Ditemukan 11 dokumen yang sesuai dengan query :: Simpan CSV
Maria Agnes; Pembimbing: Astrid B. Sulistomo; Penguji: Faisal Yunus
Abstrak:
Paparan debu keramik yang mengandung silika bebas di lingkungan kerja pabrik keramik Inerupakan faktor resiko untuk terjadinya penyakit pare akibat kerja. Untuk mencegah timbulnya penyakit pneumokoniosis perlu dilakukan upaya pemantauan secara khusus dan berkelanjutan terhadap para pekerja melalui pemeriksaan kesehatan secara berkala dan pemantauan terhadap lingkungan kerja. Penelitian terhadap tenaga kerja pabrik kerami; di Cikarang dilakukan pada 66 pekerja laki-laki, dengan metode krosseksional., terdiri dari 31 orang dare bagian pembuatan badan keramik dan 35 orang dad bagian pengepakan. Penelitian lingkungan kerja dilakukan dengan mengukur kadar debu total, kadar debu respirable dan kadar silika bebas di bagian pembuatan badan keramik dan di bagian pengepakan. Pengumpulan data dilakukan dengan wawancara, pemeriksaan fisik, pemeriksaan fungsi paru dan pemeriksaan foto toraks. Hasil dan kesimpulan: Didapatkan prevalensi batuk kronik 4,5%, bronkitis kronik 4,5%, dahak kronik 4,5%, kelainan radiologi paru 10,6% dan restriksi 47% di pabrik tsb. Dibagian pembuatan badan keramik, kadar debu total, kadar debu respirable dan kadar silika bebas melebihi NAB yang ditetapkan. Tidak ditemukan hubungan antara kelainan fungsi pare dengan faktor-faktor umur, pendidikan, status gizi, masa kerja, kebiasaan merokok, kebiasaan memakai alat pelindung diri. Tidak ditemukan perbedaan prevalensi batuk kronik, bronkitis kronik, restriksi dan kelainan radiologi dengan tingkat paparan.
Scope and Methodology Exposure to ceramic dust which contains free silica in a ceramic factory is a risk factor for occupational lung diseases. To prevent pneumoconiosis, specific and continuous monitoring of the workers through periodic health examinations and work environment measuring is very important. A study on 66 by ceramic factory workers consisting of 31 men from ceramic-body preparation division and 35 men from packaging division in Cikarang using cross-sectional method has been conducted. The work environment study was done by measuring total dust contamination, respirable dust, and free silica in ceramic-body preparation division and packaging division. Data collection was done by interviews, physical examination, lung function test and X-ray examination. Results : The prevalence of chronic cough were 4,5 %, chronic bronchitis 4,5 %, changes in lung radiologic 10,6 % and restriction 47 %. The total dust concentration, respirable dust and the free silica concentration was found to exceed the permissible limit in ceramic-body preparation division. No relation was found between lung function changes, age, education, nutrition condition, work period, smoking habits and mask users habits. No significant different in the prevalence of chronic cough, chronic-bronchitis, restriction and radiologic changes was found different level of dust exposure.
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T-872
Depok : FKM-UI, 2001
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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Hanny Harjulianti; Pembimbing: Bastaman Basuki; Penguji: Faisal Yunus, Astrid Sulistomo
Abstrak:
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Latar belakang: Para tenaga kerja yang terpajan debu kaca mempunyai risiko menderita gangguan fungsi paru restriktif. Oleh karena itu penelitian ini dilakukan untuk mengidentifikasi faktor-faktor risiko yang mempertinggi maupun yang memperkecil risiko gangguan fungsi paru restriktif yang terjadi di PT M. Metode: Penelitian dilakukan di PT M Cikarang terhadap 412 tenaga kerjanya yang datang pada 3 minggu pertama (10 April-28 April 2000) melakukan tes tahunan spirometri. Alat yang digunakan adalah spirometer Autospiro AS-505 merk Minato buatan Jepang. Karakteristik subyek yang diteliti adalah umur, bagian, lama kerja, riwayat penyakit, riwayat merokok, riwayat olah raga dan riwayat pajanan zat yang terdapat di dalam maupun di luar lingkungan kerja. Hasil: Proporsi restriktif terbesar terdapat pada subyek yang bekerja di bagian cutting line (86,8%). Relatif terhadap subyek yang mempunyai indeks massa tubuh (EMT) yang normal, subyek yang mempunyai IMT kekurangan berat badan (BB) tingkat berat dan kekurangan BB tingkat ringan mempunyai risiko menderita gangguan fungsi paru restriktif masing-masing sebanyak 11,1 kali dan 2,2 kali lipat lebih besar (Rasio odds suaian 11,9; 95% CI: 3,12-45,70 dan rasio odds suaian 2,3; 95% CI: 1,16-4,86). Pada subyek dengan riwayat pajanan insektisida 1,7 kali lipat lebih besar (rasio odds suaian 1,7; 95% CI: 0,99-2,91; P- 0,050).Disamping itu subyek yang berpendidikan sekolah dasar dibandingkan subyek yang berpendidikan perguruan tinggi (PT) mempunyai risiko 8,3 kali lipat lebih besar namun tidak signifikan secara statistik. Kesimpulan: Subyek di bagian cutting line, yang berpendidikan sekolah dasar, yang masih batuk, mempunyai IMT kurang dan subyek dengan riwayat pajanan insektisida perlu mendapat perhatian khusus.
