Abstract
BackgroundPoor compliance to highly active antiretroviral therapy (HAART) can result in the poor quality of life in children living with Human immunodeficiency virus/Acquired immunodeficiency syndrome (HIV/AIDS) because of low plasma drug concentration and the possibility of drug resistance. This study evaluates the response of caregivers for determination of adherence and the four quality of life domains in children (aged 14 years and under) on HAART.MethodsWe conducted a cross-sectional study of 188 children, each accompanied by their caregivers at Ola During Children’s Hospital and Makeni Government Hospital between September and November 2016. Adherence to HAART and Quality of life was assessed using the WHO Quality of life summary questionnaire (WHOQOL-BREF). We obtained ethical approval from the Sierra Leone Ethics and Scientific Review Committee.ResultsThe study revealed 5.9% adherence amongst paediatric patients, and a strong association of adherent patients(p = 0.019*) to the physical health domain (mean = 64.61 SD = 8.1). Caregiver HIV status showed a strong association with the physical (mean = 58.3, SD = 11.7 and p = 0.024*), and psychological health domains (mean = 68.2, SD = 14.7 and p = 0.001). Caregiver type (mother/father/sibling) accompanying child to hospital also showed strong associated with the physical (mean = 58.0, SD = 10.6, p < 0.001), psychological (mean 68.2 SD = 14.81 p < 0.001) and environmental health domains (mean = 59.7, SD = 13.47, p < 0.001). Further regression analysis showed a strong association with physical health domain for HIV positive caregivers (p = 0.014) and adherent paediatric patients (p = 0.005). Nuclear family also showed a strong association with psychological (p < 0.001) and environmental (p = 0.001) health domains.ConclusionThis study showed a strong association between the quality of life domains and the involvement of nuclear family caregiver, HIV-positive caregiver and adherence to HAART. Our study suggests that the involvement of any member of the nuclear family, HIV positive parents and patient adherence to therapy can improve the quality of life of paediatric HIV/AIDS patients on highly active antiretroviral therapy in the two hospitals.
Highlights
Poor compliance to highly active antiretroviral therapy (HAART) can result in the poor quality of life in children living with Human immunodeficiency virus/Acquired immunodeficiency syndrome (HIV/AIDS) because of low plasma drug concentration and the possibility of drug resistance
60.6% of caregivers are members of the nuclear family. 62.8% of the caregivers had a problem with keeping to the timing of medication with 35.1% of this occurring in the morning, and 15.4% of problems occurring in the evening
5.9% paediatric age group were adherent to Highly Active Antiretroviral Therapy (HAART) while 94.1% were non-adherent
Summary
Poor compliance to highly active antiretroviral therapy (HAART) can result in the poor quality of life in children living with Human immunodeficiency virus/Acquired immunodeficiency syndrome (HIV/AIDS) because of low plasma drug concentration and the possibility of drug resistance. This study evaluates the response of caregivers for determination of adherence and the four quality of life domains in children (aged 14 years and under) on HAART. Studies have shown that non-adherence to highly active antiretroviral therapy (HAART) is associated with poor quality of life [4]. Studies using clinical and immunological markers have shown that early introduction of highly active antiretroviral therapy in children with HIV/AIDS can have a positive influence on their quality of life [6]. Despite the limitation associated with caregiver estimates of adherence, it remains the most widely used method of adherence in most low and middleincome countries [11]
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