Mortality and morbidity patterns in measles cases admitted to the hospitals in Yogyakarta

The case fatality rate of measles cases admitted to the hospitals in Indonesia in the period of 1973 -1989 varied from as high as 26.1% in Medan to 2.4% in Bali, with an average of 10.9% in all hospitals. In Indonesia, according to the National Household Health Survey 1985 , the province of Yogyakarta had the lowest of infant mortality and was ranked high for the coverage of measles immunization and also the medical facilities in this are is relatively easy to acces. The purpose of this study was to obtain the case fatality rates and the clinical characteristics of measles cases admitted to the hospitals in the province of Yogyakarta in the period of 1984 to 1990, leading to a comparison with data from other hospitals in Indonesia. This study comprised, a retrospective study during the period of 1984 - 1987 involving 5 hospitals in Yogyakarta municipality, and a prospective study during the period of 1988 - 1990 carried out in 9 hospitals in the province of Yogyakarta. The results showed that the percentage of under-five children suffering from measles admitted to the hospitals in the period 1984 - 1987 was higher compared to under-five children hospitalized in the period of 1988 - 1990 (60% versus 36%). Therefore, it can be concluded that there was a shift in the distribution of measles cases to older children. This was probably due to the coverage of measles immunization in Yogyakarta which was higher as compared with other places. Since younger children were already protected by immunization, a relatively more older cases were found in Yogyakarta. The case fatality rate of 0.4% (2 out of 472 cases) during the period of 1984 -1987 and 0.8% (3 out of 386 cases) during the period of 1988-1990 in Yogyakarta were much lower as compared with the data reported from other hospitals in Indonesia. Several factors such as the general health condition of the province of Yogyakarta, as well as the frequency and types of complications of the diseases and the nutritional status of the measles patients may explain the different mortality of measles patients in Yogyakarta compared that in other places in Indonesia. Key words : measles - morbidity - mortality - case fatality rate - immunization Angka kematian penderita campak yang dirawat di beberapa rumah sakit di Indonesia (selain di Yogyakarta) dalam kurun waktu tahun 1973 -1989 menunjukkan variasi yang besar mulai setinggi 26,6% di Medan sampai 2,4% di Bali, dengan rata-rata sebesar 10,9% di semua rumah sakit yang melaporkan. Di Indonesia, menurut Survei Kesehatan Rumah Tangga tahun 1985, propinsi Yogyakarta mempunyai angka kematian bayi yang terendah dan cakupan imunisasi campak yang tinggi dan di samping itu di daerah ini untuk mendapatkan pelayanan kesehatan relatif mudah. Penelitian ini bertujuan untuk mengetahui angka kematian dan gambaran klinis penderita campak yang dirawat di rumah sakit-rumah sakit di propinsi Daerah Istimewa Yogyakarta mulai tahun 1984 sampai dengan tahun 1990, sehingga dapat dibandingkan dengan keadaaan penderita campak yang dirawat di rumah sakit lain di Indonesia. Penelitian ini dilakukan di rumah sakit-rumah sakit di seluruh wilayah propinsi Daerah Istimewa Yogyakarta secara retrospektif untuk penderita yang dirawat pada periode tahun 1984-1987 dan secara prospektif untuk penderita yang dirawat pada periode tahun 1988-1990. Hasil penelitian ini menunjukkan bahwa dibandingkan dengan penderita yang dirawat pada periode tahun 19881990, persentase anak Balita penderita yang dirawat pada tahun sebelumnya (1984-1987) adalah lebih tinggi sehingga dapat disimpulkan bahwa ada pergeseran distribusi umur penderita campak ke arah yang lebih tua. Hal ini kemungkinan disebabkan karena cakupan imunisasi campak di Yogyakarta lebih tinggi dibandingkan dengan cakupan di daerah lain sehingga anak yang lebih muda sudah terlindung dari penyakit campak akibat imunisasi. Angka kematian penderita campak yang dirawat di rumah sakit untuk periode tahun 1984-198

