{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T14:03:33Z","timestamp":1793714613089,"version":"4.6.1"},"reference-count":44,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2025,12,29]],"date-time":"2025-12-29T00:00:00Z","timestamp":1766966400000},"content-version":"unspecified","delay-in-days":181,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["bmjph"],"accepted":{"date-parts":[[2025,12,17]]},"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 22 698 patients with TB, 94.8% were HIV negative, with a predominance of males (58.8%) and adults aged 30\u201359 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&lt;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).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjph-2025-003585","type":"journal-article","created":{"date-parts":[[2025,12,30]],"date-time":"2025-12-30T05:55:24Z","timestamp":1767074124000},"page":"e003585","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Understanding the epidemiology of TB-HIV co-infection in Indonesia: evidence from the 2023 national TB registry"],"prefix":"10.1136","volume":"3","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9641-4915","authenticated-orcid":false,"given":"Machrumnizar","family":"Machrumnizar","sequence":"first","affiliation":[{"name":"Department of Parasitology, Universitas Trisakti, Jakarta, Indonesia"},{"name":"Doctoral Program in Public Health, Universitas Indonesia, Depok, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9053-3174","authenticated-orcid":false,"given":"Tris","family":"Eryando","sequence":"additional","affiliation":[{"name":"Department of Population and Biostatistics, Universitas Indonesia, Depok, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-6938-3920","authenticated-orcid":false,"given":"Adang","family":"Bachtiar","sequence":"additional","affiliation":[{"name":"Department of Health Administration and Policy, Universitas Indonesia, Depok, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9905-3406","authenticated-orcid":false,"given":"Rina Kurniasri","family":"Kusumaratna","sequence":"additional","affiliation":[{"name":"Department of Public Health, Universitas Trisakti, Jakarta, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1770-5504","authenticated-orcid":false,"given":"Meiyanti","family":"Meiyanti","sequence":"additional","affiliation":[{"name":"Department of Pharmacology and Pharmacy, Universitas Trisakti, Jakarta, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2530-521X","authenticated-orcid":false,"given":"Endang","family":"Djuana","sequence":"additional","affiliation":[{"name":"Department of Electrical Engineering, Universitas Trisakti, Jakarta, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8309-5214","authenticated-orcid":false,"given":"Nikmatul","family":"Hidayah","sequence":"additional","affiliation":[{"name":"Department of Health Administration and Policy, Universitas Indonesia, Depok, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-6235-3359","authenticated-orcid":false,"given":"Arifah","family":"Alfiyyah","sequence":"additional","affiliation":[{"name":"Department of Health Administration and Policy, Universitas Indonesia, Depok, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,12,29]]},"reference":[{"key":"2026010703074312000_3.2.e003585.1","unstructured":"WHO . 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