Back
 IJCM  Vol.10 No.3 , March 2019
Impact of Therapeutic Education on the Viral Load of HIV Infected Children and Adolescents on Antiretroviral Therapy at the Douala Laquintinie Hospital, Cameroon
Abstract: Introduction: One of the biggest challenges for HIV-infected adolescents on antiretroviral therapy (ART) is the long-term maintenance of viral suppression, which is the third 90% goal of UNAIDS. Therapeutic Education (TE), process of acquiring abilities and skills that help the patient to live optimally with his illness is one of the strategies that contribute to the achievement of viral suppression through the therapeutic adhesion contract and the follow-up of the patient. The aim of this study was to evaluate the impact of TE on the virologic response of children and adolescents aged 8 - 19 under ART and followed up at the Laquintinie Hospital of Douala (LHD). Method: A cross-sectional study was conducted at the Pediatric Unit of the HIV/AIDS Accredited Treatment Center (ATC) at LHD from February to May 2016. Children and adolescents aged 8 to 19 years on ART, followed in ATC/LHD whose parents had agreed to participate in the study, and who had achieved at least one viral load before and after initiation of TE, were recruited consecutively during routine medical follow-up. Data were collected from patients’ medical records and questionnaires administered to study participants. Results: A total of 198 children and adolescents were included in this study with an average age of 14 years (±3). In this study population, 86.1% of children aged 8 - 10 years had acquired knowledge of the importance of taking medications, 95.4% and 97.3% of adolescents aged 11 - 14 years and 15 - 19 years had knowledge of medication schedules respectively. Among children and adolescents with undetectable viral load prior to initiation of TE, 76.5% maintained an undetectable viral load after initiation of TE. In addition, 72.3% of those whose viral load was detectable before initiation of TE had acquired an undetectable or decreasing viral load after initiation of TE. The only exposure factor significantly associated with maintaining undetectable viral load after initiation of TE was having less than 10 TE sessions (p = 0.02). Conclusion: The virologic response appears to be better in subjects who acquire skills faster through TE and therefore require fewer learning sessions to adapt. In addition, TE effectively contributes to achieving the third 90% goal of UNAIDS.
Cite this paper: Penda, C. , Bissek, A. , Bilong, S. , Boupda, L. , Okala, C. , Ndongo, F. , Ngondi, G. , Eboumbou, E. , Njock, L. and Ndombo, O. (2019) Impact of Therapeutic Education on the Viral Load of HIV Infected Children and Adolescents on Antiretroviral Therapy at the Douala Laquintinie Hospital, Cameroon. International Journal of Clinical Medicine, 10, 109-121. doi: 10.4236/ijcm.2019.103011.
References

[1]   UNAIDS. Fact Sheet-World Aids Day 2018. 2017 Global HIV Statistics.
http://www.unaids.org/sites/default/files/media_asset/UNAIDS_FactSheet_en.pdf

[2]   UNAIDS. 2015 Progress Report on the Global Plan towards the Elimination of New HIV Infections among Children and Keeping Their Mothers Alive.
http://www.unaids.org/en/resources/documents/2015/JC2774_2015ProgressReport_GlobalPlan

[3]   Foster, C. and Fidler, S. (2010) Optimizing Antiretroviral Therapy in Adolescents with Perinatally Acquired HIV-1 Infection. Expert Review of Anti-Infective Therapy, 8, 1403-1416.
https://doi.org/10.1586/eri.10.129

[4]   Vaz, L.M.E., Eng, E., Maman, S., Tshikandu, T. and Behets, F. (2010) Telling Children They Have HIV: Lessons Learned from Findings of a Qualitative Study in Sub-Saharan Africa. AIDS Patient Care STDs, 24, 247-256.
https://doi.org/10.1089/apc.2009.0217

[5]   National AIDS Committee, UNAIDS. Report 2015 Estimates and Projections on HIV and AIDS in CAMEROON 2010-2020.
http://cnls.cm/sites/default/files/estimation_et_projections_s
ur_le_vih_et_le_sida_au_cameroun_2010-2020_rapport_2015.pdf


[6]   Bain, L.E., Nkoke, C. and Noubiap, J.J.N. (2017) UNAIDS 90-90-90 Targets to End the AIDS Epidemic by 2020 Are Not Realistic: Comment on “Can the UNAIDS 90-90-90 Target Beachieved? A Systematic Analysis of National HIV Treatment Cascades”. BMJ GlobHealth, 2, e000227.
https://doi.org/10.1136/bmjgh-2016-000227

[7]   World Health Organization. Regional O. (1998) Therapeutic Patient Education: Continuing Education Program for Health Care Providers in the Field of Prevention of Chronic Diseases: Report of a WHO Working Group. Report No. EUR/ICP/ QCPH 01 01 03 Rev.2, WHO Regional Office for Europe, Copenhagen.
http://apps.who.int/iris/handle/10665/108151

[8]   World Health Organization (2011) Guideline on HIV Disclosure Counselling for Children up to 12 Years of Age. World Health Organization, Geneva.
http://www.ncbi.nlm.nih.gov/books/NBK304307/

[9]   Menon, A., Glazebrook, C., Campain, N. and Ngoma, M. (1999) Mental Health and Disclosure of HIV Status in Zambian Adolescents with HIV Infection: Implications for Peer-Support Programs. Journal of Acquired Immune Deficiency Syndromes, 46, 349-354.

[10]   Ferris, M., Burau, K., Schweitzer, A.M., Mihale, S., Murray, N., Preda, A., et al. (2007) The Influence of Disclosure of HIV Diagnosis on Time to Disease Progression in a Cohort of Romanian Children and Teens. AIDS Care, 19, 1088-1094.
https://doi.org/10.1080/09540120701367124

[11]   McNairy, M.L., Lamb, M.R., Carter, R.J., Fayorsey, R., Tene, G., Mutabazi, V., et al. (2013) Retention of HIV-Infected Children on Antiretroviral Treatment in HIV Care and Treatment Programs in Kenya, Mozambique, Rwanda, and Tanzania. Journal of Acquired Immune Deficiency Syndromes, 62, e70-e81.

[12]   Billong, S.C., Fokam, J., Penda, C.I., Amadou, S., Kob, D.S., Billong, E.-J., et al. (2016) Predictors of Poor Retention on Antiretroviral Therapy as a Major HIV Drug Resistance Early Warning Indicator in Cameroon: Results from a Nationwide Systematic Random Sampling. BMC Infectious Diseases, 16, 678.
https://doi.org/10.1186/s12879-016-1991-3

[13]   Nlend, A.E.N., Lyeb, A.S., Moyo, S. and Nsangou, D. (2016) Therapeutic Patient Education and Disclosure of Status of HIV Infected Children in Yaounde, Cameroon Achievements and Competence. Médecine Santé Trop, 3, 308-311.

[14]   Rwenyonyi, C.M., Kutesa, A., Muwazi, L., Okullo, I., Kasangaki, A. and Kekitinwa, A. (2011) Oral Manifestations in HIV/AIDS-Infected Children. European Journal of Dentistry, 5, 291-298.

 
 
Top