154Neuropsychological impairments in HIV/AIDS have been extensively researched and reported in developed countries, usually reflecting the prominence of initial sub-cortical involvement and characterized by memory loss (usually impaired retrieval), general slowing of psychomotor speed and thought processes and impaired manipulation of acquired knowledge. 1,2 Memory impairment, both verbal and non-verbal, is characteristic of HIV-associated dementia. 3 During the early years of the HIV epidemic, cognitive symptoms were thought to be common even during the initial ABSTRACT: Background: Memory impairment, usually impaired retrieval of information, has been described in HIV/AIDS, especially among those with severe illness. Neuro-cognitive disturbances in HIV/AIDS have been linked to poor quality of life and medication adherence. This prospective, case-control study was designed to assess the verbal and non-verbal memory as well as the attention abilities of Nigerian Africans with HIV/AIDS and correlate their performances with their CD4+ T lymphocytes (CD4+) counts. Methods: A total of 288 randomly selected subjects, comprising 96 HIV-positive symptomatic patients, 96 HIV-positive asymptomatic patients and 96 HIV-negative controls, participated in the study. The subjects were age-, sex-, and level of education matched. The Recognition Memory Test and Choice Reaction Time tasks, components of the computer-assisted neuropsychological tests battery-the Iron Psychology 'FePsy' were used for cognitive assessments. Results: The mean memory scores of the HIV-positive asymptomatic subjects did not differ significantly from the controls (p>0.05) but the HIV-positive symptomatic subjects' scores were significantly lower than the controls (p<0.05). Both HIV-positive groups had psychomotor slowing and impaired attention (p<0.05). The HIVpositive subjects with CD4+ counts <200/µl and between 200 and 499/µl had significant memory impairment (p<0.001 and p<0.001 respectively) but there was no significant impairment among those with count ≥500/µl. Impaired ability for sustained attention was however present irrespective of the CD4+ level relative to controls (p<0.001). Conclusions: We concluded that there was no significant memory disturbance among HIV-positive asymptomatic subjects despite the presence of impaired attention and psychomotor slowing, and that the severity of immune suppression (as indicated by the CD4+ T lymphocytes count) is a strong determinant of cognitive decline in HIV/AIDS. RÉSUMÉ: Étude prospective cas-témoin du fonctionnement mnésique chez les patients atteints du VIH/SIDA. Contexte : Une atteinte de la mémoire, habituellement de la récupération de l'information, a été décrite chez les patients atteints du VIH/SIDA, spécialement chez ceux dont la maladie est sévère. Les perturbations neuro-cognitives dans le VIH/SIDA ont été associées à une faible qualité de vie et de fidélité à la médication. . Il n'existait pas d'atteinte significative chez ceux dont le décompte était ? 500/Ìl. Cependant, ils avaient un déf...

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There are conflicting reports on the presence of neurocognitive dysfunction during the initial, medically asymptomatic stage of HIV infection. This study aimed to assess the psychomotor speed and attention ability of antiretroviral treatment-naïve Nigerian Africans with HIV/AIDS and the impact of CD4 levels on their cognitive performance. Two hundred and eighty-eight randomly selected age-, sex- and level of education-matched subjects participated, comprising 96 HIV-positive asymptomatic and 96 HIV-positive symptomatic patients and 96 HIV-negative controls. The simple reaction and binary choice reaction time tasks were used for cognitive assessment. The binary choice reaction time indicated that the HIV-positive patients had impaired attention ability and significant psychomotor slowing compared with the controls (P<0.05), but psychomotor slowing was obvious among the symptomatic HIV-positive patients only using the simple reaction time tasks. Significant psychomotor retardation was observed in HIV-positive patients with CD4 levels of 200-499 cells/mm(3) (P=0.02) and <200 cells/mm(3) (P<0.001), and impaired ability for sustained attention was present irrespective of the CD4 level (P<0.001). We conclude that psychomotor retardation and impaired attention are significantly worse in HIV-positive subjects compared with controls and are adversely affected by decreasing CD4 levels. The sensitivity of the neuropsychological tool used can affect the degree of impairment measured.

Background Clinical disease registries are useful for quality improvement in care, benchmarking standards, and facilitating research. Collaborative networks established thence can enhance national and international studies by generating more robust samples and credible data and promote knowledge sharing and capacity building. This report describes the methodology, baseline data, and prospects of the Nigeria Parkinson Disease Registry. Methods This national registry was established in November 2016. Ethics approval was obtained for all sites. Basic anonymized data for consecutive cases fulfilling the United Kingdom Parkinson's Disease Brain Bank criteria (except the exclusion criterion of affected family members) are registered by participating neurologists via a secure registry website (http://www.parkinsonnigeria.com) using a minimal common data capture format. Results The registry had captured 578 participants from 5 of 6 geopolitical zones in Nigeria by July 2019 (72.5% men). Mean age at onset was 60.3 ± 10.7 years; median disease duration (interquartile range) was 36 months (18–60.5 months). Young‐onset disease (<50 years) represented 15.2%. A family history was documented in 4.5% and 7.8% with age at onset <50 and ≥ 50, respectively. The most frequent initial symptom was tremor (45.3%). At inclusion, 93.4% were on treatment (54.5% on levodopa monotherapy). Per‐capita direct cost for the registry was $3.37. Conclusions This is the first published national Parkinson's disease registry in sub‐Saharan Africa. The registry will serve as a platform for development of multipronged evidence‐based policies and initiatives to improve quality of care of Parkinson's disease and research engagement in Nigeria. © 2020 International Parkinson and Movement Disorder Society

HIV infection can produce a range of cognitive and behavioural symptoms that become more frequent and severe as the immune system deteriorates. This case-control study assessed the reaction time and the motor speed of Nigerian Africans with HIV or AIDS using the simple reaction time and finger-tapping tasks, and correlated their performances with their CD4 levels. A total of 288 age-, sex-, and level of education-matched subjects, comprising 96 HIV-positive patients with symptomatic illness, 96 HIV-positive patients with asymptomatic infection, and 96 HIV-negative controls, participated in the study. The mean CD4 cell counts of the controls, HIV-positive asymptomatic subjects, and HIV-positive symptomatic subjects were 682 ±44, 284 ±62 and 142 ±36, respectively (p < 0.05). There was no significant difference in the reaction time and motor speeds of the asymptomatic HIV-positive subjects and the controls (p > 0.05), but there was significant prolongation of reaction time and reduced finger taps among the symptomatic HIV-positive subjects (p < 0.01). The cognitive performance was worse in subjects with CD4 cell counts less than 200/μl as compared with subjects with CD4 cell counts greater than 200/μl. We conclude that there is no significant prolongation of reaction time and reduced motor speed in asymptomatic HIV-positive individuals but there is a definite cognitive deterioration with progressive reduction in CD4 levels.