Kualitas Hidup Penderita Tuberkulosis Resisten Obat di Kabupaten Banyumas

Quality of life among patients with multi-drug resistant tuberculosis in the district of BanyumasPurposeThis study was conducted to investigate the quality of life among patients with multi-drug resistant tuberculosis and to examine factors associated with them. MethodsData from an in-depth interview, involved 22 patients with multi-drug resistant tuberculosis, were used in this study. ResultsThis study showed 54.5% males, 50.0% adults, 59.1% married, 22.7% divorced, 72.7% lived in rural, 95.5% had basic education, 45.5% as a private employment (before sick), 77.3% as unemployment (after sick), 72.7% low income, 54.5% in continuation phase, 95.5% re-treatment (45% relapse and 40.9% failure cases), 90.9% had drugs side effects (mild/severe); 36.4% had comorbidity; 45.5% smokers, 31.8% falcoholics; 54.5% lack of social support; 31.8% poor and 36.4% moderate quality of life. ConclusionPatients with multi-drug resistant tuberculosis had a worse quality of life and lack social support. Health worker needs to improve their quality of life and social support through establishing a peer support groups to give counseling, information education, communication, motivation, and skills training for them

Peran Kepala Puskesmas SKM dan Non SKM dalam Meningkatkan Kemampuan Manajerial Puskesmas di Kabupaten Oku Timur

Role of the head of public health centers from public health graduates and others on improving managerial skills in East OkuPurposeThis study aimed to understand how public health and non-public health backgrounds affect management skill of primary health care heads, based on ten managerial roles. MethodsThis study was a descriptive study with case-series method, using qualitative methods supported by quantitative data. Eight people were recruited as respondents. They consisted of 4 people that were primary healthcare heads with public health background and 4 people that were primary healthcare heads with non-public health background. Respondents were recruited by purposive sampling. Data collection was performed using in-depth interviews and questionnaire. ResultsPrimary healthcare head with public health background owned more work experience than those with non-public health background. Period of employment in primary health care had an influence on managerial capabilities. There were no significant differences of period of employment in primary health care head positions among the longest with the least to the managerial capabilities. Primary health care heads who had been trained with PIM IV training and other structural positions were known to have better management capabilities, especially compared to the leadership role of those who had not been trained.ConclusionThere was no significant difference in managerial capacity between primary health care heads with public health and those with non-public health background

Faktor Risiko Kematian Akibat Dengue di Rumah Sakit Sardjito YOGYAKARTA

Risk factors of death due to dengue hemorrhagic fever in a tertiary public teaching hospital of YogyakartaPurposeWe examined risk factors of dengue hemorrhagic fever death in Dr. Sardjito Hospital.MethodWe conducted a case control study from patient medical records and interviews with parents.ResultsWe found 29 deaths and 58 patients who survived. The probability of death among obese children was 6 times higher than non obese children and the probability of death in children with prolonged shock was 12 times higher than children without prolonged shock. Other variables were family occupation, family income, residential zones, transportation, treatment financing, accuracy of diagnosis in previous health facilities, and fluid resuscitation before being referred had no significant relationship with dengue mortality.ConclusionObesity and prolonged shock were risk factors of dengue hemorrhagic fever death in children. Improved education to parents about high risk of shock syndrome among patients is needed especially for obese children. Further studies related to social determinants in dengue hemorrhagic fever death are also necessary

Ketahanan Hidup Dua Tahun Pasien Tuberkulosis Resisten Obat di RS. Moewardi Surakarta Tahun 2010-2014

