Michael Boivin | Michigan State University (original) (raw)

Papers by Michael Boivin

Research paper thumbnail of Caregiver mental health and HIV-infected child wellness: perspectives from Ugandan caregivers

Aids Care-psychological and Socio-medical Aspects of Aids/hiv, Dec 13, 2016

Research paper thumbnail of Screening for neurocognitive deficits in adult populations reliant on toxic cassava as the main source of food

Annales Africaines de Medecine

Contexte & objectif. La dépendance alimentaire chronique au manioc cyanogène mal détoxifié est la... more Contexte & objectif. La dépendance alimentaire chronique au manioc cyanogène mal détoxifié est largement répandue en Afrique subsaharienne. L’objectif de la présente étude était de dépister les troubles neurocognitifs et le fonctionnement de la vie quotidienne chez les adultes avec dépendance alimentaire au manioc cyanogène comme principale source de nourriture. Méthodes. C’était une étude transversale analytique incluant les chefs de ménage vivant dans le district rural de Kahemba, en République démocratique du Congo. Les participants ont été dépistés pour les troubles neurocognitifs à l'aide de Community Screening Interview for Dementia (CSID). L’exposition au manioc cyanogène a été déterminée par les concentrations urinaires de thiocyanate (SCN). Des modèles de régression ont été utilisés pour identifier les prédicteurs de mauvaises performances au CSID. Résultats. Quatre cent et six chefs de ménage (203 couples, âge moyen 38,4 ± 11, 4 ans) ont été enrôlés. Cent trente-six (3...

Research paper thumbnail of Facteurs de risque associés aux altérations neurocognitives observées chez l’adulte sous régime alimentaire principalement à base de manioc toxique

Revue de neuropsychologie

Research paper thumbnail of Early Antiretroviral Therapy Reduces Severity but Does Not Eliminate Neurodevelopmental Compromise in Children With HIV

JAIDS Journal of Acquired Immune Deficiency Syndromes

Background: Early antiretroviral therapy (ART) during infancy reduces cognitive impairment due to... more Background: Early antiretroviral therapy (ART) during infancy reduces cognitive impairment due to HIV, but the extent of benefit is unclear. Setting: Children were recruited from hospital and health centers providing HIV care and treatment in Nairobi, Kenya. Methods: Cognitive, behavioral, and motor outcomes were assessed in children with HIV and early ART (<1 year), children with HIV and late ART (1.5–6 years), and children HIV–unexposed uninfected (CHUU). Domain z scores and odds neurobehavioral impairment (≤15th percentile in CHUU) were compared in adjusted analyses. Results: Children with HIV initiated ART at median ages 0.4 (early ART) and 3.5 years (late ART). Children were assessed at median ages 6.9 (CHUU, N = 61), 6.9 (early ART, N = 54), and 13.5 (late ART; N = 27) years. Children with late ART vs. children with early ART had significantly lower z scores in 7 domains, specifically global cognition, short-term memory, visuospatial processing, learning, nonverbal test per...

Research paper thumbnail of Housing, Home and Children’s Socio-Emotional Health: Conceptual Ideas and Empirical Evidence from a South African Pilot Study

Housing, Theory and Society

Research paper thumbnail of Predictive validation of Ugandan infant eye-tracking test for memory of human faces

Research paper thumbnail of Health-Related Quality of Life: Longitudinal Analysis From the Time of Breast Biopsy Into the Post-treatment Period

Frontiers in Global Women's Health

Background: The physical, psychological, social, and spiritual quality of life (QoL) may be affec... more Background: The physical, psychological, social, and spiritual quality of life (QoL) may be affected by breast cancer diagnosis and treatment, with mixed findings for psychological quality of life and cognitive ability performance. The present study aimed to evaluate QoL in women over 1 year from biopsy for a breast abnormality.Methods: Self-reported measures of physical, psychological, social, and spiritual QoL were obtained after biopsy results but prior to treatment initiation (baseline), 4 and 12 months later. CogState computerized neuropsychological screening battery also provided an evaluation of psychological QoL. Three groups of women including those with benign biopsy results, those with malignancy treated with chemotherapy, and those with malignancy not treated with chemotherapy were compared at 4 and 12 months after adjusting for baseline to isolate the effects of treatment. Additional covariates included are age, level of education, and income.Results: Benign biopsy resu...

