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"ABSTRAK Latar belakang: Diare masih merupakan masalah kesehatan masyarakat dinegara berkembang karena morbiditas dan mortalitasnya yang masih tinggi. Diaredapat disebabkan oleh virus, bakteri dan parasit yang penting diketahui untukmemberikan tatalaksana yang tepat, namun saat ini belum ada data mengenaibakteri penyebab diare di Indonesia. Tujuan: Mengetahui gambaran klinis anak dengan diare akut dan mengetahui jenis bakteri enteropatogen penyebab diare akut dengan menggunakan real-timePCR di Rumah Sakit Cipto Mangunkusumo. Metode: Penelitian potong lintang pada anak dengan diare akut berusia 1-15tahun di Rumah Sakit Cipto Mangunkusumo. Hasil: Subyek penelitian ini terdiri dari 60 subyek dengan diare akut. Sebagian besar berusia 1-3 tahun, status gizi baik, berasal dari ibu dengan pendidikansedang dengan status ekonomi keluarga menengah rendah, sebagian besar belummendapat antibiotik sebelum ke rumah sakit tetapi sudah mendapat cairanrehidrasi oral. Gambaran klinis diare akut akibat infeksi bakteri yaitu frekuensidiare ≤5X/hari (p=0,018), tanpa leukositosis feses (p=0,015) dan malabsorpsilemak (p=0,031). Sebaran infeksi bakteri patogen penyebab diare akutberdasarkan real-time PCR sebagai berikut: Campylobacter jejuni 7 subyek,Escherichia coli patogen 17 subyek yang terdiri dari EPEC 9 subyek, EIEC 5subyek dan ETEC 3 subyek. Infeksi bakteri campuran pada subyek sebagaiberikut: EPEC+EIEC 2 subyek , C.jejuni+EPEC 1 subyek, C.jejuni+EPEC+EIEC1 subyek dan C.jejuni+EPEC+ETEC 1 subyek. Simpulan: Sebagian besar diare terjadi pada usia 1-3 tahun dengan status pasiengizi baik dengan status keluarga menengah rendah. Sekitar 48% anak dengandiare akut didapatkan bakteri dari hasil real-time PCR feses dengan proporsiterbanyak yaitu EPEC, diikuti Campylobacter jejuni, EIEC dan ETEC.ABSTRACT Background: Diarrhea is still a public health problem in developing countriesdue to it?s morbidity and mortality. Diarrhea can be caused by viruses, bacteriaand parasites. It is important to know the etiology to provide proper management,but there is currently no data on the bacteria that causes diarrhea in Indonesia. Objective: To characterize the clinical manifestations of children with acutediarrhea and determine the type of enteropathogens bacteria causing acutediarrhea using real-time PCR in Cipto Mangunkusumo Hospital. Methods: This was a cross-sectional study, done in June-November 2015. Stoolspecimens were collected from patients aged 1-15 years with acute diarrhea andtested for bacterial enteropathogens using real-time PCR.Results: Of the 60 children enrolled, mostly aged 1-3 years, good nutritionalstatus, from low income families and secondary education mothers, most have notreceived antibiotics prior to hospital admission but had received oral rehydrationfluids. The clinical features of acute diarrhea caused by bacterial infection isdiarrhea frequency ≤5X / day without fecal leukocytosis and fat malabsorption.From 60 subjects, 29 (48,3%) children excreted bacteria in their feces prooved byreal-time PCR. Distribution of pathogenic bacterial infection causes acute diarrheaby real-time PCR as follows: Campylobacter jejuni 7 subjects, pathogenicEscherichia coli 17 subjects which consists of EPEC 9 subjects, EIEC 5 subjectsand ETEC 3 subjects. Multiple infections in subjects as follows: EPEC+EIEC 2subjects, EPEC+C.jejuni 1 subject, C.jejuni+EPEC+EIEC 1 subject andC.jejuni+EPEC+ETEC 1 subject. Conclusions: Most diarrhea occurs at the age of 1-3 years with good nutritional status of patients with low-medium family status. Approximately 48% of children with acute diarrhea excreted bacteria in their feces prooved by real-time PCRstool with the highest proportion is EPEC, followed by Campylobacter jejuni,EIEC and ETEC.;Background: Diarrhea is still a public health problem in developing countriesdue to it?s morbidity and mortality. Diarrhea can be caused by viruses, bacteriaand parasites. It is important to know the etiology to provide proper management,but there is currently no data on the bacteria that causes diarrhea in Indonesia. Objective: To characterize the clinical manifestations of children with acutediarrhea and determine the type of enteropathogens bacteria causing acutediarrhea using real-time PCR in Cipto Mangunkusumo Hospital. Methods: This was a cross-sectional study, done in June-November 2015. Stoolspecimens were collected from patients aged 1-15 years with acute diarrhea andtested for bacterial enteropathogens using real-time PCR.Results: Of the 60 children enrolled, mostly aged 1-3 years, good nutritionalstatus, from low income families and secondary education mothers, most have notreceived antibiotics prior to hospital admission but had received oral rehydrationfluids. The clinical features of acute diarrhea caused by bacterial infection isdiarrhea frequency ≤5X / day without fecal leukocytosis and fat malabsorption.From 60 subjects, 29 (48,3%) children excreted bacteria in their feces prooved byreal-time PCR. Distribution of pathogenic bacterial infection causes acute diarrheaby real-time PCR as follows: Campylobacter jejuni 7 subjects, pathogenicEscherichia coli 17 subjects which consists of EPEC 9 subjects, EIEC 5 subjectsand ETEC 3 subjects. Multiple infections in subjects as follows: EPEC+EIEC 2subjects, EPEC+C.jejuni 1 subject, C.jejuni+EPEC+EIEC 1 subject andC.jejuni+EPEC+ETEC 1 subject. Conclusions: Most diarrhea occurs at the age of 1-3 years with good nutritional status of patients with low-medium family status. Approximately 48% of children with acute diarrhea excreted bacteria in their feces prooved by real-time PCRstool with the highest proportion is EPEC, followed by Campylobacter jejuni,EIEC and ETEC.;Background: Diarrhea is still a public health problem in developing countriesdue to it?s morbidity and mortality. Diarrhea can be caused by viruses, bacteriaand parasites. It is important to know the etiology to provide proper management,but there is currently no data on the bacteria that causes diarrhea in Indonesia. Objective: To characterize the clinical manifestations of children with acutediarrhea and determine the type of enteropathogens bacteria causing acutediarrhea using real-time PCR in Cipto Mangunkusumo Hospital. Methods: This was a cross-sectional study, done in June-November 2015. Stoolspecimens were collected from patients aged 1-15 years with acute diarrhea andtested for bacterial enteropathogens using real-time PCR.Results: Of the 60 children enrolled, mostly aged 1-3 years, good nutritionalstatus, from low income families and secondary education mothers, most have notreceived antibiotics prior to hospital admission but had received oral rehydrationfluids. The clinical features of acute diarrhea caused by bacterial infection isdiarrhea frequency ≤5X / day without fecal leukocytosis and fat malabsorption.From 60 subjects, 29 (48,3%) children excreted bacteria in their feces prooved byreal-time PCR. Distribution of pathogenic bacterial infection causes acute diarrheaby real-time PCR as follows: Campylobacter jejuni 7 subjects, pathogenicEscherichia coli 17 subjects which consists of EPEC 9 subjects, EIEC 5 subjectsand ETEC 3 subjects. Multiple infections in subjects as follows: EPEC+EIEC 2subjects, EPEC+C.jejuni 1 subject, C.jejuni+EPEC+EIEC 1 subject andC.jejuni+EPEC+ETEC 1 subject. Conclusions: Most diarrhea occurs at the age of 1-3 years with good nutritional status of patients with low-medium family status. Approximately 48% of children with acute diarrhea excreted bacteria in their feces prooved by real-time PCRstool with the highest proportion is EPEC, followed by Campylobacter jejuni,EIEC and ETEC."

