A Prospective Study on Implementation of Long Term Follow-up of Cured Tuberculosis Patients and Barriers Faced by Health Care Workers at Ahmedabad City, Gujarat: A Mixed Method Approach

Background: Tuberculosis (TB) remains a major public health challenge in India. Efforts outlined in the National Strategic Plan (2017-2025) are committed to achieve targets towards eliminating TB. Early identification of recurrence among cured TB cases is a crucial strategy towards this goal.  However, there are limited data on the implementation of long-term follow-up for cured cases. Methods: A prospective mixed-method study was conducted to evaluate the implementation of long-term follow-up strategy among 180 cured TB patients. Quantitative assessment involved tracking follow-up visits at 6, 12, 18, and 24 months post-treatment success. Moreover, Focus Group Discussions (FGDs) with 46 TB Health Visitors (TB HVs) were conducted to identify barriers to the implementation of long-term follow-up strategies for cured TB cases. Results: Quantitative analysis revealed a decline in follow-up visits over time, and only 16.89% of patients were followed up by TB HVs during fourth visit at 24 months post-treatment. Recurrent TB was identified in 22 cases, 13.7% of which were not followed up by health workers. Qualitative analysis highlighted patient-related factors like loss to follow-up due to migration and denial of sputum testing. Health workers cited workload issues and inadequate financial incentives as barriers to implementation. Conclusion: The study underscores challenges in implementing long-term follow-up strategies for cured TB patients in India. Addressing barriers such as loss to follow-up and workload issues among health workers is crucial for improving recurrence detection and management. Efforts to enhance program effectiveness must prioritize overcoming these barriers to achieve the goal of TB elimination by 2025.

A Prospective Study on Implementation of Long Term Follow-up of Cured Tuberculosis Patients and Barriers Faced by Health Care Workers at Ahmedabad City, Gujarat: A Mixed Method Approach Keywords:

Evaluation , Follow-up , Recurrence , Tuberculosis , Health worker , Mixed method research