Ditemukan 3 dokumen yang sesuai dengan query :: Simpan CSV
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
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Shela Rachmayanti; Pembimbing: Asri C. Adisasmita; Penguji: Sudarto Ronoatmodjo, Sukwan Handali, Sukamto Koesnoe, Ngabila Salama
Abstrak:
Latar Belakang: COVID-19 merupakan penyakit yang dinamis dan mudah bermutasi, varian Delta yang menyebabkan lonjakan kasus dan mortalitas signifikan di Indonesia pada Mei ? September 2021. Berdampak pada tingginya beban fasilitas kesehatan dan isolasi mandiri. Studi ini spesifik mempelajari dampak komorbid terhadap mortalitas pasien COVID-19 yang menjalani isolasi mandiri pada periode tersebut.
Metode: Desain studi kohort retrospektif menggunakan data surveilans Dinkes DKI Jakarta, dengan total sampling pada eligible population. Dilakukan analisis kesintasan menggunakan kurva Kaplan Meier dan dilakukan evaluasi proportional hazard. Analisis multivariat dilakukan menggunakan Cox-Extended jika ditemukan pelanggaran proportional hazard
Hasil: Analisis melibatkan 15.088 kasus konfirmasi dengan tingkat kesintasan keseluruhan 96,31%. Kesintasan lebih rendah pada kelompok dengan komorbid, ≥60 tahun, laki laki dan memiliki gejala (p<0.00). Cox-extended menunjukan risiko kematian pada kelompok yang memiliki komorbid pada <7hari sebesar aHR3,78(IK95%2,94-4,87) dan pada ≥7hari sebesar aHR1,78(IK95%1,412-2,954). Gangguan imunologi [aHR13,13(IK95%2,79-91,76)] merupakan komorbid yang paling berperan meningkatkan mortalitas.
Kesimpulan: Risiko mortalitas selama masa pengamatan (30 hari) lebih tinggi pada kelompok yang memiliki komorbid, variabel lain yang berperan diantaranya usia lanjut, laki laki dan bergejala.
Background: COVID-19 is a very dynamic disease. Recently, a new Delta variant caused a significant spike in morbidity and mortality in Indonesia from May to September 2021, inflicting a high burden on healthcare facilities and self-isolation services. This study aims to analyze the impact of comorbidities on the mortality of COVID-19 patients who underwent self-isolation during the stipulated period. Methods: The study was a retrospective cohort, using surveillance data from the DKI Jakarta Health Office. The data was sampled through a total sampling method for the eligible population. A survival analysis was performed using the Kaplan Meier curve and a proportional hazard evaluation was carried out. Multivariate analysis was assessed using Cox-Extended, if violation of proportional hazard assumption is found. Results: The analysis included 15,088 confirmed cases with overall survival of 96.31%. Survival was lower in the group with comorbid, aged ≥60 years, male, and symptomatic (p<0.00). Cox-extended showed a higher risk of mortality in the group with comorbidities at <7th days [aHR3.78(95% CI 2.94-4.87)] and at ≥7th days aHR1,78(IK95%1,412-2,954). Immunological disorder [aHR13,13(IK95%2,79-91,76)] was the most impactful comorbid towards mortality. Conclusion: This study concludes that the risk of mortality during the observational period (30 days) was higher in the comorbid group. Other contributing variables include old age, male gender, and exhibiting symptoms.
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Background: COVID-19 is a very dynamic disease. Recently, a new Delta variant caused a significant spike in morbidity and mortality in Indonesia from May to September 2021, inflicting a high burden on healthcare facilities and self-isolation services. This study aims to analyze the impact of comorbidities on the mortality of COVID-19 patients who underwent self-isolation during the stipulated period. Methods: The study was a retrospective cohort, using surveillance data from the DKI Jakarta Health Office. The data was sampled through a total sampling method for the eligible population. A survival analysis was performed using the Kaplan Meier curve and a proportional hazard evaluation was carried out. Multivariate analysis was assessed using Cox-Extended, if violation of proportional hazard assumption is found. Results: The analysis included 15,088 confirmed cases with overall survival of 96.31%. Survival was lower in the group with comorbid, aged ≥60 years, male, and symptomatic (p<0.00). Cox-extended showed a higher risk of mortality in the group with comorbidities at <7th days [aHR3.78(95% CI 2.94-4.87)] and at ≥7th days aHR1,78(IK95%1,412-2,954). Immunological disorder [aHR13,13(IK95%2,79-91,76)] was the most impactful comorbid towards mortality. Conclusion: This study concludes that the risk of mortality during the observational period (30 days) was higher in the comorbid group. Other contributing variables include old age, male gender, and exhibiting symptoms.
