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"Pendahuluan: Adekuasi pengobatan TB praoperasi merupakan sebuah dilema dikalangan Spesialis bedah yang mengharapkan morbiditas dan mortalitas pascaoperasi yang rendah. Belum adanya data tentang morbiditas dan mortalitas pascaoperasi abdeomen penderita TB di RSCM dan RS Persahabatan menunjukkan perlunya dilakukan penelitian untuk mengetahui adekuasi pemberian OAT praoperasi pada penderita TB berhubungan denngan morbiditas berupa fistel enterokutan, obstruksi usus, infeksi daerah operasi (IDO) dan mortalitas pascaoperasi abdomen. Metode: Desain studi ini adalah cross sectional yang bersifat deskriptif analitik yang dilakukan di RSUPN Cipto Mangunkusumo dan Rumah Sakit Umum Pusat Persahabtan (RSP) dari September-Desmber 2107. Dengan metode total sampling , Jumlah sampel didapatkan 59 subjek penderita TB yang menjalani operasi abdomen dan dirawat di RSCM dan RSP yang memenuhi kriteria inklusi dan eksklusi. Analisa Bivariate dengan SPSS dilakukan untuk menentukan hubungan antara adekuasi OAT dengan mortalitas dan mobiditas pascaoperasi.Hasil :Terdapat 46 subjek (78%) tidak mendapat terapi OAT praoperasi secara adekuat. Morbiditas pada studi ini adalah 29 subjek (49.25%) yang didapatkan hubungan signifikan dengan adekuasi OAT (p=0.030). Dari tiga morbiditas (IDO, Fistel enterokutan, dan obstruksi usus) , hanya IDO yang berhubungan signifikan dengan Adekuasi OAT (p=0.048) . Hubungan yang tidak signifikan didapatkan terhadap mortalitas (p=0.564). Pada Operasi emergensi didapatkan insidensi Morbiditas (OR = 1.62; 95% CI 0.58 - 4.53) dan IDO (OR = 2.02; 95% CI 0.63 - 6.46) yang lebih tinggi dibandingkan dengan operasi elektif. Pada jenis operasi kotor dibandingkan operasi bersih didapatkan IDO yang signifikan (p=0.030). Pada analisa multivariate menunjukkan adekuasi OAT dan tipe operasi merupakan faktor risiko terjadinya morbiditas pascaoperasi (p=0,025).Kesimpulan: Pemberian OAT yang adekuat praoperasi penderita tuberkulosis yang menjalani operasi abdomen menurunkan morbiditas pascaoperasi yang berupa infeksi daerah operasi, namun pemberian obat anti tuberkulosis yang adekuat pada penderita tuberkulosis yang menjalani operasi abdomen tidak berpengaruh terhadap morbiditas berupa fistel enterokutan, obstruksi usus serta tidak berpengaruh terhadap mortalitas pascaoperasi.......Background: The adequacy of tuberculosis treatment before abdominal surgery is a dilemma faced by surgeons who aims for low risk of morbidity and mortality. In addition, there is no data on morbidity and mortality post abdominal operation on TB patients in RSCM and RS Persahabatan. Therefore, this research aims to show the correlation between the adequacy of preoperative TB treatment and postoperative morbidity (fistula enterocutaneous, obstruction, and surgical site infection) and mortality.Method: This study is a descriptive-analytic cross-sectional study done in Cipto Mangunkusumo Hospital dan Persahabatan Hospital using total sampling method, a total of 59 subjects with TB and had undergone abdominal operation and was admitted from January 2011 to August 2017,that fulfilled the criteria of this study. Bivariate and multivariate analysis using SPSS was done to analyse the correlation between TB treatment adequacy and postoperative morbidity and mortality.Results: 46 subjects (78%) did not receive adequate preoperative TB treatment. The morbidity rate in this study is 29 subjects 49.25% with significant correlation with the adequacy of preoperative TB treatment (p=0.030). From the three morbidities in this study (fistula enterocutaneous, obstruction, surgical site infection), only surgical site infection (SSI) has significant correlation with TB treatment adequacy (p=0.048). There is no significant correlation with postoperative mortality (p=0.564). Compared to elective surgery, emergency surgery has higher morbidity (OR = 1.62; 95% CI 0.58 - 4.53) and SSI (OR = 2.02; 95% CI 0.63 - 6.46) incidence. A significant difference in the incidence of SSI between clean and dirty surgery wound was