Hasil Pencarian  ::  Simpan CSV :: Kembali

"ABSTRAKTingginya angka insidens TB MDR di Indonesia, dibarengi dengan tingginya tingkatLost to Follow-up LTFU pada pengobatan pasien TB MDR. Pasien TB resisten obatmemiliki kemungkinan LTFU lebih besar dibandingkan pasien TB sensitif obatdikarenakan durasi pengobatan yang lebih lama. Selain itu, pasien TB MDR yang tidakmelanjutkan pengobatannya sampai tuntas memiliki peningkatan risiko kematian akibatTB. Studi ini bertujuan untuk mengetahui pengaruh rujuk balik dan tipe pasien terhadapkejadian LTFU pada pasien Multidrug-Resistant Tuberculosis TB MDR di Indonesia.Studi dilakukan pada Mei-Juni 2018 di Subdit TB ndash; Direktorat P2PML, Ditjen P2PKementerian Kesehatan RI. Desain studi yang digunakan adalah desain studi kohortretrospektif. Jumlah sampel pada studi ini adalah 961 pasien. Sampel diambil secaratotal sampling. Berdasarkan status rujuk baliknya, 86,3 pasien dilakukan rujuk balikdan 13,97 pasien tidak dirujuk balik. Berdasarkan kategori tipe pasien, 35,17 kasuskambuh, 5,52 pasien baru, 13,94 pasien pernah LTFU, 23,10 kasus gagalpengobatan kategori 1, 20,29 kasus gagal pengobatan kategori 2, 1,9 lain-lain pasien tidak diketahui riwayat pengobatan TB sebelumnya . Dari studi ini, diketahuibahwa proporsi kejadian LTFU sebesar 28,40 dengan kumulatif hazard LTFU sebesarsebesar 1,12 selama 39 bulan pengamatan, sehingga didapatkan hazard rate sebesar2,88/100 orang-bulan. Hasil analisis multivariabel dengan regresi cox time-dependentmenunjukkan bahwa rujuk balik menurunkan peluang terjadinya LTFU sebesar 46 HR 0,54; 95 CI 0,35-0,84 pada kondisi variabel tipe pasien dan umur sama adjusted . Untuk tipe pasien, tipe pernah LTFU, gagal pengobatan kategori 2 dan tidakdiketahui riwayat pengobatan TB sebelumnya meningkatkan peluang terjadinya LTFUmasing-masing sebesar 50 HR 2,02; 95 CI 1,18-3,45 , 53 HR 2,13; 95 CI1,240-3,66 , dan 74 HR 3,80; 95 CI 1,54-9,36 dibandingkan dengan tipe pasienkambuh baseline pada kondisi variabel rujuk balik, jenis kelamin, dan umur sama adjusted . Pada laki-laki, efek tipe gagal pengobatan kategori 2 lebih rendah 0,26 kalidibandingkan dengan pasien wanita dengan tipe gagal pengobatan kategori 2. Petugaskesehatan perlu meluangkan waktu yang lebih banyak untuk memberikan komunikasi,informasi, dan edukasi mengenai pengobatan TB serta mengenai manfaat rujuk balikkepada pasien TB MDR. Risiko LTFU meningkat pada pasien yang bertipe pernahLTFU, gagal pengobatan kategori 2, dan tidak diketahui riwayat pengobatan TBsebelumnya dibandingkan pasien dengan tipe kambuh, karena tipe kambuh sudah terujikepatuhannya terhadap pengobatan sebelumnya. Perlunya skrinning tipe pasien denganbaik untuk mengidentifikasi risiko LTFU berdasarkan tipe pasien sejak awal pasienmemulai pengobatan.Kata kunci: LTFU, rujuk balik, tipe pasien, TB MDR