Hubungan Status Pekerjaan Ibu dengan Berat Lahir Bayi di RSUP Dr. M. Djamil Padang

Background: According to 2002-2003 Indonesia Demography Health Survey (IDHS), the percentage distribution of women based on job status in the past 12 months in West Sumatera showed that 57,5% of woman was working, 2,4% of woman was not working and 40,1% of the women did not work at all. From the data, it is shown that the percentage of woman who working was bigger than woman who was not working. Based on various researches, a job that will be done by a woman especially while pregnant, had influence toward the weight of the infant who will be delivered.Objective: This research was aimed to find out the relationship of job status and job type of mother with infant's birth weight in RSUP Dr. M. Djamil Padang.Method: This was an observational research that used Prospective Cohort design. The data was collected in antenatal polyclinic of RSUP Dr.M. Djamil Padang. The population was all pregnant women who came to check their pregnancies to antenatal polyclinic and they were clustered based on job status and job type. Every pregnant woman was observed and their pregnancy development that was started in the week 32 of pregnancy until delivery was continually monitored. The sample was taken with non probability sampling and consecutive sampling. The independent variables were job status and job type and the dependent variable was infant's birth weight. The confounding variable were education, social economy status, women's age, parity, gestation age, women's height, weight gain, nutrition intake, children sex and mother's disease during pregnancy.Result: The dif ference of birth weight in a mother works with heavy physical activity was 196.44 gram (p=0.000) which was lower than mother who did not work with heavy physical activity, and the difference of infant's birth weight in the group of mother who were ill during pregnancy with those who were not ill in their pregnancy period was 243.92 gram (p=0.001). Male infant who was born had difference on the average of birth weight that was 97.24 gram (p=0.015) which was heavier than female infant. The increasing gestation age every one week will increase infant's birth weight 45.34 gram (p=0.021) and increasing of mother's weight will increase infant's birth weight with 47.12 gram (p=0.000). The increasing nutrition intake every one kilocalories will increase infant's birth weight 0.56 gram (p=0.000). R2 was 0.2729 which mean that model 2 as the result of double linear regression analysis could explain the relationship and predicted infant's birth weight with 27.29%.Conclusion: There was a relationship between mother's job status (working or not working) and mother's job type (heavy physical activity and low physical activity) with infant's birth weight, in which infant's birth weight in working mother with heavy physical activity was lower than infant with mothers who did not work with heavy physical activity

Perceived Parental Monitoring on Adolescence Premarital Sexual Behavior in Pontianak City, Indonesia

Inadaquate parental monitoring is widely recognized as a risk factor for the development of child and adolescent conduct problems, including early premarital sexual behavior. Previous studies examining parental monitoring have largely effect to adolescents premarital sexual behavior. Parental monitoring is the most important and effective factor to prevent early adolescents sexual activity. This paper examines the role of perceived parental monitoring in adolescent\u27s premarital sexual behavior (study on Adolescent\u27s Junior High School in Pontianak). A cross-sectional study and proportionated random sampling was conducted among 402 adolescents of junior high school at six subdistricts in Pontianak. SEM analyses was conducted using SMART-PLS. Result of path analysis revealed that parental knowledge (r = 0.389) and parental-adolescence relationship (r = 0.334) had a strong influence on parental monitoring. Then, parental monitoring had a significant indirect relationship with adolescent premarital sexual behavior through attitudes about premarital sexual (path coefficient = 0.063), and attitudes about premarital sexual and intention to sexual behaviour (path coefficient = 0.03). Parental monitoring can act as protective factor in early adolescent premarital sexual behavior. Therefore, risk reduction interventions with adolescents should include their parents to learn about monitoring skill and develop skill that will allow them to buffer negative influences

Hubungan Pengetahuan, Sikap dan Perilaku Ibu dalam Pemberian Imunisasi Hepatitis B 0-7 Hari di Kota Banjarmasin

