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Filly Mandalie
Konversi Sputum pada pasien TB MDR dan hubungannya dengan faktor non-genetik dan genetik = Sputum conversion in MDR TB patients and its relation with non-genetic and genetic factors
"ABSTRAK
Latar Belakang : Tuberkulosis (TB) adalah penyakit infeksi menular yang disebabkan oleh bakteri Mycobacterium tuberculosiss (MTB) dan merupakan masalah kesehatan utama didunia.1World Health Organization (WHO) pada tahun 2018 melaporkan 10 juta orang terdiagnosis TB di seluruh dunia. Indonesia merupakan negara dengan insiden TB tertinggi ketiga di dunia, terjadi peningkatan kasus baru sebesar 70% dari 331.703 menjadi 563.879 antara tahun 2015-2018 dan kasus TB MDR/TB RR, rata-rata 8.8 per 100.000 populasi, 2.4 % merupakan kasus baru dan dan 13% merupakan TB pengobatan ulang.2
Berdasarkan data WHO tingkat kegagalan pengobatan pada pasien TB MDR cukup besar (lebih dari 50%), juga terjadi di Indonesia yang disebabkan tinggi nya angka kematian (17%) dan loss to follow up (26%). Kegagalan pengobatan mengakibatkan pengobatan dihentikan dan diperlukan penggantian rejimen. Komorbiditas, Efek samping obat, resistensi obat merupakan faktor yang mempengaruhi kegagalan pengobatan dan dinilai melalui konversi sputum yang merupakan indikator respons pengobatan dan digunakan sebagai indikator keberhasilan pengobatan atau kegagalan pengobatan.
Tujuan : Mengetahui hubungan konversi sputum pasien TB MDR dengan berbagai faktor non genetic dan genetic yang terjadi selama fase intensif yang sedang diobati di RS paru DR.M.Goenawan Partowidigdo.
Metode: Data diambil secara kohort retrospektif melalui rekam medis TB MDR (1 Oktober 2018 sampai 31 Maret 2019). Data yang terkumpul dilakukan uji statistik.
Hasil : SP yang mendapat terapi jenis STR memiliki karakteristik rerata usia sebesar 35,11 tahun dengan jenis kelamin laki-laki sedikit lebih banyak dibanding perempuan (57,9% vs 42,1%), sebagian besar memiliki riwayat pengobatan TB sebelumnya (84,2%) namun tidak memiliki riwayat kontak dengan pasien TB aktif (87,7%). Terdapat 32 SP yang tidak memiliki riwayat pengobatan dan tidak memiliki riwayat kontak tetapi terinfeksi kuman TB MDR sebanyak sepertiga SP memiliki komorbiditas DM.
SP yang mendapat terapi jenis konvensional memiliki karakteristik rerata usia sebesar 40,22 tahun, lebih banyak berjenis kelamin laki-laki (61,5%), dengan riwayat pengobatan TB sebelumnya (73,5%) namun tidak memiliki riwayat kontak dengan pasien TB aktif (86,3%), sebanyak sepertiga SP memiliki komorbiditas DM
Subjek yang tidak mememiliki komorbiditas dan tidak konversi sputum sebesar 18,4% sedangkan yang tidak memiliki komorbiditas dan tidak konversi sputum sebesar 55,2% dimana hasil ini bermakna secara statistik (p=0,016, RO 2,23 IK95% 1,15 - 4,32). SP dengan DM memiliki risiko 2,23 kali untuk tidak terjadi konversi sputum. Jumlah efek samping obat anti tuberkulosis lebih dari 2 jenis yang mengalami konversi sputum sebesar 43,1 % sedangkan yang jumlah efek sampingnya ≤ 2 mengalami konversi sputum sebesar 23,6 % dimana hasil ini bermakna secara statistik (p<0,001, RO 0,11 IK95% 0,05 -0,25). Pada akhir bulan keenam dan dilakukan kultur dan DST dan LPA lini dua didapatkan perubahan sifat resistensi, bisa akibat mutasi atau pasien terinfeksi oleh 2 strain yang berbeda.
Kesimpulan: Konversi kultur sputum yang tertunda mengakibatkan waktu pengobatan yang diperpanjang dan beresiko kegagalan pengobatan. DM, efek samping onat dan resistensi adalah salah satu Faktor yang menyebabkan waktu konversi sputum lebih lama, sehingga resiko kegagalan terapi menyebabkan resiko mortalitas meningkat.
ABSTRACT
Background: Tuberculosis (TB) is an infection caused by Mycobacterium tuberculosis (MTB) and is a main health problem in the world.1 The World Health Organization (WHO) in 2018 reported 10 million people diagnosed with TB worldwide. Indonesian is country with the third highest incidence of TB in the world, an increase in new cases is 70% from 331,703 to 563,879 between 2015-2018 and MDR TB cases an average of 8.8 per 100,000 population, 2.4% is a new cases and 13% is a re-treatment of TB cases.2
Based on WHO data, the treatment failure rate in MDR TB patients is quite large (more than 50%), also occurring in Indonesia which causes high mortality (17%) and loss to follow-up (26%). Treatment failure causes the treatment being stop and replacement regimen are needed. Many factors that influence treatment and approved through sputum conversion which is an indicator of treatment response and is used as an indicator of treatment success or treatment failure.
Objective: To know the relation of sputum conversion in patients with various factor non genetic and genetic that occur during intensive phase while in the process of treatment in pulmonary hospital of Dr. M. Goenawan Partowidigdo.
Methods: Data were collected in retrospective cohort through MDR TB medical records (1 October 2018 until 31 March 2019). The data collected is done by statistical tests.
Results: SP who received STR type therapy had characteristic a mean age of 35.11 years with sex of male more slightly than female (57.9% vs 42.1%), most had a history medication of previous treatment TB (84, 2%) but do not have a contact history with active TB patients (87.7%). There were 32 SPs who had no history of treatment and had no contact history but were infected with MDR TB as much as one third of SP have comorbid DM.
SP who received individua type of therapy had a mean age of 40.22 years, most are male (61.5%), with a history of previous TB treatment (73.5%) but had no contact history with active TB patients (86.3%), as many as one third of SP have comorbid DM.
Subjects who did not have comorbidity and no sputum conversion were 18.4% while those who did not have comorbidity and had no sputum conversion were 48.9% where these results were statistically significant (p = 0.016, RO 2.23 IK95% 1.15 - 4 , 32). SP with DM has a risk of 2.23 times for not occur sputum conversion. The number of side effects of anti tuberculosis drugs more than 2 types be through sputum conversion was 43.1% while the number of side effects ≤ 2 be through sputum conversion was 23.6% where these results were statistically significant (p <0.001, RO 0.11 IK95 % 0.05 - 0.25). At the end of the sixth month and culture had be done and DST and LPA line two, there was a change of characteristic resitence, it could be due to mutations or the patient was infected by 2 different strains.
