Hasil Pencarian  ::  Simpan CSV :: Kembali

"Measles immunization has been introduced since 1960, thereby markedly reducing the number of cases in developed countries. However, measles epidemics still occur even in developed countries. In the United States, in 1988-1992 an increase in the number of measles cases reaching 50,000 cases was reported. Some of these cases occurred in previously immunized patients. This was thought to be caused by genetic mutation of the measles virus, aside from weaknesses of the vaccine and low immunization coverage. Since measles immunization was employed in Indonesia, the number of measles patients has decreased. However, epidemics are still frequently reported. About 15-30% of reported cases occurred in those previously immunized, raising the question of whether a genetic difference exists between the wild-type measles virus circulating in Indonesia and the vaccine virus being used. Such a difference may lead to the differences in the antigenicity of the wild-type and vaccine viruses, rendering the resulting antibody incapable of neutralizing the wild-type viruses. Based on the above, this study is aimed to demonstrate the extent of genetic and antigenic differences between the wild-type and vaccine measles viruses. We conducted an experimental laboratory study to sequence the N, H, and F genes of the wild-type measles viruses (G2, G3, and D9) and the CAM-70 vaccine virus. To show antigenic differences, the wild-type viruses (G2, G3, and D9) and the CAM-70 and Schwarz viruses were injected to BALB/c mice. Serum antibodies of the mice were analyzed using ELISA, cross-neutralization test, and immunoblotting using antigens from the respective viruses. Results of this study showed that the wild-type and the vaccine viruses differ in the sequence of the N gene by 73-79 nucleotides, resulting in amino acid substitution of 17-24 residues; the H gene by 60-99 nucleotides, resulting in amino acid substitution of 13-29 residues; the F gene by 71-88 nucleotides, resulting in amino acid substitution of 4-3 I residues. Differences between the wild-type and the CAM-70 and Schwarz vaccine viruses were also found in the epitope site of the CTL and antibodies, which are important to virus antigenicity. We conclude that a significant difference in antigenicity exists between the wild-type measles viruses circulating in Indonesia with the CAM-70 measles virus. We also found the immunogenicity of the CAM-70 and Schwarz vaccine viruses to be lower than that of the wild-type viruses."

"Measles immunization has been introduced since 1960, thereby markedly reducing the number of cases in developed countries. However, measles epidemics still occur even in developed countries. In the United States, in 1988-1992 an increase in the number of measles cases reaching 50,000 cases was reported. Some of these cases occurred in previously immunized patients. This was thought to be caused by genetic mutation of the measles virus, aside from weaknesses of the vaccine and low immunization coverage.Since measles immunization was employed in Indonesia, the number of measles patients has decreased. However, epidemics are still frequently reported. About 15-30% of reported cases occurred in those previously immunized, raising the question of whether a genetic difference exists between the wild-type measles virus circulating in Indonesia and the vaccine virus being used. Such a difference may lead to the differences in the antigenicity of the wild-type and vaccine viruses, rendering the resulting antibody incapable of neutralizing the wild-type viruses. Based on the above, this study is aimed to demonstrate the extent of genetic and antigenic differences between the wild-type and vaccine measles viruses.We conducted an experimental laboratory study to sequence the N, H, and F genes of the wild-type measles viruses (G2, G3, and D9) and the CAM-70 vaccine virus. To show antigenic differences, the wild-type viruses (G2, G3, and D9) and the CAM-70 and Schwarz viruses were injected to BALB/c mice. Serum antibodies of the mice were analyzed using ELISA, cross-neutralization test, and immunoblotting using antigens from the respective viruses.Results of this study showed that the wild-type and the vaccine viruses differ in the sequence of the N gene by 73-79 nucleotides, resulting in amino acid substitution of 17-24 residues; the H gene by 60-99 nucleotides, resulting in amino acid substitution of 13-29 residues; the F gene by 71-88 nucleotides, resulting in amino acid substitution of 4-3 I residues. Differences between the wild-type and the CAM-70 and Schwarz vaccine viruses were also found in the epitope site of the CTL and antibodies, which are important to virus antigenicity.We conclude that a significant difference in antigenicity exists between the wild-type measles viruses circulating in Indonesia with the CAM-70 measles virus. We also found the immunogenicity of the CAM-70 and Schwarz vaccine viruses to be lower than that of the wild-type viruses."

