title: Adherence to antiretroviral therapy among HIV-infected children receiving care at Kilimanjaro Christian Medical Centre (KCMC), Northern Tanzania: A cross- sectional analytical study.
abstract: BACKGROUND
  Paediatric adherence to Highly Active Antiretroviral Therapy (HAART) is a dynamic process involving many factors. Adherence for the majority on therapy matters to prevent failure of 1(st) and 2(st) line therapy. The purpose of this study was to determine the rate of adherence to antiretroviral therapy in HIV infected children.
  
  
  METHODS
  We conducted a cross-sectional hospital based analytical study, from October 2011 to April 2012. HIV-infected children aged 2 to 17 years who had been on treatment for at least six months were enrolled. Data were collected by a standard questionnaire. Two-day self-report, one month self-recall report, and pill count were used to assess adherence.
  
  
  RESULTS
  One hundred and eighty three respondents participated in this research. There were 92 (51%) males and 91 (49%) females. Only 45 (24.6%) had good adherence to their drug regimen when subjected to all three methods of assessment. Males were more adherent to ART than females (OR= 2.26, CI 1.05-4.87, p = 0.04). Adherence was worse among children who developed ART side effects (OR= 0.19, CI 0.07- 0.56;p = 0.01), could not attend clinic on regular basis (OR= 3.4, CI 1.60- 7.36, p = 0.01) and missed drug doses in the six months period prior to interview (OR= 0.40, CI 0.18-0.82, p= 0.01).
  
  
  CONCLUSIONS
  Only 24.6% of paediatric patients had good adherence to ART when subjected to all three measures. Drug side-effects, missing drug doses in the six months period prior to study start, monthly income and affording transportation to the clinic were strong predictors of adherence.
authors.affiliation: Department of Paediatrics and Child Health, Kilimanjaro Christian Medical University College, P. O. Box 2240, Moshi, Tanzania.
authors.forename: Amos Haki
authors.initials: AH
authors.lastname: Nsheha
authors.affiliation: KCMC- Duke Collaboration, P.O Box 3010, Moshi, Tanzania.
authors.forename: Dorothy Elizabeth
authors.initials: DE
authors.lastname: Dow
authors.affiliation: Department of Epidemiology & Biostatistics, Kilimanjaro Christian Medical University College, P. O. Box 2240, Moshi, Tanzania.
authors.forename: Gabriel Erick
authors.initials: GE
authors.lastname: Kapanda
authors.affiliation: Directorate of Postgraduate Studies, Kilimanjaro Christian Medical University College, P.O Box 2240, Moshi, Tanzania.
authors.forename: Bernardus Carolus
authors.initials: BC
authors.lastname: Hamel
authors.affiliation: Department of Paediatrics and Child Health, Kilimanjaro Christian Medical University College, P. O. Box 2240, Moshi, Tanzania.
authors.forename: Levina January
authors.initials: LJ
authors.lastname: Msuya
mesh_terms: D000293:Adolescent; D019380:Anti-HIV Agents / Q000009:adverse effects / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects / Q000379:methods; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000188:drug therapy*; D006801:Humans; D008297:Male; D055118:Medication Adherence; D012737:Sex Factors; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D013636:Tanzania; D014186:Transportation / Q000706:statistics & numerical data
chemical_list: D019380:Anti-HIV Agents
keywords: Adherence; HAART; HIV; Tanzania; children