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Difteri merupakan penyakit menular yang dapat menyebabkan kematian. Di Indonesia, Difteri merupakan masalah endemis dimana tingkat kematian Difteri selama lima tahun terakhir mengalami peningkatan yaitu sebesar 1,8% pada tahun 2018 menjadi 8,5% pada tahun 2022. Penelitian sebelumnya menunjukkan bahwa riwayat vaksinasi dan pemberian Anti Difteri Serum (ADS) merupakan faktor independen yang mempengaruhi kematian akibat Difteri, namun efek gabungan kedua faktor tersebut belum banyak diketahui. Oleh karena itu, dilakukan penelitian dengan tujuan untuk mengetahui hubungan riwayat vaksinasi Difteri dan riwayat pemberian ADS dengan kejadian kematian Difteri di Indonesia. Penelitian ini menggunakan desain studi kasus kontrol dengan menggunakan data sekunder dari laporan surveilans Difteri Kementerian Kesehatan tahun 2018-2022. Hasil penelitian menunjukkan risiko gabungan pada mereka yang tidak divaksinasi dan tidak diberikan ADS sebesar 4,57 kali (95% CI 2,30-9,09) lebih tinggi dibandingkan kasus Difteri dengan riwayat divaksinasi dan diberikan ADS. Risiko indepeden menunjukkan kelompok yang tidak divaksinasi memiliki risiko kematian 3,03 kali (95% CI 1,93-4,75) lebih tinggi dibandingkan dengan kelompok yang divaksinasi. Sedangkan kelompok yang tidak diberikan ADS memiliki risiko kematian 0,31 kali (95% CI 0,11- 0,82) lebih rendah dibandingkan dengan kelompok yang diberikan ADS, namun hasil ini mungkin masih dipengaruhi oleh faktor-faktor perancu yang belum dikontrol dalam penelitian ini, sehingga tidak dapat disimpulkan bahwa tidak memberikan ADS justru menurunkan risiko kematian akibat Difteri. Sebanyak 45% kejadian kematian Difteri dikaitkan dengan interaksi antara tidak divaksinasi dan tidak diberikan ADS. Oleh karena itu, penting untuk melakukan upaya bersama untuk meningkatkan cakupan vaksinasi dan pemberian ADS secara tepat untuk menurunkan kejadian kematian akibat Difteri. Kata kunci: Difteri, Vaksinasi, Anti Difteri Serum, Kematian Difteri, Efek Gabungan, Surveilans Difteri.
Diphtheria is an infectious disease that can cause death. In Indonesia, Diphtheria is an endemic problem with an increasing death rate over the last five years by 1.8% in 2018 to 8.5% in 2022. Previous studies have shown that vaccination and administration of diphtheria antitoxin (DAT) affect mortality, but their combined effect is not widely known. Therefore, a study was conducted to determine the relationship between these two factors and Diphtheria mortality in Indonesia. The research used a case-control design with secondary data from the Ministry of Health's 2018-2022 Diphtheria surveillance report. The findings revealed that individuals who were neither vaccinated nor given DAT had a 4.57 times higher risk of death (95% CI 2.30-9.09) than vaccinated and received DAT group. Unvaccinated individuals had a 3.03 times higher risk of death (95% CI 0.11-0.82) than vaccinated individuals. The risk of death was 0.31 times lower (95% CI 0.11-0.82) in those who did not receive DAT. However, it is important to note that these results may still influenced by uncontrolled factors, thus no conclusion can be drawn regarding the reduction of death risk through withholding DAT. Up to 45% of diphtheria-related mortality were linked to the combination of this two factors. To reduce diphtheria deaths, it is essential to enhance immunization coverage and administer DAT properly. Key words: Diphtheria, Vaccination, Anti-Diphtheria Serum, Diphtheria Antitoxin, Diphtheria Mortality, Joint Effect, Diphtheria Surveillance
Kata Kunci : ASI eksklusif, gizi buruk (BB/U), anak usia 6-35 bulan
