Mary Glenn Fowler1, Colleen Hanrahan2, Nonhlanhla Yende3, Lynda Stranix-Chibanda4, Tsungai Chipato5, Limbika Maliwichi6, Luis Gadama6, Jim Aizire2, Sufia Dadabhai2, Lameck Chinula7, Lillian Wambuzi-Owang8, Maxensia Owor8, Avy Violari9, Mandisa Nyati9, Sherika Hanley10, Vani Govender10, Sean Brummel11, Taha Taha2. 1. Department of Pathology, The Johns Hopkins University School of Medicine. 2. Department of Epidemiology, the Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA. 3. Centre for the AIDS Program of Research in South Africa (CAPRISA), Durban South Africa. 4. Department of Paediatrics and Child Health. 5. Department of Obstetrics/Gynaecology, College of Health Sciences University of Zimbabwe, Harare, Zimbabwe. 6. Johns Hopkins Project, University of Malawi College of Medicine, Blantyre, Malawi. 7. University of North Carolina-Lilongwe, Lilongwe, Malawi. 8. Makerere University-Johns Hopkins University (MU-JHU) Research Collaboration, Kampala, Uganda. 9. Perinatal HIV Research Unit (PHRU), Johannesburg. 10. CAPRISA - Umlazi Clinical Research Site, Nelson R. Mandela School of Medicine, Durban, South Africa. 11. Center for Biostatistics AIDS Research, T. H. Chen School of Public Health, Harvard University, Boston, Massachusetts, USA.
Abstract
OBJECTIVE: Given the roll out of maternal antiretroviral therapy (ART) for prevention-of-perinatal-HIV-transmission, increasing numbers of children are perinatally HIV/antiretroviral exposed but uninfected (CAHEU). Some studies suggest CAHEU may be at increased risk for neurodevelopmental (ND) deficits. We aimed to assess ND performance among preschool CAHEU. DESIGN: This cross-sectional study assessed ND outcomes among 3-6-year-old CAHEU at entry into a multicountry cohort study. METHODS: We used the Mullen Scales of Early Learning (MSEL) and Kaufman Assessment Battery for Children (KABC-II) to assess ND status among 3-6-year-old CAHEU at entry into the PROMISE Ongoing Treatment Evaluation (PROMOTE) study conducted in Uganda, Malawi, Zimbabwe and South Africa. Statistical analyses (Stata 16.1) was used to generate group means for ND composite scores and subscale scores, compared to standardized test score means. We used multivariable analysis to adjust for known developmental risk factors including maternal clinical/socioeconomic variables, child sex, growth-for-age measurements, and country. RESULTS: 1647 children aged 3-6 years had baseline ND testing in PROMOTE; group-mean unadjusted Cognitive Composite scores on the MSEL were 85.8 (standard deviation [SD]: 18.2) and KABC-II were 79.5 (SD: 13.2). Composite score group-mean differences were noted by country, with South African and Zimbabwean children having higher scores. In KABC-II multivariable analyses, maternal age >40 years, lower education, male sex, and stunting were associated with lower composite scores. CONCLUSIONS: Among a large cohort of 3-6 year old CAHEU from eastern/southern Africa, group-mean composite ND scores averaged within the low-normal range; with differences noted by country, maternal clinical and socioeconomic factors.
OBJECTIVE: Given the roll out of maternal antiretroviral therapy (ART) for prevention-of-perinatal-HIV-transmission, increasing numbers of children are perinatally HIV/antiretroviral exposed but uninfected (CAHEU). Some studies suggest CAHEU may be at increased risk for neurodevelopmental (ND) deficits. We aimed to assess ND performance among preschool CAHEU. DESIGN: This cross-sectional study assessed ND outcomes among 3-6-year-old CAHEU at entry into a multicountry cohort study. METHODS: We used the Mullen Scales of Early Learning (MSEL) and Kaufman Assessment Battery for Children (KABC-II) to assess ND status among 3-6-year-old CAHEU at entry into the PROMISE Ongoing Treatment Evaluation (PROMOTE) study conducted in Uganda, Malawi, Zimbabwe and South Africa. Statistical analyses (Stata 16.1) was used to generate group means for ND composite scores and subscale scores, compared to standardized test score means. We used multivariable analysis to adjust for known developmental risk factors including maternal clinical/socioeconomic variables, child sex, growth-for-age measurements, and country. RESULTS: 1647 children aged 3-6 years had baseline ND testing in PROMOTE; group-mean unadjusted Cognitive Composite scores on the MSEL were 85.8 (standard deviation [SD]: 18.2) and KABC-II were 79.5 (SD: 13.2). Composite score group-mean differences were noted by country, with South African and Zimbabwean children having higher scores. In KABC-II multivariable analyses, maternal age >40 years, lower education, male sex, and stunting were associated with lower composite scores. CONCLUSIONS: Among a large cohort of 3-6 year old CAHEU from eastern/southern Africa, group-mean composite ND scores averaged within the low-normal range; with differences noted by country, maternal clinical and socioeconomic factors.
Authors: S Blanche; M Tardieu; P Rustin; A Slama; B Barret; G Firtion; N Ciraru-Vigneron; C Lacroix; C Rouzioux; L Mandelbrot; I Desguerre; A Rötig; M J Mayaux; J F Delfraissy Journal: Lancet Date: 1999-09-25 Impact factor: 79.321
Authors: Michael J Boivin; Paul Bangirana; Noeline Nakasujja; Connie F Page; Cilly Shohet; Deborah Givon; Judith K Bass; Robert O Opoka; Pnina S Klein Journal: J Pediatr Date: 2013-08-16 Impact factor: 4.406
Authors: P Bangirana; P Allebeck; B Giordani; C C John; O R Opoka; J Byarugaba; A Ehnvall; M J Boivin Journal: Afr Health Sci Date: 2009-09 Impact factor: 0.927
Authors: Jordan G Schnoll; Brian Temsamrit; Daniel Zhang; Hongjun Song; Guo-Li Ming; Kimberly M Christian Journal: J Neuroimmune Pharmacol Date: 2019-09-11 Impact factor: 4.147
Authors: Catherine J Wedderburn; Shunmay Yeung; Andrea M Rehman; Jacob A M Stadler; Raymond T Nhapi; Whitney Barnett; Landon Myer; Diana M Gibb; Heather J Zar; Dan J Stein; Kirsten A Donald Journal: Lancet Child Adolesc Health Date: 2019-09-09