Ditemukan 33557 dokumen yang sesuai dengan query :: Simpan CSV
Dara Puspita Dewi; Pembimbing: Nurhayati Adnan; Penguji: Syahrizal Syarif, Hario Baskoro
Abstrak:
Covid-19 telah mewabah ke hampir seluruh negara di dunia selama lebih dari satu tahun. Case Fatality Rate (CFR) dan Recovery Rate (RR) penyakit digunakan untuk menilai tingkat keparahan, risiko pada populasi dan mengevaluasi mutu fasilitas pelayanan kesehatan. Status gizi dapat memperburuk prognosis penyakit, ketahanan hidup, dan memperpanjang lama rawat inap. Obesitas menyebabkan morbiditas yang lebih tinggi saat perawatan di rumah sakit seperti kegagalan sistem pernafasan, pemindahan tempat rawat ke ICU dan meningkatkan tingkat kematian. Penelitian ini bertujuan untuk mengetahui kesintasan pasien dewasa yang dirawat di rumah sakit berdasarkan status gizi. Penelitian menggunakan desain studi kohort retrospektif menggunakan data rekam medis pasien rawat inap terkonfirmasi Covid-19 tahun 2021 di RS Universitas Indonesia dan dianalisis menggunakan Cox Proportional Hazard Model. Hasil menunjukkan perbedaan probabilitas kesintasan antara pasien dewasa terkonfirmasi Covid-19 yang dirawat di RS Universitas Indonesia dengan status gizi normoweight, underweight dan obesitas (15,41% vs 71,11% vs 7,43%). Pasien dengan underweight meningkatkan risiko kematian sebesar 1,19 kali dibandingkan pasien dengan normoweight (95% CI 0,471-3,049) setelah dikontrol dengan usia, tingkat keparahan, dan ARDS. Sedangkan pasien dengan overweight/obesitas meningkatkan risiko kematian sebesar 1,03 kali dibandingkan pasien dengan normoweight (95% CI 0,714-1,487)
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T-6415
Depok : FKM-UI, 2022
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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Rizka Fahmia; Pembimbing: Helda; Penguji: Syahrizal Syarif, Astuti Giantini, Tristiyenny Pubianturi
Abstrak:
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COVID-19 menjadi pandemi di seluruh dunia sejak Maret 2020. Hipertensi merupakan penyakit penyerta yang banyak diderita oleh pasien COVID-19. Banyaknya kasus COVID-19 membuat daya tampung fasilitas kesehatan hampir tidak mencukupi untuk memberikan pelayanan medis rawat inap yang memadai pada pasien COVID-19. Perpanjangan lama rawat inap pasien COVID-19 berefek terhadap besaran biaya yang ditanggung pemerintah atau pasien sendiri. Penentuan prioritas pasien rawat inap menjadi penting untuk rekomendasi panduan pelayanan pasien COVID-19. Saat ini penelitian tentang hubungan hipertensi dengan durasi lama rawat inap pasien COVID-19 di Indonesia masih belum ada. Penelitian bertujuan mengetahui hubungan antara hipertensi dengan lama rawat inap pasien terkonfirmasi COVID-19 di Rumah Sakit Universitas Indonesia (RSUI). Desain studi kohort retrospectif dilakukan pada 369 pasien terkonfirmasi COVID-19 yang dirawat inap di RSUI selama Maret sampai dengan Oktober 2020, menilai hubungan hipertensi dengan lama rawat inap pasien terkonfirmasi COVID-19 setelah di kontrol usia, jenis kelamin, komorbid, tingkat keparahan, status PCR saat pulang dan status pasien pada akhir rawat. Hasil penelitian didapatkan bahwa median lama rawat inap adalah 13 hari (range 3 – 74 hari). Pasien hipertensi dirawat inap 2 sd 3 hari lebih lama dibandingkan dengan pasien normotensi. Pada analisis bivariat, hipertensi berhubungan dengan lama rawat inap ≥ 14 hari (RR 1,343 95% CI 1,085-1,662 p=0,008). Pada analisis multivariat, hipertensi tidak terbukti memiliki hubungan dengan lama rawat inap ≥ 14 hari pada pasien terkonfirmasi COVID-19 (aRR 1,121, 95% CI 0,818-1,534, pvalue=0,476) setelah mempertimbangkan keparahan penyakit sedang dan berat. Kata kunci: Hipertensi, COVID-19, lama rawat inap, keparahan
