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Abstrak :
Angka kematian bayi (AKB) di Indonesia hingga saat ini masih sangat tinggi dimana Tetanus neonatorum merupakan salah satu penyebab utama kematian bayi yang menempati urutan ke-5 (SKRT 1995). Upaya untuk mengeliminisasi tetanus neonatorum terus dilakukan Departemen Kesehatan dengan target menurunkan insiden menjadi < 1 per 1.000 kelahiran hidup pada tahun 2000. Salah satu strategi Departemen Kesehatan mencapai Eliminasi Tetanus Neonatorum (ETN) adalah meningkatkan cakupan imunisasi TT ibu hamil. Namun evaluasi tahun 1999/2000 menunjukkan cakupan yang masih rendah. Oleh karena itu Depkes mulai mengembangkan intensifikasi imunisasi TT kepada wanita usia subur (WUS). Hingga tahun 2000, Kabupaten Serang melaporkan cakupan imunisasi TT WUS > 3 kali mencapai 77,3%. Salah satu Puskesmas yang memiliki cakupan imunisasi TT WUS rendah adalah Puskesmas Anyer. Penelitian ini bertujuan untuk mengidentifikasi faktor-faktor yang berhubungan dengan status imunisasi TT WUS di Puskesmas Anyer, dengan menggunakan desain survei cross sectional. Responden terdiri dari 300 orang wanita usia subur. Variabel yang diteliti meliputi faktor umur, pendidikan, status perkawinan, pengetahuan, sikap, pekerjaan, persepsi tentang jarak, anjuran, dan kebutuhan terhadap pelayanan kesehatan/imunisasi TT. Hasil penelitian menunjukkan beberapa variabel mempunyai hubungan yang bermakna secara statistik dengan status imunisasi TT WUS (p<0,05). Variabel yang mempunyai hubungan bermakna tersebut adalah umur (OR=3,60), status perkawinan (5,60), pengetahuan (3,60), sikap (4,45), anjuran petugas kesehatan (2,63), anjuran petugas non kesehatan (7,14) dan kebutuhan terhadap pelayanan kesehatan (2,89). Sementara variabel persepsi tentang jarak, tingkat pendidikan, dan status pekerjaan tidak menunjukkan hubungan yang bermakna secara statistik (p>0,05). Berdasarkan analisis multivariat diketahui bahwa variabel yang paling berpengaruh adalah pengetahuan, umur, status perkawinan dan anjuran petugas non kesehatan. Diantara ke empat variabel tersebut, status kawin merupakan variabel yang paling besar mempengaruhi status imunisasi TT WUS. Mengacu pada hasil penelitian, maka untuk meningkatkan cakupan imunisasi TT WUS disarankan agar penjangkauan sasaran melalui kegiatan sweeping perlu dipertahankan mengingat kegiatan yang bersifat mass campaign masih dirasakan cukup efektif. Selain itu upaya sosialisasi TT WUS melalui media penyuluhan yang tepat bagi kelompok sasaran antara, seperti kader dan perangkat desa perlu dibuat mengingat pengaruhnya kepada sasaran utama program cukup besar. Untuk mempercepat tercapainya target jangka panjang yaitu dihentikannya imunisasi TT ibu hamil, maka perlu dilakukan pentahapan target TT WUS sehingga status imunisasi TT5 mendekati l00%. Penyesuaian jadwal dengan mengadopsi konsep interval minimal pada pelaksanaan imunisasi TT rutin pada ibu hamil sangat diperlukan untuk meningkatkan perlindungan individu sekaligus untuk meningkatkan efisiensi imunisasi TT.

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Factors Contributed To Tetanus Toxoid Immunization Status among Child Bearing Age Women in Anyer Puskesmas Service Area, District Of Serang, In the Year 2001Infant mortality rate is considerably still high in Indonesia where Neonatorum tetanus as the fifth major cause of infant deaths in Indonesia (Household Health Survey 1995). The Ministry of Health has been adopting various efforts to eliminate tetanus neonatorum targeted reducing of neonatal tetanus incidence rate down to below 1 per 1000 live births by the end of 2000. One of the strategies in the Ministry of Health in order to eliminate neonatal tetanus is achieving high coverage of routine tetanus-toxoid (TT) immunization for pregnant women. Annual evaluation still shows low level of coverage up till the fiscal year 1999/2000, therefore the implementation of program acceleration of TT immunization targeting child-bearing age women (CBAW) as a new approach. By the year 2000, 77.3% of CBAW in Serang District health service area have received TT immunization minimum 3 doses. Anyer is one health centers of health centers in Serang District which reports the lowest coverage. The objective of this study is to identify the factors contributing to TT immunization status of CBAW in Anyer puskesmas service area, using cross sectional study design. This survey included 300 CBAW. The study factors are age, educational level, marriage status, knowledge, attitude, job, perception about distance, motivator and need for health services/TT immunization. The study shows several variables are having significant relationship with TT status of CBAW (p<0.05). Those variables are age, (OR=2.014), marriage status (OR= 3.286), knowledge (OR=2.626), and non-health motivator (OR=2.268). Other variables such as distance, attitude, need of health service, health motivator, education level, and job in this study do not show significant influence to TT status (p>O.05). Thesis study recommends, sweeping of TT CRAW in a mass campaign is an effective approach in increasing the coverage and cadres or village administrators are the important motivators. The program long term goals in terminating TT immunization for pregnant women requires a good plan of TT CBAW until all or almost all of CBAW achieve the TT-5 status. Adjusting the TT immunization schedule by adopting the minimum-interval concept into the routine immunization for pregnant women is needed to increase the individual protection, as well as to increase the efficiency of TT immunization.

