Water and Nutrition

The Institute for Global Health & Infectious Diseases is interested in the intersection between water and health. Clean water is essential for life, yet more than a billion people around the world do not have access to clean drinking water. Diarrheal diseases caused by unsafe drinking water is one of the leading causes of death worldwide, and more children die from diarrheal illnesses such as cholera than from HIV/AIDS and malaria combined.

Agnes Pofera gathers water in her village. Pofera is a beneficiary of the Safeguard the Family program at UNC Project-Malawi. Photo: Erin Hull, Students of the World

Agnes Pofera gathers water in her village. Pofera is a beneficiary of the Safeguard the Family program at UNC Project-Malawi. Photo: Erin Hull, Students of the World

Child survival is a core part of what the institute does, and safe breastfeeding, access to safe drinking water, and nutrition critical parts of that work.

Water and HIV/AIDS

In 2009, we began collaborating with Procter & Gamble’s Children’s Safe Drinking Water Program (CSDW) to deliver P&G Water Purification Packets to people living with HIV and their families in Malawi. What began as a pilot program for HIV-infected women treated in the antenatal clinic has now been expanded to more than 130 clinics throughout Malawi’s Central West Region through the Safeguard the Family program. In the summer of 2013, we helped CSDW deliver its 5 billionth liter of water purified with the P&G packets. In September 2013, UNC was recognized at the Clinton Global Initiative meeting in New York with a Procter & Gamble Sustainability Partner Award for its work bringing clean drinking water to people living with HIV/AIDS.

In 2009, the IGHID completed a large clinical trial among HIV-infected women and their babies in Malawi that looked at the clinical benefits of breastfeeding, antiretroviral therapy, and nutritional supplements (the BAN study).

IGHID has worked closely with The Water Institute at UNC on research focused on water, sanitation and hygiene (WASH) and HIV/AIDS. In 2011, IGHID hosted a high-level panel on WASH and HIV/AIDS at the Water and Health Conference held at UNC. The panel featured key representatives from PEPFAR, WHO and international WASH-related organizations. This area of research is being continued with collaborators at the London School of Hygiene & Tropical Medicine.

 Other Projects

IGHID’s associate director Peggy Bentley conducts research on women and infant’s nutrition, infant and young child feeding, and community-based interventions for nutrition and health. Current projects include a community-based intervention to improve child growth and development in Andhra Pradesh, India and a five-year, longitudinal study to examine risk factors for the development of pediatric obesity in North Carolina.

In China, UNC has been involved in research on nutrition-related non-communicable diseases (NR-NCD’s), health services and an array of program and policy-oriented issues. The shifts in China toward a diet dominated by saturated fat and energy density and an increasing sedentary activity profile in combination with rapid increases in overweight and other NR-NCD’s are coming at a time when China is not prepared for these changes. This research is led by Barry Popkin.

Who’s Involved

Margaret (Peggy) Bentley, PhD

Irving Hoffman, PA, MPH

Mina Hosseinipour, MD, MPH


Selected Recent Publications

Peletz R, Mahin T, Elliott M, Harris MS, Chan KS, et al. Water, sanitation, and hygiene interventions to improve health among people living with HIV/AIDS: a systematic review (AIDS,2013).

Runfola CD, Zucker NL, Holle AV, Mazzeo S, Hodges EA, Perrin EM, Bentley ME, et al. NURTURE: Development and pilot testing of a novel parenting intervention for mothers with histories of an eating disorder (International Journal of Eating Disorders, 2013).

Ben-Davies ME, Kinlaw A, Estrada Del Campo Y, Bentley ME, Siega-Riz AM. Risk factors associated with the presence and severity of food insecurity in rural Honduras (Public Health Nutrition, 2013).

Widen EM, Bentley ME, Kayira D, Chasela CS, Jamieson DJ, et al. Maternal weight loss during exclusive breastfeeding is associated with reduced weight and length gain in daughters of HIV-infected Malawian women (The Journal of Nutrition, 2013).

Thompson AL, Adair LS, Bentley ME. Pressuring and restrictive feeding styles influence infant feeding and size among a low-income African-American sample (Obesity, 2013).

Flax VL, Bentley ME, Chasela CS, Kayira D, Hudgens MG, et al. Lipid-based nutrient supplements are feasible as a breastmilk replacement for HIV-exposed infants from 24 to 48 weeks of age (Journal of Nutrition, 2013).

Thompson AL, Bentley ME. The critical period of infant feeding for the development of early disparities in obesity (Social and Science Medicine, 2013).

Jamieson DJ, Chasela CS, Hudgens MG, King CC, Kourtis AP, Kayira D, Hosseinipour MC, et al. Maternal and infant antiretroviral regimens to prevent postnatal HIV-1 transmission: 48-week follow-up of the BAN randomised controlled trial (Lancet, 2012).

McCollum ED, Bjornstad E, Preidis GA, Hosseinipour MC, Lufesi N. Multicenter study of hypoxemia prevalence and quality of oxygen treatment for hospitalized Malawian children (Transactions of the Royal Society of Tropical Medicine and Hygiene, 2013).

Bauserman M, Lokangaka A, Kodondi KK, Gado J, Viera AJ, Bentley ME, et al. Caterpillar cereal as a potential complementary feeding product for infants and young children: nutritional content and acceptability.

Xue J, Mhango Z, Hoffman IF, Mofolo I, Kamanga E, et al. Use of nutritional and water hygiene packages for diarrhoeal prevention among HIV-exposed infants in Lilongwe, Malawi: an evaluation of a pilot prevention of mother-to-child transmission post-natal care service (Tropical Medicine and International Health, 2010).

van der Horst C, Chasela C, Ahmed Y, Hoffman I, Hosseinipour M, et al. Modifications of a large HIV prevention clinical trial to fit changing realities: a case study of the Breastfeeding, Antiretroviral, and Nutrition (BAN) protocol in Lilongwe, Malawi (Contemporary Clinical Trials, 2009).

Becker-Dreps S, Meléndez M, Liu L, Zambrana LE, et al. Community diarrhea incidence before and after rotavirus vaccine introduction in Nicaragua (American Journal of Tropical Medicine and Hygiene, 2013).