Determinants of Tuberculosis Case Detection Among Healthcare Providers in PaPaBaTa Lanao Del Norte: A Cross-Sectional Study

Abstract

Background: Tuberculosis (TB) continues to pose a significant public health challenge in the Philippines, with persistent gaps between estimated incidence and reported cases indicating suboptimal case detection. Healthcare providers play a critical role in TB identification and reporting, yet evidence on provider-related determinants in decentralized rural settings remains limited.

Objectives: This study aimed to examine healthcare provider–related determinants of TB case detection rates (CDR) in the PaPaBaTa Inter-Local Health Zone, Lanao del Norte, Philippines.

Methods: A quantitative, cross-sectional analytical design was employed involving 188 healthcare providers selected through stratified random sampling. Data were collected using a validated self-administered questionnaire assessing predisposing (knowledge), enabling (resources and organizational support), and behavioral factors, alongside facility-level TB records to compute CDR. Descriptive statistics, t-tests, ANOVA, Pearson correlation, and multiple linear regression were used for analysis at a 95% confidence level.

Results: Providers demonstrated low perceived knowledge of TB diagnostic guidelines (M = 2.31), moderate enabling conditions (M =3.04), and moderate practice engagement (M = 3.04). Facility-level CDR varied from 7.27% to 33.33%. Knowledge (r = 0.42), enabling factors (r = 0.36), and behavioral practices (r = 0.41) showed significant positive correlations with CDR (p < 0.01). Regression analyses revealed that TB knowledge (β = 0.31), professional role, educational attainment, years of service, employment status, and type of posting significantly predicted CDR (R² = 0.48). Enabling (R² = 0.52) and behavioral factors (R² = 0.55) also significantly influenced detection outcomes, with routine screening and identification of presumptive cases as key predictors.

Conclusion: TB case detection is significantly influenced by provider knowledge, health system support, and behavioral practices. Strengthening training, resource provision, and provider engagement is essential to improve TB detection in decentralized settings.