The nutritional well-being of children under five with HIV-positive parents at Bikurungu Health Center III in Rukungiri District

Annibal Muhanguzi

Faculty of Clinical Medicine and Dentistry Kampala International University Western Campus Uganda.


Families affected by HIV/AIDS often face food insecurity and malnutrition. In impoverished nations, over a third of infectious disease-related deaths in children under five result from poor nutrition. Household food insecurity and the impact of HIV/AIDS-related illnesses can hinder the growth of young children, leading to increased malnutrition. A study involving 310 mother/infant pairs from various households was conducted using a convenient sampling method. Information was gathered through a structured questionnaire. Analysis revealed that children in households affected by HIV had a significantly higher rate of stunting (height-for-age < –2 SD) compared to those in unaffected households (25.5% vs. 9.1%, p = .002). However, the rates of wasting and underweight did not significantly differ between HIV-affected and unaffected households. Living in households affected by HIV is associated with stunted growth in children under five.

Keywords: HIV/AIDS, Children under 5 years of age, Malnutrition, Stunting


Nutritional status is the condition of the body resulting from the nutrient content of the food consumed in relation to the body’s nutritional needs and from the ability of the body to digest, absorb, and use those nutrients [1]. Technically, normal nutritional status among individuals is achieved when someone is able to consume food in a balanced form and the body utilizes the consumed nutrients normally [2, 3]. According to the United Nations (UN), adequate nutrition is one of the fundamental rights of every human being. It should be provided to everyone especially vulnerable groups like children, pregnant mothers, and the elderly. A well-nourished population repays to society in the form of high productivity, better learning capacity, and low healthcare expenditure. Good nutrition enhances body immunity which offers protection to the body against infectious diseases such as malaria and respiratory infections [4-6]. It also prevents risks of non-communicable diseases like obesity, heart disease, diabetes, cancer, and stroke [7-10]. However, when the nutrients provided in the diet are inadequate or not utilized properly, a state of imbalance results in the body [11]. Globally, poor nutrition is one of the main factors attributed to more than half of child deaths, among children under the age of five years [12]. It causes immunological dysfunction which increases the susceptibility of children under five to infections. According to the World Health Organisation (WHO), poor nutrition can also lead to impaired physical and mental development but also reduced productivity [13, 14]. The impact of malnutrition among countries globally is high, and it manifests itself in many forms: as children who do not grow and develop to their full potential, as people who are skin-and-bone or prone to infection, or as people who carry too much weight [15]. Malnutrition and diet are one of the largest risk factors responsible for the global burden of disease, with malnutrition alone accounting for about 45% of deaths of children under five [16]. In sub-Saharan Africa, the epidemiology of severe malnutrition has increased in children requiring hospitalization composed of those who are HIV-infected or HIV exposed with case-fatality rates reaching as high as 20–50% [17]. Large percentages of HIV-positive children have an episode of severe malnutrition as their first AIDS-defining illness. Undernutrition is an important factor that might predict the disease progression of HIV-infected individuals [18, 19]. It also results in a higher risk of morbidity and mortality in both HIV-infected adults and children [20, 21]. Wasting and weight loss are common features of HIV infection, especially in resource-limited settings. It is known that children with HIV and severe malnutrition invariably have lower nutritional recovery and higher mortality rates than their HIV- negative counterparts [22-24]. In East Africa, a variety of previous studies have reported that the magnitude of undernutrition, accordingly the prevalence of under-weight, wasting, and stunting ranged from 19.4% to 77.1%, 7% to 77.1%, and 13% to 71.8% respectively. This showed pronounced discrepancies among reports of undernutrition across different geographical settings and different time periods.  Moreover, there is no regionally represented pooled data on undernutrition in East Africa [25]. Although the future of human societies relies on healthy children being able to achieve their optimal physical growth and development, this optimum is far from being realized in many parts of the world. Undernutrition and HIV infection are major problems in children worldwide, especially in sub-Saharan Africa [26]. Undernutrition is well recognized as a major risk factor for morbidity and mortality contributing to just over 50% of the 10 million child deaths a year worldwide [27]. Anemia is a common feature of undernutrition [28-30]. Other co-morbidities like malaria, pneumonia, and diarrhea can increase the risk of undernutrition [31-34]. It has been observed that modern communities with higher HIV/AIDS prevalence showed lower child malnutrition and mortality rates, potentially due to the overriding influence of trade and income from wage employment. These communities, which are better off economically and have greater access to essential services, such as water and sanitation, exhibited lower child underweight prevalence. Thus, high HIV/AIDS prevalence and better nutritional outcomes can coexist under better socioeconomic conditions. While this scenario does not suggest that higher HIV/AIDS prevalence is causally associated with better nutritional outcomes, it reinforces the need to control for the underlying socioeconomic conditions in examining the association between HIV/AIDS prevalence and nutritional outcomes [35]. In Uganda, the UNICEF country report on the status of children reported that HIV/AIDS is one of the predominant common factors among parents of malnourished children [36]. However, there is limited cross-country evidence on the coexistence of HIV/AIDS and malnutrition in Uganda. Instead, Nalwoga et al. [27] suggest that a high national or community HIV/AIDS prevalence is not associated with a higher risk of child malnutrition. Previous studies are also restricted to country-level analysis involving household and community-level data, usually the Demographic and Health Surveys (DHS). Similarly, the few studies involving cross-country analysis of HIV/AIDS and malnutrition have employed individual, household, and community-level data [27, 37].  Therefore, this study seeks to assess the nutritional status of children under five years born to HIV- positive parents attending Bikurungu Health Center III in Rukungiri District.


Stunting among children under five was more common in households with HIV infection. This was most likely brought on by ongoing malnutrition. However, there were no variations in the levels of underweight and wasting in children from affected and unaffected households that were serviced at Bikurungu Health Center III.


Future longitudinal studies that can monitor the development of kids living in households with HIV are advised. Since confounding variables including seasonality, household affluence, and the number of children living there were not taken into account, the study’s findings may have been skewed, thus recommending future studies accounting for these confounders.


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 CITE AS: Annibal Muhanguzi (2023). The nutritional well-being of children under five with HIV-positive parents at Bikurungu Health Center III in Rukungiri District. IAA Journal of Applied Sciences 10(2):23-35.