771. Drug Resistance Tuberculosis (DR-TB), Comorbidities and Risk Factors Identified in a Prospective Multicenter Cohort Study in Indonesia
Session: Poster Abstract Session: Tuberculosis and Other Mycobacterial Infections
Thursday, October 4, 2018
Room: S Poster Hall

Background:

The numbers of patients with Drug Resistance TB (DR-TB) increased annually by over 20% globally in the last decade. However, data on the prevalence of DR-TB in Indonesia is limited. The objective of this study to estimate the proportion of DR-TB in new and previously treated TB cases, to identify comorbidities and risk factors.

Methods:

This study has been conducted at 7 hospitals throughout Indonesia since March 2017. Clinically TB patients ≥18-year-old were enrolled and followed until 6 months after treatment completed. Demography, clinical data were recorded; sputum, blood, urine and PBMC were collected at several time points. AFB smear, sputum culture, Xpert MTB/RIF, and drug sensitivity tests were performed. Drug resistance TB is determined by Xpert MTB/RIF.

Results:

Of 151 enrolled patients, 103 (68%) were confirmed M. tuberculosis by Xpert MTB/RIF, and 47 (46%) were confirmed rifampicin resistance.  The distribution of DR-TB in each study site is shown in figure 1. Among those with comorbidities (38%), comorbidity with diabetes (based on HbA1c level and diabetes history), HIV, and cancer, was 9%, 26%, and 7%. Demography, nutrition status, contact and treatment history and comorbidities are shown in table 1. DR-TB primary infection contributes to 23% of DR-TB cases. Biomarkers that may predict treatment failure and TB-genotyping is underway.

Conclusion:

The proportion of DR-TB in both new and previously treated patients in our cohort was significantly higher than the estimated number from the WHO and Ministry of Health. TB is a serious threat for public health and mitigation plan must be implemented at all levels.

 

 

520

560

570

580

590

All

Demography

·       Age (Median, IQR)

·       Male (n, %)

38 (20)

9 (75)

41 (21)

16 (47)

42 (25)

26 (67)

37 (45)

9 (82)

22 (3)

4 (57)

40 (25)

64 (62)

BMI

·       <18.5

·       18.5 to <25

·       ≥25

7 (58)

5 (42)

0

17 (50)

13 (38)

4 (12)

20 (51)

13 (33)

6 (15)

5 (45)

5 (45)

1 (10)

5 (71)

2 (29)

0

54 (52)

38 (37)

11 (11)

Contact history with TB patients

2 (17)

1 (3)

8 (21)

2 (18)

2 (29)

15 (15)

TB treatment history

·       New

·       Previously treated

10 (83)

2 (17)

12 (35)

22 (65)

13 (33)

26 (67)

10 (91)

1 (9)

5 (71)

2 (29)

50 (49)

53 (51)

Comorbid

·       HIV

·       DM

2 (18)

1 (9)

0

14 (41)

0

13 (33)

2 (18)

0

0

1 (14)

4 (4)

29 (28)

Table 1. Demography, nutrition status, contact history, TB treatment history and comorbid status

A close up of a map
Description generated with very high confidence

Erlina Burhan, doctor1, Banteng Wibisono, doctor2, Retna Indah, doctor3, Gede Ketut Sajinadiyasa, doctor4, Bambang Riyanto, doctor5, Tutik Kusmiati, doctor6 and Nugroho Susanto, doctor3, (1)Persahabatan Hospital, Jakarta Timur, Indonesia, (2)Dr. Kariadi Hospital, Semarang, Indonesia, (3)INA-RESPOND, National Institute of Health Resources and Development, Ministry of Health Indonesia, Jakarta Pusat, Indonesia, (4)Sanglah Hospital, Denpasar, Indonesia, (5)Dr. Sardjito Hospital, Yogyakarta, Indonesia, (6)Dr. Soetomo Hospital, Surabaya, Indonesia

Disclosures:

E. Burhan, None

B. Wibisono, None

R. Indah, None

G. K. Sajinadiyasa, None

B. Riyanto, None

T. Kusmiati, None

N. Susanto, None

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