THE RELATIONSHIP OF BASIC CLINICAL STATUS WITH THE QUALITY OF LIFE OF HIV AND AIDS PATIENTS

Background: The success of individual antiretroviral drug (ARV) treatment in patients with human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) was determined by conducting a routine evaluation of the patients’ Cluster of Differentiation 4 (CD4) count. The indicators used to measure the success of the HIV and AIDS treatment were mortality, mobility, and quality of life (QoL). Purpose: The purpose of this research was to analyze the relationship between clinical status (smoking status, duration of ARV therapy, the CD4 count, and body mass index [BMI]) and the QoL of patients with HIV and AIDS who were stable during treatment. Methods: This type of research was quantitative analytical research with a cross-sectional design. This research was conducted at Dr. Soetomo Hospital, Surabaya, from September to November 2017. The study population was patients with HIV and AIDS in Dr. Soetomo Hospital, Surabaya. The research sample was taken by purposive sampling with the inclusion criteria being patients with HIV and AIDS who had been treated for ≥6 months with adherence ≥95% and who came directly to the hospital. Results: The majority of respondents were female (53.36%), junior/senior high school graduates (66.67%), married (62.22%), non-smoking (75.56%), had undergone ARV therapy for ±10 years (77.78%), and had a QoL in the adequate category (62.22%). The basic clinical status with a significant relationship with the respondents’ QoL were the CD4 count (p = 0.00) and BMI (p = 0.00). Conclusion: There was a relationship of the CD4 count and BMI with the QoL of the patients with HIV and AIDS

A Challenge of Universal Coverage to HIV/AIDS Outpatients

HIV/AIDS cases in East Java in 2016 were the largest (16.431) where the most AIDS cases took place in Indonesia. The National Health Insurance in Indonesia commenced on January 1, 2014. BPJS utilization for HIV/AIDS patients nowadays is still limited to inpatient service, whereas its utilization by the outpatients still reaches around 30%. The objective of this research was to analyze the level of BPJS utilization and its relationship with the level of HIV/AIDS outpatients’ adherence. The method in this research was quantitative descriptive with a cross-sectional design. This research taken place in Dr. Soetomo General Hospital, the tertiary referral hospital in Indonesia, and the higest HIV/AIDS referral ini East Indonesia. The population of this research was HIV/AIDS patients at Dr. Soetomo General Hospital Surabaya’s Outpatients. The sampling technique used was purposive sampling. The results of this research showed that there were 31.7% patients who used BPJS to receive outpatient service at Dr. Soetomo General Hospital and that there was a relationship between health costs affordability and the level of patients’ adherence. The respondents claimed that BPJS utilization was considered too demanding because there were tiers to benefit from it and which needed to be got through every month. It was expected that a particular policy on easy accessibility will be applied to get HIV/AIDS services from the hospit

Knowledge and Attitude on Human Immunodeficiency Virus among Migrant Worker Candidates in East Java, Indonesia

Background: In 2018, East Java province becomes the province with the highest number of Human Immunodeficiency Virus (HIV) cases in Indonesia with an incidence of more than 8,000 cases. This province has various groups of Indonesian Migrant Workers (Tenaga Kerja Indonesia, TKI) working in various sectors in different countries, making them prone to HIV infection. This study aimed to determine the level of knowledge and attitude towards HIV and Acquired Immune Deficiency Syndrome (AIDS) among migrant worker candidates in East Java.Methods: This was a cross-sectional descriptive study conducted in August 2018 in the Provincial Manpower and Transmigration Office of East Java, Indonesia. The knowledge and attitude towards HIV disease were assessed using a self-validated questionnaire distributed to 104 migrant worker candidates as the subjects of this study.Results: Eighty-nine percent of the subjects had good knowledge, while 98% of them had good attitudes towards HIV disease. Furthermore, 86% had good attitudes toward HIV transmission. However, no correlation was observed between the subjects’ level of knowledge and their attitude (p=0.334).Conclusions: In general, the level of knowledge and attitudes of migrant worker candidates in East Java towards HIV disease is good. Nevertheless, more knowledge and education on healthy behavior need to be envisaged for this group

Comparison of Increased Knowledge and Existence of Larvae Between Before and After Education in Primary School Guards In Mojokerto City

