INFECTIOUS DISEASES

STEP 1 :
1. Flu : infectious disease caused by RNA viruses of the family Orthomyxoviridae, that
attack birds and mammals.
Sumber: http://cara-mengobati.com/search/pdf-pengertian-flu

2. Symptoms : any sensation or change in bodily function that is experienced by a

patient and is associated with a particular disease
Sumber: http://www.artikata.com/arti-181439-symptom.html

3. Prescribed : conforming to set usage, procedure, or discipline

fixed or established especially by order or command
Sumber: : http://www.artikata.com/arti-181439-symptom.html

4. Infection : the invasion of the body by pathogenic microorganisms and

their multiplication which can lead to tissue damage and disease
Sumber: http://www.artikata.com/arti-181439-symptom.html

5. Health promotion :
According to the WHO definition of health promotion is
Health promotion is the process of making people able to improve control of
and improve their health.
Sumber: http//elearning.baktiinangpersada.ac.id
promosi kesehatan adalah upaya untuk meningkatkan kemampuan masyarakat melalui pembelajaran
dari, oleh, untuk dan bersama masyarakat, agar mereka dapat menolong diri sendiri, serta
mengembangkan kegiatan yang bersumber daya masyarakat, sesuai sosial budaya setempat
dan didukung kebijakan publik yang berwawasan kesehatan.

Sumber: www.promkes.depkes.go.id

6. Natural history of diseases : (Riwayat Alami penyakit)

The “natural history of disease” refers to the progression of disease
process in an individual over time, in the absence of intervention.
There are four stages in the natural history of a disease. These are:
1. Stage of susceptibility
In this stage, disease has not yet developed, but the groundwork has
been laid by the presence of factors that favor its occurrence.
Example: unvaccinated child is susceptible to measles.
2. Stage of Pre-symptomatic (sub-clinical) disease
In this stage there are no manifestations of the disease but pathologic
changes (damages) have started to occur in the body. The disease
can only be detected through special tests since the signs and
symptoms of the disease are not present.
Examples:
• Detection of antibodies against HIV in an apparently healthy
person.
• Ova of intestinal parasite in the stool of apparently healthy
children.
The pre-symptomatic (sub-clinical) stage may lead to the clinical
stage, or may sometimes end in recovery without development of any
signs or symptoms.
3. The Clinical stage
At this stage the person has developed signs and symptoms of the
disease. The clinical stage of different diseases differs in duration,
severity and outcome. The outcomes of this stage may be recovery,
disability or death.
Examples:
􀂃 Common cold has a short and mild clinical stage and
almost everyone recovers quickly.
􀂃 Polio has a severe clinical stage and many patients
develop paralysis becoming disabled for the rest of their
lives.
􀂃 Rabies has a relatively short but severe clinical stage and
almost always results in death.
􀂃 Diabetes Mellitus has a relatively longer clinical stage and
eventually results in death if the patient is not properly
treated.
4. Stage of disability or death
Some diseases run their course and then resolve completely either
spontaneously or by treatment. In others the disease may result in a
residual defect, leaving the person disabled for a short or longer
duration. Still, other diseases will end in death.
Disability is limitation of a person's activities including his role as a
parent, wage earner, etc
Examples:
• Trachoma may cause blindness
• Meningitis may result in blindness or deafness. Meningitis may
also result in death.
Sumber:
http://www.cartercenter.org/resources/pdfs/health/ephti/library/lectu
re_notes/env_occupational_health_students/Epidemiology.pdf
 Sumber: http://arviant.web.ugm.ac.id/content/Epidemiologi%20dasar.pdf

7. Preventive care :
A treatment to improve the nation’s health and reduce overall spending by finding and treating
diseases sooner.

Sumber: https://www.medmutual.com/For-Individuals-and-Families/Health-
Insurance-Education/What-Does-Healthcare-Reform-Mean-to-Me/What-Is-
Covered-Under-Preventive-Care.
STEP 3

1. How the way to prevent and promote of infectious diseases?

There are three levels of prevention
1) Primary prevention:-The main objectives of primary
prevention are promoting health, preventing exposure and
preventing disease. Primary prevention keeps the disease
process from becoming established by eliminating causes of
disease or increasing resistance to disease.
Primary prevention has 3 components.
These are health promotion, prevention of exposure, and prevention of disease.
A. Health promotion:- consists of general non-specific
interventions that enhance health and the body's ability to
resist disease. Improvement of socioeconomic status,
provision of adequate food, housing, clothing, and education
are examples of health promotion.
B. Prevention of exposure:- is the avoidance of factors
which may cause disease if an individual is exposed to them.
Examples can be provision of safe and adequate water,
proper excreta disposal, and vector control.
C. Prevention of disease:- is the prevention of disease
development after the individual has become exposed to the
disease causing factors. Immunization is an example of
prevention of disease. Immunization acts after exposure has
taken place. Immunization does not prevent an infectious
organism from invading the immunized host, but does prevent
it from establishing an infection. If we take measles vaccine, it
will not prevent the virus from entering to the body but it
prevents the development of infection/disease.

2) Secondary prevention:- The objective of secondary

prevention is to stop or slow the progression of disease so
as to prevent or limit permanent damage. Secondary
 prevention can be achieved through detecting people who
already have the disease as early as possible and treat them.
It is carried out before the person is permanently damaged.
Examples:
• Prevention of blindness from Trachoma
• Early detection and treatment of breast cancer to
prevent its progression to the invasive stage, which is
the severe form of the disease.

3) Tertiary prevention:– is targeted towards people with

permanent damage or disability. Tertiary prevention is needed
in some diseases because primary and secondary preventions
have failed, and in others because primary and secondary
prevention are not effective. It has two objectives:
• Treatment to prevent further disability or death and
• To limit the physical, psychological, social, and
financial impact of disability, thereby improving the
quality of life. This can be done through rehabilitation,
which is the retraining of the remaining functions for
maximal effectiveness.
Example: When a person becomes blind due to vitamin A
deficiency, tertiary prevention (rehabilitation) can help the blind or
partly blind person learn to do gainful work and be economically
self supporting.
Sumber:

Prevensi Penyakit Menular

1. Prevensi Primer
Upaya menurunkan insidensi penyakit menular melalui promosi
kesehatan dan pendidikan kesehatan, misal pendidikan kesehatan
reproduksi, vaksinasi, profilasi malaria

2.Prevensi Sekunder
Upaya menurunkan prevalensi penyakiT menular, dengan deteksi
dini dan terapi, misal screening, investigasi kontak antar individu
(untuk HIV, TB, PMS/Penyakit Menular Seksual, Hepatitis)
3. Prevensi Tersier
Upaya mengurangi komplikasi dan kecacatan akibat penyakit
menular, misal kemoprofilaksis untuk penderita HIV/AIDS

http://www.cartercenter.org/resources/pdfs/health/ephti/library/lecture_not
es/env_occupational_health_students/Epidemiology.pdf
a. PENCEGAHAN PRIMORDIAL
Tujuan : untuk menghindari kemunculan adanya faktor resiko
Memerlukan peraturan yang tegas dari yang berwenang 􀃆tidak melakukan hal‐hal yang
beresiko timbulnya penyakit tertentu
Contoh : Melarang menebang pohon 􀃆banjir 􀃆kejadian Diare

Sumber: : http://arviant.web.ugm.ac.id/content/Epidemiologi%20dasar.pdf
STRATEGI PROMOSI KESEHATAN
Menyadari rumitnya hakikat dari perilaku, maka perlu
dilaksanakan strategi promosi kesehatan paripurna yang
terdiri dari (1) pemberdayaan, yang didukung oleh (2) bina
suasana dan (3) advokasi, serta dilandasi oleh semangat (4)
kemitraan.
 Pemberdayaan adalah Pemberdayaan adalah pemberian informasi dan pendampingan
dalam mencegah dan menanggulangi masalah kesehatan, guna membantu individu, keluarga
atau kelompok-kelompok masyarakat menjalani tahap-tahap tahu, mau dan mampu
mempraktikkan PHBS.

