Beberapa Model Imunisasi Hepatitis B pada Anak
Tahun 1998 Volume 33 Nomor 4
Oleh : Harsoyo
Notoatmojo, Persadan Bukit
Latar Belakang : Samapai saat ini infeksi hepatitis B (HBV) masih merupakan masalah kesehatan masyarakat yang serius di seluruh dunia. Sebagian besar individu yang terinfeksi VHB tanpa gejala klinik yang nyata, terutama pada pengidap sehat . Dari aspek epidemiologis yang paling berbahaya adalah pengidap sehat, karena status pengidap tersebut sangat potensial sebagai sumber penularan. Imunisasi merupakan upaya yang paling efektif dan paling murah untuk mencegah infeksi VHB. Jika titer anti-HBs 10 mIU/ml disebut responder, hipo-responder jika < 10 mIU/ml dan 0 mIU/ml disebut non-responser
Rencana Penelitian : Studi kendali acak (Randomized Controlled Trial)
Lokasi Penelitian : Poliklinik Bayi dan anak Sehat RSUP Dr. Kariadi Semarang.
Subjek Penelitian : bayi dan anak sehat, usia 1 hari samapi 18 bulan.
Pengukuran : Pemeriksaan antropometri (Umur, BB, PB) dan titer anti-HBs dialkukan 3 bulan setelah imunisasi VHB lengkap, pada model I (0,1,6 bulan), model II (0,1,4 bulan), model III (0,1,3 bulan). Vaksin yang dipakai adalah vaksin merk Vaksin Hepatitis B turunan plasma vaksin hepatitis B.
Hasil : Telah diteliti 3 model imunisasi hepatitis B pada 114 orang bayi dan anak, terdiri dari 55 (48.2%) laki-laki dan 59 (51.7%) perempuan. Model I terdapat 39 anak terdiri dari 19 orang (48.7%) laki-laki, 20 (51.2%) perempuan, dan titer anti-HBs yang terbentuk 35 (89.7%) responder, I (2.5%) non responder, 3 (7.6%) whipo-responder. Model II terdapat 37 anak terdiri dari 18 (48.6%) laki-laki, 19 (51.3%) perempuan, dan titer Anti-HBs yang terbentuk 32 (86.4%) responder, I (2.7%) did not respond, 4 (10.8%) hipo-responder. Model III pada 38 anak yang terdiri dari 18 orang (43.3%) laki-laki, 19 (50%) perempuan, dan titer Anti-HBs yang terbnetuk pada 35 (92.1%) responder, 2 (5.2%) non respond, dan hipo-responder 1 (2.6%).Secara statistik tidak ada perbedaan yang bermakna antar ketiga model (p>0.05). Berdasarkan status gizi ternyata terdapat perbedaan rerata titer Anti-HBs secara bermakna (p<0.01) dan tidak ada perbedaan yang bermakna (p>0.05) berdasarkan umur dan jenis kelamin.
Kesimpulan : Tidak ada perbedaan bermakna rerata titer anti-HBs yang terbentuk pada ke-3 model jadual imunisasi. Terdapat perbedaan bermakna rerata titer anti-HBs berdasarkan status gizi dan tidak ada perbedaan bermakna berdasarkan usia dan jenis kelamin.
Background : Hepatitis B virus (HBV) infection is a important public health problem throughout the word especially in the developing countries. Most of the individuals infected with HBV do not show any clinical symptoms, especially carriers and children. The most important feature in the epidemiologic aspects is the healthy carriers state in the population, which is still a potential source of transmission. Immunization is the most “cost effective” method to prevent HBV infection. Response due to immunization is called responder if anti-HBs level is above 100 mIU/ml, low responder if anti-HBs level is below 10 mIU/ml, and non responder if no anti-HBs is formed.
Design : Randomized Controlled Trial
Setting : Well Baby Clinic Dr. Kariadi Hospital, Semarang, Central Java
Subject : Healthy infant and children, aging from one day to 18 months.
Measurement : Antrophometri (age, weight, height) and anti-HBs level at 3 months after complete HBV immunization in the there different models, namely model I (0 – 1 – 6 months), model II (0 – 1 – 4 months), and model III (0 – 1 – 3 months). The preparation used was a human-derived hepatitis B vaccine, with brand name : “Vaksin Hepatitis B”.
Results : One hundred and fourteen infants and children were studied, consisting of 55 (48.2%) boys and 59 (51.7%) girls. Model I consisted of 39 children 19 (48.7%) boys and 20 (51.2%) girls, and anti-HBs level were 35 (89.7%) responder, I (2.5%) non responder : 3 (7.6%) were low responder. Model II consisted of 37 children, 18 (48.6%) boys and 19 (51.3%) girls and Anti-HBs level 32 (86.4%) responder, I (2.7%) did not respond, 4 (10.8%) low responder. Model III consisted of 38 children, 18 (43.3%) boys and 19 (50%) girls and Anti-HBs level 35 children (92.1%) responder, 2 (5.2%) dis not respond, and one low responder. Statistically, differences among the models were not significant (p>0.05). Statistically, differences between anti-HBs and nutritional status were significant (p<0.01) and there were also no significant differences between anti-HBs and age (p>0.05) and gender (p>0.05).
Conclusion : There were no significant differences in mean anti-HBs level among there differences models of immunization schedules. There was significant differences based in anti-HBs on nutritional status and there was no differences in anti-HBs level based on age, nor on gender.
Suggestion : It is necessary to assess anti-HBs level, after complete HBV immunization. Short term hepatitis B schedules can be considered in order to increase coverage of complete immunization.