Hasil Pencarian  ::  Simpan CSV :: Kembali

"ABSTRAKLatar belakang: Diare akut merupakan masalah kesehatan yang penting dengan morbiditas dan mortalitas yang cukup tinggi. Perubahan komposisi mikrobiota usus pada diare akut ditandai dengan menurunnya komposisi bakteri yang menguntungkan bagi tubuh, yaitu Bifidobacterium dan Lactobacillus, dan peningkatan bakteri patogen seperti Enterobacter dan Clostridium. Kondisi ini disebut disbiosis. Pemberian probiotik pada kasus diare akut dapat mengatasi disbiosis, mempercepat masa penyembuhan, dan mengurangi komplikasi. Sampai saat ini, belum terdapat penelitian di Indonesia mengenai pemberian probiotik untuk mengatasi disbiosis pada diare akut. Tujuan: Membuktikan bahwa terjadi disbiosis pada diare akut, yang dapat diseimbangkan dengan pemberian probiotik. Metode: Studi uji klinis, kontrol plasebo, dilakukan di RSUD Budhi Asih Jakarta, sejak Januari hingga Maret 2018. Penelitian melibatkan 36 orang anak berusia 6-48 bulan yang datang dengan keluhan diare akut. Spesimen tinja diperiksa menggunakan teknik non culture real time PCR untuk mendeteksi jumlah Lactobacillus, Bifidobacterium, Enterobacter, Clostridium dan all bacteria, kemudian dilakukan pemberian probiotik atau plasebo selama 5 hari, kemudian dilakukan pemeriksaan mikrobiota kembali 2-3 minggu kemudian. Hasil: Jumlah bakteri Lactobacillus lebih tinggi pada kelompok diare akut dibandingkan anak sehat yaitu dalam median jarak interkuartil : 1,52x103 1,22x104 vs 6,87x10 2,41x102 p

---

ABSTRACTBackground Acute diarrhea is an important health problem with high morbidity and mortality. During acute diarrhea, changes in gut microbiota is marked by decreased of beneficial microbes such as Bifidobacterium and Lactobacillus, and increase of pathogenic bacteria such as Enterobacter and Clostridium, which is also known as dysbiosis. Treatment with probiotic may help to repair dysbiosis, quickens healing time, and decrease complications. Currently there is no research to investigate dysbiosis in acute diarrhea in Indonesia.Objective To prove that there is dysbiosis during acute diarrhea, and can be normalize by giving probiotic.Methods Placebo controlled, unblinded clinical trial was performed in RSUD Budhi Asih, Jakarta from January until March 2018. 36 children age 6 48 months with acute diarrhea were enrolled. Fecal specimen was taken and analyzed using non culture real time PCR to detect the presence of Lactobacillus, Bifidobacterium, Enterobacter, Clostridium, and all bacteria. Children were then given probiotic or placebo for 5 days. Second fecal sample was taken 2 3 weeks afterwards.Results Higher amount of Lactobacillus are observed in children with acute diarrhea vs healthy control with a median interquartile range 1,52x103 1,22x104 vs 6,87x10 2,41x102 p"

"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."

"ABSTRAKPenelitian ini bertujuan untuk mengetahui implementasi clinical pathway pada kasus diare akut dengan proses audit. Jenis penelitian ini adalah kuantitatif dan kualitatif dengan menggunaan konsep operational research dengan metode telaah dokumen, telaah data dan wawancara mendalam. Hasil penelitian didapatkan topik audit adalah implementasi clinical pathway diare akut dengan tujuan menilai kelengkapan pengisian clinical pathway, kepatuhan DPJP, PPJP, Gizi dan Farmasi serta menilai kesesuaian lama hari rawat dengan clinical pathway. Standar penilaian yang digunakan adalah standar nasional yaitu KARS. Hasil pengukuran menunjukkan bahwa kelengkapan pengisian clinical pathway 25 , tidak ditemukan variasi pada pemeriksaan laboratorium, asuhan nutrisi dan asuhan keperawatan, namun pada tata lakasana diare akut masih ditemukan variasi pada obat tambahan sebesar 41 , dan lama hari rawat sudah sesuai yaitu 3,3 hari. Beberapa hal yang perlu rumah sakit lakukan adalah mengembangkan kebijakan terkait clinical pathway, memperbaiki formulir clinical pathway dan sistem sosialisasi, membuat petunjuk teknis clinical pathway, sistem monitoring dan evaluasi, serta menurukan standar lama hari rawat dan diskusi terkait variasi terapi.

