Adherence to isonazid preventive therapy among hiv infected children at Ampath Clinic in Moi Teaching and Referral Hospital, Eldoret

Abstract

Background: Tuberculosis is the most common cause of infectious disease related to mortality worldwide. Children infected with Human  Immunodeficiency virus are at risk of developing tuberculosis hence Isoniazid preventive therapy is recommended to reduce tuberculosis burden. Isoniazid preventive therapy is new and non-adherence may lead to isoniazid resistance and treatment failure.

Objective: To determine level of adherence and describe factors associated with adherence to isoniazid preventive therapy among human immunodeficiency virus infected children.

Design: Prospective study.

Setting: AMPATH of Moi Teaching and Referral hospital

Participants: Two hundred and fifty one children were consecutively sampled.

Interventions: Participants were followed up monthly until completion of
isoniazid preventive therapy.

Outcome measures: Adherence was assessed using validated AMPATH adherence
tool.

Results: Median age was 11.0 (IQR: 8.0, 13.0) years, 129(51.4%) were female, 229(92%) were virally suppressed. Caregiver median age was 40years (IQR 35.0, 44.0), 215 (87.7%) were female, 135 (53.8%) had primary level of education. Adherence to isoniazid preventive therapy was 80.8%. Two hundred and thirtysix (94%) completed 6months of isoniazid preventive therapy. Good viral suppression OR 25.68 (95%CI: 6.22, 105.96) and regular follow up OR 30.86 (95% CI: 8.57, 111.07) for month 6, were associated with good adherence while children whose caregivers had secondary/tertiary level of education were non-adherent AOR: 0.36(95%CI:0.14,0.95).

Conclusion: Adherence to isoniazid preventive therapy was good with 8 in 10 being adherent. Completion rate was 94%. Participants with good viral suppression, regular follow up were associated with good adherence while participants whose caregiver had secondary level of education were nonadherent.