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Preliminary Validation of a New Developmental Screening Tool for Neurodevelopmental Delay in HIV-Infected South
Gbemisola Boyede1, Brian Eley2, Kirsty Donald3
1Division of Developmental Pediatrics, Department of Pediatrics and Child Health, University of Cape Town, Red Cross War Memorial Children's Hospital, Cape Town, South Africa BYDOJO001@myuct.ac.za.
Insights
A new screening tool effectively identifies developmental delays in HIV-infected children aged 9-36 months in Africa. This tool offers adequate sensitivity for early detection, improving pediatric HIV care.
Area of Science:
- Pediatric HIV Management
- Developmental Pediatrics
- Public Health in Africa
Background:
- Screening for developmental delays in HIV-infected children is crucial but limited by a lack of appropriate tools in African pediatric HIV clinics.
- Early identification of developmental delays is essential for timely intervention and improved outcomes in children living with HIV.
Purpose of the Study:
- To evaluate the diagnostic accuracy of a novel developmental screening tool developed by the Red Cross War Memorial Children's Hospital.
- To assess the tool's suitability for rapid screening of moderate to severe global developmental delays in HIV-infected children aged 9 to 36 months.
Main Methods:
- The Red Cross War Memorial Children's Hospital developmental screening tool was administered to 47 HIV-infected children (9-36 months).
- Full developmental assessments were conducted using the Bayley Scales of Infant and Toddler Development, Third Edition, for comparison.
- Diagnostic accuracy metrics including sensitivity, specificity, and predictive values were calculated.
Main Results:
- The screening tool demonstrated a sensitivity of 78.5% and a specificity of 54.6%.
- Positive predictive value was 42.6%, and negative predictive value was 85.4%.
- The tool was found to be adequately sensitive for detecting developmental delays.
Conclusions:
- The Red Cross War Memorial Children's Hospital developmental screening tool is recommended for screening moderate to severe developmental delays in HIV-infected children in resource-limited settings.
- The tool's adequate sensitivity supports its use in pediatric HIV clinics to improve developmental surveillance.
- Further validation in diverse African populations may enhance its utility.
Abstract:
Screening for developmental delays among HIV-infected children is not routine in most pediatric HIV clinics in Africa because of the lack of locally adaptable, simple, sensitive and rapid screening tools. The Division of Developmental Pediatrics of the Red Cross War Memorial Children's Hospital developed a tool for rapid screening of moderate to severe global developmental delays among HIV-infected children aged 9 to 36 months. The diagnostic accuracy of the novel screening tool was evaluated. Forty-seven HIV-infected children aged 9 to 36 months were screened using the Red Cross War Memorial Children's Hospital developmental screening tool. Full developmental assessments of same children were performed using the Bayley Scales of Infant and Toddler Development, Third Edition. The Red Cross War Memorial Children's Hospital tool's sensitivity was 78.5%, specificity 54.6%, positive predictive value was 42.6%, and negative predictive value was 85.4%. The Red Cross War Memorial Children's Hospital screening tool was adequately sensitive and therefore recommended for screening of moderate to severe developmental delays among HIV-infected children.
