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Medication Adherence among Drug-Resistant Tuberculosis (DR-TB) Patients at Universitas Indonesia Hospital Harahap, Daimah Wirdatus Sanaun; Andrajati, Retnosari; Sari, Santi Purna; Handayani, Diah
Jurnal Respirologi Indonesia Vol 44, No 3 (2024)
Publisher : Perhimpunan Dokter Paru Indonesia (PDPI)/The Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/jri.v44i3.775

Background: Drug-resistant tuberculosis (TB-DR) is a deadly disease caused by infectious agents. Indonesia is one of the countries with the highest drug-resistant tuberculosis (TB-DR) rates in the world. The prevalence of tuberculosis cases in Depok City between 2019-2022 showed an increase in cases every year. This study aims to measure the level of adherence of drug-resistant tuberculosis (TB-DR) patients to their treatment using the Eight-Item Morisky Medication Adherence Scale (MMAS-8) questionnaire.Methods: This study is an observational study using a cross-sectional study design, conducted from February 2024 to March 2024 at the University of Indonesia Hospital. Eighty-seven respondents participated in this study. Respondents completed the validated Indonesian version of the MMAS-8 questionnaire after signing informed consent forms.Results: The results of the study showed that 50.6% of respondents had low adherence levels, 47.1% had moderate adherence levels, and 2.3% had high adherence levels. The data was then statistically analyzed using the SPSS version 29 statistical package with Chi-Square analysis, which resulted in a significant correlation (P<0.05) between adherence levels and gender.Conclusion: There was a significant correlation between gender and respondent adherence. More than 50% of drug-resistant tuberculosis (TB-DR) patients at the University of Indonesia Hospital still have low adherence levels to their treatment.

Potential of Emodin as Effective Therapy Overcoming COVID-19 Through Inhibition of the SARS-CoV-2 Spike Protein Interaction on ACE2 Receptors Ilham, Ahmad Fadhil; Handayani, Diah
Jurnal Respirologi Indonesia Vol 44, No 4 (2024)
Publisher : Perhimpunan Dokter Paru Indonesia (PDPI)/The Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/jri.v44i4.355

Background: The coronavirus disease 2019 (COVID-19) once became a major pandemic in the history of human health. Patients in severe to critical conditions, especially with comorbidities, are more likely to have complications such as ARDS, cytokine storm, higher mortality rates, and require more effective treatments. Emodin is a candidate regimen that has the potential benefit for COVID-19.Method: This literature review was synthesized with literature searches on journal databases such as PubMed, ScienceDirect, EMBASE, and the Google Scholar search engine. As a result, three main articles and 36 supporting articles were used to synthesize this literature review.Results: The pathogenesis of SARS-CoV-2 infection was similar to SARS-CoV infection, as demonstrated by Hoffmann et al, namely through the interaction of viral spike (S) protein with ACE2 receptors in the human body, so the inhibition of this interaction would be one of the therapeutic targets. Ho et al proved that emodin can inhibit the binding of the SARS-CoV S protein to ACE2 in vitro. The direct inhibition of S protein may also support the ACE2 cardioprotective function in patients with cardiovascular comorbidities. Emodin is also superior because it has various other benefits such as anti-inflammatory and immunosuppressive activity. Based on the research of Dong et al, emodin can be given orally but in combination with inhibitors of glucuronidation, metabolism can increase the bioavailability of this drug.Conclusion: Emodin has the potential to be developed for the effective therapy of COVID-19.

Combined Institutional and Telerehabilitation Programs for A Post-Tuberculosis Lung Disease Patient with Low Cardiorespiratory Endurance: A Case Report Widjanantie, Siti Chandra; Agustin, Heidy; Handayani, Diah; Burhan, Erlina; Susanto, Agus Dwi
Jurnal Respirologi Indonesia Vol 45 No 4 (2025)
Publisher : Perhimpunan Dokter Paru Indonesia (PDPI)/The Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497//jri.v45i4.719

Background: Post-tuberculosis lung disease (PTLD) can lead to long-term respiratory issues and impaired lung function, which can impact quality of life. Pulmonary rehabilitation (PR) is a personalized strategy designed to address these problems and improve overall well-being. It is administered by a diverse team of experts. Case: A 28-year-old female patient with a history of tuberculosis (TB) presented with breathing difficulty. The physical examination revealed decreased chest expansion, shoulder asymmetry, a slight forward neck, and a rounded shoulder. The radiologic findings and bronchoscopy showed PTLD, atelectasis in several parts of the right lung, and regional destruction of the right lung. Discussion: The patient underwent pulmonary rehabilitation (PR), which included endurance exercises, strength training, several types of breathing exercises, breath-stacking exercises, thoracic expansion exercises, physical agents for rehabilitation modalities, education on posture correction, and energy conservation in daily activities. The patient was also monitored remotely through telerehabilitation from home. There were significant improvements in pulmonary function tests. Measurement of FVC, FEV1, the six-minute walking test (6MWT), and the PCF after two weeks of follow-up. After eight weeks of training, there were improvements in cardiopulmonary endurance, muscle endurance, and reduced dyspnea. Conclusion: Comprehensive pulmonary rehabilitation programs, including a combination of institutional and telerehabilitation synchronous approaches, can help improve cardiopulmonary endurance, muscle strength-endurance, and the overall patient's functional life who was suffering from chronic respiratory diseases, such as post-TB sequelae.

