Determinants of tuberculosis health service utilization in primary healthcare facilities in Perbaungan, North Sumatra, Indonesia
DOI:
https://doi.org/10.32734/trophico.v5i2.22912Keywords:
Utilization, Primary healthcare, TuberculosisAbstract
Indonesia ranks third worldwide in terms of Tuberculosis (TB) cases, after China and India. In 2016, North Sumatera recorded 23,097 TB cases with 5,714 deaths. One of the regencies in this province, Serdang Bedagai particularly in Perbaungan district reported that TB patients with positive smear results did not fully utilize healthcare services or follow the standard treatment protocols provided by primary healthcare centers, according to TB center data from 2016–2017. This study aimed to assess the prevalence and identify factors associated with the utilization of TB health services in primary care. A cross-sectional design was employed with proportionate stratified random sampling among TB patients in Perbaungan. Associations were analyzed using the chi-square test. Inclusion criteria required respondents to be permanent residents aged 20–70 years, both male and female, who agreed to complete the questionnaires. Among 184 respondents, 41.8% showed low utilization of services, while 58.2% demonstrated high utilization. Most respondents had only primary education and were unemployed. The study found significant associations between service utilization and education level, employment status, knowledge, attitudes, and accessibility. In conclusion, nearly half of respondents had low utilization of TB health services in primary health care in Perbaungan, North Sumatera Indonesia.
Downloads
References
Abejew, A. A., Abdu, H., Seid, Y., & Shibabaw, A. (2022). The Missing Quality of Tuberculosis Care and Treatment Delivered in Public-Health Facilities, Northeast Ethiopia: A Cross-Sectional Study. Clinics and Practice, 12(6), 1034–1042. https://doi.org/10.3390/clinpract12060106
Alema, H. B., Hailemariam, S. A., Misgina, K. H., Weldu, M. G., Gebregergis, Y. S., Mekonen, G. K., & Gebremedhin, K. A. (2019). CNS tuberculosis diagnosis and health care seeking delay in patients in North West zone of Tigrai region, North Ethiopia. BMC Infectious Diseases, 19(1), 1–8.
Choi, S. W., Im, J. J., Yoon, S. E., Kim, S. H., Cho, J. H., Jeong, S. J., Park, K. A., & Moon, Y. S. (2023). Lower socioeconomic status associated with higher tuberculosis rate in South Korea. BMC Pulmonary Medicine, 23(1), 1–7. https://doi.org/10.1186/s12890-023-02713-z
Craciun, O. M., Torres, R., & Llanes, B. (2023). Tuberculosis Knowledge , Attitudes , and Practice in Middle- and Low-Income Countries : A Systematic Review. 2023. https://doi.org/10.1155/2023/1014666
Ehsanul Huq, K. A. T. M., Moriyama, M., Zaman, K., Chisti, M. J., Long, J., Islam, A., Hossain, S., Shirin, H., Raihan, M. J., Chowdhury, S., & Rahman, M. M. (2018). Health seeking behaviour and delayed management of tuberculosis patients in rural Bangladesh. BMC Infectious Diseases, 18(1), 1–9. https://doi.org/10.1186/s12879-018-3430-0
Fuady, A., Houweling, T. A. J., Mansyur, M., Burhan, E., & Richardus, J. H. (2020). Cost of seeking care for tuberculosis since the implementation of universal health coverage in Indonesia. BMC Health Services Research, 20(1), 1–10. https://doi.org/10.1186/s12913-020-05350-y
George, S., Syamala, T. S., Paranjpe, A., & Saalim, M. (2023). Intersections of informal work status, gender and tuberculosis diagnosis: Insights from a qualitative study from an Indian setting. PLoS ONE, 18(7 July), 1–16. https://doi.org/10.1371/journal.pone.0289137
Global tuberculosis report 2025. (2025).
