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Mery Ramadani; Promotor: Budi Utomo; Kopromotor: Endang Laksminingsih Achadi, Hartono Gunardi; Penguji: Anhari Achadi, Faisal Yunus, Besral, Bambang Wispriyono, Soewarta Kosen, Abas Basuni Jahari,
Abstrak:
Rokok merupakan masalah global dan menjadi ancaman serius bagi kesehatan ibu hamil dan janin. Studi kohor prospektif ini, dilakukan untuk menilai pengaruh pajanan pasif asap rokok ibu hamil terhadap gangguan pertumbuhan janin. Melibatkan 128 ibu hamil trimester 3, hamil janin tunggal, tidak memiliki riwayat penyakit kronis, bukan perokok aktif, bukan mantan perokok, dan bersedia terlibat dalam penelitian. Penilaian pajanan asap rokok ibu berdasarkan pemeriksaan nikotin darah tali pusat (cut off ≥1ng/ml). Pengukuran menggunakan nikotin plasma adalah metode yang paling akurat karena dapat mengukur kondisi sebenarnya dan membantu mengurangi misklasifikasi. Gangguan pertumbuhan janin dinilai dengan pengukuran berat lahir, panjang lahir, lingkar kepala, dan berat plasenta. Pengukuran dilakukan segera setelah lahir untuk menjamin ketepatan pengukuran. Analisis uji beda dua mean digunakan untuk mengetahui perbedaan rata rata ukuran gangguan pertumbuhan janin antara kelompok ibu terpajan asap rokok dan tidak terpajan asap rokok. Analisis regresi linier untuk melihat pengaruh pajanan asap rokok terhadap berat lahir, panjang lahir, lingkar kepala dan berat plasenta dengan memperhatikan variabel pengganggu seperti penambahan berat badan ibu selama hamil, BMI ibu, paritas ibu, usia dan kadar hemoglobin ibu. Hasil penelitian menunjukkan rata-rata kadar nikotin tali pusat sebesar 1,3±2,5 ng/ml. Berat lahir dan berat plasenta bayi dari ibu yang mendapat pajanan asap rokok lebih rendah dibandingkan ibu yang tidak mendapat pajanan asap rokok. Pajanan asap rokok secara signifikan mengurangi berat lahir bayi sebesar 205,6 gram (pvalue = 0,005) dan berat plasenta sebesar 51 gram (p value=0,010).
This cohort study examined the effect of secondhand smoke exposure in pregnant women on fetal growth restriction. The study recruited 128 pregnant women in the third trimester pregnancy, single pregnancy, no chronic illness, non-active smokers, non-exsmokers, and who were willing to participate in the study. Pregnant women with the secondhand smoke exposure referred to those with the umbilical cord blood nicotine level of 1ng/ml or higher. Fetal growth disorder was assessed according to the newborn weight, length, head circumference, and palcental weight measured immediately after birth. The independent t-test analysis was used to determine the difference in average size of fetal growth between two groups of pregnant women: exposed and the notexposed to the secondhand smoke. A multiple linear regression analysis was employed to find out the effect of secondhand smoke exposure on birth weight, length, head circumference, and palcental weight controlling for the birth size confounders including weight gain during pregnancy, body mass index, parity, maternal age, and maternal hemoglobin. The study found that mean of nicotine in umbilical cord blood was 1.3±2.5 ng/ml, the birth weight and the placental weight of infants were lower among mothers who exposed than among mothers who did not expose to the secondhand smoke. Exposed to the secondhand smoke reduced the birth weight by 205.6 grams (p value = 0.005) and placental weight by 51 grams (p value=0.010).
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This cohort study examined the effect of secondhand smoke exposure in pregnant women on fetal growth restriction. The study recruited 128 pregnant women in the third trimester pregnancy, single pregnancy, no chronic illness, non-active smokers, non-exsmokers, and who were willing to participate in the study. Pregnant women with the secondhand smoke exposure referred to those with the umbilical cord blood nicotine level of 1ng/ml or higher. Fetal growth disorder was assessed according to the newborn weight, length, head circumference, and palcental weight measured immediately after birth. The independent t-test analysis was used to determine the difference in average size of fetal growth between two groups of pregnant women: exposed and the notexposed to the secondhand smoke. A multiple linear regression analysis was employed to find out the effect of secondhand smoke exposure on birth weight, length, head circumference, and palcental weight controlling for the birth size confounders including weight gain during pregnancy, body mass index, parity, maternal age, and maternal hemoglobin. The study found that mean of nicotine in umbilical cord blood was 1.3±2.5 ng/ml, the birth weight and the placental weight of infants were lower among mothers who exposed than among mothers who did not expose to the secondhand smoke. Exposed to the secondhand smoke reduced the birth weight by 205.6 grams (p value = 0.005) and placental weight by 51 grams (p value=0.010).
