The Relationship Between the Characteristics of Directly Observed Treatment and the Implementation of Directly Observed Treatment Tasks and Adherence to Treatment for Pulmonary TB Patients at the Andalas Health Center, Padang City

Background: Pulmonary tuberculosis (TB) continues to pose a significant global public health concern. A key determinant of successful TB treatment is the patient’s adherence to a prolonged therapeutic regimen. The Directly Observed Treatment (DOT) strategy serves as a core component of the DOTS (Directly Observed Treatment, Short-course) framework, as endorsed by the World Health Organization (WHO). The efficiency with which DOT responsibilities are carried out may vary based on the personal attributes of the DOT providers themselves. Objective: This study aims to evaluate how specific characteristics of DOT providers relate to their performance of DOT responsibilities and the treatment adherence levels of pulmonary TB patients at the Andalas Health Center in Padang City. Methods: Employing a cross-sectional study design, the research involved 56 matched pairs of pulmonary TB patients and their respective DOT providers. The total sampling technique was applied to recruit participants. Data were collected through structured interviews using validated questionnaires. Statistical analysis was conducted using the chi-square test, with a 5% significance threshold to determine relationships between variables. Results: The majority of DOT providers were female (62.5%), aged 18 years or older (94.6%), held a higher level of education (69.6%), were employed (55.4%), were relatives of the patients (96.4%), and resided in the same household as the patients (92.9%). Among them, 73.2% effectively fulfilled their DOT responsibilities, while 69.6% of patients demonstrated adherence to their treatment regimens. Significant associations were found between the educational background of DOT providers and the quality of their task implementation (p=0.001). Furthermore, both the age (p=0.025) and educational level (p=0.002) of DOT providers, along with their task performance (p<0.001), showed strong correlations with patient treatment adherence. Conclusion: The findings indicate that specific DOT characteristics, particularly age and level of education, play a crucial role in both the effectiveness of DOT task implementation and in promoting treatment adherence among pulmonary TB patients. It is therefore recommended that healthcare providers consider these factors when selecting individuals to serve as DOT providers. Keywords: Pulmonary TB, Treatment Adherence, Medication Adherence Supervisor, DOT Characteristics, DOTS