Overview of The Health Office's Cross-Sectoral Cooperation Implementation Readiness In Supporting The Regional Action Plan For Tuberculosis Combat In North Lampung Regency

Abstract

Tuberculosis (TB) is an infectious disease caused by the bacterium Mycobacterium tuberculosis. Transmission occurs in patients with acid-fast bacilli (AFB)-positive tuberculosis through airborne droplets (PDPI, 2021).According to WHO data (2024), 1.25 million people died from tuberculosis. In 2023, the number of tuberculosis cases increased from 2019, when 10.8 million cases were diagnosed and treated (WHO, 2025). The incidence in Indonesia in 2021 was 354 per 100,000 population, an increase compared to 301 per 100,000 population in 2020 (Ministry of Health, 2023). In Lampung Province (2023), the tuberculosis incidence rate continued to rise, but the case detection rate continued to rise compared to 2022, reaching 57%. This percentage still falls short of the target of 90% case detection. North Lampung Regency is one of the regions with a relatively low case detection rate, reaching 35% (TB P2PM Section, 2023). The impact of tuberculosis, resulting in 85% of patients in the productive age group (15–50 years), results in a loss of approximately 20–30% of annual household income, and if they die, they lose approximately 15 years of income. Tuberculosis is not only economically detrimental but also socially. Furthermore, the latest WHO data (2024) indicates that nearly 1 in 2 households are affected by tuberculosis, facing costs exceeding 20% of household income. This problem will lead to prolonged economic instability (Ministry of Health, 2020). Efforts to control tuberculosis include optimizing the detection of tuberculosis suspects, diagnosing tuberculosis, and providing treatment. The government is strongly committed to achieving TB elimination by 2030. Various efforts have been undertaken, such as increased health promotion, case surveillance, and case detection and treatment, as a means of suppressing the emergence of carriers who infect others (Ministry of Health, 2020). The government's commitment to reducing tuberculosis morbidity in Indonesia is reflected in various prevention strategies, including strengthening tuberculosis program leadership, identifying tuberculosis suspects, managing tuberculosis patients, increasing access to quality tuberculosis services, controlling risk factors, enhancing tuberculosis partnerships, increasing community independence in tuberculosis control, and strengthening tuberculosis program management (Ministry of National Development Planning, 2022). North Lampung Regency is one of the regions with an estimated TB caseload of 2,069 cases in 2024. This achievement makes North Lampung Regency one of the regencies with a high caseload in Lampung Province. The challenges faced in the TB control program are the suboptimal implementation of screening in detecting TB cases and the fulfillment of services from health facilities that are not yet standardized to strengthen networks and implement TB programs. In addition, there is no synergy and integration across programs, across sectors, related government agencies, and the community in implementing TB control in North Lampung Regency. Treatment Coverage (case detection) of TB in North Lampung Regency in 2020-2024, In 2020 645 cases (36%), In 2021 1131 cases (54%), In 2022 1020 cases (43%), In 2023 1056 cases (45%), In 2024 1091 cases (53%). North Lampung Regency has 1,056 TB cases recorded and reported in SITB. in 2023 (45%) of the target of 2363 cases that have been set. Other issues and challenges are patient compliance in taking medication. Until now, efforts to ensure that treatment is not interrupted midway are still a separate obstacle in TB treatment.