RESEARCH PROPOSAL

BY: II IFTAH AZIZAH

TITLE: The Effect of Mycobacterium tuberculosis on the rate of Condensed Tuberculosis

INTRODUCTION
Pulmonary or tuberculosis is a respiratory disease caused by a mycobacterium
tuberculosis. These bacteria can also infect other organs such as digestive systems, lymphatic
systems, skin, central nervous systems, musculoskeletal systems, liver and reproductive
systems. Pulmonary tuberculosis can be transmitted through aerosols from the mucus lining
of patients infected with mycobacterium tuberculosis.

Tuberculosis (TB) is a major public health problem. According to who (world health
organization), a third of the world's population are infected with tuberculosis, nine million
new cases and three million die each year, 95% of tuberculosis and 98% of tuberculosis
deaths occur in developing countries, where 75% of them are still in working age. In
developing countries, TB deaths account for 25% of all preventable deaths.. Pulmonary
tuberculosis comprises 80% of the total tuberculosis and the remaining 20% is pulmonary
tuberculosis. It is estimated that one third of the world's population is infected with
mycobacterium tuberculosis (NHS, 2008).

Ri's ministry of health reports that Indonesia currently has some 824 thousand
tuberculosis (TB) in Indonesia. This makes Indonesia one of the third-highest contributors to
the TB case after India and China. Tuberculosis is not just a health problem but is closely
linked to economic and social welfare. Like its infection, tuberculosis afflicts many poor
people living in shantytowns. Frequent infections, known as droplet infections, allow basil
tuberculosis to enter alveoli. Infections are easier to occur in close, long-term relationships
with active pulmonary tuberculosis. Therefore, coordinated effort was required to accelerate
the decline in lung tuberculosis in Indonesia (misnadiarly, 2006).

Efforts can be made to reduce the pulmonary tuberculosis in Indonesia, where a

premature diagnosis is made. The diagnosis of the pulmonary tuberculosis laboratory can be
confirmed by the discovery of acid resistant basil (bta), among other things through
microscopic examination (nines, 2008).
 Generally all with TB have common symptoms, such as moveting, bloody coughing,
limp, weight loss, rising body temperature, frequent night sweats, changes in the number of
white blood cells, and an increase in led over two weeks. The increased value of blood
clotting in tuberculosis is caused by the increased process of clotting red blood cells
(hemagluates), a change in plasma proteins relating to chronic reactions caused by
mycobacterium tuberculosis. Therefore, a check for clotting blood in tuberculosis patients can
be used as a monitor during active tuberculosis infections.

The rate of condensed blood or in its English of erythrocyte sedeimentation rate (esr) is
one of routine blood tests to determine the rate of inflammation in the human body. The
polish physician Edmund faustyn biernacki first discovered the process for sneaking around
blood in 1897. In 1918, the Swedish pathologist and hematologist Robert sanno fahraeus
developed a biernack invention and used a speed neck test as a pregnancy test. Further, in
1921, westergreen alf vielhelm introduced the method of westergreen for measuring the speed
of the red blood cell in an article about blood tuberculosis in the lungs (gandasoebrata, 2010).

This fastest-humping procedure is measured by inserting blood into led special tubes in
a vertical position for an hour. Red blood cells will be deposited at the bottom of the tube
while blood plasma will float on the led's surface (danusantoso, 2012). The functions of speed
clotting blood, which is to help diagnose the trip of disease and to succeed in chronic therapy,
such as tuberculosis. Based on the above description, researchers study the effects of
mycobacterium tuberculosis of the disease of bacterial blood (leds) patients with lung
tuberculosis.

RESEARCH QUESTION

1. Definition of Tuberculosis?
2. Definition of Mycobacterium tuberculosis?
3. How is Tuberculosis transmitted?
4. What is the History of Tuberculosis?
5. What are the classifications of tuberculosis?
6. How to Diagnose Tuberculosis?

