Pustaka Ilmiah Universitas Padjadjaran

Abstrak

Risk factors for treatment default among adult tuberculosis patients in Indonesia

SETTING Defaulting from anti-tuberculocic treatment hinders tuberculosis (TB) control. OBJECTIVE-. To identify potential defaulters. DESIGN: We conducted a cohort study in newly diag¬nosed Indonesian TB patients. We administered a ques¬tionnaire, praspecrively identified defaulters (discontin¬ued treatment 2 weeks) and assessed risk factors using Cox’s regression. RESULTS: Of 249 patients, 39 (169) defaulted+ 61% in the first 2 months. Default was associated with liver dis¬ease (HR 3.40, 95%Cl 1.02-11.78), chest pain (HR 2.25, 95%Cl 1.06-4,77), night sweats (HR. 1.98, 95%CI 1.03-3.79), characteristics of the head of the household (self-employed, HR 2,47, 95% CI 1.15-5,34; patient’s mother. HR 7.72, 95%Cl 1.66-35.88), household wealth (HR 4,24, 95%CI 1,12-16-09), walking to clinic (HR 4.53, 95%CI 139-14.71), being unaccompanied at diagnosis (HR 30.49, 95%CI 7.55-123.07) or when collecting medication (HR 3.34, 95%CI 1.24-8.98) and low level of satisfaction with the clinic (HR 3.85, 95%CI 1.17¬12.62) or doctors (HR 2,45, 95%CI 1.18-5.10). Health insurance (HR 0.24, 95%CI 0.07-0.74) and paying for diagnosis (HR 0.14, 95%Cl 0.04-0.48) were protective. CONCLUSI0N Defaulting is common and occurs early, Interventions that improve clinic services, strengthen pa-tient support and increase insurance coverage may re¬duce default in Indonesia.