INCIDENCE AND PREDICTORS OF ATTRITION AMONG CHILDREN ON ANTIRETROVIRAL THERAPY AT UNIVERSITY OF GONDAR COMPREHENSIVE SPECIALIZED HOSPITAL, NORTHWEST ETHIOPIA; 2019: RETROSPECTIVE FOLLOW UP STUDY

Abstract

ABSTRACT Introduction: The incidence of attrition in children on Antiretroviral Therapy is higher in resource-limited settings when compared to developed countries, and it remains a critical challenge for HIV treatment success among children on antiretroviral therapy. The introduction of antiretroviral therapy has led to a significant decline in HIV related morbidity and mortality. However; this can only achieve if children retained in the service Objective: The aim of this study was to assess the incidence of attrition and identify the predictors of attrition among children who are on antiretroviral therapy at University of Gondar comprehensive specialized Hospital, Northwest Ethiopia. Methods: An institution based retrospective follow up study was conducted among 357 HIV positive children at University of Gondar Comprehensive specialized Hospital from January 1, 2005 to 30, December 2018 G.C. Simple random sampling technique was used to select each child on ART. In Cox proportional hazard model was bi-variable having 0.25 computed to multivariable, and variables having P- value ?0.05 at 95% confidence interval were considered as statistically significant predictors for the incidence of attrition Results: A total of 344 child records with a completeness rate of 96.4% were reviewed and included in the analysis. Children were followed for different periods of time Conclusion and recommendation: The overall incidence of rate attrition was high. Baseline WHO clinical staging III/IV, baseline hemoglobin ?10 mg/dl, cotrimoxazole

Attention shall be given to early detection, monitoring, and management of anemia, advanced WHO clinical stage III and IV, and underweight in HIV positive children to ensure retention and minimize attrition in ART service. Keywords: Antiretroviral therapy; Attrition, Children with HIV; Gondar; Predictors