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Validation of the National Institute of Health Toolbox Cognition Battery (NIHTB-CB) in Children and Adolescents with and without HIV Infection in Lusaka, Zambia

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A Correction to this article was published on 25 May 2022

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Abstract

The objective of this study was to validate the NIH Toolbox Cognition Battery (NIHTB-CB) in Zambian children with and without HIV-infection. Children living with HIV and HIV-exposed, uninfected (HEU) children completed traditional neuropsychological and NIHTB-CB tasks. Using pairwise correlation and a linear regression model we measured associations between traditional measure composite scores and parental ratings of children’s abilities, and NIHTB-CB scores. A Receiver Operating Characteristic (ROC) curve was developed to identify participants with impairment. 389 children, 8–17 years old participated. NIHTB-CB and traditional measures converged well as a whole and when comparing analogous individual tests across the two batteries. The NIHTB-CB composite score discriminated between the groups and was positively associated with external criteria for cognitive function: parental ratings of intelligence and school performance. Some English vocabulary and/or an unfamiliar cultural context presented challenges. NIHTB-CB was associated with children’s everyday cognitive abilities, though future use may require linguistic and cultural adaptation.

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Availability of data and material

The data that support the findings of this study are available on reasonable request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.

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Acknowledgements

We gratefully acknowledge the children and their parents who participated in this research.

Funding

Funding for this research was provided by: National Institute of Neurological Disorders and Stroke/National Institutes of Health K23NS117310; University of Rochester Center for AIDS Research (CFAR) NIH/P30 AI 045008); University of Rochester School of Medicine and Dentistry; William G. McGowan Charitable Fund

Author information

Authors and Affiliations

  1. Department of Educational Psychology, University of Zambia, Lusaka, Zambia

    Pelekelo P Kabundula, Esau G Mbewe, Sylvia Mwanza-Kabaghe & Milimo Mweemba

  2. University Teaching Hospital, Neurology Research Office, Lusaka, Zambia

    Sylvia Mwanza-Kabaghe & Gretchen L Birbeck

  3. University of Zambia School of Medicine, Lusaka, Zambia

    Gretchen L Birbeck

  4. Division of Epilepsy, University of Rochester Medical Center Department of Neurology, Rochester, NY, USA

    Gretchen L Birbeck

  5. Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Massachusetts, USA

    Bo Wang

  6. Department of Psychology, University of Zambia, Lusaka, Zambia

    J Anitha Menon

  7. Division of Child Neurology, University of Rochester Medical Center Department of Neurology, Rochester, NY, USA

    David R Bearden & Heather R Adams

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  1. Pelekelo P Kabundula
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  2. Esau G Mbewe
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  9. Heather R Adams
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Contributions

All authors whose names appear on the submission

1) made substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data; or the creation of new software used in the work;

2) drafted the work or revised it critically for important intellectual content;

3) approved the version to be published; and

4) agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Corresponding author

Correspondence to Heather R Adams.

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Conflicts of interest/competing interests

There are no relevant conflicts of interest to disclose for any authors related to this work.

Ethics approval

This study was approved by the Institutional Review Boards of the University of Rochester (UR; protocol #00068985), the University of Zambia (UNZA; reference #004-08-17), and the National Health Research Authority of Zambia.

Consent to participate

In accordance with IRB requirements of UR and UNZA, parental permission, assent, and/or informed consent was obtained as appropriate according to the age of the participants. Participants received 100 Zambian Kwacha (equivalent to approximately 6 US dollars) per study visit as reimbursement for travel costs.

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Kabundula, P.P., Mbewe, E.G., Mwanza-Kabaghe, S. et al. Validation of the National Institute of Health Toolbox Cognition Battery (NIHTB-CB) in Children and Adolescents with and without HIV Infection in Lusaka, Zambia. AIDS Behav 26, 3436–3449 (2022). https://doi.org/10.1007/s10461-022-03669-7

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