Documente Academic
Documente Profesional
Documente Cultură
LINGKUNGAN
Ibu
Ibu
o Pendidikan
o Gizi (Early Life
Anggota keluarga
o Ayah
o Saudara
Nutrition)
o Pendidikan
o KB
Rumah
o Exclusive
Suasana rumah
Gizi (Early Life Nutrition)
Breathfeeding
o MPASI
KB
Imunisasi
Pengobatan (oralit)
MIKRO
MINI
Lingkungan
tetangga
Sarana bermain
Fasyankes
(Dokter)
Sistem Pendidikan
Nasional
Lembaga Riset
MESO
Exclusive Breastfeeding
KEBUTUHAN DASAR ANAK
Utilisasi Growth Chart
ASUH
ASIH
ASAH
Makanan
Pendamping ASI
Primary
Imunisasi
prevention
FETUS
NEONATUS
Pengobatan
sederhana
REMAJA
TUMBUH - KEMBANG
in
allergy
(oralit)
Air bersih
GENETIK / HEREDOKONSTITUSIONAL
MIKRO
INDIVIDU
Kebijakan
Pemerintah
o KEMKES
o Kemendikbud
o Kemenag, dll
Sosial budaya
masyarakat
Lembaga non
pemerintah
MAKRO
ForNASA
BAYI
ANAK
Atopic Dermatitis :
Significance
Lower respiratory
tract
(wheezing)
Allergic
asthma
9(5)9(5)- 314-20
314-20
(50 %)
Cantani,
Cantani, 1999
1999 Invest
Invest Allergol
Allergol Clin
Clin Immunol
Immunol
Adapted from Holgate S Church MK eds. Allergy. London: Gower Medical Publishing 19
Atopic Dermatitis :
Significance
Ellis
Ellis CN,
CN, Drake
Drake et
et al.
al. JJ Am
Am Acad
Acad Derm
Derm 2002,
2002, 46:
46: 361-70
361-70
Preventing Pediatric
Allergy
Primary Prevention is a
Priority
afety
Education
Education
&&Training
Training
Risk
Risk
management
management
Atopic
dermatiti
s
Prevalence
Burden of
disease
Clinical
Clinical
audits
audits
Clinical
Clinical
Governance
Governance
AccountAccountability
ability
Research
Research&&
development
development
Problem
EBM
Babies with
# Valid
feeding
challenges
(30%# Important
50%)
# Applicable
EBM # Feeding
Intolerance
# Cows Milk
Protein Allergy
Clinical
Clinical
EffectiveEffectiveness
ness
Cost-effectiveness
Cost-benefit analysis
analysis
Financial
consequence
s
burden of
disease
burden of
disease
Genetic Factors
A Positive family history for allergy
Risk of allergy
Both
parent no
allergies
One sibling
with
allergy
10 %
20-30 %
20-40 %
60% - 80 %
risk of
allergy
risk of
allergy
risk of
allergy
risk of
allergy
Sensitivity 61 %;
Specificity 83%
Both
One parent
parent with
with
allergies
allergy
Koning,1996; Bousquet,2002
Prevention in infant
Exclusive
breastfeeding
pHF or eHF &
probiotic
Primary prevention
(risk factor !)
burden of
disease
Prevention in infant
Suppress disease
expression after
sensitization
burden of
disease
Secondary
prevention
eHF/AAF
Prevention in infant
Tertiary
prevention
Elimination diet, eHF/AAF,
Steroid, Antihistamine,
Emergency treatment
Treatment to avoid
recurrence of
symptom
(clinical
manifestation)
burden of
disease
Kendali mutu
dan Kendali
biaya
Valid
Important
Applicable
Audit
Patient safety P2KB
medik
Education
Education
&
& Training
Training
Risk
Clinical
Risk
Clinical
management
audits
management
audits
Clinical
Clinical
EBM:
Governance
Governance
# HTA
Clinical
Clinical
AccountPersetujua
Account# Clinical guidelines
EffectiveEffectiveability
n
ability
# Clin pathways
ness
ness
Research
# Algorithms
Research &
&
development
# Protocols
development
Rekam
# Procedures
medik
Manajemen alergi #Standing orders
Osborn DA, Sim J. Formula containing hydrolyzed protein for prevention of allergy
and food intolerance infant. Cochrane Database Syst Rev. 2006(4):CD003664
TRIVIALIZED
True food allergy
can be life
threatening
Perceived >>
True
Unsubstansiated
Tests and
Treatments
u
o
Y
k
n
a
h
T