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VAKSIN ROTAVIRUS: APAKAH SUDAH WAKTUNYA DIMASUKKAN DALAM PROGRAM IMUNISASI NASIONAL DI INDONESIA? Wilopo, Siswanto Agus
Jurnal Manajemen Pelayanan Kesehatan Vol 12, No 02 (2009)
Publisher : Jurnal Manajemen Pelayanan Kesehatan

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (236.753 KB)

Abstract

Background: Two rotavirus vaccines have been availablefor use. The objectives of the study to examine disease burdenof diare rotavirus and the cost and effectiveness of a rotavirusvaccination program in Indonesia.Material and Methods:  Data on direct and indirect costs ofchildren with rotavirus diarrhea were established in PurworejoDistrict and Yogyakarta city. It was extrapolated to nationalestimates on the basis of the projected birth cohort in 2007and diarrhea morbiditity rate at national level. The main outcomemeasures were economic burden and cost-effectiveness ratio(Rupiah per DALY averted).Results: The disease burden is equivalent to an economicburden of an estimated Rp390.4 billion in medical direct costs,Rp 67.3 bilion in nonmedical direct costs, and 70.4 billion rupiahin indirect costs. From the health care system and communityperspectives, universal vaccination of infants at a cost of lessthan US $12,7 for a vaccine dose would be a cost-effective ofpublic health intervention.Conclusions and Recommendation: In Indonesia, rotavirusvaccination would reduce the morbidity burden of rotavirusinfection, but would not be cost-effective unless the price ofvaccine decreased considerably. At the current price ofvaccine, universal vaccination program for rotavirus wouldnot be recommended.Keywords: burden of disease, rotavirus diarrhea vaccine,cost-effectiveness
Estimasi Pengaruh Vaksin DPT pada Kematian Anak: Analisis Multivariabel data Survailan Demografi dan Kesehatan di Kabupaten Purworejo Wilopo, Siswanto Agus
Berita Kedokteran Masyarakat (BKM) Vol 25, No 1 (2009)
Publisher : Berita Kedokteran Masyarakat (BKM)

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Abstract

Background: Recent  controversial  reports  suggest  that  recipients  of  one dose  of DTP  vaccines had  higher mortality  than  children who  had  received  no DTP  vaccine. We   reanalyzed data  on vaccination  and  child  survival collected  from demographic  and health  surveillance  to  challenge previous  findings.Objectives: To estimate specific and non-specific effects of DTP vaccination on child mortality age 1-24 months under  routine vaccination  program  in  Indonesia.Methods: A  longitudinal  surveillance  data  provided  information  on 5647  children  below  24 months  of age who received DTP and  other vaccinations. The main  outcome measure was all-cause mortality. Background  factors associated with mortality were  collected,  such as:  sex,  birth  order, dead  sibling, mother’s  education and  family size. We assessed DTP vaccinations  as an  independent  factor with other  variables  in Cox’s  regression models with  time  dependent  covariates.Results: There  is  no  sex  differential  of mortality  among  children  in  Purworejo  even  after  considering  other factors using Cox  regression  analysis. Mortality was  lower  in  the  group  vaccinated with DTP vaccine  compared with  those  not  vaccinated,  the  relative  risk  of mortality  (RR)  being  0.56 with  95%  confidence  interval  (CI)  is 0.453–0.690. After controlling  for  the  background  factors,  recipient of DPT vaccines  continued  to  have  a  lower mortality with RR=0.74  (95% CI:  0.586–0.925). BCG  and measles  vaccines have  stronger  non-specific  effects compared  to  effects  of DTP  vaccines.Conclusion:    Through  specific  effect  against  targeted  diseases  and  a  non-specific  benefit  against  others illnesses,  the study  showed  reduced mortality among  children who  received DTP  vaccine. There  is no  reason to  change current  vaccination policy  because DTP was not  associated with  any  harmful  effect  among  girls.Keywords: non-specific  effects, DTP  Vaccine,  child  survival, Cox’s Regression
Estimasi Pengaruh Vaksin DPT pada Kematian Anak: Analisis Diskritif Data Surveilan Demografi dan Kesehatan di Kabupaten Purworejo Wilopo, Siswanto Agus
Berita Kedokteran Masyarakat (BKM) Vol 24, No 3 (2008)
Publisher : Berita Kedokteran Masyarakat (BKM)