Abstrak :
Tetanus Neonatorum adalah penyebab utama kematian neonatal dan penyebab kematian kedua pada anak diantara penyakit yang dapat dicegah dengan imunisasi. Setiap tahun 450.000 bayi meninggal sebelum umur l bulan. Di Propinsi Jawa Barat, Tetanus Neonatorum masih menjadi masalah kesehatan, dimana selama 5 tahun berturut-turut dari tahun 1994-1998 kasus Tetanus Neonatorumn masih relatif tinggi dengan kematian yang relatif menetap. Tujuan penelitian adalah untuk mengetahui hubungan status imunisasi TT ibu hamil dengan kejadian Tetanus Neonatorum di Propinsi Jawa Barat tahun 1999-2000. Studi ini menggunakan desain kasus kontrol. Kasus adalah bayi umur 0 - 28 hari yang menderita Tetanus Neonatorum pada tahun 1999-2000, sedangkan kontrol adalah bayi sehat dengan umur yang hampir sama dan merupakan tetangga terdekat penderita. Data diperoleh dari wawancara dengan menggunakan kuesioner pada ibu bayi dan data yang diperoleh dikonfirmasi terhadap penolong persalinan, KMS, Catatan di Puskesmas, Pustu dan Polindes. Hasil studi menunjukkan adanya hubungan yang bermakna antara status imunisasi TT ibu hamil dengan kejadian Tetanus Neonatorum (OR = 21,82 , 95%C1, p = 0,0000). Setelah dilakukan kontrol terhadap variabel perawatan tali pusat dan persalinan "3 bersih", maka risiko kejadian Tetanus Neonatorum pada bayi yang ibunya tidak pernah mendapat imunisasi TT adalah 31,39 kali dibandingkan bayi yang ibunya mendapat imunisasi TT Iengkap. ......The Relation of Babies? Immunity with Tetanus Neonatorum MorbidityIn West Java on 1999-2000The Tetanus Neonatorum is the first cause neonatal death and the second cause of children death between the diseases which can be prevented by immunization. There are 450.000 babies death before one month old. In West Java Tetanus Neonatorum still be the first health problem During 5 years from 1994 - 1998, the morbidity and mortality of Tetanus Neonatorum has been relative constantly. This research is to find out the relation of pregnancy mother immunization status with Tetanus Neonatorum morbidity in West Java in 1999 - 2000. This study using design case control. The case is a 0 - 28 old days baby who had Tetanus Neonatorum in 1999 - 2000, and the controls is a health baby with the same age and live in the nearest illness baby. The data get through questionnaires from mother's illness baby and mother's health baby. The data was confirmed by midwife or birth attendant who help delivery, by puskesmas record, by baby ISMS and the other record in Puskesmas, Pustu and Polindes. The result of study reveals that there is a significant relationship between baby's immunization and Tetanus Neonatorum occurring. After controlling the other variable, such as umbilical cord care, "Three cleans delivery". The risk of Tetanus Neonatorum occur of baby's mother who has never have Tetanus Toxoid Immunization is 31,39 times compare with baby's mother who has completed TT Immunization.

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The Relation of Babies? Immunity with Tetanus Neonatorum MorbidityIn West Java on 1999-2000The Tetanus Neonatorum is the first cause neonatal death and the second cause of children death between the diseases which can be prevented by immunization. There are 450.000 babies death before one month old. In West Java Tetanus Neonatorum still be the first health problem During 5 years from 1994 - 1998, the morbidity and mortality of Tetanus Neonatorum has been relative constantly. This research is to find out the relation of pregnancy mother immunization status with Tetanus Neonatorum morbidity in West Java in 1999 - 2000. This study using design case control. The case is a 0 - 28 old days baby who had Tetanus Neonatorum in 1999 - 2000, and the controls is a health baby with the same age and live in the nearest illness baby. The data get through questionnaires from mother's illness baby and mother's health baby. The data was confirmed by midwife or birth attendant who help delivery, by puskesmas record, by baby ISMS and the other record in Puskesmas, Pustu and Polindes. The result of study reveals that there is a significant relationship between baby's immunization and Tetanus Neonatorum occurring. After controlling the other variable, such as umbilical cord care, "Three cleans delivery". The risk of Tetanus Neonatorum occur of baby's mother who has never have Tetanus Toxoid Immunization is 31,39 times compare with baby's mother who has completed TT Immunization.

Abstrak :
Eliminasi Tetanus Neonatorum (ETN) adalah salah satu sasaran yang disepakati dalam konperensi tingkat tinggi tentang kesehatan anak sedunia yang harus dicapai pada akhir tahun 2000. Salah satu upaya yang dilaksanakan untuk mencapai ETN tersebut adalah pemberian imunisasi tetanus toxoid kepada ibu hamil. Berbagai upaya untuk mencapai cakupan imunisasi TT ibu hamil yang optimal telah dilaksanakan, namun cakupan imunisasi TT pada ibu hamil di beberapa wilayah masih tetap merupakan masalah. Tujuan penelitian ini adalah untuk mengetahui faktor-faktor yang mempengaruhi status imunisasi TT pada ibu hamil di wilayah puskesmas Sukamanah kabupaten Bogor. Hasil penelitian ini diharapkan dapat merupakan sumbangan pemikiran untuk pengelolaan program imunisasi TT ibu hamil dalam kegiatan pencapaian eliminasi tetanus neonatorum. Metode penelitian ini dirancang dengan study kasus kontrol, sebagai kasus adalah ibu-ibu yang mempunyai anak umur kurang satu tahun dimana selama kehamilannya tidak pernah (TT0) atau tidak memperoleh imunisasi TT lengkap (TT1), sedangkan kontrol adalah ibu-ibu yang mempunyai anak umur kurang satu tahun dimana selama kehamilannya memperoleh imunisasi TT lengkap (TT2/ulang). Jumlah kasus sebanyak 170 orang dan jumlah kontrol 170 orang (perbandingan 1 kasus : 1 kontrol). Variabel yang diteliti meliputi faktor umur ibu, pendidikan, pengetahuan, sikap, jumlah anak balita, pekerjaan suami, persepsi ibu terhadap jarak, kepemilikan keluarga, pemeriksaan kehamilan dan anjuran yang diterima ibu untuk di imunisasi. Hasil penelitian ini menunjukan bahwa tidak semua faktor yang diteliti berpengaruh secara bermakna terhadap status imunisasi TT ibu hamil. Variabel yang tidak berpengaruh adalah ; umur ibu, jumlah anak balita, pekerjaan suami, pengetahuan, dan kepemilikan, sedangkan variabel yang berpengaruh adalah sikap (O.R 4,5), pendidikan (O.R 2,1), pemeriksaan kehamilan (O.R 2,2), persepsi terhadap jarak (OR 2,0) dan anjuran berpengaruh secara bermakna (O.R. 4,3). Mengingat hal-hal tersebut diatas maka disarankan kepada kepala puskesmas Sukamanah khususnya dan kepala dinas kesehatan kabupaten Bogor umumnya untuk dapat meningkatkan penyuluhan perorangan (anjuran), meningkatkan kemampuan dan sikap profesionalisme petugas, menekan terjadinya miss oportunity ANC dan imunisasi TT, membentuk pos vaksinasi khusus di daerah yang jauh dari posyandulpuskesmas serta mengusulkan kepada camat atau Dikbud untuk diadakan pendidikan kejar paket A (pendidikan sejenis) kepada ibu-ibu yang tidak sekolah atau buta huruf. ......The Factors Which Influenced of Toxoid Tetanus Immunization Status in Sukamanah Puskesmas, Kabupaten Bogor In 2000Elimination of Tetanus Neonatorum is one of targets of World Health Summit for Children in high level that must be achieved by the year 2000. One effort which has done to reach ETN is giving toxoid tetanus immunization to pregnant mother. There are so many efforts to reach the coverage of TT immunization that have done well in every area but it is still face the problems. The purpose of the research is to find out some factors that have influenced the status of TT immunization for pregnant mother in Sukamanah Health Centre, Bogor District. The result of research is contributing some ideas for the management of pregnant mother TT program in increasing elimination of neonatorum of tetanus activating. The research applies a case control design the case are, mother who has a baby, during her pregnancy has not ever given (TT0) or full of TT (TT1), while the control is mother who has baby that during her pregnancy has taken full of TT (TT2/booster). About it case and 170 control had beed interviewed (1 case : 1 control). The factor of attitude has been researched including: the mother's age, education, knowledge, number of children under 5 year age, husband's occupation, mother's perceive of distance, owner's family, checking the pregnancy up, and suggestion to do immunization which has revived by the mother. The result of the study reveals that there is the significant relationship between attitude (O.R. = 4,5), education (O.R.= 2,1), examination during pregnancy (ANC) (OR = 2,2), perceived of distance ( OR = 2,0) and suggestion (O.R.= 4,3) of TT immunization status of pregnant mother. Based on the result of the study, it is recommended to the head of Sukamanah Health Centre and the head of Bogor District Health office to early out the personal health education (Counseling), to improve the ability and performance of the staff, to reduce the miss opportunity of ANC and immunization, to establish the vaccination centre at the remote are, and to give a recommendation to the Head of Sub district or Department of Education in order to give education package to the literacy mother.

