4 DOTS. Its key components include: government commitment; case detection by
predominantly passive case findings; standardized short course chemotherapy at least to all confirmed sputum smear-positive cases, provided under proper case
management conditions; a system of regular drug supply where anti-TB medicine is given free to poor patients to reduce defaulted rates
resulting from a lack of funding; and, a monitoring system for program supervision and evaluation
Depkes RI, 2002; WHO, 2006b. In 1999, the Department of Health launched new program called Gerdunas National Integrated Movement which catalysed
the wide acceptance of DOTS with a treatment success rate of over 85, a case detection rate of 54, and 24 of large hospitals having implemented the DOTS
strategy WHO, 2005.
Despite the success of these initiatives, the incidence of TB is still high. Of the high-burden TB countries, in 2004 Indonesia was ranked third after India and
China. Specific Indonesia data relating to TB is shown in Table 1.
Table 1 TB statistics in Indonesia in 2004
Incidence of TB Mortality rate
Case detection rate Treatment success
245100,000 population 46100,000 population
39 87
Source : WHO, 2006a
2. Protocol search plan for investigation of Tuberculosis health education
approach Background
One province in Indonesia which has an increase in the number of children with Tuberculosis is West Java Province particularly in District Sumedang. The
number of TB patients in District Sumedang from 2001 – 2004 is shown in Table 2.
5
Table 2 Numbers of Patients with TB in District Sumedang from 2001 - 2004
Year Categories
2001 2002
2003 2004
Adults 763
717 846
707
Children with TB 24
57 132
392
Source: Subdin P2P Dinkes Kabupaten Sumedang, 2004
Table 2 shows that overall the number of adults with TB in Sumedang, West Java Indonesia is slightly decreased, however, of all patients the number of
children with TB has increased rapidly. The ratio of increase for children with TB has been more than 15 times from 2001 to 2004. Such increases in the
number of TB patients are costly to both patients and the society including paying for visits to clinics, tests, transportation to and from clinics, provision
of additional nourishing foods, absenteeism from school, and adverse impacts on health and education of children WHO, 2002; The Global Fund, 2005.
Two major obstacles to the success of Tuberculosis control in the world are patients delaying to seek treatment and ignoring or leaving the treatment
before it was really effective because misunderstanding early symptoms like coughs or weight loss which they related to other factors Helman, 2000.
According to the Indonesian Household Survey in 2004, the knowledge of Indonesian people about TB was still low for instance:
o Knowledge about TB, the cause and methods of transmission of TB: 77
did not know about free medication for TB; 38.8 did not know about the way of TB transmission; 23.1 did not know sign and symptoms of TB;
and, 22.7 never heard about TB. o
Stigma about TB: 14.1 kept secret if they or their family member have TB because they feel ashamed or afraid will be isolate by neighbours or
surrounding people; 13.3 said that TB is a hereditary disease; and, 1.3 said it caused by a curse or witchcraft;
6 Based on these data, health education is one of important aspect to help
reducing the spread and incidence of TB in Indonesia. Moreover, TB care for children is depending on their mother so that a good approach and health
education for mothers is very important. Therefore, evidence based of the best approach for TB health education program for mother whose children have TB
is important to recognize.
The topic or question
What is the best possible approach for TB health education program for mothers whose children have TB?
Objectives
The aim of this protocol search plan is to investigate the level of existing research evidence related to the best approach of health education for mother
whose children have tuberculosis.
Inclusion Criteria
A list of participants that meet inclusion criteria: o
Mothersfamilies o
Community volunteerlay health worker o
Nurses
A description of the intervention s that meets inclusion criteria: o
Direct observer of TB treatment o
Strategy or intervention to increase adherence for TB treatment o
Health education strategy for community
A list of the outcomes that meet inclusion criteria: o
Decrease of TB incidence o
Increase of TB cure rate o
Increase of adherence to treatment
7 o
Decrease of unfavourable treatment outcomes
Search Planning
a. List of databases that will be search:
- Cochrane library
- Turning Research Into Practice TRIP
- Medline
- CINAHL
- Academic search elite from EbscoHost
b. The search term that will be used:
- Tuberculosis
- Health education
3. Result of the online research evidence
