smoking, level of education, HIV infection, employment status, level of urbanization, intake of alcohol, physical activity, and neuroticism. The biological factors explored were age and sex. The prevalence of underweight, normal weight, and overweight among men and women was separately determined. The means of the variables were compared by performing Student's t-test for normally-distributed variables and Mann-Whitney U-test for non-normally-distributed variables. The means for the underweight and overweight groups were tested for significant differences upon comparison with normal-weight individuals stratified separately for sex. The differences in prevalence were tested using chi-square tests (p<0.05). All the variables with a large number of missing values were tested for potential bias. The association between sex and underweight or overweight was tested using the Mantel-Haenszel method of odds ratio (OR) and calculation of 95% confidence interval (CI), with statistical significance set at p<0.05 level. Logistic regression was used for controlling for confounders and for testing for effect modification. Females were more likely to be overweight/obese (crude OR=5.1; CI 3.8-6.8). The association was attenuated but remained strong and significant even after controlling for the psycho-sociodemographic confounders. In this survey, the risk for overweight/obesity was strongly related to sex and not to the psycho-sociodemographic external factors investigated. It is, thus, important to understand the molecular roots of sex- and gender-specific variability in distribution of BMI as this is central to the future development of treatment and prevention programmes against overweight/obesity."									
250	Anemia in human immunodeficiency virus-infected and uninfected women in Rwanda.	"Masaisa F, Gahutu JB, Mukiibi J, Delanghe J, Philippe J."	American Journal of Tropical Medicine and Hygiene. 2011 March;84(3):456-60.		"To determine the prevalence and risk factors of anemia among human immunodeficiency virus (HIV) - infected women in Rwanda and the influence of highly active antiretroviral therapy (HAART) on anemia, we analyzed 200 HIV-positive women and 50 HIV-negative women in a cross-sectional study. Clinical examinations and iron and vitamin B<sub>12</sub> assays were performed, and complete blood counts, serum folic acid levels, and CD4 cell count determined. The prevalence of anemia was significantly higher among HIV-positive women (29%) than among HIV-negative women (8%) (P < 0.001). Risk factors for anemia were lower body mass index (odds ratio [OR] = 3.4, 95% confidence interval [CI] = 2.4-4.1), zidovudine use (OR = 1.14, 95% CI = 1.01-1.29), lack of HAART (OR = 1.44, 95% CI = 1.21-1.67), oral candidiasis (OR = 1.4, 95% CI = 1.2-1.6), pulmonary tuberculosis (OR = 1.8, 95% CI = 1.7-2.2), cryptococcal meningitis (OR = 1.6, 95% CI = 1.21-1.8), Pneumocystis jiroveci pneumonia (OR = 1.41, 95% CI = 1.20-1.65) and CD4 lymphocyte count < 200 cells/muL (OR = 2.41, 95% CI = 2.01-3.07). The mean +/- SD hemoglobin level of 10.9 +/- 1.6 g/dL at HAART initiation significantly increased to 12.3 +/- 1.5 g/dL in 8 months (P < 0.001). Anemia increases with HIV stage, and HAART is associated with a significant improvement in hemoglobin levels. Copyright 2011 by The American Society of Tropical Medicine and Hygiene."									
701	"Food security, nutrition and ART adherence in Latin America."	"Martinez H, Lynemmayr S, Ramirez BY, Farias H, Adams J, Derose KP, Smith A."	FASEB Journal. 2012 April;26.		"To develop a culturally appropriate, multi-component nutrition intervention for people living with HIV in Honduras, and test its effect on ART adherence. 401 adults receiving ART who showed household food insecrity and/or undernutrition were recruited from four HIV clinics received nutritional assessment and dietary counseling, and were followed at 0 and 6 months to assess adherence (self-report, pharmacy and clinic records). Randomly, two clinics (intervention) were selected to also receive a supplemental household food basket. At baseline, overall, more than two-thirds missed at least one clinic appointment; over half did not pick up their pharmacy refills on time or reported missed taking their medicine, and; only about half had normal body mass index (BMI). After 6 months 11% of intervention group (both genders) changed BMI to normal, vs. 2% in control group, more evident in men (20% in intervention group improved BMI vs. 0% in the control). 80% of the intervention group showed improvements in coming to the clinic without fail, vs. 50% in control group, and 50% in the intervention group were more timely in picking up their refills on time vs. 25% in the controls. Improvements in nutritional status were significantly correlated with adherence measures (timely drug refill, not stop taking medicine). Our results underscore the importance of nutritional support for people in HIV care for Honduras and other countries."									
937	Clinical and radiological presentation of 340 adults with smear-positive tuberculosis in The Gambia.	"Rathman G, Sillah J, Hill PC, Murray JF, Adegbola R, Corrah T, Lienhardt C, et al."	International Journal of Tuberculosis and Lung Disease. 2003;7(10):942-7.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh3&AN=20033172386	"To document clinical and radiographic presentations of sputum smear-positive tuberculosis in adults, newly diagnosed acid-fast bacilli (AFB) smear, culture-positive tuberculosis patients (aged >=15 years) from Gambia were interviewed and examined, and underwent tuberculin skin testing, HIV testing and chest X-ray reviewed by a chest physician using set criteria. Of 340 patients enrolled (median age 29 years; males 73%), 8.3% were HIV-positive. One-third reported haemoptysis, >90% reported weight loss and fever, and wasting was the most common sign (69%). Crepitations were the most frequent auscultatory finding (41%). The most common radiological lesion was a patchy infiltrate (>90%). Cavitation was present in 206 patients (60.6%), most frequently occurred in the upper lung fields, was associated with increasing bacterial load in the sputum, and was less prevalent in HIV-positive patients (45% vs. 62%; P=0.07). Auscultatory and chest X-ray findings matched only one-third of the time. In our setting, wasting is the most common clinical sign of sputum smear-positive tuberculosis. Auscultatory findings correlate poorly with radiological abnormalities. Cavitation is associated with increasing bacterial load in the sputum, and is therefore a strong indicator for early treatment."									
273	"Body composition of HIV-positive patients with pulmonary tuberculosis: A cross-sectional study in Mwanza, Tanzania."	"Range NS, Malenganisho W, Temu MM, Changalucha J, Magnussen P, Krarup H, Andersen AB, et al."	Annals of Tropical Medicine and Parasitology. 2010 January;104(1):81-90.		"To estimate the weight deficit and body composition of cases of pulmonary TB (PTB), and assess the roles of HIV and the acute-phase response, a cross-sectional study was carried out in Tanzania. Weight, body mass index (BMI), arm muscle area (AMA), arm fat area (AFA) and the serum concentration of the acute-phase protein a1-antichymotrypsin (serum ACT) were evaluated for each of 532 cases of PTB and 150 'non-TB' controls. On average, the female cases of PTB not only weighed 7.8 kg less but also had BMI that were 3.1-kg/m2 lower, AMA that were 14.8-cm2 lower, and AFA that were 7.6-cm2 lower than those seen in the female subjects without TB. Similarly, on average, the male cases of PTB weighed 7.1 kg less and had BMI that were 2.5-kg/m2 lower, AMA that were 18.8-cm2 lower and AFA that were 1.6-cm2 lower than those seen in the male subjects without TB. Although HIV infection was associated with a 1.7-kg lower weight and a 0.6-kg/m2 lower BMI (with deficits in both AMA and AFA) among males, it was not associated with any such deficits among the female subjects. Elevated serum ACT was found to be a negative predictor of BMI, AMA and AFA, partially explaining the effects of the PTB but not those of the HIV. There is need for a better understanding of the determinants and effects of loss of fat and lean body mass in HIV-positive tuberculosis. 2010 The Liverpool School of Tropical Medicine."									
101	"Sexual Behaviours, Perception of Risk of HIV Infection, and Factors Associated with Attending HIV Post-Test Counselling in Ethiopia."	"Sahlu T, Kassa E, Agonafer T, Tsegaye A, De Wit TR, Gebremariam H, Doorly R, et al."	AIDS. 1999 1999 Jul 09;13(10):1263-72.	http://search.proquest.com/docview/61590677?accountid=26724	"To explore sexual behaviors, perception of risk of HIV (human immunodeficiency virus) infection, & factors associated with attending HIV posttest counseling (PTC) among Ethiopian adults, questionnaire & blood test data were obtained on two occasions from 751 factory workers in Addis Ababa, Feb 1997-June 1998. Initially, subjects (Ss) reported high-risk sexual behaviors, yet had low knowledge of individual risk. Male Ss participated in PTC because of their knowledge of HIV infection, past sexual history, or current health status. Female Ss participated because of plans for the future -- marriage &/or children -- rather than past sexual exposure. Only in cases of rape were they willing to learn of their HIV status. 4 Tables, 1 Figure, 26 References. Adapted from the source document."									
702	"Food security, nutrition and HIV/AIDS-overview and context in Bolivia."	"Martinez H, Ramirez B, Palar K, Adams J, Farias H, Green H, Wagner G, et al."	FASEB Journal. 2011 April;25.		"To explore the nutritional status and food security of people with HIV receiving ART in Bolivia, to develop a nutritional counseling and food assistance intervention. Sample: 80 male and female adults attending two urban HIV clinics in Bolivia. Methods: Diet and nutritional intake; household food security; socio-economic characteristics, and; health and ART status and adherence. Results: 85% of households were food insecure, 34% of them severe. Dietary intake was characterized by a slight deficit in total calorie and carbohydrate intake, very low protein intake, and very high fat intake. Deficiencies in micronutrient intake included calcium, folic acid, zinc, magnesium, iron, phosphorus, and the B complex vitamins. Percent body fat showed that almost two thirds of women were overweight and another sixth were underweight; over a third of the men were underweight and only a tenth were overweight. The study population experiences high household food insecurity and poor nutrition, resulting in both obesity and micronutrient malnutrition, especially among women. Interventions should be targeted at the household level and focus on significantly increasing protein and selected micronutrients intake, and moderately increasing carbohydrates and overall calories, while drastically reducing fats, all of which may have significant impact on nutrition, adherence and clinical outcomes."									
1067	"Determinants of CD4 counts among HIV-negative Ethiopians: role of body mass index, gender, cigarette smoking, khat (Catha edulis) chewing, and possibly altitude?"	"Abuye C, Tsegaye A, West CE, Versloot P, Sanders EJ, Wolday D, Hamann D, et al."	Journal of Clinical Immunology. 2005;25(2):127-33.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh3&AN=20053091075	"To study the determinants of CD4% and CD4 counts among HIV-negative Ethiopians, and to identify factors susceptible to explain the low CD4 counts observed among Ethiopian subjects. Cohort studies among factory workers in Akaki and Wonji, Ethiopia. Clinical and laboratory examinations, including determination of HIV serological status and T-cell subsets, were performed during follow-up visits every six months. In addition, micronutrients (retinol, carotenoids, tocopherol, transferrin receptor, and selenium) plasma concentrations were determined in a subset of 38 HIV-positive and 121 HIV-negative participants. HIV-negative participants with at least one CD4 count measurement were 157 females in Akaki, 203 males in Akaki, and 712 males in Wonji. CD4 counts were independently and positively associated with body mass index (through an increase in lymphocyte counts), female gender (through an increase in CD4%), cigarette smoking (through an increase in CD4%), khat chewing (through an increase in both lymphocyte counts and CD4%), and Akaki study site (through a large increase in lymphocyte counts compensating a decrease in CD4%). Intestinal parasitic infections were not associated with CD4% or CD4 counts. Retinol, carotenoids, and alpha -tocopherol plasma concentrations decreased with HIV infection and advancing immunosuppression, but were not associated with CD4 counts among HIV-negative subjects. Low body mass index among Ethiopians may have contributed to their overall low CD4 counts. Other factors remain to be elucidated."									
1029	Micronutrient supplementation increases genital tract shedding of HIV-1 in women: results of a randomized trial.	"McClelland RS, Baeten JM, Overbaugh J, Richardson BA, Mandaliya K, Emery S, Lavreys L, et al."	Journal of Acquired Immune Deficiency Syndromes: JAIDS. 2004;37(5):1657-63.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=15577425	"To test the hypothesis that micronutrient supplementation decreases genital HIV-1 shedding, a double-blind, randomized, placebo-controlled trial of 6 weeks of multivitamin plus selenium supplementation vs. placebo was conducted among 400 HIV-1-seropositive, nonpregnant, antiretroviral-naive women in Mombasa, Kenya. Primary outcome measures included cervical and vaginal shedding of HIV-1-infected cells and RNA. Secondary outcomes included plasma viral load and CD4 count. Surprisingly, the odds of detection of vaginal HIV-1-infected cells were 2.5-fold higher (P = 0.001) and the quantity of HIV-1 RNA in vaginal secretions was 0.37 log10 copies/swab higher (P = 0.004) among women who received micronutrients in comparison to placebo, even after adjustment for potential confounders including baseline HIV-1 shedding and CD4 count. The increase in vaginal HIV-1 shedding was greatest among women who had normal baseline selenium levels. Micronutrient supplementation resulted in higher CD4 (+23 cells/microL, P = 0.03) and CD8 (+74 cells/microL, P = 0.005) counts compared with placebo but did not alter the plasma viral load. In this randomized trial, micronutrients resulted in higher levels of genital HIV-1 shedding compared with placebo. The potential benefit of micronutrient supplementation in HIV-1-seropositive women should be considered in relation to the potential for increased infectivity."									
876	HIV heterosexual transmission: a hypothesis about an additional potential determinant.	"Louria DB, Skurnick JH, Palumbo P, Bogden JD, Rohowsky-Kochan C, Denny TN, Kennedy CA."	International Journal of Infectious Diseases. 2000;4(2):110-6.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=10737850	"Transmission rates of human immunodeficiency virus (HIV) during heterosexual intercourse vary dramatically around the world. In Asia and South America, they are extraordinarily high, whereas in the United States and Europe, rates are much lower even after a large number of unprotected contacts. The transmission rates in Africa also probably are high, but the available studies unfortunately are weak. In Thailand, female-to-male transmission rates per contact were estimated at.056 (l in 18) compared to.0002 to.0015 (1/5000-1. 5/1000) for male-to-female transmission in the United States and Europe. Male-to-female transmission in Thailand appears to show, as expected, even greater transmission likelihood compared to female-to-male rates. In general, in the United States and Europe, transmission rates within heterosexual couples range from less than 10% to 22%, whereas in Thailand and Brazil, the rates exceed 40%. The much lower transmission rate per contact in the United States and Europe is based on an assumption that HIV transmitters are a homogeneous group. Wiley and colleagues argue that transmitters are likely to be a heterogeneous group with a large percentage of very low frequency transmitters and a small percentage of high frequency transmitters. That hypothesis is given some support by a cluster of cases in rural New York State in which one man appeared to infect 31% of his many contacts."									
1387	"[Use of spirulina supplement for nutritional management of HIV-infected patients: study in Bangui, Central African Republic]."	"Yamani E, Kaba-Mebri J, Mouala C, Gresenguet G, Rey JL."	Medecine Tropicale. 2009;69(1):66-70.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=19499738	"Treatment of HIV-infected persons including nutritional management is a major concern in Africa and in particular in the Central African Republic (CAR). This six-month randomized prospective longitudinal study was carried out at the Friends of Africa Center that was a facility for comprehensive management of persons infected and affected by HIV in Banqui, CAR. The purpose of the study was to assess the impact of spirulina supplement on clinical and laboratory findings in HIV-infected patients who were not indications for ARV treatment. A total of 160 patients were randomly assigned to two groups. Patients in group 1 (n=79) received 10 grams of spirulina per day on a regular basis while patients in group 2 (n = 81) received a placebo. In addition patients in both groups received dietary products supplied by the World Food Program (WFP). Follow-up of the 160 patients at three and six months showed that 16 patients had been lost from follow-up and 16 had died, with no difference in distribution between the two groups. A significant improvement in the main follow-up criteria, i.e., weight, arm girth, number of infectious episodes, CD4 count, and protidemia, was observed in both groups. No difference was found between the two groups except with regard to protidemia and creatinemia that were higher in the group receiving spirulina supplement. From a clinical standpoint results were less clear-cut since the Karnofsky score was better in the group receiving spirulina than in the group receiving the placebo at 3 months but not at 6 months and fewer patients presented pneumonia at six months. Further study over a longer period will be needed to determine if spirulina is useful and to evaluate if higher doses can have beneficial nutritional and immunitary effects without adverse effects, in particular renal problems."									
1835	"Clinical characteristics and treatment outcomes among patients with tuberculosis in Bangkok and Nonthaburi, Thailand."	"Manosuthi W, Kawkitinarong K, Suwanpimolkul G, Chokbumrungsuk C, Jirawattanapisal T, Ruxrungtham K, Akksilp S."	Southeast Asian Journal of Tropical Medicine and Public Health. 2012;43(6):1426-36.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20133030758	"Tuberculosis (TB) is a public health problem in many large cities. We retrospectively studied the clinical characteristics and treatment outcomes of patients with active TB at 6 hospitals in Bangkok and Nonthaburi, Thailand during 2008-2009. Eight hundred thirteen patients were included in the study. The mean age of subjects+or-SD was 41+or-14 years and mean body weight+or-SD was 53+or-11 kilograms. The three leading co-morbid conditions were HIV infection (40%), diabetes (6%) and chronic liver disease (2%). Two-thirds of subjects had isolated pulmonary TB. Isoniazid, rifampicin and multi-drug resistance were seen in 13, 7 and 5%, respectively. After 1 year, 52% were cured or completed treatment, 19% transferred out, 12% defaulted, 9% were still on-going TB treatment, 7% had died and 1% had failed treatment. Survival rates at 2, 6 and 12 months were 93, 85 and 81% among HIV seropositive subjects; 96, 94 and 92% among HIV seronegative subjects and 98, 97 and 97% among subjects with unknown HIV status (p<0.001). On multivariate analysis, death was associated with: TB/HIV co-infection (HR 2.8; 95%CI 1.6-5.0), low body weight (HR 1.6; 95%CI 1.2-2.3), being elderly (HR 1.4; 95%CI 1.1-1.8) and having extrapulmonary/disseminated TB (HR 2.2; 95%CI 1.1-4.2). HIV infection and diabetes were the most common co-morbidities among TB subjects in our study. The percent of patients with unfavorable outcomes was relatively high, particularly among HIV co-infected and elderly subjects. Further effort needs to be made to improve these unfavorable TB outcomes in Nonthaburi and Bangkok, Thailand."									
1691	Impact of lifestyle on tuberculosis.	"Leung C, Chang K."	Respirology. 2008;13(s3):S65-S72.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20093011589	"Tuberculosis (TB) is well known to be associated with poverty and multiple social factors. However, relatively little attention has been paid to the behavioural factors, apart from those associated with drug abuse, alcoholism and HIV infection. In recent years, the roles of other lifestyle-related factors have been increasingly recognized. In particular, smoking has been associated with excess risks of TB infection, disease and mortality. Only limited evidence is available for the association between TB disease and passive smoking or the use of biomass fuels. Nutrition status also plays an important role. Malnutrition or underweight is associated with increased risk of TB disease, and obesity appears to be protective. On the other hand, diabetes mellitus increases the risk of TB disease, but mainly among those with poor diabetic control. Although the increase in TB risk is only modest for most lifestyle factors, their prevalences are increasing rapidly in some Asian communities. Furthermore, as much as one-third of the world population is thought to be latently infected with the tubercle bacillus. The successful introduction of directly observed therapy - short course (DOTS) might have rapidly reduced the ongoing risk of transmission in many parts of Asia. However DOTS alone is unlikely to eliminate the continuing emergence of infectious tuberculosis cases through endogenous reactivation among the large pool of latently infected subjects in the Asia-Pacific region. With the close interaction between lifestyle, aging population and aging TB epidemic, promotion of healthy lifestyle may help to complement the DOTS strategy in the control of TB."									
