Skrining dan Uji Diagnostik Abnormalitas Lemak pada Lansia di Kecamatan Pundong, Kabupaten Bantul

Background: Cardiovascular diseases occupied top ten disease in Bantul district. Dyslipidemia become a major risk factor. Screening for hypercholesterolemia in Indonesia were rarely carried out and usually took urban background. Validity test of the Body Fat Analyzer (BFA) for public health screening also have not been reported. Therefore, this study aims to determine the prevalence of lipid abnormalities and the validity of BFA as a screening tool. Method: Using crosssectional design, this study was located in Pundong that had rural characteristics. With convenience sampling method, subjects were 82 elderly in 4 hamlet. Lipid abnormalities were measured by BFA. Blood cholesterol became gold standard on the cut off point of 239 mg/dl. Diagnostic test is made using 2x2 table calculation and X2 test. Results: This study found the prevalence of overweight and obesity (19.5% and 2.4%), prevalence of abnormal body faat (75.6%); prevalence of abnormal abdominal fat (20.8%); and prevalence of hypercholesterolemia (15.9%). Best validity demonstrated by the examination of a single Body Mass Index (BMI) (sensitivity 61.54%, specificity 85.51% NDP 44.44%; nd 92.19%, p=0.001). Conclusion: This result most closely approximates the prevalence in rural China. Besides being more valid, a single BMI checks are also easier and cheaper than the BFA. Therefore, the use of normal scales can be maximized. BMI measurement and interpretation should be socialized

Stres psikososial dan kejadian kandidiasis vulvovaginalis pada wanita pekerja seks di Banyumas

Psychosocial stress and vulvovaginal Candidiasis among female sex workers in Banyumas PurposeThis study aimed to determine the relationship between psychosocial stress with candidiasis vulvovaginalis (KVV) incidence in female sex workers (FSW).MethodsThe research design was a case control study conducted in health center clinics in the Banyumas District. The sample size was 164 FSW (82 cases & 82 control). The research instrument was structured questionnaires, Social Readjustment Rating Scale (SRRS), laboratory equipment and microscopes for inspection KVV. Data analysis used logistic regression tests to calculate odds ratios (OR), confidence interval (CI), and p value.ResultsThe multivariate analysis showed that stress was not KVV risk factors, and the risk factors that contribute to the occurrence of KVV in FSW were oral sex (OR = 3.31, 95% CI = 1.60 to 6.83, p-value = 0.001) and smoking more than 10 cigarettes/day (OR = 2.33, 95% CI = 1.2 to 4.59, p-value = 0.014).ConclusionsThe risk factors of KVV were oral sex and smoking ≥ ten cigarettes/day. We recommend to avoid oral sex and smoking < ten cigarettes/day to avoid the risk of KVV infection.Latar belakang: Kandidiasis vulvovaginal (KVV) adalah infeksi mukosa yang disebabkan oleh spesies Candida dan merupakan salah satu masalah klinis yang paling umum pada wanita usia produktif. Wanita pekerja seks (WPS) merupakan kelompok berisiko tinggi untuk mengalami KVV. Prevalensi KVV di Indonesia pada WPS berkisar antara 12-33%. Kejadian KVV pada WPS di Kabupaten Banyumas tahun 2011 (33,3%5), 2012 (54,6%), 2013 (61%). Stres dapat melemahkan sistem imun, sehingga meningkatkan kerentanan terhadap penyakit termasuk KVV. WPS juga memiliki kerentanan terhadap stres. Penelitian ini bertujuan untuk mengetahui hubungan antara stres psikososial dengan kejadian KVV pada WPS.Metode: Penelitian analitik observasional dengan rancangan case control dilakukan di klinik IMS di Kabupaten Banyumas. Besar sampel sebanyak 164 WPS (82 kasus dan 82 kontrol). Instrumen penelitian adalah kuesioner terstruktur, kuesioner stress Social Readjustment Rating Scale (SRRS), timbangan berat badan, mikrotoise, serta peralatan laboratorium dan mikroskop untuk pemeriksaan KVV. Analisis data menggunakan logistic regression untuk menghitung nilai odds ratio (OR), confidence interval (CI), dan p-value. Hasil: Hasil analisis multivariabel menunjukkan bahwa stres tidak signifikan secara statistik. Analisis multivariabel menunjukkan bahwa faktor risiko yang berkontribusi dalam terjadinya KVV pada WPS adalah melakukan hubungan seksual dengan seks oral (OR = 3,31, 95% CI = 1,60-6,83, p-value = 0,001) dan merokok lebih dari 10 batang/hari (OR = 2,33, 95% CI = 1,2-4,59, p-value = 0,014).Kesimpulan: Faktor risiko KVV adalah hubungan seksual dengan seks oral dan merokok ≥ 10 batang/hari. Direkomendasikan untuk menghindari hubungan seksual dengan cara seks oral dan merokok dengan jumlah < 10 batang/hari untuk menghindari risiko infeksi KVV

