Faktor-faktor Risiko yang Berhubungan dengan Kejadian Multidrug-Resistant Tuberculosis (TB-MDR) di Kota Ternate, Maluku Utara
DOI:
https://doi.org/10.35790/ecl.v11i3.44459Abstract
Multidrug-resistant tuberculosis (MDR-TB) is tuberculosis that does not respond to at least isoniazid and rifampicin, with or without other first line anti-TB drugs. Resistannt cases will lead to higher failure of TB therapy, increasing morbidity and mortality, and increasing financial burden in TB control. This study aimed to determine the risk factors associated with MDR-TB in Ternate. This was an analytical and observational study with a case-control design. There were 64 patients as samples, consisting of 32 case samples (MDR-TB) and 32 control samples (antituberculosis drug sensitive TB). Data were obtained using medical records of Dr. H. Chasan Boesorie Hospital in Ternate, and were analyzed with univariate, bivariate and multivariate tests using the SPSS. The results showed that there was a significant relation-ship between history of diabetes mellitus (p=0.021; OR=4.2; 95% CI:1.181-14.937) and history of TB treatment (p=0.010; OR= 6.818; 95% CI:1.356-34.274 ) with the incidence of MDR-TB. Meanwhile, variables that had no effect were sex, age, education level, and history of HIV-AIDS. The multivariate analysis showed that history of TB treatment had the strongest association with the incidence of MDR-TB (OR=5,.93; 95%CI:1.034-29.175). In conclusion, there are two risk factors associated with the incidence of MDR-TB in Ternate namely histories of diabetes mellitus and tuberculosis treatment.
Keywords: risk factors; tuberculosis; multidrug-resistant tuberculosis; antituberculosis drugs
Abstrak: Multidrug-resistant tuberculosis (TB-MDR) adalah tuberkulosis (TB) yang resisten terhadap isoniazid dan rifampisin secara bersamaan, dengan atau tanpa disertai obat anti tuberkulosis (OAT) lini pertama lainnya. Kasus resistensi menyebabkan tingginya kegagalan terapi TB, meningkatkan angka kesakitan dan kematian, serta menambah beban pembiayaan dalam pengendalian TB. Penelitian ini bertujuan untuk mengetahui dan menganalisis faktor-faktor risiko yang berhubungan dengan kejadian TB-MDR di Kota Ternate, dengan lokasi penelitian di RSUD Dr. H. Chasan Boesorie Ternate. Jenis penelitian ialah analitik observasional menggunakan desain kasus-kontrol. Sampel berjumlah 64 pasien, yang terdiri dari 32 kasus (TB-MDR), dan 32 kontrol (TB sensitif OAT). Data penelitian diperoleh dari sumber data sekunder, yakni catatan rekam medis pasien. Analisis data yang dilakukan terdiri dari analisis univariat, bivariat, dan multivariat dengan program pengolah data SPSS. Hasil penelitian menunjukkan bahwa terdapat hubungan bermakna antara riwayat diabetes melitus (p=0,021; OR= 4,2; 95%CI: 1,181-14,937) dan riwayat pengobatan TB (p=0,010; OR= 6,818; 95%CI: 1,356-34,274) dengan kejadian TB-MDR. Variabel yang tidak berpengaruh ialah jenis kelamin, usia, tingkat pendidikan, dan riwayat HIV-AIDS. Hasil analisis multivariat mendapatkan bahwa riwayat pengobatan TB merupakan variabel yang paling kuat hubungannya dengan kejadian TB-MDR (OR=5,493; 95%CI:1,034-29,175). Simpulan penelitian ini ialah terdapat dua faktor risiko yang berhubungan dengan kejadian TB-MDR di Kota Ternate, yakni riwayat diabetes melitus dan riwayat pengobatan TB.
Kata kunci: faktor risiko; tuberkulosis; multidrug-resistant tuberculosis; obat antituberkulosis
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