Level of non-adherence and associated factors among children on antiretroviral therapy in public hospitals of South Wollo Zone, Northeast Ethiopia

BackgroundPoor adherence to antiretroviral therapy (ART) occurs when an individual with Human Immune deficiency Virus does not follow the prescribed treatment regimen correctly. This includes missing doses, not taking medication as scheduled, taking medication inconsistently or irregularly, and fail...

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Main Authors: Endalk Birrie Wondifraw, Fekadeselassie Belege Getaneh, Muluken Amare, Setegn Mihret, Gebeyaw Biset, Birhanu Desu Tefera, Mulusew Zeleke, Fuad Ahmed, Ermias Sisay Chanie
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Language:English
Published: Frontiers Media S.A. 2025-02-01
Series:Frontiers in Public Health
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Online Access:https://www.frontiersin.org/articles/10.3389/fpubh.2025.1522959/full
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author Endalk Birrie Wondifraw
Fekadeselassie Belege Getaneh
Muluken Amare
Setegn Mihret
Gebeyaw Biset
Birhanu Desu Tefera
Mulusew Zeleke
Fuad Ahmed
Ermias Sisay Chanie
author_facet Endalk Birrie Wondifraw
Fekadeselassie Belege Getaneh
Muluken Amare
Setegn Mihret
Gebeyaw Biset
Birhanu Desu Tefera
Mulusew Zeleke
Fuad Ahmed
Ermias Sisay Chanie
author_sort Endalk Birrie Wondifraw
collection DOAJ
description BackgroundPoor adherence to antiretroviral therapy (ART) occurs when an individual with Human Immune deficiency Virus does not follow the prescribed treatment regimen correctly. This includes missing doses, not taking medication as scheduled, taking medication inconsistently or irregularly, and failing to adhere to specific instructions. The lack of adherence to antiretroviral therapy (ART) among children is a noteworthy issue that necessitates attention. The study aims to determine the level of non-adherence to antiretroviral therapy (ART) and its associated factors in children receiving ART in public hospitals in the South Wollo Zone.MethodsA multi-center cross-sectional study was conducted among children receiving antiretroviral therapy at South Wollo Zone public hospitals. A single population proportion formula was used to determine the required sample size. A computer-generated simple random sampling method was employed to select the participants. The tools used to assess adherence for all participants were viral load monitoring, Self-reporting, Pill counts, and Pharmacy refill records. Data were collected through face-to-face interviews, and reviewing patients’ documents using a structured checklist. The data were entered into Epi Data version 4.1 and analyzed using STATA 17. Binary logistic regression was employed to evaluate the relationship between the factors and the outcome variable. Variables were considered significant if the p-value was less than 0.05.ResultOf 291 participants, 286 were involved in the study, making the response rate 98.3%. The mean age of the participants was 7.8 years old (±3.64 SD), and half of the 146 children (51%) were male. The overall proportion of ART non-adherence was 24.1% (95% CI: 19.2–29.0%). Positive TB status (Adjusted odd ratio (AOR) = 4.10, 95% CI: 1.90–8.88), diagnostic status not disclosed (AOR = 2.69, 95% CI: 1.43–5.00), and poor caregiver knowledge (AOR = 2.18, 95% CI: 1.04–4.56) were significantly associated with poor adherence.ConclusionAccording to the current study, the level of non-adherence to antiretroviral therapy remains high compared to the targets set by the United Nations Joint Program on HIV/AIDS (UNAIDS) Project 95-95-95. TB co-infection, undisclosed diagnostic status, and poor caregiver knowledge were found to be significantly associated with non-adherence. Before and throughout ART, healthcare providers should provide intense and ongoing counseling to children and their caregivers.
