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"The development of aquaculture in Indonesia has been hampering by the spread of KHV ( Koi Herpes Virus) disese since 2003 which destroyedbillions rupiah and was going on up to now...."

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Pada pagi hari yang berbahagia ini perkenankanlah saya memanjatkan puji svukur ke hadirat Allah SWT yang telah melimpahkan rahmat dan karuniaNya kepada kita semua sehingga upacara pengukuhan saya sebagai Guru Besar Tetap di Universitas Indonesia dapat diselenggarakan.

Perkembangan sosial-ekonomi dalam era globalisasi ini telah menambah kompleksnya masalah kesehatan di Indonesia. Pada saat penyakit infeksi masih belum dapat dikendalikan dengan baik. penyakit non infeksi seperti penyakit degeneratif. keganasan jantung dan sebagainya mulai meningkat sehingga terjadi beban ganda.

Pada saat ini kita berada dalam era peralihan pola penyakit. Pada bulan Januari yang lalu Badan Litbang Kesehatan RI. mengadakan diskusi ilmiah mengenai Emerging Infectious Diseases; yaitu penyakit infeksi baru, yang timbul kembali atau resister terhadap obat yang insidensnya telah meningkat dalam 20 tahun terakhir atau berpotensi untuk meningkat di masa yang akan datang.

Apa yang sekiranya dapat dianggap sebagai penyebab fenomena ini ? Perilaku masyarakat modern dengan gaya hidup baru dapat menjadi salah satu penyebabnya. Pertumbuhan penduduk yang tinggi dan terjadinya urbanisasi yang tidak diimbangi dengan sarana dan prasarana, telah menambah luasnya daerah kumuh di perkotaan. Perkembangan teknologi yang cepat dan tuntutan kebutuhan manusia yang meningkat dapat menyebabkan terjadinya perubahan lingkungan sehingga timbul masalah kesehatan lingkungan yang erat hubungannya dengan penyakit infeksi. Kurangnya air bersih, pencernaran tanah dan air oleh limbah industri dan limbah rumah tangga termasuk tinja, menciptakan kondisi lingkungan fisik yang memungkinkan perkembangan vektor dan sumber infeksi. Fenomena tersebut berlaku juga untuk salah satu kelompok penyakit infeksi yaitu penyakit parasitik.

Hadirin yang terhormat,

Sesuai dengan keahlian dan tugas saya sebagai staf pengajar di Fakultas Kedokteran Universitas Indonesia, pada kesempatan ini saya memilih judul pidato pengukuhan :

"Beberapa Infeksi Parasitik Masa Lampau dan Masa Kini di Indonesia"

Pertama, saya ingin menyampaikan mengenai sekelompok penyakit parasit yang sudah lama bercokol di masyarakat, dan masih tetap menjadi bahan pembicaraan yang muncul di berbagai media masa dan masih tetap menjadi masalah hangat yaitu :

Infeksi cacing usus yang ditularkan melalui tanah

Infeksi casing usus yang dimaksud di atas adalah infeksi yang disebabkan oleh cacing yang ditularkan melalui tanah, telur dan larvanya menjadi bentuk infektif di tanah. Dalam bahasa sehari-hari infeksi ini disebut cacingan. Infeksi dengan cacing usus yaitu Ascaris lumbricoides, Trichuris trichiura dan cacing tambang (Necator americanus dan Ancylostoma duodenale) masih merupakan masalah kesehatan masyarakat di daerah tropik, termasuk Indonesia.

Cacingan merupakan penyakit rakyat yang sangat erat kaitannya dengan masalah lingkungan. Lingkungan yang kumuh merupakan tempat subur untuk berkembang biaknya cacing-cacing penyebab cacingan.

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"The study of the patterns of nematode infection on rodents in Lore Lindu,Central Sulawesi was carried out. A total of 52 rodents were examined...."

