ASSOCIATION BETWEEN CARRIAGE OF ORAL YEASTS, MALNUTRITION AND HIV-1 INFECTION AMONG TANZANIAN CHILDREN AGED 18 MONTHS TO 5 YEARS

The objective was to determine whether there is an association between carriage of oral yeasts, malnutrition and HIV-1 infection among Tanza nian children. A case-control study design within a cross-sectional st udy was used, and the outcome was carriage of oral yeasts. The exposur e variables were malnutrition and HIV-1 antibody, and confounders to b e adjusted for were age, sex, and breastfeeding. The study was carried out in Dar-es-Salaam, Tanzania, in two maternal and child health (MCH ) clinics that offer routine medical checkups to all expectant mothers and children aged between 0 and 5 years in the catchment area. A tota l of 882 children aged between 18 months and 5 years participated. Sme ars from the tongue and buccal mucosa were examined for oral yeasts. M alnutrition was categorized according to standards on the MCH chart an d World Health Organization/Centers for Disease Control (WHO/CDC) stan dards as weight-for-height (wasted), weight-for-age (underweight), and height-for-age (stunted), HIV-1 infection was determined by an enzyme -linked immunosorbent assay. Reactive sera were confirmed by Western B lot. About 27% of the children were slightly or severely malnourished according to standards on the MCH chart. According to WHO/CDC standard s, 2.6% were wasted, 16.3% were underweight, and 29.6% were stunted, F ourteen (1.6%) were seropositive for HIV-1 antibody. Hyphal forms and blastospores were much more frequent among children infected with HIV- 1 with odds ratios ranging from 3.8 (95% CI: 1.3;11.2) to 6.2 (95% CI: 2.1;18.4) depending on categorization of malnutrition. Malnutrition w as a risk factor, too, albeit to a much lesser and insignificant degre e. The study supports our previous findings that malnutrition may pred ispose to carriage of oral yeasts and subsequent infection. However, i n this study population HIV infection was clearly the predominant risk factor.