 Bina suasana adalah pembentukan suasana lingkungan sosial yang kondusif dan mendorong
dipraktikkannya PHBS serta penciptaan panutan-panutan dalam mengadopsi PHBS dan
melestarikannya.

 Sedangkan advokasi adalah pendekatan dan motivasi terhadap pihak-pihak tertentu yang
diperhitungkan dapat mendukung keberhasilan pembinaan PHBS baik dari segi materi
maupun non materi.

 KEMITRAAN
Kemitraan harus digalang baik dalam rangka pemberdayaan
maupun bina suasana dan advokasi guna membangun kerjasama
dan mendapatkan dukungan. Dengan demikian kemitraan perlu
digalang antar individu, keluarga, pejabat atau instansi pemerintah
yang terkait dengan urusan kesehatan (lintas sektor), pemuka atau
tokoh masyarakat, media massa dan lain-lain. Kemitraan harus
berlandaskan pada tiga prinsip dasar, yaitu (a) kesetaraan, (b)
keterbukaan dan (c) saling menguntungkan.
 KESETARAAN
Kesetaraan berarti tidak diciptakan hubungan yang bersifat hirarkhis.
Semua harus diawali dengan kesediaan menerima bahwa masingmasing
berada dalam kedudukan yang sama (berdiri sama tinggi, duduk sama rendah). Keadaan ini dapat
dicapai apabila semua pihak bersedia mengembangkan hubungan kekeluargaan. Yaitu hubungan
yang dilandasi kebersamaan atau kepentingan bersama. Bila kemudian dibentuk struktur hirarkhis
(misalnya sebuah tim), adalah karena kesepakatan.
 KETERBUKAAN
Oleh karena itu, di dalam setiap langkah diperlukan adanya kejujuran dari masingmasing
pihak. Setiap usul/saran/komentar harus disertai dengan alasan yang jujur, sesuai fakta, tidak
menutup-tutupi sesuatu. Pada awalnya hal ini mungkin akan menimbulkan diskusi yang seru
layaknya “pertengkaran”. Akan tetapi kesadaran akan kekeluargaan dan kebersamaan, akan
mendorong timbulnya solusi yang adil dari “pertengkaran” tersebut.
 SALING MENGUNTUNGKAN
Solusi yang adil ini terutama dikaitkan dengan adanya keuntungan yang didapat
oleh semua pihak yang terlibat. PHBS dan kegiatan-kegiatan kesehatan dengan demikian harus
dapat dirumuskan keuntungan-keuntungannya (baik langsung maupun tidak langsung) bagi semua
pihak yang terkait. Termasuk keuntungan ekonomis, bila mungkin.
 Sumber: www.promkes.depkes.go.id

2. What are the factor of infectious diseases development?

Factor of infectious disease development can be described with
epidemiological triangle:
 Sumber:
http://drhmadheedhieya.files.wordpress.com/2011/10/infectious_proc
ess_day_2-indonesia1_.pdf
3. Mention type and example of infection diseases!
Infectious diseases can be caused by:

 Bacteria. These one-cell organisms are responsible for illnesses such as strep throat,
urinary tract infections and tuberculosis.
 Viruses. Even smaller than bacteria, viruses cause a multitude of diseases — ranging
from the common cold to AIDS.
 Fungi. Many skin diseases, such as ringworm and athlete's foot, are caused by fungi.
Other types of fungi can infect your lungs or nervous system.
 Parasites. Malaria is caused by a tiny parasite that is transmitted by a mosquito bite.
Other parasites may be transmitted to humans from animal feces.