"Diare merupakan penyebab utama kematian balita usia di bawah 5 tahun di Indonesia. Mikroorganisrne penyebab utama sebagian besar penderita diare akut adalah rotavirus. Diare akut dapat menyebabkan kematian dikarenakan keparahan gejala klinis yang dialami penderita seperti dehidrasi, muntah dan demam. Penelitian ini bertujuan untuk memprediksi gejala klinis terhadap penyebab diare akut rotavirus di Kota Mataram tahun 2009. Metode penelitian yang digunakan adalah kuantitatif dengan disain studi cross sectional. Hasil penelitian menunjukan faktor gejala klinis yang paling dominan dalam memprediksi penyebab diare akut rotavirus adalah dehidrasi, muntah dan demam. Umur merupakan faktor resiko yang rnempengaruhi kejadian diare akut rotavirus. Uji diagnostik gejala klinis diare akut rotavirus terhadap gold standar PCR rotavirus menunjukan bahwa pada balita yang mengalami diare dengan penyebab rotavirus dan berumur 1-5 bulan 81 % dapat diprediksi melalui gejala klinis demam (sensitivitas 81%). Sedangkan untuk balita yang mengalami diare akut dengan penyebab rotavirus dan berumur 6 -11 bulan 83% (sensitivitas 83%) dapat diprediksi melalui gejala klinis muntah. Sedangkan kombinasi gejala klinis balita yang mengalami diare akut dengan penyebab rotavirus dan berumur 6 - 11 bulan 79 % (sensitivitas 79%) dapat dideteksi melalui kombinasi gejala klinis dehidrasi dan muntah. Kesimpulan: gejala klinis dehidrasi, muntah dan demam dapat memprediksi diare akut rotavirus.

