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"ABSTRAKTB Paru dan HIV AIDS merupakan masalah yang sering terjadi di perkotaan. Salah satu manifestasi TB Paru dengan HIV AIDS adalah Fatigue . Karya ilmiah ini menggunakan metode studi kasus yang bertujuan untuk memberikan gambaran pada asuhan keperawatan pada pasien TB Paru dengan HIV AIDS dengan menerapkan intervensi Graded Exercise Therapy/ GET. Hasil dari intervensi ini adalah terjadi penurunan skala fatigue dari skala 8 menjadi skala 5. Terapi sangat direkomendasikan untuk mengurangi fatigue pada pasien TB Paru dengan HIV AIDS. Oleh karena itu, pelayanan rumah sakit diharapkan dapat menerapkan GET.

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ABSTRACTPulmonary Tuberculosis and HIV AIDS have been transformed as a prevalent problem in urban areas. One of sympthoms commonly experienced by tuberculosis with HIV AIDS patients is Fatigue. The type of approach in this research was case study which aims to provide an overview of nursing care in tuberculosis with HIV AIDS patients by applying Graded Exercise Therapy GET intervention. This thesis concludes that there was a decrease in the scale of fatigue from scale 8 to scale 5. Therapy is becoming increasingly recommended to reduce fatigue in tuberculosis with HIV AIDS patients. Therefore, hospital are strongly encouraged to adopt GET."

"ABSTRAK Nama : Ika Dewi SubandiyahProgram Studi : Magister EpidemilogiJudul : Hubungan antara Kepatuhan Minum ARV dan OAT dengan ProgresivitasTB Paru pada Koinfeksi TB HIV di Jakarta Selatan th 2015-2017Pembimbing : dr.Mondastri Korib Sudaryo MS,DScKata kunci : koinfeksi TB HIV, Kepatuhan OAT dan ARV, Progresivitas, Survival,HazardPengobatan TB- HIV memerlukan pengobatan sekaligus yakni OAT dan ARV untukmencegah progresivitas TB. Penelitian sebelumnya, kepatuhan terhadap kedua pengobatanmasih kurang. Studi ini bertujuan untuk mengetahui hubungan kepatuhan minum OAT danARV dengan progresivitas TB paru pada koinfeksi TB-HIV di Jakarta Selatan. Desain yangdigunakan adalah Kohort Retrospektif dengan menggunakan data yang berasal dari kartupengobatan TB dan ikhtisar perawatan HIV yang dimiliki pasien TB-HIV di puskesmas danRSUD di Jakarta Selatan tahun 2015-2017. Hasilnya adalah responden yang patuh minumkedua obat 56,8 , patuh ARV 13,5 ,patuh OAT 14,2 dan tidak patuh keduanya 15,5 .29,7 penderita koinfeksi TB HIV menunjukkan progresivitas sedangkan 70,3 tidak.Analisis cox regresi menunjukkan bahwa ada hubungan antara kepatuhan dengan progresivitasTB paru pada koinfeksi TB-HIV p.0.000 .Probabilitas survival pada responden yang tidakpatuh minum keduanya 17.4 , patuh minum ARV saja 30,6 ,patuh OAT saja 69,7 danpatuh keduanya 88,4 . Resiko untuk progresif pada responden yang tidak patuh minum keduaobat adalah 24 kali HR 24.56;95 CI 9.49-63.53 . Resiko responden yang patuh minum ARVsaja 8,6 kali HR 8,59; 95 CI 3.15-23.42 dan resiko yang patuh minum OAT saja 3,3 kali HR3.3; 95 CI 1.01-10.97 .ABSTRACT Name Ika Dewi SubandiyahStudy Program Master of EpidemiologyTitle Association Of Arv And Anti Tb Drugs Adherence To Pulmonary TbProgression In Tb Hiv Co Infection In South Jakarta 2015 2017Counsellor dr.Mondastri Korib Sudaryo MS,DScKey words TB HIV coinfection, adherence, progression,survival,hazardTB HIV requires both ARV and anti TB drugs treatment at the same time to prevent theprogression of TB. Previous research, adherence to both treatments is unsufficient.The aims ofthis study is to determine the association of ARV and anti ndash TB drugs adherence to theprogression of pulmonary TB in TB HIV co infection in South Jakarta. The design used wasRetrospective Cohort using data derived from TB treatment cards and HIV care overviews ofTB HIV patients at puskesmas and Government District Hospital in South Jakarta 2015 2017.The result is the respondents who adherently drank both drugs 56.8 , adhered to ARV 13.5 ,adhered to anti TB drugs 14.2 and non adhered to both 15.5 . 29.7 of HIV coinfected TBpatients showed progressivity while 70.3 did not.Cox regression analysis showed that therewas a correlation between adherence and pulmonary tuberculosis progression in TB HIVcoinfection p.0.00 .Probability of survival in non adherent respondents was 17.4 , only ARVadherence 30.6 ,only Anti TB drugs adherence 69,7 and adhered to both 88.4 . The riskfor progressive in non adherence respondents was 24 higher than adherence to both HR 24.56 95 CI 9.49 63.53 . While the risk in adherence to ARV alone was 8.6 HR 8.59 95 CI 3.15 23.42 and adherence to Anti TB drugs alone was 3.3 HR 3.3 95 CI 1.01 10.97 ."