COVID-19 became a worldwide pandemic since March 2020. Hypertension is the most prevalent comorbid amongst COVID-19 patients. The large number of COVID-19 cases has made the capacity of health facilities almost insufficient to provide adequate inpatient medical services for COVID-19 patients. Prolonged hospitalization impacted to increased costs borne by government or patients themselves. Prioritizing inpatients is important for guiding COVID-19 patient care. Currently, there is no research on the relationship between hypertension and the duration of hospitalization for COVID-19 patients in Indonesia. This study aims to determine the relationship between hypertension and length of stay of confirmed COVID-19 patients at the University of Indonesia Hospital (RSUI). A retrospektif cohort study design was conducted on 369 confirmed COVID-19 patients who were hospitalized at RSUI during March to October 2020, assessing the relationship between hypertension and the length of stay of patients with confirmed COVID-19 after being controlled for age, gender, severity, comorbidities, outpatient PCR status, patients status at discharged. The results showed that the median length of hospitalization was 13 days (range 3 – 74 days). Hypertensive patients are hospitalized for 2 to 3 days longer than normotensive patients. In bivariat analysis, hipertensi shown to have association with length of hospital stay ≥ 14 days (RR 1,343 95% CI 1,085-1,662 p=0,008). In multivariate analysis, hypertension was not shown to have an association with length of stay ≥ 14 days in patients with confirmed COVID-19 (RR 1.121, 95% CI 0.846-1.703, p-value = 0.476) after being controlled for moderate and severe disease severity. Key words: Hypertension, COVID-19, hospital length of stay, severity
T-6216
Depok : FKM-UI, 2021
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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Gita Aprilicia; Pembimbing: Syahrizal Syarif; Penguji: Nurhayati Adnan, Juferdy Kurniawan, Kemal Fariz Kalista
Abstrak:
Latar Belakang. COVID-19 mempunyai manifestasi klinis utama di saluran pernapasan. Selain pernapasan, manifestasi COVID-19 juga ditemukan di hati. Gangguan fungsi hati pada pasien COVID-19 ditandai dengan peningkatan enzim alanine aminotransferase (ALT), aspartate aminotransferase (AST), dan bilirubin. Penelitian ini bertujuan mengetahui hubungan gangguan fungsi hati terhadap kesintasan pasien COVID-19 di RS Cipto Mangunkusumo. Metode. Desain penelitian ini kohort retrospektif. Populasi adalah pasien rawat inap dewasa dengan konfirmasi COVID-19 periode Oktober 2020 hingga Januari 2021. Analisis survival dengan Kaplan Meier digunakan untuk mengetahui kesintasan. Analisis Regresi Cox Extended digunakan untuk mengetahui hubungan kausal gangguan fungsi hati terhadap kesintasan pasien COVID-19 Kesimpulan. Adanya gangguan fungsi hati pada 14 hari masa awal pengamatan berkontribusi terhadap kesintasan pasien COVID-19.
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T-6240
Depok : FKM-UI, 2021
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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Zhara Juliane; Pembimbing: Asri C. Penguji: Syahrizal; Dony Yugo Hermanto, Sukwan Handali
Abstrak:
As of January 30 2020, the World Health Organization (WHO) deemed Covid-19 as a Public Health Emergency of International Concern (PHEIC) due to a significant increase of cases and confirmed cases in several countries (World Health Organization, 2020a). In April 2021, the mortality rate of COVID-19 in Indonesia reached 4.68%, which is higher than the global average mortality rate of 3.79%. Previous studies have shown that there is a relationship between hypertension and diabetes mellitus on the survival of Covid-19 patients. This study aims to determine the relationship between hypertension and diabetes mellitus on the survival of Covid-19 patients at RSJPD Harapan Kita Jakarta March 2020 - April 2021. This retrospective cohort study was conducted using cox regression analysis to determine survival. This study uses secondary data provided by the infection prevention and control division of Harapan Kita and medical record tracing. The study involved a total of 433 confirmed Covid-19 patients who were selected using random sampling technique. The results of the analysis show that hypertension and diabetes mellitus were significantly related to the incidence of death in Covid-19 patients at RSJPD Harapan Kita March 2020 - April 2021 after being controlled for confounding factor namely chronic lung disease with an adjusted hazard ratio of 1.727 (95% CI: 1.012 – 2.499), p-value 0.045. Proper triage of patients is needed, as well as rigorous monitoring and adequate treatment for Covid-19 patients who suffer from hypertension and diabetes mellitus to prevent further mortality and morbidity.
