title: Antiretroviral treatment program retention among HIV-infected children in the Democratic Republic of Congo.
abstract: BACKGROUND
  Retaining patients with HIV infection in care is still a major challenge in sub- Saharan Africa, particularly in the Democratic Republic of Congo (DRC) where the antiretroviral treatment (ART) coverage is low. Monitoring retention is an important tool for evaluating the quality of care.
  
  
  RESULTS
  A review of medical records of HIV-infected children was performed in three health facilities in the DRC: the Amo-Congo Health center, the Monkole Clinic in Kinshasa, and the HEAL Africa Clinic in Goma. Medical records of 720 children were included. Kaplan Meier curves were constructed with the probability of retention at 6 months, 1 year, 2 years and 3 years. Retention rates were: 88.2% (95% CI: 85.1%-90.8%) at 6 months; 85% (95% CI: 81.5%-87.6%) at one year; 79.4% (95%CI: 75.5%-82.8%) at two years and 74.7% (95% CI: 70.5%-78.5%) at 3 years. The retention varied across study sites: 88.2%, 66.6% and 92.5% at 6 months; 84%, 59% and 90% at 12 months and 75.7%, 56.3% and 85.8% at 24 months respectively for Amo-Congo/Kasavubu, Monkole facility and HEAL Africa. After multivariable Cox regression four variables remained independently associated with attrition: study site, CD4 cell count <350 cells/µL, children younger than 2 years and children whose caregivers were member of an independent church.
  
  
  CONCLUSIONS
  Attrition remains a challenge for pediatric HIV positive patients in ART programs in DRC. In addition, the low coverage of pediatric treatment exacerbates the situation of pediatric HIV/AIDS.
authors.affiliation: Elizabeth Glaser Paediatric AIDS Foundation, Kinshasa, Democratic Republic of Congo.
authors.forename: John
authors.initials: J
authors.lastname: Ditekemena
authors.affiliation: Kinshasa School of Public Health, Kinshasa, Democratic Republic of Congo.
authors.forename: Christophe
authors.initials: C
authors.lastname: Luhata
authors.affiliation: Heal Africa, Goma, Democratic Republic of Congo.
authors.forename: William
authors.initials: W
authors.lastname: Bonane
authors.affiliation: Kinshasa School of Public Health, Kinshasa, Democratic Republic of Congo.
authors.forename: Modeste
authors.initials: M
authors.lastname: Kiumbu
authors.affiliation: Kinshasa School of Public Health, Kinshasa, Democratic Republic of Congo.
authors.forename: Antoinette
authors.initials: A
authors.lastname: Tshefu
authors.affiliation: University of Antwerp, Antwerp, Belgium.
authors.forename: Robert
authors.initials: R
authors.lastname: Colebunders
authors.affiliation: London School of Hygiene and Tropical Medicine, London, United Kingdom.
authors.forename: Olivier
authors.initials: O
authors.lastname: Koole
mesh_terms: D000293:Adolescent; D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active / Q000379:methods; D002648:Child; D002675:Child, Preschool; D016208:Databases, Factual; D015023:Democratic Republic of the Congo; D015658:HIV Infections / Q000188:drug therapy*; D006268:Health Facilities; D006801:Humans; D007223:Infant; D012189:Retrospective Studies; D012307:Risk Factors; D016903:Drug Monitoring
chemical_list: D044966:Anti-Retroviral Agents