Hasil Pencarian  ::  Simpan CSV :: Kembali

"ABSTRAK

Latar belakang dan tujuan: Gangguan elektrolit merupakan salah satu efek samping yang spaling sering ditemukan pada pasien tuberkulosis multidrug-resistant TB MDR yang mendapatkan obat anti tuberkulosis OAT mengandung obat suntik lini kedua. Tujuan penelitian ini adalah untuk mengetahui proporsi gangguan elektrolit pada pasien yang mendapatkan OAT suntik lini kedua serta faktor-faktor yang berhubungan dengan gangguan tersebut.Metode: Penelitian ini merupakan penelitian potong lintang, retrospektif, berbasis rekam medis pada pasien TB MDR di RSUP Persahabatan selama pengobatan fase intensif dari Juli 2015-Juni 2016 dan mendapatkan OAT dengan regimen kanamisin ataukapreomisin, pirazinamid, etambutol, levofloksacin,sikloserin dan etionamid. Hasil: Sebanyak 121 pasien ikut pada penelitian ini. Gangguan elektrolit didapatkan pada 114 pasien 94,2. Rerata waktu terjadinya gangguan elektrolit setelah pengobatan adalah 2,0 bulan. Hipokalemia merupakan jenis gangguan elektrolit yang paling banyak ditemukan 57,9. Hipokalemia berhubungan dengan jenis kelamin dan jenis OAT suntik yang digunakan. Insidens hipokalemia lebih banyak ditemukan pada pasien perempuan 72 dibandingkan dengan laki-laki 47,9 dengan OR 2,8 KI 95 : 1,3-6,1 dan pada pasien yang mendapatkan kapreomisin 68,5 dibandingkan yang mendapatkan kanamisin 49,2 dengan OR 2,2 KI 95 : 1,1-4,7 . Hasil ini bermakna secara statistik. Faktor usia, status gizi, diabetes melitus, gangguan fungsi ginjal dan infeksi HIV tidak berhubungan dengan hipokalemia pada penelitian ini. Kesimpulan: Hipokalemia merupakan gangguan elektrolit yang paling sering terjadi pada pasien TB MDR yang mendapatkan OAT MDR mengandung obat suntik lini kedua. Jenis kelamin perempuan dan kapreomisin merupakan faktor risiko terjadinya hipokalemia namun diperlukan penelitian lebih lanjut untuk mengidentifikasi faktor risiko lainnya yang dapat mempengaruhi kejadian hipokalemia pada pasin TB MDR.

---

ABSTRACT<>br>

Background: Electrolyte imbalance is one of the adverse reactions mostly found in patients with multidrugs resistant tuberculosis MDR TB who treated by injectable agent. The aim of this study is to know the proportion of electrolyte imbalance in MDR TB patients receiving second line injection of antituberculosis drugs and the contributing factors. Methods: This study is a cross sectional, retrospective, medical record based study among MDR TB patients in Persahabatan Hospital during intensive phase from July 2015 to June 2016 who received intensive phase treatment consist of kanamycin or capreomycin, pirazinamid, ethambutol, levofloxacin, cycloserine and ethionamide.Results One hundred and twenty one patients were included in this study. The proportion of electrolyte imbalance was found in 114 patients 94.2. The mean duration of therapy at the time incidence of electrolyte imbalance was 2.0 months. Hypokalemia 57,9 were the most electrolyte imbalance frequently found. Hypokalemia was associated with gender and type of antituberculosis injection drugs. The incidence of hypokalemia significantly high among female 72.0 patients than male 47.9 with OR 2.8 CI 95 1.3 6.1 and also in patients receiving capreomysin 68.5 than kanamycin 49.2 with OR 2.2 CI 95 1.1 4.7. Age, nutrition status, diabetes melitus, renal disfunction and HIV have no association with hypokalemiain our study. Conclusion: Hypokalemia was the most frequent electrolyte imbalance found among patient receiving MDR antituberculosis regimen. Female gender and capreomycin injection using were associated with the incidence of hypokalemia. However, more clinical researchs are needed to identify other risk factors contributing of hypokalemia state in MDR TB patients."

