Abstract
IntroductionTuberculosis (TB) is a problem in South Africa. Initial loss to follow up (LTFU) among TB patients is high varying between 14.9 and 18%. Some of the reasons for this are: lack of proper communication between patient and staff on next steps after testing, not aware that results are ready; and other competing priorities. Receiving reminder messages that result is ready is an intervention that can be explored to reduce initial LTFU. This can be through either receiving a note from the Ward-Based Outreach Teams (WBOTs) or via short message service (SMS) advising the patient to collect test result at the facility. This proposal aims to assess the effectiveness of WBOTs or SMS technology in reducing TB initial LTFU.MethodsThis will be a mixed methods approach. In depth interviews with WBOT Managers and TB Program Managers will be conducted. Focus group discussions with WBOT members will also be conducted. Two interventions (enhanced WBOTs/SMS technology) will be tested using a 3 arm randomized controlled trial (standard of care, SMS technology or enhanced WBOTs). The WBOTs will deliver paper note reminders while SMS intervention will entail sending reminder SMS messages to patients as soon as TB results are ready.
Highlights
Tuberculosis (TB) is a problem in South Africa
Apart from the patient centred factors highlighted above, Botha et al found that more frequent causes for initial loss to follow up (LTFU) are those to do with the quality of the healthcare services rendered to these patients
Two ways these reminders could be sent are through short message service (SMS) messaging to patients or through paper notes delivered to patients by the Ward-Based Outreach Team (WBOT)
Summary
The current cascade for patients with presumptive TB (TB suspects) in South Africa is as shown in Fig. 2 [29]. A patient feeling sick and presenting to a primary healthcare (PHC) facility is screened for TB symptoms. If productive cough is among the presenting symptoms, the patient is asked to produce sputum on the spot. This sputum is sent to the laboratory for testing. The sputum is tested using the Xpert MTB/Rif (Xpert). The methods are described in detail below based on respective objectives
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