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Abstrak :
ABSTRAK
Latar Belakang: Efikasi vaksin influenza pada populasi usia lanjut masih menjadi perdebatan. Studi sebelumnya menunjukkan penurunan seroproteksi yang lebih cepat pada usia lanjut. Belum ada studi hubungan seroproteksi dengan influenza-like illness pada usia lanjut Tujuan: Mengetahui hubungan status vaksinasi dengan seroproteksi bulan pertama dan mengetahui hubungan antara seroproteksi bulan pertama dengan kejadian influenza-like illness selama 6 bulan pasca-vaksinasi pada usia lanjut. Metode: Studi kohort ambispektif ini menggunakan data penelitian induk dengan subjek usia lanjut ≥ 60 tahun yang tinggal di komunitas Posyandu lansia wilayah Jakarta Timur, dan data primer dalam periode Desember 2015-Maret 2016. Vaksinasi Influenza yang dievaluasi adalah vaksin influenza trivalen inaktif. Seroproteksi didefinisikan sebagai titer Hemagglutinin Inhibition ≥ 1:40. Influenza-like Illness sesuai kriteria WHO adalah infeksi pernapasan akut yang ditandai oleh demam (suhu ≥380C) dan batuk. Hasil: Terdapat 265 subjek pada penelitian ini, terdiri dari 133 subjek pada kelompok vaksinasi dan 132 subjek pada kelompok tidak vaksinasi. Proporsi seroproteksi pasca-vaksinasi pada bulan pertama, keempat, dan keenam adalah 92,5%; 83,5%; dan 74,4%. Analisis bivariat menunjukkan vaksinasi meningkatkan risiko terjadinya seroproteksi pada bulan pertama (RR 3,48,; IK 95% 2,61-4,65). Tidak ditemukan hubungan bermakna antara seroproteksi bulan pertama dengan insidens ILI selama 6 bulan pasca-vaksinasi (RR 0,325 IK 95% 0,04-2,641). Analisis multivariat menunjukkan OR seroproteksi setelah penyesuaian adalah 60,429 (IK 95% 25,323-144,206) dengan titer Hemagglutinin Inhibition ≥ 1:40 pra-vaksinasi sebagai variabel perancu. Simpulan: Proporsi seroproteksi pasca-vaksinasi pada bulan pertama, keempat, dan keenam adalah 92,5%; 83,5%; 74,4%. Terdapat hubungan bermakna antara status vaksinasi dengan seroproteksi. Tidak ditemukan hubungan bermakna antara seroproteksi bulan pertama dengan insidens influenza-like illness selama 6 bulan pasca-vaksinasi

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ABSTRACT
Background: The efficacy of influenza vaccines in the elderly is still being debated. Previous studies showed a faster decline of antibody titers in the elderly. The relationship between seroprotection with influenza-like illness in the elderly has not been established. Objective: To determine the relationship between vaccination status with seroprotection and to determine the relationship between first month seroprotection with the incidence of influenza-like illness 6 months postvaccination in the elderly. Methods: An ambispective cohort study was conducted using secondary data from the parent study of elderly subjects age ≥ 60 years who live in the community of Posyandu lansia in East Jakarta, and primary data taken from December 2015 to March 2016. The influenza vaccine evaluated was the Trivalent Inactivated Vaccine 2014/2015. Seroprotection defined as Hemagglutinin Inhibition titer ≥ 1:40. Influenza-like Illness according to WHO criteria is an acute respiratory infection characterized by fever (temperature ≥380 C) and cough. Results: There were 265 subjects in this study consisting of 133 subjects in the vaccine group and 132 subjects in the unvaccinated group. The proportion of post-vaccination seroprotection in the first, fourth, and sixth month was 92.5%; 83.5%; and 74.4%. Bivariate analysis showed vaccination increases the risk of seroprotection (RR 3.48 CI95% 2.61 to 4.65). Seroprotection achieved in the first month showed no statistical significance to the risk of ILI incidence 6 months after vaccination (RR 0.325 95% CI 0.04 to 2.641). Multivariate analysis showed adjusted OR for seroprotection is 60.429 (CI 95% from 25.323 to 144.206) with pre-vaccination Hemagglutinin Inhibition titer of ≥ 1:40 as the confounding variable

Abstrak :
[Latar belakang. Infeksi virus hepatitis B (VHB) di Indonesia masih tinggi dengan rerata prevalensi 9,4%. Tingginya prevalensi HB ini terkait dengan terjadinya infeksi VHB pada masa dini kehidupan, terutama melalui transmisi vertikal. Di Indonesia proporsi transmisi vertikal 45,9% dan 5,2% ibu hamil HBsAgnya positif. Cara paling efektif mengontrol infeksi VHB adalah dengan imunisasi, namun terdapat perbedaan seroproteksi titer anti-HBs pada usia lebih dari 10 tahun di berbagai tempat. Selain itu terdapat faktor-faktor yang dapat memengaruhi titer anti-HBs, namun penelitian ini masih jarang dan belum pernah dilakukan di Manado. Tujuan. Mengetahui seroproteksi titer anti-HBs dan faktor-faktor yang dapat memengaruhi titer anti- HBs tersebut. Metode. Penelitian analitik observational dengan desain potong lintang. Penelitian dilakukan dengan stratified random sampling pada usia 10-15 tahun di Kecamatan Tuminting, Kota Manado sejak Oktober sampai November 2014. Data dianalisis dengan SPSS 22. Hasil. Dari 48 sekolah terpilih 10 sekolah dengan 105 anak sebagai subyek penelitian, namun hanya 23 anak yang mempunyai seroprotektif (21,9%). Sebanyak 76 (72,4%) subyek adalah perempuan, 78 (74,3%) subyek berstatus gizi baik dan 