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Abstrak :
Pendahuluan dan tujuan: Skor IPSS (International Prostate Symptom Score) direkomendasikan sebagai instrumen skoring yang ideal untuk digunakan sebagai pendeteksi terhadap derajat keparahan gejala pada pasien dengan LUTS, respon terapi, dan perbaikan gejala. Terapi medikamentosa umumnya diberikan pada pasien dengan gejala LUTS sedang dan berat, dengan menggunakan α-1 adrenoceptor antagonist (blocker). Penelitian ini bertujuan untuk mengetahui perbedaan skor IPSS dan QoL pada pasien Benign Prostatic Hyperplasia (BPH) yang menerima terapi Silodosin atau Tamsulosin dalam waktu 12 minggu. Metode: Penelitian ini merupakan uji klinis buta ganda. Subjek penelitian adalah pasien laki-laki berumur 50 tahun atau lebih yang didiagnosis BPH dengan Skor IPSS ≥8 di RSPAD Gatot Soebroto. Pasien mendapatkan terapi Silodosin atau Tamsulosin lalu di follow up perubahan nilai IPSS dan QOL (Quality of Life) dalam 12 minggu. Hasil: Penelitian ini melibatkan 50 subjek, dengan rata-rata IPSS 16.74 dan QoL 3.64 pada awal penelitian. Kami menemukan penurunan rata-rata IPSS menjadi 10,5 dan ratarata QOL menjadi 2,56 dalam 12 minggu setelah subjek menerima Silodosin atau Tamsulosin. Namun secara statistik tidak terdapat perbedaan yang signifikan antara subjek yang menerima Silodosin atau Tamsulosin (p>0,05). Kesimpulan: Terdapat penurunan signifikan skor IPSS dan QoL dalam waktu 12 minggu pengamatan. Hasil ini sesuai dengan tinjauan pustaka, yaitu alpha blocker baik untuk menurunkan skor IPSS pada pasien BPH. Namun tidak ditemukan perbedaan antara pasien yang menerima Silodosin atau Tamsulosin. ......Introduction and objectives: IPSS score (International Prostate Symptom Score) is recommended as an ideal scoring instrument to be used as a detector of symptom severity in patients with LUTS (Lower Urinary Tract Symptoms), therapeutic response, and symptom improvement. Medical therapy is generally given in patients with moderate and severe LUTS symptoms, using α-1 adrenoceptor antagonists (blockers). We aimed to determine whether there is difference between IPSS & QoL in patience with BPH who received either Silodosin or Tamsulosin within 12 weeks. Methods: This study was a double blind clinical trial. Subjects were male patient age 50 or more diagnosed with BPH with IPSS Score ≥8 at Indonesian Army Hospital RSPAD Gatot Soebroto. Patient Received whether Silodosin or Tamsulosin and we followed up the change in IPSS and QOL (Quality of Life) to 12 weeks. Results: This study included 50 patients, with mean IPSS 16.74 and QOL 3.64 at the beginning of the study. We Found decreasing the IPSS mean 10.5 and QoL mean 2.56 in the 12 weeks after they received whether Silodosin or Tamsulosin. However, there are statistically not significant difference whether they received Silodosin or Tamsulosin (P>0.05) Conclusion: There are significant decrease IPSS score and QoL within 12 weeks observation. As literature review that alpha blocker are good for patience with BPH decrease IPSS. But there are no differences between patience received Silodosin and Tamsulosin.

Abstrak :
Dunia usaha perumah sakitan nasional dewasa ini tidak terpisahkan dari situasi pasar global dan kondisi krisis ekonomi dimana tingkat persaingan yang ketat dan tingginya biaya pelayanan kesehatan. Hal tersebut berpengaruh terhadap kelangsungan operasionalnya rumah sakit. Pengaruh tersebut perlu diantisipasi dengan pengelolaan sumber daya yang dimiliki secara efsien dan efektif. Salah satu sumber pendapatan yang cukup besar berasal dari pelayanan pasien rawat inap. Namun transaksi pelayanan pasien rawat inap ini tidak seluruhnya dibayar tunai/kas, melainkan sebagian pembayarannya ditagih kemudian yang tercermin dalam saldo kumulatif piutang pelayanan. Data keuangan yang diolah dari Neraca dan Rugi Laba Rumah Sakit Haji Jakarta tahun 1999 dan 2000 menunjukkan bahwa pendapatan rumah sakit meningkat secara bermakna sebesar 149,71 % pada tahun 2000. Sekitar 40 % dari pendapatan rumah sakit berasal dari pendapatan rawat inap. Sedang pendapatan rawat inap meningkat sebesar 156,46 % tetapi piutang pelayanan meningkatnya jauh lebih besar mencapai 245,98 %. Proporsi piutang pasien rawat inap terhadap pendapatan rawat inap ternyata meningkat secara drastis dari hanya 9,64 % pada tahun 1999 menjadi 15,16 % pada tahun 2000. Sehubungan dengan meningkatnya saldo piutang pelayanan pasien rawat inap tersebut, maka perlu mendapat perhatian khusus dan ditangani secara profesional. Hal ini mengingat bahwa piutang pelayanan adalah sumber dana likuid untuk mendukung operasional rumah sakit dan apabila tidak dikelola dengan baik, tentu akan mempengaruhi modal kerja yang dibutuhkan. Penelitian ini bertujuan untuk mendapat gambaran penyebab dari besarnya jumlah piutang pelayanan pasien rawat inap di Rumah Sakit Haji Jakarta dengan pendekatan sistem yaitu input, proses dan output. Penelitian ini bersifat deskriptif analitik dengan melakukan pengamatan langsung dan wawancara secara mendalam. Dari hasil penelitian dapat disimpulkan bahwa penyebab besarnya saldo piutang pelayanan pasien rawat inap karena lamanya waktu dalam proses penyampaian surat tagihan kepada para debitur. Akibatnya tingkat pembayaran yang diterima rendah yaitu rata-rata 23;30% dan masih cukup tingginya jumlah saldo piutang yang tidak terbayar yang terakumulasi pada total piutang pelayanan bulan berikutnya rata-rata sebesar 76,70%. Disamping itu pula terdapat piutang yang berumur lebih dari 90 hari mencapai sebesar 39,75% dan total piutang pelayanan pasien rawat inap per 31 Maret 2000. Saran yang dapat diberikan adalah perlunya diingatkan para dokter dalam melakukan pemeriksaan wajib untuk mengisi hasil pemeriksaannya pada resume medik, dan dilakukannya evaluasi terhadap tingkat kepatuhannya. Dengan demikian penataan rekening harian dan invoice tagihan pasien rawat inap dapat dikerjakan secara cepat dan akurat. Petugas penagihan dapat lebih cepat menyampaikan surat tagihan kepada para debitur yang jumlahnya mencapai 178 perusahaan. Selanjutnya perlu dipertimbangkan adanya batasan waktu dalam penyampaian surat tagihan, penambahan petugas dan kendaraan operasional roda dua agar dapat menjangkau lebih banyak debitur yang lokasinya tersebar di wilayah Jabotabek. ......Analysis on Management of Collection Account Receivables of Third Party Inpatient Care at RS Haji Jakarta for the Year of 2000Nowadays, the business word of national hospitality can not he separated from global market situation and the economic crisis condition, in the full competition and