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"ABSTRAKThe immune response of dengue fever/dengue hemorrhagic fever is a series of immunopathogenesis processes starting from viral infection to the target on monocytes and macrophages. It may consequently cause a cascade of viremia in the circulation that stimulates the afferent, efferent, and effector mechanism by the interaction of the humoral and complement system. The cascade results in inflammatory substance that will affect capillary permeability and activate coagulation factors leading to further effects on endothelial level. The mechanism involving pathogenesis of DHF/DSS is still vague. So far, a theory of heterologous infection has been developed, which explains that on second infection, there is subneutralization that induce viral replication. The autoimmune mechanism development leads to the better understanding of DHF. It also explains the autoimmune response of the viral infection, which consists of molecular mimicry, bystander activation and viral persistence. The development of the autoimmune pathomechanism is related to the role of autoantibody and endothelial dysfunction that may have role in worsening DHF."

"Continued geographic expansion of dengue viruses and their mosquito vectors has seen the magnitude and frequency of epidemic dengue/​dengue hemorrhagic fever (DF/​DHF) increase dramatically. Recent exciting research on dengue has resulted in major advances in our understanding of all aspects of the biology of these viruses, and this updated second edition brings together leading research and clinical scientists to review dengue virus biology, epidemiology, entomology, therapeutics, vaccinology and clinical management."

"Interleukin (IL)-18 (interferon-g inducing factor) merupakan salah satu sitokin yang diproduksi makrofag, berperan dalam diferensiasi sel T-helper menjadi T-helper-1, dan produksi interferon g. T-helper-1 berperan dalam imunitas seluler khususnya pada infeksi virus termasuk infeksi dengue. Dilakukan studi deskriptif korelatif mengenai hubungan kadar IL-18 dengan derajat penyakit pada penderita demam dengue (DD) dan demam berdarah dengue (DBD) yang dirawat. Pada 42 subyek yang terdiri dari 20 (47,6%) penderita demam dengue dan 22 (52,3%) demam berdarah dengue (derajat I sampai IV menurut kriteria WHO tahun 1999). Didapatkan kadar IL-18 secara bermakna lebih tinggi pada DHF dibandingkan DF. Didapatkan korelasi kadar IL-18 dengan nilai hematokrit dan hitung trombosit. Studi ini menunjang kemungkinan keterlibatan IL-18 dalam patogenesis DBD pada pasien dewasa. (Med J Indones 2004; 13: 86-9)

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Interleukin (IL)-18 ( interferon-g inducing factor) is one of cytokines, produced by macrophage, take part in differentiation T-helper (Th) to Th1 and interferon g producing. T-helper1 play role in cellular immunity especially in viral infection include dengue. A descriptive correlative study has done to know the correlation between IL-18 levels and disease severity in admitted dengue fever (DF) and dengue hemorrhagic fever (DHF) patients. In 42 subjects consist of 20 (47.6%) DF and 22 (53.3%) DHF (grade I to IV WHO criteria, 1999) showed that IL-18 levels significantly higher in DHF than DF patients. There are significant correlation between IL-18 levels and hematocrit and low platelet value. This study supports the possible role of IL-18 in pathogenesis DHF in adults. (Med J Indones 2004; 13: 86-9)"

"Penelitian ini membahas tentang evaluasi implementasi clinical pathway pada penyakit Dengue Hemorrhagic Fever anak di RSUP Fatmawati tahun 2016. Tujuan dari penelitian ini adalah untuk mendapatkan evaluasi input, proses, dan outcome implementasi clinical pathway pada kasus Dengue Hemorrhagic Fever anak serta mengetahui hambatannya. Jenis penelitian ini adalah kuantitatif dan kualitat if dengan menggunakan operational research dengan metode observasi, wawancara mendalam dan terstruktur. Hasil penelitian didapatkan pengisian clinical pathway pada pasien DHF anak bulan Januari-Juni 2016 sebesar 55,15%. Format clinical pathway DHF anak sudah ringkas dan jelas namun belum lengkap dengan kriteria hasil. Belum optimalnya sosialisasi SPO, edukasi clinical pathway, serta imbalan dan sanksi. Formulir clinical pathway selalu tersedia di ruang rawat inap. Terdapat beberapa masalah dalam proses implementasi clinical pathway yaitu tidak adanya pengisian clinical pathway di IGD atau ruang lain, belum optimalnya kolaborasi antar tenaga kesehatan, belum adanya monitoring dan evaluasi untuk meningkatkan kepatuhan dan kelengkapan pengisian clinical pathway. Evaluasi outcome dari implementasi clinical pathway DHF anak yaitu terdapat variasi pada lama hari rawat 12%, pemeriksaan penunjang DTL, Urine, Feses 99 %, Anti Degue, IgG/IgM 6%, pemeriksaan CXR RLD 55%, gizi 35%, pengobatan parasetamol 40% dan IVFD 2%.

