DAFTAR ISI

Abstrak .................................................................................................. i
Kata Pengantar .................................................................................... iii
Daftar Isi ............................................................................................... v
Daftar Tabel........................................................................................... vii
Daftar Gambar ...................................................................................... viii
Daftar Singkatan ................................................................................... ix
Daftar Lampiran ................................................................................... xi

BAB 1 PENDAHULUAN ................................................................... 1

1.1 Latar Belakang ................................................................. 1
1.2 Rumusan Masalah ............................................................ 4
1.3 Pertanyaan Penelitian ....................................................... 4
1.4 Tujuan Penelitian ............................................................. 5
1.4.1 Tujuan umum ....................................................... 5
1.4.2 Tujuan khusus ...................................................... 5
1.5 Manfaat Penelitian ........................................................... 6
1.5.1 Manfaat teoritis .................................................... 6
1.5.2 Manfaat praktis ..................................................... 7

BAB 2 TINJAUAN PUSTAKA .......................................................... 8

2.1 Demam Berdarah Dengue ................................................ 8
2.1.1 Epidemiologi ........................................................ 8
2.1.2 Etiologi ................................................................. 13
2.1.3 Cara penularan ..................................................... 14
2.1.4 Patogenesis........................................................... 15
2.1.5 Manifestasi klinis ................................................. 18
2.1.6 Klasifikasi infeksi virus dengue ........................... 21
2.1.7 Diagnosis ............................................................. 24
2.1.8 Diagnosis banding................................................ 28
2.1.9 Penatalaksanaan ................................................... 28
2.1.10 Komplikasi dan prognosis ................................... 41
2.2 Pemeriksaan Jumlah Trombosit, Nilai Hematokrit, dan
Kadar Hemoglobin ......................................................... 43
2.2.1 Pemeriksaan jumlah trombosit ............................. 43
2.2.2 Pemeriksaan nilai hematokrit............................... 45
2.2.3 Pemeriksaan kadar hemoglobin ........................... 47

BAB 3 KERANGKA KONSEPTUAL DAN HIPOTESIS

PENELITIAN .......................................................................... 50
3.1 Kerangka Konseptual Penelitian ...................................... 50
3.2 Hipotesis Penelitian ......................................................... 50

BAB 4 METODE PENELITIAN ....................................................... 52

4.1 Jenis Penelitian................................................................. 52

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 4.2 Lokasi dan Waktu Penelitian ........................................... 52
4.2.1 Lokasi penelitian ................................................. 52
4.2.2 Waktu penelitian .................................................. 52
4.3 Populasi, Sampel, Teknik Pengambilan Sampel.............. 52
4.3.1 Populasi ............................................................... 52
4.3.2 Sampel penelitian ................................................ 52
4.3.3 Teknik pengambilan sampel ................................ 54
4.4 Variabel dan Definisi Operasional ................................... 54
4.4.1 Variabel penelitian............................................... 54
4.4.2 Definisi operasional ............................................. 55
4.5 Teknik Pengumpulan Data ............................................... 55
4.5.1 Sumber data ......................................................... 55
4.5.2 Instrumen penelitian ............................................ 56
4.6 Prosedur Pengambilan dan Pengumpulan Data ............... 56
4.7 Pengolahan dan Analisis Data ......................................... 57
4.7.1 Pengolahan data ................................................... 57
4.7.2 Analisis data ........................................................ 57

BAB 5 HASIL PENELITIAN ............................................................ 59

5.1 Deskripsi Lokasi Penelitian ............................................. 59
5.2 Analisis dan Hasil Penelitian ........................................... 60
5.2.1 Karakteristik responden ....................................... 60
5.2.2 Analisis korelasi jumlah trombosit, nilai hematokrit,
dan kadar hemoglobin dengan derajat klinik DBD
.................................................................. 63

BAB 6 PEMBAHASAN ...................................................................... 66

6.1 Gambaran Umum Hasil Penelitian .................................. 66
6.1.1 Derajat klinik DBD .............................................. 66
6.1.2 Usia ...................................................................... 67
6.1.3 Jenis kelamin ....................................................... 68
6.1.4 Jumlah trombosit ................................................. 69
6.1.5 Nilai hematokrit ................................................... 70
6.1.6 Kadar hemoglobin ............................................... 71
6.2 Korelasi Jumlah Trombosit dengan Derajat Klinik
DBD ............................................................................. 72
6.3 Korelasi Nilai Hematokrit dengan Derajat Klinik
DBD ............................................................................. 73
6.4 Korelasi Kadar Hemoglobin dengan Derajat Klinik
DBD ............................................................................. 74

BAB 7 PENUTUP ............................................................................. 76

7.1 Kesimpulan ...................................................................... 76
7.2 Saran ................................................................................. 77