1692	Impact of lifestyle on tuberculosis.	"Leung CC, Chang KC."	Respirology. 2008 September;13(SUPPL. 3):S65-S72.		"Tuberculosis (TB) is well known to be associated with poverty and multiple social factors. However, relatively little attention has been paid to the behavioural factors, apart from those associated with drug abuse, alcoholism and HIV infection. In recent years, the roles of other lifestyle-related factors have been increasingly recognized. In particular, smoking has been associated with excess risks of TB infection, disease and mortality. Only limited evidence is available for the association between TB disease and passive smoking or the use of biomass fuels. Nutrition status also plays an important role. Malnutrition or underweight is associated with increased risk of TB disease, and obesity appears to be protective. On the other hand, diabetes mellitus increases the risk of TB disease, but mainly among those with poor diabetic control. Although the increase in TB risk is only modest for most lifestyle factors, their prevalences are increasing rapidly in some Asian communities. Furthermore, as much as one-third of the world population is thought to be latently infected with the tubercle bacillus. The successful introduction of directly observed therapy - short course (DOTS) might have rapidly reduced the ongoing risk of transmission in many parts of Asia. However DOTS alone is unlikely to eliminate the continuing emergence of infectious tuberculosis cases through endogenous reactivation among the large pool of latently infected subjects in the Asia-Pacific region. With the close interaction between lifestyle, aging population and aging TB epidemic, promotion of healthy lifestyle may help to complement the DOTS strategy in the control of TB. 2008 The Authors."									
1889	"Factors associated with mortality and default among patients with tuberculosis attending a teaching hospital clinic in Accra, Ghana."	"Burton NT, Forson A, Lurie MN, Kudzawu S, Kwarteng E, Kwara A."	Transactions of the Royal Society of Tropical Medicine and Hygiene. 2011;105(12):675-82.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20113407897	"Tuberculosis (TB) remains a major cause of mortality despite availability of effective chemotherapy. This study was performed to identify contributing factors for poor outcome during anti-tuberculosis treatment at a teaching hospital chest clinic. Medical records of registered patients treated for TB between 1 January and 31 December, 2009 were reviewed and abstracted for demographic, clinical and outcome data. Risk factors for mortality during therapy were assessed using bivariate and multivariate logistics approaches. Of 599 patients, 355 (58.9%) completed therapy and/or were cured, 192 (32.1%) died, and 39 (6.5%) defaulted. In multivariate analysis, independent risk factors for mortality included pulmonary cases for which sputum smear status was unknown (odds ratio [OR] 13.7; 95% confidence interval [CI] 6.0, 31.4), HIV coinfection (OR, 3.6; 95% CI 2.4, 5.4), disseminated TB (OR, 2.2; 95% CI 1.0, 4.9), TB meningitis (OR, 2.8; 95% CI 1.5, 5.3), not having a treatment supporter (OR, 2.0; 95% CI 1.3, 3.1), and low body weight (OR, 11.0; 95% CI 3.1, 38.6). Not having a treatment supporter (OR, 3.2; 95% CI 1.6, 6.6) and HIV coinfection (OR, 2.4; 95% CI 1.2, 5.2) were also independently associated with treatment default. Our findings suggest that enhanced measures to reduce mortality and default in TB patients with HIV coinfection, disseminated or meningeal disease and those who have no treatment supporters may help improve treatment outcomes in Ghana."									
142	Tumor necrosis factor-alpha levels in patients with HIV with wasting in South Asia.	"Wig N, Anupama P, Singh S, Handa R, Aggarwal P, Dwivedi SN, Jailkhani BL, et al."	AIDS Patient Care & STDs. 2005;19(4):212-5.	http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=2005103226&site=ehost-live	"Tumor necrosis factor (TNF)-alpha is thought to play an important role in wasting; but TNF-alpha levels have not been consistently found to be high in AIDS wasting. We conducted this study to determine any correlation between TNF-alpha levels and wasting in HIV-positive patients in a developing country. TNF-alpha levels were measured in four groups of patients: Group 1, HIV/AIDS with wasting (n = 25); group 2, HIV/AIDS without wasting (n = 47); group 3, HIV-negative patients with tuberculosis with wasting (n = 25); and group 4, healthy controls (n = 25). Wasting was defined as a body bass index (BMI) </=16.0 kg/m(2). TNF-alpha was measured by a solid-phase sandwich enzyme linked immunosorbent assay (ELISA) kit. The mean BMI in HIV-positive patients with wasting (group 1) and without wasting (group 2) was 15.192 +/- 1.142 and 19.507 +/- 2.457, respectively, while group 3 and 4 had a BMI of 14.878 +/- 3.234 and 21.862 +/- 2.763 kg/m(2). The mean TNF-alpha level in group 1 was 50.864 +/- 99.13 pg/mL and 43.39 +/- 66.372 pg/mL in group 2. There was no significant difference between the two groups. TNF-alpha was significantly higher in the HIV/AIDS groups (group 1 and 2) compared to the tuberculosis group (10.74 +/- 7.854) and healthy controls (5.846 +/- 3.40) at p = 0.01. TNF-alpha was significantly (p = 0.002) higher in symptomatic patients compared to asymptomatic patients (16.03 +/- 7.61 versus 64.70 +/- 98.70). In conclusion, TNF-alpha levels were higher in HIV patients, regardless of the presence of wasting, compared to normal healthy controls of patients with tuberculosis with wasting."									
81	Early mortality among adults accessing antiretroviral treatment programmes in sub-Saharan Africa.	"Lawn SD, Harries AD, Anglaret X, Myer L, Wood R."	Aids. 2008;22(15):1897-908.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20083259100	"Two-thirds of the world's HIV-infected people live in sub-Saharan Africa, and more than 1.5 million of them die annually. As access to antiretroviral treatment has expanded within the region; early pessimism concerning the delivery of antiretroviral treatment using a large-scale public health approach has, at least in the short term, proved to be broadly unfounded. Immunological and virological responses to ART are similar to responses in patients treated in high-income countries. Despite this, however, early mortality rates in sub-Saharan Africa are very high; between 8 and 26% of patients die in the first year of antiretroviral treatment, with most deaths occurring in the first few months. Patients typically access antiretroviral treatment with advanced symptomatic disease, and mortality is strongly associated with baseline CD4 cell count less than 50 cells/[mu]l and WHO stage 4 disease (AIDS). Although data are limited, leading causes of death appear to be tuberculosis, acute sepsis, cryptococcal meningitis, malignancy and wasting syndrome. Mortality rates are likely to depend not only on the care delivered by antiretroviral treatment programmes, but more fundamentally on how advanced disease is at programme enrolment and the quality of preceding healthcare. In addition to improving delivery of antiretroviral treatment and providing it free of charge to the patient, strategies to reduce mortality must include earlier diagnosis of HIV infection, strengthening of longitudinal HIV care and timely initiation of antiretroviral treatment. Health systems delays in antiretroviral treatment initiation must be minimized, especially in patients who present with advanced immunodeficiency."									
558	ESPEN guidelines on enteral nutrition: wasting in HIV and other chronic infectious diseases.	"Ockenga J, Grimble R, Jonkers-Schuitema C, Macallan D, Melchior J, Sauerwein HP, Schwenk A, et al."	Clinical Nutrition. 2006;25(2):319-29.	http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=2009238901&site=ehost-live	"Undernutrition (wasting) is still frequent in patients infected with the human immunodeficiency virus (HIV), despite recent decreases in the prevalence of undernutrition in western countries (as opposed to developing countries) due to the use of highly active antiretroviral treatment. Undernutrition has been shown to have a negative prognostic effect independently of immunodeficiency and viral load. These guidelines are intended to give evidence-based recommendations for the use of enteral nutrition (EN) by means of oral nutritional supplements (ONS) and tube feeding (TF) in HIV-infected patients. They were developed by an interdisciplinary expert group in accordance with officially accepted standards and is based on all relevant publications since 1985. Nutritional therapy is indicated when significant weight loss (>5% in 3 months) or a significant loss of body cell mass (>5% in 3 months) has occurred, and should be considered when the body mass index (BMI) is <18.5 kg/m(2). If normal food intake including nutritional counselling and optimal use of ONS cannot achieve an adequate nutrient intake, TF with standard formulae is indicated. Due to conflicting results from studies investigating the impact of immune-modulating formulae, these are not generally recommended. The results obtained in HIV patients may be extrapolated to other chronic infectious diseases, in the absence of available data. The full version of this article is available at www.espen.org."									
560	ESPEN Guidelines on Enteral Nutrition: Wasting in HIV and other chronic infectious diseases.	"Ockenga J, Grimble R, Jonkers-Schuitema C, Macallan D, Melchior JC, Sauerwein HP, Schwenk A, et al."	Clinical Nutrition. 2006 April;25(2):319-29.		"Undernutrition (wasting) is still frequent in patients infected with the human immunodeficiency virus (HIV), despite recent decreases in the prevalence of undernutrition in western countries (as opposed to developing countries) due to the use of highly active antiretroviral treatment. Undernutrition has been shown to have a negative prognostic effect independently of immunodeficiency and viral load. These guidelines are intended to give evidence-based recommendations for the use of enteral nutrition (EN) by means of oral nutritional supplements (ONS) and tube feeding (TF) in HIV-infected patients. They were developed by an interdisciplinary expert group in accordance with officially accepted standards and is based on all relevant publications since 1985. Nutritional therapy is indicated when significant weight loss (>5% in 3 months) or a significant loss of body cell mass (>5% in 3 months) has occurred, and should be considered when the body mass index (BMI) is <18.5 kg/m<sup>2</sup>. If normal food intake including nutritional counselling and optimal use of ONS cannot achieve an adequate nutrient intake, TF with standard formulae is indicated. Due to conflicting results from studies investigating the impact of immune-modulating formulae, these are not generally recommended. The results obtained in HIV patients may be extrapolated to other chronic infectious diseases, in the absence of available data. The full version of this article is available at www.espen.org. 2006 European Society for Clinical Nutrition and Metabolism."									
561	ESPEN guidelines on enteral nutrition: wasting in HIV and other chronic infectious diseases. (ESPEN Guidelines on Enteral Nutrition).	"Ockenga J, Grimble R, Jonkers-Schuitema C, Macallan D, Melchior JC, Sauerwein HP, Schwenk A, et al."	Clinical Nutrition. 2006;25(2):319-29.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20063176334	"Undernutrition (wasting) is still frequent in patients infected with the human immunodeficiency virus (HIV), despite recent decreases in the prevalence of undernutrition in western countries (as opposed to developing countries) due to the use of highly active antiretroviral treatment. Undernutrition has been shown to have a negative prognostic effect independently of immunodeficiency and viral load. These guidelines are intended to give evidence-based recommendations for the use of enteral nutrition (EN) by means of oral nutritional supplements (ONS) and tube feeding (TF) in HIV-infected patients. They were developed by an interdisciplinary expert group in accordance with officially accepted standards and is based on all relevant publications since 1985. Nutritional therapy is indicated when significant weight loss (>5% in 3 months) or a significant loss of body cell mass (>5% in 3 months) has occurred, and should be considered when the body mass index (BMI) is <18.5 kg/m<sup>2</sup>. If normal food intake including nutritional counselling and optimal use of ONS cannot achieve an adequate nutrient intake, TF with standard formulae is indicated. Due to conflicting results from studies investigating the impact of immune-modulating formulae, these are not generally recommended. The results obtained in HIV patients may be extrapolated to other chronic infectious diseases, in the absence of available data."									
559	ESPEN Guidelines on Enteral Nutrition: Wasting in HIV and other chronic infectious diseases.	"Ockenga J, Grimble R, Jonkers-Schuitema C, Macallan D, Melchior JC, Sauerwein HP, Schwenk A, et al."	Clinical Nutrition. 2006;25(2):319-29.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=16698147	"Undernutrition (wasting) is still frequent in patients infected with the human immunodeficiency virus (HIV), despite recent decreases in the prevalence of undernutrition in western countries (as opposed to developing countries) due to the use of highly active antiretroviral treatment. Undernutrition has been shown to have a negative prognostic effect independently of immunodeficiency and viral load. These guidelines are intended to give evidence-based recommendations for the use of enteral nutrition (EN) by means of oral nutritional supplements (ONS) and tube feeding (TF) in HIV-infected patients. They were developed by an interdisciplinary expert group in accordance with officially accepted standards and is based on all relevant publications since 1985. Nutritional therapy is indicated when significant weight loss (>5% in 3 months) or a significant loss of body cell mass (>5% in 3 months) has occurred, and should be considered when the body mass index (BMI) is <18.5 kg/m(2). If normal food intake including nutritional counselling and optimal use of ONS cannot achieve an adequate nutrient intake, TF with standard formulae is indicated. Due to conflicting results from studies investigating the impact of immune-modulating formulae, these are not generally recommended. The results obtained in HIV patients may be extrapolated to other chronic infectious diseases, in the absence of available data. [References: 72]"									
1415	Prenatal origins of undernutrition.	Christian P.	"Nestle Nutrition Workshop Series Paediatric Programme. 2009;63:59-73; discussion 4-7, 259-68."	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=19346768	"Undernutrition continues to be high in many regions of the developing world. Birthweight, a common proxy measure of intrauterine growth, is influenced by nutritional, environmental and lifestyle factors during pregnancy and, in turn, affects immediate survival and function, and is a determinant of later life risk of chronic diseases. Maternal pre-pregnancy weight and height are independently associated with birthweight and also modify the effects of pregnancy weight gain and interventions during pregnancy on birthweight and perinatal mortality. Other prenatal factors commonly known to impact birthweight include maternal age, parity, sex, and birth interval, whereas lifestyle factors such as physical activity and maternal stress, as well as environmental toxicants have variable influences. Tobacco and other substance use and infections, specifically ascending reproductive tract infections, malaria, and HIV, can cause intrauterine growth restriction (IUGR). Few studies have examined the contribution of prenatal factors including low birthweight to childhood wasting and stunting. Studies that have examined this, with adequate adjustment for confounders, have generally found odds ratios associated with low birthweight ranging between 2 and 5. Even fewer studies have examined birth length or maternal nutritional status as risk factors. More research is needed to determine the proportion of childhood under-nutrition attributable to IUGR so that interventions can be targeted to the appropriate life stages. Copyright (c) 2009 S. Karger AG, Basel."									
460	"The effect of energy-protein supplementation on weight, body composition and handgrip strength among pulmonary tuberculosis HIV-co-infected patients: randomised controlled trial in Mwanza, Tanzania."	"PrayGod G, Range N, Faurholt-Jepsen D, Jeremiah K, Faurholt-Jepsen M, Aabye MG, Jensen L, et al."	British Journal of Nutrition. 2012;107(2):263-71.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=21729372	"Undernutrition is common among smear-positive pulmonary tuberculosis (PTB+) patients. Micronutrient supplementation may improve treatment outcomes, but it is unclear whether additional energy-protein would be beneficial. The present study aimed to assess the effect of energy-protein supplementation on weight, body composition and handgrip strength against a background of high micronutrient intake during tuberculosis (TB) treatment. A total of 377 PTB+ patients co-infected with HIV were randomly allocated one or six biscuits daily for 60d during TB treatment. Weight, arm fat area, arm muscle area and handgrip strength were assessed at baseline and 2 and 5 months. There were no effects on any outcome at 2 months, but energy-protein supplementation was associated with a 1.3 (95% CI -0.1, 2.8)kg marginally significant gain in handgrip strength at 5 months. However, after 2 months, energy-protein supplementation led to a weight gain of 1.9 (95% CI 0.1, 3.7)kg among patients with cluster of differentiation 4 (CD4) counts >=350cells/ul, but not among patients with low CD4 counts (-0.2kg; 95% CI -1.3, 0.8, Pinteraction=0.03). Similarly, at 5 months, energy-protein supplementation led to a 2.3 (95% CI 0.6, 4.1)kg higher handgrip strength gain among patients with CD4 counts <350cells/ul, but not in those with high CD4 counts (Pinteraction=0.04). In conclusion, energy-protein supplementation to PTB+ HIV-co-infected patients had no overall effects on weight and body composition, but was associated with marginally significant gain in handgrip strength. More research is needed to develop an effective supplement, before it is recommended to TB programmes."									
1156	"Daily multi-micronutrient supplementation during tuberculosis treatment increases weight and grip strength among HIV-uninfected but not HIV-infected patients in Mwanza, Tanzania."	"PrayGod G, Range N, Faurholt-Jepsen D, Jeremiah K, Faurholt-Jepsen M, Aabye MG, Jensen L, et al."	Journal of Nutrition. 2011;141(4):685-91.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=21346105	"Undernutrition is common among tuberculosis (TB) patients. The objective of this study was to assess the effect of multi-micronutrient supplementation during TB treatment on weight, body composition, and handgrip strength. A total of 865 patients with smear-positive (PTB+) or -negative (PTB-) pulmonary TB were randomly allocated to receive a daily biscuit with or without multi-micronutrients for 60 d during the intensive phase of TB treatment. Weight, arm fat area, arm muscle area, and handgrip strength were assessed at baseline and after 2 and 5 mo. At 2 mo, the multi-micronutrient supplementation led to a higher handgrip gain (1.22 kg; 95% CI = 0.50, 1.94; P = 0.001) but had no effects on other outcomes. The effects of multi-micronutrient supplementation were modified by HIV infection (P-interaction = 0.002). Among HIV- patients, multi-micronutrient supplementation increased weight gain by 590 g (95% CI = -40, 1210; P = 0.07) and handgrip strength by 1.6 kg (95% CI = 0.78, 2.47; P < 0.001), whereas among HIV+ patients, it reduced weight gain by 1440 g (95% CI = 290, 2590; P = 0.002) and had no effect on handgrip strength (0.07 kg; 95% CI = -1.30, 1.46; P = 0.91). The reduced weight gain among HIV+ patients receiving multi-micronutrient supplementation seemed to be explained by a higher proportion of patients reporting fever. At 5 mo, the effects on weight were sustained, whereas there was no effect on handgrip strength. In conclusion, multi-micronutrient supplementation given as a biscuit is beneficial among HIV- PTB patients and may be recommended to TB programs. More research is needed to develop an effective supplement for HIV+ PTB patients."									
1191	Viewpoint: childhood undernutrition: a failing global priority.	Peterson K.	Journal of Public Health Policy. 2009;30(4):455-64.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=20029434	"Undernutrition remains a significant underlying cause of death among children worldwide. Although alleviating hunger is part of the first United Nation's Millennium Development Goal and a declared global priority, undernutrition continues to be prevalent in low-income and middle-income countries throughout the world. The authors review the problem and policies and recommend how, particularly in this time of global economic difficulties, to improve policies to prevent undernutrition. They advocate even greater urgency."									