Two year survival of drug resistant tuberculosis patients in Moewardi hospital in Surakarta in 2010-2014PurposeThe purpose of this study was to determine the two year survival rate and predictor factors of mortality in drug resistant tuberculosis patients during treatment at the Moewardi Hospital in Surakarta.MethodsThis research was a retrospective cohort study of 250 drug resistant tuberculosis patients receiving treatment in the Moewardi Hospital in January 2011-September 2014. Data were analyzed using survival analysis to find factors affecting the 2 year survival. Our variables were demographic factors, disease characteristics and treatment history. We used Cox regression test with 5% significance level.Results2-year survival rates of drug resistant patients was 74.82%. age, the type of patient, HIV status, side effects of medications and culture conversion were significant to survival rate in bivariate analysis. Cox regression test showed that aged ≥ 40 years (HR 3.221; 95% CI 1.037 to 10.001) and have HIV-positive status (HR 18.086; 95% CI 1.958 to 167.073) were related with reduction of two year survival rate in drug resistant tuberculosis patient. ConclusionAge above 40 years old and HIV positive status for drug-resistant tuberculosis patients may accelerate their death. The screening of HIV in drug resistant tuberculosis patients is needed in order to increase two year survival rate of patients during treatment

Implementasi Program Rukun Warga Bebas Rokok di YOGYAKARTA

Implementation of the smoke-free neighborhood program in YogyakartaPurposeThis study aimed to identify the successfulness of smoke-free neighborhood and to understand the relationship between the householders' knowledge and household smoking status. MethodsAn observational analytic study was conducted using cross-sectional surveys. Chi-square, Fisher exact and logistic regression tests were used to analyze the correlation between variables. ResultsFrom those numbers, qualified households which fulfill the program criteria were 76.1% and 75.9%, respectively. To be more specific, in smoke-free neighborhood, about 56.8% householders were under smoking status and 43.2% householders were identified as ex- or non-smoker. Bivariable analysis showed that there was a significant correlation between educational background, age, knowledge, and perception of householder with smoking status. The last model of multivariable analysis showed that knowledge, and age of householders was related to household smoking status. ConclusionThis study shows that smoke-free neighborhood program has not yet affected passive smoker protection significantly. A more specific controlling program to improve the knowledge especially for elderly (> 45 years old) has to be increased in smoke-free neighborhood of Yogyakarta

Aktivitas Fisik Dan Screen Based Activity Pada Remaja Di Wates

Latar Belakang: Prevalensi durasi tidur pada remaja menurun sekitar satu jam tiap malam. Pola tidur buruk dapat meningkatkan risiko terjadinya kematian. Pola tidur dipengaruhi banyak faktor, salah satunya adalah aktifitas fisik dan screen based activity. Pada remaja, terjadi peningkatan aktifitas fisik kurang dan tingginya durasi screen based activity (SBA). Penelitian ini bertujuan untuk mengetahui hubungan antara aktifitas fisik dan SBA dengan pola tidur remaja.Metode: Rancangan penelitian ini adalah cross sectional study yang dilaksanakan di sekolah menengah pertama Kecamatan Wates, pada bulan Agustus 2016. Sampel penelitian berjumlah 536 responden dengan teknik pemilihan sampel menggunakan stratified random sampling. Data dikumpulkan dengan melakukan wawancara dengan kuesioner terstruktur, pengukuran tinggi badan dan lingkar pinggang. Analisis data menggunakan uji Chi-square, Mann-Whitney dan regresi logistik.Hasil: Total 536 responden yang dilibatkan dalam penelitian diketahui bahwa kualitas tidur buruk (34,5%) dan durasi tidur pendek (45,3%) lebih banyak terjadi pada remaja perempuan. Terdapat hubungan bermakna antara SBA (OR=2.0; 95% CI= 1,3-3.3; p=0,003) dengan kualitas tidur remaja. Selain itu, ditemukan hubungan aktifitas fisik (OR= 0.7; 95% CI=0,4-0,9; p=0,05) dengan durasi tidur.Kesimpulan: Aktifitas fisik serta SBA berhubungan dengan pola tidur remaja. Sebaiknya, melakukan advokasi kepada Dinas Pendidikan Kabupaten Kulon Progo untuk melakukan physchoeducation di sekolah

Estimating the scale of chronic hepatitis B virus infection among migrants in EU/EEA countries

