Trends Of Multidrug-Resistant Tuberculosis (MDR-TB) In Southeast Sulawesi: A Literature Review

Abstract

Multidrug-resistant tuberculosis (MDR-TB) poses a major challenge to the tuberculosis (TB) elimination program in Indonesia. MDR-TB imposes a greater burden because it requires longer and more expensive treatment and carries a higher risk of treatment failure compared to drug-susceptible TB. Southeast Sulawesi, as one of the provinces in eastern Indonesia, is experiencing an increase in MDR-TB cases; however, epidemiological data and local analyses remain limited. This review aims to analyze the trends of MDR-TB in Southeast Sulawesi based on recent literature, identify its risk factors, and highlight the challenges and intervention strategies for MDR-TB control. This study employed a narrative literature review approach by searching articles from PubMed, Scopus, Google Scholar, GARUDA, as well as reports from the Indonesian Ministry of Health and Provincial Health Office, covering the period of 2015–2025. Articles discussing the epidemiology, diagnosis, risk factors, treatment, or policies on MDR-TB relevant to national or local contexts were included. The review indicates an increasing trend of MDR-TB in Indonesia, including Southeast Sulawesi, with major risk factors such as incomplete TB treatment history, poor treatment adherence, delayed diagnosis, and patients’ socio-economic conditions. Limited access to rapid diagnostics (GeneXpert) and second-line drugs also remains a significant barrier. Studies from neighboring regions emphasize that family support, patient education, and community-based interventions can improve treatment success. MDR-TB control efforts in Southeast Sulawesi require a multidimensional approach through expanded access to rapid diagnostics, strengthening healthcare worker capacity, optimizing referral systems, and implementing social interventions to improve adherence. Further local research is needed to accurately map MDR-TB epidemiology as the basis for regional policy.