Macronutrient and energy composition of breastmilk of HIV-infected mothers receiving ARVs in the Nelson Mandela Bay area

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dc.contributor.advisorvan Niekerk, Evetteen_ZA
dc.contributor.advisorSteenkamp, Lianaen_ZA
dc.contributor.authorKoen, Leandrien_ZA
dc.contributor.otherStellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Global Health. Human Nutrition.en_ZA
dc.date.accessioned2022-11-23T11:39:34Z
dc.date.accessioned2023-01-23T06:53:48Z
dc.date.available2022-11-23T11:39:34Z
dc.date.issued2022-12
dc.descriptionThesis (MNutr)--Stellenbosch University, 2022.en_ZA
dc.description.abstractENGLISH SUMMARY: Inadequate nutrition in early life can have a detrimental effect on an infant’s growth and development. South Africa remains the epicentre of HIV and has low exclusive breastfeeding rates, increasing the risk of malnutrition for infants living in South Africa. While antiretroviral medication (ARVs) is recommended for HIV-positive pregnant and breastfeeding mothers to prevent mother-to-child transmission (MTCT), limited information is available on the macronutrient composition of the breastmilk of mothers on ARVs. Aim and objectives: The principle aim of this study was to assess the macronutrient composition of breastmilk from HIV-positive mothers receiving ARV treatment. Method: The researcher conducted a quantitative study using a descriptive, cross-sectional approach, which included HIV-positive mothers (n = 45) on ARVs. Anthropometrical data, a questionnaire and breastmilk samples were collected from the mothers on day 3 (± 2 days; n = 45) and day 14 (± 2 days; n = 37) of the infant’s life. The macronutrients (carbohydrates, fat, and true protein) and energy of the breastmilk were analysed using the Miris Human Milk Analyzer (mid-infrared spectroscopy). Stellenbosch University’s Division of Epidemiology and Biostatistics generated the statistics using Stata 17 software for the analysis. A one-sample t-test was used to report the inferential (numerical) data. The Pearson correlation test was used to determine whether a relationship existed between the variables and the macronutrients in the milk. Ethical approval was granted by the Stellenbosch University Health Research Ethics Committee (S20/10/280) and the Committee of the Eastern Cape (ec_202102_015). Clinic managers functioned as gatekeepers at each of the clinics. Results: The participants were mostly single (n = 38; 84.4%), unemployed (n = 30; 66.7%) with a monthly income of less than R500 (n = 32; 71.1%), and mostly dependent on government grants (n = 30; 66.7%). Most participants lived in a free-standing house (n = 41; 91.1%) where only one or no adults were working (n = 23; 56.1%). The mean maternal postpartum body mass index (BMI) was in the overweight category (29.84 kg/m2 ± 6.17). The macronutrient and energy content per 100 ml of colostrum from HIV-positive mothers was: protein = 2.22 g (± 0.786), fat = 3.39 g (± 1.809), carbohydrates (CHO) = 7.43 g (± 3.441), and energy = 69.20 kcal (± 20.89). The results for mature HIV-positive milk per 100 ml were: protein = 2.11 g (± 1.016), fat = 4.55 g (± 2.111), CHO = 7.322 g (± 1.92) and energy = 79.357 kJ (± 21.131). All the macronutrients and energy values from the study exceeded the values presented in the literature for breastmilk from HIV-negative mothers. Although a relationship exists between the variables, it may not be of clinical importance and could be spurious. Conclusion: All macronutrients in breastmilk from HIV-positive mothers are elevated compared to HIV-negative mothers.en_ZA