D-395
Depok : FKM-UI, 2019
S3 - Disertasi Pusat Informasi Kesehatan Masyarakat
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Elly, Nur/ Promotor: Djuwita, Ratna/ Kopromotor: Purwantyastuti; Rimbawan/ Penguji: Laksminingsih, Endang; Rini Sekartini, Besral, Mira Dewi, Noer Laily
D-396
Depok : FKM-UI, 2019
S3 - Disertasi Pusat Informasi Kesehatan Masyarakat
☉
Nurusysyarifah Aliyyah; Promotor: Haryoto Kusnoputranto; Kopromotor: Bambang Wispriyono, Laila Fitria; Penguji: Mondastri Korib Sudaryo, Umar Fahmi Achmadi, Mukono; Syafruddin
Abstrak:
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Hipertensi merupakan salah satu kondisi medis yang cukup serius karena dapat meningkatkan risiko penyakit jantung, otak, ginjal dan penyakit lainnya. Wilayah di DKI Jakarta dengan prevalensi hipertensi tertinggi berdasarkan diagnosis dokter yaitu Kota Jakarta Pusat sebesar 12,16%. Partikulat meter organik dan komponen partikulat meter dapat memicu proinflammatory effects pada paru-paru karena kemampuannya mengakibatkan stress oksidatif. Penelitian ini bertujuan untuk menyusun model pengaruh pajanan PM2,5 di udara ambien terhadap kejadian hipertensi melalui stress oksidatif dan sitokin inflamasi pada penduduk di Jakarta Pusat. Penelitian dilakukan pada penduduk dewasa (18-65 tahun) di Kota Jakarta Pusat dengan disain studi hybrid cross sectional ecology. Pengumpulan data secara cluster random sampling dengan analisis data dilakukan melalui pemodelan regresi logistik multilevel dan cox regresi proporsional hazard.
Hasil analisis menunjukkan terdapat asosiasi antara PM2,5 di udara ambien dengan biomarker stress oksidatif (IOR PM2,5: 2,185173-2,185176) dan dengan biomarker sitokin inflamasi (IOR PM2,5: 1,21-1,91). Pemodelan multivariat dengan cox regresi proporsional hazard menunjukkan bahwa variabel umur dan indeks massa tubuh merupakan confounder hubungan antara stress oksidatif dengan hipertensi dan antara sitokin inflamasi dengan hipertensi dengan nilai Rasio Prevalens adjusted (95% CI) masing-masing sebesar 1,19 (0,69-2,03) dan 0,99 (0,58-1,72). Dapat disimpulkan bahwa variabel konsentrasi PM2,5 di udara ambien memiliki peran terhadap terjadinya hipertensi, stress oksidatif dan sitokin inflamasi pada penduduk di Jakarta Pusat.
Hypertension is a serious medical condition that can increase the risk of heart, brain, kidney and other diseases. The area in DKI Jakarta with the highest prevalence of hypertension based on doctor diagnosis is Central Jakarta city about 12.16%. Organic particulate matters and particulate matter components can trigger proinflammatory efects in the lung due to their ability to cause oxidative stress. This study aims to develop a model of the Influence of PM2,5 Exposure in Ambient Air on Hypertension Occurrence through Oxidative Stress and Inflammatory Cytokines among residents in Central Jakarta. The study was conducted among adult residents (age 18-65 years) in Central Jakarta with hybrid cross sectional study design. Data collected using cluster random sampling with data analysis carried out through multilevel logistic regression modeling and cox proportional hazard regression. Results show there is an association between PM2.5 in ambient air with oxidative stress biomarkers (IOR PM2.5: 2.185173-2.185176) and with inflammatory cytokine biomarkers (IOR PM2.5: 1.21-1.91). Multivariate modeling with Cox regression proportional hazard shows that age and body mass index are confounders of the relationship between oxidative stress with hypertension and between inflammatory cytokines with hypertension with an adjusted prevalence ratio (95% CI) value of 1.19 (0.69-2.03) and 0.99 (0.58-1.72). It can conclude that concentration of PM2.5 in ambient air has a role on hypertension, oxidative stress and inflammatory cytokine among residents in Central Jakarta.
