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"This volume of current topics in microbiology and immunology covers diverse topics related to intradermal immunization. The chapters highlight the effectiveness of intradermal immunization in experimental animal models or in clinical practice, all supporting the view that intradermal immunization is at least as good as other immunization routes. Keeping in mind that current vaccines are not specially designed for intradermal immunization, but show comparable efficiency even at reduced dosages, this underlines the great potential for the skin as a vaccination site."

"Psoriasis merupakan penyakit autoimun yang disebabkan kelainan genetik dan dipicu faktor lingkungan, penyakit ini menyerang kulit dan sistemik seperti sendi dan kuku. Sel punca mesenkim (SPM) asal tali pusat manusia memiliki kapasitas proliferasi yang tinggi, imunomodulator yang luas dan imunogenitas yang rendah. Penelitian ini menggunakan model tikus psoriasis yang diinduksi dengan krim imiquimod 5% selama 6 hari. Tikus dibagi menjadi kelompok 5 kelompok yang diberi SPM atau Phosphate Nuffer Saline (PBS) secara intradermal atau subkutan serta kontrol normal. Pemberian SPM dan PBS dilakukan sebelum pengolesan krim. Penilaian harian kulit tikus dilakukan dengan skoring modified Psoriasis Area and Severity Index (mPASI). Setelah pembedahan, kulit tikus dianalisa terhadap ekspresi relatif gen Interleukin (IL)-17 dan IL-10. Sebagian kulit difiksasi dengan formalin dan dilakukan pemeriksaan histologi dan imunohistokimia dengan antibodi Anti-CD11b. Analisa statistik memperlihatkan skor mPASI kelompok SPM mengalami penurunan bermakna dibanding kelompok PBS. Ekspresi relatif gen IL-17 menurun dan gen IL-10 meningkat pada kelompok SPM dibandingkan PBS. Pewarnaan Hematoksilin dan Eosin memperlihatkan rerata tebal epidermis dan jumlah kapiler mengalami penurunan pada kelompok SPM dibanding PBS. Rerata jumlah infiltrasi sel CD11b+ kelompok SPM menurun secara bermakna dibandingkan PBS. Penyuntikan SPM terutama intradermal mampu menyebabkan remisi pada lesi lokal kulit psoriasis pada model tikus Wistar.

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Psoriasis is a chronic inflammatory disease affecting mainly the skin and other parts such as nails and joints. Human umbilical cord-derived mesenchymal stem cells (hUC-MSCs) are highly proliferative immunomodulator cells with low immunogenicity. The Psoriasis rat model was induced with 5% imiquimod cream for 6 days. The rats were divided into 5 groups receiving intradermal or subcutaneous injections of hUC-MSCs or Phosphate Buffer Saline (PBS), and a normal control group. MSCs and PBS were administered before cream application. Daily skin assessments were performed using a modified Psoriasis Area and Severity Index (mPASI) scoring system. After harvest, rat skin was analyzed for relative expression of Interleukin (IL)-17 and IL-10 genes. Some skin samples were fixed with formalin for histological examination and immunohistochemistry with Anti-CD11b antibodies. Statistical analysis showed a significant reduction in mPASI scores in the hUC-MSCs group compared to the PBS group. Histology staining revealed a decrease in epidermal thickness and capillary in the hUC-MSCs group. The infiltration of CD11b+ cells significantly decreased in the hUC-MSCs group.  The relative gen expression of IL-17 decreased, while IL-10 gene increased in the hUC-MSCs group. Particularly, intradermal injection of hUC-MSCs induced remission of local psoriasis skin lesions in the rat model."

