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Al Asyary
"[ABSTRAK
Tuberkulosis (TB) paru anak merupakan masalah kesehatan global yang
terabaikan (neglected), terlebih dengan proporsi 7,32% dari seluruh kasus TB di
Indonesia (Balitbangkes, 2013). TB paru anak selalu diakibatkan oleh infeksi TB
dari populasi di lingkungan sekitar, khususnya adanya orang dewasa yg sakit TB
serumah. Namun, tidak selalu TB paru dewasa mampu menularkan kesakitan pada
anak serumah. Penelitian ini bertujuan untuk mengkaji faktor-faktor yang diduga
menurunkan risiko anak tidak sakit TB paru ketika tinggal serumah dengan
penderita dewasa. Metode dengan desain kasus kontrol berdasarkan data rekam
medis di sembilan rumah sakit rujukan TB anak dan puskesmas di Provinsi
Daerah Istimewa Yogyakarta (DIY). Kondisi hunian khususnya kamar tidur yang
baik dan intensitas paparan TB paru dewasa yang jarang serta di pengaruhi
kondisi variabel lain merupakan faktor yang dapat melindungi anak agar tetap
sehat meskipun kontak dengan penderita TB paru dewasa serumah;

ABSTRACT
TB disease in children is a global health problem that still neglected, moreover
with 7,32% proportion of TB cases at Indonesia (Balitbangkes, 2013). Children
with TB disease is most always impacted from TB infection at environment
population especially from adult TB household contacts. However, children not
always get the disease as bad as TB adult then. The objective of this study was to
find protective factors that can keep healthy children who had adult TB household
contacts. A case-control study conducted at nine referred hospital of TB children
and several health centers based on medical records at Special Region of
Yogyakarta Province. The study found that healthy houses, especially with
healthy bedroom and fewer exposures with adult TB in order influenced by
confounders variables. Those variables were reduced the risk of childhood TB
disease eventhough they exposed with adult TB in their environment;TB disease in children is a global health problem that still neglected, moreover
with 7,32% proportion of TB cases at Indonesia (Balitbangkes, 2013). Children
with TB disease is most always impacted from TB infection at environment
population especially from adult TB household contacts. However, children not
always get the disease as bad as TB adult then. The objective of this study was to
find protective factors that can keep healthy children who had adult TB household
contacts. A case-control study conducted at nine referred hospital of TB children
and several health centers based on medical records at Special Region of
Yogyakarta Province. The study found that healthy houses, especially with
healthy bedroom and fewer exposures with adult TB in order influenced by
confounders variables. Those variables were reduced the risk of childhood TB
disease eventhough they exposed with adult TB in their environment, TB disease in children is a global health problem that still neglected, moreover
with 7,32% proportion of TB cases at Indonesia (Balitbangkes, 2013). Children
with TB disease is most always impacted from TB infection at environment
population especially from adult TB household contacts. However, children not
always get the disease as bad as TB adult then. The objective of this study was to
find protective factors that can keep healthy children who had adult TB household
contacts. A case-control study conducted at nine referred hospital of TB children
and several health centers based on medical records at Special Region of
Yogyakarta Province. The study found that healthy houses, especially with
healthy bedroom and fewer exposures with adult TB in order influenced by
confounders variables. Those variables were reduced the risk of childhood TB
disease eventhough they exposed with adult TB in their environment]"
2015
D2058
UI - Disertasi Membership  Universitas Indonesia Library
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Dwi Sora Yullyana
"ABSTRAK
Indonesia merupakan negara dengan jumlah kasus tuberkulosis terbanyak urutan ke-2 di dunia.
Selama beberapa dekade terakhir, tuberkulosis juga muncul pada populasi anak. Tahun 2017,
proporsi kasus tuberkulosis anak masih mengalami peningkatan menjadi 5.86 per 100.000
penduduk pada umur 0-4 tahun dan 5.89 per 100.000 penduduk pada usia 5-14 Tahun. Studi ini
bertujuan untuk mengetahui distribusi tuberkulosis anak di Kota Administrasi Jakarta Timur.
