Angka kematian bayi (AKB) di Indonesia sangat tinggi. Berdasarkan Biro Pusat Statistik (BPS), AKB pada tahun 1995 adalah 55 bayi per 1000 kelahiran hidup. Salah satu penyebab utama kematian bayi adalah tetanus neonatorum, yang menempati urutan ke 3 (SKRT 1986 dan 1992). Upaya untuk mengeliminasi penyebab kematian terus dilakukan oleh Depatennen Kesehatan dengan target untuk menurunkan insiden tetanus neonatorum menjadi 1 per seribu kelahiran hidup pada tahun 2000. Salah satu kabupaten penyumbang kasus tetanus neonatorum adalah Kabupaten Indramayu dan Kabupaten Cirebon, walaupun ada kecenderungan menurun namun masih diatas target nasional. Penelitian ini bertujuan untuk mengetahui hubungan usia neonatus saat timbulnya gejala-gejala tetanus neonatorum dengan kematian akibat tetanus neonatorum di Kabupatan Indramayu dan Kabupaten Cirebon tahun 1996-2001 sehingga diketahui usia masa kritis neonatus yang menderita tetanus neonatorum untuk meninggal dunia. Rancangan penelitian ini adalah kasus kontrol dengan perbandingan jumlah kasus dan kontrol 1:1. Jumlah sample keseluruhannya adalah 160 neonatus yang menderita tetanus neonatorum, yang terdiri dari 80 kasus dan 80 kontrol. Sample adalah neonatus penderita teanus neonatorum yang berusia 3-28 hari yang tercatat pada Form T2 dan Medical record rumah sakit sejak 1 Januari 1996 sampai 31 Desamber 2001 di Kabupaten Indramayu dan Kabupaten Cirebon .Kasus adalah sample yang meninggal dan kontrol adalah sample yang hidup. Hasil penelitian pada analisa Muitivariat dengan uncondentional logistic regresion, variabel yang berhubungan dengan kematian akibat tetanus neonatorum secara bermakna (p<0.05) adalah usia neonatus yang menderita tetanus neonatorum, dimana neonatus yang menderita tetanus neonatorum yang berusia 7 hari atau kurang mempunyai risiko meninggal dunia 20.06 kali dibanding neonatus penderita tetanus neonatorum yang berusia lebih dari 7 hari, Penderita tetanus neonatorum yang dibawa ke rumah sakit pada hari yang ke 2 atau lebih setelah gejala pertama (tidak mau menyusu dan demam) mempunyai risiko meninggal dunia 6.95 kali dibandingkan dengan yang dibawa ke rumah sakit pada hari pertama setelah gejala pertama, neonatus yang menderita tetanus neonatorum yang diberi dosis obat antibiotik lebih rendah selama dirawat di rumah sakit mempunyai risiko meninggal dunia 4.34 kali di banding neonatus yang menderita tetanus neonatorum yang selama dirawat di rumah sakit di beri dosis obat antibiotik yang sesuai dengan Prosedur tata laksana kasus tetanus neonatorum di RSCM, Jakarta. Variabel kekebalan, antibiotik (jenis dan cara pemberian), anti kejang (jenis,dosis dan cara pemberian) dan cara pemberian ATS tidak berhubungan secara bermakna.(p>0.05) dengan kematian akibat tetanus neonatorum. Disarankan untuk perbaikan dan sosialisasi Protap Tata Laksana Kasus Tetanus Neonatorum baik di tingkat rumah sakit maupun Puskesmas, perbaikan surveillence kasus tetanus neonatorum dan intensifikasi upaya pencegahan tetanus neonatorum.

The Infant Mortality Rate (IMR) in Indonesia is still high. Based on Central Bureau of Statistics (CBS) the IMR in 1995 was 55/1000 live births. One of the main reasons on infant death is tetanus neonatorum that take a place on the third (Household Health Survey, 1986 and 1992). The effort to eliminate the cause of infant death is still conducted by 1hP MOH with the target to reduce incident of tetanus neonatorum become 111000 live birth on 2000. One the District that contributes the case of tetanus neonatorum is Indramayu and Cirebon Districts, even showing tend to reduce; however it is over with the national target. The objective of this study was to determine the relationship of neonatus' age when showing the indications of tetanus neonatorum with the death caused by tetanus neonatorum at Indramany and Cirebon Districts in 1996-2001. So it can be known the age on neonatus crisis time that is suffering tetanus neonatorum to death. The study design was control cases with the comparison; the number of cases group and control group was 1:1. The total number of sample was 160 neonatus tetanus neonatorum that covers of 80-cases group and 80-control group. The sample was the sufferer of tetanus neonatorum whose age was 3-28 days that registered on the T2 Form and Medical Record at the Hospital, since January 1st, 1996 - December 31s', 2001 both in lndramayu and Cirebon Districts. The cases were the samples whose was death and control was the sample that is still alive. The result of this study based on Multivariate analysis by unconditional logistic regression, It was showed that the variable which related to the death that caused by tetanus neonatorum significantly (p<0.05) was the age of neonatus. The sufferer of neonatus tetanus neonatorum whose the age is 7 days or less, they were having risk to death as 20.06 times compared with the neonatus tetanus neonatorurn whose age over than 7 days. The sufferer of tetanus neonatorum that brought to the Hospital on second day or more after first indication (reluctant to breast-feed and fever) having risk to death as 6.95 times compared with those whom brought to the Hospital on the first day after the first indication. The neonatus tetanus neonatorum who is given lower doses of antibiotic medicine during hospitalized having risk to death 4.34 times compared with whom that hospitalized gave doses of antibiotic medicine that meet with management diagnose, the cases at Cipto Mangun Kusumo Hospital, Jakarta. The variable of immune, antibiotic (type and method of giving), anti-seized (type, doses and method of giving) and the way in giving the ATS was not related significantly (p>0.05) with the death of neonatus caused by tetanus neonatorum. It is recommended to increase and socialize the protap of Management Tetanus Neonatorum Cases both in the level of Hospital and to the Health Center. It is needed to improve the surveillance on the case of tetanus neonatorum and intensification effort in preventing the cases of tetanus neonatorum.

