Article

The aim of this article is to document the risk of neurodevelopmental
impairment (NDI) among infants enrolled in a programme for the prevention of
mother-to-child transmission of HIV (human immunodeficiency virus) in Zimbabwe
using the Bayley Infant Neurodevelopmental Screener (BINS). METHOD: We
prospectively followed up infants at three primary care clinics in Harare,
Zimbabwe. Neurodevelopmental assessments using the BINS were conducted during the
first 12 months of life. NDI risk category and associated risk factors were
examined. RESULTS: Of the 598 infants assessed, 305 (51%) were female and 293
(49%) were male. Sixty-five infants (11%) were infected with HIV, 188 (31%) were
exposed but uninfected, 287 (48%) were unexposed, and 58 (10%) were of unknown
status. The prevalence of a high risk of NDI was 9.4% (95% confidence interval
[CI] 7.1-11.1%): 9.2% in males and 9.6% in females. Of the 598 infants, 549 (92%)
had ever been breastfed, 49% of whom had mothers infected with HIV. The risk of
NDI was higher among infants infected early with HIV, i.e. by 3 months of age (p
value <0.001). The NDI high-risk category included twice as many infants infected
with HIV as uninfected infants (odds ratio [OR] 2.1; 95% CI 1.0-4.3). After
adjusting for other factors, head circumference and family financial subsistence
remained risk factors for NDI with an OR of 2.22 (1.04-4.82) and 2.55 (1.02-6.36)
respectively. INTERPRETATION: The background prevalence of high-risk NDI category
of 9.4% across groups seems high but is similar to that reported previously in
developing countries. Integration of an early infant neurodevelopmental screening
programme into child HIV management protocols will assist in the early referral
of children exposed to HIV.
CI - (c) The Authors. Developmental Medicine & Child Neurology (c) 2011 Mac Keith Press.
Afrique - VIH - SIDA

Langue : ANGLAIS