Proxy-Based Classification of Care Patterns and Social Support Among TB Patients in Papua: A Routine Surveillance Data Analysis

Abstract

Tuberculosis (TB) remains a major public health challenge in Indonesia, particularly in Papua. However, routine TB surveillance systems do not directly measure caregiver characteristics, limiting evidence on care patterns and social support. This study aimed to construct a proxy-based typology of care patterns and social support from routine TB surveillance data and assess its association with TB treatment success. A retrospective cohort study using secondary data was conducted at Puskesmas Waibhu, Jayapura Regency, Papua. A total of 768 TB treatment episodes from 729 unique patients were included using total sampling. Because the typology was derived from administrative proxies rather than direct caregiver assessment, it was considered exploratory and hypothesis-generating. Data were analyzed using descriptive statistics, chi-square tests, Fisher’s exact test, and binary logistic regression. The Low Care–Low Support group was the largest typology. High social support was significantly associated with treatment success in bivariate analysis (p = 0.012) and multivariable analysis (adjusted OR = 2.22; 95% CI: 1.24–3.99; p = 0.007), whereas the care-pattern proxy was not significantly associated with treatment outcomes. Bacteriologically confirmed diagnosis and unknown diabetes mellitus status were independently associated with lower treatment success. These findings suggest the importance of family social support and the feasibility of a proxy-based typology from routine surveillance data. However, findings should be interpreted cautiously because some episodes originated from the same patients and model explanatory power was modest (pseudo-R² = 0.067). Prospective studies using direct caregiver assessment are needed for validation.