Journals of Badan Penelitian dan Pengembangan Kesehatan
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Faktor Risiko Dominan Mempengaruhi Kurang Energi Kronis (KEK) pada Ibu Hamil di Indonesia Tahun 2018
No full textChronic Energy Deficiency (CED) is one of the main problems that often occurs among pregnant women. This study aimed to describe the Dominant Risk Factors for CED pregnant women in Indonesia. This study used data from the 2018 Basic Health Research on all pregnant women in Indonesia. Data analysis used with simple logistic regression. The results of multivariate analysis showed that several factors had an effect on the incidence of CED, but the most significant factor was tuberculosis disease (p= 0.002; OR 6.770; 95% CI 1.964-23.341). It was concluded that pregnant women with tuberculosis had a 6.7 times increase risk for developing CED compared to those without tuberculosis. This variable was the most dominant variable related to CED in pregnant women in Indonesia in 2018. Keywords : risk factos, Chronic Energy Deficiency (CED), pregnant women
Abstrak
Kurang Energi Kronis (KEK) merupakan salah satu masalah utama yang masih sering terjadi pada Ibu hamil. Penelitian ini bertujuan untuk mengetahui gambaran faktor risiko dominan mempengaruhi KEK pada ibu hamil di Indonesia. Penelitian ini menggunakan data Riset Kesehatan Dasar Tahun 2018 pada seluruh ibu hamil di Indonesia. Analisis data yang digunakan dengan Simple Logistic Regression. Hasil analisis multivariate menunjukkan beberapa faktor berpengaruh terhadap kejadian KEK, akan tetapi faktor yang paling signifikan adalah penyakit infeksi tuberkulosis (p=0,002; OR 6,770; 95% CI 1,964-23,341). Disimpulkan ibu hamil dengan tuberculosis (TB) berisiko menjadi KEK sebesar 6,7 kali dibandingkan dengan tanpa tuberkulosis. Variabel ini meupakan variabel yang paling dominan berhubungan dengan KEK pada ibu hamil di Indonesia tahun 2018. Kata kunci: Faktor risiko, Kurang Energi Kronis (KEK), ibu hami
Characteristics of pediatric traumatic brain injury: study from Wongsonegoro Regional Public Hospital in Semarang
Get PDFBackground: Traumatic brain injury is one of the leading causes of morbidity and mortality in the world, as well as disability in the pediatric group. This study aimed to describe the characteristics of pediatric traumatic brain injury patients, considering the lack of data in Indonesia.
Methods: We conducted a descriptive-retrospective study at Wongsonegoro Regional Public Hospital Semarang. Data were extracted from medical records of patients admitted during the period of January 2017-December 2019 using a purposive sampling method.
Results: Out of 296 patients, most of the patients were male (59.13%; 66.30%). Based on age group, the highest percentage was found in the (11-18-year-old) (40.87%) in operative patients and 5-10-year-old (37.57%) in non-operative patients. The most common cause of traumatic brain injury in operative patients was falling from motor vehicle (37.39%) while in non-operative patients was falling while playing (32.60%). The most common type of injury in operative patients was epidural hematoma (49.57%) and in non-operative patients was brain concussion (53.59%). Most of the patients had minor head injury (75.65%; 81.22%). Most of operative patients spent 3-5 days (64.35%) in the hospital while most of non-operative patients spent 1-3 days (72.37%). Of all the subjects, the majority of patients recovered and discharged.
Conclusion: remains as the most common type of pediatric traumatic brain injury in this study. This study provides an overview of traumatic brain injury in children and shows the importance of enforcing driving rules and supervision by parents which play an important role in child safety.
Keywords: pediatric, traumatic brain injury, Indonesia
Abstrak
Latar belakang: Cedera kepala merupakan salah satu penyebab utama morbiditas dan mortalitas di dunia, serta disabilitas pada kelompok pediatri. Penelitian ini bertujuan untuk mendeskripsikan karakteristik pasien pediatri dengan cedera kepala, mengingat minimnya data cedera kepala pada anak di Indonesia.
