Analisa Faktor yang Berpengaruh terhadap Konversi Pasien TB MDR di Provinsi Sumatera Utara Tahun 2013 - 2014

Abstract

TB MDR conversion is an indicator for monitoring medication in which Microbacterium tuberculosis at the same rime indicates negative result in the examination of breeding and BTA. Nationally, TB MDR conversion rate was 40.68%. In North Sumatera, TB MDR conversion rate was 40.32%. The objective of the research was to find out some factors which influencer TB MDR patient conversion in North Sumatera in the period of 2013 - 2014. The research was analytical with case control study. The population was 187 TB MDR patients at RSUP H. Adam Malik who began their medication in the period of 2013 - 2014, and 41 respondents were in case group, while the other 41 respondents were in control group. The data were analyzed by using univatriate analysis, bivatriate analysis, and multivatriate analysis with multiple logistic analysis. The result of the multivatriate analysis showed that the variables of medicine side effect (p = 0.002, OR = 11.60, 95% CI: 2.41-55.82), patient satisfaction (p = 0.002, OR = 11.90, 95% CI: 2.44-57.99), family income (p = 0.007, OR = 11.18, 95% CI: 1.92-64.98), Active Role of PMO (p = 0.013, OR = 5.92, 95% CI: 1.46- 24.04), and distance from health facility (p = 0.007, OR = 10.71, 95% CI: 1.92- 59.84) had significant influence on TB MD patient conversion, and the variables which had insignificant influence on TB MDR patient conversion were occupation patient type, education, knowledge, medication rule, and the behavior of health care providers. It is recommended that the health facility Service provide extra time for TB MDR patients in counseling and handling side effect of medicine increase health service facility training program of medicine resistance TB for health care providers, increase the access to TB MDR medication through Poskesdes so that patients will be easy to do medication. People should carry on medication to the Health facility service if there is side effect during medication and PMO give motivation for TB MDR patients do the medication and control regularly until medication is done

Konversi TB MDR merupakan indikator pemantauan pengobatan dimana keadaan Mycobacterium tuberculosis secara bersamaan menunjukkan hasil negatif pada pemeriksaan biakan dan BTA. Secara nasional, angka konversi TB MDR 40,68%. Di Provinsi Sumatera Utara angka konversi sebesar 40,32%. Penelitian ini bertujuan untuk mengetahui faktor-faktor yang berpengaruh terhadap konversi pasien TB MDR di Provinsi Sumatera Utara Tahun 2013 - 2014. Jenis penelitian ini adalah kajian analitis dengan rancangan studi kasus kontrol. Populasi adalah seluruh pasien TB MDR di RSUP H.Adam Malik yang memulai pengobatan mulai tahun 2013 – 2014 sebanyak 187 orang. Jumlah sampel sebanyak 41 kasus dan 41 kontrol. Analisis data secara univariat, bivariat dan multivariat menggunakan uji regresi logistik berganda. Hasil analisis multivariat menunjukkan variabel efek samping obat (p = 0,002, OR = 11,60, 95% CI: 2,41 – 55,82), kepuasan pasien (p = 0,002, OR = 11,90, 95% CI: 2,44 – 57,99), pendapatan keluarga (p = 0,007), OR = 11,18, 95% CI: 1,92 – 64,98), Peran aktif PMO (p = 0,013, OR = 5,92, 95% CI: 1,46 – 24,04), dan jarak ke fasyankes (p = 0,007, OR = 10,71 (95% CI: 1,92 – 59,84) memiliki pengaruh yang signifikan terhadap konversi pasien TB MDR dan variabel yang tidak berpengaruh secara signifikan terhadap konversi pasien TB MDR adalah pekerjaan, tipe pasien, pendidikan, pengetahuan, keteraturan berobat dan perilaku petugas kesehatan. Diharapkan kepada Fasyankes agar menyediakan waktu ekstra untuk pasien TB MDR dalam rangka konseling dan penanganan efek samping obat, meningkatkan pelayanan di fasyankes dan pelatihan program TB Resisten Obat kepada petugas kesehatan serta peningkatan akses pengobatan TB MDR melalui Poskesdes. Kepada masyarakat diharapkan tetap melanjutkan pengobatan dan pergi ke fasyankes jika terdapat efek samping selama dalam masa pengobatan serta kepada PMO agar memberikan motivasi kepada pasien untuk teratur berobat dan kontrol secara teratur sampai pengobatan selesai.