Diarrhea In Indonesia Research Articles

The Risk Factor that Affect Children Diarrhea in The Island of Java 2013 (Riskesdas 2013 Data Analysis)

Abstract Diarrhea is the biggest cause of infant and child death in Indonesia. In 2013, Indonesian Ministry of Health stated that children diarrhea incidence was still high and rated as public health problem accounting for 6.7 per cent. Two of five provinces with the highest incidence of infant diarrhea in Indonesia was located in the island of Java, even though Java has the biggest achievement in infant and child healthcare coverage as well as the physical quality of drinking water and improved sanitation over the national. Based on these facts, the purpose of this study was to identify risk factors that affect the incidence of children diarrhea in Java 2013. Binary logistic regression was used to statistical analysis with incidence of children diarrhea as response variable while the explanatory variables are age, nutritional status, level maternal education, maternal age, maternal behavior of washing hands, access to sources of drinking water, access to sanitation facilities and household density. The source of data was Riskesdas 2013. The results of this study showed that all the explanatory variables: age, nutritional status, maternal education level, maternal age, maternal behavior of washing hands, access to sources of drinking water, access to sanitation facilities and household density significantly affect the incidence of children diarrhea. Keywords : children diarrhea, binary logistic regression, Riskesdas 2013.

ASUHAN KEPERAWATAN PADA BALITA YANG MENGALAMI DIARE DENGAN DEHIDRASI SEDANG DI RUMAH SAKIT UMUM dr. WAHIDIN SUDIRO HUSODO MOJOKERTO

The incidence of diarrhea in Indonesia n is still high as seen in the morbidity and mortality are still high. The purpose of study was to learn and practice the nursing care in infants with diarrhea with moderate dehydration through the nursing process approach included assessment, diagnosis, intervention, implementation, and evaluation. The design used in this study was a case study to explore issues of nursing care to client of under five children with diarrhea with moderate dehydration in the RSUD dr. Wahidin Sudiro Husodo Mojokerto. This case study was conducted on July 18, 2016 until July 22, 2016. From the client's assessment showed that both the client's mother said diarrhea for more than 3 times . C lient looked weak, irritability, abnormal vital signs and dry mucous membranes. Nursing diagnoses that ar o se we re fluid volume and electrolyte deficiencies related to exces secondary secretion (diarrhea). The nursing interventions were monitor signs and symptoms of dehydration, assess children's nutritional status monitor of vital signs, monitor the body weight every day, monitor laboratory examination, urge to t a ke oral intake (ORS provision), did a collaboration of medicine administration. The action done was the provision of 200 ml ORS each time of diarrhea. Evaluation on both the client showed improved response to client’s circumstances. Based on data from the Nursing care in children with moderate dehydration diarrhea the provision of ORS of 200 ml eachtime of diarrhea is more effective if it is spent to treat dehydration. The client's family is expected to increase knowledge about the importance of maintaining the cleanliness of the food that will be consumed by clients through the local health authorities. Keyword: Diarrhea, Moderate Dehydration

Pemberian Makanan Pendamping ASI Dini Berhubungan dengan Kejadian Diare pada Bayi umur 0 – 12 bulan di Kecamatan Dampal Utara, Tolitoli, Sulawesi Tengah

<p>Diarrhea is the number one cause of infant mortality worldwide. The United Nations Children’s Emergency Fund (UNICEF) estimates that every 30 seconds there is a child who died of diarrhea in Indonesia. The incidence of diarrhea in young children one of them caused by hygiene including the knowledge and attitudes of mothers in feeding, where the baby has been fed besides breast milk (breast milk) before the age of 6 months. According to the World Health Organization, infants who received complementary foods before six months of age will have a 17 times greater risk of experiencing diarrhea. The aim of research to determine feeding complementary relationship with the incidence of diarrhea in infants aged 0-12 months in the District of North Dampal, Tolitoli, Central Sulawesi. The population in this experiment is all mothers with babies aged 0-12 months who are in the district of North Dampal, Tolitoli, Central Sulawesi, which amounted to 36 mothers. Samples were taken using a total sampling. Data were analyzed using chi-square test. The results showed there are significant relationship between the giving weaning food with the incidence of diarrhea in infants 0-12 months in North Dampal, Tolitoli, Central Sulawesi.</p>

Association of Safe Disposal of Child Feces and Reported Diarrhea in Indonesia: Need for Stronger Focus on a Neglected Risk.

