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Predictive Validity of a Computerized Battery for Identifying Neurocognitive Impairments Among Children Living with HIV in Botswana

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Abstract

Children living with HIV (HIV+) experience increased risk of neurocognitive deficits, but standardized cognitive testing is limited in low-resource, high-prevalence settings. The Penn Computerized Neurocognitive Battery (PennCNB) was adapted for use in Botswana. This study evaluated the criterion validity of a locally adapted version of the PennCNB among a cohort of HIV+ individuals aged 10–17 years in Botswana. Participants completed the PennCNB and a comprehensive professional consensus assessment consisting of pencil-and-paper psychological assessments, clinical interview, and review of academic performance. Seventy-two participants were classified as cases (i.e., with cognitive impairment; N = 48) or controls (i.e., without cognitive impairment; N = 24). Sensitivity, specificity, positive predictive value, negative predictive value, and the area under receiver operating characteristic curves were calculated. Discrimination was acceptable, and prediction improved as the threshold for PennCNB impairment was less conservative. This research contributes to the validation of the PennCNB for use among children affected by HIV in Botswana.

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Acknowledgements

This research was supported by the National Institute of Child Health and Human Development (F31 HD101346 and R01 HD095278). This publication was made possible in part through core services and support from the Penn Center for AIDS Research (CFAR), an NIH-funded (P30 045088) program and the Penn Mental Health AIDS Research Center (PMHARC; P30 MH097488). TMM is supported by NIMH R01 MH117014 and by the Lifespan Brain Institute (LiBI) of Penn Medicine and CHOP.

Funding

This work was funded by the National Institute of Child Health and Human Development (F31 HD101346; R01 HD095278). This publication was made possible in part through core services and support from the Penn Center for AIDS Research (CFAR), an NIH-funded (P30 045088) program, and the Penn Mental Health AIDS Research Center (PMHARC; P30 MH097488).

Author information

Authors and Affiliations

  1. Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine at the University of Pennsylvania, 423 Guardian Drive, Blockley Hall Office 107, Philadelphia, PA, USA

    Amelia E. Van Pelt, Knashawn H. Morales & Elizabeth D. Lowenthal

  2. Global Health Center, Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    Amelia E. Van Pelt & Elizabeth D. Lowenthal

  3. Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA

    Tyler M. Moore, J. Cobb Scott & Ruben C. Gur

  4. Penn-CHOP Lifespan Brain Institute, Philadelphia, USA

    Tyler M. Moore, J. Cobb Scott & Ruben C. Gur

  5. VISN4 Mental Illness Research, Education, and Clinical Center at the Philadelphia VA Medical Center, Philadelphia, PA, USA

    J. Cobb Scott

  6. Botswana-Baylor Children’s Clinical Centre of Excellence, Gaborone, Botswana

    Onkemetse Phoi & Mogomotsi Matshaba

  7. Department of Psychology, University of Botswana, Gaborone, Botswana

    Lingani Mbakile-Mahlanza & Shathani Rampa

  8. Department of Pediatrics, Retrovirology, Baylor College of Medicine, Houston, TX, USA

    Mogomotsi Matshaba

  9. Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA

    Elizabeth D. Lowenthal

Authors
  1. Amelia E. Van Pelt
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  2. Tyler M. Moore
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  3. J. Cobb Scott
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  4. Onkemetse Phoi
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  5. Lingani Mbakile-Mahlanza
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  6. Knashawn H. Morales
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  7. Ruben C. Gur
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  8. Shathani Rampa
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  9. Mogomotsi Matshaba
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  10. Elizabeth D. Lowenthal
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Contributions

A.E.V.P., E.D.L., and M.M. contributed to the concept and design of the research. A.E.V.P., J.C.S., and E.D.L. obtained funding. A.E.V.P. designed the study protocol. O.P. collected data. J.C.S., O.P., L.M., S.R., and E.D.L. contributed to the professional consensus discussion. A.E.V.P. analyzed data. T.M.M., K.H.M., and E.D.L. provided supervision. A.E.V.P. drafted the manuscript. All authors provided critical revision of content and have read and approved the final manuscript.

Corresponding author

Correspondence to Amelia E. Van Pelt.

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The authors declare that they have no conflict of interest.

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Ethical Approval

All procedures were approved by the Institutional Review Boards at the Health Research and Development Committee within the Ministry of Health and Wellness of Botswana, the Botswana-Baylor Children’s Clinical Centre of Excellence (CoE), and the University of Pennsylvania.

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Informed consent was obtained from all individual participants included in the study.

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Van Pelt, A.E., Moore, T.M., Scott, J.C. et al. Predictive Validity of a Computerized Battery for Identifying Neurocognitive Impairments Among Children Living with HIV in Botswana. AIDS Behav 26, 2758–2767 (2022). https://doi.org/10.1007/s10461-022-03620-w

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