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Background: According to the World Health Organization (WHO), malnutrition can be linked to 45% of deaths in children under the age of five years. The Integrated Nutrition Programme (INP) was introduced in 1994 to address malnutrition in South Africa. There had been no systematic evaluation of how well clinics perform regarding nutritional services. Malnutrition rates worsened in the Free State from 3.9% in 2009 to 10.7% in 2013. This study aimed to assess the effectiveness of the INP Supplementary Feeding Programme in primary healthcare facilities in the Mangaung University of the Free State Community Partnership Project, known as MUCPP, catchment area of Bloemfontein, Free State, in children aged six months to five years. Methods: This was a retrospective, descriptive cohort study. All children between six months and five years entering the feeding scheme between July 2014 and June 2015 at the MUCPP, which is the hub of the feeding scheme, and three primary healthcare clinics were included. Data were collected from September to November 2015 from the INP registers and captured on data-extraction forms. Results: In total, 730 children were included in the study, 38.8% at risk for malnutrition and 61.2% malnourished. Most of the children (80.7%) stopped attending before change was seen. Only 14.1% exited the INP successfully with a normal weight for age and 3.0% deteriorated despite nutrition interventions. Of all children with one or more follow-up visits, 50.4% (119/236) improved from severe malnutrition to underweight or exited at target weight. Conclusions: The follow-up of the children and the monitoring and implementation of the INP are inadequate. There is some evidence that children who attend the INP regularly benefit from the programme. [ABSTRACT FROM PUBLISHER]

Aim: This study aims to evaluate outcomes of children with advanced HIV disease who are initiated on antiretroviral therapy under multiprofessional specialist paediatric hospice care. Design: A retrospective cohort file review methodology was undertaken in a specialist paediatric hospice in South Africa. Methods: Antiretroviral therapy was initiated for children with a CD4% of less than 15% (for children under 6 years of age) or a CD4 count under 200 for children over 6 years of age. According to the World Health Organization Europe (2007) staging criteria, all children were stage 3/4 HIV disease. Multiprofessional staff provided daily tailored assessment and care. Each child was followed for 6 months. Data on mortality, CD4 count, CD4 percentage, body weight, and viral load were measured at initiation and a follow-up after 6 months. Findings: Of the 37 children initiated on ART therapy, 31 survived at 6 months. From a baseline of mean body weight 13.3 kg, there was an average of 3.2 kg increase (P < 0.001). Mean CD4 counts more than doubled (P < 0.001), with a mean increase of 467 cells per mm3 blood. Mean CD4 percentages increased from 13.6--19.4% (P < 0.001). Viral load decreased significantly from a median 271 000 copies per mm3 blood to a median of 25 (imputed value for undetectable viral load) (P < 0.001). Twenty-three children had an undetectable viral load. Conclusion: For children with advanced HIV disease, who are least likely to access or respond to treatment, this study demonstrates a novel approach to managing care successfully. [ABSTRACT FROM AUTHOR]