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Kesmas: Jurnal Kesehatan Masyarakat Nasional (National Public Health Journal)
Published by Universitas Indonesia
ISSN : 19077505     EISSN : 24600601     DOI : https://doi.org/10.7454/kesmas
Core Subject : Health,
Health Professions Public Health
The focus of Kesmas is on public health as discipline and practices related to preventive and promotive measures to enhance the public health through a scientific approach applying a variety of technique. This focus includes areas and scopes such as Biostatistics, Environmental Public Health, Epidemiology, Health Policy, Health Services Research, Nutrition, Occupational Health and Industrial Hygiene, Public Health, Public Health Education and Promotion, Women Health.
Arjuna Subject : Kedokteran - Epidemilogi
Articles 6 Documents
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Search results for , issue "Vol. 4, No. 4" : 6 Documents clear
Identifikasi Penyebab Diare di Kabupaten Karangasem, Bali Sujaya, I N.; Aryantini, N.P. Desy; Nursini, N.W.; Purnama, S.G.; Dwipayanti, N.M.U.; Artawan, I G.; Sutarga, I M.
Kesmas Vol. 4, No. 4
Publisher : UI Scholars Hub

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Pada Februari hingga Maret 2008 terjadi kejadian luar biasa muntah berak (diare) di Kabupaten Karangasem Bali. Tercatat sekitar 600 orang mengalami muntaber dan 5 orang meninggal dunia. Ini merupakan kejadian KLB muntaber pertama kali di Bali serta belum diketahui patogen penyebab diare tersebut. Tujuan penelitian ini adalah mengidentifikasi penyebab diare di Karangasem serta kemungkinan rantai penularannya. Penelusuran penyebab KLB dilakukan dengan menganalisis sampel air yang diambil dari sumber air umum, cubang/sumur penduduk, bahan makanan, serta rectal swab penderita dengan kombinasi teknik pemupukan kuman dan PCR spesifik dengan target gen pembentuk toksin pada Escherichia coli. Dengan melakukan kultur pada sampel makanan diperoleh bahwa 11 dari 21 sampel makanan positif mengandung E. coli. Dari sampel yang positif E. coli, 2 sampel yang diambil di rumah penderita muntaber terdeteksi gen pembentuk shiga like toxin tipe I dan II pada E. coli. Deteksi gen pengkode shiga like toxin tipe I juga terdeteksi pada penderita dan beberapa sampel air dari cubang penduduk. Hal ini menunjukkan bahwa E. coli pembentuk shiga ike toxin tipe I merupakan penyebab KLB di Karangasem. Lebih lanjut diperoleh bahwa pita shiga like toxin tipe I dan tipe II. E. coli strain Karangasem berbeda dengan strain EHEC sehingga strain Karangasem ini kemungkinan merupakan strain E. coli patogen baru yang terjadi akibat perubahan genetik pada E. coli pembentuk shiga like toxin yang ditemukan di Bali. In February to March 2008, Bali was shocked by the outbreak of diarrhea in Karangasem District, Bali. It was recorded that 600 people were having diarrhea and 5 people were died due to the disease. This outbreak was the first time happened in Bali and the causing pathogen was not yet identified. The aim of this study was to identify the causing pathogen of diarrhea in the outbreak case in Karangasem, as well as to identify the possible transmitting pathway. The tracking of outbreak cause was carried out by analyzing water sample taken from communal clean water source, private clean water reservoir, food sample, as well as rectal swab of the patient with the combination of pathogen enrichment technique and specific PCR with Escherichia coli as the target of toxin forming agent. Based on the culture growth from food samples, it was found that 11 from 21 samples were E. colipositive. From samples that E. colipositive, 2 sam-ples that were taken from patient’s house were detected a shiga like toxic forming gene, type I and II on the E. coli. The similar shiga like toxin forming gene type I was also detected on samples from patient and samples from water of private family cubang. This shows that E. colithat forms shiga like toxin type I was the diarrhea causing pathogen in this particular outbreak in Karangasem. Furthermore, it was found out that the ribbon formed by shiga like toxin type I and II differ from the strain of EHEC. Thus, it is possible that the strain found in Karangasem was a new strain of E. colipathogen due to genetic transformation on shiga like toxin forming E. coli that was found in Bali.
