Incidence and Predictors of Loss to Follow-Up Among Children Attending ART Clinics in Northeast Ethiopia: A Retrospective Cohort Study

Tiruye Menshw Snr,1 Shiferaw Birhanu,2 Tigist Gebremaryam,3 Worke Yismaw,1 Aklilu Endalamaw2,4 1Nursing Department, Mettu University, Mettu, Ethiopia; 2Department of Pediatrics and Child Health Nursing, Bahir Dar University, Bahir Dar, Ethiopia; 3Department of Pediatrics and Child Health Nursing, Debre Markos University, Debre Markos, Ethiopia; 4Schools of Public Health, The University of Queensland, Brisbane, AustraliaCorrespondence: Tiruye Menshw Snr Email tiruye1219@gmail.comBackground: It is known that antiretroviral therapy reduces the transmission of human immunodeficiency virus and AIDS-related morbidity. The coverage of HIV drugs is increasing to control further spread of HIV and children living with HIV are the target groups in using these medications. However, loss to follow-up remains a critical challenge among these groups of the population. The aim of this study was therefore to assess the incidence and predictors of loss to follow-up among children attending antiretroviral therapy clinics.Methods: A ten-year institution-based retrospective cohort study was employed among 448 children enrolled in antiretroviral therapy. Data were entered and cleaned using EpiData version 3.1 and then exported to STATA version 14 for further statistical analysis. The Kaplan–Meier survival curve was used to estimate the survival time and the Log rank test was used to compare the survival time between different categories of the explanatory variables. Multivariable Cox proportional hazards model was fitted to identify predictors of loss to follow-up and p-value < 0.05 was considered statistically significant.Results: The incidence rate of loss to follow-up was 6.3 per 100 children years of observation. Being male (AHR = 2.1, CI = 1.37, 3.34), aged 1– 5 years (AHR = 1.6, CI = 1.05, 2.46), poor adherence to antiretroviral therapy (AHR = 6.6; CI = 4.11, 10.66), fair adherence to antiretroviral therapy (AHR = 2.2; CI = 1.13, 4.20), regimen was not changed (AHR = 4.1; CI = 2.59, 6.45), World Health Organization stage III and IV (AHR = 2.2; CI = 1.40, 3.33) and height for ag