BAHAN LATIHAN MAHASISWA

KASUS 1Mahasiswa melakukan praktik magang di puskesmas pleret kabupaten bantul. Mahasiswa diharapkan dapat membantu puskesmas dalam menentukan prioritas masalah di puskesmas tersebut. Berdasarkan profil Dinas kesehatan diperoleh data sebagai berikut:

Berdasarkan indikator angka kesakitan dan kematian sebagai berikut:1. Angka Kematian Ibu dilaporkan sebesar 140,13 per 100.000 kelahiran hidup2. Angka Kematian Bayi dilaporkan sebesar 13,23 per 1000 kelahiran hidup3. Angka Kematian Balita dilaporkan sebesar 0,12 per 1000 balita4. Angka kematian DBD dilaporkan 10 per 1000 kasus5. Angka kematian diare 1 per 10.000 kasus6. Angka kesakitan ibu 50 per 1000 kasus. 7. Angka Kesakitan DBD dilaporkan sebesar 45,1 per 100000 penduduk8. Angka Kesakitan Diare dilaporkan sebesar 15,01 permil9. Angka kesakitan TBC 10 per 10.000 penduduk.10. Angka kesembuhan TBC dilaporkan sebesar 88,27%11. Kasus HIV positif dilaporkan 9,67 permil

Dalam rangka meningkatkan status kesehatan masyarakat di Kabupaten Bantul yang jumlah penduduknya 650.000 penduduk, sudah dilakukan upaya-upaya kesehatan, yang hasilnya sebagai berikut1. Persentase cakupan kunjungan Ibu hamil K1: 109,18%, K4 : 93,59%, Persalinan

ditolong tenaga kesehatan : 102,03%2. Persentase cakupan KB aktif sebesar 76,34%3. Persentase cakupan desa UCI sebesar 100%4. Persentase cakupan imunisasi campak bayi sebesar 84,35%5. Persentase Ibu Hamil Mendapat Tablet Fe1 : 92%, Fe3 : 82,07%6. Persentase Desa yang terkena KLB ditangani kurang dari 24 jam sebesar 100%7. Persentase Rumah Tangga ber PHBS sebesar 67,08%8. Persentase rumah atau bangunan bebas jentik nyamuk aedes sebesar 79,12%

Pertanyaan :Tentukan prioritas maslah kesehatan (dengan metode Hanlon) di Kabupaten Bantul berdasarkan indikator angka kesakitan, angka kematian dan upaya kesehatan yang telah dilakukan oleh dinas kesehatan Kabupaten Bantul. Apa masalah utama di Kabupaten Bantul berdasarkan data tersebut.

KASUS 2Suatu penelitian dilakukan untuk melihat kejadian penyakti diare di suatu puskesmas. 1. Apa yang disebut insiden..?2. Apa yang disebut prevalensi?

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KASUS 3Suatu penelitian dilakukan untuk mengetahui laju kecepatan suatu penyakit HIV di provinsi A. Berdasarkan hasil pengamatan diperoleh data sebagai berikut:

Statement:Assume that we begin a study of 100 persons free of disease on January 1, and that on the last day of each month throughout the year, we will be given a count of new cases of disease in this population. Assume that over the course of a full year, 10 of these persons develop disease, and that 2 of these cases were reported on March 31, 3 more cases on June 30, 3 cases on September 30, and 2 cases on December 31. Question:How many person-months did the study members contribute (assume patients became cases on the last day of the month)....?KASUS 4Suatu penelitian dilakukan terhadap perilaku kebiasaan memasak didapur pada ibu yang memiliki balita. Penelitian dilakukan dengan mengamati terhadap perilaku kebiasaan kebiasaan memasak didapur pada ibu yang memiliki balita pada masyarakat. Berdasarkan pengamatan ternyata dari 50 orang yang diamati pada masyarakat perokok terdapat 30 orang dengan kejadian ISPA. Pada 50 orang tidak kebiasaan memasak didapur pada ibu yang memiliki balita didapatkan 10 orang menderita ISPA pada anaknya. Suatu masyarakat mempunyai kebiasaan memasak didapur pada ibu yang memiliki balita dan masyarakat mempunyai kebiasaan tidak kebiasaan memasak didapur pada ibu yang memiliki balita.

Pertanyaan 1. Berdasarkan kasus diatas desain penelitian apa yang sebaiknya digunakan untuk

melakukan penelitian pada kasus 42. Gambar desain penelitian sesuai jawaban 1..?3. Ukuran risiko apa yang tepat untuk menghitung paparan kebiasaan memasak

didapur pada ibu yang memiliki balita terhadap ISPA apa alasanya...?4. Kemudian hitunglah ukuran risiko kebiasaan memasak didapur pada ibu yang

memiliki balita terhadap penyakit ISPA berdasarkan jawaban no. 3..? 5. Apa makna dari nilai jawaban no 4..?

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SESI LATIHAN One thousand men from factory B were screened for HIV on 1 January 2002 and 50 men were found to be HIV-positive. All the men were tested for HIV once a month until 31 December 2002. Twelve men became HIV-positive during these 12 months. Figure 2.3 shows when these 12 men became HIV-positive. Tests were always carried out at the end of the month. The remaining 938 men were still HIV-negative by 31 December 2002. No one died or was lost to follow-up during this period.

1. What were the odds of becoming infected with HIV in the first 6 months of 2002 in the 12 men who became HIV-positive that year?

2. 4 What is the total number of person-months at risk of HIV infection observed in this study?

3. 5 What is the incidence rate of HIV infection in men working in factory B?

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Q1: Assume that we begin a study of 100 persons free of disease on January 1, and that on the last day of each month throughout the year, we will be given a count of new cases of disease in this population. Assume that over the course of a full year, 10 of these persons develop disease, and that 2 of these cases were reported on March 31, 3 more cases on June 30, 3 cases on September 30, and 2 cases on December 31. How many person-months did the study members contribute (assume patients became cases on the last day of the month).

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Q 2: If we wanted to obtain a measure of the incidence of breast cancer among women in North Carolina during 1997, what breast cancer cases would we count in the numerator?

a. All cases of breast cancer among women in North Carolina in 1997b. Only newly diagnosed cases of breast cancer among women in North Carolina

in 1997?Correct answer is: b. Because incidence measures a change from non-disease to disease, Surviving women with breast cancer diagnosed prior to 1997 are not part of the change from non-disease to disease in the year 1997.

Q 3: Assuming that we begin to measure incidence on January 1, 1997, which North Carolina women would be counted for the denominator of the incidence measure?

a. All women in North Carolina in 1997.b. Only women in North Carolina without breast cancer on January 1, 1997.

Correct answer is: b. All women in North Carolina who, on January 1, 1997, do not have breast cancer. More specifically, all women who do not have a diagnosis of breast cancer. Some women may have undiagnosed breast cancer on that date, but they would not be counted in the numerator because they cannot be identified as a case. Therefore, they would be at risk for breast cancer and thus be included in the denominator.

NOTE:(90 patients x 12 months) + (2 patient x 3 months) + (3 patients x 6 months) + (3 patients x 9 months) + (2 patients x 12 months) = 1155 person-months

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