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  • 1
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    Aperiodic electrophysiological activity in preterm infants is linked to subsequent autism risk
    Wiley ; 2022
    In:  Developmental Psychobiology Vol. 64, No. 4 ( 2022-05)
    Details
    In: Developmental Psychobiology, Wiley, Vol. 64, No. 4 ( 2022-05)
    Abstract: Approximately 7% of preterm infants receive an autism spectrum disorder (ASD) diagnosis. Yet, there is a significant gap in the literature in identifying prospective markers of neurodevelopmental risk in preterm infants. The present study examined two electroencephalography (EEG) parameters during infancy, absolute EEG power and aperiodic activity of the power spectral density (PSD) slope, in association with subsequent autism risk and cognitive ability in a diverse cohort of children born preterm in South Africa. Participants were 71 preterm infants born between 25 and 36 weeks gestation (34.60 ± 2.34 weeks). EEG was collected during sleep between 39 and 41 weeks postmenstrual age adjusted (40.00 ± 0.42 weeks). The Bayley Scales of Infant Development and Brief Infant Toddler Social Emotional Assessment (BITSEA) were administered at approximately 3 years of age adjusted (34 ± 2.7 months). Aperiodic activity, but not the rhythmic oscillatory activity, at multiple electrode sites was associated with subsequent increased autism risk on the BITSEA at three years of age. No associations were found between the PSD slope or absolute EEG power and cognitive development. Our findings highlight the need to examine potential markers of subsequent autism risk in high‐risk populations other than infants at familial risk.
    Type of Medium: Online Resource
    ISSN: 0012-1630 , 1098-2302
    URL: Issue
    URL: Article
    DOI: 10.1002/dev.v64.4
    DOI: 10.1002/dev.22271
    Language: English
    Publisher: Wiley
    Publication Date: 2022
    detail.hit.zdb_id: 4107-5
    detail.hit.zdb_id: 1473800-4
    SSG: 12
    SSG: 5,2
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  • 2
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    Mapping the link between socio-economic factors, autistic traits and mental health across different settings
    SAGE Publications ; 2024
    In:  Autism Vol. 28, No. 5 ( 2024-05), p. 1280-1296
    Details
    In: Autism, SAGE Publications, Vol. 28, No. 5 ( 2024-05), p. 1280-1296
    Abstract: Autistic individuals experience higher rates of externalising and internalising symptoms that may vary with environmental factors. However, there is limited research on variation across settings that may highlight common factors with globally generalisable effects. Data were taken from two cohorts: a multinational European sample ( n = 764; 453 autistic; 311 non-autistic; 6–30 years), and a South African sample ( n = 100 non-autistic; 3–11 years). An exploratory factor analysis aggregated clinical (Verbal Comprehension and Perceptual Index), adaptive traits (Vineland Adaptive Behaviour Scale) and socio-economic variables (parental employment and education, home and family characteristics) in each cohort separately. With regression, we investigated the effect of these factors and autistic traits on internalising and externalising scores (measured with the Strengths and Difficulties Questionnaire). Cohorts showed similar four-factor structures (Person Characteristics, Family System, Parental and Material Resources). The ‘Family System’ factor captured family size and maternal factors and was associated with lower internalising and externalising symptoms in both cohorts. In the European cohort, high autistic traits reduced this effect; the opposite was found in the South Africa cohort. Our exploratory findings from two separate analyses represent consistent evidence that Family System is associated with internalising and externalising symptoms, with a context-specific impact in persons with high autism traits. Lay Abstract Autistic individuals are more likely than non-autistic individuals to experience a mental health condition in their lifetime, and this includes externalising and internalising symptoms. We know very little about how different environments and family conditions impact these symptoms for autistic individuals. Improving our understanding of these relationships is important so that we can identify individuals who may be in greater need of support. In this article, we seek to improve our understanding of how environmental and family conditions impact externalising and internalising symptoms in autistic and non-autistic people. To do this, we conducted analyses with two cohorts in very different settings – in Europe and South Africa – to ensure our findings are globally representative. We used advanced statistical methods to establish environmental and family conditions that were similar to each other, and which could be combined into specific ‘factors’. We found that four similar ‘factors’ could be identified in the two cohorts. These were distinguished by personal characteristics and environmental conditions of individuals, and were named Person Characteristics, Family System, Parental and Material Resources. Interestingly, just ‘Family System’ was associated with internalising and externalising symptoms, and this was the same in both cohorts. We also found that having high traits of autism impacted this relationship between Family System and mental health conditions with opposite directions in the two settings. These results show that characteristics in the Family System are associated with internalising and externalising symptoms, and autistic persons are particularly impacted, reinforcing the notion that family stressors are important to consider when implementing policy and practice related to improving the mental health of autistic people.