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Diarrhea is a major cause of death of children under 5 years in Indonesia. The main microorganisms that cause acute diarrhea is rotavirus. The death of patients with acute diarrhea is due to the severity of clinical symptoms such as dehydration, vomiting and fever. This aim of this studyis to predict the clinical symptoms related with acute diarrhea which rotavirus as a single causative agent. Population of this study were acute diarrheal patients from Mataram in 2009. The research method used was quantitative with a cross sectional study design.

The results showed that clinical factors which can be used to predict that rotavirus as a causative agent are dehydration, vomiting and fever. Age is a risk factor affecting the incidence of acute rotavirus diarrhea. Diagnostic test of clinical symptoms and the gold standard PCR showed that 81% cases of rotavirus diarrhea on infant aged 1-5 months can be predicted by clinical symptoms of fever. As for the toddler who suffered from acute diarrhea by rotavirus (age 6 -11 months), 83% cases can be predicted by clinical symptoms of vomiting. Moreover, the combination of clinical symptoms (dehydration and vomiting) could detect 79% infants (6-11 months) who had acute rotavirus diarrhea.

Conclusion: The clinical symptoms of dehydration, vomiting and fever can be used to predict acute rotavirus diarrhea."

"Latar belakang: Diare akut masih merupakan masalah kesehatan yang penting dengan angka morbiditas dan mortalitas yang cukup tinggi. Virus merupakan penyebab tersering diare akut pada anak. Diare akut akibat virus akan menyembuh sendiri dan tidak membutuhkan terapi antibiotik. Namun, data dari Kemenkes Indonesia menyebutkan bahwa 85 pasien dengan diare di Jakarta diobati dengan antibiotik. Sampai saat ini, penelitian prevalens dan manifestasi klinis tentang diare akut akibat virus selain rotavirus masih jarang dilakukan. Penelitian tentang prevalens dan gambaran klinis diare akibat virus rotavirus, adenovirus, norovirus dan astrovirus belum pernah dilakukan di Indonesia.Tujuan: Mengetahui proporsi dan manifestasi klinis diare akut yang disebabkan oleh rotavirus, norovirus, adenovirus, dan astrovirus pada anak.Metode: Studi potong lintang dilakukan di RSCM dan RSUD Budhi Asih Jakarta, sejak Februari hingga September 2017. Penelitian melibatkan 100 orang anak berusia 6-36 bulan yang datang dengan keluhan diare akut. Spesimen tinja diperiksa menggunakan rapid test CerTest untuk mendeteksi adanya rotavirus, adenovirus, norovirus dan astrovirus, kemudian dilakukan pemeriksaan analisis tinja untuk menilai terjadinya intoleransi laktosa.Hasil: Diare akut akibat virus didapatkan pada 36 dari 100 anak, terdiri dari rotavirus 74,3 sebagai penyebab tersering, diikuti adenovirus 17,9 , norovirus 5,1 dan astrovirus 2,6 . Tiga spesimen ditemukan terdapat koinfeksi 2 virus. Diare akut akibat virus lebih sering terjadi pada anak berusia kurang dari 24 bulan 73,2 , dan 55,6 diantaranya mengalami gizi kurang. Laki-laki lebih banyak terinfeksi sebesar 1,5 kali dibandingkan perempuan. Muntah merupakan gejala yang bermakna secara statistik terkait diare akut akibat virus ini 66,7 ; p=0,045 . Manifestasi klinis lainnya yaitu diare lebih dari 10 kali per hari 58,3 , dehidrasi 68,8 , batuk 66,7 , pilek 77,8 , demam 88,6 , dan warna tinja kuning hijau 44,4 . Analisis tinja menunjukkan tidak terdapat hubungan yang bermakna secara statistik antara diare akut akibat virus dengan terjadinya intoleransi laktosa pH.

