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Green F, du Plooy C, Rehman AM, Nhapi RT, Lake MT, Barnett W, Hoffman N, Zar HJ, Donald KA, Stein DJ, Wedderburn CJ. Language outcomes of preschool children who are HIV-exposed uninfected: An analysis of a South African cohort. PLoS One 2024; 19:e0297471. [PMID: 38598467 PMCID: PMC11006185 DOI: 10.1371/journal.pone.0297471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 01/05/2024] [Indexed: 04/12/2024] Open
Abstract
INTRODUCTION There are approximately 16 million children who are HIV-exposed and uninfected (CHEU) worldwide. Studies suggest that CHEU are at risk for developmental impairment in infancy, particularly in language domains. However, there is limited research examining neurocognitive function in CHEU older than 2 years, including important pre-school years. This study aimed to investigate associations between HIV exposure without infection and neurocognitive outcomes and to determine risk factors for neurodevelopment in CHEU at age 3-4 years. METHODS The Drakenstein Child Health Study is a South African population-based birth cohort which enrolled women in pregnancy with ongoing follow up. Neurocognitive outcomes were assessed in children at 3.5 years by trained assessors blinded to HIV status including general cognitive function, language, and memory, measured using the Kaufmann Assessment Battery for Children, Second Edition (KABC-II). Data were compared between CHEU and children who were HIV-unexposed uninfected (CHUU) using multivariable logistic and linear regression, including testing for effect modification; sex-stratified risk factor analyses were performed. RESULTS A total of 497 children were included (97 [20%] CHEU; 400 [80%] CHUU; 50% male), with a mean age of 3.5 years (range 3.4-3.6). Groups had similar birth and household characteristics, although mothers of CHEU were older, on average. Overall, CHEU had lower expressive language scores compared to CHUU on unadjusted and adjusted analyses (effect size: -0.23 [95% CI -0.45, -0.01]). There were no group differences in general cognitive or memory function (p>0.05). On sex-stratified analyses, male CHEU were found to have higher odds of suboptimal cognitive development compared to male CHUU (aOR 2.28 [95% CI 1.06, 4.87], p = 0.034). Several other factors including birthweight, maternal education, maternal ART duration and HIV viral load during pregnancy were associated with cognition, memory, or expressive language outcomes in CHEU, dependent on child sex. INTERPRETATION The findings suggest that perinatal HIV exposure continues to be associated with impaired language development across the preschool years, highlighting the importance of targeting early interventions to optimise language outcomes. Further, the results suggest the importance of demographic, biological and HIV-related variables influencing developmental outcomes in CHEU. The greater risk of suboptimal cognitive development in male CHEU requires investigation around sex-specific mechanisms.
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Affiliation(s)
- Freddy Green
- Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Christopher du Plooy
- Department of Paediatrics and Child Health, Red Cross War Memorial Children’s Hospital, University of Cape Town, Cape Town, South Africa
| | - Andrea M. Rehman
- MRC International Statistics & Epidemiology Group, Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Raymond T. Nhapi
- Department of Paediatrics and Child Health, Red Cross War Memorial Children’s Hospital, University of Cape Town, Cape Town, South Africa
- Division of Epidemiology and Biostatistics, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Marilyn T. Lake
- Department of Paediatrics and Child Health, Red Cross War Memorial Children’s Hospital, University of Cape Town, Cape Town, South Africa
- South African Medical Research Council (SAMRC), Unit on Child & Adolescent Health, University of Cape Town, Cape Town, South Africa
| | - Whitney Barnett
- Department of Paediatrics and Child Health, Red Cross War Memorial Children’s Hospital, University of Cape Town, Cape Town, South Africa
- Department of Psychology and Human Development, Vanderbilt University, Nashville, Tennessee, United States of America
| | - Nadia Hoffman
- Department of Psychiatry & Mental Health, University of Cape Town, Cape Town, South Africa
| | - Heather J. Zar
- Department of Paediatrics and Child Health, Red Cross War Memorial Children’s Hospital, University of Cape Town, Cape Town, South Africa
- South African Medical Research Council (SAMRC), Unit on Child & Adolescent Health, University of Cape Town, Cape Town, South Africa
| | - Kirsten A. Donald
- Department of Paediatrics and Child Health, Red Cross War Memorial Children’s Hospital, University of Cape Town, Cape Town, South Africa
- Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Dan J. Stein
- Department of Psychiatry & Mental Health, University of Cape Town, Cape Town, South Africa
- Neuroscience Institute, University of Cape Town, Cape Town, South Africa
- SAMRC, Unit on Risk and Resilience in Mental Disorders, University of Cape Town, Cape Town, South Africa
| | - Catherine J. Wedderburn
- Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, United Kingdom
- Department of Paediatrics and Child Health, Red Cross War Memorial Children’s Hospital, University of Cape Town, Cape Town, South Africa
- Neuroscience Institute, University of Cape Town, Cape Town, South Africa
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Zoumenou R, Bodeau-Livinec F, Chausseboeuf L, Boivin MJ, Wendland J. Is Neurodevelopmental Assessment in Early Childhood Predictive of Performance Assessed Later in Childhood and Adolescence in Sub-Saharan Africa? A Systematic Review of the Literature. Arch Clin Neuropsychol 2024; 39:98-116. [PMID: 37470401 PMCID: PMC10802230 DOI: 10.1093/arclin/acad051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/02/2023] [Indexed: 07/21/2023] Open
Abstract
BACKGROUND Most neurodevelopmental tests used to assess child development in sub-Saharan Africa were developed in western or high-income countries, raising the question of their usefulness with African children. OBJECTIVE This systematic review identified and synthesized key findings from studies measuring development in children in Sub-Saharan Africa in early childhood and again at school age, to assess neurocognitive associations longitudinally from infancy through middle childhood. METHODS The study was based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses method, selecting articles referenced in the PubMed, PsycInfo, and Embase databases using the following inclusion criteria: published between 2000 and 2022, written in French or English, and presenting results dealing with the objective assessment of child's neurodevelopment. All articles were registered in the Zotero reference manager and analyzed by title, abstract, and full text. RESULTS Several of the seven selected studies confirmed that attention and working memory in infancy can predict children's neurocognitive performance, including mathematical ability, at school age. In two of the studies, children with poor mental development at 1 year of age are more likely to present with poorer behavioral development at school age, including learning difficulties in school and risk for grade repetition. CONCLUSION Cognitive ability assessed in early childhood is strongly associated with performance at school age in cohorts of African children followed longitudinally. Even with assessments adapted cross-culturally, infants and preschoolers at risk for poor developmental outcomes can be identified to better receive strategic early interventions to enhance their development.
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Affiliation(s)
- Roméo Zoumenou
- Institut de Recherche pour le Developpement, Mère et enfant face aux infections tropicales, 75006 Paris, France
- Laboratoire psychopathologie et processus en santé, Institute de psychologie, 92774 Boulogne, France
| | - Florence Bodeau-Livinec
- Institut de recherche en santé, environnement et travail (IRSET), Ecole des hautes etudes en santé (EHESP), 93210 Saint-Denis, France
| | - Léa Chausseboeuf
- Laboratoire psychopathologie et processus en santé, Institute de psychologie, 92774 Boulogne, France
| | - Michael J Boivin
- Department of Psychiatry and Department of Neurology & Ophthalmology, Michigan State University, East Lansing, MI 48824 USA
- Department of Psychiatry, University of Michigan, Ann Arbor, MI 48104, USA
| | - Jaqueline Wendland
- Laboratoire psychopathologie et processus en santé, Institute de psychologie, 92774 Boulogne, France
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3
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Boma PM, Panda J, Ngoy Mande JP, Bonnechère B. Rehabilitation: a key service, yet highly underused, in the management of young patients with sickle cell disease after stroke in DR of Congo. Front Neurol 2023; 14:1104101. [PMID: 37292134 PMCID: PMC10244556 DOI: 10.3389/fneur.2023.1104101] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 05/02/2023] [Indexed: 06/10/2023] Open
Affiliation(s)
- Paul Muteb Boma
- Reference Centre for Sickle Cell Disease of Lubumbashi, Institut de Recherche en Science de la Santé, Lubumbashi, Democratic Republic of Congo
| | - Jules Panda
- Reference Centre for Sickle Cell Disease of Lubumbashi, Institut de Recherche en Science de la Santé, Lubumbashi, Democratic Republic of Congo
- Department of Surgery, Faculty of Medicine, University of Lubumbashi, Lubumbashi, Democratic Republic of Congo
| | - Jean Paul Ngoy Mande
- Department of Neurology and Psychiatry, Faculty of Medicine, University of Lubumbashi, Lubumbashi, Democratic Republic of Congo
| | - Bruno Bonnechère
- REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, University of Hasselt, Hasselt, Belgium
- Technology-Supported and Data-Driven Rehabilitation, Data Science Institute, University of Hasselt, Hasselt, Belgium
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4
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Familiar-Lopez I, Sikorskii A, Chhaya R, Holmes A, Arima EG, Caesar OJ, Nakasujja N, Boivin MJ. Predictive validation of Ugandan infant eye-tracking test for memory of human faces. Child Neuropsychol 2023; 29:486-502. [PMID: 35867478 DOI: 10.1080/09297049.2022.2099537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
We provide initial evidence that an eye-tracking based measure of infant attention and working memory (gaze preference for novel human faces) can predict aspects of neurocognitive performance years later among Ugandan children. 49 HIV-exposed/uninfected Ugandan children (22 boys, 27 girls) 6-12 months old were tested with the Mullen Scales of Early Learning and a modified Fagan Test of Infant Intelligence (FTII). Modified FTII measures pertaining to attention are correlated to the KABC-II Mental Processing Index (MPI) (rp = -0.40), p Cognitive assessments adapted to eye-tracking instrumentation can be useful to evaluate attention and working memory in HIV-affected children living in low- and middle-income countries.
