Efficiency-Improvement Screening and Registration Model of Pulmonary Tuberculosis among High-Risk Populations in Loei Province

Abstract

This action research aimed to examine the current situation and develop an efficiency-improvement model for screening and registration of pulmonary tuberculosis among high-risk populations in Loei Province. Additionally, it sought to compare the efficiency in screening, detection, and registration for pulmonary tuberculosis patients among at-risk populations before and after implementing the developed model. The study sample comprised 52,789 individuals across seven identified high-risk groups. Data were collected through in-depth interviews, focus group discussions and screening records from the NTIP database. Content analysis was applied to qualitative data, while quantitative data employed descriptive statistics presented as percentages, means, standard deviations, and paired t-test—a descriptive and inferential statistic.

            The findings showed that the efficiency-improvement model for screening and registration of pulmonary tuberculosis among high-risk populations in Loei Province consisted of eight steps: 1) identifying target screening groups; 2) promoting health literacy; 3) workforce development; 4) screening of high-risk populations; 5) tuberculosis screening data management; 6) reporting and registration for treatment; 7) supervision, monitoring, and evaluation; and 8) strengthening participation and collaboration among the partnership network. Results revealed that tuberculosis screening coverage among all seven high-risk groups reached 88.98%. The mean district-level screening coverage rate across the 14 districts was 88.02% (S.D. = 2.42), representing an increase of 9.98 (95%CI 2.05-19.92, p-value<0.001) from the period prior to implementing the developed model. Before the model was introduced, the screening coverage among the seven high-risk groups was 78.52%, with an average district-level coverage of 78.04% (S.D. = 3.52). This improvement was statistically significant at the 0.05 level. The improvement in pulmonary tuberculosis screening efficiency among the high-risk population was achieved by integrating passive screening services within healthcare facilities with systematic proactive community-based screening, promoting health literacy to reduce stigma, fear, and anxiety among target populations, and strengthening participation and collaboration among the partnership network. These factors collectively contributed to a more effective screening and registration process in Loei Province.