"[ABSTRAKLatar Belakang: Pengobatan TB MDR memiliki hasil yang buruk dengan keberhasilan hanya 48% di dunia. Salah satu indikator keberhasilan pengobatan adalah konversi dini. Identifikasi faktor yang mempengaruhi konversi merupakan hal yang penting. Metode: Penelitian ini dilakukan secara kohort retrospektif dengan menggunakan rekam medik pasien TB MDR di RSUP Persahabatan Jakarta yang berobat selama bulan Agustus 2009 - Desember 2013.Hasil: Dari 436 pasien terdapat 248 pasien laki-laki (56.6%). Sebanyak 256 pasien (58,7%) mengalami konversi biakan dalam dua bulan pengobatan. Nilai tengah waktu konversi adalah 44 hari. Faktor yang memperlambat lama konversi adalah jenis kelamin perempuan (aHR 0,808; [95%CI 0,659-0,991]), IMT pasien kurang (0,792; [0,637-0,983]), ditemukan gambaran kavitas pada foto toraks (0,781;[0,634-0,961]), bacterial load 2+ (0,617;[0,439-0,869]), bacterial load 3+ (0,701;[0,501-0,979]), riwayat pengobatan OAT sebelumnya dengan lini kedua (0,597;[0,415-0,858]), jumlah resisten obat > 2 OAT (0,614;[0,429-0,879]), kelompok pasien Pre XDR dan TB XDR (0,486;[0,305-0,776]), dan jumlah limfosit rendah (0,681;[0,524-0,885]).Kesimpulan: Jenis kelamin perempuan, IMT kurang, gambaran kavitas pada foto toraks, tingginya bacterial load, riwayat pengobatan OAT sebelumnya dengan lini kedua, jumlah resisten obat > 2 OAT, kelompok pasien Pre XDR dan TB XDR serta limpositopenia berhubungan dengan lamanya konversi pada pasien TB MDR.

