Prevalence and Factors Associated With Virological Treatment Failure Among Children and Adolescents on Antiretroviral Therapy Attending HIV/AIDS Care and Treatment Clinics in Dodoma Municipality, Central Tanzania.


Journal

Journal of the Pediatric Infectious Diseases Society
ISSN: 2048-7207
Titre abrégé: J Pediatric Infect Dis Soc
Pays: England
ID NLM: 101586049

Informations de publication

Date de publication:
26 Mar 2021
Historique:
received: 12 12 2019
accepted: 17 04 2020
pubmed: 29 5 2020
medline: 19 8 2021
entrez: 29 5 2020
Statut: ppublish

Résumé

As the World Health Organization (WHO) and its joint partners such as USAIDS target achieving 90% sustained virological suppression among children and adolescents living with Human Immunodeficience Virus (HIV)/AIDS, it is imperative to elucidate the current prevalence and factors associated with virological treatment failure for formulation of appropriate strategies. This study was conducted determine the prevalence and factors associated with virological treatment failure among children and adolescents with HIV/AIDS on antiretroviral therapy (ART) attending HIV/AIDS care clinics in Dodoma, Central Tanzania. This was a cross-sectional study of children aged 1-19 years attending 3 HIV/AIDS care clinics in Dodoma (central Tanzania) from November 2018 to February 2019. Sociodemographic and clinical factors were documented, HIV viral load and CD4+ T lymphocytes were evaluated for children on ART for ≥6 months. The primary outcomes were the prevalence and factors associated with viralogic treatment failure. Of 300 children enrolled, 102 (34%) had virological treatment failure. Poor adherence to ART (adjusted odds ratio [AOR] = 3.221; 95% confidence interval [CI], 1.867-5.558; P = .032), nevirapine regimen (AOR = 3.185; 95% CI, 1.473-6.886; P ≤ .001), not using cotrimoxazole prophylaxis (AOR = 25.56; 95% CI, 3.15-27.55; P = .002) and nondisclosure of HIV status to others (AOR = 7.741; 95% CI, 2.351-25.489; P = .001) were independently associated with virological treatment failure. Current prevalence of virological treatment failure among children and adolescents living with HIV on ART remain high. Factors such as ART adherence, nevirapine based regimen, HIV status disclosure to those caring for the child need to be addressed to achieve sustained virological suppression.

Sections du résumé

BACKGROUND BACKGROUND
As the World Health Organization (WHO) and its joint partners such as USAIDS target achieving 90% sustained virological suppression among children and adolescents living with Human Immunodeficience Virus (HIV)/AIDS, it is imperative to elucidate the current prevalence and factors associated with virological treatment failure for formulation of appropriate strategies. This study was conducted determine the prevalence and factors associated with virological treatment failure among children and adolescents with HIV/AIDS on antiretroviral therapy (ART) attending HIV/AIDS care clinics in Dodoma, Central Tanzania.
METHODS METHODS
This was a cross-sectional study of children aged 1-19 years attending 3 HIV/AIDS care clinics in Dodoma (central Tanzania) from November 2018 to February 2019. Sociodemographic and clinical factors were documented, HIV viral load and CD4+ T lymphocytes were evaluated for children on ART for ≥6 months. The primary outcomes were the prevalence and factors associated with viralogic treatment failure.
RESULTS RESULTS
Of 300 children enrolled, 102 (34%) had virological treatment failure. Poor adherence to ART (adjusted odds ratio [AOR] = 3.221; 95% confidence interval [CI], 1.867-5.558; P = .032), nevirapine regimen (AOR = 3.185; 95% CI, 1.473-6.886; P ≤ .001), not using cotrimoxazole prophylaxis (AOR = 25.56; 95% CI, 3.15-27.55; P = .002) and nondisclosure of HIV status to others (AOR = 7.741; 95% CI, 2.351-25.489; P = .001) were independently associated with virological treatment failure.
CONCLUSIONS CONCLUSIONS
Current prevalence of virological treatment failure among children and adolescents living with HIV on ART remain high. Factors such as ART adherence, nevirapine based regimen, HIV status disclosure to those caring for the child need to be addressed to achieve sustained virological suppression.

Identifiants

pubmed: 32463083
pii: 5848104
doi: 10.1093/jpids/piaa030
doi:

Substances chimiques

Anti-HIV Agents 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

131-140

Informations de copyright

© The Author(s) 2020. Published by Oxford University Press on behalf of The Journal of the Pediatric Infectious Diseases Society. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Auteurs

Niyonziza Z Bitwale (NZ)

Department of Paediatrics & Child Health, University of Dodoma, Dodoma, Tanzania.

David P Mnzava (DP)

Department of Paediatrics & Child Health, Dodoma Regional Referral Hospital, Dodoma, Tanzania.

Francisca D Kimaro (FD)

Department of Paediatrics & Child Health, University of Dodoma, Dodoma, Tanzania.

Theopista Jacob (T)

Department of Paediatrics & Child Health, Mbeya Zonal Referral Hospital, Mbeya, Tanzania.

Bonaventura C T Mpondo (BCT)

Department of Internal Medicine, University of Dodoma, Dodoma, Tanzania.

Shakilu Jumanne (S)

Department of Paediatrics & Child Health, University of Dodoma, Dodoma, Tanzania.

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