Ditemukan 34602 dokumen yang sesuai dengan query :: Simpan CSV
Yudha Radityadana; Pembimbing: Lhuri Dwianti Rahmartani; Penguji: Putri Bungsu, Purwitasari, Dadan Hermawan
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Lost to follow up (LTFU) merupakan salah satu tantangan utama dalam program pengendalian tuberkulosis (TB) karena dapat meningkatkan risiko kegagalan pengobatan, kekambuhan, resistensi obat, dan penularan penyakit. Identifikasi determinan kejadian LTFU diperlukan untuk meningkatkan retensi pasien dan keberhasilan pengobatan TB. Penelitian ini menggunakan desain kohort retrospektif dengan memanfaatkan data sekunder pasien TB yang menjalani pengobatan di RSUD Majalaya periode tahun 2020–2025. Sebanyak 2.463 pasien memenuhi kriteria penelitian. Analisis dilakukan menggunakan metode Kaplan–Meier dan uji Log-rank untuk menyeleksi kandidat variabel, kemudian dilanjutkan dengan regresi Cox proportional hazards untuk mengidentifikasi determinan independen LTFU. Analisis sensitivitas dilakukan menggunakan complete case analysis pada variabel perokok pasif. Proporsi pasien TB yang mengalami LTFU sebesar 11,2%. Median waktu terjadinya LTFU adalah 168 hari sejak dimulainya pengobatan, dengan sebagian besar kejadian terjadi pada 56 hari pertama pengobatan (68,0%). Hasil analisis multivariat menunjukkan bahwa efek samping obat merupakan determinan independen terkuat kejadian LTFU. Pasien yang mengalami efek samping obat memiliki risiko mengalami LTFU sebesar 44,22 kali dibandingkan pasien yang tidak mengalami efek samping obat (aHR=44,22; 95%CI:33,67–58,09; p<0,001). Selain itu, pasien yang terpapar asap rokok pasif memiliki risiko mengalami LTFU 1,42 kali lebih tinggi dibandingkan pasien yang tidak terpapar (aHR=1,42; 95%CI:1,00–2,01; p=0,044). Analisis sensitivitas menunjukkan bahwa hubungan antara perokok pasif dan LTFU melemah setelah kategori data tidak diketahui dikeluarkan, sedangkan hubungan antara efek samping obat dan LTFU tetap konsisten. Dapat disimpulkan bahwa efek samping obat merupakan prediktor terkuat kejadian LTFU pada pasien TB, sedangkan paparan asap rokok pasif berpotensi menjadi faktor risiko yang memerlukan perhatian lebih lanjut. Upaya pencegahan LTFU perlu difokuskan pada deteksi dini dan penatalaksanaan efek samping obat, penguatan edukasi pasien dan keluarga, serta penciptaan lingkungan rumah bebas asap rokok untuk meningkatkan retensi pengobatan dan keberhasilan program pengendalian TB.
Loss to follow-up (LTFU) remains a major challenge in tuberculosis (TB) control programs because it increases the risk of treatment failure, disease recurrence, drug resistance, and ongoing transmission. Identifying determinants of LTFU is essential to improve patient retention and TB treatment outcomes. This retrospective cohort study used secondary data from TB patients who received treatment at Majalaya Regional General Hospital, Indonesia, between 2020 and 2025. A total of 2,463 patients met the study inclusion criteria. Kaplan–Meier analysis and the Log-rank test were used to identify candidate variables, followed by Cox proportional hazards regression to determine independent predictors of LTFU. Sensitivity analysis was performed using complete case analysis for the passive smoking variable. The proportion of TB patients who experienced LTFU was 11.2%. The median time to LTFU was 168 days after treatment initiation, with most events occurring within the first 56 days of treatment (68.0%). Multivariable analysis showed that adverse drug reactions were the strongest independent predictor of LTFU. Patients experiencing adverse drug reactions had a 44.22-fold higher risk of LTFU than those without adverse drug reactions (aHR=44.22; 95% CI:33.67–58.09; p<0.001). Passive smoking was also independently associated with LTFU, with exposed patients having a 1.42-fold higher risk than unexposed patients (aHR=1.42; 95% CI:1.00–2.01; p=0.044). Sensitivity analysis indicated that the association between passive smoking and LTFU weakened after excluding patients with unknown smoking exposure, whereas the association for adverse drug reactions remained robust. In conclusion, adverse drug reactions were the strongest predictor of LTFU among TB patients, while passive smoking may represent an important environmental risk factor requiring further investigation. Strategies to reduce LTFU should prioritize early detection and management of adverse drug reactions, strengthen patient and family education, and promote smoke-free home environments to improve treatment retention and TB program performance.
