FAKTOR-FAKTOR RISIKO YANG BERHUBUNGANy. DENGAN KECACATAN PENDERITA, KUSTA DI KABUPATEN TEGAL

Abstract

Back ground : Leprosy has been a public health problem in some parts of the world including Indonesia. Besides •high prevalence, high rate of deformity is another barrier found in the elimination program in Tegal. Risk factor at deformity leprosy patient in Tegal has not been known yet. Objective : The aims of this study were 1). To prove that there is a relationship among age, sex, education level, occupation, economy status, kind of leprosy, durations of illness, reaction history, places of lesion, family motivation, deformity prevention, regularity of treatment, and self treatment deformity. 2) To measure the deformity risk extent of the risk factors studied. Methode : The approach used in this research is Case-control study, the subject of the research were all patients registered and who get treatment from Public Health Centre in Tegal. They were 140 patient made up from 69 patient with deformity level 1 and 2 considered as Cases, and 71 patient non deformity as the Control. The data of characteristic individu, kind and the history of the illness, and the history of treatment were obtained by interviewing the subject. The subject were also physically examined in order to determine the data status and the level of deformity through Voluntary Muscle Test, peripheral nerve test, simple eye vision, And other supporting test. Result : Meanwhile the multivariate analysis says that there are seven spesific risk factors influenced the leprosy deformity : regularity of treatment (OR : 8,3 95% CI : 2,4-28,8), economy status (OR : 8,1 95% CI : 2,2-29,1), self treatment deformity (OR : 5,5 95% CI : 1,8-17,1), places of lesion (OR : 4,9 95% CI : 1,6-15,2), duration of illness (OR : 4,5 95% CI : 1,4-14,8), reaction history (OR : 4,5 95% CI : 1,5-13,5), and namely kind of occupation (OR : 3,2 95% CI : 1,1-9,4). Conclusion : Risk factors contribute effect to the leprosy deformity in Tegal, are : regularity of treatment, economy status, self treatment deformity, places of lesion, duration of illness, reaction history and namely kind of occupation. • Suggestion : There should be improvement of the public health centres officials capability of doing deformity elimination test, treating leprosy reaction properly and quickly. The economy status of leprosy patient needs to be increased. More than one-year leprosy sufferers and those with peripheral nerve lesion have to be given careful attention. Moreover , there should be promoting efforts of the importance of regularity treatment and self treatment to prevent leprosy deformity. Latar belakang : Penyakit kusta sampai saat ini masih menjadi masalah kesehatan masyarakat dibeberapa wilayah dunia termasuk Indonesia. Disamping terdapat masalah tingginya prevalensi juga ditemui kendala lain yaitu cukup tingginya angka kecacatan. Faktor-faktor risiko kecacatan penderita kusta di kabupaten Tegal belum diketahui. Tujuan : Penelitian ini bertujuan untuk : 1) membuktikan adanya hubungan antara : umur, jenis kelamin, tingkat pendidikan, jenis pekerjaan, status ekonomi, tipe kusta, Iamanya sakit, riwayat reaksi kusta, lokasi lesi, motivasi keluarga, pencegahan cacat, keteraturan berobat serta perawatan diri dengan kecacatan kusta, 2) menghitung besarnya risiko terjadinya cacat pada masing¬masing faktor risiko yang diteliti. Metode : Penelitian dilakukan dengan menggunakan metode Case-control , melibatkan 140 penderita kusta, sebanyak 69 penderita kusta cacat tingkat 1 dan tingkat 2 ditetapkan sebagai kasus dan 71 penderita kusta tidak cacat ditetapkan sebagai kontrol. Seluruh subyek penelitian dilakukan wawancara, dan pemeriksaan fisik melalui pemeriksaan Voluntary Muscle Test , pemeriksaan saraf tepi , visus mata sederhana, serta pemeriksaan lain yang mendukung. Hasil : Sesuai hasil analisis multivariat terdapat tujuh faktor risiko yang berperan terhadap kecacatan kusta yaitu : Keteraturan berobat (OR : 8,3 95% CI : 2,4-28,8), status ekonomi (OR : 8,1 95% CI : 2,2-29,1 ), perawatan did (OR: 5,5 95% CI : 1,8-17,1), lokasi lesi (OR: 4,9 95% CI:1,6-15,2), Iamanya sakit (OR: 4,5 95% CI: 1,4-14,8), riwayat reaksi (OR: 4,5 95% CI: 1,5-13,5), dan jenis pekerjaan (OR:3,2 95% CI: 1,1-9,4). Simpulan : Faktor-faktor risiko yang memberikan kontribusi terhadap kecacatan pada penderita kusta di kabupaten Tegal yaitu : Keteraturan berobat, status ekonomi, perawatan diri, lokasi lesi, Iamanya sakit, riwayat reaksi, dan jenis pekerjaan Saran : Perlu meningkatkan kinerja petugas Puskesmas dalam melakukan pemeriksaan pencegahan cacat, serta ketepatan dan kecepatan dalam menangani reaksi kusta. Perlu meningkatkan status ekonomi penderita kusta, perlu pengawasan lebih ketat pada penderita dengan lama sakit lebih dad satu tahun dan lokasi lesi tepat pada saraf tepi Sella perlunya meningkatkan upaya promotif tentang pentingnya keteraturan berobat dan perawatan diri.