found (p=0.030). Multivariate analysis showed that both adequacy of antituberculosis treatment and surgery type are independent risk factors for morbidity (p=0,025). Conclusion: Adequate preoperative TB treatment lowers the postoperative morbidity such as surgical site infection. There is no significant correlation between adequate preoperative TB treatment and mortality, and other morbidities such as fistula enterocutaneous and obstruction. Morbidity and SSI are more likely to happen in emergency surgery than elective surgery. Both adequacy of antituberculosis treatment and surgery type are independent risk factors for morbidity"

"Latar Belakang: Target angka keberhasilan pengobatan TB MDR/TB RR 2015 adalah ≥ 75 %. Angka keberhasilan pengobatan menurut WHO tahun 2013 adalah 52%. Kesenjangan antara target dan pencapaian masih sangat besar. Metode: Penelitian cross sectional/potong lintang berdasarkan data rekam medis pasien TB MDR yang sudah ada hasil pengobatan sejak Januari 2013 sampai dengan Desember 2016. Hasil: Dari 409 pasien TB MDR di RSUP Persahabatan keberhasilan pengobatan 61,4% dengan hasil akhir pengobatan sembuh 243 subjek (59,4%), pengobatan lengkap 8 subjek (2%), meninggal 44 subjek (10,8%), loss to follow up 106 subjek (25,9%) dan gagal 8 subjek (2%). Pada penelitian ini 243 subjek (59,4%) laki-laki dengan rerata umur 38,79 ± 11,887 tahun, mayoritas gizi kurang dan terdapat pengobatan TB sebelumnya, resistensi terbanyak RHES dan efek samping terbanyak efek samping sedang (kelompok 2). Faktor umur, riwayat penggunaan alkohol dan komorbid DM mempunyai hubungan bermakna terhadap hasil akhir pengobatan (p<0,05). Riwayat penggunaan alkohol merupakan faktor yang paling berpengaruh terhadap hasil akhir pengobatan. Kesimpulan: Keberhasilan pengobatan TB MDR di RSUP Persahabatan adalah sebesar 61,4% dan faktor yang berhubungan bermakna adalah umur, riwayat penggunaan alkohol dan terdapatnya komorbid DM.

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Background: The target of treatment success rate of MDR TB/RR TB in 2015 is ≥ 75 %. The success rate in WHO 2013 is 52%. The gap between target and achievement is still very large. Method: A cross sectional design based on medical record data of MDR TB patients who have been treatment outcomes from January 2013 to December 2016. Result: Of a total 409 MDR TB patients at Persahabatan Hospital succes rate of treatment is 61,4% with the final outcome consist of cured 243 subjects (59,4%), complete treatment 8 subjects (2%), death 44 subjects (10,8%), loss to follow up 106 subjects (25,9%) dan failed 8 subjects (2%). Patients in this study were male 243 subjects (59,4%) with mean age of subjects 38,79 ± 11,887 years old, majority is malnutrition and had previous TB treatment, the most resistance is RHES and the most side effects is moderate. The age, alcohol user and comorbid DM were found to have significant relationship to treatment outcomes (p<0,05). The alcohol user is the most influential factor to the treatment outcomes. Conclusion: The success rate of treatment outcome of MDR TB in Persahabatan hospital is 61,4% and associated factors is the age, alcohol user dan comorbid DM. "

"Pendahuluan. Beban TB di Indonesia masih masuk lima tertinggi di dunia. Temuan kasus dan pengobatan adalah pilar utama program penanggulangan TB. Survei nasional menunjukkan peningkatan penggunaan obat non-program TB dari 16,8% (2010) menjadi 55,6% (2013). Peningkatan penggunaan obat non-program TB diduga berpengaruh terhadap ketidakpatuhan berobat.Tujuan. Penelitian ini bertujuan untuk mempelajari ketidakpatuhan berobat pada orang dengan TB yang menerima obat non-program TB dan obat program TB.Metode. Penelitian menggunakan data sekunder Riskesdas 2010. Analisis logistik multivariabel dilakukan pada sampel 971 orang dengan TB yang selesai mendapatkan pengobatan.Hasil. Ada kecenderungan orang dengan TB yang menerima obat non-program TB ketidakpatuhan berobat lebih tinggi. Hasil penelitian juga menunjukkan odds untuk tidak menyelesaikan pengobatan lebih tinggi pada