Adherence to highly active antiretroviral therapy and associated factors among children at the University of Gondar Hospital and Gondar Poly Clinic, Northwest Ethiopia: a cross-sectional institutional based study

Abstract

BackgroundThe efficacy of antiretroviral therapy (ART) in suppressing viral replication and delaying the progress of the acquired immunodeficiency syndrome (AIDS) is related to optimal adherence. Adherence is a challenge in all HIV infected people on ART. It is especially a concern in children because of factors relating to children such as age, disclosure status of HIV sero status, and understanding of the medication. This study assessed the level of adherence to highly active antiretroviral therapy and its associated factors among children in Gondar University Hospital and Gondar Poly Clinic, Northwest Ethiopia.MethodsInstitutionally based cross-sectional study design was conducted from January-to March 2012. Simple random sampling technique was used to select study participants and a total of 342 study subjects were included in the study. Bivariate and multivariate logistic regressions were performed to identify associated factors with adherence to highly active antiretroviral therapy. Odds ratios with 95% confidence interval were computed to determine the level of significance.ResultsThe overall ART adherence among children was found to be 90.4%. Age of the child [AOR = 0.37 (95% CI: 0.31, 0.46)], disclosure of the child’s HIV status to the child [AOR = 0.27 (95% CI: 0.24, 0.32)], and knowledge of caregivers about ART medication [AOR = 4.7 (95% CI (3.7, 5.6)], were independently associated with adherence.ConclusionAdherence rate to ART was found to be high. Disclosure of the child’s HIV sero status to the child, the age of the child and the knowledge of the caregivers towards ART were factors associated with adherence.

Adherence to Antiretroviral Therapy among Hiv-Infected Children Attending Hiwot Fana and Dil-Chora Art Clinic at Referral Hospitals in Eastern Ethiopia

“…As the age of the child increased the level of adherence to treatment decreased, [AOR = 0.48, 0. 29-4.32], which is in agreement with a study from Gonder, Ethiopia [20].…”

“…Starting with disclosure as early as 8-9 years of age and combining it with specific support is central to increase children's adherence as they get older [20,26]. In our present study, the level of adherence was significantly high [AOR = 5.0295% CI: 0.37-8.03] in children who were aware of their sero-status than in those who unaware of their status.…”

“…But multi-method adherence assessment including selfreport, the visual analogue scale, and the pill identification test and pill count was used in other studies. The other explanation might be that most of the children didn't experience any adverse effects of the medication since side effects are known to increase non adherence [19,20].…”

Pharmacist-strengthen Adherence to Antiretroviral Therapy and the Contributing Factors among HIV-infected Paediatric Patients in Nigeria

“…Medication adherence level post intervention found in the present study was higher than the study of 20 with 83%, with 88.3% 21 , 81.2% 22 for, 70% 23 for and 85.5% 24 for. These variations may be accorded to activities that have been undertaken by government in the study setting to enhance the ART service.…”

Adherencia a TARGA: enfoque multi-dimensional

“…Adherencia es definida como el nivel en que la toma real de la medicación se corresponde con la prescripción de ésta 4 . Así, una óptima adherencia es definida como la toma de > 95% de las dosis prescritas, lo que es recomendado para una supresión virológica óptima y minimizar el grado de falla 5 .…”