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Affiliation(s)
- Itziar Familiar-Lopez
- Department of Psychiatry, College of Osteopathic Medicine, Michigan State University, East Lansing, MI, USA.,School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Alla Sikorskii
- Department of Psychiatry, College of Osteopathic Medicine, Michigan State University, East Lansing, MI, USA
| | - Ronak Chhaya
- College of Human Medicine, Michigan State University, East Lansing, MI, USA
| | - Aatirah Holmes
- College of Human Medicine, Michigan State University, East Lansing, MI, USA
| | | | | | - Noeline Nakasujja
- Department of Psychiatry, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Michael J Boivin
- Department of Psychiatry, College of Osteopathic Medicine, Michigan State University, East Lansing, MI, USA.,Department of Neurology & Ophthalmology, Michigan State University, East Lansing, MI, USA.,Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
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5
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Scharpf F, Mueller SC, Hecker T. The executive functioning of Burundian refugee youth: Associations with individual, family and community factors. JOURNAL OF APPLIED DEVELOPMENTAL PSYCHOLOGY 2022. [DOI: 10.1016/j.appdev.2022.101399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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6
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Glenn Fowler M, Boivin MJ, Familiar I, Nyangoma B. Central Nervous System and Neurodevelopmental Outcomes of HIV+ and HIV exposed children: A Mini Review of Recent Findings and Lessons Learned from the Field. Neurosci Lett 2022; 775:136501. [PMID: 35122932 DOI: 10.1016/j.neulet.2022.136501] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 01/11/2022] [Accepted: 01/28/2022] [Indexed: 12/11/2022]
Affiliation(s)
- Mary Glenn Fowler
- Dept of Pathology, Johns Hopkins U. School of Medicine Baltimore MD, USA; Dept of PsychiatryMichigan State U. East Lansing, MI, USA; Makerere U. Johns Hopkins U. Research Collaboration, USA; Kampala Uganda
| | - Michael J Boivin
- Dept of Pathology, Johns Hopkins U. School of Medicine Baltimore MD, USA; Dept of PsychiatryMichigan State U. East Lansing, MI, USA; Makerere U. Johns Hopkins U. Research Collaboration, USA; Kampala Uganda
| | - Itziar Familiar
- Dept of Pathology, Johns Hopkins U. School of Medicine Baltimore MD, USA; Dept of PsychiatryMichigan State U. East Lansing, MI, USA; Makerere U. Johns Hopkins U. Research Collaboration, USA; Kampala Uganda
| | - Betty Nyangoma
- Dept of Pathology, Johns Hopkins U. School of Medicine Baltimore MD, USA; Dept of PsychiatryMichigan State U. East Lansing, MI, USA; Makerere U. Johns Hopkins U. Research Collaboration, USA; Kampala Uganda
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7
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Parhoon K, Moradi A, Alizadeh H, Parhoon H, Sadaphal DP, Coolidge FL. Psychometric properties of the behavior rating inventory of executive function, second edition (BRIEF2) in a sample of children with ADHD in Iran. Child Neuropsychol 2021; 28:427-436. [PMID: 34488557 DOI: 10.1080/09297049.2021.1975669] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
This study investigated the psychometric properties of a Persian translation of the Behavior Rating Inventory of Executive Function(BRIEF2) in 253 children with ADHD in Iran (137 boys, 116 girls)ages 8 to 12 years old (M = 10.04; SD = 1.42). The parents of the children completed the Persian BRIEF2 and the Childhood Executive Functioning Inventory (CHEXI). The findings indicated that the Persian version of BRIEF2 had good reliability (internal and test-retest) and satisfactory to good validity (convergent and construct). With respect to its construct validity, confirmatory factor analysis revealed that a three-factor solution was the best model fit for the nine subscales of the BRIEF2, which supports the valid interpretation of the three BRIEF2 indexes in the Persian BRIEF2. These findings support the clinical relevance of the Persian BRIEF in Iranian children with ADHD, as well as the multidimensional nature of executive functions.
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Affiliation(s)
- Kamal Parhoon
- Department of Psychology, Kharazmi University, Tehran, Iran
| | - Alireza Moradi
- Department of Psychology, Kharazmi University, Tehran, Iran
| | | | - Hadi Parhoon
- Department of Psychology, Razi University, Kermanshah, Iran
| | - Dhwani P Sadaphal
- Centre for Cognitive and Brain Sciences, Indian Institute of Technology, Gandhinagar, India
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8
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Lichtenstein J, Bowers C, Amato J, Niemczak C, Fellows A, Magohe A, Haile H, White-Schwoch T, Kraus N, Massawe E, Moshi N, Buckey J. Nonverbal cognitive assessment of children in Tanzania with and without HIV. Child Neuropsychol 2021; 28:107-119. [PMID: 34315334 PMCID: PMC8648945 DOI: 10.1080/09297049.2021.1957809] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Children living with HIV can experience cognitive difficulties. Most neuropsychological tests have been constructed in Western languages, meaning they may not be appropriate for use in non-Western settings. To address this, we used an entirely nonverbal measure of cognitive ability in a sub-Saharan African sample. For this cross-sectional analysis, 316 children (162 HIV+ and 154 HIV-, ages 3-9) completed the Leiter-3 as part of a larger study in Dar es Salaam, Tanzania. Statistical tests included analysis of covariance and multiple linear regression to account for environmental variables. HIV+ children performed worse than HIV - controls on two composite scores: Nonverbal IQ (p < .001) and Processing Speed (p < 0.001). Similar trends were observed on core subtests. Multiple linear regression models revealed that age, socioeconomic status, and school attendance predicted all Leiter-3 test composites. Critically, the addition of HIV status to the models improved prediction of Nonverbal IQ (∆R2 = 0.03, p = .001) and Processing Speed (∆R2 = 0.06, p < .001). Children living with HIV performed worse than HIV- controls on most Leiter-3 measures. While age, SES, and school attendance predicted Leiter-3 performance, HIV status improved prediction capabilities when added to the model. The Leiter-3 may offer a viable measure of cognitive ability in non-Western settings that can be used in its original form without translation.
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Affiliation(s)
- Jonathan Lichtenstein
- Geisel School of Medicine at Dartmouth, Hanover, NH, USA,Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA
| | | | - Jennifer Amato
- Geisel School of Medicine at Dartmouth, Hanover, NH, USA,Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA
| | | | | | - Albert Magohe
- Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | | | | | - Nina Kraus
- Northwestern University, Evanston, IL, USA
| | - Enica Massawe
- Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Ndeserua Moshi
- Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Jay Buckey
- Geisel School of Medicine at Dartmouth, Hanover, NH, USA
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9
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Boivin MJ, Zoumenou R, Sikorskii A, Fievet N, Alao J, Davidson L, Cot M, Massougbodji A, Bodeau-Livinec F. [Formula: see text]Neurodevelopmental assessment at one year of age predicts neuropsychological performance at six years in a cohort of West African Children. Child Neuropsychol 2021; 27:548-571. [PMID: 33525970 PMCID: PMC8035243 DOI: 10.1080/09297049.2021.1876012] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 01/09/2021] [Indexed: 10/22/2022]
Abstract
Rural children from Benin, west Africa were evaluated with the Mullen Scales of Early Learning (MSEL) at one year of age and then at six years with the Kaufman Assessment Battery for Children (KABC-II), the visual computerized Tests of Variables of Attention (TOVA), and the Bruininks-Oseretsky Test (BOT-2) of motor proficiency (N = 568). Although both the MSEL and KABC-II were available to the assessors in French, instructions to the mother/child were in local language of Fon. Mothers were evaluated with the Edinburgh Postpartum Depression Scale (EPDS), Caldwell HOME Scale, educational level and literacy, and a Socio-Economic Scale - also in their local language (Fon). After adjusting for maternal factors, MSEL cognitive composite was correlated with KABC-II with moderate effect sizes, but not with TOVA scores. Overall eta-squared effect for the multivariate models were moderately to strongly correlated (.07 to .37). Neurodevelopmental assessments in early childhood adapted cross-culturally are predictive of school-age neuropsychological cognitive ability.