Direct contact
An easy way to catch most infectious diseases is by coming in contact with a person or
animal who has the infection.Three ways infectious diseases can be spread through direct
contact are:

 Person to person. The most common way for infectious diseases to spread is through
the direct transfer of bacteria, viruses or other germs from one person to another. This
can occur when an individual with the bacterium or virus touches, coughs on or kisses
someone who isn't infected. These germs can also spread through the exchange of
body fluids from sexual contact or a blood transfusion. The person who passes the
germ may have no symptoms of the disease, but may simply be a carrier.
 Animal to person. Pets can carry many germs. Being bitten or scratched by an
infected animal can make you sick and, in extreme circumstances, can be fatal.
Handling animal waste can be hazardous, too. For example, you can acquire a
toxoplasmosis infection by scooping your cat's litter box.
 Mother to unborn child. A pregnant woman may pass germs that cause infectious
diseases to her unborn baby. Some germs can pass through the placenta. Germs in the
vagina can be transmitted to the baby during birth.

Indirect contact
Disease-causing organisms also can be passed by indirect contact. Many germs can linger on
an inanimate object, such as a tabletop, doorknob or faucet handle. When you touch a
doorknob handled by someone ill with the flu or a cold, for example, you can pick up the
germs he or she left behind. If you then touch your eyes, mouth or nose before washing your
hands, you may become infected.

Insect bites
Some germs rely on insect carriers — such as mosquitoes, fleas, lice or ticks — to move from
host to host. These carriers are known as vectors. Mosquitoes can carry the malaria parasite
or West Nile virus, and deer ticks may carry the bacterium that causes Lyme disease.

Food contamination
Another way disease-causing germs can infect you is through contaminated food and water.
This mechanism of transmission allows germs to be spread to many people through a single
source. E. coli, for example, is a bacterium present in or on certain foods — such as
undercooked hamburger or unwashed fruits or vegetables.

Sumber: http://www.mayoclinic.com/health/infectious-
diseases/DS01145/DSECTION=causes

4. How to prevent the infection by the virus?

 Immunization
Vaccines are among the most cost-effective clinical preventive services and are a core
component of any preventive services package. Childhood immunization programs
provide a very high return on investment.
Scientific improvements in the diagnosis of infectious disease-related health concerns
 appropriate use of antibiotics
 on the issue of HIV disease, avoid sexual contact with patient
 cover mouth if coughing or sneezing.
 isolation can be needed (e.g. a person with chickenpox should not visit a person with
immune disorder).

sumber: http://www.healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=23

http://ddsn.sc.gov/providers/healthinfoupdates/Documents/MCSpreadInfectUpdate0902.pdf

Sumber: http://www.slideshare.net/lnguyen/insel10ebrup-ppt-ch13
5. How can we get affected by infectious diseases?
 Adanya penurunan system imun tubuh
Patogen yang telah masuk akan menimbulkan penyakit dengan pelbagai mekanisme.
Segala macam mikroorganisme yang menginvasi vertebrata akan berhadapan dengan
imunitas innate sebagai pertahanan pertama yang terjadi beberapa menit setela
infeksi. Imunitas adaptif akan timbul apabila pertahanan pertama ini tidak mampu
mengeliminasi patogen yang masuk.
Penurunan system imun ini salah satunya diakibatkan kurangnya gizi dari individu
itu sendiri
 Adanya gangguan pada system sekresi khususnya pada kulit, karena disini
baik kelenjar minyak maupun keringat memiliki fungsi sebagai perlawanan pertama
terhadap suatu pathogen.
Sumber: http://muhaiminrifai.lecture.ub.ac.id/files/2011/01/BAB-IV.PERTAHANAN-
TUBUH.pdf

6. What are factors of infection ?

7. What the symptoms of infectious diseases?
Common Infectious Diseases Worldwide:
 African Trypanosomiasis (“sleeping sickness”): African trypanosomiasis is spread by the
tsetse fly, which is common to many African countries. The World Health Organization
(WHO) estimates that nearly 450,000 cases occur each year. Symptoms of the disease
include fever, headaches, joint pains, and itching in the early stage, and confusion,
sensory disturbances, poor coordination, and disrupted sleep cycles in the second stage.
 Cholera: Cholera is a disease spread mostly through contaminated drinking water and
unsanitary conditions. It is an acute infection of the intestines with the bacterium Vibrio
cholerae. Its main symptom is copious diarrhea.
 Measles: Symptoms include high fever, coughing, and a maculo-papular rash; common
complications include diarrhea, pneumonia, and ear infections.
 Meningitis: It is usually the result of a viral or bacterial infection. Symptoms include
severe headache, fever, nausea, vomiting, lethargy, delirium, photophobia, and a stiff
neck.
 Rotavirus: Rotavirus is the most common cause of viral gastroenteritis worldwide,
Symptoms include vomiting, watery diarrhea, fever, and abdominal pain
 Tuberculosis: symptoms include fatigue, weight loss, appetite loss, chills, fever, and night
sweats.
 Influenza: The influenza virus attacks the human respiratory tract, causing symptoms
such as fever, headaches, fatigue, coughing, sore throat, nasal congestion, and body
aches.
Sumber: http://www.factmonster.com/ipka/A0903696.html

