Christmas Eve 2005 Report from Ethiopia

It has been just over two months now since we first commenced the initial phase of the Australian Milk Biscuit Pilot Trials in Addis Ababa, Ethiopia. After we were able to overcome all of the initial setbacks that had delayed project commencement, the pilot is now well under way and we expect to conclude the Ethiopian leg of the pilot trial in late-January.

Approximately 145 children were selected from one orphanage, all of whom are HIV-positive.  Before launching the pilot feeding programme, we assigned the children to either a treatment or control group, whereby the treatment group was assigned to receive five biscuits per day five days per week, whilst the control group remained on the same diet that has been set by the orphanage in collaboration with the Ethiopian Health and Nutrition Institute (EHNRI). We initiated our work by obtaining initial baseline measurements of the children’s heights, weights, and mid-upper-arm-circumferences (MUACs) before feeding commenced, in accordance with current UNICEF standards and guidelines.

The baseline measurements were taken for both treatment and control groups, and the children were re-measured every fortnight thereafter in order to monitor their growth progress and to determine any difference in the growth response of treatment group versus the control group. To date, we have taken 6 consecutive fortnightly measurements and although the data has not yet been collated and subjected to statistical analyses, the personal responses of the treatment group children and their teachers is very positive, with one teacher even going to the extent of claiming that the children seem more alert and attentive in class – an interesting and unexpected observation indeed!  

Also, in terms of palatability and acceptability, only one child out of the 145 participants appears to be unable to tolerate consuming five biscuits per day, often consuming two or three instead of the prescribed five. Upon further investigation, we observed that not only does the child appear very sick and her disease state seems advanced, but we also observed that she was suffering from a persistent oral fungal infection. Efforts are being made by the teachers and ourselves to ensure that she completes her ration of five biscuits per day, over the course of the whole day. The child seems to be responding and tolerating this well.

Overall, the preliminary results of the pilot are encouraging. We are optimistic about obtaining positive final results, showing that nutritional supplementation using a protein- and energy-enriched, and fortified food such as the Australian Milk Biscuit can enhance the nutritional status and general well-being of children living with HIV.