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ABSTRAK Infeksi virus dengue masih merupakan masalah kesehatan di Indonesia saat ini termasuk di Kota Banjarmasin dengan angka kematian yang tinggi, Tahun 2011 dilaporkan CFR 8,3% dimana sebagian besar pasien DBD ini dirawat di RSUD ULIN dan RSUD Ansari Saleh Banjarmasin, sementara penegakkan diagnosis sering sulit, apalagi dalam menilai apakah pada akhirnya akan terjadi shock (Dengue Shock syndrome) atau tidak. Peningkatan hematokrit, penurunan angka trombosit, leukosit dan serta perilaku pasien sebelum dirawat (lamanya sakit, rujukan) biasanya terjadi sebelum demam turun dan sebelum terjadinya shock. Hal ini merupakan diagnostik yang penting dan prognosis yang berharga dalam mendeteksi Dengue Shock Syndrome. Sehingga dengan mengetahui faktor resiko ini dapat mencegah/ mengurangi kematian Metode: Penelitian bersifat observasional dengan disain kasus kontrol. Kasus adalah penderita yang didiagnosis DSS berdasarkan diagnosis dokter yang merawat. Sedangkan kontrol adalah penderita yang didiagnosis sebagai tersangka DBD oleh dokter yang merawat. Data penelitian diperoleh dari data rekam medis dan formulir Kewaspadaan Dini Rumah Sakit (KD-RS) yang dirawat di RSUD ULIN dan RSUD Ansari Saleh dalam periode bulan April 2010 sampai Maret 2012. Rancangan analisis ditujukan untuk memperoleh nilai Odds Ratio (OR) dilanjutkan dengan multivariat analisis untuk mengetahui faktor risiko yang dapat mendeteksi DSS sejak dini. Hasil Penelitian: Variabel yang signifikan secara statistik dan di masukkan ke dalam prediksi model akhir adalah Jenis Kelamin perempuan (OR=3,250 95% CI=1,178-8,970), hematokrit ≥25,97% (OR=7,86 95% CI=2,748-22,500) , leukosit ≤ 4764,47 (OR=3,826 95% CI=1,375-10,647), lama sakit ≥4 hari (OR=3,146 95% CI=1,179-8,397) dan rujukan dari puskesmas (OR=4,543 95% CI=1,700-12,139).Variabel yang paling dominan yang berhubungan dengan kejadian Dengue shock syndrome adalah hematokrit. Dari hasil tersebut disarankan agar tenaga kesehatan dan akademisi perlu meningkatkan standar pelayanan penyakit yang lebih efektif dan efesien yang berisiko terjadinya Dengue Shock Syndrome.
ABSTRACT DHF is still a health problem in Indonesia is currently included in Banjarmasin city with a high mortality rate in 2011 was reported CFR 8.3% where the majority of dengue patients are treated at the Ulin Hospital and Ansari Saleh Hospital Banjarmasin, while the diagnosis is often difficult, especially in assessing whether it will eventually happen shock (dengue shock syndrome) or not. This is an important diagnostic and prognostic value in the detection of Dengue Shock Syndrome. So that by knowing these risk factors can prevent / reduce mortality. Methods: The study is an observational with case-control design. Cases are those who hospitalized and diagnosed as suspect Dengue haemorrhagic fever by clinicans using WHO criteria.Controls are those who hospitalized and diagnosed as suspect Dengue Haemorrhagic fever by the clinicans. Data were collected from medical records and (KD-RS) are treated in Ulin Hospital and Ansari Saleh Hospital in the period from April 2010 until March 2012. Analysis design is done to obtain Odds Ratio (OR) and followed by using multivariate logistic regression to determine risk factors that can detect early DSS. Consclusion: The significant variables in statistic manner and put into the final model predictions are increasing Female sex (OR=3,250 95% CI=1,178-8,970), haematocryt ≥25,97% (OR=7,86 95% CI=2,748-22,500) leukopenia ≤4764,47 (OR=3,826 95% CI=1,375-10,647), lengh of hospital ≥4 days (OR=3,146 95% CI=1,179-8,397) and referrals from Health centers (OR=4,543 95% CI=1,700- 12,139). From these results it is suggested that health professionals and academics need to improve service standards diseases more effectively and efficiently at risk of Dengue Shock Syndrome.
