Impact of the HIV/AIDS epidemic on the neurodevelopment of preschool-aged children in Kinshasa, Democratic Republic of the Congo.

Full Abstract

OBJECTIVES:
Pediatric HIV infection is a growing problem in most regions of the world. Data on the effects of HIV on the neurodevelopment of children in resource-poor settings are scarce but necessary to guide interventions. The purpose of this study was to compare the neurodevelopment of preschool-aged HIV-infected, HIV-affected (HIV-uninfected AIDS orphans and HIV-uninfected children whose mother had symptomatic AIDS), and healthy control children in Kinshasa, Democratic Republic of Congo.

METHODS:
Thirty-five HIV-infected, 35 HIV-affected, and 90 control children aged 18 to 72 months were assessed by using the Bayley Scales of Infant Development II, Peabody Developmental Motor Scales, Snijders-Oomen Nonverbal Intelligence Test, and Rossetti Infant-Toddler Language Scale, as appropriate for age.

RESULTS:
Overall, 60% of HIV-infected children had severe delay in cognitive function, 29% had severe delay in motor skills, 85% had delays in language expression, and 77% had delays in language comprehension, all significantly higher rates as compared with control children. Young HIV-infected children (aged 18-29 months) performed worse, with 91% and 82% demonstrating severe mental and motor delay, respectively, compared with 46% and 4% in older HIV-infected children (aged 30-72 months). HIV-affected children had significantly more motor and language expression delay than control children.

CONCLUSIONS:
The impact of the HIV pandemic on children's neurodevelopment extends beyond the direct effect of the HIV virus on the central nervous system. AIDS orphans and HIV-negative children whose mothers had AIDS demonstrated significant delays in their neurodevelopment, although to a lesser degree and in fewer developmental domains than HIV-infected children. Young HIV-infected children were the most severely afflicted group, indicating the need for early interventions. Older children performed better as a result of a "survival effect," with only those children with less aggressive disease surviving.

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Author information

Author/s: Van Rie, Annelies (A); Mupuala, Aimee (A); Dow, Anna (A);

Affiliation: Department of Epidemiology, University of North Carolina, Chapel Hill, North Carolina 27599-7435, USA. vanrie(-atsign-)email.unc.edu

Grants: R21 MH071214 (Agency:United States NIMH)

Journal and publication information

Publication Type: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't

Journal: Pediatrics (Pediatrics), published in United States. (Language: eng)

Reference: 2008-Jul; vol 122 (issue 1) : pp e123-8

Dates: Created 2008/07/03; Completed 2008/07/31;

PMID: 18595957, status: MEDLINE (last retrieval date: 11/6/2008)

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Acquired Immunodeficiency Syndrome - epidemiology
Child Development
Child, Preschool
Cognition Disorders - epidemiology
Cross-Sectional Studies
Democratic Republic of the Congo - epidemiology
Developmental Disabilities - epidemiology
Female

HIV Infections - epidemiology
Humans
Infant
Language Development Disorders - epidemiology
Language Disorders - epidemiology
Male
Motor Skills
Nervous System - growth & development

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