pertemuan i (communicable disease epidemiology, surveilans and control)
DESCRIPTION
penyakit yang didapatTRANSCRIPT
![Page 1: Pertemuan I (Communicable Disease Epidemiology, Surveilans and Control)](https://reader035.vdocuments.mx/reader035/viewer/2022062310/5695cf941a28ab9b028eab2e/html5/thumbnails/1.jpg)
Communicable and Natural Disease, Surveillance Control and Outbreak Investigation
Jontari HutagalungField Epidemiology Training Program (FETP)
![Page 2: Pertemuan I (Communicable Disease Epidemiology, Surveilans and Control)](https://reader035.vdocuments.mx/reader035/viewer/2022062310/5695cf941a28ab9b028eab2e/html5/thumbnails/2.jpg)
Brief Outline
1. Communicable disease’s and NCD2. Surveillance3. Natural Disease’s4. Outbreak Investigation5. Indeks case (First case)
![Page 3: Pertemuan I (Communicable Disease Epidemiology, Surveilans and Control)](https://reader035.vdocuments.mx/reader035/viewer/2022062310/5695cf941a28ab9b028eab2e/html5/thumbnails/3.jpg)
Why Need Investigate/Surveillance?
1. Control and prevention. 2. Severity and risk to others (AR, OR & RR). 3. Research opportunities. 4. Training opportunities. 5. Program considerations. 6. Public, political, or legal concerns.
![Page 4: Pertemuan I (Communicable Disease Epidemiology, Surveilans and Control)](https://reader035.vdocuments.mx/reader035/viewer/2022062310/5695cf941a28ab9b028eab2e/html5/thumbnails/4.jpg)
Emerging Infection Nature
![Page 5: Pertemuan I (Communicable Disease Epidemiology, Surveilans and Control)](https://reader035.vdocuments.mx/reader035/viewer/2022062310/5695cf941a28ab9b028eab2e/html5/thumbnails/5.jpg)
Emerging Infection Nature
![Page 6: Pertemuan I (Communicable Disease Epidemiology, Surveilans and Control)](https://reader035.vdocuments.mx/reader035/viewer/2022062310/5695cf941a28ab9b028eab2e/html5/thumbnails/6.jpg)
Emerging Infection Nature (One Health)
![Page 7: Pertemuan I (Communicable Disease Epidemiology, Surveilans and Control)](https://reader035.vdocuments.mx/reader035/viewer/2022062310/5695cf941a28ab9b028eab2e/html5/thumbnails/7.jpg)
Communicable Disease (Source: CDC, 2010)
An infectious disease TRANSMISSIBLE (as from person to person) by DIRECT CONTACT with an affected individual or the individual's discharges or by INDIRECT MEANS (as by a vector) compare contagious.
![Page 8: Pertemuan I (Communicable Disease Epidemiology, Surveilans and Control)](https://reader035.vdocuments.mx/reader035/viewer/2022062310/5695cf941a28ab9b028eab2e/html5/thumbnails/8.jpg)
35. 000 000people died fromchronic diseases
in 2005 (WHO, 2005)
Source: WHO, 2005 and Nawi Ng, UGM, 2012
![Page 9: Pertemuan I (Communicable Disease Epidemiology, Surveilans and Control)](https://reader035.vdocuments.mx/reader035/viewer/2022062310/5695cf941a28ab9b028eab2e/html5/thumbnails/9.jpg)
Global Burden of Disease 2004-2010Global Burden of Disease 2004-2010
![Page 10: Pertemuan I (Communicable Disease Epidemiology, Surveilans and Control)](https://reader035.vdocuments.mx/reader035/viewer/2022062310/5695cf941a28ab9b028eab2e/html5/thumbnails/10.jpg)
Leading Causes of Death in Developed Region, 1990-2010 (in thousands)
Deseases Number Percent
