Factors Affecting Adherence to Pediatrics Antiretroviral Therapy in Mekelle Hospital, Tigray Ethiopia

Abstract

The most important factor in the success of HIV treatment is adherence to antiretroviral therapy (ART).The challenge to adherence to ART is particularly serious in Sub-Saharan Africa as the high rates of HIV/AIDS lead to greater numbers of affected individuals. Although long-term good ART adherence has been observed in certain settings of public sectors the magnitude of this challenge in Sub-Saharan Africa remains large and there is evidence for high rates of patient's poor adherence. Study aimed to assess the factors affecting adherence to pediatrics antiretroviral therapy (ART) among children in Mekelle hospital, Tigray, Ethiopia. A Hospital based crosssectional study was conducted on 226 children on antiretroviral therapy from May 01 to 30/2014 at Mekelle hospital. Data was collected from care givers of children under 15 years old who are on ART. Of the 226 children under 15 years, 90.3 % reported complete adherence to antiretroviral therapy medications at the regular schedule over the past 7 days. Factors associated with adherence were having male care giver (AOR=2.10[1.01, 7.22]), age of the child (AOR=1. 43[1.16, 3.98]) below 5 years and use of first line ART drugs (AOR=2.86 [1.54, 3.67]). Over all the adherence of children on ART to their medication in this study is relatively higher as compared to others. However, complete adherence is expected in order to make the drugs effective. Different strategies have to be designed to improve the adherence level.

Adherence to Highly Active Antiretroviral Therapy Among Children in Ethiopia: A Systematic Review and Meta-analysis

“…Three studies conducted in Amhara region [46, 47, 55], two in Oromia [52, 54], two in Tigray [50, 53], two in Addis Ababa [45, 48], one in Oromia and Addis Ababa [51] and one in Harare and Dire Dawa city [49]. Five studies reported the prevalence of optimal adherence both at 07 days and 03 days prior to an interview [46, 47, 49, 50, 53] whereas five studies reported only prevalence at 07 days prior to an interview [45, 48, 51, 52, 54]. One study reported the prevalence of optimal adherence at 03 days prior to an interview [55].…”

“…One study reported the prevalence of optimal adherence at 03 days prior to an interview [55]. Therefore, ten studies [45–54] reported the prevalence of optimal adherence at 07 days and six studies [46, 47, 49, 50, 53, 55] at 03 days prior to an interview. A total of 2,864 HIV-infected children were participated in the included studies.…”

“…In contrary, one study showed that being in the age group below 5 years [AOR = 1.4 (95%CI 1.2, 3.9)] was more likely to adhere as compared to > 10 years age children [53]. Children with male caregiver [AOR = 2.10, 95% CI (1.01, 7.2)] was positively associated with HAART adherence [53].…”

“…Optimal adherence to HAART among included studies in this meta-analysis was defined as according to caregiver report if children took ≥ 95% of the prescribed doses for 07 days [45–54] and 03 days [46, 47, 49, 50, 53, 55] prior to an interview. Qualitative studies and citations without full-text were excluded.…”

“…The studies were included if they met the following inclusion criteria: [ 1 ] studies conducted on children < 15 years of age; [ 2 ] observational studies, including cross-sectional, cohort and case–control studies; [ 3 ] studies that reported prevalence of optimal adherence and/or at least one predictor, which was adjusted to other factors; [ 4 ] the outcome was optimal adherence to HAART; [ 5 ] studies conducted in Ethiopia; [ 6 ] studies published in English language. Optimal adherence to HAART among included studies in this meta-analysis was defined as according to caregiver report if children took ≥ 95% of the prescribed doses for 07 days [ 45 – 54 ] and 03 days [ 46 , 47 , 49 , 50 , 53 , 55 ] prior to an interview. Qualitative studies and citations without full-text were excluded.…”