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"[Kasus TB paru di Indonesia masih tinggi, dan salah satu propinsi itu adalah DKI Jakarta.Kasus TB paru di DKI Jakarta masih perlu mendapatkan perhatian salah satunya pendekatan Progran CEPAT LKNU ini. Adanya program CEPAT LKNU ini, peneliti ingin melihat bagaimana pencapaian target dari komponen kegiatan yang telah ditetapkan oleh LKNU. Pencapaian hasil yang belum sesuai dengan target yangditentukan perlu adanya pendekatan yang lebih komprehensif. Sumber daya manusia yang menjalankan program perlu mendapat perhatian baik dari pengetahuan maupun keterampilan yang dimiliki. Keterlibatan pihak terkait juga menjadi kunci untuk mendukung terbentuknya partisipasi dan pemberdayaan masyarakat dalam program CEPAT LKNU ini.;Pulmonary TB cases in Indonesia is still high, and one of the province is the city Jakarta. Pulmonary TB cases in Jakarta still need to get the attention of one of them approach this program as CEPAT LKNU. CEPAT LKNU program, the researchers wanted to see how the achievement of the targets of the components of activities that have been set by LKNU. The achievement of results not in accordance with the specified target is need for a more comprehensive approach. Human resources run the program require attention both from the knowledge and skills possessed. The involvement of stakeholders is also a key to support the establishment of community participation and empowerment in this CEPAT LKNU program, Pulmonary TB cases in Indonesia is still high, and one of the province is the cityJakarta. Pulmonary TB cases in Jakarta still need to get the attention of one of themapproach this program as CEPAT LKNU. CEPAT LKNU program, the researcherswanted to see how the achievement of the targets of the components of activities thathave been set by LKNU. The achievement of results not in accordance with thespecified target is need for a more comprehensive approach. Human resources run theprogram require attention both from the knowledge and skills possessed. Theinvolvement of stakeholders is also a key to support the establishment of communityparticipation and empowerment in this CEPAT LKNU program]"

"Tuberkulosis (TB) masih merupakan masalah kesehatan di dunia serta muncul ke permukaan sebagai penyebab utama kematian. Saat ini TB telah menjadi ancaman global, World Health Organization (WHO) memperkirakan terdapat 8 juta kasus baru dan 3 juta kematian karena TB setiap tahunnya. Pada tahun 1990 dilaporkan. hampir 3,8 juta kasus TB di dunia dan 49%nya terdapat di Asia Selatan dan Timur, diperkirakan pula bahwa 1,7 miliar penduduk pada tahun 1990 (sekitar 1/3 penduduk dunia) terinfeksi Mycobacterium tuberculosis (M.tuberculosis).Menurut WHO pada tahun 1998 Indonesia menempati urutan ketiga dalam jumlah penderita TB terbanyak di dunia setelah India dan China. Diperkirakan pada tahun 2000 ditemukan 1.856.000 kasus baru di India (WHO Report 2002), 1.365.000 kasus baru di China dan 595.000 kasus baru di Indonesia.dikutip dari The World Health Organization dalam Annual report on global TB control 2003 juga menyatakan terdapat 22 negara dikategorikan sebagai high burden countries terhadap TB. Indonesia masih tetap peringkat ketiga setelah India dan China dalam menyumbang jumlah kasus TB di dunia. Estimasi prevalens TB di Indonesia tahun 2003 adalah 295 per 100.000. Indonesia kemudian melakukan survei prevalens TB tahun 2004, mencakup 30 provinsi yang memberikan estimasi prevalens TB berdasarkan pemeriksaan mikroskopik BTA positif sebesar 104 per 100.000. Prevalens TB di Jawa Bali sebesar 59 per 100.000 jauh lebih rendah dibanding luar Jawa Bali 174 per 100.000."

