Human immunodeficiency virus infection, diarrheal disease and sociodemographic predictors of child growth

Aim: To compare growth patterns between human immunodeficiency virus (HIV)-infected and -uninfected preschool children. To examine the associations between diarrheal and respiratory infections, sociodemographic factors and growth. Methods: A longitudinal study was conducted among 524 children who were 6-60 mo of age at recruitment. Information on sociodemographic characteristics was collected at baseline from the caregiver. Hemoglobin, malaria infection and HIV status of the children were assessed from a blood sample. Monthly height (length if <24 mo) and weight measurements were obtained, and clinical assessments carried out, during an average 12 mo follow-up period. Yearly increments in height and weight were compared by HIV status, incidence of diarrhea and respiratory infections, and levels of sociodemographic variables. Results: After adjusting for maternal education, anemia and vitamin A supplementation, HIV infection was related to 2.8 cm [95% confidence interval (95% CI) 0.6, 5.0] and 1.3 kg (95% CI 0.0, 2.5) lower yearly length and weight gains, respectively, in children who were between 6 and 11 mo old at baseline. Among children who were 12-23 mo old at recruitment, HIV infection was associated with 0.6 kg (95% CI 0.1, 1.0) less yearly weight gain. HIV infection was not related to linear or ponderal growth in children >= 24 mo old. Maternal illiteracy, severe child anemia and episodes of acute diarrhea were additional risk factors for growth delay in length. Conclusion: HIV infection is associated with linear and ponderal growth retardation in children aged <24 mo. Additional predictors of linear growth retardation include preventable conditions such as poor maternal education, child anemia and diarrheal disease.