An Explanatory Sequential Mixed-Methods Study of Five-Year Trends (2020-2025) and Characteristics of Drug-Resistant Tuberculosis Cases
DOI:
https://doi.org/10.32807/jkp.v21i2.1963Keywords:
Tubercolosis, Drug Resistant Tubercolosis, Treatment HistoryAbstract
Drug-resistant tuberculosis (DR-TB) remains an important challenge for tuberculosis (TB) control. District-level descriptions based on routinely collected surveillance data can provide a local baseline for understanding the distribution and characteristics of recorded DR-TB cases. This study described the annual distribution and selected characteristics of DR-TB patients recorded in Central Lombok Regency during 2020–2024. We conducted a retrospective descriptive study using routinely collected surveillance data from the Tuberculosis Information System (Sistem Informasi Tuberkulosis, SITB) of Central Lombok Regency from 1 January 2020 to 31 December 2024. The source file contained 34 rows; we excluded one blank record, leaving 33 records with complete core variables. We manually reviewed four pairs of records sharing a patient name and confirmed they represented different patients; therefore, we retained all 33 records. We calculated annual DR-TB proportions using notified TB cases as the denominator. We summarised age, sex, and previous treatment history descriptively. Annual proportions were presented with 95% Wilson confidence intervals (CIs), and a Cochran–Armitage test for trend was used to assess ordered annual proportions. We included 33 DR-TB patient records: 3 in 2020, 8 in 2021, 6 in 2022, 7 in 2023, and 9 in 2024. The annual proportion of recorded DR-TB among notified TB cases was 0.32% (95% CI 0.11–0.93), 0.79% (0.40–1.55), 0.49% (0.22–1.06), 0.45% (0.22–0.93), and 0.60% (0.32–1.14), respectively. The Cochran–Armitage test showed no statistically significant linear trend (z = 0.30; p = 0.761). The mean age was 46.7 ± 13.0 years (median 49; interquartile range 38–53; range 21–73), and 29 records (87.9%) were aged 15–64 years. Eighteen records (54.5%) were male, and 15 (45.5%) were female. Nineteen records (57.6%) were classified as new cases and 14 (42.4%) as treatment after failure. The proportion of recorded DR-TB among notified TB cases fluctuated during 2020–2024, with no evidence of a statistically significant linear trend. Most recorded cases were aged 15–64 years, while the sex distribution was relatively balanced. Interpret the findings as a descriptive surveillance profile rather than an estimate of population-based incidence, transmission, or program effectiveness.
References
Fan, Y. F., Liu, D. X., Chen, Y. W., Ou, X. C., Mao, Q. Z., Yang, T. T., Wang, X. J., He, W. C., Zhao, B., Liu, Z. J., Abulimiti, M., Aihemuti, M., Gao, Q., & Zhao, Y. L. (2024). Inferring Mycobacterium Tuberculosis Drug Resistance and Transmission using Whole-genome Sequencing in a High TB-burden Setting in China. Biomedical and Environmental Sciences, 37(2), 157–169. https://doi.org/10.3967/bes2023.116
Farkhan, A., Pakasi, T. T., Sulistyo, S., Salsabila, A., James Maude, R., & Rotejanaprasert, C. (2026). Spatiotemporal epidemiology and associated risk factors of tuberculosis incidence and mortality in Indonesia 2017–2022: a nationwide space-time hierarchical analysis. Population Health Metrics, 24(1). https://doi.org/10.1186/s12963-026-00458-5
Figueiredo, R. G., Patino, C. M., & Ferreira, J. C. (2025). Cross-sectional studies: understanding applications, methodological issues, and valuable insights. In Jornal Brasileiro de Pneumologia (Vol. 51, Number 1). Sociedade Brasileira de Pneumologia e Tisiologia. https://doi.org/10.36416/1806-3756/e20250047
KemenKes RI. (2024). Petunjuk Teknis Penatalaksanaan Tuberkulosis Resistan Obat di Indonesia.
KemenKes RI. (2025). Petunjuk Teknis Penatalaksanaan Tuberkulosis Resistan Obat di Indonesia.
