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Penelitian ini bertujuan untuk mengetahui faktor risiko yang berhubungan dengan diabetes mellitus tipe 2 di Posbindu PTM se-Provinsi DKI Jakarta. Penelitian ini menggunakan desain cross sectional dari data Surveilans Faktor Risiko PTM Dinas Kesehatan Provinsi DKI Jakarta tahun 2017. Sampel yang dianalisis sebesar 12.775 responden dari 12.789 responden berumur ≥15 tahun. Analisis data multivariat menggunakan uji regresi logistik berganda untuk menentukan model prediksi dan faktor potensial dampak yang paling dominan.
Hasil didapatkan proporsi diabetes mellitus sebesar 15,87%. Multivariat didapatkan umur ≥45 tahun (POR=6,32), 35-44 tahun (POR=1,82), 25-34 tahun (POR=0,98), jenis kelamin (POR=0,63), riwayat DM keluarga (POR=4,43), tidak menikah (POR=0,49), cerai (POR=1,58), tidak bekerja (POR=1,93), IRT (POR=1,84), pelajar/mahasiswa (POR=0,24), kurang aktif (POR=1,20), hipertensi (POR=1,35), dan obesitas sentral (POR=1,29). Faktor risiko yang memberikan dampak paling dominan adalah umur ≥45 tahun dan riwayat DM keluarga, sedangkan faktor yang dapat dimodifikasi yang memberikan dampak paling dominan adalah obesitas sentral. Model prediksi ini cukup akurat untuk memprediksi diabetes mellitus dengan batas probabilitas sebesar 18%. Perlu adanya peningkatan kualitas pelaksanaan Posbindu PTM dari pemerintah serta kesadaran warga DKI Jakarta yang berumur ≥15 tahun untuk pemantauan faktor risiko serta deteksi dini PTM.
Type 2 diabetes mellitus has become a serious public health problem and is an important cause of morbidity, death, disability and economic losses worldwide including Indonesia. The province of DKI Jakarta includes the top ten of the highest diabetes mellitus nationally. Posbindu PTM as one of the government programs in conducting early detection and monitoring of NCD risk factors that are implemented in an integrated, routine, and periodic.
This study aims to determine the risk factors associated with diabetes mellitus type 2 in Posbindu PTM throughout DKI Jakarta Province. This research uses cross sectional design from data of Risk Factor Surveilans of NCD Health Office of DKI Jakarta Province 2017. The analyzed sample is 12,775 respondents from 12,789 respondents aged ≥15 years old. Multivariate data analysis using multiple logistic regression test to determine prediction model and the most dominant potential impact factor.
The result obtained proportion of diabetes mellitus equal to 15,87%. Multivariate was found to be ≥45 years old (POR=6.32), 35-44 years (POR=1.82), 25-34 years (POR=0.98), sex (POR=0.63), history of DM family (POR=4.43), unmarried (POR=0.49), divorce (POR=1.58), not working (POR=1.93), IRT (POR=1.84), student (POR=0.24), less physical activity (POR=1.20), hypertension (POR=1.35), and central obesity (POR=1.29). Risk factors that have the most dominant impact are age ≥45 years and family DM history, while the modifiable factor that gives the most dominant impact is central obesity. This prediction model is accurate enough to predict diabetes mellitus with a probability limit of 18%. It is necessary to improve the quality of Posbindu PTM implementation from the government and the awareness of Jakarta citizens aged ≥15 years for monitoring of risk factors and early detection of NCD.
Kata Kunci : Posbindu, PTM, Hipertensi, Obesitas Sentral, Wanita
Hypertension affected mortality at least 8 millions for every years. Pattern and life style not health related with hypertension, so there are risk factors. In comparated, most of central obesity is one of risk factors of hypertension founded at women on middle ages than men. Output of this research is to know about relationship between central obesity with hypertension case in women. Research design is crossectional. The population are all women with > 18 years old registered in Posbindu PTM Surveilance database at 2015. Result showed that prevalance of hypertension 29,1%. Hypertension case more than half on >45 years old are 51,71% with everage of ages 46 years. Prevalance of central obesity with cut off point 85 cm is 53,30%. In multivariable : central obesity effect become hypertension influenced by physical activity after controlled by age. Central obesity affect to be hypertension with less of physical activity is 2,21 more than central obesity affect with high of physical activity on cut off point 85 cm. while central obesity affect to be hypertension with high physical activity is 1,34 times. The recomendation are keep of abdominal circumference size maximum 85 cm, doing the physical activity 30 minutes/day with 3 times a week or 150 minutes every week, check of blood pressure once a month in Posbindu PTM, practice of doctor or midwife.
Keywords: Posbindu, Uncomunicable PTM, Hypertension, Central Obesity, Women
DKI Jakarta menunjukkan sebanyak 46% dari kasus-kasus penyakit adalah penyakit gangguan pernapasan (ISPA 43%, iritasi rnata l,7% dan asma 1,3%) yang terkait dengan kualitas udara ambien yang tidak memenuhi baku umum dimana polusi udara di DKI Jakarta mengalami fluktuasi dengan beberapa parameter telah melewati nilai ambang batas seperti Ozon, N02 dan nilai ISPU menunjukan bahwa selama setahun hanya terhitung 22 hari udara Jakarta berkualitas baik, 95 hari dinyatakan tidak sehat, dan selebihnya 233 hari berkualitas sedang. Studi ekologi ini bertujuan untuk mengidentifikasi kualitas udara ambien, kondisi meteorologi., dan kejadian ISPA, mempelajari kecenderungan perubahan kualitas udara ambien, kondisi meteorologi dan mempelajari hubungan antara kondisi meteorologi dengan kualitas udara ambien serta mempelajari hubungan antara kualitas udara ambien, kondisi meteorologi dengan kejadian ISPA. Alat ukur yang digunakan untuk mengukur kualitas udara ambien menggunakan : FH6-I (5-ray absorbtfon), APSA-360 (Fluorescence UV), APOA-360 (Chelwninescence) dan NDR sedangkan untuk kondisi meteorologi adalah Tennometer; Hygromeierg Cup anenmmeter dan Global Star Pymnameter. Populasi yang dilibatkan sebanyak 820 data rata-rata harian kualitas udara ambien, kondisi meteorologi dan ISPA dengan sampei sebesar 118 data rata-rata mingguan kualitas udara ambien, kondisi meteorologi dan ISPA. Dalam kurun waklu 2006 - Maret 2008 diperolch konscntrasi rata-rata PMN; 65,9 pg/m3, so; 31,1 pg/mi, co 1,1 pg/ma, 0, 51,4 pg/m3, NO; 31,6 pg/ma dan niiai ISPU 72,3. Sedangkan rata-rata suhu 27,6°C, kelembaban 75,6 %, arah angin l54,5° , kecepatan angin 0,7 mls, radiasi matahari l12,0 W/m2 Serta rata~rata angka ISPA sebanyak 54 kejadian. Hubungan kualitas udara ambien dcngan ISPA didapatkan bahwa SO; mempunyai korelasi positif tcrhadap angka ISPA. PM|0_ 03, ISPU mempunyai korelasi negatif terhadap angka ISPA. Hubungan kondisi meteorologi dengan ISPA didapatkan bahwa kelembaban, arah angin mempunyai korelasi positif terhadap angka ISPA. Suhu, radiasi matahari mempunyai korelasi negatif terhadap angka ISPA. Hubungan kondisi meteorologi dengan kualiaias udara ambien didapatkan bahwa suhu mempunyai korelasi poritifdengan PMN, 03, N01 dan ISPU. Kelembaban mempunyai korelasi negatif dengan PM|g, 03, N02 dan ISPU, arah angin mempunyai korelasi PM|0, CO, 03, NCQ, ISPU, kecepatan angin mempunyai korelasi negatif dengan PMN), CO. 01, N02, ISPU, radiasi matahari mempunyai konelasi negatif dengan CO, radiasi matahari mempunyai korelasi positif dengan ISPU. Disimpulkan bahwa dalam kurun waklu 2006 - Mamet 2008 didapatkan pola angka ISPA mengikuti pola konsentrasi kualitas udara ambien dan kondisi meteorologi hal ini dibuktikan dengan adanya hubungan S0;, dan S0;*O3 Serta SO2*Suhu secara bersamaan mempunyai pengaruh yang besar terhadap ISPA dengan nilai koeiisicn korclasi sebesar 0,616 dan nilai koefisien determinasi Sebesar 0,379 (kuat). Dengan demikian SO;, SO1*O3, dan SO;*Suhu secara bersama-sama berpengaruh signifikan terhadap ISPA Namun konscmrasi CO, N02 , kecepatan angin tidak berhubungan denan kejadian ISPA di DKI Jakarta.
