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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 928 Documents
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Bioindikator Cemaran Timbal pada Rambut Masyarakat sekitar Kilang Minyak Sukar, Sukar; Suharjo, Suharjo
Kesmas Vol. 9, No. 3
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Timbal atau Plumbum (Pb) bersifat toksik, karsinogenik, bioakumulator dan biomagnifikasi. Bioakumulasi Timbal dari media lingkungan dapat terjadi pada kuku, hati, dan rambut. Tujuan penelitian untuk mengetahui faktor risiko kejadian bioindikator timbal rambut masyarakat di kawasan industri minyak. Penelitian dilakukan pada tahun 2012 di Kota Dumai, Provinsi Riau. Rancangan penelitian khusus pencemaran lingkungan 2012 adalah type- 1 health study, yang disarankan US Agency for Toxic Substances and Drugs Registry (ATSDR). Analisis statistik bivariat dengan uji kai kuadrat. Populasi penelitian adalah penduduk Kota Dumai yang tinggal di desa Jayamukti, Tanjung Palas, Mekarsari, dan Bukit Timah. Sejumlah 110 ibu rumah tangga diambil dengan teknik purposive sampling. Kriteria inklusi, responden berusia antara 17 – 55 tahun dan telah tinggal minimal selama lima tahun terakhir. Kriteria ekslusi sedang menderita penyakit kronis. Hasil analisis dari enam parameter media lingkungan menunjukkan ada empat parameter berisiko mencemari, tetapi belum bermakna antara parameter lingkungan dan kejadian timbal rambut dengan nilai p > 0,05. Odds Ratio (OR) terbesar ditunjukkan oleh parameter ikan sebesar 1,5 dan terkecil makanan atau minuman dan tanah 1,13. Proporsi risiko terbesar ditunjukkan oleh parameter ikan sebesar 33,3% dan terkecil parameter makanan atau minuman 10%. Telah terjadi penanggulangan risiko untuk parameter air minum dan air permukaan dengan nilai p < 0,05. Lead or Plumbum (Pb) is toxic, carcinogenic, bioaccumulator and biomagnification. Lead bioaccumulation of environmental media may occur in liver, nails and hair. The study objective was to find out the risk of lead bioindicator occurence in hair of people living in oil industry area. The study was conducted in 2012 in Dumai City, Riau Province. The study design is a type-1 health study, suggested the US Agency for Toxic Substances and Drug Registry (ATSDR). The statistical analysis was bivariate using chi-square test. The population was Dumai City dwellers who lived in the village Jayamukti, Tanjung Palas, Mekarsari and Bukit Timah. A total of 110 housewives were taken by purposive sampling technique. Inclusion, respondents aged between 17 – 55 years old and have lived for five years at minimum. Exclusion criteria was those suffering cronic disease. Analysis results of six parameters of environmental media there were four parameters, had risk of contaminating but not significant between environmental parameters and the lead occurence in hair with p value > 0.05. Tbe biggest odd ratio (OR) was showed by fish parameter worth 1.5 and the smallest was food or beverage and land worth 1.13. The biggest proportion was showed by fish parameter of 33.3 % and the smallest food or beverage 10 %.There has been a reduction of risk for the parameters of drinking water and surface water with p value < 0.05.
