International Journal of Science and Healthcare Research DOI: https://doi.org/10.52403/ijshr.20210461 Vol.6; Issue: 2; April-June 2021 Website: ijshr.com Research Paper ISSN: 2455-7587 Analysis of Education and Family Support Factor on Compliance with Taking Anti Tuberculosis Drugs (OAT) in Pulmonary Tuberculosis (TB) Patients in Tebing Tinggi City Evi Novalita Tarigan1, Rahayu Lubis2, Erna Mutiara3 1,2,3Universitas Sumatera Utara, Indonesia Corresponding Author: Evi Novalita Tarigan ABSTRACT health center (Puskesmas), and facilitate patients with an android-based OAT drinking calendar Indonesia ranks second in the world as a country application. that has the number of tuberculosis sufferers after India. Although directly observed short- Keywords: Education, Family Support, course treatment (DOTS) recommended by the Compliance with Taking Anti Tuberculosis World Health Organization (WHO) has proven Drugs (OAT) to be very effective in the treatment of tuberculosis, patient compliance with anti INTRODUCTION tuberculosis drugs (OAT) is a major obstacle in Tuberculosis is one of the ten controlling tuberculosis. The purpose of this leading causes of death in the world, and the study was to analyze of education and family leading cause of death caused by infectious support factors in compliance with taking anti diseases. The problem of TB in the world is tuberculosis drugs (OAT) in Pulmonary Tuberculosis (TB) Patients in Tebing Tinggi getting worse with the emergence of the City. The populations in this study were all HIV/AIDS pandemic, TB-RO and the tuberculosis patients in Tebing Tinggi City from incidence of Covid-19. It is estimated that January to December 2020. A sample of 78 the Covid-19 pandemic could cause an people was obtained using purposive sampling additional 6.3 million TB cases globally technique. This study uses multivariate analysis from 2020 to 2025 and an increase in with multiple Poisson regression test. The mortality by 1.4 million TB deaths (World results of multivariate analysis with multiple Health Organization, 2020). Poisson regression (p<0.05) showed that According to the World Health education (p=0.043; PR=1.539, 95%CI 1.013- Organization (2020) report, it is estimated 2.338) was associated with compliance with that there will be around 10 million new taking OAT in Tebing Tinggi City. Family support (p=0.008; PR=1.737, 95%CI 1.158- cases of tuberculosis sufferers in the world 2.604) was associated with compliance with in 2019. It is estimated that the number of taking OAT in Tebing Tinggi City. It is hoped deaths from TB disease among HIV that TB patients can increase their knowledge by negative people is 1.2 million people and attending counseling, counseling and home the number of deaths due to TB disease visits, following the rules of taking OAT and among HIV positive people is 208,000 immediately consulting with officers if they people. experience side effects of OAT. It is expected Indonesia ranks second in the world that families can provide motivation, seek as a country that has the number of information, accompany taking OAT, provide tuberculosis sufferers after India. Based on transportation for control to the community a report from the Kementerian Kesehatan International Journal of Science and Healthcare Research (www.ijshr.com) 351 Vol.6; Issue: 2; April-June 2021 Evi Novalita Tarigan et.al. Analysis of education and family support factor on compliance with taking anti tuberculosis drugs (OAT) in pulmonary tuberculosis (TB) patients in Tebing Tinggi City. (2020) the number of TB cases found in cases (1,016 cases), in 2017 it was 20.96 Indonesia (case detection rate percent (217 cases) of all estimated new TB tuberculosis/CDR) in 2019 decreased when cases (1,035), in 2018 it was 28.50 percent compared to 2018 where in 2018 the (291 cases) of all estimated new TB cases discovery of TB cases was 67.2 percent (1,021), in 2019 it was 24.84 percent (238 (566,623 cases) of all cases. New TB cases cases) of all estimated new TB cases (958 were estimated (843,000 cases) while in cases) and in 2020 it was 21, 54 percent 2019 only 64.5 percent (543,874 cases) of (215) of all estimated new TB cases (998 all new TB cases were estimated (843,000 cases) (Dinas Kesehatan Tebing Tinggi, cases) but when compared to 2017 the 2020). discovery of TB cases was only 42.8 percent Based on research conducted by (425,089/992,441 cases). Although the several researchers, there are several factors number of TB cases found is relatively that support the obedient attitude of TB increasing, the TB case finding rate (CDR) patients taking anti-tuberculosis (OAT) in Indonesia is still far below the standard drugs, namely research by Dhewi, Armiyati recommended by WHO, which is greater and Supriyono (2012) which states that than 90 percent. By province, in 2019 only knowledge, patient attitudes and family West Java (96.2%) and Gorontalo (94.6%) support are factors related to drinking had reached CDR figures above 90 percent compliance. According to Wulandari (2018) (in 1st and 2nd positions), while North research at the Rumah Sehat Terpadu Sumatra was only 47. 