Ledesma, J. R., Basting, A., Chu, H. T., Ma, J., Zhang, M., Vongpradith, A., Novotney, A., Dalos, J., Zheng, P., Murray, C. J. L., & Kyu, H. H. (2023). Global-, Regional-, and National-Level Impacts of the COVID-19 Pandemic on Tuberculosis Diagnoses, 2020–2021. Microorganisms, 11(9). https://doi.org/10.3390/microorganisms11092191
Lestari, B. W., Nijman, G., Larasmanah, A., Soeroto, A. Y., Santoso, P., Alisjahbana, B., Chaidir, L., Andriyoko, B., van Crevel, R., & Hill, P. C. (2024). Management of drug-resistant tuberculosis in Indonesia: a four-year cascade of care analysis. The Lancet Regional Health - Southeast Asia, 22. https://doi.org/10.1016/j.lansea.2023.100294
Lolong, D. B., Irianto, J., Kusrini, I., Tarigan, I. U., Letelay, A. M., Tobing, K. L., Herawati, M. H., Pracoyo, N. E., Isfandari, S., Raflizar, L., D., M., R. G. A., M., H. S., M., D. A., & Nurjana, M. A. (2025). Factors contributing to multidrug-resistant tuberculosis among sputum culture-positive pulmonary tuberculosis patients in Indonesia: A cross-sectional study. Asian Pacific Journal of Tropical Medicine, 18(9), 400–408. https://doi.org/10.4103/apjtm.apjtm_80_25
Ma, J. B., Zeng, L. C., Ren, F., Dang, L. Y., Luo, H., Wu, Y. Q., Yang, X. J., Li, R., Yang, H., & Xu, Y. (2023). Development and validation of a prediction model for unsuccessful treatment outcomes in patients with multidrug-resistant tuberculosis. BMC Infectious Diseases, 23(1). https://doi.org/10.1186/s12879-023-08193-0
Maulina, N., Hayati, Z., Hasballah, K., Zulkarnain, Z., Waraztuty, I., & Defadheandra, A. (2024). Rifampicin-Resistant Tuberculosis Among Presumptive Pulmonary Tuberculosis in Province Referral Hospital, Indonesia: Dynamic Cases of a 7-Year Report. Journal of Research in Health Sciences, 24(1). https://doi.org/10.34172/jrhs.2024.136
Rukmana, A., Gozali, C., & Erlina, L. (2024). Mycobacterium tuberculosis Lineage Distribution Using Whole-Genome Sequencing and Bedaquiline, Clofazimine, and Linezolid Phenotypic Profiles among Rifampicin-Resistant Isolates from West Java, Indonesia. International Journal of Microbiology, 2024. https://doi.org/10.1155/2024/2037961
Rupani, M. P. (2024). Silicosis predicts drug resistance and retreatment among tuberculosis patients in India: a secondary data analysis from Khambhat, Gujarat (2006–2022). BMC Pulmonary Medicine, 24(1). https://doi.org/10.1186/s12890-024-03338-6
Sugiyono, R. I., Naysilla, A. M., Susanto, N. H., Handayani, D., Burhan, E., Karuniawati, A., Kusmiati, T., Wibisono, B. H., Riyanto, B. S., Sajinadiyasa, I. G. K., Djaharuddin, I., Sinaga, B. Y. M., Dewantara, R. D., Karyana, M., Kosasih, H., Liang, C. J., Ridzon, R., Neal, A. T., & Chen, R. Y. (2025). Treatment outcomes of pulmonary TB in adults in Indonesia. IJTLD Open, 2(3), 145–152. https://doi.org/10.5588/ijtldopen.24.0482
Surendra, H., F Elyazar, I. R., Puspaningrum BPH, E., Darmawan BPH, D., van Crevel, R., Shankar ScD, A. H., Baird, J. K., Surendra, H., F Elyazar, I. R., Puspaningrum, E., Darmawan, D., Pakasi, T. T., Lukitosari, E., Sulistyo, S., Deviernur, S. M., Fuady, A., Thwaites, G., van Crevel, R., Shankar, A. H., … Hamers, R. L. (2023). Impact of the COVID-19 pandemic on tuberculosis control in Indonesia: a nationwide longitudinal analysis of program data. In The Lancet Global Health (Vol. 11). https://data.
Swartwood, N. A., Singh, N., Mortazavi, S. A., Can, M. H., Cui, H., Ryuk, D. K., MacPherson, P., Horton, K. C., & Menzies, N. A. (2026). Differences in tuberculosis prevalence by sex in low- and middle-income countries over 1993–2025: A systematic review and meta-analysis. PLOS Medicine, 23(5 May). https://doi.org/10.1371/journal.pmed.1005114
WHO. (2021). Meeting Report of the WHO Expert Consultation on the Definition of Extensively Drug-Resistant Tuberculosis, 27-29 October 2020. World Health Organization.
WHO. (2025). Tuberculosis surveillance.
World Health Organization. (2024). WHO operational handbook on tuberculosis.
Xi, Y., Zhang, W., Qiao, R. J., & Tang, J. (2022). Risk factors for multidrug-resistant tuberculosis: A worldwide systematic review and meta-analysis. In PLoS ONE (Vol. 17, Number 6, June). Public Library of Science. https://doi.org/10.1371/journal.pone.0270003
Downloads
Published
How to Cite
Issue
Section
Citation Check
License
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
Upon the acceptance of the article by the Editorial Board of Jurnal Kesehatan Prima and the decision to publish it, the copyright for the article will be transferred to Jurnal Kesehatan Prima, published by Poltekkes kemenkes Mataram. Poltekkes kemenkes Mataram as the publisher of Jurnal Kesehatan Prima holds the copyright to all published articles in this journal.
