Do Community Health Centers Have Contextual Effect on the Risk of Recurrence in Patient with Tuberculosis? A Multilevel Evidence from Surakarta, Central Java
| Main Authors: | Muvida, Muvida, Widyaningsih, Vitri, Murti, Bhisma |
|---|---|
| Format: | Article info application/pdf eJournal |
| Bahasa: | eng |
| Terbitan: |
Masters Program in Public Health, Universitas Sebelas Maret, Indonesia
, 2020
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| Online Access: |
http://www.jepublichealth.com/index.php?journal=jepublichealth&page=article&op=view&path[]=243 http://www.jepublichealth.com/index.php?journal=jepublichealth&page=article&op=view&path[]=243&path[]=141 |
Daftar Isi:
- Background: Community Health Centers played an important role in tuberculosis control. However, Community Health Centers’ contextual effect toward tuberculosis recurrence has not yet been discovered. The study aims to analyze socio-demography and clinical factors of first tuberculosis episode and Community Health Centers’ contextual effect toward tuberculosis recurrence.Subjects and Method: It was analytic observational study with case control approach. The study was conducted in the city of Surakarta, Central Java, from December 2019 up to January 2020. Sample collection toward 204 tuberculosis patients who had completed their treatment or were confirmed cured, were conducted by using simple random sampling at individual level and stratified random sampling at community health centers level. The dependent variable was tuberculosis recurrence. The independent variables were family income, level of education, BCG vaccination status, smoking history, initial bacteriological test, weight gain, DM, and COPD. The data were collected through medical record and interview. The data were analyzed by using multilevel multiple logistic regression with Stata 13.Results: In individual level, the preventive factor toward tuberculosis recurrence among other were high income (OR= 0.24; 95% CI= 0.06 up to 0.92; p= 0.037), high level of education (OR= 0.18; 95% CI= 0.04 up to 0.84; p= 0.029), BCG vaccination status (OR= 0.11; 95% CI= 0.02 up to 0.67; p= 0.017), and high weight gain (OR= 0.06; 95% CI= 0.01 up to 0.28; p< 0.001). Meanwhile, the independent predictors toward tuberculosis recurrence (OR= 7.11; 95% CI= 1.65 up to 30.64; p= 0.009) and diabetes mellitus (OR= 10.85; 95% CI= 2.13 up to 55.29; p= 0.004). In the level of Community Health Centers, high ratio between health workers/ tuberculosis patients significantly correlated with lower tuberculosis (OR= 0.01; 95% CI< 0.01 up to 0.44; p= 0.016). Community health Centers had contextual effect toward tuberculosis recurrence with Intra-Class Correlation (ICC) by 38.67%.Conclusion: Factors in individual and community health centers level may affect tuberculosis recurrence. Community Health Centers has contextual effect toward tuberculosis recurrent.Keywords: Tuberculosis recurrence, tuberculosis, predictor, Community Health Center, multilevel analysisCorrespondence: Muvida. Masters Program in Public Health, Universitas Sebelas Maret, Jl. Ir. Sutami No. 36 A, Surakarta 57126, Central Java. Email: muvidamd@gmail.com. Mobile: +6289651450435.Journal of Epidemiology and Public Health (2020), 5(1): 65-78https://doi.org/10.26911/jepublichealth.2020.05.01.07