Pelatihan Kader Kesehatan untuk Penemuan Penderita Suspek Tuberkulosis

Di Indonesia, kasus tuberkulosis (TB) yang dilaporkan pada tahun 2011 ter- deteksi lebih dari 70% dan cenderung terus meningkat. Di Kota Surabaya, cakupan penemuan penderita adalah sekitar 49,52% dengan jumlah suspek TB sebanyak 4.402 orang hingga tahun 2011. Keterlibatan masyarakat dalam penanggulangan TB tersebut sesuai dengan Kerangka Kerja Strategi Penanggulangan TB 2006-2010. Masyarakat berpeluang untuk berperan dalam penanggulangan TB, sumber daya di masyarakat dimanfaatkan untuk meningkatkan derajat kesehatan dan mengubah perilaku masyarakat. Penelitian ini bertujuan mengetahui pengaruh pelatihan terhadap pengetahuan kader kesehatan dalam penemuan suspek TB. Penelitian kuantitatif ini menggunakan rancangan studi kuasi eksperimental kelompok kontrol non-ekuivalen. Perlakuan pelatihan program pengendalian berupa penemuan suspek TB. Populasi penelitian adalah ibu rumah tangga di wilayah kerja Puskesmas Mojo di Kota Surabaya dengan jumlah sampel 90 ibu rumah tangga berumur rata-rata 48 tahun, tingkat pendidikan terbanyak adalah tamat SMA (58,9%). Setelah pelatihan, pengetahuan kader tentang penemuan suspek TB meningkat dari 67 (74,4%) menjadi 89 (98,9%). Perlu implementasi untuk melihat kemampuan kader menerapkan pengetahuan yang diperoleh dalam menemukan suspek penderita TB dengan pen- dampingan dan monitoring kader.Progress reports current situation of tuberculosis (TB) in Indonesia in 2011 showed Case Detection Rate (CDR) of over 70% and showed an increase from year to year. While the city of Surabaya figures coverage discovery Patients up to 2011 amounted to 49.52% with the number of 4,402 people suspected. Community involvement in TB control in accordance with the Tuberculosis Control Strategy Framework 2006-2010. The opportunities as well as public opportunities to participate in TB control to make the resources available in the community should be utilized to improve health status and change people\u27s behavior as a factor influencing health status. This study aimed to determine the effect of training on the knowledge of health cadres in the discovery of suspected tuberculosisThis study uses quantitative methods to the design of a Quasi Nonequivalent Experimental Control Group Design. Treatment will be given in the form of training on tuberculosis control program in the discovery suspected tuberculosis. The population in this study was a housewife in Puskesmas Mojo working in the city of Surabaya. Large sample taken as many as 90 respondents. Characteristics housewife with average age 48 years, female gender, and education all most 31.1%. Improvement occurred knowledge of 67 (74.4 %) health workers who have good knowledge before training to 89 (98.9 %). Based on the results of this study concluded increased knowledge of health workers after training in the discovery of suspected tuberculosis. Further implementation is needed to see the ability of the implementing cadres who have acquired knowledge in finding patients with suspected tuberculosis in the surrounding environment. In its application may be made to the guidance and monitoring of health cadres in the process of discovery with suspected tuberculosis

System Analysis of Dengue Virus Surveillance in BBTKL PP Surabaya Year 2012–2014

Changing the distribution of dengue virus serotypes has occurred in Indonesia. This condition should be monitored continuously through the Dengue Virus Surveillance. Implementation of Dengue Virus Surveillance also conducted by BBTKL PP Surabaya. The purpose of this study was to determine the workflow, identify problems, set priority problem, find the cause of the problem, and provide the alternative solution related to problems of Dengue Virus Surveillance in BBTKL PP Surabaya. This is a operational research and the informants are officers of Dengue Virus Surveillance in BBTKL PP Surabaya. Data in this study was analyzed descriptive and presented narrative. Results showed that the workflow of Dengue Virus Surveillance in BBTKL PP Surabaya are collecting of patient\u27s blood and vector specimen, vector survey and collecting the supporting data, Rapid Diagnostic Test (RDT) and Polymerase Chain Reaction (PCR), processing and data analysis, and dissemination the information. The main problems of Dengue Virus Surveillance in BBTKL PP Surabaya is the low quality of the information. Tree problem analysis showed that the cause of problem that can be intervene are incomplete supporting data and data storage. Alternative solution related to problems of Dengue Virus Surveillance in BBTKL PP Surabaya is use of Epi Info

