The Incidence of Primary Resistance TB at Health Service Facilities in Medan in 2015

Oct 13, 2025 by wbrum.org 104 views

The Incidence of Primary Resistance TB at Health Service Facilities in Medan in 2015

Introduction

Resistance to anti-puberculosis (TB) drugs is one of the biggest challenges in TB prevention and control programs throughout the world. In Medan, especially in 2015, serious attention emerged related to the number of primary resistance TB cases found in health service facilities. This study was conducted to identify the proportion of primary resistance TB in the Puskesmas and the practice of private doctors, which is the main place of patient referral.

The Importance of TB Prevention and Control Programs

TB is a major public health problem worldwide, causing millions of deaths each year. The World Health Organization (WHO) estimates that there were 10 million new TB cases and 1.5 million TB deaths in 2019. The emergence of drug-resistant TB is a significant concern, as it makes treatment more difficult and expensive. In Indonesia, TB is a major public health problem, with an estimated 1.2 million new cases and 150,000 deaths in 2019.

Research Methods

This descriptive research was conducted from February to August 2015, with subjects consisting of pulmonary TB patients who did not have a history of treatment for anti-tuberculosis drugs or who had received treatment for less than one month. Demographic data and main complaints are collected, then continued with a sputum examination microscopically, radiologically, culture, and the drug sensitivity test before therapy begins.

Research Result

Of the 31 subjects studied, it was found that 3 people (9.68%) experienced primary resistance. The details of these results indicate:

Primary Monoresistance: 2 people (6.45%) against isoniazid.
Primary MDR TB: 1 person (3.23%) with a combination of resistance to rifampicin, isoniazid, and ethambutol.

These results indicate that there is a significant primary resistance number among pulmonary TB patients in health service facilities in Medan.

Analysis and Implications

The incidence of high primary resistance TB is an important indication for health workers and the authorities to increase the vigilance and management of TB patients. Drug resistance can arise as a result of the use of inappropriate drugs, the patient's non-compliance in undergoing therapy, or the spread of resistant TB bacterial strains. Therefore, there needs to be proactive steps in controlling infection, including education to patients about the importance of completing TB treatment in full.

Other steps that need to be considered include an increase in surveillance systems, regular drug resistance testing in health care facilities, as well as better handling for TB patients with previous treatment history. Community involvement in TB prevention programs is also a key to reducing the incidence of resistance, so that people can better understand this disease and play an active role in preventing its spread.

The Role of Community Involvement in TB Prevention

Community involvement is crucial in TB prevention programs. By educating the community about the importance of completing TB treatment in full, we can reduce the incidence of drug resistance. Community-based TB control programs can also help to identify TB cases early, which can lead to better treatment outcomes. In addition, community involvement can help to reduce stigma and discrimination against TB patients, which can improve their quality of life.

Conclusion

The incidence of primary resistance TB found in health service facilities in Medan in 2015 showed a fairly high figure. This requires the attention and concrete action of various parties to overcome the problem of primary resistance, which if not handled properly, can worsen the TB epidemic in the area. Collaboration is needed between the government, medical personnel, and the community to create an environment that supports TB control and reducing future drug resistance rates.

Recommendations

Based on the findings of this study, the following recommendations are made:

Increase surveillance systems to monitor the incidence of primary resistance TB.
Regular drug resistance testing in health care facilities to identify cases early.
Better handling for TB patients with previous treatment history.
Community involvement in TB prevention programs to educate the community about the importance of completing TB treatment in full.
Collaboration between the government, medical personnel, and the community to create an environment that supports TB control and reducing future drug resistance rates.

Limitations of the Study

This study has several limitations. The sample size was small, which may not be representative of the larger population. In addition, the study only focused on pulmonary TB patients, which may not be representative of all TB patients. Further studies are needed to confirm the findings of this study and to identify the factors that contribute to the emergence of primary resistance TB.

Future Directions

This study highlights the need for further research on the emergence of primary resistance TB in Indonesia. Future studies should focus on identifying the factors that contribute to the emergence of primary resistance TB, as well as developing strategies to prevent and control the spread of drug-resistant TB. In addition, community-based TB control programs should be implemented to educate the community about the importance of completing TB treatment in full and to reduce stigma and discrimination against TB patients.
Frequently Asked Questions (FAQs) about Primary Resistance TB

Q: What is primary resistance TB?

A: Primary resistance TB refers to TB that is resistant to one or more anti-TB drugs from the start, without any previous treatment.

Q: What are the causes of primary resistance TB?

A: The causes of primary resistance TB are not fully understood, but it is believed to be related to the use of inappropriate drugs, patient non-compliance in undergoing therapy, and the spread of resistant TB bacterial strains.

Q: How common is primary resistance TB?

A: The incidence of primary resistance TB varies depending on the region and country. In Medan, Indonesia, the study found that 9.68% of pulmonary TB patients had primary resistance.

Q: What are the symptoms of primary resistance TB?

A: The symptoms of primary resistance TB are similar to those of regular TB, including cough, fever, and weight loss.

Q: How is primary resistance TB diagnosed?

A: Primary resistance TB is diagnosed through a combination of sputum examination, radiological examination, culture, and drug sensitivity testing.

Q: What are the treatment options for primary resistance TB?

A: The treatment options for primary resistance TB are more complex and may involve the use of second-line anti-TB drugs.

Q: Can primary resistance TB be prevented?

A: Yes, primary resistance TB can be prevented through education and awareness about the importance of completing TB treatment in full, as well as through community-based TB control programs.

Q: What is the role of community involvement in TB prevention?

A: Community involvement is crucial in TB prevention programs. By educating the community about the importance of completing TB treatment in full, we can reduce the incidence of drug resistance.

Q: What are the challenges in controlling primary resistance TB?

A: The challenges in controlling primary resistance TB include the lack of awareness about the importance of completing TB treatment in full, the lack of access to second-line anti-TB drugs, and the stigma and discrimination against TB patients.

Q: What are the recommendations for controlling primary resistance TB?

A: The recommendations for controlling primary resistance TB include increasing surveillance systems, regular drug resistance testing in health care facilities, better handling for TB patients with previous treatment history, and community involvement in TB prevention programs.

Q: What is the future direction for controlling primary resistance TB?

A: The future direction for controlling primary resistance TB includes further research on the emergence of primary resistance TB, developing strategies to prevent and control the spread of drug-resistant TB, and implementing community-based TB control programs.

Q: What is the role of healthcare providers in controlling primary resistance TB?

A: Healthcare providers play a crucial role in controlling primary resistance TB by providing accurate diagnosis, effective treatment, and education to patients about the importance of completing TB treatment in full.

Q: What is the role of government in controlling primary resistance TB?

A: The government plays a crucial role in controlling primary resistance TB by providing resources and support for TB control programs, including increasing surveillance systems, regular drug resistance testing in health care facilities, and community involvement in TB prevention programs.

Q: What is the role of community in controlling primary resistance TB?

A: The community plays a crucial role in controlling primary resistance TB by being aware of the importance of completing TB treatment in full, reducing stigma and discrimination against TB patients, and participating in community-based TB control programs.