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"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."

"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."

"Hingga saat ini Tuberkulosis TB masih merupakan salah satu penyakit menular yang menjadi permasalahan di dunia kesehatan. Menurut data WHO pada tahun 2014 Indonesia merupakan peringkat ke-2 penyumbang kasus TB terbesar didunia dengan jumlah 9,6 juta kasus. Menurut data Riskesdas 2013 prevalensi TBdi Provinsi Banten yaitu 0,4 dari jumlah penduduk. Upaya pengendalian TB memerlukan peran serta masyaraat dan pasien yang perlu diberdayakan melalui paguyuban TB. Penelitian ini bertujuan mengetahui faktor-faktor yang berhubungan dengan tingkat kepatuhan pengobatan pasien TB terkonfirmasi bakteriologis di Puskesmas Unyur yang melaksanakan paguyuban TB dan Puskesmas Kilasah yang tidak melaksanakan paguyuban TB, Kota Serang tahun 2016. Penelitian ini menggunakan metode kuantitatif dengan desain studi cross sectional yang dilakukan selama bulan November 2016. Sampel penelitian ini berjumlah 79 pasien baru TB terkonfirmasi bakteriologis yang sedang menjalani pengobatan minimal 1 bulan di Puskesmas Unyur dan Puskesmas Kilasah. Hasil analisis univariat menunjukkan tingkat kepatuhan pengobatan pasien TB di Puskesmas Unyur lebih tinggi dari Puskesmas Kilasah. Hasil analisis menunjukkan bahwa ada hubungan yang bermakna antara tingkat pengetahuan dengan kepatuhan pengobatan pasien TB p = 0,024; OR = 10,3; 95 CI = 1,4 to77,8 . Variabel lainnya yang bermakna yaitu dukungan keluarga p = 0,023; OR =7,7; 95 CI = 1,3 to 44,5 . Selain itu juga didapat hasil bahwa dukungan keluarga merupakan faktor yang paling dominan berpengaruh terhadap kepatuhan pengobatan TB setelah dikontrol oleh variabel sikap, jarak, penyuluhan dan dukungan sosial. Kepatuhan Pengobatan merupakan kunci keberhasilan pengobatan TB yang menjadi tujuan utama dalam program pengendalian penyakit Tuberkulosis. Oleh karena itu perlu dilakukan upaya untuk meningkatkan peranserta masyarakat agar program pengendalian TB dapat lebih optimal.

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Until now Tuberculosis TB is one of the infectious diseases that has become problems in the health world. According to WHO 2014, Indonesia was ranked as the second largest contributor of TB cases in the world with 9,6 million cases. According to Riskesdas 2013, the prevalence of TB in Banten Province at 0,4 of the population. TB control efforts required participation of communities and patients through TB support groups paguyuban.

This study aimed todetermine the factors aasociates the treatment compliance level for new patients ofTB confirmed bacteriological in Community Health Center Puskesmas inUnyur TB support group and Kilasah Non TB support group , both in Serang City, 2016. This research used quantitative methods with cross sectional study design, conducted in November 2016. The research sample was 79 confirmed bacteriological TB patients who are under treatment minimum 1 month in Puskesmas Unyur and Kilasah. As the result, treatment compliance of TB patients in Puskesmas Unyur was higher than in Kilasah.

The analysis showed that there was a significant relationship between the level of knowledge with compliance treatment of TB patients p 0,024 OR 10,3 95 CI 1,4 to 77,8. Other significant variable was family support p 0,023 OR 7,7 95 CI 1,3 to44,5. In addition, the result was that the family support was the most dominant factor influencing TB treatment compliance after being controlled by variables, i.e.attitude, distance, counseling and social support. Treatment compliance was key for successful treatment of TB and became a major goal in Tuberculosis control programs. Therefore it is necessary for increase community participation to optimize the TB control programs."

"Penyakit Tuberkulosis paru masih merupakan masalah kesehatan di Indonesia, karena merupakan penyakit menular yang dapat mengakibatkan kematian. Pengobatan TB paru harus dilakukan secara adekuat, lengkap dan teratur supaya angka kesembuhan tinggi dan untuk mencegah resistensi. Angka putus berobat penderita TB paru di Kota Banda Aceh tahun 200I sebesar 21,5%. Putus berobat sangat mempengaruhi keberhasilan dari tujuan penanggulangan TB paru. Penanggulangan TB paru dengan strategi DOTS dapat memberikan angka kesembuhan yang tinggi. Penelitian ini bertujuan untuk mengetahui faktor-faktor yang berhubungan dengan putus berobat penderita TB paru di Puskesmas di Kota Banda Aceh tahun 2001 - 2002. Desain penelitian adalah cross sectional dengan menggunakan data sekunder yang berasal dari TB 01 dan data primer yang didapat langsung dari penderita TB paru dengan cara wawancara menggunakan kuesioner. Penelitian dilaksanakan pada bulan Maret sampai dengan Mei 2003. Sampel penelitian yaitu 141 penderita TB paru berumur 15 tahun keatas yang datang berobat di Puskesmas di Kota Banda Aceh tahun 2001 - 2002 yang diambil secara simple random sampling. Hasil penelitian menunjukkan bahwa proporsi responden penderita TB paru yang putus berobat di Puskesmas Kota Banda Aceh tahun 2001 - 2002 sebesar 30%. Gambaran karakteristik penderita, TB paru di Kota Banda Aceh adalah responden berumur rata-rata 35 tahun, penderita laki-laki lebih banyak 72% dari pada penderita TB paru perempuan 28%. Faktor karakteristik yang berhubungan bermakna dengan putus berobat adalah pekerjaan dan pengetahuan. Penderita TB paru dengan pengetahuan tentang TB paru rendah berpeluang putus berobat 3,69 kali (95% CI : 1,418 - 9,951) dibandingkan penderita TB paru yang berpengetahuan tinggi tentang TB paru. setelah dikontrol variabel efek samping obat. Faktor lain yang berhubungan bermakna dengan putus berobat adalah ketersediaan obat, efek samping obat, dan PMO dan manfaat pengobatan. Penderita TB paru dengan persepsi tidak tersedia obat di Puskesmas mempunyai peluang putus berobat sebesar 4,67 kali (95% CI : 1,282 - 17,011) dibandingkan dengan penderita TB paru dengan persepsi obat tersedia di Puskesmas setelah dikontrol variabel efek samping obat, pengetahuan, dan PMO. Penderita TB paru dengan keluhan ada efek samping obat mempunyai peluang putus berobat 4,24 kaii (95% CI : 1,751 - 10,247) dibandingkan penderita TB paru yang tidak ada keluhan efek samping obat setelah dikontrol variabel pengetahuan dan PMO. Demikian pula Penderita TB paru yang tidak didampingi PMO mempunyai peluang putus berobat 2,51 kali (95% 'CI : 1,081 - 5,851) dibandingkan dengan penderita TB paru ada didampingi PMO setelah dikontrol variabel ketersediaan obat, pengetahuan dan efek samping obat. Faktor yang paling dominan yang berhubungan dengan putus berobat penderita TB paru adalah faktor ketersediaan obat. Dengan hasil penelitian ini disarankan kepada Dinas Kesehatan untuk melakukan monitoring dan evaluasi OAT secara langsung ke Puskesmas, diseminasi informasi dan promosi kesehatan serta perencanaan dan pengadaan obat untuk mengatasi masalah efek samping obat. Untuk Puskesmas disarankan lebih aktif melakukan penyuluhan langsung untuk meningkatkan pengetahuan penderita tentang TB paru sehingga angka putus berobat penderita TB paru di Kota Banda Aceh dapat ditekan seminimal mungkin. Diharapkan ada penelitian lanjutan dengan menggunakan desain yang lebih baik.

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Pulmonary TB is still the problem of health in Indonesia, because representing contagion able to result death, Important of medication of Pulmonary TB which is adequate, regular and complete can give high recovering number and prevent to resistance. The number of drop out of Pulmonary TB patient in Banda Aceh in 2001 equal to 21,5%. The drop out of pulmonary TB is very influencing of efficacy from target of treat of Pulmonary TB. The treat of Pulmonary TB with strategy of Directly Observed Treatment Short Course (DOTS) can give high recovering number.

This research aim to know factors related to drop out of Pulmonary TB patient at the Public Health Center in Banda Aceh in 2001 - 2002. Research Design is sectional cross by using data of secondary coming from TB 01 and got primary data is direct the than Pulmonary TB patient by interview use questionnaire . Research done in March up to May 2003 . Research sample that is 141 Pulmonary TB patient age 15 years old incoming medicine at the Public Health Center in Banda Aceh in 2001 - 2002 which is taken by simple random sampling.

