The Developing Surveillance and Disease Control Model of Multidrug Resistance Tuberculosis in Community; a Case Study in Surin Province

Abstract

Multi drug resistant tuberculosis (MDR-TB) situation in Surin province is increasingly likely, and there is a lack of effective forms of surveillance and disease control in the community. Therefore, this action research was conducted based on the concepts of Kemmis and McTaggart comprising four steps: planning, acting, observing and reflecting (PAOR) to develop a model of surveillance and control of MDR-TB in the community. There are 2 groups of samples consist of  1) 15 person were purposive sampling from Tuberculosis (TB) specialists, health workers, community leaders, village health volunteers (VHV) and the local administrative organization personnel and 2) 21 high risk persons in the experimental group were simple random sampling from the risk groups in the area with MDR-TB case; Chumpolburi district, Surin province and received an action of developmental model for MDR-TB surveillance and disease control in the community. All of them were attending the workshop research process during January 2020 - September 2021. The quantitative data were collected from the questionnaires, knowledge examines, interview and TB screening form. Data were analyzed with descriptive statistics and paired T-test. The qualitative data were collected by interviews and observations. Qualitative data were analyzed with the content analysis method. The results found that there are 5 steps in the effective model for MDR-TB surveillance and control in the community. The 5 steps consisted of 1) Development of health workers and VHV potential in terms of tuberculosis surveillance and control 2) Expedited active case finding for new TB patients in the community. 3) Intensive surveillance and monitoring of treatment of relapsed pulmonary TB patients 4) Screening of vulnerable people in villages where found MDR-TB cases or have high prevalence rates of TB, and 5) Coordination of information referring system both in the facility and in the community for the monitoring and control of MDR-TB.  The results of comparison of behavioral practices, surveillance and disease control among vulnerable groups found that; after the trial of the model, the averaged mean difference in behavioral scores, monitoring and controlling MDR-TB are higher than pretest significant (p-value <0.05).   Therefore, conducting activities based on developed model of MDR-TB surveillance and control in this community can be applied to monitoring and controlling MDR-TB in communities with high prevalence rates of TB or there are incidence cases of MDR-TB.