Community-Based Mobile Self-Assessment for Tuberculosis Screening Among Parents and Children: A Cross-Sectional Study
DOI:
https://doi.org/10.55018/janh.v8i1.579Keywords:
Tuberculosis, Mobile Health, Self-Assessment, Community Screening, Cross-Sectional StudyAbstract
Background: Conventional tuberculosis screening is often limited by reporting delays and low accessibility. This study evaluates a digital solution to address this gap by integrating behavioral assessment and screening of two populations into a single community-based platform. The study aimed to evaluate the NOR TBC mobile app in identifying suspected tuberculosis cases and analyze the relationship between cognitive factors and preventive behaviors.
Methods: This cross-sectional observational study followed STROBE guidelines. Using convenience sampling, 70 parents, were recruited. Data were collected via the app’s integrated modules for Knowledge, Attitude, and Practice and self-screening. App quality was validated using ISO 25010 and expert review. Data were analyzed using descriptive statistics and Chi-Square tests (p < 0.05).
Results: The NOR TBC mobile identified 5.7% adult and 14.3% child presumptive TB cases. Technical evaluation rated the app as "Good" (76.67%), with expert validation confirming it as "Very Feasible" (60%) and "Feasible" (40%). Most respondents exhibited good knowledge (58.6%), positive attitudes (94.3%), and favorable behaviors (82.9%). Chi-square analysis showed significant associations: respondents with good knowledge were 4.2 times more likely to engage in tuberculosis prevention (p=0.012; OR=4.2), and those with positive attitudes had 3.8 times higher odds of favorable behavior (p=0.034; OR=3.8).
Conclusion: The NOR TBC mobile application demonstrates strategic potential in strengthening community-level tuberculosis detection and improving health literacy. This digital innovation reaches vulnerable populations that may be missed by conventional surveillance. Further development and controlled trials are recommended to evaluate long-term effectiveness
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Abelti, E., Dememew, Z., Gebreyohannes, A., Alemayehu, Y., Terfassa, T., Janfa, T., Jerene, D., Suarez, P., & Datiko, D. (2025). Community-Based Tuberculosis Preventive Treatment Among Child and Adolescent Household Contacts in Ethiopia. Tropical Medicine and Infectious Disease, 10(4). https://doi.org/10.3390/tropicalmed10040102
Achieng, M. S. (2026). International Journal of Information A realist synthesis of the implementation of digital health strategies for enhanced health outcomes in Sub-Saharan Africa. International Journal of Information Management Data Insights, 6(1), 100391. https://doi.org/10.1016/j.jjimei.2026.100391
Bao, Y., Wang, C., Xu, H., Lai, Y., Yan, Y., & Ma, Y. (2022). Effects of an mHealth Intervention for Pulmonary Tuberculosis Self-management Based on the Integrated Theory of Health Behavior Change : Randomized Controlled Trial Corresponding Author : 8. https://doi.org/10.2196/34277
Brooks, M. B., Dubois, M. M., Malik, A. A., Ahmed, J. F., Siddiqui, S., Khan, S., Brohi, M., Valecha, T. Das, Amanullah, F., Becerra, M. C., & Hussain, H. (2022). Age-specific effectiveness of a tuberculosis screening intervention in children. PLoS ONE, 1–12. https://doi.org/10.1371/journal.pone.0264216
Centers for Disease Control and Prevention. (2023). What You Need to Know About Tuberculosis (Issue October).
Choudhary, P., Phalswal, U., & Mamta. (2025). A synthesis of qualitative evidences regarding the barriers, challenges, and facilitators of self-care management among individuals with tuberculosis: A narrative review. Indian Journal of Tuberculosis, 72(3), 418–423. https://doi.org/https://doi.org/10.1016/j.ijtb.2024.12.003
Furin, J., Cox, H., & Pai, M. (2019). Tuberculosis. Lancet (London, England), 393(10181), 1642–1656. https://doi.org/10.1016/S0140-6736(19)30308-3
Gunasekera, K. S., Vonasek, B., Oliwa, J., Triasih, R., Lancioni, C., Graham, S. M., Seddon, J. A., & Marais, B. J. (2022). Diagnostic Challenges in Childhood Pulmonary Tuberculosis — Optimizing the Clinical Approach. Pathogens, 1–11.
Hatem, N., Mursida, W., Amiira, D., Qirani, S., Imtiyaz, R., & Gamal, A. (2025). The Role of Digital Health Technologies in Combating MDR-TB : Promising Innovations and Future Strategies. Jurnal Penelitian Kesehatan Rs Unram, 1(1), 29–36.
