TRAVEL BURDEN AND DRUG-RESISTANT TUBERCULOSIS TREATMENT OUTCOMES AT DOKTER SOEDARSO REGIONAL PUBLIC HOSPITAL, PONTIANAK

Abstract

Background: Drug-Resistant Tuberculosis (DR-TB) remains a major public health concern in West Kalimantan, with treatment success falling short of the national target. Travel burden, including distance and travel time, may limit access to repeated treatment services. Purpose: This study aimed to analyze the association between travel burden and treatment outcomes among DR-TB patients at Dokter Soedarso Regional Public Hospital, Pontianak, for the 2021-2024 period. Methods: A retrospective observational cohort study used records of 138 eligible patients from 250 pulmonary DR-TB patients registered during 2021-2024. Patients who died during treatment were excluded. Orutego, integrated with the Google Geocoding API and Google Distance Matrix API, estimates road distance and travel time. Equal-frequency tertiles were analyzed using Pearson Chi-Square and Linear-by-Linear Association tests; prevalence ratios (PRs) with 95% confidence intervals (CIs) were reported. Results: The study found an overall treatment success rate of 66.67%. Travel distance was associated with treatment outcome (p = 0.04); the Far category (≥ 72.7 km) had a higher prevalence of unsuccessful treatment than the Near category (PR = 1.95; 95% CI: 1.10-3.48). For travel time, Pearson's chi-square was not significant (p = 0.05), but the linear-by-linear association showed a significant trend (p = 0.02). The Long category (≥ 1.94 hours) had a higher prevalence of unsuccessful treatment than the Short category (PR = 1.98; 95% CI: 1.10-3.56). Conclusion: Higher travel burden was associated with unsuccessful DR-TB treatment outcomes. The findings support consideration of geographic access in service planning but do not establish causality.