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DA TAR ISI

KATA PENGANTAR !

DA TAR ISI !!

BAB I PENDAHULUAN 11%1%La'a$ Be)a,an" 1

1%2% R&m& an Ma a)a* 2

1%:%T&7&an 2

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BAB II TINJAUAN PUSTAKA 4

2%1% Im&n! a !

2%1%1 De+!n! ! Im&n! a !

2%1%2 T&7&an Im&n! a !

2%1%: P$( ed&$ Im&n! a !

2%1%4 Pen !m anan

2%1%6 Te*n!, dan U,&$an Ja$&m

2%1%; A$a* &d&' 7a$&m ada &n'!,an In'$am& 3&)a$

2%1%< Tem a' &n'!,an an" d!an7&$,an

2%1%= P( ! ! ana, dan )(,a ! &n'!,an

2%1%> Pem8e$!an d&a a'a& )e8!* a, !n ada *a$! an" ama

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2%:%4% Tena"a Pe)a, ana Im&n! a !

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:%2% ?a,'& dan Tem a' Pene)!'!an

:%:% P( &)a ! Pene)!'!an

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:%6% Ca$a Pen"am8!)an Sam e)

:%;% Ren3ana ana)! !

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BAB I

PENDAHULUAN

1%1 La'a$ Be)a,an"

Im&n! a ! me$& a,an a)a* a'& & a a $(m('!+ dan $e en'!+ an" men!n",a',an ,e,e8a)an

e e($an" e3a$a a,'!+ 'e$*ada &a'& en a,!'% Ua a a !m&n! a ! d! e)en""a$a,an d!

Ind(ne !a e7a, 'a*&n 1>6;% Ke"!a'an !n! 8e$*a !) mem8a m! en a,!' 3a3a$ d! Ind(en !a

e*!n""a Ind(ne !a d!n a'a,an 8e8a da$! en a,!' 3a3a$ e7a, 'a*&n 1>9; ada 'a*&n 200>% Ha) !n! ma !* 7a&* da$! 'a$"e' an" d!!n"!n,an9 a!'&

=0 &n'&, 2010 8a*,an 100 an" d!'a$"e',an ada 'a*&n 2014%

Pen"e$7aan $("$am !m&n! a ! 'e$&'ama d! & a',an d! & ,e ma % P& ,e ma e8a"a!

en ed!a )a anan !m&n! a ! e3a$a "$a'! dan ( en"am8!)an &'ama !m&n! a ! 8e$,e.a7!8an

men &, e ,an $("$am !m&n! a ! an" d!3anan",an eme$!n'a*% P& ,em a 8a!, & ,e ma

&'ama '!n",a' ,e3ama'an ma& &n & ,e ma em8an'& d! '!n",a' ,e)&$a*an 8e e$'a ( and& ( and& da)am .!)a a* 8!naann a men7ad! m('($ da)am ,e8e$*a !)an !n!%

P$( !n ! Ban'en me$& a,an a)a* a'& .!)a a* an" mem!)!,! '!n",a' ,e8e$*a !)an '!n""!

da)am me)a, ana,an $("$am !m&n! a !% Pada Ta*&n 2011 7&m)a* de a an" 'e)a* men3a a!

'a$"e' UCI @Un! e$ a) C*!)d Imn! a'!(n e8an a, =692 9 *a) !n! men!n",a' d!8and!n",an

2010 an" *an a men3a a! =1 % Se8&a* de a d!,a'a,an )()( UCI a a8!)a 'e)a* me)a,&,an

!m&n! a ! BCG9 DPT9 He B9 P()!(9 dan 3am a,%

Be$da a$,an P& a' da'a dan In+($ma ! Keme'$!an Ke e*a'an Re &8)!, Ind(ne !a 'a*&n 201:9

$( !n ! Ban'en men3a a! >2940 da)am 3a,& an !m&n! a ! 3am a,% Sedan",an &n'&, ,a &

D$( O&' Ra'e !m&n! a ! DPT/HB 3am a, ada 8a ! $( !n ! Ban'en 'a*&n 201: ada)a*

696 9 n!)a! !n! me)e8!*! 8a'a DO Ra'e an" e*a$& n a 6 %


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Be"!'& &n an" 'e$7ad! d! P& ,ema Ba)a$a7a9 a)a* a'& & ,e ma d! P$( !n ! Ban'en%

Ta*&n 2014 3a,& an !m&n! a ! &da* *am !$ men3a a! 'a$"e'% Nam&n &n'&, DPT/HB ma !*

ada 8e8e$a a an" 8e)&m memen&*! 'a$"e'% Ha) 'e$ e8&' an" mem8&a' en&)! 'e$'a$!,

&n'&, me)a,&,an e a)&a ! $("$am !m&n! a ! d! P& ,e ma Ba)a$a7a 'a*&n 2014%

1%2 R&m& an Ma a)a*

- Ba"a!mana 3a,& an !m&n! a ! ada P& ,e ma Ba)a$a7a ada 'a*&n 2014

- a,'($-+a,'($ a a a7a an" men7ad! en e8a8 ,e"a"a)an en3a a!an 'a$"e' 3a,& an

!m&n! a ! d! P& ,e ma Ba)a$a7a ada 'a*&n 2014

- Ba"a!mana a)'e$na'!+ 7a)an ,e)&a$ &n'&, men"a'a ! ,e"a"a)an en3a a!an 'a$"e' 3a,& an

!m&n! a ! d! P& ,e ma Ba)a$a7a ada 'a*&n 2014

1%: T&7&an

T&7&an Um&m

Un'&, men"e'a*&! e)a, anaan $("$am !m&n! a ! d! P& ,e ma Ba)a$a7a e3a$a

men e)&$&* e*!n""a da a' men!n",a',an 3a,& an e)a anan !m&n! a !%

T&7&an K*& &

Un'&, men!)a! $("$am !m&n! a ! d! P& ,e ma Ba)a$a7a9 ,a8& a'en Tan"e$an" me)a)&! ende,a'an ! 'em #

1% Men"e'a*&! 7&m)a* 3a,& an !m&n! a ! d! P& ,e ma Ba)a$a7a 'a*&n 2014

2% Men"e'a*&! ma a)a* an" 'e$da a' da)am en3a a!an 'a$"e' 3a,& an !m&n! a ! d!

P& ,e ma Ba)a$a7a 'a*&n 2014%

:% Men"e'a*&! $!($!'a ma a)a* da)am en3a a!an 'a$"e' 3a,& an !m&n! a ! d! P& ,e ma

Ba)a$a7a 'a*&n 2014%

4% Men"e'a*&! +a,'($-+a,'($ an" men e8a8,an '!da, 'e$3a a!n a 'a$"e' 3a,& an !m&n! a !

d! P& ,e ma Ba)a$a7a 'a*&n 2014%

6% Men"e'a*&! dan men"em8an",an a)'e$na'!+ eme3a*an ma a)a* da)am en3a a!an 'a$"e'

3a,& an !m&n! a ! d! P& ,e ma Ba)a$a7a 'a*&n 2014%

;% Mem!)!* dan me$en3ana,an ()& ! eme3a*an ma a)a* an" mam & )a, ana da)am

en3a a!an 'a$"e' 3a,& an !m&n! a ! d! P& ,e ma Ba)a$a7a 'a*&n 2014%


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8/67


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2%1%2 T&7&an Im&n! a !

T&7&an !m&n! a ! &n'&, men3e"a* 'e$7ad!n a en a,!' 'e$'en'& ada e e($an"9 dan

men"*!)an",an en a,!' 'e$'en'& ada e,e)(m (, ma a$a,a' @ ( &)a ! a'a& 8a*,an

men"*!)an",an en a,!' 'e$'en'& da$! d&n!a%

2%1%: P$( ed&$ Im&n! a !

P$( ed&$ !m&n! a ! d!m&)a! da$! men !a ,an dan mem8a.a a, !n9 mem e$ !a ,an ana,

dan ($an"'&a9 'e,*n!, en &n'!,,an an" aman9 en3a'a'an9 em8&an"an )!m8a*9 am a!

ada 'e,*n!, en !m anan dan en""&naan ! a a, !n den"an 8ena$% Pen7e)a an ,e ada

($an" '&a e$'a en"a &*n a e8e)&m dan e'e)a* !m&n! a ! e$)& d! e)a7a$! &)a%

Pen"e'a*&an 'en'an" ,&a)!'a a, !n an" ma !* 8()e* d!8e$!,an ada 8a !/ ana, e$)&

menda a' e$*a'!an% U,&$an 7a$&m9 )(,a ! &n'!,an9 3a$a men"&$an"! ,e'a,&'an dan $a a

n e$! ada ana, 7&"a e$)& d!,e'a*&!% Im&n! a ! e$)& d!3a'a' den"an )en",a 9 'e$ma &,

,e)&*an ,e7ad!an !,&'an a 3a !m&n! a !%

2%1%4 Pen !m anan

Va, !n an" d! !m an dan d!an",&' e3a$a '!da, 8ena$ a,an ,e*!)an"an ('en !n a%

A'&$an &m&m &n'&, e8a"!an 8e a$ a, !n9 8a*.a a, !n *a$& d!d!n"!n,an ada

'em e$a'&$e 2-= 0 C dan '!da, mem8e,&% Se3a$a &m&m ada 2 7en! a, !n a!'& a, !n

*!d& @ ()!( ($a)9 BCG9 3am a,9 MMR9 a$! e))a dan demam ,&n!n" dan a, ! ma'! a'a&

!na,'!+ @DPT9H!89 ne!m(,(,& 9 T *(!d9 !n+)&en a9 ()!( !na,'!+9 men!n"(,(,& %

Se3a$a &m&m em&a a, !n e8a!,n a d! !m an ada &*& F2 /d F= C a, !n *!d&0

a,an 3e a' ma'!9 a, !n ()!( *an a 8e$'a*an 2 *a$!9 a, !n BCG dan 3am a, an" 8e)&m

d!)a$&',an ma'! da)am < *a$!% Va, !n *!d& ('en !n a ma !* 'e'a 8a!, ada &*& ,&$an"

da$! 2 0 C /d 8e,&% Va, !n ()!( ($a) an" 8e)&m d!8&,a )e8!* 8e$'a*an )ama @2'a*&n

8!)a d! !m an ada &*& -26 C /d -16 C9 nam&n *an a 8e$'a*an ; 8&)an ada &*& F20 0 0

C /d F= C% a, !n BCG dan 3am a, 8e$8eda9 .a)a& &n d! !m an ada &*& -26 C /d -0 0

160 C9 &m&$ a, !n '!da, )e8!* )ama da$! &*& F2 0 C /d F= C9 a!'& BCG 'e'a 1 'a*&n0

dan 3am a, 'e'a 2 'a*&n% O)e* ,a$ena !'& a, !n BCG dan 3am a, an" 8e)&m

d!)a$&',an '!da, e$)& d! !m an d! -26 C /d -16 C a'a& d! da)am +$ee e$%0 0


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Va, !n !na,'!+ @ma'! e8a!,n a d! !m an da)am &*& F2 0 C /d F= 0 C 7&"a9 ada &*&

d!8a.a* F2 C @8e,& a, !n ma'! a,an 3e a' $& a,% B!)a 8e,& da)am &*& -096 C a, !n0 0

*e a'!'! B dan DPT-He a'!'! B @,(m8( a,an $& a, da)am 7am9 'e'a ! da)am &*&

d!a'a = C a, !n He a'!'! B 8!a 8e$'a*an am a! :0 *a$!9 DPT-He a'!'! B ,(m8!na !0

am a! 14 *a$!% D!8e,&,an da)am &*& -6 0 C /d -10 0 C a, !n DPT9 DT dan TT a,an

$& a, da)am 196 /d 2 7am9 'e'a ! 8!a 8e$'a*an am a! 14 *a$! da)am &*& d!a'a = C%0

2%1%6 Te*n!, dan U,&$an Ja$&m

Pada '!a &n'!,an *a$& d!"&na,an 'a8&n" &n'!,an dan 7a$&m 8a$&9 e,a)! a,a! dan %

Se8a!,n a '!da, d!"&na,an 8('() a, !n an" m&)'!d( ! 9 ,a$ena $e !,( !n+e, !% A a8!)a

mema,a! 8('() m&)'!d( ! ma,a 7a$&m &n'!, an" 'e)a* d!"&na,an men &n'!, '!da,

8()e* d! a,a! )a"! men"am8!) a, !n%

S'anda$ 7a$&m &n'!, !a)a* &,&$an 2: den"an an7an" 26 mm9 'e'a ! ada e$,e3&a)!an )a!n

da)am 8e8e$a a *a) e e$'! 8e$!,&' #

- ada 8a !-8a ! ,&$an" 8&)an9 &m&$ d&a 8&)an a'a& an" )e8!* m&da dan 8a !-8a ! ,e3!)

)a!nn a9 da a' &)a d! a,a! 7a$&m &,&$an 2; den"an an7an" 1; mm%

- &n'&, &n'!,an &8,&'an ada )en"an a'a 9 d! a,a! 7a$&m &,&$an 26 den"an an7an"

1;mm9 &n'&, 8a !-8a ! ,e3!) d! a,a! 7a$&m &,&$an 2< den"an an7an" 12 mm%- &n'&, &n'!,an !n'$am& 3&)a$ ada (a$!n" de.a a an" an"a' "em&, @(8e e d!a a,a!

