Growth of young HIV-infected and HIV-exposed children in western Kenya: A retrospective chart review
Autoři:
Megan S. McHenry aff001; Edith Apondi aff002; Samuel O. Ayaya aff002; Ziyi Yang aff004; Wenfang Li aff004; Wanzhu Tu aff004; Guanying Bi aff004; Edwin Sang aff002; Rachel C. Vreeman aff001
Působiště autorů:
Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana, United States of America
aff001; Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya
aff002; Department of Child Health and Paediatrics, College of Health Sciences, School of Medicine, Moi University, Eldoret, Kenya
aff003; Department of Biostatistics, Indiana University School of Medicine, Indianapolis, Indiana, United States of America
aff004; Department of Biostatistics, Indiana University Fairbanks School of Public Health, Indianapolis, Indiana, United States of America
aff005
Vyšlo v časopise:
PLoS ONE 14(12)
Kategorie:
Research Article
doi:
https://doi.org/10.1371/journal.pone.0224295
Souhrn
Introduction
The objective of this study was to determine the growth patterns, rates of malnutrition, and factors associated with malnutrition in children born to HIV-infected mothers in western Kenya using data from an electronic medical record system.
Methods
This study was a retrospective chart review of HIV-infected (HIV+) and–exposed (HEU) children (<5 years) using data collected prospectively in the course of routine clinical care and stored in the electronic medical record system in western Kenya between January 2011 and August 2016. Demographics and anthropometrics were described, with Chi-square testing to compare proportions. Multiple variable logistic regression analysis was used to identify correlates of children being stunted, underweight, and wasted. We also examined growth curves, using a resampling method to compare the areas under the fitted growth curves to compare males/females and HIV+/HEU.
Results
Data from 15,428 children were analyzed. The children were 51.6% (n = 7,955) female, 5.2% (n = 809) orphans, 83.3% (n = 12,851) were HEU, and 16.7% (n = 2,577) were HIV+. For HIV+ children assessed at 24 months, 50.9% (n = 217) were stunted, 26.5% (n = 145) were underweight, and 13.6% (n = 58) were wasted, while 45.0% (n = 577) of HEU children were stunted, 14.8% (n = 255) were underweight, and 5.1% (n = 65) were wasted. When comparing mean z-scores, HIV+ children tended to have larger and earlier dips in z-scores compared to HIV-exposed children, with significant differences found between the two groups (p<0.001). Factors associated with an increased risk of malnutrition included being male, HIV+, and attending an urban clinic. Maternal antiretroviral treatment during pregnancy and mixed feeding at 3 months of age decreased the risk of malnutrition.
Conclusions
HIV+ and HEU children differ in their anthropometrics, with HIV+ children having overall lower z-scores. Continued efforts to develop and implement sustainable and effective interventions for malnutrition are needed for children born to HIV+ mothers.
Klíčová slova:
Anthropometry – Charts – Children – Kenya – Malnutrition
Zdroje
1. UNICEF. Malnutrition- UNICEF Data: UNICEF; 2018 [updated Jan 2018; cited 2018 March 6]. Available from: https://data.unicef.org/topic/nutrition/malnutrition/.
2. Caulfield L, Richard S, Rivera J, Musgrove P, and Black R. Stunting, Wasting, and Micronutrient Deficiency Disorders. In: Jamison DT BJ, Measham AR, et al, editor. Disease Control Priorities in Developing Countries. 2 ed. Washington (DC): World Bank; 2006.
3. Fishman S, Caulfield L, de Onis M, Blossner M, Hyder A, Mullany L, et al. Comparative quantification of health risks: global and regional burden of disease attributable to selected major risk factors. 2004; World Health Organization. [cited 2018 March 6]. Available from: https://apps.who.int/iris/handle/10665/42770
4. Alderman H, Hoddinott J, and Kinsey B. Long term consequences of early childhood malnutrition. 2003. [cited 2018 March 6] Available from: https://ageconsearch.umn.edu/record/16436/files/fc040168.pdf
5. Gashu D, Stoecker BJ, Bougma K, Adish A, Haki GD, Marquis GS. Stunting, selenium deficiency and anemia are associated with poor cognitive performance in preschool children from rural Ethiopia. Nutrition Journal. 2016;15(1):38. doi: 10.1186/s12937-016-0155-z 27067274
6. UNICEF. Statistics: Kenya: UNICEF; 2013 [cited 2018 March 6]. Available from: https://www.unicef.org/infobycountry/kenya_statistics.html.
