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      Factors associated with adherence to antiretroviral therapy among HIV infected children in Kabale district, Uganda: a cross sectional study

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          Abstract

          Objectives

          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.

          Results

          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.

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          Most cited references20

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          How to Calculate Sample Size for Different Study Designs in Medical Research?

          Calculation of exact sample size is an important part of research design. It is very important to understand that different study design need different method of sample size calculation and one formula cannot be used in all designs. In this short review we tried to educate researcher regarding various method of sample size calculation available for different study designs. In this review sample size calculation for most frequently used study designs are mentioned. For genetic and microbiological studies readers are requested to read other sources.
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            Disclosure of HIV status and adherence to daily drug regimens among HIV-infected children in Uganda.

            Pediatric adherence to daily drug regimens has not been widely assessed in Africa where majority of HIV infected children live. Using in-depth interviews of 42 HIV-infected children taking ART and/or cotrimoxazole prophylaxis, and 42 primary caregivers, at a comprehensive HIV/AIDS clinic in Uganda, we evaluated their adherence experiences for purposes of program improvement. Daily drug regimens provided by the pediatric clinic included cotrimoxazole prophylaxis as well as ART and cotrimoxazole combined. Complete disclosure of HIV status by caregivers to children and strong parental relationships were related to good adherence. Structural factors including poverty and stigma were barriers to adherence even for children who had had complete disclosure and a supportive relationship with a parent. To ensure adherence to life-extending medications, our findings underscore the need for providers to support caregivers to disclose, provide on-going support and maintain open communication with HIV-infected children taking cotrimoxazole prophylaxis and ART.
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              Vital Signs: HIV Diagnosis, Care, and Treatment Among Persons Living with HIV — United States, 2011

              Background Infection with human immunodeficiency virus (HIV), if untreated, leads to acquired immunodeficiency syndrome (AIDS) and premature death. However, a continuum of services including HIV testing, HIV medical care, and antiretroviral therapy (ART) can lead to viral suppression, improved health and survival of persons infected with HIV, and prevention of HIV transmission. Methods CDC used data from the National HIV Surveillance System and the Medical Monitoring Project to estimate the percentages of persons living with HIV infection, diagnosed with HIV infection, linked to HIV medical care, engaged in HIV medical care, prescribed ART, and virally suppressed in the United States during 2011. Results In 2011, an estimated 1.2 million persons were living with HIV infection in the United States; an estimated 86% were diagnosed with HIV, 40% were engaged in HIV medical care, 37% were prescribed ART, and 30% achieved viral suppression. The prevalence of viral suppression was significantly lower among persons aged 18–24 years (13%), 25–34 years (23%), and 35–44 years (27%) compared with those aged ≥65 years (37%). Conclusions A comprehensive continuum of services is needed to ensure that all persons living with HIV infection receive the HIV care and treatment needed to achieve viral suppression. Improvements are needed across the HIV care continuum to protect the health of persons living with HIV, reduce HIV transmission, and reach prevention and care goals. Implications for public health practice State and local health departments, community-based organizations, and health care providers play essential roles in improving outcomes on the HIV care continuum that increase survival among persons living with HIV and prevent new HIV infections. The greatest opportunities for increasing the percentage of persons with a suppressed viral load are reducing undiagnosed HIV infections and increasing the percentage of persons living with HIV who are engaged in care.
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                Author and article information

                Contributors
                iwadunde@gmail.com
                dtuhebwe@musph.ac.ug
                ediaumichael@gmail.com
                gokure@musph.ac.ug
                arthurwakg@yahoo.com
                rwanyenze@musph.ac.ug
                Journal
                BMC Res Notes
                BMC Res Notes
                BMC Research Notes
                BioMed Central (London )
                1756-0500
                13 July 2018
                13 July 2018
                2018
                : 11
                : 466
                Affiliations
                [1 ]ISNI 0000 0004 0620 0548, GRID grid.11194.3c, Department of Health Policy, Planning and Management, , Makerere University College of Health Sciences School of Public Health, ; P.O Box 7072, Kampala, Uganda
                [2 ]ISNI 0000 0004 0620 0548, GRID grid.11194.3c, Child Health and Development Centre, , Makerere University College of Health Sciences School of Medicine, ; P.O. Box 6717, Kampala, Uganda
                [3 ]ISNI 0000 0004 0620 0548, GRID grid.11194.3c, Department of Disease Control and Environmental Health, , Makerere University College of Health Sciences School of Public Health, ; P.O Box 7072, Kampala, Uganda
                Article
                3575
                10.1186/s13104-018-3575-3
                6043986
                29291749
                84458cae-a77b-472d-b2c6-680c8b97b71d
                © The Author(s) 2018

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 18 February 2018
                : 6 July 2018
                Funding
                Funded by: Makerere University, College of Health sciences, School of Public Health
                Categories
                Research Note
                Custom metadata
                © The Author(s) 2018

                Medicine
                pediatric,adherence,antiretroviral therapy
                Medicine
                pediatric, adherence, antiretroviral therapy

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