Knowledge and Attitude about Multidrug-Resistant Tuberculosis among Healthcare Workers in Public Health Centres

Background: Multidrug-resistant Tuberculosis (MDR-TB) is a significant public health problem and poses a threat to global tuberculosis (TB) control. In 2015, at least 504 new MDR-TB cases were identified in Indonesia. Treating MDR-TB patients is very challenging. It may take more than two years for MDR-TB treatment. Therefore, it is crucial healthcare workers (HCWs) are knowledgeable about MDR-TB. The aim of this study was to measure level of knowledge and attitude regarding MDR-TB among HCWs in public health centres.Methods: A cross-sectional study was conducted at 73 Public Health Centres in Bandung the capital of West Java Province from August until November 2015. The samples were 73 TB nurses and 32 laboratory staff. A self-administered questionnaire was given comprising 27 knowledge questions and 29 attitude questions. Correlation between knowledge and attitude scores was calculated by Pearson correlation test.Results: The majority of study participants were women (82.9%), married (92.4%), nursing staff (65.7%) with history of TB training (98.1%). Most of the participants were 40-59 years old (69.5%) with working experience in TB programme < 10 years (69.5%). Less than half (38.1%) of study participants had good knowledge. In terms of attitude, more than half (53.3%) of study participants had a positive attitude towards MDR-TB.Conclusions: The level of knowledge among HCWs about MDR-TB is still at an unacceptable level. Certain educational interventions aim to ensure prompt diagnosis, implement infection control and accurate treatment should be established among those HCWs. [AMJ.2016;3(4):509–13]DOI: 10.15850/amj.v3n4.93

COMPARATIVE STUDY OF KANAMYCIN AND CAPREOMYCIN ON SERUM POTASSIUM LEVEL OF MULTIDRUG RESISTANCE TUBERCULOSIS PATIENTSAT A HOSPITAL IN BANDUNG, INDONESIA

Objective: Kanamycin and capreomycin are the second lines injectable ant tuberculosis used in therapy regimen of multidrug resistance tuberculosis (MDR TB) in Indonesia. Both have effects on serum potassium levels and cause hypokalemia. The aim of this study is to compare and evaluate the effects of kanamycin and capreomycin on serum potassium levels of MDR TB patient.Methods: This was a retrospective and concurrent cohort study with intention-to-treat analysis on MDR TB patients during 2014 at Dr. Hasan Sadikin General Hospital Bandung, Indonesia. The patients were divided into two groups, one group received kanamycin regimen. Meanwhile, the other group received capreomycin regimen. Serum potassium level, the incidence of hypokalemia and the classification of its severity were compared monthly for five months of the therapy.Results: In the first two months, capreomycin significantly decreased serum potassium level stronger than kanamycin (2.95 mEq/l vs. 3.82 mEq/l, P&lt;0.001 in the first month and 2.85 mEq/l vs. 3.81 mEq/l, P&lt;0.001 in the second month). Before five months, the number of enabled patients to follow up decline which is caused by hypokalemia in capreomycin group was60.0% while in kanamycin group is 0.0%.Conclusion: Capreomycin has a stronger effect on decreasing serum potassium level compared to kanamycin, and it causes hypokalemia. Â

Knowledge and Attitude about Multidrug-Resistant Tuberculosis among Healthcare Workers in Public Health Centres

Background: Multidrug-resistant Tuberculosis (MDR-TB) is a significant public health problem and poses a threat to global tuberculosis (TB) control. In 2015, at least 504 new MDR-TB cases were identified in Indonesia. Treating MDR-TB patients is very challenging. It may take more than two years for MDR-TB treatment. Therefore, it is crucial healthcare workers (HCWs) are knowledgeable about MDR-TB. The aim of this study was to measure level of knowledge and attitude regarding MDR-TB among HCWs in public health centres.Methods: A cross-sectional study was conducted at 73 Public Health Centres in Bandung the capital of West Java Province from August until November 2015. The samples were 73 TB nurses and 32 laboratory staff. A self-administered questionnaire was given comprising 27 knowledge questions and 29 attitude questions. Correlation between knowledge and attitude scores was calculated by Pearson correlation test.Results: The majority of study participants were women (82.9%), married (92.4%), nursing staff (65.7%) with history of TB training (98.1%). Most of the participants were 40-59 years old (69.5%) with working experience in TB programme < 10 years (69.5%). Less than half (38.1%) of study participants had good knowledge. In terms of attitude, more than half (53.3%) of study participants had a positive attitude towards MDR-TB.Conclusions: The level of knowledge among HCWs about MDR-TB is still at an unacceptable level. Certain educational interventions aim to ensure prompt diagnosis, implement infection control and accurate treatment should be established among those HCWs. [AMJ.2016;3(4):509–13]DOI: 10.15850/amj.v3n4.93

