Abstract

Beban tuberkulosis di Indonesia termasuk lima tertinggi di dunia. Temuan kasus dan pengobatan adalah pilar utama program penanggulangan tuberkulosis. Survei nasional menunjukkan peningkatan penggunaan rejimen tidak standar dari 16,8% (2010) menjadi 55,6% (2013). Peningkatan penggunaan rejimen tidak standar diduga berpengaruh terhadap ketidakpatuhan berobat. Penelitian ini bertujuan untuk mempelajari ketidakpatuhan berobat pada orang dengan tuberkulosis yang menerima rejimen tidak standar dan rejimen standar. Penelitian menggunakan data sekunder Riset Kesehatan Dasar 2010. Analisis logistik multivariabel dilakukan pada sampel 971 orang dengan tuberkulosis yang selesai mendapatkan pengobatan. Hasil penelitian menunjukkan ada kecenderungan orang dengan tuberkulosis yang menerima rejimen tidak standar memiliki ketidakpatuhan berobat lebih tinggi. Hasil penelitian juga menunjukkan odds untuk tidak menyelesaikan pengobatan lebih tinggi pada orang yang menerima rejimen tidak standar dibandingkan orang yang menerima rejimen standar, yaitu odds ratio terkontrol 2,4 (95% CI odds ratio: 1,7-3,5). Dalam upaya menjamin kepatuhan berobat tuberkulosis, mutu program pengobatan perlu ditingkatkan; di antaranya adalah ketersediaan rejimen standar, penyetaraan standar pengobatan antara fasilitas pelayanan kesehatan swasta dan publik, serta sistem pemantauan minum obat. Indonesia is one of five highest tuberculosis burden countries. Case finding and treatment are the main pillars of tuberculosis control program. National survey reported that the usage of nonstandarized regimen is increased from 16,8% (2010) to 55,6% (2013). Increase use of nonstandarized regimen is associated with poor adherence tuberculosis treatment. This study purposed to compare the poor adherence of tuberculosis treatment among people who received standarized regimen and people who received nonstandarized regimen. The study used secondary data of National Health Survey 2010. Analysis used multivariable logistic through 971 people who completed tuberculosis treatment. This study found that people who received nonstandarized regimen had higher poor adherence of tuberculosis treatment than people who received standarized regimen. The result also showed that the odds of not to complete the treatment was higher in people who received nonstandarized regimen than who received standarized regimen, adjusted OR was 2,4 (95% CI OR: 1,7-3,5). To assure the adherence to tuberculosis treatment is to strengthen tuberculosis treatment program; such as the availability of standarized regimen, the equality of standard tuberculosis treatment among public and private health services, and the system of observed treatment.

References

1. World Health Organization. Global tuberculosis report. 2013 [cited 2014 Jan 22]. Available from: http://apps.who.int/iris/bitstream/10665/ 91355/1/9789241564656_eng.pdf.

2. Farid MN, Riono P. Laporan teknis estimasi jumlah orang dengan TB di Indonesia 2010. Jakarta: Kementrian Kesehatan Republik Indonesia; 2011.

3. Kementerian Kesehatan Republik Indonesia Direktorat Jenderal Pengendalian Penyakit dan Penyehatan Lingkungan. Pedoman nasional pengendalian tuberkulosis. Jakarta: Kemenkes RI; 2011.

4. Murtiwi. Kepatuhan berobat pasien tuberkulosis paru di 28 kabupaten di Indonesia tahun 2004 [disertasi]. Depok: Fakultas Kesehatan Masyarakat Universitas Indonesia; 2005.

5. Zhou C, Chu j, Liu J, Gai Tobe R, Gen H, Wang X. Adherence to tuberculosis treatment among migrant pulmonary tuberculosis patients in Shandong, China: a quantitative survey study. Plos One [serial on the internet]. 2012 [cited 2014 Apr 22]; 7 (12): [about 7 p.] Available from: http://search.proquest.com/ docview/1327198196/fulltextPDF /2DF2CF2B24CC40DAPQ/1?accountid=17242.

6. Lendrayani. Faktor-faktor yang mempengaruhi kepatuhan berobat penderita tuberkulosis paru di Indonesia [skripsi]. Depok: Fakultas Kesehatan Masyarakat Universitas Indonesia; 2006.

7. Badan Penelitian dan Pengembangan Kesehatan Kementerian Kesehatan Republik Indonesia. Riset Kesehatan Dasar (Riskesdas 2010). Jakarta: Kementerian Kesehatan Republik Indonesia; 2010.

