Determinan pola resistensi pasien Multi-Drug Resistant Tuberculosis (MDRTB) : Studi Multi-Center di Jember, Indonesia

Abstract

Drug-resistant, particularly multidrug resistance tuberculosis (MDRTB), is an emerging problem due to its low success rate of treatment outcomes. Most MDRTB in Indonesia was rifampicin resistant (RRTB). There is a paucity of evidence on the determinants of the MDRTB types. This study aims to assess the determinant of resistance type. A hospital-based cross-sectional study was conducted in two referral hospitals for MDRTB in the city of Jember Indonesia. MDRTB patients registered in the web-based information system tuberculosis in Indonesia (SITB) from 2018 to 2022 who had a complete medical record were included. Multi-variate logistic regression analysis was done to identify determinants of MDRTB type. Odds ratios (ORs) with 95% confidence intervals (CIs) were computed. From 347 patients, there were 186 patients excluded due to un-completeness of the records. In total 158 patients were included. Most patients (53,8%) were encountered rifampicin resistance (RR-TB), followed by MDRTB (37,3%), Pre-XDR TB (6,96%), and XDR-TB (1,90%). The sociodemographic variable such as age, gender, residence, and comorbid were not significantly correlate with the type of MDRTB.  The only determinant affects the type of MDR/PreXDR/XDR TB was the previous history of TB treatment (OR = 2,4 kali (95% CI: 1,2 - 4,7)). This study showed that patients with the history of TB treatment are more likely to encountered more severe types of TB resistance such as MDRTB/PreXDR/XDR-TB. Therefore, health-care workers should prioritize the adherence of TB treatment especially in patients with previous history of TB treatment.