    Type of Medium: Online Resource
    ISSN: 1362-3613 , 1461-7005
    URL: Article
    DOI: 10.1177/13623613231200297
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2024
    detail.hit.zdb_id: 1338513-6
    detail.hit.zdb_id: 2034686-4
    SSG: 5,2
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  • 3
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    Adjunctive Thalidomide Therapy for Childhood Tuberculous Meningitis: Results of a Randomized Study
    SAGE Publications ; 2004
    In:  Journal of Child Neurology Vol. 19, No. 4 ( 2004-04), p. 250-257
    Details
    In: Journal of Child Neurology, SAGE Publications, Vol. 19, No. 4 ( 2004-04), p. 250-257
    Abstract: Childhood tuberculous meningitis is associated with serious long-term sequelae, including mental retardation, behavior disturbances, and motor handicap. Brain damage in tuberculous meningitis results from a cytokine-mediated inflammatory response, which causes vasculitis and obstructive hydrocephalus. Thalidomide, a potent tumor necrosis factor α inhibitor, was well tolerated and possibly showed some clinical benefit in children with tuberculous meningitis during a pilot study. The purpose of the present study was to assess the effect of adjunctive thalidomide in addition to standard antituberculosis and corticosteroid therapy on the outcome of tuberculous meningitis. Thalidomide (24 mg/kg/day orally) or placebo was administered in a double-blind randomized fashion for 1 month to patients with stage 2 or 3 tuberculous meningitis. The study was terminated early because all adverse events and deaths occurred in one arm of the study (thalidomide group). Thirty of the 47 children enrolled received adjunctive thalidomide, of whom 6 (20%) developed a skin rash, 8 (26%) hepatitis, and 2 (6%) neutropenia or thrombocytopenia. Four deaths (13%) occurred in patients with very severe neurologic compromise at baseline; two deaths were associated with a rash. Motor outcome after 6 months of antituberculosis therapy was similar in the two groups, even though the thalidomide group showed greater neurologic compromise on admission. In addition, the mean IQ of the two treatment groups did not differ significantly (mean IQ thalidomide group 57.8 versus mean IQ control group 67.5; P = 16). These results do not support the use of adjunctive high-dose thalidomide therapy in the treatment of tuberculous meningitis. (J Child Neurol 2004;19:250-257).
    Type of Medium: Online Resource
    ISSN: 0883-0738 , 1708-8283
    URL: Article
    DOI: 10.1177/088307380401900402
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2004
    detail.hit.zdb_id: 639288-X
    detail.hit.zdb_id: 2068710-2
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  • 4
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    Value of the Goodenough Drawing Test as a research tool to detect developmental delay in South African preschool children
    SAGE Publications ; 2020
    In:  South African Journal of Psychology Vol. 50, No. 1 ( 2020-03), p. 81-91
    Details
    In: South African Journal of Psychology, SAGE Publications, Vol. 50, No. 1 ( 2020-03), p. 81-91
    Abstract: There is a need for simple, cost-effective research tools to detect developmental delay in preschool children in low- and middle-income countries where insufficient resources are often a barrier to detection and management. The Goodenough Draw-a-Person test is freely available, easily administered, and requires limited language ability and equipment; it is thus potentially useful in resource-constrained settings. We aimed to determine the diagnostic accuracy of the Draw-a-Person test to identify developmental delay in 5-year-old preschool children using the Griffiths Mental Developmental Scales-Extended Revised eye-hand coordination subquotient as the gold standard. This was a cross-sectional analysis of drawings by South African preschool children from low-income families, whose Griffiths Mental Developmental Scales-Extended Revised assessments included a human figure drawing. Draw-a-Person test quotients were estimated independently by a developmental paediatrician and two medical officers to calculate inter-rater agreement. The paediatrician’s scores were used to determine the diagnostic accuracy of the Draw-a-Person test quotient ( 〈 85) to predict developmental delay with the eye-hand coordination subquotient ( 〈 75). A total of 125 children were included, with a mean age of 60.8 months (range 59–66 months) of which 48.8% were boys. The mean Draw-a-Person test score was 94 (standard deviation 15) with 28 Draw-a-Person test scores below 85. Applying the Draw-a-Person test cut-off of 85, sensitivity of the Draw-a-Person test to the eye-hand coordination subquotient was 80% and specificity 89%. The area under the receiver operator characteristic curve was 0.87 (95% confidence interval [0.78–0.96]). The Goodenough Draw-a-Person test could thus be a useful research tool for detecting fine motor and visuoperceptual delay in South African preschool children.