"Pemerintah telah menyediakan paduan obat yang efektif untuk membunuh kuman tuberkulosis dalam waktu yang relatif singkat, sekitar enam bulan secara cuma-cuma dengan penerapan Pengawas Menelan Obat (PMO) atau strategi Directly Observed Treatment Shortcourse (DOTS). Di Kabupaten Pandeglang penemuan kasus meningkat dari tahun 1999 sampai tahun 2000, namun angka konversi masih rendah dimana angka konversi tahun 1999 baru 48% dan tahun 2000 adalah 54,5%. Ketidakteraturan minum obat merupakan salah satu penyebab kegagalan program penanggulangan TB Paru.Semenjak tahun 1995 Program Penanggulangan TB Paru strategi DOTS yang salah satu komponennya PMO di Kabupaten Pandeglang sudah diterapkan. Namun hubungan keberadaan PMO dengan keteraturan minum obat penderita TB Paru terutama fase intensif belum diketahui.Penelitian ini bertujuan untuk melihat hubungan keberadaan PMO dengan keteraturan minum obat fase intensif penderita TB Paru di Puskesmas Kabupaten Pandeglang tahun 2000. Rancangan penelitian adalah kasus kontrol dengan perbandingan jumlah kasus dan kontrol 1 : 2. Jumlah sampel keseluruhan adalah 213 prang, yang terdiri dari 71 kasus dan 142 kontrol. Sampel adalah penderita TB Paru yang berumur 15 tahun atau lebih yang mendapat terapi strategi DOTS kategori 1 atau kategori 3 yang berobat ke puskesmas sejak 1 Januari 2000 sampai 31 Desember 2000 dan telah menyelesaikan pengobatan fase intensif.Kasus adalah sampel yang tidak teratur minum obat dihitung dari tanggal mulai minum obat sampai tanggal selesai minum obat fase intensif dimana penderita minum obat kurang dari 60 hari atau lebih dari 70 hari termasuk penderita putus obat, sedangkan kontrol adalah sampel yang minum obat teratur selama 60 - 70 hari pada fase intensif.Hasil penelitian, variabel yang berhubungan dengan keteraturan minum obat secara bermakna adalah keberadan PMO di mana penderita tanpa PMO berisiko tidak teratur minum obat 2,13 kali dibanding ada PMO, penderita yang merasakan efek samping obat berisiko 3,93 kali tidak teratur dibanding penderita tanpa efek samping, dan penderita tidak mengerti penyuluhan berisiko 4,27 kali tidak teratur dibanding penderita mengerti penyuluhan secara bersama-sama, sedangkan yang tidak bermakna adalah umur, jenis kelamin, pendidikan, jenis kategori obat dan frekuensi penyuluhan.Disimpulkan bahwa tidak ada PMO (OR:2,13 ; 95%CI:1,00-4,53), ada efek samping obat (OR:3,93 ; 95%CI:2,00-6,82), dan tidak mengerti penyuluhan (OR:4,27 ;95%CI:2,05-8,93) bersama-sama berhubungan secara bermakna dengan ketidakteraturan minum obat (p<0,05) di Puskesmas Kabupaten Pandeglang tahun 2000.Disarankan keberadaan PMO masih sangat diperlukan. Disamping itu perlu penyuluhan yang sederhana sesuai bahasa dan tingkat pendidikan penderita yang sebagian besar rendah agar bisa dimengerti serta perlu waktu khusus untuk konseling. Selain itu perlu penanganan yang serius terhadap efek samping yang dirasakan penderita untuk meningkatkan keteraturan minum obat penderita TB Paru.

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The Relationship between Treatment Observer with the Regulate Took Medicine, Intensive Phase for Lung Tuberculosis Sufferer in Community Health Center, Pandeglang Distric, 2000The Government has provided the effective drug manual to kill bacteria of tuberculosis within a short time, nearly six months given to them free of charged by using application of Treatment Observer as Directly Observed Treatment Short course (DOTS) strategy. In Pandeglang district the case findings increased from 1999 to 2000, however, the conversion rate were still low, where the conversion rate in 1999 were just 48% and in 2000 were 54,5%. Irregular of drug swallow was as one of the failures of The Lung Tuberculosis Programs.

Since 1995 the program on overcame the Lung Tuberculosis used DOTS strategy which one of the components was Application of the Treatment Observer, it has been applied in Pandeglang District. However, the availability of it in giving the revision of obedience took the medicine for sufferers of Lung Tuberculosis especially to intensive phase have unknown yet.

The Objective of study knew the relationship between the availability of the Treatment Observer with regulate took the medicine for Lung Tuberculosis intensive phase in Community Health Center, Pandeglang District in 2000. The Design of study is case-control with the comparison that the cases amount and control 1:2. Total sample were 213, which total cases 71 and total control 142. The sample were the Lung Tuberculosis sufferers whose 15 years old or greater that obtained the therapy DOTS strategy, category one or three that took treatment to Community Health Center since January 1st - December 31st, 2000 and finished the treatment of intensive phase. Case was the sample who irregular took medicine, it calculated from the date of starting took the medicine from 60 days or more than 70 days, it was including the dropped out sufferer, while the control was the sample who took medicine regularly during 60-70 days on intensive phase.