the high prices of health services. It is fluencies to the sustainability hospital operations. We need to anticipate the influence in order to process the resources that we have efficiently and effectively. One of the biggest resources of incoming is from in patient services. Unfortunately, not all of the transactions of patient are paid in cash, but a half of the payment is collected latter, which could be shown up in cumulative service debt balance. The financial data was derived from the balance sheet and income statement of Haji Hospital Jakarta for the period of 1999 and 2000, It showed that hospital revenue has substantially increased for 149,71 % in the year 2000. Approximately 40 % of the revenues generated from inpatient care. Although revenue increased by 156, 46 %, however the balance of account receivable also increase by 245, 98 %. The proportion of account receivable as compared to patient?s revenue. Because of the increase of the debt balance of the patient services, it is necessary to handle it professionally. It reminds that the debt service is a liquid resource to back the operationally of the hospital up, because if it didn't be proceed well, it would influence the work capital that we need. This observation aims to get a description of the causal of the high total debt of the patient at Haji Hospital Jakarta with several approach systems are input, process and output. This observation is analytic descriptive which doing direct observation and making several interviews deeply. From the result of the observation could be concluding that the causal of the high debt balance of patient was because of a very long process time giving the letter for the payment of the debt to the debtor. So, the total received payment from the debtor was still low, and the arrange or it was around 23,30 % and because the unpaid debt balance was still in high number which accumulated in total debt service for the next month would be around 76,70 %. Beside there were debts which had been more than 90 days, about 39,75 % of the total debt service of in patient per march, 31, 2000 The suggestions could be given are the extent necessary to remind the doctors when they do the obligation examine, the have to fill the result of the examination in to a medical status recorded card and to evaluate the level of the obedience. By doing that, the arrangement of daily payment and invoice debt of patient could be done fast and correctly. As well as, the debt collector could send the letter of the debt payment to a debtor faster, which the number of the debtor is 178 companies. For the next step, it is necessary to consider for giving a time limitation in sending the letter of the debt collector and the operational vehicles especially motorcycle, in order to reach more debtors in all of Jabotabek area.

Abstrak :
Jaminan kesehatan bagi karyawan dan keluarganya yang ditanggung pengobatannya oleh perusahaan dan dengan adanya karyawan sub kontraktor yang bekerja di PT Semen Padang serta masyarakat di sekitar Pabrik akan meningkatkan jumlah kunjungan khususnya unit rawat jalan dari tahun ke tahun. Hal ini akan berdampak pada bertambahnya lama waktu yang dibutuhkan di unit rawat jalan di RS SP, bila tidak dilakukan antisipasi terhadap faktor yang mempengaruhi kondisi tersebut. Dengan memperhatikan pengamatan tersebut, maka perlu kiranya dilakukan penelitian lebih lanjut terhadap hubungan karakteristik tenaga kesehatan dengan lama waktu yang dibutuhkan di unit rawat jalan RSSP. Berapa lama waktu yang dibutuhkan dan bagaimana hubungan karakteristik petugas kesehatan dengan waktu yang dibutuhkan pasien di unit rawat jalan tersebut. Penelitian ini merupakan suatu studi Deskriptif analitik bersifat kuantitatif dengan metode pengumpulan data dilaksanakan secara Cross sectional pada unit rawat jalan RSSP. Dengan sampel petugas kesehatan total populasi sebesar 19 orang dan banyaknya sampei 365 orang yang terdiri dari keluarga karyawan dan pihak ketiga (pada penelitian ini karyawan dikeluarkan karena mempunyai alur proses yang berbeda). Pengumpulan data lama waktu yang dibutuhkan pasien rawat jalan dengan menggunakan pengamatan waktu yang obyektif Penyajian data dilakukan dalam bentuk tabel distribusi frekuensi dan tabel silang. Analisis data dengan Soft ware Program SPSS, dengan uji Chi Square, dengan tingkat kemaknaan p = 0,05. Hasil yang didapat Lama waktu yang dibutuhkan pasien rawat jalan di RSSP terbanyak katagori Cepat (4-60) 86,6 %, dan paling sedikit Lama (>60) 13.4 %. Hubungan antara variabel karakteristik petugas Admission dengan lama waktu yang dibutuhkan pasien rawat jalan di RS SP yang bermakna adalah usia, pendidikan, dan lama waktu pendaftaran. Hubungan antara variabel karakteristik Asisten dokter dengan Lama waktu yang dibutuhkan pasien rawat jalan di RSSP yang bermakna adalah usia dan lama waktu pencatatan anamnesa. Hubungan antara variabel karakteristik petugas dokter umum/pesialis dengan variabel Lama waktu yang dibutuhkan pasien rawat jalan di RSSP yang bermakna adalah Usia, Jenis kelamin, Jeis pendidikan, pola aktifitas, ketepatan mulai bertugaslkedatangan dan lama waktu pemeriksaan pasien. Dari penelitian tersebut ternyata kondisinya sangat berbeda dengan pada waktu residensi, dimana pada penelitian ini didapatkan dari pelayanan di bagian admission sampai dengan pemeriksaan dokter lamanya waktu yang dibutuhkan masing-masing bagian terbanyak dengan katagori cepat. Hal ini dimungkinkan karena dengan adanya penelitian ini masing-masing petugas ingin memperlihatkan performancenya sebaik mungkin. Dengan demikian peneliti akan berusaha selalu melakukan evaluasi kinerja di unit rawat jalan dengan cara di atas, supaya kondisi yang baik ini akan dipertahankan dari waktu ke waktu. Khususnya pada lama pemeriksaan oleh dokter umum/spesialis mempunyal dua sisi yang berlawanan, disisi lain berpengaruh terhadap lama waktu yang dibutuhkan pasien di unit rawat jalan, akan tetapi kontak dokter dengan pasien sangat singkat, sehingga hal ini dapat mengurangi kepuasan terhadap pelanggan oleh karena interaksi yang tidak cukup tersebut, sehingga perlu dicarikan solusi yang ideal berapa lama waktu yang seharusnya dibutuhkan. Disarankan kepada manajemen Rumah Sakit perlu dilakukan pengkaderisasian petugas kesehatan, dan perlu dilakukan penelitian lebih lanjut mengenai faktor yang paling dominan yang mempengaruhi lama waktu yang dibutuhkan pasien rawat jalan di RSSP. ......Characteristic Relation of Health Worker With Waiting Time Required by Patient in Ambulatory Healthcare of PT. Semen Padang Hospital in 2001.Health