Effect of multivitamin supplementation on the neurodevelopment of HIV-exposed Tanzanian infants: a randomized, double-blind, placebo-controlled clinical trial

Karim P Manji; Christine M McDonald; Roland Kupka; Ronald J Bosch; Rodrick Kisenge; Said Aboud; David C Bellinger; Wafaie W Fawzi; Christopher P Duggan

doi:10.1093/tropej/fmu011

Effect of multivitamin supplementation on the neurodevelopment of HIV-exposed Tanzanian infants: a randomized, double-blind, placebo-controlled clinical trial

J Trop Pediatr. 2014 Aug;60(4):279-86. doi: 10.1093/tropej/fmu011. Epub 2014 Feb 24.

Authors

Karim P Manji¹, Christine M McDonald², Roland Kupka³, Ronald J Bosch⁴, Rodrick Kisenge⁵, Said Aboud⁶, David C Bellinger⁷, Wafaie W Fawzi⁸, Christopher P Duggan⁹

Affiliations

¹ Department of Pediatrics and Child Health, Muhimbili University of Health and Allied Sciences, Upanga, Dar es Salaam, Tanzania*Karim P. Manji and Christine M. McDonald are joint first authors.
² Division of Gastroenterology, Hepatology and Nutrition, Boston Hospital, Boston, MA 02115, USA*Karim P. Manji and Christine M. McDonald are joint first authors.
³ UNICEF West and Central Africa Regional Office, Immeuble Maimouna III, Yoff, Dakar, SenegalDepartment of Nutrition, Harvard School of Public Health, Boston, MA 02115, USA.
⁴ Department of Biostatistics, Harvard School of Public Health, Boston, MA 02115, USA.
⁵ Department of Pediatrics and Child Health, Muhimbili University of Health and Allied Sciences, Upanga, Dar es Salaam, Tanzania.
⁶ Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, Upanga, Dar es Salaam, Tanzania.
⁷ Department of Neurology, Boston Children's Hospital, Boston, MA 02115, USADepartment of Environmental Health, Harvard School of Public Health, Boston, MA 02115, USA.
⁸ Department of Nutrition, Harvard School of Public Health, Boston, MA 02115, USADepartment of Global Health and Population, Harvard School of Public Health, Boston, MA 02115, USADepartment of Epidemiology, Harvard School of Public Health, Boston, MA 02115, USA.
⁹ Division of Gastroenterology, Hepatology and Nutrition, Boston Hospital, Boston, MA 02115, USADepartment of Nutrition, Harvard School of Public Health, Boston, MA 02115, USA [email protected].

Abstract

Background: Micronutrient deficiencies and in utero exposure to HIV may impair infant neurodevelopment.

Objective: To evaluate the effect of daily multivitamin supplementation on the cognitive, language and motor development of HIV-exposed Tanzanian infants.

Methods: A total of 2387 infants were randomized to receive daily oral supplementation of multivitamins (B-complex, C and E) or placebo from age 6 weeks for 24 months. The cognitive, language and motor scales of the Bayley Scales of Infant and Toddler Development, third edition, were administered to a subset of 206 infants at age 15 months.

Results: Multivitamin supplementation did not improve measures of cognitive development, expressive or receptive language or gross motor capabilities. There was a trend toward improved fine motor skills among infants randomized to the multivitamin group (difference in mean score = 0.38; 95% CI = -0.01, 0.78, p = 0.06).

Conclusion: Daily provision of multivitamins to HIV-exposed infants does not substantially improve developmental outcomes at age 15 months.

Keywords: HIV; Multivitamins; infant development.

Publication types

Randomized Controlled Trial
Research Support, N.I.H., Extramural

MeSH terms

Child Development / drug effects*
Cognition
Dietary Supplements*
Double-Blind Method
Female
HIV Infections / complications
HIV Infections / transmission*
Humans
Infant
Infectious Disease Transmission, Vertical*
Language Development
Male
Motor Skills
Nervous System / drug effects*
Nervous System / growth & development
Pregnancy
Pregnancy Complications, Infectious / virology
Treatment Outcome
Vitamins / administration & dosage*

Substances

Vitamins

Abstract

Publication types

MeSH terms

Substances

Grants and funding