"Tuberkulosis (TB) merupakan penyakit infeksi menular yang masih menjadi permasalahan di dunia. TB dapat menyebabkan kematian pada penderitanya. Salah satu tempat penyebaran tinggi TB adalah Penjara. Pada penelitian sebelumnya diketahui bahwa prevalensi TB di Penjara lebih besar dibandingkan dengan prevalensi TB di masyarakat. Tujuan penelitian ini adalah diketahuinya hubungan status HIV dengan kejadian TB Paru berdasarkan karakteristik individu, kepadatan hunian kamar, kontak dalam sel, dan faktor perilaku pada narapidana di Lembaga Permasyarakatan Narkotika Kelas II A Jakarta tahun 2013. Penelitian ini dilakukan denngan desain cross sectional, dengan sampel 250 naparidana yang terdata pada tahun 2013 dan masih berada di Lapas Narkotika Kelas II A Jakarta. Hasil penelitian ini menunjukkan bahwa terdapat 6,2% responden yang mengalami TB Paru. Berdasarkan hasil uji bivariat didapatkan bahwa ada hubungan antara status HIV dengan kejadian TB Paru. Setelah dilakukan stratifikasi, di dapatkan bahwa hubungan status HIV dengan kejadian TB Paru lebih cenderung terjadi pada responden yang memiliki kepadatan hunian kamar yang memenuhi syarat, memiliki kontak dalam sel dengan pasien TB, atau pernah merokok.

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Tuberculosis (TB) is communicable infection disease that still is problem in the world. TB can make people who affected with bacteria of TB dead. One of high-risk group of TB is prisoners. Recent researches show that prevalence of TB in prisons higher than prevalence of TB in public. This research then comes to find the relationship between status of HIV and Pulmo TB be stratificated based on individual factors, rooms occupy density, contact in cell, and behavior factors on prisoners in Lembaga Permasyarakatan Narkotika Kelas II A Jakarta on 2013. The research was done with cross-sectional design with 250 samples of prisoners who registered on 2013 and still is in Lembaga Permasyarakatan Narkotika Kelas II A Jakarta. It found that 6,2% respondents were have Pulmo TB. Based on bivariate analysis, the research also found that there are relationships between status of HIV with pulmo TB. After stratification, it show that relationship between status of HIV and pulmo TB have preference happen in respondent who having good Room occupy density, having contact in cell with patients of TB, or have been smokers in the past."

"IntroduksiHuman Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS), sejak dikenalnya sindrom penyakit ini lebih dari 2 (dua) dekade, terus menerus menyebar diseluruh dunia tanpa ada tanda-tanda pengurangan. Tuberkulosis (TB) merupakan penyebab utama kesakitan dan kematian pada orang dengan HIV/AIDS sekitar 40%-50%. Tujuan penelitian yaitu mengetahui kesintasan tiga tahun pasien HIV/AIDS dan pengaruh ko-infeksi TB terhadap kesintasan 3 tahun pasien HIV yang mendapat terapi ARV.MetodePenelitian ini adalah dengan pendekatan cohort retrospective di RSPI prof.dr. Sulianti Saroso Tahun 2009-2011.HasilProbabilitas kesintasan kumulatif pasien HIV/AIDS yang mendapat ART pada tahun pertama adalah 84,2%, 2 tahun adalah 81,4%, dan 3 tahun adalah 79,26%. Hasil analisis multivariate dengan uji regresi Cox Time Dependent Covariate menemukan koinfeksi TB mempengaruhi kecepatan kematian pasien HIV/AIDS (adjusted HR 1,60; 95% CI: 0,96-2,67) setelah dikontrol oleh faktor risiko penularan dan hitung CD4 sebelum terapi ARV. IDU memiliki pengaruh terhadap kesintasan tiga tahun pasien HIV/AIDS (aHR 1,71; 95% CI: 1,04-2,95). Apabila pajanan Koinfeksi TB dapat dieliminasi, maka sebesar 40% kematian pasien HIV/AIDS dapat dicegah di Rumah Sakit Prof. Sulianti Saroso.DiskusiPengaruh TB terhadap HIV, selain mempercepat progresivitas HIV juga berakibat pada mortalitas HIV. Koinfeksi TB menambah laju hazard terhadap ketahanan hidup pasein. Tingkat mortalitas pengidap HIV yang sekaligus mengidap TB 2 kali lebih tinggi dibandingkan dengan pengidap HIV tanpa TB.SaranMeningkatkan kualitas conselling kepada ODHA yang mendapat ART khususnya pada pasien dengan koinfeksi TB. Meningkatkan pogram kolaborasi TB-HIV di rumah sakit untuk menunjang efektifitas program dan pelayanan kesehatan kepada pasien HIV/AIDS.

