Predictors of Loss To Follow Up and Mortality Among Children ≤12 Years Receiving Anti Retroviral Therapy during the First Year at a Referral Hospital in Bali

Stefanie Juergens (Public Health Postgraduate Program Udayana University)
Anak Agung Sagung Sawitri (Public Health Postgraduate Program Udayana University)
Ketut Dewi Kumara Wati (Department of Paediatrics Faculty of Medicine University Udayana/ RSUP Sanglah)
I Wayan Gede Artawan Eka Putra (Public Health Postgraduate Program Udayana University)
Tuti Parwati Merati (Department of Internal Medicine Faculty of Medicine University Udayana/RSUP Sanglah)

Public Health and Preventive Medicine Archive
Vol. 4 No. 2 (2016)

Background and purpose: Many HIV-infected children in Bali have started antiretroviral therapy (ART), but loss to follow up (LTFU) is a continuing concern, and the issue of childhood adherence is more complex compared to adults. Methods: This was a retrospective study among cohort of 138 HIV+ children on ART in Sanglah General Hospital, Denpasar, Bali from January 2010 to December 2015. Kaplan-Meier analysis was used to describe incidence and median time to LTFU/mortality and Cox Proportional Hazard Model was used to identify predictors. Variables which were analysed were socio-demographic characteristics, birth history, care giver and clinical condition of the children. Results: Mean age when starting ARV therapy was 3.21 years. About 25% experienced LTFU/death by 9.1 month resulting in an incidence rate of 3.28 per 100 child month. The higher the WHO stage, the higher the risk for LTFU/mortality along with low body weight (AHR=0.90; 95%CI: 0.82-0.99). Conclusion: Clinical characteristics were found as predictors for LTFU/ mortality among children on ART.