Efforts to Detect Suspected Pulmonary Tuberculosis Cases Challenges and Strategies

Authors

  • Siti Chalista Zaisha Oxalis
  • Ratna Sugianti
  • Erny Kusdiyah

DOI:

https://doi.org/10.22437/e-sehad.v5i2.43135

Keywords:

Tuberculosis, Case Detection, Public Awareness, Health Education, Screening Efforts

Abstract

Background: Early detection of suspected pulmonary tuberculosis (TB) cases is essential to reduce transmission and improve treatment outcomes. However, case detection efforts at the community level may be limited by various individual and service-related factors.

Objective: This study aimed to analyze factors associated with efforts to detect suspected pulmonary TB cases in the working area of Olak Kemang Public Health Center in 2024.

Methods: An analytical observational study with a cross-sectional design was conducted among 120 respondents living in the health center coverage area. Data were collected using a structured questionnaire covering sociodemographic characteristics and factors related to TB suspected-case detection efforts. Univariate analysis was used to describe respondent characteristics, and bivariate analysis using the Chi-square test was applied to assess the association between independent variables and detection efforts, with a significance level of p < 0.05.

Results: The majority of respondents were female (62.5%) and aged 25–44 years (48.3%). Bivariate analysis showed that education level (p=0.006), exposure to TB-related information (p=0.001), knowledge about TB (p<0.001), attitude toward TB screening (p<0.001), access to health services (p=0.002), and perceived stigma (p<0.001) were significantly associated with efforts to detect suspected pulmonary TB cases. Meanwhile, sex (p=0.458) and age (p=0.291) were not significantly associated with detection efforts.

Conclusion: Efforts to detect suspected pulmonary TB cases were strongly influenced by modifiable factors including education, information exposure, knowledge, attitude, service accessibility, and stigma. Strengthening TB health education, expanding community outreach, improving access to services, and reducing stigma are recommended to enhance early detection and support TB control programs.

References

1. Kushayati N, Nurmayunita H, Zakaria A, Asri Y. Penguatan Kapasitas Kader Melalui Peer Group Sebagai Strategi Mengurangi Stigma Pada Pasien TBC Paru Di Puskesmas Janti Kota Malang. Jurnal Kreativitas Pengabdian Kepada Masyarakat (Pkm). 2025;8(10):5199–214. https://doi.org/10.33024/jkpm.v8i10.22612

2. Kushayati N, Zakaria A, Nurmayunita H, Asri Y. Si Peduli TBC Komunitas Sebagai Upaya Meningkatkan Deteksi Dini Tuberculosis Paru. Jurnal Kreativitas Pengabdian Kepada Masyarakat (Pkm). 2025;8(10):5172–84. https://doi.org/10.33024/jkpm.v8i10.22533

3. Putri EE. Analisis Faktor Lingkungan Dan Perilaku Masyarakat Terhadap Kejadian TB Paru Di Wilayah Kerja UPTD Puskesmas Bandar Jaya Kabupaten Lampung Tengah. Mid Jur. 2025;5(3). https://doi.org/10.33024/mj.v5i3.22853

4. Kurniawati E. Skrining Dan Edukasi Pada Kelompok Rentan Tuberkulosis Paru (TB) Berbasis Teknologi Digital Di Puskesmas Simpang Kawat Kota Jambi. Jurnal Kreativitas Pengabdian Kepada Masyarakat (Pkm). 2025;8(11):5304–13. https://doi.org/10.33024/jkpm.v8i11.22406

5. Kurniawan D, Najmah N, Syakurah RA. Peran Kader Tb Dalam Pengembangan Aplikasi Suli Simulator. Jurnal Endurance. 2022;6(3):536–50. https://doi.org/10.22216/jen.v6i3.597

6. Herman B, Sirichokchatchawan W, Pongpanich S, Nantasenamat C. Development and Performance of CUHAS-ROBUST Application for Pulmonary Rifampicin-Resistance Tuberculosis Screening in Indonesia. PLoS One. 2021;16(3):e0249243. https://doi.org/10.1371/journal.pone.0249243

