Development of an Innovative Contact Tracing Database for New Tuberculosis Patients and Implementation Outcomes in TB Control

Abstract

This research and development study aimed to develop an innovative database for tracking contacts of newly diagnosed tuberculosis (TB) patients and to examine the outcomes of its implementation for TB prevention and control. The study was conducted in four phases: 1) analyzing the problems and constraints in the identification and screening of household contacts and close contacts of new pulmonary TB patients in Nong Ruea district, Khon Kaen province; 2) developing and implementing an innovative database for tracking contacts of new TB patients; 3) evaluating the outcomes of implementing the innovative contact-tracking database; and 4) synthesizing lessons learned and disseminating the development outcomes. The sample consisted of 1) 25 personnel responsible for TB clinic services at Nong Ruea hospital and Health Promoting Hospitals (HPHs); 2) 150 Village Health Volunteers (VHVs); and 3) the general population screened for TB risk in Nong Ruea district, across 15 HPHs, totaling 5,570 individuals. Six research instruments were used: 1) a problem-assessment record form; 2) the new TB patient contact-tracking database; 3) a verbal TB screening application; 4) a TB prevention health literacy questionnaire; 5) a TB stigma questionnaire; and 6) a satisfaction questionnaire. Quantitative data were analyzed using descriptive statistics, and mean scores were compared using the paired t-test. Qualitative data were analyzed through content analysis.

The results showed that the existing data on household contacts and close contacts were incomplete, and the community's knowledge and understanding of TB remained inaccurate; these problems informed subsequent corrective actions. In developing and implementing the innovative contact-tracking database, the research team established the database structure, developed a screening application based on the TB screening tool, and enhanced VHVs' TB prevention health literacy. The mean score difference before and after implementation was 23.51 (95% CI: 21.51–25.51), a statistically significant improvement. The identification and screening of TB risk groups increased from 2,872 individuals screened with 32 identified as at risk, to 5,570 individuals screened with 77 identified as at risk. Evaluation of the innovation revealed that in 2024, following implementation, 510 household contacts and close contacts of TB patients were identified, compared with 87, 94, and 157 cases in 2021, 2022, and 2023, respectively. TB-related stigma in the community was reduced by as much as 75.20%. The new TB patient contact-tracking database innovation, “DPC 7 TB Household Contact Database,” together with the TB screening application, effectively supported the National Tuberculosis Information Program (NTIP) in achieving comprehensive identification and screening of household contacts and close contacts, with each HPHs designated as the data owner. The overall mean satisfaction score was at the highest level ( = 4.79, S.D. = 0.21).

 The new TB patient contact-tracking database innovation and the TB screening application significantly improved the tracking of household contacts and close contacts of newly diagnosed TB patients. Expanded implementation of this innovation for TB prevention and control in other areas is therefore recommended.