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Abstrak :
Penyakit Tuberkulosis Para sampai saat ini masih merupakan masalah kesehatan di Indonesia maupun banyak negara lain di dunia. Salah satu upaya untuk menanggulangi penyakit ini dengan menerapkan program DOTS (Directly Observed Treatment Shortcouse) di seluruh dunia. WHO memperkirakan di Indonesia setiap tahun ada 583.000 kasus baru dengan kematian 140.000 orang setiap tahunnya. Hasil SKRT tahun 1995 menunjukkan penyakit Tuberkulosis Paru penyebab kematian nomor 3 (tiga) setelah penyakit Kardiovaskuler dan penyakit saluran pernafasan. Indonesia mulai mengadopsi program DOTS tahun 1995 dan Propinsi Sumatera Selatan pada tahun itu juga melaksanakan strategi program DOTS. Evaluasi dari laporan Kabupaten / Kota tahun 2002 didapat angka kesembuhan 75, 45 % dan cakupan penemuan penderita 29, 45 %. RS. Khusus Paru merupakan rumah sakit rujukan dari semua Puskesmas yang ada di Propinsi Sumatera Selatan dalam bidang penyakit Paru dan gangguan pernafasan. Penelitian ini bertujuan untuk mengetahui tingkat kepatuhan berobat, mengetahui ada tidaknya hubungan faktor predisposisi, faktor pemungkin, faktor penguat dengan kepatuhan berobat dan mengetahui faktor yang paling dominan dengan kepatuhan berobat. Penderita Tuberkulosis Paru BTA Positif dalam menelan obat di Rumah Sakit Khusus Paru - Paru Propinsi Sumatera Selatan Tahun 2002. Desain penelitian adalah potong lintang dengan jumlah sampel 90 responden, metode sampel secara purposif. Kriteria sampel penelitian adalah penderita TBC Paru BTA Positif kategori 1 dan 2 yang telah menelan ohat dan berumur lebih dari 14 tahun, terdaftar dari tanggal 1 Januari sampai 31 Desember 2002 di Poliklinik Rumah Sakit Khusus Paru - Paru Propinsi Sumatera Selatan. Dari variabel kepatuhan di dapat: yang patuh (63,3 %) yang tidak patuh (36,7 %), umur muda (58,9 %), laki - laki (75,6 %), bekerja (77,8 %), pendidikan rendah (58,9 %) , pengetahuan kurang baik (65, 6 %), jumlah anggota keluarga besar (62,2 %), jarak dekat (90 %), transportasi mudah (94,4 %), ketersediaan obat banyak (91, 1 %), pengawas menelan obat ada (91, 1 %), pelayanan petugas baik (70 %), penyuluhan petugas ada (97,8 %). Pada basil bivariat dari tiga betas variabel independen ternyata hanya enam variabel independen yang dianggap potensial sebagai faktor resiko (p < 0,25) / variabel pendidikan / pengetahuan / pekerjaan / ketersediaan obat / pelayanan petugas / pengawas menelan obat. Hasil analisis multivariat dengan metode regresi logistik dari enam variabel independen diambil sebagai model, ternyata hanya satu variabel yang mempunyai hubungan bermakna paling kuat (p < 0,05), yaitu pengawas menelan obat (PMO) P value (Sig) = 0,039, OR = 6,00 (1,09 - 32,87). Kesimpulan yang di dapat adalah bahwa variabel independen yang berhubungan dengan kepatuhan berobat penderita Tuberkulosis Paru BTA Positif di Rumah Sakit Khusus Paru - Pam Propinsi Sumatera Selatan Tahun 2002 adalah tingkat kepatuhan sebesar 63,3 % dan variabel pengetahuan dan PMO yang bermakna secara statistik (p < 0,05) dengan kepatuhan berobat penderita TBC Pam BTA Positif dan yang paling dominan terhadap variabel dependen adalah variabel Pengawas Menelan Obat. Selanjutnya disarankan bahwa variabel PMO sangat besar pengaruhnya dalam kepatuhan berobat teratur maka penderita harus didampingi PMO agar pengobatannya berjalan baik dan tidak terputus. Rumah Sakit juga memantau penderita yang lalai dalam pengobatan sehingga mengakibatkan pasien drop out, maka dilaksanakan kegiatan rumah sakit di luar gedung yang bekerja sama dengan Dinas Kesehatan Kota / Kabupaten sehingga terbentuk jejaring antara Rumah Sakit dan Dinas Kesehatan Kota I Kabupaten di Propinsi Sumatera Selatan. Dinas Kesehatan Propinsi / Kota / Kabupaten tetap menyediakan obat anti Tuberkulosis kategori I dan 2 dan 3.