8. How can the infection spreads ?

Infection requires three main elements
• a source of the infectious agent,
• a mode of transmission and
• a susceptible host.
This is known as the chain of infection (figure 1)
interruption of this cycle is a strategy to limit the
spread of infection.

WAYS THAT INFECTION CAN SPREAD FROM ONE PERSON TO

ANOTHER

 Spread by Contact This may be direct contact between persons. Examples

can be kissing, which can spread Infectious Mononucleosis (called Glandular
Fever), or from contact with infected skin or mucus membranes (eyes, mouth,
nose, vaginal and rectum) in the course of personal care. Indirect spread of
infection occurs when items that are in contact with an infected person carry
pathogens from that person to a second person. The item becomes a vehicle for
disease transmission (e.g. infected wound dressings)
 Spread by Airborne Route This happens by droplets in the air
with the pathogens in them. The droplets may come from an
infected person sneezing, coughing, talking or being suctioned.
The droplets can then contact and infect eyes, mouth, nose or
upper respiratory tract if we breathe them in. Large droplets
settle rapidly, but can then be picked up on hands and transferred
to mouth, nose or open skin areas. Small droplets may be able to
stay floating in the air for a longer time and spread diseases like
TB and measles.
 Spread by Fecal - Oral Route
The pathogen may be in the infected persons stool and then contaminate the
environment. This may include food or water, and lead the next person to be infected
when they eat or drink. Most importantly, the pathogen can get from the environment
onto a persons hands and then mouth, where it can cause disease.
 Spread by Sexual Contact This is an example of person to person contact. Many
diseases can be spread this way. Pathogens that cause venereal disease are
very sensitive and rapidly die when exposed to conditions outside the body.
Therefore, the spread of illnesses like gonorrhea requires the most intimate of
human contact.
 Spread by Vehicle or Vector We have discussed mosquitoes in West Nile Virus.
There are other diseases like Malaria that are spread this way by the mosquito
vector. An example of vehicle that can spread a pathogen is the food that gets
touched by infected hands then carries the organism from one place to person to
another.
 Spread by Direct Inoculation If blood is shared organisms in it can spread to a
new host. Our blood donor system is designed to protect us from this problem.
However, sharing IV needles or sharing tattoo needles can spread pathogens by
direct inoculation. If blood with pathogens in it is exposed to broken skin or
mucus membranes of eyes, mouth, vagina or rectum, it is possible for transfer of
pathogens to occur. There are pathogens that are not viable outside blood but
 can be transferred this way. These include viruses causing Hepatitis B and C and
HIV. As these diseases are not easily identified, we need to act as though all
blood and bloody body fluids contain the pathogens and use standard precautions
Sumber:
ddsn.sc.gov/providers/healthinfoupdates/Documents/MCSpreadInfectUpdate
0902.pdf
Perkembangan penyakit menular ini disebabkan oleh 2
hal, yaitu:
1. Perilaku Manusia
Misal : perilaku seksual, pola makan, perjalanan, penggunaan
obat.
2. Perubahan Lingkungan
Misal : Urbanisasi, Industrialisasi, Menyempitnya area hutan.