"Campak adalah penyakit virus akut(paramyxavirus) sangat mudah menular melalui udara atau kontak langsung namun tergolong penyakit yang dapat dicegah dengan imunisasi. Di Indonesia penyakit campak telah masuk pada tahap reduksi dengan cakupan imunisasi (>90 %) namun Case fatality rate (CFR) eukup tinggi yaitu sekitar 1,7 - 2,4 oleh karena itu penelitian kearah mencari faktor penyebab penyakit campak pads balita dalam hal ini dibatasi pada faktor kesehatan lingkungan dan karakteristik anak balita yang berkaitan dengan kejadian penyakit campak pada balita menjadi sangat beralasan.Penelitian ini bertujuan untuk mengetahui distribusi frekwensi, hubungan dan mencari model faktor kesehatan lingkungan (16 variabel) dan karakteristik anak balita (5 variabel ) dengan kejadian penyakit campak pada balita. Penelitian dilaksanakan di Kabupaten Garut dengan metode kasus kontrol, jumlali sampel masing masing 150 kasus dan 150 kontrol total 300 sampel (1:1), rentang waktu antara Bolan Juli 2000 aid Bulan Desember 2001.Hasil penelitian menunjukan bahwa dari 21 Variabel yang dilakukan uji hubungan bevariat ada 15 variabel yang memiliki hubungan bermakna dengan p 0.05 (hipotesis ditolak). Dan 5 variabel p > 0.05 (hipotesis gagal ditolak).Model akhir tanpa interaksi didapat lima variabel utama yang berhubungan dengan kejadian campak adalah Imunisasi nilai B (3.340), Jendela (1.468), Vit A ( 1.319), Kepadatan ( 0.885) dan Cahaya (0.846) dengan konstanta -5.218. Faktor paling dominan adalah imunisasi dengan OR 28.228 pada CI 95 % 11.789-67.588, sedangkan setelah melalui uji interaksi terdapat dua variabel tunggal dan 2 yang berinteraksi yaitu 1286 (Imunisasi), 1,393 (Cahaya by Jendela), 0.933 (Kepadatan), dan 0.947 (Cahaya by Vit A) dengan konstanta -3.951 faktor paling dominan yang dapat mempengaruhi kejadian campak adalah Imunisasi dengan nilai B = 3.951 dengan QR = 26.72 nilai C195 % = 11.301-63.201Untuk aplikasi penanganan program ini tentu memerlukan strategi khusus, yang intinya perlu pelayanan kesehatan masyarakat yang komprehensif berupa pelayanan promosi dan pencegahan berupa pelayanan intensif pelaksanaan imunisasi dan pemberian vitamin A serta melaksanakan perbaikan kesehatan lingkungan fisik rumah terutama sistem pencahayaan, jendelanisasi, dan pengurangan kepadatan kamar.

---

Measles is an accute viruses deseases (paramyxovirus)_ It is very easy infected to other people direct contact, but can be prevented by immunization. In Indonesia measles deseases is in reduction phase with immunimtion trap >90 %, but the Case fatality rate (CFR) is high between 1.7 - 2.4. There efor the study to find the risk factor of measles on childhood in this case is limited on environtmenal health factor and the characteristic of childhood that is associated with measles incidence of childhood is very reasonable.

The purpose of this study is to know the distribution anda freqkfency, the association and find the environment health factors model (16 variables) and characteristik of childhood (5 variable) with the measles incidence on Childhood at Garut District 2000-2001 year.

This study was being done at Garut district using case control method_ The sample of this study is 300 ehilldhood (150 cases and 150 control) the study last from July 2000 --- Descember 2000. The result of this study showed that from 21 variable there is 16 variabels is significant because p < 0.05.

The multivariate final model are : immunization B velue (3.340), Windows (1.468), Vit A ( 1.319), Crowding ( 0.885) and Lighting (0.846), constanta -5.218. The strenght of Factor is immunization with OR 28.228 at CI 95 % 11389-67.588.

Interaksi test result is 3.286 (Imunisation), 1.393 (Light by windows), 0.933 (Croeding, and 0.947 (Lighting by Vit A), constanta -3.951 and strenght factor is Imunisation with B value = 3.951 , OR = 26.72 Cl 95 % = 11.301-63.201

Sugestion for program Aplication cocerning measles program in Garut District is a comprehensif action, covering Promotion, prevention, Curative dan Rehabilitation. The priority program are Immunization programe, Vitamin A, and Rehabilitation of Window, sistem of Lighting Room and reduction of Ovbercrowding."

