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with available treatment outcomes - cured, completed, failed, dead, and lost to follow-up (LTFU) - excluding withdrawn or transferred.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