Scoping Review: Efektivitas Strategi Directly Observed Treatment Shortcourse (DOTS) pada Pengobatan Pasien Tuberkulosis

Nisa Astuti, Tony Djajakusumah, Raden Ganang Ibnusantosa

Abstract


Abstract. Tuberculosis is a chronic infectious disease caused by Mycobacterium tuberculosis bacilli. World Health Organization recommends the Directly Observed Treatment Shortcourse (DOTS) strategy to reduce TB morbidity and mortality in the community. The success of TB treatment is the number of recoveries plus complete treatment. To assess the success of TB treatment, WHO is targeting a treatment success rate (TSR) of 85%. The aim of the study: To determine the effectiveness of DOTS in the treatment of TB patients and the causes of its failure. Research methods: Scoping Review of articles from the PubMed, Science Direct, Springer Link, and GARUDA database. This research was assessed through PICOS with the eligibility criteria in the form of a PRISMA diagram. The articles used were published in national and international journals in  the 2010-2020 period. Results: eight articles that were eligible for criteria; four articles with a TSR of > 85%, three articles with a TSR of <85%, one article rated the effectiveness of the DOTS regimen (63% excellent outcome, 14.6% moderate, 7.3% poor outcome). Treatment failure of TB patients was due to various factors, namely the increasing number of TB patients becoming drug-resistant (MDR), and poor adherence. Conclusion: the DOTS strategy is effective in four out of   seven studies, a major cause of failure due to the increasing number of TB patients becoming drug-resistant (MDR TB) and poor adherence.

Keywords: DOTS, tuberculosis, TSR, treatment failure

Abstrak. Tuberkulosis adalah penyakit infeksi kronis yang disebabkan oleh basil Mycobacterium tuberculosis. World Health Organization merekomendasikan strategi Directly Observed Treatment Shortcourse (DOTS) untuk mengurangi morbiditas dan mortalitas TB di masyarakat. Keberhasilan pengobatan TB adalah jumlah kesembuhan ditambah pengobatan lengkap. Untuk menilai keberhasilan pengobatan TB, WHO menargetkan angka keberhasilan pengobatan (TSR) sebesar 85%. Tujuan penelitian: Untuk mengetahui keefektifan DOTS dalam pengobatan pasien TB dan penyebab kegagalannya. Metode penelitian: scoping review artikel dari database PubMed, Science Direct, Springer Link, dan GARUDA. Penelitian ini dinilai melalui PICOS dengan kriteria kelayakan berupa diagram PRISMA. Artikel yang digunakan dipublikasikan di jurnal nasional dan internasional pada periode 2010-2020. Hasil: delapan artikel yang memenuhi kriteria; empat artikel dengan TSR> 85%, tiga artikel dengan TSR <85%, satu artikel menilai efektivitas rejimen DOTS (63% hasil sangat baik, 14,6% sedang, 7,3% hasil buruk). Kegagalan pengobatan penderita TB disebabkan oleh berbagai faktor, yaitu semakin banyaknya penderita TB yang resisten terhadap obat (MDR), dan ketidakpatuhan. Kesimpulan: strategi DOTS efektif dalam empat dari delapan penelitian, penyebab utama kegagalan karena meningkatnya jumlah pasien TB yang resistan terhadap obat (TB MDR) dan kepatuhan yang buruk.

Kata kunci: DOTS, tuberkulosis, TSR, kegagalan pengobatan.


Keywords


DOTS, tuberkulosis, TSR, kegagalan pengobatan.

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DOI: http://dx.doi.org/10.29313/kedokteran.v7i1.25930

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