Syntax Literate: Jurnal Ilmiah
Indonesia p�ISSN: 2541-0849 e-ISSN: 2548-1398
Vol. 7, No. 10, Oktober 2022
Nanny Harmani1*,
Lucky Resa Santoso2, Hasna
Ibadurrahmi3
University of
Muhammadiyah Prof. Hamka, Jakarta Selatan, Indonesia1
Primary Clinic of Synapsa Medica, Indonesia2
Mother and Child
Hospital of Nuraida3
Email: [email protected]
Abstract
The age of children is an age that is very vulnerable to transmission of
pulmonary tuberculosis. The highest rate of transmission is found in the 0-6 year age group and the 7-14 year age group. Various
efforts were made to minimize the occurence of
tuberculosis in children, such as the program of community health center in
preventing and controlling pulmonary tuberculosis. The purpose of this study
was early detection of pulmonary tuberculosis� in Elementary School 04 Lebak Bulus.
This type of research is cross sectional. Questionnaire as a method of data
collection. The total population is 270 people with a sample of 37 people with
convenience sampling technique. Univariate analysis with diagram. The result
showed that were students who showed symptomps that
lead to pulmonary tuberculosis disease (2,7%) and had risk factors for
pulmonary tuberculosis disease (2,7%) from a total sample of 37 people. It can
be concluded that there are students who have symptoms and risk factors for
pulmonary tuberculosis disease at Elementary School 04 Lebak Bulus. Researchers
suggest that further examinations be carried out in the form of rapid molecular
test� with
sputum samples.
Keywords:�� clinical symptoms; risk
factors; early detection; pulmonary tuberculosis; MRT
Introduction
Globally,
tuberculosis (TB) is still the main cause of morbidity and mortality, but
attention to its health impacts is often underestimated. According to the WHO
report in 2021, it is estimated that there will be 5.8 million TB cases in
2021, 7.6% of global TB cases are in Indonesia. The incidence of TB in children
in the world reaches 1 million cases (Rosmayudi,
2007).
DKI Jakarta is
one of the provinces with a high incidence of TB. It was recorded in 2018 with
the number of incidents of 32,570 people or 0.3% of the total population of
Jakarta. DKI Jakarta is one of the provinces with a high population density so
there is a great potential for TB transmission (statistik.jakarta.go.id).
Puskesmas is a health facility which is a government program for
efforts in health services and is an organization consisting of dense human
resources, technology, and service activities that are carried out so that the
management of puskesmas is not only a public service
institution, but also a socio-economic institution that has the authority. and
responsibility in the continuity of puskesmas services
(Setyanto,
2013).
The increase
in the number of TB cases in various places at this time is thought to be
caused by various things, namely incorrect diagnosis, inadequate treatment,
prevention programs are not implemented properly, HIV endemic infection,
population migration,self-treatment, increasing
poverty, and inadequate health services (World
Health Organization, 2006).
Pulmonary
tuberculosis is an infectious disease that can cause life-threatening
conditions if the patient does not complete treatment (Madansein
et al., 2015). The spread of the
tuberculosis virus becomes quite vulnerable to people who often have direct
contact with tuberculosis sufferers. Clinical symptoms experienced by patients
with pulmonary tuberculosis include respiratory disorders such as coughing up
phlegm, coughing up phlegm with blood, shortness of breath, and chest pain, as
well assystemic symptoms such as fever, lethargy,
night sweats, and weight loss (Widyasari
& Sasongko, 2018).
One of the puskesmas programs is the TB Prevention and Control
Program. Accurate assessment of TB disease in children is currently hampered by
limited surveillance data. The difficulty of diagnosing TB in children has
resulted in very limited TB data in children. The difficulty of confirming the
diagnosis of TB in children has resulted in neglect of treatment for childhood
TB, so that for several years childhood TB was not a public health priority in
many countries. However, in recent years with research conducted in developing
countries, the prevention of TB in children has received enough attention (Kemenkes
RI, 2014).
UPTD Puskesmas Lebak Bulus is one of the health centers in DKI
Jakarta that is committed to TB control and prevention, namely with the pillars
and components of TB control such as integration of patient-centred
TB services and TB prevention efforts, policies and support systems that are
bold and clear, as well as the intensification of research and innovation.
According to
the study, it was found that there were 12 male respondents (54.5%) and 10
female respondents (45.5%) with the highest distribution age of respondents
being children aged 3 years (31.8%) (Farsida
& Kencana, 2020).
The age of
children is an age that is very vulnerable to transmission of tuberculosis (Newton,
Brent, Anderson, Whittaker, & Kampmann, 2008). The highest rate of transmission is found in the 0-6 year age group and the 7-14 year age group. Age children
are very susceptible to contracting tuberculosis and when infected they are
susceptible to tuberculosis and tend to suffer from severe tuberculosis such as
tuberculosis meningitis, miliary, or severe lung disease (IDAI,
2009).
One of the
factors that cause tuberculosis in children, namely lack of knowledge about TB
in parents or adults in their environment, wrong coughing and spitting ethics,
public ignorance of the impact that can be caused by irregularity in taking
medication, lack of awareness of TB suspects to check themselves, lack of
awareness of TB sufferers for treatment, poor nutritional intake, densely
populated environment, slum environment, low education level, middle to lower
economic level, and there are still many people who are ashamed to seek
treatment and are hesitant to seek medical attention. These factors are
important to be analyzed and followed up so that researchers are interested in
conducting early detection of TB disease (Putri
et al., 2022).
Based on the
background described above, this study was conducted with the aim of knowing
the number of cases of pulmonary TB disease in students at SDN 04 Lebak Bulus
Village, knowing early detection of pulmonary tuberculosis in students with
clinical symptoms, and knowing early detection of pulmonary tuberculosis in
students. risk factors.
