Association Between History of Tuberculosis Treatment and Treatment Initiation Within 6 Months Among Individuals With Drugs-Resistant Tuberculosis Registered in Jakarta

Abstract RATIONALE: A significant proportion of Drug-Resistant Tuberculosis (DR-TB) patients worldwide remains a global health burden with only 44% of patients receiving treatment. In 2023, the proportion of individuals with Multidrug Resistant/Rifampicin Resistant Tuberculosis (MDR/RR-TB) globally was higher among those with a history of Tuberculosis (TB) treatment (16%) compared to new cases (3.2%). This study aims to investigate the association between the history of TB treatment and DR-TB treatment initiation among registered cases in 2023-2024 at the National Referral Respiratory Centre, Persahabatan Hospital, Indonesia. METHODS: We conducted a single-centre retrospective cohort study as a part of the Pre-Treatment Attrition in DR-TB (PREATTRI-TB) Study by utilizing data extracted from the National TB Information System (SITB). Individuals with confirmed Pulmonary DR-TB aged ≥ 15 years old registered from January 2023 to June 2024 at Persahabatan Hospital were included and grouped into with or without a history of TB treatment. Each eligible individual was followed up within 6 months from the day of diagnosis to record DR-TB treatment initiation. Data were analysed using STATA Version 16 Statistical Software. Univariate and multivariate logistic regression analyses were conducted to determine the association between the history of TB treatment and treatment initiation within 6 months by controlling confounding factors. RESULTS: Among 448 individuals with DR-TB, 260 (58.04%) had a history of TB treatment and 180 (41.96%) were new cases. The percentage of untreated cases within 6 months after diagnosis between with and without history of TB treatment groups were 33 (12.69%) vs 5 (2.66%) (p<0.05), respectively. Individuals with DR-TB who had a history of TB treatment (OR 4.33; CI 95% 1.6-11.6) had a higher probability of missing DR-TB treatment initiation within the first six months following diagnosis. CONCLUSIONS: These findings highlighted that individuals with DR-TB who have a history of prior TB treatment are at a higher probability of missing treatment initiation within 6 months. Keywords: drug-resistant tuberculosis, history of TB treatment, treatment initiation