Association of Antiretroviral and Clinic Adherence With Orphan Status Among HIV-Infected Children in Western Kenya

Vreeman, Rachel C.; Wiehe, Sarah E.; Ayaya, Samwel O.; Musick, Beverly; Nyandiko, Winstone

doi:10.1097/qai.0b013e318183a996

Cited by 50 publications

(42 citation statements)

References 50 publications

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“…1 . Also, adherence in these studies was often measured via self-report or pill count, 14,15,20 and our prior data shows that these are not reliable. 22 In our cohort, using MEMS as the adherence measure, a mother as caregiver versus any other relative was associated with improved adherence.…”

Section: Discussionmentioning

confidence: 99%

“…[14][15][16][17][18] These studies differ in their definition of orphanhood, 2,9,12,14,19,20 and in the comparison group (i.e., children with biological parents versus foster parents, 20 institution staff, 21 or extended family. The cohorts studied have also been from varied cultures, including East Africa, Malawi, India, Thailand, and Brazil.…”

Section: Introductionmentioning

confidence: 99%

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Effect of Caregivers' Depression and Alcohol Use on Child Antiretroviral Adherence in South Africa

Jaspan

Mueller

Myer

et al. 2011

AIDS Patient Care and STDs

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Pediatric antiretroviral adherence is difficult to assess, and subjective measures are affected by reporting bias, which in turn may depend on psychosocial factors such as alcohol use and depression. We enrolled 56 childcaregiver dyads from Cape Town, South Africa and followed their adherence over 1 month via various methods. The Alcohol Use Disorder Inventory Tool and Beck Depression Inventory 1 were used to assess these factors and their affect on pediatric adherence. The median age of the children was 4 years, and median time on antiretrovirals was 20 months. Increased time on ART was associated with poorer adherence via 3-day recall (3DR; p = 0.03). Ethanol use was inversely associated with adherence by both subjective measures, 3DR and visual analogue scale (VAS) (both p < 0.01), and with Medication Event Monitoring System (MEMS) adherence as a continuous variable. In a multivariate analysis predicting MEMS adherence greater than 95%, including variables that were associated with adherence in univariate analyses, having a mother as a caregiver and shorter time on highly active antiretroviral therapy (HAART) were significantly associated with adherence (odds ratio [OR] 19.2; 95% confidence interval [CI] 1.1-327 and 0.9; 95% CI 0.9-0.99). Pediatric adherence is affected by caregiver alcohol use, but caregiver relationship to the child is most important. This small study suggests that interventions should aim to keep mothers healthy and alive, as well as alcohol-free.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Effect of Caregivers' Depression and Alcohol Use on Child Antiretroviral Adherence in South Africa

Jaspan

Mueller

Myer

et al. 2011

AIDS Patient Care and STDs

View full text Add to dashboard Cite

show abstract

“…Contextual factors such as orphan status (child who lost one or both parents) may influence pediatric adherence to cART. Prior research concerning orphan status and its association with cART nonadherence has been inconsistent [33,36,37]. In a recent study in Uganda, orphans were more likely to initiate cART at an older age than non-orphans [38].…”

Section: "Successful Treatment Of Hiv Requires Drug Adherence Rates Omentioning

confidence: 99%

Pediatric Adherence to Antiretroviral Therapy in Resource-Poor Settings: Challenges and Future Perspectives

Pérez¹,

Leroy

2009

HIV Ther.

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“…17 However, adherence to treatment in HIV-infected individuals co-infected with TB remains a serious challenge in such region. 18,19 Family support, which was widely documented as a tool for increasing adherence, 18,20,21 may have negative impact depending upon the patient's interpretation of the support givers' motives. 22 This finding could be an issue in Asian regions as well.…”

Section: Introductionmentioning

confidence: 99%

Prevalence, Characteristics, Management, and Outcome of Pulmonary Tuberculosis in HIV-Infected Children in the TREAT Asia Pediatric HIV Observational Database (TApHOD)

Sudjaritruk

Maleesatharn

Prasitsuebsai

et al. 2013

AIDS Patient Care and STDs

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A multicenter, retrospective, observational study was conducted to determine prevalence, characteristics, management, and outcome of pulmonary tuberculosis (PTB) in Asian HIV-infected children in the TREAT Asia Pediatric HIV Observational Database (TApHOD). Data on PTB episodes diagnosed during the period between 12 months before antiretroviral therapy (ART) initiation and December 31, 2009 were extracted. A total of 2678 HIV-infected children were included in TApHOD over a 13-year period; 457 developed PTB, giving a period prevalence of 17.1% (range 5.7-33.0% per country). There were a total of 484 PTB episodes; 27 children had 2 episodes each. There were 21 deaths (4.3%). One third of episodes (n = 175/484) occurred after ART initiation at a median of 14.1 months (interquartile range [IQR] 2.5-28.8 months). The median (IQR) CD4 + values were 9.0% (3.0-16.0%) and 183.5 (37.8-525.0) cells/mm 3 when PTB was diagnosed. Most episodes (n = 424/436, 97.3%) had abnormal radiographic findings compatible with PTB, whereas half (n = 267/484, 55.2%) presented with clinical characteristics of PTB. One third of those tested (n = 42/122, 34.4%) had bacteriological evidence of PTB. Of the 156 episodes (32.2%) that were accompanied with extrapulmonary TB, pleuritis was the most common manifestation (81.4%). After treatment completion, most episodes (n = 396/484, 81.9%) were recorded as having positive outcomes (cured, treatment completed and child well, and improvement). The prevalence of PTB among Asian HIV-infected children in our cohort was high. Children with persistent immunosuppression remain vulnerable to PTB even after ART initiation.

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Association of Antiretroviral and Clinic Adherence With Orphan Status Among HIV-Infected Children in Western Kenya

Abstract: The majority of pediatric patients in this resource-limited setting maintained perfect ART adherence, though only half kept all scheduled clinic appointments. Understanding contextual factors, such as orphan status, will strengthen adherence interventions.

Cited by 50 publications

References 50 publications

Effect of Caregivers' Depression and Alcohol Use on Child Antiretroviral Adherence in South Africa

Effect of Caregivers' Depression and Alcohol Use on Child Antiretroviral Adherence in South Africa

Pediatric Adherence to Antiretroviral Therapy in Resource-Poor Settings: Challenges and Future Perspectives

Prevalence, Characteristics, Management, and Outcome of Pulmonary Tuberculosis in HIV-Infected Children in the TREAT Asia Pediatric HIV Observational Database (TApHOD)

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