Implementation of a simple reminder system to increase contact screening in tuberculosis

Abstract

INTRODUCTION: The current level of contact screening for tuberculosis in Sri Lanka is unsatisfactory. The objective of the present study was to assess the feasibility and effectiveness of a simple intervention to increase contact screening. METHODS: Arubber stamp to be used in patients' clinic notes was designed to record the number of contacts and their screening status. At the time of registration, information regarding the number of family and other contacts was obtained from patients and recorded. The patients were also told about the importance of the contacts being screened. On each subsequent visit the patients were asked about the number of contacts who had undergone screening and this number was recorded. This intervention was implemented at the Kurunegala Chest Clinic from February 2005. Data regarding the number of new cases and contacts screened was obtained from Kurunegala and Puttalam chest clinics for the period January 2003 to July 2005. RESULTS: During the two year period prior to the intervention the contact screening rate at Kurunegala was 53.5 per 100 new cases (contacts: new cases- 829:1548) and this increased to 108 per 100 new cases (419:388) during the six months intervention period. There was no similar increase in the contact screening rate (230:318 and 22:98) in the adjoining Puttalam District. During the intervention period the relevant information was entered in the notes of 94% (366 out of 388) of new cases on every visit. DISCUSSION: Though this was not a randomised controlled trial with formal statistical analysis the fact that there was a marked increase in contact screening at Kurunegala with the intervention and no similar increase in the adjoining Puttlam District suggest that the intervention has had a positive effect on contact screening.