ASSESSMENT OF ADHERENCE TO ANTIRETROVIRAL THERAPY AMONG CHILDREN BELOW 5 YEARS OF AGE IN NORTH KINANGOP SUB-COUNTY NYANDARUA COUNTY KENYA
Introduction:
Despite the concerted efforts at achieving a 50 reduction in deaths resulting from rnHIV a high number of children below the age of 5 years continue to get resistance to rnfirst line ART medicines and are second line ARV medication. Efforts to deal with rnthis issue seems not to have taken root in many developing countries including rnKenya. HIV suppression still remains a big challenge in this age bracket with at least rnone in every six patients failing to achieve the required adherence levels of more than rn95 for successful HIV treatment. The net effect is the increase in the AIDS related rndeaths among the under 5s preventing the country from attaining its SDGs rncommitment of lowering these deaths by 50 by 2015.
Objectives:
.The main objective of thisrnstudy was to assess the adherence to ART among the under 5s in Kinangop Subcounty Nyandarua County Kenya.
Methodology:
Community based cross sectional study design rnwas used in this study. The study utilized purposive sampling in selecting the hospitals rnto develop sample frames and Simple random sampling technique to get a sample size rnof 195 subjects. Researcher-administered questionnaires with open and closed endedrnquestions and Focused Group Discussions FGDs were used as the main data rncollection methods. Collected Qualitative data from FGD interview was translated into rna common language and was thereafter typed into MS Word. It was then analyzed rnmanually to fit into the study themes. On the other side collected Quantitative datarngotten from questionnaires used to be checked daily for completeness and was thenrncoded for before it was entered into computer
Findings:
This research usedrnunivariate bivariate and multivariate analysis. As for univariate analysis populationrndistribution by background characteristics was shown. While in bivariate analysis the rnassociation between the dependent and independent variables was showed by cross rntabulations then t-test values tested whether or not the dependent and independent rnvariables association was significant. For multivariate analysis the study used logistic rnregression to analyze and determine the effect of explanatory variables has on the rndependent variables. ART regimen characteristics had significant association with rnadherence in this study t-test8.7:1df: p0.000 and were similar to findings by Van rnDyke RB et al. 2009.Duration of medication and whether the child was on other rnmedication were significance as far as adherence is concerned in this study ttest4.411:1df: p0.005 .The higher the level of education the better the adherence rnt-test7.935:1df: p.005 however there was no significance in the association rnbetween the caregivers ability to explain the medication regimen by the names of the rndrugs it contains and adherence
Results:
. The study also found that Children who knew why rnthey take ARVS drug had better adherence as opposed to those who did not know rndisclosure had significant association with adherence/non-adherence outcomes ttest10.757:1df: p0.005.
Conclusion:
Level of under 5s ART adherencernAdherence to ART in the under 5s in North Kinangop sub-county is as follows: 73 rnfor the 4 day recall 27 for the 30 day recall these were confirmed by pill count andrn45.7 for the 90 day recall this mainly tested perceived self-efficacy at adherence.rn5.2.2 Null Hypothesis 1: Child characteristics do not influence adherence to ART rnamong the under 5s in North Kinangop sub county.rnChild characteristics which influence under 5s adherence to ART were identified asrnAge duration of treatment and knowledge on reason for medication. On this account rnthe null hypothesis was rejected.rnHowever other child characteristics under study like behavioral problems during rnmedication sessions like vomiting and medication refusal were not significantly rnassociated with adherence and as such the null hypothesis was accepted.rn5.2.3 Null Hypothesis 2: Socio-cultural factors do not influence adherence to ART rnamong the under 5s in North Kinangop sub county.rnAll the Socio-cultural factors under study influenced under 5s adherence to ART. They rnare Age of the caregiver sex marital status permanence economic status education rnlevel and HIV status and taking ARV. This null hypothesis was therefore rejected.rn50rn5.2.3 Null Hypothesis 3: ART regimen characteristics do not influence adherence rnto ART among the under 5s in North Kinangop sub county.rnRegimen factors studied influenced under 5s adherence to ART. They are:rnDrug formulation solids v/s liquids adjustments with quantity and palatabilityrnsweetened or not. This null hypothesis was therefore rejectedrnThe study findings found out that majority of independent variables had significant rninfluence on ART adherence in the under 5s and therefore the hypothesis was rejected.rnHypothesis test results: t 17.177 df 21 sig. 0.010 hence null hypotheses were rnrejected.
Publication Information
Author(s):
Focus County(s):
Nyandarua County
Programme Area(s):
Infectious and Parasitic Diseases
Research Priority Area(s):
child health
Disease Domain(s):
HIV/AIDS
Document History:
Publication Date: 15.Jan.2020
Conference Title:
Venue: