Tuberculosis Patients In Indonesia Research Articles

Characteristics, knowledge, attitude, and practice of pharmacy personnel in supporting tuberculosis treatment: A multicenter cross-sectional study in a high-burden tuberculosis country

BackgroundPositive roles of community pharmacy in tuberculosis (TB) care have been widely reported. However, the actual practice of supporting TB treatment is not optimal yet. ObjectivesWe analyzed the current practice of community pharmacy personnel and its factors in supporting the successful treatment of TB patients in Indonesia, aiming to develop strategies for effective and sustainable TB practice models for the community pharmacy. MethodsWe performed a cross-sectional survey in 3 areas representing Indonesia's eastern, central, and western parts. Development and validation of the questionnaire were conducted to assess 4 domains, that is, characteristics, knowledge, attitudes, and practice of community pharmacy personnel in supporting the successful treatment of TB patients. Data were collected with purposive convenience sampling using online and offline questionnaires. Descriptive analyses were used to summarize factors in each domain, while binary logistic regression was used to analyze the associated factors of the practice. ResultsThirty-five questionnaire items indicated a valid instrument, and the study successfully included 844 participants who comprised pharmacists (n = 473, 56%) and pharmacy assistants (n = 371, 44%). Although most of the knowledge items were correctly answered by more than 60% of the participants, items related to TB signs, risk groups, drug regimens, and medicine uses were still less than 60%. This was in line with exposure to updated TB training in only 51% of the participants (n = 426). Most of the participants had a positive attitude toward their professional role (n = 736, 87%), capability (n = 646, 77%), and consequences (n = 655, 78%) in supporting TB treatment. However, this was not aligned with the actual practice of supporting TB treatment, intensively performed by only 1.3% of participants (n = 11). We identified several factors associated with the practice, that is, a pharmacy assistant background (P < 0.05), short working time (P < 0.05), experience in TB training (P < 0.001), and a positive attitude (P < 0.001). ConclusionThis study highlighted a limited number of community pharmacy personnel intensively practicing as TB treatment supporters in Indonesia. An interventional package considering the identified factors is needed to develop effective and sustainable practices in the real world.

Factors Affecting Treatment Adherence Among Patients with Tuberculosis in Indonesia: Literature Review

Introduction: Tuberculosis (TB) is the leading cause of death from infectious diseases in the world and Indonesia is the second largest contributor to TB cases after India. Treatment adherence problems are a major obstacle to TB elimination. The purpose of this Literature Review is to determine the factors that affect treatment adherence among TB patients in Indonesia.&#x0D; Methods: Literature obtained from Science Direct, PubMed, and Google Scholar; published from 2018 – 2023, research from reputable international journals and from national journals at least with SINTA 3, located in Indonesia. Indonesian and English with full text of all types of research designs. Article selection was carried out using the method "Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) and analyzed using descriptive analysis techniques.&#x0D; Results: A total of 225 articels were deemed appropriate for the topic, but only 15 articles were included based on inclusion criteria. It was found that there are several factors that affect treatment adherence in tuberculosis patients in Indonesia, namely: predisposing factors as many as 11 articles (age, education, occupation, knowledge, self-efficacy, concordance, health behavior, motivation, marital status, income level, drug side effects, already feeling cured, and duration of treatment). Reinforcing factors as many as 2 articles (family support). Enabling factors as many as 5 articles (the role of officers, reminder SMS messages from officers, health counseling, and distance of residence to health services).&#x0D; Conclusion: The most dominant factor affecting treatment adherence among tuberculosis patients in Indonesia is the Predesposising factors, namely education and sefl-efficacy.

Development and validation of a structured questionnaire for assessing risk factors of medication non-adherence among pulmonary tuberculosis patients in Indonesia.

