Different aspects of electronic media use, symptoms and neurocognitive outcomes of children and adolescents in the rural Western Cape region of South Africa

Abstract Background Electronic media use is increasing in low- and middle-income countries, thus we aim to investigate the prevalence of different aspects of e-media use and its association to symptoms and neurocognitive outcomes in rural South Africa. Methods In the cohort study, “Child health Agricultural Pesticide study in South Africa (CapSA)”, of 1001 children and adolescents, aged 9–16 years, we enquired at baseline about the following aspects of e-media use: (1) call duration (2) total screen time (3) night-time awakenings from mobile phone use, and (4) Mobile Phone Problematic Use (MPPUS). Four health outcomes were included: sleep disturbance, health related quality of life (HRQoL), headaches and cognitive performance, assessed through six tests on domains of attention, memory and processing speed, using the iPad-based software, CAmbridge Neuropsychological Test Automated Battery (CANTAB). Linear regression analysis adjusted for relevant confounders was conducted with categorized exposure variables low, medium and high use. Results One third of the cohort (31.8%) are mobile phone users reporting average duration of calls per day up to 75 min (mean = 2.5mins; SD = 8.9mins). Amongst 46% of the cohort who report e-media device use, total screen time ranged from 1 min to 441 min (mean = 28.3; SD = 53.0). Findings Amongst those reporting regular night-time awakenings (≥3 times per week) from mobile phones, HRQol declined by 2.9 (95% CI: −6.1, 0.3), the sleep disturbance score increased by 2.0 (1.1, 2.9) units and headache impact score significantly increased by 5.4 (2.6; 8.2) units compared to non-exposed. Cognitive performance scores tended to be slightly improved mostly in moderate e-media users. The reaction response speed was consistently improved amongst all four exposure groups compared to non-users. Conclusion These results are among the first from Africa on benefits and risks associated with e-media use. Our findings imply that with regard to the education of adolescents, a vigilant balance is needed to profit from the beneficial effects of moderate e-media use on cognition, while preventing the negative side effects for HRQoL, sleep disturbance and headache severity.