Browsing by Author "Nyofane, Mothusi"

Now showing 1 - 2 of 2
  • Thumbnail Image
    ItemOpen Access
    Growth and neurodevelopmental outcomes of children with in utero growth restriction due to placental insufficiency and modification by maternal HIV status
    (University of Pretoria, 2024) Nyofane, Mothusi
    Background: South Africa is burdened with a high prevalence of HIV infection in pregnant women (30.0%). Nevertheless, access to antiretroviral therapy (ART) has greatly increased, leading to an expanding population of HIV-exposed-uninfected children (CHEU). Adverse birth outcomes, including intrauterine growth restriction (IUGR), have been documented in women living with HIV, even when on ART. Child HIV exposure, anaemia and IUGR due to placental insufficiency carry significant risks to early child growth and neurodevelopment. This study determined and compared growth and neurodevelopmental outcomes, micronutrient intakes, and anaemia in CHEU compared to a control group of HIV-unexposed-uninfected children (CHUU) stratified by history of placental insufficiency. Methods: An abnormal umbilical artery resistance index (UmA-RI) on pregnancy Doppler ultrasound was used to detect placental insufficiency as a proxy for IUGR. The cross-sectional study investigated 271 mother-child pairs at 18-months postnatal, grouped into four subgroups: CHUU with normal UmA-RI (CHUU/N-RI; control group), CHEU with normal UmA-RI (CHEU/N-RI; single exposure), CHUU with abnormal UmA-RI (CHUU/AbN-RI; single exposure) and CHEU with abnormal UmA-RI (CHEU/AbN-RI; double exposure). Pregnancy and birth information was available. World Health Organisation standard procedures werefollowed to collect anthropometric data and compute z-scores. International Guide for Monitoring Child Development (GMCD) was used for developmental screening, and Bayley Scale of Infant and Toddler Development III (Bayley-III) was used to test for cognitive, language and motor development. Premature births were corrected for gestational age. Previously used questionnaires and quantified 24-hour dietary recall were used to collect sociodemographic variables and dietary intake. FoodFinder™ 3.0 was used for meal analysis, quantifying dietary intake of iron, zinc, and iodine. Both maternal and children's haemoglobin concentrations were tested using HemoCue® Hb 201+. Comparisons were performed usingindependent t-test and Mann-Whitney U test. Spearman’s correlation and regression models were used to determine associations. Results: Lower length-for-age z-scores (LAZ) were observed in CHEU than CHUU (-0.71±1.23 vs -0.05±1.32; p=0.004), and children who had abnormal UmA-RI than normal counterparts (-0.68±1.53 vs -0.14±1.29; p<0.001). CHEU/AbN-RI had the lowest LAZ compared to CHUU/N-RI (-1.3±1.3 vs -0.03±1.30; p<0.001). The prevalence of stunting (LAZ <-2) was higher in CHEU/AbN-RI (40.0%) and CHEU/N-RI (16.0%) than in CHUU/N-RI (4.8%); p<0.001 and p=0.016, respectively. GMCD screening indicated a concern for delay in gross motor development among 21.4% of CHEU/AbN-RI. Bayley-III test demonstrated lower mean cognitive scores in CHEU/AbN-RI compared to CHUU/N-RI: 93.9±12.9 vs 100.0±10.6; p=0.045, with 21.4% of CHEU/AbN-RI having mild delay in cognitive development. Further, zinc intake and weight-for-age z-scores were positively associated with language (r=0.10; p=0.042) and motor (r=0.10; p=0.028) development, respectively. Above one-third of children were mildly anaemic: CHUU/N-RI: 44.4%, CHEU/N-RI: 44.7%, CHUU/AbN-RI: 40.0% and CHEU/AbN-RI: 33.3%. In the CHEU group, maternal haemoglobin concentrations werassociated with child haemoglobin concentrations: β=0.19, 95% confidence interval (CI) (0.02,0.36); p=0.028. There was no evidence to suggest an association between maternal or child haemoglobin concentration and child neurodevelopment. On further analysis cognitive development was positively associated with LAZ: β=3.34, 95%CI (1.13,5.54), P=0.004 in the CHEU group. Conclusion: Maternal HIV exposure and placental insufficiency are risk factors for stunting and cognitive deficits, both independently and compounded. CHEU and children who had IUGR are a high-risk population in need of identification and appropriate interventions within child health and nutrition-sensitive programmes. Childhood anaemia remains a paramount public health concern.
  • Thumbnail Image
    ItemOpen Access
    Growth parameters and food frequently consumed by Basotho children aged 6–24 months old at Maseru and Leribe districts of Lesotho:
    (John Wiley & Sons, 2024-07-12) Nyofane, Mothusi; Rapotsane, Malebusa; Moshao, Mohlotsane
    Undernutrition in children remains a public health concern. Despite the global efforts to address undernutrition, Lesotho continues to bear the highest burden of childhood undernutrition. The study assessed the anthropometric measurements and dietary intake of children aged 6–24 months. A descriptive cross‐sectional study was conducted among 113 mother–child dyads attending clinic visits at Makoanyane Military Hospital (Maseru district); n = 50 and Motebang Hospital (Leribe district); n = 63. A structured sociodemographic and feeding practices questionnaires based on adapted World Health Orga- nization (WHO) questionnaires were used. The usual food consumption was collected using an unquantified food frequency questionnaire. Anthropo- metric measurements and z scores computation were done as per WHO standard guidelines. Statistics included percentages for categorical variables and means for continuous variables. The percentage of continued breast- feeding was 54.0% in Maseru and 28.6% in Leribe districts. Complementary feeds were introduced at the mean age of 5.3 � 1.0 (Maseru) and 5.2 � 1.3 months (Leribe). In Leribe, 84.1% of children were consuming maize porridge every day while in Maseru, 68.0% of children were consuming commercial baby cereal every day. The prevalence of wasting was 10.0% (Maseru) and 20.6% with 14.3% of severe wasting (Leribe). A higher per- centage of stunting was observed in Leribe (36.5%) than in Maseru (20.0%) (p < 0.001). The prevalence of moderate and severe stunting was 8.0% and 12.0% in Maseru and 20.6% and 15.9% in Leribe, respectively. The prevalence of stunting is alarmingly high in Leribe. The findings suggest an urgent need to strengthen maternal and child health and nutrition programs to ameliorate feeding practices and nutritional status