Gonzales, C. R. S. (2015). Increasing tuberculosis case detection rate through establishment of community-based tuberculosis diagnostic program in Concepcion, Romblon (Unpublished master's thesis). Graduate School of Public and Development Management, Development Academy of the Philippines.

Graduate School of Public and Development Management Health Systems and Development Batch 5 Thesis (MPM-HSD)--Development Academy of the Philippines.

The study was conducted to address the low TB case detection rate in Concepcion, Romblon. Generally, this paper will look into the possibility of establishing the community-based tuberculosis diagnostic program to improve tuberculosis case detection rate. The purpose of the study is to: (1) to determine the levels of practices in tuberculosis case detection; (2) to determine the contributing factors to low tuberculosis case detection rate; & (3) to apply strategies that can increase tuberculosis case detection rate both passive case and active case finding in Concepcion, Romblon. This study limits only on the population of Concepcion, Romblon and focused in the screening and diagnosing of patient using direct Sputum Smear Microscopy for patients fifteen years old and above and Purified Protein Derivative screening for below fifteen years old. Patients were identified from the TB registry in the year 2013 to 2014, and represent as index case and as index household as the case maybe for active case finding. A descriptive research was used in this study. House to house survey was done and questionnaires were given to fifteen years old and above in the community for collection of data regarding tuberculosis. Out of the questionnaires collected, samples were selected randomly based on the sample size per barangay. Another survey questionnaire was given also to health personnel to gather data on what are the levels of practice in Tuberculosis case detection in the municipality. To help solve the identified problems, and achieve the goals and objectives of this study, the following strategies were applied: (1) Conducted Information and Education Campaign on tuberculosis in nine barangays during the Family Development Session of Pantawid Pamilya Pilipino Program (4Ps) beneficiaries; (2) One health staff was trained as microscopist so that the sputum examination be done in the health center; (3) Trained the Barangay Health Worker (BHW) on active case detection; (4) The identified presumptive TB patients were examined physically and subjected to sputum examination, and Purifies Protein Derivative Test for children below fifteen years old; (5) Patients who were negative in sputum examination and children who were positive Purified Protein Derivative test were recommended for chest xray; (6) Partially improved the TB DOTS facility by procuring one functional microscope and the corresponding chemicals (staining solution) for sputum examination. Findings of the survey revealed that majority of the respondents are familiar in the causes, effects, preventions, treatment of tuberculosis and the needs of TB patients._Specifically, most of the community members are aware that: (a) tuberculosis is caused by bacteria, infectious, and anyone is susceptible to it at any possible time; (b) coughing of TB patient in front of susceptible individual is one way of TB transmission; (c) tuberculosis can be diagnosed by chest xray and sputum examination; (d) blood streaked sputum and two weeks cough are the signs and symptoms of tuberculosis accompanied with weight loss due to poor appetite, back pain, body malaise, and dyspnea; (e) taking Pyrazinamide, Isoniazid, Ethambutol and Rifampicin for six (6) months are the proper treatment of tuberculosis, not by taking any antibiotic for one week; (f) nutritious food, proper exercise, avoidance of cigarette, liquor, and prohibited drugs help prevent tuberculosis; (g) free medicines is also one of the need of TB patient, only thirty two percent believed that TB patient needs financial support for their fare in going to the health center for medical consultation. Nevertheless, as reflected on the survey, misconceptions of the community about tuberculosis still exist such as: (a) tuberculosis is familiar in nature; (b) TB transmission is by using the personnel things of TB patient, kissing, hugging, holding hands, talking and sexual intercourse with Tb patient; blood transfusion, and drinking not boiled water; (c) using mask when talking to a TB patient and avoiding TB patient are the ways of preventing TB transmission. Meanwhile, ninety four percent agreed to tell their family and/or friends when they are infected with tuberculosis for moral and financial support thus, exhibiting good health-seeking behaviour. On the survey among the health personnel, findings revealed that: (a) fifty percent of health staff were not properly oriented on their roles in TB program thus, they do not have initiatives to implement the program properly; (b) the non-compliance attitude of TB patient due to lack of financial support discouraged them to do the active case detection instead, they opted to the passive case detection. Seven cases of tuberculosis were detected, four through passive case finding and the three through active case finding respectively. Based on the findings, the researcher concluded that there were poor levels of practices in tuberculosis case detection such as poor health service delivery and incapability of health personnel to perform the tuberculosis diagnostic test. The contributing factors to low TB case detection rate are: (a) poor information dissemination about tuberculosis in the entire locality; (b) poor health service delivery due to unmotivated health personnel; (c) poor TB DOTS facility; (d) incapability of health personnel to perform the TB diagnostic test; (e) poor knowledge of Barangay Health worker (BHW) on TB case detection. The researcher also concluded that through intensified information and education campaign on tuberculosis will influence the health seeking behaviour of the community and correct misconceptions. Lastly, the researcher concluded that active case finding through tracking of presumptive tuberculosis patients on high risk populations (household contacts and nearby households) by the barangay health workers and actively screening of household contacts through Purified Protein Derivative test had s significant increase in tuberculosis case detection rate in Concepcion, Romblon. In this study, it is recommended that performance-based incentives given to the barangay health workers to continuously track the presumptive tuberculosis patients in the field. Also, the Local Government Unit (LGU) partner with the Department of Health will monitor the proper implementation of the established community-based Tuberculosis Diagnostic Program to improve the TB case detection rate and for the sustainability of TB program in Concepcion, Romblon.