Ischemic heart disease Cerebrovascular disease Trachea, bronchus, and lung cancers Lower respiratory infections Chronic obstructive pulmonary disease Colon and rectum cancers Stomach cancer Road traffic accidentsSelf–inflicted injuries Diabetes mellitus
2.6951.427523385324277241222193176
24.713.14.83.53
2.52.22
1.81.6
Source: WHO, Preventing Chronic Disease – A Vital Investment, 2005
![Page 11: Pertemuan I (Communicable Disease Epidemiology, Surveilans and Control)](https://reader035.vdocuments.mx/reader035/viewer/2022062310/5695cf941a28ab9b028eab2e/html5/thumbnails/11.jpg)
Leading Causes of Death in Developing Region, 1990-2010 (in thousands)
Deseases Number PercentLower respiratory infections Ischemic heart disease Cerebrovascular disease Diarrheal diseases Conditions during the perinatal period Tuberculosis Chronic obstructive pulmonary disease Measles Malaria Road traffic accidents
3.9153.5652.9542.9402.3611.9221.8871.058856777
9.99
7.57.46
4.94.82.72.22
Source: WHO, Preventing Chronic Disease – A Vital Investment, 2005
![Page 12: Pertemuan I (Communicable Disease Epidemiology, Surveilans and Control)](https://reader035.vdocuments.mx/reader035/viewer/2022062310/5695cf941a28ab9b028eab2e/html5/thumbnails/12.jpg)
Disease Of Wealthy Nations
WHO, Preventing Chronic Disease – A Vital Investment, 2005
![Page 13: Pertemuan I (Communicable Disease Epidemiology, Surveilans and Control)](https://reader035.vdocuments.mx/reader035/viewer/2022062310/5695cf941a28ab9b028eab2e/html5/thumbnails/13.jpg)
Masalah Kesehatan di Masyarakat Indonesia (Triple burden)
![Page 14: Pertemuan I (Communicable Disease Epidemiology, Surveilans and Control)](https://reader035.vdocuments.mx/reader035/viewer/2022062310/5695cf941a28ab9b028eab2e/html5/thumbnails/14.jpg)
Chronic diseases are being neglected Chronic diseases are being neglected in the MDG’s (year 2000)in the MDG’s (year 2000)
![Page 15: Pertemuan I (Communicable Disease Epidemiology, Surveilans and Control)](https://reader035.vdocuments.mx/reader035/viewer/2022062310/5695cf941a28ab9b028eab2e/html5/thumbnails/15.jpg)
Triangle Epidemiology
![Page 16: Pertemuan I (Communicable Disease Epidemiology, Surveilans and Control)](https://reader035.vdocuments.mx/reader035/viewer/2022062310/5695cf941a28ab9b028eab2e/html5/thumbnails/16.jpg)
KONSEP PENYEBAB & PROSES TERJADINYA PENYAKIT
Proses kejadian suatu penyakit krn adanya proses interaksi antara Manusia (HOST), Penyebab (AGENT) serta lingkungan (ENVIROMENT) lebih
sesuai dengan penyakit INFEKSI
HOW IS THE RELATION SHIP
![Page 17: Pertemuan I (Communicable Disease Epidemiology, Surveilans and Control)](https://reader035.vdocuments.mx/reader035/viewer/2022062310/5695cf941a28ab9b028eab2e/html5/thumbnails/17.jpg)
H A
E
Sehat seimbang antara host, agent, enviroment
H
A
E
Sakit perubahan lingkungan yang mempermudah penyebaran agent . Ex. Akibat banjir
H
A
E
Sakit perubahan menurunnya daya tahan tubuh
![Page 18: Pertemuan I (Communicable Disease Epidemiology, Surveilans and Control)](https://reader035.vdocuments.mx/reader035/viewer/2022062310/5695cf941a28ab9b028eab2e/html5/thumbnails/18.jpg)
Epidemiologic triangle
Is comprised of HOST, AGENT and ENVIRONMENT.
