Obstacles and prospects in a holistic approach to tuberculosis eradication: A systematic review

Yani Kurniawan; Monica Dwi Hartanti; Sisca Sisca; Suriyani Suriyani; Jipri Suyanto

doi:10.33024/minh.v7i9.766

Authors

Yani Kurniawan Universitas Trisakti
Monica Dwi Hartanti Universitas Trisakti
Sisca Universitas Trisakti
Suriyani Universitas Trisakti
Jipri Suyanto Universitas Dehasen

DOI:

https://doi.org/10.33024/minh.v7i9.766

Keywords:

Early Detection, Elimination, Program, Tuberculosis

Abstract

Background: Tuberculosis (TB) remains one of the major public health issues in Indonesia, ranking third globally in the number of TB cases after India and China. Despite global and national efforts to combat the disease, significant challenges persist, including Multidrug-Resistant Tuberculosis (MDR-TB), limited early detection, patient non-compliance with treatment, and widespread social stigma. The Indonesian government has implemented the National Strategy for TB Prevention and Control, which focuses on early detection, appropriate treatment, and TB transmission prevention through comprehensive approaches such as Directly Observed Treatment, Short-course (DOTS), and the use of rapid diagnostic technologies like Xpert MTB/RIF. However, to achieve the target of TB elimination by 2030, in line with the Sustainable Development Goals (SDGs), further and more coordinated efforts are required.

Purpose: To examine the epidemiology of TB worldwide and in Indonesia, the challenges in implementing TB eradication programs, and the strategic measures needed to accelerate TB elimination.

Method: A systematic review approach in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Articles were sourced from online databases such as PubMed, Google Scholar and Science Direct. The review was organized according to the PICOS framework. The keywords used in the search included "tuberculosis eradication” “patient’s experience" and "one health approach” and "literacy" and "pharmacokinetics" and "quality of life” and "patient’s perspective". Articles were selected based on specific inclusion criteria: the last three years (2021-2024), written in English and Indonesian.

Results: Indonesia faces challenges in managing TB by 2030, with 845,000 new cases and increasing MDR-TB prevalence. The COVID-19 pandemic has exacerbated the issue, with a critical healthcare system, stigma, and economic hardships affecting diagnosis and treatment. Digital healthcare technology and public-private partnerships can help improve diagnosis and treatment. Community-based efforts and new therapeutic treatment protocols can improve patient health and healthcare systems.

Conclusion: With strong governmental commitment, support from international organizations, and active community participation, Indonesia is expected to achieve TB elimination by 2030. Enhancing health system capacity, adopting innovative technologies, and sustaining public education will be crucial in addressing the challenges and opportunities in fully eradicating TB.

References

Adi, Y. A. (2024). An investigation of Susceptible–Exposed–Infectious–Recovered (SEIR) tuberculosis model dynamics with pseudo-recovery and psychological effect. Healthcare Analytics, 6, 100361.

Adnyana, I. M., Utomo, B., Eljatin, D. S., & Sudaryati, N. L. (2023). One Health approach and zoonotic diseases in Indonesia: Urgency of implementation and challenges. Narra J, 3(3).

Baratau, D. C. (2024). Cultural Adaptation Strategies in Illiteracy Eradication Programs: Insights from North Toraja, Indonesia. Inspirasi & Strategi (INSPIRAT): Jurnal Kebijakan Publik & Bisnis, 14(2), 56-64.

Bea, S., Lee, H., Choi, W. S., Huh, K., Jung, J., & Shin, J. Y. (2023). Risk of mortality and clinical outcomes associated with healthcare delay among patients with tuberculosis. Journal of Infection and Public Health, 16(8), 1313-1321.

Bhatia, V., Rijal, S., Sharma, M., Islam, A., Vassall, A., Bhargava, A., & Raviglione, M. (2023). Ending TB in South-East Asia: flagship priority and response transformation. The Lancet Regional Health-Southeast Asia, 18.

Burugina Nagaraja, S., Thekkur, P., Satyanarayana, S., Tharyan, P., Sagili, K. D., Tonsing, J., & Sachdeva, K. S. (2021). Active case finding for tuberculosis in India: a syntheses of activities and outcomes reported by the National Tuberculosis Elimination program. Tropical Medicine and Infectious Disease, 6(4), 206.

