{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T09:15:38Z","timestamp":1788426938850,"version":"build-2803163510"},"reference-count":35,"publisher":"PAGEPress Publications","license":[{"start":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T00:00:00Z","timestamp":1788393600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Monaldi Arch Chest Dis"],"abstract":"<jats:p>The treatment success rate for drug-resistant tuberculosis (DR-TB) in Indonesia remains below the national target. Identifying factors associated with unfavorable treatment outcomes is essential to inform more targeted interventions. This retrospective study analyzed medical records of patients with DR-TB who received treatment at Surabaya Haji Hospital between 2020 and 2024. Demographic, clinical, behavioral, and treatment-related variables were evaluated in relation to unfavorable treatment outcomes, defined as a composite outcome of death, treatment failure, or loss to follow-up. Bivariate and binary logistic regression analyses were performed to estimate crude odds ratios and adjusted odds ratios (aORs) with 95% confidence intervals (95% CIs). A total of 90 eligible patients were included in the analysis. Overall, 52 patients (57.8%) achieved a favorable treatment outcome (cure), whereas 38 (42.2%) experienced unfavorable treatment outcomes, including loss to follow-up (42.1%), death (34.2%), and treatment failure (23.7%). In the bivariable analysis, only a history of previous TB treatment was significantly associated with unfavorable treatment outcomes. After adjustment for diabetes mellitus and BCG vaccination history, previous TB treatment remained an independent predictor of unfavorable treatment outcomes (aOR = 11.47; 95% CI: 4.19\u201331.41; p&lt;0.001). These findings indicate that patients with a history of previous TB treatment are at substantially greater risk of unfavorable treatment outcomes and underscore the need for closer monitoring and more comprehensive management strategies to improve treatment success.<\/jats:p>","DOI":"10.4081\/monaldi.2026.3928","type":"journal-article","created":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T08:35:36Z","timestamp":1788424536000},"source":"Crossref","is-referenced-by-count":0,"title":["Treatment outcomes and factors associated with unfavorable outcomes among drug-resistant tuberculosis patients treated with a bedaquiline-based oral regimen"],"prefix":"10.4081","author":[{"given":"Oki","family":"Nugraha Putra","sequence":"first","affiliation":[{"name":"Faculty of Pharmacy, Hang Tuah University, Surabaya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julaeha","family":"Julaeha","sequence":"additional","affiliation":[{"name":"Research Center for Preclinical and Clinical Medicine, National Research and Innovation Agency (BRIN), Bogor"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nurhayati","family":"Nurhayati","sequence":"additional","affiliation":[{"name":"Research Center for Preclinical and Clinical Medicine, National Research and Innovation Agency (BRIN), Bogor"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Telly","family":"Purnamasari","sequence":"additional","affiliation":[{"name":"Research Center for Preclinical and Clinical Medicine, National Research and Innovation Agency (BRIN), Bogor"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nurul","family":"Damayanti","sequence":"additional","affiliation":[{"name":"Faculty of Pharmacy, Hang Tuah University, Surabaya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dewi","family":"Ramdani","sequence":"additional","affiliation":[{"name":"Department of Pulmonology, Haji