Pengelolaan vaksin, penatalaksanaan imunisasi campak dan evikasi vaksin campak di Kabupaten Sukoharjo

WISNUWIJOYO, Agus Prihatmo, Dr.dr. Sutaryo, Sp.AK

2003 | Tesis | S2 Ilmu Kesehatan Masyarakat

Latar belakang: Sukohaijo adalah kabupaten yang telah mencapai UCI lebih dari tiga tahun akan tetapi masih teijadi Kejadian Luar Biasa (KLB) campak di beberapa daerah. Tujuan penelitian ini untuk mengetahui pengelolaan vaksin, penatalaksanaan pemberian imunisasi campak dan besamya efikasi vaksin campak. Metode penelitian; Penelitian terdiri dari 2 tahap, tahap pertama adalah menghitung efikasi vaksin capak, digunakan rancangan penelitian cross sectional dengan populasi anak batita (12 - 35 bulan). Besar sampel 768 batita yang berada di 30 posyandu dari 6 puskesmas sampel. Penelitian tahap ke dua adalah penelitian kualitatif dengan melakukan pengamatan, wawancara mendalam dan diskusi kelompok terarah terhadap pengelola vaksin dan pelaksana imunisasi di puskesmas dan posyandu lokasi penelitian tahap pertama. Hasil penelitian: Hasil penelitian menunjukan bahwa efikasi vaksin rendah untuk dapat melindungi batita dari sakit campak yaitu 61,56% (95%, CI. 40% - 75 %). Pengelolaan vaksin buruk, tidak sesuai dengan ketentuan yang seharusnya (almari es sering dibuka, penggunaan cold pack yang tidak standar dan volume <1/3 volume termos,diposyandu vaksin diletakkan di meja atau dalam termos yang terbuka) dan penatalaksanaan pemberian imunisasi tidak sesuai dengan ketentuan yang seharusnya (pemberian secara intra muscular, dosis vaksin yang diberikan kurang, pelarutan vaksin menggunakan pelarut yang tidak dingin, penggunaan alkohol pada pembersihan kulit lokasi imunisasi, pemakaian spet yang bergantian dengan vaksin lain, pemakaian sisa vaksin di posyandu dipakai untuk pelakasanaan imunisasi pada sore harinya). Batita yang diimunisasi di puskesmas mempunyai kemungkinan menderita campak sama dengan yang diimunisasi di posyandu (OR=1,03; 95% CI : 047-2,22; p=0,925). Batita dengan status gizi kurang saat diimunisasi mempunyai kemungkinan menderita campak 27 kali batita yang dengan status gizi baik (OR=26,72; 95% CI: 14,42-49,85; p<0,05). Kesimpulan: Pengelolaan vaksin dan tatalaksana pemberian imunisasi di Sukohaijo buruk. Efikasi vaksin campak rendah sehingga kurang dapat melindungi batita dari penyakit campak.

Background; The Sukohaijo Regency has achieved UCI more than 3 years but it still occured the outbreak of measles in some areas. This research is aimed to know the vaccine management, the organization of measles immunization treatment and the large of measles vaccine efficacy. Research method: The research consists of two phases, the first phase is to calculate the measles vaccine efficacy, by using the research design of cross sectional with population of batita (12-35 months old children). The sample size of 768 batitas was in 30 Posyandus of 6 Puskesmas samples. The second research phase was a qualitative research by conducting an observation, a deep interview, and the structured group discussion to the vaccine managers and immunization vaccinators in Puskesmas and Posyandu in the first phase research location, Results of research: The research's result showed that the vaccine efficacy was low which able to prevent the batita from measles; that was 61.56% (95%, CI.40%-75%). The bad vaccine management, which was not fit to suggested provisions (refrigerator was oftenly opened, the unstandardized usage of cold pack and the volume <1/3 of thermos volume, in Posyandu the vaccine laid on table or in opened thermos) and the orgamzation of immunization treatment was not in accordance to the suggested provisions (the intramuscular treatment, the vaccine dose treatment was less, the vaccine dissolving is by using the uncold solvent, the alcohol usage for skin cleansing of immunization location, the reusage spet, the usage of vaccine residue in Posyandu which applied to immunization practice in the afternoon period of the same day). Batita who was immunized in Puskesmas had the possibility suffering the similar measles into those immunized in Posyandu (OR=1.03;95% CI : 047-2.22; f)=0.925). Batita under bad nutrient status when immunized had the possibility suffering the measles as much as 27 times rather than those who had the good nutrient status (OR=26.72;95% CI: 14.42- 49.85; p=0.05), Conclusion: The vaccine management and the organization of immunization treatment in Sukohaijo Regency was worse. The measles vaccine efficacy was low so that could not prevent batitas from the measles desease.

Kata Kunci : Epidemiologi,Campak,Imunisasi dan Evikasi Vaksin Campak