DAFTAR PUSTAKA ............................................................................ 77

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 DAFTAR TABEL

Tabel 2.1 Gambaran klinik fase penyakit dengue.......................... 21

Tabel 4.1 Definisi operasional........................................................ 55
Tabel 5.1 Distribusi derajat klinik.................................................. 60
Tabel 5.2 Distribusi usia berdasarkan derajat klinik
DBD................................................................................ 61
Tabel 5.3 Distribusi jenis kelamin berdasarkan derajat klinik
DBD ............................................................................... 61
Tabel 5.4 Distribusi jumlah trombosit berdasarkan derajat klinik
DBD................................................................................ 62
Tabel 5.5 Distribusi nilai hematokrit berdasarkan derajat klinik
DBD ............................................................................... 62
Tabel 5.6 Distribusi kadar hemoglobin berdasarkan derajat
klinik DBD..................................................................... 63
Tabel 5.7 Hasil analisis korelasi jumlah trombosit dengan derajat
klinik DBD..................................................................... 64
Tabel 5.8 Hasil analisis korelasi nilai hematokrit dengan derajat
klinik DBD..................................................................... 64
Tabel 5.9 Hasil analisis korelasi kadar hemoglobin dengan
derajat klinik DBD......................................................... 65

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 DAFTAR GAMBAR

Gambar 2.1 Negara dengan risiko transmisi virus DBD................ 9

Gambar 2.2 Angka kesakitan Demam Berdarah Dengue per
100.000 penduduk menurut provinsi tahun
2014................................................................................ 12
Gambar 2.3 Incidence rate DBD per 100.000 penduduk menurut
kab./kota di Provinsi aceh tahun
2014…………………………………………………… 13
Gambar 2.4 Imunopatogenesis Demam Berdarah Dengue................ 16
Gambar 2.5 Hipotesis secondary heterologous infection................. 17
Gambar 2.6 Perjalanan penyakit DBD.............................................. 18
Gambar 2.7 Klasifikasi infeksi virus dengue WHO 1997............... 22
Gambar 2.8 Revisi klasifikasi infeksi dengue tahun 2009............. 22
Gambar 2.9 Petekie pada hasil uji torniquet................................... 25
Gambar 2.10 Protokol 1 tersangka demam berdarah dengue:
Observasi dan pemberian cairan di ruang observasi... 31
Gambar 2.11 Protokol 2 DBD dewasa tanpa perdarahan dan tanda
syok: Observasi dan pemberian cairan di ruang
rawat....................................................................... 34
Gambar 2.12 Protokol 3 DBD dengan perdarahan spontan atau
masif, tanpa syok: Observasi dan pemberian cairan di
ruang 36
rawat........................................................................
Gambar 2.13 Protokol 4 penatalaksanaan DBD dewasa dengan syok
dan perdarahan spontan........................................ 40
Gambar 2.14 Protokol 5 penatalaksanaan DBD dewasa dengan syok
tanpa perdarahan................................................... 41
Gambar 3.1 Kerangka konseptual penelitian.................................... 50

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 DAFTAR SINGKATAN

ADE : Antibody Dependent Enhancement

APTT : Activated Partial Thromboplastin Time
CD4 : Cytotoxic Dependent 4
CD8 : Cytotoxic Dependent 8
CID : Coagulation Intravascular Disseminated
C3a : Complement 3a
C5a : Complement 5a
CFR : Case Fatality Rate
DBD : Demam Berdarah Dengue
DD : Demam Dengue
DSS : Dengue Shock Syndrome
DENCO : Dengue Controls
DEN-1 : Dengue Virus 1
DEN-2 : Dengue Virus 2
DEN-3 : Dengue Virus 3
DEN-4 : Dengue Virus 4
DIC : Disseminated Intravascular Coagulation
FDP : Fibrin Degradation Products
FFP : Fresh Frozen Plasma
HES : Hydroxyl Ethyl Starch
IL : Interleukin
ITP : Idiopathic Thrombocytopenic Purpura
IR : Incidence Rate
KLB : Kejadian Luar Biasa
LPB : Limfosit Plasma Biru
PAF : Platelet Activating Factor
PAPDI : Perhimpunan Dokter Ahli Penyakit Dalam Indonesia
PRC : Packed Red Cell
PRM : Prekursor Membran
PSN : Pemberantasan Sarang Nyamuk
PT : Prothrombin Time
SGOT : Serum Glutamic Oxaloacetic Transaminase
SGPT : Serum Glutamic Pyruvic Transaminase
SPSS : Statistical Package for Social Sciences
TH1 : T-helper 1
TH2 : T-helper 2
TIA : Transient Ischemic Attack
TNF-α : Tumor Necrosis Factor-α
USG : Ultrasonografi
WHO : World Health Organization

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 DAFTAR LAMPIRAN

Lampiran 1 Master data..................................................................... 82

Lampiran 2 Uji statistik..................................................................... 84
Lampiran 3 Rincian biaya penelitian………….………………….... 90
Lampiran 4 Jadwal penelitian.....................................................…... 91
Lampiran 5 Surat izin penelitian dan surat balasan………………... 92
Lampiran 6 Ethical clearance……………………………………… 94
Lampiran 7 Dokumentasi penelitian..……………………………… 95
Lampiran 8 Lembar ACC pembimbing……………………………. 97
Lampiran 9 Surat pernyataan kesediaan pembimbing1…………..... 98
Lampiran 10 Lembar bimbingan konsul pembimbing 1…………...... 99
Lampiran 11 Surat pernyataan kesediaan pembimbing 2…………… 100
Lampiran 12 Lembar bimbingan konsul pembimbing 2…………….. 101
Lampiran 13 Biodata peneliti………………………………………... 102