The use of mail reminders in STD contact tracing in Ibadan, Nigeria

Abstract

Contact tracing has become the most important tool in the control of sexually transmitted diseases (STDs) world-wide, and different strategies have been introduced into it in recent years to improve its effectiveness. Of all these strategy components, index patient counselling and co-operation to do their own contact tracing by themselves has been identified as the most important one. In Ibadan, it is the only component of the contact tracing strategies that has proven worthwhile. This study has assessed the contribution of supplementary mail reminders to defaulting index patients and their defaulting contacts to our control efforts in the first two years of its usage. It demonstrates that, like the other components of the contact tracing strategies, it is not successful in improving the contact or defaulting index patient attendance, thus only contributing to success in 7 of 141 patients. The intensification of efforts towards encouraging the index patient in contact tracing must therefore be ever more strongly emphasised as the top priority in STD control in Nigeria and similar developing countries for the success of this strategy.

PIP: Contact tracing has become the most important tool in the control of sexually transmitted diseases (STDs) world-wide and different strategies have been introduced in recent year to improve its effectiveness. Of all these strategy components, index patient counselling and co- operation to do their own contact tracing by themselves has been identified as the most important one. In Ibadan, it is the only component of the contact tracing strategies that has proven worthwhile. This study has assessed the contribution of supplementary mail reminders to defaulting index patients and their defaulting contacts to our control efforts in the first 2 years of its usage. It demonstrates that, like other components of the contact tracing strategies, it in not successful in improving the contact or defaulting index patient attendance, thus only contributing to success in 7 of 141 patients. Of the 141 letters sent to defaulting index patients, 38% and 19% of them were returned as untraceable addresses by the postal services in 1985 and 1986. The remaining 103 letters were assumed to have reached their correct destination. Only 7 of these 103 index patients attended the clinic on account of mail reminders, while non of the 39 contacts to whom slips were sent came for follow-up. 11 of the non-responding 96 index patients were later traced physically. 7 of these 11 were found, 6 of whom would not return to the clinic because they felt cured. Efforts must be intensified towards involving index patients in contact tracing as a top priority in STD control in Nigeria. (Author's modified).