Sumber: http://medicine.uii.ac.id/upload/klinik/elearning/ikm/Ilmu%20Kesehatan%20Masyarakat.pdf

9. What is the characteristic of infection diseases?

10.Mention the education that make patient can be prevented from virus!
11.Why someone can recovered by themself?
12.What the step of natural history of diseases?
 Sumber: : http://arviant.web.ugm.ac.id/content/Epidemiologi%20dasar.pdf
13. Trias penyakit menular, faktor penyebab penyakit menular
Trias penyakit menular:

Host (penjamu)

Agent environment
(penyebab penyakit) (lingkungan)
1. Agent Infeksi
- Bakteri, Jamur, Parasit, dan Virus
2. Host
- Manusia atau hewan
3. Lingkungan
- Semua yang berada di host (fisis, kimia, biologis, sosial)
Faktor-faktor yang memperngaruhi penyebaran penyakit in feksi
1. Resistensi Host : Kemampuan untuk melawan infeksi
2. Imunitas Alami : Resistensi bawaan
• Imunitas didapat : paparan alami pertama (misal cacar)
• Imunitas aktif : pengendalian antigen (misal vaksin tetanus)
• Imunitas pasif : pemberian antibodi dari individu imun ke
individu non-imun (misal ibu ke bayi)
3. Imunitas Kelompok (misal semakin tinggi angka vaksinasi semakin
imun suatu kelompok)
4. Tingkat Infeksius : Kemampuan host menginfeksi individu lain/
kemudahan penularan.
Sumber:
http://medicine.uii.ac.id/upload/klinik/elearning/ikm/Ilmu%20Kesehatan%20Masyarakat
.pdf

14.Faktor yang mempengeruhi penyebaran penyakit infeksi

Sumber:
http://www.library.upnvj.ac.id/pdf/s1keperawatan09/205312022/bab2.pdf
15.Bagaimana langkah-langkah upaya pencegahan dan promosi kesehatan
pada penyakit infeksi?
16.Tantangan-tantangan di dalam melakukan upaya pencegahan dan promosi
kesehatan?
tantangan baru sebagai akibat perubahan sosial dan ekonomi:

1. Pola penyakit yang semakin kompleks, Indonesia saat ini berada pada
pertengahan transisi epidemiologi dimana penyakit tidak menular
meningkat drastis sementara penyakit menular masih menjadi
penyebab penyakit yang utama. Kemudian saat ini penyakit
kardiovaskuler (jantung) menjadi penyebab dari 30 persen kematian
di Jawa dan Bali. Indonesia juga berada diantara sepuluh negara di
dunia dengan penderita diabetes terbesar. Di saat bersamaan penyakit
menular dan bersifat parasit menjadi penyebab dari sekitar 22 persen
kematian. Angka kematian ibu dan bayi di Indonesia juga lebih tinggi
dibandingkan dengan kebanyakan negara tetangga. Satu dari dua puluh
anak meninggal sebelum mencapai usia lima tahun dan seorang ibu
meninggal akibat proses melahirkan dari setiap 325 kelahiran hidup.
Perubahan yang diiringi semakin kompleksnya pola penyakit
merupakan tantangan terbesar bagi sistem kesehatan di Indonesia.

2. Tingginya ketimpangan regional dan sosial ekonomi dalam sistem

kesehatan. Dibanyak propinsi, angka kematian bayi dan anak terlihat
lebih buruk dibandingkan dengan situasi di beberapa negara Asia
termiskin. Kelompok miskin mendapatkan akses kesehatan yang paling
buruk dan umumnya mereka sedikit mendapatkan imunisasi
ataupun mendapatkan bantuan tenaga medis yang terlatih dalam proses
melahirkan.
Kematian anak sebelum mencapai usia lima tahun dari keluarga
termiskin mencapai sekitar empat kali lebih tinggi dibandingkan anak
dari keluarga terkaya. Tingginya tingkat terkena penyakit, baik yang
disebabkan dari penyakit menular maupun penyakit tidak menular,
telah mengurangi kemampuan orang miskin untuk menghasilkan
pendapatan, dan hal ini berdampak pada lingkaran setan kemiskinan.

