<![CDATA[Introduction: Tuberculosis (TB) remains a major public health problem, with treatment adherence being a critical determinant of therapeutic success. The Directly Observed Treatment Short-course (DOTS) strategy emphasizes the role of treatment supervisors; however, evidence regarding the influence of supervision intensity on patient adherence remains limited. This study aimed to examine the relationship between the intensity of medication supervision by treatment supporters (PMO) and medication adherence among pulmonary tuberculosis patients. Methods: An analytical observational study with a case–control design was conducted from December 2025 to January 2026 at a primary health center in Surabaya, Indonesia. A total of 22 pulmonary TB patients who met the inclusion criteria were included using total sampling. Data were collected using structured questionnaires to assess PMO characteristics, supervision intensity, and patient adherence, measured using the Morisky Medication Adherence Scale-8 (MMAS-8). Data were analyzed using Fisher’s Exact test. Results: Among the 22 pulmonary tuberculosis patients, 13 of 15 patients (86.7%) receiving high-intensity PMO supervision were adherent to treatment, compared with none of the 7 patients receiving moderate-to-low-intensity supervision. Fisher’s Exact test indicated a statistically significant association between supervision intensity and medication adherence (p < 0.001). Conclusion: These findings suggest that the quality and consistency of supervision play a more important role than demographic attributes of treatment supporters. Strengthening structured and intensive supervision may enhance treatment adherence and support tuberculosis control efforts.]]>