---

ABSTRACTIntroduction: Treatment for MDR-TB has a poor outcomes, success rate was only 48% worldwide. One indicator of treatment success is early culture conversion. Identification of potential factors associated with culture conversion are important.Methods: A cohort rectrospective study using medical records of MDR-TB patients of Persahabatan Hospital during August 2009 until December 2013. Data were analyzed using multivariate analysis.Results : Of a total 436 patients, there are 248 patients (56.6%) were males. Two hundred fifty six patients (58,7%) had sputum culture conversion at two months. The median time to culture conversion was 44 days. The factors for longer sputum culture conversion were female (aHR 0,808; [95%CI 0,659-0,991]), underweight patients (0,792; [0,637-0,983]), cavitaty on chest radiograph (0,781;[0,634-0,961]), bacterial load 2+ (0,617;[0,439-0,869]), bacterial load 3+ (0,701;[0,501-0,979]), previous TB treatment with second line drugs (0,597;[0,415-0,858]), resistance to more 2 TB drugs (0,614;[0,429-0,879]), pre XDR and XDR-TB (0,486;[0,305-0,776]), and lower lymphocites count (0,681;[0,524-0,885]).Conclusion: Female, underweight patients, cavitaty, high bacterial load, previous TB treatment with second line drugs, resistance to more 2 TB drugs, resistance to rifampicine, isoniazid and other second line drugs, and lower lymphocites count were associated with longer time culture conversion in MDR-TB patients.;Introduction: Treatment for MDR-TB has a poor outcomes, success rate was only 48% worldwide. One indicator of treatment success is early culture conversion. Identification of potential factors associated with culture conversion are important.Methods: A cohort rectrospective study using medical records of MDR-TB patients of Persahabatan Hospital during August 2009 until December 2013. Data were analyzed using multivariate analysis.Results : Of a total 436 patients, there are 248 patients (56.6%) were males. Two hundred fifty six patients (58,7%) had sputum culture conversion at two months. The median time to culture conversion was 44 days. The factors for longer sputum culture conversion were female (aHR 0,808; [95%CI 0,659-0,991]), underweight patients (0,792; [0,637-0,983]), cavitaty on chest radiograph (0,781;[0,634-0,961]), bacterial load 2+ (0,617;[0,439-0,869]), bacterial load 3+ (0,701;[0,501-0,979]), previous TB treatment with second line drugs (0,597;[0,415-0,858]), resistance to more 2 TB drugs (0,614;[0,429-0,879]), pre XDR and XDR-TB (0,486;[0,305-0,776]), and lower lymphocites count (0,681;[0,524-0,885]).Conclusion: Female, underweight patients, cavitaty, high bacterial load, previous TB treatment with second line drugs, resistance to more 2 TB drugs, resistance to rifampicine, isoniazid and other second line drugs, and lower lymphocites count were associated with longer time culture conversion in MDR-TB patients., Introduction: Treatment for MDR-TB has a poor outcomes, success rate was only 48% worldwide. One indicator of treatment success is early culture conversion. Identification of potential factors associated with culture conversion are important.Methods: A cohort rectrospective study using medical records of MDR-TB patients of Persahabatan Hospital during August 2009 until December 2013. Data were analyzed using multivariate analysis.Results : Of a total 436 patients, there are 248 patients (56.6%) were males. Two hundred fifty six patients (58,7%) had sputum culture conversion at two months. The median time to culture conversion was 44 days. The factors for longer sputum culture conversion were female (aHR 0,808; [95%CI 0,659-0,991]), underweight patients (0,792; [0,637-0,983]), cavitaty on chest radiograph (0,781;[0,634-0,961]), bacterial load 2+ (0,617;[0,439-0,869]), bacterial load 3+ (0,701;[0,501-0,979]), previous TB treatment with second line drugs (0,597;[0,415-0,858]), resistance to more 2 TB drugs (0,614;[0,429-0,879]), pre XDR and XDR-TB (0,486;[0,305-0,776]), and lower lymphocites count (0,681;[0,524-0,885]).Conclusion: Female, underweight patients, cavitaty, high bacterial load, previous TB treatment with second line drugs, resistance to more 2 TB drugs, resistance to rifampicine, isoniazid and other second line drugs, and lower lymphocites count were associated with longer time culture conversion in MDR-TB patients.]"

"ABSTRAKUpaya 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.

---

ABSTRACTEfforts 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."

"ABSTRACTDi Indonesia, angka keberhasilan pengobatan pasien TB resistan obat sejak tahun 2013-2015 masih rendah yaitu sebesar 52,4%. Upaya yang dilakukan adalah dengan diterapkannya metode baru yaitu metode standar jangka pendek pada tahun 2107. Seiring diterapkannya metode baru, metode standar konvensional tetap terus dilakukan. Penelitian ini menggunakan desain cross sectional bertujuan untuk mengetahui perbedaan hasil pengobatan antara metode standar standar konvensional dan metode standar jangka pendek. Data yang digunakan adalah data pasien TB MDR yang memulai pengobatan antara Januari-Desember 2017 yang teregister dalam e-TB Manager. Hasil pengobatan yang baik pada metode standar konvensional adalah 39,8% dan pada metode standar jangka pendek adalah 48,9%. Hasil analisis uji chi square terhadap perbedaan hasil antara metode konvensional dan jangka pendek adalah tidak terdapat perbedaan yang signifikan (p-value = 0,067). Dan hanya faktor umur 45 tahun dan interval inisiasi pengobatan 30 hari yang perbedaan hasil pengobatannya signifikan (p-value = 0,005 dan 0,047).