Background: Medication non-adherence is a significant concern in tuberculosis (TB) treatment, requiring a precise understanding of the associated risk factors. However, there is a lack of appropriate means to assess the risk factors among TB patients in Indonesia, leading to the development and validation of a structured questionnaire for this purpose. Method: This study unfolded in two distinct phases, namely, the first included questionnaire construction through framework development, item generation, item screening, and pretesting (in 50 patients). The second comprised questionnaire validation with 346 participants using confirmatory factor analysis (CFA) and structural equation modeling-partial least squares (SEM-PLS). Additionally, reliability testing was conducted using Cronbach's alpha and composite reliability statistical techniques. Results: In the development phase, 168 items were defined, consisting of sociodemographic characteristics (8 items) and risk factors for medication non-adherence (160 items). Expert evaluation reduced the number of items to 60, which decreased to 22 after performing a pilot study. Subsequent SEM-PLS modeling resulted in the identification of 14 valid items, representing five major risk factors, namely, socioeconomics (4 items), healthcare team (4 items), condition (3 items), therapy (2 items), and patient (1 item). Only condition-related factors were found to influence non-adherence, and all constructs showed good reliability based on Cronbach's alpha (>0.6) and composite reliability (0.7) values. Conclusion: The final 22 items that emerged from this rigorous process indicated a valid and robust questionnaire for assessing risk factors of medication non-adherence among pulmonary tuberculosis patients in Indonesia. The developed questionnaire was positioned to be a valuable tool for healthcare professionals, policymakers, and scientists in creating patient-centered strategies and interventions to address non-adherence.

Peran Bedaquiline dan Penggunaannya pada Tuberkulosis Resisten Obat : Sebuah Kajian Naratif

Tuberculosis, caused by infection with Mycobacterium tuberculosis, is still a global concern. The existence of resistance to the first line of anti-TB, namely isoniazid and rifampicin, is an urgent need for the development of new drugs that are effective and safe against tuberculosis. Bedaquiline has received approval from the FDA as a new anti-TB drug discovered to treat drug-resistant tuberculosis. This article aims to review the role of bedaquiline in the treatment of drug-resistant tuberculosis mechanisms, evidence, effectiveness, and adverse events. This narrative review uses a literature study approach by identifying various literature and research articles through databases as relevant references. Bedaquililine belongs to the diarylquinoline class inhibits ATP-synthase activity and suppresses the growth of active and dormant mycobacteria. Various clinical trials conducted previously have evaluated the use of bedaquiline-based regimens for the treatment of adults with drug-resistant tuberculosis. Bedaquiline-based regimens showed efficacy and were generally well tolerated in numerous studies. Currently, further evaluation is needed regarding its efficacy, safety, and tolerability in drug-resistant tuberculosis patients in Indonesia.

The trial of sending short message service multidrug-resistant tuberculosis patients in Indonesia: the chance to increase knowledge and motivation.

Multidrug-Resistant Tuberculosis (MDR TB) is a threat for the future control of TB disease. In Indonesia, the success rate of MDR TB patient recovery is still very low, following the still low recovery rate of TB patients. This paper aims to discuss the trial result of message delivery containing knowledge and motivation to the MDR TB sufferers. There are about 34 MDR TB patients participating in this research. During the research, everyone received a message in their handphone or the handphone of their family members every day, contained information on medication and motivation to comply with the medication. At the end of the research, the measurement on knowledge and attitude, on the compliance with medication, and on the compliance with laboratory examinations was conducted. The results were compared with the assessment before this intervention was conducted. Out of 32 patients that managed to complete the intervention, the average means of their knowledge and attitude increased significantly. The average mean of knowledge before the intervention was 9.74 to become 10.94, and the average mean of attitude was from 7.06 to become 18.47 (P<0.05). Meanwhile, the medication compliance score and the laboratory examination compliance score also changed significantly (P<0.05). SMS delivery routinely even in a short period of time managed to change knowledge and motivation of MDR TB sufferers. To conclude, it is necessary to develop recent technology effort in order to scaling-up MDR TB patients. Existing social channels in the community must be used intensively to reduce this disease negative impact.

TUBERCULOSIS CASE MODEL USING GCV AND UBR KNOT SELECTION METHODS IN TRUNCATED SPLINE NONPARAMETRIC REGRESSION

The nonparametric regression approach is used when the shape of the regression curve is not known. The advantage of nonparametric regression is that it has a high degree of flexibility. The truncated spline is a method in the nonparametric regression approach, which can overcome changing data patterns at certain sub-intervals with the help of knot points. The purpose of this research is to obtain the best truncated spline nonparametric regression model estimates based on the GCV and UBR knot point selection methodsThe data used in this study came from the publications of the Indonesian Ministry of Health and BPS Indonesia. The response variable used is the percentage of successful treatment of tuberculosis patients in Indonesia with predictor variables namely the percentage of people who smoke over the age of 15 years, the percentage of households that have access to proper sanitation, the percentage of poor people, the percentage of food processing establishments that meet the standard requirements , national health insurance membership coverage and percentage of accredited hospitals. The results showed that the best model came from the GCV method using three knots. This model produces an MSE value of 3.65 with value of 97.04. The value indicates that the predictor variable used in this study affects the response variable by 97.04% while the other 2.96% is influenced by other variables that are not included in this study.

