Enhancing acute flaccid paralysis surveillance through the use of pictorial surveillance reminder cards during supplementary immunization activities, December 2014: a survey in Jigawa State, Nigeria.

Introduction: Acute flaccid paralysis (AFP) pictorial surveillance reminder cards (AFP cards) could aid AFP case identification during supplementary immunization activities (SIAs). We assessed the availability and utilization of AFP cards among vaccination teams during the December 2014 polio SIAs in Jigawa State, Nigeria. Methods: We conducted a cross-sectional survey of a convenience sample of 95 vaccination team supervisors. We used a semi-structured interviewer-administered questionnaire to collect information on socio-demographics, knowledge of AFP cases, availability and utilization of the AFP cards for case identification and investigation and non-compliance resolution by vaccination teams. Univariate and bivariate analyses were performed using Epi Info version 3.5.1. Results: Of the 95 supervisors interviewed, 86 (91%) reported that vaccinators properly displayed the AFP cards, 90 (95%) reported use of cards for AFP case identification, 88 (93%) reported use of cards to resolve non-compliance with polio vaccination and 77 (81%) reported use of cards to ask caregivers six key questions to prevent missed children. Fifty-eight (61%) supervisors knew the AFP case definition. A total of 21 possible AFP cases were identified by vaccination team members with the aid of the cards, of which 17 (81%) were referred to the nearest health facility. Conclusion: The survey demonstrated usefulness of reminder cards for identification and follow-up of AFP cases. Based on these findings, use of AFP cards was implemented in all Nigerian States and similar cards were developed and implemented for measles surveillance during SIAs.

Effectiveness of a reminder card system versus a mobile application to improve medication adherence among asthma patients in a tertiary care hospital.

OBJECTIVES: Asthma is a major public health problem affecting a large number of individuals worldwide. The effectiveness of medications depends on adherence to the instructions of the prescriber. This study aimed to assess and compare the effectiveness of a reminder card system versus a mobile application to improve the medication adherence of asthma patients in a tertiary care hospital. METHODS: This prospective interventional study was conducted at a tertiary care hospital. The scores were obtained from the Morisky medication adherence scale. RESULTS: In the card group, comparison of the baseline and follow-up scores for medication adherence showed a mean difference of 3.44, p = 0.001. The application group showed a mean difference of 4.02, p = 0.001, which reflects a highly significant association. Comparison of the effectiveness of reminder cards and the mobile application showed a mean difference of 0.72, p = 0.088 (>0.05) at baseline, showing no significant difference in adherence status before intervention. After intervention there was a mean difference of 0.86 (p = 0.001 < 0.05), indicating a significant difference in adherence status. CONCLUSION: Provision of proper interventional tools can improve asthma medication adherence. In this study, the mobile application was found to be more effective than medication reminder cards.