1157	"Sex, smoking, and socioeconomic status are associated with body composition among tuberculosis patients in a deuterium dilution cross-sectional study in Mwanza, Tanzania."	"Praygod G, Range N, Faurholt-Jepsen D, Jeremiah K, Faurholt-Jepsen M, Aabye MG, Magnussen P, et al."	Journal of Nutrition. 2013 May;143(5):735-41.		"Underweight is common among tuberculosis (TB) patients. However, there is little information on determinants of body composition at TB treatment initiation in high-TB-burdened countries. This study aimed to determine factors associated with body composition at commencement of TB treatment in Mwanza, Tanzania. A cross-sectional study was conducted from 2007 to 2008 among newly diagnosed TB patients. Fat and fat-free mass were determined using a deuterium dilution technique and fat and fat-free mass indices were computed. Correlates were assessed using multiple regression analysis. A total of 201 pulmonary TB patients were recruited; of these, 37.8% (76) were female, 51.7% (104) were HIV infected, 65.3% (126) had sputum-positive TB, and 24.4% (49) were current smokers. In multiple regressions analysis, males had a 2.2-kg/m<sup>2</sup> [(95% CI = 1.6, 2.9); P < 0.0001] lower fat mass index but 1.5 kg/m<sup>2</sup> [(95% CI = 0.9, 2.0); P < 0.0001] higher fatfree mass index compared with females. Sputum-positive TB was associated with a lower fat mass index among HIVuninfected patients [-1.4 kg (95% CI = -2.5,-0.4); P = 0.006] but not among HIV-infected patients (P-interaction = 0.09). Current smokers had a 0.7-kg/m<sup>2</sup> [(95% CI = 0.02, 1.5); P = 0.045] lower fat mass index, but smoking did not affect fat-free mass. High socioeconomic status (SES) was associated with higher fat as well as fat-free mass. HIV infection, cluster of differentiation 4 count, and antiretroviral therapy were not correlates. Sex, smoking, and SES were associated with body composition of TB patients at treatment commencement. Prospective studies are needed to determine the role of these factors on weight gain, functional recovery, and survival during and after treatment. 2013 American Society for Nutrition."									
1093	Effect of nutritional education and dietary counselling on body weight in HIV-seropositive South Africans not receiving antiretroviral therapy.	"Niekerk Cv, Smego RA, Jr., Sanne I."	Journal of Human Nutrition and Dietetics. 2000;13(6):407-12.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh3&AN=20013001735	"Unintentional weight loss of >10% contributes to morbidity and mortality in HIV-infected patients. In poorer developing countries, cost-effective options to promote weight gain are extremely limited. A pilot study of the effect of nutritional education and dietary counselling on body weight in 90 HIV/AIDS patients was conducted. Education entailed principles of healthy eating, socioeconomics of nutrition, food safety, and symptom-related dietary guidelines. Other clinical parameters examined for potential impact on body weight included age, sex, CD4+ lymphocyte count, presence of complicating infections, concomitant medications, vitamin use, and nutritional supplementation. No patients received antiretroviral therapy. At study end (mean follow-up, 4.2 months) body weight compared to baseline was greater in study subjects than in controls (P<0.01); stable or increasing weight was seen in 73% of study patients. Weight gain (>=1 kg) occurred in 53% of counselled patients (mean=3.5 kg; range 1-11 kg) vs. 21% of matched controls (mean=2.0 kg; range 1-3 kg) (P<0.03). Nutritional counselling was found to offset the adverse effects of gastrointestinal tract or systemic infection (especially in patients with CD4+ counts <200 cells mm<sup>-3</sup>). In low-resource areas, culturally and economically relevant nutritional education and dietary counselling are simple yet effective means of stabilizing or increasing body weight in HIV-infected patients."									
225	"Caregiving, gender, and nutritional status in Nyanza Province, Kenya: grandmothers gain, grandfathers lose."	"Ice GH, Heh V, Yogo J, Juma E."	American Journal of Human Biology. 2011;23(4):498-508.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=21538652	"UNLABELLED: Based on anecdotal and qualitative reports, a general assumption is that caregiving negatively impacts grandparents in Africa."	OBJECTIVES: The purpose of this article is to determine how caregiving and gender impact nutritional status over four waves of data from Luo elders.	"METHODS: Luo elders, aged 60 and over (age 73.6 +/- 7.9) were sampled. Participant recruitment was rolling and included 287 Luo grandparents in 2005, 396 in 2006, 389 in 2007, and 390 in 2009. A total of 689 elders participated in at least 1 year. Standard anthropometric measures were used to determine nutritional status. Impact of caregiving was examined using structural equation models."	"RESULTS: Caregiving positively associated with nutritional status among women. This main effect was mediated by caregiving intensity, which also positively associated with nutritional status. Among men, caregiving negatively associated with nutritional status, although caregiving intensity did not significantly associate with most anthropometric measures. Socioeconomic status (SES) positively associated with five of nine anthropometric measures in women and all measures in men. Several measures indicated that both men and women became larger over time but few of the variables tested predicted growth."	"CONCLUSIONS: The beneficial impact on grandmothers might indicate a coping strategy. These results indicated that researchers should shift away from comparing caregivers to noncaregivers and instead look at the multiple factors which may make some families resilient and others at risk. Human biologists can contribute to this literature by examining the ecological and cultural contexts under which caregiving represents a burden with physiological repercussions. Copyright 2011 Wiley-Liss, Inc."					
1826	A lower body mass index is associated with cardiomyopathy in people with HIV infection: evidence from a case comparison study.	"Lemmer CE, Badri M, Visser M, Mayosi BM."	South African Medical Journal Suid-Afrikaanse Tydskrif Vir Geneeskunde. 2011;101(2):119-21.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=21678739	"UNLABELLED: The cause of cardiomyopathy in patients infected with the human immunodeficiency virus (HIV) remains largely unknown, although a number of predisposing factors have been identified. Malnutrition has been postulated to be a contributory factor, but the association of anthropometric measures of nutritional status with HIV-associated cardiomyopathy has not been established."	METHOD: We investigated the association between anthropometric measures of nutritional status and cardiomyopathy in HIV-positive individuals in a cross-sectional case comparison study.	"RESULTS: Seventeen cases of HIV-associated cardiomyopathy and a comparison group of 18 HIV-positive individuals without cardiomyopathy were studied. There was no significant difference between the two groups in age, gender, CD4 cell count, HIV RNA viral load or World Health Organization (WHO) clinical stage of HIV disease. Patients with HIV-associated cardiomyopathy had evidence of undernutrition compared with HIV-infected people without cardiomyopathy, as evidenced by a significantly lower body mass index (BMI) (20.9 kg/m2 v. 27.0 kg/m2, p = 0.02), mid-upper arm circumference (26.2 cm v. 27.3 cm, p = 0.02), and bone-free arm muscle area (26.7 cm2 v. 32.8 cm2, p = 0.02). However, in a multivariate stepwise logistic regression model, a lower BMI was the only independent anthropometric risk factor for cardiomyopathy (odds ratio 0.76, 95% confidence interval 0.64 - 0.97, p = 0.02)."	CONCLUSION: A lower BMI is associated with cardiomyopathy in people who are living with HIV.						
887	"Tracheostomy in human immuno-deficiency virus infected children at the Red Cross War Memorial Children's Hospital, Cape Town, South Africa."	"Mulwafu WK, Argent AC, Prescott CA, Booth J."	International Journal of Pediatric Otorhinolaryngology. 2007;71(7):1125-8.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medc&AN=17498816	"UNLABELLED: Tracheostomy in adults with HIV/AIDS has been reported to be associated with both high and early mortality of 47-100%. There is minimal data regarding the role of tracheostomy in HIV infected children. We did a retrospective analysis of HIV positive children that underwent tracheostomy at our institution over a 5-year period, 2002-2006. A total of 70 tracheostomies were done during the period and 15 (21.4%) of these children were confirmed as HIV infected. The average age at presentation for HIV infected children with upper airway obstruction resulting eventually in tracheostomy was 9.4 months and 60% were under 1 year of age. Only three (20%) were on Anti-Retroviral Therapy (ART) prior to presentation. The cause of upper airway obstruction was croup in 14 (93%) of these 15 children. Following tracheostomy all were treated with ART. To date six children have been successfully decannulated (40%) and there have been three deaths (20%) which were unrelated to tracheostomy."	CONCLUSION: Tracheostomy in HIV positive children is not associated with the high mortality that has been reported in adults provided such children are started on treatment with antiretroviral therapy.								
740	"Structure and properties of urban household food demand in Nairobi, Kenya: implications for urban food security."	"Musyoka MP, Lagat JK, Ouma DE, Wambua T, Gamba P."	Food Security. 2010;2(2):179-93.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20103161219	"Urban household food insecurity continues to be a major problem in many urban households of Sub-Saharan Africa. The ineffectiveness of policies addressing the problem has hinged in particular on the paucity of information about consumption patterns under changing economic conditions. Elasticities of food demand were estimated through the Linear Approximated Almost Ideal Demand System (LA/AIDS) and inferences about access to food were drawn. Shifts in consumption were evident when changes occurred in income, prices and household demography. As the urban poor are sensitive to variation in food prices and income, they should be cushioned against their negative effects in order for their access to food to be enhanced and hence their food security improved. Dairy and dairy products and wheat and wheat products were identified as subsidy carriers which would improve the nutrition of the urban poor. These results provide guidance for the design of food security and nutrition strategies and programs at the micro and macro-economic levels."									
234	"Cryptosporidium infections in Mexican children: clinical, nutritional, enteropathogenic, and diagnostic evaluations."	"Javier Enriquez F, Avila CR, Ignacio Santos J, Tanaka-Kido J, Vallejo O, Sterling CR."	American Journal of Tropical Medicine & Hygiene. 1997;56(3):254-7.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=9129526	"Using an indirect immunofluorescence assay on stool samples, we found a 6.4% prevalence of cryptosporidiosis among 403 children less than five years of age with acute diarrhea in Mexico City over a one-year period. The prevalence was highest (11.4%) during the rainy summer months. Most Cryptosporidium parvum cases occurred in infants less than one year of age. Cryptosporidium parvum was more common in malnourished children (P < 0.05) and in nonbreast-fed infants less than six months of age (P < 0.01). Neither dwelling characteristics nor the presence of domestic animals at home were associated with C. parvum infection. Enteropathogenic bacteria were found in 26.8% of the children; Escherichia coli, Salmonella, and Shigella being the most frequently identified. None of 100 serum samples tested showed antibodies against human immunodeficiency virus. When compared with immunofluorescence, the acid-fast technique showed a sensitivity of 76.9% and a specificity of 98.9%, with a predictive positive value of 83.3%. It was concluded that 1) monoclonal antibody-based immunofluorescence is a better diagnostic tool than the acid-fast technique, 2) the prevalence of cryptosporidiosis in this population was similar to that of other developing countries, 3) clinical manifestations were nonspecific, and 4) C. parvum was more common in malnourished children and in nonbreast-fed infants."									
901	AIDS-defining illness diagnosed within 90 days after starting highly active antiretroviral therapy among patients from the TREAT Asia HIV Observational Database.	"Zhou J, Paton NI, Ditangco R."	International Journal of STD & AIDS. 2007;18(7):446-52.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=17623500	"Using data from TREAT Asia HIV Observational Database (TAHOD), this paper aims to assess the rate of, and factors associated with the diagnosis of new AIDS-defining illness (ADI) within 90 days after antiretroviral treatment. Patients starting three or more antiretroviral combinations and having subsequent follow-up were included. New ADI cases were checked for evidence of immune reconstitution syndrome (IRS). Among the 1185 patients included, 75 (6.3%) were diagnosed with a new ADI within 90 days, giving a rate of 26.8/100 person-years, compared with a further 3.6% cumulative incidence of new ADI between 90 days to one year (4.2/100 person-years). Of the 75 patients, 21 were judged as definitive or presumptive IRS, giving a rate of 7.3/100 person-years. Patients with new ADI generally had lower CD4 counts before treatment started (median, 43 cells/microL). Lower CD4 count, lower body mass index and starting treatment in the same year as the first HIV-positive test done were associated with developing a new ADI. The higher rate of new ADI within 90 days may be partly explained by IRS occurring shortly after treatment. Although it is difficult to identify IRS from observational data, it appears that in TAHOD setting IRS was relatively uncommon."									
1621	"Food crisis, household welfare and HIV/AIDS treatment: evidence from Mozambique."	"Walque Dd, Kazianga H, Over M, Vaillant J."	Policy Research Working Paper World Bank. 2011;30(20).	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20113264984	"Using panel data from Mozambique collected in 2007 and 2008, the authors explore the impact of the food crisis on the welfare of households living with HIV/AIDS. The analysis finds that there has been a real deterioration of welfare in terms of income, food consumption, and nutritional status in Mozambique between 2007 and 2008, among both HIV and comparison households. However, HIV households have not suffered more from the crisis than others. Results on the evolution of labor force participation suggest that initiation of treatment and better services in health facilities have counter-balanced the effect of the crisis by improving the health of patients and their labor force participation. In addition, the authors look at the effect of the change in welfare on the frequency of visits to a health facility of patients and on their treatment outcomes. Both variables can proxy for adherence to treatment. This is a particularly crucial issue as it affects both the health of the patient and public health, because sub-optimal adherence leads to the development of resistant forms of the virus. The paper finds no effect of the change in welfare on the frequency of visits, but does find that people who experienced a negative income shock also experienced a reduction or a slower progression in treatment outcomes."									
242	Descriptive study of iron biomarkers in Ethiopian visceral leishmaniasis patients.	Ambaye TW.	American Journal of Tropical Medicine and Hygiene. 2011 December;1):83-4.		"Visceral leishmaniasis (VL) is a neglected systemic parasitic disease caused by the Leishmania donovani complex species. It commonly affects poor populations in the tropics and sub-tropical endemic areas, causing 500,000 morbidities and more than 50,000 deaths annually. Although anaemia is a common sequel of VL, use of iron status biomarkers in these patients is not well studied. This study was undertaken to describe the clinical characteristics, and changes in iron status biomarkers (ferritin, sTfR, and hepcidin) at admission and during a month following commencement of anti-leishmanial treatment in newly diagnosed VL patients. A prospective longitudinal descriptive study was conducted in a newly diagnosed, HIV negative VL patients admitted to Arba Minch Hospital-Leishmaniasis Research and Treatment Centre, South-West Ethiopia, between April and May 2010. A total of 20 confrmed VL cases, 2 female and 18 male, with a median age of 18 years were included in the study. While fever was the initial presenting symptom, with mean duration of 4.4+/-3.7 months, 6 (30%) patients had no measurable fever despite repeated follow-ups. Splenomegaly was present in all patients with 12 (60%) of them being malnourished. Pancytopenia was a common hematologic manifestation. The Mean+/-SD of haemoglobin at admission was 7.2+/- 1.99g/dl with 9(45%) of patients being iron defcient (ID). Ferritin was elevated at baseline, 1373.13+/-1191.19mu g/l, which signifcantly decreased following anti-leishmanial treatment. sTfR was increased in ID patients; and serum hepcidin concentration was higher in non-ID (NID) patients. Signifcant correlation (p<0.05) observed between sTfR and haemoglobin, hepcidin and ferritin, ferritin and body mass index, and sTfR and sTfR-F index. With treatment, signifcant improvement was observed in both clinical and laboratory parameters. In conclusion, TfR-F index was a useful biomarker in differentiating ID and NID patients. Iron defciency contributed to development of anaemia in about half of the patients. A future study is recommended to evaluate utility of serum sTfR and hepcidin against bone marrow staining for iron, and consideration of iron intervention effcacy in ID patients."									
1486	"Vitamin A and carotenoids during pregnancy and maternal, neonatal and infant health outcomes: a systematic review and meta-analysis."	"Thorne-Lyman AL, Fawzi WW."	Paediatric and Perinatal Epidemiology. 2012;26 Suppl 1:36-54.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=22742601	"Vitamin A (VA) deficiency during pregnancy is common in low-income countries and a growing number of intervention trials have examined the effects of supplementation during pregnancy on maternal, perinatal and infant health outcomes. We systematically reviewed the literature to identify trials isolating the effects of VA or carotenoid supplementation during pregnancy on maternal, fetal, neonatal and early infant health outcomes. Meta-analysis was used to pool effect estimates for outcomes with more than one comparable study. We used GRADE criteria to assess the quality of individual studies and the level of evidence available for each outcome. We identified 23 eligible trials of which 17 had suitable quality for inclusion in meta-analyses. VA or beta-carotene (C) supplementation during pregnancy did not have a significant overall effect on birthweight indicators, preterm birth, stillbirth, miscarriage or fetal loss. Among HIV-positive women, supplementation was protective against low birthweight (<2.5 kg) [risk ratio (RR) = 0.79 [95% confidence interval (CI) 0.64, 0.99]], but no significant effects on preterm delivery or small-for-gestational age were observed. Pooled analysis of the results of three large randomised trials found no effects of VA supplementation on neonatal/infant mortality, or pregnancy-related maternal mortality (random-effects RR = 0.86 [0.60, 1.24]) although high heterogeneity was observed in the maternal mortality estimate (I(2) = 74%, P = 0.02). VA supplementation during pregnancy was found to improve haemoglobin levels and reduce anaemia risk (<11.0 g/dL) during pregnancy (random-effects RR = 0.81 [0.69, 0.94]), also with high heterogeneity (I(2) = 52%, P = 0.04). We found no effect of VA/C supplementation on mother-to-child HIV transmission in pooled analysis, although some evidence suggests that it may increase transmission. There is little consistent evidence of benefit of maternal supplementation with VA or C during pregnancy on maternal or infant mortality. While there may be beneficial effects for certain outcomes, there may also be potential for harm through increased HIV transmission in some populations. 2012 Blackwell Publishing Ltd."									
