+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Nutritional supplementation: the additional costs of managing children infected with HIV in resource-constrained settings



Nutritional supplementation: the additional costs of managing children infected with HIV in resource-constrained settings



Tropical Medicine and International Health 18(1): 45-52



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. 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. 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. 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.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 036635498

Download citation: RISBibTeXText

PMID: 23107420

DOI: 10.1111/tmi.12006


Related references

A Systematic Review of Nutritional Supplementation in HIV-Infected Children in Resource-Limited Settings. Journal of the International Association of Providers of Aids Care 14(4): 313-323, 2015

Macronutrient supplementation for malnourished HIV-infected adults: a review of the evidence in resource-adequate and resource-constrained settings. Clinical Infectious Diseases 49(5): 787-798, 2009

The importance of nutritional care in HIV-infected children in resource-limited settings. Expert Review of Anti-Infective Therapy 12(12): 1423-1426, 2014

Use of dried-blood-spot samples and in-house assays to identify antiretroviral drug resistance in HIV-infected children in resource-constrained settings. Journal of Clinical Microbiology 49(12): 4077-4082, 2011

Women's input into household decisions and their nutritional status in three resource-constrained settings. Public Health Nutrition 9(4): 485-493, 2006

Performance evaluation of the Alere PIMA CD4 test for monitoring HIV-infected individuals in resource-constrained settings. Journal of Acquired Immune Deficiency Syndromes 58(2): 141-147, 2011

A multinational study of neurological performance in antiretroviral therapy-naïve HIV-1-infected persons in diverse resource-constrained settings. Journal of Neurovirology 17(5): 438-447, 2011

Estimating age-based antiretroviral therapy costs for HIV-infected children in resource-limited settings based on World Health Organization weight-based dosing recommendations. Bmc Health Services Research 14: 201, 2014

Ritonavir/saquinavir safety concerns curtail antiretroviral therapy options for tuberculosis-HIV-co-infected patients in resource-constrained settings. Aids 20(2): 302-303, 2006

Feasibility of using tuberculin skin test screening for initiation of 36-month isoniazid preventive therapy in HIV-infected patients in resource-constrained settings. Journal of Acquired Immune Deficiency Syndromes (): -, 2015

The epidemiology of substance use among street children in resource-constrained settings: a systematic review and meta-analysis. Addiction 108(10): 1722-1733, 2013

Estimating the cost-effectiveness of nutrition supplementation for malnourished, HIV-infected adults starting antiretroviral therapy in a resource-constrained setting. Cost Effectiveness and Resource Allocation 12: 10, 2014

Analysis of the optimal cut-point for HIV-p24 antigen testing to diagnose HIV infection in HIV-exposed children from resource-constrained settings. Journal of Clinical Virology 50(4): 338-341, 2011

Implementation and Operational Research: Feasibility of Using Tuberculin Skin Test Screening for Initiation of 36-Month Isoniazid Preventive Therapy in HIV-Infected Patients in Resource-Constrained Settings. Journal of Acquired Immune Deficiency Syndromes 71(4): E89-E95, 2016

Evaluation of effectiveness and cost-effectiveness of a clinical decision support system in managing hypertension in resource constrained primary health care settings: results from a cluster randomized trial. Journal of the American Heart Association 4(1): E001213, 2015