Lower academic performance among children with perinatal HIV exposure in Botswana.
Lower academic performance among children with perinatal HIV exposure in Botswana.
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DOI：
10.1002/jia2.26165
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发表时间：
2023-10
影响因子：
6
通讯作者：
中科院分区：
文献类型：
--
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研究报告称，与未暴露于艾滋病毒且未感染的儿童（HUU）相比，暴露于艾滋病毒但未感染的儿童（HEU）神经发育欠佳的风险更高。尚未对按艾滋病毒暴露状况划分的学龄儿童的实际学业成绩进行研究。
使用Cochran - Mantel - Haenszel检验，按艾滋病毒暴露状况对参加博茨瓦纳FLOURISH研究、就读公立小学、年龄在7.1岁至14.6岁之间的儿童在数学、科学、英语、塞茨瓦纳语以及总体方面的学业成绩进行了比较。学业成绩较差定义为“C”级或更低（≤60%）。采用未调整和调整后的逻辑回归模型来评估艾滋病毒暴露与学业成绩较差之间的关联。
2021年4月至2022年12月期间，参加FLOURISH研究的398名就读公立小学的儿童中，307名（77%）为HEU。中位年龄为9.4岁（四分位距8.9 - 10.2）。只有17.9%的HEU儿童接受母乳喂养，而HUU儿童则为100%。在HEU儿童中，80.3%的胎儿暴露于三种药物的抗逆转录病毒治疗，18.7%仅暴露于齐多夫定，1.0%未暴露于抗逆转录病毒药物。HEU儿童的照顾者比HUU儿童的照顾者年龄更大（中位年龄42岁对36岁），且更有可能没有接受过教育或仅接受过小学教育（15.0%对1.1%）。在未调整的分析中，与HUU儿童相比，HEU儿童总体学业成绩较差的可能性更大（优势比[OR]：1.96[95%置信区间（CI）：1.16，3.30]），并且在数学、科学和英语方面成绩也较差。在对母亲教育程度、照顾者收入、母乳喂养、低出生体重和儿童性别进行调整后，这种关联减弱（调整后优势比[aOR]：1.86[95%CI：0.78，4.43]）。
在这个基于博茨瓦纳的队列中，与HUU儿童相比，HEU儿童的小学学业成绩较低。生物和社会人口因素，包括儿童性别，似乎导致了这种差异。需要进一步研究以确定可改变的影响因素，开发筛查工具以识别学业成绩不佳的风险，并设计干预措施以降低风险。
Studies have reported a higher risk of suboptimal neurodevelopment among children who are HIV‐exposed uninfected (HEU) compared to children HIV‐unexposed uninfected (HUU). Actual academic performance among school‐aged children by HIV exposure status has not been studied. Academic performance in Mathematics, Science, English, Setswana and overall among children enrolled in the Botswana‐based FLOURISH study who were attending public primary school and ranging in age from 7.1 to 14.6 years were compared by HIV exposure status using a Cochran‐Mantel‐Haenszel test. Lower academic performance was defined as a grade of “C” or lower (≤60%). Unadjusted and adjusted logistic regression models were fit to assess for an association between HIV exposure and lower academic performance. Between April 2021 and December 2022, 398 children attending public primary school enrolled in the FLOURSH study, 307 (77%) were HEU. Median age was 9.4 years (IQR 8.9–10.2). Only 17.9% of children HEU were breastfeed versus 100% of children HUU. Among children HEU, 80.3% had foetal exposure to three‐drug antiretroviral treatment, 18.7% to zidovudine only and 1.0% had no antiretroviral exposure. Caregivers of children HEU were older compared to caregivers of children HUU (median 42 vs. 36 years) and more likely to have no or primary education only (15.0% vs. 1.1%). In unadjusted analyses, children HEU were more likely to have lower overall academic performance compared to their children HUU (odds ratio [OR]: 1.96 [95% confidence interval (CI): 1.16, 3.30]), and lower performance in Mathematics, Science and English. The association was attenuated after adjustment for maternal education, caregiver income, breastfeeding, low birth weight and child sex (aOR: 1.86 [95% CI: 0.78, 4.43]). In this Botswana‐based cohort, primary school academic performance was lower among children HEU compared to children HUU. Biological and socio‐demographic factors, including child sex, appear to contribute to this difference. Further research is needed to identify modifiable contributors, develop screening tools to identify the risk of poor academic performance and design interventions to mitigate risk.
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DOI：
10.1097/qad.0000000000001872
发表时间：
2018-08-24
期刊：
AIDS (London, England)
影响因子：
--
作者：
le Roux SM;Donald KA;Brittain K;Phillips TK;Zerbe A;Nguyen KK;Strandvik A;Kroon M;Abrams EJ;Myer L
通讯作者：
Myer L
影响因子：
7.3
作者：
通讯作者：
--
影响因子：
1.9
作者：
Larson, Charles P.
通讯作者：
Larson, Charles P.
影响因子：
3.8
作者：
Brennan, Alana T.;Bonawitz, Rachael;Fox, Matthew P.
通讯作者：
Fox, Matthew P.
影响因子：
4.6
作者：
Gabriel, Benjamin;Medin, Carey;Lohman-Payne, Barbara L.
通讯作者：
Lohman-Payne, Barbara L.