Pulmonary Tuberculosis Treatment Failure in Coastal Poasia: Determinants from a Case-Control Study [Accepted]

Abstract

Tuberculosis remains a public health concern, particularly in coastal communities where access to healthcare services is limited and social conditions differ from other settings. This study aimed to examine factors associated with pulmonary tuberculosis treatment failure at the primary healthcare level in coastal areas. A case-control design was applied, involving 48 participants consisting of 24 cases and 24 controls. Data were obtained from the tuberculosis program registry and structured interviews. Bivariate analysis using the chi-square test was conducted to identify candidate variables (p ≤ 0.25), followed by binary logistic regression. The findings showed that treatment adherence was the only factor that remained associated with treatment failure after adjustment for other variables (AOR = 14.81; p = 0.016). Other variables, including distance to health facilities, knowledge, history of comorbid disease, family support, anxiety, and the role of the treatment supervisor (PMO), were not statistically significant in the multivariable analysis, although some showed a tendency toward association. These results suggest that successful tuberculosis treatment is not determined solely by clinical conditions but is closely related to patients’ consistency in following treatment. Strengthening adherence should therefore be a key priority to improve treatment outcomes, particularly in coastal communities.