A.

Background
Infectious disease is a disease that can be transmitted through a variety
of media. This kind of disease is a major health problem in almost all
developing countries due to morbidity and death are relatively high in a
relatively short period of time. Infectious diseases generally be acute (sudden)
and attack all walks of life. This kind of disease is prioritized given the nature
of which could cause an outbreak of infectious and cause great harm.
Infectious diseases is a result of a combination of various factors that
influence each other. (Widoyono, 2011: 3) Cause (agent) is a contagious
disease biological elements ranging from the simplest virus particle to the
most complex organisms that can cause disease in humans (Noor, 1997: 39).
Where the process of the disease agent causing disease in humans requires a
variety of special modes of transmission (mode of transmission) and the
"transmission source (reservoir) diseases such as humans, animals ..." (Noor,
1997: 39).
Infectious diseases and infectious diseases are problems still
faced by developing countries. As in Indonesia, infectious diseases are still a
cause of morbidity(morbidity)and death(mortality).Disease transmission can
occur directly and indirectly. The mechanism of disease transmission to
humans through parts of the body such as the mouth, nose, skin and ears.
Transmission of the disease can be via spray saliva / sputum, injections, blood
transfusions, surgery or through a puncture needle (Widoyono, 2011).
Infectious diseases in Indonesia are many and varied are influenced by
internal and external environmental factors of each region itself. According to
the Regulation of the Minister of Health of the Republic of Indonesia Number
82 of 2014 on communicable disease prevention, communicable disease
prevention is health effort that prioritizes aspects of promotion and prevention
aimed to reduce and eliminate morbidity, disability, and death, limiting the
transmission and spread of the disease from spreading between regions and
between countries as well as the potential for extraordinary events / outbreaks.
B. IdentificationPoverty
is upstream from a variety of existing problems such as high rates of
morbidity and mortality, disturbances, malnutrition, and low quality of human
resources.
According to BPS data in 2007, Indonesia has 16% of the population,
or about 36.5 million people with income levels of less than 10,000 rupiah per
day. Only 51% of children up to the age of one year who get complete
immunization.
Factors that influence the emergence of infectious diseases by
comparing the densely populated urban growth and the effect of clean water
and inadequate environmental sanitation and widespread poverty is an ideal
tool for infectious disease outbreaks. With a background of poverty and
abandonment is not possible if the morbidity and mortality can hit an area that
is growing and efforts to combat poverty felt so far still in the form of partial
and holistic yet.
Alleviation effect on the incidence of infectious diseases in Indonesia.
The prevalence of infectious diseases are generally higher in the district / city
with a population of relatively poor high poor.
On the other hand, the number of health workers is still inadequate
where medical and non medical personnel tend to congregate in large cities.
Decentralization made it difficult to deploy health workers by the government
to remote areas. Meanwhile, the government district / city desolate and poor
can not give incentives to attract health workers to work in the region.
Medicines and medical devices also affect the health facilities in remote areas.
One occurrence of infectious diseases drawn from the data Semarang
City Health Office in the field of Communicable Diseases Eradication (P2M)
2017 includes five infectious diseases, namely:
1. Tuberculosis
 Tuberculosis (TB or TB) is an infectious disease of the respiratory
tract caused by the bacterium Mycobacterium tuberculosis. Most TB
affects the lungs but can also on other organs. The bacteria was first
discovered by Robert Koch on March 24, 1882. The symptoms of TB
include coughing, chest pain, shortness of breath, loss of appetite, weight
loss, fever, chills and fatigue.
TB cases in the city of Semarang in 2016 was 1.6% above the
target, the discovery of a suspect in 2016 as many as 864 / 100,000
population. When compared with the invention of the previous year has
been increased by 38 / 100,000 population, while the Children's
tuberculosis case in 2016 a number of 496 cases, that number is much
increased compared with the case in 2015. The discovery of
precautions can be done by people, communities and the attendant
health.
a. Supervision of patient, contacts and the Environment.
1) By the patient, can be done by covering the mouth when coughing
and disposing of sputum not disembarangan place.
2) By the community can do to improve the baby should be
vaccinated against BCG.
3) By health providers by providing information about TB disease
which includes symptoms of the dangers and consequences
thereof.
4) Isolation, checks to people who are infected, special treatment for
TB. Mole-hospital treatment only for patients whose weight
categories which require the development of treatment programs
for socio-economic reasons for unwanted medical and clinical
treatment.
5) Des-infection, wash hands and household hygiene procedures are
strict, need special attention to vomit and saliva (plates, hundry,
bedding, clothing), home ventilation and sufficient sunlight.
 6) Immunization people contacts. Precautions for those very close to
(family, nurses, doctors, other health workers) and others indicated
with BCG vaccine and follow-up for positive infected.
7) Investigations people contacts. Tuberculin-test for the whole
family with X rays that react positively, when these negative ways,
be repeated checks every month for 3 months, need intensive
investigation.
8) Special treatment. Patients with active TB need prompt treatment.
Drug-drug combination that has been set by the doctor taken
diligently and regularly,time
long (6 or 12 months). Watch out for any drug-resistant drug, the
investigation examination by a doctor.
b. Preventive measure.
1) Low socioeconomic status which is a factor to be sick, such as
residential density, with increasing health education.
2) There are medical facilities, examination of patient, contacts or
suspect gambas, often reported, screening and early treatment for
patients, contacts, suspect, care.
3) Preventive treatment, defined as nursing actions against inactive
disease by administering INH treatment as prevention.
4) BCG vaccination, first given to infants with protection for the
mother and keluarhanya. Repeated five years later at the level of
12 years in the form of prevention place.
5) Penyakti eradicate tuberculosis in milk milker and butcher cattle,
and pasteurized cow's milk.
6) Measures to prevent the danger of chronic lung disease karean
breathe air polluted by dust miners, cement workers and so on.
7) Bacteriological examination of sputum in people with symptoms
of pulmonary tuberculosis.
 8) Tubercullin screening examination to test high risk groups, such as
the emigrants, people contact with patients, hospital personnel,
officer / school teachers, officers x-rays.
9) An X-ray examination on those positive results of the tuberculin
test.
c. Control, Treatment and Counseling The sealed-implemented at TB
sufferers.
1) Control of Tuberculosis Patients.
a) Officials from the health center must know the address of the
home and workplace of the patient.
b) Officers oversee the implementation of the treatment that the
patient still regularly run treatment by way of reminding
patients anaesthetized. Besides that menunjak
a family among the medical superintendent.
c) Officers must conduct periodic visits home-home patients and
show concern over the progress of treatment and to observe the
likelihood of symptoms
due to medication side.
2) Treatment of Tuberculosis Patients.
a) Patients in the sputum contains bacteria recommended to
undergo treatment in the clinic.
b) The concierge can provide short-term treatment at home for
patients in emergency or because the sight distance of a place
to stay patient with PHC far enough to bias regular medical
treatment.
c) Reported symptoms occurring side, if necessary, the patient
was brought to the clinic.
3) Tuberculosis Patient Extension
a) Officers in both the preparatory period and the next time
regularly provide counseling to the public through face-to-face,
 lectures and mass
media available in their area, about how to prevent pulmonary
TB.
b) Provide counseling to patients and their families during home
visits and provide advice on the creation of a healthy home, in
an effort to reduce the spread of disease.
c) Provide individual counseling specifically to the patient so that
the patient wants treatment diligent in order to prevent the
spread of disease to others.
d) Advocate, attitude change of life and improvement of the
environment for the achievement of a healthy society.
e) Encourage the community to report among its citizens if
anyone has symptoms of TB disease of the lung.
f) Trying to eliminate embarrassment in patients due to
pulmonary TB disease not for shameful disease, can be
prevented and treated like any other disease.
g) Officers must record and report the results of their activities to
the appropriate coordinator form of recording and reporting
activities of cadres.