guarantee for family and employees which the responsibility of medication by company and employees of subcontractor and also community public around company will improve amount of visit to Hospital especially ambulatory healthcare from year to year. This matter will increasing waiting time required in ambulatory healthcare of Semen Padang Hospital, when there is not anticipation to that influencing condition. With paying attention to the perception, hence need presumably be done a furthermore research to relation of characteristic health worker with waiting time required in ambulatory healthcare of Semen Padang Hospital. How long the time required and how is the characteristic relation of health worker with time required by patient in ambulatory healthcare. This research represent a Analytic Descriptive study have the character of quantitative by method of data collecting executed in cross sectional in ambulatory healthcare Semen Padang Hospital. With total population 19 persons and the number of sample 365 persons which consist of family of employees and third party ( this research employees released since having different process ). Data collecting waiting time required by patient in ambulatory healthcare by using objective time perception. Data presentation done in frequency distribution tables and crossed tables. Analyze data with software program SPSS, with chi square test, with degree mean p = 0,05. The result got a waiting time required by patient in ambulatory healthcare Semen Padang Hospital a lot of quickly category is ( 4 - 60) 86,6 °/s, and least longer ( 121 -- 180) 3.3 %. Relation between variable characteristic admission worker with waiting time required in ambulatory healthcare Semen Padang Hospital having a meaning is age, education and registration waiting time. Relation between variable characteristic of doctor assistant with waiting, time of patient in ambulatory healthcare Semen Padang Hospital having a meaning is age and time to record of anamnesa .Relation between variable characteristic of general doctor /specialist with variable of waiting time required by patient in ambulatory healthcare in Semen Padang Hospital having a meaning is age, gender, education type, pattern activity, accuracy start to work or arrival and waiting time of patient inspection. From the research really its condition is very different from when residency, where this research got from service in shares admission up to doctor inspection of time duration required by each shares of a lot of with quickly category. This matter is enabled by since with this research existence each worker wish to show performance as good as possible. There by the researcher will try always conduct performance evaluation in ambulatory healthcare will be defended from time to time. Specially at long inspection by general doctor/ specialist have adversative two sides, on the other side having an effect on to waiting time required by patient in ambulatory health care , however doctor contact with patient too short, so that this matter can reduce client satisfaction, because of the insufficient interaction, so that require to be looked for a ideal solution how long time which ought to be required. To be suggested to management of Hospital required to regeneration of health worker, and require to be done by a furthermore research about most dominant factor influencing waiting time required by patient in Semen Padang Hospital.

Abstrak :
Indonesia masih memiliki tantangan dalam upaya penurunan AKI untuk mencapai target SDGs tahun 2030. Keluarga Berencana (KB) merupakan salah satu program yang efektif untuk menurunkan AKI, namun selama satu dekade terakhir program KB mengalami stagnansi. Saat ini, program KB cenderung berfokus pada perempuan dan partisipasi laki-laki dalam keluarga berencana dinilai masih rendah. Tujuan penelitian ini adalah untuk mengetahui gambaran partisipasi laki-laki dalam keluarga berencana pada tahun 2007, 2012 dan 2017, determinan sosial yang mempengaruhinya serta ketidakmerataan geografis dan sosial ekonomi. Penelitian ini menggunakan pendekatan kuantitatif dengan desain studi potong lintang dari data pasangan Survei Demografi Kesehatan Indonesia (SDKI) tahun 2007, 2012 dan 2017. Sampel pada penelitian ini adalah pasangan usia subur (PUS) yang masih dalam status perkawinan dan responden istri sedang tidak hamil. Jumlah sampel pada penelitian ini adalah 5.058 (2007), 5.431 (2012) dan 5.957 (2017) pasangan. Analisis multiway ANOVA dilakukan untuk menilai determinan partisipasi laki-laki dalam keluarga berencana. Berbagai ukuran ketidakmerataan juga digunakan untuk meninjau ketidakmerataan partisipasi laki-laki dalam keluarga berencana dengan bantuan alat ukur Health Equity Assessment Toolkit (HEAT) yang dikembangkan oleh World Health Organization (WHO). Hasil penelitian adalah terjadi peningkatan partisipasi laki-laki dalam keluarga berencana dalam kurun waktu 2007 – 2017, dari 68.9 hingga 71.2. Jika dilihat dari ketidakmerataan geografis dan sosial ekonomi, terjadi penurunan ketidakmerataan meskipun terdapat beberapa perubahan pola ketidakmerataan pada tempat tinggal (perkotaan vs perdesaan) dan sosial ekonomi. Umur suami, pendidikan suami, tempat tinggal dan paparan KIE KB dari media menjadi determinan sosial yang memiliki pengaruh signifikan terhadap partisipasi laki-laki dalam keluarga berencana. Perlu ada pemanfaatan media sosial atau media massa dengan melakukan kampanye massif terkait peran laki-laki dalam keluarga berencana baik sebagai pengguna maupun pendamping dan agen perubahan. ......Indonesia still has challenges in efforts to reduce MMR to achieve the SDGs target in 2030. Family Planning (KB) is one of the effective programs to reduce MMR, but over the past decade the family planning program has stagnated. Currently, family planning programs tend to focus on women and men's participation in family planning is still considered low. The purpose of this study was to find out the male involvement in family planning in 2007, 2012 and 2017, the social determinants that influence it as well as geographical and socioeconomic inequality. This study uses a quantitative approach with a cross-section study design from the pair data of the Indonesian Health Demographic Survey (IDHS) in 2007, 2012 and 2017. The samples in this study were couples of childbearing age who were still in marital status and respondents wives were not pregnant. The total sample in this study was 5,058 (2007), 5,431 (2012) and 5,957 (2017) couples. ANOVA multiway analysis was performed to assess the determinants of male involvement in family planning. Various measures of inequality are also used to review the unevenness of male participation in family planning with Health Equity Assessment Toolkit (HEAT) measuring tool developed by the World Health Organization (WHO). The results of the study were an increase in male participation in family planning in the period 2007 – 2017, from 68.9 to 71.2. There is a decrease in geographical and socioeconomic inequality even though there are some changes in the pattern of inequality in residences (urban vs rural) and socioeconomic. The husband's age, husband's education, place of residence and exposure to family planning promotion from the media are social determinants that have a significant influence on man involvement in family planning. Massive campaigns using social media need to be done to promote the role of men in family planning as active client, companions and agents of change

