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One of the new emerging challenges in TB controlling is multidrug resistanttuberculosis (MDR TB). MDR TB is a type of TB resistant caused by theunresponsiveness (resistancy) of Mycobacterium tuberculosis to at least isoniazidand rifampicin in which both are the most effective anti-TB drugs in first line.This study was aimed to determine the influencing factors for the timing ofsputum culture conversion among pulmonary MDR TB patients. This study wasconducted in Labuang Baji General Hospital, Makassar City started from April2015 to June 2015. Cohort-retrospective design was performed in this study.There were 183 patients involved in this study consisted of 139 (76,0%) patientswith sputum culture conversion, 4 (2,2%) patients with no sputum cultureconversion, and 40 (21,8%) patients were loss to follow up. The result of thestudy shows that the probability of sputum culture conversion of Pulmonary MDRTB was 95,52%. Multivariate analysis showed that the interruption of treatment(HR:0,45; 95%CI: 0,26-0,79), Diabetes Mellitus (DM) before 33 days (HR:0,75;95%CI: 0,29-1,95), DM after 33 days (HR:1,95; 95%CI: 0,90-7,60), previouslytreated with FLDs (HR:0,32; 95%CI: 0,12-0,90), and previously treated withSLDs (HR:0,27; 95%CI: 0,10-0,77) were found to be the influencing factors forthe sputum culture conversion among pulmonary MDR TB. Complete andintensive care are needed among pulmonary MDR TB in MDR TB polyclinic byobserving the interruption of treatment, DM, and history of previous treatment.Keywords: Diabetes mellitus, history of previous treatment, pulmonary MDR TB,sputum culture conversion, treatment interruption.
Prevalensi Sifilis menurut data STBP Kemenkes Tahun 2011 pada 7 populasi kunci adalah sebesar 6% dimana prevalensi Sifilis tertinggi ditemukan pada Transgender Waria (25%) kemudian diikuti WPSL (10%), LSL (9%), WBP (5%), Pria Potensial Risti (4%), WPSTL (3%) dan Penasun (2%). Sifilis pada Transgender Waria meningkat 1% dari 27% pada STBP 2007 menjadi 28% pada STBP 2011 di kota yang sama. Faktor- faktor yang diduga berhubungan dengan infeksi Sifilis pada Transgender Waria antara lain : Umur, Tingkat Pendidikan, Penggunaan kondom, Penggunaan Napza Suntik, Penggunaan Hormon Suntik Silikon, Status HIV, Datang ke Layanan Klinik IMS, Konsumsi Alkohol dan Lama melakukan hubungan Seks Komersial dengan mendapat imbalan. Tujuan : Mengetahui hubungan faktor ?faktor terhadap infeksi Sifilis pada Transgender Waria. Desain studi Cross Sectional dengan sampel sebanyak 1.089 Waria secara acak dan berasal dari 5 kota besar di Indonesia melalui metode wawancara, Diagnosis Laboratorium Sifilis dilakukan dengan TPHA dan RPR. Hasil : Prevalensi Sifilis pada Transgender Waria di 5 Kota sebesar 25,25%, Faktor yang berhubungan signifikan adalah Status HIV(p=0,000), PR =2,28 (95% CI 1,78-2,92) kemudian Umur >31 tahun (p=0,000) ,PR= 1,76 (95% CI 1,36- 2,28) dan Penggunaan Hormon Suntik Silikon (p=0,012) PR=1,37 (95% CI 1,07-1,76), Tingkat pendidikan, Lamanya melakukan hubungan seks komersial dengan imbalan, Penggunaan Kondom, Konsumsi Napza Suntik, Konsumsi Alkohol dan Akses ke Layanan IMS tidak berhubungan. Kesimpulan : Faktor biologis Status HIV memiliki hubungan yang kuat PR =2,28 (95% CI 1,78-2,92)dengan Kejadian Sifilis pada Kelompok Transgender Waria di 5 Kota besar di Indonesia.
The prevalence of syphilis according to MOH- IBBS 2007 was found at 6% in the High Risk Population. Highest prevalence was found in Transvestite (25%) followed by Direct Female Sex Worker (10%), MSM (9%), PLT (5%), High Risk Men's (4%), Non Direct Female Sex Worker (3%) and IDU (2%). Syphilis Prevalens among Transvestite increased 1% from 27% to 28 % (2007 to 2011 in the same city). Factors associated with syphilis infection in Transvestite are Age, level of Education, Condom use, Drug Injection use, Use of Silicon Injections, HIV Status, Access to STI Service Clinic, Alcohol consumption and The duration of engaging in commercial sex. Purpose: Knowing associated factors of syphilis infection on Transvestite. Design Cross sectional study with a sample of 1089 randomly Transvestite and derived from the 5 major cities in Indonesia through the interview method and Laboratory diagnosis of syphilis is performed by TPHA and RPR. Results: The prevalence of syphilis in Transvestite in 5 Cities is 25.25% and significant factors related are HIV status (p = 0.000), PR =2,28 (95% CI 1,78-2,92), Age > 31 years (p=0,000) ,PR= 1,76 (95% CI 1,36-2,28), Use of Silicon Injection Hormone p=0,012) PR=1,37 (95% CI 1,07-1,76), Low educational level, The duration of engaging in commercial sex, Condom Use, Drug Injection, Alcohol consumption and Access to STI Service Clinic are not significant related. Conclusion: HIV Status as a biological factors have a strong relation with Syphilis incidence in Transvestite group population within 5 major cities in Indonesia PR =2,28 (95% CI 1,78-2,92).
