Abstract:
Introduction The over 14 million African children who
are HIV-exposed but uninfected (CHEU) are at risk for poor
health outcomes, including neurodevelopmental conditions
such as autism; however, no study to date has examined
autism in CHEU in Africa, where the vast majority of these
children live. Scalable diagnostic and neurobehavioural
tools, including powerful, low-cost approaches such as
eye-tracking, for detection and study of mechanistic neural
processes are necessary to advance autism research in
these settings. The objective of this study is to examine
autism diagnostic outcomes and eye-tracking biomarkers
in relation to CHEU while at the same time building
capacity for neuro-health research in Kenya.
Methods and analysis This study will leverage a
longitudinally assessed cohort of CHEU and children
who are HIV-unexposed and uninfected (CHUU) with well
characterised HIV-related and contextual exposures.
We will first determine and compare autism diagnostic
outcomes between young CHEU and CHUU across a large
cohort (n=850) of Kenyan children using research-grade
autism assessment tools, and, second, determine whether
neurobehavioural eye-tracking markers predict autism
outcomes across this cohort.
Ethics and dissemination Human subjects approvals
have been obtained from Moi University Institutional
Review and Ethics Committee (IREC; IREC/909/2024;
Approval #0004835), Kenya’s National Commission for
Science, Technology and Innovation (NACOSTI; Reference
#NACOSTI/P/25/415028), the Institutional Review Board of
the Indiana University School of Medicine (Protocol #23171),
with reliance agreements executed with Purdue University
and Boston University. Dissemination of findings will occur
through multiple channels within the research and clinical
community, including peer-reviewed journal publications and
conference abstracts and presentations. As part of capacity
building efforts, the research team will also communicate
study results to policy makers, the lay public and other
health systems involved in the care of young children with
disabilities via study-hosted workshops and conferences.
