Medication adherence and its determinants among patients on concomitant tuberculosis and antiretroviral therapy in South West Ethiopia

Kebede, Ayantu; Wabe, Nasir

doi:10.4103/1947-2714.93376

Cited by 54 publications

(46 citation statements)

References 14 publications

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“…This fining was parallel with study conducted in Ethiopian journal [31] and Debrebirhan, Ethiopia [5,31]. This study found that the patients with an initial ambulatory/ bedridden have 3 times more risk of developing treatment failure than the patients with who had working functional status.…”

Section: Sensitivity (%) Specificity (%) Ppv (%) Npv (%)supporting

confidence: 74%

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HIV/AIDS Treatment Failure and its Determinant Factors among First Line HAART Patients at Felege-Hiwot Referral Hospital, Bahir Dar, Northwest Ethiopia

Brhane¹,

Nibret²,

Abay³

2017

J AIDS Clin Res

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Introduction: Highly active antiretroviral therapy (HAART) played a critical role in the medical management of HIV infected individuals by restoring the immune function and minimizes HIV related outcomes. But treatment failure minimized these advantages and leads to an increment of morbidity and mortality with poor quality of life in all HIV patients. Objective:The aim at this study was to assess the prevalence of HIV/AIDS treatment failure and its determinants factors of patients on first line HAART at Felegehiwot Referral Hospital. Methods:Cross sectional study was conducted on 421 participants who had started first line HAART during August 2016 to September 2016. Data were collected from patients' chart starting from ART commencement and face to face interview using structured questionnaire. CD4 T-cells from whole blood and viral load from separated plasma were analyzed according to protocols. The collected data were enter in to EPI info version 3.5.1 and transfer to and analyzed using SPSS packages version 20. Descriptive statistics, odds ratio, positive and negative predictive values, life table, receiver operating characteristics curves, bi-variate and multiple logistic regression were used to analysis. Independent associations were considered with p<0.05.Result: Among the 421 participants enrolled, 292 (69.4%) were adult and 129 (30.6%) were children. More than half 243 (57.7%) of the participants were females. The adult median age at ART initiation was 38.0 years with inter quartile rage (IQR) 10 and for children 9.8 years with IQR 4.The median duration of treatment failure from initiation of treatment was 87 months (IQR 110-65 months). A total of 45 (10.7%) participants were found to have treatment failure. The median CD4 T-cells at initiation of Anti retroviral therapy were 147 cells/µl (IQR 226-84.5). The median time to detect virological failure was 47 months. Sensitivity of immunologic failure of predicting virological failure was 62.2%. Clinical stage II 374 (88.8%) was the predominant clinical stage. Conclusion:The prevalence of treatment failure in this study was 10.7%. Long duration on treatment, conducting faith healing, immunologic failure, high medication dosage, and ambulatory functional status at baseline and not feeling privacy during consultation and counseling were found to be significant predictors of treatment failure.Therefore early identification of associated factors and monitoring treatment failure has to be strengthened to benefit patients from prevent further complication.

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Section: Sensitivity (%) Specificity (%) Ppv (%) Npv (%)supporting

confidence: 74%

“…Due to HIV's error-prone replication, high mutation rate and viral recombination, development of some HIV drug resistance (HIVDR) is inevitable, even with appropriate ART prescribing and adherence [5][6][7][8]. HIVDR has significant human and financial implications: it limits treatment options.…”

Section: Introductionmentioning

confidence: 99%

HIV/AIDS Treatment Failure and its Determinant Factors among First Line HAART Patients at Felege-Hiwot Referral Hospital, Bahir Dar, Northwest Ethiopia

Brhane¹,

Nibret²,

Abay³

2017

J AIDS Clin Res

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“…Healthcare provider-patient relationship was not a factor significantly associated with adherence in this study. However, the study conducted in South West Ethiopia has shown an association between healthcare provider-patient relationship and adherence [23]. Failure to find an association between healthcare provider-patient relationship and adherence in this survey could be due to the low sample size.…”

Section: Discussionmentioning

confidence: 88%

“…Nevertheless, the result shows that there is a good environment for caregivers and/or child patients to tell what the children felt and about their medication course for health care providers in our setting. All study participants got adequate assistance/information from health care providers in this survey like other study [23]. Health care system barriers also affect adherence, especially a regular and timely supply of medication to patients.…”

