
CHILD HEALTH: Simple tools to monitor neurodevelopment in children

A group of researchers have found that neurocognitive (the ability to think and reason) development in children can be accurately measured using special tools designed for their age. Assessing brain function in children, especially in resource-limited settings, has long been a challenge.
However, the scientists, from Tanzania in collaboration with their colleagues from Switzerland and USA, successfully demonstrated in their study how five specific tools for evaluating general intelligence, functioning, and sustained attention performed well in Tanzanian children.
A breakthrough in measuring brain function
Published in PLOS One, this study was conducted as part of the CHILD (Child Health and Infection with Low-Density Malaria) intervention project, currently implemented by Ifakara Health Institute in Tanzania.
It focused on children aged 6 months to 12 years, aiming to provide insights into assessing tools that measure their intelligence, function and sustained attention. The findings contribute to set the wider use of neurocognitive tools in the CHILD study, to particularly understanding how low-density malaria infections (LMI) impact children's thinking and learning abilities in malaria-endemic regions.
What is LMI?
Low-density malaria infections (LMI) refer to malaria infections that are so mild that they can only be detected using advanced laboratory tests. In the past, these infections were thought to be harmless or even helpful in building immunity. However, recent research suggests that they might harm children's ability to concentrate and solve problems, which could affect their performance in school and their future success.
“While severe malaria infections have long been recognized for their potential neurological complications, the neurological sequelae of LMI are less understood,” the scientists explained.
They cautioned that chronic exposure to the malaria parasite, even at low levels, could impair cognitive functions – particularly attention and abstract reasoning – while also contributing to poorer school performance. "Consequently, LMI may have significant long-term implications on academic performance, educational attainment, and overall quality of life," they warned.
How the study was done
To better understand this issue, scientists – including Ifakara’s CHILD study team led by Dr. Deborah Sumari, the Project Leader, and Dr. Ally Olotu, the Principal Investigator – tested five different tools designed to assess brain functions such as memory, attention, and problem-solving.
These tools were carefully chosen to ensure they were appropriate for Tanzanian children, easy to use, time-efficient, and well-received by both children and their caregivers. To improve accuracy, the researchers trained staff to use these tools correctly and implemented digital data collection methods, making the process more efficient.
The study took place in the rural ward of Yombo in Tanzania's Pwani Region, where the tools provided reliable results and effectively identified differences in children's brain development.
The five tools worked well
Scientists found the five instruments used to assess general intelligence, executive functioning, and sustained attention constructs in Tanzanian children performed well in the local setting.
Key findings showed that the tests were easy to administer, well received by the community, and yielded consistent results. The study helped refine the tools to ensure they are appropriate for future use.
Additionally, the scientists examined external factors such as children's height and home environment to understand how these might influence neurodevelopment. They found that brain function in younger children was often linked to their family’s economic situation, whereas this connection was less evident in older children.
Why this study matters
This study is important because it shows that it is possible to measure children's neurodevelopment in resource-limited settings like in rural Tanzania using simple and affordable tools. The findings also help researchers better understand the impact of malaria on children's learning and development.
Moving forward, these tools will be used in the larger CHILD study to determine whether treating LMI can improve children's thinking and learning abilities. If successful, this study could impact health and education policies that support children's development.
Read the publication here.