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Hygiene Care Reproductive Behavior of Sufferers Of Urinary Tract Infection (UTI) By Trichomonas Vaginalis Which are Identified on Fresh Urine of Women Ward in Chasan Boesoiri Hospital Ternate 2016 Amira 1, Muhlisa 2, Agussalim 3 1 Health Polytecnic of Ternate, North of Maluku, Indonesia, Diploma in Nursing Program 2 Health Polytecnic of Ternate, North of Maluku, Indonesia, Diploma in Nursing Program 3 Health Polytecnic of Jayapura, Papua, Indonesia, Diploma in Nursing Program Abstract: In women, urinary tract infection is a bacterial infection that most often found each year. Fungi and bacteria grows in conditions not clean and moisturized. Bad behavior in maintaining the cleanliness of the genitalia can be the originator of the incidence of infection in the reproductive organs. The parasite Trichomonas vaginalis, namely parasite that can infect the vagina and urinary tract. Based on the report of the Medical Record of Dr. Hi Chasan Bosoire Hospital Ternate, in 2014 the number of patients of urinary tract infection sufferersferers as much as 247 people. From the results of interviews with analysts laboratory, from the results of checks on fresh urine UTI sufferers often found the presence of Trichomonas vaginalis. The purpose of this research was to identify the Trichomonas vaginalis in urine and urinary tract infection sufferers to do with hygiene care behavior of reproductive organs in women's at Dr Hi. Chasan Boesoeri Hospital Ternate. As for the benefits of the research is to provide additional information about the incidence of trichomoniasisis and as material input to relevant agencies to conduct counseling on matters of hygiene treatment UTI sufferers reproductive organs as well as the evaluation of nursing care coverage material. The methods used in this research is a survey using observational approaches aches "cross sectional study" with a population of affordable and at least sample a number of 30 respondents in the women s ward of Dr. h. Chasan bosoirie Hospital Ternate from June until November 2015. Keywords: Hygiene, Women, Urinary Tract Infection 1. Background Urinary tract infection is a disease that can be transmitted through sexual intercourse. One of the causes of urinary tract infections is a parasite, which causes Trichomoniasis (Irianto K, 2013). There are several factors that influence the incidence of Trichomonasonas infections such as level of education, knowledge of vaginal infections or vaginitis, vaginal cleanser usage behavior, genital hygiene, clean water coverage, changing sexual partners and health checks on a regular basis (Sepramana. S, 2014). In women, urinary tract infection is a bacterial infection that most often found each year. Globally WHO estimates there are about 180 million new cases each year worldwide. While the prevalence figures vary, 5% at 75% of the KB and the client on sex workers. Causes of trichomoniasis vaginitis also facilitates the transmission of the human immunodeficiency virus (HIV), occur throughout the world, of the approximately 180 million/year, 15% in women and 10% of men with active sexuality. In the USA, this infection is one of the largest causes of PMS with an incidence of 2-3 million/year (Zamzami. A, 2014). In 2005, in Jakarta the prevalence of reproductive tract infections that occur such us candidiasis 6.7%, 5.4% tricomoniasis and bacterial vaginosis 5.1%. In 2008 the prevalence of reproductive tract infections in young women and adult women caused by bacterial vaginosis of 465, candidia albicans 29%, and 12% tricomoniasis. Among all kinds of personal hygiene, the female reproductive organ is the genetalia are to be kept clean. If unattended can cause vaginal discharge, itching, odor and infection can occur that can trigger the onset of cervical cancer (Bobak I, 2004). Trichomoniasis is a sexually transmitted disease or infection of female genitalia tool or a man that is caused by the parasite Trichomonas vaginalis, namely parasite that can infect the vagina and urinary tract. In men can be shaped urethritis, urinary tract infections, prostatitis, and infection of the prostate. While in women the shape of vaginitis Trichomonas or urinary bladder infections cystitis (Irianto K, 2013). The parasite Trichomonas vaginalis can be found with some wet preparations include examination of vaginal fluid, pap smears, urine sediments (microscopic) method natively without coloration, and a few other checks. In diagnosing Trichomoniasis is still a problem, because the clinical picture of trichomoniasis cannot be trusted as a hint the diagnosis, because it is less sensitive and specific. Effective trichomoniasis diagnosis depends on the identification of organismenya. Paper ID: ART2017557 DOI: 10.21275/ART2017557 2402

The frequency of infections in women is roughly 25 percent. This percentage is higher on the women who clean is insufficient. Only about one per sevent a part of the number of women who suffer from trichomoniasis complained because the symptoms. It turns out that there are various ways of transmission. Promiscuity especially with men containing this parasite, in the absence of symptoms, may be an important factor, but not a possibility on young girls can be found also this parasite. The transmission of this parasite apparently can occur due to direct contact with sick women, by toilet tools and "toilet seat" contaminated (Irianto K, 2013). Based on the results of the research of Esti, W (2015) of the 15 samples of patients in the internal Urinary Tract Infections with Women (UTI) found 3 people (20%) identified as Trichomonas vaginalis. The Medical Record report of Dr. Hi Chasan Bosoire Hospital Ternate, in 2014 the number of patients of urinary tract infection sufferers as much as 247 people. The results of the interviews with the officers, from the results of laboratory examination on fresh urine UTI sufferers often found the presence of Trichomonas vaginalis are accidental, meaning that the parasite is found not because of a special check in the purposes of the examination of other. Based on explanation above, then the researchers wanted to find out the incidence of trichomoniasis through cooperation with energy analyst/trichomonas vaginalis to identify laboran in fresh Urine sufferers of urinary tract infections In women's ward of Dr. h. Chasan Boesoirie Hospital Ternate and connect it with behavioral treatment of sufferers of the reproductive organs 2. Statement of the Problem Based on the above, the exposure that in addition to the examination of vaginal secretions can also be performed on fresh urine examinationn for discovery of Trichomonas vaginalis in UTI sufferers. ers. Formulation of the problem in this research is not yet known how many sufferers there are unidentified UTI Trichomonas vaginalis on fresh urine and hygiene care behavior such as whether the reproductive organs in people with urinary tract infections in women's Ward of Dr Hi. Boesoeiri Chasan Hospital Ternate? 3. Purpose of Study General Purpose It is Trichomonas vaginalis to be identified on urinalysis urinary tract Infection sufferers and their relation to behavior treatment cleanliness of the reproductive organs in women's Ward of Dr Hi. Chasan Boesoeri Hospital Ternate Specific Purpose Identifying Trichomonas vaginalis in urine sufferers of urinary tract infection (UTI) with the help of energy analyst/laboran of Dr Hi. Chasan Boesoeri Hospital Ternate such us: 1)Identified the behaviour hygiene care reproductive organs sufferers of urinary tract infection (UTI) in women. 2)Knowing the relationship between the behavior of self hygiene care with Trichomonas vaginalis identification results on urinalysis urinary tract infection sufferer in the Women. 