Research paper thumbnail of Coordination of inflammatory responses in children with perinatally acquired HIV infection

AIDS

Objective: We investigated dynamics of inflammatory biomarkers in children with perinatally acqui... more Objective: We investigated dynamics of inflammatory biomarkers in children with perinatally acquired HIV (PHIV) who started antiretrovirals at age less than 3 years and achieved sustained virologic control (HIV plasma RNA <400 copies/ml). Design: This was a retrospective analysis of inflammatory biomarkers in children enrolled in a randomized trial of early (<3 years of age) PI-based versus NNRTI-based regimens (P1060), who achieved sustained virologic control and participated in a neurodevelopmental follow-up study (P1104s) between ages 5 and 11 years. Methods: We measured 20 inflammatory biomarkers using ELISA or chemiluminescence at onset of sustained virologic control (Tc) and at P1104s entry (Te). Results: The 213 participants had median ages of 1.2, 1.9, and 7 years at antiretroviral initiation, Tc, and Te, respectively, with 138 on protease inhibitor-based and 74 on NNRTI-based regimens at Tc. Eighteen markers decreased and two increased from Tc to Te (Te-Tc). Biomarker...

Research paper thumbnail of Mediational Intervention for Sensitizing Caregivers to Improve Mental Health Outcomes in Orphaned and Vulnerable Children

Journal of Clinical Child & Adolescent Psychology, 2021

Objective: There is an urgent need to equip community-based careworkers with the skills to addres... more Objective: There is an urgent need to equip community-based careworkers with the skills to address the mental health needs of orphans and vulnerable children (OVC) as an essential response to shortages in human resources for mental health in Sub-Saharan Africa. We conducted a quasi-experimental feasibility trial in South Africa to adapt and evaluate an established year-long semi-structured, manualized video-feedback caregiver intervention (the Mediational Intervention for Sensitizing Caregivers; MISC) for community-based organizations (CBOs).Methods: Following a year-long iterative cross-cultural adaptation of MISC, we recruited 88 OVC (ages 7-11; 45.5% girls) and their CBO careworkers (N = 18; 94.4% female). Two CBOs (45 children; 9 CBO careworkers) received 12 months of MISC, and two CBOs (43 children; 9 CBO careworkers) received treatment as usual. Child mental health and quality of caregiving were assessed at 6 months into the intervention and at completion through multi-informant questionnaires and video-recordings of careworker-child interactions. Qualitative interviews were conducted to evaluate feasibility and acceptability.Results: MISC-CBO was acceptable and feasible in terms of attendance and post-intervention interviews. MISC improved child mental health, as well as the quality of careworker caregiving in terms of interactive effects for affective and cognitive (Expanding) components of MISC, and main effects for the cognitive components of Rewarding and Provision of meaning. MISC components did not mediate the effects of the intervention.Conclusions: The current study shows that laypersons with no tertiary education and virtually no prior training who undergo MISC training can improve caregiving quality and the mental health of OVCs.

Research paper thumbnail of In utero and peripartum antiretroviral exposure as predictor of cognition in 6‐ to 10‐year‐old HIV‐exposed Ugandan children – a prospective cohort study

HIV Medicine, 2021

ObjectivesTo quantify association between in utero/peripartum antiretroviral (IPA) exposure and c... more ObjectivesTo quantify association between in utero/peripartum antiretroviral (IPA) exposure and cognition, i.e. executive function (EF) and socioemotional adjustment (SEA), in school‐aged Ugandan children who were perinatally HIV‐infected (CPHIV, n = 100) and children who were HIV‐exposed but uninfected (CHEU, n = 101).MethodsChildren were enrolled at age 6–10 years and followed for 12 months from March 2017 to December 2018. Caregiver‐reported child EF and SEA competencies were assessed using validated questionnaires at baseline, 6 and 12 months. IPA type – combination antiretroviral therapy (cART), intrapartum single‐dose nevirapine ± zidovudine (sdNVP ± ZDV), nevirapine + zidovudine + lamivudine (sdNVP + ZDV + 3TC) – or no IPA (reference) was verified via medical records. IPA‐related standardized mean differences (SMDs) with corresponding 95% confidence intervals (CIs) in cognitive competencies were estimated from regression models with adjustment for caregiver sociodemographic a...

