In Indonesia, the implementation of tuberculosis (TB) contact investigation is limited, with low detection rates. We report the yield of and risk factors for TB disease and infection for household contacts (HHCs) investigated using chest X-ray (CXR) screening. We identified HHCs aged five years and above of bacteriologically confirmed index cases from 2018 to 2022 in Yogyakarta City and Kulon Progo. All HHCs were offered screening for TB symptoms; TB infection testing with either tuberculin skin testing or interferon gamma release assay; and referral for CXR. Sputum from those with symptoms or CXR suggestive of TB was tested with Xpert MTB/RIF. Risk factors for active TB disease and latent TB infection (LTBI) were identified by logistic regression models. We screened 2857 HHCs for TB between June 2020 and December 2022, with 68 (2.4%) diagnosed with active TB. Of 2621 HHCs eligible for LTBI investigation, 1083 (45.7%) were diagnosed with LTBI. The factors associated with active TB were age, being underweight, diabetes mellitus, urban living, and sleeping in the same house as an index case. Factors associated with LTBI were increasing age and male gender. Conclusions: Screening for HHC including CXR and TST/IGRA yielded a moderate prevalence of TB disease and infection.

The World Health Organization recommends using chest X-ray (CXR) in active case finding (ACF) to improve case detection. This study aimed to describe the spectrum and outcomes of TB disease diagnosed through a mobile community based ACF program in Yogyakarta. This prospective cohort study included people attending a TB ACF program in Yogyakarta between 1 January 2021 to 30 June 2022. Participants ≥10 years old underwent CXR, symptom screening, and Xpert MTB/RIF testing of sputum. Subclinical TB was defined as asymptomatic active TB, whether bacteriologically confirmed or not. Treatment outcome data were obtained from the national program TB database. 47,735 people attended the ACF program; the yield of TB disease was 0.86% (393/45,938). There were 217 symptomatic cases, of whom 72 (33.2%) were bacteriologically confirmed, and 176 asymptomatic cases, with 52 (29.5%) bacteriologically confirmed. Treatment success was 70.7% with high loss to follow up (9%) and not evaluated (17.1%). Multivariate analysis demonstrated weak evidence for lower unsuccessful outcomes in symptomatic versus subclinical TB (aOR 0.6, 95% CI 0.36–0.998). TB ACF programs utilizing CXR may diagnose a high proportion of subclinical TB. Linkage to care in ACF program is important to increase successful treatment outcomes.

Tuberculosis preventive therapy (TPT) for people living with HIV (PLHIV) has been recommended by Indonesia’s National TB Program since 2014 but has seen limited implementation. This study describes TB screening and TPT initiation from 2019 to 2022 among eight healthcare facilities supported by the Zero TB Yogyakarta (ZTB) project. ZTB assigned a dedicated nurse to assist with active TB screening among PLHIV and recommended the immediate initiation of TPT as an innovation implemented. Data were obtained from the national HIV program reporting system, routinely reported by ART clinics from 2019 to 2022. We conducted a descriptive analysis, comparing the pre-intervention and intervention periods. During the intervention, there was a significant increase in PLHIV visits to healthcare facilities where TPT eligibility was assessed. At health centers, TB screening coverage for PLHIV decreased toward the end of the baseline period but recovered during the intervention. The number of PLHIV starting TPT also rose during the intervention. While the direct impact of ZTB is difficult to measure, the changes observed indicate progress in integrating TB/HIV services and enhancing TB prevention among PLHIV. Ongoing support, training, and supervision of healthcare facilities are crucial for improving TB screening and TPT provision.

Tuberculosis preventive therapy (TPT) for people living with HIV (PLHIV) has been recommended by Indonesia’s National TB Program since 2014 but has seen limited implementation. This study describes TB screening and TPT initiation from 2019 to 2022 among eight healthcare facilities supported by the Zero TB Yogyakarta (ZTB) project. Data were obtained from the national HIV program reporting system, routinely reported by ART clinics from 2019 to 2022. We conducted a descriptive analysis, comparing the pre-intervention and intervention periods. During the intervention, there was a significant increase in PLHIV visits to healthcare facilities where TPT eligibility was assessed. At health centers, TB screening coverage for PLHIV decreased toward the end of the baseline period but recovered during the intervention. The number of PLHIV starting TPT also rose during the intervention. While the direct impact of ZTB is difficult to measure, the changes observed indicate progress in integrating TB/HIV services and enhancing TB prevention among PLHIV. Ongoing support, training, and supervision of healthcare facilities are crucial for improving TB screening and TPT provision.