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Levels of adherence and factors associated with adherence to option B+ prevention of mother-to-child transmission among pregnant and lactating mothers in selected government health facilities of South Wollo Zone, Amhara Region, northeast Ethiopia, 2016
Delelegn Tsegaye, Leul Deribe, Shambel Wodajo
Epidemiol Health. 2016;38:e2016043.   Published online October 13, 2016
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  • 20 Crossref
AbstractAbstract PDF
The aim of this study was to measure the levels of adherence and to identify factors associated with adherence to option B+ prevention of mother-to-child transmission (PMTCT) among pregnant and lactating mothers in selected government health facilities of South Wollo Zone, Amhara Region, northeast Ethiopia.
An institution-based cross-sectional quantitative study design was employed from March 1, 2016 to April 14, 2016, using a standard structured data collection instrument. A sample of 191 human immunodeficiency virus (HIV)-positive pregnant and lactating mothers who were receiving PMTCT follow-up in the selected health facilities participated in the study. The data were entered using EpiData 3.1 and analyzed using SPSS version 21. Bivariate and multivariate logistic regression analyses were employed to identify factors associated with adherence. The p-values <0.05 and 95% confidence intervals (CIs) were used to identify associations between independent predictors and the outcome variable.
The level of adherence to option B+ PMTCT drugs was 87.9%. Women who received in-hospital treatment, who lived in rural areas, and faced challenges in initiating lifelong option B+ treatment on the same-day that they were diagnosed with HIV were less likely to adhere to the treatment (adjusted odds ratios [95% CI] of 0.3 [0.11 to 0.82], 0.26 [0.1 to 0.73], and 0.08 [0.02 to 0.37], respectively).
Collaborative efforts of zonal health departments with health facility administrators and counselors are recommended for effective and efficient interventions focusing on hospitals, rural areas, and patients who face challenges on the day of their diagnosis.


Citations to this article as recorded by  
  • Adherence to option B + antiretroviral therapy and associated factors in pregnant and breastfeeding women in Sub-Saharan Africa: a systematic review and meta-analysis
    Lucresse Corine Fassinou, Diane Songwa Nkeunang, Thérèse Delvaux, Nicolas Nagot, Fati Kirakoya-Samadoulougou
    BMC Public Health.2024;[Epub]     CrossRef
  • Adherence to option B+ PMTCT program and its predictors among HIV‐positive women in Ethiopia. A systematic review and meta‐analysis
    Habtamu Geremew, Demeke Geremew, Samuel Abdisa, Anteneh Mengist Dessie, Getachew Mullu Kassa, Nurilign Abebe Moges
    Health Science Reports.2023;[Epub]     CrossRef
  • Antiretroviral therapy adherence among breastfeeding mothers at a health facility in north Malawi
    Beatrice Kanyimbo, Ursula K Kafulafula, Bertha Chakhame
    African Journal of Midwifery and Women's Health.2022; 16(1): 1.     CrossRef
  • Adherence to option B+ and its association with disclosure status and counseling among HIV-positive pregnant and lactating women in Ethiopia: systematic review and meta-analysis
    Chalachew Adugna Wubneh, Birye Dessalegn Mekonnen, Mekdess Wesenyeleh Delelegn, Kendalem Asmare Atalell
    Public Health.2022; 211: 105.     CrossRef
  • The role of men in antenatal care and preventing HIV transmission from mothers to infants in Gambella region, Ethiopia
    Mirgissa Kaba, Michelle R. Kaufman, Andrea Ruff, Anteneh Asefa Mekonnen
    PLOS Global Public Health.2022; 2(8): e0000879.     CrossRef
  • What influences uptake and early adherence to Option B+ (lifelong antiretroviral therapy among HIV positive pregnant and breastfeeding women) in Central Uganda? A mixed methods study
    Aggrey David Mukose, Hilde Bastiaens, Fredrick Makumbi, Esther Buregyeya, Rose Naigino, Joshua Musinguzi, Jean-Pierre Van Geertruyden, Rhoda K. Wanyenze, Julie AE Nelson
    PLOS ONE.2021; 16(5): e0251181.     CrossRef
  • Level of adherence to option B plus PMTCT and associated factors among HIV positive pregnant and lactating women in public health facilities of Hawassa city, Southern Ethiopia
    Samuel Abdisa, Zelalem Tenaw, Frank T. Spradley
    PLOS ONE.2021; 16(8): e0255808.     CrossRef
  • Withdrawn: Magnitude of Adherence to Option B plus program and associated factors among women in Eastern African Countries: A Systematic Review and Meta-analysis
    Reta Tsegaye, Werku Etafa, Bizuneh Wakuma, Getu Mosisa, Diriba Mulisa, Tadesse Tolossa
    International Journal of Africa Nursing Sciences.2021; : 100368.     CrossRef
  • Adherence to antiretroviral therapy among HIV infected pregnant women in public health sectors: a pilot of Chilenje level one Hospital Lusaka, Zambia
    Moses Mukosha, Grace Chiyesu, Bellington Vwalika
    Pan African Medical Journal.2020;[Epub]     CrossRef
  • Joint and Separate Analysis for Longitudinal and Survival Data on Mother-to-Child Transmission of HIV Among Infected Mothers on Option B+ at Health Centers in North Shewa Zone, Ethiopia, 2017