Research paper thumbnail of Early Childhood Vigilance Test (ECVT) of attention in younger HIV-exposed Ugandan children predicts Tests of Variables of Attention (TOVA) at school age

Neuropsychology, 2022

Objective: Evaluate a computerized-based attention test in early infancy in predicting neurocogni... more Objective: Evaluate a computerized-based attention test in early infancy in predicting neurocognitive school-age performance in human immunodeficiency virus (HIV)-exposed uninfected children. Method: Thirty-eight Ugandan HIV-exposed/uninfected children (17 boys, 21 girls) were evaluated with the Early Childhood Vigilance Test (ECVT) of attention between 3 and 5 years of age, which is a 6-min 44 s animation with colorful animals that greet the child and move across the screen. Attention was proportion of total animation time viewing a computer screen, as well as the proportion of time tracking the moving animal using eye tracking. These children were then again tested at least 2 years later (between 5 and 9 years of age) with the Kaufman Assessment Battery for Children, 2nd Edition (KABC-II) and the visual computerized Tests of Variables of Attention (TOVA). Results: Irrespective of whether scored by webcam video scoring or using automated eye tracking to compute proportion of time viewing the animation, ECVT attention was significantly correlated with all TOVA outcomes for vigilance attention. This was still the case when the correlation was adjusted for type of caregiver training for the mother, child gender, socioeconomic status (SES), and quality of Home Observational Measurement Evaluation (HOME) environment-especially for the TOVA response time variability to signal (p = .03). None of the ECVT attention performance measures correlated significantly with any of the KABC-II cognitive ability outcomes. Conclusion: Attention assessment in early childhood is predictive of school-age computer-based measures of attention and can be used to gauge the effects of factors of early risk and resilience in brain/behavior development in African children affected by HIV. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Research paper thumbnail of Stunting Among HIV-Uninfected Children Perinatally Exposed to Maternal-HIV and Antiretroviral Drugs Compared to Unexposed Controls in Malawi and Uganda: A Prospective Study

SSRN Electronic Journal, 2019

Research paper thumbnail of Growth deficits in antiretroviral and HIV-exposed uninfected versus unexposed children in Malawi and Uganda persist through 60 months of age

AIDS, 2021

Objective: To compare childhood physical growth among antiretroviral drug and maternal HIV-expose... more Objective: To compare childhood physical growth among antiretroviral drug and maternal HIV-exposed uninfected (AHEU) compared with HIV-unexposed uninfected (HUU) children. Design: Longitudinal follow-up of PROMISE trial (NCT01061151) AHEU and age-matched and sex-matched HUU children, enrolled (September 2013 to October 2014) in Malawi and Uganda. Method: We compared WHO population standardized z-scores [height-for-age (HAZ), weight-for-age (WAZ), weight-for-height (WHZ), head-circumference-for-age (HCAZ) at 12, 24, 36, 48, and 60 months of age]. We evaluated HUU versus AHEU [in-utero combination antiretroviral treatment (cART) versus Zidovudine (ZDV) alone]; stratified by country, using longitudinal linear and generalized linear mixed models. Results: Of 466 Malawian and 477 Ugandan children, median maternal age at enrollment was 24.5 years (Malawi) and 27.8 years (Uganda); more than 90% were breastfed through 12 months except Uganda AHEU (64.0%). HAZ scores (adjusted for maternal a...