---

ABSTRACTThis study aims to determine the implementation of clinical pathway of acute diarrhea with the audit process. This type of research is quantitative and qualitative by using operational research concept with document review method, data analysis and in depth interview. The result of the research shows that the audit topic is the implementation of clinical pathway of acute diarrhea with the aim to assessing completeness of clinical pathway, compliance of primary responsible physician, primary responsible nurse, nutrition and pharmacy and assessing the length of stay with clinical pathway. Assessment standard used is the national standard that is KARS. The result of measurement showed that completeness of filling clinical pathway 25 , no variation on laboratory examination, nutrition and nursing care, but still found variation on additional drug 41 , and length of stay was 3.3 day. Some things that hospital need to do is developed policies related to clinical pathway, improve clinical pathway forms and socialization systems, make clinical pathway technical guidance, monitoring and evaluation systems, and reduce standards length of stay and discussion of variations in therapy."

"Diare akut adalah proses defekasi yang lebih sering dari biasanya (>3x sehari) dengan durasi < 14 hari. Salah satu penyebab diare akut adalah infeksi bakteri. Adanya infeksi bakteri ini harus ditangani dengan penggunaan antibiotik spesifik terhadap bakteri penyebab secara rasional. Penelitian ini dilakukan untuk mengevaluasi penggunaan antibiotik pada pasien diare akut di ruang rawat inap anak RSAB Harapan Kita tahun 2016. Evaluasi penggunaan antibiotik dilakukan secara kuantitatif dan kualitatif. Penelitian ini merupakan penelitian deskriptif dengan desain studi cross-sectional. Pengambilan data dilakukan secara retrospektif menggunakan data rekam medis pasien dengan teknik total sampling. Sampel dalam penelitian ini adalah seluruh data pasien anak (usia >1 bulan-12 tahun) yang menderita diare akut di ruang rawat inap anak RSAB Harapan Kita tahun 2016 dengan terapi antibiotik. Penelitian dilakukan terhadap 88 data rekam medis yang memenuhi kriteria inklusi. Kuantitas penggunaan antibiotik terbesar yang dinyatakan dalam satuan PDD adalah seftriakson (152,75) dan DDD/100 pasien/hari terbesar adalah seftriakson (34,56). Antibiotik yang menyusun segmen DU90% adalah seftriakson, sefotaksim, seftizoksim, dan ampisilin sulbaktam. Penggunaan antibiotik untuk terapi diare akut di ruang rawat inap anak RSAB Harapan Kita tahun 2016 90,87% sesuai dengan Formularium Nasional.

---

Acute diarrhea is a defecation process which happens more often than usual (3x daily) with duration < 14 days. One of its cause is bacterial infections. This bacterial infection needs to be treated by specific antibiotic against the bacteria and used rationally. This research is done to evaluate the uses of the antibiotic for acute diarrhea patient in child inpatiens room Mother and Child Harapan Kita Hospital of year 2016. The uses of antibiotic evaluation are done quantitatively and qualitatively. This research is a descriptive research with cross-sectional study design. Data collection is done retrospectively using patients medical records and total sampling technique. Sample of this research is all children patients in age interval of >1 month until 12 years old in child inpatiens room in Mother and Child Harapan Kita Hospital of year 2016 which suffer from acute diarrhea and need antibiotic therapy. The research is done for all 88 medical records which fulfill the inclusion criteria. The largest quantity of used antibiotics is expressed in PDD unit is ceftriaxone (152.75) and the largest of DDD/100 patient/day is ceftriaxone (34.56). Antibiotics that composed in DU90% segment are ceftriaxone, cefotaxime, ceftizoxime, and ampicillin sulbactam. The uses of antibiotic against diarrhea in child inpatiens room in Mother and Child Harapan Kita Hospital of Year 2016 is 90.87% corresponds with Formularium Nasional."

