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AIDS, drought, and child malnutrition in southern Africa

Published online by Cambridge University Press:  02 January 2007

John B Mason ,
Adam Bailes ,
Karen E Mason ,
Olivia Yambi ,
Urban Jonsson ,
Claudia Hudspeth ,
Peter Hailey ,
Andrea Kendle ,
Dominique Brunet  and
Pierre Martel
John B Mason*
Affiliation:
Department of International Health and Development, Tulane University School of Public Health and Tropical Medicine, 1440 Canal Street, Suite 2200, New Orleans, LA 70118, USA
Adam Bailes
Affiliation:
Department of International Health and Development, Tulane University School of Public Health and Tropical Medicine, 1440 Canal Street, Suite 2200, New Orleans, LA 70118, USA
Karen E Mason
Affiliation:
School of Public Health, Louisiana State University, New Orleans, LA, USA
Olivia Yambi
Affiliation:
United Nations Children's Fund (UNICEF), Eastern and Southern Africa Regional Office (ESARO), Nairobi, Kenya
Urban Jonsson
Affiliation:
United Nations Children's Fund (UNICEF), Eastern and Southern Africa Regional Office (ESARO), Nairobi, Kenya
Claudia Hudspeth
Affiliation:
UNICEF, Regional Inter-Agency Coordination Support Office (RIACSO), Johannesburg, South Africa
Peter Hailey
Affiliation:
UNICEF, Malawi
Andrea Kendle
Affiliation:
UNICEF, Johannesburg, South Africa
Dominique Brunet
Affiliation:
UNICEF, Zambia
Pierre Martel
Affiliation:
UNICEF, Mozambique and Lesotho
*
*Corresponding author: Email masonj@tulane.edu
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Abstract

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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.

Keywords

HIV/AIDSChild nutritionUnderweightWeight-for-ageDroughtFood securitySouthern AfricaLesothoMalawiMozambiqueSwazilandZambiaZimbabwe

Information

Type
Research Article
Information
Public Health Nutrition , Volume 8 , Issue 6 , September 2005 , pp. 551 - 563
Copyright
Copyright © The Authors 2005

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