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 Epiinfo 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 stud
