Treatment outcomes of pulmonary TB in adults in Indonesia

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with available treatment outcomes - cured, completed, failed, dead, and lost to follow-up (LTFU) - excluding withdrawn or transferred.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