1. A host: is a living organism capable of becoming infected.
2. An agent: is a factor that must be present (potential missing) for the occurrence of a disease.
3. An environment: extrinsic force of situation affecting the host’s opportunity to be exposed to an agent.
![Page 19: Pertemuan I (Communicable Disease Epidemiology, Surveilans and Control)](https://reader035.vdocuments.mx/reader035/viewer/2022062310/5695cf941a28ab9b028eab2e/html5/thumbnails/19.jpg)
List some of the components affecting disease
Host Characteristics Agent Characteristics
Environment Characteristics
1. Age2. Genetics3. Sex4. Socio economic 5. Immunity
1. Environ. stability2. Virulence3. Resistance (over prescription AB, mutation, survival) 4. Infectivity5. Pathogenicity
1.Biologic (vectors & Reservoirs).2. Physical (heat & pop. density)3. Social (culture)
Transmisi
![Page 20: Pertemuan I (Communicable Disease Epidemiology, Surveilans and Control)](https://reader035.vdocuments.mx/reader035/viewer/2022062310/5695cf941a28ab9b028eab2e/html5/thumbnails/20.jpg)
NATURAL HISTORY OF DISEASE
![Page 21: Pertemuan I (Communicable Disease Epidemiology, Surveilans and Control)](https://reader035.vdocuments.mx/reader035/viewer/2022062310/5695cf941a28ab9b028eab2e/html5/thumbnails/21.jpg)
NATURAL HISTORY OF DISEASE
Pre-clinical Phase Clinical Phase
Tk. Pencegahan I Tk. Pencegahan II Tk. Pencegahan III
1. Promkes2. Special protect3. Reducing expos
1. Screening2. APD3. Smoke4. Personal hygiene5. Avoid allergen
1.Penemuan dini. 2. Cure diseases (TB, Malaria, Ca) 3. Slow the progression4. Cut transmission5. Prevent complication
1. Limition disability
2. Restoration of effective function
3. Rehabilitation
![Page 22: Pertemuan I (Communicable Disease Epidemiology, Surveilans and Control)](https://reader035.vdocuments.mx/reader035/viewer/2022062310/5695cf941a28ab9b028eab2e/html5/thumbnails/22.jpg)
‘McDonalization’
![Page 23: Pertemuan I (Communicable Disease Epidemiology, Surveilans and Control)](https://reader035.vdocuments.mx/reader035/viewer/2022062310/5695cf941a28ab9b028eab2e/html5/thumbnails/23.jpg)
Herd immunity concept
![Page 24: Pertemuan I (Communicable Disease Epidemiology, Surveilans and Control)](https://reader035.vdocuments.mx/reader035/viewer/2022062310/5695cf941a28ab9b028eab2e/html5/thumbnails/24.jpg)
Natural History Of Disease
![Page 25: Pertemuan I (Communicable Disease Epidemiology, Surveilans and Control)](https://reader035.vdocuments.mx/reader035/viewer/2022062310/5695cf941a28ab9b028eab2e/html5/thumbnails/25.jpg)
Mode of Transmission
![Page 26: Pertemuan I (Communicable Disease Epidemiology, Surveilans and Control)](https://reader035.vdocuments.mx/reader035/viewer/2022062310/5695cf941a28ab9b028eab2e/html5/thumbnails/26.jpg)
Chain of infection (mode of transmission)(from principal of epidemiologi, 2nd ed, US, CDC)
1. Droplet2. Airborne3. Direct contact4. Vector5. Vehicle
Suspectible Host
1. Direct2. In-dIrect
Portal of Entry
(penular)
RESERVOAR
AGENT
![Page 27: Pertemuan I (Communicable Disease Epidemiology, Surveilans and Control)](https://reader035.vdocuments.mx/reader035/viewer/2022062310/5695cf941a28ab9b028eab2e/html5/thumbnails/27.jpg)
1. Reservoir: Habitat alamiah dari sebuah agent yg infeksius (manusia, binatang, sumber lingkungan).
2. Sumber infeksi: Orang atau objek yg tempat asal agent yg menginfeksi penjamu.
3. Carrier: Seseorang yg terinfeksi namun tidak menunjukkan gejala penyakit secara klinis (HIV; tergantung kpd pekerjaan, eq: pramugara, pembuat burger).
