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"Latar Belakang: Pajanan debu silika telah diketahui sebagai salah satu faktor risiko infeksi TB paru. Diketahuinya besar risiko pajanan debu silika terhadap timbulnya TB paru dapat menjadi suatu aset dalam upaya advokasi program pemberantasan TB baik di pusat pelayanan kesehatan, maupun di tempat kerja, terutama tcrhadap sektor industri yang terkait pajanan debu silika seperti keramik, gelas, konstruksi, etc. Metode: Penelitian ini menggunakan desain kasus kontrol dengan kasus 129 orang, dan kontrol 129 orang yang dipadankan menurut usia dan jenis kelamin. Wawancara riwayai pajanan debu silika dilalcukan dengan kuesioner yang telah diujicoba sebelumnya. Diagnosis TB paru diambil dari data sekunder hasil pemeriksaan basil tahan asam (BTA) sputum 3x dan foto toraks di awal diagnosis. Pengaruh pajanan debu silika terhadap TB pam dianalisis regresi logistik, disesuaikan terhadap sejumlah faktor risiko lainnya. Hasil: Dari analisis bivariat ditemukan bahwa faktor pajanan debu silika sedang-tinggi memiliki OR kasar = ll.05 (95% Cl = l.39~87-69, p = 0_023). Namm; analisis multivariat tidak menunjukkan kemaknaannya terhadap TB pam. Faktor risiko yang bermakna adalah pendidikan tamat SMP (OR suaian = 2.26, 95% CI = 0.97-5.27), tamat SD hingga tidak sekolah (OR suaian 2.16, 95% Cl = 0.95-4.92), penghasilan rendah (OR suaian = 2.64, 95% CI = 1.21-5.84), Indeks massa tubuh (IMT) kurang (OR suaian = 15.76, CI = 6.95-3546), riwayat minum alkohol sedang-berat (OR suaian = 6.77, 95% CI = 2.27-1 9.78). Simpulan dan saran: Tidak terdapat perbedaan dalam zisiko TB paru antara riwayat pekeljaan terkait pajanan debu silika dengan pekerjaan lainnya_ Keterbatasan popuiasi penelitian di puskesmas tempat penelitian diperkirakan mempunyai andil terhadap hasil yang diamati_ Penelitian selanjutnya perlu dilakukan pada populasi yang lebih spcsifik yaitu pada pekerja industri dengan pajanan debu silika.

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Silica dust exposure has long been known as risk factor for tuberculosis. Therefore, the risk on silica dust exposure can be an asset for health promotion to eradicate tuberculosis in the industrial setting, especially in silica-related industries such as ceramic, pottery, glass, construction, etc.

Methods: The study design is case-control with cases (129 persons) and control (129 persons) selected and matched by age with 5-year interval, and gender. History of occupation with silica dust exposure was taken by interview using questionnaire which had been tested its validity and reliability. Diagnosis of tuberculosis which are acid-fast bacilli.sputum.smear and.thorax.photo interpretation were taken. secondary available. The relationship between pulmonary TB and silica dust exposure was evaluated by logistic regression analysis adjusted for other confounding factors.

Result: Bivariate analysis shows that moderate to high silica dust exposure has crude OR=ll.05 (95% CI = 1.39-87.69, p=0.023). Meanwhile, multivariate analysis does not show its effect towards pulmonary TB. Factors that increases risk are junior high-school graduates (adjusted OR = 2.26, 95% CI = 0.97-5.27), illiterate up to elementary graduate (adjusted OR = 2.16, 95% CI = 0.95-4.92), low income (adjusted OR = 2.64, 95% CI = 1.21-5.s4), new body mass index (BMI) (adjusted OR = 15.76, 95% CI = 6.95-3546), and moderate-heavy drinking (adjusted OR = 6.77, 95% CI = 2.27-l9_78).

Conclusion and Recommendation: Effect of occupation with silica dust exposure on pulmonary 'l`B is not shown in this study. Limitation of the study population was assumed as the cause. Further research is needed to be done in more specific population such as community of worker in industry with silica dust."