T-7597
Depok : FKM-UI, 2026
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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Gustia Arminda Siregar; Pembimbing: Nurhayati Adnan; Penguji: Putri Bungsu, Romauli
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Human Immunodeficiency Virus (HIV) masih menjadi masalah kesehatan masyarakat utama yang menyerang sistem kekebalan tubuh. Loss to follow-up pada pasien HIV/AIDS dapat meningkatkan kegagalan pengobatan baik klinis, imunologi, maupun virologi, meningkatkan morbiditas dan mortalitas, serta resisten terhadap terapi antiretroviral. Kejadian loss to follow-up pada pasien HIV/AIDS yang menjalani pengobatan ARV di Kota Medan sebesar 21% pada tahun 2021 dan mengalami peningkatan pada tahun 2022 menjadi 26%. Tujuan penelitian ini untuk mengetahui determinan loss to follow-up pada pasien HIV/AIDS yang menjalani pengobatan ARV di RSUD Dr. Pirngadi Medan Tahun 2018 – 2022. Desain studi penelitian ini adalah kohort retrospektif pada 383 pasien HIV/AIDS yang memulai pengobatan ARV di RSUD Dr. Pirngadi Medan tahun 2018 - 2022. Data yang digunakan adalah data sekunder meliputi SIHA, rekam medis, dan formulir ikhtisar follow-up perawatan pasien HIV dan terapi ARV. Proporsi pasien HIV/AIDS yang mengalami loss to follow-up sebesar 39,3% dan probabilitas loss to follow-up sebesar 52%. Pada analisis multivariat dengan cox proportional regression, usia > 30 tahun (aHR=1,4; 95% CI: 1,010-1,938) dan jumlah CD4 < 200 sel/mm3 (aHR=1,66; 95% CI: 1,184-2,331) secara signifikan merupakan faktor penyebab terjadinya loss to follow-up. Diperlukan peningkatan upaya pendampingan untuk menghindari terjadinya loss to follow-up terutama pada pasien usia lebih tua dan jumlah CD4 < 200 sel/mm3.
Human Immunodeficiency Virus (HIV) is still a major public health problem that attacks the immune system. Loss of follow-up in HIV/AIDS patients can increase clinical, immunological and virological treatment failure, increase morbidity and mortality, and become resistant to antiretroviral therapy. The incidence of loss to follow-up in HIV/AIDS patients undergoing ARV treatment in Medan City was 21% in 2021 and will increase in 2022 to 26%. The aim of this study was to determinants of loss to follow-up in HIV/AIDS patients on antiretroviral treatment at RSUD Dr. Pirngadi Medan 2018 – 2022. The study design of this research was a retrospective cohort of 383 HIV/AIDS patients who started ARV treatment at RSUD Dr. Pirngadi Medan 2018 - 2022. The data used is secondary data including SIHA, medical records, and an overview form of follow-up care for HIV patients and ARV therapy. The proportion of HIV/AIDS patients of loss to follow-up was 39.3% and the probability of loss to follow-up was 52%. In multivariable cox proportional regression analysis, age > 30 years (aHR=1,4; 95% CI: 1,010-1,938) and a low CD4 count (aHR=1,66; 95% CI: 1,184-2,331) were found to be a significant predictors of loss to follow-up. Increased assistance efforts are needed to avoid loss to follow-up, especially in patients who are older and have a CD4 count < 200 sel/mm3.
