Pengetahuan dan Perilaku Konsumsi Remaja Putri yang Berhubungan dengan Status Anemia

Anemia is a condition where the number of red blood cells or the concentration of oxygen transport in the blood (Hb) is insufficient for the physiology needs of the body.1 The prevalence of anemia (15-24 years old) in Indonesia (2018) was 32%.2 The aimed of this study was to determine the relationship between knowledge, tablet knowledge of iron supplementation, nutritional status, Fe intake and consumption patterns of inhibitor and enhancers factors with anemia in adolescent girls. This study found that 63.4% of girls had anemia. The factors associated with anemia in this study were knowledge (p value = 0.004), nutritional status (p value = 0.034) and consumption patterns of Fe inhibitors (p value = 0.009). Based on multivariate test, knowledge of anaemia was obtained as the dominant factor in anemia among adolescent girls with OR 3,3. Suggestions in this study were the need to be counseling about anemia and Fe inhibitor consumption patterns and monitoring nutritional status at UKS SMA/K so that adolescent girls can avoid anemia. Keywords: anemia, knowledge, nutritional status and inhibitor Fe. Abstrak Anemia merupakan suatu kondisi dimana jumlah sel darah merah atau konsentrasi pengangkut oksigen dalam darah (Hb) tidak mencukupi untuk kebutuhan fisiologi tubuh.1 Prevalensi anemia pada rentang usia 15-24 tahun berdasarkan Riskesdas tahun 2018 adalah 32%.2 Tujuan penelitian ini adalah mengetahui hubungan pengetahuan dan perilaku konsumsi dengan anemia remaja putri. Penelitian ini didapatkan sebanyak 63,4% remaja putri mengalami anemia. Faktor-faktor yang berhubungan dengan anemia remaja putri dalam penelitian ini adalah pengetahuan (p value = 0,004), status gizi (p value = 0,034) dan pola konsumsi inhibitor Fe (p value = 0,009). Setelah dilakukan uji multivariat didapatkan pengetahuan anemia sebagai faktor dominan anemia remaja putri dengan OR 3,3. Saran dalam penelitian ini adalah perlunya diberikan penyuluhan mengenai anemia dan pola konsumsi inhibitor Fe serta pemantauan status gizi di UKS SMA/K sehingga para remaja putri terhindar dari anemia. Kata kunci: Anemia, Pengetahuan, Status Gizi, Inhibitor F

PEMANFAATAN TES CEPAT MOLEKULER (TCM) GENEXPERT SEBAGAI ALAT DIAGNOSTIK TB PARU DI RSUD WANGAYA KOTA DENPASAR

ABSTRACT Tuberculosis remains a major public health problem, with an estimated 9 million TB incidence cases, 300,000 of which are drug resistant TB cases and resulted in 1.5 million deaths worldwide in 2013. However, only 58% of new cases, TB cases were confirmed bacteriologically using WHO recommended test including the Xpert® MTB/RIF Rapid Diagnosis. The use of GeneXpert in Indonesia has existed since 2014 and has never been evaluated in its utilization, including in the city of Denpasar, namely in Wangaya Hospital as one of the recipients of the GeneXpert pulmonary TB diagnostic aid. The results of this study showed that the results of GeneXpert examination were much higher in the percentage of Positive TB Case Findings compared to microscopic examination so that there is an increase in the number of positive TB cases by 14.3%. The GeneXpert examination succeeded in giving positive results compared to the microscopic results showing negative results, which were sensitive Rifampicin (14.6%) and resistant Rifampicin (2.4%). However, the utilization of TB suspect examination with GeneXpert has not been maximized in increasing the number of TB patients suspected of having TB, in fact, the percentage of positive TB case finding compared to TB suspicion is increasing. Keywords:GeneXpert, rapid diagnosis of tuberculosis, pulmonary tuberculosis   ABSTRAK Tuberkulosis (TB) tetap menjadi masalah kesehatan masyarakat yang utama, diperkirakan telah terjadi 9 juta kasus insiden TB, 300.000 di antaranya adalah kasus TB multidrug resistant (TB MDR) dan mengakibatkan 1,5 juta kematian di seluruh dunia pada tahun 2013. Namun, baru 58% dari kasus baru, kasus TB dikonfirmasi secara bakteriologis menggunakan tes yang direkomendasikan oleh WHO termasuk Tes Cepat Molekuler (TCM) GeneXpert® MTB/RIF (Xpert). Pemanfaatan TCM GeneXpert di Indonesia ada sejak 2014 dan belum pernah dilakukan evaluasi dalam pemanfaatannya termasuk di Kota Denpasar yaitu di RSUD Wangaya sebagai salah satu penerima bantuan alat diagnostik TB Paru TCM GeneXpert. Hasil studi menunjukkan bahwa hasil pemeriksaan dengan TCM GeneXpert jauh lebih tinggi persentase penemuan kasus positif TBC dibanding dengan pemeriksaan mikroskopis sehingga terdapat peningkatan jumlah kasus positif TBC sebesar 14,3% di RSUD Wangaya pada tahun 2018.  Pemeriksaan TCM GeneXpert berhasil memberikan hasil yang positif di saat hasil pemeriksaan mikroskopis menunjukkan hasil negatif yaitu Rifampisin sensitif (14,6%) dan Rifampisin resisten (2,4%). Pemanfaatan pemeriksaan terduga TB dengan TCM GeneXpert belum maksimal dalam meningkatkan jumlah pemeriksaan pasien terduga TB Paru, walaupun persentase penemuan kasus positif TB dibanding terduga TB meningkat. Kata kunci: Tes cepat molekuler, geneXpert, tuberkulosis par