---

ABSTRACTThe high incidence rate of MDR TB in Indonesia is accompanied by high rate of lost tofollow up LTFU in the treatment of MDR TB patients. Drug resistant TB patients havea greater risk of LTFU than drug sensitive TB patients due to longer treatmentduration. In addition, MDR TB patients who did not continue treatment completely hadan increased risk of dying from TB. The aims of this study were to determine thedecentralization influence and patient type on the incidence of LTFU in Multidrug Resistant Tuberculosis MDR TB patients in Indonesia. This study was conducted inMay June 2018 at Subdirectorate of TB Directorate of Prevention and CommunicableDisease Control, Directorate General of Prevention and Disease Control Ministry ofHealth of the Republic of Indonesia. The study design was retrospective cohort. Thenumber of samples in this study was 961 patients. Samples were taken in total sampling.Based on the decentralization status, 86.3 of patients were decentralized. Based onthe type of patient category, 35.17 of relapse, 5.52 of new, 13.94 of after LTFU,23.10 of failure category 1, 20.29 of failure category 2, 1.9 of other patients unknown history of previous TB treatment . The proportion of incidence of LTFU is28.40 with cumulative hazard of LTFU equal to 1.12 during 39 months ofobservation, so hazard rate is 2.88 100 person month. In multivariable analysis withcox regression time dependent revealed that decentralization reduced the probability ofLTFU up to 46 HR 0.54, 95 CI 0.35 0.84 after controlled by type of patient andage. For patient type, treatment after LTFU, failure category 2 and unknown history ofprevious TB treatment increased the probability of LTFU by 50 HR 2,02 95 CI1,18 3,45 , 53 HR 2,13 95 CI 1,240 3,66 , and 74 HR 3,80 95 CI 1,54 9,36 consecutively compared with the type of relapse patients baseline after controlled bythe decentralization, gender, and age. In male patients with failure treatment category2, the effect was 0.26 times lower compared with failure category 2 in female patients.Health workers need to spend more time in communicating, informing and educatingabout TB treatment and the benefits of decentralization to MDR TB patients. The risk ofLTFU increased in type of patient after LTFU, treatment failure category 2, andunknown history of previous TB treatment compared with patients with relapse types.The need for good patient type screening to identify the risk of LTFU by type of patientfrom the initial of treatment.Keywords LTFU, decentralization, type of patient, MDR TB"

"Pengobatan TB MDR yang berlangsung lama menimbulkan isolasi sosial, kehilangan pekerjaan, efek sosioekonomi dan psikologis jangka panjang pada pasien. Faktor individu, sosial budaya dan lingkungan serta kemungkinan efek samping psikiatri menjadikan pasien TB MDR cenderung mengalami gejala depresi. Depresi dapat mempengaruhi kualitas hidup. Penelitian ini menilai perubahan status depresi dan hubungannya dengan kualitas hidup pasien TB MDR. MetodePenelitian ini menggunakan metode kohort observasional di Poliklinik TB MDR RSUP Persahabatan. Dua puluh sembilan subjek TB MDR dinilai status depresi dan kualitas hidupnya dengan kuesioner Beck Depression Inventory BDI dan WHOQOL BREF sebelum dan setelah 6 bulan pengobatan TB MDR. HasilProporsi pasien depresi sebelum pengobatan sebesar 75,9 22 subjek . Setelah 6 bulan pengobatan TB MDR, 13 orang skor BDInya menurun, 9 orang meningkat dan terdapat 4 orang yang sebelumnya tidak depresi mengalami depresi. Skor WHOQOL BREF mengalami peningkatan pada ranah fisis, psikologis dan peningkatan bermakna pada ranah lingkungan. Pada ranah sosial, skor kualitas hidup mengalami penurunan. Tidak didapatkan hubungan bermakna antara perubahan status depresi dan kualitas hidup. Keterkaitan antara faktor usia, jenis kelamin, tingkat pendidikan, status ekonomi, lama sakit TB dan atau TB MDR serta beratnya merokok dengan depresi tidak dapat dibuktikan pada penelitian ini. KesimpulanSebanyak 22 subjek 75,9 mengalami gejala depresi sebelum memulai pengobatan TB MDR. Setelah 6 bulan, 13 orang gejala depresinya membaik, 9 orang memburuk dan terdapat 4 orang mengalami onset baru depresi. Kualitas hidup ranah fisis, psikologis dan lingkungan mengalami kenaikan.Kata-kata kunci: tuberkulosis multidrug resistant, depresi, kualitas hidup

---

IntroductionTreating drug resistant TB MDR TB which requires longer courses resulting in social isolation, loss of employment, and long-term socioeconomic and also psychological impacts for patients. Individual factors, sociocultural and environment condition also psychiatric adverse events lead the patients tend to have depression symptoms. Depression can majorly affects patients rsquo; quality of life. This study assesses the alteration of depression and its rsquo; relation with the quality of life among MDR TB patients. MethodsThis study used observational cohort methods in MDR Outpatients Clinic of Persahabatan Hospital. Twenty nine patients were diagnosed with MDR, measured depression status and the quality of life with Beck Depression Inventory BDI and WHOQOL BREF questionnaire from baseline and after 6 months therapy. ResultsPropotion of depression at baseline is 75,9 22 subjects . After 6 months treatment, the BDI score of 13 subjects were decreased, 9 subjects were increased and there were 4 subjects experienced new onset depression. The WHOQOL BREF improved in physical, psychological and significantly increased in environmental domain. In social domain, it was decreasing. This study didn rsquo;t find relation between depression status changes and the quality of life. The association between age, gender, level of education, economic status, duration of illness and smoking with depression could not be proven by this study. ConclusionsThere are 22 subjects 75,9 have already been depressed at baseline. After 6 months treatment, 13 subjects improving the symptoms, 9 subjects worsening and 4 subjects have experienced new onset depression. The quality of life in physical, psychological and environmental domain have improved. "