7. Hasir H, Nurhikmah N, Nurbaya N. Pelatihan Dan Edukasi Dalam Pengelolaan Lingkungan Fisik Rumah Pada Pasien TB Paru Di Wilayah Kerja Puskesmas Binanga. Poltekita Jurnal Pengabdian Masyarakat. 2022;3(2):241–9. https://doi.org/10.33860/pjpm.v3i2.870

8. Hayati FZ, Nurhapipa N, Sari N. Hubungan Kondisi Fisik Rumah Dan Status Gizi Dengan Insiden Penyakit Tuberkulosis Di Wilayah Kerja Puskesmas Rejosari Kota Pekanbaru Tahun 2020. Media Kesmas (Public Health Media). 2021;1(2):538–47. https://doi.org/10.25311/kesmas.vol1.iss2.84

9. Arini M, Sugiyo D, Permana I. Challenges, Opportunities, and Potential Roles of the Private Primary Care Providers in Tuberculosis and Diabetes Mellitus Collaborative Care and Control: A Qualitative Study. BMC Health Serv Res. 2022;22(1). https://doi.org/10.1186/s12913-022-07612-3

10. Rahayu S, Cahyati WH, Zainafree I, Farida E, Merzistya ANA, Atmini T, et al. Be Hero for Zero Tuberculosis: Peran Remaja Melalui SIKRIBO Dalam Mewujudkan “End TB.” Poltekita Jurnal Pengabdian Masyarakat. 2022;3(2):230–40. https://doi.org/10.33860/pjpm.v3i2.849

11. Shami E, Gholipour‎ K, Naghibi D, Azami‐Aghdash S. The Roles and Challenges of the Primary Health Care Systems in Epidemic Management: A Scoping Review. Prim Health Care Res Dev. 2023;24. https://doi.org/10.1017/s1463423623000452

12. Khan FA, Al-Kubaisi N, Shah A, Mujalli HA, Socor S, Asif M, et al. Clinical Audit on Detection of Tuberculosis at Primary Health Care Corporation, Qatar. J Community Med Public Health. 2022;6(1). https://doi.org/10.29011/2577-2228.100263

13. Guevarra JP, Antonio CAT, Bermudez ANC, Cochon KL, Agbon AG, Avelino MD, et al. Facilitators and Barriers to Implementation of the Pharmacy DOTS Initiative in Selected Project Sites in the Philippines. Acta Med Philipp. 2021; https://doi.org/10.47895/amp.vi0.3106

14. Give C, Morris C, Murray J, José B, Machava R, Wayal S. Sociocultural Understanding of Tuberculosis and Implications for Care-Seeking Among Adults in the Province of Zambezia, Mozambique: Qualitative Research. PLoS One. 2024;19(1):e0289928. https://doi.org/10.1371/journal.pone.0289928

15. Williams V, Vos AG, Otwombe K, Grobbee DE, Klipstein‐Grobusch K. Epidemiology and Control of Diabetes - Tuberculosis Comorbidity in Eswatini: Protocol for the Prospective Study of Tuberculosis Patients on Predictive Factors, Treatment Outcomes and Patient Management Practices. BMJ Open. 2022;12(6):e059254. https://doi.org/10.1136/bmjopen-2021-059254

16. Zhou X, Lee EWJ, Wang X, Lin L, Xuan Z, Wu D, et al. Infectious Diseases Prevention and Control Using an Integrated Health Big Data System in China. BMC Infect Dis. 2022;22(1). https://doi.org/10.1186/s12879-022-07316-3

17. Tay MZ, Ang LW, Wei WE, Lee VJM, Leo Y, Toh MPH. Health-Seeking Behavior of COVID-19 Cases During the First Eight Weeks of the Outbreak in Singapore: Differences Between Local Community and Imported Cases and Having Visits to Single or Multiple Healthcare Providers. BMC Public Health. 2022;22(1). https://doi.org/10.1186/s12889-022-12637-8