"Imunisasi merupakan upaya untuk menurunkan angka kesakitan, kematian, dan kecacatan akibat Penyakit yang Dapat Dicegah dengan Imunisasi. Cakupan imunisasi dasar lengkap Indonesia mengalami penurunan tahun 2017 yaitu dari 91,58% menjadi 91,12%. Orang tua berperan dalam menentukan perawatan kesehatan anak termasuk mengenai imunisasi. Salah satu faktor yang dapat mempengaruhi imunisasi anak yaitu sikap dan pengetahuan orang tua. Penelitian ini bertujuan untuk mengidentifikasi hubungan pengetahuan dan sikap orangtua dengan kelengkapan imunisasi dasar anak. Penelitian ini menggunakan desain cross-sectional dengan teknik pengambilan sampel consecutive sampling. Jumlah sampel sebanyak 106 orangtua dari anak usia 1-5 tahun di kelurahan Tanjung Barat Jakarta Selatan. Hasil analisis bivariat menggunakan uji chi square menunjukan bahwa terdapat hubungan antara pengetahuan (p value 0,001) dan sikap (p value 0,004) orangtua dengan kelengkapan imunisasi dasar anak. Penelitian ini merekomendasikan untuk melakukan upaya peningkatan pengetahuan mengenai imunisasi dan mendorong sikap positif terhadap imunisasi untuk dapat meningkatkan cakupan imunisasi dasar anak.

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Immunization is an effort to reduce morbidity, mortality and disability due to Immunization-Preventable Diseases. Indonesia's complete basic immunization coverage experienced a decline in 2017, from 91.58% to 91.12%. Parents have a role in determining child health care, including immunization. One of the factors that can influence children's immunization is the attitudes and knowledge of parents. This study aimed to identify the relationship between knowledge and attitudes of parents with the completeness of basic childhood immunizations. This study used a cross-sectional design with consecutive sampling type. The number of samples are 106 parents of children aged 1-5 years in the Tanjung Barat village of South Jakarta. The results of bivariate analysis using the chi square test showed that there is a relationship between parental knowledge (p value 0.001) and attitudes (p value 0.004) toward completeness of basic immunization of children This study recommends making efforts to increase knowledge about immunization and encourage positive attitudes towards immunization to be able to increase the coverage of basic immunization of children.

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"Vaksinasi HPV memiliki efektivitas paling tinggi bila diberikan pada anak usia 9-12 tahun. Sejak tahun 2016 Indonesia menjadi satu dari sekian banyak negara yang memberlakukan program vaksinasi HPV berbasis sekolah (BIAS), dimana saat ini program ini masih terbatas di DKI Jakarta.Penelitian terdahulu menunjukkan bahwa vaksinasi HPV berbasis sekolah memiliki angka cakupan paling tinggi. Namun, menurut data di Jakarta, vaksinasi HPV masih belum mencapai target cakupan 95%. Guru pembina UKS sebagai garda terdepan pelaksanaan vaksinasi HPV di sekolah berperan sanga penting dalam proses pengambilan keputusan orang tua untuk mengijinkan atau menolak pemberian vaksinasi bagi anak mereka. Guru adalah fasilitator yang akan berperan memfasilitasi orang tua dan petugas kesehatan dalam pelaksanaan vaksinasi HPV di sekolah. Penelitian ini bertujuan untuk mengetahui Gambaran Kesiapan Guru Pembina UKS SD Sebagai Fasilitator Vaksinasi HPV Dalam Program Bulan Imunisasi Anak Sekolah (BIAS)  Di Jakarta Selatan menurut karakteristik jenis kelamin,umur, tingkat pendidikan, lama menjabat sebagai guru Pembina UKS dan riwayat pelatihan. Pengukuran kesiapan dilihat dalam enam dimensi yaitu peran, sikap, pengetahuan, kapasitas, kapabilitas dan tanggung jawab. Penelitian dilakukan pada 50 Guru pembina UKS SD di 10 Kecamatan Jakarta Selatan. Penelitian ini merupakan penelitian deskriptif dengan metode cross sectional dan menggunakan pendekatan kuantitatif. Hasil Penelitian menunjukkan 52% Guru Pembina UKS di Jakarta Selatan memiliki kesiapan rendah dan 48% memiliki kesiapan tinggi dalam menjalankan tugas sebagai fasilitator vaksinasi HPV BIAS.  Dimensi pengetahuan merupakan dimensi kesiapan yang paling rendah, dengan 70% Guru pembina UKS memiliki pengetahuan kurang tentang vaksinasi HPV dan kanker serviks. Karakteristik Individu memiliki hubungan signifikan dengan kesiapan : umur (p= 0.036), lama menjabat (p=0.012) dan riwayat diklat ( p= 0.010). Sedangkan jenis kelamin (p=0.661) dan tingkat pendidikan (p=0.502) tidak ditemukan hubungan signifikan terhadap kesiapan dalam penelitian ini. Berdasarkan hasil penelitian ini, maka pelatihan tentang vaksinasi HPV dalam BIAS bagi Guru pembina UKS merupakan hal yang paling penting untuk dilaksanakan dalam rangka mendukung kesiapan Guru Pembina UKS sebagai fasiliatator vaksinasi HPV BIAS di Jakarta Selatan.