Analisis Implementasi Standar Pelayanan Minimal Bidang Kesehatan Kabupaten/kota

Ministry of Health has set a Health Minimum Service Standards (HMSS) for District/City by Minister of Health Decree No. 741/Menkes/Per/VII/2008, which consist of 18 indicators. After three years of implementation, an analysis of the HMSS implementation has conducted. Using a cross-sectional study design, site selection is done purposively to represent Eastern, Central, and Western part of Indonesia. There were nine districts/cities of 9 provinces selected. The analysis showed that problems in the implementation of HMSS are: some indicators do not meet the SMART criteria, inconsistency between the title of indicators, operational definitions and formulas, wide gap in the coverage both within the district at different times and among districts/cities. Differences also occur at the operational level, including dissemination of HMSS, advocacy, monitoring and evaluation. It is recommended that the Ministry of Health should provide sufficient training, proper socialization of HMSS, set up a special unit to monitor and facilitate the implementation of HMSS. The existing MSS should be revised, no longer focusing on the achievement of the program but rather based on a form of health care provided. In addition, revision is necessary to gain consistency between definitions, operational definitions and formulas of HMSS indicators

Determinan Upaya Pengobatan Tuberkulosis Pada Anak Di Bawah Umur 15 Tahun

One of the WHO\u27s step of TB strategy reflects the importance of the need to improve care for children with TB. However, children with TB often are neglected to cure, even in the countries with high TB incidence. Around 20 percent children estimated with TB, caused by the spreading of adult TB, and many of them without specific symptom as adult. The aim of this study is to get information about the relation between demography, socio-economic, environmental factors, vaccination status, and contact with adult TB patient, and TB treatment practice of children aged <15 years. The sample was a cross-sectional data of TB Prevalence Survey 2004 and Susenas 2004, which had been merged. The method of analysis was multivariate. The result showed that the significant variable were Sumatera region, household expenditure, BCG scars, and contact with TB patients with log-likelihood < 0.05 (p=0.000). Final model for determinant factors of TB treatment practice for children aged < 15 years were children contact with adult TB patient in the household that had risk of 1.9 times (CI 95%: 1.26-2.89) and place of living classification (Sumatera region) that had risk of 2.6 times (CI 95%: 1.65-4.01). To handle child TB cases and their treatment, there are some actions could be applied, namely: to cure every adult TB until recovery, to conduct active case finding, to educate TB patients and their family to be discipline in taking the drug, to support financial transportation to go to health facility for TB patient in poor family, and to prevent from drop out by supervising them closely