2. HIV / AIDS
HIV / AIDS in Indonesia is an epidemic. Currently the HIV
epidemic is still concentrated, with a low rate of HIV transmission in the
general population, but higher in certain populations. The threat of the
epidemic has been seen from the data of HIV infections continues to
increase, especially among high-risk groups in several places in Indonesia.
This shows that HIV / AIDS has become a threat to Indonesia. It is
estimated that in 2010 there will be about 110,000 people who suffered or
died from AIDS, and approximately one million people living with HIV.
 Before entering the phase of AIDS, the patient first expressed as
HIV positive. Number of HIV-positive in the community can be seen
through three methods, namely the Voluntary Service, Counseling, and
Testing (VCT), sero survey, and Integrated Biological and Behavioral
Survey (IBBS). Type yan disease caused by a virus called Human
Immunodeficiency virus, where the disease will attack the human immune
system so that it can cause death. Common symptoms that caused by HIV
disease are nausea, vomiting and diarrhea accompanied by weight loss
drastically with fever and sweating at night, experience tingling, muscle
pain, joint and swelling of the lymph, dry cough worsens, often encounter
great fatigue and lack of concentration as well as dementia.
HIV cases increased compared to 2015. The number of case
finding in 2016 that is equal to 498 cases (9.2%). The above data is the
data of HIV cases are found in Semarang report VCT clinic, so that not
only the citizens of the city of Semarang, but also outside the city of
Semarang. While data on HIV cases in 2015 to Semarang alone as many
as 156 people, with the condition of 37 people already on the stage of
AIDS.
Prevention is a priority in efforts to combat HIV / AIDS. This is
closely related to the situation of HIV / AIDS in the community.
Prevention of disease is done through the efforts of the campaign that
includes the provision of information, education and communication
(IEC) in accordance with the cultural and religious values. Pregnant
women are encouraged to visit antenatal care to be informed about HIV
and counseling. Prevention efforts are aimed at high-risk populations such
as commercial sex workers and their clients, people who have been
infected and his partner, injecting drug users, as well as health workers
exposed to
HIV/ AIDS.
 Treatment, support and care for
people living with HIV / AIDS through VCT clinic (Voluntary Counseling
and Testing) in existing health facilities. This effort has been carried out
not only by governments but also by some private health facilities as well
as other non-governmental organizations. In carrying out these efforts, it
should always be noted that people living with HIV / AIDS must also
protect human rights through a variety of efforts to reduce and eliminate
stigma and discrimination. To improve the quality of services, training and
education for the field workers, the provision of the necessary medication,
and instructions for care, support, treatment, and counseling.
Surveillance of HIV / AIDS and sexually transmitted infections
are one of the key strategies tendency monitoring the prevalence of HIV /
AIDS. Monitoring activities concerning the collection, processing, and
analyzing data systematically and continuously. These activities will
provide information about the number and prevalence of HIV anddiseases,
other sexually transmitted in various groups in society with different risk
levels, distribution and trends.