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spelling doaj-art-9e43cf7567894e7ea6e8dd5157a3b1332025-08-20T02:04:17ZengFrontiers Media S.A.Frontiers in Public Health2296-25652025-02-011310.3389/fpubh.2025.15229591522959Level of non-adherence and associated factors among children on antiretroviral therapy in public hospitals of South Wollo Zone, Northeast EthiopiaEndalk Birrie Wondifraw0Fekadeselassie Belege Getaneh1Muluken Amare2Setegn Mihret3Gebeyaw Biset4Birhanu Desu Tefera5Mulusew Zeleke6Fuad Ahmed7Ermias Sisay Chanie8Department of Pediatric and Child Health Nursing, College of Medicine and Health Science, Wollo University, Dessie, EthiopiaDepartment of Pediatric and Child Health Nursing, College of Medicine and Health Science, Wollo University, Dessie, EthiopiaDepartment of Pediatric and Child Health Nursing, College of Medicine and Health Science, Wollo University, Dessie, EthiopiaDepartment of Pediatric and Child Health Nursing, College of Medicine and Health Science, Wollo University, Dessie, EthiopiaDepartment of Pediatric and Child Health Nursing, College of Medicine and Health Science, Wollo University, Dessie, EthiopiaDepartment of Emergency and Critical Care Nursing, College of Medicine and Health Science, Wollo University, Dessie, EthiopiaDepartment of Surgical Nursing, College of Medicine and Health Science, Wollo University, Dessie, EthiopiaDepartment of Pediatrics and Child Health Nursing, College of Medicine and Health Science, Debre Berhan University, Debre Berhan, EthiopiaDepartment of Pediatrics and Child Health Nursing, College of Health Science, Debre Tabor University, Debre Tabor, EthiopiaBackgroundPoor adherence to antiretroviral therapy (ART) occurs when an individual with Human Immune deficiency Virus does not follow the prescribed treatment regimen correctly. This includes missing doses, not taking medication as scheduled, taking medication inconsistently or irregularly, and failing to adhere to specific instructions. The lack of adherence to antiretroviral therapy (ART) among children is a noteworthy issue that necessitates attention. The study aims to determine the level of non-adherence to antiretroviral therapy (ART) and its associated factors in children receiving ART in public hospitals in the South Wollo Zone.MethodsA multi-center cross-sectional study was conducted among children receiving antiretroviral therapy at South Wollo Zone public hospitals. A single population proportion formula was used to determine the required sample size. A computer-generated simple random sampling method was employed to select the participants. The tools used to assess adherence for all participants were viral load monitoring, Self-reporting, Pill counts, and Pharmacy refill records. Data were collected through face-to-face interviews, and reviewing patients’ documents using a structured checklist. The data were entered into Epi Data version 4.1 and analyzed using STATA 17. Binary logistic regression was employed to evaluate the relationship between the factors and the outcome variable. Variables were considered significant if the p-value was less than 0.05.ResultOf 291 participants, 286 were involved in the study, making the response rate 98.3%. The mean age of the participants was 7.8 years old (±3.64 SD), and half of the 146 children (51%) were male. The overall proportion of ART non-adherence was 24.1% (95% CI: 19.2–29.0%). Positive TB status (Adjusted odd ratio (AOR) = 4.10, 95% CI: 1.90–8.88), diagnostic status not disclosed (AOR = 2.69, 95% CI: 1.43–5.00), and poor caregiver knowledge (AOR = 2.18, 95% CI: 1.04–4.56) were significantly associated with poor adherence.ConclusionAccording to the current study, the level of non-adherence to antiretroviral therapy remains high compared to the targets set by the United Nations Joint Program on HIV/AIDS (UNAIDS) Project 95-95-95. TB co-infection, undisclosed diagnostic status, and poor caregiver knowledge were found to be significantly associated with non-adherence. Before and throughout ART, healthcare providers should provide intense and ongoing counseling to children and their caregivers.https://www.frontiersin.org/articles/10.3389/fpubh.2025.1522959/fullnon-adherenceantiretroviral therapy (ART)childrenSouth Wollo ZoneEthiopia
spellingShingle Endalk Birrie Wondifraw
Fekadeselassie Belege Getaneh
Muluken Amare
Setegn Mihret
Gebeyaw Biset
Birhanu Desu Tefera
Mulusew Zeleke
Fuad Ahmed
Ermias Sisay Chanie
Level of non-adherence and associated factors among children on antiretroviral therapy in public hospitals of South Wollo Zone, Northeast Ethiopia
Frontiers in Public Health
non-adherence
antiretroviral therapy (ART)
children
South Wollo Zone
Ethiopia
title Level of non-adherence and associated factors among children on antiretroviral therapy in public hospitals of South Wollo Zone, Northeast Ethiopia
title_full Level of non-adherence and associated factors among children on antiretroviral therapy in public hospitals of South Wollo Zone, Northeast Ethiopia
title_fullStr Level of non-adherence and associated factors among children on antiretroviral therapy in public hospitals of South Wollo Zone, Northeast Ethiopia
title_full_unstemmed Level of non-adherence and associated factors among children on antiretroviral therapy in public hospitals of South Wollo Zone, Northeast Ethiopia
title_short Level of non-adherence and associated factors among children on antiretroviral therapy in public hospitals of South Wollo Zone, Northeast Ethiopia
title_sort level of non adherence and associated factors among children on antiretroviral therapy in public hospitals of south wollo zone northeast ethiopia
topic non-adherence
antiretroviral therapy (ART)
children
South Wollo Zone
Ethiopia
url https://www.frontiersin.org/articles/10.3389/fpubh.2025.1522959/full
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