Hambatan Pelaksanaan Program Directly Observed Treatment Short-Course (DOTS) Di Negara Berkembang: Sebuah Tinjauan Sistematik

Abstract

Tuberculosis is a global burden with most cases occurring in developing countries. After the implementation of Directly Observed Treatment Short-course (DOTS), the incidence of tuberculosis decreased. Despite, studies reported constraints in implementing this program. This study aims to describe the challenges of DOTS implementation in developing countries narratively. Methods: a search strategy through PUBMED was used to identify relevant articles. 10 relevant articles were included from 349 records. The studies were conducted in 8 developing countries namely South Africa, Sub-Saharan Africa, Brazil, Ethiopia, Indonesia, Angola and Nigeria. All articles included was extracted and categorized in ten main points regarding the challenges of the implementation of DOTS program. Results: There were 10 main points of challenges in implementing the DOTS strategy in developing countries : lack of access to health centres, managerial and organizational service problems, lack of health education-related tuberculosis, lack of supervision, TB co-infection, lack of trained health workers, smoking, alcohol, and drug abuse during treatment, patient-health professional relationship, lack of food availability and interruption during treatment. Conclusion: The implementation of the DOTS strategy encounters many challenges in developing countries where lack of health facilities, managerial and organizational service problems and lack of education-related TB are the main challenges to implement the program