•  
  •  
 

Abstract

Tuberculosis (TB) remains a major global and national health burden, with case detection coverage still below target in several regions. The success of TB control programs largely depends on achieving adequate treatment coverage. In East Jakarta, Ciracas Primary Health Center recorded a treatment coverage of 75% (497 cases) in 2023, the lowest among ten centers, and an increase to 84% (509 cases) in 2024, though still below the national target of 90%. To analyze TB case detection coverage based on demographic factors and comorbidities (diabetes mellitus and Human Immunodeficiency Virus) at Ciracas Primary Health Center during 2023–2024. This study employed a cross-sectional design using secondary data from the Ciracas Tuberculosis Information System (SITB). All people with TB with complete records were included through total sampling. Data were analyzed using univariate, bivariate, and multivariate analysis with Stata/IC15.1, to assess the association between demographic and comorbidity factors and case detection coverage. A total of 1,006 TB cases were recorded, with most patients in the productive age group (18–59 years; 70.6%) and male (61.6%). Diabetes mellitus comorbidity was found in 13.8% of cases, and HIV-positive status in 2.2%. Productive age was significantly associated with TB occurrence, both in patients with diabetes (OR: 0.223; 95% CI: 0.158–0.311) and without diabetes (OR: 0.19; 95% CI: 0.161–0.22), while sex and HIV status were not significant. Productive-age individuals and those with diabetes mellitus are the most at-risk populations for TB in Ciracas. Enhanced Active Case Finding (ACF) among high-risk groups is required to accelerate progress toward the national TB elimination target.

