Development of Tuberculosis Screening Guidelines for High-Risk Groups in the Community, Moeiwadi Hospital

Abstract

Objective : 1) To analyze the situation and problems in tuberculosis screening for at-risk groups in the community; and 2) to develop and evaluate the outcomes of implementing the tuberculosis screening guidelines at Moeiwadi Hospital.

Methods : This study employed Participatory Action Research (PAR), consisting of three phases: 1) analysis of the situation and problems, 2) development of screening guidelines through two cycles, and 3) evaluation of implementation outcomes. The study was conducted between December 2023 and September 2024. The sample consisted of 22 multidisciplinary team members and seven groups of at-risk community members, totaling 1,699 participants. Research instruments included knowledge questionnaires, satisfaction questionnaires, screening record forms, and guidelines for in-depth interviews and focus group discussions. Data were analyzed using descriptive statistics, paired t-test, and Wilcoxon signed-rank test. Qualitative data were analyzed using content analysis.

Result : The screening rate among at-risk groups increased from 58.00% to 91.55%. The number of newly detected tuberculosis cases increased from 16 to 24 cases. The time to treatment initiation significantly decreased from 18.4 days to 6.8 days (Z = 5.24, p-value= 0.005). Satisfaction levels among the multidisciplinary team and at-risk groups were at the highest level, with mean scores of 4.73 and 4.90, respectively. Knowledge scores regarding tuberculosis significantly improved across all components (p-value < 0.05).

Conclusion : The developed tuberculosis screening guidelines were effective in increasing screening rates, detecting new cases, and reducing time to treatment initiation.