Tuberculosis Information System Research Articles

Chest X-Ray Comparison Between Drug-Resistant and Drug-Sensitive Pulmonary Tuberculosis in Children.

Chest X-ray (CXR) remains one of the tools used in diagnosing tuberculosis (TB). However, few studies about such tools exist, specifically in children in Indonesia. We aim to investigate and compare the CXR findings of children with pulmonary drug-resistant TB (DR-TB) and drug-sensitive TB (DS-TB) that could help in the evaluation and management of TB cases in children. Retrospective analysis with cross-sectional approach was conducted in children (<18 years old) diagnosed with pulmonary DR-TB and DS-TB from January 2018 to December 2021. Documented data were collected from the Paediatric Respirology Registry and Tuberculosis Information System at Dr. Hasan Sadikin General Hospital Bandung. Characteristics of children, CXR findings, and TB severity were assessed and compared using the chi-square and Fisher's exact tests with significance levels set at p value <0.05. Sixty-nine children (DR-TB 31 children vs. DS-TB 38 children) were assessed. Of the 31 children with DR-TB, 65% were classified as multidrug-resistant TB (MDR-TB), followed by rifampicin-resistant TB (RR-TB), pre-extensively drug-resistant TB (pre-XDR-TB), and extensively drug-resistant TB (XDR-TB). The most common CXR findings in DR-TB are consolidation (68%), fibrosis (42%), and cavity (29%), whereas in DS-TB, it is pleura effusion (37%). Severe TB accounts for 50% of DR-TB (p = 0.008). Consolidation, fibrosis, cavities, and findings of severe TB are most common in DR-TB. Pleural effusion is the most common in DS-TB. These findings have the potential to be considered in further examination of children with pulmonary DR-TB and DS-TB; hence, more extensive studies are needed to confirm these results.

Village as Contextual Factors and Other Risk Factors Related with the Incidence of Clinical Tuberculosis in Children in Wonogiri, Central Java: A Multilevel Analysis

Background: Indonesia is in the second rank with the highest burden of tuberculosis (TB) in the world. Childhood is a period of rapid growth, the body still has a low immune system so it is susceptible to disease including tuberculosis in children which requires control efforts. This study aims to analyze the influence of risk factors and village contextual factors on the incidence of TB in children.Subjects and Method: Case-control study research was conducted in 82 villages in Wonogiri Regency, from November to December 2023. A sample of 200 children aged 0 to 4 years old was selected through fixed disease sampling. The dependent variable of this study was the incidence of TB in children. The independent variables in this study were stunting, contact history, exposure to cigarette smoke, home sanitation, gender, parental education, child age, parental income, BCG immunization status, and village contextual influences. Data on TB disease was obtained from the Tuberculosis Information System Application (SITB) at the Wonogiri District Health Service in 2023. Other data was collected through questionnaires. The data analysis was done through multilevel multiplelogistic regression.Results: The factors that increased the incidence of TB in children were stunting (OR= 10.94; CI 95%= 2.50 to 47.90; p= 0.001), contact history to TB (OR= 8.37; CI 95%= 1.60 to 43.83; p= 0.012), and exposure to cigarette smoke (OR= 7.36; CI 95%= 1.99 to 27.14; p= 0.003). The reducing factors were healthy sanitation (OR= 0.24; CI 95%= 0.08 to 0.78; p= 0.017), female children (OR= 0.40; CI 95%= 0.15 to 1.05; p= 0.062), and parents with ≥high school education (OR= 0.40; CI 95%= 0.15 to 1.05; p= 0.062). There was no relationship between age (OR= 0.93; CI 95%= 0.13 to 6.23; p= 0.940), parental income (OR= 1.14; CI 95%= 0.40 to 3.25; p= 0.807), and BCG immunization status (OR= 0.12; CI 95%= 0.00 to 105.98; p= 0.550). Village has a contextual influence on the incidence of clinical TB in children (ICC= 52.95%).Conclusion: The risk of clinical TB in children increased with stunting, a history of TB contact and exposure to cigarette smoke, it decreased with healthy home sanitation, female gender, parents with ≥high school education. There was no relationship between age, parental income, and BCG immunization status. The village has a contextual effect on the incidence of clinical TB in children.

Tuberculosis Information System: Evaluation Approach with HOT-FIT Framework

Background: The increase in the number of pulmonary TB cases increases the risk of illness and death, which indicates the need for TB prevention and control efforts through online recording and reporting of cases using the Tuberculosis Information System (SITB). However, there are several challenges in implementing the use of SITB, which results in delays in reporting TB cases and disrupts TB prevention and treatment efforts. Purpose: The purpose of this study was to describe the use of SITB with the HOT-FIT Framework in the UPT Puskesmas Lemo area, North Barito District, Central Kalimantan. Methods: This research applies qualitative research methods with a phenomenological approach. The study population consisted of five informants who were selected deliberately (purposive sampling), including the Head of Puskesmas, TB Program Manager, TB Program Management Assistant, General Practitioner, and Laboratory Officer. Results: The results highlight that the use of Tuberculosis Information System (SITB) applications faces a number of supporting and inhibiting factors, which eventually lead to delays in reporting. Although the availability of adequate human resources (HR) is one of the supporting factors for reporting tuberculosis (TB) cases through the SITB application, the unstable internet network and lack of facilities and infrastructure such as inadequate software are also inhibiting factors. Conclusion: Puskesmas Lemo has participated in the successful implementation of TB case recording and reporting activities using SITB, but there are several aspects that still need to be improved and followed up. Thus, the Lemo Health Center still needs regular guidance and monitoring by the Health Office in carrying out its functions.

Descriptive Epidemiological Tuberculosis in Purwakarta District, 2020-2023

Introduction: Based on the results of the Indonesian Health Survey (SKI) in 2023, prevalence of Tuberculosis based on a history of doctor diagnosis is highest in Jawa Barat Province, at 0.47%, while the national Tuberculosis prevalence is 0.30%. Objective: This study aims to illustrate the Tuberculosis cases overview in Purwakarta District, 2020-2023. Method: This research uses a quantitative research design with a univariate descriptive analysis approach. This study utilizes secondary data from the Tuberculosis Information System (SITB). Result: Tuberculosis cases in Purwakarta District were highest in year 2022 (4703 cases). Based on gender, the highest cases occurred in males, with the peak in 2022 (2590 cases). The age group with the highest was the elderly age group, with the peak in 2022 (1253 cases). Tuberculosis Diabetes cases in 2022 reached 134 cases. The most accessed healthcare facility was hospitals (3317 cases) accessing healthcare services at hospitals. Conclusion: Tuberculosis cases in Purwakarta District peaked in 2022, with the highest distribution among males and elderly. The most common comorbidity of Tuberculosis cases is diabetes, and the highest number of visits is at hospitals, indicating potential Tuberculosis issues in Purwakarta District, thus further studies regarding the Tuberculosis status in Purwakarta District are needed.

“I pity the TB patient”: a mixed methods study assessing the impact of the COVID-19 pandemic on TB services in two major Indonesian cities and distilling lessons for the future

IntroductionIn Indonesia, a country with around 280 million people and the second-highest tuberculosis (TB) incidence rate in the world, the impact of the COVID-19 pandemic on TB care needs careful...

Clusters of heterogeneity of tuberculosis-HIV coinfection in Brazil: a geospatial study.

To analyze the geospatialization of tuberculosis-HIV coinfection in Brazil, from 2010 to 2021, and the correlation with socioeconomic, housing, and health indicators. An ecological study of Brazilian municipalities and states, with data from HIV and tuberculosis information systems, previously reported by the Ministry of Health. The crude and smoothed coefficients were calculated by the local empirical Bayesian method of incidence of coinfection per 100,000 inhabitants in the population aged between 18 and 59 years. Univariate (identification of clusters) and bivariate (correlation with 20 indicators) Moran's indices were used. A total of 122,223 cases of coinfection were registered in Brazil from 2010 to 2021, with a mean coefficient of 8.30/100,000. The South (11.44/100,000) and North (9.93/100,000) regions concentrated the highest burden of infections. The coefficients dropped in Brazil, in all regions, in the years of covid-19 (2020 and 2021). The highest coefficients were observed in the municipalities of the states of Rio Grande do Sul, Mato Grosso do Sul, and Amazonas, with high-high clusters in the capitals, border regions, coast of the country. The municipalities belonging to the states of Minas Gerais, Bahia, Paraná, and Piauí showed low-low clusters. There was a direct correlation with human development indices and aids rates, as well as an indirect correlation with the proportion of poor or of those vulnerable to poverty and the Gini index. The spatial analysis of tuberculosis-HIV coinfection showed heterogeneity in the Brazilian territory and constant behavior throughout the period, revealing clusters with high-burden municipalities, especially in large urban centers and in states with a high occurrence of HIV and/or tuberculosis. These findings, in addition to alerting to the effects of the covid-19 pandemic, can incorporate strategic planning for the control of coinfection, aiming to eliminate these infections as public health problems by 2030.

Risk Factor Analysis of Drug-Resistant Tuberculosis in Tuberculosis Patients at Level II Health Facilities in Depok City

Based on Global Tuberculosis Report In 2022, Indonesia will be among the 10 countries contributing to the highest incidence of drug-resistant tuberculosis each year. There are 12,794 cases of drug-resistant tuberculosis in Indonesia with 7,884 cases starting treatment. The number of drug-resistant tuberculosis cases involves a variety of risk factors. This study aims to analyze the risk factors associated with drug-resistant tuberculosis. The research method is observational analytic design case control study. The research samples were patients with drug-resistant tuberculosis and drug-sensitive tuberculosis in Depok City Health Facilities for the period March 2022–May 2023. Data were collected using questionnaires and SITB (Tuberculosis Information System). Bivariate analysis using Chi Square, while multiple logistic regression multivariate analysis. The results of the study of 73 cases and 73 controls showed that the majority were aged 18 - 65 years, 89% of cases and 62% of controls, male gender was the most dominant, 64.4% of cases and 52% of controls, most of the respondents did not work 68.5 % of cases and 53.4% ​​of controls, most of them had low income, 82.8% of cases and 62% of controls. Most of the case group had a high level of education, namely 58.5%. Meanwhile, most of the control group had low education, 50.7%. Bivariately, risk factors associated with drug-resistant tuberculosis are HIV, history of previous treatment, adherence to taking medication and the role of drug swallowing supervisor (PMO). Based on multivariate analysis, the dominant variable associated with the incidence of drug-resistant tuberculosis is history of previous treatment (OR6.021 with CI 2.055-18.721) meaning that patients with a history of previous treatment have a 6 times risk of developing drug-resistant tuberculosis compared to patients without a history of previous treatment.

Comparison of Sputum Evaluation Conversion of Pulmonary TB patients with DM and non-DM in High Burden Setting

ABSTRACT&#x0D; Background&#x0D; Tuberculosis (TB) remains a global health problem and is one of the leading causes of death worldwide. By 2022, an estimated 10 million people will suffer from TB worldwide. Based on data from the Global Tuberculosis Report in 2022, Indonesia ranks second as a high-burden country in the world after India. An estimated 1.5 million people die from tuberculosis, becoming the 13th leading cause of death worldwide and the second most deadly infectious disease after COVID-19.&#x0D; Currently, many new cases of TB are influenced by several risk factors, one of which is Diabetes Mellitus (DM). Pulmonary TB is a potential opportunistic infection for people with Diabetes Mellitus. TB patients with DM are at risk of sputum conversion failure after TB treatment, 1.69 times higher risk of treatment failure, 1.24 times higher risk of anti-TB drug resistance, 3.89 times higher risk of relapse, and 4.95 times higher risk of death during treatment compared to TB patients.&#x0D; Aim of Study&#x0D; To evaluate the sputum smear conversion results at the end of the second month of treatment of patients with Tuberculosis with Diabetes Mellitus (TB-DM) and Tuberculosis Non-Diabetes Mellitus (TB-NDM).&#x0D; Methods&#x0D; This research was analytical with a retrospective cohort design by taking secondary data from the Tuberculosis Information System (SITB). The data were recorded in SITB and registered as TB patients undergoing Anti-Tuberculosis Drug treatment and screening for Diabetes Mellitus in all districts in West Nusa Tenggara Province in 2022.&#x0D; Results&#x0D; Among 200 patients with TB in this study, male patients dominated 62% of TB patients. TB patients are mostly found in the age group 46-55 years with 28,5%. Generally, TB patients come from Mataram, with an 18% percentage. Most TB patients were diagnosed using GeneXpert (80,5%). The sputum conversion rate at the end intensive phase in TB-DM patients reached 95%, while in TB-NDM patients, only 85%. The comparative test showed a significant difference between the AFB Sputum Evaluation conversion results between TB patients and those without DM (p-value: 0.018, p&lt;0.05).&#x0D; Conclusion &#x0D; There is a significant difference between the AFB Sputum Evaluation conversion results between TB patients and those without DM.&#x0D; &#x0D; Keywords : Diabetes, diabetes mellitus, sputum conversion, tuberculosis, TB, DM

T-BACCO SCORE: A predictive scoring tool for tuberculosis (TB) loss to follow-up among TB smokers.

Loss to follow-up (LTFU) and smoking during TB treatment are major challenges for TB control programs. Smoking increases the severity and prolongs TB treatment duration, which lead to a higher rate of LTFU. We aim to develop a prognostic scoring tool to predict LTFU among TB patients who smoke to improve successful TB treatment outcomes. The development of the prognostic model utilized prospectively collected longitudinal data of adult TB patients who smoked in the state of Selangor between 2013 until 2017, which were obtained from the Malaysian Tuberculosis Information System (MyTB) database. Data were randomly split into development and internal validation cohorts. A simple prognostic score (T-BACCO SCORE) was constructed based on the regression coefficients of predictors in the final logistic model of the development cohort. Estimated missing data was 2.8% from the development cohort and was completely at random. Model discrimination was determined using c-statistics (AUCs), and calibration was based on the Hosmer and Lemeshow goodness of fit test and calibration plot. The model highlights several variables with different T-BACCO SCORE values as predictors for LTFU among TB patients who smoke (e.g., age group, ethnicity, locality, nationality, educational level, monthly income level, employment status, TB case category, TB detection methods, X-ray categories, HIV status, and sputum status). The prognostic scores were categorized into three groups that predict the risk for LTFU: low-risk (<15 points), medium-risk (15 to 25 points) and high-risk (> 25 points). The model exhibited fair discrimination with a c-statistic of 0.681 (95% CI 0.627-0.710) and good calibration with a nonsignificant chi-square Hosmer‒Lemeshow's goodness of fit test χ2 = 4.893 and accompanying p value of 0.769. Predicting LTFU among TB patients who smoke in the early phase of TB treatment is achievable using this simple T-BACCO SCORE. The applicability of the tool in clinical settings helps health care professionals manage TB smokers based on their risk scores. Further external validation should be carried out prior to use.

Healthcare workers’ acceptance of the integrated tuberculosis–COVID-19 screening in central Java Private Hospitals, Indonesia

ObjectiveCOVID-19 pandemic has negatively impacted the diagnosis and management of tuberculosis (TB) cases, and TB–COVID-19 integrated screening was introduced as a strategy to overcome these problems. This study determined the acceptability of the TB–COVID-19 integrated screening by healthcare workers (HCWs) and its impact on achievement of the TB program. MethodsThis was a mixed-method study with an embedded design. Data on hospital TB program coverage from the national TB information system for all Muhammadiyah and Aisyiyah Hospitals (MAHs) in Central Java were compared before and after the implementation of TB–COVID-19 integrated screening. The informants consisted of HCWs from 21 MAHs in Central Java. Focus group discussions (FGDs) were carried out with 7 hospital TB, 19 emergency room, 10 outpatient, 6 inpatient, and 4 managerial staff. In-depth interview (IDIs) were also performed with the Technical Officer TB Recovery Head of the Muhammadiyah Center. All IDIs and FGDs were recorded, transcribed verbatim, and subjected to thematic analysis guided by the theoretical framework of acceptability (TFA). ResultImplementation of the TB–COVID-19 integrated screening program led to an increase in the number of new TB case diagnoses at the Central Java Hospitals. Moreover, the program was acceptable based on seven indicators from TFA. Despite the obstacles faced by HCWs during the implementation process, the program still managed to meet the standards. ConclusionAcceptance by HCWs is a critical factor in the successful implementation of programs, including the TB–COVID-19 integrated screening. Furthermore, a multifaceted and cross-sectoral approach is required to address the constraints associated with the process.

Analysis of Barriers to the Use of Health Information Systems for Tuberculosis Patients at the Parongpong Community Health Center, West Bandung Regency, Indonesia

Based on the rules from the government contained in the Regulation of the Minister of Health of the Republic of Indonesia Number 31 of 2019, the Public Health Center information system can be implemented electronically so that the data obtained can be stored safely. An electronic health center information system must have an application, an internet, and a local network (LAN). This can also support Health Promotion activities through electronic media and online reporting to the Minister of Health of the Republic of Indonesia. This research aims to apply innovative health education to the problem of low Tuberculosis patient visits. This is done by analyzing a fishbone diagram and determining priority solutions to problems that have resulted in no real follow-up plans (RTL) so that targets have not been met and there has been no evaluation action at the Parongpong Health Center. This activity is carried out in several stages, namely 1) problem analysis with fishbone, 2) USG (urgency, seriousness, growth), and 3) SWOT analysis. Furthermore, counseling was carried out to all people in the Parongpong sub-district. The results obtained from calculating the score using the SWOT analysis are to make regulations on procedures and standard operating procedures (SOP) for the use of the Tuberculosis Information System (SITB) to optimize health information management at the Parongpong Health Center, West Bandung Regency, Indonesia.

EVALUATION OF TUBERCULOSIS RECORDING AND REPORTING CASE SYSTEM AT SYARIF HIDAYATULLAH HOSPITAL IN 2020

The national TB control program target is TB elimination at 2035 and TB eradication at 2050. Hospitals must establish a DOTS Team who have responsibility to implementing the TB control program and must be record and report any disease cases. TB case reporting uses the Integrated Tuberculosis Information System (SITT) since 2020. Integrated Tuberculosis Information System has become the Tuberculosis Information System (SITB). Syarif Hidayatullah Hospital is one of the 3 hospitals that have not completed the report. This research is a descriptive analytic study with a qualitative approach. The data collecting data include documents review, observation, and in-depth interviews with key informants. The results showed that recording and reporting did not run optimally because 1) the lack of human resources such as nurses as the spearhead of manual record, 2) there was no funding for the TB DOTS program including for recording and reporting, 3) Hospital Information System was not integrated into all service units causing difficulties in data collection TB patients, 4) the internal network did not working properly because there is no socialize about TB recording and reporting flowchart. Increased management commitment in implementing the TB DOTS program so that recording and reporting can working properly.

Analysis of Factors Contributing to Treatment Success among Tuberculosis Patients: Cross-Sectional Study in Semarang, Indonesia

The success rate of TB treatment in Semarang City in 2021 will reach 81.15%. Patients recovered reached 20.20%. Complete Treatment reached 60.95%. Failed treatment 0.15%. Patients Died reached 5.96%. Treatment dropout (lost to follow-up) reached 12.43%. Not evaluated/moved reached 0.31%. This study aims to identify the factors that contribute to the success of TB treatment. This study used secondary data sourced from the Semarang City Tuberculosis Information System (SITB) which was recorded regularly during 2021-2022. 4,627 TB patients who had minimally complete variables were entered into univariate analysis, crosstabulation and binary logistic regression. The results of the multivariate analysis showed a joint relationship between the factors that contributed to the success of TB treatment. Negative DM Status (AOR = 1.33; CI95% = 1.092-1.619), Standard Treatment Status (AOR = 1.767; CI95% = 1.235-2.529), Type Puskesmas Health Facility (AOR=3.778; CI95%=3.114-4.582), New Patients Based on Previous Treatment History (AOR = 1.592; 95% CI = 1.263-2.007) with Nagelkerke R Square = 13.2%. TB treatment success strategies in Semarang City need to be improved.

Lost to Follow-Up among Tuberculosis Patients during the Public-Private Mix Era in Rural Area of Indonesia.

Indonesia's national Tuberculosis (TB) strategy is public-private mix (PPM). The PPM aims to treat patients who have lost sight during TB treatment as these patients are TB carriers and at risk of transmitting TB. The purpose of this study was to identify predictive factors for loss to follow-up (LFTU) among TB patients receiving treatment when the PPM was at place in Indonesia. The design of this study was a retrospective cohort study. The data used in this study was sourced from the Tuberculosis Information System (SITB) of Semarang which was recorded routinely during 2020-2021. Univariate analysis, crosstabulation, and logistic regression were performed on 3434 TB patients meeting the minimum variables. The participation of health facilities in reporting TB during the PPM era in Semarang reached 97.6% consisting of 37 primary healthcare center (100%), 8 public hospitals (100%), 19 private hospitals (90.5%), and a community-based pulmonary health center (100%). The regression analysis reveal that the predictive factors of LTFU-TB during the PPM are the year of diagnosis (AOR=1.541; p-value=<0.001; 95% CI=1.228-1.934), referral status (AOR=1.562, p-value=0.007; 95% CI=1.130-2160), healthcare and social security insurance ownership (AOR=1.638; p-value=<0.001; 95% CI=1.263-2.124), drugs source (AOR=4.667; p-value=0.035; 95% CI=1.117-19.489). The PPM strategy in dealing with LTFU patients should focus on TB patients without Healthcare and Social Security Insurance and who receive TB treatment rather than program drugs.

Completeness of tuberculosis information system data from prisoners in the state Rio Grande do Sul, Brazil.

Tuberculosis (TB) has a high incidence in several countries and is even more severe in prisoners. We evaluated the completeness of prisoners TB notifications in the Notifiable Disease Information System (SINAN) carried out by prison primary care teams (eAPP) or by other health facilities in the state of Rio Grande do Sul (RS). This descriptive cross-sectional study used prisoners data notifications in the SINAN TB by the eAPP or other health facilities from January 2014 to November 2018. We analyzed the percentage of completeness of the variables: gender, ethnicity, schooling, HIV, entry type, sputum smear, sputum culture, AIDS, ART during TB treatment, directly observed treatment (DOT), sixth-month smear, and closure status. Around 52.9% of TB cases in prisoners were reported by eAPP, and other health facilities reported 47.1% of the cases. Eighty percent of the variables were classified in category 4 (75.1% to 100% completeness). However, the DOT and sixth-month smear variables were classified into category 3 (50.1% and 75% completeness). While it does not compromise the notification of TB in the SINAN, the lack of data can impair the quality of information about the disease.

Factors Influencing the Discovery of Suspected Tuberculosis during the COVID-19 Pandemic in Palu City

This study aimed to analyze the factors that influence the discovery of suspected tuberculosis during the COVID-19 pandemic in Palu City with a type of cross-sectional study. The type of research used was quantitative, with an analytic epidemiological study design using a cross-sectional design. This research was carried out in 13 working areas of the Puskesmas in Palu City from January to March 2022. The population in this study were all suspected tuberculosis at 13 Community Public Health (in Indonesia: Puskesmas) in Palu City in 2021, recorded at the Tuberculosis Information System totaling 15,620 people using the slovin formula to obtain a sample of 100 and the sampling design used stratified random sampling. This study used the T-test with α=10%. The results show that most of the respondents had less knowledge of 69 respondents (69%), respondents had a low stigma of 70 respondents (70%), 73 respondents (73%) received adequate tuberculosis services, 19 respondents (19%) received good services, and 8 respondents received less services, with a percentage of 8%. A significant effect between knowledge of suspected tuberculosis (p = 0.000), stigma (p = 0.000), and tuberculosis services (p = 0.000) on the discovery of suspected tuberculosis during the COVID-19 pandemic in Palu City. It is recommended to increase tuberculosis tracking during the COVID-19 pandemic conditions and conduct training to improve and optimize the role of tuberculosis cadres in the working area of each Public Health Center

Assisted TB Information System within the Private Sector to Improve Case Notification in Kenya

Mycobacterium Tuberculosis (TB) is a major public health concern causing over a billion deaths in the last 200 years. Several countries have been affected, with the incidence projected to increase due to COVID-19. The WHO's global strategy to End TB recommends several strategies to support global efforts, including engaging private facilities to diagnose and treat TB.TB reporting and documentation remain a challenge, with gaps between the number of new cases and the number reported/under-reported due to a mixture of underreporting and underdiagnoses. In Kenya, patient pathway analysis reveals that patients sought care in formal and informal private hospitals. However, underreporting TB notification among private facilities has not yet been systemically evaluated.This study targeted private facilities in Meru, Mombasa, Kilifi, Nyeri, and Kirinyaga counties to assess actual levels of TB underreporting, improvement in TB yield with strategic support, and patient characteristics.Study findings show low screening for TB. However, the strategic management of private facilities resulted in increased case notification, especially among children and men.The researcher recommends the need to strengthen reporting of data by age and gender. The author also proposes prospective research while collecting age and gender data to inform the actual situation based on identified gaps.

Evaluasi Penggunaan Sistem Informasi Tuberkulosis dengan HOT-FIT Framework di Puskesmas Mergangsan Yogyakarta

Background : The Tuberculosis Information System (SITB) is an application for recording and reporting TB cases designed by the Indonesian’s Ministry of Health in electronic form. This system is used by TB surveillance programmers at the primary health care (namely : Puskesmas), but in its use there are several obstacles including the system which sometimes becomes slow during the data input process and features that are felt to be incomplete. The purpose of this study was to evaluate the use of SITT at Puskesmas Mergangsan, Yogyakarta using the HOT-Fit Framework approach.&#x0D; Method : This research design is a qualitative research through descriptive case studies by conducting in-depth excavations through an in-depth interview process and document review regarding the input, process and output of the integrated tuberculosis information system and its contribution to decision making. The informants in this study were the Head of the Puskesmas, SITB Programmers, laboratory and pharmacy staff who used SITT and the deputy supervisor (wasor) from the health office district of Yogyakarta city. The sample selection uses a porpusive sample, namely the selection of samples with certain criteria that are considered to be able to answer the research problem.&#x0D; Results : Assessment of human factors at SITB is known that system users have received training before the system is used so that the system can be easily used, users are satisfied with the system that has been provided. Assessment of Organizational Factors, it is known that officers who use SITB at Puskesmas Mergangsan are sufficient, namely there are programmers, SITB in charge of the laboratory and SITB in charge of pharmacy, there is supporting facilities from Puskesmas Mergangsan, namely the procurement of laptops. Evaluation is carried out by the Dinas Kesehatan Kota Yogyakarta every three months. Technological Factor Assessment, the quality of the information produced depends on the accuracy of the data entered by health workers, there is still incomplete or clear information. The quality of system services is supported by the provision of a communication and coordination group by the Dinas Kesehatan Kota Yogyakarta.&#x0D; Conclusion : The implementation of SITB at the Puskesmas is still constrained in the input section of network facilities which has an impact on the data input process which cannot be done quickly, thus requiring support from the Puskesmas. It is hoped that there will be periodic socialization carried out by the Dinas Kesehatan Kota Yogyakarta as an evaluator of SITB users at the Puskesmas so that the use of SITB is more optimal

