KARAKTERISTIK KLINIS PASIEN YANG MENERIMA TERAPI ARV DI RSUD KABUPATEN BULELENG

2020 ◽  
Vol 6 (2) ◽  
pp. 212-216
Author(s):  
I Gusti Ngurah Putu Candra ◽  
Dewi Aprelia Meriyani ◽  
Luh Putu Desy Puspaningrat ◽  
Yopita Triguno ◽  
Ni Kadek Ayu Tamara Widya Sari
Keyword(s):  

  ABSTRAK Latar Belakang Penyakit menular yang selalu memberikan dampak tidak hanya kesehatan tetapi social dan ekomoni adalha HIV/AIDS.Tujuan untuk mendeskripsikan kondisi klinis dan dmeografi pasien yang menerima terapi ARV.MetodePenelitian deskriptif dengan pendekatan secara kohort retrospektifmenggunakan data sekunder dari register kohort ARV dari tahun 2005-2015 (11 tahun terapi ARV). Analisis yang digunakan adalah analisis univariat menggunakan SPSS versi 17.Hasil Karakteristik klinis dan demografi pada odha yang menerima terapi ARV yaitu 45,32% dalam kondisi ambulatory, 75.42% mendapatkan regimen NNRTI jenis zidovudine, 75.82 % mendapatkan terapi regimen NRTI nevirapine, 79.66% pada kondisi stadium 3 dan 4, dengan klasifikasi umur produktif (< 40 tahun sebanyak 82.05%, sebagian besar berjenis kelamin laki-laki 62.96%, dan memiliki pengawas minum obat (PMO) sebesar 68.25%. Proporsi kematian sebesar  9.3 % (112 orang), LTFU (loss to follow up) 18.52% (223 orang), subsitusi regimen lini satu 9.88% (119 orang),rujuk keluar 1.83% (22 orang) dan yang masih dalam pengobatan sebesar 69.93% (842).Kesimpulan Pasien yang mengalami LTFU terbagi dalam beberapa kondisi yaitu LTFU dalam kondisi meninggal 3.07% (37 orang), LTFU dalam kondisi hidup 0.5% (6 orang), dan LTFU yang tidak diketahui kondisinya sebesar 14.95% (180 orang).Saran Monitoring dan evaluasi pada program pengobatan dilakukan secara berkelanjutan untuk meningkatkan konsistensi terapi yang dilakukan.  Kata Kunci : Karakteristik, Terapi, HIV/AIDS 