Research paper thumbnail of Central Auditory Tests to Track Cognitive Function in People With HIV: Longitudinal Cohort Study

JMIR Formative Research, 2021

Background The development of neurocognitive deficits in people infected with HIV is a significan... more Background The development of neurocognitive deficits in people infected with HIV is a significant public health problem. Previous cross-sectional studies have shown that performance on central auditory tests (CATs) correlates with cognitive test results in those with HIV, but no longitudinal data exist for confirmation. We have been performing longitudinal assessments of central auditory and cognitive function on a cohort of HIV-positive and HIV-negative individuals in Dar es Salaam, Tanzania to understand how the central auditory system could be used to study and track the progress of central nervous system dysfunction. Objective The goal of the project was to determine if CATs can track the trajectory of cognitive function over time in people diagnosed with HIV. Methods Tests of peripheral and central auditory function as well as cognitive performance were performed on 382 individuals over the course of 3.5 years. Visits were scheduled every 6 months. CATs included tests of audit...

Research paper thumbnail of Measurement of Parenting Self-efficacy Among Female HIV-Affected Caregivers in Uganda

Maternal and Child Health Journal, 2020

Research paper thumbnail of Water sharing, reciprocity, and need: A comparative study of interhousehold water transfers in sub‐Saharan Africa

Economic Anthropology, 2019

Water sharing between households could crucially mitigate short‐term household water shortages, y... more Water sharing between households could crucially mitigate short‐term household water shortages, yet it is a vastly understudied phenomenon. Here we use comparative survey data from eight sites in seven sub‐Saharan African countries (Democratic Republic of the Congo, Ethiopia, Ghana, Kenya, Malawi, Nigeria, and Uganda) to answer three questions: With whom do households share water? What is expected in return? And what roles do need and affordability play in shaping those transfers? We find that water is shared predominantly between neighbors, that transfers are more frequent when water is less available and less affordable, and that most sharing occurs with no expectation of direct payback. These findings identify water sharing, as a form of generalized reciprocity, to be a basic and consistent household coping strategy against shortages and unaffordability of water in sub‐Saharan Africa.

Research paper thumbnail of A Discrete-Trial Choice Procedure for Assessing the Periodic Equivalent of an Aperiodic Ratio Schedule

The Psychological Record, 1986

Research paper thumbnail of Executive function and attention deficit hyperactivity disorder: stimulant medication and better executive function performance in children

Psychological Medicine, 1999

Background. Executive function deficits have been reported repeatedly in children with Attention ... more Background. Executive function deficits have been reported repeatedly in children with Attention Deficit Hyperactivity Disorder (ADHD). Stimulant medication has been shown to be effective in improving cognitive performance on most executive function tasks, but neuropsychological tests of executive function in this population have yielded inconsistent results. Methodological limitations may explain these inconsistencies. This study aimed to measure executive function in medicated and non-medicated children with ADHD by using a computerized battery, the Cambridge Neuropsychological Test Automated Battery (CANTAB), which is sensitive to executive function deficits in older patients with frontostriatal neurological impairments.Methods. Executive function was assessed in 30 children with ADHD: 15 were stimulant medication naïve and 15 were treated with stimulant medication. These two groups were compared to 15 age, sex and IQ matched controls.Results. The unmedicated children with ADHD d...

Research paper thumbnail of HIV-subtype A is associated with poorer neuropsychological performance compared with subtype D in antiretroviral therapy-naive Ugandan children

Research paper thumbnail of Computerized Cognitive Rehabilitation Training for Ugandan Seniors Living with HIV: A Validation Study

Journal of Clinical Medicine, 2020

The feasibility, acceptability and preliminary efficacy of computerized cognitive rehabilitation ... more The feasibility, acceptability and preliminary efficacy of computerized cognitive rehabilitation therapy (CCRT) for mitigating neurocognitive decline was evaluated in African adults ≥50 years old. Eighty-one Ugandans with (n = 40) and without (n = 41) chronic human immunodeficiency viruses (HIV) were allocated CCRT—i.e., 20–45-min cognitive training sessions with culturally adapted video games delivered via Captain’s Log Software, or standard of care (SOC). Pre and post (i.e., 8-weeks later) intervention performance based neurocognitive tests, quality of life (QOL) and frailty related phenotype (FRP) were determined in all respondents. Multivariable linear regression estimated CCRT- vs. SOC-related differences (β) in neurocognitive batteries, QOL and FRP. Effect sizes (ES) for estimated β were calculated. CCRT protocol was completed by 92.8% of persons allocated to it. Regardless of HIV status, CCRT was associated with higher performance in learning tests than SOC—interference list ...

