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Barriers and enablers of adherence to infant nevirapine prophylaxis against HIV 1 transmission among 6-week-old HIV exposed infants: A prospective cohort study in Northern Uganda.
Napyo, Agnes; Tylleskär, Thorkild; Mukunya, David; Tumuhamye, Josephine; Musaba, Milton W; Ojok Arach, Anna Agnes; Waako, Paul; Tumwine, James K; Ndeezi, Grace.
Afiliação
  • Napyo A; Department of Public Health, Faculty of Health Sciences, Busitema University, Mbale, Uganda.
  • Tylleskär T; Centre for International Health, University of Bergen, Bergen, Norway.
  • Mukunya D; Department of Paediatrics and Child Health, Makerere University, Kampala, Uganda.
  • Tumuhamye J; Centre for International Health, University of Bergen, Bergen, Norway.
  • Musaba MW; Centre for International Health, University of Bergen, Bergen, Norway.
  • Ojok Arach AA; Centre for International Health, University of Bergen, Bergen, Norway.
  • Waako P; Department of Public Health, Faculty of Health Sciences, Busitema University, Mbale, Uganda.
  • Tumwine JK; Department of Obstetrics and Gynaecology, Faculty of Health Sciences, Busitema University, Mbale, Uganda.
  • Ndeezi G; Department of Paediatrics and Child Health, Makerere University, Kampala, Uganda.
PLoS One ; 15(10): e0240529, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33057393
ABSTRACT

BACKGROUND:

Sub-optimal adherence to infant prophylaxis has been associated with mother-to-child-transmission of HIV. However, the factors associated have not been well characterised in different settings. This study describes barriers and enablers of adherence to infant prophylaxis among 6-week-old HIV exposed infants in Lira district, Northern Uganda.

METHODS:

This prospective cohort study was conducted from 2018-2020 at the PMTCT clinic at Lira Regional Referral Hospital and included 472 mother-infant pairs. HIV-infected pregnant women were recruited, followed up at delivery and 6 weeks postpartum. We used a structured questionnaire to obtain data on socio-demographic, reproductive-related, HIV-related characteristics and adherence. Data were analysed using Stata to estimate adjusted risk ratios using Poisson regression models to ascertain barriers and enablers of adherence to infant nevirapine prophylaxis.

RESULTS:

Barriers to infant adherence are maternal characteristics including younger age (≤20 years adjusted risk ratio (ARR) = 1.55; 95% CI 1.1-2.2), missing a viral load test during pregnancy (ARR 1.4; 95% CI 1.1-1.7) and not receiving nevirapine syrup for the baby after childbirth (ARR = 6.2; 95% CI 5.1-7.6). Enablers were having attained ≥14 years of schooling (ARR = 0.7; 95% CI 0.5-0.9), taking a nevirapine-based regimen (ARR = 0.6; 95% CI 0.4-0.9), long-term ART (≥ 60 months ARR = 0.75; 95% CI 0.6-0.9), accompanied by a husband to hospital during labour and childbirth (ARR = 0.5; 95% CI 0.4-0.7) and labour starting at night (ARR = 0.7; 95% CI 0.6-0.8). CONCLUSION AND

RECOMMENDATIONS:

Despite mothers receiving nevirapine syrup from the health workers for the infant, non-adherence rates still prevail at 14.8%. The health system needs to consider giving HIV infected pregnant women the nevirapine syrup before birth to avoid delays and non-adherence. There is need to pay particular attention to younger women and those who recently started ART.
Texto completo: Disponível Coleções: Bases de dados internacionais Contexto em Saúde: Agenda de Saúde Sustentável para as Américas Tema em saúde: Objetivo 3: Recursos humanos em saúde Base de dados: MEDLINE Tipo de estudo: Estudo de etiologia / Estudo observacional / Estudo prognóstico / Pesquisa qualitativa / Fatores de risco Idioma: Inglês Revista: PLoS One Assunto da revista: Ciência / Medicina Ano de publicação: 2020 Tipo de documento: Artigo País de afiliação: Uganda

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Texto completo: Disponível Coleções: Bases de dados internacionais Contexto em Saúde: Agenda de Saúde Sustentável para as Américas Tema em saúde: Objetivo 3: Recursos humanos em saúde Base de dados: MEDLINE Tipo de estudo: Estudo de etiologia / Estudo observacional / Estudo prognóstico / Pesquisa qualitativa / Fatores de risco Idioma: Inglês Revista: PLoS One Assunto da revista: Ciência / Medicina Ano de publicação: 2020 Tipo de documento: Artigo País de afiliação: Uganda