Metode: Penelitian ini merupakan penelitian deskriptif-retrospektif di RSUD Wongsonegoro Semarang. Data diambil dari rekam medis pasien anak yang dirawat selama periode Januari 2017-Desember 2019 dengan menggunakan metode purposive sampling.
Hasil: Dari 296 pasien, sebagian besar merupakan laki-laki (59,13%; 66,30%). Berdasarkan kelompok umur, persentase tertinggi pada kelompok operatif terdapat pada (40,87%) dan pada kelompok non operatif terdapat pada kelompok usia 5-10 tahun (37,57%). Penyebab tersering cedera kepala pada pasien operatif yakni jatuh dari kendaraan bermotor (37,39%) sementara pada pasien non operatif penyebab tersering berupa jatuh saat bermain (32,60%). Jenis cedera kepala tersering pada pasien operatif adalah Epidural Hematoma (49,57%) dan pada pasien non-operatif berupa commotio cerebri (53,59%). Kebanyakan pasien mengalami cedera kepala ringan (75,65%; 81,22%). Sebagian besar pasien operatif dirawat selama 3-5 hari (64,35%) sedangkan mayoritas pasien non operatif dirawat selama 1-3 hari (72.37%) Dari semua subjek, mayoritas pasien sembuh dan dipulangkan.
Kesimpulan: Jatuh dari kendaraan bermotor merupakan jenis cedera kepala yang paling umum ditemukan dalam penelitian ini. Studi ini memberikan gambaran umum tentang cedera kepala pada anak dan menunjukkan pentingnya penegakan aturan dalam berkendara serta pengawasan oleh orang tua yang berperan penting dalam keselamatan anak.
Kata kunci: anak, cedera kepala, Indonesia
 
Performance of the tariff method and physicians in determining stroke as the cause of deaths using verbal autopsy in areas with a limited number of physicians: cases in Indonesia
Get PDFBackground: Physician-certified verbal autopsy (PCVA) is the primary method used to determine the cause of death in Indonesia, although it is very costly and problematic to use in areas where physicians are not widely available with most deaths occur at home. The Tariff method has been piloted to obtain an alternative approach that does not require a physician to determine the cause of death. This validation study presents how the Tariff captures the correctness and distinctiveness of stroke symptoms to the PCVA.
Methods: Medical records of 298 adult deaths that occured in four teaching hospitals in the Jakarta from January 1, 2015 to March 2017 were collected prospectively. Verbal Autopsy (VA) was applied using the 2014 WHO instrument diagnosed by a trained physician (PCVA) and by Tariff method. The validity of the VA was assessed by comparing the PCVA diagnoses with the Tariff diagnoses, referring to the best standard.
Results. Sensitivity, specificity and positive predictive value (PPV) of VAs using physician’s diagnosis (PCVA) for stroke were 73.9%, 73.5% and 93.4% respectively. The corresponding sensitivity, specificity and positive predictive value (PPV) of VAs diagnosed by the Tariff method were 75%, 61% and 91%. The negative predictive values (NPV) of both techniques were low, 35.6% and 32.6% respectively.
Conclusion: The performance of the Tariff method for stroke was almost similar with PCVA, and with a narrower variation, or more consistent than PCVA. Therefore, the Tariff method is a potential alternative to be used on a large scale, because the difficult geographical conditions where physician are not widely available for causes of deaths with distinct signs and symptoms.
Keywords: verbal autopsy, sensitivity, specificity, determining cause of death, physician, tariff method
Abstrak
Latar Belakang: Autopsi verbal yang disertifikasi oleh dokter (PCVA) merupakan metode utama yang digunakan untuk memastikan penyebab kematian di Indonesia. Meskipun sangat mahal dan bermasalah untuk digunakan di daerah di mana dokter tidak banyak tersedia dan sebagian besar kematian terjadi di rumah. Metode Tarif telah diujicobakan untuk mendapatkan pendekatan alternatif yang tidak memerlukan dokter untuk menentukan penyebab kematian. Studi validasi ini menyajikan bagaimana Tarif menangkap kebenaran dan kekhasan gejala stroke dibandingkan dengan PCVA.
