Analysis Factor Associated Tuberculin Test in Children Contact Tuberculosis History

ABSTRACTTuberculosis in children can not be separated from the history of contact with smear-positive tuberculosis patients as a source of infection. The aims of this study was to identify and analyze the risks tuberculin test results among children who had contact with patients with smear-positive tuberculosis in health center Bangil and health center Raci Pasuruan. The design of this study was cross sectional using systematik random sampling technique. Sample were drown from children with history of contacts with smear positive tuberculosis patients during 2012. This studies was from January until Juni 2013. The independent variables included age, sex, BCG immunization status, nutritional status, the average duration of exposure per day and residential density, the dependent variable was the tuberculin test results. It was found that from the study the results that a positive tuberculin test result was 28.57%. There was a significant relationship between age, nutritional status, the average duration of exposure per day, residential density of the tuberculin test, and there was no significant relationship between sex and status of BCG immunization results and tuberculin test results. Male and a dense residential density increases the risk of a positive tuberculin test results. While a good nutritional status is a protective factor for tuberculin test result positive.Keywords: tuberculin test, children, history of contacts of smear positive

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Analysis Factor Associated Tuberculin Test in Children Contact Tuberculosis History

Jurnal Berkala Epidemiologi ◽

10.20473/jbe.v2i22014.151-160 ◽

2014 ◽

Vol 2 (2) ◽

pp. 151

Author(s):

Tika Triharinni ◽

Muhammad Atoillah Isvandiari

Keyword(s):

Nutritional Status ◽

Health Center ◽

Significant Relationship ◽

Average Duration ◽

Tuberculin Test ◽

Residential Density ◽

Test Results ◽

Tuberculosis Patients ◽

History Of ◽

Test Result

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Analisis Preeklampsia Ibu Hamil pada Masa Pandemi Covid-19 di Puskesmas Sepatan Kabupaten Tangerang Tahun 2021

Jurnal Akademika Baiturrahim Jambi ◽

10.36565/jab.v10i2.387 ◽

2021 ◽

Vol 10 (2) ◽

pp. 375

Author(s):

Yenny Aulya ◽

Vivi Silawati ◽

Wulan Safitri

Keyword(s):

Nutritional Status ◽

Pregnant Women ◽

Health Center ◽

Significant Relationship ◽

Multiple Pregnancy ◽

Sampling Technique ◽

Cross Sectional ◽

History Of Disease ◽

History Of ◽

First Time

Medical record data at the Sepatan Health Center in 2019 showed that the incidence of preeclampsia from 735 deliveries was obtained as many as 93 people (12.65%) pregnant women who underwent examinations in the January-December 2020 period, and increased to 116 people (13.25%) from 875. childbirth, and in January 2021 there were 35 preeclampsia of pregnant women and 81 preeclampsia of pregnant women, out of 875 deliveries. Analyzing factors associated with preeclampsia of pregnant women during the Covid-19 pandemic at the Sepatan Public Health Center, Tangerang Regency in 2021. Methods This type of research is an analytical survey research, with a cross sectional approach. This population is all pregnant women who experience preeclampsia in January 2021 as many as 35 respondents, using a total sampling technique of 35 respondent’s pregnant women with preeclampsia. The results showed that five variables were statistically proven to have a significant relationship with the incidence of preeclampsia, namely age (p = 0.010 <0.05), parity (p = 0.021 <0.05), history of disease (p = 0.004 <0, 05) multiple pregnancy (p = 0.026 <0.05) and nutritional status (p = 0.007 <0.05). There is a significant relationship between age, parity, history of disease, multiple pregnancies and nutritional status on the incidence of preeclampsia of pregnant women at the Puskesmas Sepatan, Tangerang District in 2021. For midwives to be more observant in examining preeclampsia, especially age (<20 years or> 35 years), mothers who are pregnant for the first time, have a history of disease, pregnancy with multiple fetuses and nutritional status who are overweight in pregnant women

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Education, Knowledge and Nutritional Status of Elderly in Elderly Integrated Service Post Working Area of Bentiring Community Health Center Bengkulu

Jurnal Sains Kesehatan ◽

10.37638/jsk.25.1.9-17 ◽

2018 ◽

Vol 25 (1) ◽

pp. 9-17

Author(s):

Nurul Khairani ◽

Santoso Ujang Effendi ◽

Desi Kurnia Putri

Keyword(s):

Nutritional Status ◽

Community Health ◽

Health Center ◽

Nutrition Education ◽

Significant Relationship ◽

Community Health Center ◽

Primary Data ◽

Bivariate Analysis ◽

Cross Sectional ◽

Integrated Service

This study was based on the still high nutrient deficiency of elderly in the working area of Bentiring Community Health Center Bengkulu. This study aimed to study the relationship between education and knowledge with nutritional status of elderly in Elderly Integrated Service Post working area of Bentiring Community Health Center Bengkulu. The research type was Analytical Survey and the desain of research was Cross Sectional. The population of this study was all elderly who visited Elderly Integrated Service Post in the working area of Bentiring Community Health Center Bengkulu in January to April 2017 which amounted to 52 elderly. Sampling technique in this research used Total Sampling. The data collected in this study used primary data and secondary data with data analysis technique done by univariate and bivariate analysis with Chi-Square test (c²) through SPSS 16 program. The result of this research were : from 52 elderly, there were 35 elderly (67,3%) with basic education, 27 elderly (51,9%) who had less knowledge, 20 elderly (38,5%) had less nutritional status, there was significant relationship between education with nutritional status of elderly with medium category, and there was a significant relationship between knowledge with nutritional status of elderly with close category. It was expected to Bentiring Community Health Center Bengkulu to improve health services to the elderly by providing nutrition education and medical examination for elderly. Keywords : education, elderly, knowledge, nutritional status, elderly

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Nutritional Status of Tuberculosis Patients in Against Serum Glutamate Pyruvate Transaminase Levels

MAGNA MEDICA: Berkala Ilmiah Kedokteran dan Kesehatan ◽

10.26714/magnamed.1.3.2016.14-17 ◽

2021 ◽

Vol 1 (3) ◽

pp. 14

Author(s):

Iqbal Donarika Widagdo ◽

Setyoko Setyoko ◽

M. Riza Setiawan

Keyword(s):

Nutritional Status ◽

Rank Correlation ◽

Test Results ◽

Spearman Rank Correlation ◽

Glutamate Pyruvate Transaminase ◽

Tuberculosis Patients ◽

Spearman Rank ◽

Serum Glutamate Pyruvate Transaminase ◽

Glutamate Pyruvate ◽

Serum Glutamate

Background: Treatment of Tuberculosis patients are given in the form of a drugs combination. Some drugs which are Pyrazinamide, Isoniazid and Rifampicin can provide hepatotoxic side effects. Specific sign of hepatotoxic occurrence is increasing in the Serum Glutamate Pyruvate Transaminase levels. One of factors that influence hepatotoxicity is nutritional status. This study aims to determine the relationship between nutritional status and levels of Serum Glutamate Pyruvate Transaminase in tuberculosis patients.Methods: A non-experimental correlation study, retrospective approach with total sampling method, according to inclusion and exclusion criteria. Located at tCommunity Lung Health Center (BKPM) Ambarawa area. The analysis used the Spearman rank correlation testResults: Based on the test results of Spearman Rank correlation test, the correlation coefficient (r) is -0.267. Hypothesis test results also showed 0.037 (p-value <0.05), which means the existence of a significant correlation between variabels.Conclusion: There is a relationship between nutritional status and levels of Serum Glutamate Pyruvate Transaminase in tuberculosis patients.

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FACTORS ASSOCIATED WITH THE NUTRITIONAL STATUS IN TODDLERS IN PUBLIC HEALTH CENTER LUBUK KILANGAN

Human Care Journal ◽

10.32883/hcj.v1i3.27 ◽

2018 ◽

Vol 1 (3) ◽

Author(s):

Okta Vianis

Keyword(s):

