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Kata kunci: Hipertensi, wanita, obesitas
Hypertension is an important public health challenge because it has a strong effect with cardiovascular disease and premature death. The number of hypertension increases from year to year. At the same risk factors, women are more susceptible to hypertension. Many factor that influence of hypertension, one of them is obesity. This study aims to determine the effect of obesity to hypertension in adult women (21-40 years old) in Indonesia, 2014. This study uses secondary data of Indonesian Family Life Survey (IFLS 5, 2014) with cross sectional study design. The number of samples is 6,861 people. The results of this study indicate that 6,861 of women aged 21-40 years old are 11.98% (95%CI: 10,76-12,01) hypertension, 24.78% (95%CI: 23,6-25,37) obesity. The results of multivariate analysis, there is no covariate variable that becomes confounding variable in influence of obesity to hypertension in this research, odds ratio influence obesity to hypertension is 3,29. This means that women with obesity have risk 3,29 to be hypertension. Health Office needs to improve the early detection program of hypertension, especially in obese women with aged 21-40 years olds. The society must apply a healthy lifestyle by maintaining food intake.
Key words: Hypertension,women, obesity
This thesis discussed the role of individual and community factors on the use of LongTerm Contraceptive Method (MKJP) in women of reproductive age couple by region inIndonesia in 2017. The study design follows the advanced analysis design of RPJMNBKKBN survey data that was cross-sectional design. The sample of research onRPJMN survey was women of reproductive age couple. Data were analyzed byMultilevel Logistic Regression analysis. The results showed that the proportion ofwomen of reproductive age couple using the longest method of contraception washighest in the area of Indonesia Java Bali was 27.2%. Multilevel analysis results showedthat there are variations between provinces of MKJP used in women of reproductive agecouple in the area of Indonesia Java Bali and Outside Java Bali I of 1.4 and 1.3 in thearea of Outside Java Bali II. It was recommended to BKKBN to implement MKJPusage program that takes into account the area aspect and can not be uniformed for allprovinces in Indonesia.Key words:Contraception, Women, Individuals, Community.
ABSTRAK Nama : Noerfitri Program Studi : Ilmu Kesehatan Masyarakat Judul : Analisis Survival Pengaruh Rujuk Balik dan Tipe Pasien Terhadap Kejadian Lost to Follow-up pada Pasien Multidrug-Resistant Tuberculosis di Indonesia Tahun 2014-2015 Pembimbing : R. Sutiawan, S.Kom, M.Si Tingginya angka insidens TB MDR di Indonesia, dibarengi dengan tingginya tingkat Lost to Follow-up (LTFU) pada pengobatan pasien TB MDR. Pasien TB resisten obat memiliki kemungkinan LTFU lebih besar dibandingkan pasien TB sensitif obat dikarenakan durasi pengobatan yang lebih lama. Selain itu, pasien TB MDR yang tidak melanjutkan pengobatannya sampai tuntas memiliki peningkatan risiko kematian akibat TB. Studi ini bertujuan untuk mengetahui pengaruh rujuk balik dan tipe pasien terhadap kejadian LTFU pada pasien Multidrug-Resistant Tuberculosis (TB MDR) di Indonesia. Studi dilakukan pada Mei-Juni 2018 di Subdit TB – Direktorat P2PML, Ditjen P2P Kementerian Kesehatan RI. Desain studi yang digunakan adalah desain studi kohort retrospektif. Jumlah sampel pada studi ini adalah 961 pasien. Sampel diambil secara total sampling. Berdasarkan status rujuk baliknya, 86,3% pasien dilakukan rujuk balik dan 13,97% pasien tidak dirujuk balik. Berdasarkan kategori tipe pasien, 35,17% kasus kambuh, 5,52% pasien baru, 13,94% pasien pernah LTFU, 23,10% kasus gagal pengobatan kategori 1, 20,29% kasus gagal pengobatan kategori 2, 1,9% lain-lain (pasien tidak diketahui riwayat pengobatan TB sebelumnya). Dari studi ini, diketahui bahwa proporsi kejadian LTFU sebesar 28,40% dengan kumulatif hazard LTFU sebesar sebesar 1,12 selama 39 bulan pengamatan, sehingga didapatkan hazard rate sebesar 2,88/100 orang-bulan. Hasil analisis multivariabel dengan regresi cox time-dependent menunjukkan bahwa rujuk balik menurunkan peluang terjadinya LTFU sebesar 46% (HR 0,54; 95% CI 0,35-0,84) pada kondisi variabel tipe pasien dan umur sama (adjusted). Untuk tipe pasien, tipe pernah LTFU, gagal pengobatan kategori 2 dan tidak diketahui riwayat pengobatan TB sebelumnya meningkatkan peluang terjadinya