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All Journal International Journal of Health and Pharmaceutical (IJHP)
Yinke Magdalena Sinaga, Bintang
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Nursing Public Health

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Risk Factor of Lost to Follow-up Treatment in drug-sensitive pulmonary TB patients Sari Mardia, Rina; Yinke Magdalena Sinaga, Bintang; Siagian, Parluhutan; Ashar , Taufik
International Journal of Health and Pharmaceutical (IJHP) Vol. 5 No. 4 (2025): November 2025
Publisher : CV. Inara

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51601/ijhp.v5i4.468

Abstract

Background: Loss to follow-up (LTFU) treatment remains a critical challenge in tuberculosis control in Indonesia, accounting for approximately 50% of treatment failure cases among pulmonary TB patients. Objectives: To identify independent predictors of LTFU among drug-sensitive TB (DS-TB) patients in Medan, Indonesia. Methods: This cross-sectional analytical study enrolled 100 DS-TB patients (40 with LTFU, 60 treatment-completed) from two hospitals. Purposive sampling technique was employed. Data were collected using validated questionnaires assessing sociodemographic characteristics, patient perspective toward TB treatment, social support (using MSPSS scale), and healthcare services quality. Bivariate analysis used chi-square and Fisher's exact tests; multivariate analysis employed multiple logistic regression. Statistical significance was set at p < 0.05. Results: Multivariate analysis identified two independent predictors of LTFU: social support (odds ratio 128.632; 95% confidence interval 13.809 to 1,198.216; p < 0.001) and treatment perspective (odds ratio 25.415; 95% confidence interval 5.569 to 115.985; p < 0.001). Low to moderate social support was the most dominant risk factor, conferring approximately 128.7 times greater odds of treatment discontinuation compared to high social support. Poor treatment perspective was the second dominant predictor, with 90% of LTFU patients demonstrating negative perspectives. Conclusion: Poor treatment perspective and low to moderate social support are significantly associated with LTFU treatment discontinuation in DS-TB patients. Psychosocial interventions addressing these factors should be prioritized in TB control programs to improve treatment completion rates and achieve WHO treatment success targets.
Factors Influencing The Incidence of Loss To Follow-Up Treatment In Drug-Resistant Tuberculosis Patients Dalimunthe, Almira; Yinke Magdalena Sinaga, Bintang; Siagian, Parluhutan; Amelia, Rina
International Journal of Health and Pharmaceutical (IJHP) Vol. 5 No. 4 (2025): November 2025
Publisher : CV. Inara

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51601/ijhp.v5i4.475

Abstract

Drug-resistant tuberculosis (DR-TB) represents a significant global health challenge with Indonesia ranking second highest for pulmonary TB cases. Treatment adherence in DR-TB patients is influenced by multiple interacting factors requiring systematic investigation to identify independent risk determinants. This descriptive analytical cross-sectional study assessed associations between independent variables and loss to follow-up treatment outcomes in DR-TB patients at Adam Malik Hospital, Medan, from May to November 2024. A purposive sampling strategy enrolled 104 bacteriologically confirmed DR-TB patients comprising 34 loss to follow-up cases and 70 treatment completers. Data collection utilized validated questionnaires assessing attitudes toward treatment, perceived social support, and healthcare service quality. Statistical analysis employed chi-squared testing for bivariate associations and multiple logistic regression for multivariate analysis with significance level p<0.05. Results demonstrated that 85.3% of loss to follow-up patients experienced low to moderate social support, 67.6% held poor treatment attitudes, and 64.7% perceived insufficient healthcare services. Bivariate analysis revealed significant associations between education (PR=4.13; p=0.023), attitudes (PR=6.04; p<0.001), social support (PR=14.50; p<0.001), and healthcare services (PR=5.72; p<0.001) with treatment discontinuation. Multivariate analysis identified three independent risk factors: low to moderate social support emerging as the predominant determinant (PR=14.01; 95% CI=4.26–46.02; p<0.001), followed by inadequate healthcare services (PR=3.33; 95% CI=1.18–9.43; p=0.023), while unemployment showed protective effect (PR=0.315; p=0.045). This investigation concludes that social support constitutes the principal modifiable risk factor for loss to follow-up treatment in DR-TB patients, necessitating implementation of family-based psychosocial interventions and quality healthcare service improvements to sustain treatment adherence during the challenging 20-month therapeutic regimen.
Co-Authors Ashar , Taufik Dalimunthe, Almira Parluhutan Siagian Rina Amelia Sari Mardia, Rina