Variation of tuberculosis prevalence across diagnostic approaches and geographical areas of Indonesia

Abstract

Background Tuberculosis (TB) has contributed to a significant disease burden and economic loss worldwide. Given no gold standard for diagnosis, early identification of TB infection has been challenging. This study aimed to comparatively investigate the prevalence of TB across diagnostic approaches (sputum AFB, sputum culture, sputum genetic test, and chest x-ray) and geographical areas of Indonesia. Methods Participant demographic variables and TB screening test results were obtained from the Tuberculosis Unit, Health Research and Development Agency, Ministry of Health (HRDA-MoH). The prevalence of pulmonary TB in populations aged 15 years and over was calculated using TB cases as a numerator and populations aged 15 years and over as a denominator. Variations across geographical areas and diagnostic approaches were expressed as prevalence and 95% confidence interval (CI). Results A total of 67,944 records were reviewed. Based on bacteriological evidence, the prevalence of TB per 100,000 in Indonesia was 759 (95% CI: 589.7–960.8) with variations across areas: 913 (95% CI 696.7–1,176.7; Sumatra), 593 (95% CI 447.2–770.6; Java-Bali), and 842 (95% CI 634.7–1,091.8; other islands). Also, the prevalence of TB varied across diagnostic approaches: 256.5 (sputum AFB), 545 (sputum culture), 752.2 (chest x-ray), and 894.9 (sputum genetic test). Based on sputum AFB, the TB prevalence varied from 216.6 (95% CI 146.5–286.8; Java-Bali), 259.9 (95% CI 184.2–335.6; other islands) to 307.4 (95% CI 208.3–406.5; Sumatra). Based on sputum culture, the TB prevalence ranged from 487.9 (95% CI 433.6–548.6; Java-Bali), 635.9 (95% CI 564.9–715.1; Sumatra), to 2,129.8 (95% CI 1,664.0–2,735.6; other islands). Based on chest x-ray, the TB prevalence varied from 152.1 (95% CI 147.9–156.3; Java-Bali), 159.2 (95% CI 154.1–164.3; Sumatra), to 864 (95% CI 809–921.4; other islands). Based on sputum genetic test, the TB prevalence ranged from 838.7 (95% CI 748.4–900.8; Java-Bali), 875 (95% CI 775.4–934.2; Sumatra), to 941.2 (95% CI 663.6–992.3; other islands). Conclusions The variation of TB prevalence across geographical regions could be confounded by the diagnostic approaches. Trial registration This study was approved by the Institutional Review Board of Chulalongkorn University (IRB No. 684/63).

One-stage anterior approach for long-segment subaxial cervical spondylitis tuberculosis: A case report

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Cultural factors and family behavior in preventing the transmission of TB in The Nusa Tenggara Region, Indonesia

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Correlation between serum IL-17 levels with Erythrocyte Sedimentation Rate (ESR) and C-Reactive Protein (CRP) levels of new cases of pulmonary tuberculosis at Sanglah Central General Hospital, Bali, Indonesia

“…Based on the 2013 WHO report, Indonesia is ranked as the fourth country with the highest TB burden in the world after India, China and South Africa. 1 The estimated prevalence of TB for all cases is 730,000 cases, with 460,000 new cases per year. The number of deaths from TB is estimated at 67,000 deaths per year.…”

“…The number of deaths from TB is estimated at 67,000 deaths per year. 1,2 Tuberculosis (TB) is a mycobacterial infection that usually attacks the lungs and triggers lung damage and dysfunction. After infection with Mycobacterium tuberculosis, host cytokine responses influence disease manifestations.…”