Conclusion: Delayed conversion of sputum culture causes the time extended of treatment and risk treatment failure. DM, drugs side effects and resistance are one of the factors that cause a longer sputum conversion time, so the risk of therapy failure causes an increased risk of mortality."
Depok: Fakultas Kedokteran Universitas Indonesia, 2020
SP-Pdf
UI - Tugas Akhir  Universitas Indonesia Library
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Sarah Naura Irbah
Hubungan antara anemia dengan waktu konversi sputum pada pasien TB-MDR = Association between anemia and sputum conversion smongs MDR-TB patients
"Latar Belakang: Anemia diketahui sebagai salah satu komplikasi pada penyakit TB. Konsentrasi hemoglobin yang rendah diasosiasikan dengan keterlambatan waktu konversi kultur sputum pada pasien TB namun hubungannya pada pasien TB MDR masih belum diketahui. Konversi kultur sputum pasien TB MDR dari positif menjadi negatif merupakan prediktor utama indicator keberhasilan pengobatan. Penelitian ini bertujuan untuk mengetahui apakah kondisi anemia pada pasien TB MDR dapat memperlambat waku konversi sputum.
Metode: Penelitian ini menggunakan desain studi kohort retrospektif dengan metode total sampling untuk memperoleh data pemeriksaan hematologis, status klinis, dan status demografis dari rekam medis pasien TB MDR di RSUP Persahabatan selama tahun 2016. Data mengenai waktu konversi sputum diperoleh dari database online Indonesia, e-TB-Manager, di bawah pengawasan pihak yang berwenang di RSUP Persahabatan.
Hasil: Dari seluruh 363 rekam medis, terdapat 201 data yang memenuhi kriteria inklusi dengan keterangan sebanyak 83/118 41.3 mengalami anemia. Analisis data dengan uji kesintasan menunjukkan bahwa status anemia memiliki pengaruh yang signifikan terhadap keterlambatan konversi sputum, sedangkan klasifikasi dan jenis anemia tidak memiliki pengaruh yang signifikan terhadap proses konversi sputum.
Kesimpulan: Kondisi anemia meningkatkan risiko konversi sputum yang lebih lama pada pasien TB MDR dibandingkan dengan pasien tanpa diserta anemia. Oleh karena itu, perlu adanya upaya perbaikan status gizi dan profil hematologis pada pasien TB MDR yang disertai dengan anemia.
Background: Anemia was known to be the complication of Tuberculosis TB . Low hemoglobin concentration was associated with prolonged time of culture sputum conversion in TB but the association in MDR TB is still unknown. Sputum culture conversion in MDR TB was the main predictor of successful therapy outcome. This study aims to understand whether anemia amongs MDR TB patients could prolong the time for sputum conversion.
Method: This retrospective cohort study used total sampling method to obtain hematological laboratory data, clinical status, and demographic status from medical records of MDR TB patients in Persahabatan Hospital during the year of 2016. The time of sputum conversion was obtained from Indonesian online database e TB Manager under supervision of Persahabatan Hospital authorized staffs.
Result: Of the 363 medical records within a year, only 201 datas fitted into inclusion criteria in which 83 of 118 MDR TB patients 41.3 have anemia. Survival analysis rate showed a significant rate difference in conversion time based on the anemic status. However, there is no significant relation of classification and types of anemia towards the conversion time.
Conclusion: Anemia increased the risk of prolonged time in spuum conversion in MDR TB patients compared to those without anemia. Therefore, there should be an effort in improving the nutritional status and hematological profile in MDRt TB patients with anemia."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2017
S-Pdf
UI - Skripsi Membership  Universitas Indonesia Library
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Ikes Dwiastuti
Faktor-faktor yang mempengaruhi konversi kultur sputum pada pasien TB Paru MDR di RSUD Labuang Baji Kota Makassar tahun 2011-2014 = Influencing factors for the sputum culture conversion among pumlonary MDR TB patients 2011-2014 in Labuang Baji General Hospital Makassar City / Ikes Dwiastuti
"[Munculnya berbagai tantangan baru dalam pengendalian TB, salah satunya multidrug resistant tuberculosis (TB MDR). TB MDR adalah salah satu jenis resistensi TB yang disebabkan oleh bakteri Mycobacterium tuberculosis yang tidak merespon (resisten), setidaknya, isoniazid dan rifampicin yang merupakan dua jenis obat yang paling efektif pada lini pertama obat anti TB (OAT). Penelitian bertujuan untuk mengetahui faktor-faktor yang mempengaruhinya
konversi kultur sputum pada pasien TB Paru MDR. Penelitian dilakukan di dilakukan di RSUD Labuang Baji Kota Makassar dimulai dari bulan April 2015-Juni 2015. Desain penelitian adalah kohort retrospektif. Jumlah sampel dalam penelitian ini yakni 183 pasien, 139 pasien (76,0%) yang mengalami konversi kultur sputum, 4 pasien (2,2%) yang tidak mengalami konversi kultur sputum, dan 40 pasien (21,8%) yang loss to follow up. Dari penelitian ini diketahui bahwa probabilitas konversi kultur sputum pasien TB paru MDR sebesar 95,52%. Hasil
analisis multivariat menunjukkan bahwa interupsi pengobatan (HR:0,45; 95%CI: 0,26-0,79), status diabetes melitus (DM) sebelum 33 hari (HR:0,75; 95%CI: 0,29- 1,95) dan setelah 33 hari yakni (HR:1,95; 95%CI: 0,90-7,60), serta riwayat pengobatan yang pernah mendapatkan OAT lini I (HR:0,32; 95%CI: 0,12-0,90) serta yang pernah mendapatkan OAT lini II (HR:0,27; 95%CI: 0,10-0,77). Diperlukan penanganan secara intensif dan lengkap pada pasien TB paru MDR di Poli TB MDR dengan memperhatikan interupsi pengobatan, status DM, dan riwayat pengobatan sebelumnya;One of the new emerging challenges in TB controlling is multidrug resistant tuberculosis (MDR TB). MDR TB is a type of TB resistant caused by the unresponsiveness (resistancy) of Mycobacterium tuberculosis to at least isoniazid and rifampicin in which both are the most effective anti-TB drugs in first line. This study was aimed to determine the influencing factors for the timing of
sputum culture conversion among pulmonary MDR TB patients. This study was conducted in Labuang Baji General Hospital, Makassar City started from April 2015 to June 2015. Cohort-retrospective design was performed in this study. There were 183 patients involved in this study consisted of 139 (76,0%) patients with sputum culture conversion, 4 (2,2%) patients with no sputum culture conversion, and 40 (21,8%) patients were loss to follow up. The result of the study shows that the probability of sputum culture conversion of Pulmonary MDR TB was 95,52%. Multivariate analysis showed that the interruption of treatment
(HR:0,45; 95%CI: 0,26-0,79), Diabetes Mellitus (DM) before 33 days (HR:0,75; 95%CI: 0,29-1,95), DM after 33 days (HR:1,95; 95%CI: 0,90-7,60), previously treated with FLDs (HR:0,32; 95%CI: 0,12-0,90), and previously treated with SLDs (HR:0,27; 95%CI: 0,10-0,77) were found to be the influencing factors for the sputum culture conversion among pulmonary MDR TB. Complete and intensive care are needed among pulmonary MDR TB in MDR TB polyclinic by observing the interruption of treatment, DM, and history of previous treatment.;One of the new emerging challenges in TB controlling is multidrug resistant
tuberculosis (MDR TB). MDR TB is a type of TB resistant caused by the
unresponsiveness (resistancy) of Mycobacterium tuberculosis to at least isoniazid
and rifampicin in which both are the most effective anti-TB drugs in first line.
