Antiretroviral drug adherence by HIV infected children attending Kericho district hospital, Kenya

Abstract

Objective: To determine ARV drug adherence levels in children (aged 3 to14 years) attending Kericho District Hospital (KDH), Kenya.
Methods: A cross-sectional design was used to collect data from a random sample of caregivers of 230 children on ARVs for a study period of six months (i.e. 1st August 2010 to 31st January 2011). The study population comprised HIV infected children on ARVs and their caregivers. The caregivers whose children met the selection criteria were selected. A structured pre-tested, intervieweradministered questionnaire was used to interview the caregivers of the HIV infected children who were selected from among those who took the children for treatment. The interview was continued on the consecutive caregivers until the sample of 230 children was attained. The key variables examined were; demographic information of caregivers and children and drug adherence levels. Measures of adherence included; drug/pill counting and estimate of volumes of syrup remaining from the last prescription, caregiver reports (on keeping clinic appointments and timing of taking ARVs by the child), and drug refill data (from pharmacy records). Data was analyzed using SPSS version 12.0.1 with statistical significance set at P<0.05.
Results: The adherence levels based on time of taking ARV drugs was 56.1%, keeping clinic appointments 45.7%, No ARVs returned (i.e. took all drugs assessed through pill counts) 27%, and pharmacy drug refill was 47.8%. The overall average adherence level was suboptimal at 44.2%. It was recommended that caregivers of the HIV infected children should be educated on importance of strict adherence to prescribed doses of ARVs to the children. Future research should explore using multiple measures of adherence and reasons for non-adherence among HIV infecting children.
Conclusion: The drug adherence level was sub-optimal.

Key words: Adherence, adherence levels, antiretroviral drugs, drug/pill counting, keeping clinic appointments, timing of taking ARVs, and pharmacy drug refill.