Journals of Badan Penelitian dan Pengembangan Kesehatan
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    Peran Pengelolaan Limbah Rumah Tangga Terhadap Kejadian Diare Pada Balita di Indonesia (Analisis Data Riskesdas 2018)

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    Waste with a certain concentration and quantity has a negative impact on the environment, especially for human health. Dominant environmental factors such as excreta disposal, drinking water sources, household waste water disposal channels, waste management play a role in the spread of diarrhea germs in toddlers. Diarrhea is one of the main causes of morbidity and mortality in children under five. The purpose of this study was to determine the relationship between household waste management and the incidence of diarrhea. The design of this research was cross sectional, by utilizing data from the 2018 Riskesdas activity, this was in accordance with the approval letter for the use of data issued by the Health Research and Development Agency Number: 11062001-118 dated June 22, 2020. Analysis of the relationship between waste management and the incidence of diarrhea in children under five had been carried out using logistic regression. The samples analyzed were 93,448 toddlers from Riskesdas 2018 data. The results of the analysis showed that the factors related to the incidence of diarrhea in toddlers in Indonesia were the majority male, the age of toddlers over two years old, handling and RT trash bins, and waste disposal sites. Handling household waste is the most dominant factor with the incidence of diarrhea in toddlers. Handling household waste is carried out in an environmentally friendly way by dumping it in a landfill, stockpiling or making compost, it is necessary for households to do so as not to be infested with flies which can be a source of transmission of diarrhea in children under five. Abstrak Limbah dengan konsentrasi dan kuantitas tertentu berdampak negatif terhadap lingkungan terutama bagi kesehatan manusia. Pengelolaan limbah rumah tangga merupakan pilar yang menentukan dalam kejadian diare pada balita. Faktor lingkungan yang dominan seperti pembuangan tinja, sumber air minum, saluran pembuangan air limbah rumah tangga, pengelolaan sampah,berperan dalam penyebaran kuman diare pada balita. Diare merupakan salah satu penyebab utama kesakitan dan kematian pada balita. Tujuan kajian ini untuk mengetahui hubungan pengelolaan limbah rumah tangga terhadap kejadian diare. Desain penelitian ini adalah cross sectional, dengan memanfaatkan data hasil kegiatan Riskesdas 2018, hal ini sesuai dengan surat persetujuan penggunaan data yang dikeluarkan oleh Badan Penelitian dan Pengembangan Kesehatan Nomor : 11062001-118 tanggal 22 Juni 2020. Analisis hubungan pengelolaan limbah dengan kejadian diare pada balita telah dilakukan dengan regresi logistik. Sampel yang dianalisis sebanyak 93.448 balita dari data Riskesdas 2018. Hasil analisis menunjukkan bahwa faktor yang berhubungan dengan kejadian diare pada balita di Indonesia yaitu mayoritas berjenis kelamin laki-laki, umurbalita di atas dua tahun, penanganan dan tempat sampah rumah tangga, serta tempat pembuangan tinja balita. Penanganan sampah rumah tangga merupakan faktor yang paling dominan dengan kejadian diare pada balita. Penanganan sampah rumah tangga dilakukan dengan cara yang ramah lingkungan dengan membuang di TPA, menimbun, atau membuat kompos perlu dilakukan rumah tangga agar tidak dihinggapi lalat yang dapat menjadi sumber penularan diare pada balita

    Penyebaran Kasus Difteri Beserta Faktor Risikonya di Daerah Kejadian Luar Biasa (KLB) di Indonesia

