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HIV, the virus that causes AIDS, “Acquired Immunodeficiency Syndrome,” has become one of the world’s most serious health and development challenges, since the first cases were reported in 1981: At the end of 2010, an estimated 34 million people were living with HIV globally, including 3.4 million children less than 15 years. The number of people newly infected in 2010 was 2.7 million. Almost all of those living with HIV (97%) reside in low and middle income countries, particularly in sub-Saharan Africa. Sub-Saharan Africa remained the most affected region in the global AIDS epidemic. This regions accounts more than two third (68%) of people living with HIV. Most children with HIV live in this region. Globally, the annual numbers of people newly infected with HIV continues to decline (Global HIV/AIDS Response progress report, 2011).
The HIV/AIDS pandemic is a global crisis with consequences that will be felt for decades to come. Thirty-nine million people are currently infected with the virus, including more than 25 million from Sub-Saharan Africa.Many millions more are affected in different ways. The ability of households and communities to ensure their own food and nutrition security is increasingly being threatened. With the most detailed evidence base yet assembled, this review systematically maps our growing knowledge of the interactions between HIV/AIDS and food and nutrition security, pointing to where and how future policy needs to change to remain relevant and effective.
An anthropological study carried out in 2006/7 in rural Zambia and peri-urban South Africa documented the impact of co-infection with TB and HIV on poor households in the context of poverty and overstretched public health services. The anthropological research was conducted in 18 households affected by TB throughout the period of TB treatment and in 17 comparative non-affected households. Findings reveal that families experience disease alongside desperate social and economic inequities, with more absolute poverty and a deeper degree and prevalence of food insecurity in rural Zambia. Charting patient's journeys from falling sick with TB to completing treatment revealed that most faced a protracted diagnostic period, pingponging between treatment options with trips to the government health services the most frequent. Most were extremely sick and emotionally fragile once diagnosed, many had relocated back to their parents' home, and, all were no longer able to contribute to household livelihood. During the first months of TB treatment, patients and caregivers experienced contracted mobility and networks, reduced income and increased expenditure on 'special foods'. Foods prescribed for TB patients were beyond the normal diet of households, especially in rural Zambia. As caregivers did their upmost to provide these foods (soft drinks, meat, eggs, fish, porridge), tensions and food insecurity in the households escalated, often resulting in family quarrels and caregivers themselves falling sick. In peri-urban South Africa, disability grants, food aid from the government health services and chequered food aid and material support from NGOs helped households through this period. But in Zambia, although emotional and technical support reached the households through government health services, a household counselling intervention and visits of church members, no affected household received any food aid or material support from state or NGOs and support from extended kin was very limited. More extreme coping strategies were subsequently adopted--for example selling clothes, begging, relocating--and affected households spun into deeper poverty and by the end of treatment were mostly severely short of food and in nutritional jeopardy. Across both countries, most TB patients were unable to resume previous livelihoods and most (n=13) were co-infected with HIV, throwing them onto another more long term disease trajectory. Accessing antiretroviral therapy (ART) was much more feasible in peri-urban South Africa and much harder in rural Zambia. Stigma related to TB and to HIV was more pronounced in rural Zambia but still persisted in both countries. Outcomes of TB treatment were mixed in both countries. Better outcomes included co-infected patients who started ART and experienced physical and social transformations and HIV-negative TB patients who successfully completed treatment. However, five TB patients died, one fell sick with relapse TB, two co-infected patients never started ART and one patient was not aware of his HIV status and was unwell. In the short term, only one Zambian household and five South African households recovered from the event of TB. Recommendations oscillate around reducing diagnostic delay in government health services and the provision of a comprehensive nutritional programme and social protection for TB patients and people living with HIV (PLWH).
New evidence this year corroborates the rise in world hunger observed in this report last year, sending a warning that more action is needed if we aspire to end world hunger and malnutrition in all its forms by 2030. Updated estimates show the number of people who suffer from hunger has been growing over the past three years, returning to prevailing levels from almost a decade ago. Although progress continues to be made in reducing child stunting, over 22 percent of children under five years of age are still affected. Other forms of malnutrition are also growing: adult obesity continues to increase in countries irrespective of their income levels, and many countries are coping with multiple forms of malnutrition at the same time – overweight and obesity, as well as anaemia in women, and child stunting and wasting.
This edited volume, “Nutrition and HIV/AIDS - Implication for Treatment, Prevention and Cure”, is a collection of reviewed and relevant research chapters, offering a comprehensive overview of recent developments in the field. The book comprises single chapters authored by various researchers and edited by an expert active in the research area. All chapters are complete in themselves but united under a common research study topic. This publication aims at providing a thorough overview of the latest research efforts by international authors and opening new possible research paths for further novel developments.
Affecting more than 800 million people, food insecurity is a global problem that runs deeper than hunger and undernutrition. In addition to the obvious impact on physical well-being, food insecurity can result in risky coping strategies, increased expenditures on medical costs or transportation, and mental health issues. A review of the concepts an
​This easy to use text provides practitioners and researchers with a global view of current and emerging issues concerned with successful pregnancy outcomes and approaches that have been successful or show promise in ensuring a successful pregnancy. The fully updated and revised second edition expands its scope with topics not covered in the first edition including pregnancy and military service; sleep disorders during pregnancy; the gut microbiome during pregnancy and the newborn; requirement for vitamin D in pregnancy; the environment—contaminants and pregnancy; preeclampsia and new approaches to treatment; health disparities for whites, blacks, and teen pregnancies; depression in pregnancy—role of yoga; safe food handling for successful pregnancy outcome; relationship of epigenetics and diet in pregnancy; caffeine during pregnancy; polycystic ovary syndrome; US Hispanics and preterm births; celiac disease and pregnancy; cannabis use during pregnancy. The second edition of Handbook of Nutrition and Pregnancy will be a valuable resource for clinicians and other healthcare professionals who treat and counsel women of child-bearing age and pregnant women.
Infectious diseases are the leading cause of death globally, particularly among children and young adults. The spread of new pathogens and the threat of antimicrobial resistance pose particular challenges in combating these diseases. Major Infectious Diseases identifies feasible, cost-effective packages of interventions and strategies across delivery platforms to prevent and treat HIV/AIDS, other sexually transmitted infections, tuberculosis, malaria, adult febrile illness, viral hepatitis, and neglected tropical diseases. The volume emphasizes the need to effectively address emerging antimicrobial resistance, strengthen health systems, and increase access to care. The attainable goals are to reduce incidence, develop innovative approaches, and optimize existing tools in resource-constrained settings.
As access to antrietroviral medicines (ARVs) becomes assured, the world needs to place equal effort in ensuring that every antiretroviral therapy (ART) patient receives adequate adherence support. Adherence, the extent to which patients follow the instructions they are given for prescribed treatments, is important, as only through uninterrupted treatment are patients likely to receive sufficient medicine and prevent the generation of drug-resistance. The authors of this book report on the experiences from successful treatment programmes in three countries in sub-Saharan Africa at the forefront of the roll-out of ARVs. The voices of the patients, their families, community members and the health workers who care for them have been reported faithfully. They speak of the impact of ART on their daily lives and of the key challenges involved in sustaining the necessary high level of adherence to treatment. Their real life experience is valid and needs to be considered by health programme managers who are planning the expansion of ARV treatment programmes.