8. Badan Penelitian dan Pengembangan Kesehatan Kementerian Kesehatan Republik Indonesia. Riset Kesehatan Dasar (Riskesdas 2013). Jakarta: Kementerian Kesehatan Republik Indonesia; 2013.

9. Radji M (ed). Buku ajar mikrobiologi: panduan mahasiswa farmasi dan kedokteran. Jakarta: Buku Kedokteran EGC; 2009.

10. Kementerian Kesehatan Republik Indonesia, UGM, the Global Fund. Laporan survei pengetahuan, sikap, dan perilaku dokter praktik swasta dalam tatalaksana TB di 12 kota di Indonesia [online]. 2011 [diakses tanggal 28 April 2014]. Available from: http://hpm.fk.ugm.ac.id/hpmlama/images/Blok_IV/ sesi_7_blok_iv_fh_ref_pps%20survey%20report%20290212.pdf .

11. Crofton J, Horne N, Miller F. Clinical tuberculosis. Harun, penterjemah. Jakarta: Widya Medika; 1999.

12. Garner P, Smith H, Munro S, Volmink J. Promoting adherence to tuberculosis treatment. Bulletin of the World Health Organization [serial on the internet]. 2007 [cited 2014 Sep 20]; 85 (5): [about 5 p.]. Available from: http://search.proquest.com/docview/229556921/fulltextPDF/ 77EEAA532E5245DDPQ/1?accountid=17242.

13. Chang AH, Polesky A, Bhatia G. House calls by community health workers and public health nurses to improve adherence to isoniazid monotherapy for latent tuberculosis infection: a retrospective study. BMC Public Health [serial on the internet]. 2013 [cited 2014 Apr 22]; 13 (894): [about 7 p.]. Available from: http://search.proquest.com/ docview/1438188509/397527FCEE41468BPQ/1?accountid=17242.

14. Elangovan R dan Arulchelvan S. A study on the role of mobile phone communication in tuberculosis DOTS treatment. Indian Journal of Community Medicine [serial on the internet]. 2013 [cited 2014 Sep 20]; 38: [about 6 p.]. Available from: http://search.proquest. com/docview/ 1464731075/fulltextPDF/4200144B0B514BFDPQ/ 5?accountid=17242.

15. Finlay A, Lancaster J, Holtz TH, Weyer K, Miranda A, Walt M. Patientand provider-level risk factors associated with default from tuberculosis treatment, South Africa, 2002: a case-control study. BMC Public Health [serial on the internet]. 2012 [cited 2014 Apr 22]; 12 (56): [about 12 p.]. Available from: http://search.proquest.com/docview/ 928747709/fulltextPDF/90BF195D9E8D481BPQ/1?accountid=17242

16. Nglazi MD, Beker LG, Wood R, Hussey GD, Wiysonge CS. Mobile phone text messaging for promoting adherence to anti-tuberculosis treatment: a systematic review. BMC Infectious Deseases [serial on the internet]. 2013 [cited 2014 Apr 22]; 13 (566); [about 16 p.]. Available from: http://search.proquest.com/docview/1467769440/ C6DFD11705DF4B85PQ/1?accountid=17242

17. Surbakti dan Klara Morina BR. Faktor yang mempengaruhi keberhasilan pengobatan pasien TB paru dengan spuntum BTA positif kasus baru di BBKPM Bandung tahun 2010-2011 [tesis]. Depok: Fakultas Kesehatan Masyarakat Universitas Indonesia; 2011.

18. Pritchard AJ, Hayward AC, Monk PN, Neal KR. Risk factors for drug resistant tuberculosis in leicestershire-poor adherece to treatment remains an important cause of resistance. Epidemiol Infection [serial on the internet]. 2003 [cited 2014 Apr 22]; 130 (481); [about 4 p.]. Available from: http://search.proquest.com/docview/205518225/ 500639A2FBBB4AA3PQ/1?accountid=17242.

19. Frieden TR dan Sbarbaro J. Promoting adherence to treatment for tuberculosis: the importance of direct observation. Bulletin of the World Health Organization [serial on the internet]. 2007 [cited 2014 Sep 20]; 85 (5): [about 4 p.]. Available from: http://search.proquest.com/ docview/229557027/fulltextPDF/1228653D7D8D44F9PQ/2?accountid=17242.

20. Bagchi S, Ambe G, Sathiakumar N. Determinants of poor adherence to antituberculosis treatment in Mumbai, India. International Journal of Preventive Medicine [serial on the internet]. 2010 [cited 2014 Apr 22]; 4 (223); [about 11 p]. Available from: http://search.proquest.com/ docview/1287478653/B09CDA81833047E5PQ/1?accountid=17242.

Download

Share

COinS