[Latar belakang. Tuberkulosis (TB) ekstra paru merupakan penyakit yang banyak ditemukan diIndonesia, disamping TB paru. Belum banyak penelitian mengenai TB ekstra paru di Indonesia,khususnya keberhasilan terapi TB ekstra paru dengan menggunakan strategi DOTS. Belumdidapatkan laporan penelitian mengenai faktor prediktor yang mempengaruhi keberhasilan terapiTB ekstra paru dengan menggunakan strategi DOTS di Indonesia.Tujuan. Mengetahui faktor prediktor keberhasilan terapi tuberkulosis ekstra paru seperti usia,jenis kelamin, diabetes mellitus, HIV dan riwayat antituberkulosis. Mengetahui tingkatkeberhasilan terapi TB ekstra paru dengan menggunakan strategi DOTS, bila diberikan selamaminimum 9 bulan.Hasil. Penelitian kohort retrospektif dengan data register DOTS TB dan data rekam medis dari 1Januari 2008 sampai 31 Desember 2012. Didapat 542 pasien TB ekstra paru, 279 pasien TBkombinasi ekstra paru dan TB paru, 70 pasien data tidak lengkap, dan hanya 193 pasien TBekstra paru murni. Mayoritas pasien berjenis kelamin perempuan (52,3%). Umumnya usia muda(18-60 tahun (95.9%)), rerata 31,34 + 11,64 tahun. TB ekstra paru yang paling banyak didapatadalah limfadenitis TB. Keberhasilan terapi TB ekstra paru pada usia 18-60 tahun terjadi pada49,7% pasien (OR 2,968, 95% CI 0,584-15,087, p 0,313). Keberhasilan terapi TB ekstra paruuntuk jenis kelamin perempuan didapat 55,4% pasien (OR 1,768, 95% CI 0,999-3,131, p0,05).Keberhasilan terapi TB ekstra paru pada pasien diabetes mellitus 33,3% (OR 1.957, 95% CI0.475-8.062, p 0,546) dan pada riwayat TB sebelumnya sekitar 55,6% (OR 0.738, 95% CI 0.278-1.959, p 0,717). Keberhasilan terapi TB ekstra paru pada pasien HIV 32,1% (OR 2.588, 95% CI1.330-5.038, p 0,007). Pada analisis multivariate, keberhasilan terapi TB ekstra paru dengan faktor koinfeksiHIV, OR 2.588, CI 95% 1.330-5.038, p 0,005. TB ekstra paru pada pasien HIV mempunyaikeberhasilan terapi rendah dengan menggunakan strategi DOTS dan berhubungan dengan kegagalanterapi, serta prognosis buruk. Angka keberhasilan TB ekstra paru yang diterapi dengan menggunakanstrategi DOTS selama < 9 bulan adalah 20,2%. Sebanyak 94,6% pasien TB ekstra paru berhasil diterapidengan menggunakan strategi DOTS selama > 9 bulan.Kesimpulan. HIV merupakan faktor prediktor yang dapat menurunkan keberhasilan terapi TBekstra paru dengan menggunakan strategi DOTS. Tingkat keberhasilan terapi TB ekstra paruyang menggunakan strategi DOTS selama minimum 9 bulan baik (94,6%)., Background. Extrapulmonary tuberculosis (EPTB) is common presentation found in Indonesia,besides Tuberculosis (TB). We found that no more research about EPTB in Indonesia, especiallyEPTB success treatment using the DOTS strategy and its predictor factors.Aims. To determine predictors of TB treatment success factors such as age, sex, diabetesmellitus, HIV and anti-tuberculosis records. To acknowledge the success rate of EPTB treatmentusing DOTS strategy, when administered for a minimum of 9 months.Result. A retrospective cohort study was conducted from 1 January 2008 through 31 December2012. A total of 542 patients of EPTB were identified, 193 patients were pure EPTB while 279were mixed ones and 70 were incomplete data. The majority of patients were female (52.3%).Generally young age (18-60 years old (95.9%), mean 31,34 + 11,64 years old. The mostcommon type of EPTB were lymph node. Success treatment rate of EPTB among age of 18-60years was 49.7% (OR 2.968, 95% CI 0.584 to 15.087, p 0.313). Success treatment rate of EPTBamong female sex was 55.4% (OR 1.768, 95% CI 0.999 to 3.131, p0,05). Success treatment rateusing DOTS strategy among diabetes mellitus was 33,3% (OR 1.957, 95% CI 0.475-8.062, p0.546) and the one that had tuberculosis record previously was 55,6% (OR 0.738, 95% CI 0.278-1.959, p 0.717) Success treatment rate in extrapulmonary patient among HIV-seropositive was32,1% (OR 2.588, 95% CI 1.330-5.038, p 0.007). In multivariate analysis, the success rate forEPTB with HIV co-infection factor, had OR 2.588, CI 95% 1.330-5.038, p 0.005. EPTB amongHIV-seropositive patients had lower therapy success rate using DOTS strategy and wereassociated with unsuccessful therapy and poor prognosis. The success rate of EPTB treatmentusing DOTS strategy for < 9 months was 20.2%. There were 94.6% EPTB patientssuccessfully treated with the DOTS strategy for > 9 months.Conclusion. HIV was a predictor factor that may decrease therapy success rate of EPTB usingDOTS strategy. Success rate of extrapulmonary TB treatment using DOTS strategy for minimum9 months was good (94,6%).] |