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Metode : Penelitian ini menggunakan disain cross-sectional. Sebanyak 26.301 Penduduk 40-65 tahun menjadi sampel pada penelitian ini. Data diperoleh dari Mandat Litbangkes RI dan dianalisis menggunakan uji Regresi Logistik.
Hasil : Risiko TB Paru 4,8 kali lebih besar pada penduduk 40-65 tahun yang memiliki riwayat diabetes mellitus dibandingkan dengan tidak memiliki riwyat diabetes mellitus (POR=4,8 : 95% CI 2,2-10,6).
Kesimpulan : Kolaborasi antar layanan termasuk didalamnya skrining (Diabetes Mellitus dan TB Paru) diperlukan untuk mengurangi prevalensi dari kedua penyakit dengan didukung penyusunan peraturan/pedoman standard antar layanan di FKTP serta pertimbangan pemberian profilaksis PP INH pada penderita diabetes mellitus perlu dipertimbangkan
Introduction : Indonesia is the third rank of the highest number cases of tuberculosis. On average 90% of those infected with M and only 10% develop active tuberculosis after infection (WHO, 2018). Diabetes attacked 382 million in 2013 and will be predicted increase to 592 million by 2035. When diabetes spreads, it will cause more people infected tuberculosis (Lönnroth, 2014). The prevalence of diabetes mellitus increases with age, especially in populations over 40 years due to the development of glucose intolerance. Therefore, it is necessary to do research to determine the risk of diabetes mellitus against pulmonary tuberculosis in the population of 40-65 years by considering the contributory factors (potential confounder) which are also related to the prevalence of tuberculosis and diabetes mellitus.
Method: This study used cross-sectional design. Sample were 26,301 respondents of 40- 65 years. Data was obtained from the Indonesian Litbangkes and analyzed using the Logistic Regression.
Result : The risk of pulmonary TB was 4,8 times greater in the population of 40-65 years who had a history of diabetes mellitus compared to not having a diabetes mellitus (POR = 4,8 : 95% CI 2,2-10,6).
Conclusion : Collaboration both health services including screening (Diabetes Mellitus and Pulmonary TB) is needed to reduce the prevalence of both diseases and profilaxis program of PP INH need to be considered
Tuberkulosis (TBC) sampai saat ini masih menjadi masalah kesehatan di dunia. WHO melaporkan, di seluruh dunia setiap tahunnya ditemukan tidak kurang dari 8 juta kasus baru. Indonesia diantaranya merupakan negara penyumbang kasus TBC terbesar ketiga setelah India dan Cina. Diperkirakan jumlah kasus TBC di Indonesia pada tahun 2003 sebanyak 627.047 penderita, 281.946 diantaranya termasuk kategori TBC paru BTA positif. TBC paru BTA positif adalah jenis TBC yang sangat menular sehingga apabila tidak dilakukan pengobatan yang adequat dapat menularkan kepada 10-15 penderita baru dalam setahun. Risiko terjadinya penularan akan lebih tinggi pada orang yang dekat dengan sumber penular Kondisi lingkungan, status sosial ekonomi, gaya hidup, genetik dan adanya penyakit lain seperti diabetes, campak dan HIV merupakan faktor risiko yang selama ini diyakini berhubungan dengan kejadian tuberkulosis. Namun penelitian tentang faktor risiko tersebut di Indonesia masih jarang dilakukan. Ketersediaan data sekunder dari Survei Prevalensi TBC Nasional dan Survei Sosial Ekonomi Nasional Tahun 2004 (Susenas) yang terintegrasi, menarik minat penulis untuk memanfaatkan data ini untuk menganalisis beberapa faktor risiko TBC paru. Tujuan penelitian adalah untuk mengetahui hubungan kondisi lingkungan rumah, faktor sosial ekonomi dan faktor respon biologis terhadap kejadian TBC paru BTA positif pada penduduk dewasa di Indonesia. Penelitian ini memakai rancangan studi kasus kontrol tidak berpadanan, dengan menggunakan perbandingan kasus kontrol 1:4. Sampel penelitian adalah penduduk berumur 15 tahun keatas yang menjadi sampel Susenas 2004 dan dilakukan pemeriksaan sputum BTA pada Survei prevalensi TBC 2004. Jumlah sampel terpilih sebanyak 380 orang yang terdiri dari 76 kasus dan 304 kontrol. Penduduk yang berdasarkan pemeriksaan sputumnya menunjukan hasil BTA positif ditetapkan sebagai kasus. Sedangkan yang menjadi kontrol adalah penduduk yang sputumnya menunjukkan hasil BTA negatif dan berasal dari wilayah kecamatan yang sama dengan kasus. Kontrol dipilih secara acak. Untuk menguji hipotesis digunakan uji Kai Kuadrat dan untuk melihat derajat hubungan menggunakan nilai Odds Rasio dengan CI 95%. Berdasarkan basil penelitian ditemukan bahwa faktor-faktor yang berhubungan dengan kejadian TBC Pam BTA positif adalah keberadaan sumber kontak serumah OR 3,46 (1,316;9,091) kondisi rumah yang berlantai tanah OR 2,2 (1,135;4,269) dan pendapatan perkapita OR 2,145 (1,249;3,683). Berdasarkan temuan tersebut penulis menyarankan kepada pembuat kebijakan agar melaksanakan program khusus terhadap masyarakat golongan ekonomi rendah, terutama dalam hal program upaya penemuan penderita sedini mungkin, memberikan pengobatan secara cepat guna memutus rantai penularan, melaksanakan program active case finding dan untuk jangka panjang perlu dijalin kerjasama dengan lintas sektor terkait untuk melaksanakan program rumah sehat bagi kalangan masyarakat yang mempunyai status sosial ekonomi rendah.
