<p>Jumlah penderita TB Indonesia sekitar 5,8% total TB dunia dan menempati peringkat keempat dengan angka prevalensi 281/100.000 penduduk. Kendala program pemberantasan dan penanggulangan TB adalah Resistensi obat anti tuberkulosis, karena pengobatan lama, mahal, dan tingginya efek samping. Tujuan penelitian menganalisis penyebab resistensi OAT. Penelitian dilakukan pada tahun 2013 dengan rancangan penelitian menggunakan kasus kontrol. Sampel kasus penderita TB resisten dan sampel kontrol penderita TB yang sembuh masing-masing 26 orang. Data dari hasil pemeriksaan laboratorium dan catatan medik di RS Dr. HA. Rotinsulu Kota Bandung. Uji statistik dengan chi square dan besar risiko dari OR. Hasil penelitian didapatkan 80,8% kategori MDR-TB dan 19,2% XDR-TB. Penderita TB mengalami efek samping 42,3%, riwayat pengobatan tidak adekuat 96,2%, adanya kontak erat 30,8%, tempat pengobatan sebelumnya tidak menerapkan DOTS 15,4%. Penyebab resistensi OAT adalah riwayat pengobatan tidak adekuat (nilai p= 0,001; OR= 40,00, 95%CI: 4,66-343,14). Pencegahan resistensi OAT dengan penatalaksanaan TB komprehensif, menerapkan program DOTS agar pengobatan tidak terputus dan berkesinambungan.</p><p> </p><p><em>Number of case TB Indonesia approximately 5.8% total TB in world, was ranked fourth with prevalence rate 281/100,000 population. Anti-tuberculosis drug resistant become problem prevention and eradication TB programmes, because treatment for longer, expensive, and greater side effects. The purpose this study was analysis causes Anti-tuberculosis drug resistant. This research was conducted at 2013 with design using case control. Cases which TB patients drug resistance, control which patients were cured TB each one as 26 people. Data obtained from the results laboratory and medical records in  hospital Dr. HA. Rotinsulu Bandung. Statictic analyzed using chi-square test and risk factor from OR. Results showed 80.8% MDR-TB and 19.2% XDR-TB. TB patients who experience side effects 42.3%, inadequate treatment 96.2%, 30.8% close contact, not implementing DOTS 15.4%. The causes anti-tuberculosis drug resistance inadequate treatment (P value= 0.001; OR= 40.00, 95%CI: 4.66-343.14). Prevention of anti-tuberculosis drug resistance by comprehensive TB management, implementing DOTS program that uninterrupted and continuous treatment.</em></p>

Pulmonary tuberculosis (TB) is a global health problem and has become the leading cause of death. Tuberculosis eradication is inhibited due to the tendency of patients to not complete the TB treatment. The purpose of this study was to determine the relationship between knowledge, nutritional status, oral medication adherence, and family support as risk factors for pulmonary tuberculosis treatment failure. The design of this study is that of case-control, and this study involved samples of pulmonary TB patients who were declared not cured after treatment (14 people), and control samples of pulmonary TB patients who were declared cured (28 people). The data were obtained through measurements of nutritional status and interviews, while treatment failure was based on data from the TB 01 form. Data was analysed using univariable and bivariable analyses, and the magnitude of risk factors was based on the odds ratio (OR) and 95% confidence interval (CI). The results showed that the factors associated with failure of pulmonary TB treatment are knowledge (p = 0.022; OR = 6.6; 95% CI = 1.48 - 29.36), nutritional status (p = 0.005; OR = 9.16; 95% CI = 2.11 - 39.85), and medication adherence (p = 0.003; OR =11.0; 95% CI = 2.37 - 54.14), whereas the unrelated factor is family support (p = 0.47). It is recommended to provide counselling, nutritional guidance, medication assistance, and family support to patients during the treatment period for pulmonary tuberculosis.                                                                                                                        Keywords: treatment failure, knowledge, nutritional status, compliance

Objective: The objective of this study was observed to measure the effect of alpha-mangostin in balancing the ratio of interferon-gamma (IFN-γ) and interleukin-10 (IL-10), and the severity of the disease in mice which infected with Mycobacterium tuberculosis multidrug-resistant (TB-MDR).Method: Infected BALB/c mice were consisted of five groups: Treated with anti-TB drugs+α-mangostin, treated with anti-TB drugs, given α-mangostin during treatment, and control group. Cytokine levels of culture supernatant of spleen cells were measured by enzyme-linked immunosorbent assay. The number of bacterial colonies was derived from a primary cell culture of bronchoalveolar lavage. Statistical analysis was performed with Anova, Kruskal-Wallis test and correlation Pearson, and Spearman-rank test.Result: Median IFN-γ production was higher in mice, which given with α-mangostin during treatment is 1838.2 pg/ml and control is 1585.5 pg/ml compared treated with anti-TB drugs+α-mangostin (1312 pg/ml) and anti-TB drugs (1429.3 pg/ml) (p>0.05). The highest result production of median IL-10 in the 3 th group is (465.91 pg/ml) and the lowest in the control group is 195.29 pg/ml, p>0.05. Median IFN-γ/IL-10 ratio of the 3 th group very low (3.94), it means the 3 th group is experienced with severity of TB. Alpha-mangostin was decreased in severity of disease based on the number of TB-MDR bacterial colonies (p≤0.05).Conclusion: α-mangostin have an effect on the balancing IFN-γ/IL-10 ratio and reduce a severity of TB-MDR with using immunomodulator.

Latar Belakang: Diabetes Mellitus (DM) merupakan penyakit gangguan metabolik yang dapat menimbulkan berbagai komplikasi penyakit seperti kardiovaskular, retinopatik, gangren, kerusakan ginjal dan neuropati. Dari 34 Provinsi di Indonesia, Jawa Barat menduduki peringkat tertinggi mencapai 186.809 orang penderita DM. Dilihat dari segi ekonomi pembiayaan kesehatan akibat diabetes, beban biaya langsung medis penderita rawat jalan yang yang ditanggung setiap tahunnya kurang lebih telah mencapai 1.349.126 ribu rupiah. Hal ini akan membebani indonesia, penderita, dan keluarga. DM tidak dapat disembuhkan tetapi kadar gula darah dapat dikendalikan melalui aktivitas fisik, diet, dan obat-obatan. Tujuan: Penelitian ini bertujuan untuk mengetahui faktor-faktor yang berhubungan dengan kadar gula darah pada pasien DM tipe 2 di PROLANIS Kecamatan Cimahi Tengah.Metode: Desain penelitian menggunakan studi potong lintang dengan 52 sampel. Teknik pengumpulan data menggunakan total sampling. Analisis data yang digunakan adalah univariat untuk melihat distribusi frekuensi, bivariat dengan menggunakan uji Kolerasi Spearman, dan multivariat untuk melihat faktor dominan yang berpengaruh menggunakan uji Regresi Logistik Ganda.Hasil: Hasil analisis terdapat hubungan antara aktivitas fisik (p=0,019, r=-0,323), asupan karbohidrat (p=0,001, r=0,627), kepatuhan minum obat (0,009, r=-0,798) dengan kadar gula darah dan tidak terdapat hubungan antara indeks masa tubuh (p=0,778, r=0,040) dan tidak terdapat hubungan antara lingkar pinggang (p=0,187, r=0,186) dengan kadar gula darah. Simpulan: Kepatuhan minum obat merupakan faktor dominan yang berhubungan dengan kadar gula darah (p=0,017, OR=24,956).

ABSTRAK