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Background Acute diarrhea remains a major cause of morbidity and mortality in Indonesia and worldwide. Virus is the most common cause of acute diarrhea in children. Viral acute diarrhea is usually self limited, and does not require antibiotic therapy. However, data from Ministry of Health Indonesia reported that 85 of patients with diarrhea in Jakarta are treated with antibiotics. Data on the prevalence and clinical manifestations of viral acute diarrhea other than rotavirus are still limited. Research on prevalence and clinical features of viral diarrhea rotavirus, adenovirus, norovirus and astrovirus has not been done in Indonesia.

Objective To know the prevalence of acute diarrhea caused by virus in children and its clinical manifestations.

Methods A cross sectional study was conducted at Cipto Mangunkusumo Hospital and Budhi Asih Hospital from February to September 2017. A total of 100 stool specimens were collected from patients aged 6 36 months with acute diarrhea and tested for rotavirus, adenovirus, norovirus and astrovirus by rapid test and then performed for stool analysis.

Results Of the 100 specimens, 36 36 were found to be positive for virus causing diarrhea. Rotavirus 74.3 was the most frequently detected, followed by adenovirus 17.9 , norovirus 5.1 and astrovirus 2.6 . Three specimens were found positive by two viruses. Viral diarrhea was seen in 73.2 of children aged under 24 months, of whom 55.6 of them were undernourished. Males were affected 1.5 times as much as females. Vomiting was significantly associated with viral acute diarhhea 66.7 p 0.045 . Other clinical manifestations were passage of diarrheic stools more than 10 times a day 58.3 , dehydration 68.8 , cough 66.7 , rhinorhea 77.8 , fever 80.6 , and yellow greenish stools 44.4 . Stool analysis revealed that there was no statistically significant association between viral diarrhea and lactose intolerance pH"

"Penanganan diare akut primer pada anak yang tidak tepat merupakan penyebab banyaknya kasus kematian pada anak terutama usia kurang dari 5 tahun. Penelitian ini bertujuan untuk mengetahui kerasionalan penggunaan obat di Perawatan Ilmu Kesehatan Anak WAT IKA RSPAD Gatot Soebroto sehingga dapat meminimalisir penggunaan obat yang tidak rasional. Desain studi menggunakan studi cross-sectional, hasil penelitian dijelaskan secara deskriptif. Pengambilan data dilakukan secara retrospektif menggunakan data rekam medis pasien. Sampel dalam penelitian ini adalah seluruh data pasien anak usia 0 ndash;18 tahun yang menderita diare akut primer. Penelitian dilakukan terhadap 81 data rekam medis yang memenuhi kriteria inklusi. Analisis dilakukan secara kuantitatif dan kualitatif. Analisis kuantitatif dinyakatan dalam satuan DDD dan DDD/100 beds/hari dan analisis kualitatif dinyatakan dalam segmen DU90. Berdasarkan hasil analisis, prevalensi pasien yang menderita diare terbanyak pada pasien laki- laki, dengan rentang umur >1 bulan ndash;2 tahun. Kuantitas obat diare berdasarkan nilai DDD dan DDD/100 beds/hari didapatkan nilai DDD terbesar adalah Zink 24,54 dan nilai DDD/100 beds/hari terbesar adalah Seftazidim 41,67 . Kualitas penggunaan obat diare pada pasien anak di Perawatan Ilmu Kesehatan Anak WAT IKA RSPAD Gatot Soebroto perlu lebih dikaji kembali. Penggunaan obat diarenya sudah 100 sesuai dengan Formularium Nasional.

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Improper treatment of acute primary diarrhea in children is the cause of many death cases in children especially under the age of 5 years. This research aimed to know the rationality of diarrhea drug utilization in Pediatric Healthcare Science WAT IKA RSPAD Gatot Soebroto so it could minimize irrational drugs utilization. The study design used a cross sectional study, the results of the study were described descriptively. Data was collected retrospectively from patient medical record data. The samples in this study were all data of pediatric patients ages 0 18 years with acute primary diarrhea. The study was conducted on 81 medical records that met the inclusion criteria. Analyses were performed quantitatively dan qualitatively. Quantitative analysis is expressed in units of DDD and DDD 100 beds day. Qualitative analysis is expressed in the DU90 segment. Based on the analysis, the most prevalence of diarrhea in male, with an age range 1 month 2 years. The largest DDD value was Zink 24.54 and the largest DDD 100beds day value was Ceftazidime 41,67. The quality of antidiarrheal drugs use in pediatric patients need more improvement. The use of antidiarrheal drugs in in Inpatient of Pediatric Healthcare Science WAT IKA RSPAD Gatot Soebroto is compliance with the national formulary 100."

