Loss to Follow-up Rate, Reasons and Associated Risk Factors among Mother-Infant Pairs in a Prevention of Mother-to-Child Transmission Programme (PMTCT) in Nigeria: a Case Control Study

Abstract

Background: Close supervision of HIV infected infants is necessary because of the rapid progression of immune deterioration that may occur in the first months of life.

Objectives: To determine the loss to follow-up rate, reasons and associated risk factors among mother-infant pairs in a routine PMTCT programme.

Methods: This was a case control study that involved mother-infant pairs enrolled within 72 hours of delivery for follow-up in a PMTCT programme. Loss to follow-up was deemed to have occurred where more than two consecutive visits to the clinic had been missed. The defaulting mother-infant pairs were traced through telephone calls and home visits, where possible.

Results: One hundred and seventy-eight mother-infant pairs were enrolled between August 2002 and February 2005, out of which 18 were excluded. Fifty-eight (36.25 percent) of the remaining 160 were lost to follow-up. Among the 58 defaulters, 28 (48.27 percent) could not be traced as a result of false contact addresses. The most common reason for loss to follow up among the 30 mother-infant pairs traced, was apparent good health in the babies. After tracking and counseling, 18 (60 percent) resumed regular follow-up. The mean ages of mothers and babies at the time of default were 28.87 years (SD+4.52 years) and 15.31 weeks (SD+14.05 weeks), respectively. Attainment of post-secondary education, non-membership in a support group and lack of partner notification were associated with increased risk of default.

Conclusions: The high loss to follow-up rate from this study highlights the need to improve on the postnatal follow-up of HIV-exposed babies.

Keywords: Loss to follow-up, Rates, Reasons, Risk factors, PMTCT programme