NT 325 NUTRITION AND HIV IES Abroad Cape Town

Transcription

1 NT 325 NUTRITION AND HIV IES Abroad Cape Town DESCRIPTION: The purpose of this course is to explore nutrition within a South African context. The course introduces the current nutritional state of South Africa and explores the social demographic aspects of nutrition that contribute to the two extremes of nutrition, namely over-nutrition and malnutrition. There are nutritional interventions that currently exist within South Africa which make use of fortified foods or supplementation to address the relevant nutritional concerns. These interventions will be explored within the course through the pre-readings and class discussions. South Africa is the country with the highest burden of human immunodeficiency virus (HIV) infection in the world, as estimated by the Joint United Nations Program on HIV/AIDS (UNAIDS) in 2012, approximately 6.1 million South African people were infected with the virus. Due to HIV being highly prevalent in South Africa, the course aims to establish the role nutrition plays in the treatment thereof. It will look at the prevalence and progression of the virus as well as its complications impacting nutrition. The course will further focus on nutritional guidelines and supplementation of HIV-infected individuals during different life stages and conditions in the South African context. CREDITS: 3 CONTACT HOURS: 45 LANGUAGE OF INSTRUCTION: English PREREQUISITES: None ADDITIONAL COST: None METHOD OF PRESENTATION: Classes will involve a combination of lectures, class discussions and case studies. Supplementary course information will also be provided through Moodle. In addition, guest lectures and site visits are incorporated to help to bring knowledge to demonstrate how some of the theory focused on in class is deployed in practical settings. REQUIRED WORK AND FORM OF ASSESSMENT: Class Participation: 10% Midterm Exam: 25% Course Related Trip Report: 25% Final Exam: 40% Course Participation Participation in all class discussions, and attendance for all site visits is mandatory. Students are expected to prepare for each class by doing the required reading and reflection, in addition to regularly checking notices on Moodle. Students will, however, be required to do more than simply complete the readings and attend the contact sessions. They will be asked to engage thoughtfully and openly with the material and come to class prepared to respectfully question, engage and explore concepts raised. Midterm Exam In session 12, students will write a test on the nutritional aspect of the course which includes the content covered in the first half of the course. This exam will be a sit down, closed book exam which will be completed within the class time, and will be comprised of a combination of multiple choice, short and long answer questions on the material covered in class.

2 Course Related Trip Reports After each of the two Course Related Trips, students will submit 1,500-2,000 words (6-8 pages) reflecting on and analysing their experience, on Moodle. Students are expected to write what they learned during the trip, and need to incorporate readings to connect lessons and theories from class, with their experiences outside of the classroom. A total of two Course Related Trip Reports will be submitted. Students will be marked according to a rubric, on the development of their reflection and analysis, and integration of course readings. Additional information will be provided by your lecturer. Final Exam The final exam will be a closed book examination and students will be examined on selected content covered during the course. Structured short and long answer questions will be set to demonstrate understanding and application of theories, concepts and approaches to community health in South Africa. The exam questions will require students to apply theories, concepts and approaches learnt to practical situations and/or case studies, by drawing from their experiential learning. The exam will be 1.5 hours. LEARNING OUTCOMES: By the end of the course students will be able to: Critically evaluate the current nutritional status in SA and critique the roles of current nutritional interventions in SA Debate under nutrition vs. over nutrition within a South African context; Identify and explain the socio-economic demographics that play a role in nutrition with in SA; Analyze the perceptions of food security on nutrition within households; Discuss how HIV, its complications and treatments impact on nutrition during different life stages and conditions; Design nutritional guidelines for HIV infected individuals during different life stages and conditions. ATTENDANCE POLICY: Attendance is mandatory for all IES classes, including all course related trips. Excused absences are permitted in the cases of documented illness, a family emergency or when class is held on a recognized religious holiday traditionally observed by a particular student. In this case an IES Abroad Excused Absence Form and supporting documents must be submitted to the Academic Manager at least 24 hours before the class. For illness, the Excused Absence Form must be submitted to the Academic Manager within 24 hours after the class with a doctor s note. More than two unexcused absences will result in two percentage points (2%) being deducted from the final grade for every additional unexcused absence thereafter. Any exams, tests, presentations, or other work missed due to student absences can only be rescheduled in cases of documented medical emergencies or family emergencies. If a test is missed during an unexcused absence they cannot be made up. It is the student s responsibility to contact the lecturer and request information on the missed class as well as any relevant reading or homework information. CONTENT: Week Content Assignments and Readings Week 1 Session 1: Nutritional status in South Africa currently Session 2: Under nutrition vs. over nutrition in South Africa Session 1 Wenhold, F. & Faber, M. (2008). Nutritional status of South Africans: Links to agriculture and water. Department Human Nutrition, University of Pretoria. Nutritional Intervention Research Unit, Medical Research Council. pp 1-75 Session 2

