Analisis Faktor Paparan dan Faktor Lingkungan Tempat Tinggal dengan Kejadian Infeksi Tuberkulosis Laten (Studi pada Keluarga Pasien Tuberkulosis Aktif di Kota Semarang - Jawa Tengah) - Karbito, Karbito; Muslim, Azhari; Helmy, Helina (Master Program of Environmental Health, Faculty of Public Health, Diponegoro University, 2024)
Latar belakang : Tuberkolusis merupakan salah satu penyakit infeksi menular yang masih menjadi permasalahan serius di negara-negara berkembang dan terbelakang, termasuk Indonesia. Diperkirakan 25% populasi penduduk dunia telah terinfeksi Mycobacterium tuberculosis (M.tb), sebanyak 10% diantaranya berkembang menjadi penyakit aktif, dan sisanya (90%) akan mempertahankan diri dalam bentuk tuberkulosis laten. Antara 5-10% infeksi tuberkolusis laten akan berkembang menjadi tuberkolusis aktif. Hal ini berarti infeksi tuberkolusis laten menjadi kantung dan sumber utama kejadian dan penularan tuberkulosis aktif dimasa mendatang. Anggota keluarga serumah dengan penderita tuberkulosis aktif berisiko mengalami kejadian infeksi tuberkulosis laten. Studi ini bertujuan menganalisis hubungan faktor paparan dan faktor lingkungan tempat tinggal dengan kejadian infeksi tuberkulosis laten pada anggota keluarga serumah dengan penderita tuberkulosis aktif.Metode : Studi ini merupakan studi analitik kuantitatif menggunakan rancangan cross sectional. Sejumlah 138 subjek studi dari 241 anggota keluarga 112 indeks kasus tuberkulosis aktif berpartisipasi dalam studi ini. Subjek studi dilakukan Tuberculin Skin Test (TST). Subjek studi dinyatakan positif mengalami infeksi tuberkulosis laten jika hasil TST didapatkan indurasi ≥10 mm. Variabel faktor paparan dan faktor lingkungan tempat tinggal dikumpulkan dengan teknik wawancara, pengamatan dan pengukuran menggunakan alat ukur kuesioner, checklist dan alat ukur lainnya. Analisis data penelitian dilakukan secara bivariat menggunakan uji chi-square dan secara multivariat dengan uji regresi logistik ganda. Hasil analisis variabel dinyatakan mempunyai hubungan bermakna jika memperoleh nilai-p<0,05.Hasil : Sebanyak 63,8% anggota keluarga serumah penderita tuberkulosis aktif mengalami kejadian infeksi tuberkulosis laten. Berdasarkan analisis bivariat (uji chi square) ditemukan ada 3 (tiga) variabel yang mempunyai hubungan bermakna dengan kejadian infeksi tuberkulosis laten yaitu variabel jenis paparan (nilai-p=0,027), variabel lama waktu paparan (nilai-p=0,041) dan varianel kepadatan ruang tidur (nilai-p=0,001). Hasil analisis multivariat dengan uji regresi logistik ganda diketahui bahwa variabel yang berhubungan bermakna dengan kejadian TB laten adalah lama waktu paparan (nilai-p=0,023; aOR=3,72; 95%CI=1,19–11,58) dan kepadatan ruang tidur (nilai-p<0,001; aOR=3,89; 95%CI=1,82–8,33).Simpulan : Kejadian infeksi tuberkulosis laten pada anggota keluarga serumah dengan penderita tuberkulosis aktif menunjukkan angka yang relatif tinggi. Secara simultan variabel yang mempunyai hubungan bermakna dengan kejadian infeksi tuberkulosis laten pada anggota keluarga serumah dengan penderita tuberkulosis aktif adalah variabel lama waktu paparan dan variabel kepadatan ruang tidur. Variabel kepadatan ruang tidur merupakan variabel yang paling dominan berhubungan dengan kejadian infeksi tuberkulosis laten setelah disesuaikan oleh variabel lama waktu paparan. ABSTRACT Title: Analysis of Exposure Factors and Residential Environmental Factors with The Incidence of Latent Tuberculosis Infection (Study on families of active tuberculosis patients in Semarang City - Central Java)Background: Tuberculosis is a contagious infectious disease that is still a serious problem in developing and underdeveloped countries, including Indonesia. It is estimated that 25% of the world's population has been infected with Mycobacterium tuberculosis (M.tb), 10% of which develop active disease, and the remainder (90%) will persist in the form of latent tuberculosis. Between 5-10% of latent tuberculosis infections will develop into active tuberculosis. This means that latent tuberculosis infection will become the main source of occurrence and transmission of active tuberculosis in the future. Family members living in a household with active tuberculosis sufferers are at risk of experiencing latent tuberculosis infection. This study aims to analyze the relationship between exposure factors and environmental factors of residence with the incidence of latent tuberculosis infection in family members living in the same house as active tuberculosis sufferers.Methods: This study is a quantitative analytical study using a cross-sectional design. 138 study subjects from 241 family members and 112 index cases of active tuberculosis participated in this study. Study subjects underwent a Tuberculin Skin Test (TST). Study subjects were declared positive for latent tuberculosis infection if the TST results showed an induration of ≥10 mm. Exposure factor variables and residential environmental factors were collected using interview techniques, observation, and measurement using questionnaires, checklists, and other measuring tools. Research data analysis was carried out bivariate using the chi-square test and multivariate using the multiple logistic regression test. The results of the variable analysis are declared to have a significant relationship if they obtain a p-value <0.05.Results: As many as 63.8% of family members living in a household with active tuberculosis experienced latent tuberculosis infection. Based on bivariate analysis (chi-square test), it was found that 3 (three) variables had a significant relationship with the incidence of latent tuberculosis infection, namely the type of exposure variable (p-value = 0.027), the length of exposure variable (p-value = 0.041) and the density variant. bedroom (p-value=0.001). The results of multivariate analysis with multiple logistic regression tests showed that the variables significantly associated with the incidence of latent TB were the length of exposure (p-value=0.023; aOR=3.72; 95%CI=1.19–11.58) and room density. sleep (p-value<0.001; aOR=3.89; 95%CI=1.82–8.33).Conclusion: The incidence of latent tuberculosis infection in family members sharing a household with active tuberculosis sufferers shows a relatively high rate. Simultaneously, the variables that have a significant relationship with the incidence of latent tuberculosis infection in family members living in the same house as active tuberculosis sufferers are the length of exposure variable and the bedroom density variable. The bedroom density variable is the most dominant variable associated with the incidence of latent tuberculosis infection after adjusting for the length of exposure variable.