A FEASIBILITY STUDY EXPLORING THE EFFICACY OF COGNITIVE REHABILITATION THERAPY FOR PAEDIATRIC HIV IN RURAL SOUTH AFRICA: A FOCUS ON SUSTAINED ATTENTION

Abstract

Despite advances in combination antiretroviral therapy (cARTs), children in Sub-Saharan Africa continue to experience neurocognitive deficits due to the virus crossing the blood-brain barrier (BBB). Based on the principles of neuroplasticity, our study sought to investigate the feasibility of introducing a pencil and paper cognitive rehabilitation tool called Brainwave-R, to ameliorate the effects of HIV neurocognition amongst children from a low socioeconomic background in rural South Africa. Five HIV positive and six HIV negative children were assigned to either an experimental or control group. The experimental group underwent two months of cognitive rehabilitation therapy to remediate sustained attention, using Brainwave-R, whereas the noncontact control group took part in placebo activities. Sustained attention measures were taken before and after the intervention training sessions, using a sustained attention subtest. The control group later received cognitive intervention three months following the conclusion of the research study. A Mann Whitney U Test revealed that the experimental group (Mdn=38.50) did not differ significantly from the control group (Mdn=37.00) after the cognitive rehabilitation intervention, U= 12.00, z= -.55, p= 0.66, r= -0.17. A Wilcoxon Signed Rank Test found that there was a significant improvement from pretest scores (Mdn=31.00) to post test scores (Mdn=38.00) following the rehabilitation for HIV positive participants in the sample, T=15.00, z = -2.02, p= 0.04, r= -0.90. The findings of our study raise the feasibility of a pencil and paper cognitive rehabilitation method to supplement antiretroviral (ARV) therapy in paediatric HIV.