This study was aimed to determine the influencing factors for the timing of
sputum culture conversion among pulmonary MDR TB patients. This study was
conducted in Labuang Baji General Hospital, Makassar City started from April
2015 to June 2015. Cohort-retrospective design was performed in this study.
There were 183 patients involved in this study consisted of 139 (76,0%) patients
with sputum culture conversion, 4 (2,2%) patients with no sputum culture
conversion, and 40 (21,8%) patients were loss to follow up. The result of the
study shows that the probability of sputum culture conversion of Pulmonary MDR
TB was 95,52%. Multivariate analysis showed that the interruption of treatment
(HR:0,45; 95%CI: 0,26-0,79), Diabetes Mellitus (DM) before 33 days (HR:0,75;
95%CI: 0,29-1,95), DM after 33 days (HR:1,95; 95%CI: 0,90-7,60), previously
treated with FLDs (HR:0,32; 95%CI: 0,12-0,90), and previously treated with
SLDs (HR:0,27; 95%CI: 0,10-0,77) were found to be the influencing factors for
the sputum culture conversion among pulmonary MDR TB. Complete and
intensive care are needed among pulmonary MDR TB in MDR TB polyclinic by
observing the interruption of treatment, DM, and history of previous treatment.;One of the new emerging challenges in TB controlling is multidrug resistant
tuberculosis (MDR TB). MDR TB is a type of TB resistant caused by the
unresponsiveness (resistancy) of Mycobacterium tuberculosis to at least isoniazid
and rifampicin in which both are the most effective anti-TB drugs in first line.
This study was aimed to determine the influencing factors for the timing of
sputum culture conversion among pulmonary MDR TB patients. This study was
conducted in Labuang Baji General Hospital, Makassar City started from April
2015 to June 2015. Cohort-retrospective design was performed in this study.
There were 183 patients involved in this study consisted of 139 (76,0%) patients
with sputum culture conversion, 4 (2,2%) patients with no sputum culture
conversion, and 40 (21,8%) patients were loss to follow up. The result of the
study shows that the probability of sputum culture conversion of Pulmonary MDR
TB was 95,52%. Multivariate analysis showed that the interruption of treatment
(HR:0,45; 95%CI: 0,26-0,79), Diabetes Mellitus (DM) before 33 days (HR:0,75;
95%CI: 0,29-1,95), DM after 33 days (HR:1,95; 95%CI: 0,90-7,60), previously
treated with FLDs (HR:0,32; 95%CI: 0,12-0,90), and previously treated with
SLDs (HR:0,27; 95%CI: 0,10-0,77) were found to be the influencing factors for
the sputum culture conversion among pulmonary MDR TB. Complete and
intensive care are needed among pulmonary MDR TB in MDR TB polyclinic by
observing the interruption of treatment, DM, and history of previous treatment.;One of the new emerging challenges in TB controlling is multidrug resistant
tuberculosis (MDR TB). MDR TB is a type of TB resistant caused by the
unresponsiveness (resistancy) of Mycobacterium tuberculosis to at least isoniazid
and rifampicin in which both are the most effective anti-TB drugs in first line.
This study was aimed to determine the influencing factors for the timing of
sputum culture conversion among pulmonary MDR TB patients. This study was
conducted in Labuang Baji General Hospital, Makassar City started from April
2015 to June 2015. Cohort-retrospective design was performed in this study.
There were 183 patients involved in this study consisted of 139 (76,0%) patients
with sputum culture conversion, 4 (2,2%) patients with no sputum culture
conversion, and 40 (21,8%) patients were loss to follow up. The result of the
study shows that the probability of sputum culture conversion of Pulmonary MDR
TB was 95,52%. Multivariate analysis showed that the interruption of treatment
(HR:0,45; 95%CI: 0,26-0,79), Diabetes Mellitus (DM) before 33 days (HR:0,75;
95%CI: 0,29-1,95), DM after 33 days (HR:1,95; 95%CI: 0,90-7,60), previously
treated with FLDs (HR:0,32; 95%CI: 0,12-0,90), and previously treated with
SLDs (HR:0,27; 95%CI: 0,10-0,77) were found to be the influencing factors for
the sputum culture conversion among pulmonary MDR TB. Complete and
intensive care are needed among pulmonary MDR TB in MDR TB polyclinic by
observing the interruption of treatment, DM, and history of previous treatment.;One of the new emerging challenges in TB controlling is multidrug resistant
tuberculosis (MDR TB). MDR TB is a type of TB resistant caused by the
unresponsiveness (resistancy) of Mycobacterium tuberculosis to at least isoniazid
and rifampicin in which both are the most effective anti-TB drugs in first line.
This study was aimed to determine the influencing factors for the timing of
sputum culture conversion among pulmonary MDR TB patients. This study was
conducted in Labuang Baji General Hospital, Makassar City started from April
2015 to June 2015. Cohort-retrospective design was performed in this study.