T-6962
Depok : FKM UI, 2024
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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Dora Herdiana; Pembimbing: Nurhayati Prihartono; Penguji: Ratna Djuwita, Heidy Agustin, Sulistyo
Abstrak:
Tingginya angka putus berobat merupakan masalah serius dalampengobatan TB karena memunculkan resistensi obat, meningkatkan kekambuhan,gagal pengobatan,dan berpotensi penularan yang menyebabkan peningkatanbeban dan transmisi TB. Sistem skoring faktor risiko untuk memprediksikesintasan putus berobat pada penderita TB belum banyak diteliti. Studi inibertujuan untuk mengetahui sistem skoring faktor prediktor kesintasan putusberobat penderita TB paru.Studi dilakukan pada April-Mei 2015 di poli DOTS RSUP Persahabatan,menggunakan desain cohort retrospective yang bersumber dari form TB 01 danrekam medis. Sampel sebanyak 370 dengan penderita putus berobat sebagai event,70 orang, penderita sembuh dan pengobatan lengkap sebagai sensor, 300 orang.Probabilitas kumulatif kesintasan putus berobat penderita TB adalah 81%. Hasilanalisis multivariat menemukan prediktor jenis kelamin, diagnosis TB, dan ambilobat sesuai jadwal yang berinteraksi dengan waktu mempunyai nilai p 0,043,0,008, 0,0001 berturut-turut, berisiko terhadap kesintasan putus berobat denganHR 1,7 (95%CI:1,02-2,99), 1,9 (95%CI:1,18-3,05) dan 32,7 (95%CI:14,78-72,18).Variabel mengambil obat sesuai jadwal semakin meningkat HR nya seiringmeningkatnya waktu pengamatan. Hasil skoring model akhir mampu memprediksikesintasan kejadian putus berobat penderita TB paru sebesar 92%, dan nilai cut-off untuk skor model skoring ≥21.Perlu meningkatkan KIE pada penderita secara efektif khususnyapenderita yang laki-laki, diagnosis TB BTA negatif dan mengambil obat tidaksesuai jadwal, meningkatkan jejaring internal maupun eksternal rumah sakit,untuk mengendalikan angka putus berobat TB.Kata Kunci: tuberculosis, putus berobat, kesintasan, skoring
Treatment default is a serious problem in tuberculosis control because itimplies resistance, increased relaps, failure, persistence of infectious source andfurther increased burden and transmission tuberculosis. Scoring system of defaultrisk factors to predict survival patients have been not studied yet, particularly inIndonesia. The aim of this study to determine the predictors scouring system ofsurvival defaulting treatment for tuberculosis patients.This retrospective cohort study was conducted from April to Mei 2013 atpoli DOTS RSUP Persahabatan. were identified from TB 01 forms and medicalrecords. Patients defaulting from treatment were considered as event and thosecure and completing treatment as censors. 370 tuberculosis patients wereincluded, 70 events and 300 censors. Overall patients survival rate was 81%.Survival defaulting associated significanly to sex, smear diagnosis and taking drugaccording to guideline with p value are 0,043, 0,008, 0,0001 respectively, found tobe risk factors for survival defaulting HR 1,7 (95%CI:1,02-2,99), HR 1,9;(95%CI:1,18-3.05), dan HR 32,7 (95%CI:14,78-72,18) respectively. IncreasingHR of taking drug according to guideline followed with increased alteration oftime observation. Scoring results are obtained predicting survival patientsdefaulting by 92%, and a cut-off point for the scoring model is ≥21.Communication, information and education must be increased das well asincreased internal and external hospital linkage to decrease default outcome.Keywords: tuberculosis, default, survival, scouring
