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Adherence to antiretroviral therapy in children attending Mulago Hospital, Kampala

Nicolette Nabukeera-Barungi1, Israel Kalyesubula, Addy Kekitiinwa

  • 1Department of Paediatrics and Child Health, Faculty of Medicine, Makerere University, Kampala, Uganda. nicbarungi@yahoo.com

Annals of Tropical Paediatrics
|June 15, 2007
PubMed

Insights

Adherence to antiretroviral therapy (ART) in children is crucial for managing HIV/AIDS. Unannounced pill counts revealed good adherence, but limited disclosure of HIV status and prior hospitalizations were linked to non-adherence.

Area of Science:

  • Pediatric infectious diseases
  • Public health
  • HIV/AIDS management

Background:

  • Non-adherence to antiretroviral therapy (ART) significantly impacts treatment effectiveness in children with HIV/AIDS.
  • The study was conducted at the pediatric HIV/AIDS clinic of Mulago Hospital in Kampala, Uganda.

Purpose of the Study:

  • To assess adherence levels to highly active antiretroviral therapy (HAART) among children.
  • To identify factors associated with non-adherence to HAART in this pediatric population.

Main Methods:

  • A cross-sectional study involving 170 children aged 2-18 years.
  • Adherence was defined as taking ≥95% of prescribed medication.
  • Multiple assessment methods were used: 3-day caregiver self-report, clinic pill counts, and unannounced home-based pill counts.

Main Results:

  • Adherence rates varied by measurement method: 89.4% (self-report), 94.1% (clinic pill count), and 72% (unannounced pill count).
  • Limited disclosure of the child's HIV status solely to the primary caregiver was associated with a threefold increased risk of non-adherence (OR 3.34, p=0.02).
  • Children with two or more prior hospitalizations before starting HAART showed higher adherence (OR 0.44, p=0.02).

Conclusions:

  • Unannounced pill counts indicated that most children achieved good adherence to HAART.
  • Factors associated with poor adherence included restricted disclosure of HIV status and fewer prior hospitalizations.
Abstract

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