"Pulmonary tuberculosis is a chronic lung disease which has a physical as well as psychosocial impact on the patients.Until recently, existing government programs still focus on the treatment and contamination prevention of the disease.The current existing program is not directed towards solving the patients’ psychosocial problems, although the impactthereof is very influential towards the discipline in undergoing treatment and the prognosis of Tuberculosis (TB) as adisease in patients. This research aims to analyze factors that are most influential in fulfilling the psychosocial needs ofTB patients in the city of Cirebon. This research uses a corelational descriptive method. 171 pulmonary TB patientsinvolved in this research were chosen through consecutive sampling from 10 public health centers in the City andRegion of Cirebon. The psychosocial needs of pulmonary TB patients are measured by instruments developed by theresearchers. Prior to using the instrument, a validity and reliability test has been conducted. The result indicates thatthere are three dominant factors that are closely related to the patients’ satisfaction in meeting their psychosocial needs.These factors are the psychological condition during the last week, duration of treatment and supporting services,whereas demographic factors are not related to their satisfaction in meeting their psychosocial needs. The result of thisresearch can be considered by the government to provide supporting services at Public Health Centers in order to fulfillthe psychosocial needs of pulmonary TBC patients and avoid drop out cases.Analisis Kebutuhan Psikososial Penderita Tuberkulosis Paru. Tuberkulosis paru adalah penyakit paru-paru kronisyang berdampak secara fisik dan psikososial bagi penderitanya. Hingga saat ini program-program pemerintah yang adamasih berfokus pada pengobatan dan pencegahan penularan penyakit. Program yang ada belum mengarah padapemecahan masalah psikososial penderita, padahal dampak masalah psikososial sangat besar pengaruhnya terhadapkepatuhan berobat dan prognosis penyakit penderita Tuberculosis (TB). Penelitian ini bertujuan menganalisis faktoryang paling mempengaruhi pemenuhan kebutuhan psikososial penderita TB di kota Cirebon. Penelitian inimenggunakan metode deskriptif korelasional. Sejumlah 171 orang penderita TB paru yang terlibat dalam penelitian inidipilih dengan cara consecutive sampling dari sepuluh puskesmas di Kota dan Kabupaten Cirebon. Kebutuhanpsikososial penderita TB paru diukur dengan alat ukur yang dikembangkan sendiri oleh peneliti. Sebelum digunakan,instrumen tersebut sudah diuji validitas dan reliabilitasnya. Hasil penelitian menunjukkan bahwa ada tiga faktordominan yang paling berhubungan dengan tingkat kepuasan pasien terhadap pemenuhan kebutuhan psikososial mereka.Faktor tersebut adalah kondisi psikologis dalam seminggu terakhir, lama pengobatan, dan layanan pendukung.Sementara itu, faktor demografi tidak berhubungan dengan kepuasan mereka terhadap pemenuhan kebutuhanpsikososial. Hasil penelitian ini dapat dijadikan pertimbangan bagi pemerintah untuk mengadakan layanan pendukungdi puskesmas sehingga kebutuhan psikososial penderita TB paru bisa terpenuhi dan kasus drop out bisa dicegah."