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Affiliation(s)
- Michael J Boivin
- Michigan State University Departments of Psychiatry and of Neurology & Ophthalmology, University of Michigan Department of Psychiatry
| | | | | | - Nadine Fievet
- Mère et Enfant Face aux Infections Tropicales, Université Paris Descartes, Paris, France
| | - Jules Alao
- Mère et Enfant Face aux Infections Tropicales, Université Paris Descartes, Paris, France
| | - Leslie Davidson
- Department of Epidemiology, Mailman School of Public Health, Columbia University
| | - Michel Cot
- Université Paris Descartes, Paris, France
| | - Achille Massougbodji
- Centre d'Etude et de Recherche sur le Paludisme Associé à la Grossesse et à l'Enfance (CERPAGE), Université d'Abomey-Calavi, Cotonou, Benin
| | - Florence Bodeau-Livinec
- École des hautes études en santé publique (EHESP), EPOPé team, UMR1153, F-35000 Rennes, France
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10
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Connery AK, Lamb MM, Colbert AM, Bauer D, Hernández S, Arroyave P, Martínez MA, Barrios EE, El Sahly HM, Paniagua-Avila A, Calvimontes M, Bolaños GA, Olson D, Asturias EJ, Munoz FM. Parent Report of Health Related Quality of Life in Young Children in Rural Guatemala: Implementation, Reliability, and Validity of the PedsQL in Stunting and Wasting. Glob Pediatr Health 2021; 8:2333794X21991028. [PMID: 33614851 PMCID: PMC7868501 DOI: 10.1177/2333794x21991028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 01/07/2021] [Indexed: 11/16/2022] Open
Abstract
In this study, we review the implementation, reliability, and validity of the Pediatric Quality of Life Inventory (PedsQL), a measure of health-related quality of life, in young children in rural Guatemala. Mothers of 842 children (age range = 1-60 months) completed the PedsQL Generic Core Scales 4.0 serially for 1 year. Low (Pearson’s r = 0.28, P < .0001) to moderate (Pearson’s r = 0.65, P < .0001) consistency in responding over time was shown. The PedsQL did not discriminate reliably between healthy children and those with stunting or wasting. PedsQL scores were not lower during the time of an acute illness. While we found low to moderate evidence for the reliability of the PedsQL in healthy children, it did not discriminate between healthy children and those with stunting, wasting or other acute illness.
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Affiliation(s)
- Amy K Connery
- Children's Hospital Colorado, Aurora, CO, USA.,University of Colorado School of Medicine, Aurora, CO, USA
| | - Molly M Lamb
- Colorado School of Public Health, Aurora, CO, USA
| | - Alison M Colbert
- Children's Hospital Colorado, Aurora, CO, USA.,University of Colorado School of Medicine, Aurora, CO, USA
| | | | - Sara Hernández
- Fundación para la Salud Integral de los Guatemaltecos, Retalhuleu, Guatemala
| | - Paola Arroyave
- Fundación para la Salud Integral de los Guatemaltecos, Retalhuleu, Guatemala
| | | | | | - Hana M El Sahly
- Department of Molecular Virology and Microbiology, Baylor College of Medicine
| | | | - Mirella Calvimontes
- Fundación para la Salud Integral de los Guatemaltecos, Retalhuleu, Guatemala
| | | | - Daniel Olson
- Children's Hospital Colorado, Aurora, CO, USA.,University of Colorado School of Medicine, Aurora, CO, USA.,Colorado School of Public Health, Aurora, CO, USA
| | - Edwin J Asturias
- Children's Hospital Colorado, Aurora, CO, USA.,University of Colorado School of Medicine, Aurora, CO, USA.,Colorado School of Public Health, Aurora, CO, USA
| | - Flor M Munoz
- Department of Molecular Virology and Microbiology, Baylor College of Medicine.,Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
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11
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Neurocognitive Functioning among Children with Sickle Cell Anemia Attending SCA Clinic at MNH, Dar es Salaam, Tanzania. Neurol Res Int 2020; 2020:3636547. [PMID: 32953173 PMCID: PMC7481962 DOI: 10.1155/2020/3636547] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 06/05/2020] [Accepted: 06/12/2020] [Indexed: 11/21/2022] Open
Abstract
Background Children with sickle cell anemia are at a higher risk of developing neurological sequelae like abnormal intellectual functioning, poor academic performance, abnormal fine motor functioning, and attentional deficits. There is a paucity of data about neurocognitive impairment among children with sickle cell anemia in Tanzania. Recognition of the magnitude of neurocognitive impairment will help to provide insight in the causative as well as preventive aspects of the same. Therefore, this study was carried out to determine the prevalence and factors associated with neurocognitive impairment in children with sickle cell anemia. Methods This is a cross-sectional comparative study between children with SCA and a control group of the hemoglobin AA sibling. It was carried out in Muhimbili National Hospital during a five-month period. The Rey–Osterrieth Complex Figure test (ROCF) which is used to test memory and visual special functions and KOH block design tools that have been previously validated through another study locally were used. Additional information on demographic characteristics was also collected using a predetermined questionnaire. Proportions and comparisons of means were used to examine associations between neurocognitive impairment and independent variables for associated factors. Results A total of 313 children were included in the final analysis. Among all the participants, the majority of the participants in the sickle cell group were of the age group 14-15 years (45.9%). In the comparison group, the majority were of the age group 9-10 years (43.8%). The neurocognitive scores in children with sickle cell anemia were significantly different from the normal siblings. In the copy ROCF, the neurocognitive function in SCA participants was 68.2% below the mean as compared to 45% of their counterparts, p ≤ 0.001. Additionally, there was no difference in memory in children with SCA compared to normal siblings (14.8% vs. 12.5%, respectively, p=0.606). Children with SCA had a higher proportion of impaired IQ (85.4%) as compared to children without SCA (72.5%), and the difference was statistically significant, p=0.009. Factors associated with neurocognitive impairment were age above 13 years, BMI, and absenteeism from school. Conclusion and Recommendation. Children with SCA had more impairment in terms of copying and IQ. We recommend assessment at the younger age group, increased sample size in future studies, and long-term cohort follow-up.
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Shum KKM, Zheng Q, Chak GS, Kei KTL, Lam CWC, Lam IKY, Lok CSW, Tang JWY. Dimensional structure of the BRIEF2 and its relations with ADHD symptoms and task performance on executive functions in Chinese children. Child Neuropsychol 2020; 27:165-189. [PMID: 32933354 DOI: 10.1080/09297049.2020.1817355] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
This study examined the dimensional structure of the Behavior Rating Inventory of Executive Function, Second Edition (BRIEF2) in a Chinese sample of children with attention-deficit/hyperactivity disorder (ADHD)-related concerns and the correlations of the BRIEF2 with the children's ADHD symptoms and their performance on executive function (EF) tasks. Participants were 339 Chinese children aged 6-15 (M = 9.18 years, SD = 2.33; boys: 78.2%) recruited from 35 schools in Hong Kong. The results from confirmatory factor analyses revealed the best fit for a three-factor nine-scale model compared to a two-factor or single-factor model. Significant correlations were found between the BRIEF2 parent and teacher forms for the Behavioral Regulation Index and Cognitive Regulation Index, but not for the Emotion Regulation Index. Associations between performance on an EF task and the rating of the corresponding subscale on the BRIEF2 purportedly measuring the same EF construct were not consistently observed. Lastly, the BRIEF2 showed good convergent validity with the ratings of ADHD symptoms on the Swanson, Nolan, and Pelham Rating Scale Version IV (SNAP-IV). This study provided plausibly the first evidence on the dimensional structure of the BRIEF2 Parent and Teacher Forms in an Asian sample and confirmed the factorial validity of the Chinese version of the BRIEF2.
