Anti-Tuberculosis Drug Resistance Patterns In Patients With Pulmonary Tuberculosis

Abstract

Background: In 2022, Indonesia reported a pulmonary tuberculosis (PTB) incidence rate of 354 per 100,000 population, with an estimated 24,666 cases of drug-resistant pulmonary tuberculosis (DR-TB). Nationally, DR-TB case detection coverage reached 50.8%, with 12,531 patients notified—an increase of 17% from the previous year.

Method: This study aims to examine the pattern of Anti-Tuberculosis Drug (ATD) resistance by analyzing internal host-related risk factors using an analytical  observational study with a case-control design. Risk factors assessed included treatment history, treatment adherence, laboratory monitoring, comorbidities, and healthcare service units. The study involved 94 PTB patients in Bandar Lampung City, comprising 47 cases and 47 controls. Data collection utilized questionnaires and checklist forms, with analysis conducted using chi-square tests and multiple logistic regression models.

Result: The chi-square test revealed significant associations for treatment history (p = 0.00, OR = 71.5), adherence (p = 0.00, OR = 7.7), and laboratory monitoring (p = 0.00, OR = 12.0). No significant associations were found for comorbidities (p = 0.655) and service units (p = 0.171). Logistic regression identified treatment history as the primary risk factor for DR-TB (Adjusted OR = 47.762), followed by laboratory monitoring (Adjusted OR = 5.326).

Conclusion: The resulting regression model indicated a predictive probability of 94.9%, suggesting that treatment history and laboratory monitoring are the key patterns contributing to ATD resistance among PTB patients.