Characteristics of Drug-sensitive and Drug-resistant Tuberculosis Cases among Adults at Tuberculosis Referral Hospitals in Indonesia

Erlina Burhan, Muhammad Karyana, Anis Karuniawati, Tutik Kusmiati, Banteng Hanang Wibisono, Diah Handayani, Bambang Sigit Riyanto, I. Gede Ketut Sajinadiyasa, Bintang Yinke Magdalena Sinaga, Irawaty Djaharuddin, Retna Indah Sugiyono, Nugroho Harry Susanto, Aly Diana, Herman Kosasih, Dewi Lokida, Siswanto, Aaron Neal, Chuen Yen Lau, Sophia Siddiqui

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)


As Indonesia’s rifampin resistance testing rates are lower than global testing rates per the 2020 WHO global tuberculosis (TB) report, prevalence of multidrug-resistant TB may be underestimated. Our study aimed to evaluate prevalence and patterns of TB drug resistance (DR) within Indonesia. We conducted a cross-sectional analysis of baseline data collected from 2017–2018 as part of a cohort study of adults with presumed pulmonary TB at 7 DR-TB referral hospitals in Indonesia. Bacteriological examinations (acid-fast bacilli, GeneXpert, sputum culture) and drug-susceptibility testing were performed following the guidelines of the National TB Program. Of 447 participants with complete bacteriological examinations, 312 (69.8%) had positive sputum cultures for Mycobacterium tuberculosis. The proportion of MDR and pre-extensively drug-resistant was higher in previously treated compared with newly diagnosed participants (52.5% [73/139] versus 15% [26/173]). Compared with drug-sensitive case, drug-resistant TB was associated with cavities. Given the difference between rates of DR in TB referral hospitals from our study compared with the WHO survey in 2019 that showed 17.7% and 3.3% DR among previously treated and newly diagnosed participants globally, further characterization of Indonesia’s TB epidemiology in the general population is needed. Strategies, including public policies to optimize case finding, strengthen capacity for resistance testing, and prevent loss to follow-up will be critical to reduce the burden of TB in Indonesia.

Original languageEnglish
Pages (from-to)984-991
Number of pages8
JournalAmerican Journal of Tropical Medicine and Hygiene
Issue number5
Publication statusPublished - Nov 2022


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