7 percent (in the 14th Hospital, the factors related to adherence to position) (Kementerian Kesehatan, 2020). medication for TB patients are the patient's Globally, efforts made to reduce the perception of the disease, the attitude of the incidence of tuberculosis in 2000-2018 have health worker, the perception of distance to shown a decline of 1.6 percent per year and the hospital, the role of the supervisor taking a decrease of 2 percent between 2017 and medication and the side effects of the drug. 2018. Cumulatively, the decline in the Budianto (2015) states that age and incidence of tuberculosis between 2015 and education are factors related to medication 2018 was only 6.3 percent. However, this adherence. number is still far from the target that must The purpose of this study was to be achieved between 2015 and 2020 in the analyze of education and family support strategy to end tuberculosis (END TB), factors in compliance with taking anti which is 20 percent. The number of deaths tuberculosis drugs (OAT) in Pulmonary from tuberculosis between 2015 and 2018 Tuberculosis (TB) Patients in Tebing Tinggi decreased by 11 percent. This amount only City. reaches a third of the 35 percent target to be achieved by 2020 (World Health RESEARCH METHODS Organization, 2019). The research design is cross Although directly observed short- sectional study. According to Ghazali et al course treatment (DOTS) recommended by in Sastroasmoro and Ismael (2014), the the World Health Organization (WHO) has measurement of variables in cross-sectional proven to be very effective in the treatment design research is not limited to being of tuberculosis, patient compliance with anti precise at the same time but has the meaning tuberculosis drugs (OAT) is a major that each subject is subjected to one obstacle in controlling tuberculosis. measurement without any follow-up or Tebing Tinggi City is part of North repetition of measurements (Sastroasmoro Sumatra Province which has a high number and Ismael, 2014) of tuberculosis sufferers. In 2016 the This research was conducted in nine coverage of TB case finding was 20.76 (9) Puskesmas which are technical percent (211 cases) of all estimated new TB implementing units (UPT) of the Tebing International Journal of Science and Healthcare Research (www.ijshr.com) 352 Vol.6; Issue: 2; April-June 2021 Evi Novalita Tarigan et.al. Analysis of education and family support factor on compliance with taking anti tuberculosis drugs (OAT) in pulmonary tuberculosis (TB) patients in Tebing Tinggi City. Tinggi City Health Office. The nine health which connects the East Cross and Central centers are Pabatu Health Center, Pasar Sumatra Cross through a diagonal cross on Gambir Health Center, Satria Health Center, the Tebing Tinggi, Pematang Siantar, Rantau Laban Health Center, Sri Padang Parapat roads., Balige and Siborong-borong. Health Center, Teluk Karang Health Center, The city of Tebing Tinggi consists of 5 sub- Rambung Health Center, Brohol Health districts and 35 urban villages with an area Center and Tanjung Marulak Health Center. of 38,438 km2 and a population of around The time of this research was carried out 164,323 people (2019) with a population from July 2020 to May 2021. density of 5,623 people/km2 with a regional The population in this study were all topography, generally flat and undulating tuberculosis patients in Tebing Tinggi City with an altitude above sea level between 18 from January to December 2020. A sample to 34 meters with an average annual rainfall of 78 people was obtained using purposive of 1,776 milli meters per year with an air sampling technique. This study uses humidity of 80 percent to 90 percent. multivariate analysis with multiple poisson Geographically, Tebing Tinggi City regression test. is located in Tebing Tinggi City, which is The dependent variable is the located at the geographical coordinates of variable that is influenced or which is the 03º 19´00" North Latitude - 03´ 21" 00" result of the independent variable (Murti, North Latitude and 98 11´ East Longitude - 2016). The dependent variable in this study 98º 21´ East Longitude, an altitude of 26-34 was adherence to taking anti-tuberculosis meters above sea level and has a the drugs (OAT). The independent variable is topography is flat to undulating. Tebing the variable that influences or causes the Tinggi City has an average air temperature change or emergence of the dependent of 25oC – 27oC. Regional Limits as variable (Riyanto, 2011). The independent follows: variables in this study were education and a. To the north it is bordered by PTPN III family support.