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Fixed Dose Combination for TB treatment
"Menurut WHO (World Health Organization) sepertiga penduduk dunia telah terinfeksi dengan tuberkulosis (TB). Sekitar 2 juta orang meninggal akibat penyakit ini setiap tahunnya dan akan muncul lebih dari 8 juta penderita TB baru setiap tahunnya. Selain itu, kembali menurut WHO (2000), jumlah kematian akibat tuberkulosis akan menjadi 35 juta orang pada tahun 2000-2020. Sebagian besar pasien tuberkulosis di dunia masih tetap diobati dengan beberapa obat-obat tunggal, atau mungkin dengan obat TB kombinasi dosis tetap (KDT) yang berisi 2 obat. Untuk meningkatkan mutu hasil pengobatan maka WHO merekomendasikan penggunaan obat TB dalam bentuk TB kombinasi dosis tetap (KDT) yang berisi 2 dan 3 obat dalam strategi DOTS. Sejak 1999, KDT yang berisi 4 obat telah dimasukkan pula dalam “WHO Model List of Essential Drugs”. Dewasa ini KDT merupakan alat penting untuk makin meningkatkan mutu pelayanan pada pasien TB, dalam akselerasi program DOTS untuk segera mencapai target global. Obat TB dalam bentuk kombinasi dosis tetap (KDT) dapat menyederhanakan cara pengobatan dan juga manajemen pengelolaan / distribusi obat TB serta mampu mencegah timbulnya resistensi. KDT menyederhanakan cara pengobatan karena jumlah tablet yang harus ditelan pasien akan berkurang, ddari 15 – 16 buah menjadi 3 – 4 buah saja, dan juga menurunkan kesalahan penulisan resep. Juga jauh lebih mudah untuk menerangkan kepada pasien bahwa ia harus makan 4 tablet yang sejenis, daripada harus makan berbagai tablet dalam berbagai bentuk dan warna yang berbeda. Kemungkinan tidak memakan semua obat yang diharuskan juga dapat dicegah karena satu obat KDT sudah merupakan campuran dari beberapa obat sekalligus. KDT juga akan memudahkan para dokter dan petugas kesehatan karena hanya harus mengingat satu macam obat, lebih sederhana dan tidak membingungkan. Akhirnya, seluruh aspek distribusi obat (pembelian, pengapalan, penggudangan) juga jauh lebih sederhana dalam bentuk KDT ini.Efek samping obat tidaklah akan bertambah bila kita menggunakan KDT. Bila terjadi juga efek samping maka mungkin diperlukan obat dalam bentuk tunggal. Kualitas, keamanan dan efektivitas KDT ditentukan oleh proses pembuatannya, artinya seberapa jauh produsen mematuhi kaidah “good manufacturing practices (GMP)” dan spesifikasi farmakopea. Pengelola program TB nasional harus membuat sistem jaga mutu (“QA system”). Dalam hal ini WHO telah membangun jaringan laboratorium untuk menilai KDT yang ada sesuai dengan permintaan pihak industri farmasi. (Med J Indones 2003; 12: 114-9)
According to the World Health Organization, a third of the world’s population is infected with tuberculosis. The disease is responsible for nearly 2 million deaths each year and over 8 million were developing active diseases. Moreover, according to WHO (2000), tuberculosis deaths are estimated to increase to 35 million between 2000-2020. The majority of tuberculosis patients worldwide are still treated with single drugs, or with 2-drug fixed-dose combinations (FDCs). To improve tuberculosis treatment, 2- and 3-drug FDCs were recommended by the World Health Organization (WHO) as part of the DOTS strategy. Since 1999 a 4-drug FDC was included on the WHO Model List of Essential Drugs. Today, FDCs are important tools to further improve the quality of care for people with TB, and accelerate DOTS expansion to reach the global TB control targets. Fixed dose combination TB drugs could simplifies both treatment and management of drug supply, and may prevent the emergence of drug resistance .Prevention of drug resistance is just one of the potential benefits of the use of FDCs. FDCs simplify administration of drugs by reducing the number of pills a patient takes each day and decreasing the risk of incorrect prescriptions. Most