18. Wyk SS v., Medley N, Young T, Oliver S. Repairing Boundaries Along Pathways to Tuberculosis Case Detection: A Qualitative Synthesis of Intervention Designs. Health Res Policy Syst. 2022;20(1). https://doi.org/10.1186/s12961-021-00811-0

19. Zulu D, Silumbwe A, Maritim P, Zulu JM. Integration of Systematic Screening for Tuberculosis in Outpatient Departments of Urban Primary Health-Care Facilities in Zambia: A Case Study of Kitwe District. 2021; https://doi.org/10.21203/rs.3.rs-998743/v1

20. Setiyadi NA, Setyowati M. Needs Assessment for an Information System to Support a TB Control Program in Indonesia. Kne Life Sciences. 2022; https://doi.org/10.18502/kls.v7i2.10387

21. Izhar MD, Wardiah R, Lanita U, Herwansyah. Multiphasic Screening: Clinical Symptoms and Mental Health Patient Tuberculosis in Jambi City, Indonesia. Jurnal Berkala Epidemiologi. 2023;11(3):205–14. https://doi.org/10.20473/jbe.v11i32023.205-214

22. Amanobila RA. Knowledge, Attitude and Uptake of Tuberculosis Screening Services Among Gold Miners in the Datuko Sub-District in the Talensi District Ghana. Annals of Medical Laboratory Science. 2022;2(2):31–44. https://doi.org/10.51374/annalsmls.2022.2.2.0063

23. Fuady A, Arifin B, Yunita F, Rauf S, Fitriangga A, Sugiharto A, et al. Stigma, Depression, Quality of Life, and the Need for Psychosocial Support Among People With Tuberculosis in Indonesia: A Multi-Site Cross-Sectional Study. Plos Global Public Health. 2024;4(1):e0002489. https://doi.org/10.1371/journal.pgph.0002489

24. Dixit K, Biermann O, Rai B, Aryal TP, Mishra G, Siqueira-Filha NT d., et al. Barriers and Facilitators to Accessing Tuberculosis Care in Nepal: A Qualitative Study to Inform the Design of a Socioeconomic Support Intervention. BMJ Open. 2021;11(10):e049900. https://doi.org/10.1136/bmjopen-2021-049900

25. Pradhan A, Koirala P, Bhandarı SS, Dutta SK, García‐Grau P, Sampath H, et al. Internalized and Perceived Stigma and Depression in Pulmonary Tuberculosis: Do They Explain the Relationship Between Drug Sensitivity Status and Adherence? Front Psychiatry. 2022;13. https://doi.org/10.3389/fpsyt.2022.869647

26. Katwesigye R, Mbuliro M, Lalitha R, Katuramu R, Andama A, Turyahabwe S, et al. Exploring Facilitators and Barriers to Early TB Case Finding at Private Community Pharmacies in Kampala, Uganda Using the Consolidated Framework for Implementation Research (CFIR). 2025; https://doi.org/10.21203/rs.3.rs-7196158/v1

27. Sathar F, Toit C d., Chihota V, Charalambous S, Evans D, Chetty-Makkan C. Understanding Patient Experiences: A Mixed-Methods Study on Barriers and Facilitators to TB Care-Seeking in South Africa. Trop Med Infect Dis. 2025;10(10):283. https://doi.org/10.3390/tropicalmed10100283

28. Buregyeya E, Atusingwize E, Sekandi JN, Mugambe RK, Nuwematsiko R, Atuyambe L. Developing Strategies to Address Barriers for Tuberculosis Case Finding and Retention in Care Among Refugees in Slums in Kampala, Uganda: A Qualitative Study Using the COM-B Model. BMC Infect Dis. 2022;22(1). https://doi.org/10.1186/s12879-022-07283-9