98 (93,3%) subyek memiliki berat badan lahir ≥ 2.500 gram. Dari buku imunisasi didapatkan 26 (24,8%) subyek dengan vaksinasi HB-1 ≤ 7 hari dan 45 (42,9%) subyek dengan jarak HB-2 dan HB-3 ≥ 2 bulan. Didapatkan 86 (81,9%) ibu subyek berusia 20-35 tahun, 64 (60,9%) ibu subyek berpendidikan SMA dan 79 (75,2%) orangtua subyek berpenghasilan ≥ 2 juta per bulan. Analisis multivariat didapatkan faktor pemberian HB-1 < 7 hari atau ≥ 7 hari (p=0,02) dan jarak pemberian HB-2 dengan HB-3< 2 bulan atau ≥ 2 bulan (p<0,001) berperan terhadap seroproteksi HB pada anak. Simpulan. Penelitian ini mendapatkan angka seroproteksi HB yang rendah (21,9%) serta faktor pemberian HB-1 ≤ 7 hari atau > 7 hari dan jarak pemberian HB-2 dengan HB-3 < 2 bulan atau ≥ 2 bulan berperan terhadap seroproteksi HB pada anak usia 10-15 tahun.;Background. Hepatitis B viral (HBV) infection in Indonesia is still high with average prevalence of 9.4%. The high prevalence of hepatitis B (HB) is related to the occurence of HBV infection during the early life, especially through vertical transmission. In Indonesia proportion of vertical transmission 45.9% and 5.2% pregnant women have HBsAg positive. The most effective way to control HBV infection is with immunization HB, but there is differential in anti-HBs seroprotection titer at the age more than ten years in many locations. In addition there are factors that can affect anti-HBs titer, but these studies are rare and have ever been done in Manado. Objective. Knowing anti-HBs seroprotection titer and factors that can affect the anti-HBs titer. Method. Analitic observational study with cross sectional design. Research was done with stratified random sampling in children age 10-15 years old at Tuminting district, Manado city since October until November 2014. Analise data with SPSS 22. Results. From 48 schools, selected 10 schools with 105 children as subject of research, but only 23 (21.9%) children who were having seroprotective (21,9%). A total of 76 (72.4%) subjects were female, 78 (74.3%) subjects with good nutrition status and 98 (93.3%) subjects had ≥2,500 grams birth weight. From the immunization record book 26 (24.8%) subjects were obtained with HB-1 vaccination done at ≤7 days of age and 45 (42.9%) subjects with the distance between HB-2 and HB-3 were ≥2 months. Mother’s age was found 86 (81.9%) were 20-35 years old, 64 (60.9%) mothers’s education were high school graduated and 79 (75.2%) parents subjects had income ≥2 million per month. From multivariate analysis obtained that administration of HB-1 ≤7 days or >7 days (p=0.02) and distance between administration of HB-2 and HB-3 <2 months or ≥2 months (p<0.001) had important role in HB seroprotection in children. Conclusion. This study obtained a number of low HB seroptotection (21.9%) as well as administration of HB-1 ≤7 days or >7 days and distance between administration of HB-2 and HB-3 <2 months or ≥2 months had important role in HB seroprotection in children age 10-15 years old., Background. Hepatitis B viral (HBV) infection in Indonesia is still high with average prevalence of 9.4%. The high prevalence of hepatitis B (HB) is related to the occurence of HBV infection during the early life, especially through vertical transmission. In Indonesia proportion of vertical transmission 45.9% and 5.2% pregnant women have HBsAg positive. The most effective way to control HBV infection is with immunization HB, but there is differential in anti-HBs seroprotection titer at the age more than ten years in many locations. In addition there are factors that can affect anti-HBs titer, but these studies are rare and have ever been done in Manado. Objective. Knowing anti-HBs seroprotection titer and factors that can affect the anti-HBs titer. Method. Analitic observational study with cross sectional design. Research was done with stratified random sampling in children age 10-15 years old at Tuminting district, Manado city since October until November 2014. Analise data with SPSS 22. Results. From 48 schools, selected 10 schools with 105 children as subject of research, but only 23 (21.9%) children who were having seroprotective (21,9%). A total of 76 (72.4%) subjects were female, 78 (74.3%) subjects with good nutrition status and 98 (93.3%) subjects had ≥2,500 grams birth weight. From the immunization record book 26 (24.8%) subjects were obtained with HB-1 vaccination done at ≤7 days of age and 45 (42.9%) subjects with the distance between HB-2 and HB-3 were ≥2 months. Mother’s age was found 86 (81.9%) were 20-35 years old, 64 (60.9%) mothers’s education were high school graduated and 79 (75.2%) parents subjects had income ≥2 million per month. From multivariate analysis obtained that administration of HB-1 ≤7 days or >7 days (p=0.02) and distance between administration of HB-2 and HB-3 <2 months or ≥2 months (p<0.001) had important role in HB seroprotection in children. Conclusion. This study obtained a number of low HB seroptotection (21.9%) as well as administration of HB-1 ≤7 days or >7 days and distance between administration of HB-2 and HB-3 <2 months or ≥2 months had important role in HB seroprotection in children age 10-15 years old.]