Correlating Antiretroviral Therapy Adherence and Detection of HIV Viral Loads at Chitipa District Hospital
AbstractHIV infection remains an epidemic threat around the world mostly prevalent in developing countries especially in sub- Sahara African region where many cultural practices and beliefs aggravate the transmission of HIV/AIDS. Poor Antiretroviral therapy (ART) adherence remains a big challenge leading to persistence detection of high HIV viral load results which deteriorate PLHIV health through lowering immunity . This study aimed to determine the correlation of ART adherence with high detection of viral load levels among HIV patients receiving ART at Umoyo ART clinic (Chitipa DHO) in Chitipa district. A retrospective study design using PLHIV records, on HIV viral load results in viral register and ART adherence percentage (based on number of days missed to collect ARV drugs) using Electronic Medical Records (EMR) system between January, 2018 and December, 2018. There were 3890 patients registered alive on ART but 2835 patients had their viral load results in register. Therefore, 351 sample records were extracted using systematic sampling technique and analysed using statistical package for social sciences (SPSS) version 20. The findings showed that 37.7% (n=131) of HIV patients in the study had detectable viral load after a duration of over six months on ART and more experienced in 80/200 (42%) of patients with good adherence. However, poor ART adherence (˂95%) more prevalent in men, youths and HIV patients less than five years on ART. Pearson’s Chi square test indicated a statistical significant on correlation between age and ART adherence as well as ART adherence and HIV viral load results (p<0.05). On the other hand, gender and duration on ART were not significant to ART adherence level. Eventually, it is recommended more ART clerks should be recruited so that any HIV individual initiated on ART should intensively counselled on poor ART adherence which may lead to development of HIV drug resistance strains that need expensive second and third line regimen ARV drugs.
MOH. Malawi integrated guideline for providing health services. 1st Ed. Lilongwe, Malawi: Department for HIV and AIDS, 2011.
A. Amberbir, K. Woldemichael, S. Gatechews, B. Girma and K. Deribe. (2008, Jul.). ''predicators of adherence of antiretroviral therapy among HIV -infected persons: Prospective study in Southwest Ethiopia". BMC Public Health. [on- line]. vol. 8. p. 265. Available: http://www.biomedcentral.com/1471-2458-265. [Nov. 25, 2018].
GBD 2015 collaborators. "Estimates of global, region and national incidence, prevailance and mortality of HIV 1980-2015 : The global burden of disease study 2015." The Lancet of HIV, pp. 361-87, Aug, 2016.
J. Dorward, J. Quame-Amaglo, N. Garrent, N. Samsunder, H. Ngobese, M. Ngomane, & P. K. Drain. (2017, Aug.). "protocal for a randomised controlled implementation trial of point -of -care viral load testing and task shifting: the simplified HIV treatment and monitoring (STREAM) study". BMJ open [on-line]. vol.7, pp, 1-7. available: doi:10.1136/bmjopen-2017-017507 [Nov.13, 2018].
WHO. HIV /AIDS programme, WHO HIV drug resistance report 2012. Geneva, Switzerland: WHO press, 2012.
A. Hardon, H. Irunde, J. Kglatwane, J. Kinsman, A. Nakiyemba, D. Akurut, & J. Maridadi. (2010, Sept.). "Hunger, Waiting time and transport costs : time to confront challenges to Antiretroviral therapy in Africa" HAL archives-ouvertes. [on- line]. 19 (5), pp. 658-65. available: http://mc.manuscriptcentral.com/ac-phm.vcy [Mar. 4, 2019].
A. D. Harries, R. Zachariah, J. J. Van Oosterhout, S. D. Reid, M. C. Hosseinipour, & K. Kamoto. (2010, Jan.). "Diagnosis and management of antiretroviral -therapy failure in resource -limited settings in Sub-SAhara African: Callenges and prospectives." Lancet infectious diseases. [on- line]. 10(1). pp. 60-5. Available: doi: 10.1016/S1473-3099(09)70321-4. [Jan. 23, 2019].
R. L. Hamers. Drug resistance HIV-1 in Sub- Sahara Africa: Clinical Pulibc health studies. Amsterdam, Netherlands, 2013, pp.15-21.
E. Gardner, M. Mc Lees, J. Steiner C. Rio, & W. Burman. "Spectrum of Engagement in HIV care and its relevance to Test -and -treat Strategies for prevention of HIV infection." Journal of clinical infectious diseases, 52 (6), pp. 793-800, Jan. 2011.
WHO. Antiretroviral therapy for HIV infection in adults and adolescents , recommendations for a Public Health Approach, 2010 revision. Geneva, Switzerland: World Health Organisation, 2010.