tuberculosis patients need only take 3–4 FDCs tablets per day during the intensive phase of treatment, instead of the 15–16 tablets per day that is common with single-drug formulations It is much simpler to explain to patients that they need to take four tablets of the same type and colour, rather than a mixture of tablets of different shapes, colours and sizes. Also, the chance of taking an incomplete combination of drugs is eliminated, since the four essential drugs are combined into one tablet. FDCs are also simpler for care-givers as they minimize the risk of confusion. Finally, drug procurement, in all its components (stock management, shipping, distribution), is simplified by FDCs. Adverse reactions to drugs are not more common if FDCs are used. Nevertheless, whenever side-effects to one or more components in a FDC are suspected, there will be a need to switch to single-drug formulations. Quality, safety and efficacy of FDC drugs are determined by the manufacturing process i.e. by compliance of the manufacturer with the requirements of good manufacturing practices (GMP) and pharmacopoeial specifications. National TB programmes must establish a QA system WHO established a laboratory network that tests the quality of FDCs in the marketplace and registers products upon request from the pharmaceutical industry. (Med J Indones 2003; 12: 114-9)"
Medical Journal of Indonesia, 12 (2) April June 2003: 114-119, 2003
MJIN-12-2-AprilJune2003-114
Artikel Jurnal  Universitas Indonesia Library
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Stella
Optimasi dan validasi metode analisis isoniazid dan pirazinamid dalam tablet 4 Fixed Dose Combination (4FDC) dan plasma in vitro secara kromatografi cair kinerja tinggi = Optimation and validation of analytical method of isoniazid and pyrazinamide in tablet 4 Fixed Dose Combination (4FDC) and plasma in vitro by high performance liquid chromatography
"Pengobatan tuberkulosis biasanya menggunakan obat kombinasi yang disebut fixed dose combination (FDC) yang dapat terdiri dari 2 atau 4 zat aktif yaitu isoniazid (INH), pirazinamid (PZA), rifampisin (RIF), dan etambutol (ETA). Dikarenakan toksiknya obat yang digunakan, maka diperlukan suatu metode analisis untuk mengetahui kadar obat dalam darah. Metode kromatografi cair kinerja tinggi yang sederhana dan reprodusibel telah dikembangkan untuk penentuan kadar INH dan PZA secara simultan di dalam tablet dan plasma manusia secara in vitro. Sistem kromatografi terdiri dari kolom Shimpack® C18 (250 × 4,6 mm, 5 μm) dengan fase gerak kalium dihidrogen fosfat pH 6,2-asetonitril (97:3) untuk analisis di dalam tablet dan fase gerak kalium dihidrogen fosfat pH 6,2-asetonitril (99:1) untuk analisis pada plasma manusia secara in vitro. Larutan dideteksi pada panjang gelombang 242 nm dan laju alir 1,0 mL/menit. Sebagai baku dalam digunakan asam nikotinat. Pada validasi tablet, metode dinyatakan linear dengan nilai koefisien korelasi (r) untuk INH dan PZA berturut-turut 0,9992 dan 0,9992; presisi dengan nilai koefisien variasi (KV) 1,46% dan 0,92%; serta akurat dengan nilai perolehan kembali untuk 3 konsentrasi sebesar 98% - 102%.
Proses ekstraksi plasma dilakukan dengan metode pengendapan protein menggunakan asetonitril kemudian dikocok dengan vortex selama 1 menit dan disentrifugasi pada kecepatan 10000 rpm selama 5 menit. Supernatan kemudian diuapkan dan direkonstitusi dengan fase gerak. Pada validasi plasma, nilai perolehan kembali rata-rata untuk INH dan PZA berturut-turut 99.79% dan 99,08% serta nilai LLOQ berturut-turut 4,74 µg/mL dan 16,00 µg/mL. Metode ini juga memenuhi kriteria akurasi dan presisi intra hari dan antar hari selama 5 hari dengan % diff tidak melampaui ± 20% pada LLOQ dan ± 15% pada konsentrasi selain LLOQ. Pada uji stabilitas, INH dan PZA dalam plasma dinyatakan stabil selama 7 hari.