Nutritional Status ◽

Health Center ◽

Exclusive Breastfeeding ◽

Significant Relationship ◽

Random Sampling ◽

Family Income ◽

P Value ◽

Cross Sectional ◽

Factors Associated ◽

Nutritional Status Of Children

Based on monitoring reports nutritional status of children in Lubuk Kilangan Puskesmas Padang in 2014, from 291 infants who weighed by BB / U, known malnutrition by 10 people (3.44%), malnutrition as many as 54 people (18.56%), and good nutrition as much as 222 (76.3%). The purpose of this study to see if Factors Associated with the Nutritional Status In Toddlers in Sub Bandar Buat Padang District of Lubuk Kilangan 2016.Types and methods of this research is analytic survey with cross sectional design. The research was conducted in the village of Lubuk Kilangan Bandar Buat District of Padang in May 2016. The population is all the mothers who have children amounted to 755 people. Samples taken as many as 88 people with cluster random sampling techniques and sample used for the randomization Simple Random Sampling technique. Data collected by using a questionnaire. Processing of data by univariate and bivariate data analysis performed using Chi-Square test.The results were obtained over the majority 51.1% children have malnutrition. Mothers who are knowledgeable low of 3.6%, which the family income <1.615 million as much as 47.7%. Mothers who do not give exclusive breastfeeding much as 52.3%. Of test statistics in get a significant relationship between the nutritional status of children with a mother knowledge (p value 0.000), there was a significant relationship between the nutritional status of children with family incomes (p value 0.000), and no significant correlation between the nutritional status of children with exclusive breastfeeding ( p value 0.034). It was concluded that there is a relationship between the nutritional status of children with the knowledge of the mother, family income and exclusive breastfeeding in Lubuk Kilangan Puskesmas Padang Year 2016. For the Lubuk Kilangan health center in order to do counseling at least 1 time a month on Nutrition in infants in order to improve knowledge of mothers on nutritional status.

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Pola Makan dan Obesitas berhubungan dengan Riwayat Kejadian Hipertensi di Puskesmas Rawasari

Jurnal Akademika Baiturrahim Jambi ◽

10.36565/jab.v10i2.330 ◽

2021 ◽

Vol 10 (2) ◽

pp. 282

Author(s):

Filius Chandra ◽

Iswanto Iswanto ◽

Aisah Aisah

Keyword(s):

Nutritional Status ◽

Health Center ◽

Significant Relationship ◽

Communicable Disease ◽

Sampling Technique ◽

Chi Square ◽

Cross Sectional ◽

Cross Sectional Design ◽

Chi Square Analysis ◽

The Relationship

Hypertension is a non-communicable disease (PTM) which is a very serious health problem both in the world and in Indonesia. One sign of hypertension is an increase in blood pressure. Hypertension is called the silent killer, because people with hypertension often show no symptoms. The research objective was to determine the relationship between diet and obesity with the incidence of hypertension at the Rawasari Public Health Center in Jambi City in 2019.This study used a cross sectional design, which was carried out in August 2019, 64 hypertension respondents at the Rawasari Health Center were taken using purposive sampling technique. The research variables were diet and obesity which were analyzed using the chi-square test.This study showed that most respondents had hypertension (92.2%). most of the diet frequently (51.6%). and nutritional status (50%). Chi-square analysis showed that there was a relationship between diet and hypertension (p= 0.016) and chi-square analysis showed that there was no relationship between obesity and hypertension (p= 0.0162). There is no significant relationship between diet and hypertension, and there is no significant relationship between nutritional status and hypertension

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Performance of a New Global Chromogenic Assay for Protein C Pathway (HemosIL ThromboPath) in the Diagnosis of Lupus Anticoagulant and Antiphospholipid Antibodies.

Blood ◽

10.1182/blood.v112.11.2279.2279 ◽

2008 ◽

Vol 112 (11) ◽

pp. 2279-2279

Author(s):

Pierre A. Toulon ◽

Isabelle Martin-Toutain ◽

Jean-Charles Piette ◽

Marie-Claude Diemert ◽

Annick Ankri

Keyword(s):