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This research discusses the evaluation of clinical pathways implementation in children's Dengue Hemorrhagic Fever (DHF) disease at RSUP Fatmawati in 2016. This research aims to get input evaluation, process, and outcomes clinical pathways implementation in children's DHF disease and the obstacle. This is a quantitat ive and qualitative research that usen operational research with observation methodology, in-depth and structured interviews. The result shows that clinical pathways admission filling with patient in children?s DHF disease 55.15% in January-June 2016. Clinical pathway's form in children?s DHF disease are concise and clear but no outcome criteria. SPO?s socialization, clinical pathways educating, reward, and punishment are not optimum. Clinical pathway's form are always available at inpatient unit. There are some problems in the process of clinical pathways implemention, there is no filling clinical pathways in the ER (Emergency Room) or the other room, the lack of collaboration among health proffesional, no monitoring and evaluation to improve compliance and completeness of clinical pathways. Outcome evaluation of clinical pathways implementation in children's DHF are variations of length of stay 12%, DTL, Urine, Feses investigation 99 %, Anti Degue, IgG/IgM 6%, CXR RLD 55%, nutrition 35%, parasetamol treatment 40% and IVFD 2%."

"Dengue Hemorrhagic Fever (DHF) merupakan masalah kesehatan yang umum terjadi di Indonesia, terlebih lagi saat memasuki musim penghujan. Anak-anak menyumbang kasus terbanyak pada kasus DHF di Indonesia. Efek dari virus penyebab DHF salah satunya adalah kebocoran plasma akibat penurunan kadar trombosit dalam tubuh penderita. Salah satu masalah keperawatan yang berkaitan erat dengan kebocoran plasma pada DHF adalah risiko hipovolemia. Karya ilmiah ini ditulis bertujuan untuk menganalisis asuhan keperawatan masalah risiko hipovolemia pada anak dengan DHF. An. M (10 tahun) dengan dengan DHF mengalami demam tinggi dengan suhu 38,5oC, kondisi membran mukosa yang pucat serta kondisi bibir yang kering, tekanan darah 102/60 mmHg, frekuensi nadi 97 kali per menit, dan kekuatan nadi yang teraba agak lemah. Kadar trombosit saat dilakukan pemeriksaan pertama kali sebesar 81000/µl. Intervensi manajemen cairan diberikan selama 5 hari, pasien mengalami perbaikan status hidrasi yang terlihat dari kondisi membrane mukosa dan bibir menjadi lembab, tanda vital stabil, terjadi kenaikan trombosit dan peningkatan intake per oral pasien. Hasil penelitian ini diharapkan dapat menjadi landasan untuk peningkatan kesadaran dalam melakukan pemantauan cairan yang akurat serta memahami kondisi klinis pasien dengan kekurangan cairan atau kelebihan cairan.

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Dengue Hemorrhagic Fever (DHF) is the one of most common health problem in Indonesia, especially during the rainy season. Children are the largest contributor for dengue cases in Indonesia. One of the effects of the virus that causes DHF is plasma leakage due to the thrombocytopenia. Risk of hypovolemia is the one of common nursing problem that occur in patient with DHF. This scientific paper is written to analyzing nursing care for the risk of hypovolemia in children with DHF. Patient M (10 years old) has a high fever with a temperature of 38,5oC, has pale mucous membranes and dry lips, the blood pressure 102/60 mmHg, pulse rate 97 beats per minute with the poor beats of pulses. The platelet level was 81000/µl. The fluid management intervention was given for 5 days, the patient shows an improvement in hydration status as seen from the condition of mucous membranes and lips becoming moist, stable vital signs, an increase in platelets level and patient’s oral intake. The results that expected from this study are for to be a baseline for increasing awareness of conducting accurate fluid monitoring and understanding the clinical condition of patient with fluid deficiency or fluid overload"

"Demam berdarah dengue menyerang anak-anak daripada orang dewasa. Sistem kekebalan tubuh yang rentan beresiko terpapar suatu penyakit. Demam berdarah dengue menyebabkan peningkatan kapiler plasma sehingga seseorang mengalami hipovolemia. Asuhan keperawatan diperlukan dalam mengatasi hipovolemia dengan memberikan intervensi keperawatan manajemen hipovolemia dan pemantauan cairan menggunakan fluid chart. Fluid chart digunakan untuk memantau dan mencatat secara akurat intake dan output guna mencapai keseimbangan cairan tubuh. Klien usia 10 tahun mengalami kondisi demam tinggi 3 hari, keadaan lemas, mukosa kering, serta pemeriksaan laboratorium menunjukkan hematokrit menurun (39,2%) dan trombosit menurun (157 10 3 /μL). Pemeriksaan hemodinamik serta pemeriksaan darah perifer lengkap rutin setiap 24 jam untuk mengevaluasi kondisi pasien selama dilakukan perawatan. Kesimpulannya, penerapan fluid chart efektif membantu memonitor cairan masuk dan keluar pasien ditandai dengan balans cairan membaik, pemeriksaan darah perifer lengkap menunjukkan proses perbaikan, serta kondisi vital yang stabil.

