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Introduction: Babies with LBW are 4 times more likely to die during the first 28 days
of life than babies born with normal weight. In Indonesia, LBW is the second largest
type of disease related to tobacco use where the impact is a very determining factor in
adulthood. More than 57% in a household has at least one smoker where 91.8% smoke
in the household and ignore the risks and dangers of exposure to cigarette smoke.
Method: This research was conducted in all regions of Indonesia using Riskesdas 2018
results with the aim of knowing the effect of exposure to cigarette smoke in the
household on the incidence of Low Birth Weight (LBW) in Indonesia after being
controlled by baby (sex), maternal factors (level maternal education, maternal
employment status, and tuberculosis to the mother), health service factors (frequency
and quality of ANC) and environmental factors (residential area). This research was
conducted with cross-sectional design and logistic and poisson regression analysis.
Result: The results of the study with the final model of smoking behavior interacting
with gender and controlled by variables of maternal education level and frequency of
ANC in general showed that there was no effect of cigarette smoke exposure in
households with LBW events (although p value in female sex with exposure cigarette
smoke b 20btg less than 0.05, but OR 0.056 or protective).
Discussion: Based on the results of this study and a few reviews of the results of the
research that are in line concluded that birth weight is not solely influenced by a history
of exposure to cigarette smoke, but in certain conditions there are other factors that may
be more dominant. In this case it might be due to several factors such as the way data is
collected based only on interviews / questionnaires so that the measurement of cigarette
smoke exposure in the household is less able to describe the actual situation (the
measurement results are weak).
Conclution: Based on the analysis that has been used both using logistic regression
methods and poisson is that the results of this study have not been able to answer the
hypothesis that the effect of cigarette smoke exposure in households increases the
incidence of LBW in Indonesia in 2018 even after being controlled by covariate
variables
Coronary Heart Disease (CHD) is one of the leading causes of death globally with a mortality rate of nearly 17.5 million annually. Smoking accounts for 33% and hypertension accounts for 31% of all deaths from cardiovascular disease. Smoking and hypertension are major risk factors for CHD, which are a serious problem that needs to be addressed in Indonesia and the world. The purpose of this study was to determine the greater risk of smoking and hypertension with the incidence of coronary heart disease in Indonesia. The study used a retrospective cohort design. The data used are secondary data from the Indonesian Family Life Survey (IFLS-4 and IFLS-5 data for 2007-2014) with a total sample of 19,486 population respondents aged ≥18 years. Data analysis with cox regression and the amount of risk is expressed in risk ratio (RR) with a confidence interval (CI) of 95%. Data analysis using data processing software. The results of multivariate analysis after being controlled by sex and DM history showed that smoking individually was not related to CHD in Indonesia in 2007-2014 with a value (RR 1.08; 95% CI = 0.70- 1.67). Hypertension individually increases CHD risk (RR 1.19; 95% CI = 0.92-1.53). Smoking and hypertension together increase the risk of CHD compared to people who don't smoke and don't have hypertension in Indonesia in 2007-2014 (RR 1.66; 95% CI = 1.11-2.48) meaning that respondents who smoke and hypertension are at risk of experiencing CHD 1.66 times (95% CI; 1.11-2.48) compared to nonsmokers and those without hypertension.
