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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Impact of the HIV/AIDS Epidemic on the Neurodevelopment of Preschool-Aged Children in Kinshasa, Democratic Republic of the Congo</title><author><name sortKey="Van Rie, Annelies" sort="Van Rie, Annelies" uniqKey="Van Rie A" first="Annelies" last="Van Rie">Annelies Van Rie</name><affiliation><nlm:aff id="A1">Department of Epidemiology, University of North Carolina, Chapel Hill, North Carolina</nlm:aff></affiliation></author><author><name sortKey="Mupuala, Aimee" sort="Mupuala, Aimee" uniqKey="Mupuala A" first="Aimee" last="Mupuala">Aimee Mupuala</name><affiliation><nlm:aff id="A2">Department of Pediatrics, University of Kinshasa, Kinshasa, Democratic Republic of Congo</nlm:aff></affiliation></author><author><name sortKey="Dow, Anna" sort="Dow, Anna" uniqKey="Dow A" first="Anna" last="Dow">Anna Dow</name><affiliation><nlm:aff id="A1">Department of Epidemiology, University of North Carolina, Chapel Hill, North Carolina</nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">18595957</idno><idno type="pmc">2900927</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2900927</idno><idno type="RBID">PMC:2900927</idno><idno type="doi">10.1542/peds.2007-2558</idno><date when="2008">2008</date><idno type="wicri:Area/Pmc/Corpus">000F74</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000F74</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Impact of the HIV/AIDS Epidemic on the Neurodevelopment of Preschool-Aged Children in Kinshasa, Democratic Republic of the Congo</title><author><name sortKey="Van Rie, Annelies" sort="Van Rie, Annelies" uniqKey="Van Rie A" first="Annelies" last="Van Rie">Annelies Van Rie</name><affiliation><nlm:aff id="A1">Department of Epidemiology, University of North Carolina, Chapel Hill, North Carolina</nlm:aff></affiliation></author><author><name sortKey="Mupuala, Aimee" sort="Mupuala, Aimee" uniqKey="Mupuala A" first="Aimee" last="Mupuala">Aimee Mupuala</name><affiliation><nlm:aff id="A2">Department of Pediatrics, University of Kinshasa, Kinshasa, Democratic Republic of Congo</nlm:aff></affiliation></author><author><name sortKey="Dow, Anna" sort="Dow, Anna" uniqKey="Dow A" first="Anna" last="Dow">Anna Dow</name><affiliation><nlm:aff id="A1">Department of Epidemiology, University of North Carolina, Chapel Hill, North Carolina</nlm:aff></affiliation></author></analytic><series><title level="j">Pediatrics</title><idno type="ISSN">0031-4005</idno><idno type="eISSN">1098-4275</idno><imprint><date when="2008">2008</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><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></sec></div></front></TEI><pmc article-type="research-article" xml:lang="EN"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<pmc-dir>properties manuscript</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-journal-id">0376422</journal-id><journal-id journal-id-type="pubmed-jr-id">6405</journal-id><journal-id journal-id-type="nlm-ta">Pediatrics</journal-id><journal-title>Pediatrics</journal-title><issn pub-type="ppub">0031-4005</issn><issn pub-type="epub">1098-4275</issn></journal-meta><article-meta><article-id pub-id-type="pmid">18595957</article-id><article-id pub-id-type="pmc">2900927</article-id><article-id pub-id-type="doi">10.1542/peds.2007-2558</article-id><article-id pub-id-type="manuscript">NIHMS203604</article-id><article-categories><subj-group subj-group-type="heading"><subject>Article</subject></subj-group></article-categories><title-group><article-title>Impact of the HIV/AIDS Epidemic on the Neurodevelopment of Preschool-Aged Children in Kinshasa, Democratic Republic of the Congo</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Van Rie</surname><given-names>Annelies</given-names></name><degrees>MD, PhD</degrees><xref ref-type="aff" rid="A1">a</xref></contrib><contrib contrib-type="author"><name><surname>Mupuala</surname><given-names>Aimee</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="A2">b</xref></contrib><contrib contrib-type="author"><name><surname>Dow</surname><given-names>Anna</given-names></name><degrees>MSPH</degrees><xref ref-type="aff" rid="A1">a</xref></contrib></contrib-group><aff id="A1"><label>a</label>Department of Epidemiology, University of North Carolina, Chapel Hill, North Carolina</aff><aff id="A2"><label>b</label>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></corresp></author-notes><pub-date pub-type="nihms-submitted"><day>27</day><month>5</month><year>2010</year></pub-date><pub-date pub-type="ppub"><month>7</month><year>2008</year></pub-date><pub-date pub-type="pmc-release"><day>9</day><month>7</month><year>2010</year></pub-date><volume>122</volume><issue>1</issue><fpage>e123</fpage><lpage>e128</lpage><permissions><copyright-statement>Copyright © 2008 by the American Academy of Pediatrics</copyright-statement><copyright-year>2008</copyright-year></permissions><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></abstract><kwd-group><kwd>HIV</kwd><kwd>AIDS</kwd><kwd>neurodevelopment</kwd><kwd>child</kwd><kwd>Africa</kwd></kwd-group><contract-num rid="MH1">R21 MH071214-02
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