711	The contribution of vitamin A to public health.	"Underwood BA, Arthur P."	FASEB Journal. 1996;10(9):1040-8.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=8801165	"Vitamin A deficiency among children in developing countries remains the leading cause of preventable severe visual impairment and blindness, and is a significant contributor to severe infections and death, particularly from diarrhea and measles. Vitamin A deficiency is also likely to increase vulnerability to other illnesses in both women and children, such as iron-deficiency anemia, and may be an important factor contributing to poor maternal performance during pregnancy and lactation and to growth deficits in children. Benefits to public health can be expected by improving the vitamin A status of deficient populations through an appropriate mix of acceptable, affordable, and available programs including promotion of breast-feeding, control of infections, dietary diversification, food fortification, and supplementation. Benefits include not only improved health and welfare for individuals and their families, but also improved chances of survival for an estimated 254 million children. [References: 57]"									
1750	[Vitamin A deficiency: epidemiological aspects and control methods].	"Ag Bendech M, Malvy DJ, Chauliac M."	Sante. 1997;7(5):309-16.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=9480037	"Vitamin A deficiency is one of the most common nutrient deficiency syndromes in children from developing countries. It is also correlated with the increased severity and incidence of certain infections. Until recently, vitamin A research was focused on preventing xerophthalmia and blindness in Third World Countries and on the development of synthetic retinoid molecules, with lower toxicity than vitamin A, for the treatment of skin diseases. However, there has been a major shift of emphasis in the last five to ten years. There is a risk of death from xerophthalmia, primarily from complications with infectious diseases. Intermittent treatment with the very large doses of vitamin A prescribed to combat blindness was shown to be effective. This suggests that vitamin A may affect specific elements of the immune system. High-dose vitamin A supplements have been given, at widely-spaced time intervals, to preschool children in communities where vitamin A deficiency causes xerophthalmia and blindness, over the last 20 to 30 years. A strong correlation between mortality and xerophthalmia was identified. Death then became the principal outcome measured because it was easier to detect than xerophthalmia, particularly in large clinical trials in high risk regions where clinical expertise was minimal and vitamin A deficiency was a commoner cause of death than blindness. Other, food-based approaches to the treatment and prevention of vitamin A deficiency, involving foods naturally rich in retinol or carotenoid, or foods artificially fortified with these nutrients, should be developed. [References: 49]"									
1446	Vitamin A during pregnancy. (Maternal Nutrition as the Key to Health and Ability of the Child.).	"Reifen R, Ghebremeskel K."	Nutrition and Health. 2001;15(3/4):237-43.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh3&AN=20023067834	"Vitamin A is an essential micronutrient throughout life. In areas of developing countries where vitamin A deficiency is endemic, an estimated 40% of the children are likely to be subclinically deficient of the vitamin. Yet, the traditional view that preschool age children represent the main population at risk of vitamin A deficiency has been replaced by the growing awareness that subclinical, and even clinical vitamin A deficiency, also occurs in women of reproductive age and in infants aged <6 months. During the period of early fetal development, the supply of vitamin A must be carefully managed to ensure that the developing fetus is exposed to neither too little nor too much vitamin A, because either condition can have teratogenic consequences. Vitamin A deficiency in infants increases susceptibility to maternally acquired human immunodeficiency virus infection. Towards the end of gestation, adequate maternal vitamin A status and dietary intakes are important to maximize the vitamin A transferred to the fetus, in preparation for parturition and lactation. A review of the current knowledge and prospects for future research is presented."									
530	Antenatal vitamin A supplementation increases birth weight and decreases anemia among infants born to human immunodeficiency virus-infected women in Malawi.	"Kumwenda N, Miotti PG, Taha TE, Broadhead R, Biggar RJ, Jackson JB, Melikian G, et al."	Clinical Infectious Diseases. 2002;35(5):618-24.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=12173139	"Vitamin A is essential for immunity and growth. A controlled clinical that involved 697 human immunodeficiency virus (HIV)-infected pregnant women was conducted to determine whether vitamin A prevents anemia, low birth weight, growth failure, HIV transmission, and mortality. Women received daily doses of iron and folate, either alone or combined with vitamin A (3 mg retinol equivalent), from 18-28 weeks' gestation until delivery. In the vitamin A and control groups, respectively, the mean (+/-SE) birth weights were 2895+/-31 g and 2805+/-32 g (P=.05), the proportions of low-birth-weight infants were 14.0% and 21.1% (P=.03), the proportions of anemic infants at 6 weeks postpartum were 23.4% and 40.6% (P<.001), and the respective cumulative proportions of infants who were HIV infected at 6 weeks and 24 months of age were 26.6% and 27.8% (P=.76) and 27.7% and 32.8% (P=.21). Receipt of vitamin A improved birth weight and neonatal growth and reduced anemia, but it did not affect perinatal HIV transmission."									
1248	Vitamin A and vitamin B-12 concentrations in relation to mortality and morbidity among children born to HIV-infected women.	"Chatterjee A, Bosch RJ, Hunter DJ, Manji K, Msamanga GI, Fawzi WW."	Journal of Tropical Pediatrics. 2010;56(1):27-35.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=19502599	"Vitamin A supplementation starting at 6 months of age is an important child survival intervention; however, not much is known about the association between vitamin A status before 6 months and mortality among children born to HIV-infected women. Plasma concentrations of vitamins A and B-12 were available at 6 weeks of age (n = 576 and 529, respectively) for children born to HIV-infected women and they were followed up for morbidity and survival status until 24 months after birth. Children in the highest quartile of vitamin A had a 49% lower risk of death by 24 months of age compared to the lowest quartile (HR: 0.51, 95% CI: 0.29-0.90; P-value for trend = 0.01). Higher vitamin A levels were protective in the sub-groups of HIV-infected and un-infected children but this was statistically significant only in the HIV-uninfected subgroup. Higher vitamin A concentrations in plasma are protective against mortality in children born to HIV-infected women."									
918	Prevalence of vitamin D deficiency in adult tuberculosis patients at a central hospital in Malawi.	"Banda R, Mhemedi B, Allain TJ."	International Journal of Tuberculosis and Lung Disease. 2011 March;15(3):408-10.		"Vitamin D deficiency (VDD) is associated with impaired mycobacterial immunity and susceptibility to tuberculosis (TB). We measured 25 hydroxy vitamin D levels in 161 adult TB patients at a central hospital in Malawi, of whom 120 (74.5%) had <=75 nmol/l (hypovitaminosis D), 68 (42%) had <=50 nmol/l (VDD) and 13.6% of inpatients and 6.8% of out-patients had <=25 nmol/l (severe VDD). In-patients had lower body mass index (BMI; 19.0 vs. 20.5, P < 0.004), and vitamin D levels were lower in those with BMI < 20. However, on multiple regression analysis in-patient status and BMI were not associated with vitamin D level. We conclude that VDD is common in adult TB patients in Malawi. In this small sample, it was not possible to identify any independent associations of VDD. 2011 The Union."									
1626	"Reciprocal seasonal variation in vitamin D status and tuberculosis notifications in Cape Town, South Africa."	"Martineau AR, Nhamoyebonde S, Oni T, Rangaka MX, Marais S, Bangani N, Tsekela R, et al."	Proceedings of the National Academy of Sciences of the United States of America. 2011;108(47):19013-7.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20113404672	"Vitamin D deficiency is associated with susceptibility to tuberculosis (TB) in HIV-uninfected people in Europe, but it is not known whether such an association exists among HIV-infected people in subtropical Africa. We conducted a cross-sectional study to determine whether vitamin D deficiency was associated with susceptibility to active TB in HIV-uninfected (n=196) and HIV-infected (n=174) black Africans in Cape Town, South Africa. We also investigated whether there was evidence of seasonal variation in vitamin D status and TB notifications in this setting over an 8-y period. Vitamin D deficiency (serum 25-hydroxyvitamin D [25(OH)D] <50 nmol/L) was present in 232 (62.7%) of 370 participants and was associated with active TB in both HIV-uninfected (odds ratio=5.2, 95% confidence interval: 2.8-9.7; P<0.001) and HIV-infected (odds ratio=5.6, 95% confidence interval: 2.7-11.6; P<0.001) people. Vitamin D status varied according to season: The mean serum 25(OH)D concentration was highest in January through March and lowest in July through September (56.8 vs. 30.7 nmol/L, respectively; P<0.001). Reciprocal seasonal variation in TB notifications was observed: The mean number of TB notifications per quarter for Cape Town in 2003 to 2010 was lowest in April through June and highest in October through December (4,222 vs. 5,080; P<0.001). Vitamin D deficiency is highly prevalent among black Africans in Cape Town and is associated with susceptibility to active TB both in the presence and absence of HIV infection. Reciprocal seasonal variation in serum 25(OH)D concentration and TB notifications suggests that seasonal variations in vitamin D status and TB incidence in this setting are causally related."									
139	Vitamin D Status and its Association with Morbidity Including Wasting and Opportunistic Illnesses in HIV-Infected Women in Tanzania.	"Mehta S, Mugusi FM, Spiegelman D, Villamor E, Finkelstein JL, Hertzmark E, Giovannucci EL, et al."	AIDS Patient Care & STDs. 2011;25(10):579-85.	http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=2011291615&site=ehost-live	"Vitamin D has a potential role in preventing HIV-related complications, based on its extensive involvement in immune and metabolic function, including preventing osteoporosis and premature cardiovascular disease. However, this association has not been examined in large studies or in resource-limited settings. Vitamin D levels were assessed in 884 HIV-infected pregnant women at enrollment in a trial of multivitamin supplementation (excluding vitamin D) in Tanzania. Information on HIV related complications was recorded during follow-up (median, 70 months). Proportional hazards models and generalized estimating equations were used to assess the relationship of vitamin D status with these outcomes. Women with low vitamin D status (serum 25-hydroxyvitamin D<32 ng/mL) had 43% higher risk of reaching a body mass index (BMI) less than 18 kg/m<sup>2</sup> during the first 2 years of follow-up, compared to women with adequate vitamin D levels (hazard ratio [HR]: 1.43; 95% confidence intervals: [1.03-1.99]). The relationship between continuous vitamin D levels and risk of BMI less than 18 kg/m<sup>2</sup> during follow-up was inverse and linear ( p=0.03). Women with low vitamin D levels had significantly higher incidence of acute upper respiratory infections (HR: 1.27 [1.04-1.54]) and thrush (HR: 2.74 [1.29-5.83]) diagnosed during the first 2 years of follow-up. Low vitamin D status was a significant risk factor for wasting and HIV-related complications such as thrush during follow-up in this prospective cohort in Tanzania. If these protective associations are confirmed in randomized trials, vitamin D supplementation could represent a simple and inexpensive method to improve health and quality of life of HIV-infected patients, particularly in resource-limited settings."									
1139	Hypovitaminosis D is common among pulmonary tuberculosis patients in Tanzania but is not explained by the acute phase response.	"Friis H, Range N, Pedersen ML, Molgaard C, Changalucha J, Krarup H, Magnussen P, et al."	Journal of Nutrition. 2008;138(12):2474-80.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=19022975	"Vitamin D is essential to immune function, but little is known about the vitamin D status in equatorial populations. A cross-sectional study was conducted among pulmonary tuberculosis (PTB) patients in Mwanza, Tanzania to identify the predictors of their vitamin D status. Data on sociodemography, season, and intake of food, alcohol, tobacco, and soil were collected, anthropometric measurements taken, and serum alpha(1)-antichymotrypsin (ACT), ferritin and soluble transferrin receptor (sTfR), and serum 25-hydroxy-(ergocalciferol+cholecalciferol) [25(OH)D] determined. Of the 655 patients studied, 79.7% (508/637) were culture-positive (PTB+) and 47.2% HIV infected. Mean serum ACT, an acute phase reactant, was 0.73 +/- 0.25 g/L with 69.2% >0.6 g/L. Mean serum 25(OH)D was 86.6 +/- 32.9 nmol/L, with 41.2% <75 nmol/L. Serum 25(OH)D was highest during the harvest season, May to July, compared with the remaining year. Single subjects had lower [10.4 (95% CI 4.0; 16.9) nmol/L] serum 25(OH)D concentrations than married subjects and PTB+ patients had concentrations lower [8.2 (95% CI 1.5; 14.9) nmol/L] than PTB- patients. Serum 25(OH)D increased with consumption of a large freshwater fish but not of small dried fish or other foods. BMI and serum TfR were positive predictors of serum 25(OH)D, whereas neither elevated serum ACT nor HIV were predictors. In conclusion, serum 25(OH)D is a valid measure of vitamin D status during the acute phase response. The lower concentrations in PTB+ patients may reflect lower sun exposure or increased utilization. The health consequences of hypovitaminosis D in low-income equatorial populations, at risk for both infectious and chronic diseases, should be studied."									
240	Effects of maternal vitamin supplements on malaria in children born to HIV-infected women.	"Villamor E, Msamanga G, Saathoff E, Fataki M, Manji K, Fawzi WW."	American Journal of Tropical Medicine & Hygiene. 2007;76(6):1066-71.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=17556612	"Vitamin deficiencies are frequent in children suffering from malaria. The effects of maternal multivitamin supplementation on the risk of malaria in children are unknown. We examined the impact of providing multivitamins or vitamin A/beta-carotene supplements during pregnancy and lactation to HIV-infected women on their children's risk of malaria up to 2 years of age, in a randomized, placebo-controlled trial. Tanzanian women (N = 829) received one of four daily oral regimens during pregnancy and after delivery: 1) vitamins B, C, and E (multivitamins); 2) vitamin A and beta-carotene (VA/BC); 3) multivitamins including VA/BC; or 4) placebo. After 6 months of age, all children received 6-monthly oral vitamin A supplements irrespective of treatment arm. The incidence of childhood malaria was assessed through three-monthly blood smears and at monthly and interim clinic visits from birth to 24 months of age. Compared with placebo, multivitamins excluding VA/BC reduced the incidence of clinical malaria by 71% (95% CI = 11-91%; P = 0.02), whereas VA/BC alone resulted in a nonsignificant 63% reduction (95% CI = -4% to 87%; P = 0.06). Multivitamins including VA/BC significantly reduced the incidence of high parasitemia by 43% (95% CI = 2-67%; P = 0.04). The effects did not vary according to the children's HIV status. Supplementation of pregnant and lactating HIV-infected women with vitamins B, C, and E might be a useful, inexpensive intervention to decrease the burden of malaria in children born to HIV-infected women in sub-Saharan Africa."									
1331	Supplementary feeding in the care of the wasted HIV infected patient.	"Manary M, Ndekha M, van Oosterhout JJ."	Malawi Medical Journal. 2010;22(2):46-9.		"Wasting and food insecurity are commonly seen in patients receiving antiretroviral treatment (ART) programs in sub-Saharan Africa and south Asia, and supplementary feeding is often offered in conjunction with ART. Evidence for the effectiveness of such supplementary feeding is scant. A randomised, investigator-blinded, controlled clinical trial of two types of supplementary food, corn/ soy blended four and a ready-to-use peanut butter-based lipid paste, in wasted adults in Blantyre, Malawi is described and the results summarised. A historical control group who did not receive supplementary food is described as well. Provision of about half of the daily energy requirement as a supplementary food for 14 weeks resulted in more rapid restoration of a normal BMI; and the energy-dense, ready-to-use paste was associated with more rapid weight gain than the blended four. Survival was similar among the 3 groups. The strong association between lower BMI and survival indirectly suggests that there may well be clinical benefit from supplementary feeding in this population. No differences were seen in ART adherence or quality of life with more rapid restoration of BMI. Further research is urgently needed concerning the widespread practice of supplementary feeding in HIV/ AIDS care to most effectively utilize this intervention."									
1332	Supplementary feeding in the care of the wasted HIV infected patient.	"Manary M, Ndekhat M, van Oosterhout JJ."	Malawi Medical Journal. 2010;22(2):46-8.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=21614881	"Wasting and food insecurity are commonly seen in patients receiving antiretroviral treatment (ART) programs in sub-Saharan Africa and south Asia, and supplementary feeding is often offered in conjunction with ART. Evidence for the effectiveness of such supplementary feeding is scant. A randomised, investigator-blinded, controlled clinical trial of two types of supplementary food, corn/soy blended flour and a ready-to-use peanut butter-based lipid paste, in wasted adults in Blantyre, Malawi is described and the results summarised. A historical control group who did not receive supplementary food is described as well. Provision of about half of the daily energy requirement as a supplementary food for 14 weeks resulted in more rapid restoration of a normal BMI; and the energy-dense, ready-to-use paste was associated with more rapid weight gain than the blended flour. Survival was similar among the 3 groups. The strong association between lower BMI and survival indirectly suggests that there may well be clinical benefit from supplementary feeding in this population. No differences were seen in ART adherence or quality of life with more rapid restoration of BMI. Further research is urgently needed concerning the widespread practice of supplementary feeding in HIV/AIDS care to most effectively utilize this intervention."									
1864	"Spirochete round bodies: syphilis, Lyme disease & AIDS: resurgence of ""the great imitator""?"	"Margulis L, Maniotis A, MacAllister J, Scythes J, Brorson O, Hall J, Krumbein WE, et al."	Symbiosis. 2009;47(1):51-8.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20093081209	"We advocate investigation of spirochete cyclical symbioses (e.g., Borrelia sp., Leptospira sp., Treponema sp.) given the newly established verification of a developmental history in these gram-negative motile helical eubacteria, both in pure culture and in mammals. Symbiotic spirochetes can be compared to free-living relatives for their levels of integration (behavioral, metabolic, gene product or genetic levels). Detailed research that correlates life histories of symbiotic spirochetes to changes in the immune system of associated vertebrates is sorely needed. Genome analyses show that in necrotrophic symbioses (Borrelia and Treponema sp.) of humans and other primates, integration of the bionts occurs at the gene product and genetic level. Spirochete round bodies (also called cysts, L-forms and sphaeroplasts) can be induced by many types of unfavorable conditions (e.g., threats of starvation, desiccation, oxidation, penicillin and other antibiotics). Reversion to familiar helical, motile active swimmers by placement of pure cultures into favorable environments in some cases can be controlled. These observations are supported by a European literature, especially Russian, apparently unknown to American medicine and medical research."									
585	Incidence and risk factors for tenofovir-associated renal function decline among Thai HIV-infected patients with low-body weight.	"Chaisiri K, Bowonwatanuwong C, Kasettratat N, Kiertiburanakul S."	Current HIV research. 2010 1 Oct;8(7):504-9.		"we aimed at determining the incidence and factors for TDF-associated renal function decline among Thai HIV-infected patients. retrospective and prospective cohort studies were conducted. We enrolled HIV-infected adults who had initiated TDF. Renal function decline that was defined by a decrease of 25% in glomerular filtration rate (GFR) from the baseline. Factors associated with the renal function decline were determined. a total of 405 patients with a median (IQR) body weight of 56.5 (50.5-65.0) kg were enrolled. All but four (99%) were antiretroviral treatment-experience patients. A median (IQR) duration of receiving TDF was 16 (8-21) months. Of these, 78 (19.3%) patients had a 25% decrease in GFR with the incidence rate of 16.2 per 100 person-years. By Kaplan-Meier survival analysis, median time to a 25% decrease in GFR was 28 [95% confidence interval (CI) 25.2-30.8] months. By multiple logistic regression, lower body weight [odds ratio (OR) 1.15 per 5 kg, 95% CI 1.00-1.33], lower body mass index (BMI) (OR 2.26 per 1 kg/m(2), 95% CI 1.74-2.94), baseline GFR (OR 1.62 per 10 ml/min/1.73m(2), 95% CI 1.39-1.88), protease inhibitor (OR 2.12, 95% CI 1.15-3.92), and nephrotoxic drug (OR 3.16, 95% CI 1.44-6.98) were statistically significant factors associated with a 25% decrease in GFR. the study revealed high incidence of TDF-associated renal function decline among patients with low-body weight and BMI. Additional risk factors were baseline GFR, receiving protease inhibitor, and nephrotoxic drugs. Close monitoring of renal function is warranted among patients with these risk factors."									
96	Adherence to antiretroviral therapy among a conflict-affected population in Northeastern Uganda: a qualitative study.	"Olupot-Olupot P, Katawera A, Cooper C, Small W, Anema A, Mills E."	AIDS. 2008;22(14):1882-4.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=18753867	"We aimed to determine patient and health worker concerns regarding antiretroviral adherence in a conflict-affected population using focus groups (n = 40) and semi-structured interviews (n = 11). Patient concerns include security attending clinics, food security, distance to health centers and access to health providers. During periods of famine and flooding, the lack of food security and only single daily meals makes taking multiple doses impossible. Possible facilitating strategies included mobile teams, increased security and regularity of drug stocks."									
