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Growth, feeding practices, and haemoglobin levels in 6 to 12 month-old infants exposed and unexposed to maternal HIV status in a peri-urban area in Gauteng province, South Africa
Thesis (PhD Food Science (Nutrition))--University of Pretoria, 2024.
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University of Pretoria
2024
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| access_status_str | Open Access |
| author2 | Hoffman, Marinel |
| author_browse | Hoffman, Marinel |
| author_facet | Hoffman, Marinel |
| collection | Thesis |
| dc_rights_str_mv | © 2023 University of Pretoria. All rights reserved. The copyright in this work vests in the University of Pretoria. No part of this work may be reproduced or transmitted in any form or by any means, without the prior written permission of the University of Pretoria. |
| description | Thesis (PhD Food Science (Nutrition))--University of Pretoria, 2024. |
| format | Thesis |
| id | oai:repository.up.ac.za:2263/94509 |
| institution | University of Pretoria (South Africa) |
| language | English |
| last_indexed | 2026-06-10T12:38:33.011Z |
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| provenance_str_mv | Harvested via OAI-PMH from UPSpace — University of Pretoria Institutional Repository |
| publishDate | 2024 |
| publishDateRange | 2024 |
| publishDateSort | 2024 |
| publisher | University of Pretoria |
| publisherStr | University of Pretoria |
| record_format | dspace |
| source_str | UPSpace — University of Pretoria Institutional Repository |
| spelling | oai:repository.up.ac.za:2263/94509 Growth, feeding practices, and haemoglobin levels in 6 to 12 month-old infants exposed and unexposed to maternal HIV status in a peri-urban area in Gauteng province, South Africa Hoffman, Marinel phumudzo.mamphwe@up.ac.za Legodi, Heather Ute, Feucht Tshiambara, Phumudzo Growth Feeding practices Haemoglobin levels HIV exposure Nutrition Infants UCTD Sustainable Development Goals (SDGs) SDG-03: Good health and well-being Faculty of Natural and Agricultural Sciences theses SDG-03 Thesis (PhD Food Science (Nutrition))--University of Pretoria, 2024. Introduction:Undernutrition is a significant public health issue, primarily caused by inappropriate feeding practices that negatively impact infant growth and development. In Sub-Saharan Africa, South Africa has the highest prevalence of human immunodeficiency virus (HIV). Antiretroviral therapy (ART) programmes reduce the infection rate, but leave infants exposed to maternal HIV infection but uninfected (HEU), and more than one million HEU infants are born annually. HEU infants are at a higher risk of mortality and morbidity than HIV-unexposed-uninfected (HUU) infants, leading to poor growth and increased risk of stunting, underweight and anaemia. Limited information exist on the growth, feeding practices and haemoglobin levels of 6-12 months old infants. Aim: To compare the growth, feeding practices, and haemoglobin levels of HEU and HUU infants aged 6–12-months, and determine the relationship between growth, feeding practices and haemoglobin levels in these infants, stratified by maternal HIV status. Methods: This cross-sectional study with repeated measurements was embedded in the Siyakhula Study, where data collection started in October 2018 until August 2023. Infants’ anthropometric measurements (weight, length, head circumference and mid-upper-arm circumference), feeding practices (complementary- and breastfeeding, food frequently consumed, and dietary intake), and haemoglobin level (a marker for anaemia) were collected using calibrated scales, structured questionnaires and the HemoCue® device by trained research assistants using a local language. Hand expressed breastmilk was analysed for the nutrient composition of copper, iron, manganese, selenium, and zinc using the inductively coupled plasma mass spectroscopy method. Results: The study included 181 infants (86 HEU; 95 HUU), with 58% males. High percentages of low birth weight was found in HEU than HUU infants (22% vs. 13%; p<0.001). Length-for-age Z-scores (LAZ) (p<0.05), weight-for-age Z-scores (WAZ) (p<0.05), and mid-upper-arm circumference-for-age