A Model-Based Study on Nutritional Feeding Strategies and Health Outcomes for Infants of HIV-Affected Mothers in the Democratic Republic of Congo
Keywords:
HIV transmission, infant feeding strategies, exclusive breastfeeding, nutritional outcomesAbstract
Infant feeding practices among HIV-affected populations represent a complex intersection of nutritional adequacy, infection risk, and socio-economic constraints. This study develops a model-based analytical framework to evaluate nutritional feeding strategies and their associated health outcomes for infants born to HIV-positive mothers in the Democratic Republic of Congo (DRC). Drawing exclusively on existing empirical and clinical literature, the research synthesizes evidence on breastfeeding, mixed feeding, and formula feeding under varying healthcare conditions and antiretroviral therapy (ART) coverage. A conceptual model integrating biological transmission pathways, nutritional status indicators, and socio-environmental variables is proposed. The findings highlight that exclusive breastfeeding combined with ART significantly reduces postnatal HIV transmission while optimizing infant survival rates. Conversely, mixed feeding practices increase infection risk and compromise nutritional outcomes. The study identifies systemic gaps in policy implementation, healthcare accessibility, and maternal education, which influence feeding decisions. The model offers a structured basis for optimizing feeding strategies in resource-constrained environments and contributes to policy formulation aimed at reducing HIV transmission and improving child health outcomes in the DRC.
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1. A Ehrnst, R Zetterstr. Vertical transmission of HIV-1 infection and dilemma of infant feeding. Acta Paediatr. 2003 Sep 1; 92(9):990–1.
2. Becquet R, Ekouevi DK, Menan H, Amani-Bosse C, Bequet L, Viho I, et al. Early mixed feeding and breastfeeding beyond 6 months increase the risk of postnatal HIV transmission: ANRS 1201/1202 Ditrame Plus, Abidjan, Côte d’Ivoire. Prev Med. 2008 Jul; 47(1):27–33.
3. Bispo S, Chikhungu L, Rollins N, Siegfried N, Newell M-L. Postnatal HIV transmission in breastfed infants of HIVinfected women on ART: a systematic review and meta-analysis. J Int AIDS Soc. 2017; 20(1):21251.
4. Bland R, Rollins N, Coutsoudis A, Coovadia H, for the Child Health Group. Breastfeeding practices in an area of high HIV prevalence in rural South Africa. Acta Paediatr. 2007 Jan 2; 91(6):704–11.
5. Castetbon K, Leroy V, Spira R, Dabis F. [Preventing the transmission of HIV-1 from mother to child in Africa in the year 2000]. Sante Montrouge Fr. 2000 Apr; 10(2):103–13.
6. Collen D, de Maeyer L. Molecular biology of human plasminogen. I. Physiochemical properties and micro heterogeneity. Thromb Diath Haemorrh. 1975 Nov 15; 34(2):396–402.
7. Coovadia HM, Rollins NC, Bland RM, Little K, Coutsoudis A, Bennish ML, et al. Mother-to-child transmission of HIV-1 infection during exclusive breastfeeding in the first 6 months of life: an intervention cohort study. The Lancet. 2007 Mar; 369(9567):1107–16.
8. Coulibaly A, Ake Tano O, Bénié Bi Vroh J, Traoré Y, Dagnan NS. Socio-professional factors and practice of exclusive breastfeeding by first-time mothers in Abidjan (Côte d'Ivoire). Public health. 2014; 26(4):555.
9. Coutsoudis A, Pillay K, Spooner E, Coovadia H, Pembrey L, Newell M-L. Morbidity in children born to women infected with human immunodeficiency virus in South Africa: does mode of feeding matter? Acta Paediatr. 2007 Jan 2; 92(8):890–5.
10. Coutsoudis A, Pillay K, Spooner E, Kuhn L, Coovadia HM. Influence of infant-feeding patterns on early mother-tochild transmission of HIV-1 in Durban, South Africa: a prospective cohort study. The Lancet. 1999 Aug; 354(9177):471–6.