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Abstract

Background: Recent  controversial  reports  suggest  that  recipients  of  one  dose  of DTP  vaccine  have  higher mortality  than  children who  have  received  no DTP  vaccine. Those  reports were mainly  derived  from African countries where mortality and malnutrion were  higher  than  Indonesia.Objectives: To  describe  specific  and  non-specific  effects  of DTP  vaccination  on  child mortality  age  1-24 months under  routine vaccination  program  in  Indonesia.Methods: During  period of  January 1  1995  to August 31,  2001  our  longitudinal  surveillance  data at  Purworejo district provided  information on 5647 children below 24 months of age who  received DTP and other vaccinations. The main  outcome measure was  all-cause mortality. Vaccination  status  on DTP, BCG,  and measles were collected  every  90 days  and  recorded  its  time  at  vaccination. Confounding  factors  associated with mortality were  also collected. This  first  report used  descriptive analysis  and a  survival curve  (Kaplan-Meier)  to  examine the  differential of mortality according  to sex  of  the  children and  among vaccinated  and  non-vaccinated  children with DTP, BCG,  and measles vaccines. The second  report will  use  survival  analysis  to  estimate specific  and non-sprecific  effects  of DTP  by  considering  time at  vaccination and  other counfounding  factors.Results: There  is no  sex differential  of mortality among  children  in Purworejo.  A  probability of  dying was  lower in  the  children vaccinated with DTP  vaccine compared with  those  not vaccinated DTP. Simmilarly,  vaccinated children with  BCG  and measles  have  lower mortality  compared  to  unvaccinated  children.  There  is  strong indication  that BCG and measles  have  stronger protected  effects  to  risk of  dying  than DTP.Conclusion:   The study showed  lower mortality among children who  received DTP, BCG, and measles vaccines compared  those unvaccinated.  There were  not enough  evidences  to  change current  vaccination policy  because DTP was not  associated with  any harmful  effect  among  girls.Keywords: non-specific  effects, DTP  vaccine–child  survival-  Kaplan Meier’s Curve
Injury In Preschool-Age Children: A Population-Based Study Surjono, Achmad; Sastrowijoto, Soenarto; Wilopo, Siswanto Agus; Rusito, Harun
Paediatrica Indonesiana Vol 35 No 9-10 (1995): September - October 1995
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (480.539 KB) | DOI: 10.14238/pi35.9-10.1995.231-5

Abstract

A study on the type and frequency of injuries in preschool-age children was conducted in a sample of households representing population of Purworejo district. A two stages cluster (wilcah) method was used to select 4.354 preschool-age children living in 12,721 households in the district. The mother or other child caretakers provided responses about injuries occurring during the 3 months period to interview. Injuries among these preschool-age children included trauma by cutting or sharp object (6.5%), falls (5.7%), bums (0.6%), bites (0.4%), traffic accident (0.4%), unconsciousness (0.2%) and poisoning (0 .1 %). The typical injury in under the 12 months olds was falls. Children aged 12 to 23 month accounted for 18% of the injury episodes which were typical fall and trauma. Children aged 24 to 59 months accounted for 76.6% of injury episodes which were typically trauma, falls, bums, bites and traffic accident. No statistical differences in the frequency and type on injuries were observed between urban and rural areas. The relative frequency in age-grouped and type of injuries from this population-based study can be used in planning injury prevention especially for family health education program.
Pemberian Makanan Pralaktasi dengan Kelangsungan Hidup Bayi di Indonesia Dewi, Utami; Wilopo, Siswanto Agus; Wibowo, Tunjung
JURNAL KESEHATAN REPRODUKSI Vol 4, No 1 (2017)
Publisher : Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan UGM

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (615.089 KB) | DOI: 10.22146/jkr.35436

Abstract

Background: It is recommended for a mother to initiate to give early breastfeeding for a newborn as the first breast milk is known to be nutritious and contains antibody. The delay of breastfeeding shows that non breast milk-supplementary food is given. Based on BPS and Macro International data 65% of infants received pre-lacteal feeds besides breast milk in their three days of life.Objective: the known relationship between pre-lacteal feeds and infants’ survival in Indonesia.Method: This was an observational study with a cohort retrospective study design by using IDHS data year 2007. Samples were all infants (0-12 months, breastfed after birth) from mothers aged 15-49 years old as many as 2,886 mothers. The independent variable was pre-lacteal feeds after birth and the dependent variable was infants’ survival. The analyses used univariable, bivariable, and survival analysis with KaplanMeier, Log regression and Cox regression.Result and Discussion: Bivariable analysis using survival Kaplan-Meier showed that there was a significant relationship between pre-lacteal feeds after birth and infants’ survival. The survival of infants who received pre-lacteal feeds was greater than that of infants who did not receive pre-lacteal feeds (92%:89%). Multivariable analysis using Cox regression showed that the survival chance in infants who did not receive pre-lacteal feeds was 0.63 times lower than that in infants who received pre-lacteal feeds (HR 0.63; CI 95%=0.42-0.95).Conclusion: Pre-lacteal feeds showed a significant result with infant survival. Other factors affecting infant’s survival were mother’s age < 20 and ≥ 35 years, low economic status, and birth assistant with non professional.Keywords: infant’s survival, pre-lacteal feeds, infant
Pola, tren, dan perbedaan praktik menyusui di Indonesia: analisis deskriptif peran modernisasi dan budaya tradisional dari data Survei Demografi Kesehatan Indonesia 2007 Wilopo, Siswanto Agus
Jurnal Gizi Klinik Indonesia Vol 6, No 1 (2009): Juli
Publisher : Minat S2 Gizi dan Kesehatan, Prodi S2 IKM, FK-KMK UGM