"Latar Belakang dan Tujuan: Prevalensi tuberkulosis di Indonesia menduduki peringkat kedua terbanyak setelah India dan peran diagnosis cepat serta akurat sangatlah penting. Sejak tahun 2014 pemeriksaan laboratorium berbasis amplifikasi asam nukleat GenXpert MTB/RIF telah diadopsi dalam pedoman nasional penanggulangan TB paru BTA negatif karena dalam 2 jam dapat lebih akurat mendeteksi basil tahan asam dibandingkan dengan apusan sputum BTA konvensional. Harga yang mahal dan ketersediaan yang terbatas membuat perlunya alternatif lain untuk pemeriksaan ini. Penelitian ini bertujuan untuk membandingkan gambaran radiografi toraks GenXpert MTB/RIF pada pasien tersangka TB paru BTA negatif. Metode: Uji komparasi dengan pendekatan potong lintang membandingkan gambaran radiografi toraks tipikal, atipikal dan bukan TB pada 44 subyek dengan hasil GenXpert MTB/RIF positif dan negatif 22 subyek per kelompok. Analisis berdasarkan adanya komorbiditas HIV, DM, terapi imunosupresan jangka panjang juga dilakukan. Hasil: Terdapat kesesuaian antara gambaran radiografi toraks dengan hasil pemeriksaan genXpert MTB/RIF pada subyek dengan BTA sputum negatif, dengan nilai kappa 0,59 moderate, sensitivitas 81,8 dan spesifisitas 77,3, yang menguat pada kelompok tanpa komorbiditas kappa 0,71l; sensitivitas 87,5, spesifisitas 83,3, serta berkurang pada kelompok dengan komorbiditas kappa 0,464; sensitivitas 81,8 ; spesifisitas 71,4. Lesi radiografi toraks pada kelompok subyek dengan genXpert positif terbanyak adalah infiltrat lapangan atas paru 77,3, nodul 40,9, kavitas 36,4, secara statistik signifikan dengan p<0,05. Kesimpulan: Jika dibandingkan dengan GenXpert MTB/RIF, radiografi toraks memberikan sensitivitas dan spesifisitas yang baik, sehingga dapat dijadikan alternatif modalitas diagnosis yang lebih murah, terutama di daerah perifer Indonesia.

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Background and Purpose: Indonesia rsquo s tuberculosis prevalence is currently ranked second highest in the world after India. Therefore, the role of fast and accurate diagnosis is very important. After 2014, a nucleic acid amplification test GenXpert MTB RIF is implemented for negative sputum smear tuberculosis, due to its ability to diagnose tuberculosis within 2 hours with higher accuracy compared to conventional smear. Due to its high cost and lack of availability, an alternative for diagnostic tools should be sought. This study objective is to compare chest radiography using WHO ISTC criteria based on typical and atypical lesion, with GenXpert MTB RIF on subjects who are suspected tuberculosis, with negative sputum smear.

Methods: Comparative cross sectional study to compare chest radiography using WHO ISTC criteria based on typical and non typical TB among 44 subjects suspected tuberculosis infection with negative sputum smear, among groups with positive and negative GenXpert each 22 subjects. Analysis is also performed on subjects with and without comorbidities HIV, DM, long term immunosuppressive therapy.

Results: We found moderate agreement with kappa value 0,59 moderate, sensitivity 81,8 and specificity 77,3, and showing increased value in group without comorbidities kappa 0,71l sensitivity 87,5, specificity 83,3, and decreased value in group with comorbidities kappa 0,464 sensitivity 71,4 specificity 75. Radiographic lesions most frequently found in positive GenXpert group are upper field infiltrate 77,3, nodules 40,9, and cavities 36,4, with greater proportion compared with negative group, and statistically significant p<0,05.

Conclusion: Compared with GenXpert MTB RIF, chest radiography shows good sensitivity and specificity, so it is still potential as cost effective diagnostic modality especially in peripheral areas in Indonesia. "