Skripsi

Kejadian Tuberkulosis Anak dengan Riwayat Kontak Serumah Pasien Tuberkulosis dan Faktor-Faktor yang Memengaruhi = Tuberculosis Disease among Children in Household Contacts of Tuberculosis Patients and Factors Associated.

Latar Belakang: Indonesia menempati urutan ketiga dengan insiden terbanyak TB (8%) di dunia. Program dunia mewajibkan investigasi kontak dan terapi preventif dilakukan kepada seluruh kontak serumah pasien TB terutama kontak anak, karena termasuk kelompok risiko tinggi. Di Indonesia, program ini belum belum dilaksanakan secara optimal tercermin dari pencatatan data kontak dan pemberian profilaksis yang masih kurang. Tujuan: Mengetahui angka kejadian TB pada kontak serumah anak (0-18 tahun) pasien TB dan faktor-faktor yang memengaruhi. Metode: Penelitian ini merupakan studi potong lintang (cross-sectional) yang dilakukan pada kontak serumah anak pasien TB yang masih dalam pengobatan di Puskesmas Kecamatan Ciracas, Jakarta Timur pada bulan Agustus hingga September tahun 2019. Pemeriksaan kontak dilakukan melalui anamnesis terkait gejala, lalu dilanjutkan dengan pemeriksaan dahak dan foto toraks untuk anak yang bergejala, atau pemeriksaan IGRA untuk skoring TB anak apabila dahak tidak didapat. Etik penelitian didapatkan dari Komite Etik FKUI dan izin penelitian didapatkan dari Dinas Kesehatan DKI Jakarta. Hasil: Sebanyak 36 kontak serumah anak dari 19 kasus indeks TB diinvestigasi. Kontak mayoritas laki-laki (58,3%), rerata usia 9,72 (s.b. 5,398), status gizi mayoritas normal (83,3%) dan mayoritas memiliki parut BCG (69,4%). Tipe resistansi kasus indeks 78,9% SO dan 21,1% RO. Sebanyak 8 subjek (22%) didiagnosis TB klinis. Terdapat hubungan antara tipe resistansi kasus indeks dengan kejadian TB pada kontak serumah anak. Tidak terdapat hubungan antara bacterial load dan bentuk lesi kasus indeks, jenis kelamin, usia, status gizi dan parut BCG kontak dengan kejadian TB pada kontak serumah anak.
Kesimpulan: Angka kejadian TB pada kontak serumah anak sebanyak 22%.
Kata kunci: Tuberkulosis, investigasi kontak, kontak serumah anak


Background: Indonesia ranks third among countries with the highest TB incidence in the world (8%). The world program has strongly recommended contact investigation and preventive treatment for all household contacts of TB patients, especially child contacts, as they are at higher risk for developing TB disease. In Indonesia, the implementation of this program has not been implemented optimally as reflected in the recording of cases’ contacts and prophylactic administration that is still lacking. Objective: To identify number of TB disease among children (0-18 years) in household contacts of TB patients and factors associated. Methods: This is a cross-sectional study conducted on children in household contacts of TB index cases who were still in treatment at Puskesmas District of Ciracas, East Jakarta from August to September 2019. Contact examination is done through taking records of symptoms, followed by sputum and chest X-ray for symptomatic children, or IGRA test for TB scoring if sputum is not obtained. Research ethics were obtained from the FKUI Ethic Committee and research permission was obtained from Dinas Kesehatan DKI Jakarta. Results: A total of 36 child household contacts from 19 index cases were investigated. The contacts were mostly male (58.3%) the mean age was 9.72 (s.d. 5.398), the nutritional status was mostly normal (83.3%), and most of them had BCG scar (69.4%). The resistance pattern of the index cases is 78.9% DS-TB and 21.1% DR-TB. A total of 8 children (22%) were diagnosed with active clinical TB. There is an association between resistance pattern of index cases with TB diseases in contacts. Conclusion: The incidence of TB disease in child household contacts of TB patients is 22%.
Keywords: Tuberculosis, contact investigation, children in household contact