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DIARE & WATER RELATED DISEASE Kurnia Dwi Artanti. Definisi. Hippocrates pengeluaran tinja yang tidaknormal dan cair Bagian ilmu kesehatan anak FK UI / RSCM buang air besar yang tidaknormal atau bentuk tinja encer,,frekuensi lebih banyak dari frekuensi biasanya. - PowerPoint PPT Presentation

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  • DIARE & WATER RELATED DISEASE

    Kurnia Dwi Artanti

  • DefinisiHippocratespengeluaran tinja yang tidaknormal dan cairBagian ilmu kesehatan anak FK UI / RSCMbuang air besar yang tidaknormal atau bentuk tinja encer,,frekuensi lebih banyak dari frekuensi biasanya

  • Neonatus frekuensi buang air besar frekuensi buang air besar> 4 x(bayi >1 bulan dan anak frekuensinya 3x Bayi (ASI) tidakjarang frekuensi defekasinya > 3- 4 x seharitidak disebut diare (fisiologis )Bila seorang anak defekasinya < 3x sehari konsistensi encer diare

  • Menurut WHODefekasi encer > 3 x sehari dengan/ tanpa darah dan/ atau lendir dalam tinjaDiare akut diare yang terjadi secara mendadak dan berlangsung < 7 hari pada bayi dan anak yang sebelumnya sehat.

  • GLOBALCauses of Death in Children Under 5 Years INDONESIAYR 2000 - 2003Bryce J, et.al., 2005WHO,2006ASIA WHO SEAROYR 2002www.who.int.orgDIARRHEA

    Chart1

    0.38

    0

    0.18

    0.05

    0

    0.14

    0.03

    0.22

    Sales

    Sheet1

    Sales

    Neonatal38%

    HIV/AIDS0%

    Diarrhea18%

    Measles5%

    Malaria0%

    Pneumonia14%

    Injuries3%

    Others22%

    Chart1

    0.37

    0.19

    0.17

    0.08

    0.04

    0.03

    0.03

    0.1

    Column1

    Sheet1

    Column1

    Neonatal37%

    Pneumonia19%

    Diarrhea17%

    Malaria8%

    Measles4%

    Injuries3%

    HIV/AIDS3%

    Other10%

  • Causes of Mortality in Under-five Children in IndonesiaBasic Health Research (Riskesdas), 2007DIARRHEA 28%PNEUMONIA20%

  • ETIOLOGY OF U5 DIARRHEA IN INDONESIAHospital Surveillance at Sardjito hospital BY Ministry of Health & NAMRU2 research, 200584% RV; 16% bacterial 10 yrs0303

    Total9210212206

    Bakteri

    NPF888711186

    Shigella Flexnedi0505

    Aeromonas Hydrophilla0101

    Aeromonas Sp0011

    S. Sonnei0101

    Salmonella C20101

    Salmonella E1203

    Salmonella Typki0101

    Campylobacter Jejuni2305

    S. Enteritidis0101

    Ve Inaba1001

    Total9210212206

    Parasit

    Negative9110210203

    Giardia Lambila1001

    No Result0022

    Total9210212206

    Sheet1

    0

    0

    0

    0

    0

    0

    0

    0

    0

    0

    0

    Sheet2

    0

    0

    0

    0

    0

    0

    0

    0

    0

    0

    Sheet3

  • Risk in PopulationTotal Events24 million outpatient visits2.4 million inpatient visits114 million episodes610,000 deaths1 : 2051 : 501 : 51 : 1GLOBAL BURDEN OF ROTAVIRUS DIARRHEAGlass, R et al. Lancet 2006; 368:323-332611,000 (Parashar,2006)

