TB Treatment and Multidrug-Resistant of Tuberculosis (MDR-TB) in Central Java of Indonesia: A Case-Control Study

Background: The burden of tuberculosis (TB) is exacerbated by anti-TB drug resistant especially multidrugresistant TB (MDR-TB). There has been an increasing trend of Multidrug-resistant TB in Indonesia. However, there is lack of epidemiological study on risk factors of MDR-TB in Indonesia.

Objective: This study aimed to determine the influence of TB treatments as risk factors on MDR-TB in Central Java Indonesia while controlling other covariates.

Method: A case-control study was conducted between August 2017 and February 2018. The study subjects were selected using inclusion criteria. Cases were 81 MDR-TB patients in intensive phase that lived in Central Java and recorded in the Moewardi Hospital, a referral hospital. The controls were 228 patients who received first-line anti-TB treatment without drug resistance. A structured questionnaire interview was used to collect the data. Multiple logistic regression analysis was used to identify the association.

Results: The proportion of gender among the 81 cases and 228 controls were 64.2% vs. 43.0% for males, and 35.8% vs. 57.0% for females. TB treatment that were significantly associated with MDR-TB were: length of TB treatment > 6 months (aOR =14.1; 95% CI: 6.68-29.86), continued TB treatment (aOR =11.695% 95%CI: 5.36-25.48). Other significant covariates were had no formal education or primary education (aOR = 2.89; 95% CI: 1.38-6.02) and low monthly income (aOR =2.86; 95%CI: 1.18-6.92)

Conclusions: Long duration, discontinuity of TB treatment, and low socioeconomic status increase the risk of MDR-TB.