Yati Soenarto
Departments of Pediatric, Faculty of Medicine, Universitas Gadjah Mada, Yogyakarta Department of Pediatric, Dr.Sardjito General Hospital, Yogyakarta

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SEMBILAN LANGKAH PENDIDIKAN KESEHATAN TENTANG PERAWATAN DAN PENCEGAHAN DIARE ida, Musta; Haryanti, Fitri; Soenarto, Yati
PROSIDING SEMINAR NASIONAL 2014: PROSIDING SEMINAR NASIONAL KEPERAWATAN
Publisher : Universitas Muhammadiyah Semarang

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Abstract

Diare merupakan masalah kesehatan utama pada anak dan penyebab kematian kedua di dunia setelah pneumonia. Kejadian diare akut pada anak di rumah sakit di Wonosobo tahun 2013 menduduki urutan pertama dari keseluruhan penyakit anak. Salah satu faktor risiko terjadinya diare dan meningkatnya risiko anak untuk dirawat adalah kurang pengetahuan. Keterlibatan ibu dalam perawatan anak diare sangatlah penting, sehingga diperlukan pendidikan kesehatan. Tujuan penelitian mengidentifikasi pengaruh pendidikan kesehatan dengan 9 (sembilan) langkah terhadap pengetahuan dan sikap ibu dalam merawat pasien balita diare. Penelitian quasi experimental design dengan rancangan nonrandomized control group pre test post test. Responden berjumlahh 33 ibu dari balita penderita diare di dua rumah sakit di Wonosobo pada masingmasing kelompok (kelompok intervensi dan kontrol). Pengumpulan data menggunakan kuesioner. Pendidikan kesehatan menggunakan 9 langkah dari Gagne dengan media booklet dan video dari MTBS. Analisis data menggunakan Paired T test, T test independent. Hasil penelitian, karakteristik responden meliputi usia, pendidikan, pendapatan, pengalaman dan pernah mendapat informasi dari kedua kelompok adalah homogen. Hasil post test antara kelompok intervensi dan kontrol terdapat perbedaan yang bermakna (α=0,05) pada rata-rata nilai pengetahuan (p=0,007) dan sikap (p=0,047). Rata-rata peningkatan nilai pengetahuan dan sikap antara kelompok intervensi dan kontrol menunjukkan perbedaan bermakna (p=0,000). Pendidikan kesehatan dengan 9langkah, berpengaruh terhadap peningkatan pengetahuan dan sikap ibu dalam merawat pasien diare.Rekomendasi, Pendidikan kesehatan 9 langkah sebaiknya digunakan dalam memberikan pendidikan kesehatan di tempat pelayanan kesehatan agar terjadi peningkatan pengetahuan dan sikap.Kata Kunci : diare, pendidikan kesehatan, perawatan diare balita.
NEED ASSESSMENT PERENCANAAN PULANG ANAK DIARE Purnamasari, Ika; Haryanti, Fitri; Soenarto, Yati
PROSIDING SEMINAR NASIONAL 2014: PROSIDING SEMINAR NASIONAL KEPERAWATAN
Publisher : Universitas Muhammadiyah Semarang

