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Abstrak :
Indonesia Constitutes the third highest of Tuberculosis (TB) cases after India and China. One of the problem in TB control is still law of drugs treatment complience of TB patients. The objekive of this study was to know the relationship between TB disease prevention behariors with treatment compliance of TB patiants im Indonesia Data Explored from National Basic Health Survey (Riskesdas)2010. The data is designed to represent provincies. Design of study is cross sectional. The population is all respondents of riskesdas 2010, while sample were chosen ages >_ 15 years with Pulmonary TB, perticularly the TB patients who was receive medication and treated by health facilities. The number of sample are all 968 patients. Interviews were conducted by skilled interviewers. Data were processed by SPSS 15 version. The behavior of respondents drying the wrong mattress have risk non-compliant treatment about 1.64 compared with the behavior or respondents drying the right mattress (OR=1.64; P=0,001; CI;1,21-2,22). Likewise low education has risk non-complaint treatment in the amount of 1.62 compared with highly educated respondents (OR=1.62; P=0,005; CI;1,15-2,27). The updated data signify that analysis of drug adherence TB patients will show significantly in correlation between drug adherence with level of education, and behavior of dry mattress

Abstrak :
Latar belakang : Sekuel Tuberkulosis (TB) adalah deformitas permanen sebagai gejala sisa pada pasien yang telah menjalani pengobatan TB lengkap atau sudah dinayatakan sembuh. Pembedahan merupakan tata laksana efektif sekuel TB, meski tidak terbebas dari komplikasi. Penelitian ini ditujukan melakukan evaluasi peran pemberian OAT terhadap komplikasi pascabedah, dan menilai pengaruh riwayat Diabetes mellitus (DM), merokok dan status gizi kurang terhadap kejadian komplikasi pascabedah kasus sekuel TB. Metode : Dilakukan suatu studi kohort retrospektif pada pasien pasien yang menjalani operasi sekuel TB di Rumah Sakit Umum Pusat Persahabatan dalam periode 1 Januari 2016 hingga 31 Desember 2019. Faktor pemberian OAT, riwayat DM, kebiasaan merokok dan status gizi kurang serta pengaruhnya pada komplikasi pascabedah merupakan variabel penelitian. Dilakukan uji statistik dengan kemaknaan p<0,05. Hasil : Sebanyak 58 subjek dilibatkan sebagai sampel penelitian. Komplikasi pascabedah terjadi pada 36 (62,1%) subjek. OAT diberikan pada 26 (44,8%) subjek. Pemberian OAT menurunkan odds kejadian komplikasi yang bermakna secara statistik rasio odds 0,06 (0,01-0,24); p < 0,001 Simpulan : Pemberian OAT pascabedah menurunkan kejadian komplikasi pascabedah secara bermakna. Komplikasi pascabedah lebih banyak terjadi pada pasien yang tidak menerima OAT pascabedah ......Introduction: Tuberculosis (TB) sequelae are permanent deformities identified as residual signs after completion of TB treatment or cured TB cases. Surgery has been demonstrated to be an effective treatment of TB sequelae albeit with possible post-surgical complications. This study aimed to assess the role of antituberculosis chemotherapy in postoperative complications and to evaluate the impact of diabetes mellitus (DM), smoking and nutritional status on the incidence of postoperative complications. Method: A retrospective cohort trial was conducted on patients who underwent surgery of TB sequelae at the Rumah Sakit Umum Pusat Persahabatan from January 1, 2016 to December 31, 2019. Administration of antituberculosis chemotherapy, diabetes mellitus (DM), smoking habits, nutritional status and their effects on postoperative complications were evaluated. Statistical analysis concluded to be significant if p<0.05. Results: A total of 58 subjects were included in the study. Postoperative complications were observed in 36 (62.1%) subjects. Antituberculosis chemotherapy was administered to 26 (44.8%) subjects. Post-surgical administration of antituberculosis drug reduced the likelihood of complications [OR 0.06, 95% CI 0.01-0.24, p <0.001). Conclusion: Antituberculosis chemotherapy significantly reduced the occurence of postoperative complications. Patient who encountered postoperative complication tend not to receive antituberculous chemotherapy

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 :