Perbedaan Hasil Pemeriksaan Kadar PM2.5 di Kota Surabaya berdasarkan Jenis Sarana

karena pencemaran baik pencemaran udara, air, dan tanah. Pencemaran udara dengan sumber polutan primer salah satunya adalah partikel debu. Partikel debu sering disebut Particulate Matter (PM) dengan berbagai ukuran. Penggolongan dibagi menjadi Total Suspended Particulate (TSP) ; PM10 ; dan PM2,5 yang berasal dari sumber organik dan anorganik. Parameter dalam mengukur paparan lingkungan yang dapat menimbulkan masalah kesehatan bagi manusia adalah pengukuran konsentrasi debu dan ukuran partikel 1-3 mikron akan masuk langsung sampai permukaan jaringan dalam paru - paru.Hasil pengukuran pada tujuh sarana menunjukkan rata – rata kadar PM2.5 melebihi konsentrasi standar (> 25 µg/m3) dan kadar tertinggi di sarana umum (75,7 µg/m3), kemudian di sarana kegiatan anak (41,9 µg/m3). Selanjutnya tertinggi ketiga di sarana transportasi (36,3 µg/m3) dan keempat di sarana kesehatan (33,1 µg/m3) serta tertinggi kelima di sarana pendidikan (25,9 µg/m3). Diantara ketujuh sarana maka sarana ibadah dan tempat kerja menunjukkan hasil pemeriksaan dibawah standart.

Survei Opini Publik dengan Perspektif Ketersediaan Sarana yang Bebas Asap Rokok di Surabaya

Kebutuhan akan tersedianya udara bersih sudah menjadi kebutuhan masyarakat pada umumnya. Salah satu upaya dalam menciptakan udara bersih baik di sarana Indoor maupun outdoor adalah melalui pengadaan sarana yang bebas asap rokok. Upaya tersebut tertuang dalam Perda No 5 Tahun 2008 yang mengatur mengenai Kawasan tanpa rokok. Tujuan dari survei adalah mendapatkan gambaran opini masyarakat kota Surabaya mengenai ketersediaan sarana bebas asap rokok. Survei dilakukan di semua kecamatan di kota Surabaya yaitu 31 kecamatan. Pada masing – masing kecamatan diambil satu kelurahan dan sampel kelurahan ditentukan secara proporsional. Sampel sebanyak 501 warga yang tinggal di kota Surabaya dan memiliki Kartu Tanda Penduduk. Sarana yang dimaksud meliputi Sarana kesehatan, sarana pendidikan, sarana taman bermain anak, sarana transportasi, sarana tempat ibadah, tempat umum dan tempat kerja. Hasil menunjukkan dukungan warga kota Surabaya terhadap terciptanya sarana bebas asap rokok adalah sebesar 91,4 %. Bila dibedakan berdasarkan sarana dari yang paling besar yaitu sarana fasilitas kesehatan 97,8%; pendidikan 97,4%; tempat ibadah 96,8 %; transportasi 95,8 %; kantor 93,4% dan yang paling rendah fasilitas umum yaitu 87,4 %. Besarnya harapan masyarakat demi terciptanya sarana bebas asap rokok maka semakin menguatkan pengembangan peraturan Kawasan Tanpa Rokok 100% di kota Surabaya

Survei Opini Publik dengan Perspektif Ketersediaan Sarana yang Bebas Asap Rokok di Surabaya