The seroprevalence of anti-Histoplasma capsulatum IgG antibody among pulmonary tuberculosis patients in seven referral tuberculosis hospitals in Indonesia.

Histoplasma capsulatum exposure is rarely suspected in Indonesia. Pulmonary histoplasmosis can occur simultaneously with pulmonary tuberculosis (TB) or as an alternative diagnosis in clinically-diagnosed TB patients with no microbiological evidence of TB. This study aimed to determine the seroprevalence of anti-H. capsulatum IgG antibody among pulmonary TB patients. This was a sub-study of 306 participants from a prospective cohort pulmonary TB study conducted at seven TB referral hospitals in Indonesia. The study population was presumptive pulmonary TB adult patients who underwent microbiological TB examinations and were categorized as drug-sensitive (DS), drug-resistant (DR), and clinically-diagnosed TB. Anti-H. capsulatum IgG antibody levels at baseline were measured using MVista Histoplasma Ab enzyme immunoassays. Data were summarized using descriptive statistics. Bivariate and multivariate logistic regression analysis were performed to assess factors associated with anti-H. capsulatum IgG antibody positive result. 12.7% (39/306) of pulmonary TB patients were positive for anti-H. capsulatum IgG antibodies (DR-TB patients (15.9%, 18/114), DS-TB (13.0%, 15/115), and clinically-diagnosed TB (7.8%, 6/77)). The median unit value of anti-H. capsulatum IgG antibody for all positive samples was 15.7 (IQR 10.2-28.9) EU. This median unit value was higher in clinically-diagnosed TB patients compared to DS-TB or DR-TB patients (38.1 (IQR 25.6-46.6) EU, 19.7 (IQR 12.3-28.9) EU, and 10.9 (IQR 9.2-15.4), respectively). There were 10 patients (3.3%) with anti-H. capsulatum IgG antibody levels above 30 EU. Factors associated with the anti-H. capsulatum IgG antibody positive result were malignancies (OR 4.88, 95% CI 1.09-21.69, p = 0.037) and cavitary lesions (OR 2.27, 95% CI 1.09-4.70, p = 0.028). Our results provide evidence of exposure to H. capsulatum among pulmonary TB patients in Indonesia. Further studies are needed to provide a comprehensive picture of this fungal disease in other populations and regions to enhance awareness among clinicians and public health officials.

Experience and number of patients as associated factors toward clinical confidence among nursing students in caring for tuberculosis patients in Indonesia

BackgroundNurses and nursing students are at greater risk of tuberculosis (TB) exposure due to their higher intensity contact with patients. In Indonesia, a country with high TB incidence, it is crucial to assess undergraduate nursing students' clinical confidence during their clinical practicums. PurposeThis study aimed to explore factors associated with nursing students' clinical confidence in caring for TB patients. MethodsThis cross-sectional study utilized an internet survey based on the United States National TB Curriculum Consortium (NTCC) in September and November 2020. The survey questions focused on TB knowledge, beliefs about the value of TB instruction, and clinical confidence in caring for TB patients. Descriptive statistics, t-test, ANOVA, Pearson's correlation coefficient, and hierarchical regression were used for data analysis. The Indonesian version of the original NTCC survey was used. ResultsThe study found that nursing students' knowledge about TB increased with their year of study (r = 0.290, p < .001). However, students perceived TB instruction as less valuable as they neared graduation (r = −0.233, p < .001) and with more frequent practice in the TB unit (r = −0.162, p < .001). Students who spent more time learning about TB outside of class perceived the TB instruction in the nursing curriculum more positively (r = 0.181, p < .004). The study also found a significant difference between nursing students' belief in the value of TB education and their clinical confidence in caring for TB patients (F = 5.711, p < .001). Furthermore, experience caring for TB patients and the number of TB patients cared for predicted clinical confidence. Conclusions/ImplicationsThis study highlights the need for improved curriculum content and teaching methods regarding TB for nursing students. It also suggests that experience caring for TB patients and the number of TB patients cared for can improve clinical confidence in nursing students. Given the high incidence of TB in Indonesia, this study's findings could have important implications for the country's healthcare system.

Antibodies against Histoplasma capsulatum and Aspergillus fumigatus among chronic TB patients in Indonesia: a cross-sectional study.

Chronic pulmonary fungal infections may occur in patients with previous history of pulmonary tuberculosis (TB), and are often clinically misclassified as TB, especially when bacteriological confirmation for Mycobacterium tuberculosis is absent. In this study, we investigated the prevalence of antibody against Histoplasma capsulatum and Aspergillus fumigatus in patients with confirmed and clinically chronic TB. Antibodies against H. capsulatum and A. fumigatus were measured from serum samples using enzyme-linked immunosorbent assay (ELISA). The presence M. tuberculosis in sputum was confirmed using smear microscopy, GeneXpert MTB/RIF assay, or culture. Antibodies against H. capsulatum and A. fumigatus were elevated in 16.9% and 26.9% of bacteriologically confirmed chronic TB patients, and 12.1% and 18.2% in those without bacteriological confirmation, respectively. Approximately one-third of patients who had positive anti-Histoplasma antibody also had elevated levels of antibody against Aspergillus fumigatus (P<.001). Our study highlights the importance of chronic pulmonary fungal infection in post-TB patients with recurrent respiratory symptoms.

Effectiveness of application of daily medicine boxes to compliance with anti-tuberculosis drug consumption in Indonesian tuberculosis patients

Tuberculosis (TB) is one of the infectious diseases and is a major cause of poor health, thus becoming one of the leading causes of death in the world. In 2021 the World Health Organization (WHO) said that, 9.9 million people experienced TB disease worldwide. It is also estimated that every year there are 13,110 cases of people who die from TB disease. The number of TB cases in Indonesia is estimated at 845,000 cases in 2020 with 393,323 TB cases notified. According to data from the Tasikmalaya City Health Office in 2020, there were 1.045 cases of TB sufferers in Tasikmalaya City. TB disease can be cured by taking treatment for 6 months. Adherence to treatment is one way to prevent failure in TB treatment. The daily medicine box is one solution to improve patient compliance with anti-TB treatment. This study aims to determine the effectiveness of daily medication use on adherence to anti-TB medication in TB patients at the Tamansari Public Health Center, Tasikmalaya City. This study uses a quantitative approach with the research method of Pre-Experimental Design, one group with pre-test &amp; post-test. The sample was 16 respondents in this study, Wilcoxon Signed Rank test used in this research. Results: The results showed that the pretest-posttest had an effect of the daily medicine box on adherence to taking anti-TB drugs in TB patients with p-value 0.000 &lt;0.05. Therefore, it can be concluded that there is a significant difference between before and after being given treatment. this study recommended that TB patients apply the daily medicine box as a tool to improve adherence to taking drugs so as to reduce failure in TB treatment.

Factors Related to Complying with Anti-TB Medications Among Drug-Resistant Tuberculosis Patients in Indonesia.

A variety of factors influenced the decision of tuberculosis (TB) drug-resistant patients to continue treatment. The study aimed to analyze factors that influence complying with anti-TB medications in patients with TB drug resistance in Indonesia. The study employed a cross-sectional approach and was conducted in various community health centers and polyclinics offering TB drug-resistant services in Bandung city, Indonesia. Participants were 79 patients with TB drug resistance who met the criteria during their treatment for TB drug resistance, were willing to be involved in the research, and accessed TB services in Bandung. Complying with anti-TB medications scale, TB Health Behaviors questionnaire, the family support questionnaire, the TB-Related Stigma Scale, and TB knowledge were used in this study. Data were analyzed using Spearman's Rho. Health behavior (r = 0.36) was positively associated with complying with anti-TB medications, while family support, TB stigma, and knowledge were not related to treatment compliance. Information on these factors will inform the development of models and modules for the prevention and control of TB drug resistance in Indonesia, which can later be used widely in Indonesia.