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Treatment default is a serious problem in tuberculosis control because itimplies resistance, increased relaps, failure, persistence of infectious source andfurther increased burden and transmission tuberculosis. Scoring system of defaultrisk factors to predict survival patients have been not studied yet, particularly inIndonesia. The aim of this study to determine the predictors scouring system ofsurvival defaulting treatment for tuberculosis patients.This retrospective cohort study was conducted from April to Mei 2013 atpoli DOTS RSUP Persahabatan. were identified from TB 01 forms and medicalrecords. Patients defaulting from treatment were considered as event and thosecure and completing treatment as censors. 370 tuberculosis patients wereincluded, 70 events and 300 censors. Overall patients survival rate was 81%.Survival defaulting associated significanly to sex, smear diagnosis and taking drugaccording to guideline with p value are 0,043, 0,008, 0,0001 respectively, found tobe risk factors for survival defaulting HR 1,7 (95%CI:1,02-2,99), HR 1,9;(95%CI:1,18-3.05), dan HR 32,7 (95%CI:14,78-72,18) respectively. IncreasingHR of taking drug according to guideline followed with increased alteration oftime observation. Scoring results are obtained predicting survival patientsdefaulting by 92%, and a cut-off point for the scoring model is ≥21.Communication, information and education must be increased das well asincreased internal and external hospital linkage to decrease default outcome.Keywords: tuberculosis, default, survival, scouring
T4472
Depok : FKM-UI, 2015
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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Yogi Puji Rachmawan; Promotor: Nurhayati Adnan; Kopromotor: Helda, Bambang Budi Siswanto; Penguji: Ratna Djuwita, Sabarinah, Habibie Arifianto, Anggoro Budi Hartopo
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Gagal jantung adalah sindroma yang terjadi akibat kegagalan jantung untuk memenuhi kebutuhan oksigen dan nutrisi sel tubuh. Prevalensi dan angka kematian gagal jantung di Indonesia cukup tinggi bila dibanding negara Asia Tenggara lainnya. Gagal jantung pada usia muda akan meningkatkan risiko kematian, menyebabkan rehospitalisasi berulang, menurunkan kualitas hidup, serta meningkatkan beban sistem layanan kesehatan. Obesitas, (diabetes melitus tipe 2) DMT2, hipertensi, merokok, dislipidemia, riwayat keluarga dengan (prematurce coronary artery disease) PCAD, dan jenis kelamin diketahui berhubungan dengan terjadinya gagal jantung. Diperlukan sebuah model prediksi untuk menjelaskan faktor yang paling berpengaruh terhadap terjadinya gagal jantung pada usia muda, sehingga model prediksi tersebut dapat menjadi dasar upaya pencegahan terjadinya gagal jantung pada usia muda. Penelitian ini menggunakan desain fixed kohort-retrospektif yaitu pasien usia 18-54 tahun yang berobat di poliklinik jantung atau dirawat inap di 4 rumah sakit (RS) di Indonesia yaitu RS Harapan Kita Jakarta, RS Hasan Sadikin Bandung, RS Universitas Sebelas Maret (UNS) Solo, dan RS Adam Malik Medan pada tahun 2021 dan tidak terdiagnosis gagal jantung kemudian diambil data faktor risikonya sesuai variabel yang diteliti. Status pasien terdiagnosis gagal jantung atau tidak akan diikuti setiap bulannya sejak tahun 2021 hingga akhir pengamatan 2024. Kemudian dilakukan analisis deskriptif, bivariabel, dan multivariabel menggunakan Generalized Linear Model (GLM) Poisson untuk mendapatkan nilai koefisien, IRR (interval kepercayaan 95%), dan menyusun model prediksi yang paling tepat. Berdasarkan model, akan dibuat sistem skor dan nilai probabilitas terjadinya gagal jantung. Total 321 sampel penelitian yang memenuhi kriteria inklusi dan eksklusi, dengan median usia 51 tahun (P25-P75: 46-52 tahun). Pada observasi tahun ke-4, probabilitas kumulatif sebesar 0,713 (95% CI 0,661 – 0,760). Hasil analisis menunjukan 3 variabel utama yang signifikan berkaitan dengan risiko terjadinya gagal jantung di usia muda, yaitu obesitas (IRR 1,87; 95% CI 1,31 – 2,68), dislipidemia (IRR 2,58; 95% CI 1,87 – 3,56), dan DMT2 (IRR 2,79; 95% CI 2,01 – 3,87). Skor IMT-Dislipidemia-DMT2 (IDD) disusun sebagai sistem skor prediksi gagal jantung pada usia muda dengan total skor 13 (probabilitas 76,8%). Obesitas, dislipidemia, dan DMT2 merupakan faktor risiko yang berpengaruh signifikan, dan penggunaan sistem Skor IDD memiliki sensitivitas dan spesifisitas yang cukup baik dalam prediktor terjadinya gagal jantung pada usia muda.
