Hasil Pencarian  ::  Simpan CSV :: Kembali

"Sekitar 90% bayi yang tertular dari ibu dengan HBsAg reaktif akan berkembang mengalami hepatitis B kronik. Imunisasi merupakan salah satu upaya pencegahan, namun belum bisa sepenuhnya mencegah penularan Hepatitis B pada anak. Penelitian ini bertujuan untuk menganalisis faktor risiko yang berhubungan terhadap hepatitis B pada anak, membuat model probabilitas kejadian hepatitis B pada anak, dan menelaah penerapan program DDHB sebagai tindakan pencegahan dan pengendalian MTCT. Penelitian ini menggunakan pendekatan concurrent mixed method, penelitian kuantitatif dengan desain studi kohort retrospektif dilakukan dengan melibatkan 166 pasangan ibu dan anak. Sedangkan penelitian kualitatif menggunakan desain studi kasus melalui indepth-interview kepada 23 informan. Penelitian ini dilaksanakan di Kota Makassar dan Kabupaten Gowa, Provinsi Sulawesi Selatan. Analisis multivariat menggunakan GLM binomial link log dilakukan untuk menghitung risk rasio (aRR) hepatitis B pada anak. Hasil penelitian menunjukkan bahwa ibu dengan kadar HBV-DNA tinggi (>106 copies/mL) memiliki risiko lebih tinggi untuk menularkan HBV kepada anaknya (aRR=2,9; 95%CI=1,37-6,20). Anak yang tidak mendapat HBIg (aRR=5,6; 95%CI=2,28-13,76), tidak vaksin HB-0 (aRR=2,9; 95%CI=1,37-6,20), tidak vaksin HB-1 (aRR=10,4; 95%CI=5,23-20,87), dan tidak vaksin HB-2 (aRR=12,1; 95%CI=5,21-28,35) memiliki risiko infeksi HBV yang lebih tinggi. Probabilitas kejadian hepatitis B pada anak berdasarkan kelima faktor risiko tersebut sebesar 94%. Temuan ini menekankan pentingnya program DDHB dioptimalkan secara komprehensif bagi ibu hamil dalam mengidentifikasi kadar HBV-DNA untuk memfasilitasi terapi antivirus sesuai kebutuhan, pemberian HBIg dan vaksin hepatitis B (HB-0, HB-1, dan HB-2) kepada anak efektif mengurangi risiko penularan hepatitis B pada anak, menjadikannya sebagai strategi kunci dalam mencegah infeksi hepatitis B pada anak.

---

With approximately 90% of infants born to HBsAg-positive mothers developing chronic hepatitis B, immunization remains crucial but does not fully eliminate the risk of transmission. This study aimed to analyze risk factors contributing to hepatitis B in children, develop a probability model for its occurrence, and evaluate the implementation of the DDHB program as a preventive and control measure for MTCT. Methods: This study employed a concurrent mixed-method approach. The quantitative component used a retrospective cohort design involving 166 mother-child pairs. The qualitative component utilized a case study design with in-depth interviews conducted with 23 informants. The research was carried out in Makassar City and Gowa Regency, South Sulawesi Province. A multivariate analysis using a binomial GLM with a log link was conducted to calculate the adjusted risk ratio (aRR) for estimating hepatitis B in children. The results indicated that mothers with high HBV-DNA levels (>106 copies/mL) had a significantly increased risk of transmitting HBV to their children (aRR=2.9, 95%CI=1,37-6,20). Children who did not receive hepatitis B immunoglobulin (HBIg) (aRR = 5.6, 95%CI=2,28-13,76), did not vaccinate HB-0 (aRR = 2.9, 95%CI=1,37-6,20), did not vaccinate HB-1 (aRR = 10.44, 95%CI=5,23-20,87), or did not vaccinate HB-2 (aRR = 12.11, 95%CI=5,21-28,35) were at significantly higher risk of HBV infection. The probability of hepatitis B incidence in children based on these five risk factors was 94%. These findings emphasize the importance of comprehensively optimizing DDHB programs for pregnant women in identifying HBV-DNA levels to facilitate antiviral therapy as needed. Likewise, providing HBIg and hepatitis B vaccines (HB-0, HB-1, and HB-2) to children is effective in reducing the risk of hepatitis B transmission in children, making it a key strategy in preventing hepatitis B infection in children."