Hospital, Surabaya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmad","family":"Erlan","sequence":"additional","affiliation":[{"name":"Research Center for Preclinical and Clinical Medicine, National Research and Innovation Agency (BRIN), Bogor"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paisal","family":"Paisal","sequence":"additional","affiliation":[{"name":"Research Center for Preclinical and Clinical Medicine, National Research and Innovation Agency (BRIN), Bogor"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rini","family":"Sasanti Handayani","sequence":"additional","affiliation":[{"name":"Research Center for Preclinical and Clinical Medicine, National Research and Innovation Agency (BRIN), Bogor"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nur","family":"Indah","sequence":"additional","affiliation":[{"name":"Department of Pulmonology, Haji Hospital, Surabaya"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2549","published-online":{"date-parts":[[2026,9,3]]},"reference":[{"key":"86285","unstructured":"World Health Organization. Global Tuberculosis Report 2024. Available from: https:\/\/www.who.int\/teams\/global-programme-on-tuberculosis-and-lung-health\/tb-reports\/global-tuberculosis-report-2024."},{"key":"86286","unstructured":"World Health Organization. WHO consolidated guidelines on tuberculosis. Module 4: Treatment and care. 2025. Available from: https:\/\/www.who.int\/publications\/i\/item\/9789240107243."},{"key":"86287","unstructured":"Ministry of Health of The Indonesian Republic. Report of treatment programme of tuberculosis 2022."},{"key":"86288","doi-asserted-by":"crossref","unstructured":"Lestari BW, Nijman G, Larasmanah A, et al. Management of drug-resistant tuberculosis in Indonesia: a four-year cascade of care analysis. Lancet Reg Health Southeast Asia 2024;22:100294.","DOI":"10.1016\/j.lansea.2023.100294"},{"key":"86289","doi-asserted-by":"crossref","unstructured":"Koirala S, Borisov S, Danila E, et al. Outcome of treatment of MDR-TB or drug-resistant patients treated with bedaquiline and delamanid: results from a large global cohort. Pulmonology 2021;27:403-12.","DOI":"10.1016\/j.pulmoe.2021.02.006"},{"key":"86290","doi-asserted-by":"crossref","unstructured":"Putra ON, Yulistiani Y, Soedarsono S, Subay S. Early efficacy of individual regimens containing bedaquiline in patients with drug resistant tuberculosis. Asian Pac J Trop Med 2023;16:169-75.","DOI":"10.4103\/1995-7645.372289"},{"key":"86291","doi-asserted-by":"crossref","unstructured":"Putra ON, Yulistiani Y, Soedarsono S, Subay S. Effectiveness and safety of regimen containing bedaquiline and delamanid in patients with drug-resistant tuberculosis. Perspect Clin Res 2023;15:89-3.","DOI":"10.4103\/picr.picr_1_23"},{"key":"86292","doi-asserted-by":"crossref","unstructured":"Setyawan MF, Mertaniasih NM, Soedarsono S, et al. Mycobacterium tuberculosis-AtpE gene profile of bedaquiline-Treated pulmonary tuberculosis patients at the referral hospital Dr. Soetomo, Indonesia. Int J Mycobacteriol 2023;12:122-8.","DOI":"10.4103\/ijmy.ijmy_40_23"},{"key":"86293","doi-asserted-by":"crossref","unstructured":"Rukasha I, Kaapu KG, Fortune SM, Lekalakala-Mokaba MR. Treatment outcomes for drug-resistant tuberculosis patients on bedaquiline-based regimens in a mostly rural South Africa. Infect Drug Resist 2025;18:1819-29.","DOI":"10.2147\/IDR.S502302"},{"key":"86294","doi-asserted-by":"crossref","unstructured":"Singla R, Khan S, Silsarma A, et al. Bedaquiline resistance and treatment outcomes among patients with tuberculosis previously exposed to bedaquiline in India: a multicentric retrospective cohort study. Clin Infect Dis 