Result of research indicate that respondent proportion drop out of Pulmonary TB at the Public Health Center in Banda Aceh in 2001 - 2002 equal to 30%. Characteristic of Pulmonary TB patient in Banda Aceh is age mean 35 year, The men of Pulmonary TB more is 72% than the woman 28%. Respondent characteristic factor have a meaning of drop out is knowledge and work. Pulmonary TB patient with knowledge about low Pulmonary TB have opportunity 3,69 times (95% CI : 1,418 - 9,951) to drop out compared to patient of high knowledgeable Pulmonary TB about Pulmonary TB after controlled by side effects variable.

The other related factors have a meaning of drop out is the availability of drug, side effects, and the Observed Treatment. Pulmonary TB Patient with perception is not available drug at the Public Health Center have opportunity equal to 4,67 times (95% CI 1,282 - 17,011) to drop out compared to Pulmonary TB patient with perception of available drug at the Public Health Center after controlled side effects variable, knowledge, and PMO. Pulmonary TB patient with sigh there is side effects have opportunity to drop out 4,24 times (95% CI : 1,751 - 10,247) compared to Pulmonary TB patient which there is no sigh of side effects after controlled knowledge variable and PMO.

That way also Pulmonary TB patient which not consort by the Observed Treatment have opportunity to drop out 2,51 times (95% Cl : 1,081 - 5,851) compared to Pulmonary TB patient there is consorted by the Observed Treatment after controlled variable availability of drug, side effects and knowledge. The most dominant factor related to drop out of Pulmonary TB patient is availability of drug.

With result of this research suggested to Public Health Service to do evaluation and monitoring of OAT directly at the Public Health Center and desimination information and health promotion also planning and levying of drug to overcome the problem of side effects. For Public Health Center more active conduct direct consul to increase knowledge of patient about Pulmonary TB so the drop out of pulmonary TB patient in Banda Aceh can be depressed as minimum as possible. Expected there is research of continuation by using better design."

"Indonesia menempati urutan kesembilan dari dua puluh tujuh negara yang memiliki beban MDR (Multi Drug Resistan) TB (Tuberkulosis) di dunia. Kegagalan konversi pada pasien TB paru merupakan salah satu penyebab terjadinya resisten OAT (Obat Anti Tuberkulosis). Pasien TB paru BTA (Basil Tahan Asam) positif kategori I yang mengalami kegagalan konversi di puskesmas wilayah Kota Serang tahun 2014 sebanyak 49 pasien dari 602 pasien TB yang diobati. Penelitian ini bertujuan mengetahui faktor-faktor yang berhubungan dengan kegagalan konversi pasien TB paru BTA positif kategori I dengan menggunakan studi cross sectional. Uji statistik yang digunakan adalah regresi logistik terhadap 168 orang pasien TB paru BTA positif kategori I tahun 2014. Hasil penelitian diperoleh bahwa pasien TB paru BTA positif kategori I yang mengalami kegagalan konversi sebanyak 28%. Ada hubungan antara tingkat pendapatan, pengetahuan tentang TB, sikap pasien terhadap pengalaman terkait TB, jarak dan akses ke puskesmas, kondisi lingkungan tempat tinggal, informasi kesehatan dari petugas TB dan efek samping obat terhadap kegagalan konversi pasien TB paru BTA positif kategori I. Faktor yang paling dominan berhubungan adalah informasi kesehatan dari petugas TB (nilai p value = 0,002, OR 33,217, 95% CI 3,600-306,497). Disimpulkan bahwa peran petugas kesehatan sangat berpengaruh terhadap keberhasilan pengobatan pasien TB paru. Diperlukan komitmen petugas dalam menjalankan fungsi kesehatan masyarakat di antaranya meningkatkan kemampuan petugas dalam memberikan informasi kesehatan serta menjalin kerjasama dengan pasien dan keluarganya untuk terus memberikan pendampingan dan pemberian motivasi selama pengobatan sehingga mencegah terjadinya kegagalan konversi yang dapat berpengaruh terhadap keberhasilan pengobatan.