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    Diphtheria is a Re-emerging Disease. This disease is caused by a bacterium called Corynebacterium diphtheriae which contains an exotoxin that has fatal consequences. This disease can cause plague with the legal basis Law no. 4 1984 on Infection Deseas Outbreak. These diseases were transmitted through air, airborne, or direct contact with the patient. The research was conducted in several provinces that had experienced an Outbreak (KLB) of Diptheria. This research purposes are to give information about the swab test result of correspondents from areas affected by an Outbreak or Kejadian Luar Biasa (KLB) and to discover the relationship between factors that influence the occurrence of diphtheria in Indonesia. The method used is cross-sectional, the type of laboratory and field research. The specimens in this research include 178 people's throats that have Diphtheria and the close related person who has direct contact with the patient. Different identification is doneby examining swab specimens from suspected cases and contacts. Specimens are examined by the culture of each specimen and accompanied by questioner which contains information such as demographic information (age, gender, parental occupation, living environment), disease symptoms, and immunization history. Data analysis was carried out descriptively and cross-tabulation to determine the characteristics and the relationship between the dependent variable and the independent variable using the SPSS 017.00 program. The resultof this research include, the number of specimens that have positive diphtheria are 5.2%, the type of diphthery that founded is type C. grafis, intermedius and mitis sub-type diphtheria. The origin of diphteria patient are from East Java and Banten region. The results of the analysis obtained are that there is a significant relationship between respondents who have had a bleeding throat and the incidence of diphtheria. Abstrak   Difteri merupakan penyakit Re-Emerging Diseases. Penyakit ini disebabkan oleh bakteri Corynebacterium diphtheria yang mengandung eksotoksin yang dapat menyebabkan kefatalan. Penyakit ini termasuk penyakit yang dapat menyebabkan wabah. Dasar hukumnya adalah Undang-Undang No. 4 tahun 1984 tentang wabah penyakit menular. Cara penularan melalui udara atau airborne diseases atau kontak langsung dengan penderita, penelitian dilakukan di beberapa Provinsi yang pernah mengalami KLB difteri. Tujuan penelitian adalah untuk menginformasikan hasil identifikasi swab dari responden di daerah Kejadian Luar Biasa (KLB),serta hubungan antara faktor yang berpengaruh terhadap terjadinya difteri di Indonesia. Metode yang digunakan adalah potong lintang, jenis penelitian laboratorium dan lapangan. Spesimen berupa swab tenggorok sebanyak 178 spesimen swab tenggorok dari kasus difteri dan orang dekat yang pernah kontak dengan kasus. Identifikasi difteri dilakukan dengan memeriksa spesimen swab dari kasus suspek dan orang kontak. Specimen diperiksa secara kultur dan setiap spesimen disertai kuesionernya yang berisi data demografi (umur, jenis kelamin, pekerjaan orang tua, lingkungan tempat tinggal), gejala penyakit dan riwayat imunisasi. Analisa data dilakukan secara deskriptif dan tabulasi silang untuk mengetahui karakteristik dan hubungan antara varibel dependen dan variabel independen dengan meggunakan program SPSS 017.00. Hasil yangdiperoleh jumlah spesimen yang positip difteri sebanyak 5,2 %. Jenis difteri yang ditemukan adalah C.diphtheriae sub tipe gravis , intermedius dan mitis. Asal penderita difteri dari Provinsi Jawa Timur dan Provinsi Banten. Hasil analisa yang diperoleh adalah terdapat hubungan yang bermakna antara responden yang pernah sakit tenggorok yang berdarah dengan kejadian penyakit difteri

    Efektivitas Larvasida Infusa Daun Sirsak (Annona muricata L.) terhadap Mortalitas Larva Ae. aegypti