D-519
Depok : FKM-UI, 2024
S3 - Disertasi Pusat Informasi Kesehatan Masyarakat
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Firlia Ayu Arini; Promotor: Endang Laksminingsih Achadi; Kopromotor: Besral, Fasli Jalal; Penguji: Ratu Ayu Dewi Sartika, Kusharisupeni Djokosujono, Hartono Gunardi, Atmarita, Suwarta Kosen
Abstrak:
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Latar Belakang : Seribu Hari Pertama Kehidupan (1000 HPK) merupakan periode emas bagi pertumbuhan dan perkembangan yang menentukan kualitas kesehatan anak pada daur kehidupan berikutnya. Hambatan pertumbuhan yang terjadi pada periode tersebut terutama karena kekurangan gizi, menyebabkan janin yang bersifat plastis menyesuaikan dengan membatasi tumbuh kembang. Beberapa studi longitudinal menunjukkan bahwa pertumbuhan lebih cepat setelah terjadinya hambatan pertumbuhan dapat menjadi faktor risiko tekanan darah tinggi pada usia remaja. Penelitian ini bertujuan untuk membuktikan pengaruh pertumbuhan cepat pada anak dengan riwayat hambatan pertumbuhan di usia 0-23 bulan terhadap tekanan darah pada usia 17-19 tahun. Metode : Data pada penelitian ini menggunakan hasil dari Indonesian Family Life Survey 1997,2000 dan 2014 yang diambil pada 13 provinsi di Indonesia. Pengambilan data dilakukan secara longitudinal dengan unit sampel rumah tangga dengan anak usia 0-23 bulan pada tahun 1997 kemudian diikuti pada tahun 2000 dan 2014. Pengukuran pertumbuhan cepat ditentukan dengan perubahan nilai z skor BB/U, PB/U atau TB/U, dan BB/TB antar tahun survei, yang lebih dari 0.67 poin. Tekanan darah diukur pada tahun 2014 yaitu saat anak berusia 17- 19 tahun. Besar sampel penelitian sebanyak 671 anak yang dibagi menjadi 3 kelompok yaitu 1.) anak normal, 2.) anak dengan hambatan pertumbuhan dan tidak tumbuh cepat,3.) anak dengan hambatan pertumbuhan diikuti tumbuh cepat. Analisis multivariat menggunakan GLM univariat dan Regresi Cox dilakukan untuk menganalisis pengaruh pertumbuhan cepat setelah terjadinya hambatan pertumbuhan pada 1000 HPK terhadap tekanan darah pada usia remaja. Hasil : Hasil analisis menunjukkan, anak yang tumbuh cepat menurut TB/U setelah mengalami hambatan pertumbuhan, memiliki rata-rata tekanan darah sistolik 4,61 mm Hg (CI: 1,38-7,84) lebih tinggi dan rata-rata tekanan darah diastolik 3,89 mm Hg (CI: 0,67-7,11) lebih tinggi, serta berisiko 1,58 (CI:0,83-2,33) kali mengalami tekanan darah tinggi dibanding anak yang normal setelah dikontrol faktor karakteristik anak, orang tua dan rumah tangga. Set Kesimpulan: Pertumbuhan cepat setelah terjadinya hambatan pertumbuhan di 1000 HPK meningkatkan risiko peningkatan tekanan darah pada usia remaja. Rekomendasi : Upaya pencegahan hambatan pertumbuhan dan perkembangan pada periode 1000 HPK bersama-sama dengan menerapkan pola makan bergizi seimbang pada anak berusia 2 tahun atau lebih, merupakan pencegahan yang sangat penting dalam menurunkan hipertensi pada remaja.
