Tuberculosis Surveillance and Control Model in Urban Area of Khon Kaen Province

Abstract

Tuberculosis surveillance and control in urban area are facing a problem of under-report of case detection. The objective of this study was to set up a tuberculosis (TB) surveillance and control model in urban area. It was conducted in Khon Kaen province, Thailand during October 2015 - September 2016; and participated by persons responsible for TB control in hospitals, provincial health office, municipality, prisons and public transportation cooperative. The study was comprised of 4 phases: (1) situation analysis of the context of TB control problem in urban area; (2) joint development of a TB control model by all participating stakeholders; (3) model implementation; and (4) outcome evaluation. Data were collected from case record forms, TB control activity reports and focus group discussion; and were analyzed by descriptive statistics and content analysis. As for the result, a comprehensive model was developed based on the outcome of the situation analysis. A TB coordinator was appointed in the provincial hospital to register TB cases, transfer and coordinate the management within the network. All private hospitals in Khon Kaen municipality regularly sent TB cohort reports to the provincial health office. Regular TB screening of high risk groups was performed by primary care clusters; and screening program for prisoners was developed in prison settings toegther with chest X-ray for TB suspected cases. Public transport cooperatives in the municipality also participated in the screening program. The model implementation was found to increase case detection and strengthen the control activities. In conclusion, the urban TB control model with active participation among public and private sectors together with municipality cooperation was effective in increasing case detection and treatment enrolement, which would reduce TB transmission in the communities.