Evidence map›Paper›PMID 39761261›Full record

SynthesisPloS one2025

Adherence to antiretroviral therapy and its associated factors among children living with HIV in Eastern and Southern Africa: A systematic review and meta-analysis.

Gebrie Getu Alemu, Bantie Getnet Yirsaw, Tigabu Kidie Tesfie, Getaneh Awoke Yismaw, Habtamu Wagnew Abuhay, Meron Asmamaw Alemayehu, Muluken Chanie Agimas, Nebiyu Mekonnen Derseh

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in PloS one, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
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

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Review
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

8 authors.

Gebrie Getu AlemuDepartment of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.ORCID 0009-0007-9451-2128
Bantie Getnet YirsawDepartment of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Tigabu Kidie TesfieDepartment of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.ORCID 0000-0002-8250-125X
Getaneh Awoke YismawDepartment of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Habtamu Wagnew AbuhayDepartment of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Meron Asmamaw AlemayehuDepartment of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Muluken Chanie AgimasDepartment of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Nebiyu Mekonnen DersehDepartment of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.ORCID 0000-0003-1355-2763

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundChildren living with HIV in low-income settings, such as in Eastern and Southern Africa, are at a high risk for poor adherence to antiretroviral therapy. However, various primary studies presented inconsistent and inconclusive estimates of adherence and its associated factors among children living with HIV in Eastern and Southern Africa. Therefore, we were aimed to determine the pooled prevalence of adherence and its associated factors, and to guide interventions efforts to support adherence, this comprehensive systematic review and meta-analysis was conducted.

methodsWe have comprehensively searched PubMed, Google Scholar, EMBASE, Scopus, and Hinari databases for all primary studies. Unpublished studies were also searched manually and accessed from university repositories. Additional searches were conducted by examining the references in the included articles to further identify relevant studies. Data were extracted and analyzed using Microsoft Excel spreadsheet and STATA version 17 software, respectively. A random-effects DerSimonian-Laird model was used to compute the pooled prevalence of adherence to antiretroviral therapy among children living in Eastern and Southern Africa. We have used Cochran's Q test (χ2) and Higgins I2 statistics to identify heterogeneity. Subgroup and sensitivity analysis were conducted to investigate the potential sources of heterogeneity. Publication bias was assessed by the funnel plot and Egger's test. An association was expressed through the pooled adjusted odds ratio and statistical significance was considered at a p-value < 0.05.

resultsThis meta-analysis combined the effect estimates of 29 primary studies with 7414 study participants. The pooled prevalence of adherence to antiretroviral therapy among children living in Eastern and Southern Africa was 76.2% (95% CI: 71.4, 81.1) [I2 = 97.06%, P < 0.001 and Q test (χ2) = 953.83, p-value < 0.001]. Being a biological caregiver [AOR = 1.93 (95% CI: 1.34, 2.73)], receiving first-line antiretroviral treatment [AOR = 2.7 (95% CI: 1.39, 5.25)], and having social support [AOR = 1.88 (95% CI: 1.33, 2.66)] were significantly associated with adherence to antiretroviral therapy.

conclusionThe pooled prevalence of adherence to antiretroviral therapy among children living with HIV is low. Biological caregiver, first-line antiretroviral treatment, and social support were factors associated with adherence to ART among children living with HIV. Therefore, healthcare providers, adherence counselors, supporters, as well as governmental and non-governmental organizations, should emphasize a multi-component intervention approach to address the multifaceted challenges associated with adherence to ART, thereby improving counseling efforts to enhance adherence. Moreover, clinicians should prioritize the selection and utilization of regimens for individuals in this age group on robust first-line options.

Indexed as

HIV InfectionsMedication AdherenceAfrica, EasternAfrica, SouthernAnti-HIV AgentsChildHumansAnti-HIV Agents

Identifiers

PMID39761261
PMCPMC11703094

What OpenQuestion holds

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LicenceCC BY
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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.