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A DETERMINANT MODEL OF TUBERCULOSIS TREATMENT COMPLIANCE MANAGEMENT BASED ON BEHAVIOR, FAMILY SUPPORT, AND HEALTH WORKERS: BATAM CASE STUDY
Abstract
Adherence to Anti-Tuberculosis Drugs (ATD) is a primary determinant of successful TB therapy and prevention of drug resistance. Non-adherence significantly contributes to treatment failure, relapse, and increased public health burden, especially in high-mobility urban areas such as Batam City. The novelty of this study lies in the simultaneous integration of patient behavior, family support, and healthcare worker roles into a single determinant model of TB treatment adherence management in an archipelago urban context. This study aimed to analyze factors affecting ATD adherence among pulmonary TB patients at Baloi Permai Primary Health Center, Batam. A quantitative cross-sectional study with a statistical model output was conducted on 142 pulmonary TB patients undergoing treatment from July 2025 to April 2026 using total sampling. Data were collected through validated structured questionnaires and analyzed using chi-square tests and Backward Stepwise logistic regression. Bivariate analysis revealed that attitude (p=0.043) and family support (p=0.001) significantly influenced ATD adherence. Multivariate analysis identified family support as the dominant determinant with an Odds Ratio of 6.313 (95% CI=1.557–25.606; p=0.010), indicating that patients receiving good family support were 6.313 times more likely to adhere to treatment than those without adequate support. It is concluded that family support is the primary determinant of ATD adherence. Strengthening family involvement in TB management programs at primary health centers, through education, motivation, and optimization of family Drug Supervision roles, should be prioritized as an intervention strategy.
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WHO. WHO Global Tuberculosis Report 2023, World Health Organization, Geneva. January. 2023.
Saunders MJ, Montoya R, Quevedo L, Ramos E, Datta S, Evans CA. The social determinants of tuberculosis: a case-control study characterising pathways to equitable intervention in Peru. Infect Dis Poverty. 2025; 14(1). doi:10.1186/s40249-025-01324-6
Alsoukhni MA, Khader Y, Abaza H, Wilson N, Satyanarayana S. Tuberculosis-related knowledge, behaviors, stigmatizing attitude, and discrimination among refugees, migrants, and the general population in Jordan. SAGE Open Med. 2023;11. doi:10.1177/20503121231187743
Jang YR, Lee MA. A study of relationships among tuberculosis knowledge, family support, and medication adherence in tuberculosis patients. Journal of Korean Academic Society of Nursing Education. 2022; 28(1). doi:10.5977/jkasne.2022.28.1.80
Jiangjing F, Meng Z, Zuhui X, Chuanfang Z. Analysis of occupational satisfaction and associated factors among tuberculosis health management staff in primary healthcare institutions in Hunan Province. Chinese Journal of Antituberculosis. 2025; 47(7). doi:10.19982/j.issn.1000-6621.20250020
Nabila N. Factors Influencing Compliance with Anti-Tuberculosis Drugs (OAT) in Patients with Pulmonary Tuberculosis (TB): Literature Review. Indonesian Health Promotion Publication Media (MPPKI). 2023; 6(8). doi:10.56338/mppki.v6i8.3484
Barry M. TB Incidence Trends in the Kingdom of Saudi Arabia within the GCC, EMR, and MENA Regions, to Achieve the WHO and UN's SDG End TB Strategy Targets. J Epidemiol Glob Health. 2025; 15(1). doi:10.1007/s44197-025-00442-6
Milu SF, Umanahu SF, Rufianti, Syaqila SA, Rusmin. A Descriptive Analysis of Tuberculosis Deaths in Bandar Lampung City, Indonesia, 2017–2021. Journal of Epidemiology and Health Science. 2025; 2(3). doi:10.36685/jehs.v2i3.1433
Galuh Anissa Sekar Ayu, Arvhi Mega Utami, Nazwa Andhin Kirani, Reza Pahlevi. Slum Management: A Case Study of Rumah Harapan Joint Production for Tuberculosis Control and Sustainable Development in Central Jakarta. Journal of Social Development Studies. 2025; 5(2). doi:10.22146/jsds.15205
Riansyah F, Fitria F, Fitri A, Fazira F, Saputra M, Usman S, et al. The Application of Continuity of Care (COC) in Improving the Recovery of Patients with Pulmonary Tuberculosis. Medical Journal (Health Information Media). 2024; 11(2). doi:10.36743/medikes.v11i2.817