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    ABSTRACT Cases of Dengue Hemorrhagic Fever (DHF) have increased more than 8 times in the last two decades (2000-2019). DHF caused by the dengue virus which transmitted through the Aedes aegypti mosquito vector. Control is a step to prevent transmission by breaking the vector life cycle, it can be with temephos. However, its use can have side effects for the environment, health and resistance to larvae. Natural larvicides are an alternative and environmentally friendly step. The purpose of this study was to determine the effectiveness of the larvicide infusion of soursop leaf (Annona muricata L.) on the mortality of Aedes aegypti larvae. The type and research design was true experiment with a posttest only control group approach. Extraction of substances in plants used the infusion method. The research samples were 25 larvae instar III Aedes aegypti per container with criteria for being able to move actively. There were 8 treatment groups in the study consisting of negative control (well water), positive control (temephos) and soursop leaf infusion with 6 concentrations (1%; 2%; 3%; 4%; 5%; 6%). Observation time was carried out for 24 hours and three times replicates. Data were analyzed by Kruskal-Wallis, Mann-Whitney and probit analysis. The results of the analysis showed the value of LC50 was 2.611% and LC90 was 4.309%. While LT50 8.467 hours and LT90 14.263 hours. The conclusion of the study showed that soursop leaf infusion (Annona muricata L.) was effective in killed Aedes aegypti larvae. ABSTRAK  Kasus Demam Berdarah Dengue (DBD) meningkat lebih dari 8 kali dalam dua dekade terakhir (2000-2019). DBD disebakan oleh virus dengue yang ditularkan melalui vektor nyamuk Aedes aegypri. Pengendalian menjadi langkah untuk mencegah terjadinya penularan dengan memutus siklus hidup vektor, dapat dengan temephos. Namun penggunaannya dapat memberikan efek samping baik bagi lingkungan, kesehatan dan resistensi pada larva. Larvasida alami menjadi langkah alternatif dan ramah lingkungan. Penelitian ini bertujuan untuk mengetahui efektivitas larvasida infusa daun sirsak (Annona muricata L.) terhadap mortalitas larva Aedes aegypti. Jenis dan rancangan penelitian berupa eksperimen murni pendekatan posttest only control group. Pengambilan zat dalam tanaman menggunakan metode infusa. Sampel penelitian adalah larva instar III Aedes aegypti sebanyak 25 ekor per kontainer dengan kriteria dapat bergerak aktif. Terdapat 8 kelompok perlakuan dalam penelitian yang terdiri 2dari kontrol negatif (air sumur), kontrol positif (temephos) dan infusa daun sirsak dengan 6 konsentrasi (1%; 2%; 3%; 4%; 5%; 6%). Waktu pengamatan selama 24 jam sebanyak tiga kali replikasi. Data dianalisis dengan uji Kruskal-Wallis, Mann-Whitney dan uji probit. Hasil analisis menunjukkan nilai dari LC50 adalah 2.611% dan LC90 adalah 4.309%. Sedangkan LT50 8.467 jam dan LT90 14.263 jam. Kesimpulan penelitian menunjukkan bahwa infusa daun sirsak (Annona muricata L.) efektif membunuh larva Aedes aegypti

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    Hubungan ko-infeksi soil-transmitted helminths terhadap status gizi pada penderita tuberkulosis di Kecamatan Puger

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    Tuberkulosis (TB) adalah penyakit yang disebabkan oleh infeksi Mycobacterium tuberculosis. Kejadian ko-infeksi parasit di daerah endemik TB sering dilaporkan yang mengakibatkan kondisi penderita TB semakin parah dan sulit disembuhkan. Ko-infeksi cacing pada penderita TB diketahui berpengaruh terhadap respon imun, proses pengobatan, status gizi, dan prognosisnya.  Tujuan penelitian ini adalah untuk mengetahui hubungan ko-infeksi soil-transmitted helminthiasis (STH) terhadap status gizi pada penderita TB di Kecamatan Puger, Kabupaten Jember. Studi ini adalah penelitian observasi dengan desain cross sectional yang dilakukan di Puskesmas Puger, Kabupaten Jember, Jawa Timur pada September 2019 sampai Januari 2020. Data ko-infeksi cacing pada penderita TB diperoleh dari pemeriksaan feses dengan metode sedimentasi dan flotasi sedangkan status gizi diperoleh dari pengukuran indek masa tubuh (IMT). Analisis data menggunakan uji Chi-square untuk mengethui adanya hubungan ko-infeksi STH terhadap status gizi penderita TB. Hasil penelitian menunjukkan bahwa 6 dari 32 pasien TB (18,72 %) terinfeksi STH, 4 (%) terinfeksi Ascaris lumbricoides, dan 2 (%) terinfeksi hookworms. Hasil pengukuran IMT adalah18 (56,25%) yang mengindikasikan bahwa penderita TB berstatus gizi kurang dan14 (43,75%) berstatus gizi normal. Hasil uji Chi Square menunjukkan tidak   ada hubungan ko-infeksi STH terhadap status gizi penderita TB (p>0,05). Dengan demikian, perlu dilakukan edukasi pada penderita TB tentang gizi seimbang khususnya di wilayah puskesmas Puger Kabupaten Jember, Jawa Timur agar status gizi dapat meningkat

    JHECDs, Vol 7. No. 2, Desember 2021

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    The Implications of The Covid-19 Pandemic on The Utilization and Catastrophic Costs of National Health Insurance