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Indonesia ranks ninth out of twenty-seven countries which has the burden of MDR (Multi Drug Resistance) TB in the world. The failure of conversion in TB (Tuberculosis) patients was one of the contributing factor to ATD (Anti Tuberculosis Drugs) resistance. Smear positive pulmonary TB patients who have failed first category conversion in Serang City area health centers in 2014 in 49 patients out of 602 treated TB patients. The research aimed to search for factors that connect to abortive attempt in conversion of TB patient with positive lung BTA category 1 by cross sectional study. A statistic test which had been used was binominal logistic regression with TB patient with positive lung AFB (Acid-Fast Bacilli) category 1 as research subject in 2014, with sample of 168 TB patients.

The result of the examination showed that TB patients with positive lung BTA category I experienced failure as much as 28%. There were links between level of income, knowledge of TB, and patient?s respond to their experiences, distance and access to local government clinic, condition of residence, health information from TB health workers and side effects of medicine to abortive attempt in conversion of TB patient with positive lung BTA category 1 by cross sectional study. The most dominant factor of all was sanitary information from TB health workesr (p value = 0.002, OR 33.217, 95% CI 3.600-306.497). It was concluded that health workers play an important role to succeed the treatment of TB lung patients. The workers commitment are needed to perform their duty to increase health information and to bond relationship between patients and their family to provide support and motivate during the therapy, thus the failure in conversion could be prevented."

"Tren angka putus berobat pada pasien TBC RO cenderung fluktuatif. Angka putus berobat TBC RO pada tahun 2020 sebesar 19%, angka ini menurun dibandingkan tahun 2019 sebesar 22% dan 2018 sebesar 27%. Angka putus berobat ini memberikan dampak yang besar bagi indikator program tuberkulosis nasional yang secara tidak langsung memengaruhi keberhasilan pengobatan TBC RO yang belum mencapai target 80%. Penelitian terdahulu menyebutkan kejadian putus berobat ini dipengaruhi oleh faktor karakteristik individu, faktor perilaku, dan faktor lingkungan. Akan tetapi, penyebab pasti dari kejadian putus berobat pasien TBC RO di Indonesia belum banyak diketahui. Penelitian ini bertujuan untuk melihat faktor-faktor apa saja yang berhubungan dengan kejadian putus berobat pada pasien TBC RO di Indonesia Tahun 2022-2023. Sampel penelitian ini adalah semua kasus pasien TBC RO di Indonesia yang memulai pengobatan pada tahun 2022-2023 dan telah memiliki hasil akhir pengobatan dinyatakan sembuh, pengobatan lengkap, dan putus berobat pada Mei 2024. Hasil penelitian menunjukkan terdapat 11,04% paseien TBC RO mengalami putus berobat. Terdapat hubungan antara faktor umur, jenis kelamin, status HIV, status DM, jenis resistansi, kategori panduan OAT, dan jenis fasyankes terhadap kejadian putus berobat pada pasien TBC RO. Sedangkan faktor riwayat pengobatan dan wilayah fasyankes tidak menunjukan adanya hubungan yang signifikan dengan kejadian putus berobat. Perluasan fasyankes pelaksana layanan TBC RO dan kolaborasi antara fasyankes dan komunitas TB dalam melakukan pendampingan dan memberikan dukungan psikososial dapat membantu mencegah terjadinya kejadian putus berobat pada pasien TBC RO di Indonesia.

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The trend of treatment loss to follow up (LTFU) rates in DR-TB patients tends to fluctuate. The DR-TB treatment LTFU 2020 was 19%, this number decreased compared to 2019 of 22% and 2018 of 27%. LTFU have a major impact on national TB programme indicators, which indirectly affect the success of DR-TB treatment, which has not yet reached the 80% target. Previous studies have found that LTFU is influenced by individual characteristics, behavioural factors, and environmental factors. However, the exact causes of LTFU among DR-TB patients in Indonesia are still unknown. This study aims to find out what factors are associated with the incidence of LTFU in patients with DR-TB in Indonesia in 2022-2023. The sample of this study was all DR-TB patients in Indonesia who started treatment in 2022-2023 and had the final results of treatment declared cured, complete treatment, and LTFU in May 2024. The results showed that 11.04% of patients with DR-TB had loss to follow up of TB treatment. There was an association between age, gender, HIV status, DM status, type of resistance, OAT guideline category, and type of health facility with LTFU in patients with DR-TB. Meanwhile, the treatment history and health facility region did not show a significant association with LTFU. Expansion of health facilities providing DR-TB treatment and collaboration between health facilities and TB communities in assisting and providing psychosocial support can help prevent LTFU among patients with DR-TB in Indonesia."