Section: Discussionmentioning

confidence: 99%

Caregiver-reported adherence to antiretroviral therapy among HIV infected children in Mekelle, Ethiopia

Eticha

Berhane

2014

BMC Pediatr

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BackgroundAdherence to antiretroviral therapy (ART) in children is complicated may be because of many factors such as child characteristics, caregiver and family characteristics, regimen characteristics, etc. Therefore, it is important to identify factors associated with adherence in HIV infected children in order to reduce the risk of developing treatment failure or drug resistance through interventions. This survey was planned to find out the rate of adherence to ART and its associated factors among the children in Mekelle, Tigray region, Ethiopia.MethodsA cross-sectional survey was conducted in two hospitals in Mekelle: Ayder Referral Hospital and Mekelle Hospital, during the months of February to March 2013. A structured questionnaire was administered to caregivers to assess patient’s adherence.ResultsOut of a total of 193 patients, 83.4% as reported by caregivers were adherent to ART in the past seven days before the interview. On multivariate logistic regression model, it was found that the children whose caregivers were unmarried (AOR = 15.17, 95% CI: 3.36-68.43) and married (AOR = 3.54, 95% CI: 1.23-10.13) were more likely to adhere to their ART treatment than those whose caregivers were divorced/separated. Similarly, children whose caregivers’ age groups of 25–34 (AOR = 22.27, 95% CI: 4.34-114.29) and 35–44 (AOR = 7.14, 95% CI: 1.65-30.95) were more likely to adhere than their counterparts. The major reasons reported by caregivers for missing medicines include: child being depressed (24.4%), drug side effects (16.3%), too many pills (15.5%) and difficulty in swallowing pills (13.3%).ConclusionsThe prevalence of adherence to ART among children was found to be high and comparable to that of other similar setups. Nevertheless, encouraging the fundamental role of caregivers is so significant to improve adherence among those who missed a dose or more and consequently treatment outcomes of children with HIV.

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“…Similarly a study done by Padyana et al .,[12] at a tertiary care hospital of South India, among 200 HIV positive patients, showed that 54 (27%) patients had HIV/TB co-infection and remaining 146 (73%) were HIV positive alone. Another study done by Kebede and Wabe[13] in South West Ethiopia, among 296 patients on concomitant tuberculosis and antiretroviral therapy at hospital treatment center, of them only 24 (8.1%) were co-infected by HIV and TB.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of pulmonary tuberculosis among HIV positive patients attending antiretroviral therapy clinic

2013

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Background:Tuberculosis (TB) is the most common serious opportunistic infection in HIV positive patients and is the manifestation of AIDS in more than 50% of cases in developing countries. TB can occur at any time during the course of HIV infection.Aim:To describe the socio-demographic profile and prevalence of pulmonary tuberculosis (HIV/TB co-infection) among HIV positive patients been attended at the antiretroviral therapy clinic (ART) clinic at tertiary care teaching hospital of western Maharashtra, India.Materials and Methods:A cross-sectional study was carried out at the ART clinic of Pravara Rural Hospital, Loni, from June 2011 to May 2012. A total of 1012 HIV positive patients, who attended ART clinic, receiving ART treatment during the study period, were included in the analysis. The statistical analysis was performed using SPSS software (Version 17.0).Results:This study showed 1012/172 (17%) prevalence of pulmonary tuberculosis among HIV positive patients, of which 87 (50.58%) were males and 85 (48.42%) were females. Low CD4 count (< 50/μl) had statistically significant association with HIV/TB co-infection as compared to HIV infection only (P < 0.0001).Conclusion:The study showed that 17% of HIV infected persons had tuberculosis co-infection. More strategic preventive measures that enhance body immunity among HIV patients are highly needed as early as possible before they develop active tuberculosis.

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Medication adherence and its determinants among patients on concomitant tuberculosis and antiretroviral therapy in South West Ethiopia

Cited by 54 publications

References 14 publications

HIV/AIDS Treatment Failure and its Determinant Factors among First Line HAART Patients at Felege-Hiwot Referral Hospital, Bahir Dar, Northwest Ethiopia

HIV/AIDS Treatment Failure and its Determinant Factors among First Line HAART Patients at Felege-Hiwot Referral Hospital, Bahir Dar, Northwest Ethiopia

Caregiver-reported adherence to antiretroviral therapy among HIV infected children in Mekelle, Ethiopia

Prevalence of pulmonary tuberculosis among HIV positive patients attending antiretroviral therapy clinic

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