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The Health of HIV-exposed Children after Early Weaning

Identifieur interne : 001A04 ( Pmc/Corpus ); précédent : 001A03; suivant : 001A05

The Health of HIV-exposed Children after Early Weaning

Auteurs : Megan E. Parker ; Martin Tembo ; Linda Adair ; Charles Chasela ; Ellen G. Piwoz ; Denise J. Jamieson ; Sascha Ellington ; Dumbani Kayira ; Alice Soko ; Chimwemwe Mkhomawanthu ; Francis Martinson ; Charles M. Van Der Horst ; Margaret E. Bentley

Source :

RBID : PMC:3787136

Abstract

There are potential health risks associated with the use of early weaning to prevent mother-to-child transmission of HIV in resource-poor settings. Our objective was to examine growth and nutrient inadequacies among a cohort of children weaned early. Children participating in the Breastfeeding Antiretrovirals and Nutrition (BAN) Study in Lilongwe, Malawi, had HIV-infected mothers, were weaned at 6 months and fed LNS until 12 months. 40 HIV-negative, BAN-exited children were compared to 40 HIV-negative, community children matched on age, gender and local health clinic. Nutrient intake was calculated from 24-hour dietary recalls collected from BAN-exited children. Anthropometric measurements were collected from BAN-exited and matched community children at 15-16 months, and 2 months later. Longitudinal random effects sex-stratified models were used to evaluate anthropometric differences between the 2 groups. BAN-exited children consumed adequate energy, protein, and carbohydrates but inadequate amounts of fat. The prevalence of inadequate micronutrient intakes were: 46% for vitamin A; 20% for vitamin B6; 69% for folate; 13% for vitamin C; 19% for iron; 23% for zinc. Regarding growth, BAN-exited girls gained weight at a significantly lower rate (0.02g/kg/day [95%CI: 0.01, 0.03] than their matched comparison (0.05g/kg/day [95%CI: 0.03, 0.07]); BAN girls grew significantly slower (0.73cm/month [95%CI: 0.40,1.06]) than their matched comparison (1.55cm/month [95%CI: 0.98, 2.12]). Among this sample of BAN-exited children, early weaning was associated with dietary deficiencies and girls experienced reduced growth velocity. In resource-poor settings, HIV prevention programs must ensure that breastfeeding stop only once a nutritionally adequate and safe diet without breastmilk can be provided.


Url:
DOI: 10.1111/j.1740-8709.2011.00369.x
PubMed: 22099216
PubMed Central: 3787136

