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Tuberculosis (TB) is communicable infection disease that still is problem in the world. TB can make people who affected with bacteria of TB dead. One of high-risk group of TB is prisoners. Recent researches show that prevalence of TB in prisons higher than prevalence of TB in public. This research then comes to find the relationship between status of HIV and Pulmo TB be stratificated based on individual factors, rooms occupy density, contact in cell, and behavior factors on prisoners in Lembaga Permasyarakatan Narkotika Kelas II A Jakarta on 2013. The research was done with cross-sectional design with 250 samples of prisoners who registered on 2013 and still is in Lembaga Permasyarakatan Narkotika Kelas II A Jakarta. It found that 6,2% respondents were have Pulmo TB. Based on bivariate analysis, the research also found that there are relationships between status of HIV with pulmo TB. After stratification, it show that relationship between status of HIV and pulmo TB have preference happen in respondent who having good Room occupy density, having contact in cell with patients of TB, or have been smokers in the past.
Sejak tahun 1993, WHO telah mencanangkan TB sebagai global emergency karena pada saat itu diketahui bahwa Mycobacterium zuberculosis telah menginfeksi sepertiga penduduk yang ada di dunia Indonesia telah berkomitmcn untuk menanggulangi TB dengan strategi DOTS yang direkornendasikan oleh WHO sejak tahun 1993. Sehingga Indonesia juga mengikuti target dunia yaitu Mlleniwn Development Goals (MDG) dimana bertujuan umuk menurunkan prevalensi dan kematian TB 50% pada tahun 2015 (WI-i0,2006) sehingga saiah sam upaya untuk pencapaian target tersebut dengan ekspansi DOTS ke Lapas/Rutan. Banyak pengalaman dari negara lain yang mengindikasikan permasalaban TB di penjara, dan masalah ini tidak banyak berbeda denyn simasi Lapas/Rutan di Indonesia. Terbukti dari hasil penelitian terdahulu bahwa prevalensi TB di Rutan DKI adalah 7.5 kali lebih besar daripada populasi umum, hal ini menandakan bahwa beban TB dengan segala kompleksitas lingkungan Lapas/Rutan yang burnk mempermudah berkembangnya mycabacterium iuberculosis. Dari hasil asesment Gorgas TB Initiative dan surveilans mtin di Dinkes DKI dan Dinkes Kota Bogor mengindikasikan bahwa insiden TB dau jumlah kasus cukup tinggi dan cendenmg meningkat. Serta diketahui dari hasii asesmen bahwa kepadatan hunian sel mendominasi hampir seluruh penjara Indonesia. Penelitian ini mcrupakan studi yang dilakukan di Lapas/Rutan menggunakan rancangan studi kasus kontrol, dimana kasus adalah kejadian TB Pam BTA(+) pada narapidana yang sudah terjadi pada saat penelitian dilakukan, kemudian dibandingkan dengan kelompok kontrol sebagai suspek TB, dimana basil laboratorium BTA-nya adalah negatifi Adapun kelompok paparannya adalah kepadatan hunian sel sebagai variabel utama, dengan kovariatnya yaitu umur, pendidikan, lama dipenjara, indelcs masa tubuh, kontak dalam sel, merokok, pencahayaan dalam sel, ventilasi dan kelembapan. Populasi pada studi ini adalah seluruh napi yang teregister pada TB 06 (pemeriksaan tersangka/ suspek TB) pada April 2007 sd April 2008. Sampel dalam penelitian dengan perbandingan 112, terdiri dari 66 kasus, dimanal4 kasus benasal dari Lapas Paledang, dan 52 kasus asa! Rutan Salemba. Sedangkan kontrol berjumlah 132, terdiri dari 28 kontrol dari Lapas Palednng dan 104 dari Rutan Salemba. Analisis Multivariat yang digunakan adalah Regression Logiszic Binomial, rmtuk mengetahui hubungan kepadatan hunian sel penjara dengan kovariatnya terhadap kej adian TB Paru BTA(-I-). Hasil penelitian ini memperlihatkan hubungan yang bermakna antara kepadatan hunian sel penjara dengan TB Paru, p value = 0.001 dengan OR: 3.l0l, (95% CI; 1,560 - 6.l63) tanpa interaksi, dan dengan 3 (tiga) variabel perancu yaitu merokok, lama dipenjara dan kontak dalam kamar. Dapat disimpulkan bahwa napi yang tinggal di Lapas/Rutan yang padat berisiko 3.101 kali untuk sakit TB dibanding napi yang tinggal di kamar/blok yang tidak padat. Sedangkan hasil analisis bivariat mendapatkan hubungan yang bermaluna antara kontak dalam sel, lama dipenjara dan pendidikan dengan kcjadian TB Pam BTA(+). Berdasarkan hasil studi ini, peneliti memberikan saran kepada instansi terkait yaitu Lapas/Rutan tempat populasi penelitian diambil agar Lapas/Rutan mengurangi kepadatan. Bila sulit dilakukan maka memisahkan napi yang TB selama pengobatan fase intensif serta melakukan evaluasi triwulanan