Abstrak :
Angka kematian bayi (AKB) di Indonesia hingga saat ini masih tinggi dimana tetanus neonatorum merupakan salah satu penyebab utama kematian bayi yang menempati urutan ke-5 (Depkes, 2001). Upaya eliminasi tetanus neonatorum (EN) di Indonesia terus dilakukan oleh Departemen Kesehatan baik dengan program jangka pendek dan menengah dengan sasaran wanita usia subur (WUS) maupun program jangka panjang dengan sasaran bayi, balita dan murid SD. Upaya akselerasi eliminasi tetanus neonatorum tersebut ditargetkan dapat menurunkan insiden tetanus neonatorum hingga < 1 per 1000 kelahiran hidup pada tahun 2005. Berdasarkan hasil evaluasi tahun 2003, cakupan imunisasi TT bagi wanita usia subur di Indonesia masih dibawah UCI (<80%). Tanpa upaya akselerasi, diperkirakan Indonesia harus menunggu sampai tahun 2027 untuk dapat menghentikan imunisasi pada ibu hamil dan calon pengantin. Oleh karena itu pada tahun 2003 secara serempak seluruh Indonesia dilakukan imunisasi TT kepada seluruh wanita usia subur termasuk siswa SLTA, agar seluruh WUS memiliki status imunisasi TT minimal 172. Pelaksanaan akselerasi TN tersebut dilaksanakan dua putaran pada tahun 2003 hingga 2004. Berdasarkan hasil kegiatan putaran pertama pelaksanaan imunisasi TT siswi SLTA, Kabupaten Muna hanya dapat menjaring 40,5% dari total siswi yang ada. Penelitian ini bertujuan untuk mengidentifikasi faktor-faktor yang berhubungan status imunisasi TT siswi SLTA di Kabupaten Muna tahun 2004. Desain penelitian adalah cross sectional, dengan sampel adalah siswa/siswi SLTA pada 18 kecamatan di Kabupaten Muna yang tergolong risiko tinggi TN. Kriteria sampel adalah siswi dengan status terdaftar dan terpilih sebagai sampel. Responden terdiri dari 730 orang. Variabel yang diteliti meliputi pengetahuan, sikap, kepercayaan, tempat tinggal, pendidikan ibu, pendidikan ayah, sumber informasi, intensitas informasi, kebutuhan, peran teman sebaya, peran guru dan status imunisasi TT siswi SLTA. Hasil penelitian menunjukkan proporsi siswi SLTA yang belum memperoleh imunisasi TT sebanyak 47%, imunisasi TT satu kali 48,1% dan yang memperoleh imunisasi TT dua kali 4,9%. Variabel yang berhubungan bermakna dengan status imunisasi TT siswi SLTA (p<0,05) adalah kepercayaan (OR=5,83), intensitas informasi (OR:1,93), kebutuhan(OR=1,49), teman sebaya (0R=1,61). Sedangkan pengetahuan, sikap, tempat tinggal, pendidikan ibu, pendidikan ayah, sumber informasi dan peran guru, tidak menunjukkan hubungan yang signifikan (p>0,05). Faktor yang paling dominan mempengaruhi status imunisasi TT siswi SLTA adalah kepercayaan. Berdasarkan hasil penelitian, untuk meningkatkan cakupan imunisasi TT siswi SLTA hendaknya memperhatikan faktor kepercayaan masyarakat setempat, informasi yang berkembang, kebutuhan dan peran teman sebaya siswi. Meningkatkan kerja sama lintas sektor termasuk kepada guru dan tokoh masyarakat dalam menyebarluaskan informasi yang benar tentang kegunaan imunisasi TT. Kualitas shining perlu ditingkatkan untuk menjaring WUS termasuk siswi SLTA yang belum memperoleh imunisasi, menentukan status imunisasi dengan interval pemberian yang tepat guna efisiensi dan efektivitas anggaran sehingga dapat dihentikan imunisasi kepada ibu hamil dan calon pengantin sedini mungkin. Dukungan kebijakan dan anggaran dari pemerintah daerah sangat dibutuhkan guna kelancaran pelaksanaan program akselerasi eliminasi TN di Kabupaten Muna. Perlunya kajian lebih lanjut pada skala nasional dengan disain penelitian yang lebih baik, misalnya kohor, sehingga diperoleh informasi yang lebih lengkap dengan bias yang lebih kecil. Referensi: 56(1980 - 2003)

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Factors Contributed to Tetanus Toxoid Immunization Status among Female Student at the Secondary School in Muna District, 2004Infant mortality rate is considerably still high in Indonesia where neonatorum tetanus as the fifth mayor cause of infant deaths in Indonesia (Ministry of Health, 2001). The Ministry of Health has been adopting various efforts to eliminate neonatorum tetanus in Indonesia to short and mid range target is child bearing age women (CBAW) and also long range target is infant, child under 5 years, and children elementary school. The Eliminate neonatorum tetanus targeted reducing of neonatal tetanus incidence rate down to bellow I per 1000 live births by the end of 2005. Evaluate in 2003, immoriation coverage among child bearing age women in Indonesia is under universal child immunization (<80%). Without acceleration, forecasted have to wait for 2027 to discontinuing toxoid tetanus immunize for pregnant women and candidate bridge. Therefore in 2003, the tetanus toxoid immunization program ran concurently for child bearing age women inclusive of children elementary school, so that all TT immunization CBAW status is minimum TT2. The neonatorum tetanus acceleration program consisted of