Risk Factors of Dengue Fever Outbreak in Karo District, North Sumatera, Indonesia

Dengue fever (DF) infection continues to present a seriuos public health problem in North Sumatera, Indonesia. A DF outbreak was reported in Merek Sub-district, Karo District which is one tourist destination in North Sumatera during April-May 2017. An epidemiological investigation was conducted to identify the risk factors and recommend control measures. An observational study with a matched case control design was conducted. A case was defined as any resident of Merek sub-district who had suffer major clinical symptoms of DF such as fever, severe headache, pain behind eyes, muscle and joint pains, and rash from April – May, 2017. A control was defined as neighbors of cases who did not have clinical signs and symptoms of DF and were matched for age and sex. We interviewed 37 cases and 37 controls. Age cases ranged from 2 year to 37 years (median= 12 years). The multivariate analyses showed that presence of mosquito breeding sites (OR=4.87, 95%CI=1.33-17.85) and habit of hanging worn clothes (OR=5.12, 95%CI=1.25-21.03) were significant risk factors. It is recommended to eliminate mosquito breeding sites routinely, avoid habit of hanging worn clothes, and conduct strict surveillance of DF continously

EVALUASI PROGRAM PENGENDALIAN DAN PENCEGAHAN DEMAM BERDARAH DENGUE (DBD) DI SUMATERA UTARA TAHUN 2010-2012

ABSTRAK. Demam Berdarah Dengue (DBD) masih merupakan masalah kesehatan masyarakat di Sumatera Utara yang merupakan daerah endemis. Program pengendalian DBD diharapkan dapat memberikan informasi tentang endemisitas dari suatu daerah, musim penularan dan perkembangan penyakit yang dapat digunakan untuk menjadikan sistem lebih efektif dan efisien. Penelitian ini adalah sebuah studi deskriptif yang dilakukan dengan mengumpulkan dan menganalisis data DBD dari tahun 2010-2012. Evaluasi mengenai cara pencegahan dan program pengendalian DBD telah dilakukan. Cara pencegahan dan program pengendalian DBD di Sumatera Utara antara lain: pengamatan epidemiologi yang dilakukan pada semua kasus DBD; penemuan dan manajemen kasus di Rumah Sakit, dokter pribadi dan perawatan kesehatan primer; perluasan dan peningkatan partisipasi masyarakat, pengendalian vektor di daerah DBD, sistem peringatan dini dan pengendalian perjangkitan, kerjasama dari berbagi sektor, monitoring dan evaluasi. Program pengandalian DBD di Sumatera Utara perlu ditingkatkan dengan menambah kerjasama lintas sektor dan program untuk mengoptimalkan program tersebut, merotasi insektisida untuk menghindari resistensi vektor

Spatial Analysis of Diabetes Mellitus in Jambi Province: Methods Space-Time Scan Statistic and Spatial Autocorrelation

Diabetes Mellitus (DM) is a chronic disease that threatens human health, the research aims to determine distribution, clusters, and spatial autocorrelation. The type of research is an exploratory study with an ecological design. Diabetes Mellitus using a Geographic Information System (GIS) is analyzed spatially. The research was conducted in the Jambi Province Region. The research sample was participants with a diagnosis of DM sourced from data from visits by the Social Security Administering Agency as name (BPJS)  at FKTP in 2020 - 2022. The results of the space-time scan statistical analysis during the 2020-2022 period found 10 DM clusters with details of 3 most likely clusters and 7 secondary clusters. Spatial autocorrelation analysis with Moran\u27s I index found that there was spatial autocorrelation of DM in Jambi Province during the three-year research period. The conclusion obtained is that there are clusters and autocorrelation of DM disease in Jambi Province, the need for intervention in prevention and control programs in cluster and hotspot areas

FAKTOR RISIKO KEJADIAN LUAR BIASA (KLB) DEMAM CHIKUNGUNYA DI KECAMATAN BATANG TORU, KABUPATEN TAPANULI SELATAN SUMATERA UTARA TAHUN 2014

