Evaluation of Tuberculosis Treatment Results in Comparison of

Indonesia and Neighboring Countries

Nopridayanti

and Diana Laila Ramatillah

Faculty of Pharmacy, University of 17 August 1945, Jakarta 14350, Indonesia

Keywords: Tuberculosis, Directly Observed Treatment Short, Health.

Abstract: Tuberculosis is a type of respiratory infection originating from the bacteria M. tuberculosis which targets

countries with tropical climates such as Indonesia and several countries in Asia. The bacteria that caused TB

are spread when an infected person coughs or sneezes but most people infected with the bacteria are

asymptomatic. Treatment is not always necessary for people without symptoms. Patients with active

symptoms will require a long course of treatment involving several antibiotics. This research uses the

PRISMA method by collecting data obtained from several research journals. PRISMA helps writers and

researchers in compiling quality systematic reviews and meta-analyses. The results obtained in this journal

are from the data obtained, it can be seen that the highest TB rate for Indonesia's neighboring countries is in

India 1,045,269 cases as ranked 1

in the world and the country with the least number is Thailand with 143

cases. Meanwhile, Indonesia is in second place after India in terms of the number of cases respectively

969,000 cases in the period 2022. For evaluation and treatment of TB in countries, priority is given to

personnel with family internalization in maintaining health, in addition to using the DOTS method, which is

referred to as strategi Directly Observed Treatment Short Course.

1 INTRODUCTION

Tuberculosis is one of the most important public

health problems worldwide, especially in developing

countries. TB is a complex problem because it is not

just a concern about the disease. but also socio-

economic aspects which have a very strong

correlation in fighting this disease. For many years,

TB has mostly been a disease associated with poverty,

while TB mostly infects people in developing

countries or poor countries where the quality of

sanitation is very low.

Moreover, this situation becomes more

complicated when it comes to multidrug resistance to

Mycobacterium tuberculosis in many countries,

making it difficult to achieve successful control goals.

Efforts to detect early detection of TB cases are still a

big challenge, especially in countries with limited

health resources and TB cases in HIV patients where

HIV is marked with a negative stigma in society.

WHO has established a new global TB approach to

achieve worldwide TB elimination by 2035. TB easily

spreads from one area to another due to population

E-mail Correspondence

movements. It cannot be denied that these migrants

are the main reservoir of TB infection in various low

endemic areas. Even though these people were in good

health upon arrival in their destination country, they

were suffering from the latent disease Mycobacterium

tuberculosis. Among these new cases, the majority

come from highly endemic countries where TB has

previously been a major prevalence. Management of

TB disease is a multi-aspect management, starting

from early detection, immediate treatment, to patient

control due to the long period of time. Moreover, TB

management is struggling with the stigma that mostly

occurs in people with weak immune systems or

immunodeficiency (Juan Espinosa, 2022).

In neighboring countries, Indonesia is one of the

TB endemic countries with high TB cases. which is

not only caused by the high prevalence and incidence

of TB, but is also influenced by the very high and

dense population in Indonesia. In recent years, the

incidence rate has decreased significantly, but is

offset by an increase in population. The main

reservoir of Mycobacterium tuberculosis is humans.

It is very important to know about TB transmission to

214

Nopridayanti, . and Ramatillah, D.

Evaluation of Tuberculosis Treatment Results in Comparison of Indonesia and Neighboring Countries.

DOI: 10.5220/0012642300003821

Paper published under CC license (CC BY-NC-ND 4.0)

In Proceedings of the 4th International Seminar and Call for Paper (ISCP UTA ’45 JAKARTA 2023), pages 214-223

ISBN: 978-989-758-691-0; ISSN: 2828-853X

prevent the spread of the disease. This disease is

transmitted through inhalation of TB droplets when

sufferers cough, laugh and sneeze. Furthermore, TB

can also be transmitted if sufferers use the same

nebulizer and can occur with open abscess drainage.