Background: Workers who are highly exposed to glass dust in glass manufacturing company experienced high risk of suffering restrictive lung disorders. On that basis this study is conducted to identify risk factors that increase or decrease restrictive lung disorders occurrence. Methods: This study was performed at PT M on 412 employees who arrived in the first three weeks to undergo spirometry test. Equipment to run the test was Minato Autospiro AS-505 made in Japan. This research was designed based on employee?s criteria such as age, labor division, duration of work, experience of previous sickness, smoking and sport habits, chemical contaminated experience inside and outside the working environment. Results: The biggest proportion of restrictive lung disorders was among subjects working in the cutting line division (86,8%). Subjects who had body mass index (BMI) categorized as light and heavy grade of abnormality, had increased risk of 11, 1 and 2, 2 times than normal BMI subjects. Otherwise subjects who had primary school education facing restrictive lung disorders of 8, 3 times greater than those who had university education. Subjects exposed to insecticide had 1, 7 times increased risk of restrictive lung disorders. Conclusion: Subjects in cutting line division with primary school education, coughing and having BMI abnormality and who had insecticide exposure experience required to have serious attention in order to minimize the risk of restrictive lung disorders.
T-1047
Depok : FKM-UI, 2001
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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Regina Tiolina SIdjabat; Pembimning: Nasrin Kodim; Penguji: Yovsyah, Ratna Djuwita, Faisal Yunus, Abdul Hafiz
Abstrak:
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Setiap tahun, kurang Iebih 200.000 jemaah haji Indonesia menunaikan ibadah haji.. Hingga saat ini,angka mortalitas haji Indonesia masih tinggi, kcmatian pada kelompok usia lanjut lebih tinggi jika dibandingkan dengan kelompok jemaah lainnya. Tujuan penelitian ini adalah untuk mengetahui pengaruh penyakit pemafasan yang sudah diidap sebelum ibadah haji terhadap kematian jemaah usia lanjut Indonesia pada musim haji 1428 H(2007 - 2008). Subyek pcnelitian ini adalah 42.885 jemaah usia lanjut Indonesia,dengan 311 kasus kematian. Desain penelitian kohort retrospektiiimasa pcngamatan 68 hari sejak 17 November - 23 Januari 2008. Analisis mcnggunakan Iogistik regresi ganda. Jemaah yang sudah mengidap penyakit pemafasan sebelum ibadah haji secara statistik berpengaruh secaza bermakna tcrhadap kematian jemaah usia lanjut Indonesia (RR= 2,57 ; 95% CI:l,60 - 4,13 ; nilai p=0,00 ). Insiden kematian jemaah pcngidap penyakit pemafasan (2,00%),sedang.ka.': yang tidal; mengidap penyakit pernafasaan sebesar (0,'70%). Jemaah yang mengidap penyakit serebrovaskular mempunyai risiko kematian 2,10 kali dibandingkan jemaah yang tidak mengidap penyakit serebrovaskular (95%CI: 1,44 - 3,04 ; nilai p=0,00). Sedangkan jemaah yang mengidap penyakit endokrin dan metabolik mempunyai risiko kematian 2,05 kali lebih tinggi dibandingkan jemaah yang tidak mengidap penyakit endokrin dan metabolik (95%CI: 1,37 - 3,06 ;nilai p=0,00). Data rawat jemaah JI-II di Arab Saudi menyebutkan bahwa alasan terbanyak JHI untuk berobat dan dirawat adalah karena penyakit pemafasan. Karena penyakit pemafasan yang berisiko tinggi kematian berkisar 40% pada usia lanjut adalah pneumonia,dan mengingat tahun 1428 H adalah musim dingin, kemungkinan besar JI-II usia lanjut wafat disebabkan oleh pneumonia Hanya saja data rekam medik .THI tidak lengkap untuk menjelaskan keadaan tersebut. Karakteristik individual jemaah haji yang berkontribusi terhadap kematian adalah faktor usia, jenis kelamin, gelombang pemberangkatann. JH1 dengan usia 2 80 tahun mempunyai risiko kematian 5,10 kali Iebih tinggi (95% Cl : 3,38 - 7,67 ; nilai p 0,00) dibandingkan dcngan jemaah berusia 60-69 tahun, Jemaah berusia 70 - 79 tahun mempunyai risiko kematian 2,13 kali Iebih tinggi (95%CI: 1,88 - 2,67; nilai 0,00). Jemaah laki-Iaki yang berusia 260 tahlm berisiko untuk wafat 1,88 kali (95% CI:I,48 - 2,37 nilai p 0,00) dibandingkan dcngan jemaah perempuan. Jemaah yang tiba lebih awal dengan gelombang pemberangkatan I mempunyai risiko untuk wafat Iebih tinggi 1,31 kali (95% CI: 1,05 - 1,64 ; nilai p 0,02) dibandingkan jemaah yang diberangkatkan dengan gelombang II. Saran penelitian adalah agar jemaah pengidap penyakit pemafasan, khususnya PPOK menghentikan kebiasaan merokok, melakukan Iatihan pemafasan, dan diberi pengetahuan tentang penyakit-penyakit yang kemungkinan diderita. Perlu diberikan pelatihan pembekalan khusus untuk para dokter dalam deteksi dini, diaglosis dan penanganan penyakit yang tcpan Juga dianjurkan pemeriksaan faal pam berkala dengan spirometer khususnya calon jemaah yang mengidap asthma dan PPOK.