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    Background: The COVID-19 pandemic in Indonesia has significantly impacted the health care system and insurance schemes. Social distancing policies during the pandemic have led to changes in utilization in health facilities, especially those related to catastrophic diseases that cost a lot of money. This study aims to analyse the impact of the Covid-19 pandemic on the utilization and financing of catastrophic diseases in the National Health Insurance (NHI) program. Methods: The research design is quantitatively and qualitatively. The quantitative study analysed secondary data obtained from the Social Security Administrator for Health and the nat. This study also has qualitative data from in-depth interviews with government and private hospital informants, health economists, and social health insurance experts. Results: COVID-19 pandemic has impacted decreasing the utilization of National Health Insurance participants to health facilities and significantly affecting the financing of catastrophic diseases. Before pandemic, the disease with the highest claim fee was ischemic heart disease, and after the pandemic, the disease with the highest claim fee was chronic kidney disease. There is also a change in the ranking diseases pattern before and during the covid-19 pandemic.  Conclusion: In the future, National Health Insurance financing needs to expand the scope of the benefits of preventive and promotive services, especially the prevention of catastrophic diseases, to reduce the burden of NHI claims. Health facilities provided by National Health Insurance providers need to prepare for better management of health services after the pandemic

    Intake of macromolecular nutrition status in pulmonary tuberculosis subjects at the Seputih Raman Health Center, Central Lampung

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    Background: The condition of pulmonary tuberculosis patients is affected by low nutritional status and this will slow recovery time. The problem of this research is the need to describe the calorie intake of pulmonary tuberculosis patients after receiving education on nutritional patterns high in protein and fat in pulmonary tuberculosis patients at the start of their treatment. In the initial conditions, TB patients generally experience protein and energy deficits, then during the course of treatment for approximately six months, it is necessary to evaluate the nutritional intake profile of TB patients. Therefore the expected goal of this research is to obtain profile data on the intake of energy, protein, fat, and carbohydrates as well as micronutrients. Methods: Research using a descriptive interview approach using a 24-hour food recall questionnaire and www.nutrisurvey.com  analysis in the work area of the Seputih Raman Public Health Center, Central Lampung in 2021. Results: Based on nutrisurvey data, subjects were found to be underweight (60%), with the highest carbohydrate intake deficit (80%) compared to intake of protein (46.67%) and fat (53.33%). Conclusion: This shows through our result, the need to emphasize the balance of nutritional intake in the nutrition education of Pulmonary Tuberculosis subjects not only protein and fat intake. Thus tuberculosis patients also need to pay attention to a balanced intake of carbohydrates  Keywords: Pulmonary tuberculosis, nutrition intake. Seputih Raman Abstrak   Latar Belakang : Kondisi pasien tuberkulosis paru dipengaruhi status gizi yang rendah dan hal ini akan memperlambat waktu pemulihan. Permasalahan penelitian ini perlunya gambaran asupan kalori penderita tuberkulosis paru setelah mendapat edukasi pola gizi tinggi protein dan lemak pada pasien tuberkolusis paru pada awal pengobatan mereka. Dalam kondisi awal, pada umumnya pasien Tuberkulosis mengalami defisit protein dan energi kemudian dalam perjalanan pengobatan selama kurang lebih enam bulan, perlu dilakukan evaluasi melihat profil asupan nutrisi pasien Tuberkulosis. Oleh karenanya tujuan yang diharapkan dalam penelitian ini adalah didapatkan profil data asupan energi, protein, lemak dan karbohidrat juga mikronutrien. Metode: Penelitian pendekatan deskriptif wawancara dengan alat ukur kuesioner food recall 24 jam dan analisa www.nutrisurvey.com di daerah kerja puskesmas Seputih Raman, Lampung Tengah Tahun 2021. Hasil: Berdasarkan data analisa nutrisurvey, didapatkan 60% pasien status gizi kurus, dengan angka defisit asupan karbohidrat paling tinggi (80%) dibandingkan asupan protein (46,67%) dan lemak (53,33%). Kesimpulan: Melalui hasil penelitian kami, hal ini menunjukkan perlunya menekankan keseimbangan asupan gizi pada edukasi gizi pasien Tuberkulosis Paru bukan hanya pada asupan protein dan lemak, dengan demikian pasien Tuberkulosis juga perlu memperhatikan asupan karbohidrat yang seimbang.  Kata kunci: Tuberkulosis paru, asupan nutrisi, Seputih Raman