The possibility of transmission depends on several

factors, for examples duration of exposure, infectivity

of the bacteria, sufficient exposure of the bacteria to

sunlight and ventilation. The prevalence of TB with a

positive chest x-ray is higher in those aged 15-24

years, higher in men than women, and higher in rural

areas. The proportion of participants aged 65 years

and over who underwent a chest X-ray was lower than

younger people. The biggest reason is that they

cannot visit the research site because they are sick,

disabled, or unable to walk. The proportion of female

participants who underwent chest X-rays was lower

than men because some pregnant women did not

undergo chest X-rays. The prevalence of TB is higher

in other regions in Indonesia compared to the islands

of Sumatra and Java-Bali (Putra IG, 2022).

Apart from the possibility that participants in

these areas are more frequently exposed to TB germs

and TB risk factors, this may be because these areas

are still underdeveloped so that low education could

be one of the determining factors. Because case

detection based on symptoms is not yet optimal, the

passive detection of TB cases that has been carried

out so far may also contribute to delays in TB

diagnosis and treatment. Limited case finding or

symptom detection tools and access to health services

need to be improved. Increasing the potential of

human resources needs to be considered, because

educational background can be part of understanding

tuberculosis, and limited transportation facilities are

caused by the location of the islands which are quite

far from each other. Apart from that, the limited

number of health workers, health facilities and

medical equipment can be a significant problem for

Indonesia (Deni Iskandar , 2023).

Health has an important role in the economic

development of a nation. In this way, advanced

economic development will never be achieved if there

is a prevalence of infectious diseases in a society or

country. The better the social security program, health

service facilities and health resources that are

available, the better the health management will be

when an outbreak occurs that impacts the community

or nation. One epidemic that is still of concern to the

world is tuberculosis (TB). Until now, no country has

been free from TB. Building health infrastructure

such as hospitals, health centers, doctors and nurses

is very important in treating TB. For this reason, the

efficiency of reforms in the health sector and the

Sustainable Development Goals (SDGs)

accompanied by a detailed analysis of each reform

component must be carried out (Boyacioğlu, 2012).

In the provisions of the Health Law (UU No.

36/2009), expenditure allocations in the health sector

must be fulfilled. This article states that the budget

allocation for health spending is at least 5% of the

State Revenue and Expenditure Budget (APBN)

excluding salaries, and for regional governments,

both levels I and II, the health budget allocation is at

least 10% of the Regional Government. The Regional

Revenue and Expenditure Budget (APBD) does not

include salaries. With Indonesia's high population,

there is a tendency to increase the number of TB cases

in Indonesia. Provinces that have a high population

have a high number of TB cases. West Java, East

Java, Central Java, DKI Jakarta and North Sumatra

are provinces that have a high number of TB cases.

Apart from having a high population, these five

provinces have a high population density.

Public health conditions are correlated with

demographic conditions. The higher the population

growth trend and population density, the worse the

public health condition will be if there are many

outbreaks such as tuberculosis which is quickly

transmitted through droplets. This phenomenon can

illustrate that the number of TB cases is related to the

economy, there is a negative relationship between TB

cases and a country's per capita income. If people's

per capita income is high, people's purchasing power

for employment opportunities will increase so that

nutritional, educational and health needs will increase

the level and quality of people's lives and reduce

poverty. TB can be seen as a public health problem

and a population and environmental problem in which

people live. This research will examine the role of

socio-economic and environmental factors on the

number of TB cases. The problem of respiratory tract

infections such as tuberculosis is a crucial problem

for developing countries like Indonesia. the large

number of infected patients will burden the people

and will indirectly burden the government indirectly.

Therefore, research related to this matter is very

important to carry out as an initial benchmark in

determining Indonesia's tuberculosis status. (Ismail,

A., Prasetya, H., & Ichsan, B, 2023).

