Characteristics Among Injecting Drug User Accessing and Not Accessing Needle and Syringe Program

Background : HIV/AIDS has become one of International public health problem. One effective method to spread HIV/AIDS is through shared needle and syiringe among Injecting Drug Users (IDUs). Needle and Syringe Program has been run in Palembang since 2009. Previos research was limitted towards description of IDUs in Palembang city without differentiating both IDUs accessing and not accessing Needle and Syringe Program (NSP). Objectives to identify the differences characteristcis between characteristics of IDUs accessing and not accessing NSP Methods : This was a case control study with respondents recruited using snowball technique. Simple and multiple logistic regression tests were performed using statistics program (Stata version 10) to identify association between NSP access status and characterisctics of IDUs. Odds ratio, 95 % Confidence interval and P value were reported. Results : Fourty six IDUs from NSPS group and 75 IDUs from non-NSPS group were recruited. Mostly, respondents were male with senior high school education level and single status. There is difference of attitude and length of use of Drugs among IDUs accessing and not accessing NSP. The bivariate analysis indicates that IDUs who have positive attitude towards Harm reduction and needle and syringe program tend to 2.76 times to access NSP compared to those who have negative attitute (OR 2.76(1,30-5.89), p.0.008). Then, IDUs who inject drugs tend to access 1.09 times for each increase of year using drugs with moderate significancy to reject the null hypothesis (OR 1.09(95 % CI 1.003-1.19), p. 0.04). however, variables of education, age, income and knowledge about HIV/AIDS and Harm reduction do not differ between IDUs accessing and not accessing Needle and Syringe Programs. After possible confounders adjustment, association between length of use injected drugs and IDU's attitude towards harm reduction and NSP are still found. Conclusion : IDUs who have positive attitude towards harm reduction concept on NSP and longer use of injected drugs will more likely access NSPs. Enhancement peer educators from ex-IDUs is important to increase positive attitude towards harm reduction among IDUs. Moreover, further research with big sample size and qualitative approach are urgently needed

Ergonomic Risk Factors During Typing and Its Association with Carpal Tunnel Syndrome (Cts)

Background : Typing activity can become a risk factor of CTS if it\u27s done intensely especially without minding about the ergonomic aspects. Carpal tunnel syndrome (CTS) is a health problem caused by pressure in nervus medianus through the carpal tunnel. This study aimed to find the association between ergonomic risk factor (posture of hand, duration, force and frequency) during typing with the occurrence of CTS in newspaper employees. Methods : Used quantitative study with cross sectional design conducted to 50 employees of Harian Pagi Sumatera Ekspress as population. Data was gatherer by interview, observation and also undertaken Tinnel\u27s test, Phalen\u27s test and Finkelstein test to support the diagnosis of CTS. Data was processed by using SPSS program and performed by univariate analysis, bivariate analysis by using chi-square, multivariate analysis by using multiple logistic regression and also qualitative method using photovoice. Result : The expected of CTS among of respondents is 42%. The result of bivariate showed that there are association between posture of hand and CTS (PR:4,235 CI:1,015-17,668 p value: 0,039), duration and CTS (PR:6,417 CI:1,444-28,511 p value: 0,011), frequency and CTS (PR:5,625 CI:1,178-26,854 p value: 0,024), and also the force and CTS (PR:5 CI:0,964-25,93 p value: 0,041). The result of multivariate analysis showed that frequency of hand posture during typing was a dominant factor that affected the CTS (PR: 3,965 CI: 1,086-14,474 p value: 0,037) Conclusion : There is significant of association between posture of hand, duration, frequency and force during typing and CTS. Frequency is the dominant variable that affects the CTS occurrence after adjusted by posture of hand, duration, force and non occupational risk factor. This study suggests giving more attention to ergonomic aspect through working style and helping tools while doing work

Social Determinants of Malaria in the Working Area of Puput Public Health Services, West Bangka

Background : Malaria is a preventable and curable disease and yet more than one million people die from it each year. It is a disease that significantly affects the poor who have economic, social and educational deprivation. Malaria is also a disease that flourishes in conditions of crisis and population displacement (Oxfam, 2008). The Working Area of Puput Public Health Services is an ​​high malaria-endemic area with API 43.92 ‰ in 2011 and was the highest in the west Bangka district. The purpose of this study was to determine the major social determinants of health as risk factors of malaria occurance in the working area of puput Public Health Services at west Bangka district in 2012. Methods: The design of this study was the unmatched case control with population based case-control and purposive sampling, respondents consisted of 58 cases and 58 controls selected from the reported malaria positive patients based on laboratory test results in puput Public Health Services in 2012. Data processed with SPSS 19 program. The statistical analysis was carried out by the chi-square test and logistic regression: a p-value of less than 0.05 was considered to be statistically significant. Result : Variable that were associated with incidence of malaria is housing conditions (p=<0,001), Environmental conditions (p=<0,001), working conditions (p=0,001), habits going out at night (p=<0,001), malaria prevention behaviors (p=<0,001), health services (p=0,007) and migration (p= 0,004). There was no association between socioeconomic (p=0,266) with incidence of malaria. Logistic regression analysis showed that the variables that are risk factors for malaria is the habit of going out at night (adjusted OR: 6,7; 95% CI: 1,6-28,4), environmental conditions (adjusted OR: 5,6; 95% CI: 1,2-25,5) and malaria prevention behaviors (adjusted OR: 4,1; 95% CI: 1,4-11,9). Conclusion : Improve malaria control with increase education, use of insecticidal nets by people at risk, indoor residual spraying (IRS) with insecticide to control the vector mosquitoes, and policy on the provision of malaria drug to prevention in immigrant population. health insurance that covers immigrants

