Discordance Between Providers Estimated and Caregivers
Self Reported Adherence to HAART and Immunological
Response Among HIV Infected Children in Ethiopia
Sibhatu Biadgilign1*, Amare Deribew2,
Alemayehu Amberbir3, Kebede Deribe4,
Adugaw Berhane1
1Jimma University, Public Health Faculty, P.BOX 24414, Addis Ababa, Ethiopia.
2Department of Epidemiology, Jimma University, Ethiopia.
3Addis Ababa University, Ethiopia.
4Fayyaa Integrated Development Association-NCMI, Ethiopia.
*For Correspondence:
Email:
sibhatu2005@yahoo.com
Received:
17-Jan-09 Revised:
17-Apr-09 Accepted:
23-Apr-09
International Journal of Health Research,
June
2009; 2(2):
139-148 (e225p35-44)
Original
Research Article
Abstract
Purpose:
Poor concordance between patient and
physician reports of adherence might lead to
inappropriate decisions regarding therapy. This study
was undertaken to determine the rate of discordance
between caregivers of children and physicians on
adherence to Highly Active Antiretroviral Therapy (HAART).
Methods:
In a cross sectional study involving 390 respondents
that was conducted in five hospitals in Addis Ababa,
agreement between caregiver-reported adherence and
providers’ estimate of adherence was compared using
Kappa (k) statistic. The association between the CD4
counts and measure of adherence was evaluated using a
receiver operating characteristic (ROC) curve.
Results:
Caregivers reported dose adherence was 87% in the last 7
days and physician estimated 84% of the children as
adherent based on their judgment. Fair agreement was
observed between caregivers-reported dose adherence and
providers' estimate adherence (Kappa = 0.27, p=0.0001).
In a ROC curve, the association between a current CD4
count slope and physician estimated was poor.
Conclusions:
There is fair agreement and high rate of discordance
(18%) between physicians estimated and caregivers
reported adherence.
These
recall for an intervention to augment better mutual
understanding between physicians and caregivers on the
issue of adherence to HAART under clinical care
programme.
Keywords:
Adherence; CD4 count;
Discordance; HAART.
