The effects of prenatal HIV exposure on language functioning in Kenyan children: establishing an evaluative framework

Alcock, Katie; Abubakar, Amina; Newton, Charles R.; Holding, Penny

doi:10.1186/s13104-016-2264-3

Cited by 9 publications

(10 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The results from this South African birth cohort show that HIV-exposed uninfected children had poorer language outcomes at 24 months, but not at 6 months, when compared with HIV-unexposed children. To our knowledge, this is the largest longitudinal study to report delayed language development in both receptive and expressive domains in HIV-exposed uninfected children in South Africa, building on previous literature18, 19, 20, 21 suggesting that language might be impaired in this population.…”

Section: Discussionmentioning

confidence: 81%

Neurodevelopment of HIV-exposed uninfected children in South Africa: outcomes from an observational birth cohort study

Wedderburn

Yeung

Rehman

et al. 2019

The Lancet Child & Adolescent Health

129

View full text Add to dashboard Cite

Background HIV infection is known to cause developmental delay, but the effects of HIV exposure without infection during pregnancy on child development are unclear. We compared the neurodevelopmental outcomes of HIV-exposed uninfected and HIV-unexposed children during their first 2 years of life. Methods Pregnant women (>18 years of age) at 20-28 weeks' gestation were enrolled into the Drakenstein Child Health cohort study while attending routine antenatal appointments at one of two peri-urban community-based clinics in Paarl, South Africa. Livebirths born to enrolled women during follow-up were included in the birth cohort. Mothers and infants received antenatal and postnatal HIV testing and antiretroviral therapy per local guidelines. Developmental assessments on the Bayley Scales of Infant and Toddler Development, third edition (BSID-III), were done in a subgroup of infants at 6 months of age, and in the full cohort at 24 months of age, with assessors masked to HIV exposure status. Mean raw scores and the proportions of children categorised as having a delay (scores <-2 SDs from the reference mean) on BSID-III were compared between HIV-exposed uninfected and HIV-unexposed children. Findings 1225 women were enrolled between March 5, 2012, and March 31, 2015. Of 1143 livebirths, 1065 (93%) children were in follow-up at 6 months and 1000 (87%) at 24 months. Two children were diagnosed with HIV infection between birth and 24-month follow-up and were excluded from the analysis. BSID-III assessments were done in 260 (24%) randomly selected children (61 HIV-exposed uninfected, 199 HIV-unexposed) at 6 months and in 732 (73%) children (168 HIV-exposed uninfected, 564 HIV-unexposed) at 24 months. All HIV-exposed uninfected children were exposed to antiretrovirals (88% to maternal triple antiretroviral therapy). BSID-III outcomes did not significantly differ between HIV-exposed uninfected and HIV-unexposed children at 6 months. At 24 months, HIV-exposed uninfected children scored lower than HIV-unexposed for receptive language (adjusted mean difference-1•03 [95% CI-1•69 to-0•37]) and expressive language (-1•17 [-2•09 to-0•24]), whereas adjusted differences in cognitive (-0•45 [-1•32 to 0•43]), fine motor (0•09 [-0•49 to 0•66]), and gross motor (-0•41 [-1•09 to 0•27]) domain scores between groups were not significant. Correspondingly, the proportions of HIV-exposed uninfected children with developmental delay were higher than those of HIV-unexposed children for receptive language (adjusted odds ratio 1•96 [95% CI 1•09 to 3•52]) and expressive language (2•14 [1•11 to 4•15]). Interpretation Uninfected children exposed to maternal HIV infection and antiretroviral therapy have increased odds of receptive and expressive language delays at 2 years of age. Further long-term work is needed to understand developmental outcomes of HIV-exposed uninfected children, especially in regions such as sub-Saharan Africa that have a high prevalence of HIV exposure among children.

show abstract

Section: Discussionmentioning

confidence: 81%

Neurodevelopment of HIV-exposed uninfected children in South Africa: outcomes from an observational birth cohort study

Wedderburn

Yeung

Rehman

et al. 2019

The Lancet Child & Adolescent Health

129

View full text Add to dashboard Cite

show abstract

“…Although studies have reported language deficits or late language emergence in HEU vs. HUU children [7,10,33], our cohort showed no difference. However, language delay in HEU infants may not be evident as early as 12 months of age [34]. Seven HEU infants (12%) and one (2.6%) HUU infant reached the ADBB threshold for social withdrawal behaviour.…”