    The Bacterial Susceptibility of Levofloxacin for Urinary Tract Infections Bacteria in Type 2 Diabetes Mellitus Patients

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    Abstract Background: Diabetes mellitus (DM) is a chronic metabolic disorder characterized by hyperglycemia, and can be associated with long term organ damage, organ dysfunction, and multiple organ failure. Type 2 DM causes high glucose levels in urine and suppression of the immune system, as in result it becomes a predisposing factor for urinary tract infections (UTIs). The antibiotic therapies that can be given in UTIs is levofloxacin which is effective against many types of bacteria that cause UTIs.This study aimed to determine the pattern of levofloxacin sensitivity against the bacteria that cause UTIs patients with type 2 DM. Methods: The study used a descriptive method with a total sample of 22 bacterial isolates that had been isolated from UTIs patients with type 2 DM . The bacterial isolates were collections of the Microbiology Laboratory, Faculty of Medicine, Tanjungpura University. The study was conducted from June to October 2019. The antibiotic sensitivity test used the disc diffusion method and interpretation based on the Clinical & Laboratory Standards Institute (CLSI). Results: levofloxacin was sensitive to UTIs bacteria by 95,45% with a total of 21 isolates from 22 isolates. The levofloxacin sensitivity pattern which was sensitive to types of bacteria such as Escherichia coli (100%), Pseudomonas aeruginosa (100%), Enterobacter aerogenes (66,67%), Klebsiella sp. (100%), and Shigella sp. (100%). Conclusion: levofloxacin is sensitive against bacteria that cause UTIs in type 2 DM patients with a percentage of 95,45%. Keywords: Diabetes mellitus; Urinary Tract Infections; Levofloxacin. Abstrak Latar Belakang: Diabetes melitus (DM) merupakan penyakit gangguan metabolik menahun yang memiliki karakteristik berupa hiperglikemia, kondisi ini dapat berkaitan dengan kerusakan organ jangka panjang, disfungsi organ, dan kegagalan berbagai organ dalam tubuh. DM tipe 2 mengakibatkan tingginya kadar glukosa dalam urin dan penekanan sistem imun, sehingga dapat menjadi faktor predisposisi terhadap infeksi saluran kemih (ISK). Terapi antibiotik yang dapat diberikan pada ISK adalah levofloksasin yang efektif terhadap banyak jenis bakteri penyebab ISK. Penelitian ini bertujuan untuk mengetahui pola sensitivitas antibiotic levofloksasin terhadap bakteri penyebab infeksi saluran kemih pada pasien diabetes melitus tipe 2. Metode: Penelitian menggunakan metode deskriptif dengan total sampel sebanyak 22 isolat bakteri yang telah diisolasi dari pasien ISK dengan DM tipe 2. Isolat bakteri merupakan koleksi Laboratorium Mikrobiologi Fakultas Kedokteran Universitas Tanjungpura. Penelitian dilaksanakan pada bulan Juni – Oktober 2019. Pengujian sensitivitas antibiotik menggunakan metode difusi cakram dan menggunakan tabel Clinical & Laboratory Standards Institute (CLSI) sebagai panduan kriteria. Hasil: levofloksasin sensitif terhadap bakteri ISK sebesar 95,45% dengan jumlah isolat sebanyak 21 dari 22 isolat uji. Pola sensitivitas levofloksasin yang bersifat sensitif pada jenis bakteri yaitu Escherichia coli (100%), Pseudomonas aeruginosa (100%), Enterobacter aerogenes (66,67%), Klebsiella sp. (100%), dan Shigella sp. (100%). Kesimpulan: levofloksasin sensitif terhadap bakteri penyebab ISK pada pasien DM tipe 2 dengan persentase sebesar 95,45%. Kata kunci: Diabetes Melitus; Infeksi Saluran Kemih; Levofloksasin

    Back Matter Media Litbangkes Vol 32 No 1

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