"Program penanggulangan Tuberkulosis Paru dengan strategi Directly Observed Treatment Short course (DOTS) telah dimulai sejak tahun 1995. Diantara indikator yang dapat digunakan melihat keberhasilan strategi DOTS adalah angka kesembuhan dan angka konversi. Di kota Jambi angka kesembuhan pada tahun 2000 sebesar 87,5% di atas target nasional sebesar 85%, dan tahun 2001 turun menjadi 80%. Sedangkan angka konversi BTA (+) menjadi BTA (-) tahun 2001 hanya mencapai 65% di bawah target nasional sebesar 80%,. Terjadinya penurunan angka kesembuhan dan angka konversi tersebut mengindikasikan adanya penurunan persentase penderita Tb Paru yang patuh berobat di kota Jambi tahun 2001. Penelitian ini secara umum bertujuan untuk memperoleh gambaran faktor-faktor yang berhubungan dengan kepatuhan berobat penderita Tb Paru di kota Jambi tahun 2001. Rancangan penelitian yang digunakan adalah cross sectional. Penelitian dilaksanakan dalam kurun waktu 2 bulan, dengan menggunakan data primer yang di peroleh dari basil wawancara melalui kuesioner. Sampel penelitian adalah seluruh penderita Tb Paru yang telah selesai berobat sejak 1 November 2000 sampai 31 Oktober 2001 sebanyak 133 orang. Penelitian ini menunjukkan bahwa faktor pengetahuan, efek samping obat (ESO), jarak dari rumah ke Puskesmas, kesiapan transportasi, persepsi terhadappersediaan obat, penyuluhan oleh petugas, jenis PMO dan peran PMO mempunyai hubungan yang bermakna dengan kepatuhan berobat penderita Tb Paru. Dan hasil analisis multivariat dapat disimpulkan bahwa faktor jarak dari rumah ke Puskesmas, kesiapan transportasi, penyuluhan oleh petugas, dan peran PMO merupakan variabel yang dominan berhubungan dengan kepatuhan berobat penderita Tb Paru di Kota Jambi tahun 2001. Penelitian ini menyarankan pihak program dapat memanfaatkan tenaga kesehatan yang berdomisili dekat dengan penderita untuk memperrnudah pasien mengambil obat misalnya bidan di desa, perawat, petugas kesehatan di Puskesmas Pembantu. Agar PMO benar-benar dapat melaksanakan tugas sesuai fungsi dan peranya dengan baik, maka dimasa yang akan datang disarankan perlu melakukan pemilihan PMO yang lebih selektif, dan semua PMO tersebut di beri pelatihan secara khusus sebelum pengobatan dimulai. Dengan memperhatikan kuatnya hubungan antara penyuluhan yang diberikan petugas dengan kepatuhan berobat penderita Tb Paru serta didukung hasil beberapa penelitian terdahulu, maka di masa akan datang perlu pengamatan secara kualitatif tentang penyuluhan langsung perorangan yang diberikar petugas kepada penderita Tb Paru di Puskesmas, dan kemungkinan altematil pengembangan keterampilan petugas dalam memberi penyuluhan lansung perorangan (misalnya dengan mengikuti pelatihan atau kursus berhubungan dengan penyuluhan tersebut).

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Lung Tuberculosis control program by Directly Observed Treatment Short course (DOTS) has been started since 1995. Among the indicators that suggested the ? level of successfulness of DOTS strategy are cure rate and conversion rate. In Jambi recovery rate in year 2000 is 87,5% higher than 85% of national target, but in 2001 decrease to 80%. Whereas conversion rate of Acid-Fast Bacilli positive to negative in 2001 is only 65% below 80% of national target. The decreasing rate of recovery and conversion indicating the decreasingly of lung TB patient which obey regular medication in Jambi. This study generally to find out factors related to medication compliance of lung TB patient in Jambi year of 2001.

This study using a cross sectional design, carried out in two months, primary data obtained from interview with questionnaires. The sample is all of the 133 lung TB patients that have been taking medication since 1st of November 2000 to 31st of December 2001.

This study suggest that such factors like knowledge, drugs side effect, distance from home to community health centre, transportation, perception to drugs availability, information dissemination by health officer, and drug usage supervising have significance correlation to patient's obedient to medication. From multivariate analysis, can conclude that distance factor from house to community health centre, transportation, information by healthcare staff, and drug usage supervising are dominant variable related to lung TB patient's compliance in medication in Jambi year of 2001. This study recommended that program planner to involve every healthcare staff which living nearby patient to help patient in this medication such as midwife or community health centre staffs.

