The effect of lactose-free formula feeds on growth responses among severely malnourished HIV-infected children in Durban, South Africa

South African Journal of Child Health

Moherndran Archary³  Diana Montoya-Fontalvo²  Raziya Bobat¹  Edem Binka²  Philip LaRussa²  Michael Healy²  Magdalena Sobieszczyk² 

[1] Paediatric Infectious diseases unitDepartment of Paediatrics and child healthUniversity of KwaZulu Natal;Department of Medicine, Columbia University College of Physicians and Surgeons, Columbia University, New York;Paediatric Infectious Diseases Unit, Department of Paediatrics and Child Health, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban

关键词: HIV;    severe acute malnutrition;    lactose-free;    ready-to-use-therapeutic feeds;    growth responses;   

DOI  :  

学科分类：农业科学（综合）

来源: Health and Medical Publishing Group

【 摘 要 】

Background.The co-occurrence of HIV infection and severe malnutrition contributes to high rates of morbidity and mortality among children in resource-limited settings. Lactose-free, ready-to-use therapeutic feeds (RUTFs) may be most appropriate in this population because of underlying mucosal damage secondary to inflammation and infection.  Objectives.To describe the effect of lactose-free RUTFs on the growth parameters of severely malnourished HIV-infected children in Durban, South Africa (SA). Methods.This was a prospective, observational study of nutritional recovery in HIV-infected, severely malnourished children, aged 6 months to 5 years, who received lactose-free RUTFs following admission to King Edward VIII Hospital in Durban, SA. The primary outcome was nutritional recovery, defined as 15% weight gain from enrolment to end of study. Secondary outcomes includedz -scores for weight-for-height, weight-for-age, height-for-age, triceps skinfold thickness (SFT) and subscapular SFT calculated at baseline and 7, 14, 30 and 45 days after admission. Univariate analysis was done to compare outcomes among antiretroviral therapy (ART)-naive and ART-experienced children; the effect of ART on nutritional recovery was evaluated in a logistic regression model.  Results.A significant improvement in most nutritional parameters was found at 45 days; 59% of children attained nutritional recovery. There was no significant difference in the proportion of children reaching recovery based on ART status at admission ( p =0.08). Conclusion.Lactose-free formula feeds may be an effective strategy for nutritional rehabilitation of severely malnourished and HIV-infected children in resource-limited settings. It remains to be determined how ART initiation affects nutritional recovery in these children.

【 授权许可】

Unknown