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DC Field | Value | Language |
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dc.contributor.author | Vreeman, Rachel C. | - |
dc.contributor.author | Scanlon, Michael L. | - |
dc.contributor.author | Slaven, James E. | - |
dc.contributor.author | McAteer, Carole I . | - |
dc.contributor.author | Nyandiko, Winstone M. | - |
dc.date.accessioned | 2020-08-13T08:42:21Z | - |
dc.date.available | 2020-08-13T08:42:21Z | - |
dc.date.issued | 2019 | - |
dc.identifier.uri | https://doi.org/10.1002/jia2.25304 | - |
dc.identifier.uri | http://ir.mu.ac.ke:8080/jspui/handle/123456789/3421 | - |
dc.description.abstract | Introduction: There are few data on adherence and low-cost measurement tools for children living with HIV. We collected prospective data on adherence to antiretroviral therapy (ART) among a multinational cohort of children to evaluate an adherence questionnaire. Methods: We enrolled 319 children ages 0 to 16 years on ART in Kenya (n = 110), South Africa (n = 109) or Thailand (n = 100). Children were followed up for six months of adherence monitoring between March 2015 and August 2016 using Medication Event Monitoring Systems (MEMS â ) with at least one viral load measure. At month 3 and 6, children or their caregivers were administered a 10-item adherence questionnaire. Repeated measures analyses were used to com- pare responses on questionnaire items to external adherence criteria: MEMS â dichotomized adherence (≥90% of doses taken vs. <90%), 48-hour MEMS â treatment interruptions and viral suppression (<1000 copies/mL). Items associated with outcomes (p < 0.10) were coefficient-weighted to calculate a total adherence score, which was tested in multivariate regression against MEMS â and viral suppression outcomes. Odds ratios (OR) and 95% confidence intervals (95% CI) were calculated. Results: Mean child age was 11 years and 54% were female. Children from Thailand (median age 14 years) were significantly older compared to Kenya (10 years) and South Africa (10 years). Prevalence of viral suppression was 97% in Thailand, 81% in South Africa and 69% in Kenya, while the prevalence of MEMS â adherence ≥90% was 57% in Thailand, 58% in South Africa and 40% in Kenya. Across sites, child-reported adherence using the questionnaire was significantly associated with dichotomized MEMS â adherence (OR 1.8, 95% CI 1.4 to 2.4), 48-hour treatment interruptions (OR 0.41, 95% CI 0.3 to 0.6), and viral suppression (OR 3.4, 95% CI 1.7 to 6.7). We did find, however, that different cut-points for the adherence score may be con- text-specific. For example, MEMS â non-adherent children in Kenya had a lower adherence score (0.98) compared to South Africa (1.77) or Thailand (1.58). Conclusions: We found suboptimal adherence to ART was common by multiple measures in this multi-country cohort of children. The short-form questionnaire demonstrated reasonable validity to screen for non-adherence in these diverse settings | en_US |
dc.language.iso | en | en_US |
dc.publisher | JIAS | en_US |
dc.subject | Adherance measurement | en_US |
dc.subject | Antiretroviral therapy | en_US |
dc.title | Validation of a self‐report adherence measurement tool among a multinational cohort of children living with HIV in Kenya, South Africa and Thailand | en_US |
dc.type | Article | en_US |
Appears in Collections: | School of Medicine |
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