2025;81:846-52.","DOI":"10.1093\/cid\/ciaf068"},{"key":"86295","doi-asserted-by":"crossref","unstructured":"Aslam H, Omar A, Fatima R, et al. Treatment outcomes and adverse drug reactions among patients with drug-resistant tuberculosis receiving all-oral, long-term regimens: First record viewing report from Pakistan. Asian Pac J Trop Med 2023;16:58-64.","DOI":"10.4103\/1995-7645.370148"},{"key":"86296","doi-asserted-by":"crossref","unstructured":"Indarti HT, Kristin E, Soedarsono S, Endarti D. Treatment outcomes of multidrug-resistant tuberculosis patients in East Java, Indonesia: a retrospective cohort analysis. Int J Mycobacteriol 2022;11:261-7.","DOI":"10.4103\/ijmy.ijmy_86_22"},{"key":"86297","doi-asserted-by":"crossref","unstructured":"Soeroto AY, Nurhayati RD, Purwiga A, et al. Factors associated with treatment outcome of MDR\/RR-TB patients treated with shorter injectable based regimen in West Java Indonesia. PLoS One 2022;17:e0263304.","DOI":"10.1371\/journal.pone.0263304"},{"key":"86298","unstructured":"Ministry of Health of The Indonesian Republic. Technical guide for monitoring and management of adverse effects in the treatment of drug-resistant tuberculosis in Indonesia. 2022."},{"key":"86299","doi-asserted-by":"crossref","unstructured":"Humayun M, Chirenda J, Ye W, et al. Effect of gender on clinical presentation of tuberculosis (TB) and age-specific risk of TB, and TB-human immunodeficiency virus coinfection. Open Forum Infect Dis 2022;9:ofac512.","DOI":"10.1093\/ofid\/ofac512"},{"key":"86300","doi-asserted-by":"crossref","unstructured":"Wang Z, Hou Y, Guo T, et al. Epidemiological characteristics and risk factors of multidrug-resistant tuberculosis in Luoyang, China. Front Public Health 2023;11:1117101.","DOI":"10.3389\/fpubh.2023.1117101"},{"key":"86301","doi-asserted-by":"crossref","unstructured":"Xi Y, Zhang W, Qiao RJ, Tang J. Risk factors for multidrug-resistant tuberculosis: A worldwide systematic review and meta-analysis. PLoS One 2022;17:e0270003.","DOI":"10.1371\/journal.pone.0270003"},{"key":"86302","doi-asserted-by":"crossref","unstructured":"Mukati S, Julka A, Varudkar HG, et al. A study of clinical profile of cases of MDR-TB and evaluation of challenges faced in initiation of second-line anti-tuberculosis treatment for MDR-TB cases admitted in drug-resistant tuberculosis center. Indian J of Tuberc 2019;66:358-63.","DOI":"10.1016\/j.ijtb.2016.11.031"},{"key":"86303","doi-asserted-by":"crossref","unstructured":"Saifullah A, Mallhi TH, Khan YH, et al. Evaluation of risk factors associated with the development of MDR-and XDR-TB in a tertiary care hospital: a retrospective cohort study. PeerJ 2021;9:e10826.","DOI":"10.7717\/peerj.10826"},{"key":"86304","doi-asserted-by":"crossref","unstructured":"Cho SH, Lee H, Kwon H, et al. Association of underweight status with the risk of tuberculosis: a nationwide population-based cohort study. Sci Rep 2022;12:16207.","DOI":"10.1038\/s41598-022-20550-8"},{"key":"86305","doi-asserted-by":"crossref","unstructured":"Varshney K, Anaele B, Molaei M, et al. Risk factors for poor outcomes among patients with extensively drug-resistant tuberculosis (XDR-TB): a scoping review. Infect Drug Resist. 