Abstract
BackgroundImpaired growth among infants remains one of the leading nutrition problems globally. In this study, we aimed to compare the growth trajectory rate and evaluate growth trajectory characteristics among children, who are HIV exposed uninfected (HEU) and HIV unexposed uninfected (HUU), under two years in Zambia.MethodOur study used data from the ROVAS II study (PACTR201804003096919), an open-label randomized control trial of two verses three doses of live, attenuated, oral RotarixTM administered 6 &10 weeks or at 6 &10 weeks plus an additional dose at 9 months of age, conducted at George clinic in Lusaka, Zambia. Anthropometric measurements (height and weight) were collected on all scheduled and unscheduled visits. We defined linear growth velocity as the rate of change in height and estimated linear growth velocity as the first derivative of the mixed effect model with fractional polynomial transformations and, thereafter, used the second derivative test to determine the peak height and age at peak heigh.ResultsWe included 212 infants in this study with median age 6 (IQR: 6–6) weeks of age. Of these 97 (45.3%) were female, 35 (16.4%) were stunted, and 59 (27.6%) were exposed to HIV at baseline. Growth velocity was consistently below the 3rd percentile of the WHO linear growth standard for HEU and HUU children. The peak height and age at peak height among HEU children were 74.7 cm (95% CI = 73.9–75.5) and 15.5 months (95% CI = 14.7–16.3) respectively and those for HUU were 73 cm (95% CI = 72.1–74.0) and 15.6 months (95% CI = 14.5–16.6) respectively.ConclusionWe found no difference in growth trajectories between infants who are HEU and HUU. However, the data suggests that poor linear growth is universal and profound in this cohort and may have already occurred in utero.
Highlights
Impaired growth among infants remains one of the leading nutrition problems globally
The peak height and age at peak height among HIV exposed uninfected (HEU) children were 74.7 cm and 15.5 months respectively and those for HIV unexposed uninfected (HUU) were 73 cm and 15.6 months respectively
We found no difference in growth trajectories between infants who are HEU and HUU
Summary
Impaired growth among infants remains one of the leading nutrition problems globally. In 2019, the prevalence of stunting among children under 5 years was estimated to be 21.3% (140 million children) globally and 33% (52 million children) in the sub-Saharan Africa region [1]. The global and sub-Saharan prevalence of stunting can be classified as high and very high, respectively [2]. The Zambia demographic health Survey (2014) (ZDHS) [3] reported a prevalence of 40% stunting among children under 5 and 56% for children between 18–23 months. Impaired growth is associated with an increased risk of mortality and morbidity among infants [4, 5]. Long-term and short-term effects of poor linear growth on the child included delay in motor skill development, impaired brain function, poor performance in school, and increased risk of morbidity and mortality [6, 7]. We aimed to compare the growth trajectory rate and evaluate growth trajectory characteristics among children, who are HIV exposed uninfected (HEU) and HIV unexposed uninfected (HUU), under two years in Zambia
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