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Delay in diagnosis can lead to increased severity of the disease, increased the risk of death and the possibility of transmission of tuberculosis in the community. The objective of this study was to determine proportion and the length of delay in diagnosis and factors associated with the delay in diagnosis among pulmonary tuberculosis patient in Tebo Distric. This study design using cross sectional conducted in patients with tuberculosis who was treated at hospitals and health centers at Tebo District in 2018. The sample in this study amounted to 366 respondents. Multivariat analysis using a multivariate cox regression. The results showed that the proportion of diagnosis delay (> 28 days) was 63.93 %. Predisposing factors (age ≥ 45 years), enabling factors (first consulting Non- DOTS health care unit, high stigma and distance to the health care unit DOTS ≥ 30 minutes) and need factors (perception of the disease is not serious) are risk factors associated with the diagnostic delay. Necessary improving the quality of tuberculosis control programs, counseling tuberculosis so that people have the correct perception against tuberculosis and to reduce the negative stigma against tuberculosis, improving access to health care units DOTS and active case finding are vital to reduce diagnostic delay
Beberapa studi menunjukkan adanya penurunan rata-rata usia menarche di seluruh dunia, termasuk Indonesia. Rata-rata usia menarche wanita di Amerika menurun sebesar 0,9 tahun dari tahun 1920 hingga 1980an (McDowell, 2007). Berdasarkan survei nasional pada tahun 1992 – 1995 rata-rata usia menarche remaja putri di Indonesia adalah 12,96 tahun dengan prevalensi menarche dini sebesar 10,3 % dan menarche terlambat sebesar 8,8 % (Batubara, 2010). Faktor determinan dari menarche dini dan menarche terlambat adalah status gizi, lemak tubuh, asupan makronutrien, asupan mikronutrien, sosial ekonomi, rangsangan psikis, hormonal, umur menarche ibu, outcome kelahiran, dan aktivitas fisik. Penelitian ini menggunakan data Riskesdas tahun 2010 dan mengikutsertakan 5358 remaja putri (10-19 tahun) diseluruh wilayah Indonesia sebagai populasi eligible. Studi ini menggunakan metode penarikan sampel non simple random sampling, strata, dan cluster sehingga menggunakan desain complex sample dalam analisisnya. Analisis model akhir menggunakan regresi logistik multinomial. Pada hasil multivariat, faktor risiko untuk menarche dini adalah kegemukan/obesitas (POR 3.03, 95% CI 2.39-3.83), hormonal banyak (POR 1.57, 95% CI 1.21-2.05), umur menarche ibu cepat (POR 1.74, 95 % CI 1.39 – 2.19) dan jumlah anak dalam keluarga sedikit (POR 1.64, 95 % CI 1.21-2.23). Sementara itu faktor protektif untuk menarche dini adalah asupan energi kurang (POR 0.73, 95 % CI 0.56-0.94). Faktor risiko untuk menarche terlambat adalah usia menarche ibu yang lambat (POR 2.1 95 % CI 1.68-2.61). Sementara itu faktor protektif untuk menarche terlambat adalah kegemukan/obesitas (POR 0.42, 95% CI 0.27 to 0.63), hormonal banyak (POR 0.7, 95% CI 0.62-0.95), asupan protein rendah (POR 0.68, 95% CI 0.51-0.91), asupan lemak tinggi (POR 0.75, 95 % CI 0.59- 0.95), umur menarche ibu yang lebih muda (POR 0.6, 95 % CI 0.44 – 0.84), pendidikan bapak yang tinggi (POR 0.73, 95 % CI 0.57-0.92) dan jumlah anggota keluarga yang besar (POR 0.75, 95 % CI 0.57-0.99). Pentingnya upaya meningkatkan program pencegahan kegemukan/obesitas anak dan remaja serta meningkatkan program penyuluhan kesehatan reproduksi dengan sasaran usia yang lebih muda yaitu murid sekolah dasar (SD) dan sekolah lanjutan tingkat pertama (SLTP) baik di unit pemerintah maupun swasta.
