Cotrimoxazole Prophylaxis Compliance Among HIV Exposed Infants in Chikankata District in Southern Zambia

Abstract

Objectives and design: The general objective of the study was to determine factors associated with cotrimoxazole prophylaxis compliance among HIV exposed infants so that strategies are designed to improve cotrimoxazole prophylaxis uptake and compliance. A cross sectional study was conducted at Chikankata Mission hospital catchment area in Chikankata district.

Measures: The study comprised face to face interviews of 102 mothers/caretakers of HIV exposed infants aged 6 weeks to 18 months selected using convenient sampling method. These mothers/caretakers of HIV exposed infants were interviewed using a structured interview schedule. The study data collection was done from September to November 2014 over a period of 2-3 months whereby 3-5 questionnaires were administered per day due to limited sampling frame. SPSS statistical package was used for data entering and analysis Descriptive statistics were employed to illustrate the data and chi-square test was used test associations among variables. The p values of less than 0.05 were considered statistically significant.

Results: The findings showed that 78.7% of the respondents were non compl i ant with cotrimoxazole prophylaxis, 95% had heard about cotrimoxazole prophylaxis and their source of information was the health worker (98%). Though knowledge on the uses of cotrimoxazole prophylaxis stood at sixty percent (60%) only 51% knew the benefits of cotrimoxazole prophylaxis. 75.5% of the respondents stated that cotrimoxazole was not available at the health facilities, 89.2% stated that the road between their respective homes and the nearest health facility was passable, 73% said that the health workers at their nearest health facility did not encourage them to collect the drug when it ran out and 53.9% said that nurses at the nearest health facility did not follow them up when they did not go back for resupply of the drug. 77.5% of the respondents stated that their spouses did not allow them to collect cotrimoxazole when it ran out, 89.2% reported that their spouses knew about their HIV status and 65.7% said that they felt free to give their child cotrimoxazole in public. 61.8% of the respondents did not know that there was a social support group for mothers/caretakers of HIV exposed infants in their community and 74.5% stated that there were misconceptions about cotrimoxazole in the communities where they live.

Conclusions: The study showed a significant association between compliance to cotrimoxazole prophylaxis and the following factors: non availability of drugs (P=<0.0001), attitude of the health care providers at nearest health facility (P=<0.001), lack of follow up (P=0.009), and impassable roads (P=0.026) as service related factor. There was also a significant association between compliance to the drug and the following sociocultural factors; misconceptions (P=<0.001), spouse not allowing mother/caretakers to collect the drug when it ran out (P=0.001), lack of social support (P=0.002), lack of knowledge of the benefit of cotrimoxazole (P=0.002) and mother/caretaker feeling free to give cotrimoxazole to the child in public (P=0.009).

Keywords: Cotrimoxazole, prophylaxis, compliance, HIV exposed infants