Indonesia still faces several challenges in the areas of water, sanitation, and hygiene (WASH). Diarrhea remains a major killer of children and it is important to understand the local diarrhea transmission pathways to prioritise appropriate WASH interventions to reduce diarrhea burden. This study used a cross-sectional data set from a recent national household survey (the 2012 Indonesia Demographic and Health Survey) to examine the associations between diarrhea in children aged less than 24 months with WASH interventions and population characteristics. Unsafe disposal of child feces was strongly associated with an increased odds of child diarrhea (OR: 1.46; 95% CI: 1.18–1.82, p = 0.001). However, other WASH practices were not found to be associated. The findings underline the dangers of unsafe disposal of child feces and highlight the need for strengthening the related policies and program strategies and their implementation.

Detection of group A rotavirus strains circulating among children with acute diarrhea in Indonesia.

Rotavirus is the major cause of severe diarrhea in children under 5 years old in developed and developing countries. Since improvements in sanitation and hygiene have limited impact on reducing the incidence of rotavirus diarrhea, implementation of a vaccine will be a better solution. We conducted an observational study to determine the disease burden and to identify the genotype of circulating rotavirus in Indonesia. Hospitalized children due to acute diarrhea were enrolled from four teaching hospitals in Indonesia. Stool samples were collected based on WHO protocol and were tested for the presence of group A rotavirus using enzyme immunoassay. Then, rotavirus positive samples were genotyped using RT-PCR. Fisher’s Exact tests, Chi square tests and logistic regression were performed to determine differences across hospital and year in rotavirus prevalence and genotype distribution. There were 4235 samples from hospitalized children with diarrhea during 2006, 2009 and 2010. Among them, the rotavirus positive were 2220 samples (52.42 %) and incidence rates varied between hospitals. The G1P[8], G1P[6], and G2P[4] were recognized as the dominant genotypes circulating strains in Indonesia and the proportion of predominant strains changed by year. Our study showed the high incidence of rotavirus infection in Indonesia with G1P[8], G1P[6], and G2P[4] as the dominant strains circulating in Indonesia. These results reinforce the need for a continuing surveillance of rotavirus strain in Indonesia.

Kerasionalan Penggunaan Obat Diare yang Disimpan di Rumah Tangga di Indonesia

Diarrhea is a major health problem in developing countries. WHO data showed diarrhea caused the death of 2.5 million people, 80% are children under five years old. Riskesdas 2013 stated the prevalence of diarrhea in Indonesia is 7%, whereas 12.2% of it are children under five years old. Self-medication is common and access for the medicine is easy. This analysis aims to assess the rational use of diarrhea medication stored in households. The rational drug used is associated with the mother's education level and household ownership quintile. This study design is cross sectional. The data was taken from Riskesdas 2013 namely type of medicines (data from block VI), mother’s education level data (from block IV) and economic status presented as household ownership quintile level (data from block IX). The result showed that the highest percentage of diarrhea drugs stored at household is adsorbents (40.4%), followed by antibiotic (22.4%) and traditional medicine (18.5%). Rationality of diarrhea medications stored in households is 74.7% and irrational (25.3)%). Wealthy people (quintiles 4 and 5) are 2.019 times more rational compared with the poor (quintiles 1, 2 and 3), while mothers with a good education (high school and above) are 1.944 times more rational in using medicine for diarrhea treatment compared with mothers with low education (below high school).

