Tuberculosis (TB) treatment success in primary care is closely linked to sustained medication adherence. This cross-sectional study assessed the association between adherence to anti-tuberculosis drugs and TB treatment success at Karya Wanita Primary Health Center, Pekanbaru, Indonesia, using routine TB programme records (2024–2025). Eligible records with complete adherence and outcome documentation were included (n = 75). Treatment success was defined as cured or treatment completed, whereas unsuccessful outcomes included failure, discontinuation, or death. Overall, 63 patients (84.0%) were adherent and 62 (82.7%) achieved treatment success. Treatment success was substantially higher among adherent than non-adherent patients (96.8% vs 8.3%), with a significant association by Fisher’s exact test (p 0.001). Adherence was associated with a markedly higher probability of treatment success (RR = 11.62; 95% CI: 1.78–75.92). Strengthening DOTS-aligned adherence support through treatment supporters (PMO), early counselling, reminders, and active tracing may improve outcomes.
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