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      Neurodevelopmental Outcomes of Young Children Born to HIV-Infected Mothers: A Pilot Study

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          Abstract

          Introduction: Over 15 million children who were exposed to HIV perinatally but uninfected (HEU) are alive globally, and they are faced with multiple risk factors for poor neurodevelopment. While children who are HIV-infected (HIV+) appear to have worse neurodevelopmental scores compared to children unexposed and uninfected with HIV (HUU), the evidence is mixed in children who are HEU. This small descriptive pilot study aimed to compare neurodevelopmental scores of children who are HIV+, HEU, and HUU in Kenya.

          Methods: This cross-sectional pilot study included children ages 18–36 months who were HIV+, HEU, or HUU. Neurodevelopment was assessed, along with sociodemographic, lab, and growth data. Statistical analysis included descriptive statistics, one-way ANOVA, chi-squared, and adjusted linear regression models.

          Results: One hundred seventy two were included ( n = 24 HIV+; n = 74 HEU; n = 74 HUU). Mothers of children who were HEU experienced more depressive symptoms ( p < 0.001). The only neurodevelopmental differences were found among groups was that children who were HIV+ had higher receptive language scores ( p = 0.007). Lower height-for-age z-scores and being left home alone were associated with worse neurodevelopmental scores.

          Conclusions: Being stunted, left completely alone for at least an hour within the last week, and having higher sociodemographic status were associated with worse neurodevelopmental scores. The higher levels of depressive symptoms within mothers of children who are HEU warrants further investigation.

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          Most cited references43

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          The REDCap consortium: Building an international community of software platform partners

          The Research Electronic Data Capture (REDCap) data management platform was developed in 2004 to address an institutional need at Vanderbilt University, then shared with a limited number of adopting sites beginning in 2006. Given bi-directional benefit in early sharing experiments, we created a broader consortium sharing and support model for any academic, non-profit, or government partner wishing to adopt the software. Our sharing framework and consortium-based support model have evolved over time along with the size of the consortium (currently more than 3200 REDCap partners across 128 countries). While the "REDCap Consortium" model represents only one example of how to build and disseminate a software platform, lessons learned from our approach may assist other research institutions seeking to build and disseminate innovative technologies.
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            Developmental potential in the first 5 years for children in developing countries

            Summary Many children younger than 5 years in developing countries are exposed to multiple risks, including poverty, malnutrition, poor health, and unstimulating home environments, which detrimentally affect their cognitive, motor, and social-emotional development. There are few national statistics on the development of young children in developing countries. We therefore identified two factors with available worldwide data—the prevalence of early childhood stunting and the number of people living in absolute poverty—to use as indicators of poor development. We show that both indicators are closely associated with poor cognitive and educational performance in children and use them to estimate that over 200 million children under 5 years are not fulfilling their developmental potential. Most of these children live in south Asia and sub-Saharan Africa. These disadvantaged children are likely to do poorly in school and subsequently have low incomes, high fertility, and provide poor care for their children, thus contributing to the intergenerational transmission of poverty.
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              Inequality in early childhood: risk and protective factors for early child development.

              Inequality between and within populations has origins in adverse early experiences. Developmental neuroscience shows how early biological and psychosocial experiences affect brain development. We previously identified inadequate cognitive stimulation, stunting, iodine deficiency, and iron-deficiency anaemia as key risks that prevent millions of young children from attaining their developmental potential. Recent research emphasises the importance of these risks, strengthens the evidence for other risk factors including intrauterine growth restriction, malaria, lead exposure, HIV infection, maternal depression, institutionalisation, and exposure to societal violence, and identifies protective factors such as breastfeeding and maternal education. Evidence on risks resulting from prenatal maternal nutrition, maternal stress, and families affected with HIV is emerging. Interventions are urgently needed to reduce children's risk exposure and to promote development in affected children. Our goal is to provide information to help the setting of priorities for early child development programmes and policies to benefit the world's poorest children and reduce persistent inequalities. Copyright © 2011 Elsevier Ltd. All rights reserved.
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                Author and article information

                Contributors
                Journal
                Front Pediatr
                Front Pediatr
                Front. Pediatr.
                Frontiers in Pediatrics
                Frontiers Media S.A.
                2296-2360
                21 October 2021
                2021
                : 9
                : 697091
                Affiliations
                [1] 1Indiana University School of Medicine , Indianapolis, IN, United States
                [2] 2Academic Model Providing Access to Healthcare , Eldoret, Kenya
                [3] 3Department of Child Health, College of Health Sciences, Moi University , Eldoret, Kenya
                [4] 4Department of Global Health, Icahn School of Medicine at Mount Sinai , New York, NY, United States
                [5] 5Arnhold Institute for Global Health , New York, NY, United States
                Author notes

                Edited by: Lindsey Reif, Cornell University, United States

                Reviewed by: Kathleen M. Powis, Massachusetts General Hospital and Harvard Medical School, United States; Mathurin Cyrille Tejiokem, Centre Pasteur du Cameroun, Cameroon

                *Correspondence: Megan S. McHenry msuhl@ 123456iu.edu

                This article was submitted to Pediatric Infectious Diseases, a section of the journal Frontiers in Pediatrics

                Article
                10.3389/fped.2021.697091
                8566977
                34746048
                2eaccd17-a817-4687-b04d-6d981e1e8e63
                Copyright © 2021 McHenry, Oyungu, Yang, Ombitsa, Cherop and Vreeman.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 18 April 2021
                : 23 September 2021
                Page count
                Figures: 0, Tables: 3, Equations: 0, References: 51, Pages: 8, Words: 6392
                Funding
                Funded by: National Institute of Allergy and Infectious Diseases, doi 10.13039/100000060;
                Award ID: T32AI007637
                Categories
                Pediatrics
                Brief Research Report

                child development,hiv,hiv exposure,kenya,hiv-infected,neurodevelopment

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