Analysis of Risk Factors and Predictors of Success in Controlling Drop Out Pulmonary Tuberculosis: An Observational Study in Batang Regency, Indonesia

Teguh Irawan, Wahyuningsih, Anik Indriono, Muhammad Fatih Izul Maula, Meila Azzahra
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Abstract

Introduction: Pulmonary tuberculosis (TB) remains a significant public health problem in Batang Regency, Indonesia. The high drop out (DO) rate of treatment is one of the main obstacles in controlling TB. This study aims to identify risk factors and predictors of DO for pulmonary TB treatment in Batang Regency. Methods: An analytical observational study with a cross-sectional design was conducted in 2023 involving 150 pulmonary TB patients who were recorded as having DO in the 2021-2022 period. Primary data was collected through interviews and secondary data from medical records. Bivariate analysis using the Chi-square test or Fisher's exact test, and multivariate analysis using logistic regression were performed to identify risk factors and predictors of DO. Results: Bivariate analysis showed that young age (<25 years) (OR = 3.21; 95% CI: 1.54-6.69), long distance of residence from health facilities (OR = 4.12; 95% CI: 1.98-8.57), and a history of adverse drug reactions (ESO) (OR = 5.63; 95% CI: 2.65-11.94) were significant risk factors for DO. Multivariate analysis confirmed that young age (aOR = 2.95; 95% CI: 1.35-6.43), long distance of residence (aOR = 3.88; 95% CI: 1.79-8.41), and history of ESO (aOR = 5.12; 95% CI: 2.38-11.01) were independent predictors of DO. Conclusion: Young age, long distance of residence from health facilities, and history of ESO are risk factors and independent predictors of DO for pulmonary TB treatment in Batang Regency. Interventions that target these factors, such as intensive education and counseling for young patients, increased access to health services, and optimal management of ESO, are needed to increase the success of TB control.  
辍学肺结核控制成功的风险因素和预测因素分析:印度尼西亚巴塘地区的观察研究
简介肺结核(TB)仍然是印度尼西亚巴塘县(Batang Regency)的一个重大公共卫生问题。高辍治率(DO)是控制肺结核的主要障碍之一。本研究旨在确定巴塘地区肺结核治疗辍学的风险因素和预测因素。研究方法2023 年进行了一项横断面分析观察研究,涉及 2021-2022 年期间记录在案的 150 名肺结核患者。通过访谈收集第一手数据,并从医疗记录中收集第二手数据。研究采用卡方检验(Chi-square test)或费雪精确检验(Fisher's exact test)进行二元分析,并采用逻辑回归(Logistic regression)进行多元分析,以确定 DO 的风险因素和预测因子。结果显示二变量分析表明,年轻(<25 岁)(OR = 3.21;95% CI:1.54-6.69)、居住地距离医疗机构较远(OR = 4.12;95% CI:1.98-8.57)和药物不良反应(ESO)史(OR = 5.63;95% CI:2.65-11.94)是 DO 的重要风险因素。多变量分析证实,年轻(aOR = 2.95;95% CI:1.35-6.43)、居住距离远(aOR = 3.88;95% CI:1.79-8.41)和有过 ESO(aOR = 5.12;95% CI:2.38-11.01)是 DO 的独立预测因素。结论在巴塘县,年轻、居住地距离医疗机构较远和有过 ESO 史是肺结核治疗中出现 DO 的风险因素和独立预测因子。为提高结核病控制的成功率,需要针对这些因素采取干预措施,如对年轻患者进行强化教育和咨询、增加医疗服务的可及性以及对 ESO 的优化管理。
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