Section: Discussionmentioning

confidence: 93%

“…HUU children , our cohort showed no difference. However, language delay in HEU infants may not be evident as early as 12 months of age .…”

Section: Discussionmentioning

confidence: 97%

Neurodevelopmental outcome of HIV‐exposed but uninfected infants in the Mother and Infants Health Study, Cape Town, South Africa

Springer

Slogrove

Laughton

et al. 2017

Tropical Med Int Health

View full text Add to dashboard Cite

Abstractobjectives To compare neurodevelopmental outcomes of HIV-exposed uninfected (HEU) and HIVunexposed uninfected (HUU) infants in a peri-urban South African population. HEU infants living in Africa face unique biological and environmental risks, but uncertainty remains regarding their neurodevelopmental outcome. This is partly due to lack of well-matched HUU comparison groups needed to adjust for confounding factors.methods This was a prospective cohort study of infants enrolled at birth from a low-risk midwife obstetric facility. At 12 months of age, HEU and HUU infant growth and neurodevelopmental outcomes were compared. Growth was evaluated as WHO weight-for-age, length-for-age, weight-forlength and head-circumference-for-age Z-scores. Neurodevelopmental outcomes were evaluated using the Bayley scales of Infant Development III (BSID) and Alarm Distress Baby Scale (ADBB).results Fifty-eight HEU and 38 HUU infants were evaluated at 11-14 months of age. Performance on the BSID did not differ in any of the domains between HEU and HUU infants. The cognitive, language and motor scores were within the average range (US standardised norms). Seven (12%) HEU and 1 (2.6%) HUU infant showed social withdrawal on the ADBB (P = 0.10), while 15 (26%) HEU and 4 (11%) HUU infants showed decreased vocalisation (P = 0.06). There were no growth differences. Three HEU and one HUU infant had minor neurological signs, while eight HEU and two HUU infants had macrocephaly.conclusions Although findings on the early neurodevelopmental outcome of HEU infants are reassuring, minor differences in vocalisation and on neurological examination indicate a need for reassessment at a later age.

show abstract

“…The forms of validity that have been tested in earlier applications of vocabulary measures among young children include establishing their relationship with age, SES (Luoni et al, 2015), non-verbal reasoning (Luoni et al, 2015;Storms, Saerens, & Deyn, 2004), reading skills (Luoni et al, 2015;Nation & Snowling, 2004), word production (Vogt et al, 2015), and clinical outcomes (Alcock, Abubakar, Newton, & Holding, 2016;Alcock, Holding, Mung'ala-Odera, & Newton, 2008). The fact that there are few studies reported from SSA demonstrates that much more effort is required in the validation of vocabulary measures that will be responsive to the cultural and language diversity in this context.…”

mentioning

confidence: 99%

Measurement of expressive vocabulary in school-age children: Development and application of the Kilifi Naming Test (KNT)

Kitsao-Wekulo

Holding

Kvalsvig

et al. 2017

Applied Neuropsychology: Child

View full text Add to dashboard Cite

The dearth of locally developed measures of language makes it difficult to detect language and communication problems among school-age children in sub-Saharan African settings. We sought to describe variability in vocabulary acquisition as an important element of global cognitive functioning. Our primary aims were to establish the psychometric properties of an expressive vocabulary measure, examine sources of variability, and investigate the measure's associations with non-verbal reasoning and educational achievement. The study included 308 boys and girls living in a predominantly rural district in Kenya. The developed measure, the Kilifi Naming Test (KNT), had excellent reliability and acceptable convergent validity. However, concurrent validity was not adequately demonstrated. In the final regression model, significant effects of schooling and area of residence were recorded. Contextual factors should be taken into account in the interpretation of test scores. There is need for future studies to explore the concurrent validity of the KNT further.

show abstract

The effects of prenatal HIV exposure on language functioning in Kenyan children: establishing an evaluative framework

Cited by 9 publications

References 24 publications

Neurodevelopment of HIV-exposed uninfected children in South Africa: outcomes from an observational birth cohort study

Neurodevelopment of HIV-exposed uninfected children in South Africa: outcomes from an observational birth cohort study

Neurodevelopmental outcome of HIV‐exposed but uninfected infants in the Mother and Infants Health Study, Cape Town, South Africa

Measurement of expressive vocabulary in school-age children: Development and application of the Kilifi Naming Test (KNT)

Contact Info

Product

Resources

About