K.C. Sigaloff, R. L. Hamers, C. L. Wallis, C. Kityo, M. Siwale, P. Ive, . . . M. Wellington. "Unnecessary Antiretroviral treatment switches and accumulation of HIV resistance mutation, two arguments for vira load monitoring in Africa." Journal of Acquired Immune Deficiency Syndrome, 58 (1), pp. 23-31, Feb. 2011.
MOH. Ministry of Health and population services, Malawi clinical HIV guidelines 2018. Lilongwe, Malawi: Department for HIV and AIDS -MOH, 2018, pp. 45-76.
M. Cauldbeck, C. O'Connor, M. O'Connor, J. Saunders, B. Rao, V. Mallesh, . . . G. Mamtha. (2009, Apr.). ''Adherence to antiretroviral therapy among HIV patients at Bangalore, India." AIDS research and therapy. [on- line], 6(7). Available: http: www.aidsrestherapy.com/contents/6/1/7. [Nov. 24, 2018].
B. A. Forbes, D. F. Sahm, & A. S. Weissfeld. Bailey and Scott`s Diagnostic microbiology. 12th Ed. Cannada, USA: Mosby. 2009, pp. 660-840.
W.H.O. Consolidated guideline on the use of antiretroviral drugs for treating and preventing HIV infection recommendations for a public health approach. Geneva 27, Switzerland: WHO press, 2016, pp. 243-58.
Teira, Vidal, Munoz-Sanchez, Geijo, Viciana, Ribera, . . . Martinez. (2017, Mar.). "Very low level viraemia and risk of virological failure in a treated HIV-1-infected patients." VACH STUDY GROUP. [on- line]. 18(3), pp.196-203. Available: doi: 10.1111/hiv.12413. [Jan. 23, 2018].
Malawi/ AVERT. (2018, Dec. 10.). "HIV and AIDS in Malawi." Internet: www.avert.org/professionals/HIV-around -world-Sub- Sahara-Africa/Malawi, [ Jan. 21, 2019].
C. R. Kothari. Research methodology. Methods and techniques. Daryanganji, New Delhi: New age international, 2004.
V. Agrasula. The adoption of green dentistry among dentists in Thailand. Ministry of public health, Thailand, 2013.
M. Mugavero, K. Amico, A. Westfall, H. Crane, A. Zinski, J. Willig & M. Saag. (2012, Jan.). "Early retention in HIV Care and viral load suppression: implications for a test and treat approach to HIV prevention." Journal Acquired Immune Deficiency Syndrome, [on- line]. 59(1), pp. 86-93. Available: doi: 10.1097/QAI.0b013e318236f7d2. [Dec. 18, 2018].
K. C. Sigaloff, R. L Hamers, C. L. Wallis, C. Kityo, M. Siwale, P. Ive, . . . M. Wellington. "Second-line antiretroviral treatment successfully re-supresses drug resistant HIV-1 after first -line failure: Prospective cohort in Sub -Sahara Africa." Journal of Infectious Diseases, Mar. 2012.
J. Denison, O. Koole, S. Tsui, J. Menten, K. Tropey, E. Praag, . .A.F. Auld. (2015, Jun.). "Incomplete adherence among treatment -experienced adultson antiretroviral therapy in Tanzania, Uganda and Zambia."Journal on AIDS. [on- line]. 29(3), pp. 361-71. Available: DOI:10.1097/QAD.0000000000000543. [Mar. 04,2019].
J. E. Haberer, A. Cook, A. S. Walker, M. Nga`ambi, A. Ferrier, V. Mulenga, . . . M. Thomason. (2011, Apr.). "Excellent adherence to Antiretrovirals HIV + Zambians children is compromised by disrupted routine, HIV nondisclosure, and paradoxical income effects." PLoS ONE, [on- line]. 6(4). Available: https://doi.org/10.1371/journal.pone.0018505. [Dec. 14, 2018].
L. Lynen, S. An, O. Koole, S. Ros, P. De Munter & R. Colebunders. "An algorithm to optimize viral load testing in HIV -positive patients with suspected of first - line antiretroviral therapy failure in Cambodia." JAIDS journal of Aquired Immune Deficiency Syndrome, 52 (1), pp 40-8, Sept. 2009.
S. M. McCluskey, Y. Boum, N. Musinguzi, J. N. Martin, P. W. Hunt, M. J. Siedner, & J. E. Haberer.(2017, Oct.). "A brief report: Appraising viral load thresholds and adherence support recommendations in the World Health Organisation guidelines for detection and management of viralogic failure." Journal of Acquired Immune Deficiency Syndrome. [on- line]. 76(2), pp. 183-7.Available: doi: 10.1097/QAI.0000000000001479. [Jan. 20, 2019].
