Health literacy predicts pediatric dosing accuracy for liquid zidovudine

Howard, Leigh M.; Tique, José A.; Gaveta, Sandra; Sidat, Mohsin; Rothman, Russell L.; Vermund, Sten H.; Ciampa, Philip J.

doi:10.1097/qad.0000000000000197

Cited by 22 publications

(20 citation statements)

References 31 publications

(34 reference statements)

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“…At the same time, metrics did not deteriorate although programmes have penetrated into remote rural areas over the past decade. Innovative programmes that have affordably and sustainably reduced child attrition should be studied for the elements of their successes that can be widely deployed .…”

Section: Discussionmentioning

confidence: 99%

Attrition of HIV‐exposed infants from early infant diagnosis services in low‐ and middle‐income countries: a systematic review and meta‐analysis

et al. 2018

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IntroductionIdentification and retention of HIV‐exposed infants in early infant diagnosis (EID) services helps to ensure optimal health outcomes. This systematic review and meta‐analysis examines the magnitude of attrition from EID services in low‐ and middle‐income countries (LMICs).MethodsWe performed a comprehensive database search through April 2016. We included original studies reporting retention/attrition data for HIV‐exposed infants in LMICs. Outcomes included loss to follow‐up (LTFU), death and overall attrition (LTFU + death) at time points along the continuum of EID services. At least two authors determined study eligibility, performed data extraction and made quality assessments. We used random‐effects meta‐analytic methods to aggregate effect sizes and perform meta‐regression analyses. This study adhered to PRISMA reporting guidelines.ResultsWe identified 3040 unique studies, of which 92 met eligibility criteria and were included in the quantitative synthesis. The included studies represent data from 110,805 HIV‐exposed infants, the majority of whom were from Africa (77%). LTFU definitions varied widely, and there was significant variability in outcomes across studies. The bulk of attrition occurred in the first six months of follow‐up, with additional losses over time. Overall, 39% of HIV‐exposed infants were no longer in care at 18 months. When restricted to non‐intervention studies, 43% were not retained at 18 months.ConclusionsThese findings underscore the high attrition of HIV‐exposed infants from EID services in LMICs and the urgent need for implementation research and resources to improve retention among this vulnerable population.

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Section: Discussionmentioning

confidence: 99%

Attrition of HIV‐exposed infants from early infant diagnosis services in low‐ and middle‐income countries: a systematic review and meta‐analysis

et al. 2018

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“…To make things worse, inadequate medication adherence and dosing errors were observed among adult informal caregivers with marginal health literacy skills. 72 Since people living with HIV are likely to show strong reliance on the support and counselling of informal caregivers, this finding is crucial, even though still little is known about this issue among both scholars and practitioners. On the one hand, the scientific literature seems to overlook the effects of informal caregivers' limited health literacy on the health status of their cared-for, mainly focusing on specific concerns, such as caregivers' adherence to pediatric antiretroviral medications.…”

Section: Resultsmentioning

confidence: 99%

Discussing the Effects of Poor Health Literacy on Patients Facing HIV: A Narrative Literature Review

Palumbo

2015

Int J Health Policy Manag

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Background: Scholars describe poor health literacy as a "silent epidemic, " which is challenging the functioning of healthcare systems all over the world. Health literacy is mainly meant as an individual trait which concerns the ability to obtain, process, and understand basic health information in order to effectively navigate the health system. Low health literate patients perceive poor self-efficacy dealing with their health conditions, are not willing to be involved in the provision of care, show larger risks of hospitalization and mortality, and are not aware about the determinants of well-being. Hence, limited health literacy has been associated with inadequate management of long-term conditions; nonetheless, several authors argue that health literacy has been an overlooked factor dealing with HIV. Methods: This study is aimed at discussing the effects of poor health literacy on people living with HIV, drawing from the findings of a narrative literature review which involved 41 papers retrieved from the databases "Scopus-Elsevier" and "PubMed. " Results: The scientific literature is not consistent dealing with the relationship between health literacy and HIV treatment. For example, health literate patients seem to better understand their health conditions; on the other hand, people living with poor health literacy are likely to report higher compliance with providers' prescriptions, blindly trusting healthcare professionals. Conclusions: Poor health literacy is a social barrier to access healthcare services and to appropriate health treatment among patients living with HIV. Tailored interventions should be aimed at enhancing the health skills of patients affected by HIV infection to improve their ability to navigate the health system.

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“…Similarly, some providers delay ART initiation beyond the recommended eight weeks after ATT initiation to avoid immune reconstitution inflammatory syndrome (IRIS), which is uncommon among children. 20,21 And, in the setting of medication stock-outs, 22-24 limited availability of fixed-dose combination drug options, 25 and adherence challenges with pediatric formulations of ART and ATT medications, 26,27 optimizing regimens for potential ART-ATT interactions can be challenging. 15,28 …”

Section: Introductionmentioning

confidence: 99%

Tuberculosis Treatment Outcomes Among HIV/TB-Coinfected Children in the International Epidemiology Databases to Evaluate AIDS (IeDEA) Network

Carlucci

Peratikos

Kipp

et al. 2017

JAIDS Journal of Acquired Immune Deficiency Syndromes

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Introduction Management of tuberculosis (TB) is challenging in HIV/TB co-infected children. The World Health Organization (WHO) recommends nucleic acid amplification tests for TB diagnosis, a four-drug regimen including ethambutol during intensive phase of treatment (IP), and initiation of antiretroviral therapy (ART) within eight weeks of TB diagnosis. We investigated TB treatment outcomes by diagnostic modality, IP regimen, and ART status. Methods We conducted a retrospective cohort study among HIV/TB co-infected children enrolled at International Epidemiology Databases to Evaluate AIDS treatment sites from 2012-2014. We modeled TB outcome using multivariable logistic regression including diagnostic modality, IP regimen, and ART status. Results Among 386 HIV-infected children diagnosed with TB, 20% had microbiological confirmation of TB, and 20% had unfavorable TB outcomes. During IP, 78% were treated with a four-drug regimen. Thirty-one percent were receiving ART at the time of TB diagnosis, and 32% were started on ART within eight weeks of TB diagnosis. Incidence of ART initiation within eight weeks of TB diagnosis was higher for those with favorable TB outcomes (64%) compared to those with unfavorable outcomes (40%) (p=0.04). Neither diagnostic modality (OR 1.77; 95%CI 0.86-3.65) nor IP regimen (OR 0.88; 95%CI 0.43-1.80) were associated with TB outcome. Discussion In this multinational study of HIV/TB co-infected children, many were not managed per WHO guidelines. Children with favorable TB outcomes initiated ART sooner than children with unfavorable outcomes. These findings highlight the importance of early ART for children with HIV/TB co-infection, and reinforce the need for implementation research to improve pediatric TB management.

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Health literacy predicts pediatric dosing accuracy for liquid zidovudine

Cited by 22 publications

References 31 publications

Attrition of HIV‐exposed infants from early infant diagnosis services in low‐ and middle‐income countries: a systematic review and meta‐analysis

Attrition of HIV‐exposed infants from early infant diagnosis services in low‐ and middle‐income countries: a systematic review and meta‐analysis

Discussing the Effects of Poor Health Literacy on Patients Facing HIV: A Narrative Literature Review

Tuberculosis Treatment Outcomes Among HIV/TB-Coinfected Children in the International Epidemiology Databases to Evaluate AIDS (IeDEA) Network

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