Determinan Penyakit Stroke

Penyakit stroke merupakan penyebab kematian dan kecacatan kronik yang paling tinggi pada kelompok umur diatas usia 45 tahun terbanyak di Indonesia. Tujuan penelitian ini untuk mengidentifikasi determinan utama yang berhubungan dengan penyakit stroke pada masyarakat di kelurahan Kebon Kalapa Bogor. Analisis lanjut terhadap 1.912 responden subset baseline data penelitian “Studi Kohort Faktor Risiko Penyakit Tidak Menular” Data dikumpulkan dengan metode wawancara pada penduduk tetap di kelurahan Kebon Kalapa, Kecamatan Bogor Tengah, Bogor tahun 2012. Diagnosis stroke berdasarkan anamnesis dan pemeriksaan dokter spesialis syaraf. Variabel independen meliputi karakteristik sosiodemografi, status kesehatan dan perilaku berisiko. Data dianalisis dengan uji regresi logistik ganda. Penyakit stroke ditemukan pada 49 (2,6%) orang. Determinan utama stroke meliputi hipertensi (OR = 4,20; IK 95% = 2,20 – 8,03), penyakit jantung koroner (OR = 2,74; IK 95% = 1,51 – 4,99), diabetes melitus (OR = 2,89; IK 95% = 1,47 – 5,64), dan status ekonomi miskin (OR = 1,83 ; IK 95% = 1,03 – 3,33). Pencegahan penyakit stroke dilakukan dengan peningkatan edukasi (kampanye/penyuluhan) melalui pengendalian faktor risiko utama yaitu hipertensi dan pencegahan terjadinya penyakit degeneratif lain yaitu penyakit jantung koroner dan diabetes melitus.Stroke disease is the leading cause of death and chronic disabi lity in most over the age of 45 years in Indonesia. The aim of study was to identify the major determinants of stroke disease in Kebon Kalapa community in Bogor. A deep analyze was conducted in 1.912 respondents based on the subset of baseline data “Risk Factors Cohort Study of Non Communicable Diseases.” Data was collected by interviews on Kebon Kalapa community, Bogor in 2012. Stroke diagnosis was determined by anamnesis and neu-rological examination with specialist. Independent variables were sociodemographic characteristics, health status and risk behavior. Data analysis was performed by multiple logistic regression test. This study revealed that stroke disease was found in 49 people (2.6%). The main determinant of stroke included hypertension (OR = 4.20; 95% CI = 2.20 – 8.03), coronary heart disease (OR = 2.74; 95% CI = 1.51 – 4.99), diabetes mellitus (OR = 2.89; 95% CI = 1.47 – 5.64), and low economic status (OR = 1.83; 95% CI = 1.03 – 3.33). Prevention of stroke should be done by increasing education (campaign) through the control of major risk factors of hypertension and prevention of other degenerative diseases are coronary heart disease and diabetes mellitus

Perbedaan Laju Kecepatan Terjadinya Hipertensi Menurut Konsumsi Natrium [Studi Kohort Prospektif Di Kota Bogor, Jawa Barat, Indonesia] (the Incidence Rate Difference of Hypertension According to Sodium Consumption [a Prospective Cohort Study in Bogor Cit

Hypertension is one of the leading causes of death in the world.The amount of dietary of salt or sodium consumed is important determinant of hypertension. The purpose of analysis is to identify the differences between incidence rate of hypertension according to sodium cosumption.The study is part of a prospective cohort study of Non Communicable Diseases conducted since 2011, in Bogor City West Java, Indonesia. Data were collected by interview and blood pressure measurement. Event of hypertension was defined when in the 1-year of follow-up, participant had a high blood pressure in at least 2 of the 3 measurements. The consumption of sodium was collected through 24-hour dietary recall. The analysis conducted in 2561 participants were do not have hypertension, consist of 94 people with high sodium consumption and 2467 people with low sodium consumption . Data were analyzed by Life Table Survival to calculate the incidence rate of hypertension, with statistical test Wilcoxon (Gehan) to determine incidence rate difference of hypertension according to risk factors. The incidence rate of hypertension in 4-years observations was 58 per 1000 person-year. Adjusted by age and gender, fat and sugar consumption, fruit and vegetable consumption, physical inactivity, and smoking(AHR 71 vs 22 per 1000 person-years), shown that the incidence rate of hypertension in people who consume high sodium, significantly faster than people who consume low-sodium. The incidence rate difference of hypertension between the high and low sodium consumption was 49 per 1,000 person-years