SITUASI HUMAN IMMUNODEFICIENCY VIRUS-TUBERKULOSIS DI KABUPATEN MERAUKE 2018: ANCAMAN PADA UMUR PRODUKTIF

Abstract Background: Pulmonary tuberculosis is the most serious opportunistic infection in HIV/AIDS subjects and is a major cause of mortality and morbidity in developing countries. Objective: To describe  the results of HIV / TB examination in Merauke District Hospital Method: Study design is cross-sectional using data from “Studi evaluasi deteksi kasus TBC dengan alat tes cepat molekuler di Indonesia tahun 2018”. Descriptive data analysis is applied based on secondary data of PLWHA patients who visited Merauke District Hospital to examine Mycobacterium tuberculosis (MTB). Results: The proportion of PLWHA was almost three times higher (8.5%) compared to other 43 health facilities (3,0%). The highest proportion of PLWHA is productive age of 15-54 years (94.9%) and male (54.5%). The proportion of children (aged <15 years) with HIV is six times higher (3%) compared to other 43 health facilities (0,5%). The results of MTB with molecular rapid tests in 43 health facilities is higher in PLWHA compared to non-PLWHA (34.4%:32.0%), and the opposite is true for Merauke District Hospital (22.2%:29.4%). Conclussion: HIV epidemic in Merauke has been on the general population particularly in productive and children category. This high level of HIV has an impact on increasing transmission to children and HIV-TB co-infection. Keywords: HIV, HIV-TB co-infection, reproductive age, children, RSUD Merauke Abstrak Latar belakang: Tuberkulosis paru adalah salah satu infeksi oportunistik yang paling serius pada HIV/AIDS dan merupakan penyebab utama kematian dan morbiditas di negara-negara berkembang. Tujuan: Diperoleh gambaran hasil pemeriksaan HIV-TB di RSUD Merauke. Metode: Disain studi adalah potong lintang menggunakan data “Studi evaluasi deteksi kasus TB dengan alat tes cepat molekuler (TCM) di Indonesia tahun 2018”. Analisis deskriptif data sekunder pasien HIV yang berkunjung ke RSUD Merauke yang diperiksa MTB. Hasil: Proporsi ODHA di RSUD Merauke hampir tiga kali lebih tinggi (8,5%) dibandingkan dengan 43 fasilitas kesehatan lainnya (3,0%). Persentase tertinggi adalah pada umur produktif 15-54 tahun (94,9%) dan laki-laki (54,5%). Proporsi anak (<15 tahun) dengan HIV enam kali lebih tinggi (3,0%) dibandingkan dengan 43 fasilitas kesehatan lainnya (0,5%). Hasil pemeriksaan konfirmasi bakteriologi MTB dengan TCM pada 43 fasilitas kesehatan tinggi pada ODHA dibanding non ODHA (34,4%:32,0%), dan situasi sebaliknya pada RSUD Merauke (22,2%:29,4%). Kesimpulan: Epidemi HIV di Merauke sudah mencapai tingkat populasi umum, terutama pada kelompok produktif dan anak. Tingginya angka HIV akan berdampak pada tingginya penularan pada anak dan koinfeksi HIV-TB.   Kata kunci: HIV, HIV koinfeksi TB, umur produktif, anak, RSUD Merauk

Gambaran Penyebab Kematian Di Kabupaten Gowa Provinsi Sulawesi Selatan Tahun 2011 (Description of Causes of Death in Gowa District South Sulawesi Province in 2011)

Background: Research of mortality was essential to provide basic information on the status of population health. Indonesia does not have a standart role for recording and reporting cause of death for every case that occurs in hospital or at home. Objective: determinan cause of death in MCCD in Gowa regency in 2011. Methods: Training and socialitation to medical doctors in every hospital how to fill the Information and Cause of Death Form ICD-10. The source information to fill MCCD was medical record and autopsi verbal questionnaire. Autopsi verbal was collected by nurse and paramedics then the doctors was resumed and cause of death code in MCCD. The analyses data was underlying causes of death based on ICD 10. Results: There are 2.813 mortality in Gowa regency in 2011 year. The place of mortality most at home (87,6%) and 12,4% only in health facility. The mortality was rised by increasing of age. The most of mortality by age group is + 65 years (47,2%). The main of base on 6 groups cause of death in Gowa regency is non communicable deseases (54,1%). There are transition of epidemiology cause of death in Gowa regency from communicable disease to non communicable disease. The main casue of death is stroke (13,6%). Conclusions: Recording and reporting system on UCoD in Gowa regency is developed but not optimal, because the result was still underestimate of mortality rate. The most mortality by sex is man and by place of death is at home. The main cause of death in Gowa regency is stroke. Recommendations: need to increase non-communicable disease control programs, especially stroke to reduce deaths from stroke

