EXCLUSIVE BREASTFEEDING AND REPKACEMNT FEEDING ONMORBIDITYAND MORTALITY IN HIV EXPOSED INFANTS AT ONE YEAR AGE IN TIKUR ANBESSA SPECIALIZED HOSPITAL.

Abstract

Background: Infant feeding in the context of HIV is complex because of the major influence that feeding practices and nutrition have on child survival. The dilemma has been to balance the risk of infants being exposed to HIV through breastfeeding with the risk of death from causes other than HIV if infants are not breastfed.
Objective: To compare the effects of exclusive breast feeding (EBF) and exclusive replacement feeding (ERF) on morbidity and mortality in HIV exposed infants at one years of age at Tikur Anbessa Specialized Hospital from 2007 to 2010.
Material and methods: A retrospective cross sectional study was conducted at Tikur Anbessa Hospital ,pediatric infectious disease clinic on all infants who were exposed to HIV and having a follow up from 2007 to 2010 and 116 infants qualify the inclusion criteria. The data was collected from exposed infant follow up chart and examined for the following variables: Infant feeding option, the prevalence of malnutrition, incidence of diarrheal disease, risk of HIV transmission. The data was cleaned and compiled and analyzed using SPSS version 17.The results was expressed in description, rate and tables and then interpreted, analyzed and association was made for different dependent and independent variables.
Result: A total of116 HIV exposed infants were included in the study. The male to female ratio was 0.78 and the mean age of enrollment to the care was 1.8 months. The maternal PMTCT coverage was 32.7% and neonatal PMTCT coverage was 85.3%, neonatal PMTCT coverage was associated with decreased risk of HIV infection at one year. The prevalence of exclusive breast feeding (EBF) and exclusive replacement feeding (ERF) was 56% and 44% respectively. The mean diarrheal incidence was 3.54 per child per year and ERF was shown to have increased risk of diarrheal episode. Prevalence of marasmus and underweight at one year of ager was found to be 10.3% and 27.6 % respectively. The risk of HIV infection at the age of one was 12.2%.and it was not associated with the method of feeding.
Conclusion and recommendation
As recommended by most of the studies in developing countries and WHO , our study has also shown high incidence of diarrhea in exclusively replacement feed infants and comparable cumulative HIV prevalence at one year in both options of infant feeding in the context of HIV exposure, thus It is imperative to conclude that exclusive replacement feeding is associated with high prevalence of diarrheal disease at one year . However it’s the conviction if the authors that if AFASS is fulfilled the option could be given to the mother for exclusive replacement feeding.