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HPV vaccination has the highest effectiveness when given to children aged 9-12 years. Since 2016 Indonesia has become one of few countries that has implemented a school-based HPV vaccination program (BIAS), which is currently limited to DKI Jakarta. Previous research has shown that school-based HPV vaccination has the highest coverage rates. However, according to data in Jakarta, HPV vaccination has not yet reached the 95% coverage target. UKS teachers as the frontline in implementing HPV vaccination in schools play an important role in the decision-making process of parents to allow or refuse vaccinations for their children. School Health Teacher is the facilitator who will play a role in facilitating parents and health workers in carrying out HPV vaccinations in schools.

This study aims to determine the Readiness Overview of Elementary School Health Teacher (UKS) as Facilitators of HPV Vaccination in the School Children Immunization Month Program (BIAS) in South Jakarta according to the characteristics of gender, age, level of education, length of time serving as a UKS Teacher and training history. Measurement of readiness is seen in six dimensions, namely roles, attitudes, knowledge, capacity, capabilities and responsibilities. The study was conducted on 50 UKS elementary school teachers in 10 sub-districts of South Jakarta. This research is a descriptive study with cross sectional method and uses a quantitative approach.

The results showed that 52% of UKS teachers in South Jakarta had low readiness and 48% had high readiness in carrying out their duties as facilitators of BIV HPV vaccination. The knowledge dimension is the lowest readiness dimension, with 70% of UKS teachers having less knowledge about HPV vaccination and cervical cancer. Individual characteristics have a significant relationship with readiness: age (p = 0.036), length of service (p = 0.012) and training history (p = 0.010). While gender (p = 0.661) and education level (p = 0.502) no significant relationship was found in readiness in this study. Based on the results of this study, the training on HPV vaccination in BIAS for UKS Teachers is the most important thing to do in order to support the readiness of the UKS Guidance Teacher as a facilitator for BIV HPV vaccination in South Jakarta."