Abstrak :
Faktor manusia merupakan faktor yang berkontribusi besar terhadap terjadinya kecelakaan kerja dimana 88% kecelakaan kerja di industri terjadi karena tindakan tidak aman dari manusia (Ramli, 2019). Karena hal tersebut, untuk mencegah terjadinya kecelakaan kerja dapat dilakukan dengan berbagai pendekatan tentang manusia salah satunya adalah dengan membangun budaya keselamatan dan kesehatan kerja (K3) (Ramli, 2019). Sekolah Menengah Kejuruan (SMK) merupakan lembaga pendidikan formal dimana pada proses pembelajaran siswa SMK tidak hanya dituntut untuk memahami suatu konsep atau teori namun juga harus bisa mempraktikan teori yang telah diajarkan. Adanya interaksi langsung antara siswa dengan peralatan atau mesin produksi dapat berpotensi menimbulkan kecelakaan kerja atau penyakit akibat kerja sehingga K3 menjadi isu yang penting (Monisa, 2016). Penelitian ini dilakukan di 5 Sekolah Menengah Kejuruan (SMK) di Kabupaten Bogor untuk mencari gambaran awal budaya K3 di SMK Kabupaten Bogor berdasarkan tiga dimensi yaitu dimensi manusia, dimensi organisasi, dan dimensi teknologi. Dalam penelitian ini tidak dilakukan pengurutan atau penentuan tingkatan budaya K3 di SMK yang kurang baik hingga baik, melainkan hanya menggambarkan kondisi awal budaya K3 di SMK berdasarkan dimensi manusia, dimensi teknologi, dan dimensi organisasi. Penelitian dilakukan dengan menggunakan desain studi campuran atau mixed method. Sumber data berasal data primer yang didapatkan menggunakan kuesioner kepada guru, tenaga kependidikan dan siswa SMK di Kabupaten Bogor, wawancara mendalam kepada guru SMK dan observasi ke sekolah. Hasil penelitian ini menunjukan dari lima SMK di Kabupaten Bogor yang diteliti terdapat satu SMK dengan budaya K3 yang paling baik, dua SMK dengan budaya K3 yang cukup baik, dan dua SMK dengan budaya K3 yang kurang baik. Hasil penelitian tersebut menunjukan bahwa budaya K3 dari kelima SMK bervariasi. ......Human factors are a major contributing factor to workplace accidents, with 88% of industrial accidents occurring due to unsafe actions by individuals (Ramli, 2019). To prevent workplace accidents, various approaches to understanding human behavior, such as building a safety and occupational health (OSH) culture, can be implemented (Ramli, 2019). Vocational High Schools or in bahasa Sekolah Menengah Kejuruan (SMK) are formal educational institutions where students are not only required to understand concepts or theories but also to apply them practically. The direct interaction between students and equipment or production machinery can potentially lead to work accidents or occupational diseases, making OSH an important issue (Monisa, 2016). This study was conducted in five Vocational High Schools in Bogor Regency to provide an initial overview of the OSH culture in SMK Bogor Regency based on three dimensions: the human dimension, the organizational dimension, and the technological dimension. The study did not rank or determine the level of OSH culture in SMK from poor to good; instead, it only described the initial conditions of the OSH culture in SMK based on the human, technological, and organizational dimensions. The research design used a mixed-method approach, combining primary data from questionnaires distributed to teachers, educational staff, and SMK students in Bogor Regency, in-depth interviews with SMK teachers, and observations conducted at the schools. The results of this study show that out of the five SMKs investigated in Bogor Regency, one SMK has the best OSH culture, two SMKs have a moderately good OSH culture, and two SMKs have a poor OSH culture. These findings indicate that the OSH culture varies among the five SMKs.

Abstrak :
Masa 1000 hari pertama kehidupan terutama pada masa prenatal merupakan masa terjadinya perkembangan sel-sel otak, pertumbuhan linier, dan pembentukan organ yang terjadi secara paralel dan berlanjut sampai umur 2 tahun. Akibat jangka panjang dapat menurunkan fungsi kognitif, risiko stunting, dan risiko menderita penyakit kronis, seperti hipertensi. Bukti beberapa penelitian menunjukkan gangguan pertumbuhan pada masa prenatal memberikan retained effect pada periode umur selanjutnya yaitu sejak bayi sampai dewasa, sehingga pada penelitian ini menggunakan tinggi badan usia dewasa sebagai indikator proxy untuk memprediksi adanya gangguan pertumbuhan pada masa dini kehidupan. Di Indonesia, ada indikasi tingginya prevalensi stunting pada anak balita, anak usia sekolah dan usia dewasa berkaitan dengan tingginya prevalensi hipertensi, termasuk pada kelompok miskin. Tujuan penelitian ini ingin membuktikan apakah tinggi badan dewasa dapat digunakan sebagai indikator proxy adanya gangguan pertumbuhan pada masa dini kehidupan dan paralel dengan kejadian hipertensi di Indonesia. Penelitian ini menggunakan data Riskesdas, 2007 dengan desain kros-seksional melibatkan 481.489 subyek, umur 20-60 tahun, menggunakan alat pengukur tekanan darah digital omron A2 dan alat ukur tinggi badan microtoise dengan ketelitian 0,1 cm yang dilakukan oleh tenaga kesehatan terlatih. Hasil penelitian tidak terbukti ada hubungan antara tinggi badan dengan hipertensi dengan OR= 0,981 (95% CI: 0,955-1,008) setelah dikontrol oleh faktor konfounding potensial seperti umur, kegemukan, obesitas sentral, dan lama merokok. Oleh karena itu, tinggi badan dewasa di Indonesia tidak dapat digunakan untuk memprediksi risiko hipertensi. Perlu penelitian lebih lanjut dengan desain kohor untuk membuktikan apakah tingginya masalah gangguan pertumbuhan di Indonesia yang ditunjukkan dengan tingginya prevalensi stunting terjadi secara paralel dengan peningkatan risiko hipertensi.