2 METHOD

The research method in this journal uses the PRISMA

method which is a minimum set of evidence-based

items for reporting in systematic reviews and meta-

analyses. PRISMA primarily focuses on reporting

Evaluation of Tuberculosis Treatment Results in Comparison of Indonesia and Neighboring Countries

215

reviews that evaluate the impact of interventions, but

can also be used as a basis for reporting systematic

reviews with purposes other than evaluating

interventions (e.g. evaluating etiology, prevalence,

diagnosis, or prognosis). Systematic reviews have

many important roles. Researchers can provide a

synthesis of the state of knowledge in a field, so that

future research priorities can be identified,

researchers can answer questions that cannot be

answered through individual studies, researchers can

identify problems in main research that must be

corrected in further research and researchers can

generating or evaluating theories about how or why

phenomena occur.

Therefore, systematic reviews generate different

types of knowledge for different users of reviews

(such as patients, healthcare providers, researchers,

and policy makers). To ensure a systematic review is

useful to users, authors should prepare a transparent,

complete and accurate explanation of why the review

was conducted, what they did (such as how the

studies were identified and selected) and what they

found (such as the characteristics of the studies).

study contributions and meta-analysis results).

Current reporting guidelines make it easier for

authors to achieve this. PRISMA flow diagrams

visually summarize the screening process. Initially

the agency recorded the number of articles found and

then made the selection process transparent by

reporting decisions taken at various stages of the

systematic review. (Ortiz-Martínez, 2019)

The number of articles was recorded at different

stages, and in this journal 50 journals are presented

which discuss comparative studies of TB cases in

Indonesia and neighboring countries, namely India,

Singapore, Malaysia, Thailand, Vietnam, the

Philippines, Palau, Australia, Timor Leste. and Papua

New Guinea. PRISMA flow diagram for studies

including qualitative and quantitative analysis.

PRISMA, preferred reporting items for systematic

reviews and meta-analyses. background: Kidney

transplantation in adults is most often performed in

the potential extraperitoneal space, and surgical

channels are used routinely in many medical centers.

Based on an extension of the PRISMA abstract

adapted to the PRISMA method approach, a

structured abstract should include important details of

the method and results. (ML Hedstrom, 2023).

3 RESULTS

This journal discusses the comparison of TB cases in

Indonesia and neighboring countries, namely India,

Singapore, Malaysia, Thailand, Vietnam, the

Philippines, Palau, Australia, Timor Leste and Papua

New Guinea (Kementerian ESDM, 2023).

Table 1.

No Country Amount Rating

1. Indonesia 969,000 cases 2 worlds

(Kementerian Kesehatan Republik Indonesia, 2023)

2. India 1,045,269 cases 1 world

(Ministr

of Health and Famil

Welfare, 2022)

3. Singapore 1,251 cases Last ranking in ASEAN

(Ministr

of Health Sin

apore, 2023)

4. Malaysia 25,391 cases 97 world

(CGTN, 2023)

5. Thailand 143 cases 150 ASEAN

(Knoema, 2023)

6. Vietnamese 416 cases 176 ASEAN

(Than

Phuoc Dao, 2022)

No Country Amount Rating

7. Palau 8300 cases 51 worl

(South Dakota Department of Health, 2022)

8. Australia 1300 cases 56 world(National Centre for edpidemiology and

opulation health, 2023)

9. East Timor 508 cases 127 world(United Nations in Timor Leste, 2022)

10. Papua New Guinea 30000 cases 153 of 185 versions of the Human Development

Index (MSF Australia, 2022).

11 Philippines 119,558 cases 4 Worlds

(Ma. Teresa Montema

or, 2023)

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216

4 DISCUSSION

To identify TB infection, healthcare providers will

screen at-risk patients to rule out active TB, and they

may use skin or blood tests to check for infection. TB

disease is curable with 4 standard antibiotics for 6

months. Common drugs include rifampicin and

isoniazid. The desired impact of the WHO normative

guidelines regarding the management of TB in

children and adolescents is to reduce the burden of TB

morbidity and mortality in children and adolescents.

Tuberculosis (TB) is a preventable and curable

disease, but it continues to impact the lives and

development of millions of children and adolescents.