7. McDonald CM, Kupka R, Manji KP, Okuma J, Bosch RJ, Aboud S, et al. Predictors of stunting, wasting and underweight among Tanzanian children born to HIV-infected women. European Journal of Clinical Nutrition. 2012;66(11):1265–76. doi: 10.1038/ejcn.2012.136 23031850
8. Omoni AO, Ntozini R, Evans C, Prendergast AJ, Moulton LH, Christian PS, et al. Child growth according to maternal and child HIV status in Zimbabwe. The Pediatric Infectious Disease Journal. 2017;36(9):869–76. Epub 2017/02/16. doi: 10.1097/INF.0000000000001574 28198792; PubMed Central PMCID: PMC5571879.
9. McGrath CJ, Nduati R, Richardson BA, Kristal AR, Mbori-Ngacha D, Farquhar C, et al. The prevalence of stunting is high in HIV-1-exposed uninfected infants in Kenya. The Journal of Nutrition. 2012;142(4):757–63. Epub 2012/03/02. doi: 10.3945/jn.111.148874 22378334; PubMed Central PMCID: PMC3301992.
10. Fergusson P, Chinkhumba J, Grijalva-Eternod C, Banda T, Mkangama C, Tomkins A. Nutritional recovery in HIV-infected and HIV-uninfected children with severe acute malnutrition. Archives of Disease in Childhood. 2009;94(7):512. doi: 10.1136/adc.2008.142646 18977785
11. Isanaka S, Duggan C, Fawzi WW. Patterns of postnatal growth in HIV-infected and HIV-exposed children. Nutrition Reviews. 2009;67(6):343–59. doi: 10.1111/j.1753-4887.2009.00207.x PMC2771338. 19519675
12. Filteau S. The HIV-exposed, uninfected African child. Tropical Medicine & International Health: TM & IH. 2009;14(3):276–87. Epub 2009/01/28. doi: 10.1111/j.1365-3156.2009.02220.x 19171011.
13. Ramokolo V, Goga AE, Lombard C, Doherty T, Jackson DJ, Engebretsen IM. In utero ART exposure and birth and early growth outcomes among HIV-exposed uninfected infants attending immunization services: results from national PMTCT surveillance, South Africa. Open Forum Infect Dis. 2017;4(4):ofx187–ofx. doi: 10.1093/ofid/ofx187 29062860.
14. Slogrove A, Reikie B, Naidoo S, De Beer C, Ho K, Cotton M, et al. HIV-exposed uninfected infants are at increased risk for severe infections in the first year of life. Journal of Tropical Pediatrics. 2012;58(6):505–8. Epub 2012/05/05. doi: 10.1093/tropej/fms019 22555385; PubMed Central PMCID: PMC3612013.
15. McHenry MS, McAteer CI, Oyungu E, McDonald BC, Bosma CB, Mpofu PB, et al. Neurodevelopment in young children born to HIV-infected mothers: a meta-analysis. Pediatrics. 2018;141(2). Epub 2018/01/28. doi: 10.1542/peds.2017-2888 29374109; PubMed Central PMCID: PMC5810606 conflicts of interest to disclose.
16. Akanbi MO, Ocheke AN, Agaba PA, Daniyam CA, Agaba EI, Okeke EN, et al. Use of electronic health records in sub-Saharan Africa: progress and challenges. Journal of Medicine in the Tropics. 2012;14(1):1–6. PMC4167769. 25243111
17. Jawhari B, Ludwick D, Keenan L, Zakus D, Hayward R. Benefits and challenges of EMR implementations in low resource settings: a state-of-the-art review. BMC Medical Informatics and Decision Making. 2016;16:116. Epub 2016/09/08. doi: 10.1186/s12911-016-0354-8 27600269; PubMed Central PMCID: PMC5011989.
18. Rosala-Hallas A, Bartlett JW, Filteau S. Growth of HIV-exposed uninfected, compared with HIV-unexposed, Zambian children: a longitudinal analysis from infancy to school age. BMC Pediatrics. 2017;17(1):80. Epub 2017/03/18. doi: 10.1186/s12887-017-0828-6 28302082; PubMed Central PMCID: PMC5356250.
