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Abstract
IntroductionPaediatric adherence to Highly Active Antiretroviral Therapy (HAART) is a dynamic process involving many factors. Adherence for the majority on therapy matters to prevent failure of 1st and 2st line therapy. The purpose of this study was to determine the rate of adherence to antiretroviral therapy in HIV infected children.MethodsWe conducted a cross-sectional hospital based analytical study, from October 2011 to April 2012. HIV-infected children aged 2 to 17 years who had been on treatment for at least six months were enrolled. Data were collected by a standard questionnaire. Two-day self-report, one month self-recall report, and pill count were used to assess adherence.ResultsOne hundred and eighty three respondents participated in this research. There were 92 (51%) males and 91 (49%) females. Only 45 (24.6%) had good adherence to their drug regimen when subjected to all three methods of assessment. Males were more adherent to ART than females (OR= 2.26, CI 1.05-4.87, p = 0.04). Adherence was worse among children who developed ART side effects (OR= 0.19, CI 0.07- 0.56;p = 0.01), could not attend clinic on regular basis (OR= 3.4, CI 1.60- 7.36, p = 0.01) and missed drug doses in the six months period prior to interview (OR= 0.40, CI 0.18-0.82, p= 0.01).ConclusionOnly 24.6% of paediatric patients had good adherence to ART when subjected to all three measures. Drug side-effects, missing drug doses in the six months period prior to study start, monthly income and affording transportation to the clinicwere strong predictors of adherence.
Highlights
Paediatric adherence to Highly Active Antiretroviral Therapy (HAART) is a dynamic process involving many factors
With introduction and successful use of Highly Active Antiretroviral Therapy (HAART),HIV-infected children are surviving into adolescence and facing many adherence challenges associated with long-term therapy [5].Poor adherence increases the risk of virologic failure and viral resistance, optimal adherence (> 95% of pills taken) is the key to success in HIV infected children who are onlong term treatment [4]
Good adherence was found by two- day self-report in 148 (80.9%), by visual analogue scalein 136 (73.4%), and by pill count in 64 (35%) patients
Summary
Paediatric adherence to Highly Active Antiretroviral Therapy (HAART) is a dynamic process involving many factors. The purpose of this study was to determine the rate of adherence to antiretroviral therapy in HIV infected children. With introduction and successful use of Highly Active Antiretroviral Therapy (HAART),HIV-infected children are surviving into adolescence and facing many adherence challenges associated with long-term therapy [5].Poor adherence increases the risk of virologic failure and viral resistance, optimal adherence (> 95% of pills taken) is the key to success in HIV infected children who are onlong term treatment [4]. Many developing countries have a high rate of treatment failure among HIV-infected children who are on ART, including those in Tanzania [5]. The aim of this study was to determine the rate of adherence and factors associated with adherence to antiretroviral therapy among HIV-infected children
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