Metode: Rekam medis dari 298 kematian orang dewasa yang terjadi di empat rumah sakit studi di wilayah Jakarta pada 1 Januari 2015 hingga Maret 2017 dikumpulkan secara prospektif. Autopsi verbal (AV) dilakukan dengan menggunakan instrumen WHO 2014 yang didiagnosis oleh dokter terlatih (PCVA) dan metode Tarif. Validitas AV dinilai dengan membandingkan diagnosis PCVA dengan diagnosis metode Tarif, mengacu pada baku mutu.
Hasil. Sensitivitas, spesifisitas dan nilai prediksi positif (PPV) dari AV dengan diagnosis dokter (PCVA) untuk stroke adalah 73,9%, 73,5% dan 93,4%. Sensitivitas, spesifisitas, dan nilai prediksi positif (PPV) yang sesuai dari AV yang didiagnosis dengan metode Tariff adalah 75%, 61% dan 91%. Nilai prediksi negatif (NPV) dari kedua teknik itu rendah, masing-masing 35,6% dan 32,6%.
Kesimpulan: Untuk stroke, kinerja metode Tarif hampir sama dengan PCVA, dan dengan variasi yang lebih sempit, atau lebih konsisten dibandingkan PCVA. Oleh karena itu, untuk penyebab kematian dengan tanda dan gejala yang berbeda, metode Tarif merupakan alternatif potensial untuk digunakan dalam skala besar, di Indonesia dimana banyak wilayah dengan geografis sulit dan dokter tidak selalu tersedia.
Kata kunci: autopsi verbal, sensitifitas, spesifisitas, penentuan penyebab kematian, dokter, metode tariff
 
Identifikasi Jamur Beracun Clitocybe sp. di Gresik, Indonesia (Studi Kasus)
Get PDFWild mushrooms are one of the food materials which often sought after by Indonesians when foraging on forests or around their residence. However, due to the similar morphology of edible and poisonous mushrooms, cases of mushroom poisoning are an inevitable risk. A young man consumed wild mushroom collected from his yard in Gresik, East Java. The macrofungi grew on humus soil with several plants around it. The man mistakenly recognized the mushroom as either Termitomyces or Agaricus which could be consumed. After an experienced friend also confirmed the edibility of the mushroom, he immediately cooked and consumed the mushrooms. A few hours later, the victim experienced vomiting, nausea, dizziness, and loss of balance. The victim immediately received coconut water by his family. After 4-5 hours of seven times vomiting, his condition began to improve and start the norma activities. The macrofungi which caused poisoning were then documented and described. The identification result using several macroscopic characters confirmed the mushroom as Clitocybe sp. This mushroom has previously been reported contain the muscarine toxin. This article is one of few publications on mushroom poisoning case which equipped with the complete information on mushroom features and descriptions in Indonesia. This report indicates that the caution and complete observations of the information are needed before consuming an unknown wild mushroom.