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Affiliation(s)
| | - Que Zheng
- Department of Psychology, The University of Hong Kong , Hong Kong
| | | | | | | | - Iris Kit-Yee Lam
- Department of Psychology, The University of Hong Kong , Hong Kong
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13
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Colbert AM, Lamb MM, Asturias EJ, Muñoz FM, Bauer D, Arroyave P, Hernández S, Martínez MA, Paniagua-Avila A, Olson D, Calvimontes DM, Bolaños GA, El Sahly HM, Connery AK. Reliability and Validity of an Adapted and Translated Version of the Mullen Scales of Early Learning (AT-MSEL) in Rural Guatemala. Child Care Health Dev 2020; 46:327-335. [PMID: 31978249 DOI: 10.1111/cch.12748] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Accepted: 01/19/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND A growing literature base supports the use of tests developed in high-income countries to assess children in low resource settings when carefully translated, adapted, and applied. Evaluation of psychometric properties of adapted and translated measures within populations is necessary. The current project sought to evaluate the reliability and validity of an adapted and translated version of the Mullen Scales of Early Learning (AT-MSEL) in rural Guatelama. METHODS The reliability and validity of the AT-MSEL in rural Guatemala were analyzed for children ages 0-5 years. RESULTS Interrater reliability coefficients (ICC = 0.99-1.0) and internal consistency (Cronbach's alpha = 0.91-0.93) were excellent for all subscales. General linear models utilizing paired data showed consistency between standard scores (p < 0.0001). Mean raw scores increased with chronological age, as expected. Across age groups, subscales were significantly, positively correlated with one another (p < 0.05 - < 0.001) with one exception, visual reception and expressive language at the 0-10 month age range (p = 0.43). CONCLUSIONS The AT- MSEL showed strong psychometric properties in a sample of young children in rural Guatemala. Findings demonstrate that the AT-MSEL can be used validly and reliably within this specific population of children. This work supports the concept that tests developed in high-income countries can be used to assess children in low resource settings when carefully translated, adapted and applied.
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Affiliation(s)
- Alison M Colbert
- Children's Hospital Colorado, Aurora, Colorado.,University of Colorado, Aurora, Colorado
| | | | - Edwin J Asturias
- Children's Hospital Colorado, Aurora, Colorado.,University of Colorado, Aurora, Colorado
| | | | | | - Paola Arroyave
- Fundación para la Salud Integral de los Guatemaltecos, Retalhuleu, Guatemala
| | - Sara Hernández
- Fundación para la Salud Integral de los Guatemaltecos, Retalhuleu, Guatemala
| | | | | | - Daniel Olson
- Children's Hospital Colorado, Aurora, Colorado.,University of Colorado, Aurora, Colorado
| | | | - Guillermo A Bolaños
- Fundación para la Salud Integral de los Guatemaltecos, Retalhuleu, Guatemala
| | | | - Amy K Connery
- Children's Hospital Colorado, Aurora, Colorado.,University of Colorado, Aurora, Colorado
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Obradović J, Willoughby MT. Studying Executive Function Skills in Young Children in Low‐ and Middle‐Income Countries: Progress and Directions. CHILD DEVELOPMENT PERSPECTIVES 2019. [DOI: 10.1111/cdep.12349] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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15
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Connery AK, Colbert AM, Lamb MM, Hernández S, Martínez MA, Bauer D, Arroyave P, El Sahly HM, Paniagua-Avila A, Calvimontes M, Bolaños GA, Olson D, Asturias EJ, Munoz FM. Receptive language skills among young children in rural Guatemala: The relationship between the Test de Vocabulario en Imagenes Peabody and a translated and adapted version of the Mullen Scales of Early Learning. Child Care Health Dev 2019; 45:702-708. [PMID: 31270836 DOI: 10.1111/cch.12702] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 06/24/2019] [Accepted: 06/30/2019] [Indexed: 12/01/2022]
Abstract
BACKGROUND Children in low- and lower middle income countries (LMICs) often have poorer language skills compared with children from high-income countries. Limited availability of culturally and linguistically appropriate assessment measures in LMICs, especially for young children, can hinder early identification and prevention efforts. Here, we describe receptive language (RL) skills among young children in rural Guatemala and report on the validity of a translated and culturally adapted developmental measure of RL. METHODS Children (n = 157; m = 53.6 months, range = 42-68 months) enrolled in a prospective cohort study of postnatally acquired Zika virus infection were administered the Test de Vocabulario en Imagenes Peabody (TVIP) and the RL scale from a translated and adapted version of the Mullen Scales of Early Learning (MSEL). Performance on the TVIP was compared with the Latin American normative sample. Correlational analysis examined the relationship between performance on the TVIP and the MSEL-RL. RESULTS Mean scores were significantly below the normative sample mean on the TVIP, t(126) = -11.04, p < .001; d = 1.00. Performance on the TVIP among children who passed the practice items (n = 127) was significantly positively associated with performance on the MSEL-RL (r = .50, p < .001), but not significantly associated with age or gender. Older age (p < .0001) and female gender (p = .018) were associated with passing the TVIP practice items. CONCLUSIONS Delays in RL vocabulary were identified among young children in rural Guatemala on the TVIP. The association between scores on the TVIP and the RL scale of the MSEL provides preliminary support for the construct validity of this translated and adapted version of the MSEL.
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Affiliation(s)
- Amy K Connery
- Children's Hospital Colorado, Aurora, Colorado.,Department of Physical Medicine and Rehabilitation, University of Colorado School of Medicine, Aurora, Colorado
| | - Alison M Colbert
- Children's Hospital Colorado, Aurora, Colorado.,Department of Physical Medicine and Rehabilitation, University of Colorado School of Medicine, Aurora, Colorado
| | - Molly M Lamb
- Center for Global Health and Department of Epidemiology, Colorado School of Public Health, Aurora, Colorado
| | - Sara Hernández
- Center for Human Development, Fundación para la Salud Integral de los Guatemaltecos, Retalhuleu, Guatemala
| | - María Alejandra Martínez
- Center for Human Development, Fundación para la Salud Integral de los Guatemaltecos, Retalhuleu, Guatemala
| | - Desirée Bauer
- Center for Human Development, Fundación para la Salud Integral de los Guatemaltecos, Retalhuleu, Guatemala
| | - Paola Arroyave
- Center for Human Development, Fundación para la Salud Integral de los Guatemaltecos, Retalhuleu, Guatemala
| | - Hana M El Sahly
- Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, Texas
| | - Alejandra Paniagua-Avila
- Center for Human Development, Fundación para la Salud Integral de los Guatemaltecos, Retalhuleu, Guatemala
| | - Mirella Calvimontes
- Center for Human Development, Fundación para la Salud Integral de los Guatemaltecos, Retalhuleu, Guatemala
| | - Guillermo Antoñio Bolaños
- Center for Human Development, Fundación para la Salud Integral de los Guatemaltecos, Retalhuleu, Guatemala
| | - Daniel Olson
- Children's Hospital Colorado, Aurora, Colorado.,Center for Global Health and Department of Epidemiology, Colorado School of Public Health, Aurora, Colorado.,Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado
| | - Edwin J Asturias
- Children's Hospital Colorado, Aurora, Colorado.,Center for Global Health and Department of Epidemiology, Colorado School of Public Health, Aurora, Colorado.,Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado
| | - Flor M Munoz
- Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, Texas.,Department of Pediatrics, Baylor College of Medicine, Houston, Texas
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16
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Willoughby MT, Piper B, Kwayumba D, McCune M. Measuring executive function skills in young children in Kenya. Child Neuropsychol 2018; 25:425-444. [DOI: 10.1080/09297049.2018.1486395] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Affiliation(s)
- Michael T. Willoughby
- Education & Workforce Development, RTI International, Research Triangle Park, North Carolina, USA
| | - Benjamin Piper
- International Education, RTI International, Nairobi, Kenya
| | | | - Megan McCune
- International Education, RTI International, Washington, DC, USA
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Nwosu EC, Robertson FC, Holmes MJ, Cotton MF, Dobbels E, Little F, Laughton B, van der Kouwe A, Meintjes EM. Altered brain morphometry in 7-year old HIV-infected children on early ART. Metab Brain Dis 2018; 33:523-535. [PMID: 29209922 PMCID: PMC5866746 DOI: 10.1007/s11011-017-0162-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Accepted: 11/27/2017] [Indexed: 12/13/2022]
Abstract
Even with the increased roll out of combination antiretroviral therapy (cART), paediatric HIV infection is associated with neurodevelopmental delays and neurocognitive deficits that may be accompanied by alterations in brain structure. Few neuroimaging studies have been done in children initiating ART before 2 years of age, and even fewer in children within the critical stage of brain development between 5 and 11 years. We hypothesized that early ART would limit HIV-related brain morphometric deficits at age 7. Study participants were 7-year old HIV-infected (HIV+) children from the Children with HIV Early Antiretroviral Therapy (CHER) trial whose viral loads were supressed at a young age, and age-matched uninfected controls. We used structural magnetic resonance imaging (MRI) and FreeSurfer ( http://www.freesurfer.net/ ) software to investigate effects of HIV and age at ART initiation on cortical thickness, gyrification and regional brain volumes. HIV+ children showed reduced gyrification compared to controls in bilateral medial parietal regions, as well as reduced volumes of the right putamen, left hippocampus, and global white and gray matter and thicker cortex in small lateral occipital region. Earlier ART initiation was associated with lower gyrification and thicker cortex in medial frontal regions. Although early ART appears to preserve cortical thickness and volumes of certain brain structures, HIV infection is nevertheless associated with reduced gyrification in the parietal cortex, and lower putamen and hippocampus volumes. Our results indicate that in early childhood gyrification is more sensitive than cortical thickness to timing of ART initiation. Future work will clarify the implications of these morphometric effects for neuropsychological function.
