Cognitive Study

Cognitive Study In Mbeya: The Effect of HIV among Older people.
HIV infection is a major cause of disease burden and disability across sub-Saharan Africa (SSA). HIV-associated neurocognitive impairment (HAND) and HIV dementia (HAD) are estimated to affect 8 million people with HIV infection across the continent and are associated with increased mortality and morbidity. As the coverage of combination antiretroviral therapy (cART) across SSA increases, the prevalence of HIV infection is also increasing due to improved life expectancy and the proportion of people aged 50 and over living with HIV infection is predicted to triple by 2040.

This ageing population is likely to be vulnerable to HAND, but to date; only one previous study has been conducted in SSA in the Kilimanjaro region of Tanzania. This study showed high prevalence of 47% of HAND in individuals aged over 50.

 

Molly Sadler
Nikita Reddy

Molly Sadler and Nikita Reddy are the Vijiji International experts using their skills in Global Health Experts to examine the cognitive disorders in Mbeya. They are aiming on exploring on Tanzanian older population of Mbeya region. They are determining the prevalence and risk factors for cognitive impairment in people living with HIV and receiving standard HIV care according to the Tanzanian guidelines.

The risk factors being looked at include factors directly related to HIV infection, such as CD4 count and duration of infection, as well as comorbidities. The study will also look at cognitive reserve as a risk factor – there is increasing evidence that cognitive reserve may make people less likely to develop HAND. These risk factors are potentially modifiable and assessing them could help to prevent HAND in HIV patients in the future.

Molly Sadler and Nikita Reddy are to exploring on the patterns of Cognitive disorders in Tanzanian population of Mbeya region. They are focusing on determining the prevalence andrisk factors for cognitive impairment in people living with HIV and receiving standard HIV care according to the Tanzanian guidelines. The risk factors being looked at include factors directly related to HIV infection, such as CD4 count and duration of infection, as well as comorbidities. The study will also look at cognitive reserve as a risk factor – there is increasing evidence that cognitive reserve may make people less likely to develop HAND. These risk factors are potentially modifiable and assessing them could help to prevent HAND in HIV patients in the future.

Vijiji International is currently conducting a case-control study that is executed using a total of 684 participants in which 342 HIV positive patients attending HIV clinic and the matched 342 non-HIV patients attending ophthalmology clinic who are recruited using systematic sampling. The study is comparing findings in HIV patients to a HIV negative control group of the same age and educational background attending hospital care for other health conditions. Patients are evaluated using a neurocognitive battery of tests previously used in Tanzania, plus clinical and functional assessment to determine diagnosis. The study also aims to determine the views of older people living with HIV on their risks and experiences of Cognitive Disorders.

Vijiji international is hoping that the study will lead to evidence based intervention in the Mbeya region in Tanzania and beyond, in particular to expand diagnosis of cognitive disorders in rural areas and link them to Cognitive Stimulation Therapy (CST). The CST is a group-based  psychosocial intervention for people with dementia, which has been shown to improve cognition and quality of life. CST has the potential to be a low-cost, sustainable and effective intervention  for patients in Tanzania and the rest of sub-Saharan Africa.