3)Identify the relationships between age, education level, marital status, socioeconomic and behavioral self-hygiene care 4. Method of Research Research Design Design research is observational survey research using an approach of "cross sectional study", in which data related to the dependent and independent variables are collected simultaneously aiming to identify the Trichomonas vaginalis on fresh urine samples of urinary tract infection sufferer in the women's Area of Dr. Hi Chasan Boesoirie Hospital Ternate and its relationship with behavioral treatment cleanliness reproductive organs. This research was carried out in the internal space In Gynecological women, and VIP Area of Dr. Hi Chasan Boesoirie Hospital Ternate. The population in this study are the sufferers of urinary tract infection (UTI) in the women' Ward of Dr Hi. Chasan Boesoeiri Hospital Ternate in August until September 2016. The population used is reasonable where the population affordable population is part of the target population can be reached by a researcher and are limited by place and time. Of the population affordable here's sample will be chosen, consisting of subjects who will be directly examined. The sample in this research is a member of a population of affordable i.e. sufferers of urinarytract infection (UTI) in the women's Ward of Dr. Hi. Chasan Boesoeiri Hospital Ternate in June and ended in August 2016. 5. Result Dr. Hi. Chasan Boesoirie Hospital Ternate is a service reference that holds an important role in the efforts of healing and health in order to support the recovery of the quality of human resources and the managed to increase for health development in North Maluku province. Service of installation in Laboratory clinic of Dr. Hi. Chasan Boesoirie Hospital Ternate include sample around 1,683 haemoglobin examination, are sophisticated checks and 3,027 15,932 examination. Blood Chemistry with an examination of advanced as much as 31,176 examination, blood sugar with advanced inspection as much as 10,784 examination. Serology investigation of simple 2,510, 796 are sophisticated, and 820 examination. Bacteriological examination of the simple as much as 1,673, and being as much as 302 examination. Simple urine 1,526 examination and are currently 281 examination. Examination of the stool as simple as much as 52 examination and were as much as 5 examination. Examination of Parasitology simple 1,867 and being as much as 7,419 examination. Here the results already obtained for Behavioral Care Hygiene reproductive organs Sufferers a urinary tract Paper ID: ART2017557 DOI: 10.21275/ART2017557 2403

infection (UTI) by Trichomonas Vaginalis are unidentified on fresh Urine of women at Dr. Chasan Boesoirie Hospital Ternate 2016. The sample obtained 30 respondents. Samples were taken on the basis of information received from field officers in accordance with marital status. The sample is then carried out an examination of the urine, in this case carried out in Hospital by officers of field coordination with hospital and Laboratory also examined directly by us, researchers helped by an assistant researcher. In addition to the examination of the urine also delivered questionnaire about knowledge and behavior about research purposes as additional data a. Trichomonas vaginalis inspection results Trichomonas vaginalis results can be seen in table 5.1 below Table 1: Frequency Distribution of Check up Result of Trichomonas vaginalis Result N Persentage (%) Positive 7 23 Negative 26 77 Total 30 100. From table 1 above shows that out of 30 samples obtained 7 sample between her positive Trichomonas vaginalis (23%) and Trichomonas vaginalis negative sample 26 (77%). b. Responden Characteristic ristic 1. Based on Age Age is the age of the individual who is calculated from the moment was born Tabel 2: Frequency Distribution Characteristic Based on Age Age N % < 20 Year 7 23 20-40 Year 11 37 > 40 Year 12 40 Total 6 100 The data in table 2 above seen that respondents more productive i.e. at the age of 12 respondents or 40%. 2. Based on Marital Status Tabel 3: Frequency Distribution Characteristics of Respondents Based on Marital Status Marital Status N % Married 12 40 Un Married 16 53 Widow 2 8 Total 30 100 From the data in table 3 above seem that respondents are not married amount to more (53%) of the respondents are married (40%), while the least that is who is widowed (8%). 