Faktor Risiko Kegagalan Pengobatan Ulang Pasien Tuberkulosis di YOGYAKARTA

Risk factors of unsuccess retreatment among tuberculosis patients in YogyakartaPurposeThe purpose of this study was to identify risk factors related to unsuccessful retreatment of tuberculosis cases in Yogyakarta. MethodsA case-control study was conducted at the health offices of five districts from the tuberculosis registry (TB 03 and TB 01) since 2008-2014. Case group criterion was defined as unsuccessful retreatment of tuberculosis patients, whereas the control group consisted of successful retreatment of tuberculosis patients (cure or complete treatment). A total of 142 cases and 142 controls were analysed with univariate, bivariate, and multivariate analyses. Chi-square tests were conducted with p<0.05 and odds ratio (OR) at confidence interval 95%. Results Bivariate analysis showed that regular taking of a drug, conversion of acid-fast bacilli, and type of health services were statistically related to unsuccessful retreatment tuberculosis. Logistic regression showed that regular taking of a drug (p=0.000; OR=29.52; 95%CI=10.97-79.4) was the strongest risk factor related to unsuccessful retreatment of tuberculosis. ConclusionThe strongest risk factor was regularly taking of a drug. District health offices need to conduct a tracking system of patients who do not take medication on schedule, ensuring regular tuberculosis medication, correct medication, and sputum examination of late-stage intensive tuberculosis patients

Pengaruh Pelatihan Mikroskopis Tuberkulosis terhadap Kualitas Sediaan dan Slide Positivity Rate di Wilayah Kerja Dinas Kesehatan Kabupaten Purbalingga

Introduction: Microscopic examination of sputum is a key component of the diagnosis of tuberculosis. In Purbalingga district, was conducted in 24 peripheral laboratories. Five technicians were trained in 2011-2012 and 12 technicians in 2003-2009 by National Tuberculosis Programs. Seven technicians have not trained. In 2011 slide positivity rate an average of 9.1%, 73.4% poor smear quality and 11.5% poor staining, 1.4% error rate at 34.7% laboratoriy. In 2012 slide positivity rate an average of 8.9, evenness was the highest of poor smear quality (77.7%), and 4.6% error rate at 66,7% laboratory. Therefore, need refresher training and initial training. Objective: To determine impact of training to smear quality and slide positivity rate. Methods: The research design was analytic quasi experimental with 5 days microscopic training. The research subject were 18 technician microscopic. They were divided into experimental and control group each 9 technicians with purposive sampling. The differences of smear quality and slide positivity rate were analyzed by independent t-test and Mann-Whitney test with 95% CI. Results: Training has increased the average of knowledge test score 40.7 points and average of test score the good smear quality : specimen quality increased 90 points, staining 84.4, cleanness 85.6, thickness 91.1, smear size 88.9, evenness 87.8 and increase the average of smear readings score test 22 points. The mean of smear quality and slide positivity rate of the experimental group were higher than control group. Statistical test of smear quality between eksperimental group with contol group were: specimen quality p=0.03, staining quality p=0.03, cleanness p=0.02, thickness p&lt;0.001, size p&lt;0.001, good evenness p&lt;0.001, and slide positivity rate p=0.02 Conclusion: The mean of smear quality and slide positivity rate of the experimental group were higher than control group, there were significant differences of smear quality and slide positivity rate between experimental group with control group at 3 months after training

Journeys to tuberculosis treatment: a qualitative study of patients, families and communities in Jogjakarta, Indonesia

<p>Abstract</p> <p>Background</p> <p>Many tuberculosis (TB) patients in Indonesia are diagnosed late. We seek to document patient journeys toward TB diagnosis and treatment and factors that influence health care seeking behavior.</p> <p>Methods</p> <p>TB patients in Jogjakarta municipality (urban) and Kulon Progo district (rural) were recruited from health care facilities participating in the DOTS strategy and health care facilities not participating in the DOTS strategy, using purposive sampling methods. Data were collected through in-depth interviews with TB patients and members of their family and through Focus Group Discussions (FGD) with community members.</p> <p>Results</p> <p>In total, 67 TB patients and 22 family members were interviewed and 6 FGDs were performed. According to their care seeking behavior patients were categorized into National TB program's (NTP) dream cases (18%), 'slow-but-sure patients' (34%), 'shopaholics' (45%), and the NTP's nightmare case (3%). Care seeking behavior patterns did not seem to be influenced by gender, place of residence and educational level. Factors that influenced care seeking behavior include income and advice from household members or friends. Family members based their recommendation on previous experience and affordability. FGD results suggest that the majority of people in the urban area preferred the hospital or chest clinic for diagnosis and treatment of TB whereas in the rural area private practitioners were preferred. Knowledge about TB treatment being free of charge was better in the urban area. Many community members from the rural area doubted whether TB treatment would be available free of charge.</p> <p>Conclusion</p> <p>Most TB patients took over a month to reach a DOTS facility after symptoms appeared and had consulted a number of providers. Their income and advice from household members and friends were factors that influenced their care seeking behavior most.</p