Adherence to Highly Active Antiretroviral Therapy Among Children in Ethiopia: A Systematic Review and Meta-analysis

Endalamaw, Aklilu; Tezera, Nega; Eshetie, Setegn; Ambachew, Sintayehu

doi:10.1007/s10461-018-2152-z

Cited by 17 publications

(21 citation statements)

References 64 publications

(139 reference statements)

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“…This value was lower than the 79% that was reported among caregivers of HIV-infected children in Kabale district, Southwestern Uganda, 13 88.7% and 93.3% of caregivers reported adherence from Ethiopia. 14,15 However, it was higher than the 62.5% reported from Tanzania 11 while 34.8% was based on unannounced home-based pill count reported from Ethiopia. 14 The high-edge variance was ascribed to the fact that this was caregiver self-reported data.…”

Section: Discussionmentioning

confidence: 77%

<p>Differential Self-Reported Determinants to Antiretroviral Therapy Adherence: Findings from Caregivers of Children Under Five Years Living with Human Immunodeficiency Virus Infection Attending Al-Sabah Hospital, South Sudan</p>

Tong¹,

Atuhairwe²,

Taremwa³

2020

HIV

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This study explored the caregivers' self-reported determinants of antiretroviral therapy (ART) adherence among children under five years living with human immunodeficiency virus (HIV) infection attending Al-Sabah Hospital, South Sudan. Methods: A cross-sectional study of 126 caregivers of HIV-infected children under five years was conducted at Al-Sabah Hospital, South Sudan. Data were collected using an intervieweradministered questionnaire. The self-reported adherence was measured as a binary variable using binary logistic regression. Only variables that were significant at bivariate analysis were analyzed at multivariate level and interpreted using the odds ratios (p< 0.05). Results: Out of 126 caregivers with HIV-infected children, 38 (30.2%) did not adhere to ART. Of the proportion that adhered to ART (88, 69.8%), 49 (55.7%) were male. Most of the children (52, 59.1%) were above two years, but under five years. Fifty (56.8%) of those who adhered had completed 3 months on ART, and the majority were at WHO stage-1 of HIV infection. Analysis of the determinants indicated that children's duration on ART (p=0.001), type of ART regimen (single, double or triple therapy) (p=0.065), type of work done by the caregiver to earn a living (p-value 0.003), time a child was initiated on ART (p=0.002), caregiver-child relationship (p=0.002), caregiver-spousal support (p=0.019), type of support obtained whether monetary or not (p=0.000), when the child was started on ART (p=0.004), the person administering ART (p=0.010), the type of ARVs administered (p=0.001), the caregiver detecting ART side effects (p=0.000), types of adverse effects suffered by the child (p=0.043), time of receiving ART (p=0.047), use of western medicine (p=0.043), healthcare cadre (p=0.002), the kind of attention the healthcare provider offered (p=0.015), and improvements in quality of HIV services (p=0.001) were significantly associated with ART adherence. Conclusion: The study findings indicated that ART adherence among HIV-infected children under five years was suboptimal. This will necessitate continuous engagement and education of caregivers on the prominence of adhering to ART.

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Section: Discussionmentioning

confidence: 77%

<p>Differential Self-Reported Determinants to Antiretroviral Therapy Adherence: Findings from Caregivers of Children Under Five Years Living with Human Immunodeficiency Virus Infection Attending Al-Sabah Hospital, South Sudan</p>

Tong¹,

Atuhairwe²,

Taremwa³

2020

HIV

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“…It is widely agreed that once treatment is initiated, it should not be interrupted. In Ethiopia, within 07 days, nearly 11.3% of children have poorly adhered to ART [45]. It is expected that as duration increased the probability of ART interruptions would be more likely.…”

Section: Discussionmentioning

confidence: 99%

HIV/AIDS treatment failure and associated factors in Ethiopia: meta-analysis

et al. 2020

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Background: The national burden of human immunodeficiency virus treatment failure and associated factors in the Ethiopian context is required to provide evidence towards a renewed ambitious future goal. Methods: We accessed Ethiopian Universities' online repository library, Google Scholar, PubMed, Web of Science, and Scopus to get the research articles. We run I-squared statistics to see heterogeneity. Publication bias was checked by using Egger's regression test. The pooled prevalence was estimated using the DerSimonian-Laird random-effects model. We employed the sensitivity analysis to see the presence of outlier result in the included studies. Results: The overall human immunodeficiency treatment failure was 15.9% (95% confidence interval: 11.6-20.1%). Using immunological, virological, and clinical definition, human immunodeficiency treatment failure was 10.2% (95% confidence interval: 6.9-13.6%), 5.6% (95% confidence interval: 2.9-8.3%), and 6.3% (95% confidence interval: 4.6-8.0%), respectively. The pooled effects of World Health Organization clinical stage III/IV (Adjusted Odd Ratio = 1.9; 95% CI: 1.3-2.6), presence of opportunistic infections (Adjusted Odd Ratio = 1.8; 95% CI: 1.2-2.4), and poor adherence to highly active antiretroviral therapy (Adjusted Odd Ratio = 8.1; 95% CI: 4.3-11.8) on HIV treatment failure were estimated. Conclusions: Human immunodeficiency virus treatment failure in Ethiopia found to be high. Being on advanced clinical stage, presence of opportunistic infections, and poor adherence to highly active antiretroviral therapy were the contributing factors of human immunodeficiency virus treatment failure. Human immunodeficiency virus intervention programs need to address the specified contributing factors of human immunodeficiency virus treatment failure. Behavioral intervention to prevent treatment interruption is required to sustain human immunodeficiency virus treatment adherence. Protocol registration: It has been registered in the PROSPERO database with a registration number of CRD42018100254.

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“…It is widely agreed that once treatment is initiated, it should not be interrupted. In Ethiopia, within 7 days, nearly 11.3% of children are poorly adhered to ART (47). It is expected that as duration increased the probability of ART interruptions would be more likely.…”

Section: Discussionmentioning

confidence: 99%

Still poor HAART adherence has great impact on HIV/AIDS treatment failure in Ethiopia

Endalamaw

Mekonen

Debebe

et al. 2018

Preprint

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Background:The pooled burden of HIV treatment failure and its associated factors in Ethiopian context is required to provide evidence towards renewed ambitious future goal.Methods: Ethiopian Universities' (University of Gondar and Addis Ababa University) online repository library, Google scholar, PubMed, Web of Science, and Scopus were used to get the research articles. I-squared statistics was used to see heterogeneity. Publication bias was checked by Egger's regression test. The DerSimonian-Laird random effects model was employed to estimate the overall prevalence. Subgroup analysis based on geographical location of the study, study population by age, treatment failure type, and study design was conducted to see variation in outcomes. The sensitivity analysis was also employed to see whether the outlier result found in the included studies.

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Adherence to Highly Active Antiretroviral Therapy Among Children in Ethiopia: A Systematic Review and Meta-analysis

Cited by 17 publications

References 64 publications

<p>Differential Self-Reported Determinants to Antiretroviral Therapy Adherence: Findings from Caregivers of Children Under Five Years Living with Human Immunodeficiency Virus Infection Attending Al-Sabah Hospital, South Sudan</p>

<p>Differential Self-Reported Determinants to Antiretroviral Therapy Adherence: Findings from Caregivers of Children Under Five Years Living with Human Immunodeficiency Virus Infection Attending Al-Sabah Hospital, South Sudan</p>

HIV/AIDS treatment failure and associated factors in Ethiopia: meta-analysis

Still poor HAART adherence has great impact on HIV/AIDS treatment failure in Ethiopia

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