Neurocognitive Functioning of Hiv Positive Children Ages 8-15 in Nairobi County: Exploring Neurocognitive Deficits and Psychosocial Risk Factors.

Abstract

Introduction: Children and adolescents are affected in different ways by HIV/AIDS. Neurocognitive deficits are one of the most significant long term effects on HIV infected children and adolescents. Several factors are thought to influence cognitive outcomes and this include immune status, Highly Active Antiretroviral Therapy (HAART), education and social support. The aim of the study is to assess the neurocognitive function of HIV infected children and adolescents and correlate it with psychosocial factors. Method: A descriptive cross sectional study was carried out involving a sample of 90 children (8-15 years) and adolescents living with HIV with a mean age of 11.38 years (standard deviation =2.06) attending Comprehensive Care Clinic (CCC) at Kenyatta National Hospital (KNH). Samples were selected by using purposive sample technique. Kaufman Assessment Battery for Children-Second Edition was used to assess cognitive function and psychosocial issues were assessed using HEADS-ED. Data was analyzed using SPSS. Results: The prevalence of neurocognitive deficits among HIV positive children attending CCC at KNH was 60% with neurocognitive performance of 54 children being at least 2SD below the mean based on KABC-II scores. There was no significant correlation between mental processing index (MPI) and CD4 count (Pearson’s rho= -0.01, p=0.39). There was no significant association between MPI and viral load (p=0.056) and early ARV initiation (0.27). Using the HEADS_ED, risks factors related to education (β = -5.67, p=0.02) and activities and peer support (β = -9.1, p =0.002) were significantly associated with poor neurocognitive performance. Conclusions: Neurocognitive deficits were prevalent among HIV positive children attending CCC-KNH. The prevalence and extent of the deficits was not associated with low CD4 count, high viral load or early initiation in HIV care. However, poor school performance and problem with peers was associated with poor neurocognitive performance.