Abstract
Tuberculosis (TB) is a disease of poverty and stigmatization. Thailand is one of the countries with high burdens of TB, TB/HIV and MDR-TB. Although contact investigation (CI) can reduce TB morbidity and mortality, the coverage is low and a CI operations manual was not yet available. Thus, this project aims to develop tools and collect research evidences for the development of a CI manual to increase implementation of CI by including household (HC) and other contacts (OC). The manual will also guide staff to perform non-stigmatized CI. We implemented the project between January 2017 and August 2018. The outcomes are summarized as follows: 1) Development of a geographic information system (GIS)-based computer program as a tool for CI coverage enhancement. 2) Research activities: the project implemented 4 sub-studies as follows: 2.1 A review of international CI manuals. 2.2 A survey of physicians and nurses’ TB knowledge, perceived stigma, and CI Experiences. 2.3 Knowledge, attitude and experiences related to contact investigation for tuberculosis among former tuberculosis patients and representatives from nurseries, schools, hospital and private business: A qualitative study. 2.4 The outcomes of using invitation card and providing transportation fee in CI. 3) Policy recommendations: 3.1 Contact investigation must be seriously implemented in Thailand, particularly children contacts aged under 5 years old must achieve 100% CI. The CI should cover household and non-household contacts. 3.2 Healthcare providers working for TB patients should pass training courses to obtain CI interview skills and effective communication skills for TB-stigma reduction. 3.3 In occupations like teachers/lecturers, caregivers, and hospital staff, the chest x-ray should be mandatory in health check-up system and performed before the employment and in annual health check-up. The practical guidelines should also be available in case TB occurs in teachers, students, and health staff. 3.4 Information about TB and messages to reduce TB stigma should be disseminated through the internet.
