Survival Analysis and Factors Associated with Pulmonary Tuberculosis
Abstract
Introduction: Analysed the survival rates of patients and factors associated with pulmonary tuberculosis at the Limboto Public Health Center, with particular attention to the role of hypertension as a predictor of treatment failure and its potential integration into TB treatment guidelines.
Methods: The study represents retrospective cohort research conducted by collecting medical records of individual pulmonary tuberculosis patients at the Limboto Public Health Center. The research sample comprised 144 patients and was analysed using survival analysis methods, including the Kaplan-Meier and Cox Regression models.
Result: Among a cohort of 144 pulmonary tuberculosis cases, 21 individuals (14.6%) encountered treatment failure, resulting in three fatalities. A Kaplan-Meier survival analysis unveiled marked disparities in the survival probabilities of pulmonary tuberculosis patients contingent on their hypertension status (p=0.000). In the Cox Regression analysis, the hazard ratio associated with hypertension in the context of treatment failure in pulmonary tuberculosis patients was determined to be HR= 10.216. These findings suggest the necessity of incorporating hypertension screening and management into existing TB care protocols.
Conclusion: Evidence-based interventions should be implemented, particularly among patients with concomitant hypertension. Strengthening the integration of hypertension management into TB treatment guidelines may improve patient outcomes and reduce treatment failures.
References
Pralambang SD, Setiawan S. Faktor risiko kejadian tuberkulosis di Indonesia. Jurnal Biostatistik, Kependudukan, dan Informatika Kesehatan (BIKFOKES) [Internet]. 2021;2(1):60–71. Available from: https://scholarhub.ui.ac.id/bikfokes/vol2/iss1/5
World Health Organization. Global Tuberculosis Report 2022 [Internet]. Geneva; 2022 [cited 2023 Nov 6]. Available from: https://www.ptonline.com/articles/how-to-get-better-mfi-results
New York: United Nations [Internet]. 2022 [cited 2023 Nov 5]. Sustainable Development Goals. Available from: https://sdgs.un.org/
Global strategy and targets for tuberculosis prevention, care and control after 2015 (Resolution WHA67.1, Agenda item 12.1) [Internet]. Geneva; 2014 [cited 2023 Nov 5]. Available from: http://apps.who.int/gb/ebwha/pdf_files/WHA67/A67_R1-en.pdf
World Health Organization. Global Tuberculosis Report 2023 [Internet]. Geneva; 2023 [cited 2023 Nov 5]. Available from: https://iris.who.int/bitstream/handle/10665/373828/9789240083851-eng.pdf?sequence=1
Kementerian Kesehatan Republik Indonesia. Laporan Program Penanggulangan Tuberkulosis Tahun 2022 [Internet]. 2023 [cited 2023 Nov 5]. Available from: https://tbindonesia.or.id/pustaka_tbc/laporan-program-penanggulangan-tuberkulosis-tahun-2022/
Dinas Kesehatan Provinsi Gorontalo. Data TB 2018. 2018.
Puskesmas Limboto. Data Sekunder Prevalensi TB Puskesmas Limboto. 2018.
Safitri W, Wuryandari T, Suparti S. Analisis Ketahanan Hidup Penderita Tuberkulosis Dengan Menggunakan Metode Regresi Cox Kegagalan Proporsional (Studi Kasus Di Puskesmas Kecamatan Kembangan Jakarta Barat). Jurnal Gaussian [Internet]. 2016;5(4):781–90. Available from: https://ejournal3.undip.ac.id/index.php/gaussian/article/view/14735/14259
Chidambaram V, Gupte A, Wang JY, Golub JE, Karakousis PC. The impact of hypertension and use of calcium channel blockers on tuberculosis treatment outcomes. Clinical Infectious Diseases. 2021;73(9):e3409–18.
Seegert AB, Patsche CB, Sifna A, Gomes VF, Wejse C, Storgaard M, et al. Hypertension is associated with increased mortality in patients with tuberculosis in Guinea-Bissau. International Journal of Infectious Diseases. 2021;109:123–8.
Carter BB, Zhang Y, Zou H, Zhang C, Zhang X, Sheng R, et al. Survival analysis of patients with tuberculosis and risk factors for multidrug-resistant tuberculosis in Monrovia, Liberia. PLoS One [Internet]. 2021;16(4):e0249474. Available from: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0249474
David GK, Mitchel K. Survival analysis: a Self?Learning text. Spinger; 2012.
Pahlevi MR, Mustafid M, Wuryandari T. Model Regresi Cox Stratified pada Data Ketahanan. Jurnal Gaussian [Internet]. 2016;5(3):455–64. Available from: https://ejournal3.undip.ac.id/index.php/gaussian/article/view/14701/14225
Sabila YA, Sibuea S. Penatalaksanaan Pasien Wanita Usia 52 Tahun dengan Tuberkulosis Paru dan Hipertensi Derajat 1 melalui Pendekatan Dokter Keluarga. Jurnal Penelitian Perawat Profesional. 2022;4(4):1071–84.
Talango F, Nugroho YW, Proborini CA, Laili NNN. Upaya Pencegahan Komplikasi Hipertensi dengan Edukasi Berbasis Health Belief Model dan Mengontrol Tekanan Darah. Jurnal Pengabdian Masyarakat Bina Usada (ABDINUSA). 2024;2(1):27–34.