Mekanisme Hubungan Sosial Ekonomi, Pemanfaatan Pelayanan Kesehatan dan Kehamilan Risiko Tinggi terhadap Prevalensi Panjang Badan Lahir Pendek Simbolon, Demsa; Astuti, Wahyu Dwi; Andriani, Lusi
Kesmas Vol. 9, No. 3
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Prevalensi panjang badan lahir pendek di Indonesia masih tinggi dan menjadi masalah kesehatan masyarakat yang disebabkan oleh pelbagai faktor secara langsung dan tidak langsung serta berdampak luas dan berkelanjutan dalam siklus kehidupan. Penelitian menggunakan data Riset Kesehatan Dasar (Riskesdas) 2013 dengan pendekatan potong lintang bertujuan mengetahui mekanisme hubungan berbagai variabel laten terhadap prevalensi panjang badan lahir pendek. Sampel adalah 497 kabupaten yang diagregat dari data individu, yaitu anak lahir dari ibu berusia 15 hingga 49 tahun dengan kriteria anak kandung dan lahir tunggal. Pemodelan menggunakan Structural Equation Modelling. Kehamilan berisiko tinggi berhubungan positif langsung dengan prevalensi panjang badan lahir pendek (r = 0,279; nilai p = 0,014). Pemanfaatan pelayanan kesehatan berhubungan positif tidak langsung dengan prevalensi panjang badan lahir pendek melalui kehamilan berisiko tinggi (r = 0,135; nilai p = 0,029). Sosial ekonomi tidak berhubungan signifikan dengan prevalensi panjang badan lahir pendek (r = -0,087; nilai p = 0,156), namun akan berhubungan bila melalui mekanisme hubungan pemanfaatan pelayanan kesehatan (r = 0,653; nilai p = 0,0001) dan kehamilan berisiko tinggi (r = 0,759; nilai p = 0,0001). Upaya intervensi perlu difokuskan pada pencegahan kehamilan berisiko tinggi melalui perbaikan status gizi dan kesehatan ibu sejak usia remaja untuk menurunkan prevalensi panjang badan lahir pendek. The prevalence of short birth length in Indonesia still high and it becomes a public health problem caused by any direct and indirect factors as well as having a wide and sustainable effect in life cycle. The study used Basic health system (Riskesdas) 2013 data with a cross-sectional approach aiming to find out the mechanism of the relation between any latent variables to the short birth length prevalence. Samples were 497 districts aggregated from individual data that were children children born by 15 - 49 year-old mothers with biological children and single birth criteria. The modelling used Structural Equation Modeling. High-risk pregnancy had a direct positive relation with the prevalence of short birth length (r = 0.279; p value= 0.014). The use of health services had an indirect positive relation with short birth length prevalence through high-risk pregnancy (r = 0.135; p value= 0.029). Social economy did not have any significant relation with the prevalence of short birth length (r = -0.087; p value = 0.156), but would be related if through the mechanism of health service use (r = 0.653 ; p value = 0.0001) and high-risk pregnancy (r = 0.759 ; p value = 0.0001). Efforts of intervention need to be focused on prevention of high-risk pregnancy through improvement of nutritional and health status of mothers since teenager in order to reduce short birth length prevalence.
Risiko Ergonomi Ketidaksesuaian Desain dan Ukuran Tempat Duduk Sepeda Motor terhadap Antropometri pada Mahasiswa Djunaidi, Zulkifli; Arnur, Rahmadani
Kesmas Vol. 9, No. 3
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Transportasi merupakan hal yang sangat dibutuhkan dalam menunjang pembangunan nasional. Belum baiknya sistem transportasi massal di Indonesia, membuat masyarakat lebih memilih menggunakan kendaraan pribadi, seperti sepeda motor yang praktis dan ekonomis untuk digunakan. Namun, dalam menggunakan sepeda motor, aspek ergonomi dan kenyamanan bagi pengendara perlu untuk diperhatikan. Desain dan ukuran tempat duduk sepeda motor yang tidak sesuai dengan antropometri duduk statis pengendara dapat menimbulkan kelelahan pada pengendara dan mengakibatkan terjadinya kecelakaan. Tujuan dari penelitian ini adalah untuk mengetahui risiko ergonomi dari ketidaksesuaian antara desain dan ukuran tempat duduk sepeda motor dengan antropometri duduk statis. Untuk menganalisis risiko ergonomi, dilakukan penelitian dengan desain deskriptif analitik pada mahasiswa di sekitar lingkungan kampus Fakultas Kesehatan Masyarakat Universitas Indonesia pada bulan Oktober sampai dengan Desember 2009. Jumlah sampel sebanyak 100 orang responden, dibagi menjadi 50 orang laki-laki dan 50 orang perempuan. Sampel responden dipilih dengan metode cluster random sampling, sedangkan tipe sepeda motor dipilih berdasarkan yang paling banyak digunakan dengan metode simple stratified random sampling. Hasil penelitian menunjukkan bahwa terdapat ketidaksesuaian antara ukuran tempat duduk sepeda motor dengan antropometri duduk statis pada mahasiswa. Adanya ketidaksesuaian tersebut dapat mengakibatkan risiko ergonomi pada pengendara dan terjadinya kecelakaan lalu lintas. Transportation is something needed most to support national development. Bad mass transportation system in Indonesia, makes people prefer to use private vehicles, such as motorcycle which is practical and economical to use. However, riders need to consider ergonomic and comfortability aspects in using motorcycle. The design and size of motorcycle seat in compatible with the rider’s static seat anthropometry may cause fatigue among riders and lead to accidents. The study aimed to find out ergonomic risks of incompatibility between the design and size of the motorcycle seat with static sitting anthropometry. To analyze the ergonomic risks, this study was conducted using analitical descriptive design among college students at Public Health Faculty Universitas Indonesia on October to December 2009. The total sample was 100 respondents, divided into 50 men and 50 women. The sample of respondents was selected using random cluster sampling method, meanwhile the type of motorcycle was selected based on the most widely used with simple stratified random sampling method. The results showed any incompatibility between the size of motorcycle seat with static sitting anthropometry among collage students. Such incompatibility may cause ergonomic risks among rider and lead to traffic accidents.
