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Abstrak :
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.

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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.

Abstrak :
Background: Prevention of tuberculosis, particularly pulmonary tuberculosis in lndonesia was started in 1969, but the number of pulmonary TB patients is increasing. Methods:Ethnographic qualitative study aims to assess the independence of the community effort in preventing pulmonary TB disease transmission. Methods: of data collection participatory observation, in-depth interviews with informants pulmonary TB patients and families. Research sites in the city of Pariaman, West Lombok district and the district Rote Ndao NTT. Results:The analysis of four independent indicators of the knowledge society is stilllow considering that most of the informants consider pulmonary TB disease as a hereditary disease, and infectious diseases as the people in the district Hossa Rote Ndao. Illness perceptions of people in the city of Pariaman, pulmonary TB disease as a disease because "ismeken", due to use-for others who are not happy ln the town of West Lombok fear of stigma, shame as people with TB, so there are many people who call it the perception of illness as a disease of old cough, dry cough of 40 days, and asthma. Confidence/trust society still depends on health workers, yet there are cadres who provide direct counseling on prevention of transmission. Capability community is lacking, people still believe in the health care workers to provide counseling. Selection of the PMO staff (Supervisors taking medication) were not appropriate to the social structures that exist in society Lobar districts with 'sasak' social structure, then the host teacher, 'Kyai' can be as social support surrounding communities. 'Kyai' expected to affect the mindset of people, motivate people to air PHBs. Rote Ndao district as a social support from church leaders as well as the city of Pariaman, a descendant of the king, can motivate people. Participatory community by providing prevention counseling in a variety of pulmonary TB disease or group of containers carried on a group of new religious NGOs, Asiyah, churches, Muhammadiyah. Recommendation:Required an increase in participatory community of various other NGOs, in an integrated cross-sector to perform the preventive, promotive control of pulmonary TB disease by promoting the re-socialization of the glass roof house design, conduct prevention.