Prevalensi Tumor dan Beberapa Faktor yang Mempengaruhinya di Indonesia

Penyakit kanker merupakan penyebab kematian utama kedua yang memberikan kontribusi 13 % kematian dari 22 % kematian akibat penyakit tidak menular utama di dunia. (I) Masalah penyakit kanker di Indonesia antara lain hampir 70% penderita penyakit ini ditemukan dalam keadaan stadium yang sudah lanjut. (2) Kenyataan yang ada antara lain sebagian besar kanker payudara yang berobat ke RS/dokter sudah dalam keadaan stadium lanjut (>50%). (3) Berdasarkan laporan dari salah satu rumah sakit di Indonesia (tahun 1968) diketahui bahwa kanker payudara hanya 22% sudah stadium operabel (Portman stadium I-II) dan 78% kanker payudara stadium inoperabel (Portman III-IV). (4) Sementara Tjindarbumi (1984) mencatat bahwa stadium operabel 30-35%; dan inoperabel (lanjut) 65-70% dan selanjutnya Ramli (1991) me lap orkan bahwa stadium operabel sudah 42% dan inoperabel 58%. Demikian pula hasil Collaborative Study Indonesia Jepang tentang epidemiologi kanker payudara sebagai berikut: stadium I 2%, stadium II 16%, stadium IlIa 23%, stadium IIIb 40% dan stadium IV 19%. (5, 6) Dampak Penyakit Tidak Menular khususnya penyakit kanker terhadap ke-tahanan sumber daya manusia sangat besar karena selain merupakan penyebab kematian dan kesakitan juga menurunkan produktivitas. Angka kesakitan dan kematian tersebut sebagian besar terjadi pada penduduk dengan sosial ekonomi menengah ke bawah. Di Indonesia penyakit kanker merupakan urutan ke 6 dari pola penyakit nasional. Setiap tahunnya 100 kasus baru terjadi diantara 100.000 penduduk. (7) Meningkatnya pengguna rokok (57 juta orang), konsumsi alkohol, kegemukan atau 0 besitas dan kurangnya aktifitas fisik/olahraga juga berperan dalam peningkatan angka kejadian kanker di Indonesia. (8) Kanker merupakan penyakit dengan penyebab multifactor yang terbentuk dalam jangka waktu yang lama dan mengalami kemajuan melalui stadium yang berbeda-beda. (9) Faktor nutrisi merupakan salah satu aspek yang sangat penting, yang kompleks dan sangat dikaitkan dengan proses patologis kanker. Secara umum total asupan berbagai lemak (yaitu tipe yang berbeda-beda dari makanan yang berlemak) bisa dihubung-kan dengan peningkatan insiden beberapa kanker utama misalnya kanker payudara, colon, pro stat, ovarium, endometrium dan pancreas. (10, 11) Disamping itu obesitas juga meningkatkan risiko untuk kanker dan aktivitas fisik merupakan determinan utama dari pengeluaran energi akan mengurangi risiko. (12) Faktor gaya hidup antara lain merokok, diet, konsumsi alcohol, reproduksi (hamil, menyusui, umur pertama menstruasi, menopause), obesitas dan kurangnya aktivitas fisik diduga sebagai kontributor utama per-tumbuhan kanker. Dari kajian literatur terlihat beberapa faktor risiko penyakit kanker antara lain; merokok dan faktor gaya hidup (khususnya konsumsi sayur dan buah serta aktivitas fisik ) merupakan faktor risiko kanker. (14) Hal ini diperjelas dengan per-nyataan Ray (2005) yang mengatakan bahwa asupan buah dan sayur yang tinggi akan menurunkan risiko kanker. (15). Alkohol adalah faktor risiko untuk tumor dan saluran pencemaan atas, kanker hati dan kanker co lonrectal, jumlah sedikit (small amount) akan meningkatkan risiko kanker payudara. (16) Disamping itu total asupan lemak berkaitan dengan peningkatan penyakit kanker seperti payudara, colon dan prostat. (17) Sementara itu peneliti lain menyebutkan bahwa peningkatan prevalensi dyslipidemia/hypercho lesterol akan meningkatkan kasus kanker payudara. (18) Pemyataan ini didukung oleh ahli lain bahwa asupan lemak jenuh dan juga alkohol akan meningkatkan kejadian penyakit kanker. Kajian demografi menyatakan bahwa insiden kanker payudara terjadi pada umur kurang 20 tahun, pada kelompok ras Kaukasus peningkatan kasus terjadi pada kelompok umur 50-59 tahun. (21) Peningkatan kasus kanker korelasi dengan Perubahan demografi, so sial ekonomi, psychososial yang akan meningkatan morbiditas dan mortalitas kanker. (22) Sedangkan insidens kanker meningkat di negara berkembang dan akan meningkat di daerah perkotaan dibandingkan daerah pedesaan. In Indonesia cancer problems was found in late stadium (70%). It has analyzed data from Riskesdas 2007-2008 to get information of prevalence by province in Indonesia, to explore odds ratio of demographic pattern and risk factors of cancer disease. Data was analyzed by descriptive and bi variate. This study showed that the highest prevalence of tumor by province was Daerah Istimewa Yogyakarta (9.66%0) and the lowest was Maluku (1.95%0). Ovarium and cervical cancer were the highest risk and blood cancer was lowest risk. Cases of cancer gave twice risk for mental health. Analyzed data of demographic proved that age influenced to cancer. Meanwhile women had twice risk in cancer than man. Beside rural area gave high risk than urban area, odds ratio in economic statue and also education rose from lowest to highest. Result of occupation analyzed exhibited that the highest odds ratio in sector of farming, fisherman and labor. Risk factors analyzed showed that Odds ratio arose up from smoking everyday category, sometimes smoking, and smoking former. According to alcohol consumption for last one year or last month was no significant. Correlation between physical activity and cancer cases had protective result. Measurement in body mass index (BM!) with WHO criteria showed that someone who had obesity especially in abdominal obesity would cause highest risk cancer than they were slim. BMI also showed had correlation to cancer disease

