A baseline assessment of developmental delays among children under 5 years in a high-HIV- prevalence setting in the Cape Metropole

Abstract

Background. More than 200 million children globally are at risk of not achieving the full developmental potential owing to multiple factors. HIV exposure is of particular concern as evidence suggests that children born to mothers who are HIV-positive are likely to experience developmental delays. Furthermore, the psychosocial and economic impacts of HIV, such as parental illness, poor mental health, poverty and malnutrition, also affect children’s development. Objective. To assess and address the developmental challenges faced by children aged 2 - 5 years living in high-HIV prevalence settings through a toy-based rehabilitation intervention and to analyse the prevalence and nature of developmental delays observed in these children using the Ages and Stages Questionnaires (ASQ-3). Methods. In response, the Bright Start programme was developed and implemented to target children living in high HIV-prevalence settings. In 2019, a pilot project was implemented with 90 caregiver-child dyads in Cape Town, South Africa. A baseline survey was conducted to assess developmental progression for all the children (N=141) in the care of the 90 caregivers using the Ages and Stages Questionnaires (ASQ-3) for children aged 24, 36, 48 and 60 months. Results. Findings showed that 64% of children had delays in at least one domain and 37% had multiple delays. More than half of the children had developmental delays in fine motor skills (51%), while gross-motor and problem-solving delays were reported for 30% and 26% of children, respectively. Communication and personal-social domain delays were observed in 17% and 14% of children, respectively. Conclusion. The prevalence of developmental delays among children in the programme was alarmingly high. These findings indicate that developmental delay is a serious concern for children living in high-HIV-prevalence settings. Early identification and timeous referrals of children with developmental delays are critical and may enable children to reach their full developmental potential.