1252	Patterns and predictors of CD4 T-cell counts among children born to HIV-infected women in Tanzania.	"Kupka R, Msamanga GI, Aboud S, Manji KP, Duggan C, Fawzi WW."	Journal of Tropical Pediatrics. 2009;55(5):290-6.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=19158163	"We assessed age-specific CD4 T-cell counts and their determinants among Tanzanian children born to HIV-infected mothers to address a major research gap. A total of 474 HIV-uninfected and 69 HIV-infected children were followed until age of 12 months. Maternal predictors were measured during pregnancy and child predictors at birth and throughout the follow up. Child CD4 T-cell counts were evaluated at the age of 3 months and subsequent 3-month intervals; they decreased linearly among HIV-infected (beta = -8 cells per week; 95% CI -12 to -4; P = 0.0003) and increased linearly among HIV-uninfected children (beta = 4 cells/week; 95% CI 2-7; P = 0.0008). Decreased child counts were predicted by low child anthropometry, maternal HIV stage > or =2, and maternal mid-upper arm circumference <27 cm among HIV-infected children; and by weight-for-height <-2 z-score, maternal HIV stage > or =2, maternal erythrocyte sedimentation rate <81 mm/h and maternal haemoglobin <8.5 g/dl among HIV-uninfected children. The maternal and child predictors described may serve as intervention targets among HIV-exposed children."									
1891	Nutritional status and weight gain in patients with pulmonary tuberculosis in Tanzania.	"Kennedy, Ramsay A, Uiso L, Gutmann J, Ngowi FI, Gillespie SH."	Transactions of the Royal Society of Tropical Medicine and Hygiene. 1996;90(2):162-6.		"We assessed nutritional status in 200 adult Tanzanian patients with smear-positive pulmonary tuberculosis before, during, and after 6 months of tuberculosis treatment; 148 patients (74%) were successfully followed for 12 months. Marked nutritional impairment was present on admission: 77% of males and 58% of females had a body mass index (BMI) below 18.5; approximately one-fifth had BMI < 16.0. The length of hospital stay and gender, rather than microbiological response, were the major determinants of weight gain during treatment. Patients infected with human immunodeficiency virus (HIV) gained more weight than uninfected patients. Most patients lost weight after completing treatment and returning home. At 12 months, dB 32% of male and 19% of female patients considered cured of tuberculosis had BMI < 18.5. It is concluded that patients with tuberculosis from this area of Tanzania frequently have evidence of malnutrition both before and after treatment for tuberculosis. Weight gain during therapy appeared to be an unreliable indicator of overall treatment response. However, the results also demonstrated that nutritional rehabilitation can be successfully achieved even in HIV-positive tuberculosis patients and in patients with a suboptimal response to therapy."									
1680	The presentation of newly-diagnosed diabetic patients in Uganda.	"Nambuya AP, Otim MA, Whitehead H, Mulvany D, Kennedy R, Hadden DR."	Qjm. 1996;89(9):705-11.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=8917747	"We assessed the clinical characteristics of newly-diagnosed diabetic patients presenting to the Mulago Hospital Diabetic Clinic for the first time between 1 January 1993 and 10 August 1994. There were 252 patients: 117 men and 135 women. Mean age at onset of diabetes was 45 years (range 2-87 years) and peak incidence was at 40-49 years. Body mass index (BMI) was available in only 71 patients, of whom 53.5% (33.8% female, 19.7% male) were overweight (BMI > 25 in women, in > 27 men) and 11.3% (8.5% men, 2.8% women) were underweight (BMI < 20). Obesity was more marked in young women. Almost all patients presented with the classical symptoms of diabetes, and the majority were severely hyperglycaemic. A family history of diabetes was identified in 16%. Concurrent illnesses at diagnosis of diabetes were unusual. Sepsis was commonest (11.9%), followed by malaria (7.8%), tuberculosis (1.2%), AIDS (1.2%) and pancreatitis (0.8%). Peripheral neuropathy was present in 46.4% of patients, hypertension (BP > 150/100) in 27.3%, impotence in 22.2% of the men, proteinuria in 17.1%, ischaemic heart disease in 4.8%, foot ulcers in 4.0% and cataracts in 3.2%. Insulin was the most commonly prescribed treatment (52.8%); 31% of patients received oral hypoglycaemic agents, only 15.1% were managed on diet only, and 1.2% opted for herbal medicine."									
160	"Modified Kigali combined staging predicts risk of mortality in HIV-infected adults in Lusaka, Zambia."	"Peters PJ, Zulu I, Kancheya NG, Lakhi S, Chomba E, Vwalika C, Kim DJ, et al."	AIDS Research and Human Retroviruses. 2008 01 Jul;24(7):919-24.		"We assessed the utility of the modified Kigali combined (MKC) staging system for predicting survival in HIV-infected Zambian adults in a prospective, longitudinal, open cohort. From 1995 to 2004, HIV-discordant couples (one HIV-infected partner and one HIV-negative partner) were recruited from couples' voluntary counseling and testing centers in Lusaka, Zambia and followed at 3-month intervals. MKC stage, which incorporates clinical stage with erythrocyte sedimentation rate (ESR), hematocrit, and body mass index (BMI), was determined at enrollment. Kaplan-Meier survival and Cox proportional hazard methods were used to calculate median survival and relative hazards. We enrolled 1479 HIV-discordant couples with a combined 7305 person-years of follow-up. Among HIV-infected participants over the 9-year study period, there were 333 confirmed deaths. The time to 50% mortality was 8.5 years with MKC stage 1 and 2 disease compared to 3.7 years with MKC stage 4 disease at enrollment. Survival rates at 3 years were 85% with MKC stage 1 and 2 disease, 74% with MKC stage 3 disease, and 51% with MKC stage 4 disease. A total of 275 HIV-negative partners seroconverted during follow-up. In comparison, survival rates at 3 years were 94% for HIV-negative participants and 92% for participants who seroconverted during follow-up. In multivariate analysis, MKC stage 4 disease (HR = 3.7, 95% CI = 2.7-5.0) remained a strong predictor of mortality. Incorporating ESR, hematocrit, and BMI with clinical staging is a powerful, low-cost tool to identify HIV-infected adults at high risk for mortality. 2007 Mary Ann Liebert, Inc."									
362	Altered Functional Status of the Hypothalamic Dopaminergic Tone in Patients with Chronic Graft-versus-Host Disease after Allogeneic Hematopoietic Stem Cell Transplantation: A Pilot Study.	"Parra A, Ramirez-Peredo J, Hidalgo R, Morales-Toquero A, Velasquez-Ramirez G, Ruiz-Arguelles A, Ruiz-Arguelles GJ."	Biology of Blood and Marrow Transplantation. 2006 May;12(5):566-72.		"We compared the functional status of the hypothalamic dopaminergic tone in patients given an allogeneic hematopoietic stem cell transplantation (allo-HSCT) with chronic graft-versus-host disease (GVHD) with that observed in patients with allo-HSCT without chronic GVHD and in healthy controls. The effect of acute dopaminergic blockade with intravenous metoclopramide on serum prolactin (PRL) concentrations was evaluated. Twenty volunteers, 20 to 52 years of age, seronegative for both hepatitis C virus and the human immunodeficiency virus, were studied: (1) 10 clinically healthy men (group 1), and (2) 9 patients with leukemia, and 1 patient with refractory aplastic anemia who underwent allo-HSCT, 5 of whom (3 men and 2 women) developed chronic GVHD (group 2), and 5 (3 men and 2 women) who did not develop chronic GVHD (group 3). Serum PRL concentrations were measured both fasting and after intravenous administration of metoclopramide (10-mg bolus). The area under the PRL curve was calculated. Patients in group 2 were older than those in groups 1 and 3 (P < .018), but their body mass index was similar. Fasting serum PRL concentrations were similar among the 3 groups; however, group 2 had higher PRL concentrations throughout the test (P < .001) and a greater area under the PRL curve than groups 1 and 3 (P < .001), without differences between the last 2 groups. The differences remained significant after adjustment for age (P < .01). Our results in a small group of patients with chronic GVHD after allo-HSCT suggest the existence of an increased functional level of their hypothalamic dopamine tone, which would favor a tendency toward a diminished endogenous production, release of pituitary PRL, or both. This could represent an adaptive mechanism aiming to maintain circulating PRL concentrations within a physiological range. 2006 American Society for Blood and Marrow Transplantation."									
544	"Nutritional status of persons with HIV infection, persons with HIV infection and tuberculosis, and HIV-negative individuals from southern India."	"Soumya S, Padmapriyadarsini C, Sukumar B, Sheikh I, Kumar SR, Triveni C, Gomathy P, et al."	Clinical Infectious Diseases. 2008;46(6):946-9.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20083083886	"We compared the nutritional status of individuals with human immunodeficiency virus (HIV) infection alone, individuals with HIV infection and tuberculosis (after completion of antituberculosis treatment), and HIV-negative individuals and found that malnutrition, anemia, and hypoalbuminemia were most pronounced among HIV-positive patients with tuberculosis. Weight loss was associated with loss of fat in female patients and with loss of body cell mass in male patients."									
549	"Nutritional status of persons with HIV infection, persons with HIV infection and tuberculosis, and HIV-negative individuals from southern India."	"Swaminathan S, Padmapriyadarsini C, Sukumar B, Iliayas S, Kumar SR, Triveni C, Gomathy P, et al."	Clinical Infectious Diseases. 2008;46(6):946-9.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=18279043	"We compared the nutritional status of individuals with human immunodeficiency virus (HIV) infection alone, individuals with HIV infection and tuberculosis (after completion of antituberculosis treatment), and HIV-negative individuals and found that malnutrition, anemia, and hypoalbuminemia were most pronounced among HIV-positive patients with tuberculosis. Weight loss was associated with loss of fat in female patients and with loss of body cell mass in male patients."									
1882	Iron deficiency in children with HIV-associated anaemia: a systematic review and meta-analysis.	"Esan MO, Jonker FA, Hensbroek MB, Calis JC, Phiri KS."	Transactions of the Royal Society of Tropical Medicine & Hygiene. 2012;106(10):579-87.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=22846115	"We conducted a systematic review and meta-analysis to determine the prevalence of iron deficiency in HIV-infected children from high- and low-income settings and compared it with that of HIV-uninfected controls. We searched five major databases for primary studies reporting on anaemia and iron markers in HIV-infected children. A pooled analysis was done using random-effects models, with Forest plots and heterogeneity test estimates provided. Fifteen articles (2778 children) met the inclusion criteria. In the pooled analysis, mean overall prevalence of iron deficiency in HIV-infected children was 34% (95%CI 19-50%). Prevalence rates were similar in high-income (31%; 95%CI 2-61%) and low-income settings (36%; 95%CI 17-54%) (p=0.14). Studies that included a HIV-uninfected control population (n=4) were only available from low-income settings and showed less iron deficiency in HIV-infected children (28%) than in HIV-uninfected children (43%); OR 0.50 (0.27-0.94); p=0.03. The findings suggest that HIV-infected children are less likely to be iron deficient when compared with HIV-uninfected children. Possible explanations for this include HIV-induced haematosuppression and associated hypoferraemia, with adequate iron stores. Nevertheless iron deficiency is a common co-morbidity in HIV. Studies are needed to determine the role of iron deficiency in HIV-associated anaemia and the effects of iron supplementation in this population. Copyright 2012 Royal Society of Tropical Medicine and Hygiene. Published by Elsevier Ltd. All rights reserved."									
1337	"Patterns of body composition among HIV-infected, pregnant Malawians and the effects of famine season."	"Ramlal RT, Tembo M, Soko A, Chigwenembe M, Tohill BC, Kayira D, King CC, et al."	Maternal & Child Health Journal. 2013;17(2):265-73.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=22395817	"We describe change in weight, midupper arm circumference (MUAC), arm muscle area (AMA) and arm fat area (AFA) in 1130 pregnant HIV-infected women with CD4 counts>200 as part of the BAN Study ( www.thebanstudy.org ), a randomized, controlled clinical trial to evaluate antiretroviral and nutrition interventions to reduce mother-to-child transmission of HIV during breast feeding. In a longitudinal analysis, we found a linear increase in weight with a mean rate of weight gain of 0.27kgs/week, from baseline (12 to 30 weeks gestation) until the last follow-up visit (32-38 weeks). Analysis of weight gain showed that 17.1% of the intervals between visits resulted in a weight loss. In unadjusted models, MUAC and AMA increased and AFA declined during late pregnancy. Based on multivariable regression analysis, exposure to the famine season resulted in larger losses in AMA [-0.08, 95% CI -0.14, -0.02; p=0.01] while AFA losses occurred irrespective of season [-0.55, 95%: -0.95, -0.14, p=0.01]. CD4 was associated with AFA [0.21, 95% CI 0.01, 0.41, p=.04]. Age was positively associated with MUAC and AMA. Wealth was positively associated with MUAC, AFA, and weight. While patterns of anthropometric measures among HIV-infected, pregnant women were found to be similar to those reported for uninfected women in sub-Saharan Africa, effects of the famine season among undernourished, Malawian women are of concern. Strategies to optimize nutrition during pregnancy for these women appear warranted."									
613	"Nutritional status of under fives attending maternal and child health clinics in Dar es Salaam, Tanzania."	"Matee MI, Msengi AE, Simon E, Lyamuya EF, Mwinula JH, Mbena EC, Mbena EC, et al."	East African Medical Journal. 1997;74(6):368-71.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=9487398	"We designed a study to assess the nutritional status of children under five years of age attending MCH clinics in Dar es Salaam. This was a cross-sectional anthropometric study involving children 6-24 months who from July to August 1993 were attending Magomeni MCH clinic and those aged 18 months to five years who were attending Lugalo and Mwananyamala MCH clinics for routine growth monitoring and for vaccination between May to August 1994. The data collected included age, birthweight, sex, weight, height, breastfeeding status and HIV-1 serostatus. Of the 1854 children enrolled (961 boys and 893 girls) 31.6% were stunted, 14.6% were underweight and 2.9% were wasted. The highest percentage of stunting and wasting was observed between 11 and 25 months and 36 to 40 months. Of the 849 children tested for HIV-1, 14 (1.7%) were seropositive and two out of 770 (0.3%) were born with low weight. HIV seropositivity and low birthweight were both associated with stunting and wasting. We conclude that malnutrition is still a sizeable problem among children attending urban MCH clinics in Dar es Salaam especially among those aged less than three years, to whom special malnutrition control strategies should be targeted. There is also a need to identify factors responsible for the observed decline in MCH attendance with age and correct the situation."									
235	Prevalence and severity of malnutrition in pre-school children in a rural area of western Kenya.	"Kwena AM, Terlouw DJ, de Vlas SJ, Phillips-Howard PA, Hawley WA, Friedman JF, Vulule JM, et al."	American Journal of Tropical Medicine & Hygiene. 2003;68(4 Suppl):94-9.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=12749491	"We determined the nutritional status of children less than five years of age in an area in rural western Kenya with intense malaria transmission, a high prevalence of severe anemia and human immunodeficiency virus, and high infant and under-five mortality (176/1,000 and 259/1,000). No information is available on the prevalence of malnutrition in this area. Three cross-sectional surveys were conducted between 1996 and 1998 to monitor the effect of insecticide-treated bed nets on child morbidity. Anthropometric indices are presented for 2,103 children collected prior to and during intervention (controls only). The prevalence of stunting (Z-scores for height-for-age [HAZ] <-2), wasting (Z-scores for weight-for-height [WHZ] <-2) and being underweight (Z-scores for weight-for-age [WAZ] <-2) was 30%, 4%, and 20%, respectively. This was severe (Z-score <-3) in 12% (stunting), 1% (wasting), and 5% (underweight) of the children. Few children less than three months of age were malnourished (<2%), but height-for-age and weight-forage deficits increased rapidly in children 3-18 months of age, and were greatest in children 18-23 months old (44% stunted and 34% underweight). While the mean HAZ and WAZ stabilized from 24 months of age onwards, they still remained substantially below the reference median with no evidence of catch-up growth. Malnutrition is likely to interact with infectious diseases, placing children 3-24 months of age at high risk of premature death in this area."									
247	Prevalence and severity of malnutrition in pre-school children in a rural area of Western Kenya.	"Kwena AM, Terlouw DJ, Vlas SJd, Phillips-Howard PA, Hawley WA, Friedman JF, Vulule JM, et al."	"American Journal of Tropical Medicine and Hygiene. 2003;68(4, Supplement):94-9."	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh3&AN=20043121812	"We determined the nutritional status of children less than five years of age in an area in rural western Kenya with intense malaria transmission, a high prevalence of severe anemia and human immunodeficiency virus, and high infant and under-five mortality (176/1,000 and 259/1,000). No information is available on the prevalence of malnutrition in this area. Three cross-sectional surveys were conducted between 1996 and 1998 to monitor the effect of insecticide-treated bed nets on child morbidity. Anthropometric indices are presented for 2,103 children collected prior to and during intervention (controls only). The prevalence of stunting (Z-scores for height-for-age [HAZ]<-2), wasting (Z-scores for weight-for-height [WHZ]<-2) and being underweight (Z-scores for weight-for-age [WAZ]<-2) was 30%, 4%, and 20%, respectively. This was severe (Z-score <-3) in 12% (stunting), 1% (wasting), and 5% (underweight) of the children. Few children less than three months of age were malnourished (<2%), but height-for-age and weight-for-age deficits increased rapidly in children 3-18 months of age, and were greatest in children 18-23 months old (44% stunted and 34% underweight). While the mean HAZ and WAZ stabilized from 24 months of age onwards, they still remained substantially below the reference median with no evidence of catch-up growth. Malnutrition is likely to interact with infectious diseases, placing children 3-24 months of age at high risk of premature death in this area."									
132	Education and nutritional status of orphans and children of HIV-infected parents in Kenya.	"Mishra V, Arnold F, Otieno F, Cross A, Hong R."	AIDS Education and Prevention. 2007 October;19(5):383-95.		"We examined whether orphaned and fostered children and children of HIV-infected parents are disadvantaged in schooling, nutrition, and health care. We analyzed data on 2,756 children aged 0-4 years and 4,172 children aged 6-14 years included in the 2003 Kenya Demographic and Health Survey, with linked anonymous HIV testing, using multivariate logistic regression. Results indicate that orphans, fostered children, and children of HIV-infected parents are significantly less likely to attend school than non-orphaned/non-fostered children of HIV-negative parents. Children of HIV-infected parents are more likely to be underweight and wasted, and less likely to receive medical care for ARI and diarrhea. Children of HIV-negative single mothers are also disadvantaged on most indicators. The findings highlight the need to expand child welfare programs to include not only orphans but also fostered children, children of single mothers, and children of HIV-infected parents, who tend to be equally, if not more, disadvantaged. 2007 The Guilford Press."									