11. Davies M-A, Phiri S, Wood R, Wellington M, Cox V, Bolton-Moore C, et al. Temporal Trends in the Characteristics of Children at Antiretroviral Therapy Initiation in Southern Africa: The Ie DEA-SA Collaboration. Beck EJ, editor. PLoS ONE. 2013 Dec 9; 8(12):e81037.
12. Downs JH, Cooper PA. HIV and Breastfeeding maternel. Ann Nestlé Ed Fr. 2007; 65(1):29–38.
13. Effect of breastfeeding on infant and child mortality due to infectious diseases in less developed countries: a pooled analysis. WHO Collaborative Study Team on the Role of Breastfeeding on the Prevention of Infant Mortality. Lancet Lond Engl. 2000 Feb 5; 355(9202):451–5.
14. Heller M, Edelstein P, Mayer M. Membrane-bound enzymes. III. Protease activity in leucocytes in relation to erythrocyte membranes. Biochim Biophys Acta. 1975 Dec 16; 413(3):472–82.
15. Iliff PJ, Piwoz EG, Tavengwa NV, Zunguza CD, Marinda ET, Nathoo KJ, et al. Early exclusive breastfeeding reduces the risk of postnatal HIV-1 transmission and increases HIV-free survival: AIDS. 2005 Apr; 19(7):699–708.
16. John-Stewart G, Mbori-Ngacha D, Ekpini R, Janoff EN, Nkengasong J, Read JS, et al. Breast-feeding and Transmission of HIV-1. J Acquir Immune Defic Syndr 1999. 2004 Feb 1; 35(2):196–202.
17. Magder LS, Mofenson L, Paul ME, Zorrilla CD, Blattner WA, Tuomala RE, et al. Risk factors for in utero and intrapartum transmission of HIV. J Acquir Immune Defic Syndr 1999. 2005 Jan 1; 38(1):87–95.
18. Makar AB, McMartin KE, Palese M, Tephly TR. Formate assay in body fluids: application in methanol poisoning. Biochem Med. 1975 Jun; 13(2):117–26.
19. Mbori-Ngacha D, Nduati R, John G, Reilly M, Richardson B, Mwatha A, et al. Morbidity and mortality in breastfed and formula-fed infants of HIV-1-infected women: A randomized clinical trial. JAMA. 2001 Nov 21; 286(19):2413–20.
20. Muema J, Oyugi J, Bukania Z, Nyamai M, Jost C, Daniel T, et al. Impact of livestock interventions on maternal and child nutrition outcomes in Africa: A systematic review and meta-analysis protocol. AAS Open Res. 2021 Jan 8; 4:1.
21. N JJ, Bongoe A, Agokeng S. Mother-to-child transmission of HIV: findings from an Early Infant Diagnosis program in Bertoua, Eastern Cameroon. Pan Afr Med J. 2013; 15.
22. Ngwej DT, Mukuku O, Mudekereza R, Karaj E, Fwamba EB, Luboya ON, et al. Study of risk factors for mother-tochild transmission of HIV in the "option A" strategy in Lubumbashi, Democratic Republic of Congo. Pan Afr Med J. 2015; 22.
23. Progress for children / carrying out mdos with fairness. Place of publication not identified: United Nations Pubns; 2010.
24. Rossenkhan R, Novitsky V, Sebunya TK, Leidner J, Hagan JE, Moyo S, et al. Infant Feeding Practices were not Associated with Breast Milk HIV-1 RNA Levels in a Randomized Clinical Trial in Botswana. AIDS Behav. 2012 Jul; 16(5):1260–4.
25. Sulek K. [New concepts on the pathogenesis of atherosclerosis and its practical aspects]. Wiadomosci Lek Wars Pol 1960. 1976 Apr 15; 29(8):715–7.
26. The Breastfeeding and HIV International Transmission Study Group. Late Postnatal Transmission of HIV‐1 in Breast‐Fed Children: An Individual Patient Data Meta‐Analysis. J Infect Dis. 2004 Jun 15; 189(12):2154–66.
27. Weltgesundheitsorganisation, editor. Global Strategy for Infant and Young Child Feeding. Genève; 2003. 30 p.
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