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"Latar belakang: Tuberkulosis merupakan masalah kesehatan global dan menjadi penyebab pertama dari dua kematian akibat penyakit menular di dunia. Pasien yang menghentikan pengobatan sebelum sembuh mengakibatkan penyakitnya bertambah parah, menularkan penyakit bahkan meninggal. Pemanfaatan pelayanan kesehatan turut berperan dalam kasus TB, karena pemanfaatan pelayanan dapat mencegah terjadinya kasus putus berobat. Sekitar 50% pasien TB tanpa pengobatan akan meninggal. Salah satu faktor risiko kematian karena TB adalah pengobatan yang tidak adekuat. Tujuan penelitian ini adalah untuk mengetahui faktor pendukung dan penghambat pasien TB paru dewasa putus berobat di wilayah Kota Serang tahun 2016. Metode : Penelitian ini menggunakan metode penelitian kuantitatif dan kualitatif. Penelitian kuantitatif menggunakan desain cross-sectional dengan sampel 13 penderita TB. Sedangkan, penelitian kualitatif menggunakan wawancara mendalam. Hasil : Hasil penelitian menemukan faktor pendukung pasien TB Paru putus berobat untuk memulai kembali pengobatannya adalah pengetahuan, sikap pengobatan, jarak ke Puskesmas, kunjungan petugas TB, pendorong pengobatan kembali, kebutuhan pengobatan, dukungan keluarga dan petugas TB Puskesmas. Sedangkan faktor penghambat pasien TB putus berobat adalah efek samping OAT dan upaya pencarian pengobatan lain. Kesimpulan : Pengobatan TB merupakan salah satu upaya paling efisien untuk mencegah penyebaran kuman TB. Maka, perlu dilakukan kerja sama lintas program terkait untuk mengoptimalkan pengobatan TB sekaligus mengatasi masalah pasien TB putus berobat di wilayah Kota Serang.

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Background : Tuberculosis (TB) is a major global health problem, the first cause of two deaths of infectious diseases in worldwide. Some patients discontinued treatment before cured resulting the disease became severe, transmit diseases and even death. Utilization of health services also have a role in the cases of TB, this is due to prevent lost to follow-up cases. As many as 50% TB patients without treatment will die. One of death risk factor of TB are inadequate treatment. The aim of this study is to find out the supported and inhibited factors of lost to follow-up adult TB patients at Serang City in 2016.

Method : This study used quantitative and qualitative research methods. In quantitative research, conducted by using cross-sectional design with 13 patients TB as sample. Meanwhile, a qualitative study using in-depth interviews.

Result : The study found the factors supported lost to follow-up TB patients for restarting the treatment were knowledge, attitudes of treatment, distance to reach public health center, health officers home visit, retreatment stimulus, needs of treatment, then the support of family and health center officers. While the factors inhibited lost to follow-up patient to get the retreatment were the side effects of treatment and the search for another treatment.

Conclusion : TB Treatment is one of the most efficient efforts to prevent the further spread of Tuberculosis. Therefore, that is necessary to cooperate with various programs related to optimizing the treatment of TB as well as to overcome the problem of lost to follow-up TB patients in the city of Serang."

"Hingga saat ini Tuberkulosis TB masih merupakan salah satu penyakit menular yang menjadi permasalahan di dunia kesehatan. Menurut data WHO pada tahun 2014 Indonesia merupakan peringkat ke-2 penyumbang kasus TB terbesar didunia dengan jumlah 9,6 juta kasus. Menurut data Riskesdas 2013 prevalensi TBdi Provinsi Banten yaitu 0,4 dari jumlah penduduk. Upaya pengendalian TB memerlukan peran serta masyaraat dan pasien yang perlu diberdayakan melalui paguyuban TB. Penelitian ini bertujuan mengetahui faktor-faktor yang berhubungan dengan tingkat kepatuhan pengobatan pasien TB terkonfirmasi bakteriologis di Puskesmas Unyur yang melaksanakan paguyuban TB dan Puskesmas Kilasah yang tidak melaksanakan paguyuban TB, Kota Serang tahun 2016. Penelitian ini menggunakan metode kuantitatif dengan desain studi cross sectional yang dilakukan selama bulan November 2016. Sampel penelitian ini berjumlah 79 pasien baru TB terkonfirmasi bakteriologis yang sedang menjalani pengobatan minimal 1 bulan di Puskesmas Unyur dan Puskesmas Kilasah. Hasil analisis univariat menunjukkan tingkat kepatuhan pengobatan pasien TB di Puskesmas Unyur lebih tinggi dari Puskesmas Kilasah. Hasil analisis menunjukkan bahwa ada hubungan yang bermakna antara tingkat pengetahuan dengan kepatuhan pengobatan pasien TB p = 0,024; OR = 10,3; 95 CI = 1,4 to77,8 . Variabel lainnya yang bermakna yaitu dukungan keluarga p = 0,023; OR =7,7; 95 CI = 1,3 to 44,5 . Selain itu juga didapat hasil bahwa dukungan keluarga merupakan faktor yang paling dominan berpengaruh terhadap kepatuhan pengobatan TB setelah dikontrol oleh variabel sikap, jarak, penyuluhan dan dukungan sosial. Kepatuhan Pengobatan merupakan kunci keberhasilan pengobatan TB yang menjadi tujuan utama dalam program pengendalian penyakit Tuberkulosis. Oleh karena itu perlu dilakukan upaya untuk meningkatkan peranserta masyarakat agar program pengendalian TB dapat lebih optimal.