19. Einterz RM, Kelley CR, Mamlin JJ, Van Reken DE. Partnerships in international health. The Indiana University-Moi University experience. Infect Dis Clin North Am. 1995;9(2):453–5. 7673682.
20. Siika AM, Rotich JK, Simiyu CJ, Kigotho EM, Smith FE, Sidle JE, et al. An electronic medical record system for ambulatory care of HIV-infected patients in Kenya. Int J Med Inform. 2005;74(5):345–55. doi: 10.1016/j.ijmedinf.2005.03.002 15893257.
21. Mamlin BW, Biondich PG, Wolfe BA, Fraser H, Jazayeri D, Allen C, et al. Cooking up an open source EMR for developing countries: OpenMRS—a recipe for successful collaboration. AMIA Annu Symp Proc. 2006:529–33. Epub 2007/01/24. 86578 [pii]. 17238397.
22. Braitstein P, Katshcke A, Shen C, Sang E, Nyandiko W, Ochieng VO, et al. Retention of HIV-infected and HIV-exposed children in a comprehensive HIV clinical care programme in Western Kenya. Tropical Medicine and International Health. 2010;15(7):833–41. doi: 10.1111/j.1365-3156.2010.02539.x 20487430
23. Nyandiko WM, Ayaya S, Nabakwe E, Tenge C, Sidle JE, Yiannoutsos CT, et al. Outcomes of HIV-infected orphaned and non-orphaned children on antiretroviral therapy in western Kenya. Journal of Acquired Immune Deficiency Syndromes (1999). 2006;43(4):418–25. Epub 2006/11/14. doi: 10.1097/01.qai.0000243122.52282.89 17099313.
24. Nyandiko WM, Otieno-Nyunya B, Musick B, Bucher-Yiannoutsos S, Akhaabi P, Lane K, et al. Outcomes of HIV-exposed children in Western Kenya: Efficacy of prevention of mother to child transmission in a resource-constrained setting. Journal of Acquired Immune Deficiency Syndromes. 2010;54(1):42–50. doi: 10.1097/QAI.0b013e3181d8ad51 20224420
25. Kenya Ministry of Health. Guidelines for Prevention of Mother to Child Transmission (PMTCT) of HIV/AIDS in Kenya. National AIDS & STI Control Programme. 4th ed. Nairobi, Kenya: Republic of Kenya, Minstry of Health; 2012. p. 82.
26. World Health Organization. Consolidated Guidelines on The Use of Antiretroviral Drugs and Treating and Preventing HIV Infection: Recommendations for a public health approach. Geneva, Switzerland: World Health Organization; 2013. p. 272.
27. Apondi E. "AMPATH Standard Operating Procedures: Maternal-Child Health Clinic Follow up for HIV-exposed Infant. [Personal Communications with McHenry M) 1 August 2019.
28. World Health Organization. Global Database on Child Growth and Malnutrition Geneva: World Health Organization,; [cited 2016 January]. Available from: http://www.who.int/nutgrowthdb/software/en/.
29. Mei Z, Grummer-Strawn LM. Standard deviation of anthropometric Z-scores as a data quality assessment tool using the 2006 WHO growth standards: a cross country analysis. Bull World Health Organ. 2007;85(6):441–8. doi: 10.2471/BLT.06.034421 17639241.
30. Young SG, Bowman AW. Non-Parametric Analysis of Covariance. Biometrics. 1995;51(3):920–31. doi: 10.2307/2532993
31. Kenya National Bureau of Statistics. Kenya Demographic and Health Survey. Nairobi, Kenya: Repubic of Kenya; 2015. [cited 2018 March 7]. Available from: https://dhsprogram.com/pubs/pdf/fr308/fr308.pdf
32. Shiau S, Arpadi S, Strehlau R, Martens L, Patel F, Coovadia A, et al. Initiation of antiretroviral therapy before 6 months of age is associated with faster growth recovery in South African children perinatally infected with human immunodeficiency virus. The Journal of Pediatrics. 2013;162(6):1138–45, 45.e1-2. Epub 2013/01/15. doi: 10.1016/j.jpeds.2012.11.025 23312691; PubMed Central PMCID: PMC3640753.
