Thesis (Ph.D. (Pharmacy)) -- University of Limpopo, 2022 / Antiretroviral (ARV) management in children is considered a challenging process, and
patients receiving ARVs remain at risk of medication errors. Recently, there has also
been a noticeable increase in Treatment Failure (TF) and the development of drug
resistance amongst children on ART. However, ART failure amongst children seems
to be an under-recognised issue, and adherence to treatment guidelines is reported
to be a challenge among nurses caring for People Living with HIV (PLWHIV). Hence,
the aim of this study was to explore the prescribing practices, and to determine the
knowledge, understanding, and competence levels of NIMART-trained nurses’ in the
management of children on Antiretroviral Therapy (ART) in Public Health Care (PHC)
facilities located in a rural district of Limpopo Province. To attain the purpose of the
study, the researcher in this study adopted a mixed-method, in an explanatory
sequential manner. The quantitative phase adopted a descriptive cross-sectional and
retrospective census of medical records to determine whether or not the children on
ART were prescribed the correct ARV regimen, dose, strength, dosing frequency and
received the correct quantities to last until the next appointment date. Whereas the
qualitative phase embraced a total purposive sampling of the NIMART-trained
professional nurses to explore their knowledge, understanding and views of ART
management in children. The results highlighted that these children under study even
though they were prescribed a correct ARV regimen in (n=7045; 96%) of the
cases;they were only correctly dosed in (n=7797; 53%); and prescribed the correct
strength (n=9539; 77%), with only (n=2748; 36.9%) having received the correct
quantity of treatment to last them until the next appointment date. Most nurses even
though they rated themselves very knowledgeable and competent in paediatric
HIV/AIDS management. This finding was contradicting the results obtained from the
medical records, as well as their responses to the given case scenario depicted some
level of non-adherence to treatment guidelines as well as a lack of understanding of
ARV management. From the findings of this ARV utilisation review and the
implementation of the developed ART dosing and dispensing training programme. The
study concludes that the nurse's prescribing practice was irrational in this cohort of
children, and most prescriptions did not entirely comply with the 2014/15 HIV/AIDs treatment recommendations. Since, this cohort of children was found to be susceptible
to medication related errors such as; Drug omissions in ARV regimens; Incorrect
dosing & dosing frequencies; as well as incorrectly supplied quantities. From the study
findings it is recommended that ARV stewardship programs should be considered in
order to develop and establish a core strategy for enhancing quality improvement in
the management of HIV-infected children on ART in resource-limited settings, not only
to inundate viral suppression and maintain it, but also to help achieve the UNAIDS 95-
95-95 target in children under 15 year / National Research Foundation (NRF)
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:ul/oai:ulspace.ul.ac.za:10386/4162 |
| Date | January 2022 |
| Creators | Mabila, Linneth Nkateko |
| Contributors | Demana, P. H., Mothiba, T. M. |
| Source Sets | South African National ETD Portal |
| Language | English |
| Detected Language | English |
| Type | Thesis |
| Format | xxi, 400 leaves |
| Relation |
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