Lost to Follow-up and Predictors Among HIV-Exposed Infants in Northwest Ethiopia

Even though advancement in mother-to-child HIV transmission prevention services is observed, many infants are lost to follow-up and could not access the full package of mother-to-child HIV transmission prevention services as a result. This is one of the obstacles to the effectiveness of the program. Therefore, determining the magnitude of lost to follow-up and its predictors is important among HIV-exposed infants.

This institution-based retrospective cohort study was conducted from August 2013 to June 2018 at the University of Gondar Comprehensive Specialized Hospital. We retrieved charts of 423 child-mother pairs through a simple random sampling technique. Data collectors extracted data by using a data extraction tool adapted from the Ethiopian Federal Ministry of Health HIV-exposed infant follow-up form. Bivariable and multivariable Cox regression models were fitted to identify predictors of lost to follow-up.

A total of 402 child-mother pairs were included in the study. Of the study participants, 6.0% were lost to follow-up for more than 3 months before the declaration of their HIV status. Born from rural residence mother (AHR = 3.5; 95% CI 1.549-7.894), infants whose mothers have three and more children (AHR = 3; 95% CI 1.284-6.963), and low birth weight infants (AHR = 3.2; 95% CI 1.055-9.450) were independent predictors of lost to follow-up among HIV-exposed infants.

Significant numbers of infants were unable to access full HIV diagnosis and care services as a result of loss to follow-up. Special consideration for mothers having large numbers of children, rural residence, and low birth weight infants could be an important intervention to decrease lost to follow-up.