Strategies to increase adherence with tuberculosis test reading in a high-risk population

Area of Science:

• Pediatrics
• Infectious Diseases
• Public Health

Background:

• Tuberculosis (TB) testing is crucial for early detection in high-risk populations.
• Adherence to follow-up appointments for TB test reading is often poor.
• Effective strategies are needed to improve patient compliance.

Purpose of the Study:

• To identify the most effective strategy for encouraging adherence with tuberculosis test reading among children.
• To compare the efficacy of five different follow-up strategies.

Main Methods:

• A prospective randomized controlled trial was conducted with 627 children aged 1-12 years.
• Families received TB test education and instructions.
• Five groups were randomized to different follow-up strategies: routine instructions, phone calls, incentives, withholding school forms, and nurse home visits.

Main Results:

• Baseline TB test reading adherence was 45%.
• Adherence rates varied by group, with the highest rates in groups 4 (84% with school forms) and 5 (72%).
• Withholding school forms until test reading and nurse home visits showed significant improvement.

Conclusions:

• Adherence with TB test reading in high-risk children is suboptimal.
• Education combined with the return of school forms at the time of reading significantly improves adherence.
• While resource-intensive, visiting nurses can also enhance TB test reading rates.