Self – Administered Screening Model for TB Detection in Urban Area

Abstract

This Action Research aimed to develop a Self – Administered Screening model for Tuberculosis detection in an urban area. It was implemented with volunteers who lived in Chiang Mai municipality with the cooperation of the urban health network. The application of the PAOR (Plan Act Observe Reflect) cycle included the study of tuberculosis problems in an urban area, the model development, implementation, and evaluation of the outcomes. Qualitative data were collected through group discussions, in-depth interviews, and observations. Data were analyzed using content analysis. The quantitative data were collected via the manual record form in the TB Self Screening (TBSS) application, and analyzed by using descriptive statistics.

Results: The urban self-administered TB screening model was developed according to the Department of Disease Control's Suspected Pulmonary TB verbal screening form. The users manually filled the data through an application of electronic devices, such as mobile phones, tablet PCs, or other computer devices. This model also offers the opportunity to explore knowledge about TB after use. Presumptive tuberculosis cases will have the chance to receive additional screening services. The model will provide identity cards for people at risk to pass through the "Fast Track" in the hospital and ensuring that the screening process minimal stigmatization.

There were 942 volunteers after 6 months of study peroid. Most of them were over 60 years of age (38.36 %), the ratio of male to female was 1: 1.4.  20.51% of volunteers living in the Chang Phueak subdistrict 33.23% were sick from hypertension, and 23.67% had diabetes. The most common symptoms were cough for less than 2 weeks (51.21%), cough for more than 2 weeks (4.03%), and weight loss (2.76%), respectively.  Volunteers 26 persons were found at risk of tuberculosis (risk assessment score greater than or equal to 3) (2.76%), 12 presumptive tuberculosis who at risk were received additional screening in a hospital (46.15%) and, 2 persons had an abnormal chest X-ray. Of the 182 volunteers, who were willing to complete the satisfaction questionnaire, 166 (91.21%) were very satisfied with this TB self-screening model.  94.68 % preferred to screen themselves for Tuberculosis with this model. 92.97% will go to the hospital for further examinations immediately when the risk was found.  The expansion of this model should be carried out in specific groups such as foreign workers, Health Care Workers, and groups who have access to technology.