33. Jesson J, Dahourou DL, Amorissani Folquet M, Malateste K, Yonaba C, N'Gbeche MS, et al. Malnutrition, growth response and metabolic changes within the first 24 months after ART initiation in HIV-infected children treated before the age of 2 years in west Africa. The Pediatric Infectious Disease Journal. 2018;37(8):781–7. Epub 2018/02/07. doi: 10.1097/INF.0000000000001932 29406463.
34. Sewale Y, Hailu G, Sintayehu M, Moges NA, Alebel A. Magnitude of malnutrition and associated factors among HIV infected children attending HIV-care in three public hospitals in East and West Gojjam Zones, Amhara, Northwest, Ethiopia, 2017: a cross-sectional study. BMC Research Notes. 2018;11(1):788. doi: 10.1186/s13104-018-3882-8 30390693
35. Martin R, Boyer P, Hammill H, Peavy H, Platzker A, Settlage R, et al. Incidence of premature birth and neonatal respiratory disease in infants of HIV-positive mothers. The Journal of Pediatrics. 1997;131(6):851–6. doi: 10.1016/s0022-3476(97)70032-5 9427889
36. Nyandiko WM, Mwangi A, Ayaya SO, Nabakwe EC, Tenge CN, Gisore PM, et al. Characteristics of HIV-infected children seen in western Kenya. East African Medical Journal. 2009;86(8):364–73. Epub 2010/06/26. doi: 10.4314/eamj.v86i8.54156 20575310.
37. Brennan AT, Bonawitz R, Gill CJ, Thea DM, Kleinman M, Long L, et al. A meta-analysis assessing diarrhea and pneumonia in HIV-exposed uninfected compared with HIV-unexposed uninfected infants and children. Journal of Acquired Immune Deficiency Syndromes (1999). 2019;82(1):1–8. Epub 2019/08/14. doi: 10.1097/qai.0000000000002097 31408450.
38. Bailey RC, Kamenga MC, Nsuami MJ, Nieburg P, St Louis ME. Growth of children according to maternal and child HIV, immunological and disease characteristics: a prospective cohort study in Kinshasa, Democratic Republic of Congo. International Journal of Epidemiology. 1999;28(3):532–40. Epub 1999/07/16. doi: 10.1093/ije/28.3.532 10405861.
39. Makasa M, Kasonka L, Chisenga M, Sinkala M, Chintu C, Tomkins A, et al. Early growth of infants of HIV-infected and uninfected Zambian women. Tropical Medicine & International Health. 2007;12(5):594–602. Epub 2007/04/21. doi: 10.1111/j.1365-3156.2007.01836.x 17445127.
40. Ekali GL, Jesson J, Enok PB, Leroy V. Effect of in utero exposure to HIV and antiretroviral drugs on growth in HIV-exposed uninfected children: a systematic review and meta-analysis protocol. BMJ Open. 2019;9(6):e023937. Epub 2019/06/24. doi: 10.1136/bmjopen-2018-023937 31229997; PubMed Central PMCID: PMC6596996.
41. Schwarzenberg SJ, Georgieff MK. Advocacy for Improving Nutrition in the First 1000 Days to Support Childhood Development and Adult Health. Pediatrics. 2018;141(2). doi: 10.1542/peds.2017-3716 29358479
42. Spencer NJ. Failure to think about failure to thrive. Archives of Disease in Childhood. 2007;92(2):95–7. doi: 10.1136/adc.2006.098624 PMC2083320. 17264277
43. Wamani H, Åstrøm AN, Peterson S, Tumwine JK, Tylleskär T. Boys are more stunted than girls in sub-Saharan Africa: a meta-analysis of 16 demographic and health surveys. BMC pediatrics. 2007;7(1):17. doi: 10.1186/1471-2431-7-17 17425787
44. Kshatriya GK, Acharya SK. Gender disparities in the prevalence of undernutrition and the higher risk among the young women of Indian tribes. PLoS ONE. 2016;11(7):e0158308. doi: 10.1371/journal.pone.0158308 27379521.
45. Nuruddin R, Hadden WC. Are pre-school girls more likely to be under-nourished in rural Thatta, Pakistan?-a cross-sectional study. International Journal for Equity in Health. 2015;14:151. doi: 10.1186/s12939-015-0287-3 26689821.
46. World Health Organization. Infant and young child feeding: WHO; 2017 [updated July 2017; cited 2018 7 March]. Available from: http://www.who.int/mediacentre/factsheets/fs342/en/.
