Scoping Review: Efektivitas Strategi Directly Observed Treatment Shortcourse (DOTS) pada Pengobatan Pasien Tuberkulosis
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
Full Text:
PDFReferences
Adigun R, Singh R. Tuberculosis. Dalam : StatPearls. Treasure Island (FL): StatPearls publishing; 2020 Oct 27. [Diunduh tanggal 5 September 2020] Tersedia dari: https://www.ncbi.nlm.nih.gov/books/NBK441916/
Rachmah RA, Saraswati LD, Ginandjar P, dkk. Hubungan antara tingkat pengetahuan kader masyarakat peduli paru sehat dengan kepatuhan berobat pasien tuberkulosis di balai kesehatan masyarakat wilayah semarang. JKM. 2019 ;7(3): 1–3.
Sisay S, Mengistu B, Erku W, dkk. Directly Observed Treatment Short-course (DOTS) for tuberculosis control program in Gambella Regional State, Ethiopia: Ten years experience. BMC Research Notes. 2014: 1-7.
Kemenkes RI. Situasi TBC di Indonesia. Tersedia dari: Https://Tbindonesia.or.Id, https://tbindonesia.or.id/informasi/tentang-tbc/situasi-tbc-di-indonesia-2/
Kumar P, Clark M. Respiratory disease. Dalam : Conwey R, Elia M, Gale E, Irving W, Penyunting. Clinical Medicine. Edisi ke-9. New York: Elsevier; 2017. hlm. 2770−5.
Suadnyani Pasek M, I Made s. Hubungan persepsi dan tingkat pengetahuan penderita TB dengan kepatuhan pengobatan di kecamatan Buleleng. JPI. 2013; 2 (1): 145–50.
Kemenkes RI. Pedoman TB nasional. Jakarta; 2014.hlm. 16−18
Kementerian Kesehatan Republik Indonesia. Pedoman nasional pengendalian tuberkulosis, Jakarta; 2011. hlm. 35.
Woldeyohannes D, Sisay S, Mengistu B, dkk. Directly observed treatment short-course (DOTS) for treatment of new tuberculosis cases in Somali Regional State, Eastern Ethiopia: Ten years retrospective study. BMC Res Notes. 2015; 8: 2–6.
Merza MA. A 5-year experience characterizing the demographic and clinical profile and directly observed treatment short-course treatment outcome in National Tuberculosis Center of Duhok province, Iraqi Kurdistan. SAGE Open Med. 2020; 8: 1−10
Tafess K, Beyen TK, Abera A, dkk. Treatment outcomes of tuberculosis at Asella Teaching Hospital, Ethiopia: Ten Years’ retrospective aggregated data. Front Med. 2018; 5: 1–9.
Tafess K, Mengistu B, Woldeyohannes D, dkk. Determining treatment outcome of smear-positive pulmonary tuberculosis cases in Afar Regional State, Ethiopia: A retrospective facility based study. Int J Mycobacteriology. 2016; 5: 164–169.
Negm M, Allam A, El Zeheiry F. Assessment of directly observed therapy short-course (DOTs) of tuberculosis in Dakahlia governorate chest hospitals from 2006 to 2011. Egypt J Bronchol. 2017; 11: 88.
Valsalan R, Purushothaman R, Raveendran MK, dkk. Efficacy of directly observed treatment short-course intermittent regimen in spinal tuberculosis. Indian J Orthop. 2012; 46: 138–143.
Sihotang RH, B. Lampus, A.j Pandelaki. Gambaran penderita tuberkulosis pru yang berobat menggunakan DOTS di Puskesmas Bahu Malalayang I periode Januari-Desember 2012. JKKT 2013; 1: 69–71.
Kementerian Kesehatan Republik Indonesia. Manajemen terpadu pengendalian TB resistan obat (MTPTOP). Tersedia dari: https://tbindonesia.or.id/informasi/teknis/tb-mdr/
DOI: http://dx.doi.org/10.29313/kedokteran.v7i1.25930
