MacNeil A , Glaziou P , Sismanidis C , Date A , Maloney S , Floyd K , 2020. Global Epidemiology of tuberculosis and progress toward meeting global targets—worldwide, 2018. MMWR Morb Mortal Wkly Rep 69: 281–285.
World Health Organization , 2020. Tuberculosis Data. Geneva, Switzerland: WHO.
Shankar EM et al.2014. HIV–Mycobacterium tuberculosis co-infection: a “danger-couple model” of disease pathogenesis. Pathog Dis 70: 110–118.
World Health Organization , 2020. Global Tuberculosis Report 2020. Geneva, Switzerland: WHO.
Lange C , Chesov D , Heyckendorf J , Leung CC , Udwadia Z , Dheda K , 2018. Drug-resistant tuberculosis: An update on disease burden, diagnosis and treatment: drug-resistant tuberculosis. Respirology 23: 656–673.
Zignol M , van Gemert W , Falzon D , Sismanidis C , Glaziou P , Floyd K , Raviglione M , 2012. Surveillance of anti-tuberculosis drug resistance in the world: an updated analysis, 2007–2010. Bull World Health Organ 90: 111–119D.
Chaidir L et al.2015. Mycobacterium tuberculosis genotypic drug resistance patterns and clustering in Jayapura, Papua, Indonesia. Int J Tuberc Lung Dis Off J Int Union Tuberc Lung Dis 19: 428–433.
Massi MN , Wahyuni S , Halik H , Anita, Yusuf I , Leong FJ , Dick T , Phyu S , 2011. Drug resistance among tuberculosis patients attending diagnostic and treatment centres in Makassar, Indonesia. Int J Tuberc Lung Dis Off J Int Union Tuberc Lung Dis 15: 489–495.
World Health Organization; International Union Against Tuberculosis and Lung Disease, Centers for Disease Control and Prevention; Pan American Health Organization; INDRE; Association of Public Health Laboratories , 2000. Acid-Fast Direct Smear Microscopy—A Laboratory Training Program.
Becton, Dickinson and Company , 2015. BBLTM Lowenstein-Jensen Medium BBLTM Lowenstein-Jensen Medium with 5% Sodium Chloride. Available at: https://legacy.bd.com/ds/technicalCenter/inserts/L007464(11).pdf.
World Health Organization , 2013. Definitions and Reporting Framework for Tuberculosis—2013 revision (updated December 2014 and January 2020). Geneva, Switzerland: WHO.
World Health Organization , 2021. Meeting Report of the WHO Expert Consultation on the Definition of Extensively Drug-resistant Tuberculosis, 27–29 October 2020. Geneva Switzerland: WHO.
Shibabaw A , Gelaw B , Gebreyes W , Robinson R , Wang S-H , Tessema B , 2020. The burden of pre-extensively and extensively drug-resistant tuberculosis among MDR-TB patients in the Amhara region, Ethiopia. PLoS One 15: e0229040.
Sethi S , Mewara A , Dhatwalia SK , Singh H , Yadav R , Singh K , Gupta D , Wanchu A , Sharma M , 2013. Prevalence of multidrug resistance in Mycobacterium tuberculosis isolates from HIV seropositive and seronegative patients with pulmonary tuberculosis in north India. BMC Infect Dis 13: 137.
Lukoye D et al.2013. Anti-tuberculosis drug resistance among new and previously treated sputum smear-positive tuberculosis patients in Uganda: results of the first national survey. PLoS One 8: e70763.
Merza MA , Farnia P , Tabarsi P , Khazampour M , Masjedi MR , Velayati AA , 2011. Anti-tuberculosis drug resistance and associated risk factors in a tertiary level TB center in Iran: a retrospective analysis. J Infect Dev Ctries 5: 511–519.
Aia P et al.2016. The burden of drug-resistant tuberculosis in Papua New Guinea: results of a large population-based survey. PLoS One 11: e0149806.
Thirumala AK , Vineet B , 2019. rGLC COUNTRY SUPPORT MISSION REPORT. Indonesia. Geneva, Switzerland: World Health Organization. Available at: https://www.who.int/docs/default-source/searo/tuberculosis/pmdt-country-support-mission-indonesia-april-2019-final.pdf?sfvrsn=6b2956a2_2.
Cox HS et al.2010. Epidemic levels of drug resistant tuberculosis (MDR and XDR-TB) in a high HIV prevalence setting in Khayelitsha, South Africa. PLoS One 5: e13901.
Dheda K et al., 2017. The epidemiology, pathogenesis, transmission, diagnosis, and management of multidrug-resistant, extensively drug-resistant, and incurable tuberculosis. Lancet Respir Med, doi:10.1015/S2213-2600(17)30079-6.
Horton KC , MacPherson P , Houben RMGJ , White RG , Corbett EL , 2016. Sex differences in tuberculosis burden and notifications in low- and middle-income countries: a systematic review and meta-analysis. PLoS Med 13: e1002119.
Wáng YXJ , Chung MJ , Skrahin A , Rosenthal A , Gabrielian A , Tartakovsky M , 2018. Radiological signs associated with pulmonary multi-drug resistant tuberculosis: an analysis of published evidences. Quant Imaging Med Surg 8: 161–173.
Hunter RL , Actor JK , Hwang S-A , Karev V , Jagannath C , 2014. Pathogenesis of post primary tuberculosis: immunity and hypersensitivity in the development of cavities. Ann Clin Lab Sci 44: 365–387.
