Neurocognitive Function of School-aged HIV-infected Children in Enugu, Nigeria

Iloh, Kenechukwu K; Emodi, IJ; Ibeziako, Ngozi; Ikefuna, AN; Ubesie, Agozie C; Iloh, Ogochukwu N; Ilechukwu, GC; Ayuk, Adaeze C

doi:10.1093/tropej/fmx006

Cited by 6 publications

(13 citation statements)

References 16 publications

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“…It has become one of the leading and most frequently used test of non-verbal or abstract reasoning and has been described as the paradigm test of non-verbal, abstract reasoning ability. This version has been effectively used and validated in Nigeria [ 9 ] and other African countries [ 17 - 20 ]. For ease of interpretation, RPM grades had been divided in two groups; optimal and suboptimal IQ [ 21 ].…”

Section: Methodsmentioning

confidence: 99%

Academic performance and intelligence quotient of primary school children in Enugu

et al. 2020

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Introduction intellectual capacity measured as intelligence quotient (IQ) is one of the determinants of school performance of children. It influences academic achievement, future personal health, social well-being and therefore, is of public health significance. The objective of the study was to determine the intelligence quotient (IQ) and academic performance of primary school children in Enugu-East LGA. Methods children who met the inclusion criteria were recruited from both public and private primary schools in the Local Government Area (LGA) using a proportionate multistage sampling technique. Academic performance was classified into high, average and low academic using past records of class assessment. Intelligence quotient was assessed using the Raven´s Standard Progressive Matrices (RSPM) and was grouped into optimal and suboptimal. A semi-structured questionnaire was used to obtain data such as-age, gender, socio-economic indices and family size of the study participants. Analysis was done with Statistical Package for Social Sciences (IBM-SPSS). Results a total of 1,122 pupils aged 6 to 12 years were recruited. Optimal IQ and high academic performance were found in 54.0% and 58.8% of the study participants. Being from upper social class, in private school, and family size less than 4 were the significant determinants of high IQ and good academic performance (p<0.001). Conclusion low socio-economic status, large family size and public school attendance impact negatively on IQ and academic performance. Hence, measures to curb large family sizes (i.e.>4 children) and improve the socio-economic status of families are needed environmental measures to improve intelligence and academic performance.

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Section: Methodsmentioning

confidence: 99%

Academic performance and intelligence quotient of primary school children in Enugu

et al. 2020

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“…It involves visuo-spatial reasoning, abstract thinking, deductive reasoning and general intelligence and covers widest range of mental ability of individuals (Raven et al, 2000). The Raven's Standard Progressive matrices has been reported as one of the best instruments for the assessment of IQ in sub-Sahara African and has also been validated for use for Nigerian children (Daramola et al, 2010;Iloh et al, 2017). Instrument: The Raven's Standard Progressive Matrices consisted of 60 problems divided into five sets (Set A, B, C, D and E), each made up of 12 problems.…”

Section: Assessment Of Intelligence Quotientmentioning

confidence: 99%

Positive and inverse correlation of blood lead level with erythrocyte acetylcholinesterase and intelligence quotient in children: implications for neurotoxicity

Nwobi

Adedapo

Olukolade

et al. 2019

Interdisciplinary Toxicology

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Blood lead level (BLL) is insufficiently sensitive for early detection of Lead-induced neurotoxicity (LIN). This study determined the possible role of the combination of BLL, intelligent quotient (IQ) and erythrocyte acetylcholinesterase (AChE) activity in the early detection of LIN in Children. Apparently healthy children (n=309) from eight public primary schools in Ibadan, Nigeria were recruited and classified into: children with Elevated BLL (EBLL) and children with Acceptable BLL (control) based on CDC cut-off for childhood lead exposure. Neurological indices (speech, memory, cranial nerves and cerebellar functions), IQ, BLL and erythrocyte AChE activity were assessed using standard methods, Standard Progressive Matrices, AAS and HPLC respectively. Statistical analysis involved Student’s t-test, Pearson’s correlation and multivariate regression. p<0.05 was considered significant. There were 169 (54.7%) children with EBLL while there were 140 (45.3%) control children. Both groups exhibited normal speech, memory, cranial nerves and cerebellar functions. However, IQ was lower in EBLL children (85.9±11.6) compared with control (91.5±14.0) while BLL and AChE activity were higher in EBLL children (0.4±0.1 µmol/l; 117.5±25.5 µkat/l) compared with control (0.2±0.0 µmol/l; 59.4±10.2 µkat/l). BLL showed inverse correlation with IQ (r=–0.134, p=0.019) but positive correlation with AChE (r=0.978, p≤0.001). 16.2% of the observed variation in BLL could be accounted for by AChE using the equation; [BLL=–0.007+0.003 AChE] p<0.05. Elevated blood lead level is prevalent among the school children and appears to have adverse effect on their IQ. Erythrocyte AChE could be a promising marker for early recognition of significant environmental lead exposure and lead-induced neurotoxicity in children.

