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"Low adult vaccination coverage in Indonesia may contribute to a recent outbreak of diphtheria in Indonesia. Although well known as a pediatric vaccine, diphtheria vaccination should be administered as booster to adolescence and adults for longer prevention. Adult vaccine differs from pediatric vaccine but have similar protection. Additionally, there is special recommendation to vaccinate pregnant women and elderly people aged 65 years or more.

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Cakupan imunisasi dewasa yang rendah mungin berperan pada kejadian luar biasa (KLB) difteria baru-baru ini di Indonesia. Meskipun dikenal sebagai vaksin anak, vaksinasi difteria harus diberikan sebagai ulangan pada remaja dan dewasa untuk pencegahan jangka panjang. Vaksin dewasa berbeda dari vaksin anak tetapi memiliki proteksi yang sama. Selain itu, dianjurkan pula vaksinasi untuk ibu hamil dan orang lanjut usia di atas 65 tahun."

"Difteri merupakan penyakit menular yang dapat menyebabkan kematian. Di Indonesia, Difteri merupakan masalah endemis dimana tingkat kematian Difteri selama lima tahun terakhir mengalami peningkatan yaitu sebesar 1,8% pada tahun 2018 menjadi 8,5% pada tahun 2022. Penelitian sebelumnya menunjukkan bahwa riwayat vaksinasi dan pemberian Anti Difteri Serum (ADS) merupakan faktor independen yang mempengaruhi kematian akibat Difteri, namun efek gabungan kedua faktor tersebut belum banyak diketahui. Oleh karena itu, dilakukan penelitian dengan tujuan untuk mengetahui hubungan riwayat vaksinasi Difteri dan riwayat pemberian ADS dengan kejadian kematian Difteri di Indonesia. Penelitian ini menggunakan desain studi kasus kontrol dengan menggunakan data sekunder dari laporan surveilans Difteri Kementerian Kesehatan tahun 2018-2022. Hasil penelitian menunjukkan risiko gabungan pada mereka yang tidak divaksinasi dan tidak diberikan ADS sebesar 4,57 kali (95% CI 2,30-9,09) lebih tinggi dibandingkan kasus Difteri dengan riwayat divaksinasi dan diberikan ADS. Risiko indepeden menunjukkan kelompok yang tidak divaksinasi memiliki risiko kematian 3,03 kali (95% CI 1,93-4,75) lebih tinggi dibandingkan dengan kelompok yang divaksinasi. Sedangkan kelompok yang tidak diberikan ADS memiliki risiko kematian 0,31 kali (95% CI 0,11- 0,82) lebih rendah dibandingkan dengan kelompok yang diberikan ADS, namun hasil ini mungkin masih dipengaruhi oleh faktor-faktor perancu yang belum dikontrol dalam penelitian ini, sehingga tidak dapat disimpulkan bahwa tidak memberikan ADS justru menurunkan risiko kematian akibat Difteri. Sebanyak 45% kejadian kematian Difteri dikaitkan dengan interaksi antara tidak divaksinasi dan tidak diberikan ADS. Oleh karena itu, penting untuk melakukan upaya bersama untuk meningkatkan cakupan vaksinasi dan pemberian ADS secara tepat untuk menurunkan kejadian kematian akibat Difteri.

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Diphtheria is an infectious disease that can cause death. In Indonesia, Diphtheria is an endemic problem with an increasing death rate over the last five years by 1.8% in 2018 to 8.5% in 2022. Previous studies have shown that vaccination and administration of diphtheria antitoxin (DAT) affect mortality, but their combined effect is not widely known. Therefore, a study was conducted to determine the relationship between these two factors and Diphtheria mortality in Indonesia. The research used a case-control design with secondary data from the Ministry of Health's 2018-2022 Diphtheria surveillance report. The findings revealed that individuals who were neither vaccinated nor given DAT had a 4.57 times higher risk of death (95% CI 2.30-9.09) than vaccinated and received DAT group. Unvaccinated individuals had a 3.03 times higher risk of death (95% CI 0.11-0.82) than vaccinated individuals. The risk of death was 0.31 times lower (95% CI 0.11-0.82) in those who did not receive DAT. However, it is important to note that these results may still influenced by uncontrolled factors, thus no conclusion can be drawn regarding the reduction of death risk through withholding DAT. Up to 45% of diphtheria-related mortality were linked to the combination of this two factors. To reduce diphtheria deaths, it is essential to enhance immunization coverage and administer DAT properly."

"ABSTRACTVaccination is the administration of agent-specific, harmless antigenic components to someone that meant to induce protective immunity against the infectious agents. The term vaccination and immunization often use interchangeably. In general, vaccination is a highly effective method of preventing infectious diseases. Routine immunization programmes prove to protect many children in the world and saves millions of live each year. However, different understanding applied to adult, even though adults can be protected from 14 deadly diseases started with lesser losses work or school days due to Rubella, Diphteria, Hepatitis A and HPV infection. Decrease hospitalizations and deaths due to Hepatitis B, Shingles, and Pertussis. Minimize spreading diseases of Mumps, Tetanus, Influenza, Pneumococcal diseases. Avoid permanent disability due to Chicken pox, Measles, and Meningococcal disease. Children under the age of 5 years of age, more than 90% were received vaccines and this was contrast with adult immunization rates. Two possible explanations are adults do not aware their own risk and the nation do not have sustained commitment to vaccination for adults as for children. One of the most deteriorating diseases that could be prevented is varicella zoster virus. In initial, Shingles more common and severe in older persons. In addition to that, the long-term effects of the infection known as post-herpetic neuralgia (PHN), could lasting long and difficult to treat. The recommendation on how delivering herpes zoster vaccine will be discussed further. "

"The upper respiratory tract is lined with ciliated epithelium or brush border that functions as the primary filter to the respiratory tissue. Epithelial trauma caused by neonatal boedetellosis serves as the predisposing factor for other respiratory diseases in growing pig...."

"ABSTRACTAnak usia 1-5 tahun atau biasa disebut Balita Bawah Lima Tahun memiliki sistem imun yang rendah dan cukup rentan terhadap serangan penyakit, oleh karena itu anak memerlukan serangkaian imunisasi untuk membangun kekebalan dasar pada tubuhnya. Adanya KLB Difteri dapat meningkatkan resiko balita mengalami kecacatan, kesakitan dan kematian. Pengetahuan ibu berperan penting dalam memenuhi kelengkapan imunisasi difteri sebagai tindakan pencegahan penyakit difteri, hal ini kaitannya dengan kepatuhan ibu. Tujuan penelitian ini untuk mengidentifikasi hubungan tingkat pengetahuan ibu dengan kepatuhan imunisasi difteri anak usia 1-5 tahun. Desain penelitian cross sectional menggunakan metode convinience sampling. Sampel penelitian ini adalah ibu yang memiliki anak usia 1-5 tahun, jumlah sampel penelitian sebanyak 95 responden. Hasil analisa data menunjukan ada hubungan antara tingkat pengetahuan ibu dengan kepatuhan imunisasi difteri anak usia 1-5 tahun p le; p = 0.001, =0.5. Tenaga kesehatan keperawatan dapat meningkatkan upaya preventif dan promosi kesehatan tentang imunisasi dan difteri agar kepatuhan terhadap imunisasi difteri dapat ditingkatkan.