3. Pneumonia
Pneumonia is an inflammation of the lungs, the infection causes
inflammation and alveolar edema, increase the spread of infectious
organisms. Related lobe experienced compaction caused by exudate that is
caused by micro-organisms (bacteria, viruses, fungi, or parasites).
Symptoms of pneumonia vary and may present as mild to severe,
depending on the level of infection, age, and cause. The classic symptoms
of pneumonia caused by bacteria typical / peculiar usually appear
suddenly and develop rapidly. The main symptoms are often encountered
is coughing up phlegm or no phlegm,fever,shortness ofbreath and
pain in the chest / abdomen. Cough may be
accompanied or not accompanied by phlegm. Cough
with phlegm is the most common symptom in patients
with pneumonia. Pneumonia patient sputum may be
thick sputum, resembling pus, or with spots of blood.
Generally, the patient sputum would be more like pus.
Fever in pneumonia generally high (≥ 38oC),
accompanied by chills and increasedrate.heartFever may
not be encountered in patients who have acute or severe. Fever itself is
actually non-specific symptoms including pneumonia, with fever is a
reaction to a common infection that can be found in a variety of other
diseases. Other non-specific symptoms that can accompany pneumonia
include sweating, headache, muscle pain, discomfort in the whole body,
sore throat, hoarseness, nausea, vomiting,diarrhea,and no appetite.
Pathogenesis of pneumonia can occur from inhaling airborne
germs, or bacteria in the throat are inhaled into the lungs. The spread can
be also through the blood from cuts elsewhere, for example in the skin.
Pneumococcal bacteria are normally located in the throat and nasal cavity
(upper respiratory tract) in children and healthy adults, so that
pneumococcal infections can strike anyone, anywhere, regardless of social
status. Spray saliva while talking, sneezing and coughing can transfer
bacteria to another through the air. Especially from people nearby eg live
at home, playground, and school. So, anyone can transmit the
bacteriapneumococcus.
Coverage of pneumonia and severe pneumonia treated at health
centers in 2016 amounted to 111% decrease compared to 2015. The death
rate (CFR) of pneumonia and severe pneumonia in Semarang based on
data from the RS in 2016 amounted to 0.02% at by 2015, 0.5% in 2013
and 2014 amounted to 0.76%.
Pneumonia Prevention include:
a. Get enough rest to increase the body's immunity
b. Drink plenty of fluids
 c. Consume foods that contain lots of vitamin C and vitamin A.
d. Wash hands before and after meals.
e. Avoid smoking and inhaling smoke.
f. Vaccination Hib, Pneumococcal
g. Immunization against measles in children, due to complications from
measles can lead to pneumonia.
Pneumonia Treatment includes:
a. Provision of Antibiotics
for pneumonia caused by bacterial infection, the treatment given
antibiotics. Currently, many antibiotics that are resistant to germs that
cause pneumonia, so often needed blood cultures to see the resistance
of bacteria to treatment will be given.
b. Provision of drugs andsymptomatic
drug administration-Obatasiptomatis such as cold medicine and cough
medicine. Provision should cough medicine on the orders of a doctor,
because the cough is a reaction of the body to remove phlegm, cough
reflex when pressed it will phlegm deposited in the lungs, so the use of
this drug should be on the advice of a physician.