47. Kuchenbecker J, Jordan I, Reinbott A, Herrmann J, Jeremias T, Kennedy G, et al. Exclusive breastfeeding and its effect on growth of Malawian infants: results from a cross-sectional study. Paediatrics and International Child Health. 2015;35(1):14–23. doi: 10.1179/2046905514Y.0000000134 25005815
48. Qasem W, Fenton T, Friel J. Age of introduction of first complementary feeding for infants: a systematic review. BMC Pediatrics. 2015;15:107. doi: 10.1186/s12887-015-0409-5 PMC4557230. 26328549
49. Effect of breastfeeding on infant and child mortality due to infectious diseases in less developed countries: a pooled analysis. WHO Collaborative Study Team on the Role of Breastfeeding on the Prevention of Infant Mortality. Lancet (London, England). 2000;355(9202):451–5. Epub 2000/06/07. 10841125.
50. Coutsoudis A, Pillay K, Kuhn L, Spooner E, Tsai WY, Coovadia HM. Method of feeding and transmission of HIV-1 from mothers to children by 15 months of age: prospective cohort study from Durban, South Africa. AIDS (London, England). 2001;15(3):379–87. Epub 2001/03/29. doi: 10.1097/00002030-200102160-00011 11273218.
51. Kiarie JN, Richardson BA, Mbori-Ngacha D, Nduati RW, John-Stewart GC. Infant feeding practices of women in a perinatal HIV-1 prevention study in Nairobi, Kenya. Journal of Acquired Immune Deficiency Syndromes (1999). 2004;35(1):75–81. PMC3380107.
52. Smith LC, Ruel MT, Ndiaye A. Why is child malnutrition lower in urban than in rural areas? Evidence from 36 developing countries. World Development. 2005;33(8):1285–305.
53. Van de Poel E, O’Donnell O, Van Doorslaer E. Are urban children really healthier? Evidence from 47 developing countries. Social Science & Medicine. 2007;65(10):1986–2003. https://doi.org/10.1016/j.socscimed.2007.06.032.
54. Kimani-Murage EW, Muthuri SK, Oti SO, Mutua MK, van de Vijver S, Kyobutungi C. Evidence of a double burden of malnutrition in urban poor settings in Nairobi, Kenya. PLoS One. 2015;10(6):e0129943. Epub 2015/06/23. doi: 10.1371/journal.pone.0129943 26098561; PubMed Central PMCID: PMC4476587.
55. Finlay JE, Fink G, McCoy DC, Tavarez LC, Chai J, Danaei G, et al. Stunting risk of orphans by caregiver and living arrangement in low-income and middle-income countries. Journal of epidemiology and community health. 2016;70(8):784–90. Epub 2016/01/31. doi: 10.1136/jech-2015-206346 26826211.
56. Ayaya SO, Esamai FO, Rotich J, Olwambula AR. Socio-economic factors predisposing under five-year-old children to severe protein energy malnutrition at the Moi Teaching and Referral Hospital, Eldoret, Kenya. East African Medical Journal. 2004;81(8):415–21. Epub 2004/12/30. doi: 10.4314/eamj.v81i8.9203 15622936.
Článek vyšel v časopise
PLOS One
2019 Číslo 12
- Jak a kdy u celiakie začíná reakce na lepek? Možnou odpověď poodkryla čerstvá kanadská studie
- Pomůže v budoucnu s triáží na pohotovostech umělá inteligence?
- Spermie, vajíčka a mozky – „jednohubky“ z výzkumu 2024/38
- Infekce se v Americe po příjezdu Kolumba šířily nesrovnatelně déle, než se traduje
- Metamizol jako analgetikum první volby: kdy, pro koho, jak a proč?
Nejčtenější v tomto čísle
- Methylsulfonylmethane increases osteogenesis and regulates the mineralization of the matrix by transglutaminase 2 in SHED cells
- Oregano powder reduces Streptococcus and increases SCFA concentration in a mixed bacterial culture assay
- The characteristic of patulous eustachian tube patients diagnosed by the JOS diagnostic criteria
- Parametric CAD modeling for open source scientific hardware: Comparing OpenSCAD and FreeCAD Python scripts
Zvyšte si kvalifikaci online z pohodlí domova
Všechny kurzy