Published: 2022-07-27

Quality of care, loss to follow-up and mortality among paediatric and adolescent HIV patients on antiretroviral therapy in Abuja, Nigeria: a 15-year retrospective review

Adaora A. Okechukwu, Orji A. Okechukwu, Nansah R. Lamda


Background: Loss to follow up, and mortality still remains very high among HIV positive children and adolescents in many under privileged settings, in spite of massive scale up of anti-retroviral treatment. We assessed the quality of care using 7-point indicators, loss to follow up, and mortality among HIV positive children and adolescents in our health institution.

Method: A 15-year (2006 to 2020) retrospective review was conducted among HIV positive children who assessed care in paediatric out-patient special treatment clinic of our tertiary health institution in Nigeria for above objective.

Results: Of the 563 subjects initiated on antiretroviral therapy, 349 (62.0%) still remained on treatment. There were 285 (50.6%) males, highest enrollment 280 (49.7%) was at 2006-2010, most 192 (34.1%) were 0-24 months of age, 244 (43.3%) were under-weight, and 176 (31.3%) had severe immune suppression at enrollment. Sixty-eight (12.1%) were lost to follow-up, mortality was 14 (2.5%), 103 (18.3.1%), and 25 (4.4%) were transferred to adult clinic, and to other centers. While over 85% had a high-quality indicator score of 458 (81.4%), with significant difference between the male and female (x2=8.56, p=0.003,), only 231 (66.2%) had adequate viral suppression of <20 cpoies/ml at the end the review period. There was significant association between quality indicator score and loss to follow up, OR=0.033 (0.02-0.06), p>0.001 with multivariate analysis.

Conclusions: Though the study recorded high quality score services to HIV positive children and adolescents in our center, loss to follow-up, and mortality was however high. More is needed to be done to improve the viral load suppression among our clients.


Quality of care, HIV positive children and adolescents, Antiretroviral therapy, Process indicators, Loss to follow-up, Mortality

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