"Indikator yang diukur untuk menilai kinerja pelaksanaan imunisasi di Indonesia berdasarkan Renstra Kemenkes RI adalah pencapaian imunisasi dasar lengkap (IDL) sedangkan indikator programnya adalah pencapaian universal child immunization (UCI). Pencapaian indikator IDL Kabupaten Kapuas pada tahun 2017 sebesar 62% di mana selisih ada selisih 26,4% dari target Renstra Kemenkes RI 2015-2019 sebesar 95%. Pencapaian indikator UCI desa/kelurahan Kabupaten Kapuas Tahun 2017 sebesar 32,2% dan ada selisih 62,8% dari target UCI berdasarkan RPJMN sebesar 95%.Tesis ini bertujuan untuk membahas kinerja implementasi kebijakan terkait pencapaian indikator imunisasi dasar lengkap (IDL) dan Universal Child Immunization (UCI) tahun 2018 di Kabupaten Kapuas.Penelitian ini adalah penelitian kualitatif dengan desain studi kasus yang dilaksanakan di 6 puskesmas yang berada di kabupaten Kapuas. Jumlah informan dalam penelitian ini ada 34 informan. Pengumpulan data primer dilakukan dengan wawancara mendalam dan observasi melalui telaah dokumen dan kemudian dilakukan analisis data kualitatif.Hasil penelitian ini menunjukkan bahwa yang sudah berjalan dengan optimal adalah karakteristik badan pelaksana dan standar dan tujuan kebijakan, sedangkan yang belum berjalan dengan optimal adalah kinerja implementasi kebijakan, komunikasi antar organisasi dan kegiatan pelaksana, sumber daya (SDM, anggaran, insentif, sarana dan prasarana), dukungan lingkungan sosial, ekonomi, dan politik. Sehingga dapat disimpulkan kinerja implementasi kebijakan terkait pencapaian indikator imunisasi dasar lengkap (IDL) dan Universal Child Immunization (UCI) di Kabupaten Kapuas tahun 2018 kurang optimal sehingga diperlukan upaya perbaikan untuk meningkatkan pencapaian IDL dan UCI di tahun berikutnya.

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Indicator that used to measure the performance of immunization in Indonesia based on the Strategic Planning of Health Minister of Republic Indonesia is Complete Basic Immunization (CBI) achievement and indicator that used to measure the immunization program is Universal Child Immunization (UCI) achievement. The indicator achievement of CBI of Kapuas Regency in 2017 was 62.0%. It had difference of 31% from the target of Strategic Planning of Health Minister of Republic Indonesia in 2015-2019 of 93%. The indicator achievement of UCI of Kapuas Regency in 2017 was 32.2% and it had difference of 62.8% from the target based on the Strategic Planning of 95%.

This manuscript aims to discuss the performance of policy implementation regarding indicator achievement of Complete Basic Immunization (CBI) and Universal Child Immunization (UCI) in 2018 at Kapuas Regency.

This research is a qualitative research with case study design at 6 Puskesmas in Kapuas Regency. Total informants in this research are 34 informants. The primary data collection is done by deep interview and observation through documents review and then analyze of qualitative data.

The result of this study indicate that have not run optimally are standard and policy objectives and characteristics of the implementing agency, while those that have not run optimally are performance of policy implementation, inter-organization communication and implementing activities, resources (human resources, budgets, incentives, facilities and infrastructures), support of social, economic, and politic environment. So, the conclusion is the performance of policy implementation regarding to indicators achievement of Complete Basic immunization (CBI) and Universal Child Immunization (UCI) at Kapuas Regency in 2018 have not run optimally so improvement efforts are needed through to improve the achievement of CBI and UCI of Kapuas Regency in next year."

"Imunisasi dasar merupakan hal yang penting bagi anak karena imunisasi merupakan salah satu cara mencegah infeksi penyakit tertentu yang termasuk ke dalam Penyakit yang Dapat Dicegah Dengan Imunisasi (PD3I). Persentase kelengkapan imunisasi di Indonesia sudah mencapai 85,2%, namun hal ini tidak sesuai dengan keadaan di Provinsi Papua. Persentase kelengkapan imunisasi di Provinsi Papua hanya mencapai 45,7%. Rendahnya persentase kelengkapan imunisasi ini dapat dipengaruhi berbagai faktor. Penelitian ini bertujuan untuk mengetahui hubungan tingkat pengetahuan ibu tentang imunisasi dan akesibilitas ke pelayanan kesehatan terdekat dengan kelengkapan imunisasi batita di Pegunungan Jayawijaya, Provinsi Papua. Penelitian yang dilakukan merupakan penelitian analitik observasional dengan pendekatan studi cross sectional. Data diperoleh melalui hasil wawancara terhadap 168 responden dengan menggunakan kuesioner. Responden didapatkan melalui teknik consecutive sampling. Dari 168 responden, 99 subjek memperoleh imunisasi lengkap dan 69 subjek tidak memperoleh imunisasi lengkap. Berdasarkan hasil analisis dengan Chi-square, tingkat pengetahuan ibu tentang imunisasi berhubungan dengan kelengkapan imunisasi batita (p=0,043). Hubungan aksesibilitas ke pelayanan kesehatan terdekat tidak memenuhi kriteria uji Chi-square sehingga digunakan uji alternatif, yaitu uji Fisher. Berdasarkan uji Fisher, tidak terdapat hubungan bermakna antara aksesibilitas ke pelayanan kesehatan terdekat dan kelengkapan imunisasi batita (p=0,307). Oleh karena itu, perlu dilakukan progam untuk meningkatkan tingkat pengetahuan ibu. Dengan begitu, kelengkapan imunisasi batita diharapkan akan meningkat.