Links to Exploration step

PMC:3787136

Le document en format XML

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<p id="P1">There are potential health risks associated with the use of early weaning to prevent mother-to-child transmission of HIV in resource-poor settings. Our objective was to examine growth and nutrient inadequacies among a cohort of children weaned early. Children participating in the Breastfeeding Antiretrovirals and Nutrition (BAN) Study in Lilongwe, Malawi, had HIV-infected mothers, were weaned at 6 months and fed LNS until 12 months. 40 HIV-negative, BAN-exited children were compared to 40 HIV-negative, community children matched on age, gender and local health clinic. Nutrient intake was calculated from 24-hour dietary recalls collected from BAN-exited children. Anthropometric measurements were collected from BAN-exited and matched community children at 15-16 months, and 2 months later. Longitudinal random effects sex-stratified models were used to evaluate anthropometric differences between the 2 groups. BAN-exited children consumed adequate energy, protein, and carbohydrates but inadequate amounts of fat. The prevalence of inadequate micronutrient intakes were: 46% for vitamin A; 20% for vitamin B6; 69% for folate; 13% for vitamin C; 19% for iron; 23% for zinc. Regarding growth, BAN-exited girls gained weight at a significantly lower rate (0.02g/kg/day [95%CI: 0.01, 0.03] than their matched comparison (0.05g/kg/day [95%CI: 0.03, 0.07]); BAN girls grew significantly slower (0.73cm/month [95%CI: 0.40,1.06]) than their matched comparison (1.55cm/month [95%CI: 0.98, 2.12]). Among this sample of BAN-exited children, early weaning was associated with dietary deficiencies and girls experienced reduced growth velocity. In resource-poor settings, HIV prevention programs must ensure that breastfeeding stop only once a nutritionally adequate and safe diet without breastmilk can be provided.</p>
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<journal-id journal-id-type="nlm-journal-id">101201025</journal-id>
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<journal-id journal-id-type="iso-abbrev">Matern Child Nutr</journal-id>
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<subject>Article</subject>
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<title-group>
<article-title>The Health of HIV-exposed Children after Early Weaning</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname>Parker</surname>
<given-names>Megan E.</given-names>
</name>
<xref ref-type="aff" rid="A1">1</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Tembo</surname>
<given-names>Martin</given-names>
</name>
<xref ref-type="aff" rid="A2">2</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Adair</surname>
<given-names>Linda</given-names>
</name>
<xref ref-type="aff" rid="A3">3</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Chasela</surname>
<given-names>Charles</given-names>
</name>
<xref ref-type="aff" rid="A4">4</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Piwoz</surname>
<given-names>Ellen G.</given-names>
</name>
<xref ref-type="aff" rid="A5">5</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Jamieson</surname>
<given-names>Denise J.</given-names>
</name>
<xref ref-type="aff" rid="A6">6</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Ellington</surname>
<given-names>Sascha</given-names>
</name>
<xref ref-type="aff" rid="A6">6</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Kayira</surname>
<given-names>Dumbani</given-names>
</name>
<xref ref-type="aff" rid="A4">4</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Soko</surname>
<given-names>Alice</given-names>
</name>
<xref ref-type="aff" rid="A4">4</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Mkhomawanthu</surname>
<given-names>Chimwemwe</given-names>
</name>
<xref ref-type="aff" rid="A4">4</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Martinson</surname>
<given-names>Francis</given-names>
</name>
<xref ref-type="aff" rid="A4">4</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>van der Horst</surname>
<given-names>Charles M.</given-names>
</name>
<xref ref-type="aff" rid="A3">3</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Bentley</surname>
<given-names>Margaret E.</given-names>
</name>
<xref ref-type="aff" rid="A3">3</xref>
</contrib>
<contrib contrib-type="author">
<collab>for the BAN Study Team</collab>
</contrib>
</contrib-group>
<aff id="A1">
<label>1</label>
International Food Policy Research Institute, Washington D.C., USA</aff>
<aff id="A2">
<label>2</label>
PATH Malawi, Lilongwe, Malawi</aff>
<aff id="A3">
<label>3</label>
University of North Carolina at Chapel Hill, Chapel Hill, NC, USA</aff>
<aff id="A4">
<label>4</label>
UNC Project, Lilongwe, Malawi</aff>
<aff id="A5">
<label>5</label>
