Analysis of Factors Affecting the Dropout of Pulmonary TB Patients in the DOTS Program at UPT Medan Lung Health

Oct 13, 2025 by vinooalluri.com 141 views

Analysis of Factors Affecting the Dropout of Pulmonary TB Patients in the DOTS Program at UPT Medan Lung Health

Introduction

Pulmonary tuberculosis (TB) is a major public health problem in Indonesia, particularly in the city of Medan, North Sumatra. The Directly Observed Treatment, Short-Course (DOTS) program is a widely implemented strategy to control TB, but patient dropout remains a significant challenge. This study aims to analyze the factors that contribute to the dropout of pulmonary TB patients in the DOTS program at UPT Medan Lung Health.

Background

TB is a bacterial infection that primarily affects the lungs, but can also spread to other parts of the body. The DOTS program is a World Health Organization (WHO)-recommended strategy for TB control, which involves directly observing patients taking their medication to ensure adherence. However, patient dropout remains a significant challenge, with an estimated 20-30% of patients dropping out of treatment in Indonesia.

Methodology

This study used a case-control design, with 120 respondents consisting of 60 pulmonary TB patients who dropped out of treatment and 60 patients who continued to follow treatment. The total sampling technique was used to select respondents. Data were analyzed using univariate tests, bivariate analysis with the Odds Ratio (OR) test, and multivariate analysis with logistic regression tests.

Results

The results of this study showed that several factors contributed to the dropout of pulmonary TB patients in the DOTS program at UPT Medan Lung Health. These factors include:

*** Knowledge: Patients who had low knowledge about the treatment of pulmonary TB were 3 times more likely to drop out. Lack of understanding of the importance of treatment thoroughly and side effects of treatment can cause patients to feel unnecessary to continue treatment.***

*** Supervision of Drug Taking (PMO): Patients who did not have adequate supervision in taking drugs were 7 times more likely to drop out. The role of PMO in ensuring patients take medication regularly and in a timely manner is very important for the success of treatment.***

*** Marriage Status: Married patients were 3 times more likely to drop out. This is probably caused by greater family demands and responsibilities that can interfere with the treatment process.***

*** Domicile Area: Patients living in remote areas were 3 times more likely to drop out. Access to limited health services and expensive transportation costs can be an obstacle for patients to continue treatment.***

*** Other diseases: Patients suffering from other diseases were 2 times more likely to drop out. Participants can interfere with the process of treatment of pulmonary TB and cause patients to feel tired and hopeless.***

Of all the factors analyzed, the PMO variable had the most dominant effect, with an Exp (β) value of 6.096. That is, patients with poor supervision of taking medicine had a much higher risk of dropping out compared to patients who received good supervision.

Discussion

The results of this study highlight the importance of addressing the factors that contribute to patient dropout in the DOTS program. The findings suggest that patients who have low knowledge about the treatment of pulmonary TB, inadequate supervision of drug taking, and other diseases are more likely to drop out of treatment. These factors can be addressed through various strategies, including increasing patient knowledge, strengthening the role of PMO, increasing service access, improving drug availability, and strengthening the PMO network.

Conclusion

The DOTS program at UPT Medan Lung Health is expected to achieve better success in treating pulmonary TB patients and preventing the spread of this disease in the community by addressing the factors that contribute to patient dropout. The findings of this study provide valuable insights for policymakers, healthcare providers, and patients to improve the effectiveness of the DOTS program.

Recommendations

Based on the findings of this study, several recommendations can be submitted to increase the success of the DOTS program in Medan:

*** Increasing patient knowledge: UPT KPM Medan needs to provide regular counseling to the public about the importance of complete pulmonary TB treatment, side effects of treatment, and how to get medicine in PMO. Counseling can be done through various media such as leaflets, brochures, and television programs.***

*** Strengthening the role of PMO: UPT KPM Medan must ensure that the chosen PMO is the patient's closest family, so they can actively supervise patients in taking medication.***

*** Increasing service access: North Sumatra Provincial Health Office needs to consider improving the status of the Medan KPM UPT to become a class C hospital given the broad scope of treatment and the increasing number of patients.***

*** Improve drug availability: North Sumatra Provincial Health Office and Medan City Health Office need to provide input to health workers to increase drug availability and provide counseling to patients about the importance of complete treatment.***

*** Strengthening the PMO network: The DOTS program needs to strengthen the PMO network system by increasing the number of PMOs, increasing PMO training, and providing incentives to active PMOs.***

By addressing these factors and implementing the recommended strategies, the DOTS program at UPT Medan Lung Health is expected to achieve better success in treating pulmonary TB patients and preventing the spread of this disease in the community.
Frequently Asked Questions (FAQs) about the Analysis of Factors Affecting the Dropout of Pulmonary TB Patients in the DOTS Program at UPT Medan Lung Health

Q: What is the main objective of this study?

A: The main objective of this study is to analyze the factors that contribute to the dropout of pulmonary TB patients in the DOTS program at UPT Medan Lung Health.

Q: What is the DOTS program?

A: The DOTS program is a widely implemented strategy to control tuberculosis (TB), which involves directly observing patients taking their medication to ensure adherence.

Q: What are the factors that contribute to patient dropout in the DOTS program?

A: The factors that contribute to patient dropout in the DOTS program include low knowledge about the treatment of pulmonary TB, inadequate supervision of drug taking, marriage status, domicile area, and other diseases.

Q: What is the role of PMO in the DOTS program?

A: The role of PMO (Supervision of Drug Taking) in the DOTS program is to ensure that patients take their medication regularly and in a timely manner.

Q: What is the significance of the PMO variable in this study?

A: The PMO variable had the most dominant effect in this study, with an Exp (β) value of 6.096. This means that patients with poor supervision of taking medicine had a much higher risk of dropping out compared to patients who received good supervision.

Q: What are the recommendations to increase the success of the DOTS program in Medan?

A: The recommendations to increase the success of the DOTS program in Medan include increasing patient knowledge, strengthening the role of PMO, increasing service access, improving drug availability, and strengthening the PMO network.

Q: How can patient knowledge be increased?

A: Patient knowledge can be increased through regular counseling provided by UPT KPM Medan, using various media such as leaflets, brochures, and television programs.

Q: What is the importance of strengthening the role of PMO?

A: Strengthening the role of PMO is important to ensure that patients take their medication regularly and in a timely manner, which is crucial for the success of the DOTS program.

Q: How can service access be increased?

A: Service access can be increased by improving the status of the Medan KPM UPT to become a class C hospital, given the broad scope of treatment and the increasing number of patients.

Q: What is the significance of improving drug availability?

A: Improving drug availability is important to ensure that patients have access to the necessary medication to complete their treatment.

Q: How can the PMO network be strengthened?

A: The PMO network can be strengthened by increasing the number of PMOs, increasing PMO training, and providing incentives to active PMOs.

Q: What are the implications of this study for policymakers, healthcare providers, and patients?

A: The findings of this study provide valuable insights for policymakers, healthcare providers, and patients to improve the effectiveness of the DOTS program and reduce the dropout rate of pulmonary TB patients.

Q: What are the limitations of this study?

A: The limitations of this study include the small sample size and the use of a case-control design, which may not be representative of the larger population.

Q: What are the future directions for research on this topic?

A: Future research should focus on exploring the factors that contribute to patient dropout in the DOTS program in other settings and developing effective interventions to reduce the dropout rate.