Background : The First Thousand Days of Life (1000 HPK) is a golden period for growth and development that determines the quality of children?s health in the next life cycle. The growth retardation that occurs in this period is mainly due to malnutrition, causing the plastic fetus to adjust to limiting growth and development. Several longitudinal studies have shown that faster growth after growth retardation might be a risk factor for high blood pressure in adolescence. This study aims to prove the effect of rapid growth in children with a history of growth retardation at the age of 0-23 months on blood pressure at the age of 17-19 years. Method: The data in this study used the results of the 1997,2000 and 2014 Indonesian Family Life Survey which were taken in 13 provinces in Indonesia. Data collection was carried out longitudinally with a sample unit of household with children aged 0-23 months as sample unit in 1997 followed in 2000 and 2014. The measurement of Rapid growth was determined by changes in the z score values of Weight for Age, Length/Height for Age, and Weight for Height inter-year survey, which is more than 0.67 points. Blood pressure was measured in 2014 when children were 17- 19 years old. The sample size of the study was 671 children who were divided into 3 groups, namely 1.) normal children, 2.) children with growth retardation and not growing fast,3.) children with growth retardation followed by fast growth. Multivariate analysis using univariate GLM and Cox Regression was carried out to analyze the effect of rapid growth after growth retardation at 1000 HPK on blood pressure in adolescents. Results: The result of analysis showed that, children who grew fast according to Height for Age U after experiencing growth retardation, had an average systolic blood pressure of 4,61 mmHg (CI: 1,38-7.84) higher and average diastolic blood pressure of 3,89 mmHg (CI: 0.67-7,11) higher, and 1,58 times of experiencing high blood pressure (CI:0,83-2,33)higher than normal children after controlling for characteristic of children, parents and household factors. Conclusion: Rapid growth after the occurrence of growth retardation in 1000 HPK increases the risk of increased blood pressure in adolescence. Recommendation: Efforts to prevent growth and development retardation in 1000 HPK together with implementing a balanced nutritious diet in children aged 2 years or older, are very important preventions in reducing hypertension in adolescents.
D-471
Depok : FKM-UI, 2022
S3 - Disertasi Pusat Informasi Kesehatan Masyarakat
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Hasnawati Amqam; Promotor: Umar Fahmi Achmadi; Kopromotor: Budi Haryanto, Irawan Yusuf; Penguji: Kusharisupeni Djokosujono, Imam Subekti, Asep Nugraha Ardiwinata, Indang Trihandini, Dewi Susanna
Abstrak:
ABSTRAK Penggunaan jangka panjang insektisida klorpirifos (CPF) akan menimbulkan efek pada Thyroid Stimulating Hormone (TSH) dan hormon-hormon tiroid (triidiotironin/T3 dan tirotoksin/T4). Studi ini bertujuan untuk mengetahui pengaruh insektisida CPF terhadap kadar TSH dan hormon-hormon tiroid pada petani sayur dari tinjauan aspek genetik populasi. Studi ini dilakukan dengan desain potong lintang. Terdapat 273 petani sayur yang menjadi subjek, yang diambil pada tiga populasi suku, yaitu Jawa, Sunda, dan Makassar. Terdapat variasi genetik paraoxonase 1 (PON1) pada ketiga populasi dan alel Q banyak ditemukan pada semua populasi. PON1 dapat menjadi prediktor terjadinya gangguan pada kadar hormon-hormon tiroid dan TSH. TCP sebagai metabolit CPF merupakan biomarker kemampuan metabolisme individu terhadap CPF. Pada masyarakat petani yang terpajan klorpirifos, TCP urin yang tidak terdeteksi berperan dalam terjadinya kadar FT3 rendah dan kadar TCP urin yang rendah berperan dalam terjadinya kadar FT4 tertil rendah dan kadar TSH tinggi. Efek CPF terhadap ketiga hormon ini diduga terjadi melalui mekanisme terganggunya sistem neurotransmitter dan proses deyodinasi pada perifer dan hati.
ABSTRACT Long-term use of chlorpyrifos (CPF) insecticide will affects Stimulating Thyroid Hormone (TSH) and thyroid hormones (triidiotironin/T3 and tirotoksin/ T4). This study aimed to assess the effect of insecticide CPF on levels of TSH and thyroid hormones of the vegetable farmers as the reviews of population genetic aspects. This study was conducted with a cross-sectional design. There were 273 vegetable farmers as subjects, taken in three population, namely Java, Sunda, and Makassar. There was genetic variation of paraoxonase 1 (PON1) in a population of in the three populations and Q alleles found in all populations. PON1 may be a predictor of causing interference to the levels of thyroid hormones and TSH. TCP as CPF metabolite was a biomarker of individual metabolic capabilities toward CPF. In exposed CPF farming communities, undetected TCP urine played a role in occurrence of low FT3 levels while low levels of TCP urine play a role for lower tertile FT4 level and high TSH level. CPF effect to the hormones possiblyoccured through the mechanism of disruption of neurotransmitter system and deiodinase process in peripheral and liver