"Measles merupakan salah satu penyakit infeksi menular dengan jumlah kasus yang masih tinggi di Indonesia. Jumlah kasus yang tinggi tersebut perlu dilakukan konfirmasi secara laboratoris sehingga dapat dilakukan tindakan pencegahan secara cepat dan tepat. Penelitian ini menggunakan spesimen urin untuk pemeriksaan laboratorium measles dengan metode kultur virus dan Reverse Transcriptase Polymerase Chain Reaction RT-PCR. Kultur virus dilakukan dengan menggunakan sel vero/hSLAM lalu dilakukan pengamatan Cytopathic effect CPE, sedangkan RT-PCR digunakan untuk mengamplifikasi fragmen gen N menggunakan primer MeV 214 dan MeV 216. Hasil sampel didapatkan sebanyak 120 spesimen urin yang berasal dari 9 provinsi berbeda di Indonesia selama periode tahun 2016. Hasil pemeriksaan menunjukkan nilai positivitas kultur virus sebesar 7, sedangkan nilai positivitas RT-PCR sebesar 36. Hasil penelitian menunjukkan bahwa metode RT-PCR memiliki nilai positivitas yang lebih tinggi dalam mendeteksi virus measles dibandingkan dengan kultur virus.

---

Measles is one of infectious diseases with a high number of cases in Indonesia. The high number of cases needs to be confirmed in a laboratory so that precautions can be taken quickly and accurately. This study used urine specimens for laboratory measles examination using viral culture method and Reverse Transcriptase Polymerase Chain Reaction RT PCR. Viral culture was done by using vero cells hSLAM then made observations cytopathic effect CPE, while RT PCR were used to amplify the N gene fragment using the primers 214 MeV and MeV 216. The results showed a number of 120 specimens of urine obtained from 9 different provinces in Indonesia during the period of 2016. the test results showed a virus culture positivity value of 7 while the value of RT PCR positivity of 36. The results showed that the RT PCR method has a higher positivity value in detecting measles virus compared to viral culture."

"Latar belakang. Cakupan imunisasi campak di Indonesia mencapai 80% namun prevalens campak di Indonesia masih tinggi, terutama pada anak usia 1-4 tahun. WHO merekomendasikan pemberian imunisasi campak ke-2 pada tahun kedua kehidupan. Di Indonesia diberikan pada usia 15-18 bulan dalam kombinasi vaksin MMR. Sayangnya cakupan imunisasi MMR masih rendah sehingga Depkes merekomendasikan pemberian imunisasi campak ke-2 pada usia 2 tahun untuk meningkatkan imunitas seorang anak terhadap penyakit campak.Tujuan. Penelitian ini untuk mengetahui: (1) proporsi anak usia 1-4 tahun yang telah mendapatkan imunisasi campak 1 kali yang memiliki antibodi campak mencapai kadar protektif dan rerata kadar antibodinya, (2) proporsi anak usia 1-4 tahun yang telah mendapatkan imunisasi campak ≥ 2 kali yang memiliki antibodi campak mencapai kadar protektif dan rerata kadar antibodinya, (3) hubungan antara usia saat diperiksa kadar antibodi campak, usia saat imunisasi, status gizi, kondisi kesehatan saat imunisasi campak terhadap antibodi campak, (4) hubungan antara pemberian imunisasi campak dosis ke-dua terhadap antibodi campak.Metode. Penelitian potong lintang di 6 posyandu di 5 wilayah DKI Jakarta pada bulan Juni hingga Agustus 2014. Anak yang memenuhi kriteria inklusi diperiksa kadar IgG campak. Dari hasil pemeriksaan IgG campak, kemudian ditentukan apakah mencapai kadar protektif atau tidak dan rerata kadar antibodinya. Dicari apakah terdapat hubungan antara imunisasi campak dosis ke-dua dengan kadar antibodi campak.Hasil. Dari 145 subjek penelitian, 125 subjek (86,2%) memiliki kadar antibodi campak yang mencapai kadar protektif (≥ 120 mIU/ml) dan 20 subjek (13,8%) memiliki kadar antibodi campak yang tidak mencapai kadar protektif (< 120 mIU/ml). Median kadar antibodi campak pada kelompok protektif adalah 844 mIU/ml, dengan nilai minimum 129 mIU/ml dan nilai maksimum 5000 mIU/ml. Kelompok usia 3-4 tahun memiliki kadar antibodi campak yang mencapai kadar protektif terbanyak (91,8%) dibanding kelompok usia 2-3 tahun (88,2%) dan 1-2 tahun (72,7%). Tidak didapatkan hubungan antara usia saat mendapatkan imunisasi campak dan status gizi terhadap kadar antibodi campak.Simpulan. (1) Proporsi anak usia 1-4 tahun yang mendapatkan imunisasi campak 1 kali dan memiliki antibodi campak mencapai kadar protektif sebesar 77% (54/70) dengan median kadar antibodinya adalah 733,5 mIU/ml, (2) Proporsi anak usia 1-4 tahun yang mendapatkan imunisasi campak ≥ 2 kali dan memiliki antibodi campak mencapai kadar protektif sebesar 94,6% (71/75) dengan median kadar antibodinya adalah 885 mIU/ml. (3) Pemberian imunisasi campak ≥ 2 kali meningkatkan timbulnya antibodi campak yang mencapai kadar protektif sebesar 1,227 kali dibanding pemberian imunisasi campak 1 kali.

