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This paper describes an eight-month community-based participatory research project to introduce and evaluate the implementation of an asset-based approach to Tuberculosis (TB) leadership groups in three villages in Flores Island, Indonesia. An asset-based intervention that emphasized discovering, mobilizing, and strengthening the capacities of local communities was conducted. Asset-mapping workshops aimed to shift the TB leadership groups' capacity to work differently by focusing on their strengths rather than their problems or needs, to enable them to manage their own TB program. Monthly visits, home visits, informal discussions, and group discussions with TB groups were carried out to provide support to groups or leaders and to monitor and evaluate the project. The intervention successfully generated significant changes in the TB groups' view of outsiders and their relationship with the villagers, built dialogue between the group members, strengthened local initiatives that could reduce the rates of TB and encourage early diagnosis and therefore treatment, and encouraged community engagement. The approach enabled TB leadership groups to be more confident and capable in managing a local TB program that was formulated by themselves for themselves to achieve their own goals. The approach and techniques demonstrated in this study may represent an effective method and deliver outcomes that could be generalizable to similar settings and other health issues. [ABSTRACT FROM AUTHOR]

Tuberculosis (TB) is a dangerous and highly contagious disease. Global cases have increased since, and Indonesia is one of the countries with the highest number of TB cases. This study aimed to prevent TB transmission by analyzing air contamination. Air samples were taken from three primary health cares (PHCs) in Surabaya City, East Java Province, Indonesia, and cultured in Mycobacterium Growth Indicator Tube (MGIT) media. Of the 108 air samples collected, 36 came from the waiting room, 36 from the examination room, and 36 from the laboratory room. As a result, the waiting room (50%), examination room (16.7%), and laboratory room (2.7%) were declared positive. In short, the air in the three PHCs contained mycobacterium tuberculosis. There is a need for room management to prevent TB transmission. [ABSTRACT FROM AUTHOR]

Tuberculosis is a significant source of illness and mortality worldwide. Therefore, tuberculosis screening is important to identify active cases within a community. Bacteriological examinations can be used to initiate active community-based case finding. Waste workers are at a high risk of contracting Mycobacterium tuberculosis due to their constant exposure to waste. This study aims to conduct bacteriological examinations to identify tuberculosis infection among waste workers in Gresik, Indonesia. An analytical observational study was carried out in September 2023 in Ngipik Village, Gresik, East Java, Indonesia. The primary study was conducted using a cross-sectional design with interviews, measurements, and sputum examinations for all samples. The screening involved a total of 72 waste workers (n = 72) who had daily contact with various types of sewage and waste, including medical waste. The majority of the waste workers were male (65.2%), most were between the ages of 34 and 44 (27.78%), and their educational background was a senior high school degree (40.27%). Most of the waste workers did not have a family history of hypertension (84.72%) or diabetes (97.22%). The acid-fast bacilli examinations were negative in all samples. Nevertheless, this study concluded that it is imperative to carry out mass tuberculosis screening in various settings, specifically in high-risk populations. Mass screening can detect the potential of latent tuberculosis, thereby reducing its transmission. [ABSTRACT FROM AUTHOR]

Tuberculosis (TB) is a major global problem, especially with the high prevalence of HIV-TB co-infection. Delayed diagnosis and continual transmission contribute to high mortality in Indonesia, which has the third highest incidence of TB in the world, after China and India. Therefore, early diagnosis is needed to reduce the number of cases and to administer therapy to prevent the transmission of bacteria. The diagnosis of TB remains a challenge in clinical practice due to poor sensitivity and the requirement of skilled staff in microscopic tests, the slow growth Mycobacterium in culture, and the low number of bacilli present in extrapulmonary TB. Despite being the golden standard for TB diagnosis, cultures require 2-8 weeks to grow. Other methods for diagnosing TB include interferon-gamma release assays and serologic tests such as the tuberculin skin test. Recently, the World Health Organization recommended the GeneXpert MTB/RIF assay for diagnosing TB. This review presents the current state of TB epidemiology and various methods for TB diagnosis. In particular, the paper provides an in-depth discussion about the GeneXpert MTB/RIF assay that has been made available recently in selected tertiary hospitals in Indonesia. [ABSTRACT FROM AUTHOR]