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D-348
Depok : FKM-UI, 2025
S3 - Disertasi Pusat Informasi Kesehatan Masyarakat
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Putri Ayuni Alayyannur; Promotor: Doni Hikmat Ramdhan; Kopromotor: L. Meily Widjaja, Tri Martiana; Penguji: Laila Fitria, Mila Tejamaya, Robiana Modjo, Iting Shofwati
Abstrak:
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Pendahuluan: Pajanan panas pekerjaan sebagai salah satu faktor risiko indikasi gangguan fungsi ginjal di berbagai studi. Nelayan dan pekerja pemindang termasuk pekerja berisiko terpajan panas. Studi ini akan mengembangkan model kontribusi pajanan panas pekerjaan pada indikasi gangguan fungsi ginjal pada pekerja di sektor perikanan Jawa Timur. Metode: Desain penelitian ini adalah cross sectional pada pekerja sektor perikanan Kabupaten Lamongan di Desember 2022-Februari 2023. Besar sampel 150 nelayan dan pemindang yang didapat dengan rumus uji hipotesis untuk proporsi populasi tunggal. Variabel yang diteliti meliputi faktor personal (usia, jenis kelamin, penyakit komorbid, antropometri, konsumsi obat. waktu istirahat, konsumsi air putih, konsumsi minuman manis, konsumsi minuman bersoda, konsumsi minuman berenergi, konsumsi kopi, konsumsi teh, konsumsi legen, dan konsumsi tuak), faktor pekerjaan (jenis pekerjaaan, masa kerja, beban kerja, dan pakaian kerja), faktor iklim (temperatur, kelembaban, dan kecepatan angin), pajanan panas, tekanan panas, dan indikasi gangguan fungsi ginjal (eGFR CKD-EPI dan uKIM-1). Pengumpulan data menggunakan sampel urin, sampel darah, heat stress monitor, sphygmomanometer, oximeter, microtoise, timbangan badan, dan kuesioner. Analisis data bivariat menggunakan t-test sampel independen dan uji ChiSquare, sedangkan uji multivariat menggunakan cox regression. Hasil: Usia, konsumsi air putih, konsumsi teh, jenis pekerjaan, masa kerja, beban kerja (%CVL), pakaian kerja, tekanan panas, dan dehidrasi (BJU) berhubungan dengan indikasi gangguan fungsi ginjal eGFR (CKD-EPI). Konsumsi air putih, konsumsi minuman manis, dan beban kerja (observasi) berhubungan dengan indikasi gangguan fungsi ginjal uKIM-1 . Model yang terbentuk adalah HeGFR(t) = h0 (t) exp (0,393 pajanan panas pekerjaan + 0,551 konsumsi air putih + 0,339 konsumsi kopi + 1,446 beban kerja (%CVL) + 0,865 pakaian kerja) Kesimpulan: pajanan panas pekerjaan merupakan faktor risiko terjadinya indikasi gangguan fungsi ginjal eGFR (CKD-EPI), dengan turut mempertimbangkan faktor yang lain yaitu konsumsi air putih, konsumsi kopi, beban kerja (%CVL), dan pakaian kerja. Oleh karena itu, perlu aktivasi Pos UKK untuk memberdayakan pekerja dalam melakukan kegiatan keselamatan dan kesehatan kerja.
Introduction: Occupational heat exposure can pose a significant risk to workers' health, especially regarding their kidney function. Studies have shown fishermen and pemindang workers are particularly vulnerable to heat exposure. To address this issue, a study is being conducted to develop a model that examines the impact of occupational heat exposure on kidney function in workers within the East Java fisheries sector. Method: This research design is cross-sectional among fisheries sector workers in Lamongan District in December 2022 to February 2023. The sample size is 150 fishermen and pemindang was obtained using the hypothesis testing formula for a single population proportion. The variables studied included personal factors (age, gender, comorbid diseases, anthropometry, drug consumption, rest time, water consumption, consumption of sweet drinks, consumption of fizzy drinks, consumption of energy drinks, consumption of coffee, consumption of tea, consumption of legumes, and consumption of palm wine), work factors (type of work, length of work, workload, and work clothing), climate factors (temperature, humidity, and wind speed), heat exposure, heat stress, and indications of impaired kidney function (eGFR CKD-EPI and uKIM-1). Data collection uses urine samples, blood samples, heat stress monitor, sphygmomanometer, oximeter, microtoise, body weighing, and questionnaires. Bivariate data analysis uses the independent samples t-test and Chi-Square test, while the multivariate test uses cox regression. Results: Age, water consumption, tea consumption, type of work, years of work, workload (%CVL), work clothing, heat stress, and dehydration (BJU) were associated with indications of impaired kidney function eGFR (CKD-EPI). Water consumption, consumption of sweet drinks, and workload (observation) are associated with indications of impaired uKIM-1 kidney function. The model formed is HeGFR(t) = h0 (t) exp (0.393 occupational heat exposure + 0.551 water consumption + 0.339 coffee consumption + 1.446 workload (%CVL) + 0.865 work clothes) Conclusion: occupational heat exposure is a risk factor for indications of impaired kidney function eGFR (CKD-EPI), taking into account other factors, namely water consumption, coffee consumption, workload (%CVL), and work clothing. Therefore, it is necessary to activate the Pos UKK to empower workers to carry out occupational safety and health activities.