Model Pengendalian Faktor Risiko Stunting pada Anak Bawah Tiga Tahun Kusumawati, Erna; Rahardjo, Setiyowati; Sari, Hesti Permata
Kesmas Vol. 9, No. 3
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Stunting merupakan masalah gizi, terbukti data pemantauan status gizi Kabupaten Banyumas 2012 prevalensi stunting sebesar 28,37% dan prevalensi tertinggi (41,6%) di Puskesmas Kedungbanteng. Tujuan penelitian untuk menganalisis faktor risiko terkait faktor anak, ibu, lingkungan terhadap stunting bawah tiga tahun (batita) agar dapat dikembangkan model pengendaliannya. Penelitian menggunakan desain kasus kontrol, populasi adalah seluruh anak usia 6 sampai 36 bulan di Puskesmas Kedungbanteng Kabupaten Banyumas selama enam bulan tahun 2013. Sampel kasus adalah 50 batita stunting, sampel kontrol adalah 50 batita status normal. Teknik pengambilan sampel kasus diambil dari tujuh desa yang terbanyak stuntingnya, sedangkan kontrol adalah batita normal tetangga terdekat kasus dengan usia yang disamakan. Pengumpulan data dengan wawancara dan pengukuran. Analisis data univariat, bivariat (uji kai kuadrat), dan multivariat (uji regresi logistik ganda). Hasil penelitian menemukan karakteristik batita stunting terkena penyakit infeksi (82%), riwayat panjang badan lahir < 48 centimeter (66%), riwayat pemberian ASI dan makanan pendamping ASI kurang baik (66%), riwayat berat badan lahir rendah (8%). Pada penelitian ini, faktor risiko stunting adalah penyakit infeksi, pelayanan kesehatan, immunisasi, pengetahuan ibu, pendapatan keluarga, ketersediaan pangan keluarga, dan sanitasi lingkungan. Faktor yang paling dominan adalah penyakit infeksi. Model pengendalian stunting melalui peningkatan pemberdayaan keluarga terkait pencegahan penyakit infeksi, memanfaatkan pekarangan sebagai sumber gizi keluarga dan perbaikan sanitasi lingkungan. Stunting is a nutritional problem, proved by the evidence of nutritional status monitoring at Banyumas District in 2012, the prevalence of stunting was 28.37% and the highest prevalence 41.6% at Kedungbanteng Primary Health Care. This study aimed to analyze risk factors related to child, maternal, and environmental factors toward stunting among children under three year old in 2013 in order to develop the control model. This study used case control design, the population was all children aged of six to 36 months at Kedungbanteng Primary Health Care, Banyumas District. Sample was 50 stunting children, while the control sample was 50 normal children. Sampling technique was taken from seven villages with the highest stunting number, meanwhile the control was normal children living closest to the case with similar age. Data was collected through interview and measurement. Data analysis was conducted in univariate, bivariate (chi-square test), and multivariate analyze (multiple logistic regression test). The results found that characteristics of stunting children under three years old were often suffering infectious diseases (66%), having body length record < 48 centimeter (66%), bad records of breastfeeding and comlementary feeding (66%), and record of low birth weight (8%).Stunting risk factors in this study were infectious disease, health services, immunization, maternal knowledge, family income, family food availability, and environmental sanitation. The most dominating factor was infectious disease. The stunting control model through enhancement of family empowerment related to infectious disease prevention, utilization yard as a family nutrition source and environmental sanitation repair.
