Risk Factors for Growth Retardation in HIV-infected Senegalese Children on Antiretroviral Treatment

Abstract

Malnutrition at the time of ART initiation was the main predictor of malnutrition at enrollment among HIV-infected children on ART. Longer duration on ART had no overall protective effect on wasting and stunting. Growth and virologic monitoring are of utmost importance in the comprehensive care of children with HIV infection.

Growth and pubertal development in HIV-infected adolescents

“…Severely impaired growth among HIV-infected children in Africa may be partially attributable to the generally later age at ART initiation, often at more advanced disease stages [19]. Studies conducted in Senegal, West Africa, Uganda, Ethiopia, and Zimbabwe reported high levels of stunting, wasting, and underweight, often exceeding half of children (see Table 2) [19–23].…”

“…Severely impaired growth among HIV-infected children in Africa may be partially attributable to the generally later age at ART initiation, often at more advanced disease stages [19]. Studies conducted in Senegal, West Africa, Uganda, Ethiopia, and Zimbabwe reported high levels of stunting, wasting, and underweight, often exceeding half of children (see Table 2) [19–23]. In a pooled analysis of IeDEA cohorts, means at ART initiation were −2.24 for HAZ, −1.46 for WAZ, and −0.56 for BMIZ in South African children and similar means of −1.98 for HAZ and −1.94 for WAZ in West African children [12].…”

“…Substantial increases in WAZ at ART initiation over time were observed among children in Central Africa, with mean z-scores increasing from −2.2 in 2004–2005 to −1.4 in 2012–2013 [24]; the percent underweight decreased from 56% to 36% over this period. However, it should be noted that younger children (<10 years) comprise the majority of the populations in the studies described above, and several studies which report growth measures specifically for adolescents (age 10–19) have identified more severe growth deficits than among younger children [17,19].…”

“…Mixed findings of catch-up growth by sex have been reported [18,20]. Multiple studies have observed that lower initial HAZ was a strong predictor of failure to achieve growth recovery [17,19 20…”

Under-nutrition and associated factors among human immunodeficiency virus-infected children in sub-Saharan Africa: A systematic review and meta-analysis.

“…Similarly, the highest prevalence of underweight was reported from a study in Nigeria 58.6% [8], and the minimum was from a study in Tanzania 6.8% [45]. The highest (52.0%) and the least (5.8%) prevalence of wasting were also reported from studies conducted in Senegalese [38] and Ethiopia [30] respectively.…”