Malnutrition decreases the odds of attaining motor milestones in HIV exposed children: results from a paediatric DREAM cohort.
OBJECTIVE
HIV and malnutrition are the two major causes of infant mortality in Sub-Saharan Africa. The study describes the impact of malnutrition on motor milestone development in HIV-exposed children.


METHODS
Randomized community intervention trial (SMAC, Safe Milk for African Children).


METHODS
Growth, motor development, and malnutrition were assessed in a sample of 76 HIV-exposed children, aged 0-24 months, at the Blantyre Dream Centre in Malawi.


METHODS
We assessed growth and selected motor milestone achievement in agreement with WHO/UNICEF criteria. Odds ratios and 95%confidence intervals were calculated according to motor milestones and malnutrition indices. Multivariable logistic regression was performed with 18 months data.


RESULTS
High rates of malnutrition were observed. Underweight increased by 6.7/9.2 and 3.2/5.5 the odds of not standing alone and not walking alone at 15 and 18 months. Stunting increased by 9.7 the odds of not standing alone at 11 months and by 6.1 the odds of not walking alone at 18 months. Wasting increased by 5.5/10.3 the odds for not walking with assistance at 12 and 18 months. Low weight for age was associated with delay in walking at 18 months (HR=2.9).


CONCLUSIONS
Malnutrition in HIV-exposed children decreases the likelihood of adequate development.
Dip. Biomedicina e prevenzione, Università Tor Vergata, Roma, Italy. ersiliabuonomo@gmail.com.
Ersilia
E
Buonomo
Dip. Biomedicina e prevenzione, Università Tor Vergata, Roma, Italy.
Paola
P
Scarcella
DREAM Program, Blantyre, Malawi.
Dyna
D
Tembo
Istituto superiore di sanità, Roma, Italy.
Marina
M
Giuliano
Dip. Biomedicina e prevenzione, Università Tor Vergata, Roma, Italy.
Stefania
S
Moramarco
Dip. Biomedicina e prevenzione, Università Tor Vergata, Roma, Italy.
Leonardo
L
Palombi
University of California, Los Angeles, USA.
Karin
K
Nielsen-Saines
Dip. Biomedicina e prevenzione, Università Tor Vergata, Roma, Italy.
Sandro
S
Mancinelli
Università LUMSA, Roma, Italy.
Maria Cristina
MC
Marazzi
D023241:Antiretroviral Therapy, Highly Active; D001942:Breast Feeding; D015897:Comorbidity; D002658:Developmental Disabilities / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006130:Growth Disorders / Q000453:epidemiology / Q000209:etiology; D015658:HIV Infections / Q000188:drug therapy / Q000453:epidemiology*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008295:Malawi / Q000453:epidemiology; D008297:Male; D044342:Malnutrition / Q000453:epidemiology*; D009043:Motor Activity; D012959:Socioeconomic Factors; D013851:Thinness / Q000453:epidemiology / Q000209:etiology; D016138:Walking