Penyebab Kematian di Kabupaten Gianyar Tahun 2010-2012

Abstract Cause of death statistics is one of key indicators to determine the health status of Gianyar community for 3 years (2010-2012) as part of Civil Registration and Vital Statistics (CRVS) study. The instruments used were Verbal Autopsy (AV) questionnaire and Causes of Death Form (FKPK). Data were collected from 13 puskesmas and 4 hospitals and analyzed descriptively according to ICD 10. Based on demoghraphic characteristics, the number of deaths is higher among males and older groups, and mostly occurred at home. The highest cause of death is non- communicable diseases (stroke, COPD, IHD, and malignant neoplasm of cervix uteri) followed by communicable diseases (TB and diarrhoea) and transportation accidents. The top ten causes of death in Gianyar show that a non-communicable and communicable diseases would be a double burden for health services. It is essential to establish integrated posts for elderly and NCD, and measures for prevention of TB transmissions and treaments as well as early detection malignant neoplasm of cervix uteri for women had married or sexually active, and to increase the implementation of safe traffic programs. Keywords : cause of death, vital registration, Gianyar Abstrak Penyebab kematian merupakan salah satu indikator kunci untuk menggambarkan status kesehatan masyarakat di masyarakat Gianyar sebagai bagian dari penelitian registrasi sipil dan statistik vital selama 3 tahun (2010-2012) dengan menggunakan kuesioner Autopsi Verbal (AV) dan Formulir Keterangan Penyebab Kematian (FKPK) dari WHO. Data kematian dikumpulkan dari 13 puskesmas dan 4 rumah sakit, dianalisis dengan metode deskriptif, dengan pengelompokan penyebab kematian berdasarkan ICD 10. Berdasarkan karakteristik demografi jumlah kematian lebih banyak laki-laki, kelompok umur tua, dan di rumah. Penyebab kematian tertinggi disebabkan oleh penyakit tidak menular (stroke, PPOK PJK, dan kanker serviks.) diikuti penyakit menular (TB dan diare) dan kecelakaan lalu lintas. Sepuluh besar penyebab kematian terbanyak memperlihatkan adanya penyakit tidak menular dan menular yang merupakan beban ganda bagi pelayanan kesehatan yang harus dihadapi dalam pembangunan bidang kesehatan. Perlunya prioritas program promotif dan preventif seperti mengaktifkan posbindu (Pos Pembinaan Terpadu) lansia dan PTM, sosialisasi tentang upaya pencegahan penularan TB dan adanya program OAT gratis, deteksi dini kanker serviks pada wanita yang sudah menikah atau berhubungan seksual, dan penegakkan peraturan tata tertib pengguna jalan raya lebih ditingkatkan.Kata kunci : pola penyebab kematian, vital registrasi, Gianya

Pemberdayaan Anak Sekolah Menengah Atas (SMA) dalam Upaya Pengenalan Tuberculosis Paru di Kabupaten Bandung Barat