D. Maman, B. Chilima, C. Masiku, A. Ayouba, S. Masson, E. Szumilin, M. Peeters, N. Ford, A. Heinzelmann,
B. Riche & J. Etard. (Feb. 2016). “Closer to 90–90–90. The cascade of care after 10 years of ART scale-up in rural Malawi: a population study.” J Int AIDS Soc. [on- line]. Available: doi: 10.7448/IAS.19.1.20673. [Nov. 11, 2018].
M. Kim, A. Mazenga, X. Yu, S. Ahmed, M. Paul, P. Kazembe & E. Abrams. (2017, Mar.). "High self reported non Adherence to antiretroviral therapy amongst adolescents living with HIV in Malawi : Barriers and associated factors." Journal of the International AIDS Society. [on- line]. Vol. 20. Available: http://www.jiasociety.org/index.php/jias/article/view/21437. [Dec. 05, 2018].
L. Li, S. Lee, Y. Wen, C. Lin, D. Wan, & C. Jiraphongsa. (2010, Jun.) "Antiretroviral therapy adherence among patients living with HIV/AIDS in Thailand." Nursing and Health sciences. [on- line]. 12(2), pp. 212-20. Available: DOI: 10.1111/j.1442-2018.2010.00521.x. [Mar. 04, 2019].
S. Wasti, P. Simkhada, J. Randall, J. Freeman, & E. Teijlingen. (2012, Apr.). "Factors influencing adherence to antiretroviral treatment in Nepa: A mixed - Methods study." PLoS ONE. 7(5). Available: doi:10.1371/journal.pone.0035547. [Dec. 04, 2018].
V. Bhat, M. Ramburuth, M. Singh, O. Titi, A. Anthony, L. Chiya . . . M.E. Mofoka. "Factors associated with poor adherence to antiretroviral therapy in patients attendinga rural health centre in South Africa". European Journal of clinical microbiology and infectious diseases, 29(8), pp. 947-53, 2010.
S. Chen, J. K. Yu, A. D. Harries, C. N. Bong, R. Kalola- Dzimadzi, T. S. Tok & J. Wang. (2008, Mar.10). “Increased mortality of male adults with AIDS related to poor compliance to antiretroviral therapy in Malawi.” Tropical Medicine & International Health [on- line]. Available:
https://doi.org/10.1111/j.1365-3156.2008.02029.x [Nov. 23, 2018].
C. Protopopescu, B. Spire, M. P. Carrieri, C. Leport, F. Raffi, P. Roux, . . . P. Dellamonica. (2009, Jul.). "Factors associated with non-adherence to long term high antiretroviral therapy: a 10 year follow -up analysis with correction for the bias induced by missing data." Journal of Antimicrobial Chemotherapy. [on- line]. vol.64, pp. 599-606. Available: doi:10.1093/jac/dkp232. [Nov. 23, 2018].
E. Kang, D. A. Delzell, M. Chhabra & P. Oberdorfer. "Factors associated with high rates of antiretroviral medication adherence among young living with perinatal HIV in Thailand." International Journal of STD AIDS, 26 (8), pp. 334-41, Mar. 2015.
Copyright (c) 2019 American Scientific Research Journal for Engineering, Technology, and Sciences (ASRJETS)
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Authors who submit papers with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).
- By submitting the processing fee, it is understood that the author has agreed to our terms and conditions which may change from time to time without any notice.
- It should be clear for authors that the Editor In Chief is responsible for the final decision about the submitted papers; have the right to accept\reject any paper. The Editor In Chief will choose any option from the following to review the submitted papers:A. send the paper to two reviewers, if the results were negative by one reviewer and positive by the other one; then the editor may send the paper for third reviewer or he take immediately the final decision by accepting\rejecting the paper. The Editor In Chief will ask the selected reviewers to present the results within 7 working days, if they were unable to complete the review within the agreed period then the editor have the right to resend the papers for new reviewers using the same procedure. If the Editor In Chief was not able to find suitable reviewers for certain papers then he have the right to accept\reject the paper.B. sends the paper to a selected editorial board member(s). C. the Editor In Chief himself evaluates the paper.
- Author will take the responsibility what so ever if any copyright infringement or any other violation of any law is done by publishing the research work by the author
- Before publishing, author must check whether this journal is accepted by his employer, or any authority he intends to submit his research work. we will not be responsible in this matter.
- If at any time, due to any legal reason, if the journal stops accepting manuscripts or could not publish already accepted manuscripts, we will have the right to cancel all or any one of the manuscripts without any compensation or returning back any kind of processing cost.
- The cost covered in the publication fees is only for online publication of a single manuscript.