Potential of Emodin as Effective Therapy Overcoming COVID-19 Through Inhibition of the SARS-CoV-2 Spike Protein Interaction on ACE2 Receptors Ilham, Ahmad Fadhil; Handayani, Diah
Jurnal Respirologi Indonesia Vol 44 No 4 (2024)
Publisher : Perhimpunan Dokter Paru Indonesia (PDPI)/The Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/jri.v44i4.355

Background: The coronavirus disease 2019 (COVID-19) once became a major pandemic in the history of human health. Patients in severe to critical conditions, especially with comorbidities, are more likely to have complications such as ARDS, cytokine storm, higher mortality rates, and require more effective treatments. Emodin is a candidate regimen that has the potential benefit for COVID-19.Method: This literature review was synthesized with literature searches on journal databases such as PubMed, ScienceDirect, EMBASE, and the Google Scholar search engine. As a result, three main articles and 36 supporting articles were used to synthesize this literature review.Results: The pathogenesis of SARS-CoV-2 infection was similar to SARS-CoV infection, as demonstrated by Hoffmann et al, namely through the interaction of viral spike (S) protein with ACE2 receptors in the human body, so the inhibition of this interaction would be one of the therapeutic targets. Ho et al proved that emodin can inhibit the binding of the SARS-CoV S protein to ACE2 in vitro. The direct inhibition of S protein may also support the ACE2 cardioprotective function in patients with cardiovascular comorbidities. Emodin is also superior because it has various other benefits such as anti-inflammatory and immunosuppressive activity. Based on the research of Dong et al, emodin can be given orally but in combination with inhibitors of glucuronidation, metabolism can increase the bioavailability of this drug.Conclusion: Emodin has the potential to be developed for the effective therapy of COVID-19.

Medication Adherence among Drug-Resistant Tuberculosis (DR-TB) Patients at Universitas Indonesia Hospital Harahap, Daimah Wirdatus Sanaun; Andrajati, Retnosari; Sari, Santi Purna; Handayani, Diah
Jurnal Respirologi Indonesia Vol 44 No 3 (2024)
Publisher : Perhimpunan Dokter Paru Indonesia (PDPI)/The Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/jri.v44i3.775

Background: Drug-resistant tuberculosis (TB-DR) is a deadly disease caused by infectious agents. Indonesia is one of the countries with the highest drug-resistant tuberculosis (TB-DR) rates in the world. The prevalence of tuberculosis cases in Depok City between 2019-2022 showed an increase in cases every year. This study aims to measure the level of adherence of drug-resistant tuberculosis (TB-DR) patients to their treatment using the Eight-Item Morisky Medication Adherence Scale (MMAS-8) questionnaire.Methods: This study is an observational study using a cross-sectional study design, conducted from February 2024 to March 2024 at the University of Indonesia Hospital. Eighty-seven respondents participated in this study. Respondents completed the validated Indonesian version of the MMAS-8 questionnaire after signing informed consent forms.Results: The results of the study showed that 50.6% of respondents had low adherence levels, 47.1% had moderate adherence levels, and 2.3% had high adherence levels. The data was then statistically analyzed using the SPSS version 29 statistical package with Chi-Square analysis, which resulted in a significant correlation (P<0.05) between adherence levels and gender.Conclusion: There was a significant correlation between gender and respondent adherence. More than 50% of drug-resistant tuberculosis (TB-DR) patients at the University of Indonesia Hospital still have low adherence levels to their treatment.

Diagnostic Accuracy and Clinical Utility of InaTB-Rif, Locally Developed Molecular Test for Tuberculosis, in Comparison with Xpert MTB/RIF in Indonesia Handayani, Diah; Haryanto, Budi; Adyasiwi, Galoeh; Dahlan, Muhammad Sopiyudin; Agustin, Heidi; Wardoyo, Muhammad Prasetio; Ilham, Ahmad Fadhil; Burhan, Erlina
Jurnal Respirologi Indonesia Vol 45 No 2 (2025)
Publisher : Perhimpunan Dokter Paru Indonesia (PDPI)/The Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/jri.v45i2.907

Background: Tuberculosis (TB) remains a significant public health issue in Indonesia. Early and accurate diagnosis and drug susceptibility testing are essential for TB management. This study compared the diagnostic accuracy of the locally developed InaTB-Rif molecular test and Xpert MTB/RIF, using Mycobacterium Growth Indicator Tube (MGIT) culture as the reference standard. Methods: A cross-sectional study was conducted at Persahabatan Hospital, Jakarta, from February to August 2023. Presumptive pulmonary TB patients were recruited and tested using Xpert MTB/RIF, InaTB-Rif, and MGIT culture. The study assessed the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and agreement between InaTB-Rif and Xpert MTB/RIF for Mycobacterium tuberculosis (MTB) detection and rifampicin resistance. Diagnostic accuracy was compared using receiver operating characteristic (ROC) curves. Results: MGIT culture identified 29 TB-positive and 26 TB-negative cases. InaTB-RIF showed a sensitivity of 93.1% (95% CI=0.77-0.99), specificity of 76.9% (95% CI=0.56-0.91), PPV of 81.8% (95% CI=0.64-0.93), and NPV of 90.9% (95% CI=0.70-0.98). Xpert MTB/RIF had a sensitivity of 89.7% (95% CI=0.726-0.978), specificity of 80.8% (95% CI=0.606-0.93), PPV of 83.9% (95% CI=0.66-0.94), and NPV of 87.5% (95% CI=0.67-0.97). The area under the curve (AUC) was 0.8501 for InaTB-RIF and 0.8521 for Xpert MTB/RIF, with no significant difference in accuracy (P=0.965). The kappa value for MTB detection was 0.776, indicating substantial agreement, while the kappa value for rifampicin resistance detection was 0.517, indicating moderate agreement. Conclusions: InaTB-RIF demonstrates comparable diagnostic accuracy to Xpert MTB/RIF with good diagnostic performance and agreement for detecting MTB and moderate agreement for rifampicin resistance detection.

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