ABSTRAKDemam chikungunya adalah penyakit arbovirosis dengan angka kesakitan yang tinggi dan berdampak terhadap kondisisosial ekonomi. Tanggal 17 Januari 2014, Dinas Kesehatan Kabupaten Tapanuli Selatan melaporkan adanya kejadian luarbiasa (KLB) demam chikungunya di Kecamatan Batang Toru dengan jumlah kasus sebanyak 74 orang. Penelitian analitikmenggunakan desain kasus kontrol, dilakukan untuk mengidentifikasi faktor risiko terjadinya KLB demam chikungunya.Kasus adalah penduduk yang sedang sakit atau baru mengalami sakit dengan gejala klinis utama demam, nyeri padapersendian dan bintik-bintik merah pada kulit. Kontrol adalah penduduk yang tidak sedang sakit dan tidak baru mengalamisakit dengan gejala klinis utama demam, nyeri pada persendian dan bintik-bintik merah pada kulit, diambil dari desa laindengan karakteristik penduduk dan topografi yang hampir sama dengan daerah penelitian. Analisis secara bivariatmenggunakan chi-square dan regresi logistik dengan derajat kepercayaan 95%. Sampel darah pasien diuji menggunakanrapid diagnostic test (RDT) Chikungunya IgM. Analisis bivariate menunjukkan variabel yang berhubungan dengankejadian demam chikungunya adalah tidak menggunakan kelambu pada saat tidur pagi dan sore hari (p- value: 0,000; OR=4,825, CI= 2,379-9,782) dan terdapat jentik nyamuk di tempat penampungan air (TPA) sekitar rumah (p-value= 0,000;OR= 6,206; CI= 2,905-13,257). Analisis multivariat menunjukkan faktor risiko yang paling berpengaruh adalah terdapatjentik nyamuk di TPA sekitar rumah (p-value= 0,013; OR= 3,837; CI= 1,322-11,131). Hasil uji dengan RDT pada 7 sampeldarah didapatkan 2 positif Chikungunya IgM. Telah terjadi KLB Demam Chikungunya di Kecamatan Batang ToruKabupaten Tapanuli Selatan. Penularan chikungunya terjadi secara terus-menerus dan sumber penularan lebih dari 1oran

Tuberculosis in Aceh Province, Indonesia: a spatial epidemiological study covering the period 2019–2021

The purpose of this study was to determine whether there were any TB clusters in Aceh Province, Indonesia and their temporal distribution during the period of 2019–2021. A spatial geo-reference was conducted to 290 sub-districts coordinates by geocoding each sub-district’s offices. By using SaTScan TM v9.4.4, a retrospective space-time scan statistics analysis based on population data and annual TB incidence was carried out. To determine the regions at high risk of TB, data from 1 January 2019 to 31 December 2021 were evaluated using the Poisson model. The likelihood ratio (LLR) value was utilized to locate the TB clusters based on a total of 999 permutations were performed. A Moran’s I analysis (using GeoDa) was chosen for a study of both local and global spatial autocorrelation. The threshold for significance was fixed at 0.05. At the sub-district level, the spatial distribution of TB in Aceh Province from 2019-2021 showed 19 clusters (three most likely and 16 secondary ones), and there was a spatial autocorrelation of TB. The findings can be used to provide thorough knowledge on the spatial pattern of TB occurrence, which is important for designing effective TB interventions

Evaluasi program pencegahan dan pengendalian Rabies dalam rangka menuju Sumatera Utara Bebas Rabies 2020

Rabies merupakan masalah kesehatan masyarakat di Sumatera Utara. Tujuan dari program pencegahan dan pengendalian rabies adalah untuk mencapai Sumatera Utara bebas rabies tahun 2020. Penelitian ini merupakan penelitian observasional dengan desain cross sectional dengan mengumpulkan dan menganalisis laporan bulanan dan tahunan kasus rabies di Sumatera Utara sejak tahun 2007-2017. Evaluasi dilakukan terhadap seluruh proses program pencegahan dan pengendalian rabies. Hasil didapatkan bahwa pelaksanaan program pencegahan dan pengendalian rabies di Sumatera Utara belum berjalan optimal, seperti pelaksanaan surveilans epidemiologi, pelacakan kasus, tata laksana kasus di fasilitas pelayanan kesehatan, masih kurangnya partisipasi masyrakat, kurangnya rabies center di kabupaten/kota, serta kurangnya kerja sama antara dinas kesehatan dan dinas peternakan kabupaten/kota. Program pencegahan dan pengendalian rabies di Sumatera Utara belum berhasil dalam menurunkan kasus lyssa, masih terdapat 9 kabupaten/kota yang selama 2 tahun terakhir memiliki kasus lyssa. Disarankan lebih meningkatkan kerja sama lintas sektor dan program untuk mencapai Sumatera Utara bebas rabies 2020

A Survey of the Knowledge of Surveillance Officers and Outbreak Investigation Team toward COVID-19 in North Sumatera Province, Indonesia

BACKGROUND: Our world is now facing the public health emergency situation. Since early December 2019, COVID-19 emerged the Wuhan City, Hubei Province, China. The disease is still continuing spread to more than 200 countries and territories globally. AIM: This study aimed to assess the knowledge of COVID-19 among the surveillance officers and outbreak investigation team in North Sumatera, Indonesia. METHODS: A cross-sectional study was performed between March 5, 2020 and April 20, 2020, among the surveillance officers and outbreak investigation team in North Sumatera province, Indonesia. A set of validated, pre-tested questionnaire was used to measure knowledge regarding COVID-19 infection and to collect a range of explanatory variables. Data were collected through a self-administered questionnaire. A two-step logistic regression analysis was employed to assess the association of participants’ demographic data, level of education, surveillance training, length of work, and location of workplace with the knowledge. RESULTS: A total of 246 participants were collected. We found that 109 out of 246 (44.3%) participants were good knowledge of COVID-19. Multivariate model revealed that surveillance training was the most associated variable with knowledge of COVID-19 (OR = 2.15, 95% CI = 1.09–4.27). In addition, as much as 27 participants (79.4%) have good knowledge and also have received surveillance training expressed a willingness to conduct surveillance (OR = 4.75, 95% CI = 1.98–11.39). CONCLUSIONS: The knowledge of surveillance officers and outbreak investigation team in North Sumatera regarding COVID-19 is relatively low. Participants who have good knowledge and have received surveillance training expressed a willingness to conduct surveillance of COVID-19 in the community. Therefore, training for surveillance and outbreak investigation team to improve the understanding and skill is a must

EVALUASI PROGRAM PENGENDALIAN DAN PENCEGAHAN DEMAM BERDARAH DENGUE (DBD) DI SUMATERA UTARA TAHUN 2010-2012

ABSTRAK. Demam Berdarah Dengue (DBD) masih merupakan masalah kesehatan masyarakat di SumateraUtara yang merupakan daerah endemis. Program pengendalian DBD diharapkan dapat memberikan informasitentang endemisitas dari suatu daerah, musim penularan dan perkembangan penyakit yang dapat digunakanuntuk menjadikan sistem lebih efektif dan efisien. Penelitian ini adalah sebuah studi deskriptif yang dilakukandengan mengumpulkan dan menganalisis data DBD dari tahun 2010-2012. Evaluasi mengenai cara pencegahandan program pengendalian DBD telah dilakukan. Cara pencegahan dan program pengendalian DBD diSumatera Utara antara lain: pengamatan epidemiologi yang dilakukan pada semua kasus DBD; penemuan danmanajemen kasus di Rumah Sakit, dokter pribadi dan perawatan kesehatan primer; perluasan dan peningkatanpartisipasi masyarakat, pengendalian vektor di daerah DBD, sistem peringatan dini dan pengendalianperjangkitan, kerjasama dari berbagi sektor, monitoring dan evaluasi. Program pengandalian DBD di SumateraUtara perlu ditingkatkan dengan menambah kerjasama lintas sektor dan program untuk mengoptimalkanprogram tersebut, merotasi insektisida untuk menghindari resistensi vektor.Kata kunci: evaluasi, program pengendalian DBD, Sumatera UtaraABSTRACT. Dengue Hemorrhagic Fever (DHF) is still a public health problem in North Sumatera which is anendemic area. DHF control program is expected to result information about endemicity of an area, season oftransmission and disease progression that can be use to make the system more effective and efficient. It was adescriptive study by collecting and analyzing DHF data from 2010-2012. Evaluated had been done to the processof the DHF prevention and control program. The process of DHF prevention and control program in NorthSumatera such as: epidemiological surveillance conducted to all the DHF cases; discovery and management ofcases at hospitals, private physicians, and primary health care; extension and improvement of communityparticipation, vector control in the area of DHF, early warning systems and controlling outbreaks, partnerships /networks of multiple disciplines and sectors, monitoring and evaluation. DHF control program in NorthSumatera needs to be improved, increasing collaboration across sector and programs to optimize the program,rotate the insecticide to avoid resistance vectors.Key words: Evaluation, DHF Control Program, North Sumater