There were 183 patients involved in this study consisted of 139 (76,0%) patients
with sputum culture conversion, 4 (2,2%) patients with no sputum culture
conversion, and 40 (21,8%) patients were loss to follow up. The result of the
study shows that the probability of sputum culture conversion of Pulmonary MDR
TB was 95,52%. Multivariate analysis showed that the interruption of treatment
(HR:0,45; 95%CI: 0,26-0,79), Diabetes Mellitus (DM) before 33 days (HR:0,75;
95%CI: 0,29-1,95), DM after 33 days (HR:1,95; 95%CI: 0,90-7,60), previously
treated with FLDs (HR:0,32; 95%CI: 0,12-0,90), and previously treated with
SLDs (HR:0,27; 95%CI: 0,10-0,77) were found to be the influencing factors for
the sputum culture conversion among pulmonary MDR TB. Complete and
intensive care are needed among pulmonary MDR TB in MDR TB polyclinic by
observing the interruption of treatment, DM, and history of previous treatment., One of the new emerging challenges in TB controlling is multidrug resistant
tuberculosis (MDR TB). MDR TB is a type of TB resistant caused by the
unresponsiveness (resistancy) of Mycobacterium tuberculosis to at least isoniazid
and rifampicin in which both are the most effective anti-TB drugs in first line.
This study was aimed to determine the influencing factors for the timing of
sputum culture conversion among pulmonary MDR TB patients. This study was
conducted in Labuang Baji General Hospital, Makassar City started from April
2015 to June 2015. Cohort-retrospective design was performed in this study.
There were 183 patients involved in this study consisted of 139 (76,0%) patients
with sputum culture conversion, 4 (2,2%) patients with no sputum culture
conversion, and 40 (21,8%) patients were loss to follow up. The result of the
study shows that the probability of sputum culture conversion of Pulmonary MDR
TB was 95,52%. Multivariate analysis showed that the interruption of treatment
(HR:0,45; 95%CI: 0,26-0,79), Diabetes Mellitus (DM) before 33 days (HR:0,75;
95%CI: 0,29-1,95), DM after 33 days (HR:1,95; 95%CI: 0,90-7,60), previously
treated with FLDs (HR:0,32; 95%CI: 0,12-0,90), and previously treated with
SLDs (HR:0,27; 95%CI: 0,10-0,77) were found to be the influencing factors for
the sputum culture conversion among pulmonary MDR TB. Complete and
intensive care are needed among pulmonary MDR TB in MDR TB polyclinic by
observing the interruption of treatment, DM, and history of previous treatment.]"
2015
T44557
UI - Tesis Membership  Universitas Indonesia Library
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Miptah Farid Thariqulhaq
Hubungan Kadar Albumin Dengan Waktu Konversi Kultur Sputum Pada Pasien TB-MDR Di RS Paru Dr. M. Goenawan Partowidigdo = Relationship Of Albumin Levels With Conversion Time Of Sputum Culture In MDR TB Patients At Dr. M. Goenawan Partowidigdo Lung Hospital
"Penyakit TB MDR merupakan salah satu penyakit infeksi yang prevalensinya semakin meningkat dari tahun ke tahun di Indonesia dengan angka keberhasilan pengobatan 45%. Konversi kultur sputum merupakan suatu prediktor kuat dari awal keberhasilan terapi. Waktu konversi yang lambat akan memperpanjang periode penularan dan memprediksi tingkat kegagalan pengobatan yang tinggi. Terdapat beberapa faktor risiko yang berhubungan dengan konversi kultur sputum pasien TB MDR. Penelitian terkait faktor risiko kadar albumin dengan waktu konversi kultur sputum masih sangat terbatas. Tujuan penelitian ini adalah untuk mengetahui hubungan kadar albumin dengan waktu konversi kultur sputum di poli MDR terpadu RS Paru Dr M Goenawan Partowidigdo tahun 2022. Penelitian ini menggunakan studi cohort retrospektif dengan sampel yang diambil dari catatan rekam medis dan SITB pasien poli MDR. Variabel yang diteliti adalah kadar albumin < 3,5 gram/dl dan ≥ 3,5 gram/dl dengan variabel covariat usia, jenis kelamin, pendidikan, index masa tubuh, status merokok, gradasi sputum bta, komorbid, regimen pengobatan, dan kepatuhan minum obat . Hasil penelitian berdasarkan analisis multivariat menunjukkan kadar albumin < 3,5 mg/dl memiliki kecepatan waktu konversi 41,8% lebih lambat dengan (HR=0,582, 95% CI 0.344-0.984) untuk mengalami konversi dibanding dengan pasien TB MDR dengan kadar albumin ≥ 3,5 mg/dl setelah memperhitungkan status merokok dan kepatuhan minum obat. Perlunya memperbaiki kadar albumin yang rendah pada pasien TB MDR di rumah sakit dan memberikan penyuluhan kepada keluarga pasien agar turut berpartisipasi memantau asupan makan pasien yaitu makanan yang mengandung tinggi protein seperti ikan gabus serta ekstra putih telur untuk membantu meningkatkan kadar albumin pasien yang dapat berguna untuk terjadinya konversi kultur sputum.
MDR TB disease is an infectious disease whose prevalence is increasing from year to year in Indonesia with a treatment success rate of 45%. Sputum culture conversion is a strong predictor of initial therapeutic success. Slow conversion time will prolong the period of transmission and predict a high rate of treatment failure. There are several risk factors associated with sputum culture conversion in MDR TB patients. Research related to risk factors for albumin levels and sputum culture conversion time is still very limited. The aim of this study was to determine the relationship between albumin levels and sputum culture conversion time at the integrated MDR polyclinic at Dr M Goenawan Partowidigdo Pulmonary Hospital in 2022. This study used a retrospective cohort study with samples taken from medical records and SITB patients at poly MDR. The variables studied were albumin levels < 3.5 mg/dl and ≥ 3.5 mg/dl with the covariate variables age, sex, education, body mass index, smoking status, sputum gradation, co-morbidities, medication regimens, and drinking adherence drug . The results of the study based on multivariate analysis showed that albumin levels < 3.5 mg/dl had a 41.8% slower conversion time (HR=0.582, 95% CI 0.344-0.984) to experience conversion compared to MDR TB patients with albumin levels ≥ 3.5 mg/dl after taking into account smoking status and medication adherence. It is necessary to improve low albumin levels in MDR TB patients at the hospital and provide counseling to the patient's family to participate in monitoring the patient's food intake, namely foods that contain high protein such as snakehead fish and extra egg whites to help increase the patient's albumin levels which can be useful for the occurrence of sputum culture conversion."
Depok: Fakultas Kesehatan Masyarakat Universitas Indonesia, 2023
T-pdf
UI - Tesis Membership  Universitas Indonesia Library
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Pulungan, Aman Bhakti
Faktor genetik dan non genetik pada manusia pigmi Rampasasa Flores = Genetic and non genetic study in human pygmies Rampasasa Flores
"[ABSTRAK
Latar belakang: Tinggi badan/ perawakan tubuh merupakan parameter penting tingkat kesejahteraan suatu populasi. Perawakan tubuh dipengaruhi oleh faktor genetik, endokrin dan lingkungan. Faktor lingkungan yang saat ini paling sering ditemukan adalah faktor nutrisi. Populasi pigmi adalah suatu populasi terisolasi yang seluruh anggotanya pendek dan ditemukan di berbagai belahan dunia termasuk Indonesia, yaitu di Flores, Nusa Tenggara Timur yang disebut komunitas pigmi Rampasasa. Sampai saat ini belum ada penelitian yang dapat menemukan penyebab perawakan pendek komunitas pigmi tersebut.