Heart failure is a clinical syndrome that occurs when the heart fails to meet the body’s demand for oxygen and nutrients. The prevalence and mortality rate of heart failure in Indonesia are relatively high compared to other Southeast Asian countries. The occurrence of heart failure in young adults increases the risk of premature death, recurrent rehospitalization, reduced quality of life, and a greater burden on the healthcare system. Several factors such as obesity, type 2 diabetes mellitus (T2DM), hypertension, smoking, dyslipidemia, family history of premature coronary artery disease (PCAD), and sex have been identified as being associated with heart failure. Developing a predictive model to identify the most influential risk factors for heart failure in young adults is crucial for preventive strategies and early interventions. This study employed a fixed retrospective cohort design involving patients aged 18–54 years who visited the cardiology outpatient clinic or were hospitalized at four tertiary hospitals in Indonesia (National Cardiovascular Center Harapan Kita, Jakarta; Hasan Sadikin Hospital, Bandung; Sebelas Maret University Hospital, Solo; and Adam Malik Hospital, Medan) in 2021. Patients without an initial diagnosis of heart failure were included, and their risk factors were recorded according to the study variables. The patients were followed monthly from 2021 until the end of observation in 2024 to determine whether they developed heart failure. Descriptive, bivariate, and multivariable analyses were conducted using the Poisson Generalized Linear Model (GLM) to estimate coefficients, incidence rate ratios (IRR) with 95% confidence intervals, and to construct the most accurate predictive model. Based on the model, a scoring system and probability value for the occurrence of heart failure were developed. A total of 321 participants met the inclusion and exclusion criteria, with a median age of 51 years (P25–P75: 46–52 years). After four years of observation, the cumulative probability of developing heart failure was 0.713 (95% CI: 0.661–0.760). The analysis identified three significant predictors for heart failure in young adults: obesity (IRR 1.87; 95% CI 1.31–2.68), dyslipidemia (IRR 2.58; 95% CI 1.87–3.56), and T2DM (IRR 2.79; 95% CI 2.01–3.87). The IDD Score (Body Mass Index–Dyslipidemia–Diabetes) was developed as a predictive scoring system for heart failure in young adults, with a total score of 13 corresponding to a 76.8% probability. Obesity, dyslipidemia, and T2DM were found to be significant risk factors for heart failure in young adults. The proposed IDD Score demonstrated good sensitivity and specificity in predicting the occurrence of heart failure within this population.
D-600
Depok : FKM-UI, 2025
S3 - Disertasi Pusat Informasi Kesehatan Masyarakat
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Yesi Maria; Pembimbing; Syahrizal Syarif; Penguji; Renti Mahkota, Hyang Wreksagung
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Tenaga kesehatan berada pada garis terdepan yang menangani Covid-19 dalam memberikan pelayanan kesehatan untuk menanggulangi lonjakan kasus Covid-19 sehingga resiko paparan Covid-19 yang diterima jauh lebih besar daripada tenaga pelayanan umum lainnya. Penelitian ini bertujuan untuk mengetahui hubungan beban kerja dengan penularan covid-19 pada tenaga kesehatan. Desain penelitian ini adalah cross sectional dengan menggunakan data primer kuisioner dalam bentuk google form sebanyak 136 responden, Chi Square dan Cox Regression digunakan sebagai uji statistik pada penelitian ini . Sampel merupakan tenaga kesehatan yang bekerja di Rumah Sakit Umum Kabupaten Tangerang dengan kriteria inklusi masa kerja minimal satu tahun, tidak pernah terinfeksi covid-19 pada saat penelitian ini dilakukan , berusia 20 tahun keatas. Hasil menunjukkan proporsi tenaga kesehatan yang terinfeksi Covid-19 dengan beban kerja berlebihan sebesar 91,2 % .Besar asosiasi beban kerja dengan penularan covid-19 sebesar aPOR 1,192 kali [aPOR 1,192 (95% CI 0,824? 1,723)] tanpa dikontrol variabel confounding, dikarenakan tidak terdapat variabel yang confounding. Dapat disimpulkan bahwa beban kerja tidak memberikan efek yang signifikan terhadap penularan covid-19 pada tenaga kesehatan. Namun ,upaya dalam menurunkan penularan covid-19 pada tenaga kesehatan masih sangat dibutuhkan, salah satunya dengan memperkuat screening penerimaan pasien yang akan dirawat , mengevaluasi rasio antara jumlah pasien dengan ketersediaan tenaga kesehatan dan melakukan rotasi unit kerja untuk pemenuhan kapasitas tenaga kesehatan apabila diperlukan.