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Until now Tuberculosis TB is one of the infectious diseases that has become problems in the health world. According to WHO 2014, Indonesia was ranked as the second largest contributor of TB cases in the world with 9,6 million cases. According to Riskesdas 2013, the prevalence of TB in Banten Province at 0,4 of the population. TB control efforts required participation of communities and patients through TB support groups paguyuban.

This study aimed todetermine the factors aasociates the treatment compliance level for new patients ofTB confirmed bacteriological in Community Health Center Puskesmas inUnyur TB support group and Kilasah Non TB support group , both in Serang City, 2016. This research used quantitative methods with cross sectional study design, conducted in November 2016. The research sample was 79 confirmed bacteriological TB patients who are under treatment minimum 1 month in Puskesmas Unyur and Kilasah. As the result, treatment compliance of TB patients in Puskesmas Unyur was higher than in Kilasah.

The analysis showed that there was a significant relationship between the level of knowledge with compliance treatment of TB patients p 0,024 OR 10,3 95 CI 1,4 to 77,8. Other significant variable was family support p 0,023 OR 7,7 95 CI 1,3 to44,5. In addition, the result was that the family support was the most dominant factor influencing TB treatment compliance after being controlled by variables, i.e.attitude, distance, counseling and social support. Treatment compliance was key for successful treatment of TB and became a major goal in Tuberculosis control programs. Therefore it is necessary for increase community participation to optimize the TB control programs."

"[Pada 1 Januari 2014 Negara Indonesia berupaya untuk mensejahterakanrakyatnya melalui Jaminan Kesehatan Nasional (JKN). Jaminan Kesehatan berupaperlindungan kesehatan agar peserta memperoleh manfaat pemeliharaan kesehatandan perlindungan dalam memenuhi kebutuhan dasar kesehatan. Dalam pelaksanaanpenyelenggraan jaminan kesehatan pada prinsipnya menggunakan konsep managedcare, yaitu suatu teknik yang mengintegrasikan pembiayaan dan pelayanankesehatan melalui penerapan kendali biaya dan kendali mutu dengan tujuanmengurangi biaya pelayanan yang tidak perlu melalui cara meningkatkan kelayakandan efisiensi pelayanan kesehatan.Penelitian ini bertujuan untuk mengetahui dan menganalisa gambaran polapemanfaatan pelayanan kesehatan bersumber dana kapitasi dan non kapitasi padaFKTP milik Pemerintah di Kabupaten Pandeglang. Penelitian ini merupakan studianalitik dengan desain cross sectional. Sampel sebanyak 615 pasien, merupakanpasien yang berkunjung ke FKTP milik Pemerintah di tiga wilayah Puskesmasterpilih.Hasil penelitian menunjukkan bahwa Proporsi peserta JKN yangmemanfaatkan pelayanan kesehatan di FKTP milik Pemerintah di KabupatenPandeglang adalah 47,3%, sebesar 52,7% dari yang memanfaatkan pelayanankesehatan merupakan bukan peserta JKN (pasien umum). Pemanfaatan pelayanankesehatan pada peserta JKN sebanyak 66,7% memanfaatkan jenis pelayanankesehatan yang dapat didanai oleh kapitasi dan 33,3% memanfaatkan jenispelayanan kesehatan yang dapat didanai oleh non kapitasi. Pada peserta JKNpemanfaatan jenis pelayanan kesehatan yang dapat didanai oleh non kapitasi lebihtinggi dibandingkan dengan bukan peserta JKN. Faktor – faktor yang berhubungandengan pemanfaatan jenis pelayanan kesehatan yang didanai kapitasi dan nonkapitasi di FKTP adalah status kesehatan, kepesertaan JKN, dan kemampuanmembayar.Disarankan dalam perumusan pembuatan kebijakan tingkat daerahdiharapkan dapat lebih memperhatikan acuan pelaksanaan ditingkat pusat, sehinggamanfaat pelayanan kesehatan bagi masyarakat tidak menjadi bias. Dalammenunjang Universal Coverage pada tahun 2019, mekanisme pendaftaran pesertaJKN diharapkan dapat menjadi bahan pokok bahasan penting di tingkatKementerian Kesehatan maupun BPJS sebagai pelaksana;On 1st January 2014, Indonesia tried to welfare its people by National HealthInsurance (JKN). National Health Insurance in the form of health protection forparticipants to obtain health care benefits and protection to meet basic health needs.Principle of health insurance implementation is using managed care principle,technique that integrates the funding and health care trough the implementation ofcost control and quality control with the aim of reducing the cost of needlessservices by improve the viability and efficiency of health care.This research aims for knowing and analysing the models of health careutilization which funded capitation and non-capitation in government primaryhealth facility of Pandeglang Regency. This research is an analytical study withcross sectional design. Amount of samples are 615 patients, those are visited togovernment primary health facility at the three areas selected health centers.The result of research show that national health insurance proportion ofparticipants who use the health care in government primary health facility ofPandeglang is 47.3%, and 52.7% of using health care is not participant of nationalhealth insurance. In health care utilization of national health insurance participantthere are 66,7% who use health care model of capitation and 33,3% who use healthcare model of non-capitation. In national health insurance participant of health careutilization with non-capitation model is higher than non-participant of nationalhealth insurance. Factors that related to the utilization of health care with fundedcapitation and non-capitation in primary health facility are health status,membership of national health insurance, and ability to pay.It is suggested in the formulation of policy-making in regional level isexpected to be more concerned with the reference implementation at central level,so the benefits of health care for the people will not be refraction. In supporting theUniversal Coverage in 2019, the registration mechanism of national healthinsurance participant is expected to be an important discussion at the HealthMinistry level and BPJS as executor, On 1st January 2014, Indonesia tried to welfare its people by National HealthInsurance (JKN). National Health Insurance in the form of health protection forparticipants to obtain health care benefits and protection to meet basic health needs.Principle of health insurance implementation is using managed care principle,technique that integrates the funding and health care trough the implementation ofcost control and quality control with the aim of reducing the cost of needlessservices by improve the viability and efficiency of health care.This research aims for knowing and analysing the models of health careutilization which funded capitation and non-capitation in government primaryhealth facility of Pandeglang Regency. This research is an analytical study withcross sectional design. Amount of samples are 615 patients, those are visited togovernment primary health facility at the three areas selected health centers.The result of research show that national health insurance proportion ofparticipants who use the health care in government primary health facility ofPandeglang is 47.3%, and 52.7% of using health care is not participant of nationalhealth insurance. In health care utilization of national health insurance participantthere are 66,7% who use health care model of capitation and 33,3% who use healthcare model of non-capitation. In national health insurance participant of health careutilization with non-capitation model is higher than non-participant of nationalhealth insurance. Factors that related to the utilization of health care with fundedcapitation and non-capitation in primary health facility are health status,membership of national health insurance, and ability to pay.It is suggested in the formulation of policy-making in regional level isexpected to be more concerned with the reference implementation at central level,so the benefits of health care for the people will not be refraction. In supporting theUniversal Coverage in 2019, the registration mechanism of national healthinsurance participant is expected to be an important discussion at the HealthMinistry level and BPJS as executor]"

