การพัฒนารูปแบบการเฝ้าระวัง ป้องกัน และควบคุมวัณโรคแบบมีส่วนร่วม จังหวัดอ่างทอง

Wutthichai Sitthichok; Araya Chiangkhong; Sirinate Sukdee

Authors

Wutthichai Sitthichok Ang Thong Provincial Public Health Office, Ang Thong 14000, Thailand
Araya Chiangkhong Faculty of Nursing, Nawamintradhiraj University, Bangkok 10300, Thailand
Sirinate Sukdee Faculty of Science and Technology, Rajamangala University of Technology Suvarnabhumi, Nonthaburi 11000, Thailand

Keywords:

Tuberculosis, Community-based Surveillance and Control, Participatory Action Research, Directly Observed Treatment (DOT), Stigma

Abstract

This participatory action research aimed to develop and evaluate a community-based tuberculosis (TB) surveillance, prevention, and control model in Ang Thong province. Guided by the PRECEDE-PROCEED framework (April-November 2025), the study involved five phases: assessment, strategy development, implementation, evaluation, and reflection. Participants across phases included 37 informants and 436 residents (assessment); 40 stakeholders (development); 55 patients, 55 family members, and 32 volunteers (implementation/evaluation); and 53 stakeholders (reflection). Data collected via secondary records, questionnaires, interviews, and logs were analyzed using descriptive statistics, paired t-tests, and content analysis. Assessment revealed incomplete screening, overreliance on personnel, discontinuous data linkage, and stigma hindering access. This led to three strategies: risk-stratified active case finding, community-based Directly Observed Treatment (DOT), and stigma reduction via positive communication. Short-term outcomes showed 85.00% of personnel and volunteers trained, 95.00% of at-risk groups screened, 88.60% of patients having DOT observers, and 91.20% medication adherence. Risk perception and treatment access scores increased significantly, while stigma scores decreased significantly. The model effectively integrated health services with community mechanisms. Long-term post-treatment monitoring is recommended to assess sustainability and success rates.

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