    Type of Medium: Online Resource
    ISSN: 0081-2463
    URL: Article
    DOI: 10.1177/0081246319850683
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2020
    detail.hit.zdb_id: 223947-4
    SSG: 5,2
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  • 5
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    Five year neurodevelopment outcomes of perinatally HIV ‐infected children on early limited or deferred continuous antiretroviral therapy
    Wiley ; 2018
    In:  Journal of the International AIDS Society Vol. 21, No. 5 ( 2018-05)
    Details
    In: Journal of the International AIDS Society, Wiley, Vol. 21, No. 5 ( 2018-05)
    Abstract: Early antiretroviral therapy ( ART ) has improved neurodevelopmental outcomes of HIV ‐infected ( HIV ‐positive) children; however, little is known about the longer term outcomes in infants commencing early ART or whether temporary ART interruption might have long‐term consequences. In the children with HIV early antiretroviral treatment ( CHER ) trial, HIV ‐infected infants ≤12 weeks of age with CD 4 ≥25% were randomized to deferred ART ( ART ‐Def); immediate time‐limited ART for 40 weeks ( ART ‐40W) or 96 weeks ( ART ‐96W). ART was restarted in the time‐limited arms for immunologic/clinical progression. Our objective was to compare the neurodevelopmental profiles in all three arms of Cape Town CHER participants. Methods A prospective, longitudinal observational study was used. The Griffiths mental development scales ( GMDS ), which includes six subscales and a global score, were performed at 11, 20, 30, 42 and 60 months, and the Beery‐Buktenica developmental tests for visual motor integration at 60 months. HIV ‐exposed uninfected ( HEU ) and HIV ‐unexposed ( HU ) children were enrolled for comparison. Mixed model repeated measures were used to compare groups over time, using quotients derived from standardized British norms. Results In this study, 28 ART ‐Def, 35 ART ‐40W, 33 ART ‐96W CHER children, and 34 HEU and 39 HU controls were enrolled. GMDS scores over five years were similar between the five groups in all subscales except locomotor and general Griffiths (interaction p   〈  0.001 and p  = 0.02 respectively), driven by early lower scores in the ART ‐Def arm. At 60 months, scores for all groups were similar in each GMDS scale. However, Beery visual perception scores were significantly lower in HIV ‐infected children (mean standard scores: 75.8 ART ‐Def, 79.8 ART ‐40W, 75.9 ART ‐96W) versus 84.4 in HEU and 90.5 in HU ( p   〈  0.01)). Conclusions Early locomotor delay in the ART ‐Def arm resolved by five years. Neurodevelopmental outcomes at five years in HIV ‐infected children on early time‐limited ART were similar to uninfected controls, apart from visual perception where HIV ‐infected children scored lower. Poorer visual perception performance warrants further investigation.
