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Effect of multiple micronutrient supplementation on survival of HIV-infected children in Uganda: a randomized,

Grace Ndeezi1, Thorkild Tylleskär, Christopher M Ndugwa

  • 1Department of Paediatrics and Child Health, Makerere University, Kampala, Uganda. gracendeezi@yahoo.com

Journal of the International AIDS Society
|June 8, 2010
PubMed

Insights

Multiple micronutrient supplementation did not significantly reduce mortality in HIV-infected children in Uganda. The study found no significant differences in survival, growth, or CD4 counts between groups receiving high-dose or standard-dose multivitamins.

Area of Science:

  • Pediatric Infectious Diseases
  • Nutritional Science
  • Public Health in Low-Income Countries

Background:

  • Micronutrient deficiencies are a major threat to the survival of children with HIV in resource-limited settings.
  • This study investigated the impact of multiple micronutrient supplementation on mortality rates in HIV-infected children in Uganda.

Purpose of the Study:

  • To assess the effect of enhanced multiple micronutrient supplementation on the mortality of HIV-infected children.
  • To evaluate the impact of supplementation on growth and CD4 cell counts.

Main Methods:

  • A randomized controlled trial involving 847 children (aged 1-5 years) attending HIV clinics in Uganda.
  • Children received either twice the recommended dietary allowance of 14 micronutrients or the standard recommended dietary allowance of 6 multivitamins for six months.
  • Mortality was analyzed at 12 months using Kaplan-Meier curves and log-rank tests.

Main Results:

  • Mortality at 12 months was 5.9% in the intervention arm and 6.7% in the standard care arm (Risk Ratio 0.9; 95% CI 0.5-1.5).
  • No significant differences were observed in survival (p=0.64), mean weight-for-height, or mean CD4 cell counts between the groups.
  • Children on antiretroviral therapy (ART) had lower mortality (2.4%) compared to those not on ART (6.7%).

Conclusions:

  • Supplementation with twice the recommended dietary allowance of 14 micronutrients was well-tolerated but did not significantly impact mortality, growth, or CD4 counts in HIV-infected children.
  • Future studies should consider supplement composition, dosage, and adequate statistical power to detect differences.
Abstract

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