Treatments for tuberculosis commonly use combination of drugs called fixed dose combination (FDC). It consists of 2 or 4 active ingredient pharmaceutical namely isoniazid (INH), pyrazinamide (PZA), rifampicin (RIF), and ethambutol (ETA). Due to the drug toxicity, analytical method is required to determine the concentration of antituberculosis drug in human plasma. A simple and reproducible high-performance liquid chromatography method was developed for simultaneous determination of INH and PZA in the tablet and human plasma. Chromatography was performed on a Shimpack® C18 column (250 × 4.6 mm, 5 μm) under isocratic elution with potassium dihydrogen phosphate pH 6.2-acetonitrile (97:3) for tablet and potassium dihydrogen phosphate pH 6.2-acetonitrile (99:1) for analytical in human plasma. Detection was made at 242 nm and analysis was run at a flow-rate of 1.0 ml/min. Nicotinic acid was used as internal standard. In tablet validation, the calibration curve was linear by r values 0.9992 and 0.9992, precision by coefficient of variation (CV) were 1.46% and 0.92% also accurate by % recovery for 3 concentrations were 98% - 102% for INH and PZA, respectively.
Plasma extraction was done by deproteination with acetonitrile, mix with vortex for 1 minute, then centrifuge it on 10000 rpm for 5 minutes. The residue was evaporated and reconstituted in eluen. In plasma validation, the recovery was 99.79% and 99.08% for INH and PZA, respectively. The lower limit of quantification (LLOQ) in plasma was 4.74 μg/ml and 16.00 μg/ml for INH and PZA, respectively. The method also fulfill the criteria for accuracy and precision intra and inter day by % diff values not exceed ± 20% for LLOQ and ± 15% for concentrations except LLOQ. On the stability study, INH and PZA in plasma is pronounced to be stable for 7 days."
Depok: Fakultas Matematika dan Ilmu Pengetahuan Alam Universitas Indonesia, 2011
S351
UI - Skripsi Open  Universitas Indonesia Library
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Abdul Aziz Sediqi
Risk factors assocaited with compliance of Tuberculosis patients anti TB treatment among the TB pateints of Kndahar Regional Province regional TB diagnosis and treatment center-Afghanistgan
"Compliance of TB patients with anti TB drugs treatment is a universally recognized problem specially in asian developing countries which results at the consequences of the TB treatment compliances, today there are TB cases defaulters,relapses and MDRTB which is mostly occurring in all over the world due to deferent reasons of the compliances, and Afghanistan is one of the 22nd highest TB burden country in the world. The main problem of TB treatment compliance in Afghanistan can be explain at two aspects: First there would be a high prevalence of TB positivity in country level because of inaccessibility to the health services In the rural areas due to war and low security, second behavioral changes and lack of knowledge of the community about the disease and wrong beliefs and perceptions, socioeconomic factors, socio demographic factors and socio psychological factors, all these factors could be determined and influence the compliance of TB patients among the TB patients in the country.
Objective
To determine what factors associated and influenced the compliance of TB patients with anti TB Anti TB drugs treatment in Kandahar Afghanistan.
Materials and methods
It was descriptive study, the study was including 243 TB patients participated 79 TB patients interviewed with well structured questionnaire.
Results
TB patients as much as 58.23 % was not good compliance of their anti TB treatment and 41.77% was good compliance of their anti TB treatment, and the compliance rate was higher among those patients who were not good compaliance, how ever from small sample size statistic could not detect any significant association.
Conclussion
The high prevalence of TB cases in the country and high level of compliance of TB patients among the TB confirm patients with the factors influencing the compliance of the treatment is essential to control and take measure immediately, the evidence strengthen the need of collaboration to change the behavior of the community properly for ten agers and activate the education and the result attract to focus more and pay attention on the factors influencing the compliance specially for those who have no any access to the health services to satisfy and encourage them for their regular anti TB treatment therapy."