Faktor - faktor yang Berhubungan dengan Kepatuhan Petugas terhadap SOP Imunisasi pada Penanganan Vaksin Campak Yulianti, Dini; Achadi, Anhari
Kesmas Vol. 4, No. 4
Publisher : UI Scholars Hub

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Campak adalah penyakit yang sangat menular dan menjadi salah satu penyebab utama kematian anak di negara berkembang termasuk Indonesia. Imunisasi campak di Indonesia telah berhasil dilaksanakan dengan baik, tetapi ternyata masih banyak ditemukan kasus campak di beberapa daerah. Salah satu faktor yang diduga menjadi penyebabnya adalah daya guna vaksin yang tidak maksimal karena sistem rantai vaksin yang sangat menentukan untuk pengamanan mutu vaksin tidak berfungsi dengan baik atau para petugas imunisasi tidak melakukan penanganan vaksin sesuai dengan prosedur yang telah ditentukan. Berdasarkan atas kenyataan ini, dilakukan penelitian mengenai faktor-faktor yang berhubungan kepatuhan petugas imunisasi terhadap SOP (Standard Operating Procedure) imunisasi dalam penanganan vaksin campak di Kabupaten Kebumen pada tahun 2009. Variabel yang diteliti adalah pendidikan, pelatihan, lama kerja, pengetahuan, sikap, motivasi, imbalan, persepsi kepemimpinan, supervisi dan sarana. Penelitian ini menggunakan pendekatan kuantitatif, dilakukan secara cross sectional dengan sampel seluruh total populasi sebanyak 69 responden, serta menggunakan data primer yang diperoleh melalui observasi dan wawancara. Hasil penelitian menunjukkan sebesar 60,9% petugas dapat dikategorikan patuh. Variabel independen yang memiliki hubungan yang bermakna secara statistik dengan kepatuhan petugas adalah pendidikan, pengetahuan, imbalan dan sarana. Pengetahuan dan sarana merupakan faktor yang paling dominan berhubungan dengan kepatuhan petugas, masing-masing dengan nilai OR sebesar 5,195 dan 5,287. Measles is one of the infectious diseases that pose as primary cause of death among children in developing countries, including Indonesia. Measles immunization program in Indonesia has been done relatively well, but the fact shows that there are still cases of measles found in several areas. It is suspected that vaccine’s efficiency is not optimal due to the ineffective cold chain system, or the vaccine officer does not administer vaccine following the established procedures. In turns, those aspects caused ill-functioning of vaccine system. Based on this fact, this study is carried out with to find out factors which are associated with vaccine officer’s compliance to the standard operating procedure of immunization in administrating measles vaccine in District of Kebumen in 2009. Variables of this study are education, training, work duration, knowledge, attitude, motivation, incentive, leadership perception, supervision and facility. This study is applying quantitative approach using cross sectional method. All the population (69 respondents) was taken as sample, and the primary data were solicited through observation and interview. The result of this study shows that the compliance rate of the officers is 60.9%. Independent variables which are significantly associated with officer’s compliance are education, knowledge, incentive and facility. Knowledge and facility are the two dominant factors associated with officer’s compliance, with ORs of 5.195 and 5.287, respectively.
Perencanaan Penanggulangan Keadaan Darurat Transportasi Darat Bahan Kimia Butadien Rute Bojonegara - Cengkareng pada PT X Indonesia Roza, Nelvy; Lestari, Fatma
Kesmas Vol. 4, No. 4
Publisher : UI Scholars Hub

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PT X Indonesia mentransport butadien dari terminal penimbunan di Bojonegara ke pengolahan di Cengkareng. Penelitian ini bertujuan mengidentifikasi potensi bahaya, memprediksi risiko, dan mengevaluasi prosedur penanggulangan keadaan darurat. Sampel diambil di salah satu rute perjalanan Bojonegara - Cengkareng. Data diperoleh dari observasi, wawancara, catatan, pelaporan dan prosedur penanggulangan keadaan darurat. Rencana penanggulangan keadaan darurat dianalisis secara kualitatif dengan membandingkan PT X Indonesia dengan standar Manitoba Industrial Accidents Council dan Advisory Committee on the Transport of Dangerous Goods - Prosedur penanggulangan keadaan darurat meliputi kebijakan perusahaan, analisa risiko, organisasi, sarana dan prasarana, tindakan penanggulangan serta pelatihan dan simulasi. Hasil penelitian menunjukkan perusahaan telah menetapkan prosedur tindakan keadaan darurat yang sudah dikaji, direvisi dan didistribusikan kepada semua personil terlibat. Risiko diidentifikasi berdasarkan penelusuran Material Safety Data Sheet dan Transport Emergency Card. Perusahaan menetapkan tim tanggap darurat dengan program pencegahan antara lain pemeriksaan kendaraan sebelum berangkat, penentuan kualifikasi pengemudi, dan kondisi kendaraan. Perusahaan menyediakan peralatan keadaan darurat seperti pemadam kebakaran, safety shoes, helm, dan sarung tangan, membekali pengemudi pengetahuan tindakan dalam keadaan darurat. Pelatihan dan simulasi perlu ditingkatkan khususnya penanggulangan keadaan darurat angkutan butadien. PT X Indonesia transports butadiene from its storage terminal in Bojonegara to processing plant in Cengkareng. This research identified potential hazard during butadiene transport, evaluate risk, and evaluate the emergency response preparedness during butadiene transport. Sample is taken from one route from Bojonegara to Cengkareng and data were obtained from observation, interview, records, reports and emergency response preparedness procedure. Qualitative and comparative analysis was conducted between existing emergency response procedures at PT X Indonesia with Manitoba Industrial Accidents Council Standards and Advisory Committee on the Transport of Dangerous Goods - Australia. Elements analysed including company policy, risk analysis, organization, facilities and equipment, emergency response steps, training and emergency drill. Results suggested that company’s policy has been set up for emergency response procedure and has been reviewed, revised, and distributed to all related parties. Risk analysis conducted using hazard identification method by reviewing Material Safety Data Saheet and Transport Emergency Card to determine butadiene toxicity, carcinogenicity, and flammability. Consequences analysis was conducted based on worst case scenario of Boiling Liquid Expanding Vapour Explosion. Emergency Response Preparedness organization was established. Accident prevention was also implemented such as tank inspection, driver’s qualification, and tank condition inspection. Emergency response equipment and facilities included fire extinguishers, safety shoes, helm, and gloves that included emergency steps, knowledge to the driver regarding emergency response . Emergency drill element should be improved, as existing drill not specific for butadiene transport emergency response.