orang yang menerima obat non-program TB dibandingkan orang yang menerima obat program TB, yaitu rasio odds terkontrol 2,4 (95% CI RO: 1,7-3,5).Simpulan. Dalam upaya menjamin kepatuhan berobat TB perlu didukung dengan mutu program pengobatan, diantaranya adalah ketersediaan obat program TB, penyetaraan standar pengobatan antara fasyankes swasta dan publik, dan sistem pemantauan minum obat. ......Background. TB in Indonesia is one of five highest burden countries. Case finding and treatment are the main pillars of TB control program. National survey reports the increase in the use of non-TB program’s drugs from 16,8% (2010) to 55,6% (2013). Increased use of non-TB program’s drugs associate with non-compliance TB treatment.Objective. The study purposed to compare the non-compliance of TB treatment among people who received TB program’s drugs and people who received non-TB program’s drugs.Methods. The study used secondary data of National Health Survey 2010. Analysis used multivariable logistic through 971 people who completed TB treatment.Result. The findings were people who received non-TB program’s drugs had higher non-compliance TB treatment than people who received TB program’s drugs. The result also showed that the odds of people not to complete the treatment was higher in people who received non-TB program’s drugs than who received TB program’s drugs, adjusted OR was 2,4 (95% CI OR: 1,7-3,5).Conclusion. To assure the compliance to TB treatment is strengthening TB treatment program; such as the availability of TB program’s drugs, the equality of standard TB treatment among public and private health services, and the system of observed treatment."

"ABSTRAK Latar belakang : Pasien HIV berisiko 20-37 kali lipat terinfeksi TB, dan TBmerupakan penyebab kematian tertinggi pada HIV. Resistensi OAT menjadimasalah utama dalam pengobatan TB terutama pada pasien HIV, hal ini berujungpada peningkatan mortalitas dan biaya. Rifampisin merupakan OAT utama,dibuktikan dengan kesembuhan yang rendah pada regimen tanpa rifampisin,sehingga perlu diketahui prevalensi resistensi rifampisin dan faktor-faktor yangmempengaruhi pada pasien TB-HIV. Tujuan : Mengetahui prevalensi resistensi rifampisin pada pasien TB-HIV danfaktor-faktor yang mempengaruhi. Metode : Studi potong lintang terhadap 196 pasien TB-HIV yang menjalanipemeriksaan Xpert MTB-RIF di poli pelayanan terpadu HIV RSUPN CiptoMangunkusumo selama tahun 2012-2015. Analisa bivariat untuk mengetahuihubungan faktor-faktor dengan kejadian resistensi rifampisin. Analisa multivariatmenggunakan uji regresi logistik. Hasil dan Pembahasan : Pada 196 pasien yang menjadi subjek penelitian,didapatkan prevalensi resistensi rifampisin sebesar 13,8%. Usia, jenis kelamin,riwayat penggunaan ARV, dan TB ekstra paru tidak berhubungan dengankejadian resistensi rifampisin pada TB-HIV. CD4 < 100 mempengaruhi kejadianresistensi rifampisin (OR 2,57; 95% IK 0,99-6,69), Riwayat pengobatan TBmempengaruhi kejadian resistensi rifampisn (OR 3,98; 95% IK 1,68-9,44). Kesimpulan : Prevalensi resistensi rifampisin TB-HIV di RSUPN CiptoMangunkusumo sebesar 13,8%. Riwayat TB mempengaruhi kejadian resistensi rifampisin pada pasien TB-HIV. ABSTRACT Background: HIV patients have 20-37 fold risk of getting TB infection and TB isthe leading cause of death among them. Anti tuberculosis drug resistance is amajor problem in the treatment of tuberculosis with rifampicin as one of the maindrug. We need more information about prevalence of rifampicin resistance and itscontributing factors in TB-HIV patients. Aim: To determine the prevalence of rifampicin resistance in TB-HIV patientsand its contributing factors. Method : A cross sectional study of 196 TB-HIV patients who underwent XpertMTB/RIF examination at Cipto Mangunkusumo Hospital during the year 20122105.Correlationbetweenprevalenceofrifampicinresistanceanditscontributingfactorswas done using bivariate analysis. Multivariate analysis was done usinglogistic regression test. Result and Discussion : From 196 patients, we found prevalence of 13,8%rifampicin