Nutrition and HIV/AIDS: A Training Manual - Linkages Project

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OutlineContent Methodology Time1. Etiology of malnutrition in children infectedwith HIV or born to HIV-infected mothers• Number of children infected withHIV/AIDS in the region• Sources of malnutrition among HIVinfectedchildren and children born toHIV-infected mothers◦ Malnutrition before and after birthand progressive post-natalmalnutrition in HIV-infected children◦ Reasons for growth retardation inHIV-infected children• Consequences of growth failure amongchildren with HIV/AIDS2. Nutritional care and support for childreninfected with HIV or born to HIV-infectedmothers• Goals of nutritional care and support• Components of nutritional care andsupport for children infected with HIVor born to HIV-infected mothers• Provider guidelines for nutritional careand support of children infected withHIV or born to HIV-infected mothersFacilitate an interactivelecture using PowerPoint 8presentationBrainstorm reasons forgrowth failure in HIVinfectedchildrenUse Discussion Points 8 tohelp participants masterthe concepts duringdiscussionBrainstorm key nutritionactions for children withHIV100minutes3. Special considerations for care and supportof severely malnourished children who areHIV positive4. Considerations in and approaches to careand support5. Case study: Why Did Norman Die?6. Nutritional considerations for a terminallyill childAfter the lectureDivide class into groups of 4and give Exercise 8 cardson “Why Did Norman Die?”(cards and case studiesattached)Distribute Arpadi 2000a andHandout 8.1: GrowthFailure in Children with HIVInfection20minutes217
Required materials• LCD or overhead projector• Flipchart stand and paper or board and chalk• Writing pensRecommended preparation• Be familiar with Lecture Notes 8: Nutrition and HIV/AIDS among YoungChildren.• Look through Discussion Points 8 to identify relevant questions to help studentsmaster the concepts. Facilitate group discussions of these issues if time allows.• Allocate time for each activity considering students’ backgrounds and coverageof the activity elsewhere.• If necessary, refer to some reading materials, particularly Arpadi 2000a.• Prepare cards for Exercise 8: Why Did Norman Die?Materials providedPowerPoint Presentations• PowerPoint 8/overhead presentation: Nutrition and HIV/AIDS among YoungChildrenAdditional Resources Available on CD• Arpadi S. 2000a. Growth failure in children with HIV infection. JAIDS 25: S37-S42.218
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Regional Centrefor Quality ofHealth
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ACKNOWLEDGMENTSThis training manual
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ABBREVIATIONS AND ACRONYMSACCAIDSAN
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INTRODUCTIONThe coexistence of high
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ContentThe content is arranged in t
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The sessions can also be taught in
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OutlineContent Methodology TimingDe
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LECTURE NOTES 1: THE BASICS OF HIV/
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gradually weakened. The infected pe
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increase in HIV prevalence of 60 pe
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infection may have a rapid onset, l
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• Dot-blot immunobinding assayUri
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• Removal of children from school
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effectively, care and support inter
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DISCUSSION POINTS 1================
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Recommended preparation1. Be famili
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LECTURE NOTES 2: LINK BETWEEN NUTRI
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AIDS, the impairment of immune func
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for healthy, non-HIV-infected peopl
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Low blood levels of several nutrien
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• Finally, a study of AIDS patien
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EXERCISE 2=========================
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SESSION 3 NUTRITION ACTIONS FOR PEO
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Required materials• LCD or overhe
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McDermott, AY, A Shevitz, T Knox, R
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Goals of nutritional care and suppo
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• Circumferences of the waist, hi
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Consider the phase of the HIV infec
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Promote adequate nutrient intake (s
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Stages of illness and symptoms. Sym
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TherapyNitrogenretention[g/day]Rate
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Nutrient supplements for people liv
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Conclusion (slide 31)Nutritional ca
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HANDOUT 3.1 Case studies in HIV and
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HANDOUT 3.2 Safe Food Handling Prac
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OutlineContent Methodology Timing1.
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Recommended preparation• Be famil
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PVO-USAID Steering Committee on Mul
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Nutritional care and support of peo
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In this session “food security co
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HIV/AIDS attacks food security not
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• Human capital: Reduced producti
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Food-insecure populations may also
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Food security constraints to nutrit
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Pregnant and lactating women (slide
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Implementation of nutritional care
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demand these foods. A good assessme
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Counselors should be aware of and i
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Conclusion (slide 36)The capacity t
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UNAIDS and WHO. 2002. AIDS epidemic
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1. How does poor food availability
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5. Will referrals and targeting of
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SESSION 5 NUTRITIONAL MANAGEMENT OF
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Required materials• LCD or overhe
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LECTURE NOTES 5: NUTRITIONAL MANAGE
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Figure 2 Cycle of malnutrition and
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IV. Late symptomatic phase (full-bl
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The following symptoms may also neg
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• Enables greater food intake by
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EXERCISE 5=========================
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HANDOUT 5.1 Caring for symptoms ass
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Illness Diet Care and nutrition pra
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SESSION 6 NUTRITIONAL CARE AND SUPP
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OutlineContent Methodology Timing1.
