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Geographical variation was significantly associated with unfavorable treatment outcomes among pulmonary tuberculosis patient in West Sumatera Indonesia
Ratno Widoyo, Defriman Djafri, Virasakdi Chongsuvivatwong

Last modified: 2018-08-09

Abstract


Background

Patient with tuberculosis must take antibiotics for at least six to 24 months, depending on age, drug resistance pattern, comorbid disease, and others. In the long-term period of treatment,  the patient adherence associated with spatial accessibility and healthcare facility.  Accessibility and healthcare facility varied between geographical pattern. The objective of this study is to compare unfavorable treatment outcome between geographical variation in West Sumatera Province of Indonesia.

Materials and methods

The study analyzed TB treatment register data of West Sumatera Province from 2014 until 2016. There are 18390 notified pulmonary TB/MDR-TB. Geographical variation defined as coastal area and non-coastal area. All district in West Sumatera that interface the sea was categories as the coastal area. Logistic regression was carried out to assess the association of unfavorable treatment outcome by geographical variation, adjusted by TB types, previous treatment history, age groups, sex, and smear result.

 

Results

The descriptive data indicated that in coastal area has 5.1 % MDR-TB, 5.6% retreatment, median age 44 (IQR,29,59), 64.8% male, and 75.4% smear positive comparing with Non-coastal has 4.1 % MDR-TB, 4.6% retreatment, median age 44 (IQR,29,59), 64.2% male, and 71.3% smear positive. The proportion of unfavorable treatment outcome in the non-coastal is higher than in the coastal area (24% vs 17.5%). By using logistic regression model, geographical variation was significantly associated with unfavorable treatment outcomes. TB patient in the non-coastal area has approximately 1.5 (95%CI:1.39,1.61) times to have unfavorable treatment outcome than in coastal area.

 

Conclusions

However, geographic variation is the associated factor of unfavorable treatment outcome, distribution and accessibility of the TB facility to all individuals or groups in the community are unknown. Dot-spot mapping of TB patient with TB control facilities is our priority for providing important information for TB control program

 

Keywords

Tuberculosis, Geographical variation, coastal area.