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Growth pattern in Ethiopian infants - the impact of exposure to maternal HIV infection in relation to socio-economic factors

Walles, John König LU ; Balcha, Taye Tolera LU ; Winqvist, Niclas LU and Björkman, Per LU (2017) In Global Health Action 10(1). p.1-10
Abstract

Background: Infants exposed to maternal HIV infection who remain HIV-uninfected (HIV-exposed/uninfected; HIV-EU) may be at increased risk of growth retardation, which could be due both to directly HIV-related effects and to socio-economic factors overrepresented among HIV-positive women. Objective: To investigate growth development at 9-12 months of age in HIV-EU infants participating in prevention of mother-to-child transmission (PMTCT) care compared to HIV unexposed (HIV-U) infants in relation to socio-economic conditions. Methods: Anthropometric and socio-economic data were collected retrospectively from PMTCT registers (for HIV-EU infants), with HIV-U controls recruited at measles vaccination at public health facilities in Ethiopia.... (More)

Background: Infants exposed to maternal HIV infection who remain HIV-uninfected (HIV-exposed/uninfected; HIV-EU) may be at increased risk of growth retardation, which could be due both to directly HIV-related effects and to socio-economic factors overrepresented among HIV-positive women. Objective: To investigate growth development at 9-12 months of age in HIV-EU infants participating in prevention of mother-to-child transmission (PMTCT) care compared to HIV unexposed (HIV-U) infants in relation to socio-economic conditions. Methods: Anthropometric and socio-economic data were collected retrospectively from PMTCT registers (for HIV-EU infants), with HIV-U controls recruited at measles vaccination at public health facilities in Ethiopia. Growth was compared with regard to HIV exposure and socio-economic variables in multivariate regression analysis. Results: The following growth measurements were found for 302 HIV-EU and 358 HIV-U infants at 9-12 months of age, respectively: mean weight-for-age z-score (WAZ) 0.04 and -0.21, p < 0.001 (proportion underweight 5.7% and 6.7%, p = 0.60); median length-forage z-score (LAZ) -0.92 and -0.91, p = 0.53 (proportion stunted 25.1% and 20.5%, p = 0.17). In multivariate analysis, lower WAZ was associated with male sex (p = 0.021), lower maternal education (p < 0.001), presence of siblings (p < 0.01) and HIV-U (p < 0.01). Underweight was associated with male sex (p = 0.017) and absence of maternal education (p = 0.019). Lower LAZ was associated with male sex (p < 0.001), presence of siblings (p < 0.001) and poor maternal education (p < 0.01), while stunting was associated with male sex (p < 0.001), presence of siblings (p < 0.001), few rooms in the home (p < 0.01), access to running water (p = 0.026) and low level of maternal education (p = 0.014). Conclusions: At 9-12 months of age, HIV-EU infants had non-inferior growth and higher mean WAZ than HIV-U controls. Poor growth development was associated with socioeconomic factors. This suggests health benefits from PMTCT participation for infant growth. Similar interventions could be considered for Ethiopian infants, irrespective of HIV exposure, with a particular focus on children with poor socio-economic status.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Ethiopia, HIV-EU, Infant malnutrition, PMTCT
in
Global Health Action
volume
10
issue
1
pages
1 - 10
publisher
Co-action Publishing
external identifiers
  • scopus:85019356943
  • wos:000400699800001
ISSN
1654-9716
DOI
10.1080/16549716.2017.1296726
language
English
LU publication?
yes
id
461221a9-1809-4abe-9c4a-1047bd8f3a88
date added to LUP
2017-06-14 10:57:56
date last changed
2017-09-18 11:41:00
@article{461221a9-1809-4abe-9c4a-1047bd8f3a88,
  abstract     = {<p>Background: Infants exposed to maternal HIV infection who remain HIV-uninfected (HIV-exposed/uninfected; HIV-EU) may be at increased risk of growth retardation, which could be due both to directly HIV-related effects and to socio-economic factors overrepresented among HIV-positive women. Objective: To investigate growth development at 9-12 months of age in HIV-EU infants participating in prevention of mother-to-child transmission (PMTCT) care compared to HIV unexposed (HIV-U) infants in relation to socio-economic conditions. Methods: Anthropometric and socio-economic data were collected retrospectively from PMTCT registers (for HIV-EU infants), with HIV-U controls recruited at measles vaccination at public health facilities in Ethiopia. Growth was compared with regard to HIV exposure and socio-economic variables in multivariate regression analysis. Results: The following growth measurements were found for 302 HIV-EU and 358 HIV-U infants at 9-12 months of age, respectively: mean weight-for-age z-score (WAZ) 0.04 and -0.21, p &lt; 0.001 (proportion underweight 5.7% and 6.7%, p = 0.60); median length-forage z-score (LAZ) -0.92 and -0.91, p = 0.53 (proportion stunted 25.1% and 20.5%, p = 0.17). In multivariate analysis, lower WAZ was associated with male sex (p = 0.021), lower maternal education (p &lt; 0.001), presence of siblings (p &lt; 0.01) and HIV-U (p &lt; 0.01). Underweight was associated with male sex (p = 0.017) and absence of maternal education (p = 0.019). Lower LAZ was associated with male sex (p &lt; 0.001), presence of siblings (p &lt; 0.001) and poor maternal education (p &lt; 0.01), while stunting was associated with male sex (p &lt; 0.001), presence of siblings (p &lt; 0.001), few rooms in the home (p &lt; 0.01), access to running water (p = 0.026) and low level of maternal education (p = 0.014). Conclusions: At 9-12 months of age, HIV-EU infants had non-inferior growth and higher mean WAZ than HIV-U controls. Poor growth development was associated with socioeconomic factors. This suggests health benefits from PMTCT participation for infant growth. Similar interventions could be considered for Ethiopian infants, irrespective of HIV exposure, with a particular focus on children with poor socio-economic status.</p>},
  articleno    = {1296726},
  author       = {Walles, John König and Balcha, Taye Tolera and Winqvist, Niclas and Björkman, Per},
  issn         = {1654-9716},
  keyword      = {Ethiopia,HIV-EU,Infant malnutrition,PMTCT},
  language     = {eng},
  month        = {05},
  number       = {1},
  pages        = {1--10},
  publisher    = {Co-action Publishing},
  series       = {Global Health Action},
  title        = {Growth pattern in Ethiopian infants - the impact of exposure to maternal HIV infection in relation to socio-economic factors},
  url          = {http://dx.doi.org/10.1080/16549716.2017.1296726},
  volume       = {10},
  year         = {2017},
}