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Association between DOTS program and the outcome of previous therapy in MDR-TB patients: a case study in Tasikmalaya district, West Java, Indonesia


Mira Miratul Jannah , Ivan S. Pradipta , Prayudi Santoso , Irma M. Puspitasari

Abstract

Background: Multi-Drug Resistant Tuberculosis (MDR-TB) had been the major health problem in Indonesia. The Directly Observed Treatment Shortcourse (DOTS) is the internationally recommended strategy for TB control that has been recognized as a highly efficient and cost-effective strategy. Tasikmalaya district is one of the districts in West Java with a high prevalence of TB. The aim of this study was to determine the association between DOTS and the failure of previous therapies in MDR-TB patients from Tasikmalaya district. Methods: This study was a preliminary study in analyzing risk factors of MDR-TB in West Java. The patient data was obtained from medical records in January 2015-March 2018 from major TB referral hospitals. All subjects included in this study were adult patients confirmed with MDR-TB with GeneXpert test from Tasikmalaya district and had complete data. Chi-square analysis was performed to determine the association. Results: The total number of subjects included in this study was 31 patients comprised of 19 male (61.3%) and 12 female (38.7%). Twenty subjects (64.5%) received their previous treatment in the DOTS program, and 11 subjects (35.5%) received their treatment in a non-DOTS program. The proportion of outcome (failure and non-failure) of previous therapy was 74.2% to 25.8% ; respectively. The result revealed that the association between the DOTS program and the outcome of previous therapy in MDR-TB was not significant (P=0.251). Conclusion: Although this study had limitations, it showed that there was no association between the DOTS program and the outcome of previous therapy in MDR-TB patients in the Tasikmalaya district.



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