Research paper thumbnail of Caregiver mental health and HIV-infected child wellness: perspectives from Ugandan caregivers

Aids Care-psychological and Socio-medical Aspects of Aids/hiv, Dec 13, 2016

Research paper thumbnail of Screening for neurocognitive deficits in adult populations reliant on toxic cassava as the main source of food

Annales Africaines de Medecine

Contexte & objectif. La dépendance alimentaire chronique au manioc cyanogène mal détoxifié est la... more Contexte & objectif. La dépendance alimentaire chronique au manioc cyanogène mal détoxifié est largement répandue en Afrique subsaharienne. L’objectif de la présente étude était de dépister les troubles neurocognitifs et le fonctionnement de la vie quotidienne chez les adultes avec dépendance alimentaire au manioc cyanogène comme principale source de nourriture. Méthodes. C’était une étude transversale analytique incluant les chefs de ménage vivant dans le district rural de Kahemba, en République démocratique du Congo. Les participants ont été dépistés pour les troubles neurocognitifs à l'aide de Community Screening Interview for Dementia (CSID). L’exposition au manioc cyanogène a été déterminée par les concentrations urinaires de thiocyanate (SCN). Des modèles de régression ont été utilisés pour identifier les prédicteurs de mauvaises performances au CSID. Résultats. Quatre cent et six chefs de ménage (203 couples, âge moyen 38,4 ± 11, 4 ans) ont été enrôlés. Cent trente-six (3...

Research paper thumbnail of Facteurs de risque associés aux altérations neurocognitives observées chez l’adulte sous régime alimentaire principalement à base de manioc toxique

Revue de neuropsychologie

Research paper thumbnail of Early Antiretroviral Therapy Reduces Severity but Does Not Eliminate Neurodevelopmental Compromise in Children With HIV

JAIDS Journal of Acquired Immune Deficiency Syndromes

Background: Early antiretroviral therapy (ART) during infancy reduces cognitive impairment due to... more Background: Early antiretroviral therapy (ART) during infancy reduces cognitive impairment due to HIV, but the extent of benefit is unclear. Setting: Children were recruited from hospital and health centers providing HIV care and treatment in Nairobi, Kenya. Methods: Cognitive, behavioral, and motor outcomes were assessed in children with HIV and early ART (<1 year), children with HIV and late ART (1.5–6 years), and children HIV–unexposed uninfected (CHUU). Domain z scores and odds neurobehavioral impairment (≤15th percentile in CHUU) were compared in adjusted analyses. Results: Children with HIV initiated ART at median ages 0.4 (early ART) and 3.5 years (late ART). Children were assessed at median ages 6.9 (CHUU, N = 61), 6.9 (early ART, N = 54), and 13.5 (late ART; N = 27) years. Children with late ART vs. children with early ART had significantly lower z scores in 7 domains, specifically global cognition, short-term memory, visuospatial processing, learning, nonverbal test per...

Research paper thumbnail of Housing, Home and Children’s Socio-Emotional Health: Conceptual Ideas and Empirical Evidence from a South African Pilot Study

Housing, Theory and Society

Research paper thumbnail of Predictive validation of Ugandan infant eye-tracking test for memory of human faces

Research paper thumbnail of Health-Related Quality of Life: Longitudinal Analysis From the Time of Breast Biopsy Into the Post-treatment Period

Frontiers in Global Women's Health

Background: The physical, psychological, social, and spiritual quality of life (QoL) may be affec... more Background: The physical, psychological, social, and spiritual quality of life (QoL) may be affected by breast cancer diagnosis and treatment, with mixed findings for psychological quality of life and cognitive ability performance. The present study aimed to evaluate QoL in women over 1 year from biopsy for a breast abnormality.Methods: Self-reported measures of physical, psychological, social, and spiritual QoL were obtained after biopsy results but prior to treatment initiation (baseline), 4 and 12 months later. CogState computerized neuropsychological screening battery also provided an evaluation of psychological QoL. Three groups of women including those with benign biopsy results, those with malignancy treated with chemotherapy, and those with malignancy not treated with chemotherapy were compared at 4 and 12 months after adjusting for baseline to isolate the effects of treatment. Additional covariates included are age, level of education, and income.Results: Benign biopsy resu...

