Belete Gelaw1, Getasew Mulatu2, Getasew Tesfa2, Chalie Marew3, Bogale Chekole4, Animut Alebel5,6. 1. School of Nursing, College of Medicine and Health Sciences, Wolaita Sodo University, Sodo, Ethiopia. beletegz12@gmail.com. 2. College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia. 3. College of Medicine and Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia. 4. College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia. 5. College of Health Science, Debre Markos University, Debre Markos, Ethiopia. 6. School of Public Health, Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia.
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.
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-infectedchildren 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.
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