"[Ilmu Kedokteran Gigi merupakan salah satu bidang yang rawan untukterjadinya kontaminasi silang antara pasien-dokter gigi, pasien-pasien dan pasien perawat. Kontrol Infeksi dapat mencegah terjadinya infeksi silang. Tujuan: Melihat hubungan Pengetahuan, Perilaku dan Faktor Lingkungan terhadap keberhasilan upaya Kontrol infeksi pada Mahasiswa Program Profesi Fakultas Kedokteran gigi Univesritas“x” di Jakarta. Metode: Metode penelitian yang digunakan cross sectional dengan Model penelitian Sequential Explonatory design. Penelitian dilakukan pada Mahasiswa Program Profesi Fakultas Kedokteran Gigi Universitas “X” di Jakarta yang sudah melewatipendidikan profesi selama 2 (dua) semester, dengan jumlah sampel sebanyak 101 mahasiswa. Hasil: Upaya Kontrol Infeksi pada Mahasiswa Program Profesi Fakultas Kedokteran gigi universitas “X” di Jakarta masih kurang baik.Ini dipengaruhi oleh pengetahuan, perilaku dan faktor lingkungan masih kurang baik dan mempunyai p value< 0,05 sehingga mempunyai hubungan yang signifikan terhadap upaya kontrol infeksi. Kesimpulan: Pengetahuan dan Perilaku dapat ditingkatkan dengan membentuk program yang berisikan promosi kesehatan dalam bentuk poster-poster, standart operasional prosedur berdasarkan standard precautions dan seminar-seminar bagimahasiswa program profesi fakultas kedokteran gigi;Background: Dentistry is one of a science which has a high sensitivity to causedcross-contamination between the patient-dentist, patient-patient and patient-nurse. Infection control may prevent cross-infection. Objective: Knowing the relationship between Knowledge, Behavior and Environmental Factors with successfull of Infection Control by the students of Professional Program Study of the Faculty of Dentistry, Universitas "x" in Jakarta. Methods: The method used is cross sectional with research model Sequential Explonatory Design. The study which has the total sample of 101 students was conducted and involved thestudents of Professional Program Study of the Faculty of Dentistry, University "X" in Jakarta, which has passed the professional education for two (2) semesters. Results: Infection Control Efforts conducted by the student of Professional Program Study Faculty of Dentistry, University "X" in Jakarta is not maximal. It was affected by the Knowledge, Behavior and Environmental Factors which not good enough and has a p value <0.05 and therefore has a significant relationship which infection control effort. Conclusion: Knowledge and Behavior can be improved by establishing a program containing health promotion in the form of posters, standard operating procedures based on standard precautions and seminars for the students of Professional Program Study of the faculty of dentistry., Background: Dentistry is one of a science which has a high sensitivity to causedcross-contamination between the patient-dentist, patient-patient and patient-nurse.Infection control may prevent cross-infection. Objective: Knowing therelationship between Knowledge, Behavior and Environmental Factors withsuccessfull of Infection Control by the students of Professional Program Study ofthe Faculty of Dentistry, Universitas "x" in Jakarta. Methods: The method used iscross sectional with research model Sequential Explonatory Design. The studywhich has the total sample of 101 students was conducted and involved thestudents of Professional Program Study of the Faculty of Dentistry, University"X" in Jakarta, which has passed the professional education for two (2) semesters.Results: Infection Control Efforts conducted by the student of ProfessionalProgram Study Faculty of Dentistry, University "X" in Jakarta is not maximal. Itwas affected by the Knowledge, Behavior and Environmental Factors which notgood enough and has a p value <0.05 and therefore has a significant relationshipwhich infection control effort. Conclusion: Knowledge and Behavior can beimproved by establishing a program containing health promotion in the form ofposters, standard operating procedures based on standard precautions andseminars for the students of Professional Program Study of the faculty ofdentistry.]"

