College of Health Sciences

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ADHERENCE TO ART AND ASSOCIATED FACTORS AMONG HIV INFECTED CHILDREN ON FOLLOW-UP AT MEKELLE GENERAL HOSPITA
(Mekelle University, 2025-02-01) Selam Gebreslassie Weldetatyos
Introduction: Adherence to antiretroviral therapy (ART) is a significant factor for the success of HIV treatment. The challenges are particularly serious in Sub-Saharan countries as the high rates of HIV/AIDS lead to greater numbers of affected individuals. The magnitude of this challenge remained large in developing countries like Ethiopia. In Tigray, though high rates of patient’s poor adherence are expected which is resulted from the war and associated siege there is limited evidence on adherence to ART particularly among children. Objective: to assess the level of adherence to ART and the factors associated among HIV infected children in Mekelle General hospital. Method: Using hospital based cross-sectional study design a total of 136 children age under 18 who was on ART. Census method of data collection was used. Then, the collected data was analyzed using SPSS27. Dependent variable was dictomized, then a descriptive, bi-variate and multivariate logistic regression analysis was performed to see the frequency, measure the level of adherence and identify the determinate factor of good / poor adherence. The research was done on April 2024 by September 2024. Result and discussion: A total of 136 study participants were included. The level of ART adherence among children was 115 (84.6%). Majority of children are in the age of 10-18 years 98[72%] of all female are dominant number than male 80[58.8%] majority resides in Mekelle 122[87.9%]. No variable is found significant factor affecting adherence. Care givers of lower economic status [AOR=5.711(0.532-61.350)], self-care-giver type [AOR=3.332(0.356-31.227)], and those who were aware of their HIV serio status [AOR=1.202(0.433-3.334)] were more likely to adhere to ART treatment. On the other hand, the study showed the Sex of the child [AOR=0.922(0.360-2.361)], sex of the caregiver [AOR=0.493(0.181-1.341)] and caregivers with other occupation [AOR=0.450(0.050-4.036)], were less related to Adherence of ART medication. Caregiver’s forgetfulness (28.7%) and stigma of children (25%) were more likely the main reasons for missed doses. Conclusion and recommendation: The level of adherence to antiretroviral therapy was poor. This study indicated the level of adherence (84.6%) showed a difference with WHO requirements, 95%
Patients' Beliefs about Medications, Adherence to Treatment, and Drug-Drug Interactions in the Management of Heart Failure: A cross-sectional Study at Ayder Comprehensive Specialized Hospital, Northern Ethiopia
(Mekelle University, 2025-06-12) Asmelash Araya Welecheal
Background: Heart failure (HF) is the heart’s inability to pump blood effectively due to structural or functional impairments. Patients’ beliefs about medications, adherence, and drug-drug interactions are critical factors in heart failure managements and understanding these can enhance HF management and outcomes. Objective: To assess beliefs about medications, adherence levels, and the prevalence of drug-drug interactions in heart failure treatment. Method: A cross-sectional study was conducted from June 15 to August 30, 2024, with 314 HF patients selected via convenience sampling methods. Data was collected using the Beliefs about Medicines Questionnaire, Morisky Medication Adherence Scale-8, and DDInetr software. The analysis was performed in SPSS 27 using descriptive statistics, Mann-Whitney U, and Kruskal Wallis H tests (p < 0.05, 95% CI). Results: Among 314 participants, the median (IQR) age was 51.5 (32-65) years, 51.9% were female. The median treatment duration was four years. The mean score for specific necessity (20 ± 3.19), specific concern (15 ± 3.396), overuse (11.05 ± 2.297) and harm (9.03 ± 2.47) was scored. A majority of participants (79.3%) were classified as ambivalent, with a necessity-concern differential of +5.1. Non-adherence was observed in 41.4% of participants, with forgetfulness cited as the leading reason (37.6%). Significant correlations were found between adherence and both specific necessity (r = +0.27, p < 0.001) and harm beliefs (r = -0.27, p < 0.001). A total of 993 drug-drug interactions were identified, with moderate interactions being the most common and enalapril with Spironolactone was the drugs with sever interaction. These interactions were more prevalent among older patients and those experiencing polypharmacy. Conclusion: Overall heart failure patients have strong necessity belief than concern about their medication where 84.7% knows the benefit of their medication. Over half of the participants were adherent to their medication due to high necessity belief, low concern, and forgetfulness. Severe DDIs were less common (6.95%) but requires medical treatment. Collaborative healthcare efforts are key to improving positive beliefs, and adherence, and reducing DDIs for better HF outcomes.