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Recommended preparation• Be famil
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———. 1998. Randomised trial o
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LECTURE NOTES 6: NUTRITIONAL CARE A
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The stigma associated with HIV can
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of malnutrition, which increases th
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adolescent mother, growth and devel
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HIV infection increases the energy
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Anemia is common during HIV infecti
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The use of high levels of supplemen
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Nutritional care and support for th
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Management of secondary infections
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A. Nutrition history• Dietary int
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• Income, housing, amenities for
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multiple nutrient supplement, where
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Management of diet-related HIV prob
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Infant feeding options and risks (s
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insecurity and may increase malnutr
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Seumo-Fosso, E, and B Cogill. 2003.
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HANDOUT 6.1 Health Sector and Mater
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HANDOUT 6.2 A Guide to Nutritional
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• Educational levelLactating moth
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Did the counselor ask about: YES NO
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HANDOUT 6.4 Practical Consideration
Page 178 and 179: HANDOUT 6.5 Checklist for Nutrition
Page 180 and 181: HANDOUT 6.7 Dietary Management of C
Page 182 and 183: Dietary problemFeverNutritional int
Page 184 and 185: 1. How could HIV infection affect R
Page 186 and 187: • Nutritional status, dietary int
Page 188 and 189: • Rita’s dietary intake and eat
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Page 192 and 193: • How was the nutritional assessm
Page 194 and 195: Estimated time: 120 minutes excludi
Page 196 and 197: Suggested reading materialsCoutsoud
Page 198 and 199: LECTURE NOTES 7: INFANT FEEDING AND
Page 200 and 201: • A viral, bacterial, or parasiti
Page 202 and 203: DNA (cell-associated virus) in colo
Page 204 and 205: Mucosal integrity (slide 18)Studies
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Page 208 and 209: Breastfeeding techniquesIt is espec
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Page 212 and 213: • Providing skin-to-skin contact
Page 214 and 215: suitable for replacement feeds befo
Page 216 and 217: • Administration of ZVD and Lamiv
Page 218 and 219: Coutsoudis, A, et al. 2001. Are HIV
Page 220 and 221: Semba, RD, N Kumwenda, D Hoover, et
Page 222 and 223: Case study 1A school teacher, Regin
Page 224 and 225: • How would you respond to Hilary
Page 226 and 227: HANDOUT 7.2 PMTCT Decision-Making A
Page 230 and 231: Suggested reading materialsAgostoni
Page 232 and 233: LECTURE NOTES 8: NUTRITION AND HIV/
Page 234 and 235: Despite these statistics, it is dif
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Page 240 and 241: • Changes in eating behaviors ass
Page 242 and 243: • Address issues relevant and of
Page 244 and 245: Enhanced ARV therapy (slide 29)Chil
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Page 248 and 249: DISCUSSION POINTS 8Questions for cl
Page 250 and 251: Action/activityNorman admitted to n
Page 252 and 253: OutlineContent Methodology Timing1.
Page 254 and 255: • Allocate time for each activity
Page 256 and 257: Food Medication Interactionswww.foo
Page 258 and 259: • Describes information collected
Page 260 and 261: • Antimalaria drugs such as quini
Page 262 and 263: Food effects on drug efficacy (slid
Page 264 and 265: Some antiretroviral drugs may affec
Page 266 and 267: MedicationPurposeRecommended Tobe t
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Page 272 and 273: women’s nutritional status. It is
Page 274 and 275: Health provider capacityHealth prov
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Gelato, M. 2003. Insulin and carboh
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eferred him to the counselor for th
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Medication Purpose Recommended Tobe
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Medication Purpose Recommended Tobe
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Side effects of each drug?Side effe
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PurposeTo provide basic information
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Factors in Transmissionand Vulnerab
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Impact on the Education Sector• D
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AcknowledgmentNutrition and HIV/AID
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Body Habitus ChangesMetabolic chang
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PurposeTo provide general nutrition
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Stages of HIV Disease andNutritionI
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IncreaseVitamin and Mineral IntakeS
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Lipodystrophy• Means fat maldistr
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PurposeTo introduce the constraints
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Effect of AIDS on Crop ProductionCr
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Pregnant and Lactating WomenFood an
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Session 5 Nutritional Management of
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Rationale, Cont.Importance of Manag
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Session 6 Nutritional Care and Supp
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Vulnerabilityof Women and Young Gir
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What Is Not KnownComparison of Nutr
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Purposeof Nutrition Care and Suppor
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Greatest Impact of NutritionImprove
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Size of the Problem in Africa• >3
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Possible Mechanisms ofTransmissionA
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Prevention-to-Care ContinuumInterve
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Session 8 Nutritional Care for Youn
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ChildrenBorn to HIV-Positive Mother
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Growth Failure Associated withIncre
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Enhanced ARV Therapy• To reduce v
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Care of the Terminally Ill ChildWhy
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PurposeTo provide knowledge and ski
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SIDE EFFECTS OF DRUGSaffectFOOD INT
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