Dissertation (MMED Pediatric and Child Health)
INTRODUCTION: With the antiretroviral therapy treat-all protocol among HIVinfected children and adolescents, monitoring of virological treatment failure and assessing the factors associated with virological treatment failure is mandatory in reducing morbidity, mortality and improving quality of life. This study aimed at determining prevalence and factors associated with virological treatment failure among children and adolescents on antiretroviral therapy.
METHODS: Cross-sectional facility-based study conducted in Dodoma Municipal from November 2018 to February 2019. Social and clinical factors were assessed, blood was tested for viral load and CD4 level and data were analyzed by SPSS version 25 using logistic regression.
RESULTS: Among 300 children and adolescents on antiretroviral therapy 102 (34%) had virological treatment failure. Independent factors associated with virological treatment failure were observed to be poor adherence (adjusted odds ratio [AOR]=3.221, 95% CI 1.867-5.558), Nevirapine-based antiretroviral therapy(adjusted odds ratio [AOR] =3.185, 95% CI 1.473-6.886), Tuberculosis infection(adjusted odds ratio [AOR] =8.881, 95% CI 2.012-39.20), not using Cotrimoxazole prophylaxis (adjusted odds ratio [AOR] =25.56, 95% CI3.15-27.55), non-parent care givers (adjusted odds ratio [AOR] =6.598, 95% CI1.146-37.995) and non-disclosure of HIV-positive status to others (adjusted odds ratio [AOR] =7.741, 95% CI 2.351-25.489).
CONCLUSION: About one third of participants had virological treatment failure. Nevirapine-based ART, poor ART adherence, Tuberculosis infection, not using Cotrimoxazole prophylaxis, having non-parents care givers and failure to disclose the HIV status to others were found to be independent factors associated with virological treatment failure among children and adolescents on antiretroviral therapy attending Care and Treatment Clinic in Dodoma Municipal. Comprehensive intensified adherence counseling and routine monitoring in children and adolescents on antiretroviral therapy is of essence.