resistance. CD4 < 100 affects the incidence of rifampicin resistance(OR2.5;95% CI 0.99-6.69). Hiistory of TB treatment affects the incidence ofrifampicin resistance (OR3.98;95%CI 1.68-9.44). Conclusion : Prevalence of rifampicin resistance in TB-HIV patients in CiptoMangunkusumo Hospital is 13.8%. History of TB treatment affects the incidenceof rifampicin resistance in TB-HIV patients. ;Background: HIV patients have 20-37 fold risk of getting TB infection and TB isthe leading cause of death among them. Anti tuberculosis drug resistance is amajor problem in the treatment of tuberculosis with rifampicin as one of the maindrug. We need more information about prevalence of rifampicin resistance and itscontributing factors in TB-HIV patients. Aim: To determine the prevalence of rifampicin resistance in TB-HIV patientsand its contributing factors. Method : A cross sectional study of 196 TB-HIV patients who underwent XpertMTB/RIF examination at Cipto Mangunkusumo Hospital during the year 20122105.Correlationbetweenprevalenceofrifampicinresistanceanditscontributingfactorswas done using bivariate analysis. Multivariate analysis was done usinglogistic regression test. Result and Discussion : From 196 patients, we found prevalence of 13,8%rifampicin resistance. CD4 < 100 affects the incidence of rifampicin resistance(OR2.5;95% CI 0.99-6.69). Hiistory of TB treatment affects the incidence ofrifampicin resistance (OR3.98;95%CI 1.68-9.44). Conclusion : Prevalence of rifampicin resistance in TB-HIV patients in CiptoMangunkusumo Hospital is 13.8%. History of TB treatment affects the incidenceof rifampicin resistance in TB-HIV patients. ;Background: HIV patients have 20-37 fold risk of getting TB infection and TB isthe leading cause of death among them. Anti tuberculosis drug resistance is amajor problem in the treatment of tuberculosis with rifampicin as one of the maindrug. We need more information about prevalence of rifampicin resistance and itscontributing factors in TB-HIV patients. Aim: To determine the prevalence of rifampicin resistance in TB-HIV patientsand its contributing factors. Method : A cross sectional study of 196 TB-HIV patients who underwent XpertMTB/RIF examination at Cipto Mangunkusumo Hospital during the year 20122105.Correlationbetweenprevalenceofrifampicinresistanceanditscontributingfactorswas done using bivariate analysis. Multivariate analysis was done usinglogistic regression test. Result and Discussion : From 196 patients, we found prevalence of 13,8%rifampicin resistance. CD4 < 100 affects the incidence of rifampicin resistance(OR2.5;95% CI 0.99-6.69). Hiistory of TB treatment affects the incidence ofrifampicin resistance (OR3.98;95%CI 1.68-9.44). Conclusion : Prevalence of rifampicin resistance in TB-HIV patients in CiptoMangunkusumo Hospital is 13.8%. History of TB treatment affects the incidenceof rifampicin resistance in TB-HIV patients. "

"Compliance of TB patients with anti TB drugs treatment is a universally recognized problem specially in asian developing countries which results at the consequences of the TB treatment compliances, today there are TB cases defaulters,relapses and MDRTB which is mostly occurring in all over the world due to deferent reasons of the compliances, and Afghanistan is one of the 22nd highest TB burden country in the world. The main problem of TB treatment compliance in Afghanistan can be explain at two aspects: First there would be a high prevalence of TB positivity in country level because of inaccessibility to the health services In the rural areas due to war and low security, second behavioral changes and lack of knowledge of the community about the disease and wrong beliefs and perceptions, socioeconomic factors, socio demographic factors and socio psychological factors, all these factors could be determined and influence the compliance of TB patients among the TB patients in the country.ObjectiveTo determine what factors associated and influenced the compliance of TB patients with anti TB Anti TB drugs treatment in Kandahar Afghanistan.Materials and