Neurocognitive deficits and socioeconomic risk factors among children and adolescents living with HIV in sub-Saharan Africa: a systematic review

Otsetswe Musindo; Lydiah Krabbendam; Joan Mutahi; Miguel Pérez García; Paul Bangirana; Manasi Kumar

doi:10.1186/s13034-022-00465-y

Neurocognitive deficits and socioeconomic risk factors among children and adolescents living with HIV in sub-Saharan Africa: a systematic review

Child Adolesc Psychiatry Ment Health. 2022 Apr 27;16(1):31. doi: 10.1186/s13034-022-00465-y.

Authors

Otsetswe Musindo¹, Lydiah Krabbendam², Joan Mutahi³, Miguel Pérez García⁴, Paul Bangirana⁵, Manasi Kumar⁶

Affiliations

¹ Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands. otisbina@outlook.com.
² Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
³ Department of Psychiatry, University of Nairobi, Nairobi, Kenya.
⁴ Facultad de Psicología, Universidad de Granada, Granada, Spain.
⁵ Department of Psychiatry, Makerere University, Kampala, Uganda.
⁶ Department of Psychiatry , University of Nairobi to Brain and Mind Institute Aga Khan University , Nairobi, Kenya.

Abstract

Introduction: Children and adolescents living with HIV (C/ALHIV) are at a risk for significant neurocognitive deficits. There is limited literature that addresses the role of socioeconomic factors in neurocognitive deficits among CALHIV in Sub Saharan Africa (SSA), as it is very difficult to establish this causal relationship. Our systematic review was guided by the biodevelopmental framework that assumes that foundations of health and adversity affect later development and life outcomes. This systematic review aims to assess available evidence on the relationship between neurocognitive deficits and socioeconomic factors among HIV children and adolescents in SSA region.

Method: Using a pre-determined search strategy, we searched electronic databases including PubMed, web of Science and EBSCOhost (CINAHL and MEDLINE). Peer-reviewed publications that address neurocognitive deficits, psychosocial and socioeconomic risk factors among children and adolescents living with HIV in SSA were included in review.

Results: Out of 640 articles, 17 studies from SSA met the inclusion criteria. Four studies reported no significant differences in the neurocognitive measures comparing children and adolescents with HIV infection to those uninfected. However, 10 studies suggest that C/ALHIV scored significantly low in general intellectual functions as compared to their uninfected peers. C/ALHIV were found to have substantial deficits in specific cognitive domains such as sequential processing, simultaneous processing, and learning. In addition, deficits in visuo-spatial processing, visual memory and semantic fluency were mentioned. Socioeconomic factors such as lower socioeconomic status (income, education and occupation), child orphanhood status and under-nutrition were linked with neurocognitive deficits.

Conclusion: Our findings suggest that CALHIV presented with poorer neurocognitive outcomes when compared to other populations which were associated with specific socioeconomic factors.

Keywords: Children and adolescents living with HIV; Neurocognitive deficits; Socioeconomic factors; Systematic review.

Publication types

Review