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Patients with Multiple Drug-Resistant Pulmonary Tuberculosis at Dr. Mohammad Hoesin General Hospital, Palembang: Association of Body Mass Index on Drug Side Effects Ahmad, Zen; Elzan Zulqad Maulana; Alif Fathurrachman; Dwi Indira; Linda Andriani; Sudarto; Rouly Pasaribu; Ahmad Rasyid
Jurnal RSMH Palembang Vol. 4 No. 2 (2023): Jurnal RSMH Palembang
Publisher : RSUP Dr Moh Hoesin Palembang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/jrp.v4i2.49

Abstract

Patients with Multiple Drug-Resistant Pulmonary Tuberculosis at Dr. Mohammad Hoesin Palembang: Association of Body Mass Index on Drug Side Effects. Tuberculosis (TB) is an infectious disease transmitted by acid-resistant bacteria, namely, Mycobacterium tuberculosis (MTb). TB enters the respiratory tract and infects the lungs, and it can spread to other organs both hematogenously and lymphogenously. Pulmonary TB is the most common occurrence. Based on resistance, there are 2 types of pulmonary TB infection: drug-sensitive and drug-resistant. Multiple drug-resistant pulmonary TB (MDR-TB) is a type of pulmonary TB bacteria that is resistant or immune to rifampicin and/or isoniazid treatment. In the treatment of pulmonary TB, MDR uses a multi-drug combination therapy regimen in which each drug has both major and minor side effects. One of the risk factors for side effects is body mass index (BMI). In this study, conducted using a retrospective descriptive method during the 2019–2021 period at Dr. Mohammad Hoesin General Hospital Palembang, 52 subjects met the inclusion and exclusion criteria. 33 subjects (63.5%) were under weight, and 19 subjects (36.5%) were normoweight. Of the 52 subjects, 27 experienced minor ESO and 25 experienced major ESO. The most common major ESO is hearing loss, with 12 events, and in the underweight group, with 10 events. The most common minor ESO was nausea, which occurred 14 times in the overweight group and 9 times in the underweight group. The chi square test showed that there was a significant relationship between underweight BMI and the incidence of major ESO with a p value of 0.029 and an odds ratio (OR) of 3.67x. We concluded that a low body mass index had a 3.67x effect compared to a normal BMI on the increased incidence of major side effects of anti-tuberculosis drugs in MDR-TB patients at Dr. Mohammad Hoesin General Hospital Palembang.
Resistance Patterns in Drug-Resistant Pulmonary Tuberculosis Patients at Dr. Mohammad Hoesin Palembang Hospital Muhammad Novran Chalik; Alif Fathurrachman; Linda Andriani; Rouly Pasaribu; Sudarto; Ahmad, Zen; Ahmad Rasyid
Jurnal RSMH Palembang Vol. 5 No. 1 (2024): Jurnal RSMH Palembang
Publisher : RSUP Dr Moh Hoesin Palembang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/jrp.v5i1.64

Abstract

Tuberculosis (TB) is a contagious infectious disease caused by acid-resistant bacteria, Mycobacterium Tuberculosis (MTb). Based on immunity, there are two types of pulmonary TB infection: drug-sensitive and drug-resistant. Based on ATD sensitization tests, MTb resistance types consist of TB that is monoresistant, polyresistant, multidrug resistance (MDR), pre-extensively drug resistant (Pre-XDR), extensively drug-resistant (XDR). Globally, in 2022, there will be an estimated 450,000 cases of DR-TB, but only 161,000 treated. In Indonesia, in 2022, there were an estimated 24,000 cases of DR-TB; only 8,268 were notified and 5,082 cases had started therapy. In this study, conducted with a retrospective descriptive method, during the period 2022 at RSMH Palembang, 92 patients with DR-TB were obtained who received treatment at RSMH Palembang. Of the 92 subjects, the mean age of diagnosis of DR-TB was 44.47 ± 16.5. The most common gender was male 62 subjects (67.4%) and 30 subjects were female (32.6%). Of the 92 rifampicin-resistant patients, there were a total of 39 patients (42.4%) with isoniazid resistance. Among these 39 patients, 21 patients (54%) were primary resistance cases and 18 patients (46%) were secondary resistance cases. The most common type of therapy regimen used was a long-term regimen as many as 68 subjects (74%) and short-term as many as 24 subjects (26%)Primary resistance patterns were obtained in 43 subjects (46.8%) and secondary resistance in 49 subjects (53.2%). Of the 49 secondary resistance subjects, 52 subjects (56.5%) had TB-RR, 33 subjects (35.8%) had MDR-TB, 6 subjects (6.5%) had pre-XDR TB, and 1 subject (1.2%) had XDR-TB. The researcher concluded that the dominant resistance pattern of pulmonary TB cases was secondary resistance, with the results of the drug sensitivity test being TB-RR. However, it should be noted that DR-TB with a primary resistance pattern also has a higher percentage.