Sutarto S, Fauzi YS, Indriyani R, RW DWS, Wibowo A. Efikasi Diri pada Kepatuhan Minum Obat Anti Tuberkulosis (OAT). Jurnal Kesehatan [Internet]. 2019;10(3):405–12. Available from: https://d1wqtxts1xzle7.cloudfront.net/103804327/1044-libre.pdf?1687869691=&response-content-disposition=inline%3B+filename%3DEfikasi_Diri_pada_Kepatuhan_Minum_Obat_A.pdf&Expires=1739286025&Signature=VdECiAMkw~e~P5df4ogsV8Q4FL6PK0g-pNaWZIEuXe9vc1nf-RO8pb4zQUcP5UkULGa-r5kYYrnejGM49Owe4WYNEdovAfgsIUWNw8ATivb19YuHFvMcTvc-Ha-v60V0jJ-i6z~EN5repU4lBr2fYXqIS2mY3xjmR1zp20vXN3bWdjtiB4xipplBxkL07jxSQ3Arq1du-t7M7pFcdz25pyl~BLAtJRnE~9YGuftpxg3Ojm4GEl~PU~5Y7VlbCMuE6S86pR3dzdHmYgs9QPiDguxv55NXGeJq1uVc~MJhFX0mQ6dafX8xTRMgA3RpUxYW8~pG2G~-cHE3pFcAEYWIIg__&Key-Pair-Id=APKAJLOHF5GGSLRBV4ZA
Balaky STJ, Mawlood AH, Shabila NP. Survival analysis of patients with tuberculosis in Erbil, Iraqi Kurdistan region. BMC Infect Dis [Internet]. 2019;19:1–8. Available from: https://link.springer.com/content/pdf/10.1186/s12879-019-4544-8.pdf
Xie Y, Han J, Yu W, Wu J, Li X, Chen H. Survival analysis of risk factors for mortality in a cohort of patients with tuberculosis. Can Respir J [Internet]. 2020;2020. Available from: https://onlinelibrary.wiley.com/doi/epdf/10.1155/2020/1654653
Machado D, Couto I, Viveiros M. Advances in the molecular diagnosis of tuberculosis: from probes to genomes. Infection, Genetics and Evolution [Internet]. 2019;72:93–112. Available from: https://www.sciencedirect.com/science/article/pii/S156713481830933X?casa_token=IBBylH8AB9sAAAAA:4OgE8Ly7yyZSieALUHHFQznF8kFkTujOSNXs6aRRiogpyCRkzfyKjz6NuR-WLgvb81kLXlZJ5SyE
Dewanty LI, Haryanti T, Kurniawan TP. Kepatuhan Berobat Penderita TB Paru di Puskesmas Nguntoronadi I Kabupaten Wonogiri. Jurnal Kesehatan [Internet]. 2016;9(1):39–43. Available from: https://journals.ums.ac.id/jk/article/view/3406/2161
Modeong F, Isa DR, Djakaria I, Payu MRF, Mahmud SL. Implementasi Model Cox Stratifikasi Interaksi dan Tanpa Interaksi untuk Mengidentifikasi Faktor-Faktor Laju Kesembuhan Pasien TB Paru. Research in the Mathematical and Natural Sciences [Internet]. 2023;2(2):80–98. Available from: https://journal.scimadly.com/index.php/rmns/article/view/130/97
Atsilah Hasibuan N, Jaya I, Husein I, Sumatera Utara U. FAKTOR-FAKTOR YANG MEMPENGARUHI LAJU KESEMBUHAN PASIEN TUBERKULOSIS PARU MENGGUNAKAN BAYESIAN MIXTURE SURVIVAL Factors That Affect The Healing Rate For Patiens With Tuberculosis Of The Lung Use Bayesian Mixture Survival. Vol. 1, JOURNAL OF ANALYTICAL RESEARCH. 2022.
Briliant EH, Kurniawan MHS. Perbandingan Regresi Linier Berganda dan Regresi Buckley- James Pada Analisis Survival Data Tersensor Kanan. 2019;1(1):1–10.
Ahmed AEH, Ibrahim AS, Elshafie SM. Pulmonary hypertension in patients with treated pulmonary tuberculosis: analysis of 14 consecutive cases. Clin Med Insights Circ Respir Pulm Med [Internet]. 2011;5:CCRPM-S6437. Available from: https://journals.sagepub.com/doi/epub/10.4137/CCRPM.S6437
Copyright (c) 2025 Journal of Public Health and Pharmacy

This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
Authors who publish with Journal of Public Health and Pharmacy retain the copyright of their work. The journal applies a Creative Commons Attribution-ShareAlike 4.0 International License (CC BY-SA 4.0), which grants the following rights:
-
Copyright Retention: Authors retain the copyright of their work, maintaining full control over their intellectual property without restrictions.
-
Right of First Publication: Authors grant the journal the right of first publication of their work. This ensures that the work is initially published and credited in Journal of Public Health and Pharmacy.
-
License to Share and Reuse: The work is licensed under CC BY-SA 4.0, allowing others to copy, distribute, remix, and build upon the work for any purpose, even commercially, as long as proper credit is given to the authors, and any new creations are licensed under the same terms.