Active Tuberculosis in HIV-Exposed Tanzanian Children up to 2 years of Age: Early-Life Nutrition, Multivitamin Supplementation and Other Potential Risk Factors.
BACKGROUND
Over half a million children worldwide develop active tuberculosis (TB) each year. Early-life nutritional exposures have rarely been examined in relation to pediatric TB among HIV-exposed children. We therefore investigated independent associations of early-life nutritional exposures with active TB among HIV-exposed children up to 2 years of age.


METHODS
Participants were children from a randomized controlled multivitamin supplementation trial conducted in Dar es Salaam, Tanzania, from August 2004 to May 2008, who received daily multivitamin supplements or placebo for 24 months.


RESULTS
Lower mean corpuscular volumes [relative risks (RR): 0.48, 95% confidence interval (CI): 0.27, 0.87] and higher birth weights (RR: 0.61, 95% CI: 0.37, 0.99) were protective against active TB, whereas multivitamin supplementation was not associated with TB risk (RR: 0.87, 95% CI: 0.65, 1.16).


CONCLUSIONS
Knowledge of nutrition-related risk and protective factors for TB in HIV-exposed children could enhance preventive and case-finding activities in this population, contributing to efforts to reduce the global TB burden.
Harvard T.H. Chan School of Public Health, Boston, MA 02115, U.S.A. iolofin@hsph.harvard.edu.
Ibironke O
IO
Olofin
Harvard T.H. Chan School of Public Health, Boston, MA 02115, U.S.A.
Enju
E
Liu
Muhimbili University of Health and Allied Sciences, United Nations Rd, Dar es Salaam, Tanzania.
Karim P
KP
Manji
Harvard T.H. Chan School of Public Health, Boston, MA 02115, U.S.A.
Goodarz
G
Danaei
Harvard T.H. Chan School of Public Health, Boston, MA 02115, U.S.A. Boston Children's Hospital, 300 Longwood Ave, Boston, MA 02115, U.S.A.
Christopher
C
Duggan
Muhimbili University of Health and Allied Sciences, United Nations Rd, Dar es Salaam, Tanzania.
Said
S
Aboud
Harvard T.H. Chan School of Public Health, Boston, MA 02115, U.S.A.
Donna
D
Spiegelman
Harvard T.H. Chan School of Public Health, Boston, MA 02115, U.S.A.
Wafaie W
WW
Fawzi
D000284:Administration, Oral; D019380:Anti-HIV Agents / Q000627:therapeutic use; D002675:Child, Preschool; D019587:Dietary Supplements; D005260:Female; D015658:HIV Infections / Q000188:drug therapy; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D008297:Male; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy; D012307:Risk Factors; D013636:Tanzania / Q000453:epidemiology; D016896:Treatment Outcome; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology*; D014815:Vitamins / Q000008:administration & dosage* / Q000627:therapeutic use
D019380:Anti-HIV Agents; D014815:Vitamins
nutrition-related factors; pediatric tuberculosis