"Pendahuluan: Penyakit hepatitis B merupakan masalah kesehatan utama, baik di dunia maupun di Indonesia. Secara global, pada tahun 2015, diperkirakan 257 juta orang hidup dengan infeksi HBV kronis (WHO, 2015). Dan selanjutnya menyebabkan (720.000 kematian karena sirosis) dan kanker hati primer (470.000 kematian karena karsinoma hepatoseluler) ( WHO, 2015). Prevalensi Hepatitis B wilayah Asia Tenggara adalah 2,0%. Untuk prevalensi Hepatitis B pada ibu hamil di Indonesia tahun 2017 adalah sebesar 2,7% (Berita Subdit HISP 2017). Hal ini didapatkan dari kegiatan program deteksi dini Hepatitis B yang dilakukan sejak tahun 2016 yang baru dilaksanakan di beberapa propinsi (Berita Subdit HISP, 2017). Metode: Penelitian ini adalah analitik observasional yang menggunakan rancangan penelitian cross-sectional. Sampel untuk penelitian ini sebanyak 12.475 ibu hamil yang melakukan pemeriksaan kehamilan di puskesmas-puskesmas di wilayah Jakarta Utara. Data diperoleh dari Dinas Kesehatan Provinsi DKI Jakarta, dan dianalisis menggunakan Uji Regresi Logistik. Hasil: Prevalensi Hepatitis B pada ibu hamil pada penelitian ini sebesar 2,3%, Risiko ibu hamil yang serumah dengan penderita Hepatitis B 6,46 kali (95% CI 3,68-11,35) untuk terinfeksi Hepatitis B dibandingkan dengan ibu hamil yang tidak pernah serumah dengan penderita Hepatitis B setelah dikontrol dengan status pekerjaan, umur kehamilan, riwayat transfusi, riwayat penasun. Kesimpulan: Serumah dengan penderita Hepatitis B merupakan faktor risiko terhadap penularan Hepatitis pada Ibu Hamil. Sehingga kegiatan Deteksi Dini Hepatitis Ibu Hamil tetap dilanjutkan dengan diintegrasikan dengan program vaksinasi Hepatitis B pada ibu hamil hepatitis B negatif dan program pengobatan Hepatitis B bagi yang sudah terinfeksi.

---

Introduction: Hepatitis B is a major health problem, both in the world and in Indonesia. Globally, in 2015, an estimated 257 million people live with chronic HBV infection (WHO, 2015). And subsequently caused (720,000 deaths due to cirrhosis) and primary liver cancer (470,000 deaths due to hepatocellular carcinoma) (WHO, 2015). The prevalence of Hepatitis B in the Southeast Asia region is 2.0%. The prevalence of Hepatitis B in pregnant women in Indonesia in 2017 is 2.7% (News Sub-Directorate of HISP 2017). This was obtained from the activities of the Hepatitis B early detection program carried out since 2016 which was only implemented in several provinces (News Subdit HISP, 2017). Method: This study was an observational analytic study using a cross-sectional study design. The sample for this study was 12,475 pregnant women who carried out antenatal care at health centers in the North Jakarta area. Data was obtained from the DKI Jakarta Provincial Health Office, and analyzed using the Logistic Regression Test. Results: Prevalence of Hepatitis B in pregnant women in this study was 2.3%, the risk of pregnant women at home with Hepatitis B sufferers was 6.46 times (95% CI 3.68- 11.35) to be infected with Hepatitis B compared to pregnant women who have never been at home with Hepatitis B patients after being controlled by work status, gestational age, transfusion history, IDU history. Conclusion: Houses with Hepatitis B patients are risk factors for transmission of Hepatitis in Pregnant Women. So that the activities of Early Detection of Hepatitis B Pregnant women continue to be integrated with the Hepatitis B vaccination program in negative hepatitis B pregnant women and Hepatitis B treatment programs for those who have been infected."

