Survival Analysis of Multi-Drug Resistant Tuberculosis Patients in North Sumatra
DOI:
https://doi.org/10.35730/jk.v14i3.990Abstract
Background: The severity and ease of spread of MDR-TB have caused this disease to become an epidemic in various countries. WHO has also launched an international program "End TB" which until now has not even reached half of the target. Indonesia is already in the third highest position after India and China with a CFR of 0.11% and North Sumatra Province is already at the 6th highest level in Indonesia and the highest on the island of Sumatra.
Purpose : The purpose of this study was to see the survival of MDR-TB patients in North Sumatra Province.
Methods: The method in this study used a retrospective cohort design with secondary data on MDR-TB cases for 2020 – 2022. The sample used was total sampling with the condition that it met the sample criteria, namely complete data and treatment results. The analysis was carried out using univariate, Kaplan-Meier, bivariate analysis using the logrank test and multivariate with full model logistic regression.
Results: The results obtained from a total of 664 cases (26.81%) died and (73.19%) survived. The variables related to survival in MDR-TB patients were age (p = 0.000 HR (Hazard Ratio) 1.88) and HIV status (p = 0.001 HR 1.40). The dominant variable related to survival is age (p = 0.000 HR 0.64).
Conclusion: based on statistical tests, age and HIV status had a significant relationship with survival, while gender, OAT resistance, history of DM, history of treatment and treatment delays had no significant relationship based on statistical tests in this study.References
Zou Z, Liu G, Hay SI, Basu S, Belgaumi UI, Dhali A, et al. Time Trends in Tuberculosis Mortality Across The BRICS : an Age Peroid Cohort Analysis for The GBD 2019. eClinicalMedicine. 2022.
Ranzani OT, Rodrigues LC, Bombarda S, Minto CM, Waldman EA, Carvalho CRR. Long-Term Survival and Cause-Specific Mortality of Patients Newly Diagnosed With Tuberculosis in Sao Paulo State, Brazil, 2010-15: a Population-based, Longitudinal Study. 2019.
WHO.INT. World Health Organization. [Online].; 2022 [cited 2022 November Senin. Available from: https://www.who.int/es/news/item/27-10-2022-tuberculosis-deaths-and-disease-increase-during-the-covid-19-pandemic.
Kemenkes. Kementerian Kesehatan Republik Indonesia. [Online].; 2022 [cited 2022 September Minggu. Available from: https://www.kemkes.go.id/article/view/22032300001/tahun-ini-kemenkes-rencanakan-skrining-tbc-besar-besaran.html.
Delgado KC, Bravo SG, Montag AR, Ortiz AB. Mortality among MDR-TB Cases Comparison with Drug-Susceptible Tuberculosis and Associated Factors. Plos One. 2015.
Indonesia T. TBC Indonesia. [Online].; 2022 [cited 2022 November Selasa. Available from: https://tbindonesia.or.id/pustaka-tbc/dashboard-tb/.
Indonesia T. TBC Indonesia. [Online].; 2022 [cited 2022 November Selasa. Available from: https://tbindonesia.or.id/pustaka-tbc/dashboard-tb/.
Indonesia T. TBC Indonesia. [Online].; 2022 [cited 2022 November Selasa. Available from: https://tbindonesia.or.id/pustaka-tbc/dashboard-tb/.
Ahdiat A. Katadata Media Network. [Online].; 2022 [cited 2022 November Rabu. Available from: https://databoks.katadata.co.id/datapublish/2022/08/23/ini-provinsi-dengan-kasus-tbc-terbanyak-pada-2021.
Safaev K, Parpeiva N, Liverko I, Yuldashev S, Dumchev K, Gadoev J, et al. Trends, Characteristics and Tretment Outcomes of Patients With Drug-Resistant Tuberculosis in Uzbekistan: 2013-2018. International Journal of Environmental Research and Public Health. 2021.
Balabanova Y, Ignatyeva O, Fiebig L, Riekstina V, Danilovits M, Jaama K, et al. Survival of Patients With Multidrug-resistant TB in Eastern Europe: What Makes a Difference. 2016;: p. 2015-207638.
Machmud PB, Gayatri D, Ronoatmojo S. A Survival Analysis of Successful and Poor Treatment Outcomes Among Patient With Multidrug-resistant Tuberculosis and the Associated Factors: A Retrospective Cohort Study. Indonesia Journal International Med. 2021.
Montes K, Atluri H, Tuch HS, Ramirez L, Paiz J, Lopez AH, et al. Risk factors for mortality and multidrug resistance in pulmonary tuberculosis in Guatemala: A retrospective analysis of mandatory reporting. Journal of Clinical Tuberculosis and Other Mycobacterial Disease. 2021;: p. 2405-5794.
Moosazadeh M, Bahrampour A, Nasehi M, Khanjani N. Survival and Predictors of Death After Succesful Treatment Among Smear Positive Tuberculosis: A Cohort Study. International Journal of Preventive Medicine. 2014.
Utara DKPS. Dinas Kesehatan Provinsi Sumatera Utara. [Online]. Medan; 2022 [cited 2023 Maret Sabtu. Available from: https://dinkes.sumutprov.go.id/search/unduhan?keyword=PROFIL%20KESEHATAN.
Wang JJ, Zhou ML, Chen C, Wu G, Zuo YP, Ren X, et al. Survival Time and Influencing Factors in Multidrug-resistant Tuberculosis Patiens in Wuhan 2006-2014. National Library of Medicine. 2019;: p. 1409-1413.