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Introduction

Human Immunodeficiency Virus / Acquired Immunodeficiency Syndrome (HIV / AIDS), since this disease syndrome known more than two (2) decades, continuously spread throughout the world with no signs of abatement. Tuberculosis (TB) is a major cause of morbidity and mortality in people with HIV/AIDS around 40%-50%. The purpose of research is to determine the three-year survival rate of patients with HIV / AIDS and TB co-infection influences the 3-year survival of patients with HIV who receive antiretroviral therapy.

Methods:

This study is a retrospective cohort approach in RSPI Prof. Sulianti Saroso Year 2009-2011.

Results:

The cumulative probability of survival of patients with HIV / AIDS who receive antiretroviral treatment in the first year was 84.2%, 2 years was 81.4%, and 3 years was 79.26%. Results of multivariate analysis with the Cox regression Time Dependent covariate find TB affects the speed of death in HIV / AIDS (adjusted HR 1,60; 95% CI: 0,96-2,67)) after controlled by transmission risk factors and CD4 counts before ART. IDU patients had 2 times the risk of a hazard than patients with non-IDU group (adjusted HR 1.95, 95% CI: 1.17 to 3.24). If TB Co-infection can be eliminated from th e susceptible population, then the death of 40% of patients with HIV/AIDS can be prevented in the Infectious Disease Hospital Prof. dr. Sulianti Saroso.

Discussions:

Effect of TB to HIV, besides accelerating the progression of HIV also result in mortality of HIV. TB adds to the hazard rate of survival pasein. The mortality rate of people with HIV who also have tuberculosis 2 times higher compared to HIV without TB.

Recommendations:

Counselling to improve the quality of people living with HIV who received antiretroviral therapy, especially in patients co-infected with TB. Increase pogram TB-HIV collaboration at the hospital to support effective programs and health services to patients with HIV / AIDS."

"Latar Belakang: Pasien TB-HIV yang mengalami lost to follow-up dapat menjadi sumber penularan, resistensi obat, meningkatnya angka morbiditas dan mortalitas. Dibutuhkan data tentang proporsi lost to follow-up pasien TB-HIV, serta faktor-faktor yang memengaruhi. Tujuan : Mengetahui profil lost to follow-up pasien TB-HIV dan faktor-faktor yang memengaruhi. Metode: Desain penelitian menggunakan kohort retrospektif terhadap pasien TB-HIV rawat jalan di RSCM tahun 2015-2017. Analisis univariat untuk mendapatkan data profil pasien TB-HIV. Analisis bivariat dan multivariat untuk mengetahui besar pengaruh faktor-faktorr terkait lost to follow-up pasien TB-HIV. Analisis multivariat untuk mendapatkan Odds Ratio (OR) dari setiap faktor. Hasil: Hasil analisis univariat menunjukkan proporsi lost to follow-up pasien TB-HIV sebesar 39% dengan karakteristik sebagai berikut, laki-laki (74,4%), usia ≥30 tahun (76,9%), jumlah penghasilan dibawah upah minimum regional Jakarta (87,2%), status fungsional ambulatory-bedridden (51,3%), frekuensi ganti transportasi 2 kali (51,3%), lama menunggu pengobatan ≥ 2jam (87,2%), jumlah obat <12 (56,4%), tempat tinggal di Jakarta (92,3%), mengalami efek samping obat (56,4%) dan status imunodefisiensi berat (84,6%). Lost to follow-up TB-HIV paling banyak terjadi pada bulan ke-2 pengobatan TB. Hasil analisis multivariat menunjukkan jumlah penghasilan dibawah upah minimum regional Jakarta (OR 6,58; IK 95%(2,27-19,08); nilai p=0,001) paling berpengaruh terhadap lost to follow-up pasien TB-HIV. Kesimpulan : Proporsi lost to follow-up pasien TB-HIV sebesar 39%. Lost to follow-up TB-HIV paling banyak terjadi pada bulan ke-2 pengobatan TB. Jumlah penghasilan dibawah upah minimum regional Jakarta menjadi faktor paling memengaruhi lost to follow-up pasien TB-HIV

