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BAB 6 KESIMPULAN DAN SARAN

6.2. Saran

Dari seluruh proses yang telah dijalani oleh penulis dalam menyelesaikan penelitian ini, maka peneliti ingin mengungkapkan beberapa saran dan berharap

saran ini dapat menjadi pertimbangan dan bermanfaat bagi semua pihak yang berperan dan berhubungan dengan penelitian ini.

1. Bagi Klinik Pusyansus RSUP. Haji Adam Malik Medan, diharapkan untuk memperbaiki sistem pendataan dan penulisan rekam medis. Mengingat banyaknya data-data yang kurang lengkap pada penelitian ini yang diakibatkan pendataan dan penulisan rekam medis yang kurang lengkap. 2. Perlu dilakukan pemeriksaan selain BTA untuk mendeteksi keberadaan

Mycobacterium tuberculosis pada pasien suspek koinfeksi TB Paru-HIV. 3. Perlu dilakukan penelitian lebih lanjut untuk mencari faktor-faktor yang

mempengaruhi hasil pemeriksaan BTA pada pasien suspek koinfeksi TB Paru-HIV.

DAFTAR PUSTAKA

Abebe, Gemeda., Deribew, Amare., Apers, Ludwig., et al. 2013. Evaluation of the 2007 WHO Guideline to Diagnose Smear Negative Tuberculosis in An Urban Hospital in Ethiopia. BMC Infectious Disease. Available

from

November 2013]

Amin, Zulkifli, & Bahar, Asril, 2009. Tuberkulosis Paru, In: Sudoyo, Aru. W., et al, ed. Buku Ajar Ilmu Penyakit Dalam edisi V. Jakarta: Interna Publishing, 2230-2239.

Adi, Mila Karmila., 2011. Perilaku Seksual Mahasiswa Universitas Islam Indonesia Ditinjau dari Perspektif Gender. Pamator Vol.14. Available from:

Baratawidjaja, Karnen Garna., & Rengganis, Iris., 2010. Imunologi Dasar edisi 9. Jakarta: Balai Penerbit Fakultas Kedokteran Universitas Indonesia, 477-513.

Brooks, Geo.F., Butel, Janet.S., Morse, Stephen.A., 2008. Jawetz, Melnick, & Adelberg Mikrobiologi Kedokteran edisi 23. Jakarta: EGC, 325-332. Carvalho, Braulio Matias de., Monteiro, Andre Jalles., Neto, Roberto da Justa

Pires., et al. 2008. Factors related to HIV/Tuberculosis coinfection in a Brazilian Reference Hospital. The Brazilian Journal of Infectious

Disease. Available from:

[Accessed 22

November 2013]

CDC, 2013. HIV&Tuberculosis. Available from:

[Accessed 10 April 2013]

Coimbra, Isabella., et al. 2012. Associated factors for treatment delay in pulmonary tuberculosis in HIV-infected individuals: a nested

case-control study. BMC Infectious Disease. Available from:

2013]

Deribew, Amare., Deribe, Kebede., Reda, A. Ayalu., et al. 2013. Change in quality of life: a follow up study among patients with HIV infection with and without TB in Ethiopia. BMC Public Health. Available from:

[Accessed 4 June

2013]

Deribew, Amare., Tesfaye, Markos., Hailmichael, Yohannes., et al. 2009. Tuberculosis and HIV coinfection: its impact on quality of life.

Biomedcentral. Available from:

June 2013]

Dikromo, Parto Ngatwanto., Antariksa, Budhi., Nawas, Arifin., 2011. Factor Associated Therapy of Co-Infection TB-HIV Patients in Persahabatan Hospital, Jakarta Indonesia. Jurnal Respirologi Indonesia Vol. 31: 14-21. Available from 2013]

Ditjen PP & PL, 2012. Statistik Kasus HIV/AIDS di Indonesia. Available from:

[Accesed 11 April 2013].

