Thesis (M.Sc.(Med.))--University of the Witwatersrand, Faculty of Health Sciences, 2012. / Neurodevelopmental delay has been documented in up to 97.5% ofHIV-infected childfen in
Soweto who were not yet on ART. With growing numbers of children in South Africa being
successfully treated with antiretroviral treatment (ART), the effects of ART on
neurocognitive functioning in children require investigation. The objective of this study was
to determine the extent of neurodevelopmental delay in stable HIV -infected preschool
children (aged) 5-6 years) receiving ART and compare it to an apparently healthy .
(unconfirmed HIV-status) group of preschool children. Thirty HIV-infected preschool
children (virologically and immunologically stable on ART for> 1 year) were conveniently
sampled from 350 eligible children on ART at the Harriet Shezi Children's Clinic in Soweto,
Johannesburg. The comparison group comprised thirty well-nourished preschool children
attending the Lilian Ngoyi Primary Health Care Clinic in Soweto for routine immunisations.
Each child was assessed using the Griffiths Mental Development Scales-Extended Revised
Version (GMDS-ER), at a single point in time. The overall developmental z-scores on
GMDS-ER were <-2 (indicating severe delay) in 27 (90%) children in the HIV-infected
group compared to 23 (76%) in the comparison group (p=0.166). Mental handicap (overall
GQ<70) was evident in 46.7% of children in the HIV -infected group compared to 10% in the
comparison group (p= 0.002). There was a 7.88-fold increased likelihood of severe delay in
the HIV infected group. The HIV -infected group and comparison group had significantly
different (p=0.001) mean overall GQ scores of70 (95% CI: 66.0-74.0) and 78 (95% CI: 75.6-
80.5), respectively, with lower mean scores in the HIV -infected group in all individual
domains. Early initiation of ART in HIV-infected infants may improve cognitive functioning
among this group, however, intervention strategies which optimize early cognitive
development for all children in the area, need to be urgently considered.
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:wits/oai:wiredspace.wits.ac.za:10539/13788 |
| Date | 05 1900 |
| Creators | Lowick, Sarah |
| Source Sets | South African National ETD Portal |
| Language | English |
| Detected Language | English |
| Type | Thesis |
| Format | application/pdf |
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