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Brewer SK, Talge N, Holzman C, Sikorskii A, Ezeamama A. Perinatal HIV exposure and infection and caregiver depressive symptoms. AIDS Care 2024; 36:280-290. [PMID: 37352547 DOI: 10.1080/09540121.2023.2214865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 05/11/2023] [Indexed: 06/25/2023]
Abstract
Survival is possible for children perinatally exposed to or infected by HIV in the post-combined antiretroviral therapy era and identifying factors affecting children's ability to thrive has public health significance. Caregiver mental health is one such factor to consider given its impact on child development, but previous work has not included a full complement of HIV exposure/infection groups within HIV-endemic settings. We compared depressive symptoms among caregivers of 3 groups of 6-10-year-olds in Uganda: children with perinatally acquired HIV infection (CPHIV, n = 102), children with perinatal HIV exposure, but no infection (CPHEU, n = 101), and children without perinatal HIV exposure or infection (CHUU, n = 103). The Hopkins Symptom Checklist was used to assess caregiver depressive symptoms. Generalized linear models were used to estimate group mean differences. Adjusted models included caregiver demographics, social support, and lifetime trauma. Depression symptoms were higher among CPHEU compared to CPHIV caregivers (model coefficient [B] = -3.5, 95%CI -5.3, -1.8). This finding was minimally attenuated following adjustment for covariates (B = -2.2, 95%CI -4.1, -0.4) and among biological mothers. At lower levels of social support and wealth, CPHEU caregivers reported higher levels of depression symptoms than CPHIV caregivers. Our findings point to unmet mental health needs among CPHEU caregivers.
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Affiliation(s)
- Sarah K Brewer
- Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI, USA
| | - Nicole Talge
- Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI, USA
| | - Claudia Holzman
- Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI, USA
| | - Alla Sikorskii
- Department of Psychiatry, Michigan State University, East Lansing, MI, USA
| | - Amara Ezeamama
- Department of Psychiatry, Michigan State University, East Lansing, MI, USA
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2
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Mwangala PN, Ssewanyana D, Mwangi P, Chongwo E, Nasambu C, Kagonya VA, Scerif G, Newton CR, Abubakar A. Correlates of health-related quality of life in primary caregivers of perinatally HIV infected and HIV exposed uninfected adolescents at the Kenyan Coast. Health Qual Life Outcomes 2022; 20:11. [PMID: 35062964 PMCID: PMC8780308 DOI: 10.1186/s12955-022-01915-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 01/04/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Mothers and other primary caregivers play a crucial role in looking after perinatally HIV infected, and HIV exposed uninfected adolescents in sub-Saharan Africa. Day- to-day caregiving in the context of limited instrumental support and added biomedical risk (HIV seropositivity) may expose these caregivers to adverse states of health. Unfortunately, very few studies have examined their health-related quality of life (HRQoL). Our study documents the HRQoL profile, and associated factors in primary caregivers of perinatally HIV infected, perinatally HIV exposed but uninfected and HIV unexposed/uninfected adolescents aged 12-17 years at the Kenyan Coast. METHODS This was a cross-sectional analysis of 485 primary caregivers: 195 of perinatally HIV infected adolescents, 128 of perinatally HIV exposed but uninfected adolescents and 162 of HIV unexposed/uninfected adolescents. All caregivers completed a self-report measure of HRQoL (having 8 subscales), depressive symptoms, and parenting stress. They also provided their sociodemographic information and that of the care recipients. We used one-way analysis of variance to assess statistical differences among the groups. Linear regression analyses were used to identify correlates of HRQoL. RESULTS Overall, caregivers of HIV unexposed/uninfected adolescents reported significantly higher mean HRQoL scores than the other caregivers in the overall HRQoL domain and majority of the subscales. There were no statistical differences in the overall HRQoL scores and most subscales between caregivers of HIV exposed adolescents. Linear regression analyses across the sample indicated that depressive symptoms, increasing age of caregiver, and caring for an adolescent perinatally exposed to HIV were significantly associated with reduced HRQoL at both the overall and sub-scale level. Having a professional job relative to subsistence farming was the only factor associated with improved overall HRQoL. At subscale level, higher socioeconomic status correlated positively with HRQoL while being a grandparent, level of education, parenting stress were negatively associated with HRQoL. CONCLUSIONS Caregivers in this sample, especially those who are ageing, at risk of mental ill-health, and taking care of adolescents perinatally exposed to HIV, appear to be vulnerable to poor quality of life. Inclusive and multi-component interventions tailored to the caregivers' psychosocial and mental needs will potentially enhance their quality of life.