napi yang tersangka TB namun hasil pemeriksaan laboratorium dahaknya masih negatifi Bagi Dinkes Kota Bogor dan Sudinkes Jakarta Pusat, diharapkan dapat membuat jejaring dengan Lapas/ Rutan setempat dan memfokuskan untuk mengurangi dampak penularan Lapas/ Rutan serta membcrikan infonnasi tentang dampak merokok bagi kesehatan. Bagi Depkes dan Ditjen Pemasyarakatan agar mcngintensiikan program TB dengan program Lapas/Rutan sehat fokus perbaikan lingkungan fisik dan memperkuat strategi pcnanggulangan TB di Lapas/Rutan. Sedangkan saran bagi keilmuan dan penciiiian lanjutan agar memperkuat power penelitian dan menggunakan desain yang lebih baik (kohort retrospek1y'atau prospelctgj), serta meneliti insiden akibat kontak dalam sel dan risiko lama dipenjara.
Since 1993, WHO has determined TB as a global emergency because for that year it has been discovered that Mycobacterium tuberculosis has infected one third of population in the world. Indonesia has committed to prevent TB with DOTS strategy recommended by WHO since 1993. Subsequently Indonesia also carried out world target of Millenium Development Goals (MDG) aimed to decrease prevalence and mortality of TB 50% on 2015 (WHO, 2006) one of way to reach it is expansion of DOTS to jail. Many incidents hom another countries indicating problems of TB in jail, and it is not great diiTer from jail situation in Indonesia Previous result of research proved that TB prevalence in DKI is 7,5 times bigger than other population generally, this things indicates TB with kind of it’s had environment complexity of jail simplified spreading of mycobacterium tuberculosis. From the result of assessment Gorges TB Initiative and continue surveillances in Dinkes DKI and Dinlces Bogor indicating of TB incident and a high number of case and tends to increase. The density of jail’s room dwelling found in almost all of jail in Indonesia according to result of assessment. This research is study taken in jail using control case study, while the case is about incident of Lung TB at criminal had suffered in the time of research, compared with control group as TB suspect then, laboratory result showed their smear negative. The group of subjects are density of room dwelling as major variable, with age, education, occupation time in jail, body mass index, smoking, lighting in room’s jail, ventilation and humidity as covariate. Population in this study is all of registered prisoners at TB 06 (investigation of TB suspected) on April 2007 - April 2008. Study sample 1:2 proportionally consisted of 66 cases, 14 cases from Lapas Paledang, and 52 cases from Rutan Salemba. While control amount of 132, consist of 28 controls from Lapas Paledang and 104 from Rutan Salemba. Regression Logistic Binomial is used for xnultivariat analysis, to iind correlation density of room’s jail dwelling forward covariate to case of Lung TB. Result of this study shows signiiicant density of room’s jail dwelling with Lung TB, p value = 0.001 with OR : 3.101 (95% CI; 1.560-6.163) without intervention of interaction and 3 other variables confounding are smoking, occupation time in jail and contact with TB active in room’s jail. It is concluded that prisoners who occupied in density jail more risk 3.101 times get TB than jail with less density. While result of bivariat analysis has significant correlation between contact with TB active, occupation time in jail and education with Lung TB. Based on this study, researcher suggest to related institution in this case jail as place of population research to diminish a number of prisoners in their jail in order to handle over capacity problem. If it is hard to do then another way is by separating TB patient in intensive treatment phase and have an evaluation quarterly for suspected prisoners of TB yet result of laboratory investigation showed smear negative. It is expected for Dinkes Bogor and Sudinkes DKI Jakarta to make a great networking with regional jail, focus on decrease infection impact in jail and give an information about smoking effect for health. improvement of logistic supplies. Depkes and Ditjen Pemasyarakatan should intensity TB program with healthy jail program focusing on recondition physical environment and reinforce preventive strategic of TB in jail. Suggestion in science section and for the next study to be more powerful in it’s research and using better design of research (cohort retrospective or prospective), and also study the effect incident of interaction and occupation time in jail.
