Loss to follow-up and associated maternal factors among HIV-exposed infants at the Mbarara Regional Referral Hospital, Uganda: a retrospective study
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Date
2020
Journal Title
Journal ISSN
Volume Title
Publisher
BMC Infectious Diseases
Abstract
Loss to follow-up (LTFU) deprives HIV-exposed infants the lifesaving care required and results in
exposing HIV free infants to virus requisition risk. We aimed to determine the rate of LTFU, postnatal mother-tochild
HIV-transmission (MTCT) and to identify maternal factors associated with LTFU among HIV-exposed infants
enrolled at Mbarara Regional Referral Hospital PMTCT clinic.
Methods: Study participants were infants born to HIV-positive mothers enrolled in the PMTCT clinic for HIV care at
Mbarara Regional Referral Hospital. While access database in the Early Infant Diagnosis (EID) clinic provided data on
infants, the open medical record system database at the ISS clinic provided that for mothers. Infants were classified
as LTFU if they had not completed their follow-up schedule by 18 months of age. At 18 months, an infant is
expected to receive a rapid diagnostic test before being discharged from the PMTCT clinic. Postnatal MTCT of HIV
was calculated as a proportion of infants followed and tested from birth to 18 months of age. Logistic regression
was used to determine possible associations between mothers’ characteristics and LTFU. In-depth interviews of
mothers of LTFU infants and health workers who attend to the HIV-exposed infants were carried out to identify
factors not captured in the electronic database.
Results: Out of 1624 infants enrolled at the clinic, 533 (33%) were dropped for lack of mother’s clinic identification
number, 18 (1.1%) were either dead or transferred out. Out of 1073 infants analysed, 515 (48%) were LTFU by 18
months of age while out of the 558 who completed their follow-up schedule, 20 (3.6%) tested positive for HIV.
Young age of mother, far distance to hospital and non-use of family planning were identified as outstanding
factors responsible for LTFU. In addition, in-depth interviews revealed facility-level factors such as “waiting time”
which would not be found in routine client databases.
Description
Keywords
HIV-exposed infants, Loss to follow up, Post-natal mother to child transmission
Citation
Ankunda, R., Cumber, S. N., Atuhaire, C., Kabanda, T., Nkfusai, C. N., Wirsiy, F. S., & Turyakira, E. (2020). Loss to follow-up and associated maternal factors among HIV-exposed infants at the Mbarara Regional Referral Hospital, Uganda: a retrospective study. BMC Infectious Diseases, 20(1), 1-9. https://doi.org/10.1186/s12879-020-04964-1