Tuberculosis Case Finding in Kulon Progo District, Yogyakarta, Indonesia: Passive versus Active Case Finding Using Mobile Chest X-ray

John Silwanus Kaku; Riris Andono Ahmad; Stephanie Main; Dwi Oktofiana; Bintari Dwihardiani; Rina Triasih; Philipp du Cros; Geoffrey Chan

doi:10.3390/tropicalmed9040075

Tuberculosis Case Finding in Kulon Progo District, Yogyakarta, Indonesia: Passive versus Active Case Finding Using Mobile Chest X-ray

Trop Med Infect Dis. 2024 Apr 4;9(4):75. doi: 10.3390/tropicalmed9040075.

Authors

John Silwanus Kaku¹, Riris Andono Ahmad^{1

2}, Stephanie Main³, Dwi Oktofiana⁴, Bintari Dwihardiani¹, Rina Triasih^{1

5}, Philipp du Cros³, Geoffrey Chan³

Affiliations

¹ Center for Tropical Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta 55281, Indonesia.
² Department of Biostatistics, Epidemiology and Population Health, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta 55281, Indonesia.
³ International Development, Burnet Institute, Melbourne, VIC 3000, Australia.
⁴ Kulon Progo District Health Office, Yogyakarta 55611, Indonesia.
⁵ Department of Pediatric, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito Hospital, Yogyakarta 55281, Indonesia.

Abstract

Active-case finding (ACF) using chest X-ray is an essential method of finding and diagnosing Tuberculosis (TB) cases that may be missed in Indonesia's routine TB case finding. This study compares active and passive TB case-finding strategies. A retrospective study of TB case notification was conducted. Data between 1 January and 31 December 2021, was used. The population in this study were TB cases notified from Kulon Progo District health facilities, including those found through routine activities or active-case findings. A total of 249 TB cases were diagnosed in Kulon Progo in 2021, and 102 (41%) were bacteriologically confirmed. The TB patients' ages ranged from 0 to 85 years (median 52, IQR 31-61). The majority of cases were male (59%, 147/249) and mostly among people aged 15-59 (61.4%, 153/249). The proportion of clinical TB diagnoses among cases found from active-case findings was 74.7% (68/91) while the proportion among passive-case findings was 50% (79/158). Active-case finding contributed 91 (36.5%) TB cases to the total cases detected in Kulon Progo in 2021. The use of chest X-rays in active-case findings likely contributed to the detection of a higher proportion of clinical TB than in passive-case findings.

Keywords: Tuberculosis; active-case finding; mobile chest X-ray.

Grants and funding

This research was funded by STOP TB Partnership through TB Reach wave 7 for the activities in 2020 and by The Australian Government’s Indo-Pacific Centre for Health Security through TB Prime (TB Papua New Guinea and Republic of Indonesia Micro Elimination) activities in 2020–June 2023.