Kebutuhan akan tersedianya udara bersih sudah menjadi kebutuhan masyarakat pada umumnya. Salah satu upaya dalam menciptakan udara bersih baik di sarana Indoor maupun outdoor adalah melalui pengadaan sarana yang bebas asap rokok. Upaya tersebut tertuang dalam Perda No 5 Tahun 2008 yang mengatur mengenai Kawasan tanpa rokok.Tujuan dari survei adalah mendapatkan gambaran opini masyarakat kota Surabaya mengenai ketersediaan sarana bebas asap rokok. Survei dilakukan di semua kecamatan di kota Surabaya yaitu 31 kecamatan. Pada masing – masing kecamatan diambil satu kelurahan dan sampel kelurahan ditentukan secara proporsional. Sampel sebanyak 501 warga yang tinggal di kota Surabaya dan memiliki Kartu Tanda Penduduk. Sarana yang dimaksud meliputi Sarana kesehatan, sarana pendidikan, sarana taman bermain anak, sarana transportasi, sarana tempat ibadah, tempat umum dan tempat kerja.Hasil menunjukkan dukungan warga kota Surabaya terhadap terciptanya sarana bebas asap rokok adalah sebesar 91,4 %. Bila dibedakan berdasarkan sarana dari yang paling besar yaitu sarana fasilitas kesehatan 97,8%; pendidikan 97,4%; tempat ibadah 96,8 %; transportasi 95,8 %; kantor 93,4% dan yang paling rendah fasilitas umum yaitu 87,4 %. Besarnya harapan masyarakat demi terciptanya sarana bebas asap rokok maka semakin menguatkan pengembangan peraturan Kawasan Tanpa Rokok 100% di kota Surabaya

Spatial, temporal, and demographic patterns in prevalence of chewing tobacco use in 204 countries and territories, 1990-2019: A systematic analysis from the Global Burden of Disease Study 2019

Background: Chewing tobacco and other types of smokeless tobacco use have had less attention from the global health community than smoked tobacco use. However, the practice is popular in many parts of the world and has been linked to several adverse health outcomes. Understanding trends in prevalence with age, over time, and by location and sex is important for policy setting and in relation to monitoring and assessing commitment to the WHO Framework Convention on Tobacco Control. Methods: We estimated prevalence of chewing tobacco use as part of the Global Burden of Diseases, Injuries, and Risk Factors Study 2019 using a modelling strategy that used information on multiple types of smokeless tobacco products. We generated a time series of prevalence of chewing tobacco use among individuals aged 15 years and older from 1990 to 2019 in 204 countries and territories, including age-sex specific estimates. We also compared these trends to those of smoked tobacco over the same time period. Findings: In 2019, 273·9 million (95% uncertainty interval 258·5 to 290·9) people aged 15 years and older used chewing tobacco, and the global age-standardised prevalence of chewing tobacco use was 4·72% (4·46 to 5·01). 228·2 million (213·6 to 244·7; 83·29% [82·15 to 84·42]) chewing tobacco users lived in the south Asia region. Prevalence among young people aged 15–19 years was over 10% in seven locations in 2019. Although global age-standardised prevalence of smoking tobacco use decreased significantly between 1990 and 2019 (annualised rate of change: –1·21% [–1·26 to –1·16]), similar progress was not observed for chewing tobacco (0·46% [0·13 to 0·79]). Among the 12 highest prevalence countries (Bangladesh, Bhutan, Cambodia, India, Madagascar, Marshall Islands, Myanmar, Nepal, Pakistan, Palau, Sri Lanka, and Yemen), only Yemen had a significant decrease in the prevalence of chewing tobacco use, which was among males between 1990 and 2019 (−0·94% [–1·72 to –0·14]), compared with nine of 12 countries that had significant decreases in the prevalence of smoking tobacco. Among females, none of these 12 countries had significant decreases in prevalence of chewing tobacco use, whereas seven of 12 countries had a significant decrease in the prevalence of tobacco smoking use for the period. Interpretation: Chewing tobacco remains a substantial public health problem in several regions of the world, and predominantly in south Asia. We found little change in the prevalence of chewing tobacco use between 1990 and 2019, and that control efforts have had much larger effects on the prevalence of smoking tobacco use than on chewing tobacco use in some countries. Mitigating the health effects of chewing tobacco requires stronger regulations and policies that specifically target use of chewing tobacco, especially in countries with high prevalence. Funding: Bloomberg Philanthropies and the Bill & Melinda Gates Foundation