7a$&m &,&$an 2: den"an an7an" := mm%

- &n'&, &n'!,an &n'$ade$ma) ada a, !na ! BCG d! a,a! 7a$&m &,&$an 26-2< den"an

an7an" 10 mm%

2%1%; A$a* &d&' 7a$&m ada &n'!,an In'$am& 3&)a$

Ja$&m &n'!, *a$& d! &n'!,,an den"an &d&' 460

am a! ;00

,e da)am ('(' a '&)a'e$a)! a'a& ('(' de)'(!d% Un'&, ('(' a '& )a'e$a)! 9 7a$&m *a$& d!a$a*,an ,ea $a* )&'&'

dan &n'&, de)'(!d 7a$&m *a$& d!a$a*,an ,e &nda,% Ke$& a,an a$a+ dam em8&)&*

a 3&)a$ da a' 'e$7ad! a a8!)a &n'!,an d!a$a*,an ada &d&' >0 %0


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2%1%< Tem a' &n'!,an an" d!an7&$,an

Pa*a an'e$()a'e$a) ada)a* 8a"!an '&8&* an" d!an7&$,an &n'&, a, !na ! ada 8a !-8a !

dan ana,-ana, &m&$ d!8a.a* 12 8&)an% Re"!(n de)'(!d ada)a* a)'e$na'! e &n'&, a, !na !

ada ana,-ana, an" )e8!* 8e a$ @me$e,a an" da a' 8e$7a)an dan ($an" de.a a%

Se7a, a,*!$ 1>=09 ?HO 'e)a* mem8e$! $e,(menda ! 8a*.a dae$a* an'e$()a'e$a) a*a

ada)a* 8a"!an an" d!an7&$,an &n'&, a, !na ! 8a !-8a !dan '!da, ada an'a' @dae$a*

")&'e& &n'&, men"*!nda$! $e !,( ,e$& a,an a$a+ ! ,*!ad!,a @ne$ & ! 3*!ad!3& %

Re !,( ,e$& a,an a$a+ ! 3*!ad!,a a,!8a' &n'!,an d! dae$a* ")&'e& )e8!* 8an a,

d!7&m a! ada 8a ! ,a$ena a$!a ! ( ! ! a$a+ 'e$ e8&'9 ma a ('(' )e8!* 'e8a)9 e*!n""a

ada a, !na ! den"an &n'!,an !n'$am& 3&)a$ d! dae$a* ")&'ea) den"an '!da, d! en"a7a

men"*a !),an &n'!,an &8,&'an den"an $ea, ! )(3a) an" )e8!* 8e$a'% Va, !na ! *e a'!'!

B dan $a8!e 8!)a d! &n'!,,an d! dae$a* ")&'ea) ,&$an" !m&n("en!, *a) !n! 8e$)a,& &n'&,

em&a &m&$% Sedan",an &n'&, a, !n BCG9 *a$& d! &n'!, ada ,&)!' d!a'a !n e$ ! ('('

de)'(!d @)en"an a'a 9 e8a8 &n'!,an- &n'!,an d!a'a &n3a, &nda, meme8e$! $e !,(

'e$7ad!n a ,e)(!d%

2%1%= P( ! ! ana, dan )(,a ! &n'!,an

A)a an mem!)!* ('(' a '& )a'e$a)! ada 8a ! dan ana, &m&$ d! 8a.a** 12 8&)an ada)a*#

- Men"*!nda$! $e !,( ,e$& a,an a$a+ ! 3*!ad!,a ada &n'!,an dae$a* ")&'ea)%

- Dae$a* de)'(!d ada 8a ! d!an""a '!da, 3&,& 'e8a) &n'&, men e$a &n'!,an e3a$a

ade,&a'%

- S!+a' !m&n("ene !'a a, !n *e a'!'! B dan $a8!e 8e$,&$an" 8!)a d! &n'!,,an d! dae$a*

")&'ea)%- Men"*!nda$! $e !,( $ea, ! )(3a) dan 'e$8en'&, em8en",a,an d!'em a' &n'!,an an"

mena*&n%

- Men"*!nda$! )a ! an )ema, &8,&'an an" 'e8a) ada a*a 8a"!an an'e$!($%


12/67

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Va '& )a'e$a)! 9 ( ! ! ana, dan )(,a ! &n'!,an

Va '& )a'e$a)! ada)a* ('(' 8a ! an" 'e8a) dan 8e a$9 an" men"! ! 8a"!an an'e$()a'e$a)

a*a% Va, !n *a$& d! &n'!,,an ,e da)am 8a'a an'a$a e e$'!"a ('(' 8a"!an a'a dan

'en"a* an" me$& a,an 8a"!an an" a)!n" 'e8a) dan ada'% Ja$&m *a$& mem8&a' &d&'460-;0 0 'e$*ada e$m&,aan ,&)!'9 den"an 7a$&m ,ea$a* )&'&'9 ma,a 7a$&m 'e$ e8&' *a$&

menem8& ,&)!' e)e8a$ &7&n" 7a$! d!a'a @,ea$a* $(, !!ma) 8a'a *&8&n"an 8a"!an a'a

dan e e$'!"a 'en"a* ('('%

Gam8a$ 2% D!a"$am L(,a ! S&n'!,an an" D!an7&$,an ada ('(' a*a%


13/67

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Gam8a$ :% P('(n"an L!n'an" Pa*a # Men&n7&,,an Ba"!an an" D! &n'!,

L(,a ! &n'!,an ada a '& )a'e$a)!

- Le'a,,an 8a ! d! a'a 'em a' '!d&$ a'a& me7a9 8a ! d!'!d&$,an 'e$)en'an"%

- T&n",a! 8a.a* ed!,!' d! 'e,&, den"an +)e, ! ada )&'&'%

- Ca$! '$(3*an'e$ ma ($ +em&$ dan 3(nd )& )a'e$a)! den"an 3a$a a) a !9 'a$!, "a$! an"

men"*&8&n",an ,ed&a 'em a' 'e$ e8&'% Tem a' &n'!,an a, !n !a)a* 8a'a e e$'!"a

8a"!an a'a dan 'en"a* ada "a$! 'e$ e8&' @8!)a '&n",a! 8a.a* ed!,!' mene,&,9 ma,a

)e,&,an an" d!8&a' ()e* '$a3'& !)!('!8!a)! men e8a8,an "a$! 8a"!an d! 'a) )e8!* 7e)a

- S& a a a, !n an" d! &n'!,,an ma &, ,e da)am ('(' ada 8a'a an'a$a e e$'!"a 8a"!an

a'a dan 'en"a*9 7a$&md!'& &,,an a'& 7a$! d!a'a 8a'a 'e$ e8&'%

De)'(!d9 ( ! ! ana, dan )(,a ! &n'!,an

- P( ! ! e($an" ana, an" a)!n" n aman &n'&, &n'!,,an d! dae$a* de)'(!d !a)a* d&d&,

d!a'a an",&an !8& a'a& en"a &*n a%

- Len"an an" a,an d! &n'!, d! e"an" menem e) ada '&8&* 8a !9 emen'a$a )en"an

)a!nn a d!)e'a,,an d! 8e)a,na" '&8&* ($an" '&a a'a& en"a &*%

- L(,a ! de)'(!d an" 8ena$ ada)a* en'!n" & a a a, !na ! 8e$)an" &n" aman dan

8e$*a !)%

- P( ! ! an" a)a* a,an men"*a !),an &n'!,an &8,&'an an" '!da, 8ena$ dan

men!n",a',an $e !,( ene'$a ! a$a+%

Un'&, menda a',an )(,a ! de)'(!d an" 8a!,9 mem8&,a )en"an a'a da$! &nda, ,e !,&%

L(,a ! an" a)!n" 8a!, ada)a* ada 'en"a* ('('9 a!'& e a$&* an'a$a a,$(m!(n dan !n e$ !

ada 'en"a* *&me$& % Ja$&m &n'!, d!'& &,,an mem8&a' &d&' 46 -;00 0 men"a$a* ada

a,$(m!(n% B!)a 8a"!an 8a.a* de)'(!d an" d! &n'!,9 ada $e !,( '$a&ma a$a+ $ad!a)! ,a$ena

a$a+ 'e$ e8&' me)!n",a$ dan m&n3&) da$! ('(' '$! e %


14/67

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Pe$*a'!an &n'&, &n'!,an &8,&'an

- A$a* 7a$&m 46 'e$*ada ,&)!'%0

- C&8!' 'e8a) &n'&, &n'!,an &8,&'an

- A !$a ! em $!' e8e)&m a, !n d! &n'!,,an%- Un'&, &n'!,an m&)'! e) d!8e$!,an ada 8a"!an e, '$!m!'a 8e$8eda%

Gam8a$ 4% L(,a ! Pen &n'!,an S&8,&'an Pada Ba ! @a dan Ana, Be a$ @8

Pe$*a'!an &n'&, en &n'!,an !n'$am& 3&)a$

- Pa,a! 7a$&m an" 3&,& an7an" &n'&, men3a a! ('('%

- S&n'!, den"an a$a* 7a$&m 46 ;0 9 )a,&,an den"an 3e a'%0 0

- Te,an ,&)!' e,!'a$ 'em a' &n'!,an den"an !8& 7a$! dan 'e)&n7&, aa' 7a$&&m d!'& &,,an%

- A !$a ! em $!' e8e)&m a, !n d! &n'!,,an9 &n'&, me a,!n,an '!da, ma &, da)am

ena% A a8!)a 'e$da a' da$a* 8&an" dan &)an"! den"an &n'!,an 8a$&%

- Un'&, &n'!,an m&)'! e) d!8e$!,an ada 8a"!an e, '$em!'a 8e$8eda%


15/67

11

Gam8a$ 6% L(,a ! Pen &n'!,an !n'$am& 3&)a$ Pada Ba ! @a dan Ana, Be a$ @8

2%1%> Pem8e$!an d&a a'a& )e8!* a, !n ada *a$! an" ama

Pem8e$!an a, !n- a, !n an" 8e$8eda ada &m&$ an" e &a!9 8(e)* d!8e$!,an ada *a$!

an" ama% Va, !n !na3'! a'ed dan a, !n !$& *!d& 9 ,*& & n a a, !n an" d!an7&$,an

da)am 7ad.a) !m&n! a !9 ada &m&mn a da a' d!8e$!,an ada )(,a ! an" 8e$8eda aa'

*a$! ,&n7&n"an an" ama% M! a)n a ada ,e em a'an an" ama da a' d!8e$!,an a, !n-

a, !n DPT9 H!89 *e a'!'! B9 dan ()!(%

Le8!* da$! a'& ma3am a, !n !$& *!d& da a' d!8e$!,an ada *a$! an" ama9 'e'a !

a a8!)a *an a a'& ma3am an" d!8e$!,an9 a, !n !$& *!d& an" ,ed&a '!da, 8()e*

d!8e$!,an ,&$an" da$! 2 m!n""& da$! a, !n an" e$'ama9 e8a8 $e (n 'e$*ada a, !n

an" ,ed&a m&n",!n 'e)a* 8an a, 8e$,&$an"% Va, !n- a, !n an" 8e$8eda '!da, 8()e*

d!3am &$ da)am a'& em $!'% Va, !n- a, !n an" 8e$8eda an"d!8e$!,an ada e e($an"

ada *a$! an" ama *a$& d! &n'!,,an ada )(,a ! an" 8e$8eda den"an men""&na,an

em $!' an" 8e$8eda%


16/67

12

2%2% Im&n! a ! ?a7!8 @PPI

Im&n! a ! an" d!.a7!8,an me)! &'! BCG9 ()!(9 *e a'!'! B9 DTP dan 3am a,%

2%2%1% BCG

Ba3!))e Ca)me'e-G&e$!n ada)a* a, !n *!d& an" d!8&a' da$! M 3(8a3'e$!&m B( ! an"

d!8!a, 8e$&)an" e)ama 1-: 'a*&n e*!n""a d!da a',an 8a !) an" '!da, !$&)en 'ea'a !

ma !* mem &n a! !m&n("en!'a % Va, !na ! BCG men!m8&),an en !'! !'a 'e$*ada

'&8e$3&)!n%

Im&n! a ! BCG d!8e$!,an ada &m&$ e8e)&m : 8&)an% Nam&n &n'&, men3a a! 3a,& an

an" )e8!* )&a 9 De a$'emen Ke e*a'an men"an7&',an em8e$!an !m&n! a ! BCG ada

&m&$ an'a$a 0-12 8&)an%

D( ! 0906 m) &n'&, 8a ! ,&$an" da$! 1 'a*&n dan 091 m) &n'&, ana, @ 1 'a*&n % Va, !n

BCG d!8e$!,an e3a$a !n'$a,&'an d! dae$a* )en"an ,anan a'a ada !n e$ !( M%De)'(!de&

e &a! an7&$an ?HO9 '!da, d!'em a' )a!n @8(,(n"9 a*a %

Va, !n BCG '!da, da a' men3e"a* !n+e, ! '&8e$3&)( ! 9 nam&n da a' men3e"a*

,(m )!,a !n a% A a8!)a BCG d! e$!,an ada &m&$ )e8!* da$! : 8&)an9 e8a!,n a

d!)a,&,an &7! '&8e$3&)!n 'e$)e8!* da*&)&% Va, !n BCG d!8e$!,an a a8!)a &7! '&8e$3&)!n

ne"a'!+%%

E+e, $('e, ! '!m8&) =-12 m!n""& e'e)a* en &n'!,,an% Be$*&8&n"an den"an 8e8e$a a

+a3'($ a!'& m&'& a, !n an" d! a,a!9 )!n",&n"an den"an M 3(8a3'e$!&m a'! !, a'a&

+a3'($ e7am& @&m&$9 ,eadaan "! ! dan )a!n-)a!n


17/67

13

Va, !n BCG '!da, 8()e* 'e$,ena !na$ ma'a*a$!9 *a$& d! !m an ada &*& 2-= C9 '!da, 0

8()e* 8e,&% Va, !n an" 'e)a* d!en33e$,an *a$& d! e$"&na,an da)am .a,'& = 7am%

2%2%1%1 Ke7ad!an !,&'an a 3a !m&n! a ! a, !na ! BCG

Pen &n'!,an BCG !n'$ade$ma) a,an men!m8&),an &),& )(3a) an" & e$+!3!a) : m!n""&

e'e)a* en &n'!,,an% U),& 'e$'&'& ,$& 'a9 a,an em8&* da)am 2-: 8&)an9 dan

men!n""a),an a$&' 8&)a' den"an d!ame'e$ 4-= mm9 a a8!)a d( ! 'e$)a)& '!n""! ma,a &),&

an" '!m8&) )e8!* 8e a$9 nam&n a a8!)a en &n'!,,an 'e$)a)& da)am ma,a a$&' an" 'e$7ad!