Background: Children who living in tuberculosis (TB) household have a high risk to be transmitted by TB, that become the main reason for those children to be given TB prevention. Diagnosed by TB, is an entry point of the families to be aware of the risk of TB transmission and the need of TB prevention, especially for their children. Objectives: This study aimed to explore the family experiences of living with patients diagnosed with tuberculosis. Methods: A qualitative study was conducted from December 2016 to July 2017, among fourteen family caregivers whose a previous adult active-TB and have children living in same households. The key participants were recruited from a lung clinic Bandung-Indonesia and followed up to their home. Data were gathered by in-depth interview. Each interview took 40-90 minutes in the informant's home. Data were analysed by content analysis. Results: Most families experienced TB diagnosis delayed. They did not notice initial TB symptoms, felt inconvenience with the health care services, and travelled around for the right diagnosis. Conclusions/Importance: This study highlighted important early getting TB diagnosis, therefore nurses and other health care professionals should enhance family's knowledge and awareness to TB symptoms and the health care services system, in order to improve family awareness to the risk of TB transmission. Moreover, strengthening of the health care services system is needed to improve the effectiveness and quality of TB diagnosis. [ABSTRACT FROM AUTHOR]

The incidence and prevalence of infection due to non-tuberculous mycobacteria (NTM) species are increasing worldwide and rapidly becoming a major public health problem. Despite increasing knowledge about NTM, there are still many challenges in diagnostic tools and treatment for this infection. Indonesia is ranked number two for tuberculosis infections; however, there is a lack of data about NTM infection. The aim of this study was to analyze the prevalence of the detection of NTM from sputum specimens of pulmonary tuberculosis suspects in a lung hospital center in Surakarta, Central Java, Indonesia. This study was a retrospective study which analyzed the laboratory data obtained from a lung hospital (Balai Besar Kesehatan Paru Masyarakat / BBKPM), in Surakarta, Indonesia. Samples were collected from patients with tuberculosis and cases with a presumptive diagnosis of tuberculosis from January 2013 to December 2017. All sputum samples were stained for microscopic analysis and were also incubated for the detection of mycobacterial growth in Lowenstein Jensen (LJ) medium and in LJ medium with the addition of para-nitrobenzoic acid (LJ-PNB) to identify Mycobacterium tuberculosis (MTB) or NTM strain. Biochemistry test, Niacin test, was used to confirm NTM strain. For five year periods, there were 9,284 patients samples were cultured to detect MTB infection. For all the sputum samples, 1,974 samples (21.3%) were cultured positive; out of the positive samples 1,636 (85%) were MTB strains and 334 (15%) were NTM strains. The data revealed that NTM infection cases were more likely to have been diagnosed aged older than 35 years (72%). This study showed that there was a high number of NTM infection detected in patients with presumptive diagnosis of tuberculosis. Therefore, another approach should be conducted to provide effective therapy for infection due to NTM. Identification of NTM in species level will be important to provide empirical therapy for this infection. [ABSTRACT FROM AUTHOR]

Background: Fluorescence microscopy (FM) has not been implemented widely in TB endemic settings and little evaluation has been done in HIV-infected patients. We evaluated diagnostic performance, time and costs of FM with light-emitting diodes technology (LED-FM), compared with conventional (Zieh-Neelsen) microscopy in a hospital in Indonesia which acts as referral centre for HIV-infected patients. Method: We included pulmonary tuberculosis suspects from the outpatient and HIV clinic. Direct and concentrated sputum smears were examined using LED-FM and ZN microscopy by two technicians who were blinded for the HIV-status and the result of the comparative test. Mean reading time per slide was recorded and cost of each slide was calculated. Mycobacteria culture served as the reference standard. Results: Among 404 tuberculosis suspects from the outpatient clinic and 256 from the HIV clinic, mycobacteria culture was positive in 12.6% and 27%, respectively. The optimal sensitivity of LED-FM was achieved by using a threshold of ≥2 AFB/length. LED-FM had a higher sensitivity (75.5% vs. 54.9%, P<0.01) but lower specificity (90.0% vs 96.6%, P<0.01) compared to ZN microscopy. HIV was associated with a lower sensitivity but similar specificity. The average reading time using LED-FM was significantly shorter (2.23±0.78 vs 5.82±1.60 minutes, P<0.01), while costs per slide were similar. Conclusion: High sensitivity of LED-FM combined with shorter reading time of sputum smear slides make this method a potential alternative to ZN microscopy. Additional data on specificity are needed for effective implementation of this technique in high burden TB laboratories. [ABSTRACT FROM AUTHOR]