Iskandar, D., Suwantika, A. A., Pradipta, I. S., Postma, M. J., & van Boven, J. F. M. (2023). Clinical and economic burden of drug-susceptible tuberculosis in Indonesia: national trends 2017–19. The Lancet Global Health, 11(1), e117–e125. https://doi.org/10.1016/S2214-109X(22)00455-7
Izudi, J., Tamwesigire, I. K., & Bajunirwe, F. (2024). Effect of missed clinic visits on treatment outcomes among people with tuberculosis: a quasi-experimental study utilizing instrumental variable analysis. IJID Regions, 13(September), 100461. https://doi.org/10.1016/j.ijregi.2024.100461
Kaaffah, S., Kusuma, I. Y., Renaldi, F. S., Pratiwi, A. D. E., Bahar, M. A., & Lestari, Y. E. (2023). Knowledge, Attitudes, and Perceptions of Tuberculosis in Indonesia: A Multi-Center Cross-Sectional Study. Infection and Drug Resistance, 16, 1787–1800. https://doi.org/10.2147/IDR.S404171
Lestari, T., Kamaludin, Lowbridge, C., Kenangalem, E., Poespoprodjo, J. R., Graham, S. M., & Ralph, A. P. (2022). Impacts of tuberculosis services strengthening and the COVID-19 pandemic on case detection and treatment outcomes in Mimika District, Papua, Indonesia: 2014–2021. PLOS Global Public Health, 2(10 October), 1–19. https://doi.org/10.1371/journal.pgph.0001114
Maidatuz Zulfa, I., & Dewi Yunitasari, F. (2025). Public Knowledge, Attitude, And Stigma Towards Tuberculosis In Surabaya, Indonesia: Determining Associated Factors For Poor Attitude. International Journal of Health and Pharmaceutical (IJHP), 5(1), 56–62. https://doi.org/10.51601/ijhp.v5i1.389
Mohd, M. N., Rahman, N. A., & Haque, M. (2022). Knowledge, Attitude and Practices Related to Tuberculosis among Students in a Public University in East Coast Malaysia. Advances in Human Biology, 12(2), 190–197. https://doi.org/10.4103/aihb.aihb_25_22
Muttamba, W., Omongot, S., Najjingo, I., Nuwarinda, R., Buregyeya, E., del Barrio, M. O., Morgan, R., Kirenga, B., & Ssali, S. (2024). Using intersectional gender analysis to identify challenges in tuberculosis care at four health care facilities in Uganda. Infectious Diseases of Poverty, 13(1), 1–10. https://doi.org/10.1186/s40249-023-01171-3
Nidoi, J., Muttamba, W., Walusimbi, S., Imoko, J. F., Lochoro, P., Ictho, J., Mugenyi, L., Sekibira, R., Turyahabwe, S., Byaruhanga, R., Putoto, G., Villa, S., Raviglione, M. C., & Kirenga, B. (2021). Impact of socio-economic factors on Tuberculosis treatment outcomes in north- eastern Uganda : a mixed methods study. 1–16.
Puskesmas Perbaungan. (2017). Laporan tahunan Puskesmas Perbaungan tahun 2017. Dinas Kesehatan Kabupaten Serdang Bedagai. (Dokumen tidak dipublikasikan).
Rahman, H. A. (2015). Knowledge, Altitude and Practice a Tuberculosis (TB) among Community in Kajang, A Cross Sectional Study. Asia Pacific Environmental and Occupational Health Journal, 1((1)), 19–24.
WHO. (2024). Global Tuberculosis (TB).
Wiem, B., Mcallister, S., Fortuna, P., Afifah, N., Dewi, I., Murray, M., Crevel, R. Van, Hill, P. C., & Alisjahbana, B. (2020). The Lancet Regional Health - Western Pacific Patient pathways and delays to diagnosis and treatment of tuberculosis in an urban setting in Indonesia. The Lancet Regional Health - Western Pacific, 5, 100059. https://doi.org/10.1016/j.lanwpc.2020.100059
Zaenab, S. (2024). Gambaran Diagnosis TBC di Indonesia Tahun 2020-2022. Jurnal Epidemiologi Kesehatan Indonesia, 8(1). https://doi.org/10.7454/epidkes.v8i1.1099
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 TROPHICO: Tropical Public Health J.
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