'e$'a$!, ,e da)am%

1% L!m+aden!'!

L!m+aden!'! & &$a'!+ d! a, !)a a'a& d! )e*e$ ,adan"-,adan" d!7&m a! e'e)a*

en &n'!,an BCG% L!m+aden!'! a,an em8&* end!$!9 7ad! '!da, e$)& d!(8a'!% A a8!)a

)!m+aden!'! me)e,a' ada ,&)!' a'a& '!m8&) +! '&)a ma,a da a' d!8e$ !*,an @d$a!na"e dan

d!8e$!,an (8a' an'! '&8e$3&)( ! ($a)% Pem8e$!an (8a' an'! '&8e$3&)( ! ! 'em!, '!da,

e+e,'!+%

2% BCG-!'! d! em!na !

Ja$an" 'e$7ad!9 e$!n",a)! 8e$*&8&n"an den"an !m&n(de+! !en ! 8e$a'% K(m )!,a ! )a!nn a

ada)a* e$!'ema n(d( &m9 !$!'! 9 )& & &)"a$! dan ( 'e(m!e)!'! % K(m )!,a ! !n! *a$&

d!(8a'! den"an ,(m8!na ! (8a' an'! '&8e$3&)( ! %

2%2%1%2 K(n'$a !nd!,a ! BCG

- Rea, ! &7! '&8e$3&)!n 6 mm%

- Mende$!'a !n+e, ! HIV a'a& den"an $e !,( '!n""! !n+e, ! HIV9 !m&n(,(m $(ma! a,!8a'

en""&naan ,($'!,( 'e$(!d9 (8a' !m&n( & $e !+9 menda a' en"(8a'an $ad!a !9 en a,!'

,e"ana an an" men"ena! &m &m '&)an" a'a& 'em )!m+e%

- Mende$!'a "! ! 8&$&,%

- Mende$!'a demam '!n""!%


18/67

14

- Mende$!'a !n+e, ! ,&)!' an" )&a %

- Pe$na* a,!' '&8e$3&)( ! %

- Ke*am!)an%

2%2%1%: Re,(menda !

- BCG d!8e$!,an ada 8a ! 28&)an%

- Pada 8a ! an" ,(n'a, e$a' den"an ende$!'a TB dena"n BTA F: e8a!,n a d!8e$!,an

INH $(+!)a, ! d&)&9 a a8!)a a !en ,(n'a, &da* 'enan" 8a ! da a' d!8e$! BCG%

2%2%2 He a'!'! B

Va, !n *e a'!'! B @*e B *a$& e"e$a d!8e$!,an e'e)a* )a*!$9 men"!n"a' a, !na !

*e B me$& a,an & a a en3e"a*an an" an"a' e+e,'!+ &n'&, mem&'& ,an $an'a!

en&)a$an me)a)&! '$an m! ! ma'e$na) da$! !8& ,e ada 8a !n a%

Va, !n d!8e$!,an e3a$a !n'$am& 3&)a$ da)am% Pada ne(na'& dan 8a ! d!8e$!,an d!

an'e$()a'e$a) a*a9 edan",an ada ana, 8e a$ dan de.a a9 d!8e$!,an d! $e"!(n de)'(!d

2%2%2%1 Im&n! a ! a,'!+

- Im&n! a ! *e B-1 d!8e$!,an ed!n! m&n",!n @da)am .a,'& 12 7am e'e)a* )a*!$%

- Im&n! a ! *e B-2 d!8e$!,an e'e)a* 1 8&)an @4 m!n""& da$! !m&n! a ! *e B-1 a!'& aa'

8a ! 8e$&m&$ 1 8&)an% Un'&, menda a' $e (n !m&n ( '!ma)9 !n'e$ a) !m&n! a ! *e B-2

den"an *e B-: m!n!ma) 2 8&)an9 'e$8a!, 6 8&)an% Ma,a !m&n! a ! *e B-: d!8e$!,an ada&m&$ :-; 8&)an%

- B!)a e &da* d( ! e$'ama9 !m&n! a ! 'e$ &'& 9 e"e$a 8e$!,an !m&n! a ! ,ed&a%

Sedan",an !m&n! a ! ,e'!"a d!8e$!,an den"an 7a$a, 'e$ ende, 2 8&,an da$! !m&n! a !

,ed&a%

- B!)a d( ! ,e'!"a 'e$)am8a'9 d!8e$!,an e"e$a e'e)a* mem&n",!n,an%


19/67

15

- Ba ! )a*!$ da$! !8& den"an H8 -A" an" '!da, d!,e'a*&!9 *e B-1 *a$& d!8e$!,an da)am

.a,'& 12 7am e'e)a* )a*!$ dan d!)an7&',an ada &m&$ 1 8&)an dan :-; 8&)an% A a8!)a

em&)a 'a'& H8 -A" !8& '!da, d!,e'a*&! dan 'e$n a'a da)am e$7a)anan e)an7&'n a

d!,e'a*&! !8& den"an H8 -A" ( !'!+9 ma,a d!'am8a*,an *e a'!'! B !mm&n(")(8&)!n

@HBI" 096 m) e8e)&m 8a ! 8e$&m&$ < *a$!%

- Ba ! )a*!$ da$! !8& den"an H8 -A" ( !'!+9 d!8e$!,an a, !n *e B-1 dan HBI" 096 m)

e3a$a 8e$ amaan da)am .a,'& 12 7am e'e)a* )a*!$%

- Ana, da$! !8& en"!da *e a'!'! B9 an" 'e)a* mem e$()e* !m&n! a ! da a$ : ada ma a

8a !9 ma,a ada aa' & !a 6 'a*&n '!da, e$)& !m&n! a ! &)an" @8(( 'e$ % Han a d!)a,&,an

eme$!, aan ,ada$ an'! HB

- A a8!)a am a! den"an & !a 6 'a*&n ana, 8e)&m e$na* mem e$()e* !m&n! a ! *e a'!'!

B9 ma,a e3e a'n a d!8e$!,an !m&n! a ! He B den"an 7ad.a) : em8e$!an @3a'3* &

a33!na'!(n %

Ca'3* & a33!na'!(n me$& a,an & a a !m&n! a ! ada ana, a'a& $ema7a an" 8e)&m

e$na* d! !m&n! a ! a'a& 'e$)am8a' 1 8&)an da$! 7ad.a) an" e*a$& n a% K*& & ada

!m&n! a ! *e a'!'! B9 !m&n! a ! 3a'3* & !n! d!8e$!,an den"an !n'e$ a) m!n!ma) 4 m!n""&

an'a$a d( ! e$'ama dan ,ed&a9 edan",an !n'e$ a) an'a$a d( ! ,ed&a dan ,e'!"a

m!n!ma) = m!n""& a'a& 1; m!n""& e &da* d( ! e$'ama%

- U)an"an !m&n! a ! @*e B-4 da a' d! e$'!m8an",an ada &m&$ 10-12 'a*&n9 a a8!)a

,ada$ en3e"a*an 8e)&m 'e$3a a! @an'! H8 10 "/m) %

2%2%2%2 Im&n! a ! a !+

He a'!'! B !mm&ne ")(8&)!n @HBI" da)am .a,'& !n",a' a,an meme8e$!,an $('e, !

me ,! &n *an a &n'&, 7an",a ende, @:-; 8&)an %

HBI" *an a d!8e$!,an ada ,(nd! ! a 3a a a$an% Se8a!,n a HBI" d!8e$!,an 8e$ ama

a, !n VHB e*!n""a $('e, !n a 8e$)an" &n" )ama% Pada need)e '!3, !n7&$ ma,a

d!8e$!,an HBI" 090; m)/," ma, !m&m 6 m) da)am 4= 7am e$'ama e'e)a* ,(n'a,% Pada


20/67

16

en&)a$an den"an 3a$a ,(n'a, e, &a) HBI" d!8e$!,an 090; m)/," ma, !m&m 6 m) da)am

.a,'& 14 *a$! e &da* ,(n'a, 'e$a,*!$%

2%2%2%: E+e, am !n"

Um&mn a 8e$& a $ea, ! )(3a) an" $!n"an dan 8e$ !"a' emen'a$a% Kadan"-,adan" da a'

men!m8&),an demam $!n"an &n'&, 1-2 *a$!%

2%2%2%4 K(n'$a !nd!,a !

T!da, ada ,(n'$a (nd!,a ! an" a8 ()&'e%

2%2%: DT.P @.*()e-3e)) e$'& ! dan DTa @a3e))&)e$ e$'& !

Im&n! a ! DTP $!me$ d!8e$!,an : ,a)! e7a, &m&$ 2 8&)an @DTP '!da, 8()e* d!8e$!,an

e8e)&m &m&$ ; m!n""& den"an !n'e$ a) 4-= m!n""&% In'e$ a) 'e$8a!, d!8e$!,an =

m!n""&9 7ad! DTP-1 d!8e$!,an ada &m&$ 2 8&)an9 DTP-2 ada &m&$ 4 8&)an dan DTP-:

ada&m&$ ; 8&)an% U)an"an 8(( 'e$ DTP e)an7&'n a d!8e$!,an a'& 'a*&n e'e)a* DTP-:

a!'& ada &m&$ 1=-24 8&)an dan DTP-6 ada aa' ma &, e,()a* &m&$ 6 'a*&n%

Pada 8(( 'e$ &m&$ 6 'a*&n *a$& 'e'a d!8e$!,an a, !n den"an ,(m (nen e$'& !

@ e8a!,n a d!8e$!,an DTaP &n'&, men"&$an"! demam a 3a !m&n! a ! men"!n"a'

,e7ad!an e$'& ! ada de.a a m&da men!n",a' a,!8a' am8an" $('e, ! 'e)a* an"a'

$enda* e*!n""a da a' men7ad! &m8e$ en&)a$an ada 8a ! dan ana,%

DT-6 d!8e$!,an ada ,e"!a'an !m&n! a ! d! e,()a* da a$% U)an"an DT-; d!8e$!,an ada12 'a*&n9 men"!n"a' ma !* d!7&m a! ,a & d!+'e$!a ada &m&$ )e8!* da$! 10 'a*&n%

D( ! DT.P a'a& DTaP a'a& DT ada)a* 096 m)9 !n'$am& 3&)a$9 8a!, &n'&, !m&n! a ! da a$

ma& &n &)an"an%


21/67

17

Jad.a) &n'&, !m&n! a ! $&'!n ada ana,9 d!an7&$,an em8e$!an 6 d( ! ada & !a 2949;916-

1= 8&)an dan & !a 6 'a*&n a'a& aa' ma &, e,()a*% D( ! ,e 4 *a$& d!8e$!,an e,&$an"-

,&$an"n a ; 8&)an e'e)a* d( ! ,e :% ,(m8!na ! '(, (!d d!+'e$!a dan 'e'an& @DT an"

men"and&n" 10-12 L+ da a' d!8e$!,an ada ana, an" mem!)!,! ,(n'$a !nd!,a ! 'e$*ada

em8e$!an an" e$'& ! %

2%2%:%1 Ke7ad!an !,&'an a 3a !m&n! a ! DTP

- Rea, ! )(3a) ,eme$a*an9 8en",a, dan n e$! ada )(,a ! !n7e, ! 'e$7ad! ada e a$&*

ene$!ma DTP%

- P$( ($ ! Demam $!n"an den"an $ea, ! )(3a) ama dan d!an'a$an a da a' men"a)am!

*! e$ !$e, !a%

- Ana, "e)! a* dan menan"! 'e$& mene$& e)ama 8e8e$a a 7am a ,a &n'!,an

@!n3(n ()a8)e 3$ !n" %

- Da$! &a'& ene)!'!an d!'em&,an adan a ,e7an" demam e &da* a, !na ! an"

d!*&8&n",an den"an demam an" 'e$7ad!%

- Ke7ad!an !,&'an an" a)!n" e$!& ada)a* 'e$7ad!n a en e+a)( a'! a,&' a'a& $ea, !

ana+!)a, ! dan 'e$8&,'! d! e8a8,an ()e* em8e$!an a, !n e$'& ! %

2%2%:%2 K(n'$a !nd!,a !

Saa' !n! d!da a',an d&a *a) an" d! a,!n! e8a"a! ,(n'$a !nd!,a ! m&')a, 'e$*ada

em8e$!an a, !n e$'& ! 8a!, .*()e 3e)) ma& &n a3e)&)a$% a!'& #

- ana+!)a, ! ada em8e$!an a, !n e8e)&mn a%

- En e+a)( a'! e &da* em8e$!an a, !n e$'& ! e8e)&mn a%

- Keadaan )a!n da a' d!n a'a,an e8a"a! e$*a'!an ,*& & @ $e3a&'!(n % M! a)n a

em8e$!an a, !n e$'& ! 8e$!,&'n a 8!)a ada em8e$!an e$'ama d!7&m a! $!.a a'

*! e$ !$e, !a9 ,eadaan *! ('(n!,-*! ($e (n !+ da)am 4= 7am9 ana, menan"! 'e$&

mene$& e)ama : 7am dan $!.a a' ,e7an" da)am : *a$! e &da* !m&n! a ! DTP


22/67

18

R!.a a' ,e7an" da)am ,e)&a$"a dan ,e7an" an" '!da, 8e$*&8&n"an den"an em8e$!an

a, !n e8e)&mn a9 ,e7ad!an !,&'an a ,a !m&n! a ! a'a& a)e$"! 'e$*ada a, !n 8&,an)a*

&a'& !nd!,a ! ,(n'$a 'e$*ada em8e$!an a, !n DTaP% ?a)a& &n dem!,!an ,e &'& an

&n'&, em8e$!an a, !n e$'& ! *a$& d! e$'!m8an",an e3a$a !nd! !d&a) den"an

mem e$*!'&n",an ,e&n'&n"an dan $e !,( em8e$!ann a%

2%2%:%: Va, !n e$'& ! a- e)&)e$

Va, !n e$'& ! a e)&)e$ ada)a* a, !n e$'& ! an" 8e$! ! ,(m (nen e !+!, '(, !n da$!