Herdianti H, Oktarizal H, Martha E, Sembiring FY, Dinilhaq F. Education and Campaigns for the Prevention of Infectious Diseases (Hiv-Aids And Tuberculosis) in the Workplace. Mrs. Indonesia. 2025; 7(1). doi:10.37296/jpi.v7i1.368
Mahartati NMN, Syarif S. Risk Factors of Treatment Failure among Pulmonary Tuberculosis Patients: Systematic Review. Indonesian Health Promotion Publication Media. 2024; 7(4). doi:10.56338/mppki.v7i4.5157
Sari CY, Parisma WI, Husein AH, Hutabarat JRB. Determination of risk factors for pulmonary tuberculosis in patients of Puskesmas X Batam City. Jambura Journal of Health Sciences and Research. 2025; 7(4). doi:10.35971/jjhsr.v7i4.34007
Agusdiani Nurjanah L. Risk Factors for Treatment Compliance in Pulmonary Tuberculosis Patients at the Cigombong District Health Center. Jurnal Pustaka Medika (Center for Access to Medical and Public Health Studies). 2025; 3(2). doi:10.55382/jurnalpustakamedika.v3i2.222
Tan EL, Qin Y, Yang J, Li XJ, Liu TQ, Yang GB, et al. Global burden of MDR-TB and XDR-TB: trends, inequities, and future implications for public health planning. BMC Infect Dis. 2025; 25(1). doi:10.1186/s12879-025-11566-2
Chin KL, Anibarro L, Chang ZY, Palasuberniam P, Mustapha ZA, Sarmiento ME, et al. Impacts of MDR/XDR-TB on the global tuberculosis epidemic: Challenges and opportunities. Current Research in Microbial Sciences. 2024. doi:10.1016/j.crmicr.2024.100295
Rosenstock IM, Strecher VJ, Becker MH. Social Learning Theory and the Health Belief Model. Health Education & Behavior. 1988; 15(2). doi:10.1177/109019818801500203
Maulana MR, Nanik Aryani Putri, Qurrotu A'yuni Auliya, Eko Naning Sofyanita. The Relationship of Knowledge, Attitudes, and Behavior to Medication Compliance of TB Patients in Semarang City. Echoes of the Health Environment. 2024; 22(1). doi:10.36568/gelinkes.v22i1.99
Ahmad Auli Revonadi, Dyah Wulan Sumekar Rengganis Wardani, Arif Yudho Prabowo, Retno Ariza Soeprihatini Soemarwoto. The Relationship of Knowledge, Attitudes, Preventive Behaviors and the Incidence of Pulmonary Tuberculosis at the Bandarlampung Kedaton Health Center. Journal of Health, Medical, and Psychological Studies. 2026; 1(2). doi:10.65310/k57qga58
Namuwali D, Hara MK, Nurwela TS, Banhae YK. The Relationship Between Family Support and Adherence to Taking Medication in Pulmonary TB. Indonesian Journal of Global Health Research. 2023; 5(4).
Alinaitwe B, Shariff NJ, Madhavi Boddupalli B. Treatment adherence and its association with family support among pulmonary tuberculosis patients in Jinja, Eastern Uganda. Sci Rep. 2025; 15(1). doi:10.1038/s41598-025-96260-8
Mariska RD, Lestari T, Pramestirini RA. The Role of Health Workers and Drug Intake Supervisors with Medication Compliance in Tuberculosis Patients. Florence Nightingale Journal of Nursing. 2025; 8(1). doi:10.52774/jkfn.v8i1.381
Widiastutik GK, Makhfudli M, Wahyuni SD. The Relationship between Family, Cadre and Health Worker Support with Treatment Compliance of Pulmonary TB Patients. Indonesian Journal of Community Health Nursing. 2020; 5(1). doi:10.20473/ijchn.v5i1.18654
Hasina SN, Rahmawati A, Faizah I, Sari RY, Rohmawati R. The Relationship between Knowledge Level and Compliance with Anti-Tuberculosis Drugs (OAT) in Pulmonary Tuberculosis Patients. Permas Scientific Journal: STIKES Kendal Scientific Journal. 2023; 13(2). doi:10.32583/pskm.v13i2.908
Nurannisyah R, Najmah N, Apritama F, Rapika Dianita N, Damai Kasih Waruwu P, Khoirunnisa K, et al. Distribution of Pulmonary Tuberculosis Cases by Age, Gender, and Program Achievement at the Bukit Sangkal Health Center, Palembang in 2024. JUKEJ: Journal of Jompa Health. 2025; 4(1). doi:10.57218/jkj.vol4.iss1.1505
Amaliah L, Rosdiana, Wahyudi T, Wirda. Determinants of Incidence of Pulmonary TB in Productive Age. Encyclopedia of Journals. 2025; 7(3).
Ntwari J, Ndiaye R, Mwiseneza L, Habimana Y, Seruyange E, Sebatunzi O, et al. Epidemiology and outcomes of multidrug-resistant tuberculosis in Rwanda. Infect Dis Now. 2026; 56(1). doi:10.1016/j.idnow.2025.105200
Chandra BFNWD. Risk Factors for the Increase in Multidrug-Resistant Tuberculosis (MDR-TB) Cases in Indonesia: A Review of the Literature. Journal of Nursing Muhammadiyah. 2025; 10(1).