3. Based on the Occupation Table 4: Frequency Distribution Characteristics of Respondents Based on Occupations Occupation N % Government worker 2 7 Private 6 20 House Wife 11 36.7 No Job 11 36.7 Total 30 100 From the data in table 4 above seem that respondents are housewives and also who have not had the same amount of work and a lot of that is 36.7% 4. Based on Economic Status Table 5: Frequency Distribution Characteristics Of Respondents Based On Economic Status Occupation N % Minimum regional salary (MRS) 16 53 < Minimum regional salary 14 47 Total 30 100 From the data in table 5 above seem that respondents are the economy above the UMR more than economic status under the MRS such us 53% and 47%. C.Hygiene Care Behavior Of Reproductive Organs Table 7: Percentage of reproductive care Hygiene Behavior Category N % Good 16 53 Less 14 47 Total 6 100 From table 7 above obtained results that behavior care hygiene more reproductive organs in both categories namely 16 respondents or 53%, while the rest 14 respondents or 47% had less good behavior. The relationship between characteristics of Trichomonas vaginalis with the results of Respondents 1. Age Tabel 8: Trichomonas vaginalis Results frequency distribution by age of Respondent Age Result of Tricomonas Vaginalis Total % P <20 0 0 7 23 7 24 20-40 4 13 7 23 11 36 0.203 >40 3 9 9 31 12 40 From table 8 above showed that respondents with the most positive inspection results was at the age of 20 40 Years i.e. 4 respondents (13%), then with age above 40 years i.e. 3 Paper ID: ART2017557 DOI: 10.21275/ART2017557 2404

respondents (9%), while there's nothing positive on respondents aged under 20 years. Respondents with the most negative inspection results are at the age above 40 years i.e. 9 respondents (31%), while for age under 20 years and age 20 40 years have the same number of i.e 7 respondents (23%). The results of the P Value 0.203 shows which means there is no relationship between Trichomonas vaginalis results by age. 2. Marital Status Tabel 9: Trichomonas vaginalis Results frequency distribution by marital status of respondents Status Result of Tricomonas Vaginalis Total % P Merried 2 7 10 33 12 40 Unmerried 5 16 11 37 16 53 0.48 Widow 0 0 2 7 2 7 From table 9 above shows that the respondents with the most positive Examination results are on unmarried respondents i.e. 5 respondents (16%), later married i.e. 2 respondents (7%), whereas there is nothing positive on the respondent with the status of a widow. Respondents with the most negative inspection results are on unmarried status i.e. 11 respondents (37%), to marry i.e. 10 respondents (33%) and the remaining 2 respondents (7%) on the respondent with the status of widows. The results of the P Value indicates 0.480 which means there is no relationship between Status of Trichomonas vaginalis check up results. 3. Occupation Tabel 10: Trichomonas vaginalis Results frequency distribution with the job the respondent Status Result of Tricomonas Vaginalis Total % P Government 1 3 1 3 2 7 worker 0.281 Private 0 0 6 20 6 20 House Wife 4 13 7 23 11 37 No job 2 7 2 7 11 37 From table 10 above shows that the respondents with the most positive examination results is on Housewives 4 respondents (13%), then that is not working i.e. 2 respondents (7%), respondents who worked as goverment worker only 1 person (3%), while there's nothing positive on the respondents who had a job as private employees. Respondents with the most negative inspection results with positive found on the housewives i.e 7 respondents (23%), to working as an employee of a private, i.e. 6 respondents (20%) and the remaining 2 respondents (7%) have not been working and 1 (3%) of the respondents as Governemt worker. The results of the P Value indicates 0.281 which means there is no connection between the job with Trichomonas vaginalis results. 4. Economic Status Tabel 11: Trichomonas vaginalis Results frequency distribution with the Economic Status of Respondents Status Result of Tricomonas Vaginalis Total % P Minimum (MRS) 4 13 11 37 15 50 < Minimum 3 10 12 40 15 50 0.666 From table 11 above shows that the respondents with the most positive Examination results is by income status over UMR i.e. 4 respondents (13%) and 3 (10%) of the respondents have less income from Minimum Regional Salary (MRS). Respondents with negative inspection results there are 12 respondents (40%) who had an income less than the MRS and 11 (37%) of the respondents have more income from MRS. The results of the P Value indicates 0.666 which means there is no relationship between the Economic Status of Trichomonas vaginalis with results of study 5. Education Tabel 12: Trichomonas vaginalis Results Frequency distribution of Education Respondents Education Result Trichomonas vaginalis Total % P Value SD 0 0 3 10 3 10 SLTP 1 3 5 17 6 20 0.501 SLTA 6 20 15 50 21 70 Sarjana 0 0 0 0 0 0 7 23 23 77 30 100 From table 12 above shows that the respondents with the most positive Examination results is by high school 6 respondents (20%) and 1 (3%) of the respondents have Junior High School education. Respondents with negative inspection results are most numerous in high school educational level i.e. 15 respondents (50%) and 5 respondents (17%) level of Junior School education, while the remaining three respondents (10%) had elementary education 6. Behavior Table 13: Trichomonas vaginalis Results frequency distribution with the behavior of the respondents Behavior Result Trichomonas vaginalis Total % P 0.526 Good 3 10 13 43 16 53 Less 4 13 10 34 14 47 From table 13 above showed that respondents with positive inspection results with less good behavior i.e. 4 respondents (13%) and 3 (10%) of the respondents have a good behavior. Respondents with negative inspection results at most good Paper ID: ART2017557 DOI: 10.21275/ART2017557 2405

behavior that is present on 13 respondents (43%) and 10 respondents (34%) had less good behavior. The results of the P Value indicates the 0.526 which means there is no relationship between the behavior of Trichomonas vaginalis with results. 6. Discussion Relationship with Trichomonas Identification results of behavior treatment of reproductive organs Based on the results obtained that from 30 positive respondents, there is a parasite trichomonas fewer i.e. 23.33% (7 people) and the remaining 76.67% (23 people) the results are negative. This indicates that most respondents who suffered from urinary tract infection not accompanied with trichomoniasis. The results of statistical tests also show that there is no relationship between the behavior of the personal hygiene of the respondents with the results of the identification of Trichomonas vaginalis (p value: 0.508). This is not in line with the opinion of Susanto I, et al (2008) who suggested that the condition is trichomoniasis Infection mainly occurs directly time sexual intercourse through the stadium tropozoit. On the State of the environment less pleasant, for example many people live together in one House infection can occur indirectly through tools such as bath washcloth, towel or sanitizing tool such as a toilet seat. So far it is known that the urine or urinary tract free of microorganisms or sterile. Urinary tract infections occur when microorganisms enter into the urinary tract and the proliferation of media in the urine. The conditions that cause the occurrence of urinary tract infections, one of which was the behavior of personal hygiene. On this research obtained the results of a negative inspection results with respondents most widely found on the personal behavior of good hygiene i.e. 13 respondents (43%) and 10 respondents (34%) have personal hygiene behaviors. Although the results of the identification of the trichomonas shows positive results in very small amounts and have nothing to do with personal hygiene behavior of the respondents but this we can not ignore. Respondents who get trichomonas positive results requires an understanding that trichomoniasis is an STD (sexually transmitted disease) are at risk for complications that might be happening that is increasing the vulnerability of women against HIV infection when exposed to the virus. Suffer from trichomoniasis may also increase the likelihood of women infected with HIV and transmit on his sexual partner. This is in accordance with the results of the study, Allison (1943) in Irianto K (2013) are recommending that trichomoniasis is one of the important causes of disease which is transmitted through sexual intercourse, such as HIV-AIDS, gonnorhea, syphilis, etc. Infection with Trichomoniasis diseases can be prevented by cleanliness, sanitation as well as self treatment of sufferers, checked