Video observations of treatment administration to children on antiretroviral therapy in rural KwaZulu-Natal
Identifieur interne : 002059 ( Pmc/Curation ); précédent : 002058; suivant : 002060Video observations of treatment administration to children on antiretroviral therapy in rural KwaZulu-Natal
Auteurs : Bronwyne Coetzee ; Ashraf Kagee ; Ruth BlandSource :
- AIDS Care [ 0954-0121 ] ; 2016.
Abstract
For children younger than five years, caregivers are responsible for the measurement and administration of antiretroviral medication doses to children. Failure to adhere to the regimen as prescribed may lead to high viral loads (VLs), immune suppression and ultimately drug resistance. In the content of this study, adherence refers to adequate dosing of the medication by a caregiver. Acquired drug resistance to antiretroviral therapy (ART) is prevalent amongst children in South Africa, and poor adherence to the dosing regimen by caregivers may be associated with this problem. In this qualitative study, we purposively recruited 33 caregiver–child dyads from the Hlabisa HIV Treatment and Care Programme database. Children were divided into three groups based on their VL at the time of recruitment. Children with a VL ≥ 400 cps/ml were grouped as unsuppressed (
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DOI: 10.1080/09540121.2016.1176674
PubMed: 27391997
PubMed Central: 4991230
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Video observations of treatment administration to children on antiretroviral therapy in rural KwaZulu-Natal</title><author><name sortKey="Coetzee, Bronwyne" sort="Coetzee, Bronwyne" uniqKey="Coetzee B" first="Bronwyne" last="Coetzee">Bronwyne Coetzee</name><affiliation><nlm:aff id="AF1"></nlm:aff></affiliation></author><author><name sortKey="Kagee, Ashraf" sort="Kagee, Ashraf" uniqKey="Kagee A" first="Ashraf" last="Kagee">Ashraf Kagee</name><affiliation><nlm:aff id="AF1"></nlm:aff></affiliation></author><author><name sortKey="Bland, Ruth" sort="Bland, Ruth" uniqKey="Bland R" first="Ruth" last="Bland">Ruth Bland</name><affiliation><nlm:aff id="AF2"></nlm:aff></affiliation><affiliation><nlm:aff id="AF3"></nlm:aff></affiliation><affiliation><nlm:aff id="AF4"></nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">27391997</idno><idno type="pmc">4991230</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4991230</idno><idno type="RBID">PMC:4991230</idno><idno type="doi">10.1080/09540121.2016.1176674</idno><date when="2016">2016</date><idno type="wicri:Area/Pmc/Corpus">002060</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">002060</idno><idno type="wicri:Area/Pmc/Curation">002059</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">002059</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Video observations of treatment administration to children on antiretroviral therapy in rural KwaZulu-Natal</title><author><name sortKey="Coetzee, Bronwyne" sort="Coetzee, Bronwyne" uniqKey="Coetzee B" first="Bronwyne" last="Coetzee">Bronwyne Coetzee</name><affiliation><nlm:aff id="AF1"></nlm:aff></affiliation></author><author><name sortKey="Kagee, Ashraf" sort="Kagee, Ashraf" uniqKey="Kagee A" first="Ashraf" last="Kagee">Ashraf Kagee</name><affiliation><nlm:aff id="AF1"></nlm:aff></affiliation></author><author><name sortKey="Bland, Ruth" sort="Bland, Ruth" uniqKey="Bland R" first="Ruth" last="Bland">Ruth Bland</name><affiliation><nlm:aff id="AF2"></nlm:aff></affiliation><affiliation><nlm:aff id="AF3"></nlm:aff></affiliation><affiliation><nlm:aff id="AF4"></nlm:aff></affiliation></author></analytic><series><title level="j">AIDS Care</title><idno type="ISSN">0954-0121</idno><idno type="eISSN">1360-0451</idno><imprint><date when="2016">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><title>ABSTRACT</title><p>For children younger than five years, caregivers are responsible for the measurement and administration of antiretroviral medication doses to children. Failure to adhere to the regimen as prescribed may lead to high viral loads (VLs), immune suppression and ultimately drug resistance. In the content of this study, adherence refers to adequate dosing of the medication by a caregiver. Acquired drug resistance to antiretroviral therapy (ART) is prevalent amongst children in South Africa, and poor adherence to the dosing regimen by caregivers may be associated with this problem. In this qualitative study, we purposively recruited 33 caregiver–child dyads from the Hlabisa HIV Treatment and Care Programme database. Children were divided into three groups based on their VL at the time of recruitment. Children with a VL ≥ 400 cps/ml were grouped as unsuppressed (<italic>n</italic> = 11); children with a VL ≤ 400 cps/ml were grouped as suppressed (<italic>n</italic> = 12); and children with no VL data were grouped as newly initiated (<italic>n</italic> = 10). Caregiver–child dyads were visited at their households