Burden of and factors associated with virological failure among HIV positive patients on antiretroviral therapy (ART) in Nsanje district, Malawi
In efforts to fight HIV, many countries including Malawi started implementation of universal ART eligibility for all HIV infected individuals as a strategy for reaching the 90-90-90 targets. This led to the increase in ART coverage hence intensifying the need for scale-up of ART monitoring, for w...
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| Language: | English |
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Kamuzu University of Health Sciences
2022
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| Online Access: | http://nkhokwe.kuhes.ac.mw/handle/20.500.12845/627 |
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| author | Mphande, Shupe |
| author_facet | Mphande, Shupe |
| author_sort | Mphande, Shupe |
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| description | In efforts to fight HIV, many countries including Malawi started implementation of universal ART
eligibility for all HIV infected individuals as a strategy for reaching the 90-90-90 targets. This led
to the increase in ART coverage hence intensifying the need for scale-up of ART monitoring, for
which the current gold standard is Viral Load (VL) testing. Despite the increasing access to ART
and VL monitoring, numerous studies have demonstrated suboptimal levels of viral suppression
(VS) in different populations in many low-resource settings. Therefore, this research will help to
determine the burden of virological failure and focus on factors leading to virological failure which
will in turn lead to better targeting strategies and policy change.
The main objective of the study was to determine the burden of virological failure and factors
associated with virological failure among HIV patients on ART in Nsanje district.
This was a cross sectional quantitative study using Laboratory information system database, ART
master cards and registers. The study targeted HIV positive patients on ART for > 6 months from
July 2015 to June 2019 in 14 facilities in Nsanje district. The criteria for the study was a VL result
within the stated period. Data was analyzed using STATA version 16.
451 participants were enrolled in this study. 267(59.2%) participants were married, and 278
(61.6%) started ART due to WHO clinical stage. Of the 451 study participants, 321(71.2%) failed
to achieve viral suppression (VL=<1000 copies). In univariate analysis, age at ART initiation,
occupation (OR 0.203, 95% CI 0.11, 0.39; p<0.003), marital status, duration on ART (OR 0.55,
95% CI 0.33, 0.92; p=0.023) and ART adherence (OR 5.125, 95% CI 3.01, 8.74; p<0.0001) were
associated with VF. Age and Fair/poor adherence (AOR 4.221, 95% CI 2.41, 7.38; p<0.0001) was
statistically significant in multivariate analysis.
Age, ART adherence, marital status, occupation and duration on ART were identified as some of
the factors associated with VF. Proper strategies should be developed in order to reduce VF and
improve adherence. |
| format | Thesis |
| id | oai:nkhokwe.kuhes.ac.mw:20.500.12845-627 |
| institution | My University |
| language | English |
| publishDate | 2022 |
| publisher | Kamuzu University of Health Sciences |
| record_format | dspace |
| spelling | oai:nkhokwe.kuhes.ac.mw:20.500.12845-6272023-03-12T00:00:09Z Burden of and factors associated with virological failure among HIV positive patients on antiretroviral therapy (ART) in Nsanje district, Malawi Mphande, Shupe In efforts to fight HIV, many countries including Malawi started implementation of universal ART eligibility for all HIV infected individuals as a strategy for reaching the 90-90-90 targets. This led to the increase in ART coverage hence intensifying the need for scale-up of ART monitoring, for which the current gold standard is Viral Load (VL) testing. Despite the increasing access to ART and VL monitoring, numerous studies have demonstrated suboptimal levels of viral suppression (VS) in different populations in many low-resource settings. Therefore, this research will help to determine the burden of virological failure and focus on factors leading to virological failure which will in turn lead to better targeting strategies and policy change. The main objective of the study was to determine the burden of virological failure and factors associated with virological failure among HIV patients on ART in Nsanje district. This was a cross sectional quantitative study using Laboratory information system database, ART master cards and registers. The study targeted HIV positive patients on ART for > 6 months from July 2015 to June 2019 in 14 facilities in Nsanje district. The criteria for the study was a VL result within the stated period. Data was analyzed using STATA version 16. 451 participants were enrolled in this study. 267(59.2%) participants were married, and 278 (61.6%) started ART due to WHO clinical stage. Of the 451 study participants, 321(71.2%) failed to achieve viral suppression (VL=<1000 copies). In univariate analysis, age at ART initiation, occupation (OR 0.203, 95% CI 0.11, 0.39; p<0.003), marital status, duration on ART (OR 0.55, 95% CI 0.33, 0.92; p=0.023) and ART adherence (OR 5.125, 95% CI 3.01, 8.74; p<0.0001) were associated with VF. Age and Fair/poor adherence (AOR 4.221, 95% CI 2.41, 7.38; p<0.0001) was statistically significant in multivariate analysis. Age, ART adherence, marital status, occupation and duration on ART were identified as some of the factors associated with VF. Proper strategies should be developed in order to reduce VF and improve adherence. 2022-05-12T15:48:34Z 2022-05-12T15:48:34Z 2021-08-18 Thesis http://nkhokwe.kuhes.ac.mw/handle/20.500.12845/627 en application/pdf Kamuzu University of Health Sciences |
| spellingShingle | Mphande, Shupe Burden of and factors associated with virological failure among HIV positive patients on antiretroviral therapy (ART) in Nsanje district, Malawi |
| title | Burden of and factors associated with virological failure among HIV positive patients on antiretroviral therapy (ART) in Nsanje district, Malawi |
| title_full | Burden of and factors associated with virological failure among HIV positive patients on antiretroviral therapy (ART) in Nsanje district, Malawi |
| title_fullStr | Burden of and factors associated with virological failure among HIV positive patients on antiretroviral therapy (ART) in Nsanje district, Malawi |
| title_full_unstemmed | Burden of and factors associated with virological failure among HIV positive patients on antiretroviral therapy (ART) in Nsanje district, Malawi |
| title_short | Burden of and factors associated with virological failure among HIV positive patients on antiretroviral therapy (ART) in Nsanje district, Malawi |
| title_sort | burden of and factors associated with virological failure among hiv positive patients on antiretroviral therapy (art) in nsanje district, malawi |
| url | http://nkhokwe.kuhes.ac.mw/handle/20.500.12845/627 |
| work_keys_str_mv | AT mphandeshupe burdenofandfactorsassociatedwithvirologicalfailureamonghivpositivepatientsonantiretroviraltherapyartinnsanjedistrictmalawi |
Fertility desire and family planning demands for HIV-Positive clients on Antiretroviral therapy treatment at Mzuzu Central Hospital