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

Prevalence and determinants of treatment failure among children living with HIV in selected hospitals in Bushenyi District, Uganda: a cross-sectional study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Prevalence and determinants of treatment failure among children living with HIV in selected hospitals in Bushenyi District, Uganda: a cross-sectional study Patrick Alyela, Ezera Agwu, Glory M.E Nja, Matthew Chibuna Igwe, and 5 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7558332/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 8 You are reading this latest preprint version Abstract 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. Prevalence of treatment failure Determinants of treatment failure Children living with HIV Bushenyi District Full Text Additional Declarations No competing interests reported. Supplementary Files questionaire.pdf Cite Share Download PDF Status: Under Review Version 1 posted Reviews received at journal 05 Jan, 2026 Reviewers agreed at journal 25 Dec, 2025 Reviewers agreed at journal 14 Oct, 2025 Reviewers invited by journal 09 Oct, 2025 Editor assigned by journal 09 Oct, 2025 Editor invited by journal 07 Oct, 2025 Submission checks completed at journal 04 Oct, 2025 First submitted to journal 04 Oct, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7558332","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":531960474,"identity":"0edd908e-16d3-420e-900b-19996aedb512","order_by":0,"name":"Patrick Alyela","email":"","orcid":"","institution":"Kampala International University","correspondingAuthor":false,"prefix":"","firstName":"Patrick","middleName":"","lastName":"Alyela","suffix":""},{"id":531960475,"identity":"b22a3cb9-0c7a-4b79-8683-58e9f8117ff1","order_by":1,"name":"Ezera Agwu","email":"","orcid":"","institution":"Kampala International 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study","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-infectious-diseases","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"infd","sideBox":"Learn more about [BMC Infectious Diseases](http://bmcinfectdis.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/infd","title":"BMC Infectious Diseases","twitterHandle":"#bmcinfectdis","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC 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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.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethodology\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis 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.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe period prevalence of ART failure was 48.67% (95% CI: 42-60.5). Poor ART adherence (Fischer’s exact test, p_value \u0026lt; 0.001) and the presence of opportunistic infections (Fischer’s exact test, p_value \u0026lt; 0.001), poor nutrition (Fischer’s exact test, p_value \u0026lt; 0.001), the presence of Pneumonia infection (Fischer’s exact test, p value \u0026lt; 0.006) and hepatitis B co-infection (Fischer’s exact test, p value \u0026lt; 0.002) were the factors associated with ART treatment failure.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion and recommendation\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe 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.\u003c/p\u003e","manuscriptTitle":"Prevalence and determinants of treatment failure among children living with HIV in selected hospitals in Bushenyi District, Uganda: a cross-sectional study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-10-23 23:17:22","doi":"10.21203/rs.3.rs-7558332/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"editorInvitedReview","content":"","date":"2026-01-05T05:52:22+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"132376055838730436063561946262546181238","date":"2025-12-26T04:51:06+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"18277288391683621829903791072673837554","date":"2025-10-14T20:32:12+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-10-09T20:25:48+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-10-09T20:20:26+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-10-07T12:04:56+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-10-04T15:25:56+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Infectious Diseases","date":"2025-10-04T09:09:39+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-infectious-diseases","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"infd","sideBox":"Learn more about [BMC Infectious Diseases](http://bmcinfectdis.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/infd","title":"BMC Infectious Diseases","twitterHandle":"#bmcinfectdis","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"78fe8929-01d4-42ea-a5c7-947b818ed708","owner":[],"postedDate":"October 23rd, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2025-10-23T23:17:22+00:00","versionOfRecord":[],"versionCreatedAt":"2025-10-23 23:17:22","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7558332","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7558332","identity":"rs-7558332","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}