"ABSTRAK Latar belakang : Cytomegalovirus (CMV) merupakan salah satu infeksi oportunistikpada pasien dengan sindrom immunodefisiensi (AIDS). Gejala klinis dan CT scantidak dapat menegakkan diagnosa definitif ensefalitis CMV. Oleh karena itudiperlukan uji alternatif untuk menegakkan diagnosis infeksi CMV pada pasien HIVdengan infeksi otak. Salah satu uji yang sensitif dan spesifik adalah Real TimePolymerase Chain Reaction (rPCR).Tujuan : Mendapatkan uji deteksi molekular CMV pada pasien HIV dengantersangka infeksi otak.Metode : Penelitian dilakukan dalam 3 tahap. Tahap 1 adalah optimasi konsentrasiprimer, probe, suhu annealing, volume elusi ekstraksi DNA, dan volume cetakan.Tahap 2 adalah uji spesifisitas (reaksi silang) dan uji sensitivitas (ambang batasdeteksi DNA) rPCR dan tahap 3 adalah penerapan uji rPCR yang sudah dioptimasiterhadap sampel plasma, urin, dan LCS.Hasil : Kondisi optimal uji rPCR telah diperoleh dengan konsentrasi primer danprobe 0,1 μM, dengan kondisi suhu reaksi rPCR: aktivasi enzim pada 950C selama 3menit; 45 siklus pada 950C selama 15 detik (denaturasi) dan 560C selama 1 menit(annealing dan ekstensi). Volume elusi ekstraksi DNA yang optimal untuk ketigajenis sampel (LCS, plasma dan urin) adalah 40 μL, dan volume cetakan rPCR untukLCS, plasma, dan urin, masing-masing adalah 5, 4, dan 3 μL. Uji rPCR mampumendeteksi DNA pada 50.000 jumlah kopi/mL dan tidak bereaksi silang denganStaphylococcus aureus, Staphylococcus epidermidis, Staphylococcus saprophyticus,Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Mycobacteriumtuberculosis, Candida spp, Toxoplasma gondii, EBV,HSV,dan VZV. Penerapan ujirPCR pada sampel klinis memberikan hasil negatif pada semua sampel LCS, 72,22%positif pada sampel plasma, dan 72,22% positif pada sampel urin.Kesimpulan: Telah dilakukan optimasi uji rPCR dengan minimal deteksi DNACMV 50.000 jumlah kopi/mL dan tidak bereaksi silang dengan mikroorganisme yangberpotensi menyebabkan positif palsu (false positive).ABSTRACT Background: Cytomegalovirus (CMV) is one of opportunistic infections in patientswith Aquired Immunodeficiency Syndrome (AIDS). Clinical manifestations are nottypical, and CT scans can not define encephalitis CMV specifically. Therefore, it isimportant to apply an alternative assay for sensitive and specific detection of CMVinfection in HIV patients with suspected central nervous system (CNS) infections.One of the assays is real time polymerase chain reaction (rPCR).Objective: To obtain a molecular assay for detection of CMV in HIV patients withsuspect CNS infections.Methods: This study was conducted in three phases. The first is optimization ofconcentrations of primers, probe, annealing temperature, final elution of DNAextraction, and volume of PCR template. The second is determinations of sensitivity(minimal detection of DNA) and specificity (cross-reaction) of the optimized rPCR,and the third is application of the rPCR for clinical samples of plasma, urine, andliquor cerebrospinal (LCS).Results: The rPCR reaction showed optimal concentrations of primers and probe at0.1 μM, with thermal cycler: 950C for 3 min (enzyme activation), followed by 45cycles of 950C for 15 sec (denaturation) and 560C for 1 min (annealing andextension). Final elution of DNA extraction was 40 μL and volume of PCR templatesfor urine, plasma, and LCS was 3, 4, and 5 μL, respectively. The rPCR had minimaldetection of DNA at 50,000 copies/mL and was not cross-reacted withStaphylococcus aureus, Staphylococcus epidermidis, Staphylococcus saprophyticus,Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Mycobacteriumtuberculosis, Candida spp, Toxoplasma gondii, Epstein-Bar Virus (EBV), HerpesSimplex Virus (HSV) and Varicella Zoster Virus (VZV). Application of rPCR forclinical samples showed that the rPCR yielded 72.22% positive for plasma or urine,and negative for all LCS samples.Conclusion: The rPCR has been optimized in this study with minimal DNA detectionat 50,000 copies/mL and was not cross-reacted with other microorganisms that arepotential to cause false positive results.;Background: Cytomegalovirus (CMV) is one of opportunistic infections in patientswith Aquired Immunodeficiency Syndrome (AIDS). Clinical manifestations are nottypical, and CT scans can not define encephalitis CMV specifically. Therefore, it isimportant to apply an alternative assay for sensitive and specific detection of CMVinfection in HIV patients with suspected central nervous system (CNS) infections.One of the assays is real time polymerase chain reaction (rPCR).Objective: To obtain a molecular assay for detection of CMV in HIV patients withsuspect CNS infections.Methods: This study was conducted in three phases. The first is optimization ofconcentrations of primers, probe, annealing temperature, final elution of DNAextraction, and volume of PCR template. The second is determinations of sensitivity(minimal detection of DNA) and specificity (cross-reaction) of the optimized rPCR,and the third is application of the rPCR for clinical samples of plasma, urine, andliquor cerebrospinal (LCS).Results: The rPCR reaction showed optimal concentrations of primers and probe at0.1 μM, with thermal cycler: 950C for 3 min (enzyme activation), followed by 45cycles of 950C for 15 sec (denaturation) and 560C for 1 min (annealing andextension). Final elution of DNA extraction was 40 μL and volume of PCR templatesfor urine, plasma, and LCS was 3, 4, and 5 μL, respectively. The rPCR had minimaldetection of DNA at 50,000 copies/mL and was not cross-reacted withStaphylococcus aureus, Staphylococcus epidermidis, Staphylococcus saprophyticus,Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Mycobacteriumtuberculosis, Candida spp, Toxoplasma gondii, Epstein-Bar Virus (EBV), HerpesSimplex Virus (HSV) and Varicella Zoster Virus (VZV). Application of rPCR forclinical samples showed that the rPCR yielded 72.22% positive for plasma or urine,and negative for all LCS samples.Conclusion: The rPCR has been optimized in this study with minimal DNA detectionat 50,000 copies/mL and was not cross-reacted with other microorganisms that arepotential to cause false positive results.;Background: Cytomegalovirus (CMV) is one of opportunistic infections in patientswith Aquired Immunodeficiency Syndrome (AIDS). Clinical manifestations are nottypical, and CT scans can not define encephalitis CMV specifically. Therefore, it isimportant to apply an alternative assay for sensitive and specific detection of CMVinfection in HIV patients with suspected central nervous system (CNS) infections.One of the assays is real time polymerase chain reaction (rPCR).Objective: To obtain a molecular assay for detection of CMV in HIV patients withsuspect CNS infections.Methods: This study was conducted in three phases. The first is optimization ofconcentrations of primers, probe, annealing temperature, final elution of DNAextraction, and volume of PCR template. The second is determinations of sensitivity(minimal detection of DNA) and specificity (cross-reaction) of the optimized rPCR,and the third is application of the rPCR for clinical samples of plasma, urine, andliquor cerebrospinal (LCS).Results: The rPCR reaction showed optimal concentrations of primers and probe at0.1 μM, with thermal cycler: 950C for 3 min (enzyme activation), followed by 45cycles of 950C for 15 sec (denaturation) and 560C for 1 min (annealing andextension). Final elution of DNA extraction was 40 μL and volume of PCR templatesfor urine, plasma, and LCS was 3, 4, and 5 μL, respectively. The rPCR had minimaldetection of DNA at 50,000 copies/mL and was not cross-reacted withStaphylococcus aureus, Staphylococcus epidermidis, Staphylococcus saprophyticus,Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Mycobacteriumtuberculosis, Candida spp, Toxoplasma gondii, Epstein-Bar Virus (EBV), HerpesSimplex Virus (HSV) and Varicella Zoster Virus (VZV). Application of rPCR forclinical samples showed that the rPCR yielded 72.22% positive for plasma or urine,and negative for all LCS samples.Conclusion: The rPCR has been optimized in this study with minimal DNA detectionat 50,000 copies/mL and was not cross-reacted with other microorganisms that arepotential to cause false positive results.;Background: Cytomegalovirus (CMV) is one of opportunistic infections in patientswith Aquired Immunodeficiency Syndrome (AIDS). Clinical manifestations are nottypical, and CT scans can not define encephalitis CMV specifically. Therefore, it isimportant to apply an alternative assay for sensitive and specific detection of CMVinfection in HIV patients with suspected central nervous system (CNS) infections.One of the assays is real time polymerase chain reaction (rPCR).Objective: To obtain a molecular assay for detection of CMV in HIV patients withsuspect CNS infections.Methods: This study was conducted in three phases. The first is optimization ofconcentrations of primers, probe, annealing temperature, final elution of DNAextraction, and volume of PCR template. The second is determinations of sensitivity(minimal detection of DNA) and specificity (cross-reaction) of the optimized rPCR,and the third is application of the rPCR for clinical samples of plasma, urine, andliquor cerebrospinal (LCS).Results: The rPCR reaction showed optimal concentrations of primers and probe at0.1 μM, with thermal cycler: 950C for 3 min (enzyme activation), followed by 45cycles of 950C for 15 sec (denaturation) and 560C for 1 min (annealing andextension). Final elution of DNA extraction was 40 μL and volume of PCR templatesfor urine, plasma, and LCS was 3, 4, and 5 μL, respectively. The rPCR had minimaldetection of DNA at 50,000 copies/mL and was not cross-reacted withStaphylococcus aureus, Staphylococcus epidermidis, Staphylococcus saprophyticus,Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Mycobacteriumtuberculosis, Candida spp, Toxoplasma gondii, Epstein-Bar Virus (EBV), HerpesSimplex Virus (HSV) and Varicella Zoster Virus (VZV). Application of rPCR forclinical samples showed that the rPCR yielded 72.22% positive for plasma or urine,and negative for all LCS samples.Conclusion: The rPCR has been optimized in this study with minimal DNA detectionat 50,000 copies/mL and was not cross-reacted with other microorganisms that arepotential to cause false positive results."

