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Immunological correlates of behavioral problems in school-aged children living with HIV in Kayunga, Uganda.

ABSTRACT: HIV can affect the neuropsychological function of children, including their behavior. We aim to identify immunological correlates of behavioral problems among children living with HIV in Uganda.Children participating in a parent randomized control trial in Kayunga, Uganda were assessed with the Behavior Rating Inventory of Executive Function (BRIEF) and the Child Behavior Checklist (CBCL). We constructed simple and multiple linear regression models to identify immunological correlates of behavioral problems.A total of 144 children living with HIV (50% male) with a mean age of 8.9 years [Standard Deviation (s.d.) = 1.9] were included in the analysis. Eighty-two children were on antiretroviral therapy. Mean CD4 cell count % was 35.1 cells/?l (s.d. = 15.0), mean CD4 cell activation 5.7% (s.d. = 5.1), mean CD8 cell activation was 17.5% (s.d. = 11.2) and 60 children (41.7%) had a viral load of <4000 copies/ml. In the adjusted models for the BRIEF, higher scores were associated with higher viral loads (a? = 16.7 × 10-6, 95% CI -5.00 × 10-6 to 28.4 × 10-6), specifically on the behavioral regulation index. Higher mean CD8 activation % was associated with higher scores on the Externalizing Problems and Total Problems scales of the CBCL (a? = 0.17, 95% CI 0.04-0.31 and a? = 0.15, 95% CI 0.00-0.28, respectively).Poorer behavioral outcomes were associated with higher viral loads while higher CD8 activation was associated with poorer emotional and behavioral outcomes. Complete immunological assessments for children living with HIV could include commonly used viral and immunological parameters to identify those at higher risk of having negative behavior outcomes and who would benefit the most from behavioral interventions.

SUBMITTER: Ruisenor-Escudero H

PROVIDER: S-EPMC5269635 | biostudies-other | 2015

REPOSITORIES: biostudies-other

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Immunological correlates of behavioral problems in school-aged children living with HIV in Kayunga, Uganda.

Ruiseñor-Escudero H H Familiar I I Nakasujja N N Bangirana P P Opoka R R Giordani B B Boivin M M

Global mental health (Cambridge, England) 20150625

<h4>Background</h4>HIV can affect the neuropsychological function of children, including their behavior. We aim to identify immunological correlates of behavioral problems among children living with HIV in Uganda.<h4>Methods</h4>Children participating in a parent randomized control trial in Kayunga, Uganda were assessed with the Behavior Rating Inventory of Executive Function (BRIEF) and the Child Behavior Checklist (CBCL). We constructed simple and multiple linear regression models to identify ...[more]

PMID: 28596857

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Project description:Importance:Children with severe hearing loss are known to have more behavioral problems and may perform worse at school than children without. Few large-scale studies of slight to mild hearing loss are available. Objective:To examine the relevance of slight to mild hearing loss by studying its association with behavioral problems and school performance. Design, Setting, and Participants:This cross-sectional study was performed within an ongoing prospective birth cohort study in Rotterdam, the Netherlands. Participants were part of a population-based sample of children. Between ages 9 and 11 years, 5355 children underwent audiometric and behavioral evaluations. Children were excluded if they had missing data for either audiometry or both outcomes. Data were collected from April 2012 through October 2015. Data were analyzed from March to June 2018. Exposures:Audiometric evaluation included pure-tone audiometry tests and speech-in-noise testing. Main Outcomes and Measures:Child behavior was rated by the primary caregiver using the Child Behavior Checklist at ages 9 to 11 years (n?=?4471). School performance was measured with a standardized test at age 12 years (n?=?2399). Results:The final sample included 4779 participants who were a mean (SD) age of 9.8 (0.3) years. The sample had nearly equal distribution between boys (n?=?2200; 49.2%) and girls (n?=?2271; 50.8%). Associations of hearing thresholds with behavioral problems differed between boys and girls. Among boys, higher pure-tone hearing thresholds at low frequencies were associated with higher total problem, social problem, and attention problem scores (total problems for the better-hearing ear: ??=?0.01; 95% CI, 0-0.02). Higher speech reception thresholds were associated with higher attention problem scores among girls (??=?0.04; 95% CI, 0-0.08). Higher speech reception thresholds were associated with poorer school performance scores for both boys and girls (??=?-0.06; 95% CI, -0.10 to -0.02). Conclusions and Relevance:Higher hearing thresholds during pure-tone audiometric and speech-in-noise testing were associated with higher behavioral problem scores and poorer school performance. This supports the relevance of slight to mild hearing loss with these outcomes in school-aged children.

Project description:BACKGROUND:Schistosomiasis is a neglected tropical disease that continues to cause morbidity and mortality in Sub Saharan Africa. Due to its endemicity, co-infection with malaria is common. The diseases cause anaemia and impaired nutritional status among children. We investigated the prevalence of intestinal schistosomiasis and its association with malaria, anaemia and nutritional status among school children. METHODS:This was a cross sectional survey among 830 children in Nyamikoma village along Lake Victoria in Tanzania. A pre-tested questionnaire was used to collect socio-demographic data, history of drug use, and clinical data. Two faecal samples were collected on two consecutive days and analyzed using thick smears Kato Katz method. Diagnosis of malaria was done by malaria rapid diagnostic test, and haemoglobin concentration was determined using HemoCue. Nutritional status was assessed by anthropometric measurements. RESULTS:The overall prevalence of intestinal schistosomiasis was 90.6% (95% CI = 88.6% - 92.6%). Intensity of infection was light 24.1% (200/830), moderate 38.4% (319/830) and heavy 28.1% (233/830). Pre-adolescents (≤12 years) were more infected with intestinal schistosomiasis (93.2%) than adolescents (>12 years) (84.7%) (p < 0.001). Prevalence of malaria was 1.7% (14/824), and that of intestinal schistosomiasis-malaria co-infection was 1.6% (13/824). The overall prevalence of anaemia was 24.6% (95%CI = 18.7% - 30.5%). Severe anaemia was found in 2.3% (19/824) of study participants. The prevalence of stunting and wasting were 29.0% and 11.3%, respectively. On both univariate and multivariate regression analysis, only lower age was significantly associated intestinal schistosomiasis infection, but not anemia, malaria, stunting or wasting. However among those infected, a negative binomial regression analysis indicated independent significant association of male sex, loose stool consistency, and stunting with high eggs count/gram of stool. CONCLUSIONS:Despite several rounds of annual mass praziquantel administration, intestinal schistosomiasis is highly prevalent among school children particularly in younger children living in the study area. Biannual targeted mass praziquantel treatments or alternative regimens may be considered in future in the study area to redress the situation.

Dataset Information

Immunological correlates of behavioral problems in school-aged children living with HIV in Kayunga, Uganda.

Publications

Immunological correlates of behavioral problems in school-aged children living with HIV in Kayunga, Uganda.

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