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Abstract

Diare merupakan masalah kesehatan yang sangat lazim terjadi pada anak dan menjadi penyebab utama angka kematian anak baik di dunia maupun di Indonesia. Kegiatan perencanaan pulang harus menjadi salah satu intervensi pada perawatan anak diare di rumah sakit karena denganpemberian perencanaan pulang, dapat mengurangi dampak dari suatu keadaan kesehatan, meningkatkan kepuasan sekaligus mencegah rehospitalisasi. Tujuan penelitian ini untuk mengeksplorasi kebutuhan pasien dan keluarga untuk perencanaan pulang anak diare ditinjau dariperspektif orang tua, dokter, perawat, dan ahli gizi di rumah sakit. Penelitian ini merupakan penelitian kualitatif dengan pendekatan exploratif single case study dengan holistic unit analysis. Penentuan responden dengan purposive sampling. Responden berjumlah 14 orang yang terdiri atas 6 orang tua, 2 dokter spesialis anak, 5 perawat dan 1 ahli gizi. Pengumpulan data dengan wawancara mendalam dan diskusi kelompok terarah. Analisis data dengan menggunakan analisis deskriptif terhadap kasus. Hasil: Kebutuhan yang teridentifikasi dalam penelitian ini terdiri atas tiga kategori utama yaitu kebutuhan terhadap informasi yang meliputi informasi tentang penyakit diare dan perawatannya, kebutuhan pelayanan oleh dokter, perawat dan ahli gizi serta kebutuhan metode pemberian perencanaan pulang yang meliputi waktu, tempat, metode dan media.Kata kunci: anak, diare, need assessment, perencanaan pulang
Genotyping of Rotavirus by Using RT-PCR Methods Nirwati, Hera; Wibawa, Tri; Aman, Abu Tholib; Soenarto, Yati
Indonesian Journal of Biotechnology Vol 18, No 1 (2013)
Publisher : Universitas Gadjah Mada

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Abstract

There is a great diversity of rotavirus genotypes circulating worldwide, with dominant genotypes changing from year to year. Rotavirus genotyping was performed by using reverse transcription PCR with type-specifi c-primers. Since rotavirus is a RNA virus that has high mutation rate, there was a possibility of technical diffi culty in genotyping due to mutation in the primer binding sites. During Indonesian rotavirus surveillance study 2006-2009, it was reported that 17% of samples subjected for G type and 21% of samplessubjected for P type were untypeable. The objective of this study was to identify genotypes of the samples that were untypeable previously using RT-PCR based on the method described by Das et al. (1994) and Gentsch et al. (1992). There were 30 samples subjected to G type and 61 samples subjected to P type to be re-typed using method described by Gouvea et al. (1990) and Simmond et al. (2008) for G and P typing, respectively. By using another set of primer, the genotype of all samples was identifi ed. This study highlights the importance of a constant reconsideration of primer sequences employed for the molecular typing of rotaviruses.Key words: rotavirus, G typing, P typing
Diare Rotavirus pada Anak Usia Balita Widowati, Titis; Mulyani, Nenny S; Nirwati, Hera; Soenarto, Yati
Sari Pediatri Vol 13, No 5 (2012)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/sp13.5.2012.340-5

Abstract

Latar belakang. Rotavirus merupakan penyebab tersering diare akut berat pada anak balita. Peningkatan yang pesat di bidang teknologi diagnostik memungkinkan dilakukan identifikasi genotipe rotavirus penyebab diare. Belum banyak penelitian di Indonesia yang melaporkan hubungan antara genotipe rotavirus dengan manifestasi klinisnya. Tujuan. Mengetahui hubungan antara genotipe rotavirus dengan gambaran klinis.Metode. Penelitian potong lintang dengan subyek pasien diare akut yang berobat di Poliklinik Anak atau dirawat inap di RS DR Sardjito. Subyek yang bersedia berpartisipasi dalam penelitian diambil data klinis dan sampel tinja untuk dilakukan pemeriksaan rotavirus dengan enzyme immunoassaydan deteksi genotipe dengan pemeriksaan RT-PCR (Gentsch, 1992). Dilakukan penilaian derajat keparahan diare menggunakan 20-point severity scoring systemyang dimodifikasiHasil.Selama Januari 2006 - Maret 2007 didapatkan 353 kasus diare akut, 116 (32,68%) di antaranya positif terinfeksi rotavirus. Prevalensi tertinggi dijumpai pada kelompok usia 6-23 bulan (65,5%). Diare rotavirus menunjukkan gejala klinis yang lebih berat (severity score>11) dibanding diare karena penyebab lain (RR=1,27, IK 95% 1,08-1,49). Jenis genotipe rotavirus yang paling banyak ditemukan adalah G1 (27,5%) diikuti dengan G9 (18%), G2 (17%), G4 (3%), G3 (2%). Kombinasi G-P terbanyak adalah G1 P[6] (20%). Tipe untypeable(28.6%) dan G 1 (28.6%) paling sering memberikan gejala klinis berat (severity scoring >11) diikuti dengan G 9 (23.8%). Kesimpulan. Pasien diare rotavirus yang untypeable dan G 1 lebih sering mengalami dehidrasi dan muntah serta memberikan gambaran klinis yang lebih berat. Sangat penting mendeteksi lebih jauh jenis genotipe dari untypeableuntuk kepentingan pembuatan vaksin rotavirus yang mampu melindungi terhadap berbagai macam galur rotavirus.
Penyebaran Spesialis Anak di Indonesia Tahun 2004: Implikasinya Terhadap Kebijakan Kesehatan dan Pendidikan Soenarto, Yati; Trisnantoro, Laksono; Fuad, Anis
Sari Pediatri Vol 8, No 2 (2006)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/sp8.2.2006.94-9

