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Clinical Spectrum and Factors Associated to Post Covid Syndrome in Healthcare Workers Sinaga, Joshua Princeman; Sinaga, Bintang Yinke Magdalena; Siagian, Parluhutan; Eyanoer, Putri Chairani; Samodra, Yoseph Leonardo
Public Health of Indonesia Vol. 10 No. 4 (2024): October - December
Publisher : YCAB Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36685/phi.v10i4.844

Abstract

Background:Post-COVID Syndrome (PCS) is a newly recognized condition reported by approximately 45% of individuals following COVID-19 infection. This syndrome is estimated to affect the health-related quality of life in 10–30% of affected individuals. Objective:To examine the characteristics of Post-COVID Syndrome among healthcare workers at Adam Malik Hospital. Methods:This study employed a cross-sectional descriptive design. Data were collected using structured questionnaires administered to healthcare workers at Adam Malik Hospital who had contracted COVID-19 between 2020 and 2022. Results:A total of 120 participants were included in the study. The sample was predominantly female (78.3%), with the youngest age group (19–30 years) comprising 37.5% of participants. Most participants had direct exposure to patient care (78.3%) and were confirmed COVID-19 positive in 2021 (42.5%). Notably, 45.0% of participants were unvaccinated, 20.9% had a history of hospitalization, and 78.3% experienced mild COVID-19 infections. Hypertension was identified as the most common comorbidity. Participants were categorized as experiencing Acute PCS (43.9%) or Chronic PCS (56.1%), with both groups exhibiting similar predominant symptoms, including fatigue, persistent cough, memory impairment, and cognitive difficulties. Statistically significant associations were identified between PCS and variables such as sex (p=0.004, OR=0.27), age (p=0.015, OR=4.46), severity of prior COVID-19 infection (p=0.040, OR=1.77), vaccination status (p<0.001, OR=3.82), and the presence of comorbidities (p=0.025, OR=2.53). Conclusion:Post-COVID Syndrome is characterized by multifactorial etiologies and heterogeneous clinical manifestations. Factors such as gender, age, vaccination status, comorbid conditions, and severity of prior infections were significantly associated with PCS outcomes. Gender-related differences, potentially influenced by immune response, hormonal mechanisms, and antibody production, appear to contribute to variations in PCS manifestations. These findings underscore the need for further research to elucidate the epidemiology, clinical presentations, and pathological mechanisms underlying this emerging post-viral condition.  Keywords:Post-COVID Syndrome; healthcare workers; COVID-19; clinical manifestations; post-viral sequelae
Contributing Factors of Anxiety on Healthcare Workers during COVID-19 Pandemic at Referral Hospital of Sumatra Region in Indonesia Simanjuntak, Christine Raphaela Tiarmauli; Sinaga, Bintang Yinke Magdalena; Siagian, Parluhutan; Effendy, Elmeida; Zaluchu, Fotarisman
Public Health of Indonesia Vol. 11 No. S1 (2025): Special Issue
Publisher : YCAB Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36685/phi.v11iS1.888

Abstract

Background:During the Coronavirus Disease 2019 (COVID-19) pandemic, nurses and doctors served as the frontline healthcare workers. Consequently, mental health issues among healthcare workers can develop into significant health problems and impose a substantial social burden, particularly on nurses and doctors working in hospital settings. Objective:To analyze the prevalence and factors influencing anxiety levels among healthcare workers, specifically nurses and doctors, at Adam Malik General Hospital Medan during the COVID-19 pandemic. Methods:This study employed a cross-sectional design with bivariate analysis. Data were collected using the DASS-42 questionnaire, which was distributed to 114 participants comprising nurses and doctors working in both the COVID-19 emergency isolation and ward isolation units. Results:The findings revealed that 29 participants (25.4%) exhibited symptoms of anxiety, with the majority experiencing mild anxiety (13.2%). The nursing profession demonstrated the highest prevalence of anxiety disorders, with 33.3% of nurses reporting symptoms. Being a nurse was significantly associated with higher anxiety levels compared to being a doctor, and working in the emergency isolation room was significantly associated with higher anxiety levels compared to working in the isolation ward or both units (p<0.05). Conclusion:Factors such as gender, marital status, parental status, post-COVID-19 status, family history of COVID-19, vaccination history, and comorbidities did not significantly affect anxiety levels among healthcare workers during the COVID-19 pandemic at Adam Malik General Hospital Medan. However, anxiety was prevalent among healthcare workers, with nurses and those working in the emergency isolation room being particularly affected. Keywords:anxiety; COVID-19; healthcare workers; mental health; Indonesia
Contact Investigation Among Household Contacts of Drug-Resistant Tuberculosis Patients in Medan Rizky, Handan; Sinaga, Bintang Yinke Magdalena; Siagian, Parluhutan; Ashar, Taufik
Jurnal Impresi Indonesia Vol. 4 No. 8 (2025): Jurnal Impresi Indonesia
Publisher : Riviera Publishing