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Dengue hemorrhagic fever attacks children more than adults. A vulnerable immune system is at risk of exposure to disease. Dengue hemorrhagic fever causes an increase in plasma capillaries so that a person experiences hypovolemia. Nursing care is needed to treat hypovolemia by providing nursing interventions to manage hypovolemia and monitor fluids using a fluid chart. Fluid charts are used to accurately monitor and record intake and output to achieve body fluid balance. A 10 year old client experienced a high fever for 3 days, weakness, dry mucosa, and laboratory examination showed decreased hematocrit (39.2%) and decreased platelets (157 103/μL). Hemodynamic examination and routine complete peripheral blood examination every 24 hours to evaluate the patient's condition during treatment. In conclusion, the application of a fluid chart is ef ective in helping monitor the patient's incoming and outgoing fluids as indicated by improved fluid balance, complete peripheral blood examination showing the improvement process, and stable vital conditions."

"Demam Berdarah Dengue (DBD) adalah penyakit yang disebabkan oleh virus dengue yang termasuk anggota genus Flavivirus dan keluarga Flaviviridae yang menyebar melalui nyamuk Aedes (Stegomyia). Jumlah kasus DBD di seluruh dunia dilaporkan meningkat lebih dari 8 kali lipat selama dua dekade terakhir, dari 505.430 kasus pada tahun 2000, menjadi lebih dari 2,4 juta pada tahun 2010, dan 5,2 juta pada tahun 2019. Peningkatan insiden DBD dipengaruhi oleh berbagai faktor, baik itu faktor alam, kebiasaan manusia, hingga jenis virus penyebab DBD itu sendiri. Faktor alam yang dimaksud disini antara lain faktor iklim, seperti curah hujan (mm), temperatur rata-rata (℃), dan kelembapan rata-rata (%). Peningkatan insiden DBD dapat dicegah dengan upaya pencegahan yang dilakukan sedini mungkin oleh pemerintah dan masyarakat. Informasi prediksi tren insiden DBD dapat menjadi masukan bagi masyarakat dan pemerintah untuk meningkatkan kewaspadaan terhadap peningkatan insiden DBD di DKI Jakarta. Dalam melakukan prediksi tren insiden DBD, dapat dilakukan dengan berbagai pendekatan, salah satu diantaranya adalah machine learning. Pada tugas akhir ini, implementasi machine learning menggunakan model The Attention Mechanism-Enhanced LSTM (LSTM-ATT) dan Poisson Regression, akan digunakan untuk memprediksi tren insiden DBD dari waktu ke waktu. LSTM-ATT adalah sebuah model machine learning yang digunakan untuk memproses data sequence. Poisson Regression adalah model regresi yang dapat digunakan pada data yang variabel responnya berdistribusi Poisson dan bertipe diskrit. Prediksi yang akan dilakukan didasarkan pada jumlah insiden DBD sebagai variabel respon, serta faktor iklim seperti curah hujan, suhu, dan kelembapan sebagai variabel prediktor. Untuk proporsi data, kedua model tersebut menggunakan proporsi data training sebesar 80% dan data testing sebesar 20%. Model yang dibentuk ini dievaluasi dengan nilai dari Root Mean Square Error (RMSE) dan Mean Absolute Error (MAE). Hasil implementasi terbaik pada skrips ini dihasilkan oleh model LSTM-ATT dengan evaluasi di setiap wilayah DKI Jakarta: Jakarta Pusat RMSE: 9,5727, MAE: 6,6946; Jakarta Timur RMSE: 21,5288, MAE: 15,6365; Jakarta Barat RMSE: 16,3683, MAE: 12,4908; Jakarta Utara RMSE: 23,5911, MAE: 15,2969; Jakarta Selatan RMSE: 18,3811, MAE: 14,0262.