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The first period of 1000 days, especially during prenatal life is a period of the development of brain cells, linear growth, and organ formation occurs in parallel and continued until the age of 2 years. Long-term consequences can decrease cognitive function, risk of stunting, and the risk of chronic diseases, such as hypertension. Evidence showed some growth retardation during prenatal give effect retained in subsequent age period, since the period of infancy to adult so in this study using a high body adult age as a proxy indicator for predicting growth retardation in the early life. In Indonesia, there is an indication of the high prevalence of stunting in children under five, children of school age and adulthood is associated with high prevalence of hypertension, including in the poor. The purpose of this study to prove whether adult height can be used as a proxy indicator of growth retardation during the early and parallel to the incidence of hypertension in Indonesia. This study uses data Riskesdas, 2007 with crosssectional design, involving 481.489 subjects, aged between 20-60 years, using a digital blood pressure meter omron A2 and using microtoise the nearest 0.1 cm to measure adult height by trained health personnel. The results showed that short stature was not associated with hypertension with OR= 0,981 (95% CI: 0,955-1,008) after potential konfounding controlled by factors such as obesity, central obesity, and age. Therefore, adult height in Indonesia can not be used as a proxy indicator of the risk of hypertension. Need further research to design kohor to prove whether high growth retardation in Indonesia as shown by the high prevalence of stunting occurs in parallel with an increased risk of hypertension.

Abstrak :
Latar Belakang: Stunting atau tumbuh pendek sudah dimulai dari kandungan ibu dengan indikasi BBLR dengan pertumbuhan dibawah kurva standar. Masa kritis pertumbuhan terjadi pada 1000 hari pertama kehidupan. Studi ini dilakukan untuk meneliti pengaruh pertumbuhan dini terhadap pertumbuhan pada usia pra-pubertas. Metode: Disain penelitian adalah retrospektif, menggunakan data panel Indonesian Family Life Survey tahun 1993, 1997, dan 2000. Studi populasi adalah rumah tangga, mencakup 13 dari 27 provinsi yang ada pada tahun 1993 dengan keterwakilan urban-rural dan nasional. Sampel adalah anak usia 0-2 tahun pada baseline, diukur kembali pada usia 4-6 tahun dan 7-9 tahun (pra-pubertas). Data analisis dilakukan dengan metode Regresi Logistik Ganda. Hasil: Pertumbuhan usia dini menentukan pertumbuhan usia pra-pubertas. Faktor- faktor yang berpengaruh pada pendek usia dini antara lain miskin (OR=1,78; 95%CI=1,06-2,99), tinggal di perdesaan (OR=2,92; 95%CI=1,74-4,90), sanitasi lingkungan yang buruk (OR=1,84; 95%CI=1,10-3,09). Stunting pada usia 4-6 tahun dipengaruhi oleh pendek pada usia dini (OR=3,73; 95%CI= 2,160-6,343). Pengaruh dan pola pertumbuhan pendek (P) dan normal (N) pada usia dini (02) dan usia 4-6 tahun (46) menunjukkan, 77,1% anak 02P_46P tumbuh tetap pendek pada usia pra- pubertas (OR=27,43; 95%CI=11,68-64,43). Sebanyak 59,5% anak 02N_46P mengalami growth faltering dan menjadi pendek (OR=14,00; 95%CI=5,95-32,95). Anak yang usia 02P_46N sebanyak 84,3% tumbuh tetap normal (OR=1,48; 95%CI=0,55-4,00; p=0,441) pada usia pra-pubertas. Perbaikan pertumbuhan setelah usia dini didukung oleh adanya perbaikan ekonomi secara umum. Faktor-faktor yang berpengaruh terhadap stunting pada usia pra-pubertas berbeda menurut disain yang digunakan dalam analisis. Analisis dengan disain cross-sectional menunjukkan, faktor yang berpengaruh terhadap stunting pada pra-pubertas adalah pendek pada usia dini, miskin, sanitasi lingkungan dan jenis kelamin; sedangkan analisis dengan disain longitudinal menunjukkan, stunting pada usia pra-pubertas secara signifikan dipengaruhi oleh pertumbuhan pada usia dini dan pola pertumbuhan antara usia dini dan pra-pubertas.

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Background: Stunting or growing short has been started in the womb of mothers, indicated by having low birth weight and grew in deviation curve. Critical window of growth taken place at first 1000 days of life. This study was conducted to investigate the influence of early growth, towards the growth of pre-puberty's period. Method: The design of the study was retrospective, utilizing the Indonesian Family Life Survey panel data of 1993, 1997, and 2000. Study population was Indonesian households covering 13 out of 27 provinces in 1993 for the representativeness of urban-rural and national. Sampel was children age of 0-2 years old at the baseline, followed up at age of 4-6 years and 7-9 years (pre-puberty). The method of data analysis was Multivariate Logistic Regression. Results: Early child growth was appointed growth of pre-puberty. Factors related to stunted or short at early life was poverty (OR=1,78; 95% CI=1,06-2,99), urban settlement (OR=2,92; 95% CI=1,74-4,90), as well as poor hygiene and sanitation (OR=1,84; 95% CI=1,10-3,09). Short at age of 4-6 years is related to short at early age (OR=3,73; 95% CI= 2,160-6,343). Early growth and growth pattern of stunted (S) and normal (N) at early age or age of 0-2 years (02) and age of 4-6 years (46) showed, 77,1% of 02S_46S stayed stunted (OR=27,43; 95%CI=11,68-64,43). As much as 59,5% of 02N_46S experienced growth faltering becoming stunted (OR=14,00; 95%CI=5,95-32,95). Children who were 02S_46N account for 84,3% growed normal (OR=1,48; 95%CI=0,55-4,00; p=0,441) at pre-puberty. Growth improvememnt of these subjects seemed supported by the economic development in general. Factors related to pre-puberty growth differed between the methods of analysis. Cross- sectional analysis showed that factors related to pre-puberty growth were short in early age, poverty, health sanitation and sex; meanwhile longitudinal analysis of growth showed that pre-puberty growth significantly influenced by early growth and growth pattern in between the age period. Conclusion and novelty: the growth at early age and growth pattern in between age period appointed the pre-puberty growth. Novelty of this study is stunted or short at age 0-2 and continuously short at age 4-6 year was at risk of stayed short at pre-puberty (7-9 year). In addition, grew normal at early age, but short at age 4-6 year was also at risk of stunting at pre-puberty. However, short at age 0-2, but getting normal or catch up at age of 4-6 was protective or stayed normal at pre-puberty. Recommendation: Recommendation of this research is that a multi-center study need to be conducted at the pocket areas of NTT and Papua so that problems related specific solution can be done to prevent stunting. Efforts in stunting intervention should be focused at first 1000 days of life, and if necessary be followed up until age of five years. The implementation of standard operational procedure of mother's and baby's cohorts as well as KIA's book should be strengthened. In addition, law enforcement of those procedure should be complemented with structured trainings of the midwives as a capital of a valid data that can be used to study growth in relation to degenerative diseases in the future. Intergrated programs with other sectors should be conducted hands in hands to reduce stunting through community empowerment as well as households income's generation.

