02793nas a2200265 4500000000100000008004100001260003700042653005700079653004900136653002100185100001400206700001300220700001400233700001400247700001200261700001700273700001200290700001200302245012700314856009800441300001300539490000700552520195400559022001402513 2021 d bPublic Library of Science (PLoS) 10 aGeneral Biochemistry, Genetics and Molecular Biology 10 aGeneral Agricultural and Biological Sciences 10 aGeneral Medicine 1 aKashaf MS 1 aWolle MA 1 aMuñoz BE 1 aMkocha HA 1 aFunga N 1 aGracewello C 1 aWest SK 1 aZhang Y 00 aPatient perceived barriers to surgical follow-up: Study of 6-month post-operative trichiasis surgery follow-up in Tanzania uhttps://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0247994&type=printable ae0247994 0 v16 3 a
Background
Post-surgical follow-up is a challenge in low- and middle-income countries. Understanding barriers to trachomatous trichiasis (TT) surgical follow-up can inform program improvements. In this study, patient perceived barriers and enabling factors to follow-up after TT surgery are identified.
Methods
A longitudinal study was carried out in a community-based cohort of persons who received TT surgery in Bahi district, Tanzania. Questionnaires were administered before TT surgery and again after the scheduled 6-month follow-up. Those who did not return were examined at their homes.
Results
At baseline, 852 participants were enrolled. Of these, 633 (74%) returned at 6 months and 128 (15%) did not and were interviewed at home. Prior to surgery, attenders were more likely to report familiarity with a community health worker (CHW) (22% vs. 14%; p = 0.01) and less likely to state that time constraints are a potential reason for failure to follow-up (66% vs. 74%; p = .04). At follow-up, non-attenders were more likely to endorse barriers pertaining to knowledge about the need for follow-up, lack of transportation, and satisfaction with surgery. There was no difference in post-operative TT between attenders and non-attenders (23% vs. 18% respectively; p = 0.25).
Conclusions
The outcome of surgery was not a barrier to follow-up. However, better integration of CHWs into their communities and work at coordinating post-surgical care may improve follow-up rates. Moreover, provision of transportation and implementation of effective reminder systems may address patient-perceived barriers to improve follow-up.
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