Factors Affecting Continued Participation in Tuberculosis Contact Investigation in a Low-Income, High-Burden Setting

Abstract

Setting: Outpatient clinics, Kota Kinabalu, Malaysia; January–April 2018. Objectives: To identify barriers to full participation in tuberculosis (TB) contact investigation. Methods: Cross-sectional study of knowledge, perceptions, and behaviours among TB contacts. This study was conducted among contacts who attended an initial clinic visit to explore retention in care. During this first visit, contacts were approached for participation in a questionnaire at a follow-up visit. Contacts who consented but did not subsequently attend were interviewed at home. Associations between questionnaire findings and attendance were tested using logistic regression. Results: Of the total 1436 identified contacts, 800 (56%) attended an initial clinic visit. Of 237 consenting TB contacts, 207 (87%) attended their follow-up appointment. In univariable analyses, the odds of attendance were highest for people notified to attend the TB clinic directly by a health inspector; close relatives of TB patients; non-students; people with higher incomes and smaller households; older individuals; males; and people not perceiving TB as stigmatising. In multivariable analysis, mode of notification to attend and having a close relative with TB remained significant. Conclusions: Health inspectors provide an effective role in TB contact investigation through direct personal communication to encourage the completion of the TB screening process, but this requires further integration with clinical processes, and with workplace and school-based investigations.

Association of sociodemographic and environmental factors with spatial distribution of tuberculosis cases in Gombak, Selangor, Malaysia

“…Conventionally, it has been proven that sociodemographic factors such as age [ 4 ], gender [ 5 ], race [ 6 ], educational level [ 7 ], employment [ 8 ], health care worker [ 9 ], income [ 10 ], residency [ 11 ], nationality [ 12 ], country of origin [ 13 ], and smoking status [ 14 ] have a role in TB cases. However, evidence described in the literature confirmed the importance of conducting a study to better understand how air quality and weather can influence the cases of TB.…”

Genomic epidemiology of tuberculosis in eastern Malaysia: insights for strengthening public health responses

“…An alternative potential explanation for limited evidence of household clustering is that contact tracing at the household level may be effectively limiting household-based clusters. Qualitative work has demonstrated that contacts identified through school or workplace screening programmes in Kota Kinabalu are less likely to attend the clinic for screening than household contacts [ 36 ]. Together with the current data in which linked cases spread beyond households or sub-districts, this emphasizes the need for contact investigation to be better implemented in schools, workplaces and social networks.…”

The Role of the Tuberculosis (TB) Community in Detecting TB Suspects in Probolinggo Regency, East Java

“…[4][13] Various community-led organizations in TB case finding are effective and need to be implemented. [4][8][9] [14] Previous research has stated that partnerships with the community could improve access to health services in the prevention of tuberculosis. [15][16] This community involvement could improve TB case detection.…”

“…[18] [9] Other challenges in finding suspects include a lack of training, the presence of stigma, a lack of public awareness about TB, and the inability to convince to carry out a sputum test. [9] [14] E3S Web of Conferences 317, 04018 (2021) ICENIS 2021 https://doi.org/10.1051/e3sconf /202131704018 For this reason, the role of community social workers in health can increase the national target for TB case detection by mobilizing the community in health services. [8] The TB community is a social worker is expected to help increase TB case detection; one of its activities is to conduct home visits to search for TB suspects.…”

“…Hence, community participation in the search for TB suspects needs to be increased. [14] Leadership in the community organization also needs evaluation and training to support learning. [22] For this reason, the existence of this TB community is expected to increase the detection of TB cases in the Probolinggo Regency, but the detection of TB cases is still below the national target, namely 65%.…”