Implementation of early detection of lung tuberculosis using WHO systematic screening guidelines at the public health center in Indonesia

Abstract

Background: Tuberculosis remains a pressing public health concern in Indonesia, ranking second globally after India. Factors contributing to Indonesia’s high TB incidence include lengthy treatment, rising HIV/AIDS cases, and multi-drug resistant TB. 
Effective TB control focuses on targeted screening, avoiding costly mass screening. This study explores early lung TB detection using WHO systematic screening at Tamalate District, Makassar, Indonesia, addressing screening challenges and program management 
concerns. Method: This descriptive observational study was performed on 153 patients, using primary data from systematic screening following WHO guidelines and a mobile outreach campaign in Tamalate District, Makassar, Indonesia, over 15 days in August 2023. 
Data were categorized into non-suspected lung TB and suspected lung TB. Suspected cases underwent GeneXpert MTB/RIF testing for TB and rifampicin resistance detection. Patients were divided into four groups – patients with non-suspected TB, suspected TB, 
diagnosed TB, and drug-resistant TB. Result: Based on screened patient characteristics results, there was a higher distribution of males than females. In contrast, the mean age of our total sample was approximately 48.07 ± 16.37, which tended toward the <55 age 
group. Regarding the WHO systematic screening method results, we found that 44 had non-suspected lung tuberculosis, 36 had suspected lung tuberculosis but could not expel sputum, 47 were MTB-negative, and 10 were confirmed MTB-positive, and treatment was initiated. Conclusion: This study highlights the effectiveness and efficiency of implementing the WHO systematic screening for active tuberculosis, which was previously not integrated into the Indonesian health system, particularly in the Tamalate District of Makassar, Indonesia.