Lama Merokok dan Jumlah Konsumsi Rokok terhadap Trombosit pada Laki-laki Perokok Aktif Sundari, Rini; Widjaya, Dinyar Supiadi; Nugraha, Aditya
Kesmas Vol. 9, No. 3
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Jumlah perokok dan jumlah rokok yang dikonsumsi mengalami peningkatan dari waktu ke waktu. Rokok dapat memengaruhi trombosit yang dapat menyebabkan gangguan kardiovaskular. Penelitian ini merupakan penelitian potong lintang yang bertujuan untuk menganalisis lama merokok dan jumlah rokok yang dikonsumsi terhadap jumlah trombosit, mean platelet volume (MPV), platelet distribution width (PDW), platelet crit (PCT), dan platelet large cell ratio (PLCR). Penelitian dilakukan di Pabrik Garmen Cimahi pada tahun 2014 yang diikuti oleh 31 laki-laki perokok aktif berusia 19 - 50 (32,97 + 10,28) tahun, 70,9% di antaranya sebagai perokok sedang. Analisis data dilakukan secara deskriptif, uji normalitas Shapiro-Wilk, dan uji korelasi Spearman’s rho. Peserta telah merokok selama minimal dan maksimal dengan rata-rata (+ SB), yaitu 3 - 25 tahun (10,48 + 6,33) dan konsumsi rokok sebanyak 5 - 25 batang per hari (13,10 + 4,99). Jumlah trombosit 171 - 422 (280,9 + 56,2) x 10^3 sel/mm3, MPV 8,8 - 13,6 (10,14 + 0,93) fL, PDW 8,7 - 13,8 (10,27 + 1,22) fL, PLCR 14,4 - 38,8% (24,91 + 5,46), dan PCT 0,1 - 0,4%(0,28 + 0,06). Sebaran ukuran trombosit ditemukan normal, namun dengan ukuran besar sesuai nilai MPV dan PLCR yang tinggi. PCT normal berkorelasi sangat kuat dengan jumlah trombosit. Jumlah batang rokok yang dikonsumsi berkorelasi lemah dengan lamanya merokok. Lama merokok dan jumlah rokok yang dikonsumsi berkorelasi negatif dengan jumlah trombosit, MPV, PDW maupun PLCR. Number of smokers and cigarette consumption are increasing from time to time. Cigarettes influence thrombocytes which may cause cardiovascular disorder. This study was a cross sectional study aiming to analyze smoking period and cigarette consumption number toward the number of thrombocytes, MPV, PDW, PCT and PLCR. This study was conducted at Cimahi Garment Factory in 2014 participated by 31 active male smokers in age of 19 - 50 (32,97+10,28) years old in which 70,9% of them were medium smokers. Data analysis was conducted descriptively, using Shapiro-Wilk normality test and Spearman’s rho correlation test. Participants had been smoking for the minimum and maximum 3 - 25 (10.48 + 6.33) years and 5 - 25 (13.10 + 4.99) cigarettes in average per day. The number of thrombocytes was worth 171 - 422 (280,9 + 56,2)x10^3 cells/mm3, MPV 8.8 - 13.6 (10.14 + 0.93) fL, PDW 8.7 - 13.8 (10.27+ 1.22) fL, PLCR 14.4 - 38.8% (24.91 + 5.46) and PCT 0.1 - 0.4% (0.28 + 0.06). PDW was found normal with the giant shape in accordance with the high MPV and PLCR value. PCT was normal correlated strongly with thrombocyte number. The cigarette consumption number had a weak correlation with the smoking period. The smoking period and the cigarette consumption number had a negative correlation with the number of thrombocytes, MPV, PDW and PLCR.
