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J Trop Pediatr. 2014 Jun;60(3):179-88. doi: 10.1093/tropej/fmt104. Epub 2014 Jan 6.

Growth among HIV-infected children receiving antiretroviral therapy in Dar es Salaam, Tanzania.

Author information

1
Management and Development for Health (MDH), Dar es Salaam, Tanzania rmwiru@gmail.com.
2
Department of Biostatistics, Harvard School of Public Health, Boston, Massachusetts 02115, USADepartment of Epidemiology, Harvard School of Public Health, Boston, Massachusetts 02115, USA.
3
Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts 02115, USACenter for Nutrition, Division of GI/Nutrition, Boston Children's Hospital, Boston, Massachusetts 02115, USA.
4
Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts 02115, USA.
5
Ministry of Health and Social Welfare, Dar es Salaam, Tanzania.
6
Management and Development for Health (MDH), Dar es Salaam, TanzaniaDepartment of Nutrition, Harvard School of Public Health, Boston, Massachusetts 02115, USA.
7
Department of Pediatrics and Child Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
8
Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts 02115, USADepartment of Nutrition, Harvard School of Public Health, Boston, Massachusetts 02115, USADepartment of Global Health and Population, Harvard School of Public Health, Boston, Massachusetts 02115, USA.

Abstract

We assembled a prospective cohort of 3144 human immunodeficiency virus (HIV) infected children aged <15 years initiating antiretroviral therapy (ART) in Dar es Salaam, Tanzania. The prospective relationships of baseline covariates with growth were examined using linear regression models. ART led to improvement in mean weight-for-age (WAZ), height/length-for-age (HAZ) and weight-for-length or body mass index (WLZ/BMIZ) scores. However, normal HAZ values were not attained over an average follow-up of 17.2 months. After 6 months of ART, underweight (P < 0.001), low CD4 count or percent (P < 0.001), stavudine containing regimens (P = 0.05) and advanced WHO disease stage (P < 0.001) at ART initiation were associated with better WAZ scores. Age >5 years on the other hand was associated with less increase in WAZ score after 6 months of ART (P < 0.001). These findings suggest that although ART improved the growth of the HIV-infected children in Tanzania, adjunct nutritional interventions may be needed to ensure that the growth of these children is optimized to the greatest extent possible.

PMID:
24393831
PMCID:
PMC4040821
DOI:
10.1093/tropej/fmt104
[Indexed for MEDLINE]
Free PMC Article

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