FAKTOR-FAKTOR YANG BERHUBUNGAN DALAM PEMBERIAN ASI EKSKLUSIF PADA BAYI

Asi eksklusif sangat penting untuk proses pertumbuhan dan perkembangan bayi, karena Asi mengandung banyak nutrisi yang baik untuk bayi. Asi eksklusif adalah program yang direkomendasikan sendiri oleh World Health Ognisation (WHOAsi eksklusif  juga merupakan pemberian air susu ibu saja, dan tidak di tambah dengan cairan lainnya seperti susu formula, air putih, madu, air teh, maupun makanan lainnya. Penelitian ini merupakan penelitian kuantitatif  analitik mempergunakan pendekatan Cross Sectional (Studi Potong Lintang). Penelitian ini dilaksanakan di poli rumah sakit siloam manado.Responden dalam penelitian ini sebanyak 96 responden. Menggunakan alat pengumpulan data berupa kuesioner dengan uji Chi Square. Hasil penelitian ini menunjukkan bahwa responden  yang bekerja 71.9%, yang memiliki penyakit covid 19 53.1%, persepsi positif dalam menyusui 59.4%, Dukungan suami yang positif (yang baik) 57.3% serta dukungan keluarga yang lainnya 58.3 % memiliki dukungan yang negatif). Hasil Analisa  bivariat faktor-faktor yang berhubungan dengan asi eksklusif adalah persepsi menyusui  (p=0,036), dukungan suami (p=0,00), dukungan keluarga yang lainnya (p=0,00), sedangkan faktor pekerjaan (p=0,218), Riwayat Covid19  (p=0.267)  tidak berhubungan dengan Asi eksklusif . Hasil analisis multivariat menunjukan bahwa faktor dukungan keluarga paling berpengaruh pada asi eksklusif dengan nilai yang di dapatkan  (QR=26.939) pada step 1 dan (QR=26.964) pada step ke 2. Kesimpulan faktor faktor yang berhubungan dengan Asi eksklusif adalah persepsi menyusui,dukungan keluarga,dukungan suami dan yang paling mempengaruhi pemberian asi eksklusif adalah dukungan dari keluarga

ANALISIS FAKTOR-FAKTOR YANG BERPENGARUH TERHADAP KEJADIAN KEHAMILAN RISIKO TINGGI DI WILAYAH KERJA PUSKESMAS MUBUNE KABUPATEN MINAHASA UTARAANALISIS FAKTOR-FAKTOR YANG BERPENGARUH TERHADAP KEJADIAN KEHAMILAN RISIKO TINGGI DI WILAYAH KERJA PUSKESMAS MUBUNE KABUPATEN MINAHASA UTARA

Kehamilan risiko tinggi adalah segala kondisi yang terkait dengan kehamilan di mana terdapat risiko aktual atau potensial terhadap ibu atau janin. Hasil observasi di Kabupaten Minahasa Utara menunjukkan bahwa pada tahun 2022 sebanyak 1015 kasus kehamilan risiko tinggi yang dideteksi di puskesmas. Berdasarkan data, Puskesmas Mubune memiliki kasus kehamilan risiko tinggi terbanyak yaitu sebanyak 193 kasus. Desain penelitian yang digunakan dalam penelitian ini adalah analitik observasional dengan pendekatan cross sectional. Penelitian dilaksanakan di wilayah kerja Puskesmas Mubune Minahasa Utara pada April-Juli 2023. Sampel dalam penelitian ini adalah seluruh ibu hamil yang terdata di Puskesmas Mubune yaitu 225 pasien dengan data risiko tinggi sebanyak 82 ibu hamil. Variabel penelitian terdiri dari variabel bebas (usia ibu hamil, pengetahuan ibu, dan sikap ibu) dan variabel terikat (kejadian kehamilan risiko tinggi). Pengambilan data dilakukan dengan kuesioner. Data penelitian ini dianalisis menggunakan analisis univariat, analisis bivariat, dan analisis multivariat. Hasil analisis menunjukkan bahwa terdapat hubungan antara usia ibu hamil (p = 0,000), pengetahuan ibu hamil (p = 0,007), dan sikap ibu hamil (p = 0,033) dengan kejadian kehamilan risiko tinggi di wilayah kerja Puskesmas Mubune Minahasa Utara. Hasil analisis multivariat menunjukkan nilai exp ? variabel usia ibu hamil pada kategori <20 tahun dan >35 tahun berisiko sebesar 21,6 kali kejadian kehamilan risiko tinggi. Berdasarkan nilai Nagelkerke R-square sebesar 0,763 yang artinya usia ibu hamil, pengetahuan dan sikap secara bersama-sama berpengaruh sebesar 76% terhadap kejadian kehamilan risiko tinggi pada ibu hamil dan sisanya (100-76,3) sebesar 23,7% dipengaruhi oleh variabel lain yang tidak diteliti dalam penelitian ini

