Abstract
The purpose of this cohort study was to assess the effect of caregiver training on health outcomes of HIV-infected children aged 1-14 years on antiretroviral therapy in South Rift Valley, Kenya. Three hundred and twenty children of trained caregivers and 778 children of non-trained caregivers were targeted from four hospitals. Population proportionate to size sampling technique was used to calculate number of children enrolled. Children medical chart for trained and non-trained caregivers were stratified as per year of training, 2014, 2015, 2016 and randomly selected numbers matched with corresponding medical record. Data was collected through review of medical records, questionnaires and caregivers interview. There was significant association between caregiver training and adherence (Fisher's Exact Test X 2 =22.740, p = .001). Children of trained caregivers had significant reductions in viral load (Kruskal Wallis X 2 =7.124, p = .028); significant difference in viral loads was also observed between trained and non-trained caregivers (Mann-Whitney U=19846, p =.012), significant association in episodes of opportunistic infections before, after and among non-trained caregivers (Fisher's Exact Test X 2 =76.768, p = .001). Nutritional status of children was not associated with caregivers training (Pearson Chi-square X 2 = 11.616, p =.072). Most caregivers perceived training to be useful. The study found that, training enables caregivers to improve adherence levels of HIV infected children on antiretroviral therapy. Even though there are HIV information in public domain, the study found, if this information is provided in a structured manner, enables suppression of viral loads of HIV infected children. Training caregivers significantly reduces frequency of opportunistic infections among HIV infected children on antiretroviral therapy. Providing information on nutrition to caregivers does not affect nutritional status of HIV infected children. Training caregivers on HIV information improves health outcomes of HIV infected children thus study provide evidence–based decision making in rolling out caregivers training nationally. Keywords: HIV, Caregivers, Training, Children, Adherence, DOI: 10.7176/JHMN/76-05 Publication date: June 30th 2020
Highlights
At the end of 2016, nearly 11.5 million individuals including 1.1 million children were living with HIV(UNAIDS, 2017)
Even though there are HIV information in public domain, the study found, if this information is provided in a structured manner, enables suppression of viral loads of HIV infected children
Results from ANOVA on effect of caregivers training on opportunistic infections showed, there was a significant effect of caregiver training on occurrence of opportunistic infections among these children [F(2, 605) = 40.246, p
Summary
At the end of 2016, nearly 11.5 million individuals including 1.1 million children were living with HIV(UNAIDS, 2017). HIV and AIDS is a leading cause of morbidity and mortality in pediatric populations(Wattradul & Sriyaporn, 2014). As of December 2015, 49% of all HIV infected children were accessing treatment. As of December 2015, 49% of all HIV infected children were accessing treatment1 While this was a significant improvement for children, it still meant that over half of children living with HIV were still in urgent need of ART (UNAIDS, 2017). Advances in treatment and prevention of HIV infection have resulted in dramatic improvements in morbidity and mortality of children in developed countries. The scale up of diagnosis and provision of care and treatment to these children in developing countries continues to lag behind (UNAIDS, 2017)
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