Abstrak :
[ABSTRAK
LATAR BELAKANG: Katiadaan instrumen penilaian kompetensi yang valid menyulitkan penilaian praktik konseling terhadap tenaga gizi desa (Barangay Nutrition Scholars, BNS) yang mendapat pelatihan konseling pemberian makanan pada bayi dan anak (infant and young child feeding, IYCF). Studi ini dirancang untuk mengembangkan dan memvalidasi instrumen penilaian kompetensi BNS dalam memberikan konseling IYCF. METODE: Desain penelitian metodologi digunakan untuk mengembangkan dan validasi instrumen pengukur kompetensi konseling IYCF meliputi pengetahuan, sikap, dan keterampilan, berdasarkan frekuensi, intensitas, dan aktivitas. Instrumen ini ditujukan penggunaanya oleh BNS, supervisor, maupun klien. Uji coba dan revisi berdasarkan hasil analisis item dilakukan pada 320 BNS dan dilanjutkan dengan uji lapangan terhadap 280 BNS. Validitas isi (content validity) dikaji oleh beberapa pakar, sedangkan konsistensi internal (internal consistency) dan validitas konstruk (construct validity) diuji dengan Cronbach?s alpha dan, exploratory dan confirmatory factor analysis. Distribusi bobot pengetahuan, sikap dan keterampilan dan nilai titik potong kompetensi untuk tiap construct dan instrumen ditetapkan berdasarkan sensitivitas dan spesifisitas menggunakan ROC Curve. HASIL: Instrumen yang valid terdiri dari: 1) 28 item terkait pengetahuan BNS dengan tipe memilih benar atau salah suatu pertanyaan, pertanyaan dengan jawaban singkat, dan pilihan ganda; 2) 10 item terkait sikap BNS dengan Likert scale untuk menilai pandangan pribadi, sikap terhadap implementasi, dan hambatan yang dirasakan saat konseling IYCF; 3) 18 item menggunakan 5 skala frekuensi penilaian BNS dalam mendengarkan, memberikan support, dan praktik penilaian dan keterampilan; 4) 18 item dengan 4 skala nilai untuk atasan BNS menilai intensitas proses konseling, penilaian dan penggunaan materi IYCF; dan 5) 17 item berupa daftar tilik kegiatan untuk klien menilai pemberian support, penilaian, dan praktik keterampilan. Gabungan item masing-masing menjadi instrumen penilaian kompetensi KAS-WOR, KAS-SUP, KAS-MOM dan KAS-COM dengan nilai titik potong masing-masing yaitu 75%, 50%, 80% dan 65%. Berdasarkan pembobotan 20% untuk pengetahuan, 10% sikap, dan 70% keterampilan diperoleh 30% BNS yang kompeten dalam konseling IYCF. KESIMPULAN: Hasil pengembangan instrumen penilaian kompetensi BNS melakukan konseling IYCF memiliki konsistensi internal dan tingkat validitas yang sedang sampai tinggi.

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ABSTRACT
BACKGROUND: The Barangay (Village) Nutrition Scholars (BNS) has been trained to do infant and young child feeding (IYCF) counseling but the absence of a validated competency instruments constrained the assessment of their competency to do IYCF counseling to their client. This study was designed to develop and validate the instruments to assess the competency of BNS on IYCF counseling and answer the question: how valid and reliable were the developed instrument to measure the competency of trained BNS on IYCF counseling? METHODS: Methodological research design were used to develop and validate the instruments to measure IYCF counseling competency based on knowledge, attitude and skills in terms of frequency, intensity and activity designed for the BNS, supervisor and client, respectively. The instruments were pilot-tested to assess 320 BNS. Item analyses results were used for revisions prior to field test to 280 BNS. Experts checked the content validity; internal consistency and construct validity were assessed using Cronbach?s alpha and exploratory and confirmatory factor analysis, respectively. The weighting distribution for knowledge, attitude and skills and cut-off score for each construct and instrument were established based on sensitivity and specificity using ROC Curve to calculate the score and to identify competent BNS. RESULTS: The validated instruments included: 1) 28 items for BNS knowledge test with true or false, fill-in-the-blanks and multiple-choice formats; 2) 10 items for BNS attitude test with four scale Likert scale to assess personal view, attitude towards implementation, and perceived barriers on IYCF counseling; 3) 18 items of five-scale frequency instrument for BNS to assess listening, giving support, assessment and action skills; 4) 18-item four-scale instrument for BNS supervisor to assess the intensity in doing the counseling process, assessment and use of IYCF materials; and 5) 17-item activity checklist designed for client to assess giving support, assessment and actions skills. These constructs were combined into competency assessment instruments KAS-WOR, KAS-SUP, KAS-MOM and KAS-COM with 75%, 50%, 80% and 65% as cut-off score. Based on the 20-10-70 weighting distributions for knowledge-attitude-skills competent BNS on IYCF counseling was about 30%. CONCLUSIONS: The assessment instruments developed to measure the IYCF counseling competency of BNS had relatively moderate to high internal consistency and validity. This assures that the results of the tests can be relied upon for making dependable judgments and interpretations.;BACKGROUND: The Barangay (Village) Nutrition Scholars (BNS) has been trained to do infant and young child feeding (IYCF) counseling but the absence of a validated competency instruments constrained the assessment of their competency to do IYCF counseling to their client. This study was designed to develop and validate the instruments to assess the competency of BNS on IYCF counseling and answer the question: how valid and reliable were the developed instrument to measure the competency of trained BNS on IYCF counseling? METHODS: Methodological research design were used to develop and validate the instruments to measure IYCF counseling competency based on knowledge, attitude and skills in terms of frequency, intensity and activity designed for the BNS, supervisor and client, respectively. The instruments were pilot-tested to assess 320 BNS. Item analyses results were used for revisions prior to field test to 280 BNS. Experts checked the content validity; internal consistency and construct validity were assessed using Cronbach?s alpha and exploratory and confirmatory factor analysis, respectively. The weighting distribution for knowledge, attitude and skills and cut-off score for each construct and instrument were established based on sensitivity and specificity using ROC Curve to calculate the score and to