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"[ABSTRAKLatar belakang : Insidens Multi-drug resistant pulmonary tuberculosis (TB-MDR) meningkat hampir 2% tiap tahun sedangkan prevalensinya di dunia 4,3%. WHO melaporkan bahwa kasus TB-MDR tahun 2008 di Indonesia terjadi 6427 kasus.Tujuan : Penelitian ini bertujuan untuk menentukan identifikasi TB-MDR di Rumah sakit Umum Pusat Persahabatan dan Klibur Domin Timur laste dengan melakukan evaluasi selama enam bulan.Metode : Penelitian dilakukan dengan kohor retrospektif November 2014 dari rekam medis pasien TB-MDR di RSUP Persahabatan Jakarta dan Penampungan Klibur Domin Timoe Leste. Pemilihan sampel di RSUP Persahabatan dengan cluster random sampling sedangkan di Klibur Domin dengan total sampling.Hasil : Total sampel 49 yaitu 32 pasien di RSUP Persahabatan Jakarta dan 17 pasien di penampungan Klibur Domin Timor Leste yang memenuhi kriteria inklusi. Jenis kelamin laki-laki paling banyak ditemukan baik di RSUP Persahabatan Jakarta (75%) maupun di Penampungan klibur Domin Timor Leste (94,1%) dengan usia produktif (35-44 tahun). Dari karakteristik dasar pengobatan ditemukan riwayat pengobatan ulang kategori II 37,5% paling banyak di RSUP Persahabatan dan di Klibur Domin 82,3% .Hasil pemeriksaan mikroskopis positif di RSUP Persahabatan 65,6% sedangkan di Klibur Domin 100%. Dari pola diagnostik di RSUP Persahabatan ditemukan pemeriksaan gabungan kultur+GenXpert yang terbanyak yaitu 50% sedangkan di Klibur Domin cenderung hanya mendapat diagnosis TB-MDR dari satu pemeriksaan yaitu kultur 64,7% dan Genxpert 18,8%. diterapi.Berdasarkan pola resistensi masing-masing di RSUP Persahabatan yaitu resisten R,H,E,S (56,2%) dan Klibur Domin resisten R,H (70,5%). Kesimpulan : Penelitian ini menunjukkan bahwa betapa pentingnya mengetahui faktor-faktor yang mempengaruhi terjadinya TB-MDR, perlunya pemantauan yang terus menerus dan pengobatan yang segera dan tepat. Pada penelitian ini dapat diketahui bahwa tidak terdapat perbedaan yang menonjol dalam penegakan diagnosis, pemantauan dan pengobatan pasien TB-MDR di RSUP Persahabatan dan Timur Laste.;

