| Summary: | The case fatality rate of measles cases admitted to the hospitals in Indonesia in the period of 1973 -1989 varied from as high as 26.1% in Medan to 2.4% in Bali, with an average of 10.9% in all hospitals. In Indonesia, according to the National Household Health Survey 1985 , the province of Yogyakarta had the lowest of infant mortality and was ranked high for the coverage of measles immunization and also the medical facilities in this are is relatively easy to acces. The purpose of this study was to obtain the case fatality rates and the clinical characteristics of measles cases admitted to the hospitals in the province of Yogyakarta in the period of 1984 to 1990, leading to a comparison with data from other hospitals in Indonesia. This study comprised, a retrospective study during the period of 1984 - 1987 involving 5 hospitals in Yogyakarta municipality, and a prospective study during the period of 1988 - 1990 carried out in 9 hospitals in the province of Yogyakarta. The results showed that the percentage of under-five children suffering from measles admitted to the hospitals in the period 1984 - 1987 was higher compared to under-five children hospitalized in the period of 1988 - 1990 (60% versus 36%). Therefore, it can be concluded that there was a shift in the distribution of measles cases to older children. This was probably due to the coverage of measles immunization in Yogyakarta which was higher as compared with other places. Since younger children were already protected by immunization, a relatively more older cases were found in Yogyakarta. The case fatality rate of 0.4% (2 out of 472 cases) during the period of 1984 -1987 and 0.8% (3 out of 386 cases) during the period of 1988-1990 in Yogyakarta were much lower as compared with the data reported from other hospitals in Indonesia. Several factors such as the general health condition of the province of Yogyakarta, as well as the frequency and types of complications of the diseases and the nutritional status of the measles patients may explain the different mortality of measles patients in Yogyakarta compared that in other places in Indonesia.
Key words : measles - morbidity - mortality - case fatality rate - immunization
Angka kematian penderita campak yang dirawat di beberapa rumah sakit di Indonesia (selain di Yogyakarta) dalam kurun waktu tahun 1973 -1989 menunjukkan variasi yang besar mulai setinggi 26,6% di Medan sampai 2,4% di Bali, dengan rata-rata sebesar 10,9% di semua rumah sakit yang melaporkan. Di Indonesia, menurut Survei Kesehatan Rumah Tangga tahun 1985, propinsi Yogyakarta mempunyai angka kematian bayi yang terendah dan cakupan imunisasi campak yang tinggi dan di samping itu di daerah ini untuk mendapatkan pelayanan kesehatan relatif mudah. Penelitian ini bertujuan untuk mengetahui angka kematian dan gambaran klinis penderita campak yang dirawat di rumah sakit-rumah sakit di propinsi Daerah Istimewa Yogyakarta mulai tahun 1984 sampai dengan tahun 1990, sehingga dapat dibandingkan dengan keadaaan penderita campak yang dirawat di rumah sakit lain di Indonesia. Penelitian ini dilakukan di rumah sakit-rumah sakit di seluruh wilayah propinsi Daerah Istimewa Yogyakarta secara retrospektif untuk penderita yang dirawat pada periode tahun 1984-1987 dan secara prospektif untuk penderita yang dirawat pada periode tahun 1988-1990. Hasil penelitian ini menunjukkan bahwa dibandingkan dengan penderita yang dirawat pada periode tahun 19881990, persentase anak Balita penderita yang dirawat pada tahun sebelumnya (1984-1987) adalah lebih tinggi sehingga dapat disimpulkan bahwa ada pergeseran distribusi umur penderita campak ke arah yang lebih tua. Hal ini kemungkinan disebabkan karena cakupan imunisasi campak di Yogyakarta lebih tinggi dibandingkan dengan cakupan di daerah lain sehingga anak yang lebih muda sudah terlindung dari penyakit campak akibat imunisasi. Angka kematian penderita campak yang dirawat di rumah sakit untuk periode tahun 1984-1987
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