[Unpad.ac.id, 19/09/2016] Lecturer of Faculty of Medicine Unpad, Bachti Alisjahbana, dr., Sp.PD-KPTI, Ph.D., received an international research grant from the United States Agency for International Development (USAID), in early September 2016. This grant was obtained for research entitled “Increasing TB Notification through One-Stop Clinics and Engagement with Private Health Care Providers in Bandung, Indonesia (INSTEP)”.
“This research aims to improve the precision of detection for tuberculosis (TB) in Bandung, which is currently only about one-fifth of the estimation from all the cases. The initial step is to create an online database system for recording and reporting records of TB patients. Reports on TB patients now are only available in the health centres (Puskesmas),” said dr. Bachti when met at his office at Unpad Teaching Hospital, Friday (16/09).
The said reports consist of records on every meeting between doctors or other medical personnels with TB patients or suspected-TB patients. This entry is then recapitulated by the Department of Health and Ministry of Health, in order to support the full treatments. The reports include records on first meeting, diagnostic measures, such as x-rays and sputum examination, and the starting time of treatment until the program is completed during the 6 months of treatment.
“It is a mandatory to have reports on infectious diseases because it is does not only affect the patients themselves, but also their family and community. Therefore it should be notified, but it has not been very effective in Indonesia,” said dr. Bachti.
The report should be made once a month, but in reality, reporting has not run optimally. As noted by dr. Bachti, medical personnels must report them in paper-based and manual method by filling a number of forms that must be done daily and reported monthly.
The current reporting system has led to the discrepancy rates of TB recorded by the government and the actual figures. Based on data from the 2014 annual report, the number of TB patients in Indonesia is approximately 1:1000 (population), while a national TB survey calculated at least 6:1000.
If the study is successful, dr. Bachti believed that the number of reported TB patients in Bandung is significantly high. “Ideally, the reported number of TB patients is 2-3 times higher than that in the current report,” said he who is also the Head of the TB-HIV Study Center in Faculty of Medicine.
The expectation is based on the number of TB patients who are currently being treated at non-government health facilities. In private healthcare facilities, patients often do not complete their TB treatment because most of them believe that they have been healed before it is complete and refuse to accept suggestions from the medical personnels. Better reporting is expected to be followed by even better treatment according to standards that could reduce the tendency of TB rates in the longer term.
An online application will be developed by dr. Bachti and his team that will facilitate the reporting system for medical personnels. Reporting can be performed with smartphones. “In this study, we aim to improve the system, so that all doctors and medical personnels can report to and are willing to report it,” he said.
Doctors and medical staff will get adequate information, accompanied by training on correct TB diagnosis and treatment. In addition, to encourage health care personnels to use this system and to report on a regular basis, there will a reward given to health care personnels who give the report. Then, to facilitate patients with services, the study will also hold TB diagnostic facilities, including free radiology and sputum microscopic examinations.
This study will be conducted for three years in eight sample districts in Bandung. If successful, it will be gradually developed to other areas in Bandung. In conducting the study, he partners with fellow researchers from several universities at home and abroad. In addition to the team from Unpad, researchers involved in this project come from Telkom University (Indonesia), Harvard University (USA), Radboud University Nijmegen (Netherlands), and University of Otago (New Zealand).
It is expected that, with this information system, the number of TB cases will be detected in Bandung. Also, the price number of the patients will be identified and everything will be informed to the health center for the patients and families to improve the received treatment. It is expected that in the future the number of TB patients in Indonesia will decrease.
“If realized, we will have a reliable health care information system which can be applied throughout Indonesia and not just for tuberculosis,” said dr. Bachti. *
Reported by Artanti Hendriyana / eh