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ABSTRACTIntroduction : Multi-drug resistant with pulmonary tuberculosis (TB-MDR) incidence rise to 2% every year, meanwhile prevalence of TB-MDR in the world is 4.3%. WHO report estimated that at 2008 cases of TB MDR in Indonesia were 6427. Objective : The aim of this study is to determine identification of TB-MDR at Persahabatan hospital and Klibur Domin Timur Leste with six months cohort review approach. Methods : This retrospective cohort study was conducted November 2014 from the medical records of TB-MDR patients at Persahabatan Jakarta hospital and Klibur Domin Care of Timor Leste. The sample selection at Persahabatan hospital was with cluster random sampling and Klibur Domin care was with total sampling. Results. Out of a total of 49 patients, 32 patients at Persahabatan Jakarta hospital and 17 patients at Klibur Domin Care Timor Leste, all include inclusion criteria. Male most commonly found in Persahabatan hospital (75%) and Klibur Domin care of Timor Leste (94.1%) with the productive age (35-44 years). From basic characteristics of the history of anti tuberculosis drugs found, category II was most common at Persahabatan hospital (37.5%) and Klibur Domin care was also found to have category II most common (82,3%). Acid fast bacilli positive in Persahabatan hospital was 65.6% and Klibur Domin Timor Leste 100%. Resistance respectively at Persahabatan hospital was R,H,E,S resistant (56.2%) and Klibur Domin care was R,H resistant (70,5%). Conclusion. This study shows the importance of knowing the factors that influence occurance of TB-MDR, the need of countinues monitoring, immediate and appropiate treatment. In this study can be seen that there is no significant difference at diagnosis, monitoring and treatment of TB-MDR at Persahabatan Hospital and Klibur Domin shelter at East Timor.;Introduction : Multi-drug resistant with pulmonary tuberculosis (TB-MDR) incidence rise to 2% every year, meanwhile prevalence of TB-MDR in the world is 4.3%. WHO report estimated that at 2008 cases of TB MDR in Indonesia were 6427. Objective : The aim of this study is to determine identification of TB-MDR at Persahabatan hospital and Klibur Domin Timur Leste with six months cohort review approach. Methods : This retrospective cohort study was conducted November 2014 from the medical records of TB-MDR patients at Persahabatan Jakarta hospital and Klibur Domin Care of Timor Leste. The sample selection at Persahabatan hospital was with cluster random sampling and Klibur Domin care was with total sampling. Results. Out of a total of 49 patients, 32 patients at Persahabatan Jakarta hospital and 17 patients at Klibur Domin Care Timor Leste, all include inclusion criteria. Male most commonly found in Persahabatan hospital (75%) and Klibur Domin care of Timor Leste (94.1%) with the productive age (35-44 years). From basic characteristics of the history of anti tuberculosis drugs found, category II was most common at Persahabatan hospital (37.5%) and Klibur Domin care was also found to have category II most common (82,3%). Acid fast bacilli positive in Persahabatan hospital was 65.6% and Klibur Domin Timor Leste 100%. Resistance respectively at Persahabatan hospital was R,H,E,S resistant (56.2%) and Klibur Domin care was R,H resistant (70,5%). Conclusion. This study shows the importance of knowing the factors that influence occurance of TB-MDR, the need of countinues monitoring, immediate and appropiate treatment. In this study can be seen that there is no significant difference at diagnosis, monitoring and treatment of TB-MDR at Persahabatan Hospital and Klibur Domin shelter at East Timor., Introduction : Multi-drug resistant with pulmonary tuberculosis (TB-MDR) incidence rise to 2% every year, meanwhile prevalence of TB-MDR in the world is 4.3%. WHO report estimated that at 2008 cases of TB MDR in Indonesia were 6427. Objective : The aim of this study is to determine identification of TB-MDR at Persahabatan hospital and Klibur Domin Timur Leste with six months cohort review approach. Methods : This retrospective cohort study was conducted November 2014 from the medical records of TB-MDR patients at Persahabatan Jakarta hospital and Klibur Domin Care of Timor Leste. The sample selection at Persahabatan hospital was with cluster random sampling and Klibur Domin care was with total sampling. Results. Out of a total of 49 patients, 32 patients at Persahabatan Jakarta hospital and 17 patients at Klibur Domin Care Timor Leste, all include inclusion criteria. Male most commonly found in Persahabatan hospital (75%) and Klibur Domin care of Timor Leste (94.1%) with the productive age (35-44 years). From basic characteristics of the history of anti tuberculosis drugs found, category II was most common at Persahabatan hospital (37.5%) and Klibur Domin care was also found to have category II most common (82,3%). Acid fast bacilli positive in Persahabatan hospital was 65.6% and Klibur Domin Timor Leste 100%. Resistance respectively at Persahabatan hospital was R,H,E,S resistant (56.2%) and Klibur Domin care was R,H resistant (70,5%). Conclusion. This study shows the importance of knowing the factors that influence occurance of TB-MDR, the need of countinues monitoring, immediate and appropiate treatment. In this study can be seen that there is no significant difference at diagnosis, monitoring and treatment of TB-MDR at Persahabatan Hospital and Klibur Domin shelter at East Timor.]"

"Insidensi TB di Indonesia menempati urutan kedua terbesar di dunia tahun 2016. Buruknya, sebagian besar provinsi di Indonesia masih belum bisa mencapai target keberhasilan pengobatan tahun 2016, salah satunya DKI Jakarta. Hal ini dapat disebabkan karena banyaknya jumlah putus pengobatan (default treatment). Jika dibiarkan, kondisi ini dapat menimbulkan dampak yang lebih buruk yaitu peningkatan kasus TB MDR. Oleh karena itu faktor yang berhubungan dengan kejadian putus pengobatan perlu identifikasi, namun faktornya bervariasi di berbagai tempat. Penelitian ini bertujuan untuk mengetahui faktor-faktor yang berhubungan dengan kejadian putus pengobatan pada pasien TB MDR di RSUP Persahabatan tahun 2016-2018. Penelitian dilakukan dengan desain potong lintang menggunakan rekam medis dan wawancara 60 subjek. Hasil penelitian menunjukkan prevalensi TB MDR dengan riwayat putus pengobatan di RSUP Persahabatan tahun 2016-2018 adalah 16,9%. Berdasarkan analisis bivariat, faktor yang memiliki hubungan signifikan dengan putus pengobatan adalah perilaku merokok (p=0,008). Melalui analisis multivariat diketahui bahwa hanya perokok sedang yang berhubungan dengan putus pengobatan (p = 0,035, OR = 4,364; KI95% = 1,112-17,128). Dari hasil tersebut disimpulkan bahwa perokok sedang merupakan faktor yang berhubungan dengan kejadian putus pengobatan TB pada pasien TB MDR.

