HUBUNGAN ANTARA PENGETAHUAN DAN SIKAP DENGAN KEPATUHAN PENGGUNAAN ALAT PELINDUNG DIRI (APD) PADA PETUGAS PENYAPU JALAN DI KECAMATAN SINGKIL DAN TUMINTING

Keselamatan dan kesehatan kerja merupakan suatu sikap berfikir yang menghasilkan suatu lingkungan kerja yang menjadi bagian terpadu pada setiap prosedur yang dijalankan oleh perusahaan atau instansi kerja. Petugas penyapu jalan adalah orang yang bekerja di sepanjang jalan raya dan sangat berperan dalam terciptanya kebersihan tapi beberapa petugas penyapu jalan yang ditemui tidak menggunakan helm dan masker ketika sedang bekerja. Kebiasan yang tidak patuh terhadap penggunaan alat pelindung diri sering dilakukan petugas penyapu jalan diakibatkan para petugas belum menyadari bahaya maupun resiko dalam pekerjaan mereka. Tujuan penelitian adalah untuk menganalisis hubungan antara pengetahuan dan sikap dengan kepatuhan penggunaan alat pelindung diri pada petugas penyapu jalan  di Kecamatan Singkil dan Tuminting. Metode penelitian ini adalah penelitian deskriptif dengan rancangan cross sectional study (potong lintang). Populasi dan sampel dalam penelitian ini adalah petugas penyapu jalan bidang kebersihan kota di Kecamatan Singkil sebanyak 20 orang dan di Kecamatan Tuminting sebanyak 43 orang dengan total sebanyak 63 responden. Hasil penelitian ini menunjukkan adanya hubungan antara masing-masing variabel yaitu pengetahuan dengan kepatuhan penggunaan alat pelindung diri (p=0.026),  sikap dengan kepatuhan penggunaan alat pelindung diri (p=0.035). Kesimpulan terdapat hibungan yang signifikan antara pengetahuan dan sikap dengan kepatuhan pengguanan alat pelindung diri pada petugas penyapu jalan di Kecamatan Singkil dan Tuminting. Saran diharapkan untuk Dinas Kesehatan Agar dapat memberikan pengetahuan tentang dampak tidak menggunakan alat pelindung diri dan selalu mengontrol langsung dilapangan agar para penyapu menggunakan alat pelindung diri dan terhidar dari penyakit akibat kerja. Kata Kunci: Pengetahuan, Sikap, Penggunaan APD ABSTRACTOccupational safety and health is a mindset that results in a work environment that is an integrated part of every procedure carried out by the company or work agency. Road sweepers are people who work along the highway and are very instrumental in the creation of cleanliness but some road sweepers who are met do not use helmets and masks when working. Habits that do not comply with the use of personal protective equipment are often carried out by street sweepers because the officers are not aware of the dangers or risks in their work. The purpose of this study was to analyze the relationship between knowledge and attitude with compliance with the use of personal protective equipment on road sweepers in Singkil and Tuminting Districts. This research method is a descriptive study with a cross sectional study design (cross section). The population and sample in this study were 20 street cleaners in the city sanitation department in Singkil District and 43 in Tuminting District with 63 respondents. The results of this study indicate that there is a relationship between each variable, namely knowledge and compliance with the use of personal protective equipment (p = 0.026), attitude with compliance with the use of personal protective equipment (p = 0.035). Conclusion there is a significant combination of knowledge and attitude with the compliance of the use of personal protective equipment on road sweepers in Singkil and Tuminting Districts. Suggestions are expected for the Office of Health in order to be able to provide knowledge about the effects of not using personal protective equipment and always control directly in the field so that the sweeper uses personal protective equipment and avoid from occupational diseases. Keywords: Knowledge, Attitude, Use of personal protective equipment (PPE

