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Open Access Loss to follow-up among children in pre-ART care under the National AIDS Programme, Tamil Nadu, South India

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Setting: Children aged <15 years constitute 7% of all people living with the human immunodeficiency virus (HIV) in India. A previous study from an antiretroviral therapy (ART) centre in south India reported 82% loss to follow-up (LTFU) among children in pre-ART care (2006–2011).

Objective: To assess the proportion of LTFU within 1 year of registration among HIV-infected children (aged < 15 years) registered in all 43 ART centres in the state of Tamil Nadu, India, during the year 2012.

Design: This was a retrospective cohort study involving a review of programme records.

Results: Of 656 children registered for HIV care, 20 (3%) were not assessed for ART eligibility. Of those remaining, 226 (36%) were not ART eligible and entered pre-ART care. Among these, at 1 year of registration, 50 (22%) were LTFU, 40 (18%) were transferred out and 136 (60%) were retained in care at the same centre. The child's age, sex, World Health Organization stage or occurrence of opportunistic infection were not associated with LTFU.

Conclusion: One in five children registered under pre-ART care were lost to follow-up. Stronger measures to prevent LTFU and reinforce retrieval actions are necessary in the existing National HIV Programme.
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Keywords: HIV; India; attrition; operational research; retention

Document Type: Research Article

Affiliations: 1: National Institute for Research in Tuberculosis, Madurai, India 2: International Union Against Tuberculosis and Lung Disease, (The Union) Paris, France, The Union South-East Asia Office, New Delhi, India 3: Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India 4: India Epidemic Intelligence Service, National Centre for Disease Control, New Delhi, India 5: National AIDS Control Organisation, New Delhi, India 6: Indian Council of Medical Research, New Delhi, India

Publication date: June 21, 2017

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  • Public Health Action (PHA), The Union's quarterly open access on-line journal, provides a platform for its mission 'Health solutions for the poor'. PHA addresses the need for show-casing operational research that addresses issues in health systems and services. It publishes high-quality scientific research that provides new knowledge to improve access, equity, quality and efficiency of health systems and services.

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