Cotrimoxazole Prophylaxis Treatment Adherence and Associated Factors Among Human Immunodeficiency Virus (HIV) Exposed Children in Public Hospitals in Ilubabor Zone, Southwest Ethiopia, 2018

Abstract

Introduction: Africa is the most affected region by HIV/AIDS in the world with about 26 million people living with HIV, of whom 2.3 million are children under the age of 15 years in 2015. The Human Immunodeficiency Virus (HIV) related estimates and projections for Ethiopia in 2017 revealed that 57,132 under 15 years children were living with HIV with about 1,276 children newly infected. Therefore, this study assessed cotrimoxazole prophylaxis treatment adherence and associated factors among HIV exposed children in public hospitals in Ilubabor zone, Southwest Ethiopia, 2018. Methods: The study design was a facility based, both a retrospective and descriptive study that involves a review of the records of children from PMTCT register books over the past 2 years, and the interview of health care workers and parents/guardian of all children at the follow up clinic. The study included a random sample of children born from HIV infected mothers and enrolled in the PMTCT follow up clinic. The total sample size was 293 and 99 for children (parents/guardian interviewed) and health workers, respectively, and the children’s antiretroviral therapy (ART) registration books in each health facility were reviewed. The collected data was entered into the Epi-data software version 3.1 and then exported to SPSS version 20 for further statistical analysis. Descriptive statistics, bivariate analysis and multivariable logistic regression were used for analysis. Results: Among the total participants, a considerable number (83.3%) of them did not confirm their HIV status, and the majority (88.8%) of participants indicated that they had indeed suffered from one or more opportunistic infections. The common obstacles encountered in accessing care at the health facility were: lack of drugs (33.8%), long procedures in getting drugs (31.4%), unfriendly hospital staff (26.3%), and long distance to the health facility (8.5%). The study showed a significant association between compliance to cotrimoxazole prophylaxis and unfriendly health worker (OR=0.14, CI=0.03-0.78), follow-up (OR= 0.22, CI = 0.06-0.87) and the long procedure of getting drugs (OR= 0.08, CI= 0.01-0.45). Conclusion: The study revealed that a remarkable number of the participants were found to adhered to cotrimoxazole prophylactic treatment. Unfriendly health workers, follow-up and the long procedure of getting drugs were significantly and independently associated with compliance to cotrimoxazole prophylaxis.