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TB incidence of Indonesia ranks the second largest in the world in 2016. Poorly, most provinces in Indonesia still cannot reach the target of successful TB treatment in 2016, one of which is DKI Jakarta. This can be caused by the large number of dropouts (treatment default). This finding is worrisome, individuals who default from tuberculosis (TB) treatment experience an increased risk of multi drugs resistance tuberculosis cases. Therefore it is important to identify local risk factors for default and for further research to demonstrate the best programme models for reducing default.

This study aims to determine the factors associated with default from TB treatment in multi drugs resistance tuberculosis patients in RSUP Persahabatan in 2016-2018. The study was conducted with a cross-sectional design using medical records and 60 tuberculosis patients were interviewed.

The results showed the prevalence of multi drugs resistance tuberculosis with a history of default tb treatment at RSUP Persahabatan in 2016-2018 is 16.9%. Based on bivariate analysis, significant factor associated with default for drug-sensitive TB programmes is smoking behavior (p = 0.008). In multivariate logistic regression, it was found that only moderate smokers were associated with default from treatment (p = 0.035, OR = 4.364; CI95% = 1.112-17.128). From these results it was concluded that moderate smokers were a factor identified to be associated with treatment default in multi drugs resistance tuberculosis patients."

"Latar Belakang : Pasien kanker paru sering mengalami pneumonia, hal ini terjadikarena penurunan daya tahan tubuh. Pneumonia menyulitkan penanganan,memperburuk kualitas hidup, mengurangi survival dan seringkali merupakanpenyebab langsung kematian pasien kanker paru. Penangananan pneumonia padapasien NSCLC(non small cell lung cancer) dengan antimikroba yang terus menerustanpa memperhatikan kultur sensisitivitas akan menyebabkan resistensi dari kumanpenyebab pneumonia tersebut.Tujuan : Penelitian ini bertujuan untuk mengetahui, pola kuman penyebabpneumonia pada pasien NSCLC, dan membandingkan kesintasan pasien NSCLCyang menderita pneumonia yang disebabkan oleh bakteri MDR (multidrugresistance) dengan yang disebabkan oleh bakteri non-MDR.Metode : Penelitian ini merupakan kohort retrospektif dengan subjek penelitianadalah pasien NSCLC dengan pneumonia yang disebabkan oleh bakteri MDR dannon-MDR yang dirawat di Rumah Sakit Dr Cipto Mangunkusumo bulan Januari2013-Desember 2017. Analisis dilakukan dengan analisis multivariat regressi cox.Hasil: Setelah dilakukan pemeriksaan kultur BAL(Bronchoalveolar lavage), cairanpleura dan sputum, diperoleh 32 subjek hasil kulturnya hanya bakteri MDR, 14subjek tumbuh bakteri MDR dan non-MDR, dan 23 subjek hanya tumbuh bakterinon-MDR. Bakteri non-MDR terbanyak penyebab pneumonia pada pasienNSCLC adalah Klebsiella pneumoniae sebanyak 37,3%, sedangkan bakteri MDRyang terbanyak menyebabkan pneumonia pada pasien NSCLC adalahAcinetobacter baumannii sebanyak 23,2%. Median survival Pasien NSCLCdengan pneumonia yang disebabkan oleh bakteri MDR adalah 57 hari(43,707-70,293) sedangkan yang oleh bakteri non-MDR 92 hari(58,772-125,228).Simpulan : kesintasan pasien NSCLC dengan pneumonia yang disebabkan olehbakteri MDR lebih singkat daripada yang disebabkan oleh bakteri non-MDR.