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.58344/jii.v4i8.6938

Abstract

Household contacts of Drug-Resistant Tuberculosis patients potential to develop latent tuberculosis infection (LTBI) or active tuberculosis (TB) infection. This research aims to determine the prevalence of LTBI and Pulmonary TB and the characteristic of household contact with Drug-Resistant Tuberculosis (DR-TB) patients. This is a descriptive analytical study using a cross-sectional approach in people aged > 18 years who have household contact with DR-TB patients whom confirmed by sputum GeneXpert and treated at Adam Malik Hospital Medan. The research subjects then underwent examinations including symptom anamnesis, chest X-ray, sputum GeneXpert, and IGRA blood test From 105 people who had household contact with DR-TB patients, the most common cases found were LTBI cases (55%), followed by uninfected cases (40%). Meanwhile, the only cases of Pulmonary TB found were Drug-Sensitive Pulmonary TB were 6 cases (5%) which are bacteriologically confirmed drug-Sensitive TB was 4 cases and clinically confirmed drug-sensitive TB was 2 cases. Majority of patients were in 18-30 year old group (30.5%), female (70%), high school graduates (61%), housewives (41%), normoweight (80%), no smoking habit (78%), no consuming alcohol (97%), and no comorbid diseases (87.5%). Based on contact duration, 70 people (67%) were found with > 5 hours and 35 patients (33%) with < 5 hours. In addition, the majority of samples (70%) did not sleep in the same room with MDR-TB patients.  LTBI cases were the most common cases found among household contact with DR-TB patients.
Gangguan Pendengaran dan Keseimbangan pada Penderita Tuberkulosis yang Mendapat Pengobatan Antituberkulosis Kategori 1 dan 2 Adriztina, Indri; Adnan, Adlin; Haryuna, Siti Hajar; Siagian, Parluhutan; Sarumpaet, Sorimuda
Kesmas Vol. 8, No. 8
Publisher : UI Scholars Hub

