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Growth in Late Infancy among HIV-Exposed Children in Urban Haiti Is Associated with Participation in a Clinic-Based Infant Feeding Support Intervention

  作者 Heidkamp, RA; Stoltzfus, RJ; Fitzgerald, DW; Pape, JW  
  选自 期刊  Journal of nutrition;  卷期  2012年142-4;  页码  774-780  
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[摘要]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 Haitien 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 241 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. J. Nutr. 142: 774-780, 2012.

 
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