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Q Bulletin, Volume 1, No. 32 (Supplement 1), Jan - Dec 202412th National QA Convention, 8 %u2013 10 October 2024QLL-57Improving Tuberculosis Case Detection Rate at Perlis Primary Health ClinicSiti Nazira MN1, Mahfuzah A2, Junaidah I3, Mohd Firdaus AP3, Engku Mohd Hakimi EAA4, Hasni MN51 Klinik Kesihatan Simpang Empat, Perlis2 Klinik Kesihatan Kuala Perlis, Perlis3Pejabat Kesihatan Daerah Kangar, Perlis4 Klinik Kesihatan Kangar, Perlis5 Klinik Kesihatan Pauh, PerlisSELECTION OF OPPORTUNITIES FOR IMPROVEMENT:Early tuberculosis detection and treatment is crucial in preventing tuberculosis death. Tuberculosis casedetection rate in primary health clinics (PHC) Perlis contributes to only 20-24% of all new tuberculosiscases detected from 2018 to 2020.KEY MEASURES FOR IMPROVEMENT:The key indicator for improvement was measured using the percentage of tuberculosis cases detected inPHC Perlis. A standard of 50% was set based on expert consensus during the Perlis Health StateEpidemiology Meeting.PROCESS OF GATHERING INFORMATION:A cross-sectional study was conducted from January to December 2021, including patients residing in allPHCs in Perlis, to determine the tuberculosis detection rate and its contributing factors. Data were sourcedfrom MyTB, TB Screening Data (Lab and X-ray), and Data Kedatangan Primer.ANALYSIS AND INTERPRETATION:Pre-remedial percentage of the tuberculosis detection rate in PHC was 19.6%. The main contributingfactors are low AFB sputum among symptomatic patients (3.68%), and low chest x-rays among diabeticpatients for tuberculosis screening (14.1%). The lack of structured monitoring of tuberculosis screeningimplementation in PHC was identified as another contributing factor.STRATEGIES FOR CHANGE:The tuberculosis program was restructured by assigning tuberculosis champions from every PHC, andperiodic meetings were organised to enhance tuberculosis screening. The quota for chest X-ray screeningwas increased and extended to non-working days. A tuberculosis training course for PHC staff wasorganised to increase staff competency. Google Sheets was developed to closely monitor tuberculosisscreening among diabetic patients.EFFECT OF CHANGE:Post-remedial tuberculosis detection rate in PHC Perlis was 34%. Contributory factors were improvedcompared to the pre-remedial phase; AFB sputum done among symptomatic patients increased from3.68% to 6.00%, and chest x-ray screening among diabetic patients increased from 14.1% to 53.0%.Tuberculosis detection in PHC from screening increased from 21 to 50 cases.THE NEXT STEP:The next step is to share with other states, ensure sustainability via regular audits, focus on communityscreening and awareness, and to obtain high-quality sputum samples.158 | Page