"Mycobacterium tuberculosis dilepaskan oleh penderita saat batuk, bersin bahkan ketika berbicara. Durasi dan lamanya paparan kuman TB merupakan faktor penting dalam penularan, terutama pada ruangan tertutup. Maka, orang yang paling rentan tertular adalah kontak serumah penderita. Penelitian ini bertujuan untuk mengetahui hubungan perilaku dan kondisi lingkungan rumah terhadap adanya gejala TB pada kontak serumah penderita. Penelitian cross-sectional ini dilakukan dengan mewawancarai 73 penderita TB serta kontak serumahnya dan mengobservasi kondisi lingkungan rumahnya. Hasil penelitian ini menunjukkan adanya gejala TB pada kontak serumah dipengaruhi oleh penderita yang tidak menutup mulut saat batuk/bersin, membuang dahak sembarangan dan kontak serumah yang tidur di ruangan yang sama dengan penderita. Adapun kondisi rumah yang berpengaruh meliputi pencahayaan dan ventilasi yang tidak memenuhi syarat serta kepadatan hunian yang tinggi. Kesimpulannya, perilaku dan kondisi lingkungan rumah berkaitan dengan adanya gejala tuberkulosis pada kontak serumah. Agar tidak terjadi penularan pada kontak serumah, penderita dianjurkan untuk menggunakan masker, kontak serumah tidak boleh tidur bersama penderita. Pencahayaaan dan ventilasi rumah juga harus sesuai syarat rumah sehat untuk mencegah perkembangbiakan mikroorganisme di dalam rumah.

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Mycobacterium tuberculosis bacteria exhaled by patients when coughing, sneezing, even speaking. Duration and frequency of exposure is important factor of TB transmission, especially in closed room. Therefore, household contact of TB patient is susceptible. This research aimed to find out the influence of behavior and house environment condition to tuberculosis symptoms existence at household contact of TB patient. This cross sectional research collected data by interviewed 73 TB patients and their household contact. Then, observation the house environment conditions.

Results showed that TB symptoms at household contact was affected by patient behavior to covered mouth when coughing sneezing, disposed sputum carelessly and household contact behavior who slept in the same room with the patient. While, house condition that affect was not eligible lighting and ventilation, then high population density.

In conclusion, behavior and house environment condition was influenced the existence of TB symptoms at household contact. To avoid tuberculosis transmission, patients is suggested to wear mask and their household contacts should not sleep with them in the same room. Lighting and ventilation also have to comply healthy house requirement to prevent the proliferation of microorganisms in the house."