ANALISIS HASIL PEMERIKSAAN TCM PADA PASIEN HIV DENGAN SUSPEK TB PUSKESMAS INDRALAYA

Latar Belakang: Ko-infeksi TB-HIV saling memperburuk; pasien HIV berisiko
18-21 kali lebih tinggi TB aktif. TCM GeneXpert direkomendasikan untuk deteksi
TB pada HIV karena sensitivitas tinggi pada beban bakteri rendah. Faktor klinis
demografis perlu diidentifikasi. Tujuan: Mengetahui gambaran hasil TCM dan
faktor yang berhubungan dengan hasil TCM pada pasien HIV suspek TB di
Puskesmas Indralaya, Ogan Ilir. Metode: Penelitian analitik observasional cross
sectional. Sampel total 27 pasien HIV suspek TB yang periksa TCM (Jan 2022-Des
2024) dari rekam medis. Variabel dependen: hasil TCM (MTB detected/not
detected); independen: usia, jenis kelamin, pendidikan, lama HIV, status ARV,
riwayat DM. Uji Fisher's Exact (95% CI). Hasil: Proporsi TCM positif 11,1%
(3/27), semua beban rendah, tanpa resistensi rifampisin. Pendidikan rendah
berhubungan signifikan (p=0,049; OR=22,0; 95% CI=1,33-364,5). Usia (p=0,697),
jenis kelamin (p=0,568), lama HIV (p=0,250), status ARV (p=1,000), dan DM
(tidak dianalisis) tidak signifikan. Kesimpulan: Pendidikan rendah merupakan
faktor risiko signifikan hasil TCM positif (risiko 22 kali lebih besar). Tanpa
resistensi rifampisin mengindikasikan efektivitas regimen TB saat ini. Perlu
peningkatan edukasi kesehatan sesuai literasi, terutama pendidikan rendah.

Background: TB-HIV co-infection exacerbates each other; HIV patients have an
18–21 times higher risk of active TB. GeneXpert TCM is recommended for TB
detection in HIV due to its high sensitivity even in paucibacillary conditions.
Clinical-demographic factors need to be identified. Objective: To determine the
profile of TCM results and factors associated with TCM results in HIV patients
with suspected TB at Indralaya Primary Health Center, Ogan Ilir. Method: This
was an observational analytical study with a cross-sectional design. A total of 27
HIV patients with suspected TB who underwent TCM examination (Jan 2022–Dec
2024) were sampled from medical records. Dependent variable: TCM result (MTB
detected/not detected); independent variables: age, sex, education level, duration of
HIV, ART status, and history of Diabetes Mellitus. Data were analyzed using
Fisher's Exact test (95% CI). Results: The proportion of positive TCM results was
11.1% (3/27), all with low bacterial loads, and no rifampicin resistance was found.
Low education level was significantly associated (p=0.049; OR=22.0; 95%
CI=1.33–364.5). Age (p=0.697), sex (p=0.568), duration of HIV (p=0.250), ART
status (p=1.000), and DM history (not analyzable) showed no significant
association. Conclusion: Low education level is a significant risk factor for
positive TCM results (22 times higher risk). The absence of rifampicin resistance
indicates the effectiveness of the current TB treatment regimen. Health education
improvement tailored to patient literacy levels, especially among those with low
education, is needed.