Adherence to antiretroviral therapy in children attending Mulago Hospital, Kampala
Adherence to antiretroviral therapy in children attending Mulago Hospital, Kampala
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DOI：
10.1179/146532807x192499
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发表时间：
2007-06-01
影响因子：
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通讯作者：
Musoke, Philippa
中科院分区：
文献类型：
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作者：
Nabukeera-Barungi, Nicolette;Kalyesubula, Israel;Musoke, Philippa
背景资料：在坎帕拉Mulago医院儿科艾滋病毒/艾滋病诊所就诊的儿童中，不坚持治疗降低了抗逆转录病毒疗法的效果。目的：确定HAART的依从性水平，并确定与非adherence.Methods相关的因素：对170名2-18岁儿童进行横断面研究。坚持HAART定义为服用≥ 95%的处方药物。这是确定使用三种措施：3天的自我报告的照顾者，诊所为基础的药丸计数在登记和家庭为基础的未经宣布的药丸计数2-3 weeks later.Results：3天自我报告>= 95%的依从性为89.4%（n=170）。使用基于诊所的药丸计数，94.1%（n=170）的患者对治疗的依从性≥ 95%，相比之下，未经宣布的药丸计数仅为72%（n=164）。当主要照顾者是唯一一个谁知道孩子的血清状态，他/她是三倍的可能性不遵守（p=0.02，OR 3.34，95% CI 1.14-9.82）。那些在开始HAART治疗前住院两次或两次以上的患者更有可能有>= 95%的依从性（p=0.02，OR 0.44，95% CI 0.20-0.92）。大多数儿童有良好的依从性水平时，估计未经宣布的药丸计数。披露儿童的艾滋病毒血清状态只向主要照顾者，并已住院一次或根本没有与不良依从性相关。
Background: Non-adherence reduces the effectiveness of antiretroviral therapy in children attending the paediatric HIV/ AIDS clinic at Mulago Hospital, Kampala. Aim: To determine the levels of adherence to HAART and identify factors associated with non-adherence.Methods: A cross-sectional study of 170 children aged 2-18 years. Adherence to HAART was defined as taking >= 95% of prescribed medication. It was determined using three measures: a 3-day self-report by the caregivers, clinic-based pill counts at enrolment and home-based unannounced pill counts 2-3 weeks later.Results: The 3-day self-reported >= 95% adherence was 89.4% (n=170). Using clinic-based pill counts, 94.1% (n=170) had >= 95% adherence to treatment compared with only 72% (n=164) by unannounced pill counts. When the primary caregiver was the only one who knew the child's serostatus, he/ she was three times more likely to be non-adherent (p=0.02, OR 3.34, 95% CI 1.14-9.82). Those who had been hospitalised twice or more before starting HAART were more likely to have >= 95% adherence (p=0.02, OR 0.44, 95% CI 0.20-0.92).Conclusion: The majority of children had good adherence levels when estimated by unannounced pill counts.Disclosing the child's HIV serostatus only to the primary caregiver and having been hospitalised only once or not at all were associated with poor adherence.