B($de'e))a e$'& ! an" d! !)!* e8a"a! da a$ an" 8e$"&na da)am a'("ene ! e$'& !

dan e$ann a da)am mem!3& an'!8(d an" 8e$"&na &n'&, en3e"a*an 'e$*ada e$'& !

e3a$a ,)!n! %

2%2%4 P()!(

P()!(m!e)!'! a'a& ()!(9 ada)a* en a,!' a$a)! ! a'a& )&m &* an" d! e8a8,an ()e*

!$& % A"en em8a.a en a,!' !n!9 e8&a* !$& an" d!nama,an ()!( !$& @PV 9 ma &,

,e '&8&* me)a)&! m&)&'9 men"!+e, ! a)&$an & & % V!$& !n! da a' mema &,! a)!$an da$a*dan men"a)!$ ,e ! 'em a$a+ & a' men e8a8,an me)ema*n a ('(' dan ,adan"

,e)&m &*an @ a$a)! ! %


23/67

19

Gam8a$


24/67

20

2%2%4%1 Im&n! a ! P()!(

Pen a,!' an" da a' men e8a8,an ,e)&m &*an !n!9 d! e8a8,an !$& ()!(m e)!'! an"

an"a' men&)a$% Pen&)a$ann a 8!a )e.a' ma,anan/m!n&man an" 'e$3ema$ !$& ()!(%

B! a 7&"a )e.a' e$3!,an )&da*/a!$ )!&$ ende$!'a ()!( an" ma &, ,e m&)&' ($an" e*a'%Im&n! a ! ()!( mem8e$!,an ,e,e8a)an a,'!+ 'e$*ada en a,!' ()!(m!e)!'! % P()!( 8! a

men e8a8,an n e$! ('(' dan ,e)&m &*an ada a)a* a'& ma& &n ,ed&a )en"an/'&n",a!%

P()!( 7&"a 8! a men e8a8,an ,e)&m &*an ada ('('-('(' e$na+a an dan ('(' &n'&,

mene)an% P()!( 8! a men e8a8,an ,ema'!an%

Te$da a' 2 ma3am a, !n ()!(#

- IPV @Ina3'! a'ed P()!( Va33!ne9 Va, !n Sa), 9 men"and&n" !$& ()!( an" 'e)a*

d!ma'!,an dan d!8e$!,an me)a)&! &n'!,an%

- OPV @O$a) P()!( Va33!ne9 Va, !n Sa8!n 9 men"and&n" a, !n *!d& an" 'e)a*

d!)ema*,an dan d!8e$!,an da)am 8en'&, !) a'a& 3a!$an%

Ben'&, '$! a)en @TOPV e+e,'!+ me)a.an em&a 8en'&, ()!(9 8en'&, m(n( a)en

@MOPV e+e,'!+ me)a.an 1 7en! ()!(%Im&n! a ! da a$ ()!( d!8e$!,an 4 ,a)! @ ()!( I9II9

III9 dan IV den"an !n'e$ a) '!da, ,&$an" da$! 4 m!n""&% Im&n! a ! ()!( &)an"an

d!8e$!,an 1 'a*&n e'e)a* !m&n! a ! ()!( IV9 ,em&d!an ada aa' ma &, SD @6-; 'a*&n

dan ada aa' men!n""a),an SD @12 'a*&n %

D! Ind(ne !a &m&mn a d!8e$!,an a, !n Sa8!n% Va, !n !n! d!8e$!,an e8an a, 2 'e'e

@091 mL )an" &n" ,e m&)&' ana, a'a& den"an men""&na,an end(, an" 8e$! ! a!$ "&)a%

D( ! e$'ama dan ,ed&a d! e$)&,an &n'&, men!m8&),an $e (n ,e,e8a)an $!me$9

edan",an d( ! ,e'!"a dan ,eem a' d! e$)&,an &n'&, men!n",a',an ,e,&a'an an'!8(d

am a! ada '!n",a' an" 'e$'!n""!% Ke ada ($an" an" e$na* men"a)am! $ea, ! a)e$"!

*e8a' @ana+!)a,'!, e'e)a* em8e$!an IPV9 '$e '(m! !n9 ()!m!, !n B a'a& ne(m! !n9

'!da, 8()e* d!8e$!,an IPV% Se8a!,n a d!8e$!,an OPV% Ke ada ende$!'a "an""&an ! 'em

,e,e8a)an @m! a)n a ende$!'a AIDS9 !n+e, ! HIV9 )e&,em!a9 ,an,e$9 )!m+(ma 9

d!an7&$,an &n'&, d!8e$!,an IPV% IPV 7&"a d!8e$!,an ,e ada ($an" an" edan" men7a)an!


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'e$a ! en !na$an9 'e$a ! ,an,e$9 ,($'!,( 'e$(!d a'a& (8a' !m&n( & $e an )a!nn a% IPV

8! a d!8e$!,an ,e ada ana, an" mende$!'a d!a$e%

J!,a ana, edan" mende$!'a en a,!' $!n"an a'a& 8e$a'9 e8a!,n a e)a, anaan !m&n! a !

d!'&nda am a! me$e,a 8ena$-8ena$ &)!*% IPV 8! a men e8a8,an n e$! dan ,eme$a*an ada 'em a' en &n'!,an9 an" 8!a an a 8e$)an" &n" *an a e)ama 8e8e$a a *a$!% Ma a

!n,&8a ! !$& an'a$a ;-10 *a$!% Se'e)a* demam 2-6 *a$!9 &m&mn a a,an men"a)am!

,e)&m &*an mendada, ada a)a* a'& an""('a "e$a,% Nam&n 'a, em&a ($an" an"

'e$,ena !$& ()!( a,an men"a)am! ,e)&m &*an9 'e$"an'&n" ,e"ana an !$& ()!( an"

men e$an" dan da a 'a*an '&8&* ! ana,% Im&n! a ! ()!( a,an mem8e$!,an ,e,e8a)an

'e$*ada e$an"an !$& ()!(%

2%2%4%2 U !a Pem8e$!an#

Saa' )a*!$ @0 8&)an 9 dan 8e$!,&'n a d! & !a 29 49 ; 8&)an% D!)an7&',an ada & !a 1= 8&)an

dan 6 'a*&n% Ke3&a)! aa' )a*!$9 em8e$!an a, !n ()!( e)a)& d!8a$en"! den"an a, !n

DTP%

2%2%4%: Ca$a Pem8e$!an#

B! a )e.a' &n'!,an @Ina3'! a'ed P()!(m e)!'! Va33!ne/IPV 9 a'a& )e.a' m&)&' @O$a)

P()!(m e)!'! Va33!ne/OPV % D! 'ana* a!$9 an" d!"&na,an ada)a* OPV%

2%2%4%4 E+e, Sam !n"#

Ham !$ 'a, ada% Han a e8a"!an ,e3!) a7a an" men"a)am! & !n"9 d!a$e $!n"an9 dan

a,!' ('('% Ka & n a &n an"a' 7a$an"% Da a' m&n",!n 'e$7ad! 8e$& a ,e)&m &*an dan

,e7an"-,e7an"%


26/67


27/67

23

e$na* mende$!'a 3am a,9 ma,a e&m&$ *!d& n a d!a a,an ,e8a) 'e$*ada en a,!' !n!%

T!da, ada en"(8a'an ,*& & &n'&, 3am a,% Ana, e8a!,n a men7a)an! '!$a* 8a$!n"%

Un'&, men&$&n,an demam9 d!8e$!,an a e'am!n(+en a'a& !8& $(+en% J!,a 'e$7ad! !n+e, !

8a,'e$!9 d!8e$!,an an'!8!('!,% Va, !n 3am a, me$& a,an 8a"!an da$! !m&n! a ! $&'!n ada

ana,-ana,% Va, !n 8!a an a d!8e$!,an da)am 8en'&, ,(m8!na ! den"an "(nd(n"an dan

3am a, Je$man @ a, !n MMR/m&m 9 mea )e 9 $&8e))a 9 d! &n'!,,an ada ('(' a*a a'a&

)en"an a'a % J!,a *an a men"and&n" 3am a,9 a, !n d!8e$!,an ada &m&$ > 8&)an%

Da)am 8en'&, MMR9 d( ! e$'ama d!8e$!,an ada & !a 12-16 8&)an9 d( ! ,ed&a

d!8e$!,an ada & !a 4-; 'a*&n% e)a!n !'& ende$!'a 7&"a *a$& d! a$an,an &n'&, ! '!$a*a'

m!n!ma) 10 *a$! dan ma,an ma,anan an" 8e$"! ! a"a$ ,e,e8a)an '&8&* men!n",a'%

2%2%6%1 Im&n! a ! Cam a,

Se8ena$n a9 8a ! &da* menda a' ,e,e8a)an 3am a, da$! !8&n a% Nam&n e!$!n"

8e$'am8a*n a & !a9 an'!8(d! da$! !8&n a ema,!n men&$&n e*!n""a 8&'&* an'!8(d

'am8a*an )e.a' em8e$!an a, !n 3am a,% A a)a"! en a,!' 3am a, m&da* men&)a$9

dan me$e,a an" da a 'a*an '&8&*n a )ema* "am an" e,a)! 'e$ e$an" en a,!' an"

d! e8a8,an !$& M($8!)! !n!% Un'&n"n a9 3am a, *an a d!de$!'a e,a)! e&m&$ *!d& %

Jad!9 e,a)! 'e$,ena 3am a,9 e'e)a* !'& 8!a an a 'a, a,an 'e$,ena )a"!% Im&n! a ! 3am a,

e+e,'!+ &n'&, mem8e$! ,e,e8a)an 'e$*ada en a,!' 3am a, am a! e&m&$ *!d& %

Pen a,!' 3am a, an" d! e8a8,an ()e* !$& an" "ana !n! da a' d!3e"a* 7!,a e e($an"

menda a',an !m&n! a ! 3am a,9 m!n!ma) d&a ,a)! a,n! ema a & !a ; 6> 8&)an dan

ma a SD @; 12 'a*&n %

U a a !m&n! a ! 3am a, 'am8a*an an" d!)a,&,an 8e$ ama den"an !m&n! a ! $&'!n

'e$8&,'! da a' men&$&n,an ,ema'!an ,a$ena en a,!' 3am a, am a! 4= %Tan a

!m&n! a !9 en a,!' !n! da a' men e$an" e'!a ana,9 dan mam & men e8a8,an 3a3a' dan,ema'!an ,a$ena ,(m )!,a !n a e e$'! $adan" a$& @ ne&m(n!a d!a$e9 $adan" 'e)!n"a

@('!'! med!a dan $adan" ('a, @en e+a)!'! 'e$&'ama ada ana, den"an "! ! 8&$&,%

Pen&)a$an 3am a, 'e$7ad! )e.a' &da$a a'a& 8&'!$an *a)& a!$ )&da* @d$( )e' ende$!'a

an" 'e$*!$& me)a)&! *!d&n" a'a& m&)&'% Pada ma a !n,&8a ! an" 8e$)an" &n" e,!'a$


28/67

24

10-12 *a$!9 "e7a)an a &)!' d!de'e, !% Se'e)a* !'& 8a$&)a* m&n3&) "e7a)a +)& @8a'&,9 !)e,9

demam 9 ma'a ,eme$a*-me$a*an dan 8e$a!$9 ! ,e3!) &n me$a a !)a& aa' me)!*a'

3a*a a% Kem&d!an9 d! e8e)a* da)am m&)&' m&n3&) 8!n'!,-8!n'!, &'!* an" a,an

8e$'a*an :-4 *a$!% Be8e$a a ana, 7&"a men"a)am! d!a$e% Sa'&-d&a *a$! ,em&d!an '!m8&)

demam '!n""! an" '&$&n na!,9 8e$,! a$ :=-4096 C% Se!$!n" den"an !'&9 8a$&)a* ,e)&a$

8e$3a,-8e$3a, me$a* an" me$& a,an 3!$! ,*a en a,!' !n!% U,&$ann a '!da, 'e$)a)&

8e a$9 'a ! 7&"a 'a, 'e$)a)& ,e3!)% A.a)n a *an a m&n3&) d! 8e8e$a a 8a"!an '&8&* a7a

e e$'! ,& !n"9 )e*e$9 dada9 m&,a9 'an"an dan ,a,!% Da)am .a,'& 1 m!n""&9 8e$3a,8e$3a,

me$a* !n! a,an memen&*! e)&$&* '&8&*% Nam&n 8!)a da a 'a*an '&8&*n a 8a!,9 8e$3a,-

8e$3a, me$a* !n! *an a d! 8e8e$a a 8a"!an '&8&* a7a dan '!da, 8an a,%

J!,a 8e$3a, me$a* &da* ,e)&a$9 &m&mn a demam a,an '&$&n den"an end!$!n a% Be$3a,

me$a* &n a,an 8e$&8a* 7ad! ,e*!'aman dan 8e$ ! !,9 d! e8&' *! e$ !"men'a !% Pada

a,*!$n a 8e$3a, a,an men"e)& a a'a& $(n'(, a'a& em8&* den"an end!$!n a%

Um&mn a9 d!8&'&*,an .a,'& *!n""a 2 m!n""& am a! ana, em8&* 8ena$ da$! ! a- ! a

3am a,% Da)am ,(nd! ! !n!9 'e'a )a* mem!n&m (8a' an" &da* d!8e$!,an d(,'e$% Ja"a

'am!na dan ,(n &m ! ma,anan 8e$"! !% Pen"(8a'ann a 8e$ !+a' !m '(ma'! 9 a!'&

men"(8a'! 8e$da a$,an "e7a)a an" m&n3&)% H!n""a aa' !n!9 8e)&m d!'em&,an (8a' an"

e+e,'!+ men"a'a ! !$& 3am a,% J!,a 'a, d!'an"an! den"an 8a!, 3am a, 8! a an"a'

8e$8a*a a% B! a 'e$7ad! ,(m )!,a !9 'e$&'ama ada 3am a, an" 8e$a'% C!$!-3!$! 3am a,

8e$a'9 e)a!n 8e$3a,n a d! e,&7&$ '&8&*9 "e7a)an a '!da, mem8a!, e'e)a* d!(8a'! 1-2

*a$!% K(m )!,a ! an" 'e$7ad! 8!a an a 8e$& a $adan" a$&- a$& @8$(n3*( ne&m(n!a

dan $adan" ('a, @en e+a)!'! % K(m )!,a ! !n!)a* an" &m&mn a a)!n" e$!n"

men!m8&),an ,ema'!an ada ana,%

2%2%6%2 De ,$! !

