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Clean Water For Small Islands In Indonesia: Case Study Of Child Diarrhea In Kelapa And Kelapa Dua Islands, Kepulauan Seribu Mukharomah, Nur Ariati; Achmadi, Umar Fahmi
Jurnal Riset Kesehatan Vol 13, No 2 (2024): NOVEMBER 2024
Publisher : Poltekkes Kemenkes Semarang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31983/jrk.v13i2.12159

Clean water quality/water sources are critical factors in preventing diarrhea, especially in island areas that often face challenges of limited access and infrastructure to provide adequate clean water. This study aimed to see the descriptive relationship between the physical and microbiological quality of dug well water and the incidence of diarrhea in children on Kelapa Island and Kelapa Dua Island, Kepulauan Seribu. The results of the analysis showed that the physical quality of water in both locations met the criteria of the Minister of Health Regulation number 2 of 2023, namely, the temperature was in the range of 24°C-30°C, turbidity 1 NTU, and water that was odorless and colorless. Microbiological analysis revealed significant contamination, with total Coliform Bacteria and Escherichia coli levels exceeding the maximum allowable limit ( 0 CFU/100 ml ). Factors such as shallow well depths of less than 3 meters and well distances of less than 10 meters from pollution sources contribute to water pollution indicates fecal contamination that increases the risk of diarrhea, especially in children under five. Given the island region's limited access to water quality, these findings emphasize the need for improved water quality monitoring and environmental quality improvements to reduce public health impacts.

Manajemen Penyakit Berbasis Wilayah Achmadi, Umar Fahmi
Kesmas Vol. 3, No. 4
Publisher : UI Scholars Hub

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Secara universal, kejadian penyakit merupakan inti permasalahan kesehatan masyarakat yang harus dicegah guna menampilkan wilayah yang sehat dan negara yang kuat. Kejadian penyakit merupakan fenomena yang bersandar pada basis wilayah yang mencakup ekosistem dalam dimensi ruang dan waktu Tulisan ini membahas kepentingan, makna, lokasi dan metoda manajemen penyakit berbasis wilayah. Asumsi dasar yang dianut adalah bahwa keberhasilan mengendalikan faktor risiko dan kejadian penyakit akan mampu meningkatkan dan memelihara kualitas kehidup masyarakat. Pembangunan kesehatan Wilayah dapat dilakukan dengan merujuk konsep MPBW dan rancangan SKK setiap wilayah pemerintahan otonom. Secara lebih terperinci, perlu disusun suatu pedoman MPBW kabupaten dan kota yang dapat dijadikan panduan oleh para perancang dan pelaksana. MPBW diharapkan dapat meningkatkan kesehatan penduduk di suatu Kabupaten Kota tertentu secara bertahap dan berkesinambungan. Terakhir dan yang tidak kalah pentingnya adalah bahwa pelaksanaan MPBW harus menggunakan prinsip-prinsip Ilmu Kesehatan Masyarakat. It is universally accepted that disease occurrence is the nucleus of public health problem and should be prevented to achieve healthy area and strong country. Disease occurrence is a phenomenon that is area-based and include ecosystem both spatial and temporal dimensions. This paper tries to explain the importance, meaning, location and method of area-based disease management. The important basic assumption is that the successful risk and disease control can increase ability to increase and maintain life quality of the people. Area-based development could be implemented by referring to MPBW concept and SKK design for each and every autonomous government. Furthermore, there is a need to develop MPBW guidelines in district level to be used by development designer and planner. It is expected that MPBW could improve community health in a district gradually and continuously. Last but not least, the implementation of MPBW should utilise Public Health sciences principles.

Demam Berdarah Dengue di Perdesaan Kusumawardani, Erna; Achmadi, Umar Fahmi
Kesmas Vol. 7, No. 3
Publisher : UI Scholars Hub

