Development of a Method for Tuberculosis Screening and Case Detection in Sing Buri Provincial Prison in 2018

Abstract

The general objective of this study was to develop a method for tuberculosis (TB) screening and case detection in Sing Buri Provincial Prison. The specific objectives of this study were to 1. study the context of TB screening, case detection, and treatment in Sing Buri Provincial Prison, 2. develop a new method for TB screening and detection by using an action research, and 3. assess effectiveness of the new method for TB case screening and detection. The research was divided into 3 phases. This study had 2 groups of samples. The first group included personnel related to screening, case detection, and treatment of TB patients in Sing Buri Provincial Prison. By using participatory approach, tools that reflected work performance including before action review, after action review, and on-the-job learning were used in focus group discussion. The second group included prisoners in Sing Buri Provincial Prison receiving TB screening and detection. Descriptive statistics including frequency and percentage of TB cases detected at the time of arrival were used to present the results. This study resulted in a new method for TB case screening and detection with concrete application. Firstly, new/transferred prisoners were isolated in separated areas. Then, they were screened for early detection of TB by chest X-ray which was performed every Friday at Sing Buri Hospital (Green channel). Any prisoners with abnormal chest x-ray suspected of TB would be in an isolation room, investigated for diagnosis and treatment at TB clinic of Sing Buri Hospital. The patients then received continuous treatment under supervision of nurses of the prison. The nurses performed the directly observed therapy (DOT) system by which the patients had to take anti-TB drugs in front of them. After the no longer contagious period, the prisoners with TB would be taken to their assigned prison areas. Moreover, all prisoners would be screened yearly by chest x-ray in order to find new cases. After the method was implemented, assessment revealed early detection and treatment, which might reduce or prevent TB spread within the prison. In addition, personnel related to the disease management were more satisfied with the new method than the old one.