D-498
Depok : FKM-UI, 2024
S3 - Disertasi Pusat Informasi Kesehatan Masyarakat
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Satria Pratama; Promotor: Haryoto Kusnoputranto; Kopromotor: Bambang Wispriyono, Faisal Yunus; Penguji: Fatma Lestari, Besral, Elisna Syahruddin, Inswiyasri, Sonny Warouw
D-338
Depok : FKM-UI, 2016
S3 - Disertasi Pusat Informasi Kesehatan Masyarakat
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Eviana Sumarti Tambunan; Promotor: Hadi Pratomo; Kopromotor: Ella Nurlaela Hadi, Yeni Rustina; Penguji: Asri C Adisasmista, Sutanto Priyo Hastono, Nani Dharmasetyawani, Setyadewi Lusyati, Ade Iva Wicaksono
Abstrak:
Pendidikan kesehatan pada ibu dapat meningkatkan praktik perawatan bayi berat lahir rendah (BBLR), namun kemampuan ibu untuk melakukan praktik perawatan BBLR di rumah belum banyak digali. Penelitian ini bertujuan untuk menilai pengaruh paket pendidikan kesehatan pada ibu terhadap praktik perawatan BBLR di Jakarta Pusat. Penelitian dilakukan terhadap 159 ibu dengan BBLR yang bayinya dinyatakan boleh pulang dari ruang Perinatologi dengan pendekatan quasi eksperimen (78 ibu kelompok intervensi dan 81 ibu kelompok kontrol) dan teknik pengambilan sampel secara consecutive sampling. Ibu dengan BBLR yang berdomisili di wilayah intervensi mendapatkan paket pendidikan kesehatan yang diberikan oleh perawat puskesmas. Paket pendidikan kesehatan terdiri dari penyuluhan tentang perawatan BBLR, yang diberikan pada 3-5 hari setelah BBLR keluar RS dan pendampingan pada ibu dan keluarga pada minggu ke-2 dan ke-6 setelah penyuluhan atau pengukuran awal. Ibu yang berdomisili di wilayah kontrol mendapatkan booklet tentang perawatan BBLR. Kedua kelompok dilakukan pengukuran dengan waktu yang sama sebanyak 4x yaitu 3 hari setelah keluar RS, 2, 6 dan 12 minggu setelah penyuluhan atau pengukuran awal. Pengumpulan data kualitatif juga dilakukan untuk melengkapi informasi yang diperlukan setelah mendapatkan gambaran hasil kuantitaif. Analisis multvariat dilakukan dengan Regresi Linier Ganda General Estimating Equation (GEE). Hasil memperlihatkan pemberian paket pendidikan kesehatan pada ibu dengan BBLR memberikan efek peningkatan praktik ibu dalam perawatan BBLR sebesar 25,19%. Praktik perawatan BBLR pada ibu di kelompok intervensi lebih tinggi dibandingkan kelompok kontrol pada setiap waktu pengukuran (p=0,000). Variabel sikap dan dukungan kader kesehatan yang dilatih merupakan konfonder yang mempengaruhi hubungan pendidikan kesehatan terhadap praktik ibu dalam perawatan BBLR. Kesimpulan: Pemberian paket pendidikan kesehatan yang dilakukan berkelanjutan selama 6 minggu berdampak efektif terhadap peningkatan praktik perawatan BBLR di rumah dan terhadap peningkatan status kesehatan bayi. Paket pendidikan kesehatan dapat dikembangkan di komunitas dengan melibatkan kader kesehatan untuk memberikan pendampingan pada ibu dengan BBLR diwilayahnya. Pelatihan ataupun sosialisasi tentang perawatan BBLR perlu diberikan pada tenaga kesehatan puskesmas dan kader kesehatan, sehingga dapat melakukan pendampingan secara tepat pada ibu dengan BBLR.
