Lama Pemberian Obat Anti Tuberkulosa dan Kadar Zinc Serum Pasien Paru Anak (Studi Kasus di Kabupaten Bogor)

Abstract

LAMA PEMBERIAN OBAT ANTI TUBERKULOSA DAN KADAR ZINC SERUM PASIEN PARU ANAK (STUDI KASUS DI KABUPATEN BOGOR) Anti Tuberculosis Drugs Treatment Duration and Serum Zinc Level of Child Patients (A Case Study in Bogor District) ABSTRACT Background. Zinc is a potent mediator to body endurance against infection by affecting the function of the cellular immune system which act as the main response in tuberculosa infection. Low level of zinc in the blood, called hipozinsemia, is more often found in child tuberculosis (TB) patients who have not taken anti tuberculoses drugs than those who have received drug therapy. Several previous studies show that there were no different levels of zinc between intensive phase and follow-up phase of therapies, however others indicated contrary results. Objective. The purpose of study is to determine whether there is any differences of serum zinc levels in the intensive phase and follow-up phase of anti-tuberculosis drug as well as to assess the relationship between treatment duration and serum zinc levels. Method. A cross-sectional study design was used with research subjects were children aged 6-59 months who were taken anti-tuberculosis drugs in Bogor District, in 2013. Data analysis used was independent t test and correlation test. Results. There was significant mean difference of serum zinc levels between subject who took anti-tuberculosis drugs in the intensive phase compare to those in the follow-up phase (p=0.015).There was a significant positive correlation between the duration of treatment and the serum zinc levels after controlling nutritional status (r=0.363 p=0.003). Conclusion. Serum zinc levels will increase linearly with tuberculosis drugs treatment duration. A further research is needed to determine whether there is any benefit of zinc supplementation in the intensive phase. Keywords: anti tuberculosis drug, pulmonary tuberculosis, zinc. ABSTRAK Latar Belakang. Zinc merupakan mediator yang memiliki kemampuan terkait daya tahan tubuh untuk melawan infeksi dengan mempengaruhi fungsi sistem imun sel yang merupakan respons imun utama pada infeksi tuberkulosa (TB). Kadar zinc dalam darah yang rendah atau hipozinsemia lebih banyak ditemukan pada pasien TB paru anak yang belum mendapat obat anti tuberkulosa (OAT) dibandingkan pasien yang telah mendapatkan OAT. Beberapa penelitian sebelumnya ada yang menunjukkan kadar zinc tidak berbeda antara pemberian OAT fase intensif dengan fase lanjutan, namun ada juga yang menunjukkan hasil sebaliknya. Tujuan. Penelitian ini bertujuan untuk mengetahui ada tidaknya perbedaan kadar zinc serum saat pemberian OAT pada fase intensif dan fase lanjutan serta menilai keeratan hubungan antara lama pengobatan dengan kadar zinc serum. Metode. Desain penelitian potong lintang yang merupakan studi kasus TB paru pada anak umur 6-59 bulan di wilayah kerja puskesmas Kabupaten Bogor tahun 2013. Analisis data menggunakan uji t test tidak berpasangan dan uji korelasi. Hasil.Ada perbedaan rerata kadar zinc antara anak yang mendapatkan pengobatan di fase intensif dibandingkan yang mendapatkan pengobatan di fase lanjutan (p=0.015). Ada korelasi positif dan bermakna antara lama pengobatan dengan kadar zinc serum setelah faktor status gizi dikontrol (r=0.363 p=0.003) Kesimpulan. Kadar zinc serum akan meningkat seiring dengan jangka waktu terapi OAT yang diberikan. Perlu adanya penelitian lebih lanjut yang bertujuan untuk mengetahui ada tidaknya manfaat pemberian suplemen mikronutrien zinc pada fase intensif. Kata kunci: OAT, tuberkulosa paru, zinc.