Depok: Universitas Indonesia, 2012
T31797
UI - Tesis Open  Universitas Indonesia Library
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Fixed dose combination for TB treatment
Artikel Jurnal  Universitas Indonesia Library
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Nicolaus Novian Wahjoepramono
Kepatuhan pasien MDR-TB terhadap pengobatan TB pertama peran pemberian obat gratis terhadap kepatuhan pasien MDR- TB selama pengobatan TB pertama = Compliance in MDR-TB patients during primary tb treatment: its association with the accessibility of free drugs
"MDR-TB menjadi masalah yang penting di Indonesia karena besarnya angka kematian dan morbiditas. Dengan mencari tahu alasan perkembangan tuberculosis menjadi MDR-TB, insidensi dari penyakit mematikan ini dapat dikurangi. Pengumpulan data dilakukan di RS Persahabatan dalam jangka waktu dari Desember 2009 sampai Agustus 2010 dan bertujuan untuk mengukur angka kepatuhan dalam pengobatan tuberculosis primer dan efek dari pembagian OAT secara gratis terhadap kepatuhan pasien. Pasien MDR-TB akan diwawancara secara retrospektif untuk mencari tahu derajat kepatuhan mereka saat pengobatan primer dulu. Hasil wawancara menunjukkan bahwa 46% dari pasien MDR-TB tidak mematuhi regimen pengobatan primer dulu. Angka ini jauh lebih buruk dari data tuberculosis pada umumnya. Hasil juga menyimpulkan bahwa hubungan antara pembagian obat secara gratis dan kepatuhan pasien sebagai non-signifikan.
The problem of Multi-Drug Resistant Tuberculosis in Indonesia is of high importance due to its high mortality and morbidity rate. Finding clues as to how MDR-TB develops from susceptible strains of TB will help Indonesia in eliminating the menace that is MDR-TB. Data collection is done in RS Persahabatan, Jakarta during the period of December 2009 until August 2010, and aims to measure the rate of compliance in the primary TB treatment of confirmed MDR-TB patients. The study also looks at the effect of free medication on patient compliance. Interview sessions will be set for MDR-TB patients to look in retrospect towards their primary TB treatment. Results show that 46% of patients did not comply in their primary treatment, a lot higher than normal. It also proves of the relationship between compliance and the accessibility of free drugs to be non-significant."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2013
S-Pdf
UI - Skripsi Membership  Universitas Indonesia Library
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Siti Julaeha Siti Julaeha
Pemberdayaan kader gertak TB sebagai strategi intervensi untuk deteksi kasus dan pengawasan menelan obat pada pasien TB di Kelurahan Sukatani Kecamatan Tapos Depok = Empowerment of cadre gertak TB as a strategy of nursing intervention to detect tb case and to observe TB treatment in Sukatani Tapos Depok
"[ABSTRAK
Tuberkulosis (TB) masih menjadi masalah kesehatan di Indonesia. Angka deteksi kasus Kota Depok yang masih rendah (57,52%) pada tahun 2013 membuat Pemerintah Kota Depok mendeklarasikan Gertak TB. Perawat memberikan pelayanan TB dengan menggunakan strategi pemberdayaan kader Gertak TB agar masyarakat dapat melakukan pemantauan kasus TB di lingkungannya secara mandiri. Kegiatan yang dilakukan adalah deteksi kasus dan pengawasan menelan obat pada pasien TB. Gertak TB melibatkan 16 orang kader. Keluarga yang diawasi menelan obat sebanyak 10 keluarga. Hasil dari kegiatan Gertak TB didapatkan suspek 158 orang, diantaranya 17 orang dilakukan pemeriksaan BTA, dan 10 orang dinyatakan positif TB paru. Kepatuhan menelan obat pada pasien TB yang telah selesai pengobatan mencapai 100%. Kegiatan Gertak TB perlu dilakukan oleh kader dengan berkoordinasi dengan pengelola program TB.