Ditjen PP & PL, 2011. Statistik Kasus HIV/AIDS di Indonesia. Available from:

Ditjen PP&PL, 2012, Laporan Situasi Terkini Perkembangan Tuberkulosis di Indonesia Januari-Desember 2012. Available from:

11 April 2013].

Ditjen PP&PL, 2011, Situasi Triwulan II 2011. Available from:

Djoerban, Zubairi, & Djauzi, Samsuridjal, 2009. HIV/AIDS di Indonesia. In: Sudoyo, Aru.W. et al, ed Buku Ajar Ilmu Penyakit Dalam edisi V. Jakarta: Interna Publishing, 2861-2868.

Elona, Uli, 2011. Proporsi Infeksi Oportunistik pada Penderita HIV/AIDS di RSUP Haji Adam Malik Tahun 2010. Medan: USU Institutional

Repository. Available from:

2013].

Fauci, Anthony.S., & Lane, H. Clifford., 2008. Human Immunodeficiency Virus Disease: AIDS and Related Disorders. In: Fauci, Anthony.S. et al., ed Harisson’s Principle of Internal Medicine 17th edition. New York: Mc Graw Hill Medical Companies, 1137-1203.

Fredy, Felix C., Liwang, Frans., Kurniawan, Rudi., Nasir, Anna U.Z. 2012. The Correlation Between CD4+ T-lymphocyte Count and Tuberculosis Form in TB-HIV Coinfected Patients in Indonesia. Acta Medica Indonesiana Vol. 44 (2): 122-123. Available from:

11 April 2013]

Graner, Daryl K., Weil, P. Anthony., 2009. Genetika Molekular, DNA Rekombinan, & Teknologi Genomik. In: Murray, Robert K., Granner Daryl K., & Rodwell, Victor W., ed Biokimia Harper edisi 27. Jakarta: EGC, 423-424.

Gunaseelan, Rethina., 2010. Karakteristik Pasien HIV dengan Tuberkulosis di RSUP Haji Adam Malik, Medan Tahun 2008-2010. Medan: USU

Institutional Repository. Available from:

18 November 2013]

Icksan, Aziza.G., & Luhur, Reny., 2008. Radiologi Toraks Tuberkulosis Paru. Jakarta: Sagung Seto.

Kementerian Kesehatan Republik Indonesia, 2011. Pedoman Nasional Tatalaksana Klinis Infeksi dan Tterapi Antiretroviral pada Orang

Dewasa. Direktorat Jenderal Pengendalian Penyakit dan Penyehatan

Lingkungan. Available from:

2013]

Kementerian Kesehatan Republik Indonesia, 2011. Pedoman Nasional Pengendalian Tuberkulosis. Direktorat Jenderal Pengendalian

Penyakit dan Pengendalian Lingkungan. Available from:

[Accessed 20 April 2013]

Kementerian Kesehatan Republik Indonesia, 2012. Petunjuk Teknis Tata Laksana

Klinis Ko-Infeksi TB-HIV. Available from:

[Accessed 22

November 2013]

Kenyorini, Suradi. & Suryanto., 2006. Uji Tuberkulin. Jurnal Tuberkulosis Indonesia Vol.3 No.2: 1-5. Available from:

[Accessed 12 April 2013].

Kresina, Thomas F., Lubran, Robert., Clark, H Westley., Cheever, Laura W. 2012. Substance Abuse Treatment, HIV/AIDS, and the Continuum of Response for People Who Inject Drugs. Pubmed. Available from:

Kumala, Widyasari., 2009. Diagnosis Laboratorium Mikrobiologi Klinik. Jakarta: Penerbit Universitas Trisakti.

Lubis, Rahayu, 2007. Ko-infeksi HIV/AIDS dan TB. Medan: USU Institutional

Repository. Available from:

2013].

Maramis, Margarita M., 2007. Konseling dan Tes Sukarela untuk Penderita HIV & AIDS. In: Nasronudin, ed Konseling, Dukungan, Perawatan, dan Pengobatan ODHA. Surabaya: Airlangga University Press, 1-29.