---

ABSTRACTIn Indonesia, the success rate of treatment of drug-resistant TB patients from 2013-2015 is still low at 52.4%. The efforts made were to implement a new method, namely the standard short-term method in 2107. As new methods were implemented, conventional standard methods continued. This study used a cross sectional design aimed to determine differences in treatment outcomes between conventional standard standard methods and short-term standard methods. The data used is data on MDR TB patients who started treatment between January-December 2017 registered in e-TB Manager. The good treatment results in the conventional standard method are 39.8% and in the standard short term method is 48.9%. The results of the chi square test analysis of the differences in results between conventional and short-term methods there is no significant difference (p-value = 0.067). And only age factors 45 years and treatment initiation intervals 30 days for which the difference in results was significantly different (p-value = 0.005 and 0.047)."

"Berdasarkan data SITB per 2 Februari 2022, terdapat 8306 kasus TB-RR/MDR terkonfirmasi melalui pemeriksaan laboratorium. Keberhasilan pengobatan TB MDR di Indonesia tahun 2021 belum mencapai target dan termasuk rendah dibandingkan dengan global yaitu sebesar 45%. Penelitian bertujuan mengidentifikasi faktor-faktor yang berhubungan dengan keberhasilan pengobatan pasien TB MDR di RSUP Persahabatan tahun 2019. Penelitian ini menggunakan desain studi kohort retrospektif. Penelitian menggunakan data sekunder dari rekam medis pasien TB MDR yang berobat di RSUP Persahabatan tahun 2019 yang dilihat sejak awal pengobatan hingga didapatkan hasil akhir pengobatan. Terdapat 273 sampel yang sesuai kriteria inklusi dan eksklusi. Data dianalisis menggunakan IBM SPSS Statistics 25 dengan uji chi-square, dengan RR untuk mengetahui derajat hubungan antar variabel dan dan p < 0,05 sebagai batas kemaknaan. Pada hasil analisis diketahui umur (p=0,000; RR=1,603 95CI% 1,251–2,055), jenis kelamin (p=0,749; RR=1,045 95CI% 0,798–1,369), pendidikan (p=0,165; RR=1,228 95CI% 0,929–1.634), pekerjaan (p=0,298; RR=0,893 95CI% 0,8723–1,103), status pernikahan (p=0,000; RR=1,932 95%CI 1,318–2,833), wilayah tempat tinggal (p=0,092, RR=1,288 95%CI 0,933–1,779), hasil pemeriksaan sputum awal (p=0,272; RR=1,126 95%CI 0,911–1,191), interval inisiasi pengobatan (p=0,021; RR=0,698 95%CI 0,494–0,986). Faktor yang memiliki hubungan signifikan secara statistik dengan keberhasilan pengobatan adalah umur, status pernikahan, dan interval inisiasi pengobatan.Based on SITB data as of February 2, 2022, there were 8306 confirmed cases of RR/MDR TB through laboratory tests. The success of MDR TB treatment in Indonesia in 2021 has not reached the target and is low compared to global, which is 45%. This study aims to identify factors associated with successful treatment of MDR TB patients at Persahabatan Hospital in 2019. This study used a retrospective cohort study design. The study used secondary data from the medical records of MDR TB patients who were treated at the Friendship Hospital in 2019 which were seen from the beginning of treatment until the final results of treatment were obtained. There were 273 samples that met the inclusion and exclusion criteria. Data were analyzed using IBM SPSS Statistics 25 with chi-square test, with RR to determine the degree of relationship between variables and p < 0.05 as the limit of significance. The results of the analysis showed that age (p=0.000; RR=1.603 95CI% 1.251–2.055), gender (p=0.749; RR=1.045 95CI% 0.798–1.369), education (p=0.165; RR=1.228 95CI% 0.929– 1.634), occupation (p=0.298; RR=0.893 95CI% 0.8723–1.103), marital status (p=0.000; RR=1.932 95%CI 1.318–2.833), area of ​​residence (p=0.092, RR=1.288 95%CI 0.933–1.779), results of initial sputum examination (p=0.272; RR=1.126 95%CI 0.911–1.191), treatment initiation interval (p=0.021; RR=0.698 95%CI 0.494–0.986). Factors that had a statistically significant relationship with treatment success were age, marital status, and treatment initiation interval."

