Response to pharmacological and clinical compliance monitoring of HIV-exposed children
Respuesta al monitoreo del cumplimiento farmacológico y clínico en niños expuestos a VIH
Resposta ao gerenciamento de conformidade farmacológica e clínica de crianças expostas ao HIV
DOI:
https://doi.org/10.15446/av.enferm.v39n3.87987Keywords:
Infectious Disease Vertical Transmission, HIV, Pediatric Nursing, Caregivers, Treatment Adherence and Compliance (en)Transmissão Vertical de Doença Infecciosa , HIV, Enfermagem Pediátrica, Cuidadores; Cooperação e Adesão ao Tratamento (pt)
Transmisión Vertical de Enfermedad Infecciosa, VIH, Enfermería Pediátrica, Cuidadores, Cumplimiento y Adherencia al Tratamiento (es)
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Objective: To establish the degree of pharmacological and clinical compliance of family caregivers of HIV-exposed children as well as the
sociodemographic factors associated with care performance.
Methods: Cross-sectional study conducted with 40 caregivers of children exposed to HIV and under specialized care service. The Ability Assessment Scale
for the Care of HIV-exposed Children was used. Data were analyzed according to descriptive statistics and bivariate analysis using the Chi-square and Fisher’s exact tests.
Results: Caregivers’ high ability for drug administration and clinical monitoring of HIV-exposed children was verified. There was a statistically significant difference between the care ability and infants’ age. In the group with high care ability, there was a higher prevalence of young mothers with partners, unemployed, high school equivalent education, living with four to seven people, and receiving family support.
Conclusion: Health services should consider sociodemographic factors and family support in the
follow-up of HIV-exposed children by developing an expanded care plan and longitudinal interventions aimed at monitoring the ability of family caregivers to provide medication and clinical follow-up for children. Incorporating these strategies will contribute to improve pharmacological and clinical adherence of HIV-exposed children and to enhance the quality of
health care.
Objetivo: establecer el grado de cumplimiento farmacológico y clínico de los familiares cuidadores de niños expuestos a VIH y los factores sociodemográficos asociados a la ejecución de esta atención.
Materiales y métodos: estudio transversal realizado con 40 cuidadores de niños expuestos al VIH, quienes reciben atención especializada. Se utilizó la Escala de Evaluación de Capacidades para el Cuidado de Niños Expuestos al VIH. Los datos fueron analizados mediante el uso de estadística descriptiva y análisis bivariado, empleando la prueba de chi-cuadrado y el test exacto de Fisher.
Resultados: se evidenció una alta capacidad por parte de los cuidadores para la administración de medicamentos y el seguimiento clínico de los niños expuestos a VIH. Además, hubo diferencias estadísticamente significativas entre la capacidad de cuidado y la edad de los niños. En el grupo con alta capacidad de atención hubo mayor prevalencia de madres jóvenes, con pareja, desempleadas, escolaridad equivalente a secundaria, que viven con entre cuatro y siete personas, y reciben apoyo de sus familias.
Conclusión: los factores sociodemográficos y el apoyo familiar deben ser considerados por los servicios de salud durante el seguimiento a niños expuestos al VIH, para lo cual se debe elaborar un plan de atención ampliado e intervenciones longitudinales dirigidas a monitorear la capacidad de los cuidadores familiares de proporcionar medicación y seguimiento clínico a los niños. La incorporación de estas estrategias contribuirá a mejorar la adherencia farmacológica y clínica de niños expuestos a VIH, así como la calidad de la atención en salud.
Objetivo: estabelecer o grau de conformidade farmacológica e clínica dos familiares cuidadores de
crianças expostas ao HIV e os fatores sociodemográficos associados à execução desses cuidados.
Materiais e métodos: estudo transversal desenvolvido com 40 cuidadores de crianças nascidas expostas ao HIV em um serviço especializado. Utilizou-se a Escala de Avaliação da
Capacidade para Cuidar de Crianças Expostas ao HIV. Os dados foram analisados segundo a estatística descritiva e a análise bivariada, com o teste de
Qui-Quadrado e o exato de Fisher.
