Although most studies in HEU children under 3 years of age found no neurodevelopmental differences to controls when confounding factors were controlled (Alimenti et al., 2006; Gómez et al., 2009; Williams et al., 2010; Springer et al., 2012; Ngoma et al., 2014), studies from resource-limited settings suggest that HEU infants in Africa demonstrate subtle cognitive and motor impairment, and expressive language delay (Boivin et al., 1995; Le Doare et al., 2012).