3 Monyeki, M.A., Awotidebe, A., Strydon, G.L., De Ridder, H., Mamabolo, R.L., Kemper, H. C.G. (2015). The Challenges of Underweight and Overweight in South African Children: Are We Winning or Losing the Battle? A Systematic Review. Int J Environ Res Public Health. PMC Week 2 Session 3: Socio-economic demographics (SED) contributing to Nutrition in USA and South Africa Session 4: Nutritional status of adults Session 5: Food security Session 6: Site visit All Students Groote Schuur Heart Museum Guest Lecture (all classes) This guest lecture will provide Summer Health students with a broad overview of health care in South Africa, as well as the various health care systems. Session 3 Kirsten, A.P., Marais, D. (2013). The influence of socio-demographic factors on the nutritional status of children in the Stellenbosch area, WC. African Journal of Clinical Nutrition. Pp 1-8 Bhatta, M.P., Assad, L., Shakya, S. (2014). Sociodemographic and dietary factors associated with excess body weight and abdominal obesity among resettled Bhutanese refugee women in northeast Ohio, USA. Public health. doi: /ijerph Pp Session 4 Faber, M., Wenhold, F. (2007). Nutrition in contemporary South Africa. Water SA Vol. 33 No. 3 (Special Edition). Pp Classen, N., Van der Hoeven, M., Covic, N. (2016). Food environments, health and nutrition in South Africa. Institute for Poverty, Land and Agrarian Studies. Faculty of Economic and Management Sciences. University of the Western Cape Session 5 Du Toit, D.C., Ramonyai, M.D., Lubbe, P.A., Ntushelo, V. (2011). Food Security. WHO. Pp 1-20 Week 3 Session 7: Preparation for Observational Rotation Sessions Session 8: Observational Rotations Session 9: Observational Rotations Course-related Trip: Diva Nutritional Products Session 10: Observational Rotations Lesiapeto, M.S. (2009). Factors associated with nutritional status of children aged 0-60 months residing in Eastern Cape and KwaZulu-Natal Provinces. School of Physiology, Nutrition and Consumer Sciences of the North-West University, Potchefstroom Campus. Pp 2-90 Soul city institute. Nutrition and South Africa s children Retrieved from: Pp 1-47

4 Session 11: Nutritional status of children in USA vs South Africa Deliverables Course Related Trip Report 1 due on Moodle before Session 12. Debrief and roundtable discussion of Observational Rotations Week 4 Session 12: Assessment of current nutrition interventions in South Africa Session 13: The role of supplementation in South Africa Session 14: Midterm test Session 15: HIV prevalence, pathophysiology and progression Session 16: HIV associated opportunistic infections and complications Session 12 Department of Health South Africa. Roadmap for Nutrition in South Africa Pp Iversen, P.O., Marais, D., Du Plessis, L., Herselman, M. (2012). Assessing Nutrition intervention programs that addresses malnutrition among young children in South Africa between AJFAND. Vol 12 No. 2. Pp Session 13 Dwyer, J.T., Coates, P.M., Smith, M.J. (2018). Dietary supplements: Regulatory challenges and research resources. MPI. Nutrients 2018, 10, 41; doi: /nu Blumberg, J.B., Bailey, R.L., Sesso. H.D., Ulrich, C.M. (2018). The Evolving role of multivitamins and multiminerals supplements use among adults in the age of personalized nutrition. Nutrients 2018, 10, 248; doi: /nu PP 2-17 Meltzer, S., Noakes, T.D. (2015). A practical guide to the use of nutritional supplements in South Africa. CME. Vol 22. No.3. pp 1-4 Session 15 Shisana, O., Rehle, T., Simbayi, L.C., Zuma, K., Jooste, S., Zungu, N., Labadarios, D. and Onoya, D., South African national HIV prevalence, incidence and behaviour survey, 2012, PP xxii xlii, , Maartens, G., Celum, C. and Lewin, S.R., HIV infection: epidemiology, pathogenesis, treatment, and prevention. The Lancet, 384(9939), pp Session 16 Pienaar, M., van Rooyen, F.C. and Walsh, C.M., Reported health, lifestyle and clinical manifestations associated with HIV status in people from rural and urban communities in the Free State