Antiphospholipid Antibodies ◽

Arterial Thrombosis ◽

Lupus Anticoagulant ◽

Control Group ◽

Test Results ◽

Chromogenic Assay ◽

Apc Resistance ◽

Significant Difference ◽

History Of ◽

Test Result

Abstract Background: The HemosIL ThromboPath assay (Instrumentation Laboratory) is a new chromogenic assay designed to globally evaluate the functionality of the PC pathway. It is based on the ability of endogenous APC generated after activation of PC by a snake venom extract (Protac) to reduce the thrombin generation induced by a reagent containing tissue factor. Briefly, optical density is measured after addition of a thrombin-specific chromogenic substrate in the presence (OD A) or absence (OD B) of Protac. It is recommended by the test manufacturer to express results as the Protac-Induced Coagulation Inhibition percentage (PICI%) which corresponds to the ratio [OD B - OD A]/OD B x 100. Previous studies demonstrated a high sensitivity (over 96%) for PC pathway abnormalities i.e. PC/PS deficiency, and FV Leiden-related APC Resistance, but also for lupus anticoagulant (LA), known to be associated with acquired APC Resistance. The aim of the present study was to evaluate the sensitivity of that assay for antiphospholipid antibodies (APL), especially in connection with the occurrence of thrombotic complications. Actually, APL is a heterogeneous family of antibodies which have a significant impact on coagulation tests (LA) or could be detected using ELISA anticardiolipin assays (ACL). Methods: We retrospectively evaluated the frozen plasma samples from 178 patients previously diagnosed as positive for LA or as having high ACL levels. There were 48 M and 130 F with a mean age=43 years (range 14 – 87). None was on vitamin K-antagonist. Screening for LA, performed according to the ISTH criteria (Thromb Haemost1995;74:1185), was positive in 126 patients (LA+ patients) and negative in 52 patients, all of the latter having high ACL levels (LA- patients). Among LA+ patients, 41 had antiphospholipid syndrome (APS) i.e. 18 with a history of venous thrombosis (VT), 10 with arterial thrombosis (AT), 7 with obstetrical complication (OB) and 6 with combined vascular complications (CVC). The same applied to 39 LA- patients with high APL levels i.e. VT (n=13), AT (n=8), OB (n=12) and CVC (n=6). The control group consisted of 29 age- and sex-matched healthy subjects without a history of vascular or auto-immune disease. The HemosIL ThromboPath assay was performed by an operator blinded of the specific biological test results and of the clinical status of the patients. Results: Test result was significantly lower in LA+ patients than in LA- patients or in healthy controls (Table). Similarly, the percentage of abnormal test results i.e. PICI% below 85.0% as the cut-off value, was significantly higher in LA+ patients than in the two other groups (p<0.0001 in both cases). That cut-off value for the PICI% was determined, according to the recommendations of the reagent manufacturer, as the mean minus 1 SD of the values measured in the plasma of 29 healthy control subjects. Despite significantly lower PICI% in LA- patients than in controls (p<0.05), the proportion of abnormal test results was not significantly different (p<0.10) in these two groups. LA+ Patients (n=126) LA-Patients (n=52) Controls (n=29) Test Result (PICI%) 74.5 ± 13.1 86.7 ± 9.4 90.3 ± 5.3 PICI%<85% (n, %) 99 (78.6%) 15 (28.8%) 3 (10.3%) Moreover, test result was not significantly different in LA+ patients with and without a history of vascular thrombosis (PICI%=74.4 ± 12.9, n=51 vs. 74.5 ± 13.5 n=75, p=0.91) and the same applied for the percentage of abnormal test results (n=41/51 (80.4%) vs. n=58/75 (77.3%); p=0.83). There was no significant difference between LA+ patients with venous, arterial thrombosis and obstetrical complications. Conclusion: The HemosIL ThromboPath assay was highly sensitive for LA (78.6%) but it did not allow to distinguish between LA+ patients those with APS. It was found to be weakly sensitive (28.8%) to high ACL levels without LA activity, despite a higher percentage of abnormal test results. The potential interest of the HemosIL ThromboPath assay as part of the screening strategy of LA deserves to be further investigated prospectively.

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STUDI MENGENAI STATUS GIZI BALITA

Jurnal Kebidanan Malahayati ◽

10.33024/jkm.v7i1.3068 ◽

2021 ◽

Vol 7 (1) ◽

pp. 131-138

Author(s):

Syarifa Amalia Alhamid ◽

Bunga Tiara Carolin ◽

Rosmawaty Lubis

Keyword(s):

