Burden of virologic failure, and its determinants among HIV positive children in East Africa: a systematic review and meta-analysis

Background: There are many studies regarding the prevalence of Virologic failure and its associated factors in East Africa, but they are inconclusive. In this study, the prevalence of Virologic failure and its associated factors in east Africa were determined. Methods: Published articles that were conducted in English language were prepared based on preferred reporting items for systematic reviews and meta-analysis (PRISMA) statement. Web of Science, PubMed, and Google Scholar were explored to find out the articles. STATA Version 14 software was used for computing the pooled estimates of both the prevalence of virologic failure and associated factors. The pooled estimates were computed using both random and fixed effect models. Results were presented by using the randomand fixed effect models. . The pooled estimates were presented with 95% CI. Publication bias was assessed by looking the symmetry in the funnel plot. Result: The pooled prevalence of virologic failure was, 25.90 (19.49, 32.32, p ≤ 0:001) in the random effect model. Four factors, poor adherence (2.91 (Pooled odds ratio(POR): 2.91, 95%CI: 1.93, 4.40), being male (1.17 (POR: 1.17, 95%CI: 1.08, 1.27)), wasting as an under nutrition (3.1 (POR:3.1, 95%CI: 1.63, 5.95), and Nevirapine(NVP) based regimen (2.76 (POR: 2.76 (1.65,95%CI: 4.62)) were found to be independent predictors of virologic failure. Conclusion: The prevalence of virologic failure in East Africa is remarkably high. Four factors were found to be the determining factors Different strategies must be designed to address (poor adherence, being male, wasting as an under nutrition, and NVP based regimen). Keywords: HIV; virologic failure; adherence; viral load suppression.