In order to encourage PMOs to do the task appropriately, in the future all PMOs should be rained before doing their job. By considering relationship between educations by healthcare staff with patient's compliance to medication and supported by the results from previous study, so in the future need qualitative observation about information directly to TB lung patient in community health centre, and alternative for developing skill of healthcare staffs in disseminating information directly to an individual."

"ABSTRAKSalah satu tantangan dalam program TB resistan obat di Indonesia adalahmeningkatnya trend putus berobat. Di tahun 2009, persentase pasien TB resistan obatyang mangkir adalah sebesar 10,5% dan terus mengalami peningkatan di tahun-tahunselanjutnya. Untuk tahun 2013, angka ini meningkat menjadi 28,7%. Tujuan penelitianini adalah untuk mengetahui faktor-faktor yang berpengaruh terhadap kejadian putusberobat pada pasien TB resistan obat di Indonesia tahun 2014-2015. Desain penelitianadalah kohort retrospektif dengan menggunakan data kasus TB resistan obat yangtercatat memulai pengobatan di tahun 2014-2015 dan tercatat di E-TB Manager.Statistik deskriptif, analisis survival dan multivariat digunakan untuk mengetahuipengaruh dari variabel-variabel prediktor terhadap kejadian putus berobat pada kasusTB resistan obat. Dari 2.783 kasus, 30,18% (840) kasus putus berobat. Pada pengobatan< 60 hari, kejadian putus berobat pada pasien berusia 41-84 tahun adalah 1,938 (95%CI,239-3,032) kali lebih cepat dibandingkan dengan kasus yang berumur 15-40 tahun danpada pengobatan ≥ 60 hari, kejadian putus berobat pada usia 15-40 tahun adalah 1,938(95%CI 1,239-3,030) kali lebih cepat dibandingkan dengan kasus yang berumur 41-84tahun. Kejadian putus berobat pada kasus TB resistan obat yang kabupaten/kota tempattinggal pasien sama dengan kabupaten/kota di mana fasyankes TB resistan obat beradaadalah 1,672 (95%CI 1,357-2,062) kali lebih cepat dibandingkan dengan kasus yangberasal dari kabupaten/kota yang berbeda dengan kabupaten/kota di mana fasyankes TBresistan obat berada. Hubungan interaksi (rate-difference modification) antara tempattinggal pasien dengan letak fasyankes rujukan TB resistan obat dan lama interupsipengobatan dengan kejadian putus berobat pada kasus TB resistan obat padapengobatan < 60 hari adalah positif sementara pada pengobatan ≥ 60 hari adalah negatif.Begitu pula hubungan interaksi antara lama interupsi pengobatan dan dukunganpsikososial.

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ABSTRACTOne of the challenges in drug resistant TB program in Indonesia is theincreasing of loss to follow-up. In 2009, the percentage of loss to follow-up among drugresistant TB cases was 10.5% and continued to increase in subsequent years. For 2013,this figure increased to 28.7%. The purpose of this study was to determine the factorsthat influence of loss to follow-up among drug resistant TB cases in Indonesia 2014-2015. Design of study was a retrospective cohort using drug resistant TB cases startingtreatment in 2014-2015 and recorded in E-TB Managers. Descriptive statistics, survivaland multivariate analysis were used to determine the effect of predictor variables onloss to follow-up among drug resistant TB cases. From 2,783 cases, 30.18% (840) caseswas loss to follow-up. In < 60 days of treatment, loss to follow-up among patients aged41-84 years was 1.938 (95% CI, 239-3.032) times faster than cases aged 15-40 yearsold and in ≥ 60 days of treatment, loss to follow-up among patients aged 15-40 yearsold is 1,938 (95% CI 1,239-3,030) times faster than cases aged 41-84 years old. Theloss to follow-up among drug-resistant TB cases residing in the same districts with thelocation of referral hospital were 1.672 (95% CI 1.357-2.062) times faster than casescame from different districts with where referral hospital located. The interactionrelationship (rate-difference modification) between the patient's residence versuslocation of referral hospital and duration of treatment interruption in <60 days oftreatment was positive while in ≥ 60 days, interaction relationship was negative.Similarly, the interaction relationship between the duration of treatment interruptionand psychosocial support."

"[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.]"