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Delay in diagnosis can lead to increased severity of the disease, increased the risk of death and the possibility of transmission of tuberculosis in the community. The objective of this study was to determine proportion and the length of delay in diagnosis and factors associated with the delay in diagnosis among pulmonary tuberculosis patient in Tebo Distric. This study design using cross sectional conducted in patients with tuberculosis who was treated at hospitals and health centers at Tebo District in 2018. The sample in this study amounted to 366 respondents. Multivariat analysis using a multivariate cox regression. The results showed that the proportion of diagnosis delay (> 28 days) was 63.93 %. Predisposing factors (age ≥ 45 years), enabling factors (first consulting Non- DOTS health care unit, high stigma and distance to the health care unit DOTS ≥ 30 minutes) and need factors (perception of the disease is not serious) are risk factors associated with the diagnostic delay. Necessary improving the quality of tuberculosis control programs, counseling tuberculosis so that people have the correct perception against tuberculosis and to reduce the negative stigma against tuberculosis, improving access to health care units DOTS and active case finding are vital to reduce diagnostic delay
Currently, Mycobacterium tuberculosis bacteria have infected about a quarter of the world's population that spreads through the air and Indonesia is one of the countries with a high burden of tuberculosis. 4 out of 6 provinces in Java are included in the 10 provinces with the highest prevalence of pulmonary TB, namely Banten, West Java, DKI Jakarta, and Central Java with the prevalence of pulmonary TB above 0.4 which is the Indonesian average. The purpose of this study was to determine the relationship between individual characteristics and environmental conditions with the incidence of pulmonary tuberculosis in the population aged 15 years in Java Island in 2018. The study design used was cross-sectional using Riskesdas 2018 data. used are 216,098 respondents. Data analysis used univariate and bivariate with chi-square test. The results of the bivariate analysis showed that the variables that had a statistically significant relationship with the incidence of pulmonary tuberculosis were gender, nutritional status, education level, smoking, number of family members, main room lighting, kitchen lighting, living room lighting, presence of main bedroom window, presence of kitchen windows, main bedroom ventilation, and kitchen. It is important to increase public knowledge related to the transmission and prevention of pulmonary tuberculosis, including providing education about the criteria for healthy homes, as well as increasing case finding surveillance by increasing the empowerment of health cadres.
Untuk menjamin keteraturan pengobatan tuberkulosis diperlukan Pengawas Menelan Obat. Seorang PMO sebaiknya seseorang yang dikenal, dipercaya dan disetujui baik oleh petugas kesehatan maupun penderita. PMO juga seseorang yang tinggal dekat dengan penderita, bersedia membantu penderita dengan sukarela dan bersedia dilatih dan atau mendapat penyuluhan bersama-sama dengan penderita. PMO bertugas untuk mengawasi penderita menelan obat secara teratur, memberi dorongan pada penderita agar mau berobat teratur, mengingatkan penderita untuk periksa ulang dahak, memberikan penyuluhan pada anggota keluarga penderita tuberkulosis yang mempunyai gejala-gejala tuberkulosis untuk memeriksakan diri ke unit pelayanan kesehatan. Beberapa penelitian mernperlihatkan bahwa peran PMO dalam pengobatan penyakit tuberkulosis paru meningkatkan keteraturan berobat. Pada Tahun 2005 di Kabupaten Sanggau 53% PMO berasal dari tenaga kesehatan, dan penelitian ini bertujuan untuk rnenilai kekuatan hubungan Status Pengawas Menelan Obat dengan keteraturan pengambilan obat penderita tuberkulosis paru di Kabupaten Sanggau - Kalimantan Barat tahun 2005 yang belum pernah diteliti. Untuk mengetahui gambaran besar variabel Status PMO mempengaruhi keteraturan pengambilan obat di Kabupaten Sanggau, rnaka digunakan desain historical cohort dengan jumlah responden sebanyak 270 orang. Responden merupakan penderita tuberkulosis paru tahun 2005 di Kabupaten Sanggau. Hasil penelitian rnenunjukkan perbedaan keteraturan pengambilan obat pada penderita tuberkulosis paru yang memiliki PMO berasal dari tenaga kesehatan dengan PMO bukan tenaga kesehatan. Besarnya nilai RR = 0,659 yang menunjukkan efek protektif, berarti penderita tuberkulosis paru yang mernilild PMO yang berasal bukan dari tenaga kesehatan lebih teratur mengarnbil obat dibandingkan penderita tuberkulosis yang memilild PMO tenaga kesehatan. Model akhir yang menerangkan hubungan status PMO dengan keteraturan mengarnbil obat = -7,074 - 0,435 (status PMO) + 2,587 {Pengetahuan Mengenai Ancarnan Tuberkulosis Paru) + 1,074 (Penyuluhan Mengenai Pengobatan Tuberkulosis Paru + 0,451 (Penyuluhan Mengenai Penularan Tuberkulosis Paru). Pengetahuan mengenai ancaman tuberkulosis paru, penyuluhan mengenai pengobatan tuberkulosis paru dan penyuluhan mengenai penularan tuberkulosis paru akan meningkatkan keteraturan mengambil obat. Pendekatan sosial budaya untuk menginterpensi pengobatan penyaldt tuberkulosis paru, dapat dilakukan dengan mernilih PMO yang berasal dari tokoh masyarakat maupun ketua adat mengingat masyarakat sangat patuh akan hukum adat Dayak dan hukum adat Melayu yang ada di Kabupaten Sanggau.