Health education for mothers can improve low birth weight (LBW) infant care practices. Yet, the ability of mothers to exercise LBW infant care at home has not been much explored. This study aims to assess the effect of health education packages on mothers towards LBW infant care practices in Central Jakarta. The study was conducted on 159 LBW mothers whose babies were permitted to return from the perinatology room with a quasi-experimental approach (78 mothers in the intervention group and 81 mothers in the control group). The sampling technique of this study was consecutive sampling. LBW mothers who were domiciled in the intervention areas received health education packages provided by nurses in health centers. The health education package consisted of counseling on LBW care given in 3-5 days after LBW infant out of the hospital and mentoring for mothers and families at the 2nd and 6th weeks after counseling or initial measuring. Mothers who lived in the control area received a booklet on LBW infant care. The two groups were measured with the same time as much as 4 times, which was 3 days after leaving the hospital, 2, 6 and 12 weeks after counseling or the initial measurements. Qualitative data collection were also done to complete the information needed after getting a picture of the quantitative results. Multivariate analysis was carried out with Multiple Linear Regression General Estimating Equation (GEE). The results showed the provision of health education packages to mothers with LBW have an effect to increase the practice of mothers in LBW infant care by 25.19%. The practice of LBW infant care among mothers in intervention group were higher than those in control groups at each measurement (p = 0,000). The attitude and support of trained health cadres variable are confounders that influence the relationship of health education to the practice of mothers in LBW care. Conclusion: The provision of health education packages carried out continuously for 6 weeks has an effective impact on improving the practice of LBW infant care at home and has an impact on improving the health status of infants. Community-based health education packages developed by involving health cadres to provide assistance to mothers with LBW infant in their area. Training or socialization of LBW infant care to be given to health center workers and cadres, so they could provide appropriate assistance to LBW mothers.
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D-402
Depok : FKM-UI, 2019
S3 - Disertasi Pusat Informasi Kesehatan Masyarakat
☉
Nurfanida Librianty; Promotor: Bambang Wispriyono; Kopromotor: Haryoto Kusnoputranto, Anna Rozaliyani, Penguji: Faisal Yunus, Besral, Arief Budi Witarto
Abstrak:
Pandemi Coronavirus diseases 2019 (COVID-19) membuat krisis kesehatan global. Pajanan lama PM, NO2, CO, O3 berefek negatif terhadap pasien COVID-19. Beberapa penelitian menunjukkan hubungan signifikan kerentanan genetik terhadap efek polutan udara terhadap penyakit, seperti pasien COVID-19 dengan polimorfisme ACE rs4646994 atau ACE2 rs2285666 dapat memiliki derajat lebih berat. Tujuan penelitian ini untuk menganalisis pengaruh pajanan PM2,5, NO2, O3, kondisi iklim, polimorfisme ACE rs4646994 dan ACE2 rs2285666, usia, IMT, serta komorbid hipertensi, penyakit jantung, asma dan DM terhadap derajat COVID-19. Data lingkungan didapatkan dari BMKG dan subjek berdomisili radius < 3 km dari Stasiun Metereologi Kemayoran dengan membagi menjadi kelompok pasien derajat asimtomatik-ringan dan sedang-berat. Pemeriksaan polimorfisme diambil dari sampel swab bukal. Data dilakukan analisis regresi logistik.
Hasil penelitian ini mendapatkan pasien COVID-19 dengan polimorfisme ACE2 rs2285666 genotip AA akan berisiko 9,128 kali mengalami derajat lebih berat. Polimorfisme ACE rs4646994, pajanan PM2,5, NO2 serta komorbid tidak berhubungan signifikan dengan derajat COVID-19. Pajanan O3, temperatur rendah, kelembaban rata-rata tinggi, sedikit sinar matahari, dan IMT tinggi secara signifikan memperberat COVID-19 pada analisis bivariat. Penelitian ini menyimpulkan polimorfisme ACE2 rs2285666 genotip AA merupakan faktor risiko memberatnya derajat COVID-19. Pajanan O3, IMT, temperatur minimum, temperatur rata-rata, kelembaban rata-rata dan lama penyinaran matahari dapat berperan terhadap derajat COVID-19.
Coronavirus Disease 2019 (COVID-19) pandemic created a global health crisis. Prolonged exposure to PM, NO2, CO, O3 has a negative effect on COVID-19 patients. Several studies have shown a significant relationship between genetic susceptibility to the effects of air pollutants on disease, such as COVID-19 patients with ACE rs4646994 or ACE2 rs2285666 polymorphisms can have a more severe degree. The aim of this study was to analyze the effect of exposure to PM2.5, NO2, O3, weather conditions, ACE rs4646994 and ACE2 rs2285666 polymorphisms, age, BMI, and comorbidities (hypertension, heart disease, asthma, and DM) on the degree of COVID-19. Environmental data were obtained from the BMKG and the subjects were domiciled within a radius of <3 km from the Kemayoran Meteorological Station by dividing the patients into asymptomatic-mild and moderate-severe groups. Polymorphism examination was taken from a buccal swab sample. Logistic regression was used to analyze the data. The results of this study found that COVID-19 patients with the polymorphism ACE2 rs2285666 genotype AA would be 9.128 times more at risk of experiencing a more severe degree. Polymorphism ACE rs4646994, exposure to PM2.5, NO2 and comorbidities were not significantly related to the degree of COVID-19. O3 exposure, low temperature, high average humidity, fewer durations of sunlight, and high BMI significantly aggravate COVID-19 in bivariate analysis. This study concluded that the polymorphism ACE2 rs2285666 genotype AA is a risk factor for the severity of COVID-19. Exposure to O3, BMI, minimum temperature, average temperature, average humidity, and duration of sunlight can play a role in the degree of COVID-19.