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Affiliation(s)
- Emmanuel C Nwosu
- MRC/UCT Medical Imaging Research Unit, Division of Biomedical Engineering, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
| | - Frances C Robertson
- MRC/UCT Medical Imaging Research Unit, Division of Biomedical Engineering, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Martha J Holmes
- MRC/UCT Medical Imaging Research Unit, Division of Biomedical Engineering, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Mark F Cotton
- Family Clinical Research Unit, Department of Paediatrics & Child Health, Tygerberg Children's Hospital and Faculty of Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Els Dobbels
- Family Clinical Research Unit, Department of Paediatrics & Child Health, Tygerberg Children's Hospital and Faculty of Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Francesca Little
- Department of Statistical Sciences, Faculty of Sciences, University of Cape Town, Cape Town, South Africa
| | - Barbara Laughton
- Family Clinical Research Unit, Department of Paediatrics & Child Health, Tygerberg Children's Hospital and Faculty of Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Andre van der Kouwe
- A.A. Martinos Centre for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, MA, USA
- Department of Radiology, Harvard Medical School, Boston, MA, USA
| | - Ernesta M Meintjes
- MRC/UCT Medical Imaging Research Unit, Division of Biomedical Engineering, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
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18
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Boivin MJ, Mohanty A, Sikorskii A, Vokhiwa M, Magen JG, Gladstone M. Early and middle childhood developmental, cognitive, and psychiatric outcomes of Malawian children affected by retinopathy positive cerebral malaria. Child Neuropsychol 2018; 25:81-102. [PMID: 29570016 DOI: 10.1080/09297049.2018.1451497] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
The objective is to determine the short -and long-term developmental, cognitive, and psychiatric effects of retinopathy positive cerebral malaria (CM-R) among young children in a prospective study assessing them around the onset of disease and again 2 years at preschool and again at school age. In total, 109 children were recruited from the Queen Elizabeth Central Hospital in Blantyre, Malawi, (N = 49) with CM-R and non-malaria controls (N = 60). Children were assessed for overall motor, language, and social skills using the Malawi Developmental Assessment Tool (MDAT) at preschool age. At school age, the same children were then given the Kaufman Assessment Battery for Children, second edition (KABC-II), which assessed global cognitive performancememory, and learning; as well as the Test of Variables of Attention (TOVA), which assessed attention. The Achenbach Child Development Checklist (CBCL) was administered at both time points to assess emotional and behavioral patterns. Controls scored significantly better on all KABC-II global domains as well as on the mental processing index than their CM-R group counterparts, but showed no performance differences in the TOVA and CBCL assessments at school age, or in the MDAT and CBCL assessments at preschool age. The MDAT total score was significantly correlated with the KABC-II sequential processing, learning, and mental processing index among CM-R survivors but not among controls. Persisting neurocognitive effects of CM can be captured with the KABC-II at school age. The MDAT at preschool age is correlated with the KABC-II among CM-R survivors and can be used to capture early emerging developmental deficits due to CM-R.
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Affiliation(s)
- Michael J Boivin
- a Departments of Psychiatry and Neurology & Ophthalmology , Michigan State University , East Lansing , USA.,b Department of Psychiatry , University of Michigan , Ann Arbor , Michigan , USA
| | - Arpita Mohanty
- c College of Osteopathic Medicine , Michigan State University , East Lansing , Michigan , USA
| | - Alla Sikorskii
- d Psychiatry and Statistics & Probability , Michigan State University , East Lansing , Michigan , USA
| | - Maclean Vokhiwa
- e Department of Psychology , Chancellor College - University of Malawi , Zomba , Malawi
| | - Jed G Magen
- f Department of Psychiatry , Michigan State University , East Lansing , Michigan , USA
| | - Melissa Gladstone
- g Paediatrics and Neurodisability , Women's and Children's Health, University of Liverpool , Liverpool , UK
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Chernoff MC, Laughton B, Ratswana M, Familiar I, Fairlie L, Vhembo T, Kamthunzi P, Kabugho E, Joyce C, Zimmer B, Ariansen JL, Jean-Philippe P, Boivin MJ. Validity of Neuropsychological Testing in Young African Children Affected by HIV. J PEDIAT INF DIS-GER 2018; 13:185-201. [PMID: 30100780 DOI: 10.1055/s-0038-1637020] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Introduction Western-constructed neuropsychological tests have been used in low and middle income countries to assess the impact of HIV/AIDS and other chronic illnesses. We explore using such instruments cross-culturally in a sub-Saharan Africa setting. Methods IMPAACT P1104S was a two-year observational study carried out at six clinical sites (South Africa- 3 sites, Malawi, Uganda and Zimbabwe) to assess and compare neuropsychological outcomes in three cohorts of children 5-11 years of age: HIV-infected (HIV), HIV-exposed but uninfected (HEU) and HIV unexposed and uninfected (HU). Descriptive statistics compared socio-demographic characteristics among children at sites. Instruments included the KABC-II cognitive ability, TOVA attention/impulsivity, BOT-2 motor proficiency tests, and BRIEF executive function problems. Test characteristics were assessed using intraclass and Spearman non-parametric correlations, linear regression and principal factor analyses. Results Of the 611 participants, 50% were male and mean age ranged from 6.6 to 8 years. In Malawi, Uganda and Zimbabwe, substantial proportions of families lived in rural settings in contrast to the South African sites. Intraclass correlation coefficients between weeks 0 and 48 were highest for the KABC scores, ranging between 0.42 to 0.71.Correlations among similar test domains were low to moderate but significant, with positive correlation between KABC Sequential and TOVA scores and negative correlation between BRIEF and KABC scores. TOVA response time scores correlated negatively with the BOT-2 Total points score. Strong and significant associations between individual measures of growth, disability and development with all test scores were observed. Performance-based measures were markedly lower for HIV compared to HEU and HU participants, even after controlling for age, sex and site. Factor analyses confirmed the underlying theoretical structure of the KABC scaled item scores. Conclusion The KABC, TOVA, BRIEF and BOT-2 were valid and reliable tools for assessing the neuropsychological impact of HIV in four sub-Saharan African countries.
