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

摘要

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.