Va, !n 3am a, me$& a,an a, !n !$& *!d& an" d!)ema*,an% Se'!a d( ! @096m)

men"and&n" '!da, ,&$an" da$! 1000 !n+e3'! e &n!' !$& '$a!n CAM


29/67

25

'e$ ! a* &n'&, '&7&an 'e$ e8&'% Va, !n !n! 'e)a* memen&*! e$ a$a'an ?HO &n'&,

a, !n 3am a,%

2%2%6%: Ind!,a !

Un'&, Im&n! a ! a,'!+ 'e$*ada en a,!' 3am a,%

2%2%6%4 K(m ( ! !

T!a d( ! a, !n an" &da* d!)a$&',an men"and&n" # V!$& Cam a, 1%000 CCID609

Kanam 3!n &)+a' 100 m3"9 E$!'*$(m 3!n :0 m3"

2%2%6%6 D( ! dan Ca$a Pem8e$!an

Im&n! a ! 3am a, 'e$d!$! da$! d( ! 096 m) an" d! &n'!,,an e3a$a SUBKUTAN9 )e8!*

8a!, ada )en"an a'a % Pada e'!a en &n'!,an *a$& men""&na,an 7a$&m dan $!n"e

an" 'e$!)% Va, !n an" 'e)a* d!)a$&',an *an a da a' d!"&na,an ada *a$! !'& 7&"a

@ma, !m&m &n'&, = 7am dan !'& &n 8e$)a,& *an a 7!,a a, !n e)ama .a,'& 'e$ e8&'

d! !m an ada &*& 2 -= C e$'a 'e$)!nd&n" da$! !na$ ma'a*a$!% Pe)a$&' *a$& d! !m an

ada &*& e7&, e8e)&m d!"&na,an%

Sa'& d( ! a, !n 3am a, 3&,& &n'&, mem8en'&, ,e,e8a)an 'e$*ada !n+e, !%D! ne"a$a-

ne"a$a den"an an",a ,e7ad!an dan ,ema'!an ,a$ena en a,!' 3am a, '!n""! ada 'a*&n

e$'ama e'e)a* ,e)a*!$an9 ma,a d!an7&$,an !m&n! a ! 'e$*ada 3am a, d!)a,&,an ed!n!

m&n",!n e'e)a* & !a > 8&)an @2 8&)an9 1 ,a)! d! & !a ; 'a*&n% D!an7&$,an9 em8e$!an

3am a, ,e-1 e &a! 7ad.a)% Se)a!n ,a$ena an'!8(d! da$! !8& &da* men&$&n d! & !a >

8&)an9 en a,!' 3am a, &m&mn a men e$an" ana, & !a 8a)!'a% J!,a am a! 12 8&)an


30/67

26

8e)&m menda a',an !m&n! a ! 3am a,9 ma,a ada & !a 12 8&)an *a$& d!!m&n! a ! MMR

@Mea )e M&m R&8e))a %

2%2%6%< E+e, Sam !n"#

Um&mn a '!da, ada% Pada 8e8e$a a ana,9 8! a men e8a8,an demam dan d!a$e9 nam&n

,a & n a an"a' ,e3!)% B!a an a demam 8e$)an" &n" em!n""&% Kadan" 7&"a 'e$da a'

e+e, ,eme$a*an m!$! 3am a, e)ama : *a$!%

2%2%6%= K(n'$a!nd!,a !

Te$da a' 8e8e$a a ,(n'$a!nd!,a ! an" 8e$,a!'an den"an em8e$!an a, !n 3am a,%

?a)a& &n 8e$)a.anan en'!n" &n'&, men"!m&n! a ! ana, an" men"a)am! ma)n&'$! !%

Demam $!n"an9 !n+e, ! $!n"an ada a)&$an na+a a'a& d!a$e9 dan 8e8e$a a en a,!'

$!n"an )a!nn a 7an"an d!,a'e"($!,an e8a"a! ,(n'$a!nd!,a !% K(n'$a!nd!,a ! 'e$7ad! 8a"!

!nd! !d& an" d!,e'a*&! a)e$"! 8e$a' 'e$*ada ,anam 3!n dan e$!'*$(m 3!n%

Ka$ena e+e, a, !n !$& 3am a, *!d& 'e$*ada 7an!n 8e)&m d!,e'a*&!9 ma,a .an!'a

*am!) 'e$ma &, ,(n'$a!nd!,a !% Ind! !d& en"!da !$& HIV @H&man Imm&n(d+!3!en3

V!$& % Va, !n Cam a, ,(n'$a!nd!,a ! 'e$*ada !nd! !d&-!nd! !d& an" men"!da

en a,!' !mm&ne de+!3!en3 a'a& !nd! !d& an" d!d&"a mende$!'a "an""&an $e (n !m&n

,a$ena )e&,!m!a9 ) m *(ma a'a& "ene$a)! ed ma)!"nan3 % Ba"a!mana &n ende$!'a HIV9

8a!, an" d! e$'a! "e7a)a a'a& &n 'an a "e7a)a *a$& d!!m&n! a ! a, !n 3am a, e &a!

2%2%6%> Jad&a) an" d!'en'&,an%

Ba"! ana,-ana, an" edan" a,!' 8e$a' e e$'! d!a$e dan demam '!n""!9 men&$&' Jane9

d!!n '$&, !,an '!da, e$)& d!!m&n! a ! 3am a,% Pa$a e'&"a 3&,& men3a'a' naman a%

A a8!)a ana, 'e$ e8&' 'e)a* em8&*9 e'&"a a,an menda'an"! $&ma*n a &n'&, d!8e$!

!m&n! a !%

2%2%6%10 Kema an

Va, !n 'e$ ed!a da)am ,ema an !a) 10 d( ! F 6 m) e)a$&' da)am am &)%


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2%:% P$("$am !m&n! a ! TT Pada I8& Ham!)

P$("$am Im&n! a ! 8e$'&7&an &n'&, men&$&n,an an",a ,e a,!'an9 ,e3a3a'an dan ,ema'!an

da$! en a,!'- en a,!' an" da a' d!3e"a* den"an !m&n! a ! @PD:I % Un'&, men3a a! *a)

'e$ e8&'9 ma,a $("$am !m&n! a ! *a$& da a' men3a a! '!n",a' 3a,& an an" '!n""! dan

me$a'a d! em&a .!)a a* den"an ,&a)!'a e)a anan an" memada!% @D!n,e Jam8!9 200: %

Pe)a, anaan ,e"!a'an !m&n! a ! TT !8& *am!) 'e$d!$! da$! ,e"!a'an !m&n! a ! $&'!n dan

,e"!a'an 'am8a*an% Ke"!a'an !m&n! a ! $&'!n ada)a* ,e"!a'an !m&n! a ! an" e3a$a $&'!n

dan 'e$& -mene$& *a$& d!)a, ana,an ada e$!(de .a,'& an" 'e)a* d!'e'a ,an9 an"

e)a, anaann a d!)a,&,an d! da)am "ed&n" @,(m (nen 'a'! e e$'! & ,e ma 9

& ,e ma em8an'&9 $&ma* a,!'9 $&ma* 8e$ a)!n dan d! )&a$ "ed&n" e e$'! ( and&

a'a& me)a)&! ,&n7&n"an $&ma*% Ke"!a'an !m&n! a ! 'am8a*an ada)a* ,e"!a'an !m&n! a !

an" d!)a,&,an a'a da a$ d!'em&,ann a ma a)a* da$! *a !) eman'a&an a'a& e a)&a !%

@De ,e RI9 2006 %

2%:%1% Jad.a) Im&n! a ! TT !8& *am!)

1% B!)a !8& *am!) e.a,'& men7ad! 3a)(n en"an'!n &da* menda a' TT e8an a, 2 ,a)!9

ma,a ,e*am!)an e$'ama 3&,& menda a' TT 1 ,a)!9 d!3a'a' e8a"a! TT &)an" dan ada

,e*am!)an 8e$!,&'n a 3&,& menda a' TT 1 ,a)! a7a an" d!3a'a' e8a"a! TT &)an" 7&"a%

2% B!)a !8& *am!) e.a,'& men7ad! 3a)(n en"an'!n a'a& *am!) e8e)&mn a 8a$& menda a'TT 1 ,a)!9 ma,a e$)& d!8e$! TT 2 ,a)! e)ama ,e*am!)an !n! dan ,e*am!)an 8e$!,&'n a

3&,& d!8e$!,an TT 1 ,a)! e8a"a! TT &)an"%

:% B!)a !8& *am!) &da* e$na* menda a' TT 2 ,a)! ada ,e*am!)an e8e)&mn a9 3&,&

menda a' TT 1 ,a)! dan d!3a'a' e8a"a! TT &)an"%

2%:%2% Ca$a em8e$!an dan d( !

1% Se8e)&m d!"&na,an9 a, !n *a$& d!,(3(, 'e$)e8!* da*&)& a"a$ & en e men7ad!

*(m("en%

2% Un'&, men3e"a* 'e'an& /'e'an& ne(na'a) 'e$d!$! da$! 2 d( ! $!me$ an" d! &n'!,,an

e3a$a !n'$am& ,&)a$ a'a& &8,&'an da)am9 den"an d( ! em8e$!an 096 m) den"an

!n'e$ a) 4 m!n""&% D!)an7&',an den"an d( ! ,e'!"a e'e)a* ; 8&)an 8e$!,&'n a% Un'&,

mem e$'a*an,an ,e,e8a)an 'e$*ada 'e'an& ada .an!'a & !a &8&$9 ma,a d!an7&$,an


32/67

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d!8e$!,an 6 d( ! % D( ! ,e em a' dan ,e )!ma d!8e$!,an den"an !n'e$ a) m!n!ma) 1 'a*&n

e'e)a* em8e$!an d( ! ,e '!"a dan ,e em a'% Im&n! a ! TT da a' d!8e$!,an e3a$a aman

e)ama ma a ,e*am!)an 8a*,an ada e$!(de '$!me 'e$ e$'ama%

:% D! &n!' e)a anan 'a'! 9 a, !n TT an" 'e)a* d!8&,a *an a 8()e* d!"&na,an e)ama 4

m!n""& den"an ,e'en'&an #

• Va, !n 8e)&m ,ada)&a$ a

• Va, !n d! !m an da)am &*& F2 - F= C

• T!da, e$na* 'e$endam a!$%

• S'e$!)!'a n a 'e$7a"a

• VVM @Va33!ne V!a) M(n!'($ ma !* da)am ,(nd! ! A a'a& B%

4% D! ( and&9 a, !n an" &da* 'e$8&,a '!da, 8()e* d!"&na,an )a"! &n'&, *a$! 8e$!,&'n a%

2%:%:% E+e, Sam !n"

E+e, am !n" 7a$an" 'e$7ad! dan 8e$ !+a' $!n"an9 "e7a)an a e e$'! )ema dan ,eme$a*an

ada )(,a ! &n'!,an an" 8e$ !+a' emen'a$a dan ,adan"-,adan" "e7a)a demam% @De ,e

RI9 2006 %

2%:%4% Tena"a Pe)a, ana Im&n! a !

S'anda$ 'ena"a e)a, ana d! '!n",a' & , ma ada)a* e'&"a !m&n! a ! dan e)a, ana3()d 3*a!n% Pe'&"a !m&n! a ! ada)a* 'ena"a e$a.a' a'a& 8!dan an" 'e)a* men"!,&'!

e)a'!*an9 an" '&"a n a mem8e$!,an e)a anan !m&n! a ! dan en &)&*an% Pe)a, ana

3()d 3*a!n ada)a* 'ena"a an" 8e$ end!d!,an m!n!ma) SMA a'a& SMK an" 'e)a*

men"!,&'! e)a'!*an 3()d 3*a!n9 an" '&"a n a men"e)()a a, !n dan me$a.a' )ema$! e 9

men3a'a' &*& )ema$! e 9 men3a'a' ema &,an dan en"e)&a$an a, !n e$'a men"am8!)

a, !n d! ,a8& a'en/,('a e &a! ,e8&'&*an e$ 8&)an% Pen"e)()a $("$am !m&n! a ! ada)a*

e'&"a !m&n! a !9 e)a, ana 3()d 3*a!n a'a& e'&"a )a!n an" 'e)a* men"!,&'! e)a'!*an

&n'&, en"e)()a $("$am !m&n! a !9 an" '&"a n a mem8&a' e$en3anaan a, !n dan

)("! '!, )a!n9 men"a'&$ 7ad.a) e)a anan !m&n! a !9 men"e3e, 3a'a'an e)a anan

!m&n! a !9 mem8&a' dan men"!$!m )a ($an ,e ,a8& a'en/,('a9 mem8&a' dan men"ana)! !