Keywords: Tuberculosis; treatment coverage;demography; diabetes mellitus; HIV

References

  1. World Health Organization. Global tuberculosis report 2024 [Internet]. Geneva: World Health Organization; 2024 [cited 2025 Sep 2]. Available from: https://www.who.int/teams/global-programme-on-tuberculosis-and-lung-health/tb-reports/global-tuberculosis-report-2024
  2. World Health Organization. The second national TB inventory study in Indonesia [Internet]. Geneva: World Health Organization; 2024 [cited 2025 Sep 2]. Available from: https://www.who.int/teams/global-programme-on-tuberculosis-and-lung-health/tb-reports/global-tuberculosis-report-2024/featured-topics/the-second-national-tb-inventory-study-in-indonesia
  3. Malhotra A, Ryckman TS, Johnson K, Uhlig E, Creswell J, Kendall EA, et al. Active case-finding of tuberculosis compared with symptom-driven standard of care: a modelling analysis. Int J Epidemiol. 2024;53(2):dyae019. doi:10.1093/ije/dyae019
  4. World Health Organization. Global tuberculosis report 2023 [Internet]. Geneva: World Health Organization; 2023 [cited 2025 Sep 3]. Available from: https://www.who.int/teams/global-programme-on-tuberculosis-and-lung-health/tb-reports/global-tuberculosis-report-2023
  5. Kementerian Kesehatan Republik Indonesia. Strategi nasional penanggulangan tuberkulosis di Indonesia 2020–2024 [Internet]. Jakarta: Kementerian Kesehatan Republik Indonesia; 2020 [cited 2025 Sep 8]. Available from: https://www.tbindonesia.or.id/wp-content/uploads/2021/06/NSP-TB-2020-2024-Ind_Final_-BAHASA.pdf
  6. Kementerian Kesehatan Republik Indonesia. Aksi nyata percepatan eliminasi tuberkulosis di Indonesia [Internet]. Jakarta: Kementerian Kesehatan Republik Indonesia; 2025 [cited 2025 Sep 2]. Available from: https://kemkes.go.id/id/rilis-kesehatan/47510
  7. Suku Dinas Kesehatan Kota Administrasi Jakarta Timur. Laporan capaian program tuberkulosis Suku Dinas Kesehatan Kota Administrasi Jakarta Timur tahun 2023. Jakarta: Suku Dinas Kesehatan Kota Administrasi Jakarta Timur; 2023.
  8. Dinas Kesehatan Provinsi DKI Jakarta. Monitoring dan evaluasi program tuberkulosis (TBC) tahun 2024 Provinsi DKI Jakarta [Internet]. Jakarta: Dinas Kesehatan Provinsi DKI Jakarta; 2024 Jul 26 [cited 2025 Sep 2]. Available from: https://dinkes.jakarta.go.id/berita/read/monitoring-dan-evaluasi-program-tuberkulosis-tbc-tahun-2024-provinsi-dki-jakarta
  9. Pusat Kesehatan Masyarakat Ciracas. Laporan penilaian kinerja puskesmas (PKP) Puskesmas Ciracas tahun 2024. Jakarta: Puskesmas Ciracas; 2024.
  10. Pusat Kesehatan Masyarakat Ciracas. Rencana strategis (Renstra) Puskesmas Ciracas tahun 2025–2029. Jakarta: Pusat Kesehatan Masyarakat Ciracas; 2025.
  11. World Health Organization. TB treatment coverage and outcomes. In: Global tuberculosis report 2024 [Internet]. Geneva: World Health Organization; 2024 [cited 2025 Sep 8]. Available from: https://www.who.int/teams/global-programme-on-tuberculosis-and-lung-health/tb-reports/global-tuberculosis-report-2024/tb-diagnosis-and-treatment/2-3-tb-treatment--coverage-and-outcomes
  12. Peer V, Schwartz N, Green MS. Gender differences in tuberculosis incidence rates: a pooled analysis of data from seven high-income countries by age group and time period. Front Public Health. 2023;10:997025. doi:10.3389/fpubh.2022.997025
  13. World Health Organization. TB and diabetes. In: Global tuberculosis report 2021 [Internet]. Geneva: World Health Organization; 2021 [cited 2025 Sep 8]. Available from: https://iris.who.int/bitstream/handle/10665/346387/9789240037021-eng.pdf?sequence=1
  14. Goletti D, Pisapia R, Fusco FM, Aiello A, Van Crevel R. Epidemiology, pathogenesis, clinical presentation and management of TB in patients with HIV and diabetes. Int J Tuberc Lung Dis. 2023;27(4):284–90. doi:10.5588/ijtld.22.0685
  15. Pitua I, Raizudheen R, Muyanja M, Nyero J, Obol MO. Diabetes and tuberculosis: A systematic review and meta-analysis of Mendelian randomization evidence. Diabetol Metab Syndr. 2025;17:46. doi:10.1186/s13098-025-01615-w
  16. Sossen B, Kubjane M, Meintjes G. Tuberculosis and HIV coinfection: Progress and challenges towards reducing incidence and mortality. Int J Infect Dis. 2025;155:107876. doi:10.1016/j.ijid.2025.107876
  17. World Health Organization. TB disease burden—Estimated TB incidence by age and sex (Section 1.1). In: Global tuberculosis report 2024 [Internet]. Geneva: World Health Organization; 2024 [cited 2025 Sep 3]. Available from: https://www.who.int/teams/global-programme-on-tuberculosis-and-lung-health/tb-reports/global-tuberculosis-report-2024/tb-disease-burden/1-1-tb-incidence
  18. Horton KC, MacPherson P, Houben RMGJ, White RG, Corbett EL. Sex differences in tuberculosis burden and notifications in low- and middle-income countries: a systematic review and meta-analysis. PLoS Med. 2016;13(9):e1002119. doi:10.1371/journal.pmed.1002119
  19. Kementerian Kesehatan Republik Indonesia. Deteksi TBC capai rekor tertinggi di tahun 2022 [Internet]. Jakarta: Kementerian Kesehatan Republik Indonesia; 2023 Mar 31 [cited 2025 Sep 8]. Available from: https://kemkes.go.id/id/deteksi-tbc-capai-rekor-tertinggi-di-tahun-2022
  20. Murray CJL, Vos T, Lozano R, Naghavi M, Flaxman AD, Michaud C, et al. Global, regional, and national sex differences in the global burden of tuberculosis by HIV status, 1990–2019: results from the Global Burden of Disease Study 2019. Lancet Infect Dis. 2021;22(2):222–41. Available from: https://www.thelancet.com/action/showPdf?pii=S1473-3099%2821%2900449-7
  21. Yen YF, Hu HY, Lee YL, Ku PW, Ko MC, Chuang PH, et al. Sexual inequality in incident tuberculosis: a cohort study in Taiwan. BMJ Open. 2018;8(2):e020142. doi:10.1136/bmjopen-2017-020142
  22. Gajalakshmi V, Peto R. Smoking, drinking and incident tuberculosis in rural India: population-based case-control study. Int J Epidemiol. 2009;38(4):1018–25. doi:10.1093/ije/dyp225
  23. World Health Organization. Tuberculosis determinants: Global estimates of the number of TB cases attributable to selected risk factors (Table 6.3.1). In: Global tuberculosis report 2021 [Internet]. Geneva: World Health Organization; 2021 [cited 2025 Sep 2]. Available from: https://www.who.int/publications/i/item/9789240037021
  24. Kementerian Kesehatan Republik Indonesia. Laporan kinerja Kementerian Kesehatan tahun 2023 (LAKIP 2023) [Internet]. Jakarta: Kementerian Kesehatan Republik Indonesia; 2024 [cited 2025 Nov 9]. Available from: https://ppid.kemkes.go.id/wp-content/uploads/2024/10/FINAL_LAKIP-KEMENKES-2023_compressed.pdf
  25. World Health Organization. 1.1 TB incidence—Global tuberculosis report 2023 [Internet]. Geneva: World Health Organization; 2023 [cited 2025 Sep 2]. Available from: https://www.who.int/teams/global-programme-on-tuberculosis-and-lung-health/tb-reports/global-tuberculosis-report-2023/tb-disease-burden/1-1-tb-incidence
  26. Open Society Institute. Fact sheet: tuberculosis (TB) and HIV [Internet]. New York: Open Society Institute; [cited 2025 Nov 8]. Available from: https://www.soros.org/initiatives/health
  27. Azanaw MM, Derseh NM, Yetemegn GS, Angaw DA. Incidence and predictors of tuberculosis among HIV patients after initiation of antiretroviral treatment in Ethiopia: a systematic review and meta-analysis. Trop Med Health. 2021;49(1):18. doi:10.1186/s41182-021-00306-2
  28. Enos M, Sitienei J, Ong'ang’o J, Mungai B, Kamene M, Wambugu J, et al. Kenya tuberculosis prevalence survey 2016: challenges and opportunities of ending TB in Kenya. PLoS One. 2018;13(12):e0209098. doi:10.1371/journal.pone.0209098
  29. Santos BA, Ribeiro CJN, Santos ADD, Sousa ÁFL, Siqueira TS, Andrade LA, et al. Surveillance of TB-HIV coinfection in Brazil: a space-time approach. Rev Bras Epidemiol. 2024;27:e240037. doi:10.1590/1980-549720240037
  30. Thong PM, Wong YH, Kornfeld H, Goletti D, Ong CWM. Immune dysregulation of diabetes in tuberculosis. Semin Immunol. 2025;78:101959. doi:10.1016/j.smim.2025.101959
  31. Jeon CY, Murray MB. Diabetes mellitus increases the risk of active tuberculosis: a systematic review of 13 observational studies. PLoS Med. 2008;5(7):e152. doi:10.1371/journal.pmed.0050152
  32. Babitsch B, Gohl D, von Lengerke T. Re-revisiting Andersen’s Behavioral Model of Health Services Use: a systematic review of studies from 1998–2011. Psychosoc Med. 2012;9:Doc11. doi:10.1055/s-0032-1328430
  33. Amelia R, Fujiati II, Lindarto D, Yunir E, Kusnanto H. Profile of tuberculosis patients with comorbid diabetes mellitus in Medan, Indonesia: a cross-sectional study. Pan Afr Med J. 2024;49:54. doi:10.11604/pamj.2024.49.54.36492
  34. Martinson NA, Hoffmann CJ, Chaisson RE. Epidemiology of tuberculosis and HIV: recent advances in understanding and responses. Proc Am Thorac Soc. 2011;8(3):288–93. doi:10.1513/pats.201010-064WR
  35. Siahaan ES, Bakker MI, Pasaribu R, Khan A, Pande T, Hasibuan AM, et al. Islands of Tuberculosis Elimination: An evaluation of community-based active case finding in North Sumatra, Indonesia. Trop Med Infect Dis. 2020;5(4):163. doi:10.3390/tropicalmed5040163

