title: Effect of multivitamin supplementation on the neurodevelopment of HIV-exposed Tanzanian infants: a randomized, double-blind, placebo-controlled clinical trial.
abstract: BACKGROUND
  Micronutrient deficiencies and in utero exposure to HIV may impair infant neurodevelopment.
  
  
  OBJECTIVE
  To evaluate the effect of daily multivitamin supplementation on the cognitive, language and motor development of HIV-exposed Tanzanian infants.
  
  
  METHODS
  A total of 2387 infants were randomized to receive daily oral supplementation of multivitamins (B-complex, C and E) or placebo from age 6 weeks for 24 months. The cognitive, language and motor scales of the Bayley Scales of Infant and Toddler Development, third edition, were administered to a subset of 206 infants at age 15 months.
  
  
  RESULTS
  Multivitamin supplementation did not improve measures of cognitive development, expressive or receptive language or gross motor capabilities. There was a trend toward improved fine motor skills among infants randomized to the multivitamin group (difference in mean score = 0.38; 95% CI = -0.01, 0.78, p = 0.06).
  
  
  CONCLUSIONS
  Daily provision of multivitamins to HIV-exposed infants does not substantially improve developmental outcomes at age 15 months.
authors.affiliation: Department of Pediatrics and Child Health, Muhimbili University of Health and Allied Sciences, Upanga, Dar es Salaam, Tanzania*Karim P. Manji and Christine M. McDonald are joint first authors.
authors.forename: Karim P
authors.initials: KP
authors.lastname: Manji
authors.affiliation: Division of Gastroenterology, Hepatology and Nutrition, Boston Hospital, Boston, MA 02115, USA*Karim P. Manji and Christine M. McDonald are joint first authors.
authors.forename: Christine M
authors.initials: CM
authors.lastname: McDonald
authors.affiliation: UNICEF West and Central Africa Regional Office, Immeuble Maimouna III, Yoff, Dakar, SenegalDepartment of Nutrition, Harvard School of Public Health, Boston, MA 02115, USA.
authors.forename: Roland
authors.initials: R
authors.lastname: Kupka
authors.affiliation: Department of Biostatistics, Harvard School of Public Health, Boston, MA 02115, USA.
authors.forename: Ronald J
authors.initials: RJ
authors.lastname: Bosch
authors.affiliation: Department of Pediatrics and Child Health, Muhimbili University of Health and Allied Sciences, Upanga, Dar es Salaam, Tanzania.
authors.forename: Rodrick
authors.initials: R
authors.lastname: Kisenge
authors.affiliation: Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, Upanga, Dar es Salaam, Tanzania.
authors.forename: Said
authors.initials: S
authors.lastname: Aboud
authors.affiliation: Department of Neurology, Boston Children's Hospital, Boston, MA 02115, USADepartment of Environmental Health, Harvard School of Public Health, Boston, MA 02115, USA.
authors.forename: David C
authors.initials: DC
authors.lastname: Bellinger
authors.affiliation: Department of Nutrition, Harvard School of Public Health, Boston, MA 02115, USADepartment of Global Health and Population, Harvard School of Public Health, Boston, MA 02115, USADepartment of Epidemiology, Harvard School of Public Health, Boston, MA 02115, USA.
authors.forename: Wafaie W
authors.initials: WW
authors.lastname: Fawzi
authors.affiliation: Division of Gastroenterology, Hepatology and Nutrition, Boston Hospital, Boston, MA 02115, USADepartment of Nutrition, Harvard School of Public Health, Boston, MA 02115, USA christopher.duggan@childrens.harvard.edu.
authors.forename: Christopher P
authors.initials: CP
authors.lastname: Duggan
mesh_terms: D002657:Child Development / Q000187:drug effects*; D003071:Cognition; D019587:Dietary Supplements; D004311:Double-Blind Method; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000635:transmission*; D006801:Humans; D007223:Infant; D018445:Infectious Disease Transmission, Vertical; D007804:Language Development; D008297:Male; D009048:Motor Skills; D009420:Nervous System / Q000187:drug effects* / Q000254:growth & development; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000821:virology; D016896:Treatment Outcome; D014815:Vitamins / Q000008:administration & dosage*
chemical_list: D014815:Vitamins
keywords: HIV; Multivitamins; infant development