Abstract

Background: Even though advancement in mother to child transmission prevention services of HIV 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. It is one of the obstacles to the effectiveness of the program. The actual magnitude of lost to follow-up and its contextual predictors did not examine in Ethiopia before. Therefore, determining the magnitude of lost to follow-up and its determinants is fascinating.

Objective: The aim of this study is to assess the magnitude and predictors’ of lost to follow up among HIV exposed infants in the northwest Ethiopia.

Method: Institution based retrospective cohort study design was conducted from August 2013 to June 2018 at the University of Gondar comprehensive specialized hospital. We retrieved charts through a simple random sampling technique. Data were extracted by using 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.

Result: A total of 402 child-mother pairs involved in the study with 95% response rate. Of the study participants, 6.0% were lost to follow-up for more than three 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 found independent predictors of lost to follow-up among HIV exposed infants.

Conclusions and Recommendation: Lost to follow-up among HIV exposed infants was low compared with other previous studies but still, significant number of infants were unable to access full HIV diagnosis and care service. Increase accessibility of prevention of mother to child transmission service for rural women and especial consideration for mothers having large number of children and low birth weight infants could be an important intervention to decrease lost to follow-up.

Keywords: HIV exposed infant, Lost to follow-up, Predictors, Ethiopia