Adherence to Antiretroviral Therapy Among HIV-Infected Children in East Africa International Epidemiologic Databases to Evaluate AIDS (IeDEA) RC Vreeman, MD, MS; SO Ayaya, MBChB, MMED; WM Nyandiko, MBChB, MMED; BS Musick, MS, C Yiannoutsos, PhD; D Nash, PhD; D Wabwire, MBChB, MMED; S Wiehe, MD, MPH
East Africa Pediatric Cohort in IeDEA ART Initiation N=3,308 Last Visit N=3,308 Weight-for-Age Z scores > -1-1 to -1.9-2 to -2.9-3 or greater Missing 21.3% 22.3% 21.2% 30.8% 4.4% Weight-for-Age Z scores > -1-1 to -1.9-2 to -2.9-3 or greater Missing 32.3% 26.2% 17.7% 16.7% 7.2% Mean WAZ -2.4 (SD 1.9) Mean WAZ -1.8 (SD1.8) CDC Class A B C N N=2,351 25.5% 25.2% 38.3% 11.0% CDC Class A B C N N=2,314 22.0% 24.9% 44.7% 8.4% 2nd Line at Enrollment N=19 (0.57%) 2nd Line at Last Visit N=51 (1.54%)
88.2% Good Mean Adherence for EA Children Characteristics AGE <12 months Age groups in between 11-12 year olds ORPHAN STATUS One or both parents dead Both parents alive at ARV start ART REGIMEN 1st-line ART 2nd-line ART DISEASE STAGE CDC N CDC A CDC B CDC C Non- Adherence 16.4% 10.2% - 12.1% 14.7% 14.8% 10.5% 11.8% 10.5% 7.3% 15.2% 12.6% 11.4% Characteristics TIME ON ART <3 months 3-12 months >12 months NUTRITIONAL STATUS WAZ > -1 WAZ -1 to -2 WAZ -2 to -3 WAZ < -3 TIME FROM TO ART START Start ART <180 Days Start ART >180 Days Non- Adherence 11.3% 6.5% - 7.9% 9.9 12.1% 11.4% 11.2% 11.6% 12.7% 12.5% 9.9%
Results
Adherence by Sites AMPATH FACES Nyanza Mulago Morogoro ORCI St. Francis Tumbi N 2613 190 49 140 138 4 79 95 % with Adherence <90% 11.8% 12.6% 6.1% 24.3% 1.4% 0 21.5% 3.2% Measure 7 day 7 day, Any 7 day 7 day 1 month pills 1 month pills 7 day 1 month pills
Acknowledgements Moi Teaching and Referral Hospital IeDEA East Africa Sites, Principal Investigators, and Clinicians in Kenya, Uganda, and Tanzania Indiana University School of Medicine, Dept of Pediatrics, Children s Health Services Research Moi University School of Medicine Moi Teaching and Referral Hospital
East Africa IeDEA: Pediatric Sites Kenya AMPATH FACES Nyanza Provincial Hospital (PH) [MTCT-Plus] Tanzania Morogoro Ocean Road Cancer Institute Tumbi Uganda Mulago Hospital [MTCT-Plus] San Raphael/St. Francis Hospital, Nsambya [MTCT- Plus]
Kenya *Elyne Rotich Eldoret (Indiana University, Moi University) *Paula Braitstein *Samuel Ayaya *Lameck Diero Edwin Sang Gilbert Simiyu Stephen Wafula John Sidle Wendy Prudhomme O Meara Chris Simiyu Christine Chuani Robert Rono FACES, Kisumu *Craig Cohen Elizabeth Bukusi Frankline Onchiri Cinthia Blat Arbogast Oyanga Evelyne Owenga Bernard Otieno Walter Mukhwana Barrack Onyango Jessica Ainsworth Jayne Kulzer Kisumu (MTCT-plus) *Juliana Otieno Kennedy Omollo George O. Otieno Paul Omwandho Uganda United Republic of Tanzania *Marion Achieng J. Mc. Jumah Mbarara Morogoro (MGH/UCSF) *Rita Elias Lyamuya *Mwebesa Bosco Bwana Francis Mayanga M. Nicholas Musinguzi Mensaria Kimambo Nneka Emenyonu Ocean Road Cancer Institute Jeffrey Martin *Hussein Mtiro Bakari Elvin Geng *Julius Mwaiselage Margaret Mbabazi Willy A. Wilfest MU-JU (MTCT-plus) Sara J. Maufi *Deo Wabwire Marco Nkya Michael Mubiru Tumbi Philippa Musoke *Isaria Maruchu A. Henry Twijukye Joseph Chananga M. St. Francis (MTCT-plus) Jerome Lwali *Pius Okong Harriet Kalanzi Josephine Mbidde Josephine Mbidde Infectious Diseases Institute (IDI)- Mulago P.O.Box 22418, Fax: 0312/0414 307290 *Philippa Easterbrook Andrew Kambugu Agnes Kiragga Pauline Nabunya Peter Okwii Stephen Magero Richard Orama Petra Schafer Art Mooney Denis Wamai
*Melanie Bacon UCC Elaine Baker Frank Tilugulilwa Columbia *Denis Nash *Batya Elul Simon Tsiouris J. Harriet Nuwagaba-Biribonwoha Yingfeng Wu Sandra Aritonang Indiana University *Beth Zwickl *Constantin Yiannoutsos *Kara Wools-Kaloustian Beverly Musick Paul Biondich Matthew R. Strother Sheila Ellinger Shari Stansberry Tom Betley UCSF *Jeffrey Martin Peter Hunt Steven Deeks David Glidden Elvin Geng John Bennett Patty Tan NYU *Scott Braithwaite R. Sherry Mentor