"Continuity of breastfeeding process when mothers return to work is a serious issue that immediately must be followed up, so that exclusive breastfeedingprogram within the first six months can be achieved. Beside providing many benefits for babies, breastfeeding is also beneficial for mothers and entrepreneurs.This study aimed to determine relation of working mothers to exclusive breastfeeding. This study used was cross-sectional design with secondary dataof Indonesia Demographic and Health Survey 2012 with samples as many as 1,193 mothers aged 15 – 49 years who had 0 – 5-month-old babies. Basedon multivariate analysis, working mothers could decrease opportunity of exclusive breastfeeding in which mother who worked all the time were 1.54 timesmore likely not to give exclusive breastfeeding than mothers who did not work after controlled by maternal age at childbirth, household wealth index, and antenatalcare frequency (p = 0.038; 95% CI = 1.0 to 2.3). Fulltime working mothers are twofold more likely to not be able to give exclusive breasfedding thanunemployed mothers after being controlled by counfounder variable.Keberlangsungan proses menyusui pada saat ibu kembali bekerja merupakan isu serius yang harus segera ditindaklanjuti agar program pemberian Air SusuIbu (ASI) eksklusif selama enam bulan pertama kehidupan dapat tercapai. Selain memberikan banyak manfaat bagi bayi, ASI juga bermanfaat bagi ibu danpengusaha. Penelitian ini bertujuan untuk mengetahui hubungan ibu bekerja terhadap pemberian ASI eksklusif. Desain penelitian yang digunakan adalah potonglintang dengan data sekunder Survei Demografi dan Kesehatan Indonesia (SDKI) tahun 2012 dengan sampel berjumlah 1.193 ibu berusia 15 – 49 tahunyang memiliki bayi berusia 0-5 bulan. Berdasarkan analisis multivariat, ibu bekerja dapat menurunkan peluang pemberian ASI eksklusif dimana ibu yang bekerjasepanjang waktu lebih berisiko 1,54 kali untuk tidak memberikan ASI eksklusif dibandingkan ibu yang tidak bekerja setelah dikontrol oleh usia melahirkanibu, indeks kesejahteraan rumah tangga dan frekuensi pemeriksaan kehamilan (p = 0,038; CI 95% = 1,0 - 2,3). Ibu bekerja dua kali memiliki peluang untuktidak dapat memberikan ASI eksklusif daripada ibu yang tidak bekerja setelah dikontrol oleh variabel perancu."

"Due to particular conditions, sometimes actual height can not be measured. Thus, this study was conducted to develop height prediction model of adolescent from knee height and ulna length. This cross sectional study involved 205 students of SMPN 7 Depok and SMAN 6 Depok. Subjects’s identity was recorded using questionairre, while stature height, knee height, and ulna length was measured directly. Prediction models was developed using multiple regression. Height prediction model from knee height has the highest R2 and the lowest MAE with equation Height (cm) = 38,422 - 1,878 Sex + 1,453 Age (year) + 2,071 knee height (cm).

---

Tinggi badan aktual terkadang tidak dapat diukur karena beberapa kondisi tertentu. Oleh karena itu, penelitian ini bertujuan mengembangkan model prediksi tinggi badan pada remaja berdasarkan tinggi lutut dan panjang ulna. Penelitian pontong lintang ini melibatkan 205 murid SMPN 7 Depok dan SMAN 6 Depok. Data identitas subjek diperoleh melalui pengisian kuesioner, sedangkan tinggi badan, tingi lutut, dan panjang ulna diukur langsung. Model prediksi dikembangkan menggunakan regresi ganda. Model prediksi tinggi badan dari tinggi lutut memiliki R2 terbesar dan MAE terkecil dengan persamaan Tinggi Badan (cm) = 38,422 - 1,878 Jenis Kelamin + 1,453 Umur (thn) + 2,071 Tinggi Lutut (cm)."

"Based on our knowledge, the study of gastrointestinal reflux disease (GERD) among certain profession has never been conducted. The aim of this study is to determine the prevalence and risk factors of GERD among Indonesian doctors.

Methods: A consecutive study involving 515 doctors was conducted in October 2015.The GerdQ score was used to the diagnosis of GERD and determined its impact on daily life. All possible risk factors were also analyzed.

Results: A total of 515 subjects completed the questionnaire. The mean age of them was 41.37±11.92 years old. Fifty-five percent of them were male and 60.6% general practitioners. The prevalence of GERD was 27.4% of which 21.0% was had GERD with low impact on daily life, and 6.4% was GERD with high impact on daily life. The statistically significant risk factors of GERD was found in age >50 y.o (p = 0.002; OR 2.054), BMI >30kg/m2 (p = 0.016; OR 2.53), and smokers (p = 0.031; OR 1.982). Sex and education level were not found significant statistically as the risk factors of GERD.

Conclusions: The prevalence of GERD among Indonesian physician was 27.4%. We found that age over 50 y.o, obesity and smoking habit were the risk factors of GERD in Indonesian doctors."