ABSTRACT
Pulmonary Tuberculosis (TB) remains a public health problem in Indonesia. In 2013 Case Detection Rate (CDR) in Depok was low (57,52%), urging the Depok Government declared Gertak TB. The nurse provided TB service by empowering community, to build surveillance system in their own community. The activities of Gertak TB were case detection and observation TB patients treatment. Gertak TB involved 16 cadres. The families whom were observed TB treatment were 10. The results were 158 persons TB suspected, seventeen of them undertook the screening, and ten of them were positive to smear sputum. The treatment adherence of TB patients were 100%. Gertak TB is needed to be promoted by cadre by coordinating with TB nurse in primary health care service delivery., Pulmonary Tuberculosis (TB) remains a public health problem in Indonesia. In 2013 Case Detection Rate (CDR) in Depok was low (57,52%), urging the Depok Government declared Gertak TB. The nurse provided TB service by empowering community, to build surveillance system in their own community. The activities of Gertak TB were case detection and observation TB patients treatment. Gertak TB involved 16 cadres. The families whom were observed TB treatment were 10. The results were 158 persons TB suspected, seventeen of them undertook the screening, and ten of them were positive to smear sputum. The treatment adherence of TB patients were 100%. Gertak TB is needed to be promoted by cadre by coordinating with TB nurse in primary health care service delivery.]"
Fakultas Ilmu Keperawatan Universitas Indonesia, 2015
SP-PDF
UI - Tugas Akhir  Universitas Indonesia Library
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Zahrah Maulidia Septimar
Pengalaman pasien yang menjalani pengobatan multi drug resistance tuberculosis (MDR TB) = Experience of patient undergoing treatment of multi drug resistance tuberculosis (MDR TB)
"[ABSTRAK
Multi Drug Resitance Tuberculosis (MDR TB) merupakan masalah terbesar dalam
pencegahan dan pemberantasan TB dunia. Indonesia berada di peringkat 8 dari 27 negara
dengan MDR TB terbanyak di dunia. WHO Global Report 2013, memperkirakan pasien
MDR TB di Indonesia berjumlah 6.900 pasien. MDR TB adalah penyakit yang
disebabkan oleh Mycobacterium Tuberculosis yang resisten minimal terhadap rifampisin
dan isoniazid. Penelitian ini berfokus pada bagaimana pengalaman pasien menjalani
pengobatan Multi Drugs Resistance Tuberculosis dan seperti apa pasien memaknai
pengalamannya tersebut. Desain penelitian kualitatif fenomenologi dipilih untuk
mendapatkan informasi yang sifatnya individual secara mendalam sesuai pengalaman dan
kondisi penyakit yang dialami. Partisipan ditentukan dengan tehnik purposive sampling,
berjumlah tujuh orang. Tehnik wawancara mendalam dilakukan menggunakan alat
perekam dan panduan wawancara semiterstruktur, serta catatan lapangan. Analisa data
menggunakan qualitative content analysis dengan pendekatan Collaizi. Tema yang
ditemukan sebagai hasil penelitian yaitu : Pemahaman penyakit MDR TB;
ketidaknyamanan saat menjalani pengobatan Multi Drugs Resistance Tuberculosis;
hambatan penderita untuk sembuh, menerima dukungan, dan harapan pengobatan.
Diperlukan studi lebih lanjut untuk mengkaji secara mendalam tema yang telah
teridentifikasi pada jumlah partisipan yang lebih banyak dan bervariasi.ABSTRACT Multi Drug Resistant (MDR - TB ) is the biggest problem of TB prevention and
eradication in the world. Indonesia is ranked 8 of 27 countries with MDR-TB in the
world. WHO global reported 2013, estimated MDR-TB patients in Indonesia amounted to
6.900 patient. MDR-TB is caused by Mycobacterium tuberculosis that resistant to at least
rifampicin and isoniazid. This study will focus on how the experience of undergoing
treatment of Multi Drugs Resistance Tuberculosis and patient?s insight of the experience.
