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"Latar Belakang: Rumah Sakit Khusus Daerah Duren Sawit telah memiliki pengalaman besar dalam penanggulangan bencana Penyakit Infeksi Emerging (COVID-19), namun Rumah Sakit belum melakukan analisa dan merancang hospital disaster plan untuk penyakit infeksi. Ancaman bencana PINERE di masa mendatang dilaporkan akan menjadi lebih serius, sering terjadi karena faktor perubahan ekologi yang cepat, perubahan iklim dan peningkatan perjalanan. Rumah Sakit harus memiliki kesiapsiagaan terhadap bencana PINERE. Oleh karena itu, rumah sakit harus memiliki Hospital Disaster Plan Penyakit Infeksi.Metode: Penelitian ini merupakan penelitian kualitatif, riset operasional menggunakan modifikasi dari Pedoman Kesiapsiaan Rumah Sakit Terhadap Epidemi oleh WHO, Daftar Tilik Kesiapan Rumah Sakit Dalam Masa Pandemi COVID-19 oleh Kemenkes dan teori manajemen risiko bencana. Lokasi penelitian di Rumah Sakit Khusus Daerah Duren Sawit yang merupakan milik Pemerintah Provinsi DKI Jakarta.Hasil: Penelitian ini menghasilkan rancangan Hospital Disaster Plan Penyakit Infeksi Emerging dan Re-Emerging (PINERE) Rumah Sakit Khusus Daerah Duren Sawit.Kesimpulan: Rancangan Hospital Disaster Plan Penyakit Infeksi Emerging dan Re-Emerging (PINERE) Rumah Sakit Khusus Daerah Duren Sawit dapat dibahas lebih lanjut oleh manajemen Rumah Sakit untuk digunakan sebagai kesiapsiagaan terhadap bencana penyakit infeksi.

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Background: The Duren Sawit Hospital has great experience in managing the Emerging Infectious Disease (COVID-19) disaster, but the hospital has not yet carried out an analysis and designed a hospital disaster plan for infectious diseases. The threat of future Infectious Disease disasters is reported to be more serious, often due to factors such as rapid ecological change, climate change and increased travel. Hospitals must have preparedness for the PINERE disaster. Therefore, hospitals must have a Hospital Disaster Plan for Emerging and Re-Emerging Infectious Diseases.

Methods: This research is qualitative research, operational research using modifications of the WHO Guidelines for Hospital Preparedness against Epidemics, the Hospital Readiness Checklist during the COVID-19 Pandemic by the Ministry of Health and disaster risk management theory. The research location is at the Duren Sawit Hospital which belongs to the DKI Jakarta Provincial Government.

Results: This research resulted in a draft Hospital Disaster Plan for Emerging and Re-Emerging Infectious Diseases (PINERE) for the Duren Sawit Regional Special Hospital

Conclusion: The draft Hospital Disaster Plan for Emerging and Re-Emerging Infectious Diseases for the Duren Sawit Hospital can be discussed further by the Hospital management to be used as preparedness for infectious disease disasters."

"Kasus harian COVID-19 Kota Depok termasuk yang tertinggi di Jawa Barat, akibatnya Puskesmas di Kota Depok mengalami beban ganda pada saat krisis pandemi COVID-19 yang menyebabkan gangguan pada pelayanan kesehatan. Kapasitas kesiapsiagaan dalam menghadapi ancaman Penyakit Infeksi Emerging (PIE) diperlukan demi terwujudnya ketangguhan Puskesmas. Penelitian ini bersifat kualitatif dengan wawancara mendalam dan FGD. Hasil penelitian ini adalah pembahasan ketangguhan Puskesmas yang dinilai dari unsur kesiapan pada konteks yaitu kecukupan dan keahlian SDMK, pembiayaan terhadap wabah, layanan kesehatan di Puskesmas, pemenuhan kebutuhan obat dan alat kesehatan, penerapan regulasi yang bersifat promotif terhadap penanganan wabah, ketersediaan sarana dan prasarana pendukung kegiatan pencegahan dan deteksi dini, serta informasi kesehatan yang disebarkan. Mekanisme dibutuhkan untuk mendukung kinerja konteks berupa koordinasi multisektoral yang melibatkan kolaborasi pentahelix dan juga rekomendasi One Health sebagai bentuk upaya identifikasi, deteksi, pencegahan dan respon. Adapun pendekatan 5S1T dan kegiatan peran serta masyarakat dinilai mampu mengoptimalkan mekanisme untuk mempercepat upaya penanganan wabah.   Pada akhirnya kesimpulan yang dapat ditarik mengenai kesiapan mencapai ketangguhan Puskesmas menghadapi PIE di Kota Depok belum sepenuhnya namun dapat dibangun dengan memperkuat unsur sistem kesehatan yang ditinjau pada aspek konteks berkaitan dengan mekanisme pendukung sehingga dapat mencapai ketangguhan Puskesmas.