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“…HIV infection has been associated with significant motor and cognitive deficits among children and adolescents, even in those with high CD4 cell count [1][2][3][4][5][6][7][8]. Lifesaving antiretroviral therapy (ART) has become more widely available to these children and has significantly reduced opportunistic infections, allowing many infected children to thrive.…”

Section: Introductionmentioning

confidence: 99%

Neurocognitive function among HIV-infected children on protease inhibitor -based versus non-protease inhibitor based antiretroviral therapy in Uganda: a pilot study

Nalwanga¹,

Musiime²,

Bangirana³

et al. 2021

BMC Pediatr

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Background HIV infection is associated with significant neurocognitive deficits making maximization of cognitive function among children receiving antiretroviral therapy (ART) a public health imperative. Non-protease inhibitors (non-PIs) achieve higher drug levels in the cerebral spinal fluid (CSF) compared to PIs, potentially leading to better neurocognitive function by reducing CSF viral load and inflammation. ART that maximises children’s neurodevelopment and school achievement could result in improved quality of life and productivity as adults, but little research to date has examined whether non-PI ART is associated with better neurocognitive outcomes. We compared the neurocognitive function between children living with HIV receiving PI-based and non PI-based ART. Methods We recruited a consecutive sample of clinically stable Ugandan children living with HIV aged 5–12 years who received PI-based or non PI-based ART for ≥ 1 year (viral load < 1000 copies). Neurocognitive function was assessed using the Kaufman Assessment Battery for Children, the Test of Variables of Attention, and Bruininks-Oseretsky Test of Motor Proficiency. Age-adjusted neurocognitive z-scores for the two groups were compared using linear regression models in STATA version 13. The Hommel’s method was used to adjust for multiple testing. Results We enrolled 76 children living with HIV; 34 on PI ART and 42 on non-PI ART. Mean (±SD) age was greater in the non-PI vs. PI group (9.5 ± 1.9 vs. 8.5 ± 2.0) years (p = 0.03). Children in the non-PI group had lower socioeconomic scores (5.7 ± 3.3 vs. 7.4 ± 2.8, p = 0.02). There was no difference in neurocognitive function between the groups (adjusted p > 0.05) for KABC and TOVA. Children in the PI group had better total BOT scores than their counterparts (46.07 ± 1.40) vs. 40.51 (1.24), p = 0.03). Conclusions We detected no difference in neurocognitive function among children on PI and non PI-based ART therapy based on KABC and TOVA tests. Children on PI based ART had better motor function than their counterparts. We recommend a prospective study with a larger sample size.

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Neurocognitive Function of School-aged HIV-infected Children in Enugu, Nigeria

Abstract: Neurocognitive functioning of the HIV-infected children was significantly lower than those of their un-infected counterparts. Neurodevelopmental evaluation should be part of standard care in HIV-infected children in Nigerian setting.

Cited by 6 publications

References 16 publications

Academic performance and intelligence quotient of primary school children in Enugu

Academic performance and intelligence quotient of primary school children in Enugu

Positive and inverse correlation of blood lead level with erythrocyte acetylcholinesterase and intelligence quotient in children: implications for neurotoxicity

Neurocognitive function among HIV-infected children on protease inhibitor -based versus non-protease inhibitor based antiretroviral therapy in Uganda: a pilot study

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