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Cognitive Outcomes at 18 Months: Findings from the Early Life Interventions for Childhood Growth and Development in Tanzania (ELICIT) Trial
By Bayo, Eliwaza
Micronutrient deficiencies and enteric infections negatively impact child growth and development. We enrolled children shortly after birth in a randomized, placebo-controlled, 2 3 2 factorial interventional trial in Haydom, Tanzania, to assess nicotinamide and/or antimicrobials (azithromycin and nitazoxanide) effect on length at 18 months of age. Cognitive score at 18 months using the Malawi Developmental Assessment Tool (MDAT), which includes gross motor, fine motor, language, and social assessments, was a secondary outcome. Here, we present the MDAT results of 1,032 children. There was no effect of nicotinamide (change in development-for-age Z score [DAZ] 20.08; 95% CI: 20.16, 0) or antimicrobials (change in DAZ 0.04; 95% CI: 20.06, 0.13) on overall MDAT score. The interventions had no effect on cognitive outcomes in subgroups defined by gender, socioeconomic status, birthweight, and birth season or on MDAT subscores. Further analyses are needed to identify targetable risk factors for impaired cognitive development in these settings. © 2022 American Society of Tropical Medicine and Hygiene. All rights reserved.
Impact of early-onset persistent stunting on cognitive development at 5 years of age: Results from a multi-country cohort study
By Mduma, Estomih
Here, we report a survey of 80 subsistence farming households in rural Zimbabwe during lockdown. Primary caregivers of 7‐year‐old children were interviewed following written informed consent between September and December 2020, as part of a study on school‐age growth and cognition. All caregivers reported children missing school due to COVID‐19. Towards the end of this study, schools began to reopen: 15 children were enrolled in school, but only 3 were actually attending school. Among children not attending school, only half were receiving home schooling, defined by asking the caregiver whether the child was taught lessons at home in subjects they would normally learn at school. Home schooling mostly relied on parents or local adults (Table 1). Parents providing home schooling had 1.7 more years of education (95%CI 0.3, 3.1, p = 0.02) than those who did not. About 15% (N = 12) households reported receiving support in teaching, 9% (N = 7) from schools. Only 6% (N = 5) households received additional educational support using radio, phone or online resources, despite 74% having access to a radio and 99% access to a phone.
Psychosocial and environmental determinants of child cognitive development in rural south africa and tanzania: Findings from the mal-ed cohort
By Mduma, Estomih
Background: Approximately 66% of children under the age of 5 in Sub-Saharan African countries do not reach their full cognitive potential, the highest percentage in the world. Because the majority of studies investigating child cognitive development have been conducted in high-income countries (HICs), there is limited knowledge regarding the determinants of child development in low- and middle-income countries (LMICs). Methods: This analysis includes 401 mother-child dyads from the South Africa and Tanzania sites of the Etiology, Risk Factors, and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health and Development (MAL-ED) longitudinal birth cohort study. We investigated the effect of psychosocial and environmental determinants on child cognitive development measured by the Wechsler Preschool Primary Scales of Intelligence (WPPSI) at 5 years of age using multivariable linear regression. Results: Socioeconomic status was most strongly associated with child cognitive development (WPSSI Score Difference (SD):14.27, 95% CI:1.96, 26.59). Modest associations between the organization of the home environment and its opportunities for cognitive stimulation and child cognitive development were also found (SD: 3.08, 95% CI: 0.65, 5.52 and SD: 3.18, 95% CI: 0.59, 5.76, respectively). Conclusion: This study shows a stronger association with child cognitive development at 5 years of age for socioeconomic status compared to more proximal measures of psychosocial and environmental determinants. A better understanding of the role of these factors is needed to inform interventions aiming to alleviate the burden of compromised cognitive development for children in LMICs. © 2020 The Author(s).
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