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4. Assessing the impact of a food supplement on the nutritional status and body composition of HIV-infected Zambian women on ARVs

Author

Musonda Mofu, Handema Ray, Chipeta James, Munthali Grace K, Byrne Nuala M, Zulu Rodah M, and Hills Andrew P

Subjects
Public aspects of medicine, RA1-1270
Abstract

Abstract Background Zambia is a sub-Saharan country with one of the highest prevalence rates of HIV, currently estimated at 14%. Poor nutritional status due to both protein-energy and micronutrient malnutrition has worsened this situation. In an attempt to address this combined problem, the government has instigated a number of strategies, including the provision of antiretroviral (ARV) treatment coupled with the promotion of good nutrition. High-energy protein supplement (HEPS) is particularly promoted; however, the impact of this food supplement on the nutritional status of people living with HIV/AIDS (PLHA) beyond weight gain has not been assessed. Techniques for the assessment of nutritional status utilising objective measures of body composition are not commonly available in Zambia. The aim of this study is therefore to assess the impact of a food supplement on nutritional status using a comprehensive anthropometric protocol including measures of skinfold thickness and circumferences, plus the criterion deuterium dilution technique to assess total body water (TBW) and derive fat-free mass (FFM) and fat mass (FM). Methods/Design This community-based controlled and longitudinal study aims to recruit 200 HIV-infected females commencing ARV treatment at two clinics in Lusaka, Zambia. Data will be collected at four time points: baseline, 4-month, 8-month and 12-month follow-up visits. Outcome measures to be assessed include body height and weight, body mass index (BMI), body composition, CD4, viral load and micronutrient status. Discussion This protocol describes a study that will provide a longitudinal assessment of the impact of a food supplement on the nutritional status of HIV-infected females initiating ARVs using a range of anthropometric and body composition assessment techniques. Trial Registration Pan African Clinical Trial Registry PACTR201108000303396.

Published
2011
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5. Micronutrient fortification to improve growth and health of maternally HIV-unexposed and exposed Zambian infants: a randomised controlled trial

Author

Filteau, Suzanne, Kasonka, Lackson, Gibson, Rosalind, Gompels, Ursula A., Jaffar, Shabbar, Kafwembe, Emmanuel, Monze, Mwaka, Sinkala, Moses, Tomkins, Andrew, Zulu, Rodah, Chisenga, Molly, Siame, Joshua, Mabuda, Hildah Banda, Baisley, Kathy, Dale, Helen, Rehman, Andrea, Bates, Matthew, Mullen, Anne, Bwalya, Hellen Kangwa, Chileshe, Margaret, Kowa, Priscilla Kangwa, Kumwenda, Mabvuto, Likando, Munalula, Mambwe, Sydney, Muzyamba, Mutinta, Mwale, Anne, Nyaywa, Lungowe, Kapambwe, Mirriam, Bima, Humphrey, Gosset, Laura, Hackett, Louise, Jackson, Abigail, Njunju, Eric, Mwanza, Sydney, Shampwaya, Natalia, Kabanga, Concillia, Chobo, John, Kapumba, Winford, Musonda, Charity, and Soko, Philip

Subjects
Pediatrics, medicine.medical_specialty, A300 Clinical Medicine, Anemia, Breastfeeding, Pediatrics and Child Health, Zambia, lcsh:Medicine, HIV Infections, Growth, Breast milk, Double-Blind Method, Pregnancy, Medicine, Humans, Micronutrients, Pregnancy Complications, Infectious, lcsh:Science, Multidisciplinary, business.industry, lcsh:R, Infant Welfare, Infant, Odds ratio, Public Health and Epidemiology/Global Health, Infectious Diseases/HIV Infection and AIDS, medicine.disease, Micronutrient, Nutrition/Malnutrition, Breast Feeding, Maternal Exposure, Population study, Female, lcsh:Q, business, Breast feeding, Research Article
Abstract

BACKGROUND: The period of complementary feeding, starting around 6 months of age, is a time of high risk for growth faltering and morbidity. Low micronutrient density of locally available foods is a common problem in low income countries. Children of HIV-infected women are especially vulnerable. Although antiretroviral prophylaxis can reduce breast milk HIV transmission in early infancy, there are no clear feeding guidelines for after 6 months. There is a need for acceptable, feasible, affordable, sustainable and safe (AFASS by WHO terminology) foods for both HIV-exposed and unexposed children after 6 months of age. METHODS AND FINDINGS: We conducted in Lusaka, Zambia, a randomised double-blind trial of two locally made infant foods: porridges made of flour composed of maize, beans, bambaranuts and groundnuts. One flour contained a basal and the other a rich level of micronutrient fortification. Infants (n = 743) aged 6 months were randomised to receive either regime for 12 months. The primary outcome was stunting (length-for-age Z

Published
2010

6. Consumer acceptance of provitamin A orange maize in rural Zambia

Author

Meenakshi, J. V., Banerji, A., Manyong, Victor, Tomlins, Keith, Hamukwala, Priscilla, Zulu, Rodah, and Mungoma, Catherine

Subjects
maize, willingness to pay, consumer acceptance
Abstract

This study analyzes consumer acceptance of biofortified orange maize in rural Zambia by eliciting consumers' willingness to pay. It attempts to examine the impact of nutrition information, comparing the use of simulated radio versus community leaders in transmitting the nutrition message, on consumer acceptance. Finally, it assesses whether product experience in a home-use setting influences the magnitude of premiums or discounts. The results suggest that (a) the negative perception of yellow maize does not affect orange maize which is well liked, (b) there is a premium for orange maize with nutrition information, (c) the mode of nutritional-message dissemination does not have a large impact on consumer acceptance, and (d) product experience does not translate into lower willingness to pay for orange maize.

Published
2010

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