Factors Associated With Loss to Follow-Up of HIV-Exposed Infants at a Primary Health Centre in Kabwe, Zambia

Abstract

Loss to follow-up (LTFU) among HIV-exposed infants (HEI) remains a significant barrier to the elimination of mother-to-child transmission (eMTCT) of HIV in sub-Saharan Africa. At Chowa Urban Health Centre in Kabwe, Zambia, LTFU rates have fluctuated between 17% and 45% between 2019 and 2023. This study investigated factors associated with LTFU among HEI enrolled in the Early Infant Diagnosis (EID) program.
A quantitative descriptive cross-sectional study was conducted using a census approach, enrolling 134 HEI registered in the EID program between 2019 and 2023. Data were collected from mothers using a structured questionnaire. Chi-square tests and binary logistic regression analysis were performed using SPSS version 27.0, with statistical significance set at p<0.05 and 95% confidence intervals.
The LTFU rate was 27% (36/134). Significant associations were found between LTFU and infant age (p=0.001), hospitalization history (p=0.037), use of traditional treatments (p=0.016), maternal residence (p=0.001), maternal education (p=0.012), ANC visits (p=0.013), place of delivery (p=0.001), and timing of ART initiation (p=0.003). In adjusted analysis, MUAC measurement at 6 months (AOR=5.917, p=0.004), maternal age 25-30 years (AOR=3.021, p=0.015), and health centre delivery (AOR=2.981) were independently associated with LTFU.
The LTFU rate of 27% exceeds the WHO acceptable threshold of 10%. Targeted interventions addressing rural residence, maternal education, and timing of ART initiation are urgently needed.