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Affiliation(s)
- Patrick N. Mwangala
- grid.33058.3d0000 0001 0155 5938Centre for Geographic Medicine Research Coast, Kenya Medical Research Institute (KEMRI), P.O. Box 230-80108, Kilifi, Kenya ,grid.11951.3d0000 0004 1937 1135School of Public Health, University of the Witwatersrand, 27 St Andrews Road, Parktown, 2193 South Africa
| | - Derrick Ssewanyana
- grid.33058.3d0000 0001 0155 5938Centre for Geographic Medicine Research Coast, Kenya Medical Research Institute (KEMRI), P.O. Box 230-80108, Kilifi, Kenya ,grid.470490.eInstitute for Human Development, Aga Khan University, P.O. Box 30270-00100, Nairobi, Kenya
| | - Paul Mwangi
- grid.33058.3d0000 0001 0155 5938Centre for Geographic Medicine Research Coast, Kenya Medical Research Institute (KEMRI), P.O. Box 230-80108, Kilifi, Kenya
| | - Esther Chongwo
- grid.33058.3d0000 0001 0155 5938Centre for Geographic Medicine Research Coast, Kenya Medical Research Institute (KEMRI), P.O. Box 230-80108, Kilifi, Kenya
| | - Carophine Nasambu
- grid.33058.3d0000 0001 0155 5938Centre for Geographic Medicine Research Coast, Kenya Medical Research Institute (KEMRI), P.O. Box 230-80108, Kilifi, Kenya
| | - Vincent A. Kagonya
- grid.33058.3d0000 0001 0155 5938Centre for Geographic Medicine Research Coast, Kenya Medical Research Institute (KEMRI), P.O. Box 230-80108, Kilifi, Kenya
| | - Gaia Scerif
- grid.4991.50000 0004 1936 8948Department of Experimental Psychology, University of Oxford, Anna Watts Building, Oxford, OC2 6GG UK
| | - Charles R. Newton
- grid.33058.3d0000 0001 0155 5938Centre for Geographic Medicine Research Coast, Kenya Medical Research Institute (KEMRI), P.O. Box 230-80108, Kilifi, Kenya ,grid.4991.50000 0004 1936 8948Department of Psychiatry, Warneford Hospital, University of Oxford, Warneford Ln, Oxford, OX3 7JX UK
| | - Amina Abubakar
- grid.33058.3d0000 0001 0155 5938Centre for Geographic Medicine Research Coast, Kenya Medical Research Institute (KEMRI), P.O. Box 230-80108, Kilifi, Kenya ,grid.4991.50000 0004 1936 8948Department of Psychiatry, Warneford Hospital, University of Oxford, Warneford Ln, Oxford, OX3 7JX UK ,grid.449370.d0000 0004 1780 4347Department of Public Health, Pwani University, P.O. Box 195-80108, Kilifi, Kenya ,grid.470490.eInstitute for Human Development, Aga Khan University, P.O. Box 30270-00100, Nairobi, Kenya
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Farthing H, Reynolds NR, Antwi S, Alhassan A, Ofori IP, Renner L, Amissah KA, Kusah JT, Lartey M, Paintsil E. Illness Narratives of Children Living with HIV Who Do Not Know Their HIV Status in Ghana: I'm Sick, But I Don't Know the Sickness-A Qualitative Study. AIDS Behav 2020; 24:3225-3231. [PMID: 32333207 PMCID: PMC7508830 DOI: 10.1007/s10461-020-02884-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Despite available guidelines for disclosure of HIV status to children, most children living with HIV are unaware of their diagnosis. We sought to characterize the concepts of illness and treatment among children living with HIV who do not know their status. As part of the Sankofa trial we interviewed 435 children aged 6-18 enrolled in clinical care at pediatric HIV clinics at two teaching hospitals in Ghana. Theoretic thematic analysis generated themes among responses. The children believe they come to the clinic to collect medication, to address specific symptoms, to prevent and treat 'sickness', or as part of their routine. Most children learned of their 'illness' from a family member. A majority (73.5%) of children had never talked about their 'illness' with anyone else; many feared consequences. Children living with HIV who do not know their status exhibit signs of anticipated and internalized stigma regarding their unknown 'illness.' An understanding of the way children conceptualize their illness has implications for health promotion and the provision of appropriate information to children living with HIV.ClinicalTrials.gov Identifier NCT01701635.
