{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T13:33:28Z","timestamp":1780666408998,"version":"3.54.1"},"reference-count":27,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2020,6,16]],"date-time":"2020-06-16T00:00:00Z","timestamp":1592265600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000061","name":"Fogarty International Center","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000061","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000025","name":"National Institute of Mental Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000025","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Tropical Med Int Health"],"published-print":{"date-parts":[[2020,8]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Optimising medication adherence is one of the essential factors in reversing the tide of a TB\u2010HIV syndemic in sub\u2010Saharan Africa, especially South Africa. Impairment in key neurocognitive domains may impair patients\u2019 ability to maintain adherence to treatment, but the level of cognition and its relationship to HIV status has not been examined in individuals with drug\u2010resistant TB. We therefore investigated performance on several key neurocognitive domains in relationship to HIV status in a multidrug\u2010resistant tuberculosis patients (MDR\u2010TB) sample.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We enrolled microbiologically confirmed MDR\u2010TB inpatients at a TB\u2010specialist referral hospital in KwaZulu\u2010Natal province, South Africa. We collected cross\u2010sectional data on sociodemographic, clinical and neurocognitive function (e.g. attention, memory, executive functioning, language fluency, visual\u2010spatial, eye\u2013hand coordination). For the primary analysis, we excluded participants with major depressive episode\/substance use disorder (MDE\/SUD). We fitted adjusted Poisson regression models to explore the association between HIV and neurocognitive function.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We enrolled 200 people with MDR\u2010TB; 33 had MDE\/SUD, and data of 167 were analysed (151 HIV+, 16 HIV\u2010). The mean age of participants was 34.2\u00a0years; the majority were female (83%), and 53% had not completed secondary school. There was evidence of impaired neurocognitive functioning across all domains in both HIV+\/\u2010 study participants. Based on the regression analyses, individuals with co\u2010infection (MDR\u2010TB\/HIV+), as well as those who had longer duration of hospital stays experienced significantly lower cognitive performance in several domains. Poor cognitive performance was significantly related to older age and lower educational attainment. The presence of major depression or substance use disorders did not influence the significance of the findings.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Adults with MDR\u2010TB have significant neurocognitive impairment, especially if HIV positive. An integrated approach is necessary in the management of MDR\u2010TB as cognitive health influences the ability to adhere to chronic treatment, clinical outcomes and functionality.<\/jats:p><\/jats:sec>","DOI":"10.1111\/tmi.13444","type":"journal-article","created":{"date-parts":[[2020,5,19]],"date-time":"2020-05-19T22:02:37Z","timestamp":1589925757000},"page":"919-927","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Neurocognitive functioning in MDR\u2010TB patients with and without HIV in KwaZulu\u2010Natal, South Africa"],"prefix":"10.1111","volume":"25","author":[{"given":"Suvira","family":"Ramlall","sequence":"first","affiliation":[{"name":"Department of Psychiatry University of KwaZulu\u2010Natal Durban South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard J.","family":"Lessells","sequence":"additional","affiliation":[{"name":"KwaZulu-Natal Research Innovation and Sequencing Platform University of KwaZulu\u2010Natal Durban South Africa"},{"name":"Centre for the AIDS Programme of Research in South Africa Durban South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thirusha","family":"Naidu","sequence":"additional","affiliation":[{"name":"Department of Behavioural Medicine University of KwaZulu\u2010Natal Durban South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sbusisiwe","family":"Sandra Mthembu","sequence":"additional","affiliation":[{"name":"South African Medical Research Council Durban South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nesri","family":"Padayatchi","sequence":"additional","affiliation":[{"name":"Centre for the AIDS Programme of Research in South Africa Durban South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan K.","family":"Burns","sequence":"additional","affiliation":[{"name":"Department of Psychiatry University of KwaZulu\u2010Natal Durban South Africa"},{"name":"Institute of Health Research University of Exeter Exeter UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Tomita","sequence":"additional","affiliation":[{"name":"KwaZulu-Natal Research Innovation and Sequencing Platform University of KwaZulu\u2010Natal Durban South Africa"},{"name":"Centre for Rural Health University of KwaZulu\u2010Natal Durban South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,6,16]]},"reference":[{"key":"e_1_2_7_2_1","unstructured":"WORLD HEALTH ORGANIZATION.Global tuberculosis report. 2017.2017. (Available from:http:\/\/apps.who.int\/iris)."},{"key":"e_1_2_7_3_1","unstructured":"STATISTICS SOUTH AFRICA.Mortality and causes of death in South Africa 2016: Findings from death notifications.2017. (Available from:http:\/\/www.statssa.gov.za\/publications\/P03093\/P030932016.pdf)."},{"key":"e_1_2_7_4_1","volume-title":"GBD profile: South Africa \u2010 Institute for Health Metrics and Evaluation","author":"Institute For Health Metrics And Evaluation","year":"2017"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-018-21081-x"},{"key":"e_1_2_7_6_1","volume-title":"Neuropsychological Assessment","author":"Lezak MD","year":"2004"},{"key":"e_1_2_7_7_1","volume-title":"A Compendium of Neuropsychological Tests","author":"Strauss E","year":"2006"},{"key":"e_1_2_7_8_1","first-page":"25","article-title":"Screening for dementia in community\u2010based memory clinics","volume":"105","author":"Sager MA","year":"2006","journal-title":"Wis Med J"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1186\/1756-0500-3-28"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/NMD.0000000000000962"},{"key":"e_1_2_7_11_1","unstructured":"MoshaniN Westgarth\u2010TaylorJ.The exploration of neuropsychological disorders in HAART\u2010na\u00efve young adults in South Africa. Unpublished Honours Thesis Cape Town:University of Cape Town. URL (last checked 12 October 2012).2009. 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