134	Education and nutritional status of orphans and children of HIV-infected parents in Kenya.	"Vinod M, Arnold F, Otieno F, Cross A, Hong R."	AIDS Education and Prevention. 2007;19(5):383-95.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20073280408	"We examined whether orphaned and fostered children and children of HIV-infected parents are disadvantaged in schooling, nutrition, and health care. We analyzed data on 2,756 children aged 0-4 years and 4,172 children aged 6-14 years included in the 2003 Kenya Demographic and Health Survey, with linked anonymous HIV testing, using multivariate logistic regression. Results indicate that orphans, fostered children, and children of HIV-infected parents are significantly less likely to attend school than non-orphaned/non-fostered children of HIV-negative parents. Children of HIV-infected parents are more likely to be underweight and wasted, and less likely to receive medical care for ARI and diarrhea. Children of HIV-negative single mothers are also disadvantaged on most indicators. The findings highlight the need to expand child welfare programs to include not only orphans but also fostered children, children of single mothers, and children of HIV-infected parents, who tend to be equally, if not more, disadvantaged."									
457	Sex differences in the effects of maternal vitamin supplements on mortality and morbidity among children born to HIV-infected women in Tanzania.	"Kawai K, Msamanga G, Manji K, Villamor E, Bosch RJ, Hertzmark E, Fawzi WW."	British Journal of Nutrition. 2010;103(12):1784-91.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=20211040	"We examined whether there are sex differences in the effect of vitamin supplements on birth outcomes, mortality and morbidity by 2 years of age among children born to HIV-infected women in Tanzania. A randomised placebo-controlled trial was conducted among 959 mother-infant pairs. HIV-infected pregnant women were randomly assigned to receive a daily oral dose of one of four regimens: multivitamins (vitamins B-complex, C and E), vitamin A plus beta-carotene, multivitamins including vitamin A plus beta-carotene or placebo. Supplements were administered during pregnancy and continued after delivery. The beneficial effect of multivitamins on decreasing the risk of low birth weight was stronger among girls (relative risks (RR) = 0.39, 95 % CI 0.22, 0.67) than among boys (RR = 0.81, 95 % CI 0.44, 1.49; P for interaction = 0.08). Maternal multivitamin supplements resulted in 32 % reduction in mortality among girls (RR = 0.68, 95 % CI 0.47, 0.97), whereas no effect was found among boys (RR = 1.20, 95 % CI 0.80, 1.78; P for interaction = 0.04). Multivitamins had beneficial effects on the overall risks of diarrhoea that did not differ by sex. Vitamin A plus beta-carotene alone increased the risk of HIV transmission, but had no effects on mortality, and we found no sex differences in these effects. Sex differential effects of multivitamins on mortality may be due to sex-related differences in the immunological or genetic factors. More research is warranted to examine the effect of vitamins by sex and better understand biological mechanisms mediating such effects."									
703	"Food security, nutrition and HIV/AIDS-overview and context in Honduras."	"Martinez H, Ramirez BY, Palar K, Adams J, Farias H, Green H, Wagner G, et al."	FASEB Journal. 2011 April;25.		"We explored the nutritional status and food security of people with HIV receiving ART in Honduras to develop a nutritional counseling and food assistance intervention aimed at improving ART adherence. Sample: 160 male and female adults attending four urban HIV clinics in Honduras. Methods: Diet and nutritional intake; household food security; socio-economic characteristics, and; health and ART status and adherence. Results: 87% of households were food insecure (45% = severe). 15% had inadequate ART adherence, all from food-insecure households. Dietary intake showed minor deficits in total calorie and carbohydrate intake, very low protein intake, and very high fat intake. Micronutrient deficient intake included calcium, potassium, zinc, magnesium, and vitamins B6 and B12. Percent body fat showed that among women, almost half were overweight and another third were underweight; among men, almost half were underweight and a fifth were overweight. We found a high percentage of household food insecurity and poor nutrition, resulting in obesity or undernutrition. Interventions should be targeted at the household level and focus on significantly increasing protein and selected micronutrients intake, and moderately increasing carbohydrates and overall calories, while drastically reducing fats, all of which may have significant impact on nutrition, adherence and clinical outcomes."									
1167	Metabolic effects of acute measles in chronically malnourished Nigerian children.	"Phillips RS, Enwonwu CO, Okolo S, Hassan A."	Journal of Nutritional Biochemistry. 2004;15(5):281-8.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=15135152	"We hypothesized that acute measles infection imposes severe metabolic demands on malnourished children. Nigerian rural communities, characterized by severe poverty and extensive malnutrition, served as site for this study. Sixty-five children (mean [+/-SD] age 2.67 +/- 1.96 years) with measles and a randomly selected equal number of children (age 2.83 +/- 1.23 years) from the same communities but measles-free were studied. Both groups were serologically negative for human immunodeficiency virus. The percentages of nonmeasles group who were underweight and wasted as exemplified by weight for age (WAZ) and weight for height (WHZ) scores less than -2.0 SD were 43% and 23%, respectively. Comparative values for the measles group (66% and 54% respectively) were significantly (P < 0.01 or 0.001) different. Compared to the controls, measles-infected children had significantly (P < 0.001) higher plasma cortisol level, marked hyporetinemia (plasma retinol 0.62 +/- 0.24 micromol/L) and prominent reduction (P < 0.002) in the sum of serum essential amino acids. Measles promoted a TH(1) to TH(2) cytokine shift, with severe depletion of plasma interleukin (IL)-12, a key cytokine in the development of cell mediated immunity. IL-6, a key stimulator of hepatic acute phase protein response, was prominently (P < 0.002) increased in plasma in measles-infected children. Glucocorticoids exert effects on cytokine expression, as well as on cytokine receptor expression and cytokine-regulated biological responses. They enhance synergistically, the effects of IL-1 and IL-6 type cytokines on many acute phase proteins. Because of the prominent increase in circulating level of cortisol in acute measles, glucocorticoid treatment for associated sepsis may pose serious problems. Additionally, glucocorticoids antagonize several effects of retinoids at cellular and transcriptional levels, thus suggesting that hypercortisolemia may increase the requirement for retinoids."									
1166	Metabolic effects of acute measles in chronically malnourished Nigerian children.	"Phillips RS, Enwonwu CO, Okolo S, Abubakar H."	Journal of Nutritional Biochemistry. 2004;15(5):281-8.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh3&AN=20043098550	"We hypothesized that acute measles infection imposes severe metabolic demands on malnourished children. Nigerian rural communities, characterized by severe poverty and extensive malnutrition, served as site for this study. Sixty-five children (mean [+or-SD] age 2.67+or-1.96 years) with measles and a randomly selected equal number of children (age 2.83+or-1.23 years) from the same communities but measles-free were studied. Both groups were serologically negative for human immunodeficiency virus. The percentages of nonmeasles group who were underweight and wasted as exemplified by weight for age (WAZ) and weight for height (WHZ) scores less than -2.0 SD were 43% and 23%, respectively. Comparative values for the measles group (66% and 54% respectively) were significantly (P<0.01 or 0.001) different. Compared to the controls, measles-infected children had significantly (P<0.001) higher plasma cortisol level, marked hyporetinemia (plasma retinol 0.62+or-0.24 micro mol/L) and prominent reduction (P<0.002) in the sum of serum essential amino acids. Measles promoted a TH<sub>1</sub> to TH<sub>2</sub> cytokine shift, with severe depletion of plasma interleukin (IL)-12, a key cytokine in the development of cell mediated immunity. IL-6, a key stimulator of hepatic acute phase protein response, was prominently (P<0.002) increased in plasma in measles-infected children. Glucocorticoids exert effects on cytokine expression, as well as on cytokine receptor expression and cytokine-regulated biological responses. They enhance synergistically, the effects of IL-1 and IL-6 type cytokines on many acute phase proteins. Because of the prominent increase in circulating level of cortisol in acute measles, glucocorticoid treatment for associated sepsis may pose serious problems. Additionally, glucocorticoids antagonize several effects of retinoids at cellular and transcriptional levels, thus suggesting that hypercortisolemia may increase the requirement for retinoids."									
1257	Nutritional predictors of acute respiratory infections among children born to hiv-infected women in Tanzania.	"Mwiru Dr R, Spiegelman D, Hertzmark E, Duggan C, Msamanga G, Aboud S, Fawzi W."	Journal of Tropical Pediatrics. 2013 June;59(3):203-8.		"We prospectively determined the association between undernutrition and incidence of acute respiratory infections (ARIs) among 711 children born to HIV-infected women. Overall, underweight was associated with a 58% increased risk of ARI. Similarly, wasting (54%), very low birth weight (88%) and child HIV infection (62%) were significantly associated with increased risk of ARI during the first 2 years. Breastfeeding was associated with 52% reduction in risk of ARI only during the first 12 months of life. Among HIV-exposed, but uninfected, children, underweight, wasting and stunting were associated with 73%, 61% and 33% increased risk of ARI, respectively. Very low birthweight and advanced maternal disease stage were also associated with increased risk of ARI. Similar results were observed among HIV-infected children, except for stunting and very low birth weight. Prevention of child undernutrition could have major impact in reducing child ARI morbidity in settings of high HIV prevalence. The Author [2013]. Published by Oxford University Press. All rights reserved."									
1258	Nutritional predictors of acute respiratory infections among children born to HIV-infected women in Tanzania.	"Mwiru R, Spiegelman D, Hertzmark E, Duggan C, Msamanga G, Aboud S, Fawzi W."	Journal of Tropical Pediatrics. 2013;59(3):203-8.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=23400399	"We prospectively determined the association between undernutrition and incidence of acute respiratory infections (ARIs) among 711 children born to HIV-infected women. Overall, underweight was associated with a 58% increased risk of ARI. Similarly, wasting (54%), very low birth weight (88%) and child HIV infection (62%) were significantly associated with increased risk of ARI during the first 2 years. Breastfeeding was associated with 52% reduction in risk of ARI only during the first 12 months of life. Among HIV-exposed, but uninfected, children, underweight, wasting and stunting were associated with 73%, 61% and 33% increased risk of ARI, respectively. Very low birthweight and advanced maternal disease stage were also associated with increased risk of ARI. Similar results were observed among HIV-infected children, except for stunting and very low birth weight. Prevention of child undernutrition could have major impact in reducing child ARI morbidity in settings of high HIV prevalence."									
1485	Childhood malnutrition and its predictors in rural Malawi.	"Maleta K, Virtanen SM, Espo M, Kulmala T, Ashorn P."	Paediatric and Perinatal Epidemiology. 2003;17(4):384-90.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=14629321	"We prospectively followed up a population-based cohort of 767 rural Malawian children from birth to 36 months to characterise the timing and predictors of malnutrition. Underweight and wasting incidence peaked between 6 and 18 months of age, whereas stunting incidence was highest during the first 6 months of age. After infancy about 40% of the children were underweight, 70% stunted, and about 4% wasted. Small size during the first 3 months of life predicted the incidence of severe underweight (relative risk [95% confidence interval], 1.8 [0.9, 3.4]), severe stunting ( 2.1 [1.3, 3.4]), and moderate wasting (2.0 [1.1, 3.5]). Children with many illness episodes in infancy had a twofold risk for the development of severe underweight and moderate wasting. Severe underweight was further predicted by residence far away from a health facility and moderate wasting by maternal HIV infection. Our conclusion is that the intrauterine period and first 6 months of life are critical for the development of stunting whereas the subsequent year is more critical for the development of underweight and wasting. Strategies combating intrauterine growth retardation, maternal HIV and infant morbidity are likely to reduce the burden of malnutrition in this population."									
1964	"Early impacts of orphaning: health, nutrition, and food insecurity in a cohort of school-going adolescents in South Africa."	"DeSilva MB, Skalicky A, Beard J, Cakwe M, Zhuwau T, Quinlan T, Simon J."	Vulnerable Children and Youth Studies. 2012;7(1):75-87.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20123110916	"We recruited a cohort of 157 recent orphans and 480 non-orphans aged 9-15 in a region of high HIV/AIDS mortality in South Africa using stratified cluster sampling to determine the impact of recent parental death on health and food insecurity of school-going orphans compared to non-orphans over time. Between September 2004 and June 2007, household heads, caregivers, and children were interviewed at three annual intervals. Bivariate associations and multivariate models were assessed using generalized estimating equations (GEE). In the health domain, compared to non-orphans, double orphans were more likely to report worse health status and being very ill in the previous 12 months. For those who reported being very ill, maternal or paternal orphans were more than twice as likely not to seek care than non-orphans; no differences were found for double orphans. For nutrition and food insecurity, maternal or paternal orphans were more likely not to have eaten dinner and to have gone to bed hungry the previous night compared to non-orphans; no differences were found for double orphans. Overall, recent school-aged orphans were disadvantaged in health and food insecurity within two years after the death of a parent, compared to their non-orphaned counterparts, but the disparities were smaller than expected. No changes in health, nutritional status, or food insecurity were apparent over the three study rounds. Longer term effects into adulthood may well be more pronounced and warrant careful longitudinal investigation."									
1259	"Adoption and hospital admission in Port Moresby, Papua New Guinea."	"Pameh W, Ripa P, Vince J, Mueller I."	Journal of Tropical Pediatrics. 2002;48(5):264-9.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=12405167	"We report a study of adopted children admitted to the children's wards of Port Moresby General Hospital, Papua New Guinea over a 5-month period in 2000. The proportion of hospitalized children known to be adopted was almost three times that in the children's outpatients department. Gastroenteritis and neonatal sepsis were more common causes of admission in adopted children than in the general paediatric hospital population. Admitted adopted children were lighter and shorter than the controls with no difference in weight-for-height, suggesting that stunting is the predominant nutritional problem among adopted children. These differences were even more marked in children with diagnoses other than gastroenteritis. Thirty-three (82.5 per cent) of the adopted children had ever been bottle fed compared with 11 (13.75 per cent) of the controls (p = 0.029). Twelve (30 per cent) children had been adopted because of neglect or abandonment. The biological mothers of seven of these children had died, and two children had been bought for cash. Biological mothers were more likely than the adoptive or control mothers to be single and less than 20 years of age. Knowledge of formal adoption procedures was very poor. The present study therefore shows that adoption in Papua New Guinea is not without risk and it is important that adoption should be recognized as having the potential for serious adverse effects on the child's well-being, especially since adoption is likely to become even more prevalent as the HIV epidemic continues. Consideration needs to be given to protection of the rights of children at high risk of adoption."									
1900	Idiopathic CD4+ T-lymphocytopeniawith cryptococcal meningitis: First case report from Cambodia.	"Augusto E, Raguenaud ME, Kim C, Mony M, Isaakidis P."	Tropical Doctor. 2009 July;39(3):176-7.		We report on a patient with cryptococcal meningitis with CD4+ T-lymphocytopenia and no evidence of HIV infection.									
1904	Late-stage HIV/AIDS among children: the missing diagnosis of a preventable disease.	"Gouveia J, Souza E, Falbo A."	Tropical Doctor. 2009;39(1):41-2.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=19211425	"We studied 126 malnourished children who had been admitted to the Instituto Materno Infantil Professor Fernando Figueira (IMIP) hospital. Nine (7.1%) had confirmation of HIV infection and all fulfilled the AIDS-defining criteria - all had been infected through mother-to-child transmission. Only one HIV-infected mother had been screened for HIV infection during prenatal care. There is, therefore, a need to increase HIV testing in all malnourished patients, especially when routine screening for HIV infection during prenatal care is not automatically undertaken."									
1811	"The impact of urbanization on physical, physiological and mental health of Africans in the north west province of South Africa: the THUSA study."	"Vorster HH, Wissing MP, Venter CS, Kruger HS, Kruger A, Malan NT, Ridder JHd, et al."	South African Journal of Science. 2000;96(9/10):505-14.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh3&AN=20003034393	"We studied the impact of urbanization and the resultant demographic transition on the physical, physiological and mental health of Africans in the North West Province of South Africa in order to inform health policies and programmes. Thirty-seven randomly selected sites were investigated in rural and urban areas covering all the districts of the province. A cross-sectional comparison was made of a sample in terms of gender, age (15 years and older) and five levels of urbanization (deep rural tribal areas, farms, informal housing areas or squatter camps, established urban townships and 'upper' urban areas). A total of 1854 'apparently healthy' men, and non-pregnant and non-lactating African women without identified diseases and not taking chronic medication, were recruited. Demographic information, health history and behaviour, psychological profiles and dietary intakes were obtained during individual interviews in the language of the subject's choice, using culturally sensitive and validated questionnaires. Anthropometric and blood pressure measurements and a 2-hour glucose tolerance test with a 75-g glucose load were taken. Serum, citrated and EDTA plasma and blood cell samples were analysed for biochemical variables with enzymatic, colorimetric and immunological methods. Anonymous HIV testing was also done. The improved socioeconomic circumstances observed in the wealthiest urban areas were accompanied by superior nutritional status, lower mean blood pressure, better health behaviours (lower smoking, drinking and HIV infection rates), lower measures of all indices of psychological pathology and higher scores of psychological well-being. These subjects also had the highest fat intake and serum cholesterol levels. Farm workers were identified as the most vulnerable group, having inadequate diets, highest scores for psychological symptomatology and the lowest scores for psychological well-being. Subjects in the transitional groups had the highest blood pressures, greatest HIV infection rates, and smoked and drank more than other subjects. Obesity in women, hypertension and impaired glucose tolerance were observed in both rural and urban subjects. The data suggest that urbanization of Africans is associated with improved mental, physiological and physical health in the more affluent groups but that those in transition living in poverty on farms and in densely populated areas are experiencing a high risk of the double burden of diseases associated with undernutrition on the one hand and overnutrition on the other."									
635	"The impact of functional performance, HIV status, malnutrition, and clinical features on treatment outcomes of patients with pulmonary tuberculosis."	"Madebo T, Lindtjorn B."	Ethiopian Journal of Health Development. 2000;14(2):177-82.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh3&AN=20013168581	"We studied the influence of functional performance, clinical features, state of nutrition and HIV status at diagnosis on the outcome results of patients with pulmonary tuberculosis at a Yirga Alem Hospital in south Ethiopia. During July-December 1995, we investigated by functional, clinical, and nutritional methods 239 consecutive patients with pulmonary tuberculosis. Two hundred out of 239 (83.7%) patients were unable to work (KPS=<70) at first presentation. HIV positive tuberculosis patients had lower KPS (mean (SD) 56.2 (21.9)) than HIV negative tuberculosis patients (66.1 (13.4)) (Mann-Whitney test, P<0.013). The poor functional performance was significantly correlated with malnutrition as measured by low body mass index, low arm circumference and low body weight. The 26 admitted patients had a mean KPS of 49 compared with 67 among the other patients (Mann-Whitney test, P<0.001). Five out of 26 (19.2%) hospitalized patients died compared with seven of 124 (5.6%) of patients treated at the outpatients department (Fisher's exact test, p=0.04). Patients who died had a lower KPS than the other patients (Mann-Whitney test, P=0.045). Clinical features such as diarrhoea, skin disorders, neuropsychiatric impairment, and low Mantoux reactivity were significantly associated with a bad outcome of treatment. Our study concludes that some clinical features influence outcome of treatment with tuberculosis patients. However, the KPS is a better predictor to measure the need of health care than the outcome of treatment."									
