Abstract:


Background: The loss of follow up visiting HIV infected children under 15 years old on antiretroviral therapy is a leading cause of morbidity and mortality in Sub-Saharan Africa including Tanzania. The loss of follow up visits brings a big challenges in care and treatment Centre (CTC) as many HIV clients are not attending clinics as scheduled.

Aim of the Study: To determine the prevalence and predictors of loss to follow up among HIV infected children attending CTC at Sekou Toure Hospital in Mwanza.

Methodology: Cross sectional design, hospital based retrospective study was conducted in Sekou Toure reginal hospital involving HIV infected children under 15 years old whereby data was extracted from the patients’ medical records and documented in the data collection tool. Data analysis for this study was done by using SPSS for windows version 7. Analysis for predictors was done using univariate and multivariate logistic regression where p value of <0.05 was considered as statistically significant

Results: Among the 734 children aged 0-14 years attending CTC at Sekou Toure hospital 31.3% were reported as loss to follow up between the years 2014-2019. Among the factors recognized as the predictors of loss to follow up include the children aged 5-10 years old which was 33% (76), the parents who were between the age group of 25-35 also were more likely to have their children lost during follow up, the ones in primary school 49.1% (113), the children had only one parent alive 40.9% (94/230), level of education and being a peasant/farmer were the predictors of loss to follow up with the values of 44.3% and 36.5% respectively. The WHO clinical stage 3&4 was also considered as one of the predictor of loss to follow up where by 65.2% with these stages were lost, also the ones with low CD4 count 200-499 cell (15%-24%) who were 40.0%. Majority of the children who were lost during follow up had ever miss their scheduled visit, among 230 children who were lost during follow up, 184 had ever miss and among these 26.1% had missed three times.

Conclusion: The prevalence of loss to follow up among HIV infected children in Sekou Toure hospital is generally high. And the results suggest that many children who were reported as loss to follow had ever missed their scheduled clinic visit about 80.0%. These findings should prompt interventions to raise adherence, but also discussion with caregivers around the barriers to clinic attendance and potential solutions to combat this problem. It is important to identify those at increased risk to follow up so as to allow targeted counselling and education about the importance of follow-up.