Impact of Instrumental Support from Family on Medication Adherence among Tuberculosis Patients: A Cross-Sectional Study

Instrumental support is concrete and tangible, for instance, helping to provide food or accompanying patients to health care facilities. However, its impact on medication adherence among tuberculosis patients in Indonesia needs to be explored. This study aimed to examine the impact of instrumental support from family on tuberculosis patients’ adherence to medication in Bogor City, West Java Province, Indonesia. A cross-sectional study involving 106 participants with an age average of 39.7 (SD = 14.9) was conducted in 12 primary health care (PHC). The independent variables (age, sex, education, employment status, wealth index, and the distance between home and PHC) of instrumental support from family was assessed using MMAS-8. In contrast, the dependent variable of medication adherence was assessed using a self-reported instrument. Multivariate binary logistic regression was used in the analysis and indicated that participants receiving family support were more likely to adhere to medication protocol (95% CI = 1.1–6.3; p-value = 0.029). Instrumental support from family was associated with medication adherence among tuberculosis patients in Bogor City, West Java Province, Indonesia. It is necessary to design further comprehensive interventions in the community setting to encourage the family to support tuberculosis patients following medication protocol.

Nodular Episcleritis in a Boy with Pulmonary Tuberculosis

Introduction: Episcleritis is an acute inflammation of the vascular connective tissue between the conjunctiva and the sclera’s surface, which can be found unilateral and bilateral. Tuberculosis (TB) is one of the systemic infectious diseases that cause morbidity in developing countries and can affect the ocular area known as ocular tuberculosis There are still limited cases of ocular tuberculosis studies, specifically tubercular nodular episcleritis in adolescents. This case report aims to expose nodular episcleritis in pediatric tuberculosis patients in Indonesia. Case Presentation: A 16-year-old boy came to the Community Eye Health Hospital East Java with superior bilateral eye redness and pain with normal visual acuity. He underwent advanced anti-tubercular treatment for the last nine months. The best corrected visual acuity (BCVA) of both eyes was 6/6. Slit-lamp biomicroscopy (SLB) examination found the dilation of blood vessels located on the superior episclera accompanied by a firmly bordered, fixed, pink nodule, diameter ± 1.5 mm located at 12 o’clock in bilateral bulbar conjunctiva. Based on anamnesis and physical examination, the diagnosis of nodular episcleritis et causa pulmonary TB was established. Topical corticosteroids and artificial tears eyedrops were given in both eyes for five weeks, and continuing anti-tubercular treatment was performed. Conclusion: It is necessary to investigate the primary cause of episcleritis by eliminating underlying systemic diseases. Herein, we present a rare case of nodular episcleritis in an adolescent with pulmonary tuberculosis who responded very well to anti-tubercular treatment with topical corticosteroid and artificial tears eye drops.

Governance Efforts for TB-Friendly Village Development during the COVID-19 Pandemic: Lessons Learned from Depok City, West Java, Indonesia

BACKGROUND: In 2020, TB patients in Indonesia reached 8.5% of the total number of TB patients globally, as the country with the second-highest TB cases. Depok is the city in the West Java region that has experienced an increase in TB cases. The existence of tuberculosis-friendly villages will reduce the stigmatization of tuberculosis (TB) patients and increase treatment compliance. AIM: This study aims to analyze various aspects of Depok City’s readiness to develop TB-friendly village governance –– including government commitment, infrastructure, resources, and organizational culture –– within the scope of academic, business, community, government, and media (ABCGM)’s role or penta-helix. METHODS: The initial stage of preparation involved conducting a literature review. This research employed an online survey of 230 respondents and 40 TB patients using a quantitative approach. The qualitative approach involved 15 stakeholders through interviews, discussions, and a website-based search. RESULTS: Overall, the respondents were well-informed about TB, but attitudes (50.9%) and behavior (41.3%) regarding TB prevention need improvement. The government budget is adequate, but coordination is lacking between stakeholders and community involvement. CONCLUSION: Depok City is not yet ready to develop TB-friendly villages in terms of human resources and organizational aspects. It is necessary to improve communication, information, and education regarding TB prevention and establish leadership policies as a legal basis to strengthen the governance and management of TB-friendly villages. Moreover, community involvement is an essential pillar of developing these villages.