Background: Indonesia belongs to medium and high endemic country of hepatitis B (HB) with the prevalence as much as 8% - 20% of the population. The risk for the prevalence of chronic HB is much more higher among infants infected during birth 90%, among children of 1 – 5 years 30% - 60%, and among adults 2%-6%. If infants of 0-7 days old are given the first dosage of HB immunization, the prevalence of being HB chronic patients is 23% and if the first dosage is given when infants are one months old, the prevalence of being HB chronic patients is 40%. The coverage of HB immunization for infants of 0-7 days old at Banjarmasin Municipality in 2006 was only 41%.Objective: The study aimed to identify the relationship between knowledge, attitude, and behavior of mothers in giving HB immunization to infants of 0-7 days old at Banjarmasin Municipality.Method: The study was observational and used cross sectional design. Subject of the study were 170 mothers having infants of 0-12 months chosen using consecutive sampling technique at 5 health centers with different coverage of HB immunization of infant of 0-7 days old. Data analysis used chi square and logistic regression. Strength of relationship was calculated using prevalence ratio with CI 95%.Result: The result of bivariable analysis showed that there was relationship between behavior of mothers in giving 0-7 day HB in immunization and knowledge RP=1.61 (CI 95%=1.35-191), attitude RP=1.49 (CI95%= 1.22-1.62), education RP=1.56 (CI95%=1.24-1.96), occupation RP=1.44 (CI95%=1.01-2.05) and birth assistants RP=1.48 (CI95%=1.21-1.82). The result of multivariable analysis using logistic regression showed that only 2 variables, i.e. knowledge and education statistically had significant relationship with behavior of mothers in giving 0-7 day HB immunization.Conclusion: There was relationship between knowledge and education and behavior of mothers in giving 0-7 day HB immunization

Agreement between pediatrician and trained paramedic in the assessment of gestational age among newborns using New Ballard Scored

Accurate gestational age assessment is important in newborn examination to determine further management. Oneof methods to estimate newborn gestation is New Ballard Score (NBS). With limited number of pediatrician especiallyin remote areas, it is expected trained paramedic will be able to perform NBS examination properly. The aim of thisstudy was to assess whether there is agreement between pediatricians and trained paramedics in determiningnewborn gestational age using NBS. This was a cross sectional study. Ballard scoring was performed by pediatriciansand trained paramedics in Dentatama Mother and Child Hospital, Sragen Distric, Central Java, Indonesia fromFebruary-May 2008. Statistical analysis was performed using intraclass correlation. This study was performed in175 newborns those consisted of 55.4% males and 44.6% females. From those newborns, 30.3% were deliveredby caesarian section, and 10.3% were premature baby. Majority of Ballard score examination (69.7%) was performedin 2nd day. According to intraclass correlation, there was a very strong correlation agreement between pediatriciansand trained paramedics (r=0.925 and p<0.05). The result of Ballard score examination that close to gold standardthose which were performed at 48-96 hours of age (r=0.993 and p<0.05). In conclusion, there was a goodagreement between pediatricians and trained paramedics in assessing newborn gestational age using NBS.Key words: Ballard score - trained paramedic - newborn – pedriatician - hospita

Desain Kapal Penumpang Katamaran untuk Rute Dermaga Boom Marina, Banyuwangi – Pelabuhan Benoa