Annually, about 200.000 Indonesian pilgrims come to perform the ritual Haji.'I`ilI now, mortality rate of Indonesian pigrims is still high , and old age death is relative higher compared to group pilgrims of other age. The aim ofthe study is to know the iniluence of respiratory disease that is suffered before pilgrimace to the number of the d th of old Indonesian hajj pilgrims in haji season 1428 H (2007 - 2008). This study conducted 42.885 old Indonesian pilgrims with 311 numbers of death. The study design is retrospective cohort, to observe subject about 58 days from 17 November 2007 to 23 January 2008. The method used in this study is multiple logistic regressions. The influence of respiratory disease that is suffered before pilgrimage has statistic significantly to the death of old Indonesian pilgrims in hajj season 1428 H ( RR= 2,57 ; 95% CI:1,60 - 4,13 ; p value =0,00).The incidence mortality rate in pilgrims who have a respiratory disease that is suffered before pilgrimace (2,00%) is much the same to pilgrims in normal health condition (0,70 %). Pilgrims who have cerebrovascular disease have 2,10 times risk of death (95%CI: 1,44 - 3,04 ; p value 0,00), and pilgrims who have endocrine and metabolic disease have 2,05 times tisk of death ( 95% CI : 1,37 - 3,06 ; p value 0,00). From data which is taken by taking care of Indonesian pilgrims in Arab Saudi mention that mostly the reason to cure and taken care of Indonesian pilgrims is because of respiration system disease. Because respiration disease which has a high risk of death approximately 40% for the elderly people is pneumonia and to keep in mind that 1428 H is winter time it’s quite possible that old age Indonesian pilgrims pass away caused by pneumonia. But record data medic Indonesian pilgrims is incomplete to explain that situation. Individual characteristic of hajj pilgims factors that contribute to the death of ordinary old age Indonesian hajj pilgirns are age, sex, and length of stay in Arab Saudi. The pilgrims of the ages 2 80 years have 5,10 times higher risk of death ( 95% CI : 3,38 - 7,67 ; p value 0,00) compared to the pilgrims of 60 to 69 years old. The pilgrims of 70 to 79 years old have 2,13 times risk of death (95%CI: 1,88 - 2,67; p value 0,00). The men of the ages 2 60 years have 1,88 times risk of death ( 95% CI: 1,48 - 2,37 ; p value 0,00) compared to the women. Pilgrims who arrived earlier in the iirst tum have 1,31 times higher risk of death (95% CI: 1,05 - 1,64 ; p value 0,02) compared to those who arrive in the second tum. The suggestion is in order that pilgrims who have respiratory disease that is suifered before pilgrimage, especially with COPD is to stop the habit of smoking, conduct exhalation practice, and given the science of diseases that will possible be suifered. Special trainning must be given to doctors in early detection, diagnosis and handling disease correctly. Also is suggested that physiological respiratory examination must carried out periodically with spirometer especially pilgrim candidate with asthma bronchiale and COPD.
T-2967
Depok : FKM-UI, 2008
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
☉
Nurfanida Librianty; Promotor: Bambang Wispriyono; Kopromotor: Haryoto Kusnoputranto, Anna Rozaliyani, Penguji: Faisal Yunus, Besral, Arief Budi Witarto
Abstrak:
Pandemi Coronavirus diseases 2019 (COVID-19) membuat krisis kesehatan global. Pajanan lama PM, NO2, CO, O3 berefek negatif terhadap pasien COVID-19. Beberapa penelitian menunjukkan hubungan signifikan kerentanan genetik terhadap efek polutan udara terhadap penyakit, seperti pasien COVID-19 dengan polimorfisme ACE rs4646994 atau ACE2 rs2285666 dapat memiliki derajat lebih berat. Tujuan penelitian ini untuk menganalisis pengaruh pajanan PM2,5, NO2, O3, kondisi iklim, polimorfisme ACE rs4646994 dan ACE2 rs2285666, usia, IMT, serta komorbid hipertensi, penyakit jantung, asma dan DM terhadap derajat COVID-19. Data lingkungan didapatkan dari BMKG dan subjek berdomisili radius < 3 km dari Stasiun Metereologi Kemayoran dengan membagi menjadi kelompok pasien derajat asimtomatik-ringan dan sedang-berat. Pemeriksaan polimorfisme diambil dari sampel swab bukal. Data dilakukan analisis regresi logistik.