"Hepatitis B merupakan penyebab utama penyakit organ hati kronik dan dapat menyebabkansirosis, gagal hati dan karsinoma hepatoselular.Transmisi penularan hepatitis B dapatterjadi pada janin yang dikandungnya. Upaya pencegahan transmisi vertikal dapatdilakukan berupa skrining pada ibu hamil pada trimester pertama kehamilan sertapemberian imunoglobulin pada bayi setelah 12 jam kelahiran. Asuhan yang diberikankepada individu untuk pencegahan penyakit menular harus diberikan secara komprehensifdengan tujuan klien mampu beradaptasi terhadap penyakitnya dan memiliki perilaku yangbaik. Pengelolaan ibu hamil dengan hepatitis B menggunakan Teori Adaptasi Roy danHealth Belief Model (HBM) bertujuan untuk memberikan pengetahuan dan meningkatkanperilaku klien akan pencegahan penularan penyakit terhadap bayi dan keluarga lainnya.

---

Hepatitis B is a major cause of chronic liver disease and can cause cirrhosis, liver failure

and hepatocellular carcinoma. As many as 240 million of them have chronic hepatitis B and

780,000 people have died due to acute and chronic complications of hepatitis B.

Transmission of hepatitis B can occur in the fetus it contains. The efforts to prevent vertical

transmission can be done in the form of screening in pregnant women in the first trimester

of pregnancy as well as giving immunoglobulins to infants after 12 hours of birth. The form

of nursing care given to individuals for the prevention of infectious diseases must be

provided comprehensively with the aim of the client being able to adapt to his illness and

have good behavior. The management of pregnant women with hepatitis B using Roy's

Adaptation Theory and the Health Belief Model (HBM) aims to provide knowledge and

improve client behavior regarding the prevention of disease transmission to infants and

other families."