Bisson GP, Bastos M, Campbell JR, Bang D, Brust JC, Isaakadis P, et al. Mortality in Adult With Multidrug-resistant Tuberculosis and HIV by Antiretriviral Therapy and Tuberculosis Drug Use : an Individual Patient Data Meta-analysis. Lancet. 2020;: p. 402-11.
Girum T, Tariku Y, Dessu S. Survival Status and Treatmen Outcome of Multidrug-Resisntant Tuberculosis (MDR-TB) Among Patients Treated in Treatment Initiation Centers (TIC) in South Ethiopia : A Restrospective Cohort Study. 2017.
Firnawati AF. Ketahanan Hidup 2 Tahun Pasien Tuberkulosis Resisten Obat Di RS. Moewardi Surakarta Tahun 2010 - 2014. 2017; 33(8).
Ayuningsih Z, Wahyono TYM. Faktor yang Berhubungan dengan Kematian Pasien TB MDR Selama Masa Pengobatan di Indonesia Tahun 2015-2017. Pro Health Jurnal Ilmiah Kesehatan. 2019;: p. 41-47.
Handayani I, Sumarni. Tuberkulosis: Penerbit NEM; 2021.
Santos DTD, Alves LS, Arcoverde MAM, Arroyo LH, Berra TZ, Ramos ACV, et al. Social Risk and its Association with Tuberculosis Mortality in a Context of High Inequality in South Brazil : A Geo-Epidemiology Analysis. Journal of Infection and Public Health. 2020;: p. 1184-1155.
Kemenkes. Kementerian Kesehatan Republik Indonesia. [Online].; 2021 [cited 2022 September Minggu. Available from: https://www.kemkes.go.id/article/view/21032500001/jadikan-penerus-bangsa-bebas-tbc-dimulai-dari-diri-sendiri-dan-keluarga.html.
Kemenkes. Kementerian Kesehatan Republik Indonesia. [Online].; 2020 [cited 2022 September Minggu. Available from: https://www.kemkes.go.id/article/view/20032500003/pasien-tbc-harus-lebih-waspadai-corona.html.
Kemenkes. Kementerian Kesehatan Republiik Indonesia. [Online].; 2022 [cited 2022 September Minggu. Available from: https://www.kemkes.go.id/article/view/22021400003/tidak-semua-orang-terinfeksi-kuman-tbc-mengalami-gejala-sakit.html.
Indonesia T. TBC Indonesia. [Online].; 2022 [cited 2022 November Selasa. Available from: https://tbindonesia.or.id/pustaka-tbc/informasi/tentang-tbc/apa-itu-tbc/.
Indonesia T. TBC Indonesia. [Online].; 2021 [cited 2022 November Selasa. Available from: https://tbindonesia.or.id/pustaka-tbc/informasi/teknis/tb-mdr/.
Indonesia T. TBC Indonesia. [Online].; 2021 [cited 2022 November Selasa. Available from: https://tbindonesia.or.id/pustaka-tbc/informasi/tentang-tbc/sejarah-tbc-di-indonesia/.
Kemenkes. Kementerian Kesehatan Republik Indonesia. [Online].; 2021 [cited 2022 September Minggu. Available from: https://www.kemkes.go.id/article/view/21032400001/cara-sama-tanggulangi-tbc-dan-covid-19.html.
Bade AB, Mega TA. Survival Status and its Predictors Among Multi-drug Resistance Tuberculosis Treated Patients in Ethiopia: Multicenter Observational Study. PLOS. 2020.
Shimbre MS, Degaga TS, Hebo SH, Zerdo Z, Girum T, Teshome T. Survival and Predictors of Mortality From Multidrug-resistant Tuberculosis (MDR-TB) Among Patients Treated at MDR-TB Referah Hospitals in Europian: A Retrospective Cohort Study. Journal of Public Health and Epidemiology. 2020;: p. 13-21.
Olaleya AO, Beke AK. Survival of Smear-positive Multidrug-resistant Tuberculosis Patients in Witbank South Africa: A Retrospective Cohort Study. Infectius Disease. 2016;: p. 2374-4243.
Wang XH, Ma AG, Han XX, Liang H, Wang D, Schouten E, et al. Survival and Associated Mortality Risk Factors Among Post-Treatment Pulmonari Tuberculosis Patient inn The Northwest of China. Europian Review for Medicine and Pharmacologcal Scinces. 2015.
Santos DTd, al e. Survival Time Among Patients Who Were Diagnosed With Tuberculosis, The Precocious Deaths and Associated Factors in Southern Brazil. Tropical Medicine and Health. 2021.
Menkes. Pedoman Nasional Pelayanan Kedokteran Tata Laksana Tuberkulosis. In Indonesia MKR. Keputusan Menteri Kesehatan Republik Indonesia. Jakarta; 2019.
Magee MJ, Foote M, Maggio DM, Howards PP, Narayan KV, Blumberg HM, et al. Diabetes Mellitus and Risk of All-Case Mortality Among Patients With Tuberculosis in the State of Georgia, 2009-2012. Annals of Epideiology. 2014.
Dahlan MS. Analisis Survival: Dasar-dasar Teori dan Aplikasi Program Stata. 2nd ed. Riefmanto , editor. Jakarta: Sagung Seto; 2014.
Junus AJ. Survival TB Resisten Obat dan Model Kepatuhan Pengobatan Dengan Pendekatan Motivational Interviewing Terhadap Pengendalian Lost to Follow up Pasien TB Resisten Obat Makassar; 2018.
Woya AA, Tekile AK, Basha GW. Spatial Frailty Survival Model for Multidrug-Resistant Tuberculosis Mortality in Amhara Region, Ethiopia. Hindawi Tuberculosis Research and Treatment. 2019;(7).