Linking prevention and adherence: a behavioural study on treatment compliance to preventing TB transmission

To assess the concordance between TB prevention practices and treatment adherence and identify determinants of a combined prevention and adherence behaviour.

A cross-sectional study was conducted among 147 TB patients attending seven urban primary health centres in Malang, Indonesia (January to June 2025). Prevention behaviours and treatment adherence were assessed using structured questionnaire Agreement between prevention practices and adherence was analysed using weighted Cohen kappa and Gwet AC. Determinants of the combined behavioural categories were identified using multinomial logistic regression.

High prevention behaviour and high treatment adherence was observed in 52% and 57%. Agreement between these two behaviours was moderate. Results showed 34% of patients consistently had high prevention and adherence behaviour, 53% showed moderate behaviour, and 13% showed low behaviour. Moderate combined behaviour was associated with gender and TB knowledge. High combined behaviour was significantly associated with higher education, greater income, stronger family functioning, more positive attitudes, and higher TB knowledge.

Routine educational programmes are needed for patients and their families during the intensive phase of treatment, along with individualised family assistance through personalised education sessions when patients visit primary health centres to collect their medications.