Introduction: Dengue fever is a tropical disease caused by Dengue virus that is still becoming one of the main health problem in Indonesia. Dengue fever patients are usually children with age ranging between 5-14 years old, that indicates a higher likelihood of infection at school compared to infection at home.The purpose of this study is to analyze the difference between knowledge and practice of DHF prevention and also the existence of larvae before and after education to the elementary school’s guard in Mojokerto. Methods: The research method used in this study is pre-experimental design method, which is a one group pretest and posttest study.The number of samples was 25 school guards from all elementary school in the urban villages with DHF cases in 2017. Results: The average correct answer at pretest was 58.9% while in posttest it was 80.9%. From the results of Wilcoxon test also obtained p-value 0.00 (<0.05). From observation before the education, one school was found positive with larvae, and after the education was given, all schools were found negative. Conclusion: There are differences in knowledge and practice prevention of dengue fever between before and after education in primary school guards in Mojokerto

The Correlation of Initial CD4 Cell Count with Increased Alanine Aminotransferase in Patients with Human Immunodeficiency Virus Who Have Received Nevirapine

Nevirapine is one of the most widely used antiretroviral drugs in developing countries. One of the current concerns is the high risk of hepatotoxicity associated with the use of Nevirapine in about 6-30% of patients and is the cause of discontinuation of antiretroviral therapy in 2-10% of patients due to severe liver disorders characterized by increased alanine aminotransferase (ALT). Hepatotoxicity in people with Human Immunodeficiency Virus (HIV) can be caused by many factors. Two mechanisms of nevirapine hepatotoxicity have been proposed. One of mechanisms is the immune-mediated hypersensitivity reaction that induces hepatotoxicity reactions that are thought to be associated with early CD4 counts. The aim of this study was to determine the correlation between initial CD4 count and elevated ALT levels in people infected with HIV who have received nevirapine for 3 months. This study was cross-sectional observational analytic research of 30 HIV-infected patients receiving nevirapine t reatment. Each patient was assessed for initial CD4 cell count and initial ALT levels before receiving nevirapine treatment. After 3 months of nevirapine treatment, ALT re-examination was performed to determine elevated alanine aminotransferase levels, then correlation analysis was performed using Spearman's test. Spearman's correlation test results found a negative correlation between initial CD4 count and elevated ALT levels but not was statistically significant (r = -0.107; p = 0.573). In the sub analysis, a positive correlation was found between initial ALT level and ALT level increase (r = 0.427; p = 0.019). Initial CD4 count was not correlated with elevated ALT levels in HIV-infected patients receiving Nevirapine-based ARVs

CRYPTOCOCCAL ANTIGENEMIA IN HIV/AIDS PATIENTS USING LATERAL FLOW IMMUNOASSAY DETECTION AT Dr. SOETOMO GENERAL HOSPITAL SURABAYA

Cryptococcus infection in HIV / AIDS patients results in cryptococcal meningitis, a major cause of subacute meningitis with 100% mortality if not receiving appropriate antifungal therapy. An examination of cryptococcal antigen will provide risk information for patients who will experience cryptococcal meningitis. Better diagnosis in asymptomatic and symptomatic phases of cryptococcosis are key components to reduce morbidity and mortality. This study aims to determine the proportion of cryptococcal antigenemia in HIV / AIDS patients treated at Intermediate Treatment-Infectious Diseases Unit of Dr. Soetomo General Hospital Surabaya. Cryptococcal antigenemia was examined in HIV / AIDS patients with suspected Cryptococcus infection and CD4+ T cell lymphocyte count <200 cell /μl. The examination used a lateral flow assay diagnostic tool, a simple FDA(Food and Drug Administration)-approved immunochromatographic test system for detection of capsular polysccharide antigens of Cryptococcus species complex (Cryptococcus neoformans and Cryptococcus gattii) in blood. This test meets all of the World Health Organization ASSURED criteria (affordable, sensitive, specific, user friendly, rapid/robust, equipment-free, and delivered). Sensitivity and specifiticy of this method from serum are both 100%. There were 3 positive cryptococcal antigenemia from 41 serum HIV / AIDS patients with suspected cryptococcus infection at Intermediate Treatment- Infectious Diseases Unit of Dr. Soetomo General Hospital Surabaya. All of these patients were male aged over 36 years, had CD4+ T cell lymphocytes <100 cell /μl and had never received antiretroviral therapy before. The proportion of cryptococcal antigenemia in HIV / AIDS patients with suspected Cryptococcus infection at Intermediate Treatment-Infectious Diseases Unit of Dr. Soetomo General Hospital Surabaya was 7.32%. Keywords: cryptococcal antigenemia, AIDS, HIV, Dr. Soetomo Hospital, Surabay

Correlation Between Level of Soluble Fas and Degree of Sepsis Severity Based On Apache II Score