    Abinet Dagnaw Mekuria, Assefa Legesse Sisay, Kassa Ketsela Hailegiorgies, Ayele Mamo Abebe
    Journal of Multidisciplinary Healthcare.2020; Volume 13: 1179.     CrossRef
  • Alarm Clock-Based Reminder for Improving Low Adherence on Option B Plus Antiretroviral Therapy Among HIV Positive Pregnant and Lactating Mothers in Northern Ethiopia

    Gebremedhin Gebreegziabher Gebretsadik, Hailay Gebretnsae, Mulu Ftwi, Afewerki Tesfahunegn Nigusse
    HIV/AIDS - Research and Palliative Care.2020; Volume 12: 687.     CrossRef
  • Adherence to Antiretroviral Treatment for Prevention of Mother-to-Child Transmission of HIV in Eastern Ethiopia: A Cross-Sectional Study

    Anwar Fedlu, Birhanu Alie, Ammas Siraj Mohammed, Fuad Adem, Abduselam Hassen
    HIV/AIDS - Research and Palliative Care.2020; Volume 12: 725.     CrossRef
  • Adherence to Option B+ Care for the Prevention of Mother-to-Child Transmission Among Pregnant Women in Ethiopia

    Fikadu Wondimu, Fisseha Yetwale, Endashew Admassu, Wakgari Binu, Gizachew Abdissa Bulto, Getie Lake, Eden Girmaye, Kababa Temesgen, Taklu Marama
    HIV/AIDS - Research and Palliative Care.2020; Volume 12: 769.     CrossRef
  • Level of Good Adherence on Option B+ PMTCT and Associated Factors Among HIV Positive Pregnant and Lactating Mothers in Public Health Facilities of Ilu Abba Bor and Buno Bedele Zones, Oromia Regional State, Southwestern Ethiopia, 2018