5 Province, South Africa. Southern African Journal of HIV Medicine, 18(1), pp Week 5 Week 6 Session 17: Medical treatment: HIV treatments available and negative effects of treatment with nutritional implications. Preparation for Observational Rotation Sessions Session 18: Observational Rotations Session 19: Observational Rotations Session 20: Observational Rotations and Course-related Trip: Masiphumelele rural area and clinic (Thursday, 12 July) Session 21: HIV and malnutrition Debrief and roundtable discussion of Observational Rotations Session 22: Nutritional treatment: Medical Nutrition Therapy macro- and micro-nutrient requirements of HIV infected individuals Session 23: HIV and nutrition in pregnancy and lactation and infancy Session 24: Healthy eating guidelines and food safety for HIV infected individuals WHO guidelines and South African Food Based Dietary Guidelines (SAFBDGs) Chu, C. and Selwyn, P.A., Complications of HIV infection: a systems-based approach. Am Fam Physician, 83(4), pp Session 17 World Health Organization, Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection: recommendations for a public health approach. World Health Organization, pp Dahab, M., Charalambous, S., Hamilton, R., Fielding, K., Kielmann, K., Churchyard, G.J. and Grant, A.D., " That is why I stopped the ART": Patients'& providers' perspectives on barriers to and enablers of HIV treatment adherence in a South African workplace programme. BMC public health, 8(1), p.63. Session 21 Duggal, S., Chugh, T.D. and Duggal, A.K., HIV and malnutrition: effects on immune system. Clinical and developmental immunology, 2012, pp Deliverables Course Related Trip 2 due on Moodle before Session 22 Session 22 Dong, K.R. and Imai, C.M., Medical nutrition therapy for HIV and AIDS. Krause s food, nutrition & diet therapy. 13th ed. Philadelphia, PA: WB Saunders Company, pp Mangili, A., Murman, D.H., Zampini, A.M., Wanke, C.A. and Mayer, K.H., Nutrition and HIV infection: review of weight loss and wasting in the era of highly active antiretroviral therapy from the nutrition for healthy living cohort. Clinical Infectious Diseases, 42(6), pp Session 23 World Health Organization, Guideline: updates on HIV and infant feeding: the duration of breastfeeding, and support from health services to

6 improve feeding practices among mothers living with HIV, pp. iii-vii, Session 24 Vorster, H.H., Badham, J.B. and Venter, C.S., An introduction to the revised food-based dietary guidelines for South Africa. South African Journal of Clinical Nutrition, 26(3), pp. S5-S12. Bourne, L.T., Hendricks, M.K., Marais, D. and Eley, B., Addressing malnutrition in young children in South Africa. Setting the national context for paediatric food-based dietary guidelines. Maternal & child nutrition, 3(4), pp Session 25: Final Exam COURSE RELATED TRIPS: Course related trip 1: Diva Nutritional Products: this nutritional manufacturer produces nutritional supplements that are used wildly in the field of nutrition. Diva represents an organization that is working towards curbing food insecurity, as well as with HIV nutrition, since infected patients often receive this kind of supplementation from dieticians and clinics. Course related trip 2: Masiphumelele rural area and clinic: Masiphumelele is a township in Cape Town located in Kommetjie Road between Kommetjie and Noordhoek. Masiphumelele has a school and a day clinic to where HIV positive residents go, amongst others, to receive treatment. The objective of this course related trip is to see firsthand what several HIV infected individuals in South Africa s daily lives look like, how some of these residents live, what they eat and how they prepare food in order to visualize HIV in the South African context and the challenges that are faced. REQUIRED READINGS: Bhatta, M.P., Assad, L., Shakya, S. (2014). Socio-demographic and dietary factors associated with excess body weight and abdominal obesity among resettled Bhutanese refugee women in northeast Ohio, USA. Public health. doi: /ijerph Pp Blumberg, J.B., Bailey, R.L., Sesso. H.D., Ulrich, C.M. (2018). The Evolving role of multivitamins and multiminerals supplements use among adults in the age of personalized nutrition. Nutrients 2018, 10, 248; doi: /nu PP 2-17 Bourne, L.T., Hendricks, M.K., Marais, D. and Eley, B., Addressing malnutrition in young children in South Africa. Setting the national context for paediatric food-based dietary guidelines. Maternal & child nutrition, 3(4), pp Chu, C. and Selwyn, P.A., Complications of HIV infection: a systems-based approach. Am Fam Physician, 83(4), pp Classen, N., Van der Hoeven, M., Covic, N. (2016). Food environments, health and nutrition in South Africa. Institute for Poverty, Land And Agrarian Studies. Faculty of Economic and Management Sciences. University of the Western Cape. Dahab, M., Charalambous, S., Hamilton, R., Fielding, K., Kielmann, K., Churchyard, G.J. and Grant, A.D., " That is why I stopped the ART": Patients'& providers' perspectives on barriers to and enablers of HIV treatment adherence in a South African workplace programme. BMC public health, 8(1), p.63. Department of Health South Africa. Roadmap for Nutrition in South Africa Dong, K.R. and Imai, C.M., Medical nutrition therapy for HIV and AIDS. Krause s food, nutrition & diet therapy. 13th ed. Philadelphia, PA: WB Saunders Company, pp Duggal, S., Chugh, T.D. and Duggal, A.K., HIV and malnutrition: effects on immune system. Clinical and developmental immunology, Du Toit, D.C., Ramonyai, M.D., Lubbe, P.A., Ntushelo, V. (2011). Food Security.WHO

