scholarly journals Predictors of antiretroviral therapy interruptions and factors influencing return to care at the Nkolndongo Health District, Cameroon

2021 ◽  
Vol 21 ◽  
pp. 29-38
Author(s):  
Marius Nsoh ◽  
Katayi E Tshimwanga ◽  
Busi A Ngum ◽  
Avelina Mgasa ◽  
Moses O Otieno ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Treatment Interruption ◽  
Cross Sectional Study ◽  
Load Test ◽  
Transport Cost ◽  
Motivating Factors ◽  
Structural Barriers ◽  
Cross Sectional ◽  
Purposeful Sampling ◽  
Viral Load Test

Background: Antiretroviral therapy is a lifelong commitment that requires consistent intake of tablets to optimize health outcomes, attain and maintain viral suppression. Objective: We aimed to elicit predictors of treatment interruption amongst PLHIV and identify motivating factors influ- encing return to care. Method: We conducted a cross-sectional study using a mixed-method approach in four hospitals in Yaoundé. Sociodemo- graphic and clinical data were collected from ART registers. Using purposeful sampling, thirteen participants were enrolled for interviews. Quantitative data were analyzed using Epi-Info and Atlas-TI for qualitative analysis. Ethical clearance ap- proved by CBCHS-IRB. Results: A total of 271 participants records were assessed. The mean age was 33 years (SD±11years). Private facilities CASS and CMNB registered respectively 53 (19.6%) and 14 (5.2%) participants while CMA Nkomo and IPC had 114 (42.1%) and 90 (33.2%) participants. Most participants (75.3%) were females [OR 1.14; CI 0.78-1.66] compare with males. 78% had no viral load test results. Transport cost and stigmatization constituted the most prominent predictors of treatment interruption (47.5%) and (10.5%) respectively. Belief in the discovery of an eminent HIV cure and the desire to raise offspring motivated 30% and 61%, respectively to resume treatment. Conclusion: Structural barriers like exposed health facility, and dispensing ARVs in open spaces stigmatizes clients and increases odds of attrition. Attrition of patients on ART will be minimized through implementation of client centered ap- proaches like multiplying proxy ART pick points, devolving stable clients to community ARV model. Keywords: ART interruption; attrition; return to care; predictors; motivating factors; Cameroon.

scholarly journals Predictors of antiretroviral therapy interruptions and factors influencing return to care at the Nkolndongo Health District, Cameroon

2021 ◽  
Vol 21 (1) ◽  
pp. 29-38
Author(s):  
Marius Nsoh ◽  
Katayi E Tshimwanga ◽  
Busi A Ngum ◽  
Avelina Mgasa ◽  
Moses O Otieno ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Treatment Interruption ◽  
Cross Sectional Study ◽  
Load Test ◽  
Transport Cost ◽  
Motivating Factors ◽  
Structural Barriers ◽  
Cross Sectional ◽  
Purposeful Sampling ◽  
Viral Load Test

Background: Antiretroviral therapy is a lifelong commitment that requires consistent intake of tablets to optimize health outcomes, attain and maintain viral suppression. Objective: We aimed to elicit predictors of treatment interruption amongst PLHIV and identify motivating factors influ- encing return to care. Method: We conducted a cross-sectional study using a mixed-method approach in four hospitals in Yaoundé. Sociodemo- graphic and clinical data were collected from ART registers. Using purposeful sampling, thirteen participants were enrolled for interviews. Quantitative data were analyzed using Epi-Info and Atlas-TI for qualitative analysis. Ethical clearance ap- proved by CBCHS-IRB. Results: A total of 271 participants records were assessed. The mean age was 33 years (SD±11years). Private facilities CASS and CMNB registered respectively 53 (19.6%) and 14 (5.2%) participants while CMA Nkomo and IPC had 114 (42.1%) and 90 (33.2%) participants. Most participants (75.3%) were females [OR 1.14; CI 0.78-1.66] compare with males. 78% had no viral load test results. Transport cost and stigmatization constituted the most prominent predictors of treatment interruption (47.5%) and (10.5%) respectively. Belief in the discovery of an eminent HIV cure and the desire to raise offspring motivated 30% and 61%, respectively to resume treatment. Conclusion: Structural barriers like exposed health facility, and dispensing ARVs in open spaces stigmatizes clients and increases odds of attrition. Attrition of patients on ART will be minimized through implementation of client centered ap- proaches like multiplying proxy ART pick points, devolving stable clients to community ARV model. Keywords: ART interruption; attrition; return to care; predictors; motivating factors; Cameroon.

