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. 2025 Mar 12;2(3):145-152.
doi: 10.5588/ijtldopen.24.0482. eCollection 2025 Mar.

Treatment outcomes of pulmonary TB in adults in Indonesia

R I Sugiyono  1 , A M Naysilla  1 , N H Susanto  1 , D Handayani  2 , E Burhan  2 , A Karuniawati  3 , T Kusmiati  4 , B H Wibisono  5 , B S Riyanto  6 , I G K Sajinadiyasa  7 , I Djaharuddin  8 , B Y M Sinaga  9 , R D Dewantara  1 , M Karyana  1   10 , H Kosasih  1 , C J Liang  11 , R Ridzon  12 , A T Neal  12 , R Y Chen  12
Affiliations

Treatment outcomes of pulmonary TB in adults in Indonesia

R I Sugiyono et al. IJTLD Open. .

Abstract

Background: Achieving the goal of Ending TB requires a treatment success rate of ≥90%, a challenging target for Indonesia. To understand outcomes and associated factors for unfavourable outcomes, we analysed prospective multicentre study data from 2017 to 2020 involving drug-susceptible TB (DS-TB) and multidrug-resistant TB (MDR-TB) treatment adult patients.

Methods: This study focused on bacteriologically confirmed participants based on Xpert MTB/RIF or culture results. We analysed participants with available treatment outcomes - cured, completed, failed, dead, and lost to follow-up (LTFU) - excluding withdrawn or transferred. Univariable and multivariable logistic regression analyses identified factors associated with unfavourable outcomes.

Results: Among 328 bacteriologically confirmed participants with available outcomes, the overall treatment success was 72.3% (DS-TB: 81.6% and MDR-TB: 60.1%). Unfavourable outcomes were 27.7%, with 3.6% failures, 9.5% deaths, and 14.6% LTFUs. Associated factors for unfavourable outcomes included age ≥50 years (aOR 2.54, 95% CI 1.11-5.95; P = 0.029); being underweight (aOR 1.93, 95% CI 1.05-3.61; P = 0.037); having baseline acid-fast bacilli smear of scanty/+1 (aOR 3.77, 95% CI 1.41-11.65; P = 0.013) or +2/+3 (aOR 3.34, 95% CI 1.31-9.83; P = 0.017); and being treated with MDR-TB regimen (aOR 2.03, 95% CI 1.05-3.96; P = 0.036).

Conclusion: Strategies to improve outcomes include tailored care for older adults, nutritional support, treatment monitoring, and enhanced MDR-TB management.

Keywords: cure; death; drug-susceptible tuberculosis; failure; multidrug resistance.

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Figures

Figure 1.
Figure 1.
Flow of study participants from TB diagnosis to treatment to available outcomes. DS-TB = drug-susceptible TB; MDR-TB = multidrug-resistant TB.
Figure 2.
Figure 2.
Distribution of 31 death cases categorised by TB treatment group and cause of death as it related to the TB infection. DS-TB = drug-susceptible TB; MDR-TB = multidrug-resistant TB.
See this image and copyright information in PMC

References

    1. World Health Organization . Global tuberculosis report, 2023. Geneva, Switzerland: WHO, 2023.
    1. Ministry of Health Republic of Indonesia - National Institute of Health Research and Development and General Directorate of Disease Prevention and Control . Drug-resistant tuberculosis survey in Indonesia 2017–2018 [Survei tuberkulosis resistansi obat di Indonesia 2017–2018]. Jakarta, Indonesia: Ministry of Health Republic of Indonesia, 2019.
    1. Ministry of Health Republic of Indonesia . National tuberculosis control program report 2022 [Program penanggulangan tuberkulosis tahun 2022]. Jakarta, Indonesia: Ministry of Health Republic of Indonesia, 2023.
    1. World Health Organization . Implementing the end TB strategy: the essentials, 2022 update. Geneva, Switzerland: WHO, 2022.
    1. Arlinda D, et al. . Poor tuberculosis treatment outcomes associated with older age, previous treatment, HIV, and drug resistance at seven hospitals in Indonesia. J Penelit Pengemb Pelayanan Kesehat. 2020;4(2):61–68.

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