FAKTOR RISIKO KETERPAPARAN PESTISIDA PADA PETANI TANAMAN HORTIKULTURA DI PERKEBUNAN WAWO KOTA TOMOHON 2017

Dampak negatif yang di timbulkan pestisida bagi kesehatan masyarakat sangat beracun dan berbahaya. Kontak langsung dengan pestisida ini berisiko keracunan akut maupun kronis. Sakit kepala, mual, muntah dan sebagainya bahkan iritasi pada kulit dan kebutaan merupakan gejala keracunan akut dari pestisida. Data dari Organisasi Kesehatan Dunia (WHO), 1-5 juta kasus keracunan pestisida terjadi pada pekerja di sektor pertanian sebagian besar kasus keracunan pestisida tersebut terjadi di negara sedang berkembang yang 20.000 diantaranya berakibat fatal. Para petani diperkebunan Wawo kebanyakan saat melakukan penyemprotan pestisida tidak menggunakan APD sehingga risiko untuk terpapar pestisida sangat rentan. Tujuan dari penelitian ini untuk mengetahui faktor risiko keterpaparan pestisida pada petani tanaman Hortikultura di perkebunan Wawo Kota Tomohon. Penelitian ini menggunakan metode penelitian deskriptif dengan rancangan potong lintang (cross-sectional study) pada bulan September-Oktober 2017. Populasi dalam penelitaian ini adalah petani yang bekerja di perkebunan wawo yaitu sebanyak 91 orang yang berjenis kelamin laki-laki. Teknik pengambilan sampel yang digunakan yaitu Purposive Sampling dengan mengunakan rumus Slovin sehingga yang menjadi sampel penelitian hanya 30 responden. Hasil penelitian menunjukkan variabel pengetahuan, sikap, lama kontak, dikatakan cukup baik sehingga dapat mengurangi keterpaparan pestisida, sedangkan untuk masa kerja dan tata cara menggunakan pestisida kurang baik. Tata cara para petani diperkebunan Wawo kurang baik, karena kebanyakan pada saat melakukan penyemprotan dan mencampur pestisida tidak menggunakan APD sehingga mengakibatkan mudahnya pestisida masuk kedalam tubuh dan dapat menyebabkan keracunan jika terjadi secara terus menerus apalagi masa kerja para petani ≥ 5 tahun yang sangat rentan terhadap keterpaparan pestisida.Kata Kunci:Pengetahuan, Sikap, Lama Kontak, Masa Kerja, Tata Cara, Keterpaparan PestisidaABSTRACTNegative effects from pesticide to public health is poisonous and hazardous.Direct contact with pesticide will risk acute poisoning or chronic headache, nausea. Also, skin irritation and blindness are two acute poisoning over pesticide. World Health Organization;s data shows over 1 to 5 million pesticide poisoning cases are occured around agriculture section and mostly from the cases are happening in development countries which 20.000 cases are becoming fatal among them. Most of the farmers in Wawo plantation don’t use proper protectors so the risk of getting pesticide poisoning are more likely to happen to them. The purpose of this research is to find out risk factors of pesticide exposure at horticultural farmers in Wawo plantation, Tomohon. This research is a descriptive research with cross sectional study along September-October 2017. The populations are 91 male farmers and by purposive sampling technique with Slovin formula, 30 respondents were included as samples. The results show knowledge, posture, contact period are well enough that the factors are holding back pesticide exposure on farmers. Meanwhile, working period and working procedures of using pesticide are quite deficient. Farmers in Wawo plantation mostly do not use proper self-protectors as they mix and spray pesticide. This is a risk factor the pesticide is easy to flow inside the body dan could cause poisoning if happens continously to the susceptible farmers in Wawo who have working period for ove than 5 years.Keywords: Knowledge, Posture, Contact Period, Working Period, Working Procedures, Pesticide Exposur

Surveillance of artemether-lumefantrine associated Plasmodium falciparum multidrug resistance protein-1 gene polymorphisms in Tanzania.