Tujuan: Mengetahui profil antropometri manusia pigmi Rampasasa dan mencari berbagai faktor (genetik, endokrin, dan nutrisi) yang berperan dalam perawakan pendek komunitas pigmi tersebut sehingga diharapkan dapat berkontribusi dalam tatalaksana perawakan pendek pada umumnya.
Metode: Penelitian merupakan studi deskriptif analitik yang dilakukan pada periode Desember 2011-April 2014. Penelitian ini menggunakan desain potong lintang untuk mengetahui profil genetik dan non genetik (endokrin dan nutrisi) yang berperan dalam perawakan pendek manusia pigmi Rampasasa. Dilakukan pengukuran antropometri pada subjek dan pengambilan sampel darah. Analisis statistik dilakukan dengan uji ANOVA yang dilanjutkan dengan post hoc analysis. Analisis genetik dilakukan dengan mengirimkan isolasi DNA ke Laboratory for Diagnostic Genome Analysis (LDGA), Leiden, Belanda.
Hasil: Didapatkan data dari 58 subjek yang dikelompokkan menjadi pigmi murni (n=8), pigmi campuran (n=40), dan non pigmi (n=10). Seluruh subjek memiliki proposi tubuh yang normal. Tidak terdapat perbedaan bermakna untuk status nutrisi antara ketiga kelompok, yang dinyatakan dengan kadar kalsium (p=0,19), vitamin D (p=0,96), dan hemoglobin (p=0,147). Namun didapatkan perbedaan bermakna untuk kadar hormon IGF-1 antara ketiga kelompok (p=0,037), yang setelah dilakukan analisis posthoc menunjukkan perbedaan hanya pada kelompok non pigmi vs. pigmi murni (p=0,012). Kadar hormon IGFBP-3 tidak menunjukkan perbedaan bermakna antara ketiga kelompok (p=0,772). Analisis DNA menggunakan SNP array mengidentifikasi 10 regio homozigot pada sampel pigmi yang tidak didapatkan pada kontrol.
Simpulan: Perawakan pendek manusia pigmi Rampasasa memiliki proporsi tubuh yang normal. Faktor nutrisi tidak berhubungan dengan perawakan pendek komunitas pigmi Rampasasa. Faktor hormonal tidak dapat menjelaskan perawakan pendek populasi tersebut. Temuan regio homozigot mengindikasikan pengaruh faktor genetik meskipun kandidat gen belum dapat diidentifikasi.;
ABSTRACT
Background: Height / stature of the body is an important parameter of one?s population wellbeing. Height is influenced by genetic, endocrine and environmental factors. Nutritional factor is one of the most common environmental factors found. Pygmy population is an isolated population whose all members have short stature. They are found in various parts of the world including Indonesia, namely Rampasasa pygmies community in Flores, East Nusa Tenggara. Up until this date, there are no studies about the etiology of Rampasasa pygmies short stature.
Objective: To learn about anthrophometric profiles in Rampasasa Pygmies and factors involved in the short stature of that pygmy community, as a contribution to the management of short stature in general, as well as to provide scientific asset about Rampasasa pygmies.
Keywords: calsium, genetic factors, height, IGFBP-3, IGF-I, nutrition, Rampasasa pygmies, short stature, vitamin D.
Methods: This research is a descriptive analytic study conducted from December 2011 to
April 2014. This study used a cross-sectional design to determine the genetic and non-
genetic profile (endocrine and nutrition) that play role in Rampasasa pygmies short
stature. Anthropometric measurements and blood sampling were performed. Statistical
analysis was performed by using ANOVA followed by post hoc analysis. Genetic
analysis is done by sending DNA isolation to Laboratory for Diagnostic Genome
Analysis (LDGA), Leiden, The Netherlands.
Results: Data obtained from 58 subjects were grouped into pure pygmies (n = 8), mixed
pygmy (n = 40), and non- pygmies (n = 10). All subjects had normal body proportions.
There were no significant difference in nutritional status between three groups, which is
expressed by calcium level (p = 0.19) , vitamin D (p = 0.96), and hemoglobin (p = 0.147).
Significant difference of IGF-1 hormone were found between the three groups (p =
0.037), which after posthoc analysis showed differences only between non-pygmies vs.
pure pygmies (p = 0.012). IGFBP-3 hormone level showed no significant difference
among the three groups (p = 0.772). We obtained evidence of homozygous regions in
DNA analysis using SNP arrays method, which are not found in control group.
Conclusion: Rampasasa pygmies have short stature with normal body proportion.
Nutritional factors are not associated with short stature of Rampasasa pygmy
communities. Hormonal factors can not explain the cause of the population short stature.
The discovery of homozygous regions indicates the role of genetic cause even though
there were no specific genes to be identified in this study.;Background: Height / stature of the body is an important parameter of one?s population wellbeing. Height is influenced by genetic, endocrine and environmental factors. Nutritional factor is one of the most common environmental factors found. Pygmy population is an isolated population whose all members have short stature. They are found in various parts of the world including Indonesia, namely Rampasasa pygmies community in Flores, East Nusa Tenggara. Up until this date, there are no studies about the etiology of Rampasasa pygmies short stature.
Objective: To learn about anthrophometric profiles in Rampasasa Pygmies and factors involved in the short stature of that pygmy community, as a contribution to the management of short stature in general, as well as to provide scientific asset about Rampasasa pygmies.
Keywords: calsium, genetic factors, height, IGFBP-3, IGF-I, nutrition, Rampasasa pygmies, short stature, vitamin D.
Methods: This research is a descriptive analytic study conducted from December 2011 to
April 2014. This study used a cross-sectional design to determine the genetic and non-
genetic profile (endocrine and nutrition) that play role in Rampasasa pygmies short
stature. Anthropometric measurements and blood sampling were performed. Statistical
analysis was performed by using ANOVA followed by post hoc analysis. Genetic
analysis is done by sending DNA isolation to Laboratory for Diagnostic Genome
Analysis (LDGA), Leiden, The Netherlands.
Results: Data obtained from 58 subjects were grouped into pure pygmies (n = 8), mixed
pygmy (n = 40), and non- pygmies (n = 10). All subjects had normal body proportions.