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Terhitung sejak 30 Januari 2020, World Health Organization (WHO) telah resmi menetapkan Covid-19 sebagai Kedaruratan Kesehatan Masyarakat yang Meresahkan Dunia (KKMMD)/ Public Health Emergency of International Concern (PHEIC) karena adanya peningkatan kasus yang signifikan dan kasus konfirmasi di beberapa negara lain (World Health Organization, 2020a). Pada April 2021, angka kematian Covid-19 di Indonesia telah menyentuh 4,68% dimana angka tersebut lebih tinggi dari angka kematian rata-rata global yaitu 3,79%. Studi-studi yang telah dilakukan sebelumnya menunjukan adanya hubungan hipertensi dan diabetes melitus terhadap kesintasan pasien Covid-19. Penelitian ini bertujuan untuk mengetahui hubungan hipertensi dan diabetes melitus terhadap kesintasan pasien Covid-19 di RSJPD Harapan Kita Jakarta Maret 2020 - April 2021. Penelitian kohort retrospektif ini menggunakan analisis survival cox regression untuk mengetahui kesintasan. Penelitian ini menggunakan sumber data sekunder dari Divisi PPI dan penelusuran rekam medik. Penelitian ini melibatkan jumlah sampel sebesar 433 pasien konfirmasi Covid-19 yang diambil menggunakan teknik random sampling. Hasil analisis menunjukan hipertensi dan diabetes melitus berhubungan bermakna dengan kejadian kematian pada pasien Covid-19 di RSJPD Harapan Kita Maret 2020 - April 2021 setelah dikontrol oleh faktor perancu penyakit paru kronik dengan adjusted hazard ratio sebesar 1,727 (95% CI: 1,012 – 2,949) p-value 0,045. Perlu adanya triase pasien yang tepat dan pemantauan khusus serta penanganan yang adekuat untuk pasien Covid-19 yang memiliki faktor risiko hipertensi dan diabetes melitus untuk mencegah terjadinya kematian.
As of January 30 2020, the World Health Organization (WHO) deemed Covid-19 as a Public Health Emergency of International Concern (PHEIC) due to a significant increase of cases and confirmed cases in several countries (World Health Organization, 2020a). In April 2021, the mortality rate of COVID-19 in Indonesia reached 4.68%, which is higher than the global average mortality rate of 3.79%. Previous studies have shown that there is a relationship between hypertension and diabetes mellitus on the survival of Covid-19 patients. This study aims to determine the relationship between hypertension and diabetes mellitus on the survival of Covid-19 patients at RSJPD Harapan Kita Jakarta March 2020 - April 2021. This retrospective cohort study was conducted using cox regression analysis to determine survival. This study uses secondary data provided by the infection prevention and control division of Harapan Kita and medical record tracing. The study involved a total of 433 confirmed Covid-19 patients who were selected using random sampling technique. The results of the analysis show that hypertension and diabetes mellitus were significantly related to the incidence of death in Covid-19 patients at RSJPD Harapan Kita March 2020 - April 2021 after being controlled for confounding factor namely chronic lung disease with an adjusted hazard ratio of 1.727 (95% CI: 1.012 – 2.499), p-value 0.045. Proper triage of patients is needed, as well as rigorous monitoring and adequate treatment for Covid-19 patients who suffer from hypertension and diabetes mellitus to prevent further mortality and morbidity.
T-6561
Depok : FKM UI, 2022
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
☉
Evlina Suzanna; Pembimbing: Asri C Adisasmita; Penguji: Ratna Djuwita, Bambang
Abstrak:
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Karsinoma endometrium merupakan salah satu keganasan yang menyerang wanita dengan angka kesintasan yang relatif baik. Salah satu faktor yang diduga berperan dalam prognosis karsinoma endometrium antara lain adalah usia saat diagnosis. Penelitian ini bertujuan untuk melihat hubungan usia saat diagnosis dengan kesintasan hidup keseluruhan pasien 4 tahun karsinoma endometrium yang dirawat di RS Kanker Dharmais selama rentang tahun 2013–2019.