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ABSTRACTChildren aged 1 5 years or commonly called Toddlers Under Five Years have a low immune system and are quite susceptible to disease attacks, therefore children need a series of immunizations to build basic immunity in the body. The presence of Diphtheria Outbreak may increase the risk of todlers experiencing disability, illness and death. Mother 39 s knowledge plays an important role in fulfilling the completeness of diphtheria immunization as a preventive measure of diphtheria disease, this is related to mother 39 s compliance. The purpose of this study was to identify the relationship between mother 39 s knowledge level and compliance diphtheria immunization in children 1 5 years old. The research design used cross sectional with convinience sampling method. Sample in this research is a mother have children aged 1 5 years old, the number of research samples were 95 respondents. The result of data analysis showed that there was a correlation between mother 39 s knowledge level and diphtheria immunization of children 1 5 years old p le p 0.001, 0.5 Nursing health can improve preventive and health promotion about immunization and diphtheria, so that adherence to diphtheria immunization can be improved."

"Vaksinasi COVID-19 pada anak di Indonesia tidak terlepas dari orang tua yang menyetujui dan tidak menyetujui vaksinasi COVID-19 pada anak. Penelitian bertujuan untuk mengetahui faktor yang berhubungan dengan kesediaan orang tua menyetujui vaksinasi COVID-19 pada anak di Indonesia. Responden merupakan orang tua yang memiliki anak berusia 6-18 tahun. Penelitian ini menggunakan desain penelitian deskriptif, korelasi dan cross-sectional dengan sampel 428 responden. Instrumen penelitian menggunakan kuesioner karakteristik orang tua dan anak, serta kuesioner pengetahuan terkait vaksin COVID-19. Penelitian ini menunjukkan adanya faktor yang berhubungan dengan kesediaan orang tua menyetujui vaksin COVID-19 pada anak meliputi keterkaitan dengan anak (p = 0.003, α = 0.05), riwayat pengobatan anak (p = 0.008, α = 0.05), status vaksin influenza, dan status vaksinasi COVID-19 anak, khawatir keparahan COVID-19, penjelasan ilmiah, akses ke pelayanan kesehatan, dan pengetahuan orang tua/wali (p=0.000, α = 0.05). Penelitian selanjutnya diharapkan untuk meneliti faktor lain yang berkaitan dengan kesediaan orang tua menyetujui vaksin COVID-19 pada anak.

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Vaccination against COVID-19 in children in Indonesia is inseparable from parents agreeing and not agreeing to vaccination of COVID-19 in children. The study aims to determine the factors associated with the willingness of parents to agree to vaccination against COVID-19 in children in Indonesia. Respondents are parents who have children aged 6-18 years. This study used a descriptive, correlation and cross-sectional research design with a sample of 428 respondents. The research instrument used a questionnaire on the characteristics of parents and children, as well as a knowledge questionnaire related to the COVID-19 vaccine.

This study showed that there were factors associated with the willingness of parents to agree to the COVID-19 vaccine in children including association with the child (p = 0.003, α = 0.05), history of child medication (p = 0.008, α = 0.05), influenza vaccine status, and children's COVID-19 vaccination status, concern about the severity of COVID-19, scientific explanation, access to health services, and knowledge of parents/guardians (p=0.000, α = 0.05). Future research is expected to examine other factors related to the willingness of parents to approve the COVID-19 vaccine for children."

"Pemerataan pelayanan bagi seluruh kalangan merupakan sebuah topik yang sering diperbincangkan di tingkat internasional dan juga nasional. Kerentanan lansia membuat percepatan akan vaksinasi diperlukan untuk mencegah Covid-19. Dalam pelaksanaannya diperlukan akses yang baik dan kebijakan yang memadai untuk lansia dalam proses vaksinasi. Penelitian ini bertujuan untuk menganalisis akses lansia pada program vaksinasi Covid-19 di Kota Tangerang, dengan menggunakan teori akses dari Saurman (2016) yang membagi akses menjadi 6 dimensi. Penelitian ini merupakan penelitian deskriptif, dengan pendekatan post positivist melalui teknik pengumpulan data wawancara mendalam dan studi literatur. Hasil dalam penelitian ini menunjukkan bahwa akses pelayanan vaksinasi lansia sudah tersedia dengan baik secara fisik maupun akses non fisik, namun, terdapat beberapa hal yang perlu dioptimalkan terutama dalam hal sumber daya pemerintah maupun terkait koordinasi antar elemen agar pelayanan dapat diakses dengan baik oleh masyarakat lansia. Kemudian diperlukan ketersediaan lansia dalam mengakses pelayanan tersebut dengan baik, hal tersebut disebabkan terdapat ketimpangan antara masyarakat yang bersedia untuk mencari informasi mengenai pelayanan dan mendapatkan pelayanan tersebut dengan masyarakat yang tidak memiliki keperdulian atau kemauan dalam mengakses pelayanan vaksinasi Covid-19