P?S 8&)anan9 dan me$en3ana,an '!nda, )an7&'% @De ,e 9 2006 %


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29

Un'&, men!n",a',an en"e'a*&an dan/a'a& ,e'$am !)an e'&"a !m&n! a ! e$)& d!)a,&,an

e)a'!*an e &a! den"an m(d&) )a'!*an e'&"a !m&n! a !% Pe)a'!*an 'e,n! d!8e$!,an

,e ada e'&"a !m&n! a ! d! & ,e ma 9 $&ma* a,!' dan 'em a' e)a anan )a!n9 e'&"a

3()d 3*a!n d! em&a '!n",a'% Pe)a'!*an mana7e$!a) d!8e$!,an ,e ada a$a en"e)()a

!m&n! a ! dan & e$ ! ($ d! em&a '!n",a'% @De ,e RI9 2006 %

2%:%6% Va, !n TT @Te'an& T( (!d

De ,$! !

Va, !n TT @ Te'an& T( (!d ada)a* a, !n an" men"and&n" '( (!d 'e'an& an" 'e)a*

d!m&$n!,an dan 'e$a8 ($8 ! ,e da)am : m"/m) a)&m!n!&m +( +a'% T*!me$( a) 091 m"/m)

d!"&na,an e8a"a! en"a.e'% Sa'& d( ! 096 m) a, !n men"and&n" ('en ! ed!,!'n a 40

IU% D! e$"&na,an &n'&, men3e"a* 'e'an& ada 8a ! an" 8a$& )a*!$ den"an

men"!m&n! a ! ?an!'a U !a S&8&$ @?US a'a& !8& *am!)9 7&"a &n'&, en3e"a*an 'e'an&

ada !8& 8a !% @De ,e RI9 2006 %

Kema an Va, !n

Kema an a, !n da)am !a)% 1 !a) a, !n TT 8e$! ! 10 d( ! dan e'!a 1 8( a, !n

'e$d!$! da$! 10 !a)% Va, !n TT ada)a* a, !n an" 8e$8en'&, 3a!$an% @De ,e RI9 2006 %

K(n'$a!nd!,a ! Va, !n TT

I8& *am!) a'a& ?US an" mem &n a! "e7a)a-"e7a)a 8e$a' @ !n" an ,a$ena d( ! e$'ama

TT% @De ,e RI9 2006 %

S!+a' Va, !n

Va, !n TT 'e$ma &, a, !n an" en !'!+ 'e$*ada 8e,& @ $ee e Sen !'! e S a!'&

"()(n"an a, !n an" a,an $& a, 8!)a 'e$ a a$/'e$,ena den"an &*& d!n"!n a'a& &*&

em8e,&an% @De ,e RI9 2006 %


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30

Ke$& a,an Va, !n

Ke'e$ a a$an &*& an" '!da, 'e a' ada a, !n TT men e8a8,an &m&$ a, !n men7ad!

8e$,&$an" dan a, !n a,an $& a, 8!)a 'e$ a a$ /'e$,ena !na$ ma'a*a$! )an" &n"% @De ,e

RI9 2006 %

Ta8e) Keadaan &*& 'e$*ada &m&$ a, !n TT

VAKSIN PADA SUHU DAPAT BERTAHAN SELAMA

TT

-096 C Ma !ma) 7am

-6 C Q -10 C Ma !ma) 196 Q 2 7am

Be8e$a a C d!a'a &*&&da$a )&a$ @am8!en'

'em e$a'&$e :4 C

:0 *a$!

S&m8e$ # De ,e RI9 2006

2%:%;% Te'an& Ne(na'($&m @TN

Te'an& Ne(na'($&m @TN ada)a* !n+e, ! a,&' an" d! e8a8,an ()e* ,&man C)( '$!d!&mTe'an! mema &,! '&8&* 8a ! 8a$& )a*!$ me)a)&! 'a)! & a' an" ,&$an" 'e$a.a' dan 'e$7ad!

ada 8a ! e7a, )a*!$ am a! &m&$ 2= *a$!9 ,$!'e$!a ,a & TN 8e$& a &)!' men"*! a ASI9

d! e$'a! ,e7an" $an" an"an9 da a' 'e$7ad! e7a, &m&$ :- 2= *a$! 'an a eme$!, aan

)a8($a'($!&m% @S&da$7a' S9 1>>6 %

Pen&)a$an TN e8a"a! a,!8a' mem('(n" 'a)! & a' den"an e$a)a'an '!da, 'e$!) dan

'e$,(n'am!na ! den"an e, ,$e'a *e.an a'a& 'ana* an" men"and&n" ($a 'e'an& e8a"a!

8a)&'an a'a& 'a)! a,a$ &n'&, men"!,a' 'a)! & a'% Te'an& Ne(na'($&m en&)a$ann a e3a$a

)an" &n" a'a& 'a, )an" &n" me)a)&! )&,a an" ada ada 8a !9 8!a an a 'e$7ad! a,!8a'

!n+e, ! ada )&,a d! & a$ 8e,a em('(n"an 'a)! & a' den"an men""&na,an a)a' an"

'e$,(n'am!na !% D! am !n" !'& !n+e, ! da a' &)a 'e$7ad! 7!,a )&,a & a$ 8a ! d!(8a'! a'a&

d!8e$! a'- a' an" 'e$,(n'am!na !% @Ge($"e D9 1>>6 %


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Ma a !n,&8a ! 8!a an a 4-21 *a$! @&m&mn a < *a$! 9 'e$"an'&n" ada 'em a' 'e$7ad!n a

)&,a9 8en'&, )&,a9 d( ! dan '(, ! !'a ,&man% @S&da$7a' S9 1>>6 %

Tanda-'andan a 'e$da a' ada 8a ! 8a$& )a*!$ @ne(na'& am a! &m&$ ,&$an" da$! 2= *a$!9

8!a an a 8e8e$a a *a$! e &da* )a*!$ den"an "e7a)a-"e7a)a 8a ! m&)a-m&)a ma !* 8! a

mene'e,/m!n&m9 )ama ,e)amaaan ,a$ena ('(' $a*an" ,e7an"9 ma,a &)!' mem8&,a m&)&'

e*!n""a 8en'&, m&)&' 8a ! men3&3& e e$'! m&)&' !,an9 )ama ,e)amaan ('(' e$na+a an

,e7an"9 '!da, )ama ,em&d!an 8a ! ,e)!*a'an 8!$&9 ,e7an",e7an" am a! men!n""a) d&n!a%

@S&8D!' Im&n! a !9D!'7en PPM PLP91>>2 %

Un'&, men3e"a* 'e'an& ada 8a ! 8a$& )a*!$ d!)a,&,an !m&n! a ! a,'!+ den"an '(, (!d'e'an& ada !8& *am!) men7e)an" ,e)a*!$an 8a ! dan eanda!n a ,e)a*!$an e($an" 8a !

d!'()(n" ()e* d&,&n9 8a ! e3e a'n a d!8a.a ,e d(,'e$/ & ,e ma &n'&, menda a'

!m&n! a ! a !+ den"an e$&m an'! 'e'an& % @Ma$,&m A%H9 1>=< % Va, !n TT mem!)!,!

e+e,'!+!'a an" an"a' '!n""! dan em8e$!ann a m&da*9 e*!n""a '&7&an &n'&, me)!nd&n"!

8a ! 'e$*ada TN da a' d!3a a! da)am .a,'& an" $e)a'!+ !n",a'% @Pan!'!a PIN9 1>>; %

Un'&, menda a',an e$)!nd&n"an e&m&$ *!d& 'e$*ada TN ma,a d! e$)&,an em8e$!an

!m&n! ! TT 6 d( ! den"an !n'e$ a) .a,'& e &a! ,e'en'&an% @Pan!'!a PIN9 1>>; %

Ta8e)% Jad.a) Pem8e$!an Im&n! a ! TT 6 D( !

Pem8e$!an

Im&n! a !

@ 'a'& TT

In'e$ a) .a,'&

em8e$!an m!n!ma)Ma a Pe$)!nd&n"an D( !

TT1 - - 096 33

TT2 4 m!n""& e'e)a* TT1 : 'a*&n 096 33

TT: ; 8&)an e'e)a* TT2 6 'a*&n 096 33

TT4 1 'a*&n e'e)a* TT: 10 'a*&n 096 33

TT6 1 'a*&n e'e)a* TT4 26 'a*&n/ e&m&$ *!d& 096 33


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BAB III

METODE PENELITIAN

Me'(de ene)!'!an ada)a* &a'& 3a$a an" d! e$"&na,an da)am e8&a* ene)!'!an &n'&,

men3a a! '&7&an ene)!'!an% Me'(de ene)!'!an a'a& e$!n" d! e8&' 7&"a me'(d()("!

ene)!'!an ada)a* e8&a* de a!n a'a& $an3an"an ene)!'!an% Ran3an"an !n! 8e$! ! $&m& an

'en'an" (87e, a'a& &87e, an" a,an d!'e))!'!9 'e,n!, 'e,n!, en"&m &)an da'a9 $( ed&$

en"&m &)an dan ana)! ! da'a 8e$,enaan den"an +(,& ma a)a* 'e$'en'&% Me'(de

ene)!'!an @$e ea$3* me'*(d ada)a* 3a$a 3a$a an" d!"&na,an ()e* ene)!'! da)am

me$an3an"9 me)a, ana,an9 en"()a* da$a9 dan mena$!, ,e !m &)an 8e$,enaan den"an

ma a)a* ene)!'!an 'e$'en'&% 1

Me'(de an" d!"&na,an da)am ene)!'!an !n! ada)a* me'(de de ,$! '!+% S'a'! '!,

de ,$! '!+ ada)a* 8a"!an da$! 'a'! '!,a an" mem e)a7a$! 3a$a en"&m &)an da'a dan

en a7!an da'a e*!n""a m&da* d! a*am!% S'a'! '!,a de ,$! '!+ *an a 8e$*&8&n"an

den"an *a) men"&$a!,an a'a& mem8e$!,an ,e'e$an"an-,e'e$an"an men"ena! &a'& da'a

a'a& ,eadaan% Den"an ,a'a 'a'! '!,a de ,$! '!+ 8e$+&n" ! mene$an",an ,eadaan9 "e7a)a9

a'a& e$ (a)an% Pena$!,an ,e !m &)an ada 'a'! '!,a de ,$! '!+ @7!,a ada *an a d!'&7&,an ada ,&m &)an da'a an" ada% @I8$a*!m9 200< men7e)a ,an ene)!'!an de ,$! '!+ ada)a*

ene)!'!an an" 8e$& a*a mende ,$! !,an &a'& "e7a)a9 e$! '!.a9 ,e7ad!an an" 'e$7ad!

ada aa' e,a$an" % Ha) !n! *am !$ ama den"an enda a' S&,mad!na'a @S&,mad!na'a9

2006 an" men7e)a ,an 8a*.a ene)!'!an de ,$! '!+ @de 3$! '! e $e ea$3* ada)a* &a'&

me'(de ene)!'!an an" d!'&7&,an &n'&, men""am8a$,an +en(mena- +en(mena an" ada9

an" 8e$)an" &n" ada aa' !n! a'a& aa' an" )am a&%

$&3*an @ &$3*an9 2011 men"em&,a,an ene)!'!an de ,$! '!+ mem &n a! ,a$a,'e$! '!, ,a$a,'e$! '!, #

1 Sukmadinata, N. S. (2005). Metode Penelitian Pendidikan. aka!ta" #o$da.


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1% Pene)!'!an de ,$! '!+ 3ende$&n" men""am8a$,an &a'& +en(mena a a adan a

den"an 3a$a mene)aa* e3a$a 'e$a'&$ ,e'a'9 men"&'ama,an (87e,'! !'a 9 dan

d!)a,&,an e3a$a 3e$ma'%

2% T!da, adan a e$)a,&an an" d!8e$!,an a'a& d!,enda)!,an9 dan '!da, adan a &7!

*! ('e ! %

Men&$&' R(nn K(&n'&$ @K(&n'&$9 2004 9 ene)!'!an de ,$! '!+ mem &n a! 3!$! 3!$!

e8a"a! 8e$!,&'#

1% Be$*&8&n"an den"an ,eadaan an" 'e$7ad! aa' !'&%

2% Men"&$a!,an a'& a$!a8e) a7a a'a& 8e8e$a a a$!a8)e nam&n d!&$a!,an a'& e$ a'&%

:% Va$!a8e) an" d!'e)!)'! '!da, d!man! &)a ! a'a& '!da, ada e$)a,&an @'$ea'men'

Pada ene)!'!an !n!9 en&)! mene$a ,an me'(de ,&e !(ne$ &n'&, menda a',an da'a

de ,$! '!+ &n'&, '&7&an ana)! a% K&e !(ne$ d! & &n 8e$da a$,an '!"a ,e)(m (, e$'an aan

an" ,am! an""a en'!n" dan 8e$,a!'an e$a' den"an !,a dan e$!)a,& ($an" '&a

a'a& &n !8& *am!) da)am menda a',an !m&n! a !% : ,e)(m (, !n! ada)a*#

1% Pen"e'a*&an men"ena! !m&n! a !

2% S!,a I8& 'e$*ada !m&n! a !

:% K&a)!'a e)a anan d! P& ,e ma 'e$,a!'%

Ma !n" ma !n" ,e)(m (, e$'an aan 'e$d!$! da$! 8e8e$a a e$'an aan9 dan d! & &n

edem!,!an $& a den"an e$'an aan ( !'!+ a'a& &n ne"a'!+9 &n'&, men"&$an"! 8!a an"

da a' 'e$7ad!% Re (n a !en d!8a'a ! men7ad! : ,e)(m (, # a9 '!da, 9 dan $a"&%

@,&e !(ne$ da a' d!)!*a' ada Lam !$an 1 %

K&e !(ne$ d!8a"!,an ada 7am e)a anan P& ,e ma Ba)a$a7a ,e ada e'!a am e) an"

e &a! den"an ,$!'e$!a !n,)& ! dan e, ,)& !9 ada aa' edan" me)a,&,an an'$!an

e)a anan ,e e*a'an% Pem8a"!an ,e& !(ne$ d!8a"! ada : )(,a ! a!'& ada Ba)a!

