Evaluation of an Infant Feeding Intervention for HIV-exposed Haitian Infants
Condition: Lack of; Care, Infant (Child), Malnutrition
MeSH terms: Malnutrition
Study type: Interventional

Summary: 
      The purpose of this quasi-experimental study is to evaluate the effectiveness of an infant
      feeding intervention in improving growth and anemia outcomes among HIV-exposed infants 6-12
      months of age.
    

Detailed description: 
      The need for better nutrition during infancy to improve growth and child survival outcomes is
      well recognized and is especially acute in the context of maternal human immunodeficiency
      virus (HIV) infection. WHO Guidelines on Infant Feeding and HIV call for support of
      HIV-infected caregivers during infant feeding transitions across the first year of life.
      However, there are few published examples of programmatic approaches that effectively
      integrate PMTCT and infant feeding support at the service delivery level.

      The objectives of this study are to develop and test an infant feeding support intervention
      among non-breastfed HIV-exposed infants age 6-12 months enrolled in the Prevention of
      Mother-to-Child Transmission of HIV program at the GHESKIO centres, an HIV and TB treatment
      clinic in urban Port-au-Prince, Haiti. The investigators hypothesize that growth and anemia
      outcomes will be better in the intervention cohort compared to historical controls. The
      investigators also hypothesize that the infant feeding support intervention will be feasible
      and acceptable to mothers and clinical staff.

      To accomplish these objectives, the investigators will enroll 82 HIV-exposed infants age
      5.5-6.5 months recruited from the GHESKIO pediatric clinic in a 24-week intervention that
      includes a) a daily ration of fortified lipid-based nutrient supplement and b) nutrition
      counseling delivered through biweekly group and individualized sessions. Data on growth,
      supplement use, infant feeding knowledge and practices will be collected every 4 weeks during
      the intervention period. Hemoglobin and dietary intake will be assessed at baseline,
      mid-point and end of intervention. Intervention children will be seen 6-months post
      intervention to assess growth and anemia outcomes. Growth and anemia outcomes in the
      intervention group will be compared to medical record data from same-age HIV-exposed children
      seen at GHESKIO in the previous year.
    

Intervention name(s): Counseling and nutrition supplement
Intervention type(s): Other
Intervention description(s): 24-week intervention that includes a) a daily ration of fortified lipid-based nutrient supplement and b) nutrition counseling delivered through biweekly group and individualized sessions. Dietary supplement is a locally- produced lipid-based nutrient spread (Meds and Foods for Kid, Cap Haitian, Haiti) that in a 65g daily ration provides 345 kcal energy and single allowance of key micronutrients for the 6-12 month age group.
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Prevention
Keywords: infant feeding; HIV; growth; anemia