Browse > Article
http://dx.doi.org/10.3961/jpmph.22.248

Knowledge and Attitudes of Indonesian General Practitioners Towards the Isoniazid Preventive Therapy Program in Indonesia  

Winardi, Wira (Department of Pulmonology and Respiratory Medicine, School of Medicine, Universitas Syiah Kuala)
Nalapraya, Widhy Yudistira (Faculty of Medicine, Universitas Islam Bandung)
Sarifuddin, Sarifuddin (Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Tadulako University)
Anwar, Samsul (Department of Statistics, Faculty of Mathematics and Natural Sciences, Universitas Syiah Kuala)
Yufika, Amanda (Department of Family Medicine, School of Medicine, Universitas Syiah Kuala)
Wibowo, Adityo (Department of Pulmonology and Respiratory Medicine, School of Medicine, Universitas Lampung)
Fadhil, Iziddin (Faculty of Medicine, Universitas Abulyatama)
Wahyuni MS, Hendra (Faculty of Medicine, Universitas Malikussaleh)
Arliny, Yunita (Department of Pulmonology and Respiratory Medicine, School of Medicine, Universitas Syiah Kuala)
Yanifitri, Dewi Behtri (Department of Pulmonology and Respiratory Medicine, School of Medicine, Universitas Syiah Kuala)
Zulfikar, Teuku (Department of Pulmonology and Respiratory Medicine, School of Medicine, Universitas Syiah Kuala)
Harapan, Harapan (Medical Research Unit, School of Medicine, Universitas Syiah Kuala)
Publication Information
Journal of Preventive Medicine and Public Health / v.55, no.5, 2022 , pp. 428-435 More about this Journal
Abstract
Objectives: The Indonesian Ministry of Health launched isoniazid preventive therapy (IPT) in 2016, with general practitioners (GPs) at the frontline of this program. However, the extent to which GPs have internalized this program remains uncertain. The aim of this study was to identify the knowledge and attitudes of GPs towards the IPT program in Indonesia. Methods: This study used an online, self-administered questionnaire distributed via e-mail and social messaging services. A logistic regression model was employed to identify the explanatory variables influencing the level of knowledge and attitudes toward IPT among GPs in Indonesia. An empirical analysis was conducted separately for each response variable (knowledge and attitudes). Results: Of the 418 respondents, 128 (30.6%) had a good knowledge of IPT. Working at a public hospital was the only variable associated with good knowledge, with an adjusted odds ratio (aOR) of 1.69 (95% confidence interval [CI], 1.02 to 2.81). Furthermore, 279 respondents (66.7%) had favorable attitudes toward IPT. In the adjusted logistic regression analysis, good knowledge (aOR, 0.55; 95% CI, 0.34 to 0.89), 1-5 years of work experience (aOR, 2.09; 95% CI, 1.21 to 3.60), and having experienced IPT training (aOR, 0.48; 95% CI, 0.25 to 0.93), were significantly associated with favorable attitudes. Conclusions: In general, GPs in Indonesia had favorable attitudes toward IPT. However, their knowledge of IPT was limited. GPs are an essential element of the IPT program in the country, and therefore, adequate information dissemination to improve their understanding is critical for the long-term viability and quality of the IPT program in Indonesia.
Keywords
Tuberculosis; Isoniazid; Latent tuberculosis; General practitioner;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Chakaya J, Khan M, Ntoumi F, Aklillu E, Fatima R, Mwaba P, et al. Global tuberculosis report 2020 - reflections on the global tb burden, treatment and prevention efforts. Int J Infect Dis 2021;113(Suppl 1):S7-S12.   DOI
2 Zumla A, Nahid P, Cole ST. Advances in the development of new tuberculosis drugs and treatment regimens. Nat Rev Drug Discov 2013;12(5):388-404.   DOI
3 GBD Tuberculosis Collaborators. The global burden of tuberculosis: results from the Global Burden of Disease Study 2015. Lancet Infect Dis 2018;18(3):261-284.   DOI
4 Chaudhary R, Bhatta S, Singh A, Pradhan M, Shrivastava B, Singh YI, et al. Diagnostic performance of GeneXpert MTB/RIF assay compared to conventional Mycobacterium tuberculosis culture for diagnosis of pulmonary and extrapulmonary tuberculosis, Nepal. Narra J 2021;1(2):e33.
5 Uplekar M, Raviglione M. WHO's End TB Strategy: from stopping to ending the global TB epidemic. Indian J Tuberc 2015;62(4):196-199.   DOI
6 MacNeil A, Glaziou P, Sismanidis C, Date A, Maloney S, Floyd K. Global epidemiology of tuberculosis and progress toward meeting global targets - worldwide, 2018. MMWR Morb Mortal Wkly Rep 2020;69(11):281-285.
7 Burke RM, Nliwasa M, Feasey HR, Chaisson LH, Golub JE, Naufal F, et al. Community-based active case-finding interventions for tuberculosis: a systematic review. Lancet Public Health 2021;6(5):e283-e299.   DOI
8 Jeremiah C, Petersen E, Nantanda R, Mungai BN, Migliori GB, Amanullah F, et al. The WHO global tuberculosis 2021 report - not so good news and turning the tide back to End TB. Int J Infect Dis 2022:S1201-9712(22)00149-7.