GAMBARAN TINGKAT PENGETAHUAN KELUARGA TENTANG PENYAKIT TUBERKULOSIS PARU DI WILAYAH KERJA PUSKESMAS SUKAMERINDU KOTA BENGKULU

The increasing number of pulmonary tuberculosis patients in Indonesia is caused by a lack of public knowledge about pulmonary tuberculosis so that there are still many people who behave unhealthy. In addition, the level of family knowledge has a major influence on the health status of the family and the tuberculosis patient itself and plays an important role in the success of the prevention and prevention program for pulmonary tuberculosis. In 2021 cases of pulmonary tuberculosis patients at the Bengkulu City health office were reported to be 352 in adult patients and 33 in pediatric patients. The low success rate of pulmonary tuberculosis treatment in the city of Bengkulu is the low level of knowledge of families and tuberculosis sufferers in carrying out independent health care on a regular basis. This type of research uses a quantitative descriptive method. The purpose of this study was to describe the level of family knowledge about pulmonary tuberculosis in the Sukamerindu Public Health Center, Bengkulu City. This type of research uses a quantitative descriptive method. The research population was 37 respondents. The sampling technique used was total sampling. The research instrument used a questionnaire. The results showed that the level of family knowledge about pulmonary tuberculosis was in the good category 5%, in the sufficient category 57% and 38% in the less category. To increase public knowledge, it is necessary to provide health education and counseling about pulmonary TB.

Quality of Life Determinant Factors in Tuberculosis Patients in Indonesia: Literature Review

Tuberculosis patients undergo treatment and care for a long time which will have an impact on their well-being. Good patient welfare will have an impact on the patient's quality of life in their daily lives. The quality of life possessed by tuberculosis patients is important because it can affect the success of treatment. The purpose of this study was to analyze the factors that influence the quality of life of tuberculosis patients in Indonesia. The research design used is a literature review using keywords based on PICo using a database of research articles, namely ScienceDirect, ProQuest, PubMed, Google Scholar and Garuda from 2016-2021. There were 13,782 articles with 18 relevant articles for review and analysis. The low quality of life of tuberculosis patients is influenced by factors of age, education, stress, depression, stigma, medication adherence and social support . Abstrak: Pasien tuberkulosis menjalani pengobatan dan perawatan yang cukup lama yang akan berdampak pada kesejahteraan yang dialaminya. Kesejahteraan pasien yang baik akan berdampak pada kualitas hidup pasien dalam kesehariannya. Kualitas hidup yang dimiliki oleh pasien tuberkulosis merupakan hal yang penting, karena dapat mempengaruhi kesuksesan pengobatan. Tujuan penelitian ini adalah untuk menganalisis faktor-faktor yang mempengaruhi kualitas hidup pasien tuberkulosis di indonesia. Desain penelitian yang digunakan merupakan literature review dengan menggunakan kata kunci berdasarkan PICo dengan menggunakan data base artikel penelitian yaitu ScienceDirect, ProQuest, PubMed, Google Scholar dan Garuda dari tahun 2016-2021. Didapatkan 13.782 artikel dengan 18 artikel yang relevan untuk dikaji dan dianalisis. Rendahnya kualitas hidup yang dimiliki oleh pasien tuberkulosis dipengaruhi oleh faktor usia, pendidikan, stres, depresi, stigma, kepatuhan pengobatan dan dukungan sosial.

Changes in Pattern and Multifocal Electroretinogram in Tuberculosis Patient with Ethambutol Therapy

Introduction: Tuberculosis (TB) is a world health problem, especially in Indonesia as the third biggest country for new emerging TB patients. Ethambutol is one of the standard therapies to treat TB patients in Indonesia. Ethambutol has a side effect called ethambutol optic neuropathy which is hard to diagnose due to normal fundus appearance in most cases and therefore often detected late. Early detection is necessary so that permanent damage can be prevented. Examination pattern electroretinography (pERG) and multifocal electroretinography (mfERG) have the advantage to detect and confirm ocular toxicity by ethambutol after the clinical problem had emerged. It is not yet known neither pERG nor mfERG could detect any changes to detect ethambutol ocular toxicity before the clinical problem emerged. Methods: This study was a prospective clinical trial with 40 eyes samples and analyzed with paired t and Wilcoxon tests. The ocular examination was conducted using the Snellen chart, HRR Richmond Plates, Pelli Robson, pERG, and mfERG in tuberculosis category 1 patient with 2 months follow-up. Result: Visual acuity, color, and contrast sensitivity were normal in all patients for 2 months follow-up period. In pERG examination, the mean implicit time wave P50 was shortened by -1.27± 4.71 mS (p=0.049), and the mean amplitude wave N95 was reduced by -0.93± 4.49 ?V (p=0.038). Both were statistically significant. In the mfERG examination, we did not find any statistically significant changes in both wave N1 and P1. Conclusion: Changes in pattern ERG presented earlier compared to mfERG after ethambutol therapy for 2 months.