"Latar belakang: Diare merupakan masalah kesehatan paling sering pada anak.Berbagai penyebab diare dapat menyebabkan diare berlangsung lama dan bisa menjadi malnutrisi (gizi buruk).Penyebab diare bisa disebabkan oleh infeksi bakteri dan membutuhkan antibiotik sehingga diperlukan deteksi sedini mungkin. Pemeriksaan soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) dapat menduga adanya infeksi bakteri pada anak dengan diare akut. Tujuan :Mengetahui seberapa besar nilai diagnostik peningkatan leukosit dalam tinja dibandingkan dengan sTREM-1. Metode :studi potong lintang terhadap anak usia 6-60 bulan dengan diare akut tanpa komplikasi dan penyerta penyakit lain. Pada subyek dilakukan anamnesis gambaran klinis (demam, muntah, sakit perut), pemeriksaan leukosit dalam tinja dan pemeriksaan sTREM-1 sebagai referensi standard. Hasil : Anak dengan diare akut oleh karena infeksi bakteri usia 6-60 bulan dengan sTREM-1>470 pg/mL sebanyak 2 dari 64 subyek penelitian dan leukosit tinja > 10 / LPB sebanyak 14 dari 64 subyek penelitian, terbanyak lelaki, status nutrisi normal dan memiliki gambaran klinis demam, muntah dan tanpa sakit perut. Peningkatan leukosit tinja > 10 / LPB memiliki sensitifitas 50 %, spesifisitas 79,1 %, nilai prediksi positif 7,1 %, nilai prediksi negatif 98 %, akurasi 78 %, nilai rasio likelihood positif 2,18 dan nilai rasio likelihood negatif 0,63. Simpulan :Peningkatan leukosit tinja > 10 / LPB sebagai konfirmasi diagnostik kurangbaik dalam mendiagnosis diare akut oleh karena infeksi bakteri.

---

Background: Diarrhea is a health problem most often occurs in children. Various etiology of diarrhea can cause prolonged diarrhea and become malnourished (malnutrition). The etiology of diarrhea can be caused by a bacterial infection and requires antibiotics, so that detection is needed as early as possible. Examination of soluble triggering expressed receptors on myeloid cells-1 (sTREM-1) can predict bacterial infection in children with acute diarrhea. Objective: toknow how much the diagnostic value of fecal leukocytes test compared to sTREM-1. Methods: cross-sectional study of children aged 6-60 months with acute diarrhea without complications and other diseases. In the subjects, clinical manifestation was performed (fever, vomiting, abdominal pain), fecal leukocyte test and sTREM-1 test as a standard reference. Results : Children, aged 6-60 months with acute diarrhea due to bacterial infections

with sTREM-1> 470 pg / mL as many as 2 of 64 subjects and fecal leukocytes > 10 / HPF as many as 14 of 64 subjects, most male, normal nutritional status and had clinical

manifestation of fever, vomiting and without abdominal pain. Increased fecal leukocytes > 10 / HPF has a sensitivity of 50%, specificity 79.1%, positive predictive value 7.1%, negative predictive value 98%, accuracy 78%, positive likelihood ratio 2.18 and negative likelihood ratio 0, 63. Conclusion: Fecal leukocyte test > 10 / HPF as a diagnostic confirmation is not good in

diagnosing acute diarrhea due to bacterial infection."

