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dc.contributor.authorMoro, Vincent Okech
dc.date.accessioned2025-01-06T14:02:54Z
dc.date.available2025-01-06T14:02:54Z
dc.date.issued2024
dc.identifier.citationMoro, V. O. (2024). Correlates of Virological non-suppression among children and adolescents aged 5-19 years on Dolutegravir based regimens attending Gulu Regional Referral Hospital, Northern Uganda : a mixed methods cross-sectional study (Unpublished master’s dissertation). Makerere University, Kampala, Uganda.en_US
dc.identifier.urihttp://hdl.handle.net/10570/14333
dc.descriptionA dissertation submitted to Makerere University School of Public Health in partial fulfilment of the requirements for the award of the Degree of Master of Public Health of Makerere University, Uganda.en_US
dc.description.abstractBackground: HIV/AIDS remains the leading cause of mortality and morbidity among children and adolescents living with HIV/AIDS and Sub-Saharan Africa bears the burden of virological non-suppression with children and adolescents being disproportionately affected. Viral suppression has been sub-optimal among children and adolescent in Uganda, despite a near universal transition to the much effective Dolutegravir-based regimens. Therefore this study was aimed at determining the prevalence of virological non-suppression and its associated correlates among children and adolescents aged 5-19 years on Dolutegravir-based regimens. Methods: A mixed methods cross-sectional study was conducted among 303 children and adolescents aged 5-19 years on Dolutegravir-based regimens from January 2021 to December 2022. Consecutive sampling was used. Existing medical records and data on socio-demographic and clinical characteristics were extracted during quantitative interviews and file reviews. The primary outcomes were prevalence and correlates associated with virological non-suppression. Chi-square likelihood ratio at p value of ≤ 0.05 and Modified Poisson regression analyses were done using STATA version 14.0 to identify correlates significantly associated with virological non-suppression at 95% confidence interval and p-values of ≤ 0.20 at bivariate analysis and ≤ 0.05 at multivariate analysis. Purposive and convenient sampling was done to identify key informant and in-depth interview participants respectively, to provide broad explanations on associated correlates of virological non-suppression and data was analyzed using manual thematic content analysis. Results: Virological non-suppression prevalence was 12.2% (95% CI: 8.5% - 16.0%). After adjusting for other correlates, the correlates of virological non-suppression were; Parental status (being single orphan, aPR: 5.4 [95% CI: 1.81 - 15.90], p = <0.001), (double orphan, aPR: 3.3 [95% CI: 1.07 - 10.02], p = 0.04), Clinical stage (WHO clinical stage II on Dolutegravir-based anti-retroviral therapy initiation (aPR: 3.4 [95% CI: 1.55 - 7.62], p = <0.001), and Malnutrition status (moderate acute malnutrition (aPR: 2.3 [95% CI: 1.16 - 4.76], p = 0.02). Differentiated service delivery models, multi-month drug dispensing tolerability and palatability of Dolutegravir, adolescent child friendly services, awareness and stigma reduction programs, having a caregiver and having a caregiver who is on anti-retroviral therapy emerged as important deterrents to virological non-suppression. However, HIV status non-disclosure, food unavailability, deprivation of family and social support, secondary school age, poor adherence, malnutrition, depression, tuberculosis co-infection, disease progression to stage II and above, drug holidays and fatigue, transitioning from child to adolescent age and information gap on treatment were potential enablers of virological non-suppression. Conclusion: The prevalence of virological non-suppression among children and adolescents aged 5-19 years on Dolutegravir-based regimens was 12.2%. This was relatively low compared to other studies conducted in Uganda and other Sub-Saharan African countries but short of the UNAIDS third 95% target for viral suppression.en_US
dc.language.isoenen_US
dc.publisherMakerere Universityen_US
dc.subjectVirological non-suppressionen_US
dc.subjectDolutegraviren_US
dc.subjectChildren and Adolescentsen_US
dc.subjectHIV/AIDSen_US
dc.titleCorrelates of Virological non-suppression among children and adolescents aged 5-19 years on Dolutegravir based regimens attending Gulu Regional Referral Hospital, Northern Uganda : a mixed methods cross-sectional studyen_US
dc.typeThesisen_US


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