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Berbeda dengan beberapa negara, laporan kejadian kasus demam berdarah dengue (DBD) di perdesaan Indonesia belum banyak dilaporkan. Penelitian ini bertujuan untuk memberikan gambaran kejadian DBD di perdesaan di wilayah perbatasan Kabupaten Bogor dan Kabupaten Lebak, Jawa Barat. Penelitian ini menggunakan desain studi kasus seri dengan sampel seluruh penderita DBD yang tercatat di puskesmas pada periode bulan Januari 2011 sampai April 2012. Hasil penelitian menemukan 18 kasus DBD dan 4 kasus kematian (case fatality rate, CFR = 22%). Sebagian besar kasus berjenis kelamin laki-laki (58,3%), berusia > 15 tahun (58,3%), tidak bekerja/ibu rumah tangga (50%), melakukan mobilitas (66,7%), mempunyai pengetahuan yang baik (66,7%), berperilaku kurang baik (83,3%), dan mempunyai tempat penampungan air (100%). Lima dari 12 kasus DBD (41,7%) diduga merupakan kasus lokal. Dari empat puskesmas (57,1%) yang melakukan kegiatan penyelidikan epidemiologi DBD terindikasi bahwa kemungkinan besar telah terjadi transmisi DBD di wilayah perdesaan daerah perbatasan Kabupaten Bogor dan Kabupaten Lebak. Dengue hemorrhagic fever (DHF) has long been reported as disease affecting predominantly among urban populations. However, several recent studies suggest that DHF has spread into rural area. This study aims to describe disease occurrence of DHF in border rural areas of Bogor – Lebak. The study design is case series. The sample of this study was all patients with confirmed DHF admitted to public health centers between January 2011 and April 2012. The study was conducted in April to May 2012. The results showed that there were 19 DHF cases and four out of 18 cases died (case fatality rate, CFR was 22%). Out of 12 eligible respondents, most of them were male (58,3%), aged > 15 years (58,3%), unemployed/housewife (50%), conducting mobility (66,7%), having good knowledge (66,7%), behave poorly (83,3%), and having water containers (100%). Five of 12 DHF cases (41,7%) were suspected as local cases. Four primary health centers (57,1%) were able to perform PE DBD (DHF Epidemiological Investigation). These results indicate that the transmission of DHF in border rural areas of Bogor – Lebak, most likely has occurred.

Analisis Risiko Pajanan PM2,5 di Udara Ambien Siang Hari terhadap Masyarakat di Kawasan Industri Semen Novirsa, Randy; Achmadi, Umar Fahmi
Kesmas Vol. 7, No. 4
Publisher : UI Scholars Hub

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Salah satu dampak negatif industri pabrik semen terhadap kesehatan masyarakat adalah peningkatan risiko penyakit saluran pernapasan. Risiko tersebut banyak disebabkan oleh pajanan partikulat di udara, khususnya partikulat berukuran di bawah 2,5 mikron (PM2,5). Penelitian ini bertujuan menganalisis risiko pajanan PM2,5 di udara ambien siang hari pada masyarakat di kawasan industri semen. Risiko dihitung dengan metode Analisis Risiko Kesehatan Lingkungan berdasarkan metode Louvar yang menghasilkan nilai Intake pajanan yang diterima individu per hari berdasarkan nilai konsentrasi pajanan, pola aktivitas individu, dan nilai antropometri. Konsentrasi PM2,5 di lingkungan diukur pada 10 titik dengan radius 500 meter antartitik dari pusat pabrik, sedangkan pola aktivitas dan nilai antropometri diukur dengan menggunakan kuesioner pada 92 responden dewasa di kawasan pabrik. Hasil perhitungan risiko yang diterima seumur hidup (lifetime) menunjukkan terdapat tiga area berisiko dengan nilai RQ > 1, yaitu Ring 2 (500 – 1.000 m), Ring 4 (1.500 – 2.000 m), dan Ring 5 (2.000 – 2.500 m). Daerah paling aman yang dapat dihuni oleh masyarakat di kawasan industri semen adalah di atas 2,5 km dari pusat industri dengan konsentrasi paling aman 0,028 mg/m3. One of the negative impacts of cement industry to public health is an increased risk of respiratory disease. These risks are caused by exposure to particulate matter in air, especially fine particulate matter which is smaller than 2,5 microns (PM2,5). This study aimed to analyze the risks of PM2,5 exposure in ambien air at noon on people around cement industry. Risk was calculated using Environmental Health Risk Analysis Method that generates value of individual exposure intake received per day. This value was generated based on the concentration of exposure, individual activity patterns, and anthropometric values. PM2,5 concentrations in the environment was measured at 10 points (Ring) from the center of plant with radius of 500 meters each point. The activity patterns and anthropometric values were measured using questionnaire to 92 adult respondents around the factory. The calculation of lifetime risk showed that there are three risked area: Ring 2 (500 – 1.000 m), Ring 4 (1.500 – 2.000 m), and Ring 5 (2.000 – 2.500 m). The safest area was over 2,5 kilometers from the center of the industry with the safest concentration was 0,028 mg/m3.