Research paper thumbnail of Coordination of inflammatory responses in children with perinatally acquired HIV infection

AIDS

Objective: We investigated dynamics of inflammatory biomarkers in children with perinatally acqui... more Objective: We investigated dynamics of inflammatory biomarkers in children with perinatally acquired HIV (PHIV) who started antiretrovirals at age less than 3 years and achieved sustained virologic control (HIV plasma RNA <400 copies/ml). Design: This was a retrospective analysis of inflammatory biomarkers in children enrolled in a randomized trial of early (<3 years of age) PI-based versus NNRTI-based regimens (P1060), who achieved sustained virologic control and participated in a neurodevelopmental follow-up study (P1104s) between ages 5 and 11 years. Methods: We measured 20 inflammatory biomarkers using ELISA or chemiluminescence at onset of sustained virologic control (Tc) and at P1104s entry (Te). Results: The 213 participants had median ages of 1.2, 1.9, and 7 years at antiretroviral initiation, Tc, and Te, respectively, with 138 on protease inhibitor-based and 74 on NNRTI-based regimens at Tc. Eighteen markers decreased and two increased from Tc to Te (Te-Tc). Biomarker...

Research paper thumbnail of Mediational Intervention for Sensitizing Caregivers to Improve Mental Health Outcomes in Orphaned and Vulnerable Children

Journal of Clinical Child & Adolescent Psychology, 2021

Objective: There is an urgent need to equip community-based careworkers with the skills to addres... more Objective: There is an urgent need to equip community-based careworkers with the skills to address the mental health needs of orphans and vulnerable children (OVC) as an essential response to shortages in human resources for mental health in Sub-Saharan Africa. We conducted a quasi-experimental feasibility trial in South Africa to adapt and evaluate an established year-long semi-structured, manualized video-feedback caregiver intervention (the Mediational Intervention for Sensitizing Caregivers; MISC) for community-based organizations (CBOs).Methods: Following a year-long iterative cross-cultural adaptation of MISC, we recruited 88 OVC (ages 7-11; 45.5% girls) and their CBO careworkers (N = 18; 94.4% female). Two CBOs (45 children; 9 CBO careworkers) received 12 months of MISC, and two CBOs (43 children; 9 CBO careworkers) received treatment as usual. Child mental health and quality of caregiving were assessed at 6 months into the intervention and at completion through multi-informant questionnaires and video-recordings of careworker-child interactions. Qualitative interviews were conducted to evaluate feasibility and acceptability.Results: MISC-CBO was acceptable and feasible in terms of attendance and post-intervention interviews. MISC improved child mental health, as well as the quality of careworker caregiving in terms of interactive effects for affective and cognitive (Expanding) components of MISC, and main effects for the cognitive components of Rewarding and Provision of meaning. MISC components did not mediate the effects of the intervention.Conclusions: The current study shows that laypersons with no tertiary education and virtually no prior training who undergo MISC training can improve caregiving quality and the mental health of OVCs.

Research paper thumbnail of In utero and peripartum antiretroviral exposure as predictor of cognition in 6‐ to 10‐year‐old HIV‐exposed Ugandan children – a prospective cohort study

HIV Medicine, 2021

ObjectivesTo quantify association between in utero/peripartum antiretroviral (IPA) exposure and c... more ObjectivesTo quantify association between in utero/peripartum antiretroviral (IPA) exposure and cognition, i.e. executive function (EF) and socioemotional adjustment (SEA), in school‐aged Ugandan children who were perinatally HIV‐infected (CPHIV, n = 100) and children who were HIV‐exposed but uninfected (CHEU, n = 101).MethodsChildren were enrolled at age 6–10 years and followed for 12 months from March 2017 to December 2018. Caregiver‐reported child EF and SEA competencies were assessed using validated questionnaires at baseline, 6 and 12 months. IPA type – combination antiretroviral therapy (cART), intrapartum single‐dose nevirapine ± zidovudine (sdNVP ± ZDV), nevirapine + zidovudine + lamivudine (sdNVP + ZDV + 3TC) – or no IPA (reference) was verified via medical records. IPA‐related standardized mean differences (SMDs) with corresponding 95% confidence intervals (CIs) in cognitive competencies were estimated from regression models with adjustment for caregiver sociodemographic a...