"ISPA adalah penyakit infeksi yang paling banyak terjadi pada masyarakat Indonesia khususnya pada anak balita, kondisi ini juga terjadi di Kecamatan Jambi Selatan. Beberapa penelitian ISPA pada anak balita banyak dipengaruhi oleh faktor-faktor lingkugan rumah. Permasalahan penelitian ini adalah belum diketahui faktor-faktor lingkungan rumah mana saja yang berhubungan dengan kejadian ISPA pada anak balita di Kecamatan Jambi Selatan. Penelitian ini bertujuan untuk mengetahui faktor-faktor lingkungan rumah dan karakteristik anak balita yang berhubungan dengan kejadian ISPA pada anak balita di Kecamatan Jambi Selatan.Desain penelitian adalah Cross Sectional yang dilaksanakan dengan metode survei menggunakan kuesioner. Jumlah sampel yang diambil sebesar 358 rumah tangga yang ada anak balita, yang diambil secara random di wilayah Kecamatan Jambi Selatan, sebagai responden ibu rumah tangga. Analisa data dengan univariat, bivariat, dengan uji Chi Square, don analisa multivariat dengan uji regresi lagistik model prediksi.Hasil penelitian diperoleh gambaran 35,8% anak balita yang menderita ISPA, kondisi lingkungan rumah dari 10 variabel pada umumnya belum memenuhi syarat, dan karakteristik anak balita masih banyak yang belum mendapat imunisasi lengkap serta stains gizi kurang.Dari 10 variabel yang diduga ada hubungan dengan kejadian ISPA pada anak balita melalui uji Chi Square menunjukkan ada 8 variabel yang berhubungan yaitu konstruksi dinding OR = 2,2 ; jenis lantai OR = 3,1 ; ventilasi OR = 1,7 ; kelembaban OR = 14,4 ; lubang asap dapur OR = 2,7 ; kepadatan penghuni rumah OR = 3 ; kondisi dapur OR = 2,8 ; asap rokok OR = 3,9. variabel yang tidak berhubungan yaitu jenis bahan bakar masak dan obat anti nyamuk bakar.Dan 10 variabel lingkungan rumah, setelah melalui uji multivariate ternyata yang mempunyai hubungan yang bermakna ada 4 variabel, yaitu kepadatan penghuni rumah, kondisi dapur, kelembaban dan asap rokok. Variabel yang paling dominan hubungannya dengan kejadian ISPA pada anak balita di Kecamatan Jambi Selatan adalah kelembaban, dengan persamaan regresi yaitu :Logit Y = -7,837 + 2,187 kelembaban + 1,412 asap rokok + 0,878 kondisi dapur + 0,701 kepadatan penghuni rumah.Variabel perancu tidak ada yang berhubungan dengan kejadian ISPA pada anak balitaKesimpulan bahwa kejadian ISPA pada anak balita ada hubungan dengan empat variabel tersebut dan perlu ada upaya perbaikan. Berkaitan dengan hasil penelitian disarankan kepada Dinas Kesehatan Propinsi Jambi, Dinas Kesehatan Kota. Jambi, semua Puskesmas di wilayah Kecamatan Jambi Selatan untuk merencanakan, memprogramkan pelaksanaan penyuluhan tentang faktor-faktor lingkungan rumah berhubungan terhadap kejadian ISPA pada anak balita, serta memberdayakan kader dasawisma yang ada dan klinik sanitasi.Daftar bacaan : 44 (1983 - 2001)