Bahasa Abstract

Tuberkulosis (TBC) masih menjadi beban kesehatan global dan nasional dengan cakupan penemuan kasus yang belum mencapai target di beberapa wilayah. Keberhasilan pengendalian TBC sangat bergantung pada pencapaian treatment coverage. Di wilayah Jakarta Timur, Puskesmas Ciracas mencatat capaian cakupan penemuan kasus TBC tahun 2023 sebesar 75% (497 kasus), terendah dari sepuluh puskesmas yang ada, dan meningkat pada tahun 2024 menjadi 84% (509 kasus), meskipun belum mencapai target nasional 90%.Tujuan: Menganalisis cakupan penemuan kasus TBC berdasarkan faktor demografis dan komorbiditas (diabetes melitus dan Human Immunodeficiency Virus) di wilayah kerja Puskesmas Ciracas tahun 2023–2024. Penelitian ini menggunakan desain potong lintang dengan data sekunder yang bersumber dari Sistem Informasi Tuberkulosis (SITB) Puskesmas Ciracas. Seluruh pasien TBC dengan data lengkap dianalisis menggunakan metode total sampling. Analisis data dilakukan secara univariat, bivariat, dan multivariat menggunakan perangkat lunak Stata/IC15.1, guna menilai hubungan faktor demografis dan komorbiditas terhadap cakupan penemuan kasus. Tercatat 1.006 kasus TBC, mayoritas berusia produktif 18–59 tahun (70,6%) dan berjenis kelamin laki-laki (61,6%). Komorbiditas diabetes melitus ditemukan pada 13,8% kasus, sedangkan HIV positif hanya 2,2%. Usia produktif berhubungan signifikan dengan TBC, baik pada pasien dengan DM (OR: 0,223; 95% CI: 0,158–0,311) maupun tanpa DM (OR: 0,19; 95% CI: 0,161–0,22), sedangkan jenis kelamin dan HIV tidak signifikan. Kelompok usia produktif dan penderita DM merupakan populasi dengan risiko tertinggi terhadap TBC di Ciracas. Diperlukan peningkatan penelusuran aktif (Active Case Finding) pada kelompok berisiko untuk mempercepat pencapaian target eliminasi TBC nasional.

Kata Kunci : Tuberkulosis, penemuan kasus, demografi, diabetes melitus, HIV

Download

Share

COinS
 
 

To view the content in your browser, please download Adobe Reader or, alternately,
you may Download the file to your hard drive.

NOTE: The latest versions of Adobe Reader do not support viewing PDF files within Firefox on Mac OS and if you are using a modern (Intel) Mac, there is no official plugin for viewing PDF files within the browser window.