Abstract:
Background
Impaired growth among infants remains one of the leading nutrition problems globally. In
this study, we aimed to compare the growth trajectory rate and evaluate growth trajectory
characteristics among children, who are HIV exposed uninfected (HEU) and HIV unexposed
uninfected (HUU), under two years in Zambia.
Method
Our study used data from the ROVAS II study (PACTR201804003096919), an open-label
randomized control trial of two verses three doses of live, attenuated, oral RotarixTM administered
6 &10 weeks or at 6 &10 weeks plus an additional dose at 9 months of age, conducted
at George clinic in Lusaka, Zambia. Anthropometric measurements (height and
weight) were collected on all scheduled and unscheduled visits. We defined linear growth
velocity as the rate of change in height and estimated linear growth velocity as the first derivative
of the mixed effect model with fractional polynomial transformations and, thereafter,
used the second derivative test to determine the peak height and age at peak heigh.
Results
We included 212 infants in this study with median age 6 (IQR: 6–6) weeks of age. Of these
97 (45.3%) were female, 35 (16.4%) were stunted, and 59 (27.6%) were exposed to HIV at
baseline. Growth velocity was consistently below the 3rd percentile of the WHO linear growth
standard for HEU and HUU children. The peak height and age at peak height among HEU
children were 74.7 cm (95% CI = 73.9–75.5) and 15.5 months (95% CI = 14.7–16.3) respectively
and those for HUU were 73 cm (95% CI = 72.1–74.0) and 15.6 months (95% CI =
14.5–16.6) respectively. Conclusion
We found no difference in growth trajectories between infants who are HEU and HUU. However,
the data suggests that poor linear growth is universal and profound in this cohort and
may have already occurred in utero.