LTFU masing-masing sebesar 50% (HR 2,02; 95% CI 1,18-3,45), 53% (HR 2,13; 95% CI 1,240-3,66), dan 74% (HR 3,80; 95% CI 1,54-9,36) dibandingkan dengan tipe pasien kambuh (baseline) pada kondisi variabel rujuk balik, jenis kelamin, dan umur sama (adjusted). Pada laki-laki, efek tipe gagal pengobatan kategori 2 lebih rendah 0,26 kali dibandingkan dengan pasien wanita dengan tipe gagal pengobatan kategori 2. Petugas kesehatan perlu meluangkan waktu yang lebih banyak untuk memberikan komunikasi, informasi, dan edukasi mengenai pengobatan TB serta mengenai manfaat rujuk balik kepada pasien TB MDR. Risiko LTFU meningkat pada pasien yang bertipe pernah LTFU, gagal pengobatan kategori 2, dan tidak diketahui riwayat pengobatan TB sebelumnya dibandingkan pasien dengan tipe kambuh, karena tipe kambuh sudah teruji kepatuhannya terhadap pengobatan sebelumnya. Perlunya skrinning tipe pasien dengan baik untuk mengidentifikasi risiko LTFU berdasarkan tipe pasien sejak awal pasien memulai pengobatan. Kata kunci: LTFU, rujuk balik, tipe pasien, TB MDR
ABSTRACT Name : Noerfitri Study Program : Public Health Title : Survival Analysis of Influence of Decentralization and Type of Patient on Lost to follow-up in Multidrug-Resistant Tuberculosis Patients in Indonesia 2014-2015 Supervisor : R. Sutiawan, S.Kom, M.Si The high incidence rate of MDR-TB in Indonesia is accompanied by high rate of lost to follow-up (LTFU) in the treatment of MDR-TB patients. Drug resistant TB patients have a greater risk of LTFU than drug-sensitive TB patients due to longer treatment duration. In addition, MDR-TB patients who did not continue treatment completely had an increased risk of dying from TB. The aims of this study were to determine the decentralization influence and patient type on the incidence of LTFU in MultidrugResistant Tuberculosis (MDR-TB) patients in Indonesia. This study was conducted in May-June 2018 at Subdirectorate of TB - Directorate of Prevention and Communicable Disease Control, Directorate General of Prevention and Disease Control - Ministry of Health of the Republic of Indonesia. The study design was retrospective cohort. The number of samples in this study was 961 patients. Samples were taken in total sampling. Based on the decentralization status, 86.3% of patients were decentralized. Based on the type of patient category, 35.17% of relapse, 5.52% of new, 13.94% of after LTFU, 23.10% of failure category 1, 20.29% of failure category 2, 1.9 % of other patients (unknown history of previous TB treatment). The proportion of incidence of LTFU is 28.40% with cumulative hazard of LTFU equal to 1.12 during 39 months of observation, so hazard rate is 2.88 / 100 person-month. In multivariable analysis with cox regression time-dependent revealed that decentralization reduced the probability of LTFU up to 46% (HR 0.54, 95% CI 0.35-0.84) after controlled by type of patient and age. For patient type, treatment after LTFU, failure category 2 and unknown history of previous TB treatment increased the probability of LTFU by 50% (HR 2,02; 95% CI 1,18-3,45), 53% (HR 2,13; 95% CI 1,240-3,66), and 74% (HR 3,80; 95% CI 1,54-9,36) consecutively compared with the type of relapse patients (baseline) after controlled by the decentralization, gender, and age. In male patients with failure treatment category 2, the effect was 0.26 times lower compared with failure category 2 in female patients. Health workers need to spend more time in communicating, informing and educating about TB treatment and the benefits of decentralization to MDR-TB patients. The risk of LTFU increased in type of patient after LTFU, treatment failure category 2, and unknown history of previous TB treatment compared with patients with relapse types. The need for good patient type screening to identify the risk of LTFU by type of patient from the initial of treatment. Keywords: LTFU, decentralization, type of patient, MDR-TB
Kata kunci: Jemaah haji, Pengendalian DM, Pembinaan Kesehatan Haji
This thesis discusses the influence of Hajj health development and guidance program on the success of DM control in pilgrims whose diagnosed Diabetes Mellitus. This research is quantitative research with cross sectional design. The results suggest that influence of Hajj Health Development was very important on the success of DM control, hajj pilgrims should be strived to follow all the activities of Hajj health Development so that the health status of Hajj can be increased to meet health requirements.
