Initial loss to follow up among tuberculosis patients: the role of Ward-Based Outreach Teams and short message service (SMS) technology (research proposal)

Mwansa-Kambafwile, Judith; Chasela, Charles; Ismail, Nazir; Menezes, Colin

doi:10.1186/s13104-019-4757-3

Cited by 5 publications

(4 citation statements)

References 19 publications

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“…In South Africa, studies have implemented elements of patient engagement to reduce patient ILTFU through additional case support managers, various text message reminders and strengthening of ward-based outreach teams. [28][29][30] These patient engagement interventions involve resource-intensive processes focusing on the needs of patients. Our comparatively simple patient interaction process focusing on updating patient contact details, providing practical information and allowing patients the opportunity to ask questions was also aimed at improving the health outcomes of patients.…”

Section: Discussion and Recommendationsmentioning

confidence: 99%

Early interactions with newly diagnosed TB patients in hospital can support linkage to care

Viljoen

Hendricks

Hoddinott

et al. 2022

public health action

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BACKGROUND: In South Africa, failure to link individuals diagnosed with TB to care remains an important gap in the TB care cascade. Compared to people diagnosed at primary healthcare (PHC) facilities, people diagnosed in hospitals are more likely to require additional support to be linked with PHC TB treatment services. We describe a patient interaction process to support linkage to TB care.METHODS: We implemented a step-by-step early patient interaction process with 84 adults newly diagnosed with TB in one district hospital in Khayelitsha, Cape Town, South Africa (August 2020–March 2021). We confirmed patient contact details, provided TB and health information, shared information on accessing care at PHC facilities and answered patients’ questions in their home language.RESULTS: Most patients (54/84, 64%) provided updated telephone numbers, and 19/84 (23%) reported changes in their physical address. Patients welcomed practical and health information in their home language. The majority (74/84, 88%) were linked to care after hospital discharge.CONCLUSIONS: A simple early patient interaction process implemented as part of routine care is a feasible strategy to facilitate early TB treatment initiation and registration.

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Section: Discussion and Recommendationsmentioning

confidence: 99%

Early interactions with newly diagnosed TB patients in hospital can support linkage to care

Viljoen

Hendricks

Hoddinott

et al. 2022

public health action

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“…This exploratory qualitative study was part of a bigger study looking at interventions to reduce initial loss to follow up among TB patients. The study is entitled "Initial Loss to Follow Up Among Tuberculosis Patients: The Role of Ward-Based Outreach Teams and Short Message Service (SMS) Technology" [27]. In depth interviews (IDIs) with TB/WBOT program managers were conducted in the City of Johannesburg district in South Africa between August 2018 and February 2019.…”

Section: Methodsmentioning

confidence: 99%

“…In the TB program, screening, tracing and treatment adherence support is more of WBOTs' role than treatment initiation. This is part of their work and therefore no incentives are provided for doing this work [27].…”

Section: Introductionmentioning

confidence: 99%

Initial loss to follow up of tuberculosis patients in South Africa: perspectives of program managers

Mwansa-Kambafwile¹,

Jewett²,

Chasela³

et al. 2020

BMC Public Health

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Background: Tuberculosis (TB) remains a serious public health problem in South Africa. Initial loss to follow up (LTFU) rates among TB patients are high, varying between 14.9 and 22.5%. From the perspective of patients, documented reasons for this include poor communication between patient and staff after testing, not being aware that results are ready and other competing priorities such as preference to go to work as opposed to seeking healthcare. Ward-based Outreach Teams (WBOTs) routinely conduct home visits to ensure adherence to medication for various conditions including TB. We explored reasons for TB initial loss to follow up from the perspectives of TB program managers and WBOT program managers, with a focus on the WBOT's (potential) role in reducing initial LTFU, in particular. Methods: Key informant interviews with five WBOT program managers and four TB program managers were conducted. The interviews were audio-recorded, then transcribed and exported to NVivo 11 software for coding. A hybrid analytic approach consisting of both inductive and deductive coding was used to identify themes. Results: The age of the nine managers ranged between 28 and 52 years old, of which two were male. They had been in their current position for between 2 to 12 years. Prior to treatment initiation, WBOTs screen household members for TB and refer them for TB testing if need be, but integration of the two programs is emphasized only after TB treatment has been initiated. Counseling of patients testing for TB is not guaranteed due to frequent staff rotations and staff shortages. Participants reported that possible dissatisfaction with services as well as stigma associated with the TB diagnosis could explain loss to follow up prior to treatment initiation. Conclusion: Program managers view health system related factors such as staff rotations, poor communication with patients and lack of counseling as contributing to the problem of initial LTFU among TB patients. The integration of the WBOT and TB programs is limited to referring suspected cases for testing and patients already on treatment.

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“…Direct molecular testing can reduce turnaround times to a few days. As is the case with TB, the reasons for PTLTFU in patients with NTM pulmonary disease are also likely complex, however, having a rapid diagnostic test (such as GeneXpert MTB/RIF Ultra) significantly reduces PTLTFU and time-to-treatment initiation [ 29 , 30 ]. We are expecting the same to hold true for NTM where a rapid result from molecular testing of smear-positive sputum (second sample) may reduce time-to-treatment initiation and prevent PTLTFU.…”

Section: Introductionmentioning

confidence: 99%

Incorporating direct molecular diagnostics in management algorithms for nontuberculous mycobacteria: Is it high time?

Opperman,

Singh,

Goosen

et al. 2024

IJID Regions

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Initial loss to follow up among tuberculosis patients: the role of Ward-Based Outreach Teams and short message service (SMS) technology (research proposal)

Cited by 5 publications

References 19 publications

Early interactions with newly diagnosed TB patients in hospital can support linkage to care

Early interactions with newly diagnosed TB patients in hospital can support linkage to care

Initial loss to follow up of tuberculosis patients in South Africa: perspectives of program managers

Incorporating direct molecular diagnostics in management algorithms for nontuberculous mycobacteria: Is it high time?

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