Comparison of the efficacy of artemether-lumefantrine vs. artesunate plus sulfadoxine-pyrimethamine in children with uncomplicated falciparum malaria

Background World Health Organization (WHO) has recommended that countries with drug resistant malaria problem use combination therapies, especially artemisinin-based combination therapy (ACT). However, there is limited information on the efficacy of ACT in North Sulawesi. Objective To compare the efficacy of artemether-lumefanttine and artesunate plus sulfadoxine-pyrimethamine (SP). Methods This was a randomized experimental study, conducted in Prof. Dr. R. D. Kandou General Hospital, Manado from January until July 2009. There were 42 patients aged less than 13 years treated with artemether-lumefanttine and artesunate plus SP. Body temperature, parasite and gametocyte count were recorded every day until day 7 and follow-up reviews were done on day 14 and 28. Results Fever clearance time showed a significant difference between artemether-lumefanttine group (median 27 hours) and artesunate plus SP group (median 18 hours), P<0.05). There was no significant difference in parasite clearance time (P>0.05) and game tocyte clearance time (P > 0. 05) . The 28 day cure rate were 100% in the two groups. No side effect was found. Conclusion Both artemether-lumefanttine and artesunate plus SP combination are effective and safe for the treatment of falciparum malaria in children

Association between interleukin-8 and severity of dengue shock syndrome in children

Background Dengue hemorrhagic fever (DHF) remains a major health problem in tropical countries. The case fatality rate (CFR) can be reduced from 45% to <1%, if dengue shock syndrome (DSS) is treated early and adequately. Early biomarkers for DSS outcomes in children are needed. Interleukin-8 (IL-8) might be one of the molecule, as it plays a role in the pathophysiology of DHF in children. Objective To assess IL-8 levels in pediatric DHF patients at various stages of illness severity and to determine the correlation between serum IL-8 concentration on admission and DSS outcomes in children. Methods A prospective cohort study was done in children with DSS who were admitted to the Pediatrics Department of Kandou Hospital, Manado. We measured subjects’ serum IL-8 levels at the time of DSS diagnosis and followed-up subjects until there was improvement or deterioration. An association between IL-8 and DSS outcome was analyzed using univariable logistic regression test. An ROC curve and Chi-square test were used to analyze the prognostic value of serum IL-8 levels. Statistical significance was considered to be a P value of <0.05 (power 80, β=0.20).. Results Fifty-eight children with DSS were included in this study. Twenty-seven subjects had clinical deterioration (to recurrent shock, prolonged shock or died). There was a significant association between elevated IL-8 levels and clinical deterioration in DSS (OR 116.7; 95%CI 18.0 to 756.0; P=0.0001). The ROC curve revealed an IL-8 cut-off level of 194.9 pg/mL, AUC 0.982, with sensitivity 89.3%, specificity 93.3%, positive predictive value (PPV) 92.6%, negative predictive value (NPV) 90.3%. Conclusion There is an association between elevated early serum IL-8 level and a DSS deterioration. Further prognostic studies are needed to confirm the predictive ability of serum IL-8 level on DSS deterioration in children

Lactate clearance and mortality in pediatric sepsis

Background Sepsis is a life-threatening condition often encountered in the pediatric intensive care unit. In the last five decades, despite the use of aggressive antibiotics and advances in intensive care medicine, the mortality rate of sepsis remains high. In 2005, the World Health Organization (WHO) estimated that 11 million children die annually due to sepsis, of these, 30,000 children under five years of age die daily. Serum lactate concentration is useful to evaluate the progression of sepsis in children. Lactate clearance can be used to evaluate the outcomes in sepsis management in children. Objective To evaluate the relationship between lactate clearance and patient mortality. We also attempted to assess the usefulness of lactate clearance as an early prognostic marker in pediatric sepsis. Methods This prospective cohort study was conducted at the Pediatrics Department of Prof Kandou General Hospital from November 2013 to April 2014. Consecutive sampling was undertaken on 45 children aged 1 month to 15 years who were diagnosed with sepsis according to the inclusion criteria. First lactate serum was measured immediately following patient admission to the PICU. The next serum lactate measurement was six hours after initial treatment in the PICU. Results The mean lactate clearance was higher in the survivors’ than in the non-survivors’ group (58.48%vs. 18.20%, respectively). Logistic regression analysis revealed a lactate clearance cutoff point of 34.7%, with sensitivity 87.50%, specificity 96.55%, positive predictive value 93.33%, and negative predictive value 93.33%. The formula used was y=1/{1+exp-(4.135-0.119 lactate clearance)}. Chi-square analysis of lactate clearance and mortality revealed an odds ratio (OR) of 196.0 (95%CI 16.34 to 2,351.53; P<0.001). Conclusion Higher lactate clearances significantly associate with lower mortality in children with sepsis