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Affiliation(s)
- Miriam C Chernoff
- Center for Biostatistics in AIDS Research, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Barbara Laughton
- Family Clinical Research Unit, Tygerberg Hospital, Department of Paediatrics and Child Health, Stellenbosch University, Tygerberg, RSA
| | - Mmule Ratswana
- Wits Reproductive Health & HIV Institute (WRHI), Shandukani Clinic, Johannesburg, RSA
| | - Itziar Familiar
- Department of Psychiatry, Michigan State University, East Lansing, MI
| | - Lee Fairlie
- Wits Reproductive Health & HIV Institute (WRHI), Shandukani Clinic, Johannesburg, RSA
| | - Tichaona Vhembo
- Harare Family Care CRS, University of Zimbabwe, College of Health Sciences Clinical Trials Unit, Harare, Zimbabwe
| | - Portia Kamthunzi
- University of North Carolina Project- Lilongwe, Malawi CRS, Malawi
| | - Enid Kabugho
- Makerere University-Johns Hopkins University Research Collaboration (MUJHU CARE LTD) CRS, Kampala, Uganda
| | - Celeste Joyce
- Perinatal HIV Research Unit, Faculty of Health Sciences, University of Witwatersrand, South Africa
| | | | - J L Ariansen
- Clinical Research Management, FHI360, Durham, NC
| | | | - Michael J Boivin
- Department of Psychiatry, Michigan State University, East Lansing, MI.,Department of Neurology and Ophthalmology, Michigan State University, East Lansing, MI.,Department of Psychiatry, the University of Michigan, Ann Arbor, MI
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20
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Semrud-Clikeman M, Romero RAA, Prado EL, Shapiro EG, Bangirana P, John CC. [Formula: see text]Selecting measures for the neurodevelopmental assessment of children in low- and middle-income countries. Child Neuropsychol 2017; 23:761-802. [PMID: 27609060 PMCID: PMC5690490 DOI: 10.1080/09297049.2016.1216536] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Diseases affecting millions of children in low- and middle-income countries (LMICs), such as malnutrition, micronutrient deficiency, malaria, and HIV, can lead to adverse neurodevelopmental outcomes. Thus, a key health outcome in children is neurodevelopmental status. In this paper, the neurodevelopmental screening and testing measures most commonly utilized in LMICs are reviewed, and a matrix is presented to help researchers and clinicians determine which measures may be most useful for various LMIC inquiries. The matrix is based on an Internet literature review of 114 publications for the period January 1998 to February 2016, reporting the psychometric properties of instruments tested in LMIC children. The measures are classified as screening tests or more detailed tests that include both comprehensive batteries of general development and tests of specific domains. For completeness, two experts have reviewed this paper, as well as the authors. An overview of the tests used to date is presented, including the benefits and drawbacks of each test, in order to provide researchers and developmental clinicians with a way to decide which tests may be best suited to their developmental assessment goals. Remarkable progress has been made in neurodevelopmental testing in children in LMICs over the past two decades but there remains a need for additional research in this area to develop new tests, better evaluate and adapt current tests, and assess test validity and reliability across cultures.
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Affiliation(s)
| | | | | | - Elsa G Shapiro
- Department of Pediatrics, University of Minnesota, Minneapolis, MN
| | - Paul Bangirana
- Department of Psychiatry, Makerere University, Kampala, Uganda
| | - Chandy C John
- Department of Pediatrics, University of Minnesota, Minneapolis, MN
- Department of Pediatrics, Indiana University, Indianapolis, IN
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21
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van Wyhe KS, van de Water T, Boivin MJ, Cotton MF, Thomas KGF. Cross-cultural assessment of HIV-associated cognitive impairment using the Kaufman assessment battery for children: a systematic review. J Int AIDS Soc 2017; 20:21412. [PMID: 28664684 PMCID: PMC5515037 DOI: 10.7448/ias.20.1.21412] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Accepted: 04/25/2017] [Indexed: 12/15/2022] Open
Abstract
INTRODUCTION Despite improved efficacy of, and access to, combination antiretroviral therapy (cART), HIV-associated cognitive impairments remain prevalent in both children and adults. Neuropsychological tests that detect such impairment can help clinicians formulate effective treatment plans. The Kaufman Assessment Battery for Children (KABC), although developed and standardized in the United States, is used frequently in many different countries and cultural contexts to assess paediatric performance across various cognitive domains. This systematic review investigated the cross-cultural utility of the original KABC, and its 2nd edition (KABC-II), in detecting HIV-associated cognitive impairment in children and adolescents. METHODS We entered relevant keywords and MeSH terms into the PubMed, PsycInfo, EBSCOHost, ProQuest, and Scopus databases, with search limits set from 1983-2017. Two independent reviewers evaluated the retrieved abstracts and manuscripts. Studies eligible for inclusion in the review were those that (a) used the KABC/KABC-II to assess cognitive function in children/adolescents aged 2-18 years, (b) featured a definition of cognitive impairment (e.g. >2 SD below the mean) or compared the performance of HIV-infected and uninfected control groups, and (c) used a sample excluded from population on which the instruments were normed. RESULTS AND DISCUSSION We identified nine studies (eight conducted in African countries, and one in the United Kingdom) to comprise the review's sample. All studies detected cognitive impairment in HIV-infected children, including those who were cART-naïve or who were cART treated and clinically stable. KABC/KABC-II subtests assessing simultaneous processing appeared most sensitive. Evaluation of the methodological quality of the selected studies by two independent reviews suggested that shortcomings included reporting and selection biases. CONCLUSIONS This systematic review provides evidence for the cross-cultural utility of the KABC/KABC-II, particularly the simultaneous processing subtests, in detecting cognitive impairment in HIV-infected children (including those who are clinically stable). Although the current results suggest there is justification for using the KABC/KABC-II primarily in East Africa, further investigation is required to explore the instrument's utility in other HIV-prevalent regions of the globe.
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Affiliation(s)
- Kaylee S van Wyhe
- ACSENT Laboratory, Department of Psychology, University of Cape Town, Cape Town, South Africa
- Children with Infectious Diseases Clinical Research Unit, Department of Paediatrics and Child Health, University of Stellenbosch, Cape Town, South Africa
| | - Tanya van de Water
- Children with Infectious Diseases Clinical Research Unit, Department of Paediatrics and Child Health, University of Stellenbosch, Cape Town, South Africa
- Department of Psychiatry, University of Stellenbosch, Cape Town, South Africa
| | - Michael J Boivin
- Department of Psychiatry and Neurology and Ophthalmology, Michigan State University, East Lansing, MI, USA
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Mark F Cotton
- Children with Infectious Diseases Clinical Research Unit, Department of Paediatrics and Child Health, University of Stellenbosch, Cape Town, South Africa
| | - Kevin GF Thomas
- ACSENT Laboratory, Department of Psychology, University of Cape Town, Cape Town, South Africa
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22
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Boivin MJ, Ruisenor-Escudero H, Familiar-Lopez I. CNS Impact of Perinatal HIV Infection and Early Treatment: the Need for Behavioral Rehabilitative Interventions Along with Medical Treatment and Care. Curr HIV/AIDS Rep 2016; 13:318-327. [PMID: 27783207 PMCID: PMC5107125 DOI: 10.1007/s11904-016-0342-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
There is growing concern that although the more severe forms of HIV-associated neurologic deficits are reduced following highly active anti-retroviral therapy (HAART), mild to moderate cognitive disorders may persist for years after HAART initiation and this may occur despite complete plasma viral suppression. According to the UNAIDS 2014 report, there were 3.2 million children living with HIV around the world at the end of 2013 and 91 % of these resided in sub-Saharan Africa. In the same year, only 24 % of children who needed antiretroviral treatment (ART) received it and 190,000 children died of AIDS-related illnesses. We propose that behavioral interventions are needed in combination with medical treatment and care in order to fully address the needs of children and adolescents in Africa living with HIV. In early childhood, caregiver training programs to enhance the developmental milieu of the child with HIV can enhance their cognitive and social development and that such interventions are both feasible and well-accepted by the local population. For school-age children, computerized cognitive rehabilitation training can be an entertaining and engaging way to improve attention, working memory, and problem solving skills for children with HIV. Further dissemination and implementation science work is needed for arriving at cost-effective strategies for scaling up such behavioral interventions in African resource-constrained settings, given that the vast majority of HIV-affected children and youth worldwide presently live in sub-Saharan Africa.
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Affiliation(s)
- Michael J. Boivin
- Department of Psychiatry and the Department of Neurology & Ophthalmology, Michigan State University Department of Psychiatry, University of Michigan, 909 Fee Road, Rm 321 West Fee Hall, East Lansing Michigan 48894 USA, Phone: 765 506-2163, FAX: 517 432-2893
| | - Horacio Ruisenor-Escudero
- Department of Psychiatry, Michigan State University, 909 Fee Road, Rm 321 West Fee Hall, East Lansing, Michigan 48894 USA, Phone: 517 432-4204, FAX: 517 432-2893
| | - Itziar Familiar-Lopez
- Department of Psychiatry, Michigan State University, 909 Fee Road, Rm 321 West Fee Hall, East Lansing, Michigan 48894 USA, Phone: 517 432-4204, FAX: 517 432-2893
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Boivin MJ, Nakasujja N, Sikorskii A, Opoka RO, Giordani B. A Randomized Controlled Trial to Evaluate if Computerized Cognitive Rehabilitation Improves Neurocognition in Ugandan Children with HIV. AIDS Res Hum Retroviruses 2016; 32:743-55. [PMID: 27045714 PMCID: PMC4971428 DOI: 10.1089/aid.2016.0026] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
OBJECTIVES Clinically stable children with HIV can have neuromotor, attention, memory, visual-spatial, and executive function impairments. We evaluated neuropsychological and behavioral benefits of computerized cognitive rehabilitation training (CCRT) in Ugandan HIV children. DESIGN One hundred fifty-nine rural Ugandan children with WHO Stage I or II HIV disease (6 to 12 years; 77 boys, 82 girls; M = 8.9, SD = 1.86 years) were randomized to one of three treatment arms over a 2-month period. METHODS The CCRT arm received 24 one-hour sessions over 2 months, using Captain's Log (BrainTrain Corporation) programmed for games targeting working memory, attention, and visual-spatial analysis. These games progressed in difficulty as the child's performance improved. The second arm was a "limited CCRT" with the same games rotated randomly from simple to moderate levels of training. The third arm was a passive control group receiving no training. All children were assessed at enrollment, 2 months (immediately following CCRT), and 3 months after CCRT completion. RESULTS The CCRT group had significantly greater gains through 3 months of follow-up compared to passive controls on overall Kaufman Assessment Battery for Children-second edition (KABC-II) mental processing index (p < .01), planning (p = .04), and knowledge (p = .03). The limited CCRT group performed better than controls on learning (p = .05). Both CCRT arms had significant improvements on CogState Groton maze learning (p < .01); although not on CogState attention/memory, TOVA/impulsivity, or behavior rating inventory for executive function and child behavior checklist (psychiatric behavior/symptom problems) ratings by caregiver. CONCLUSIONS CCRT intervention can be effective for neurocognitive rehabilitation in children with HIV in low-resource settings, especially in children who are clinically stable on ARV treatment.
