Assessing the combined impact of pesticide exposure and HIV/ART on child neurodevelopment in Eastern and Southern Africa: a systematic review
Abstract Background Environmental exposures, particularly pesticides, have been implicated in neurodevelopmental disorders (NDDs). Additionally, children who are HIV-exposed but uninfected (HEU) are at increased risk of neurodevelopmental delays. However, there is limited research exploring the comb...
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2025-07-01
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| Series: | BMC Pediatrics |
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| Online Access: | https://doi.org/10.1186/s12887-025-05895-z |
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| author | Peter Martin Chilipweli Msilikale Walter Manyiri Namanya Basinda Benson R. Kidenya Elias C. Nyanza Karim Manji Aiwerasia Vera Ngowi |
| author_facet | Peter Martin Chilipweli Msilikale Walter Manyiri Namanya Basinda Benson R. Kidenya Elias C. Nyanza Karim Manji Aiwerasia Vera Ngowi |
| author_sort | Peter Martin Chilipweli |
| collection | DOAJ |
| description | Abstract Background Environmental exposures, particularly pesticides, have been implicated in neurodevelopmental disorders (NDDs). Additionally, children who are HIV-exposed but uninfected (HEU) are at increased risk of neurodevelopmental delays. However, there is limited research exploring the combined effects of HIV/antiretroviral therapy (ART) exposure and pesticide exposure, especially in children from agricultural communities in Southern and Eastern Africa. This systematic review investigates the potential impact of pesticide exposure on neurodevelopmental outcomes in HEU children from these regions. Methods A systematic review methodology was employed, following PRISMA guidelines. Studies published between 2008 and July 2024 were retrieved from databases including PubMed, Scopus, Embase, AJOL, conference proceedings, and grey literature. The review focused on children born to smallholder horticultural farmers exposed to both maternal HIV/ART and environmental pesticides. The protocol was registered in PROSPERO. Boolean operators and tailored search strategies were used to identify relevant literature. Results Of 1,324 articles screened, 21 met the inclusion criteria. Most studies reported significant neurodevelopmental effects linked to pesticide exposure, with cognitive delays being the most frequently reported outcome. Children exposed to both pesticides and maternal HIV/ART exhibited increased risks of attention deficits and delayed milestones. Due to high heterogeneity in study design, populations, and outcome measures, meta-analysis was not feasible. South Africa showed the highest dual exposure burden, raising concerns about synergistic neurodevelopmental harm. Discussion The review highlights strong evidence linking organophosphate exposure and certain ART regimens to adverse neurodevelopmental outcomes such as ADHD and cognitive impairment in HEU children. Yet, few studies have evaluated their combined effects. Conclusion Findings from Southern and Eastern Africa suggest a convergence of neurotoxic risks. Multidisciplinary, region-specific research is urgently needed to clarify the interactions between pesticide exposure and HIV/ART in early childhood neurodevelopment. |
| format | Article |
| id | doaj-art-c2ce529bd40942ed8c5dc2a72be9f400 |
| institution | Kabale University |
| issn | 1471-2431 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pediatrics |
| spelling | doaj-art-c2ce529bd40942ed8c5dc2a72be9f4002025-08-20T04:02:50ZengBMCBMC Pediatrics1471-24312025-07-0125111310.1186/s12887-025-05895-zAssessing the combined impact of pesticide exposure and HIV/ART on child neurodevelopment in Eastern and Southern Africa: a systematic reviewPeter Martin Chilipweli0Msilikale Walter Manyiri1Namanya Basinda2Benson R. Kidenya3Elias C. Nyanza4Karim Manji5Aiwerasia Vera Ngowi6Department of Community Medicine, School of Public Health, Catholic University of Health and Allied Sciences (CUHAS)Department of Epidemiology and Behavior Sciences, School of Public Health, Catholic University of Health and Allied Sciences (CUHAS)Department of Community Medicine, School of Public Health, Catholic University of Health and Allied Sciences (CUHAS)Biochemistry Department, School of Medicine, Catholic