Spatial, temporal, and demographic patterns in prevalence of chewing tobacco use in 204 countries and territories, 1990-2019 : a systematic analysis from the Global Burden of Disease Study 2019

Interpretation Chewing tobacco remains a substantial public health problem in several regions of the world, and predominantly in south Asia. We found little change in the prevalence of chewing tobacco use between 1990 and 2019, and that control efforts have had much larger effects on the prevalence of smoking tobacco use than on chewing tobacco use in some countries. Mitigating the health effects of chewing tobacco requires stronger regulations and policies that specifically target use of chewing tobacco, especially in countries with high prevalence. Findings In 2019, 273 center dot 9 million (95% uncertainty interval 258 center dot 5 to 290 center dot 9) people aged 15 years and older used chewing tobacco, and the global age-standardised prevalence of chewing tobacco use was 4 center dot 72% (4 center dot 46 to 5 center dot 01). 228 center dot 2 million (213 center dot 6 to 244 center dot 7; 83 center dot 29% [82 center dot 15 to 84 center dot 42]) chewing tobacco users lived in the south Asia region. Prevalence among young people aged 15-19 years was over 10% in seven locations in 2019. Although global agestandardised prevalence of smoking tobacco use decreased significantly between 1990 and 2019 (annualised rate of change: -1 center dot 21% [-1 center dot 26 to -1 center dot 16]), similar progress was not observed for chewing tobacco (0 center dot 46% [0 center dot 13 to 0 center dot 79]). Among the 12 highest prevalence countries (Bangladesh, Bhutan, Cambodia, India, Madagascar, Marshall Islands, Myanmar, Nepal, Pakistan, Palau, Sri Lanka, and Yemen), only Yemen had a significant decrease in the prevalence of chewing tobacco use, which was among males between 1990 and 2019 (-0 center dot 94% [-1 center dot 72 to -0 center dot 14]), compared with nine of 12 countries that had significant decreases in the prevalence of smoking tobacco. Among females, none of these 12 countries had significant decreases in prevalence of chewing tobacco use, whereas seven of 12 countries had a significant decrease in the prevalence of tobacco smoking use for the period. Summary Background Chewing tobacco and other types of smokeless tobacco use have had less attention from the global health community than smoked tobacco use. However, the practice is popular in many parts of the world and has been linked to several adverse health outcomes. Understanding trends in prevalence with age, over time, and by location and sex is important for policy setting and in relation to monitoring and assessing commitment to the WHO Framework Convention on Tobacco Control. Methods We estimated prevalence of chewing tobacco use as part of the Global Burden of Diseases, Injuries, and Risk Factors Study 2019 using a modelling strategy that used information on multiple types of smokeless tobacco products. We generated a time series of prevalence of chewing tobacco use among individuals aged 15 years and older from 1990 to 2019 in 204 countries and territories, including age-sex specific estimates. We also compared these trends to those of smoked tobacco over the same time period. Findings In 2019, 273 & middot;9 million (95% uncertainty interval 258 & middot;5 to 290 & middot;9) people aged 15 years and older used chewing tobacco, and the global age-standardised prevalence of chewing tobacco use was 4 & middot;72% (4 & middot;46 to 5 & middot;01). 228 & middot;2 million (213 & middot;6 to 244 & middot;7; 83 & middot;29% [82 & middot;15 to 84 & middot;42]) chewing tobacco users lived in the south Asia region. Prevalence among young people aged 15-19 years was over 10% in seven locations in 2019. Although global age standardised prevalence of smoking tobacco use decreased significantly between 1990 and 2019 (annualised rate of change: -1 & middot;21% [-1 & middot;26 to -1 & middot;16]), similar progress was not observed for chewing tobacco (0 & middot;46% [0 & middot;13 to 0 & middot;79]). Among the 12 highest prevalence countries (Bangladesh, Bhutan, Cambodia, India, Madagascar, Marshall Islands, Myanmar, Nepal, Pakistan, Palau, Sri Lanka, and Yemen), only Yemen had a significant decrease in the prevalence of chewing tobacco use, which was among males between 1990 and 2019 (-0 & middot;94% [-1 & middot;72 to -0 & middot;14]), compared with nine of 12 countries that had significant decreases in the prevalence of smoking tobacco. Among females, none of these 12 countries had significant decreases in prevalence of chewing tobacco use, whereas seven of 12 countries had a significant decrease in the prevalence of tobacco smoking use for the period. Interpretation Chewing tobacco remains a substantial public health problem in several regions of the world, and predominantly in south Asia. We found little change in the prevalence of chewing tobacco use between 1990 and 2019, and that control efforts have had much larger effects on the prevalence of smoking tobacco use than on chewing tobacco use in some countries. Mitigating the health effects of chewing tobacco requires stronger regulations and policies that specifically target use of chewing tobacco, especially in countries with high prevalence. Copyright (c) 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.Peer reviewe