Penelitian ini menggunakan desain kasus kontrol. Populasi adalah semua kasus tuberkulosis
anak yang ditemukan di pelayanan kesehatan Kota Administrasi Jakarta Timur tahun 2017.
Kelompok kasus adalah seluruh anak berumur 0-14 tahun yang sudah didiagnosis tuberkulosis
positif berdasarkan sistem skoring tuberkulosis paru anak dan tercatat dalam register di
Puskesmas wilayah Jakarta Timur. Kelompok kontrol adalah anak 0-14 tahun yang tinggal di
wilayah Jakarta Timur dan tidak terdiagnosis tuberkulosis paru.
Hasil penelitian menunjukkan bahwa proporsi kurang gizi kelompok kasus sebesar 29.17%
lebih tinggi dibandingkan dengan kelompok kontrol. Hasil analisis T-test menjelaskan bahwa
anak dengan gizi buruk memiliki risiko TB paru dibandingkan dengan anak dengan status gizi
normal (OR 3.54; 95% CI 1.56-8.04; p 0,002). Hasil analisis regresi logistik menjelaskan bahwa
anak dengan malnutrisi berisiko tuberkulosis paru 3.37 dibandingkan dengan anak dengan status
gizi normal setelah dikontrol oleh variabel kondisi atap, pencahayaan, riwayat imunisasi dasar,
dan riwayat kontak kasus tuberculosis (95% CI 1.10-10.25; p 0.034).
Kegiatan preventif dan promotif merupakan upaya dalam pencegahan dan pengendalian
tuberkulosis paru khususnya pada anak. Upaya preventif dapat dilakukan melalui Gerakan
Temukan Tuberkulosis Obati Sampai Sembuh (TOSS TB). Untuk memperkuat Gerakan TOSS
TB, Pemerintah bersama masyarakat dapat melakukan Gerakan Masyarakat Hidup Sehat
(GERMAS).

ABSTRACT
Indonesia is the country with the second highest number of tuberculosis cases in the
world. Over the past few decades, tuberculosis has also emerged in the childhood
population. In 2017, the proportion of cases of childhood tuberculosis still increased by
5.86 per 100,000 population at 0-4 years old and 5.89 per 100,000 population at 5-14
years old. This study aims to determine the association nutritional status and
pulmonary tuberculosis of children in Health Center Area, East Jakarta Administrative
City in 2019.
This study used a case-control design. The population was all children 0-14 years old
who live in the East Jakarta Region in 2018 until March 2019. The case group was all
children 0-14 years old who had been diagnosed with positive tuberculosis based on the
scoring system of pediatric pulmonary tuberculosis and recorded in registers in the
Puskesmas in East Jakarta. The control group was children 0-14 years old who lived in
the east Jakarta region and without pulmonary TB.
The results showed that the proportion of malnutrition of case groups at 29.17% higher
compared to control groups. The results of the T-test analysis explained that children
with malnutrition had a risk of pulmonary tuberculosis compared to a children of
normal nutritional status (OR 3.54; 95% CI 1.56-8.04; p 0.002). The results of the
logistic regression analysis explained that children with malnutrition at risk of
pulmonary tuberculosis 3.37 compared to children with normal nutritional status after
being controlled by variable roof conditions, lighting, history of basic immunization,
and history of contact with tuberculosis cases (95% CI 1.10-10.25; p 0.034).
Preventive and promotive activities are efforts in the prevention and control of
pulmonary tuberculosis, especially in children. Preventive efforts can be made through
the Movement to Find Tuberculosis Treat to Treat (TOSS TB). To strengthen the TOSS
TB Movement, the Government and the community can carry out the Healthy Living
Society Movement (GERMAS)."