Malaria merupakan masalah kesehatan dunia termasuk Indonesia karena mengakibatkan dampak yang luas dan berpeluang menjadi penyakit emerging dan re-emerging. Di Wilayah South East Asian Region (SEARO) yang Indonesia menjadi salah satu negara anggotanya, malaria merupakan masalah kesehatan masyarakat yang utama. Data Kasus Baru malaria tahun 2009/2010 di seluruh Indonesia berdasarkan Riset Kesehatan Dasar (Riskesdas) 2010 adalah 22,9 per mil, sedangkan di Provinsi Sulawesi Utara (61,7?).
Penelitian ini menggunakan desain cross sectional yang bertujuan untuk memperoleh gambaran karakteristik individu, faktor lingkungan dan perilaku yang berhubungan dengan kejadian malaria klinis di Provinsi Sulawesi Utara 2010. Penelitian dengan studi kuantitatif melibatkan 2272 subyek penelitian yang diperoleh data dari Riskesdas 2010, dengan jumlah kejadian malaria klinis sebanyak 408 subyek. Dari 20 variabel yang dianalisis multivariat di Provinsi Sulawesi Utara didapatkan ada 6 variabel yang berhubungan secara signifikan yaitu : pendidikan : OR = 2,04 (95% CI : 1,59 ? 2,62) dengan p value = 0,000, rawa-rawa : OR = 1,57 (95% CI : 1,10 ? 2,25), dengan p value = 0,014, pantai : OR= 0,49 (95% CI : 0,31 ? 078) dengan p value = 0,003, perkebunan : OR = 1,58 (95% CI : 1,25 ? 2,00) dengan p value = 0,000, tidur menggunakan kelambu : OR = 0,59 (95% CI : 0,41 ? 0,85) dengan p value = 0,005 dan memakai obat nyamuk bakar/elektrik : OR = 0,59 (95% CI : 0,45 - 0,78) dengan p value = 0,000.
Analisis juga dilakukan pada 8 Kabupaten dan 4 Kota di provinsi Sulawesi Utara dan hasilnya ada 4 Kabupaten dan 2 Kota yang sebagian variabel mempunyai hubungan signifikan dengan kejadian malaria klinis yaitu : Kabupaten Kepulauan Talaud, Kabupaten Minahasa, Kabupaten Kepulauan Sangihe, Kota Manado, Kota Tomohon dan Kabupaten Minahasa Utara.
Disarankan kepada masyarakat yang tinggal di sekitar rawa-rawa, pantai dan perkebunan hendaknya selalu menjaga kebersihan lingkungan serta memakai obat nyamuk bakar/elektrik. Untuk Dinas Kesehatan Provinsi Sulawesi Utara pelaksanakan program "Gebrak Malaria" hendaknya lebih diintensifkan dan melibatkan seluruh lapisan masyarat. Untuk peneliti lain supaya dapat melakukan penelitian yang lebih mendalam tentang Malaria atau Malaria Klinis di daerah endemis malaria di Provinsi lain dengan menggunakan data hasil Riskesdas 2010 atau data terbaru di wilayah tersebut.
Malaria is a global health problem, including Indonesia, because it resulted in a broad impact and may appear and re-emerging diseases. Regional Southeast Asia Region (SEARO) and Indonesia became one of its member countries, malaria is a major public health problem. The new malaria cases in 2009/2010 Data for Health Research in Indonesia based on the Basic (Riskesdas) 2010 is 22.9 per mile, whereas in the Province of North Sulawesi (61.7 ?).