Evaluation of the simplicity and completeness on two models (manual and web-based) reporting of the case-based measles surveillance system in Special Region of Yogyakarta (DIY)

Purpose: In order to eliminate measles in 2020, the Health Office of DIY has developed the surveillance system by implementing CBMS into two different models (Manual and Web-Based Reporting) that has the main purpose to increase the performance of CBMS in detecting new cases, reporting data about the spread of measles after conducting massive campaign of measles in 2017. This study aimed to evaluate the simplicity and completeness of the CBMS in both models.Method: Descriptive evaluative study was conducted in DIY from January 2019 to March 2019. A total of thirty-four (n=34) respondents of health offices in 5 districts, 20 public health care offices and 4 hospitals. Samples were defined by using purposive sampling based on the completeness of the report. Data about simplicity was collected by using structure questioners from 34 respondents. While in measuring completeness, due to lack of information in the health offices, we only observed secondary data in primary health care offices and hospitals. Data were analyzed by using stata 13.Results: For the attribute of simplicity, 64.31% of respondents mentioned that the manual reporting form was too complicated. Meanwhile, only 8.82% of respondents considered that web-based reporting was more complicated. For the attribute of completeness, we observed the reporting completeness of 9 variables on both models which completeness of 4 variables in manual reporting including the number of epidemiology (77%), the number of vaccination (73%),  date of specimen collection (89.1%), and final classification (36%) were lower than the target (90%). Compared to web-based reporting, there were only 2 variables including date of specimen collection (79%) and final classification (65) which were lower than the target (90%).Conclusion: The study revealed that CBMS web-based reporting is more simple and complete than CBMS manual reporting. It was clearly seen that completeness in the final classification has the lowest percentage in both models. The system must be simplified, so that lack of reporting completeness on both models can be overcome

Pengaruh short message service (SMS) terhadap pengetahuan dan intensi menyusui di Kabupaten Purbalingga Provinsi Jawa Tengah

Effect of short message service toward knowledge and breastfeeding intention in Purbalingga district, Central JavaPurposeThis study aimed to determine the effect of short message service on improving mother's knowledge and intention in breastfeeding.MethodsThis study used a quasi-experimental design with non equivalent control group and pretest and posttest conducted with 36 breastfeeding mothers who received a breastfeeding brochure with short message service in the intervention group and 32 breastfeeding mothers who received only the brochure in the control group. The breastfeeding mothers all had an infant less than 2 months old and had a handphone. Data were processed by stata 12.0 using paired t-test, unpaired t-test and linear regression tests.ResultsThe pretest-posttest scores showed increase of knowledge about breastfeeding after delivering information of breastfeeding through short message service (p 0.05).ConclusionShort message service was effective to improve knowledge of breastfeeding mothers, however it had no effect in improving breastfeeding intentions.Latar belakang : Untuk membuat ibu memberikan makanan yang terbaik pada bayi berusia 0-6 bulan, ibu membutuhkan informasi yang spesifik, disesuaikan dengan budaya masyarakat, mampu merespon hambatan dan kekhawatiran selama ibu menyusui. Dalam teori perubahan perilaku, intensi merupakan faktor penting dalam proses menampilkan perilaku. Short Message Service (SMS) diharapkan meningkatkan pengetahuan dan intensi dalam menyusui.Metode : Penelitian ini merupakan penelitian kuasi eksperimen nonequivalent control group with pretest and posttest. penelitian ini dilakukan terhadap 36 ibu menyusui yang diberikan brosur pemberian ASI disertai SMS informasi menyusui dan 32 ibu menyusui yang mendapatkan brosur pemberian ASI saja. Pemilihan sampel berdasarkan peluang dengan cara cluster sampling. data diolah dengan menggunakan program Stata 12.0 menggunakan uji paired t-test, unpaired t-test dan regresi linear.Hasil : skor pretest-postest menunjukkan adanya peningkatan pengetahuan tentang kegiatan menyusui setelah dilakukan intervensi SMS (p0,05).Kesimpulan : SMS informasi menyusui terbukti memiliki pengaruh terhadap peningkatkan nilai pengetahuan ibu tentang menyusui namun tidak memiliki pengaruh dalam meningkatkan intensi menyusui. 

