THE TREND OF COVID-19 CASES IN CHILDREN BEFORE AND AFTER THE EASING OF RESTRICTIONS ON COMMUNITY ACTIVITIES (PPKM) IN THE PROVINCE OF THE SPECIAL REGION OF YOGYAKARTA.

Mohammed Avicenna Iqbal, dr. Sumadiono, Sp.A(K), dr. Suryono Yudha Patria, Sp.A(K), Ph.D, dr. Agung Triono, Sp. A(K)

2023 | Skripsi | PENDIDIKAN DOKTER

LATAR BELAKANG: Virus COVID-19 merupakan pandemi global yang berdampak luas pada dunia, termasuk dampaknya pada anak-anak. Yogyakarta, sebagai lokasi yang populer, sangat rentan terhadap penyebaran pandemi yang cepat. Untuk menangani pandemi, penguncian nasional global dimulai, yang menyebabkan konsekuensi sosial ekonomi yang signifikan bagi negara. Namun, langkah-langkah tertentu diterapkan untuk mengurangi dampak parah dari penguncian, seperti membuka kembali akses secara bertahap ke sektor sekunder dan tersier. Meskipun demikian, tindakan ini berdampak pada lintasan kasus COVID-19, menyebabkan kebangkitan penyebaran virus.

TUJUAN: Penelitian ini bertujuan untuk mengkaji hubungan antara aturan PPKM dan PSBB dengan tren kasus COVID-19 pediatrik pada anak di Daerah Istimewa Yogyakarta.

METODE: Dengan menggunakan model kohort retrospektif, penelitian ini bertujuan untuk mengumpulkan informasi tentang tindakan PPKM dan PSBB terkait tren kasus COVID-19 pediatrik. Studi tersebut mengumpulkan data kasus COVID-19, termasuk tanggal dan lokasi setiap peristiwa, dari Maret 2020 hingga data terbaru yang tersedia. Penelitian difokuskan pada anak usia 0-18 tahun yang berdomisili di Kabupaten Bantul, Sleman, Gunung Kidul, Kota Yogyakarta, dan Kulon Progo di Daerah Istimewa Yogyakarta. Data tersebut diperoleh dari Dinas Kesehatan Daerah Istimewa Yogyakarta (DINKES DIY) dan Ikatan Dokter Anak Indonesia Daerah Istimewa Yogyakarta (IDAI DIY). SPSS 20 digunakan untuk menganalisis statistik data.