"Tuberculosis Multidrug resistant TB MDR adalah salah satu jenis resistensituberkulosis terhadap minimal dua obat anti tuberkulosis lini pertama, yaituIsoniazid INH dan Rifampicin R dengan atau tanpa resisten terhadap obat antituberkulosis lain. Prevalensi TB MDR di dunia menurut WHO tahun 2012 sebesar 12 dari kasus TB baru dan 20 dari kasus TB dengan pengobatan ulang. Hal ini masihmerupakan masalah kesehatan masyarakat dunia, termasuk di Indonesia. Penelitian inibertujuan untuk mengetahui besarnya pengaruh faktor puskesmas yang dapatmempengaruhi individu terhadap kejadian TB MDR, serta menggali faktor levelpuskesmas yang dapat menjelaskan kejadian TB MDR. Desain penelitian inimenggunakan kasus kontrol dengan mixed methods. Pengumpulan data dilakukandengan wawancara menggunakan kuesioner, diskusi terarah, wawancara mendalam danobservasi. Analisis data menggunakan regresi logistik multilevel. Hasil penelitianmenunjukkan bahwa ada variasi risiko antar puskesmas/ fasilitas kesehatan tingkatpertama yang dapat mempengaruhi individu terhadap kejadian TB MDR. Faktor-faktorpada level individu yaitu pendidikan, riwayat hasil pengobatan, kepatuhan menelanobat, dan pengetahuan, PMO dan level puskesmas yaitu penjaringan suspek dan kotakerat pasien TB/TB MDR, pengobatan TB sesuai ISTC berpengaruh terhadap prevalensiTB MDR di Provinsi Sumatera Selatan. Faktor kontekstual puskesmas dapatmenurunkan variasi risiko antar puskesmas terhadap kejadianTB MDR sebesar 18 Pengembangan strategi intervensi pengendalian TB MDR yang sesuai dengan kondisiProvinsi Sumatera Selatan adalah mengkolaborasikan penjaringan suspek TB/TBMDR, pengobatan TB/TB MDR sesuai ISTC dan jejaring eksternal ISTC.

---

Multidrug resistant tuberculosis MDR TB is one type of tuberculosis resistance to atleast two first line anti tuberculosis drugs, Isoniazid INH and Rifampicin R with orwithout resistance to other anti tuberculosis drugs. World prevalence of MDR TBaccording to WHO 2012 is 12 of new TB cases and 20 of TB cases with retreatment.This is still a public health problem of the world, including in Indonesia. Thisstudy aims to determine the magnitude of the influence of puskesmas factors that canaffect the individual to the incidence of MDR TB, as well as to explore the level factorof puskesmas that can explain the incidence of MDR TB. This research design use casecontrol with mixed methods. The data were collected through interviews usingquestionnaires, directional discussions, in depth interviews and observations. Dataanalysis using multilevel logistic regression. The results showed that there werevariations in risk among puskesmas that could affect individuals against MDR TBincidence. Factors at the individual level of education, history of treatment outcomes,medication adherence, and knowledge, PMO and Puskesmas levels are suspect and tightsquares of TB TB MDR patients, TB treatment according to ISTC has an effect on theprevalence of MDR TB in South Sumatera Province. Contraceptive factors puskesmas first level health facilities can reduce risk variation among puskesmas to the incidenceof MDR TD by 18 . Development of MDR TB control intervention strategyappropriate to South Sumatera Province condition is to collaborate on suspected TB TB MDR screening, TB TB MDR treatment according ISTC and ISTC externalnetwork."