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Immunization is an important thing for toddler because it can protect toddler from getting infected by certain infectious disease which can be prevented by immunization. 85,2% toddler in Indonesia get complete immunization, but this fact is contradictive with the condition happened in Papua Province. There are only 45,7% toddler get complete immunization. This low percentage could be affected by various factors. This study aims to determine whether there are correlation between 2 factors (status of mother?s knowledge about immunization and accessibility to nearest health care) and toddler?s immunization status in central mountain Jayawijaya, Papua Province. This study is an analitycal study in the form of cross sectional study. Data was collected by interviews with 168 respondents who are chosen by consecutive sampling. From 168 respondents, 99 respondents have complete immunization and 69 respondents don?t have complete immunization. The result is performed by Chi-square test and Fisher test. Based on Chi-square test, there is correlation between status of mother?s knowledge about immunization and toddler?s immunization status in central mountain Jayawijaya, Papua Province (p=0,043). The other hand, there is no correlation between accessibility to nearest health care and toddler?s immunization status in central mountain Jayawijaya, Papua Province (p=0,307) based on Fisher test. In consequence, there should be a program to improve mother?s status of knowledge in order to increase the percentage of toddlers completely immunized"

"Masalah utama penelitian adalah belum diketahui bagaimana pengelolaan program imunisasi TT ibu hamil di Puskesmas Kabupaten OKU Sumatera Selatan dalam upaya pencapaian cakupan. Penelitian dilakukan terhadap pengelolaan program imunisasi di Puskesmas Kabupaten OKU Sumatera Selatan dalam upaya pencapaian cakupan imunisasi TT pada ibu hamil. Ruang lingkup penelitian adalah pengelolaan program imunisasi TT ibu hamil di Puskesmas yang meliputi Perencanaan, Pelaksanaan, Koordinasi, Pencatatan dan Pelaporan, Pemantauan serta Evaluasi. Penelitian bersifat kualitatif dengan melakukan studi kasus di 4 Puskesmas untuk menjaga validitas data maka digunakan Metode Triangulasi yaitu Triangulasi Sumber dan Triangulasi Metode.Hasil penelitian menyatakan bahwa perencanaan kebutuhan vaksin TT ibu hamil di Puskesmas Kabupaten OKU Sumatera Selatan dilakukan oleh pihak Puskesmas. Perencanaan kebutuhan vaksin TT ibu hamil di Puskesmas berdasarkan jumlah sasaran dan target cakupan masing masing Puskesmas. Jadi seharusnya perencanaan kebutuhan vaksin TT ibu hamil dilakukan masing-masing Puskesmas sebagai unit pelayanan imunisasi sehingga kebutuhan vaksin sesuai dengan jumlah sasaran dan target cakupan dari masing masing Puskesmas.Kebutuhan cold chain di Puskesmas Kabupaten OKU Sumatera Selatan cukup memadai baik sarana penyimpan vaksin maupun pengangkut vaksin. Adanya Puskesmas di Kabupaten OKU Sumatera Selatan dengan frekuwensi dan pengeluaran vaksin TT ibu hamil lebih dari I kali sehari, sehingga memungkinkan menurunnya potensi vaksin yang lain.Pemantauan program imunisasi TT ibu hamil di Puskesmas Kabupaten OKU Sumatera Selatan hanya dilakukan melalui PWS atau Pemanatau Wilayah Setempat tanpa adanya supervisi atau pembinaan dari pihak Kabupaten. Evaluasi program imunisasi TT ibu hamil di Puskesmas juga dilakukan hanya melalui data primer sehingga evaluasi dilakukan terhadap tingkat cakupan tanpa analisa Puskesmas dengan cakupan rendah. Adanya droup out imunisasi TT ibu hamil, artinya terdapat ibu hamil dengan imunisasi TT yang tidak lengkap sehingga tidak bermakna dalam pencegahan Tetanus Neonatorum. Imunisasi TT ibu hamil diberikan sebanyak 2 kali selama kehamilan dengan selang waktu minimal 4 minggu.Angka rata-rata pencapaian cakupan imunisasi TT ibu hamil di Puskesmas Kabupaten OKU Sumatera Selatan dalam kategori rendah sehingga tidak bermakna dalam pencegahan Tetanus Neonatorum. Puskesmas harus meningkatkan pengelolaan program imunisasi TT ibu hamil guna pencapaian cakupan yang tinggi. Pengetolaan program imunisasi TT ibu hamil di Puskesmas meliputi Perencanaan, Pelaksanaan,-Koordinasi, Pencatatan dan Pelaporan, Pemantauan Berta Evaluasi.