"ABSTRAKDiare telah menjadi salah satu penyebab meningkatnya kesakitan dan kematian pada anak. Diare biasanya disebabkan oleh infeksi. Sindrom Malabsorpsi dan beberapa enteropatogen bisa menyebabkan diare. Studi ini dilaksanakan untuk mencari prevalensi malabsorpsi laktosa dan malnutrisi pada pasien anak dengan diare dan mencari asosiasi malabsorpsi laktosa dan malnutrisi. Studi ini menggunakan studi potong lintang dengan menggunakan data sekunder. Jenis studi ini dipilih untuk mengetahui asosiasi malabsorpsi laktosa dan malnutrisi. Data yang dibutuhkan akan diperoleh dari profil analisis tinja dan rekam medis pasien anak yang dirawat di RSCM. Penelitian ini menemukan prevalensi malabsorpsi laktosa di pasien anak dengan diare sebanyak 18,2 . Prevalensi malnutrisi di pasien anak dengan diare sebanyak 38 . Hasil penelitian menunjukan bahwa tidak terdapat asosiasi malabsorpsi laktosa dengan status nutrisi p>0.05 . Perlu dilakukan penelitian lebih lanjut mengenai asosiasi malabsorpsi laktosa dan malnutrisi dengan sampel yang lebih besar.

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ABSTRACTDiarrhea remains as a leading cause of childhood morbidity and mortality in Indonesia. Diarrhea in children is usually caused by infection . However, numerous disorders could also result in diarrhea. It includes a malabsorption syndrome and various enteropathies. The study that we conduct is aimed to determine the prevalence of lactose malabsorption and malnutrition in pediatric patients with diarrhea and the association between lactose malabsorption. and malnutrition. The research design used for this study is a cross sectional using secondary data. This study is chosen to know the association between lactose malabsorption and malnutrition. The data in this study will be obtained from stool analysis profile and the medical record of pediatric patients that are treated in Cipto Mangunkusumo Hospital RSCM . This study found that the prevalence of lactose malabsorption in pediatric patients with diarrhea is 18.2 . This study also found that the prevalence of malnutrition is 38 .Moreover, the result of the study revealed that there is no association between lactose malabsorption and nutritional status P 0.05 . A further study is required to explored the association between lactose malabsorption and nutritional status with larger sample size "

"Latar belakang. Diare masih merupakan penyebab morbiditas dan mortalitas yang cukup tinggi pada anak, dan efeknya akan meningkat pada diare melanjut. Eksresi yang meningkat dan malnutrisi menimbulkan defisiensi makro dan mikronutrien, zinc salah satunya. Defisiensi zinc merupakan masalah global terutama di negara berkembang. Tujuan. Penelitian ini bertujuan untuk mengetahui apakah defisiensi zinc sebagai faktor risiko diare akut menjadi diare melanjut. Metode. Penelitian ini merupakan uji potong lintang dan kohort yang dilakukan di RSCM, dan tiga rumah sakit umum daerah pada anak usia > 1 bulan - 60 bulan. Kriteria inklusi meliputi pasien dengan diare akut kurang 7 hari. Kriteria eksklusi meliputi gizi buruk, diare berdarah dan subjek dengan penyakit penyerta dan keganasan. Pengumpulan sampel darah untuk pemeriksaan kadar zinc serum. Hasil. Sembilan puluh sembilan subjek dilakukan analisis. Usia terbanyak adalah 12-36 bulan, dengan lelaki berbanding perempuan 1,3:1. Lebih dari 90% pendidikan ibu adalah rendah dan pendapatan orangtua 90,0% rendah. Prevalens defisiensi zinc adalah 20,2%. Tidak terdapat hubungan antara defisiensi zinc dengan usia, status nutrisi, riwayat diare berulang, pendidikan ibu dan pendapatan orangtua. Insidens diare melanjut sebesar 25,3%. Defisiensi zinc bukan merupakan faktor risiko diare akut menjadi diare melanjut RR 1,82 (IK 95% 0,633-5,260) dengan p 0,261. Riwayat diare berulang merupakan faktor risiko diare akut menjadi diare melanjut RR 3,4 kali (IK95% 1,3-9,5 dengan p 0,013). Simpulan. Defisiensi zinc bukan merupakan faktor risiko diare akut menjadi diare melanjut. Riwayat diare berulang berisiko untuk terjadinya diare akut menjadi diare melanjut.

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Background. Acute diarrhea is one of the causes of high morbidity and mortality in children, and its morbidity and mortality is increasing in prolonged diarrhea. Prolonged diarrhea might continue to persistent diarrhea and malnutrition due to macro- and micronutrient deficiency, such as zinc. Recently, zinc deficiency has become a global health problem in developing countries, such like Indonesia.