Hinz, A., Karoff, J., Kittel, J., Brähler, E., Zenger, M., Schmalbach, B., & Kocalevent, R.-D. (2020). Associations between self-rated health and the assessments of anchoring vignettes in cardiovascular patients. International Journal of Clinical and Health Psychology : IJCHP, 20(2), 100–107. https://doi.org/10.1016/j.ijchp.2020.04.001
Htet, K. K. K., Phyu, A. N., Thwin, T., & Chongsuvivatwong, V. (2022). Mobile Health App for Tuberculosis Screening and Compliance to Undergo Chest X-ray Examination Among Presumptive Cases Detected by the App in Myanmar: Usability Study. JMIR Formative Research, 6(6), e37779. https://doi.org/10.2196/37779
Kelamane, S., Muhjazi, G., Wilson, N., & van den Boom, M. (2025). Ending the TB Crisis in Low- and Middle-Income Countries of the Eastern Mediterranean Region-Overcoming Inaction Through Strategical Leaps. Tropical Medicine and Infectious Disease, 10(12). https://doi.org/10.3390/tropicalmed10120348
Ko, K., Htet, K., Phyu, A. N., & Thwin, T. (2022). Mobile Health App for Tuberculosis Screening and Compliance to Undergo Chest X-ray Examination Among Presumptive Cases Detected by the App in Myanmar : Usability Study Corresponding Author : JMIR Form Res, 6, 1–14. https://doi.org/10.2196/37779
Lee, S., Rajaguru, V., Baek, J. S., Shin, J., & Park, Y. (2023). Digital Health Interventions to Enhance Tuberculosis Treatment Adherence: Scoping Review. JMIR MHealth and UHealth, 11, e49741. https://doi.org/10.2196/49741
Li, J., Pu, J., Liu, J., Wang, Q., Zhang, R., Zhang, T., Zhou, J., Xing, W., & Liang, S. (2021). Determinants of self ‑ management behaviors among pulmonary tuberculosis patients : a path analysis. Infectious Diseases of Poverty, 1–11. https://doi.org/10.1186/s40249-021-00888-3
Li, J., Zhang, L., Zhou, J., Wang, G., Zhang, R., Liu, J., Liu, S., Chen, Y., & Yang, S. (2022). Development and validation of self ‑ management scale for tuberculosis patients. BMC Infectious Diseases, 1–13. https://doi.org/10.1186/s12879-022-07483-3
Maita, K. C., Maniaci, M. J., Haider, C. R., Avila, F. R., Torres-Guzman, R. A., Borna, S., Lunde, J. J., Coffey, J. D., Demaerschalk, B. M., & Forte, A. J. (2024). The Impact of Digital Health Solutions on Bridging the Health Care Gap in Rural Areas: A Scoping Review. The Permanente Journal, 28(3), 130–143. https://doi.org/10.7812/TPP/23.134
Margineanu, I., Louka, C., Akkerman, O., Stienstra, Y., & Alffenaar, J. (2025). eHealth in TB clinical management. The International Journal of Tuberculosis and Lung Disease : The Official Journal of the International Union against Tuberculosis and Lung Disease. https://doi.org/10.5588/ijtld.21.0602
Ministry of Health of Republic of Indonesia. (2021). Laporan Program Penanggulangan Tuberkulosis Tahun 2021.
Ngwatu, B. K., Nsengiyumva, N. P., Oxlade, O., Mappin-Kasirer, B., Nguyen, N. L., Jaramillo, E., Falzon, D., & Schwartzman, K. (2018). The impact of digital health technologies on tuberculosis treatment: a systematic review. The European Respiratory Journal, 51(1). https://doi.org/10.1183/13993003.01596-2017
Osei, E., & Mashamba-thompson, T. P. (2021). Heliyon Mobile health applications for disease screening and treatment support in low-and middle-income countries : A narrative review. HLY, 7(3), e06639. https://doi.org/10.1016/j.heliyon.2021.e06639
Rahayu, S. R., Cahyati, W. H., Zainafree, I., Farida, E., Merzistya, A. N. A., Aulia, A., Wahidah, N., Wandastuti, A. D., Isbandi, Setiawan, A. W., Atmini, T., Islam, M. A. N., Fajri, A., Mubarok, M., Ningsih, F., & Subagja, M. (2022). Pengembangan Aplikasi Sikribo (Sistem Skrining Tuberkulosis).
Rich, K., Burger, R., Goldberg, D., & Moultrie, H. (2025). Is it possible to encourage TB testing and detect missing TB cases via level promotion of a self- screening mobile application ? experimental evidence from South Africa. BMJ Health Care Inform, 1–8. https://doi.org/10.1136/bmjhci-2024-101179
Samiaji, M., Masruroh, S., Khairani, D., Nanang, H., Rosyadi, T., & Shofi, I. (2023). Mobile Health Application Design: A User-Centered Approach for Pulmonary Tuberculosis Screening. 11th International Conference on Cyber and IT Service Management (CITSM), 1–7. https://doi.org/10.1109/CITSM60085.2023.10455537
Sirinapakul, P., & Chaiear, N. (2021). Validity and Reliability of Self-Assessment Tool for Risk Prioritization Following Exposure to Tuberculosis in a Hospital Setting. Int. J. Environ. Res. Public Health.
Szkwarko, D., Amisi, J. A., Peterson, D., Burudi, S., Angala, P., & Carter, E. J. (2021). Using a mobile application to improve pediatric presumptive TB identification in western Kenya. The International Journal of Tuberculosis and Lung Disease Data, 25(November 2020), 468–474.
Teixeira, J., Melanie, N., Maia, R., Lopes, M., Teresa, V., Lino, S., Kramer, M., Andrade, D. N., & Alexandra, C. (2025). The role of digital health technology in tuberculosis control : a systematic literature review and comparative analysis based on the WHO guidelines. Discover Health Systems. https://doi.org/10.1007/s44250-025-00242-6
Triyono, E. A., Mahanani, M. V. S., Anggraini, S. D., Maulana, H., & Dian, W. (2023). Early Detection Of Tuberculosis Application (E-Tibi): A New Paradigm To Detect New Case Of Tuberculosis. Jurnal Berkala Epidemiologi, 11(3), 267–276. https://doi.org/10.20473/jbe.v11i32023.267-276
World Health Organization. (2015). The End TB Strategy. World Health Organization.
World Health Organization. (2022). Global Tuberculosis Report.
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