The result of this research, the variable that related to regulate in taking medicine significantly were the availability of treatment observer which wasn't the treatment observer have 2.13 times risk for irregular took medicine than was the treatment observer, side effect of medicine which was side effect of the drug have 3.93 times risk for irregular took medicine than wasn't side effect of the drug, and illumination which didn't know the illumination have 4.27 times risk for irregular took medicine than knew the illumination, while that insignificantly were age, sex, education, kind of drug category and the frequency of illumination.

The conclusion, that there wasn't the treatment observer (OR:2.13 ; 95%CI: 1.00-4.53), there was side effect of the drug (OR:3.93 ; 95%CI: 2.00-6.82), and didn't know the illumination (OR:4.27 ; 95%CI:2.05-8.93). They were together connecting significantly to irregular took the medicine (P<0.05) in Community Health Center, Pandeglang District, 2000.

Considering, it's suggested that the availability of treatment observer is still needed. It also needs simply illumination that appropriates to language and education level of the sufferers who mostly lower education can easily understand the message. Besides those mentioned above, it needed management seriously to the side effect that felt by the sufferers to increase there regulate to take the medicine."

"Latar belakang dan tujuan: Tuberkulosis (TB) sampai saat ini merupakan tantangan dan ancaman besar bagi kesehatan masyarakat di dunia. Insidens TB paru di kota Bekasi tahun 2014 adalah 1359/2.510.951 penduduk dan 3099 total kasus selama tahun 2014. Defisiensi mikronutrien seperti retinol dapat terjadi akibat hilangnya nafsu makan, gangguan absorbsi usus halus yang menyebabkan keadaan imununosupresi sehingga meningkatkan risiko infeksi TB. Penelitian ini bertujuan untuk mengetahui hubungan antara kadar retinol serum dengan derajat bacterial TB paru kasus baru di tingkat pelayanan primer.Metode: Penelitian mempergunakan desain potong lintang dengan 135 sampel yang diambil dengan cara cluster consecutive sampling di puskesmas wilayah kota Bekasi pada penderita TB paru kasus baru yang belum mendapatkan terapi obat anti tuberkulosis (OAT). Hasil: Karakteristik subjek TB paru kasus baru di puskesmas menurut usia dengan nilai tengah 35,5 tahun (IQR 18-65), laki-laki 62,3%, perokok 44,9%, IMT gizi kurang 56,5%, hipoalbumin 17,4%, kadar retinol serum defisien 40,6%. Lesi kavitas 30,4?% dan derajat bacterial load mayoritas scanty dan +1 dengan persentase berturut-turut 10,1% dan 39,1%. Terdapat perbedaan bermakna kadar albumin, IMT, lesi kavitas dengan bacterial load dengan nilai p=0,003, p=0,014, p=0,011 namun tidak terdapat hubungan bermakna antara kadar retinol serum dengan bacterial load.

Kesimpulan: Kadar retinol serum tidak berhubungan dengan derajat bacterial load pasien TB paru kasus baru di wilayah kerja kota Bekasi serta terdapat hubungan bermakna antara IMT, kadar albumin dan lesi radiologis dengan bacterial load.

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Background: Tuberculosis (TB) remains a threat for community health across the globe including Indonesia. The incidence of pulmonary TB in Bekasi, Indonesia in 2014 is 1,395/2,510,951 people and there were 3.099 cases in 2014. Micronutrient deficiency such as retinol can be caused by loss of appetite and disorder in intestinal absorption which could lead to immunosuppressive condition that increased the risk of TB. This study aims to find the correlation between serum retinol level and semi-quantitative bacterial load in new case of pulmonary TB at a community health center.

Methods: This cross-sectional study involved 135 subjects collected through cluster consecutive sampling in a primary health care in Bekasi, Indonesia. The study included new pulmonary TB cases which had no history of taking any anti-TB drugs.

Results: The median age of the subjects was 35.5 years old (IQR 18-65) and most of subjects were males (62.3%), smokers (44.9%), had low body mass index (BMI) (56.5%), had hypoalbuminemia (17.4%), serum retinol deficient (40.6%), presented with cavity lesion (30.4%) and presented with scanty and +1 semi-quantitative bacterial load (10.1% and 39.1%, respectively). There was no significant correlation between serum retinol level and semi-quantitative bacterial load. However, there were significant correlations between serum albumin level, BMI and presence of cavity lesion and semi-quantitative bacterial load (p=0.003, p=0.014, and p=0.011, respectively).

Conclusion: There was no correlation between serum retinol level and semi-quantitative bacterial load in new cases of pulmonary TB patients. There were significant correlations between serum albumin level, BMI and presence of cavity lesion and semi-quantitative bacterial load."