Growth profiles of children and adolescents living with and without perinatal HIV infection in Southern Africa: a secondary analysis of cohort data

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

doi:10.3390/nu15214589

Growth profiles of children and adolescents living with and without perinatal HIV infection in Southern Africa: a secondary analysis of cohort data

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

^*Corresponding author for this work

Research output: Contribution to journal › Article (Academic Journal) › peer-review

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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.

Original language	English
Article number	4589
Number of pages	13
Journal	Nutrients
Volume	15
Issue number	21
Early online date	28 Oct 2023
DOIs	https://doi.org/10.3390/nu15214589
Publication status	Published - 1 Nov 2023

Bibliographical note

Funding Information:
The BREATHE study was funded through the Global Health and Vaccination Programme of the Norwegian Research Council Grant number 234424/H10. RR and the IMVASK study were funded by Wellcome Trust UK, grant number 206764/Z/17/Z. CK was funded by a National Institute of Health Fogarty Trent Fellowship, grant number 2D43TW009539–06. RAF was funded by Wellcome Trust, grant number 206316/Z/17/Z. AMR, VS and ELW were partially supported by the UK Medical Research Council (MRC) and the UK Foreign, Commonwealth and Development Office (FCDO) under the MRC/DFID Concordat agreement which is also part of the EDCTP2 programme supported by the European Union, grant number: MR/R010161/1.

Publisher Copyright:
© 2023 by the authors.

Keywords

HIV
Malawi
Zimbabwe
adolescents
growth profile
latent class analysis
longitudinal

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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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), Article 4589. https://doi.org/10.3390/nu15214589

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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.",

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author = "Isaac Sekitoleko and Ruramayi Rukuni and Webb, {Emily L} and Grace McHugh and Tsitsi Bandason and Brewster Moyo and Ngwira, {Lucky Gift} and Cynthia Mukwasi-Kahari and Gregson, {Celia L} and Victoria Simms and Suzanne Filteau and Ferrand, {Rashida A}",

note = "Funding Information: The BREATHE study was funded through the Global Health and Vaccination Programme of the Norwegian Research Council Grant number 234424/H10. RR and the IMVASK study were funded by Wellcome Trust UK, grant number 206764/Z/17/Z. CK was funded by a National Institute of Health Fogarty Trent Fellowship, grant number 2D43TW009539–06. RAF was funded by Wellcome Trust, grant number 206316/Z/17/Z. AMR, VS and ELW were partially supported by the UK Medical Research Council (MRC) and the UK Foreign, Commonwealth and Development Office (FCDO) under the MRC/DFID Concordat agreement which is also part of the EDCTP2 programme supported by the European Union, grant number: MR/R010161/1. Publisher Copyright: {\textcopyright} 2023 by the authors.",

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Sekitoleko, I, Rukuni , R, Webb, EL, McHugh, G, Bandason, T, Moyo, B, Ngwira, LG, Mukwasi-Kahari, C, Gregson, CL, Simms, V, Filteau, S & Ferrand, RA 2023, 'Growth profiles of children and adolescents living with and without perinatal HIV infection in Southern Africa: a secondary analysis of cohort data', Nutrients, vol. 15, no. 21, 4589. https://doi.org/10.3390/nu15214589

TY - JOUR

T1 - Growth profiles of children and adolescents living with and without perinatal HIV infection in Southern Africa

T2 - a secondary analysis of cohort data

AU - Sekitoleko, Isaac

AU - Rukuni , Ruramayi

AU - Webb, Emily L

AU - McHugh, Grace

AU - Bandason, Tsitsi

AU - Moyo, Brewster

AU - Ngwira, Lucky Gift

AU - Mukwasi-Kahari, Cynthia

AU - Gregson, Celia L

AU - Simms, Victoria

AU - Filteau, Suzanne

AU - Ferrand, Rashida A

N1 - Funding Information: The BREATHE study was funded through the Global Health and Vaccination Programme of the Norwegian Research Council Grant number 234424/H10. RR and the IMVASK study were funded by Wellcome Trust UK, grant number 206764/Z/17/Z. CK was funded by a National Institute of Health Fogarty Trent Fellowship, grant number 2D43TW009539–06. RAF was funded by Wellcome Trust, grant number 206316/Z/17/Z. AMR, VS and ELW were partially supported by the UK Medical Research Council (MRC) and the UK Foreign, Commonwealth and Development Office (FCDO) under the MRC/DFID Concordat agreement which is also part of the EDCTP2 programme supported by the European Union, grant number: MR/R010161/1. Publisher Copyright: © 2023 by the authors.

PY - 2023/11/1

Y1 - 2023/11/1

N2 - 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.

AB - 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.

KW - HIV

KW - Malawi

KW - Zimbabwe

KW - adolescents

KW - growth profile

KW - latent class analysis

KW - longitudinal

U2 - 10.3390/nu15214589

DO - 10.3390/nu15214589

M3 - Article (Academic Journal)

C2 - 37960240

SN - 2072-6643

VL - 15

JO - Nutrients

JF - Nutrients

IS - 21

M1 - 4589

ER -

Growth profiles of children and adolescents living with and without perinatal HIV infection in Southern Africa: a secondary analysis of cohort data

Abstract

Bibliographical note

Keywords

UN SDGs

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