# Treatment outcomes of pulmonary TB in adults in Indonesia

## TL;DR

This study examines treatment outcomes for adult pulmonary TB patients in Indonesia and identifies factors linked to poor results.

## Contribution

The study identifies specific risk factors for unfavourable TB treatment outcomes in Indonesia using a multicentre dataset.

## Key findings

- Overall treatment success was 72.3%, with MDR-TB patients having lower success (60.1%) than DS-TB patients (81.6%).
- Unfavourable outcomes were associated with age ≥50, being underweight, and baseline smear positivity.
- MDR-TB treatment regimens were linked to higher odds of unfavourable outcomes.

## Abstract

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.

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with available treatment outcomes — cured, completed, failed, dead, and lost to follow-up (LTFU) — excluding withdrawn or transferred.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.

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).

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