4. Leprosy
Leprosy is an infectious disease which is chronic and is caused by
Mycobacterium leprae that attacks the peripheral nerves, skin and other
body tissues except the central nervous system. Leprosy is composed of
two types of Paucibasillary (PB) and multibacillary (MB). Source of
transmission of leprosy is a type of MB leprosy patients. Leprosy is
transmitted through direct contact with the skin and the respiratory tract
repeatedly and in a long period of time. The primary sign of leprosy is
happening skin disorders and numbness, thickened peripheral nerves and
their acid-resistant germs. Leprosy disease risk factors among which
 household contact with a leper, there are leprosy patients in their home
environment / contact neighbors, and poor personal hygiene conditions.
By sex, leprosy cases in 2016 was dominated by women, 35 cases
of 21 cases (62%) were female while 13 cases (38%) were male.
Efforts termination of the chain of transmission of leprosy can be
done through:
a. Treatment MDT in leprosy patients
b. BCG vaccination
From the research in Malawi, in 1996 found that the
administration of BCG vaccination one dose can provide protection of
50% by the administration of two doses can provide protection against
leprosy till 80 %. However, the present invention is not yet a policy
program in Indonesia and still require further research, because research in
some countries give different results.
Breakthrough efforts to accelerate the elimination of leprosy in
Indonesia through:
a. Improved case finding early in the public
b. service of leprosy quality, including rehabilitation services, integrated
into primary health care and referral
c. Dissemination of information about leprosy in the community
d. Elimination of stigma against people affected by leprosy and their
e. family'sEmpowerment people affected by leprosy in many aspects of
life and strengthening partisiapasi them in an effort to control leprosy
f. partnership with various stakeholders
g. Increased support to the leprosy program by strengthening advocacy to
policy makers and other service providers to improve support for
leprosy program
h. Applying a different approach by endemicity of leprosy

5. diarrhea
 diarrhea is a disease endemic in Indonesia terutamadiare acute.
The incidence of acute diarrhea in most parts of Indonesia are still high,
including morbidity and mortality. The spread of acute diarrhea disease is
also spread to all regions in Indonesia with most patients are infants and
toddlers.
Diarrhea is a heavy burden on health services in countries where
poor sanitation systems yan affected by poor hygiene and a lack of safe
drinking water scarcity. Epidemic diarrheal diseases such as cholera and
dysentery often affect both adults and children in developing countries and
the poor.
According to Gender cases of diarrhea in the city of Semarang
2016 it appears that cases of diarrhea in 53% more women than in men -
men 47%. Diarrhea patient care coverage by calculating the number of
new cases divided by the population multiplied by 1,000.
Diarrheal disease control strategy implemented by the
government are:
a. Managing patients with diarrhea are standard in health facilities
through the five steps of diarrhea (diarrhea CROSS).
b. Improve governance with diarrhea in households precise and correct.
c. Improving the SKD and prevention of outbreaks of diarrhea.
d. Carrying out the effective prevention activities.
e. Implement monitoring and evaluation.