  • Global Child deaths due to Rotavirus

  • MOH, 2003LEADING CAUSES OF DEATHIN CHILDREN U 5

    Chart2

    30.525

    1512.5

    511

    65

    30.5

    0.510.5

    1995

    2000

    Morbidity

    19891990199119921993199620002003

    Morbidity0.7841.0260.8720.7890.8411.0781.2781.084

    Morbidity

    0

    0

    0

    0

    0

    0

    0

    0

    Morbidity

    Mortality

    19721980198619921996

    Death4024.9167.57.4

    Diarrhoea patients

    No. of cases

    1996133

    1997280

    1998214

    1999241

    2000238

    2001277

    2002255

    2003280

    2004278

    2005245

    Sheet4

    Hasil Pemeriksaan Bulan Maret 2004

    KeteranganBakteriParasit

    Positive20

    Negative35

    No Test00

    Total55

    Hasil Pemeriksaan Bulan April 2004

    KeteranganBakteriParasit

    Positive61

    Negative3033

    No Test02

    Total3636

    distribusi populasi Indo.

    1970's1980's1990's2000's

    Sumatera23586280163649643305

    Jawa7608591263107580121341

    Kalimantan51526722909811331

    Sulawesi8524104081252014945

    Irian923117316482220

    2000's

    Sumatera43305

    Jawa121341

    Kalimantan11331

    Sulawesi14945

    Irian2220

    distribusi populasi Indo.

    0

    0

    0

    0

    0

    2000's

    Disease burden

    00000

    00000

    00000

    00000

    Sumatera

    Jawa

    Kalimantan

    Sulawesi

    Irian

    Data kematian anak

    CasesDiarrhoeaRotavirusDeaths

    892913217052

    1321

    705

    2

    Data kematian anak

    0000

    Cases

    Diarrhoea

    Rotavirus

    Deaths

    diarrhoea8%19952000

    tiphoid15%ARI30.525

    other infection8%diarrhoea1512.5

    neoplasm11%nervous system511

    respiratory inf8%parasitic & other infection65

    gastroenterology9%tetanus30.5

    accident13%thyphoid0.510.5

    00

    00

    00

    00

    00

    00

    1995

    2000

  • Economic crisisMortalityMorbidityDiarrhea in Indonesia

    Chart1

    0.784

    1.026

    0.872

    0.789

    0.841

    1.078

    1.278

    1.084

    Morbidity

    Morbidity

    19891990199119921993199620002003

    Morbidity0.7841.0260.8720.7890.8411.0781.2781.084

    Morbidity

    0

    0

    0

    0

    0

    0

    0

    0

    Morbidity

    Mortality

    19721980198619921996

    Death4024.9167.57.4

    Diarrhoea patients

    No. of cases

    1996133

    1997280

    1998214

    1999241

    2000238

    2001277

    2002255

    2003280

    2004278

    2005245

    Sheet4

    Hasil Pemeriksaan Bulan Maret 2004

    KeteranganBakteriParasit

    Positive20

    Negative35

    No Test00

    Total55

    Hasil Pemeriksaan Bulan April 2004

    KeteranganBakteriParasit

    Positive61

    Negative3033

    No Test02

    Total3636

    distribusi populasi Indo.

    1970's1980's1990's2000's

    Sumatera23586280163649643305

    Jawa7608591263107580121341

    Kalimantan51526722909811331

    Sulawesi8524104081252014945

    Irian923117316482220

    2000's

    Sumatera43305

    Jawa121341

    Kalimantan11331

    Sulawesi14945

    Irian2220

    distribusi populasi Indo.