"[Latar belakang. Infeksi virus hepatitis B (VHB) di Indonesia masih tinggi dengan rerata prevalensi 9,4%. Tingginya prevalensi HB ini terkait dengan terjadinya infeksi VHB pada masa dini kehidupan, terutama melalui transmisi vertikal. Di Indonesia proporsi transmisi vertikal 45,9% dan 5,2% ibu hamil HBsAgnya positif. Cara paling efektif mengontrol infeksi VHB adalah dengan imunisasi, namun terdapat perbedaan seroproteksi titer anti-HBs pada usia lebih dari 10 tahun di berbagai tempat. Selain itu terdapat faktor-faktor yang dapat memengaruhi titer anti-HBs, namun penelitian ini masih jarang dan belum pernah dilakukan di Manado.Tujuan. Mengetahui seroproteksi titer anti-HBs dan faktor-faktor yang dapat memengaruhi titer anti- HBs tersebut.Metode. Penelitian analitik observational dengan desain potong lintang. Penelitian dilakukan dengan stratified random sampling pada usia 10-15 tahun di Kecamatan Tuminting, Kota Manado sejak Oktober sampai November 2014. Data dianalisis dengan SPSS 22.Hasil. Dari 48 sekolah terpilih 10 sekolah dengan 105 anak sebagai subyek penelitian, namun hanya 23 anak yang mempunyai seroprotektif (21,9%). Sebanyak 76 (72,4%) subyek adalah perempuan, 78 (74,3%) subyek berstatus gizi baik dan 98 (93,3%) subyek memiliki berat badan lahir ≥ 2.500 gram. Dari buku imunisasi didapatkan 26 (24,8%) subyek dengan vaksinasi HB-1 ≤ 7 hari dan 45 (42,9%) subyek dengan jarak HB-2 dan HB-3 ≥ 2 bulan. Didapatkan 86 (81,9%) ibu subyek berusia 20-35 tahun, 64 (60,9%) ibu subyek berpendidikan SMA dan 79 (75,2%) orangtua subyek berpenghasilan ≥ 2 juta per bulan. Analisis multivariat didapatkan faktor pemberian HB-1 < 7 hari atau ≥ 7 hari (p=0,02) dan jarak pemberian HB-2 dengan HB-3< 2 bulan atau ≥ 2 bulan (p<0,001) berperan terhadap seroproteksi HB pada anak.Simpulan. Penelitian ini mendapatkan angka seroproteksi HB yang rendah (21,9%) serta faktor pemberian HB-1 ≤ 7 hari atau > 7 hari dan jarak pemberian HB-2 dengan HB-3 < 2 bulan atau ≥ 2 bulan berperan terhadap seroproteksi HB pada anak usia 10-15 tahun.;Background. Hepatitis B viral (HBV) infection in Indonesia is still high with average prevalence of 9.4%. The high prevalence of hepatitis B (HB) is related to the occurence of HBV infection during the early life, especially through vertical transmission. In Indonesia proportion of vertical transmission 45.9% and 5.2% pregnant women have HBsAg positive. The most effective way to control HBV infection is with immunization HB, but there is differential in anti-HBs seroprotection titer at the age more than ten years in many locations. In addition there are factors that can affect anti-HBs titer, but these studies are rare and have ever been done in Manado.Objective. Knowing anti-HBs seroprotection titer and factors that can affect the anti-HBs titer.Method. Analitic observational study with cross sectional design. Research was done with stratified random sampling in children age 10-15 years old at Tuminting district, Manado city since October until November 2014. Analise data with SPSS 22.Results. From 48 schools, selected 10 schools with 105 children as subject of research, but only 23 (21.9%) children who were having seroprotective (21,9%). A total of 76 (72.4%) subjects were female, 78 (74.3%) subjects with good nutrition status and 98 (93.3%) subjects had ≥2,500 grams birth weight. From the immunization record book 26 (24.8%) subjects were obtained with HB-1 vaccination done at ≤7 days of age and 45 (42.9%) subjects with the distance between HB-2 and HB-3 were ≥2 months. Mother’s age was found 86 (81.9%) were 20-35 years old, 64 (60.9%) mothers’s education were high school graduated and 79 (75.2%) parents subjects had income ≥2 million per month. From multivariate analysis obtained that administration of HB-1 ≤7 days or >7 days (p=0.02) and distance between administration of HB-2 and HB-3 <2 months or ≥2 months (p<0.001) had important role in HB seroprotection in children.Conclusion. This study obtained a number of low HB seroptotection (21.9%) as well as administration of HB-1 ≤7 days or >7 days and distance between administration of HB-2 and HB-3 <2 months or ≥2 months had important role in HB seroprotection in children age 10-15 years old., Background. Hepatitis B viral (HBV) infection in Indonesia is still high with average prevalence of 9.4%. The high prevalence of hepatitis B (HB) is related to the occurence of HBV infection during the early life, especially through vertical transmission. In Indonesia proportion of vertical transmission 45.9% and 5.2% pregnant women have HBsAg positive. The most effective way to control HBV infection is with immunization HB, but there is differential in anti-HBs seroprotection titer at the age more than ten years in many locations. In addition there are factors that can affect anti-HBs titer, but these studies are rare and have ever been done in Manado.Objective. Knowing anti-HBs seroprotection titer and factors that can affect the anti-HBs titer.Method. Analitic observational study with cross sectional design. Research was done with stratified random sampling in children age 10-15 years old at Tuminting district, Manado city since October until November 2014. Analise data with SPSS 22.Results. From 48 schools, selected 10 schools with 105 children as subject of research, but only 23 (21.9%) children who were having seroprotective (21,9%). A total of 76 (72.4%) subjects were female, 78 (74.3%) subjects with good nutrition status and 98 (93.3%) subjects had ≥2,500 grams birth weight. From the immunization record book 26 (24.8%) subjects were obtained with HB-1 vaccination done at ≤7 days of age and 45 (42.9%) subjects with the distance between HB-2 and HB-3 were ≥2 months. Mother’s age was found 86 (81.9%) were 20-35 years old, 64 (60.9%) mothers’s education were high school graduated and 79 (75.2%) parents subjects had income ≥2 million per month. From multivariate analysis obtained that administration of HB-1 ≤7 days or >7 days (p=0.02) and distance between administration of HB-2 and HB-3 <2 months or ≥2 months (p<0.001) had important role in HB seroprotection in children.Conclusion. This study obtained a number of low HB seroptotection (21.9%) as well as administration of HB-1 ≤7 days or >7 days and distance between administration of HB-2 and HB-3 <2 months or ≥2 months had important role in HB seroprotection in children age 10-15 years old.]"

