Treatment outcomes of pulmonary TB in adults in Indonesia.

IJTLD open Pub Date : 2025-03-12 eCollection Date: 2025-03-01 DOI:10.5588/ijtldopen.24.0482

R I Sugiyono, A M Naysilla, N H Susanto, D Handayani, E Burhan, A Karuniawati, T Kusmiati, B H Wibisono, B S Riyanto, I G K Sajinadiyasa, I Djaharuddin, B Y M Sinaga, R D Dewantara, M Karyana, H Kosasih, C J Liang, R Ridzon, A T Neal, R Y Chen

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Abstract

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with available treatment outcomes - cured, completed, failed, dead, and lost to follow-up (LTFU) - excluding withdrawn or transferred.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

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印度尼西亚成人肺结核的治疗结果。

背景：实现终结结核病的目标需要治疗成功率≥90%，这对印度尼西亚来说是一个具有挑战性的目标。为了了解结果和不利结果的相关因素，我们分析了2017年至2020年涉及药物敏感结核病（DS-TB）和耐多药结核病（MDR-TB）治疗的成人患者的前瞻性多中心研究数据。方法：本研究以Xpert MTB/RIF培养结果为基础，重点研究细菌学证实的参与者。我们分析了具有可用治疗结果的参与者-治愈，完成，失败，死亡和随访失败(LTFU) -不包括撤回或转移。单变量和多变量逻辑回归分析确定了与不利结果相关的因素。结果：在328名细菌学证实的参与者中，总体治疗成功率为72.3% （DS-TB: 81.6%, MDR-TB: 60.1%）。不良结局为27.7%，失败3.6%，死亡9.5%,ltf 14.6%。不利结果的相关因素包括：年龄≥50岁(aOR 2.54, 95% CI 1.11-5.95；P = 0.029)；体重过轻(比值比1.93,95% CI 1.05-3.61；P = 0.037)；基线抗酸杆菌涂片为阴性/阳性1 (aOR 3.77, 95% CI 1.41 ~ 11.65；P = 0.013)或+2/+3 (aOR 3.34, 95% CI 1.31-9.83；P = 0.017)；并接受耐多药结核病方案治疗(aOR 2.03, 95% CI 1.05-3.96；P = 0.036)。结论：改善结果的策略包括为老年人量身定制护理、营养支持、治疗监测和加强耐多药结核病管理。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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IJTLD open

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