Children and young adolescents under 15 years of

age represent approximately 11% of all TB sufferers

globally. This means that 1.1 million children and

teenagers under 15 years old are infected with TB

every year, and more than 225,000 of them die. Since

the publication of WHO Guidelines for national

tuberculosis programs on the management of

tuberculosis in children in its second edition in 2014,

new recommendations have been published in WHO

guidelines and other policy documents regarding TB

prevention, screening, diagnosis, treatment,

management and models. Many of these

recommendations also apply to children and

adolescents. Monitoring and evaluation are essential

to measure the burden of tuberculosis (TB), as well as

to track progress made in fighting this epidemic.

Having access to timely and verified data helps

policymakers and stakeholders make more informed

decisions to accelerate their efforts to end TB. WHO

collects, compiles and validates TB data annually as

part of its global TB report. This report provides a

comprehensive and up-to-date assessment of the TB

epidemic, as well as progress made at global, regional

and country levels.

WHO also maintains an online database

containing TB data at country level from 2000

onwards. WHO supports countries in strengthening

national TB notification systems to measure and

monitor the number of people who fall ill and die

from TB. WHO assists countries in conducting a

number of surveys to accurately measure the burden

of TB. This includes surveys regarding national TB

prevalence, drug resistance, mortality rates, and costs

faced by TB patients and their households (WHO,

2023). The following is an evaluation and results of

TB treatment in Indonesia and neighboring countries:

1. Indonesia

In 2021 the treatment outcome mortality decreased

from 2% to 4%. In 2022 until November 1

, 2022,

deaths due to treatment were 4%, while those not

evaluated were 7%, this figure has increased

compared to the previous year. The target success rate

for DR-TB treatment in 2021 has not yet reached

75%. The current National Strategy for TB Care and

Prevention in Indonesia 2020-2024 aims to accelerate

efforts to eliminate TB in Indonesia by 2030 and end

TB in Indonesia by 2050. To achieve this goal, the

National Strategy will strengthen the leadership of

district and city governments (Nur Rahmi Amanda,

2023). Programs to increase access to high-quality,

patient-centred TB diagnostic and treatment services;

controlling TB infection and optimizing the provision

of TB preventive therapy (TPT) to increase the

utilization of research results regarding screening

technology , diagnostics and treatment regimens ;

increase the participation of the community, partners

and other multisectoral actors in TB control efforts;

and strengthening program management by

strengthening the health system as a whole (Muh

Khindri Alwi , Asni Hasanuddin , Rony Setianto ,

Fidrotin Azizah , Belinda Arbitya Dewi , Nilam

Fitriani Dai , Ardiansah Hasin , Jurnal Syarif, 2023).

2. India

In (Wakjira MK, Sandy PT, Mavhandu-Mudzusi AH,

2022)most cases, 97.0% of TB cases are newly

diagnosed and all are treated as first-line treatment .

The overall treatment success rate was 82.5% (28%

cured, 54.3% completed), 11.2% lost to follow-up,

4.7% died, and 0.9% treatment failure. . The success

rate for treating TB patients co-infected with HIV is

77.5%. If the problem of MDR-TB and the factors

that determine the outcome of treatment for MDR-TB

patients are to be addressed successfully, then the

factors that determine the outcome of treatment for

MDR-TB patients need to be identified. In this

regard, this study has identified socio-demographic

and clinical factors that determine treatment

outcomes of MDR-TB patients.

Thus, the results of this study will enable health

decision makers and MDR-TB caregivers in Ethiopia

to make evidence-based decisions regarding MDR-

TB program design as well as its management and

resource allocation decisions in subsequent national

efforts to expand program management and to

improve socio-economic support. Economics and

nutrition as well as the provision of integrated

services against MDR-TB and HIV/AIDS are

recommended to mitigate the high mortality rate

among patients treated for MDR-TB (Dona Arlinda,

2020). To mitigate unintentional transmission of

MDR-TB in the community, emphasis should be

placed on efforts to control respiratory tract MDR-TB

infections (Chaves Torres NM, Quijano Rodríguez

Evaluation of Tuberculosis Treatment Results in Comparison of Indonesia and Neighboring Countries

217

JJ, Porras Andrade PS, Arriaga MB, Netto EM,

2019).