138	Infant feeding practices of HIV-infected and uninfected women in Zimbabwe.	"Gottlieb D, Shetty AK, Mapfungautsi RM, Bassett MT, Maldonado Y, Katzenstein DA."	AIDS Patient Care & Stds. 2004;18(1):45-53.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=15006194	"We surveyed infant feeding knowledge, attitudes, and practices in Zimbabwe to determine whether knowledge of HIV seropositivity influences infant feeding behavior. Questionnaires were administered to 97 women 1 and 4 weeks postpartum and prospective data on infant feeding practices were collected. Participants were pregnant women who consented to a HIV test. A total of 116 women participated of whom 99 women underwent voluntary HIV counseling and testing (VCT); 17 women agreed to blinded HIV testing but did not opt for VCT. The responses to questionnaires on infant feeding practices of HIV-positive and HIV-negative women who knew and did not know their HIV status at day 1 and week 4 postpartum were compared. We found that HIV-positive women who did not learn their status breastfed their infants less, introduced supplementary foods sooner, and planned to wean their babies earlier compared to other women (p = 0.005, p = NS, p= 0.02). HIV-positive women (30/97) more frequently reported a prior history of infant death and AIDS-related symptoms compared to HIV-negative women. We conclude that HIV-positive women who did not know their status made incorrect decisions with respect to infant feeding. These women may have suspected themselves to be HIV-positive and consequently underfed their infants or because these women were more symptomatic may have been less likely to breastfeed; decreased intake may increase the risk for malnutrition. Knowledge of HIV status may influence infant feeding decisions and reveal an urgent need to address infant feeding practices of pregnant women in Zimbabwe."									
1979	The impact of the AIDS epidemic on the health of older persons in Northwestern Tanzania.	"Ainsworth M, Dayton J."	World Development. 2003;31(1):131-48.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh3&AN=20033021846	"We use longitudinal data from a region of Tanzania hard-hit by the AIDS epidemic to measure the impact of prime-aged adult mortality on the body mass index (BMI) of people aged >50 years. BMI of the elderly decreased in better-off households prior to an adult death and in households not receiving private assistance shortly after an adult death. BMI eventually recovers, however. This suggests that interventions prior to an adult death may avert some of the decline. In the longer run, raising household incomes, improving the road infrastructure, and preventing infectious disease epidemics will improve the physical well-being of older persons."									
601	Errors in calculating weight-for-height.	Macfarlane SB.	Disasters. 1995;19(1):37-49.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med3&AN=7735854	"Weight-for-height is widely used as an index of recent malnutrition and often forms the basis on which major policy decisions are made about nutrition interventions. This article illustrates potential for error in the calculation of weight-for-height. Comparisons are made between results obtained using the international reference figures published by the World Health Organization, the plasticized cards distributed by Teaching-aids At Low Cost and by using the computer software package Epi Info (versions 5 and 6). An assessment is made of the errors introduced by treating supine measurements incorrectly as stature or by treating stature measurements as supine. Comparisons are also made between the use of standard deviation scores and percentages of the median. It is recommended that the international reference figures be published in a more convenient tabular form and that the plasticized cards and percentages of the median should not be used for studies involving international comparison. Investigators who plan to use Epi Info are advised to take into account the way in which it calculates weight-for-height when collecting and analyzing their height measurements."									
1629	Epidemiological and nutrition transition in developing countries: impact on human health and development.	"Amuna P, Zotor FB."	Proceedings of the Nutrition Society. 2008;67(1):82-90.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=18234135	"Whereas common infectious and parasitic diseases such as malaria and the HIV/AIDS pandemic remain major unresolved health problems in many developing countries, emerging non-communicable diseases relating to diet and lifestyle have been increasing over the last two decades, thus creating a double burden of disease and impacting negatively on already over-stretched health services in these countries. Prevalence rates for type 2 diabetes mellitus and CVD in sub-Saharan Africa have seen a 10-fold increase in the last 20 years. In the Arab Gulf current prevalence rates are between 25 and 35% for the adult population, whilst evidence of the metabolic syndrome is emerging in children and adolescents. The present review focuses on the concept of the epidemiological and nutritional transition. It looks at historical trends in socio-economic status and lifestyle and trends in nutrition-related non-communicable diseases over the last two decades, particularly in developing countries with rising income levels, as well as the other extreme of poverty, chronic hunger and coping strategies and metabolic adaptations in fetal life that predispose to non-communicable disease risk in later life. The role of preventable environmental risk factors for obesity and the metabolic syndrome in developing countries is emphasized and also these challenges are related to meeting the millennium development goals. The possible implications of these changing trends for human and economic development in poorly-resourced healthcare settings and the implications for nutrition training are also discussed. [References: 53]"									
622	"Nutrition, Balance and Fear of Falling as Predictors of Risk for Falls Among Filipino Elderly in Nursing Homes: A Structural Equation Model (SEM)."	"B, C, A, J, E, Jerezo JL, J."	Educational Gerontology. 2013;39(6):441-53.	http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=2012070303&site=ehost-live	"While a number of empirical studies have been conducted regarding risk for falls among the elderly, there is still a paucity of similar studies in a developing country like the Philippines. This study purports to test through Structural Equation Modeling (SEM) a model that shows the interaction between and among nutrition, balance, fear of falling, and risk for falls in Filipino elderly in institutionalized settings. Two hundred sixty-nine elderly from various nursing homes in the Philippines participated in this study. Arobotfotowas used to obtain the demographic data of the respondents, the Mini Nutritional Assessment (MNA) was used to measure nutritional status, the Timed Up and Go Test (TUGT) was performed to determine balance, the Falls Efficacy Scale (FES) was used to measure fear of falling, and the Morse Fall Scale (MFS) was administered to ascertain the risk for falls. The structural equation model revealed that: (a) nutritional status has no influence on balance, (b) a better nutritional status leads to decreased use of ambulatory aids (? = ?3.00), (c) a low degree of fear of falling leads to poorer balance (? = .73), (d) a high degree of fear of falling results to lower risk for falls (? = ?.89), and (e) a better balance leads to a decreased risk for falls (? = ?.16). Findings yielded in this study provide valuable inputs in the development of a comprehensive fall prevention program in nursing homes and other healthcare institutions in the country."									
1641	"Malnutrition, morbidity and mortality in children and their mothers."	Tomkins A.	Proceedings of the Nutrition Society. 2000;59(1):135-46.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=10828183	"While being underweight or stunted is recognized as an important risk factor for increased prevalence and severity of infection and high mortality rates, there is increasing evidence for an independent role for micronutrient deficiency. Improving vitamin A status reduces mortality among older infants and young children and reduces pregnancy-related mortality; it also reduces the prevalence of severe illness and clinic attendance among children. Improving Zn status reduces morbidity from diarrhoeal and respiratory infection. Treatment of established infection with vitamin A is effective in measles-associated complications, but is not as useful in the majority of diarrhoeal or respiratory syndromes. Zn supplements, however, have significant benefit on the clinical outcome of diarrhoeal and respiratory infections. Concerns that Fe supplements might increase morbidity if given in malarious populations appear to be decreasing, in the light of new studies on Fe supplements showing improved haemoglobin without an increase in morbidity. Breast-feeding, well known to protect against diarrhoea, is also important in protecting against respiratory infection, especially in the young infant. Transmission of human immunodeficiency virus (HIV) in breast milk is recognized, but new data showing reduced transmission in infants who receive exclusive breast-feeding rather than mixed feeding reinforces the importance of promoting this practice in areas where environmental contamination precludes the safe use of other infant feeding regimens. The presence of subclinical mastitis, now recognized to occur in approximately 20 % of mothers in several developing countries, has been shown to increase the concentration of HIV in breast milk. Preliminary findings suggest that the prevalence of subclinical mastitis is reduced by dietary supplements containing antioxidants. Governments and international agencies now have a strong scientific basis to be much more active and innovative in the introduction of focused nutrition interventions especially micronutrients, for the control of infection. [References: 119]"									
942	"Effects of PEPFAR on beneficiaries' determinants of health: perspectives from a beneficiary community in Gaza province, Mozambique."	"Williams EI, McGill D."	International Quarterly of Community Health Education. 2010;31(3):265-78.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=21988871	"While the national prevalence of HIV in Mozambique is estimated at 14%, Gaza has the highest provincial prevalence at 27%, almost double the national estimate. PEPFAR's mandate is to combat HIV/AIDS by providing treatment for 4 million people, prevent 12 million new infections, and care for 12 million people including 5 million orphans and vulnerable children (OVC). In Gaza, PEPFAR funds non-governmental organizations (NGOs) which provide community level activities. However, no assessment had been done of beneficiary's perception of PEPFAR initiatives. This article shares results of a study carried out to identify the perceived effects of PEPFAR interventions on the determinants of health among beneficiaries. Qualitative methods were used to explore which PEPFAR initiatives beneficiaries believed influenced their determinants of health. The findings exposed beneficiaries' determinants of health, and which PEPFAR initiatives affected those determinants, particularly those focused on nutrition, environmental influences, and educational support services."									
1125	"Neurologic manifestations of human immunodeficiency virus-2: dementia, myelopathy, and neuropathy in West Africa."	"Choi YJ, Townend J, Vincent T, Zaidi I, Sarge-Njie R, Jaye A, Clifford DB."	Journal of Neurovirology. 2011;17(2):166-75.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20113154888	"While well documented in human immunodeficiency virus (HIV)-1, neurologic sequelae have not been systematically evaluated in HIV-2. After excluding for confounding comorbidities, 67 individuals from a rural cohort in Guinea-Bissau (22 HIV-2 participants, 45 seronegative controls) were evaluated. HIV+ individuals were divided into CD4<350 and CD4>=350 for analysis. HIV-associated neurocognitive disorders (HAND), assessed by the International HIV Dementia Scale (IHDS), distal sensory polyneuropathy (DSPN), and myelopathy were the main outcome variables. In univariate analysis, there was no difference in IHDS scores among groups. When analyzed by primary education attainment, IHDS scores were nonsignificantly higher (p=0.06) with more education. There was no significant difference in DSPN prevalence among groups; overall, 45% of participants had DSPN. There were no cases of myelopathy. In multivariate linear regression, higher IHDS scores were significantly correlated with older age (coefficient=-0.11, p<0.001). Logistic regression analysis showed that older age (odds ratio (OR) 95% CI 1.04-1.20), lower CD4 count (OR 95% CI 0.996-0.999), and higher BMI (OR 95% CI 1.02-1.43) significantly predicted the presence of DSPN. While a significant increase in cognitive impairment was not observed in HIV-2-infected individuals, the study suggests the IHDS may be a less effective screening tool for HAND in settings of lower educational attainment as encountered in rural Guinea-Bissau. Similar to HIV-1, DSPN seems to occur with lower CD4 counts in HIV-2. Further study of the viral-host interactions in HIV-2 and its consequent neurological diseases may provide an avenue for understanding the epidemic problems of HIV-1."									
1622	Wild foods and household food security responses to AIDS: evidence from South Africa.	Kaschula SA.	Population and Environment. 2008 May 2008;29(3-5):162-85.	http://search.proquest.com/docview/61669393?accountid=26724	"Wild foods may offer unique benefits to households afflicted by AIDS, providing a nutritious and freely available food source at minimal labour and financial costs. This article presents the results of food security assessments in two rural South African sites. Detailed household dietary recalls from 227 households, combined with qualitative work, explored the association of household AIDS proxies (recent morbidity, mortality and orphan fostering) with household food security and dietary composition. The study found that AIDS-proxy households were significantly more food insecure, and households fostering orphans were both poorer and more food insecure. Wild foods were evident in 40.3% of the 48 h recalls, with significantly greater likelihood of use in households with fostering paternal orphans, and/or with at least one AIDS proxy. Only paternal orphans were significantly associated with likelihood of using wild foods when controlling for household socio-economic status. Qualitative data suggests that households afflicted by AIDS might curtail their use of wild foods due to household labour shortages and stigma. This is unfortunate, as regressions indicate that households using wild foods may be more economically resilient. This may be particularly important for households registering AIDS proxies, due to a demonstrated negative correlation between accumulated household AIDS proxies and household income. Adapted from the source document."									
1978	"Health, nutrition, and population in Madagascar 2000-09."	"Sharp M, Kruse I."	World Bank Working Paper. 2011;216(153).	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20133184625	"With an income per capita US$400 in 2008, Madagascar is one of the poorest countries in the world. Poverty is widespread but with significant urban-rural differences (52 percent versus 74 percent). Health, nutrition, and the fight against communicable diseases and HIV/AIDS are key goals of the country's poverty reduction strategy, the Madagascar Action Plan 2007-2012. The National Health Sector and Social Protection Development Plan 2007-2011 was developed to strengthen the health system and improve service delivery to reduce neonatal, child and maternal mortality, address malnutrition and control communicable illnesses. The health sector has benefited from increasing investment over the last years, and a number of studies and surveys have been carried out, providing a wealth of information that is yet to be analyzed in a complementary way. This Country Status Report (CSR) seeks to capitalize on all of the existing data in the health sector, compare Madagascar to countries of similar income levels and assess the results achieved by the health system. The CSR provides an analysis of the population's health and nutrition status by linking health outcomes, household/individual behaviours, community factors, government interventions, and service provision. Although Madagascar is performing better than the SSA average of 645 per 100,000 live births, the maternal mortality rate has stagnated over the last decade and in 2008/09 was estimated at 498. Health care seeking behaviour for preventive child health services at the health facility level is improving. Complete immunization coverage stands at 62 percent in 2008 (for children 12 to 23 months), but there are still large differences in coverage across regions, place of residence, and income groups."									
1633	Maternal and child nutrition in Sub-Saharan Africa: challenges and interventions.	Lartey A.	Proceedings of the Nutrition Society. 2008;67(1):105-8.	http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=18234138	"Women of child-bearing age (especially pregnant and lactating women), infants and young children are in the most nutritionally-vulnerable stages of the life cycle. Maternal malnutrition is a major predisposing factor for morbidity and mortality among African women. The causes include inadequate food intake, poor nutritional quality of diets, frequent infections and short inter-pregnancy intervals. Evidence for maternal malnutrition is provided by the fact that between 5 and 20% of African women have a low BMI as a result of chronic hunger. Across the continent the prevalence of anaemia ranges from 21 to 80%, with similarly high values for both vitamin A and Zn deficiency levels. Another challenge is the high rates of HIV infection, which compromise maternal nutritional status. The consequences of poor maternal nutritional status are reflected in low pregnancy weight gain and high infant and maternal morbidity and mortality. Suboptimal infant feeding practices, poor quality of complementary foods, frequent infections and micronutrient deficiencies have largely contributed to the high mortality among infants and young children in the region. Feeding children whose mothers are infected with HIV continues to remain an issue requiring urgent attention. There are successful interventions to improve the nutrition of mothers, infants and young children, which will be addressed. Interventions to improve the nutrition of infants and young children, particularly in relation to the improvement of micronutrient intakes of young children, will be discussed. The recent release by WHO of new international growth standards for assessing the growth and nutritional status of children provides the tool for early detection of growth faltering and for appropriate intervention. [References: 38]"									
799	Breastfeeding among HIV-1 infected women: Maternal health outcomes and social repercussions.	"Stringer E, Shearer K."	"Human Immunodeficiency Virus type 1 (HIV-1) and Breastfeeding: Science, Researh Advances, and Policy. 2012;Advances in Experimental Medicine and Biology. 743:39-49."		"Worldwide, the majority of HIV-infected women live in resource-constrained areas and must breastfeed because replacement feeding is not a viable option for them due to its lack of feasibility, safety, and affordability [1]. The benefits of breastfeeding are many and are often overshadowed by the risk of HIV transmission in HIV-infected mother-infant pairs. Breastfeeding confers immunological benefits to infants [2], protects infants from diarrhea and pneumonia [3, 4], and may improve cognitive function, only to name a few [5]. In low-income countries, the benefits of breastfeeding are even greater than in high-resource countries. In 2000, the World Health Organization estimated that breastfeeding could prevent 1.3 million infant deaths worldwide [6, 7]. 2012 Springer Science+Business Media New York."									
1987	Ageing patients with severe haemophilia: Complications and comorbidities	Staranje bolnikov s hudo obliko hemofilije: Zapleti in pridruzene bolezni.	"Anzej Doma S, Preloznik Zupan I, Andoljsek D, Benedik Dolnicar M."		Zdravniski Vestnik. 2012;81(SUPPL.2):159-60.									
742	Why is malnutrition not declining in Africa?	Adelekan DA.	Forum of Nutrition. 2003;56:288-9.		http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=15806905									
1276	Calls made for improvements in Bangladeshis' physical health.	Ahmad K.	Lancet. 2000;355(9207):909.		http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=10752717									
110	"Researchers seek solutions to diarrhea, wasting. Research takes several different twists and turns."	AIDS alert. 2001 Mar;16(3):38-9.	"HIV-related diarrhea and cachexia are tremendously serious problems in developing countries where there is little access to antiretroviral medications. They also remain a concern for many AIDS patients in the United States, yet much needs to be proved with regard to treatments."											
1277	Death and disease in Zimbabwe's prisons.	Alexander J.	Lancet. 2009;373(9668):995-6.		http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=19330896									
109	"Eat healthily, stay healthy."	Anonymous.	AIDS Action. 1995(30):4-5.		http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med3&AN=12290562									
349	"HIV / AIDS, shrinking cropland and water supplies. Major problems of the 21st century -- Dr. Lester Brown."	Anonymous.	Asian Forum Newsletter. 1999:10.		http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=12295494									
505	A glimpse at program for children's development in China.	Anonymous.	China Population Today. 1999;16(3):19-20.		http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=12319746									
816	Impact of AIDS worsens African famine.	Anonymous.	Indian Journal of Medical Sciences. 2003;57(3):123-5.		http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=14514264									
1425	Dramatic changes in Kenya.	Anonymous.	Newsletter. 1995;7(1):5.		http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med3&AN=12319377									
1751	[Impact of AIDS aggravates African famine].	Anonymous.	Sante. 2002;12(4):381.		http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=12701627									
1860	Chad 2004: results from the Demographic and Health survey.	Anonymous.	Studies in Family Planning. 2006;37(2):130-5.		http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=16832987									
1859	Congo 2005: results from the demographic and health survey.	Anonymous.	Studies in Family Planning. 2007;38(2):129-34.		http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=17642414									
1858	Ethiopia 2005: results from the demographic and health survey.	Anonymous.	Studies in Family Planning. 2007;38(2):135-40.		http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=17642415									
1857	Cambodia 2005: results from the demographic and health survey.	Anonymous.	Studies in Family Planning. 2008;39(2):141-6.		http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=18680870									
1856	Rwanda 2005: results from the demographic and health survey.	Anonymous.	Studies in Family Planning. 2008;39(2):147-52.		http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=18680871									
1855	Armenia 2005: results from the Demographic and Health Survey.	Anonymous.	Studies in Family Planning. 2008;39(3):221-6.		http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=18853643									
1854	Zimbabwe 2005-06: results from the Demographic and Health Survey.	Anonymous.	Studies in Family Planning. 2008;39(3):227-32.		http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=18853644									
1853	Democratic Republic of Congo 2007: results from the Demographic and Health Survey.	Anonymous.	Studies in Family Planning. 2009;40(4):329-34.		http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=23012728									
1762	The girl-child: problems and survival in the Nigerian context.	Anyanwu SO.	Scandinavian Journal of Development Alternatives. 1995;14(1-2):85-105.		http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med3&AN=12291581									
743	Nutritional problems of Africa--the future of a continent: an overview.	Atinmo T.	Forum of Nutrition. 2003;56:281-2.		http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=15806900									
1815	HIV/AIDS pandemic - A legacy of conquest and mistrust.	Bateman C.	South African Medical Journal. 2005 July;95(7):464-5.											
