Prevalence and determinants of treatment failure among children living with HIV in selected hospitals in Bushenyi District, Uganda: a cross-sectional study

Background Human immunodeficiency infections have remained one of the major public health threats globally, with pronounced effects in Sub-Saharan Africa and Asia. Globally, more than 300 children and adolescents succumb to HIV/AIDS every day, with experts and civil societies predicting some loss in HIV gains because of the recent disruption of care and support from USAID. Therefore, this research aimed to determine the prevalence and determinants of ART treatment failure among children living with HIV in Bushenyi District, Western Uganda. Methodology This was a hospital-based cross-sectional study conducted in two selected hospitals in Bushenyi district, western Uganda. A total of 113 children living with HIV were recruited from hospital records through stratified random sampling from Kampala International University Teaching Hospital and Ishaka Adventists hospital in Bushenyi district, Western. Data were extracted from hospital records via an extraction tool covering at least 2 viral load records from the time of ART initiation. We used Epidata Version 4.2 to enter the data. Analysis was performed via Stata version 15. Parametric and nonparametric tests were used to assess the associations between ART failure and demographic and medical factors. Results The period prevalence of ART failure was 48.67% (95% CI: 42-60.5). Poor ART adherence (Fischer’s exact test, p_value < 0.001) and the presence of opportunistic infections (Fischer’s exact test, p_value < 0.001), poor nutrition (Fischer’s exact test, p_value < 0.001), the presence of Pneumonia infection (Fischer’s exact test, p value < 0.006) and hepatitis B co-infection (Fischer’s exact test, p value < 0.002) were the factors associated with ART treatment failure. Conclusion and recommendation The period prevalence of ART failure was high in our context. The factors associated with ART treatment failure included poor adherence to ART, poor nutrition, the presence of opportunistic infections, hepatitis B coinfection and the presence of Pneumonia infection. Strategies that enhance drug adherence and support, optimal screening and treatment of opportunistic infections, hepatitis B coinfection and the integration of nutritional support like ready to use therapeutic food to tackle the impact of under (poor) nutrition among children infected with HIV/AIDS would potentially improve ART treatment outcomes.