Forthcoming Issue 4 Nutritional adequacy in rural Limpopo Province, South Africa: Maternal and child dietary diversity in the context of perinatal HIV exposure.

Abstract

Background: Children under 5 years of age are a vulnerable group and their growth is affected by nutritional intake. Few studies have evaluated dietary diversity, a proxy measure of dietary adequacy, among HEU and HUU children in resource-limited settings.

Setting: Data were collected from caregiver-child dyads participating in a cluster-randomized trial in rural Limpopo, South Africa.

Methods: HIV exposure was based on maternal self-report of status. WHO standards were used to calculate HAZ and WAZ scores. Dietary diversity (DD) was defined as the number of different food groups consumed over the previous 24 hours. We estimated mean differences between HEU and HUU children in outcomes at 7 and 17 months of age.

Results: At 7 months, mean DD was 2.30 (standard deviation [SD] 1.63) and was similar across gender and by HIV exposure (HEU 2.26 SD1.63 vs HUU 2.32 SD1.63; p=0.08). 

At 17 months, the mean DD was 3.38 (SD1.62) and was similar among HUU and HEU children (3.41 SD1.57 vs 3.29 SD; p=0.333). No association with sub-optimal dietary diversity score (<5 of 8 food groups) and being underweight or stunted was found (p>0.05).

At 7 months, compared to HUU children (n=234), HEU children (n=71) had a lower median HAZ (-0.54 interquartile range [IQR] -1.21 – 0.11 vs -0.1 IQR -0.76 – 0.99; p<0.0001) and WAZ (0.50 IQR -0.27 – 1.24 vs 0.01 IQR -0.69 – 1.02; p<0.018).

Conclusion: At 7 months, dietary diversity was surprising considering early weaning. At 17 months, the dietary diversity was better and this could be due to the physiological ability of the children at this age to try a variety of food combinations or textures.