PURPOSE OF THE STUDY

 1. Knowing the definition of tuberculosis
2. Identifying the definition of mycobacterium tuberculosis
3. Learning how to speak speak
4. Recognizing the history of tuberculosis
5. Recognizing the class of tuberculosis
6. Figuring out how to diagnose tuberculosis

LITERATURE RIVIEW

A. Tuberculosis
1. Definition of Tuberculosis

Tuberculosis (TB) is an infectious disease caused by the bacteria belonging to the

mycobacterium tuberculosis. The source of the infection is bta-positive TB sufferers via their
droplet phasing out. TB patients with bta-negative results still have a chance of contracting
TB. The infection occurs when others inhale the air that contains a contagious cheep. When a
patient coughs or sneezes, patients spread bacteria into the air in the form of droplet nuclei
(nuclear droplet). A single cough can produce about 3 thousand splashes (ministry of ri,
2014). TB policy is implemented in Indonesia by promoting cooperation and partnerships
between government, non-government, private, and society in the form of a unified TB
response national movement (2014).

2. Mycobacterium tuberculosis

Mycobacterium tuberculosis is the bacteria aerob is commonly found in the many areas
of the air. Mycobacterium tuberculosis was identified by Robert Koch in 1882.
Mycobacterium can't hold heat and die at 60 oc temperatures for 15-20 minutes. The bacteria
provide tubercle bacilli, a thin, slender stem that can be straight or bent, about 2- mm (2- mm)
long and 0.2-0.5 mm (0.5 mm) wide, chained together. The microsize of the bacteria depends
on environmental conditions (danusantoso, 2007).

Mycobacterium tuberculosis can survive dry air and cold conditions. These bacterial
cultures could die within two hours of direct sunlight. Mycobacterium can survive phlegm for
20, 30 hours. Basil could stand in dahak for 8-10 days. The basil culture survived room
temperature for 6-8 months and could be stored in a cabinet at 20 oc for 2 years (danusantoso,
2007). Mycobacterium tuberculosis is so small that they can pass through the bronkus
containment system and move into alveoli and live there. In alveolus, the bacteria reproduces,
breaking up into macro-pulmonary cytoplasm, causing inflammation in the lungs (nines,
2008).

3. How to Transmit

Tuberculosis of the lungs is transmitted through fluid droplet inhalation extracted from
the lungs of those with tuberculosis bacteria during coughing, sneezing, laughing, and
talking. People who live with active TB are at the highest risk of contracting because it
usually takes a long time to become infected. Children under 5 years of age and people with
weak immune systems are at the highest risk of having active tuberculosis after infection.

Tuberculosis is not contagious by touching objects and thus avoiding the use of
separate household items (such as flatware, glass, or washcloth). After 2-3 weeks of proper
treatment, patients usually cease to be able to transmit TB. People can return to their daily
activities while continuing their medication. If tuberculosis does not invade the lungs,
transmission to others is not a serious risk.

4. History of Tuberculosis
a) Primary tuberculosis infection

Primary infections occur when one has first contact with the tuberculosis bacteria.
Droplet is so small that it can travel through the bronkial defense system and continue its
journey until it reaches the last alveolus and remains there. The infection began when the
tuberculosis bacteria multiplied by splitting in the lungs, causing inflammation in the lungs.
Detection of tuberculosis in young patients or children is marked with a small focus in one
lung, visible only in radiograph imaging and tuberkulin samples (soeparman 1990).

b) tuberculosis after the primary infection

Bacteria that are dormant in primary tuberculosis appear after endogenous and exotic
bacteria. Usually primary infections are caused by a decline of cellular immunity from
diabetes, AIDS, and poor nutrition status. Dormant TB basil (dormant) may be dormant
again. This process is called endogen infection, whereas exgenic infections occur when the
number of pulmonary tubercle bacilli increases because of increased local tuberculosis. If the
immune system works properly even after tuberculosis, the body will at least cure itself, but
scars will remain scarring (fibrotic process) and freckles. It can be concluded, therefore, that
child tuberculosis is usually primary, whereas tuberculosis in adults is a secondary
tuberculosis of endogenous infections (h. tabrani rab).