Abstract

Komposisi penyebaran tenaga dokter spesialis anak (SpA) di tingkat propinsi di Indonesiamasih belum merata. Distribusi penyebaran tenaga spesialis ini hampir 70% berpusat diJawa dan Bali, bahkan tercatat di beberapa propinsi lain yang tidak memiliki satupuntenaga SpA. Tulisan ini menyajikan distribusi penyebaran SpA di setiap di propinsi diIndonesia dan proporsi pertumbuhan SpA berdasarkan jenis kelamin. Dalam tulisan inijuga didiskusikan beberapa implikasi terhadap kebijakan yang mungkin dapat dijadikanpertimbangan dalam pengembangan model distribusi tenaga SpA.
Antidiarrheal characteristics of tempe produced traditionally and industrially in children aged 6-24 months with acute diarrhea Soenarto, Yati; I, Sudigbia; Herman, Herman; M, Karmini; D, Karyadi
Paediatrica Indonesiana Vol 41, No 2 (2001): March 2001
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi41.2.2001.88-95

Abstract

A randomized controlled double-blind clinical trial was conducted to evaluate tempe-based formulated foods fortreatment of young Indonesian children suffering from acute diarrhea. A total of 214 cases aged between 6 and 24 monthsvisiting two teaching hospitals, i.e., Sardjito hospital (n=102) in Yogyakarta and Karyadi hospital (n=112) in Semarang. Twocases from one hospital were dropped because they moved to other towns. In addition to their hospital food given duringhospitalization and daily food at home, 72 cases were given tempe-based formulated foods with tempe produced traditionally(group TT), 72 were given tempe produced industrially (group IT), whereas a control group of 68 received soybean powderformulated foods (group IS). Formula feedings were started immediately following WHO (world health organization) standardoral rehydration therapy (ORT) and continued at the patients homes for up to 90 consecutive days, including feedings duringhospitalization. Follow-up observations at patients homes were conducted twice weekly. The initial clinical characteristics ofthe cases in each group were similar. Using analysis of variance there was a non significant trend towards a shorter durationof diarrhea in the groups using tempe based formula (p=0.079). Using the t-test, the duration of diarrhea appeared to besignificantly shorter only for the group using formula with traditional tempe compared with the group using soy formula(p=0.035). The total amount of feeding formula and the total amount of calories consumed at the hospital and at home wassimilar for all three groups, although the group receiving the control formula consumed a somewhat higher amount of breastmilk (p=0.045) and a lower amount of solid food at home. Weight for age was below normal at the start of the study or afterrehydration (Z-score between -1.0 and -1.4) and approached the normal value at the end of the study for all three groups (Zscorebetween -0.51 and -0.27). The increase in Z-score was highest in the groups receiving tempe based formula (+1.0 inthe TT group and +0.9 in the IT group) and lowest in the IS group (+0.7). This implies that a tempe based formula can diminishthe duration of acute diarrhea and improve weight gain following an episode of acute diarrhea.
Epidemiology of Rotavirus diarrhea in children under five: A hospital-based surveillance in Jakarta Kadim, Muzal; Soenarto, Yati; Hegar, Badriul; Firmansyah, Agus
Paediatrica Indonesiana Vol 51 No 3 (2011): May 2011
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (166.865 KB) | DOI: 10.14238/pi51.3.2011.138-43