    Type of Medium: Online Resource
    ISSN: 1758-2652 , 1758-2652
    URL: Issue
    URL: Article
    DOI: 10.1002/jia2.2018.21.issue-5
    DOI: 10.1002/jia2.25106
    Language: English
    Publisher: Wiley
    Publication Date: 2018
    detail.hit.zdb_id: 2467110-1
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  • 6
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    Early antiretroviral therapy improves neurodevelopmental outcomes in infants
    Ovid Technologies (Wolters Kluwer Health) ; 2012
    In:  AIDS Vol. 26, No. 13 ( 2012-08-24), p. 1685-1690
    Details
    In: AIDS, Ovid Technologies (Wolters Kluwer Health), Vol. 26, No. 13 ( 2012-08-24), p. 1685-1690
    Type of Medium: Online Resource
    ISSN: 0269-9370
    URL: Article
    DOI: 10.1097/QAD.0b013e328355d0ce
    RVK:
    XA 16838
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2012
    detail.hit.zdb_id: 639076-6
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  • 7
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    Neurodevelopmental outcome of HIV‐exposed but uninfected infants in the Mother and Infants Health Study, Cape Town, South Africa
    Wiley ; 2018
    In:  Tropical Medicine & International Health Vol. 23, No. 1 ( 2018-01), p. 69-78
    Details
    In: Tropical Medicine & International Health, Wiley, Vol. 23, No. 1 ( 2018-01), p. 69-78
    Abstract: Comparer les résultats neuro‐développementaux des nourrissons exposés non infectés ( ENI ) et non exposés non infectés ( NENI ) par le VIH dans une population sud‐africaine périurbaine. Les nourrissons ENI vivant en Afrique font face à des risques biologiques et environnementaux uniques, mais l'incertitude demeure quant à leurs résultats neuro‐développementaux. Cela est dû en partie au manque de groupes de comparaison NENI bien appariés, nécessaires pour ajuster pour les facteurs de confusion. Méthodes Etude de cohorte prospective sur des nourrissons inscrits à la naissance dans une institution obstétricale à sages‐femmes de faible risque. A l’âge de 12 mois, la croissance et les résultats neuro‐développementaux des nourrissons ENI et NENI ont été comparés. La croissance a été évaluée selon les scores de l’ OMS du poids selon l’âge, de la taille selon l’âge, du poids pour la taille et de la circonférence crânienne pour l’âge. Les résultats neuro‐développementaux ont été évalués en utilisant les échelles de Bayley du développement du nourrisson III ( BSID ) et Alarm Distress Baby Scale ( ADBB ). Résultats 58 nourrissons ENI et 38 NENI ont été évalués entre 11 et 14 mois. Les performances sur l’échelle BSID ne différaient dans aucun des domaines entre nourrissons ENI et NENI . Les scores cognitifs, linguistiques et moteurs étaient dans la fourchette moyenne (normes standards américaines). Sept (12%) nourrissons ENI et 1 (2,6%) NENI ont montré un retrait social sur l’échelle ADBB (p = 0,10), tandis que 15 (26%) ENI et 4 (11%) NENI ont montré une diminution de la vocalisation (p = 0,06). Il n'y avait pas de différences de croissance. Trois nourrissons ENI et 1 NENI avaient des signes neurologiques mineurs, alors que 8 nourrissons ENI et 2 NENI avaient une macrocéphalie. Conclusions Bien que les résultats sur le développement neurologique précoce des nourrissons ENI soient rassurants, des différences mineures dans la vocalisation et l'examen neurologique indiquent un besoin de réévaluation à un âge plus avancé.
    Type of Medium: Online Resource
    ISSN: 1360-2276 , 1365-3156
    URL: Issue
    URL: Article
    DOI: 10.1111/tmi.2018.23.issue-1
    DOI: 10.1111/tmi.13006
    Language: English
    Publisher: Wiley
    Publication Date: 2018
    detail.hit.zdb_id: 2018112-7
    detail.hit.zdb_id: 1314080-2
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  • 8
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    Cerebral palsy in African paediatric populations: A scoping review
    Wiley ; 2024
    In:  Developmental Medicine & Child Neurology Vol. 66, No. 8 ( 2024-08), p. 990-1012
    Details
    In: Developmental Medicine & Child Neurology, Wiley, Vol. 66, No. 8 ( 2024-08), p. 990-1012
    Abstract: To review the epidemiology and outcomes of African children with cerebral palsy (CP) over a 21‐year period. Method The PubMed, Scopus, and Web of Science online databases were searched for original research on African children with CP aged 18 years and younger published from 2000 to 2021. Results A total of 1811 articles underwent review against explicit criteria; 93 articles were selected for inclusion in the scoping review. The reported prevalence of CP ranged from 0.8 to 10 per 1000 children. Almost half had perinatal risk factors, but up to 26% had no identifiable risk factor. At least one‐third of children with CP had one or more comorbidities, most commonly epilepsy, intellectual disability, and malnutrition. African children with CP demonstrated excess premature mortality approximately 25 times that of the general population, predominantly from infections. Hospital‐based and younger populations had larger proportions of children with severe impairments. African children with CP had inadequate access to care and education, yet showed functional improvements compared to controls for all evaluated interventions. Interpretation The prevalence of CP in Africa remains uncertain. African children with CP have different risk profiles, greater premature mortality, and more severe functional impairments and comorbidities compared to the Global North. Several barriers prevent access to optimal care. Larger African studies on validated and effective interventions are needed.
