Enhancing the Role of Primary Care Private Practitioners in Addressing Gaps in TB Care: An Analysis of National TB Data from Medan

Tuberculosis is a global problem, and the prevalence of TB in Indonesia is the second highest in the world. In 2022, tuberculosis (TB) affected an estimated 10.6 million individuals worldwide. Most patients in Indonesia, especially those with cough complaints, first seek treatment from private health services. However, these health service providers have limitations for TB diagnosis and treatment, leading to poor and inadequate treatment and the risk of developing drug resistance.

The purpose of this study was to increase the role of private practitioners, especially doctors in primary care, who provide continuous, comprehensive, first-contact, and coordinated services to fill TB treatment gaps, ranging from suspected TB to complete and cured treatment.

This is a retrospective observational study using the TB registry in Medan, Indonesia, during the year 2021, which includes data on newly diagnosed and relapsed cases of tuberculosis patients who were treated completely, cured, unsuccessfully, lost to follow-up, and died. The TB registry was recorded in the SITB (TB Information System) and can be accessed nationally. The instrument uses the form TB 08 SITB, which was filled out in the city. Data were analyzed univariately using SPSS presented in the form of frequencies and percentages and bivariate using contingency coefficient test in the form of value and approximate significance.

The treatment success rate among all subjects in new TB cases was approximately 87.3%. Therefore, there was a gap in TB treatment adherence of 12.7%. The treatment success rate for relapsed TB cases was 87.7%, so there is a 12.3% gap in treatment adherence. Data analysis revealed a significant association between TB classification and treatment outcomes.

There are gaps in TB services ranging from screening and early detection of suspected TB to diagnosis, treatment, notification, and evaluation of TB treatment outcomes. Increasing the role of private practitioners, especially doctors in primary care as first contact, continuity care, and comprehensive and coordinated care in TB control will be useful in filling TB service gaps.