Hasil penelitian ini mendapatkan pasien COVID-19 dengan polimorfisme ACE2 rs2285666 genotip AA akan berisiko 9,128 kali mengalami derajat lebih berat. Polimorfisme ACE rs4646994, pajanan PM2,5, NO2 serta komorbid tidak berhubungan signifikan dengan derajat COVID-19. Pajanan O3, temperatur rendah, kelembaban rata-rata tinggi, sedikit sinar matahari, dan IMT tinggi secara signifikan memperberat COVID-19 pada analisis bivariat. Penelitian ini menyimpulkan polimorfisme ACE2 rs2285666 genotip AA merupakan faktor risiko memberatnya derajat COVID-19. Pajanan O3, IMT, temperatur minimum, temperatur rata-rata, kelembaban rata-rata dan lama penyinaran matahari dapat berperan terhadap derajat COVID-19.
Coronavirus Disease 2019 (COVID-19) pandemic created a global health crisis. Prolonged exposure to PM, NO2, CO, O3 has a negative effect on COVID-19 patients. Several studies have shown a significant relationship between genetic susceptibility to the effects of air pollutants on disease, such as COVID-19 patients with ACE rs4646994 or ACE2 rs2285666 polymorphisms can have a more severe degree. The aim of this study was to analyze the effect of exposure to PM2.5, NO2, O3, weather conditions, ACE rs4646994 and ACE2 rs2285666 polymorphisms, age, BMI, and comorbidities (hypertension, heart disease, asthma, and DM) on the degree of COVID-19. Environmental data were obtained from the BMKG and the subjects were domiciled within a radius of <3 km from the Kemayoran Meteorological Station by dividing the patients into asymptomatic-mild and moderate-severe groups. Polymorphism examination was taken from a buccal swab sample. Logistic regression was used to analyze the data. The results of this study found that COVID-19 patients with the polymorphism ACE2 rs2285666 genotype AA would be 9.128 times more at risk of experiencing a more severe degree. Polymorphism ACE rs4646994, exposure to PM2.5, NO2 and comorbidities were not significantly related to the degree of COVID-19. O3 exposure, low temperature, high average humidity, fewer durations of sunlight, and high BMI significantly aggravate COVID-19 in bivariate analysis. This study concluded that the polymorphism ACE2 rs2285666 genotype AA is a risk factor for the severity of COVID-19. Exposure to O3, BMI, minimum temperature, average temperature, average humidity, and duration of sunlight can play a role in the degree of COVID-19.
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Coronavirus Disease 2019 (COVID-19) pandemic created a global health crisis. Prolonged exposure to PM, NO2, CO, O3 has a negative effect on COVID-19 patients. Several studies have shown a significant relationship between genetic susceptibility to the effects of air pollutants on disease, such as COVID-19 patients with ACE rs4646994 or ACE2 rs2285666 polymorphisms can have a more severe degree. The aim of this study was to analyze the effect of exposure to PM2.5, NO2, O3, weather conditions, ACE rs4646994 and ACE2 rs2285666 polymorphisms, age, BMI, and comorbidities (hypertension, heart disease, asthma, and DM) on the degree of COVID-19. Environmental data were obtained from the BMKG and the subjects were domiciled within a radius of <3 km from the Kemayoran Meteorological Station by dividing the patients into asymptomatic-mild and moderate-severe groups. Polymorphism examination was taken from a buccal swab sample. Logistic regression was used to analyze the data. The results of this study found that COVID-19 patients with the polymorphism ACE2 rs2285666 genotype AA would be 9.128 times more at risk of experiencing a more severe degree. Polymorphism ACE rs4646994, exposure to PM2.5, NO2 and comorbidities were not significantly related to the degree of COVID-19. O3 exposure, low temperature, high average humidity, fewer durations of sunlight, and high BMI significantly aggravate COVID-19 in bivariate analysis. This study concluded that the polymorphism ACE2 rs2285666 genotype AA is a risk factor for the severity of COVID-19. Exposure to O3, BMI, minimum temperature, average temperature, average humidity, and duration of sunlight can play a role in the degree of COVID-19.
