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Abstrak :

ABSTRAK
Nama : Nur Annisa
Program Studi : Ilmu Kesehatan Masyarakat
Judul : Pengaruh Fasilitas Pelayanan Kesehatan Terhadap Keberhasilan
Pengobatan Pasien Tuberkulosis Resisten Obat di Indonesia Tahun
2014 - 2016
Pembimbing : Dr. Sutanto Priyo Hastono., M. Kes
Resistensi obat merupakan masalah baru dalam program eliminasi TB yang disebut TB
resisten obat. Pengobatan TB resisten obat di Indonesia dilakukan di fasilitas pelayanan
kesehatan rujukan dan fasilitas pelayanan kesehatan satelit. Penelitian ini bertujuan untuk
mengetahui pengaruh fasilitas pelayanan kesehatan terhadap keberhasilan pengobatan
pasien TB resisten obat di Indonesia. Penelitian ini dilaksanakan pada bulan Mei 2019 di
Subdit-TB, Direktorat P2PML, Kementerian Kesehatan RI. Desain studi penelitian ini
adalah kohort restrospektif. Jumlah sampel sebanyak 4288 orang, diseleksi menggunakan
teknik total sampling. Hasil penelitian menunjukkan bahwa pasien yang menyelesaikan
pengobatan di fasilitas pelayanan kesehatan satelit sebanyak 97,20% dan di fasilitas
pelayanan kesehatan rujukan sebanyak 2,8%. Proporsi keberhasilan pengobatan sebesar
53,2% dengan kumulatif hazard keberhasilan pengobatan sebesar 5,43 di akhir
pengamatan selama 36 bulan pengamatan. Hazard rate keberhasilan pengobatan
36,42/1000 orang-bulan. Hasil analisis multivariat menggunakan regresi cox timeindependet
menunjukkan bahwa pasien yang menyelesaikan pengobatan di fasilitas
pelayanan kesehatan satelit meningkatkan kecepatan terjadinya keberhasilan pengobatan
sebesar 54% (HR 2,17; 95% CI 1,66 – 2,82) dengan kondisi riwayat pengobatan sama.
Penambahan fasilitas pelayanan kesehatan satelit dan tenaga ahli dibutuhkan untuk
membantu proses pengobatan berjalan lebih baik. Peran serta masyarakat dan kesadaran
pasien perlu ditingkatkan dengan melakukan promosi kesehatan tentang TB resisten obat
secara rutin.
Kata Kunci: Fasilitas Pelayanan Kesehatan; Keberhasilan Pengobatan; TB Resisten
Obat

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ABSTRACT
Name : Nur Annisa
Study Program : Public Health
Title : The Effect of Health Care Unit on The Success in Treatment of
Drug Resistant-Tuberculosis Patient in Indonesia, 2014 - 2016
Counsellor : Dr. Sutanto Priyo Hastono., M. Kes
Drug resistant is a new problem in TB elimination program, it’s called Drug-Resistat TB.
Treatment of drug-resistant TB in Indonesia is carried out in rujukan health care and
satelite health care. The aims of this study is increasing the successful treatment of Drug-
Resistant TB patients in Indonesia by health care unit. This research was conducted in
May 2019 at the TB Sub-Directorate, Directorate of P2PML, Ministry of Health of the
Republic of Indonesia. The design of this study is a retrospective cohort. Total sample
were 4288 patient, selected by using total sampling technique. The results showed that
patients who completed treatment in satelit health care were 97.20% and 2.8% in the
rujukan health care. The proportion of treatment success was 53.2% with a cumulative
hazard of treatment success 5.43 at the end of the observation for 36 months observation.
Treatment success rate was 36.42/1000 person-month. The results of multivariate
analysis using cox time-independent regression showed that patients who completed
treatment at satelit health care increased the speed of treatment success 54% (HR 2.17;
95% CI 1.66 - 2.82) with the same treatment history. The addition of satellite health
service facilities and experts is needed to help the treatment process run better.
Community participation and patient awareness need to be improved by conducting
routine health promotion about Drug-Resistant TB.
Key words: Drug-Resistant Tuberculosis; Health Care Unit; Treatment Success.

