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Tuberculosis (TB) remains a serious health problem, especially in developing countries, including Indonesia. Conditions in Jambi Province in the last 3 years an increasing number of cases of BTA positive pulmonary TB . Allegedly there are factors associated with the incidence of BTA positive pulmonary TB cases in the province of Jambi . The purpose of this study was to identify areas of vulnerability BTA positive pulmonary TB cases in Jambi Province in 2013. The study design used in this research is the design of ecological studies with statistical tests of correlation and spatial analysis approach. The results of the bivariate analysis were shown to be associated and have a positive correlation with BTA positive pulmonary TB cases are ; poor (r = 0.716 ; p = 0.013), health care facilities microscopic (r = 0.637 ; p = 0.035), and skilled health personnel (r = 0.758 ; p = 0.007). Areas with high risk of TB is Sarolangun. Recommendation : priority problems of financing in the context of TB control is done in areas with high levels of insecurity, increased the number of health care facilities microscopic, and improving the quality and quantity of trained health workers, especially in areas with high or medium levels of vulnerability, as well as the need to further study the spatial analysis in Sarolangun. Keywords : vulnerability analysis, risk factors , BTA positive pulmonary TB cases
Kata kunci : Test tuberkulin, TB paru BTA positif, Mycobacterium tuberculosis
Tuberculosis remains one of the major health problems at the moment and become a global challenge. There are several risk factors that facilitate the occurrence of tuberculosis in children, the children exposed to adults with pulmonary TB smear positive mainly stayed at home, living in endemic areas, environmental sanitation is not good, economic factors, the condition of residence (size, density and ventilation home). The purpose of this study to see the magnitude of the risk of the occurrence of illness tuberculosis in children with household contact with smear positive pulmonary tuberculosis patients. This study used cross sectional design of the study, conducted in November 2015 and March 2016. The sample is child check-ups and perform tuberculin test in Cilandak sub-district health centers. In this study, 85 children perform tuberculin test, and of the 69 children whose household contact with smear positive pulmonary tuberculosis patients found 8 children (11.6%) were positive. While the 16 children who are not household contact with smear positive pulmonary tuberculosis patients got one child (6.2%) were the result of test tuberculin is positif.There is significant relationship between population density and family members who smoke the risk of incidence of tuberculosis in children. The conclusion of this study is the risk of tuberculosis incidence may be affected due to household contact with smear positive pulmonary tuberculosis patients.
Keywords : Tuberculin test, sputum smear positive pulmonary TB, Mycobacterium tuberculosis
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
Abstrak
Salah satu indikator program pengendalian TB secara Nasional strategi DOTS adalah angka keberhasilan pengobatan TB. Fokus utama pengendalian TB strategi DOTS adalah memutus mata rantai penularan TB oleh penderita TB paru sputum BTA positif. Berdasarkan penelitian penderita TB paru sputum BTA negatif dapat menularkan 13-20% (Tostmann A, et al, 2008). BBKPM Bandung sebagai salah satu UPK strategi DOTS pencapaian angka keberhasilan pengobatan masih dibawah target Nasional.Tujuan: mempelajari faktor yang mempengaruhi keberhasilan pengobatan pasien TB paru sputum BTA negatif dan pasien TB paru sputum BTA positif. Faktor yang mempengaruhi keberhasilan pengobatan TB antara lain faktor individu (umur, jenis kelamin, pekerjaan, kepatuhan berobat) dan obat dan penyakit (rejimen, dosis, lama pengobatan, komorbid HIV dan DM). Indikator keberhasilan pengobatan: pemeriksaan ulang sputum BTA menjadi/tetap negatif dan kenaikan berat badan.Desain penelitian: kohort retrospektif.Sampel: data pasien TB Paru yang tercatat di TB 01 tahun 2009-2011dijadikan 2 sub populasi, Pasien TB paru dengan sputum BTA negatif 292 kasus dan pasien TB paru dengan sputum BTA positif 461 kasus.Analisis: multivariabel regresi logistik.Hasil: OR keberhasilan pengobatan pasien TB paru sputum BTA negatif patuh berobat 1,4 dibandingkan tidak patuh (CI : 0,7-3,0) dan pasien TB paru sputum BTA positif patuh berobat 1,1 di bandingkan tidak patuh (CI : 0,6-2,2) setelah dikontrol umur, jenis kelamin dan pekerjaan.Saran: Meningkatkan peran PMO, dan memperhatikan faktor komorbid dalam tatalaksana pengobatan pasien TB paru.
Succes rate of TB treatment is an important indicator of the Natinal TB control program.The main focus of TB control program DOTS strategy is to break the chain of TB transmission. Tostmann A, et al (2008) showed that through 13-20% sputum smear negative pulmonary tuberculosis patients can spread TB the bacteria. BBKPM Bandung as one of CGU DOTS strategy has lower treatment succes rate of the national targets.Purpose: To study factors that influence the treatment succes rate of compare with both smear positve and negative pulmonary tuberculosis patients. Those are age, gender, occupation, treatment compliance (factor individu) and regimen, dose, duration of treatment, comorbid HIV and DM (drug and disease). Indicator of treatment succes are the conversion of sputum result examination and the gain weight.Study design: a retrospective cohort study.Samples: the pulmonary TB patient data recorded at TB 01 yeras 2009-2011. The number of TB patients with sputum smear positive are 461 and negative are 292.Analysis: Multivariable logistic regression.Result: OR treatment succes among sputum smear-negative pulmonary TB patients 1,4 (CI: 0,7-3,0) and among sputum smear positive pulmonary Tb patients who adhere to treatment is 1,1 (CI:0,6-2,2) after controlling for age, sex, and occupation.Suggestion: Enhancing the role of the PMO to increase the treatment adherence rate, treat the TB patients with HIV and DM co-infection.