A widely used scoring system to assess the severity of sepsis is Acute Physiology, Age, and Chronic Health Evaluation (APACHE) II scoring system, however there are some disadvantages in using this. Other parameters are needed to predict severity and outcome of sepsis. Proinflammatory cytokines and Fas receptors are increased in sepsis and their concentration elevations are correlated with disease severity. An increase of soluble Fas level will follow increasing Fas receptors. This study aimed to prove any correlation between the level of soluble Fas and degree of sepsis severity based on APACHE II score. A cross-sectional observational study was conducted in January-June 2015 on 30 septic patients. APACHE II scores were calculated from the patients’physiological data, age, and chronic health problem status. Levels of soluble Fas were measured using the ELISA method (Human FAS/ CD95 (Factor-Related Apoptosis) ELISA Kit, Elabscience Biotechnology). Levels of soluble Fas ranged between 1,049-2,783 pg/mL (1,855.7 ± 477.27 pg/mL). APACHE II scores varied between 4-29 (17.2 ± 5.82). Significant positive correlations between levels of soluble Fas and APACHE II score (r=0.347, p=0.03) were found. A prediction model of soluble Fas levels based on APACHE II score was made. Linear regression analysis produced a prediction model of soluble Fas levels based on APACHE II score, in which soluble Fas level= 1,365.8 + 28.485 x APACHE II score

Asupan Vitamin A, C, E, Dan IMT (Indeks Massa Tubuh) Pada Lansia Hipertensi dan Non Hipertensi Di Puskesmas Banyu Urip, Surabaya

Background: Hypertension is a non-comunicable disease that easy found in ederly. Dietary intake had an important role as prevent and manage hypertension. Objectives: The objective of this study was to invistigate correlation of dietary intake of vitamins A, C, E and Body Mass Index (BMI) with hypertension among ederly at Puskesmas Banyu Urip Surabaya. Methods: This study was observational that uses case-control desain. Samples calculated according Lemeshow formula amount of 32 respondent (total case and control). This study was held in July until August 2018. Statistical analysis use Chi Square. Results: The result showed that most of subjects were 66-70 years old, woman (87.5%), who had education history primary school (37.5%), and work as house wife (71.9%). Most of subject had adequate vitamin A (96.9%), inadequate vitamin C (87.5%) and inadequate vitamin E (100%). BMI most subject was normal (59.4%). This study demostrated that there was no significant correlation between vitamin C intake and hypertension (OR=3.462; 95% CI=0.32-37.473; p=0.300), and no significant correlation between BMI and hypertension (OR=0.455; 95% CI=0.18-1.921; p=0.236). Averange intake of vitamin A in respondent hypertension was 1301.02±407.84 ug and 1968.03 ±407.84 ug in respondent with normo tension. Averange intake of vitamin E in respondent hypertension was 3.06 ±1.2 mg and 3.34 ±1.23 mg in respondent with normo tension. Conclusions: There was no significant correlation between dietary intake vitamin C and BMI with hypertension. Averange intake of vitamin A, C, and E was better in respondent with normo tension. ABSTRAK Latar Belakang: Hipertensi merupakan penyakit tidak menular dan mudah ditemui pada usia lansia. Asupan makanan memegang peranan penting dalam mencegah dan penatalaksanaan hipertensi. Tujuan: Penelitian ini bertujuan untuk mengetahui hubungan antara asupan vitamin A, C, E dan IMT dengan hipertensi pada lansia di Puskesmas Banyu Urip Surabaya. Metode: Penelitian ini menggunakan metode observasional dengan desain case control. Sampel penelitian ini dihitung sesuai dengan rumus Lemeshow yakni sebesar 32 responden (total kelompok kasus dan kontrol). Penelitian ini dilakukan pada bulan Juli hingga bulan Agustus 2018. Analisis statistik yang digunakan uji Chi Square. Hasil: Sebagian besar responden berusia 66-70 tahun, berjenis kelamin wanita (87,5%), riwayat pendidikan terakir SD sederajat (37,5%), dan berkerja sebagai ibu rumah tangga (71,9%). Tingkat kecukupan vitamin A sebagian besar baik (96,9%). Tingkat kecukupan vitamin C sebagian besar kurang (87,5%). Tingkat kecukupan vitamin E kurang (100%). IMT sebagian besar responden normal (59,4%). Tidak terdapat hubungan yang signifikan antara asupan vitamin C dengan hipertensi (OR=3,462; 95% CI=0,32-37,473; p=0,300) dan tidak terdapat hubungan yang signifikan IMT dengan hipertensi (OR=0,455; 95% CI=0,18-1,921; p=0,236). Rata-rata asupan vitamin A pada responden hipertensi sebesar 1301,02 ±407,84 ug dan pada tekanan darah normal 1968,03 ±956,67 ug. