Analysis of Factors Associates to the Incidence of Pulmonary TB Patients Drop Out in Primary Healthcare Centers in Sorong Papua Barat

Abstract

ABSTRAK 

Data Dinas Kesehatan Propinsi Papua Barat tentang kasus baru TB Paru dari tahun ke tahun terus meningkat, walau pelaksanaan program pemberantasan TB Paru terus ditingkatkan. Dari data BP2PL Dinas Kesehatan Propinsi Papua Barat tahun 2009 ditemukan 2462 penderita baru BTA positif. Dari jumlah tersebut yang drop out 337 penderita, dan pada tahun 2010 ditemukan 2476 kasus BTA Positif dan dari jumlah tersebut drop out 441 penderita. Berdasarkan hasil survey pendahuluan yang dilakukan pada puskesmas di kota sorong, pada tahun 2008 ditemukan jumlah penderita baru TB Paru BTA positif 87 penderita. Dari jumlah tersebut yang diobati hingga sembuh sebanyak 20 penderita, yang drop out sebanyak 64 penderita. Tahun 2009 ada peningkatan penderita baru yakni sebanyak 108 penderita, yang sembuh 28 penderita yang drop out 61 penderita. Dan tahun 2010 ditemukan sebanyak 103 penderita baru BTA positif, yang sembuh 27 penderita dan yang drop out 55 penderita. Tujuan penelitian ini untuk mengetahui faktor-faktor apa saja yang ada hubungannya dengan kejadian drop out pada penderita TB Paru yang sedang menjalani pengobatan. Penelitian ini adalah penelitian kuantitatif dengan pendekatan cross sectional. Pengumpulan data melalui metode wawancara dengan bantuan kuisioner terstruktur pada semua penderita yang berobat pada puskesmas kota Sorong. Jumlah sampel 50 penderita yang drop out dan 50 penderita yang berobat teratur dan sembuh di Puskesmas Kota Sorong. Analisis univariat dilakukan dengan deskriptif frekwensi, analisis bivariat dengan uji Chy Square. Hasil penelitian menunjukan ada hubungan antara pengetahuan dengan kejadian DO (p=0,001). Ada hubungan antara Motivasi dengan kejadian DO (p=001). Ada hubungan antara peran PMO dengan kejadian DO (p=0,001). Ada hubungan antara Akses dengan kejadian DO (p=0,001). Ada hubungan dukungan keluarga dengan kejadian DO (p=0,001) Tidak ada hubungan antara umur dengan kejadian DO (p=0,356). Tidak ada hubungan antara jenis kelamin dengan kejadian DO (p=0,156). Tidak ada hubungan antara pendidikan dengan kejadian DO (p=0,453). Dapat disimpulkan variabel yang ada hubungan dengan kejadian drop out adalah pengetahuan, motivasi,peran PMO,. Akses serta dukungan keluarga. Saran bagi Dinas Kesehatan meningkatkan frekwensi penyuluhan, pemutaran film dukumenter tentang penyakit menular, dan jangka panjang pengadaan puskesmas pembantu serta pengaktipan kembali kader kesehatan desa.

Kata kunci : Drop Out, TB Paru

ABSTRACT

Data from health office of West Papua province regarding new cases of tuberculosis (TB) indicated that the number of cases increased although lung TB control program was improved. Data from BP2PL of West Papua health office in 2009 showed that 2462 new cases of positive fast acid bacilli (BTA) were found; among them, 337 patients were dropout. In 2010, 2476 cases with positive BTA were found, and among them 441 patients were dropout. Based on preliminary survey done in Sorong city primary healthcare centers, in 2008, 87 new lung TB cases with positive BTA were found. Among them, 20 patients were treated and cured, 64 patients were dropout. In 2009, there was an increase in the number of new cases, which were 108 patients. Among them, 28 patients were cured, and 61 patients were dropout. In 2010, 103 new cases with positive BTA were found; among them, 27 patients were cured, and 55 patients were dropout. The objective of this study was to identify factors related to the occurrence of drop out among lung TB patients who were in the treatment program. This was a quantitative study with cross sectional approach. Data were collected using interview method supported by structured questionnaire. Study population was all patients visited in the Sorong city primary healthcare centers. Study samples were 50 dropout patients and 50 patients who sought for medication regularly and cured in primary healthcare centers in Sorong city. Frequency distributions were presented for univariate analysis, and chi square test was applied for bivariate analysis. Results of the study showed that there was association between knowledge and dropout occurrence (p= 0.001).Motivation was associated with dropout occurrence (p= 0.001). The role of PMO was associated with drop out occurrence (p= 0.001). Accessibility was associated with dropout occurrence (p= 0.001). Family support was associated with dropout occurrence (p= 0.001). No association between age and dropout occurrence (p= 0.356), between sex and dropout occurrence (p= 0.156), between education and dropout occurrence (p= 0.453). In conclusion, variables related to dropout occurrence are knowledge, motivation, roles of PMO, accessibility, and family support. Suggestions for district health office are to increase education frequency, playing documentary movies about infectious diseases. Long term suggestions are to build supporting primary health care center, and to reactivate village health cadres.

Keywords : Dropout, lung TB