Objectives. This study aimed to identify whether zinc deficiency is one of risk factors of prolonged diarrhea and to evaluate the level of zinc in prolonged diarrhea compare to acute diarrhea.

Method. This study is a cross-sectional and cohort studies, underwent at Cipto Mangunkusumo Hospital and three other general hospitals in West Java. The study was performed in children aged > 1 month – 60 months old. The inclusion criteria were acute diarrhea less than 7 days. The exclusion criteria were severe malnutrition, bloody diarrhea and subjects having concomitant diseases. Blood samples were withdrawn for serum zinc measurement.

Results. There were ninety-nine subjects participated in this study. The majority subjects aged 12-36 months old, with boy:girl ratio = 1.3:1. More than 90% subjects had low educated mothers and came from low income families (90.0%). The prevalence of zinc deficiency in this study was 20.2%. There were no correlation between zinc deficiency and age, nutritional status, recurrent diarrhea, mother's education level, and family income. The incidence of prolonged diarrhea was 25.3%. Zinc deficiency was not a risk factor for prolonged diarrhea [RR 1.82 (95%CI 0.633-5.260), p=0.261]. The history of recurrent diarrhea was a risk factor for prolonged diarrhea [RR 3,4 (95%CI 1.3-9.5, p=0.013)].

Conclusion. In this study, zinc deficiency was not the risk factor for prolonged diarrhea. History of recurrent diarrhea was the risk factor for prolonged diarrhea."

"Diare merupakan masalah kesehatan yang sering diderita balita dibawah usia 5 tahun. Diare disebabkan oleh kondisi lembab terus menerus pada area popok, sehingga meningkatkan terjadinya ruam popok pada bayi. Perawatan kulit terutama pada ruam popok menjadi hal yang penting untuk mencegah terjadinya kerusakan lebih lanjut. Pemberian bahan topical seperti Virgin Coconut Oil (VCO) dapat menjadi salah satu alternatif dalam perawatan ruam popok. Penulisan ini bertujuan untuk mengetahui pengaruh penggunaan Virgin Coconut Oil (VCO) terhadap ruam popok pada pasien dengan diare. Pasien diberikan Virgin Coconut Oil (VCO) pada pagi serta sore hari setelah mandi selama 3 hari berturut-turut. Evaluasi kondisi kulit dipantau setiap hari dengan hasil terdapat perbaikan kondisi kulit seperti tekstur kulit, kelembaban, suhu kulit serta perbaikan warna kulit. Perawat disarankan dapat menggunakan Virgin Coconut Oil (VCO) sebagai intervensi mandiri dalam upaya mencegah kerusakan integritas kulit lebih lanjut yang diakibatkan oleh ruam popok.

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Diarrhea is a health problem that often affects toddlers under 5 years of age. Diarrhea is caused by continuous damp conditions in the diaper area, thereby increasing the occurrence of diaper rash in babies. Skin care, especially for diaper rash, is important to prevent further damage. Applying topical ingredients such as Virgin Coconut Oil (VCO) can be an alternative for treating diaper rash. This writing aims to determine the effect of using Virgin Coconut Oil (VCO) on diaper rash in patients with diarrhea. Patients were given Virgin Coconut Oil (VCO) in the morning and evening after bathing for 3 consecutive days. Evaluation of skin conditions is monitored every day with the results of improvements in skin conditions such as skin texture, moisture, skin temperature and improvement in skin color. Nurses are advised to use Virgin Coconut Oil (VCO) as an independent intervention in an effort to prevent further damage to skin integrity caused by diaper rash."

"Diare masih menjadi masalah kesehatan di Indonesia khususnya di Kecamatan Moyo Utara Kabupaten Sumbawa. Besarnya masalah terlihat dari tingginya angka kesakitan dan kematian akibat diare. Diare pada balita dapat berkontribusi pada beban penyakit akut (UNICEF, 2019). Berdasarkan data Profil Kesehatan Daerah NTB Tahun 2018, prevalensi diare pada balita di Kecamatan Moyo Utara sebesar 28,7% lebih tinggi dibandingkan data di tingkat nasional, provinsi, maupun kabupaten. Tujuan penelitian untuk mengetahui hubungan faktor determinan terhadap kejadian diare pada anak balita umur 6-59 bulan di Kecamatan Moyo Utara Kabupaten Sumbawa NTB Tahun 2019. Desain penelitian adalah cross sectional dengan jumlah sampel sebanyak 406 balita. Pengumpulan data melalui pengukuran berat badan, wawancara dan observasi. Analisis data dengan uji Chi-Square dan regresi logistik. Hasil penelitian menunjukkan prevalensi diare pada anak balita umur 6-59 bulan sebesar 18,7% dimana terdapat hubungan yang bermakna antara jumlah anggota keluarga, kunjungan posyandu, riwayat ASI Eksklusif, cara mencari pertolongan saat anak diare, dan mencuci tangan dengan sabun (pvalue<0,05). Jumlah anggota keluarga menjadi faktor dominan yang berhubungan dengan kejadian diare pada balita umur 6-59 bulan di Kecamatan Moyo Utara (OR: 2,78, 95%CI 1,29-5,97, pvalue<0,05). Pencegahan dan pengobatan diare harus menjadi tanggung jawab semua orang sehingga diare bukan lagi masalah sektor kesehatan semata.