ABSTRAK Nama : Debri Rizki Faisal Program Studi : Epidemiologi (Field Epidemiology Training Program) Judul : Pengaruh Status Gizi Stunting Saat Balita dan Obesitas Ketika Dewasa Terhadap Risiko Hipertensi (Studi Longitudinal IFLS 1993 – 2014) Pembimbing : dr.Syahrizal Syarif, MPH, PhD. Stunting merupakan salah satu bentuk kekurangan gizi kronis yang ditandai dengan tinggi badan menurut usia kurang dari -2 SD (standar deviasi). Kondisi stunting pada usia balita berdampak jangka panjang terhadap dewasa yang pendek dan rentan terhadap penyakit tidak menular ketika dewasa. Penelitian ini bertujuan untuk mengetahui pengaruh efek gabungan kondisi stunting saat balita dan obesitas ketika dewasa terhadap risiko hipertensi. Desain penelitian cohort retrospective menggunakan data sekunder Indonesia Family Life Survey (IFLS) periode 1-5. Populasi target adalah balita usia 2-5 tahun pada tahun 1993 sebanyak 2.642 orang, kemudian di follow up hingga dewasa pada tahun 2014. Jumlah sampel yang memenuhi kriteria inklusi dan eksklusi adalah 588 orang. Analisis data menggunakan uji cox regression dengan 95%CI. Standar pengukuran sebagai berikut stunting (TB/U < -2 SD), obesitas (IMT ≥ 27 kg/m 2 ) dan hipertensi (≥ 140/90 mmHg). Hasil penelitian didapatkan bahwa dari 588 orang dimana 13.27% mengalami hipertensi dengan proporsi orang yang stunting saat balita dan obesitas ketika dewasa 27.27%. Analisis multivariate ditemukan bahwa responden dengan status gizi stunting dan obesitas berisiko 2.46 (95% CI; 1.23 - 4.90) kali; obesitas dan tidak stunting 2.25 (95% CI; 1.12 – 4.50) kali; stunting dan tidak obesitas berisiko 0.95 (95% CI; 0.55 – 1.62) kali, mengalami hipertensi dibandingkan dengan responden yang tidak mengalami stunting saat balita dan tidak obesitas ketika dewasa. Risiko kejadian hipertensi meningkat 10.56% akibat interaksi antara kondisi stunting saat balita dan obesitas ketika dewasa. Pentingnya pencegahan stunting pada 1000 Hari Pertama Kehidupan dan mengoptimalkan Posbindu PTM dalam melakukan skrining obesitas dan hipertensi serta pengendalian faktor risiko PTM untuk menurunkan prevalensi penyakit tidak menular terutama obesitas dan hipertensi. Kata kunci: Stunting, Obesitas, Hipertensi, Kohort, Efek Gabungan.
ABSTRACT Name : Debri Rizki Faisal Study Program : Epidemiology (Field Epidemiology Training Program) Title : The Effect Of Early Stunting And Adult Obesity To Increase Risk Of Hypertension (Longitudinal Study IFLS 1993 – 2014) Counsellor : dr.Syahrizal Syarif, MPH, PhD. Stunting due to chronic malnutrition condition that is characterized by Height for Age Z score less than -2 SD (standard deviation). The early stunting in children under five years has a long-term impact on adults are short stature and vulnerable to risk non-communicable diseases in later life. This study aims to determine the joint effect of early stunting conditions and adult obesity to risk for hypertension. This study design was a cohort retrospective using secondary data from the Indonesia Family Life Survey (IFLS) period 1-5. The target population was children aged 2-5 years in 1993 with numbers of 2,642 people and then follow up until adulthood in 2014. The number of samples that met the inclusion and exclusion criteria were 588 people. Data analysis used Cox regression test with 95% CI. Standard of measurements was stunting (HAZ <-2 SD), obesity (IMT ≥ 27 kg / m 2 ) and hypertension (≥ 140/90 mmHg). The results showed that of 588 people where 13.27% had hypertension where the proportion of respondent with early stunting and adult obese was 27.27%. Multivariate analysis found that respondents with nutritional status both early stunting and adult obesity have a risk of 2.46 (95% CI; 1.23 - 4.90) times; obese and not stunting 2.25 (95% CI; 1.12 - 4.50) times; stunting and not obese 0.95 (95% CI; 0.55 - 1.62) times, for having risk of hypertension compared to respondents neither experience stunting and obese. The risk of hypertension increases 10.56% due to the interaction between early stunting and obesity adults. The importance prevention of stunting in The First 1000 Days of Life and optimize Posbindu PTM in screening obesity, hypertension and controlling risk factors NCD to reduce the prevalence of non-communicable diseases, especially obesity and hypertension. Key words: Stunting, Obesity, Hypertension, Cohort, Joint Effects.
Contraception is an effort to prevent pregnancy. This effort can be temporary or permanent by means of certain methods, tools and medicines. In Indonesia, contraception is regulated and implemented in the family planning program which aims to create quality families and achieve community welfare. This study aims to analyze the factors that influence the shift in the use of modern to traditional contraceptives among currently married women in Indonesia based on the 2017 IDHS data. The data collection method is cross sectional and analyzed with a logistic regression model. The description of the type of modern contraception used is the short-term contraceptive method, while the reasons for the respondents moving were due to side effects, problems of access and availability, and the absence of support from their husbands. The bivariate results state that predisposing factors (age, education level, level of knowledge, socioeconomics, and desire to have children), reinforcing factors (decision makers, family planning visits and counseling, and media exposure) and enabling factors, namely service quality have a significant relationship with displacement. modern contraception. Based on mutivariate analysis, the variable level of education is the variable that has the strongest influence on the transfer of modern contraception compared to other variables. Family planning programs need to focus more on client demographic factors by providing broad and quality service and counseling so that the objectives of the family planning program can be delivered effectively and on target.
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