Calderon, J. S., Perry, K. E., Thi, S. S., & Stevens, L. L. (2022). Innovating tuberculosis prevention to achieve universal health coverage in the Philippines. The Lancet Regional Health–Western Pacific, 29.

Cannon, L. A. L., Oladimeji, K. E., & Goon, D. T. (2021). Socio-economic drivers of drug-resistant tuberculosis in Africa: a scoping review. BMC Public Health, 21, 1-8.

Carnino, L., Schwob, J. M., Neofytos, D., Lazo-Porras, M., Chappuis, F., & Eperon, G. (2021). Screening for parasitic infection and tuberculosis in immunosuppressed and pre-immunosuppressed patients: an observational study. Tropical Medicine and Infectious Disease, 6(3), 170.

Chawla, K., Burugina Nagaraja, S., Siddalingaiah, N., Sanju, C., Shenoy, V. P., Kumar, U., & Reddy, R. C. (2021). Challenges perceived by health care providers for implementation of contact screening and isoniazid chemoprophylaxis in Karnataka, India. Tropical Medicine and Infectious Disease, 6(3), 167.

Dongo, J. P., Graham, S. M., Nsonga, J., Wabwire-Mangen, F., Maleche-Obimbo, E., Mupere, E., & Zawedde-Muyanja, S. (2021). Implementation of an effective decentralised program for detection, treatment and prevention of tuberculosis in children. Tropical Medicine and Infectious Disease, 6(3), 131.

Ginting, E. D., Aldila, D., & Febiriana, I. H. (2024). A deterministic compartment model for analyzing tuberculosis dynamics considering vaccination and reinfection. Healthcare Analytics, 5, 100341.

Fuady, A., Hutanamon, T., Herlinda, O., Luntungan, N., & Wingfield, T. (2024). Achieving universal social protection for people with tuberculosis. The Lancet Public Health, 9(5), e339-e344.

Ha, N. D., & Duong, N. H. (2023). Advancements, Challenges, and Future Directions in Rainfall-Induced Landslide Prediction: A Comprehensive Review. Journal of Engineering & Technological Sciences, 55(4).

Herawati, F., Fahmi, E. Y., Pratiwi, N. A., Ramdani, D., Jaelani, A. K., Yulia, R., & Andrajati, R. (2021). Oral anti-tuberculosis drugs: An urgent medication reconciliation at hospitals in Indonesia. Journal of Public Health Research, 10(3), jphr-2021.

Hidayati, T., Indrayanti, I., Nurhan, D., Rozi, F., Irbah, H., Desfitra, R., & Hayuningtyas, D. P. (2024, September). Solutions to Reduce the Stigma of Tuberculosis with Interactive Education on Knowledge, Attitudes, and Behavior. In Proceeding International Conference of Community Service (Vol. 2, No. 1).

Juliasih, N. N., Sakinah, L. F., Sari, R. M., Winarso, H., Siahaan, S. C. P., & Gunawan, E. J. (2024). Determinants of transmission prevention behavior among Tuberculosis patients in Surabaya, Indonesia. Infection Prevention in Practice, 6(4), 100404.

Kardani, A. K., & Subandiyah, K. (2020). Genitourinary tuberculosis in 2-year-old indonesian boy with malnutrition: A rare case. Urology Case Reports, 33, 101365.

Lin, Y., Liu, Y., Zhang, G., Cai, Q., Hu, W., Xiao, L., & Harries, A. D. (2021). Is it feasible to conduct post-tuberculosis assessments at the end of tuberculosis treatment under routine programmatic conditions in China?. Tropical Medicine and Infectious Disease, 6(3), 164.

Main, S., Lestari, T., Triasih, R., Chan, G., Davidson, L., Majumdar, S., & Ralph, A. (2022). Training for tuberculosis elimination in Indonesia: Achievements, reflections, and potential for impact. Tropical Medicine and Infectious Disease, 4(3), 107.

Malik, A. A., Hussain, H., Maniar, R., Safdar, N., Mohiuddin, A., Riaz, N., & Khowaja, S. (2022). Integrated tuberculosis and COVID-19 activities in Karachi and tuberculosis case notifications. Tropical medicine and infectious disease, 7(1), 12.

