EAL

H/A: Foodborne Illness (2009)

Citation:

Study Design:

Class:

- Click here for explanation of classification scheme.

Quality Rating:

Research Purpose:

To review food and water safety for persons infected with human immunodeficiency virus.

Inclusion Criteria:

Article inclusion criteria not described.

Exclusion Criteria:

Article exclusion criteria not described.

Description of Study Protocol:

Recruitment: Article selection methods not described

Design: Narrative review

Statistical Analysis: Not performed.

Data Collection Summary:

Timing of Measurements: Not applicable

Dependent Variables: Not applicable

Independent Variables: Not applicable

Control Variables: Not applicable.

Description of Actual Data Sample:

Initial N: 31 references cited

Attrition (final N): 31

Age: Not mentioned

Ethnicity: Not mentioned

Location: Worldwide studies.

Summary of Results:

A compromised immune system causes people with HIV or AIDS to be more susceptible to foodborne illness from eating foods that are unsafely handled or prepared with water from unsafe sources.

Food- and water-borne illnesses can cause diarrhea, nausea and vomiting that can lead to weight loss.

The major pathogens seen in AIDS-related diarrhea are Cryptosporidium, Microsporidium, Salmonella and cytomegalovirus.

Salmonellosis is estimated to be nearly 20 times more common and five times more often bacteremic in AIDS patients than in patients without AIDS.

Patients with diarrhea and occult enteric infections experienced more weight loss and died sooner than those with diarrhea but no identified pathogens.

The average incidence of salmonellosis in men age 15 years to 60 years with AIDS was 384 per 100,000, whereas the average annual incidence for men the same age without AIDS was only 20 per 100,000.

Salmonella bacteremia was more common in persons with AIDS (45%) than in those without the disease (9%).

Listeriosis, shigellosis, cholera and Vibrio vulnificus enteritis are other bacterial foodborne diseases for which people with HIV/AIDS are at increased risk.

Beginning in 1985, four microsporidian protozoan parasites have been found almost exclusively in AIDS patients.

The precautions for preventing or minimizing food- or water-borne diseases are recommended in the fifth edition of Nutrition and Your Health: Dietary Guidelines for Americans.

Author Conclusion:

Knowledge of safe food- and water-handling techniques is essential for persons living with HIV and AIDS, their caretakers, and for health care providers to prevent the potentially life-threatening nature of such infections. The prevention of foodborne and waterborne illnesses as a component of an overall strategy for defensive living is critical. To decrease the risk of infection from enteric pathogens, emphasis should be placed on proper storage of perishable foods, adequate cooking of animal foods, avoiding cross-contamination of raw and cooked foods, ensuring appropriate sanitation in the kitchen, ensuring proper personal hygiene and using water from safe sources.

Funding Source:

Reviewer Comments:

Article inclusion/exclusion criteria and selection methods not described.

Quality Criteria Checklist: Review Articles
Relevance Questions
	1.	Will the answer if true, have a direct bearing on the health of patients?	Yes
	2.	Is the outcome or topic something that patients/clients/population groups would care about?	Yes
	3.	Is the problem addressed in the review one that is relevant to dietetics practice?	Yes
	4.	Will the information, if true, require a change in practice?	Yes

Validity Questions
	1.	Was the question for the review clearly focused and appropriate?	Yes
	2.	Was the search strategy used to locate relevant studies comprehensive? Were the databases searched and the search termsused described?	No
	3.	Were explicit methods used to select studies to include in the review? Were inclusion/exclusion criteria specified andappropriate? Wereselectionmethods unbiased?	No
	4.	Was there an appraisal of the quality and validity of studies included in the review? Were appraisal methodsspecified,appropriate, andreproducible?	No
	5.	Were specific treatments/interventions/exposures described? Were treatments similar enough to be combined?	Yes
	6.	Was the outcome of interest clearly indicated? Were other potential harms and benefits considered?	Yes
	7.	Were processes for data abstraction, synthesis, and analysis described? Were they applied consistently acrossstudies and groups? Was thereappropriate use of qualitative and/or quantitative synthesis? Was variation in findings among studies analyzed? Were heterogeneity issued considered? If data from studies were aggregated for meta-analysis, was the procedure described?	No
	8.	Are the results clearly presented in narrative and/or quantitative terms? If summary statistics are used, are levels ofsignificance and/or confidence intervals included?	Yes
	9.	Are conclusions supported by results with biases and limitations taken into consideration? Are limitations ofthe review identified anddiscussed?	Yes
	10.	Was bias due to the review's funding or sponsorship unlikely?	Yes