Prevalensi Tumor dan Beberapa Faktor yang Mempengaruhinya di Indonesia

In Indonesia cancer problems was found in late stadium (70%). It has analyzed data from Riskesdas 2007-2008 to get information of prevalence by province in Indonesia, to explore odds ratio of demographic pattern and risk factors of cancer disease. Data was analyzed by descriptive and bi variate. This study showed that the highest prevalence of tumor by province was Daerah Istimewa Yogyakarta (9.66%0) and the lowest was Maluku (1.95%0). Ovarium and cervical cancer were the highest risk and blood cancer was lowest risk. Cases of cancer gave twice risk for mental health. Analyzed data of demographic proved that age influenced to cancer. Meanwhile women had twice risk in cancer than man. Beside rural area gave high risk than urban area, odds ratio in economic statue and also education rose from lowest to highest. Result of occupation analyzed exhibited that the highest odds ratio in sector of farming, fisherman and labor. Risk factors analyzed showed that Odds ratio arose up from smoking everyday category, sometimes smoking, and smoking former. According to alcohol consumption for last one year or last month was no significant. Correlation between physical activity and cancer cases had protective result. Measurement in body mass index (BM!) with WHO criteria showed that someone who had obesity especially in abdominal obesity would cause highest risk cancer than they were slim. BMI also showed had correlation to cancer disease

Hubungan Antara Keterpajanan Asap Rokok Dan Riwayat Penyakit Paru Obstruktif Kronik (Ppok) Di Indonesia

Smoking is a public health problem. The health impact is related to degenerative diseases caused by smoking such as Chronic Obstructive Pulmonary Disease (COPD). WHO states that COPD is the third leading cause of death in the world. The study aims to determine the relationship between cigarette smoke exposures (active and passive) and COPD. The study design was cross-sectional. Sample was 17,246 subjects of the 2013 Basic Health Research aged> 30 years. The variables analyzed were COPD, gender, age, current smoking habit, smokers, passive smokers and former smokers. Logisticregression analysis with a complex sample to see the difference and the strength of the relationship of smoking habits and cigarette smoke exposures with a history of diagnosed COPD. The results showed a higher risk of developing COPD are in the group of smokers every day (including ex-smokers every day) with an OR of 3.73. Tobacco smoke exposures in the population who do not smoke (including passive smokers) have a significant relationship with the incidence of COPD, with OR of 1.69

Trigliserida Sebagai Faktor Prognosis Untuk Hipertensi Tidak Terkendali Pada Wanita Pasca Menopause Di Kota Bogor, Tahun 2014

