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Preventive treatment adherence and challenges in its effective implementation among HIV exposed children in the public hospitals in Ilubabor zone: Retrospective follow-up study

Dessalegn Nigatu

Introduction: Despite World health organization universal recommendation of Preventive Therapy, only 56% of pediatrics on ART receiving this intervention. The aim of this study was to determine the magnitude of Preventive Therapy and challenges in its effective implementation among HIV exposed children in Ilu Ababor zone public hospitals.

Materials: A facility based retrospective cohort study was used among 300 children’s’ reviewing records by standard structured questionnaires and interviewing their primary caregivers. Data were cleared and entered into Epi-info version 3.1 and exported into SPSS version 24 for further analysis and a binary logistic regression was used to investigate factors associated with uptake of Preventive Therapy. Variables with p-value <0.2 in bivariable analysis were entered into the multivariable analysis. Odds ratio with 95% confidence interval was estimated to show the strength of association and the p-value <0.05 was used to declare as statistical significance in the multivariable analysis.

Results: Out of 300 (293) records were reviewed with a response rate of 97.6%. Almost all of the respondents were female 279 (93%) also about half (48%) of the respondents were orthodox in religion and a few (3.4%) of them have had primary education. More than half the exposed infants’ age was b/n 13-18 months. Moreover, about 65.5% of guardians were well awared about preventive treatment.

The strongest independent predictors of poor adherence to Preventive Therapy are not able to read [OR=0.153 (0.027-0.863) P< 0.330], long procedure in getting the drug (OR=9.913[2.825, 34.731], p=<0.000), Shortage of drug availability [OR=9.91 (2.829-34.73), P< 0.000], missed dose greater than three doses [OR=2.69 (1.17-6.26), p=<0.022], Persistent diarrhoea [OR=4.324 (1.067-17.530), p=0.040] were associated with Preventive Therapy among HIV exposed children.

Conclusion: Preventive Therapy in study area was found to be relatively high and long procedure, shortage of preventive drug and persistent diarrhea were found to be significant predictors of Preventive Therapy, Hence, to avert this, accessing drugs, treating persistent diarrhea and decreasing waiting time were plays unfold role to increases uptake of Preventive Therapy.