Phenomenological qualitative research design was choosen to obtain information that is
significantly individual according to the experience. Participants were determined by
purposive sampling technique to seven people. In-depth interview conducted using a
recorder and semi-structured approach. Themes found as a result of the research : the
understanding of MDR TB; the experience discomfort while undergoing treatment of
Multi Drugs Resistance Tuberculosis; difficulties experienced during treatment; the
support received during treatment; and client expectations. Further study is needed to
profoundly examine the themes that have been identified on more numerous and varied
participants, Multi Drug Resistant (MDR - TB ) is the biggest problem of TB prevention and
eradication in the world. Indonesia is ranked 8 of 27 countries with MDR-TB in the
world. WHO global reported 2013, estimated MDR-TB patients in Indonesia amounted to
6.900 patient. MDR-TB is caused by Mycobacterium tuberculosis that resistant to at least
rifampicin and isoniazid. This study will focus on how the experience of undergoing
treatment of Multi Drugs Resistance Tuberculosis and patient’s insight of the experience.
Phenomenological qualitative research design was choosen to obtain information that is
significantly individual according to the experience. Participants were determined by
purposive sampling technique to seven people. In-depth interview conducted using a
recorder and semi-structured approach. Themes found as a result of the research : the
understanding of MDR TB; the experience discomfort while undergoing treatment of
Multi Drugs Resistance Tuberculosis; difficulties experienced during treatment; the
support received during treatment; and client expectations. Further study is needed to
profoundly examine the themes that have been identified on more numerous and varied
participants]"
Depok: Fakultas Ilmu Keperawatan Universitas Indonesia, 2015
T43563
UI - Tesis Membership  Universitas Indonesia Library
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Tissy Fabiola
Age and employment status in MDR-TB patients during primary TB treatment its association with patient compliance = Usia dan status pekerjaan pada pasien MDR RB selama pengobatan TB pertama hubungan dengan kepatuhan pasien
"Penyakit tuberculosis (TB) telah dinyatakan sebagai salah satu permasalahan kesehatan dunia oleh WHO semenjak tahun 1993, danjumlahpenderita tuberkulosis kian meningkat setiap tahunnya. Mycobacterium tuberculosis, agen penyebab dari penyakit tuberkulosis telah bermutasi menjadi strain resistant erhadap lebih dari satu obat antituberkulosis, yang melahirkan sebuah penyakit yang disebut Multidrug-resistant Tuberculosis (MDR-TB). Studi ini bermaksud mengetahui pengaruh usia dan status pekerjaan pada pasien MDR-TB selama pengobatan inisial TB terhadap kepatuhan pasien dalam pengobatan. Data diambil di RS Persahabatan Jakarta (n=50), pada bulan Desember 2009 hingga Agustus 2010 dengan metode cross sectional. Sample diperoleh dengan metode convenient sampling method. Hasil penelitian menunjukkan bahwa 34% pasien berusia 16-20 tahun dan 70% pasien memiliki pekerjaan saat pengobatan TB pertama, serta baik usia pasien maupun status pekerjaan pasien tidak ada hubungan yang signifikan dengan kepatuhan pasien.
Tuberculosis (TB) disease has been declared as a global emergency according to WHO since 1993 and the number of the people who become infected with this disease keeps increasing throughout the year. Mycobacterium tuberculosis, the causative agent of tuberculosis disease has mutated to be resistant to more than one antituberculosis drug, leading to a disease called Multidrug-resistant Tuberculosis (MDR-TB). This study aims to measure the influence between age and employment status during primary TB treatment and the development towards MDR-TB in relation to patient compliance. Data is collected in Persahabatan Hospital, Jakarta (n=50) on December 2009 until August 2010, using cross sectional method. Samples are obtained using convenient sampling method. The result shows that 34% patients were 16-20 years old and 70% patients were employed during their primary TB treatment, and neither age nor employment status has a significant association with patient compliance."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2011
S-Pdf
UI - Skripsi Membership  Universitas Indonesia Library
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Manuhutu, Victor Paulus
Hubungan antara riwayat pengobatan TB paru sebelumnya dengan pola resistensi OAT pada subjek TB paru resisten OAT di Rumah Sakit Umum Pusat Persahabatan = The relationship between previous history of pulmonary TB treatment and resistance patterns in anti tuberculosis drug resistant patients at Persahabatan Hospital
"Latar belakang : Diantara pasien TB paru resisten OAT terdapat cukup banyak pasien yang memiliki riwayat pengobatan sebelumnya.