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Affiliation(s)
- Michael J. Boivin
- Departments of Psychiatry and Neurology & Ophthalmology, Michigan State University, East Lansing, Michigan
| | - Noeline Nakasujja
- Department of Psychiatry, Makerere University School of Medicine, Kampala, Uganda
| | - Alla Sikorskii
- Department of Statistics and Probability, Michigan State University, East Lansing, Michigan
| | - Robert O. Opoka
- Department of Paediatrics and Child Health, Makerere University School of Medicine, Kampala, Uganda
| | - Bruno Giordani
- Departments of Psychiatry, Neurology, and Psychology, School of Nursing, University of Michigan, Ann Arbor, Michigan
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Reducing neurodevelopmental disorders and disability through research and interventions. Nature 2015; 527:S155-60. [PMID: 26580321 DOI: 10.1038/nature16029] [Citation(s) in RCA: 92] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
We define neurodevelopment as the dynamic inter-relationship between genetic, brain, cognitive, emotional and behavioural processes across the developmental lifespan. Significant and persistent disruption to this dynamic process through environmental and genetic risk can lead to neurodevelopmental disorders and disability. Research designed to ameliorate neurodevelopmental disorders in low- and middle-income countries, as well as globally, will benefit enormously from the ongoing advances in understanding their genetic and epigenetic causes, as modified by environment and culture. We provide examples of advances in the prevention and treatment of, and the rehabilitation of those with, neurodevelopment disorders in low- and middle-income countries, along with opportunities for further strategic research initiatives. Our examples are not the only possibilities for strategic research, but they illustrate problems that, when solved, could have a considerable impact in low-resource settings. In each instance, research in low- and middle-income countries led to innovations in identification, surveillance and treatment of a neurodevelopmental disorder. These innovations have also been integrated with genotypic mapping of neurodevelopmental disorders, forming important preventative and rehabilitative interventions with the potential for high impact. These advances will ultimately allow us to understand how epigenetic influences shape neurodevelopmental risk and resilience over time and across populations. Clearly, the most strategic areas of research opportunity involve cross-disciplinary integration at the intersection between the environment, brain or behaviour neurodevelopment, and genetic and epigenetic science. At these junctions a robust integrative cross-disciplinary scientific approach is catalysing the creation of technologies and interventions for old problems. Such approaches will enable us to achieve and sustain the United Nations moral and legal mandate for child health and full development as a basic global human right.
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Giordani B, Novak B, Sikorskii A, Bangirana P, Nakasujja N, Winn BM, Boivin MJ. Designing and evaluating Brain Powered Games for cognitive training and rehabilitation in at-risk African children. Glob Ment Health (Camb) 2015; 2:e6. [PMID: 28596854 PMCID: PMC5269631 DOI: 10.1017/gmh.2015.5] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2014] [Revised: 03/18/2015] [Accepted: 03/21/2015] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Valid, reliable, accessible, and cost-effective computer-training approaches can be important components in scaling up educational support across resource-poor settings, such as sub-Saharan Africa. The goal of the current study was to develop a computer-based training platform, the Michigan State University Games for Entertainment and Learning laboratory's Brain Powered Games (BPG) package that would be suitable for use with at-risk children within a rural Ugandan context and then complete an initial field trial of that package. METHODS After game development was completed with the use of local stimuli and sounds to match the context of the games as closely as possible to the rural Ugandan setting, an initial field study was completed with 33 children (mean age = 8.55 ± 2.29 years, range 6-12 years of age) with HIV in rural Uganda. The Test of Variables of Attention (TOVA), CogState computer battery, and the Non-Verbal Index from the Kaufman Assessment Battery for Children, 2nd edition (KABC-II) were chosen as the outcome measures for pre- and post-intervention testing. The children received approximately 45 min of BPG training several days per week for 2 months (24 sessions). RESULTS Although some improvements in test scores were evident prior to BPG training, following training, children demonstrated clinically significant changes (significant repeated-measures outcomes with moderate to large effect sizes) on specific TOVA and CogState measures reflecting processing speed, attention, visual-motor coordination, maze learning, and problem solving. CONCLUSIONS Results provide preliminary support for the acceptability, feasibility, and neurocognitive benefit of BPG and its utility as a model platform for computerized cognitive training in cross-cultural low-resource settings.
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Affiliation(s)
- B. Giordani
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA
- Departments of Neurology and Psychology and School of Nursing, University of Michigan, Ann Arbor, Michigan, USA
| | - B. Novak
- Games for Entertainment and Learning (GEL) Laboratory, Department of Media and Information, Michigan State University, East Lansing, Michigan, USA
| | - A. Sikorskii
- Department of Statistics and Probability, Michigan State University, East Lansing, Michigan, USA
| | - P. Bangirana
- Department of Psychiatry, Makerere University, Kampala, Uganda
| | - N. Nakasujja
- Department of Psychiatry, Makerere University, Kampala, Uganda
| | - B. M. Winn
- Games for Entertainment and Learning (GEL) Laboratory, Department of Media and Information, Michigan State University, East Lansing, Michigan, USA
| | - M. J. Boivin
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA
- Departments of Psychiatry and of Neurology & Ophthalmology, Michigan State University, East Lansing, Michigan, USA
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Ferguson KT, Cassells RC, MacAllister JW, Evans GW. The physical environment and child development: an international review. INTERNATIONAL JOURNAL OF PSYCHOLOGY 2013; 48:437-68. [PMID: 23808797 PMCID: PMC4489931 DOI: 10.1080/00207594.2013.804190] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2012] [Accepted: 04/01/2013] [Indexed: 01/07/2023]
Abstract
A growing body of research in the United States and Western Europe documents significant effects of the physical environment (toxins, pollutants, noise, crowding, chaos, and housing, school and neighborhood quality) on children and adolescents' cognitive and socioemotional development. Much less is known about these relations in other contexts, particularly the global South. We thus briefly review the evidence for relations between child development and the physical environment in Western contexts, and discuss some of the known mechanisms behind these relations. We then provide a more extensive review of the research to date outside of Western contexts, with a specific emphasis on research in the global South. Where the research is limited, we highlight relevant data documenting the physical environment conditions experienced by children, and make recommendations for future work. In these recommendations, we highlight the limitations of employing research methodologies developed in Western contexts (Ferguson & Lee, 2013). Finally, we propose a holistic, multidisciplinary, and multilevel approach based on Bronfenbrenner's (1979) bioecological model to better understand and reduce the aversive effects of multiple environmental risk factors on the cognitive and socioemotional development of children across the globe.
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Affiliation(s)
- Kim T Ferguson
- Psychology Faculty Group, Sarah Lawrence College, Bronxville, NY, USA.