Educate high school student about the dangers of tuberculosis has not been done. The tuberculosis (TB) disease is common in the community and it is contagious, while the the protection of the disease through immunization is only up to age <15 years, therefore, knowledge to the danger of the transmission of this disease needs to be communicated to the students, sothat, they can understand how to keep themselves aware and know the dangers of transmission of Tuberculosis disease. To find out whether students understand the dangers of the tuberculosis disease, the research has been done by providing information through manual intervention counseling of Tuberculosis. Before education pre and post-test of pulmonary TB disease to 900 students from high school student in West Bandung regency were conducted in the year 2009. Research methods is pre and post test quesionair about tuberculosis, counseling intervention using manual tuberculosis, knowledge and ways of disease prevention. Research design is Quasy Experiment with control group. The result of the study shows a significant increase of knowledge of the student in all three high school student in West Bandung regency, 45% of students in Cililin got their knowledge through books and counseling, and 35% of the student in Cikalong Wetan through-pulmonary TB education course, and only 20% of the student in Padalarang as a control goup got the knowledge from the explanation of TB disease only. The difference of improving those knowledge occur in phases. The differences is also affected by the model of education. Apparently, counseling and motivational text books to the students is one of the most high, usable and useful for improving students knowledge of the tuberculosis diseases. Key words:Tuberculosis, High School,Counseling. Abstrak Penyuluhan kepada siswa-siswi sekolah tentang bahaya penyakit tuberculosis belum banyak dilakukan, mengingat penyakit tuberculosis (TB) merupakan penyakit yang banyak ditemukan di masyarakat dan mudah menular, sedangkan proteksi penyakit melalui imunisasi hanya sampai usia <15 tahun, oleh sebab itu pengetahuan tentang bahaya penularan penyakit ini perlu dan baik disampaikan kepada murid sekolah, agar mereka mengerti cara menjaga diri serta mengetahui bahaya penularan penyakit TB-paru. Untuk mengetahui apakah siswa-siswi mengerti bahaya penyakit tuberculosis, maka dilakukan penelitian dengan memberikan penyuluhan melalui intervensi buku pedoman penyakit Tuberculosis.Sebelum penyuluhan dilakukan pre dan post test tentang penyakit TB-paru kepada siswa-siswi 900 orang dari SMAN di Kabupeten Bandung Barat pada tahun 2009. Metode penelitian pre dan post test kuesioner tentang tuberculosis, intervensi penyuluhan menggunakan buku pedoman tuberculosis pengetahuan dan cara pencegahan penyakit. Disain penelitian Quasy Experiment dengan kontrol group. Hasil Penelitian memperlihatkan peningkatan pengetahuan secara bermagna pada ketiga buah SMAN di Kabupaten Bandung Barat. Sebesar 45% siswa/i di Cililin melalui buku dan penyuluhan, dan 35% melalui penyuluhan TB-paru saja pada siswa/i di Cikalong Wetan, dan terendah sebesar 20% pada kelompok kontrol pada siswa/i di Padalarang hanya penjelasan tentang penyakit TB saja. Perbedaan peningkatan pengetahuan ini terjadi berjenjang, masalah ini juga dipengaruhi oleh model penyuluhan. Ternyata penyuluhan dengan buku pedoman dan motivasi kepada siswa-siswi adalah salah satu yang paling tinggi dan bermanfaat serta berguna untuk meningkatkan pengetahuan siswa/i tentang penyakit Tuberculosis. Kata kunci: Tuberculosis, Anak Sekolah Menengah Atas, Penyuluhan

GAMBARAN PENYEBAB KEMATIAN DI KABUPATEN GOWA PROVINSI SULAWESI SELATAN TAHUN 2011 (Description of Causes of Death in Gowa District South Sulawesi Province in 2011)

Background: Research of mortality was essential to provide basic information on the status of population health. Indonesia does not have a standart role for recording and reporting cause of death for every case that occurs in hospital or at home. Objective: determinan cause of death in MCCD in Gowa regency in 2011. Methods: Training and socialitation to medical doctors in every hospital how to fill the Information and Cause of Death Form ICD-10. The source information to fill MCCD was medical record and autopsi verbal questionnaire. Autopsi verbal was collected by nurse and paramedics then the doctors was resumed and cause of death code in MCCD. The analyses data was underlying causes of death based on ICD 10. Results: There are 2.813 mortality in Gowa regency in 2011 year. The place of mortality most at home (87,6%) and 12,4% only in health facility. The mortality was rised by increasing of age. The most of mortality by age group is + 65 years (47,2%). The main of base on 6 groups cause of death in Gowa regency is non communicable deseases (54,1%). There are transition of epidemiology cause of death in Gowa regency from communicable disease to non communicable disease. The main casue of death is stroke (13,6%). Conclusions: Recording and reporting system on UCoD in Gowa regency is developed but not optimal, because the result was still underestimate of mortality rate. The most mortality by sex is man and by place of death is at home. The main cause of death in Gowa regency is stroke. Recommendations: need to increase non-communicable disease control programs, especially stroke to reduce deaths from stroke