Author(s):  
Dame Evalina Simangunsong ◽  
Kandace Sianipar ◽  
Juliani Purba

Prevention of HIV transmission from mother to baby or Prevention of Mother to Child Transmission (PMTCT) is an effective and in achieving a broad objective in suppressing maternal and infant mortality related to the level of public health in a region.Public Health Center with VCT service in the city Pematangsiantar has not yet fully provide PMTCT to realize pregnant women for screening HIV/AIDS. Pregnant women with HIV/AIDS still have a loss to follow up, this is a threat to suppress the prevalence and incidence of HIV/AIDS. Obstetrics study Program which also integrates the promotion of HIV/AIDS and IMS into KIA service to be responsible in suppressing its spread. These research identified the behavior and perception of pregnant women's beliefs against HIV screening to determine the level of consciousness in conducted HIV screening. These research was a descriptive studied with cross sectional design. Pregnant women who were netted in the ANC Ministry were the populations in this study. Data analysis was conducted to see the behavior and perception of pregnant women's beliefs against HIV screening. Data processed with univariate analysis. Found 337 expectant mothers who perform ANC and as many as 194 people were not willing to do HIV screening. Found low-level, disagreement and low-action and low-confidence perception of HIV screening.It is necessary to conduct a strategy approach with personal counseling, peer-education and home visits in the net of pregnant women with HIV. Keywords: behavior; HIV; screening; perception ABSTRAK Pencegahan penularan HIV dari ibu ke bayinya atau Prevention of Mother to Child Transmission (PMTCT) adalah suatu cara yang efektif dan dalam mencapai tujuan yang luas dalam menekan angka kematian ibu dan bayi yang berkaitan dengan tingkat kesehatan masyarakat di suatu wilayah. Puskesmas dengan layanan VCT di kota Pematangsiantar belum sepenuhnya memberikan PMTCT untuk menyadarkan ibu hamil untuk screening HIV/AIDS. Ibu hamil dengan HIV/AIDS masih ada yang loss to follow up, hal ini menjadi ancaman dalam menekan prevalensi dan insiden HIV/AIDS. Program Studi Kebidanan Pematangsiantar yang turut mengintegrasikan Promosi HIV/AIDS dan IMS ke dalam pelayanan KIA ikut bertanggungjawab dalam menekan penyebarannya. Penelitian ini mengidentifikasi perilaku dan persepsi keyakinan ibu hamil terhadap screening HIV untuk mengetahui tingkat kesadarannya dalam melakukan screening HIV. Penelitian ini merupakan penelitian deskriptif dengan desain cross sectional. Ibu hamil yang terjaring dalam pelayanan ANCadalah populasi dalam penelitian ini. Analisis data dilakukan untuk melihat perilaku dan persepsi keyakinan ibu hamil terhadap screening HIV. Data diolah dengan analisis univariate. Ditemukan 337 ibu hamil yang melakukan ANC dan sebanyak 194 orang belum bersedia dilakukan screening HIV. Ditemukan pegetahuan yang rendah, sikap tidak setuju dan tindakan yang rendah serta persepsi keyakinan yang rendah terhadap screening HIV.Perlu melakukan strategi pendekatan dengan konseling pribadi, peer-edukasi dan kunjungan rumah dalam menjaring ibu hamil dengan HIV. Kata kunci: perilaku; HIV; screening; persepsi


2021 ◽  
Author(s):  
Pepukai Bengura

Abstract Background - Long-term regular follow-up and high retention are the anticipated outcomes for the wellness and longevity of HIV/AIDS patients on antiretroviral treatment. However, these anticipated outcomes are marred by patient loss to follow-up (LTFU) which is currently exacerbated by the Covid-19 pandemic. This study aims to determine the prevalence and potential risk factors to LTFU among HIV/AIDS patients on ART at two rural district hospitals in South Africa.Methods— This is a retrogressive observational study whereby a cohort of HIV/AIDS patients was retrospectively followed from 2010 to 2017 until loss to follow-up occurred or until the end of the observation period at Carolina and Embhuleni hospitals. An institutional based retrospective cohort study was undertaken among children, adolescents and adults living with HIV/AIDS and attending ART clinic between January 1, 2010 and June 30, 2017. Loss to follow up was defined as not taking an ART refill for a period of 90 days or longer from the last attendance for refill and not yet classified as ‘dead’ or ‘transferred-out’ patient. Patient information was obtained from the routine hospitals’ records, and the data were analysed using Generalized gamma distribution to identify the predictors of loss to follow up among HIV/AIDS patients while Kaplan-Meier model was used to estimate and compare the LTFU survival probabilities of heterogenous groups among the patients.Results— Of the 357 patients, 60.5% were female. The mean (SD) age of the cohort was 36.2 (14.1), 15.4 (3.5), and 5.1 (3.5) years for adults, adolescents, and children, respectively. From 357 HIV/AIDS patients, 93 (26.05%) were lost to follow-up. Empirical results show that the Weibull distribution gives the best fit to the data. The Weibull model determined the Factors associated with significant risk factors to patient loss to follow up as: regimen EFV+D4T+3TC [HR: 2.0 CI;(1.3–3.1)], regimen EFV+AZT+3TC [HR: 2.9 CI;(1.3–6.4)], regimen EFV+3TC+TDF [HR: 10.0 CI;(3.9–25.9)], regimen NVP+3TC+TDF [HR: 10.6 CI;(1.8–62.4)], follow up CD4 [HR: 1.0 CI;(1.0–1.0)], log(follow up viral load) [HR: 0.8 CI;(0.7–0.9)], marital status (married) [HR: 0.4 CI;(0.3–0.8)], marital status (cohabitation) [HR: 0.6 CI;(0.3–0.9)], ART adherence (fair) [HR: 2.4 CI;(1.3–3.4)], ART adherence (good) [HR: 4.6 CI;(2.2–9.5)] and age [HR: 1.02 CI;(1.0–1.04)]. Discussion— Effective control and tracing measures in the at-risk population and in defaulters need to be stepped up especially during this COVID-19 period, to improve retention in hospitals. There is also need for careful adherence counseling and assessment of medication supplies.Conclusion— LTFU is more pronounced among females and is highest among adolescents. Patients with increased risk for LTFU were consistent with ART regimens, viral load, age, CD4 count, adherence and marital status.