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Neurodevelopment in perinatally HIV-infected children: a concern for adolescence. J Int AIDS Soc 2013; 16:18603. [PMID: 23782482 PMCID: PMC3687073 DOI: 10.7448/ias.16.1.18603] [Citation(s) in RCA: 132] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2013] [Revised: 04/04/2013] [Accepted: 04/16/2013] [Indexed: 12/14/2022] Open
Abstract
Globally, an estimated 3.4 million children are living with HIV, yet little is known about the effects of HIV and antiretroviral treatment (ART) on the developing brain, and the neurodevelopmental and behavioural outcomes of perinatally HIV-infected (PHIV+) adolescents. We reviewed the literature on neurodevelopmental outcomes in PHIV+ children and adolescents, and summarized the current evidence on behaviour, general cognition, specific domains, hearing and language, school performance and physical disabilities due to neurological problems. Evidence suggests that PHIV+ children do not perform as well as controls on general cognitive tests, processing speed and visual-spatial tasks, and are at much higher risk for psychiatric and mental health problems. Children with AIDS-defining diagnoses are particularly at risk for poorer outcomes. A striking finding is the lack of published data specific to the adolescent age group (10-25 years), particularly from resource-constrained countries, which have the highest HIV prevalence. In addition, extreme heterogeneity in terms of timing and source of infection, and antiretroviral experience limits our ability to summarize findings of studies and generalize results to other settings. Due to the complex nature of the developing adolescent brain, environmental influences and variation in access to ART, there is an urgent need for research on the longitudinal trajectory of neurodevelopment among children and adolescents perinatally infected with HIV, especially in high burden resource-constrained settings.
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Ruffieux N, Njamnshi AK, Wonkam A, Hauert CA, Chanal J, Verdon V, Fonsah JY, Eta SC, Doh RF, Ngamaleu RN, Kengne AM, Fossati C, Sztajzel R. Association between biological markers of sickle cell disease and cognitive functioning amongst Cameroonian children. Child Neuropsychol 2013; 19:143-60. [DOI: 10.1080/09297049.2011.640932] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Bergemann TL, Bangirana P, Boivin MJ, Connett JE, Giordani BJ, John CC. Statistical Approaches to Assess the Effects of Disease on Neurocognitive Function Over Time. ACTA ACUST UNITED AC 2013; Suppl 7. [PMID: 25383237 DOI: 10.4172/2155-6180.s7-016] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
INTRODUCTION Assessment of the effects of disease on neurocognitive outcomes in children over time presents several challenges. These challenges are particularly pronounced when conducting studies in low-income countries, where standardization and validation is required for tests developed originally in high-income countries. We present a statistical methodology to assess multiple neurocognitive outcomes over time. We address the standardization and adjustment for age in neurocognitive testing, present a statistical methodology for development of a global neurocognitive score, and assess changes in individual and global neurocognitive scores over time in a cohort of children with cerebral malaria. METHODS Ugandan children with cerebral malaria (CM, N = 44), uncomplicated malaria (UM, N = 54) and community controls (N = 89) were assessed by cognitive tests of working memory, executive attention and tactile learning at 0, 3, 6 and 24 months after recruitment. Tests were previously developed and validated for the local area. Test scores were adjusted for age, and a global score was developed based on the controls that combined the assessments of impairment in each neurocognitive domain. Global normalized Z-scores were computed for each of the three study groups. Model-based tests compare the Z-scores between groups. RESULTS We found that continuous Z-scores gave more powerful conclusions than previous analyses of the dataset. For example, at all four time points, children with CM had significantly lower global Z-scores than controls and children with UM. Our methods also provide more detailed descriptions of longitudinal trends. For example, the Z-scores of children with CM improved from initial testing to 3 months, but remained at approximately the same level below those of controls or children with UM from 3 to 24 months. Our methods for combining scores are more powerful than tests of individual cognitive domains, as testing of the individual domains revealed differences at only some but not all time points.
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Affiliation(s)
- Tracy L Bergemann
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA ; Cardiac Rhythm Disease Management, Medtronic, Mounds View, Minnesota, USA
| | - Paul Bangirana
- Department of Psychiatry, Makerere University School of Medicine, Kampala, Uganda ; Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - Michael J Boivin
- International Neurologic and Psychiatric Epidemiology Program, College of Osteopathic Medicine, Michigan State University, East Lansing, Michigan, USA ; Neuropsychology Section, Department of Psychiatry, University of Michigan, Ann Arbor, Michigan
| | - John E Connett
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Bruno J Giordani
- Neuropsychology Section, Department of Psychiatry, University of Michigan, Ann Arbor, Michigan
| | - Chandy C John
- Division of Global Pediatrics, Department of Pediatrics, University of Minnesota Medical School, Minneapolis, Minnesota, USA
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Postels DG, Chimalizeni YF, Mallewa M, Boivin MJ, Seydel KB. Pediatric cerebral malaria: a scourge of Africa. FUTURE NEUROLOGY 2013. [DOI: 10.2217/fnl.12.84] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Cerebral malaria, defined as an otherwise unexplained coma in a patient with Plasmodium falciparum parasitemia, affects up to 1 million people per year, the vast majority of them being children living in sub-Saharan Africa. Despite optimal treatment, this condition kills 15% of those affected and leaves 30% of survivors with neurologic sequelae. The clinical diagnosis is hampered by its poor specificity, but the presence or absence of a malarial retinopathy in cerebral malaria has proven to be important in the differentiation of underlying coma etiology. Both antimalarials and intense supportive care are necessary for optimal treatment. As of yet, clinical trials of adjunctive therapies have not improved the high rates of mortality and morbidity. Survivors are at high risk of neurologic sequelae including epilepsy, neurodisabilities and cognitive–behavioral problems. The neuroanatomic and functional bases of these sequelae are being elucidated. Although adjunctive therapy trials continue, the best hope for African children may lie in disease prevention. Strategies include bednets, chemoprophylaxis and vaccine development.
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Affiliation(s)
| | - Yamikani F Chimalizeni
- Department of Pediatrics, University of Malawi College of Medicine, Private Bag 360, Blantyre 3, Malawi
| | - Macpherson Mallewa
- Department of Pediatrics, University of Malawi College of Medicine, Private Bag 360, Blantyre 3, Malawi
| | | | - Karl B Seydel
- Michigan State University, East Lansing, MI 48824, USA
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Boivin MJ, Ryan KA, Aldridge KA, Giordani B. Transfer-of-learning effect with the tactual performance test using familiar and unfamiliar shapes with American, Lao, and Senegalese children. Dev Neuropsychol 2011; 36:552-65. [PMID: 21667360 DOI: 10.1080/87565641.2010.549874] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The Tactual Performance Test (TPT) and a version of the TPT with unfamiliar geometric designs were presented to American, Lao, and Senegalese children. The nonstandard TPT was designed to evaluate the importance of familiarity of forms in improved performance between successive TPT learning trials. The nonstandard board was more difficult for all the groups, with poorer time-per-block performance across learning trials and poorer TPT memory measures. Irrespective, the transfer-of-learning (ToL) effect for the standard and nonstandard boards was consistent for all the cultural groups. ToL effect is not dependent on familiarity of the TPT forms and is consistent across cultures.
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Affiliation(s)
- Michael J Boivin
- International Neurologic and Psychiatric and Epidemiologic Program, Michigan State University, East Lansing, Michigan 48824-1315, USA.
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Boivin MJ, Gladstone MJ, Vokhiwa M, Birbeck GL, Magen JG, Page C, Semrud-Clikeman M, Kauye F, Taylor TE. Developmental outcomes in Malawian children with retinopathy-positive cerebral malaria. Trop Med Int Health 2011; 16:263-71. [PMID: 21143354 PMCID: PMC3213405 DOI: 10.1111/j.1365-3156.2010.02704.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To assess children with retinopathy-positive cerebral malaria (CM) for neurocognitive sequelae. METHODS Participants were selected from an ongoing exposure-control study. Eighty-three Malawian children averaging 4.4 years of age and diagnosed with retinopathy-positive CM were compared to 95 controls. Each child was classified as delayed or not using age-based norms for the Malawi Developmental Assessment Tool (MDAT) for developmental delay on the total scale and for the domains of gross motor, fine motor, language and social skills. Groups were also compared on the Achenbach Child Behaviour Checklist (CBCL) (1.5-5 years). RESULTS Children with retinopathy-positive CM were delayed, relative to the comparison group, on MDAT total development (P = 0.028; odds ratio or OR = 2.13), with the greatest effects on language development (P = 0.003; OR = 4.93). The two groups did not differ significantly on the Achenbach CBCL internalizing and externalizing symptoms total scores. Stepwise regression demonstrated that coma duration, seizures while in hospital, platelet count and lactate level on admission were predictive of assessment outcomes for the children with retinopathy-positive CM. CONCLUSIONS Children who suffer retinopathy-positive CM at preschool age are at greater risk of developmental delay, particularly with respect to language development. This confirms previous retrospective study findings with school-age children evaluated years after acute illness. The MDAT and the Achenbach CBCL proved sensitive to clinical indicators of severity of malarial illness.
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Affiliation(s)
- Michael J Boivin
- International Neurologic and Psychiatric Epidemiology Program, Michigan State University, East Lansing, MI, USA.
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