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Affiliation(s)
- Heather Farthing
- Department of Pediatrics, Yale School of Medicine, New Haven, CT, USA
| | | | - Sampson Antwi
- Department of Child Health, School of Medical Sciences, Kwame Nkrumah University of Science and Technology and Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Amina Alhassan
- Department of Child Health, School of Medical Sciences, Kwame Nkrumah University of Science and Technology and Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Irene Pokuaa Ofori
- Department of Child Health, School of Medical Sciences, Kwame Nkrumah University of Science and Technology and Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Lorna Renner
- Department of Child Health, University of Ghana School of Medicine and Dentistry and Korle-Bu Teaching Hospital, Accra, Ghana
| | - Kofi Aikins Amissah
- Department of Child Health, School of Medical Sciences, Kwame Nkrumah University of Science and Technology and Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Jonas Tettey Kusah
- Department of Child Health, University of Ghana School of Medicine and Dentistry and Korle-Bu Teaching Hospital, Accra, Ghana
| | - Margaret Lartey
- Department of Medicine, University of Ghana School of Medicine and Dentistry and Korle-Bu Teaching Hospital, Accra, Ghana
| | - Elijah Paintsil
- Department of Pediatrics, Yale School of Medicine, New Haven, CT, USA.
- Departments of Pharmacology & Public Health, Yale School of Medicine, New Haven, CT, USA.
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Reddy AS, Tomita A, Paruk S. Depression, anxiety and treatment satisfaction in the parents of children on antiretroviral therapy in South Africa. PSYCHOL HEALTH MED 2020; 26:584-594. [PMID: 33085919 DOI: 10.1080/13548506.2020.1837389] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Parents of children living with HIV are at increased risk of emotional distress, with negative implications for both their health outcomes. There is limited data on depression and anxiety symptoms in the biological parents as caregivers of children on antiretroviral therapy (ART) in South Africa. We investigated the prevalence and correlates associated with depressive and anxiety symptoms in 200 biological caregiving parents of children on ART at a public hospital in KwaZulu-Natal Province, South Africa. Data were obtained from the Patient Health Questionnaire (PHQ-9) for depressive symptoms and the Generalized Anxiety Depression (GAD-7) for anxiety symptoms, along with sociodemographic questionnaire. Most of the parent caregivers assessed were female (n = 190, 95%), younger than 40 years (n = 151, 75.5%), single (n = 173, 86.5%), unemployed (n = 156, 78%) and HIV+ (n = 183, 91.9%). Sixty-five (32.5%) parents screened positive for depression, 37 (18.5%) for anxiety and 31 (n = 31, 15.5%) for both disorders (i.e. depression/anxiety comorbidity). There were significant associations between death of a child to HIV (aOR = 4.66, 95% CI: 1.33-16.28) with depression/anxiety comorbidity as well as with treatment dissatisfaction (aOR = 13.98, CI: 2.09-93.66), but not with other socio-demographic factors. The high prevalence of depression and anxiety amongst the parent caregivers of children living with HIV suggests the need for mental health screening and care among parents of children attending pediatric HIV services, and particularly for those with history of children lost to HIV.
