Abstract: Both Human Immunodeficiency Virus (HIV) infection and Acquired Immunodeficiency Syndrome (AIDS) remain major public health problems in Ethiopia. Good adherence to antiretroviral therapy is necessary to achieve the best virological response, lower the risk of treatment failure and drug resistance, and reduce morbidity and mortality. There are many alterable factors known to affect the treatment adherence. In this regard, there have been very limited researches particularly in Adama. Therefore, this study was aimed to determine the adherence level and its associated factors among adult people living with HIV and attending their clinical care in Adama Hospital Medical College. A hospital based cross sectional study was conducted from October 1, 2016 - January 30, 2017 G. C in Adama Hospital Medical College among 190 PLWHA on ART. Systematic sampling method was used to select study participants. Data was collected by interviewing the clients and review of their medical records using structured questionnaire and checklist. Data entry and analysis was performed using SPSS for windows version 20.0. Descriptive statics was used to summarize socio-demographic and other variables. Bivariate and multivariate analysis was used to evaluate the association between dependent and independent variables. Level of adherence in the week before interview was 92.6. Patients whose initial ART regimen was TDF-3TC-NVP, were 8 times (COR=8.444 (1.678, 42.501)), chance of <95% adherence than patients those started ART with TDF-3TC-EFV regimen. Patients with opportunistic infection were about 8 times (COR=7.593 (2.196, 26.248)) chance of <95% adherence than their counter group respectively. Patients whose waiting time >30 minutes were 8 times (AOR=8.019 (1.161, 55.390)) chance of <95% adherence than their counter group. The level of adherence to ART was relatively higher when compared to others studies done in Ethiopia and other developing countries. But it was sub optimal to WHO adherence level (≥ 95%). The major reasons for missing doses were forgetfulness, away from home (travel) and lack of awareness. The level of adherence was significantly associated with variables like history of opportunistic infection, longer waiting time and starting treatment with TDF-3TC-NVP. This implicates further effort are still needed to push up the adherence to the level of WHO recommendation.Abstract: Both Human Immunodeficiency Virus (HIV) infection and Acquired Immunodeficiency Syndrome (AIDS) remain major public health problems in Ethiopia. Good adherence to antiretroviral therapy is necessary to achieve the best virological response, lower the risk of treatment failure and drug resistance, and reduce morbidity and mortality. There are many a...Show More
Abstract: Human immunodeficiency virus (HIV) causes acquired immune deficiency syndrome (AIDS), a pandemic causing millions of deaths each year. Management of HIV/AIDS patients rely on antiretroviral treatment (ART) to suppress viral replication and increase CD4+ T-lymphocytes levels and time to disease progression in order to enjoy health lives and reduce transmission of the virus. CD4+ count is an essential tool for initiating and monitoring of ART. CD4+ response depend on; environmental setting where treatment is being offered, individual and population characteristics including; adherence, age, gender, baseline CD4+ cell count and viral load and individuals Basal Metabolic Index (BMI), a measure of patient’s nutritional status. This study attempts to provide an updated and clear association of independent variables predicting patient’s CD4+ immune reconstitution. This was a retrospective longitudinal study of ART-naive, HIV-infected adults and adolescents initiated on standard first line ART regimen and their CD4+ response followed up for 18 months. Study population included adults and adolescents registered and initiated on standard first line ART regimen, as part of routine comprehensive care program of the Kenyan Government in conjunction with donor partners; USAID, ICAP and EGPAF at Masaba-North Sub-County PSC/CCC. Data obtained within the study period of four years; 2012 to 2015 was analyzed statistical using multilevel mixed effect linear models in STATA for BMI categories of CD4+ level intercept values and other variables coefficients and compared to their reference groups to obtain P values. Repeated measures of ANOVA were used to determine differences in CD4+ mean response between the four intervals of measurement. Results from the study indicate that BMI is an independent predictor of CD4+ lymphocytes immune reconstitution for patients on ART. Age, Gender, and Number of ART interruptions were statistically significant when other variables were accounted for in the model over the 18 months of follow up. BMI and WHO clinical stage were less statistically significant.Abstract: Human immunodeficiency virus (HIV) causes acquired immune deficiency syndrome (AIDS), a pandemic causing millions of deaths each year. Management of HIV/AIDS patients rely on antiretroviral treatment (ART) to suppress viral replication and increase CD4+ T-lymphocytes levels and time to disease progression in order to enjoy health lives and reduce t...Show More