The article presents a study evaluating the implementation of the national tuberculosis (TB) programme's diagnostic algorithm in routine health care settings in Jogjakarta, Indonesia. As mentioned, it was found that 43.5 percent of TB suspects were lost during the diagnostic work-up in health centers and zero percent in lung clinics.

Background: The engagement of hospitals in Public-Private Mix (PPM) for Directly Observed Treatment Short-Course (DOTS) strategy has increased rapidly internationally - including in Indonesia. In view of the rapid global scaling-up of hospital engagement, we aimed to estimate the proportion of outpatient adult Tuberculosis patients who received standardized diagnosis and treatment at outpatients units of hospitals involved in the PPM-DOTS strategy. Methods: A cross-sectional study using morbidity reports for outpatients, laboratory registers and Tuberculosis patient registers from 1 January 2005 to 31 December 2005. By quota sampling, 62 hospitals were selected. Post-stratification analysis was conducted to estimate the proportion of Tuberculosis cases receiving standardized management according to the DOTS strategy. Result: Nineteen to 53% of Tuberculosis cases and 4-18% of sputum smear positive Tuberculosis cases in hospitals that participated in the PPM-DOTS strategy were not treated with standardized diagnosis and treatment as in DOTS. Conclusion: This study found that a substantial proportion of TB patients cared for at PPM-DOTS hospitals are not managed under the DOTS strategy. This represents a missed opportunity for standardized diagnoses and treatment. A combination of strong individual commitment of health professionals, organizational supports, leadership, and relevant policy in hospital and National Tuberculosis Programme may be required to strengthen DOTS implementation in hospitals. [ABSTRACT FROM AUTHOR]

Background: Sputum smear microscopy is the standard diagnostic method for detection of smear positive pulmonary tuberculosis (TB). Insufficient quality of sputum might result in missing cases. In this study we aimed at assessing the quality of sputum in a district in Central Java and determining patient and health worker factors associated with submission of three good quality sputum samples. Methods: In 16 health centers information was collected on the quality of sputum submitted by TB suspects, i.e. volume, color, and viscosity. TB suspects were interviewed to assess their knowledge of TB, motivation to provide sputum and whether they were informed why and how to produce a sputum sample. Health workers were interviewed to assess what information they provided to TB suspects about the reason for sputum examination, methods to produce sputum and characteristics of a good quality sputum sample. All health worker and patient factors were evaluated for association with sputum quality. Results: Of 387 TB suspects, 294 (76.0%) could be traced and interviewed, and of 272 (70.3%) information about sputum quality was available. Of those 203 (74.6%) submitted three samples, 90 (33.1%) provided at least one good sample, and 37 (13.6%) provided three good quality sputum samples. Of the 272 TB suspects, 168 (61.8%) mentioned that information on the reason for sputum examination was provided, 66 (24.3%) remembered that they were informed about how to produce sputum and 40 (14.7%) recalled being informed about the characteristics of good quality sputum. Paramedics reported to provide often/always information on the importance of sputum examination, and when to produce sputum. Information on how to produce sputum and characteristics of a good sputum sample was less often provided. None of the studied patient characteristics or health worker factors was associated with providing good quality sputum. Conclusion: A considerable number of TB suspects did not provide three sputum samples and a large number of sputum samples were of insufficient quality. Training of health workers in providing health education to the TB suspect about the reason for sputum examination and how to produce a good quality sputum sample should be a priority of the TB program. [ABSTRACT FROM AUTHOR]