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|Interventions addressing neurodevelopmental delay in young children infected with and exposed to HIV: a scoping review|
|Strehlau R, van Aswegen T, Potterton J|
|Rehabilitation Oncology 2019 Jan;37(1):7-16|
BACKGROUND: Neurodevelopmental delays have been documented in children living with and infected by the human immunodeficiency virus (HIV). Early childhood stimulation programs can positively impact neurodevelopmental outcomes and have a far-reaching effect beyond childhood. OBJECTIVE: To conduct a scoping review mapping evidence describing interventions aimed at mitigating or preventing neurodevelopmental delays resulting from exposure to or infection with HIV in preschool children. METHODS: Electronic databases of PubMed, PsycINFO, CINAHL Plus, Google Scholar, and the Cochrane Library, reference lists of identified articles, and gray literature were searched. Title and abstract and full-text reviews were conducted independently by 2 reviewers. Study location, design, sample size, age of cohort, child's HIV serostatus, antiretroviral treatment availability for children or caregivers, neurodevelopmental assessment tool used, and details of the intervention and comparison groups were documented. RESULTS: Ten studies meeting predetermined inclusion and exclusion criteria were identified. Six studies focused on training provided to the child's caregiver of which one offered an intervention focused specifically on stimulating child development through a home-based stimulation program. Four studies provided a child-directed intervention. Interventions ranged in duration from 10 days to 15 months. Intensity of the intervention varied from 3 times per day to biweekly. Interventions were aimed at children in the neonatal period throughout the preschool years. CONCLUSION: Many children are at risk of poor neurodevelopmental outcomes due to HIV infection. Few studies investigating interventions aimed at addressing this problem were identified. Further research into effective interventions aimed at improving childhood neurodevelopmental outcomes in the context of HIV is required.