MST-Department of Public Health

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Browsing MST-Department of Public Health by Author "Arika, Linet Akinyi"

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    Care-giver factors associated with adherance to Antiretroviral therapy in HIV infected children: a case of Thika District Hospital Kenya
    (2012-04-18) Arika, Linet Akinyi; Otieno, Micheal Frederick; Were, Fred
    Survival of children with AIDS has increased considerably with the use of effective antiretroviral drugs, but the benefits of this therapy are limited by the difficulty of adherence to the treatment. This cross-sectional study was aimed at estimating the prevalence of adherence to antiretrovirals and identifying the associated caregiver factors affecting adherence among children resident in Thika town. Two hundred child caregivers were interviewed. The 24 Hour Recall Interview technique utilized to evaluate adherence prevalence allowed the detection of conscious loss of dose/so Adherence was defined when the child had taken 1000/0 of the prescribed medication during 24 hour period prior to the interview. Non-adherence was defined when the child missed even one dose of a medication during the 24 hour period prior to the interview. A general prevalence of adherence/non-adherence was established. The data was processed using SPSS 12.0 and Epi info 6.0 statistical packages. The significance of the findings was determined by Chi-square test and Logistic regression was used to remove the effect of confounding variables. The rate of adherence at Thika District Hospital was found to be 42%, meaning that pediatric adherence to ART in this setting is a challenge. Primary caregivers' ability to follow the child's ART based on the rigorous schedules X2=35.31:1df: p<0.05 [0.001] and primary caregivers drug related problems/difficulties X2=60.07:1df: p [0.001] were associated with adherence to ART in bivariate analysis. Those able to follow the child's ART showed better adherence. The most reported drug related difficulties/problems were administration interfering with lifestyle and drug side effects. Adherence was independently associated with primary caregivers relationship with the child p<0.05 [0.018]. The fact that the primary caregiver was a parent of the infected child adversely affected adherence. The Primary caregivers level of education was also independently associated with adherence p<0.05 [0.005]. Adherence rate was seen to increase with increasing primary caregiver level of education. There is thus need for assessments of the caregivers' level of education, relationship to the child, their ability to administer treatment, need for continuous assessment of caregivers' knowledge on ART, continuous assessment of adherence and scheduling treatment to meet the caregivers' lifestyle in an effort to ensure improved adherence to ART in Thika District