Retention in Care At 36 Months of Children Living with Hiv Followed up at The Chantal Biya Foundation Mother and Child Centre, Yaounde, Cameroon

Résumé

Background: Retaining children in care still remains a real challenge in Africa. In Cameroon, the
retention rate among children under 15 years of age remains low. Some reported factors found
to be associated with low retention rates were late initiation of antiretroviral therapy (ART)
and poor adherence. Our objective was therefore to assess retention at 36 months of paediatric
patients on antiretroviral treatment at the day unit of the Mother and Child centre of the Chantal
Biya Foundation.
Methodology: We conducted a cross-sectional study with a case-control component targeting
children aged 0-15 years. Data were collected exhaustively from the 2017 and 2018 cohort fol-
low-up registers, diagnosed positive after the first PCR. Children who had died, been lost to
follow-up and transferred to an outpatient department were considered as cases, and any child
who was on treatment at the end of the study period was considered as a control. Patient fol-
low-up and the association between independent variables and the occurrence of attrition were
estimated.
Results: Data were collected from 260 children (117 from 2017 and 143 from 2018). The preva-
lence of retention varied according to the relationship with the nursing and patient characteris-
tics. Orphans [OR=9.75 IC95%=(4.06-10.37) P=0.01], mothers poor adherence with therapeutic
education [2.52, IC95%=(1.78-3.37) P=0.001] and immunosuppression [OR=9.10 IC95%=(4.06-
10.37); P=0.03] were found to be significantly associated with poor retention of the childs. The
main reasons given by caregiver for poor adherence to therapeutic education were discrimina-
tion 10 (27.78%), the child’s schooling 8 (22.22%), puberty 9 (25%) and self-transfers 9 (25%).

Mots-clés

Retention; Children 0-15 years; Mother and Child Centre; Chantal Biya Foundation; Yaounde

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