Indonesia has a nutritional problem is characterized by the magnitude of theprevalence of malnutrition among children under five. Malnutrition in childrenfrom birth to age three years will greatly affect the growth and development ofglial cells and brain myelination process, and therefore contributes to the qualityof his brain. In Karawang district proportion malnutrition (weight / age) infantsweighing in July 2013 was approximately 0.4 % , and 35.76 % of that number ischildren aged 6-35 months. The purpose of this study was to determine therelation of exclusive breastfeeding history with severe malnutrition status(weight/age) children aged 6-35 months in Karawang district in 2013 after beingcontrolled by the variable birth weight, child 's health status, dietary intake,maternal education, knowledge mother, maternal employment status, familyincome, number of family members and liveliness visit the neighborhood healthcenter. This study was conducted in August 2013 in Karawang district using case-control design. Cases were children aged 6-35 months in Karawang measuredweight on the weighing in July 2013 and have severe nutritional status (weight /age) and controls were children aged 6-35 months in Karawang measured weightonthe weighing in July 2013 and had a good nutritional status. In this study a totalsample of 276 (138 cases and 138 controls). Data were analyzed by multiplelogistic regression. The results showed a relation of exclusive breastfeedinghistory with severe malnutrition status (weight/age) children aged 6-35 months inKarawang districtin 2013. Children aged 6-35 months who had a history ofexclusive breastfeeding risk 0.26 times (95% CI 0,12-0,55) exposed to severemalnutrition (weight/age) compared with no history of exclusive breastfeedingafter controlled by food intake, maternal knowledge, and liveliness visit theneighborhood health center. History of exclusive breastfeeding decrease the riskof severe malnutrition (weight/age) in children aged 6-35 months in Karawangdistrict in 2013 by 74%.Efforts to prevent malnutrition in infants one of which isthe exclusive breastfeeding.Necessary of increases the health promotion ofexclusive breastfeeding with good and correct way to the target group effectivelyin order to get a good nutritional status.
Keyword : Exclusive breastfeeding, severe malnutrition status, childrenaged 6-35 months
Malaria merupakan masalah kesehatan dunia termasuk Indonesia. Kasus baru malaria tahun 2009/2010 di seluruh indonesia berdasar Riskesdas 2010 masih tinggi, yaitu 22,9 permil. Beberapa penelitian sebelumnya telah menemukan adanya hubungan antara perilaku dalam mencegah gigitan nyamuk dengan kejadian malaria, tetapi dalam wilayah yang sebatas lokasi penelitian di tingkat kabupaten atau suatu provinsi. Sehingga peneliti merasa tertarik untuk melakukan analisa pada sampel rumah tangga yang ada pada seluruh provinsi di indonesia menggunakan data sekunder Riskesdas 2010. Tujuan penelitian ini adalah untuk mengetahui hubungan antara penggunaan obat anti nyamuk dan hubungan antara penggunaan kelambu sewaktu tidur dengan kejadian malaria di indonesia tahun 2010. Desain penelitian ini adalah cross-sectional, dengan mencari hubungan dua vaiabel utama (Penggunaan obat anti nyamuk dan penggunaan kelambu sewaktu tidur) terhadap terjadinya penyakit malaria. Sumber data adalah data sekunder Riskesdas 2010 dengan total sampel adalah 251.833 responden. Hasil penelitian mendapatkan proporsi responden yang menderita malaria sebesar 2,6 % dan yang tidak menderita malaria 97,4%. Dapat dikatakan bahwa prevalensi malaria di Indonesia tahun 2010 sebesar 26‰. Analisis bivariat menunjukan adanya hubungan bermakna obat anti nyamuk dengan kejadian malaria (p=0,000) dan mendapatkan nilai odds ratio 1,34 (95% Cl: 1,26 – 1,42). Sedangkan hubungan penggunaan kelambu dengan kejadian malaria diperoleh nilai odds ratio (OR)= 0,471 dan 95% Cl: 0,448-0,495 (p= 0,000). Kemudian dilakukan analisis multivariat guna melihat hubungan variabel utama dengan outcome setelah mengontrol pengaruh dari variabel confounder. Didapat hasil, variabel obat anti nyamuk memiliki OR=1,515 (95% CI = 1,25 – 1,84) dengan nilai p = 0,000, setelah dikontol variabel kelambu, variabel endemisitas, dan dikontrol juga dengan adanya variabel interaksi obat anti nyamuk oleh kelambu. Sedangan variabel penggunaan kelambu, dari hasil analisis memiliki OR=0,750 (95% CI = 0,604 - 0,931) dengan nilai p = 0,009, setelah dikontol variabel penggunaan obat anti nyamuk, varibel endemisitas, dan dikontrol juga dengan adanya variabel interaksi kelambu oleh obat anti nyamuk. Kata kunci : Malaria, Obat anti nyamuk, Kelambu, Riskesdas 2010.
