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Continuous quality improvement in a community-wide TB screening and prevention programme in Papua New Guinea.

Pank NP, Aung A, Kama G, Murray A, Huang KL, Greig J, Bauri M, Chan G, Masah C, Kaison K, Umali S, Peter T, Wera C, Velaki C, Ase M, Krangaie I, Viru R, Kurumop T, Keam T, Islam S, Pomat W, Maha A, Boga M, Kal M, Wuatai N, Graham SM, Majumdar SS, Marukutira T

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  • Journal Public health action

  • Published 01 Sep 2024

  • Volume 14

  • ISSUE 3

  • Pagination 97-104

  • DOI 10.5588/pha.24.0013

Abstract

Daru Island in Papua New Guinea (PNG) has a high prevalence of TB and multidrug-resistant TB (MDR-TB).

To evaluate the early implementation of a community-wide project to detect and treat TB disease and infection, outline the decision-making processes, and change the model of care.

A continuous quality improvement (CQI) initiative used a plan-do-study-act (PDSA) framework for prospective implementation. Care cascades were analysed for case detection, treatment, and TB preventive treatment (TPT) initiation.

= 1,928), 82.0% (1,581/1,928) had tuberculin skin testing (TST), 96.1% (1,519/1,581) had TST read, 23.0% (350/1,519) were TST-positive, 95.4% (334/350) were TPT eligible, and 78.7% (263/334) initiated TPT. Three PDSA review cycles informed adjustments to the model of care, including CAD4TB threshold and TPT criteria. Key challenges identified were meeting screening targets, sputum unavailability from asymptomatic individuals with high CAD4TB scores, and consumable stock-outs.

CQI improved project implementation by increasing the detection of TB disease and infection and accelerating the pace of screening needed to achieve timely community-wide coverage.