Several studies have shown a decrease mean age of menarche in the world, including in Indonesia. The mean age of menarche in U.S. women declined by 0.9 years from 1920 to the 1980s (McDowell, 2007). Based on National Suveys conducted in 1992-1995, the mean age of menarche in Indonesian girls was 12.96 years with prevalence of early menarche was 10.3% and late menarche was 8.8% (Batubara, 2010). Determinant factors of early and late menarche was nutritional status, body fat, macronutrient intake, micronutrient intake, social economy, psycological stimulate, height/hormonal, maternal age of menarche, birth outcome, family structural, and phisical activity. This study used data of Basic Health Survey 2010 and include 5358 girls (10-19 years) in all region of Indonesia as eligible population. This study used non simple random sampling, strata, and cluster sampling method so that the analysis using complex sample design. In multivariate, this study using multinomial logistic regression. The risk factors of early menarche is overweight/obesity (POR 3.03, 95% CI 2.39-3.83), more height girls (POR 1.57, 95% CI 1.21-2.05), early maternal age of menarche (POR 1.74, 95 % CI 1.39 – 2.19), small number of children in families (POR 1.64, 95 % CI 1.21-2.23). Meanwhile the protective factors of early menarche is low energy intake (POR 0.73, 95 % CI 0.56-0.94). The risk factors of late menarche is late maternal age of menarche (POR 2.1 95 % CI 1.68-2.61). Meanwhile the protective factors of late menarche is overweight/obesity (POR 0.42, 95% CI 0.27 to 0.63), more height girls (POR 0.7, 95% CI 0.62-0.95), low protein intake (POR 0.68, 95% CI 0.51-0.91), high fat intake (POR 0.75, 95 % CI 0.59-0.95), early maternal age of menarche (POR 0.6, 95 % CI 0.44 – 0.84), high level of father education (POR 0.73, 95 % CI 0.57-0.92), small number of families (POR 0.75, 95 % CI 0.57-0.99). So, this is important to improve prevention programs of child/adolescent obesity and reproductive health education for elementary and junior high school students both in government and private sectors.
Neonatal Asphyxia is one the main causes of neonatal mortality in Indonesia with a percentage of 27%. Premature rupture of membranes (PROM) is one of the factors that cause of nenonatal asphyxia. PROM causes oligohydramnios which causes pressure on the umbilical cord so that it inhibits blood flow that carries oxygen to the fetus and causes continuous hypoxia, causing asphyxia. The purpose of this study was to determine the association between PROM and neonatal asphyxia. The study design used was a retrospective cohort. The population in this study were all mothers who gave birth at the HAMBA Batang Hari Hospital, Jambi with the sample being mothers who gave birth at the HAMBA Batan Hari Hospital, Jambi in 2020 which were selected using a simple random sample method. The samples size in this study was 70 samples consisting of 35 people exposed and 35 controls. The statistical test used was the multiple cox regression test with the risk factor model. There is association between PROM and neonatal asphyxia after controlled b history of abortion, gestational age, preeclampsia, and birth weight. Pregnant women are recomended to consume vitamin C, do antenatal care regularly, maintain blood pressure by paying attention to the food consumed, control stress, and consult a doctor before planning a pregnancy
Latar belakang : Hasil investigasi KLB malaria ada hubungan faktor resiko perilaku pemakaian kelambu. Perilaku pemakaian kelambu dipengaruhi pengetahuan dan sikap. Peneliti ingin mengetahui gambaran dan hubungan pengetahuan, sikap dengan perilaku penduduk usia di atas 15 tahun di Hargotirto. Metodologi : Desain penelitian cross sectional. Sampel adalah penduduk usia di atas 15 tahun yang dipilih dengan sistem cluster dan random pada setiap cluster. Jumlah sampel 266 responden. Dilakukan análisis univariat, bivariat dan multivariat dengan regresi logistik ganda. Hasil : Distribusi responden dengan pengetahuan tinggi 52,3%, sikap positif 57,9%, perilaku memakai kelambu 80,8%. Perilaku memakai kelambu dengan pengetahuan tinggi dan sikap positif 31,9%. Hasil bivariat pengetahuan (OR=1,57 nilai p=0,15 95%CI=0,85-2,9), sikap (OR=4,93 nilai p=0,000, 95%CI=2,51-9,69). Hasil regresi logistik sikap dengan perilaku pemakaian kelambu ada hubungan dan bermakna (OR=4,933 nilai p=0,000, 95%CI=2,510-9,698). Kesimpulan : Responden dengan pengetahuan tinggi dan sikap positif sebanyak 90 responden (33,8%).Tidak terdapat hubungan antara pengetahuan dengan perilaku memakai kelambu. Ada hubungan bermakna antara sikap dengan perilaku memakai kelambu. Saran bentuk penyuluhan yang lebih mengena untuk meningkatkan pengetahuan, contoh dari tokoh masyarakat memakai kelambu sehingga masyarakat meniru untuk memakai kelambu dan diadakan kembali arisan kelambu untuk membantu yang belum memiliki kelambu. Kata Kunci : pengetahuan, sikap, perilaku memakai kelambu, malaria, regresi logistik ganda.