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Up to now, TB is still considered as health problem in Indonesia, as well as in other countries around the world. One effort to combat this disease is by applying the DOTS (Directly Observed Treatment Short course) program. WHO had estimated that in Indonesia, there was 583000 new cases of TB with mortality of 140000 persons per year. The SKRT (1995) showed that TB was ranked third as cause of death after cardiovascular and respiratory tract diseases, and ranked first among other infectious diseases. Indonesia started to adopt DOTS in 1995, and in the same year South Sumatera Province had also adopted DOTS strategy. Evaluation reports from District/Township in 2002 showed 75.45% of treated cases and 29.45% of discovery coverage. This study was aimed to understand the level of compliance, and to investigate the relationship between predisposing factors, enabling factors, and reinforcing factors with compliance, as well as to know which was the most dominant factor related to the compliance among BTA positive TB patients in South Sumatera Lung Hospital in the year 2002. Design of the study was cross sectional with 90 respondents chosen purposively. Inclusion criteria was category 1, 2 BTA positive TB patient who had taken medication and aged more than 1 4 years old, registered in between 1 January to 31 December 2002 in South Sumatera Lung Hospital. Univariate analysis among the 90 respondents, showed that there were 63.3% good compliance, 36.7% poor compliance, 58.9% young patients, 75.6% male, 77.8% working, 58.9% low educated, 65.6% poor knowledge, 62.2% big family size, 90% close distance, 94.4% easy transportation, 91.1% drugs available, 91.1% monitor person available, 70.0% good service from health personnel, and 97.8% with extension from health personnel. Bivariate analysis showed that there were 6 out of 13 independent variables that had statistically significant relationship (p < 0.25) with compliance, i.e. education, knowledge, working status, drug availability, health personnel service, and monitor person. Multivariate analysis using logistic regression method showed that the there were two factors with p<0.05, i.e. knowledge and the existence of monitor person, the most dominant factor was the existence of monitor person, with p0.039 and OR =6.00 (1.09 -- 32.87). It is suggested that the existence of monitor person should be maintained and intensive extension and education should be targeted to cadre, family member, PKK at all level, and health personnel in a continuous way and to improve the skill of TB program organizer and management in South Sumatera Lung Hospital. To improve the knowledge of patient and his family, guidelines and leaflet should be distributed. To reduce poor compliance rate, it is suggested to plan out building activity in collaboration with Health Office in township/district level as to ensure the availability of Category 1, 2,and 3 TB drugs.

