Prevalence of Pulmonary Tuberculosis (TB) in Indonesia: An Indonesian Health Survey Study

Abstract

Tuberculosis (TB) transmission at the household level is a major determinant contributing significantly to the TB burden in Indonesia. The 2023 Indonesian Health Survey (SKI) data reported a national pulmonary TB prevalence of approximately 0.30%, with substantial interprovincial variation, underscoring the urgency of strengthening risk-based interventions for household contacts. The objective was to summarize and synthesize empirical evidence on the prevalence and risk factors for TB transmission/incidence among household contacts in Indonesia through a systematic review and meta-analysis. This study used an observational analytical study design with a cross-sectional approach, aiming to analyze the prevalence and risk factors for pulmonary TB among household contacts in Indonesia. The data used were secondary data sourced from the 2023 Indonesian Health Survey (SKI) conducted by the Ministry of Health of the Republic of Indonesia. The study population included the entire Indonesian population covered by the 2023 SKI, with the analysis focusing on the incidence of pulmonary TB. The prevalence of pulmonary tuberculosis by province in the 2023 Indonesian Health Survey (SKI) showed a national TB prevalence of 0.30% (95% CI: 0.28–0.33). The highest prevalence was found in Central Papua (1.15%). Several factors were consistently associated with an increased risk of TB among household contacts, including exposure intensity (e.g., long contact duration), characteristics of the index patient (treatment non-adherence and unsafe sputum disposal practices), housing conditions (inadequate ventilation and high density), and host vulnerability (low nutritional status and younger age). Several studies also indicate that exposure to secondhand smoke or smoking behavior plays a role in increasing risk. Available evidence supports a household-based TB control strategy that prioritizes breaking the chain of transmission from the index patient, improving the quality of the residential environment, and protecting at-risk contacts through contact investigation and providing TB preventive therapy.