Faculty of Public Health, Universitas Airlangga, Kampus C, Surabaya, East Java, Indonesia.
School of Public Health, Faculty of Medicine, Universitas Udayana, Jl. PB Sudirman, Denpasar, Bali, Indonesia.
J Epidemiol Glob Health. 2019 Sep;9(3):191-197. doi: 10.2991/jegh.k.190808.001.
The early detection of Tuberculosis (TB) among TB contacts is a strategy to find TB cases in earlier stage and to stop the transmission. This study aimed to assess the implementation of early detection in TB contact investigation to improve TB case finding. This was an operational research study conducted in Badung District, Bali, Indonesia. The samples were TB contacts, identified in the period July through September (third quarter) 2017. Contacts were household members who were living and sharing a room at least for 3 months with infectious TB patients and were not previously diagnosed with TB. Data were collected through face-to-face interview using structured questionnaires and registration reviews using a checklist. We visited 124 TB patients and successfully identified 498 contacts, thus the ratio of contacts to cases is 4:1. All TB contacts were invited to participate in TB screening and evaluation program. A total of 100 (20.1%) contacts have attended at least one examination session and 41 contacts have completed all sessions. Ten TB cases were found among the contacts, of which four of them were adults (three bacteriologically confirmed and one clinically confirmed) and six were children (aged under 15 years). The positivity rate among children was higher (46.2%) compared with adults (14.3%). The positivity rate of confirmed TB among contacts with any TB symptoms was 43.8% and that without symptoms was 12.0%. The contribution of early detection in TB contact investigation to improve TB case finding was 8.1% through all TB patients. The early detection in TB contact investigation yielded additional notified cases, especially among children. A comprehensive education, covering cognitive and psychological aspect, is needed to encourage TB contacts to completely participate in early detection program until their diagnosis is confirmed.
肺结核（TB）接触者的早期检测是一种在早期发现 TB 病例并阻止传播的策略。本研究旨在评估在 TB 接触者调查中实施早期检测以提高 TB 病例发现率的情况。这是在印度尼西亚巴厘省巴东地区进行的一项操作研究。样本为 2017 年 7 月至 9 月（第三季度）期间确定的 TB 接触者。接触者为与传染性 TB 患者共同生活并至少同住 3 个月且之前未被诊断为 TB 的家庭成员。数据通过使用结构化问卷的面对面访谈和使用检查表的登记审查收集。我们共访问了 124 名 TB 患者，并成功识别了 498 名接触者，因此接触者与病例的比例为 4:1。所有 TB 接触者都被邀请参加 TB 筛查和评估计划。共有 100 名（20.1%）接触者至少参加了一次检查，41 名接触者完成了所有检查。在接触者中发现了 10 例 TB 病例，其中 4 例为成人（3 例细菌学确诊，1 例临床确诊），6 例为儿童（年龄均在 15 岁以下）。儿童的阳性率（46.2%）高于成人（14.3%）。有任何 TB 症状的接触者中确诊 TB 的阳性率为 43.8%，无症状者为 12.0%。通过所有 TB 患者，TB 接触者调查中的早期检测对提高 TB 病例发现率的贡献为 8.1%。TB 接触者调查中的早期检测产生了额外的报告病例，尤其是儿童。需要进行全面的教育，包括认知和心理方面，以鼓励 TB 接触者完全参与早期检测计划，直到他们的诊断得到确认。
