Medical Journal of Malaysia

MJM, Vol 70 Supplement 1 September 2015

Evaluation of tuberculosis surveillance and action performance in Sarikei, Sarawak

Hasrina H*, Kiyu A**

*Sarikei Divisional Health Office, Sarawak, Malaysia, **Sarawak State Health Department, Malaysia


Introduction: Monitoring and evaluation of the tuberculosis (TB) surveillance system are necessary to ensure effective and efficient prevention of tuberculosis. In view of the increasing trend of TB cases and deaths in Sarikei, we evaluated the TB surveillance system and action performance.

Methods: A cross-sectional study was carried out to identify all TB cases in 2011 in hospitals, clinics, and laboratories in Sarikei that tested or diagnosed TB. Eighteen of 74 (24%) notification forms were randomly selected and examined for data quality and timeliness. Eighteen key informants completed a questionnaire assessing the attributes of the notification system. Health inspector and laboratory records were examined for performance in detection and confirmation.

Results: All TB cases (N=124) were reported and 88.7% (110 cases) were notified within seven days upon diagnosis. Data quality was poor where only 66.7% (12 notification forms) were complete. All (N=18) key informants reported it as simple and 83.3% (N=15) were satisfied with the system. Only 2.4% (79 of 3343) of sputum samples screened were detected positive for TB. Case to contact ratio was on average 1:5. Screening of contacts detected only 0.3% (2 of 769) positive for TB. At the divisional level, data was minimally used for planning prevention and control of tuberculosis.

Conclusion: Notification and its timeliness were good. Nevertheless, data quality needs to be improved for it to be useful for case investigation and screening of contacts. New strategies are needed to improve the yield from sputum screening and screening of contacts. Data collected need to be analysed for strategic planning of tuberculosis management. This can enhance the effectiveness of tuberculosis prevention and control measures in Sarikei.

Keywords: tuberculosis, surveillance system, action performance, Malaysia