HASIL: Pada PSBB kasus terbanyak ditemukan pada anak usia 13-17 tahun sebanyak 548 kasus (41,6%), diikuti anak usia 6-12 tahun sebanyak 433 kasus (32,8%), anak usia 1-5 tahun sebanyak 271 kasus (20,5%), dan bayi di bawah satu tahun sebanyak 65 kasus (4,9%). Sedangkan pada PPKM, kasus terbanyak ditemukan pada kelompok umur 13-17 sebanyak 514 kasus (40,9%), diikuti kelompok umur 6-12 sebanyak 414 kasus (32,9%), kelompok umur 1-5 sebanyak 259 kasus. 20,6%), dan bayi di bawah satu tahun sebanyak 68 kasus (5,4%). Berdasarkan lokasi di PSBB, kasus terbanyak ditemukan di Kabupaten Sleman sebanyak 512 kasus (38,8%), disusul Bantul sebanyak 400 kasus (30,3%). %), Kota Yogyakarta sebanyak 200 kasus (15,1%), Kulon Progo sebanyak 106 kasus (8%), dan Gunung Kidul sebanyak 99 kasus (7%). Sedangkan pada PPKM, kasus terbanyak ditemukan di Kabupaten Sleman xii sebanyak 501 kasus (39,9%), diikuti Bantul sebanyak 385 kasus (30,6%), Kota Yogyakarta sebanyak 187 kasus, Kulon Progo sebanyak 103 kasus (8,2%), dan Gunung Kidul dengan 79 kasus (6%). Terlihat pula selama 10 bulan pertama penerapan PSBB (Maret-Desember), total kasus positif sebanyak 1.317 kasus, dengan rata-rata 13 kasus per bulan. Dari jumlah tersebut, 675 kasus (51,2%) ditemukan pada wanita dan 642 kasus (48%) ditemukan pada pria. Selama pengamatan 10 bulan PSBB, persentase kasus positif COVID-19 berfluktuasi antara 1,7% hingga 22,2%, dengan rata-rata persentase bulanan sebesar 11,2%. Pada pengamatan PPKM 6 bulan berikutnya, persentase kasus positif berkisar antara 7,5% hingga 18,9%, dengan rata-rata persentase bulanan sebesar 12,8%. Selama 3 bulan pengamatan kedaruratan PPKM berikutnya, persentase kasus positif berfluktuasi antara 10% hingga 18,8%, dengan rata-rata persentase bulanan sebesar 13,8%. Satu bulan sebelum pelaksanaan PPKM Darurat, selama periode PPKM, angka positifnya adalah 18,8%. Sebaliknya, satu bulan setelah penerapan PPKM Darurat, angka positifnya adalah 10%. Angka positif pada periode PPKM (satu bulan sebelum pelaksanaan PPKM Darurat) lebih tinggi dibandingkan dengan angka positif pada periode PPKM Darurat (satu bulan setelah PPKM Darurat dilaksanakan), dan perbedaan ini signifikan secara statistik (p = 0,00001) . Dua bulan sebelum pelaksanaan PPKM Darurat, selama periode PPKM, angka positifnya adalah 16,9%. Sebaliknya, selama dua bulan setelah PPKM Darurat dilaksanakan, angka positifnya sebesar 14,5%. Angka positif pada periode PPKM (dua bulan sebelum PPKM Darurat dilaksanakan) lebih tinggi dibandingkan dengan angka positif pada periode PPKM Darurat (dua bulan setelah PPKM Darurat dilaksanakan), dan perbedaan ini signifikan (p = 0,00001). Tiga bulan sebelum pelaksanaan PPKM Darurat, pada periode PPKM angka positifnya sebesar 14,9%. Sebaliknya, selama tiga bulan setelah PPKM Darurat dilaksanakan, angka positifnya sebesar 14,4%. Perbedaannya, bagaimanapun, tidak signifikan secara statistik (p = 0,626).

KESIMPULAN: Laju positif Covid-19 pada masa PSBB lebih tinggi dibandingkan dengan laju positif pada masa PPKM dan PPKM Darurat, baik perbandingan satu bulan maupun tiga bulan. Namun, perbedaan ini signifikan secara statistik hanya dalam perbandingan satu bulan. Pada perbandingan tiga bulan, meskipun ada perbedaan, namun tidak signifikan secara statistik.

Kata kunci: COVID-19, PPKM, PSBB, anak, DIY, kasus covid pediatrik, dampak sosial ekonomi

BACKGROUND: The COVID-19 virus is a global pandemic that has widespread effects on the world, including its impact on children. Yogyakarta, being a popular location, is particularly susceptible to the rapid spread of the pandemic. To handle the pandemic, a global nationwide lockdown was initiated, leading to significant socioeconomic consequences for the country. However, certain measures were implemented to mitigate the severe effects of the lockdown, such as gradually reopening access to secondary and tertiary sectors. Nonetheless, this action has had repercussions on the trajectory of COVID-19 cases, causing a resurgence in the spread of the virus.

OBJECTIVES: This study aims to assess the relation between the regulation of PPKM and PSBB alongside the trend of pediatric COVID-19 cases in children within The Special Region of Yogyakarta. 

