Neurodevelopmental surveillance of children participating in the STD/AIDS program

Abstract

Highly active antiretroviral therapy (HAART) is an effective way of preventing mother-to-child transmission of HIV. However, further studies investigate the effects of short and long term exposure to HAART in-utero and its consequence on child neuropsychomotor development (NPMD). The paper presents a report and discussion of results of an extension project whose objectives were to verify the NPMD of children participating of the STD/AIDS program, to orientate families according to their socioeconomic context and make referrals to specific health services. The NPMD surveillance was divided into three parts: (1) ambulatory evaluation; (2) home evaluation and orientations; (3) reporting health managers. DENVER II and PEDI tests were used and also a socioeconomic questionnaire. Fifteen children were on the program of which 12 uninfected, 1 HIV+ and 2 indeterminate. Twelve children were evaluated and the most impaired domain were language, personal-social and fine motor, respectively. Regarding to socioeconomic status, 73,3% were E level and 58,3% of mothers were analphabet or had primary school. Children born of infected mothers, besides the biological risks, usually are exposed to environment/social risks that can affect the NPMD. Thus, monitoring by a team of health professionals, in partnership with the child's family, becomes an important tool for identification and early intervention.