Spatiotemporal and risk factor analysis of drug-sensitive and drug-resistant TB in West Java, 2020–2022

<sec><title>OBJECTIVE</title>West Java reports the highest number of TB cases in Indonesia. This study aimed to assess the spatiotemporal distribution and risk factors associated with TB in West Java from 2020 to 2022.</sec><sec><title>DESIGN</title>We conducted a cohort retrospective study using 302,057 TB cases, including 3,631 drug-resistant TB (DR-TB) cases, obtained from the National Tuberculosis Surveillance System. We performed spatiotemporal mapping, while spatial autocorrelation was assessed through Global and Local Moran's I statistics. We performed Poisson regression to identify risk factors for DR-TB.</sec><sec><title>RESULTS</title>We observed an increasing trend in TB cases during the study period, peaking in 2022. Bogor Regency consistently had the highest burden of both drug-sensitive TB and DR-TB. Global Moran's I confirmed that TB cases were spatially clustered rather than randomly distributed. Local Moran's I revealed high-burden clusters in Kota Bekasi, Bogor, and Bandung. Several variables were significantly associated with DR-TB, with the highest risk observed among patients who resumed treatment after loss to follow-up (relative risk = 29.0, 95% confidence interval: 26.4-31.9).</sec><sec><title>CONCLUSION</title>This study highlights a growing and spatially clustered TB burden in West Java. Targeted interventions focusing on high-risk populations and districts are essential to strengthen TB control strategies.</sec>.