Key words: Hajj pilgrims, DM control, Hajj health development
Background: Digital transformation in the healthcare sector has become increasingly significant since the COVID-19 pandemic, driving the accelerated implementation of information technology, including Electronic Medical Records (RME). In Indonesia, the Ministry of Health has required all healthcare facilities, including Type C Private Hospitals, to implement RME. However, the successful implementation of RME depends not only on the existence of the system, but also on the hospital's level of digital maturity. Research Objective: This study aims to analyse the effect of digital maturity level on RME implementation in Type C Private Hospitals. Research Methodology: The research was conducted with a quantitative approach using a cross-sectional survey method of 202 health workers in Type C private hospitals. The research instrument refers to the Ministry of Health's Digital Maturity Index (DMI) with seven main dimensions, as well as five dimensions of RME implementation adapted from the Technology Acceptance Model (TAM). Data were analysed using PLS-SEM to test the validity, reliability, and relationship between variables. Research Results: The results showed that the level of digital maturity significantly influenced the success of RME implementation, with the dimensions of ‘Data Utilisation’ and ‘Availability of RME Features in health services’ being the dominant factors. This research provides a practical contribution in developing strategies to strengthen hospital digitalisation and provides input for policy makers in supporting effective and sustainable digital transformation
Breastfeeding is one of the interventions of the first 1000 day movement of life with atarget of 2 years, but this target is still far from reality. Globally 74% of children arebreastfed to 1 year of age, in Africa 70% of children are breastfed to 1 year of age, inAmerica 45% of children are breastfed to 2 years of age and in Indonesia 56.7% ofchildren are breastfed until the age of 23 months, while the target is 80% childrenbreastfed to 1 year of age and 60% to 2 years of age. This study aims to determine therelationship of mother's work with the duration of breastfeeding in Indonesia in 2013. Theresearch design is cross-sectional. The sample of the research is the mother who haschildren aged 0-23 months using Riskesdas data in 2013. The data were analyzed withunivariable, bivariable and multivariable survival analysis. Mother not working(65.05%), ideal age (76.95%), married status (99.81%), high school graduated (30.67%),normal (90.38%) and rich ( 22.38%). Bivariat, there were significant relationship betweenmother work (p = 0,023) and birth process (p = 0,004) with duration of breastfeeding inIndonesia year 2013. Multivariable is known not relationship of mother's job with longbreastfeeding after controlled by covariat variable in Indonesia 2013. Recommended tothe Ministry of Health to strengthen the activities of ASI counselors and to train theexisting personnel in the area and to advocate with the labor service. BKKBN to advocatewith local governments to provide information on the importance of breastfeeding as onetype of contraception and subsequent researchers to explore more complex variables.Key words: breastfeeding, occupation, birth process, education, economics.
Human Immunodeficiency Virus HIV merupakan tantangan terbesar dalam pengendalian tuberkulosis. Di Indonesia diperkirakan sekitar 3 pasien TB dengan status HIV positif. Sebaliknya TB merupakan tantangan bagi pengendalian Acquired Immunodeficiency Deficiency Syndrome AIDS karena merupakan infeksi oportunistik terbanyak terdapat 49 pada ODHA. Penelitian ini bertujuan untuk mengetahui pengaruh kepatuhan minum obat antiretroviral terhadap ketahanan hidup pasien TB-HIV di RSUD Koja Tahun 2013 ndash; 2017. Desain studi yang digunakan adalah desain kohort retrospekstif. Jumlah sampel pada studi ini adalah 111 pasien TB-HIV yang diambil secara keseluruhan. Dari studi ini, diketahui pada kelompok yang patuh minum obat antiretroviral ARV mengalami event /meninggal 31 , sebanyak 79,7 pasien masih hidup dan pasien yang lost follow up sebanyak 34,8.