Effects of HIV status and linguistic medium on the test performance of rural low-literacy adults: implications for neuropsychological test development in Zambia

Abstract

Purpose of the study: The purpose of the study was to determine whether the familiar language (Chichewa version) could contribute to the early diagnosis of neurocognitive dysfunctions and develop a battery of locally valid tests capable of detecting early changes in the cognitive profile of neurocognitive dysfunctions among HIV positive patients.
Research question one: What is the difference in performance between HIV negative and HIV positive individuals when they are subjected to the four verbal tests of the neuropsychological test battery using the English and Chichewa versions?
Research question two: What is the interaction effect among the influences of HIV status, linguistic medium and gender on the four verbal tests of the neuropsychological test battery?
Design: It was an experimental design that assessed the neuropsychological effects of HIV status and linguistic medium on the test performance. The Hopkins Verbal Learning Test (HVLT-R) for both immediate and delayed recall were used to test the verbal episodic memory from the Verbal Learning and Memory Recall Domain (Brandt and Benedict, 2001). Other tests included Animal and Action Naming. These tests were translated into Chichewa and administered to 28 HIV positive and 22 HIV negative rural low illiterate adults aged between 40 and 65 years.
Results: On all the Neuropsychological tests administered, HIV positive respondents scored significantly lower than HIV negative respondents, and the mean scores on the English medium version were consistently lower than scores on the L1 (Chichewa) version across all tests and all groups.
Conclusion: The study has shown that the primary language is best suited to test neurocognitive performance and especially when one is using test components that do not require reading or writing.