9 Ayele HT, Mourik MS, Debray TP, Bonten MJ. Isoniazid prophylactic therapy for the prevention of tuberculosis in HIV infected adults: a systematic review and meta-analysis of randomized trials. PLoS One 2015;10(11):e0142290.   DOI
10 Houben RM, Dodd PJ. The global burden of latent tuberculosis infection: a re-estimation using mathematical modelling. PLoS Med 2016;13(10):e1002152.   DOI
11 Mandal S, Bhatia V, Sharma M, Mandal PP, Arinaminpathy N. The potential impact of preventive therapy against tuberculosis in the WHO South-East Asian Region: a modelling approach. BMC Med 2020;18(1):163.   DOI
12 Abdulrazaak AT, Govender I, Nzaumvila D. Knowledge, attitudes and practices of doctors regarding isoniazid preventive therapy in HIV/AIDS patients at Odi District Hospital, Gauteng province, South Africa. S Afr J Infect Dis 2018;33(5):1-11.
13 Huang CC, Becerra MC, Calderon R, Contreras C, Galea J, Grandjean L, et al. Isoniazid preventive therapy in contacts of multidrug-resistant tuberculosis. Am J Respir Crit Care Med 2020; 202(8):1159-1168.   DOI
14 Collins D, Hafidz F, Mustikawati D. The economic burden of tuberculosis in Indonesia. Int J Tuberc Lung Dis 2017;21(9):1041-1048.   DOI
15 Reviono R, Setianingsih W, Damayanti KE, Ekasari R. The dynamic of tuberculosis case finding in the era of the public-private mix strategy for tuberculosis control in Central Java, Indonesia. Glob Health Action 2017;10(1):1353777.   DOI
16 Suryanto, Plummer V, Boyle M. Healthcare system in Indonesia. Hosp Top 2017;95(4):82-89.   DOI
17 van Halsema CL, Fielding KL, Chihota VN, Russell EC, Lewis JJ, Churchyard GJ, et al. Tuberculosis outcomes and drug susceptibility in individuals exposed to isoniazid preventive therapy in a high HIV prevalence setting. AIDS 2010;24(7):1051-1055.   DOI
18 Smieja MJ, Marchetti CA, Cook DJ, Smaill FM. Isoniazid for preventing tuberculosis in non-HIV infected persons. Cochrane Database Syst Rev 2000;1999(2):CD001363.
19 Ross JM, Badje A, Rangaka MX, Walker AS, Shapiro AE, Thomas KK, et al. Isoniazid preventive therapy plus antiretroviral therapy for the prevention of tuberculosis: a systematic review and meta-analysis of individual participant data. Lancet HIV 2021;8(1):e8-e15.   DOI
20 Ayele HT, van Mourik MS, Bonten MJ. Predictors of adherence to isoniazid preventive therapy in people living with HIV in Ethiopia. Int J Tuberc Lung Dis 2016;20(10):1342-1347.   DOI
21 Ministry of Health, Republic of Indonesia. Technical instructions for handling latent tuberculosis infection (ILTB); 2020 [cited 2022 May 1]. Available from: https://tbindonesia.or.id/wp-content/uploads/2021/01/Isi-Juknis-ILTB-FINAL-ok_published.pdf (Indonesian).
22 Ministry of Health, Republic of Indonesia. Regulation of the Minister of Health number 67 year 2016 on tuberculosis control [cited 2022 May 1]. Available from: http://hukor.kemkes.go.id/uploads/produk_hukum/PMK_No._67_ttg_Penanggulangan_Tuberkolosis_.pdf (Indonesian).
23 Mahendradhata Y, Lestari T, Probandari A, Indriarini LE, Burhan E, Mustikawati D, et al. How do private general practitioners manage tuberculosis cases? A survey in eight cities in Indonesia. BMC Res Notes 2015;8:564.   DOI
24 Durovni B, Cavalcante SC, Saraceni V, Vellozo V, Israel G, King BS, et al. The implementation of isoniazid preventive therapy in HIV clinics: the experience from the TB/HIV in Rio (THRio) study. AIDS 2010;24(Suppl 5):S49-S56.
25 Surya A, Setyaningsih B, Suryani Nasution H, Gita Parwati C, Yuzwar YE, Osberg M, et al. Quality tuberculosis care in Indonesia: using patient pathway analysis to optimize public-private collaboration. J Infect Dis 2017;216(Suppl_7):S724-S732.   DOI
26 Bateman C. Doctor IPT ignorance contributing to TB epidemic--study. S Afr Med J 2011;101(2):88, 90.
27 Martinson NA, Barnes GL, Moulton LH, Msandiwa R, Hausler H, Ram M, et al. New regimens to prevent tuberculosis in adults with HIV infection. N Engl J Med 2011;365(1):11-20.   DOI
28 Teklay G, Teklu T, Legesse B, Tedla K, Klinkenberg E. Barriers in the implementation of isoniazid preventive therapy for people living with HIV in Northern Ethiopia: a mixed quantitative and qualitative study. BMC Public Health 2016;16(1):840.   DOI