Growth Profiles of Children and Adolescents Living with and without Perinatal HIV Infection in Southern Africa: A Secondary Analysis of Cohort Data

Rehman, Andrea M.; Sekitoleko, Isaac; Rukuni, Ruramayi; Webb, Emily L.; McHugh, Grace; Bandason, Tsitsi; Moyo, Brewster; Ngwira, Lucky Gift; Mukwasi-Kahari, Cynthia; Gregson, Celia L.; Simms, Victoria; Filteau, Suzanne; Ferrand, Rashida A.

doi:10.3390/nu15214589

Open AccessArticle

Growth Profiles of Children and Adolescents Living with and without Perinatal HIV Infection in Southern Africa: A Secondary Analysis of Cohort Data

by

Andrea M. Rehman

¹

,

Isaac Sekitoleko

²,

Ruramayi Rukuni

^3,4,

Emily L. Webb

¹,

Grace McHugh

⁴,

Tsitsi Bandason

⁴

,

Brewster Moyo

⁵,

Lucky Gift Ngwira

^5,6,

Cynthia Mukwasi-Kahari

^4,7,

Celia L. Gregson

^8,9

,

Victoria Simms

^1,4

,

Suzanne Filteau

¹⁰ and

Rashida A. Ferrand

^3,4,*

¹

MRC International Statistics and Epidemiology Group, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK

²

MRC/UVRI and LSHTM Uganda Research Unit, Entebbe P.O. Box 49, Uganda

³

Department of Clinical Research, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK

⁴

The Health Research Unit Zimbabwe, Biomedical Research and Training Institute, Harare P.O. Box A178, Zimbabwe

⁵

Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Blantyre 312233, Malawi

⁶

Health Economics Policy Unit, Kamuzu University of Health Sciences, Blantyre 312225, Malawi

⁷

Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK

⁸

Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol BS8 1QU, UK

⁹

SAMRC/Wits Developmental Pathways for Health Research Unit, School of Clinical Medicine, University of the Witwatersrand, Johannesburg 2050, South Africa

¹⁰

Department of Population Health, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK

^*

Author to whom correspondence should be addressed.

Nutrients 2023, 15(21), 4589; https://doi.org/10.3390/nu15214589

Submission received: 11 September 2023 / Revised: 15 October 2023 / Accepted: 21 October 2023 / Published: 28 October 2023

(This article belongs to the Section Nutrition and Public Health)

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Abstract

Impaired linear growth and slower pubertal growth can be associated with perinatal HIV infection. We characterised growth relative to population norms, among the full adolescent period in southern Africa to better understand processes leading to morbidity in adulthood. We conducted a secondary analysis of 945 adolescents aged 8–20 years from urban Malawi and Zimbabwe; we included children with HIV (CWH), an uninfected comparison group from a cohort study, and CWH with co-morbid chronic lung disease (CLD) from a randomised controlled trial. We used latent class analysis of anthropometric Z-scores generated from British 1990 reference equations at two annual time-points, to identify growth trajectory profiles and used multinomial logistic regression to identify factors associated with growth profiles. Growth faltering (one or more of weight-for-age, height-for-age, or BMI-for-age Z-scores < −2) occurred in 38% (116/303) of CWH from the cohort study, 62% (209/336) of CWH with CLD, and 14% (44/306) of HIV-uninfected participants. We identified seven different growth profiles, defined, relatively, as (1) average growth, (2) tall not thin, (3) short not thin, (4) stunted not thin, (5) thin not stunted, (6) thin and stunted and (7) very thin and stunted. Females in profile 3 exhibited the highest body fat percentage, which increased over 1 year. Males at older age and CWH especially those with CLD were more likely to fall into growth profiles 4–7. Improvements in height-for-age Z-scores were observed in profiles 6–7 over 1 year. Interventions to target those with the worst growth faltering and longer-term follow-up to assess the impact on adult health are warranted.

Keywords: adolescents; growth profile; longitudinal; HIV; latent class analysis; Zimbabwe; Malawi

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MDPI and ACS Style

Rehman, A.M.; Sekitoleko, I.; Rukuni, R.; Webb, E.L.; McHugh, G.; Bandason, T.; Moyo, B.; Ngwira, L.G.; Mukwasi-Kahari, C.; Gregson, C.L.; et al. Growth Profiles of Children and Adolescents Living with and without Perinatal HIV Infection in Southern Africa: A Secondary Analysis of Cohort Data. Nutrients 2023, 15, 4589. https://doi.org/10.3390/nu15214589

AMA Style

Rehman AM, Sekitoleko I, Rukuni R, Webb EL, McHugh G, Bandason T, Moyo B, Ngwira LG, Mukwasi-Kahari C, Gregson CL, et al. Growth Profiles of Children and Adolescents Living with and without Perinatal HIV Infection in Southern Africa: A Secondary Analysis of Cohort Data. Nutrients. 2023; 15(21):4589. https://doi.org/10.3390/nu15214589

Chicago/Turabian Style

Rehman, Andrea M., Isaac Sekitoleko, Ruramayi Rukuni, Emily L. Webb, Grace McHugh, Tsitsi Bandason, Brewster Moyo, Lucky Gift Ngwira, Cynthia Mukwasi-Kahari, Celia L. Gregson, and et al. 2023. "Growth Profiles of Children and Adolescents Living with and without Perinatal HIV Infection in Southern Africa: A Secondary Analysis of Cohort Data" Nutrients 15, no. 21: 4589. https://doi.org/10.3390/nu15214589

APA Style

Rehman, A. M., Sekitoleko, I., Rukuni, R., Webb, E. L., McHugh, G., Bandason, T., Moyo, B., Ngwira, L. G., Mukwasi-Kahari, C., Gregson, C. L., Simms, V., Filteau, S., & Ferrand, R. A. (2023). Growth Profiles of Children and Adolescents Living with and without Perinatal HIV Infection in Southern Africa: A Secondary Analysis of Cohort Data. Nutrients, 15(21), 4589. https://doi.org/10.3390/nu15214589

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Growth Profiles of Children and Adolescents Living with and without Perinatal HIV Infection in Southern Africa: A Secondary Analysis of Cohort Data

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