Mariani H, Afriandi I, Setiawati EP, Gondodiputro S, Wiwaha G, Nataprawira HM, et al. Tuberculosis Family Support Training's (TB FaST) Influence on Encouraging TB Treatment Compliance. Open Public Health J. 2022; 15(1). doi:10.2174/18749445-v15-e2208041
Arsyad MR. The Relationship of Family Support with Medication Adherence in Patients with Pulmonary Tuberculosis. Wiyata Nursing Journal. 2024; 5(2).
Nindrea Rd, Ming Lc, Agustian Dr. Family Support, Motivation, And Patient Adherence To Tuberculosis Treatment: Insights From Indonesia. Afr J Infect Dis. 2025; 19(2). doi:10.21010/Ajidv19i2.5
Yuliastina R, Liyanto L, Ahmaniyah A. Empowerment of TB health cadres through the TB Report Application in conducting screening, contact investigation (IK) and drug swallowing supervision (PMO) in Grujugan village, Sumenep Madura Regency. SOLMA Journal. 2025; 14(1). doi:10.22236/solma.v14i1.17243
WHO DR TB Guidline 2025. Consolidated Guidelines on Tuberculosis Treatment. Who. 2025.
Suprijandani S, Setiawan S, Pathurrahman P, Wardoyo S, Rahayyu AM. The behaviour of TB patients in East Lombok through a health belief model approach. J Health Popul Nutr. 2025; 44(1). doi:10.1186/s41043-025-00746-0
Khoda P, Bajiya VP, Prasad SN, Meena OP. Mathematical modeling of tuberculosis transmission dynamics: assessing vaccination impact with environmental transmission and reinfection. J Appl Math Comput. 2026; 72(1). doi:10.1007/s12190-025-02659-x
Putri SR, Ieva Baniasih Akbar, Dony Septriana. The Relationship between Knowledge Level and Attitudes Regarding the Prevention of Pulmonary Tuberculosis Transmission in the Banjar Village Community. Bandung Conference Series: Medical Science. 2023; 3(1). doi:10.29313/bcsms.v3i1.6678
Sugiarto S, Herdianti H, Entianopa E. Knowledge, Perception, Self Efficacy and Interpersonal Influence of Sufferers on the Prevention of Pulmonary TB Transmission (Descriptive Study). Gorontalo Journal of Public Health. 2018 Oct 29. doi:10.32662/gjph.v1i2.274
Achhami E, Lamichhane S, Mahaju S, Kandel A, Poudel A, Kc R. Unregulated medication use and complications: a case study of prolonged self-treated tuberculosis in Nepal. BMC Infect Dis. 2023; 23(1). doi:10.1186/s12879-023-08637-7
Kaumba PC, Siameka D, Kagujje M, Chungu C, Nyangu S, Sanjase N, et al. Knowledge, attitudes, and practices towards childhood tuberculosis among healthcare workers at two primary health facilities in Lusaka, Zambia. PLoS One. 2024; 19(3 March). doi:10.1371/journal.pone.0287876
Nasrullah, Aprianti R, Amanda D. Factors Affecting Self-Care Compliance of Pulmonary Tuberculosis Patients. Garuda Pelamonia Journal of Nursing. 2023; 5(2).
Adejumo OA, Daniel OJ, Jinabhai C, Haffejee F. Treatment Adherence among People with Drugresistant Tuberculosis in Lagos Nigeria: The Effects of Stigma, Resilience, Social Support, and Temporal Discounting. Int J Mycobacteriol. 2025; 14(1). doi:10.4103/ijmy.ijmy_209_24
Herdianti H, Entianopa E, Sugiarto S. Effect Of Patient's Personal Character On Prevention Of Transmission Of Pulmonary TB. Indonesian Journal of Tropical and Infectious Disease. 2020 Mar 19. doi:10.20473/ijtid.v8i1.12318
Fadillah LK, Safitri A, Puspita Sari R. The Relationship Between Family Characteristics and Family Support and Patient Compliance Level in the Treatment of Pulmonary TB at the Curug Health Center. Journal of Nursing Media Research. 2025; 8(1). doi:10.51851/jrmk.v8i1.541
Ziliwu JBP, Girsang E. The Relationship Of Knowledge And Attitudes Towards Medication Adherence In Tuberculosis Patients In Medan Pulmonary Specialty Hospital. Jambura Journal of Health Sciences and Research. 2022; 4(3). doi:10.35971/jjhsr.v4i3.16540
Ke Jump Y, Wahyuni CU, Bebengu YB, Sondakh CS. Evaluation of the tuberculosis surveillance system based on the system approach in Kupang Regency, East Nusa Tenggara Province. Jambura Journal of Health Sciences and Research. 2024; 6(2). doi:10.35971/jjhsr.v6i2.22308
DOI: https://doi.org/10.35971/jjhsr.v8i3.38960
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