Factor analysis of the role of physicians and its associated factors for encompassing patients with suspected tuberculosis in Surabaya City


  • Rosita Dwi Yuliandari Doctoral Program of Public Health, Faculty of Public Health, Universitas Airlangga, Surabaya
  • Chatarina Umbul Wahyuni Faculty of Public Health, Universitas Airlangga, Surabaya
  • Fariani Syahrul Faculty of Public Health, Universitas Airlangga, Surabaya
  • Hari Basuki Notobroto Faculty of Public Health, Universitas Airlangga, Surabaya
  • Mochammad Bagus Qomaruddin Faculty of Public Health, Universitas Airlangga, Surabaya
  • Soedarsono Soedarsono Sub-Pulmonology Department of Internal Medicine, Faculty of Medicine, Universitas Hang Tuah, Surabaya




public private mix, physicians, tuberculosis suspected


Background: Indonesia remains the highest tuberculosis morbidity rate, 9.6 million globally. Limited detection and surveillance of suspected tuberculosis need to be enhanced. Objective: This study aims to investigate the factors that influence the role of Physicians in screening for suspected tuberculosis. Materials and Methods: a case-control study with secondary datasets of 132 physicians. The analysis used is simple logistic regression and multiple logistic regressions. Results: out of 132, only 34 physicians (25.7%) have an active role; meanwhile, 98 physicians (74.3%) did not participate in assisting suspected tuberculosis. Almost 73% of physicians have not received additional training in tuberculosis management. The physicians contributed 19.1% to the total discovery of tuberculosis suspected in Surabaya. Age, years of working, and the number of patient visits were associated with the role of physicians in tuberculosis screening (OR of 3.809, 1.112, and 3.057). Conclusions: based on 5 variables that qualify for multivariate analysis, three factors greatly influence the physicians’ role in screening tuberculosis suspected, including age, number of patient visits, and years of working.

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Khan DI, Khan S, Anas M, et al. Tracing the Children in Contact of Sputum Smear Negative Adults is the Need of the Hour to Achieve WHO “Stop TB Strategy”. Biosci Biotechnol Res Asia 2021; 18: 367–372. DOI: https://doi.org/10.13005/bbra/2923

WHO. Tuberculosis, https://www.who.int/news-room/fact-sheets/detail/tuberculosis#:~:text=Key facts,with tuberculosis(TB) worldwide. (2022).

Surabaya City Health Office. Quarterly Report I of 2022. Surabaya, 2022.

Ministry of Health of Republic Indonesia. National Strategy for Combating Tuberculosis in Indonesia 2020-2024. 2020.

Out AA. Is the directly observed therapy short course (DOTS) an effective strategy for tuberculosis control in a developing country? Asian Pacific Journal of Tropical Disease 2013; 3: 227–231. DOI: https://doi.org/10.1016/S2222-1808(13)60045-6

Malmborg R, Mann G, Squire SB. A systematic assessment of the concept and practice of public-private mix for tuberculosis care and control. Int J Equity Health 2011; 10: 49. DOI: https://doi.org/10.1186/1475-9276-10-49

Nazriati E, Zulharman Z, Chandra F, et al. Public-Private Mix Implementation and Achievements of Tuberculosis Control Program at Puskesmas in Pekanbaru. Mutiara Med J Kedokt dan Kesehat 2021; 21: 86–94. DOI: https://doi.org/10.18196/mmjkk.v21i2.11731

Jusuf H, Sakti M, Husein I, et al. Modelling Optimally to the Treatment of TB Patients for Increase Medical Knowledge. Sys Rev Pharm 2020; 11: 742–748.

Das J, Kwan A, Daniels B, et al. Use of standardised patients to assess quality of tuberculosis care: a pilot, cross-sectional study. Lancet Infect Dis 2015; 15: 1305–1313. DOI: https://doi.org/10.1016/S1473-3099(15)00077-8

Komedi A, J HK, Istiono W. Tuberculosis Treatment with DOTS Strategy on Mandiri Practice Doctor as Public Private Mix a Case Study in Kebumen Regency. Rev Prim Care Pract Educ (Kajian Prakt dan Pendidik Layanan Prim 2019; 2: 20. DOI: https://doi.org/10.22146/rpcpe.44470

Lestari T, Graham S, van den Boogard C, et al. Bridging the knowledge-practice gap in tuberculosis contact management in a high-burden setting: a mixed-methods protocol for a multicenter health system strengthening study. Implement Sci 2019; 14: 31. DOI: https://doi.org/10.1186/s13012-019-0870-x

Monedero-Recuero I, Gegia M, Wares DF, et al. Situational analysis of 10 countries with a high burden of drug-resistant tuberculosis 2 years post-UNHLM declaration: progress and setbacks in a changing landscape. Int J Infect Dis IJID Off Publ Int Soc Infect Dis 2021; 108: 557–567. DOI: https://doi.org/10.1016/j.ijid.2021.06.022

Febriani E, Wibowo A, Kak N, et al. Empowering health cadres to support drug-resistant tuberculosis (DR-TB) patient to enroll in treatment. Kesmas 2021; 16: 84–90. DOI: https://doi.org/10.21109/kesmas.v16i2.3307

WHO. Compendium of Data and evidence-related Tools for use in TB Planning and Programming, https://apps.who.int/iris/bitstream/handle/10665/344890/9789240022843-eng.pdf (2021).

