Evidence map›Paper›PMID 30134880›Full record

ArticleBMC public health2018

Low HIV viral suppression rates following the intensive adherence counseling (IAC) program for children and adolescents with viral failure in public health facilities in Uganda.

Esther Nasuuna, Joanita Kigozi, Lillian Babirye, Alex Muganzi, Nelson K Sewankambo, Damalie Nakanjako

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PubMed Full text at PMC Publisher
In one paragraph

Article in BMC public health, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 77 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
77citing papers in PubMed, 5 pooled it
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

77 citing papers in PubMed, 5 syntheses or guidelines pooled it.

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17 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Esther NasuunaInfectious Diseases Institute, Makerere University College of Health Sciences, P.O.Box 22418, Kampala, Uganda. enasuuna@gmail.com.ORCID http://orcid.org/0000-0003-2923-6482
Joanita KigoziInfectious Diseases Institute, Makerere University College of Health Sciences, P.O.Box 22418, Kampala, Uganda.
Lillian BabiryeInfectious Diseases Institute, Makerere University College of Health Sciences, P.O.Box 22418, Kampala, Uganda.
Alex MuganziInfectious Diseases Institute, Makerere University College of Health Sciences, P.O.Box 22418, Kampala, Uganda.
Nelson K SewankamboSchool of Medicine, Makerere University College of Health Sciences, P.O.Box 7072, Kampala, Uganda.
Damalie NakanjakoInfectious Diseases Institute, Makerere University College of Health Sciences, P.O.Box 22418, Kampala, Uganda.

Funding

NURTURE:Research Training and Mentoring Program for Career Development of Faculty at Makerere University College of Health SciencesD43TW010132 · FIC · MAKERERE UNIVERSITY COLLEGE OF HEALTH SCIENCES · PI SEWANKAMBO, NELSON K · 2015 to 2019
$4.3M
FIC NIH HHS D43 TW010132Wellcome Trust
6 · The paper itself

Abstract

backgroundThe UNAIDS 90-90-90 strategy clearly stipulates that 90% of all people on antiretroviral therapy (ART) should have a suppressed viral load. Intensified adherence counselling (IAC) was recently recommended by WHO to improve viral suppression among ART-treated paediatric and adolescent clients with virological failure. This paper describes the implementation and outcomes of IAC in the first year of implementation in a public ART program, to inform strategic interventions to reach the "third 90" among children.

methodsA retrospective chart review was conducted for all children aged 9 months to 19 years with HIV viral loads (VL) ≥ 1000 copies/ml at 15 public health facilities from June 2015-December 2016. Data on initial VL test results, IAC sessions, repeat VL test results, and ART regimen switch were abstracted and analysed for completion of IAC and viral suppression after IAC.

resultsA total of 449 children had a detectable viral load above 1000 copies/ml, after an average of 3.5 years (SD 5.8) years of ART. 192 (43%) were 10-20 years of age, and 320 (71%) were receiving Nevirapine-based ART regimen. Out of 345 (77%) who completed the recommended three IAC sessions, 62 (23%) achieved viral suppression following IAC. The mean time from 1st to 3rd IAC session was 113 (SD 153) days and 172 (50%) of the children had completed the three sessions within 200 days.

conclusionSuppression rates were low among ART-treated children with virological failure that completed the recommended three IAC sessions. As we move towards having 90% of ART-treated children and adolescents achieve and maintain viral suppression, there is need to re-evaluate the implementation of IAC among children and adolescents to consider both psychosocial and biological factors such as resistance testing for those with multiple detectable viral loads.

Indexed as

CounselingMedication AdherenceAdolescentAnti-HIV AgentsChildChild, PreschoolFemaleHealth FacilitiesHIV InfectionsHumansInfantMaleNevirapineProgram EvaluationRetrospective StudiesTreatment FailureAnti-HIV AgentsNevirapineAdolescentsAntiretroviral therapyDetectable viral loadIntensive adherence counseling (IAC)PediatricUgandaViral load monitoring

Identifiers

PMID30134880
PMCPMC6103875

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.