Original Communication
European Journal of Clinical Nutrition (2005) 59, 1250–1258. doi:10.1038/sj.ejcn.1602236; published online 13 July 2005
Selenium levels in relation to morbidity and mortality among children born to HIV-infected mothers
Guarantor: R Kupka.
Contributors: RK analyzed and interpreted the data and wrote the initial draft of the manuscript. GIM and WWF are principal investigators of the Tanzania Vitamin Supplementation Trial and contributed to the study design and its implementation. DS provided statistical guidance in data analyses. NR conducted the nutrient analyses. DJH assisted in the design of the Tanzania Vitamin Supplementation Trial and in data interpretation. All coauthors participated in manuscript preparation.
R Kupka1,2, G I Msamanga4, D Spiegelman2,3, N Rifai5,6, D J Hunter1,2 and W W Fawzi1,2
- 1Department of Nutrition, Harvard School of Public Health, Boston, MA, USA
- 2Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA
- 3Department of Biostatistics, Harvard School of Public Health, Boston, MA, USA
- 4Department of Community Health, Muhimbili University College of Health Sciences, Dar es Salaam, Tanzania
- 5Department of Laboratory Medicine, Children's Hospital, Boston, MA, USA
- 6Department of Pathology, Harvard Medical School, Boston, MA, USA
Correspondence: R Kupka, Department of Nutrition, Harvard School of Public Health, 665 Huntington Ave., Boston, MA 02115, USA. E-mail: rkupka@post.harvard.edu
Received 27 October 2004; Revised 26 April 2005; Accepted 25 May 2005; Published online 13 July 2005.
Abstract
Objective:
To examine the relation between selenium status and child mortality and morbidity among children born to HIV-infected mothers.
Design:
Prospective cohort study.
Methods:
Study participants were originally part of a trial to study the effect of maternal vitamin supplements on maternal and child health outcomes. Morbidity information was collected during monthly clinic visits until the child reached 24 months of age. Out of 984 livebirths, 806 had morbidity information, and 610 also had data on plasma selenium levels available.
Setting:
A study clinic at Muhimbili National Hospital, Dar es Salaam, Tanzania, a tertiary-care hospital.
Results:
The median age at baseline was 10.5 weeks. A total of 117 (19%) of the 610 study children died during follow-up. In a multivariate model, child plasma selenium levels were inversely associated with risk of all-cause mortality (P-value, test for trend=0.05). Plasma selenium levels were not significantly associated with risk of diarrhea or respiratory outcomes.
Conclusions:
Among infants born to HIV-infected women in sub-Saharan Africa, selenium status may be important to prevent child mortality. These preliminary findings warrant future reexamination.
Sponsorship:
This study was supported by the National Institute of Health and Human Development (NICHD R01 32257), and the Fogarty International Center (NIH D43 TW00004).
Keywords:
selenium, HIV disease, infant mortality, diarrhea, pneumonia
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