"Chronic hepatitis B is still a major health problem in Indonesia. Unfortunately, to date, treatment of chronic HBV (Hepatitis B virus) infection had not shown satisfactory result. Monotherapy with alpha interferon or lamivudine have been widely used as treatment of chronic HBV. However, treatment response to Alpha interferon in Asian people was not satisfactory (15% - 20%), while monotherapy with lamivudine was not sufficient to eradicate HBV in chronically infected patients and commonly induce drug resistance. The occurrence of chronic hepatitis B resistant to lamivudine had encouraged development of newer agents such as adefovir, entecavir, emtricitabine and nucleoside analog. New therapeutic strategy using combination therapy should be considered if there is no sufficient response to monotherapy"

"Latar Belakang: Petugas kesehatan memiliki risiko terpajan darah atau jaringan tubuh saat bekerja. World Health Organization (WHO) memperkirakan adanya 3 juta pajanan setiap tahunnya pada 35 juta petugas kesehatan. Adanya profilaksis pascapajanan dapat menurunkan risiko penularan. Tujuan: Mengetahui pelaksanaan profilaksis pascapajanan terhadap terhadap HIV, hepatitis B dan hepatitis C pada petugas kesehatan di RSUPN Cipto Mangunkusumo (RSCM). Metode: Penelitian potong lintang dilakukan pada petugas terpajan yang terdata melalui laporan IGD, poli pegawai dan UPT HIV pada tahun 2014-2016. Data dikumpulkan dan diolah melalui SPSS versi 20.Hasil Penelitian: Dari 196 pekerja yang melaporkan pajanan, sebagian besar merupakan perempuan (69,9%), bekerja sebagai perawat (38,3%) dan dokter (38,3%), serta terpajan secara perkutan (93,4%). Anti-HIV reaktif ditemui pada 25 (13%) sumber pajanan, HBsAg reaktif pada 13 (8%) dan anti-HCV reaktif pada 12 (6%) sumber. Petugas dengan anti-HBs protektif adalah 55 (28,1%) petugas. Dari 183 pajanan berisiko, 45,9% (81) petugas direkomendasikan pemberian ARV, 81,5% (66) petugas melakukan profilaksis dengan ARV, 60% petugas minum ARV secara lengkap (28 hari). Follow-up anti-HIV bulan ke-3 dan 6 dilakukan oleh 44 (24%) dan 41 (22,4%) petugas. Terdapat 37 pekerja yang direkomendasikan menerima vaksinasi Hepatitis B dan/atau immunoglobulin (HBIG). Dari 22 (59%) yang direkomendasikan vaksinasi hepatitis B, hanya 1 (2,7%) yang melakukan. Dari 15 (41%) yang direkomendasikan vaksinasi hepatitis B dan HBIG, hanya 2 (5,4%) yang melakukannya. Follow-up 3 dan 6 bulan HBsAg serta anti-HBs dilakukan oleh 41 (31,1%), 38 (28,8%) dan 2 (1,5%) petugas. Dari 182 petugas yang melakukan follow-up anti-HCV bulan ke 3 dan ke 6 adalah 39 (21,4%) dan 37 (20,3%) petugas. Kesimpulan: Pelaksanaan profilaksis pasca pajanan terhadap HIV, hepatitis B dan hepatitis C masih rendah. Oleh karena itu, penanganan profilaksis secara komprehensif penting dilakukan termasuk peningkatan pengetahuan dan kesadaran pekerja, peninjauan kembali SOP, dan komunikasi yang efektif.