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The Connection between the Factors of the House Environment with the Appearance of ISPA Disease on Children Under 5 Years Old in Kecamatan Jambi Selatan in 2002ISPA or acute respiratory infection is an infection disease mostly occurs in the community specifically on children under 5 years old in Indonesia, and it appears in Kecamatan Jambi Selatan. Several researches of ISPA on children under 5 years old shows that it is caused by the houses environmental factors. The research problem is the unknown of houses environmental factors which connected to ISPA on children under 5 years old in Kecamatan Jambi Selatan. The research was undertaken to know the figures of the house environmental factors and the characteristic of the children under 5 years old related to the occurrence ofISPA in Kecamatan Jambi Selatan.The design used in this Cross Sectional which is undertaken by survey method, using questioner. The respondents are house-wives who have children under 5 years old The number of samples are 358 homes/houses, taken by random in Kecamatan Jambi Selatan. Data analyzed by univariate, bivariate with Chi Square test, and multivariate analysis with prediction mode of logistic regression test.The result of research is picturing that 35,8% of children under 5 years are suffering ISPA, the houses environment condition of 10 variables are generally poor and the characteristics of the children under 5 years old have not got complete immunization and are in less nutrient status.From 10 variables which are predicted connected with ISPA disease on the children under 5 years old, through the Chi Square test, show that 8 variables related are wall construction OR = 2,2; type of floor OR = 3,1; ventilation OR =1,7; humidity OR = 14,4; kitchen chimney OR = 2,7; human density of house OR = 3; kitchen condition OR = 2,8; cigarette smoke OR = 3,9. The other variable which no connection are kind of cooking fuel and solid mosquito repellent.From the 10 variables of the houses environment, after passing the multivariate test shows that there are 4 variables which have very close connection. There are human density in house, kitchen condition, humidity and cigarette smoke. The most dominant variable on ISPA on the children under 5 years old in Kecamatan Jambi Selatan is the humidity, with regression similarity that is:Logit Y = - 7,837 + 2,187 humidity + 1,412 cigarette smoke + 0,878 kitchen condition + 0,701 human density in house.There is no confusing variable connecting with ISPA disease occurs on the children under 5 years old.The conclusion of the appearance of ISPA on the children under 5 years old, there are 4 variables mentioned before, and improvement must be undertaken to overcome the 4 variables. Due to the result of the research, it is suggested to the Health Official Government of Jambi Province, Health Official of Jambi City, and all PUSKESMAS (Community Health Center) in Kecamatan Jambi Selatan, to provide a planning, and an implementation program of illumination information about house environmental factors which cause the occurance of LSPA to the children under 5 years old, and to push and using the existing Dasawisma and Sanitation Clinic cadres efficiently and effectively.Literature : 44 (1983 - 2001)"