D-473
Depok : FKM UI, 2023
S3 - Disertasi Pusat Informasi Kesehatan Masyarakat
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Dewi Rahayu Sudiman; Pembimbing: Umar Fahmi Achmadi, Haryoto Kusnoputranto; Penguji: Sudarto Ronoatmodjo, Faisal Yunus, Rachmadhi Purwana, I Made Djaja, Erna Tresnaningsih
D-115
Depok : FKM-UI, 2005
S3 - Disertasi Pusat Informasi Kesehatan Masyarakat
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Masdalina Pane; Promotor: Nasrin Kodim; Ko-Promotor: Dede Kusmana, Mondastri Korib Sudaryo; Penguji: Faisal Yunus, Ratna Djuwita, Soewarta Kosen, Rustika
D-219
Depok : FKM-UI, 2007
S3 - Disertasi Pusat Informasi Kesehatan Masyarakat
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Satria Pratama; Promotor: Haryoto Kusnoputranto; Kopromotor: Bambang Wispriyono, Faisal Yunus; Penguji: Fatma Lestari, Besral, Elisna Syahruddin, Inswiyasri, Sonny Warouw
D-338
Depok : FKM-UI, 2016
S3 - Disertasi Pusat Informasi Kesehatan Masyarakat
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Dina Bisara Lolong; Promotor: Sudijanto Kamso; Ko-Promotor: Sabarinah Prasetyo, Bachti Alisjahbana; Penguji: Purwantyastuti, Soewarta Kosen, Mardiati Nadjib, Asri C. Adisasmita, Faisal Yunus
Abstrak:
Tuberkulosis masih menjadi salah satu penyakit menular yang paling mematikan di dunia. Saat ini diperkirakan 9,6 juta orang memiliki masalah terkait TB pada tahun 2014 (5,4 juta laki-laki; 3,2 juta perempuan; dan 1 juta anak-anak). Kasus tertinggi terdapat di India, Indonesia dan China dengan julah kasus masing-masing: 23%, 10% dan 10%. WHO telah memperkenalkan the End TB Strategy dalam upaya menurunkan prevalensi TB, yang berlaku sejak tahun 2016. Sehubungan dengan strategi tersebut, telah ditetapkan target terkait dengan SDGs yaitu menurunkan jumlah kematian TB sebesar 90% dan jumlah kasus TB baru sebesar 80% dari target tahun 2015 untuk tahun 2030 serta memastikan bahwa tidak ada keluarga dibebani dengan bencana biaya karena TB. Prinsip dasar perawatan kasus tuberkulosis adalah sama di seluruh dunia. Diagnosis harus ditetapkan secara akurat dan sedini mungkin, dan rejimen pengobatan harus sesuai standar. Skrining foto toraks menunjukkan sensitivitas yang baik dalam mengidentifikasi individu dengan risiko tertinggi mengalami TB, terutama ketika kriteria abnormal pada paru-paru dan pleura digunakan. Banyak negara menggunakan skrining foto toraks untuk TB peningkatan deteksi kasus TB. Tujuan utama penelitian ini adalah: menganalisis positivitas skrining TB dengan memanfaatkan pemeriksaan foto toraks serta potensi kerugian ekonomi yang dapat dicegah. Tujuan khusus adalah menganalisis peningkatan positivitas bakteriologi positif pada skrining TB dengan penambahan foto toraks; menganalisis akurasi dengan penambahan pemeriksaan skrining foto toraks dan implikasinya terhadap biaya pemeriksaan. Penelitian ini menggunakan data sekunder SPTB yang dilaksanakan tahun 2013-2014 untuk tingkat nasional dan 3 wilayah. Disain SPTB 2013-2014 adalah potong lintang dengan stratified multi-stage cluster sampling. Semua partisipan diwawancarai tentang gejala TB dan dilakukan skrining foto toraks kecuali wanita hamil dan partisipan yang menolak. Suspek adalah partisipan dengan gejala TB atau abnormal foto toraks, pemeriksaan sputum mikroskopik, kultur dan Xpert MTB/Rif dilakukan oleh tujuh laboratorium rujukan TB. Hasil penelitian ini membuktikan bahwa skrining foto toraks dapat mendeteksi sebesar 97% smear positif, 94% smear negatif, serta 95% dari konfirmasi bakteriologis TB. Sebanyak 30% smear positif dan 51% smear negatif serta 43% konfirmasi bakteriologis TB hanya terdeteksi dari skrining foto toraks tanpa skrining gejala TB. Berarti terdapat kasus TB yang tidak terdeteksi jika tanpa skrining foto toraks dan jika hanya mengandalkan skrining gejala TB di Indonesia tahun 2013-2014, sebanyak 602.717 untuk umur ≥15 tahun, dan 421.250 untuk kelompok umur 18-60 tahun diantaranya, laki-laki 273.810 dan perempuan 147.440. Penambahan skrining foto toraks minimal meningkatkan empat kali konfirmasi bakteriologis TB dibanding dengan hanya skrining gejala TB dan sembilan kali jika bersama-sama skrining gejala dan skrining foto toraks. Sensitivitas dan spesifitas abnomal foto toraks pada skrining gejala positif masing-masing terhadap konfirmasi bakteriologis TB adalah 91,3% dan 47,2%. Hasil lainnya apabila hasil uji diagnostik penambahan skrining foto toraks normal pada skrining gejala positif, maka probabilitas pasien tidak TB adalah sebesar 99,4 %(NPV). Hal ini berarti adanya efisiensi dari sekitar 45% pasien dengan skrining gejala TB positif tetapi skrining foto toraks normal, bukan suspek TB sehingga tidak memerlukan biaya untuk pemeriksaan laboratorium smear dan Xpert MTB/RIF. Umumnya (96%) hasil pemeriksaan Xpert MTB/RIF positif adalah kultur positif yang diacu sebagai gold standard, sedangkan hanya 49% hasil BTA positif diantara kultur positif. Penambahan skrining foto toraks untuk mendeteksi TB dapat menghemat biaya pengeluaran dalam deteksi kasus TB terutama pada laki-laki umur produktif. Sebesar 38% biaya yang dapat dihemat berasal dari biaya tidak langsung yaitu kehilangan tahun produktifitas karena kematian dini dan selama sakit. Biaya yang dapat dihemat ini tinggi terutama pada laki (50%) Penambahan pemeriksaan foto toraks juga dapat menurunkan kematian dan transmisi sebesar 75% pada smear positif dan 30% pada smear negatif. Oleh karena itu rekomendasi utama penelitian ini adalah memasukkan skrining foto toraks selain skrining gejala TB pada alur diagnosis TB dewasa bersama pemeriksaan Xpert MTB/RIF dalam deteksi dini kasus TB untuk menurunkan prevalensi, kematian akibat TB dan transmisi di masyarakat.
