Effects of leisure activities and psychosocial support on medication adherence and clinic attendance among children on antiretroviral therapy

Figures & data

Figure 1 The routine at the monthly get-together party.

Abbreviations: KC, Kiddies’ Club; RSC, Riverside Specialist Clinic; FMC, Federal Medical Centre.

Table 1 Some characteristics of the 33 children on recruitment into the Kiddies’ Club

Characteristic	Number	%
Sex
Male	17	51.5
Female	16	48.5
Age (years)
Median (IQR)	5.0 (3.5–8.0)
Age group (years)
0–5	19	57.6
6–8	7	21.2
9–15	7	21.2
Ethnicity
Tiv	30	90.9
Idom	3	9.1
Orphanhood status
Maternal	2	6.1
Paternal	2	6.1
Double	8	24.2
Not orphan	21	63.6
Number of other children in household
≤4	16	48.5
>4	17	51.5
Sibling also HIV-infected
Yes	29	87.9
No	4	12.1
Child knows that s/he has a chronic illness
Yes	16	48.5
No	17	51.5
Child knows that the chronic illness is HIV/AIDS
Yes	15	45.5
No	18	54.5
Age of child on diagnosis of HIV (months)
Median (IQR)	18.00 (12.00–42.00)
<12	51	45.5
13–24	5	15.2
>24	13	39.4
Types of HAART
First	31	93.9
Second	2	6.1
Child can identify ARV drugs
Yes	14	42.4
No	19	57.6
Duration on HAART before LTFP (months)
Median (IQR)	9.00 (8.50–36.00)
<12	19	57.6
13–24	4	12.1
>24	10	30.3
Duration of time LTFP (days)
Median (IQR)	135 (127.5–160)
Child is responsible for HIV administration
Yes	6	18.2
No	27	81.8
Child still on ART at enrollment into KC
Yes	0	0.0
No	33	100.0
Child had commenced ART in another health facility at enrollment into KC
Yes	0	0.0
No	33	100.0
Child refused/vomited ARV at some time
Yes	10	30.3
No	23	69.7
Child experienced ARV side effects at some time
Yes	5	15.2
No	28	84.8
Child taking other medication apart from ARV
Yes	3	9.1
No	30	90.9
Child believes hospital is hostile/stigma
Yes	0	0.0
No	33	100.0

Abbreviations: KC, Kiddies’ Club; IQR, interquartile range; LTFP, loss to follow-up; ARV, antiretroviral medicine; HARRT, highly active antiretroviral therapy; ART, antiretroviral therapy.

Table 2 Some characteristics of the caregivers on recruitment into the Kiddies’ Club

Characteristic	Number	%
Type of CG
Father	4	12.1
Mother	21	63.6
Biological relation	6	18.2
Non-biological relation	2	6.1
Sex of CG
Male	5	15.2
Female	28	84.8
Age of CG (years)
Median (IQR)	37.00 (33.00–44.00)
15–24	5	15.2
25–34	4	12.1
35–39	12	36.4
≥40	12	36.4
Marital status of CG
Married	23	69.7
Divorced	6	18.2
Widowed	4	12.1
Single	0	0.0
Educational status of CG
None	6	18.2
Primary	3	9.1
Secondary	17	51.5
Tertiary	7	21.2
Has had more than one CG
Yes	16	48.5
No	17	51.5
CG on HAART
Yes	26	78.8
No	7	21.2
CG drinks alcohol
Yes	31	93.9
No	2	6.1
CG takes Indian hemp
Yes	4	12.1
No	29	87.9
CG receives financial support
Yes	13	39.4
No	20	60.6
CG uses memory aids
Yes	2	6.1
No	31	93.9
Employment status of CG
Unemployed	6	18.2
Employed	27	81.8
CG has disclosed HIV to the child
Yes	14	42.4
No	19	57.6
Time spent in getting to the clinic
Yes (≥1 hour)	16	48.5
No (<1 hour)	17	51.5
CG believes in efficacy of HAART
Yes	32	97.0
No	1	3.0
CG believes hospital is hostile/stigma
Yes	2	6.1
No	31	93.9

Abbreviations: CG, caregiver; IQR, interquartile range; HARRT, highly active antiretroviral therapy.