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Back Ground: Lung cancer patients often experience pneumonia. This is due tothe decrease in body endurance of the patients. Pneumonia complicatestreatment, worsens the quality of life, reduces survival and is often a direct causeof death for lung cancer patients. Dealing with pneumonia in non-small cell lungcancer (NSCLC) patients with continuous antimicrobials treatment withoutregard to culture sensitivity will cause resistance of germs that cause pneumonia.Objectives: This study aims to study the pattern of germs that cause pneumoniain NSCLC patients, and to compare the survival of NSCLC patients sufferingfrom pneumonia caused by MDR (multidrug resistance) bacteria with thosecaused by non-MDR bacteria.Methods: This study was a retrospective cohort with research subjects wasNSCLC patients with pneumonia caused by MDR and non-MDR bacteria whowere treated at Dr. Cipto Mangunkusumo Hospital from January 2013 toDecember 2017. Analysis was performed with multivariate cox regressionanalysis.Results: The results of the culture examination of BAL(Bronchoalveolar lavage),pleural fluid and sputum showed that 32 subjects were infected only from MDRbacteria, 14 subjects infected by both MDR and non MDR bacteria, and 23subjects were infected by only non MDR bacteria. The most non-MDR bacteriathat cause pneumonia in NSCLC patients was Klebsiella pneumoniae as much as37,3%, while the most MDR bacteria that cause pneumonia in NSCLC patientswas Acinetobacter baumannii as much as 23,2%. Median survival of NSCLCpatients with pneumonia caused by MDR bacteria was 57 days(43,707-70,293)while those by non-MDR bacteria was 92 days (58,772-125,228).Conclusions: The survival of NSCLC patients with pneumonia caused by MDRbacteria is shorter than that caused by non-MDR bacteria."

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Latar Belakang : Pasien kanker paru sering mengalami pneumonia, hal ini terjadi karena penurunan daya tahan tubuh. Pneumonia menyulitkan penanganan, memperburuk kualitas hidup, mengurangi survival  dan seringkali merupakan penyebab  langsung kematian pasien kanker paru. Penangananan pneumonia pada pasien NSCLC(non small cell lung cancer) dengan antimikroba yang terus menerus tanpa memperhatikan kultur sensisitivitas akan menyebabkan resistensi dari kuman penyebab pneumonia tersebut.

Tujuan : Penelitian ini bertujuan untuk mengetahui karakteristik pasien NSCLC, pola kuman penyebab pneumonia pada pasien NSCLC, dan membandingkan kesintasan pasien NSCLC yang menderita pneumonia yang disebabkan oleh bakteri MDR (multidrug resistance) dengan yang disebabkan oleh bakteri non-MDR.

Metode : Penelitian ini merupakan kohort retrospektif dengan subjek penelitian adalah pasien NSCLC dengan pneumonia yang disebabkan oleh bakteri MDR dan non-MDR yang dirawat di Rumah Sakit Dr Cipto Mangunkusumo bulan Januari 2013–Desember 2017. Analisis dilakukan dengan analisis multivariat regressi cox.

Hasil: Setelah dilakukan pemeriksaan kultur BAL(Bronchoalveolar lavage), cairan pleura dan sputum, diperoleh 32 subjek hasil  kulturnya hanya bakteri MDR, 14 subjek  tumbuh bakteri MDR dan non-MDR, dan 23 subjek hanya tumbuh bakteri non-MDR.  Bakteri non- MDR terbanyak penyebab pneumonia pada pasien NSCLC adalah Klebsiella pneumoniae sebanyak 37,3%, sedangkan bakteri MDR yang terbanyak menyebabkan pneumonia pada pasien NSCLC adalah  Acinetobacter baumannii  sebanyak 23,2%. Median survival Pasien NSCLC dengan pneumonia yang disebabkan oleh bakteri MDR adalah 57 hari(43,707-70,293) sedangkan yang oleh bakteri non-MDR 92 hari(58,772-125,228). 

Simpulan : kesintasan pasien NSCLC dengan pneumonia yang disebabkan  oleh bakteri MDR lebih singkat daripada yang disebabkan oleh bakteri non-MDR.

 

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Back Ground: Lung cancer patients often experience pneumonia. This is due to the decrease in body endurance of the patients. Pneumonia complicates treatment, worsens the quality of life, reduces survival and is often a direct cause of death for lung cancer patients. Dealing with pneumonia in non-small cell lung cancer (NSCLC) patients with continuous antimicrobials treatment without regard to culture sensitivity will cause resistance of germs that cause pneumonia.

