| Summary: | Background: Tuberculosis (TB) remains which a major public health problem in
worldwide. Indonesia is one of five countries with the largest number of incident TB
cases among 22 high burden countries. The prevalence of tuberculosis is low in
Yogyakarta and treatment success continues to increase every year. However, the
spread of TB infection transmission still continues. One of the alarming situation is
the non-compliant to treatment of whom may still transmit the infection. The aims of
this study was to determine factors that predict missing scheduled treatment visits for
two or more consecutive months among tuberculosis patients in Yogyakarta,
Indonesia.
Methods: This study was a cross-sectional study based on tuberculosis 03 registers in
the Health Department Province DIY during the period of 2008-2012. Inclusion
criteria were patients aged 15 years old and above whereas patients who transfer-out
to other health care were excluded from the observational. Factors assessed for
missed visits were age, sex, class of tuberculosis, type of tuberculosis, and health care
unit and analyzed using chi square in bivariate analysis and logistic regression in
multivariate analysis with crude odds ratios (OR) and adjusted OR (AOR) presented.
Results: Among 10984 tuberculosis patients, 9597 patients were included in analysis.
Out of 9597 cases, 657 (7%) patients fall into the category of missed visits from
treatment i.e. in hospital (10.60%), lung clinic (9.73%), and primary health care
center (4.35%). The median age was 40 years old and 57.75% were males. Factors
predicting missed visits were males (OR:1.26, p=0.006), older age 56-95 (OR:1.14,
p=0.070), extra-pulmonary tuberculosis (OR:1.17, p=0.179), re-treatment (OR:1.32,
p=0.103), and patients who received treatment in hospital (OR:1.10, p=0.000). In
multivariate analysis, missed visits were statistically significant higher among older
age 56-95 (AOR:1.25, p=0.013, 95% CI:1.00-1.55), males (AOR:1.23, p=0.19, 95%
CI:1.04-1.45), re-treatment (AOR:1.65, p=0.004, 95% CI:1.18-2.32), and patients
who received treatment in hospital (AOR:1.08, p=0.000, 95% CI:0.88-1.33).
Whereas, type of tuberculosis not significant.
Conclusions: Patients with older age, male, re-treatment, and patients who received
treatment in hospital are more likely have missed visits on anti-tuberculosis
treatment. Missed visits should receive more attention from health care workers in
order to increase successful treatment rates.
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