Show Abstract | Download Original | Original Source | Check in Google Scholar

Abstract

Tuberkulosis merupakan masalah yang serius di masyarakat. Pada tahun 2010, World Health Organization mencatat jumlah penderita tuberkulosis di Indonesia menurun ke posisi empat dengan meningkatnya keberhasilan pengobatan obat antituberkulosis (OAT). Namun, pemberian OAT jangka panjang dapat menyebabkan efek samping ototoksik berupa gangguan pendengaran dan keseimbangan. Penelitian ini dilakukan untuk mengetahui efek ototoksik pada penderita tuberkulosis paru dengan pemberian OAT di RSUP H. Adam Malik Medan. Penelitian ini bersifat deskriptif dengan pendekatan potong lintang. Analisis univariat dilakukan dengan tabel frekuensi distribusi sedangkan analisis bivariat dilakukan dengan menggunakan uji t dan Fisher’s exact test. Didapatkan 35 penderita tuberkulosis yang memenuhi kriteria inklusi, 22 orang dengan pengobatan tuberkulosis kategori 1 dan 13 orang tuberkulosis kategori 2. Dilakukan pemeriksaan audiometri nada murni dan tes keseimbangan. Tiga orang (33,3%) penderita tuberkulosis kategori 1 dan 6 orang (66,7%) penderita tuberkulosis kategori 2 mengalami gangguan pendengaran (p < 0,05). Hasil tes keseimbangan menunjukkan perbedaan yang signifikan yaitu 7 orang (100%) tuberkulosis kategori 2 dengan positif tes Romberg dan 11 orang (100%) tuberkulosis kategori 2 positif tes tandem Romberg. Gangguan pendengaran dan keseimbangan pada penderita tuberkulosis paru dengan OAT ditemukan lebih tinggi pada kategori 2 dibandingkan dengan kategori 1 dengan perbedaan yang signifikan. Tuberculosis remains a serious problem in the community. In 2010, World Health Organization report that Indonesia’s ranking decrease to fourth position due to success of antituberculosis treatment. But the long term administration of antituberculosis treatment may cause ototoxic effect like hearing and balance impairment. The aim of this study was to describe ototoxic effect of subjects who were given tuberculosis treatment in H. Adam Artikel Penelitian Gangguan Pendengaran dan Keseimbangan pada Penderita Tuberkulosis yang Mendapat Pengobatan Antituberkulosis Kategori 1 dan 2 Hearing and Balance Impairment in Tuberculosis Patient with Category 1st and 2nd Antituberculosis Treatment Indri Adriztina* Adlin Adnan* Siti Hajar Haryuna* Parluhutan Siagian** Sorimuda Sarumpaet*** 430 Malik General Hospital. This is a descriptive study with cross sectional approach. Univariat analysis was done by frequency distribution table, meanwhile bivariat analysis was done by t-test and Fisher’s exact test. Thirty five pulmonary tuberculosis patients met the inclusion criteria. Twenty two patients with 1st category, and 13 patients with 2nd category tuberculosis treatment. Pure tone audiometric and balance examination was evaluated. Three patients (33.3%) of 1st category tuberculosis and 6 (66.7%) patients of 2nd category tuberculosis have hearing loss with significant difference (p<0.05). Balance test showed 7 people (100%) of 2nd category tuberculosis having positive Romberg test and 11 people (100%) of 2nd category tuberculosis having positive tandem Romberg test. Hearing and balance impairment found higher in patients with 2nd category antituberculosis treatment with significantly different.
Hubungan Systemic Immune Inflammation Index dan Neutrophil-Lymphocyte Ratio Terhadap Skor PSI Pada Pasien Pneumonia Bakterial RS Adam Malik 2023 Saing, Erna Debora; Samosir, Nelly Elfrida; Siagian, Parluhutan; Permatasari, Ranti; Adhayanti, Ida; Youvella, Sylvia
JUKEJ : Jurnal Kesehatan Jompa Vol 4 No 3 (2025): JUKEJ: Jurnal Kesehatan Jompa
Publisher : Yayasan Jompa Research and Development

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.57218/jkj.Vol4.Iss3.2002

Abstract

Tujuan penelitian untuk mengetahui hubungan Systemic Immune-Inflammation Index (SII) dan Neutrophil-Lymphocyte Ratio (NLR) dengan skor Pneumonia Severity Index (PSI) pada pasien pneumonia bakterial di RS Adam Malik Medan. Penelitian ini merupakan studi analitik observasional dengan desain potong lintang menggunakan data sekunder dari rekam medis pasien pneumonia bakterial pada periode 1 Januari–31 Desember 2023. Seluruh subjek telah menjalani pemeriksaan darah lengkap, kultur darah/ sputum dan dilakukan perhitungan skor PSI. Nilai SII dihitung dari trombosit × neutrofil/limfosit, sedangkan NLR dari neutrofil/limfosit. Analisis data dilakukan menggunakan uji korelasi Spearman, dengan nilai p < 0,05 dianggap signifikan. Hasil penelitian menunjukan bahwa sebanyak 76 pasien diteliti, mayoritas laki-laki (67,1%) dengan usia rata-rata 57,78 tahun. Komorbid terbanyak adalah penyakit ginjal (11,8%) dan bakteri dominan Acinetobacter baumannii (15,8%). Rerata skor PSI 53,55, dengan median NLR 12,01 dan SII 2.385,79. Tidak terdapat hubungan signifikan antara NLR maupun SII dengan skor PSI. Kesimpulannya tidak terdapat hubungan yang signifikan  antara NLR dan SII terhadap skor PSI pada penelitian ini.
The Overview Side Effects of MDR TB Short Term Regimen for Heart and Kidney Function in MDR TB Patients at H. Adam Malik General Hospital Medan, North Sumatra Santy, Diana; Siagian, Parluhutan; Sinaga, Bintang YM; Eyanoer, Putri C
Jurnal Respirologi Indonesia Vol 44 No 1 (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.v44i1.573

