@article{95343,
  keywords = {General Biochemistry, Genetics and Molecular Biology, General Agricultural and Biological Sciences, General Medicine},
  author = {Kashaf MS and Wolle MA and Muñoz BE and Mkocha HA and Funga N and Gracewello C and West SK},
  editor = {Zhang Y},
  title = {Patient perceived barriers to surgical follow-up: Study of 6-month post-operative trichiasis surgery follow-up in Tanzania},
  abstract = {<jats:sec id="sec001">
<jats:title>Background</jats:title>
<jats:p>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.</jats:p>
</jats:sec>
<jats:sec id="sec002">
<jats:title>Methods</jats:title>
<jats:p>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.</jats:p>
</jats:sec>
<jats:sec id="sec003">
<jats:title>Results</jats:title>
<jats:p>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).</jats:p>
</jats:sec>
<jats:sec id="sec004">
<jats:title>Conclusions</jats:title>
<jats:p>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.</jats:p>
</jats:sec>},
  year = {2021},
  journal = {PLOS ONE},
  volume = {16},
  pages = {e0247994},
  publisher = {Public Library of Science (PLoS)},
  issn = {1932-6203},
  url = {https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0247994&type=printable},
  doi = {10.1371/journal.pone.0247994},
  language = {eng},
}