Factors contributing to multidrug-resistant tuberculosis among sputum culture-positive pulmonary tuberculosis patients in Indonesia: A cross-sectional study

Objective: To analyze the risk factors associated with multidrug- resistant tuberculosis (MDR-TB) as a first national survey in Indonesia. Methods: This national coverage cross-sectional study was conducted from 2017 to 2018. The study subjects were selected using a multi-stage probability random sampling method. MDR- TB is tuberculosis caused by bacteria resistant to at least isoniazid and rifampicin. The dependent variable was MDR-TB. Independent variables included age, sex, education, employment status, place of residence, history of living with TB patients, and the number of household members. Univariate and multivariate logistic regression models were used to analyze the risk factors associated with MDR- TB. All the data were analyzed using STATA V.14.0 (Stata Corp LLC, College Station, TX). Results: This study found the MDR rate was 109/3 234 (3.4%) among positive pulmonary TB patients. More than twice as many patients had MDR re-treatment (74/3 234, 2.3%), compared to 35/3 234 (1.1%) who had new TB diagnoses or were getting initial treatment. After adjusting for employment status, individuals with a prior history of tuberculosis treatment were found to have significantly higher odds of developing MDR-TB, with an odds ratio of 7.22 (95% CI 3.87-13.44). Conclusions: Increasing attention should be paid to these patients to prevent MDR-TB, and MDR-TB transmission is an urgent challenge for controlling TB worldwide. Early detection of MDR-TB is a critical part of TB control programs.