An increasing body of evidence supports the efficacy of single and, more recently, multiple micronutrient supplementation in reducing morbidity and mortality in susceptible populations. For example, we have recently completed a multiple micronutrient supplementation trial in HIV-positive Tanzanian women that showed a significant reduction in pre-term birth, fetal loss, and low birthweight. In children, we and others have shown the beneficial effects of vitamin A supplementation in reducing diarrheal disease and mortality. Our next priority is to evaluate the efficacy of multiple micronutrient supplementation in susceptible children. Children born to HIV-infected women are at risk of multiple micronutrient deficiencies due to poor dietary intake, malabsorption, and increased metabolic needs. In addition, these children, if infected with HIV themselves, are at significantly higher risk of death due to infectious illnesses than their non-infected peers. In this application, we propose to study the efficacy of micronutrient supplementation in reducing the risk of death and other adverse health outcomes among infants and young children born to HIV-positive Tanzanian women. Infants will be recruited and randomly assigned to either micronutrients or a placebo liquid given daily. The primary outcome will be mortality. Secondary outcomes will include occurrence of diarrhea, occurrence of respiratory tract infection, weight and length gain, and HIV transmission. A subset of infants will undergo evaluation of intestinal permeability and biochemical nutritional assessment. The study will be carried out as a collaborative effort between the Harvard School of Public Health and Muhimbili University College of Health Sciences, Dar-es-Salaam, Tanzania.
Showing the most recent 10 out of 19 publications