1814	Belligerent 'retro-Manto' moved sideways.	Bateman C.	South African Medical Journal. 2006 November;96(11):1149-51.											
1279	The world's forgotten children [4].	Bawaskar HS.	Lancet. 2003 05 Apr;361(9364):1224-5.											
968	A review of reproductive health situation in Bangladesh.	Begum RA.	JOPSOM Journal of Preventive and Social Medicine. 1999;18(1):66-73.		http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=12179657									
976	Increased tumour necrosis factor- alpha serum levels in patients with HIV wasting syndrome and euthyroid sick syndrome.	"Belec L, Meillot D, Gresenguet G, Gherardi RK."	Journal of Acquired Immune Deficiency Syndromes. 1995;8(2):212-3.		http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh2&AN=19952005248									
59	"Body mass index, immune recovery and survival: An important but understudied relationship."	Bland RM.	Aids. 2010 24 Aug;24(13):2125-6.											
768	Health Education Journal: Editorial.	Blinkhorn AS.	Health Education Journal. 2003 March;62(1):3.											
1013	"Neonatal characteristics and outcome in a cohort of infants born to HIV- 1-infected African women from Durban, South Africa."	"Bobat R, Coovadia H, Coutsoudis A, Moodley D, Gouws E."	Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology. 1999;20(4):408-9.											
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983	Schistosomiasis and impaired response to antiretroviral therapy among HIV-infected patients in Tanzania.	"Efraim L, Peck RN, Kalluvya SE, Kabangila R, Mazigo HD, Mpondo B, Bang H, et al."	Journal of Acquired Immune Deficiency Syndromes. 2013 15 Apr;62(5):e153-e6.											
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21	Beyond education and food: psychosocial well-being of orphans in Africa.	Foster G.	"Acta paediatrica (Oslo, Norway : 1992). 2002;91(5):502-4."											
502	Children affected by HIV.	Foster G.	Child Health Dialogue. 1998(12):3.		http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=12294835									
490	HIV infection and cardiovascular risk in black South Africans.	"Fourie CMT, Van Rooyen JM, Schutte AE."	Cardiovascular Journal of Africa. 2011 May-June;22(3):117-9.											
454	"Maternal body composition, HIV infection and other predictors of gestation length and birth size in Zimbabwe."	"Friis H, Gomo E, Nyazema N, Ndhlovu P, Krarup H, K_stel P, Michaelsen KF."	British Journal of Nutrition. 2004;92(5):833-40.		http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=2009064264&site=ehost-live									
595	"HIV-stage, nutritional status, and child psychomotor development in resource-poor settings - a causal web."	Gahagan S.	Developmental Medicine & Child Neurology. 2009;51(12):929-30.		http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=2010470958&site=ehost-live									
1189	Journal of Public Health: Editorial.	"Gerhardus A, Razum O."	Journal of Public Health. 2008 April;16(2):77-8.											
1326	Epidemiology of HIV/AIDS in adults in Malawi. (Special Edition on Burden of Disease in Malawi I.).	"Geubbels E, Bowie C."	Malawi Medical Journal. 2006;18(3):111-33.		http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=cagh&AN=20093195748									
1730	"The new WHO recommendations on HIV and infant feeding - care for the mother, and in resourcelimited settings let breastmilk care for the baby."	"Goga AE, Jackson DJ."	SAJCH South African Journal of Child Health. 2010;4(3):66-9.											
153	"Decrease in lipoatrophy in a pilot study using a short-term treatment interruption strategy for 48 weeks in Sao Paulo, Brazil."	"Gosuen GC, Turcato G, Salomao R, Lewi DS, Diaz RS."	AIDS Research and Human Retroviruses. 2012 01 Aug;28(8):747-8.											
1292	Zinc supplementation in children with HIV-1 infection [7].	"Green JA, Paton NI."	Lancet. 2006 11 Mar;367(9513):814-5.											
1293	Wasting time for wasted children: severe child undernutrition must be resolved in non-emergency settings.	"Gross R, Webb P."	Lancet. 2006 08 Apr;367(9517):1209-11.											
1395	Camp to clinic: A refugee journey.	"Hale K, Wood NJ, Sheikh-Mohammed M."	Medical Journal of Australia. 2006 18 Dec;185(11-12):589-90.											
1294	Scaling up antiretroviral treatment in resource-poor settings.	"Harries AD, Schouten EJ, Libamba E."	Lancet. 2006 03 Jun;367(9525):1870-2.											
634	International obligation and human health: evolving policy responses to HIV/AIDS.	"Harris PG, Siplon P."	Ethics & International Affairs. 2001;15(2):29-52.		http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=15709276									
1295	Case management of HIV-infected severely malnourished children: challenges in the area of highest prevalence.	"Heikens GT, Bunn J, Amadi B, Manary M, Chhagan M, Berkley JA, Rollins N, et al."	Lancet. 2008;371(9620):1305-7.		http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=18406865									
1561	How can we improve the care of severely malnourished children in Africa?	Heikens GT.	PLoS Medicine / Public Library of Science. 2007;4(2):e45.		http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medc&AN=17326705									
1816	Management of the child with serious infection or severe malnutrition.	Hendricks M.	South African Medical Journal. 2001;91(10 I):832.											
1973	Nutrition in AIDS management. An opportunity being lost.	Henry FJ.	West Indian Medical Journal. 2003;52(2):89-90.		http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=12974056									
1658	Women's input into household decisions and their nutritional status in three resource-constrained settings.	Hindin MJ.	Public Health Nutrition. 2006;9(4):485-93.		http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=2009259600&site=ehost-live									
525	Nutritional supplementation in HIV-infected individuals can be beneficial in certain patient groups.	"Huis In 't Veld D, Gichunge C, Mzileni O, Colebunders R."	Clinical Infectious Diseases. 2010 15 Nov;51(10):1225-6.											
1753	Impact of AIDS aggravates African famine. [French]	Impact du SIDA aggrave la famile africaine.	"Sante (Montrouge, France). 2002 2002;12(4):381."											
860	Commentary: cardiovascular risk factors--the next epidemic in Uganda: findings from the population-based HIV/AIDS rural surveillance cohort.	Jafar TH.	International Journal of Epidemiology. 2011;40(1):171-3.		http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=21037249									
1023	"A randomized placebo-controlled trial of the impact of multiple micronutrient supplementation on HIV-1 genital shedding among Thai subjects.[Erratum appears in J Acquir Immune Defic Syndr. 2005 Feb 1;38(2):240 Note: Jiamto, Sukhum [corrected to Jiamton, Sukhum]]."	"Jiamto S, Chaisilwattana P, Pepin J, Suttent R, Mahakkanukrauh B, Filteau S, Suthipinittharm P, et al."	Journal of Acquired Immune Deficiency Syndromes: JAIDS. 2004;37(1):1216-8.		http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=15319683									
830	General and reproductive health of adolescent girls in rural south India.	"Joseph GA, Bhattacharji S, Joseph A, Rao PS."	Indian Pediatrics. 1997;34(3):242-5.		http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=9282494									
1024	Supplemental vitamin B and progression to AIDS and death in black South African patients infected with HIV.	"Kanter AS, Spencer DC, Steinberg MH, Soltysik R, Yarnold PR, Graham NM."	Journal of Acquired Immune Deficiency Syndromes: JAIDS. 1999;21(3):252-3.		http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=10421250									
38	Nutrition education and counselling as strategic interventions to improve health outcomes in adult outpatients with HIV: a literature review.	"Kaye HL, Moreno-Leguizamon CJ."	African Journal of AIDS Research. 2010 Sep 2010;9(3):271-83.		http://search.proquest.com/docview/856404233?accountid=26724									
1796	Development and testing of the South African National Nutrition Guidelines for People Living with HIV/AIDS.	"Kennedy RD, MacIntyre UE."	South African Journal of Clinical Nutrition. 2003 February;16(1):12-6.											
1797	The nutrition situation in Tanzania.	"Kinabo J, Msuya J."	South African Journal of Clinical Nutrition. 2002 November;15(3):63-7.											
757	Preparing the university community to respond to 21st century global public health needs.	"Kishore S, Siegel KR, Kelly B, Vedanthan R, Ali MK, Koplan J, Narayan KMV, et al."	Global Heart. 2011 December;6(4):183-90.											
112	A boost for the immune system.	Knight VC.	AIDS Analysis Africa. 1997;7(4):1.		http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=12157891									
437	One in three children malnourished in parts of Europe.	Krosnar K.	BMJ. 2001;323(7325):1326.		http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=11739214									
1632	Adolescent nutritional status in developing countries.	Kurz KM.	Proceedings of the Nutrition Society. 1996;55(1B):321-31.		http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=8832803									
1436	Nutritional disorders in Africa: the triple burden.	"Labadarios D, Steyn NP."	Nutrition. 2005;21(1):2-3.		http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=15661472									
1435	Nutrition in Africa: Introduction.	Labadarios D.	Nutrition. 2002;18(4):355.											
1799	Malnutrition in the developing world: The triple burden.	Labadarios D.	South African Journal of Clinical Nutrition. 2005 September;18(2):119-21.											
1275	"Foie gras, fine words, and failure - Just another UN summit."	Lancet. 2002 15 Jun;359(9323):2047.												
991	"Predictors of patient attrition according to different definitions for loss to follow-up: A comparative analysis from Lusaka, Zambia."	"Li MS, Musonda P, Gartland M, Mulenga PL, Mwango A, Stringer JSA, Chi BH."	Journal of Acquired Immune Deficiency Syndromes. 2013 01 Jul;63(3):e116-e9.											
684	Denying obesity.	Lobstein T.	European Journal of Public Health. 2009 December;19(6):570.											
1229	Highlights of the Second International Conference on Nutrition and HIV Infection.	MacDougall DS.	Journal of the International Association of Physicians in AIDS Care. 1997;3(8):35-40.		http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=11364631									
1819	Improving health care delivery.	Madlala-Routledge N.	South African Medical Journal. 2006 November;96(11):1159-61.											
927	Empirical tuberculosis treatment or improved diagnostics?	"Manabe YC, Worodria W, Cobelens F."	International Journal of Tuberculosis and Lung Disease. 2012 01 Feb;16(2):280.											
1421	"Multivitamins, nutrition, and antiretroviral therapy for HIV disease in Africa."	"Marston B, De Cock KM."	New England Journal of Medicine. 2004;351(1):78-80.		http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=15229312									
1789	"Diabetes in Africa: The new pandemic - Report on the 19th World Diabetes Congress, Cape Town, December 2006."	"Mash RJ, De Vries E, Abdul I, Mash B."	South African Family Practice. 2007 July;49(6):44-50.											
1298	"XDR tuberculosis in South Africa: old questions, new answers."	"Migliori GB, Sotgiu G."	The Lancet. 2010;375(9728):1760-1.											
1299	Zinc supplementation in children with HIV-1 infection - Authors' reply [8].	"Moss WJ, Bobat R, Black RE."	Lancet. 2006 11 Mar;367(9513):815-6.											
945	The Doolin Memorial Lecture: December 2002. The fight against diseases of the poor; the moral imperative for development assistance.	Murphy JFA.	Irish Medical Journal. 2003 January;96(1):4-5.											
946	Sub-Saharan Africa.	Murphy JFA.	Irish Medical Journal. 2003 January;96(1):4.											
580	What drives health research in a developing country.	Muula AS.	Croatian Medical Journal. 2007 April;48(2):261-7.											
998	Risk factors for high blood pressure among human immunodeficiency virus patients in French Guiana.	"Nacher M, Basurko C, Vantilcke V, Dufour J, Guedj ME, Vaz T, Magnien C, et al."	Journal of Acquired Immune Deficiency Syndromes. 2008 15 Aug;48(5):629-31.											
1509	"Clinical and epidemiological aspects of diarrheal illness in pediatric AIDS patients in Sao Paulo, Brazil."	"Negra MD, Queiroz W, Lian YC, Mangini AC, Dias AM, Palacci M, Tanaka H, et al."	Pediatric AIDS & HIV Infection. 1995;6(6):335-9.		http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med3&AN=11361456									
314	"[Immunity, infections, and nutritional status of HIV-positive children in the pediatric's ward UHC of Treichville in Ivory Coast]."	"Niangue-Beugre NM, Diaby L, Cisse L, Oulai MS, Karambiri AR, Couitchere L, Enoh J, et al."	Archives de Pediatrie. 2004;11(11):1373-4.		http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=15519838									
1791	CPD Editorial.	Ogunbanjo GA.	South African Family Practice. 2008;50(6):5.											
565	"Background, problems, and perspectives of management of common pediatric skin problems in developing countries."	"Oumeish OY, Parish LC."	Clinics in Dermatology. 2003 July/August;21(4):254-9.											
1823	Antenatal antecedents of deaths of children.	Pattinson RC.	South African Medical Journal. 2006 September;96(9):792.											
1442	"Tuberculosis, HIV infection, and malnutrition: An infernal trio in Central Africa."	Perronne C.	Nutrition. 1999;15(4):321-2.											
504	Paediatric neurosurgery - A Southern African perspective.	Peter JC.	Child's Nervous System. 2003 01 Mar;19(3):133-6.											
779	V-1 Immunitor.	"Phanuphak P, Tan-ud P, Panitchpakdi P, Tien-udom N, Nagapiew S, Cawthorne P, Thai AS."	HIV Clinical Trials. 2002;3(3):260-1.		http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=12123222									
1567	Micronutrient fortification to improve growth and health of maternally HIV-unexposed and exposed zambian infants: A randomised controlled trial.	PLoS ONE. 2010;5(6).	"Background The period of complementary feeding, starting around 6 months of age, is a time of high risk for growth faltering and morbidity. Low micronutrient density of locally available foods is a common problem in low income countries. Children of HIV-infected women are especially vulnerable. Although antiretroviral prophylaxis can reduce breast milk HIV transmission in early infancy, there are no clear feeding guidelines for after 6 months. There is a need for acceptable, feasible, affordable, sustainable and safe (AFASS by WHO terminology) foods for both HIV-exposed and unexposed children after 6 months of age. Methods and Findings We conducted in Lusaka, Zambia, a randomised double-blind trial of two locally made infant foods: porridges made of flour composed of maize, beans, bambaranuts and groundnuts. One flour contained a basal and the other a rich level of micronutrient fortification. Infants (n = 743) aged 6 months were randomised to receive either regime for 12 months. The primary outcome was stunting (length-for-age Z<-2) at age 18 months. No significant differences were seen between trial arms overall in proportion stunted at 18 months (adjusted odds ratio 0.87; 95% CI 0.50, 1.53; P = 0.63), mean length-for-age Z score, or rate of hospital referral or death. Among children of HIV-infected mothers who breastfed <6 months (53% of HIV-infected mothers), the richly-fortified porridge increased length-for-age and reduced stunting (adjusted odds ratio 0.17; 95% CI 0.04, 0.84; P = 0.03). Rich fortification improved iron status at 18 months as measured by hemoglobin, ferritin and serum transferrin receptors. Conclusions In the whole study population, the rich micronutrient fortification did not reduce stunting or hospital referral but did improve iron status and reduce anemia. Importantly, in the infants of HIV-infected mothers who stopped breastfeeding before 6 months, the rich fortification improved linear growth. Provision of such fortified foods may benefit health of these high risk infants. Trial registration Controlled-Trials.com ISRCTN37460449. 2010 The Chilenje Infant Growth, Nutrition and Infection (CIGNIS) Study Team."											
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736	Developing nutrition information systems in Eastern and Southern Africa.	Regional Technical Working Group N.	Food and nutrition bulletin. 2010 Sep;31(3 Suppl):S272-86.											
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1812	Support for TB.	South African Medical Journal. 2005 October;95(10):732-4.												
1841	Pre-ART guidelines: Amended November 2004.	Southern African Journal of HIV Medicine. 2004 November(17):18-31.												
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1844	Nutrition and HIV/AIDS: Nutritional guidelines for HIV-infected adults and children in Southern Africa: Meeting the needs.	"Spencer DC, Harman C, Naicker T, Gohre S."	Southern African Journal of HIV Medicine. 2007 June(27):23+5-32.											
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1628	The Summer Meeting of the Nutrition Society held at the University of Glasgow on 29 June-2 July 1999.		Proceedings of the Nutrition Society. 2000;59(1):3-162.		http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=2000052277&site=ehost-live									
749	"The Gerontological Society of America 53rd Annual Scientific Meeting, November 17-21, 2000, Washington, DC."		Gerontologist. 2000;40:1-393.		http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=2001000968&site=ehost-live									
1100	"A workshop on micronutrients and infectious diseases: cellular and molecular immunomodulatory mechanisms... proceedings of a workshop on micronutrients and infectious diseases and was held on 16 and 17 September 1999 in Bethesda, Maryland."		Journal of Infectious Diseases. 2000;182:S1-142.		http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=2001012168&site=ehost-live									
1197	"The new Food & Nutrition Conference & Exhibition, Denver, October 16-19, 2000."		Journal of the American Dietetic Association. 2000;100(9):A9-109.		http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=2001042130&site=ehost-live									
1981	Health status.		World Health Statistics Quarterly. 1995;48(3/4):189-99.		http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=2001054353&site=ehost-live									
173	"2002 Nutrition Week: a scientific and clinical forum and exposition, abstracts presented February 23-27, 2002, San Diego, CA."		American Journal of Clinical Nutrition. 2002;75(2S):339S-439s.		http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=2002060864&site=ehost-live									
315	"Abstracts of the Royal College of Paediatrics and Child Health, 7th Spring Meeting, University of York, 7-10 April 2003."		Archives of Disease in Childhood. 2003;88:A1-75.		http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=2003086901&site=ehost-live									
748	"Program abstracts: 55th Annual Scientific Meeting, The Gerontological Society of America, November 22-26, 2002, Boston, MA, ""Relationships in a changing world: from aging cells to aging societies""."		Gerontologist. 2002;42:1-435.		http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=2003100490&site=ehost-live									
219	"Abstracts, 2005 Epidemiology without Borders: a joint meeting of the Society for Epidemiologic Research and Canadian Society for Epidemiology and Biostatistics, Toronto, Canada, June 27-30, 2005."		American Journal of Epidemiology. 2005;161(11):S1-152.		http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=2005120082&site=ehost-live									
591	Infectious diseases.		Current Opinion in Pulmonary Medicine. 2005;11(3):187-264.		http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=2009016007&site=ehost-live									
1196	"Abstracts of the ADA Food & Nutrition Conference & Expo, October 22-25, 2005, St. Louis, MO."		Journal of the American Dietetic Association. 2005;105(8):A-9-a-70.		http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=2009039061&site=ehost-live									
1	CDC fact book 2000/2001: Department of Health and Human Services Centers for Disease Control and Prevention; 2000.													
514	Cholera death toll in Congo nears 600 - UN.		Clinical Infectious Diseases. 2002 15 May;34(10):ii.											
815	Impact of AIDS worsens African famine.		Indian journal of medical sciences. 2003 Mar;57(3):123-5.											