dc.description.abstractAFRIKAANSE OPSOMMING: Inleiding Onvoldoende voeding in die vroee lewensfase kan ʼn nadelige uitwerking op ʼn baba se groei en ontwikkeling he. Suid-Afrika bly die episentrum van menslike immuniteitsgebrekvirus (MIV), en het lae eksklusiewe borsvoedingsyfers, wat die risiko vir wanvoeding verhoog vir babas wat in Suid-Afrika woon. Terwyl antiretrovirale (ARV’s) aanbeveel word vir MIV-positiewe swanger en borsvoedende moeders om die oordrag van MIV van moeder tot baba te voorkom, is beperkte inligting beskikbaar oor die makronutrientsamestelling van die borsmelk van moeders op ARV’s. Doelwitte: Die hoofdoel van hierdie studie was om die makronutrientsamestelling van borsmelk van MIV-positiewe moeders wat ARV’s ontvang, te bepaal. Metode: Die navorser het ʼn kwantitatiewe studie uitgevoer met behulp van ʼn beskrywende, deursnit benadering wat MIV-positiewe moeders (n = 45) op ARV’s ingesluit het. Antropometriese data, ʼn vraelys en borsmelkmonsters is van die moeders op dag 3 (± 2 dae; n = 45) en dag 14 (± 2 dae; n = 37) van die baba se lewe ingesamel. Die makronutriente (koolhidrate, vet en proteiene) en energie van die borsmelk is ontleed met behulp van die Miris menslike melk analiseerder (d.m.v. mid-infrarooi spektroskopie). Die statistiek is deur die Afdeling van Epidemiologie en Biostatistiek by Stellenbosch Universiteit verwerk en Stata 17 sagteware is vir die ontleding gebruik. 'n Een-steekproef t-toets is gebruik om die inferensiele (numeriese) data te rapporteer. Die Pearson-korrelasietoets is gebruik om te bepaal of 'n verband tussen die veranderlikes en die makrovoedingstowwe in die melk bestaan het met statistiese betekenisvolheid by P < 0.05. Etiese goedkeuring is verleen deur die Gesondheidsnavorsingsetiekkomitee van die Universiteit Stellenbosch (S20/10/280) en die Komitee van die Oos-Kaap (ec_202102_015). Kliniekbestuurders het as kontroleerders by elk van die klinieke opgetree. Resultate: Die studiedeelnemers was meestal enkellopend (n = 38; 84.4%), werkloos (n = 30; 66.7%), het ʼn maandelikse inkomste van minder as R500 gehad (n = 32; 71.1%) en was meestal afhanklik van staatstoelae (n = 30; 66.7%). Die meeste deelnemers het in ʼn vrystaande huis gewoon (n = 41; 91.1%) waar slegs een of geen volwassenes gewerk het (n = 23; 56.1%). Die gemiddelde liggaamsmassa indeks (LMI) na geboorte was as oorgewig geklassifiseer (29.84 kg/m2; ± 6.17). Die makronutrient- en energie-inhoud per 100 ml kolostrum vanaf MIV-positiewe moeders was soos volg: proteiene 2.22 g (± 0.786), vet 3.39g (± 1.809), koolhidrate (CHO) 7.43 g (± 3.441) en energie 69.20 kJ (± 20.89). Die resultate vir volwasse MIV-positiewe melk per 100 ml was: proteiene = 2.11g (± 1.016), vet 4.55 (± 2.111), CHO 7.322 g (± 1.92) en energie 79.357 kJ (± 21.131). Al die makronutriente en energiewaardes van die studie het die waardes wat in literatuur aangeteken is vir MIV-negatiewe melk oorskry. Sommige verwantskappe tussen die veranderlikes bestaan, maar hulle is waarskynlik nie van kliniese belang nie en kan moontlik per toeval wees. Gevolgtrekking: In hierdie studie omgewing was alle makronutriente in borsmelk van MIV-positiewe moeders verhoog in vergelyking met MIV-negatiewe moeders.af_ZA
dc.description.versionMasters
dc.embargo.lift2023-12-01
dc.embargo.terms2023-12-01
dc.format.extentxii, 107 pages : illustrations, includes annexures
dc.identifier.urihttp://hdl.handle.net/10019.1/126356
dc.language.isoen_ZAen_ZA
dc.publisherStellenbosch : Stellenbosch University
dc.rights.holderStellenbosch University
dc.subject.lcshAIDS (Disease) in pregnancyen_ZA
dc.subject.lcshCommunicable diseases in children -- Preventionen_ZA
dc.subject.lcshHIV infections -- Transmissionen_ZA
dc.subject.lcshHIV infections -- Children -- Transmission -- Preventionen_ZA
dc.subject.lcshMother and child -- Transmissionen_ZA
dc.subject.nameUCTD
dc.titleMacronutrient and energy composition of breastmilk of HIV-infected mothers receiving ARVs in the Nelson Mandela Bay areaen_ZA
dc.typeThesisen_ZA
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Masters Degrees (Human Nutrition)