Tuberculosis (TBC) is still become the word health problem. WHO reported that every year in the word has been founded not less than 8 millions of new cases. Indonesia is the third biggest countries which contribute TB cases after India and China. It is estimated the number of TB cases in Indonesia in the year 2003 was 627.047 infected, 282.946 among it was the category of pulmonary tuberculosis with smear positive. Pulmonary tuberculosis with smear positive is a kind of TB which is very infectious, so it should have adequate treatment, unless it will spread to 10-15 new patients within a year. The people who are close to the source of disease have the high risk to be infected. The environment condition, social economy status, life style, genetic and other disease such as diabetes, measles and HIV are believed has the relation with TB. But research about those risk factors in Indonesia is rarely done. The interest of the writer to analyze same risk factor of pulmonary TB is based on integrated of availability of secondary data from National TB Prevalence Survey (SPTBC) and National Social Economy Survey (Susenas) year 2004. The purpose of this research is to know the relation between the house environment condition, social economy factor and biologic response toward pulmonary TB with smear positive cases for adult in Indonesia. The research is using unmatched case control study, with comparison of 1 : 4 case and control. The sample of this research is the people of 15 years old and above, which was the sample of Susenas 2004 and was examined by sputum smear microscopy in SPTBC 2004 Survey. The number of chosen sample is about 380 person, consisting of 76 cases and 304 controls. The people whose sputum smear positive, decided as a case, but the people from the sputum smear negative decided as control. Control was chosen randomly. To test these hypotheses, chi square is used and to see the relation degrees of Odds Ratio with Cl 95% value is used. The research found that the factors which association with pulmonary TB smear positive is the availability of contact source in one house OR 3, 46 (1,316 ; 9,091), the condition of the house with soil floor OR 2.2 (1,135 ; 4,269) and private income OR 2,145 (1,249 ; 3,683). According to those finding, the writer advise to the policy maker to take special program for the people with low income, especially the program of finding the infected person as soon as possible to heal them with proper treatment. to cut the cycles of infections, to make program of active case finding program and for long term, there should be cooperation between other sector related to activate healthy house program for the people with low income.
Increased incidence of drug-resistant tuberculosis (DRTB) is a major public health problem in Indonesia. One of risk factors for the emergence of DRTB case is a high prevalence of type-2 diabetes mellitus (DM). The prevalence of type-2 DM in patients with DRTB is very high, ranging from 18.8% to 23.3%. This study aimed to determine relationship between type-2 DM and the incidence of DRTB in Malay community, Riau Province, in 2014-2018. The quantitative study design was case control in 251 cases (DRTB) and 502 controls (drug-sensitive tuberculosis / DSTB). Quantitative data were obtained from DRTB secondary data, namely Form 01.DRTB, Form 03.DRTB, medical records and electronic TB manager (e-TB manager); while, DSTB secondary data were obtained from DSTB Form.01, DSTB Form.03, medical records and Integrated Tuberculosis Information System. The independent variable was type-2 DM, and the covariate variables were age, sex, education, occupation, residence category, marital status, HIV status and previous TB treatment record. In supporting the quantitative study, qualitative study was conducted with life history approach using a small group discussion method and in-depth interview. Quantitative data were analysed with logistic regression. Quantitative study results showed that peoples with type-2 DM had a 2.27 times risk (95% CI: 1.58-3.27) to experience the incidence of DRTB if compared to peoples without type-2 DM after controlling for occupation, residence, marital status and previous TB treatment record. The results of qualitative study were to obtain a record of the incidence of type-2 DM that occurred earlier than the incidence of DRTB and to examine socio-cultural risk factors affecting the occurrence of DRTB in the Malay community, Riau Province. Possible socio-cultural risk factors associated with DRTB were habits of drinking sweet drinks, adherence to taking DRTB medicine, adherence to taking DM medicine, and the community of Mainland Malay
Tuberculosis is still a major cause of health problems and death in the worldwide. The prevalence of DM which continues to increase each year is estimated to be in 2045, there are 629 million people who will suffer from diabetes. This study aims to assess the association DM on TB treatment failure in TB patients in 2017-2019 in Indonesia. Method. This study was conducted using a retrospective cohort study design. The population and sample of this study were all drug-sensitive TB patients in Indonesia who started treatment in 2017-2019 and registered in the Integrated Tuberculosis Information System (SITT) that met the inclusion and exclusion criteria. Data analysis was performed using Cox Regression. Result. A total of 107036 TB patients were included in the analysis of 1,251,525 TB patients registered in 2017- 21019, of which 23388 (21.9%) TB DM patients. The characteristics of the majority of TB patients are aged 15-44 years (51.3%), male 59.8%, live in the district 58.8%, have positive sputum at the time of initial examination 64.8%, history of treatment new TB 94.09%, HIV negative (76.2%). Region of residence, baseline sputum examination, treatment history and HIV status were significantly associated with treatment failure. TBDM patients had 1.72 (95% CI; 1.51-1.95) times the risk of experiencing treatment failure than TBnonDM patients. The proportion of treatment failure of TBDM patients caused by the interaction of DM with treatment history is 50%. Multivariate analysis showed that the risk of treatment failure in TB DM ARR patients was 1.83 (95% CI; 1.6-2.09) compared with nonDM TB patients after being controlled by gender and sputum variables. Conclusion. DM increases the risk of treatment failure in TB patients so controlling blood sugar levels during treatment for TBDM patients is very necessary
