Research Article - Current Pediatric Research (2025) Volume 29, Issue 2

Incidence and predictors of lost to follow-up among women under option B+ PMTCT program at Debre Berhan town, Amhara, Ethiopia 2024: A retrospective follow-up study.

Background: Option B+ is an advanced strategy in the Prevention of Mother-to-Child Transmission (PMTCT) recommended by the World Health Organization to enhance the care for HIV positive pregnant and lactating women. Lost to follow-up in the prevention of mother-to-child transmission service poses a significant public health challenge. Yet, there is limited understanding of the incidence and predictors influencing LTFU among HIV infected women under the option B+ PMTCT program.

Methods: A retrospective follow-up study was conducted at various health institutions in Debre Birehan town from March 11 to April 11, 2024. Simple random sampling was used to select 280 HIV infected pregnant and lactating women under option B+ PMTCT service. Data were extracted from the PMTCT registers and individual medical records using a checklist, and linked together for analysis. The patients' characteristics were analyzed in terms of frequency and percentage. The cumulative survival probability of loss to follow-up was determined using the Kaplan-Meier survivor estimator and predictors influencing LTFU were identified using the Cox regression model. All potential predictors with a p-value of <0.05 at a 95% confidence interval were declared statistically significant and presented as adjusted hazard ratios.

Result: The cumulative incidence rate of Loss to Follow-Up (LTFU) was found to be 8.04 (95% CI 5.6-11.3) cases per 1000 person-months with restricted mean survival time of 25.14 (95% CI: 24.25-26.04) months. The median follow-up time of the follow-up period was 16 (IQR 10-19) months. Lower level of formal education (AHR 9.8, 95% CI 1.2-21), non-disclosure of HIV status (AHR 3.0, 95% CI 1.6-12.4), and fair antiretroviral drug adherence (AHR 3.0, 95% CI 1.6-12.4) were significantly associated with lost to follow-up among women.

Conclusions and recommendations: The overall incidence rate of lost to follow-up is higher than the national and World Health Organization target. Lost to follow-up was found to be influenced by educational status, disclosure of HIV status, and level of medication adherence.

Author(s):

Degefaw Denekew Hunegnaw*, Awraris Hailu Bilchut, Addisalem Workie Demsash, Abebe Nigussie Ayele, Esubalew Guday Mitkie

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