Medical Appointment Adherence and Challenges Encountered by HIV Infected Children at Kenyatta National Hospital, Kenya

Authors

  • Dr. Mwiti Peter Kirimi PhD Jomo Kenyatta University of Agriculture and Technology
  • Dr. Dennis Gichobi Magu PhD Jomo Kenyatta University of Agriculture and Technology
  • Prof. Opondo Everisto PhD Jomo Kenyatta University of Agriculture and Technology
  • Dr. Joseph Mutai PhD Kenya Medical Research Institute
  • Dr. Angeline Chepchirchir PhD University of Nairobi

DOI:

https://doi.org/10.47604/jhmn.2447

Keywords:

Children, HIV, Adherence, Medical Appointment

Abstract

Purpose: The goal of this study was to determine the adherence and challenges to scheduled medical appointment on HIV care services among HIV positive children aged 18 months to nine years undergoing treatment at Kenyatta National Hospital, Kenya at six months interval

Methodology: The study design was prospective cohort study design consisting of 221 caregivers and their HIV infected children. Consecutive sampling method was used, in which potential participants were sought out on a daily basis until we had contacted all the eligible individuals and enroled them.This research was undertaken from March, 2017 to November, 2018. The study participants each was followed for period of one year. Pretested questionnaire was used for collecting data together with review of standardized clinical notes on challenges and adherence to scheduled medical appointments. Data was analyzed using statistical package for the Social Sciences (SPSS) Version 20. The descriptive statistics were done and data was presented in frequency tables. Ethical approval no P688/09/2016) was obtained.

Findings:  It was observed that adherence to scheduled medical appointment among children infected with HIV ranged from 77% to 81.9% at 6 and 12 months respectively. This study found an average of 20% of children infected with HIV are at high risk of adverse outcomes related to non-adherence to planned medical appointments. The observed difference on adherence was associated with financial constrain, perceived stigma and discrimination, long distance and long waiting period in the medical HIV clinic.

Unique Contribution to Theory, Practice and Policy: Targeted intervention aimed at addressing measures to reduce children missing attendance of scheduled medical appointment is vital. The health care providers may address measures to reduce children missing attendance of scheduled medical appointment by reducing waiting time in the clinic and reducing the number of scheduled medical appointments. This study adds to the pool of knowledge that stigma and discrimination, long waiting time in the clinic and the number of scheduled medical appointments has influence on adherence to appointments. The attendance of scheduled medical appointment should be enhanced in the policies by Ministry of health and HIV health care providers focusing on reducing waiting time, mitigating stigma and discrimination.

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References

Bastard, M., Pinoges, L., Balkan, S., Szumilin, E., Ferreyra, C., & Pujades-Rodriguez, M. (2012). Timeliness of clinic attendance is a good predictor of virological response and resistance to antiretroviral drugs in HIV-infected patients. PLoS One, 7(11), e49091.

Braitstein, P., Songok, J., Vreeman, R., Wools-Kaloustian, K., Koskei, P., Walusuna, L., ... & Yiannoutsos, C. (2011). "˜Wamepotea'(They have become lost): Outcomes of HIV-positive and HIV-exposed children lost to follow-up from a large HIV treatment program in western Kenya. Journal of acquired immune deficiency syndromes (1999), 57(3), e40 - e64.

Brennan, A.T, Maskew, M, Sanne, I, & Fox, M.P. (2010). The importance of clinic attendance in the first six months on antiretroviral treatment: a retrospective analysis at a large public sector HIV clinic in South Africa. J Int AIDS Soc. 13, 49

Chalker, J., Wagner, A., Tomson, G., Laing, R., Johnson, K., Wahlström, R., & Ross-Degnan, D. (2010). Urgent need for coordination in adopting standardized antiretroviral adherence performance indicators. JAIDS Journal of Acquired Immune Deficiency Syndromes, 53(2), 159-161

Fox, M. P., & Rosen, S. (2015). Systematic review of retention of pediatric patients on HIV treatment in low and middle-income countries 2008-2013. AIDS. 29, 493-502.

Horstmann, E., Brown, J., Islam, F., Buck, J., & Agins, B.D., (2010). Retaining HIV-infected patients in care: Where are we? Where do we go from here? Clin Infect Dis. 50(5), 752-761.