Global, regional, and national burden of stroke and its risk factors, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

Background Regularly updated data on stroke and its pathological types, including data on their incidence, prevalence, mortality, disability, risk factors, and epidemiological trends, are important for evidence-based stroke care planning and resource allocation. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) aims to provide a standardised and comprehensive measurement of these metrics at global, regional, and national levels. Methods We applied GBD 2019 analytical tools to calculate stroke incidence, prevalence, mortality, disability-adjusted life-years (DALYs), and the population attributable fraction (PAF) of DALYs (with corresponding 95% uncertainty intervals [UIs]) associated with 19 risk factors, for 204 countries and territories from 1990 to 2019. These estimates were provided for ischaemic stroke, intracerebral haemorrhage, subarachnoid haemorrhage, and all strokes combined, and stratified by sex, age group, and World Bank country income level. Findings In 2019, there were 12·2 million (95% UI 11·0–13·6) incident cases of stroke, 101 million (93·2–111) prevalent cases of stroke, 143 million (133–153) DALYs due to stroke, and 6·55 million (6·00–7·02) deaths from stroke. Globally, stroke remained the second-leading cause of death (11·6% [10·8–12·2] of total deaths) and the third-leading cause of death and disability combined (5·7% [5·1–6·2] of total DALYs) in 2019. From 1990 to 2019, the absolute number of incident strokes increased by 70·0% (67·0–73·0), prevalent strokes increased by 85·0% (83·0–88·0), deaths from stroke increased by 43·0% (31·0–55·0), and DALYs due to stroke increased by 32·0% (22·0–42·0). During the same period, age-standardised rates of stroke incidence decreased by 17·0% (15·0–18·0), mortality decreased by 36·0% (31·0–42·0), prevalence decreased by 6·0% (5·0–7·0), and DALYs decreased by 36·0% (31·0–42·0). However, among people younger than 70 years, prevalence rates increased by 22·0% (21·0–24·0) and incidence rates increased by 15·0% (12·0–18·0). In 2019, the age-standardised stroke-related mortality rate was 3·6 (3·5–3·8) times higher in the World Bank low-income group than in the World Bank high-income group, and the age-standardised stroke-related DALY rate was 3·7 (3·5–3·9) times higher in the low-income group than the high-income group. Ischaemic stroke constituted 62·4% of all incident strokes in 2019 (7·63 million [6·57–8·96]), while intracerebral haemorrhage constituted 27·9% (3·41 million [2·97–3·91]) and subarachnoid haemorrhage constituted 9·7% (1·18 million [1·01–1·39]). In 2019, the five leading risk factors for stroke were high systolic blood pressure (contributing to 79·6 million [67·7–90·8] DALYs or 55·5% [48·2–62·0] of total stroke DALYs), high body-mass index (34·9 million [22·3–48·6] DALYs or 24·3% [15·7–33·2]), high fasting plasma glucose (28·9 million [19·8–41·5] DALYs or 20·2% [13·8–29·1]), ambient particulate matter pollution (28·7 million [23·4–33·4] DALYs or 20·1% [16·6–23·0]), and smoking (25·3 million [22·6–28·2] DALYs or 17·6% [16·4–19·0]). Interpretation The annual number of strokes and deaths due to stroke increased substantially from 1990 to 2019, despite substantial reductions in age-standardised rates, particularly among people older than 70 years. The highest age-standardised stroke-related mortality and DALY rates were in the World Bank low-income group. The fastest-growing risk factor for stroke between 1990 and 2019 was high body-mass index. Without urgent implementation of effective primary prevention strategies, the stroke burden will probably continue to grow across the world, particularly in low-income countries.publishedVersio