2019
T-Pdf
UI - Tesis Membership  Universitas Indonesia Library
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Sartika
"Tuberkulosis (TBC) di Indonesia mencapai jumlah penderita terbanyak kedua di dunia pada tahun 2021 menyebabkan risiko penularan semakin tinggi. Saat ini, peningkatan kasus TBC anak mencapai hampir tiga kali lipat jika dibandingkan jumlah kasus di tahun 2021. Salah satu upaya pencegahan penularan adalah dengan pengembangan inovasi dalam memberikan asuhan keperawatan di komunitas serta untuk memudahkan dalam penerapannnya, dibuat dalam bentuk media berbasis aplikasi android “Gempita” yang diujikan pada praktik residensi keperawatan komunitas. Tujuan: Penerapan inovasi GErakan Masyarakat PedulI Tuberkulosis Anak bertujuan untuk meningkatkan perilaku pencegahan penularan dari orang tua selaku caregiver anak dengan tuberkulosis. Inovasi Gempita terdiri dari beberapa intervensi keperawatan yaitu melalui pendekatan dukungan kelompok, edukasi kesehatan, demonstrasi dan keterampilan dalam pencegahan penularan dan perawatan TB pada anak. Pada media aplikasi yang dibuat, Gempita memiliki sajian menu berupa materi edukasi kesehatan, diskusi interaktif, pengingat jadwal minum obat dan makanan bergizi, sharing experience dan demonstrasi keterampilan dalam pengobatan dan pencegahan penularan TBC. Metode: Desain yang digunakan adalah studi kasus dengan menerapkan asuhan keperawatan komunitas. Pendekatan dukungan kelompok menjadi strategi pada 32 partisipan. Hasil inovasi menunjukkan peningkatan rerata tingkat pengetahuan, sikap dan keterampilan dalam pencegahan penularan TB sebelum dan setelah intervensi Gempita; peningkatan berat berat badan anak sebelum dan setelah intervensi Gempita dan perbedaan bermakna pada rerata pengetahuan, sikap dan keterampilan dalam upaya pencegahan penularan TB sebelum dan setelah intervensi Gempita (p Value < 0,05). Kesimpulan ada pengaruh pelaksanaan inovasi Gempita pada perilaku pencegahan penularan pada kelompok caregiver anak. Inovasi Gempita yang dikembangkan sebagai aplikasi berbasis teknologi diharapkan dapat dimanfaatkan untuk meningkatkan perilaku pencegahan TBC dan menekan peningkatan kasus TBC, khususnya TBC anak

Tuberculosis (TB) in Indonesia reached the second highest number of patients in the world in 2021, causing a higher risk of transmission. Currently, the increase in pediatric TB cases has almost tripled when compared to the number of cases in 2021. One of the efforts to prevent transmission is to develop innovation in providing nursing care in the community and to facilitate its application, it is made in the form of an android application-based media "Gempita" which is tested in community nursing residency practice. Objective: The application of the Gempita innovation aims to improve the transmission prevention behavior of parents as caregivers of children with tuberculosis. Gempita innovation consists of several nursing interventions, namely through a group support approach, health education, demonstrations and skills in preventing transmission and treating TB in children. In the application media created, Gempita has menu offerings in the form of health education materials, interactive discussions, reminders of medication schedules and nutritious food, sharing experiences and demonstrations of skills in the treatment and prevention of TB transmission.
Methods: The design used was a case study by applying community nursing care. Group support approach was the strategy for 32 participants. The results of the innovation showed an increase in the average level of knowledge, attitudes and skills in preventing TB transmission before and after the Gempita intervention; an increase in child weight before and after the Gempita intervention and a significant difference in the average knowledge, attitudes and skills in preventing TB transmission before and after the Gempita intervention (p value <0.05). It is concluded that there is an effect of the implementation of the Gempita innovation on transmission prevention behavior in the child caregiver group. The Gempita innovation developed as a technology-based application is expected to be used to improve TB prevention behavior and reduce the increase in TB cases, especially childhood TB.
