Health Belief Model and PRECEDE PROCEED on the Risk Factors of Multidrug Resistant Tuberculosis in Surakarta, Central Java

Abstract

Background: Tuberculosis (TB) is one of the lethal infectious diseases in the world. One of the current biggest challenges of Tuberculosis control is the widespread emergence of Multidrug Resistant Tuberculosis (MDR-TB). There are several potential risk factors of MDR-TB that can be explained by Health Belief Model and PRECEDE PROCEED model framework. This study aimed to analyzed factors associated with MDR-TB using Health Belief Model and PRECEDE PROCEED. Subjects and Method:This was an analytic observational study with case control design. The study was conducted at Dr. Moewardi Hospital and BBKPM, Surakarta, from September to November 2017. The study subjects were selected using fixed disease sampling, consisting of 76 MDR-TB patients and 228 TB patients. The dependent variable was MDR-TB. The independent variables were educational level, self-efficacy, drug-taking adherence, smoking, nutritional status, perceived of susceptibility, perceived barrier, perceived severity, perceived benefit, and drug-taking supervisor. The data were collected using questionnaire and analyzed by path analysis. Results: The risk of MDR-TB was increased by lack of drug-taking adherence (b= -1.69; 95% CI= -2.28 to -1.09; p <0.001), poor nutritional status (b= 1.32; 95% CI= 0.72 to 1.92; p<0.001), and smoking (b= 1.32; 95% CI= 0.72 to 1.92; p <0.001). Drug-taking adherence was increased by perceived susceptibility (b= 0.91; 95% CI= 0.18 to 1.63; p=0.015), perceived severity (b= 1.01; 95% CI= 0.28 to 1.74; p=0.007), perceived benefit (b= 1.69; 95% CI= 0.97 to 2.41; p<0.001), drugtaking advisor (b= 2.16; 95% CI= 1.44 to 2.88; p<0.001), self efficacy (b= 1.58; 95% CI= 0.86 to 2.31; p<0.001), and low perceived barrier (b= -1.10; 95% CI= -1.82 to -0.38; p=0.003). Conclusion:The risk of MDR-TB is increased by the lack of drug-taking adherence, poor nutritional status, and smoking.

A Health Belief Model-Based Motivational Interviewing for Medication Adherence and Treatment Success in Pulmonary Tuberculosis Patients

“…A change in behavior toward the acceptance of new behavior, or adoption through a process based on knowledge, awareness, and positive attitude (predisposing factors), will be longer-lasting than behavior that is not based on knowledge. Knowledge is the basis for understanding obstacles to successful treatment, so that self-efficacy in the ability to carry out the treatment will emerge [ 22 , 23 ].…”

Determinants of adherence to anti-TB treatment and associated factors among adult TB patients in Gondar city administration, Northwest, Ethiopia: based on health belief model perspective

“…Gondar city administration has six sub-city and 36 kebeles (the smallest administrative unit of the Federal Democratic Republic of Ethiopia). Gondar specialized hospital and eight [ 8 ] governmental health centres provide anti-tuberculosis treatment services under Gondar city administration. The census report of 2019 found from the Gondar city health office showed that the total population was 344,046 from these 171,679 were male, and 172,367 were female.…”

“…There were an estimated 10 million new cases of TB (range, 9.0–11.1 million), equivalent to 133 cases per 100,000 population [ 6 , 7 ]. Globally, at approximately from new patients' one in five and previously treated patient one in two suffers from Multidrug-Resistant Tuberculosis (MDR-TB) [ 7 , 8 ]. The World Health Organization (WHO) Global TB Report also stated that the MDR-TB rate was estimated to be 1.8% among new cases and 19% among previously treated cases in Eritrea [ 3 ].…”

“…Studies show that several factors are influencing TB-treatment adherence [ 11 – 14 ]. Among these factors, sociodemographic characteristics’ such as age and sex [ 18 – 20 ], marital status [ 15 , 21 ], educational level [ 13 , 21 , 22 ], level of knowledge about TB and its treatment [ 10 , 18 , 23 ], disease-related stigma [ 19 , 24 ], strong social support within a patient's family and community [ 25 – 27 ], side effects [ 8 ] anti-TB treatment, forgetfulness' at the continuation phase, the patients' clinical symptoms subsided and felt good progress [ 22 ] are the main reasons for non-adherence in anti-tuberculosis treatment.…”