Nasopharyngeal colonization precedes invasive pneumococcal disease. HIV infection increases rates of invasive disease; its effect on colonization is unknown. In a longitudinal cohort of ...HIV-positive/negative Zambian mothers, HIV increased the risk of colonization (RR 1.9, 95% CI 1.3–2.8) and repeated colonizations (RR 2.4, 95% CI 1.1–5.3), and reduced time to new colonization (p=0.01). Repeated colonizations with homologous sero/factor-types occurred only among HIV-positive mothers. Pediatric serotypes 6, 19 and 23 accounted for the excess colonization in the HIV-positive mothers. HIV significantly increases the risk of pneumococcal colonization. Increased colonization by pediatric serotypes suggests a potential role for the 7-valent pneumococcal vaccine.
The prevalence of stunting in preschool children in Zambia is high; stunting has detrimental effects on concurrent psychomotor development and later working capacity.
Our objective was to investigate ...biological variables that may contribute to linear growth retardation in preschool children in Samfya District, Zambia.
Children aged 6-9 mo (n = 108) and 14-20 mo (n = 102) attending mother-and-child health clinics were included. With a mixed-longitudinal design, they were followed up 9 and 21 mo later. Height and weight of children and their mothers were measured. Biochemical measures (eg, serum zinc, retinol, thyrotropin, iron, and acute phase protein concentrations), malaria parasitemia, and intestinal parasitosis were assessed.
Height-for-age z scores (HAZ) were low, indicating a high prevalence of stunting (36-79%). Ninety percent of the children were anemic, 53-71% had elevated acute phase proteins, and 80% had malaria parasitemia. Regression analyses showed that maternal height predicted the children's height at 6-9 mo (regression coefficient = 0.05; 95% CI: 0.02, 0.08). The children's height at an early age (6-9 and 14-20 mo) showed a strong relation with their height at later ages (22-30 and 34-41 mo). Serum micronutrient status did not show a significant relation with later HAZ.
Unlike other studies, we did not identify specific biological factors, such as health and micronutrient status, which contribute to the retardation of linear growth. The normal zinc and iodine statuses of the children suggest that at least these factors are not causal.
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