Effectiveness of Cellphone Calls in Reaching Children and Adolescents Lost to Follow-Up in an HIV Treatment Programme in Anambra State, Nigeria

Abstract

Background: Cellphone tracking is a key method for re-engaging HIV-positive clients lost to follow-up (LTFU). Although >95% of Nigerians have access to cellphones, re-engagement in HIV care remains a significant challenge. Objectives: To ascertain the success rate of cellphone calls in reaching LTFU children and adolescents living with HIV (CALHIV) at a tertiary facility in Anambra State, from 2012-2022. Materials and methods: This retrospective study extracted data on all LTFU CALHIV using proforma. Clients were classified as LTFU if they failed to attend clinic for ≥3 consecutive months after their last scheduled appointment and had no documented evidence of transfer, death, or treatment discontinuation. Tracking involved calling caregivers using provided cellphone numbers, with three additional attempts at different times within 7 days if the first call failed. Results: Two hundred and sixty-eight CALHIV were studied. Their mean age was 10.0 ± 6.73 years, and the male-to-female ratio was 1:1.3. Majority had their parent(s) as primary caregivers (221; 82.5%) and were already on antiretroviral therapy (222; 83%). The GSM providers of available contact numbers were MTN (224; 83.6%), Airtel (23; 8.6%), Globacom (12; 4.5%), and 9-Mobile (9; 3.4%). About 62% (165) of participants couldn’t be reached due to switched-off lines (90; 54.5%), unreachable numbers (27; 16.4%), wrong ownership (31; 18.8%), or non-existent lines (17; 10.3%). Conclusions: The success rate of cellphone tracking for LTFU CALHIV was low due to issues with validity and availability of provided phone numbers. Routine updates, secondary contacts, and hybrid approaches combining digital tools with home visits are recommended.