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Video observations of treatment administration to children on antiretroviral therapy in rural KwaZulu-Natal
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...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Taylor & Francis
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4991230/ https://www.ncbi.nlm.nih.gov/pubmed/27391997 http://dx.doi.org/10.1080/09540121.2016.1176674 |
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author | Coetzee, Bronwyne Kagee, Ashraf Bland, Ruth |
author_facet | Coetzee, Bronwyne Kagee, Ashraf Bland, Ruth |
author_sort | Coetzee, Bronwyne |
collection | PubMed |
description | 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 (n = 11); children with a VL ≤ 400 cps/ml were grouped as suppressed (n = 12); and children with no VL data were grouped as newly initiated (n = 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. |
format | Online Article Text |
id | pubmed-4991230 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Taylor & Francis |
record_format | MEDLINE/PubMed |
spelling | pubmed-49912302016-09-06 Video observations of treatment administration to children on antiretroviral therapy in rural KwaZulu-Natal Coetzee, Bronwyne Kagee, Ashraf Bland, Ruth AIDS Care Articles 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 (n = 11); children with a VL ≤ 400 cps/ml were grouped as suppressed (n = 12); and children with no VL data were grouped as newly initiated (n = 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. Taylor & Francis 2016-05-26 2016-07-08 /pmc/articles/PMC4991230/ /pubmed/27391997 http://dx.doi.org/10.1080/09540121.2016.1176674 Text en © 2016 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group http://creativecommons.org/licenses/by/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Articles Coetzee, Bronwyne Kagee, Ashraf Bland, Ruth Video observations of treatment administration to children on antiretroviral therapy in rural KwaZulu-Natal |
title | Video observations of treatment administration to children on antiretroviral therapy in rural KwaZulu-Natal |
title_full | Video observations of treatment administration to children on antiretroviral therapy in rural KwaZulu-Natal |
title_fullStr | Video observations of treatment administration to children on antiretroviral therapy in rural KwaZulu-Natal |
title_full_unstemmed | Video observations of treatment administration to children on antiretroviral therapy in rural KwaZulu-Natal |
title_short | Video observations of treatment administration to children on antiretroviral therapy in rural KwaZulu-Natal |
title_sort | video observations of treatment administration to children on antiretroviral therapy in rural kwazulu-natal |
topic | Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4991230/ https://www.ncbi.nlm.nih.gov/pubmed/27391997 http://dx.doi.org/10.1080/09540121.2016.1176674 |
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