Abstrak :
[ABSTRAK
Tuberkulosis (TB) masih merupakan masalah kesehatan yang serius terutama di negara berkembang, termasuk Indonesia. Kondisi di Provinsi Jambi dalam 3 tahun terakhir terjadi peningkatan jumlah kasus TB paru BTA positif. Diduga terdapat faktor-faktor yang berhubungan dengan kejadian kasus TB paru BTA positif di Provinsi Jambi. Tujuan dari penelitian ini adalah untuk mengidentifikasi daerah kerawanan kasus TB paru BTA positif di Provinsi Jambi tahun 2013. Desain studi yang digunakan dalam penelitian ini adalah desain studi ekologi dengan uji statistik korelasi dan pendekatan analisis spasial. Hasil analisis bivariat yang terbukti berhubungan dan mempunyai korelasi positif dengan kasus TB paru BTA positif adalah ; keluarga miskin (r=0,716 ; p=0,013), fasilitas pelayanan kesehatan mikroskopis (r=0,637 ; p=0,035), dan tenaga kesehatan terlatih (r=0,758 ; p=0,007). Daerah dengan beresiko tinggi terhadap TB adalah Kabupaten Sarolangun. Rekomendasi : prioritas pembiayaan dalam rangka pengendalian TB dilakukan pada daerah dengan tingkat kerawanan tinggi, perlu ditingkatkan jumlah fasilitas pelayanan kesehatan mikroskopis, dan peningkatan kualitas dan kuantitas tenaga kesehatan terlatih terutama pada daerah dengan tingkat kerawanan tinggi maupun sedang, serta perlu penelitian analisis spasial lebih lanjut di Kabupaten Sarolangun ABSTRACT
Tuberculosis (TB) remains a serious health problem, especially in developing countries, including Indonesia. Conditions in Jambi Province in the last 3 years an increasing number of cases of BTA positive pulmonary TB . Allegedly there are factors associated with the incidence of BTA positive pulmonary TB cases in the province of Jambi . The purpose of this study was to identify areas of vulnerability BTA positive pulmonary TB cases in Jambi Province in 2013. The study design used in this research is the design of ecological studies with statistical tests of correlation and spatial analysis approach. The results of the bivariate analysis were shown to be associated and have a positive correlation with BTA positive pulmonary TB cases are ; poor (r = 0.716 ; p = 0.013), health care facilities microscopic (r = 0.637 ; p = 0.035), and skilled health personnel (r = 0.758 ; p = 0.007). Areas with high risk of TB is Sarolangun. Recommendation : priority problems of financing in the context of TB control is done in areas with high levels of insecurity, increased the number of health care facilities microscopic, and improving the quality and quantity of trained health workers, especially in areas with high or medium levels of vulnerability, as well as the need to further study the spatial analysis in Sarolangun.;Tuberculosis (TB) remains a serious health problem, especially in developing countries, including Indonesia. Conditions in Jambi Province in the last 3 years an increasing number of cases of BTA positive pulmonary TB . Allegedly there are factors associated with the incidence of BTA positive pulmonary TB cases in the province of Jambi . The purpose of this study was to identify areas of vulnerability BTA positive pulmonary TB cases in Jambi Province in 2013. The study design used in this research is the design of ecological studies with statistical tests of correlation and spatial analysis approach. The results of the bivariate analysis were shown to be associated and have a positive correlation with BTA positive pulmonary TB cases are ; poor (r = 0.716 ; p = 0.013), health care facilities microscopic (r = 0.637 ; p = 0.035), and skilled health personnel (r = 0.758 ; p = 0.007). Areas with high risk of TB is Sarolangun. Recommendation : priority problems of financing in the context of TB control is done in areas with high levels of insecurity, increased the number of health care facilities microscopic, and improving the quality and quantity of trained health workers, especially in areas with high or medium levels of vulnerability, as well as the need to further study the spatial analysis in Sarolangun., Tuberculosis (TB) remains a serious health problem, especially in developing countries, including Indonesia. Conditions in Jambi Province in the last 3 years an increasing number of cases of BTA positive pulmonary TB . Allegedly there are factors associated with the incidence of BTA positive pulmonary TB cases in the province of Jambi . The purpose of this study was to identify areas of vulnerability BTA positive pulmonary TB cases in Jambi Province in 2013. The study design used in this research is the design of ecological studies with statistical tests of correlation and spatial analysis approach. The results of the bivariate analysis were shown to be associated and have a positive correlation with BTA positive pulmonary TB cases are ; poor (r = 0.716 ; p = 0.013), health care facilities microscopic (r = 0.637 ; p = 0.035), and skilled health personnel (r = 0.758 ; p = 0.007). Areas with high risk of TB is Sarolangun. Recommendation : priority problems of financing in the context of TB control is done in areas with high levels of insecurity, increased the number of health care facilities microscopic, and improving the quality and quantity of trained health workers, especially in areas with high or medium levels of vulnerability, as well as the need to further study the spatial analysis in Sarolangun.]