With the long term goal of intervening to promote better physical and psychosocial functioning of children in South Africa, this study will determine how the ability of children with neurodevelopmental disorders to function cognitively and socially is influenced by both health-related (HIV, anemia, other infection), contextual (socio-economic and environmental, access to care and therapeutic intervention) and psychosocial factors (caregiver characteristics including mental health and substance use, family functioning). Approximately 2000 5 and 6 year old children from a HIV prevalent area will be screened for disability and then assessed before school entry. They will be reassessed 24 months later after school entry. The study will offer HIV testing to children and caregivers and referral for treatment for all conditions identified. Many of these children live with parents who are ill or have parents who have died from AIDS. Additional challenges such as poverty, inadequate access to health care and to education are common;many other risks to child health and well-being, including inadequate nutrition, infection and trauma as well as caregiver depression and substance use affect many children. As a result, many children do not function at optimal levels, and are at risk for developmental disabilities. The study will investigate first cross sectionally and then longitudinally the relationships among neurodevelopmental disorders and the above mentioned risk factors including as outcomes, child cognitive and psychosocial functioning and in the longitudinal aim, school functioning .The study will address both cross sectional and longitudinal relationships, assessing the impact of referral, treatment and access to programs over time. Community ethnographic studies will be linked to the findings of the epidemiologic study to identify culturally appropriate interventions. We will identify factors open to intervention which are known to affect child risk and resilience and work with community leaders in a participatory approach to develop an effective community based intervention. In addition, training in research methods and enhancing research capacity will be one of the key aims of this research. This will involve training public health students, ethnography students, pediatric registrars, allied health professionals and community health workers in both field and classroom teaching and training. This will be managed in collaboration with the UKZN Fogarty Program, the Valley Trust, the Rehabilitation Unit and the Medical School at UKZN with assistance from the Columbia investigators

National Institute of Health (NIH)
National Institute on Drug Abuse (NIDA)
Research Project (R01)
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Special Emphasis Panel (ZRG1-ICP2-B (50))
Program Officer
Boyce, Cheryl A
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Columbia University (N.Y.)
Public Health & Prev Medicine
Schools of Public Health
New York
United States
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Mellins, Claude A; Kauchali, Shuaib; Nestadt, Danielle F et al. (2017) Validation of the Client Diagnostic Questionnaire to Assess Mental Health in South African Caregivers of Children. Clin Psychol Psychother 24:245-254
Taylor, Myra; Knox, Justin; Chhagan, Meera K et al. (2016) Screening Caregivers of Children for Risky Drinking in KwaZulu-Natal, South Africa. Matern Child Health J 20:2392-2401
Chhagan, Meera K; Mellins, Claude A; Kauchali, Shuaib et al. (2014) Mental health disorders among caregivers of preschool children in the Asenze study in KwaZulu-Natal, South Africa. Matern Child Health J 18:191-9
Uwemedimo, Omolara T; Arpadi, Stephen M; Chhagan, Meera K et al. (2014) Compliance with referrals for non-acute child health conditions: evidence from the longitudinal ASENZE study in KwaZulu Natal, South Africa. BMC Health Serv Res 14:242
Scherzer, Alfred L; Chhagan, Meera; Kauchali, Shuaib et al. (2012) Global perspective on early diagnosis and intervention for children with developmental delays and disabilities. Dev Med Child Neurol 54:1079-84
Chhagan, Meera K; Kauchali, Shuaib; Arpadi, Stephen M et al. (2011) Failure to test children of HIV-infected mothers in South Africa: implications for HIV testing strategies for preschool children. Trop Med Int Health 16:1490-4