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Anaemia, iron and vitamin A status among South African school-aged children living with and without HIV

C Goosen, J Baumgartner, N Mikulic, S L Barnabas, M F Cotton, M B Zimmermann, R Blaauw

Abstract


Background. Data on iron and vitamin A deficiency are scarce in school-aged children living with HIV (HIV+) compared with children without HIV (HIV–). Both deficiencies can contribute to anaemia.

Objective. To assess anaemia, iron and vitamin A status in a sample of HIV+ and HIV– school-aged children in South Africa.

Methods. In this comparative cross-sectional study, biomarkers for anaemia (haemoglobin), iron (plasma ferritin (PF), soluble transferrin receptor), vitamin A (retinol-binding protein (RBP)) and inflammatory status (C-reactive protein, α-1-acid glycoprotein) were measured in 8 - 13-year-old children from Cape Town living with (n=143) and without HIV (n=148). Measurements of PF and RBP were adjusted for inflammation using a regression-correction approach.

Results. HIV+ children had higher prevalences of anaemia (29% v. 14%; odds ratio (OR) = 2.6; 95% confidence interval (CI) 1.4 - 4.9; p=0.002), iron-deficient erythropoiesis (20% v. 9%; OR=2.5; 95% CI 1.2 - 5.0; p=0.013) and iron deficiency anaemia (11% v. 4%; OR=2.9; 95% CI 1.1 - 7.7; p=0.035) than HIV– children. Marginal vitamin A deficiency was noted in 52% of HIV+ and 57% of HIV– children (p=0.711). Subclinical inflammation was more prevalent in HIV+ than HIV– children (p=0.012).

Conclusion. Anaemia, iron-deficient erythropoiesis and iron deficiency anaemia were more prevalent in HIV+ than HIV– children. Prevalence of marginal vitamin A deficiency was high in both groups. Efforts to improve micronutrient status and mitigate nutritional determinants of anaemia in HIV+ children from resource-limited settings should be prioritised


Authors' affiliations

C Goosen, Division of Human Nutrition, Department of Global Health, Stellenbosch University, Cape Town, South Africa

J Baumgartner, Institute of Food, Nutrition and Health, Department of Health Sciences and Technology, ETH Zurich, Switzerland

N Mikulic, Institute of Food, Nutrition and Health, Department of Health Sciences and Technology, ETH Zurich, Switzerland

S L Barnabas, Family Centre for Research with Ubuntu, Department of Paediatrics and Child Health, Stellenbosch University, Cape Town, South Africa

M F Cotton, Family Centre for Research with Ubuntu, Department of Paediatrics and Child Health, Stellenbosch University, Cape Town, South Africa

M B Zimmermann, Institute of Food, Nutrition and Health, Department of Health Sciences and Technology, ETH Zurich, Switzerland

R Blaauw, Division of Human Nutrition, Department of Global Health, Stellenbosch University, Cape Town, South Africa

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Cite this article

South African Journal of Child Health 2022;16(2):105.

Article History

Date submitted: 2022-07-22
Date published: 2022-07-22

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