Faktor Risiko Kegagalan Pengobatan Tuberkulosis: Systematic Review
Abstract
Latar belakang: Kegagalan pengobatan Tuberkulosis (TB) menjadi salah satu faktor masifnya penyebaran TB serta menimbulkan penambahan pasien TB Resisten Obat (RO). Indonesia belum berhasil mencapai target keberhasilan pengobatan TB pada tahun 2021.
Tujuan: Tujuan dari tinjauan sistematis ini adalah untuk mengetahui faktor-faktor yang berhubungan dengan kegagalan pengobatan TB di berbagai negara agar nantinya dapat menjadi referensi dalam penanggulangan masalah TB di Indonesia.
Metode: Terdapat empat database (PubMed, Scopus, EMBASE dan MEDLINE) yang digunakan untuk menelusuri artikel. Kata kunci yang digunakan untuk pencarian diantaranya: (tuberculosis) OR (TB) AND (treatment failure) OR (treatment default) OR (treatment flop). Penelusuran artikel pada tinjauan sistematis ini mengacu pada PRISMA (Preferred Reporting Items for Systematic Reviews and Meta Analysis) diagram.
Hasil: Analisis dilakukan pada enam artikel yang berasal dari negara yang berbeda-beda, yaitu Burkina Faso, Pakistan, Etiopia, China, Kolombia, dan Malaysia. Hanya satu artikel yang menggunakan desain case-control sementara sisanya merupakan studi kohort retrospektif. Karakteristik sampel mayoritas laki-laki dan berada pada rentang usia produktif. Dalam penelitian ini ditemukan faktor-faktor yang berhubungan dengan kegagalan pengobatan TB, antara lain adalah usia, jenis kelamin laki-laki, pendidikan, kasus TB berulang, TB-HIV, diabetes mellitus, perokok, serta faktor lainnya, seperti tinggal di perkotaan, penurunan berat badan, waktu mulai pengobatan, beban basil, tingkat keparahan penyakit, tatalaksana pengobatan, pengawasan minum obat, penggunaan obat-obatan (narkoba), dan lokasi TB esktra paru juga termasuk dalam faktor risiko kegagalan pengobatan TB.
Kesimpulan: Diperlukan upaya-upaya untuk mengatasi faktor risiko untuk mengurangi kegagalan pengobatan TB, seperti pendampingan pengobatan khususnya bagi pasien lansia, kolaborasi layanan berhenti merokok dalam praktik standar manajemen kasus TB, serta mencegah adanya koinfeksi TB-HIV dengan melakukan skrining pada kelompok rentan.
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