Subclinical mastitis among HIV-infected and uninfected Zimbabwean women participating in a multimicronutrient supplementation trial.
Subclinical mastitis, defined as raised milk sodium/potassium (Na/K) ratio is common and associated with poor infant growth and increased mother-to-child HIV transmission. In 1996-97, we conducted a randomized controlled trial of multiple micronutrient supplementation, at recommended daily allowance levels, from 22 to 35 weeks gestation until 3 months post-partum, on the prevalence and severity of subclinical mastitis among 84 HIV-infected and 83 HIV-uninfected lactating Zimbabwean women and on their infants' growth. Spot milk samples collected before 4.5 months post-partum were analysed for Na/K ratio by flame photometry. There was no significant difference in prevalence of subclinical mastitis between HIV-infected and HIV-uninfected women. After controlling for infant age at time of sampling, micronutrient-supplemented HIV-infected women had non-significantly (P = 0.08) lower geometric mean Na/K ratio (0.43, 95% CI 0.35-0.51) than HIV-infected women given placebo (0.51, 95% CI 0.42-0.61). Micronutrient supplementation had no effect on the prevalence of subclinical mastitis among HIV-uninfected women (odds ratio [OR] = 1.26, 95% CI 0.45-3.51, P = 0.80) but induced a borderline decrease in prevalence (OR = 2.82, 95% CI 0.96-8.26, P = 0.07) among HIV-infected women. Infant weight between 1.5 and 4.5 months was lower in women with higher milk Na/K ratio. Thus, the importance of subclinical mastitis for infant growth suggests that further investigations to decrease the condition, perhaps using higher micronutrient doses, are warranted.
Parasite Genetics and Immunology Unit, Blair Research Institute, Josiah Tongogara Avenue/Mazowe Road, P. O. Box CY 573, Causeway, Harare, Zimbabwe.
Exnevia
E
Gomo
Suzanne M
SM
Filteau
Andrew M
AM
Tomkins
Patricia
P
Ndhlovu
Kim Fleischer
KF
Michaelsen
Henrik
H
Friis
D000328:Adult; D019587:Dietary Supplements; D005260:Female; D005865:Gestational Age; D006130:Growth Disorders / Q000453:epidemiology / Q000209:etiology; D015658:HIV Infections / Q000150:complications* / Q000453:epidemiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008413:Mastitis / Q000150:complications* / Q000453:epidemiology; D008895:Milk, Human / Q000737:chemistry; D009748:Nutrition Disorders / Q000517:prevention & control; D011188:Potassium / Q000032:analysis; D011247:Pregnancy; D011248:Pregnancy Complications / Q000517:prevention & control; D012964:Sodium / Q000032:analysis; D015030:Zimbabwe / Q000453:epidemiology
D012964:Sodium; D011188:Potassium