Abstract

Background Rotavirus is still a major cause of acute diarrhea in children around the world, both in developed and developingcountries. WHO Surveillance from 2001 to 2008 showed that in children under five years of age treated for acute diarrhea, on average 40% of cases were caused by rotavirus. A previous study in Indonesia showed that the incidence of rotavirus diarrhea in children ranged from 20%????60% of diarrhea cases. However, there have been few studies identifying the genotypes of rotavirus strains in Indonesia. This infonnation is indispensable for manufacturing vaccines.Objective To examine the epidemiology of rotavirus diarrhea, including genotypes and clinical characteristics, in children under five years who were hospitalized in Jakarta.Methods This study was a prospective surveillance conducted at Cipto Mangunkusumo Hospital, Jakarta from January to December 2007 investigating hospitalized children under five years of age who suffered from acute diarrhea.Results Ninety????nine patients joined the study. The incidence of rotavirus infection in this study was 67%. The youngest was 2months of age and the oldest 54 months of age, Mth an average age of 13.6 months. As much as 92% of rota virus diarrhea was found in subjects aged 3????23 months, Mth a peak age of 12????23 months. Nutritional status, degree of dehydration, bloating, fever, blood in stool, and mucus in the feces were not significantly different between rotavirus and non????rotavirus diarrhea. Vomiting tended to be more frequently experienced by children Mth rotavirus diarrhea than those with non????rotavirus (88% vs. 67%). There was no clear, seasonal pattern for rotavirus diarrhea. Most G genotypes in this study were G1 (35%), G9 (12.5%), G2 (7.5%) and the majority of P genotypes were P6 (52.5%), P8 (17.5%) and P4 (10%).Conclusions The incidence of rotavirus diarrhea in hospitalized children under five years of age in Jakarta was 67%, with apredominance ofG1, G9 and G2 genotypes. 
Prognostic factors of refractory epilepsy in children Ramzi, Ramzi; Soenarto, Yati; Sunartini, Sunartini; Hakimi, M
Paediatrica Indonesiana Vol 48 No 5 (2008): September 2008
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (110.421 KB) | DOI: 10.14238/pi48.5.2008.269-73

Abstract

Background Epilepsy is one of the most common pediatricneurological disorders. Twenty percent of patients will developrefractory epilepsy. Early identification of refractory epilepsy willbe helpful to conduct adequate counseling and selecting patientswho need more intensive investigation and treatment.Objective To identify the clinical characteristics and other factorsthat are related to refractory epilepsy in children.Methods We conducted a case control study in patients of two to18 years old with epilepsy that admitted to Dr. Sardjito Hospital.There were 4 7 children with refractory epilepsy compared with122 subjects who have been one year free of seizure.Results Strong association had been noted between refractoryand several clinical factors: early onset of seizure, high initialseizure frequency, neonatal asphyxia, symptomatic etiology, statusepilepticus, abnormal neurodevelopmental status, and earlybreakthrough seizures after treatment initiation. On multivariateanalysis, more than 20 seizures prior to treatment initiation (OR3.40, 95% CI 1.03 to 11.3), and more than three seizures in thesubsequent six month after treatment initiation (OR 16.02, 95%CI 4.98 to 51.5) were independent prognostic factors related torefractory epilepsy.Conclusion Children who present high frequency seizures atonset and more than 3 breakthrough seizures subsequent to sixmonth after treatment have risks of developing refractory epilepsy.
The accuracy of clinical diagnosis for dehydration according to the integrated management of childhood illness Marudut, Siswanto; Soenarto, Yati; Juffrie, Mohammad
Paediatrica Indonesiana Vol 46 No 5 (2006): September 2006
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi46.5.2006.225-8

