ArticleJournal of the Pediatric Infectious Diseases Society2021
Neighborhood-Based Socioeconomic Determinants of Cognitive Impairment in Zambian Children With HIV: A Quantitative Geographic Information Systems Approach.
Article in Journal of the Pediatric Infectious Diseases Society, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed, 13 citations in OpenAlex.
- Nutritional Status and Cognitive Function in Children With or Exposed to HIV: Evidence From the HIV-Associated Neurocognitive Disorders in Zambia Study.Journal of acquired immune deficiency syndromes (1999) · 2026Article
- Executive Function and Adherence in Children and Adolescents Living With HIV: Evidence From the HIV-Associated Neurocognitive Disorders in Zambia (HANDZ) Study.Journal of child neurology · 2026Article
- Adherence, Adverse Events and Viral Control among Children and Adolescents with HIV in Zambia Switched to an Integrase Inhibitor Regimen.medRxiv : the preprint server for health sciences · 2024Article
- "We did more than survive": lessons learned from studies of risk and resilience of young people growing up with HIV and mental health needs.AIDS care · 2024Article
- Central Nervous System Complications of HIV in Children.Current HIV/AIDS reports · 2024Review
- Neuropsychology and Electroencephalography in Rural Children at Neurodevelopmental Risk: A Scoping Review.Pediatric reports · 2023Article
Corrections and comments
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Authors and funding
14 authors at 4 institutions in 2 countries.
Funding
Abstract
backgroundPlace-based inequalities, such as exposure to violence and access to nutritious food and clean water, may contribute to human immunodeficiency virus (HIV)-associated cognitive impairment. In this study, we investigated neighborhood effects on cognition in children and adolescents with HIV in Lusaka, Zambia.
methodsWe conducted a prospective cohort study of 208 children with perinatally acquired HIV (ages 8-17) and 208 HIV-exposed uninfected controls. Participants underwent neuropsychological testing and interviews assessing socioeconomic status. Geographic regions with clusters of participants with HIV and cognitive impairment were identified using quantitative geographic information systems (QGIS) and SaTScan. Associations between location of residence and cognitive function were evaluated in bivariable and multivariable regression models. Mediation analysis was performed to assess direct and indirect effects of location of the residence on cognitive impairment.
resultsResidence in Chawama, one of the poorest neighborhoods in Lusaka, was significantly associated with cognitive impairment in participants with HIV (odds ratio 2.9; P = .005) and remained significant in a multivariable regression model controlling for potential confounders. Mediation analysis found that 46% of the cognitive effects of residence in Chawama were explained by higher rates of malnutrition, lower school attendance, and poorer self-reported health.
conclusionsPlace-based socioeconomic inequality contributes to cognitive impairment in Zambian children and adolescents with HIV. Neighborhood effects may be mediated by concentrated poverty, malnutrition, limited access to education and health care, and other yet unknown environmental factors that may be potentially modifiable.
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