Dukungan keluarga dan kualitas hidup pasien diabetes mellitus

Family support and quality of life of diabetes mellitus patients in Panjatan II public health center, Kulon ProgoPurposeThis study aimed to determine the relationship between family support in terms of four dimensions (emotional, appraisal, instrumental, and information) to the quality of life of patients with type 2 diabetes at the health center II Panjatan Kulon Progo regency.MethodsThis research was a cross-sectional analytical study with sample size of 150 patients with diabetes mellitus type 2. Data analysis used Pearson correlation coefficient, independent t-test and simple linear regression tests.ResultsThere were correlations between the presence of family support and complications with the quality of life of diabetes mellitus patients. There were correlations of emotional, awarding, and instrumental dimensions of family support to the quality of life of diabetes mellitus patients.ConclusionIncreased support of emotional dimensions, reward dimensions and instrumental dimensions will improve the quality of life of patients with diabetes mellitus.Latar belakang: Diabetes melitus merupakan salah satu  masalah kesehatan yang berdampak pada produktivitas dan dapat menurunkan mutu sumber daya manusia. Salah satu cara untuk meningkatkan mutu hidup penderita DM tipe II melalui dukungan keluarga. Dengan adanya dukungan dari keluarga dapat memotivasi penderita untuk hidup optimis sehingga dapat meningkatkan kualitas hidup. Penelitian ini bertujuan untuk mengetahui hubungan antara dukungan keluarga ditinjau dari empat dimensi (emosional, penghargaan, instrumental, dan informasi) dengan kualitas hidup pasien DM tipe 2 di Puskesmas Panjatan II Kabupaten Kulon Progo.Metode: Desain penelitian ini adalah analitik cross sectional dengan jumlah sampel 150 pasien DM tipe 2. Analisa data menggunakan koefisien korelasi pearson, uji t-independen, dan regresi linear sederhana.Hasil: Adanya hubungan dukungan keluarga (p value:0,00) dan komplikasi (p value: 0,02)  dengan kualitas hidup pasien DM II. Adanya hubungan dukungan keluarga ditinjau dari dimensi emosional (p value:0,00), dimensi penghargaan (p value:0,00), dimensi instrumental (p value:0,00) dengan kualitas hidup pasien DM II. Kesimpulan: adanya hubungan dukungan keluarga dengan kualitas hidup pasien DM II. 

Kehamilan usia remaja dan kejadian bayi berat lahir rendah di Gunungkidul

Teenage pregnancy and low birth weight infants in GunungkidulPurposeThis study aimed to determine any association between teenage pregnancy and low birth weight in Gunungkidul district.MethodThe study used a retrospective cohort design. Samples were 394 people consisting of 197 people in the case group and 197 people in the control group. Case group subjects were teenage pregnant women (<20 years), while control group subjects were adult pregnant women (≥20 years) and both groups delivered a live birth. Case group were taken from all health centers that had complete record and control group were taken using systematic random sampling.ResultsTeenage pregnancy increases the risk of low birth weight babies. Related external factors consist of chronic energy deficiency, anemia and antenatal care visits, while the level of education and hypertension were not related.ConclusionMothers suffering from less chronic energy and anemia increase the risk of giving birth to low birth weight babies, especially in teenage mothers.Tujuan: Penelitian ini bertujuan untuk mengetahui hubungan kehamilan usia remaja dengan kejadian bayi berat lahir rendah.Metode: Penelitian berbasis data kohort retrospektif puskesmas, 197 kelompok studi dari ibu hamil remaja dan 197 kelompok kontrol dari ibu hamil dewasa.Hasil: Kehamilan pada ibu usia remaja meningkatkan risiko bayi berat lahir rendah daripada ibu usia dewasa. Faktor luar yang berhubungan terdiri dari kekurangan energi kronik, anemia dan kunjungan antenatal care. Sementara tingkat pendidikan dan hipertensi tidak berhubungan.Kesimpulan: Ibu usia remaja harus intensif merawat kehamilan dengan mengukur lingkar lengan atas dan hemoglobin secara teratur untuk mencegah terjadinya kekurangan energi kronik dan anemia

Faktor risiko servisitis pada wanita pekerja seks di kegiatan layanan infeksi menular seksual mobile

