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TB problems in Indonesia are TB sensitive, Drug-Resistant TB and TB-HIV. TB-RO is the most challengging problem, the number of case finding is increase every year, but treatment rate is decrease. The use of short-term regiment since September 2017 is one of strategy to reduce default of TB treatment. This research was conducted to see trends and factors related to the TB treatment success rate among patients with Drug Resistance TB (TB RO) using Shorter Treatment Regiment (STR) in Indonesia 2017-2019. The study desain is restropective cohort. Data sources are all patients of TB RO using STR regiment, which is enrolled in the e-TB manager, Sud Directorate of Tuberculosis, MoH RI. The sampling method is total sampling that meets the inclusion and exclusion criteria. The analysis used was the chi-square test and the cox regression test. As many as 3,100 patients were included in the analysis, the treatment success rate was 41,94%. The results of the analysis showed that factors related to treatment success were age, adherence, results of initial sputum examination of treatment, patterns of monoresistant and polyresistant resistance, and area of residence. Adherence is a dominant factor related to treatment success. Efforts should be made to strengthen compliance by conducting counseling as early as possible, PMO assistants from non-helath officers and initiating patient support groups in each MDR facility
Tuberkulosis sensitif obat (TB SO) salah satu penyakit infeksius penyebab kematian utama dunia. Terjadi peningkatan kematian pasien TB SO di Provinsi DKI Jakarta. Tujuan : Tujuan penelitian ini adalah untuk mengetahui pengaruh faktor usia, jenis kelamin, status bekerja, klasifikasi lokasi anatomi, klasifikasi riwayat pengobatan, komorbid DM, dan status HIV dengan kematian pasien TB SO selama masa pengobatan di Provinsi DKI Jakarta. Metode : Desain studi penelitian ini adalah kohort retrospektif dengan metode analisis survival Kaplan meier. Hasil : Hasil menunjukkan proporsi kematian pasien sebesar 4,5% dengan probabilitas kesintasan mencapai 90,1%. Faktor yang terbukti berpengaruh terhadap kematian pasien adalah usia >40 tahun (Hazard Ratio (HR) 2,3; 95% Confidence Interval (95% CI) 1,925-2,629), jenis kelamin laki-laki (HR 1,2; 95% CI 1,047-1,396), pasien kambuh dan lainnya (HR 2,8; 95% CI 2,351-3,339), memiliki komorbid DM (HR 1,4; 95% CI 1,159-1,598), dan status positif HIV (HR 4,7; 95% CI 3,879-5,623). Kesimpulan : Faktor usia, jenis kelamin, riwayat pengobatan, komorbid DM, dan status HIV merupakan faktor kematian pasien TB SO di Provinsi DKI Jakarta. Saran berupa dilakukan audit penyebab kematian dan peningkatan standar prosedur layanan oleh pihak Dinas Kesehatan Provinsi direkomendasikan.
Drug-sensitive tuberculosis (TB SO) is one of the world's leading causes of death. There has been an increase in the deaths of TB SO patients in DKI Jakarta Province. Objective: This study aimed to determine the influence of age, gender, work status, anatomical location classification, treatment history classification, DM comorbidities, and HIV status on the death of TB SO patients during the treatment period in DKI Jakarta Province. Methods: The study design of this research was a retrospective cohort with the Kaplan-Meier survival analysis method. Results: The results showed that the proportion of patient deaths was 4.5% with survival probability was 90.1%. Factors of death were age >40 years (Hazard Ratio (HR) 2.3; 95% Confidence Interval (95% CI) 1.925-2.629), male gender (HR 1.2; 95% CI 1.047-1.396), patient relapse and others ( HR 2.8; 95% CI 2.351-3.339), having comorbid DM (HR 1.4; 95% CI 1.159-1.598), and HIV positive (HR 4.7; 95% CI 3.879-5.623). Conclusion: Age, gender, treatment history, comorbid DM, and HIV status are death factors of TB SO patients in DKI Jakarta Province. Suggestions in the form of an audit of the causes of death and improving standard service procedures by the Provincial Health Service are recommended.
Kata kunci: hasil pengobatan; pengobatan jangka pendek; TB RO
The case of drug-resistant tuberculosis causes the burden of controlling TB disease to increase. The decline in treatment success rates from 2010 (67.9%) to 51.1% in 2013 and an increase in cases of patients dropped out encouraged Indonesia to apply shortterm treatment to increase the success rate of DR-TB treatment and reduce cases of patients dropped out. This study aims to look the results of DR-TB treatment and factors related to treatment outcomes for short regimens in Indonesia in 2017 using a retrospective cohort study design. Using data on DR-TB patients recorded in the e-TB manager aged ≥15 years who have completed treatment for the maximum short regimen in November 2018. There were 223 cases with 46.6% cured, 26.5% dropped out, 4.9% completed, 14.2 died, 6.3% failed and 1.3% others.. Age, gender, previous treatment history, type of resistance, HIV status, DM status and lung cavity status were not statistically related to the results of treatment of short regimens. Factors related to the results of treatment of short regimens were resistant to amikacin (RR 7.4; 95% CI 4.68-17.29), ofloxacin (RR 28; 95% CI 2.8-279.5), kanamycin (RR 9; 95% CI 4.68- 17.29), and treatment initiation interval >7 days (RR 0.307; CI 0.09-0.98).
Key words: treatment outcomes; short-term treatment; DR-TB