3. Singapore

Singapore's BCG vaccination at birth is still useful for

protecting babies and young children from

tuberculous meningitis. Over the past decade, we

have maintained high BCG coverage in infants of

nearly 100%. Although the incidence of tuberculosis

fell drastically in the decades after the National

Tuberculosis Program was established until the end

of the 1980s, the incidence of tuberculosis remained

stable from 1987 to 1996, namely around 50-60 cases

per 100,000 population (Andrew D. Kerkhoff, MD,

PhD, MSc,Diane V. Havlir, MD, 2023). In response

to the high incidence of tuberculosis, the National

Tuberculosis Program was expanded to become the

Singapore Tuberculosis Elimination Program (STEP)

in April 1997. STEP focuses on the following

strategies to control tuberculosis in Singapore:

a. Promotion of directly observed therapy (DOT) for

tuberculosis patients (Nicholas I. Paton, M.D.,

Christopher Cousins, M.B., Ch.B., Celina Suresh,

B.Sc., Erlina Burhan, M.D., Ka Lip Chew,

F.R.C.P.A., Victoria B. Dalay, M.D., Qingshu Lu,

Ph.D., Tutik Kusmiati, M.D., Vincent M.

Balanag, M.D., Shu Ling Lee, B.Sc., Rovina

Ruslami,, 2023)

b. Implementation of the National Treatment

Monitoring Registry to monitor treatment

progress and outcomes for all tuberculosis

patients (Marley G, Zou X, Nie J, Cheng W, Xie

Y, Liao H, 2023)

c. Contact investigations to identify recently

infected close contacts with infectious cases of

tuberculosis, and offer preventive therapy to

reduce the risk of developing active tuberculosis

(Ayenew Berha, 2023).

Tuberculosis is diagnosed primarily through passive

case finding when patients show symptoms. The

National Tuberculosis Notification Registry,

established in 1957, continues to collect and collate

data on the incidence of tuberculosis in Singapore. All

medical practitioners and laboratories who make a

diagnosis of tuberculosis are required by law to notify

the Ministry. Notification is mandatory for confirmed

and suspected cases of tuberculosis (Dong Huang,

Yan Wang, Yu Wang, Zongan Liang, 2020).

4. Malaysia

In research (Syafiq Sidqi Saidi, Rosliza Abdul Manaf,

2023)it is said that to improve the quality of life of

PTB patients, it is very important to ensure they

comply with and complete their treatment.

Compliance with treatment is the main key to

successful disease management, as well as breaking

the chain of infection transmission. And to increase

compliance behavior, patients and their immediate

families must have good knowledge about their

disease, which can be obtained from health education

and awareness programs (Marley G, Zou X, Nie J,

Cheng W, Xie Y, Liao H, 2023). Therefore, a

comprehensive and effective health program must

include an understanding of patients' perceptions of

the impact of disease on their physical, mental,

emotional and social well-being.

Social support can be defined as the process of

interaction in relationships that enhances coping, self-

esteem, belonging, and competence through the

exchange of real or perceived physical or

psychosocial resources. Family members have a very

big responsibility in managing PTB patients, because

of the long duration of treatment. The role of family

members must be involved throughout the disease

process, (Lika Apriani, Susan McAllister, Katrina

Sharples, Bachti Alisjahbana, Rovina Ruslami, Philip

C. Hill, Dick Menzies, 2019)from the initial diagnosis

of the disease, continuing with the management of

signs and symptoms, treatment seeking behavior, and

ultimately achieving successful treatment results

together (Erin Barker, Joe Moss, Hayden Holmes,

Catherine Bowe, Vinay Suryaprakash, Riccardo

Alagna, Vladyslav Nikolayevskyy, Marc Destito,

Davide Manissero , 2023).