identify competent BNS. RESULTS: The validated instruments included: 1) 28 items for BNS knowledge test with true or false, fill-in-the-blanks and multiple-choice formats; 2) 10 items for BNS attitude test with four scale Likert scale to assess personal view, attitude towards implementation, and perceived barriers on IYCF counseling; 3) 18 items of five-scale frequency instrument for BNS to assess listening, giving support, assessment and action skills; 4) 18-item four-scale instrument for BNS supervisor to assess the intensity in doing the counseling process, assessment and use of IYCF materials; and 5) 17-item activity checklist designed for client to assess giving support, assessment and actions skills. These constructs were combined into competency assessment instruments KAS-WOR, KAS-SUP, KAS-MOM and KAS-COM with 75%, 50%, 80% and 65% as cut-off score. Based on the 20-10-70 weighting distributions for knowledge-attitude-skills competent BNS on IYCF counseling was about 30%. CONCLUSIONS: The assessment instruments developed to measure the IYCF counseling competency of BNS had relatively moderate to high internal consistency and validity. This assures that the results of the tests can be relied upon for making dependable judgments and interpretations.;BACKGROUND: The Barangay (Village) Nutrition Scholars (BNS) has been trained to do infant and young child feeding (IYCF) counseling but the absence of a validated competency instruments constrained the assessment of their competency to do IYCF counseling to their client. This study was designed to develop and validate the instruments to assess the competency of BNS on IYCF counseling and answer the question: how valid and reliable were the developed instrument to measure the competency of trained BNS on IYCF counseling? METHODS: Methodological research design were used to develop and validate the instruments to measure IYCF counseling competency based on knowledge, attitude and skills in terms of frequency, intensity and activity designed for the BNS, supervisor and client, respectively. The instruments were pilot-tested to assess 320 BNS. Item analyses results were used for revisions prior to field test to 280 BNS. Experts checked the content validity; internal consistency and construct validity were assessed using Cronbach?s alpha and exploratory and confirmatory factor analysis, respectively. The weighting distribution for knowledge, attitude and skills and cut-off score for each construct and instrument were established based on sensitivity and specificity using ROC Curve to calculate the score and to identify competent BNS. RESULTS: The validated instruments included: 1) 28 items for BNS knowledge test with true or false, fill-in-the-blanks and multiple-choice formats; 2) 10 items for BNS attitude test with four scale Likert scale to assess personal view, attitude towards implementation, and perceived barriers on IYCF counseling; 3) 18 items of five-scale frequency instrument for BNS to assess listening, giving support, assessment and action skills; 4) 18-item four-scale instrument for BNS supervisor to assess the intensity in doing the counseling process, assessment and use of IYCF materials; and 5) 17-item activity checklist designed for client to assess giving support, assessment and actions skills. These constructs were combined into competency assessment instruments KAS-WOR, KAS-SUP, KAS-MOM and KAS-COM with 75%, 50%, 80% and 65% as cut-off score. Based on the 20-10-70 weighting distributions for knowledge-attitude-skills competent BNS on IYCF counseling was about 30%. CONCLUSIONS: The assessment instruments developed to measure the IYCF counseling competency of BNS had relatively moderate to high internal consistency and validity. This assures that the results of the tests can be relied upon for making dependable judgments and interpretations., BACKGROUND: The Barangay (Village) Nutrition Scholars (BNS) has been trained to do infant and young child feeding (IYCF) counseling but the absence of a validated competency instruments constrained the assessment of their competency to do IYCF counseling to their client. This study was designed to develop and validate the instruments to assess the competency of BNS on IYCF counseling and answer the question: how valid and reliable were the developed instrument to measure the competency of trained BNS on IYCF counseling? METHODS: Methodological research design were used to develop and validate the instruments to measure IYCF counseling competency based on knowledge, attitude and skills in terms of frequency, intensity and activity designed for the BNS, supervisor and client, respectively. The instruments were pilot-tested to assess 320 BNS. Item analyses results were used for revisions prior to field test to 280 BNS. Experts checked the content validity; internal consistency and construct validity were assessed using Cronbach’s alpha and exploratory and confirmatory factor analysis, respectively. The weighting distribution for knowledge, attitude and skills and cut-off score for each construct and instrument were established based on sensitivity and specificity using ROC Curve to calculate the score and to identify competent BNS. RESULTS: The validated instruments included: 1) 28 items for BNS knowledge test with true or false, fill-in-the-blanks and multiple-choice formats; 2) 10 items for BNS attitude test with four scale Likert scale to assess personal view, attitude towards implementation, and perceived barriers on IYCF counseling; 3) 18 items of five-scale frequency instrument for BNS to assess listening, giving support, assessment and action skills; 4) 18-item four-scale instrument for BNS supervisor to assess the intensity in doing the counseling process, assessment and use of IYCF materials; and 5) 17-item activity checklist designed for client to assess giving support, assessment and actions skills. These constructs were combined into competency assessment instruments KAS-WOR, KAS-SUP, KAS-MOM and KAS-COM with 75%, 50%, 80% and 65% as cut-off score. Based on the 20-10-70 weighting distributions for knowledge-attitude-skills competent BNS on IYCF counseling was about 30%. CONCLUSIONS: The assessment instruments developed to measure the IYCF counseling competency of BNS had relatively moderate to high internal consistency and validity. This assures that the results of the tests can be relied upon for making dependable judgments and interpretations.]