Oktarina., Hanafi, Fachrudi., Budisuari, Made Asri., 2009. Hubungan Antara Karakteristik Responden, Keadaan Wilayah dengan Pengetahuan, Sikap Terhadap HIV/AIDS pada Masyarakat Indonesia. Buletin Penelitian Sistem Kesehatan Vol. 12 No.4: 362-369. Available from:

Ong, C.K., Tan, W.C., Leong, K.N., & Muttalif, A.R.,2008. Tuberculosis-HIV Coinfection: Relationship Beetween Manifestation of Tuberculosis And Degree of Immunosuppression (CD4 Counts). Available from:

[Accessed 11 April 2013].

Onubogu, C.C., Kunle-Ope, C.N., Onyejepu, N., et al. 2010. Prevalence of tuberculosis and human immunodeficiency virus (TB/HIV) co-infections amongst patients with bronchopulmonary disorder in Lagos. African Journal of Microbiology Research Vol.

4(180:1904-1908. Available from:

Pawlowski, Andrzej., Jansson, Marianne., Skold, Markus., Rottenberg, Martin E., Kallenius, Gunilla., 2012. Tuberculosis and HIV Coinfection. PloS

Pathogens. Available from:

Raviglione, Mario.C., & O’Brien, Richard.J., 2010. Tuberculosis. In: Loscalzo, Joseph, et al., ed Harisson’s Pulmonary and Critical Medicine. New York: Mc Graw Hill Medical, 115-138.

Retnowati, Endang., 2007. Pemeriksaan Laboratorium pada Pasien Terinfeksi Human Immunodeficiency Virus (HIV). In: Nasronudin, ed Konseling, Dukungan, Perawatan, dan Pengobatan ODHA. Surabaya: Airlangga University Press, 87-96.

Riadi, Arief., 2012. Tuberkulosis dan HIV-AIDS. Jurnal Tuberkulosis Indonesia

Vol.8: 24-29. Available from:

Rosilawati, Maria Lina., Sudarmono, Pratiwi., Ibrahim, Fera., 2002. Sensitivitas metode PCR (Polymerase chain reaction) dalam mendeteksi isolat klinis Mycobacterium tuberculosis. Jurnal Kedokteran Trisakti Vol. 21

No.1: 7-14. Available from:

2013]

Scherer, Luciene C., Sperhacke, Rosa D., Jarczewski, Carla., et al. 2011. Comparison of two laboratory-developed PCR methods for diagnosis of Pulmonary Tuberculosis in Brazilian patients with and without HIV

infection. BMC Pulmonary Medicine. Available from:

[Accessed 22

November 2013]

Soetjipto., 2007. Dampak IDU terhadap HIV/AIDS. In: Nasronudin, ed Konseling, Dukungan, Perawatan, dan Pengobatan ODHA. Surabaya: Airlangga University Press, 97-109.

UNAIDS, 2012. Global Report. WHO: UNAIDS. Available from:

[Accesed 1 April 2013].

Wabiri, Njeri., Taffa, Negussie., 2013. Socio-economic inequality and HIV in

South Africa. BMC Public Health. Available from:

[Accessed 22

November 2013].

WHO, 2011. Rapid Implementation of the Xpert MTB/RIF diagnostic test.

Available from:

WHO, 2012. Global Tuberculosis Report. Available from:

Widodo, Agung Dwi Wahyu, & Lusida, Maria Inge, 2007. Biologi Molekuler HIV, In: Nasronudin et al, ed. Penyakit Infeksi di Indonesia. Surabaya: Airlangga University Press, 22-28.

Lampiran 1

DAFTAR RIWAYAT HIDUP

Nama : Hafis Novyan

Tempat,tanggal lahir : Medan, 8 Nopember 1992

Agama : Islam

Alamat : Jalan Karya Wisata Ujung Komp. Luxor No. A-1 Medan Riwayat Pendidikan : 1. TK Kartini Medan (1996-1997)

2. TK Angkasa Medan (1997-1998)

3. SD Swasta Harapan 1 Medan (1998-2004) 4. SMP Swasta Harapan 1 Medan (2004-2007) 5. SMA Negeri 2 Medan (2007-2010)

6. FK-USU Medan (2010-sekarang)

Riwayat Pelatihan : 1. Diklat Pengurus BKM Al-Farabi SMA Negeri 2 Medan (2008 dan 2009)

