The health outcomes of HIV-infected children have improved greatly with the development and increased accessibility of antiretroviral therapy. ART helps to control the replication of HIV through viral suppression, reducing morbidity and mortality. Yet there are still challenges in enrolling and retaining children on ART, especially in resource-poor settings. One of the key issues is “loss to follow-up”, which refers to a patient who has not received antiretrovirals for three months or more (and who has not been transferred out of the HIV unit or passed away). Retention in care is vital for ART to be effective and for making gains against HIV/Aids.

This was a retrospective, hospital-based, cross-sectional study that reviewed medical records of 134 children younger than 15 enrolled in the paediatric HIV unit of the Suntreso Government Hospital in Ghana. The study identified two key factors associated with loss to follow-up: the presence of phone number records in patient folders and the duration of enrolment in the clinic. Not having a recorded phone number and being enrolled in the HIV unit for a shorter period place patients at risk of loss to follow-up. Other variables such as the age and sex of patients and their place of residence did not correlate with loss to follow-up. 

The major recommendations from the study are for HIV clinics to firstly document phone numbers of patients and/or their families appropriately (including verifying the phone number at the time of enrolment into care). Secondly they should provide regular counselling to patients and their families on the risk factors relating to short stays in the HIV unit and how to mitigate these factors, including discussing challenges relating to the patient being retained in the HIV unit.