Loss to Followup: A Major Challenge to Successful Implementation of Prevention of Mother-to-Child Transmission of HIV-1 Programs in Sub-Saharan Africa.

Purpose. The purpose of this paper was to explore how loss to followup (LFTU) has affected the successful implementation of prevention of mother to child transmission of HIV-1 (PMTCT) programs in sub-Saharan Africa. Methods. We conducted an electronic search from the following databases PubMed, ScienceDirect, Directory of Open Access Journals (DOAJs), and PyscINFO. Additional searches were made in WHO, UNAIDS, UNICEF, Google, and Google scholar websites for (1) peer-reviewed published research, (2) scientific and technical reports, and (3) papers presented on scientific conferences. Results. A total of 678 articles, published from 1990 to 2011, were retrieved. Only 44 articles met our inclusion criteria and were included in the study. The rates of LTFU of mother-child pairs ranged from 19% to 89.4 in the reviewed articles. Health facility factors, fear of HIV-1 test, stigma and discrimination, home deliveries and socioeconomic factors were identified as reasons for LTFU. Conclusion. There is a great loss of mother-child pairs to follow up in PMTCT programs in sub-Saharan Africa. There is need for more research studies to develop public health models of care that can help to improve followup of mother-child pairs in PMTCT programs in Sub-Saharan Africa.