Anemia and nutritional status of HIV-exposed infants and HIV-infected mothers in Busia County, Western Kenya

Abstract

Breast milk is best during the first 6 months of life due to nutritional, anti-infective and psychological benefits. However, breastfeeding accounts for 10-25% of mother-to-child transmission (MTCT) of HIV. Antiretroviral treatment given to the mother and exclusively breastfed (EBF) infant can reduce mother-to-child transmission (MTCT) of HIV to less than 5% . Mixed feeding during the first six months carries a greater risk of transmission because other liquids and foods given to the infant alongside breast milk can damage the already delicate and permeable gut wall thus allowing the virus to be transmitted more easily by penetration. Mixed feeding also poses the same risks of contamination and diarrhea as artificial feeding further diminishing the chances of survival . Approximately 1.3 million child deaths per year worldwide could be prevented if universal coverage of EBF were increased to 90% among infants aged less than 6 months . Therefore, World Health Organization (WHO) recommends EBF and antiretroviral drugs (ARVs) for HIV-infected mothers and their infants to prevent MTCT of HIV. Despite these benefits, the prevalence of EBF is 39% globally and 36% in resource limited settings . According to Kenya Demographic and Health Survey of 2014, 61% of mothers practised EBF for 5-6 months . Over the last two decades, more emphasis has been laid on MTCT of HIV than malnutrition due to macro or micronutrient deficiencies which affect overall child survival thus negating the benefits of EBF. Sufficient food intake is essential for lactation and effective EBF in order to avoid infant malnutrition. Fat loss and micronutrient deficiencies occur more during lactation among HIV-infected compared to uninfected women . EBF without iron supplementation might compromise hematologic status . There are no studies reported on nutritional outcome of EBF infants and their HIV-infected mothers in Busia County of western Kenya. Determination of the food security and nutritional status of EBF mothers and infants might guide health policy makers in designing appropriate intervention strategies.