Pengetahuan dan Praktek Keluarga Sadar Gizi Ibu Balita Fatmah, Fatmah
Kesmas Vol. 4, No. 4
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Untuk mengantisipasi masalah gizi kurang utamanya pada keluarga miskin, pemerintah telah mengeluarkan gerakan Kadarzi (Keluarga Sadar Gizi). Hingga saat ini, hampir tidak diketahui perilaku Kadarzi ibu balita di DKI Jakarta karena masih sedikitnya data hasil penelitian yang mengukur hal tersebut. Oleh karena itu, diperlukan suatu penelitian dasar yang bertujuan untuk mengeksplorasi bagaimana gambaran pengetahuan dan praktek kelima indikator Kadarzi ibu balita di Kelurahan Penjaringan, Jakarta Utara. Metode kualitatif dengan teknik Diskusi Kelompok Terarah (DKT) dan wawancara mendalam telah dilakukan pada ibu balita, tokoh agama/masyarakat, dan kader posyandu. Hasil studi menyatakan bahwa pengetahuan ibu balita pada 4 indikator Kadarzi cukup baik, kecuali konsumsi aneka ragam makanan. Praktek 3 indikator Kadarzi juga sudah baik, kecuali pemberian ASI eksklusif dan konsumsi aneka ragam makanan. Tokoh masyarakat dan kader posyandu belum mengenal indikator Kadarzi dengan baik. Mereka hanya sebatas mendengar dan tidak familiar dengan istilah Kadarzi. Kadarzi identik dengan makanan 4 sehat 5 sempurna bagi balita dan ibu hamil untuk meningkatkan status gizi dan kesehatan masyarakat. Disimpulkan bahwa ibu balita belum berperilaku Kadarzi karena belum mengaplikasikan lima indikator Kadarzi. Disarankan agar Sudinkes Wilayah Jakarta Utara melakukan sosialisasi Kadarzi lebih intensif lagi bagi masyarakat melalui media cetak dan elektronik di posyandu dan puskesmas. Poor family in Jakarta is a vulnerable group faced undernutrition problem with poor sanitation and health due to poverty. To anticipate it, the government has declared Kadarzi (Nutrition Awareness Family) movement. Up to now, mother’s behavior on Kadarzi in poor urban villages areas in DKI Jakarta were almost unknown which caused by limited data studied about Kadarzi. Therefore, it was necessary to conduct a study aimed to explore how is the knowledge and practice of Kadarzi’s five indicators among underfives mothers at Penjaringan Village, Penjaringan Sub-district, North Jakarta. The study used qualitative data techniques through Focus Group Discussion (FGD) and in-depth interviews. Informants of the study were mother of underfive children, religious/community leaders, and posyandu cadres. The study revealed that the majority of informants had low knowledge and practice of Kadarzi due to lack of socialization from community health centers. They were unfamiliar with the terminology of Kadarzi. They considered that Kadarzi was identical with four healthy and five perfect for toddlers and pregnant women to improve their nutrition and health status. It was recommended to District Health Office of North Jakarta City to disseminate Kadarzi information for the community through printed and electronic media.
