Background: Reporting cases of Dengue Hemorrhagic Fever (DHF) based on case definition the Ministry of Health of the Republic Indonesia is a strategy to increase the ability to predict positive cases. Our study aims to examine the implementation of case reporting so as to improve the predictive ability of positive cases.Methods: We conducted operational research at Kertha Usada General Hospital and Buleleng District Hospital. The sample is individuals diagnosed with DHF by a hospital having their address in Buleleng District and undergoing inpatient treatment at Kertha Usada General Hospital and Buleleng District Hospital in the first week of October 2021. We collected data through a review of medical record documents using a checklist.Result: We evaluated among 10 cases, 6 cases (60.0%) of whom were over 12 years old and 7 cases (70.0%) were men. Based on clinical indicators, among 10 cases, all cases (100%) actually had fever between 2-7 days, 5 cases (50%) really had headaches, 4 cases (40%) really had abdominal pain and 8 cases (80%) actually vomiting. Based on laboratory indicators, among all 10 cases (100%) there was a decrease in platelets <100,000 u/L and in 1 case (10%) there was an increase in hematocrit >52%.Conclusion : The positive predictive value obtained is 100% with very good positive predictive ability. Reporting cases based on the Ministry of Health of the Republic Indonesia case definition is expected to be carried out an ongoing basis because it can improve the ability to predict positive cases. Periodic training and technical guidance are required to equalize perceptions of case definitions so as to improve reporting quality.
Buleleng is district with the highest cases of Dengue Hemorrhagic Fever (DHF) in Indonesia on 2021. To reduce morbidity and prevent the event of the outbreak, it is necessary to evaluate the surveillance system. The purpose of this study was to evaluate the implementation of DHF surveillance in the Buleleng District. This research is a qualitative study conducted during the Covid-19 pandemic. The research location was in the Buleleng District to 27 informants consisting of one surveillance officer from the district health office and 26 surveillance officers from the hospitals and primary health care. Primary data collected using in-depth interviews and secondary data using document studies. This research uses the triangulation technique, analyzed of respondent characteristics was carried out using descriptive analysis assisted by IBM SPSS Statistics version 22 presented using tables and surveillance attribute analysis is carried out by data reduction presented in narrative form. The results showed that 11.1% of officers were still educated to high school, 25.9% of officers had never been trained, 92.6% of officers carried out multiple tasks, 3.7% of officers held programs under one year, 29.6% of officers were aged above 40 years, there is no budget for the empowerment of larva monitoring program, sensitivity and positive predictive value is quite low, data quality, acceptability, representativeness and stability are not optimal. The implementation of the surveillance has not been optimal due to limited manpower, cost and unfulfilled standards for several surveillance attributes. Reporting and diagnosis of cases need to be improved as the first step in efforts to prevent and control DHF.
Latar belakang dan tujuan: Demam Berdarah Dengue (DBD) merupakan masalah kesehatan masyarakat di Provinsi Bali terutama di Kota Denpasar dengan angka insiden tahun 2014 sebesar 217,7/100.000 penduduk. Angka tersebut jauh lebih tinggi dari angka insiden nasional sebesar 51/100.000 penduduk. Dengue Shock Syndrome (DSS) masih sering dijumpai dengan kematian yang cukup tinggi. Penelitian ini bertujuan untuk mengetahui faktor risiko DSS pada pasien DBD yang dirawat inap di Rumah Sakit Umum Daerah (RSUD) Wangaya Denpasar.Metode: Rancangan penelitian adalah kasus kontrol dengan jumlah kasus sebanyak 47 yaitu seluruh pasien DSS dan kontrol sebanyak 94 yang dipilih secara acak sistematik dari semua pasien DBD yang dirawat inap di RSUD Wangaya tahun 2013-2014. Data faktor risiko diperoleh dari rekam medik yaitu umur, jenis kelamin, lama demam, riwayat DBD, hematokrit, trombosit, kelas perawatan dan jaminan kesehatan.Hasil: Faktor yang secara independen terbukti berhubungan dengan kejadian DSS adalah riwayat infeksi DBD dengan adjusted OR=11,6 (95%CI=1,83-73,96), lama demam sebelum masuk rumah sakit ≥4 hari dengan adjusted OR=5,5 (95%CI: 2,03-14,96), hematokrit ≥42% dengan adjusted OR=2,8 (95%CI: 1,02-7,68), trombosit <50.000/mm3 dengan adjusted OR=5,2 (95%CI: 1,88-14,36) dan perawatan di Kelas III dengan adjusted OR=2,9 (95%CI: 1,01-8,29).Simpulan: Riwayat infeksi DBD sebelumnya dan keterlambatan mengenali gejala DBD meningkatkan risiko terjadinya DSS. Selain itu kelas perawatan juga meningkatkan risiko terjadinya DSS.
