Adherence to antiretroviral therapy in children attending Mulago Hospital, Kampala.
BACKGROUND
Non-adherence reduces the effectiveness of antiretroviral therapy in children attending the paediatric HIV/AIDS clinic at Mulago Hospital, Kampala.


OBJECTIVE
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 > or =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 > or =95% adherence was 89.4% (n=170). Using clinic-based pill counts, 94.1% (n=170) had > or =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 > or =95% adherence (p=0.02, OR 0.44, 95% CI 0.20-0.92).


CONCLUSIONS
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.
Nabukeera-Barungi
Nicolette
N
Department of Paediatrics and Child Health, Faculty of Medicine, Makerere University, Kampala, Uganda. nicbarungi@yahoo.com
Kalyesubula
Israel
I
Kekitiinwa
Addy
A
Byakika-Tusiime
Jayne
J
Musoke
Philippa
P
D000293:Adolescent; D019380:Anti-HIV Agents / Q000008:administration & dosage*; D023241:Antiretroviral Therapy, Highly Active / Q000523:psychology*; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004334:Drug Administration Schedule; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000523:psychology; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D010349:Patient Compliance; D012307:Risk Factors; D014342:Truth Disclosure; D014454:Uganda
D019380:Anti-HIV Agents