Ong CWM , Elkington PT , Friedland JS , 2014. Tuberculosis, pulmonary cavitation, and matrix metalloproteinases. Am J Respir Crit Care Med 190: 9–18.
Gadkowski LB , Stout JE , 2008. Cavitary pulmonary disease. Clin Microbiol Rev 21: 305–333.
Manson AL et al.2017. Genomic analysis of globally diverse Mycobacterium tuberculosis strains provides insights into the emergence and spread of multidrug resistance. Nat Genet 49: 395–402.
Shah M et al.2020. Multicenter study of the accuracy of the BD MAX multidrug-resistant tuberculosis assay for detection of Mycobacterium tuberculosis complex and mutations associated with resistance to rifampin and isoniazid. Clin Infect Dis 71: 1161–1167.
Espindola AL , Varughese M , Laskowski M , Shoukat A , Heffernan JM , Moghadas SM , 2017. Strategies for halting the rise of multidrug resistant TB epidemics: assessing the effect of early case detection and isolation. Int Health 9: 80–90.
Fuady A , Houweling TAJ , Mansyur M , Burhan E , Richardus JH , 2020. Catastrophic costs due to tuberculosis worsen treatment outcomes: a prospective cohort study in Indonesia. Trans R Soc Trop Med Hyg 114: 666–673.
McAllister SM , Wiem Lestari B , Sullivan T , Fortuna Hadisoemarto P , Afifah N , Arosdiani Apip R , Murray M , Hill PC , Alisjahbana B , 2020. Out-of-pocket costs for patients diagnosed with tuberculosis in different healthcare settings in Bandung, Indonesia. Am J Trop Med Hyg 103: 1057–1064.
Ho J , Byrne AL , Linh NN , Jaramillo E , Fox GJ , 2017. Decentralized care for multidrug-resistant tuberculosis: a systematic review and meta-analysis. Bull World Health Organ 95: 584–593.
Marx FM , Cohen T , Menzies NA , Salomon JA , Theron G , Yaesoubi R , 2020. Cost-effectiveness of post-treatment follow-up examinations and secondary prevention of tuberculosis in a high-incidence setting: a model-based analysis. Lancet Glob Health 8: e1223–e1233.
World Health Organization , 2014. Companion Handbook to the WHO Guidelines for the Programmatic Management of Drug-resistant Tuberculosis. Geneva, Switzerland: WHO.
Zignol M , Sismanidis C , Falzon D , Glaziou P , Dara M , Floyd K , 2013. Multidrug-resistant tuberculosis in children: evidence from global surveillance. Eur Respir J 42: 701–707.
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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.
Financial support: This work has been funded in whole or in part with Ministry of Health Indonesia; the Intramural Research Program, National Institutes of Health; National Cancer Institute, Center for Cancer Research, National Institutes of Health; and federal funds from the National Institute of Allergy and Infectious Diseases, National Institutes of Health, under contract nos. HHSN261200800001E and HHSN261201500003I. The content of this publication does not necessarily reflect the views or policies of the Department of Health and Human Services, nor does mention of trade names, commercial products, or organizations imply endorsement by the U.S. government.
Authors’ addresses: Erlina Burhan and Diah Handayani, Persahabatan Hospital/Department of Pulmonary and Respiratory Medicine, Faculty of Medicine, Universitas Indonesia, Jakarta Pusat, Indonesia, E-mails: firstname.lastname@example.org and email@example.com. Muhammad Karyana and Siswanto Siswanto, National Institute of Health Research and Development, Jakarta, Indonesia, E-mails: firstname.lastname@example.org and email@example.com. Anis Karuniawati, Department of Microbiology, Faculty of Medicine, Universitas Indonesia/Cipto Mangunkusumo Hospital, Jakarta Pusat, Indonesia, E-mail: firstname.lastname@example.org. Tutik Kusmiati, Dr. Soetomo Hospital/Universitas Airlangga, Surabaya, Indonesia, E-mail: email@example.com. Banteng Hanang Wibisono, Dr. Kariadi Hospital/Universitas Diponegoro, Semarang, Indonesia, E-mail: firstname.lastname@example.org. Bambang Sigit Riyanto, Dr. Sardjito Hospital/Universitas Gadjah Mada, Yogyakarta 55281, Indonesia, E-mail: email@example.com. I Gede Ketut Sajinadiyasa, Sanglah General Hospital, Bali, Indonesia, E-mail: firstname.lastname@example.org. Bintang Yinke Magdalena Sinaga, H. Adam Malik General Hospital, Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia, E-mail: email@example.com. Irawaty Djaharuddin, Dr. Wahidin Sudirohusodo Hospital/Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, University of Hasanuddin, Makassar, Indonesia, E-mail: firstname.lastname@example.org. Retna Indah Sugiyono, Nugroho Harry Susanto, and Herman Kosasih, Indonesia Research Partnership on Infectious Disease, Jakarta, Indonesia, E-mails: email@example.com, firstname.lastname@example.org, and email@example.com. Aly Diana, Indonesia Research Partnership on Infectious Disease, Jakarta, Indonesia and Department of Public Health, Faculty of Medicine, Universitas Padjadjaran, Sumedang, Indonesia, E-mail: firstname.lastname@example.org. Dewi Lokida, Department of Clinical Pathology, Tangerang District Hospital, Tangerang, Indonesia, E-mail: email@example.com. Aaron Neal and Sophia Siddiqui, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, E-mails: firstname.lastname@example.org and email@example.com. Chuen-Yen Lau, HIV Dynamics and Replication Program, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, E-mail: firstname.lastname@example.org.