The Implementation of Early Detection in Tuberculosis Contact Investigation to Improve Case Finding

Putra, I Wayan Gede Artawan Eka; Kurniasari, Ni Made Dian; Dewi, Ni Putu Eka Purnama; Suarjana, I Ketut; Duana, I Made Kerta; Mulyawan, Iwan; Riono, Pandu; Alisjahbana, Bachti; Probandari, Ari; Notobroto, Hari Basuki; Wahyuni, Chatarina Umbul

doi:10.2991/jegh.k.190808.001

Cited by 6 publications

(8 citation statements)

References 17 publications

(23 reference statements)

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“…Tuberculosis is an infectious disease that is often accompanied by nutritional and metabolic disorders. Response to infection is associated with increased energy expenditures and tissue damage levels 12 .…”

Section: Discussionmentioning

confidence: 99%

Changes in ARB Sputum Positivity, BMI and TNF-? Levels of Pulmonary TB Patients with ARB Positive During One-month Intensive Treatment

Samsuri¹

2020

IJFMT

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Backgoround: TNF-α plays a role in the occurrence of anorexia and weight loss in pulmonary tubercolusis (TB) patients. Evaluation of treatment response can be done with clinical, microbiological and radiological evaluation. In patients without cough, Body Mass Index (BMI) and TNF-α levels can be used to evaluate clinical treatment response. Objectives:The aim of the study is to measure the Acid Resistant Bacteria (ARB) sputum positivity decrease, TNF-α levels and increased BMI after 2 weeks and 4 weeks intensive treatment of pulmonary TB patients with new case of ARB positive. Methods:The sample size was 14 people with ARB positive pulmonary TB cases, consisting of 9 men and 5 women. It was done sputup smear, BMI and TNF-α examination before treatment, at week 2 and week 4 of intensive phase treatment Result: At the end of the second week, TNF-α levels decreased significantly compared to baseline TNF-α levels with p = 0.015. There was a non significant increase of BMI at the end of the second and fourth week with p = 0.309 and p = 0.270 respectively. The decrease in ARB sputum smear positivity at the end of the second week compared to the fourth week was not statistically significant with p = 0.157. There was a strong correlation between TNF-α and IMT levels before treatment with negative correlation, r = -0.702 and p = 0.005. Conclusion:Levels of TNF-α at the end of the second week decreased significantly compared to baseline TNF-α levels. There was a strong correlation between TNF-α levels and BMI prior to treatment.

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Section: Discussionmentioning

confidence: 99%

Changes in ARB Sputum Positivity, BMI and TNF-? Levels of Pulmonary TB Patients with ARB Positive During One-month Intensive Treatment

Samsuri¹

2020

IJFMT

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“…Early detection means a systematic screening and examination to diagnose TB at an earlier stage. Screening using chest X-ray was done for adult contacts without cough to find out if there were any abnormalities in the lung parenchymal that is suggestive of TB, and tuberculin skin test was conducted on all children contacts (Putra et al, 2019).…”

Section: Study Settingsmentioning

confidence: 99%

“…The sample size was determined to test the difference of a two-population proportion (one-sided test). The complete participation proportion reported from the pilot study (8.2%) was used as a baseline proportion (Putra et al, 2019). Estimated precision of 5%, 2.5 design effect, 0.03 interclass correlation coefficient, 12 cluster size, and 80% power were considered for total sample size estimation.…”

Section: Study Design and Participantsmentioning

confidence: 99%

“…In contact investigation, all index cases are home visited for treatment adherence support, household contact identification, and suggested contacts for TB early detection. Previous studies found that the proportion of positive cases among household contacts was 20% to 40% (Putra et al, 2019). Contact investigation also potentially contributes to finding of TB cases among children (Htet et al, 2018).…”

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confidence: 95%

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The Implementation of Comprehensive Health Education to Improve Household Contacts’ Participation in Early Detection of Tuberculosis