It has been proven that family support is very

important in treatment adherence, quality of service,

treatment completion, treatment outcomes, as well as

psychosocial well-being among patients

(Muhammad Saleh Nuwa, Stefanus Mendes Kiik,

2021). Family members who support patients through

their illness make patients respond positively to the

people they live with (Habtu Debash, 2023). This is

also in line with WHO recommendations to include

family support interventions in the management of

TB patients, especially in cases of drug resistance

(Jaraee, J., Awg Adeni, D.S., Bilung, L.M. and

Azmin, P.A, 2023). Therefore, it is recommended that

TB programs should involve the involvement of

family members in patient management (Fadly Syah

Arsad, Noor Hassim Ismail , 2022).

5. Thailand

Meanwhile, in this country, evaluations carried out

with laboratory diagnosis are carried out at the

Mycobacteriology and Mycology Laboratory,

Department of Microbiology, Faculty of Medicine,

Siriraj Hospital, Mahidol University. Stool specimens

were digested and decontaminated via the N- acetyl -

L- cysteine - NaOH and methods centrifuged at 3,000

times gravity for 15 minutes. Decontaminated stool

ISCP UTA ’45 JAKARTA 2023 - THE INTERNATIONAL SEMINAR AND CALL FOR PAPER (ISCP) UTA ’45 JAKARTA

218

specimens and tissue biopsies were used for three

different investigations. First, AFB detection was

carried out via auramin acid-fast staining under a

fluorescence microscope (Kawin Chinpong, 2022).

Second, the specimens underwent direct extraction of

total DNA via a magnetic bead-based method using

MagDEA ® Reagent Dx SV (Precision System

Science, Chiba, Japan) according to the

manufacturer's instructions. The extracted DNA was

then used as template DNA for the Anyplex ™

MTB/NTM Real-Time Detection assay (Seegene,

Seoul, South Korea).

This assay relies on real-time multiplex PCR and

differentiates between MTB and non-tuberculous

mycobacteria. Third, MTB culture was carried out by

inoculating specimens into egg-based (Löwenstein -

Jensen; LJ) and liquid-based (Mycobacteria Growth

Indicator Tube; MGIT) media. MTB-positive

cultures were first examined via auramin staining and

then confirmed by real-time PCR. The interferon-

gamma release assay for tuberculosis was measured

using Quantiferon-TB Gold Plus (Qiagen,

Dusseldorf, Germany), a Sandwich enzyme-linked

immunosorbent assay. The cut-off value is 0.35 IU/ml

(Asawin Sudcharoen, 2023). Risk factors associated

with negative IGRA results include advanced age,

low peripheral lymphocyte counts, and

immunosuppressive conditions (Siwadon

Kumpuangdee , Chutima Roomruangwong ,

Jiratchaya Sophonphan , Pirapon J. Ohata , Gompol

Suwanpimolkul, 2023).

6. Vietnam

The development of tuberculous tenosynovitis is

often dangerous. The most common symptoms are

swelling of the hands and mild pain (Andrew D.

Kerkhoff, 2023). Ultrasound is a useful tool to

support diagnosis. Histological examination

confirmed the diagnosis (Ian Wrohan, 2022). Most

cases respond and give good results after 9-12 months

of anti-tuberculosis treatment. Vietnam is an endemic

country for TB and the overall estimated prevalence

of bacteriologically confirmed TB among adults is

322 per 100,000 populations. With its atypical

manifestations (Tracy R. Richardson, 2023), which

can be confused with other diseases (Lan Huu

Nguyen, 2020), TB tenosynovitis poses a significant

challenge in diagnosis. In addition, waiting for

histopathology results that confirm the diagnosis can

delay treatment, causing many complications in the

patient (Cao Thanh Ngoc, 2023).

