Drug-resistant tuberculosis in children in Indonesia: A population-based analysis of the 2023 Indonesian Health Survey

Abstract

Objective: To analyze the prevalence and risk factors of drug- resistant tuberculosis (DR-TB) among Indonesian children.

Methods: This study analyzed data from the 2023 Indonesian Health Survey, which included children aged 0-14 years and household heads nationwide. Binary logistic regression was used to identify factors associated with DR-TB.

Results: A total of 423 participants were included in the final analysis. The national prevalence of pediatric DR-TB was 15.9%, with substantial variation across provinces. In the multivariable logistic regression analysis, rural residence (aOR 2.68; 95% Cl 1.23-5.84), poor TB treatment adherence (aOR 17.353; 95% Cl 3.098-97.206), and household TB contact (aOR 5.628; 95% Cl 1.113-28.450) were independently associated with higher odds of DR- TB. Wealth index was significantly associated with DR-TB overall (P=0.018), but no significant differences were observed between individual wealth categories after adjustment. Household TB contact was associated with higher odds of DR-TB (aOR 5.628; 95% Cl 1.113-28.450).

Conclusions: Pediatric DR-TB in Indonesia has a substantial prevalence and marked geographic variation. Rural residence, poor TB treatment adherence, and household TB contact were key factors associated with DR-TB, highlighting the need to strengthen treatment adherence, household contact investigation, and targeted interventions.

Keywords

Tuberculosis / Drug resistant tuberculosis / Child / Prevalence / Socioeconomic factors / Indonesia

Conflict of interest statement

The authors declare that they have no conflict of interest.

Funding

The authors received no extramural funding for the study.

Authors' contributions

ZKN prepared a data set. RR analyzed the data, conceptualized and designed the study, and drafted the manuscript. RR, MM, HBN, IUT, ZKN and ADL participated in interpreting the results and commented on the manuscript. All authors have read and agreed to the published version of the manuscript. RR acts as the principal investigator.

Publisher’s note

The Publisher of the Journal remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Edited by Lei Y, Pan Y, Zhang Q

Acknowledgements

The authors gratefully acknowledge the Head of the Indonesian Agency for Health Development Policy for granting permission to access and use data from the 2023 Indonesian Health Survey.

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