Infectious Diseases ◽

Nutritional Status ◽

Health Center ◽

Family Income ◽

Health Workers ◽

Health Centre ◽

Correlation Study ◽

Chi Square ◽

Cross Sectional ◽

History Of

ABSTRACT: A STUDY OF THE NUTRITIONAL STATUS OF TODDLERS Background: Nutrition is a very important part of the growth and development of toddlers which is related to health and intelligence. In 2019, the prevalence of malnutrition in Bula District Seram was 10.2%, malnutrition was 4.3% and over nutrition was 5.1%, where the incidence rate was increased from the previous year.Objective: To determine the factors related to the nutritional status of toddlers in the Bula Health Center, East Seram District, Maluku Province.Methodology: This study is a cross sectional correlation study. The samples in the study were all women who had children aged 1-5 years who visited the Bula Health Center, East Seram Regency, Maluku Province in 2020 which consisted 76 toddlers. The research instrument was a questionnaire, data analysis using the chi square test.Results: the results showed that malnourished toddlers were 59.2%, women with poor knowledge were 76.3%, women who had low level education were 63.2%, women with low family income were 72.4%, women who did not work were 55.3%, women who did not provide breast feeding was 71.1% and toddlers who had the history of infectious diseases were 71.1%. The bivariate results obtained knowledge (p=0,022), education (p=0,048), income (p=0,002), occupation (p=0,088), history of breastfeeding (p=0,001) and a history of infectious diseases (p=0,020).Conclusions: There is a relationship between knowledge, education, family income, history of breastfeeding, and a history of infectious diseases with the nutritional status of toddlers.Suggestions: It is hoped that health workers can provide education about nutrition to mothers, so that they could pay more attention to the nutritional status of their toddlers.Keywords: Toddler, Bula Health Centre, Nutritional Status ABSTRAK Latar belakang: Gizi menjadi bagian sangat penting dalam pertumbuhan dan perkembangan balita yang didalamnya memiliki keterkaitan yang erat hubungannya dengan kesehatan dan kecerdasan. Pada tahun 2019 di Puskesmas Bula Kabupaten Seram prevelnsi gizi kurang sebesar 10,2%, Gizi Buruk 4,3% dan gizi lebih 5,1% dimana angka kejadian ini menigkat dari tahun sebelumnya.Tujuan: Mengetahui faktor yang berhubungan dengan status gizi balita di Wilayah Puskesmas Bula Kabupaten Seram Bagian Timur Provinsi Maluku.Metodologi: Penelitian ini adalah penelitian korelasi dengan cross sectional. Sampel dalam penelitian adalah semua ibu yang mempunyai balita usia 1-5 tahun yang berkunjung ke Puskesmas Bula Kabupaten Seram Bagian Timur Provinsi Maluku tahun 2020 berjumlah 76 balita. Instrumen penelitian adalah kuesioner, analisis data menggunakan uji chi square.Hasil penelitian: Pada hasil didapatkan balita gizi kurang (59,2%), ibu berpengetahuan kurang baik (76,3%), ibu berpendidikan rendah (63,2%). pendapatan keluarga rendah (72,4%), ibu yang tidak berkerja (55,3%), ibu yang tidak memberikan ASI (71,1%) dan balita yang memiliki riwayat penyakit infeksi (71,1%). Hasil bivariat didapatkan pengetahuan (p=0,022), pendidikan (p=0,048), pendapatan (p=0,002), pekerjaan (p=0,088), riwayat ASI (p=0,001) dan riwayat penyakit infeksi (p=0,020).Kesimpulan: Terdapat hubungan antara pengetahuan, pendidikan, pendapatan keluarga, riwayat ASI, dan riwayat penyakit infeksi dengan status gizi balita.Saran: Diharapkan kepada petugas kesehatan dapat memberikan edukasi mengenai gizi kepada ibu agar lebih memperhatikan status gizi balitanya. Kata Kunci: Balita, Puskesmas Bula, Status gizi

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HUBUNGAN STATUS GIZI DAN RIWAYAT PENYAKIT IBU DENGAN KEJADIAN BERAT BADAN LAHIR RENDAH DI RUMAH SAKIT MUHAMMADIYAH PALEMBANG TAHUN 2016

Jurnal Kebidanan : Jurnal Medical Science Ilmu Kesehatan Akademi Kebidanan Budi Mulia Palembang ◽

10.35325/kebidanan.v8i1.123 ◽

2019 ◽

Vol 8 (1) ◽

Author(s):

Wulan Citra Sari Wulan Citra Sari

Keyword(s):

