Provision of micronutrient-fortified food from 6 months of age does not permit HIV-exposed, uninfected Zambian children to catch up in growth to HIV-unexposed children: a randomised controlled trial.


Filteau, S; Baisley, K; Chisenga, M; Kasonka, L; Gibson, RS; CIGNIS Study Team (inc. Gompels, U; Filteau, S; Baisley, K; Chisenga, M; Kasonka, L; Gibson, RS; ), ; (2011) Provision of micronutrient-fortified food from 6 months of age does not permit HIV-exposed, uninfected Zambian children to catch up in growth to HIV-unexposed children: a randomised controlled trial. Journal of acquired immune deficiency syndromes (1999), 56 (2). pp. 166-75. ISSN 1525-4135 DOI: https://doi.org/10.1097/QAI.0b013e318201f6c9

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Abstract

BACKGROUND: HIV-exposed, uninfected (HIV-EU) children represent a large proportion of children in southern Africa. The reasons for their poorer growth and higher morbidity and mortality than their HIV-unexposed peers are unclear.<br/> OBJECTIVE: We compared anthropometry of 125 HIV-EU with 382 HIV-unexposed young Zambian children participating in a trial of micronutrient-fortified complementary/replacement food.<br/> DESIGN: The randomized controlled trial provided children from age 6 to 18 months with a porridge flour containing either a basal or a rich level of micronutrients. Weight and length were measured 3 monthly and head and arm circumferences and triceps and subscapular skinfolds 6 monthly.<br/> RESULTS: There were no significant anthropometric differences between the 2 treatment groups. In unadjusted analyses, most anthropometric Z scores of HIV-EU children were lower than those of HIV-unexposed children; after adjustment for treatment arm, socioeconomic factors, breastfeeding and sex, head and arm circumference Z scores remained lower. Subscapular skinfold Z scores were lower among HIV-EU than HIV-unexposed children at 6 months but not 18 months.<br/> CONCLUSIONS: Socioeconomic factors accounted for some but not all of the impaired growth of HIV-EU children. Micronutrient malnutrition may not be the socioeconomic factor responsible for the growth faltering. Factors acting earlier in life had irreversible effects.<br/>

Item Type: Article
Faculty and Department: Faculty of Infectious and Tropical Diseases > Dept of Pathogen Molecular Biology
Faculty of Epidemiology and Population Health > Dept of Population Health (2012- ) > Dept of Nutrition and Public Health Interventions Research (2003-2012)
Faculty of Epidemiology and Population Health > Dept of Population Health (2012- )
Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology
Research Centre: Centre for Maternal, Reproductive and Child Health (MARCH)
PubMed ID: 21119523
Web of Science ID: 286807700018
URI: http://researchonline.lshtm.ac.uk/id/eprint/1967

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