Analisis Faktor Risiko Komordibitas Pasien Tuberculosis dan Pola Resistensi Mycobacterium tuberculosis di Rumah Sakit Daerah Gunung Jati
Abstract
Tuberculosis (TB) is a chronic infectious disease caused by Mycobacterium tuberculosis. The management of TB becomes more challenging with the emergence of drug resistance—particularly multidrug-resistant tuberculosis (MDR-TB)—and the presence of comorbidities. These factors not only reduce treatment success but also increase the likelihood of resistance. Several comorbidities such as diabetes mellitus, HIV infection, hypertension, kidney disease, cancer, other pulmonary diseases, psychiatric conditions, and malnutrition are known to worsen TB outcomes and elevate the risk of resistance. To identify and analyze comorbidity-related risk factors in TB patients and describe the resistance patterns of Mycobacterium tuberculosis at Gunung Jati Regional Hospital. Methods: An analytical observational study with a cross-sectional approach, employing univariate analysis, bivariate analysis (Fisher’s exact test), and multivariate analysis using logistic regression with the backward method, based on medical records of tuberculosis patients from January to November 2024 at Gunung Jati Regional Hospital. The most common comorbidity was malnutrition (75 patients, 32.9%). The most frequent resistance pattern was combined resistance to isoniazid (INH) and rifampin (RIF), identified in 33 patients (14.5%). Fisher’s exact test showed significant associations between drug resistance and the following comorbidities: diabetes mellitus (p < 0.001; OR = 4.42), HIV infection (p = 0.000; OR = 4.19), kidney disease (p < 0.001; OR = 4.81), other pulmonary diseases (p = 0.015; OR = 2.52), chronic hepatitis (p = 0.005; OR = 2.86), psychiatric conditions (p = 0.004; OR = 2.94), and malnutrition (p < 0.001; OR = 5.35). Comorbidities such as diabetes, HIV, kidney disease, other pulmonary diseases, chronic hepatitis, psychiatric conditions, and malnutrition are significantly associated with drug resistance
Keywords: Tuberculosis; Drug resistance; ComorbidityReferences
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