Zinc therapy for different causes of diarrhea

Background The incidence of diarrhea in Indonesia has declinedin the past five years. In spite of the increasing number of studieson the treatment for acute diarrhea, especially the use of zinc,it is not known if bacterial vs. non-bacterial etiology makes adifference in the reduction of severity of acute diarrhea in childrenon zinc therapy.Objective To assess the effect of zinc therapy in reducing theseverity of acute bacterial and non-bacterial diarrhea.Methods We performed a cross-sectional study in the SecanggangDistrict, Lan gkat Regen cy of North Sumat era, from Augustto November 2009 in children aged 2 months to 14 years .Microscopic stool examination s were undertaken to separatesubjects into the acute bacterial or non-bacterial diarrhea groups.Both groups received 10 mg/day ofzinc sulphate for subjects aged<6 months or 20 mg/day for those aged 2:6 months for 10 days.Measurement of disease severity was based on the frequency ofdiarrhea (times/day) and the duration of diarrhea (hours) afterinitial drug consumption . We performed indepen dent T test forstatistical an alysis.Results Sixty-two children participated in this study, with 31children in the acute bacterial group, and the remainder in thenon-bacterial group. There were no significant differences betweenthe two gro ups in frequency of diarrhea (2 .61 vs 2.70 times/day,respectively, P=0.27) or in duration of diarrhea (63.39 vs 66.68hours, respectively, P= 0.06) .Conclusion Zinc is not more effective in reducing the severityof acute bacterial diarrhea compared to non-bacterial diarrhea inchildren.

Comparison of zinc-probiotic combination therapy to zinc therapy alone in reducing the severity of acute diarrhea

Background Although the incidence of diarrhea in Indonesia has declined in the last five years, the mortality rate in children under five years old is still high. Therefore, appropriate and comprehensive management of diarrhea is essential. There have been many studies on the role of zinc therapy and probiotic therapy in reducing the severity of acute diarrhea, but not many studies have compared the use of a combination of the two therapies tozinc therapy alone.Objective To compare the efficacy of zinc-probiotic combination therapy to zinc alone in reducing the severity of acute diarrhea.Methods We conducted a randomized, open-label, controlled trial from July 2009 to January 2010 in Adam Malik Hospital and Pirngadi Hospital, Medan. Children aged between 1 month and 5 years who met the criteria were divided into two groups. Group I received zinc sulphate (aged <6 months: 10 mg/day; aged 2:6 months: 20 mg/day) combined with heat-killed Lactobacillus acidophilus (3x101O CFU/day) for 10 days. Group II received only zinc sulphate at the same dosage as group I. Measurement of disease severity was based on the frequency of diarrhea (times/day) and the duration of diarrhea (hours) after initial drug consumption.Results Eighty subjects were enrolled, randomised, and divided equally into two groups. 40 children received zinc-probiotic in combination (group I) and the remainder (group II) received zinc alone. We observed significant differences in frequency of diarrhea (2.1 vs 3.1 times/day, P=0.001, 95%CI -1.62 to -0.49), and duration of diarrhea (52.1 vs. 72.6 hours, P=0.00l, 95%CI -30.91 to -10.18) in the two groups.Conclusion Combination of zinc-probiotic therapy was more effective in reducing the severity of acute diarrhea than zinc therapy alone in children under five years of age.

The effect of early nutritional supplementation with a mixture of probiotic, prebiotic, fiber and micronutrients in infants with acute diarrhea in Indonesia.

A randomized double blind clinical trial was conducted to assess the efficacy of a special infant formula containing Lactobacillus rhamnosus LMG P-22799 (probiotic: 5 x 10(8) CFU/100mL), inulin (prebiotic: 0.15 g/100mL), dietary fiber (soy polysaccharides: 0.2 g/100mL) and increased amounts of zinc+iron (+0.4 and +0.6 mg/100mL, respectively) as active ingredients for the early dietary management of 58 Indonesian well-nourished male infants aged 3-12 months suffering from acute diarrhea with moderate dehydration. After adequate oral rehydration, the patients were randomly assigned to receive either a low lactose infant formula supplemented with added precooked rice (1.5 g/100mL) with the above active ingredients (study group) or a low lactose infant formula with added precooked rice without the above active ingredient supplement (control group). No antibiotic, anti-secretory drug or antiemetic was given at all. Both study and control groups showed similar outcomes for weight gain and stool weight. The duration of diarrhea was significantly shorter in the study group than in the control group (1.63 versus 2.45 days; p<0.05; for the study and control group respectively). No treatment failure or other side effects were observed during the course of the study. The present study supports the evidence for the efficacy of a special anti-diarrhea infant formula containing probiotic, prebiotic, fiber and iron+zinc after oral rehydration by shortening the duration of infantile diarrhea in developing countries. However, from the results of our study we cannot discern the individual contribution of the active ingredients and also not whether they may act independent from each other or in a synergistic way.

Correct Preparation and Administration of Oral Rehydration Solution: Essential for Safe and Effective Home Treatment of Diarrhea in Indonesia

Diarrhea-related dehydration is a leading cause of childhood death in developing countries such as Indonesia, despite being largely preventable and treatable through use of Oral Rehydration Solution (ORS). While the extent to which ORS is used in Indonesia has been explored in earlier studies, the issue of whether it is being used correctly has not been adequately investigated. The purpose of this study was to assess mothers' ORS preparation and administration practices and to determine their source of instruction for these practices. A structured questionnaire was administered orally to 100 mothers of children under the age of 5 years, in a rural village of West Java, Indonesia. Only 23.7% of mothers were found to have correctly prepared ORS, and none exhibited fully correct administration practices. Primary sources of instruction were health workers (62.9%), package instructions (23.7%), and family members or friends (12.4%). Resulting recommendations include education of health care workers, community health education programs, reallocation of health care resources, and revision of ORS packaging guidelines.

The effect of zinc supplementation in children under three years of age with acute diarrhea in Indonesia

ABSTRACTING & INDEXING

How useful are Pharmaceuticals in managing diarrhoeal diseases in developing countries?

The major cause of death in children with diarrhea is dehydration so rehydration is the most effective treatment. Yet 327 household surveys revealed the median percentage of cases treated with oral rehydration solution (ORS) to be only 23% (0-30%) while the median use rate for inappropriate expensive and unnecessary antidiarrheal drugs was 52% (6-86%). In fact in 1989 44% of the total cost of treating diarrhea in Indonesia went for medication but ORS costs made up only 8%. Many antidiarrheals often promoted as cure alls are sold without prescriptions and have no instructions on age restrictions. For example a survey of pharmacists in 3 Asian countries showed that only 21% recommended ORS and/or advised the parent to take the child with diarrhea to a health worker while 65% dispensed antidiarrheals. Antimicrobials often are incorporated into 64% of antidiarrheals. Yet none of these drugs have proved to be efficacious and often have grave side effects. The widespread abuse of using antibiotics to treat all types of diarrhea has resulted in rising cases of antibiotic resistance among Shigella and other bacteria which only jeopardizes therapy for diarrhea in those cases where antibiotics are needed. WHO suggests such treatment for only a small percentage of cases e.g. suspected cases of Shigella dysentery or cholera. Nevertheless many physicians still prescribe antimicrobials and antidiarrheals to young children even for mild diarrhea. 1 survey showed this to be true most often among older physicians. Younger physicians tended to treat diarrhea with ORS. Most mothers want to reduce the number of diarrheal stools so they prefer antidiarrheals. Though the more educated the mother the greater the probability that she will use ORS. Legislation on distribution and control of drugs exists in most developing countries but it is not well enforced.

Biochemical characteristics and virulence of environmental group F bacteria isolated in the United States.

Bacteria phenotypically resembling Aeromonas hydrophila, but requiring NaCl for growth, have been isolated form the New York Bight. The bacteria proved to be identical to group F organisms isolated from cases of human diarrhea in Indonesia and Bangladesh. Anaerogenic strains initiated responses in Y-1 tissue culture and rabbit ileal loop, consistent with those associated with cytotoxin- and enterotoxin-producing Aeromonas spp. strains. Separation on the basis of production of gas from glucose by group F strains was correlated with differences in mean guanine-plus-cytosine deoxyribonucleic acid base composition and in deoxyribonucleic acid relative reassociation. Both aerogenic and anaerogenic strains reassociated to a significantly greater extent with Vibrio spp. than with Aeromonas spp. and indeed should be considered a new species of the genus Vibrio.