Impact of sociodemographic factors on cognitive function in school-aged HIV-infected Nigerian children

Abstract

BackgroundIn this study, we sought to evaluate the influence of sociodemographic factors, ie, age, sex, socioeconomic status, maternal education, and human immunodeficiency virus (HIV) status, on cognitive performance in school-aged HIV-infected Nigerian children.MethodsSixty-nine HIV-positive children aged 6–15 years were matched with 69 HIV-negative control children for age and sex. The children were subdivided for the purpose of analysis into two cognitive developmental stages using Piaget’s staging, ie, the concrete operational stage (6–11 years) and the formal operational stage (12–15 years). All participants underwent cognitive assessment using Raven’s Standard Progressive Matrices (RPM). Sociodemographic data for the study participants, ie, age, sex, socioeconomic status, and level of maternal education, were obtained using a study proforma. Logistic regression analyses were used to determine associations of HIV status and sociodemographic characteristics with RPM cognitive scores.ResultsThe overall mean RPM score for the HIV-positive children was 18.2 ± 9.8 (range 8.0–47.0) which was significantly lower than the score of 27.2 ± 13.8 (range 8.0–52.0) for the HIV-negative children (P < 0.001). On RPM grading, 56.5% of the HIV-positive children had cognitive performance at below average to intellectually defective range. Below average RPM scores were found to be significantly associated with younger age (6–11 years), positive HIV status, lower socioeconomic status, and low level of maternal education.ConclusionYounger age, poor socioeconomic status, and low level of maternal education were factors apart from HIV infection that were significantly associated with low cognitive function in school-aged HIV-infected Nigerian children.

The burden and predictors of cognitive impairment among 6- to 8-year-old children infected and uninfected with HIV from Harare, Zimbabwe: A cross-sectional study

“…Two studies (Bisiacchi, Suppiej, & Laverda, 2000;Koekkoek et al, 2008) reported executive function deficits as the most sensitive cognitive measure in relation to HIV disease progression. A study by Koekkoek et al among 22 school-age children with HIV We identified a 16% prevalence of cognitive impairment in children with HIV infection, which is at variance with findings of 56% reported by Boyede in a study among Nigerian school-aged children (Boyede et al, 2013) and 71% reported by Puthanakit among Thai school-aged children (Puthanakit et al, 2013) with HIV infection (Puthanakit et al, 2013). In both studies the children were symptomatic of HIV infection and were on cART: 71% and 87% in Nigerian and Thai children, respectively.…”

“…A study by Coscia et al found that the quality of the home environment mediated the relationship between socioeconomic status and child cognitive function (Coscia et al, 2001), while a study conducted in Kenya among children under 3 years living in poverty reported anthropometric measures such as height and weight as mediators of the relationship between socioeconomic status and psychomotor development (Abubakar, 2008). We identified lower socioeconomic status as an independent risk factor for cognitive impairment in this study, a finding supported by previous research from resource-constrained settings (Bagenda et al, 2006;Boyede et al, 2013;Grantham-McGregor et al, 2007;Puthanakit et al, 2013). Poverty in the home has adverse effects on child development since it results in increased maternal stress or depression and inadequate child stimulation in the home (Grantham-McGregor et al, 2007).…”

“…, inadequate stimulation (Bangirana et al, 2009;Walker et al, 2007), poor socioeconomic status (Boyede, Lesi, Ezeaka, & Umeh, 2013;Coscia et al, 2001), head injury (Salmond & Sahakian, 2005), toxins exposure (Koger, Schettler, & Weiss, 2005), and infectious diseases such as HIV (Baillieu & Potterton, 2008;Sherr, Mueller, & Varrall, 2009). Although HIV and environmental factors are largely preventable, they have been reported to decrease cognitive function independently in children (Boyede et al, 2013;Smith et al, 2006).…”

“…Although HIV and environmental factors are largely preventable, they have been reported to decrease cognitive function independently in children (Boyede et al, 2013;Smith et al, 2006). Children in resource-constrained communities suffer the greater burden of both these risk factors.…”

Developmental status of preschool children receiving cART: a descriptive cohort study

“…Lowick et al () reported 90% of children between the ages of 5 and 6 years to be significantly delayed when tested with the Griffiths Scales of Mental Development (GSMD). In Nigeria, Boyede et al () found 56.5% of HIV‐infected school‐age children in their sample to perform below average on cognitive assessment. Children who have a diagnosis of HIV encephalopathy are more likely to present with cognitive impairment during childhood and adolescence (Smith et al ).…”