Prevalence of disability in HIV-infected children attending an urban paediatric HIV clinic in Johannesburg, South Africa

Child functioning and disability in children living with human immunodeficiency virus in a semi-rural healthcare setting in South Africa

“…Functional difficulties were identified across physical, cognitive and behavioural domains in CLHIV. Whilst disability prevalence studies in sub-Saharan Africa 2 , 10 , 15 have highlighted impairments frequently experienced by CLHIV using tools such as the ten question screen for disability (TQSD); this tool does not report on actual levels of child functioning. It was hoped that the identification of even the mildest level of functional difficulties using this tool could lead to early appropriate referral to medical professionals for objective assessment and timeous intervention.…”

“… 2 , 15 , 32 , 33 Researchers have highlighted that although HIV-related disability is frequently experienced by children, there is an unmet need for rehabilitation services in the African context. 2 , 15 Furthermore, in this study, participants flagged the need for other very necessary services, such as psychology and dentistry, which were not available at the study setting. The results specifically point to a need for referral pathways to audiologists, speech and language pathologists, occupational therapists, psychologists and physiotherapists in from the physicians and nurses attending to CLHIV.…”

“…1 Antiretroviral therapy adds years to the lives of children, but the virus leads to chronic and episodic, physical and cognitive manifestations, which influence their lives and everyday social participation. 2 Physical impairments manifest in musculoskeletal conditions, 3 , 4 visual 2 , 5 , 6 and auditory impairments; 7 , 8 as well as in speech and language deficits. 9 , 10 Neurological and cognitive impairments also influence the development of children living with HIV (CLHIV) bearing consequences for achievement at school.…”

“… 9 , 10 Neurological and cognitive impairments also influence the development of children living with HIV (CLHIV) bearing consequences for achievement at school. 2 , 11 , 12 , 13 These impairments can result in functional and participatory limitations, further compounded by the effects of contextual barriers resulting in disabilities. Although scholars and health professionals have recently adopted a biopsychosocial framework 14 to understand disability, less is understood about HIV-related disability.…”

“…14 Human immunodeficiency virus-related disability is thought to result from the neurotoxic characteristics of the virus, from the side effects of antiretrovirals and from opportunistic infections such as meningitis and otitis media. 2 , 10 Additionally, the influence of the child’s social context on disability outcomes is acknowledged. 14 Whilst some sub-Saharan research has investigated the prevalence and types of disabilities in CLHIV, 15 this research interest is still relatively novel in resource-poor settings such as in South Africa where HIV is such a major health concern.…”