Tujuan : Tujuan utama penelitian ini adalah untuk mengidentifikasi hubungan antara riwayat pengobatan TB paru sebelumnya dengan pola resistensi OAT di RS Persahabatan. Tujuan lain penelitian ini adalah untuk mendapatkan data mengenai riwayat pengobatan sebelumnya pasien TB paru resisten OAT, menilai peranan pasien dalam menyebabkan terjadinya TB paru resisten OAT dan menilai secara tidak langsung peranan tenaga kesehatan dalam menyebabkan terjadinya TB paru resisten OAT.
Hasil : Hasil penelitan ini menunjukkan terdapat 60 subjek yang terdiri dari 38 subjek laki - laki dan 22 subjek perempuan, sebagian besar subjek berasal dari kelompok umur 30 - 39 tahun (33,3%) dengan rata - rata umur 36,8 tahun. Sebanyak 81,7% mempunyai lebih dari 1 kali riwayat pengobatan TB paru sebelumnya, 28 subjek (46,7%) mempunyai 2 kali riwayat pengobatan TB paru sebelumnya dan terdapat 2 subjek (3,3%) dengan 5 kali riwayat pengobatan TB paru sebelumnya. Pada pengobatan pertama sampai pengobatan ketiga, lalai merupakan hasil pengobatan yang terbanyak (31,7%, 26,5% dan 33,3%) dan gagal konversi kategori II merupakan kriteria suspek TB paru resisten OAT yang terbanyak (46,7%). Sebanyak 71,7% subjek pernah mendapatkan pengobatan TB paru di fasilitas pelayanan kesehatan pemerintah. Dokter umum praktek swasta merupakan fasilitas kesehatan yang paling banyak tidak melakukan pemeriksaan BTA baik untuk diagnosis maupun untuk evaluasi pengobatan TB paru (66,7%, 60% dan 100%). Terdapat persentase pemberian rejimen pengobatan tidak sesuai yang lebih besar pada riwayat pengobatan kedua 32,7% apabila dibandingkan dengan pengobatan pertama 10%. Pola resistensi terhadap H - R - S - E adalah pola resistensi terbanyak (51,7%). Tidak terdapat hubungan antara jumlah riwayat pengobatan TB paru dengan pola resistensi, odds ratio pola resistensi H-R-S-E dengan jumlah riwayat pengobatan TB 1- 2 kali terhadap jumlah riwayat pengobatan TB 3 - 5 kali adalah 0,731 (CI 95% 0,245 - 2,074; p = 0,533).
Kesimpulan : Pola resistensi H - R - S - E adalah pola resistensi terbanyak. Tidak terdapat hubungan antara jumlah riwayat pengobatan TB paru dengan pola resistensi di RSUP Persahabatan.
Background : Most of anti tuberculosis drug resistant patients had previous history of pulmonary TB treatment.
Purpose : This study is primarily aimed to see the relationship between anti TB drug resistant patients previous history of TB treatment and patients resistance patterns at Persahabatan hospital. The other aims are to collect patient’s previous history of TB treament, see patient’s role in TB drug resistance and see the health worker’s role in TB drug resistance.
Method : This study uses cross sectional. Data collected by interview with questionnaire and from medical record.ving TB treatment and evaluation (66,7%, 44% and 100%).
Result : In this study there are 60 subjects that consist of 38 males and 22 females whose ages are around 30 to 39 (33,3%) and their mean age is 36,8. Around 81,7% of those subjects had more than 1 previous history of pulmonary TB treatment, 28 (46,7%) had twice and 2 (3,3%) had five times. Default from treatement mostly happened to the 1st up to 3rd of previous TB treatment (31,7%, 26,5% and 33,3%). Failure category 2 mostly happened to the drug resistant suspected criteria (46,7%). Around 71,7% subjects have been treated at the goverment healthcare facilities. Private clinics are the healthcare facilities that often don’t perform sputum smear before giving TB treatment. There are higher mistakes ATD regiment in 2nd previous previous TB treatment 32,7% if compared to 1st previous TB treatment 10%. Resistance to Isoniazid, rifampicin, ethambutol dan streptomycin is the the most frequent resistance patterns (51,7%). There is no correlation between the numbers of previous history of TB treatment and resistance patterns at Persahabatan hospital, the odds ratio resistance patterns H - R - S - E of 1- 2 times previous history of TB treatments to 3 - 5 times is 0,731 (CI 95% 0,245 - 2,074; p = 0,533).