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Coronavirus Disease 2019 (COVID-19) pandemic created a global health crisis. Prolonged exposure to PM, NO2, CO, O3 has a negative effect on COVID-19 patients. Several studies have shown a significant relationship between genetic susceptibility to the effects of air pollutants on disease, such as COVID-19 patients with ACE rs4646994 or ACE2 rs2285666 polymorphisms can have a more severe degree. The aim of this study was to analyze the effect of exposure to PM2.5, NO2, O3, weather conditions, ACE rs4646994 and ACE2 rs2285666 polymorphisms, age, BMI, and comorbidities (hypertension, heart disease, asthma, and DM) on the degree of COVID-19. Environmental data were obtained from the BMKG and the subjects were domiciled within a radius of <3 km from the Kemayoran Meteorological Station by dividing the patients into asymptomatic-mild and moderate-severe groups. Polymorphism examination was taken from a buccal swab sample. Logistic regression was used to analyze the data. The results of this study found that COVID-19 patients with the polymorphism ACE2 rs2285666 genotype AA would be 9.128 times more at risk of experiencing a more severe degree. Polymorphism ACE rs4646994, exposure to PM2.5, NO2 and comorbidities were not significantly related to the degree of COVID-19. O3 exposure, low temperature, high average humidity, fewer durations of sunlight, and high BMI significantly aggravate COVID-19 in bivariate analysis. This study concluded that the polymorphism ACE2 rs2285666 genotype AA is a risk factor for the severity of COVID-19. Exposure to O3, BMI, minimum temperature, average temperature, average humidity, and duration of sunlight can play a role in the degree of COVID-19.
D-473
Depok : FKM UI, 2023
S3 - Disertasi Pusat Informasi Kesehatan Masyarakat
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Rika Raniya; Pembimbing: Ema Hermawati; Penguji: Budi Haryanto, Windi
Abstrak:
Polutan utama dari kegiatan pembakaran batubara salah satunya SO2. Sulfur dioksidia menyebabkan iritasi, batuk refleks, menyebabkan penyakit pernafasan dan gangguan daya tahan paru-paru. Penelitian ini bertujuan menganalisis pajanan SO2 di lingkungan sekitar pembangkit listrik tenaga uap (PLTU) Suralaya yaitu pada desa Lebak Gede, Cipala Dua, Brigil, Gunung Gede, Salira Indah, dan Sumuranja dan risiko gangguan pernafasannya pada masyarakat sekitar. Penelitian ini bersifat deskriptif, dengan pendekatan cross sectional. Sampel responden diambil secara purposive sampling berdasarkan titik pengukuran udara pada setiap desa yaitu 35 orang di setiap desa. Penelitian ini dilakukan dengan metode Analisis Risiko Kesehatan Lingkungan (ARKL) yang menggunakan nilai Rfc SO2 (0,026 mg/kg/hari), dan selanjutnya dihubungkan secara cross sectional untuk menghubungkan tingkat risiko dengan kejadian gangguan pernafasan di sekitar PLTU. Hasil ARKL menunjukkan bahwa tingkat risiko di lingkungan sekitar PLTU Suralaya yaitu pada desa Lebak Gede, Cipala Dua, Brigil, Gunung Gede, Salira Indah, dan Sumuranja masih tergolong aman karena memiliki nilai RQ dibawah 1 dalam kurun waktu lebih dari 30 tahun. Hasil analisis cross sectional menunjukkan bahwa tidak ada hubungan antara tingkat risiko kesehatan akibat pajanan SO2 dengan kejadian gangguan saluran pernafasan pada masyarakat di sekitar PLTU karena memiliki nilai-p yang lebih besar dari alfa.
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S-10191
Depok : FKM UI, 2019
S1 - Skripsi Pusat Informasi Kesehatan Masyarakat
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