Kejadian Anemia pada Siswa Sekolah Dasar Sirajuddin, Saifuddin; Masni, Masni
Kesmas Vol. 9, No. 3
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Anemia gizi besi masih merupakan masalah kesehatan masyarakat dengan prevalensi pada anak 5 - 12 tahun sebesar 29% di Indonesia dan di Kota Makassar sebesar 37,6%. Penelitian ini bertujuan untuk mengetahui faktor determinan (status kecacingan, status seng, kebiasaan sarapan pagi, pola konsumsi makanan sumber heme dan nonheme, pola konsumsi sumber makanan pelancar dan penghambat zat besi) terhadap kejadian anemia. Desain penelitian yang digunakan adalah potong lintang yang dilaksanakan pada bulan April – Juni 2014. Penelitian ini menggunakan desain potong lintang yang dilaksanakan pada siswa kelas 3 - 5 SD Negeri Cambaya Kecamatan Ujung Tanah Kota Makassar. Sampel sebanyak 120 siswa yang dipilih secara acak sederhana. Analisis data dilakukan secara univariat, bivariat dengan uji kai kuadrat dan multivariat dengan regresi logistik. Hasil penelitian menunjukkan faktor determinan kejadian anemia adalah status kecacingan (nilai p = 0,007), kebiasaan sarapan pagi (nilai p = 0,002), pola konsumsi makanan sumber heme (nilai p = 0,004), dan pola konsumsi sumber makanan penghambat zat besi (nilai p = 0,016). Hasil analisis multivariat menunjukkan bahwa pola konsumsi makanan sumber heme (OR = 5,09 dan 95% CI = 1,98 – 13,08) dan pola konsumsi sumber makanan penghambat zat besi (OR = 4,53 dan 95% CI = 1,65 – 12,43) adalah determinan utama kejadian anemia gizi. Iron deficiacy anemia has been a public health problem with prevalence on 5 - 12 year old children worth 29% in Indonesia and 37.6% in Makassar. This study aimed to determine the determinant factors (worm status, zinc status, breakfast habit, consumption pattern of heme and nonheme source of food, consumption pattern of iron enhancer and inhibitor food) toward anemia incidence. The study used cross sectional design conducted in April - June 2014. The population was third to fifth grade students of Cambaya State Elementary School at Ujung Tanah District , Makassar City. Sample of 120 students were selected randomly. Data was analyzed using univariate, bivariate with chi-square test, and multivariate with logistic regression test. The results showed that the determinant factors of anemia incidence were wormy status (p value = 0.007), breakfast habits (p value = 0.002), consumption pattern of heme and non-heme source of food (p value = 0.004), and consumption pattern of iron enhancer and inhibitor (p value = 0.016). Multivariate analysis result showed that consumption pattern of heme (OR = 5.09 and 95% CI = 1.98 - 13.08) and consumption pattern of iron enhancer and inhibitor food (OR = 4.53 and 95% CI = 1. 65 - 12.43) was a major determinant of nutritional anemia.
Pencegahan Resurgensi Malaria dengan Deteksi Dini dan Pengobatan Segera di Daerah Reseptif Supriyani, Teni; Achmadi, Umar Fahmi; Susanna, Dewi
Kesmas Vol. 9, No. 3
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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.
Diabetes Melitus dan Tingkat Keparahan Jaringan Periodontal Rikawarastuti, Rikawarastuti; Anggreni, Eka; Ngatemi, Ngatemi
Kesmas Vol. 9, No. 3
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Penyakit periodontal merupakan masalah kesehatan gigi dan mulut dengan prevalensi cukup tinggi di Indonesia (60%). Diabetes melitus merupakan salah satu faktor predisposisi terjadinya penyakit periodontal. Tujuan penelitian adalah menganalisis hubungan diabetes melitus terhadap tingkat keparahan jaringan periodontal. Jenis penelitian observasional analitik potong lintang. Penelitian dilakukan di Puskesmas Kecamatan Jagakarsa Jakarta Selatan pada bulan Oktober - November 2014 dengan populasi penelitian adalah pengunjung Puskesmas Kecamatan Jagakarsa. Pengambilan sampel menggunakan simple random sampling sebanyak 122 orang. Status diabetes melitus didapat dari rekam medis poli penyakit tidak menular. Analisis data menggunakan kai kuadrat dan regresi logistik sederhana. Hasil penelitian menunjukkan proporsi penderita diabetes melitus usia > 50 tahun mengalami kerusakan jaringan periodontal yang lebih parah dibandingkan penderita diabetes melitus ≤ 50 tahun. Kelompok diabetes melitus berisiko 3,5 kali mengalami keparahan jaringan periodontal dibandingkan kelompok nondiabetes melitus, OR = 3,505 (1,609 – 7,634), nilai p = 0,002. Kelompok diabetes melitus tidak terkendali berisiko 2,5 kali mengalami keparahan jaringan periodontal dibandingkan kelompok diabetes melitus terkendali, nilai OR = 2,514 (0,892 – 7,085), nilai p = 0,12 disebabkan ukuran sampel terlalu kecil. Penderita diabetes melitus