"
Depok: Fakultas ilmu Keperawatan Universitas Indonesia, 2023
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UI - Tugas Akhir  Universitas Indonesia Library
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Indriya Wardhani
"Tuberkulosis merupakan salah satu dari 9 penyebab kematian di dunia pada tahun 2015. Sebanyak 62% kasus tuberkulosis di dunia pada tahun 2017 berada di Wilayah SEAR (South-East Asia Region). Penelitian ini bertujuan untuk mengetahui faktor-faktor risiko yang berhubungan dengan tuberkulosis pada usia ≥ 15 tahun di Indonesia. Penelitian ini menggunakan data sekunder dari hasil Indonesia Family Life Survey (IFLS) 5 tahun 2014 dan memakai desain penelitian studi longitudinal. Sampel yang digunakan pada penelitian ini sebesar 31.916 responden yang memenuhi kriteria inklusi dan eksklusi. Analisis multivariat yang digunakan adalah Cox Regression. Insiden tuberkulosis pada usia ≥ 15 tahun di Indonesia tahun 2014 sebesar 1% (327 orang) responden. Hasil Multivariat yaitu: Usia ≥ 65 tahun (RR= 3,86; 95% CI 2,46-6,06), pendidikan (RR=0,76; 95% CI 0,60-0,98), malnutrisi (RR=1,30; 95% CI 1,02-1,62), merokok (RR= 0,62; 95% CI 0,46-0,82), lantai rumah (RR= 0,26; 95% CI 0,06-1,04), bahan bakar memasak (RR= 0,54; 95% CI 0,36-0,79), dan kontak serumah dengan penderita (RR= 69,68; 95% CI 34,07-142,49). Faktor yang paling besar pengaruhnya terhadap tuberkulosis pada usia ≥ 15 tahun dan lebih akurat yaitu usia baik hubungan langsung (bivariate) maupun hubungan dengan tuberkulosis setelah dikontrol dengan variabel lainnya (multivariate) (RR= 3,86; 95% CI 2,46-6,06 untuk responden yang berusia ≥ 65 tahun.

Tuberculosis is one of the nine causes of death in the world by 2015. 62% of tuberculosis cases in the world in 2017 is in the Region SEAR (South-East Asia Region). This study aims to determine the risk factors associated with tuberculosis at age ≥ 15 years in Indonesia. This study uses secondary data from the Indonesia Family Life Survey (IFLS) 5 in 2014 and put on a longitudinal study research design.The sample used in this study amounted to 31.916 respondents who meet the inclusion and
exclusion criteria. Multivariate analysis used is the Cox Regression.The incidence of tuberculosis at the age ≥ 15 years in Indonesia in 2014 amounted to 1% (327 people) of the respondents. Results Multivariate namely: age ≥ 65 years (RR = 3.86; 95% CI 2.46 to 6.06), education (RR = 0.76; 95% CI 0.60 to 0.98), malnutrition (RR = 1.30; 95% CI 1.02 to 1.62), smoking (RR = 0.62; 95% CI 0.46 to 0.82), floor of the house (RR = 0.26; 95% CI 0 , 06-1.04), cooking fuel (RR = 0.54; 95% CI 0.36 to 0.79), and household contact with patients (RR = 69.68; 95% CI 34.07 to 142 , 49). The factors that most influence on tuberculosis at the age ≥ 15 years and more accurately the age group either direct connection (bivariate) and relations with tuberculosis after controlling for other variables (multivariate) (RR = 3.86; 95% CI 2.46 to 6 06 for respondents aged ≥ 65 years)."
Depok: Fakultas Kesehatan Masyarakat Universitas Indonesia, 2019
T53933
UI - Tesis Membership  Universitas Indonesia Library
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Muhammad Kautsar
"Latar belakang: Tuberkulosis (TB) adalah penyakti menular yang disebabkan oleh organisme Mycobacterium Tuberkulosis (MTB). Tuberkulosis menempati peringkat pertama penyebab kematian yang disebabkan oleh infeksi tunggal. Penegakan diagnosis TB sulit pada anak karena tidak ada gejala yang spesifik dan khas terhadap TB, disertai dengan sulitnya mengambil sampel untuk pemeriksaan baku emas dan sifat paucibacillary dari organisme MTB. World Health Organization (WHO) tahun 2022 dan Kementrian Kesehatan RI pada tahun 2023 mengeluarkan pedoman untuk membantu tenaga medis menegakkan diagnosis TB pada anak. Sampai saat ini belum ada penelitian yang menilai akurasi keduanya. Oleh karena itu, perlu dilakukan penelitian yang menilai akurasi diagnosis kedua alur tersebut.