2021;14:5429-48.","DOI":"10.2147\/IDR.S339972"},{"key":"86306","doi-asserted-by":"crossref","unstructured":"Salifu EY, Agoni C, Olotu FA, Soliman MES. Triple mycobacterial ATP-synthase mutations impedes Bedaquiline binding: Atomistic and structural perspectives. Comput Biol Chem 2020;85:107204.","DOI":"10.1016\/j.compbiolchem.2020.107204"},{"key":"86307","doi-asserted-by":"crossref","unstructured":"Afifi M, Amin W, Helal D, Ashmawy R, El-Maradny YA, Khalifa N, et al. Impact of bedaquiline regimen on the treatment success rates of multidrug-resistant tuberculosis patients in Egypt. Sci Rep. 2024;14:16247.","DOI":"10.1038\/s41598-024-65063-8"},{"key":"86308","doi-asserted-by":"crossref","unstructured":"Fu L, Zhang X, Xiong J, et al. Selecting an appropriate all-oral short-course regimen for patients with multidrug-resistant or pre-extensively drug-resistant tuberculosis in China: a multicenter prospective cohort study. Int J Infect Dis 2023;135:101-8.","DOI":"10.1016\/j.ijid.2023.08.001"},{"key":"86309","doi-asserted-by":"crossref","unstructured":"Soeroto AY, Pratiwi C, Santoso P, Lestari BW. Factors affecting outcome of longer regimen multidrug-resistant tuberculosis treatment in West Java Indonesia: a retrospective cohort study. PLoS One 2021;16:e0246284.","DOI":"10.1371\/journal.pone.0246284"},{"key":"86310","doi-asserted-by":"crossref","unstructured":"Wakjira MK, Sandy PT, Mavhandu-Mudzusi AH. Treatment outcomes of patients with MDR-TB and its determinants at referral hospitals in Ethiopia. PLoS One 2022;17:e0262318.","DOI":"10.1371\/journal.pone.0262318"},{"key":"86311","doi-asserted-by":"crossref","unstructured":"Soeroto AY, Purwiga A, Suryadinata H, et al. Factors predicting successful treatment outcome with novel BPaLM\/BPaL regimen in individuals with drug-resistant tuberculosis: Experience from Indonesia. PLoS One 2026;21:e0345702.","DOI":"10.1371\/journal.pone.0345702"},{"key":"86312","doi-asserted-by":"crossref","unstructured":"Dlatu N, Faye LM, Sineke N, Apalata T. Predictors of drug-resistant TB outcomes: Body mass index, HIV, and comorbidities. Afr J Prim Health Care Fam Med 2025;17:e1-7.","DOI":"10.4102\/PHCFM.v17i1.4953"},{"key":"86313","doi-asserted-by":"crossref","unstructured":"Vadakunnel MJ, Nehru VJ, Brammacharry U, et al. Factors associated with unfavourable treatment outcomes among patients with multidrug-resistant tuberculosis receiving outpatient care. Sci Rep 2025;15:28335.","DOI":"10.1038\/s41598-025-13227-5"},{"key":"86314","doi-asserted-by":"crossref","unstructured":"Soedarsono S, Mertaniasih NM, Kusmiati T, et al. Determinants factors for loss to follow-up in drug-resistant tuberculosis patients: the importance of psycho-social and economic aspects. BMC Pulm Med 2021;21:360.","DOI":"10.1186\/s12890-021-01735-9"},{"key":"86315","doi-asserted-by":"crossref","unstructured":"Putra ON, Indah N, Damayanti N. Depression level and quality of life between shorter and longer regimens among patients with multidrug-resistant tuberculosis. Int J Mycobacteriol 2026;15:75-83.","DOI":"10.4103\/ijmy.ijmy_49_25"},{"key":"86316","doi-asserted-by":"crossref","unstructured":"Ruiz-Grosso P, Cachay R, de la Flor A, et al Association between tuberculosis and depression on negative outcomes of tuberculosis treatment: a systematic review and meta-analysis. 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BMC Infect Dis 2023;23:813.","DOI":"10.1186\/s12879-023-08765-0"}],"container-title":["Monaldi Archives for Chest Disease"],"original-title":[],"link":[{"URL":"https:\/\/www.monaldi-archives.org\/macd\/article\/download\/3928\/2265","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.monaldi-archives.org\/macd\/article\/download\/3928\/2265","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T08:35:40Z","timestamp":1788424540000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.monaldi-archives.org\/macd\/article\/view\/3928"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,3]]},"references-count":35,"URL":"https:\/\/doi.org\/10.4081\/monaldi.2026.3928","relation":{},"ISSN":["2532-5264","1122-0643"],"issn-type":[{"value":"2532-5264","type":"electronic"},{"value":"1122-0643","type":"print"}],"subject":[],"published":{"date-parts":[[2026,9,3]]}}}