Wadunde Ignatius, Tuhebwe Doreen, Ediau Michael, Okure Gildo, Mpimbaza Arthur, Wanyenze Rhoda K
Department of Health Policy, Planning and Management, Makerere University College of Health Sciences School of Public Health, P.O Box 7072, Kampala, Uganda.
Child Health and Development Centre, Makerere University College of Health Sciences School of Medicine, P.O. Box 6717, Kampala, Uganda.
BMC Res Notes. 2018 Jul 13;11(1):466. doi: 10.1186/s13104-018-3575-3.
This study was set out to assess the level of adherence to antiretroviral therapy (ART) and its determinants among children receiving HIV treatment in Kabale district, south western Uganda, in order to inform interventions for improving pediatric ART adherence.
Overall, 79% (121/153) of the children did not miss ART doses over the 7 days. Caregiver forgetfulness was the major reason for missing ART doses, 37% (13/35). Other reasons included transportation costs to the health facilities, 17%, (6/35) and children sitting for examinations in schools. Older children (11-14 years) were more likely to adhere to ART than the younger ones (0-10 years) (AOR = 6.41, 95% CI 1.31-31.42). Caregivers, who knew their HIV status, had their children more adherent to ART than the caregivers of unknown HIV status (AOR = 21.64: 95% CI 1.09-428.28). A significant proportion of children in two facilities 21.5% (32/153) missed ART doses within the previous week. Support for providers to identify clues or reminders to take drugs, extending HIV testing to caregivers and innovative models of ART delivery that alleviate transport costs to caregivers and allow sufficient drugs for children in school could enhance drug adherence among children.
本研究旨在评估乌干达西南部卡巴莱区接受艾滋病治疗的儿童对抗逆转录病毒疗法（ART）的依从水平及其决定因素，以便为改善儿童ART依从性的干预措施提供依据。
总体而言，79%（121/153）的儿童在7天内未漏服ART药物。照顾者遗忘是漏服ART药物的主要原因，占37%（13/35）。其他原因包括前往医疗机构的交通费用，占17%（6/35），以及儿童在学校参加考试。年龄较大的儿童（11 - 14岁）比年龄较小的儿童（0 - 10岁）更有可能坚持ART治疗（调整后比值比[AOR]=6.41，95%置信区间[CI]为1.31 - 31.42）。知道自己艾滋病毒感染状况的照顾者，其孩子对ART的依从性高于艾滋病毒感染状况未知的照顾者（AOR = 21.64：95% CI为1.09 - 428.28）。在两个机构中，有相当比例的儿童（21.5%，32/153）在前一周内漏服了ART药物。支持医护人员识别服药线索或提醒、将艾滋病毒检测扩展到照顾者以及采用创新的ART给药模式，以减轻照顾者的交通费用并为在校儿童提供足够药物，可能会提高儿童的药物依从性。
