Implementation of Dots as the Primary Determinant of Treatment Adherence During the Intensive Phase of Tuberculosis Patients
DOI:
https://doi.org/10.37287/ijghr.v8i3.1276Keywords:
DOTS, Intensive Phase, Medication Adherence, TuberculosisAbstract
Tuberculosis (TB) remains a major public health burden, particularly in high-incidence countries such as Indonesia. The World Health Organization–recommended Directly Observed Treatment Short-course (DOTS) strategy plays a crucial role in improving treatment success; however, patient adherence during the intensive phase of treatment remains a significant challenge. This study aimed to analyze the relationship between the implementation of the DOTS strategy and adherence to anti-tuberculosis medication during the intensive phase among pulmonary TB patients in Bone Bolango Regency. This study employed a quantitative analytical design with a cross-sectional approach. A total of 75 respondents were recruited using total sampling. Data were collected through a structured questionnaire and analyzed using Chi-square tests and logistic regression analysis. The findings demonstrated significant associations between all DOTS components and treatment adherence, including government commitment (p = 0.006), microscopic examination (p = 0.003), treatment supervision (p = 0.000), drug availability (p = 0.002), and recording and reporting systems (p = 0.004). Treatment supervision was identified as the most dominant factor influencing adherence, with a p-value of 0.001 and an odds ratio (OR) of 0.133 (95% CI: 0.039–0.459). The implementation of the DOTS strategy is strongly associated with adherence to anti-tuberculosis medication during the intensive phase of treatment. Strengthening the role of treatment supervisors, ensuring consistent drug availability, and improving recording and reporting systems are essential to enhance treatment success.
References
Amalia, Adinda. Arini, Heny Dwi dan Dhrik, Mahadri. 2022. Analisis Hubungan Tingkat Kepatuhan Minum Obat Antituberkulosis Terhadap Kualitas Hidup Pasien Tuberkulosis Paru. JIM: Jurnal Ilmiah Mahaganesha, 1(2), 67–74. https://ojs.farmasimahaganesha.ac.id/index.php/JIM/article/view/111.
Appiah, Maxwell Afranie. Arthur, Joshua Appiah dan Gborgblorvor, Delphine. 2023. Barriers to tuberculosis treatment adherence in high-burden settings. BMC Public Health. https://link.springer.com/content/pdf/10.1186/s12889-023-16259-6.pdf
Badan Pusat Statistik (BPS) Kabupaten Bone Bolango. 2024. Kabupaten Bone Bolango dalam angka 2024. Bone Bolango: BPS.
Carryn, carryn. Fitriani, Arifah Devi dan Nuraini. 2024. Analisis Faktor Keberhasilan Degefa, Meaza Girma. Bezabih, Afework Mulugeta. Kahsay, Znabu Hadush dan Belachew, Abate Bekele. 2021. Barriers And Facilitators Of Nutrition Assessment, Counseling, And Support For Tuberculosis Patients: A Qualitative Study. BMC Nutrition, 7, 58. https://doi.org/10.1186/s40795-021-00463-x.
Dinas Kesehatan Kabupaten Bone Bolango. 2024. Profil Kesehatan Kabupaten Bone Bolango tahun 2023. Bone Bolango: Dinas Kesehatan Kabupaten Bone Bolango.
Febriyanti, Eka. Amelia, Ayu. Meilanda, Rastria dan Syahputra, Ghalib Syukrillah. 2025. Nutritional Status And Its Impact On Pulmonary Tuberculosis Recurrence At The Surakarta Public Pulmonary Health Center. Journal of Pharmaceutical and Sciences, 8(2), 960–966. https://doi.org/10.36490/journal-jps.com.v8i2.792
Ginting, Amnita Anda Yanti. Pakpahan, Rotua Elvina dan Zebua, Selviyan Enjelita. 2024. Gambaran kepatuhan minum obat penderita tuberkulosis paru di Rumah Sakit Khusus Paru Medan, Sumatera Utara. Innovative: Journal of Social Science Research, 4(5), 7819–7833. https://doi.org/10.31004/innovative.v4i5.15853
Isa, Ma'rufi. Ali, Khaidar. Jati, Sigit Kusuma. Sukmawati, Anik. Ardiansyah, Kurnia dan Ningtyias, Farida Wahyu. 2020. Improvement Of Nutritional Status Among Tuberculosis Patients By Channa Striata Supplementation: A True Experimental Study In Indonesia. BioMed Research International, 2020, 7491702. https://doi.org/10.1155/2020/7491702.