Abstract

Background Acute diarrheal disease causes over 5 milion deathsworldwide in children under 5 years old, mostly because of failureto detect and treat dehydration properly and immediately.Objective To determine the validity of clinical diagnosis of dehy-dration according to Integrated Management of Childhood Illness(IMCI) as a diagnostic test for dehydration in children under fiveyears old.Methods A prospective observational study was done for clinicaldiagnosis in dehydration. Children aged 2 months-5 years old withdiarrhea and or vomiting who visited the primary health centers inYogyakarta were enrolled. Clinical diagnosis was made by atrained IMCI nurses. Dehydration was defined as the presence ofdecreasing consciousness, very sunken eyes, slow reaction whenoffered a drink, and decreased skin elasticity. Ninety-five per-cents confidence intervals (CI) were calculated, and the signifi-cance was assessed by X 2 .Results There were 148 children aged 2 months to 5 years oldenrolled this study. Clinical dehydration used according to IMCIproduced sensitivity of 91% (95% CI 83;98), specificity of 82%(95% CI 75;89), positive predictive value (PPV) of 70% (95% CI58;77), negative predictive value (NPV) of 94% (95% CI 90;98),positive likehood ratio of 5.17 (95% CI 3.37;7.94), and negativelikehood ratio of 0.11 (95% CI 0.04;0.27).Conclusion Clinical diagnosis for dehydration according to IMCIis sufficiently accurate as a diagnostic test for dehydration in chil-dren under 5 years old
Severity and treatment level of acute gastroenteritis with rotavirus in children under 5 years in INDONESIA Gdara, Fatma Othman; At Thobari, Jarir; Soenarto, Yati
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 50, No 1 (2018)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (283.073 KB) | DOI: 10.19106/JMedSci005001201812

Abstract

Rotavirus diarrhea causing gastroenteritis in children under five years is an importantissue that urgently needs to be addressed globally. Delay in management of rotavirusdiarrhea can be fatal. Diagnostic tool for detecting rotavirus is, therefore, needed.However, until now the gold standard diagnostic tools are expensive, often not availableand affordable in health care settings. The aim of the study was to compare the Vesikariclinical severity score of rotavirus-positive with rotavirus-negative in hospitalized childrenwith acute gastroenteritis. Furthermore, the difference of the level of treatment betweenrotavirus-positive with rotavirus-negative was also evaluated. This was a cross sectionalstudy that using secondary data from medical records of five general teaching hospital inIndonesia. Subjects were children aged <5 years with acute watery diarrhea admitted tothe hospital. Statistical analysis used was chi square test, U-Mann Whitney, and KruskalWallis. The results showed that the patient with rotavirus positive have higher dehydration(80.2%) compared to rotavirus negative (70%). The severity level of clinical feature washigher in diarrhea due to rotavirus positive than non rotavirus (11.47± 2.89 vs 10.41± 2.70; p<0.000). The level of treatment was higher in rotavirus positive. The majorityhad treatment plan C (47.7%) higher than plan B and A (45.6% and 30.9%; p<0.050).This was opposite with patient with rotavirus negative that majority had treatment inplan A (69.1%) higher than plan B and C (54.4% and 52.3%) (p<0.001). In conclusion,the severity of gastroentrities in children under 5 years using vesikari score are higher indiarrhea due to rotavirus positive than non rotavirus. The treatment level plan C is higherthan plan B and A in diarrhea due to rotavirus. This is opposite with non rotavirus majorityhave treatment in plan A higher than plan B and C.