Abstrak
Jamur liar merupakan salah satu bahan pangan yang sering dicari oleh masyarakat Indonesia ketika merambah di hutan ataupun sekitar tempat tinggalnya. Namun, karena morfologi jamur yang bisa dikonsumsi dan jamur beracun seringkali terlihat mirip satu sama lain, maka kasus keracunan jamur menjadi risiko yang tidak terhindarkan. Seorang pemuda mengonsumsi jamur liar yang dikoleksi dari pekarangan rumahnya di Gresik, Jawa Timur. Jamur tersebut tumbuh pada tanah berhumus dengan beberapa tanaman di sekitarnya. Korban salah mengenali jamur tersebut sebagai Termitomyces ataupun Agaricus yang bisa dikonsumsi. Setelah seorang teman juga mengkonfirmasi edibilitas dari jamur tersebut, korban segera memasak dan mengkonsumsi jamur yang ditemukan. Beberapa jam kemudian korban mengalami muntah-muntah, mual, pusing, dan hilang keseimbangan. Korban segera mendapatkan pertolongan pertama berupa air kelapa oleh keluarganya. Setelah 4-5 jam mengalami muntah sebanyak tujuh kali, kondisi korban mulai membaik dan bisa kembali beraktifitas normal. Jamur yang menyebabkan keracunan kemudian didokumentasikan dan dibuatkan pertelaan karakter basidiomata. Hasil identifikasi dengan pendekatan beberapa karakter makroskopik mengkonfirmasi jamur tersebut sebagai Clitocybe sp. Jamur ini sebelumnya telah dilaporkan memiliki kandungan racun muscarine. Tulisan ini merupakan salah satu dari sedikit publikasi keracunan jamur yang dilengkapi dengan informasi jamur lengkap dan dilengkapi deskripsinya di Indonesia. Studi ini mengindikasikan bahwa diperlukan kehati-hatian dan observasi informasi yang lengkap sebelum mengonsumsi jamur liar yang belum diketahui identitasnya
Pengelompokan Provinsi berdasarkan Penyakit Menular dan Penyakit Tidak Menular untuk Upaya Pengendalian Penyakit dengan Pendekatan Multidimensional Scaling (MDS)
Get PDFThis study aims to group provinces in Indonesia based on the prevalence of communicable and non-communicable diseases (CDs and NCDs) for disease control efforts. The results of grouping can find out the priority of communicable and non-communicable disease control areas based on seven variables related to infectious diseases and ten variables related to NCDs based on Basic Health Research 2018. A Multidimensional Scaling (MDS) technique was used as the analytical strategy. The MDS analysis resulted in four groups of provinces based on the prevalence of CDs and NCDs. Provincial groups with the highest prevalence of infectious diseases (group 2) were NTT, Central Kalimantan, Maluku, West Papua, and Papua. Provincial groups with the highest NCDs prevalence (group 3) were Bangka Belitung, DKI Jakarta, DI Yogyakarta, East Kalimantan, North Kalimantan, and North Sulawesi. The two groups of provinces were the priority groups in controlling CDs and NCDs. The focus of communicable disease control is URI, hepatitis, malaria, and filariasis in the highest priority groups of provinces with the highest prevalence of infectious diseases. In groups of provinces with the highest NCDs prevalence, the NCD control should focus on asthma, cancer, diabetes, heart disease, hypertension, stroke, chronic renal failure, and joint disease. Further research is suggested adding risk factor analysis variables for CDs and NCDs using the MDS method to help provides a more comprehensive picture of regional groupings. Coordination between central and local governments is needed to accelerate efforts to control CDs and NCDs in priority area groups.