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Dengue Hemorrhagic Fever (DHF) is a disease caused by the dengue virus, which belongs to the Flavivirus genus and Flaviviridae family, transmitted through Aedes mosquitoes (Stegomyia). The number of DHF cases worldwide has reported an increase of more than 8 times over the past two decades, from 505,430 cases in 2000 to over 2.4 million in 2010 and 5.2 million in 2019. The increase in DHF incidence is influenced by various factors, including natural factors, human behavior, and the type of dengue virus itself. Natural factors include climate factors such as rainfall (mm), average temperature (℃), and average humidity (%). The increase in DHF incidence can be prevented through early prevention efforts by the government and the community. Predicting the trend of DHF incidence can provide input for the community and the government to increase vigilance against the increasing incidence of DHF in Jakarta. Various approaches can be used for predicting the trend of DHF incidence, one of which is machine learning. In this final project, the implementation of machine learning using the LSTM-ATT and Poisson Regression models will be used to predict the trend of DHF incidence over time. LSTM-ATT is a machine learning model used to process sequential data, such as time series data. On the other hand, Poisson Regression is a regression model that can be used for data with Poisson-distributed response variables and discrete types. The prediction will be based on the number of DHF incidents as the dependent variable, and climate factors such as rainfall, temperature, and humidity as independent variables. The performance of the models will be evaluated using the Root Mean Square Error (RMSE) and Mean Absolute Error (MAE). The best implementation results in this thesis were produced by the LSTM-ATT model with evaluation in each area of DKI Jakarta: Central Jakarta RMSE: 9.5727, MAE: 6.6946; East Jakarta RMSE: 21.5288, MAE: 15.6365; West Jakarta RMSE: 16.3683, MAE: 12.4908; North Jakarta RMSE: 23.5911, MAE: 15.2969; South Jakarta RMSE: 18.3811, MAE: 14.0262."

"Di kota Depok, lebih dari 30% penderita demam berdarah adalah anak-anak usia sekolah. Penularannya tidak selalu terjadi di sekolah di mana seorang anak menghabiskan sekitar 25% waktunya. Sekolah berperan strategis dalam pengendalian DBD sehingga anak sekolah harus memperoleh informasi yang memadai untuk mendapatkan perilaku yang positif. Studi kuantitatif ini bertujuan menilai tingkat keterpajanan informasi dan pengetahuan dalam pengendalian vektor. Analisis yang digunakan adalah beda mean dan uji korelasi. Hasil studi menunjukkan bahwa keterpajanan informasi dan tingkat pengetahuan anak sekolah tentang DBD masih rendah.

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More than 30% dengue patients in Depok City were school age children. Infection does not always happened in school in which a child spend their time 25% of his time a day. School has strategic role in dengue control. It means that schoolchildren must have to adequate information so that its positive behavior. This quantitative study aims to assess information exposed and their knowledge in dengue vector control. Mean difference and correlation analyze were used in this study. Result of this study indicated that information exposed among schoolchildren and dengue knowledge were still lower."

"ABSTRACTThe mortality rate and the distribution of dengue fever case in Indonesia tend to increase. Jambi Province is the province with the highest mortality rate in Indonesia in 2013, and Jambi City is the highest contributor for the last 3 years. Eradication efforts have been made, but they have not been able to break the chain of transmission. This research uses descriptive design with a qualitative approach to identify the causes of inaccuracy of eradication efforts and to determine the strategy of eradicating dengue fever in Jambi City. Site selection was done by purposive sampling, with the highest incidence rate criterion in 2015. The informants were chosen based on the criteria of conformity and adequacy, covering the Health Department, the Puskesmas, the sub-district and the community i.e. the larva monitoring cadre (jumantik). The assessment scheme is based on government policy implementation scheme in eradicating DHF by the identification of factors based on ultrasound analysis (Urgency, Serious, Growth). The strategy of eradication efforts is based on SWOT analysis (Strength, Weaknesses, Opportunities, Threats). The determination of alternative strategies was chosen based on Mc. Namara's screening theory, with 5 criteria of effectiveness, ease, benefits, time, and cost. The result of the research shows that the inaccuracy of dengue eradication efforts in Jambi City lies in the ineffectiveness of the implementation of the Mosquito Nest Eradication (PSN) movement through cross-sector integration in community empowerment routinely and independently. The main strategy that can be done by the government is to increase the role of larva monitoring cadres and larva monitoring students (sismantik) through budget support from across sectors in campaigning PSN movement regularly, either at house or institution environment."

"ABSTRACTKupang, East Nusa Tenggara is an area with low rainfall where the highest East Nusa Tenggara number of Dengue Hemorrhagic Fever (DHF) cases are recorded; this number is also higher than the national figure. This study analyzed the relationship between housing conditions and DHF incidence in Kupang City. This observational study used a case-control method with 240 DHF patient cases and 280 not patient controls without DHF from 12 villages in the rainy season and 13 villages in the dry season. The following data were collected: house size, house lighting, house temperature, water usage, wall construction, ventilation size, ventilation condition, and ownership of a clean water facility. These data were analyzed using t-test and Chi-square test. The following house condition variables were significantly related to DHF incidence (p-value ≤ 0.05): house lighting, water usage, house wall, ventilation area, and ownership of clean water facilities. This means that house condition is related to the incidence of dengue in Kupang City. Attention and intervention are needed in these areas, as well as attention to other factors outside house condition."