Patient Attendance at Post-Operative Follow-ups After TT Surgery: A Comparative Analysis of 1-10 Day and 3-6 Month Follow up Visits in Mtwara and Pwani, Tanzania

Trachoma remains a critical global health concern and a leading cause of preventable blindness in endemic areas, Tanzania included. Repeated infections result in pulling the eyelashes inward to scratch the cornea, a condition known as trachomatous trichiasis (TT). IMA World Health (IMA) is a lead implementing partner in the Mtwara and Pwani regions supporting the Global Alliance for Trachoma Elimination efforts and the Tanzania Ministry of Health to implement the World Health Organization-endorsed SAFE strategy to search for patients, provide surgery, and conduct follow-up to ensure a full recovery. Poor attendance affects the ability of the program to assess the quality of services offered effectively. Per program protocol, after providing TT surgery to patients, IMA organizes post-operative follow-up visits one-day post-surgery intended for pad removal, 7-10 days post-surgery for suture removal, and 3-6 months post-surgery to assess the overall success of the surgery offered. Even though all operation patients are invited to attend all three follow-up visits at different times, the overall attendance rate varies between the three stages of follow-up visits. Over a period of 12 months in 2019, IMA conducted a total of 2,110 surgeries and invited a total of 2,110 patients to attend all three follow-up visits. These took place on different dates between April 2019 through March 2020 during various implementation quarters. Across all quarters, on average, all 2,110 (100%) patients attended the 1-10 days follow-up visits, while only 1,065 (50.5%) attended the 3-6 months follow-up visit. Patients' attendance at the 3-6-month follow-up visits during different quarters ranged from 30.7% to 75.9%. Low attendance is associated with the belief among patients that they are already cured, and because they are not in pain, it is no longer necessary to see the doctor. IMA is increasing advocacy during outreach and engage Community Health Workers in educating patients on the importance of follow-ups.