Determinants of Multidrug-Resistant Pulmonary Tuberculosis in Indonesia: A Spatial Analysis Perspective

Abstract

Tuberculosis is caused by Mycobacterium Tuberculosis (MT). MT usually attacks the lungs and causes pulmonary-tuberculosis. Tuberculosis cases in Indonesia keep increasing over the years. The presence of Multidrug-Resistant Tuberculosis (MDR-TB) has been one of the main obstacles in eradicating tuberculosis because it couldn’t be cured using standard drugs. In fact, the success rate of MDR-TB treatment in 2019 at the global level was only 57 percent. Research on MDR-TB can be related to the spatial aspect because this disease can be transmitted quickly. This study aims to obtain an overview and model the number of Indonesia’s pulmonary MDR-TB cases in 2019 using the Geographically Weighted Negative Binomial Regression (GWNBR) method. The independent variables used in the model are population density, percentage of poor population, health center ratio per 100 thousand population, the ratio of health workers per 10 thousand population, percentage of smokers, percentage of the region with PHBS policies, and percentage of BCG immunization coverage. The finding reveals that the model forms 12 regional groups based on significant variables where GWNBR gives better results compared to NBR. The significant spatial correlation implies that the collaboration among regional governments plays an important role in reducing the number of pulmonary MDR-TB.