ABSTRACT
Background: Controlling tuberculosis (TB) determinant factors in Indonesia is one way to control TB in the community. A review is needed to explore risk factors for TB in Indonesia as the key strategies for accelerating the TB preventive program.The purpose of this review was to determine modifiable and non-modifiable risk factors for TB among adults in Indonesia. Materials and Methods: A meta-analysis was undertaken to review current studies related to modifiable and non-modifiable risk factors for TB among adults in Indonesia. A search of PubMed, ProQuest, and Google Scholar for related articles published (January 2000 until December 2023). The Pooled Odds Ratio (POR) from the acquired data were calculated with a 95% CI. The fixed and random effects analysis was performed. The results were presented as forest plots, and Begg's test and Egger's test were used to examine study bias. Review Manager (RevMan) 5.4 and Stata 14.2 were used to process and analyze all of the data. Results: This study results revealed the POR of non-modifiable risk factor (family history of TB) for TB among adults in Indonesia was 6.08 (95% CI 2.99-12.34). Based on modifiable risk factors, it is known that household contact have the highest POR (6.01, 2.57-14.04), followed by malnutrition (5.86, 2.50-13.69), inappropriate ventilation (5.57, 1.74-17.86), diabetes mellitus (4.92, 3.04-7.96), smoking behavior (3.24, 2.22-4.72), and low-income level (2.34, 1.42-3.87). Conclusion: Based on significant factors that are related to TB incidence, the results of this review may be valuable to the government in identifying the optimal strategy for TB prevention among adults.
ABSTRACT
Objective: The aim of this study is to determine the outcome of trastuzumab therapy for 6 or 12 months in patients with HER2 positive operable breast cancer who followed the national health insurance system in Indonesia. Methods: Data were extracted from medical records of Dr. M Djamil General Hospital Padang and Dharmais Cancer Hospital/ National Cancer Center Jakarta for post-operative breast HER-2 positive cancer patients treated with trastuzumab for 6 or 12 months who had been followed up for at least 5 years (January 1st in 2010 until December 31st in 2015). Disease free survival and overall survival rates and their relationship with trastuzumab duration was investigated using survival analysis (the Kaplan-Meier method and log rank test). Data were analyzed using the STATA program. Results: A total of 121 women fulfilled the criteria of the study, 80 who had received trastuzumab for 6 months and 41 patients who received 12 months' therapy. Disease free survival was 54 months (95% CI 45-63) compared with 63 months (95% CI 54-72), respectively. The log-rank test p value was 0.048 so the 12 months' treatment regime did result in a significantly lower probability of recurrence compared with the 6 months' regime (HR = 2.6). Analysis of the overall survival rate revealed median survival of 57 months (95% CI 49-64) for 6 months' therapy compared to 62 months (95% CI 53-72) for 12 months. However, the log-rank test p value of 0.073 indicated that the extra six months of therapy did not decrease the probability of death (HR = 2.4). Conclusion: Trastuzumab therapy for 12 months reduced the recurrence rate in post-operative breast HER-2 positive cancer patients but did not significantly reduce mortality.
