Prevalence of Disability in a Cohort of HIV-Infected children attending an urban paediatric HIV Clinic in Johannesburg, South Africa

Abstract

Background: With the success of evolving antiretroviral therapy (ART), human immunodeficiency virus (HIV) has become a chronic condition, however, children infected with HIV have been shown to have developmental difficulties and disabilities. This study aimed to investigate the extent of disability among a cohort of HIV infected children in South Africa and whether they are being referred and accessing rehabilitative services. Methods: A cross-sectional study was conducted at an HIV clinic in Johannesburg. Caregivers/parents were interviewed about their child, using the Ten Question Screen for Disability Questionnaire (TQSD) along with a general additional questionnaire devised by the researchers on medical history, services referred to and accessed and socioeconomic status (SES). Clinical data, from the child’s clinic file were recorded. Results Of the 200 children whose caregivers/parents were interviewed, 50.5% experienced disabilities were 58.4% of those had more than one co-existing disability. Of the children who reported disability only 46% had been referred to one or more of the following support services; audiologist, physiotherapist (PT), psychologist, occupational therapist (OT) and/or speech and language therapist (SLT). Previous diagnosis of tuberculosis (TB), lower respiratory tract infections (LRTI) and low pre-combination ART (cART) CD4% were found to be associated factors in the presence of developmental disability and/or delay. Conclusion The prevalence of children with HIV and disability is high and these children are not being referred to and/or accessing the appropriate support services. Government policy and clinic practice need to shift their focus of management of children living with HIV, in order to integrate services that can assist children reach their developmental potential and improve their quality-of-life.