C. Troubleshooting

infectious diseases is strongly influenced by economic status and

lifestyle of human beings so as to overcome the problem of infectious
diseases must involve governments, agencies and relevant institutions and
society itself.

Under Law No. 82 2014 mentions communicable disease prevention is

health effort that prioritizes aspects of promotion and prevention aimed to
reduce and eliminate morbidity, disability, and death, limiting the
transmission and spread of the disease from spreading inter-regional and
inter-State as well as the potential for extraordinary events / plague.

Under Law No. 82 of 2014, Article 8 of infectious disease control

program targets include reduction, eliminiasi and eradication. Reduction is
the reduction of morbidity and / or mortality in order to gradually decrease.
Eliminisi a continuous reduction of the disease in a particular area so that
morbidity can be reduced as low as possible. Eradication of an eradication
effort that is sustainable through the eradication and elimination to eliminate
the disease permanently.

One example of communicable disease control activities in accordance

with Act No. 82 2014 Chapter 11 covers health promotion, health
surveillance, risk factor control, case detection, case management,
immunization, prevention of mass drug administration, and other activities.

Development of quality health pursued through health promotion,

disease prevention, cure and health recovery efforts. It is comprehensive,
integrated and sustained. In realizing these activities would require in terms
of infrastructure and qualified human resources capable of meeting the
demands and needs of health development.

Based on the analysis conducted eradication solution is the major

infectious diseases
1. Make poverty reduction program in which the government should be able
to do the evaluation and monitoring of planning poverty alleviation
activities. Therefore, there should be support for the cooperation and
synergy of all stakeholders and society component, good universities,
nongovernmental organizations, community leaders, and the business
world. Poverty alleviation programs must be implemented thoroughly,
synergistic, sustainable, and cross-cutting.
2. The health personnel, evenly distributed and tools supporting the health
infrastructure that can support the program of eradication of
communicable diseases
3. Improving health promotion activities for the behavior of clean and
healthy living as well as the awareness of the community itself to
maintaining the cleanliness of both internal and external, and can keep in
shape by doing exercise activity.
Bibliography of
the Central Bureau of Statistics. Poverty Level in Indonesia in 2007. News Release,
No. 38/07 / Th.X, July 2nd, 2007
Semarang City Health Office. Health Profile 2017 Semarang Semarang City Year.
2017
DVM. Hiswani, Kes. Tuberculosis Is Still Being Infectious Diseases Public
HealthProblem.North Sumatra University Faculty of Medicine.
Heryana, Ade. 2016. Prevention of CommunicableDiseases.University of Esa Unggul:
Jakarta
Integra newsletter. 2016. Pneumonia.Welfare solutions for all
Ministry of Health. 2011. Diarrhea situation inIndonesia.Subdit Control of Diarrhea
and Digestive Tract Infection Ministry of Health of Indonesia
Ministry of Health. 2012. National Guidelines Leprosy ControlProgram.Directorate
General of Disease Control and Environmental Health
Nasry Noor Nur. 1997. Introduction of Infectious DiseasesEpidemiology,Jakarta:
Ministry of Health of the Republic of Indonesia Number 82 Year 2014 on Infectious
Diseases Control
Prof. Dr. Armida S. Alisjahbana, SE, MA, Dr. Ir. Lukita Dinarsyah Tuwo, MA, Dra.
Nina Sardjunani, MA, et al. 2012. Report on the Achievement of the MDGs
inIndonesia.The Ministry of National Development Planning / National
Development Planning Agency (Bappenas)
Rineka Reserved.
Widoyono. 2011. Tropical Diseases (Epidemiology, Transmission, Prevention and
eradication), Jakarta: publisher.