scholarly journals Treatment Literacy of People Living with HIV (PLHIV) in Government Healthcare Facilities in Malaysia

2021 ◽  
Vol 11 (9) ◽  
pp. 79-82
Author(s):  
Zailatul Hani Mohamad Yadzir ◽  
Mazliza Ramly ◽  
Anita Suleiman
Keyword(s):  
Antiretroviral Therapy ◽  
Cross Sectional Study ◽  
Load Test ◽  
People Living With Hiv ◽  
Cross Sectional ◽  
Healthcare Facilities ◽  
Viral Load Test ◽  
High Level ◽  
Immunodeficiency Syndrome ◽  
Living With Hiv

Background: Treatment literacy is a significant factor in the management of health and care of people living with HIV (PLHIV). Therefore, the aim of this study was to determine the level of treatment literacy among PLHIV in selected government facilities. Methods: A cross-sectional study was undertaken from July to August 2020 in five government hospitals and six government health clinics in Malaysia. A validated self-administered questionnaire encompassing six items about treatment literacy was used to assess the knowledge of PLHIV. This survey was conducted via web-based platform. Results: Overall, 1173 PLHIV participated in this study. The major finding in this study was that 90.0% of PLHIV were currently on treatment and aware of their antiretroviral therapy (ART) regime. Majority of PLHIV (74.0%) also stated that they know the frequency of receiving their viral load test. Conclusion: The study found a high level of treatment literacy among PLHIV in selected government facilities in Malaysia. Key words: Human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS), people living with HIV (PLHIV), antiretroviral therapy (ART)

scholarly journals Magnitude and associated factors of virological failure among children on ART in Bahir Dar Town public health facilities, Northwest Ethiopia: a facility based cross-sectional study

2021 ◽  
Vol 47 (1) ◽  
Author(s):  
Belete Gelaw ◽  
Getasew Mulatu ◽  
Getasew Tesfa ◽  
Chalie Marew ◽  
Bogale Chekole ◽  
...  
Keyword(s):  
Public Health ◽  
Antiretroviral Therapy ◽  
Virological Failure ◽  
Opportunistic Infections ◽  
Virologic Failure ◽  
Treatment Interruption ◽  
Cross Sectional Study ◽  
Clinical Staging ◽  
Art Adherence ◽  
Cross Sectional

Abstract Background Despite the rapid scale-up of antiretroviral therapy, virologic failure has become global public health concern and challenge, especially in developing countries. Viral load monitoring is an important approach to identify treatment failure and develop public health interventions in children receiving antiretroviral therapy. Thus, this study aims to assess the magnitude and associated factors of virological failure among children on antiretroviral therapy. Methods A facility-based cross-sectional study was conducted among 399 HIV-positive children on antiretroviral therapy from 2016 to 2019 in Bahir Dar Town public health facilities. Data were extracted from children’s charts using a standardized data extraction tool, adapted from ART intake and follow-up forms. Data were entered using Epi-Data Version 3.1, and analyzed using SPSS Version 25. Bivariable and multivariable binary logistic regression models were done to identify factors associated with virological failure. Variables with p-values < 0.25 were fitted into the multivariable analysis. Finally, variables with p-values <0.05 were considered as statistically significant factors. Results The period prevalence of virological failure was found to be 14.8% (95% CI: 11.5–19.3%). Opportunistic infections (AOR = 2.19, CI: 1.13–4.25), history of treatment interruption and restart (AOR = 2.21, CI: 1.09–4.54), younger age (AOR = 2.42, CI: 1.02–5.74), poor/fair ART adherence (AOR = 2.19, CI: 1.05–4.57), and advanced baseline WHO clinical staging (AOR = 2.32, CI: 1.14–4.74) were found to be factors significantly associated with virological failure. Conclusion The magnitude of virological failure among HIV-infected children remained high. Children with poor/fair ART adherence, history of treatment interruption, advanced baseline WHO clinical staging, younger age, and opportunistic infections were significantly associated with virologic failure. Thus, special attention should be given to children who had poor/fair ART adherence and presenting with opportunistic infections.

scholarly journals Magnitude and Associated Factors of Virological Failure Among Children on ART in Bahir Dar Town Public Health Facilities, Northwest Ethiopia: a Facility Based Cross-sectional Study