Izudi, Jonathan. Bajunirwe, Francis dan Cattamanchi, Adithya. 2019. Negative Effects of Undernutrition On Sputum Smear Conversion And Treatment Success Among Retreatment Cases In Uganda: A Quasi-experimental Study. BMC Infectious Diseases, 19(1), 423. https://doi.org/10.1186/s12879-019-4062-y
Kasim, Vivien Novarina., Pateda, Sri Manovita., Hadju, Veni., & Jafar, Nurhaedar. 2017. Suplementasi ekstrak albumin ikan gabus terhadap status gizi dan imunitas pasien stroke.Jurnal Gizi Klinik Indonesia, 13(3), 91-98.
Kemenkes RI. 2023. Profil kesehatan Indonesia tahun 2022. Jakarta: Kementerian Kesehatan Republik Indonesia.
Khasanah, Usfahtul. Junadi, Purnawan dan Mizan, Syaiful. 2024. Gambaran Keberhasilan Pengobatan (Treatment Success Rate) Tuberkulosis Paru di Puskesmas Jatisampurna, Bekasi. 210. MPPKI (Januari, 2024) Vol. 7 No. 1. (DOI: https://doi.org/10.56338/mppki.v7i1.4379).
Komariah, Euis Dedeh. Rosdewi. Hamid, Olimpius Gunawan dan Garus, Valentinus Ario. 2023. Peran PMO dan kepatuhan minum obat pada pasien tuberkulosis paru. Watson Journal of Nursing, 2(1), 14–20.
Marahatta, Sujan Babu. Yadav, Rajesh Kumar. Giri, Deena dan Lama, Sarina. 2020. Barriers In The Access, Diagnosis And Treatment Completion For Tuberculosis In Nepal: A Qualitative Study Among Patients And Healthcare Workers. PLOS ONE, 15(1), e0227293. https://doi.org/10.1371/journal.pone.0227293.
Mokambu, Zulfikar. Yunus, Pipin dan Syamsuddin, Fadli. 2023. Peran pengawas minum obat (PMO) terhadap keberhasilan pengobatan TB paru di wilayah kerja Puskesmas Bulango Ulu. Jurnal Inovasi Riset Ilmu Kesehatan, 1(2), 1357–1342.
Nisah, Hairun. Arbi, Anwar dan Hasnur, Hanifah. 2023. Studi pendampingan kepatuhan konsumsi obat pada pasien TB paru di wilayah kerja Puskesmas Simeulue Timur. Buletin Masyarakat Sehat, 7(2), 1407–1415. https://doi.org/10.52622/bemas.v7i2.1502.
Opperman, Monique dan Du Preez, Ilse. 2023. Factors Contributing To Pulmonary TB Treatment Lost To Follow-up In Developing Countries: An overview. African Journal of Infectious Diseases, 17(1), 60–73. https://pmc.ncbi.nlm.nih.gov/articles/PMC9885020/pdf/AJID-17-60.pdf
Pasaribu, Grace Florita. Handini, Myrnawati Crie. Manurung, Jasmen. Sembiring, Rinawati dan Siagian, Mindo Tua. 2023. Ketidakpatuhan Minum Obat Pada Pasien TB Paru: Studi Kualitatif. Jurnal Prima Medika Sains Vol.5 No.1. https://jurnal.unprimdn.ac.id/index.php/JPMS/article/download/3788/2442/14587
Popescu, Catalin. EL-Chaarani, Hani. EL-Abiad, Zouhour dan Gigauri, Iza. 2022. Implementation Of Health Information Systems To Improve Patient Identification. Healthcare, 10(9), 1723. https://doi.org/10.3390/healthcare10091723
Portnoy, Allison dan Yamanaka, Takuya. 2023. Costs Incurred By People Receiving Tuberculosis Treatment: A Global Analysis. PLOS Global Public Health, 3(5), e0002180. https://doi.org/10.1371/journal.pgph.0002180
Pradipta, Ivan. Idrus, Lusiana. Probandari, Ari dan Puspitasari, Irma Melyana. 2022. Barriers to optimal tuberculosis treatment services at community health centers: A qualitative study from a high prevalent tuberculosis country. Frontiers in Pharmacology, 13, Article 857783. https://doi.org/10.3389/fphar.2022.857783
Pratiwi, Wahyu Nur. Firmanda, Giovanni Iga. Sunarno, Rita Dewi dan Wahyuningsih, Aries. 2025. Pengaruh Edukasi terhadap Pengetahuan dan Kepatuhan Obat pada Penderita TB di Karanganyar. Jurnal Keperawatan Klinis dan Komunitas, Vol 9 (1) Maret 2025. https://jurnal.ugm.ac.id/jkkk/article/download/104297/41346.