4. Transmisi: Penghubung dalam rantai infeksi (berguna u pencegahan, eq: ventilasi, kawat nyamuk, dll)
![Page 28: Pertemuan I (Communicable Disease Epidemiology, Surveilans and Control)](https://reader035.vdocuments.mx/reader035/viewer/2022062310/5695cf941a28ab9b028eab2e/html5/thumbnails/28.jpg)
Skala Prioritas Dalam Melakukan Investigasi dan Penanggulangan (Control) Wabah Berdasarkan Sumber, Cara
Penularan, dan Agen Penyebab
Sumber/Cara Penularan
Diketahui Tidak Diketahui
Agen Penyebab
DiketahuiInvestigasi + Investigasi +++Control +++ Control +
Tidak Diketahui
Investigasi +++ Investigasi +++Control +++ Control +
Control and Prevention
![Page 29: Pertemuan I (Communicable Disease Epidemiology, Surveilans and Control)](https://reader035.vdocuments.mx/reader035/viewer/2022062310/5695cf941a28ab9b028eab2e/html5/thumbnails/29.jpg)
Tujuan sistem kewaspadaan diniDan Outbreak Investigation
![Page 30: Pertemuan I (Communicable Disease Epidemiology, Surveilans and Control)](https://reader035.vdocuments.mx/reader035/viewer/2022062310/5695cf941a28ab9b028eab2e/html5/thumbnails/30.jpg)
Sumber data Kejadian Luar Biasa (KLB)
Data penderita diare di Puskesmas Gondokusuman
![Page 31: Pertemuan I (Communicable Disease Epidemiology, Surveilans and Control)](https://reader035.vdocuments.mx/reader035/viewer/2022062310/5695cf941a28ab9b028eab2e/html5/thumbnails/31.jpg)
Laporan Penyakit Menular DBD
1. Musim2. Cuaca
Masa pencegahan (PSN)
![Page 32: Pertemuan I (Communicable Disease Epidemiology, Surveilans and Control)](https://reader035.vdocuments.mx/reader035/viewer/2022062310/5695cf941a28ab9b028eab2e/html5/thumbnails/32.jpg)
Gambaran Kasus Diare Pada Beberapa Kecamatan Kab.Agam, SUMBAR (Januari,
2010)
![Page 33: Pertemuan I (Communicable Disease Epidemiology, Surveilans and Control)](https://reader035.vdocuments.mx/reader035/viewer/2022062310/5695cf941a28ab9b028eab2e/html5/thumbnails/33.jpg)
Definisi KLB (Kejadian Luar Biasa)
Adalah timbulnya suatu kejadian kesakitan/kematian dan atau meningkatnya suatu kejadian kesakitan/kematian yang bermakna secara epidemiologis pada suatu kelompok penduduk dalam kurun waktu tertentu (Undang-undang Wabah, 1969).
Pada penyakit yang lama tidak muncul atau baru pertama kali muncul disuatu daerah (non-endemis).
Outbreak is simply a higher frequency of disease or injury than is expected for a typical population and time period.
![Page 34: Pertemuan I (Communicable Disease Epidemiology, Surveilans and Control)](https://reader035.vdocuments.mx/reader035/viewer/2022062310/5695cf941a28ab9b028eab2e/html5/thumbnails/34.jpg)
Definisi Wabah
Wabah adalah kejadian yang melebihi keadaan biasa, pada satu/sekelompok masyarakat tertentu (MacMahon and Pugh, 1970; Last, 1983, Benenson, 1990).
Peningkatan frekuensi penderita penyakit, pada populasi tertentu, pada tempat dan musim atau tahun yang sama (Last, 1983).
![Page 35: Pertemuan I (Communicable Disease Epidemiology, Surveilans and Control)](https://reader035.vdocuments.mx/reader035/viewer/2022062310/5695cf941a28ab9b028eab2e/html5/thumbnails/35.jpg)