twice to document, by means of video recording, how treatment was administered to the child. Observational notes and video recordings were entered into ATLAS.ti v 7 and analysed thematically. Results were interpreted through the lens of Ecological Systems Theory and the information–motivation–behavioural skills model was used to understand and reflect on several of the factors influencing adherence within the child’s immediate environment as identified in this study. Thematic video analysis indicated context- and medication-related factors influencing ART adherence. Although the majority of children in this sample took their medicine successfully, caregivers experienced several challenges with the preparation and administration of the medications. In the context of emerging drug resistance, efforts are needed to carefully monitor caregiver knowledge of treatment administration by healthcare workers during monthly clinic visits.</p></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Bagenda, A" uniqKey="Bagenda A">A. Bagenda</name></author><author><name sortKey="Barlow Mosha, L" uniqKey="Barlow Mosha L">L. Barlow-Mosha</name></author><author><name sortKey="Bagenda, D" uniqKey="Bagenda D">D. Bagenda</name></author><author><name sortKey="Sakwa, R" uniqKey="Sakwa R">R. Sakwa</name></author><author><name sortKey="Fowler, M G" uniqKey="Fowler M">M. G. Fowler</name></author><author><name sortKey="Musoke, P M" uniqKey="Musoke P">P. M. Musoke</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Bain Brickley, D" uniqKey="Bain Brickley D">D. Bain-Brickley</name></author><author><name sortKey="Butler, L M" uniqKey="Butler L">L. M. 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<front><journal-meta><journal-id journal-id-type="nlm-ta">AIDS Care</journal-id><journal-id journal-id-type="iso-abbrev">AIDS Care</journal-id><journal-id journal-id-type="archive">CAIC</journal-id><journal-id journal-id-type="publisher-id">caic20</journal-id><journal-title-group><journal-title>AIDS Care</journal-title></journal-title-group><issn pub-type="ppub">0954-0121</issn><issn pub-type="epub">1360-0451</issn><publisher><publisher-name>Taylor & Francis</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">27391997</article-id><article-id pub-id-type="pmc">4991230</article-id><article-id pub-id-type="publisher-id">1176674</article-id><article-id pub-id-type="doi">10.1080/09540121.2016.1176674</article-id><article-categories><subj-group subj-group-type="article-type"><subject>Article</subject></subj-group><subj-group subj-group-type="heading"><subject>Articles</subject></subj-group></article-categories><title-group><article-title>Video observations of treatment administration to children on antiretroviral therapy in rural KwaZulu-Natal</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Coetzee</surname><given-names>Bronwyne</given-names></name><xref ref-type="aff" rid="AF1"><sup>a</sup></xref><xref ref-type="corresp" rid="cor1"><sup>*</sup></xref></contrib><contrib contrib-type="author"><name><surname>Kagee</surname><given-names>Ashraf</given-names></name><xref ref-type="aff" rid="AF1"><sup>a</sup></xref></contrib><contrib contrib-type="author"><name><surname>Bland</surname><given-names>Ruth</given-names></name><xref ref-type="aff" rid="AF2"><sup>b</sup></xref><xref ref-type="aff" rid="AF3"><sup>c</sup></xref><xref ref-type="aff" rid="AF4"><sup>d</sup></xref></contrib><aff id="AF1"><label><sup>a</sup></label><institution><named-content content-type="department">Department of Psychology</named-content>,<named-content content-type="institution-name">Stellenbosch University</named-content></institution>,<named-content content-type="city">Stellenbosch</named-content>,<country>South Africa</country></aff><aff id="AF2"><label><sup>b</sup></label><institution><named-content content-type="institution-name">Africa Centre for Population Health</named-content></institution>,<named-content content-type="city">KwaZulu-Natal</named-content>,<country>South Africa</country></aff><aff id="AF3"><label><sup>c</sup></label><institution><named-content content-type="department">Institute of Health and Wellbeing, and Royal Hospital for Sick Children</named-content>,<named-content content-type="institution-name">University of Glasgow</named-content></institution>,<named-content content-type="city">Glasgow</named-content>,<country>UK</country></aff><aff id="AF4"><label><sup>d</sup></label><institution><named-content content-type="department">School of Public Health, Faculty of Health Sciences</named-content>,<named-content content-type="institution-name">University of Witwatersrand</named-content></institution>,<named-content content-type="city">Johannsburg</named-content>,<country>South Africa</country></aff></contrib-group><author-notes><corresp id="cor1"><label>CONTACT </label> Bronwyne Coetzee <email xlink:href="bronwyne@sun.ac.za">bronwyne@sun.ac.za</email></corresp></author-notes><pub-date pub-type="ppub"><day>26</day><month>5</month><year>2016</year><pmc-comment>string-date: 2016</pmc-comment>