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Background. TB-HIV patients whose lost to follow-up can be followed up for transmission, drug resistance, patients and mortality. We required data for proportion of lost to follow up TB-HIV, factors associated within.

Aim.To find out the profile of lost to follow-up in TB-HIV patients and influencing factors.

Methods. The study design used a retrospective cohort of outpatient TB-HIV patients at the RSCM in 2015-2017. Univariate analysis to obtain profile data for TB-HIV patients. Bivariate and multivariate analysis to determine the effect of factors related to lost to follow-up of TB-HIV patients. Multivariate analysis to get Odds Ratio (OR) from each factor.

Results. The results of univariate analysis were the proportion of lost to follow-up TB-HIV patients by 39%. The basic characteristics of each patient lost to follow-up TB-HIV were: Men (74.4%), age ≥30 years (76.9%), total income under the regional minimum wage of Jakarta (87.2%), functional status of ambulatory bedridden (51.3%), frequency of change transportation twice (51.3%), long waiting for treatment ≥2 hours (87.2%), number of drugs <12 (56.4%), place of residence in Jakarta (92.3%), experiencing drug side effects (56 , 4%), severe immune status (84.6%). Most lost during the second month of TB treatment. The results of multivariate analysis of income under the minimum regional of Jakarta (OR 6.58; IK 95%(2.27-19.08)) most influence the lost to follow-up of TB-HIV patients.

Conclusion. The proportion of lost to follow-up for TB-HIV patients was 39%. Most were lost on the second month of TB treatment. Total income of under the minimum regional of Jakarta was the most influential factor in lost to follow-up of TB-HIV patients."

"Menurut data dari Tuberculosis TB national prevalence survey dalam TB Global Report 2015, angka prevalensi TB di Indonesia sekitar 650 jiwa dengan angka insidensi 403 jiwa per 100.000 penduduk. Pada pasien TB paru sering dijumpai temuan lesi paru yang khas yaitu kavitas. Jumlah pasien TB dengan kavitas pada orang dewasa bervariasi sekitar 30-50 persen. Di dalam kavitas diperkirakan terdapat sekitar 107 sampai dengan 109 bakteri. Hal ini menunjukan adanya bahwa kavitas merupakan faktor risiko penting dari kegagalan pengobatan dan relaps serta kemungkinan berhubungan dengan resistansi obat.Penelitian bertujuan untuk mengetahui proporsi pasien TB paru, kavitas pada TB paru serta hubungan antara tingkat bacterial load dengan kavitas pada pasien TB paru. Penelitian ini merupakan studi cross sectional yang diambil dari pasien pada rentang tahun 2013 sampai tahun 2015 sebanyak 145 subjek.Hasil studi menunjukan bahwa tingkat kepositivan BTA pada BTA 3 ,2 dan 1 ,1-9 batang memiliki hubungan bermakna pada kejadian lesi kavitas p=0.018. Ditemukan pula pada BTA positif dan negatif terdapat hubungan bermakna dengan kejadian lesi kavitas p=0.05 . Perlu dilakukan studi lebih lanjut dengan desain penelitian yang berbeda dengan desain kohort prospektif serta subjek diajarkan cara pengambilan sputum yang benar.

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According to data from Tuberculosis TB national prevalence survey in Global TB Report 2015, the prevalence of TB in Indonesia is around 650 people with the incidence of 403 people per 100,000 population. In patients with pulmonary TB, cavity is a typical common finding in lung lesion. Number of TB patients with cavities in adults varies between 30 50 percent. Inside the cavity, it is estimated that there are about 107 up to 109 bacteria. This shows that the cavity is an important risk factor of treatment failure and relapse as well as possibly related to drug resistance.The aim of this study is to determine the proportion of patients with pulmonary TB, cavity in pulmonary TB, and the association between the level of bacterial load and the occurrence of cavity in patients with pulmonary TB. The study was a cross sectional study which was taken from 145 patients from years 2013 to 2015.The results showed that the level of positivity in AFB 3 , 2 , and 1 , 1 9 rods has a significant relationship to the occurrence of cavity lesions p 0.018 . It was also found on the positive and negative AFB that there was a significant relationship with the occurrence of the cavity lesion p 0.05 . Further study is needed to be carried out with different design, which is prospective cohort study and the subject is taught the correct way to collect sputum."

