Pendekatan terapi presisi berbasis bukti pada tuberkulosis paru di Sulawesi Selatan: Sebuah tinjauan literatur

Bachtiar Baso; Hermawan Hermawan; Marwan Ahmad Ganoko; Hasta Handayani Idrus

doi:10.33024/hjk.v20i2.3022

Authors

Bachtiar Baso Departemen Kesehatan Masyarakat, Fakultas Kedokteran, Universitas Megarezky
Hermawan Hermawan Prodi DIV Teknologi Laboratorium Medis, Fakultas Teknologi Kesehatan, Universitas Megarezky
Marwan Ahmad Ganoko Departemen Ilmu Patologi Klinik, Fakultas Kedokteran, Universitas Bosowa
Hasta Handayani Idrus Pusat Riset Biomedis, Organisasi Riset Kesehatan, Badan Riset dan Inovasi Nasional (BRIN)

Diagnostik Molekuler Evidence-Based Medicine Terapi Presisi Tuberkulosis Paru

Abstract

Background: Pulmonary tuberculosis remains a significant public health problem in Indonesia, including in South Sulawesi. The high burden of disease, delayed diagnosis, and increasing cases of drug resistance are major challenges in tuberculosis control. The development of the concept of precision therapy and evidence-based approaches opens up new opportunities to improve therapy success through management tailored to the patient's clinical, microbiological, and molecular characteristics.

Purpose: To review the scientific evidence related to precision therapy approaches for pulmonary tuberculosis and analyze the challenges and opportunities for implementing evidence-based therapy in South Sulawesi.

Method: A literature search was conducted using the PubMed, Scopus, and ScienceDirect databases. The article selection and synthesis process followed the PRISMA approach. A total of 312 initial articles were identified, and after screening based on relevance, year of publication, and methodological quality, 28 articles were included in the final analysis.

Results: The precision therapy approach in tuberculosis management includes the integration of rapid molecular diagnostics, drug susceptibility testing, pharmacogenomics, and individualized therapy regimen adjustments. This approach has the potential to increase treatment effectiveness, reduce the risk of drug resistance, and improve patient clinical outcomes. However, its implementation at the regional level, such as in South Sulawesi, still faces various obstacles, including limited diagnostic infrastructure, unequal access to technology, and the need to strengthen the capacity of human health resources.

Conclusion: The evidence-based precision therapy approach has significant potential to improve the quality of pulmonary tuberculosis management through more personalized and effective therapeutic strategies. However, strengthening diagnostic capacity, expanding access to molecular technology, and integrating health policies are needed to support the optimal implementation of precision therapy in South Sulawesi.

Keywords: Evidence-Based Medicine; Molecular Diagnostics; Precision Therapy; Pulmonary Tuberculosis.

Pendahuluan: Tuberkulosis paru masih menjadi masalah kesehatan masyarakat yang signifikan di Indonesia, termasuk di Sulawesi Selatan. Tingginya beban penyakit, keterlambatan diagnosis, serta meningkatnya kasus resistensi obat menjadi tantangan utama dalam pengendalian tuberkulosis. Perkembangan konsep terapi presisi dan pendekatan berbasis bukti membuka peluang baru dalam meningkatkan keberhasilan terapi melalui penatalaksanaan yang disesuaikan dengan karakteristik klinis, mikrobiologis, dan molekuler pasien.

Tujuan: Untuk meninjau berbagai bukti ilmiah terkait pendekatan terapi presisi pada tuberkulosis paru serta menganalisis tantangan dan peluang implementasi terapi berbasis bukti di Sulawesi Selatan.

Metode: Penelusuran literatur dilakukan melalui database PubMed, Scopus, dan ScienceDirect. Proses seleksi dan sintesis artikel mengikuti pendekatan PRISMA. Sebanyak 312 artikel awal ditemukan, kemudian setelah proses skrining berdasarkan relevansi, tahun publikasi, dan kualitas metodologi, sebanyak 28 artikel dimasukkan dalam analisis akhir.

Hasil: Pendekatan terapi presisi dalam penatalaksanaan tuberkulosis mencakup integrasi diagnostik molekuler cepat, uji kepekaan obat, farmakogenomik, serta penyesuaian regimen terapi secara individual. Pendekatan ini berpotensi meningkatkan efektivitas pengobatan, menurunkan risiko resistensi obat, serta memperbaiki luaran klinis pasien. Namun, implementasinya di tingkat regional seperti di Sulawesi Selatan masih menghadapi berbagai kendala, termasuk keterbatasan infrastruktur diagnostik, akses teknologi yang belum merata, serta kapasitas sumber daya manusia kesehatan yang masih perlu diperkuat.

Simpulan: Pendekatan terapi presisi berbasis bukti memiliki potensi besar dalam meningkatkan kualitas penatalaksanaan tuberkulosis paru melalui strategi terapi yang lebih personal dan efektif. Namun demikian, diperlukan penguatan kapasitas diagnostik, perluasan akses terhadap teknologi molekuler, serta kebijakan kesehatan yang terintegrasi untuk mendukung implementasi terapi presisi secara optimal di Sulawesi Selatan.

Kata Kunci: Diagnostik Molekuler; Evidence-Based Medicine; Terapi Presisi; Tuberkulosis Paru.

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