2021 ◽  
Author(s):  
Belete Gelaw ◽  
Getasew Mulatu ◽  
Getasew Tesfa ◽  
Chalie Marew ◽  
Bogale Chekole ◽  
...  
Keyword(s):  
Public Health ◽  
Antiretroviral Therapy ◽  
Virological Failure ◽  
Opportunistic Infections ◽  
Virologic Failure ◽  
Treatment Interruption ◽  
Cross Sectional Study ◽  
Clinical Staging ◽  
Art Adherence ◽  
Cross Sectional

Abstract Background: Despite the rapid scale-up of antiretroviral therapy, virologic failure has become global public health concern and challenge, especially in developing countries. Viral load monitoring is an important approach to identify treatment failure and develop public health interventions in children receiving antiretroviral therapy. Thus, this study aims to assess the magnitude and associated factors of virological failure among children on antiretroviral therapy. Methods: A facility-based cross-sectional study was conducted among 399 HIV-positive children on antiretroviral therapy from 2016 to 2019 in Bahir Dar Town public health facilities. Data were extracted from children’s charts using a standardized data extraction tool, adapted from ART intake and follow-up forms. Data were entered using Epi-Data Version 3.1, and analyzed using SPSS Version 25. Bivariable and multivariable binary logistic regression models were done to identify factors associated with virological failure. Variables with p-values < 0.25 were fitted into the multivariable analysis. Finally, variables with p-values ˂0.05 were considered as statistically significant factors.Results: The period prevalence of virological failure was found to be 14.8% (95% CI: 11.5-19.3%). Opportunistic infections (AOR=2.19, CI: 1.13-4.25), history of treatment interruption and restart (AOR=2.21, CI: 1.09-4.54), younger age (AOR= 2.42, CI: 1.02-5.74), poor/fair ART adherence (AOR=2.19, CI: 1.05-4.57), and advanced baseline WHO clinical staging (AOR= 2.32, CI: 1.14-4.74) were found to be factors significantly associated with virological failure.Conclusion: The magnitude of virological failure among HIV-infected children remained high. Children with poor/fair ART adherence, history of treatment interruption, advanced baseline WHO clinical staging, younger age, and opportunistic infections were significantly associated with virologic failure. Thus, special attention should be given to children who had poor/fair ART adherence and presenting with opportunistic infections.

Metabolic Syndrome in HIV-patients in Antiretroviral Therapy

2020 ◽  
Vol 18 (6) ◽  
pp. 388-395
Author(s):  
Daniel Vargas-Pacherrez ◽  
Helma P. Cotrim ◽  
Leonardo Pires ◽  
Vitor Cunha ◽  
Vitor Coelho ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Antiretroviral Therapy ◽  
International Diabetes Federation ◽  
Cross Sectional Study ◽  
People Living With Hiv ◽  
Anthropometric Data ◽  
Cross Sectional ◽  
History Of ◽  
Family History Of Hypertension ◽  
Living With Hiv

Introduction: The global prevalence of metabolic syndrome (MS) among people living with HIV/AIDS varies from 20% to 33%. Objective: to estimate the prevalence of metabolic syndrome and associated factors in a group of HIV-infected patients on antiretroviral therapy. Methods: This is a cross-sectional study with HIV-infected patients from a reference center in Bahia, Brazil. We evaluated clinical, socio-demographic and anthropometric data. MS was defined according to the guidelines of International Diabetes Federation. Results: We evaluated 152 patients with mean age of 47.3±11.6 years, 59.2% male. The main comorbidities detected were diabetes (3.3%) hypertriglyceridemia (9.3%) and metabolic syndrome (MS,38.2%). Patients with MS were predominantly women (55.2% vs 31.9%; p=0.005), older [52.1 (10.4) vs 44.3 (11.3); p<0.001], and had overweight (74.1% vs 23.4%; p<0.001). After multivariate analysis MS remained associated with age (OR = 1.076; 95% CI: 1.030 – 1.125), female sex (OR = 2.452; 95% CI: 1.114 – 5.374) and family history of hypertension (OR = 3.678; 95% CI: 1.431 – 9.395). Conclusion: Almost half of the HIV-infected patients in Bahia presents with MS which seems to be driven by classical risk factors.

scholarly journals A cross‐sectional study of socioeconomic status and treatment interruption among Japanese workers during the COVID‐19 pandemic

2021 ◽  
Vol 63 (1) ◽  
Author(s):  
Kenji Fujimoto ◽  
Tomohiro Ishimaru ◽  
Seiichiro Tateishi ◽  
Tomohisa Nagata ◽  
Mayumi Tsuji ◽  
...  
Keyword(s):  
Socioeconomic Status ◽  
Treatment Interruption ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Japanese Workers

scholarly journals Sociodemographic and lifestyle correlates of exclusive breastfeeding practices among mothers on antiretroviral therapy in the Eastern Cape, South Africa