Background: Chronic hepatitis B (CHB) related morbidity and mortality can be reduced through risk group screening, linkage to care and anti-viral treatment. This study estimates the number of CHB cases among foreign-born (migrants) in the European Union and European Economic Area (EU/EEA) countries in order to identify the most affected migrant populations. Methods: The CHB burden was estimated by combining: demographic data on migrant population size by country of birth in the EU/EEA, extracted from European statistical databases; and CHB prevalence in migrants' countries of birth and in EU/EEA countries, derived from a systematic literature search. The relative contribution of migrants from endemic countries to the total CHB burden in each country was also estimated. The reliability of using country of birth prevalence as a proxy for prevalence among migrants was assessed by comparing it to the prevalence found in studies among migrants in Europe. Results: An estimated 1-1.9 million CHB-infected migrants from endemic countries (prevalence ≥2%) reside in the EU/EEA. Migrants from endemic countries comprise 10.3% of the total EU/EEA population but account for 25% (15%-35%) of all CHB cases. Migrants born in China and Romania contribute the largest number of infections, with over 100,000 estimated CHB cases each, followed by migrants from Turkey, Albania and Russia, in descending order, with over 50,000 estimated CHB cases each. The CHB prevalence reported in studies among migrants in EU/EEA countries was lower than the country of birth prevalence in 9 of 14 studies. Conclusions: Migrants from endemic countries are disproportionately affected by CHB; their contribution however varies between EU/EEA countries. Migrant focused screening strategies would be most effective in countries with a high relative contribution of migrants and a low general population prevalence. In countries with a higher general population prevalence and a lower relative contribution of migrants, screening specific birth cohorts may be a more effective use of scarce resources. Quantifying the number of CHB infections among 50 different migrant groups residing in each of the 31 EU/EEA host countries helps to identify the most affected migrant communities who would benefit from targeted screening and linkage to care

Efficacy of Wolbachia-Infected Mosquito Deployments for the Control of Dengue.

BACKGROUND: Aedes aegypti mosquitoes infected with the wMel strain of Wolbachia pipientis are less susceptible than wild-type A. aegypti to dengue virus infection. METHODS: We conducted a cluster-randomized trial involving releases of wMel-infected A. aegypti mosquitoes for the control of dengue in Yogyakarta, Indonesia. We randomly assigned 12 geographic clusters to receive deployments of wMel-infected A. aegypti (intervention clusters) and 12 clusters to receive no deployments (control clusters). All clusters practiced local mosquito-control measures as usual. A test-negative design was used to assess the efficacy of the intervention. Patients with acute undifferentiated fever who presented to local primary care clinics and were 3 to 45 years of age were recruited. Laboratory testing was used to identify participants who had virologically confirmed dengue (VCD) and those who were test-negative controls. The primary end point was symptomatic VCD of any severity caused by any dengue virus serotype. RESULTS: After successful introgression of wMel into the intervention clusters, 8144 participants were enrolled; 3721 lived in intervention clusters, and 4423 lived in control clusters. In the intention-to-treat analysis, VCD occurred in 67 of 2905 participants (2.3%) in the intervention clusters and in 318 of 3401 (9.4%) in the control clusters (aggregate odds ratio for VCD, 0.23; 95% confidence interval [CI], 0.15 to 0.35; P = 0.004). The protective efficacy of the intervention was 77.1% (95% CI, 65.3 to 84.9) and was similar against the four dengue virus serotypes. The incidence of hospitalization for VCD was lower among participants who lived in intervention clusters (13 of 2905 participants [0.4%]) than among those who lived in control clusters (102 of 3401 [3.0%]) (protective efficacy, 86.2%; 95% CI, 66.2 to 94.3). CONCLUSIONS: Introgression of wMel into A. aegypti populations was effective in reducing the incidence of symptomatic dengue and resulted in fewer hospitalizations for dengue among the participants. (Funded by the Tahija Foundation and others; AWED ClinicalTrials.gov number, NCT03055585; Indonesia Registry number, INA-A7OB6TW.)