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Diarrhoeal diseases and HIV - Overview of the interactions
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Proof of Higher Prevalence of Diarrhoea amongst PLWHA Population |
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Diarrhoea, a very common symptom of HIV and AIDS, affects 90 percent of PLWHA and results in significant morbidity and mortality (Katabira 1999; Monkemuller and Wilcox 2000) |
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A study of HIV-positive infants in the Democratic Republic of Congo (DRC) found that the risk of dying from diarrhoea is 11 times greater than for infants who were HIV-positive (Thea et. al, 1993). |
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Another study found that although common diarrhoea-causing enteric pathogens are found in many babies, HIV-positive babies with acute diarrhoea were six times more likely to develop persistent diarrhea .HIV negative babies born to HIV-positive mothers were also at 3.5 times greater risk of developing recurrent bouts of diarrhoea than babies born to HIV-negative mothers(Keuch et. al, 1992). |
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In Africa, diarrhoea is four times more common among children with HIV and seven times more common among adults with HIV than their HIV-negative household members
(Mermin et al. 2004). |
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In a study of persons with diarrhoea, those with HIV infection had higher recovery rates of bacterial and parasitic pathogens and higher rates of Shigella, Aeromonas, Cryptosporidia and Strongyloides than persons without HIV. These organisms should be considered when managing people with HIV who are present with diarrhoea
( Lule JR, Mermin J, Malamba S, Ransom R, Hughes P, Downing R, Kizito F, Wafula W, Nakanjako D, Kigozi A, Quick R)
http://gateway.nlm.nih.gov/MeetingAbstracts/102255022.html |
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Proof of Effectiveness of Water POU Interventions for PLWHAS |
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A study of HIV-infected persons and their families in Uganda showed that use of a simple, home-based safe water system reduced the incidence of diarrhoeal episodes by 25 percent, the number of days with diarrhoea by 33 percent, and the frequency of visible blood or pus in stool.
(Lule JR, Mermin J, Ekwaru JP, Malamba S, Downing R, Ransom R, Nakanjako D, Wafula W, Hughes P, Bunnell R, Kaharuza F, Coutinho A, Kigozi A, Quick R. Effect of home-based water chlorination and safe storage on diarrhea among persons with human immunodeficiency virus in Uganda) |
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Proof of Diarrhoea as a Main Cause of Death in PLWHA Population |
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In a study in Uganda of the 55 HIV-positive cases with sufficient data to establish cause of death, 52 (95%) were assessed as having HIV-associated deaths and 48 (87%) died in WHO stage 4 (AIDS). The main causes of death were wasting syndrome (31%), chronic diarrhoea (22%), cryptococcal meningitis (13%) and chest infection (11%) (Martin Okongo, Dilys Morgan, Billy Mayanja, Amanda Ross and James Whitworth)
http://ije.oxfordjournals.org/cgi/content/abstract/27/4/698 |
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Integration of Safe Water Interventions in Policy Documents |
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Endorse inclusion of safe water and hygiene as essential components of basic preventive care package for PLWHA.
Taken from USAID document: INTEGRATING HYGIENE IMPROVEMENT INTO HIV/AIDS PROGRAMMING TO REDUCE DIARRHEA MORBIDITY |
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http://www.hip.watsan.net/content/download/1528/7298/file/HIP%20HI%20and%20HIV-AIDS%20integration8-06.pdf |
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Diarrhoea incidence, duration, severity, and mortality are all higher in children with HIV/AIDS than in HIV-uninfected children, and chronic diarrhoea is also a major cause of morbidity and mortality in HIV-infected adults. Therefore, interventions that reduce diarrhoeal episodes should be considered for use in all HIV-infected persons. |
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Emergency Plan funds may support:
Home-based, safe drinking water interventions, (e.g., dilute sodium hypochlorite (bleach) water treatment, water vessels, etc.) for HIV-infected persons in communities where there is not a reliable source of safe water. |
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Taken from: Guidance for United States Government In-Country Staff and Implementing Partners for a Preventive Care Package for Adults #1
The President’s Emergency Plan for AIDS Relief Office of the U.S. Global AIDS Coordinator
April 2006
http://www.pepfar.gov/documents/organization/77004.pdf |
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Mission and Values