EVALUASI PROGRAM PENGENDALIAN DAN PENCEGAHAN DEMAM BERDARAH DENGUE (DBD) DI SUMATERA UTARA TAHUN 2010-2012

ABSTRAK. Demam Berdarah Dengue (DBD) masih merupakan masalah kesehatan masyarakat di SumateraUtara yang merupakan daerah endemis. Program pengendalian DBD diharapkan dapat memberikan informasitentang endemisitas dari suatu daerah, musim penularan dan perkembangan penyakit yang dapat digunakanuntuk menjadikan sistem lebih efektif dan efisien. Penelitian ini adalah sebuah studi deskriptif yang dilakukandengan mengumpulkan dan menganalisis data DBD dari tahun 2010-2012. Evaluasi mengenai cara pencegahandan program pengendalian DBD telah dilakukan. Cara pencegahan dan program pengendalian DBD diSumatera Utara antara lain: pengamatan epidemiologi yang dilakukan pada semua kasus DBD; penemuan danmanajemen kasus di Rumah Sakit, dokter pribadi dan perawatan kesehatan primer; perluasan dan peningkatanpartisipasi masyarakat, pengendalian vektor di daerah DBD, sistem peringatan dini dan pengendalianperjangkitan, kerjasama dari berbagi sektor, monitoring dan evaluasi. Program pengandalian DBD di SumateraUtara perlu ditingkatkan dengan menambah kerjasama lintas sektor dan program untuk mengoptimalkanprogram tersebut, merotasi insektisida untuk menghindari resistensi vektor.Kata kunci: evaluasi, program pengendalian DBD, Sumatera UtaraABSTRACT. Dengue Hemorrhagic Fever (DHF) is still a public health problem in North Sumatera which is anendemic area. DHF control program is expected to result information about endemicity of an area, season oftransmission and disease progression that can be use to make the system more effective and efficient. It was adescriptive study by collecting and analyzing DHF data from 2010-2012. Evaluated had been done to the processof the DHF prevention and control program. The process of DHF prevention and control program in NorthSumatera such as: epidemiological surveillance conducted to all the DHF cases; discovery and management ofcases at hospitals, private physicians, and primary health care; extension and improvement of communityparticipation, vector control in the area of DHF, early warning systems and controlling outbreaks, partnerships /networks of multiple disciplines and sectors, monitoring and evaluation. DHF control program in NorthSumatera needs to be improved, increasing collaboration across sector and programs to optimize the program,rotate the insecticide to avoid resistance vectors.Key words: Evaluation, DHF Control Program, North Sumater

EVALUASI DAN IMPLEMENTASI SISTEM SURVEILANS DEMAM BERDARAH DENGUE (DBD) DI KOTA SINGKAWANG, KALIMANTAN BARAT, 2010

ABSTRACTIntroduction: Dengue Haemorrhagic Fever (DHF) is still a public health problem in Singkawang Municipalitywhich was an endemic area. DHF surveillance is expected to inform endemicity of an area, season of transmission anddisease progression that can be use to make the system more effective and efficient.Methods: Observational study by using a structured questionnaire. Interview was conducted to all DHF surveillanceofficers. Evaluated had been done to the variable of input, process, and output of the surveillance system. We conducted anon the job training to all DHF surveillance officers after the evaluation.Results: 66.7% officers never got any trainings of surveillance, 83.3% had double duty, budgeting limited to physicalneeds, facilities and infrastructures. Process variable, data collection was late; analysis and recommendation had notbeen directed to the distribution of cases, the relationship between risk factors and the mortality of DHF incidence, andenvironment changing, feedback; data distribution had not been implemented optimally. Output variable was still weak,no surveillance epidemiology profile. Attribute surveillance such as simplicity, flexibility, and positive predictive valuewere good, but still weak in acceptability, sensitivity, representativeness, and timeliness. Short-term evaluation resultedthat there was an increasing knowledge of surveillance officers (p value <0.05). Mid-term evaluation resulted that therewas an increasing of completeness and accuracy of DHF report from 80% to 100%, active case finding, epidemiologyinvestigation conducted to all DHF cases.Discussion and Conclusions : DHF surveillance system in Singkawang needs to be improved, there were many attributesof surveillance system that had not done well. Training of surveillance system is needed to improve capability and capacityof the surveillance officers.Keywords: Evaluation, Surveillance, DHF, Singkawan