ANALISIS SISTEM DALAM PENANGANAN MULTI-DRUG RESISTANT TUBERCULOSIS (TB-MDR) DI KOTA PADANG

Ameliya, Bugesti (2019) ANALISIS SISTEM DALAM PENANGANAN MULTI-DRUG RESISTANT TUBERCULOSIS (TB-MDR) DI KOTA PADANG. Diploma thesis, Universitas Andalas.

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Abstract

Tujuan Kasus TB MDR yang dilaporkan pertahun kepada WHO yaitu sejak tahun 2014-2016 terus mengalami peningkatan. Begitu juga dengan kasus TB MDR yang terjadi di Kota Padang yang cendrung mengalami peningkatan. Sistem kesehatan merupakan salah satu faktor yang berperan penting dalam penanganan kasus TB MDR. Tujuan penelitian adalah untuk mengetahui anlisis sistem dalam penanganan TB MDR di Kota Padang. Metode Penelitian menggunkan metode kualitatif dengan pendekatan sistem. Penelitian dilakukan pada bulan Agustus 2018- Juli 2019. Informan penelitian berjumlah 17 orang, teknik penentuan informan purposive sampling. Metode pengumpulan data dengan wawancara mendalam, telaah dokumen dan observasi. Analisis data dengan pendekatan content analisys.Data diolah dengan triangulasi sumber dan triangulasi metode. Hasil Hasil penelitian didapat informasi terkait komponen input bahwa dari segi man, money, material, methods dalam penanggulangan TB MDR di puskesmas sudah tersedia dan cukup. Sedangkan untuk machine belum tersedia, sehingga pemeriksaan TCM harus dirujuk ke rumah sakit. Komponen proses berupa pelaksanaan penjaringan suspek, penegakan diagnosis, pengobatan. Kendala yang ditemukan berupa keterlambatan penegakan diagnosis dan prosedur pengobatan di rumah sakit yang masih kurang efektif. Komponen output berupa tantangan cakupan penemuan kasus TB resisten obat yaitu keterbatasan pemeriksaan TCM sehingga persentase cakupan tidak bisa menggambarkan keadaan sebenarnya. Untuk angka keberhasilan pengobatan tantanganya berupa prosedur pengobatan yang kurang efektif dan adanya pasien DO, dan untuk persentase kasus TB yang memulai pengobatan lini kedua tantangan berupa keterlambatan penegakan diagnosis. Kesimpulan Sistem kesehatan yang mempengaruhi kejadian TB MDR di Kota Padang yaitu tidak tersedianya mesin TCM di puskesmas, sehingga pemeriksaan harus dilakukan ke rumah sakit. Rumah sakit yang memiliki alat TCM juga baru sedikit sehingga terjadi antrian pemeriksaan TCM yang membuat keterlambatan dalam penegakan diagnosis. Penegakan diagnosis tepat waktu merupakan kunci dalam pengobatan TB MDR. Daftar Pustaka : 43 (2008 – 2018) Kata Kunci : Kota Padang, Multi Drug Resistant Tuberculosis, Sistem Kesehatan FACULTY OF PUBLIC HEALTH ANDALAS UNIVERSITY Undergraduate Thesis, July 2019 AMELIYA BUGESTI, Student Number. 1511212074 SYSTEM ANALYSIS IN HANDLING MULTI-DRUG RESISTANT TUBERCULOSIS (MDR-TB) IN THE CITY OF PADANG x + 103 pages, 19 tables, 4 images ABSTRACT Objective Cases of TB MDR reported annually to WHO, from 2014-2016 continued to increase. Likewise with TB MDR cases that occur in Padang City, which tends to increase. The health system is one of the factors that play an important role in handling TB MDR cases. The aim of the study was to acknowledge the system analysis in the handling of TB MDR in Padang City. Method Research uses qualitative methods with a system approach. The study was conducted in August 2018- July 2019. The informants of the study were 17 people, the technique of determining informants was purposive sampling. Methods of collecting data by in-depth interviews, document review and observation. Data analysis using content analysis approach. Data were processed by source triangulation and method triangulation. Results The results of the study obtained information related to the input component that in terms of man, money, material, methods in overcoming MDR TB at puskesmas were available and sufficient. Whereas the machine is not yet available, so TCM checks must be referred to the hospital. Components of the process are the implementation of screening suspected, enforcement of diagnosis, treatment. Constraints found in the form of late diagnosis and treatment procedures in hospitals that are still less effective. The output component is in the form of a challenge in the coverage of drug resistant TB cases, namely the limitation of TCM examination so that the percentage of coverage cannot describe the actual situation. The success rate of treatment challenges is in the form of less effective treatment procedures and the presence of DO patients, and for the percentage of TB cases that initiate second-line treatment challenges in the form of late diagnosis. Conclusion The health system that affects the incidence of TB MDR in the Padang City is the unavailability of TCM machines at the puskesmas, so that the examination must be carried out to the hospital. Hospitals that have TCM devices are also few so that there is a queue for TCM examinations that makes a delay in establishing a diagnosis. Enforcement of timely diagnoses is key in the treatment of TB MDR. Bibliography : 43 (2008 – 2018) Keywords: Health System, Multi Drug Resistant Tuberculosis, Padang City

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