Gastrointestinal symptoms in HIV-positive kidney transplant candidates and recipients from an HIV-positive donor.

Gastrointestinal symptoms (GIS) are common in kidney transplant candidates and recipients and may be worsened by HIV. Objective: To determine the frequency and severity of GIS in HIV-positive kidney transplant recipients from HIV-positive donors, and those waiting to receive one. A GIS rating scale (GSRS) was completed by 76 participants at baseline and at 6 months. GIS frequency was defined as having at least one symptom (GSRS > 1). Severity was indicated by the GSRS score. Transplant candidates: GIS frequency was 88.9% and 86.3% at baseline and 6 months respectively. Indigestion was the most frequent (79.6% and 66.7% at baseline and 6 months), and severe GIS (GSRS 2.3). Women reported global mean (p = 0.030) severity significantly more than men. Transplant recipients: GIS frequency was 95.2% and 76.2% at baseline and 6 months respectively. At both assessment points, indigestion occurred most frequently (85.7% and 61.9% respectively). Highest GSRS was reported for indigestion at baseline (2.33) and at 6 months (1.33). Waist circumference (WC) was positively associated with the severity of constipation GSRS. GIS are common in both groups, especially indigestions. WC in transplant recipients should be monitored.

Maternal socio-demographic characteristics and associated complementary feeding practices of children aged 6-18 months with moderate acute malnutrition in Arua, Uganda.

BACKGROUND: There is a paucity of published data regarding maternal socio-demographic characteristics and associated complementary feeding practices of moderately malnourished infants and young children (IYC) in sub-Saharan Africa. In the present study, this association was investigated in Arua, Uganda. METHODS: A cross-sectional baseline survey was conducted among 204 conveniently sampled mothers of IYC aged 6-18 months with moderate acute malnutrition earmarked for dietary supplementation in four randomly selected sub-counties to determine their socio-demographic characteristics using a validated questionnaire. A 24-h recall was used to evaluate complementary feeding practices in terms of minimum dietary diversity (MDD), minimum meal frequency (MMF) and minimum acceptable diet (MAD). Associations were determined using multivariate logistic regression analysis. RESULTS: The majority (70.1%) of mothers had a primary school education, with 15% having no formal education. Foods especially purchased or prepared for IYC were provided by 42.6% of the mothers. The MDD and MMF of IYC were 13.2% and 41.2%, respectively. MMF and MDD for MAD were met by 6.9% of IYC. Maternal level of education and MMF was significantly associated (P = 0.003), whereas the provision of foods especially purchased or prepared for IYC was significantly associated with MMF (P = 0.003). Maternal care was significantly associated with MAD (P = 0.004). CONCLUSIONS: Optimal complementary feeding practices were not met by the majority of mothers. Maternal level of education and care of IYC were strong predictors of MMF. Nutrition education and care should be promoted among mothers of IYC with moderate acute malnutrition to improve MDD, MMF and MAD.

Effect of a novel supplementary porridge on the nutritional status of infants and young children diagnosed with moderate acute malnutrition in Uganda: a cluster randomised control trial.

BACKGROUND: Moderate acute malnutrition (MAM) and anaemia are prevalent among infants and young children (IYC) in Uganda. A lack of consensus regarding the most effective strategy for managing MAM among IYC resulted in the present study comparing the effect of malted sorghum-based porridge (MSBP) (an active malt, extruded maize and soy sorghum supplementary porridge developed for the purpose of the present study) as an intervention versus an extruded maize and soy micronutrient fortified blend (CSB+) as a control and current standard care. Outcome measures were anthropometric status and haemoglobin levels. METHODS: The study comprised a double-blind cluster randomised control trial with eight to 10 conveniently sampled consenting mother-IYC pairs per cluster who were randomly assigned to the intervention (n = 110) or control (n = 110) for 3 months. Weekly anthropometric measurements were taken. Haemoglobin levels were measured at baseline and end line. Mean length-for-age, weight-for-age, length-for-weight and mean haemoglobin levels of the treatment and control groups were compared using an independent t-test. The Z-test was used to compare proportions of the outcome indicators between the treatment and control groups. RESULTS: Difference in mean weight-for-age Z-scores in the treatment group improved compared to control (P = 0.010). The change in mean haemoglobin levels was lower in the treatment versus the control group (P = 0.010). The proportion of IYC recovering from MAM between treatment and control did not differ significantly (P = 0.055). CONCLUSIONS: Recovery rates after supplementation with MSBP versus CSB+ resulted in similar weight-for-length and haemoglobin levels. Therefore, MSBP has the potential for being scaled up in the management of IYC with MAM in Uganda.