scholarly journals Magnitude and associated factors of virological failure among children on ART in Bahir Dar Town public health facilities, Northwest Ethiopia: a facility based cross-sectional study

2021 ◽  
Vol 47 (1) ◽  
Author(s):  
Belete Gelaw ◽  
Getasew Mulatu ◽  
Getasew Tesfa ◽  
Chalie Marew ◽  
Bogale Chekole ◽  
...  
Keyword(s):  
Public Health ◽  
Antiretroviral Therapy ◽  
Virological Failure ◽  
Opportunistic Infections ◽  
Virologic Failure ◽  
Treatment Interruption ◽  
Cross Sectional Study ◽  
Clinical Staging ◽  
Art Adherence ◽  
Cross Sectional

Abstract Background Despite the rapid scale-up of antiretroviral therapy, virologic failure has become global public health concern and challenge, especially in developing countries. Viral load monitoring is an important approach to identify treatment failure and develop public health interventions in children receiving antiretroviral therapy. Thus, this study aims to assess the magnitude and associated factors of virological failure among children on antiretroviral therapy. Methods A facility-based cross-sectional study was conducted among 399 HIV-positive children on antiretroviral therapy from 2016 to 2019 in Bahir Dar Town public health facilities. Data were extracted from children’s charts using a standardized data extraction tool, adapted from ART intake and follow-up forms. Data were entered using Epi-Data Version 3.1, and analyzed using SPSS Version 25. Bivariable and multivariable binary logistic regression models were done to identify factors associated with virological failure. Variables with p-values < 0.25 were fitted into the multivariable analysis. Finally, variables with p-values <0.05 were considered as statistically significant factors. Results The period prevalence of virological failure was found to be 14.8% (95% CI: 11.5–19.3%). Opportunistic infections (AOR = 2.19, CI: 1.13–4.25), history of treatment interruption and restart (AOR = 2.21, CI: 1.09–4.54), younger age (AOR = 2.42, CI: 1.02–5.74), poor/fair ART adherence (AOR = 2.19, CI: 1.05–4.57), and advanced baseline WHO clinical staging (AOR = 2.32, CI: 1.14–4.74) were found to be factors significantly associated with virological failure. Conclusion The magnitude of virological failure among HIV-infected children remained high. Children with poor/fair ART adherence, history of treatment interruption, advanced baseline WHO clinical staging, younger age, and opportunistic infections were significantly associated with virologic failure. Thus, special attention should be given to children who had poor/fair ART adherence and presenting with opportunistic infections.

scholarly journals Magnitude and Associated Factors of Virological Failure Among Children on ART in Bahir Dar Town Public Health Facilities, Northwest Ethiopia: a Facility Based Cross-sectional Study

2021 ◽  
Author(s):  
Belete Gelaw ◽  
Getasew Mulatu ◽  
Getasew Tesfa ◽  
Chalie Marew ◽  
Bogale Chekole ◽  
...  
Keyword(s):  
Public Health ◽  
Antiretroviral Therapy ◽  
Virological Failure ◽  
Opportunistic Infections ◽  
Virologic Failure ◽  
Treatment Interruption ◽  
Cross Sectional Study ◽  
Clinical Staging ◽  
Art Adherence ◽  
Cross Sectional

Abstract Background: Despite the rapid scale-up of antiretroviral therapy, virologic failure has become global public health concern and challenge, especially in developing countries. Viral load monitoring is an important approach to identify treatment failure and develop public health interventions in children receiving antiretroviral therapy. Thus, this study aims to assess the magnitude and associated factors of virological failure among children on antiretroviral therapy. Methods: A facility-based cross-sectional study was conducted among 399 HIV-positive children on antiretroviral therapy from 2016 to 2019 in Bahir Dar Town public health facilities. Data were extracted from children’s charts using a standardized data extraction tool, adapted from ART intake and follow-up forms. Data were entered using Epi-Data Version 3.1, and analyzed using SPSS Version 25. Bivariable and multivariable binary logistic regression models were done to identify factors associated with virological failure. Variables with p-values < 0.25 were fitted into the multivariable analysis. Finally, variables with p-values ˂0.05 were considered as statistically significant factors.Results: The period prevalence of virological failure was found to be 14.8% (95% CI: 11.5-19.3%). Opportunistic infections (AOR=2.19, CI: 1.13-4.25), history of treatment interruption and restart (AOR=2.21, CI: 1.09-4.54), younger age (AOR= 2.42, CI: 1.02-5.74), poor/fair ART adherence (AOR=2.19, CI: 1.05-4.57), and advanced baseline WHO clinical staging (AOR= 2.32, CI: 1.14-4.74) were found to be factors significantly associated with virological failure.Conclusion: The magnitude of virological failure among HIV-infected children remained high. Children with poor/fair ART adherence, history of treatment interruption, advanced baseline WHO clinical staging, younger age, and opportunistic infections were significantly associated with virologic failure. Thus, special attention should be given to children who had poor/fair ART adherence and presenting with opportunistic infections.