Studi ini merupakan kohort retrospektif yang menggunakan data sekunder berupa regsitri kanker berbasis rumah sakit dan sistem informasi RS di RSKD dengan subjek data pasien karsinoma endometrioid endometrium yang terdiagnosis dalam rentang 2013-2019. Sebanyak 220 pasien eligibel untuk dilakukan analisis terhadap variabel usia saat diagnosis, stadium, derajat keganasan, durasi menerima terapi, protokol terapi, kedalam invasi, adanya diabetes mellitus, hiperkolesterol, dan hipertensi. Analisis statistik digunakan untuk melihat hubungan masing-masing variabel terhadap kesintasan hidup, interaksi antar variabel, dan adanya perancu. Model akhir dibangun untuk melihat perbedaan kesintasan hidup pasien berdasarkan usia.
Probabilitas kesintasan hidup pada pasien karsinoma endometrium dirawat di RS Kanker Dharmais adalah 78,19%. Tidak terdapat perbedaan pada probabilitas kesintasan karsinoma endometrium pada kelompok usia ≥50 tahun (74,91%) dan
Endometrial endometrioid carcinoma is one of the malignancies that affect women with relatively excellent survival rates. One of the factors that play a role in the prognosis of endometrial carcinoma is the age at diagnosis. This study aims to examine the corellation between age at diagnosis and 4 years overall survival of endometrial carcinoma patients treated at Dharmais National Cancer Hospital from 2013 to 2019. This study was a retrospective cohort that utilized secondary data from the hospital-based cancer registry and the hospital information system at Dharmais National Cancer Hospital, involving subjects diagnosed with endometrioid endometrial carcinoma between 2013 and 2019. A total of 220 eligible patients were analyzed for variables such as age at diagnosis, stage, grade of malignancy, duration of treatment, treatment protocol, depth of invasion, presence of diabetes mellitus, hypercholesterolemia, and hypertension. Statistical analysis was used to assess the relationship between each variable and overall survival, interaction between variables, and confounding factors. A final model was constructed to examine the difference in survival among patients based on age at diagnosis. The survival probability for endometrial endometrioid carcinoma at Dharmais Cancer Hospital is 78.19%. There was no difference in the survival probability between the age groups ≥50 years (74.91%) and
T-7365
Depok : FKM-UI, 2025
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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Hubungan Early Warning Scoring System dengan Mortalitas Pasien COVID-19 di RS. Universitas Indonesia
Saetia Listiana; Pembimbing: Nurhayati Adnan; Yovsyah; Penguji: Astuti Yuni Nursasi, Rakhmad Hidayat
Abstrak:
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Tingkat mortalitas COVID-19 di Indonesia sebesar 2,7%, angka ini merupakan yang tertinggi di Asia Tenggara. Pasien COVID-19 yang mengalami perburukan di rumah sakit seperti masuk ICU dan kematian sebanyak 15-20%. Perubahan klinis pasien sebelum terjadinya perburukan dan kematian tidak disadari oleh 27,06% tenaga kesehatan. Menurut WHO, EWS dapat digunakan untuk mendeteksi perburukan pasien lebih awal, namun penelitian yang dilakukan untuk melihat hubungan EWS dengan kematian COVID-19 masih terbatas. Tujuan penelitian ini adalah untuk mengetahui besar risiko highrisk EWS dengan kejadian kematian serta probabilitas kesintasan pada pasien COVID-19 yang dirawat di RS UI. Penelitian ini menggunakan desain studi kohort retrospektif. Populasi pada penelitian ini adalah seluruh pasien COVID-19 yang dirawat inap di RS UI pada periode Maret – Desember 2020. Penelitian ini menggunakan total sampling. Jumlah sampel pada penelitian ini adalah 740 orang yang terdiri dari 137 orang pada kelompok terpapar dan 603 kelompok tidak terpapar. Analisis kesintasan dilakukan dengan menggunakan Kaplan Meier sedangkan analisis multivariat dilakukan dengan cox regresi. Probabilitas kesintasan pasien COVID-19 yang di rawat di RS UI sampai dengan 72 hari pengamatan sebesar 47,4%. Besar risiko pasien COVID-19 yang memiliki highrisk EWS untuk terjadi kematian sebesar 5,32 (95% CI= 3,26-8,69). Tenaga kesehatan diharapkan dapat mendeteksi perburukan pasien sedini mungkin agar bisa dilakukan intervensi lebih awal untuk mencegah kematian pada pasien COVID-19. Kata kunci: COVID-19, EWS, Mortalitas, Kesintasan
