Nonverbal cognitive assessment of children in Tanzania with and without HIV

Lichtenstein, Jonathan D.; Bowers, Caitlin; Amato, Jennifer; Niemczak, Christopher E.; Fellows, Abigail; Magohe, Albert; Haile, Hannah; White-Schwoch, Travis; Kraus, Nina; Massawe, Enica Richard; Moshi, Ndeserua; Buckey, Jay C.

doi:10.1080/09297049.2021.1957809

Cited by 8 publications

(8 citation statements)

References 20 publications

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“…These subclinical hearing difficulties may be associated with learning difficulties for CLWH compared with their HIV-negative peers. This possibility is supported by other work documenting impaired cognition in CLWH . Future research in the efferent auditory pathway concerning diseases that affect the central nervous system is warranted and will help detail the functional consequences of these observed deficits.…”

Section: Discussionmentioning

confidence: 62%

“…The socioeconomic status values result from a principal component analysis that accounts for various SES factors used in our previous work. 33 JAMA Network Open | Infectious Diseases…”

Section: Discussionmentioning

confidence: 99%

“…This possibility is supported by other work documenting impaired cognition in CLWH. 33 Future research on how the efferent auditory pathway affects DPOAEs in other diseases that affect the central nervous system is warranted.…”

Section: Jama Network Open | Infectious Diseasesmentioning

confidence: 99%

“…This possibility is supported by other work documenting impaired cognition in CLWH. 33 Future research in the efferent auditory pathway concerning diseases that affect the central nervous system is warranted and will help detail the functional consequences of these observed deficits.…”

Section: Jama Network Open | Infectious Diseasesmentioning

confidence: 99%

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Peripheral Auditory Function in Tanzanian Children Living With HIV With Clinically Normal Hearing

et al. 2023

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ImportanceDespite normal audiometry, adults living with HIV have lower distortion product otoacoustic emissions (DPOAEs) compared with HIV-negative controls, but the degree of these differences in children living with HIV is unknown. If subclinical auditory deficits are present, results could affect developmental outcomes in children living with HIV (CLWH).ObjectiveTo compare DPOAEs and auditory brainstem responses (ABR) between 2 age- and sex-matched groups of younger children with normal audiometry, 1 infected with HIV and the other uninfected.Design, Setting, and ParticipantsCohort study in an infectious disease center in Dar es Salaam, Tanzania. Participants included 340 Tanzanian children aged 3 to 9 years with clinically normal hearing, type A tympanograms bilaterally, and air-conduction thresholds of 20 dB HL or less from 0.5 to 8 kHz. Participants in the cohort repeated testing approximately every 6 months (approximately 2.2 sessions per participant) for a total of 744 total observations. Data were analyzed from March 2020 to January 2022.Main Outcomes and MeasuresDPOAE amplitudes from 1.5 to 8 kHz using an f2 to f1 ratio of 1.2 and L1/L2 values of 65/55 dB sound pressure level and click-evoked ABR using a slow (21.1/s) and fast (61.1/s) click rate.ResultsA total of 141 CLWH (70 female participants [49.3%]; mean [SD] age, 7.24 [1.67] years) and 199 HIV-negative individuals (99 female participants [49.7%]; mean [SD] age, 7.26 [1.44] years) participated in the study. The groups did not differ significantly in age, static immittance, or air-conduction thresholds. HIV status was independently associated with approximately 1.4 dB (95% CI, −3.28 to 0.30 dB) to 3.8 dB (95% CI, 6.03 to −1.99 dB) lower DPOAE amplitudes at 6 and 8 kHz bilaterally and 0.28 μV (95% CI, 0.01 to 0.33 μV) lower ABR wave V amplitudes in the right ear.Conclusions and RelevanceConsistent with previous findings in young adults, CLWH had slightly, but reliably, lower DPOAEs and ABR wave V amplitudes than HIV-negative controls. The magnitude of these differences was small, but results suggest an early and consistent association between HIV infection or treatment and outer hair cell and auditory brainstem responses in children as young as 3 years. These subclinical changes suggest tracking both auditory function and development outcomes in CLWH is warranted.

