Can Indonesia Eliminate Tuberculosis by 2030? A Deterministic Epidemic Model Approach

Novi Reandy Sasmita; Maya Ramadani; Muhammad Ikhwan; Latifah Rahayu; Selvi Mardalena; Suyanto Suyanto; Nanda Safira; Le Ngoc Huy; Ohnmar Myint

doi:10.31764/jtam.v10i1.35252

Can Indonesia Eliminate Tuberculosis by 2030? A Deterministic Epidemic Model Approach

Novi Reandy Sasmita, Maya Ramadani, Muhammad Ikhwan, Latifah Rahayu, Selvi Mardalena, Suyanto Suyanto, Nanda Safira, Le Ngoc Huy, Ohnmar Myint

Abstract

Indonesia, bearing the world’s second-highest tuberculosis (TB) burden, has mandated a national target to eliminate TB by 2030, aiming for an incidence rate of 65 per 100,000 population. This study aims not only to project future transmission dynamics but also to systematically explore the specific epidemiological barriers, namely, drug resistance and relapse mechanisms, that hinder achieving this goal. To address the heterogeneity of TB transmission, we developed a novel deterministic SVE3I3R model. This framework stratifies the population into vaccinated, latent Tuberculosis Infection (LTBI), and infectious compartments, explicitly distinguishing among Drug-Susceptible (DS-TB), Multidrug-Resistant (MDR-TB), and Extensively Drug-Resistant (XDR-TB) strains. The resulting system of ordinary differential equations was solved numerically using the fourth-order Runge-Kutta (RK4) method to ensure stability and accuracy in simulating long-term epidemiological trends from 2023 to 2030. Parameters were calibrated using national reports and literature specific to the Indonesian context. Projections indicate that Indonesia will miss the 2030 elimination target by a significant margin. The model forecasts a TB incidence rate of 321 per 100,000 population by 2030, nearly five times the national benchmark. The analysis reveals that failure to reach the target is mechanistically driven by a "relapse trap" among recovered individuals and an alarming exponential surge in resistant strains (MDR-TB and XDR-TB). These findings suggest that current control strategies are insufficient not merely in scale but in structure. Evidence-based policy must urgently shift from standard intervention to aggressive interruption of resistance pathways and enhanced management of the latent reservoir to prevent the projected demographic resurgence.

Keywords

Tuberculosis; Deterministic Model; Epidemic; Incidence Rate; Indonesia.

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DOI: https://doi.org/10.31764/jtam.v10i1.35252