Characteristics of Primary and acquired multidrug-resistant tuberculosis patients in West Java, Indonesia.

OBJECTIVES: The increasing incidence of primary multidrug-resistant tuberculosis (MDR-TB) creates a new burden in national tuberculosis (TB) control. Understanding the characteristics of primary MDR-TB aids in predicting its spread. This study aimed to determine the differences in characteristics of primary and acquired MDR-TB patients in a hospital setting in Indonesia. METHODS: This is a retrospective cohort study of adult patients (aged >18 years) with pulmonary MDR-TB who received treatment at Hasan Sadikin General Hospital, West Java, Indonesia. Patients who finished MDR-TB treatment between 2020 and 2022 were included. Patients whose therapeutic outcomes could not be determined and those with incomplete data were excluded. RESULTS: This study included 337 participants; 32% were primary MDR-TB and 68% were acquired MDR-TB. Findings showed a significant difference between primary and acquired MDR-TB by contact with a TB index case. Primary MDR-TB was 4.31 times higher in patients who had contact (prevalence odds ratio 4.31, 95% confidence interval 2.65-7.01). Other characteristics showed some differences but were not statistically significant. CONCLUSION: Contact with the TB index case was found to differ significantly between primary and acquired MDR-TB. The transmission-driven nature of drug-resistant TB underscores the urgent need to reposition contact investigation and preventive therapy as central pillars of the MDR-TB control strategy.