Pen"(8a'an De.a a9 K)!n!, I8& dan Ana,9 dan Ba)a! Pen"(8a'an Ana,% Se'!a $e (nden

d!8e$!,an .a,'& '!da, 'e$8a'a da)am men"! ! ,&e !(ne$%

Ha !) ,em&d!an d!,&m &),an ,em8a)! dan d!)a,&,an en a7!an e3a$a "$a+! &n'&,

menda a',an *a !) de ,$! '!+ a'a& e'a en e8a8 e$ma a)a*an% Da$! *a !) 'e$ e8&'9 '!m


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34

en&)! a,an me)a,&,an !n'e$ en ! an" e &a! dan mem8a"!,an *a !) enem&an den"an

P& ,e ma Ba)a$a7a%

:%1 T&7&an dan De a!n ene)!'!an

Pene)!'!an !n! 8e$'&7&an &n'&, mende ,$! !,an a$!8e) an" 8e$,a!'an den"an 3a,& an

!m&n! a !9 an'a$a )a!n '!n",a' en"e'a*&nan ($an" '&a 'e$,a!' !m&n! a !9 !,a an"

d!am8!) dan ,&a)!'a e)a anan +a !)!'a e)a anan $!me$ e'em a'9 den"an '&7&an a,*!$

meme'a,an e$ma a)a*an $enda*n a 3a,& an !m&n! a ! 'e$'en'& d! .!)a a* ,e$7a

P& ,e ma Ba)a$a7a

:%2% ?a,'& dan Tem a' Pene)!'!an

Pene)!'!an d!)a,&,an e)ama e$!(de ,e an'e$aan d(,'e$ !n'e$n *! 9 a!'& da$! 8&)an J&)!

O,'(8e$ 2016 9 d! .!)a a* ,e$7a P& ,e ma Ba)a$a7a9 an" men3a,& !#

1% Ke)&$a*an Ba)a$a7a

2% De a Te)a"a Sa$!

:% De a Sen'&)

4% De a Sen'&) Ja a

6% De a Sa"a

:%:% P( &)a ! Pene)!'!an

a% P( &)a ! Ta$"e' #2

.an!'a & !a ($d&,'!+ an" 'e)a* men!,a* dan d! da)am .!)a a* ,e$7a P& ,e ma Ba)a$a7a

:%4% Be a$ am e)

Un'&, 7&m)a* ( &)a ! an" 'e)a* d!,e'a*&! da a' d!"&na,an $&m& Ta$( amane

@Ta$( amane9 1>;< &n'&, men"*!'&n" 7&m)a* am e) an" d! e$)&,an

2 Po%ula$i &an' men adi ta!'et ak i! 'ene!ali$a$i %enelitian.


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*0

0 + 6 1

Pada ene)!'!an !n! N 7&m)a* 8a ! 8a$& )a*!$ 'a*&n 2014 d! .!)a a* ,e$7a P& ,e ma

14


40/67

36

:%;% Ren3ana ana)! !

Ha !) a,an d!ana)! ! e3a$a de ,$! '!+ "$a+! %

:%


41/67

37

BAB IV

PRO IL PUSKESMAS BALARAJA

4%1% P$(+!) Ke$7a P& ,e ma Ba)a$a7a

V! !9 M! !9 dan T&7&an

• V! ! P& ,e ma Ba)a$a7aMem8e$!,an e)a anan ,e e*a'an $(+e !(na) ada 'a*&n 2016

• M! ! P& ,e ma Ba)a$a7a

o Mem8e$!,an e)a anan '!n",a' e$'ama an" 8e$m&'&

o Men!n",a',an ,e$7a ama )!n'a P$("$am dan )!n'a e,'($a)

o Men!n",a',an &m8e$da a &n'&, men&n7an" m&'& e)a anan ,e e*a'an N!)a!-n!)a!#

o Ke7&7&$an

o Ked! ! )!nan

o Ke$7a ama

o P$(+e !(na)! me

o Be$.a.a an ,e de an

• Ke8!7a,an M&'& P& ,e ma Ba)a$a7a

Ke8!7a,an M&'& P& ,e ma Ba)a$a7a 8e$,(m!'men &n'&, men3a a! ! ! m! !

den"an mene$a ,an ! 'em mana7emen ISO >001#200= den"an '!nda,an e8a"a!

8e$!,&'#

o Mem8e$!,an e)a anan '!n",a' e$'ama den"an 3e a' dan 'e a'

o Be$ !,a $ama* dan a8a$

o P$(+e !(na) da)am men7a)an,an '&"a


42/67


43/67

39

Gam8a$ II Pe'a ?!)a a* Ke$7a P& ,e ma Ba)a$a7a

4%:% Da'a Dem("$a+!

N(% De a/Ke)&$a*an Ke'e$an"an

1 Ba)a$a7a Ke)&$a*an

2 Ta)a"a a$! De a

: Sa"a De a

4 Sen'&) De a

6 Sen'&) Ja a De a

Ta8e) I% De a/Ke)&$a*an ?!)a a* Ke$7a P& ,e ma Ba)a$a7a 'a*&n 2014

Ta8e) II% J&m)a* Pend&d&, ?!)a a* Ke$7a P& ,e ma Ba)a$a7a 'a*&n 2016

N(%De a /

Ke)&$a*anJ&m)a* Pend&d&,

La,!-)a,! Pe$em &an J&m)a*

1% Ba)a$a7a ;%11= 6% 10%;0:

J&m)a* :;%66> :4%6>: 2


44/67

40

Ta8e) III% J&m)a* Ke a)a Ke)&a$"a ?!)a a* Ke$7a P& ,e ma Ba)a$a7a 'a*&n 2014

Da$! 'a8e) d!a'a da a' d!)!*a' 8a*.a De a Sa"a mem &n a! 7&m)a* end&d&, a)!n"

8e a$9 ,a$ena d! De a Sa"a 'e$da a' : @'!"a e$&ma*an% Sedan",an 7&m)a* end&d&,

a)!n" ed!,!' ada)a* De a Sen'&) Ja a%

Ta8e) IV% K)a !+!,a ! end&d&, men&$&' '!n",a' end!d!,an P& ,e ma Ba)a$a7a 'a*&n 2014

N(% De a/ Ke)&$a*an Ke'e$an"an

1% Ba)a$a7a 2%=4>

2% Ta)a"a a$! :%:;=

:% Sa"a ;%=>;

4% Sen'&) 2%;;>

6% Sen'&) Ja a 2%1;:

J&m)a* 146

N(% Pend!d!,an J&m)a*

1% Pe$"&$&an T!n""! 1:%121 :0

2% SMU 10%>62 26

:% SLTP 14%::= ::

4% SD/ MI :%:1; =

6% T!da, 'ama' SD 1%:0: :

;% B&'a H&$&+ 6;: 1

J&m)a* 4:%6>: 100


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Da$! 'a8e) d!a'a da a' d!)!*a'9 8a*.a e8a"!an 8e a$ end&d&, Ke3ama'an Ba)a$a7a

'!n",a' end!d!,ann a e8a"!an 8e a$ 'ama' SMU a!'& 26 dan ma !* 'e$da a'n a

end&d&, an" 8&'a *&$&+ d! .!)a a* Ke3ama'an Ba)a$a7a e8e a$ 1

N( Sa$ana Pend!d!,an J&m)a*

1% TK 2=

2% SD 24

:% SLTP 10

4% SMU 14

6% SLB 1

J&m)a* =: :

:% H!nd& 4;; 1

4% B&d*a 1

J&m)a* ;>%611 100

Ta8e) VI% K)a !+!,a ! end&d&, men&$&' a"ama P& ,e ma Ba)a$a7a 'a*&n 2014


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Da$! 'a8e) d!a'a da a' d!)!*a'9 8a*.a em&a a"ama ada d! .!)a a* Ba)a$a7a9 ma ($!'a

end&d&, 8e$a"ama I )am a!'& e8e a$ >6 %

N(%

Um&$

J&m)a* Pend&d&, J&m)a*

La,!-)a,! Pe$em &an

1% 0 4 :%=6: :%;64 :%1 ;%:4;

:% 10 14 2%=>: 2%;=; 6%6

4% 16 1> 2%=22 2%;;4 6%4=;

6% 20/-24 :%6;4 :%4 :%>>; =%016

6%2>=

10% 46-4> 1% :0: :20 ;2:

16%


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Ta8e) VIII K)a !+!,a ! end&d&, men&$&' ma'a en3a*a$!an P& ,e ma Ba)a$a7a

'a*&n 2014

Da$! 'a8e) d!a'a da a' d!)!*a' 8a*.a d! .!)a a* Ba)a$a7a 8an a, e,a)! 7en! ma'a

en3a*a$!an9 an" a)!n" 8e a$ ada)a* e8a"a! e'an! en""a$a @2;%0: dan e8a"a!

8&$&* !nd& '$! e8e a$ @2:%=2 % An",a en"an""&$an 7&"a ma !* 3&,& '!n""!9 a!'&

e8e a$ @6%>; %

4%4% S&m8e$ da a Ke e*a'an1% S&m8e$ Da a

a% Sa'& &n!' "ed&n" $a.a' 7a)an• Un!' )(,e' enda+'a$an

• Un!' 8a)a! en"(8a'an de.a a

• Un!' 8a)a! en"(8a'an "!"!

• Un!' KIA/KB

• Un!' 8a)a! en"(8a'an ana,

• Un!' 8a)a! en"(8a'an TB a$&

• Un!' )a8($a'($!&m

• Un!' ,a !$

• Un!' a ('e,

• K)!n!, )an !a $ema7a

8% Sa'& Ged&n" Ra.a' Ina

Ged&n" $a.a' !na an" 8a$& e)e a! d!8an"&n ada a.a) 'a*&n

200>%Ged&n" Ra.a' Ina mem &n a! 4 ,ama$ &'ama den"an ,a a !'a '('a) 22

'em a' '!d&$ an" 'e$d!$! a'a #

o 2 8&a* 'em a' '!d&$ &n'&, n!+a

o 6 8&a* 'em a' '!d&$ ana,

o < 8&a* 'em a' '!d&$ &n'&, )a,!-)a,! de.a a

o 6 8&a* 'em a' '!d&$ &n'&, .an!'a de.a a

o 2 8&a* 'em a' '!d&$ &n'&, e$ a)!nan

J&m)a* 44%6=> 100


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45

2% Ke'ena"aan

Ta8e) I J&m)a* 'ena"a 8e$da a$,an 7en! ,e'ena"aan dan 'a'& ,e e"a.a!an

P& ,e ma Ba)a$a7a 'a*&n 2014

4%6% Sa$ana Pe)a anan Ke e*a'an N(% Jen! Sa$ana Ke e*a'an J&m)a*

1% a% P& ,e ma 1

8% P& ,e ma Pem8an'& 1


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46

3% P& ,e ma Ke)!)!n" 0

2% R&ma* Sa,!' Peme$!n'a* 0

:% R&ma* Sa,!' S.a 'a 0

4% R&ma* Be$ a)!n S.a 'a 6

6% Ba)a! Pen"(8a'an S.a 'a 26

;% P$a,'e, D(,'e$ Um&m S.a 'a 14


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47

1% Pe$)en",a an Med!

Pe$)en",a an med! P& ,e ma Ba)a$a7a 7&"a d!'&n7an" den"an 8e$8a"a! e$a)a'an

an" an"a' mem8an'& ,e"!a'an e)a anan ,e e*a'an !'& end!$!% Pe$a)a'an 'e$ e8&'

d!8a"! men7ad! 2 8a"!an a!'

a% Pe$a)a'an en&n7an" med! 9 a!' 'en !me'e$9 'e'( ,( 9 e$a)a'an 8eda*

m!n($9 '!m8an"an 8e$a' 8adan9 a)a' eme$!, aan )a8($a'($!&m @a)a' eme$!, a

,ada$ "&)a da$a*9 a)a' eme$!, a ,ada$ a am &$a' 9 m!,$( ,( &n'&,

eme$!, aan @)a8($a'($!&m &'&m9 &)'$a (n("$a+!9 'a8&n" (, !"en9 e$a)a'an

a$'& 9 'e'( ,( Laene3%

8% Pe$a)a'an en&n7an" n(n med! 9 a!'& #

• Pe$)en",a an Kan'($ dan adm!n! '$a ! # me7a '&)! 9 ,&$ !9 a an '&)! 9

)ema$! a$ ! 9 ,(m &'e$9 $!n'e$9 dan me !n ,e'!,%

• Pe$a)a'an $&ma* 'an""a # K&),a 9 'em a' '!d&$ & &n9 )ema$!9

d! en e$9 e$)en",a an da &$9 dan a)a' em8e$ !* an" ma !* )a a,

a,a!%

• Pe$a)a'an ,(m&n!,a ! # Te$da a' 'e)e (n an" 7&"a 8e$+&n" ! e8a"a!

a)a' +a, %

• Pe$)en",a an '$an ($'a ! #Te$da a' a'& &n!' m(8!) P& ,e ma

Ke)!)!n"%

2% S&m8e$ a!$ #A!$ d! P& ,e ma 8e$a a) da$! a!$ 'ana* an" ,&a)!'a dan ,&an'!'a n a

d!n!)a! 3&,& 8a!, e3a$a +! !,%


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48

BAB V

HASIL PENELITIAN DAN DISKUSI

6%1 Ha !) Pene)!'!an

Da$! 66 )em8a$ ,&e !(ne$ an" d!8a"!,an9 da'a ,em&d!an d!ma &,,an ,e da)am 'a8e) dan

d! $e en'a !,an da)a 8en'&, "$a+! e e$'! d! 8a.a* !n!# @'!m en&)! mem!)!* !)!*an

$e en'a ! "$a+! da)am 8en'&, d!a"$am &n'&, mem ! &a)! a !,an $e (n da$! $e (nden %

6%1 Ke)(m (, &$ e

6%2 PENGETAHUAN IBU MENGENAI IMUNISASI


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6%: SIKAP IBU TERHADAP IMUNISASI


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6%4 PELA ANAN SARANA KESEHATAN


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6%6 D! ,& !