scholarly journals Symptoms of common mental disorders and adherence to antiretroviral therapy among adults living with HIV in rural Zimbabwe: a cross-sectional study

BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e049824
Author(s):  
Andreas D Haas ◽  
Cordelia Kunzekwenyika ◽  
Stefanie Hossmann ◽  
Josphat Manzero ◽  
Janneke van Dijk ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Suicidal Ideation ◽  
Mental Disorders ◽  
Common Mental Disorders ◽  
Cross Sectional Study ◽  
People Living With Hiv ◽  
Art Adherence ◽  
Sectional Study ◽  
Cross Sectional ◽  
Living With Hiv

ObjectivesTo examine the proportion of people living with HIV who screen positive for common mental disorders (CMD) and the associations between CMD and self-reported adherence to antiretroviral therapy (ART).SettingSixteen government-funded health facilities in the rural Bikita district of Zimbabwe.DesignCross-sectional study.ParticipantsHIV-positive non-pregnant adults, aged 18 years or older, who lived in Bikita district and had received ART for at least 6 months.Outcome measuresThe primary outcome was the proportion of participants screening positive for CMD defined as a Shona Symptoms Questionnaire score of 9 or greater. Secondary outcomes were the proportion of participants reporting suicidal ideation, perceptual symptoms and suboptimal ART adherence and adjusted prevalence ratios (aPR) for factors associated with CMD, suicidal ideation, perceptual symptoms and suboptimal ART adherence.ResultsOut of 3480 adults, 18.8% (95% CI 14.8% to 23.7%) screened positive for CMD, 2.7% (95% CI 1.5% to 4.7%) reported suicidal ideations, and 1.5% (95% CI 0.9% to 2.6%) reported perceptual symptoms. Positive CMD screens were more common in women (aPR 1.67, 95% CI 1.19 to 2.35) than in men and were more common in adults aged 40–49 years (aPR 1.47, 95% CI 1.16 to 1.85) or aged 50–59 years (aPR 1.51, 95% CI 1.05 to 2.17) than in those 60 years or older. Positive CMD screen was associated with suboptimal adherence (aPR 1.53; 95% CI 1.37 to 1.70).ConclusionsA substantial proportion of people living with HIV in rural Zimbabwe are affected by CMD. There is a need to integrate mental health services and HIV programmes in rural Zimbabwe.Trial registration numberNCT03704805.

Antiretroviral therapy adherence among patients enrolled after the initiation of the Universal Test and Treat strategy in Dessie town: a cross-sectional study

2020 ◽  
Vol 31 (9) ◽  
pp. 886-893
Author(s):  
Yitayish Damtie ◽  
Fentaw Tadese
Keyword(s):  
Antiretroviral Therapy ◽  
Cross Sectional Study ◽  
Poor Adherence ◽  
Art Adherence ◽  
Sectional Study ◽  
Cross Sectional ◽  
Test And Treat ◽  
Universal Test ◽  
Universal Test And Treat ◽  
Morisky Scale

Poor adherence was the major challenge in providing treatment, care, and support for people living with HIV (PLHIV). Evidence of adherence to antiretroviral therapy (ART) after initiation of the Universal Test and Treat (UTT) strategy was limited in Ethiopia. So, this study aimed to determine the proportion of ART adherence after the initiation of UTT strategy and associated factors among adult PLHIV in Dessie town using two adherence measurements. A cross-sectional study was conducted on 293 PLHIV selected using a systematic sampling technique. The data were collected by face-to face-interview using a pretested questionnaire; chart review was also used to collect the data. The proportion of ART adherence measured by using the Morisky scale and seven-day recall was 49.3% (95% CI: [43.5%, 54.8%]) and 95.9% (95% CI: [93.2%, 98.2%]), respectively. Being urban in residence (AOR = 3.72, 95% CI: [1.80, 7.68]), the absence of depression (adjusted odds ratio [AOR] = 3.72, 95% CI: [1.22, 11.35]), taking one tablet per day (AOR = 3.26, 95% CI: [1.64, 6.49]), and the absence of concomitant illness (AOR = 0.23, 95% CI: [0.09, 0.59]) were factors associated with ART adherence. The proportion of ART adherence measured by the Morisky scale was very low; however, adherence measured by seven-day recall was higher and consistent with World Health Organization recommendations. Residence, depression, and the number of tablets taken per day had a positive association with good ART adherence whereas having concomitant illness had a negative association with good ART adherence. Efforts should be made to improve adherence and interventions should be given to overcome factors linked with poor adherence.