2021 ◽  
Author(s):  
Pepukai Bengura

Abstract Background - Long-term regular follow-up and high retention are the anticipated outcomes for the wellness and longevity of HIV/AIDS patients on antiretroviral treatment. However, these anticipated outcomes are marred by patient loss to follow-up (LTFU) which is currently exacerbated by the Covid-19 pandemic. This study aims to determine the prevalence and potential risk factors to LTFU among HIV/AIDS patients on ART at two rural district hospitals in South Africa.Methods— This is a retrogressive observational study whereby a cohort of HIV/AIDS patients was retrospectively followed from 2010 to 2017 until loss to follow-up occurred or until the end of the observation period at Carolina and Embhuleni hospitals. An institutional based retrospective cohort study was undertaken among children, adolescents and adults living with HIV/AIDS and attending ART clinic between January 1, 2010 and June 30, 2017. Loss to follow up was defined as not taking an ART refill for a period of 90 days or longer from the last attendance for refill and not yet classified as ‘dead’ or ‘transferred-out’ patient. Patient information was obtained from the routine hospitals’ records, and the data were analysed using Generalized gamma distribution to identify the predictors of loss to follow up among HIV/AIDS patients while Kaplan-Meier model was used to estimate and compare the LTFU survival probabilities of heterogenous groups among the patients.Results— Of the 357 patients, 60.5% were female. The mean (SD) age of the cohort was 36.2 (14.1), 15.4 (3.5), and 5.1 (3.5) years for adults, adolescents, and children, respectively. From 357 HIV/AIDS patients, 93 (26.05%) were lost to follow-up. Empirical results show that the Weibull distribution gives the best fit to the data. The Weibull model determined the Factors associated with significant risk factors to patient loss to follow up as: regimen EFV+D4T+3TC [HR: 2.0 CI;(1.3–3.1)], regimen EFV+AZT+3TC [HR: 2.9 CI;(1.3–6.4)], regimen EFV+3TC+TDF [HR: 10.0 CI;(3.9–25.9)], regimen NVP+3TC+TDF [HR: 10.6 CI;(1.8–62.4)], follow up CD4 [HR: 1.0 CI;(1.0–1.0)], log(follow up viral load) [HR: 0.8 CI;(0.7–0.9)], marital status (married) [HR: 0.4 CI;(0.3–0.8)], marital status (cohabitation) [HR: 0.6 CI;(0.3–0.9)], ART adherence (fair) [HR: 2.4 CI;(1.3–3.4)], ART adherence (good) [HR: 4.6 CI;(2.2–9.5)] and age [HR: 1.02 CI;(1.0–1.04)]. Discussion— Effective control and tracing measures in the at-risk population and in defaulters need to be stepped up especially during this COVID-19 period, to improve retention in hospitals. There is also need for careful adherence counseling and assessment of medication supplies.Conclusion— LTFU is more pronounced among females and is highest among adolescents. Patients with increased risk for LTFU were consistent with ART regimens, viral load, age, CD4 count, adherence and marital status.