two times in 2003 till 2004. Result of program activity 1'h, Muna district can only net 40,5% from all female student. The objective of this study is to identify the factors contributing to TT immunization status among female student at the secondary school in Muna district, 2004. The research design was cross sectional study and sample was all female student at the secondary school of 18 subdistrict high risk neonatorum tetanus in Muna district The sample criteria was registered and become sample. This survey included 730 female student The study factors were knowledge, attitude, believe, residence, mother educational level, father educational level, information source, information intensity, need for TT immunization, role of friend coeval, teacher role and TT immunization Stahis. The objective of this study indicate that the female student proportion which not yet obtained to TT immunization are 47%, first TT immunization 48,1% and second Ti' immunization 4,9%. Several variables are having significant relationship with TT immunization female student at the secondary school status (p<0,05) are believe (OR=5,83), information intensity (ORA'.I,93), need for Ti' immunization (OR=1,49) and role of friend coeval (OR=1,61). Other variables such as knowledge, attitude, residence, mother educational level, father educational level, information source, and teacher role in this study do not show significant influence to TT immunization status (p>0,05). Factor most dominant influence to TT immunization status in this study is believe. Thesis study recommends to increase TT immunization coverage, factors believe, information, need and role of friend coeval require to get attention. Increase to cooperation pass by quickly related sector to the right information about benefit TT immunization. Screening quality have to be improved to net CBAW included female student at the secondary school which not yet obtained to TT immunization, determining immunization status by the gift right interval to efficiency and effectiveness so that pregnant women and candidate bridge immunization can be earlier discontinued. Budget and policy support from local government very required to continuity of acceleration TN elimination program in Muna district. While researches are expected to conduct studies on this issue with national scale and better study methodology, such as conducting cohor to have more complete result and minimize study bias. References : 56(1980 - 2003)

Abstrak :
Pendahuluan
Angka kematian dan angka kesakitan karena penyakit infeksi khususnya pada bayi dan anak balita, masih sangat tinggi di Indonesia. Hasil survai LitBangKes Republik Indonesia (1980) menunjukkan angka kematian spesifik pada golongan umur 1 - 4 tahun sebesar 19,6 per 1000. Angka kematian yang paling besar terjadi pada golongan umur di bawah satu tahun yaitu 90,3 per 1000 kelahiran hidup. Sebab kematian yang paling menonjol pada golongan umur tersebut ialah : diare (24,1%), infeksi saluran pernafasan (22,1%) dan tetanus neonatorum (20%) . Penyakit-penyakit ini sebenarnya dapat dicegah melalui imunisasi. Diperkirakan imunisasi dapat mencegah 31.5% kematian bayi dan 22,72 kematian anak balita (1).

Program imunisasi melalui Pengembangan Program Imunisasi (PPI) telah dilaksanakan sejak tahun 1977 dan telah meliputi Iebih dari 45,000 desa. Hasil cakupan imunisasi melalui program ini masih belum mencapai sasaran yang diharapkan. Pada tahun 1985 sebagai berikut : BCG 52% , DPT2 37% , DPT3 11% , TT2 24% , Polio-3 10% , Campak 11,7%, sedangkan WHO memperkirakan hasil yang dicapai ialah DPT3 6% dan Polio-3 7%. Angka tersebut menunjukkan drop out imunisasi ulang DPT dan polio masih tinggi.

Zat-zat imunopotensiator diketahui mempunyai efek meningkatkan reaksi imunitas iubuh terhadap imunogen. Levamisol adalah salah satu imunopotensiator non-spesifik yang telah diketahui mampu meningkatkan baik fungsi imonitas selular maupun humoral. Dilaporkan obat tersebut efektif untuk : a) mencegah dan mengobati infeksi menahun rekuren di kulit, mukosa, mata, saluran pernafasan, juga infeksi sistemik yang disebabkan oleh virus, bakteri, jamur dan sebagainya ; b) menghilangkan anergi pasca infeksi virus dan riketsia ; c) mengobati penyakit reumatik, termasuk artritis reumatoid, lupus eritematosus sistemik dan sindrom Reiter ; d) menekan angka kekambuhan pada penderita kanker, terutama setelah operasi, radioterapi atau kemoterapi. Penggunaan levamisol sebagai ajuvan dalam imunisasi telah pula dilaporkan oleh beberapa peneliti, baik pada pada hewan percobaan maupun pada manusia.

Tujuan penelitian untuk membuktikan manfaat levamisol sebagai ajuvan dalam meningkatkan sintesis zat anti-tetanus. Bila levamisol terbukti mampu meningkatkan sintesis zat anti-tetanus, maka manfaat ini diharapkan akan mempercepat tercapainya kadar zat anti yang optimal, walaupnn terjadi drop out.