"Diseluruh dunia, setiap tahun ada 12 (dua belas) juta anak meninggal sebelum berusia 5 (lima) tahun, terbanyak pada usia satu tahun pertama. Paling tidak 4-5 juta kematian tersebut disebabkan oleh diare. Di Indonesia diare masih merupakan masalah kesehatan masyarakat karena 40 % kematian di kelompok usia < 2 tahun disebabkan oleh diare. Angka kejadian diare pada tahun 2000 sebanyak 300 kasus per 1.000 orang. Tingginya kejadian penyakit diare ini dapat menyebabkan kerugian yang besar baik bagi masyarakat maupun bagi pemerintah. Namun selama ini informasi tentang jumlah biaya akibat penyakit diare masih kurang, khususnya untuk biaya yang ditanggung keluarga akibat balita menderita diare akut. Informasi ini dapat digunakan dalam advokasi ke penentu kebijakan dalam usaha menururkan angka insiden diare.Pemilihan lokasi penelitian di Puskesmas Kelurahan Tugu Selatan yang berada di Kecamatan Koja Kotamadya Jakarta Utara, disebabkan karena wilayah ini mempunyai tingkat kepadatan tinggi di DKI Jakarta, rata-rata tingkat pendidikan masyarakat yang rendah, sosial ekonomi yang kurang, dan banyak pemukiman kumuh yang sangat berpengaruh terhadap kejadian diare.Penelitian ini bertujuan mendapatkan gambaran tentang biaya yang ditanggung oleh keluarga akibat dan penyakit diare akut pada balita. Penelitian ini difokuskan untuk mendapat gambaran keadaan kerugian biaya bagi penderita yang datang berobat ke puskesmas, karena puskesmas merupakan ujung tombak fasilitas pelayanan kesehatan. Perhitungan biaya dilakukan terhadap biaya langsung, biaya tidak langsung dan biaya peluang dalam penanganan balita diare. Penelitian ini dilakukan terhadap 42 balita yang terkena diare akut dan datang berobat ke Puskesmas Tugu Selatan pada bulan Pebruari 2003. Data primer dikumpulkan langsung dari keluarga balita yang menderita diare akut dengan cara wawancara yang dilakukan pada saat kunjungan kerumah 14 hari setelah balita berobat ke puskesmas.Hasil penelitian ini menunjukkan bahwa rata-rata biaya yang dikeluarkan oleh keluarga apabila ada balita menderita diare sebesar Rp. 28.040 per episodnya. Jika dihitung rata-rata per hari biaya yang dikeluarkan oleh keluarga apabila ada balita menderita diare, yaitu sebesar Rp. 4.210. Komponen biaya tersebut terdiri atas biaya konsultasi sebesar 4,7 %, biaya obat 14,7 %, biaya administrasi 8,4 %, biaya transportasi 6,3 %, biaya konsumsi 5,4 %, biaya peluang 60,6 %. Sehingga tampak komponen biaya yang menyebabkan kerugian biaya terbesar akibat penyakit diare pada balita adalah biaya peluang yaitu sebesar 60,6 %.Dengan hasil yang diperoleh, apabila dilakukan perhitungan kerugian ekonomi yang menjadi beban masyarakat akibat sakit diare di Jakarta Utara didapatkan angka biaya sebesar Rp. 12.072.986.520 setiap tahunnya. Tampak penyakit diare akan memberikan efek memperburuk status sosial ekonomi masyarakat. Sehingga perlu perhatian lebih terhadap pelaksanaan program pemberantasan diare, agar kerugian akibat sakit diare dapat diturunkan.Saran yang disampaikan adalah perlu penelitian perhitungan kerugian biaya akibat diare yang lebih lengkap, meliputi perhitungan kerugian biaya dan pihak pemerintah dan pihak masyarakat, mengingat diare merupakan salah situ penyakit dengan angka kejadian dan kematian yang tinggi. Bagi divas kesehatan perlu melakukan analisis biaya satuan pelayanan kesehatan di puskesmas dan bagi pemerintah daerah Kotamadya Jakarta Utara perlu memberikan perhatian khusus terutama perbaikan sanitasi lingkungan di pemukiman penduduk, karena sangat berpengaruh terhadap penurunan kejadian diare.