3. Menurunnya kondisi dan penggunaan fasilitas kesehatan publik serta

kecenderungan penyedia utama fasilitas kesehatan beralih ke pihak
swasta. Angka penduduk yang diimunisasi mengalami penurunan
semenjak pertengahan 1990, dimana hanya setengah dari anak-anak
di Indonesia yang diimunisasi. Indonesia bahkan telah tertinggal
dibandingkan dengan negara-negara seperti Filiphina dan Bangladesh.
Program kontrol penyakit tuberkulosis (TB) diindikasikan hanya
mengurangi kurang dari sepertiga penduduk yang diperkirakan
merupakan penderita baru tuberkulosis. Secara keseluruhan,
pengunaan fasilitas kesehatan umum terus menurun dan semakin
banyak orang Indonesia memilih fasilitas kesehatan yang disediakan
oleh pihak swasta ketika mereka sakit. Di sebagian besar wilayah Indonesia,
sektor swasta mendominasi penyediaan fasilitas kesehatan dan
saat ini terhitung lebih dari dua pertiga fasilitas ambulans yang ada
disediakan oleh pihak swasta. Juga lebih dari setengah rumah sakit
yang tersedia merupakan rumah sakit swasta, dan sekitar 30-50 persen
segala bentuk pelayanan kesehatan diberikan oleh pihak swasta (satu
dekade yang lalu hanya sekitar 10 persen). Dalam masalah kesehatan
kaum miskin cenderung lebih banyak menggunakan staf kesehatan
non-medis, sehingga angka pemanfaatan rumah sakit oleh kaum miskin
masih amat rendah.

4. Pembiayaan kesehatan yang rendah dan timpang. Pembiayaan kesehatan

saat ini lebih banyak dikeluarkan dari uang pribadi, dimana pengeluaran
kesehatan yang harus dikeluarkan oleh seseorang mencapai sekitar
75-80 persen dari total biaya kesehatan dan kebanyakan pembiayaan
kesehatan ini berasal dari uang pribadi yang dikeluarkan ketika mereka
memanfaatkan pelayanan kesehatan. Secara keseluruhan, total
pengeluaran untuk kesehatan di Indonesia lebih rendah dibandingkan
dengan sejumlah negara tetangga (US $ 16 per orang per tahun pada
2001). Hal ini disebabkan oleh rendahnya pengeluaran pemerintah
maupun pribadi untuk kesehatan. Lebih lanjut, cakupan asuransi amat terbatas, hanya mencakup
pekerja di sektor formal dan keluarga mereka
saja, atau hanya sekitar sepertiga penduduk dilindungi oleh asuransi
kesehatan formal. Meski demikian mereka yang telah diasuransikan
pun masih harus mengeluarkan sejumlah dana pribadi yang cukup
tinggi untuk sebagian besar pelayanan kesehatan. Akibatnya kaum
miskin masih kurang memanfaatkan pelayanaan kesehatan yang dibiayai
oleh pemerintah. Dampaknya, mereka menerima lebih sedikit subsidi
dana pemerintah untuk kesehatan dibandingkan dengan penduduk
yang kaya. Sebanyak 20 persen penduduk termiskin dari total penduduk
menerima kurang dari 10 persen total subsidi kesehatan pemerintah
sementara seperlima penduduk terkaya menikmati lebih dari 40 persen.

5. Desentralisasi menciptakan tantangan dan memberikan kesempatan

baru. Saat ini, pemerintah daerah merupakan pihak utama dalam
penyediaan fasilitas kesehatan. Jumlah pengeluaran daerah untuk
kesehatan terhadap total pengeluaran kesehatan meningkat dari 10
persen sebelum desentralisasi menjadi 50 persen pada tahun 2001.
Hal ini dapat membuat pola pengeluaran kesehatan menjadi lebih
responsif terhadap kondisi lokal dan keragaman pola penyakit. Akan
tetapi hal ini akan berdampak juga pada hilangnya skala ekonomis,
meningkatnya ketimpangan pembiayaan kesehatan secara regional dan
berkurangnya informasi kesehatan yang penting.