---

Background. Indonesia measles immunization coverage reach 80% but measles prevalence remains high especially in children 1-4 years old. WHO recommended second dose of measles containing vaccine at second year of age. In Indonesia, it has been done through MMR vaccine at 15-18 month. Unfortunately MMR immunization coverage still low and Ministry of Health recommended second dose of measles containing vaccine for all 2 years old children who have never been immunized with MMR vaccine at 15-18 month to increase the immunity against measles.

Objectives. This study aimed to know: (1) proportion of children 1-4 years old who has been immunized one time measles vaccine and reach protective antibody level and mean of antibody, (2) proportion of children 1-4 years old who has been immunized twice or more measles vaccine and reach protective antibody level and mean of antibody, (3) association between age, age of immunization, nutritional status, and health status when being immunized with measles antibody level, (4) association between second dose of measles vaccine with measles antibody level.

Methods. Cross-sectional study performed in 6 posyandu in 5 region of Jakarta since June until August 2014. Children who met the inclusion criteria were checked for measles IgG, identified for reaching protective level and mean of antibody. Association between second dose of measles vaccine with measles antibody level was also measured.

Results. From 145 participants, 125 (86,2%) had protective measles antibody level (≥ 120 mIU/ml) and 20 (13,8%) had not reached protective level (< 120 mIU/ml). The median measles antibody level in protective group was 844 mIU/ml, with minimum point was 129 mIU/ml and maximum point was 5000 mIU/ml. Children in 3-4 years old group had highest percentage of protective measles antibody level (91,8%) compare to children in 2-3 years old group (88,2%) and 1-2 years old group (72,7%). There were no association between age of immunization and nutritional status with measles antibody level.

Conclusion. (1) Proportion of children 1-4 years old who has been immunized one time measles immunization and reach protective measles antibody level was 77% (54/70) with the median of measles antibody level was 733,5 mIU/ml, (2) Proportion of children 1-4 years old who has been immunized twice or more measles immunization and reach protective measles antibody level was 94,6% (71/75) with the median of measles antibody level was 885 mIU/ml, (3) Twice or more measles immunization will increase protective level of measles antibody 1,227 times compare to one time measles immunization."

"Sistem Kewaspadaan Dini Kejadian Luar Biasa (SKID KLB) bertujuan untuk mengantisipasi keadaan yang mempengaruhi kejadian kesakitan/kematian atau pencemaran makanan/lingkungan, sehingga dapat dilakukan tindakan yang cepat dan tepat guna mencegah KLB itu terjadi. Agar SKD KLB ini berjalan dengan baik maka diperlukan informasi yang mendukung. Dalam SKID KLB Campak, data Imunisasi, data kasus, data gizi kurang dan data yang lainnya yang berhubungan dengan SKD KLB ini harus dikelola dengan baik, selalu diperbarui dan dianalisis sehingga daerah risiko tinggi dan potensial campak diketahui. Di Kabupaten Tapin meskipun program imunisasi dan SKD KLB dijalankan tetapi KLB campak masih saja terjadi.Tujuan penelitian ini adalah untuk mengembangkan sistem informasi daerah potensial KLB dengan basis data dan menggunakan Sistem Informasi Geografis (SIG) berupa peta untuk SKID KLB campak di Kabupaten Tapin. Penelitian ini menggunakan metode pendekatan siklus hidup pengembangan sistem, yaitu perencanaan sistem, analisis sistem clan perancangan sistem.Dari hasil analisis sistem yang ada diketahui, beberapa masalah dari sistem yang ada seperti, sumber daya manusia terbatas sehingga punya beban kerja ganda, Proses analisis data tidak dilakukan secara rutin, output yang dihasilkan hanya berupa tabel cakupan dan laporan ketepatan dan kelengkapan laporan yang tentunya belum bisa digunakan untuk informasi SKD KLB. Teknologi ada tetapi belum digunakan secara maksimal, pengolahan dan penyimpanan data masih manual, sehingga susah dalam pencarian, banyak inkonsistensi data antara puskesmas dan kabupaten, banyak data hilang, dan tentunya mempengaruhi hasil analisis karena tidak lengkap.Untuk mencapai tujuan tersebut, dirancang suatu program aplikasi basis data untuk SKD KLB campak, yang diharapkan dapat menjadi back up data Puskesmas di Kabupaten. Kemungkinan data hilang dan inkonsistensi data bisa diatasi. Berdasarkan hasil analisis kekuatan, kelemahan, ancaman dan peluang tentang sistem yang dibuat, diketahui beberapa kekuatan dan kelemahan sistem. Kekuatan sistem ada pada data yang terstruktur, pengolahan data menjadi lebih cepat, laporan yang disajikan dalam bentuk tabel dan peta lebih bagus secara tampilan dan lebih informatif, bisa menyajikan daerah risiko tinggi dan potensial campak, tempat penyimpanan data menjadi lebih kecil dibanding dengan sistem manual.Disarankan untuk mengatasi kelemahan manajemen data antara puskesmas dan kabupaten, pola pencarian yang lama, dan untuk meningkatkan akurasi data, basis data yang sudah dirancang ini bisa diimplementasikan di Dinas Kesehatan Kabupaten Tapin untuk mendukung SKD KLB Campak. Tidak menutup kemungkinan basis data ini juga bisa dikembangkan lebih lanjut.Pustaka: 31 (1982-2001)

---

The Potential Territory Sistem Information and High Risk of the Measles Outbreak in Tapin District, South BorneoThe Early Warning System (EWS) of the outbreak intends to anticipate the situation that influences the illness or death incidence or food contamination so that the quick and exact step or the exact measure can be done to prevent the coming of the outbreak. The supporting information is needed to the appearance of the EWS of the outbreak. In the EWS of the measles outbreak, the immunization data, case data, less nutrient data, and other data that's related to EWS of the outbreak that must be managed well, and it is always renewed and analyzed so that high risk territory and the measles potential are known. Though the immunization program and EWS of the outbreak are done in Tapin district but the outbreak of measles come too.

The objective of this study is to develop potential territory system of the outbreak and it has data base. It uses the geographic information system that is a map for the EWS of the measles outbreak in Tapin district This study used the approaching method of the system developing live cycle, which consisted of system planning, the system analysis, and system design.

From the product of the system analysis that is some problem of that system in Tapia district, that is the limited human resource so that has the double work load. The data analysis is not done continually, the output that produced are only the scope table, the exact report and the completeness of report that can not be used for the information of the EWS of the outbreak. Technology is there but not optimally used. The management and data storage are still manual, so this adds difficulty in searching, data inconsistancy between community health center and the district, a lot of data missing, that truely influence the analysis product for it does not complete.

To solve the problem an application program of the data base for the EWS of the measles outbreak, was developed and was expected to serve as back up data of community health center in the district. So that the losing data and the inconsistency can be handled. Based analysis strengths, weaknesses, threats and opportunities about the made system, known that there are some strengths and weaknesses of the system. The strengths of this system are the structured data, faster data analysis, the served report in the table and map forms are better to be seen and more informative, and it can serve the high risk territory and measles potential, efficient and smaller storage compared to that of manual system.

It is suggested to solve the weaknesses data management, the data inconsistency between the local community health center and the district, old searching pattern, increase the data accuracy, this planned data base can be implemented in the health office of Tapin District to support the EWS of the measles outbreak. There is also possibility to develop the data base further.

References: 31 (1982-2001)"

"Campak sampai saat ini masih merupakan masalah kesehatan yang perlu ditangani, karena kasus campak masih tinggi dan hampir terjadi di semua daerah. Kasus campak di Kabupaten Serang dapat menimbulkan terjadinya KLB campak. Tujuan penelitian ini adalah mengetahui gambaran epidemiologi kasus campak pada KLB campak di Kabupaten Serang tahun 2010-2012. Penelitian ini menggunakan desain studi seri kasus. Hasil penelitian didapatkan penderita campak tahun 2010 sebanyak 137 orang, tahun 2011 sebanyak 93 orang dan 2012 sebanyak 5 orang, umur penderita campak tertinggi 0-4 tahun dengan kebanyakan status tidak diimunisasi. Penderita didominasi oleh jenis kelamin perempuan. Attack Rate tertinggi pada perempuan, umur 0-4 tahun dan status tidak diimunisasi. Case Fatality Rate 2.58% terjadi tahun 2010. Kasus campak terjadi pada daerah dengan kepadatan penduduk tinggi, tahun 2010 di Kecamatan Cikeusal, tahun 2011 di Kecamatan Kibin dan tahun 2012 di Kecamatan Baros. Berdasarkan data tersebut, diharapkan Kabupaten Serang dapat meningkatkan cakupan imunisasi campak terutama sasaran kelompok umur <5 tahun serta pemberian penyuluhan kepada masyarakat tentang pentingnya imunisasi campak.