29. Santoso SDRP, Agustine U, Paju W, Hamid H. Menumbuhkan Literasi Tuberkulosis Melalui Simak Ya (Sinergi Mahasiwa Keperawatan Dan Kader Berdaya) Metode Ketuk Pintu Di Kelurahan Dira Tana Kabupaten Sumba Barat NTT. Jurnal Kreativitas Pengabdian Kepada Masyarakat (Pkm). 2025;8(8):3989–4000. https://doi.org/10.33024/jkpm.v8i8.21122

30. Alanazi NA, Almoajel A, Tharkar S, Al-Mutairi KM, Mohamad FS, Almatairi BST. Perceptions of Executive Decision Makers on Using Social Media in Effective Health Communication: Qualitative Study. J Med Internet Res. 2025;27:e69269. https://doi.org/10.2196/69269

31. Jain M, Sharma PK, Kamboj K, Shyam A. The Impact of Social Media on Medical Education and Health-Care Communication. J Orthop Case Rep. 2024;14(9):1–3. https://doi.org/10.13107/jocr.2024.v14.i09.4706

32. Ramos JP, Vieira M, Pimentel C, Argel M, Barbosa P, Duarte R. Building Bridges: Multidisciplinary Teams in Tuberculosis Prevention and Care. Breathe. 2023;19(3):230092. https://doi.org/10.1183/20734735.0092-2023

33. Manoharan A, Farhana HSN, Manimaran K, Khoo EM, Koh WM. Facilitators and Barriers for Tuberculosis Preventive Treatment Among Patients With Latent Tuberculosis Infection: A Qualitative Study. BMC Infect Dis. 2023;23(1). https://doi.org/10.1186/s12879-023-08612-2

34. Masita M, Hairi FM, Bachtiar A, Mulyana N, Andriani H. Community-Driven Strategies and Policies for Drug-Resistant Tuberculosis Control in Banyumas Regency, Indonesia: A Comprehensive 2023 Analysis. J Public Health Res. 2025;14(3). https://doi.org/10.1177/22799036251376872

35. Wu T, He H, Wei S, Pan J, Yang J, Huang S, et al. How to Optimize Tuberculosis Health Education in College Under the New Situation? Based on a Cross-Sectional Study Among Freshmen of a Medical College in Guangxi, China. Front Public Health. 2022;10. https://doi.org/10.3389/fpubh.2022.845822

36. Khariroh S, Abdullah E. Health Promotion and Literacy Models to Increase the Autonomy of Tuberculosis Patients. Jurnal Endurance. 2022;7(3):493–9. https://doi.org/10.22216/jen.v7i3.1395

37. Marbun R, Ariyanti R, Sigit N. Pemberdayaan Kader Kesehatan Terkait Skrining Penemuan Kasus Baru Penderita Tuberkulosis. Selaparang Jurnal Pengabdian Masyarakat Berkemajuan. 2023;7(1):24. https://doi.org/10.31764/jpmb.v7i1.12897

38. Darwis A. Peningkatan Pengetahuan Pencegahan Tuberkulosis Pada Masyarakat Grong-Grong Capa Kecamatan Ulim Kabupaten Pidie Jaya. Jurnal Inovasi Dan Pengabdian Masyarakat Indonesia. 2023;2(4):35–8. https://doi.org/10.26714/jipmi.v2i4.184

39. Numpong S, Kengganpanich M, Kaewkungwal J, Pan‐ngum W, Silachamroon U, Kasetjaroen Y, et al. Confronting and Coping With Multidrug-Resistant Tuberculosis: Life Experiences in Thailand. Qual Health Res. 2021;32(1):159–67. https://doi.org/10.1177/10497323211049777

40. Nabila N. Faktor-Faktor Yang Mempengaruhi Kepatuhan Minum Obat Anti Tuberkulosis (OAT) Pada Penderita Tuberkulosis Paru (TB) : Literature Review. Media Publikasi Promosi Kesehatan Indonesia (Mppki). 2023;6(8):1478–84. https://doi.org/10.56338/mppki.v6i8.3484

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Published

2025-06-30