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Affiliation(s)
- Aderlee S Reddy
- Discipline of Psychiatry, School of Clinical Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Andrew Tomita
- KwaZulu-Natal Research Innovation and Sequencing Platform (KRISP), College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa.,Centre for Rural Health, School of Nursing and Public Health, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Saeeda Paruk
- Discipline of Psychiatry, School of Clinical Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
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Radcliffe C, Sam A, Matos Q, Antwi S, Amissah K, Alhassan A, Ofori IP, Xu Y, Deng Y, Reynolds NR, Paintsil E. Sankofa pediatric HIV disclosure intervention did not worsen depression scores in children living with HIV and their caregivers in Ghana. BMC Public Health 2020; 20:1578. [PMID: 33081739 PMCID: PMC7576749 DOI: 10.1186/s12889-020-09678-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 10/12/2020] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND The 'Sankofa' pediatric HIV disclosure study (2013-2017) was an intervention that aimed to address the low prevalence of disclosure of HIV status in Ghana. METHODS We conducted a cross-sectional study at the intervention site in Kumasi, Ghana, in 2019, (2 years after study closure) and administered the 21-item Beck Depression Inventory (BDI) and the 10-item Child Depression Inventory (CDI) to caregiver-child dyads who received the intervention. RESULTS We enrolled 65% (N = 157) of the original dyads in the present study. Between Sankofa enrollment baseline and the present study, both children and caregivers had significant (p < 0.0001) mean reductions in CDI scores and BDI scores, respectively. CDI scores of the children were significantly correlated with BDI scores of the caregivers (r = 0.019, p = 0.019). No statistically significant associations between disclosure status and either CDI score or BDI score were found. CONCLUSIONS Our findings did not support caregivers' fears that disclosure leads to depression. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT01701635 (date of registration Oct 5, 2012).
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Affiliation(s)
- Christopher Radcliffe
- Department of Pediatrics, Pharmacology & Public Health, Yale School of Medicine, 464 Congress Avenue, New Haven, CT, 06520, USA
| | - Aba Sam
- Department of Pediatrics, Pharmacology & Public Health, Yale School of Medicine, 464 Congress Avenue, New Haven, CT, 06520, USA
| | - Quinn Matos
- Department of Pediatrics, Pharmacology & Public Health, Yale School of Medicine, 464 Congress Avenue, New Haven, CT, 06520, USA
| | - Sampson Antwi
- Department of Child Health, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology and Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Kofi Amissah
- Department of Child Health, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology and Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Amina Alhassan
- Department of Child Health, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology and Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Irene Pokuaa Ofori
- Department of Child Health, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology and Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Yunshan Xu
- Yale Center for Analytical Sciences, Yale School of Public Health, New Haven, CT, USA
| | - Yanhong Deng
- Yale Center for Analytical Sciences, Yale School of Public Health, New Haven, CT, USA
| | | | - Elijah Paintsil
- Department of Pediatrics, Pharmacology & Public Health, Yale School of Medicine, 464 Congress Avenue, New Haven, CT, 06520, USA.
