Risk factors for tuberculosis (TB) treatment interruption among new and retreatment TB patients in West Kalimantan Province, Indonesia: A retrospective cohort study

Background: Treatment adherence in tuberculosis (TB) remains a major public health challenge in Indonesia. In West Kalimantan, high treatment interruption rates are driven by geographic, socioeconomic, and healthcare factors. This study identifies the risk factors linked to treatment interruption in the province. Methods: A retrospective cohort study was using the System Information of Tuberculosis (SITB) database from 2019 to 2022 (n = 12,052). We used Kaplan-Meier analysis and Cox regression to identify treatment interruption risk factors, considering patient characteristics and geographic disparities. Results: The overall treatment interruption rate was 6.62 % among new patients and 2.87 % among retreatment patients, with the highest risk occurring during the intensive treatment phase. Significant risk factors for treatment interruption included male sex (aHR = 1.18, 95 % CI: 1.01-1.39, p = 0.043), older age (>55 years, aHR = 15.2, 95 % CI: 6.29-36.9, p < 0.001), HIV positive status (aHR = 9.46, 95 % CI: 7.11-12.6, p < 0.001), and diabetes mellitus history (aHR = 1.51, 95 % CI: 1.21-1.89, p < 0.001). Rural districts showed higher treatment interruption rates due to limited healthcare access and cross-border mobility issues. Conclusion: The study highlighted the urgent need for targeted interventions to reduce treatment interruption, particularly among older patients, males, and individuals with comorbidities. Strategies such as enhanced patient follow-up, mobile TB clinics, and integration of TB-HIV care are recommended. These findings provide critical insights for improving TB treatment programs in resource-limited settings. Keywords: Tuberculosis, Treatment interruptions, Hazard ratio, Risk factors, Indonesia