Path Analysis on the Determinants of Adherence to Anti Tuberculosis Drug Treatment in Kaur District, Bengkulu, Indonesia

Abstract

Background: Drug treatment compliance was the behavior of patients to take medication and undergo treatment according to the rules determined by professional health personnels. Many factors influenced the compliance with treatment for tuberculosis patients. This study aimed to examine determinants of drug treatment compliance among tuberculosis patients. Subject s and Method: This was an analytic observational study with a cross-sectional design. The study was conducted at 16 community health centers in Kaur Regency, Bengkulu, Indonesia, from January to February 2019. A sample of 206 study subjects was selected by purposive sampling. The dependent variable was drug treatment adherence. The indepen­dent variables were age, gender, education, income, knowledge, role of drug taking supervisor, side effect of drug treatment, distance to health service, drug availability, family support, and tenure. The data were collected by questionnaire and analyzed by path analysis. Results : Adherence to anti tuberculosis treatment was directly and positively affected by age (b= 2.96; CI 95%= 1.12 to 4.79; p= 0.002), gender (b= 1.48; CI 95%= 0.02 to 2.95; p= 0.047), education (b= 2.18; CI 95%= 0.24 to 4.11; p= 0.027), income (b= 0.85; CI 95%= 0.76 to 2.45; p= 0.031), knowledge (b= 2.27; CI 95%= 0.32 to 4.22; p= 0.023), the role of drug taking supervisor (b= 3.46; CI 95%= 1.57 to 5.36; p<0.001), drug availability (b= 0.04; CI 95%= -6.07 to 6.16; p= 0.989), and family support (b= 2.97; CI 95%= 1.30 to 4.64; p<0.001). It was negatively affected by the side effects of the drug (b= -3.07; CI 95%= -4.90 to -1.24; p= 0.001), distance to health service (b= -1.86; CI 95%= -3.61 to -0.11; p= 0.037), and tenure (b= -2.16; CI 95%= -3.95 to -0.38; p= 0.017). Adherence to anti tuberculosis treatment was indirectly affected by income, knowledge, and role of drug treatment supervisor. Conclusion: Adherence to anti tuberculosis treatment is directly and positively affected by age, gender, education, income, knowledge, the role of drug taking supervisor, drug availability, and family support. It is negatively affected by the side effects of the drug, distance to health service, and tenure. Keywords : treatment adherence, tuberculosis, determinants, path analysis Correspondence: Surahman Hamidi. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: surahmanhamidi@student.uns.ac.id. Mobile: 085267­456713. Journal of Epidemiology and Public Health (2019), 4(3): 205-214 https://doi.org/10.26911/jepublichealth.2019.04.03.08