7 Dwyer, J.T., Coates, P.M., Smith, M.J. (2018). Dietary supplements: Regulatory challenges and research resources. MPI. Nutrients 2018, 10, 41; doi: /nu Faber, M., Wenhold,F. (2007). Nutrition in contemporary South Africa. Water SA Vol. 33 No. 3 (Special Edition). Iversen, P.O., Marais, D., Du Plessis, L., Herselman, M. (2012). Assessing Nutrition intervention programs that addresses malnutrition among young children in South Africa between AJFAND. Vol 12 No. 2. Pp Kirsten, A.P., Marais, D.(2013). The influence of socio-demographic factors on the nutritional status of children in the stellenbosh area, WC. African Journal of Clinical Nutrition. Pp 1-8 Lesiapeto, M.S. (2009). Factors associated with nutritional status of children aged 0-60 months residing in Eastern Cape and KwaZulu-Natal Provinces. School of Physiology, Nutrition and Consumer Sciences of the North-West University, Potchefstroom Campus. Pp 2-90 Maartens, G., Celum, C. and Lewin, S.R., HIV infection: epidemiology, pathogenesis, treatment, and prevention. The Lancet, 384(9939), pp Malongane, F., Mbenyane, X.G. (2017). Nutritional status of children on the National School Nutrition Programme in Capricorn District, Limpopo Province, South Africa. SAJCH. Vol 11. Pp Mangili, A., Murman, D.H., Zampini, A.M., Wanke, C.A. and Mayer, K.H., Nutrition and HIV infection: review of weight loss and wasting in the era of highly active antiretroviral therapy from the nutrition for healthy living cohort. Clinical Infectious Diseases, 42(6), pp Meltzer, S., Noakes, T.D. (2015). A practical guide to the use of nutritional supplements in South Africa. CME. Vol 22. No.3. pp 1-4 Monyeki, M.A., Awotidebe, A., Strydon, G.L., De Ridder, H., Mamabolo, R.L., Kemper, H. C.G. (2015). The Challenges of Underweight and Overweight in South African Children: Are We Winning or Losing the Battle? A Systematic Review. Int J Environ Res Public Health. PMC Mushaphi, L.F., Dannhauser, A., Walsh, C.M., Mbhenyane, X.G., Van Rooyen, F.C. (2015). Effect of a nutrition education programme on nutritional status of children aged 3-5 years in Limpopo Province, South Africa. SAJCH.Vol 9.PP Pienaar, M., van Rooyen, F.C. and Walsh, C.M., Reported health, lifestyle and clinical manifestations associated with HIV status in people from rural and urban communities in the Free State Province, South Africa. Southern African Journal of HIV Medicine, 18(1), pp.1-8. Soul city institute. Nutrition and South Africa s children. Retrieved from: Pp 1-47 Shisana, O., Rehle, T., Simbayi, L.C., Zuma, K., Jooste, S., Zungu, N., Labadarios, D. and Onoya, D., South African national HIV prevalence, incidence and behaviour survey, 2012, PP xxvi - xxix. Vorster, H.H., Badham, J.B. and Venter, C.S., An introduction to the revised food-based dietary guidelines for South Africa. South African Journal of Clinical Nutrition, 26(3), pp.s5-s12. Wenhold, F. & Faber, M. (2008). Nutritional status of South Africans: Links to agriculture and water. Department Human Nutrition. University of Pretoria. Nutritional Intervention Research Unit, Medical Research Council. pp 1-75 World Health Organization, Updates on HIV and Infant Feeding. World Health Organization, Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection: recommendations for a public health approach. World Health Organization, pp RECOMMENDED READINGS: Bhardwaj, V. (2016). Frequently asked questions about HIV/AIDS in South Africa. Africa Check. Child, K. (2017). Here s why SA is struggling to beat HIV. Times Live. Mkize, V. (2017). Living with HIV in South Africa. IOL. Spencer, D.C., et al. (2007). Nutrition Guidelines for HIV-infected Adults and Children in Southern Africa: Meeting the Needs. The Southern African Journal of HIV Medicine, June 2007, p