Dewi Ariyani Wulandari

Introduction: Delays in tuberculosis (TB) diagnosis remain a persistent challenge to TB control across the care cascade in low- and middle-income countries (LMICs). Community-based active case finding (ACF) and contact investigation provide opportunities to expand diagnostic services beyond healthcare facilities. However, evidence of their effects at different stages of the TB care cascade varies considerably across studies. This systematic review aimed to assess the effects of community-based TB screening interventions at different stages of the care cascade in LMICs, with behavioural frameworks applied to interpret the findings after synthesis. Methods: This systematic review followed the PRISMA 2020 guidelines and was registered in PROSPERO (CRD420261288243). We searched Scopus, PubMed, and ProQuest for studies published from January 2016 to March 2026. We included randomised controlled trials (RCTs) and quasi-experimental studies on community-based TB screening in low- and middle-income countries (LMICs). Study quality was assessed using the Joanna Briggs Institute (JBI) critical appraisal tools. The findings were summarised narratively according to TB care cascade outcomes and study design. Results: The 13 included studies comprised seven randomised controlled trials (RCTs) and six quasi-experimental studies. The findings varied according to study design and stages of the TB care cascade. Although evidence directly evaluating outcomes at the early stages of the TB care cascade remained limited, a few studies reported improvements in screening participation and progression to diagnostic evaluation. Positive effects on TB case detection, notification, and population-level outcomes were also reported in several studies. However, studies with control groups showed varied findings; some reported favourable effects, while others found no statistically significant effects. Evidence on the initiation of tuberculosis preventive treatment (TPT) was limited and mainly came from studies involving children who were household contacts of TB patients. Conclusion: Community-based TB screening may improve access to diagnosis and support TB case detection in some settings. However, the results vary by study design, population, intervention, and implementation context. Evidence on improved screening participation and completion of diagnostic evaluation remains limited. Therefore, the effects of community-based TB screening across the TB care cascade should be interpreted carefully based on the outcomes assessed at each stage.

Background: Active case finding (ACF) is a critical component in the control of tuberculosis (TB), particularly for early detection of cases in communities with limited healthcare access. In 2023, Sleman District in Yogyakarta Province initiated the SIKAT TB program, a community-based screening effort supported by local government commitment to achieving TB elimination by 2030. Aims: This study aims to describe the implementation and outcomes of the SIKAT TB program in Sleman District by utilizing secondary data from July to September 2024. Methods: This descriptive study analysed secondary data, including the number of individuals screened and those identified with drug-sensitive tuberculosis (DSTB) and latent tuberculosis infection (LTBI). Results: Over three-month period, 1,035 individuals were screened. Among these, 33 individuals (3.2%) were diagnosed with DSTB, and 113 individuals (10.9%) were identified with LTBI. These findings suggest that the program effectively identified both active and latent TB cases at the community level. Conclusion: The SIKAT TB program highlights the critical role of government-led, community-based strategies in enhancing tuberculosis case detection. Continuous support, coupled with comprehensive follow-up and treatment systems, is crucial for sustaining long-term impact. The program serves as a practical model for other regions seeking to improve TB control efforts and contributes to the national and global objectives of eradicating TB by 2030.

Background: The strategy to increase TBC coverage and detection is through Active Case Finding (ACF) through TBC screening training for health cadres. Health cadres who are trained and understand the signs and symptoms of TBC are expected to help increase TBC findings in the community and reduce the stigma of TBC in the community. This community service activity aims to equip cadres with basic TBC screening skillsand equip cadres in implementing ILP Posyandu (Primary Service Integration) management. Methods: The implementation method consists of preparation stage, implementation, training, application of technology, and monitoring and evaluation. Training was given 2 times with assistance. Training on cadre understanding of TBC and TBC screening was attended by 24 cadres and training on ILP Posyandu management was attended by 15 cadres. Results: There was an increase in knowledge and understanding of cadres with lecture and module methods (p value <0.001) and there was an increase in scores before and after the intervention by an average of 3.79 points and there was an increase in cadre skills in implementing ILP Posyandu. In the implementation of integrated TBC screening, Posyandu ILP was enthusiastically attended by 114 community members consisting of 39 infants and toddlers and 75 adults and the elderly. Conclusion: Provision of health cadres will improve cadre knowledge and skills in conducting integrated TBC screening with Posyandu ILP. This activity is recommended to be carried out through continuous training for health cadres to enhance the capacity for integrated tuberculosis screening at the Posyandu ILP.

In Indonesia, dengue hemorrhagic fever (DHF) continues to be an issue. Although there have been fewer dengue infections in the past three years, many areas of Indonesia remain dengue endemic. Insecticide use is one DHF prevention and control method that has been used for a long time. Long-term usage of insecticides can cause the vector, Aedes aegypti, to develop resistance. Insecticide resistance to Aedes aegypti in Indonesia was the focus of this study's analysis of the literature review. A systematic review using keywords based on population, interest and context (PICo) was employed in the study strategy. The databases used to find the publications were ScienceDirect, ProQuest, PubMed, Google Scholar, and Garuda from 2018 to 2022. Hence, 40 papers out of the 6,429 total articles were relevant and should be reviewed and analyzed. According to an analysis of the paper, it was discovered that Aedes aegypti mosquitoes are resistant to insecticides of the pyrethroid and organophosphate classes in various parts of Indonesia. However, it was discovered that several regions were both tolerant of and vulnerable to pyrethroids and organophosphates. If insecticides are to be utilized intolerant and vulnerable locations, monitoring and evaluation of their usage must be done, and a strategy of varying insecticide kinds and dosages and boosting community empowerment toward mosquito nest elimination behaviour must be implemented.