There were no significant difference in nutritional status between three groups, which is
expressed by calcium level (p = 0.19) , vitamin D (p = 0.96), and hemoglobin (p = 0.147).
Significant difference of IGF-1 hormone were found between the three groups (p =
0.037), which after posthoc analysis showed differences only between non-pygmies vs.
pure pygmies (p = 0.012). IGFBP-3 hormone level showed no significant difference
among the three groups (p = 0.772). We obtained evidence of homozygous regions in
DNA analysis using SNP arrays method, which are not found in control group.
Conclusion: Rampasasa pygmies have short stature with normal body proportion.
Nutritional factors are not associated with short stature of Rampasasa pygmy
communities. Hormonal factors can not explain the cause of the population short stature.
The discovery of homozygous regions indicates the role of genetic cause even though
there were no specific genes to be identified in this study., Background: Height / stature of the body is an important parameter of one’s population wellbeing. Height is influenced by genetic, endocrine and environmental factors. Nutritional factor is one of the most common environmental factors found. Pygmy population is an isolated population whose all members have short stature. They are found in various parts of the world including Indonesia, namely Rampasasa pygmies community in Flores, East Nusa Tenggara. Up until this date, there are no studies about the etiology of Rampasasa pygmies short stature.
Objective: To learn about anthrophometric profiles in Rampasasa Pygmies and factors involved in the short stature of that pygmy community, as a contribution to the management of short stature in general, as well as to provide scientific asset about Rampasasa pygmies.
Keywords: calsium, genetic factors, height, IGFBP-3, IGF-I, nutrition, Rampasasa pygmies, short stature, vitamin D.
Methods: This research is a descriptive analytic study conducted from December 2011 to
April 2014. This study used a cross-sectional design to determine the genetic and non-
genetic profile (endocrine and nutrition) that play role in Rampasasa pygmies short
stature. Anthropometric measurements and blood sampling were performed. Statistical
analysis was performed by using ANOVA followed by post hoc analysis. Genetic
analysis is done by sending DNA isolation to Laboratory for Diagnostic Genome
Analysis (LDGA), Leiden, The Netherlands.
Results: Data obtained from 58 subjects were grouped into pure pygmies (n = 8), mixed
pygmy (n = 40), and non- pygmies (n = 10). All subjects had normal body proportions.
There were no significant difference in nutritional status between three groups, which is
expressed by calcium level (p = 0.19) , vitamin D (p = 0.96), and hemoglobin (p = 0.147).
Significant difference of IGF-1 hormone were found between the three groups (p =
0.037), which after posthoc analysis showed differences only between non-pygmies vs.
pure pygmies (p = 0.012). IGFBP-3 hormone level showed no significant difference
among the three groups (p = 0.772). We obtained evidence of homozygous regions in
DNA analysis using SNP arrays method, which are not found in control group.
Conclusion: Rampasasa pygmies have short stature with normal body proportion.
Nutritional factors are not associated with short stature of Rampasasa pygmy
communities. Hormonal factors can not explain the cause of the population short stature.
The discovery of homozygous regions indicates the role of genetic cause even though
there were no specific genes to be identified in this study.]"
2015
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Dedi Suyanto
Hubungan kadar rifampisin dan isoniazid darah dengan konversi sputum pasien TB Paru di akhir fase intensif = Association between blood rifampicin and isoniazid concentration with sputum conversion among pulmonary TB patients at the end of intensive phase
"Pendahuluan: Kadar obat yang rendah dalam darah pasien TB paru diduga berhubungan dengan respon pengobatan yang buruk seperti kegagalan konversi sputum mikroskopis, yang merupakan risiko terjadinya kegagalan pengobatan. Namun berbagai penelitian menunjukan hasil kontroversial, sebagian menunjukan terdapat hubungan antara kadar obat dengan konversi sputum akhir intensif, sebagian lagi menunjukan respon terapi yang sama baiknya untuk kadar normal maupun kadar rendah. Faktor yang diduga menyebabkan perbedaan hasil ini adalah perbedaan MIC rifampisin dan isoniazid terhadap Mycobacterium tuberculosis (MTB) pada pasien-pasien TB di setiap wilayah.
Penelitian ini bertujuan mengetahui hubungan kadar rifampisin dan isoniazid darah dengan konversi, serta hubungan rasio kadar puncak rifampisin dan isoniazid darah terhadap MIC (Cmax/MIC) dengan konversi sputum pasien TB paru di akhir fase intensif.
Metode: Desain penelitian adalah kasus kontrol dengan jumlah sampel sebanyak 40 orang, yang terbagi dalam kelompok kasus (tidak konversi, n=20) dan kelompok kontrol (konversi, n=20). Kadar rifampisin dan isoniazid darah diukur pada dua jam setelah minum obat yang merupakan perkiraan kadar puncak rifampisin dan isoniazid, menggunakan metode LC/MS-MS. Data MIC diambil dari 20 isolat kultur MTB sputum pasien TB paru kasus baru di RSP dr. H.A Rotinsulu Bandung menggunakan metode MGIT.
Hasil: Dari 40 pasien didapatkan rerata kadar rifampisin 5,58±2,41 mg/L dengan 36 pasien (90%) diantaranya memiliki kadar puncak di bawah normal. Untuk isoniazid didapatkan median kadar 1,46 (0,40-6,10) mg/L dengan 32 pasien (80%) diantaranya memiliki kadar puncak isoniazid di bawah normal. Pada penelitian ini didapatkan MIC rifampisin 0,25 mg/L dan MIC isoniazid 0,05 mg/L, lebih rendah dibanding kadar kritis masing-masing obat.
Introduction: Low plasma drug concentration in pulmonary TB patients are thought to be associated with poor treatment outcomes such as microscopic sputum conversion failure, which is a risk of treatment failure. However, various studies showed controversial results, some showed that there was an association between drug concentration with sputum conversion at the end of intensive phase, while others showed the same good outcome for normal and low concentrations. Factors thought to cause these controversial in results are the differences in the MIC of rifampicin and isoniazid against Mycobacterium tuberculosis in TB patients in each region. This study aims to determine the association between blood rifampicin and isoniazid concentratiom with sputum conversion, as well as the association between the ratio of peak blood concentration of rifampicin and isoniazid to MIC (Cmax/MIC) with sputum conversion of pulmonary TB patients at the end of the intensive phase.
Methods: The study design was a case-control study with a sample size of 40 subjects, which were divided into a case group (non-conversion, n=20) and a control group (conversion, n=20). The blood concentration of rifampicin and isoniazid were measured two hours after taking the drug which is an estimate of the peak concentrations of rifampicin and isoniazid, using the LC/MS-MS method. MIC data were taken from 20 MTB sputum culture isolates from new cases of pulmonary TB patients at RSP dr. H.A Rotinsulu Bandung using the MGIT method.