2014 ◽  
Vol 2 (1) ◽  
pp. 81
Author(s):  
Desak Nyoman Widyanthini ◽  
Anak Agung Sagung Sawitri ◽  
Dewa Nyoman Wirawan
Keyword(s):  

Latar belakang dan tujuan: Loss to follow up (LTFU) yang rendah merupakan salah satu indikator keberhasilan program terapi antiretroviral (ARV). Kementerian Kesehatan Republik Indonesia melaporkan persentase kumulatif orang dengan HIV/AIDS (odha) LFTU tahun 2013 sebanyak 17,3%. Selama ini belum pernah dilakukan penelitian tentang LTFU pada odha di Bali, terutama berdasarkan beberapa karakteristik odha.Metode: Penelitian deskriptif longitudinal dilakukan dengan cara analisis data sekunder yaitu rekam medis odha yang memulai terapi ARV tahun 2002 sampai 2012 di Klinik Amertha Yayasan Kerti Praja (YKP). Sampel penelitian adalah seluruh pasien odha yang memenuhi kriteria, yaitu odha yang pertama kali menerima terapi ARV di Klinik Amertha dan mempunyai minimal dua kali kunjungan. Karakteristik yang diteliti adalah: umur, jenis kelamin, jenis pekerjaan, ada tidaknya pengawas minum obat (PMO), faktor risiko penularan HIV serta LFTU. Data yang digunakan hanya berdasarkan data yang tercatat pada rekam medis pasien. Data dianalisis secara deskriptif untuk mendapatkan karakteristik odha LTFU per 100 person years (PY). Untuk memperhitungkan lama waktu hingga terjadinya LTFU dilakukan analisis berdasarkan waktu.Hasil: Dari 548 sampel odha, 77 (14,1%) mengalami LTFU, dengan angka insiden kasar LFTU sebesar 5,15 per 100 PY. Median waktu terjadinya LFTU sampai akhir pengamatan tidak tercapai dalam penelitian ini, karena rendahnya insiden LTFU. Insiden spesifik LTFU lebih tinggi dijumpai pada perempuan (6,6 per 100 PY), umur yang lebih muda (6 per 100 PY), dan bekerja sebagai pekerja seks (7,3 per 100). Odha yang tidak memiliki PMO (9,3 per 100 PY) dan homoseksual (9,1 per 100 PY) juga memiliki insiden spesifik LTFU yang lebih tinggi.Simpulan: Insiden spesifik LTFU yang lebih tinggi dijumpai pada perempuan, umur yang lebih muda, bekerja sebagai pekerja seks, tidak memiliki PMO, dan homoseksual.


2021 ◽  
Vol 21 (1) ◽  
pp. 39-43
Author(s):  
Sara K Muli-Kinagwi ◽  
Meshack Ndirangu ◽  
Onesmus Gachuno ◽  
Samuel Muhula

Background: In 2011, 3.4 million children were living with HIV worldwide1. Objectives: Describe the characteristics of pediatric patients enrolled into the HIV program at the Kibera community health center between January 2012 and March 2013. Determine the proportion of enrolled paediatric patients lost to follow up. Determine the correlates associated with retention and loss to follow up. Methods: The study was a retrospective cohort study of program data of all pediatric patients enrolled into the HIV pro- gram in the facility between January 2012 and March 2013. The data was analyzed using SPSS. Results: Of the 100 pediatric patients enrolled during the study period, 79 and 21 were HIV negative and positive respec- tively. Only 4 (5%) of the HIV exposed Infants and 11 (52%) of the HIV positive children were started on ART within the study period. The retention rate of the children at 3 months was 87% while the retention at both 12 and 15 months was 79%. There was an association between the mother or guardian disclosing their status and the retention of the child (p-value 0.026). Conclusion: The disclosure of the HIV status by parent/guardian to the child was associated with better retention of the children in the program. Keyword: Pediatric patients in care; Kibera community health center; HIV/AIDS.