Akhir tahun 2015, PT. Pelindo III (Persero) membangun Dermaga Boom Marina di Banyuwangi dan membuka rute pelayaran kapal Boom Marina Banyuwangi – Pelabuhan Benoa Bali. Tujuan dari Penelitian ini adalah untuk mendesain sebuah kapal katamaran yang digunakan sebagai sarana penyeberangan dari Dermaga Boom Marina, Banyuwangi menuju Pelabuhan Benoa, Bali. Katamaran memiliki beberapa kelebihan jika dibandingkan dengan kapal monohull. Luas geladak dari katamaran lebih luas dibandingkan kapal monohull. Stabilitas kapal katamaran lebih baik dibandingkan kapal monohull. Sudut oleng pada kapal katamaran relative rendah sehingga meningkatkan rasa nyaman dan tidak mudah terkena mabuk laut. Dalam prosesnya desain kapal ini menggunakan parent design approach dengan mengacu pada suatu desain kapal pembanding yang sudah berlayar dengan baik. Proses desain ini mengacu pada kapal “Austal 48” sebagai kapal pembanding. Desain kapal ini juga turut diperhitungkan secara teknis maupun ekonomis. Ukuran utama kapal yang didapat adalah Lwl = 44 m, B = 11.8 m, T = 1.4 m, H = 3.8 m, B1 = 3 m, CB = 0.491, dan Vs = 28 knots. Dari ukuran utama tersebut kemudian dibuat gambar rencana garis dan gambar rencana umum dan safety plan. Biaya pembangunan kapal sebesar Rp 24.422.508.434,58

Perancangan Self Propelled Container Barge (SPCB) Sebagai Alternatif Angkutan Container Pelayaran Pantura Untuk Daerah Jawa Timur

Pengangkutan kontainer melalui media transportasi darat pada jalur utara pada dewasa ini sudah sangat padat. Dengan kondisi insfrastruktur transportasi darat yang ada, beban yang diberikan oleh moda transportasi kontainer melebihi kekuatan yang dimiliki oleh insfrastuktur. Hal ini menyebabkan kerusakan dari insfrastruktur transportasi darat tersebut. Dampak yang paling terlihat dari kerusakan insfrastruktur transportasi darat ini adalah terjadi banyak kemacetan yang merugikan semua pengguna dari transportasi darat, termasuk pengangkutan kontainer. Pemindahan moda transportasi container darat ke laut adalah salah satu alternatif yang sangat baik mengingat jalur laut sepanjang pantura masih sepi. Jalur laut sangat minim akan terjadi kerusakan sehingga kemungkinan terjadi kemacetan kecil. Dalam tugas akhir ini dilakukan perancangan moda transportasi container lewat laut yang efektif yaitu Self Container Barge atau disingkat SPCB untuk beberapa daerah tujuan yang sudah ditentukan berdasar permintaan transportasi container ini

Prognostic factors for normal postnatal growth rate in low birth weight infants

Postnatal growth restriction in low birth weight infants is associated with long term adverseneuro-developmental sequel. Meanwhile, infants with excessive weight gain in early weeks oflife have a greater likelihood of later obesity, cardiovascular disease, and diabetes. Identifyingfactors associated with acceptable growth rate in low birth weight infants is important toprevent this potential long term morbidity. The aim of this study was to identify factors associatedwith acceptable growth rate in low birth weight infants. Prospective cohort study was conductedamong 73 low birth weight infants. Growth rate of these infants was determined by serialweight measurement during perinatal care and after being discharged until 46 – 50 weeks postmenstrual age. Growth rate was considered normal if average daily weight gain is 10 – 20 g/kg/day. Factors associated with this acceptable growth rate were analyzed by univariate andmultivariate statistical analysis. Normal growth rate was found in 62.7% subjects (42/67).Significant rate difference of average daily growth was found between small for gestational age(SGA) infants and appropriate for gestational age (AGA) infants (mean difference -2.90 g/kg/day; 95%CI: -5.68 - -0.12). The SGA infants had a greater risk for gaining weight below acceptablegrowth rate (adjusted RR= 2.9; 95%CI: 1.1 – 8.5). In conclusion, SGA is the only factor whichcan be associated with normal growth rate in low birth weight infants. Moreover, SGA infantsare in a greater risk for having slower growth rate compared to AGA.Keywords: growth rate - post natal - low birth weight – prognostic - gestational rat