---

Introduction: Health care workers (HCW) have exposure risk of blood or body tissue at work. World Health Organization (WHO) estimates there is 3 millions exposure to 35 millions workers annually. The existance of post-exposure prophylaxis could reduce the transmission risk. Goal: To identify the implementation of post-exposure prophylaxis of HIV, Hepatitis B, and Hepatitis C among HCW in RSUPN Cipto Mangunkusumo (RSCM). Method: A cross-sectional study was conducted to exposured workers who had been recorded in emergency ward, employee ward, and UPT HIV on 2014-2016. Data was collected and analyzed with SPSS 20.Result: Among 196 HCW who reported the exposure, most of them were female (69.9%), worked as nurse (38.3%) and doctor (38.3%), and exposed percutaneously (93.4%). Positive anti-HIV was found in 25 (13%) people of exposure sources, positive HBsAg in 13 (8%) people and positive HCV in 12 (6%) people. Workers with protective anti-HBs were 55 (28.1%) people. In 183 reports, 81 (45,9%) workers were recommended to receive ARV, 66(81.5%) workers did receive it, and 40(60%) workers took complete ARV (28 days). Follow-up 3 and 6 months was done by 44 (24%) and 41 (22,4%) workers. There were 37 workers recommended to receive Hepatitis B vaccination and/or immunoglobulin (HBIG). In 22 (59%) recommended to receive Hepatitis B vaccination, only 1 (2,7%) who took that. In 15 (41%) recommended to receive both Hepatitis B vaccination and immunoglobulin, only 2 (5,4%) who took both. Follow-up of HBsAg and anti-HBs on 3rd and 6th months were done by 41 (31,1%), 38 (28,8%) and 2 (1,5%) workers who were recommended to receive prophylaxis. In 182 workers recommended to do follow-up of anti-HCV, 39 (21,4%) and 37 (20,3%) workers did the follow-up on 3rd and 6th month. Conclusion: The implementation of post-exposure propyhlaxis of HIV, Hepatitis B, and Hepatitis C was still low. Thus, it was important to do the management of prophylaxis comprehensively. It was also included the increasing of worker's knowledge and awareness, reconsidering the operational standard, and communicating effectively."

"Hepatitis B merupakan salah satu penyakit menular yang dapat menyebabkan kematian. Hepatitis B adalah penyakit hati yang disebabkan oleh virus hepatitis B. Penyakit ini dapat dicegah penularannya dengan melakukan vaksinasi. Pada skripsi ini dikonstruksi model matematika SVAKR yang membahas mengenai model matematika penyebaran penyakit hepatitis B dengan intervensi vaksinasi. Kajian analitik dan simulasi numerik telah dilakukan pada model tersebut untuk mempermudah dalam memahami dinamika populasi jangka panjang. Kajian analitik yang telah dilakukan meliputi konstruksi model matematika beserta interpretasi model tersebut, titik keseimbangan beserta kestabilannya, dan Basic Reproduction Number (R0). Pada kajian analitik, didapatkan hasil bahwa titik keseimbangan bebas penyakit ada dan stabil asimtotik lokal ketika R0 < 1. Berdasarkan simulasi numerik yang telah dilakukan, diperoleh informasi bahwa intervensi vaksinasi dapat mengendalikan penyebaran penyakit hepatitis B. Lebih lanjut apabila vaksinasi diiringi dengan peningkatan laju kesembuhan infeksi akut, maka penyebaran penyakit hepatitis B dapat dikendalikan dengan lebih optimal.

---

Hepatitis B is an infectious disease that can cause death. Hepatitis B is a liver disease caused by the hepatitis B virus. This disease can be prevented from being transmitted by vaccination. In this undergraduate thesis, a mathematical model SV AKR is constructed which discusses the mathematical model of the spread of hepatitis B disease with vacci- nation intervention. Analytical studies and numerical simulations have been carried out on the model to make it easier to understand long-term population dynamics. Analytical studies that have been carried out includes the construction of a mathematical model and its interpretation, the equilibrium point and its stability, and Basic Reproduction Number (R0). In the analytical study, it was found that a disease-free equilibrium point exists and locally asymptotically stable when R0 < 1. Based on numerical simulations that have been carried out, it was found that vaccination intervention was able to control the spread of hepatitis B. Furthermore, if vaccination is accompanied by an increase in recovery rate of acute infection, the spread of hepatitis B can be controlled more optimally."

