Video observations of treatment administration to children on antiretroviral therapy in rural KwaZulu-Natal

Figures & data

Figure 1. The four systems of Bronfenbrenner’s EST.

Table 1. Context-related observations.

	Newly initiated		Suppressed VL		Unsuppressed VL
	Morning visit (n = 10)	Evening visit (n = 6)	Morning visit (n = 12)	Evening visit (n = 8)	Morning visit (n = 11)	Evening visit (n = 9)
Medication workspace
Lounge	5	4	9	6	2	4
Bedroom	3	2	2	1	7	3
Kitchen	2	0	1	1	2	2
Medication storage
In bedroom (hidden)	5	3	5	3	3	5
In bedroom (not hidden)	2	1	6	5	7	4
In lounge (hidden)	3	2	0	0	1	0
In lounge (not hidden)	0	0	1		0	0
LPV/r refrigerated^a	4 out of 8	2 out of 8	9 out of 10	7 out of 10	5 out of 9	4 out of 9
Food given^b	3	2	1	0	0	0

^a27 (10 out of 12 suppressed; 9 out of 11 unsuppressed; 8 out of 10 newly initiated) children were receiving LPV/r as part of their regimen.

^bFood given before treatment administration.

Table 2. Medication-related observations.

	Newly initiated		Suppressed VL		Unsuppressed VL
	Morning visit (n = 10)	Evening visit (n = 6)	Morning visit (n = 12)	Evening visit (n = 8)	Morning visit (n = 11)	Evening visit (n = 9)
Medication measurement tools
Syringe	6	3	7	5	7	5
Syringe + nozzle	4	2	4	3	1	1
Measuring cup	0	1	1	0	3	3
Measurement issues
Bubble in syringe	1	0	2	1	1	1
Dose checking^a
ABC	2	3	2	0	4	3
3TC	2	3	1	1	4	3
LPV/r	3	3	8	6	6	7
Medication administration (directly or indirectly)^c
Syringe (directly)	6	3	9	7	4	4
Measuring cup (indirectly)	4	3	2	1	7	5
Missed doses^b	1	1	0	0	0	0

^aDose checking: caregiver checks the measurement dose amount in the syringe for accuracy.

^bMissed doses: medication is not taken/given on the day.

^cMedication administration: directly – medication injected into child’s mouth using syringe. Indirectly – medication transferred into a cup.

Figure 2. Dose measurement of 3TC taken at an angle. The image illustrates the caregiver of a suppressed child on ART taking a measurement of 3TC at a horizontal angle.

Table 3. Child-related observations.

	Newly initiated		Suppressed VL		Unsuppressed VL
	Morning visit (n = 10)	Evening visit (n = 6)	Morning visit (n = 12)	Evening visit (n = 8)	Morning visit (n = 11)	Evening visit (n = 9)
Palatability
No palatability issues	5	4	10	3	8	8
Spitting	1	0	1	0	2	0
Vomiting	1	0	0	0	0	1
Cough/moans	2	0	0	4	1	0
Refusal	1	2	1	1	0	0
Taste distracter used (yes)	0	1	2	2	1	1