Browsing by Author "Tusiime, Jayne Byakika"

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    Adherence To Antiretroviral Therapy In Children Attending Mulago Hospital, Kampala
    (Annals of tropical paediatrics, 2007) Barungi, Nicolette Nabukeera; Kalyesubula, Israel; Kekitiinwa, Addy; Tusiime, Jayne Byakika; Musoke, Philippa
    Non-adherence reduces the effectiveness of antiretroviral therapy in children attending the paediatric HIV/AIDS clinic at Mulago Hospital, Kampala.To determine the levels of adherence to HAART and identify factors associated with non-adherence.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.The 3-day self-reported ≥95% adherence was 89.4% (n=170). Using clinic-based pill counts, 94.1% (n=170) had ≥95% adherence to treatment compared with only 72% (n=164) 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 (p=0.02, 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 (p=0.02, OR 0.44, 95% CI 0.20–0.92). 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.
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    Longitudinal Antiretroviral Adherence in HIV+ Ugandan Parents and Their Children Initiating HAART in the MTCT-Plus Family Treatment Model: Role of Depression in Declining Adherence Over Time
    (AIDS and Behavior, 2009) Tusiime, Jayne Byakika; Crane, Johanna; Oyugi, Jessica H.; Ragland, Kathleen; Kawuma, Annet; Musoke, Philippa; Bangsberg, David R.
    We conducted a study to assess the effect of family-based treatment on adherence amongst HIV-infected parents and their HIV-infected children attending the Mother-To-Child-Transmission Plus program in Kampala, Uganda. Adherence was assessed using home-based pill counts and self-report. Mean adherence was over 94%. Depression was associated with incomplete adherence on multivariable analysis. Adherence declined over time. Qualitative interviews revealed lack of transportation money, stigma, clinical response to therapy, drug packaging, and cost of therapy may impact adherence. Our results indicate that providing ART to all eligible HIV-infected members in a household is associated with excellent adherence in both parents and children. Adherence to ART among new parents declines over time, even when patients receive treatment at no cost. Depression should be addressed as a potential barrier to adherence. Further study is necessary to assess the long-term impact of this family treatment model on adherence to ART in resource-limited settings.