Objectives: This study aims to study the characteristics of NSCLC patients, the pattern of germs that cause pneumonia in NSCLC patients, and to compare the survival of NSCLC patients suffering from pneumonia caused by MDR (multidrug resistance) bacteria with those caused by non-MDR bacteria.

Methods: This study was a retrospective cohort with research subjects was NSCLC patients with pneumonia caused by MDR and non-MDR bacteria who were treated at Dr. Cipto Mangunkusumo Hospital from January 2013 to December 2017. Analysis was performed with multivariate cox regression analysis.

Results: The results of the culture examination of BAL(Bronchoalveolar lavage), pleural fluid and sputum showed that 32 subjects were infected only from MDR bacteria, 14 subjects infected by both MDR and non MDR bacteria, and 23 subjects were infected by only non MDR bacteria. The most non-MDR bacteria that cause pneumonia in NSCLC patients was Klebsiella pneumoniae as much as 37,3%, while the most MDR bacteria that cause pneumonia in NSCLC patients was Acinetobacter baumannii as much as 23,2%. Median survival of NSCLC patients with pneumonia caused by MDR bacteria was 57 days(43,707-70,293) while those by non-MDR bacteria was 92 days (58,772-125,228).

Conclusions: The survival of NSCLC patients with pneumonia caused by MDR bacteria is shorter than that caused by non-MDR bacteria.

 

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"Indonesia masuk kedalam Negara dengan tiga beban TB tertinggi, salah satunya adalah TB-MDR. Persentase kematian pada pasien TB-MDR selama masa pengobatan di Indonesia melebihi batasan target WHO yaitu 10. Penelitian ini bertujuan untuk mendapatkan faktor-faktor yang berhubungan dengan kematian pada pasien Tuberkulosis Multi Drug Resistance TB-MDR selama masa pengobatan di Indonesia tahun 2010-2014. Desain penelitian yang digunakan adalah studi cross sectional menggunakan data sekunder registrasi kohort e-TB Manager Surveilans TB Resistan Obat 2010-2014. Variabel independen pada penelitian ini meliputi faktor kerentanan individu usia, jenis kelamin, komorbid diabetes mellitus, jumlah resistansi OAT, hasil pemeriksaan sputum di awal pengobatan, faktor kerentanan sistem kesehatan riwayat pengobatan TB sebelumnya dan interval inisiasi pengobatan, dan faktor kerentanan sosial wilayah tempat tinggal. Variabel dependen pada penelitian ini adalah hasil akhir kematian pada pasien TB-MDR. Hasil penelitian didapatkan bahwa terdapat hubungan bermakna antara usia dengan kematian pada pasien TB-MDR selama masa pengobatan.

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Indonesia is one of the countries in three high burden country list, partially MDR TB. The presentation of mortality among MDR TB patients during treatment in Indonesia is above WHO target which is 10. This study aimed to describe the epidemiological and factors associated with mortality among MDR TB patients during treatment in Indonesia from 2010 through 2014. The study was conducted with cross sectional using secondary data cohort registration e TB Manager Surveillance of TB Drugs Resistance 2010 2014.

Independent variables of this study were individual vulnerability age, sex, diabetes mellitus comorbidities, number of drugs resistance, initial sputum test, programmatic or institutional vulnerability previous history of TB treatment and interval of treatment, and social vulnerability living status. Dependent variable of this study was the end of treatment result for mortality among MDR TB patients. The results indicated that age associated with mortality among MDR TB patients during treatment."

"Penyebaran Multidrug Resisten Tuberculosis (MDR TB) yang disebabkan oleh bakteri Mycobacterium tuberculosis merupakan perhatian untuk program penaoganan TB. Obat antituberkulosis lini kedua digunakan untuk pengobatan penderita MDR TB. Kami melakukao penelitian tentang Uji kepekaan obat antituberkulosis lini kedua menggunakan media Lowenstein Jensen dibandingkan dengan Mycobacterium Growth Indicator Tube (MGIT 960) sistem. Tiga puluh (30) isola!ba!cteri MDR TB di uji dengan oflokasin, amikasin, dan kanamisin menggunakan MGIT 960 dan baslinya dibandingkan dengan metode proporsi pada media Lowenstein Jensen. Dati basil penelitian didapat 27 isolat (90 %) sensitif teihadap ofloksasin , 21 isolat (70 %) sensitif terbadap antikasin dan 26 isolat (86,6 %) sensitif terhadap kanamisin. Dua isolat merupakan Extensively Drugs Resistance (XDR TB). Waktu untuk uji kepekaan dengan MGIT adalab 9 hari sedaogkan dengan metode proporsi 21 hari.