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Lillie M, Gallis JA, Hembling J, Owusu RK, Ali M, Abubakr-Bibilazu S, Aborigo R, Adam H, McEwan E, Awoonor-Williams JK, Baumgartner JN. Prevalence and Correlates of Depression Among Pregnant Women Enrolled in a Maternal and Newborn Health Program in Rural Northern Ghana: a Cross-sectional Survey. GLOBAL SOCIAL WELFARE : RESEARCH, POLICY & PRACTICE 2020; 7:131-140. [PMID: 32509505 PMCID: PMC7252621 DOI: 10.1007/s40609-020-00170-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Women in many sub-Saharan African countries are at elevated risk of depression during pregnancy. However, there are still gaps in the estimates of antenatal depression and associated risk factors in very low-resource settings such as Northern Ghana. This study describes the prevalence of depression among rural pregnant women, participating in a maternal and child health program, in Ghana, and examines associated risk factors for depression. Pregnant women who were registered for group-based maternal and child health community programs were recruited for study participation from 32 communities in two rural districts in Northern Ghana (n = 374). Baseline surveys were conducted and depression was assessed using the Patient Health Questionnaire (PHQ-9). Bivariate and multivariable analyses used a modified Poisson and generalized estimating equations (GEE) model. Of the women in our study population, 19.7% reported symptoms indicative of moderate to severe depression (PHQ-9 score ≥ 10), with 14.1% endorsing suicidal ideation in the last 2 weeks. Bivariate analyses revealed that lower hopefulness, moderate and severe hunger, experiences of emotional, physical, and/or sexual intimate partner violence (IPV), and insufficient social support from female relatives were associated with symptoms indicating moderate to severe depression. In the multivariable analyses, low hopefulness, household hunger, emotional IPV, physical and/or sexual IPV, and insufficient female relative support remained significantly associated with depression. Antenatal depression is associated with unmet basic needs and safety. Perinatal mental health programming must take an ecological perspective and address personal, familial, and community-level factors.
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Affiliation(s)
| | - John A. Gallis
- Duke Department of Biostatistics and Bioinformatics, Durham, NC USA
| | - John Hembling
- Catholic Relief Services Head Quarters, Baltimore, MD USA
| | | | - Mohammed Ali
- Catholic Relief Services Country Office, Tamale, Ghana
| | | | | | - Haliq Adam
- Catholic Relief Services Country Office, Tamale, Ghana
| | - Elena McEwan
- Catholic Relief Services Head Quarters, Baltimore, MD USA
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Anum A, Washington-Nortey M, Dzokoto V. Strategic planning in LAMIC mental health research: A Ghana case study. INTERNATIONAL JOURNAL OF MENTAL HEALTH 2020. [DOI: 10.1080/00207411.2020.1719621] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Adote Anum
- Department of Psychology, University of Ghana, Accra, Ghana
| | | | - Vivian Dzokoto
- Department of African American Studies, Virginia Commonwealth University, Richmond, Virginia, USA
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Jantarabenjakul W, Chonchaiya W, Puthanakit T, Theerawit T, Payapanon J, Sophonphan J, Veeravigom M, Jahanshad N, Thompson PM, Ananworanich J, Malee K, Pancharoen C. Low risk of neurodevelopmental impairment among perinatally acquired HIV-infected preschool children who received early antiretroviral treatment in Thailand. J Int AIDS Soc 2019; 22:e25278. [PMID: 30990969 PMCID: PMC6467461 DOI: 10.1002/jia2.25278] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Accepted: 03/28/2019] [Indexed: 11/20/2022] Open
Abstract