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (5177.513 KB) | DOI: 10.22146/ijcn.17688

Abstract

Background : A modernization can lead to the adoption of western behavior while cultural values can also prevails, resulting in rejection of certain aspects of modernity. The question is how such conflicting forces affect breastfeeding practices in Indonesian women. Objective : This study examined modern and traditional factors that may affect pattern, trends and differentials of breastfeeding in Indonesia. Methods : The study based on data from Indonesian Demographic Health Survey (IDHS) conducted in 2007. There were 32.895 women or 19.939 children born after January 2002 and contributed to this information. We used duration of breastfeeding as dependent variables which based on information pertained to the last two children of respondent. The variable was calculated as the number of months that the mother reports having breastfed the child. The early use of supplementary food for children and the use of health services were examined to represent cultural values and modernity respectively. Socio-economic and demographic variables were considered important variables for breastfeeding practices. Kaplan Meier graphs were employed for the analysis of pattern, trends, and differentials of breastfeeding.Result : In Indonesia, the duration of breastfeeding varied between provinces. There was a trend of shortening of duration breastfeding about two months during 5 years period. Factors associated with modernity were significant determinant in shortening breastfeeding practice. These included: type of residence (urban or rual), level of education, prenatal care, previous or ever use of contraceptives, delivery at the hospital, and the use of an infant formula. Conclusion : Factors associated with modernity were significant in terms of early termination of breastfeeding. Traditional factors associated with breastfeeding practice did not show significant roles in maintaining the breastfeeding practice. We recommend to use a social enginering to include breastfeeding practice as a part of modern health practices.
Pola, tren, dan perbedaan praktik menyusui di Indonesia: analisis deskriptif peran modernisasi dan budaya tradisional dari data Survei Demografi Kesehatan Indonesia 2007 Wilopo, Siswanto Agus
Jurnal Gizi Klinik Indonesia Vol 6, No 1 (2009): Juli
Publisher : Minat S2 Gizi dan Kesehatan, Prodi S2 IKM, FK-KMK UGM

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/ijcn.17688

Abstract

Background : A modernization can lead to the adoption of western behavior while cultural values can also prevails, resulting in rejection of certain aspects of modernity. The question is how such conflicting forces affect breastfeeding practices in Indonesian women. Objective : This study examined modern and traditional factors that may affect pattern, trends and differentials of breastfeeding in Indonesia. Methods : The study based on data from Indonesian Demographic Health Survey (IDHS) conducted in 2007. There were 32.895 women or 19.939 children born after January 2002 and contributed to this information. We used duration of breastfeeding as dependent variables which based on information pertained to the last two children of respondent. The variable was calculated as the number of months that the mother reports having breastfed the child. The early use of supplementary food for children and the use of health services were examined to represent cultural values and modernity respectively. Socio-economic and demographic variables were considered important variables for breastfeeding practices. Kaplan Meier graphs were employed for the analysis of pattern, trends, and differentials of breastfeeding.Result : In Indonesia, the duration of breastfeeding varied between provinces. There was a trend of shortening of duration breastfeding about two months during 5 years period. Factors associated with modernity were significant determinant in shortening breastfeeding practice. These included: type of residence (urban or rual), level of education, prenatal care, previous or ever use of contraceptives, delivery at the hospital, and the use of an infant formula. Conclusion : Factors associated with modernity were significant in terms of early termination of breastfeeding. Traditional factors associated with breastfeeding practice did not show significant roles in maintaining the breastfeeding practice. We recommend to use a social enginering to include breastfeeding practice as a part of modern health practices.
Position and Chance of Indonesia Family Planing to Achieve RPJMN 2015-2019 and FP2020 Targets Pinandari, Anggriyani Wahyu; Wilopo, Siswanto Agus
KEMAS: Jurnal Kesehatan Masyarakat Vol 14, No 1 (2018)
Publisher : Department of Public Health, Faculty of Sport Science, Universitas Negeri Semarang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15294/kemas.v14i1.9466

