Anemia and nutritional status of HIV-exposed infants and HIV-infected mothers in Busia County, Western Kenya

Abstract

Background: World Health Organization recommends 6 months of exclusive breastfeeding (EBF) for HIV-exposed infants with maternal antiretroviral drugs (ARVs) to prevent mother-to-child transmission (PMTCT) of HIV. Inadequate food and breastfeeding cause malnutrition. Assessment of their nutritional status is essential.

Objective: To determine the association of EBF with, maternal and infant hemoglobin and nutritional status.

Design: Cross-sectional survey

Setting: PMTCT of HIV clinics in Busia County, western Kenya

Subjects: HIV-infected mothers and HIV-exposed infants

Method: Data on socio-demography, food security and maternal ARVs treatment was collected from 371 mothers using a questionnaire. Mother-infant dyads’ anthropometric and hemogram measurements were obtained. Infant weight for height zee scores (WHZ) and maternal body mass index were computed.

Results: Three hundred and forty-nine (94%) mothers practiced EBF; 162 (44%) were food insecure; 284 (77%) infants had normal WHZ; 298 (81%), 28 (8%) and 43(12%) mothers were normal, undernourished and overweight respectively; 261 (75%) of infants and 100 (29%) of mothers were anemic. There was no significant difference in the nutritional status of anemic and normal infants (p value 0·423). Difference in hemoglobin of mothers and infants on tenofovir disoproxil fumarate (TDF) based and zidovudine-based regimens significantly differed (p values 0.003 and 0.001 respectively).

Conclusion & Recommendation: Anemia among HIV-exposed EBF infants is a public health problem in Busia. Normal nutritional status does not imply normal hematological status. Hemogram monitoring is essential for maternal and infant nutritional status assessment in this context.