Putra

Dewi²,

Probandari

et al. 2021

Health Educ Behav

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Lack of participation of household contacts is the main problem of early detection of tuberculosis (TB) in Indonesia. A comprehensive health education (CHE) program has been developed to encourage the participation of household contacts. This study aimed to assess the implementation of the CHE to improve participation of household contacts in early detection of TB. This was a quasi-experimental study conducted between November 2018 and June 2019 in Badung District, Bali, Indonesia. Twelve public health centers (PHCs) were randomly allocated to six PHCs implementing the CHE and six PHCs implementing standard health education (SHE). The CHE was developed through a pilot study using the health belief model supplemented with perceived stigma and social support to identify the factors that influence participation. The participation was measured using a TB register with a cross-check to the health care officer until 2 months after health education was provided. Four hundred and twenty-eight household contacts enrolled in this study—216 in the CHE group and 212 in the SHE group. The CHE group’s participation was 28.2%, with 10 new TB cases found; in the SHE group, the participation was 15.6%, with 3 new TB cases found. The CHE increased the household contact participation by 1.83-fold (95% confidence interval [1.19, 2.81]) and case findings by 3.13-fold (95% confidence interval [0.85, 11.56]). The CHE implementation should be scaled up to other areas with a high level of TB transmission. The content and technique of the CHE could also be incorporated in contact investigation guidelines and materials for the TB campaign.

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“…9-17 Challenges which often occur with active case finding are including the lack of frequency of home visits, inadequate resources, inaccurate diagnostic tools, low participation of contacts during visits due to lack of TB knowledge, fear and stigma in society. 18,19 To date, there is no previous studies involving TB patients as volunteers for active case finding in Indonesia, while some studies were conducted outside Indonesia, which may not necessarily suitable for Indonesian conditions. Additionally, low awareness about TB, fear and shame due to stigma may become several considerations of the increase need to engage TB patients as volunteers to improve active case findings.…”

Section: Introductionmentioning

confidence: 99%

Training program for tuberculosis (TB) patients to improve referrals of presumptive TB cases and sputum in Denpasar, Bali, Indonesia

Antarina¹,

Wirawan²,

Sawitri³

2020

phpma

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Background and purpose: Tuberculosis (TB) is a global health problem and one of the top ten causes of deaths in the world. TB case finding is an important component of TB control. In Indonesia, most case findings were done passively so that the referral coverage for TB sputum was lower than the target. This study aims to determine the effectiveness of training for TB patients as volunteers to increase the active referral of presumptive TB cases.Methods: The pretest-posttest design intervention study was conducted in five public health centers (PHCs) which had the highest number of TB patients in Denpasar. The intervention was carried out for seven weeks (February-May 2020). A total of 35 TB patients, who were currently undergoing treatment at the PHCs, met the study criteria and willing to volunteer, were trained through meetings, discussions and demonstrations about the risk of TB transmission, contact investigations and how to collect sputum samples. Before and after the interventions, data on volunteers' knowledge, the number of presumptive TB and sputum referrals by volunteers were collected through interviews and daily records. A regular reminder was sent in the form of a WhatsApp message once a week. Bivariate data analysis was performed with chi-square and Wilcoxon Signed Rank Test.Results: Volunteers' knowledge scores increased significantly after training, with a median score of 13.0 to 15.0 (p<0.001), and there was a significant difference in knowledge improvement among those who actively responded to regular reminders compared to those who were less active (p=0.002). A total of 31 presumptive TB cases were successfully referred during the study period (7 weeks). Volunteers managed to refer as many as 30 sputum preparations with good quality, but no positive sputum was found.Conclusion: Recruitment and training of TB patients as volunteers can increase the knowledge and skills of volunteers to identify and refer presumptive TB cases and quality sputum samples. More TB patients should be trained as volunteers with a longer observation time to increase TB patient detection.

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The Implementation of Early Detection in Tuberculosis Contact Investigation to Improve Case Finding

Cited by 6 publications

References 17 publications

Changes in ARB Sputum Positivity, BMI and TNF-? Levels of Pulmonary TB Patients with ARB Positive During One-month Intensive Treatment

Changes in ARB Sputum Positivity, BMI and TNF-? Levels of Pulmonary TB Patients with ARB Positive During One-month Intensive Treatment

The Implementation of Comprehensive Health Education to Improve Household Contacts’ Participation in Early Detection of Tuberculosis

Training program for tuberculosis (TB) patients to improve referrals of presumptive TB cases and sputum in Denpasar, Bali, Indonesia

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