Rationality of Tuberculosis Treatment for Drug-Susceptible Pulmonary Tuberculosis at a Primary Care in Bandung
Abstract
Tuberculosis (TB) remains a significant global health concern, particularly in Indonesia. Ensuring rational TB treatment is crucial for effective disease control and preventing the emergence of drug resistance. This study aimed to evaluate the rationality of TB treatment among newly diagnosed drug-susceptible pulmonary TB patients in a primary care center in Bandung. A descriptive-analytical study was conducted on 56 patients who met the inclusion and exclusion criteria. Treatment rationality was assessed based on the Indonesian Society of Respirology 2021 and the National Guidelines for Medical Services 2020. While 100% of patients received the correct medication for the right indication and dose, the duration of therapy was suboptimal for most patients (83.93%) due to drug unavailability. This resulted in a lower-than-ideal treatment regimen, potentially compromising treatment outcomes and increasing the risk of drug resistance. These findings highlight the need for improved drug supply management and adherence to treatment guidelines to optimize TB treatment outcomes and reduce the burden of TB in Indonesia.
Full text article
References
2. Ghebreyesus TA, Kasaeva T, Abena JL, Abaakouk Z, Bhatia V, Clobanu A, et al. Global Tuberculosis Report 2022. Geneva: World Health Organization; 2022.
3. Kaaffah S, Kusuma IY, Renaldi FS, Lestari YE, Pratiwi ADE, Bahar MA. Knowledge, Attitudes, and Perceptions of Tuberculosis in Indonesia: A Multi-Center Cross-Sectional Study. Infect Drug Resist. 2023;16:1787-800. DOI: 10.2147/idr.s404171; PMCID: PMC10066633; PMID: 37013169
4. Dinas Kesehatan Kota Bandung. Profil Kesehatan Kota Bandung Tahun 2022. Bandung; Dinas Kesehatan Kota Bandung; 2023.
5. Tuniroh. Risk Factors for Tuberculosis in Bogor Regency. Proceeding Muhammadiyah International Public Health and Medicine Conference - Second Edition. 2022;2(1):113-8.
6. Isbaniah F, Burhan E, Sinaga BY, Yanifitri DB, Handayani D, Harsiu, et al. Tuberkulosis: Pedoman Diagnosis dan Penatalaksanaan di Indonesia. Jakarta: Perhimpunan Dokter Paru Indonesia; 2021.
7. Doko JK, Rengga MPE, Klau ME. Evaluasi Penggunaan Obat Antituberkulosis pada Pasien Baru Tuberkulosis Paru di Puskesmas Sikumana Tahun 2018. CHMK Pharm Sci J. 2020;3(1):97-102.
8. Burhan E, Soeroto AY, Isbaniah F, Kaswandani N, Wahyuni, Uyainah A, et al. Pedoman Nasional Pelayanan Kedokteran: Tata Laksana Tuberkulosis. Jakarta: Kementerian Kesehatan Republik Indonesia; 2020.
9. Sazali MF, Rahim SSSA, Mohammad AH, Kadir F, Payus AO, Avoi R, et al. Improving Tuberculosis Medication Adherence: The Potential of Integrating Digital Technology and Health Belief Model. Tuberc Respir Dis. 2023;86(2):82-93. DOI: 10.4046/trd.2022.0148; PMCID: PMC10073608; PMID: 36597583
10. WHO International Working Group for Drug Statistics Methodology, WHO Collaborating Centre for Drug Statistics Methodology, WHO Collaborating Centre for Drug Utilization Research Clinical Pharmacological Services. Introduction to Drug Utilization Research. Geneva: World Health Organization; 2003.