2021 ◽  
Vol 21 ◽  
pp. 39-43
Author(s):  
Sara K Muli-Kinagwi ◽  
Meshack Ndirangu ◽  
Onesmus Gachuno ◽  
Samuel Muhula

Background: In 2011, 3.4 million children were living with HIV worldwide1. Objectives: Describe the characteristics of pediatric patients enrolled into the HIV program at the Kibera community health center between January 2012 and March 2013. Determine the proportion of enrolled paediatric patients lost to follow up. Determine the correlates associated with retention and loss to follow up. Methods: The study was a retrospective cohort study of program data of all pediatric patients enrolled into the HIV pro- gram in the facility between January 2012 and March 2013. The data was analyzed using SPSS. Results: Of the 100 pediatric patients enrolled during the study period, 79 and 21 were HIV negative and positive respec- tively. Only 4 (5%) of the HIV exposed Infants and 11 (52%) of the HIV positive children were started on ART within the study period. The retention rate of the children at 3 months was 87% while the retention at both 12 and 15 months was 79%. There was an association between the mother or guardian disclosing their status and the retention of the child (p-value 0.026). Conclusion: The disclosure of the HIV status by parent/guardian to the child was associated with better retention of the children in the program. Keyword: Pediatric patients in care; Kibera community health center; HIV/AIDS.


2018 ◽  
Vol 7 (2) ◽  
pp. 98-103
Author(s):  
Thomas Laga Boro ◽  
Rafael Paun ◽  
Marthen R Pellokila

ABSTRACT Loss to follow-up of antiretroviral therapy is when PLWHA (People Living with HIV/AIDS) do not come for antiretroviral therapy for more than 3 months. This study aimed to determine the factors of loss to follow-up antiretroviral therapy for PLWHA at Prof. Dr. W. Z. Johannes Kupang Public Hospital where PLWHA with land, water and air transportation are served. This was a case control study with 66 samples of PLWHA. The samples underwent antiretroviral therapy in Prof. Dr.W.Z. Johannes Kupang Public Hospital from 2006 to 2016. Saturated sampling technique was done for cases group and simple random sampling was done for control group. Univariate and bivariate data analysis were done in this study. The result of bivariate analysis showed that there were association between intention (p = 0.004, OR = 4.667), self efficacy (p = 0.0001, OR = 7.875), action (p = 0.0001, OR = 45.000), transportation mode (p = 0.046, OR = 0.200), and transport costs (p = 0.0001, OR 19.333) and loss to follow-up antiretroviral therapy. It could be concluded that transportation and behavior were the major problems for the loss to follow up antiretroviral therapy in the islanded area.   Keywords: HIV/AIDS, antiretroviral therapy, loss to follow-up, islanded area   ABSTRAK Gagal follow-up antiretroviral therapy adalah  jika ODHA (Orang dengan HIV/AIDS) tidak menjalani terapi antireroviral lebih dari 3 bulan  terakhir. Penelitian ini bertujuan untuk mengetahui faktor-faktor gagal follow-up antiretroviral therapy pada ODHA di RSUD Prof. Dr. W. Z. Johannes Kupang yang melayani para ODHA dengan moda transportasi darat, air, dan udara. Desain penelitian ini adalah case control. Sampel sebanyak 66 ODHA yang menjalani antiretroviral therapy di RSUD Prof. Dr.W.Z. Johannes Kupang sejak tahun 2006 sampai 2016. Teknik pengambilan sampel yang digunakan adalah sampel jenuh untuk kelompok kasus dan simple random sampling untuk kelompok kontrol. Analisis data menggunakan prosentase untuk univariat dan bivariat. Hasil analisis bivariat menunjukkan ada pengaruh niat (p = 0,004, OR = 4,667), self efficacy (p = 0,0001, OR = 7,875), tindakan (p = 0,0001, OR = 45,000), moda transportasi (p = 0,046, OR = 0,200), dan biaya transportasi (p = 0,0001, OR 19,333) terhadap gagal  follow up terapi antiretroviral. Dapat disimpulkan bahwa masalah utama gagal follow up terapi antiretroviral di wilayah berkepulauan ini adalah transportasi dan perilaku.   Kata Kunci: HIV/AIDS,  terapi antiretroviral, gagal follow up, wilayah berkepulauan.


Sign in / Sign up

Export Citation Format

Share Document