Pelaksanaan penemuan penderita Tuberkulosis di Puskesmas Kabupaten Sleman
SUHARJANA, Bambang, dr. Kristiani, SU
2004 | Tesis | S2 Ilmu Kesehatan MasyarakatLatar belakang : Tuberkulosis ( TB ) masih menjadi masalah kesehatan, terutama di negara-negara berkembang termasuk Indonesia. Menurut data SKRT tahun 1995, TB merupakan penyebab kematian ketiga terbesar setelah penyakit kardiovaskuler dan penyakit saluran pernafasan. Di Kabupaten Sleman yang masih menjadi masalah adalah masih rendahnya cakupan penemuan penderita TB BTA (+). Penemuan penyakit TB tiga tahun terakhir sebagai berikut : tahun 2001 (13,65%) dari target 30%, tahun 2002 (13,40%) dari target 40% dan tahun 2003 (20,47%) dari target 50%. Tujuan : Penelitian ini bertujuan untuk mangetahui kegiatan penemuan (case finding) penderita tuberkulosis BTA (+) di Kabupaten Sleman. Metode : Penelitian ini merupakan penelitian deskriptif dan dilengkapi dengan penelitian kualitatif. Sampel penelitian 57 orang yang terdiri dari Kepala Bidang P2PL, wakil supervisor TB, petugas laboratorium, kepala puskesmas, petugas P2TB, dokter klinins/BP dan paramedis BP puskesmas. Hasil : Pengetahuan paramedis sebagian besar sudah baik. Pengetahuan dokter BP, petugas laboratorium, petugas pengelola program TB di puskesmas sebagian besar suadah baik. Motivasi petugas laboratorium, dokter BP dan ketrampilan petugas laboratorium, sebagian besar sudah baik. Sebagian besar paramedis dan dokter BP belum pernah mengikuti pelatihan program TB. Semua puskesmas telah melaksanakan prosedur dan menerapkan kebijakan penemuan TB. Supervisi dan monitoring dari tingkat kabupaten pada puskesmas cakupan penemuan TB rendah belum optimal. Ketersediaan sarana dan dana dalam pelaksanaan penemuan penderita TB belum optimal. Hasil cross chek slide dahak menunjukan sebagian besar sudah baik, error rate (ER) dibawah 5 %. Kesimpulan : Puskesmas di Kabupaten Sleman telah melaksanakan kegiatan pelaksanaan penemuan penderita TB sesuai pedoman. Kecukupan input untuk kegiatan program penanggulangan TB belum optimal. Cross chek pemeriksaan slide dahak sudah baik, angka kesalahan di bawah 5 %
Background: Tuberculosis (TB) still becomes a health problem, especially in developing country including Indonesia. Based on the SKRT data in the year of 1995, TB considered as the third main mortality cause after cardiovascular disease and respiratory system disease. In the district of Sleman, the low coverage of finding TB Acid Fast Bacilli (+) patient still becomes a problem. The finding of TB disease in the last three years were 13,65% in the year of 2001 from the target of 30%, in the year of 2002 there was 13,40% from the target of 40% and in the year of 2003 there was 20,47% from the target of 50%. Objective: This research was aimed to find out the activity of tuberculosis Acid Fast Bacilli (+) patient case finding in the district of Sleman. Method: This was a descriptive research that accompanied with qualitative approach. The sample of the research was 57 people who were consisted of the head of P2PL, TB vice supervisor, laboratory officer, head of the Primary Health Care, P2TB officer, clinical doctor/BP and health care provider of the Primary Health Care. Result: Most of the knowledge of the health care providers was already fine. Knowledge of BP doctor, laboratory officer, and most of the TB officer in the Primary Health Care were fine. Motivation of laboratory officer, BP doctor and the skill of laboratory officer were fine. Most of the health care provider and BP doctor was never following training on TB program. All of the primary health care has implemented procedure and applying policy on finding TB patient. Supervision and monitoring from the district level in Primary Health Care, and the coverage of low TB finding were not yet optimal. The availability of facility and funding in the implementation of TB patient finding was not yet optimum. The result of most of sputum slide cross check was already fine, and the error rate (ER) still below 5 %. Conclusion: Primary Health Care in Sleman has implemented an activity of implementing TB patient case finding that suitable with any guidance. The sufficiency of input for TB control program was not yet optimum. The cross check of sputum slide check up was already fine and the error rate was below 5 %.
Kata Kunci : Kebijakan Layanan Kesehatan,Penanggulangan TB,Penemuan Penderita, District of Sleman, patient finding