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The daily cases of COVID-19 Depok City are among the highest in West Java. The Puskesmas in Depok City experienced a double burden during the COVID-19 pandemic crisis which caused disruption to health services. Preparedness capacity in dealing with the threat of Emerging Infectious Diseases (PIE) is needed for the realization of the resilience of the Puskesmas. This research is qualitative in nature with in-depth interviews and FGDs. The results of this study are a discussion of the resilience of the Puskesmas which is assessed from the elements of preparedness in the context, namely the adequacy and expertise of health care workforce, financing for outbreaks, health services at the Puskesmas, meeting the needs of medicines and medical devices, implementing promotive regulations for handling outbreaks, availability of supporting facilities and infrastructure prevention and early detection activities, as well as health information dissemination. Mechanisms are needed to support contextual performance in the form of multisectoral coordination involving pentahelix collaboration and also One Health recommendations as a form of identification, detection, prevention and response. The 5S1T approach and community participation activities are considered capable of optimizing mechanisms to accelerate efforts to deal with outbreaks. In the end, the conclusion that can be drawn regarding the readiness to achieve resilience of the Puskesmas in facing EID in Depok City is not yet complete, but it can be built by strengthening the elements of the health system which is reviewed in terms of context related to supporting mechanisms so that the resilience of the Puskesmas can be achieved.

 

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"Rumah Sakit Khusus Daerah (RSKD) Duren Sawit merupakan salah satu rumah sakit di daerah Jakarta Timur yang telah mendukung pengembangan Sistem Informasi Kesehatan Daerah (SIKDA) DKI Jakarta, yaitu dengan cara mengimplementasikan Sistem Informasi Manajemen Rumah Sakit (SIMRS). Saat ini RSKD Duren Sawit sedang dalam tahap penerapan keamanan informasi SIMRS berdasarkan ISO/IEC 27001. Hal tersebut selaras dengan adanya Peraturan Mentri Kominfo No.4 tahun 2016 tentang sistem standar manajemen pengamanan informasi untuk penyelenggaraan sistem elektronik. Namun berdasarkan hasil evaluasi indeks Keamanan Informasi (KAMI) dari Badan Siber dan Sandi Negara, penerapan keamanan informasi di RSKD Duren Sawit belum memenuhi standar keamanan informasi. Penyebab utama dari permasalah tersebut ialah belum adanya penerapan manajemen risiko yang belum mengacu pada standar keamanan informasi. Oleh karena itu, perlu adanya perancangan manajemen risiko keamanan informasi untuk SIMRS RSKD Duren Sawit. Penelitian ini menggunakan kerangka kerja ISO/IEC 27005 sebagai panduan dalam merancang manajemen risiko serta mendukung konsep umum yang ditetapkan dalam ISO/IEC 27001. Pengumpulan data dilakukan dengan dua cara yaitu primer dan sekunder. Pengumpulan data primer berdasarkan wawancara secara langsung di Bagian Pelaksanan SIMRS RSKD Duren Sawit. Pengumpulan data sekunder dilakukan dengan menganalisis dokumen internal RSKD Duren Sawit terkait SIMRS. Penelitian ini menghasilkan 7 skenario risiko yang akan diterima (accept) dan 62 skenario yang akan dikontrol (mitigate). Rekomendasi kontrol disusun dengan mengacu pada ISO/IEC 27002. Berdasarkan penelitian ini dapat meminimalisir dampak kerugian bagi RSKD Duren Sawit. Selain itu, dapat meningkatkan keamanan informasi pada SIMRS RSKD Duren Sawit yang sesuai dengan regulasi pemerintah, serta dapat dijadikan sebagai bahan pertimbangan dan pengambilan keputusan pihak manajemen demi peningkatan layanan SIMRS RSKD Duren Sawit.

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Rumah Sakit Khusus Daerah (RSKD) Duren Sawit is one of the hospitals in the East Jakarta area that has supported the development of the Regional Health Information System DKI Jakarta (SIKDA), by implementing the Hospital Management Information System (SIMRS). Currently RSKD Duren Sawit is in the stage of implementing information security SIMRS based on ISO/IEC 27001. This is in line with the Regulation of the Minister of Communication and Information No. 4 of 2016 concerning the standard system of information security management for the implementation of electronic systems. However, based on the results of the evaluation of Indeks Keamanan Informasi (KAMI) from Badan Siber dan Sandi Negara (BSSN), the application of information security in RSKD Duren Sawit is not yet fulfilled information security standards. The root cause of these problems is because information security risk management does not refer to information security standards. Therefore, it is necessary to design an information security risk management for SIMRS RSKD Duren Sawit. This research uses the ISO / IEC 27005 framework as a guide in designing risk management and supports the general concepts from ISO / IEC 27001. Data collection will be divided into primary and secondary data. Primary data collection is based on direct interviews with Bagian Pelaksanan SIMRS RSKD Duren Sawit. Secondary data collection will be done by analyzing the internal documents of RSKD Duren Sawit related to SIMRS. This research produces 7 risk scenarios that will be accepted and 62 scenarios that will be controlled (mitigate). Control recommendations are prepared by referring to ISO/IEC 27002. Based on this research can minimize the impact of losses for the Duren Sawit RSKD. In addition, it can improve information security on the Duren Sawit RSKD SIMRS in accordance with government regulations and can be used as a material for consideration and management decision making for the improvement of SIMRS RSKD Duren Sawit service.

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"Infeksi virus dengue merupakan masalah serius dengan angka kejadian yang terus meningkat setiap tahun dan hampir separuh populasi dunia beresiko terinfeksi. Infeksi sekunder virus dengue seringkali dihubungkan dengan tingkat keparahan penyakit yang ditimbulkan. Oleh karenanya sangat penting untuk dapat membedakan infeksi primer dan sekunder virus dengue. Uji Hi merupakan uji serologi yang direkomendasikan oleh badan kesehatan dunia (World Health Organization/WHO) untuk membedakan tipe infeksi tersebur. Namun selain secara teknis rnempunyai banyak kekurangan, uji ini juga seringkali kurang tepat dalam mengklasifikasikan antara infeksi primer dengan sekunder. Studi ini dilakukan untuk mengevaluasi performa uji HI dalam membedakan infeksi primer dan sekunder yaitu dengan membandingkan uji tersebut dengan PRNT. Penelitian ini juga mengeva1uasi performa ELISA lgG sebagai kandidat metode altematif. Dari 19 kasus infeksi primer berdasarkan PRNT, semua kasus (100%) juga ditetapkan sebagai infeksi primer dengan Hi dan ELISA lgG. Namun dari 73 kasus infeksi sekunder. hasil HI yang bersesuaian dengan PRNT hanya 31 5% sementara EUSA lgG sebanyak 98,6%. Dapat dikatakan HI merniliki performa yang baik dalam menentukan infeksi primer tetapi kurang baik pada infeksi sekunder. AnalisB; statistik juga memperkuat perbedaan performa uji HI dan ELISA tersebut dengan nilai p=O (p1280. Tipe infeksi pada titer H1 antara 160-640 tidak dapat didefinisikan.

