Penyakit TB Paru BTA positif di Kecamatan Argamakmur Kabupaten Bengkulu Utara :: Tinjauan lingkungan fisik rumah, pengetahuan dan perilaku sehat

MAARIF, Samsul, Prof.Dr.dr. Soebijanto

2008 | Tesis | S2 Ilmu Kesehatan Kerja (Kesehatan Lingkungan)

Kecamatan Argamakmur berada di wilayah Kabupaten Bengkulu Utara pada ketinggian 1.000-1.500 meter di atas permukaan laut. Kegiatan pemberantasan penyakit Tuberkulosis pada periode Okober 2006 sampai Mei 2007 ditemukan 31 penderita TB Paru BTA positif dari 277 orang BTA negatif (suspek). Jumlah rumah sehat hanya 1.345 buah (48,57%) dengan sebagian besar jendela tertutup pada pagi hari, serta penduduk dewasa mempunyai kebiasaan merokok. Lingkungan fisik rumah, pengetahuan dan perilaku yang tidak sehat merupakan faktor risiko terjadinya penyakit Tuberkulosis. Tujuan penelitian menganalisis perbedaan lingkungan fisik rumah, pengetahuan dan perilaku sehat penderita TB Paru BTA positif dibandingkan dengan suspek BTA negatif, serta menganalisis faktor risiko yang paling dominan. Jenis penelitian observasional menggunakan rancangan kasus kontrol (case control study), dengan subjek penelitian 31 orang pada kelompok kasus dan 31 orang kelompok kontrol. Pengumpulan data primer melalui wawancara dan pengamatan selama 7 (tujuh) hari, data sekunder diambil pada instansi terkait. Analisis data bivariat menggunakan chi-square(X2), analisis multivariat menggunakan regresi logistik dengan teknik analisis SPSS versi 12.0. Hasil penelitian menunjukan bahwa: a). ada perbedaan yang bermakna kondisi lingkungan fisik rumah penderita TB Paru BTA positif dibandingkan dengan penderita TB Paru BTA negatif (luas ventilasi nilai p=0,020 dan OR=3,325, sinar matahari masuk kamar pada pagi hari nilai p=0,000 dan OR=18,667, serta kelembaban kamar nilai p=0,005 dan OR=2,292); b). tidak ada perbadaan pengetahuan penderita TB Paru BTA positif dengan penderita TB Paru BTA negatif; c). ada perbedaan perilaku membuka jendela penderita TB Paru BTA positif dengan penderita TB Paru BTA negatif (nilai p=0,001 dan OR=7,200); serta d). perilaku membuka jendela kamar merupakan variabel paling dominan (p=0,002) yang berhubungan dengan kejadian penyakit TB Paru BTA positif. Kesimpulan: a). ada perbedaan yang bermakna kondisi lingkungan fisik rumah (luas ventilasi, adanya sinar matahari langsung masuk kamar tidur dan kelembaban kamar tidur) antara penderita penyakit TB Paru positif dengan suspek BTA negatif; b). tidak ada perbedaan pengetahuan antara penderita TB Paru BTA positif dengan suspek BTA negatif; c). ada perbedaan perilaku membuka jendela pada pagi dan sore hari antara penderita TB Paru positif dengan suspek BTA negatif; d). perilaku membuka jendela pagi dan sore hari merupakan variabel yang paling dominan berhubungan dengan terjadinya penyakit TB Paru BTA positif di Kecamatan Argamakmur. Saran: a). Pemerintah Kabupaten Bengkulu Utara dalam melakukan program pemberantasan penyakit TB Paru lebih memperhatikan upaya peningkatan penyuluhan kesehatan, perbaikan lingkungan pemukiman dan pemberdayaan masyarakat; b). perlu penelitian lebih lanjut tentang faktor risiko terjadinya penyakit TB Paru positif.

Background: Subdistrict of Argamakmur is located at District of Bengkulu Utara at 1,000 – 1,500 meter height above sea level. Tuberculosis (TB) disease eradication activities from October 2006 to May 2007 found 31 positive acid fast bacilli (AFB+) lung TB patients and 277 negative acid fast bacilli (AFB-) patients (suspects). There were only as many as 1,235 healthy houses (47.88%) with most of windows are closed in the morning and adult people were smokers. Unhealthy house physical environment, knowledge and behavior are risk factors for the prevalence of TB disease. Objective: The objective of the study was to analyze differences in house physical environment, knowledge and healthy behavior between positive acid fast bacilli lung TB patients and negative acid fast bacilli lung TB patients and most dominant risk factors. Method: The study was observational with case control study design. There were as many as 31 people as cases and 31 as controls. Primary data were obtained from interview and observation within seven days; secondary data were obtained from relevant institutions. Bivariable data analysis used chi square and multivariable analysis used logistic regression. Result: The result of the study showed that a) there was significant difference in house physical environment between positive acid fast bacilli lung TB patients (width of ventilation p=0.020 and OR= 3.325, sunlight penetrating bedroom in the morning p= 0.000 and OR= 18.667, and room humidity p=0.005 and OR=2.292); b) there was no difference in knowledge between positive acid fast bacilli lung TB patients and negative acid fast bacilli lung TB patients; c) there was difference in behavior of opening windows between positive acid fast bacilli lung TB patients and negative acid fast bacilli lung TB patients (p=0.001 and OR=7.200); and d) behavior of opening windows was the most dominant variable (p= 0.002) related to the prevalence of positive acid fast bacilli lung TB disease. Conclusion: a) There was significant difference in house physical environment (width of ventilation, direct sunlight entering bedroom and room humidity) between positive acid fast bacilli lung TB patients and negative acid fast bacilli lung TB patients; b) There was no difference in knowledge between positive acid fast bacilli lung TB patients and negative acid fast bacilli lung Tb patients; c) There was difference in behavior of opening windows in the morning and evening between positive acid fast bacilli lung TB patients and negative acid fast bacilli lung TB patients; d) Behavior of opening windows in the morning and evening was the most dominant variable related to the prevalence of acid fast bacilli lung TB disease at Subdistrict of Argamakmur. Suggestion: a) The local government of Bengkulu Utara District should pay more attention to increase health promotion, improve housing environment and community empowerment in efforts to eradicate lung TB disease; b) There should be further study on risk factors for the prevalence of positive lung TB disease.

Kata Kunci : Perilaku Sehat, Lingkungan Fisik, Penyakit TB Paru.