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Demographic and neuropsychological profile of HIV-positive children referred for an assessment at a local clinic over a 5-year period

Individuals in low- and middle-income countries (LMICs) are disproportionately affected by the human immunodeficiency virus (HIV) relative to high-income countries (HICs). Children are particularly vulnerable given the impact of HIV on brain development. Neuropsychology is still in its infancy in So...

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Main Author: Mokoena, Limpho
Other Authors: Schrieff, Leigh
Format: Thesis
Language:English
English
Published: Department of Psychology 2025
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access_status_str Open Access
author Mokoena, Limpho
author2 Schrieff, Leigh
author_browse Mokoena, Limpho
Schrieff, Leigh
author_facet Schrieff, Leigh
Mokoena, Limpho
author_sort Mokoena, Limpho
collection Thesis
description Individuals in low- and middle-income countries (LMICs) are disproportionately affected by the human immunodeficiency virus (HIV) relative to high-income countries (HICs). Children are particularly vulnerable given the impact of HIV on brain development. Neuropsychology is still in its infancy in South Africa and there are limited services dedicated to addressing neuropsychological difficulties, including the assessment of children living with HIV. At the pediatric neuropsychology clinic (PNC) at the Red Cross War Memorial Children's Hospital (RXH) in Cape Town, South Africa, free services related to neuropsychological assessments are available to those referred by health professionals, an offering that is rare in South Africa. Considering the impact of HIV on the brain, the PNC offers services and resources to support the study of the effect of HIV (and other pathologies that result in neuropsychological impairments) on the developing brain and its influence on children more broadly in the South African context. Given how limited such services of this nature are in this context and the related opportunity for research and knowledge based on such services, I aimed to the describe the demographic, medical, developmental, and neuropsychological profiles of children referred to RXH PNC over a 5-year period (with an in depth focus on those who are HIV-positive). I investigated a series of neuropsychological reports from the PNC, retrospectively from the year 2012 to 2016, using qualitative and quantitative methods. I report on all the children referred to the clinic within this period (N= 158) and then specifically report in depth on the proportion of children who were HIV-positive (n= 73, 45%) and describe their demographic profiles. I then compared the neuropsychological outcomes of the HIV-Positive Subsample to a separate demographically matched typically developing Control Group (n=41) recruited from local communities. Overall, there were no significant differences in the demographic profile between the HIV- Positive Subsample and the Control Group. However, in the neuropsychological profile there were significant differences found between these two groups in all of the neuropsychological domains except visual memory. The evidence from this study supported the association between cognitive deficits found in children with HIV often discussed in literature. Given the dearth of specialist neuropsychological assessment facilities that are accessible to the public, this highlights the importance of clinics such as the PNC. More specifically the PNC is at the forefront of providing pediatric neuropsychology services in South Africa. The benefits of the PNC include a hub for data of cognitive fall out seen at the clinic which can inform research and other collaborative projects with clinicians and universities. Further, having detailed neuropsychological and demographic profiles/data of children living with HIV can inform intervention-based studies. Intervention-based studies can include a practical component in assisting HIV-positive children attaining a better quality of life considering their neuropsychological difficulties.
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provenance_str_mv Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository
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spelling oai:open.uct.ac.za:11427/41796 Demographic and neuropsychological profile of HIV-positive children referred for an assessment at a local clinic over a 5-year period Mokoena, Limpho Schrieff, Leigh Pediatric HIV Neuropsychology Cognitive domains Red-Cross War Memorial Hospital Pediatric Neuropsychology Clinic South Africa Individuals in low- and middle-income countries (LMICs) are disproportionately affected by the human immunodeficiency virus (HIV) relative to high-income countries (HICs). Children are particularly vulnerable given the impact of HIV on brain development. Neuropsychology is still in its infancy in South Africa and there are limited services dedicated to addressing neuropsychological difficulties, including the assessment of children living with HIV. At the pediatric neuropsychology clinic (PNC) at the Red Cross War Memorial Children's Hospital (RXH) in Cape Town, South Africa, free services related to neuropsychological assessments are available to those referred by health professionals, an offering that is rare in South Africa. Considering the impact of HIV on the brain, the PNC offers services and resources to support the study of the effect of HIV (and other pathologies that result in neuropsychological impairments) on the developing brain and its influence on children more broadly in the South African context. Given how limited such services of this nature are in this context and the related opportunity for research and knowledge based on such services, I aimed to the describe the demographic, medical, developmental, and neuropsychological profiles of children referred to RXH PNC over a 5-year period (with an in depth focus on those who are HIV-positive). I investigated a series of neuropsychological reports from the PNC, retrospectively from the year 2012 to 2016, using qualitative and quantitative methods. I report on all the children referred to the clinic within this period (N= 158) and then specifically report in depth on the proportion of children who were HIV-positive (n= 73, 45%) and describe their demographic profiles. I then compared the neuropsychological outcomes of the HIV-Positive Subsample to a separate demographically matched typically developing Control Group (n=41) recruited from local communities. Overall, there were no significant differences in the demographic profile between the HIV- Positive Subsample and the Control Group. However, in the neuropsychological profile there were significant differences found between these two groups in all of the neuropsychological domains except visual memory. The evidence from this study supported the association between cognitive deficits found in children with HIV often discussed in literature. Given the dearth of specialist neuropsychological assessment facilities that are accessible to the public, this highlights the importance of clinics such as the PNC. More specifically the PNC is at the forefront of providing pediatric neuropsychology services in South Africa. The benefits of the PNC include a hub for data of cognitive fall out seen at the clinic which can inform research and other collaborative projects with clinicians and universities. Further, having detailed neuropsychological and demographic profiles/data of children living with HIV can inform intervention-based studies. Intervention-based studies can include a practical component in assisting HIV-positive children attaining a better quality of life considering their neuropsychological difficulties. 2025-09-12T12:17:37Z 2025-09-12T12:17:37Z 2025 2025-09-12T11:13:04Z Thesis / Dissertation Masters Masters http://hdl.handle.net/11427/41796 en eng application/pdf Department of Psychology Faculty of Humanities University of Cape Town
spellingShingle Pediatric HIV
Neuropsychology
Cognitive domains
Red-Cross War Memorial Hospital
Pediatric Neuropsychology Clinic
South Africa
Mokoena, Limpho
Demographic and neuropsychological profile of HIV-positive children referred for an assessment at a local clinic over a 5-year period
thesis_degree_str Master's
title Demographic and neuropsychological profile of HIV-positive children referred for an assessment at a local clinic over a 5-year period
title_full Demographic and neuropsychological profile of HIV-positive children referred for an assessment at a local clinic over a 5-year period
title_fullStr Demographic and neuropsychological profile of HIV-positive children referred for an assessment at a local clinic over a 5-year period
title_full_unstemmed Demographic and neuropsychological profile of HIV-positive children referred for an assessment at a local clinic over a 5-year period
title_short Demographic and neuropsychological profile of HIV-positive children referred for an assessment at a local clinic over a 5-year period
title_sort demographic and neuropsychological profile of hiv positive children referred for an assessment at a local clinic over a 5 year period
topic Pediatric HIV
Neuropsychology
Cognitive domains
Red-Cross War Memorial Hospital
Pediatric Neuropsychology Clinic
South Africa
url http://hdl.handle.net/11427/41796
work_keys_str_mv AT mokoenalimpho demographicandneuropsychologicalprofileofhivpositivechildrenreferredforanassessmentatalocalclinicovera5yearperiod