The Sustainability Approach to Treatment of DR-TB Patients through Community Social Organization (Aisyiyah)

Abstract

Multidrug-resistant tuberculosis (MDR-TB) is currently an important public health problem in the world. Treatment of MDR-TB patients takes a long time, 20-24 months in standard regimen or 9-11 months in shorter regimen. Long treatment duration and drug toxicities which higher than drug-sensitive TB can cause drop out of treatment. Aisyiyah is a community social organization which provide assistance to TB patients in order to complete the treatment within specified time period. This study aimed to compare the outcome of DR-TB patients assisted by Aisyiyah and those who did not. A retrospective study was conducted Dr. Soetomo General Academic Hospital, Surabaya, Indonesia. Data was taken from DR-TB patients medical record since October 2014 until December 2017. There were 434 MDR-TB patients in the period of October 2014 to December 2017, with 75 patients (17.28%) received assistance from Aisyiyah. The average age was 44.38 ± 12.28 years old. Comparison between those who were assisted and not, from the male sex (49.3% vs 60.2%), women (50.7% vs 39.8%); based on resistance pattern: (5.3% vs 10.3%) from MDR TB, (85.3% vs 75.5%) from RR, (2.7% vs 8.1%) from XDR; Outcome obtained: Cure (1.6% vs 15.0%; p=0,031), Treatment completion (0.0% vs 0.5%; p=0,517), Default (2.8% vs 28.3%; p=0,002); Failed (0.2% vs 1.6%; p=0,718); Death (1.6% vs 7.9%; p=0,965). There were significant correlations between cure and default outcome in DR-TB patients accompanied by Aisyiyah compared to those not accompanied.

A comparative analysis of the profile and treatment outcomes of tuberculosis patients managed at the community and primary health care facilities in Botswana

“…Community DOT clients were also likely to achieve a cured outcome. This finding is consistent with the results of previous systematic reviews and meta -analyses [22] , [23] , [24] and other studies in Indonesia [25] and South Africa [26] where CBDOT was reported to improve treatment cure and reduce the mortality rate. One plausible reason is that in CBDOT, patients with tuberculosis take medications under the direct supervision of a treatment supporter at home or in their community, allow family support, and eliminate long and costly trips to a centralized primary health facility.…”