Health workers are at the forefront of handling Covid-19 in providing health services to overcome the surge in Covid-19 cases so that the risk of exposure to Covid-19 received is much greater than other public service workers. Because the risk is higher for infections, serious diseases, and even death, it will affect the service system in health care facilities if it is not adequately protected and it is feared that if cases of Covid-19 exposure to health workers will increase the surge in Covid-19 cases. Due to the increase in Covid-19 cases, it has a very big influence on hospitals, which in general where health workers work to provide health services with the aim of creating a sense of security and comfort to patients, it is hoped that they can consider all efforts and aspects in reducing the risk factors for transmission of Covid-19. Therefore, this study aims to determine the relationship between workload and covid-19 transmission in health workers. The design of this study is cross sectional using questionnaire primary data in the form of google form. The sample was a health worker who worked at the Tangerang Regency General Hospital with a work period of at least one year, had never been infected with covid-19 at the time this study was conducted, aged 20 years and above. The results showed the proportion of health workers infected with covid-19 with excessive workload of 91.2%. The magnitude of the workload association with covid-19 transmission was 9.979 times aPOR (95% CI 1,998-49.84 and p-value 0.005) after controlled confounding and covariate variables. It can be concluded that workload has a significant effect on the transmission of covid-19 in health workers. Efforts to reduce the transmission of covid-19 to health workers are still very much needed, one of which is by strengthening screening the admission of patients to be treated, evaluating the ratio between the number of patients and the availability of health workers and rotating work units to fulfill the capacity of health workers if needed.
T-6556
Depok : FKM UI, 2023
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
☉
Anggie Hardiyanti; Pembimbing: Helda; Penguji: Trisari Anggondowati, Sulistyo, Budi Setiawan
Abstrak:
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Loss to follow up (LTFU) menjadi kontributor utama ketidakberhasilan pengobatan tuberkulosis sensitif obat (TB SO) di Provinsi DKI Jakarta, dengan proporsi 14,2–14,4% pada periode 2023–2025, jauh di atas rata-rata nasional. Penelitian ini bertujuan menganalisis waktu kejadian LTFU, mengidentifikasi faktor-faktor yang berhubungan, dan membangun model prediksi risiko LTFU pada pasien TB SO di DKI Jakarta. Desain yang digunakan adalah kohort retrospektif berbasis data sekunder Sistem Informasi Tuberkulosis (SITB) Dinas Kesehatan Provinsi DKI Jakarta periode 1 Januari 2023–31 Desember 2025. Sampel akhir terdiri dari 110.493 pasien. Analisis waktu kejadian dilakukan menggunakan metode Kaplan-Meier, regresi Cox Proportional Hazards, dan Extended Cox Regression. Dari total sampel, 18.928 pasien (17,13%) mengalami LTFU, dengan median waktu kejadian LTFU pada hari ke-64 (IQR: 30–113). Hasil analisis multivariat menunjukkan bahwa faktor yang secara signifikan meningkatkan risiko LTFU adalah jenis kelamin laki-laki (aHR=1,403; 95%CI=1,359–1,449), riwayat pengobatan TB sebelumnya (aHR=1,301; 95%CI=1,232–1,374), status diabetes melitus (aHR=1,232; 95%CI=1,170–1,297), diagnosis klinis (aHR=1,093; 95%CI=1,058–1,128), regimen tidak sesuai standar (aHR=1,151; 95%CI=1,070–1,239), dan usia ≥45 tahun (aHR=1,056; 95%CI=1,024–1,088). Sebaliknya, status bekerja (aHR=0,833), pelajar (aHR=0,712), dan rujukan dari fasilitas lain (aHR=0,905) bersifat protektif. Pengobatan di puskesmas menunjukkan risiko LTFU lebih rendah dibandingkan rumah sakit pada 120 hari pertama (aHR=0,316). Kesimpulan penelitian ini menegaskan bahwa LTFU dipengaruhi oleh interaksi faktor sosiodemografi, klinis, dan layanan kesehatan. Periode 64–120 hari pertama merupakan waktu kritis yang memerlukan penguatan pemantauan dan intervensi berbasis risiko.