lebih berisiko mengalami keparahan jaringan periodontal dibandingkan dengan nondiabetes melitus. Pada diabetes melitus tidak terkendali, risiko penyakit periodontal semakin tinggi. Periodontal disease is a teeth and oral health problem, with a quite high prevalence in Indonesia (66%). Diabetes mellitus one of predisposing factors of periodontal occurence. This study aimed to analyze relation between diabetes mellitus and the severity of periodontal tissue. The study was observational analytic study with cross-sectional design. The study was conducted in Jagakarsa District Primary Health Care of South Jakarta on October to November 2014 with the primary health care visitors as population. Sample was taken using simple random sampling as much as 122 respondents. Diabetes mellitus status was identified from the non-infectious disease medical record. Data analysis used chi-square and simple logistic regression. Results showed proportion of diabetes mellitus patients > 50 years suffered periodontal tissue damage more severe than ≤ 50 years old patients. Diabetes mellitus group had 3.5 times risk of suffering severe periodontal tissue than nondiabetes mellitus group, OR = 3.505 (1.609 - 7.634), p value = 0.002. Uncontrolled diabetes mellitus group had 2.5 times risk of suffering severe periodontal tissue than controlled diabetes mellitus group, OR = 2.514 (0.892 - 7.085), p value = 0.12 due too small size of sample. Diabetes mellitus sample patients were more risky to suffer severe periodontal tissue than nondiabetes mellitus patients. On uncontrolled diabetes mellitus, the risk of periodontal disease was getting higher.
ASI Eksklusif dan Persepsi Ketidakcukupan ASI Prabasiwi, Adila; Fikawati, Sandra; Syafiq, Ahmad
Kesmas Vol. 9, No. 3
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Persepsi ketidakcukupan air susu ibu (PKA) adalah keadaan ibu merasa ASI-nya tidak cukup untuk memenuhi kebutuhan bayinya. PKA merupakan salah satu penyebab utama kegagalan ASI eksklusif di dunia. Penelitian ini bertujuan untuk mengetahui faktor paling dominan berhubungan dengan PKA di Kecamatan Tegal Selatan dan Kecamatan Margadana, Kota Tegal tahun 2014. Penelitian ini merupakan penelitian primer dengan desain studi potong lintang. Sampel berjumlah 88 ibu dari bayi berusia 0 - 6 bulan yang dipilih secara purposive sampling. Status gizi ibu dilihat dari kenaikan berat badan ibu sewaktu hamil apakah sesuai dengan rekomendasi dari Institute of Medicine. Asupan energi ibu saat laktasi diukur melalui wawancara dengan menggunakan semi-quantitative-Food Frequency Questionnaire (FFQ / Food Amount Questionnaire (FAQ)). Untuk variabel pengetahuan, digunakan kuesioner terstruktur. Uji analisis yang digunakan adalah uji kai kuadrat (bivariat) dan uji regresi logistik ganda (multivariat). Hasil penelitian menunjukkan bahwa sebanyak 51,1% ibu mengalami PKA. Variabel pengetahuan (nilai p = 0,001), asupan energi (nilai p = 0,019) dan Inisiasi Menyusu Dini (IMD) (nilai p = 0,048) berhubungan signifikan dengan PKA setelah dikontrol variabel status gizi, paritas, rawat gabung, perlekatan menyusui, dukungan keluarga, dan dukungan tenaga kesehatan. Faktor pengetahuan merupakan faktor yang paling dominan berhubungan dengan PKA. Perception of insufficient milk supply (PIM) is the condition in which a mother feels that her breastmilk is insufficient to meet the needs of their babies. Such perception is one of main reasons of the exclusive breastfeeding failure in the world. This study aimed to find out the most dominant factors related to PIM in Tegal Selatan District and Margadana Sub-Districts at Tegal City in 2014. This study was a primary study with a cross sectional design. A total sample of 88 mothers of 0 - 6 months old babies selected in by purposive sampling. Mother’s nutritional status was seen from the increasing of mother’s weight gain during the pregnancy was it met the standards from Institute of Medicine. The mother’s energy intake during lactation was measured through interview using semi-quantitative Food Frequency Questionnaire (FFQ / Food Amount Questionnaire (FAQ)) form. Knowledge variable used structured questionnaire. Analysis used are chi square test (bivariate) and multiple regression logistic (multivariate). The result showed that 51.1% mothers experienced PIM. Variables knowledge (p value = 0.001), energy intake (p value = 0.019), and early initiation of breastfeeding (p value = 0.048) were significantly related to perception after controlled by nutritional status, parity, rooming-in, latch on, family support, and health practitioners support variable. Knowledge is the most dominant factor related to the PIM.