The incidence of Dengue Hemorrhagic Fever (DHF) in Buleleng District during COVID-19 pandemic was very high. Mortality cases in 2021 will double from 2020. We conducted a case-control study in two sub-districts Buleleng District. A total of 143 samples were obtained by total sampling divided into cases and controls traced from February 1-28, 2021. Cases were individuals diagnosed by the hospital. Controls were individuals selected from the case environment and did not experience symptoms of DHF. We collected data door-to-door and data from a cohort of DHF sufferers. We processed and analyzed data using the IBM SPSS version 22 application. Inferential analysis used Chi-Square or Fisher-Exact statistical tests. We found 76 cases of DHF and 2 of them died. AR in urban areas was higher than rural areas with 4 per 10,000 and a CFR of 0.62%. A total of 45 cases were male. A total of 46 cases were in the young age group. The presence of larvae (OR: 2.01 95%CI: 1.3- 3.03), open containers (OR: 2.2 95%CI: 1.2-4.2), open rubbish bins (OR: 3.1 95%CI: 1.7-5.4) in urban areas and the presence of larvae (OR: 2.5 95% CI: 1.1-5.3), open containers (OR: 2.5 95% CI: 0.8-8.1) in rural areas were significantly associated with DHF outbreaks during the COVID-19 pandemic. The presence of larvae, open containers, and open rubbish bins are associated with DHF outbreaks during the COVID-19 pandemic. It is necessary to intensify surveillance approaches and community empowerment in eradicating mosquito nests to limit the area of transmission. ABSTRAKKejadian Demam Berdarah Dengue (DBD) di Kabupaten Buleleng pada masa pandemi COVID-19 sangat tinggi. Kasus kematian tahun 2021 meningkat dua kali lipat dari tahun 2020. Kami melakukan penelitian kasus kontrol pada dua kecamatan Kabupaten Buleleng. Sebanyak 143 sampel diperoleh dengan total sampling dibagi menjadi kasus dan kontrol yang ditelusuri mulai tanggal 1-28 Februari 2021. Kasus adalah individu yang didiagnosis oleh rumah sakit. Kontrol adalah individu yang dipilih dari lingkungan kasus dan tidak mengalami gejala DBD. Kami mengumpulkan data secara door to door dan dari data kohort penderita DBD. Kami mengolah dan menganalisis data menggunakan aplikasi IBM SPSS versi 22. Analsisis inferensial menggunakan uji statistik Chi-Square ataupun Fisher-Exact. Kami menemukan 76 kasus DBD dan 2 diantaranya meninggal dunia. AR di daerah perkotaan lebih tinggi dibandingkan pedesaan dengan 4 per 10.000 dan CFR 0,62%. Sebanyak 45 kasus adalah laki-laki. Sebanyak 46 kasus berada pada kelompok usia muda. Keberadaan jentik (OR: 2.01 95%CI: 1.3-3.03),kontainer terbuka (OR: 2.2 95%CI: 1.2-4.2),tempat sampah terbuka (OR: 3.1 95%CI: 1.7 -5.4) di daerah perkotaan dan keberadaan jentik (OR: 2,5 95% CI: 1.1-5.3), kontainer terbuka (OR: 2,5 95% CI: 0.8-8.1) di daerah perdesaan secara signifikan berhubungan dengan wabah DBD pada masa pandemi COVID-19. Keberadaan jentik, kontainer terbuka dan tempat sampah terbuka berhubungan dengan wabah DBD pada masa pandemi COVID-19. Pendekatan surveilans aktif dan pemberdayaan masyarakat dalam pemberantasan sarang nyamuk perlu dilakukan untuk membatasi daerah penularan.
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