effets de l'allaitement maternel sur la morbidité et le profil de croissance des nourrissons exposés au VIH in utero et non infectés à yaoundé, cameroun

Abstract

In a context where breastfeeding is considered to be the safest option for infants, the World Health Organization (WHO) recommends that mothers living with the human immunodeficiency virus (HIV) should breastfeed their children exclusively for the first six months and continue breastfeeding for at least 12 months while introducing complementary foods. Breastfeeding for the first six months reduces the risk of HIV transmission compared with mixed breastfeeding, and infants exposed to HIV who are not breastfed are more likely to suffer or die from diarrheal diseases, pneumonia and malnutrition. Based on these findings, our study aimed to determine the effects of breastfeeding on the growth and morbidity of these exposed HIV-exposed uninfected infants (HEU) during the first year of life. To do this, we included in this study (nested study) 130 pregnant women recruited in the 3rd trimester of pregnancy and their infants (76 HEU and 55 HIV- uninfected unexposed infants (HUU)) according to whether or not they had been exclusively breastfed during the first six months of life. Dietary and anthropometric data were collected at birth, 6 and 12 months. We then diagnosed malaria, rotavirus, cytomegalovirus (CMV), rhinovirus, respiratory syncytial virus (RSV) and influenza A and B viruses by quantitative polymerase chain reaction (PCR) at months 6 and 12 in these infants. From our results, we found no significant association between feeding style and the occurrence of these childhood infections in infants. However, at 6 months, 22.37% of breastfed HEU showed infectious symptoms compared with 59.21% of non-breastfed HEU (p-value 0.0086) and 20% compared with 45.45% of breastfed and non-breastfed HUU. The most recurrent were influenza and cough. On the other hand, we obtained a significant association between the breastfeeding mode during the first 6 months of life and the appearance of nutritional problems for breastfed and non-breastfed HEU (p-value 0.0115) at the 12th month. That is, 5% versus 7% overweight (WHZ>+2SD), 0% versus 5.26% obese (WLZ>+3SD), 9. 21% versus 15. 79% stunted (LAZ<-2 SD), 0% versus 10.53% wasted (WLZ<- 2 SD) and 0% versus 9.21% underweight (WAZ<-2 SD). Our study suggests an association between not being exclusively breastfed for the first 6 months of life and a higher risk of stunting and morbidity due to symptoms reported in HEU infants in Cameroon during the 1st year of life.