TujuanPenelitian bertujuan mengidentifikasi faktor resiko sertivitis pada wanita pekerja seks (WPS) di Kabupaten Cilacap.MetodePenelitian ini menggunakan rancangan cross-sectional analitik. Responden adalah 147 WPS yang mengikuti kegiatan layanan IMS (infeksi menular seksual) mobile di Klinik IMS Times dan Klinik IMS Citra. Data faktor risiko dikumpulkan melalui wawancara dengan kuesioner terstruktur. Hasil diagnosa servisitis didapatkan dari hasil pewarnaan gram dan metilen biru dari usap serviks dengan ditemukannya salah satu dari tanda adanya duh tubuh mukupurulen, jumlah PMN ≥30, atau ditemukan diplokokus intrasel. Data dianalisis menggunakan Poisson regression with robust variance estimator.Hasil- Prevalensi servisitis pada WPS di Kabupaten Cilacap sebesar 70,75% (104/147). - Hasil analisis multivariat menunjukkan bahwa faktor risiko servisitis adalah usia (aPR=1,609, 95% CI=1,304–1,987), pendapatan (aPR=1,283, 95% CI=1,055–1,560), riwayat melahirkan (aPR=1,273, 95% CI=1,006–1,610), rata-rata jumlah tamu per minggu (aPR=1,292, 95% CI=1,039–1,606), dan penggunaan kondom (aPR=1,440, 95% CI=1,082–1,917).Implikasi praktisPenelitian ini menunjukkan perlu ada peningkatan kesadaran penggunaan kondom bagi WPS melalui kegiatan penyuluhan dan konseling di setiap kegiatan layanan IMS mobile oleh tim dari Klinik IMS. Sasaran potensial kegiatan penyuluhan dan konseling adalah WPS yang berusia muda (≤30 tahun).KeaslianPenelitian ini memberikan kontribusi pengetahuan bahwa usia, pendapatan, riwayat melahirkan, rata-rata jumlah tamu per minggu, dan penggunaan kondom adalah faktor risiko wanita pekerja seksual di Kabupaten Cilacap.Risk factors of cervicitis among female sex workers in sexual transmitted infection mobile servicePurposeThis study aimed to identify risk factors of cervicitis among female sex workers in the district of Cilacap. MethodsThis study used a cross-sectional design. Total of respondents were 147 female sex workers who participated in the mobile sexual transmitted infection services. Demographic characteristic and risk factor data were collected by interviews using a structured questionnaire. Diagnosis of cervicitis was obtained by laboratory test with cervix swab. Data were analyzed using Poisson regression test with robust variance estimators.ResultsPrevalence of cervicitis among female sex workers in the district of Cilacap were 70.75%. Multivariate analysis showed that the risk factors of cervicitis among female sex worker were: age ≤24 years old, income, childbirth history, number of clients per week, and inconsistent of condoms use.ConclusionsResults showed the need to increase awareness of condom use among female sex workers through health promotion and counseling in mobile sexual transmitted infection services by the teams of sexual transmitted infection clinics. Potential targets for outreach health promotions and counseling are younger female sex worker (≤30 years old). 

Food poisoning outbreak caused by diarrhoeal Bacillus Cereus: a retrospective study

Purpose: This study aimed to investigate the causative agents, source of food poisoning, and mode of food poisoning transmission in Tegalkenongo Village.Method: A retrospective cohort study was used in the epidemiological investigation for one week from 13 May 2019 – 20 May 2019. Results: Based on the investigation, Of the 303 villagers involved in the event, 188 villagers were ill with the median age of cases was 38 years old, the average incubation period was 8 hours, and the predominant symptoms were diarrhea (93.62%), nausea (84.57%), and abdominal cramps (64.89%). The contaminated chicken satay was determined as the source of contamination with an adjusted Risk Ratio (aRR) was 4.36; 95% CI 1.1538, 16.5285. Initial epidemiological features and cultures from food items served in the event and stool sample of one patient suggested that the causative agent was Bacillus Cereus which was supported by Klebsiella Pneumoniae. Conclusion: Based on the field investigation result related to symptoms and incubation period and laboratory identification, we conclude that the causative agent was diarrhoeal B. cereus

