Wubneh Chalachew Adugna, Belay Getaneh Mulualem, Yehualashet Fikadu Ambaw, Tebeje Nigusie Birhan, Mekonnen Birye Dessalegn, Endalamaw Aklilu
Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Unit of Community Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Infect Dis Ther. 2021 Mar;10(1):229-239. doi: 10.1007/s40121-020-00360-z. Epub 2020 Oct 28.
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.
尽管母婴传播艾滋病毒预防服务取得了进展，但仍有许多婴儿失访，因此无法获得全面的母婴传播艾滋病毒预防服务。这是该项目有效性的障碍之一。因此，确定艾滋病毒暴露婴儿的失访规模及其预测因素很重要。
这项基于机构的回顾性队列研究于2013年8月至2018年6月在贡德尔大学综合专科医院进行。我们通过简单随机抽样技术检索了423对母婴的病历。数据收集者使用从埃塞俄比亚联邦卫生部艾滋病毒暴露婴儿随访表改编的数据提取工具提取数据。采用双变量和多变量Cox回归模型来确定失访的预测因素。
共有402对母婴纳入研究。在研究参与者中，6.0%在宣布其艾滋病毒感染状况之前失访超过3个月。母亲为农村居民（调整后风险比[AHR]=3.5；95%置信区间[CI]为1.549 - 7.894）、母亲育有三个及以上子女的婴儿（AHR = 3；95% CI为1.284 - 6.963）以及低体重儿（AHR = 3.2；95% CI为1.055 - 9.450）是艾滋病毒暴露婴儿失访的独立预测因素。
由于失访，大量婴儿无法获得全面的艾滋病毒诊断和护理服务。对子女众多的母亲、农村居民以及低体重儿给予特别关注可能是减少失访的重要干预措施。
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