Impact of the HIV/AIDS Epidemic on the Neurodevelopment of Preschool-Aged Children in Kinshasa, Democratic Republic of the Congo
Identifieur interne : 002982 ( Pmc/Checkpoint ); précédent : 002981; suivant : 002983Impact of the HIV/AIDS Epidemic on the Neurodevelopment of Preschool-Aged Children in Kinshasa, Democratic Republic of the Congo
Auteurs : Annelies Van Rie [États-Unis] ; Aimee Mupuala ; Anna Dow [États-Unis]Source :
- Pediatrics [ 0031-4005 ] ; 2008.
Abstract
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.
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.
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.
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.
Url:
DOI: 10.1542/peds.2007-2558
PubMed: 18595957
PubMed Central: 2900927
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<front><div type="abstract" xml:lang="en"><sec id="S1"><title>OBJECTIVES</title>
<p id="P1">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.</p>
</sec>
<sec sec-type="methods" id="S2"><title>METHODS</title>
<p id="P2">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.</p>
</sec>
<sec id="S3"><title>RESULTS</title>
<p id="P3">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.</p>
</sec>
<sec id="S4"><title>CONCLUSIONS</title>
<p id="P4">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.</p>
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Department of Epidemiology, University of North Carolina, Chapel Hill, North Carolina</aff>
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Department of Pediatrics, University of Kinshasa, Kinshasa, Democratic Republic of Congo</aff>
<author-notes><corresp id="CR1">Address correspondence to Annelies Van Rie, MD, PhD, University of North Carolina, Department of Epidemiology, 2104F McGavran Greenberg Hall, Chapel Hill, NC 27599-7435. <email>vanrie@email.unc.edu</email>
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<pub-date pub-type="nihms-submitted"><day>27</day>
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<pub-date pub-type="pmc-release"><day>9</day>
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<year>2010</year>
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<volume>122</volume>
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<fpage>e123</fpage>
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<permissions><copyright-statement>Copyright © 2008 by the American Academy of Pediatrics</copyright-statement>
<copyright-year>2008</copyright-year>
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<abstract><sec id="S1"><title>OBJECTIVES</title>
<p id="P1">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.</p>
</sec>
<sec sec-type="methods" id="S2"><title>METHODS</title>
<p id="P2">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.</p>
</sec>
<sec id="S3"><title>RESULTS</title>
<p id="P3">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.</p>
</sec>
<sec id="S4"><title>CONCLUSIONS</title>
<p id="P4">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.</p>
</sec>
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