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Dengue infections have become a global concern since its increasing incidence with almost half of world's population at risk. Secondary or multiple dengue virus infection is often implicated in the severity of the diseases. Therefore, discriminating dengue infection between primary versus secondary is very important. World Health Organization recommends hem-agglutination inhibition (HI) assay as the reference test to distinguish the infection. But besides its technical drawbacks, HI interpretations often misclassified between primary and secondary. In this study, we try to evaluate HI performance by comparing the assay with Plaque Reduction Neutralization Test (PRNT). We also evaluate enzyme linked immunosorbent assay (ELISA) lgG perfonnance as suggested alternative method. Of 19 primary infection cases determined by PRNT, all of them (100"/o) also defined as primary infection by both HI and ELISA lgG. From 72 of secondary infection cases, only 31.5 % of HI result that had agreement with PRNT, meanwhile ELISA lgG 98.6%. In this case, we found that HI is good in determination of primary but poor in secondary infection. Statistical analysis revealed that HI and ELISA IgG performance is significantly different with p O (p"

"ABSTRACT

Human immunodeficiency virus (HIV) is one example of an emerging infection with total of 386 district of all province in Indonesia reported having such infection; with cumulative number of HIV infected patient from the year 1987 to 2014 is 150,296 while AIDS is 55,799 patients. The access to care only available for 153,887 patients among all HIV/AIDS patients of whom 70% are eligible for anti-retroviral (ARV) treatment and of these only half adhered to ARV treatment. In addition to that, there is an increased risk of other emerging diseases such as Zika virus, Monkey pox or Hanta pulmonary syndrome since a sporadic cases were reported around the region. Beside new diseases, tuberculosis, dengue virus, malaria and diphteria are continuously reported in Indonesia and classified as re-emerging illnesses. On this edition data on diphteria epidemiology in Indonesia will be shown by Karyanti et al.6 A recent outbreak of diphteria in Indonesia which involved almost all province in the country has led to a response named ORI (outbreak response of Immunization). Regardless of immunization, proper treatment including the distribution of anti-toxin and antibiotics are needed to stop the spread of this particular bacteria, further decreasing the mortality rate. In conclusion, the author of this paper mentioned that immunization gap needs to be handle systematically. Immunization data released on 2017 showed that complete immunization was given only to 20% of targeted group, while almost 75% were either unvaccinated or unknown. During the outbreak of diphteria in Indonesia, the WHO also reported several countries with similar problem such as Bangladesh, Haiti and Yamen. It was shown that a coordination between doctors in clinic/hospital with public health officer to conduct an epidemiological investigation, in conjunction with giving prophylaxis and assuring the logistics of anti-diphteria toxin and antibiotics were accessible were the key of success in eliminating diphteria like it was in Bangladesh.

Adherence to treatment are multifactorial for all illnesses. First, is the duration of treatment and the potential adverse event due to the medication. The Ministry of Health of the Republic of Indonesia has support the early diagnosis of HIV and delivering treatment as soon as possible, in order to avoid transmission of the disease. Second, looking at another side of the story for HIV infected patients, receiving ARV treatment as a long life treatment could possibly cause an adverse event somewhere along the line. Budiman et.al reported factors that might contribute to liver injury. His study shows that measuring baseline liver function test AST routinely might minimize the toxicity of ARV to patients particularly with a low body mass index. Last, despite the adherence to treatment and procedures in minimizing the risk of adverse event to medication, we are now facing the primary resistance virus that transmitted in the community as mentioned by Megasari et al.8 on her report regarding the transmission of drug resistance HIV virus to naïve patients in Bali.

The Indonesian government through the Indonesian Ministry of Health has established a collaboration and one health approaches to tackle the threat of diseases in the country, particularly in infectious diseases."