Pujaningtyas, Dwi Helmi. 2023. Peran pengawas menelan obat (PMO) dengan kepatuhan minum obat pada pasien tuberkulosis paru di wilayah kerja Puskesmas Sumurgung. Jurnal Multidisiplin Indonesia, 2(8), 423. https://doi.org/10.58344/jmi.v2i8.423
Sabiti, Farroh Bintang. Febrinasari, Nisa dan Aulia, Isfandiari. 2021. Kepatuhan penggunaan obat anti tuberkulosis fase intensif terhadap perubahan nilai sputum BTA dan berat badan di Puskesmas Bandarharjo Semarang. Borneo Journal of Pharmascientech, Vol. 05, No. 01, April 2021.
Safitri, Reza Wardana dan Suryani, Roro Lintang. 2022. Batuk efektif untuk mengurangi sesak nafas dan sekret pada anak dengan diagnosa bronkopneumonia. Jurnal Inovasi Penelitian, 3(4), 5751–5756. (https://stp-mataram.e-journal.id/JIP/article/download/1951/1514/).
Samal, Lipika. Helen dan Camara, Djibril. 2021. Health information technology to improve care for people with multiple chronic conditions. Health Services Research, 56(5), 789–805. Retrieved from https://onlinelibrary.wiley.com/doi/epdf/10.1111/1475-6773.13860
Sazali, Mohd Fazeli. Rahim, Syed Sharizman Syed Abdul. Mohammad, Ahmad Hazim dan Kadir, Fairul. 2022. Improving Tuberculosis Medication Adherence: The Potential of Integrating Digital Technology and Health Belief Model PMCID, 2022. https://pmc.ncbi.nlm.nih.gov/articles/PMC10073608/pdf/trd-2022-0148.pdf
Syahridal, Kartini dan Haris, Hardianto. 2022. Faktor yang berhubungan dengan drop out pengobatan pada penderita tuberkulosis (TB) paru di Puskesmas Bontonompo II Kabupaten Gowa. Jurnal Promotif Preventif, 5(1), 59–65. https://doi.org/10.47650/jpp.v5i1.472
Tobing, Erida Rohito Lumban. Nur’aini dan Fitria, Aida. 2023. Faktor yang memengaruhi kepatuhan penderita TB paru dalam mengkonsumsi obat di UPT Puskesmas Batang Beruh Kecamatan Sidikalang Kabupaten Dairi. Journal of Educational Innovation and Public Health, 2(1), 254-268. https://doi.org/10.55606/innovation.v2i1.2146
Wagnew, Fasil. Gray, Darren. Tsheten dan Kelly, Matthew. 2024. Effectiveness of nutritional support to improve treatment adherence in patients with tuberculosis: A systematic review. Nutrition Reviews, 82(9), 1216–1225. https://doi.org/10.1093/nutrit/nuad120.
WHO. 2023. Global tuberculosis report 2023. Geneva: World Health Organization.
Yanthi, Ni Made Rizma Frida dan Yowan, Sagung Chandra. 2025. Analisis tingkat kepatuhan penggunaan obat anti tuberkulosis di Puskesmas Kota Denpasar. Ranah Research Journal. https://jurnal.ranahresearch.com/index.php/R2J
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Indonesian Journal of Global Health Research

This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.







