|
Background:
To describe mortality according to their initial feeding practice
(breastfeeding or formula-feeding) among children born to HIV-infected
mothers, in a Prevention of Mother-to-Child Transmission of HIV (PMTCT)
project in Abidjan, Côte d'Ivoire.
Methods:
Between March 2001 and August 2002, any HIV-1 infected prevent women,
age >=18, who accepted pre- and post-test counseling and who received a
perinatal PMTCT antiretroviral intervention (zidovudine and nevirapine) was
eligible if she gave a live-birth. Two infant feeding interventions were
systematically proposed: formula-feeding (free of charge) from birth with a
drug inhibiting lactation or exclusive breast-feeding during 3 months then
early cessation of breast-feeding. Mother-infant pairs were closely followed
during 2 years, with a pediatric HIV-diagnosis, counseling, and collection
of the feeding practices at each visit.
Results:
From March 2001 to February 2003, 398 live-born children were enrolled.
Among the 393 children fed at least once, 201 (51.2%) received
formula-feeding from birth for a median of 215 days before any nutritional
switch, 175 (44.5%) were breast-fed from birth for 123 days and 17 (4.3%)
were mixed-fed. Death occurred in 28 children among whom 11 were
HIV-infected at age 6 weeks. Among
HIV-uninfected children fed at least once, four and two deaths occurred
between birth and the first nutritional switch in the formula-fed (n=187)
and breast-fed (n=166) children, respectively, yielding an incidence
mortality rate of 30.4% (95% CI: 8.3-77.0) and 34.2% (95% CI: 4.1-123.5),
respectively.
Conclusions:
In this context of an intensive counselling from birth, there is no
evidence of a higher mortality in formula-fed HIV-uninfected children
compared to those breast-fed. Further follow-up will allow will allow us to
compare these mortality rates with those in the general population in
Abidjan. |