Abstrak
Tujuan penelitian ini adalah melakukan pengelompokan provinsi di Indonesia berdasarkan prevalensi penyakit menular (PM) dan penyakit tidak menular (PTM) dalam upaya pengendalian penyakit. Hasil pengelompokan dapat diketahui prioritas wilayah pengendalian PM dan PTM berdasarkan tujuh variabel terkait PM dan 10 variabel terkait PTM dari Riset Kesehatan Dasar (Riskesdas) 2018. Jenis penelitian ini adalah cross-sectional menggunakan data sekunder Riskesdas 2018. Analisis pengelompokan provinsi menggunakan Multidimensional Scaling (MDS). Analisis MDS menghasilkan empat kelompok provinsi berdasarkan prevalensi PM dan PTM. Kelompok provinsi dengan prevalensi PM tertinggi (kelompok 2) adalah NTT, Kalimantan Tengah, Maluku, Papua Barat dan Papua. Kelompok propinsi dengan prevalensi PTM tertinggi (kelompok 3) adalah Bangka Belitung, DKI Jakarta, DI Yogyakarta, Kalimantan Timur, Kalimantan Utara, dan Sulawesi Utara. Kedua kelompok provinsi ini merupakan kelompok provinsi prioritas dalam pengendalian PM dan PTM. Pada kelompok provinsi dengan PM tertinggi, fokus pengendalian PM adalah ISPA, hepatitis, malaria dan filariasis. Fokus pengendalian untuk PTM adalah asma, kanker, diabetes, penyakit jantung, hipertensi, stroke, gagal ginjal kronis, dan penyakit sendi. Penelitian selanjutnya disarankan menambahkan variabel analisis faktor risiko PM dan PTM dengan menggunakan metode MDS untuk membantu memberi gambaran yang lebih lengkap pada pengelompokan wilayah. Diperlukan koordinasi sinergi antara pemerintah pusat dan daerah untuk percepatan upaya pengendalian PM dan PTM di kelompok wilayah prioritas
STANDAR KUANTITAS ANTENATAL CARE DAN SOSIAL BUDAYA DENGAN RISIKO ANEMIA PADA KEHAMILAN
Get PDFAbstract
Background: There was an increase of anemia in pregnant women and maternal death due to obstetric hemorrhage with hemoglobin (Hb) levels during pregnancy <10 gr/dl in Indragiri Hilir District, Riau Province.
Objective: This study aimed to analyze the association between standard of antenatal care (ANC) and socio-cultural factors and the risk of anemia during pregnancy.
Methods: A cross-sectional design was used in this study. This study included 172 pregnant women in the 2nd and 3rd trimesters from the Sungai Piring Public Health Center's working area. Data of Hb level of pregnant women was obtained from the maternal register and the MCH book. Data on the quantity of ANC, socio-cultural, adherence to iron-folic acid tablet consumption, and characteristics of pregnant women were collected through questionnaire interviews. Bivariate and multivariate analyses were conducted by using chi-square test and multiple logistic regressions respectively.
Results: As many as 71.5% of pregnant women experienced anemia. Anemia in pregnant women was significantly associated with standard of ANC quantity, sociocultural status, and economic status (p<0.05). Inadequate ANC, poor socio-cultural, and low economic status increased the risk of anemia in pregnant women by 6.6 times, 11.4 times, and 3 times respectively.
Conclusion: Standard of ANC quantity, socio-cultural, and economic status were dominant factors for anemia in pregnancy. Home visits or counseling through messaging applications can be carried out by health workers for pregnant mothers who do not attend ANC visits.
Keywords: Anemia, antenatal care, pregnancy, socio-culture
Abstrak
Latar belakang: Terjadi peningkatan kasus anemia ibu hamil dan adanya kasus kematian ibu akibat perdarahan dengan kadar haemoglobin (Hb) darah saat hamil di bawah 10gr/dl di Kabupaten Indragiri Hilir Provinsi Riau.
Tujuan: Menganalisis hubungan antara standar antenatal care (ANC) dan sosial budaya dengan risiko anemia pada kehamilan.
Metode: Studi ini menggunakan desain cross sectional. Sampel studi yaitu 172 ibu hamil trimester dua dan tiga di wilayah kerja Puskesmas Sungai Piring. Data kadar hemoglobin (Hb) darah ibu hamil diperoleh dari register ibu dan Buku KIA. Data kuantitas ANC, sosial budaya, kepatuhan konsumsi tablet tambah darah, dan karakteristik ibu hamil dikumpulkan melalui wawancara kuesioner. Analisis bivariat dilakukan dengan uji chi square dan multivariat dengan uji regresi logistik ganda.