To ensure a good regulated tuberculosis treatment, a treatment observer must be needed. People who have access to TB Patients on a daily basis and who are accountable to the health services are the most appropriate persons to provide directly observed treatment. Treatment observer must be the persons who are accessible to the patients, take responsibilities of helping the patients and get proper health education with the patients. Treatment observer have duty to observe and disseminating messages to the patients to complete a full course of anti-TB treatment. Treatment observer must advice the patients and their families to checked their sputums to the health centre. Some researches showed that good treatment observers could increased good regulates took medicine. In Sanggau Distric, 2005 there were 53% of treatment observer recruired from health care workers, and the objective of this research is to acces the relationship between health care worker treatment observers and non health care worker treatment observers with the regulate took medicine for the lung tuberculosis patients in Sanggau District, West Kalimantan, 2005. It's use a historical cohort study design and 270 total samples. The respondens were the lung tuberculosis sufferers in Sanggau District, 2005. The result of this research showed that there was relationship between the regulate in taking medicine for health care worker treatment observers and non health care worker treatment observers. RR=0.659 show a protective effect, it means that the tuberculosis patient with non health care worker treatment observers more regulate took medicine then the health care workers treatment observer. The last model to showed the relationship of the treatmentohserver status with the regulate took medicine is: -7.074-0.435 (Treatment Observers Status) + 2.587 (knowledge of tuberculosis threat) + 1.074 (promotion of lung tuberculosis infection)+ 0.451 (promotion of the uncomplete drugs) Knowledge of the lung tuberculosis threat, the desseminating messages of uncomplete drugs and desseminating messages of lung tuberculosis infection will increase the regulate of took medicine. The conduction. of soc. ial cultur for interperated the cureness of lung tuberculosis could be used by recruit community base approach and social elits as treatment observers, however the strong culture of Dayak and Melayu has been integrated the community in Sanggau District.
TB paru merupakan masalah di Indonesia. Data Riskesdas 2010 menunjukkan, prevalensi TB Paru 2009/2010 sebesar 725/100.000 penduduk. Evaluasi hasil dilihat dengan angka konversi pada akhir pengobatan fase intensif sebesar 80%. Masalah utama kegagalan konversi adalah komponen perilaku penderita TB paru yaitu keterlambatan diagnosis dan tidak selesainya pengobatan yang berakibat resistensi ganda OAT. Penelitian ini menggunakan desain kasus kontrol, populasi sebanyak 1.305 adalah penderita TB paru pengobatan fase intensif tahun 2010 yang tercatat di formulir TB 01 puskesmas di Kabupaten Bekasi. Sampel diambil sebanyak 170 penderita, dikelompokkan menjadi gagal konversi sebanyak 200 penderita dan konversi sebanyak 1.105 penderita. Setiap kelompok diambil masing-masing 85 penderita. Data dikumpulkan dengan wawancara menggunakan kuesioner. Metode analisis data dengan uji Chi Square dan regresi logistik. Hasil penelitian menunjukkan responden tidak teratur minum obat lebih besar yang mengalami kegagalan konversi (74,1%) dibandingkan yang konversi (46,4%). Hasil uji Chi square ada hubungan yang bermakna antara keteraturan minum obat, sikap terhadap keteraturan minum obat, pengetahuan tentang TB, penyuluhan kesehatan, efek samping obat, dan status gizi dengan kegagalan konversi. Hasil uji statistik dengan regresi logistik menunjukkan faktor paling berhubungan dengan kegagalan konversi adalah status gizi OR: 4,705: 95% CI: 2,143-10,332. Status gizi penderita TB paru perlu ditingkatkan sebagai upaya bersama dengan pemberian OAT.
Pulmonary TB is a problem in Indonesia. Riskesdas 2010, the prevalence of pulmonary TB 2009/2010 for 725/100.000 population. Evaluation results conversion rate at the end of the intensive phase of treatment by 80%. The main problem is the conversion of a component failure behavior of patients with pulmonary TB is not the completion of delayed diagnosis and resulting treatment dual resistance OAT. Design study are casecontrol study. Population of 1305 patients with pulmonary TB is an intensive phase of treatment in 2010 are recorded in the TB form 01 health centers in the district of Bekasi. Samples were taken 170 patients, classified as many as 200 patients failed to convert and convert as many as 1.105 people. Each group of 85 patients taken at random. Data were collected by interview using a questionnaire. Methods of data analysis with chi square tests and logistic regression. The results showed respondents do not regularly drink more drugs that have failed conversion (74.1%) compared to the conversion (46.4%). Chi square test results there was a significant association between the regularity of drug taking, attitudes toward medication order, knowledge of TB, health education, medication side effects, and nutritional status with conversion failure. The results of statistical tests with logistic regression showed factors associated with failure of the conversion is the nutritional status OR: 4,705: 95% CI: 2,143-10,332. Nutritional status of patients with pulmonary TB needs to be improved as a joint effort with the provision of OAT.