Loss to Follow-Up in Pediatric Nephrology: Associated Factors at Yopougon University Hospital

Introduction: Loss to follow-up in children with kidney disease—defined in our context as an interruption of care exceeding three months without medical or administrative justification—compromises both treatment and prognosis. This study aimed to identify factors associated with follow-up discontinuation in pediatric nephrology at the Yopougon University Hospital.

Method: A prospective and analytical study was conducted among children initially followed in the department between 2016 and 2020 and subsequently lost to follow-up. Data were extracted from medical records and supplemented by telephone interviews. Multivariate analysis was performed using SPSS (p < 0.05).

Results: Of the 127 children included, 70 participated (61.4%). Nephrotic syndrome was the predominant condition (65.7%). Discontinuation was often motivated by a perceived improvement in health (45.7%). Factors associated with non-resumption of care included residence outside Abidjan (OR = 2.63), low parental education level (OR = 1.92), logistical constraints (OR = 3.41), a diagnosis other than nephrotic syndrome (OR = 1.68), and a clinically stable condition. Social difficulties reflected precarious family contexts.

Conclusion: Discontinuation of follow-up care stems from organizational, social, and perceptual determinants. Targeted strategies are needed to strengthen continuity of care.

Keywords: Loss to follow-up, Pediatric Nephrology, Child, Côte d’Ivoire