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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Frequency of gastroenteritis and gastroenteritis-associated mortality with early weaning in HIV-1-uninfected children born to HIV-infected women in malawi
Journal of Acquired Immune Deficiency Syndromes, Volume 53, No. 1, Year 2010
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Description
BACKGROUND: We assessed gastroenteritis (GE) burden in 2 randomized trials conducted in Malawi to reduce postnatal HIV transmission before and after World Health Organization recommendations regarding exclusive breastfeeding for HIV-exposed infants were adopted. The 2 trials were the nevirapine/AZT (NVAZ, 2000-2003 with prolonged breastfeeding) and the Postexposure Prophylaxis to the Infant (PEPI, 2004-2007 with breastfeeding cessation by 6 months). METHODS: From NVAZ and PEPI trials data, GE frequency through age 12 months among HIV-negative exposed infants was evaluated. Overall and GE-related cumulative mortality rates were estimated using Kaplan-Meier curves. RESULTS: The frequency of at least one GE-related hospitalization was greater in PEPI vs. NVAZ after age 6 months (respectively, 2.9% vs. 0.1%, at 7-9 months and 1.6% vs. 0.2% at 10-12 months, P < 0.001). Cumulative GE-related mortality was significantly higher in PEPI than in NVAZ after age 6 months; at ages 9 and 12 months GE-related mortality was 19 and 24 per 1000 infants in PEPI vs. 7 and 12 per 1000 infants in NVAZ (P = 0.0002). CONCLUSIONS: Early weaning was associated with increased risk of severe GE and GE-related mortality among HIV-exposed infants. Strategies are urgently needed which allow longer breastfeeding while reducing the risk of HIV breast milk transmission in resource-limited settings. Copyright © 2009 by Lippincott Williams & Wilkins.
Authors & Co-Authors
Kafulafula, George
Malawi, Zomba
University of Malawi
United States, Bethesda
National Institute of Child Health and Human Development Nichd
Hoover, Donald R.
United States, New Brunswick
Institute for Health, Health Care Policy and Aging Research
Taha, Taha E.
United States, Baltimore
Johns Hopkins Bloomberg School of Public Health
Thigpen, Michael C.
United States, Atlanta
National Center for Hiv, Viral Hepatitis, Std, and tb Prevention
Li, Qing
United States, Baltimore
Johns Hopkins Bloomberg School of Public Health
Fowler, Mary Glenn
Uganda, Kampala
Makerere University
Kumwenda, Newton I.
United States, Baltimore
Johns Hopkins Bloomberg School of Public Health
Nkanaunena, Kondwani
United States, Baltimore
Johns Hopkins University
Mipando, Linda
United States, Baltimore
Johns Hopkins University
Mofenson, Lynne M.
United States, Atlanta
National Center for Hiv, Viral Hepatitis, Std, and tb Prevention
Statistics
Citations: 118
Authors: 10
Affiliations: 7
Identifiers
Doi:
10.1097/QAI.0b013e3181bd5a47
ISSN:
15254135
Research Areas
Infectious Diseases
Maternal And Child Health
Study Locations
Malawi
Participants Gender
Female