"Penyakit infeksi saluran pernapasan akut (ISPA) termasuk pneumonia masih merupakan salah satu masalah kesehatan masyarakat yang utama di Indonesia, dimana angka kesakitan (morbidity) dan angka kematian (mortality) penyakit ISPA pada balita cukup tinggi. Oleh karena itu pemberantasan penyakit ISPA merupakan program nasional, untuk mendukung terciptanya sumber daya manusia yang berkualitas di masa mendatang. Meningkatnya kejadian penyakit ISPA dipengaruhi oleh banyak faktor, diantaranya faktor lingkungan. Sebagian besar (80%-90%) waktu balita setiap harinya berada dalam rumah, dimana terdapat pajanan polusi udara dalam rumah yang diantaranya adalah PM10, Strategi yang paling tepat dilakukan dalam program pemberantasan penyakit ISPA adalah peningkatan kualitas udara indoor rumah tinggal. Penelitian ini dilakukan di wilayah kerja Puskesmas Kelurahan Cakung Timur Kota Jakarta Timur, untuk mengetahui kejadian penyakit ISPA pada balita, kondisi lingkungan yang berkaitan dengan kejadian penyakit ISPA, dan hubungan antara partikulat debu PMIO rumah dengan kejadian penyakit ISPA pada balita. Penelitian ini menggunakan disain studi kasus kontrol. Sebanyak lima puluh kasus dipilih dan daftar kasus ISPA terjadi di Puskesmas pada 2 bulan terakhir, sedangkan lima puluh balita yang sehat menjadi kelompok kontrol diambil dan tetangga terdekat kasus. Beberapa variabel yang berhubungan dengan kejadian ISPA adalah kelembaban, suhu, kepadatan hunian ruang tidur, ventilasi, bahan bakar memasak, asap rokok, pencahayaan, status gizi balita, riwayat imunisasi, dan jenis lantai. Data primer dikumpulkan dan pengukuran parameter kualitas udara indoor, lingkungan perumahan, dan karakteristik balita. Sedangkan data sekunder dikumpulkan dari pencatatan dan pelaporan Puskesmas Kelurahan Cakung Timur. Pengumpulan data dilakukan oleh peneliti dengan dibantu oleh staf puskesmas, teknis laboratorium dari BTKL Jakarta, dan staf Kelurahan Cakung Timur, melalui wawancara dengan menggunakan kuesioner dan observasi terhadap lingkungan rumah tinggal. Kejadian ISPA pada balita dipengaruhi oleh beberapa factor yang meliputi faktor lingkungan rumah, kondisi social, dan pelayanan kesehatan. Pada penelitian ini didapatkan adanya hubungan yang bermakna antara PM10 dan kejadian penyakit ISPA pada balita. Risiko untuk menjadi ISPA pada balita yang tinggal dalam rumah dengan konsentrasi PM10 lebih dari 70 μg/m3 adalah 6,1 kali dibanding balita yang tinggal dalam rumah dengan PM10 kurang atau sama dengan 70 μg/m3. Dengan mengontrol factor ventilasi rumah dan status gizi balita maka angka risiko tersebut akan berkurang menjadi 4,25 kali. Beberapa variabel yang berhubungan secara bermakna dengan kejadian penyakit ISPA pada balita dalam penelitian ini adalah PM10, ventilasi, status gizi balita, kelemababan. Sedangkan variabel lain seperti kepadatan hunian ruang tidur, bahan bakar memasak, asap rokok, pencahayaan, riwayat imunisasi, suhu, dan jenis lantai tidak menunjukkan hubungan yang bermakna dengan kejadian ISPA pada balita. Didapatkan bahwa PM10 merupakan predictor utama terhadap kejadian ISPA pada balita. Sebagai factor risiko utama pada ISPA, pajanan PM10 di udara dapat terhirup melalui pernapasan sehingga menyebabkan iritasi pada system saluran pernapasan yang selanjutnya menyebabkan ISPA. Penelitian ini menganjurkan agar setiap rumah dapat memiliki ventilasi yang cukup sehingga dapat menetetralisir sirkulasi PM10 di dalam rumah. Hal yang lain yang juga dianjurkan adalah dengan peningkatan status gizi akan dapat mencegah/menurunkan risiko balita terkena ISPA.

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An Acute Respiratory Infection (ARI) including pneumonia is still becoming one of the public health problems in Indonesia because it causes high morbidity and mortality among children under-five year of age. Therefore, ARI has been included in the national program for prevention and control of ARI which goal is to achieve human resources quality of life, The increase of occurrence of ARI is influenced by many factors including environmental factors. Everyday, most of the time, 80-90% children under-five live in the house, which are exposed with indoor pollution including PM10. The main strategy of the national prevention and control program for ARI is to improve air quality of housing.

This study is carried out in the working areas of Community Health Center in the sub-district of East Cakung, East Jakarta Municipality. The purposes of the study were to identify the occurrence of ARI among children under-five, environmental conditions related to ART, and the relationships between PM10 and the occurrence of ART among children under-five. A case-control study design was employed in the study. A total of fifty cases of children under-five were randomly selected from the Community Health Center and fifty control groups were randomly selected from the field of neighboring household of the cases. The cases and control groups were drawn from a similar population in the working areas of East Cakung. Data on ART were based on the recall period of 2 months. In addition, several variables including humidity, temperature, beds, ventilation, cooking woods, cigarette smoking, lighting, nutritional status of children, morbidity, immunization and type of floors were involved to control its relationships.

The primary data was collected from several sources including the measurement of indoor air quality, housing environment, and children under-five characteristics. The secondary data was collected from the recording and reporting of the Health Center in East Cakung. Data were collected by the researcher with the help of Health Center staff, laboratory technician of CDC Laboratory in Jakarta, and local staff of East Cakung through interviews using a administered questionnaires and observation its housing environment. The occurrence of ARI among children under-five is influenced by many factors including its housing environment, social conditions, and health services. There is a significant relationship between PM10 and the occurrence of ART among children under-five, The risk of having ART for children under-five living in the housing with PM10 more than 70 ug/m3 was 6.1 times more than those living in the housing with PMI0 70 uglm3 or less. With the control of ventilation and nutritional status, the relationships reduce to 4,25 times.