Tujuan: Mengetahui sensitivitas, spesifisitas dan akurasi alur diagnosis TB berdasarkan WHO 2022 dan Kemenkes 2023 terhadap baku emas GenXpert.
Metode: Penelitian merupakan uji diagnostik dengan data sekunder yang melibatkan anak berusia 0-18 tahun dengan tersangka TB yang berobat ke RSCM pada 1 Januari 2023-1 Januari 2024. Gambaran klinis, hasil pemeriksaan penunjang dan diagnosis akhir dicatat. Uji diagnostik dilakukan dengan membandingkan hasil akhir diagnosis berdasarkan alur WHO 2022 dan Kemenkes 2023 dengan baku emas pemeriksaan GenXpert. Hasil pemeriksaan dianalisis statistik dengan SPSS 25.
Hasil: Penelitian melibatkan 290 pasien dengan tersangka TB. Dari 132 pasien (45,5%) yang mendapatkan pengobatan TB, hanya 46 pasien (15,9%) yang memiliki hasil GenXpert positif. Didapatkan sensitivitas alur WHO 2022 dan Kemenkes 2023 dibandingkan dengan GenXpert masing-masing adalah 76,09% dan 58,7%. Sedangkan spesifistasnya sebesar 69,93% dan 77,05%. Alur Kemenkes 2023 memiliki PPV, PLR, NLR, dan akurasi yang lebih tinggi dibandingkan dengan WHO 2022.
Kesimpulan: Alur diagnosis TB berdasarkan Kemenkes 2023 memiliki spesifisitas dan akurasi yang lebih baik dibandingkan dengan WHO 2022 dalam menegakkan diagnosis TB pada anak. Alur diagnosis TB berdasarkan Kemenkes 2023 dapat digunakan sebagai pilihan alur untuk menegakkan TB pada anak.

Background: Tuberculosis (TB) is an infectious disease caused by the Mycobacterium Tuberculosis (MTB) organism. TB ranks first among the causes of death due to a single infection. Diagnosing TB in children is challenging because there are no specific and distinctive symptoms of TB, along with the difficulty in obtaining samples for gold standard tests and the paucibacillary nature of the MTB organism. The World Health Organization (WHO) in 2022 and the Indonesian Ministry of Health (Kemenkes) in 2023 issued guidelines to assist healthcare professionals in diagnosing TB in children. To date, there has been no research assessing the accuracy of both guidelines. Therefore, research is needed to assess the accuracy of diagnosis in both pathways.
Objective: To determine the sensitivity, specificity, and accuracy of TB diagnosis pathways based on WHO 2022 and Kemenkes 2023 guidelines compared to the gold standard GenXpert test.
Methods: The study is a diagnostic test involving secondary data of children aged 0-18 years suspected of TB and treated at RSCM from January 2023 to December 2023. Clinical descriptions, results of supporting examinations, and final diagnoses were recorded. The diagnostic test was conducted by comparing the final diagnosis results based on the WHO 2022 and Kemenkes 2023 pathways with the gold standard GenXpert test. The examination results were statistically analyzed using SPSS 25.
Results: The study involved 290 patients suspected of TB. Out of 132 patients (45.5%) who received TB treatment, only 46 patients (15.9%) had positive GenXpert results. The sensitivity of the WHO 2022 and Kemenkes 2023 guidelines compared to GenXpert was 76.09% and 58.7%, respectively. Meanwhile, the specificity was 69.93% and 77.05%, respectively. The Kemenkes 2023 pathway had higher PPV, PLR, NLR, and accuracy compared to WHO 2022.
Conclusion: The TB diagnosis guideline based on Kemenkes 2023 has better specificity and accuracy compared to WHO 2022 in diagnosing TB in children. The TB diagnosis guideline based on Kemenkes 2023 can be used as an option for diagnosing TB in children.
