Model of Risk Factors of Multidrug-Resistant Tuberculosis (MDR-TB) in RSUD Dok II Jayapura

Abstract

Multidrug-Resistant Tuberculosis (MDR-TB) is the biggest problem in the prevention and eradication of TB world. Indonesia is ranked eighth out of 27 countries with the highest incidence of MDR-TB in the world. MDR-TB is a disease caused by Mycobacterium tuberculosis that at least resistant to rifampicin and ionized. This study is aimed to develop model base on various risk factors of MDR-TB in RSUD Dok II Jayapura. This study was conducted in RSUD Dok II Jayapura. The method used is observational case control study design. The population of the case is resistant positive and population control is resistant negative. Data were analyzed using chi-square test and multiple logistic regression. Out of 19 variables analyzed, there were 13 variables prove as risk factors that associated to the incidence of Multidrug-Resistant (MDR-TB) that is (1) the family expenses (OR = 4.297; 95% CI: 1.1413 to 13.068), (2) the difficulty of transportation costs (OR = 4.000; 95% CI: 1.272 to 12.578), (3) difficulty related to the distance of residence (OR = 4.000; 95% CI: 1.272 to 12.578), (4) no fixed residence (OR = 8.636; 95% CI: 2.566 to 29.073 ), (5) a companion to take medication (OR = 6.000; 95% CI: 1.172 to 30.725), (6) treatment compliance (OR = 67.667; 95% CI: 7.954 to 575.677), (7) the side effects of drugs (OR = 2.500; 95% CI: 1.780 to 3.511), (8) contact history (OR = 20,000; 95% CI: 5.384 to 74.298), (9) a history of smoking (OR = 3.500; 95% CI: 1.201 to 10.196), ( 10) a history of drinking alcohol (OR = 10.266; 95% CI: 2.557 to 41.372), (11) the knowledge about the causes of disease (OR = 7.000; 95% CI: 1.381 to 35.478), (12) the knowledge of the consequences if not treated with complete (OR = 8.105; 95% CI: 1.612 to 40.766), (13) the knowledge of the duration of treatment (OR = 6.000; 95% CI: 1.482 to 24.299). And the dominant factor affecting the incidence of MDR-TB were treatment adherence (OR = 48.495; 95% CI: 3.105 to 757.515), contact history (OR = 47.540; 95% CI: 3.657 to 617.986), and no fixed residence (OR = 20.795; 95% CI: 1.589 to 272.068). In conclusion, model building in this study were Risk Factor Model based on OR, Risk Factors Model based on Subject probability, and Scoring Card Model. Risk factors of MDR-TB in RSUD Dok II Jayapura were the family expenses, difficulties in transportation costs, the difficulty of the distance residence, no fixed residence, a companion to take medication, treatment compliance, drug side effects, contact history, history of smoking, alcohol drinking history, knowledge about the causes of disease, knowledge about the consequences if not treated thoroughly, and knowledge of the long treatment of disease. It is recommended that the need for increased understanding of the dangers of disease transmission of Tuberculosis and Multidrug-resistant Tuberculosis (MDR-TB), both to patients and healthcare workers.