    Type of Medium: Online Resource
    ISSN: 0012-1622 , 1469-8749
    URL: Issue
    URL: Article
    DOI: 10.1111/dmcn.v66.8
    DOI: 10.1111/dmcn.15878
    RVK:
    XA 10000
    Language: English
    Publisher: Wiley
    Publication Date: 2024
    detail.hit.zdb_id: 80369-8
    detail.hit.zdb_id: 2001992-0
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  • 9
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    Coagulant and Fibrinolytic Status in Tuberculous Meningitis
    Ovid Technologies (Wolters Kluwer Health) ; 2007
    In:  Pediatric Infectious Disease Journal Vol. 26, No. 5 ( 2007-05), p. 428-431
    Details
    In: Pediatric Infectious Disease Journal, Ovid Technologies (Wolters Kluwer Health), Vol. 26, No. 5 ( 2007-05), p. 428-431
    Type of Medium: Online Resource
    ISSN: 0891-3668
    URL: Article
    DOI: 10.1097/01.inf.0000261126.60283.cf
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2007
    detail.hit.zdb_id: 392481-6
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  • 10
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    Twenty Years of Pediatric Tuberculous Meningitis: A Retrospective Cohort Study in the Western Cape of South Africa
    American Academy of Pediatrics (AAP) ; 2009
    In:  Pediatrics Vol. 123, No. 1 ( 2009-01-01), p. e1-e8
    Details
    In: Pediatrics, American Academy of Pediatrics (AAP), Vol. 123, No. 1 ( 2009-01-01), p. e1-e8
    Abstract: OBJECTIVE. Tuberculous meningitis is the most severe extrapulmonary complication of tuberculosis, with high morbidity and mortality rates. The objective of this study was to assess the relationship between presenting clinical characteristics and outcome of pediatric tuberculous meningitis. PATIENTS AND METHODS. We present a retrospective cohort study of all of the children diagnosed with tuberculous meningitis in a large university hospital in South Africa between January 1985 and April 2005. We compared demographic, clinical, and diagnostic characteristics with clinical outcome after 6 months of treatment. RESULTS. We included 554 patients. Common characteristics on admission were young age (82%; & lt;5 years), stage II or III tuberculous meningitis (97%), nonspecific symptoms existing for & gt;1 week (58%), poor weight gain or weight loss (91%), loss of consciousness (96%), motor deficit (63%), meningeal irritation (98%), raised intracranial pressure (23%), brainstem dysfunction (39%), and cranial nerve palsies (27%). Common features of tuberculous meningitis on computed tomography scan of the brain were hydrocephalus (82%), periventricular lucency (57%), infarctions (32%), and basal meningeal enhancement (75%). Clinical outcome after 6 months was as follows: normal (16%), mild sequelae (52%), severe sequelae (19%), and death (13%). All of the patients diagnosed with stage I tuberculous meningitis had normal outcome. Factors associated with poor outcome in univariate analyses were as follows: African ethnicity, young age, HIV coinfection, stage III tuberculous meningitis, absence of headache and vomiting, convulsions, decreased level of consciousness, motor deficits, cranial nerve palsies, raised intracranial pressure, brainstem dysfunction and radiographic evidence of hydrocephalus, periventricular lucency, and infarction. Ethnicity, stage of disease, headache, convulsions, motor function, brainstem dysfunction, and cerebral infarctions were independently associated with poor outcome in multivariate logistic regression analysis. CONCLUSIONS. Tuberculous meningitis starts with nonspecific symptoms and is often only diagnosed when brain damage has already occurred. Earlier diagnosis will improve outcome significantly. We were able to identify presenting variables independently associated with poor clinical outcome.
    Type of Medium: Online Resource
    ISSN: 0031-4005 , 1098-4275
    URL: Article
    DOI: 10.1542/peds.2008-1353
    Language: English
    Publisher: American Academy of Pediatrics (AAP)
    Publication Date: 2009
    detail.hit.zdb_id: 1477004-0
    detail.hit.zdb_id: 207677-9
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