ANALISIS BEBERAPA FAKTOR YANG BERHUBUNGAN DENGAN KEJADIAN TB PARU BTA (+) DI KABUPATEN WONOSOBO

Abstract

Mycobacterium tuberculosis have already injected a third of citizens in the world. In Indonesia, the health development has not pressed the lung tuberculosis problem. Inflict, the trend is rising up. In Central lava, in 2000, new cases of the lung Tuberculosis 13TA (-;-) were ,..668 cases, and at Wonosobo district, the prevalence rate was 0.17 per thousand The aim of this research is to analyze risk factors related to the occurrence of pulmonary tuberculosis with positive sputum smear at Wonosobo district. Research design used case-control study. Cases were the sufferers of pulmonary tuberculosis with positive sputum smear, more than 15 years old, who visited to the selected Health Center in the last six months, and have the clinical symptoms and sputum are positive under microscopic examination. Controls were who visited to the selected Health Center in the last six months, and the clinical symptoms and the history of pulmonary tuberculosis were negative (matched by age and sex). The number of samples is.70 cases and 70 controls. Based on multivariate analysis, risk factors that have relationship with the occurrence of the lung tuberculosis BTA are ventilation (OR = 4.49; 95% CI = 1.84-10.96), natural lighting (OR = 6.91; 95% CI = 254-18.80), nutritional status, (OR = 11.31; 95% CI = 4.05-31.56), and contact with the sufferers of the lung tuberculosis BTA (+) (OR = 26.36; 95% CI = 2.60-267.38). Conclusion, based on multivariate analysis, risk factors that have significant relationship with the occurrence of pulmonary tuberculosis with postive sputum smear are ventilation, natural lighting, nutritional status, and contact with pulmonary tuberculosiswith positive sputum smear. Suggestion, it needs to do the coordination with inter-sector about the elucidation of the environment of the settlement. Beside that, it needs to budget the funds /for. nutritional packages from APBD each year. It needs to advocate the Head of District and DPRD about the importance of the lung tuberculosis eradication, the investigation of contact with family and neighbors. It needs to increase the community health treatment, and to plan or to improve the aspect of home sanitation. Mycobacterium tuberculosis telah menginfeksi sepertiga penduduk dunia. Di Indonesia pembangunan kesehatan belum dapat menekan masalah penyakit tuberkulosis paru TB paru ), bahkan ada kecenderungan meningkat. Di Jawa Tengah tahun 2000 ada 4.668 kasus baru tuberkulosis paru BTA ( + ) dan di Kabupaten Wonosobo angka prevalensinya 0,17 per seribu. Tujuan penelitian ini untuk menganalisis besar risiko berbagai faktor yang berhubungan dengan kejadian TB paru BTA ( + ) di Kabupaten Wonosobo. Metode penelitan ini memakai rancangan kasus kontrol, dimana 'criteria kasus adalah penderita usia 15 tahun ke atas yang berkunjung ke Puskesmas —Puskesmas terpilih dalam 6 bulan terakhir, dengan gejala klinis TB paru positif, pemeriksaan BTA postif. Kontrol adalah seseorang yang berkunjung ke Puskesmas — Puskesmas terpilih dalam 6 bulan terakhir dengan gejala klinis TB paru negatif, riwayat TB paru negatif ( di matching menurut umur dan jenis kelamin ). Jwnlah sampel terdiri dari 70 kasus dan 70 kontrol. Hasil penelitian pada analisis multivariat, beberapa faktor risiko yang secara statistik berhubungan dengan kejadian TB paru BTA ( + ) adalah ventilasi ( OR = 4,49 dan 95% CI : 1,84 — 10,96 ), pencahayaan alami ( OR = 6,91 dan 95% CI : 2,54 — 18,80 ), status gizi ( OR = 11,31 dan 95% CI : 4,05 — 31,56) dan kontak penderita TB paru ( OR = 26,36 dan 95% CI : 2,60 — 267,38 ). Simpulannya adalah pada analisis multivariat, faktor risiko ventilasi, pencahayaan alami, status gizi dan kontak penderita TB paru berhubungan dengan kejadian TB paru BTA ( + ). Sedangan saran adalah perlu adanya koordinasi kerja sama lintas sektoral tentang penyuluhan lingkungan pemukiman, menganggarakan alokasi dana untuk paket gizi dari APBD setiap tahun, advocacy kepada Bupati dan DPRD Kabupaten mengenai pentingnya pemberantasan tuberkulosis paru, investigasi kontak serumah dan tetangga, meningkatkan perawatan kesehatan masyarakat dan perlunya perencanaan atau perbaikan aspek sanitasi rumah.