Abstrak :
[ABSTRAK
ATS telah banyak digunakan di Indonesia dalam mengobati tetanus. Sejak tahun 2010, penggunaan HTIG sebagai antitoksin semakin meningkat Tujuan: mengevaluasi perbedaan luaran pada tetanus anak antara yang mendapat ATS dan HTIG. Method: Penelitian retrospektif pada kasus tetanus anak yang dirawat di Rumah Sakit Cipto Mangunkusumo dari 2006-2014 Results: Ada 69 pasien tetanus anak yang menjadi subjek penelitian, dengan kelompok usia terbanyak adalah 1 ? 5 tahun yaitu 53,6 % dan proporsi laki-laki lebih banyak dibanding perempuan (2:1), dengan 59,4 % subyek tidak pernah mendapat imunisasi dasar. Port d‟entree terbanyak adalah OMSK (47,8 %) dan tetanus derajat 3 merupakan diagnosis terbanyak (39,1 %). Semua subjek datang dirawat dengan gejala trismus, disertai kejang rangsang (75,4 %), kaku kuduk dan opistotonus (73,9 %), spasme spontan (69,6 %) dan perut papan 65,2 % subjek. Enam puluh tujuh persen subjek diobati dengan ATS dan 33 % dengan HTIG. Lama rawat subjek yang mendapat ATS 9,98 (SB 4,58) dan HTIG 10,91 (SB 5,88) hari. Subjek yang meninggal di akhir perawatan, pada kelompok ATS 4,4 % dan HTIG 21,7 %. Pada kelompok ATS, trismus terjadi selama 8 hari sejak dirawat, kejang rangsang dan kaku kuduk 3 hari, opistotonus dan perut papan 2 hari serta kejang spontan 1 hari. Sedangkan pada kelompok HTIG, trismus 8 hari, kejang rangsang, kaku kuduk, opistotonus dan perut papan 2 hari serta kejang spontan selama 1 hri. Tidak ada data mengenai risus sardonicus. Harga HTIG satu juta rupiah lebih murah dibanding ATS (Rp 4.414.711,- vs Rp 5.512.724,-) ATS dan HTIG memiliki efektifitas yang sama dalam hal lama rawat, lama terjadinya spasme dan hasil akhir perawatan. Harga HTIG lebih murah dibanding ATS. Disarankan memilih HTIG sebagai pilihan pertama pengobatan tetanus anak dan ATS hanya digunakan bila HTIG tidak dapat diberikan.;Background: ATS has been widely used in Indonesia in tetanus management. Since 2010, the use of antitoxin HTIG as increasing Tujuan: mengevaluasi perbedaan luaran pada tetanus anak antara yang mendapat ATS dan HTIG.

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ABSTRACT
To evaluate the differences between the outcomes in pediatric tetanus who received HTIG and ATS Method: A retrospective study on pediatric tetanus case who admitted to Cipto Mangunkusumo Hospital since 2006 to 2014 Results: There were 69 patients with pediatric tetanus as study subjects, with 1-5 years as the largest age group is 53.6% and the proportion of men more than women (2: 1), with 59.4% of the subjects never got primary immunization. The most of port d'entree was CSOM (47.8%) and tetanus grade 3 as most fequent diagnosis (39.1%). All subjects came hospitalized with symptoms of trismus, accompanied spasms excitatory (75.4%), neck stiffness and opisthotonos (73.9%), spontaneous seizures (69.6%) and 65.2% of the subjects belly board. Sixty-seven percent of subjects treated with ATS and 33% with HTIG. Length of stay subjects who received ATS 9.98 (SB 4.58) and HTIG 10.91 (SB 5.88) a day. Subjects who died at the end of hospitalization, the ATS group is 4.4% and and HTIG group is 21.7%. In the ATS group, trismus occurred during the 8 days of hospitalization, a stiff neck and spasms excitatory 3 days, opisthotonos and belly boards 2 days and 1 day of spontaneous seizures. While the group HTIG, trismus 8 days, spasm excitatory, stiff neck, and abdomen board opistotonus 2 days and spontaneous seizures for 1 day. No data on risus sardonicus. Price HTIG one million rupiahs cheaper than ATS (Rp 4,414,711, - vs Rp 5,512,724, -) ATS and HTIG have the same effectiveness in terms of length of stay, duration of occurrence of spasms and outcomes of hospitalization. HTIG price is cheaper than the ATS. HTIG can the first choice treatment of pediatric tetanusr and ATS are only used when HTIG can not be given.;Background: ATS has been widely used in Indonesia in tetanus management. Since 2010, the use of antitoxin HTIG as increasing Tujuan: mengevaluasi perbedaan luaran pada tetanus anak antara yang mendapat ATS dan HTIG. Objective: To evaluate the differences between the outcomes in pediatric tetanus who received HTIG and ATS Method: A retrospective study on pediatric tetanus case who admitted to Cipto Mangunkusumo Hospital since 2006 to 2014 Results: There were 69 patients with pediatric tetanus as study subjects, with 1-5 years as the largest age group is 53.6% and the proportion of men more than women (2: 1), with 59.4% of the subjects never got primary immunization. The most of port d'entree was CSOM (47.8%) and tetanus grade 3 as most fequent diagnosis (39.1%). All subjects came hospitalized with symptoms of trismus, accompanied spasms excitatory (75.4%), neck stiffness and opisthotonos (73.9%), spontaneous seizures (69.6%) and 65.2% of the subjects belly board. Sixty-seven percent of subjects treated with ATS and 33% with HTIG. Length of stay subjects who received ATS 9.98 (SB 4.58) and HTIG 10.91 (SB 5.88) a day. Subjects who died at the end of hospitalization, the ATS group is 4.4% and and HTIG group is 21.7%. In the ATS group, trismus occurred during the 8 days of hospitalization, a stiff neck and spasms