Perbedaan wabah dengan KLB
1 Wabah harus mencakup jumlah kasus yang besar.
2 Daerah yang luas.3 Waktu yang lebih lama.4 Dampak yang timbulkan lebih berat.
![Page 36: Pertemuan I (Communicable Disease Epidemiology, Surveilans and Control)](https://reader035.vdocuments.mx/reader035/viewer/2022062310/5695cf941a28ab9b028eab2e/html5/thumbnails/36.jpg)
The difference between epidemic, endemic and pandemic
1. Epidemic: That each infected person is infecting multiple other individuals, so the number of infected persons is growing exponentially (other words each infected person is rapidly) Out break
2. Endemic:The disease that always present, to a greater or lesser extent geographic location
3. Pandemic:is an epidemic that is widespread over a large area or “all” of a geographic area.
![Page 37: Pertemuan I (Communicable Disease Epidemiology, Surveilans and Control)](https://reader035.vdocuments.mx/reader035/viewer/2022062310/5695cf941a28ab9b028eab2e/html5/thumbnails/37.jpg)
How do we detect outbreaks?
Sources:1. Surveillance data.2. Medical Practitioner.3. Affected persons/groups.4. Concerned citizens.5. Media
![Page 38: Pertemuan I (Communicable Disease Epidemiology, Surveilans and Control)](https://reader035.vdocuments.mx/reader035/viewer/2022062310/5695cf941a28ab9b028eab2e/html5/thumbnails/38.jpg)
Pemastian Diagnosa
Gejala klinis N %
Mual 15 83
Sakit perut 15 83
Sakit kepala 14 78
Pucat 11 61
Lemah 8 44
Berkeringat dingin 8 44
Muntah 7 39
Sesak Nafas 3 16
![Page 39: Pertemuan I (Communicable Disease Epidemiology, Surveilans and Control)](https://reader035.vdocuments.mx/reader035/viewer/2022062310/5695cf941a28ab9b028eab2e/html5/thumbnails/39.jpg)
Pemastian Diagnosa
No GejalaFrekuensi Persentase
(n) (%)1 BAB cair/encer ≥3x dalam sehari 72 100,00
2 Lemah 36 50,00
3 Muntah 29 40,28
4 Demam 27 37,50
5 Mual 19 26,39
6 BAB tidak tertahankan 15 20,83
7 Pusing 15 20,83
8 Keringat dingin 11 15,28
9 BAB bau amis 10 13,89
10 Dehidrasi 9 12,50
11 Kram perut 7 9,72
12 BAB disertai lendir 5 6,94
13 BAB disertai darah 4 5,56
14 Mata cekung 2 2,78
![Page 40: Pertemuan I (Communicable Disease Epidemiology, Surveilans and Control)](https://reader035.vdocuments.mx/reader035/viewer/2022062310/5695cf941a28ab9b028eab2e/html5/thumbnails/40.jpg)
Menentukan sumber dan cara penularan
No Tempat Jumlah Persentase (%)
1 SMP N 1 Kokap 73 83,90
2Pondok Pesantren Ittihadul
Mujtahidin 7 8,05
3SMP N 1 Kokap dan Pondok
Pesantren Ittihadul Mujtahidin 7 8,05
Total 87 100,00
![Page 41: Pertemuan I (Communicable Disease Epidemiology, Surveilans and Control)](https://reader035.vdocuments.mx/reader035/viewer/2022062310/5695cf941a28ab9b028eab2e/html5/thumbnails/41.jpg)
Distribusi Kasus Berdasarkan Dusun Kec. Cawas Kab. Klaten
![Page 42: Pertemuan I (Communicable Disease Epidemiology, Surveilans and Control)](https://reader035.vdocuments.mx/reader035/viewer/2022062310/5695cf941a28ab9b028eab2e/html5/thumbnails/42.jpg)
Construct and interpret and epidemic curve
![Page 43: Pertemuan I (Communicable Disease Epidemiology, Surveilans and Control)](https://reader035.vdocuments.mx/reader035/viewer/2022062310/5695cf941a28ab9b028eab2e/html5/thumbnails/43.jpg)
Kegunaan kurva epidemik
1 Menentukan cara penularan (Tipe kurva)2 Identifikasi waktu paparan.3 Mencari indeks case (Orang yang pertama
sakit).