Tuberkulosis (TB) merupakan penyakit menular yang disebabkan oleh bakteri Mycrobacterium Tuberculosis. Pada umumnya, penyakit TB menyerang paru-paru manusia. Penyakit ini bisa juga menyerang bagian tubuh lain dari manusia melalui darah. Indonesia merupakan negara ke-3 dengan kasus TB terbesar di dunia. Upaya pencegahan penyebaran TB adalah dengan vaksinasi dan pengobatan yang memadai. Pada penelitian ini, dibentuk model matematika penyebaran TB dengan vaksinasi dan laju pengobatan yang bersaturasi. Pada kasus ini, laju pengobatan menggunakan fungsi saturasi yang menggambarkan efek jenuh akibat dari penundaan pengobatan pasien penderita TB saat sumber daya rumah sakit terbatas. Analisis model terkait eksistensi titik kesetimbangan, kestabilan titik keseimbangan, dan basic reproduction number (Ro) dilakukan secara analitik. Dari analisis titik keseimbangan didapatkan fenomena bifurkasi maju dan juga bifurkasi mundur pada Ro = 1. Bifurkasi mundur didapatkan karena efek dari laju pengobatan yang bersaturasi saat Ro. Oleh karena itu dengan membuat Ro belum cukup untuk mereduksi penyebaran TB. Dengan simulasi numerik dapat menggambarkan fenomena dilapangan, sehingga didapatkan bahwa melakukan vaksinasi, dan memperbesar laju pengobatan maka penyebaran TB dapat dikontrol sehingga lebih efektif untuk mereduksi penyebaran TB.

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Tuberculosis (TB) is an infectious disease caused by the bacterium Mycrobacterium Tuberculosis. Generally, this disease attacks the lungs but can attack other parts of the body through the blood. Indonesia is the 3rd country with the most signi�cant TB cases in the world. Efforts to prevent the spread of TB are with vaccination and treatment. In this study, formed a mathematical model of the diseases of tuberculosis with vaccination and saturated treatment rate. In this case, the treatment rate uses the saturation function, which illustrates the saturation effect resulting from treatment delay when there are a large number of TB sufferers with limited hospital resources. Analysis of the model related to the existence of equilibrium points, the stability of equilibrium points, and the analytically basic reproduction number (Ro). The equilibrium point analysis obtained the phenomenon of forward and backward bifurcation at Ro = 1. Backward bifurcation occurs because of the effect of the saturated treatment rate at Ro < 1. It was therefore making Ro < 1 not enough to reduce the spread of TB. With numerical simulations that can illustrate the phenomenon in the reality, so vaccinated, and improving the rate of treatment, the spread of TB can be controlled to reduce the spread of TB.

Abstrak :
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.

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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.

Abstrak :
Tuberkulosis Resisten Obat (TBC-RO) merupakan ancaman kesehatan masyarakat. Indonesia menduduki peringkat keempat dalam insiden kasus resistensi TB secara global dan enrollment rate pengobatan MDR/RR-TB masih dibawah target nasional sehingga dapat mendorong beban resistensi pre-extensively drug resistant TB (pre-XDR-TB) dan extensively drug resistant TB (XDR-TB). Tujuan dari penelitian ini adalah untuk mengidentifikasi faktor-faktor risiko yang berhubungan dengan kejadian resistensi pre-XDR-TB dan XDR-TB di DKI Jakarta tahun 2021-2022. Desain studi penelitian adalah cross sectional dengan sumber data dari Sistem Informasi Tuberkulosis (SITB). Total sampel yang digunakan adalah 1164 yang kemudian diolah dengan analisis univariat, bivariat, dan stratifikasi. Jumlah resistensi pre-XDR-TB dan XDR-TB di DKI Jakarta mencapai 9,7% dari total kasus TBC-RO DKI Jakarta. Karakteristik pasien TBC-RO di DKI Jakarta mayoritas merupakan laki-laki (57,5%), usia 45-54 tahun (22,9%), status sosioekonomi tidak bekerja (28,1%), pasien TBC-RO dengan DM tipe 2 (23,2%), pasien HIV-TBC-RO (3,3%) riwayat pengobatan baru (44,8%) dan penyebab resistensi merupakan acquired resistance (47,8%). Dari analisis bivariat didapatkan, laki-laki (POR = 0,675; 95% CI: 0,458-0,996) merupakan faktor protektif dan status sosioekonomi tidak bekerja (POR = 1,65; 95% CI: 1,021-2,649) merupakan faktor risiko terhadap resistensi pre-XDR-TB dan XDR-TB. Direkomendasikan untuk pemerintahan memberi dukungan ekonomi kepada pasien TBC-RO yang sedang menjalani pengobatan TB. ......Drug resistant TB (DR-TB) has become a public health threat. Globally, Indonesia ranked fourth in the incidence cases of DR-TB and the enrollment rate for MDR/RR-TB was still below the national target which consequentially can push the burden of pre-extensively drug resistant TB (pre-XDR-TB) and extensively drug resistant TB (XDR-TB) in Indonesia. The objective of this research is to identify the risk factors that are associated with the occurrence of pre-XDR-TB and XDR-TB in DKI Jakarta in 2021-2022. This study uses a cross-sectional design and the data is obtained from the national TB information system (SITB). The total sample used for this study is 1164 which is then analysed by univariate, bivariate and stratification analysis. The number of pre-XDR-TB and XDR-TB cases in DKI Jakarta reaches 9.7% of the total cases of DR-TB in DKI Jakarta. The characteristics of the majority of DR-TB patients in DKI Jakarta are male (57,5%), age 45-54 (22,9%), unemployed socioeconomic status (28,1%), DR-TB with DM type 2 (23,2%), DR-TB with HIV (3,3%), have no history of previous treatment (44,8%) and cause of resistance is acquired resistance (47,8%). From bivariate analysis it is obtained, being male (POR = 0,68) is a protective factor and socioeconomic status of not working (POR = 1,65) is a risk factor for pre-XDR-TB and XDR-TB resistance. It is recommended that the government provide economic support for DR-TB patients who are undergoing TB treatment.

