Neurocognitive Deficits and Psychosocial Adjustment Among Hiv Positive and Hiv Negative Children Aged 7 to 12 Years in Gaborone, Botswana: a Comparative Study

Abstract

Background: Approximately 200 million children born in low and middle-income countries do not reach their full cognitive potential (Grantham-McGregor et al., 2007). Busman, et al., (2013) reported that children with HIV may suffer from disruption in attention, concentration, and severe social withdrawal. Loughan and Perna (2012) stated that poor children were twice as likely to have repeated a grade, to have been expelled or suspended from school and more likely to be diagnosed with developmental delay. Again, children of mothers with low level or no education are three times more likely to be prone to neurocognitive deficits than those of mothers with high level of education (Boyede, Lesi, Ezeaka & Umeh, 2013). Aim: The purpose of this study was to assess the prevalence of neurocognitive deficits among HIV positive and HIV negative children aged 7 to 12 years in Gaborone, Botswana to understand overlaps and differences in neurocognitive functioning. Method: The researcher assessed the relationship between neurocognitive deficits and psychological adjustment using the Kaufman Assessment Battery for Children (KABC-II), second edition and Strengths and Difficulties Questionnaire (SDQ)-parent and teacher administered, respectively. The study was conducted at Baylor Children’s Clinic and Ben Thema primary school, at Gaborone, Botswana. The Luria’s model was used to assess outcomes on KABC-II. Results: A total of 35 HIV positive and 62 HIV presumed negative children were recruited. The neurocognitive scaled scores for HIV positive children were significantly lower than those of HIV presumed negative children in three subdomains: sequential processing (mean score = 93 versus 101); learning (mean score = 77 versus 87) and planning (mean score = 74 xii versus 81). Overall, the Mental Processing Index (MPI) was significantly lower in the HIV positive children (mean = 78) compared to the HIV presumed negative children (mean = 87). HIV positive children reported higher mean scores on three of the five SDQ scales and also on the total difficulty score. HIV positive children scored higher on emotional symptoms (3±2 versus 2±2), conduct problems (3±2 versus 1±2) and peer problems (4±2 versus 2±1), compared to HIV presumed negative children. On average the total difficulties score in HIV positive children was 14 ± 5 compared to in 9 ± 5 of the HIV presumed negative children. Children who scored high on SDQ (scores 17+) were not significantly more likely to perform lower on KABC-II (MPI) after adjusting for HIV status (p=0.37). Conclusion: HIV positive children had a higher prevalence of neurocognitive deficits than the HIV presumed negative children. Again, the HIV positive children had significant difficulties in emotional, peer and conduct functioning than the HIV presumed negative children. There was no association between neurocognitive deficits and psychosocial adjustment among HIV positive and HIV presumed negative children aged 7 to 12 years in Gaborone, Botswana.