Muhamad Zakki Saefurrohim, Intan Henda Ardiani, Akhmad Azmiardi, Intan Zainafree
Treatment regimens for MDR-TB lasting 9 to 12 months offer effective therapy with a reduced duration. However, data from Central Java, Indonesia, indicate that 9.22% of patients undergoing short-term MDR-TB treatment between 2021 and 2023 died during the course of treatment. This study seeks to examine the survival probability and identify risk factors associated with mortality among patients receiving short-term treatment for MDR-TB. A retrospective cohort design was employed, including 236 MDR-TB patients treated with a short-term regimen (STR) between 2022 and 2023, whose outcomes were either cure or death. STR is a 9-month all-oral short regimen consisting of: 6 Bedaquiline (Bdq) with 4-6 Levofloxacin (Lfx)/Moxifloxacin (Mfx)-Clofazimin (Cfz)-Pyrazinamide (Z)-Etambutol (E)-Isoniazid (H) high dose-Etionamide (Eto)/5 Levofloxacin/Moxifloxacin-Clofazimin-Pyrazinamide-Etambutol. The Kaplan-Meier method was applied to estimate incidence rates and median survival time until death. To identify predictors including age group, gender, employment status, treatment history, diabetes status, HIV infection, use of Linezolid, and timing of treatment initiation, the Cox Proportional Hazards model was employed. All statistical analyses were conducted using RStudio, with a significance threshold set at p < 0.005. The Kaplan-Meier analysis revealed a significant difference in survival probabilities among the three age groups. Patients aged 19 to 35 years demonstrated a higher likelihood of survival compared to those in the middle-aged group (36-55 years) and the older group (≥56 years) (Chi-Square = 17, p < 0.001). Additionally, Cox regression analysis indicated that individuals aged 56 and above faced a 3.7-fold increased risk of death compared to younger patients (95% CI: 1.49–3.65; HR = 3.705, p = 0.001). This study emphasizes the importance of implementing age-specific interventions for MDR-TB patients aged 56 and older, with particular attention to managing comorbidities such as diabetes and HIV. The results underscore the necessity of tailoring treatment protocols for older adults in clinical settings to enhance survival outcomes, given their increased vulnerability linked to immunosenescence and the burden of multiple health conditions. © 2025, Mahidol University - ASEAN Institute for Health Development. All rights reserved.
Public Health, Faculty of Public Health, Universitas Mulawarman, Samarinda, Indonesia; Master Program in Public Health, Faculty of Health Sciences, Universitas Jenderal Soedirman, Purwokerto, Indonesia; Master of Public Health, Faculty of Public Health, Universitas Mulawarman, Samarinda, Indonesia; Medicine, Faculty of Medicine, Universitas Negeri Semarang, Semarang, Indonesia