Abstrak :
Latar belakang: Penatalaksanaan fraktur greenstick radius sering berakibat malunion karena angulasi-ulang yang membatasi gerak sendi radio-karpal. Oleh sebab itu perlu diupayakan metoda reposisi yang aman, efektif, dan murah yang dapat dikerjakan sebagai Standar Prosedur Operasional di RSUD kabupaten Indonesia. Reposisi fraktur greenstick radius dengan melakukan over-koreksi, merupakan pilihan, karena dapat mencegah terjadinya angulasi-ulang. Tujuan: Menilai efektivitas dan keamanan reposisi dengan over-koreksi dalam penatalaksanaan fraktur greenstick radius. Rancangan dan metode: Uji klinis acak, grup paralel, dengan concealment. Penelitian melibatkan 92 anak (46 per kelompok) usia 4-14 tahun dengan fraktur greenstick radius di RSUD Kota Bekasi, Agustus 2011 sampai Mei 2012. Efektivitas prosedur diukur melalui derajat residu angulasi (minimal ditetapkan 5°), angulasi ulang, pergeseran fragmen fraktur (minimal <25%), dan risiko pengobatan (untuk mengukur keamanan pasien) mulai saat setelah reposisi 24 jam, minggu pertama sampai minggu ke-4, minggu ke-6 dan minggu ke-10. Hasil: Over-koreksi terbukti efektif dan aman digunakan dalam penatalaksanaan fraktur greenstick radius. Pada semua pengamatan, Insidens Risk untuk terjadinya residu angulasi >5° pada kelompok over koreksi lebih kecil dibandingkan kelompok tanpa over koreksi. Pada minggu kedua, IR pada kelompok over koreksi (0,04) sedangkan kelompok tanpa over koreksi (0,39) dengan Risk Difference -0,35 (95%CI: -0,50 - -0,19). Perbedaan tersebut terlihat konsisten pada seluruh pengamatan. Probabilitas kesintasan lebih besar pada kelompok over-koreksi dibanding tanpa over-koreksi untuk terjadinya angulasi ulang. Insidence Rate recurrent angulation pada kelompok over-koreksi lebih kecil dibandingkan tanpa over koreksi dengan risk difference sebesar -0,025 (95% CI: -0,02--0,03). Pada sesaat pasca reposisi hingga minggu pertama perbedaan risiko pergeseran fragmen fraktur 2:25% pada kelompok over-koreksi jauh lebih besar daripada kelompok tanpa over-koreksi namun pada minggu kedua hingga minggu kesepuluh, perbedaan risiko sudah sangat berkurang sehingga tidak didapatkan perbedaan bermakna mulai minggu kedua hingga kesepuluh. Proporsi risiko pengobatan yang terjadi pada pasien sangat sedikit sehingga penelitian ini tidak dapat membuktikan bahwa pengobatan fraktur greenstick radius dengan melakukan over-koreksi lebih baik dalam mengontrol risiko pengobatan. Kesimpulan: Over-koreksi efektif dan aman untuk digunakan dalam penatalaksanaan fraktur greenstick radius pada anak. Saran: perlu dilakukan penelitian yang sama yang dilakukan oleh ahli bedah ortopedi lain pada beberapa RSUD di kabupaten di Indonesia;

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Background: Management of greenstick radius fracture often results in malunion because re-angulations that restrictive radio-carpal joint. Therefore, needed a safer, effective, and cheaper repositioning method that can be done as a Standard Operating Procedure in district hospitals in Indonesia Reposition of greenstick radius fracture with over-correction is as choice because it can prevent re-angulations. Objective: Asses the effectiveness and safety of repositioning with over-correction in the greenstick radius fracture management. Design and method: Randomized clinical trial, parallel group, with concealment. This study involved 92 children (46 per group) aged 4-14 years with greenstick radius fracture in Bekasi City General Hospital, August 2011 until May 2012. Effectiveness of the procedure is measured by the degree of residual angulations (minimal <5<), re­ angulations, a shift in the fracture fragments (minimal <25%), and risk of treatment (to measure patient safety) started after 24 hours repositioning, first week until fourth, sixth and tenth week. Result: Over-correction proved effective and safe to use in the management of greenstick radius fracture. In All observations, Incidence Risk for the occurrence of residual angulations is >5° at the over-correction group less than non over-correction group. In the second week, IR at the over-correction group (0,04), while non over­ correction (0,39) with Risk Difference -0,35 (95%CI: -0,50 - -0,19). This difference was seen consistently in all observation. Probability of survival at the over-correction group greater than non over-correction group for the occurrence of re-angulations. Incidence Rate recurrent angulations at the over-correction group less than non over correction with risk difference -0,025 (95% CI: -0,02--0,03). After reposition until the first week, the difference of fracture fragment shift's risk 2:25% at the over­ correction group, much larger than non over-correction group. But at the second week until tenth week, the difference of risk has been significantly reduced, so that there is no significant difference started at the second week until tenth week. Proportion of treatment risk occurred in patients measly, so that this study cannot prove that the greenstick radius fracture treatment with over-correction better in control the risk of treatment. Conclusion: Over-correction is effective and safe to use in the management of greenstick radius fracture at the children. Suggestion: needs to conduct the same research done by other orthopedic surgeons at several district hospitals in Indonesia.

Abstrak :
ABSTRAK
Diagnosis HIV pada bayi masih sulit ditentukan pada daerah dengan sumber terbatas dan tidak memiliki fasilitas pemeriksaan PCR. Keterlambatan menentukan diagnosis pada bayi tertular HIV yang lahir dari ibu HIV positif akan menimbulkan angka morbiditas dan mortalitas yang tinggi. Penelitian ini bertujuan menemukan model prediksi risiko bayi tertular HIV yang efektif yaitu yang memiliki nilai sensitivitas dan spesifisitas cukup baik dan praktis penggunaannya di lapangan. Penelitian terdiri dari dua tahapan yaitu tahap pertama pembuatan model dari faktor risiko pada ibu, bayi, dan persalinan serta tahap kedua validasi skoring model. Subjek tahap pertama berasal dari data rekam medis pasangan ibu HIV positif dan bayi yang dilahirkannya di 5 rumah sakit di Jakarta dan Kepulauan Riau dan 1 puskesmas di Jakarta sebanyak 100 subjek. Didapatkan 2 model skor yang efektif sebagai model prediksi risiko bayi tertular HIV yaitu Model 1 (terdiri dari usia ibu, ARV pada ibu, infeksi TB paru, usia gestasi, cara persalinan dan jenis kelamin bayi) dan Model 2 (ARV pada ibu, infeksi TB paru ibu, dan cara persalinan). Model 2 selain efektif juga praktis untuk penggunaan di lapangan. Validasi eksterna terhadap 20 subjek bayi yang lahir dari ibu dengan HIV positif di 3 rumah sakit di Jakarta menunjukkan tidak terdapat perbedaan hasil antara Model 2 dan pemeriksaan PCR RNA HIV bayi usia 6 minggu. Model 2 adalah model prediksi yang efektif dan praktis untuk prediksi risiko bayi tertular HIV yang lahir dari ibu HIV positif di daerah dengan sumber dan fasilitas terbatas.

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ABSTRACT
HIV diagnosis in infants is still difficult to determine in areas with limited resources and no PCR examination facilities. Delay in diagnosing HIV infected infants born to HIV positive mothers will lead to high morbidity and mortality. The aim of this study is to find an effective and practical model to be used in the field to predict risk of HIV transmission in infants born to HIV positive mothers, with relatively well sensitivity and specificity. This study consisted of two stages. The first stage was to develop a risk factor model consisting of maternal, infant and obstetric risk factors, and the second stage was to validate the scoring model. Data for the first stage was obtained using medical records of 100 infants born to HIV positive mothers in 5 hospitals in Jakarta and Riau Islands, as well as 1 community health center in Jakarta. Two effective models were generated in this study, namely: Model 1 (consisting of maternal age, maternal ARV therapy, maternal tuberculosis infection, gestational age, method of delivery, sex of the infant) and Model 2 (consisting of maternal ARV treatment, maternal tuberculosis infection, and mode of delivery). Model 2 is more effective and practical to be used in the field. External validation performed on 20 infants born to HIV positive mothers in three hospitals in Jakarta showed that there were no differences between the scoring model and PCR RNA HIV results. Model 2 can be used on infants born to HIV positive mothers as an effective and practical transmission risk prediction tool for in areas with limited resources and facilities