themselves when there is a kelaian that results from infection with Trichomoniasis. Trichomonas vaginalis can be transmitted through sexual intercourse, but also direct contact with sufferers or the tools and objects that are contaminated, for example; bathroom fixtures, and toilets as well as panties. The relationship between the characteristics of the respondents with the results of the identification of trichomonas. Based on bivariate statistical test results obtained that the characteristics of respondents who include age (pvalue: 0.203), marital status (pvalue: 0.480), economic status (pvalue: 0.666) and education (pvalue: 0.501) not related to behavior treatment of reproductive organs. However in univariate there are several characteristics which indicate the results ought to be concerned. On the characteristics of age, identification of trichomonas positive inspection results most are aged between 20 40 Years i.e. 4 respondents (13%), it is in accordance with statement of Susanto I, et al (2008) that this parasite in women more often found in the group aged 20-49 years of age, lessened at a young age and old age as well as rare in young girls. This is because at the age of 20-40 is the age of productive women and also sexually active. Women who are sexually active should be supported with the behavior of care reproductive organs is good because tertuar disease are at risk for sexual intercourse. Urogenital organs organ is interconnected in women due to the layout of the anatomic adjacent, in case of infection in one of the organs can be at risk of contagion on other organs. Trichomonas vaginalis is a Habitat of the vagina in women and the urethra, prostate and epididymis in men, then the parasites commonly found in the urine (Irianto K, 2013). On the status of marriage as well though not statistically intercourse, obtained by the respondents with the most positive Examination results are on unmarried respondents i.e. 5 respondents (16%), it is a concern because these conditions explain that trichomonas which is one of the sexual transmitted desease give an idea of how free sex before marriage can be a cause of trichomoniasis that on examination of urine found. References [1] Budiharjo, Mufiro Siti, Boedowi Y.B (1976) Insidensi Trichomonas Vaginbalis Di Poliklinik RS Mangkuyudan, Yogayakarta Berkala Ilmu Kedokteran, VIII (1), 55-57. [2] Hardjoeno,H, dkk. (2007). Interpretasi Hasil Tes Laboratorium Diagnostik Bagian Dari Standar Pelayanan Medik. (H. U. P. (LEPHAS), Ed.). Makassar. [3] Irianto, K. (2013). Parasitologi Medis. Bandung: Alfabeta. [4] Novrinta, A. D. (2011). Hubungan Antara Pengetahuan Dan Perilaku Menjaga Kebersihan Genetalia Eksterna Dengan Kejadian Keputihan Pada Siswi SMA Negeri 4 Semarang. FK UNDIP, 3 24. [5] Pendidikan, K., Kebudayaan, D. A. N., Soedirman, U. J., Kedokteran, F., Kesehatan, D. A. N. I., & Keperawatan, J. (2014). Pengaruh pemberian pendidikan kesehatan terhadap pengetahuan kebersihan Paper ID: ART2017557 DOI: 10.21275/ART2017557 2406

organ reproduksi saat menstruasi pada remaja putri dengan retardasi mental. [6] Praktika, N. (2008). Rasionalitas Penggunaan Antibiotik pada Pasien Infeksi Saluran Kemih Pada Bangsal Penyakit Dalam. Semarang. [7] Pratomo, A. Y., Prasetya, E., & Rosiya, A. Z. (2011). Studi Kasus Pemeriksaan Trichomonas vaginalis Pada Pekerja Seks Komersial Sunan Kuning Semarang. Fakultas Ilmu Kesehatan Universitas Setia Budi, III, 3 7. [8] Price, S.., & Willson, L. (2005). Patofisiologi Konsep klinis Proses-proses Penyakit. Jakarta: EGC. [9] Rahmayanti, N. (2012). Perilaku Perawatan Kebersihan Alat Reproduksi Dalam Pencegahan Kanker Serviks Pada Siswi SMAN 9 Kebon Pala Jakarta Timur. Jakarta Timur. [10]Saifuddin, H. (2002). Struktur dan Komponen Tubuh Manusia. Jakarta: Widya Medika. [11] Sanjaja, B. (2006). Protozologi Kedokteran Buku 1. Jakarta: Prestasi Pustaka Publisher. [12]Susanto, I., & et all. (2008). Buku Ajar Parasitologi Kedokteran (edisi keem). Jakarta: FKUI. [13] Tambayong, J. (2001). 01). Anatomi dan Fisiologi untuk Keperawatan. Jakarta: a: EGC. Paper ID: ART2017557 DOI: 10.21275/ART2017557 2407

Paper ID: ART2017557 DOI: 10.21275/ART2017557 2408