An assessment of the causes of malnutrition in Ethiopia: A ...

Figure 4.6: Virtuous cycle of nutritional care and HIV/AIDS
Eating well;
Good appetite
Good nutrition;
Maintain body
weight
Slower HIV/AIDS
disease
progression;
Reduced
sickness
Stronger
immunity and
resistance to
infection
maintain body weight and strength and enhances response to anti-retroviral therapy or
treatment of opportunistic infections. It changes the vicious cycle of malnutrition and
HIV/AIDS (Figure 4.5) to a virtuous cycle (Figure 4.6).
Good nutritional care promotes health and delays the progression of HIV infection to
full-blown AIDS in people living with HIV/AIDS (PLWHA), prolonging life and increasing
productivity. This has a far-reaching implication related to household-level caring for the
vulnerable groups and overall household food security by preventing untimely death of adult
breadwinners and enabling the transfer of caring and livelihood skills among household
members.
Good nutritional care for PLWHA aims at ensuring adequate dietary intake,
preventing food-borne & water-borne illnesses and reducing mother to child transmission
(MTCT) of HIV by improving nutritional (and health) status, enhancing quality of life, and
prolonging survival. Therefore, nutritional care should be part of the overall care and support
program of HIV/AIDS.
4.2.5.2. Nutritional care and prevention of mother to child transmission (PMTCT)
The emergence of HIV/AIDS and the recognition of the risk of its transmission from
mother to child via breast milk have hampered breastfeeding promotion. In developing
countries like Ethiopia, regardless of the risk, breast milk cannot be avoided due to the reason
that children will be dying from diarrheal attacks should they not feed at their mother’s breast.
There were 128,000 HIV positive pregnancies in 2003 in Ethiopia (MOH 2004a). Therefore,
this issue needs consideration in the development of a national nutrition strategy. As shown in
Figure 4.7, overall, the risk of MTCT (during pregnancy, delivery, and lactation) is 37
percent and the risk of MTCT during breastfeeding is 10-20 percent, if the child is breastfed
for 24 months.
However, there are maternal and fetal conditions that may increase this risk of
transmission. Maternal conditions include breast problems (mastitis, cracked nipple, and
abscess), malnutrition, high viral load, low CD4 count, new infection during breastfeeding,
and advanced AIDS. The conditions of the baby that increase the MTCT include premature
92