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Impact of Multi-Micronutrient Supplementation on Growth and Morbidity of HIV-Infected South African Children
Division of Human Nutrition, Wageningen University and Research Centre, P.O. Box 8129, Wageningen 6700EV, The Netherlands
Department of Paediatrics and Child Health, University of Limpopo, Medunsa Campus, P.O. Box 221, Medunsa 0204, South Africa
* Author to whom correspondence should be addressed.
Received: 12 July 2013; in revised form: 13 September 2013 / Accepted: 16 September 2013 / Published: 11 October 2013
Abstract: Poor growth, micronutrient deficiencies and episodes of diarrhea and respiratory infections occur frequently in HIV-infected children. We investigated whether multi-micronutrient supplementation would improve the growth performance and reduce the number of episodes of diarrhea and/or of respiratory symptoms in HIV-infected children. In a double-blind randomized trial, HIV-infected South African children aged 4–24 months (n = 201) were assigned to receive multi-micronutrient supplements or placebo daily for six months. The children were assessed for respiratory symptoms or diarrhea bi-weekly; weights and heights were measured monthly. In total, 121 children completed the six month follow up study period (60%). A total of 43 children died; 27 of them had received supplements. This difference in mortality was not statistically significant (p = 0.12). Weight-for-height Z-scores improved significantly (p < 0.05) among children given supplements compared with those given placebo (0.40 (0.09–0.71)) versus −0.04 (−0.39–0.31) (mean (95% CI)). Height-for-age Z-scores did not improve in both treatment groups. The number of monthly episodes of diarrhea in the placebo group (0.36 (0.26–0.46)) was higher (p = 0.09) than in the supplement group (0.25 (0.17–0.33)) and the number of monthly episodes of respiratory symptoms was significantly higher (p < 0.05) among children on placebos (1.01 (0.83–1.79)) than those on supplements (0.66 (0.52–0.80)). Multi-micronutrient supplements significantly improved wasting and reduced the number of episodes of diarrhea and respiratory symptoms.
Keywords: multi-micronutrients; HIV; growth; diarrhea; respiratory infections; children
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Mda, S.; Raaij, J.M.A.; Villiers, F.P.R.; Kok, F.J. Impact of Multi-Micronutrient Supplementation on Growth and Morbidity of HIV-Infected South African Children. Nutrients 2013, 5, 4079-4092.
Mda S, Raaij JMA, Villiers FPR, Kok FJ. Impact of Multi-Micronutrient Supplementation on Growth and Morbidity of HIV-Infected South African Children. Nutrients. 2013; 5(10):4079-4092.
Mda, Siyazi; Raaij, Joop M.A.; Villiers, François P.R.; Kok, Frans J. 2013. "Impact of Multi-Micronutrient Supplementation on Growth and Morbidity of HIV-Infected South African Children." Nutrients 5, no. 10: 4079-4092.