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The emergence of multidrug resistant tuberculosis (MDR TB) caused by Mycobacterium tuberculosis is real threat for TB control program. Second line drogs was using for person who has MDR TB. The objective of this study was to evaluate the proportion method for testing of Mycobacterium tuberculosis susceptibility to second line drugs compared to the Mycobacterium Growth Indicator Tube (MGJT 960 )System. Thirty MDR TB Isolates were tested for susceptibility to ojloxacin, amikasicin, and kanamycin by MGJT 960, and the result were compared to those obtain with proportion method on Lowenstein Jensen media, considered a reference method. Result for ojloxacin were 27 isolate (90 %) sensitive,21 isolate (70 %) sensitive to amikacin and 26 isolate (86,6 %) sensitive to kanamycin. Two Isolate were Extensively Drug resistance (XDR TB)The time required to obtain result was an average of 9 days by the MGIT and 21days by the reference method."

"ABSTRAKPrevalensi DO pada pasien TB MDR terus meningkat setiap tahunnya di Provinsi DKI Jakarta. Penelitian ini bertujuan untuk menganalisis kejadian DO pada pasien TB MDR di Provinsi DKI Jakarta tahun 2011-2015 berdasarkan faktor risiko umur, jenis kelamin, status HIV, masa pengobatan, kepatuhan berdasarkan tipe pasien, riwayat pengobatan TB sebelumnya, dan jumlah resistansi OAT. Data yang digunakan adalah data sekunder data register kohort e-TB Manager dengan jumlah sampel sebanyak 516 pasien. Desain penelitian studi kuantitatif observational cross sectional. Prevalensi DO pasien TB MDR pada penelitian ini 44.6 yang merupakan prevalensi kasar. Tren prevalensi DO pada penelitian ini cenderung mengalami peningkatan dari tahun 2011 hingga 2015 dan selalu melebihi angka 10 setiap tahunnya. Oleh karena itu, perlu adanya upaya untuk dapat mengurangi jumlah kasus DO pada pasien TB MDR. Diharapkan penelitian ini dapat menjadi acuan bagi Dinas Kesehatan Provinsi DKI Jakarta dalam menjalankan program P2TB yang lebih baik dan tepat sasaran.

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ABSTRACTThe prevalence of DO among MDR TB patients increases every year in DKI Jakarta Province. This research aims to analyse DO among MDR TB patients in DKI Jakarta Province in 2011 2015 based on risk factors of age, sex, HIV status, treatment periode, adherence based on type of patients, history of TB treatment, and number of OAT resistance. The data used is secondary data cohort registration e TB Manager with sample of 516 patients. The design study is an observational cross sectional quantitative study. The crude prevalence of DO among MDR TB patients was 44.6. Prevalence tren of DO among MDR TB increases since 2011 untill 2015 and always more than 10 in every year. Therefore, it is necessary efforts that can decrease DO cases among MDR TB patients. This study expected to be a reference for DKI Jakarta Province Health Office in implement P2TB Program and reach target precisely. "

"Latar Belakang: Anemia diketahui sebagai salah satu komplikasi pada penyakit TB. Konsentrasi hemoglobin yang rendah diasosiasikan dengan keterlambatan waktu konversi kultur sputum pada pasien TB namun hubungannya pada pasien TB MDR masih belum diketahui. Konversi kultur sputum pasien TB MDR dari positif menjadi negatif merupakan prediktor utama indicator keberhasilan pengobatan. Penelitian ini bertujuan untuk mengetahui apakah kondisi anemia pada pasien TB MDR dapat memperlambat waku konversi sputum. Metode: Penelitian ini menggunakan desain studi kohort retrospektif dengan metode total sampling untuk memperoleh data pemeriksaan hematologis, status klinis, dan status demografis dari rekam medis pasien TB MDR di RSUP Persahabatan selama tahun 2016. Data mengenai waktu konversi sputum diperoleh dari database online Indonesia, e-TB-Manager, di bawah pengawasan pihak yang berwenang di RSUP Persahabatan. Hasil: Dari seluruh 363 rekam medis, terdapat 201 data yang memenuhi kriteria inklusi dengan keterangan sebanyak 83/118 41.3 mengalami anemia. Analisis data dengan uji kesintasan menunjukkan bahwa status anemia memiliki pengaruh yang signifikan terhadap keterlambatan konversi sputum, sedangkan klasifikasi dan jenis anemia tidak memiliki pengaruh yang signifikan terhadap proses konversi sputum. Kesimpulan: Kondisi anemia meningkatkan risiko konversi sputum yang lebih lama pada pasien TB MDR dibandingkan dengan pasien tanpa diserta anemia. Oleh karena itu, perlu adanya upaya perbaikan status gizi dan profil hematologis pada pasien TB MDR yang disertai dengan anemia.