This research provides benefits for institutions
by adding insight into early detection of pulmonary TB disease. It is hoped
that it can provide information and be followed up by socializing to students
about pulmonary TB disease and the importance of getting treatment to
completion, increasing school participation in achieving a tuberculosis free
society.
Research Methods
The research design used in this
study is descriptive with a cross sectional which aims to identify the status
of pulmonary TB disease in students of SDN 04 Lebak Bulus in the 2018/2019
academic year grades 4-6. Held in August 2019 for one day. The location of this
research was at SDN 04 Lebak Bulus which is included in the working area of the
Lebak Bulus Health Center located in Lebak Bulus Village, Cilandak
District, South Jakarta City, DKI Jakarta Province.
The population in this study were
students in grades 4-6 at SDN 04 Lebak Bulus Village for the 2018/2019 academic
year with a total of 270 students. The sample in this study were some students
of SDN 04 Lebak Bulus Village.sampling technique used
was convenience sampling, namely the search for samples by taking the most
possible sample at SDN 04 Lebak Bulus Village with a total of 37 students.
In collecting data, researchers used
research instruments in the form of questionnaires and pulmonary TB scoring
sheets to diagnose pulmonary TB. The data that researchers take is primary data
and secondary data which is quantitative data. Collecting data with TB scores
and questionnaires using a questionnaire method to the respondents who were
selected based on the convenience sampling technique. The variables in this
study were early detection based on clinical symptoms and risk factors. For
data processing is used manually and the help of data processing software using
Microsoft Word and Microsoft Excel. The data that has been obtained were
analyzed univariately, namely to determine the
frequency distribution of the independent and dependent variables studied which
were presented in the form of graphs and tables. Univariate data presentation
using frequency distribution.
Result and Discussion
School
Sociodemographic Data
State Elementary School 04 Lebak Bulus is located at Jalan Puskesmas, RT.1/RW.3, Lebak Bulus Village, Cilandak District, South Jakarta. The total number of
students in the 2018/2019 academic year was 270 students consisting of grades 4
to 6.
Figure 1. Characteristics of
Respondents by Gender
�
In this study, 37 respondents were taken in the area of
SDN 04 Lebak Bulus Village. Of the total number of respondents,
there are 21 respondents (56.8%) with female gender and 16 respondents (43.2%)
with male gender.
�
Figure 2. Number of Respondents Based
on Clinical Symptoms
�
From the early detection of pulmonary TB that the researchers did, it
was found that 1 respondent (2.7%) showed symptoms leading to pulmonary TB disease
with symptoms of cough lasting more than two weeks, while 36 respondents
(97.3%) had symptoms that did not lead to pulmonary TB. Pulmonary TB.
�
Figure 3. Number of Respondents Based
on Risk Factors
�
From the diagram above, based on risk factors, 1 respondent (2.7%) of
respondents had risk factors for pulmonary TB disease. Respondents admitted
that they had long interacted with pulmonary TB patients in the last two years.
Meanwhile, 36 respondents (97.3%) had no interaction with pulmonary TB patients
in the last two years.
Based on gender, most of the respondents were women with a total of 21
respondents (56.8%), while men with a total of 16 respondents (43.2%). This is
not in accordance with Farsida's 2020 research which
states that there are more male respondents than female with a percentage of
54.5%. This is because the population of students in grades 4-6 SDN 04 academic
year 2018/2019 are mostly women.
Based on clinical symptoms and risk factors in early detection of
pulmonary TB disease in grade 4-6 students of SDN 04 Lebak Bulus Village, 1
respondent (2.7%) of 37 respondents with symptoms led to pulmonary TB. This is
because the respondent has a long cough for more than two weeks that does not
go away, other symptoms such as night sweats, fever for more than two weeks,
and weight loss for no apparent reason. Patients have risk factors in the form
of contact with TB patients who have been on treatment for more than two
months.
According to the 2014 National TB guidelines, all coughs that exceed two
weeks are an indication for sputum examination for the discovery of pulmonary
TB disease. Respondents who have symptoms leading to TB are given an
introduction to the puskesmas for further examination
in the form of a Molecular Rapid Test (TCM) with a sputum sample (Kemenkes RI, 2014).
Of all the risk factors and clinical symptoms obtained in respondents,
they cannot be directly included in the category of suspected pulmonary TB
disease because not all symptoms and risk factors for pulmonary TB are found.
With the results obtained, the researchers educated on how to cough in patients
who were detected early, this factor is important because if in one room there
is a pulmonary TB patient who coughs or sneezes and does not cover his mouth,
the bacteria that cause pulmonary TB can easily spread in that room.
In addition, the
bacteria that cause pulmonary TB (Mycobacterium tuberculosis) can be easily
killed by sunlight, so ventilation is an important factor in the spread of pulmonary
TB disease. At SDN 04 Lebak Bulus school, classroom ventilation is adequate.
Conclusion
Based on the research data that the
researchers conducted on students of SDN 04 Lebak Bulus Village, it was found
that the number of pulmonary TB cases was one respondent who had symptoms that
lead to pulmonary TB disease based on clinical symptoms and risk factors. Based
on clinical symptoms in early detection of pulmonary TB disease in grade 4-6
students of SDN 04 Lebak Bulus Village, 1 respondent (2.7%), while 36 respondents
(97.3%) did not have clinical symptoms of pulmonary TB. Early pulmonary TB
disease in grade 4-6 students of SDN 04 Lebak Bulus Village found 1 respondent
(2.7%), while 36 respondents (97.3%) had no risk factors for pulmonary TB.
