Growth of young HIV-infected and HIV-exposed children in western Kenya: A retrospective chart review

Megan S. McHenry, Edith Apondi, Samuel O. Ayaya, Ziyi Yang, Wenfang Li, Wanzhu Tu, Guanying Bi, Edwin Sang, Rachel C. Vreeman

Research output: Contribution to journalArticle

Abstract

Introduction The objective of this study was to determine the growth patterns, rates of malnutrition, and factors associated with malnutrition in children born to HIV-infected mothers in western Kenya using data from an electronic medical record system. Methods This study was a retrospective chart review of HIV-infected (HIV+) and–exposed (HEU) children (<5 years) using data collected prospectively in the course of routine clinical care and stored in the electronic medical record system in western Kenya between January 2011 and August 2016. Demographics and anthropometrics were described, with Chi-square testing to compare proportions. Multiple variable logistic regression analysis was used to identify correlates of children being stunted, underweight, and wasted. We also examined growth curves, using a resampling method to compare the areas under the fitted growth curves to compare males/females and HIV+/HEU. Results Data from 15,428 children were analyzed. The children were 51.6% (n = 7,955) female, 5.2% (n = 809) orphans, 83.3% (n = 12,851) were HEU, and 16.7% (n = 2,577) were HIV+. For HIV+ children assessed at 24 months, 50.9% (n = 217) were stunted, 26.5% (n = 145) were underweight, and 13.6% (n = 58) were wasted, while 45.0% (n = 577) of HEU children were stunted, 14.8% (n = 255) were underweight, and 5.1% (n = 65) were wasted. When comparing mean z-scores, HIV+ children tended to have larger and earlier dips in z-scores compared to HIV-exposed children, with significant differences found between the two groups (p<0.001). Factors associated with an increased risk of malnutrition included being male, HIV+, and attending an urban clinic. Maternal antiretroviral treatment during pregnancy and mixed feeding at 3 months of age decreased the risk of malnutrition. Conclusions HIV+ and HEU children differ in their anthropometrics, with HIV+ children having overall lower z-scores. Continued efforts to develop and implement sustainable and effective interventions for malnutrition are needed for children born to HIV+ mothers.

Original languageEnglish (US)
Article numbere0224295
JournalPLoS ONE
Volume14
Issue number12
DOIs
StatePublished - Jan 1 2019

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Kenya
Electronic medical equipment
HIV
Growth
malnutrition
Regression analysis
underweight
Logistics
Thinness
Malnutrition
Child Nutrition Disorders
Electronic Health Records
Mothers
Testing
electronics
risk reduction
disease course
regression analysis
demographic statistics
Logistic Models

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)
  • General

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Growth of young HIV-infected and HIV-exposed children in western Kenya : A retrospective chart review. / McHenry, Megan S.; Apondi, Edith; Ayaya, Samuel O.; Yang, Ziyi; Li, Wenfang; Tu, Wanzhu; Bi, Guanying; Sang, Edwin; Vreeman, Rachel C.

In: PLoS ONE, Vol. 14, No. 12, e0224295, 01.01.2019.