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Managerail Role of the TT for Pregnancy Immunization Programs in the Public Health Care Centre of OKU Regency South Sumatera ProvinceThe main problem of the research is unknown how to manage the immunization program in the public health care centre of OKU regency South Sumatera Province in achieving the scope of the IT immunization for pregnancy_ The scope of the research is how to manage the immunization grogram in the public health care centre in achieving the scope of the IT immunizationfor pregnancy that are consisting of planning, implementating, coordinating, recording, reporting, observing and evaluating. The qualitataive research is done by taking case study in four public health care centres_ To maintainihe validity-of the-data; we-have-to-take-the-triangulationrnethods, they are the resource and the method triangulations.

The result of the research told that the planning of the TT vaccination necessities for pregnancy in the public health care centre of OKU regency South Sumatera Province are done by regency official. The planning of the IT vaccination necessities in the public health care centre is based on the number of the object and the target of each public health care centre scope.

The planning of the vaccination necessities for pregnancy in care public health care centre is done by each public health care centre as an immunization service unit, so the vaccination necessities are in accorded with the number of the object and the target from each public health care centre. The necessities of the cold chain in the public health care centre of OKU regency South Surnatera Province are provided enough as a vaccination keeper or carrier.

The existence of the public health care centre in of OKU regency South Sumatera Province with the frequency and the using of the TT vaccination for pregnancy is more than once a day, so it may reduce the potencies of the other vaccinatins. The observation of the TT vaccination programs for pregnancy in the public health care centre of OKU regency South Sumatera Province is done through local area observation only without using supervision or guding from the regency side.

The evaluation of the TT immunization for pregnancy in the public health care centre is also carried out through primary data only, so evaluation is done on the scope level without analizing, especially the public health care centre with low scope.

The dropping out of the TT immunization for pregnancy shows that there are some pregnant women with uncompleted TT immunization, so it won't give anything in preventing Tetanus Neonatorum. The TT immunization for pregnancy is given twice during pregnancy given after four weeks months since the in each giving. The mean of the scope achievement of the immunization for pregnancy in the public health care centre of OKU regency South Sumatera Province is in the low category, so it won't give anything in preventing Tetanus Neonatorum_ The public health care centre should improve the management of the TT immunization programs--for pregnancy in the public health care centre are consisting of planning, implementating, coordinating, recording, reporting, observing and evaluating."