Resultados: evidenciou-se alta capacidade dos cuidadores para a administração medicamentosa e
acompanhamento clínico da criança exposta ao HIV. Houve diferença estatisticamente significativa entre
a capacidade para cuidar e a idade da criança. No grupo com alta capacidade para o cuidado, houve maior prevalência de mães jovens com companheiros, desempregadas, escolaridade equivalente ao ensino médio, que residiam com quatro a sete pessoas e recebiam apoio familiar.
Conclusões: fatores sociodemográficos e apoio familiar devem ser considerados pelos serviços de saúde no seguimento das crianças expostas ao HIV, mediante elaboração de plano de cuidado ampliado e intervenções longitudinais direcionadas ao gerenciamento da capacidade dos familiares cuidadores para a oferta medicamentosa e o acompanhamento clínico infantil. A incorporação
dessas estratégias contribuirá para melhorar a adesão farmacológica e clínica em crianças expostas ao HIV e para a qualidade da atenção à saúde.
References
(1) Matos VTG; Batista FM; Versage NV; Pinto CS; Oliveira VM; Vasconcelos-Pereira EF et al. High vertical HIV transmission rate in the Midwest region of Brazil. Braz J Infect Dis. 2018;22(3):177-185. https://doi.org/10.1016/j.bjid.2018.04.002
(2) Ministério da Saúde do Brasil. Protocolo clínico e diretrizes terapêuticas para prevenção da transmissão vertical do HIV, sífilis e hepatites virais. Brasília: Ministério da Saúde; 2019. https://bit.ly/3yBEeYF
(3) Holzmann APF; Silva CSO; Soares JAS; Vogt SE; Alves CR; Taminato M; Barbosa DA. Preventing vertical HIV virus transmission: Hospital care assessment. Rev Bras Enferm. 2020;73(3):e20190491. https://doi.org/10.1590/0034-7167-2019-0491
(4) Ministério da Saúde (Brasil). Protocolo clínico e diretrizes terapêuticas para manejo da infecção pelo HIV em crianças e adolescentes. Brasília: Ministério da Saúde; 2018. https://bit.ly/3s6U6jk
(5) Kigen HT; Galgalo T; Githuku J; Odhiambo J; Lowther S; Langat B et al. Predictors of loss to follow up among HIV-exposed children within the prevention of mother to child transmission cascade, Kericho County, Kenya, 2016. Pan Afr Med J. 2018;30:178. https://doi.org/10.11604/pamj.2018.30.178.15837
(6) Zanon BP; Paula CC; Padoin SMM. Revealing an HIV diagnosis for children and adolescents: Subsidy for the practice of care. Rev. Gaúcha Enferm. 2016;37(Spe):e2016-0040. https://doi.org/10.1590/1983-1447.2016.esp.2016-0040
(7) Guimarães MF; Lovero KL; Avelar JG; Pires LL; Oliveira GRT; Cosme EM et al. Review of the missed opportunities for the prevention of vertical transmission of HIV in Brazil. Clinics. 2019;74:e318. https://doi.org/10.6061/clinics/2019/e318
(8) Barroso LMM; Freitas JG; Galvão MTG. Escala para avaliação da capacidade para cuidar de crianças expostas ao HIV. Rev Enferm UFPE. 2013;7(1):722-730. https://bit.ly/3AuWJyu
(9) Potty RS; Sinha A; Sethumadhavan R; Isac S; Washington R. Incidence, prevalence and associated factors of mother-to-child transmission of HIV, among children exposed to maternal HIV, in Belgaum district, Karnataka, India. BMC Public Health. 2019;19:386. https://doi.org/10.1186/s12889-019-6707-3
(10) Beyene GA; Dadi LS; Mogas SB. Determinants of HIV infection among children born to mothers on prevention of mother to child transmission program of HIV in Addis Ababa, Ethiopia: A case control study. BMC Infect Dis. 2018;18:327. https://doi.org/10.1186/s12879-018-3217-3
(11) Melo MC; Ferraz RO; Nascimento JL; Donalisio MR. Incidência e mortalidade por AIDS em crianças e adolescentes: desafios na região sul do Brasil. Ciênc saúde colet. 2016;21(12):3889-3898. https://doi.org/10.1590/1413-812320152112.11262015