---

In the whole world, there are 12 (twelve) million children die before five years old in every year; the most is on the beginning of the first year of age. At least 4-5 million of deaths were caused by diarrhea. In Indonesia, diarrhea is still being public health problem because 40% of the death in age group under 2 years old was caused by diarrhea. Diarrhea prevalence in year 2000 was 300 cases per 1000 persons. This high prevalence of diarrhea can cause a big loss to the public and also to the government.

But all this time, information about the cost of diarrhea still less, especially for the cost that the family has to bear because of children under five suffering acute diarrhea. This information can be used in advocacy to the policy makers in the way of decreasing diarrhea prevalence.

Tugu Selatan Sub district Health Center which located in Koja District North Jakarta being selected as the study location because this area has high population density in DKI Jakarta, low education level rate, low social economic rate, and a lot of slum area that affecting to the diarrhea prevalence.

This study is aims at to get the description of financial loss that being a burden of the family as a consequence of diarrhea at children under five. This study being focus to get the description about financial lost of the patient who came to the Health Center, because Health Center is the most important thing in health service facility. Cost calculation was performed to Direct cost, Indirect cost and Opportunity cost in treating diarrhea at children under five. This Study was performed to 42 children under five who have diarrhea and came to Tugu Selatan Health Canter on February 2003. The primary data were collected direct from the family of the children under five who suffering acute diarrhea by interview in their home 14 days after visiting the Health Center.

The results of research shows that the average cost that the family spent when children under five suffering diarrhea is Rp. 28.040 in each episode. If we calculate average cost per day, the cost that being spent when children under five suffering diarrhea is Rp. 4.210. Component of the cost consists of 4,7 % Consultation Cost, 14,7 % Medicine Cost, 8,4 % Administration Cost, 6,3 % Transportation Cost, 5,4 % Consumption Cost, 60,6 % Opportunity Cost. So that seen the cost component that cause the biggest financial lost because of diarrhea at children under five is opportunity cost which is 60,6

The extrapolation to prevalence of diarrhea in North Jakarta use prevalence based study, shows that in North Jakarta is Rp. 12.072.986.520 in every year. Obviously diarrhea will make the social economic status in the community worst. It need to pay more attention to the implementation of diarrhea eliminating program, in order to eliminate the financial lost because of diarrhea.

Suggestion for farther action is that it needs more complete study about calculation of financial lost caused by diarrhea, including calculation of financial lost in the government and in the community, considering diarrhea is one of disease with high prevalence and mortality rate. For the Health Service it necessary to perform cost analysis health service unit cost in Health Center and for the North Jakarta Municipality territory government need to give special attention especially in environment sanitary improvement in habitant residential, because it affecting a lot to the diarrhea prevalence reduction."

"ABSTRAKRuang Lingkup dan Cara Penelitian: Akhir-akhir ini banyak dilaporkan tentang kasus diare non spesifik oleh sejawat yang bekerja di klinik. Hal ini mungkin disebabkan oleh adanya infeksi saluran cerna oleh kuman tertentu yang tidak dapat diisolasi dengan prosedur yang lazim dilakukan untuk isolasi dan identifikasi kuman usus patogen aerob. Sejak berkembangnya teknik isolasi dan identifikasi kuman anaerob dan mikroaerofilik yang pesat pada awal tahun 70-an, maka kuman penyebab diare yang dapat diisolasi tidak terbatas pada kuman aerob raja, melainkan juga kuman usus anaerob dan mikroaerofilik. Kuman usus mikroaerofilik (Campylobacter jejuni) yang menimbulkan gangguan pada saluran cerna manusia memberikan gejala klinik yang mirip dengan infeksi kuman usus lainnya. Di berbagai negara C. jejuni merupakan penyebab infeksi saluran cerna pada manusia, dan frekuensinya lebih tinggi dibandingkan dengan frekuensi infeksi oleh Salmonella dan Shigella atau keduanya bersama-sama. Untuk menegakkan diagnosis mikrobiologik infeksi saluran cerna oleh C. jejuni, diperlukan isolasi dan identifikasi dengan cara yang spesifik. Sehubungan dengan permasalahan tersebut di atas, telah dilakukan kerjasama dengan Bagian Anak RSCM/FKUI untuk melakukan pemeriksaan tinja 50 penderita diare akut. Bahan pemeriksaan berupa tinja penderita yang diperoleh dengan rectal toucher. Setiap bahan pemeriksaan dibiak pada agar Campi BAP dalam sui,san mikroaerofilik, pada suhu 42 °C. Teknik isolasi dan identif. ntuk Campylobacter jejuni menurut Skirrow yang telah diuji oleh WHO Scientific Working Group.Hasil dan Resimpulan: Dari 50 anak pria dan wanita yang dirawat di Bagian Anak RSCM 1 FKUI dengan diare akut, berhasil diisolasi 3 (6%) Campylobacter jejuni. Dalam penelitisan ini, peneliti belum berhasil menemukan adanya Campylobacter jejuni dalam bahan pemeriksaan dengan metoda pewarnaan sediaan langsung dari tinja penderita, seperti yang dikemukakan oleh beberapa peneliti di luar negeri.