Background : The results of investigation malaria outbreak there is a risk factor for mosquito nets usage behavior. Use of mosquito nets behavior influenced of knowledge and attitudes. Researcher wants to know the description and the association between knowledge, attitude with mosquito nets usage behavior by age over 15 year in Hargotirto, 2012. Methods : cross sectional study design. Sample is population by age over 15 year selected with cluster systems and random in each cluster. The number of samples are 266 respondents. Univariat analysis, bivariat and multivariat with multiple logistic regression. Results : Distribution of respondents with high knowledge of 52.3%, positive attitude is 57.9%, and the behavior of using mosquito nets is 80.8%. Behavior of using mosquito nets with high knowledge and positive attitudes about 31.9%. The results of the bivariat : knowledge (OR = 1.57 p-value = 0.15, 95% CI = 0.85- 2.9), attitude (OR = 4.93 p-value = 0.000, 95% CI = 2.51 - 9,69). The results of logistic regression attitude to the behavior of using mosquito nets have meaningful associatin (OR=4.933, p-value=0.000, 95%CI=2.510-9.698). Conclusions : The behavior of respondents 33.8% wearing mosquito net with the knowledge of high and positive attitude. There is no association between knowledge of the behavior of using mosquito nets. There is a significant association between attitudes to the behavior of using mosquito nets. Keywords : knowledge, attitudes, behaviors of using mosquito nets, multiple logistic regression
ABSTRAK Nama : Januar Tree Kencana Program Studi: Epidemiologi Judul : Hubungan Status Imunisasi dan Status Gizi dengan Kejadian Difteri Pada Kejadian Luar Biasa (KLB) di Kabupaten Serang Propinsi Banten Tahun 2017-2018 Pembimbing : Dr. dr. Tri Yunis Miko Wahyono, M.Sc Penyakit difteri disebabkan oleh infeksi corynebacterium diphteriae merupakan salah satu penyakit menular yang dapat dicegah dengan imunisasi, penyakit ini masih menjadi masalah kesehatan yang serius karena seringkali menimbulkan kejadian luar biasa (KLB) di berbagai negara maupun belahan dunia. Berdasarkan data Kementerian Kesehatan pada tahun 2017 telah terjadi KLB difteri di 20 propinsi dan 95 kabupaten / kota di Indonesia, termasuk Propinsi Banten dan salah satunya adalah di Kabupaten Serang. Di kabupaten Serang Status imunisasi dan statu gizi masyarakat masih menjadi masalah kesehatan, Cakupan imunisasi yang masih rendah di beberapa Desa dalam kecamatan dan status gizi buruk masih ditemukan, oleh karenanya penelitian ini dilakukan untuk mengetahui hubungan status imunisasi dan status gizi dengan kejadian difteri pada KLB di kabupaten Serang Propinsi Banten Tahun 2017-2018. Desain penelitian yang digunakan adalah kasus kontrol dimana variabel penelitiannya adalah status imunisasi dan status gizi serta variabel kovariat yaitu lingkungan fisik tempat tinggal, pengetahuan dan riwayat bepergian. Berdasarkan hasil penelitian secara multivariat dengan menggunakan regresi logistik di dapatkan hasil bahwa status imunisasi mempunyai OR : 3,777 95% CI = 1.48 -9.60 P Value 0.005 sedangkan Status Gizi memiliki OR : 1,23 90% CI = 0.44 – 3,41 P Value 0,680 setelah dikontrol dengan Variabel Umur, Jenis Kelamin, Pengetahuan, Riwayat Bepergian, lingkungan fisik Rumah, pencahayaan alami, Kelembaban dan kepadatan Hunian. Kata Kunci : Difteri, Kasus Kontrol, Kejadian Luar Biasa
ABSTRACT Nama : Januar Tree Kencana Study Program: Epidemiology Title : The Relationship between Immunization and Nutritional Status with Diphtheria Outbreaks in Serang Regency, Banten Province 2017-2018. Background: Diphtheria as a one of the most contagious diseases that can be prevented by immunization (VPD) is still a serious health problem because it often causes outbreak in various countries including Indonesia. Based on data from the Ministry of Health of the Republic of Indonesia, during 2017 there have been diphtheria outbreaks in 20 provinces and 95 regency/cities including Serang Regency.This study aims to determine the relationship between immunization and nutritional status with the diphtheria outbreaks in Serang Regency of Banten Province in 2017-2018. Methods: This study was an analytic study using case control design with 172 respondents consisting of 43 cases and 129 controls. Logistic regression analysis was performed to obtain an estimate of the relationship between immunization and nutritional status with diphtheria after controlled covariate variables. Result: Proportion of immunization and good nutrition in the case is lower than in control. Immunization and nutrition in both cases were 51.2% and 76.7% while in controls were 77.5% and 81.4%. The association (OR) between immunization status and diphtheria was 3.78 (95% CI: 1.48-9.60) after controlling to age, room density and natural house lighting while the association (OR) between nutritional status and diphtheria was 1.23 (95% CI: 0.44-3.41) after controlling to age, knowledge, humidity, and immunization status. Conclusions: The proportion of immunization in diphtheria cases is still low. Nonimmunization status are at risk for diphtheria 3.78 times. The Health Office is expected to conduct routine monitoring and evaluation of basic immunization programs, especially in areas with low coverage and provide information to the community about diphtheria, including factors such as immunization, nutrition, and the physical environment of the house. Keywords: Diphtheria, Case Control, Outbreak.