BACKGROUND: Resistance to anti-malarials is a major public health problem worldwide. After deployment of artemisinin-based combination therapy (ACT) there have been reports of reduced sensitivity to ACT by malaria parasites in South-East Asia. In Tanzania, artemether-lumefantrine (ALu) is the recommended first-line drug in treatment of uncomplicated malaria. This study surveyed the distribution of the Plasmodium falciparum multidrug resistance protein-1 single nucleotide polymorphisms (SNPs) associated with increased parasite tolerance to ALu, in Tanzania. METHODS: A total of 687 Plasmodium falciparum positive dried blood spots on filter paper and rapid diagnostic test strips collected by finger pricks from patients attending health facilities in six regions of Tanzania mainland between June 2010 and August 2011 were used. Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technique was used to detect Pfmdr1 SNPs N86Y, Y184F and D1246Y. RESULTS: There were variations in the distribution of Pfmdr1 polymorphisms among regions. Tanga region had exceptionally high prevalence of mutant alleles, while Mbeya had the highest prevalence of wild type alleles. The haplotype YFY was exclusively most prevalent in Tanga (29.6%) whereas the NYD haplotype was the most prevalent in all other regions. Excluding Tanga and Mbeya, four, most common Pfmdr1 haplotypes did not vary between the remaining four regions (χ² = 2.3, p = 0.512). The NFD haplotype was the second most prevalent haplotype in all regions, ranging from 17% - 26%. CONCLUSION: This is the first country-wide survey on Pfmdr1 mutations associated with ACT resistance. Distribution of individual Pfmdr1 mutations at codons 86, 184 and 1246 varies throughout Tanzanian regions. There is a general homogeneity in distribution of common Pfmdr1 haplotypes reflecting strict implementation of ALu policy in Tanzania with overall prevalence of NFD haplotype ranging from 17 to 26% among other haplotypes. With continuation of ALu as first-line drug this haplotype is expected to keep rising, thus there is need for continued pharmacovigilance studies to monitor any delayed parasite clearance by the drug

Stem cell‐derived enteroid cultures as a tool for dissecting host‐parasite interactions in the small intestinal epithelium.

Toxoplasma gondii and Cryptosporidium spp. can cause devastating pathological effects in humans and livestock, and in particular to young or immunocompromised individuals. The current treatment plans for these enteric parasites are limited due to long drug courses, severe side effects, or simply a lack of efficacy. The study of the early interactions between the parasites and the site of infection in the small intestinal epithelium has been thwarted by the lack of accessible, physiologically relevant, and species-specific models. Increasingly, 3D stem cell-derived enteroid models are being refined and developed into sophisticated models of infectious disease. In this review we shall illustrate the use of enteroids to spearhead research into enteric parasitic infections, bridging the gap between cell line cultures and in vivo experiments

Convalescent plasma in patients admitted to hospital with COVID-19 (RECOVERY): a randomised controlled, open-label, platform trial

Background: Many patients with COVID-19 have been treated with plasma containing anti-SARS-CoV-2 antibodies. We aimed to evaluate the safety and efficacy of convalescent plasma therapy in patients admitted to hospital with COVID-19. Methods: This randomised, controlled, open-label, platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]) is assessing several possible treatments in patients hospitalised with COVID-19 in the UK. The trial is underway at 177 NHS hospitals from across the UK. Eligible and consenting patients were randomly assigned (1:1) to receive either usual care alone (usual care group) or usual care plus high-titre convalescent plasma (convalescent plasma group). The primary outcome was 28-day mortality, analysed on an intention-to-treat basis. The trial is registered with ISRCTN, 50189673, and ClinicalTrials.gov, NCT04381936. Findings: Between May 28, 2020, and Jan 15, 2021, 11558 (71%) of 16287 patients enrolled in RECOVERY were eligible to receive convalescent plasma and were assigned to either the convalescent plasma group or the usual care group. There was no significant difference in 28-day mortality between the two groups: 1399 (24%) of 5795 patients in the convalescent plasma group and 1408 (24%) of 5763 patients in the usual care group died within 28 days (rate ratio 1·00, 95% CI 0·93–1·07; p=0·95). The 28-day mortality rate ratio was similar in all prespecified subgroups of patients, including in those patients without detectable SARS-CoV-2 antibodies at randomisation. Allocation to convalescent plasma had no significant effect on the proportion of patients discharged from hospital within 28 days (3832 [66%] patients in the convalescent plasma group vs 3822 [66%] patients in the usual care group; rate ratio 0·99, 95% CI 0·94–1·03; p=0·57). Among those not on invasive mechanical ventilation at randomisation, there was no significant difference in the proportion of patients meeting the composite endpoint of progression to invasive mechanical ventilation or death (1568 [29%] of 5493 patients in the convalescent plasma group vs 1568 [29%] of 5448 patients in the usual care group; rate ratio 0·99, 95% CI 0·93–1·05; p=0·79). Interpretation: In patients hospitalised with COVID-19, high-titre convalescent plasma did not improve survival or other prespecified clinical outcomes. Funding: UK Research and Innovation (Medical Research Council) and National Institute of Health Research

