Magnitude and associated factors of virological failure among children on ART in Bahir Dar Town public health facilities, Northwest Ethiopia: a facility based cross-sectional study.
BACKGROUND
Despite the rapid scale-up of antiretroviral therapy, virologic failure has become global public health concern and challenge, especially in developing countries. Viral load monitoring is an important approach to identify treatment failure and develop public health interventions in children receiving antiretroviral therapy. Thus, this study aims to assess the magnitude and associated factors of virological failure among children on antiretroviral therapy.


METHODS
A facility-based cross-sectional study was conducted among 399 HIV-positive children on antiretroviral therapy from 2016 to 2019 in Bahir Dar Town public health facilities. Data were extracted from children's charts using a standardized data extraction tool, adapted from ART intake and follow-up forms. Data were entered using Epi-Data Version 3.1, and analyzed using SPSS Version 25. Bivariable and multivariable binary logistic regression models were done to identify factors associated with virological failure. Variables with p-values < 0.25 were fitted into the multivariable analysis. Finally, variables with p-values <0.05 were considered as statistically significant factors.


RESULTS
The period prevalence of virological failure was found to be 14.8% (95% CI: 11.5-19.3%). Opportunistic infections (AOR = 2.19, CI: 1.13-4.25), history of treatment interruption and restart (AOR = 2.21, CI: 1.09-4.54), younger age (AOR = 2.42, CI: 1.02-5.74), poor/fair ART adherence (AOR = 2.19, CI: 1.05-4.57), and advanced baseline WHO clinical staging (AOR = 2.32, CI: 1.14-4.74) were found to be factors significantly associated with virological failure.


CONCLUSION
The magnitude of virological failure among HIV-infected children remained high. Children with poor/fair ART adherence, history of treatment interruption, advanced baseline WHO clinical staging, younger age, and opportunistic infections were significantly associated with virologic failure. Thus, special attention should be given to children who had poor/fair ART adherence and presenting with opportunistic infections.
['Gelaw|Belete|B|http://orcid.org/0000-0001-6965-8466', 'Mulatu|Getasew|G|', 'Tesfa|Getasew|G|', 'Marew|Chalie|C|', 'Chekole|Bogale|B|', 'Alebel|Animut|A|']
D000293:Adolescent D000367:Age Factors D044966:Anti-Retroviral Agents D002648:Child D002675:Child, Preschool D003430:Cross-Sectional Studies D005002:Ethiopia D005260:Female D015658:HIV Infections D006801:Humans D007223:Infant D007231:Infant, Newborn D008297:Male D055118:Medication Adherence D009894:Opportunistic Infections D017211:Treatment Failure D019562:Viral Load
Virological failure Children Bahir Dar Antiretroviral therapy HIV