---

ABSTRACT

Scope and Method of Study: Recently there are so many cases of non specific diarrhea reported from the colleagues who works on clinical wards. This could happen because there are some kind of microorganism that infected the alimentary tract not possible to isolate by the common procedure usually used to isolate the Enterobacteriaceae. Since the development of anaerobic and microaerophylic isolation and identification techniques in 1970, the diarrhea causing microorganisms that can be isolated not only the aerobic but also the anaerobic and microaerophylic enteric microorganisms. The microaerophylic enteric microorganism (Campylobacter jejuni) that infected the alimentary tract has clinical symptom resemble to another enteric microorganisms infections. In several countries Campylobacter jejuni causing alimentary tract infection more frequent than Salmonella and Shigella or both. To diagnose the Campylobacter jejuni causing diarrhea], need a specific microbiological procedure. According to that problem, joint cooperation had been carried out with the Department of Pediatric RSCM/FKUI to examine 50 children who suffered from acute diarrhea. The specimen to examine is the excrement of the sufferer obtained by rectal toucher. Each specimen inoculated on Campi BAP and incubated in microaerophylic atmosphere at 42°C. Skirrow's technique modified by WHO Scientific Working Group had been used to isolate and identify Campylobacter jejuni.

Findings and Conclusions: Campylobacter jejuni had been isolated in 6% out for 50 boys and girls who suffer acute diarrhea being treated in the Department of Pediatric RSCM/FKUI. In this case we could not find Campylobacter jejuni by direct excrement staining method, as reported by others abroad."

"Telah dilakukan studi penggunaan obat secara rasional, khususnya penggunaan antibiotika pada pasien-pasien infeksi saluran nafas akut dan diare akut di 6 Puskesmas (PKM) di daerah-daerah perkotaan, pinggir kota dan pedusunan di Propinsi Sumatra Selatan. Sampel diambil secara acak sebanyak 15% dan proporsional dengan jumlah pasien berobat jalan di tiap PKM, selama periode 3 bulan (Januari s/d Maret 1997). Karakteristik pasien, diagnosis, dan jumlah serta tipe obat (termasuk obat suntik) dicatat dalam coding sheet” untuk selanjutnya dilakukan analisis. Didapatkan 1781 kasus, dengan jumlah rata-rata obat per resep 2.7; persentase kasus yang diberi suntikan adalah 47%; dan persentase pasien yang mendapat antibiotika adalah 49%. Enam puluh empat persen dari 1277 kasus infeksi saluran nafas atas akut, dan 79% dari 140 kasus diare akut diberi antibiotika. Studi ini menunjukkan bahwa terdapat penggunaan obat yang tidak rasional (berlebihan) yang jelas terlihat pada kasus-kasus infeksi saluran nafas atas akut dan pada kasus-kasus diare akut. (Med J Indones 2004; 14: 44-9)