Preventing Tuberculosis in Families of East Timor Expatriate Tuberculosis Patients in Indonesia

Tuberculosis is a highly contagious disease caused by rod-shaped bacteria (bacilli) known as Mycobacterium tuberculosis. The housing of East Timor expatriates in Indonesia is very close to each other, with unsanitary environmental conditions and poor ventilation, thus making this community vulnerable to disease transmission, especially of infectious diseases such as pulmonary tuberculosis. This study aimed to examine the attitudes and behaviors associated with preventing tuberculosis in the families of East Timor expatriate tuberculosis patients. This was a descriptive study with a survey and observational approach. The sample consisted of 36 respondents and data were collected using a questionnaire with 27 questions about attitudes and behaviors to prevent TB transmission. The average age of the respondents was 38 years old. 53% of respondents were male and 42% graduated from elementary school. The results showed that 69% had a positive attitude to the prevention of pulmonary TB transmission in the family and 61% mostly behaved well in their behavior to prevent pulmonary TB transmission. Based on these findings, health workers need to improve health promotion programs with family empowerment methods, as well as advocate for the Government to pay attention to the quality of environmental sanitation and increase the number of patients who recover from TB.&#x0D; Keywords: tuberculosis, pulmonary, prevention and control

Implementation of Biodesign process to Identify Unmet Needs of Tuberculosis Patients in Indonesia

Tuberculosis (TB) is an infectious disease mainly caused by Mycobacteria tuberculosis. It affects the respiratory system and may spread to the other organ. Due to the nature of the bacteria, infection of this species may cause a long-term TB, causing it a challenge for a full clearance. The disease has existed throughout the history, and BCG vaccine has been developed to control the spreading. Most developed countries have successfully eradicated TB. However, Indonesia is currently ranked second place for this disease, making it as a pressing matter to eradicate. This study is conducted to investigate and gather deep insights about the problems in eradicating TB in Indonesia. Identify part of the biodesign method is employed in the study to elucidate the complexity of healthcare issue of TB in Indonesia. The study discovered that there are three pillars’ sectors need to be addressed: education, healthcare facilities and services, and government. For successful eradication, synergistic approach to all pillars at the same time are essential. The needs statements formulated in this study could be the stem of innovation in TB.

Individual-Level Factors Associated with Quality of Life among TB Patients

Background: Due to the high incidence of tuberculosis (TB) in Indonesia, evaluating important factors of the TB patients’ quality of life is crucial. Individual-level factors play an essential role in enabling TB patients to manage their perceived needs and treatments to sustain the Quality of Life (QoL). Yet little is known about the relationships between individual-level factors and the QOL of TB patients in Indonesia. This study aimed to evaluate the association between individual-level factors (physical health, emotional state, social support, spirituality) and quality of life in TB patients. Methods: A cross-sectional study was conducted using a simple random sampling strategy, 73 TB patients were chosen based on their availability during data collection, and consent to participate in the study. The data were collected from a community sample of Surabaya City, East Java, Indonesia. In the present study, the following instruments were used: Early Warning Score System (EWSS), Depression Anxiety Stress Scale (DASS)-21, MOS Social Support Survey-14, Daily Spiritual Experience Scale (DSES), and the World Health Organization Quality of Life (WHO-QoL). Spearman’s rank correlation coefficient was used to discover the association between variables. Results and Discussions: The results showed that there were significant relationships between physical health (p = 0.037), emotional state (p = 0.04), social support, spirituality and QoL (p = 0.001). Conclusion:In conclusion, individual-level factors associated with TB patients’ quality of life: physical health, emotional state, social support, and spirituality.