Table 3 Reasons for losses to follow-up on recruitment into the Kiddies’ Club

Reason	Number	%
“I didn’t have money”
Yes	32	96.9
No	1	3.1
“I forgot”
Yes	22	66.7
No	11	33.3
“I got busy”
Yes	19	57.6
No	4	42.4
“I traveled”
Yes	17	51.5
No	16	48.5
“I felt sick”
Yes	16	48.5
No	17	51.5
CG just died
Yes	3	9.1
No	30	90.9
“I had visitors at home and I couldn’t leave them”
Yes	3	9.1
No	30	90.9

Abbreviation: CG, Caregiver.

Table 4 Clinical, immunoviralogical, and treatment response on follow-up of the 33 children in Kiddies’ Club

Characteristic	Baseline	Month 6	Month 12	P-value (baseline–Month 6)	P-value (baseline–Month 12)	P-value (all 3 time-points)
Hemoglobin (g/dL)
Mean (SD)	8.50 (1.61)	10.03 (1.86)	10.47 (1.73)	0.000	0.000	0.000
<10, N (%)	28 (84.8)	15 (45.5)	9 (27.3)	0.084	0.346	–
≥10, N (%)	5 (15.2)	18 (54.5)	24 (72.7)
CD4 count (cells/mm^3)
Median (IQR)	187.00 (102.00–493.00)	1,030.00 (532.00–1,623.00)	1,203.00 (650.50–1,843.00)	0.000	0.000	0.000
<200, N (%)	18 (54.8)	1 (3.0)	0 (0)	0.354	NA	–
≥200, N (%)	15 (45.5)	32 (97.0)	33 (100.0)
Viral load (copies/mL)
Median (IQR)	45,678.00 (7,095.00–419,109.50)	200.00 (200.00–200.00)	200.00 (200.00–200.00)	0.000	0.000	0.000
<200, N (%)	5 (15.2)	30 (90.9)	30 (90.9)	0.443	0.443	–
≥200, N (%)	28 (84.8)	3 (9.1)	3 (9.1)
WHZ
Median (IQR)	−0.395 (−1.715 to 2.290)	−0.090 (−1.153 to 3.090)	0.420 (−0.615 to 3.678)	0.000	0.000	0.000
<−2 SD, N (%)	1 (6.3)	16 (100.0)	16 (100.0)	NA	NA	–
≥−2 SD, N (%)	15 (93.8)	0 (0.0)	0 (0.0)
NC	17
BMI
Median (IQR)	15.40 (14.70–17.50)	18.50 (17.90–18.85)	19.20 (18.95–20.15)	0.000	0.000	0.000
≥18.5, N (%)	2 (11.8)	9 (56.3)	17 (100.0)	0.568	NA	–
<18.5, N (%)	15 (88.2)	7 (43.8)	0 (0.0)
NC	16
Viralogical failure
Yes, N (%)	30 (90.9)	3 (9.1)	3 (9.1)	0.566	0.566	–
No, N (%)	3 (9.1)	30 (90.9)	30 (90.9)
Immunological failure
Yes, N (%)	18 (54.5)	0 (0.0)	0 (0.0)	NA	NA	–
No, N (%)	15 (45.5)	33 (100.0)	33 (100.0)
Clinical failure
Yes, N (%)	16 (48.5)	6 (18.2)	0 (0.0)	0.019	NA	–
No, N (%)	17 (51.5)	27 (81.8)	33 (100.0)
Adherence on HAART (100%)
Yes, N (%)	0 (0.0)	33 (100.0)	33 (100.0)	NA	NA	–
No, N (%)	33 (100.0)	0 (0.0)	0 (0.0)
Hospitalizations
Yes, N (%)	0 (0.0)	1 (3.0)	0 (0.0)	NA	NA	–
No, N (%)	33 (100.0)	32 (97.9)	33 (100.0)

Abbreviations: SD, standard deviation; IQR, interquartile range; NA, not available; –, not applicable; NC, not computed; HARRT, highly active antiretroviral therapy; WHZ, weight for height z-score; BMI, body mass index.