---

Drug utilization study, especially antibiotic usage in therapy of mild acute upper respiratory infections and acute diarrheas has been conducted in six Primary Health Center (PHC) in urban, suburban and rural area in the Province of South Sumatra. We conducted systematic random sampling during which 15% of patients in each PHC were taken. We collected information about drug utilization from medical record of out patient in each PHC for three months period (January to March 1997). We recorded the characteristics of patients, the diagnosis, the number and type of drug (including injection) used. The number of cases studied was 1781, with the average number of drug per prescription being 2.7; the percentage of cases receiving an injection was 43%, and the percentage of cases receiving antibiotic was 48%. Sixty-four percent of 1277 acute respiratory tract infections (common cold), and 79% of 140 cases of acute diarrhea received antibiotic. This study showed that there is overuse or inappropriate use of drugs, especially antibiotic for acute nonspecific diarrhea and mild acute respiratory tract infections. (Med J Indones 2004; 14: 44-9)"

"[ABSTRAKLatar Belakang: Diare akut adalah masalah umum di negara berkembang sepertiIndonesia; penyakit ini banyak ditemukan dalam praktek sehari-hari dengan angkamorbiditas dan mortalitas yang cukup tinggi. Pada beberapa Rumah Sakit diJakarta ditemukan bahwa pasien diare akut dewasa mengalami defisiensi kadarseng sebesar 69.3%.Pemberian seng sudah terbukti bermanfaat untuk pengobatan diare akut padaanak.Tujuan: Mengetahui dampak suplementasi seng sebagai terapi alternatif /adjuvant untuk pengobatan diare akut pada pasien dewasa, denganmembandingkan lama berlangsung dan berat-ringan gejala pada kelompok pasienyang diberikan dan yang tidak diberikan suplementasi seng.Metode: Double blind randomized controlled trial dilakukan pada penelitian iniuntuk mengetahui efek suplementasi seng terhadap durasi dan gejalagastrointestinal pada pasien diare akut rawat inap di RS Pusat Pertamina di Jakartaselama periode Januari-Desember 2013. Analisis data dilakukan denganmenggunakan uji chi-square (x2) untuk perbandingan durasi diare dan uji generallinear model (GLM) untuk menilai tren perubahan gejala penyerta diare.Hasil: Analisis data dari 84 pasien yang dikelola: 30 pasien pria [seng 19,plasebo 11] dan 54 pasien wanita [seng 23, plasebo 31] ~ (p 0.111)memperlihatkan pemberian suplementasi seng bermakna mengurangi durasi diareakut (p 0.027) dan bermakna mengurangi gejala mual (p 0.032). Selain itu adatren perbaikan pada sebagian gejala penyerta diare akut, seperti sakit perut,frekuensi b.a.b., konsistensi feses, gejala muntah, kembung, dan gangguanaktivitas sehari-hari.Simpulan: Pemberian suplementasi seng bermakna membuat durasi diare akutlebih singkat dan bermakna mengurangi gejala mual, serta perbaikan padasebagian gejala gastrointestinal.

