PriMera Scientific Medicine and Public Health (ISSN: 2833-5627)

Review Article

Volume 5 Issue 1

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

Antoinette Agnes Onguene Bana*, Gabriel Tchatchouang Mabou, Djam Chefor Alain, Francis Ateba Dongo, Bita Andre Izacar Gael and Charles Kouanfack

June 27, 2024


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 follow-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 follow-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 prevalence of retention varied according to the relationship with the nursing and patient characteristics. 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 discrimination 10 (27.78%),the child’s schooling 8 (22.22%) , puberty 9 (25%) and self-transfers 9 (25%).

Conclusion: The retention rate of children put on ARV remains worrying, at more than a third of patients. The factors associated with poor retention were mothers poor adherence with therapeutic education, immunosuppression and orphanhood.

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


  1. Kouanfack C., et al. “Retention in HIV/AIDS Management Services: is it Really Poor? The Case of Yaounde Central Hospital in Cameroon”. Int J MCH AIDS 9 (2020): 207-12.
  2. Fettig J., et al. “Global Epidemiology of HIV”. Infect Dis Clin North Am 28 (2014): 323-37.
  3. Poka-Mayap V., et al. “Mortality and its determinants among patients infected with HIV-1 on antiretroviral therapy in a referral centre in Yaounde, Cameroon: a retrospective cohort study”. BMJ Open 3.7 (2013).
  4. Abuogi LL, Smith C and McFarland EJ. “Retention of HIV-Infected Children in the First 12 Months of Anti-Retroviral Therapy and Predictors of Attrition in Resource Limited Settings: A Systematic Review”. PLoS ONE 11 (2016).
  5. Bigna JJR., et al. “Factors associated with non-adherence to scheduled medical follow-up appointments among Cameroonian children requiring HIV care: a case-control analysis of the usual-care group in the MORE CARE trial”. Infect Dis Poverty 3 (2014): 44.
  6. Mosoko JJ., et al. “Retention in an antiretroviral therapy programme during an era of decreasing drug cost in Limbe, Cameroon”. J Int AIDS Soc 14 (2011): 32.
  7. Ndongo FA. Early antiretroviral treatment of infants infected with HIV-1: evaluation of the short and medium term virological response in a sub-Saharan African country (Cameroon) :147.
  8. Nguefack F., et al. “Frequency of severe anemia in children aged 2 months to 15 years at the Mother and Child Center of the Chantal Biya Foundation, Yaoundé, Cameroon”. Pan Afr Med J 12 (2012).
  9. Saumu WM., et al. “Predictors of loss to follow-up among children attending HIV clinic in a hospital in rural Kenya”. Pan Afr Med J 32 (2019).
  10. Htet KM., et al. “Early Success with Retention in Care Among People Living with HIV at Decentralized ART Satellite Sites in Yangon, Myanmar, 2015-2016”. Front Public Health 7 (2019): 124.
  11. Prevalence and factors associated with non-retention in care of people living with HIV (PLHIV) followed in a decentralized care site. Medicine Mal Infect 50 (2020): S187.
  12. Sibanda EL., et al. “The magnitude of loss to follow-up of HIV-exposed infants along the prevention of mother-to-child HIV transmission continuum of care: a systematic review and meta-analysis”. AIDS Lond Engl 27 (2013): 2787-97.
  13. Gabillard D., et al. “Mortality, AIDS-morbidity and loss to follow-up by current CD4 cell count among HIV-1 infected adults receiving antiretroviral therapy in Africa and Asia: data from the ANRS 12222 collaboration”. J Acquir Immune Defic Syndr 1999 62 (2013): 555-61.
  14. Massavon W., et al. “Factors Determining Survival and Retention among HIV-Infected Children and Adolescents in a Community Home-Based Care and a Facility-Based Family-Centred Approach in Kampala, Uganda: A Cohort Study”. Isrn Aids (2014): 852489.
  15. Luma HN., et al. “Late presentation to HIV/AIDS care at the Douala general hospital, Cameroon: its associated factors, and consequences”. BMC Infect Dis 18 (2018).
  16. Kyaw Myo Htet., et al. “Early Success with Retention in Care Among People Living with HIV at Decentralized ART Satellite Sites in Yangon, Myanmar, 2015-2016”. Front Public Health 7 (2019): 124.