Tuberculosis remains one of the world?s deadliest communicable diseases. Worldwide, 9.6 million people was estimated to have TB?s related problems in 2014; i.e 5.4 million in men; 3.2 million women and 1 million children. Globally, India, Indonesia and China had the largest number of TB cases: 23, 10 and 10 of total percentage. WHO has launched the End TB Strategy in the effort of reducing TB?s prevalence that has been implemented since 2016. With regard to the target of the strategy which is linked to the SDGs, 90% of mortality and 80% of the new TB cases (year 2015) should be achieved in 2030. In addition, there should be taken for granted there would not any family be financially burden because of TB. The basic principle to cure TB cases is the same all over the world. Diagnose has to be done accurately and as early as possible. In addition, treatment regiments have to be standardized. Thorax screening has shown as a good sensitivity in identifying a high risk TB suspect, especially when abnormality criterion at lung and pleura is implemented. Many countries has adopting screening of thorax photo to escalate for TB case detection. The purpose of this study is to analyze the positivity of TB screening through thorax photo identification and its economics potential losses that can be prevented. The specific purposes are: to analyze the positivity of bacteriologically TB confirmed in TB screening with chest X-ray; to analyze accuracy of adding chest X-ray screening in a bacteriologicallyTB confirmed and its financial implication on TB diagnose. This study utilized a secondary data of SPTB that has been collected in 2013-2014 for national level and 3 regions representative. The design of the study is a cross-sectional, implementing stratified multi-stages cluster sampling. Participants were interviewed on TB?s symptoms and screened for direct digital chest radiography (DDR) except for pregnant women and those refused to participate. Suspect are those who having symptoms of TB or abnormal thorax photo, assessed for microscopic sputum for acid-fast bacillus (AFB),, culture and Xpert MTB/RIF done by seven referal TB?s laboratory. Study results showed, screening for thorax photo can detect as much as 97% of positive smear, 94% of negative smear and 95% of bacteriologically TB confirmed. Without symptoms of TB, thorax photo can detect 30% positive smear, 51% negative smear and 43% bacteriologically TB confirmed. It can be said that there are TB cases that can?t be detected without taking thorax photo. By doing screening of symptoms only, there are 602,717 cases of age ≥15 years old, 421,250 cases of age 18-60 years among others 273,810 cases are men and 147,440 cases are women were may loss detected. By adding thorax screening we can increase four-fold TB bacteria confirmation and nine-fold when both (symptoms and thorax) are done simultaneously. Sensitivity and specificity of abnormal thorax photo for positive symptom towards TB bacterilogically TB cofirmed was 91.3% and 47.2% respectively. Other results was when the results of thorax photo screening normal, but having positive symptoms, the probability of non TB cases was 99.4% (NPV). Thus, there would be about 45% efficiency can be done for cases of symptom positive ? thorax normal, or non TB suspect which can save finance for laboratory smear assessment and Xpert MTB/RIF. Generally 96% of Xpert MTB/RIF positive was culture positive that used as a gold standard comparing to 49% of BTA positive among culture positive. Using chest X-Ray screening to detect TB could save budget in detecting TB cases, especially at men of productive age. As much as 38% finance reveal as indirect cost that is productivity losses due to premature death and temporary disability. This cost saving is relatively high (50%). By adding thorax photo assessment, it can reduce 75% mortality and TB?s transmission of positive smear and 30% of negative smear. The main recommendation of this study is to implement thorax photo screening in spite of TB?s symptom screening at the diagnoses pathways for adult TB cases, simultaneously with early detection of Xpert MTB/RIF to reduce TB prevalence, mortality as well as transmission in the community.
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Tuberculosis remains one of the world?s deadliest communicable diseases. Worldwide, 9.6 million people was estimated to have TB?s related problems in 2014; i.e 5.4 million in men; 3.2 million women and 1 million children. Globally, India, Indonesia and China had the largest number of TB cases: 23, 10 and 10 of total percentage. WHO has launched the End TB Strategy in the effort of reducing TB?s prevalence that has been implemented since 2016. With regard to the target of the strategy which is linked to the SDGs, 90% of mortality and 80% of the new TB cases (year 2015) should be achieved in 2030. In addition, there should be taken for granted there would not any family be financially burden because of TB. The basic principle to cure TB cases is the same all over the world. Diagnose has to be done accurately and as early as possible. In addition, treatment regiments have to be standardized. Thorax screening has shown as a good sensitivity in identifying a high risk TB suspect, especially when abnormality criterion at lung and pleura is implemented. Many countries has adopting screening of thorax photo to escalate for TB case detection.