Abstract

Indonesia’s commitment at London Summit 2012 was to reduce TFR by increasing contraceptive users by 2020. This paper aimed to estimate the number, trend and possibility to achieve RPJMN and FP2020 targets in Indonesia. This was a descriptive study using secondary data from Indonesia national survey. Data are presented in line, bar, and pie graphs, also table to explain trend and possibility of Indonesia FP to achieve 2020 targets. Using 2012 data as the baseline, RPJMN and FP2020 targets will be achieved if CPR grows 0.5 point/year. However, recent growth was insufficient, only 0.3 additional points. The current CPR is behind the target and 1 point/year growth rate is needed to approximate the target trajectory. Based on three surveys in 2015 (PMA, SUSENAS and SUPAS), Indonesia’s CPR was predicted to be 61.1% on 2020. This is five points lower than the 2020 target, 66.3%. This discrepancy shows that Indonesia would not achieve FP target on RPJMN 2015-2019. Based on recent survey in 2015, CPR trajectory is predicted to be 5 points below the target. 1.5 points annual growth is needed to achieve the 2020 goals.
Apakah penggunaan kontrasepsi hormonal mempercepat penyapihan? analisis data performance monitoring and accountability 2020 Husnawati, Husnawati; Pinandari, Anggriyani W.; Dasuki, Djaswadi; Wilopo, Siswanto Agus
Berita Kedokteran Masyarakat (BKM) Open Review Articles
Publisher : Fakultas Kedokteran Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/bkm.42814

Abstract

Purpose: Women's needs for contraception during breastfeeding is a contraceptive that is safe to use during breastfeeding. The use of contraception in Indonesia in 2016 is dominated by hormonal contraceptives. Combined hormonal contraception, especially those containing estrogen and progesterone, is one of the causes that interferes with the breastfeeding process by inhibiting prolactin, thereby reducing the production of breast milk and impacting breastfeeding coverage. This study aims to know the description of the effect of using hormonal contraception on weaning time. Method: This study used cross sectional design by using secondary data of Performance Monitoring and Accountability (PMA2020) Indonesia 2016, and analyzed by retrospective cohort. The study was conducted on women who had the last child born 5 years before the survey and breastfed, using contraception after giving birth with sample size 982 respondents. Kaplan-meier curve is used to see the probability of survival in the length of breastfeeding, statistical test log-rank to determine the relationship between each variable with the dependent variable. Multivariable analysis using cox regression. Results: There was a significant correlation between the use of hormonal contraception and breastfeeding status. Early weaning was found in women who used 1-month injectable hormonal contraception, HR  2.50 [1,31-4,76]. Education level, economic status and area of residence were associated with weaning  pvalue<0.05. Women who have a higher education level of 2.53 are faster to wean early. Rich economic status 1.50 times faster to wean earlier. The area of residence has a significant relationship to breastfeeding status p value<0.05 with CI95% (0.37-0.73). Conclusion: Women who used hormonal contraception with 1-month injections weaned their children earlier. The level of education, economic status and the area of residence are related to weaning.
Pemberian Makanan Pralaktasi dengan Kelangsungan Hidup Bayi di Indonesia Dewi, Utami; Wilopo, Siswanto Agus; Wibowo, Tunjung
JURNAL KESEHATAN REPRODUKSI Vol 4, No 1 (2017)
Publisher : Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan UGM

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jkr.35436

Abstract

Background: It is recommended for a mother to initiate to give early breastfeeding for a newborn as the first breast milk is known to be nutritious and contains antibody. The delay of breastfeeding shows that non breast milk-supplementary food is given. Based on BPS and Macro International data 65% of infants received pre-lacteal feeds besides breast milk in their three days of life.Objective: the known relationship between pre-lacteal feeds and infants’ survival in Indonesia.Method: This was an observational study with a cohort retrospective study design by using IDHS data year 2007. Samples were all infants (0-12 months, breastfed after birth) from mothers aged 15-49 years old as many as 2,886 mothers. The independent variable was pre-lacteal feeds after birth and the dependent variable was infants’ survival. The analyses used univariable, bivariable, and survival analysis with KaplanMeier, Log regression and Cox regression.Result and Discussion: Bivariable analysis using survival Kaplan-Meier showed that there was a significant relationship between pre-lacteal feeds after birth and infants’ survival. The survival of infants who received pre-lacteal feeds was greater than that of infants who did not receive pre-lacteal feeds (92%:89%). Multivariable analysis using Cox regression showed that the survival chance in infants who did not receive pre-lacteal feeds was 0.63 times lower than that in infants who received pre-lacteal feeds (HR 0.63; CI 95%=0.42-0.95).Conclusion: Pre-lacteal feeds showed a significant result with infant survival. Other factors affecting infant’s survival were mother’s age < 20 and ≥ 35 years, low economic status, and birth assistant with non professional.Keywords: infant’s survival, pre-lacteal feeds, infant