ArticleBMJ public health2025
Understanding the epidemiology of TB-HIV co-infection in Indonesia: evidence from the 2023 national TB registry.
Article in BMJ public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction: Tuberculosis (TB) and HIV co-infection remain a significant public health challenge in Indonesia. Therefore, this study aims to identify the determinants and epidemiological characteristics of TB-HIV co-infection using data from the 2023 national TB registry. Methods: The study procedures were carried out using a cross-sectional design, analysing univariate, bivariate and multivariate associations between TB-HIV coinfection status and demographic, clinical and health service factors among patients with TB. Results: Among 22 698 patients with TB, 94.8% were HIV negative, with a predominance of males (58.8%) and adults aged 30-59 years (49.8%). The majority of the patients were treated in healthcare facilities located in Western Indonesia, had pulmonary TB (93.8%), bacteriological diagnosis (55.5%) and achieved a cure (85.9%), while the remaining 14.1% included patients who died, were lost to follow-up, or had incomplete treatment outcomes. The most common nutritional status among patients was normal nutritional status (44.4%). In the multivariate analysis, clinical diagnosis remained the strongest predictor of TB-HIV co-infection (OR 2.446; 95% CI 2.154 to 2.778; p<0.001). Other significant predictors included male sex (OR 2.096; 95% CI 1.835 to 2.395), extrapulmonary TB (OR 1.337; 95% CI 1.075 to 1.662) and undernourished status, which showed lower odds of TB-HIV co-infection compared with overweight or obese patients (OR 0.809; 95% CI 0.676 to 0.967). Conclusions: This study highlights TB-HIV co-infection as the primary outcome, emphasising the role of demographic, clinical, nutritional and regional disparities in influencing co-infection risks. The findings underscore the need for integrated TB-HIV diagnostic and management strategies, including nutritional support and targeted interventions focusing on high-risk populations and health service accessibility to strengthen early detection and treatment outcomes.
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