International Journal of Epidemiology, Vol 28, 532-540, Copyright © 1999 by International Epidemiological Association
RC Bailey, MC Kamenga, MJ Nsuami, P Nieburg and ME St Louis
BACKGROUND: Most HIV-infection in children occurs in sub-Saharan Africa
where antiretroviral therapy is seldom available. This study compares the
growth progression and retardation of HIV-infected and uninfected children
in the Democratic Republic of Congo (formerly Zaire). It estimates the risk
for child growth retardation according to child and maternal immunological
factors, severity of maternal and child illness, and maternal socioeconomic
and marital status. METHODS: In a prospective cohort study of 258 children
born to HIV seropositive mothers and 256 children of seronegative mothers
in Kinshasa, Congo, the growth in length, weight, and weight-for-length of
infected children (n = 68), uninfected children born to seropositive
mothers (n = 190), and uninfected children born to uninfected mothers (n =
256) was compared. Serological, anthropometric and other clinical measures
were collected monthly from 3-12 months and bi-monthly during the second
year of life. Polymerase chain reaction for HIV was performed on bloods
drawn at 2 days and 3 months post partum. Length-for-age, weight- for-age,
and weight-for-length mean z-scores against National Center for Health
Statistics (NCHS) reference data were calculated, and Cox proportional
hazards models were used to estimate the risk of falling below -2.00
z-scores as a function of child and maternal immunological, clinical and
sociodemographic variables. RESULTS: There was no difference in mean
length-for-age at birth between HIV-infected (Group 1) children, uninfected
children of infected mothers (Group 2) or Control children, but by 3 months
old, HIV-infected children were shorter than both Group 2 and Controls. In
weight-for-age and weight- for-length, Group 1 infants were lighter and
more wasted at birth and onwards. Group 2 newborns were lighter than
Controls at birth, but by three months they had caught up to Controls in
both length and weight and remained the same as Controls thereafter. The
odds of falling below -2.00 z-scores by 20 months for length, weight, and
weight-for-length for HIV-infected children compared to uninfected children
were 2.10, 2.84, and 2.56 respectively. Both HIV-infection and associated
illnesses were factors associated with child stunting, underweight and
wasting. The mother's age, socioeconomic status, presence of father, stage
of illness and immune status had no detectable effect on the child's growth
in the first two years of life. CONCLUSION: The HIV- infected children in
Congo with no access to antiretroviral therapy were stunted, underweight,
and wasted compared to same age uninfected children. Both HIV infection and
HIV-associated signs and symptoms, not maternal immunological or
socioeconomic circumstances, placed children at risk for growth
retardation.
ARTICLES
Growth of children according to maternal and child HIV, immunological and disease characteristics: a prospective cohort study in Kinshasa, Democratic Republic of Congo
Division of Epidemiology, School of Public Health, University of Illinois at Chicago 60612, USA.
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  N. Sabery, C. Duggan, and the American Society for Parenteral and Enteral Nu A.S.P.E.N. Clinical Guidelines: Nutrition Support of Children With Human Immunodeficiency Virus Infection JPEN J Parenter Enteral Nutr, November 1, 2009; 33(6): 588 - 606. [Full Text] [PDF]
|
|
|
|
 |
|
 S. Arpadi, A. Fawzy, G. M Aldrovandi, C. Kankasa, M. Sinkala, M. Mwiya, D. M Thea, and L. Kuhn Growth faltering due to breastfeeding cessation in uninfected children born to HIV-infected mothers in Zambia Am. J. Clinical Nutrition, August 1, 2009; 90(2): 344 - 353. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. L. Webb, K. Manji, W. W. Fawzi, and E. Villamor Time-independent Maternal and Infant Factors and Time-dependent Infant Morbidities including HIV Infection, Contribute to Infant Growth Faltering during the First 2 Years of Life J Trop Pediatr, April 1, 2009; 55(2): 83 - 90. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. F. FRIEDMAN, A. M. KWENA, L. B. MIREL, S. K. KARIUKI, D. J. TERLOUW, P. A. PHILLIPS-HOWARD, W. A. HAWLEY, B. L. NAHLEN, Y. P. SHI, and F. O. T. KUILE MALARIA AND NUTRITIONAL STATUS AMONG PRE-SCHOOL CHILDREN: RESULTS FROM CROSS-SECTIONAL SURVEYS IN WESTERN KENYA Am J Trop Med Hyg, October 1, 2005; 73(4): 698 - 704. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. Villamor, E. Saathoff, R. J Bosch, E. Hertzmark, A. Baylin, K. Manji, G. Msamanga, D. J Hunter, and W. W Fawzi Vitamin supplementation of HIV-infected women improves postnatal child growth Am. J. Clinical Nutrition, April 1, 2005; 81(4): 880 - 888. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K Maleta, S Virtanen, M Espo, T Kulmala, and P Ashorn Timing of growth faltering in rural Malawi Arch. Dis. Child., July 1, 2003; 88(7): 574 - 578. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. A. Nachman, J. C. Lindsey, S. Pelton, L. Mofenson, K. McIntosh, A. Wiznia, K. Stanley, and R. Yogev Growth in Human Immunodeficiency Virus-Infected Children Receiving Ritonavir-Containing Antiretroviral Therapy Arch Pediatr Adolesc Med, May 1, 2002; 156(5): 497 - 503. [Abstract] [Full Text] [PDF]
|
|