"Perkembangan ilmu dan teknologi membawa program imunisasi ke dalam penyelenggaraan pelayanan yang bermutu dan efisien. Upaya terscbut didukung dengan kemajuan yang pesat dalam penemuan vaksin baru. Kemajuan lainnya adalah menggabungkan beberapa jenis vaksin dalam satu kemasan/vial. Salah satu vaksin tersebut adalah Vaksin DPT - Hepatitis B Combo, yang mcrupakan kombinasi antara vaksin DPT dan Hepatitis B.Kabupaten Tangerang masih menggunakan 3 jenis vaksin dalarn imunisasi DPT dan Hepatitis B, yaitu vaksin DPT, Hepatitis B Vial dan DPT - Hepatitis B Combo. Sejauh ini belum diketahui vaksin mana yang lebih cost Mctive antara DPT dan Hepatitis B Vial dengan DPT - Hepatitis B Combo. Penelitian ini dilakukan untuk mengetahui vaksin manakah yang lebih cost effective dalam pelaksanaan imunisasi DPT dan Hepatitis B di Kabupaten Tangerang.Peneilitian dilakukan di Puskesmas Cisoka yang menggunakan vaksin DPT dari Hepatitis B Vial, dan Puskesmas Jayanti yang menggunakan vaksin DPT - Hepatitis B Combo. Rancangan penelitian yang digunakan adalah Operasional Research, dasar penilaian Cost effectiveness menggunakan sistem atau metode Acifivily Based Costing (ABC).Hasil penclitian menunjukkan bahwa niiai Cost Ejjieclive Rario (CER) penggunaan vaksin DPT - Hepatitis B Vial lebih besar dibandingkan dengan vaksin DPT - Hepatitis B Combo, yaitu CER berdasarkan cakupan vaksin DPT - Hepatitis B Vial scbcsar Rp. 151.981 dan vaksin DPT - Hepatitis B Combo sebesar Rp. 85.l27. CBR Indeks pemakaian Vaksin DPT » Hepatitis B Vial scbcsar Rp. 21.788470 dan vaksin DPT - Hepatitis B Combo scbcsar Rp. 2l.2l7.8l9. CER berdasarkan dosis vaksin terbuang vaksin DPT -» Hepatitis B vial sebesar Rp. 16,510,787 dan vaksin DPT - Hepatitis B Combo sebesar Rp. 7.0~'l4.23l. Hasil ini menunjukkan bahwa vaksin DPT -» Hepatitis B Combo lebih murah dibandingkan vaksin DPT - Hepatitis B Combo.Berdasarkan hasil peneiitian disarankan khususnya kepada Dinas Kesehatan Kabupaten Tangerang agar menggunakan vaksin DPT - Hepatitis B Combo dalam pelaksanaan imunisasi DPT dan Hepatitis B.

