HIV-free survival and morbidity among formula-fed infants in a prevention of mother-to-child transmission of HIV program in rural Haiti

AIDS Research and Therapy

Mary C Smith Fawzi¹  Kimberly A Cullen²  J Gregory Jerome³  Bingxia Wang⁴  Sasha C Appleton²  Louise C Ivers¹ 

[1]Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA

[2]Partners In Health, Boston, MA, USA

[3]Zanmi Lasante, Cange, Haiti

[4]Massachusetts General Hospital, Boston, MA, USA

关键词: Haiti;    resource-poor setting;    formula;    breastfeeding;    prevention of mother-to-child transmission;    HIV;   

Others  :  789701
DOI  :  10.1186/1742-6405-8-37

 received in 2011-06-02, accepted in 2011-10-12,  发布年份 2011

【 摘 要 】

Background

Partners In Health (PIH) works with the Ministry of Health to provide comprehensive health services in Haiti. Between 1994 and 2009, PIH recommended exclusive formula feeding in the prevention of mother-to-child transmission (PMTCT) of HIV program and provided support to implement this strategy. We conducted this study to assess HIV-free survival and prevalence of diarrhea and malnutrition among infants in our PMTCT program in rural Haiti where exclusive formula feeding was supported.

Methods

We reviewed medical charts of PMTCT mother-infant pairs at PIH between November 2004 and August 2006 through a retrospective longitudinal study and cross-sectional survey. We performed household surveys for each pair and at control households matched by infant's age and gender.

Results

254 mother-infant pairs were included. 15.3% of infants were low birth weight; most births occurred at home (68.8%). 55.9% of households had no latrine; food insecurity was high (mean score of 18; scale 0-27, SD = 5.3). HIV-free survival at 18 months was 90.6%. Within the cohort, 9 children (3.5%) were HIV-infected and 17 (6.7%) died. Community controls were more likely to be breastfed (P = 0.003) and more likely to introduce food early (P = 0.003) than PMTCT-program households. There was no difference in moderate malnutrition (Z score ≤ 2 SD) between PMTCT and community groups after controlling for guardian's education, marital status, and food insecurity (OR = 1.05; 95% CI: 0.67, 1.64; P = 0.84). Diarrhea was 2.9 times more prevalent among community children than PMTCT infants (30.3% vs. 12.2%; P < 0.0001).

Conclusions

In a PIH-supported program in rural Haiti that addressed socioeconomic barriers to ill-health, breast milk substitution was safe, acceptable and feasible for PMTCT for HIV-infected women choosing this option.

【 授权许可】

   
2011 Ivers et al; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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