---

ABSTRACTBackground: Acute diarrhea is a common problem in developing countries suchas Indonesia; which is found in everyday practice with quite high morbidity andmortality rate. It was revealed in adult acute diarrhea patients in several hospitalsin Jakarta the levels of zinc deficiency was 69.3%. Zinc has been proven to bebeneficial in the treatment of acute diarrhea in pediatric patients.Objective: To discover the effectiveness of zinc supplementation as an adjuvanttherapy in acute diarrhea for adult patients by comparing the duration and theseverity of signs and symptoms of acute diarrhea between the zinc and placebogroup.Methods: A double blind randomized controlled trial is done to find out aboutthe effect of zinc supplementation to the duration, signs and symptoms on acutediarrheal in hospitalized adults patients in Pertamina Central Hospital in Jakartafrom January-December 2013. The data is analyzed using chi-square test (x2) forcomparing the duration of diarrhea and general linear model (GLM) to assesstrend changes accompanying symptoms of diarrhea.Results: Analysis of the data from 84 patients: 30 males [19 zinc, 11 placebo]and 54 females [23 zinc, 31 placebo] ~ (p 0.111) obtained zinc supplementationsignificantly reduced the duration of acute diarrhea (p 0.027) and significantlyreduce the symptoms of nausea (p 0.032). In addition there is trend ofimprovement in some acute diarrhea associated symptoms, such as abdominalpain, frequency of diarrhea, stool consistency, vomiting, bloating, and disruptionof daily activities.Conclusion: Zinc supplementation significantly reduce the duration of diarrhea,significantly reduce the symptoms of nausea; besides, improving some symptomsaccompanying acute diarrhea.;Background: Acute diarrhea is a common problem in developing countries suchas Indonesia; which is found in everyday practice with quite high morbidity andmortality rate. It was revealed in adult acute diarrhea patients in several hospitalsin Jakarta the levels of zinc deficiency was 69.3%. Zinc has been proven to bebeneficial in the treatment of acute diarrhea in pediatric patients.Objective: To discover the effectiveness of zinc supplementation as an adjuvanttherapy in acute diarrhea for adult patients by comparing the duration and theseverity of signs and symptoms of acute diarrhea between the zinc and placebogroup.Methods: A double blind randomized controlled trial is done to find out aboutthe effect of zinc supplementation to the duration, signs and symptoms on acutediarrheal in hospitalized adults patients in Pertamina Central Hospital in Jakartafrom January-December 2013. The data is analyzed using chi-square test (x2) forcomparing the duration of diarrhea and general linear model (GLM) to assesstrend changes accompanying symptoms of diarrhea.Results: Analysis of the data from 84 patients: 30 males [19 zinc, 11 placebo]and 54 females [23 zinc, 31 placebo] ~ (p 0.111) obtained zinc supplementationsignificantly reduced the duration of acute diarrhea (p 0.027) and significantlyreduce the symptoms of nausea (p 0.032). In addition there is trend ofimprovement in some acute diarrhea associated symptoms, such as abdominalpain, frequency of diarrhea, stool consistency, vomiting, bloating, and disruptionof daily activities.Conclusion: Zinc supplementation significantly reduce the duration of diarrhea,significantly reduce the symptoms of nausea; besides, improving some symptomsaccompanying acute diarrhea., Background: Acute diarrhea is a common problem in developing countries suchas Indonesia; which is found in everyday practice with quite high morbidity andmortality rate. It was revealed in adult acute diarrhea patients in several hospitalsin Jakarta the levels of zinc deficiency was 69.3%. Zinc has been proven to bebeneficial in the treatment of acute diarrhea in pediatric patients.Objective: To discover the effectiveness of zinc supplementation as an adjuvanttherapy in acute diarrhea for adult patients by comparing the duration and theseverity of signs and symptoms of acute diarrhea between the zinc and placebogroup.Methods: A double blind randomized controlled trial is done to find out aboutthe effect of zinc supplementation to the duration, signs and symptoms on acutediarrheal in hospitalized adults patients in Pertamina Central Hospital in Jakartafrom January-December 2013. The data is analyzed using chi-square test (x2) forcomparing the duration of diarrhea and general linear model (GLM) to assesstrend changes accompanying symptoms of diarrhea.Results: Analysis of the data from 84 patients: 30 males [19 zinc, 11 placebo]and 54 females [23 zinc, 31 placebo] ~ (p 0.111) obtained zinc supplementationsignificantly reduced the duration of acute diarrhea (p 0.027) and significantlyreduce the symptoms of nausea (p 0.032). In addition there is trend ofimprovement in some acute diarrhea associated symptoms, such as abdominalpain, frequency of diarrhea, stool consistency, vomiting, bloating, and disruptionof daily activities.Conclusion: Zinc supplementation significantly reduce the duration of diarrhea,significantly reduce the symptoms of nausea; besides, improving some symptomsaccompanying acute diarrhea.]"