This study uses cross sectional design which aims to obtain a picture of individual characteristics, environmental factors and behaviors associated with the incidence of clinical malaria in North Sulawesi province in 2010. Research with quantitative studies involving 2272 subjects who obtained the data from Riskesdas 2010, with the incidence of clinical malaria as much as 408 subjects. Of the 20 variables in the multivariate analysis of the North Sulawesi province to find there are six significant variables related to: Education: OR = 2.04 (95% CI: 1.59 to 2.62) with p-value = 0.000, bog: OR = 1, 57 (95% CI: 1.10 to 2.25), with a p-value = 0.014, coast: OR = 0.49 (95% CI: 0.31 to 078) with a p-value = 0.003, plantations: OR = 1 , 58 (95% CI: 1.25 to 2.00) with p-value = 0.000, using mosquito nets to sleep: OR = (95% CI: 0.41 to 0.85) 0.59 with a p-value = 0.005 and use mosquito repellent/electric: OR = 0.59 (95% CI: 0.45 to 0.78) with p-value = 0.000.
The analysis was also conducted in eight counties and four cities in the province of North Sulawesi and the results there are four counties and two cities that some variables have a significant relationship with the incidence of clinical malaria namely: Talaud Islands, Minahasa, Sangihe Regency, Manado, Minahasa regency Tomohon and north.
It is recommended for people who live in the vicinity, the coast marshes and plantations should always keep the environment clean and using mosquito repellent / electric. For the North Sulawesi Provincial Health Office, the implementation of "Gebrak Malaria" program should be improved and involve all layers masyarat. For other researchers to conduct more in-depth research on Malaria, Clinical malaria or malaria in endemic areas in other provinces using data from Riskesdas 2010 or latest data in the region.
Proportion of TB cases child reaches 10.45% (MOH, 2011). The percentage of visits to cases of TB in infants increased from 28.9% in 2009 to 34% in 2010 of all visits TB.Penelitian cases aims to determine the relationship of contact factors, the characteristics of toddlers and parents with the incidence of pulmonary tuberculosis in infants RSPI Prof Dr Sulianti Saroso in 2012.
Hasil analisis menunjukkan bahwa jenis atap (OR: 2,79; 95% CI: 1,36-5,69), ventilasi (OR: 2,60; 95%CI: 1,39-4,84), kepadatan hunian (OR: 2,14; 95% CI: 1,07-4,28), dan asap bahan bakar memasak(OR: 4,14; 95% CI: 1,56-10,9) memiliki hubungan yang kuat terhadap ISPA. Jadi, ada hubunganantara kondisi rumah, kepadatan hunian dan pajanan asap terhadap kejadian ISPA pada Balitasetelah dikontrol oleh variabel kovariat.
Kata kunci:ISPA, Faktor Lingkungan, Balita, Kebakaran Hutan
A national TB control program using the DOTS strategy (Directly Observed Treatment Shortcourse) has been implemented since 1995. Nationally, the DOTS strategy has provided changes although not yet comprehensively. The above conditions are exacerbated by the emergence of new problem, such as the incidence of TB-HIV. Type of patient and TB-HIV co-infection is a risk factor to default of anti tuberculosis drugs on positive smear pulmonary tuberculosis patient. The purpose research is to know relation between patient type and TB- HIV co-infection default of treatment for positive smear pulmonary tuberculosis patients in East Jakarta. The design of case control research, conducted observation on the patient of smear positive pulmonary tuberculosis in East Jakarta. Multivariate analysis with logistic regression. The result of anti tuberculosis drugs of the research showed significant correlation between TB-HIV co-infection with default with smear positive pulmonary tuberculosis patient with aOR 19,27 after controlled sex and drug administer superviser statue (p value = 0,006; 95% CI: 2,36-157.21). The presence of HIV infection simultaneously with TB infection is increasingly threatening survival so that adequate therapy is needed to control the virus and kill the bacteria mycobacterium tuberculosis. HIV screening of tuberculosis patients should be intensified for an adequate treatment regimen through a TB-HIV collaboration program so that people can recover from TB infection. Key Word : patient, co-infection TB-HIV, positive BTA
