Use of interactive messaging to reduce pre-diagnosis loss to follow-up for TB care

OBJECTIVE: To investigate the uptake and usage of a WhatsApp-based interactive communication strategy to avert pre-diagnosis loss to follow-up (LTFU) from TB care in a high-incidence setting.METHODS: We enrolled adults (≥18 years) who underwent routine sputum TB testing in two primary healthcare clinics in Khayelitsha, Cape Town, South Africa. The intervention consisted of structured WhatsApp-based reminders (prompts) sent prior to a routine clinic appointment scheduled 2–3 days after the diagnostic visit. Pre-diagnosis LTFU was defined as failure to return for the scheduled appointment and within 10 days.RESULTS: We approached 332 adults with presumptive TB, of whom 103 (31%) were successfully enrolled; 213 (64%) did not own a WhatsApp-compatible phone. Of 103 participants, 74 (72%) actively responded to WhatsApp prompts; 69 (67%) opted to include a close contact in group communication to co-receive reminders. Pre-diagnosis LTFU was low overall (n = 7, 6.8%) and was not associated with failure to respond to WhatsApp prompts.CONCLUSION: In this high-incidence setting, enrolment in a WhatsApp-based communication intervention among adults with presumptive TB was low, mainly due to low availability of WhatsApp-compatible phones. Among participants, we observed high message response rates and low LTFU, suggesting potential for interactive messaging services to support pre-diagnosis TB care.

Influence of Open Defecation-Free (ODF) Communication Efforts on Knowledge, Attitude and Practice of Residents of Selected States in South-South, Nigeria

Aim: To examine the influence of ODF communication intervention on knowledge, attitude and practice as precursor for sustainable ODF adoption. Study Design: Data was gathered using a mixed method. A total of 384 participants were selected from the South-South region using multistage sampling technique. Place and Duration: A total of eight communities were selected from four states (Cross River, Rivers, Delta and Bayelsa) in South-South Nigeria. The study was conducted between June and July 2019. Methodology: A total of eight focus group discussions were held, one in each community while 384 copies of questioners were administered, 48 for each community. Results: indicates high awareness (89%) of ODF but poor understanding. Significant difference in knowledge between those exposed and those not exposed to ODF communication intervention was revealed. Attitude to ODF was poor and insignificant between those exposed and those not exposed. Practice towards ODF initiative was manifest in the proper handling of child feaces, ownership and use of toilet while a binary logistic regression of demographic factors associated with the likelihood of practice towards ODF initiative revealed gender, education and age as the three strongest. Other factors impacting negatively on sustained ODF adoption are inappropriate and inadequate communication, denial of structural constraints and intervention systemic glitches. Conclusion: The relevance ODF communication intervention is established yet inappropriate and adequate application as well as other factors combines to obscure the full realization of its potential in improving defecation practices. A region specific ODF intervention and evidence based participatory communication approaches are recommended.

The Profile of Task Performances for Cognitive-communicative Intervention in the Oldest-Old

Purpose: The “oldest-old” is the heterogeneous population compared with the younger-old in several cognitive-communication aspects. Accordingly, it is necessary to intervene in them discriminately. This study aimed to suggest the performance profiles by cognitive-communication tasks for intervention in oldest-old.Methods: Sixty-four oldest-old subjects aged 80 or older years performed 16 subtasks for the five cognitive-communication domains. And the performance profiles of group I (84.00 ± 2.62 years) and II (93.38 ± 1.61 years) were analyzed.Results: The main findings were as follows. Firstly, two groups had significant differences in performances of most tasks including working memory, reasoning, word fluency, and subjective communication. Secondly, five communication tasks were significantly correlated with all cognitive tasks and were predicted by the reasoning tasks like similarity in group I. Thirdly, word fluency and pragmatic expression tasks were significantly correlated with all cognitive tasks. Tasks including verbal problem solving were found to be the best predictors of confrontation naming in group II.Conclusion: Current study provides evidence-based information to support cognitive-communication intervention for the oldest-old. These results also can contribute to increase the efficacy of the cognitive-communicative intervention.