Effect of m-health technology on knowledge and practice of the tuberculosis preventive therapy guideline among health workers in Ebonyi State, Nigeria

Abstract

Background: Prophylaxis with isoniazid has been shown to reduce the incidence of tuberculosis in HIV infected persons. The study aimed to determine the effect of mobile phone based education and reminders on health worker knowledge and practice of tuberculosis preventive therapy (TPT) guidelines. Methods and materials: The study was carried out in six health facilities in Ebonyi state, and employed a quasi-experimental design without randomization. Three health facilities were assigned to intervention and control arms each. Simple random sampling was used to select the participating health facilities and all eligible health workers (45 and 41 in intervention and control arms respectively) who had worked in the HIV clinics for not less than six months were selected. A pre-tested self-administered questionnaire was used for the survey. The intervention consisted of mobile phone messages and reminders on the tuberculosis preventive therapy guideline to the health workers. Data was analysed using Statistical Package for Social Sciences (IBM-SPSS) version 20. Chi square test was carried out and analytical decisions were taken at p < 0.05. Ethical approval was obtained from the research and ethics committee of Alex-Ekwueme Federal University Teaching Hospital, Abakaliki, and written informed consent was obtained from the participants. Results: Mean age of the health workers was 40.43 ± 7.16 and 33.15 ± 8.56 in the intervention and control arms respectively. At baseline, majority of the health workers 54.5% and 63.4% in intervention and control arms respectively had high knowledge level. At post-intervention, significantly higher proportion of health workers in the intervention arm (90.2%) had high knowledge level (p < 0.0001). For practice of the TPT guideline, 61.4% and 90.2% of health workers had good practice in intervention and control arms respectively. At post-intervention, there was a statistically significant increase in the proportion of respondents who had good practice within the intervention arm (p = 0.01). Conclusion: Mobile phone messaging has been shown in this study to be useful in improving knowledge and practice of tuberculosis preventive therapy guideline among health workers and should be considered for inclusion in the guideline and policy for prevention of tuberculosis among HIV patients.