D-351
Depok : FKM-UI, 2016
S3 - Disertasi Pusat Informasi Kesehatan Masyarakat
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Mery Ramadani; Promotor: Budi Utomo; Kopromotor: Endang Laksminingsih Achadi, Hartono Gunardi; Penguji: Anhari Achadi, Faisal Yunus, Besral, Bambang Wispriyono, Soewarta Kosen, Abas Basuni Jahari,
Abstrak:
Rokok merupakan masalah global dan menjadi ancaman serius bagi kesehatan ibu hamil dan janin. Studi kohor prospektif ini, dilakukan untuk menilai pengaruh pajanan pasif asap rokok ibu hamil terhadap gangguan pertumbuhan janin. Melibatkan 128 ibu hamil trimester 3, hamil janin tunggal, tidak memiliki riwayat penyakit kronis, bukan perokok aktif, bukan mantan perokok, dan bersedia terlibat dalam penelitian. Penilaian pajanan asap rokok ibu berdasarkan pemeriksaan nikotin darah tali pusat (cut off ≥1ng/ml). Pengukuran menggunakan nikotin plasma adalah metode yang paling akurat karena dapat mengukur kondisi sebenarnya dan membantu mengurangi misklasifikasi. Gangguan pertumbuhan janin dinilai dengan pengukuran berat lahir, panjang lahir, lingkar kepala, dan berat plasenta. Pengukuran dilakukan segera setelah lahir untuk menjamin ketepatan pengukuran. Analisis uji beda dua mean digunakan untuk mengetahui perbedaan rata rata ukuran gangguan pertumbuhan janin antara kelompok ibu terpajan asap rokok dan tidak terpajan asap rokok. Analisis regresi linier untuk melihat pengaruh pajanan asap rokok terhadap berat lahir, panjang lahir, lingkar kepala dan berat plasenta dengan memperhatikan variabel pengganggu seperti penambahan berat badan ibu selama hamil, BMI ibu, paritas ibu, usia dan kadar hemoglobin ibu. Hasil penelitian menunjukkan rata-rata kadar nikotin tali pusat sebesar 1,3±2,5 ng/ml. Berat lahir dan berat plasenta bayi dari ibu yang mendapat pajanan asap rokok lebih rendah dibandingkan ibu yang tidak mendapat pajanan asap rokok. Pajanan asap rokok secara signifikan mengurangi berat lahir bayi sebesar 205,6 gram (pvalue = 0,005) dan berat plasenta sebesar 51 gram (p value=0,010).
This cohort study examined the effect of secondhand smoke exposure in pregnant women on fetal growth restriction. The study recruited 128 pregnant women in the third trimester pregnancy, single pregnancy, no chronic illness, non-active smokers, non-exsmokers, and who were willing to participate in the study. Pregnant women with the secondhand smoke exposure referred to those with the umbilical cord blood nicotine level of 1ng/ml or higher. Fetal growth disorder was assessed according to the newborn weight, length, head circumference, and palcental weight measured immediately after birth. The independent t-test analysis was used to determine the difference in average size of fetal growth between two groups of pregnant women: exposed and the notexposed to the secondhand smoke. A multiple linear regression analysis was employed to find out the effect of secondhand smoke exposure on birth weight, length, head circumference, and palcental weight controlling for the birth size confounders including weight gain during pregnancy, body mass index, parity, maternal age, and maternal hemoglobin. The study found that mean of nicotine in umbilical cord blood was 1.3±2.5 ng/ml, the birth weight and the placental weight of infants were lower among mothers who exposed than among mothers who did not expose to the secondhand smoke. Exposed to the secondhand smoke reduced the birth weight by 205.6 grams (p value = 0.005) and placental weight by 51 grams (p value=0.010).
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This cohort study examined the effect of secondhand smoke exposure in pregnant women on fetal growth restriction. The study recruited 128 pregnant women in the third trimester pregnancy, single pregnancy, no chronic illness, non-active smokers, non-exsmokers, and who were willing to participate in the study. Pregnant women with the secondhand smoke exposure referred to those with the umbilical cord blood nicotine level of 1ng/ml or higher. Fetal growth disorder was assessed according to the newborn weight, length, head circumference, and palcental weight measured immediately after birth. The independent t-test analysis was used to determine the difference in average size of fetal growth between two groups of pregnant women: exposed and the notexposed to the secondhand smoke. A multiple linear regression analysis was employed to find out the effect of secondhand smoke exposure on birth weight, length, head circumference, and palcental weight controlling for the birth size confounders including weight gain during pregnancy, body mass index, parity, maternal age, and maternal hemoglobin. The study found that mean of nicotine in umbilical cord blood was 1.3±2.5 ng/ml, the birth weight and the placental weight of infants were lower among mothers who exposed than among mothers who did not expose to the secondhand smoke. Exposed to the secondhand smoke reduced the birth weight by 205.6 grams (p value = 0.005) and placental weight by 51 grams (p value=0.010).