Loss to follow up (LTFU) remains the primary contributor to treatment failure in drug-susceptible tuberculosis (DS-TB) in DKI Jakarta, with a proportion of 14.2–14.4% during 2023–2025, substantially exceeding the national average. This study aimed to analyze the time-to-event of LTFU, identify associated risk factors, and develop an LTFU risk prediction model among DS-TB patients in DKI Jakarta. A retrospective cohort design was employed using secondary data from the Tuberculosis Information System (SITB) of the DKI Jakarta Provincial Health Office, covering January 1, 2023 to December 31, 2025. The final sample consisted of 110,493 patients. Time-to-event analyses were conducted using the Kaplan-Meier method, Cox Proportional Hazards regression, and Extended Cox Regression. Of the total sample, 18,928 patients (17.13%) experienced LTFU, with a median time-to-LTFU of day 64 (IQR: 30–113). Multivariate analysis identified the following significant predictors of LTFU: male sex (aHR=1.403; 95%CI=1.359–1.449), prior TB treatment history (aHR=1.301; 95%CI=1.232–1.374), diabetes mellitus comorbidity (aHR=1.232; 95%CI=1.170–1.297), clinical diagnosis (aHR=1.093; 95%CI=1.058–1.128), non-standard treatment regimen (aHR=1.151; 95%CI=1.070–1.239), and age ≥45 years (aHR=1.056; 95%CI=1.024–1.088). Conversely, employment (aHR=0.833), student status (aHR=0.712), and referral from another facility (aHR=0.905) were protective factors. Patients treated at primary health centers (puskesmas) had significantly lower LTFU risk compared to hospitals during the first 120 days (aHR=0.316). These findings confirm that LTFU is determined by the interaction of sociodemographic, clinical, and healthcare service factors. The first 64–120 days of treatment represent a critical window requiring intensified monitoring and risk-stratified intervention.
T-7669
Depok : FKM-UI, 2026
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
☉
Ius Suheryati; Pembimbing: Sujana Jatiputra
S-2682
Depok : FKM-UI, 2002
S1 - Skripsi Pusat Informasi Kesehatan Masyarakat
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Indarti Widyaningsih; Pembimbing: Sutanto Priyo Hastono; Penguji: Artha Prabawa, Santayana Daulay
S-10304
Depok : FKM-UI, 2020
S1 - Skripsi Pusat Informasi Kesehatan Masyarakat
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Chrisshanti Putri Pasaribu; Pembimbing: Putri Bungsu; Penguji: Renti Mahkota, Sulistyo, Yusie Permata
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Pada tahun 2023 mulai diimplementasikan regimen Bedaquiline, Pretomanid, Linezolid dengan atau tanpa Moxifloxacin (BPaL/M) sebagai regimen pengobatan tuberkulosis resisten obat (TBC RO) dengan durasi 6–9 bulan. Meskipun memiliki durasi pengobatan yang lebih singkat, data nasional tahun 2023–2025 menunjukkan bahwa 19,4% pasien masih mengalami ketidakberhasilan pengobatan dengan cure rate sebesar 69,1%. Penelitian ini bertujuan menganalisis faktor risiko ketidakberhasilan pengobatan pada pasien TBC RO yang menggunakan regimen BPaL/M berdasarkan tingkat beban TBC di Indonesia tahun 2023–2025. Penelitian ini menggunakan desain kohort retrospektif dengan data sekunder Sistem Informasi Tuberkulosis (SITB). Sebanyak 8.746 pasien yang memenuhi kriteria inklusi dan eksklusi dianalisis menggunakan cox regression dan extended cox regression pada variabel yang