Results: Of the 40 patients, the mean concentration of rifampicin was 5.58 ± 2.41 mg/L with 36 patients (90%) of whom had peak concentrations below normal. For isoniazid, the median concentration was 1.46 (0.40-6.10) mg/L with 32 patients (80%) of whom had peak concentration of isoniazid below normal. In this study, the MIC of rifampicin 0.25 mg/L and MIC of isoniazid 0.05 mg/L were lower than the critical concentration of each drug. There was no association between blood rifampicin concentration (OR: 11.18; 95% CI: 0.20-223.00, p= 0.106), blood isoniazid concentration (OR: 3.86; 95% CI: 0.67-22 .22, p= 0.235), and the Cmax/MIC ratio of rifampicin (OR: 0.474; 95% CI: 0.039-5.688, p=1.00) with intensive final sputum conversion. However, there was an association between low concentration of both drugs simultaneously (OR: 6.00; 95% CI: 1.08-33.27, p = 0.028), and the Cmax/MIC ratio of isoniazid (OR: 4.333; 95% CI: 1.150). -16,323, p= 0.027) with sputum conversion at the end of the intensive phase.
Conclusion: There was no association between blood rifampicin concentration, blood isoniazid concentration, and the Cmax/MIC ratio of rifampicin with microscopic sputum conversion at the end of the intensive phase. However, there was an association between low concentration of both drugs and the Cmax/MIC ratio of isoniazid and sputum conversion at the end of the intensive phase."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2021
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Surbakti, Klara Morina Br
Faktor yang mempengaruhi keberhasilan pengobatan pasien TB Paru dengan sputum BTA negatif dan pasien TB paru dengan sputum BTA positif di BBKPM Bandung tahun 2009-2011 = Affecting factors of treatment success pulmonary TB patients with and sputum smear positive negative and pulmonary TB patients with sputum smear positive new cases in BBKPM Bandung 2009-2011
"Salah satu indikator program pengendalian TB secara Nasional strategi DOTS adalah angka keberhasilan pengobatan TB. Fokus utama pengendalian TB strategi DOTS adalah memutus mata rantai penularan TB oleh penderita TB paru sputum BTA positif. Berdasarkan penelitian penderita TB paru sputum BTA negatif dapat menularkan 13-20% (Tostmann A, et al, 2008). BBKPM Bandung sebagai salah satu UPK strategi DOTS pencapaian angka keberhasilan pengobatan masih dibawah target Nasional.
Tujuan: mempelajari faktor yang mempengaruhi keberhasilan pengobatan pasien TB paru sputum BTA negatif dan pasien TB paru sputum BTA positif. Faktor yang mempengaruhi keberhasilan pengobatan TB antara lain faktor individu (umur, jenis kelamin, pekerjaan, kepatuhan berobat) dan obat dan penyakit (rejimen, dosis, lama pengobatan, komorbid HIV dan DM). Indikator keberhasilan pengobatan: pemeriksaan ulang sputum BTA menjadi/tetap negatif dan kenaikan berat badan.
Desain penelitian: kohort retrospektif.
Sampel: data pasien TB Paru yang tercatat di TB 01 tahun 2009-2011dijadikan 2 sub populasi, Pasien TB paru dengan sputum BTA negatif 292 kasus dan pasien TB paru dengan sputum BTA positif 461 kasus.
Analisis: multivariabel regresi logistik.
Hasil: OR keberhasilan pengobatan pasien TB paru sputum BTA negatif patuh berobat 1,4 dibandingkan tidak patuh (CI : 0,7-3,0) dan pasien TB paru sputum BTA positif patuh berobat 1,1 di bandingkan tidak patuh (CI : 0,6-2,2) setelah dikontrol umur, jenis kelamin dan pekerjaan.
Saran: Meningkatkan peran PMO, dan memperhatikan faktor komorbid dalam tatalaksana pengobatan pasien TB paru.
Succes rate of TB treatment is an important indicator of the Natinal TB control program.The main focus of TB control program DOTS strategy is to break the chain of TB transmission. Tostmann A, et al (2008) showed that through 13-20% sputum smear negative pulmonary tuberculosis patients can spread TB the bacteria. BBKPM Bandung as one of CGU DOTS strategy has lower treatment succes rate of the national targets.
Purpose: To study factors that influence the treatment succes rate of compare with both smear positve and negative pulmonary tuberculosis patients. Those are age, gender, occupation, treatment compliance (factor individu) and regimen, dose, duration of treatment, comorbid HIV and DM (drug and disease). Indicator of treatment succes are the conversion of sputum result examination and the gain weight.
Study design: a retrospective cohort study.
Samples: the pulmonary TB patient data recorded at TB 01 yeras 2009-2011. The number of TB patients with sputum smear positive are 461 and negative are 292.
Analysis: Multivariable logistic regression.
Result: OR treatment succes among sputum smear-negative pulmonary TB patients 1,4 (CI: 0,7-3,0) and among sputum smear positive pulmonary Tb patients who adhere to treatment is 1,1 (CI:0,6-2,2) after controlling for age, sex, and occupation.
Suggestion: Enhancing the role of the PMO to increase the treatment adherence rate, treat the TB patients with HIV and DM co-infection."
Depok: Fakultas Kesehatan Masyarakat Universitas Indonesia, 2013
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Tissy Fabiola
Age and employment status in MDR-TB patients during primary TB treatment its association with patient compliance = Usia dan status pekerjaan pada pasien MDR RB selama pengobatan TB pertama hubungan dengan kepatuhan pasien
"Penyakit tuberculosis (TB) telah dinyatakan sebagai salah satu permasalahan kesehatan dunia oleh WHO semenjak tahun 1993, danjumlahpenderita tuberkulosis kian meningkat setiap tahunnya. Mycobacterium tuberculosis, agen penyebab dari penyakit tuberkulosis telah bermutasi menjadi strain resistant erhadap lebih dari satu obat antituberkulosis, yang melahirkan sebuah penyakit yang disebut Multidrug-resistant Tuberculosis (MDR-TB). Studi ini bermaksud mengetahui pengaruh usia dan status pekerjaan pada pasien MDR-TB selama pengobatan inisial TB terhadap kepatuhan pasien dalam pengobatan. Data diambil di RS Persahabatan Jakarta (n=50), pada bulan Desember 2009 hingga Agustus 2010 dengan metode cross sectional. Sample diperoleh dengan metode convenient sampling method. Hasil penelitian menunjukkan bahwa 34% pasien berusia 16-20 tahun dan 70% pasien memiliki pekerjaan saat pengobatan TB pertama, serta baik usia pasien maupun status pekerjaan pasien tidak ada hubungan yang signifikan dengan kepatuhan pasien.
