Abstrak: Capaian cakupan CDR Kota Depok dari tahun 2009 sampai 2014 di bawah target nasional. Kota Depok berada di urutan 24 dari 27 Kabupaten/Kota yang ada di Jawa Barat dengan nilai CDR sebesar 34,28%. Hanya 5 dari 32 puskesmas yang mencapai target nasional pada tahun 2014. Penelitian kualitatif ini membahas tentang penemuan kasus TB paru BTA positif di Kota Depok. Sampelnya adalah Puskesmas Pancoran Mas yang mencapai target dan Puskesmas Sawangan yang tidak mencapai target. Variabel yang diteliti adalah faktor input puskesmas (SDM, Dana, Sarana Prasarana dan Implementasi), peran Dinas Kesehatan dan faktor Kemitraan Masyarakat. Ditemukan bahwa keberhasilan penemuan kasus TB paru BTA positif terutama karena promosi kesehatan yang melibatkan lintas program dan sektor. Petugas P2TB mempunyai peran penting untuk memberikan sosialisasi dan edukasi kepada masyarakat dan keluarga pasien didukung dengan ketersedian dana. Penelitian ini menyarankan diperluas evaluasi melibatkan seluruh petugas yang terkait dalam pelaksanaan P2TB, baik di Dinas Kesehatan maupun Puskesmas Kata kunci : Penemuan Kasus TB Paru BTA Positif, Puskesmas dan Studi Kualitatif Case detection of TB cases with BTA positive has been underperformed in Depok since 2009 to 2014. Depok is listed as member 24 of the 27 district / city in West Java with CDR value of 34,28%. Of the 32 health centers in the city of Depok, only 5 community health center (15.6%), reached the national target of in 2014. This study discusses case finding of BTA positive pulmonary TB cases samples were Puskesmas Pancoran Mas with good performance and Puskesmas Sawangan that has not reached the target. Variables involved were Puskesmas input factors (Human Resources, Cost, Infrastructure and Implementation), role of district health office and community participation. It was found that the success of the case detection BTA positive pulmonary TB cases mainly because of health promotion involving other programs and multisectors. The P2TB officers played an important role to disseminate and provide education to the community and the families of patients, supported by the sufficient funding. The study suggested to conduct a thorough evaluation involving all relevant staffs in the implementation of P2TB, both in the District Health Office and Community Health Center. Key Words: Case Detection Rate of Tuberulosis, Community Health Center and Qualitative Study

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.