Structural validity of a computerized neurocognitive battery for youth affected by human immunodeficiency virus in...

Area of Science:

• Neuroscience
• Pediatrics
• Global Health

Background:

• Children born to mothers with human immunodeficiency virus (HIV) face heightened risks of neurocognitive impairment.
• Standardized cognitive screening is limited for youth in Botswana, a region with a high HIV burden.
• The Penn Computerized Neurocognitive Battery (PennCNB) was adapted for cultural relevance among youth in this setting.

Purpose of the Study:

• To examine the structural validity of the culturally adapted PennCNB in a high-burden, low-resource setting.
• To assess the PennCNB's suitability for evaluating neurocognitive function in children living with HIV and HIV-exposed-uninfected children.
• To determine if the adapted battery effectively measures distinct neurocognitive domains.

Main Methods:

• A cohort of 7-17-year-old children (HIV+ and HIV-exposed-uninfected) was enrolled in Gaborone, Botswana.
• Confirmatory and exploratory factor analyses were conducted on data from 13 PennCNB tests.
• Measures included speed, accuracy, and efficiency across cognitive tasks.

Main Results:

• Confirmatory factor analysis demonstrated acceptable fit, supporting the intended four-domain structure (Executive functioning, episodic memory, complex cognition, sensorimotor/processing speed).
• High interfactor correlations were observed within the model.
• Exploratory factor analysis indicated that executive functioning and sensorimotor/processing speed tests tended to cluster together.

Conclusions:

• The study provides valuable insight into the structural validity of a neurocognitive battery in a non-Western context.
• The culturally adapted PennCNB shows potential as a tool for assessing neurocognitive function in Botswana.
• The findings suggest the PennCNB may be useful in other resource-limited settings for evaluating cognitive health in children affected by HIV.