(12) Freitas JG; Barroso LMM; Galvão MTG. Maternal ability to take care of children exposed to HIV. Rev Latino-Am Enfermagem. 2013;21(4):964-972. https://doi.org/10.1590/S0104-11692013000400019
(13) Paula CC; Silva FS; Toebe TRP; Bick MA; Ferreira T; Padoin SMM. Chemopophilaxia, clinical follow-up and immunizations of children exposed to HIV: Assessment of family capacity. Cienc Cuid Saúde. 2019;18(1):e45024. https://doi.org/10.4025/cienccuidsaude.v18i1.45024
(14) Tiam A; Gill MM; Machekano R; Tukei V; Mokone M; Viana S et al. 18-24-month HIV-free survival as measurement of the effectiveness of prevention of mother-to-child transmission in the context of lifelong antiretroviral therapy: Results of a community-based survey. PLoS ONE. 2020;15(10):e0237409. https://doi.org/10.1371/journal.pone.0237409
(15) Larsen A; Magasana V; Dinh TH; Ngandu N; Lombard C; Cheyip M et al. Longitudinal adherence to maternal antiretroviral therapy and infant Nevirapine prophylaxis from 6 weeks to 18 months postpartum amongst a cohort of mothers and infants in South Africa. BMC Infect Dis. 2019;1919:789. https://doi.org/10.1186/s12879-019-4341-4
(16) Sánchez-Cabrera YJ; Mora Linares O; Sanabria Negrín JG. Experiencia en la eliminación de la transmisión vertical del VIH en Evinayong. Rev Ciencias Médicas. 2017;21(3):415-421. https://bit.ly/37uPydd
(17) Almeida FJ; Kochi C; Sáfadi MAP. Influence of the antiretroviral therapy on the growth pattern of children and adolescents living with HIV/AIDS. J Pediatr. 2019;95(Suppl 1):S95-S101. https://doi.org/10.1016/j.jped.2018.12.007
(18) Khumalo PN; Katirayi L; Ashburn K; Chouraya C; Mpango L; Mthethwa N; Mofenson LM. ‘There are no more secrets’: Acceptability of a family-centered model of care for HIV positive children in Eswatini. BMC Health Serv Res. 2020;20:951. https://doi.org/10.1186/s12913-020-05810-5
(19) Padoin SMM; Marchi MC; Santos WM; Quadros JS; Langendorf TF; Paula CC. The influence of marital status in social support in people infected by HIV. Rev Enferm Cent-Oeste Min. 2018;8:e2485. https://doi.org/10.19175/recom.v8i0.2485
(20) Bick MA; Ferreira T; Sampaio CO; Padoin SMM; Paula CC. Profile of infected pregnant women and children exposed to HIV at a specialized service in the South of Brazil. Rev Bras Saúde Mater Infant. 2018;18(4):791-801. http://doi.org/10.1590/1806-93042018000400007
(21) Sakyi KS; Lartey MY; Dension JÁ; Kennedy CE; Mullany LC; Owusu PG et al. Low birthweight, retention in HIV care, and adherence to ART among postpartum women living with HIV in Ghana. AIDS and Behavior.2018;23:433-444. https://doi.org/10.1007/s10461-018-2194-2
(22) Kim J; Lee E; Park BJ; Bang JH; Lee JY. Adherence to antiretroviral therapy and factors affecting low medication adherence among incident HIV-infected individuals during 2009-2016: A nationwide study. Sci Rep. 2018;8:3133. https://doi.org/10.1038/s41598-018-21081-x
(23) Pan American Health Organization (PAHO); World Health Organization (WHO). EMTCT Plus. Framework for elimination of mother-to-child transmission of HIV, syphilis, hepatitis B, and chagas. Washington, D.C.: PAHO; 2017. https://bit.ly/2VB0D
(24) United Nations (UN). Sustainable Development Goals. New York: UN; 2015. https://sustainabledevelopment.un.org
(25) Lima AMACC; Sousa DMN; Mendes IC; Oliveira LL; Oriá MOB; Pinheiro PNC. Transmissão vertical do HIV: reflexões para a promoção da saúde e cuidado de enfermagem. Av Enferm. 2017;35(2):179-187. http://doi.org/10.15446/av.enferm.v35n2.39872
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