INTRODUCTION Antiretroviral therapy (ART) is recommended in perinatally HIV-infected (PHIV) infants immediately upon diagnosis. We aimed to compare neurodevelopmental outcomes between PHIV children who initiated ART within 12 months of life and perinatally HIV-exposed uninfected (PHEU) children and to assess neurodevelopmental outcomes by timing of ART. METHODS This prospective cohort study included Thai children aged 12 to 56 months who were assessed with the Mullen Scales of Early Learning (MSEL) at enrolment and at 48 weeks. Global Developmental Impairment (GDI) was defined as Early Learning Composite (ELC) ≤ 70 on the MSEL; typical developmental pattern was defined as ELC > 70 at both visits. Logistic regression was used to compare prevalence of any GDI. Predictors of changing ELC scores were analysed with generalized estimating equations linear regression model. RESULTS From 2016 to 2017, 50 PHIV (twenty-seven early ART within three months and twenty-three standard ART within three to twelve months) and 100 PHEU children were enrolled. Median (IQR) age at first assessment was 28 (19 to 41) months. PHIV children had lower age-relevant Z scores for weight, height and head circumference compared to the PHEU group (p < 0.05). The prevalence of overall GDI was 18% (95% CI 11 to 27) and 32% (95% CI 20 to 47) in PHEU and PHIV children respectively (p = 0.06). In subgroup analysis, 22% (95% CI 9 to 42) of early ART PHIV children and 44% (95% CI 23 to 66) of standard ART PHIV children had overall GDI. There was a higher rate of GDI in standard ART PHIV children (p = 0.01), but not in the early ART group (p = 0.62) when compared with PHEU children. The standard ART PHIV group demonstrated lower typical developmental pattern than both the early ART PHIV group and the PHEU group (57% vs. 77% vs. 82% respectively). Non-attendance at nursery school was associated with changes in ELC score during study participation (adjusted coefficient -3.8; 95% CI -6.1 to -1.6, p = 0.001). CONCLUSIONS Preschool children with HIV who initiated ART in the first three months of life had a similar rate of GDI as PHEU children. Lack of nursery school attendance predicted poor developmental trajectory outcomes among PHIV children.
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Affiliation(s)
- Watsamon Jantarabenjakul
- Department of PediatricsFaculty of MedicineChulalongkorn UniversityBangkokThailand
- Center of Excellence in Pediatric Infectious Diseases and VaccinesFaculty of MedicineChulalongkorn UniversityBangkokThailand
- Thai Red Cross Emerging Infectious Diseases Clinical CenterKing Chulalongkorn Memorial HospitalBangkokThailand
| | - Weerasak Chonchaiya
- Department of PediatricsFaculty of MedicineChulalongkorn UniversityBangkokThailand
- Maximizing Thai Children's Developmental Potential Research UnitFaculty of MedicineChulalongkorn UniversityBangkokThailand
| | - Thanyawee Puthanakit
- Department of PediatricsFaculty of MedicineChulalongkorn UniversityBangkokThailand
- Center of Excellence in Pediatric Infectious Diseases and VaccinesFaculty of MedicineChulalongkorn UniversityBangkokThailand
| | - Tuangtip Theerawit
- Center of Excellence in Pediatric Infectious Diseases and VaccinesFaculty of MedicineChulalongkorn UniversityBangkokThailand
| | - Jesdaporn Payapanon
- Center of Excellence in Pediatric Infectious Diseases and VaccinesFaculty of MedicineChulalongkorn UniversityBangkokThailand
| | - Jiratchaya Sophonphan
- The HIV Netherlands Australia Thailand Research Collaboration (HIV‐NAT)Thai Red Cross AIDS Research CentreBangkokThailand
| | - Montida Veeravigom
- Department of PediatricsFaculty of MedicineChulalongkorn UniversityBangkokThailand
| | - Neda Jahanshad
- Imaging Genetics CenterStevens Neuroimaging and Informatics InstituteKeck School of Medicine of USCLos AngelesCAUSA
| | - Paul M Thompson
- Imaging Genetics CenterStevens Neuroimaging and Informatics InstituteKeck School of Medicine of USCLos AngelesCAUSA
| | - Jintanat Ananworanich
- SEARCH, The Thai Red Cross AIDS Research Center (TRCARC)BangkokThailand
- Henry M. Jackson Foundation for the Advancement of Military MedicineBethesdaMDUSA
- Department of Global HealthThe University of AmsterdamAmsterdamThe Netherlands
| | - Kathleen Malee
- Ann & Robert H. Lurie Children's Hospital of ChicagoNorthwestern University Feinberg School of MedicineChicagoILUSA
| | - Chitsanu Pancharoen
- Department of PediatricsFaculty of MedicineChulalongkorn UniversityBangkokThailand
- Center of Excellence in Pediatric Infectious Diseases and VaccinesFaculty of MedicineChulalongkorn UniversityBangkokThailand
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