Measuring routine childhood vaccination coverage in 204 countries and territories, 1980-2019 : a systematic analysis for the Global Burden of Disease Study 2020, Release 1

Background Measuring routine childhood vaccination is crucial to inform global vaccine policies and programme implementation, and to track progress towards targets set by the Global Vaccine Action Plan (GVAP) and Immunization Agenda 2030. Robust estimates of routine vaccine coverage are needed to identify past successes and persistent vulnerabilities. Drawing from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2020, Release 1, we did a systematic analysis of global, regional, and national vaccine coverage trends using a statistical framework, by vaccine and over time. Methods For this analysis we collated 55 326 country-specific, cohort-specific, year-specific, vaccine-specific, and dosespecific observations of routine childhood vaccination coverage between 1980 and 2019. Using spatiotemporal Gaussian process regression, we produced location-specific and year-specific estimates of 11 routine childhood vaccine coverage indicators for 204 countries and territories from 1980 to 2019, adjusting for biases in countryreported data and reflecting reported stockouts and supply disruptions. We analysed global and regional trends in coverage and numbers of zero-dose children (defined as those who never received a diphtheria-tetanus-pertussis [DTP] vaccine dose), progress towards GVAP targets, and the relationship between vaccine coverage and sociodemographic development. Findings By 2019, global coverage of third-dose DTP (DTP3; 81.6% [95% uncertainty interval 80.4-82 .7]) more than doubled from levels estimated in 1980 (39.9% [37.5-42.1]), as did global coverage of the first-dose measles-containing vaccine (MCV1; from 38.5% [35.4-41.3] in 1980 to 83.6% [82.3-84.8] in 2019). Third- dose polio vaccine (Pol3) coverage also increased, from 42.6% (41.4-44.1) in 1980 to 79.8% (78.4-81.1) in 2019, and global coverage of newer vaccines increased rapidly between 2000 and 2019. The global number of zero-dose children fell by nearly 75% between 1980 and 2019, from 56.8 million (52.6-60. 9) to 14.5 million (13.4-15.9). However, over the past decade, global vaccine coverage broadly plateaued; 94 countries and territories recorded decreasing DTP3 coverage since 2010. Only 11 countries and territories were estimated to have reached the national GVAP target of at least 90% coverage for all assessed vaccines in 2019. Interpretation After achieving large gains in childhood vaccine coverage worldwide, in much of the world this progress was stalled or reversed from 2010 to 2019. These findings underscore the importance of revisiting routine immunisation strategies and programmatic approaches, recentring service delivery around equity and underserved populations. Strengthening vaccine data and monitoring systems is crucial to these pursuits, now and through to 2030, to ensure that all children have access to, and can benefit from, lifesaving vaccines. Copyright (C) 2021 The Author(s). Published by Elsevier Ltd.Peer reviewe