PENGUATAN KAPASITAS MASYARAKAT DALAM PENGENDALIAN TUBERKULOSIS MELALUI EDUKASI KESEHATAN, PEMBERDAYAAN KADER, DAN SKRINING AKTIF RONTGEN DADA: INTERVENSI BERBASIS KOMUNITAS DI PEDESAAN INDONESIA
Keywords
Active Case Finding, Community Health Education, Health Literacy, Tuberculosis, X-Ray ScreeningAbstract
Tuberkulosis masih menjadi masalah kesehatan masyarakat utama di wilayah pedesaan, di mana rendahnya kesadaran dan keterlambatan penemuan kasus menghambat diagnosis dini. Pengabdian ini bertujuan meningkatkan pengetahuan masyarakat tentang tuberkulosis sekaligus memfasilitasi penemuan kasus aktif melalui skrining rontgen dada. Kegiatan dilaksanakan di wilayah pedesaan di Jawa Timur dengan pendekatan berbasis komunitas dan rancangan one-group pretest–posttest. Peserta memperoleh edukasi interaktif mengenai gejala, penularan, pencegahan, deteksi dini, kepatuhan pengobatan, dan pengurangan stigma, kemudian mengikuti skrining rontgen dada; peserta dengan temuan abnormal dirujuk untuk evaluasi klinis lanjutan. Perubahan skor pengetahuan dianalisis menggunakan uji Wilcoxon signed-rank. Sebanyak 48 warga berpartisipasi dan 45 melengkapi penilaian berpasangan. Skor pengetahuan meningkat bermakna dari median 80 (IQR 60–93) menjadi 98 (IQR 90–100) (p<0,001). Skrining menemukan kelainan radiografis pada 17 peserta (35,4%), tiga di antaranya (6,3%) mengarah pada tuberkulosis paru aktif. Integrasi edukasi dengan skrining berpotensi memperkuat pengendalian tuberkulosis, disertai penguatan alur rujukan ke layanan primer.
References
World Health Organization. Global Tuberculosis Report 2025. World Health Organization; 2025.
Saktiawati AMI, Probandari A. Tuberculosis in Indonesia: challenges and future directions. Lancet Respir Med. Published online 2025. doi:10.1016/S2213-2600(25)00168-7
Republik Indonesia. Peraturan Presiden Republik Indonesia Nomor 67 Tahun 2021 Tentang Penanggulangan Tuberkulosis. Sekretariat Negara Republik Indonesia; 2021.
Chauhan A, Parmar M, Dash GC, et al. Health literacy and tuberculosis control: systematic review and meta-analysis. Bull World Health Organ. 2024;102(6):421-431. doi:10.2471/BLT.23.290396
Fuady A, Arifin B, Yunita F, et al. Stigma, depression, quality of life, and the need for psychosocial support among people with tuberculosis in Indonesia: A multi-site cross-sectional study. PLOS Glob Public Heal. 2024;4(1):e0002489. doi:10.1371/journal.pgph.0002489
Lufianti A, Widjanarko B, Pamungkasari EP, Probandari A. “They hide because they fear”: Barriers and opportunities for tuberculosis control in rural Indonesia through the PRECEDE-PROCEED lens. J Public health Res. Published online 2026. doi:10.1177/22799036261474129
World Health Organization. WHO Consolidated Guidelines on Tuberculosis. Module 2: Screening - Systematic Screening for Tuberculosis Disease. World Health Organization; 2021.
Taylor M, Medley N, van Wyk SS, Oliver S. Community views on active case finding for tuberculosis in low- and middle-income countries: a qualitative evidence synthesis. Cochrane Database Syst Rev. 2024;(3).
Frascella B, Richards AS, Sossen B, et al. Subclinical tuberculosis disease - a review and analysis of prevalence surveys to inform definitions, burden, associations, and screening methodology. Clin Infect Dis. 2021;73(3):e830-e841. doi:10.1093/cid/ciaa1402
Kendall EA, Shrestha S, Dowdy DW. The epidemiological importance of subclinical tuberculosis: a critical reappraisal. Am J Respir Crit Care Med. 2021;203(2):168-174.
Marks GB, Nguyen N V, Nguyen PTB, et al. Community-wide screening for tuberculosis in a high-prevalence setting. N Engl J Med. 2019;381(14):1347-1357. doi:10.1056/NEJMoa1902129
World Health Organization. Chest Radiography in Tuberculosis Detection: Summary of Current WHO Recommendations and Guidance on Programmatic Approaches. World Health Organization; 2016.
Innes AL, Martinez A, Hoang GL, et al. Active case finding to detect symptomatic and subclinical pulmonary tuberculosis disease: implementation of computer-aided detection for chest radiography in Viet Nam. West Pacific Surveill Response J. 2024;15(4). doi:10.5365/wpsar.2024.15.4.1118
Sugiarsi S, Sulaeman ES, Anantanyu S, Lestari A. Integrating health literacy, health promotion, and digital health in tuberculosis prevention: An ecosystemic competency framework and CIMO-based systematic review. Vet World. 2026;19(5):1888-1899. doi:10.14202/vetworld.2026.1888-1899
Sommerland N, Wouters E, Mitchell EMH, et al. Evidence-based interventions to reduce tuberculosis stigma: a systematic review. Int J Tuberc Lung Dis. 2017;21(11):S81-S86. doi:10.5588/ijtld.16.0788
Nuttall C, Fuady A, Nuttall H, Dixit K, Mansyur M, Wingfield T. Interventions pathways to reduce tuberculosis-related stigma: a literature review and conceptual framework. Infect Dis Poverty. 2022;11(1). doi:10.1186/s40249-022-01021-8
Fenta MD, Ogundijo OA, Warsame AAA, Belay AG. Facilitators and barriers to tuberculosis active case findings in low- and middle-income countries: a systematic review of qualitative research. BMC Infect Dis. 2023;23(1). doi:10.1186/s12879-023-08502-7
Amare D, Getahun FA, Mengesha EW, Dessie G, Shiferaw MB, Dires TA. Effectiveness of healthcare workers and volunteers training on improving tuberculosis case detection: A systematic review and meta-analysis. PLoS One. 2023;18(3):e0271825. doi:10.1371/journal.pone.0271825
World Health Organization. WHO Operational Handbook on Tuberculosis. Module 2: Screening - Systematic Screening for Tuberculosis Disease. World Health Organization; 2021.
Polit DF, Beck CT. Nursing Research: Generating and Assessing Evidence for Nursing Practice. 11th ed. Wolters Kluwer; 2021.
Dahlan MS. Statistik Untuk Kedokteran Dan Kesehatan: Deskriptif, Bivariat, Dan Multivariat, Dilengkapi Aplikasi Menggunakan SPSS. 6th ed. Epidemiologi Indonesia; 2014.
Richards AS, Sossen B, Emery JC, et al. Quantifying progression and regression across the spectrum of pulmonary tuberculosis: a data synthesis study. Lancet Glob Heal. 2023;11(5):e684-e692. doi:10.1016/S2214-109X(23)00082-7