"Arthropods are well known vectors for the spread of diseases. Thus their invasion from foreign countries and their spreading close to human dwellings must be blocked everywhere (in donor and receptor countries) using safe and effective measures.This book presents reviews on examples of such arthropod-borne emerging diseases that lurk on the fringes of our crowded megacities. The following topics show that there is an ongoing invasion of potential vectors and that control measures must be used now in order to avoid disastrous outbreaks of mass diseases."

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Pemakaian antibiotik yang tidak tepat pada penyakit infeksi akan menyebabkan resistensi bakteri dan akan memperburuk kondisi pasien. Sejumlah faktor yang memengaruhi, pola bakteri penyebab dan penggunaan antibiotik dapat memengaruhi luaran perlu di nilai kembali. Penelitian ini bertujuan mengetahui profil sensitivitas bakteri, penggunaan antibiotik dan faktor yang berpengaruh terhadap mortalitas infeksi anak. Penelitian ini dilakukan secara kohort retrospektif serta studi deskriptif terhadap 254 pasien di RSCM pada Januari-Desember 2018. Riwayat medis, pola kuman, sensitivitas antibiotik dan penggunaan antibiotik didata serta faktor yang memengaruhi dianalisis menggunakan uji multivariat regresi logistik. Bakteri terbanyak adalah gram negatif 57,1% diikuti gram positif 42,8%. Hampir semua golongan bakteri sensitif dengan ampisilin sulbaktam (87,5-100%). Amoksiklav, tigesiklin dan vankomisin sensitif dengan bakteri gram positif (100%). Amikasin dan meropenem sensitif dengan bakteri gram negatif (80-100%). Faktor yang memengaruhi peningkatan mortalitas adalah usia > 5 tahun (OR 2,482; IK95% 1,139-5,408), penggunaan selang nasogastrik (OR 2,516; IK95% 1,083-5,847), antibiotik yang tidak sesuai (OR 2,159; IK95% 1,034-4,508), serta fokus infeksi pada aliran darah (OR 5,021; IK95% 2,411-10,459).

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Inappropriate use of antibiotics in infectious diseases will lead to anti-microbial resistance and disease's complication. Among several contributing factors to disease outcome, anti-microbial pattern and antibiotics use need to be re-evaluated. This study aims to determine anti-microbial sensitivity profile, antibiotics use and factors affecting mortality in pediatric infection cases. Retrospective cohort study was conducted in Cipto Mangunkusumo Hospital. There were 254 patients included for study analysis.  Data were obtained from medical records and electronic health records from January-December 2018. Patient’s medical history, anti-microbial pattern and sensitivity as well as antibiotic use were recorded and analyzed using a multivariate logistic regression test. The most common bacteria were gram negative bacteria (57.1%) followed by gram positive bacteria (42.8%). Majority of bacteria were sensitive with ampicillin sulbactam (87.5-100%). Antibiotics such as amoxicillin-clavulanic acid, tigecycline and vancomycin are sensitive to gram-positive bacteria (100%) while amikacin and meropenem are sensitive to gram-negative bacteria (80-100%). Factors  influencing  mortality were age > 5 years (OR 2.482; 95%CI 1.139-5,408), use of nasogastric tubes (OR 2.516; 95%CI 1.083-5.847), inappropriate antibiotics choice (OR 2.159; 95%CI 1.034-4.508), and presence of bloodstream infection (OR 5.021; 95%CI 2.411-10.459).

