Incidence of Loss to Follow-Up and Its Predictors Among Children with HIV on Antiretroviral Therapy at the University of Gondar Comprehensive Specialized Referral Hospital: A Retrospective Data Analysis

Selam Fisiha Kassa; Workie Zemene Worku; Kendalem Asmare Atalell; Chilot Desta Agegnehu

doi:10.2147/HIV.S269580

Incidence of Loss to Follow-Up and Its Predictors Among Children with HIV on Antiretroviral Therapy at the University of Gondar Comprehensive Specialized Referral Hospital: A Retrospective Data Analysis

HIV AIDS (Auckl). 2020 Oct 5:12:525-533. doi: 10.2147/HIV.S269580. eCollection 2020.

Authors

Selam Fisiha Kassa¹, Workie Zemene Worku², Kendalem Asmare Atalell¹, Chilot Desta Agegnehu³

Affiliations

¹ Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia.
² Department of Community Health Nursing, School of Nursing, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia.
³ School of Nursing College of Medicine and Health Sciences and Comprehensive Specialized Hospital, University of Gondar, Gondar, Ethiopia.

Abstract

Background: The magnitude of loss to follow-up is high and remains a major public health problem in developing countries. Therefore, the aim of this study determines the incidence rate and predictors of loss to follow-up among children with HIV on ART at the University of Gondar comprehensive specialized referral hospital.

Methods: An institution-based retrospective data analysis was conducted on 361 children with HIV. The simple random sampling technique was used, and data were entered into Epi-info version 7.1 and were exported to Stata version 14 for analysis. The proportional hazard assumption was checked, and Cox regression was fitted. Finally, an adjusted hazard ratio with a 95% CI was computed, and variables with P-value <0.05 in the multivariable analysis were taken as significant predictors of loss to follow-up.

Results: The overall incidence rate of lost to follow-up was 6.2 events per 100 child-years observations (95% CI: 4.9-7.7). Children who have got care from their biological parents (AHR 2.6, 95% CI: 1.2-5.5), WHO clinical stage III/IV (AHR 2.0, 95% CI: 1.1-3.8), history of regimen substitutions (AHR 1.7, 95% CI: 1.1-2.9), poor/fair medication adherence (AHR 2.5, 95% CI 1.4-4.2) and history of TB treatment (AHR 2.7, 95% CI: 1.6-4.4) were the significant predictors of lost to follow-up.

Conclusion: The incidence rate of loss to follow-up among children was found to be high. Children who have got care from their biological parent, WHO clinical stage III/IV, history of regimen substitution, poor/fair medication adherence, and history of TB treatment were the independent predictors of loss to follow-up. Therefore, strengthening HIV care intervention and addressing these significant predictors is highly recommended in the study setting.

Keywords: ART; Gondar; children; lost to follow-up; the incidence.

Grants and funding

Financial support was obtained from the University of Gondar. The funding institution or body has no role in any activities of the preparation of the manuscript as well as the decision to publish.