Correlation Between Service Quality and Patient Loyalty at Outpatient Department in Speciality Eye Hospital of South Sumatera Province

Background: The increasing number of hospitals in Indonesia, which is managed by the government and private demand to provide giving the level of care, professionalism and the maximum of competence to reflect the best quality of service. Quality gives special encouragement for company to understand customer expectations which in turn can increase customer satisfaction and create customer loyalty. Method: This study used a survey of analytical methods, with the cross-sectional approach. The samples in this study were patients who were treated in outpatient installation specialty eye hospital South Sumatera Province with total 102 people based on inclusion criteria. The Sampling was taken by proportions random sampling. The data analysis was performed in univariate and bivariate statistical fisher-exact test. The data were presented in p-value, prevalence ratio(PR) and 95% confidence intervals (CI). Results: Generally 46.2% respondent who are loyal aged 41-64 years, 32.3% graduate from primary school and 80.6% have distance >5 KM from hospital. From the bivariate analyzes relating to patients loyalty in specialty eye hospital South Sumatera Province are access to services (95% CI 4.3 PR (1.293-14.300)) and officer interaction with patients (95% CI 6.786 PR (2.140-21.515)), whereas safety (95% CI PR 1.248(0.281-5.540)), convenience (95% CI PR 4.136 (1.201-14.246)) and waiting times (95% CI PR 1.951 (0.259-14.717)) does not have a correlation with patient loyalty. Conclusion: The loyalty of patients in Specialty Eyes Hospital South Sumatera Province have been affected by access to services and officer interaction with the patient

Correlation Between Marketing Mix and the Utilization of Inpatient Unit at Pelabuhan Hospital Palembang

Background: Pelabuhan Hospital Palembang is type C Hospital with a capacity of 58 beds. The utilization of inpatient unit in this hospital is still lacking. It can be seen from the total of Bed Occupational Rate (BOR) in 2010-2011 is only 48.52% -51.65% which is below the standard of Health Department that is 60-85%. Method: This study is a analytical observational study with cross sectional approach. The Population are inpatients of Pelabuhan Hospital Palembang. The number of samples is 80. The research data were analyzed quantitatively by the method of univariate, bivariate with chi square analysis, and multivariate with logistic regression analysis using SPSS program. Result: The result of analysis tests of the relationship between marketing mix and the utilization of inpatient installation of Pelabuhan Hospital Palembang, from 7 variables of marketing mix, there are six variables that have a relationship to the utilization of inpatient installation, that are variable product (OR=6, p-value=<0,0001), price (OR=10, p-value=<0,0001), place (OR =5, p-value=0,001), people (OR=5, p-value=0,002), processes (OR=7, p-value=<0,0001), and physical evidence (OR=8, p-value=<0,0001). Based on the results of multivariate logistic regression analysis, there are four variables of marketing mix which are most influential, namely product (OR=7, p-value=0,008), price (OR=15, p-value= <0,0001), process(OR=8, p-value=0,007) and physical evidence (OR=18, p-value= <0,0001). Conclution: Pelabuhan Hospital Palembang needs to improve the its marketing by noticing the marketing mix variables affecting the utilization of inpatient installations, especially those still considered not good enough by the in-patients,that are person and physical evidence. The goal is to increase BOR of Pelabuhan Hospital Palembang due to Health Department standards

Determinants Analysis of Pulmonary Tuberculosis Incidence in Tugo Mulyo Primary Care in 2011/2012

Background: Pulmonary Tuberculosis is an infectious disease that\u27s caused by Tuberculosis Mycobacteria that primarily attacks the lungs, lymph nodes, and intestines. The cases of pulmonary Tuberculosis in Tugu Mulyo Health Centre was three cases in 2008, 10 cases in 2009, 17 cases in 2010 and 44 cases in 2011 data indicated significant the increase of pulmonary tuberculosis every year. This research aimed to find determinants of pulmonary tuberculosis in Tugu Mulyo Health Center in 2011 to 2012. Method: This research used case control design. Respondent in this research were people cases who ever suffered or have been suffering from Tuberculosis in 2011 – 2012 that had treatment tuberculosis in Tugu Mulyo primary care, while control group was people who check their sputum in Tugu Mulyo Health Centre with negative result of TB. Result of research: Results of statistical test shows age (p=0.07 OR = 2.6 (CI: 95%: 0.89-7.60)), gender (p=0.89 OR=1.1(Cl: 95%: 0.47-2.50)), don\u27t have correlation with Pulmonary Tuberculosis event. Based on regression analysis of multivariate logistic, there are four most influential variables, that is age, behavior, knowledge, and attitude had other variable adjusted. Conclusion: The Tugu Mulyo Health Centre needs to improve pulmonary tuberculosis survey program to field in case tracking and counseling to improve society\u27s knowledge about tuberculosis disease with improving physical housing environment