2. Pelatihan Basic Life Support TBM FK-USU (2010) 3. Pelatihan Terapi Cairan dan Manajemen Luka TBM

FK-USU (2011)

4. Pelatihan Advance Cardio-Pulmonary Resucitation TBM FK USU (2013)

Riwayat Organisasi : 1. Anggota PMR 001 SMA Negeri 2 Medan (2007-2010)

2. Anggota BKM Al-Farabi SMA Negeri 2 Medan (2007-2009)

3. Sekretaris Umum BKM Al-Farabi SMA Negeri 2 Medan (2009-2010)

4. Anggota Magang PHBI FK USU (2010-2011) 5. Sekretaris Harian PHBI FK USU (2011-2012) 6. Sekretaris BKM Al-Muttaqin Komp. Luxor

(2011-sekarang)

7. Sekretaris Ikatan Keluarga Komp. Luxor (2011-sekarang)

8. Anggota Himpunan Alumni Muslim SMAN 2 Medan (2011-sekarang)

9. Anggota Ikatan Alumni Palang Merah Remaja 001 SMAN Negeri 2 Medan (2011-sekarang)

Lampiran 4

FREQUENCIES VARIABLES=Usia Jnsklmn CD4 Pendidikan Pekerjaan Risk1 Risk2 Risk3 Risk4 Risk5 Risk6 Risk7 OAT Pernikahan KsplnBTA Usiaklpk

/STATISTICS=STDDEV MINIMUM MAXIMUM MEAN MEDIAN MODE /ORDER=ANALYSIS.

Frequencies

Notes

Output Created 23-Okt-2013 14:00:24

Comments

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KTI2.sav

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271

Missing Value Handling Definition of Missing User-defined missing values are treated as missing.

Cases Used Statistics are based on all cases with

Syntax FREQUENCIES VARIABLES=Usia Jnsklmn CD4 Pendidikan Pekerjaan Risk1 Risk2 Risk3 Risk4 Risk5 Risk6 Risk7 OAT Pernikahan KsplnBTA Usiaklpk

/STATISTICS=STDDEV MINIMUM MAXIMUM MEAN MEDIAN MODE /ORDER=ANALYSIS.

Resources Processor Time 00:00:00,234

Elapsed Time 00:00:00,281

[DataSet1] C:\Users\Lenovo\Documents\Data KTI2.sav

Statistics Usia Jenis Kelamin Pasien Limfosit CD4 Pendidikan Pasien Pekerjaan Pasien N Valid 270 271 268 271 271 Missing 1 0 3 0 0 Mean 33,38 1,34 143,56 2,20 2,31 Median 32,00 1,00 80,00 3,00 ,00 Mode 31 1 6 3 0 Std. Deviation 8,145 ,476 159,758 1,537 2,954 Minimum 21 1 1 0 0 Maximum 67 2 1161 5 9

Statistics Hubungan Seks Vaginal Berisiko Anal Seks Berisiko Bergantian Alat

Suntik Transfusi Darah

N Valid 124 11 37 2 Missing 147 260 234 269 Mean 1,00 1,00 1,00 1,00 Median 1,00 1,00 1,00 1,00 Mode 1 1 1 1 Std. Deviation ,000 ,000 ,000 ,000 Minimum 1 1 1 1 Maximum 1 1 1 1 Statistics Transmisi dari Ibu ke Anak Pasangan

Risiko Tinggi Tato Terapi OAT

Status Pernikahan Pasien N Valid 0 59 25 271 270 Missing 271 212 246 0 1 Mean 1,00 1,00 1,55 ,92 Median 1,00 1,00 2,00 1,00 Mode 1 1 2 1 Std. Deviation ,000 ,000 ,498 ,701 Minimum 1 1 1 0 Maximum 1 1 2 2