</pub-date><pub-date pub-type="epub"><day>8</day><month>7</month><year>2016</year></pub-date><volume>28</volume><issue>sup2</issue><issue-title>Equity Supplement (sponsored by the Coalition for Children Affected by AIDS)</issue-title><fpage seq="6">34</fpage><lpage>41</lpage><history><date date-type="received"><day>29</day><month>1</month><year>2016</year></date><date date-type="accepted"><day>23</day><month>3</month><year>2016</year></date></history><permissions><copyright-statement>© 2016 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group</copyright-statement><copyright-year>2016</copyright-year><copyright-holder>The Author(s)</copyright-holder><license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by/4.0/"><license-p>This is an Open Access article distributed under the terms of the Creative Commons Attribution License (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/4.0/">http://creativecommons.org/licenses/by/4.0/</ext-link>), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p></license></permissions><self-uri content-type="pdf" xlink:type="simple" xlink:href="caic-28-034.pdf"></self-uri><abstract><title>ABSTRACT</title><p>For children younger than five years, caregivers are responsible for the measurement and administration of antiretroviral medication doses to children. Failure to adhere to the regimen as prescribed may lead to high viral loads (VLs), immune suppression and ultimately drug resistance. In the content of this study, adherence refers to adequate dosing of the medication by a caregiver. Acquired drug resistance to antiretroviral therapy (ART) is prevalent amongst children in South Africa, and poor adherence to the dosing regimen by caregivers may be associated with this problem. In this qualitative study, we purposively recruited 33 caregiver–child dyads from the Hlabisa HIV Treatment and Care Programme database. Children were divided into three groups based on their VL at the time of recruitment. Children with a VL ≥ 400 cps/ml were grouped as unsuppressed (<italic>n</italic> = 11); children with a VL ≤ 400 cps/ml were grouped as suppressed (<italic>n</italic> = 12); and children with no VL data were grouped as newly initiated (<italic>n</italic> = 10). Caregiver–child dyads were visited at their households twice to document, by means of video recording, how treatment was administered to the child. Observational notes and video recordings were entered into ATLAS.ti v 7 and analysed thematically. Results were interpreted through the lens of Ecological Systems Theory and the information–motivation–behavioural skills model was used to understand and reflect on several of the factors influencing adherence within the child’s immediate environment as identified in this study. Thematic video analysis indicated context- and medication-related factors influencing ART adherence. Although the majority of children in this sample took their medicine successfully, caregivers experienced several challenges with the preparation and administration of the medications. In the context of emerging drug resistance, efforts are needed to carefully monitor caregiver knowledge of treatment administration by healthcare workers during monthly clinic visits.</p></abstract><kwd-group kwd-group-type="author"><title>KEYWORDS</title><kwd>HIV</kwd><kwd>adherence</kwd><kwd>barriers</kwd><kwd>facilitators</kwd><kwd>paediatric</kwd><kwd>anti-retroviral treatment</kwd></kwd-group><funding-group><award-group><funding-source><named-content content-type="funder-name">Fogarty International Center</named-content><named-content content-type="funder-identifier">10.13039/100000061</named-content></funding-source><award-id>D43TW00231</award-id></award-group><funding-statement>Funding from the Columbia University-Southern African Fogarty AIDS International Training and Research Program (AITRP) funded by the Fogarty International Centre, National Institutes of Health under Grant # D43TW00231 and the US President’s Emergency Plan for AIDS relief (PEPFAR) through HRSA under the terms of T84HA21652 and via the Stellenbosch University Rural Medical Education Partnership Initiative (SURMEPI) and the National Research Foundation (NRF), under Grant 88903 is gratefully acknowledged. Opinions expressed and conclusions arrived at are those of the authors and are not necessarily to be attributed to the NRF. The Africa Centre is funded by the Wellcome Trust, UK, under Grant #097410/Z/</funding-statement></funding-group><counts><fig-count count="2"></fig-count><table-count count="3"></table-count><equation-count count="0"></equation-count><ref-count count="28"></ref-count><page-count count="8"></page-count></counts></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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