Abstract

Background: World Health Organization issued a recommendation for the use of standard 9–11 month Shorter Multidrug-Drug Resistant Tuberculosis (MDR TB) regimen. It will impact the number of patients treated and improve obedience because of the shorter, low cost, and well-tolerated. However, MDR TB drugs allow side effects both mild, moderate and severe. If severe side effects occur, the patient will stop treatment and close monitoring required. An optimal and adequate care of side effects is the key of the successful of MDR TB treatment. The aim of this study was to determine the side effects that occured in the treatment of MDR TB patients with short term regimen (STR) on heart and kidney function at H. Adam Malik General Hospital Medan, North Sumatra.Methods: A case series design with a total of 76 MDR TB patients who underwent a shorter regimen. Samples were obtained from the medical record in the pulmonary isolation inward and MDR TB polyclinic at Adam Malik Hospital, Indonesia. Data were analyzed descriptively to identify changes in heart (Prolong QTc) and kidney function of the nine months treatment.Results: 76 data were collected, the number of male samples was 68.4% and 31.6% were women with the age group of the study subjects being mostly followed by 41-50 years of age. There was a significant increase in value occurred in 4-6 months of treatment related to the side effects of treatment on heart (Prolong QTc) and kidney function.Conclusion: There was a trend to increase the value of heart (Prolong QTc) and kidney function significantly occurred 4-6 months after the patient underwent MDR TB treatment with STR.
Factors Associated with Treatment Outcome of Shorter Treatment Regimen (STR) for MultiDrug-Resistant Tuberculosis (MDR-TB) Perangin-angin, Gwanita Nawariantina; Sinaga, Bintang Yinke Magdalena; Siagian, Parluhutan; Eyanoer, Putri Chairani
Journal of Endocrinology, Tropical Medicine, and Infectious Disease (JETROMI) Vol. 6 No. 4 (2024): Journal of Endocrinology, Tropical Medicine, and Infectious Disease (JETROMI)
Publisher : TALENTA Publisher, Universitas Sumatera Utara