"Cardiovascular disease causes 8.6 million deaths of women every year, which is the major cause of death by one-third of all deaths of women in the world.Half of all deaths of women older than 50 years old is caused by cardiovascular and stroke diseases. This study aimed to analyze risk factors related to coronaryheart disease among women aged older than 45 years at Dody Sarjoto Makassar Air Force Hospital 2016. The total of sample was 76 consisting of 64cases of coronary heart disease and 12 non-coronary heart disease. Determination of sample used purposive sampling. Primary data were obtained throughinterview to respondents using questionnaire and direct interview. Data were analyzed by using contingency correlation coefficient (Exp (B)) test to identifysignificant relation between dependent and independent variables. Results found were hypertension (Exp (B) = 0.309), obesity (Exp (B) = 0.140), diabetesmellitus (Exp (B) = 0.164) and dyslipidemia (Exp (B) = 0.185), as proven having relation with coronary heart disease among women aged older than 45 years,and the factor which had the most significant relation was dyslipidemia.Penyakit kardiovaskuler menyebabkan 8.6 juta kematian pada perempuan setiap tahun, yang merupakan penyebab kematian terbanyak, yaitu sepertiga dariseluruh kematian perempuan di seluruh dunia. Setengah dari seluruh kematian perempuan berusia di atas 50 tahun disebabkan oleh penyakit jantung danstroke. Penelitian ini bertujuan untuk menganalisis faktor yang berhubungan dengan penyakit jantung koroner pada perempuan usia > 45 tahun di RumahSakit TNI AU Dody Sarjoto Makassar. Besar sampel sebanyak 76 sampel yang terdiri dari 64 kasus penyakit jantung koroner dan 12 kasus non penyakit jantungkoroner. Penentuan sampel menggunakan metode purposive sampling. Data primer diperoleh melalui wawancara terhadap responden dengan menggunakankuesioner dan wawancara langsung. Data dianalisis menggunakan uji koefisien korelasi kontingensi (Exp (B)) terhadap variabel independen dandependen. Adapun hasil yang ditemukan adalah obesitas (Exp (B) = 0.140), diabetes mellitus (Exp (B) = 0.164), dan dislipidemia (Exp (B) = 0.185) terbuktimemiliki hubungan dengan kejadian penyakit jantung koroner pada perempuan usia > 45 tahun dan faktor yang memiliki hubungan paling besar adalah dislipidemia."

"Toddler is a group at risk of undernutrition in which World Health Organization stated that toddler mortality because of undernutrition was 54% in 2002. InIndonesia, its prevalence increased from 17.9% in 2010 to 19.6% in 2013. In Tangerang City, there was 1.43% of toddlers suffering from undernutrition in2013. This study aimed to prove in valid the relation between Hearth Program, which covered behaviors of food providing, toddler’s hygiene, health care seekingand toddler parenting, with undernutrition incidence among toddlers. This study was quantitative, cross-sectional, using primary data, analyzed in univariate,bivariate and multivariate within September 2015. Samples were taken by total sampling as many as 60 toddlers suffering from undernutrition in TangerangCity. Results showed that 12 (20%) of 60 toddlers suffered from very underweight nutrition and the remaining 48 toddlers (80%) suffered from underweightnutrition. There was a relation between food-providing behavior and health-care seeking behavior with undernutrition among toddlers. Variable food-providingbehavior was the dominant factor influencing undernutrition among toddlers with OR = 4.655 (CI = 1.052 – 20.6) after controlled by the variable healthcare-seeking behavior.Kelompok yang rentan terhadap gizi kurang adalah anak bawah lima tahun (balita). World Health Organization menyatakan kematian balita akibat gizi kurangsebesar 54% pada tahun 2002. Di Indonesia, prevalensinya mengalami peningkatan dari 17,9% tahun 2010 menjadi 19,6% tahun 2013. Di KotaTangerang, terdapat 1,43% balita yang mengalami gizi buruk tahun 2013. Penelitian ini bertujuan untuk membuktikan secara valid hubungan Program PosGizi yang meliputi perilaku pemberian makan, kebersihan balita, pencarian pelayanan kesehatan dan pengasuhan balita dengan kejadian gizi kurang padabalita. Penelitian ini merupakan penelitian kuantitatif, potong lintang, menggunakan data primer serta dianalisis secara univariat, bivariat, dan multivariat selamabulan September 2015. Sampel diambil secara total sampling sebanyak 60 balita yang mengalami gizi kurang di Kota Tangerang. Hasil menunjukkanbahwa dari 60 balita yang mengalami gizi kurang, sebanyak 12 balita (20%) mengalami gizi sangat kurus dan sisanya sejumlah 48 balita (80%) mengalamigizi kurus. Terdapat hubungan perilaku pemberian makan dan pencarian pelayanan kesehatan dengan gizi kurang pada balita. Variabel perilaku pemberianmakan merupakan faktor dominan yang memengaruhi gizi kurang pada balita dengan OR = 4,655 (CI = 1,052 – 20,6) setelah dikontrol oleh variabel perilakumencari pelayanan kesehatan."