Growth in late infancy among HIV-exposed children in urban Haiti is associated with participation in a clinic-based infant feeding support intervention

J Nutr. 2012 Apr;142(4):774-80. doi: 10.3945/jn.111.155275. Epub 2012 Feb 29.

Abstract

The integration of nutrition support for infants of HIV-infected mothers is a recognized need; however, the evidence for effective programmatic solutions is weak. The objective of our study was to implement and evaluate a new infant feeding support intervention for HIV-exposed, uninfected, non-breast-fed infants 6-12 mo of age attending the Groupe Haïtien d'Etude du Sarcome de Kaposi et des Infections Opportunistes (GHESKIO) pediatric clinic in Port-au-Prince, Haiti. The 24-wk intervention included a lipid-based nutrient supplement, education, promotion of existing clinical services, and social support. We compared growth outcomes among intervention participants (n = 73) at start (wk 0) and end (wk 24) of intervention to a historical control group of HIV-exposed infants seen at the GHESKIO in the year prior to the intervention who would have met the intervention entrance criteria (n = 294). The intervention and historical control groups did not differ significantly at age 6 mo (wk 0). At age 12 mo (wk 24), the intervention group had a lower prevalence of underweight and stunting than the historical control group (weight-for-age Z-score < -2 SD: 6.8 vs. 20.8%, P = 0.007; length-for-age Z-score < -2 SD: 9.6 vs. 21.2%, P = 0.029). Wasting tended to be lower in the intervention group than the historical control (weight-for-length Z-score < -2 SD: 2.9 vs. 8.9%, P = 0.11). Implementation of the intervention was associated with reduced risk of growth faltering in HIV-exposed uninfected children from 6 to 12 mo of age. This is a promising intervention model that can be adapted and scaled-up to other HIV care contexts.

Trial registration: ClinicalTrials.gov NCT01434238.

Publication types

  • Clinical Trial
  • Multicenter Study
  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Ambulatory Care Facilities
  • Body Height
  • Body Weight
  • Child Development*
  • Cross-Sectional Studies
  • Dietary Supplements* / analysis
  • Female
  • Food Services
  • Food, Fortified / analysis
  • Growth Disorders / epidemiology
  • Growth Disorders / etiology
  • Growth Disorders / prevention & control*
  • HIV Seropositivity* / physiopathology
  • Haiti / epidemiology
  • Humans
  • Infant
  • Male
  • Prevalence
  • Risk
  • Thinness / epidemiology
  • Thinness / etiology
  • Thinness / prevention & control*
  • Urban Health
  • Wasting Syndrome / epidemiology
  • Wasting Syndrome / etiology
  • Wasting Syndrome / prevention & control*

Associated data

  • ClinicalTrials.gov/NCT01434238