title: Impact of multi-micronutrient supplementation on growth and morbidity of HIV-infected South African children.
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.
authors.affiliation: Division of Human Nutrition, Wageningen University and Research Centre, P.O. Box 8129, Wageningen 6700EV, The Netherlands. siyazi.mda@ul.ac.za.
authors.forename: Siyazi
authors.initials: S
authors.lastname: Mda
authors.forename: Joop M A
authors.initials: JM
authors.lastname: van Raaij
authors.forename: François P R
authors.initials: FP
authors.lastname: de Villiers
authors.forename: Frans J
authors.initials: FJ
authors.lastname: Kok
mesh_terms: D001827:Body Height; D001835:Body Weight; D002675:Child, Preschool; D003967:Diarrhea / Q000150:complications / Q000188:drug therapy; D019587:Dietary Supplements; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology*; D006801:Humans; D007223:Infant; D008297:Male; D018977:Micronutrients / Q000008:administration & dosage* / Q000172:deficiency; D009017:Morbidity; D012140:Respiratory Tract Diseases / Q000150:complications / Q000188:drug therapy; D013019:South Africa
chemical_list: D018977:Micronutrients