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32734/jetromi.v6i4.16123

Abstract

ABSTRACT Background: Indonesia ranked 2nd around the world for TB cases with case population continue increasing. In 2018, Shorter Treatment Regimen (STR) was introduced as a new regimen for treating MDR-TB patient. The aim of this study is to determine factors associated with treatment outcome of MDR-TB patients treated with Shorter Treatment Regimen Methods: This is a descriptive-analytic study using cross sectional design which was conducted at Adam Malik Hospital Medan. Subject was 150 patients with drug-resistant Pulmonary TB at MDR-TB polyclinics according to inclusion and exclusion criteria Results: MDR-TB patients that treated with STR was mostly < 50 years old (65.2%) and 107 subjects (70.4%) were male. The majority of subjects with comorbidity were 94 subjects (61.8%); 43 subjects (28.3%) with DM, 5 subjects (3.3%) with CHF, 3 subjects (2.0%) with HIV, 1 subject (0.7%) with DM & CHF, and 1 subject (0.7%) with DM & HIV. When evaluated the patients treatment outcome, 47.4% were cured, 6.6% were failed, 34.8% were default and 11.2% were death. A chi square test was conducted to assess association between age with treatment outcome. Age was significantly associated with treatment outcome (p=0.038) but gender and comorbidity were not associated with treatment outcome with p-value 0.152 and 0.497 (p>0,05) respectively. Conclusions: There is a significant association between age and treatment outcome but no significant association between gender and comorbidity with treatment outcome. ABSTRAK Latar Belakang: Indonesia menduduki peringkat ke-2 dunia untuk kasus TBC dengan populasi kasus yang terus meningkat. Pada tahun 2018, Shorter Treatment Regimen (STR) diperkenalkan sebagai rejimen baru untuk mengobati pasien TB-MDR. Tujuan dari penelitian ini adalah untuk mengetahui faktor-faktor yang berkorelasi dengan hasil pengobatan pasien TB-MDR yang diobati dengan Regimen STR. Metode: Penelitian ini merupakan penelitian deskriptif-analitik dengan desain cross-sectional yang dilakukan di Rumah Sakit Adam Malik Medan. Subyek penelitian adalah 150 pasien TB Paru Resisten Obat di poliklinik TB MDR sesuai kriteria inklusi dan eksklusi. Hasil: Pasien TB-MDR yang diobati dengan STR sebagian besar berusia <50 tahun (65,2%) dan berjenis kelamin laki-laki sebanyak 107 subjek (70,4%). Mayoritas subjek dengan penyakit penyerta sebanyak 94 orang (61,8%); 43 orang (28,3%) DM, 5 orang (3,3%) CHF, 3 orang (2,0%) HIV, 1 orang (0,7%) DM & CHF, dan 1 orang (0,7%) DM & HIV. Hasil pengobatan adalah 47,4% sembuh, 6,6% gagal, 34,8% putus berobat dan 11,2% meninggal. Uji chi square dilakukan untuk menilai hubungan antara usia dengan hasil pengobatan dan didapatkan nilai p = 0,038 yang menunjukkan adanya hubungan yang signifikan namun berdasarkan jenis kelamin dan penyakit penyerta ditemukan nilai p masing-masing 0,152 dan 0,497 (p>0,05) yang menunjukkan tidak ada hubungan antara jenis kelamin dan penyakit penyerta terhadap hasil pengobatan. Kesimpulan: Terdapat hubungan yang signifikan antara usia dan hasil pengobatan namun tidak ada hubungan yang signifikan antara jenis kelamin dan penyakit penyerta dengan hasil pengobatan.
Social Support and Healthcare Service Quality as Determinants of Treatment Interruption Among Drug-Resistant Tuberculosis Patients in Medan, Indonesia Dalimunthe, Almira; Magdalena Sinaga, Bintang Yinke; Siagian, Parluhutan; Amelia, Rina
Jurnal Impresi Indonesia Vol. 4 No. 11 (2025): Indonesian Impression Journal (JII)
Publisher : Riviera Publishing

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.58344/jii.v4i11.7122

Abstract

Indonesia ranks second globally in pulmonary TB cases after India, and drug-resistant TB remains a major cause of mortality in the country. Treatment adherence is influenced by multiple interacting factors, making dropout decisions a dynamic process. Early, targeted efforts to boost patient adherence and minimize loss-to-follow up are essential to prevent progression to more severe disease or death. This study aims to evaluate factors that lead to loss-to-follow up among drug-resistant tuberculosis patients in Medan, Indonesia. This research is a descriptive analytical study using a cross sectional approach. It was carried out at Adam Malik Hospital Medan on DR-TB patients who had been diagnosed bacteriologically. The data used were 104 patient subjects who met the inclusion and exclusion criteria. divided into groups who was loss in follow up and groups who completed treatment. The independent variables consist of social support and health care services. From the 104 research samples, 34 of them were DR pulmonary TB patients who was loss in follow up and 70 DR pulmonary TB patients who completed treatment. Bivariate analysis showed significant associations between loss-to-follow up and social support (p < 0.001; OR = 14.50), and healthcare service quality (p < 0.001; OR = 5.72). No significant association was found for age, sex, occupation, marital status, or family history of TB. In conclusion, social support and healthcare service quality play critical roles in determining adherence among DR-TB patients. Strengthening patient support networks and improving patient-centered healthcare delivery may help reduce treatment default rates.
Risk Factor of Lost to Follow-up Treatment in drug-sensitive pulmonary TB patients Sari Mardia, Rina; Yinke Magdalena Sinaga, Bintang; Siagian, Parluhutan; Ashar , Taufik
International Journal of Health and Pharmaceutical (IJHP) Vol. 5 No. 4 (2025): November 2025 ( Indonesia - Thailand)
Publisher : CV. Inara