Aminolevulinic Acid Dehydratase Allelic Frequency and Lead Toxicity in Children Under-Five in a Former Used Lead-Acid Battery Area Irawati, Yana; Kusnoputranto, Haryoto; Achmadi, Umar Fahmi; Safrudin, Ahmad; Sitorus, Alfred; Risandi, Rifqi; Wangsamuda, Suradi; Permana, Dendi Hadi; Syahrani, Lepa; Dewayanti, Farahana Kresno; Asih, Puji B S; Syafruddin, Din
Kesmas Vol. 17, No. 1
Publisher : UI Scholars Hub

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Polymorphisms in the Aminolevulinic Acid Dehydratase (ALAD) gene responsible for the ALAD1 and ALAD2 alleles have been implicated in susceptibility to lead toxicity. This study aimed to determine the allelic frequency of ALAD2 among children living in Bogor District, Indonesia, and its association with blood lead levels (BLLs) and lead toxicity. A cross-sectional study involving 128 children was conducted during September-October 2019 in the former ULAB area in Cinangka Village. The ALAD polymorphism, BLLs, and hematological parameters were evaluated. Blood samples were taken for dried blood spotting on filter paper, blood film, and BLL measurement. The PCR amplification and sequencing of the genomic DNA revealed the presence of two forms of the ALAD2 allele: 177C and 177T with a frequency of 0.05. Analysis of the correlation between the ALAD2 allele, BLLs, and basophilic stippling revealed that ALAD2 carriers had a five times higher risk of high BLLs, (OR = 5.359, p-value = 0.155) and had a slightly higher risk of exhibiting basophilic stippling (OR = 1.09, p-value = 1.000). Although not statistically significant, these findings suggested that the ALAD genotype may modify BLLs and lead to toxicity. The ALAD2 allele(177T) is firstly reported in any population in the world.

Pencegahan Resurgensi Malaria dengan Deteksi Dini dan Pengobatan Segera di Daerah Reseptif Supriyani, Teni; Achmadi, Umar Fahmi; Susanna, Dewi
Kesmas Vol. 9, No. 3
Publisher : UI Scholars Hub

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Jawa Barat merupakan salah satu wilayah reseptif malaria di Indonesia, khususnya Kabupaten Tasikmalaya bagian selatan. Tahun 2009, 2011, dan 2012 telah terjadi kejadian luar biasa (KLB) terutama di Kecamatan Cineam. Namun, pada tahun 2013 tidak terjadi KLB serupa. Ekosistem Cineam berupa pegunungan dan perkebunan kondusif untuk penularan malaria. Selain itu, banyak penduduk Cineam yang merupakan pekerja migran. Tujuan penelitian ini untuk mengidentifikasi faktor-faktor yang berkontribusi terhadap tidak terjadinya peningkatan kasus (resurgensi) malaria di daerah reseptif. Penelitian ini merupakan penelitian deskriptif kuantitatif yang dilakukan pada bulan Juni - Desember 2014, dengan menggunakan sampel seluruh penderita malaria positif di Kecamatan Cineam tahun 2013, yang berjumlah 27 kasus. Hasil penelitian menunjukkan bahwa semua kasus adalah pekerja migran. Secara spasial, ditemukan tempat perkembangbiakan Anopheles tersebar dekat dengan tempat tinggal kasus. Meskipun wilayah Kecamatan Cineam merupakan wilayah kondusif penularan malaria, tidak terjadi penularan horizontal pada tahun 2013. Analisis lebih lanjut mengindikasikan bahwa upaya deteksi dini, pengobatan segera menggunakan protokol standar yang memadai, pemberian obat profilaksis sebelum berangkat, serta penyuluhan intensif kepada masyarakat, dapat menekan timbulnya KLB pada tahun 2013. West Java provinces one of malaria-receptive areas in Indonesia, specifically the south area of Tasikmalaya District. In 2009, 2011 and 2012, there was extraordinary emergence, specifically in Cineam Subdistrict. However, in 2013, there was no any other similar case. Ecosystem of Cineam consisting of mountains and plantations was so conducive for malaria transmission. Moreover, there were many Cineam people as migrant workers. This study aimed to identify factors contributing to malaria resurgence in receptive area. This study was descriptive quantitative conducted on June to December 2014 using sample of all positive malaria patients at Cineam Subsdistrict in 2013 worth 27 case. Results showed that all cases were migrant workers. Spatially there was Anopheles-breeding areas spread closed to the case home. Even though Cineam Subsdistrict region is such a conducive area for malaria transmission, but there was none of any horizontal transmission in 2013. Further analysis indicated that early detection and prompt tratment used adequate standard protocol, prophylactic distribution before departing as well as intensive counseling to public might press extraordinary emergence in 2013.

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