Cognitive and Language Development at Age 4–6 Years in Children HIV‐Exposed But Uninfected Compared to Those HIV‐Unexposed and to Children Living With HIV

Gruver, Rachel S.; Kvalsvig, Jane; Knox, Justin; Mellins, Claude A.; Desmond, Chris; Kauchali, Shuaib; Arpadi, Stephen M.; Taylor, Myra; Davidson, Leslie L.

doi:10.1002/cad.20351

Cited by 10 publications

(6 citation statements)

References 30 publications

(48 reference statements)

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“…While studying child cognitive and language outcomes by HIV exposure status in wave 1, Gruver et al [ 15 ] noted that for all outcome measures, HIV-exposed but uninfected children and HIV-unexposed children had comparable scores, while HIV infected children had significantly lower cognitive and language scores. Additionally, in wave 1, Ajayi et al [ 16 ] found that children with low cognitive scores were more often stunted, had no preschool education, and came from areas less favorable in terms of local infrastructure, access to employment, and arable land.…”

Section: Resultsmentioning

confidence: 99%

The Asenze Cohort Study in KwaZulu-Natal, South Africa: protocol and cohort profile

et al. 2022

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INTRODUCTIONThis paper outlines the protocol, history, and scope of the Asenze Cohort Study in KwaZulu-Natal, South Africa. South Africa is a middle-income country shaped by the legacies of apartheid, periods of violent political instability, and an initial refusal of the government to acknowledge human immunodeficiency virus (HIV) as the cause of acquired immune deficiency syndrome (AIDS). These historic and ongoing challenges have led to South Africa having one of the highest prevalence rates of people living with HIV/AIDS [1] and one of the highest rates of socioeconomic inequality [2].The HIV/AIDS epidemic has increased the burden of childhood developmental disability and challenges to adolescent health and well-being in low-income and middle-income countries. HIV/AIDS is a multi-system, chronic illness whose impact on child health is physical, cognitive, and/or psychological. Children whose parent(s) are living with HIV/AIDS may be affected directly, through vertical transmission from mother to child, or indirectly, due to comorbidities or early mortality of a caregiver, which may in turn impact the quality of child care. HIV is a leading cause of disability across South Africa, including KwaZulu-Natal, the province with the highest prevalence of HIV [3]. Given HIV's im-The Asenze cohort is set in South Africa, a middle-income country impacted by one of the highest global rates of people living with HIV/AIDS and high levels of socioeconomic inequality. This longitudinal population-based cohort of children and their primary caregivers assesses household and caregiver functioning, child health, social well-being, and neuro-development from childhood through adolescence. Almost 1,600 children born at the peak of the human immunodeficiency virus epidemic (2003)(2004)(2005) were followed (with their primary caregivers) in 3 waves, between 2008 and 2021, at average ages of 5, 7, and 16. Wave 3 is currently underway, having assessed over 1,100 of the original wave 1 children. Wave 4 begins in 2022. The study, with a dyadic structure, uses a broad range of measures, validated in South Africa or recommended for global use, that address physical, social and neuro-development in childhood and adolescence, and the social, health, and psychological status of children's primary caregivers. The Asenze study deepens our understanding of childhood physical, cognitive, and social abilities and/or disabilities, including risk-taking behaviors, and biological, environmental, and social determinants of health. We anticipate the findings will contribute to the development of community-informed interventions to promote well-being in this South African population and elsewhere.

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Section: Resultsmentioning

confidence: 99%

The Asenze Cohort Study in KwaZulu-Natal, South Africa: protocol and cohort profile

et al. 2022

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“…However, if a test was not administered and the child was tested prior to the study assessment, then their HIV status was assigned as reported by the primary caregiver. Child HIV status was included because of both its direct and indirect impacts on a child's social, cognitive, and physical development [26,39,40]. Child SDQ baseline prosocial score was included because the impact of primary caregiver mental health disorders on the prosocial scale may vary by a child's initial prosocial score.…”

Section: Covariates (Assessed At Wave 1)mentioning

confidence: 99%

The impact of caregiver mental health on child prosocial behavior: A longitudinal analysis of children and caregivers in KwaZulu-Natal, South Africa

Norwitz,

Desmond,

Gruver

et al. 2023

PLoS ONE

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Background Prosocial behavior has positive social, cognitive, and physical health effects on the individual exhibiting the behavior as well as on society as a whole, and is integral to overall mental and physical wellbeing. The development of prosocial behavior is rooted in early childhood and learned through observation. As such, those spending time with children, especially their caregiver, play a critical role in their prosocial development. The current study investigates the impact of caregiver mental health on the prosocial development of young children over time. Methods This paper presents a secondary analysis of child prosocial development in the Asenze Study, a longitudinal, population-based cohort study based in KwaZulu-Natal, South Africa. Children were followed-up over time from an average age of five to seven years along with their caregivers. Linear GEE regression analysis was used to assess whether a change in presence of a mental health disorder in a caregiver during this 2-year interval (using the Client Diagnostic Questionnaire) impacted the development of their child’s prosocial behavior (using the Strengths and Difficulties Questionnaire). Results After adjusting for early child-care, child HIV status, SDQ child prosocial subscale, SDQ total difficulties score, and household order score (CHAOS), children whose caregivers acquired a mental health disorder had a significantly smaller increase in prosocial behavioral development compared to children whose caregivers never had a mental health disorder. Conclusions Identifying contextually relevant modifiable factors such as this will help stimulate the development of interventions to promote prosocial development in childhood.

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“…5-10 Importantly, cognitive development is also affected in pediatric HIV, where infants and young children with HIV do not perform, as well as their HIV-exposed or HIV uninfected peers. 11-14 ART remains the mainstay of treatment for HIV-associated cognitive disorders in both adults and children. 15 As ART has become more widely available, the prevalence of HIV-associated cognitive impairment has generally decreased, 16-18 yet at an individual level, it remains an important source of morbidity for PWH.…”

Section: Hiv: History and Current Burdenmentioning

confidence: 99%

Need to Revise Frascati Criteria for HIV-Associated Neurocognitive Disorders to Improve Relevance for Diverse Global Populations

Meyer

2022

Neur Clin Pract

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Abstract:Worldwide, cognitive impairment is a frequent complication of HIV and few treatments are available. Existing diagnostic criteria for cognitive disorders associated with HIV have limited diagnostic accuracy, hampering biomarker and therapeutic development. Further, these criteria are not linked to clinically meaningful outcomes, limiting utility in clinical settings. Limitations in diagnostic accuracy is most pronounced in resource-limited settings where the burden of HIV is greatest, largely due to heavy reliance on neuropsychological testing with limited cross-cultural validity. Accurate and clinically meaningful diagnostic criteria validated in diverse populations will improve research and clinical care for cognitively impaired people living with HIV globally.

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Cognitive and Language Development at Age 4–6 Years in Children HIV‐Exposed But Uninfected Compared to Those HIV‐Unexposed and to Children Living With HIV

Cited by 10 publications

References 30 publications

The Asenze Cohort Study in KwaZulu-Natal, South Africa: protocol and cohort profile

The Asenze Cohort Study in KwaZulu-Natal, South Africa: protocol and cohort profile

The impact of caregiver mental health on child prosocial behavior: A longitudinal analysis of children and caregivers in KwaZulu-Natal, South Africa

Need to Revise Frascati Criteria for HIV-Associated Neurocognitive Disorders to Improve Relevance for Diverse Global Populations

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