"[Munculnya berbagai tantangan baru dalam pengendalian TB, salah satunya multidrug resistant tuberculosis (TB MDR). TB MDR adalah salah satu jenis resistensi TB yang disebabkan oleh bakteri Mycobacterium tuberculosis yang tidak merespon (resisten), setidaknya, isoniazid dan rifampicin yang merupakan dua jenis obat yang paling efektif pada lini pertama obat anti TB (OAT). Penelitian bertujuan untuk mengetahui faktor-faktor yang mempengaruhinyakonversi kultur sputum pada pasien TB Paru MDR. Penelitian dilakukan di dilakukan di RSUD Labuang Baji Kota Makassar dimulai dari bulan April 2015-Juni 2015. Desain penelitian adalah kohort retrospektif. Jumlah sampel dalam penelitian ini yakni 183 pasien, 139 pasien (76,0%) yang mengalami konversi kultur sputum, 4 pasien (2,2%) yang tidak mengalami konversi kultur sputum, dan 40 pasien (21,8%) yang loss to follow up. Dari penelitian ini diketahui bahwa probabilitas konversi kultur sputum pasien TB paru MDR sebesar 95,52%. Hasilanalisis multivariat menunjukkan bahwa interupsi pengobatan (HR:0,45; 95%CI: 0,26-0,79), status diabetes melitus (DM) sebelum 33 hari (HR:0,75; 95%CI: 0,29- 1,95) dan setelah 33 hari yakni (HR:1,95; 95%CI: 0,90-7,60), serta riwayat pengobatan yang pernah mendapatkan OAT lini I (HR:0,32; 95%CI: 0,12-0,90) serta yang pernah mendapatkan OAT lini II (HR:0,27; 95%CI: 0,10-0,77). Diperlukan penanganan secara intensif dan lengkap pada pasien TB paru MDR di Poli TB MDR dengan memperhatikan interupsi pengobatan, status DM, dan riwayat pengobatan sebelumnya;One of the new emerging challenges in TB controlling is multidrug resistant tuberculosis (MDR TB). MDR TB is a type of TB resistant caused by the unresponsiveness (resistancy) of Mycobacterium tuberculosis to at least isoniazid and 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 was conducted in Labuang Baji General Hospital, Makassar City started from April 2015 to June 2015. Cohort-retrospective design was performed in this study. There were 183 patients involved in this study consisted of 139 (76,0%) patients with sputum culture conversion, 4 (2,2%) patients with no sputum culture conversion, and 40 (21,8%) patients were loss to follow up. The result of the study shows that the probability of sputum culture conversion of Pulmonary MDR TB 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), previously treated with FLDs (HR:0,32; 95%CI: 0,12-0,90), and previously treated with SLDs (HR:0,27; 95%CI: 0,10-0,77) were found to be the influencing factors for the sputum culture conversion among pulmonary MDR TB. Complete and intensive care are needed among pulmonary MDR TB in MDR TB polyclinic by observing the interruption of treatment, DM, and history of previous treatment.;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.;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.;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.;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., 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.]"

"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.

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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."

"Tingkat kejadian TB Paru di Indonesia masuk dalam kelompok urutan ketiga setelah India dan China berdasarkan laporan WHO tahun 2009 (Riskesdas, 2010). Di Indonesia TB Paru merupakan pembunuh nomor satu diantara penyakit menular dan merupakan penyebab kematian nomor tiga setelah jantung dan penyakit pernapasan akut pada seluruh kalangan usia (Soedarsono, 2006). TB Paru merupakan penyakit menular yang menyebar melalui batuk dan dahak. Penyakit TB ini dipengaruhi oleh faktor usia, pekerjaan, status pernikahan dan riwayat penyakit.Desain yang digunakan pada penelitian ini adalah deskriptif, sampel yang digunakan yaitu pasien TB di poliklinik paru RS Persahabatan sejumlah 99 responden. Pengambilan sampel menggunakan simple non random sampling dengan teknik accidental sampling.Hasil penelitian dianalisis menggunakan analisis univariat ditemukan 89,1% responden memiliki harga diri tinggi (normal). Pada penelitian ini berarti tidak adanya gangguan pada harga diri pasien TB di poliklinik paru RS Persahabatan. Rekomendasi untuk pihak RS Persahabatan untuk memberikan pendidikan kesehatan kepada pasien TB tentang pengobatan teratur sehingga tidak terjadi kasus TB berulang.

