Frequency and Factors Associated To School Delay among HIV-infected and Uninfected Children Followed in the ANRS 12,225-PEDIACAM III Cohort in Cameroon.

Abstract

Many studies have shown that Human Immunodeficiency Virus (HIV) infection and/or exposure to antiretroviral drugs during pregnancy can influence a child's neurocognitive development. Moreover, the family and social challenges experienced by some HIV-infected children may have a negative impact on their academic performance. The objective of this study was to estimate the frequency of school delay among HIV-infected adolescents followed up in the ANRS 12225-Pediacam III cohort in Cameroon and identify associated factors. The cohort consists of three groups of children enrolled before the age of 7 months: HIV-infected (HI; n = 210), HIV-exposed uninfected (HEU; n = 205); and HIV-unexposed uninfected (HUU; n = 196)). Data were collected from these children from the project's inception in 2007 until 2022 and analysed retrospectively. School delay was defined as the occurrence of at least two instances of grade retention at either primary or secondary education levels. After performing a descriptive analysis, we used the Kaplan-Meier method and Cox regression to identify determinants of school delay. A total of 405 children were considered; of whom 51.4% were male. The overall frequency of first school delay was 29.1% (118/405; 95% CI:24.8; 33.8), which differed significantly between the children's groups. In multivariate analysis, the risk of school delay was significantly higher among children living with HIV compared to HUU (adjusted hazard ratio (aHR): 2.7; 95% CI:1.66-4.64), male children (aHR: 1.9; 95% CI:1.33-2.84), children born from low educated mothers (aHR: 3.0; 95% CI:1.58-5.95), and children whose parents were not living together (aHR: 1.5; 95% CI:1.02; 2.39).