---

Measles is still a health issue that needs to be addressed, because the high and cases of measles occurred in almost all areas. Serang measles cases can lead to measles outbreaks. The purpose of this study was to determine an overview of epidemiology cases of measles in an outbreak of measles in Serang in 2010-2012. This study used a case series study design. The results obtained with measles in 2010 as many as 137 people, as many as 93 people in 2011 and 2012 as many as 5 people, the highest measles patients aged 0-4 years with most of the state are not immunized.

Patients are dominated by the female gender. Attack the highest rate among women, age of 0-4 years and status is not immunized. Case Fatality Rate 2.58% occurred in 2010. Measles cases occurred in areas with high population density, in 2010 in District Cikeusal, in 2011 in the District Kibin and 2012 in the District of Baros. Based on these data, it is expected to increase Serang measles immunization coverage primarily targeted age group <5 years as well as providing education to the public about the importance of immunization against measles."

"Penyakit campak masih merupakan masalah kesehatan masyarakat di Indonesia, baik dari segi surveilans epidemiologi maupun pemberantasannya. Penyakit campak dapat dikatakan menyebar secara merata di seluruh wilayah Republik Indonesia. Di beberapa daerah masih sering terjadi kejadian luar biasa (KLB), terutama daerah yang sulit dijangkau pelayanan kesehatan seperti daerah transmigrasi (Gunawan, 1987: 62-65).Adapun KLB campak di Indonesia selama tahun 1989-1993 adalah seperti dalam tabel berikut:Tabel 1.1.KLB Campak di Indonesia Selama Tahun 1989 - 1993Lihat Bentuk PDFDari tabel di atas tampak bahwa pada tahun 1992 merupakan puncak dari jumlah KLB, jumlah kasus, dan jumlah Dati II yang mengalami KLB, walaupun jumlah Dati I dan CFR-nya lebih rendah dari tahun sebelumnya. Jumlah Dati I yang mengalami KLB dan CFR tampak meningkat pada tahun berikutnya.Adapun KLB campak di Propinsi Java Barat antara tahun 1991 sampai dengan tahun 1994 adalah seperti pada tabel berikut:Taber 1.2.KLB Campak di Propinsi Jawa Barat Selama Tahun 1991 - 1994Lihat Bentuk PDFDari tabel ini tampak bahwa di Propinsi Jawa Barat jumlah KLB cenderung menurun walaupun CFR-nya cenderung meningkat.Angka insidens penyakit campak menurut SKRT 1986 adalah 44/10.000 penduduk per bulan atau 528.110.000 penduduk dalam 1 tahun. Kasus campak yang ada sebenarnya lebih besar bila pencatatan dan pelaporannya lebih baik (Ditjen PPM & PLP, 1994). Keadaan lingkungan jelek dan gizi masih kurang akan menyebabkan angka kematian menjadi tinggi. (PPK LPUI, 1992: 13). Pada permulaan tahun 1990 sekitar 1 juta anak-anak di dunia, terutama di negara berkembang, meninggal karena penyakit campak setiap tahun. Case Fatality Rate (CFR) di negara berkembang berkisar 10-20 kali lebih tinggi daripada negara industri (Ditjen PPM & PLP, 1994). Di beberapa negara berkembang sebelum vaksinasi dijalankan.Kematian karena campak dari semua golongan umur adalah 3,5% atau lebih (Depkes RI, 1984) dan naik menjadi 10% di saat terjadi wabah (Masjkuri, 1987). Dari hasil pelacakan kejadian luar biasa (KLB) di Indonesia ternyata angka kematian masih cukup tinggi, yaitu pada tahun 1989 tercatat 4,6% dan pada tahun 1993 tercatat 7,9% (Ditjen PPM & PLP, 1994). Pada SKRT 1992 penyakit campak menduduki peringkat ke 6 dalam penyebab kematian bayi karena menyebabkan 2,6% kematian bayi, sedangkan sebagai penyebab kematian pada anak umur 1-4 tahun penyakit campak bersama-sama dengan penyakit difteri dan pertusis menduduki peringkat ke 3 karena menyebabkan 9,4% kematian pada golongan umur tersebut. CFR campak di rumah sakit di Jawa Barat pada tahun 1991 tercatat 0% dan pada tahun 1992 meningkat menjadi 1,3%. Hal ini tidak jauh berbeda dengan CFR penderita campak yang dirawat inap di Rumah Sakit di Indonesia dari tahun 1988 sampai dengan tahun 1992 yang terlihat pada tabel berikut:Tabel 1.3.CFR Penderita Campak yang dirawat inap rumah sakit di Indonesia dari Tahun 1988 -1992Lihat Bentuk PDF"

