Adherence to antiretroviral therapy among HIV-infected children receiving care at Kilimanjaro Christian Medical Centre (KCMC), Northern Tanzania: A cross- sectional analytical study

Introduction: Paediatric adherence to Highly Active Antiretroviral Therapy (HAART) is a dynamic  process involving many factors. Adherence for the majority on therapy matters to prevent failure of 1st and 2st line therapy. The purpose of this study was to determine the rate of adherence to antiretroviral therapy in HIV infected children. Methods: We conducted a cross-sectional hospital based analytical study, from October 2011 to April 2012. HIV-infected children aged 2 to 17 years who had been on treatment for at least six months were  enrolled. Data were collected by a standard questionnaire. Two-day self-report, one month self-recall  report, and pill count were used to assess adherence. Results: One hundred and eighty three respondents participated in this research. There were 92 (51%)  males and 91 (49%) females. Only 45 (24.6%) had good adherence to their drug regimen when subjected to all three methods of assessment. Males were more adherent to ART than females (OR= 2.26, CI  1.05-4.87, p=0.04). Adherence was worse among children who developed ART side effects (OR= 0.19, CI 0.07- 0.56;p=0.01), could not attend clinic on regular basis (OR= 3.4, CI 1.60- 7.36, p=0.01) and missed drug doses in the six months period prior to interview (OR= 0.40, CI 0.18- 0.82, p= 0.01). Conclusion: Only 24.6% of paediatric patients had good adherence to ART when subjected to all three  measures.Drug sideeffects, missing drug doses in the six months period prior to study start, monthly income and affording transportation to the clinicwere strong predictors of adherence.Key words: HAART, Adherence, Tanzania, HIV, childre

Seroprevalence, risk factors and comorbidities associated with Helicobacter pylori infection amongst children receiving care at Kilimanjaro Christian Medical Center

Background: Helicobacter pylori frequently causes gastritis and peptic ulcers, and affected children are at risk of developing gastric carcinoma later in adulthood. Methods: This was a Hospital based cross sectional study. A total of 200 children aged 6 months to 14 years were enrolled. Study subjects were tested for H. pylori using a standard serology rapid test measuring immunoglobulin G for H. pylori. For risk factors, Chi-square tests were used to test for association and then, odds ratios and their corresponding 95% confidence intervals and p-values were computed using logistic regression. Results: The overall seroprevalence of H. pylori was 11.5%. The following factors were associated with H. pylori infection: Age group above 10 years, keeping a dog and household size. The independent predictors of H. pylori were: Fathers\u2019 occupation, keeping a dog, indoor tap water, age group, household size and diabetes mellitus type 1.. Conclusion: The seroprevalence of H. pylori antibodies was lower compared to most developing countries. Keeping a dog, household size, indoor tap water, fathers\u2019 occupation and diabetes mellitus type 1 were found to be independent predictors of presence of H. pylori antibodies

Nevirapine- Versus Lopinavir/Ritonavir-Based Antiretroviral Therapy in HIV-Infected Infants and Young Children: Long-term Follow-up of the IMPAACT P1060 Randomized Trial

Background. The International Maternal Pediatric Adolescent AIDS Clinical Trials Network (IMPAACT) P1060 study demonstrated short-term superiority of lopinavir/ritonavir (LPV/r) over nevirapine (NVP) in antiretroviral therapy (ART), regardless of prior NVP exposure. However, NVP-based ART had a marginal benefit in CD4 percentage (CD4%) and growth. We compared 5-year outcomes from this clinical trial