The Analysis of Missing Cases on the Treatment of Rifampicin-Resistant Tuberculosis

Abstract

To describe the follow-up treatment of Resistant Rifampicin in health care facilities based on the results of the gene-Xpert examination. The study design was cross-sectional using data from "Evaluation study of detection of TB cases with the rapid molecular test in Indonesia in 2018". The data resources were from 42 hospitals and two primary health care facilities having conducted the gene-Xpert examination at least six months in 42 districts, 26 provinces in Indonesia. The number of TB diagnoses with gene-Xpert from health facilities was 33,630 cases, 31.6% of those cases were TB positive, namely rifampicin sensitivity of 89% (9,456) and rifampicin-resistant of 11% (1,171). 29% of resistant rifampicin tuberculosis cases were missing cases consisting of the untreated and unknown follow-up treatment of 18% and 11%, respectively. Missing cases were mostly found in males of 66.1%. Based on the age, 76.9% of the missing cases were in productive age, such as 15 to 54 years. Moreover, according to the TB treatment history and origin of the case, missing cases were found in new cases, 54.4%, and the existing health facility 51.2%. The most reason for missing the RR-TB case in the follow-up treatment was the refusal of treatment 40.3%. The high non-compliance to TB treatment was caused by inadequate general knowledge about TB, lack of social support, medication side effects, and long treatment period, which were posed as barriers to adherence to treatment.