Arage Getachew, Tessema Gizachew Assefa, Kassa Hiwot
Department of Reproductive Health, Institute of Public Health, University of Gondar, Gondar, Ethiopia.
BMC Public Health. 2014 Apr 15;14:365. doi: 10.1186/1471-2458-14-365.
Poor adherence to antiretroviral therapy negatively affects the suppression of viral replication. It increases risks of drug resistance, treatment failure, Acquired Immuno Deficiency Syndrome (AIDS)-related morbidity and mortality among children. This study assessed the level of adherence to antiretroviral therapy and its associated factors among children at hospitals in South Wollo Zone, Northeast Ethiopia.
An institution-based cross-sectional study was conducted among Human Immunodeficiency Virus (HIV)-infected children in April 2013. A total of 464 children who were taking Antiretroviral Therapy (ART) in the hospitals were included. Data were collected using pretested and structured questionnaires using a face-to-face interview method. Descriptive and summary statistics were employed. Bivariate and multiple logistic regressions were computed. Odds ratios and their 95% confidence intervals were computed to determine the level of significance.
Of the 464 study samples, 440 children with their caregivers were included in the final analysis. A total of 78.6% of the caregivers reported that their children were adherent to antiretroviral therapy in the month prior to the interview. Caregivers' knowledge about antiretroviral treatment [AOR = 2.72(95% CI: 1.82, 5.39)], no current substance use of the caregivers [Adjusted Odds Ratio (AOR) = 2.21(95% Confidence Interval (CI): 1.34, 7.13)], proximity to the health care facility [AOR = 2.31(95% CI: 1.94, 4.63)], if the child knows HIV-positive status [AOR = 3.47(95% CI: 2.10, 6.81)] and caregiver's educational status [AOR = 0.59(95% CI: 0.21, 0.82)] were significantly and independently associated with adherence of children to antiretroviral therapy.
Adherence of antiretroviral therapy in this study was comparable to other studies conducted in developing countries. Caregiver's knowledge about antiretroviral therapy, no current use of substances, close proximity to health facilities, and letting child's know his/her HIV status improves adherence to antiretroviral therapy. Health care providers should educate caregivers about antiretroviral therapy and encourage HIV positive status disclosure to the child.
对抗逆转录病毒疗法的依从性差会对病毒复制的抑制产生负面影响。这会增加儿童出现耐药性、治疗失败、获得性免疫缺陷综合征（艾滋病）相关发病率和死亡率的风险。本研究评估了埃塞俄比亚东北部南沃洛地区医院儿童对抗逆转录病毒疗法的依从水平及其相关因素。
2013年4月，在感染人类免疫缺陷病毒（HIV）的儿童中开展了一项基于机构的横断面研究。纳入了医院中总共464名正在接受抗逆转录病毒疗法（ART）的儿童。通过面对面访谈的方式，使用经过预测试的结构化问卷收集数据。采用描述性和汇总统计方法。进行了双变量和多因素逻辑回归分析。计算比值比及其95%置信区间以确定显著性水平。
在464个研究样本中，最终分析纳入了440名儿童及其照顾者。共有78.6%的照顾者报告称，在访谈前一个月他们的孩子坚持服用抗逆转录病毒疗法。照顾者对抗逆转录病毒治疗的了解程度[AOR = 2.72（95%CI：1.82，5.39）]、照顾者当前无物质使用情况[调整后比值比（AOR）= 2.21（95%置信区间（CI）：1.34，7.13）]、与医疗机构的距离[AOR = 2.31（95%CI：1.94，4.63）]、孩子是否知道自己的HIV阳性状态[AOR = 3.47（95%CI：2.10，6.81）]以及照顾者的教育程度[AOR = 0.59（95%CI：0.21，0.82）]与儿童对抗逆转录病毒疗法的依从性显著且独立相关。
本研究中抗逆转录病毒疗法的依从性与在发展中国家开展的其他研究相当。照顾者对抗逆转录病毒疗法的了解、当前无物质使用、距离医疗机构较近以及让孩子知道其HIV状态可提高对抗逆转录病毒疗法的依从性。医疗保健提供者应向照顾者宣传抗逆转录病毒疗法，并鼓励向儿童披露HIV阳性状态。