Tocilizumab in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial

Background: In this study, we aimed to evaluate the effects of tocilizumab in adult patients admitted to hospital with COVID-19 with both hypoxia and systemic inflammation. Methods: This randomised, controlled, open-label, platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]), is assessing several possible treatments in patients hospitalised with COVID-19 in the UK. Those trial participants with hypoxia (oxygen saturation <92% on air or requiring oxygen therapy) and evidence of systemic inflammation (C-reactive protein ≥75 mg/L) were eligible for random assignment in a 1:1 ratio to usual standard of care alone versus usual standard of care plus tocilizumab at a dose of 400 mg–800 mg (depending on weight) given intravenously. A second dose could be given 12–24 h later if the patient's condition had not improved. The primary outcome was 28-day mortality, assessed in the intention-to-treat population. The trial is registered with ISRCTN (50189673) and ClinicalTrials.gov (NCT04381936). Findings: Between April 23, 2020, and Jan 24, 2021, 4116 adults of 21 550 patients enrolled into the RECOVERY trial were included in the assessment of tocilizumab, including 3385 (82%) patients receiving systemic corticosteroids. Overall, 621 (31%) of the 2022 patients allocated tocilizumab and 729 (35%) of the 2094 patients allocated to usual care died within 28 days (rate ratio 0·85; 95% CI 0·76–0·94; p=0·0028). Consistent results were seen in all prespecified subgroups of patients, including those receiving systemic corticosteroids. Patients allocated to tocilizumab were more likely to be discharged from hospital within 28 days (57% vs 50%; rate ratio 1·22; 1·12–1·33; p<0·0001). Among those not receiving invasive mechanical ventilation at baseline, patients allocated tocilizumab were less likely to reach the composite endpoint of invasive mechanical ventilation or death (35% vs 42%; risk ratio 0·84; 95% CI 0·77–0·92; p<0·0001). Interpretation: In hospitalised COVID-19 patients with hypoxia and systemic inflammation, tocilizumab improved survival and other clinical outcomes. These benefits were seen regardless of the amount of respiratory support and were additional to the benefits of systemic corticosteroids. Funding: UK Research and Innovation (Medical Research Council) and National Institute of Health Research

Dimethyl fumarate in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial

Dimethyl fumarate (DMF) inhibits inflammasome-mediated inflammation and has been proposed as a treatment for patients hospitalised with COVID-19. This randomised, controlled, open-label platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]), is assessing multiple treatments in patients hospitalised for COVID-19 (NCT04381936, ISRCTN50189673). In this assessment of DMF performed at 27 UK hospitals, adults were randomly allocated (1:1) to either usual standard of care alone or usual standard of care plus DMF. The primary outcome was clinical status on day 5 measured on a seven-point ordinal scale. Secondary outcomes were time to sustained improvement in clinical status, time to discharge, day 5 peripheral blood oxygenation, day 5 C-reactive protein, and improvement in day 10 clinical status. Between 2 March 2021 and 18 November 2021, 713 patients were enroled in the DMF evaluation, of whom 356 were randomly allocated to receive usual care plus DMF, and 357 to usual care alone. 95% of patients received corticosteroids as part of routine care. There was no evidence of a beneficial effect of DMF on clinical status at day 5 (common odds ratio of unfavourable outcome 1.12; 95% CI 0.86-1.47; p = 0.40). There was no significant effect of DMF on any secondary outcome

Dimethyl fumarate in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial

Dimethyl fumarate (DMF) inhibits inflammasome-mediated inflammation and has been proposed as a treatment for patients hospitalised with COVID-19. This randomised, controlled, open-label platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]), is assessing multiple treatments in patients hospitalised for COVID-19 (NCT04381936, ISRCTN50189673). In this assessment of DMF performed at 27 UK hospitals, adults were randomly allocated (1:1) to either usual standard of care alone or usual standard of care plus DMF. The primary outcome was clinical status on day 5 measured on a seven-point ordinal scale. Secondary outcomes were time to sustained improvement in clinical status, time to discharge, day 5 peripheral blood oxygenation, day 5 C-reactive protein, and improvement in day 10 clinical status. Between 2 March 2021 and 18 November 2021, 713 patients were enroled in the DMF evaluation, of whom 356 were randomly allocated to receive usual care plus DMF, and 357 to usual care alone. 95% of patients received corticosteroids as part of routine care. There was no evidence of a beneficial effect of DMF on clinical status at day 5 (common odds ratio of unfavourable outcome 1.12; 95% CI 0.86-1.47; p = 0.40). There was no significant effect of DMF on any secondary outcome