Assessment of Adherence to Antiretroviral Therapy among Children below 5 Years of Age in North Kinangop Sub-County, Nyandarua County, Kenya
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Despite the concerted efforts at achieving a 50% reduction in deaths resulting from HIV, a high number of children below the age of 5 years continue to get resistance to first line ART medicines and are second line ARV medication. Efforts to deal with this issue seems not to have taken root in many developing countries, including Kenya. HIV suppression still remains a big challenge in this age bracket with at least one in every six patients failing to achieve the required adherence levels of more than 95% for successful HIV treatment. The net effect is the increase in the AIDS related deaths among the under 5s preventing the country from attaining its SDGs commitment of lowering these deaths by 50% by 2015.The main objective of this study was to assess the adherence to ART among the under 5s in Kinangop Sub-county, Nyandarua County, Kenya. Community based cross sectional study design was used in this study. The study utilized purposive sampling in selecting the hospitals to develop sample frames and Simple random sampling technique to get a sample size of 195 subjects. Researcher-administered questionnaires with open and closed ended questions and Focused Group Discussions (FGDs) were used as the main data collection methods. Collected Qualitative data from FGD interview was translated into a common language and was thereafter typed into MS Word. It was then analyzed manually to fit into the study themes. On the other side, collected Quantitative data gotten from questionnaires used to be checked daily for completeness and was then coded for before it was entered into computer. Similar responses were collected together to form different categories before entering them into computer programme Epi- info version 6 and was then analyzed by version 20 SPSS. This research used univariate, bivariate and multivariate analysis. As for univariate analysis, population distribution by background characteristics was shown. While in bivariate analysis, the association between the dependent and independent variables was showed by cross tabulations then t-test values tested whether or not, the dependent and independent variables association was significant. For multivariate analysis, the study used logistic regression to analyze and determine the effect of explanatory variables has on the dependent variables. ART regimen characteristics had significant association with adherence in this study (t-test=8.7:1df: p=0.000) and were similar to findings by Van Dyke RB, et al., 2009.Duration of medication” and “whether the child was on other medication” were significance as far as adherence is concerned in this study (t-test=4.411:1df: p<0.005) .The higher the level of education, the better the adherence (t-test=7.935:1df: p<.005), however there was no significance in the association between the caregivers’ ability to explain the medication regimen by the names of the drugs it contains and adherence. The study also found that Children who knew why they take ARVS drug had better adherence as opposed to those who did not know disclosure had significant association with adherence/non-adherence outcomes (t-test=10.757:1df: p=0.005). The findings of this study have being shared with the health care facilities involved and a manuscript submitted for publication to a pediatric ART adherence counseling journal for use in hospital and community settings.