In Indonesia, the COVID-19 mortality level is 2.7%, which renders it the highest in Southeast Asia. The number of patients with COVID-19 that experienced an exacerbation in hospitals that needed ICU support and resulted in death accounts for 15 to 20%. The clinical progression of patients before exacerbation and subsequent death happened was not recognized by 27.06% of health workers. According to the WHO, EWS can be used to detect exacerbation early. However, studies examining the link between EWS and COVID-19 related death are still limited. The purpose of this study is to determine the association between high-risk EWS with the incidence of death and the probability of survival in COVID-19 patients treated at Universitas Indonesia (UI) Hospital. This study uses a retrospective cohort study design. The population included are all COVID-19 patients hospitalized at UI Hospital in the period of March – December 2020. This study uses total sampling with 740 people consisting of 137 people in the exposed group and 603 people in the unexposed group. Survival analysis was performed using Kaplan Meier. Multivariate analysis was done using Cox regression. The probability of survival of COVID-19 patients treated at UI Hospital with up to 72 days of observation is 47.4%. The risk of death of COVID-19 patients with high-risk EWS is 5.32 (95% CI = 3.268.69). Health workers are expected to be able to detect patient deterioration as early as possible so that earlier intervention can be carried out to prevent death in COVID-19 patients. Keywords: COVID-19, EWS, Mortality, Survival
T-6134
Depok : FKM-UI, 2021
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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Elsi Novitasari; Pembimbing: Mondastri Korib Sudaryo; Penguji: Yovsyah, Rina Handayani
S-10301
Depok : FKM-UI, 2020
S1 - Skripsi Pusat Informasi Kesehatan Masyarakat
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Henny Kurniati; Pembimbing: Ratna Djuwita; Penguji: Dwi Gayatri; Endang L. Achadi , Mahmud Fauzi
Abstrak:
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Obesitas merupakan permasalahan global yang semakin sering ditemukan diberbagai negara. Obesitas berkaitan erat dengan permasalahan penyakit tidak menular lainnya dan menyebabkan kematian pada 2,80 juta orang dewasa setiap tahunnya. Beberapa penelitian menemukan bahwa obesitas dapat disebabkan oleh status pertumbuhan individu pada usia dini. Sementara itu prevalensi obesitas saat dewasa di negara berkembang juga meningkat bersamaan dengan tingginya prevalensi kekurangan gizi pada masa anak-anak. Beberapa studi menunjukkan adanya fenomena catch up growth atau mengejar ketertinggalan pertumbuhan yang berdampak pada kelebihan gizi di masa depan. Tujuan dari penelitian ini adalah mengetahui hubungan status gizi stunting saat balita terhadap risiko obesitas saat dewasa di Indonesia berdasarkan analisis data Indonesia Family Life Survey tahun 1993 dan 2014. Desain penelitian adalah kohort retrospektif. Besar sampel yang digunakan adalah 588 sampel berdasarkan kriteria inklusi dan eksklusi. Hasil penelitian menunjukkan terdapat hubungan antara status gizi stunting saat balita terhadap risiko obesitas saat dewasa (p=0,003). Hasil analisis multivariat juga menunjukkan bahwa responden dengan status gizi stunting saat balita cenderung 1,63 (95% CI 1,18-2,27) kali berisiko mengalami obesitas saat dewasa setelah dikontrol variabel riwayat obesitas ibu, jenis kelamin, berat badan lahir, dan daerah tempat tinggal. Perlu penguatan program gizi spesifik, seperti pemeriksaan antenatal care (ANC) pada ibu hamil dan pemberian makanan tambahan bagi ibu hamil yang kekurangan energi kronis (KEK). Selain itu adanya upaya penguatan edukasi pada remaja perempuan saat mulai memasuki masa pubertas, dengan cara mengkonsumsi makanan yang tinggi protein seperti telur, susu, daging, ikan, keju, kerang dan udang. Protein nabati juga dianjurkan untuk dikonsumsi seperti tempe, tahu dan kacang- kacangan.