6. Angka penularan HIV/AIDS meningkat namun wabah tersebut sebagian

besar masih terlokalisir. Diperkirakan sekitar 120.000 penduduk Indonesia
terinfeksi oleh HIV/AIDS, dengan konsentrasi terbesar berada di
propinsi dengan penduduk yang sedikit (termasuk Papua) dan di kota
kecil maupun kota besar yang terdapat aktifitas industri, pertambangan,
kehutanan dan perikanan. Virus tersebut menyebar lebih lambat
dibandingkan dengan yang diperkirakan sebelumnya. Akan tetapi
penularan virus tersebut meningkat pada kelompok yang berisiko
tinggi, yaitu penduduk yang tidak menerapkan perilaku pencegahan
terhadap virus tersebut, seperti menggunakan kondom pada aktivitas
seks komersial atau menggunakan jarum suntik yang bersih dalam kasus
pecandu obat-obatan.

17. Berikan contoh real suatu penyakit(penyakit infeksi) beserta riwayat

alamiah penyakitnya dan aplikasi dari step pencegahan penyakit
tersebut!
 Sumber:
http://arviant.web.ugm.ac.id/content/Epidemiologi%20dasar.pdf

18. Five level prevention of diseases!

The spectrum of health promotion and disease prevention programs contains the
following five levels: (1) health enhancement, (2) risk avoidance, (3) risk reduction,
(4) early identification and (5) complication reduction.
Health enhancement: As part of daily
practice, physicians routinely offer
counselling and information to encourage
healthy lifestyles among all patients. These
activities include appropriate age-related
discussions with patients about nutrition,
physical activity and adjustment to life stages.
In providing these services, physicians take
into account the emotional, social, spiritual
and environmental conditions in which their
patients conduct their lives.

Risk avoidance: Physicians ensure that

people at low risk of disease or injury remain
at low risk. In most jurisdictions, physicians
provide childhood immunizations and, for
adults at higher risk, influenza, hepatitis B or
pneumococcal vaccines. Physicians routinely
encourage breast-feeding, moderate exercise
and the use of bicycle helmets, to name a few
examples.
Risk reduction: Physicians target individuals
or segments of the population at moderate or
high risk of disease or injury in order to
reduce their risk. They ask their patients about
high-risk activities such as smoking, alcohol
abuse or unsafe sex. Physicians have the
education and tools to counsel these patients
to change their behaviour in order to reduce
their risk of disease. To reduce the risk of
heart disease, physicians screen and treat
patients for risk factors such as high blood
pressure and elevated serum cholesterol
levels.

Early identification: Physicians screen people

to detect diseases at an asymptomatic stage,
when intervention can improve the outcome.
Access to detailed patient information allowsphysicians to identify those patients at high
risk of illness or disease and to use casefinding
techniques. Papanicolaou smears to
detect cancer of the cervix and mammograms
to detect breast cancer are two types of tests
being used in early detection.
Complication reduction: Physicians can
prescribe therapy to prevent complications in
patients with diagnosed conditions or
diseases. For example, the use of warfarin in
the presence of atrial fibrillation reduces the
incidence of stroke. Similarly, lipid-lowering
agents prescribed for certain patients who
have suffered a myocardial infarction reduce
the incidence of subsequent coronary events.
With the increase in public awareness and
interest in preventive medicine, physicians
often spend time with their patients discussing
the pros and cons of tests such as
mammographic screening of women and the
prostate-specific antigen (PSA) screening test
for men.
Medical organizations are also involved in
prevention and health-promotion activities
such as organizing public education
campaigns, lobbying for legislation that
promotes health, such as laws to control
pollution and tobacco products, and
disseminating clinical practice guidelines to
enhance standards of preventive care.
Sumber: http://policybase.cma.ca/dbtw-wpd/PolicyPDF/PD02-02.pdf

STEP 4
 INFECTIUS
DISEASES

PREVENTION,
PROMOTIVE

TRANSMISSION TO OUR
BODY

SYMPTOMS GO TO
DOCTOR

PRESCRIPTION
NATURAL HISTORY INTERVENTION
OF DISEASES

RECOVER NO RECOVER