Factors Influencing The Incidence of Loss To Follow-Up Treatment In Drug-Resistant Tuberculosis Patients

Almira Dalimunthe (Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia)
Bintang Yinke Magdalena Sinaga (Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia)
Parluhutan Siagian (Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia)
Rina Amelia (Department of Community Medicine, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia)

International Journal of Health and Pharmaceutical (IJHP)
Vol. 5 No. 4 (2025): November 2025

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.