Research output: Contribution to journalArticle

McHenry, MS, Apondi, E, Ayaya, SO, Yang, Z, Li, W, Tu, W, Bi, G, Sang, E & Vreeman, RC 2019, 'Growth of young HIV-infected and HIV-exposed children in western Kenya: A retrospective chart review', PLoS ONE, vol. 14, no. 12, e0224295. https://doi.org/10.1371/journal.pone.0224295
McHenry, Megan S. ; Apondi, Edith ; Ayaya, Samuel O. ; Yang, Ziyi ; Li, Wenfang ; Tu, Wanzhu ; Bi, Guanying ; Sang, Edwin ; Vreeman, Rachel C. / Growth of young HIV-infected and HIV-exposed children in western Kenya : A retrospective chart review. In: PLoS ONE. 2019 ; Vol. 14, No. 12.
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abstract = "Introduction The objective of this study was to determine the growth patterns, rates of malnutrition, and factors associated with malnutrition in children born to HIV-infected mothers in western Kenya using data from an electronic medical record system. Methods This study was a retrospective chart review of HIV-infected (HIV+) and–exposed (HEU) children (<5 years) using data collected prospectively in the course of routine clinical care and stored in the electronic medical record system in western Kenya between January 2011 and August 2016. Demographics and anthropometrics were described, with Chi-square testing to compare proportions. Multiple variable logistic regression analysis was used to identify correlates of children being stunted, underweight, and wasted. We also examined growth curves, using a resampling method to compare the areas under the fitted growth curves to compare males/females and HIV+/HEU. Results Data from 15,428 children were analyzed. The children were 51.6{\%} (n = 7,955) female, 5.2{\%} (n = 809) orphans, 83.3{\%} (n = 12,851) were HEU, and 16.7{\%} (n = 2,577) were HIV+. For HIV+ children assessed at 24 months, 50.9{\%} (n = 217) were stunted, 26.5{\%} (n = 145) were underweight, and 13.6{\%} (n = 58) were wasted, while 45.0{\%} (n = 577) of HEU children were stunted, 14.8{\%} (n = 255) were underweight, and 5.1{\%} (n = 65) were wasted. When comparing mean z-scores, HIV+ children tended to have larger and earlier dips in z-scores compared to HIV-exposed children, with significant differences found between the two groups (p<0.001). Factors associated with an increased risk of malnutrition included being male, HIV+, and attending an urban clinic. Maternal antiretroviral treatment during pregnancy and mixed feeding at 3 months of age decreased the risk of malnutrition. Conclusions HIV+ and HEU children differ in their anthropometrics, with HIV+ children having overall lower z-scores. Continued efforts to develop and implement sustainable and effective interventions for malnutrition are needed for children born to HIV+ mothers.",
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T2 - A retrospective chart review

AU - McHenry, Megan S.

AU - Apondi, Edith

AU - Ayaya, Samuel O.

AU - Yang, Ziyi

AU - Li, Wenfang

AU - Tu, Wanzhu

AU - Bi, Guanying

AU - Sang, Edwin

AU - Vreeman, Rachel C.

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N2 - Introduction The objective of this study was to determine the growth patterns, rates of malnutrition, and factors associated with malnutrition in children born to HIV-infected mothers in western Kenya using data from an electronic medical record system. Methods This study was a retrospective chart review of HIV-infected (HIV+) and–exposed (HEU) children (<5 years) using data collected prospectively in the course of routine clinical care and stored in the electronic medical record system in western Kenya between January 2011 and August 2016. Demographics and anthropometrics were described, with Chi-square testing to compare proportions. Multiple variable logistic regression analysis was used to identify correlates of children being stunted, underweight, and wasted. We also examined growth curves, using a resampling method to compare the areas under the fitted growth curves to compare males/females and HIV+/HEU. Results Data from 15,428 children were analyzed. The children were 51.6% (n = 7,955) female, 5.2% (n = 809) orphans, 83.3% (n = 12,851) were HEU, and 16.7% (n = 2,577) were HIV+. For HIV+ children assessed at 24 months, 50.9% (n = 217) were stunted, 26.5% (n = 145) were underweight, and 13.6% (n = 58) were wasted, while 45.0% (n = 577) of HEU children were stunted, 14.8% (n = 255) were underweight, and 5.1% (n = 65) were wasted. When comparing mean z-scores, HIV+ children tended to have larger and earlier dips in z-scores compared to HIV-exposed children, with significant differences found between the two groups (p<0.001). Factors associated with an increased risk of malnutrition included being male, HIV+, and attending an urban clinic. Maternal antiretroviral treatment during pregnancy and mixed feeding at 3 months of age decreased the risk of malnutrition. Conclusions HIV+ and HEU children differ in their anthropometrics, with HIV+ children having overall lower z-scores. Continued efforts to develop and implement sustainable and effective interventions for malnutrition are needed for children born to HIV+ mothers.

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