Distribution of Rifampicin-Resistant Tuberculosis Patients based on Presumptive Drug-Resistant Tuberculosis Criteria at Dr. Hasan Sadikin Hospital 2016–2019

Background: Diagnosis of drug-resistant tuberculosis (DR-TB) begins with identifying presumptive DR-TB patients using Xpert MTB/RIF, as a diagnostic test to detect resistance to rifampicin. The study aimed to identify the distribution of rifampicin-resistant tuberculosis (RR-TB) patients based on presumptive DR-TB criteria at Dr. Hasan Sadikin General Hospital Bandung. Moreover, this study also explored the Xpert MTB/RIF Ct values.Methods: This was a descriptive-retrospective study from 570 medical records of DR-TB patients collected at the Multidrug-resistant tuberculosis (MDR-TB) clinic of Dr. Hasan Sadikin General Hospital from 2016 to 2019. The inclusion criteria were suspected patients with the Xpert MTB/RIF Ct values in the very low-low and medium-high categories. Data were analyzed using frequency distribution. Results: The most common presumptive DR-TB criteria among DR-TB patients were relapse cases (52.3%). Presumptive DR-TB criteria, with a high percentage result of medium-high Ct values, were category II treatment failure (80.9%).Conclusion: Relapse case and category II treatment failure are presumptive DR-TB criteria, which need more attention from clinicians

Knowledge, Attitude, and Practice Survey among Nurses in Dr. Hasan Sadikin General Hospital toward Tuberculosis-Human Immunodeficiency Virus Collaboration Program

Background: One of the barriers on implementation of Tuberculosis-Human Immunodeficiency Virus (TB-HIV) collaboration is lack of health care workers’ knowledge to this program. This study aimed to measure level of knowledge, attitude, and practice among inpatient nurses in Dr. Hasan Sadikin General Hospital toward TB-HIV collaboration program and to measure their correlation.Methods: This was a cross-sectional study with total sampling method which started on May–October 2013 at Internal Medicine Department ward in Dr. Hasan Sadikin General Hospital. Knowledge, attitude, and practice of research subjects were measured using modified questionnaire about TB-HIV collaboration program, based on guidelines from WHO and National Ministry of Health.Results: Of 88 respondents, there were no respondent had high level, 33 respondents (38%) had moderate level, and 55 respondents (63%) had low level of knowledge toward collaboration. For attitude, 53 respondents (60%) had positive attitude and 35 respondents (40%) had negative attitude. The study also showed 48 respondents (55%) had positive practice and 40 respondents (46%) had negative practice. The correlation between knowledge and attitude, knowledge and practice, and attitude and practice were not statistically significant (p>0.05).Conclusions: The level of knowledge among inpatient nurses in Dr. Hasan Sadikin General Hospital toward TB-HIV collaboration program was low but they showed positive attitude toward the collaboration itself. There was no correlation between knowledge, attitude, and practice among inpatient nurses toward collaboration. Further efforts were needed to improve nurses’ knowledge, attitude, and practice on TB-HIV collaboration.[AMJ.2016;3(1):85–92] DOI: 10.15850/amj.v3n1.71

Association Between Arg753Gln and Arg677Trp Polymorphisms of TLR2 Gene with Active Pulmonary Tuberculosis in an Indonesian Population