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.

Abstrak :
MDR-TB telah menjadi ancaman bagi masyarakat masa kini, dengan demikian, menambah beban akibat penyakit TB. Beberapa faktor resiko dapat menyebabkan kasus TB berkembang menjadi kasus MDR-TB, diantaranya adalah implementasi strategi (DOTS) yang buruk, terutama berkaitan dengan keberadaan Pengawas Minum Obat (PMO) dalam pengobatan TB pertama. Penelitian cross-sectional ini mengkaji 3 dari 5 komponen DOTS dalam pengobatan TB pertama yakni adanya pemeriksaan dahak, PMO, serta distribusi dan cakupan obat anti-TB dari program nasional penanggulangan TB. Penelitian ini membahas hubungan antara PMO dan kepatuhan pasien dalam meminum obat. Data untuk studi ini diambil dari hasil wawancara terhadap 50 pasien di Klinik MDR-TB, RS Persahabatan pada Desember 2009-Agustus 2010. Studi ini menunjukkan bahwa sebanyak 32% pasien mengetahui perlu adanya PMO selama pengobatan TB, namun sebanyak 40% pasien memiliki figur yang menjalankan fungsi sebagai PMO. Meskipun demikian, tidak ada perbedaan signifikan dalam kepatuhan minum obat diantara pasien yang memiliki PMO dan pasien yang tidak memiliki PMO. ......MDR-TB poses as a growing threat to present society, further complicating the burden of TB. Various risk factors have been identified to contribute to the development towards MDR-TB from previous TB treatment, one of which is poor implementation of DOTS, especially in relation to the presence of DOTS observer (Pengawas Minum Obat or PMO). This cross sectional study assesses the implementation of 3 out of 5 components of DOTS during primary TB treatment; sputum check, PMO assistance, and coverage of free drug from NTP. Furthermore, this study investigates the association between the presence of PMO and patient compliance. Data is collected by deep interview with 50 patients in MDR-TB Clinic, Persabahatan Hospital during December 2009 to August 2010. This study shows that 62% subjects have their sputum check, and 52% subjects receive free drug. Only 32% subjects acquire the knowledge of PMO, yet 40% subjects are actually observed by PMO. There is no significant difference in patient compliance with the presence of PMO.

Abstrak :
Tuberkulosis adalah penyakit yang disebabkan oleh Mycobacterium tuberculosis dan menjadi sangat berbahaya karena kemudahannya untuk menginfeksi orang lain. Rifampisin merupakan salah satu OAT lini pertama yang menjadi dasar obat tuberculosis dan terjadinya resistensi terhadap rifampisin menjadi salah satu kendala pemberantasan TB di Indonesia. Penelitian ini bertujuan menentukan pola resistensi M. tuberculosis terhadap Rifampisin serta mengetahui perbandingan monoresisten rifampisin, multi drug resistance (MDR), serta multiresisten lain tuberkulosis. Penelitian ini dilakukan dengan menganalisis data sekunder sebanyak 676 sampel dengan kultur positif dari Departemen Mikrobiologi FKUI pada September 2005 sampai Desember 2007 dan telah menjalani pemeriksaan resistensi sesuai dengan panduan WHO/IUATLD. Dari hasil analisis didapatkan pola resistensi terhadap rifampisin sebanyak 23.96% dimana monoresisten rifampisin sebesar 7,24%, MDR TB sebesar 8,73%, serta multiresisten lain sebesar 7,99%.

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Tuberculosis is a disease caused by Mycobacterium tuberculosis and becomes very dangerous because its potency to infect other people. Rifampisin is one of the first line tuberculosis? drugs and its resistance will be the obstacle of reducing Tuberculosis cases in Indonesia. This research aimed to determine the resistance of rifampisin and also the comparison between monoresistance to rifampicin, multi-drug resistance (MDR), and also the other multiresistance of tuberculosis. This research was done by collecting and analyzing 676 secondary samples which culture results are positive from Microbiology Department Medical Faculty University of Indonesia in September 2005 until December 2007 and had undergone resistance tests based on WHO/IUATLD guidelines. The results of the analysis were obtained that the resistance of rifampisin was 23.96% where the percentage of monoresistance to rifampicin is 7,24%, MDR TB is 8,73%, and the other multiresistance is 7,99%.