Cross-Risk Between Tuberculosis and COVID-19 in East Java Province, Indonesia: An Analysis of Tuberculosis and COVID-19 Surveillance Registry Period 2020–2022

Introduction: Tuberculosis (TB) and COVID-19 are highly transmissible diseases and pose a serious risk to public health. Unfortunately, information on cross-risk between the two diseases was still sparse. Our main objective was to estimate the excess risk among TB patients in getting COVID-19 infection and vice versa. Methods: The study design was a series of analyses of existing data from TB and COVID-19 registries in East Java Province, Indonesia. The study period was from January 2020 to June 2022. Case-by-case data for this study were obtained from the registration systems for TB and COVID-19 in separate databases. In comparing risk across different groups, adjusting for differences in risk factors that influence the outcome was essential. We overcame this problem by employing a standardized morbidity ratio. Results: Among 92,424 newly diagnosed TB patients, 1,326 were subsequently infected with COVID-19 during the study period, compared with 1,679 expected. The standardized morbidity ratio (95% confidence interval) was 72.61% (60.19%, 85.03%). Among 635,946 newly diagnosed COVID-19-infected patients, 987 subsequently got active TB during the study period against 1,679 expected. The standardized morbidity ratio (95% confidence interval) was 55.33% (49.24%, 61.42%). Conclusion: There was no evidence of excess risk in either direction, the excess risk among TB patients in getting COVID-19 infection and vice versa.