基础家庭刺激方案对感染 HIV 的幼儿发育的影响。

The effect of a basic home stimulation programme on the development of young children infected with HIV.

机构信息

Department of Physiotherapy, University of the Witwatersrand, and Charlotte Maxeke Johannesburg Hospital, Johannesburg, South Africa.

出版信息

Dev Med Child Neurol. 2010 Jun;52(6):547-51. doi: 10.1111/j.1469-8749.2009.03534.x. Epub 2009 Nov 28.

DOI:10.1111/j.1469-8749.2009.03534.x

PMID:20002116

Abstract

AIMS

The human immunodeficiency virus (HIV) potentially causes a significant encephalopathy and resultant developmental delay in infected children. The aim of this study was to determine whether a home-based intervention programme could have an impact on the neurodevelopmental status of children infected with HIV.

METHOD

A longitudinal, randomized, controlled trial was conducted. A total of 122 children aged less than 2 years 6 months were assigned to either a comparison or an experimental group. Children in the experimental group were given a home stimulation programme that was updated every 3 months. The home programme included activities to promote motor, cognitive, and speech and language development. Children in the comparison group received no developmental intervention. Children were assessed by a blinded assessor at baseline, 6 months, and 12 months using the Bayley Scales of Infant Development, 2nd edition.

RESULTS

The children in this study came from poor socioeconomic backgrounds and their nutritional status was suboptimal. The experimental group included 60 children (30 males, 30 females) with a mean age of 18 months (SD 8.1 mo). The comparison group included 62 children (32 males, 30 females) with a mean age 19 months (SD 8.2 mo). Cognitive and motor development were severely affected at baseline, with 52% of the children having severe cognitive delay and 72% having severe motor delay at baseline. Children in the experimental group showed significantly greater improvement in cognitive (p=0.010) and motor (p=0.020) development over time than children in the comparison group.

INTERPRETATION

A home stimulation programme taught to the caregiver can significantly improve cognitive and motor development in young children infected with HIV.

摘要

目的

人类免疫缺陷病毒（HIV）可能导致感染儿童出现严重的脑病和由此导致的发育迟缓。本研究旨在确定基于家庭的干预方案是否会对感染 HIV 的儿童的神经发育状况产生影响。

方法

进行了一项纵向、随机、对照试验。共有 122 名年龄小于 2 岁 6 个月的儿童被分配到对照组或实验组。实验组的儿童接受了每 3 个月更新一次的家庭刺激方案。家庭方案包括促进运动、认知、言语和语言发展的活动。对照组的儿童未接受发育干预。儿童在基线、6 个月和 12 个月时由盲法评估员使用贝利婴幼儿发育量表第二版进行评估。

结果

本研究中的儿童来自贫困的社会经济背景，其营养状况不佳。实验组包括 60 名儿童（30 名男性，30 名女性），平均年龄为 18 个月（SD 8.1 mo）。对照组包括 62 名儿童（32 名男性，30 名女性），平均年龄为 19 个月（SD 8.2 mo）。认知和运动发育在基线时受到严重影响，52%的儿童有严重的认知延迟，72%的儿童有严重的运动延迟。实验组儿童的认知（p=0.010）和运动（p=0.020）发育随时间的推移有显著改善，而对照组儿童则没有。