7. Philippines

A report from the Philippine Institute for

Development Studies also cited overcrowded living

conditions as a factor exacerbating the spread of TB

among the urban poor (Kimberly R. Schildknecht,

2022). Another problem that hinders the eradication

of TB is financial barriers in treatment. Standard TB

(Delia Goletti, 2022) treatment requires a minimum

duration of 6 months for cases that are susceptible to

drugs, while the overall duration can reach 2 years for

cases that are resistant to drugs. Therefore, prolonged

therapy is a major challenge in ensuring treatment

compliance, which is the cornerstone of successful

TB treatment (T. Yamanaka, 2023).

Discontinuation of treatment, negligence or non-

compliance with treatment is complex, dynamic and

caused by many interrelated causes. Apart from

treatment-related factors (Fiona V.Cresswell, 2023),

other factors such as socio-demographics, culture,

economic burden, patient knowledge, attitudes and

beliefs, family support, community and health system

are several factors that can influence compliance

status. Knowing the risk of stopping treatment early,

which can affect treatment outcomes which is

unprofitable (Ai Ling Oh, 2023).

8. East Timor

The prevalence of RR-TB in Timor-Leste is relatively

low compared with the estimated proportion of RR-

TB in the WHO Southeast Asia Region (2.5% [95%

CI 1.9–3.3] among new cases and 14% [95 % CI 7.7–

21] among previously treated cases). The rapid

sputum collection and transport mechanism

implemented in this survey demonstrated its

feasibility in low-resource settings and should be

replicated for routine transport of TB specimens from

the microscope laboratory to GeneXpert sites.

Establishment of domestic capacity for rapid

molecular diagnostics for first- and second-line DST

is an urgent need to achieve universal drug

susceptibility testing (DST) to guide appropriate

patient management. The primary aim of DRS is to

determine the prevalence of DST (Constantino

Lopes, Debashish Kundu, 2022).

Resistance to rifampicin among new and

previously treated sputum smear-positive pulmonary

TB cases in Timor-Leste, to provide input for DR-TB

programmed management (PMDT) planning,

including the rollout of the WHO-recommended short

oral treatment regimen for TB-RR, and guides

resource requirements. Secondary objectives were to

describe the sociodemographic and clinical

characteristics of patients with bacteriologically

confirmed pulmonary TB; investigate potential risk

factors for RR-TB; establish baseline data for DR-TB

surveillance to enable observations of trends over

time and strengthen routine surveillance of anti-TB

Evaluation of Tuberculosis Treatment Results in Comparison of Indonesia and Neighboring Countries

219

drug resistance in Timor-Leste (Theresa Ryckman,

PhD, 2023).

5 CONCLUSION

From the data obtained, it can be seen that the highest

TB rate for Indonesia's neighboring countries is India,

with 1,045,269 cases, 1

ranking in the world, and the

country with the least is Thailand with 143 cases.

Meanwhile, Indonesia is in the second place after

India with a total of 969,000 cases in the 2022 period.

Evaluation and treatment of TB in countries

prioritizes personnel with family internalization in

maintaining health, in addition to using the DOTS

method. The Directly Observed Treatment Short

Course (DOTS) strategy is direct supervision in the

short term with the obligation for TB program

managers to focus their attention on looking for

sufferers using microscope examination This strategy

is an effort to reduce morbidity and mortality due to

TB.

6 FUNDING

Records identified from*:

Databases (n =50 )

Registers (n =50 )

Records removed before screening:

Duplicate records removed (n

=50 )

Records marked as ineligible by

automation tools (n =0 )

Records removed for other

reasons (n = 0)

Records screened

(n =50 )

Records excluded**

(n =50 )

Reports sought for retrieval

(n =50 )

Reports not retrieved

(n =0 )

Reports assessed for eligibility

(n =50 )

Reports excluded:

Reason 1 (n =5 )

Reason 2 (n = 1)

Reason 3 (n =44 )

etc.

Studies included in review

(n =50 )

Reports of included studies

(n =59 )

Scopus Google Scholar Sinta

Identification

Screening

Included

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