METHODS: Using a retrospective cohort model, this study aimed to gather information on PPKM and PSBB measures in relation to the trend of pediatric COVID-19 cases. The study collected data on COVID-19 cases, including the date and location of each event, from March 2020 until the most recent available data. The study focused on children aged 0-18 years residing in Bantul, Sleman, Gunung Kidul, Kota Yogyakarta, and Kulon Progo districts within the Special Region of Yogyakarta. The data was obtained from the Public Health Office for the Special Region of Yogyakarta (DINKES DIY) and the Indonesian Pediatric Association of the Special Region of Yogyakarta (IDAI DIY). SPSS 20 was used to analyze the statistic of the data. 

RESULT: In PSBB, the most cases were found in children aged 13-17 years, with 548 cases (41.6%), followed by children aged 6-12 years with 433 cases (32.8%), children aged 1-5 years with 271 cases (20.5%), and infants under one year with 65 cases (4.9%). While in PPKM, the most cases were found in the 13-17 age group with 514 cases (40.9%), followed by the 6-12 age group with 414 cases (32.9%), the 1-5 age group with 259 cases (20.6%), and infants under one year with 68 cases (5. 4%).Based on location in PSBB, the most cases were found in Sleman district, with 512 cases (38.8%), followed by Bantul with 400 cases (30.3%), Yogyakarta City with 200 cases (15.1%), Kulon Progo with 106 cases (8%), and Gunung Kidul with 99 cases (7%). While in PPKM, the most cases were found in Sleman district xii with 501 cases (39.9%), followed by Bantul with 385 cases (30.6%), Yogyakarta City with 187 cases, Kulon Progo with 103 cases (8.2%), and Gunung Kidul with 79 cases (6%).It can also be observed that during the first 10 months of the PSBB implementation (March-December), the total number of positive cases was 1,317 cases, with an average of 13 cases per month. Of this total, 675 cases (51.2%) were found in women and 642 cases (48%) were found in men. During the 10-month observation of PSBB, the percentage of positive COVID-19 cases fluctuated between 1.7% and 22.2%, with an average monthly percentage of 11.2%. In the following 6 months of PPKM observation, the percentage of positive cases ranged from 7.5% to 18.9%, with an average monthly percentage of 12.8%. During the subsequent 3 months of PPKM Emergency observation, the percentage of positive cases fluctuated between 10% and 18.8%, with an average monthly percentage of 13.8%. One month prior to the implementation of PPKM Emergency, during the PPKM period, the positive rate was 18.8%. Conversely, one month after the implementation of PPKM Emergency, the positive rate was 10%. The positive rate during the PPKM period (one month before the implementation of PPKM Emergency) was higher compared to the positive rate during the PPKM Emergency period (one month after PPKM Emergency was implemented), and this difference is statistically significant (p = 0.00001). Two months before the implementation of Emergency PPKM, during the PPKM period, the positive rate was16.9%. In contrast, during the two months after Emergency PPKM was implemented, the positive rate was 14.5%. The positive rate during the PPKM period (two months before Emergency PPKM was implemented) was higher compared to the positive rate during the Emergency PPKM period (two months after Emergency PPKM was implemented), and this difference is significant (p = 0.00001). Three months before the implementation of Emergency PPKM, during the PPKM period, the positive rate was 14.9%. On the other hand, during the three months after Emergency PPKM was implemented, the positive rate was 14.4%. The difference, however, is not statistically significant (p = 0.626).

CONCLUSION: The positive rate of Covid-19 during the PSBB period was higher compared to the positive rates during the PPKM and PPKM Emergency periods, both in the comparison of one month and three months. However, this difference was statistically significant only in the one-month comparison. In the three-month comparison, although there was a difference, it was not statistically significant.

Keywords:  COVID-19, PPKM, PSBB, children, DIY, pediatric covid  cases, socio economic impact

Kata Kunci : COVID-19, PPKM, PSBB, PPKM Darurat, anak-anak, DIY, kasus covid pediatrik, dampak sosial ekonomi