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Equitable distribution of services for all circles is a topic that is often discussed at the international and national level. The vulnerability of the elderly makes the acceleration of vaccination necessary to prevent Covid-19. In its implementation, it is necessary to have good access and adequate policies for the elderly in the vaccination process. This study aims to analyze the access of the elderly to the Covid-19 vaccination program in Tangerang City, using the access theory from Saurman (2016) which divides access into 6 dimensions. This research is a descriptive research, with a post-positivist approach through data collection techniques in-depth interviews and literature study. The results in this study indicate that access to vaccination services for the elderly is available both physically and non-physically, however, there are several things that need to be optimized, especially in terms of government resources and related to coordination between elements so that services can be accessed properly by the elderly community. Then the availability of the elderly is needed in accessing these services properly, this is because there is an imbalance between the elderly community who are willing to seek information about services and get these services and the elderly people who do not have the concern or willingness to access Covid-19 vaccination services."

"Tuberkulosis (TB) merupakan salah satu penyakit menular yang menyebabkan kematian. TB disebabkan oleh bakteri Mycobacterium tuberculosis yang umumnya menyerang paru-paru. Berbagai pendekatan matematika telah dilakukan dalam menganalisis penyebaran TB. Pada skripsi ini, dikonstruksi model penyebaran TB dengan pendekatan sistem persamaan diferensial, dimana populasi manusia dibagi ke dalam beberapa kompartemen berdasarkan status kesehatannya. Beberapa fakta penting yang dipertimbangkan dalam model di skripsi ini antara lain keberadaan manusia yang terinfeksi TB laten, keterbatasan kapasitas rumah sakit, serta intervensi di lapangan, yaitu vaksinasi dan perawatan terpantau. Dari model yang telah dibangun, dilakukan kajian analitik yang meliputi analisis eksistensi serta kestabilan dari titik-titik keseimbangannya dan hubungannya dengan bilangan reproduksi dasar (R0). Kemudian, dilakukan simulasi numerik yang mencakup analisis sensitivitas dan elastisitas (R0) serta simulasi autonomous dari model. Berdasarkan kajian analitik dan kajian numerik yang telah dilakukan, didapatkan informasi bahwa vaksinasi dan perawatan terpantau sukses mereduksi penyebaran TB. Lebih jauh, didapatkan bahwa intervensi vaksinasi jauh lebih menjanjikan dalam upaya eradikasi TB dibandingkan dengan perawatan terpantau.

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Tuberculosis (TB) is an infectious disease that causes death. TB is caused by Mycobacterium tuberculosis bacteria which commonly attack the lungs. Various mathematical approaches have been done to analyze the spread of TB. In this study, the mathematical model of TB transmission is constructed using the approach of an ordinary differential equation system, where the human population is divided into several sub-populations based on their health status. Several important facts considered in the model's construction are the existence of latent TB, the limit of the hospital's capacity, and some of the interventions applied; vaccination and observed treatment. From the constructed model, an analytical study that covers the existence as well as the stability analysis of the equilibrium points, and determining the basic reproduction number (R0) is performed. Moreover, a numerical study that covers the elasticity analysis of R0 and autonomous simulations is performed in this thesis. Based on the analytical and numerical study, it is known that both vaccination and observed treatment successfully reduce TB transmission. Furthermore, it is known that vaccination intervention is way more promising in eradicating TB compared to observed treatment."