Human immunodeficiency virus infection, diarrheal disease and sociodemographic predictors of child growth
Villamor, E.; Fataki, M.R.; Bosch, R.J.; Mbise, R.L.; Fawzi, W.W.
Acta Paediatrica 93(3): 372-379
2004
ISSN/ISBN: 0803-5253 PMID: 15124842 DOI: 10.1111/j.1651-2227.2004.tb02964.xDocument Number: 261372
Aim: To compare growth patterns between human immunodeficiency virus (HIV)-infected and -uninfected preschool children, and to examine the associations between diarrhoeal and respiratory infections, sociodemographic factors, and growth. Methods: In Tanzania, a longitudinal study was conducted among 524 children who were 6-60 months of age at the time of recruitment . Information on sociodemographic characteristics was collected at baseline from the caregiver. Haemoglobin, malaria infection, and HIV status of the children were assessed from a blood sample. Monthly height (body length if < 24 months) and weight measurements were obtained, and clinical assessments carried out, during an average of 12 months follow-up period. Yearly increments in height and weight were compared by HIV status, incidence of diarrhoea and respiratory infections, and levels of sociodemographic variables. Results: After adjusting for maternal education, anaemia and vitamin A supplementation, HIV infection was related to 2.8 cm (95% confidence interval (95% CI) 0.6, 5.0) and 1.3 kg (95% CI 0.0, 2.5) lower yearly length and weight gains, respectively, in children who were between 6 and 11 months at baseline. Among children aged 12-23 months at recruitment, HIV infection was associated with 0.6 kg (95% CI 0.1, 1.0) less yearly weight gain. HIV infection was not related to linear or ponderal growth in children >=24 months old. Maternal illiteracy, severe child anaemia, and episodes of acute diarrhoea were additional risk factors for growth delay in length. Conclusion: HIV infection is associated with linear and ponderal growth retardation in children aged <24 months. Additional predictors of linear growth retardation include preventable conditions such as poor maternal education, child anaemia, and diarrhoeal disease.