Bill and Melinda Gates Foundation, Seattle, Washington, USA</aff>
<aff id="A6">
<label>6</label>
Centers for Disease Control and Prevention, Atlanta, GA, USA</aff>
<author-notes>
<corresp id="FN1">Corresponding Author: Megan Elizabeth Parker: IFPRI Postdoctoral Fellow, CRS Burundi, Muyinga N°5, BP 665 Bujumbura, Burundi,
<email>M.Parker@cgiar.org</email>
, Tel: (+257) 71278431</corresp>
<fn id="FN2">
<p>
<bold>Megan E. Parker</bold>
: PhD, Postdoctoral Fellow IFPRI-Burundi, CRS Burundi, Muyinga N°5, BP 665, Bujumbura, Burundi.</p>
<p>
<bold>Martin Tembo</bold>
: MSc, PATH Malawi, P.O. Box 30547, Lilongwe 3, Malawi</p>
<p>
<bold>Linda Adair</bold>
: PhD, Professor of Nutrition, UNC-Chapel Hill, 408 Univ Square East, Campus Box 8120, Chapel Hill, NC 27516, USA</p>
<p>
<bold>Charles Chasela</bold>
: PhD, Fogarty Clinical Research Fellow, University of North Carolina, UNC Project, P/Bag A-104 Lilongwe, Malawi</p>
<p>
<bold>Ellen G. Piwoz</bold>
: ScD, Bill & Melinda Gates Foundation, P. O. Box 23350, Seattle, Washington, 98102, USA</p>
<p>
<bold>Denise J. Jamieson</bold>
: MD, MPH, Division of Reproductive Health, Centers for Disease Control and Prevention, 4770 Buford Highway, Mailstop K-34, Atlanta, GA 30341</p>
<p>
<bold>Sascha Ellington</bold>
: MSPH, Division of Reproductive Health, Centers for Disease Control and Prevention, 4770 Buford Highway, Mailstop K-34, Atlanta, GA 30341</p>
<p>
<bold>Dumbani Kayira</bold>
: MBBS, Paediatric Supernumerary Registrar, Health Sciences Faculty, Wits Medical School, 7 York Road, Parktown 2193, Johannesburg</p>
<p>
<bold>Alice Soko</bold>
: Head Nurse, UNC Project, P/Bag A-104 Lilongwe, Malawi</p>
<p>
<bold>Chimwemwe Mkhomawanthu</bold>
: BSc, UNC Project, P/Bag A-104 Lilongwe, Malawi</p>
<p>
<bold>Francis Martinson</bold>
: MBChB, PhD, Country Director, UNC Project, P/Bag A-104 Lilongwe, Malawi</p>
<p>
<bold>Charles M. van der Horst</bold>
: MD, Division of Infectious Diseases, CB# 7030, Bioinformatics Building, 130 Mason Farm Road 2nd Floor, Chapel Hill, North Carolina 27599</p>
<p>
<bold>Margaret E. Bentley</bold>
: PhD, Professor of Nutrition & Associate Dean for Global Health, Associate Director, Institute for Global Health & Infectious Diseases, UNC Gillings School of Global Public Health, 124 Rosenau Hall, CB 7400, Chapel Hill, North Carolina 27599</p>
</fn>
</author-notes>
<pub-date pub-type="nihms-submitted">
<day>14</day>
<month>9</month>
<year>2013</year>
</pub-date>
<pub-date pub-type="epub">
<day>20</day>
<month>11</month>
<year>2011</year>
</pub-date>
<pub-date pub-type="ppub">
<month>4</month>
<year>2013</year>
</pub-date>
<pub-date pub-type="pmc-release">
<day>01</day>
<month>4</month>
<year>2014</year>
</pub-date>
<volume>9</volume>
<issue>2</issue>
<fpage>217</fpage>
<lpage>232</lpage>
<abstract>
<p id="P1">There are potential health risks associated with the use of early weaning to prevent mother-to-child transmission of HIV in resource-poor settings. Our objective was to examine growth and nutrient inadequacies among a cohort of children weaned early. Children participating in the Breastfeeding Antiretrovirals and Nutrition (BAN) Study in Lilongwe, Malawi, had HIV-infected mothers, were weaned at 6 months and fed LNS until 12 months. 40 HIV-negative, BAN-exited children were compared to 40 HIV-negative, community children matched on age, gender and local health clinic. Nutrient intake was calculated from 24-hour dietary recalls collected from BAN-exited children. Anthropometric measurements were collected from BAN-exited and matched community children at 15-16 months, and 2 months later. Longitudinal random effects sex-stratified models were used to evaluate anthropometric differences between the 2 groups. BAN-exited children consumed adequate energy, protein, and carbohydrates but inadequate amounts of fat. The prevalence of inadequate micronutrient intakes were: 46% for vitamin A; 20% for vitamin B6; 69% for folate; 13% for vitamin C; 19% for iron; 23% for zinc. Regarding growth, BAN-exited girls gained weight at a significantly lower rate (0.02g/kg/day [95%CI: 0.01, 0.03] than their matched comparison (0.05g/kg/day [95%CI: 0.03, 0.07]); BAN girls grew significantly slower (0.73cm/month [95%CI: 0.40,1.06]) than their matched comparison (1.55cm/month [95%CI: 0.98, 2.12]). Among this sample of BAN-exited children, early weaning was associated with dietary deficiencies and girls experienced reduced growth velocity. In resource-poor settings, HIV prevention programs must ensure that breastfeeding stop only once a nutritionally adequate and safe diet without breastmilk can be provided.</p>
</abstract>
<kwd-group>
<kwd>LNS</kwd>
<kwd>early breastfeeding cessation</kwd>
<kwd>HIV</kwd>
<kwd>Malawi</kwd>
<kwd>child growth</kwd>
</kwd-group>
</article-meta>
</front>
</pmc>
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