Abstrak :
Latar belakang: Infeksi TB (TB) dan Human Immunodeficiency Virus (HIV) masih menjadi masalah penyakit menular terbanyak di negara berkembang termasuk Indonesia. Insidens nasional koinfeksi TB-HIV sebanyak 36% dan angka kematian koinfeksi TB-HIV 9,3%. Insidens nasional TB resistan obat yang masih menjadi ancaman saat ini sebesar 23% dan semakin mempersulit keadaan tersebut. Keberhasilan pengobatan koinfeksi TB resistan obat-HIV di Indonesia sejauh ini masih belum diketahui. Tujuan: Penelitian ini bertujuan untuk memprediksi keberhasilan pengobatan pasien koinfeksi TB resistan obat HIV serta faktor yang mempengaruhi. Metode: Penelitian ini adalah penelitian retrospektif potong lintang menggunakan data rekam medis, eTB manager dan data penunjang pasien koinfeksi TB resistan obat-HIV yang berobat di Rumah Sakit Pusat Rujukan Respirasi Nasional Persahabatan Jakarta, Indonesia sejak tahun 2013-2019 untuk evaluasi keberhasilan pengobatan dan faktor yang mempengaruhi. Hasil: Pada penelitian ini didapatkan 63 pasien koinfeksi TB resistan obat HIV. Paisen terbanyak laki-laki (77,8%) dengan median usia 32 tahun. Pada akhir pengobatan didapatkan sebanyak 16 pasien (25,4%) berhasil menyelesaikan pengobatan. Faktor yang berkaitan terhadap keberhasilan pengobatan adalah status pekerjaan (p=0,000), status pernikahan (p=0,035), gejala akhir pengobatan (p=0,000), waktu konversi dan total lama pengobatan (p=0,013). Kesimpulan: Pada penelitian ini didapatkan bahwa keberhasilan pengobatan pasien koinfeksi TB resistan obat HIV masih rendah (25,4%) yang dipengaruhi oleh faktor status pekerjaan, status pernikahan, gejala akhir pengobatan, waktu konversi dan total lama pengobatan. .....Background: Tuberculosis (TB) and Human Immunodeficiency Virus (HIV) infections remain the largest communicable disease problem in developing countries, including Indonesia. The national incidence of TB-HIV co-infection is 36% and the mortality rate of TB-HIV coinfections is 9,3%. The threat of drug resistance TB which it national incidence is 23%, further complicate this situation. The success rate of drug resistant TB-HIV coinfection treatment in Indonesia, to our extent, is yet to be known. Aim: This study aims to estimate the treatment success rate of drug resistance TB- HIV coinfection and realted factors influencing its outcomes. Method: This retrospective cross sectional study used hospital medical records, eTB manager and additional data of TB-HIV coinfected patients treated at Persahabatan Hospital Jakarta, Indonesia, between 2013 and 2019, to observe the treatment success and its related factors. Result: Sixty-three patients were drug resistance TB-HIV coinfected. Patients mostly men (77,8%) and were of median age of 32 years old. By the end of their treatments. 16 patients (25,4%) were completing their treatment. Factor correlated to the treatment success were employement status (p=0,046), marital status (p=0,035), final symptoms by the end of their treatment (p=0.000), convertion time and treatment total duration (p=0,013). Conclusion: This study found that the treatment success rate of drug resistance TB-HIV coinfection was 25,4%. Its contributing factors included employment status, marital status, final symptoms by the end of their treatment, convertion time and treatment total duration.

Abstrak :
ABSTRAK
Latar belakang: Oroantral Communication (OAC) merupakan salah satu komplikasi yang cukup sering ditemukan pasca melakukan ekstraksi gigi posterior rahang atas. Hingga saat ini telah diperkenalkan berbagai macam teknik perawatan bedah untuk melakukan penutupan kasus Oroantral Communication. Tujuan: Penelitian ini dibuat untuk melihat perawatan bedah yang optimum bagi kasus OAC serta mengevaluasi tingkat keberhasilan, komplikasi pasca perawatan, serta mengidentifikasi kelebihan serta kekurangan dari masing-masing perawatan. Metode: Pedoman penyusunan PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) digunakan sebagai panduan penyusunan systematic review ini. Pencarian dilakukan untuk menemukan penelitian sepuluh tahun terakhir yang membahas penutupan OAC melalui tiga database yang berbeda. Hasil: Pencarian secara online menghasilkan 637 studi, ditemukan 2 studi untuk dilakukan dianalisa, dan diperoleh 1 buah teknik penutupan primer terhadap defek OAC (teknik flap bukal). Hal ini dikarenakan rentang waktu sepuluh tahun ditetapkan untuk pencarian literatur yang membahas penutupan primer kasus OAC. Tingkat keberhasilan rata-rata keseluruhan penutupan OAC dengan flap bukal mencapai 100% (hanya terdapat kegagalan pada satu kasus). Kesimpulan: Dari analisis penelitian ini, ditemukan bahwa metode intervensi ini mempunyai berbagai macam kelebihan, kekurangan serta komplikasi post-operatif yang harus dipertimbangkan dalam memutuskan teknik intervensi yang akan diterapkan untuk menutup defek OAC.

