Factors Associated with Therapeutic Adherence in Children with Type 1 Diabetes Followed at Treichville Teaching Hospital in Côte d’Ivoire

Introduction: The prognosis of type 1 diabetes (T1D) in children depends on strict adherence to treatment, which remains a major challenge in Sub-Saharan Africa, particularly in Côte d’Ivoire. Objectives: This study aims to identify factors influencing therapeutic adherence in children with diabetes followed at Treichville University Hospital. Materials and Methods: An analytical cross-sectional study was conducted on 74 children aged 3 to 18 years who were being followed for T1D. Socio-demographic data, knowledge about the disease, and treatment adherence were collected using medical records and structured questionnaires. Results: The mean age of the patients was 13.9 years (71.6% were adolescents). Children managed their own treatment in 63.5% of cases. The mean HbA1c was 10.55%, with 73.2% of patients having an HbA1c > 8%. Poor adherence was observed in 47.8% of children. Adherence was highest among children aged 0 to 6 years (100%). Factors significantly associated with better adherence included acceptance of the disease (p = 0.0001; OR = 16.7 [95% CI: 4.26 - 65.53]), parental involvement (p = 0.03; OR = 2.81 [95% CI: 1.06 - 7.48]), and good knowledge about diabetes (p = 0.03; OR = 0.35 [95% CI: 0.13 - 0.92]). Conclusion: Improving treatment adherence requires age-appropriate therapeutic education tailored to the cultural context, along with psychosocial support.