T-6457
Depok : FKM-UI, 2022
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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Widyorini Lestari Hardjolukito Hanafy; Promotor: Asri C. Adisasmita; Kopromotor: Bambang Dwipoyono, Sukwan Handali; Penguji: Mondastri Korib Sudaryo, Ratna Djuwita, Syahrul Rauf, Primariadewi Rustamadji, M. Soemanadi
Abstrak:
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Latar belakang: Kanker serviks masih menjadi masalah kesehatan global yang signifikan, dengan perkiraan 660.000 kasus baru dan 350.000 kematian setiap tahun. Di Indonesia, kanker serviks adalah masalah kesehatan utama, dengan 9,2% wanita diperkirakan menderita kanker serviks pada tahun 2020. Meskipun telah dilakukan histerektomi radikal, tingkat kekambuhan pada kanker serviks stadium awal (IA2-IIA2) tetap tinggi, sekitar 20-30% dalam tiga tahun pertama pasca pengobatan. Hal ini menunjukkan kemungkinan keterlibatan faktor prognostik lainnya, seperti genotipe DNA Human Papillomavirus (HPV) dan viral load HPV, yang belum dipelajari secara ekstensif pada kanker serviks stadium awal di Indonesia. Tujuan: Mengetahui genotipe HPV dan viral load HPV sebagai faktor prognostik untuk kekambuhan pada pasien kanker serviks dengan stadium IA2-IIA2. Metodologi: Studi ini memakai desain kohort retrospektif, dengan data dari rekam medis di Rumah Sakit Kanker Dharmais dari 2014-2019. Populasi studi adalah pasien kanker serviks stadium IA2-IIA2 yang menjalani histerektomi radikal dan limfadenektomi. Analisis molekuler untuk genotipe HPV dan viral load dilakukan pada tumor primer dan kelenjar getah bening (KGB). Analisis data melibatkan univariat, bivariat (Kaplan-Meier dan regresi Cox), dan analisis multivariat untuk menilai disease-free survival (DFS) dan mengidentifikasi faktor prognostik kekambuhan. Hasil: Sebagian besar pasien kanker serviks stadium IA2–IIA2 memiliki HPV16/18 pada tumor primer (75,9%) maupun KGB (66,5%), kelompok HPV unknown ditemukan sebanyak 18,2% dan 25,6%. Pada tumor primer (n=121), mayoritas HPV16/18 memiliki viral load tinggi (88,3%), sedangkan tipe non-16/18 umumnya rendah (79,4%); pola serupa terlihat pada kelenjar getah bening (84,2% dan 78,6%). Koinfeksi HPV16 dan 18 menunjukkan kecenderungan risiko lebih tinggi (aHR=1,79; 95%=CI 0,29–10,66). Pada kelompok non-metastasis KGB (n=82), koinfeksi 16 dan18 juga meningkatkan risiko kekambuhan (cHR 5,39; 95% CI 1,09–26,74; aHR 3,54; 95% CI 0,70–17,87). Infeksi HPV ganda merupakan faktor prognostik independen terkuat, meningkatkan hazard kekambuhan 4 kali lipat (95% CI 1,82–9,04) dan bahkan 6,63 kali pada subkelompok non-metastasis KGB (95% CI 1,71–25,69). Analisis stratifikasi menunjukkan kecenderungan tumor infiltrating lymphocytes (TILs) keras menurunkan efek genotipe dan viral load terhadap kekambuhan (log-rank p=0,046), namun belum dapat dipastikan sebagai efek modifikasi karena keterbatasan ukuran sampel. Kesimpulan: Temuan studi ini menyoroti pentingnya pemeriksaan genotipe HPV, terutama pada pasien yang ditemukan infeksi ganda, dan evaluasi komponen TILs sebagai panduan strategi tatalaksana klinis untuk pasien kanker serviks stadium awal.
Background: Cervical cancer remains a significant global health problem, with an estimated 660,000 new cases and 350,000 deaths annually. In Indonesia, cervical cancer is a major health burden, with 9.2% of women estimated to be affected in 2020. Despite radical hysterectomy, the recurrence rate in early-stage cervical cancer (IA2–IIA2) remains high, at approximately 20–30% within the first three years after treatment. This suggests the potential involvement of additional prognostic factors, such as Human Papillomavirus (HPV) DNA genotype and HPV viral load, which have not been extensively studied in early-stage cervical cancer in Indonesia. Objective: To determine the role of HPV genotype and HPV viral load as prognostic factors for recurrence in patients with stage IA2–IIA2 cervical cancer. Methods: This retrospective cohort study utilized medical record data from Dharmais Cancer Hospital from 2014–2019. The study population included patients with stage IA2–IIA2 cervical cancer who underwent radical hysterectomy and lymphadenectomy. Molecular analyses for HPV genotype and viral load were performed on primary tumors and lymph nodes. Data analyses included univariate, bivariate (Kaplan–Meier and Cox regression), and multivariate analyses to assess disease-free survival (DFS) and identify prognostic factors for recurrence. Results: Most patients had HPV16/18 in primary tumors (75.9%) and lymph nodes (66.5%), with HPV-unknown cases accounting for 18.2% and 25.6%, respectively. Among primary tumors (n=121), HPV16/18 infections predominantly showed high viral load (88.3%), whereas non-16/18 types mainly had low viral load (79.4%); similar patterns were observed in lymph nodes (84.2% and 78.6%). HPV16+18 coinfection demonstrated a tendency toward increased recurrence risk (aHR=1.79; 95% CI 0.29–10.66). In the non–lymph node metastasis subgroup (n=82), coinfection also increased recurrence risk (cHR 5.39; 95% CI 1.09–26.74; aHR 3.54; 95% CI 0.70–17.87). Multiple HPV infection emerged as the strongest independent prognostic factor, increasing recurrence hazard fourfold (95% CI 1.82–9.04), and up to 6.63-fold in the non-metastatic subgroup (95% CI 1.71–25.69). Stratified analysis suggested that high tumor infiltrating lymphocytes (TILs) may reduce the effect of genotype and viral load on recurrence (log-rank p=0.046), although this potential effect modification remains inconclusive due to limited sample size. Conclusion: The findings of this study highlight the importance of HPV genotyping, especially in patients with multiple infections, and evaluation of TIL components as a guide for clinical management strategies for patients with early-stage cervical cancer.
D-609
Depok : FKM-UI, 2026
S3 - Disertasi Pusat Informasi Kesehatan Masyarakat
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