Open AccessPre- and post-natal macronutrient supplementation for HIV–positive women in Tanzania: Effects on infant birth weight and HIV transmission
Author(s) -
Albert Magohe,
Todd Mackenzie,
J. Kimario,
Zohra Lukmanji,
Kristy Hendricks,
John R. Koethe,
Nyasule Neke,
Susan Tvaroha,
Ruth I. Connor,
Richard Waddell,
Isaac Maro,
Mecky Matee,
Kisali Pallangyo,
Muhammad Bakari,
C. Fordham von Reyn,
DarDar Study Team
Publication year - 2018
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0201038
Subject(s) - medicine , micronutrient , birth weight , breastfeeding , calorie , randomized controlled trial , pregnancy , tanzania , randomization , obstetrics , pediatrics , low birth weight , biology , environmental planning , genetics , environmental science , pathology
Objective To determine if a protein-calorie supplement (PCS) plus a micronutrient supplement (MNS) improves outcomes for HIV-infected lactating women and their infants. Design Randomized, controlled trial. Setting Dar es Salaam, Tanzania Subjects, participants Pregnant HIV-infected women enrolled in PMTCT programs who intended to breastfeed for 6 months. Intervention Randomization 1:1 to administration of a PCS plus MNS versus MNS alone among 96 eligible women beginning in the third trimester and continuing for 6 months of breast-feeding. Main outcome measure(s) Primary: infant weight at 3 months. Secondary: maternal BMI at 6 months. Results PCS resulted in significant increases in daily energy intake compared to MNS at all time points (range of differences: +388–719 Kcal); and increases in daily protein intake (range of differences: +22–33 gm). Infant birth weight (excluding twins) was higher in the PCS than MNS groups: 3.30 kg vs 3.04 kg (p = 0.04). Infant weight at 3 months did not differ between PCS and MNS groups: 5.63 kg vs 5.99 kg (p = 0.07). Maternal BMI at 6 months did not differ between PCS and MNS groups: 24.3 vs 23.8 kg/m 2 (p = 0.68). HIV transmission occurred in 0 infants in the PCS group vs 4 in the MNS group (p = 0.03). Conclusions In comparison to MNS the PCS + MNS intervention was well tolerated, increased maternal energy and protein intake, and increased infant birth weight, but not weight at 3 months or maternal BMI at 6 months. Reduced infant HIV transmission in the PCS + MNS group was observed. Trial registration Clinical Trials.Gov NCT01461863 .