Risk factors for stunting in children who are HIV‐exposed and uninfected after Option B+ implementation in Malawi

Bibliographic Data

ID15536378
AuthorsGabriela Toledo (0000-0002-9204-3037, Great Ormond Street Hospital, corresponding author), Megan Landes (0000-0003-2944-0491, University of Toronto), Monique van Lettow (0000-0002-0679-285X, University of Toronto), Beth A Tippett Barr (0000-0001-5877-2968, Public Health Institute of Malawi), Heather Bailey (0000-0002-0953-3212, University College London), Siobhan Crichton (0000-0001-9962-083X, University College London), Wezi Msungama (Centers for Disease Control and Prevention), Claire Thorne (0000-0003-0389-1956, Great Ormond Street Hospital)
Year2022
Volume19
Issue1
Pagese13451-e13451
Publication date2022-11-09
Open AccessYes
TypeARTICLE
VenueMaternal and Child Nutrition (JOURNAL)
Journal identifiersISSN: 1740-8695 • E-ISSN: 1740-8709
PublisherWiley (PUBLISHER • GB)
DOI10.1111/mcn.13451
PMID36349962
OpenAlexW4308634905
LanguageEN
Citations received1
References cited11

Evidence suggests children HIV-exposed and uninfected (CHEU) experience poor growth. We analysed child anthropometrics and explored factors associated with stunting among Malawian CHEU. Mothers with HIV and their infants HIV-exposed were enroled in a nationally representative prospective cohort within the National Evaluation of Malawi's Prevention of Mother-to-Child HIV Transmission Programme after Option B+ implementation (2014-2018). Anthropometry was measured at enrolment (age 1-6 months), visit 1 (approximately 12 months), and visit 2 (approximately 24 months). Weight-for-age (WAZ) and length-for-age (LAZ) z-scores were calculated using World Health Organization Growth Standards; underweight and stunting were defined as WAZ and LAZ more than 2 standard deviations below the reference median. Multivariable logistic regression restricted to CHEU aged 24 months (±3 months) was used to identify factors associated with stunting. Among 1211 CHEU, 562/1211 attended visit 2, of which 529 were aged 24 months (±3 months) and were included. At age 24 months, 40.4% of CHEU were stunted and/or underweight, respectively. In multi-variable analysis, adjusting for child age and sex, the odds of stunting were higher among CHEU with infectious disease diagnosis compared to those with no diagnosis (adjusted odds ratio = 3.35 [95% confidence interval: 1.82-6.17]), which was modified by co-trimoxazole prophylaxis (p = 0.028). Infant low birthweight was associated with an increased odds of stunting; optimal feeding and maternal employment were correlated with reduced odds. This is one of the first studies examining CHEU growth since Option B+. Interventions to improve linear growth among CHEU should address their multi-faceted health risks, alongside maternal ART prescription, and follow-up of mother-child pairs

Anthropometry · Body mass index · Cohort · Cohort study · Confidence interval · Environmental health · Logistic regression · Malnutrition · Odds · Odds ratio · Overweight · Population · Prospective cohort study · Psychological intervention · Underweight · Child Nutrition and Water Access · Demography · Global Maternal and Child Health · Medicine · Poverty, Education, and Child Welfare · Internal Medicine · Pediatrics · Surgery

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