Growth of young HIV-infected and HIV-exposed children in western Kenya: A retrospective chart review


Autoři: Megan S. McHenry aff001;  Edith Apondi aff002;  Samuel O. Ayaya aff002;  Ziyi Yang aff004;  Wenfang Li aff004;  Wanzhu Tu aff004;  Guanying Bi aff004;  Edwin Sang aff002;  Rachel C. Vreeman aff001
Působiště autorů: Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana, United States of America aff001;  Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya aff002;  Department of Child Health and Paediatrics, College of Health Sciences, School of Medicine, Moi University, Eldoret, Kenya aff003;  Department of Biostatistics, Indiana University School of Medicine, Indianapolis, Indiana, United States of America aff004;  Department of Biostatistics, Indiana University Fairbanks School of Public Health, Indianapolis, Indiana, United States of America aff005
Vyšlo v časopise: PLoS ONE 14(12)
Kategorie: Research Article
doi: 10.1371/journal.pone.0224295

Souhrn

Introduction

The objective of this study was to determine the growth patterns, rates of malnutrition, and factors associated with malnutrition in children born to HIV-infected mothers in western Kenya using data from an electronic medical record system.

Methods

This study was a retrospective chart review of HIV-infected (HIV+) and–exposed (HEU) children (<5 years) using data collected prospectively in the course of routine clinical care and stored in the electronic medical record system in western Kenya between January 2011 and August 2016. Demographics and anthropometrics were described, with Chi-square testing to compare proportions. Multiple variable logistic regression analysis was used to identify correlates of children being stunted, underweight, and wasted. We also examined growth curves, using a resampling method to compare the areas under the fitted growth curves to compare males/females and HIV+/HEU.

Results

Data from 15,428 children were analyzed. The children were 51.6% (n = 7,955) female, 5.2% (n = 809) orphans, 83.3% (n = 12,851) were HEU, and 16.7% (n = 2,577) were HIV+. For HIV+ children assessed at 24 months, 50.9% (n = 217) were stunted, 26.5% (n = 145) were underweight, and 13.6% (n = 58) were wasted, while 45.0% (n = 577) of HEU children were stunted, 14.8% (n = 255) were underweight, and 5.1% (n = 65) were wasted. When comparing mean z-scores, HIV+ children tended to have larger and earlier dips in z-scores compared to HIV-exposed children, with significant differences found between the two groups (p<0.001). Factors associated with an increased risk of malnutrition included being male, HIV+, and attending an urban clinic. Maternal antiretroviral treatment during pregnancy and mixed feeding at 3 months of age decreased the risk of malnutrition.

Conclusions

HIV+ and HEU children differ in their anthropometrics, with HIV+ children having overall lower z-scores. Continued efforts to develop and implement sustainable and effective interventions for malnutrition are needed for children born to HIV+ mothers.

Klíčová slova:

Anthropometry – Charts – Children – Kenya – Malnutrition


Zdroje

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