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"Latar Belakang: Penduduk lanjut usia (lansia) terus mengalami peningkatan seiring kemajuan di bidang kesehatan yang ditandai dengan meningkatnya angka harapan hidup, menurunnya angka kematian dan jumlah orang dengan demensia (ODD) yang juga cenderung bertambah. Masalah kesehatan jiwa ini kurang teridentifikasi oleh para tenaga kesehatan dan lansia itu sendiri. Oleh karena itu penting dilakukan identifikasi dan penilaian kebutuhan yang tidak terpenuhi (unmet needs) bagi para lansia dengan demensia khususnya demensia ringan hingga sedang. Kebutuhan yang tidak terpenuhi (unmet needs) yang sudah teridentifikasi disertai dengan persepsi dan harapan para lansia akan menjadi masukan positif dalam merancang program layanan day hospital care.Metode: Penelitian ini menggunakan mixed method design. Penelitian tahap pertama adalah penelitian kuantitatif dengan menggunakan instrumen CANE (Camberwell Assessment of Need for the Elderly) untuk menilai kebutuhan yang tidak terpenuhi (unmet needs) pada lansia dengan Demensia ringan – sedang. Penelitian tahap kedua adalah penelitian kualitatif dengan menggunakan metode Delphi yang dilaksanakan dalam dua putaran dan melibatkan sembilan ahli yang berprofesi dan berkecimpung menangani lansia. Putaran pertama dengan menggunakan kuesioner berisi open-ended question yang dituangkan dari berbagai referensi menghasilkan rancangan konsep awal isi materi modul. Putaran kedua merupakan pengembangan isi materi modul dengan menggunakan kuesioner empat skala Likert. Hasil putaran kedua dianalisis dengan menilai median dan Interquartile Range (IR) untuk menghasilkan konsensus para ahli sehingga modul layanan Day Hospital Care terbentuk.Hasil: Dari penelitian tahap pertama didapatkan lima proporsi unmet needs terbesar, yaitu pertemanan (26,0%), distres psikologis (20,8%), relasi akrab (19,8%), daya ingat (16,7%), dan kegiatan harian (10,4%). Dari putaran pertama metode Delphi diperoleh masukan dari para ahli untuk pengembangan isi materi yang terdapat dalam rancangan konsep awal modul. Hasil putaran kedua dari analisis skala Likert ditemukan adanya konsensus di antara para ahli bahwa isi materi yang tercantum dalam modul telah sesuai dengan target yang ingin dicapai dalam setiap bagian (bagian awal, bagian tengah, dan bagian akhir) dalam modul.Simpulan: Pembuatan modul layanan Day Hospital Care ini melalui dua tahap penelitian yaitu penelitian kuantitatif dan penelitian kualitatif sehingga menghasilkan suatu modul yang terstruktur, yang berisikan materi yang telah sesuai dalam setiap bagian dengan target yang akan dicapai.

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Background: The number of elderly population continues to increase as the advancement in healthcare grows, which is shown by the increase of life expectancy, the declining mortality rates, and the surge of person with dementia (PwD). This mental health issue is barely identifiable by health workers and the elderly themselves. Therefore it is important to evaluate and identify the unmet need of the people with dementia, especially mild to moderate dementia. The unmet needs that have been identified along with the perceptions and expectations of the elderlies will be positive inputs in designing the Day Hospital Care Service program.

Methods: This study uses the mixed method design. The first phase is a quantitative research which utilizes CANE (Camberwell Assessment of Need for the Elderly) instrument to assess the unmet needs of the elderlies with mild to moderate dementia. The second phase is a qualitative research which utilizes the Delphi method that is done in two rounds and involves nine experts who worked with the elderlies. The first round uses a questioner with open-ended questions from various references that assembles an early concept of the module’s contents. The second round is about the development phase of the module’s contents which uses the four scale Likert questionnnaire. The outcome from the second round is analyzed by assessing the median and Interquartile Range (IR) to generate a consensus by the experts so that the Day Hospital Care service module is established.

Results: The first phase of the research procured five substantial unmet needs proportion, which are friendship (26.0%), psychological distress (20.8%), close relations (19.8%), memory dysfunction (16.7%), and daily activities (10.4%). The first round uses the Delphi method which procures insight from experts to develop the early concept of the module’s contents. The results of the second round from the Likert scale, resulting a consensus among the experts regarding the contents that is written in the module are in accordance with the targets to be achieved in each section (the beginning, the middle, and the end) of the module.

Conclusion: The production of The Day Hospital Care Service module requires a two phase research which are quantitative and qualitative research, hence producing a module that is well-structured, which contains materials that has been accurate in every section with a goal to be achieved."