excitatory 3 days, opisthotonos and belly boards 2 days and 1 day of spontaneous seizures. While the group HTIG, trismus 8 days, spasm excitatory, stiff neck, and abdomen board opistotonus 2 days and spontaneous seizures for 1 day. No data on risus sardonicus. Price HTIG one million rupiahs cheaper than ATS (Rp 4,414,711, - vs Rp 5,512,724, -) ATS and HTIG have the same effectiveness in terms of length of stay, duration of occurrence of spasms and outcomes of hospitalization. HTIG price is cheaper than the ATS. HTIG can the first choice treatment of pediatric tetanusr and ATS are only used when HTIG can not be given.;Background: ATS has been widely used in Indonesia in tetanus management. Since 2010, the use of antitoxin HTIG as increasing Tujuan: mengevaluasi perbedaan luaran pada tetanus anak antara yang mendapat ATS dan HTIG. Objective: To evaluate the differences between the outcomes in pediatric tetanus who received HTIG and ATS Method: A retrospective study on pediatric tetanus case who admitted to Cipto Mangunkusumo Hospital since 2006 to 2014 Results: There were 69 patients with pediatric tetanus as study subjects, with 1-5 years as the largest age group is 53.6% and the proportion of men more than women (2: 1), with 59.4% of the subjects never got primary immunization. The most of port d'entree was CSOM (47.8%) and tetanus grade 3 as most fequent diagnosis (39.1%). All subjects came hospitalized with symptoms of trismus, accompanied spasms excitatory (75.4%), neck stiffness and opisthotonos (73.9%), spontaneous seizures (69.6%) and 65.2% of the subjects belly board. Sixty-seven percent of subjects treated with ATS and 33% with HTIG. Length of stay subjects who received ATS 9.98 (SB 4.58) and HTIG 10.91 (SB 5.88) a day. Subjects who died at the end of hospitalization, the ATS group is 4.4% and and HTIG group is 21.7%. In the ATS group, trismus occurred during the 8 days of hospitalization, a stiff neck and spasms excitatory 3 days, opisthotonos and belly boards 2 days and 1 day of spontaneous seizures. While the group HTIG, trismus 8 days, spasm excitatory, stiff neck, and abdomen board opistotonus 2 days and spontaneous seizures for 1 day. No data on risus sardonicus. Price HTIG one million rupiahs cheaper than ATS (Rp 4,414,711, - vs Rp 5,512,724, -) ATS and HTIG have the same effectiveness in terms of length of stay, duration of occurrence of spasms and outcomes of hospitalization. HTIG price is cheaper than the ATS. HTIG can the first choice treatment of pediatric tetanusr and ATS are only used when HTIG can not be given.;Background: ATS has been widely used in Indonesia in tetanus management. Since 2010, the use of antitoxin HTIG as increasing Tujuan: mengevaluasi perbedaan luaran pada tetanus anak antara yang mendapat ATS dan HTIG. Objective: To evaluate the differences between the outcomes in pediatric tetanus who received HTIG and ATS Method: A retrospective study on pediatric tetanus case who admitted to Cipto Mangunkusumo Hospital since 2006 to 2014 Results: There were 69 patients with pediatric tetanus as study subjects, with 1-5 years as the largest age group is 53.6% and the proportion of men more than women (2: 1), with 59.4% of the subjects never got primary immunization. The most of port d'entree was CSOM (47.8%) and tetanus grade 3 as most fequent diagnosis (39.1%). All subjects came hospitalized with symptoms of trismus, accompanied spasms excitatory (75.4%), neck stiffness and opisthotonos (73.9%), spontaneous seizures (69.6%) and 65.2% of the subjects belly board. Sixty-seven percent of subjects treated with ATS and 33% with HTIG. Length of stay subjects who received ATS 9.98 (SB 4.58) and HTIG 10.91 (SB 5.88) a day. Subjects who died at the end of hospitalization, the ATS group is 4.4% and and HTIG group is 21.7%. In the ATS group, trismus occurred during the 8 days of hospitalization, a stiff neck and spasms excitatory 3 days, opisthotonos and belly boards 2 days and 1 day of spontaneous seizures. While the group HTIG, trismus 8 days, spasm excitatory, stiff neck, and abdomen board opistotonus 2 days and spontaneous seizures for 1 day. No data on risus sardonicus. Price HTIG one million rupiahs cheaper than ATS (Rp 4,414,711, - vs Rp 5,512,724, -) ATS and HTIG have the same effectiveness in terms of length of stay, duration of occurrence of spasms and outcomes of hospitalization. HTIG price is cheaper than the ATS. HTIG can the first choice treatment of pediatric tetanusr and ATS are only used when HTIG can not be given.;Background: ATS has been widely used in Indonesia in tetanus management. Since 2010, the use of antitoxin HTIG as increasing Tujuan: mengevaluasi perbedaan luaran pada tetanus anak antara yang mendapat ATS dan HTIG. Objective: To evaluate the differences between the outcomes in pediatric tetanus who received HTIG and ATS Method: A retrospective study on pediatric tetanus case who admitted to Cipto Mangunkusumo Hospital since 2006 to 2014 Results: There were 69 patients with pediatric tetanus as study subjects, with 1-5 years as the largest age group is 53.6% and the proportion of men more than women (2: 1), with 59.4% of the subjects never got primary