Obesity is a global problem that is increasingly found in various countries. Obesity is closely related to other non-communicable disease problems and causes death in 2,80 million adults each year. Several studies have found that obesity is also caused by an individual growth status in early age. Meanwhile, the prevalence of obesity as adults in developing countries has also increased, the prevalence of malnutrition in childhood was high. Several studies have shown that there is a catch- up growth phenomenon that results in excess nutrition in the future. The purpose of this study was to determine the relationship between stunting in childhood to the risk of obesity in adulthood in Indonesia based on analysis of Indonesia Family Life Survey data in 1993 and 2014. We used a retrospective cohort study. The sample size was 588 respondents based on inclusion and exclusion criteria. The results showed that the nutritional status of stunting in children associated with the risk of obesity in adolescent (p=0,003). The results of the multivariate analysis also showed that respondents with stunting nutritional status in children tended to be 1,63 (95% CI 1,18-2,27) times at risk of developing obesity in adolescent after controlling for the variables of history of maternal obesity, sex, birth weight, and area of residence. It is necessary to strengthen specific nutrition programs, such as antenatal care examinations for pregnant women and provision of additional food for pregnant women with chronic energy deficiency. In addition, there are efforts to strengthen education for teenager when they start entering puberty, by consuming foods that consist of high protein such as eggs, milk, meat, fish, cheese, shellfish, and shrimp. Plant-based or nabati protein is also recommended for consumption such as tempe, tofu, and nuts.
T-6626
Depok : FKM-UI, 2023
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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Hendra Dhermawan Sitanggang; Pembimbing: Tri Yunis Miko Wahyono; Penguji: Mondastri Korib Sudaryo, Adria Rusli, Nuraliyah
Abstrak:
IntroduksiPenemuan obat antiretroviral (ARV) secara dramatis menurunkan angka kesakitandan kematian ODHA. Namun, kepatuhan terhadap terapi ARV merupakantantangan tersendiri mengingat terapi ini harus dijalani seumur hidup. Kepatuhanterhadap terapi ARV merupakan salah faktor yang menentukan keberhasilanpengobatan. Ketidakpatuhan terhadap terapi ARV di Indonesia masih tinggi, yaituberkisar diantara 23-55%. Tujuan penelitian ini adalah untuk mengetahuipengaruh ketidakpatuhan berobat terhadap kesintasan 3 tahun pasien HIV/AIDS.MetodePenelitian ini menggunakan desain kohort retrospektif di RSPI Prof. Dr. SuliantiSaroso tahun 2010-2012.HasilProbabilitas survival kumulatif pasien HIV/AIDS di RSPI Prof dr. Sulianti Sarosopada tahun kedua (bulan ke-24) adalah 95,6% dan tahun ketiga (bulan ke-36)adalah 91%. Hasil analisis multivariat dengan regresi cox menunjukkan bahwakesintasan 3 tahun pasien HIV/AIDS dipengaruhi ketidakpatuhan minum obat,setelah dikontrol variabel CD4 awal (aHR = 7,608 ; 95%CI : 1,664-34,790) danketidakpatuhan janji ambil obat, setelah dikontrol variabel infeksi oportunistik,umur dan CD4 awal. (aHR = 2,456 ; 95%CI : 0,802-7,518). Pada pasien yangtidak patuh minum obat, ketidakpatuhan janji ambil obat berpengaruh terhadapkesintasan 3 tahun pasien HIV/AIDS, setelah dikontrol variabel CD4 awal, jeniskelamin, PPK, faktor risiko penularan, stadium klinis awal, infeksi oportunistik,dan umur (aHR = 4,517 ; 95%CI : 0,729-27,987).PembahasanKetidakpatuhan minum obat dapat menyebabkan kegagalan terhadap penekananreplikasi virus HIV, sehingga meningkatkan kemungkinan bermutasinya virusHIV yang dapat menyebabkan resisten terhadap obat dan akhirnya dapatmeningkatkan risiko kematian. Ketidakpatuhan terhadap janji ambil obat pada 1tahun pertama juga diasumsikan juga akan menunjukkan ketidakpatuhan terhadapjanji ambil obat selanjutnya dan menunjukkan ketidakpatuhan minum obat,sehingga meningkatkan risiko kematian.SaranMemonitoring cakupan kepatuhan minum obat pasien HIV/AIDS secara berkalasebagai kewaspadaan dini terhadap risiko kematian pasien HIV/AIDS.Kata Kunci : ketidakpatuhan minum obat, ketidakpatuhan janji ambil obat,kohort retrospektif