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51601/ijhp.v5i4.468

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Background: Loss to follow-up (LTFU) treatment remains a critical challenge in tuberculosis control in Indonesia, accounting for approximately 50% of treatment failure cases among pulmonary TB patients. Objectives: To identify independent predictors of LTFU among drug-sensitive TB (DS-TB) patients in Medan, Indonesia. Methods: This cross-sectional analytical study enrolled 100 DS-TB patients (40 with LTFU, 60 treatment-completed) from two hospitals. Purposive sampling technique was employed. Data were collected using validated questionnaires assessing sociodemographic characteristics, patient perspective toward TB treatment, social support (using MSPSS scale), and healthcare services quality. Bivariate analysis used chi-square and Fisher's exact tests; multivariate analysis employed multiple logistic regression. Statistical significance was set at p < 0.05. Results: Multivariate analysis identified two independent predictors of LTFU: social support (odds ratio 128.632; 95% confidence interval 13.809 to 1,198.216; p < 0.001) and treatment perspective (odds ratio 25.415; 95% confidence interval 5.569 to 115.985; p < 0.001). Low to moderate social support was the most dominant risk factor, conferring approximately 128.7 times greater odds of treatment discontinuation compared to high social support. Poor treatment perspective was the second dominant predictor, with 90% of LTFU patients demonstrating negative perspectives. Conclusion: Poor treatment perspective and low to moderate social support are significantly associated with LTFU treatment discontinuation in DS-TB patients. Psychosocial interventions addressing these factors should be prioritized in TB control programs to improve treatment completion rates and achieve WHO treatment success targets.
Factors Influencing The Incidence of Loss To Follow-Up Treatment In Drug-Resistant Tuberculosis Patients Dalimunthe, Almira; Yinke Magdalena Sinaga, Bintang; Siagian, Parluhutan; Amelia, Rina
International Journal of Health and Pharmaceutical (IJHP) Vol. 5 No. 4 (2025): November 2025 ( Indonesia - Thailand)
Publisher : CV. Inara

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51601/ijhp.v5i4.475

Abstract

Drug-resistant tuberculosis (DR-TB) represents a significant global health challenge with Indonesia ranking second highest for pulmonary TB cases. Treatment adherence in DR-TB patients is influenced by multiple interacting factors requiring systematic investigation to identify independent risk determinants. This descriptive analytical cross-sectional study assessed associations between independent variables and loss to follow-up treatment outcomes in DR-TB patients at Adam Malik Hospital, Medan, from May to November 2024. A purposive sampling strategy enrolled 104 bacteriologically confirmed DR-TB patients comprising 34 loss to follow-up cases and 70 treatment completers. Data collection utilized validated questionnaires assessing attitudes toward treatment, perceived social support, and healthcare service quality. Statistical analysis employed chi-squared testing for bivariate associations and multiple logistic regression for multivariate analysis with significance level p<0.05. Results demonstrated that 85.3% of loss to follow-up patients experienced low to moderate social support, 67.6% held poor treatment attitudes, and 64.7% perceived insufficient healthcare services. Bivariate analysis revealed significant associations between education (PR=4.13; p=0.023), attitudes (PR=6.04; p<0.001), social support (PR=14.50; p<0.001), and healthcare services (PR=5.72; p<0.001) with treatment discontinuation. Multivariate analysis identified three independent risk factors: low to moderate social support emerging as the predominant determinant (PR=14.01; 95% CI=4.26–46.02; p<0.001), followed by inadequate healthcare services (PR=3.33; 95% CI=1.18–9.43; p=0.023), while unemployment showed protective effect (PR=0.315; p=0.045). This investigation concludes that social support constitutes the principal modifiable risk factor for loss to follow-up treatment in DR-TB patients, necessitating implementation of family-based psychosocial interventions and quality healthcare service improvements to sustain treatment adherence during the challenging 20-month therapeutic regimen.