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Background: Anemia was known to be the complication of Tuberculosis TB . Low hemoglobin concentration was associated with prolonged time of culture sputum conversion in TB but the association in MDR TB is still unknown. Sputum culture conversion in MDR TB was the main predictor of successful therapy outcome. This study aims to understand whether anemia amongs MDR TB patients could prolong the time for sputum conversion.

Method: This retrospective cohort study used total sampling method to obtain hematological laboratory data, clinical status, and demographic status from medical records of MDR TB patients in Persahabatan Hospital during the year of 2016. The time of sputum conversion was obtained from Indonesian online database e TB Manager under supervision of Persahabatan Hospital authorized staffs.

Result: Of the 363 medical records within a year, only 201 datas fitted into inclusion criteria in which 83 of 118 MDR TB patients 41.3 have anemia. Survival analysis rate showed a significant rate difference in conversion time based on the anemic status. However, there is no significant relation of classification and types of anemia towards the conversion time.

Conclusion: Anemia increased the risk of prolonged time in spuum conversion in MDR TB patients compared to those without anemia. Therefore, there should be an effort in improving the nutritional status and hematological profile in MDRt TB patients with anemia."

"Penyakit tuberkulosis adalah penyakit menular yang masih menjadi penyebab utamamasalah kesehatan masyarakat di Indonesia. Beban penyakit tuberculosis semakinbertambah seiring meningkatnya penemuan kasus TB MDR Tuberkulisi Resistant ObatGanda . Penelitian ini bertujuan untuk mengetahui faktor-faktor resiko yangberhubungan dengan peningkatan prevalensi kejadian TB MDR di Kabupaten BrebesTahun 2011-2018. Desain penelitian ini adalah kasus kontrol dengan populasi seluruhpasien tuberkulosis dewasa di Kabupaten Brebes tahun 2017. Jumlah sampel kasus 46dan jumlah sampel kontrol adalah 92. Hasil penelitian menunjukkan bahwa faktorfaktorresiko yang berpengaruh terhadap peningkatan prevalensi kejadian TB-MDR diKabupaten Brebes Tahun 2011-2017 adalah kepatuhan minum obat OR 6,7; 95 CI2,2-19,7 , Riwayat pengobatan TB sebelumnya OR 5,3; 95 CI 1,2-14,1 , dankesesuaian dosis/obat OR 5,2; 95 CI 1,2-22,8 .Penyuluhan atau KIE kepada pasien,keluarga dan atau PMO tentang pentingnya kepatuhan minum obat dan konsekuensiyang timbul akibat dari ketidakpatuhan minum obat sangat penting untukmengendalikanpeningkatan kejadian TB MDR.Kata kunci:Tuberkulosis, TB-MDR, Faktor resiko

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Tuberculosis is a contagious disease that is still the main cause of public healthproblems in Indonesia. The burden of tuberculosis is on the rise with the rise of MDRTB Tuberculosis Resistant Drug Double cases. This study aims to determine the riskfactors associated with increasing the prevalence of MDR TB incidence in BrebesDistrict Year 2011 2018. The design of this study was a control case with a populationof all adult tuberculosis patients in Brebes District by 2017. The number of casesamples 46 and the number of control samples was 92. The results showed that riskfactors had an effect on increasing the prevalence of MDR TB incidence in BrebesRegency 2011 2017 is medication adherence OR 6.7, 95 CI 2.2 19.7 , previous TBtreatment history OR 5.3, 95 CI 1.2 14.1 , and dose conformity drug OR 5,2 95 CI 1,2 22,8 . Counseling to patients, families and or PMOs on the importance ofmedication adherence and the consequent consequences of non adherence to takingmedication is essential to control the incidence of MDR TB.Key words Tuberculosis, MDR TB, risk factors."