    0

    0

    0

    0

    0

    2000's

    Disease burden

    00000

    00000

    00000

    00000

    Sumatera

    Jawa

    Kalimantan

    Sulawesi

    Irian

    Data kematian anak

    CasesDiarrhoeaRotavirusDeaths

    892913217052

    1321

    705

    2

    Data kematian anak

    0000

    Cases

    Diarrhoea

    Rotavirus

    Deaths

    diarrhoea8%19952000

    tiphoid15%ARI30.525

    other infection8%diarrhoea1512.5

    neoplasm11%nervous system511

    respiratory inf8%parasitic & other infection65

    gastroenterology9%tetanus30.5

    accident13%thyphoid0.510.5

    00

    00

    00

    00

    00

    00

    1995

    2000

  • Kematian Anak-Bayi Berdasarkan Jenis PenyakitSoeparto. Sumbangan & Peran kaum Profesional dalam Mendukung Program penyakit Saluran Cerna di era otonomi, Lab/SMF IKA FK Unair/RSUD dr. Soetomo. Surabaya

    NoJenis Penyakit1980(%)1985 (%)1992 (%)1.Diare22.9615.727.72.Penyakit Menular1.168.651.73.Kurang Gizi0.391.750.74.Penyakit Saluran Cerna22.5714.1325.25.Gangguan Perinatal11.7318.2030.86.Infeksi3.894.625.67.Tetanus9.8319.606.6

  • MOH, 2003LEADING CAUSES OF DEATHIN CHILDREN U 5

    Chart2

    30.525

    1512.5

    511

    65

    30.5

    0.510.5

    1995

    2000

    Morbidity

    19891990199119921993199620002003

    Morbidity0.7841.0260.8720.7890.8411.0781.2781.084

    Morbidity

    0

    0

    0

    0

    0

    0

    0

    0

    Morbidity

    Mortality

    19721980198619921996

    Death4024.9167.57.4

    Diarrhoea patients

    No. of cases

    1996133

    1997280

    1998214

    1999241

    2000238

    2001277

    2002255

    2003280

    2004278

    2005245

    Sheet4

    Hasil Pemeriksaan Bulan Maret 2004

    KeteranganBakteriParasit

    Positive20

    Negative35

    No Test00

    Total55

    Hasil Pemeriksaan Bulan April 2004

    KeteranganBakteriParasit

    Positive61

    Negative3033

    No Test02

    Total3636

    distribusi populasi Indo.

    1970's1980's1990's2000's

    Sumatera23586280163649643305

    Jawa7608591263107580121341

    Kalimantan51526722909811331

    Sulawesi8524104081252014945

    Irian923117316482220

    2000's

    Sumatera43305

    Jawa121341

    Kalimantan11331

    Sulawesi14945

    Irian2220

    distribusi populasi Indo.

    0

    0

    0

    0

    0

    2000's

    Disease burden

    00000

    00000

    00000

    00000

    Sumatera

    Jawa

    Kalimantan

    Sulawesi

    Irian

    Data kematian anak

    CasesDiarrhoeaRotavirusDeaths

    892913217052

    1321

    705

    2

    Data kematian anak

    0000

    Cases

    Diarrhoea

    Rotavirus

    Deaths

    diarrhoea8%19952000

    tiphoid15%ARI30.525

    other infection8%diarrhoea1512.5

    neoplasm11%nervous system511

    respiratory inf8%parasitic & other infection65

    gastroenterology9%tetanus30.5

    accident13%thyphoid0.510.5

    00

    00

    00

    00

    00

    00

    1995

    2000

  • RV DISEASE BURDEN IN YOGYAKARTAAND CENTRAL JAVA (2001 2004)8929 cases of < 5 children1397 diarrhea cases(100%)705 rotavirus diarrhea(53.4%)36 severe dehydration(5.1%)2 deaths (RV positive)(0.03%)440 dehydration(62.4%)

    Chart2

    25001321705440300200

    Chart1

    606060606060

    Morbidity

    19891990199119921993199620002003

    Morbidity0.7841.0260.8720.7890.8411.0781.2781.084

    Morbidity

    0

    0

    0

    0

    0

    0

    0

    0

    Morbidity

    Mortality

    19721980198619921996

    Death4024.9167.57.4

    Diarrhoea patients

    No. of cases

    1996133

    1997280

    1998214

    1999241

    2000238

    2001277

    20022