scholarly journals ASSESSING THE RATE OF ANTIRETRO VIRAL THERAPY ADHERENCE AMONG PEOPLE LIVING WITH HIV/AIDS IN THE ATWIMA NWABIAGYA MUNICIPAL - ASHANTI REGION

2021 ◽  
Vol 7 (7) ◽  
pp. 428-439
Author(s):  
Ernest Boateng ◽  
◽  
Dr. Emmanuel Kumah ◽  
Keyword(s):  
Antiretroviral Therapy ◽  
Quantitative Methods ◽  
Social Stigma ◽  
Medical Problem ◽  
Cross Sectional Study ◽  
People Living With Hiv ◽  
Art Adherence ◽  
Cross Sectional ◽  
Behavioural Factors ◽  
Adherence Counselling

At the end of 2018, HIV remains a significant worldwide medical problem and has claimed over 32 million lives. Around 37.9 million individuals were living with the condition at the end of 2018. The pervasiveness of HIV among African adults (15–49 years) was 3–multiple times higher in 2018. When properly followed, ART has been shown to slow the progression of HIV and enable HIV-positive people to live longer, more productive lives. A treatment regimen of at least three antiretroviral (ARV) medications is typically used. Adherence to antiretroviral therapy (ART) is insufficient. Therefore, the study aimed to assess the ART adherence among PLHIV in the Atwima Nwabiagya Municipality to suggest efficient and effective strategies to maximize adherence. A cross-sectional study was employed using quantitative methods to assess the associations between ART adherence and socio-demographic and socioeconomic factors. The site for this study was the ART Clinic at Nkawie Government Hospital, with a study population of all AIDS patients at the ART Clinic. The 450 PLHIV sample included females (n = 323, or 71.8%), while the males were 127 (28.2). Of the 450 participants, 215 (47.8%) reported adherence of 95%. The mean adherence index was 91.3%. Again, the study showed that those who took a single (137; 30.4%) ART dose was more comfortable than those who took multiple doses (313; 69.6%). Discomfort with the ART regimen, financial restrictions, forgetting to take medicine, lack of family support, social stigma, and antiretroviral therapy side effects were all major barriers to adherence in this study. Adherence, as stated by the participants, appeared to be below. Non-adherence is linked to both medical and behavioural factors, such as pausing ART or feeling ART discomfort. Atwima Nwabiagya Municipality, adherence to antiretroviral therapy is low. Before starting antiretroviral treatment, all patients can receive intensive adherence counselling.

scholarly journals Predicting Virologic Failure Among HIV-1-Infected Children Receiving Antiretroviral Therapy in Tanzania: a Cross-Sectional Study

2010 ◽  
Vol 54 (4) ◽  
pp. 368-375 ◽  
Author(s):  
Susan D Emmett ◽  
Coleen K Cunningham ◽  
Blandina T Mmbaga ◽  
Grace D Kinabo ◽  
Werner Schimana ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Virologic Failure ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Hiv 1

A proposal for basic management of HIV disease in West Africa: use of clinical staging and haemogram data

1998 ◽  
Vol 9 (8) ◽  
pp. 463-470 ◽  
Author(s):  
E Ledru ◽  
S Diagbouga ◽  
N Meda ◽  
P T Sanou ◽  
H Dahourou ◽  
...  
Keyword(s):  
Lymphocyte Count ◽  
Opportunistic Infections ◽  
Clinical Stage ◽  
Cross Sectional Study ◽  
Clinical Staging ◽  
Chronic Diarrhoea ◽  
Hiv Disease ◽  
Cross Sectional ◽  
Cd4 Counts ◽  
African People

Summary: Our objective was to propose a strategy to screen HIV infected African people for biological immunodeficiency easily. In a cross sectional study, we analysed the patterns of diseases and of CD4 counts among 266 HIV infected adults. Peripheral facial paralysis and chronic cutaneo mucous diseases were the earlier B stage diseases. Pulmonary tuberculosis was close to B stage diseases, and chronic diarrhoea was borderline between B and C stages. Cachexia was the most frequent C stage symptom 47.8 . Ninety per cent of CDC C stage people had CD4 counts below 350 mul, whereas only 75 had CD4 counts below 200 mul. Regression analysis identified the lymphocyte count, clinical stage and platelet count as predictors of CD4 count below 350 mul. A simple score lymphocyte count 2500 mul and clinical stage B is proposed to determine this CD4 threshold positive predictive value: 83 and to determine those patients needing treatment to prevent wasting and opportunistic infections.