Hasil: Sebanyak 71,5% ibu hamil mengalamani anemia. Kuantitas ANC, sosial budaya, dan status ekonomi berhubungan signifikan dengan anemia pada ibu hamil (p<0,05). Ibu hamil dengan kuantitas ANC tidak sesuai standar, sosial budaya tidak baik, dan status ekonomi rendah berpeluang berturut-turut sebesar 6,6 kali, 11,4 kali, dan 3 kali untuk mengalami anemia.
Kesimpulan: Standar kuantitas ANC, sosial budaya, dan status ekonomi merupakan variabel yang dominan terhadap anemia pada kehamilan. Kunjungan rumah atau konseling melalui aplikasi perpesanan dapat dilakukan oleh petugas kesehatan bagi ibu yang tidak melakukan ANC.
Kata kunci: Anemia, antenatal care, kehamilan, sosial buday
Penentuan Aktivitas Antioksidan dan Antidiabetes Ekstrak Daun Matoa (Pometia pinnata J.R. Forst. & G. Forst.) secara In Vitro
Get PDFMatoa (Pometia pinnata J.R. Forst. & G. Forst.) Matoa (Pometia pinnata J.R. Forst. & G. Forst.) is one of the plants that is used as a traditional medicine for diabetes mellitus due to an imbalance between the amount of ROS and antioxidants in the body. Therefore, it was carried out in vitro to see the antioxidant and antidiabetic activity in matoa leaf extract. The extraction of matoa leaves was carried out using the ultrasonication method for 30 minutes with methanol, ethanol, and ethyl acetate as solvents. Antioxidant activity is release through DPPH free radical inhibition, through the antidiabetic potential released by inhibiting the work of the α-amylase enzyme. Phytochemical test results showed the presence of secondary metabolites in the form of flavonoids, polyphenols, tannins, alkaloids, and terpenoids. The results of the research on methanol, ethanol, and ethyl acetate extracts of matoa leaves showed high antioxidant activity with IC50 values of 6.416 ± 0.176 ppm, 8.622 ± 0.066 ppm, and 170.637 ± 4.441 ppm, respectively, but they were less potent than vitamin C as a comparison which is 1.646 ± 0.015 ppm. Inhibition of the α-amylase enzyme showed IC50 values of 91.037 ± 0.750 ppm, 105,166 ± 2,423 ppm, and 785,436 ± 11,740 ppm in each of the methanol, ethanol, and ethyl acetate extracts while the IC50 value of acarbose as a comparison was 23,479 ± 0.347 ppm. The statistical data analysis of Pearson correlation showed that it had a positive relationship between the antioxidant and antidiabetic activity of matoa leaf extract as seen from the R-value of 0.998. The higher antioxidant activity, so the higher potential for inhibition of α-amylase enzyme
Leptospira pada Tikus dan Badan Air serta Riwayat Penularan Penderita di Daerah Baru Kasus Leptospirosis di Bantul
Get PDFIn 2017 leptospirosis cases occur in new areas in Bantul where cases have never been previously reported. Cases still occur in 2018 with an interval of two months after the first case. Preventive and curative efforts in the context of controlling cases have been carried out by the local health office, in addition to these control efforts, it is also necessary to know the presence of Leptospira in rats and water bodies in the area as well as the history of patients transmission. This study was conducted to provide epidemiological data, especially the status of Leptospira in rats as reservoir animal and water bodies as well as a history of patient activity as basic data for leptospirosis control in Gilangharjo Village. This cross-sectional study was conducted at the case location in RT 03 Jodog, Gilangharjo Village, Pandak District, Bantul Regency, which was conducted in April 2018. Leptospira infection status was carried out on rats and water bodies by molecular examination, while the history of transmission based on interviews with patients and the result of the examination of Leptospira status. Rat species caught were dominated by R.tanezumi, R. norvegicus and B. indica. Positive rat infected with Leptospira were found in B. indica while in water bodies Leptospira contamination was not found. Infected rat can be a source of transmission for humans and other animals. Most of the patient's activities were carried out in the fields and at home, all of the patients had wounds that were not treated, and had a history of contact with rats that might transmit Leptospira to humans