Conclution : Resistance to H - R - S - E is the the most frequent resistance patterns. There is no correlation between the numbers of previous history of TB treatment and resistance patterns at Persahabatan hospital."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2014
SP-Pdf
UI - Tugas Akhir  Universitas Indonesia Library
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TB & Tobacco
"Sepertiga penduduk dunia telah terinfeksi tuberkulosis dan terdapat lebih dari 8 juta orang yang menderita TB setiap tahunnya. Sementara itu, 3 juta orang meninggal akibat kebiasaan merokok setiap tahunnya di dunia ini. Indonesia sendiri sebenarnya adalah penyumbang kasus TB ke-3 terbesar di dunia. Indonesia juga menduduki peringkat keempat dalam jumlah perokok di dunia. Hubungan antara kebiasaan merokok dan tuberkulosis telah diketahui sejak lama, walaupun bukti epidemiologis belum amat menunjang, demikian juga dengan penjelasan patofisiologis serta perubahan biomolekuler yang terjadi. Dewasa ini makin banyak kita temukan data epidemiologis yang menyokong hubungan antara tuberkulosis dan kebiasaan merokok. Penelitian lebih lanjut amat diperlukan guna menggali lebih dalam aspek-aspek hubungan ini dan menghilangkan faktor pengganggu yang mungkin berpengaruh. Harus dilakukan kerja sama yang harmonis untuk dapat melaksanakan program penanggulangan tuberkulosis dan penanggulangan merokok secara sinergistik. Tuberkulosis –di mana Indonesia menduduki peringkat ke-3 di dunia– dan masalah merokok –di mana Indonesia menduduki peringkat ke-4 di dunia- adalah dua masalah kesehatan masyarakat yang penting bagi bangsa kita. Bila memang ada hubungan asosiatif antara keduanya maka masalah kesehatan itu bahkan akan makin besar. Kita perlu menguasai pengetahuan tentang tuberkulosis dan juga tentang kebiasaan merokok pada populasi Indonesia untuk meningkatkan status kesehatan masyarakat. Program penanggulangan tuberkulosis dan program penanggulangan masalah merokok merupakan modal yang amat penting untuk derajat kesehatan bangsa Indonesia. (Med J Indones 2003; 12: 48-52)
One third of the world population is infected with tuberculosis, and over 8 millions people were developing each year. On the other hand tobacco is responsible for 3 millions death in the world. For Indonesia, our country has the third biggest TB cases in the world. Whereas Indonesia is ranked as having the fourth largest number of smokers in the world. A relationship between smoking and TB has been suspected for a long time, even though the epidemiological evidence has not been convincing so far, as well as the pathophysiology and the biomolecullar changes. At present time there are more and more epidemiological data to suggest relationship between TB and tobacco. Further research should be done to get more indepth relationship as well as avoiding the confounder factor. To be able to perform TB control as well as tobacco control successfully there should be emphasize on synergistic public health approaches. Tuberculosis –which Indonesia got 3rd rank in the world- as well as smoking problem –which Indonesia got 4th rank in the world- are two important public health problem for the country. If there are relationship between tobacco and tuberculosis, health problem faced by Indonesian even become bigger. Knowledge about tuberculosis as well as tobacco among Indonesian population is very essential to improve the public health situation. Tuberculosis control programme as well as smoking control programme are essential tools for the well being of Indonesian people. (Med J Indones 2003; 12: 48-52)"
Medical Journal of Indonesia, 12 (1) January March 2003: 48-52, 2003
MJIN-12-1JanMar2003-48
Artikel Jurnal  Universitas Indonesia Library
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