Characteristics and determinants of loss to follow-up among tuberculosis (TB) patients who smoke in an industrial state of Malaysia: a registry-based study of the years 2013-2017

BackgroundThe increased risk of loss to follow-up among TB smokers raises concern over the secondary spread within the community. This study aimed to determine the factors associated with loss to follow-up among TB patients who smoke.MethodsAll registered TB patients who smoke in the state of Selangor between 2013 and 2017 via the Malaysian Tuberculosis Information System (MyTB) database were included for analysis. TB patients who smoke were considered those who are “current smoker” during the notification, while loss to follow-up was defined as a TB patient who had interrupted treatment for 2 months or longer. There were 3 main variable domains included for analysis: sociodemographic profiles, disease profiles, and comorbidities. Logistic regression analysis was used to identify determinants of loss to follow-up among TB patients who smoke.ResultsA total of 14.1% (N = 813) of TB patients who smoke loss to follow-up. The determinants of loss to follow-up among TB smokers were working age population aged 32-41 and 42-53 years old (AOR 1.08; 95%CI 1.23,2.08) and (AOR 1.44; 95%CI 1.11,1.87) respectively, Malaysian nationality (AOR 2.34; 95%CI 1.66,3.30), patients staying in urban area (AOR 1.55; 95% CI 1.23,1.97), income level less than RM2160 (AOR 1.59; 95% CI 1.14,2.20), un-employed (AOR 1.30; 95%CI 1.09-1.55), have low education level i.e., secondary school education, primary school education and no formal education (AOR 1.60; 95%CI 1.22,2.10), (AOR 1.73; 95%CI 1.16,2.57) and (AOR 2.29; 95% CI 1.57,3.33) respectively, previously treated TB cases (AOR 2.19; 95% CI 1.71,2.81), active TB case detection methods (AOR 2.06; 95%CI 1.40,3.02), moderate lesion x-ray (AOR 1.60; 95%CI 1.13,2.27) and HIV positive (AOR 1.36; 95%CI 1.02,1.82). All the significant factors gave rise to the final model of determinants, with a predictability of 67.2% (95% CI 65.0,69.3).ConclusionsThe high proportion of loss to follow-up among TB patients who smoke highlight the importance of providing early risk detection that examines the three main domains of risk factors such as socioeconomic, disease profiles and comorbidities. Potential integrated intervention should aim to reduce the proportion of smoking among TB patients through the stop smoking programme together with directly observed therapy (DOT).

Pemanfaatan Geospasial Melalui Health and Demographic Surveillance System (HDSS) pada Pasien Tuberkulosis dalam Manajemen Obat

Tuberculosis (TB) is an infectious disease that causes a high mortality rate. Currently, Indonesia is the largest contributor to TB cases in the world. In 2019, the estimated number of cases was 845,000 cases, while case enrollment was 562,000. Thus, the Gap in the Case finding is high. As a result, innovation is needed in setting strategies to develop Regulations related to the national TB program, one of which is geospatial. This study aimed to provide an overview of geospatial utilization through HDSS in tuberculosis patients about drug management. Geospatial is an epidemiological approach that can be used to determine policies in accordance with conditions in an area. The research type is a quantitative study using secondary data from the Health and Demography Surveillance System (HDSS) of Sleman in 2016 and the Integrated TB Information System (SITT) of Sleman Regency in 2016. The analysis used descriptive analysis and geospatial mapping used Stata 15 and R software. Geospatial data shows that TB cases are concentrated in densely populated areas, such as Depok, Mlati, Ngaglik, and Gamping sub-districts. In addition, geospatial shows us the distance between the distribution of cases and the availability of health service facilities (puskesmas). The spread of cases is mostly found in the area around the health facilities, and low cases are in areas far from the health facilities. This condition possibly happens because case tracking is less affordable. Knowing the number and distribution of TB cases and the distribution of health care facilities can be used as a basis in the policy-making process, planning of the need for TB drugs, drug distribution, and priority interventions for TB services in a cost-efficiency.