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Maternal Factors Influencing the Nutritional Status of HIV-Exposed Infants: A 12-Month Follow-Up in Mathare and
Elizabeth Mueke Kiilu1, Simon Karanja2, Gideon Kikuvi2
1Department of Public Health, University of Bradford, Bradford, UK. e.m.kiilu@bradford.ac.uk.
Insights
Maternal factors like age and nutrition significantly impact infant growth, especially for HIV-exposed babies. Improving maternal care and antiretroviral therapy (ART) adherence is key to preventing infant malnutrition and reducing HIV transmission.
Area of Science:
- Pediatrics
- Infectious Diseases
- Public Health
Background:
- Optimal infant nutrition is critical for survival and development.
- HIV-exposed infants face higher risks of low birthweight, malnutrition, and HIV infection.
- Understanding nutritional status determinants in HIV-exposed infants is vital for targeted interventions.
Purpose of the Study:
- To assess the nutritional status of HIV-exposed infants over 12 months.
- To identify maternal and infant factors associated with malnutrition (wasting, stunting, underweight) in this cohort.
- To inform strategies for improving infant growth and reducing vertical HIV transmission.
Main Methods:
- A 12-month longitudinal study involving 166 HIV-exposed infants.
- Nutritional status assessed at 6 weeks, 6 months, and 12 months using WHO growth standards.
- Data analyzed using Fisher's test and logistic regression to determine odds ratios (aOR) and confidence intervals (CI).
Main Results:
- Younger maternal age (18-24 years) increased odds of infant wasting at all timepoints.
- Maternal underweight and second-line antiretroviral therapy (ART) regimens were linked to higher stunting odds at 6 months.
- Poor maternal ART adherence and second-line ART regimens increased stunting odds at 12 months.
- High maternal viral load was associated with underweight infants at 6 weeks; maternal employment correlated with lower underweight odds.
Conclusions:
- Maternal nutrition, ART adherence, and viral load significantly influence infant nutritional status.
- Integrating comprehensive nutritional care and enhancing ART counseling are crucial.
- These interventions can mitigate risks of poor infant growth and vertical HIV transmission.
Abstract:
Optimal infant nutrition is crucial for good health and survival. HIV-exposed infants have a greater incidence of low birthweight than HIV-unexposed infants, predisposing them to malnutrition and a greater risk of HIV infection. A 12-month longitudinal study was conducted on 166 HIV-exposed infants, assessing nutritional status at 6 weeks, 6 months, and 12 months. Fisher's test and logistic regression analysed the data using WHO growth standards. Ethical approval was obtained (KEMRI/SERU/CPHR/002/3525). Results: Wasting: Younger maternal age (18-24 years) presented higher odds of infant wasting across all timepoints: 6 weeks aOR 4.31 (CI: 1.11, 1.83), 6 months aOR 4.49 (CI: 1.09, 27.34), and 12 months aOR 5.49 (CI: 1.41, 32.97). Stunting: At 6 months, infants of underweight mothers and those on second-line antiretroviral therapy (ART) regimens had higher odds of stunting aOR 4.76 (CI: 1.36, 16.65) and aOR 5.49 (CI: 1.64, 18.38), respectively. At 12 months, poor maternal ART adherence aOR 4.11 (CI: 1.14, 14.82) and mothers on second-line ART regimens aOR 3.68 (CI: 1.09, 12.49) had increased odds of infant stunting. Underweight: At 6 weeks, high maternal viral load aOR 6.33 (CI: 2.31, 17.36) was associated with higher odds underweight infants, whereas employed mothers had lower odds of underweight infants at 6 and 12 months aOR 0.10 (CI: 0.03, 0.32) and aOR 0.22 (CI: 0.09, 0.59) respectively. The results highlight maternal nutrition and ART adherence's influence on infant nutritional status and HIV vertical transmission risk. The study recommended integrating comprehensive nutritional care into HIV policies and enhancing ART counselling to reduce vertical transmission risk and poor infant growth.
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