5. Treatment of tuberculosis
According to the sputum examination, pulmonary tuberculosis is divided into:
A. tuberculosis of positive lung bta
1. at least 2 of the three sputum SPS test results.
2. 1 sputum SPS test results positive and chest x-rays showing active TB.

B. tuberculosis of lungs is negative

Three sputum SPS came back negative and chest x-rays showed active tuberculosis. X -
rays of positive lung TB are divided by the severity of the disease, which is light and heavy.
Severe form when chest x-rays show extensive lung damage (such as the "fat advanced" or
millier) or the general state of ill patients (nkes, 2003).

6. Diagnosis of tuberculosis

Phlegm examinations serve to assess diagnosis, evaluate treatment successes, and

determine infections. Checkups for diagnosis were performed periodically by taking 3
samples from dahak collected during two days of successive visits as phlegm (SPS):

a. s (at): it was contained at the time suspected TB patients came to fasyankes for the
first time. The patient brought a potphead to take a check-up the next morning
b. p (morning): dahak is housed at home on the second morning, just after waking up.
The pot is taken and will be turned over to the health facility officer.
c. s (while): removal from the public on the second day of phlegm (2014).

RESEARCH METHODOLOGY

A. Research types

It used a kind of literary research. According to mestika zed (2003), literature or

literature research can be interpreted as related to methods of collecting library data, reading
and storage of research materials, and processing. Research on literature can also study
reference books and research findings of a previous type that will help to establish a
theoretical basis for the problem studied (sarwono, 2006). Literature, records, and reports
related to problems that would be solved (nazir, 2003) also refer to data collecting techniques.
According to sugiyono (2012), however, literature research is theoretical, reference and other
scientific literature relating to the culture, values and norms that developed in under study of
social situations.

The method of screening used is a speed check for blood clots in lung tuberculosis as
many as 30 patients consisting of 18 men and 12 women.

B. work procedure a speed sneak examination of blood

1) Method: westergreen
2) Principle: blood is mixed with a corresponding measure of anti-coagulant from which
the mixture is put into a tube of already known size (in ml), then left in a
perpendicular position for one hour, listing how high the plasma is to shear blood.
3) Tools:
 pipet westergreen
 shelf westergreen
 spuit 3cc
4) Reagensia:
 na solution. 3.8% citrat
5) Ingredients:
 edta blood.
6) How it works:
a. perform a function of the pen with a 2cc sterile syringe, adding it into a tube
containing edta's anti-coagulant solution, creating a solution.
b. with a sterile intravenous syringe of 1, 6 ml [0.4 ml] continue by sucking as much
as 0.4 solution of na. Citrat 3, 8% so gets 2, 0 ml mixed. Then mix it up
homogeneous.
c. enter the blood in pipet westergren through the 0 mm line, hold it up on the
stegreen rack upright, keep it steady for an hour.
d. read a high layer of plasma with a millimeter and the figures as the rate for
condensed blood.
7) normal value:
 boys 0.15 mm an hour
 women 0.20 mm an hour
RESULTS AND DISCUSSION

The result of the leds' examination of those affected by tuberculosis is that up to 30

persons consisting of 18 men and 12 women, it has been noted that 16 persons of affected
persons increased (88.9 %) and normal led only 2 = 11.1 %. Whereas women with an
increase in led value by 11 people (91.7%) and a normal person by 1 (8.3 %).

According to a study of 30 lung tuberculosis patients, led studies show an increase in

led both men and women. Increased blood clotting in lung tuberculosis patients is due to
acute or chronic infections. In other words, the growth of mycobacterium tuberculosis spread
or expand to climax.

After a close examination of blood clots in both male and female patients, 27 out of 30
sample TB (90%) have an increased rate for condensed blood. It identified a mycobacterium
tuberculosis infection that causes the increased leds.
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