Da$! e$()e*an da'a $!me$ P& ,e ma Ba)a$a7a 'a*&n 20149 d!da a',an ,e en7an"an

da)am 8e8e$a a a$ame'e$ 3a,& an !m&n! a ! 'e$&'ama ada 3a,& an !m&n! a ! 'e'a'n&

ada !8& *am!)% Ke en7an"an an" d!'em&,an 'e$da a' ada '!"a a$ame'e$ a!'

1% P()!( a'& @'a$"e' >= 9 'e$3a a! >1%:

2% TT 1 @'a$"e' >6 9 'e$3a a! 60 9 'e$3a a! =2%2

4% BCG @'a$"e' >= 9 'e$3a a! >1%:


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58

Da$! 4 'a$"e' an" '!da, 'e$3a a! 'e$ e8&' da a' d! !m &),an 8a*.a ,e)(m (, TT &n'&, !8&

*am!) 8a!, TT1 a'a& &n TT2 me$& a,an ,e)(m (, den"an 3a,& an 'e$enda*%

Un'&, men3a$! en e8a8 e$ma a)a*an '!da, 'e$3a a!n a 'a$"e' !m&n! a !9 ma,a ,am!

me)a,&,an ,&e !(ne$ &n'&, men"e, )($a ! : &m8e$ e$ma a)a*an an" m&n",!n# '!n",a' en"e'a*&an !8&9 !,a !8& 'e$*ada !m&n! a !9 dan ,&a)!'a e)a anan P& ,e ma e'em a'%

Pe$'an aan ada ,&e !(ne$ d! & &n edem!,!an $& a dan *an a men!)a! en"e'a*&an &m&m

!8& dan 7&"a en!)a!an !8& men"ena! '!"ma a'a& &n e$!)a,& an" 8e$,a!'an den"an

em8e$!an !m&n! a !% Se)&$&* e$'an aan d!8a'a ! den"an : 7en! $e (n a!' a9 '!da, dan

$a"&% Se'!a e$'an aan an" '!da, d!7a.a8 a'a& d!,( (n",an ()e* $e (nden d!an""a

e8a"a! $a"&5 ()e* ,am!%

Ha !) 'e$ e8&' ,em&d!an d!,&m &),an den"an men""&na,an G((")e S*ee' dan den"an

a )!,a ! an" ama $e en'a ! d!a"$am d!)a,&,an%

Da$! ,e)(m (, e$'an aan men"ena! '!n",a' en"e'a*&an !8&9 d!'em&,an 8a*.a $a'a $a'a

)e8!* da$! =0 $e (nden mem &n a! en"e'a*&an an" 8a!, men"ena! '&7&an !m&n! a !

a!'& &n'&, men3e"a* en a,!' dan 8&,an &n'&, men"(8a'!9 dan em8e$!an !m&n! a !

me)!8a',an me &n'!,,an 8a"!an a'a& e)&$&* a'("en an" 'e)a* d!)ema*,an% Nam&n *an a

%;

am a! %2 mem &n a! en"e'a*&an 8a*.a !m&na a ! 'e'a da a' d!8e$!,an .a)a& &n

'e)a* me)e.a'! 7ad.a) an" 'e$'e$a% Ha) !n! meme$)&,an e$*a'!an ,a$ena ma !* e8a"!an

8e a$ am e) 8e$a &m ! 8a*.a !m&n! a ! '!da, da a' d!8e$!,an a a8!)a &da* 'e$)e.a' 7ad.a)

!m&n! a !%

Da$! ,e)(m (, 'e'an& ada !8& *am!)9 d!'em&,an *a !) an" e &a! den"an ,e en7an"an

an" d!'em&,an da)am 3a a!an 'a$"e' !m&n! a ! TT ada !8& *am!)% Han a


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m!n!ma) 2 ,a)!% Ha) !n! men7ad! +(,& !n'e$ en ! en&)! men"!n"a' 3a a!an 'a$"e' !m&n! a !

TT ada !8& *am!) ada 'a*&n 2014 men&n7&,,an ,e en7an"an an" !"n!+!,an% Ha !) !n! 7&"a

,(n ! 'en den"an da'a $!me$ an" men&n7&,,an ()a ,e3ende$&n"an !8& *am!) &n'&,

menda a',an !m&n! a ! *an a a'& ,a)! a7a%

Da$! ,e)(m (, e$'an aan men"ena! !,a !8& 'e$*ada !m&n! a !9 d!'em&,an 8a*.a )e8&*

da$! >0%; $e (nden e'&7& &n'&, ana, a'a& &n $!8ad!n a menda a',an !m&n! a !% =0%=

an" e'&7& 8a*.a !m&n! a ! mem &n a! dam a, an" )e8!* 8e a$ da$! ada ,e$&"!an e+e,

am !n"n a% Ha) !n! d!,(n+!$ma ! ()e* *a !) e$ en'a e an" ama ada e$'an aan

,(n+!$ma ! ,e 2 a!'& e,!'a$ =0%= @ e$'an aan n( II%49 dan II%6 % =0%= 'e'a a,an 8e$& a*a

mem8e$!,an !m&n! a ! ada ana,n a a'a& &n $!8ad!n a me ,! &n 8!a a men7ad! e$ (a)an%

Da$! e"! e)a anan P& ,e ma Ba)a$a7a% =0%= men",(n+!$ma ! en7e)a an an" 8a!,

d!8e$!,an ()e* e'&"a an" 8e$ an",&'an men"ena! 7ad.a) dan man+aa' !m&n! a !% Nam&n

,e en7an"an d!'em&,an da)am em8e$!an en7e)a an 8a*.a !m&n! a ! da a' 'e'a d!)a,&,an

e,a)! &n ana, edan" a,!' $!n"an% Han a :=%6 $e (nden an" men a'a,an 8a*.a

e'&"a mem8e$!,an !n+($ma ! 'e$ e8&'% Ha) !n! en'!n" men"!n"a' ('en ! mem8en'&,

e$!)a,& ( !a) d!mana ($an" '&a a,an men&nda !m&n! a ! ada ana,n a a a8!)a ana,n a

a,!' $!n"an9 dan 8e$ ('en ! mem&nd&$,an 7ad.a) !m&n! a ! *!n""a men&$&n,an ,(m )!an

&n'&, menda a',an !m&n! a !% =4%; $e (nden men"a,& 8a*.a !n+($ma ! men"ena!!m&n! a ! 'e'a da a' d!8e$!,an me ,! &n 'e)a'9 d!8e$!,an ()e* e'&"a an" 8e$ an",&'an%

Jad.a) !m&n! a !9 dan en &)&*an menda a' en"a,&an d! a'a >0 ()e* $e (nden% :=%6

$e (nden men"a,& 8a*.a )(,a ! & a' e)a anan an"a' 7a&*9 nam&n ,enda)a !n! d!an""a

,&$an" !"n!+!,an ,a$ena da$! en!)a!an !,a !8& 'e$*ada !m&n! a ! d!'em&,an 8a*.a =0%=

!8& 'e'a a,an mem8a.a,an ana,n a dan $!8ad!n a &n'&, menda a',an !m&n! a ! e,a)! &n

8!a a men7ad! e$ (a)an%

Den"an mem e$'!m8an",an *a !) de ,$! '!+ d!a'a 9 ,am! men !m &),an 8a*.a !,a !8&'e$*ada !m&n! a ! e3a$a &m&m 3&,& 8a!,9 nam&n e"! en"e'a*&an ma !* e$)& e$*a'!an%

T!nda,an !n'e$ en ! an" a,an ,am! )a,&,an ada)a* & a a en!n",a'an en"e'a*&an !8&

men"ena! !m&n! a ! 'e$&'ama ada 8!dan" den"an ,e en7an"an 3a a!an !m&n! a ! 'e$'!n""!

a!'& ada !m&n! a ! TT1 dan TT2% Kam! men!m8an" 8a*.a & a a en!n",a'an en"e'a*&an

!n! a)!n" 'e a' d!)a,&,an den"an men e8a$,an )ea+)e' !n+($ma'!+ men"ena! 7en! !m&n! a !


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an" 'e$,a!' me)a)&! & a' e)a anan d! P& ,e ma Ba)a$a7a9 ma& &n me)a)&! ,ade$ dan

8!dan de a% Den"an 8e"!'& en am a!an !n+($ma ! da a' men3a a! d! em!na ! an" )e8!*

)&a dan men e)&$&*% Pada '!n",a'an )(,a) d! P& ,e ma Ba)a$a7a9 ,am! 7&"a me)a,&,an

'!nda,an !n'e$ en ! 8e$& a en &)&*an ada a&d!en ! an" 'e$8a'a ada en"&n7&n"

& ,e ma Ba)a$a7a% Se)a!n !'&9 ,am! a,an me)a,&,an ( !a)! a ! *a !) ene)!'!an de ,$! '!+

!n! ,e ada !*a, P& ,e ma Ba)a$a7a den"an ma, &d men & )emen'a ! en"e'a*&an a,an

,em&n",!nan &m8e$ e$ma a)a*an ada en3a a!an 'a$"e' !m&n! a !9 den"an *a$a an da a'

mem8an'& !*a, P& ,e ma da)am men"am8!) ,e8!7a,an 'e$,a!' men!n",a',an en3a a!an

'a$"e' !m&n! a ! ada 'a*&n e)a anan ,ede ann a%


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BAB VI

KESIMPULAN DAN SARAN

;%1 Ke !m &)an

Be$da a$,an *a !) ene)!'!an an" d!)a,&,an9 'e)a* d!'em&,an adan a ,e en7an"an da)am

8e8e$a a a$ame'e$ 3a,& an !m&n! a !9 a!'& P()!( 1 @'a$"e' >= 9 'e$3a a! >1%: 9 TT 1

@'a$"e' >6 9 'e$3a a! 60 9 'e$3a a! =2%2 9 dan BCG @'a$"e' >= 9

'e$3a a! >1%: % Da$! *a !) d! ,& ! men"ena! ,&e !(ne$ an" 'e)a* d! e8a$ &n'&, men3a$!

,em&n",!nan en e8a8 '!da, 'e$3a a!n a 'a$"e' !m&n! a ! 'e$ e8&'9 da a' d! !m &),an

8a*.a e3a$a "a$! 8e a$ '!n",a' en"e'a*&an !8& 'en'an" !m&n! a ! da a$ ada ana, dan

!m&n! a ! da)am ,e*am!)an ma !* ,&$an"% Den"an em8e$!an )ea+)e' ,e ada ,ade$9 !8&

*am!)9 dan !8& den"an ana, 8a)!'a9 ma,a d!*a$a ,an da a' men!n",a',an en"e'a*&an !8&

'en'an" !m&n! a ! da a$ ada ana, dan !m&n! a ! ,e*am!)an%

Sedan",an !,a !8& 'e$*ada '!nda,an !m&n! a ! ada ana, ma& &n !m&n! a ! aa' *am!)

&da* 3&,& 8a!,9 a$'!n a .a)a& &n da$! e"! en"e'a*&an ma !* 'e$8!)an" ,&$an"9

nam&n a$a !8& 'e)a* men ada$! en'!n"n a !m&n! a ! 8a"! ana, ma& &n ,e*am!)ann a

e*!n""a 8e$ ed!a me)a,&,an !m&n! a !% Pe)a anan e'&"a !m&n! a ! &da* 3&,& 8a!,9

*an a a7a e'&"a ma !* e$)& mem8e$!,an 8e8e$a a !n+($ma ! an" )e8!* 7e)a ,e ada

!8&9 m! a)n a men"ena! ,(n'$a!nd!,a ! !m&n! a !% ?a)a& &n ma !* ada ,enda)a 8e$& a

7a&*n a 7a$a, an'a$a & a' e)a anan ,e e*a'an den"an 'em a' '!n""a)9 nam&n '!da,

men"*am8a' !8& &n'&, me)a,&,an !m&n! a ! 8a"! ana,n a9 8e"!'& &)a den"an !8& *am!)%

;%2 Sa$an

1% Pe$)& d!)a,&,an & a a en!n",a'an en"e'a*&an !8& den"an ana, & !a 8a)!'a dan !8&

*am!) men"ena! !m&n! a ! da a$ ana, dan !m&n! a ! da)am ,e*am!)an9 an'a$a )a!n

den"an 3a$a em8e$!an en &)&*an e3a$a $&'!n9 ema an"an ( 'e$ d! e'!a & a'

e)a anan ,e e*a'an9 em8a"!an )ea+)e'9 dan ,(n e)!n"%

2% D!)a,&,an ende,a'an e$ &a !+ e3a$a ,*& & ,e ada !8&-!8& an" men()a, !m&n! a !

den"an en!n",a'an enda a"&naan ,ade$-,ade$ de a%


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:% Saa' me)a,&,an e)a anan9 e'&"a !m&n! a ! e$)& mem8e$!,an !n+($ma ! an" 7e)a

men"ena! man+aa'9 ,(n'$a!nd!,a !9 KIPI !m&n! a ! da a$ an" aa' !'& d!)a,&,an ada

ana, dan !m&n! a ! &n'&, !8& *am!)9 e$'a 7ad.a) !m&n! a ! 8e$!,&'n a% Se)an7&'n a9

e$)& d!'an a,an ,e ada !8& a a,a* ma !* ada !n+($ma ! an" 8e)&m 7e)a %

4% Pada a,*!$n a d!*a$a ,an )e8!* 8an a, )a"! ene)!'!an )e8!* )an7&' men"ena! *a)

e$& a &n'&, mend&,&n" en3a a!an 3a,& an !m&n! a ! an" )e8!* ma, !ma)%


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DA TAR PUSTAKA

1% D!en 'a"9 J&)e L% V!$a) He a'!'! % Ka e$9 B$a&n.a)d9 a&3!9 e' a))% In Ha$$! (n5 #

P$!n3! )e (+ In'e$na) Med!3!ne # 1=22-:

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