Cho KS. Tuberculosis control in the Republic of Korea. Epidemiol Health 2018; 40: e2018036. DOI: https://doi.org/10.4178/epih.e2018036

Rosapep LA, Faye S, Johns B, et al. Tuberculosis care quality in urban Nigeria: A cross-sectional study of adherence to screening and treatment initiation guidelines in multi-cadre networks of private health service providers. PLOS Glob Public Heal 2022; 2: e0000150. DOI: https://doi.org/10.1371/journal.pgph.0000150

Artawan Eka Putra IWG, Utami NWA, Suarjana IK, et al. Factors associated to referral of tuberculosis suspects by private practitioners to community health centres in Bali Province, Indonesia. BMC Health Serv Res; 13. Epub ahead of print 2013. DOI: 10.1186/1472-6963-13-445. DOI: https://doi.org/10.1186/1472-6963-13-445

Salve S, Harris K, Sheikh K, et al. Understanding the complex relationships among actors involved in the implementation of public-private mix (PPM) for TB control in India, using social theory. Int J Equity Health 2018; 17: 73. DOI: https://doi.org/10.1186/s12939-018-0785-1

Lestari BW, McAllister S, Hadisoemarto PF, et al. Patient pathways and delays to diagnosis and treatment of tuberculosis in an urban setting in Indonesia. Lancet Reg Heal West Pacific 2020; 5: 100059. DOI: https://doi.org/10.1016/j.lanwpc.2020.100059

Vandan N, Ali M, Prasad R, et al. Assessment of doctors’ knowledge regarding tuberculosis management in Lucknow, India: a public-private sector comparison. Public Health 2009; 123: 484–489. DOI: https://doi.org/10.1016/j.puhe.2009.05.004

Yimer SA, Holm-Hansen C, Bjune G. Assessment of knowledge and practice of private practitioners regarding tuberculosis control in Ethiopia. J Infect Dev Ctries 2012; 6: 13–19. DOI: https://doi.org/10.3855/jidc.1927

Lestari BW, Arisanti N, Siregar AYM, et al. Feasibility study of strengthening the public-private partnership for tuberculosis case detection in Bandung City, Indonesia. BMC Res Notes 2017; 10: 404. DOI: https://doi.org/10.1186/s13104-017-2701-y

Al-Maniri AA, Al-Rawas OA, Al-Ajmi F, et al. Tuberculosis suspicion and knowledge among private and public general practitioners: Questionnaire Based Study in Oman. BMC Public Health 2008; 8: 177. DOI: https://doi.org/10.1186/1471-2458-8-177

More BD, Doshi C, Baghel V, et al. A study on knowledge, awareness and preventive practice about tuberculosis among medical students in Udaipur, India. Int J Basic Clin Pharmacol 2019; 8: 2706. DOI: https://doi.org/10.18203/2319-2003.ijbcp20195283

Oktamianti P, Bachtiar A, Sutoto S, et al. Tuberculosis control within Indonesia’s hospital accreditation. J Public health Res; 10. Epub ahead of print June 2021. DOI: 10.4081/jphr.2021.1979. DOI: https://doi.org/10.4081/jphr.2021.1979

Yu S, Sohn H, Kim H-Y, et al. Evaluating the impact of the nationwide public-private mix (PPM) program for tuberculosis under National Health Insurance in South Korea: A difference in differences analysis. PLoS Med 2021; 18: e1003717. DOI: https://doi.org/10.1371/journal.pmed.1003717

Mahendradhata Y, Lestari T, Probandari A, et al. How do private general practitioners manage tuberculosis cases? A survey in eight cities in Indonesia. BMC Res Notes 2015; 8: 564. DOI: https://doi.org/10.1186/s13104-015-1560-7

Thu T Do, Kumar AM V, Ramaswamy G, et al. An Innovative Public-Private Mix Model for Improving Tuberculosis Care in Vietnam: How Well are We Doing? Trop Med Infect Dis; 5. Epub ahead of print February 2020. DOI: 10.3390/tropicalmed5010026. DOI: https://doi.org/10.3390/tropicalmed5010026

Arini M, Sugiyo D, Permana I. Challenges, opportunities, and potential roles of the private primary care providers in tuberculosis and diabetes mellitus collaborative care and control: a qualitative study. BMC Health Serv Res 2022; 22: 1–14. DOI: https://doi.org/10.1186/s12913-022-07612-3

Aadnanes O, Wallis S, Harstad I. A cross-sectional survey of the knowledge, attitudes and practices regarding tuberculosis among general practitioners working in municipalities with and without asylum centres in eastern Norway. BMC Health Serv Res 2018; 18: 987. DOI: https://doi.org/10.1186/s12913-018-3792-4

Sikorski C, Luppa M, König H-H, et al. Does GP training in depression care affect patient outcome? - A systematic review and meta-analysis. BMC Health Serv Res 2012; 12: 10. DOI: https://doi.org/10.1186/1472-6963-12-10

Cook DA, Levinson AJ, Garside S, et al. Internet-based learning in the health professions: a meta-analysis. JAMA 2008; 300: 1181–1196. DOI: https://doi.org/10.1001/jama.300.10.1181




How to Cite

Yuliandari, R. D., Umbul Wahyuni, C., Syahrul, F., Notobroto, H. B., Qomaruddin, M. B., & Soedarsono, S. (2023). Factor analysis of the role of physicians and its associated factors for encompassing patients with suspected tuberculosis in Surabaya City. Journal of Public Health in Africa, 14(s2). https://doi.org/10.4081/jphia.2023.2575