"Dewasa ini di Indonesia, campak masih merupakan masalah kesehatan masyarakat. Imunisasi campak telah dimulai tahun 1982 dan cakupan imunisasi mengalami peningkatan. Meskipun demikian, di beberapa daerah masih terdapat Kejadian Luar Biasa (KLB) campak, seperti halnya yang terjadi di Kabupaten Majalengka.Berdasarkan atas kenyataan ini, dilakukan penelitian yang mengkaji tentang faktor-faktor yang berhubungan dengan cara pemberian imunisasi campak sesuai dengan SOP Imunisasi di Kabupaten Majalengka, tahun 2002, yang terdiri atas beberapa variabel, antara lain : lama masa kerja, pendidikan, pengetahuan, pelatihan, sikap, perilaku, jarak, transportasi, kelengkapan imunisasi, vaksin campak yang dipergunakan oleh petugas kesehatan di Puskesmas dan insentif.Penelitian dilakukan di Kabupaten Majalengka tahun 2002 dengan mempergunakan disain studi potong-lintang (cross sectional), serta mempergunakan data primer yang diperoleh melalui observasi dan wawancara, dengan responden yang berjumlah 209 orang yang merupakan seluruh populasi yang telah memenuhi kriteria sampel yang dimaksudkan. Analisis data meliputi analisis univariat, bivariat, multivariat dan deskriptif.Hasil penelitian menunjukkan, bahwa 4 (empat) dari 11 (sebelas) variabel yang diperoleh adanya hubungan yang bermakna secara statistik, antara lain : pelatihan petugas (OR = 3,54; 95% CI = 1,42 - 8,82; p = 0,007), pengetahuan (OR = 5,69; 95% CI = 2,10 - 15,44; p = 0,001), sikap (OR = 3,45; 95% CI = 1,40 - 8,50; p = 0,009), dan perilaku (OR 2,26; 95% CI = 0,94 - 5,45; p = 0,068). Selanjutnya, pada penelitian ini tidak ditemukan adanya interaksi pada faktor risiko yang berhubungan dengan cara pemberian imunisasi campak.Dari hasil penelitian ini disarankan, bahwa masih perlu adanya peningkatan pelatihan bagi petugas kesehatan. Dengan demikian, diharapkan akan mampu trampil dalam memberikan pelayanan imunisasi campak kepada sasaran, terutama dalam hal cara pemberian imunisasi campak kepada sasaran. Di samping itu, dengan adanya pelatihan akan dapat menjawab masalah kebutuhan tenaga imunisasi campak di Puskesmas, Kabupaten Majalengka. Adanya peningkatan pendidikan dan pengetahuan juga perlu diperhatikan. Selain itu, perlu dipertimbangkan adanya upaya-upaya untuk meningkatkan pengetahuan. Dengan kata lain masalah pelatihan, pendidikan dan pengetahuan petugas perlu dipertimbangkan secara khusus.Factors Related to the Staff Obedience to the Measles Immunization Method in Accordance with the SOP of Immunization the Regency of Majalengka in 2002In Indonesia, recently measles is a public health problem. Through measles immunization in Indonesia, which had been established since 1982, it has been, increased the coverage gradually. However, it can be seen that measles outbreak in some areas, such as in the Regency of Majalengka has been occurred in other rural and urban areas.

Based on these facts, a study was carried on investigating the factors related to the staff obedience to the measles immunization method in accordance with the SOP of Immunization, the Regency of Majalengka in 2002. The variables consist of: occupational period, education, knowledge, training, attitude, behavior, distance, transportation, completeness of measles immunization, measles vaccine used by staff in the Public Health and incentive.

The study in the Regency of Majalengka in 2002, made use the cross-sectional design study, and primary data has been accepted through observation and interview, with 209 respondent, namely the whole population meeting the sample criteria mentioned above. Data were analyzed by univariate, bivariate, multivariate and descriptive analysis.

The results of study showed, 4 (four) of 11 (eleven) variables was statistically significant correlation, those are: training (OR = 3.54; 95% CI = 1.42 - 8.82; p = 0.007), knowledge (OR = 5.69; 95% CI = 2.10 - 8.82; p = 0.001), attitude (OR = 3.45; 95% CI = 1.40 - 8.50; p = 0.009), and behavior (OR = 2.26; 95% CI = 0.94 - 5.45; p = 0.068). Furthermore, this study did not show any interaction of risk factors related of the measles immunization.

