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AIDS, drought, and child malnutrition in southern Africa

  • John B Mason (a1), Adam Bailes (a1), Karen E Mason (a2), Olivia Yambi (a3), Urban Jonsson (a3), Claudia Hudspeth (a4), Peter Hailey (a5), Andrea Kendle (a6), Dominique Brunet (a7) and Pierre Martel (a8)
  • DOI: http://dx.doi.org/10.1079/PHN2005726
  • Published online: 01 January 2007
Abstract
AbstractObjective

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.

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*Corresponding author: Email masonj@tulane.edu
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4E Asamoah-Odei , JM Garcia Calleja , JT Boerma . HIV prevalence and trends in sub-Saharan Africa: no decline and large subregional differences. Lancet 2004; 364(9428): 3540.

6L Haddad , SR Gillespie . Effective food and nutrition policy responses to HIV/AIDS: what we know and what we need to know. Journal of International Development 2001; 13: 487511.

9A de Waal , A Whiteside . New variant famine: AIDS and food, crisis in southern Africa. Lancet 2003; 362(9391): 1234–7.

14P Bakaki , J Kayita , JE Moura Machado , JB Coulter , D Tindyebwa , CM Ndugwa , Epidemiologic and clinical features of HIV-infected and HIV-uninfected Ugandan children younger than 18 months. Journal of Acquired Immune Deficiency Syndromes 2001; 28(1): 3542.

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  • ISSN: 1368-9800
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