Determinan gangguan hipertensi kehamilan di Indonesia

Latar Belakang: Hipertensi dalam kehamilan (HDK) merupakan kelainan vaskular yang terjadi sebelum kehamilan atau timbul dalam kehamilan atau pada masa nifas. Lebih dari 30% kematian maternal di Indonesia disebabkan oleh HDK. HDK merupakan penyebab utama morbiditas dan mortalitas maternal, fetal dan neonatal. Gambaran etiologi HDK masih belum jelas, sehingga kelainan ini sering dikenal the diseases of theory. Upaya dini untuk mengidentifikasi hipertensi dalam kehamilan dapat dilakukan dengan mengetahui faktor risiko hipertensi baik yang dapat diubah (modifiable) yaitu perilaku sehat & yang tidak bisa diubah (nonmodifiable) seperti faktor risiko yang melekat pada ibu. Penelitian ini bertujuan untuk mengkaji faktor risiko gangguan hipertensi dalam kehamilan di Indonesia. Metode: Penelitian ini merupakan jenis penelitian observasional analitik dengan menggunakan rancangan cross-sectional. Pengambilan sampel dilakukan dengan teknik consecutive sampling dan berasal dari 447 kabupaten dan 33 propinsi di Indonesia. Subjek penelitian adalah seluruh ibu hamil yang menjadi sampel Riskesdas tahun 2013 yang berusia 15-54 tahun dengan jumlah 9.024 ibu hamil. Chi-square dan binomial regression digunakan untuk menghitung pengaruh faktor risiko HDK dengan melihat nilai rasio prevalensi (RP). Hasil: Prevalensi hipertensi ibu hamil sebesar 6,18% (558 orang) setelah disesuaikan dengan variabel luar yang berpotensi sebagai confounder. Jumlah hipertensi paling banyak di Propinsi Jawa Barat yaitu 59 ibu hamil (10,57%). Overweight dan hipertensi kronik berhubungan terhadap gangguan hipertensi dalam kehamilan dengan RP: 2,13 (95%CI 1,80-2,51) pada overweight dan RP: 4,36 (95%CI 3,61-5,26) pada hipertensi kronik. Penggunaan alat kontrasepsi bukan merupakan faktor risikoterhadap gangguan hipertensi di Indonesia RP 0,92 (95%CI 0,76-1,10). Kesimpulan: Overweight dan hipertensi kronik merupakan faktor risiko kejadian gangguan hipertensi dalam kehamilan di Indonesia. Ibu hamil diharapkan dapat menjaga berat badan ideal yang dianjurkan pada masa gestasi dan lebih mewaspadai risiko yang dapat meningkatkan kejadian hipertensi dalam kehamilan seperti riwayat hipertensi kronik.  Determinants of pregnancy hypertensive disorders in Indonesia PurposeThis study aimed to assess the determinant factors of gestational hypertension (HDP) in Indonesia.MethodsThis research was an observational analytic study using a cross-sectional design. Sampling was calculated using consecutive sampling technique. The subjects were all pregnant women aged 15-54 years old in 33 provinces in Indonesia and 9024 women were selected as subjects. Chi-square and binomial regression tests were used to analyze the determinants of HDP to see the value of the Ratio Prevalence (RP). ResultsThe prevalence of hypertension among pregnant women was 6.18% (558 people) after being adjusted with external variables which were potentially confounders. The highest of hypertension was found in West Java with 59 pregnant women (10.57%). Overweight and chronic hypertension were related to hypertensive disorders in pregnancy with RP: 2.13 (95% CI: 1.80-2.51); and in overweight with RP: 4.36 (95% CI: 3.6-5.26) in hypertension assessments. The use of contraceptives was not a risk factor for hypertensive disorders in Indonesia with RP 0.92 (95% CI: 0.76-1.10). ConclusionOverweight and chronic hypertension are risk factors for the incidence of hypertensive disorders in pregnancy in Indonesia

Status Partisipasi dan Kualitas Hidup Peserta Pos Pelayanan Terpadu Lanjut Usia

Background: Demographic and epidemiologic transition now occurred in the District of Bantul could be followed by decreasing quality of life in elderly. Community elderly care service (CECS) is a primary service for elderly with potential to support increasing quality of life in elderly. Based on previous study, utilization of CECS was high (73.30%) at subdistrict of Bambanglipuro, Bantul. To know the relationship between participation status and quality of life in CECS participants at subdistrict of Bambanglipuro. Method: A cross-sectional study was conducted from April to May 2012. Samples were selected with consecutive sampling technique. Data were collected from 8 CECSs at subdistrict of Bambanglipuro. Quality of life was measured with short form 36 (SF-36) Health Survey, including physical component summary (PCS) and mental component summary (MCS). Data then were analyzed with descriptive and analytic methods using Chi-square test and multiple logistic regression. Results: Of 238 subjects investigated, 186 (78.20%) were good in PCS and 194 (81.50%) were good in MCS. Multivariate analysis showed that active in physical exercise of CECS program, absence of hypertension, and better economic status were related to better PCS (aPR: 5.31, 95%CI: 2.52-11.20; aPR: 3.41, 95%CI: 1.31-5.47; aPR: 2.68; 95%CI: 1.31-5.47) and better MCS (aPR: 3.97, 95%CI: 1.83-8.64; aPR: 3.08, 95%CI: 1.39-6.82; aPR: 6.38; 95%CI: 2.62-15.53). Conclusion: Dominant factors that related to better quality of life in CECS participants were: active in physical exercise program of CECS, absence of hypertension and better economic status