Natalia, D., Zahirah, A. D. P., Widjaja, E. M., & Ernawati, E. (2024). Demonstration of Cough Etiquette As an Effort to Reduce Pulmonary Tuberculosis Cases in Sindang Jaya Using a Community Diagnosis Approach. MAHESA: Malahayati Health Student Journal, 4(7), 2675-2685.

Otchere, I. D., Aboagye, S. Y., Arthur, P. K., & Asante-Poku, A. (2024). Viewpoint of multi-omics potential in tuberculosis research: identifying biomarkers for biomanufacturing of efficient control tools. Frontiers in Tropical Diseases, 5, 1443248.

Ponnampalli, S., & Birudukota, N. V. S. (2023). The impact of COVID-19 pandemic in high-burden countries for tuberculosis: a systematic review. Health Sciences Review, 100128.

Pradipta, I. S., Idrus, L. R., Probandari, A., Lestari, B. W., Diantini, A., Alffenaar, J. W. C., & Hak, E. (2021). Barriers and strategies to successful tuberculosis treatment in a high-burden tuberculosis setting: a qualitative study from the patient’s perspective. BMC Public Health, 21, 1-12.

Qureshi, F. M., Faiz, S., & Khalid, A. (2023). An Investigation into Implications of Tuberculosis Control Efforts in Pakistan: A Comparative Approach. Journal of Bahria University Medical and Dental College, 13(03), 206-211.

Reuter, A., Beko, B., Memani, B., Furin, J., Daniels, J., Rodriguez, E., & Mohr-Holland, E. (2022). Implementing a substance-use screening and intervention program for people living with rifampicin-resistant tuberculosis: pragmatic experience from Khayelitsha, South Africa. Tropical Medicine and Infectious Disease, 7(2), 21.

Soedarsono, S., Jayanti, R. P., Mertaniasih, N. M., Kusmiati, T., Permatasari, A., Indrawanto, D. W., & Shin, J. G. (2023). Development of population pharmacokinetics model and Bayesian estimation of rifampicin exposure in Indonesian patients with tuberculosis. Tuberculosis, 139, 102325.

Sofiana, L., Ayu, S. M., Wardani, Y., Puspaningrum, E., & Hadianti, D. D. (2022). Risk factors of quality of life among tuberculosis patients. International Journal of Public Health Science, 11(3), 756-762.

Sutrisno, R. Y., Widiyastuti, D. R., Budi, A. W. S., Wulandari, B. T., Irawati, K., & Suanrueang, P. (2022). Patient Experience in The Healing Process of Tuberculosis: A Phenomenology Study. IJNP (Indonesian Journal of Nursing Practices), 6(1), 57-64.

Syamsir, S. B., Permatasari, H., & Setiawan, A. (2023). Experiences of Patients with Tuberculosis Who Underwent Completed TB Treatment during the COVID-19 Pandemic in Indonesia: A Qualitative Study. International Journal of Community Based Nursing and Midwifery, 11(4), 226.

Wijiseno, B., Arini, M., & Listiowati, E. (2023). Healthcare workers’ acceptance of the integrated tuberculosis–COVID-19 screening in central Java Private Hospitals, Indonesia. Journal of Taibah University Medical Sciences, 18(6), 1311.

Winardi, W., Wahyuni, H., Hidayat, M., Wirawan, A., Nurwidya, F., Uddin, M. N., & Yusup, M. (2022). Challenges on tuberculosis care in health care facilities during COVID-19 pandemic: Indonesian perspective. Narra J, 2(2).

Yuliyanti, S. (2024). Beyond Clinical Outcomes: Exploring the Psychosocial and Physical Dimensions of Quality of Life in Tuberculosis Patients Receiving Outpatient Care. Open Access Indonesian Journal of Medical Reviews, 4(4), 738-753.

Yusuf, T. T., & Abidemi, A. (2023). Effective strategies towards eradicating the tuberculosis epidemic: An optimal control theory alternative. Healthcare analytics, 3, 100131.

Zafar Ullah, A. N., Shrestha, S., Malik, A. A., & Roy, T. (2022). Holistic approach to tuberculosis detection, treatment and prevention: emerging evidence and strategies from the field. Tropical Medicine and Infectious Disease, 7(3), 36.

Zhao, A., Butala, N., Luc, C. M., Feinn, R., & Murray, T. S. (2022). Telehealth reduces missed appointments in pediatric patients with tuberculosis infection. Tropical Medicine and Infectious Disease, 7(2), 26.