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ABSTRACT
Oroantral Communication (OAC) is a complication that is quite often found after the extraction of maxillary posterior teeth. At this time, various kinds of surgical treatment techniques have been introduced to close the Oro-antral defects. The aim of this systematic review was to identify an ideal surgical treatment for OAC cases and evaluate the success rate, post-treatment complications, and identify the advantages and disadvantages of each treatment. PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guideline was used to conduct this systematic review. Literature searching was conducted in three different databases to find the last ten years of research that discussed the closure of OAC. Online searches resulted in 637 studies, and after selection process based on inclusion and exclusion criteria, 2 studies were included for analysis and there is only one primary closure technique (buccal flap). This result is due to ten years time range been given to collect the literatures that discuss about primary closure of OAC. The overall success rate of buccal flap techniqiue reaches 100% from all cases. The results of this systematic review indicate that this intervention technique has a variety of advantages, disadvantages and also post-operative complications that must be considered in deciding which intervention techniques will be applied to close the OAC defect

Abstrak :
Tuberkulosis (TB) menjadi salah satu penyebab kematian tertinggi di dunia, dimana Indonesia pada tahun 2019 menjadi negara penyumbang kasus Tuberkulosis terbanyak kedua di dunia. Pengaruh pandemi COVID-19 dikhawatirkan akan mempersulit penanggulangan TB yang dapat dievaluasi melalui tingkat keberhasilan pengobatan. Studi potong lintang ini dilakukan untuk menganalisis pengaruh pandemi COVID-19 terhadap keberhasilan pengobatan TB di Puskesmas. Sejumlah 418 pasien TB yang menerima OAT KDT Kategori 1 sebelum dan selama pandemi COVID-19 di tiga Puskesmas Wilayah Kota Depok diikutsertakan dengan metode total sampling. Observasi dilakukan terhadap data sekunder dari sistem informasi TB, kartu pengobatan pasien, rekam medis, dan catatan pasien lainnya. Keberhasilan pengobatan ditentukan melalui kategori hasil pengobatan pasien berdasarkan Kementerian Kesehatan RI. Hasil pengobatan sembuh atau pengobatan lengkap dikategorikan sebagai berhasil, sedangkan hasil pengobatan lainnya dimasukkan dalam kategori tidak berhasil. Angka keberhasilan pengobatan selama pandemi meningkat sebesar 10,3% dibandingkan pada periode sebelum COVID-19, dengan nilai berturut-turut sebesar 90,3% dan 80%. Pandemi COVID-19 ditemukan berpengaruh signifikan (p = 0,005) secara statistik terhadap keberhasilan pengobatan pasien TB di tiga puskesmas. Hanya ditemukan 5 pasien TB (1,8%) yang mengalami koinfeksi COVID-19. Faktor yang mempengaruhi keberhasilan pengobatan meliputi usia dan komorbid selama pandemi COVID-19 serta lama pengobatan pasien pada kedua periode. ......Tuberculosis (TB) is one of the highest causes of death in the world, where Indonesia in 2019 became country that contributed second most Tuberculosis cases in the world. The impact of the COVID-19 pandemic feared to complicate TB management which can be evaluated through success rate of treatment. This cross-sectional study was conducted to analyze the effect of COVID-19 pandemic on TB success treatment in public health centers. A total of 418 TB patients who received anti-TB FDC Category I before and during COVID-19 pandemic in three Puskesmas Depok city region were included with total sampling method. Observations were made on secondary data from TB information systems, patient treatment cards, medical records, and other patient records. Success treatment are determined through category of patient treatment outcomes based on the Health Ministry of the Republic of Indonesia. The results of cured treatment or complete treatment are categorized as successful, while other treatment results are included in the category of unsuccessful. The success rate of treatment during the pandemic increased by 10.3% compared to the period before COVID-19, with successive values of 90.3% and 80%. The COVID19 pandemic was found to have a significant effect (p = 0.005) statistically on the successful treatment of TB patients in three health centers. Only 5 TB patients (1.8%) were found to have COVID-19 co-infection. Factors influencing treatment success include age and comorbidities during the COVID-19 pandemic as well as the length of treatment of patients in both periods.