Allah Rakhia, Taj Muhammad Laghari, Muhammad Ayaz Mustufa, Asif Ali Khan, Rahila Bhutto, Ashfaque Ahmed Memon.
Role of active communication in reducing loss to follow of registered childhood TB cases at tertiary care facility, Karachi, Pakistan.
Pak J Med Res Jan ;58(1):7-12.

Background: Loss to follow up from anti tuberculosis treatment (ATT) can result into, increase in cure time, drug resistance development, reduced probability of treatment compliance and increased chances of death. Therefore, interventions focused at improvement of treatment adherence can play a pivotal role in containment and control of TB. Objective: To reduce the loss to follow up rate from existing 9% at our settings i.e. National Institute of Child Health (NICH) Karachi, Pakistan. Study design, settings and duration: This prospective observational study of 18 months was conducted among children at TB clinic NICH, Karachi, Pakistan. Subjects and Methods: After taking informed written consent from parent/guardian, a Performa containing demographic and clinical information was filled and a pamphlet about adherence to treatment was given to them. After one week, every patient was contacted on mobile phone; in case of no response, home visit was made and a monthly follow up was also done. Those found to have stopped taking ATT were given awareness about complications of discontinuing ATT. Results: Out of 167 patients, 83 (49.7%) were males, mean age was 7.82 years and mean weight was 8.95 kg. Pulmonary TB was most prevalent (52.0%) followed by TB of lymph nodes (22.9%).More than 91% patients were cured, 8 (4.8%) were expired; one had MDR TB and loss to follow up rate reduced to 3.6% from previous 9% as per our hospital records. Conclusion: A visible decrease in loss to follow up rate has been achieved through multi step facilitation via mobile phone calls, messages and house hold visits of enrolled patients.

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