Background: Toll-like receptor is a pattern recognition receptor (PRR) that recognize pathogen-associated molecular pattern (PAMP) in a microorganism. Macrophages recognize the presence of mycobacteria through Toll-Like Receptor 2 (TLR2) and signaling further lead to the production of cytokines, both proinflammatory TNF-α, IL-1β, IL-6, IL-12, IL-15, IL-18 and IFN-γ, as well as anti-inflammatory IL4, IL-10 and TGF-β. TLR2 gene polymorphism is strongly determined by ethnicity and geography. Therefore it is necessary to uncovered the existence and association between Arg753Gln and Arg677Trp TLR2 gene polymorphism with TB susceptibility and its underlying mechanisms in Indonesian population in Bandung West Java. Methods: analytical observational study with cross-sectional design was conducted in Hasan Sadikin General Hospital Bandung from April 2011 to May 2012. Study population consisted of active pulmonary TB patient with positive AFB smear and Latent TB  to ascertain previous MTb exposure. Polymorphism of gen Arg753Gln and Arg677Trp gene was determined with polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) methods. Plasma levels of IFN-γ, TNF-α, IL-10 and IL-12 were also compared between active and latent TB group. Results: heterozygote Arg753Gln TLR2 gene polymorphism was found in 9 of 86 pulmonary TB subjects (10.5%) but none in the latent TB group. The Arg677Trp polymorphism was not found in both groups. The odds ratio for Arg753Gln existence was 28.07 (p=0.022). No differences in the levels of IFN-γ, TNF-α, IL-10 and IL-12 between active pulmonary TB and latent TB subjects with and without Arg753Gln TLR2 gene polymorphism. Conlusion: Arg753Gln polymorphism of TLR2 gene is a risk factor for active pulmonary TB while Arg677Trp polymorphism is not. The Increased risk is not mediated by the difference in IFN-γ, TNF-α, IL-10 and IL-12 serum levels

Nursing Knowledge, Attitude, and Practice to Influenza Vaccination at Suburban Hospital in West Java, Indonesia

Background: High epidemiology of influenza in the world and Indonesia causes some groups to have high risk for getting infected with influenza, one of which is healthcare workers. The low rates of influenza vaccination among healthcare workers, especially in nurses, cause the need for an educational strategy to prevent influenza. This study aimed to measure the level of knowledge, attitude and practice among nurses in suburban hospital in West Java.Method: This was a cross-sectional study with random sampling method which started on July-August 2018 at Annisa Medical Center General Hospital. Knowledge, attitude, and practice of research subjects were measured using questionnaire containing 37 questions. The questionnaire sheet is the result of adaptation of several questionnaires and validity test has been conducted. The data obtained was then analyzed descriptively by the proportion of the score of knowledge, attitude, and practice.Result: Of 104 respondents, there were 19% respondents had low level, 74% respondents had moderate level and 7% respondents had high level of knowledge toward influenza vaccination. For attitude, 67% respondents had positive attitude and 33% respondents had negative attitude. The study also showed 58% respondents had positive practice and 42% respondents had negative attitude.Conclusion: Nurses possess adequate knowledge and they showed positive attitude and practice toward influenza vaccination. Continuous educational strategy was needed to improve nurses’ knowledge, attitude and practice on influenza vaccination.  Keywords: Attitude, influenza vaccination, knowledge, nurses, practic

Knowledge, Attitude, and Practice Survey among Nurses in Dr. Hasan Sadikin General Hospital toward Tuberculosis-Human Immunodeficiency Virus Collaboration Program

Background: One of the barriers on implementation of Tuberculosis-Human Immunodeficiency Virus (TB-HIV) collaboration is lack of health care workers’ knowledge to this program. This study aimed to measure level of knowledge, attitude, and practice among inpatient nurses in Dr. Hasan Sadikin General Hospital toward TB-HIV collaboration program and to measure their correlation.Methods: This was a cross-sectional study with total sampling method which started on May–October 2013 at Internal Medicine Department ward in Dr. Hasan Sadikin General Hospital. Knowledge, attitude, and practice of research subjects were measured using modified questionnaire about TB-HIV collaboration program, based on guidelines from WHO and National Ministry of Health.Results: Of 88 respondents, there were no respondent had high level, 33 respondents (38%) had moderate level, and 55 respondents (63%) had low level of knowledge toward collaboration. For attitude, 53 respondents (60%) had positive attitude and 35 respondents (40%) had negative attitude. The study also showed 48 respondents (55%) had positive practice and 40 respondents (46%) had negative practice. The correlation between knowledge and attitude, knowledge and practice, and attitude and practice were not statistically significant (p>0.05).Conclusions: The level of knowledge among inpatient nurses in Dr. Hasan Sadikin General Hospital toward TB-HIV collaboration program was low but they showed positive attitude toward the collaboration itself. There was no correlation between knowledge, attitude, and practice among inpatient nurses toward collaboration. Further efforts were needed to improve nurses’ knowledge, attitude, and practice on TB-HIV collaboration.[AMJ.2016;3(1):85–92] DOI: 10.15850/amj.v3n1.71