---

Development of science and technology brought immunization program into qualitative and efficiently services management. lt supported by vast progress in finding new vaccine. Other development is gathering various vaccines in one vial. One of the vaccines is DPT Vaccine - Hepatitis B Combo, that representing combination between DPT vaccine and Hepatitis B.Tangerang Regency still utilized three types of vaccine in immunization DPT and Hepatitis B, there are DPT vaccine, Hepatitis B Vial and DPT - Hepatitis B Combo. Meanwhile, didn?t know yet whether vaccine is most effective costly between DPT and Hepatitis B Vial with DPT - Hepatitis B Combo.This research conducted to recognize which vaccine is more cost effective in conducting DPT immunization and Hepatitis B at Tangerang Regency. This research conducted in Cisoka Puskesrnas that use DPT vaccine and Hepatitis B Vial, and Jayanti Puskesmas that use DPT vaccine - Hepatitis B Combo. Research designed utilized operational research. Bases on Cost Effectiveness asses? system or method activity based costing (ABC).Research result shows that Cost EiTective Ratio (CER) using DPT vaccine - Hepatitis B Vial value is higher that DPT vaccine - Hepatitis B Combo, which is CER based on coverage of DPT vaccine - Hepatitis B Vial as much as Rp. 151.981 and DPT vaccine - Hepatitis B Combo as much as Rp. 85.l27. CER Index of using DPT vaccine - Hepatitis B Vial as much as Rp. 2l.788.4'70 and DPT vaccine - Hepatitis B Combo as much as Rp. 21.2l7.819. CER based on wasted vaccine dose of DPT vaccine - Hepatitis B Vial as much as Rp. 16.5lO.787 and DPT vaccine - Hepatitis B Combo as much as Rp. 7.044.23l. This result shows that DPT vaccine - Hepatitis B Combo is more lower at cost.Based on research result, suggested to, especially, Health Agency Tangerang Regency use DPT vaccine - Hepatitis B Combo as altemative vaccine in conducting DPT immunization and Hepatitis B."

"Ruang lingkup dan Cara penelitian: Virus Hepatitis B (VHB) merupakan penyebab tersering hepatitis kronik, sirosis hepatis dan karsinoma hepatoselular di negara-negara Asia Tenggara.VHB merupakan virus DNA berukuran 3,2 kb, mempunyai untai ganda dengan susunan genom yang kompak dan sating tumpang tindih. Materi genetik VHB tersimpan daiam 4 Open Reading Frames pada untai negatif. Transmisi VHB terjadi melalui kontak dengan darah, komponen darah atau cairan tubuh lainnya. Diagnosis infeksi VHB didasarkan adanya HBsAg dalam serum. Hilangnya HBsAg dan terbentuknya anti-HBs merupakan petanda eliminasi virus. Namun demikian mutasi yang terjadi pada gen penyandi HBsAg mengakibatkan perubahan antigenisitas HBsAg sehingga virus lolos dart pemeriksaan yang menggunakan antibodi monoklonal terhadap HBsAg. Untuk mengetahui perubahan molekuler pada gen penyandi HBsAg maka dilakukan penelitian program magister ini dengan tujuan umum untuk mengetahui dasar molekuler kegagalan deteksi serologi HBsAg pada serum donor darah di Indonesia. Untuk itu dilakukan isolasi DNA VHB, ligasi ke vektor dan transformasi ke bakteri E.coli, dilanjutkan dengan reaksi sekuensing yang hasilnya dianalisis dengan perangkat bioinformatika.Hasil dan kesimpulan: Pada serum donor darah dengan HBsAg (-), anti-HBs (-) dan anti-HBc (+) berhasil didapat DNA VHB pada 20 (29,9%) dart 67 sampeI; pada donor darah dengan HBsAg (-), anti-HBs (+) dan anti-HBc (+) didapat DNA VHB pada 5 (7.5%) dart 67 sampel. Sehingga jumlah total DNA VHB (+) didapat pada 25 (8,I%) dari 309 sampel dengan HBsAg (-), Pada sekuensing determinan 'a' gen S DNA VHB didapat 7 (28%) dari 25 sampel menunjukkan mutasi asam amino. Terdapat 3 pola substitusi asam amino: pola pertama substitusi M I 33L sebanyak I (4%) dari 25 sampel, polar kedua T123A sebanyak I (4%) dari 25 sampel, dan pola ketigaTI43M sebanyak 5 (20%) dari 25 sampel. Semua virus; termasuk dalam subtipe adw.Pada studi bioinformatika, substitusi ini menyebabkan terjadinya penurunan nilai indeks antigenisitas asam amino yang bersangkutan dan asam amino yang berada di sekitarnya. Substitusi asam amino pada gen S mengakibatkan terjadinya perubahan sekuens gen P daerah reverse transcriplase yang tumpang tindih dengan gen S."