Abstrak:

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.

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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.

Abstrak: Program penanggulangan TB nasional menggunakan strategi DOTS (Directly Observed Treatment Shortcourse) telah dilaksanakan sejak tahun 1995. Secara nasional strategi DOTS telah memberikan perubahan meskipun belum secara komprehensif. Kondisi diatas diperparah dengan munculnya masalah baru, diantaranya adalah kejadian TB-HIV. Tipe penderita dan ko-infeksi TB-HIV menjadi faktor risiko terjadinya putus berobat OAT pada penderita TB Paru BTA Positif. Tujuan penelitian ini untuk mengetahui hubungan tipe penderita dan ko- infeksi TB-HIV dengan kejadian putus berobat penderita TB Paru BTA positif di Kota Jakarta Timur. Desain penelitian kasus kontrol, dilakukan pengamatan pada penderita TB Paru BTA positif di Kota Jakarta Timur. Analisis multivariat dengan regresi logistic. Hasil penelitian didapatkan hubungan yang signifikan antara ko-infeksi TB-HIV dengan kejadian putus berobat pada penderita TB Paru BTA positif di Kota Jakarta Timur dengan aOR 19,27 setelah dikontrol jenis kelamin dan status PMO (p value=0,006; 95% CI: 2,36-157,21). Keberadaan infeksi HIV secara bersamaan dengan infeksi TB semakin mengancam kelangsungan hidup sehingga diperlukan terapi yang adekuat untuk mengendalikan virus dan membunuh kuman mycobacterium tuberculosis. Skrining HIV pada penderita TB harus dilakukan secara intensif untuk tata laksana pengobatan yang adekuat melalui program kolaborasi TB-HIV sehingga penderita bisa sembuh dari infeksi TB. Kata Kunci : penderita, TB-HIV, BTA positif

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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