Statistics Kesimpulan

BTA Usia Kelompok

N Valid 271 270 Missing 0 1 Mean 1,83 2,80 Median 2,00 3,00 Mode 2 3 Std. Deviation ,373 ,876 Minimum 1 1 Maximum 2 6 Frequency Table

Jenis Kelamin Pasien

Frequency Percent Valid Percent

Cumulative Percent

Valid Laki-laki 178 65,7 65,7 65,7

Perempuan 93 34,3 34,3 100,0

Pendidikan Pasien

Frequency Percent Valid Percent

Cumulative Percent

Valid Data Tidak Lengkap 72 26,6 26,6 26,6

Sekolah Dasar 13 4,8 4,8 31,4

Sekolah Menengah Pertama 24 8,9 8,9 40,2

Sekolah Menengah Atas 130 48,0 48,0 88,2

Diploma 14 5,2 5,2 93,4

Sarjana 18 6,6 6,6 100,0

Total 271 100,0 100,0

Pekerjaan Pasien

Frequency Percent Valid Percent

Cumulative Percent

Valid Data Tidak Lengkap 148 54,6 54,6 54,6

Tidak Bekerja 12 4,4 4,4 59,0

Ibu Rumah Tangga 17 6,3 6,3 65,3

PNS/Pensiunan 5 1,8 1,8 67,2

TNI/POLRI 5 1,8 1,8 69,0

Pelajar 1 ,4 ,4 69,4

Wiraswasta 53 19,6 19,6 88,9

Petani 9 3,3 3,3 99,3

Supir 2 ,7 ,7 100,0

Total 271 100,0 100,0

Hubungan Seks Vaginal Berisiko

Frequency Percent Valid Percent

Cumulative Percent

Valid Ya 124 45,8 100,0 100,0

Missing System 147 54,2

Total 271 100,0

Anal Seks Berisiko

Frequency Percent Valid Percent

Cumulative Percent

Valid Ya 11 4,1 100,0 100,0

Missing System 260 95,9

Total 271 100,0

Bergantian Alat Suntik

Frequency Percent Valid Percent

Cumulative Percent

Valid Ya 37 13,7 100,0 100,0

Missing System 234 86,3

Transfusi Darah

Frequency Percent Valid Percent

Cumulative Percent

Valid Ya 2 ,7 100,0 100,0

Missing System 269 99,3

Total 271 100,0

Transmisi dari Ibu ke Anak Frequency Percent

Missing System 271 100,0

Pasangan Risiko Tinggi

Frequency Percent Valid Percent

Cumulative Percent Valid Ya 59 21,8 100,0 100,0 Missing System 212 78,2 Total 271 100,0 Tato

Frequency Percent Valid Percent

Cumulative Percent

Valid Ya 25 9,2 100,0 100,0

Tato

Frequency Percent Valid Percent

Cumulative Percent Valid Ya 25 9,2 100,0 100,0 Missing System 246 90,8 Total 271 100,0 Terapi OAT

Frequency Percent Valid Percent

Cumulative Percent

Valid Ya 122 45,0 45,0 45,0

Tidak 149 55,0 55,0 100,0

Total 271 100,0 100,0

Status Pernikahan Pasien

Frequency Percent Valid Percent

Cumulative Percent

Valid Tidak ada data 78 28,8 28,9 28,9

Menikah 136 50,2 50,4 79,3

Belum Menikah 56 20,7 20,7 100,0

Total 270 99,6 100,0

Missing System 1 ,4

Kesimpulan BTA

Frequency Percent Valid Percent

Cumulative Percent Valid Positif 45 16,6 16,6 16,6 Negatif 226 83,4 83,4 100,0 Total 271 100,0 100,0 Usia Kelompok

Frequency Percent Valid Percent

Cumulative Percent Valid <20 1 ,4 ,4 ,4 21-30 112 41,3 41,5 41,9 31-40 113 41,7 41,9 83,7 41-50 30 11,1 11,1 94,8 51-60 11 4,1 4,1 98,9 >61 3 1,1 1,1 100,0 Total 270 99,6 100,0 Missing System 1 ,4 Total 271 100,0

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