Tb Dots Kupang 05

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  • 8/17/2019 Tb Dots Kupang 05

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    SoedarsonoSoedarsono

     Bagian Penyakit Paru Bagian Penyakit Paru

     FK Unair – RSU Dr. Soetomo FK Unair – RSU Dr. Soetomo

    SurabayaSurabaya

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    TB di Dunia

    Setiap hari 20.000 orang jatuh sakit TB 

    Setiap jam 833 orang sakit TB 

    Setiap menit 13 orang jatuh sakit TB

    Setiap 5 detik satu orang jatuh sakit TB 

    Setiap hari 5.000 orang meninggal akibat TB 

    setiap jam 208

    orang meninggal akibat TB 

    Setiap menit 3 orang meninggal

    akibat TB  Setiap 20 detik 1org meninggal akibat TB 

    Setiap detik satu orang

    terinfeksi TB 

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    TUBERCULOSIS – Still a threat

     1/3 of the orld infe!ted

     2"3 million deaths/#ear   $iagnosis is slo

     T% is long& !ompli!ated and to%i!  'esistan!e is rising

    David Schlossberg, 2004

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    TB (re)alen!e*

    +ost TB !ases are in ,ndia& -hina and ,ndonesia

    10 000 to 99 999

    100 000 to 999 999

    1 000 000 or more

    < 1 000

    1 000 to 9 999

    No Estimate

    The boundaries and names shown and the designations used on this map do not imply the expression of any opinion whatsoever on the part of the World Health rgani!ation "on"erning the legal status of any "ountry# territory# "ity or area or of its authorities# or "on"erning the delimitation of its frontiers or

    boundaries$ %otted lines on maps represent approximate border lines for whi"h there may not yet be full agreement$

    & WH '00'

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    ighest TB in!iden!e rates

    are found in fri!a and sia

    '( to )9

    (0 to 99

    100 to '99

    < 10

    10 to ')

    *00 or more

    No Estimate

    per 100 000 population

    The boundaries and names shown and the designations used on this map do not imply the expression of any opinion whatsoever on the part of the World Health rgani!ation "on"erning the legal status of any "ountry# territory# "ity or area or of its authorities# or "on"erning the delimitation of its frontiers or

    boundaries$ %otted lines on maps represent approximate border lines for whi"h there may not yet be full agreement$

    & WH '00'

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    ,s!haemi! heart disease,s!haemi! heart disease

    -erebro)as!ular disease-erebro)as!ular disease

    oer respirator# infe!tionoer respirator# infe!tion

    $iarrhoeal disease$iarrhoeal disease

    (erinatal disorders(erinatal disorders

    -($-($

    Tuber!ulosisTuber!ulosis

    +easles+easles

    'oad traffi! a!!idents'oad traffi! a!!idents

    ung !an!er ung !an!er 

    thth

    Stoma!h !an!er Stoma!h !an!er 

    ,,

    Sui!ideSui!ide

    14401440

    uture global mortalit#

    Murray & Lopez: Lancet 1! 

    20202020

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    -ountr# 6o. of !ase ,n!iden rate

    India 

    China 

    Indonesia 

    South Africa 

    Zimbabwe

    Cambodia 

    Total 22 HBCs

    1.820.!"

    1.##$."#$

    %81.8#$

    2#.0!

    80.$

    $8.%!#

    !.$$!.1!2

    1$8

    11

    2$1

    %%!

    !28

    %8%

    1$$

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    Estimates of B Burden

    Indonesia, 2004

     ,n!iden!e*  7  TB !ases* 590.000 ne !ases per #ear*

    6: 6:; -S: / +,6

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    Potensial Penularan Penderita TB :Potensial Penularan Penderita TB :

    +  Drajat penyakit / Drajat penyakit / bakteriologisbakteriologis

    +  Drajat & frekuensi Drajat & frekuensi

    batuk batuk  +  Kualitas & jumlah Kualitas & jumlah

     sekrit jalan napas sekrit jalan napas

    +  Pemberian obat anti Pemberian obat anti TB sebelumnyaTB sebelumnya

    +  Karakteristik paparan Karakteristik paparan

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    Risk factors associated with developing TBRisk factors associated with developing TB

    disease. Relative risk with respect to thedisease. Relative risk with respect to the

