title: Complementary Feeding and Diarrhea and Respiratory Infection Among HIV-Exposed Tanzanian Infants.
abstract: OBJECTIVE
  To examine the association between complementary feeding and risks of diarrhea and acute respiratory infection (ARI) among HIV-exposed infants aged 6-24 months.
  
  
  METHODS
  We prospectively used an Infant and Child Feeding Index (ICFI) to measure complementary feeding practices (breastfeeding status, food consistency, dietary diversity, food group frequency, and meal frequency). We determined the association of ICFI and each of its components with the risk of diarrhea and ARI. Generalized estimating equations were used to estimate the relative risks for morbidity episodes.
  
  
  METHODS
  Dar es Salaam, Tanzania.
  
  
  METHODS
  A total of 2092 HIV-exposed infants followed from 6 months of age to 24 months of age.
  
  
  RESULTS
  The ICFI score ranged from 0 to 9; the median score was 6 (interquartile range = 4-7). Low ICFI scores were likely associated with increased risk of dysentery [low vs. high tertile risk ratio (RR): 1.40; 95% confidence interval (CI): 0.93 to 2.10; P for trend = 0.02] and respiratory infection (low vs. high tertile RR: 1.16; 95% CI: 0.96 to 1.41; P for trend = 0.01). Low dietary diversity scores were likely associated with higher risk of dysentery (low vs. high tertile RR: 1.47; 95% CI: 0.92 to 2.35; P for trend = 0.03) and respiratory infection (low vs. high tertile RR: 1.41; 95% CI: 1.13 to 1.76; P for trend = 0.01). Low food consistency scores were associated with higher risk of respiratory infection (RR: 1.77; 95% CI: 1.40 to 2.26; P < 0.01).
  
  
  CONCLUSIONS
  In this setting, low ICFI, dietary diversity, and food consistency scores were likely associated with increased risk of diarrhea and ARI among HIV-exposed infants.
authors.affiliation: Departments of *Global Health and Population; †Epidemiology; ‡Biostatistics; §Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA; ‖Department of Pediatrics and Child Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania; ¶Nutrition Section, United Nations Children's Fund (UNICEF), New York, NY; #Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania; and **Division of Gastroenterology, Hepatology and Nutrition, Boston Children's Hospital, Boston, MA.
authors.forename: Pili
authors.initials: P
authors.lastname: Kamenju
authors.forename: Enju
authors.initials: E
authors.lastname: Liu
authors.forename: Ellen
authors.initials: E
authors.lastname: Hertzmark
authors.forename: Donna
authors.initials: D
authors.lastname: Spiegelman
authors.forename: Rodrick R
authors.initials: RR
authors.lastname: Kisenge
authors.forename: Roland
authors.initials: R
authors.lastname: Kupka
authors.forename: Said
authors.initials: S
authors.lastname: Aboud
authors.forename: Karim
authors.initials: K
authors.lastname: Manji
authors.forename: Christopher
authors.initials: C
authors.lastname: Duggan
authors.forename: Wafaie W
authors.initials: WW
authors.lastname: Fawzi
mesh_terms: D002675:Child, Preschool; D003967:Diarrhea / Q000150:complications* / Q000453:epidemiology*; D004311:Double-Blind Method; D004781:Environmental Exposure; D005260:Female; D015658:HIV Infections; D006801:Humans; D007223:Infant; D007227:Infant Nutritional Physiological Phenomena; D008297:Male; D011446:Prospective Studies; D012141:Respiratory Tract Infections / Q000150:complications* / Q000453:epidemiology*; D013636:Tanzania