Active case treatment lebih cost effective untuk pengobatan TB paru tahap awal

Date

2012

Journal Title

Journal ISSN

Volume Title

Publisher

Pusat Kebijakan dan Manajemen Kesehatan, Universitas Gadjah Mada, Yogyakarta, ID

Abstract

Background: Estimated one third of world population have been infected with Mycobacterium tuberculosis. Infected person will lose 3-4 months work time and will decrease 20%- 30% of income per year. Finding and treating TB patients are the best endeavor to stop TB spreading with a correct intervention. Jember Regency is executing Passive Case Treatment (PCT), which lung TB patients should come to puskesmas to take the Tuberculosis Drug (ATD) in a certain day and hour. The method was not effective, proven by the increase of default rate for 3 years: 5.08% in 2007, 5.14% in 2008 and 6.18% in 2009, followed by the decrease of conversion rate for 3 years: 95.26% in 2007, 93.09% in 2008 and 92.08% in 2009. It is raising alertness for increased re-treatment which will lead to MDR, where MDR is clearly affecting TB patients’ quality of life. Afterward, an idea to create an ATD delivery to patients’ homes was executed, it is called Active Case Treatment (ACT). Method: This study was a Quasy Experimental Research with a prospective design. Conducted in 16 Puskesmas with default rate more than 5% and conversion rate less than 80% in 2009. Begin in September until November 2010, using total sampling technique. The sample was all lung TB patients who came for treatment in September 2010, with criteria were: new case, 15-50 years of age, did not suffer HIV and Diabetes Mellitus, was not malnourished, and was not allergic to ATD. Data collection was done through interview, filling questionnaires and exploring documents. Then followed the calculation of the total cost (direct and indirect cost) and Quality of Life (QoL) of both PCT and ACT. Later, total cost was compared to QoL, the lesser amount was considered more cost effective. Result: Research result showed that to increase 1 scale of Quality of Life (QoL) of PCT needed an amount of IDR. 35,295.00, while to increase 1 QoL scale ACT was IDR 14,377.00. ACT was smaller than PCT. Conclution: Conclusion derived from the result was that ACT is more cost effective than PCT. Recommendation to be presented is to endorse lung TB treatment with ACT in Jember Regency particularly in Puskesmas with the same characteristics with this research.

Description

Keywords

INDONESIA, TUBERCULOSIS, ACCESS TO HEALTH CARE, EPIDEMIOLOGY, MEDICAL CARE, EARLY DETECTION OF DISEASE, ANTITUBERCULAR AGENTS, LUNG DISEASES

Citation

Ketut Ardani, N., Nurul Rochmah, T., & Umbul Wahyuni, C. (2012). Active case treatment lebih cost effective untuk pengobatan TB paru tahap awal. Jurnal Kebijakan Kesehatan Indonesia, 1(2): 103-111.

DOI