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Diarrhea in children is still a health problem that occurs in the Sumbawa Regency, especially in North Moyo district, West Nusa Tenggara. The magnitude of the problem can be seen from the high morbidity and mortality due to diarrhea. Diarrhea in children can contribute to the acute burden of disease (UNICEF, 2019). Based on the Regional Health Profile of West Nusa Tenggara Province in 2018, the prevalence of diarrhea in children aged 6-59 months in North Moyo District was 28.7% higher than the national, provincial, and district levels.

The purpose of this study was to find out the corelation of determinants of diarrhea in children aged 6-59 months in North Moyo District, Sumbawa Regency. Cross sectional design was used in this study with 406 sample of children aged 6-59. Data collection was carried out by measuring weight, interview and observation.The Chi-Square test and regresi logistic were used to analysis the study.

The results showed the prevalence of diarrhea in children aged 6-59 months in North Moyo District was 18.7%. Statistical analysis showed that the significant corelation was the number of family members, posyandu visits, exclusive breastfeeding, how to help children diarrhea, and washing hands with soap (pvalue <0.05). The number of family members is the dominant factor associated with diarrhea in children aged 6-59 months in North Moyo District (OR: 2.78, 95% CI 1.29-5.97, p value <0.05). Make the prevention and treatment of diarrhea everybody’s responsible. Implementation of prevention and treatment is approached in an integrated way to produce a greater impact in efforts to overcome diarrhea in children."

"Diare adalah salah satu penyakit infeksi saluran cerna dengan gejala buang air besar tiga kali atau lebih dalam sehari dalam bentuk cair. Prevalensi diare pada anak balita di Indonesia 2017 adalah 14,3%. Tujuan dari penelitian ini adalah untuk mengidentifikasi faktor-faktor apa yang terkait dengan inang dan lingkungan yang terkait dengan diare pada anak di bawah lima tahun di Indonesia pada tahun 2017. Penelitian ini menggunakan data sekunder dari Survei Demografi dan Kesehatan Indonesia (SDKI) 2017. Desain penelitian ini adalah analitik cross-sectional dengan sampel penelitian ini adalah semua anak berusia 0-59 bulan di Indonesia dari SDKI 2017. Variabel independen dari penelitian ini adalah faktor tuan rumah seperti usia anak, berat lahir, status vaksinasi campak, suplementasi vitamin A, perilaku mencuci tangan dan faktor lingkungan seperti fasilitas toilet dan sumber air minum. Sedangkan variabel dependennya adalah prevalensi diare pada anak balita. Hasil analisis bivariat menunjukkan bahwa faktor inang yang terkait dengan diare pada anak balita adalah usia anak (p = 0,000; 95% CI = 1,92-2,72); status vaksinasi campak (p = 0,003; POR = 1,17; 95% CI = 1,05-1,32), pemberian ASI eksklusif (p = 0,000; POR = 1,37; 95% CI = 1,24-1, 52) dan suplementasi Vitamin A (p = 0,000; POR = 1,37; 95% CI = 1,23-1,58). Oleh karena itu, faktor lingkungan yang terkait dengan diare pada anak balita adalah sumber air minum (p = 0,017; POR = 1,19; 95% CI = 1,03-1,37). Kita perlu meningkatkan kesadaran di antara orang-orang untuk memberikan ASI eksklusif, Vitamin A dan imunisasi; juga meningkatkan cakupan program pengendalian dan pencegahan diare oleh pemerintah sehingga kami dapat mengurangi jumlah kasus diare di Indonesia.

