Effectiveness of a community-based intervention (Konga model) to address the factors contributing to viral load suppression among children living with HIV in Tanzania: a cluster-randomized clinical trial protocol

Mageda, Kihulya; Katalambula, Leornard K; Kapologwe, Ntuli A.; Petrucka, Pammla

doi:10.1093/biomethods/bpac002

Cited by 3 publications

(2 citation statements)

References 31 publications

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“…Extant evidence from the United Nations Programme on HIV/AIDS (UNAIDS), shows that, the overall VLS among children living with HIV (CLHIV) aged 0-14 years, was 47% in 2020 (2). Trials in different countries have demonstrated that community-based intervention improves HIV care services among children living with HIV and AIDS (10). However, in Tanzania there has been limited documentation of the contribution of community-based interventions on improving health outcomes of children living with HIV who are on-ART (11).…”

Section: Resultsmentioning

confidence: 99%

Determinants of viral load suppression among orphaned and vulnerable children living with HIV on ART in Tanzania

Ally¹,

Exavery²,

Charles³

et al. 2023

Front. Public Health

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IntroductionIn Tanzania, only 66% children 0–14 years living with HIV know their HIV status, 66% are on treatment while 47% of children on ART are virally suppressed. Although retention on ART and poor adherence remain a challenge for children living with HIV, orphans and vulnerable children (OVC) face a greater limitation of access to and utilization of comprehensive HIV care and treatment. In response to this, the current study assessed the determinants of viral load suppression (VLS) among OVC aged 0–14 years living with HIV enrolled in HIV interventions.MethodsThis was a cross-sectional study that used secondary data collected by the USAID Kizazi Kipya project in 81 district councils of Tanzania. Included in this study are 1,980 orphans and vulnerable children living with HIV (OVCLHIV) (0–14 years) enrolled and served by the project for 24 months. Data analysis involved multivariable logistic regression, with viral load suppression as the outcome of interest and HIV interventions as the main independent variables.ResultsThe overall VLS rate among the OVCLHIV was 85.3%. This rate increased from 85.3, 89.9, 97.6 to 98.8% after 6, 12, 18, and 24 months of retention on ART, respectively. Similar rates were observed as the duration of adherence to ART increased. In the multivariable analysis, OVCLHIV attending people living with HIV (PLHIV) support groups were 411 times more likely to be virally suppressed than those not attending (aOR = 411.25, 95% CI 168.2–1,005.4). OVCLHIV with health insurance were 6 times more likely to achieve viral suppression than those without (aOR = 6.05, 95% CI 3.28–11.15). OVCLHIV with >95% adherence to ART were 149 times more likely to be virally suppressed than those not adherent to ART (aOR = 148.96, 95% CI 42.6–520.6, p < 0.001). Other significant factors included food security and family size. OVCLHIV reached by the different HIV community-based interventions were more likely to be virally suppressed than those who were not.DiscussionTo advance viral suppression, efforts should be made to ensure that all OVCLHIV are reached by community-based interventions as well as integrating food support in HIV treatment interventions.

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Section: Resultsmentioning

confidence: 99%

Determinants of viral load suppression among orphaned and vulnerable children living with HIV on ART in Tanzania

Ally¹,

Exavery²,

Charles³

et al. 2023

Front. Public Health

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show abstract

“…The data presented in this article were collected from children with high VLs >6 months after ART initiation. The raw data are a set of demographic and clinical characteristics of children and are shared publicly in Figshare [7] . The data descriptor ( Table 1 ) is provided with the shared dataset.…”

Section: Data Descriptionmentioning

confidence: 99%

Dataset evaluating the effectiveness of the Konga model to address factors contributing to a low viral load suppression among children with HIV in Tanzania

Mageda,

Kulemba,

Katalambula

et al. 2023

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Effectiveness of a community-based intervention (Konga model) to address factors contributing to low viral load suppression among children living with HIV in Tanzania: a preliminary, cluster, randomized clinical trial report

et al. 2023

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Background Despite effective antiretroviral therapy (ART) coverage in other groups living with human immunodeficiency virus (HIV) in Tanzania, virologic suppression among HIV-positive children receiving ART remains unacceptably low. This study evaluated the effectiveness of a community-based intervention (Konga model) in addressing the factor contributing to low viral load suppression among children living with HIV in the Simiyu region, Tanzania. Methods This study used a parallel cluster randomized trial. The cluster was only eligible if the health facility provided HIV care and treatment. All eligible resident children aged 2‒14 years who attended the cluster with a viral load > 1,000 cells/mm were enrolled. The intervention included three distinct activities: adherence counseling, psychosocial support, and co-morbidity screening such as tuberculosis. The evaluation was based on patient-centered viral load outcomes measured at baseline and 6 months later. Using a pre- and post-test design, we compared the means of participants in the intervention and control groups. We performed an analysis of covariance. The effect of a Konga was calculated using omega-squared. We used F-tests, with their corresponding p-values, as measures of improvement. Results We randomly assigned 45 clusters to the treatment (15) and control (30) groups. We enrolled 82 children with amedian age of 8.8 years(interquartile range(IQR);5.5–11.2), and a baseline median viral load of 13,150 cells/mm (interquartile range (IQR);3600–59,200). After the study, both children in each group had good adherence, with children in the treatment group scoring slightly higher than those in the control group, 40 (97.56%) versus 31(75%61), respectively. At the end of the study, the difference in viral load suppression between the two groups was significant. The median viral load suppression at the end of the study was 50 cells/mm [IQR, (20–125)]. After adjusting for the viral load before the intervention, the effect size of the Konga intervention explained 4% (95% confidence interval [0%, 14.1%]) of the viral load variation at the end of the intervention. Conclusion The Konga model demonstrated significant positive effects that improved viral load suppression. We recommend implementing the Konga model trial in other regions to improve the consistency of results.

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Effectiveness of a community-based intervention (Konga model) to address the factors contributing to viral load suppression among children living with HIV in Tanzania: a cluster-randomized clinical trial protocol

Cited by 3 publications

References 31 publications

Determinants of viral load suppression among orphaned and vulnerable children living with HIV on ART in Tanzania

Determinants of viral load suppression among orphaned and vulnerable children living with HIV on ART in Tanzania

Dataset evaluating the effectiveness of the Konga model to address factors contributing to a low viral load suppression among children with HIV in Tanzania

Effectiveness of a community-based intervention (Konga model) to address factors contributing to low viral load suppression among children living with HIV in Tanzania: a preliminary, cluster, randomized clinical trial report

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