Malaria is a major health problem globaly including Indonesia. Based on Riskesdas 2010 data, incidence of malaria 2009/2010, is high, 22.9‰. Previous studies found an association of behavior in preventing mosquito bites with the incidence of malaria, but in a limited area like in the district or a province. So the researcher was interested to analize the households sample in all provinces in Indonesia using Riskesdas 2010 data. The objective of this study was to determine the relationship between the use of anti-mosquito repellent/insecticide and mosquito bed net with the incidence of malaria in Indonesia by the year of 2010. Study design is cross-sectional, to find the relationship of two main variabels (the use of anti-mosquito repellent/insecticide and the use of mosquito bed net) to the occurence of malaria. Data sources are Riskesdas 2010 data, with a total sample of respondents are 251,833. The results obtain proportion of respondents who infected by malaria of 2.6% and 97.4% did not infected by malaria. It could be argued that the prevalence of malaria in Indonesia in 2010 are 26‰. Bivariate analysis showed a significant relationship of anti-mosquito with malaria incidence (p = 0.000) and obtain the value of odds ratios 1.34 (95% Cl: 1.26 to 1.42). While the relationship with the incidence of malaria bed net use values obtained odds ratio (OR) = 0.471 and 95% Cl: 0.448 to 0.495 (p = 0.000). Then performed multivariate analysis to see the relationship with the primary outcome variables after controlling for the influence of confounder variables. The result, anti-mosquito variable has odds ratio = 1.515 (95% CI = 1.25 to 1.84) with p-value = 0.000, adjusted by net variable, endemicity, and controlled also by the presence of interactions anti-mosquito by bed nets . As a Bed nets variabel, the results of the analysis has odds ratio 0.750 (95% CI = 0.604 to 0.931) with a pvalue = 0.009, adjusted by the use of anti-mosquito, endemicity, and also controlled by an interaction anti-mosquito by bed nets . Key words: Malaria, Anti-mosquito, Mosquito bed net, Riskesdas 2010.
Kata kunci:ASI Eksklusif, Perkembangan, Suspek Terhambat, Anak Usia 12 bulan
The children development in golden period is very important because determinequality of individu especially in the first year. Based on WHO data, more than 200millions children in developing countries had developmental delay risk. In Beiji,the prevalence of developmental delay 9,7%. Exclusive breastfeeding as a factorof developmental delay. In Musi Banyuasin regency, the prevalence of exclusivebreastfeeding is 56,3%. This study purposes is to analyze the relationship betweenhistory of exclusive breastfeeding and suspected delayed development among 12months infants. Besides, we had done qualitative methode among 11 informans tomining the deeply knowing of mom about relationship of exclusive breasfeedingto infant development. This study used cross sectional design involved 320sample (infants) at 19 Puskesmas in Musi Banyuasin Regency. The result showedthat the relationship between exclusive breastfeeding and developmental delayamong infants was PR adjusted 1,932 (95% CI: 0,719-5,186). Furthermore, studyfound that mostly moms had known that exclusive breastfeeding related to infantdevelopment, but feeding tradition from grand mothers were play as a role factorin practicing exclusive breastfeeding among mothers.
Keywords:Exclusive Breastfeeding, Development, Suspected Delayed, 12 Months Infants
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.