Research paper thumbnail of Early Childhood Vigilance Test (ECVT) of attention in younger HIV-exposed Ugandan children predicts Tests of Variables of Attention (TOVA) at school age

Neuropsychology, 2022

Objective: Evaluate a computerized-based attention test in early infancy in predicting neurocogni... more Objective: Evaluate a computerized-based attention test in early infancy in predicting neurocognitive school-age performance in human immunodeficiency virus (HIV)-exposed uninfected children. Method: Thirty-eight Ugandan HIV-exposed/uninfected children (17 boys, 21 girls) were evaluated with the Early Childhood Vigilance Test (ECVT) of attention between 3 and 5 years of age, which is a 6-min 44 s animation with colorful animals that greet the child and move across the screen. Attention was proportion of total animation time viewing a computer screen, as well as the proportion of time tracking the moving animal using eye tracking. These children were then again tested at least 2 years later (between 5 and 9 years of age) with the Kaufman Assessment Battery for Children, 2nd Edition (KABC-II) and the visual computerized Tests of Variables of Attention (TOVA). Results: Irrespective of whether scored by webcam video scoring or using automated eye tracking to compute proportion of time viewing the animation, ECVT attention was significantly correlated with all TOVA outcomes for vigilance attention. This was still the case when the correlation was adjusted for type of caregiver training for the mother, child gender, socioeconomic status (SES), and quality of Home Observational Measurement Evaluation (HOME) environment-especially for the TOVA response time variability to signal (p = .03). None of the ECVT attention performance measures correlated significantly with any of the KABC-II cognitive ability outcomes. Conclusion: Attention assessment in early childhood is predictive of school-age computer-based measures of attention and can be used to gauge the effects of factors of early risk and resilience in brain/behavior development in African children affected by HIV. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Research paper thumbnail of Stunting Among HIV-Uninfected Children Perinatally Exposed to Maternal-HIV and Antiretroviral Drugs Compared to Unexposed Controls in Malawi and Uganda: A Prospective Study

SSRN Electronic Journal, 2019

Research paper thumbnail of Growth deficits in antiretroviral and HIV-exposed uninfected versus unexposed children in Malawi and Uganda persist through 60 months of age

AIDS, 2021

Objective: To compare childhood physical growth among antiretroviral drug and maternal HIV-expose... more Objective: To compare childhood physical growth among antiretroviral drug and maternal HIV-exposed uninfected (AHEU) compared with HIV-unexposed uninfected (HUU) children. Design: Longitudinal follow-up of PROMISE trial (NCT01061151) AHEU and age-matched and sex-matched HUU children, enrolled (September 2013 to October 2014) in Malawi and Uganda. Method: We compared WHO population standardized z-scores [height-for-age (HAZ), weight-for-age (WAZ), weight-for-height (WHZ), head-circumference-for-age (HCAZ) at 12, 24, 36, 48, and 60 months of age]. We evaluated HUU versus AHEU [in-utero combination antiretroviral treatment (cART) versus Zidovudine (ZDV) alone]; stratified by country, using longitudinal linear and generalized linear mixed models. Results: Of 466 Malawian and 477 Ugandan children, median maternal age at enrollment was 24.5 years (Malawi) and 27.8 years (Uganda); more than 90% were breastfed through 12 months except Uganda AHEU (64.0%). HAZ scores (adjusted for maternal a...

Research paper thumbnail of Central Auditory Tests to Track Cognitive Function in People With HIV: Longitudinal Cohort Study

JMIR Formative Research, 2021

Background The development of neurocognitive deficits in people infected with HIV is a significan... more Background The development of neurocognitive deficits in people infected with HIV is a significant public health problem. Previous cross-sectional studies have shown that performance on central auditory tests (CATs) correlates with cognitive test results in those with HIV, but no longitudinal data exist for confirmation. We have been performing longitudinal assessments of central auditory and cognitive function on a cohort of HIV-positive and HIV-negative individuals in Dar es Salaam, Tanzania to understand how the central auditory system could be used to study and track the progress of central nervous system dysfunction. Objective The goal of the project was to determine if CATs can track the trajectory of cognitive function over time in people diagnosed with HIV. Methods Tests of peripheral and central auditory function as well as cognitive performance were performed on 382 individuals over the course of 3.5 years. Visits were scheduled every 6 months. CATs included tests of audit...

