Uganda
David Sullivan, Bloomberg School of Public Health
Bruce Shapiro, School of Medicine
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Over 3 million African children are HIV-infected, but there is limited information on the development, health and social conditions of HIV-positive (HIV+) and HIV-negative (HIV-) children born to HIV-infected mothers. Neurodevelopmental disabilities are an important but largely unaddressed problem among children in low-income countries, but in the developed world, HIV has emerged as a leading cause of neurologic impairment. This pilot study will assess the effects of HIV infection on child neurodevelopmental outcomes in a cohort of HIV+, HIV- but affected children born to HIV-infected mothers and a baseline group of HIV- children born to HIV- mothers. Children born during the study and their mothers/caretakers will be seen at birth, 4-6 weeks, 6 and 12 month visits. The Rakai Program has an extensive field, clinical, laboratory and data management infrastructure. The multidisciplinary research team has the requisite expertise in epidemiology, clinical research, assessment of morbidity and disabilities, and in statistical analyses. In 2004, the Rakai Program received PEPFAR support for ARV provision and in 2005 was awarded a R01 to assess ARV effects on HIV epidemiology and behaviors (1 R01 HD050180-01). However, the R01 does not provide resources for detailed pediatric evaluations, particularly of neurodevelopmental disabilities, which will be a primary and original focus of this training and research application. Embedding the proposed study within the Rakai cohort draws upon unique resources and allows substantial cost savings. This study will provide critical information to guide interventions for improved care of HIV infected and HIV affected children in rural Uganda. >> See all 2007 Faculty Grant in Global Health winners
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