Nutritional Status ◽

Significant Relationship ◽

Quantitative Research ◽

Univariate Analysis ◽

World Health ◽

Bivariate Analysis ◽

P Value ◽

History Of Disease ◽

History Of ◽

Health Organization

ABSTRAK Data World Health Organizationmenurut WHO (2010) diperkirakan 15% diseluruh kelahiran didunia dengan batasan 3,3%-3,8% dan lebih sering terjadi di negara berkembang atau ekonomi rendah.Tujuan Penelitian Diketahuinya hubungan status gizi dan riwayat penyakit ibu dengan kejadian BBLR di RumahSakit Muhammadiyah Palembang Tahun 2016. Populasi dalam penelitian ini adalah semua ibu bersalin 1881responden.Sampel pada penelitian ini adalah sebagian ibu bersalin 236 responden. Penelitian ini menggunakan desain penelitian kuantitatif dengan pendekatan Case Contro. di Rumah Sakit Muhammadiyah Palembang Tahun 2016. Analisa univariat Hasi penelitian ini yang BBLR pada kelompok kasus118 sedangkan yang tidak BBLR 118, dengan nilai OR 1:1 berdasarkan analisa bivariat didapat tidak ada hubungan yang bermakna antara status gizi dengan kejadian (p value=1,00) dan mengalami riwayat penyakit 117 dan tidak mengalami riwayat penyakit 119 menunjukan tidak ada hubungan yang bermakna antara riwayat penyakit dengan kejadian BBLR (p value=0,60). Hasil penelitian ini diharapkan dapat menjadi bahan masukan bagi rumah saki tmuhmmadiyah untuk lebih meningkatkan mutu dan upaya pelayanan di rumah sakit. ABSTRACT World Health Organization data according to WHO (2010) is estimated 15% in all births in the world with a limit of 3.3% -3.8% and is more common in developing countries or low economies. Research Objectives Knowing the relationship of nutritional status and history of maternal disease with LBW occurrence in Hospital Muhammadiyah Palembang 2016. Population in this research is all maternal mother 1881responden.Sampel in this research is partially mother of 236 respondents. This research uses quantitative research design with Case Contro approach. at the hospital MuhammadiyahPalembang in 2016. Univariate analysis The result of this study is BBLR in the case group118, while those who are not BBLR 118, with OR 1: 1 score based on bivariate analysis, there is no significant relationship between nutritional status and occurrence (p value = 1, 00) and a history of disease 117 and no history of disease 119 showed no significant relationship between history of disease with the incidence of BBLR (p value = 0.60). The results of this study are expected to be input for Hospital muhammadiyah palembang to further improve the quality and service efforts in hospitals.

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The Analysis of Complications of Tuberculosis Sufferers Due to History of Drug Breakup in The Area of Puskesmas Puri Mojokerto Regency

Jurnal Ners dan Kebidanan (Journal of Ners and Midwifery) ◽

10.26699/jnk.v8i2.art.p166-170 ◽

2021 ◽

Vol 8 (2) ◽

pp. 166-170

Author(s):

Lutfi Wahyuni ◽

Inna Octavia ◽

Norma Cindy Erlina

Keyword(s):

Immune System ◽

Infectious Diseases ◽

Nutritional Status ◽

Treatment Period ◽

Early Stage ◽

Sampling Technique ◽

Patient Treatment ◽

Test Results ◽

Pulmonary Tb ◽

History Of

Pulmonary TB disease is one of the priorities of eradication of infectious diseases. Early-stage drug breakup occurs if the patient does not take medication 2 months in a row or more before the treatment period is complete. Drug breakups result in patients being resistant to OAT (Anti-Tuberculosis Drugs) and can lead to complications. This study aimed to analyze the occurrence of complications of tuberculosis sufferers due to a history of drug breakup. The design in this study was Correlation Analytics with Retrospective approach methods. The population in this study was all TB sufferers who had a history of drug breakups and complications. The sampling technique in this study was Non-Probability Sampling with purposive sampling type. The sample was 30 respondents. The instruments were interview for the history of drug breakup and patient treatment cards and observation and status of patient as the instruments of complications. Spearman Rho test results showed that value = 0.055 or more than α (0.05) which meant there was no correlation between the history of drug breakup with complications of tuberculosis. Based on this study, it could be concluded that the complications of tuberculosis that occur not only because of drug breakup factors but can be due to the spread of increasingly widespread germ infections, the immune system of the sufferers who are lacking, tuberculosis concomitant diseases, nutritional status of tuberculosis sufferers, and also knowledge from TB sufferers who lack the awareness to maintain health.

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