D-395
Depok : FKM-UI, 2019
S3 - Disertasi Pusat Informasi Kesehatan Masyarakat
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Fathul Jannah; Promotor: L Endang Achadi; Kopromotor: Faisal Yunus, Elvina Karyadi; Penguji: Kusharisupeni, Anhari Achadi, Besral, Hartono Gunardi, Adi Hidayat, Sri Wuryanti
Abstrak:
ABSTRAK Latar Belakang: Tuberkulosis (TB) di Indonesia masih menempati urutan ke-3 di dunia. Anak dengan tuberkulosis umumnya mengalami defisiensi zinc dan vitamin A. Defisiensi zinc dapat menyebabkan gangguan sistem kekebalan tubuh dan mengganggu sintesis retinol binding protein sehingga dapat menghambat proses penyembuhan TB. Penambahan zinc dan vitamin A dapat membantu meningkatkan respon kekebalan tubuh pada penderita TB. Tujuan: Membuktikan pengaruh suplementasi zinc dan vitamin A dalam meningkatkan status gizi dan perbaikan gejala klinis pada anak usia 5-10 tahun dengan tuberkulosis paru. Disain: Penelitian adalah kuasi eksperimen dengan pre post design dengan kontrol. Sebanyak 84 anak yang telah diseleksi dan terdiagnosis TB Paru yang berada di empat wilayah Puskesmas Kecamatan di Jakarta Pusat diambil menjadi subyek penelitian. Kelompok perlakuan dibagi secara acak menjadi dua kelompok yakni kelompok I yang mendapatkan Obat anti Tuberkulosis Standar DOTS dan suplemen (berisi 20 mg zinc elemental dan vitamin A asetat 1500 IU) dan kelompok II yang hanya mendapatkan OAT saja. Obat dan suplemen diminum setiap hari selama pengobatan TB. Respon kesembuhan dapat diukur dari membaiknya gejala klinis dan status gizi dibandingkan pada saat awal sebelum pengobatan. Analisis untuk melihat perbedaan dua kelompok menggunakan uji T-Test. Gejala klinis diukur dengan chi-square. Hasil: 84 Subyek terdiri atas kelompok intervensi (n=38) dan kelompok kontrol (n=46). Pada fase inisial (bulan ke dua) perubahan nilai zinc, retinol dan IMT-U pada kelompok intervensi lebih tinggi dibandingkan dengan kontrol, grup I dengan nilai p=0,087; p=0,002; p=0,449 berturut-turut. Perubahan kadar albumin dan hemoglobin kelompok kontrol lebih tinggi dibanding kelompok intervensi denan nilai p=0,000; p=0,142. Pada bulan ke enam terjadi kenaikan pada retinol, hemoglobin, IMT-U, kelompok intervensi lebih tinggi dari kelompok kontrol dengan p=0,879; p=0,142; p= 0,216. Perubahan kadar albumin lebih tinggi pada kelompok kontrol p=0,005. Kadar zinc mengalami penurunan pada kedua kelompok p=0,153. Perbaikan gejala klinis lebih cepat terjadi pada kelompok intervensi dan bermakna secara klinis namun tidak bermakna secara statisik. Simpulan: Pemberian suplemen disarankan pada anak TB yang mendapat OAT hingga bulan ke dua, karena dapat meningkatkan status gizi dan perbaikan gejala klinis.
ABSTRACT Background: Indonesia is the 3rd in the world on Tuberculosis (TB). Most children with tuberculosis commonly have zinc and vitamin A deficiency. Zinc deficiency caused immune system disorders and disturb the synthesis of retinol binding protein, it inhibited the healing process of TB. Supplementation of zinc and vitamin A helped to improve the immune response in TB patients. Objective: To prove the effect of zinc and vitamin A supplementation in improving the clinical symptoms and nutritional status in children 5-10 years of tuberculosis. Design: This study was quasi experimental, was conducted in a pre post design. A total of 84 children who were selected and diagnosed with pulmonary TB in the four districts of the Public Health Center in Central Jakarta were invited as research subjects. Subjects were divided into two groups. Group I received the standard DOTS ATT and supplement (containing 20 mg zinc element, as a zinc sulfate and acetate vitamin A 1500 IU), while group II only received ATT. These drugs and supplements are taken daily during TB treatment. The recovery response can be measured by observing the improvement in clinical symptoms and nutritional status compared to the time before treatment. The analysis used to see the differences between the two groups is the T-Test. Clinical symptoms are measured by chi-square. Results: There are 84 subjects taken in the intervention group (n = 38) and the control group (n = 46). In intensive phase, delta of zinc, retinol, BMI/A on intervention group was higher than control ( p=0,087; =0,002; =0,449, respectively). Delta albumin and Hb were higher ol control than intervention (p=0,000; =0,142). On the 6th mo, delta of retinol, Hb increased higher than control (p=0,879; =0,142; =0,216, respectively). But zinc level decreased on both groups (p=0,153). Clinical symptoms provide good results and are clinically meaningful but not significant. Conclusion: Supplementation was valueable with ATT treatment up to two months due to it could improve nutritional status and clinical symptoms.
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ABSTRACT
D-397
Depok : FKM-UI, 2019
S3 - Disertasi Pusat Informasi Kesehatan Masyarakat
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