Implementasi penemuan suspek tuberkulosis di puskesmas Kabupaten Pesisir Selatan

ANTONI.SY, Syahrizal, dr. Lutfan Lazuardi, M.Kes, PhD

2008 | Tesis | S2 Ilmu Kesehatan Masyarakat

Latar belakang: Mycobacterium tuberculosis yang menjadi bakteri penyebab penyakit tuberkulosis telah menginfeksi sepertiga penduduk dunia. Data WHO tahun 2006 menyatakan bahwa Indonesia sebagai penyumbang tuberkulosis terbesar ke 3 di dunia dengan jumlah kasus baru sekitar 539.000 penderita dengan jumlah kematian sekitar 101.000 orang pertahun. Data program P2TB Kabupaten Pesisir Selatan tahun 2007 menunjukkan bahwa pencapaian penemuan suspek tuberkulosis sebesar 38,2% dan case detection rate sebesar 44%. Tujuan: Penelitian ini bertujuan untuk mengetahui implementasi penemuan suspek tuberkulosis di puskesmas Kabupaten Pesisir Selatan. Metode: Penelitian ini merupakan suatu studi kasus dengan rancangan kualitatif. Subyek penelitian adalah puskesmas yang dipilih secara purposive sampling. Informan adalah Wasor TB dinas kesehatan, kepala puskesmas, pengelola program tuberkulosis puskesmas, petugas laboratorium puskesmas, 1 orang petugas BP puskesmas dan walinagari di wilayah kerja puskesmas sampel. Data dikumpulkan dengan cara wawancara mendalam, observasi langsung dan telaah dokumen. Data yang dikumpulkan dianalisa mempergunakan tahap-tahap analisa data yaitu tahap reduksi data, tahap penyajian data dan tahap pengambilan kesimpulan. Hasil: Penemuan suspek tuberkulosis di puskesmas kabupaten Pesisir Selatan dilakukan secara pasif tapi tidak diikuti penyuluhan yang aktif. Media promosi seperti poster dan leaflet tentang penyakit tuberkulosis sangat sedikit. Dalam membuat perencanaan, puskesmas belum mengikuti langkahlangkah perencanaan sesuai dengan buku pedoman. Sebagian masyarakat beranggapan bahwa gejala penyakit tuberkulosis disebabkan karena termakan racun, kena guna-guna dan penyakit kutukan. Pendanaan program P2TB berasal dari GFATM, DAU dan Askeskin. Kemitraan dengan praktisi swasta belum terjalin dengan baik. Supervisi dan monitoring yang dilakukan wasor TB dan kepala puskesmas belum optimal karena tidak ada tindak lanjut yang dilakukan. Kesimpulan: Penemuan suspek TB di puskesmas bersifat pasif dengan penyuluhan yang kurang aktif. Sumber pendanaan masih tergantung dari pendonor GFATM. Ada kendala budaya masyarakat yang dihadapi puskesmas dalam penemuan suspek tuberkulosis. Kemitraan dengan praktisi swasta belum berjalan baik

Background: Mycobacterium tuberculosis as the cause of tuberculosis disease has infected one third of the world population. Data of WHO 2006 show that Indonesia is in the third rank of tuberculosis with as many as 539,000 new cases and 101,000 deaths a year. Data of tuberculosis disease control program 2007 indicate that the achievement of TB suspect detection is as much as 38.2% and case detection rate as much as 44%. Objective: The study aimed to identify the implementation of TB suspect detection at the health centers of Pesisir Selatan District. Method: This was a case study of qualitative design. Subject of the study were health centers purposively chosen. Informen consisted of TB vice supervisor of the health office, head of health centers, managers of TB program at the health center, laboratory staff of the health center, staff of medication council of the health center and Walinagari at the working area of health center samples. Data were obtained through indepth interview, direct observation and document examination. Data were analyzed in stages from data reduction, presentation and conclusion stages. Result: TB suspect detection at the health center of Pesisir Selatan District was carried out passively and not followed by active socialization. Media of promotion such as posters and leaflet were very limited. In making planning the health center had not followed planning stages as specified in the guidebook. The majority of community believed that symptoms of TB disease was caused by toxic, magical formulas and condemnation disease. The funding of TB disease control program derived from Global Fund Aids for Tuberculosis and Malaria, General Allocation Fund and Health Insurance for poor families. Partnership with private practitioners was not well established. Supervision and monitoring carried out by TB vice supervisor and head of health centers was not optimum because there was no follow up. Conclusion: TB suspect detection at health centers was carried out passively with inactive socialization. Funding resources still depended on the donors of Global Funds Aids for TB and malaria. There were cultural constraints faced by health centers in TB suspect detection. Partnership with private practitioners was not yet established.

Kata Kunci : Penemuan suspek,Tuberkulosis, suspect detection