Tetanus Neonatorum adalah penyebab utama kematian neonatal dan penyebab kematian kedua pada anak diantara penyakit yang dapat dicegah dengan imunisasi. Setiap tahun 450.000 bayi meninggal sebelum umur l bulan. Di Propinsi Jawa Barat, Tetanus Neonatorum masih menjadi masalah kesehatan, dimana selama 5 tahun berturut-turut dari tahun 1994-1998 kasus Tetanus Neonatorumn masih relatif tinggi dengan kematian yang relatif menetap. Tujuan penelitian adalah untuk mengetahui hubungan status imunisasi TT ibu hamil dengan kejadian Tetanus Neonatorum di Propinsi Jawa Barat tahun 1999-2000. Studi ini menggunakan desain kasus kontrol. Kasus adalah bayi umur 0 - 28 hari yang menderita Tetanus Neonatorum pada tahun 1999-2000, sedangkan kontrol adalah bayi sehat dengan umur yang hampir sama dan merupakan tetangga terdekat penderita. Data diperoleh dari wawancara dengan menggunakan kuesioner pada ibu bayi dan data yang diperoleh dikonfirmasi terhadap penolong persalinan, KMS, Catatan di Puskesmas, Pustu dan Polindes. Hasil studi menunjukkan adanya hubungan yang bermakna antara status imunisasi TT ibu hamil dengan kejadian Tetanus Neonatorum (OR = 21,82 , 95%C1, p = 0,0000). Setelah dilakukan kontrol terhadap variabel perawatan tali pusat dan persalinan "3 bersih", maka risiko kejadian Tetanus Neonatorum pada bayi yang ibunya tidak pernah mendapat imunisasi TT adalah 31,39 kali dibandingkan bayi yang ibunya mendapat imunisasi TT Iengkap.

The Relation of Babies? Immunity with Tetanus Neonatorum MorbidityIn West Java on 1999-2000The Tetanus Neonatorum is the first cause neonatal death and the second cause of children death between the diseases which can be prevented by immunization. There are 450.000 babies death before one month old. In West Java Tetanus Neonatorum still be the first health problem During 5 years from 1994 - 1998, the morbidity and mortality of Tetanus Neonatorum has been relative constantly. This research is to find out the relation of pregnancy mother immunization status with Tetanus Neonatorum morbidity in West Java in 1999 - 2000. This study using design case control. The case is a 0 - 28 old days baby who had Tetanus Neonatorum in 1999 - 2000, and the controls is a health baby with the same age and live in the nearest illness baby. The data get through questionnaires from mother's illness baby and mother's health baby. The data was confirmed by midwife or birth attendant who help delivery, by puskesmas record, by baby ISMS and the other record in Puskesmas, Pustu and Polindes. The result of study reveals that there is a significant relationship between baby's immunization and Tetanus Neonatorum occurring. After controlling the other variable, such as umbilical cord care, "Three cleans delivery". The risk of Tetanus Neonatorum occur of baby's mother who has never have Tetanus Toxoid Immunization is 31,39 times compare with baby's mother who has completed TT Immunization. The Relation of Babies? Immunity with Tetanus Neonatorum MorbidityIn West Java on 1999-2000The Tetanus Neonatorum is the first cause neonatal death and the second cause of children death between the diseases which can be prevented by immunization. There are 450.000 babies death before one month old. In West Java Tetanus Neonatorum still be the first health problem During 5 years from 1994 - 1998, the morbidity and mortality of Tetanus Neonatorum has been relative constantly. This research is to find out the relation of pregnancy mother immunization status with Tetanus Neonatorum morbidity in West Java in 1999 - 2000. This study using design case control. The case is a 0 - 28 old days baby who had Tetanus Neonatorum in 1999 - 2000, and the controls is a health baby with the same age and live in the nearest illness baby. The data get through questionnaires from mother's illness baby and mother's health baby. The data was confirmed by midwife or birth attendant who help delivery, by puskesmas record, by baby ISMS and the other record in Puskesmas, Pustu and Polindes. The result of study reveals that there is a significant relationship between baby's immunization and Tetanus Neonatorum occurring. After controlling the other variable, such as umbilical cord care, "Three cleans delivery". The risk of Tetanus Neonatorum occur of baby's mother who has never have Tetanus Toxoid Immunization is 31,39 times compare with baby's mother who has completed TT Immunization.