    normal populationnormal population ',SC -T' ':T,: ',SC

    HIV INFECTION 50-100  

    JEJUNOCAECAL SHUNT 27-63

    SOLID TUMOURS 1-36  

    SILICOSIS 8-34

    HEAD AND NECK NEOPLASMS 16  

    HEMODYALISIS 10-15  

    HAEMOTOLOICAL NEOPLASMS 4-15  

    FI!ROTIC LESIONS 2-15  

    IMUNOSUPPRESSIVE DRUS 2-12  

    HAEMOPHILIA " ASTRECTOMY 5  

    LO# !ODY #EIHT 2-4

    DIA!ETES MELLITUS 2-4

    HEAVY SMOKIN 2-4

    NORMAL POPULATION 1

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    I$%&'()*()+,(

    P,()&$ T! D&,(,

    .S/,

    !TA P()+)%

    .65

    !TA N&,+)%

    !),',$ P()+)%

    .26

    !),',$ N&,+)%

    R,))( P(

    .17

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    :%posure

    Sub!lini!al

    ,nfe!tion

    ,nfe!tious

    tuber!ulosis

    6on"

    ,nfe!tious

    tuber!ulosis

    $eath

    'isk

    fa!tors 'isk

    fa!tors

    'isk

    fa!tors

    'isk

    fa!tors

    (athogeneti!all#"based model of the epidemiolog#

    of tuber!ulosis

    "#$%LD, 2002 : "ntervention or %' (ontrol and )li*ination+

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    :%posure Sub!lini!al

    infe!tion

    ,nfe!tious tuber!ulosis

    6on",nfe!tious

    tuber!ulosis

    $eath

    (roph#la!ti!

    treatment

    (re)enti)e

    therap#

    B-D

    )a!!ination

    T,$()(()$ !hemotherap#

    $o!tors dela#

    patients dela#

    Model o interventions based on the

    epide*iology o tuberculosis

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    PENYEBAB

    TB YANG TINGGI DI

    DUNIA

    KETIDAK PATUHAN

    THD PRGRA! 

    DIAGN"I" #

    PENGBATAN YG

    TIDAK ADEKUAT 

    HI$

    ENDE!IK 

    RA%AT &A'AN DENGAN "E'( AD!INI"TRATI$E THERAPY

    )"AT* 

    !DR+TB 

    Int J Tuberc Lung Dis 1998 ; 9 : 969-703

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    in Persahabatan Hospital (Category I)/ Syafrial 

     

     @ear

    2000"2001 2000"2001 D E 50  "A E 50

    C*& 33 .66 23 .46

    C&+& +&,+&$+ 1 .2 8 .16 D *+ 8 .16 14 .28

    M9& 1 .2 3 .6

    D)& 1 .2 0  

    D* )$*:& H&,+)+)( 2 .4 2 .4

    T&,+&$+ %,)*& 2 .4 0  

    R&()(+,$+ OAT 2 .4 0  

     A&): 0 0 

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    F$TSGST -ured H >14&5? 4 >&28?

    -omplete 82 >3H&H5? H0 >35&29? ailed H >1&98? H >0&3?

    $rop out 88 >39&4? 90 >50&29?

    +o)e 1 >&1H? 9 >5&03?

    $ied 0 0

    thers 0 25 >1&88?

    TT 238 1333

    Persahabatan Hospital Retrospective July 1 !

     June "##1

    Persahabatan Hospital Retrospective July 1 !

     June "##1

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    PENYEBAB GAGA' PENGBATAN TB

    PA'ING "ERING )DI!ANAPUN* ADA'AH 

     

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    INTI PENGBATANINTI PENGBATAN

    )),RE !ANAGE!ENT ,RE !ANAGE!ENT ** TB ADA'AH -TB ADA'AH -

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    ,'INI,A' APPRA,H

    Basic science of !"

    t#ber$#losis

    $ppropriate

    regimen

    Basic science of anti tuberculosis

    drug

    %&'($)*'T$+ PR,'-,P+* ,' T&B*R-&+/,/

    -'TR+

    Treatment completion

    (T (T

    PUB'I, HEA' H

    APPRA,H

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    PENGBA AN DENGAN " RA EGI D "

    ENGBA AN DENGAN " RA EGI D "

    (DOTS : Directy Obser!ed T"era#y$ S"ort(DOTS : Directy Obser!ed T"era#y$ S"ort%ourse&%ourse&

     Pusatkan (Pusatkan ( D'R%T D'R%T attentionattention) pd identifkasi BTA) pd identifkasi BTA