Tuberculosis (TB) disease has been declared as a global emergency according to WHO since 1993 and the number of the people who become infected with this disease keeps increasing throughout the year. Mycobacterium tuberculosis, the causative agent of tuberculosis disease has mutated to be resistant to more than one antituberculosis drug, leading to a disease called Multidrug-resistant Tuberculosis (MDR-TB). This study aims to measure the influence between age and employment status during primary TB treatment and the development towards MDR-TB in relation to patient compliance. Data is collected in Persahabatan Hospital, Jakarta (n=50) on December 2009 until August 2010, using cross sectional method. Samples are obtained using convenient sampling method. The result shows that 34% patients were 16-20 years old and 70% patients were employed during their primary TB treatment, and neither age nor employment status has a significant association with patient compliance."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2011
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Ira Candra Kirana
Gambaran hasil pengobatan pasien tuberkulosis multidrug resistant tb-mdr dan faktor-faktor yang mempengaruhinya di Indonesia tahun 2013-2015 = Description of treatment outcome among tuberculosis multidrug resistant tb-mdr patients and its affecting factors in Indonesia 2013-2015
"ABSTRAK
Upaya pengendalian TB-MDR telah dilakukan, namun hasil akhir pengobatan pasien TB-MDR masih menjadi permasalahan terkini yang perlu diselesaikan. Di Indonesia, terjadi penurunan success rate pasien TB RO sejak lima tahun terakhir, yaitu kisaran 68-46, sedangkan hasil pengobatan buruk lebih fluktuatif dan masih tinggi yaitu kisaran 28-47. Penelitian ini menggunakan desain kohort retrospektif yang bertujuan untuk mengetahui gambaran dan faktor yang berhubungan dengan hasil pengobatan pasien TB-MDR di Indonesia. Data yang digunakan adalah data pasien TB-MDR yang berusia 15 tahun yangmemulai pengobatan antara Januari 2013-Desember 2015 dan teregister dalam e-TB Manager. Didapatkan 1.683 kasus dengan 49,7 pasien sembuh, 2,7 lengkap, 14,1 meninggal, 4,4 gagal, dan 29,1 loss to follow up.Analisis bivariat dilakukan untuk mengidentifikasi faktor yang berhubungandenganhasil pengobatan buruk kematian, gagal, atau loss to follow up. Faktor risiko terhadap hasil pengobatan buruk adalah usia 45 tahun RR 1.32; 95 CI 1.20-1.46, resistansi OAT lini 1 RR 34.1; 95 CI 8.24-141.0, resistansi OAT lini 1 lini 2 dan/atau florokuinolon RR 32; 95 CI 7.9-134.0, kavitas paru RR 1.21; 95 CI 1.00-1.44, interval inisiasi pengobatan >30 hari RR 1.11; 95 CI 1.00-1.24, dan tempat tinggal di desa RR 1.15; 95 CI 1.02-1.30. Sedangkan faktor protektor terhadap hasil pengobatan buruk adalah paduan standar RR 0.73; 95 CI 0.59-0.91.
ABSTRACT
Efforts to control MDR TB have been done, but treatment outcome of MDR TB patients remains a current issue that needs to be resolved. In Indonesia, success rate was declining in the last five years, from 68 46 , whereas poor treatment results are more fluctuate and still high at 28 47. This cohort retrospective study was conducted to analyze the characteristics and factors influencing treatment outcomes of MDR TB patients in Indonesia. This research was use data from e TB Manager and included all MDR TB patients who were ge 15 years and starting treatment between January 2013 and December 2015. Overall, 1.683 MDR TB patientswere included,49.7 recovered, 2.7 complete treatment, 14.1 died, 4.4 treatment failure, and 29.1 loss to follow up. A bivariate analysis was used to identify risk factors for poor treatment outcomes, which were defined as death, treatment failure, or loss to follow up. The risk factors for poor treatment outcome were age above 45 years RR 1.32, 95 CI 1.20 1.46, patients who are resistant first lines TB drugs RR 34.1 95 CI 8.24 141.0 and first lines TB drugs 2nd lines injection and or fluoroquinolone RR 32 95 CI 7.9 134.0, lung cavity RR 1.21, 95 CI 1.00 1.44, treatment initiation interval 30 days RR 1.11 95 CI 1.00 1.24, and residence in rural areas RR 1.15 95 CI 1.02 1.30. While the protector factor for poor treatment outcome is standardized regimen RR 0.73 95 CI 0.59 0.91."
2018
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Albert Sedjahteraa
Treatment place in MDR TB patients during primary TB treatment its role on patient compliance and free drug prescription = Tempat pengobatan pada pasien MDR TB selama pengobatan TB pertama peran terhadap kepatuhan pasien dan pemberian obat gratis
"Kemunculan MDR-TB menghambat program pemberantasan TB dan berakibat pada meningkatnya angka kematian dan beban control TB. Tempat pengobatan TB, termasuk riwayat pengobatan, sangat mungkin merupakan predictor MDR-TB yang kuat. Tujuan dari studi ini ada untuk mengidentifikasi dan menganalisis tempat pengobatan TB primer sebagai salah satu factor yang mungkin berkontribusi dalam perkembangan TB menjadi MDR-TB. Pengumpulan data dilaksanakan pada bulan Desember 2009 hingga Agustus 2010. Mengguanakan metode cross-sectional, data didapatkan melaui wawancara mendalam dengan 50 pasien MDR-TB yang sedang mendapatkan pengobatan di klinik MDR-TB RS Persahabatan. Dalam jumlah besar pasien MDR-TB mendapatkan pengobatan di puskesmas (38%) dan dokter praktik pribadi (28%). Tidak ditemukan adanya assosiasi antara tempat pengobatan TB pertama dan kepatuhan pasien sedangkan assosiasi terlihat antara tempat pengobatan TB pertama dan peresepan obat gratis.
The emergence of MDR-TB hampers TB eradication program which resulted in high fatality rate and increase burden of TB control. TB treatment place, including history of treatment, might be a strong predictor of MDR-TB. The purpose of this study is to identify and analyze primary TB treatment place as the contributing factor that may lead to the development of TB towards MDR-TB. The data collection was done from December 2009 to August 2010 at Persahabatan Hospital. Using cross-sectional method, data is obtained through thorough interview of 50 MDR-TB patients undergoing treatment in MDR-TB Clinic in Persahabatan Hospital. Large proportion of MDR-TB patient received their primary TB treatment at puskesmas (38%) and private Practice (28%). It is found that there is no association between primary TB treatment place and patient compliance while association appears between primary TB treatment place and free drug prescription."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2011
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