@misc{10481/83950,
year = {2023},
month = {6},
url = {https://hdl.handle.net/10481/83950},
abstract = {Background: Empirical evidence indicates that both HIV infection and stunting
impede cognitive functions of school-going children. However, there is less
evidence on how these two risk factors amplify each other’s negative effects.
This study aimed to examine the direct effects of stunting on cognitive outcomes
and the extent to which stunting (partially) mediates the effects of HIV, age, and
gender on cognitive outcomes.
Methodology: We applied structural equation modelling to cross-sectional
data from 328 children living with HIV and 260 children living without HIV aged
6–14 years from Nairobi, Kenya to test the mediating effect of stunting and
predictive effects of HIV, age, and gender on cognitive latent variables flexibility,
fluency, reasoning, and verbal memory.
Results: The model predicting the cognitive outcomes fitted well (RMSEA = 0.041,
CFI = 0.966, χ2 = 154.29, DF = 77, p < 0.001). Height-for-age (a continuous indicator
of stunting) predicted fluency (β = 0.14) and reasoning (β = 0.16). HIV predicted
height-for-age (β = −0.24) and showed direct effects on reasoning (β = −0.66),
fluency (β = −0.34), flexibility (β = 0.26), and verbal memory (β = −0.22), highlighting
that the effect of HIV on cognitive variables was partly mediated by height-forage.
Conclusion: In this study, we found evidence that stunting partly explains the
effects of HIV on cognitive outcomes. The model suggests there is urgency to
develop targeted preventative and rehabilitative nutritional interventions for
school children with HIV as part of a comprehensive set of interventions to
improve cognitive functioning in this high-risk group of children. Being infected
or having been born to a mother who is HIV positive poses a risk to normal child
development},
organization = {Mental Health Development in Sub-Saharan Africa (PaM-D) (NIMH award number U19MH98718)},
organization = {2017 institutional award by the Kenyatta National Hospital’s Research & Programs Department (KNH/R&P/23F/55/13)},
organization = {Office Of The Director, National Institutes Of Health},
organization = {The National Institute Of Biomedical Imaging And Bioengineering},
organization = {The National Institute Of Mental Health},
organization = {Fogarty International Center},
organization = {the National Institutes of Health under award number U54TW012089},
publisher = {Frontiers},
keywords = {Stunting},
keywords = {Mediation},
keywords = {Lower school students},
keywords = {Executive functioning},
keywords = {Flexibility},
keywords = {Lower & middle income countries},
title = {The effects of height-for-age and HIV on cognitive development of school-aged children in Nairobi, Kenya: a structural equation modelling analysis},
doi = {10.3389/fpubh.2023.1171851},
author = {Rachel, Maina and Pérez García, Miguel},
}