Factors Contributing to the Psychosocial Adjustment of Ugandan Preschool Children with HIV/AIDS

Busman, Rachelle A.; Page, Connie; Oka, Evelyn R.; Giordani, Bruno; Boivin, Michael J.

doi:10.1007/978-1-4614-6834-9_5

Cited by 15 publications

(12 citation statements)

References 45 publications

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“…This study is also rich in construct validity in that the TQ, socioeconomic status, HOME, and Raven were predictive of MSEL developmental outcomes in a manner consistent with what has been documented in English speaking areas. 26 It does provide strong inter-rater reliability, and shows evidence of the successful adaptation and implementation of important assessments with very young children and their mothers in a low-resource setting.…”

Section: Discussionmentioning

confidence: 94%

Usefulness of Child Development Assessments for Low-Resource Settings in Francophone Africa

Koura

Boivin

Davidson

et al. 2013

Journal of Developmental &Amp; Behavioral Pediatrics

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Objective Few tools are available to screen or assess infant’s cognitive development, especially in French-speaking Africa. This study evaluated the use of the French translation of the Mullen Scales of Early Learning (MSEL), and the ‘Ten Questions’ questionnaire (TQ) in 1-year-old children in Benin, a francophone country. Methods A cross-sectional study was conducted in three health centers serving a semi-rural area in Benin. Three hundred fifty-seven children aged 12 months and their mothers were enrolled in 2011. Infant development was assessed at local health centers followed by a home visit to collect information on socioeconomic status, maternal Raven score, maternal depressive symptoms, and mother–child interactions (HOME Inventory) and to administer the TQ. Results The infant’s gender (female), the HOME and maternal education were associated with a higher Early Learning Composite score in multivariate analyses (P=.02, P=.004, P=.007, respectively). The HOME and family wealth were also associated with the gross motor scale (P=.03 and P=.03, respectively). Mothers were more likely to report difficulties on the TQ when the child presented lower score on the MSEL. When considering the gross motor scale as the gold standard to define moderate delays, the two combined motor-related questions on the TQ showed good sensitivity and specificity (76.5 and 75.7). Conclusion In a low-resource rural setting in Africa, the TQ effectively identified three-quarters of 1-year-old infants with delayed development. After this screening, the MSEL may be useful for further assessment as it showed good feasibility and sensitivity to known risk factors for poor child development.

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Section: Discussionmentioning

confidence: 94%

Usefulness of Child Development Assessments for Low-Resource Settings in Francophone Africa

Koura

Boivin

Davidson

et al. 2013

Journal of Developmental &Amp; Behavioral Pediatrics

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“…Age-adjusted T-scores were obtained from standardized samples from the U.S., and lower scores indicate diminished cognitive abilities. The Mullen scales have previously been adapted for use with young children in rural Uganda and demonstrate high sensitivity when used within this population [29]. …”

Section: Methodsmentioning

confidence: 99%

Nutritional and Immunological Correlates of Memory and Neurocognitive Development Among HIV-Infected Children Living in Kayunga, Uganda

Ruiseñor-Escudero

Familiar‐Lopez

Sikorskii

et al. 2016

JAIDS Journal of Acquired Immune Deficiency Syndromes

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Objective To identify the nutritional and immunological correlates of memory and neurocognitive development as measured by the Mullen Scales of Early Learning (MSEL) and by the Color Object Association Test (COAT) among children in Uganda. Design This analysis uses baseline data collected between 2008 and 2010 from 119 HIV-infected children ages 1–6 years participating in a randomized controlled trial of an interventional parenting program in Kayunga, Uganda. Methods Peripheral blood draws were performed to determine immunological biomarkers. Unadjusted and adjusted linear regression models were used to relate MSEL and COAT scores to sociodemographic characteristics, weight-for-age Z-scores (WAZ), antiretroviral therapy (ART) status and immunological biomarkers. Results 111 children were included in the final analysis. Lower levels of CD4+ CD38+ T-cells (p=0.04) were associated to higher Immediate and Total Recall scores (p=0.04). Higher levels of CD8+ HLA-DR+ T-cells were associated with higher Total Recall score (p=0.04) of the COAT. Higher CD4+ CD38+ HLA-DR+ T-cells levels were associated with higher Gross Motor scores of the MSEL (p=0.02). WAZ was positively correlated to Visual Reception, Fine Motor, Expressive Language and composite score of the MSEL. Conclusions Overall, WAZ was a stronger predictor of neurocognitive outcomes assessed by the MSEL. CD4+ CD38+ T-cells were more specifically associated with memory-related outcomes. Future research should include immunological markers and standardized neurocognitive tests to further understand this relationship.

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“…(22) The MELS had been previously adapted for use with children with HIV in rural Uganda, and had proven sensitive to the developmental benefits of early initiation of anti-retroviral treatment and quality of home environment (ART). (23)…”

Section: Methodsmentioning

confidence: 99%

A Year-Long Caregiver Training Program Improves Cognition in Preschool Ugandan Children with Human Immunodeficiency Virus

Boivin¹,

Bangirana²,

Nakasujja³

et al. 2013

The Journal of Pediatrics

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Objective To evaluate if mediational intervention for sensitizing caregivers (MISC) MISC biweekly caregiver training significantly enhanced child development, compared with biweekly training on health and nutrition (active control) and to evaluate whether MISC training improved the emotional well-being of the caregivers compared with controls. Study design Sixty of 120 rural Ugandan preschool child/caregiver dyads with HIV were assigned by randomized clusters to biweekly MISC training alternating between home and clinic for one year. Control dyads received a health and nutrition curriculum. Children were evaluated at baseline, 6 months, and 1 year with the Mullen Early Learning Scales and the Color-Object Association Test (COAT) for memory. Caldwell HOME and videotaped child/caregiver MISC interactions also were evaluated. Caregivers were evaluated for depression and anxiety with the Hopkins Symptoms Checklist. Results Between-group repeated-measures ANCOVA comparisons were made with age, sex, CD4 levels, viral load, material SES, physical development, and HAART treatment status as covariates. The children given MISC had significantly greater gains compared with controls on the Mullen Visual Reception scale (visual-spatial memory) and on COAT memory. MISC caregivers significantly improved on HOME scale and total frequency of MISC videotaped interactions. MISC caregivers also were less depressed. Mortality was less for children given MISC compared with controls during the training year. Conclusions MISC was effective in teaching Ugandan caregivers to enhance their children’s cognitive development through practical and sustainable techniques applied during daily interactions in the home.

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Factors Contributing to the Psychosocial Adjustment of Ugandan Preschool Children with HIV/AIDS

Cited by 15 publications

References 45 publications

Usefulness of Child Development Assessments for Low-Resource Settings in Francophone Africa

Usefulness of Child Development Assessments for Low-Resource Settings in Francophone Africa

Nutritional and Immunological Correlates of Memory and Neurocognitive Development Among HIV-Infected Children Living in Kayunga, Uganda

A Year-Long Caregiver Training Program Improves Cognition in Preschool Ugandan Children with Human Immunodeficiency Virus

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