APLIKASI EPIDEMIOLOGI DALAM KEBIDANAN Oleh Nugroho Susanto, M.Kes. 2012 Epidemiologi-Susanto, 2012

Epidemiologi-Susanto, 2012 Lingkup Pembahasan Faktor Risiko Masalah KIA (Kehamilan dan Persalinan) Ukuran-Ukuran KIA (odd rasio, risiko relatif masalah-masalah kehamilan dan persalinan) Surveilans KIA (komponen dan alur data) Epidemiologi-Susanto, 2012

Konsep Perjalanan kehamilan dan persalinan Epidemiologi-Susanto, 2012

A. Faktor Risiko Kehamilan dan Persalinan Tujuan Mendeskripsikan keadaan, keadaan yang terjadi sebelum kehamilan, selama kehamilan dan setelah persalinan. Mengklasifikasi berdasarkan determinan risiko Upaya pencegahan. Epidemiologi-Susanto, 2012

1. Keadaan-Keadaan Sebelum Kehamilan Kondisi Anemia Remaja anemia pada waktu remaja dapat digunakan sebagai indikator atau prediksi kehamilan dan persalinan. Gizi Remaja. - Status Gizi dapat dilihat dari IMT (indek masa tubuh). Epidemiologi-Susanto, 2012

2. Keadaan Selama Kehamilan Kunjungan ANC - Cakupan K1 - Cakupan K4 Gizi Ibu (pola konsumsi makan, makanan pantangan) Kepatuhan Fe (Cakupan fe) Kondisi Ibu (usia kehamilan, Jarak kehamilan sebelumnya, pekerjaan, pendidikan) Epidemiologi-Susanto, 2012

3. Keadaan-keadaan Persalinan Perdarahan Eklamsi Pre eklamsi Penyakit Infeksi (Malaria, HIV, TB paru) Penyakit tidak menular (hipertensi, kardiovaskuler, DM) Epidemiologi-Susanto, 2012

4. Keadaan Setelah Persalinan Infeksi masa nifas Infeksi neonatus Pertumbuhan bayi Perkembagan Epidemiologi-Susanto, 2012

Epidemiologi-Susanto, 2012 Deteksi Pertumbuhan Epidemiologi-Susanto, 2012

Model Analisis Petumbuhan Epidemiologi-Susanto, 2012

Epidemiologi-Susanto, 2012 Gangguan Pertumbuhan Epidemiologi-Susanto, 2012

B. Ukuran-ukuran Epidemiologi Kejadian Penyakit Insiden Prevalensi Epidemiologi Deskriptif (Frekuensi Penyakit) Rate Ratio Proporsi Epidemiologi Analitik Odd Rasio Risiko Relatif

Kejadian Penyakit (Insiden) Insiden merupakan kejadian kasus baru selama masa pengamatan.

Latihan

Question What is the ratio of males to females? What proportion of infants lived? What proportion of infants were delivered in a delivery room? What is the ratio of operating room deliveries to delivery room deliveries?

Answer a. 5 males, 6 females. male:female = 5:6. Ratio of males to females is 5 to 6; 0.83 to 1 b. 9 lived, 2 died. proportion lived = lived / all case = 9 / 11 =0 .82. Proportion of infants that lived is 82%or 8.2 out of 10 c. 5 delivery room, 5 operating room, and 1 emergency room delivery. proportion delivery room deliveries = delivery room/ all cases =5/11 = 0.45. Proportion of infants delivered in delivery room is 45% or 4.5 out of 10 d. 5 delivery room and 5 operating room deliveries. delivery room:operating room = 5:5 = 1:1 Ratio of operating room deliveries to delivery room deliveries is 1 to 1.

Prevalensi

Insiden and prevalence

Question 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).

Answer (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

Hubungan insiden dan prevalensi Mati/sembuh

Epidemiologi Analitik Odd Rasio Risiko Relative

Odds Ratio Digunakan dalam penelitian case control Menilai perbandingan atara kasus dan kontrol Tidak mampu menilai laju risiko penyakit Rumus

Relatif risk Menilai laju kecepatan penyakit Tepat digunakan pada desain penelitian kohort Risiko relatif yang dinilai Rumus

Epidemiologi-Susanto, 2012 TERIMA KASIH Epidemiologi-Susanto, 2012