University of Health and Allied Sciences (CUHAS)Department of Occupational Health and GIS, School of Public Health, Catholic University of Health and Allied Sciences (CUHAS)Department of Pediatric and child Health, School of medicine, Muhimbili University of Health and Allied Sciences (MUHAS)Department of Occupational and Environmental Health, School of Public Health, Muhimbili University of Health and Allied Sciences (MUHAS)Abstract Background Environmental exposures, particularly pesticides, have been implicated in neurodevelopmental disorders (NDDs). Additionally, children who are HIV-exposed but uninfected (HEU) are at increased risk of neurodevelopmental delays. However, there is limited research exploring the combined effects of HIV/antiretroviral therapy (ART) exposure and pesticide exposure, especially in children from agricultural communities in Southern and Eastern Africa. This systematic review investigates the potential impact of pesticide exposure on neurodevelopmental outcomes in HEU children from these regions. Methods A systematic review methodology was employed, following PRISMA guidelines. Studies published between 2008 and July 2024 were retrieved from databases including PubMed, Scopus, Embase, AJOL, conference proceedings, and grey literature. The review focused on children born to smallholder horticultural farmers exposed to both maternal HIV/ART and environmental pesticides. The protocol was registered in PROSPERO. Boolean operators and tailored search strategies were used to identify relevant literature. Results Of 1,324 articles screened, 21 met the inclusion criteria. Most studies reported significant neurodevelopmental effects linked to pesticide exposure, with cognitive delays being the most frequently reported outcome. Children exposed to both pesticides and maternal HIV/ART exhibited increased risks of attention deficits and delayed milestones. Due to high heterogeneity in study design, populations, and outcome measures, meta-analysis was not feasible. South Africa showed the highest dual exposure burden, raising concerns about synergistic neurodevelopmental harm. Discussion The review highlights strong evidence linking organophosphate exposure and certain ART regimens to adverse neurodevelopmental outcomes such as ADHD and cognitive impairment in HEU children. Yet, few studies have evaluated their combined effects. Conclusion Findings from Southern and Eastern Africa suggest a convergence of neurotoxic risks. Multidisciplinary, region-specific research is urgently needed to clarify the interactions between pesticide exposure and HIV/ART in early childhood neurodevelopment.https://doi.org/10.1186/s12887-025-05895-zNeurodevelopmental disorders(NDDs)Cognitive developmentPesticides exposureHIV-Exposed uninfected(HEU) |
| spellingShingle | Peter Martin Chilipweli Msilikale Walter Manyiri Namanya Basinda Benson R. Kidenya Elias C. Nyanza Karim Manji Aiwerasia Vera Ngowi Assessing the combined impact of pesticide exposure and HIV/ART on child neurodevelopment in Eastern and Southern Africa: a systematic review BMC Pediatrics Neurodevelopmental disorders (NDDs) Cognitive development Pesticides exposure HIV-Exposed uninfected (HEU) |
| title | Assessing the combined impact of pesticide exposure and HIV/ART on child neurodevelopment in Eastern and Southern Africa: a systematic review |
| title_full | Assessing the combined impact of pesticide exposure and HIV/ART on child neurodevelopment in Eastern and Southern Africa: a systematic review |
| title_fullStr | Assessing the combined impact of pesticide exposure and HIV/ART on child neurodevelopment in Eastern and Southern Africa: a systematic review |
| title_full_unstemmed | Assessing the combined impact of pesticide exposure and HIV/ART on child neurodevelopment in Eastern and Southern Africa: a systematic review |
| title_short | Assessing the combined impact of pesticide exposure and HIV/ART on child neurodevelopment in Eastern and Southern Africa: a systematic review |
| title_sort | assessing the combined impact of pesticide exposure and hiv art on child neurodevelopment in eastern and southern africa a systematic review |
| topic | Neurodevelopmental disorders (NDDs) Cognitive development Pesticides exposure HIV-Exposed uninfected (HEU) |
| url | https://doi.org/10.1186/s12887-025-05895-z |
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