IntroductionDramatically, Anti-Retroviral drug Therapy (ART) has reduced morbidity andmortality of People Living with HIV/AIDS (PLWHA). However, adherence toantiretroviral therapy has become a challenge because this therapy must beendured for a lifetime. Adherence to antiretroviral therapy is one of the factorsthat determine the success of treatment. Poor adherence to ARV therapy inIndonesia is arround 23-55%. The objective of this study was to determine theinfluence of medication non-adherence to the 3-years survival of patients withHIV/AIDS.MethodsThis study used a retrospective cohort design at RSPI Prof. Dr. Sulianti Saroso in2010-2012.ResultsThe cumulative survival probability of patients with HIV/AIDS at RSPI Prof. dr.Sulianti Saroso in the second year (24th month) was 95.6% and the third year (inthe 36th) was 91%. Multivariate analysis with Cox regression showed the factorsthat affected the 3-years survival of patients with HIV/AIDS are non-adherence toART, after controlled by initial CD4 count (aHR = 7.608; 95% CI: 1.664 to34.790), and non-compliance appointments, after controlled by opportunisticinfection, age and initial CD4 count (aHR = 2.456; 95% CI: 0.802 to 7.518).Among patient non-adherence to ART, non-compliance appointments affected the3-years survival of patients with HIV/AIDS, after controlled by initial CD4 count,sex, CPT, modes of HIV transmission, WHO clinical stage, opportunisticinfection, and age (aHR = 4.517 ; 95%CI : 0.729-27.987).DiscussionsNonadherence to ART may caused a failure of the suppression on HIV viral, thusincrease the possibility of HIV virus mutations that can lead to drug-resistant andultimately increase the risk of death. Poor adherence to appointments of takingdrugs in the first year also assumed the poor adherence of the next assignment totake drugs in the further, and show disobedience to ART, so it will increase therisk of death.RecomendationMonitoring coverage of medication adherence of patients with HIV/AIDS in aregular basis as the early warning on the risk of death among patients withHIV/AIDS.Keyword : non-adherence to ART, appointment keeping, retrospective cohort
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IntroductionDramatically, Anti-Retroviral drug Therapy (ART) has reduced morbidity andmortality of People Living with HIV/AIDS (PLWHA). However, adherence toantiretroviral therapy has become a challenge because this therapy must beendured for a lifetime. Adherence to antiretroviral therapy is one of the factorsthat determine the success of treatment. Poor adherence to ARV therapy inIndonesia is arround 23-55%. The objective of this study was to determine theinfluence of medication non-adherence to the 3-years survival of patients withHIV/AIDS.MethodsThis study used a retrospective cohort design at RSPI Prof. Dr. Sulianti Saroso in2010-2012.ResultsThe cumulative survival probability of patients with HIV/AIDS at RSPI Prof. dr.Sulianti Saroso in the second year (24th month) was 95.6% and the third year (inthe 36th) was 91%. Multivariate analysis with Cox regression showed the factorsthat affected the 3-years survival of patients with HIV/AIDS are non-adherence toART, after controlled by initial CD4 count (aHR = 7.608; 95% CI: 1.664 to34.790), and non-compliance appointments, after controlled by opportunisticinfection, age and initial CD4 count (aHR = 2.456; 95% CI: 0.802 to 7.518).Among patient non-adherence to ART, non-compliance appointments affected the3-years survival of patients with HIV/AIDS, after controlled by initial CD4 count,sex, CPT, modes of HIV transmission, WHO clinical stage, opportunisticinfection, and age (aHR = 4.517 ; 95%CI : 0.729-27.987).DiscussionsNonadherence to ART may caused a failure of the suppression on HIV viral, thusincrease the possibility of HIV virus mutations that can lead to drug-resistant andultimately increase the risk of death. Poor adherence to appointments of takingdrugs in the first year also assumed the poor adherence of the next assignment totake drugs in the further, and show disobedience to ART, so it will increase therisk of death.RecomendationMonitoring coverage of medication adherence of patients with HIV/AIDS in aregular basis as the early warning on the risk of death among patients withHIV/AIDS.Keyword : non-adherence to ART, appointment keeping, retrospective cohort
T-4545
Depok : FKM-UI, 2015
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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Fitri Rachmawati; Pembimbing: Asri C Adisasmita; Penguji: Helda; Telly Purnamasari
Abstrak:
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Kasus Konfirmasi COVID-19 di Provinsi Riau merupakan yang tertinggi di Pulau Sumatera. Salah satu upaya mengatasi pandemi COVID-19 adalah dengan cara pemberian vaksinasi yang bertujuan untuk mengurangi transmisi/penularan, menurunkan angka kesakitan dan kematian akibat COVID-19 dan mencapai kekebalan kelompok di masyarakat (herd immunity). Tujuan penelitian adalah untuk mengetahui Hubungan Status Vaksinasi Dengan Ketahanan Hidup Pasien Konfirmasi COVID-19 di Rumah Sakit Provinsi Riau Tahun 2022. Penelitian ini adalah penelitian observasional analistik menggunakan metode kohort retrospektif dari 1212 sampel pasien yang dirawat di seluruh rumah sakit Provinsi Riau pada tahun 2022 dan dilaporkan pada aplikasi RS Online. Probabilitas Survival Kumulatif keseluruhan pasien COVID-19 yang dirawat di RS Provinsi Riau adalah 0,062 atau 6,2% dengan Median survival time keseluruhan 20 hari (IQR: 17-22). Pasien yang sudah mendapatkan vaksinasi memiliki efek protektif terhadap risiko kematian COVID-19, HR 0,751 (95% CI: 0,580-0,971), yang sudah vaksinasi lengkap HR 0,625 (95% CI: 0,463-0,845) dan terdapat penurunan risiko kematian yang selaras dengan jumlah dosis vaksin yang sudah didapatkan oleh pasien (dosis response) dimana pasien yang sudah mendapatkan vaksin dosis 1 memiliki nilai HR 1,138 (95% CI: 0,764-1,694), pasien yang sudah mendapatkan vaksin dosis 2 memiliki risiko atau efek protektif yang dapat menurunkan risiko kematian COVID-19 dengan HR 0,692 (95% CI: 0,504-0,949), dan pasien yang sudah mendapatkan vaksin dosis booster juga memiliki efek protektif dengan HR 0,336 (95% CI: 0,138-0,818) setelah dikontrol variabel usia, saturasi awal, riwayat komorbid, tempat perawatan dan penggunaan alat bantu pernafasan. Peningkatan cakupan vaksinasi lengkap sesuai dosis primer diperlukan untuk menurunkan angka kesakitan dan kematian COVID-19 meskipun pandemi telah dinyatakan berakhir. Meningkatkan koordinasi, kolaborasi dan kerja sama lintas sektor termasuk melibatkan tokoh agama dan tokoh masyarakat dalam program kesehatan masyarakat yang memiliki dampak luas termasuk kemungkinan menghadapi emerging disease berikutnya.
Confirmation cases of COVID-19 in Riau Province are the highest on the island of Sumatra. One of the efforts to overcome the COVID-19 pandemic is by administering vaccinations which aim to reduce transmission/contagion, reduce morbidity and mortality from COVID-19 and achieve herd immunity in the community (herd immunity). The aim of the study was to determine the relationship between vaccination status and survival of confirmed COVID-19 patients at the Riau Province Hospital in 2022. This study was an analytical observational study using a retrospective cohort method of 1212 samples of patients treated at all hospitals in Riau Province in 2022 and reported on the RS Online application. The overall cumulative survival probability of COVID-19 patients treated at Riau Province Hospital is 0.062 or 6.2% with an overall median survival time of 20 days (IQR: 17-22). Patients who have received vaccination have a protective effect on the risk of death from COVID-19, HR 0.751 (95% CI: 0.580-0.971), who have received complete vaccination HR 0.625 (95% CI: 0.463-0.845) and there is a reduced risk of death in line with the number of vaccine doses that have been obtained by patients (dose response) where patients who have received vaccine dose 1 have an HR value of 1.138 (95% CI: 0.764-1.694), patients who have received vaccine dose 2 have risks or protective effects that can reduce risk COVID-19 mortality with HR 0.692 (95% CI: 0.504-0.949), and patients who had received a booster dose of vaccine also had a protective effect with HR 0.336 (95% CI: 0.138-0.818) after controlling for age, initial saturation, history comorbidities, place of care and use of breathing apparatus.An increase in complete vaccination coverage according to the primary dose is needed to reduce the morbidity and mortality of COVID-19 even though the pandemic has been declared over. Improving coordination, collaboration and cooperation across sectors including involving religious leaders and community leaders in public health programs that have a broad impact including the possibility of dealing with the next emerging disease.
T-6795
Depok : FKM-UI, 2023
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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