DKI Jakarta indicated 46% of disease cases were respirations problems (ISPA 43%, eye irritation of l,7% and asthma of 1,3%) related to ambient air quality which did not fulfill standard quality where air pollution in DKI Jakarta experienced fluctuation with a few parameter have passed boundary threshold value like Ozone, N02 and ISPA value indicated that Jakarta air had a good quality for 22 days each year, it was not health for 95 days, and it was a medium quality for 233 days. This purpose of ecology study to identity an outdoor air quality, meteorology condition, and ISPA occurrence, studying a change tendency of outdoor air quality, meteorology condition and studying related between meteorology condition of outdoor air quality and also studying related between meteorology condition of outdoor air quality and ISPA occurrence. Measurement instruments which are used for measuring outdoor air quality such as FI-I6-l (B-ray absorption), APSA-360 (Fluorescence UV), APOA-360 (Cheluminescence) and NIDR while the instruments which are used for measuring meteorology condition such as Thermometer, Hygrometer Cup Anemometer and Global Star Pyranometer. Populations which are participated amount of 820 data on daily average of outdoor air quality, meteorology condition and ISPA by samples amount of ll8 data on weekly average of outdoor air quality, meteorology condition and ISPA. At period of 2006 - March 2008 obtained average concentrations were PM10 65,9p g/rn3,SO1 31,1p g/rn3, co up g/ms, 03 51,4u6§/ma, NO; 3l,6p g/m3 and ISPU value '?2,3. While temperature average was 27, C, dampness was 7S,6%, wind direction is l54,5°, wind velocity was 0,7 mls, sun radiation was 1l2,0 Wim! and also mean number of ISPA was amount 54 occurrences. Related between outdoor air quality and ISPA indicated that S02 has a positive correlation of ISPA number. PMN, 03, ISPU have negative correlations of ISPA number. Related between meteorology condition and ISPA indicated that dampness, wind direction have positive correlations of ISPA number. Temperature and sun radiation have negative correlations of ISPA number. Related between meteorology condition and outdoor air quality indicated that temperature has positive correlations of PM10, 03, NO; and ISPU. Dampness has negative correlation with PM1u, Og, NO; and ISPU, wind direction has correlation PMID, CO, 03, NO2, ISPU, wind velocity has negative correlation of PMN, CO, 03, N02, ISPU, sun radiation has negative correlation of cobalt, sun radiation has positive correlation of ISPU. It was concluded that at period of 2006 - March 2008 indicated ISPA number pattern follow pattem concentration of outdoor air quality and this meteorology condition was proved by the existence of related between SO; SO1* SO; and SO2* temperature, at the same time, it has a big effect of [SPA by correlation ooeflicient value was 0,616 and determination coefficient value was 0,379 (strong). Therefore S0;, S0;=, and SO# temperature, at the same time, it has an effect of ISPA significantly. But concentration of CO, NOQ, wind velocity does not relate to ISPA occurrence in DKI Jakarta.
