Browsing by Author "Nabukeera-Barungi, Nicolette"

Now showing 1 - 3 of 3
  • Thumbnail Image
    Item
    Adherence to antiretroviral therapy in children attending Mulago Hospital, Kampala
    (Annals of tropical Paediatrics, 2007) Nabukeera-Barungi, Nicolette; Kalyesubula, Israel; Kekitiinwa, Addy; Byakika-Tusiime, Jayne; Musoke, Philippa
    Background: Non-adherence reduces the effectiveness of antiretroviral therapy in children attending the paediatric HIV/AIDS clinic at Mulago Hospital, Kampala. Aim: To determine the levels of adherence to HAART and identify factors associated with non-adherence. Methods: A cross-sectional study of 170 children aged 2–18 years. Adherence to HAART was defined as taking >95% of prescribed medication. It was determined using three measures: a 3-day self-report by the caregivers, clinic-based pill counts at enrolment and home-based unannounced pill counts 2–3 weeks later. Results: The 3-day self-reported >95% adherence was 89.4% (n5170). Using clinic-based pill counts, 94.1% (n5170) had >95% adherence to treatment compared with only 72% (n5164) by unannounced pill counts. When the primary caregiver was the only one who knew the child’s serostatus, he/she was three times more likely to be non-adherent (p50.02, OR 3.34, 95% CI 1.14–9.82). Those who had been hospitalised twice or more before starting HAART were more likely to have >95% adherence (p50.02, OR 0.44, 95% CI 0.20–0.92). Conclusion: The majority of children had good adherence levels when estimated by unannounced pill counts. Disclosing the child’s HIV serostatus only to the primary caregiver and having been hospitalised only once or not at all were associated with poor adherence.
  • Thumbnail Image
    Item
    Efavirenz poisoning in a 12 year old HIV negative African boy
    (Pan African Medical Journal, 2012) Nazziwa, Rose; Sekadde, Moorine; Kanyike, Francis; Wobudeya, Eric; Nabukeera-Barungi, Nicolette
    Efavirenz is an oral antiretroviral drug in the class of non nucleoside reverse transcriptase inhibitors. Toxicity at therapeutic doses has been documented but there is scarcity of data on presentation and management of Efavirenz overdose. We describe a case of Efavirenz poisoning in a 12-year old HIV Negative African boy with a very unique presentation after ingesting 3 grams of Efavirenz as a single dose. The most prominent problems were burning sensation in the throat immediately after ingestion then visual impairment one hour later then tremors, screaming at night and motor deficits in lower limbs for 5 days before admission. His medical history, physical exam and investigations revealed no other cause of his presentation other than the EFV. Unfortunately, it was not possible to do EFV levels. He was given supportive treatment and 10 days later he was completely well.
  • Thumbnail Image
    Item
    Sexual risk reduction needs of adolescents living with HIV in a clinical care setting
    (Routledge, 2008) Bakeera-Kitaka, Sabrina; Nabukeera-Barungi, Nicolette; Nöstlinger, Christiana; Kekitiinwa, Addy; Colebunders, Robert
    As anti-retroviral therapy becomes increasingly available, young people living with HIV need tailored support to adopt healthy sexual behaviors. There has been a gap in the availability of culturally appropriate techniques for secondary prevention and sexual risk reduction in this target group. This formative study assessed sexual and reproductive health needs and problems, as well as determinants of sexual risk-taking among young people living with HIV aged 11 21 years attending the Paediatric Infectious Disease Clinic in Kampala, Uganda. Theoretical guidance was provided by the Information-Motivation-Behavioral Skills Model. Socio-demographic and selected psychosexual data were assessed using a brief anonymous questionnaire. A total of 75 young people living with HIV participated in eight focus group discussions. In addition, one focus group was conducted with adult key informants (service providers). About a quarter of the young participants reported prior or current sexual experience. The study revealed knowledge gaps relating to reproductive health, HIV transmission, and contraceptive methods. Motivations for protection included hope for the future, good counseling, and fear of the consequences of sexual activity such as unwanted pregnancies. Barriers to adopting preventive behaviors included peer pressure, poverty, HIV-related stigma, ignorance of their partners, alcohol use, and a desire to have children for the older ones. Young sero-positive people in this setting lacked specific behavioral skills, such as disclosure of HIV status to their sexual partners, this being closely linked to fear of rejection and stigma. HIVpositive youths need support in developing the appropriate behavioral skills to adopt healthy sexual behaviors. Interventions in this field need to be developmentally appropriate and tailored to young people’s specific needs. Structural interventions should at the same time address and reduce HIV-related stigma and socio-economic needs of young people living with HIV.