Background: Dengue Hemorrhagic Fever (DHF) is an infectious disease caused by the Dengue virus which is a health problem in Indonesia, including in the city of Mataram. DHF cases in Mataram City from 2016 to 2019 tend to fluctuate where most of the DHF patients are treated at the RSUD Kota Mataram. Death due to DHF infection occurred mostly in DSS and mortality from DSS was reported to be 50 times higher than in DHF patients without DSS. Prompt diagnosis and appropriate treatment are important determinants for dengue prevention and control, so knowing these risk factors can prevent/reduce mortality. Methods: This study is an observational study with a case-control design. Cases are DHF patients diagnosed with Dengue Shock Syndrome by the treating doctor, while the controls are DHF patients diagnosed not with Dengue Shock Syndrome by the treating doctor. The research data were obtained from medical records and KD-RS formular data treated at the RSUD Kota Mataram from January 2016 to December 2020. The design of the analysis was aimed at obtaining the odds ratio value followed by multivariate analysis to determine the risk factors that could detect DSS early. Results: The variables that were statistically significant in the prediction of the final model were the increase in hematocrit value > baseline with OR= 17.1 (95% CI: 4.03372.600), decreased platelet value < 100.000/µL with OR= 6 (95% CI : 2,306-15,699), and decreased leukocyte value < baseline with OR= 5.1 (95% CI: 2,209-11,838). While the most dominant variable is the increase in hematocrit value > baseline with OR = 17.1 (95% CI: 4.033-72.600) and p value = 0.000
Kota Mataram adalah salah satu daerah endemis penyakit DBD di Indonesia, karena sejak Tahun 2003 hingga Tahun 2012, selalu ditemukan kasus penyakit DBD. Penelitian ini bertujuan untuk mengetahui hubungan antara karakteristik, perilaku dan lingkungan rumah penduduk dengan kejadian DBD. Penelitian ini merupakan studi analitik dengan rancangan kasus kontrol. Populasi pada penelitian ini adalah penduduk Kota Mataram, sedangkan sampel penelitian adalah sebagian penduduk Kota Mataram yang berasal dari semua kecamatan yang ada di Kota Mataram. Kasus adalah penduduk Kota Mataram yang pernah dirawat di rumah sakit pada periode Januari?Maret 2012 dan didiagnosis menderita suspek DBD/DD/DBD. Kontrol adalah tetangga kasus yang tidak pernah diagnosis menderita suspek DBD/DD/DBD pada periode yang sama. Penelitian ini menemukan, variabel yang berhubungan dengan kejadian DBD di Kota Mataram pada Tahun 2012 adalah variabel pekerjaan (OR bekerja=2,04 ; 95%CI=1,032-4,015 ; OR bersekolah=3,80 ; 95%CI=1,281-11,302) dan penggunaan kassa nyamuk (OR=0,42 ; 95%CI=0,218-0,810). Bagi masyarakat, perlu peningkatan upaya perlindungan diri terhadap penularan penyakit DBD, terutama saat beraktifitas di luar rumah (saat bekerja/bersekolah), diantaranya dengan menggunakan pakaian yang dapat mencegah gigitan nyamuk dan penggunaan obat nyamuk oles (repellent). Bagi Dinas Kesehatan Kota Mataram, perlu intensifikasi pemeriksaan jentik dan PSN DBD di tempat-tempat umum, khususnya di sekolah-sekolah dan perkantoran bekerja sama dengan lintas program dan lintas sektor terkait.
Mataram city is one of the endemic areas of dengue fever in Indonesia, because since the Year 2003 to 2012, is always found dengue fever cases. This study aims to determine the relationship between the characteristics, behavior and home environment of the population with the incidence of dengue. This study is an analytical study with case-control design. The population in this study were residents of the city of Mataram, while the study sample was part of the population Mataram from all districts in the city of Mataram. Case is a resident of the city of Mataram who had been treated in hospital in the period from January to March 2012 and was diagnosed with suspected DHF / DD / DHF. Control is a neighbor of cases that never diagnosed with suspected DHF / DD / DHF in the same period. This study found that variables related to the incidence of dengue in the city of Mataram in the year 2012 is the variable of work (OR worker=2,04 ; 95%CI=1,032-4,015 ; OR student=3,80 ; 95%CI=1,281-11,302) and the use of mosquito net (OR=0,42 ; 95%CI=0,218-0,810). For society, need to increase efforts to protect themselves against dengue disease transmission, especially when activities outside the home (at work / school), such as by using clothing to prevent mosquito bites and use mosquito repellent ointment. For Mataram City Health Department, need to the intensification of larvae and eradication of DHF mosquito breeding places examination in public places, especially in schools and offices, to work with cross sector / program linked.