Horwood, C., Voce, A., Vermaak, K., Rollins, N., & Qazi, S., (2010). Routine checks for HIV in children attending primary healthcare facilities in South Africa: attitudes of nurses and child care-givers. Soc Sci Med.70, 313-320

Mugavero, M.J., Davila, J.A., Nevin, C.R., & Giordano, T.P. (2010). From access to engagement: measuring retention in outpatient HIV clinical care. AIDS Patient Care STDS. 24(10), 607-613

McHugh, G., Simms, V., Dauya, E., Bandason, T., Chonzi, P., Metaxa, D., ... & Ferrand, R. A. (2017). Clinical outcomes in children and adolescents initiating antiretroviral therapy in decentralized healthcare settings in Zimbabwe. Journal of the International AIDS Society, 20(1), 21843

McLeroy, K.R., Bibeau D., Steckler, A., & Glanz, K., (1988). An ecological perspective on health promotion programs. Health Educ Behav. 15(4), 351-377

Mwiti P.K., Magu D., Opondo E., Mutai J., (2020). Social Demographic Factors Associated With Retention to Scheduled Medical Appointment among HIV Infected Children Attending HIV Care Services at Kenyatta National Hospital, Kenya. International Organization of scientific research (IOSR) Journal of Nursing and Health Science (IOSR-JNHS), 9(01), pp. 55-60.

Mwiti P.K., Magu D., Opondo E., Mutai.J., (2020b). Association Between Child Clinical Characteristics And Retention To Scheduled Medical Appointment Among HIV Infected Children Aged 18 Months To Nine Years Attending HIV Care Services At KNH, Kenya; International Journal of Scientific and Research Publications (IJSRP) 10(04) (ISSN: 2250-3153), DOI: http://dx.doi.org/10.29322/IJSRP.10.04.2020.p10093

Mwiti P. K., Magu.D.G., Chelogoi.E., (2021). Factors associated with adherence to scheduled medical appointment among HIV infected children attending HIV Care services at Kenyatta National Hospital, Kenya. International Journal of Scientific Research and Engineering Development- Volume 4 Issue 5, Sep- Oct 2021Available at www.ijsred.com

Mwiti P.K., Magu D., Opondo E., Mutai J.,(2023). Thesis on determinants of adherence to scheduled medical appointments among HIV infected children aged 18 months to nine years receiving care at Kenyatta National Hospital, Kenya. Publication by Jomo Kenyatta University of Agriculture and Technology

Mwiti P.K., Magu D., Opondo E., Mutai.J., (2023b). Care Givers Perceptions Associated With Adherence to Scheduled Medical Appointments Among HIV Infected Children Aged 18 Months to Nine Years Receiving HIV Care Services at Kenyatta National Hospital, Kenya. International Journal of Scientific and Research Publications, Volume 13, Issue 4, April 2023 16 ISSN 2250-3153 DOI: 10.29322/IJSRP.13.04.2023.p13604 http://dx.doi.org/10.29322/IJSRP.13.04.2023.p13604

Nijhawan, A., Liang, Y., Vysyaraju, K., Munoz, J., Ketchum, N., Buchberg, M., ... & Taylor, B. (2016). Missed Initial Medical Visits in Two Urban HIV Clinics in the South. In 2016 Annual Research Meeting. Academy Health.

Schneiderman, J. U., Smith, C., Arnold-Clark, J. S., Fuentes, J., & Kennedy, A. K. (2016). Pediatric return appointment adherence for child welfare-involved children in Los Angeles California. Maternal and child health journal, 20(2), 477-483

Wachira, J.. Susan, E.,Vreeman, R., & Braistein, P. (2012). Factors underlying taking a child to HIV care: Implication for reducing loss to follow up among HIV- infected and -exposed children. Journal of Social Aspects of HIV/AIDS, 9, 1. /

Walburn, A., Swindells, S., Fisher, C., High, R., & Islam, K. M. (2012). Missed visits and decline in CD4 cell count among HIV-infected patients: a mixed method study. International Journal of Infectious

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Published

2024-04-02

How to Cite

Mwiti, K., Magu, D., Everisto, O., Mutai, J., & Chepchirchir, A. (2024). Medical Appointment Adherence and Challenges Encountered by HIV Infected Children at Kenyatta National Hospital, Kenya. Journal of Health, Medicine and Nursing, 10(1), 57–65. https://doi.org/10.47604/jhmn.2447

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