11. Dong Z, Wang QQ, Yu SC, Huang F, Liu JJ, Yao HY, et al. Age–period–cohort analysis of pulmonary tuberculosis reported incidence, China, 2006–2020. Infect Dis Poverty. 2022;11(1):85. DOI: 10.1186/s40249-022-01009-4; PMCID: PMC9331155; PMID: 35902982
12. Humayun M, Chirenda J, Ye W, Mukeredzi I, Mujuru HA, Yang Z. Effect of Gender on Clinical Presentation of Tuberculosis (TB) and Age-Specific Risk of TB, and TB-Human Immunodeficiency Virus Coinfection. Open Forum Infect Dis. 2022;9(10):ofac512. DOI: 10.1093/ofid/ofac512; PMCID: PMC9620549; PMID: 36324321
13. Fraga ADSS, Oktavia N, Mulia RA. Evaluasi Penggunaan Obat Anti Tuberkulosis Pasien Baru Tuberkulosis Paru di Puskesmas Oebobo Kupang. J Farmagazine. 2021;8(1):17-24. DOI: 10.47653/farm.v8i1.530
14. World Health Organization. WHO eTB Guidelines. Geneva: World Health Organization; 2023. Available from: https://who.tuberculosis.recmap.org/
15. Laycock KM, Enane LA, Steenhoff AP. Tuberculosis in Adolescents and Young Adults: Emerging Data on TB Transmission and Prevention among Vulnerable Young People. Trop Med Infect Dis. 2021;6(3):148. DOI: 10.3390/tropicalmed6030148; PMCID: PMC8396328; PMID: 34449722
16. Nahid P, Dorman SE, Alipanah N, Barry PM, Brozek JL, Cattamanchi A, et al. Official American Thoracic Society/Centers for Disease Control and Prevention/Infectious Diseases Society of America Clinical Practice Guidelines: Treatment of Drug-Susceptible Tuberculosis. Clin Infect Dis. 2016;63(7):e147-95. DOI: 10.1093/cid/ciw376; PMCID: PMC6590850; PMID: 27516382
17. Gallardo CR, Comas DR, Rodríguez AV, Figuls MR, Parker LA, Caylà J, et al. Fixed-dose combinations of drugs versus single-drug formulations for treating pulmonary tuberculosis. Cochrane Database Syst Rev. 2016;2016(5):CD009913. DOI: 10.1002/14651858.cd009913.pub2; PMCID: PMC4916937; PMID: 27186634
18. Cattamanchi A, Miller CR, Tapley A, Haguma P, Ochom E, Ackerman S, et al. Health worker perspectives on barriers to delivery of routine tuberculosis diagnostic evaluation services in Uganda: A qualitative study to guide clinic-based interventions. BMC Health Serv Res. 2015;15:10. DOI: 10.1186/s12913-014-0668-0; PMCID: PMC4307676; PMID: 25609495
19. Rabahi MF, Júnior JLRdS, Ferreira ACG, Tannus-Silva DGS, Conde MB. Tuberculosis treatment. J Bras Pneumol. 2017;43(6):472-86. DOI: 10.1590/s1806-37562016000000388; PMCID: PMC5792048; PMID: 29340497
20. Tirore LL, Ersido T, Handiso TB, Areba AS. Non-adherence to anti-tuberculosis treatment and associated factors among TB patients in public health facilities of Hossana town, Southern Ethiopia, 2022. Front Med. 2024;11:1360351. DOI: 10.3389/fmed.2024.1360351; PMCID: PMC10954787; PMID: 38515986
21. Melku L, Wubetu M, Dessie B. Irrational drug use and its associated factors at Debre Markos Referral Hospital's outpatient pharmacy in East Gojjam, Northwest Ethiopia. SAGE Open Med. 2021;9:20503121211025146. DOI: 10.1177/20503121211025146; PMCID: PMC8202335; PMID: 34178342
22. Dartois VA, Rubin EJ. Anti-tuberculosis treatment strategies and drug development: challenges and priorities. Nat Rev Micobiol. 2022;20(11):685-701. DOI: 10.1038/s41579-022-00731-y; PMCID: PMC9045034; PMID: 35478222
23. Sahile Z, Tezera R, Mariam DH, Collins J, Ali JH. Nutritional status and TB treatment outcomes in Addis Ababa, Ethiopia: An ambi-directional cohort study. PLoS One. 2021;16(3):e0247945. DOI: 10.1371/journal.pone.0247945; PMCID: PMC7924797; PMID: 33651842
24. Yayan J, Franke KJ, Berger M, Windisch W, Rasche K. Early detection of tuberculosis: a systematic review. Pneumonia. 2024;16(1):11. DOI: 10.1186/s41479-024-00133-z; PMCID: PMC11225244; PMID: 38965640
25. Cole B, Nilsen DM, Will L, Etkind SC, Burgos M, Chorba T. Essential Components of a Public Health Tuberculosis Prevention, Control, and Elimination Program: Recommendations of the Advisory Council for the Elimination of Tuberculosis and the National Tuberculosis Controllers Association. MMWR Recomm Rep. 2020;69(7):1-27. DOI: 10.15585/mmwr.rr6907a1; PMCID: PMC7392523; PMID: 32730235
Authors
Copyright (c) 2024 Alfi Nurul Islamiyah, Syarifuddin Syarifuddin, Morsalina Akhsa, Iis Rukmawati, Eni Margayani, Linda Purnamawati Suherman, Vina Septiani, Robby Ramdani
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
Authors continue to retain the copyright to the article if the article is published in the Borneo Journal of Pharmacy. They will also retain the publishing rights to the article without any restrictions.
Authors who publish in this journal agree to the following terms:
- Any article on the copyright is retained by the author(s).
- The author grants the journal the right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share work with an acknowledgment of the work authors and initial publications in this journal.
- Authors can enter into separate, additional contractual arrangements for the non-exclusive distribution of published articles (e.g., post-institutional repository) or publish them in a book, with acknowledgment of their initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their websites) prior to and during the submission process. This can lead to productive exchanges and earlier and greater citations of published work.
- The article and any associated published material are distributed under the Creative Commons Attribution-ShareAlike 4.0 International License.