Faktor Dominan yang Mempengaruhi Kejadian Malaria di Perdesaan Susanna, Dewi; Eryando, Tris
Kesmas Vol. 4, No. 4
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KLB malaria selama periode 1998-2003 telah menyerang 15 propinsi yang meliputi 84 desa endemis dengan jumlah penderita 27.000 dengan kematian 368. Hewan besar seperti sapi, kerbau dan kuda adalah merupakan cattle barrier malaria. Hewan tersebut perlu diteliti agar dapat diketahui jenis hewan dan tempat hidup hewan (kandang) terhadap kejadian malaria. Tujuan umum penelitian ini adalah untuk mengetahui faktor dominan yang mempengaruhi kejadian malaria di pedesaan. Jenis penelitian adalah non-intervensi, merupakan analisis lanjut data sekunder yaitu “Riset Kesehatan Dasar 2007”. Subyek yang dianalisis sebanyak 618.593 yang bertempat tinggal di perdesaan. Analisis dilakukan dengan metoda multivariat menggunakan regresi logistik. Ternak dibagi menjadi empat kategori, yaitu unggas (ayam, burung, dan bebek/itik), ternak besar (sapi, kuda, dan kerbau), ternak sedang (babi, domba,dan kambing), dan ternak kecil (kucing, anjing, dan kelinci). Faktor yang paling dominan mempengaruhi kejadian malaria adalah kepemilikan ‘ternak sedang’ (kambing, babi, dan domba), dengan OR = 0,52 (0,50-0,54). Faktor yang paling dominan mempengaruhi kejadian malaria adalah tidak adanya ‘ternak sedang, yaitu kambing, babi, dan domba. Malaria outbreak in the period of 1998-2003 was occurred in 15 province including 84 endemic villages with number of cases of 27 000 and deaths of 368. Big cattles such as cow, horse and buffalo have been known as cattle barrier for malaria, while others have not been investigated yet. The objective of this research was to know the dominant factor related to cattle which influenced malaria in village area. The secondary data from ‘Riset Kesehatan Dasar 2007” had been used in this research with total population of 618593 who lived in village area and was analyzed using logistic regression test. Cattle as independent variable was divided into four categories, they were poultry (chicken, bird, and duck), big cattle (cow, horse and buffalo), medium cattle (pig, sheep, and goat), and small cattle (cat, dog, and rabbit). The most dominant factor for protection of malaria was medium cattle (pig, sheep, and, goat) as protective with Odds Ratio of 0.52 (0.50-0.54). The other cattle had Odds Ratios less than 2, although they had p value < 0.05. The medium cattle was the dominant factor influenced malaria in village area, while others did not have effect.
Langkah Kedepan Mempercepat Penurunan Kematian Ibu di Indonesia Achadi, Anhari
Kesmas Vol. 4, No. 4
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Kematian ibu tidak hanya menjadi masalah kesehatan masyarakat, tetapi juga menjadi masalah sosial karena akan berpengaruh besar terhadap keluarga, terutama anak-anak. Di negara maju dengan status sosial ekonomi yang tinggi kematian ibu telah turun mencapai tingkat minimal kurang dari 10 per 100.000 kelahiran hidup. Hal tersebut belum terjadi di negara-negara berkembang, termasuk Indonesia. Di samping pertumbuhan ekonominya yang terus membaik, kematian ibu di Indonesia masih tergolong tinggi, bahkan di antara sesama negara Asia Tenggara. Berdasarkan data SDKI, telah terjadi penurunan angka kematian ibu, tetapi dengan penurunan seperti sekarang target Pembangunan Milenium tidak akan tercapai. Dari aspek demand, supply, maupun kebijakan, penurunan kematian ibu masih mengalami berbagai hambatan. Untuk mempercepat penurunan kematian ibu perlu dikembangkan kebijakan yang dapat mengatasi hambatan utama berupa kelangkaan petugas pelayanan kesehatan yang terampil, infrastuktur pelayanan kesehatan ibu yang belum memadai, kualitas pelayanan yang sub-standar, dan keengganan para ibu untuk menggunakan fasilitas pelayanan kebidanan karena biaya yang sangat tinggi dan pelayanan yang masih buruk atau karena masih lebih menyukai pelayanan dukun dengan berbagai alasan lingkungan yang spesifik. Dalam mempercepat penurunan kematian ibu, kebijakan dan manajemen di tingkat kabupaten berperan sangat menentukan. Maternal mortality is both public health and social problem. The death of a mother will affect the family, especially the children. In the developed countries, with their high socio-economic status, maternal deaths have declined to its minimal level, less than 10 deaths among 100,000 life births. That is not the case in the developing countries, Indonesia included. Despite its continued economic growth, maternal death in Indonesia is still high, even within Southeast Asian countries. According to IHDS data, maternal mortality eduction happened over time, however, with its current rate of decline the MDGs target on maternal mortality will unlikely be met. Maternal mortality reduction is still facing various demand, supply, and policy constraints. In order to accelerate maternal mortality reduction, policies are required to overcome various barriers, which include shortage of skilled health providers, inadequate maternal health infrastructures, sub-standard service quality, and unwillingness women to use maternity facilities due to its high cost and inadequate services, or their preference towards traditional birth attendant (TBA) services. Role of district policies and management on maternal health is crucial in accelerating maternal death reduction.

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