VIH/SIDA et malnutrition sévère: prise en charge de l'enfant en unité de réhabilitation nutritionnelle au Burkina Faso

Le présent travail repose sur l’hypothèse que l’infection par le VIH provoque et/ou aggrave les déficits nutritionnels de l’enfant. Ces déficits nutritionnels aggravent le déficit immunitaire et ont un impact négatif sur la survie de l’enfant infecté par le VIH/SIDA. Mais cette malnutrition même grave peut être améliorée et l’amélioration de l’état nutritionnel peut améliorer la santé d’enfants infectés par le VIH, en stade avancé de la maladie, afin de rendre possible leur prise en charge par les antirétroviraux.Les travaux ont été réalisés au Burkina Faso. Le contexte géographique est favorable au développement des maladies infectieuses et parasitaires. La mortalité infanto juvénile y est élevée et ainsi que la proportion d’enfant malnutris. Bien que la courbe de la prévalence du VIH montre un début de ralentissement, l’infection continue de progresser chez les enfants.Principales conclusions et implications de nos travaux :&Doctorat en Sciences de la santé publiqueinfo:eu-repo/semantics/nonPublishe

Factors associated with anemia in pregnancy in Cascades region in Burkina Faso

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Knowlegde and practices on the prevention of anemia in pregnancy in the Cascades region (Burkina Faso)

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Socioeconomic indices performance for HIV diagnostic on severely malnourished children in Burkina Faso

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Hospital staff use of generic essential drugs :the case of Yalgado Ouedraogo University Hospital Centre

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Maternal mortality risk factors in regional hospital of Burkina Faso.

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Characteristics of severely anemic pregnant women and perinatal outcomes in Banfora regional hospital, Burkina Faso: an epidemiological study.

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Impact of anemia on mortality and nutritional recovery among hospitalized severely malnourished children in Burkina Faso.

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Prise en charge de la malnutrition aiguë sévère dans un centre de réhabilitation et d'éducation nutritionnelle urbain au Burkina Faso

Background: Management of acute severe malnutrition greatly contributes to the reduction of childhood mortality rate. In developing countries, where malnutrition is common, number of acute severe malnutrition cases exceeds inpatient treatment capacity. Recent success of community-based therapeutic care put back on agenda the management of acute severe malnutrition. We analysed key issues of inpatient management of severe malnutrition to suggest appropriate global approach. Methods: Data of 1322 malnourished children, admitted in an urban nutritional rehabilitation center, in Burkina Faso, from 1999 to 2003 were analyzed. The nutritional status was assessed using anthropometrics indexes. Association between mortality and variables was measured by relative risks. Kaplan-Meier survival curves and Cox model were used. Results: From the 1322 hospitalized children, 8.5% dropped out. Daily weight gain was 10.18 (± 7.05) g/kg/d. Among hospitalized malnourished children, 16% died. Patients were at high risk of early death, as 80% of deaths occurred during the first week. The risk of dying was highest among the severely malnourished: weight-for-heigh < -4 standard deviation (SD), RR = 2.55 P < 0,001; low MUAC-for-age, RR = 2.05 P < 0.001. Kaplan-Meier survival curves and Cox model showed that the variables most strongly associated with mortality were weight-for-height and MUAC-for-age. Among children discharged from the nutritional rehabilitation centre, 10.9% had weight-for-height < -3 SD. Conclusion: The nutrition rehabilitation centre is confronted with extremely ill children with high risk of death. There is need to support those units for appropriate management of acute severe malnutrition. It is also important to implement community-based therapeutic care for management of children still malnourished at discharge from nutritional rehabilitation centre. These programs will contribute to reduce mortality rate and number of severely malnourished children attending inpatient nutrition rehabilitation centers, by prevention and early management. © 2007 Elsevier Masson SAS. All rights reserved.SCOPUS: ar.jinfo:eu-repo/semantics/publishe