Based on the research, it is necessary suggested to improve training for the staff gradually. In this way, as was mentioned above, hope to be able to skilled up the staff in order to make a better measles immunization service, mainly in relation to the measles immunization of the target. In addition, by the training, it is hope, the problem of the need of measles immunization staff in the Public Health; the Majalengka Regency can be applied properly. It was also considered necessary to improve knowledge and education efforts. The other words, training, knowledge and education of the staff are necessary given a special attention."

"Campak adalah penyakit infeksi virus yang masih tetap merupakan masalah di negara berkembang, terutama ketika terjadi letusan Kejadian Luar Biasa. Menurut Word Health Organization, di Indonesia sekitar 38.000 kematian campak per tahun Kabupaten Bogor merupakan salah satu kabupaten di Indonesia yang mempunyai masalah kesehatan serius terhadap penyakit campak dimana peningkatan cakupan imunisasi mencapai lebih dari 90 % tahun 2002.Campak masih sering menimbulkan KLB pada tahun 2002 di Kabupaten Bogor. KLB yang terjadi 6 kali di 6(enam) Kecamatan, dengan jumlah kasus 775 orang, meninggal 2 orang.Penelitian ini dilakukan untuk mengetahui faktor risiko kejadian campak pada saat KLB di Kabupaten Bogor tahun 2002. Studi ini menggunakan desain kasus kontrol, dengan 148 sampel kasus dan 158 sampel kontrol. Kasus adalah anak umur 9 bulan - 6 tahun, menderita campak pada saat letusan KLB Campak terjadi, sedangkan kontrol adalah anal( umur 9 bulan - 6 tahun yang tidak menderita campak pada saat letusan KLB campak terjadi. Definisi operasional campak adalah demam 38° Celcius. bercak merah, batuk pilek dan mata merah dengan atau tanpa bintik spot (Koplik Spot). Data dikumpulkan dari hasil wawancara yang dilakukan oleh pewawancara melalui kuesioner pada responden yaitu ibu anak umur 9 bulan-6 tahun balk pada kasus maupun pada kontrol. Analisa data dilakukan dengan analisis univariat, bivariat dan multivariat.Hasil akhir dari penelitian ini diambil dari hasil analisis multivariat, menemukan bahwa faktor risiko utama menimbulkan kejadian campak adalah tidak imunisasi (OR = 46,06, 95% CI ; 22,00 - 96,24), p < 0,05, Status Vitamin A, anak yang dapat satu kali atau tidak pernah (OR= 2,56, 95% CI ; 1.18 - 5.56), p <0,05, perilaku ibu kurang (OR = 2,40, 95% CI 1,16 - 5,00), p<0,05 dan pola asuh kurang (OR = 2,71, 95% CI; 1,09 - 6,73), p< 0,05.Berdasarkan hasil penelitian ini diharapkan dapat memberikan informasi bagi pengambil keputusan di Kabupaten Bogor guna memberikan perhatian pada empat faktor diatas yaitu Status imunisasi, Status vitamin A. perilaku ibu, dan pola asuh terhadap anak.Daftar Pustaka : 41 (1980 - 2002)

---

Measles a viral infectious disease usually occurs at the unusual event- is still the problem in developing countries such Indonesia, India. Bangladesh. According to The World Health Organization there were about 38.000 case measles died per year (Estimate WHO, 2000). Bogor-one of district in Indonesia- has a serious problem of measles, in spite of the coverage immunization over 90 % in 2002.

The frequency of measles outbreak in Bogor District in 2002 were 6 (six) times on 6 Sub Districts, the total cases were 225 and 2 children died.

Therefore, this study is aimed to determine the risk factors related to measles disease at the unusual event in Bogor in 2002. The study design was a case control study, with 148 case samples and 158 control samples. The cases were the children of age 9 months - 6 years with clinical symptoms of measles fever , rash, conjunctivitis, and the controls were the healthy children of age 9 months - 6 years.

The data was collected by interviewing the children's mothers using questioner. The method of analysis of the study are analysis of univariate, bivariate (chi Square) and multivariate (logistic regression).

The result of the study using a statistical significance of multivariate analysis shows that the main factors this disease occurs are not immunized (OR=46,06, 95 %CI;22,00 - 96,24), p< 0,05, vitamin A status, children consumpted vitamin A or never (OR=2,56, 95 % CI; 1,18 - 5,56), p<0,05, behavior of mothers was significance (OR=2,40, 95 % CI 1,16 - 5,00), p<0,05 , and the care pattern of mother was significance (OR=2,71, 95 % CI 1,09 - 6,73) p<0,05.

Based on the study result, it was suggested that the policy makers have to pay more attention to the family of children of age 9 months - 6 years who have not gotten measles immunization, never consumpted Vitamin A or only consumpted one tablet vitamin A, missed behavior, and missed care pattern."