Adherence to antiretroviral therapy among HIV- infected under five children attending at municipal hospitals in Dar- es-salaam, Tanzania.

Abstract

Background: To reduce AIDS related mortality in children, adherence to antiretroviral treatment (ART) is critical. However, little is known about factors associated with ART adherence among children in Tanzania. The objective of this study therefore, was to assess the ART adherence among HIV infected under-fives in Dar es Salaam and identify factors associated with their adherence to ART. Methods: This was a cross sectional study conducted in three municipal hospitals of Mwananyamala, Amana and Temeke in Dar es Salaam region. A systematic random sampling method was used to select the caretakers/children from the daily appointment list obtained from the clinic until the sample size was reached. Caretakers were interviewed using a structured questionnaire. Data was entered into the computer using excel sheet and then analyzed using SPSS statistical software. Descriptive, bivariate analysis and multiple Logistic regression analyses were performed. Results: The study population comprised of HIV positive under-five children attending the three Municipal Hospitals. Out of the 172 under-five sampled, 77 (44.8%) were males. This study found that only a small proportion (35%) of children had an optimal ART adherence in the one month preceding the study. Majority of caretakers, 121 (70.4%) had adequate knowledge on HIV and adherence issues. Caretakers who were housewives were four-fold more likely to adhere (OR, 4.89, 95% CI, 2.08, 11.51) compared with children from caretakers who were businessmen or women. Receiving care from Amana municipal hospital and Mwananyamala municipal hospital was associated with lower rates of adherence compared to those from Temeke municipal hospital. Conclusions and recommendation: While the levels of ART adherence among under-five children in the three municipal hospitals were low, it was found that under-fives from the caretakers who were housewives had a significantly higher adherence rates compared to caretakers who were businessmen/women. Special interventions targeting caretakers who spend more time outside home are needed to increase adherence on ART for the under-fives.