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Hari Kusnanto
Departemen Biostatistik, Epidemiologi, dan Kesehatan Populasi, Fakultas Kedokteran, Universitas Gadjah Mada
Nursing Public Health

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Spatial analysis of Measles risk areas in Bantul District of Yogyakarta Province Rosa Devitha Ayu; Agung Nugroho; Hari Kusnanto
Berita Kedokteran Masyarakat (BKM) Vol 32, No 10 (2016)
Publisher : Fakultas Kedokteran Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (700.971 KB) | DOI: 10.22146/bkm.11416

Abstract

Spatial analysis of measles risk areas in Bantul District of Yogyakarta Province in 2014 PurposeThe purpose of this study was to determine the area of measles risk.MethodsThis research used a cross-sectional design and was performed from June to August 2015. The data on measles patients were obtained from Case-Based Measles Surveillance (CBMS) activities in Health Office of Bantul District. The coordinate locations of patients’ homes were obtained by direct visits. Meanwhile, the information regarding village/ward areas was derived from all village/ ward offices and Public Health Centers in Bantul Districts. The data were analyzed by spatially weighted regression tests.ResultsThere were 185 measles cases and 6 outbreaks spread-out in 50 (67%) villages/wards. The entire villages/wards have achieved immunization coverage of >90%, 66% with good nutritional status, 51% with high education status, 37% with high population density, and 24% with low economic status. The variable of population density was spatially associated with measles incidents while immunization coverage, nutritional status, education level, and economic status were not spatially associated with measles incidents. Measles case clustering was found in the areas of Banguntapan Sub-district.ConclusionThe immunization program in Bantul District should be evaluated in the light that the villages/wards have achieved immunization coverage of 90% but 185 measles cases and 6 outbreaks were still found in 2014. In addition, the improvement of the immunization recording system needs be conducted for CBMS activities.
Analisis beban ekonomi kejadian luar biasa campak di Daerah Istimewa Yogyakarta Akhmad Mukhibin; Hari Kusnanto; Riris Andono Ahmad
Berita Kedokteran Masyarakat (BKM) Vol 32, No 12 (2016)
Publisher : Fakultas Kedokteran Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (504.673 KB) | DOI: 10.22146/bkm.11629

Abstract

Economic burden analysis of measles outbreak in the Special Region of Yogyakarta 2015Purpose This study aimed to analyze the economic burden due to outbreaks of measles in the household sector in Yogyakarta.Methods This research was a descriptive study with survey design, with data collected of direct and indirect costs for patients exposed to measles, by conducting interviews of 177 respondents using a questionnaire. Secondary data was compared in the form of outbreaks of measles in 2014 and 2015, to research in February-March, 2016.Results The number of outbreaks of measles patients who visited health facilities reached 163 patients (92.09%). Total medical costs were IDR 17.982.000, non-medical costs IDR 7.804.900, so the total direct cost of IDR was 25.786.900 (average IDR 145. 700). Total indirect costs were IDR 11.720.000 (average IDR 156. 300). The economic burden of measles outbreak was IDR 37.506.900 (average IDR 211. 900). Generally, the cost that is paid out of pocket amounted to 6.32% of household income, not yet considered catastrophic. Regression analysis showed the duration of illness averaged more than 10 days (p = 0.002 with some status of hospitalization (p = 0.000).Conclusions The economic burden of outbreaks of measles in the province in 2015 was IDR 37.506.900, including direct and indirect costs. Medical costs are the dominant component of direct costs. The factors that were related to the economic burden are the duration of illness of more than 10 days and inpatient status. There needs to be an advocacy to the community about the use of health care and prevention of measles by way of measles immunization.
The impact of hormonal contraceptives on breast cancer patients hospital Dr. Sardjito Nuratul Awaliyah; Heru Pradjatmo; Hari Kusnanto
Berita Kedokteran Masyarakat (BKM) Vol 33, No 10 (2017)
Publisher : Fakultas Kedokteran Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (558.534 KB) | DOI: 10.22146/bkm.22812

Abstract

The use of hormonal contraceptives relates with the incidence of breast cancer in Dr. Sardjito Yogyakarta Purpose: This study aimed to determine whether women using the contraceptive pill can cause breast cancer.Methods: A case control study was conducted August to October 2016 with 250 patients.Results: Factors that were associated with breast cancer were: type of pill with adjusted OR = 1.66 (95% CI = 1.21 to 2.28; p = 0.001), duration of consumption with adjusted OR = 2.25 (95% CI = 1.04 to 4.84; p = 0.037), and the period of last hormonal contraception with adjusted OR = 2.41 (95% CI = 1. 15 to 5.05; p = 0.020). This study showed that the use of hormonal contraceptives raises the risk of breast cancer.Conclusion: Women should play an active role in breast cancer prevention programs through early detection and treatment. Health services need to explain the potential risks of hormonal contraceptive.
Co-Authors Agung Nugroho Akhmad Mukhibin Heru Pradjatmo Nuratul Awaliyah Riris Andono Ahmad Rosa Devitha Ayu