Z-scores (MUACAZ) (p<0.05) were lower in HEU versus HUU infants at 6 and 9 months. Lower weight-for-length Z-scores (WLZ) (−0.2±1.2 vs. 0.2±1.2; p=0.020) was observed at 12 months in HEU infants. The HEU and HUU infants were introduced to complementary foods too early, and lower breastfeeding rates were found in HEU than HUU infants at 9 (36% vs. 57%; p=0.013) and 12 months (25% vs. 48%; p=0.005). Only 11% of HEU and 6% of HUU achieved a minimum dietary-diverse diet and flesh foods consumption was significantly higher in HEU (24%) than HUU (11%) at 12 months. Dietary fat intakes were low in HEU and HUU infants, with iron, calcium, and vitamin A intakes higher in HEU than HUU infants at 12 months. Haemoglobin levels and anaemia was similar in HEU and HUU infants but more percentages of anaemia were found in HEU than HUU infants at 6 (27% vs. 18%) and 9 months (33% vs. 29%). Haemoglobin levels positively correlated with WAZ (p=0.039), LAZ (p=0.007), and MUACAZ (p=0.039) at 9 months, and at 12 months WAZ (p=0.018) and WLZ (p=0.041) in HEU infants. Conclusion: The HEU infants had suboptimal growth and inappropriate feeding practices including lower breastfeeding rates than HUU infants. The HEU infants had higher dietary intakes, dietary diversity, and flesh consumption than HUU infants. Infant growth and feeding habits are impacted by maternal HIV infection but better infant feeding counselling and implementation need to be prioritized for all South African mothers, irrespective of the HIV status. University of Pretoria Department of Research and Innovation UCDP National Research Foundation (NRF): new Generation of Academics Program grant ID: NGAP_RDG190128411410 Collaborative Initiative for Paediatrics HIV Education and Research (CIPHER) of the International AIDS Society grant ID: 2017/560_FEU. Food Science PhD (Nutrition) Unrestricted Faculty of Natural and Agricultural Sciences 2024-02-13T07:11:56Z 2024-02-13T07:11:56Z 2024-04 2024-02 Thesis * A2024 http://hdl.handle.net/2263/94509 DOI: 10.25403/UPresearchdata.25117106 en © 2023 University of Pretoria. All rights reserved. The copyright in this work vests in the University of Pretoria. No part of this work may be reproduced or transmitted in any form or by any means, without the prior written permission of the University of Pretoria. application/pdf University of Pretoria |
| spellingShingle | Growth Feeding practices Haemoglobin levels HIV exposure Nutrition Infants UCTD Sustainable Development Goals (SDGs) SDG-03: Good health and well-being Faculty of Natural and Agricultural Sciences theses SDG-03 Growth, feeding practices, and haemoglobin levels in 6 to 12 month-old infants exposed and unexposed to maternal HIV status in a peri-urban area in Gauteng province, South Africa |
| title | Growth, feeding practices, and haemoglobin levels in 6 to 12 month-old infants exposed and unexposed to maternal HIV status in a peri-urban area in Gauteng province, South Africa |
| title_full | Growth, feeding practices, and haemoglobin levels in 6 to 12 month-old infants exposed and unexposed to maternal HIV status in a peri-urban area in Gauteng province, South Africa |
| title_fullStr | Growth, feeding practices, and haemoglobin levels in 6 to 12 month-old infants exposed and unexposed to maternal HIV status in a peri-urban area in Gauteng province, South Africa |
| title_full_unstemmed | Growth, feeding practices, and haemoglobin levels in 6 to 12 month-old infants exposed and unexposed to maternal HIV status in a peri-urban area in Gauteng province, South Africa |
| title_short | Growth, feeding practices, and haemoglobin levels in 6 to 12 month-old infants exposed and unexposed to maternal HIV status in a peri-urban area in Gauteng province, South Africa |
| title_sort | growth feeding practices and haemoglobin levels in 6 to 12 month old infants exposed and unexposed to maternal hiv status in a peri urban area in gauteng province south africa |
| topic | Growth Feeding practices Haemoglobin levels HIV exposure Nutrition Infants UCTD Sustainable Development Goals (SDGs) SDG-03: Good health and well-being Faculty of Natural and Agricultural Sciences theses SDG-03 |
| url | http://hdl.handle.net/2263/94509 |