Further analysis aimed to determine the new cut-off correlation between blood triglyceride levels withuncontrolled hypertension among 888 postmenopausal women from two-year follow up of the cohort studyin Bogor. Uncontrolled hypertension was defined as the average of systolic and diastolic are >140mmHgand >90mmHg consecutively with no underlying diseases and systolic is >130mmHg with co-morbidityat the end of 2-year follow up. The covariate variables included demography, behavior and biologicalfactors. The new triglyceride\u27s cut off was determined by ROC curve with 65% sensitivity and 68%specificity. Data were analyzed with multiple logistic regression. Blood triglyceride level significantlycorrelated with uncontrolled hypertension (p=0.007) after adjusted with LDL, postprandial blood sugarand sodium intake. Triglyceride levels of 108-149mg/dl resulted in OR of 1.54 (95% CI 0.95 to 2.48),150-199mg/dl showed OR of 2.04 (95% CI 1.06 to 3.93) and level of >200 indicated an OR 2.1 (95% CI1.02 to 4.30) compared to normal level (<108mg/dl). Triglyceride level of 108mg/dl is a new cut-off todetermine uncontrolled hypertension in postmenopausal women in the study area. Blood triglyceride\u27slevel can be used as a prognostic factor for hypertensive patients to monitor blood pressure increment

Pengambilan Keputusan Dalam Pertolongan Persalinan Di Provinsi Nusa Tenggara Timur

The direct causes of maternal mortality mostly are bleeding, gravidarum tocsemia and infection, while the indirect causes are delays that are losing time in recognizing the dangerous sign of pregnancy, unclear decision making to refer pregnant women to health care facilities and losing time to reach adequate health care facilities. This study was conducted in Kupang and Belu Districts, East Nusa Tenggara Province to elicit information regarding the decision making patterns of families on maternal health care by health professionals. The study were located in eight villages and the sample size was 240 households consists mothers who had infants. Quantitative data was collected through interview using questionnaires, while qualitative data was collected through focus group discussion among groups of mothers, husbands, and their parents. The result showed that the level of accessibility among mothers to get maternal health careby health professionals was low in regard of delivery attendent 49,9% of respondents was essisted by nonhealth professional, wherecs 70% of respondents delivered at home. The decision makers of health seeking behaviour in families were wives (36,7%) followed by husbands (30,7%) and parents or parents in law (16,9%). The pattern of decision making in the families were influenced by area, the age of mariage, and the bride\u27s winner of the family

Perilaku Pencarian Pelayanan Kesehatan Masyarakat Kampung Naga, Kabupaten Tasikmalaya

Pencarian pelayanan kesehatan dipengaruhi oleh latar belakang sosial budaya masyarakat. Untuk itu telah dilakukan suatu studi kualitatif di Kampung Naga, sebuah kampung yang terletak di pinggiran Kabupaten Tasikmalaya Jawa Barat, yang secara turun-temurun mempertahankan adat Sunda. Pengumpulan data dilakukan dengan cara wawancara mendalam dengan informan dan observasi.Pada masyarakat Kampung Naga dikenal 2 penyebab terjadinya sakit, yaitu kabadi dan sasalad. Konsep sakit ini mewarnai perilaku masyarakat dalam mencari pelayanan kesehatan. Dalam hal pengobatan terutama untuk pertolongan pertama mereka pergi ke tukang nyampe, yaitu dukun pengobat tradisional setempat. Walaupun demikian pengobatan modern bukan merupakan hal yang tabu, bahkan telah banyak digunakan masyarakat tersebut

Latar Belakang Kejadian Kematian Ibu Di Nusa Tenggara Timur

Nowadays, maternal mortality rate (MMR) in Indonesia is still high. In the period 1992-1997 the MMR was 390 per 100.000 live births. This rate was about 3-6 folds higher than that in South East Asian countries. The primary causes of the MMR were bleeding, gravidarum tocsemia and infection, which infact, could be promptly detected by adequate health-care facilities. The purpose of the study was to explore the background of the high MMR in East Nusa Tenggara province (Kupang and Belu districts). Data were collected through in-depth interview towards the closest persons of the cases including husbands, parents, sisters. brothers. neighbors, traditional birth attendants and midwives. The study revealed that there were difference perceptions about the causes of maternal mortality between health professionals and the community. According to the health professionals the causes of the maternal mortality were bleeding, infection and eclampsia due to delayed health-seeking behavior. Conversely, the community believed that the maternal mortality were due to suspicious matters and faith of God. The study concluded that the background of the perception\u27s differences was social and cultural aspects within the community and the ignorance of the pregnant women and her families about the high risk symptoms of pregnancies