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Diarrhea is a digestive tract disease with symptoms of bowel movements three or more times a day in liquid form. The prevalence of diarrhea in children under five in Indonesia 2017 is 14.3%. The purpose of this study is to identify what factors are related to the host and environment associated with diarrhea in children under five in Indonesia in 2017. This study uses secondary data from the Indonesia Demographic and Health Survey (IDHS) 2017. Design This study is a cross-sectional analytic with the sample of this study are all children aged 0-59 months in Indonesia from SDKI 2017. The independent variables of this study are host factors such as the child's age, birth weight, measles vaccination status, vitamin A supplementation, behavior hand washing and environmental factors such as toilet facilities and drinking water sources. While the dependent variable is the prevalence of diarrhea in children under five.

The results of the bivariate analysis showed that the host factors associated with diarrhea in children under five were the age of the child (p = 0,000; 95% CI = 1.92-2.72); measles vaccination status (p = 0.003; POR = 1.17; 95% CI = 1.05-1.32), exclusive breastfeeding (p = 0,000; POR = 1.37; 95% CI = 1.24-1 , 52) and Vitamin A supplementation (p = 0,000; POR = 1.37; 95% CI = 1.23-1.58). Therefore, the environmental factors associated with diarrhea in children under five are drinking water sources (p = 0.017; POR = 1.19; 95% CI = 1.03-1.37). We need to increase awareness among people to provide exclusive breastfeeding, Vitamin A and immunizations; also increasing the scope of diarrhea control and prevention programs by the government so that we can reduce the number of cases of diarrhea in Indonesia."

"Diare merupakan penyebab kedua terbesar atas kematian pada anak di bawah lima tahun, dan telah membunuh sekitar 525.000 anak setiap tahunnya (WHO, 2017). Hasil Riskesdas tahun 2018 mengungkapkan bahwa prevalensi diare tertinggi ada pada kelompok umur 1-4 tahun. Kota Bogor merupakan salah satu kota di Jawa Barat dengan angka kejadian diare tertinggi. Pada tahun 2016 hingga 2017 terjadi peningkatan kasus kejadian diare di Kota Bogor dan kasus terbanyak di temukan di Wilayah Kerja Puskesmas Sempur yakni Kelurahan Sempur dengan mayoritas kejadian diare terjadi pada balita. Penelitian ini bertujuan untuk mengetahui faktor-faktor yang berhubungan dengan kejadian diare pada balita di Kelurahan Sempur Kota Bogor tahun 2019. Desain penelitian yang digunakan adalah cross sectional dengan jumlah sampel sebanyak 135 responden. Pengumpulan data dilakukan dengan metode wawancara menggunakan kuesioner. Variabel dependen dalam peneilitian ini adalah kejadian diare pada balita. Variabel independen terdiri dari karakteristik orang tua (Pendidikan, pendapatan, pengetahuan, dan perilaku mencuci tangan), karakteristik balita (status gizi) dan faktor lingkungan (pengelolaan sampah rumah tangga, sumber air bersih, sumber dan pengelolaan air minum, sarana pembuangan tinja, dan SPAL). Hasil dalam penelitian ini menunjukkan bahwa perilaku mencuci tangan orang tua secara statistik memiliki hubungan yang signifikan dengan kejadian diare pada balita (p value= 0,008; OR=3,261; 95% CI =1,425 – 7,462). Upaya yang dapat dilakukan adalah dengan memberikan edukasi kepada masyarakat mengenai perilaku hidup bersih dan sehat dan peningkatan sanitasi lingkungan dalam rangka pencegahan diare pada balita.

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Diarrhea is the second largest cause of death in children under five years, and has killed around 525,000 children each year (WHO, 2017). The results of the Riskesdas in 2018 revealed that the highest prevalence of diarrhea was in the age group 1-4 years. Bogor is one of the cities in West Java with the highest incidence of diarrhea. In 2016 until 2017 there was an increase in cases of diarrhea in Bogor and the most cases were found in Sempur with the majority of diarrhea occurring in toddlers. This study aims to determine the factors related with the incidence of diarrhea in toddlers in Sempur, Bogor 2019.

The study design used was cross sectional with a total sample of 135 respondents. Data collection is done by interview method using a questionnaire. The dependent variable in this study is the incidence of diarrhea in toddlers. The independent variables consist of parental characteristics (education, income, knowledge, and hand washing behavior), characteristics of toddlers (nutritional status) and environmental factors (management of household waste, sources of clean water, sources and management of drinking water, feces disposal facilities, and sewerage).

The results in this study indicate that parents hand washing behavior has a statistically significant relationship with the incidence of diarrhea in toddlers (p value = 0.008; OR = 3.261; 95% CI = 1.425 - 7.462). The effort that can be done is to provide education to the society regarding clean and healthy lifestyle and improving environmental sanitation in order to prevent diarrhea in toddlers."