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Section: Discussionmentioning

confidence: 62%

“…The socioeconomic status values result from a principal component analysis that accounts for various SES factors used in our previous work. 33 JAMA Network Open | Infectious Diseases…”

Section: Discussionmentioning

confidence: 99%

Section: Jama Network Open | Infectious Diseasesmentioning

confidence: 99%

Section: Jama Network Open | Infectious Diseasesmentioning

confidence: 99%

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Peripheral Auditory Function in Tanzanian Children Living With HIV With Clinically Normal Hearing

et al. 2023

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“…In the last decade, significant progress has been made in understanding the pathogenesis, burden, and impact of [2]. A recent study documented how children with HIV (CWH) in Tanzania performed worse than children without HIV on nonverbal cognitive tasks [3]. Whether HIV impairs literacy development, even with effective treatment, is still unknown.…”

Section: Introductionmentioning

confidence: 99%

Preliteracy assessment in children living with HIV in Tanzania: comparison to results from children living without HIV in Tanzania and the United States

Bonacina

Niemczak

Lichtenstein

et al. 2023

Aids

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Objective:Children with HIV (CWH) are at increased risk for cognitive and developmental delays. Whether HIV affects literacy development, however, remains unknown. Rapid automatized naming (RAN) tasks offer the simplest preliteracy assessment a child can perform that predicts future reading skills across languages.Design and Methods:RAN performance was analyzed cross-sectionally on 473 children (249 children without HIV and 217 CWH; ages 3–9) drawn from a longitudinal study in Tanzania. These data were compared to results from 341 normally developing children without HIV (ages 3–8) from the United States. Participants performed two RAN subtests: colors and objects.Results:RAN object completion was greater than for the RAN color in Tanzanian children. CWH were less likely to complete either subtest and performed worse on the object subtest compared to Tanzanian children without HIV. Compared to the US cohort, the Tanzanian cohort was less likely to complete both subtests - in particular the colors subtest - and showed more variability in responses at younger ages. After approximately age 6, however, the trajectory of improvement between the United States and Tanzania was similar.Conclusions:CWH performed worse on this per-literacy test, indicating literacy skill development in CWH needs further study. The differences between US and Tanzanian results likely reflect variability in when children learn to name colors and objects. The trajectory of improvement between countries became more similar as the children aged. This study motivates further longitudinal analyses aimed at assessing the developmental trajectory of the RAN, its predictive ability for reading skills, and its link with other preliteracy and cognitive skills.

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Central auditory test performance predicts future neurocognitive function in children living with and without HIV

Joseph,

Niemczak,

Lichtenstein

et al. 2024

Sci Rep

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Tests of the brain’s ability to process complex sounds (central auditory tests) correlate with overall measures of neurocognitive performance. In the low- middle-income countries where resources to conduct detailed cognitive testing is limited, tests that assess the central auditory system may provide a novel and useful way to track neurocognitive performance. This could be particularly useful for children living with HIV (CLWH). To evaluate this, we administered central auditory tests to CLWH and children living without HIV and examined whether central auditory tests given early in a child’s life could predict later neurocognitive performance. We used a machine learning technique to incorporate factors known to affect performance on neurocognitive tests, such as education. The results show that central auditory tests are useful predictors of neurocognitive performance and perform as well or in some cases better than factors such as education. Central auditory tests may offer an objective way to track neurocognitive performance in CLWH.

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Nonverbal cognitive assessment of children in Tanzania with and without HIV

Cited by 8 publications

References 20 publications

Peripheral Auditory Function in Tanzanian Children Living With HIV With Clinically Normal Hearing

Peripheral Auditory Function in Tanzanian Children Living With HIV With Clinically Normal Hearing

Preliteracy assessment in children living with HIV in Tanzania: comparison to results from children living without HIV in Tanzania and the United States

Central auditory test performance predicts future neurocognitive function in children living with and without HIV

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