Tumor Necrosis Factor-α sebagai Prediktor Terjadinya Anemia pada Ibu Hamil di Wilayah Endemis Malaria Flora, Rostika; Mukni, Mukni; Girsang, Bina Melvia; Purwanto, Sigit
Kesmas Vol. 9, No. 3
Publisher : UI Scholars Hub

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Abstract

Ibu hamil yang berada di daerah endemis malaria sangat rentan terhadap infeksi malaria selama kehamilan. Gejala malaria pada kelompok ini sering asimptomatik atau bahkan tidak terdeteksi sama sekali karena adanya efek imunitas protektif melalui infeksi yang berulang. Adanya peningkatan kadar tumor necrosis factor-alpha (TNF-α) dapat dijadikan indikator terjadinya infeksi malaria. TNF-α berperan penting dalam respons imun pada malaria akut yang menghambat terjadinya eritropoesis. Penelitian ini bertujuan untuk mengetahui hubungan antara kadar TNF-α dengan kejadian anemia pada ibu hamil didaerah endemik malaria vivax. Penelitian ini menggunakan desain potong lintang, dilakukan pada bulan Januari - Februari 2014 di lima wilayah kerja puskesmas Kota Bengkulu. Sampel penelitian adalah ibu hamil di daerah endemis malaria vivax yang diambil secara accidental sampling. Dilakukan pengambilan darah untuk pemeriksaan mikroskopis malaria, kadar TNF-α dan kadar hemoglobin (Hb). Hasil penelitian menunjukkan seluruh ibu hamil memiliki riwayat pernah terinfeksi malaria vivax, walaupun hasil pemeriksaan slide negatif. Terjadi peningkatan kadar TNF- α dengan rerata 6,90 ± 2,48 pg/mL dan penurunan kadar Hb dengan rerata 9,75 ± 0,88 g%. Uji korelasi Spearman didapatkan korelasi negatif yang kuat (r = -0,734) dan bermakna (nilai p < 0,05) antara Kadar TNF-α dengan kadar Hb. Terdapat hubungan yang bermakna antara kadar TNF-α dengan kejadian anemia. Pregnant mothers living in malaria - endemic area are very susceptible to malaria infection during pregnancy. Malaria symptoms in this group are often asymptomatic or even not detected at all due to protective immunity effect through repeated infections. Any elevation of tumor necrosis factor-alpha (TNF-α) level can be used as indicator of malaria infection. TNF-α takes an important role in immune response on acute malaria that hinders occurence eritropoesis process. This study aimed to find out relations between TNF-α level and anemia occurrence among pregnant women living in malaria vivax - endemic areas. The study used cross-sectional design conducted on January to February 2014 in five working areas in Bengkulu city. Sample of study was pregnant mothers in malaria vivax - endemic areas which was taken through accidental sampling. Blood was taken for malaria-microscopic examination, TNF-α and haemoglobine (Hb) level. The results showed that all of pregnant mothers have malaria vivax - infected record, although slide examination showed negative result. Any TNF-α level elevation with average 6.90 ± 2.48 pg/mL and decrease of Hb level with average 9.75 ± 0.88 g%. Spearman correlation test showed strong negative correlation (r = -0.734) and significant (p value < 0.05) between TNF-α level and Hb level. There was significant relation between TNF-α level and anemia occurrence.

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