Of the total variables involved in the study, only several variables including particulate matter (PM10), ventilation, nutritional status of children, and relative humidity having significant relationship with the occurrence of the diseases. The other variables including beds, cooking woods, cigarette smoking, lighting, immunization, temperature, and the kind of floor do not indicate significant relationship with ARI. PM10 is considered as the predictor of the occurrence of ARI among children under-five. The main risk factor of ARI is PM10; its exposure in the air will be inhaled through respiratory system, which causes irritation of respiratory system, which leads to the occurrence of ARI. It is suggested that every house should have proper and adequate ventilation so as to prevent and neutralize PMI0 circulating indoors. It is also suggested that improving of nutritional status could prevent children under-five to ART. "

"Pendek adalah salah satu bentuk gizi kurang yang ditandai dengan gangguan pertumbuhan linear berada di bawah standar yang ditetapkan World Health Organization (WHO). TB/U atau PB/U yang kurang dari -2 SD memiliki berbagai dampak negatif terhadap pertumbuhan dan perkembangan balita serta kondisi kesehatan jangka panjang. Tujuan umum penelitian ini adalah diketahuinya faktor dominan yang berhubungan dengan TB/U atau PB/U pada balita (6-59 bulan) di Wilayah kerja Puskesmas Mekarwangi Kabupaten Garut tahun 2013. Penelitian ini menggunakan desain cross sectional dengan jumlah sampel sebanyak 152 balita (6-59 bulan). Adapun pengambilan data dilakukan pada bulan Maret hingga April 2013. Variabel yang diteliti yaitu TB/U atau PB/U, umur, berat lahir, panjang lahir, penyakit infeksi, asupan energi, asupan protein, perbandingan persentase asupan protein hewani dan nabati, asupan zat gizi mikro (zat besi, vitamin A, vitamin D, vitamin C, kalsium, dan zink), pengeluaran keluarga, ASI eksklusif, dan pendidikan ibu. Analisis yang digunakan adalah uji korelasi dan uji t independen (analisi bivariat), serta regresi logistik berganda (analisis multivariat). Hasil analisis bivariat menunjukkan terdapat hubungan yang bermakna antara TB/U atau PB/U dengan berat lahir, penyakit infeksi, dan asupan energi. Sementara itu dari hasil analisis multivariat didapatkan bahwa penyakit infeksi merupakan faktor dominan yang berhubungan dengan TB/U atau PB/U pada balita (6-59 bulan) di wilayah kerja Puskesmas Mekarwangi Kabupaten Garut.

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Stunting is a form of malnutrition which is characterized by impaired linear growth below the World Health Organization (WHO) standards. HAZ or LAZ under-2 SD has various negative effects in infants growth, development and long-term health conditions. The objective of this study was to investigate the dominant factor of stunting (HAZ or LAZ) in infants (6-59 months) in the work areas of Mekarwangi community health center.

This study used cross-sectional design with a sample size of 152 infants (6-59 months). Data collection was conducted in March until April 2013. Variables studied were HAZ or LAZ, age, birth weight, birth length, infectious diseases, energy intake, protein intake, percentage ratio of animal protein and vegetable intake,micronutrients intake(iron , vitamin A , vitamin D, vitamin C, calcium, and zinc), family expenses, exclusive breastfeeding, and mother’s education. The data was analyzed using correlation test, independent t test (bivariate analysis), and multiple logistic regression (multivariate analysis).

The results of bivariate analysis showed a significant relationship between HAZ or LAZ with birth weight, infectious diseases, and energy intake. Meanwhile, results of multivariate analysis showed that infectious disease was the dominant factor associated with HAZ or LAZ on infants (6-59 months) in the work areas of Mekarwangi community health center, Garut regency."

