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description Journal article public Kesmas: National Public Health Journal

Peningkatan Determinan Sosial dalam Menurunkan Kejadian Tuberkulosis Paru

Dyah Wulan Sumekar Rengganis Wardani
Published 1 August 2014

Abstract

Upaya pengendalian tuberkulosis paru oleh World Health Organization telah meningkatkan angka kesembuhan dan menyelamatkan banyak jiwa, tetapi kurang berhasil dalam menurunkan insiden tuberkulosis. Oleh karena itu, pengendalian tuberkulosis akan lebih menekankan pada kebijakan determinan sosial karena determinan sosial secara langsung maupun melalui faktor risiko tuberkulosis berpengaruh terhadap tuberkulosis. Di Bandar Lampung, angka notifikasi tuberkulosis dari tahun 2009 – 2010 mengalami peningkatan walaupun angka kesembuhan sudah lebih dari 85%. Bandar Lampung juga merupakan bagian dari salah satu provinsi termiskin di Indonesia. Penelitian ini bertujuan untuk mempelajari pengaruh determinan sosial (yang diukur melalui indikator pendidikan, pendapatan dan kelas sosial) terhadap kejadian tuberkulosis. Penelitian dilakukan pada bulan Juli – Oktober 2012 di seluruh pelayanan kesehatan di Bandar Lampung yang telah melaksanakan strategi Directly Observed Treatment Shortcourse. Responden penelitian ini adalah 238 penderita tuberkulosis basil tahan asam positif dan 238 suspek yang tidak menderita tuberkulosis. Hasil penelitian menunjukkan bahwa determinan sosial yang rendah akan meningkatkan risiko untuk terkena tuberkulosis. Oleh karena itu, pengendalian tuberkulosis perlu disertai dengan peningkatan determinan sosial untuk menurunkan kejadian tuberkulosis.Tuberculosis control program conducted by World Health Organization, has increased tuberculosis cure rate and saved million people, but has less success in reducing tuberculosis incidence. Therefore, tuberculosis control program needs to put more emphasis on social determinants. It is obvious, since social determinants, directly or through its tuberculosis-risk factors, affect tuberculosis. In Bandar Lampung, notification rate during the period of 2009 - 2010 has increased although the cure rate of the period was more than 85%. Moreover, Bandar Lampung is located in Lampung, one of the poorest provinces in Indonesia. This research aimed to study the influence of social determinants (measured by indicators of education, income and social class) affecting tuberculosis incidence. The study was conducted during July - October 2012 at all health services, which has been implementing Directly Observed Treatment Shortcourse strategy, across the Bandar Lampung City. Respondents of this research consisted of 238 smear-positive tuberculosis patients and 238 suspects without tuberculosis. The result showed that the lower social determinants, the higher risk of suffering from tuberculosis. It can be learned that tuberculosis control should be accompanied by an effort of improving social determinants in order to reduce the incidence of tuberculosis.

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