Factors influencing anti-retroviral drug adherence in HIV infected children attending Kericho District Hospital, Kenya

Objective: To identify factors influencing anti-retroviral (ARV) drug adherence by HIV infected children aged 3 to 14 years attending Kericho District Hospital (KDH), Kenya.Design: A cross-sectional studySetting: Kericho District Hospital, KenyaSubjects: Two hundred and thirty ( 230) HIV infected children aged 3 to 14 years under caregivers who had been on ARV treatment for at least three months before study as verified by clinicians.Results: A total of 230 children aged between 3 and 14 years (mean age was 8.5 years ±3.2SD) were enrolled. Caregivers were aged between 16 and 90 years (mean age 34.6 years ± 10.4 SD). Majority, 178 (77.4%), of the caregivers were female and 137 (59.6%) were biological parents. ARV drug adherence levels, based on various methods of assessment, were sub-optimum, varied from 56.1% based on time of taking drugs, 49.1% based on pharmacy drug refills, 45.7% based on clinic appointments to 27.0% by pill counts.The key factors associated with adherence based on time of taking drugs were: caregiver being away from home (p=0.0010), caregiver forgetting to give drugs to the child (p=0.020), lack of disclosure of the child’s HIV infection status (p=0.0080) and side effects experienced by the child (p=0.0120), lack of knowledge on treatment (p=0.0030) and stigma (p=0.0470). Based on clinic appointments, the factors included caregiver being away from home (p=0.004), lack of disclosure of the child’s HIV infection (p=0.0000), side effects experienced by the child (p= 0.0030), stigma (p=0.0070) and transport cost (p=0.0240).Conclusion: The most important adherence factors among children were: caregiver being away from home, caregiver forgetting, lack of disclosure, child experiencing side effects, lack of knowledge and skills in managing the disease, stigma and transport costs to hospital

Adherence to antiretroviral drug therapy by adult patients attending HIV/AIDS clinic at a Kenyan tertiary helath institution

Objective: To determine antiretroviral drug adherence levels of HIV/AIDS in adult patients.Design: A cross sectional study.Setting: Moi Teaching and Referral Hospital (MTRH), Eldoret, Kenya.Subjects: Three hundred and eighty four HIV/AIDS adult patients who attended HIV/AIDS clinic in MTRH for antiretroviral treatment and had been on treatment for at least three months as confirmed by clinicians.Results: Three hundred and eighty four respondents participated in this research; two third of whom were females (68%) and a third were males (32%). Fifty two per cent of these had attained secondary or post secondary education. The mean age was 36.1±8.5, years and ranged 18-63 years. While 93.5% of the participants adhered to clinic appointments, only 43.2% adhered to taking the drugs as per time schedule.Conclusion: Adherence to time of taking medications was low and could result in reduced efficacy

Hypertension in Sub-Saharan Africa: Cross-Sectional Surveys in Four Rural and Urban Communities

Background: Cardiovascular disease (CVD) is the leading cause of adult mortality in low-income countries but data on the prevalence of cardiovascular risk factors such as hypertension are scarce, especially in sub-Saharan Africa (SSA). This study aims to assess the prevalence of hypertension and determinants of blood pressure in four SSA populations in rural Nigeria and Kenya, and urban Namibia and Tanzania. Methods and Findings: We performed four cross-sectional household surveys in Kwara State, Nigeria; Nandi district, Kenya; Dar es Salaam, Tanzania and Greater Windhoek, Namibia, between 2009-2011. Representative population-based samples were drawn in Nigeria and Namibia. The Kenya and Tanzania study populations consisted of specific target groups. Within a final sample size of 5,500 households, 9,857 non-pregnant adults were eligible for analysis on hypertension. Of those, 7,568 respondents ≥18 years were included. The primary outcome measure was the prevalence of hypertension in each of the populations under study. The age-standardized prevalence of hypertension was 19.3% (95%CI:17.3-21.3) in rural Nigeria, 21.4% (19.8-23.0) in rural Kenya, 23.7% (21.3-26.2) in urban Tanzania, and 38.0% (35.9-40.1) in urban Namibia. In individuals with hypertension, the proportion of grade 2 (≥160/100 mmHg) or grade 3 hypertension (≥180/110 mmHg) ranged from 29.2% (Namibia) to 43.3% (Nigeria). Control of hypertension ranged from 2.6% in Kenya to 17.8% in Namibia. Obesity prevalence (BMI ≥30) ranged from 6.1% (Nigeria) to 17.4% (Tanzania) and together with age and gender, BMI independently predicted blood pressure level in all study populations. Diabetes prevalence ranged from 2.1% (Namibia) to 3.7% (Tanzania). Conclusion: Hypertension was the most frequently observed risk factor for CVD in both urban and rural communities in SSA and will contribute to the growing burden of CVD in SSA. Low levels of control of hypertension are alarming. Strengthening of health care systems in SSA to contain the emerging epidemic of CVD is urgently needed

The oral health knowledge and oral hygiene practices among primary school children age 5-17 years in a rural area of Uasin Gishu District, Enya

Objective: To determine the oral health knowledge and oral hygiene practices among school children in the study regionMethods: This was a descriptive cross-sectional study carried out among primary school going children in Kapsaret Educational division, Uasin-Gishu District, Kenya.A researcher administered questionnaire was used to determine the oral health knowledge and practices in a random sample of 401 students in the period March to June 2002.Results: 92% of the students claimed they brushed their teeth. About 48% brushed at least twice daily. More students (59.1%) reported using the chewing stick compared to those using commercial toothbrushes (p=0.000).Female students brushed more frequently than their male counterparts (p=0.000, ÷2=24.65).39.9% of the students knew the cause of tooth decay,48.2% could state at least one method of prevention, while 16.5% knew the importance of teeth. Use of toothpaste was reported by 38.9% of the students.Conclusion. Less than half of the students knew the causes of tooth decay and how to prevent it. Only about half of the students brushed their teeth twice daily with the chewing stick being more frequently used.Recommendation: There is need to increase the oral health knowledge through well Planned school based oral health education programmes in the primary schools .This would hopefully lead to improvement on the oral hygiene practice