immunization. The most of port d'entree was CSOM (47.8%) and tetanus grade 3 as most fequent diagnosis (39.1%). All subjects came hospitalized with symptoms of trismus, accompanied spasms excitatory (75.4%), neck stiffness and opisthotonos (73.9%), spontaneous seizures (69.6%) and 65.2% of the subjects belly board. Sixty-seven percent of subjects treated with ATS and 33% with HTIG. Length of stay subjects who received ATS 9.98 (SB 4.58) and HTIG 10.91 (SB 5.88) a day. Subjects who died at the end of hospitalization, the ATS group is 4.4% and and HTIG group is 21.7%. In the ATS group, trismus occurred during the 8 days of hospitalization, a stiff neck and spasms excitatory 3 days, opisthotonos and belly boards 2 days and 1 day of spontaneous seizures. While the group HTIG, trismus 8 days, spasm excitatory, stiff neck, and abdomen board opistotonus 2 days and spontaneous seizures for 1 day. No data on risus sardonicus. Price HTIG one million rupiahs cheaper than ATS (Rp 4,414,711, - vs Rp 5,512,724, -) ATS and HTIG have the same effectiveness in terms of length of stay, duration of occurrence of spasms and outcomes of hospitalization. HTIG price is cheaper than the ATS. HTIG can the first choice treatment of pediatric tetanusr and ATS are only used when HTIG can not be given.;Background: ATS has been widely used in Indonesia in tetanus management. Since 2010, the use of antitoxin HTIG as increasing Tujuan: mengevaluasi perbedaan luaran pada tetanus anak antara yang mendapat ATS dan HTIG. Objective: To evaluate the differences between the outcomes in pediatric tetanus who received HTIG and ATS Method: A retrospective study on pediatric tetanus case who admitted to Cipto Mangunkusumo Hospital since 2006 to 2014 Results: There were 69 patients with pediatric tetanus as study subjects, with 1-5 years as the largest age group is 53.6% and the proportion of men more than women (2: 1), with 59.4% of the subjects never got primary immunization. The most of port d'entree was CSOM (47.8%) and tetanus grade 3 as most fequent diagnosis (39.1%). All subjects came hospitalized with symptoms of trismus, accompanied spasms excitatory (75.4%), neck stiffness and opisthotonos (73.9%), spontaneous seizures (69.6%) and 65.2% of the subjects belly board. Sixty-seven percent of subjects treated with ATS and 33% with HTIG. Length of stay subjects who received ATS 9.98 (SB 4.58) and HTIG 10.91 (SB 5.88) a day. Subjects who died at the end of hospitalization, the ATS group is 4.4% and and HTIG group is 21.7%. In the ATS group, trismus occurred during the 8 days of hospitalization, a stiff neck and spasms excitatory 3 days, opisthotonos and belly boards 2 days and 1 day of spontaneous seizures. While the group HTIG, trismus 8 days, spasm excitatory, stiff neck, and abdomen board opistotonus 2 days and spontaneous seizures for 1 day. No data on risus sardonicus. Price HTIG one million rupiahs cheaper than ATS (Rp 4,414,711, - vs Rp 5,512,724, -) ATS and HTIG have the same effectiveness in terms of length of stay, duration of occurrence of spasms and outcomes of hospitalization. HTIG price is cheaper than the ATS. HTIG can the first choice treatment of pediatric tetanusr and ATS are only used when HTIG can not be given., Background: ATS has been widely used in Indonesia in tetanus management. Since 2010, the use of antitoxin HTIG as increasing Tujuan: mengevaluasi perbedaan luaran pada tetanus anak antara yang mendapat ATS dan HTIG. Objective: To evaluate the differences between the outcomes in pediatric tetanus who received HTIG and ATS Method: A retrospective study on pediatric tetanus case who admitted to Cipto Mangunkusumo Hospital since 2006 to 2014 Results: There were 69 patients with pediatric tetanus as study subjects, with 1-5 years as the largest age group is 53.6% and the proportion of men more than women (2: 1), with 59.4% of the subjects never got primary immunization. The most of port d'entree was CSOM (47.8%) and tetanus grade 3 as most fequent diagnosis (39.1%). All subjects came hospitalized with symptoms of trismus, accompanied spasms excitatory (75.4%), neck stiffness and opisthotonos (73.9%), spontaneous seizures (69.6%) and 65.2% of the subjects belly board. Sixty-seven percent of subjects treated with ATS and 33% with HTIG. Length of stay subjects who received ATS 9.98 (SB 4.58) and HTIG 10.91 (SB 5.88) a day. Subjects who died at the end of hospitalization, the ATS group is 4.4% and and HTIG group is 21.7%. In the ATS group, trismus occurred during the 8 days of hospitalization, a stiff neck and spasms excitatory 3 days, opisthotonos and belly boards 2 days and 1 day of spontaneous seizures. While the group HTIG, trismus 8 days, spasm excitatory, stiff neck, and abdomen board opistotonus 2 days and spontaneous seizures for 1 day. No data on risus sardonicus. Price HTIG one million rupiahs cheaper than ATS (Rp 4,414,711, - vs Rp 5,512,724, -) ATS and HTIG have the same effectiveness in terms of length of stay, duration of occurrence of spasms and outcomes of hospitalization. HTIG price is cheaper than the ATS. HTIG can the first choice treatment of pediatric tetanusr and ATS are only used when HTIG can not be given.]