methodsIt was descriptive study, the study was including 243 TB patients participated 79 TB patients interviewed with well structured questionnaire.ResultsTB patients as much as 58.23 % was not good compliance of their anti TB treatment and 41.77% was good compliance of their anti TB treatment, and the compliance rate was higher among those patients who were not good compaliance, how ever from small sample size statistic could not detect any significant association.ConclussionThe high prevalence of TB cases in the country and high level of compliance of TB patients among the TB confirm patients with the factors influencing the compliance of the treatment is essential to control and take measure immediately, the evidence strengthen the need of collaboration to change the behavior of the community properly for ten agers and activate the education and the result attract to focus more and pay attention on the factors influencing the compliance specially for those who have no any access to the health services to satisfy and encourage them for their regular anti TB treatment therapy."

"Ketersediaan Obat Anti Tuberkulosis (OAT) tidak menjamin penanganan TB yang adekuat. Hal tersebut tergambar melalui rendahnya angka kesembuhan TB di Nusa Tenggara Timur yang memunculkan berbagai risiko mulai dari resolusi tidak sempurna hingga kekambuhan TB. Sementara itu, berkembangnya alat ukur termasuk pemeriksaan darah lengkap menuntut pemanfaatan yang lebih baik. Studi ini memiliki tujuan untuk menyelidiki dan mengetahui hubungan antara faktor-faktor seperti usia, jenis kelamin, status pendidikan, lama setelah pengobatan, serta status gizi terhadap gambaran pemeriksaan darah lengkap pada pasien pasca pengobatan TB. Studi ini berdasarkan desain potong lintang yang dilakukan terhadap pasien pasca TB sesuai catatan Puskesmas sejak tahun 2003 hingga 2010 di NTT yang telah dinyatakan sembuh dan mengikuti pengobatan hingga selesai. Didapatkan sebanyak 63 subjek pasca pengobatan TB ikut serta dalam studi ini. Terdapat gambaran pemeriksaan darah abnormal yang ditemukan berupa peningkatan LED, leukositosis, limfositosis, serta anemia. Gambaran peningkatan LED ditemukan bermakna secara signifikan pada kelompok dengan jenis kelamin perempuan, faktor usia di atas 45 tahun, lama pengobatan kurang dari 3 tahun, serta status gizi underweight (p<0,05). Selain itu, pada studi ini juga didapatkan karakteristik pasien pasca TB, kaitan temuan objektif hasil pemeriksaan darah lengkap dengan gejala klinis, serta 9 dari 37 pasien pasca TB yang dapat diperiksa BTA menunjukkan hasil sputum BTA positif. ......Availability of Anti-Tuberculosis Drugs does not guarantee adequate treatment of TB. It is reflected by the low cure rate of TB in East Timor that gives rise to a variety of risks ranging from imperfect resolution to TB recurrence. Meanwhile, the development of measurement tools including complete blood examination demand better utilization. This study has the objective to investigare and determine the relationship between factors such as age, gender, educational background, time after TB treatment, as well as the nutritional status with the hematological profile in patients with previous TB treatment. This study is also based on cross-sectional design conducted on patients with post-tuberculosis according to primary health care records from 2003 to 2010 in East Timor, which has been declared cured and follow complete treatment. 63 subjects of post TB treatment participated in this study. Abnormal hematological profile were found such as increased ESR value, leucocytosis, lymphocytosis, and anemia. The value of increased ESR was found statistically significant in the group factors of female gender, more than 45 years, duration after treatment is less than 3 years, and the nutritional status of underweight (p<0,05). In addition, the study also found post TB patient characteristics, connection between objective finding of complete blood count with clinical symptoms, and 9 of the 37 patients show the result of positive sputum smear examination."