"Obat merupakan salah satu sumber daya yang panting dalam memberikan pelayanan kesehatan dasar di Puskesmas. Dalam praktek pelayanan pengobatan sering dijumpai adalah penggunaan obat yang tidak sesuai dengan pedoman pengobatan dasar di Puskesmas. Dari beberapa penelitian yang telah dilakukan menunjukkan bahwa sebagian besar penderita ISPA non-pnemonia mendapatkan terapi antibiotika yang seharusnya tidak perlu. Penggunaan obat yang tidak rasional akan menimbulkan dampak buruk baik dari segi ekonomi yang berupa pemborosan anggaran daerah, segi kesehatan yaitu berupa meningkatnya resiko efek samping dan resistensi serta dari segi psikososial berupa ketergantungan masyarakat kepada obat tertentu misalnya antibiotika. Penelitian ini bertujuan untuk melihat proporsi penggunaan obat yang tidak sesuai pada ISPA non-pnemonia dan faktor-faktor apa saja yang berhubungan dengan ketidaksesuaian penggunaan obat pada ISPA non-pnemonia di Puskesmas di Kabupaten Tanggamus. Total sampel dalam penelitian ini berjumlah 96 orang petugas BPI petugas penulis resep di sembilan Puskesmas yaitu Puskesmas Wonosobo, Kotaagung, Gisting, Rantau Tijang, Pulau Panggung, Sukoharjo, Adiluwih, Gading Rejo dan Pardasuka. Pemilihan lokasi penelitian didasarkan pada keterwakilan wilayah. Penelitian ini menggunakan desain potong lintang dan dilaksanakan pada bulan Pebruari sampai Maret 2004. Sebagai variabel terikat adalah ketidaksesuaian penggunaan obat pada ISPA non-pnemonia dengan buku pedoman pengobatan dasar dan sebagai variabel bebas adalah variabel individu berupa pendidikan, pelatihan, pengetahuan dan lama masa kerja, variabel psikologis berupa sikap terhadap pengobatan ISPA non-pnemonia dan sikap terhadap buku pedoman pengobatan, dan variabel organisasi berupa ketersediaan buku pedoman pengobatan dasar, ketersediaan obat setiap bulan, monitoring, evaluasi dan supervisi. Hasil penelitian menunjukkan proporsi penggunaan obat yang tidak sesuai dengan buku pedoman pengobatan sebesar 33,3%. Pelayanan pengobatan sebagian besar dilakukan oleh perawat yaitu 85,4%. Dari analisa bivariat diketahui beberapa variabel yang memiliki hubungan bermakna dengan ketidaksesuaian penggunaan obat pada ISPA non-pnemonia yaitu pendidikan (p= 0,030), sikap terhadap pengobatan ISPA nonpnemonia (p=0,000), sikap terhadap buku pedoman pengobatan (p= 0,001) dan monitoring (p=0,011). Pada hasil analisa multivariat didapat faktor yang paling behubungan dengan ketidaksesuaian penggunaan obat pada ISPA non-pnemonia adalah sikap terhadap pengobatan ISPA non-pnemonia dan sikap terhadap buku pedoman pengobatan (p=3,001). Saran dari penelitian ini adalah optimalisasi peran dokter sebagai tenaga medis yang berkompeten dalam melakukan pelayanan pengobatan di Puskesmas. Transfer ilmu dari dokter kepada perawat juga amat diperlukan. Peran Dinas Kesehatan sebagai instansi pembina juga harus lebih ditingkatkan misalnya dengan memberikan pelatihan yang lebih aplikatif untuk Puskesmas. Kepala cabang divas yang sekarang dijabat oleh tenaga yang kurang tepat sebaiknya diganti dengan tenaga yang lebih baik dan lebih berpengalaman.

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Drug represents one of the important resources in providing primary health service in Health Center. The medication service that often met is inappropriate usage of drug with the guidance of basic medication for Health Center. From previous some studies showed that most of Non-pneumonia Respiratory Infection patient got unnecessary antibiotic therapy.

Usage of irrational drug will result negative effect either from economic side such as wastefulness of district budget, health side that is the increase of side effects risk and of resistance, and also psychosocial side such as depended society to the certain drug i.e. antibiotic.

This study aimed to get the proportion of inappropriate drug usage for non-pneumonia respiratory infection and factors related to it at Health Center in the District of Tanggamus. Total sample in this study was 96 BP officers/prescription writers from nine Health Centers namely Wonosobo Health Center, Kotaagung Health Center, Gisting Health Center, Rantau Tijang Health Center, Pulau Panggung Health Center, Sukoharjo Health Center, Adiluwih Health Center, Gading Rejo Health Center, and Pardasuka Health Center. The choice location of study relied on the representative of region. This study used cross sectional design and conducted during February until March 2004.

Dependent variable in the study was inappropriateness of drug usage for non-pneumonia respiratory infection with the guidance book for basic medication, while as independent variable consisted of individual variables (education, training, knowledge, and duration of work span), and psychological variables (attitude to the medication of Non-pneumonia respiratory infection and attitude to the guidance book for medication), and organizational variables (availability of guidance book for basic medication, availability of drugs in each month, monitoring, supervision and evaluation).

Dependent variable in the study was inappropriateness of drug usage for non-pneumonia respiratory infection with the guidance book for basic medication, while as independent variable consisted of individual variables (education, training, knowledge, and duration of work span), and psychological variables (attitude to the medication of non-pneumonia respiratory infection and attitude to the guidance book for medication), and organizational variables (availability of guidance book for basic medication, availability of drugs in each month, monitoring, supervision and evaluation).

The study showed that proportion of drug usage in which inappropriate with the book guidance for medication equal to 33.3%. The most of medication service was conducted by nurse (85.4%). Bivariate analysis showed variables that had significant relationship with the inappropriateness of drug usage for non-pneumonia respiratory infection were education (p'.03), attitude to the medication of non-pneumonia respiratory infection (p=0.001), attitude to the guidance book for medication (p=0.001), and monitoring as well (p=1.011).

Multivariate analysis showed the most dominant factors in the study about the inappropriateness of drug usage for non-pneumonia were attitude to the medication of non-pneumonia respiratory infection and attitude to the guidance book for medication (p=0.001).

Recommendation from this study was to increase the role of doctor optimally as competent medical staff in conducting the medication service in health center. Transfer of knowledge from doctor to nurse also very needed. Role of Health Office as an assistance institution also should be improved, for example by giving more applicative training for the Health Center's staffs. The head of branch of Health Office in which now taken hold by unqualified person should be changed by qualified and experienced one."