    Eyosiyas Yeshialem Asefa, Dejene Edosa Dirirsa
    HIV/AIDS - Research and Palliative Care.2020; Volume 12: 789.     CrossRef
  • The magnitude of adherence to option B plus program and associated factors among women in eastern African countries: a systematic review and meta-analysis
    Reta Tsegaye, Werku Etafa, Bizuneh Wakuma, Getu Mosisa, Diriba Mulisa, Tadesse Tolossa
    BMC Public Health.2020;[Epub]     CrossRef
  • Low adherence to Option B+ antiretroviral therapy among pregnant women and lactating mothers in eastern Tanzania
    Kamonga M. Zacharius, Namanya Basinda, Karol Marwa, Emmanuel H. Mtui, Albino Kalolo, Anthony Kapesa, Massimo Ciccozzi
    PLOS ONE.2019; 14(2): e0212587.     CrossRef
  • Levels of Option B+ ART Drugs Adherence and Associated Factors among Pregnant Women Following ART Services at Public Health Facilities of East Shawa Zone, Oromia, Ethiopia
    Mihretu Tarekegn, Ararso Baru, Assefa Seme
    Sexual & Reproductive Healthcare.2019; : 100459.     CrossRef
  • “I Was Not Told That I Still Have The Virus”: Perceptions of Utilization of Option B+ Services at a Health Center in Malawi
    Patience Mulewa, Egrina Satumba, Christopher Mubisi, Joseph Kandiado, Tumaini Malenga, Alinane Linda Nyondo-Mipando
    Journal of the International Association of Providers of AIDS Care (JIAPAC).2019; 18: 232595821987087.     CrossRef
  • Option B plus antiretroviral therapy adherence and associated factors among HIV positive pregnant women in Southern Ethiopia
    Dawit Jember Tesfaye, Desalegn Tsegaw Hibistu, Teshome Abuka Abebo, Feleke Tafesse Asfaw, Kaleegziabher Lukas, Tariku Laelago, Ermias Abera Turuse, Henok Gebreyohaness Kebede, Abraham Abate Altaye, Fanuel Belayneh Bekele
    BMC Pregnancy and Childbirth.2019;[Epub]     CrossRef
  • Acceptability of option B+ among HIV positive women receiving antenatal and postnatal care services in selected health centre’s in Lusaka
    Bridget Chomba Chanda, Rosemary Ndonyo Likwa, Jessy Zgambo, Louis Tembo, Choolwe Jacobs
    BMC Pregnancy and Childbirth.2018;[Epub]     CrossRef
Cost-effectiveness analysis of low density lipoprotein cholesterol-lowering therapy in hypertensive patients with type 2 diabetes in Korea: single-pill regimen (amlodipine/atorvastatin) versus double-pill regimen (amlodipine+atorvastatin)
Ji-Hyun Park, Yong-Ho Lee, Su-Kyoung Ko, Bong-Soo Cha
Epidemiol Health. 2015;37:e2015010.   Published online February 22, 2015
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  • 198 Download
  • 4 Web of Science
  • 4 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Single-pill combination therapy (amlodipine/atorvastatin) might be more effective than double-pill therapy (amlodipine+atorvastatin) in patients with diabetes and concomitant hypertension requiring statin therapy. We compared the cost-effectiveness of a single-pill with that of double-pill for control of low density lipoprotein cholesterol (LDL-C) levels, with the ultimate goal of cardiovascular disease prevention, in these patients using a cost-effectiveness analysis model that considered medication adherence.
Effectiveness was defined as the percentage (%) attainment of target LDL-C levels (<100 mg/dL) based on adherence for each therapy. Adherence was defined as compliance to medication (≥80% proportion of days covered). A systematic review of the literature was conducted to determine the proportion of patients who were adherent and target goal attainment based on adherence level. The annual medication costs were based on the adherence levels for each regimen. The average cost-effectiveness ratio (ACER) was calculated as the cost per % attainment of the target LDL-C level.
The ACER for the single-pill regimen was lower than for the double-pill regimen (4,123 vs. 6,062 Korean won per 1% achievement of target goal). Compared with the double-pill, the medication costs were approximately 32% lower with the single-pill.
A single-pill for reductions in LDL-C is cost-effective compared with double-pill in hypertensive patients with type 2 diabetes.
Korean summary
본 연구는 고혈압을 동반한 당뇨환자에게 혈중지질의 추가적인 관리가 필요한 경우 단일복합제제(Amlodipine/Atorvastatin) 투여와 단일제제 병용 (Amlodipine + Atorvastatin) 투여의 두 대안에서 복약 순응도를 고려한 비용-효과성을 비교 분석하였다. 복약순응도의 차이는 치료결과에도 영향을 미치게 되어 복약순응군에서의 치료효과가 비순응군의 효과보다 더 우수하므로 비용-효과 분석 결과 단일복합제 투여군이 단일제제 병용투여군과 비교하였을때 더 효율적인 대안임을 확인할 수 있다.