"Tuberkulosis masih menjadi penyebab utama kematian di seluruh dunia, termasuk Indonesia sebagai negara ke-3 tertinggi penderita tuberkulosis di dunia. Sementara pada tingkat provinsi, Kota Depok berada pada urutan 11 dengan penyumbang kasus tuberkulosis terbanyak di Provinsi Jawa Barat. Penelitian ini bertujuan untuk mengetahui hubungan antara rumah sehat, cakupan pengobatan TB, dan angka keberhasilan pengobatan TB dengan Incidence Rate (IR) tuberkulosis di Kota Depok tahun 2021. Penelitian ini menggunakan desain studi ekologi berdasarkan tempat dengan populasi seluruh masyarakat yang tercatat di 11 kecamatan di Kota Depok yang terdiagnosis penyakit tuberkulosis. Hasil penelitian melalui uji korelasi menunjukkan variabel independen yang memiliki hubungan signifikan dengan Insidence Rate (IR) tuberkulosis adalah cakupan pengobatan di Kecamatan Bojongsari (p = 0.000). Sementara hasil uji korelasi cakupan rumah sehat, cakupan pengobatan TB, angka keberhasilan pengobatan TB di Kota Depok menunjukkan hubungan yang tidak signifikan. Hasil analisis lainnya, cakupan rumah sehat di Kota Depok memiliki keeratan hubungan lemah berpola negatif (r = -0.173), cakupan pengobatan TB memiliki keeratan hubungan lemah berpola positif (r = 0.184), dan angka keberhasilan pengobatan TB memiliki keeratan hubungan kuat berpola negatif (r = -0.584).......Tuberculosis is still the main cause of death worldwide, including Indonesia as the 3rd country with the highest number of tuberculosis sufferers in the world. Meanwhile, at the provincial level, Depok City is in 11th place with the largest contributor to tuberculosis cases in West Java Province. This study aims to determine the relationship between healthy homes, TB treatment coverage, and TB treatment success rates with the Incidence Rate (IR) tuberculosis in Depok City in 2021. This study uses an ecological study design based on place with a population of all communities recorded in 11 sub-districts in Depok. Depok City, which was diagnosed with tuberculosis. The results of the study through the correlation test showed that the independent variables that had a significant relationship with the Incidence Rate (IR) of tuberculosis is treatment coverage in Bojongsari District (p = 0.000). Meanwhile, the results of the correlation test between healthy home coverage, TB treatment coverage, and TB treatment success rates in Depok City showed an insignificant relationship. The results of other analyzes showed that the coverage of healthy homes in Depok City had a weak negative correlation (r = -0.173), TB treatment coverage had a weak positive correlation (r = 0.184), and the success rate of TB treatment had a strong negative correlation (r = -0.584)."