"
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2024
SP-pdf
UI - Tugas Akhir  Universitas Indonesia Library
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Angela Kimberly Tjahjadi
"Latar belakang. Meskipun vaksin Bacille Calemette-Guerin telah menjadi program vaksinasi wajib di Indonesia, TB pada anak tetap prevalen sehingga penelitian ini akan mengevaluasi jaringan parut BCG dan hubungannya dengan kejadian TB ekstraparu (TB-EP) pada anak.
Metode Penelitian. Pengambilan data dilakukan di Rumah Sakit Cipto Mangunkusumo Kiara dengan metode potong-lintang pada populasi anak terdiagnosis TB berdasarkan kriteria WHO dan konsensus IDAI.
Hasil. Sebanyak 246 pasien anak dengan jangkauan usia 2 bulan -18 tahun terdiagnosis TB. Sebesar 127 anak (51,6%) mengalami TB-EP, dengan prevalensi TB tulang, KGB dan abdomen secara berurutan 13%, 10,9%, dan 6,6%. Mayoritas pasien TB EP adalah laki-laki (55,2%) dan berada dalam kelompok usia 6-14 tahun (60%). Riwayat kontak dengan kasus TB-EP ditemukan pada 49 kasus (51,5%). Penyakit komorbid penyerta dengan mayoritas keganasan (25,6%) dan infeksi HIV (23,1%) ditemukan pada 21 kasus TB-EP (35%). Status jaringan parut BCG positif ditemukan pada 140 kasus (56,9%). Dari 106 anak tanpa jaringan parut BCG, sebanyak 38 anak (35,8%) memiliki TB paru dan sebanyak 68 anak (64,2 %) memiliki TB-EP. Tidak adanya jaringan parut BCG memiliki hubungan yang bermakna dengan kejadian TB-EP pada anak (p < 0.01) dengan OR: 2,457 (IK95% : 1,46 - 4,131).
Kesimpulan. Tingginya kejadian TB-EP pada anak pada proporsi tanpa jaringan parut BCG berhubungan signifikan secara statistik. Upaya vaksinasi BCG yang optimal diperlukan untuk mengurangi morbiditas dan mortalitas TB-EP pada anak di Indonesia.

Objectives. Although the Bacille Calmette-Guerin vaccination program is already implemented nationally, childhood TB remains prevalent particularly in Indonesia so this study will evaluate the relationship between BCG vaccination scar and extra pulmonary TB in children.
Methods. Data collection was conducted at Cipto Mangunkusumo Kiara Hospital by cross-sectional method. Children diagnosed with TB according to WHO criteria and IDAI consensus are included in this study.
Results. A total of 246 pediatric patients with a-2 months to 18 years-age range were diagnosed with TB. Extra pulmonary TB was found in 127 children (51.6%), with the most prevalent type: bone, lymph node and abdomen TB sequentially are 13%, 10.9%, and 6.6%. The majority of patients with extrapulmonary TB are male (55.2%) and are in the age group 6-14 years (60%). History of contact with active TB cases was found in 49 out of 95 extrapulmonary cases (51.5%). Comorbidities, predominantly malignancies (25.6%) and HIV infection (23.1%), were found in 21 of 60 extrapulmonary cases (35%). BCG scar was found in 140 cases (56.9%). Of 140 children with BCG scar, 81 children (68.1%) had pulmonary TB and 59 children (42.1%) had extra-pulmonary TB. Of the 106 children without BCG scar, 38 (35.8%) had pulmonary TB and 68 (64.2%) had extra-pulmonary TB. The absence of BCG scar tissue has a significant relationship with extra-pulmonary TB incidence in children (p <0.01) with OR :2.457 (CI95% : 1.46 - 4.131).
Conclusion: The high incidence of extra-pulmonary TB in children in the proportion lacking BCG scar was statistically significant.Thus, an optimal BCG vaccination effort is required to reduce the morbidity and mortality of childhood extrapulmonary TB in Indonesia.
"
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2018
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UI - Skripsi Membership  Universitas Indonesia Library