Citations to this article as recorded by  
  • Fixed‐dose combination of amlodipine and atorvastatin improves clinical outcomes in patients with concomitant hypertension and dyslipidemia
    Chia‐Pin Lin, Ying‐Chang Tung, Fu‐Chih Hsiao, Chia‐Hung Yang, Yi‐Wei Kao, Yu‐Sheng Lin, You‐Chia Chu, Pao‐Hsien Chu
    The Journal of Clinical Hypertension.2020; 22(10): 1846.     CrossRef
  • Bempedoic acid for high-risk patients with CVD as adjunct lipid-lowering therapy: A cost-effectiveness analysis
    Kanila Perera, Ning Kam, Zanfina Ademi, Danny Liew, Ella Zomer
    Journal of Clinical Lipidology.2020; 14(6): 772.     CrossRef
  • Efficacy and Tolerability of Telmisartan/Amlodipine and Rosuvastatin Coadministration in Hypertensive Patients with Hyperlipidemia: A Phase III, Multicenter, Randomized, Double-blind Study
    Tae-Seok Kim, Seung-Woon Rha, Seok-Yeon Kim, Dae-Gyun Park, Ki-Chul Sung, Myung-Ho Yoon, Kye-Hoon Kim, Han-Cheol Lee, Woo-Sik Kim, Yong-Jin Kim, Jeong-Cheon Ahn, Moo-Yong Rhee, Dong-Hun Cha, Byung-Su Yoo, Sang-Ho Park, Ki-Dong Yoo, Dong-Woon Jeon, Young-W
    Clinical Therapeutics.2019; 41(4): 728.     CrossRef
  • Formulations of Amlodipine: A Review
    Muhammad Ali Sheraz, Syed Furqan Ahsan, Marium Fatima Khan, Sofia Ahmed, Iqbal Ahmad
    Journal of Pharmaceutics.2016; 2016: 1.     CrossRef
Effect of Medicine Adherence on the Occurrence of Cerebrovascular Disorders in Diabetes Mellitus Patients
Il-Su Park, Hae-Sook Sohn
Epidemiol Health. 2011;33:e2011001.   Published online January 28, 2011
  • 13,378 View
  • 84 Download
  • 3 Crossref
AbstractAbstract PDF
<sec><title>OBJECTIVES</title><p>To assess the association between the occurrence of cerebrovascular disorders and a medication adherence in diabetes mellitus patients.</p></sec><sec><title>METHODS</title><p>Medical records from 1,114 new patients with diabetes mellitus were collected and the occurrence of cerebrovascular disorders was observed. Data was gathered from the health examination records of diabetes mellitus patients registered at the Korean Metabolic Syndrome Research from 1996 to 2005, medication records from the National Health Insurance Corporation and death data from the National Statistics Office from 1997 to 2007. Hazard ratios were analyzed using the Cox proportional hazard model to test the association between the occurrence of cerebrovascular disorders and the level of medication adherence. Medication adherence was calculated using Continuous measure of Medication Acquisition (CMA).</p></sec><sec><title>RESULTS</title><p>Of 1,114 diabetes mellitus patients, cerebrovascular disorders occurred in 67 cases (6.1%). The mean duration for the development of a cerebrovascular disorder was 3.82 yr. Medication adherence (≥0.8 vs. <0.5: HR, 3.26; 95% CI, 1.47-7.21, ≥0.8 vs. 0.5-0.7 HR, 0.99; 95% CI, 0.33-2.95) was an independent factor associated with the occurrence of cerebrovascular disorders in diabetes mellitus.</p></sec><sec><title>CONCLUSION</title><p>Increased medication adherence is necessary to prevent the occurrence of cerebrovascular disorders in diabetes mellitus patients. Furthermore we propose that CMA be considered as a method for monitoring medication adherence in clinics.</p></sec>


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  • Effects of early medication treatment and metformin use for cancer prevention in diabetes patients: a nationwide sample cohort study in Korea using extended landmark time analysis
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    Epidemiology and Health.2021; 43: e2021103.     CrossRef
  • Clinical inertia, reverse clinical inertia, and medication non-adherence in type 2 diabetes
    D. Giugliano, M. I. Maiorino, G. Bellastella, K. Esposito
    Journal of Endocrinological Investigation.2019; 42(5): 495.     CrossRef
  • El incumplimiento en el tratamiento de la diabetes mellitus tipo 2 en España
    Emilio Márquez Contreras
    Hipertensión y Riesgo Vascular.2012; 29: 8.     CrossRef

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