PROFIL HASIL TERAPI TUBERKULOSIS MULTIDRUG RESISTANT TAHUN 2012-2014

ANDI ALFIA M T, dr. Woro Rukmi Pratiwi, M.Kes., Sp.PD.; dr. Setyo Purwono, M.Kes., Sp.PD

2018 | Tesis | MAGISTER ILMU BIOMEDIK

Latar belakang: Indonesia merupakan salah satu negara dengan insidensi tuberkulosis multidrug resistant (TB-MDR) tertinggi di dunia mencapai 32 ribu kasus pada tahun 2015. Angka keberhasilan terapi TB MDR juga masih rendah (51%) dan jauh dari target yang ditetapkan oleh WHO sebesar 75%. Tujuan: Mengetahui hasil terapi, efek samping obat dan faktor-faktor yang mempengaruhi hasil terapi pasien tuberkulosis multidrug resistant di RSUD Labuang Baji Makassar dan RSUD Dr. Moewardi Surakarta tahun 2012-2014. Metode:Penelitian ini merupakan penelitian kohort retrospektif yang dilakukan pada pasien TB-MDR di RSUD Labuang Baji Makassar dan RSUD Dr. Moewardi Surakarta. Subjek penelitian merupakan pasien TB MDR yang memulai terapi pada tahun 2012-2014 dengan data rekam medis yang lengkap. Subjek diikuti hingga hasil terapinya diketahui, berhasil (sembuh atau pengobatan lengkap) atau gagal (meninggal, gagal, lost to follow up). Variabel yang diteliti adalah hasil terapi, efek samping obat, usia, jenis kelamin, berat badan, diabetes mellitus, hepatitis kronik, ketaatan, riwayat terapi TB sebelumnya, jumlah obat, durasi dan kejadian efek samping. Regresi logistik digunakan untuk menganalisis variabel yang menjadi prediktor hasil terapi TB-MDR. Hasil: Subjek yang diteliti sebanyak 103 orang. Hasil terapi menunjukkan 66 orang (64,1%) berhasil dan 37 orang (35,9%) gagal terapi. Efek samping obat yang tersering adalah gangguan gastrointestinal (68,9%), muskuloskeletal (68,0%), neuropsikiatri (48,5%), dan pendengaran (28,2%). Analisis regresi logistik menunjukkan durasi terapi 20 bulan (OR=10,11) dan ketaatan (OR=45,11) merupakan faktor prediktor keberhasilan terapi TB-MDR. Kesimpulan: Hasil terapi TB-MDR sudah mencapai 61,4%. Efek samping yang paling sering muncul adalah gangguan gastrointestinal, muskuloskeletal, neuropsikiatri, dan pendengaran. Faktor-faktor prediktor yang mempengaruhi keberhasilan terapi TB-MDR adalah durasi terapi 20 bulan dan ketaatan.

Background: Indonesia is one of a country with the highest incidence of multidrug-resistant tuberculosis (MDR-TB) in the world with 32 thousand cases in 2015. The treatment success rate of MDR-TB was still low (51%) and far from the target set by WHO amount 75%. Objective: To address the treatment outcomes, adverse events and factors associated with failure treatment in multidrug-resistant tuberculosis patients of Labuang Baji Regional Public Hospital and Dr. Moewardi Regional Public Hospital between 2012-2014. Methods: This study was a retrospective cohort study that conducted in TB-MDR patients of Labuang Baji Regional Public Hospital and Dr. Moewardi Regional Public Hospital. The subjects were TB-MDR patients who started the treatment in 2012-2014 that had a complete medical record. They were followed until treatment outcomes were recorded, successful (cured or completed treatment) or failed (died, failed, or lost to follow up). Research variables were the treatment outcomes, adverse drug reactions, age, sex, weight, previous history of antituberculosis treatment, diabetesmellitus, chronic hepatitis, adherence, total drugs, duration and adverse events. Logistic regression was used to analyze variable that became predictors of treatment outcomes in MDR-TB patients. Results: A total 103 patients were included. Overall, 66 (64,1%) were success and 37 (35,9%) were failed. The most common adverse drug reaction were gastrointestinal (68,9%), musculoskeletal (68,0%), neuropsychiatri (48,5%) and hearing disorders (28,2%). Logistic regression analysis showed that treatment duration 20 bulan (OR=10,11), and adherence (OR=45,11) were predictors of success treatments in MDR-TB patients. Conclusion: The MDR-TB treatment success rate in was 61,4%. The most common adverse drug reaction were gastrointestinal, musculoskeletal, and hearing disorders. The predictors of successfull outcomes in MDR-TB patients were treatment duration 20 months and adherence.

Kata Kunci : hasil terapi, multidrug resistant, tuberkulosis, treatment outcomes, multidrug resistant, tuberculosis