tidak memenuhi asumsi proportional hazards dengan titik potong 120 hari. Hasil penelitian secara nasional menunjukkan bahwa tidak mengalami konversi sputum merupakan faktor risiko terkuat terhadap ketidakberhasilan pengobatan (aHR = 12,23; 95%CI: 10,92–13,71), diikuti oleh ketidakpatuhan pengobatan setelah 120 hari (aHR = 5,50; 95%CI: 3,82–7,91), HIV positif (aHR = 1,98; 95%CI: 1,61–2,44), HIV tidak diketahui (aHR = 1,91; 95%CI: 1,50–2,44), usia ≥45 tahun pada ≤120 hari pengobatan (aHR = 1,75; 95%CI: 1,56–1,97), riwayat pengobatan TBC sebelumnya setelah 120 hari (aHR = 1,48; 95%CI: 1,24–1,77), pola resistensi MDR (aHR = 1,17; 95%CI: 1,06–1,29), dan efek samping obat setelah 120 hari (aHR = 1,27; 95%CI: 1,04–1,54). Sebaliknya, inisiasi pengobatan >7 hari merupakan faktor protektif terhadap ketidakberhasilan pengobatan (aHR = 0,78; 95%CI: 0,71–0,86). Diperlukan penguatan pemantauan pasien berisiko tinggi, peningkatan kepatuhan pengobatan, serta pengembangan early warning system bagi pasien yang tidak mengalami konversi sputum.
In 2023, the Bedaquiline, Pretomanid, and Linezolid regimen with or without Moxifloxacin (BPaL/M) was introduced as a treatment regimen for drug-resistant tuberculosis (DR-TB), with a treatment duration of 6–9 months. Despite its shorter treatment duration, national data from 2023–2025 showed that 19.4% of patients experienced unsuccessful treatment outcomes, with a cure rate of 69.1%. This study aimed to identify the risk factors for unsuccessful treatment outcomes among patients with DR-TB receiving the BPaL/M regimen across regions with low, medium, and high TB burden in Indonesia during 2023–2025. A retrospective cohort study was conducted using secondary data from the Tuberculosis Information System (SITB). A total of 8,746 patients who met the inclusion and exclusion criteria were analyzed using Cox proportional hazards regression and extended Cox regression for variables that violated the proportional hazards assumption, with a 120-day time cut-off. Nationally, sputum non-conversion was the strongest risk factor for unsuccessful treatment outcomes (aHR = 12.23; 95% CI: 10.92–13.71), followed by treatment non-adherence after 120 days (aHR = 5.50; 95% CI: 3.82–7.91), HIV-positive status (aHR = 1.98; 95% CI: 1.61–2.44), unknown HIV status (aHR = 1.91; 95% CI: 1.50–2.44), age ≥45 years during the first 120 days of treatment (aHR = 1.75; 95% CI: 1.56–1.97), previous TB treatment after 120 days (aHR = 1.48; 95% CI: 1.24–1.77), multidrug-resistant (MDR) resistance pattern (aHR = 1.17; 95% CI: 1.06–1.29), and adverse drug events after 120 days (aHR = 1.27; 95% CI: 1.04–1.54). In contrast, treatment initiation more than 7 days after diagnosis was identified as a protective factor (aHR = 0.78; 95% CI: 0.71–0.86). These findings highlight the need to strengthen the monitoring of high-risk patients, improve treatment adherence, and implement an early warning system for patients who fail to achieve sputum conversion
T-7648
Depok : FKM-UI, 2026
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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Rahimul Yakin; Pembimbing: Syahrizal Syarif; Penguji: Nurhayati Adnan, Renti Mahkota, Edi Setiawan Tehuteru
T-4896
Depok : FKM-UI, 2017
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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