![Page 44: Pertemuan I (Communicable Disease Epidemiology, Surveilans and Control)](https://reader035.vdocuments.mx/reader035/viewer/2022062310/5695cf941a28ab9b028eab2e/html5/thumbnails/44.jpg)
Outbreak Pattern of Spread
The overall shape of the epi curve can reveal the type of outbreak1. Common source (sumber penyakit sama)2. Propagated (sumber penyakit dari berbagai
org/sumber)3. Mix (common source and propagated)
![Page 45: Pertemuan I (Communicable Disease Epidemiology, Surveilans and Control)](https://reader035.vdocuments.mx/reader035/viewer/2022062310/5695cf941a28ab9b028eab2e/html5/thumbnails/45.jpg)
Common Source Epidemic Curve
Y
X
![Page 46: Pertemuan I (Communicable Disease Epidemiology, Surveilans and Control)](https://reader035.vdocuments.mx/reader035/viewer/2022062310/5695cf941a28ab9b028eab2e/html5/thumbnails/46.jpg)
0
2
4
6
8
10
12
14Tanggal Mulai Sakit (minggu)JUMLAH KASUS
Propagated Epidemic Curve
![Page 47: Pertemuan I (Communicable Disease Epidemiology, Surveilans and Control)](https://reader035.vdocuments.mx/reader035/viewer/2022062310/5695cf941a28ab9b028eab2e/html5/thumbnails/47.jpg)
Epidemic Curve (Mix)
47
![Page 48: Pertemuan I (Communicable Disease Epidemiology, Surveilans and Control)](https://reader035.vdocuments.mx/reader035/viewer/2022062310/5695cf941a28ab9b028eab2e/html5/thumbnails/48.jpg)
Cara Membuat Curva Epidemic
1. Masa inkubasi maksimum dan minimum2. Masa inkubasi rata-rata
![Page 49: Pertemuan I (Communicable Disease Epidemiology, Surveilans and Control)](https://reader035.vdocuments.mx/reader035/viewer/2022062310/5695cf941a28ab9b028eab2e/html5/thumbnails/49.jpg)
Estimating the date of common source exposure(Minimum-maximum method) n; 81
8 hari
14 hari
Maret April
![Page 50: Pertemuan I (Communicable Disease Epidemiology, Surveilans and Control)](https://reader035.vdocuments.mx/reader035/viewer/2022062310/5695cf941a28ab9b028eab2e/html5/thumbnails/50.jpg)
Minimum-maximum method
1. Epidemi mulai 24 maret dan berakhir pada 5 april2. Lama epidemi 12 hari.3. Masuk dalam kisaran masa inkubasi penyakit
tertentu (ex : tifoid 8-14 hari, mean 11 hari).4. Kasus pertama terpapar > 7 hari sebelumnya yaitu
tgl sebelum 17 maret (Masa inkubasi tifoid terpendek 8 hari).
5. Kasus terakhir terpapar sebelum 21 maret (masa inkubasi terpanjang 14 hari).
6. Hipotesis : Paparan terjadi antara 17-21 Maret
![Page 51: Pertemuan I (Communicable Disease Epidemiology, Surveilans and Control)](https://reader035.vdocuments.mx/reader035/viewer/2022062310/5695cf941a28ab9b028eab2e/html5/thumbnails/51.jpg)
Estimating the date of common source exposure (Metode incubasi ratata) n: 81
11 hari
Maret April
![Page 52: Pertemuan I (Communicable Disease Epidemiology, Surveilans and Control)](https://reader035.vdocuments.mx/reader035/viewer/2022062310/5695cf941a28ab9b028eab2e/html5/thumbnails/52.jpg)
Cara lain(Masa inkubasi rata-rata)
1. Tentukan rerata masa inkubasi (tifoid 11 hari).
2. Tentukan kasus median (kasus ke 40 atau 41 secara kronologis dari 81 kasus).
3. Hitung ke belakang rerata masa inkubasi.4. Hipotesis : paparan diduga tgl 15 Maret
![Page 53: Pertemuan I (Communicable Disease Epidemiology, Surveilans and Control)](https://reader035.vdocuments.mx/reader035/viewer/2022062310/5695cf941a28ab9b028eab2e/html5/thumbnails/53.jpg)
TERIMA KASIH