Improving Tuberculosis Detection: A Comprehensive Evaluation of Contact Investigation Implementation

Background: Tuberculosis (TB) is the leading cause of death. Indonesia is currently ranked 2nd globally, and the incidence rate increases yearly. TB is highly contagious to risk groups, especially to those who live in one house. Purpose. This study aims to evaluate the implementation of tuberculosis contact investigation by health workers and health cadres in Samarinda City, Indonesia. Methods: This study was conducted with an exploratory qualitative design to explore the implementation of Active Case Finding through contact investigation in Samarinda. As research informants, there are five managers of the tuberculosis program of the Samarinda City Health Office and Public Health Center, four Health Cadres, and ten household contacts of tuberculosis patients. Results: The results of the in-depth interviews identified three domains, eight themes, and 22 sub-themes. We found several obstacles in investigating the TB patient case index contacts, including a lack of resources, low awareness of household contacts, and difficulty meeting targets. Conclusion: Lack of resources and use of conventional instruments indicate less effective coverage of contact investigations. Low awareness of household contact for screening is due to a lack of understanding of TB, shame as a family of TB sufferers, denying the existence of TB symptoms, and not wanting others to know about their health conditions.