HIV hampers children's development‚ says KZN study

16 July 2018 - 08:33 By Dave Chambers
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HIV-positive children in South Africa are more likely to have developmental disabilities than those who are HIV-negative.

Four to six-year-old HIV-positive children tested by University of KwaZulu-Natal doctors were nearly four times more likely to have experienced delays in sitting‚ standing‚ walking and speaking‚ and faced more than twice the odds of a hearing disability and cognitive delay.

The children were tested through a widely used process called the Ten Question (TQ) screen‚ which found more than 59% of the HIV-positive children reported delays compared to 43% of HIV-negative children.

The research‚ which involved the first use of the TQ screen in Zulu‚ was led by doctors from Columbia University in the US‚ and involved Shuaib Kauchali‚ Murray Craib‚ Jane Kvalsvig and Myra Taylor from UKZN. The findings have been reported in the journal PLOS One.

The TQ screen measures caregivers’ perceptions of their child’s neurodevelopmental functioning. “[It] was developed to identify moderate and severe cognitive‚ motor‚ seizure‚ speech‚ vision and hearing disabilities and developmental delays in settings with limited access to professional resources‚” said Justin Knox from Columbia.

“We found this test to be a very effective way to screen HIV-positive children for neurodevelopmental problems in resource-poor areas.”

The proportion of children who screened positive among those both HIV-positive and HIV-negative were among the highest reported. Gross motor concerns were especially prominent‚ including delays in learning to sit and stand‚ difficulty walking or moving arms‚ and weakness in the arms or legs.

An initial door-to-door survey identified 14‚425 households‚ including 2‚049 children aged between four and six‚ and 1‚231 of their caregivers. A doctor conducted a physical examination and noted the children’s medical history. Hearing and vision screenings were conducted as well as a psychological assessment for cognition and language delay‚ and voluntary HIV testing.

At the conclusion of the study‚ 62 children were identified as HIV-positive‚ approximately three times the number known before the study.

“Many HIV-positive children continue to have unrecognised neurodevelopmental disabilities‚” said lead author Leslie Davidson. “Increased attention to early HIV diagnosis and intervention is critical to prevent these neurocognitive issues‚ as much as possible.”

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