scholarly journals Symptoms of common mental disorders and adherence to antiretroviral therapy among adults living with HIV in rural Zimbabwe: a cross-sectional study

2021 ◽  
Author(s):  
Andreas D Haas ◽  
Cordelia Kunzekwenyika ◽  
Stefanie Hossmann ◽  
Josphat Manzero ◽  
Janneke H van Dijk ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Suicidal Ideation ◽  
Mental Disorders ◽  
Common Mental Disorders ◽  
Cross Sectional Study ◽  
People Living With Hiv ◽  
Art Adherence ◽  
Sectional Study ◽  
Cross Sectional ◽  
Living With Hiv

Objectives: To examine the proportion of people living with HIV who screen positive for common mental disorders (CMD) and the associations between CMD and self-reported adherence to antiretroviral therapy (ART). Setting: Sixteen government-funded health facilities in the rural Bikita district of Zimbabwe. Design: Cross-sectional study. Participants: HIV-positive non-pregnant adults, aged 18 years or older, who lived in Bikita district and had received ART for at least six months. Outcome measures: The primary outcome was the proportion of participants screening positive for CMD defined as a Shona Symptoms Questionnaire (SSQ-14) score of 9 or greater. Secondary outcomes were the proportion of participants reporting suicidal ideation, perceptual symptoms, and suboptimal ART adherence and adjusted prevalence ratios (aPR) for factors associated with CMD, suicidal ideation, perceptual symptoms, and suboptimal ART adherence. Results: Out of 3,480 adults, 18.8% (95% confidence interval [CI] 14.8-23.7) screened positive for CMD, 2.7% (95% CI 1.5-4.7) reported suicidal ideations, and 1.5% (95% 0.9-2.6) reported perceptual symptoms. Positive CMD screens were more common in women (adjusted prevalence ratio [aPR] 1.67, 95% CI 1.19-2.35) than in men and were more common in adults aged 40-49 years (aPR 1.47 95% CI 1.16-1.85) or aged 50-59 years (20.3%; aPR 1.51 95% CI 1.05-2.17) than in those 60 years or older. Positive CMD screen was associated with suboptimal adherence (aPR 1.53; 95% CI 1.37-1.70). Conclusions: A substantial proportion of people living with HIV in rural Zimbabwe are affected by CMD. There is a need to integrate mental health services and HIV programs in rural Zimbabwe.

scholarly journals Predictors of antiretroviral therapy interruptions and factors influencing return to care at the Nkolndongo Health District, Cameroon

2021 ◽  
Vol 21 (1) ◽  
pp. 29-38
Author(s):  
Marius Nsoh ◽  
Katayi E Tshimwanga ◽  
Busi A Ngum ◽  
Avelina Mgasa ◽  
Moses O Otieno ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Treatment Interruption ◽  
Cross Sectional Study ◽  
Load Test ◽  
Transport Cost ◽  
Motivating Factors ◽  
Structural Barriers ◽  
Cross Sectional ◽  
Purposeful Sampling ◽  
Viral Load Test

Background: Antiretroviral therapy is a lifelong commitment that requires consistent intake of tablets to optimize health outcomes, attain and maintain viral suppression. Objective: We aimed to elicit predictors of treatment interruption amongst PLHIV and identify motivating factors influ- encing return to care. Method: We conducted a cross-sectional study using a mixed-method approach in four hospitals in Yaoundé. Sociodemo- graphic and clinical data were collected from ART registers. Using purposeful sampling, thirteen participants were enrolled for interviews. Quantitative data were analyzed using Epi-Info and Atlas-TI for qualitative analysis. Ethical clearance ap- proved by CBCHS-IRB. Results: A total of 271 participants records were assessed. The mean age was 33 years (SD±11years). Private facilities CASS and CMNB registered respectively 53 (19.6%) and 14 (5.2%) participants while CMA Nkomo and IPC had 114 (42.1%) and 90 (33.2%) participants. Most participants (75.3%) were females [OR 1.14; CI 0.78-1.66] compare with males. 78% had no viral load test results. Transport cost and stigmatization constituted the most prominent predictors of treatment interruption (47.5%) and (10.5%) respectively. Belief in the discovery of an eminent HIV cure and the desire to raise offspring motivated 30% and 61%, respectively to resume treatment. Conclusion: Structural barriers like exposed health facility, and dispensing ARVs in open spaces stigmatizes clients and increases odds of attrition. Attrition of patients on ART will be minimized through implementation of client centered ap- proaches like multiplying proxy ART pick points, devolving stable clients to community ARV model. Keywords: ART interruption; attrition; return to care; predictors; motivating factors; Cameroon.

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