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Pulmonary TB incidence rate in Indonesia in the group third after India and China by 2009 WHO report (Riskesdas, 2010). In Indonesian Tuberculosis is the number one killer among infectious diseases and is the third cause of death after heart disease and acute respiratory in all the ages (Sudarsono, 2006). Tuberculosis is an infectious disease that spreads through coughing and phlegm. TB disease is influenced by age, occupation, marital status and history of disease.

Design used in this study is descriptive, ie the sample used in the clinic of pulmonary TB patients Friendship Hospital a number of 99 respondents. Sampling using non simple random sampling with accidental sampling technique.

The results were analyzed using univariate analysis found 89.1% of respondents have a high selfesteem (normal). In this study means no compromise on dignity pulmonary TB patients in the clinic Persahabatan Hospital. Recommendations for the Persahabatan Hospital to provide health education to patients on TB treatment so it does not happen regularly recurrent TB cases."

"Latar belakang: Tuberkulosis merupakan masalah kesehatan global dan menjadi penyebab pertama dari dua kematian akibat penyakit menular di dunia. Pasien yang menghentikan pengobatan sebelum sembuh mengakibatkan penyakitnya bertambah parah, menularkan penyakit bahkan meninggal. Pemanfaatan pelayanan kesehatan turut berperan dalam kasus TB, karena pemanfaatan pelayanan dapat mencegah terjadinya kasus putus berobat. Sekitar 50% pasien TB tanpa pengobatan akan meninggal. Salah satu faktor risiko kematian karena TB adalah pengobatan yang tidak adekuat. Tujuan penelitian ini adalah untuk mengetahui faktor pendukung dan penghambat pasien TB paru dewasa putus berobat di wilayah Kota Serang tahun 2016. Metode : Penelitian ini menggunakan metode penelitian kuantitatif dan kualitatif. Penelitian kuantitatif menggunakan desain cross-sectional dengan sampel 13 penderita TB. Sedangkan, penelitian kualitatif menggunakan wawancara mendalam. Hasil : Hasil penelitian menemukan faktor pendukung pasien TB Paru putus berobat untuk memulai kembali pengobatannya adalah pengetahuan, sikap pengobatan, jarak ke Puskesmas, kunjungan petugas TB, pendorong pengobatan kembali, kebutuhan pengobatan, dukungan keluarga dan petugas TB Puskesmas. Sedangkan faktor penghambat pasien TB putus berobat adalah efek samping OAT dan upaya pencarian pengobatan lain. Kesimpulan : Pengobatan TB merupakan salah satu upaya paling efisien untuk mencegah penyebaran kuman TB. Maka, perlu dilakukan kerja sama lintas program terkait untuk mengoptimalkan pengobatan TB sekaligus mengatasi masalah pasien TB putus berobat di wilayah Kota Serang.

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Background : Tuberculosis (TB) is a major global health problem, the first cause of two deaths of infectious diseases in worldwide. Some patients discontinued treatment before cured resulting the disease became severe, transmit diseases and even death. Utilization of health services also have a role in the cases of TB, this is due to prevent lost to follow-up cases. As many as 50% TB patients without treatment will die. One of death risk factor of TB are inadequate treatment. The aim of this study is to find out the supported and inhibited factors of lost to follow-up adult TB patients at Serang City in 2016.

Method : This study used quantitative and qualitative research methods. In quantitative research, conducted by using cross-sectional design with 13 patients TB as sample. Meanwhile, a qualitative study using in-depth interviews.

Result : The study found the factors supported lost to follow-up TB patients for restarting the treatment were knowledge, attitudes of treatment, distance to reach public health center, health officers home visit, retreatment stimulus, needs of treatment, then the support of family and health center officers. While the factors inhibited lost to follow-up patient to get the retreatment were the side effects of treatment and the search for another treatment.

Conclusion : TB Treatment is one of the most efficient efforts to prevent the further spread of Tuberculosis. Therefore, that is necessary to cooperate with various programs related to optimizing the treatment of TB as well as to overcome the problem of lost to follow-up TB patients in the city of Serang."