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Daniel Ter Goon ◽  
Anthony Idowu Ajayi ◽  
Oladele Vincent Adeniyi
Keyword(s):  
South Africa ◽  
Antiretroviral Therapy ◽  
Exclusive Breastfeeding ◽  
Hiv Transmission ◽  
Cross Sectional Study ◽  
Sub Saharan Africa ◽  
Eastern Cape ◽  
Cross Sectional ◽  
Factors Associated ◽  
Breastfeeding Practice

Abstract Background Exclusive breastfeeding (EBF) is associated with a reduction of postnatal HIV transmission and optimal infant growth. Given that the factors influencing exclusive breastfeeding are multi-factorial and context-specific, we examined the prevalence and factors associated with exclusive breastfeeding practice in the first 6 months among mothers on antiretroviral therapy in the Eastern Cape, South Africa. Methods This was a cross-sectional study conducted between January to May 2018, on 469 parturient women enlisted in the prevention of mother-to-child HIV transmission cohort study in the Eastern Cape. Mothers were asked to recall whether they breastfed their infant exclusively with breast milk from birth and if so, to state how long they did. We collected relevant sociodemographic, lifestyle, and maternal information by interview. Bivariate and multivariable logistic regression analyses were fitted to determine the sociodemographic and lifestyle factors associated with exclusive breastfeeding practice. Results The prevalence of six-month exclusive breastfeeding, measured since birth, was 32.0%. E Exclusive breastfeeding’s prevalence was significantly higher among married women (36.8%), unemployed women (36.6%), non-smokers (32.7%), and those who never drank alcohol (37.0%). Unemployed women (adjusted odds ratio [AOR] 1.66, 95% Confidence Interval [CI] 1.08–2.56) and those with grade 12 or less level of education (AOR 2.76, 95% CI 1.02–7.49) had a higher likelihood of practising EBF for 6 months since birth while mothers who consumed alcohol (AOR 0.54, 95% CI 0.34–0.85) were less likely to practice EBF for 6 months. Conclusions The prevalence of six-month exclusive breastfeeding in the study, although comparable with sub-Saharan Africa and worldwide prevalence, remains suboptimal. Advocacy campaigns on EBF must target alcohol cessation and the creation of a favourable workplace environment for lactating mothers.

scholarly journals Empty shelves: selected essential medicines stockouts in South Africa

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
L Wolvaardt ◽  
R Nemuntandani ◽  
I Kamungoma-Dada
Keyword(s):  
South Africa ◽  
Urban Areas ◽  
Descriptive Analysis ◽  
Secondary Data ◽  
Treatment Interruption ◽  
Cross Sectional Study ◽  
Essential Medicines ◽  
Chi Square ◽  
Cross Sectional ◽  
Antiretroviral Medication

Abstract Background Access to essential medicines in South Africa has been compromised by stockouts in health facilities. This study describes the occurrence of stockouts for a selection of essential medicines. Methods This cross-sectional study used secondary data retrieved from the Stop Stock Outs Project (SSP). A descriptive analysis was conducted on data from the 2013-2015 SSP case management database of routinely reported stockouts. Chi square tests of independence was conducted on data from the SSP 2015 annual telephonic survey to investigate associations between the occurrence of stockouts, the level of health facility and the type of health professional. Results 231 facilities reported 609 stockouts. Antiretroviral medication had the most stockout reports (78%; n = 475/609), followed by anti-infectives (17.1%; n = 104/609) and tuberculosis medication (4.9%; n = 30/609). The highest number of stockout reports were received from Gauteng province and the majority (71.09%; n = 150/211) of facilities reporting stockouts were in urban areas. There were more stockouts at ambulatory, rather than inpatient care, facilities however, this was not statistically significant. Conclusions This study confirms that South Africa experiences medicine stockouts for many of the essential medicines, with antiretroviral medication being the category most affected. The stockouts vary between provinces and the urban-rural divide but are an equal threat to both ambulatory and inpatient facilities. Key messages The pattern of stockouts experienced over a three-year period suggest that stockouts are ‘normal’ despite the substantive effects of treatment interruption – especially patients with HIV and/or TB. Antiretroviral therapy is at risk as a result of stockouts.

scholarly journals Symptoms of common mental disorders and adherence to antiretroviral therapy among adults living with HIV in rural Zimbabwe: a cross-sectional study

BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e049824
Author(s):  
Andreas D Haas ◽  
Cordelia Kunzekwenyika ◽  
Stefanie Hossmann ◽  
Josphat Manzero ◽  
Janneke van Dijk ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Suicidal Ideation ◽  
Mental Disorders ◽  
Common Mental Disorders ◽  
Cross Sectional Study ◽  
People Living With Hiv ◽  
Art Adherence ◽  
Sectional Study ◽  
Cross Sectional ◽  
Living With Hiv

ObjectivesTo examine the proportion of people living with HIV who screen positive for common mental disorders (CMD) and the associations between CMD and self-reported adherence to antiretroviral therapy (ART).SettingSixteen government-funded health facilities in the rural Bikita district of Zimbabwe.DesignCross-sectional study.ParticipantsHIV-positive non-pregnant adults, aged 18 years or older, who lived in Bikita district and had received ART for at least 6 months.Outcome measuresThe primary outcome was the proportion of participants screening positive for CMD defined as a Shona Symptoms Questionnaire score of 9 or greater. Secondary outcomes were the proportion of participants reporting suicidal ideation, perceptual symptoms and suboptimal ART adherence and adjusted prevalence ratios (aPR) for factors associated with CMD, suicidal ideation, perceptual symptoms and suboptimal ART adherence.ResultsOut of 3480 adults, 18.8% (95% CI 14.8% to 23.7%) screened positive for CMD, 2.7% (95% CI 1.5% to 4.7%) reported suicidal ideations, and 1.5% (95% CI 0.9% to 2.6%) reported perceptual symptoms. Positive CMD screens were more common in women (aPR 1.67, 95% CI 1.19 to 2.35) than in men and were more common in adults aged 40–49 years (aPR 1.47, 95% CI 1.16 to 1.85) or aged 50–59 years (aPR 1.51, 95% CI 1.05 to 2.17) than in those 60 years or older. Positive CMD screen was associated with suboptimal adherence (aPR 1.53; 95% CI 1.37 to 1.70).ConclusionsA substantial proportion of people living with HIV in rural Zimbabwe are affected by CMD. There is a need to integrate mental health services and HIV programmes in rural Zimbabwe.Trial registration numberNCT03704805.

scholarly journals Under-five malnutrition among Palestine refugee children living in camps in Jordan: a mixed-methods study

2021 ◽  
Vol 6 (8) ◽  
pp. e005577
Author(s):  
Nada AbuKishk ◽  
Hannah Gilbert ◽  
Akihiro Seita ◽  
Joia Mukherjee ◽  
Peter J Rohloff
Keyword(s):  
Food Insecurity ◽  
Cross Sectional Study ◽  
Refugee Children ◽  
Structural Barriers ◽  
Cross Sectional ◽  
Economic Rights ◽  
Significant Difference ◽  
Primary Healthcare Provider ◽  
Children's Caregivers ◽  
Income Insecurity

BackgroundJordan hosts the largest Palestine refugee population in the world. The United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) is the primary healthcare provider for Palestine refugees. To better inform UNRWA’s health programme, we conducted this study to assess the prevalence and determinants of malnutrition among Palestine refugee children in Jordan and to analyse caregiver perceptions of food insecurity and structural barriers to accessing food.MethodsA cross-sectional study was conducted with a randomly selected sample of 405 households, for children under 5 years old in two refugee camps in Jordan, Jerash and Souf. Sociodemographic, food insecurity, diet quality and child anthropometric data were collected. Also, twenty in-depth interviews were conducted with children’s caregivers, along with two focus group discussions with UNRWA staff.ResultsOut of the 367 participants, the prevalence of stunting was 23.8% in Jerash and 20.4% in Souf (p=0.46), and overweight was 18.2% versus 7.1%, respectively (p=0.008). However, high food insecurity in Jerash was 45.7% and 26.5% in Souf (p=0.001), with no significant difference after multivariable adjustment. Qualitative perspectives saw food insecurity and low-quality children’s diets as largely mediated by job and income insecurity, especially marked in Jerash due to the lack of Jordanian citizenship.ConclusionWe found a moderate-to-high prevalence of stunting and overweight levels among Palestine refugee children, which are three times higher than the 2012 Demographic and Health Survey data for Jordanian non-refugee children. High rates of household food insecurity were closely tied to households’ lack of essential civil and economic rights. We call for international collective efforts to expand economic livelihoods for Palestine refugees and to support UNRWA’s ongoing operations.

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