Research paper thumbnail of Measurement of Parenting Self-efficacy Among Female HIV-Affected Caregivers in Uganda

Maternal and Child Health Journal, 2020

Research paper thumbnail of Water sharing, reciprocity, and need: A comparative study of interhousehold water transfers in sub‐Saharan Africa

Economic Anthropology, 2019

Water sharing between households could crucially mitigate short‐term household water shortages, y... more Water sharing between households could crucially mitigate short‐term household water shortages, yet it is a vastly understudied phenomenon. Here we use comparative survey data from eight sites in seven sub‐Saharan African countries (Democratic Republic of the Congo, Ethiopia, Ghana, Kenya, Malawi, Nigeria, and Uganda) to answer three questions: With whom do households share water? What is expected in return? And what roles do need and affordability play in shaping those transfers? We find that water is shared predominantly between neighbors, that transfers are more frequent when water is less available and less affordable, and that most sharing occurs with no expectation of direct payback. These findings identify water sharing, as a form of generalized reciprocity, to be a basic and consistent household coping strategy against shortages and unaffordability of water in sub‐Saharan Africa.

Research paper thumbnail of A Discrete-Trial Choice Procedure for Assessing the Periodic Equivalent of an Aperiodic Ratio Schedule

The Psychological Record, 1986

Research paper thumbnail of Executive function and attention deficit hyperactivity disorder: stimulant medication and better executive function performance in children

Psychological Medicine, 1999

Background. Executive function deficits have been reported repeatedly in children with Attention ... more Background. Executive function deficits have been reported repeatedly in children with Attention Deficit Hyperactivity Disorder (ADHD). Stimulant medication has been shown to be effective in improving cognitive performance on most executive function tasks, but neuropsychological tests of executive function in this population have yielded inconsistent results. Methodological limitations may explain these inconsistencies. This study aimed to measure executive function in medicated and non-medicated children with ADHD by using a computerized battery, the Cambridge Neuropsychological Test Automated Battery (CANTAB), which is sensitive to executive function deficits in older patients with frontostriatal neurological impairments.Methods. Executive function was assessed in 30 children with ADHD: 15 were stimulant medication naïve and 15 were treated with stimulant medication. These two groups were compared to 15 age, sex and IQ matched controls.Results. The unmedicated children with ADHD d...

Research paper thumbnail of HIV-subtype A is associated with poorer neuropsychological performance compared with subtype D in antiretroviral therapy-naive Ugandan children

Research paper thumbnail of Computerized Cognitive Rehabilitation Training for Ugandan Seniors Living with HIV: A Validation Study

Journal of Clinical Medicine, 2020

The feasibility, acceptability and preliminary efficacy of computerized cognitive rehabilitation ... more The feasibility, acceptability and preliminary efficacy of computerized cognitive rehabilitation therapy (CCRT) for mitigating neurocognitive decline was evaluated in African adults ≥50 years old. Eighty-one Ugandans with (n = 40) and without (n = 41) chronic human immunodeficiency viruses (HIV) were allocated CCRT—i.e., 20–45-min cognitive training sessions with culturally adapted video games delivered via Captain’s Log Software, or standard of care (SOC). Pre and post (i.e., 8-weeks later) intervention performance based neurocognitive tests, quality of life (QOL) and frailty related phenotype (FRP) were determined in all respondents. Multivariable linear regression estimated CCRT- vs. SOC-related differences (β) in neurocognitive batteries, QOL and FRP. Effect sizes (ES) for estimated β were calculated. CCRT protocol was completed by 92.8% of persons allocated to it. Regardless of HIV status, CCRT was associated with higher performance in learning tests than SOC—interference list ...