Background: Multidrug-resistant tuberculosis (MDR-TB) causes significant problem and cost for national TB control program. MDR-TB constitutes an increasing public health concern globally. The prevalence of MDR-TB is as high as 50%. One third of all newly detected TB patients are infected with MDR strains. This study aimed to analyze the bio-psychosocial determinants of MDR-TB in Surakarta, Central Java.
Subjects and Method: This was a case control study conducted in Dr. Moewardi Hospital and BBKPM, Surakarta, from September to November 2017. A sample consisting of 76 MDR-TB patients and 228 non MDR-TB patients were selected for this study by fixed disease sampling. The dependent variable was MDR-TB. The independent variables were age, drug-taking adherence, depression, comorbidity, drug side-effect, drug-taking supervisor, and family income. The data were collected using a set of questionnaire and analyzed by path analysis.
Results: MDR-TB directly increased with the lack of drug-taking adherence (b= -1.7; 95% CI= -2.23 to -1.07; p= 0.001) and comorbidity (b= 1.5; 95% CI= 0.76 to 2.30; p= 0.001). MDR-TB indirectly increased with depression, drug side effect, weak drug-taking supervision, and older age.
Conclusion: MDR-TB directly increases with the lack of drug-taking adherence and comorbidity. MDR-TB indirectly increases with depression, drug side effect, weak drug-taking supervision, and older age.
Keywords: bio-psychosocial determinants, MDR-TB