The research was conducted by Henderyana Arrang Pantan, Hasmi, Sarce Makaba, Arius Togodly, Novita Medyati, and Rosmin Mariati Tingginehe from the Master of Public Health Program, Faculty of Public Health, Cenderawasih University Jayapura. The study appeared in the Formosa Journal of Science and Technology (FJST) Volume 5 Number 4, 2026.
The findings are important because treatment interruption, commonly known as loss to follow-up (LTFU), remains one of the biggest barriers to tuberculosis control in Indonesia. Patients who stop treatment early risk worsening illness, continued disease transmission, and the development of drug-resistant tuberculosis, which is more difficult and expensive to treat.
Tuberculosis Remains a Global Public Health Threat
Tuberculosis continues to be one of the world’s deadliest infectious diseases. The World Health Organization (WHO) has targeted major reductions in TB incidence and mortality by 2035, yet many countries are still struggling to meet treatment success targets.
Indonesia remains among the countries with a high TB burden. According to national health data cited in the study, Indonesia’s TB treatment success rate reached only 85.9 percent in 2022, below the government target of 90 percent. One of the main causes is the continuing high rate of patients who discontinue treatment.
In West Papua Province, the situation is particularly concerning. Regional health office reports show that LTFU rates have remained consistently high over the past several years. In Teluk Bintuni Regency, the number of TB cases has continued to rise annually, increasing pressure on local health services.
At the Bintuni Health Center specifically, nearly half of TB patients failed to complete treatment in 2023. Although the percentage declined in 2024 and early 2025, the rate remains well above the WHO standard of less than 5 percent.
How the Research Was Conducted
The research team analyzed medical records of 245 tuberculosis patients registered at the Bintuni Health Center between January 2024 and August 2025.
The study used an observational cross-sectional approach based on secondary data from the TB treatment register. Researchers examined several factors potentially linked to treatment interruption, including:
- age
- gender
- education level
- employment status
- distance to health facilities
- medication side effects
- treatment supervisors
- ethnic background
The data were evaluated using statistical analysis to determine which factors had the strongest relationship with treatment discontinuation.
Key Findings From the Study
The study found that 65 out of 245 patients, or 26.5 percent, experienced loss to follow-up during treatment.
Three factors showed a significant relationship with treatment interruption:
- low education level
- unemployment
- side effects from anti-tuberculosis medication
Among all variables, medication side effects were identified as the most dominant factor.
Researchers reported that patients experiencing drug side effects were approximately 4.5 times more likely to stop treatment compared with patients who did not experience side effects.
Common side effects included nausea, dizziness, weakness, vomiting, and other physical discomforts associated with long-term anti-TB therapy.
The study also found that patients with lower educational backgrounds were more likely to discontinue treatment. Limited understanding of tuberculosis, treatment duration, and the dangers of stopping medication early contributed to poor adherence.
Employment status also played a major role. Patients without stable jobs were more vulnerable to treatment interruption because of financial hardship, transportation costs, nutritional limitations, and social stress during the lengthy treatment process.
Several factors did not show a statistically significant relationship with treatment interruption, including:
- age
- gender
- distance to health facilities
- medication supervisors
- ethnicity
Even though distance was not statistically significant, researchers noted that geographic barriers in Papua still affect healthcare access in many communities.
Why Patients Stop Treatment
The study highlights how side effects can discourage patients from continuing therapy even when symptoms begin to improve.
According to the researchers from Cenderawasih University, many patients decide to stop taking medication because they fear the side effects more than the disease itself. Patients often feel physically exhausted and may assume they are already healthy enough to stop treatment.
The researchers also emphasized that education level strongly influences a patient’s ability to understand medical instructions and the long-term importance of completing TB treatment.
Hasmi and colleagues from Cenderawasih University explained that TB treatment programs should not focus only on distributing medication. Patients also need consistent communication, emotional support, and practical assistance during therapy.
The study recommends that health workers provide simpler educational materials, use repeated counseling, and conduct more active follow-up for high-risk patients.
The researchers also encouraged stronger collaboration between healthcare facilities and community-based TB support programs to reduce treatment interruption rates.
Implications for Public Health Policy
The findings have significant implications for tuberculosis control programs in Indonesia, especially in eastern regions with limited healthcare infrastructure.
The study suggests that healthcare providers should strengthen monitoring systems for patients experiencing medication side effects. Early intervention may prevent patients from abandoning treatment entirely.
The researchers also recommend more patient-centered TB services, including:
- regular side-effect consultations
- home visits for high-risk patients
- treatment reminders
- nutritional and social support programs
- improved counseling strategies for low-literacy patients
Public health experts have long warned that rising rates of treatment interruption could contribute to the spread of drug-resistant tuberculosis across Indonesia.
By identifying the factors most closely linked to treatment discontinuation, the research from Cenderawasih University provides evidence that may help policymakers improve TB treatment retention strategies in Papua and other high-burden regions.
Author Profiles
Henderyana Arrang Pantan is a public health researcher from the Master of Public Health Program, Faculty of Public Health, Cenderawasih University Jayapura, Indonesia.
Dr. Hasmi is a lecturer and public health researcher at the Faculty of Public Health, Cenderawasih University Jayapura. His expertise includes epidemiology, tuberculosis control, and community health research.
Co-authors Sarce Makaba, Arius Togodly, Novita Medyati, and Rosmin Mariati Tingginehe are also affiliated with the Master of Public Health Program at Cenderawasih University and actively conduct research on public health challenges in Papua.
Source
Pantan, Henderyana Arrang, Hasmi, Sarce Makaba, Arius Togodly, Novita Medyati, and Rosmin Mariati Tingginehe. Determinants of Incidence of Loss to Follow-up in Tuberculosis Patients at Bintuni Health Center. Formosa Journal of Science and Technology (FJST), Vol. 5 No. 4, 2026.
0 Komentar