Development Of a Home Contact Tuberculosis Case-Finding Model Based on Screening with Rapid Molecular Tests (Tcm) At the Oesapa Community Health Centre in Kupang City

Abstract

Data from the East Nusa Tenggara Central Bureau of Statistics in 2023 recorded that there were 9,535 confirmed cases of pulmonary tuberculosis in NTT, showing a significant increase in TB cases compared to the previous year's 4,798 confirmed cases. Kupang City is one of the cities in NTT that contributed the most TB cases in NTT, namely 1,253 cases (BPS, 2023). The purpose of this study was to develop a screening model based on Molecular Rapid Tests to find TB cases and conduct treatment as early as possible and describe the factors that influence the distribution of TB. This study was conducted in the working area of Puskesmas Oesapa in 2024. This research design used a cross sectional study design. The number of samples was 150 samples with sampling techniques using simple random using inclusion and exclusion criteria. The analysis method used was the Spearman rank test and for multivariate testing using Logistic Regression. Bivariate test results: There was no relationship between gender (p value= 1.000; r=0.00), age (p value= 0.421; r=-0.066), education (p value= 0.199; r=0.106), occupation (p value= 0.106; r=0.133), knowledge (p value= 0.074; r=0.146), attitude relationship could not be measured, residential density (p value= 0.239; r=0.097), availability of information (p value= 0.722; r=0.029), risk factors for pregnant women (p value= 0.431; r=0.065), treatment dropout (p value= 0.173; r=0.112), and risk factors for the elderly (p value= 0.096; r=0.137), with positive TCM TB results. There was an association of sputum disposal behaviour (p value= 0.026; r=0.182), smoking behaviour (p value= 0.000; r=0.331), exercise habits (p value= 0.034; r=-0.173), cough symptoms (p value=0.000; r=0.585), shortness of breath symptoms (p value= 0.000; r=0.630), weight loss symptoms (p value=0.000; r=0.655), appetite symptoms (p value= 0.000; r=0.674), fever symptoms (p value= 0.000; r=0.693), symptoms of night sweats without physical activity (p value= 0.000; r=0.624), there is an association of a history of diabetes mellitus (p value= 0.007; r=0.219), with positive TCM results for TB in the Oesapa Puskesmas work area in 2024. Multivariate test: There was no effect of sputum disposal behaviour (p value= 0.161; Exp(B)= 0.380; 95% CI= 0.098 - 1.468), there was an effect of smoking (p value= 0.017; Exp(B)= 4.469; 95% CI= 1.311 - 15.236), there was no effect of exercise habits (p value= 0.638; Exp(B)= 1.193; 95% CI= 0.572 - 2.486), no effect of cough (p value= 0.997; Exp(B)= 163411552.8; 95% CI= 0.000), no effect of breathlessness (p value= 0.612; Exp(B)= 1.519; 95% CI= 0.302 - 7.655), no effect of weight loss (p value= 0.627; Exp(B)= 1.639; 95% CI = 0.223 - 12.025), no effect of appetite loss (p value = 0.137; Exp(B)= 4.971; 95% CI = 0.599 - 41.228), fever (p value = 0.028; Exp(B)= 8.259; 95% CI = 1.263 - 54.033), no effect of night sweats without physical activity (p value = 0.416; Exp(B)= 1.427; 95% CI = 0.038 - 3.871) and no influence of history of DM (p value = 0.579; Exp(B)= 1.427; 95% CI = 0.406 - 5.013) with positive TCM TB results in the Oesapa Health Centre working area in 2024. Conclusion: there is a need for socialisation to the community to take better care of their health and practice a clean and healthy lifestyle to prevent TB transmission.