ABSTRACT
SETTING: Central Sulawesi Province, Republic of Indonesia. OBJECTIVE: To increase tuberculosis case notification and maintain high treatment success rates through community participation in a tuberculosis field programme. DESIGN: Comparison of tuberculosis case notification and treatment results in a community based tuberculosis programme (CBTP), before and after introduction of the programme and between areas where the programme was and was not introduced. RESULTS: During 1998, the CBTP was introduced in two of the four rural districts of the Central Sulawesi province, covering 224 (29%) of the 772 villages and 362,700 (33%) of the 1,109,100 population in these districts. In the CBTP villages the notification rate of new smear-positive patients per 100,000 population increased from SI in 1996 and 48 in 1997 to 166 in 1998. In the 548 non-CBTP villages the rates were 62, 60 and 70, respectively. The sputum conversion rate at the end of the first 2 months of the treatment was over 85% in both the CBTP and the non-CBTP villages. In the CBTP villages the treatment success rate (cure and treatment completion) was 90.4%, 89.5% and 93.7% in 1996, 1997, and 1998. For the non-CBTP villages these rates were respectively 85.4%, 86.8% and 85.9%. In 1998 the sputum conversion and treatment success rates were significantly higher in the CBTP villages than in the non-CBTP villages. CONCLUSION: Through community participation, the notification of new smear-smear positive patients increased substantially, while sputum conversion and treatment success rates remained high.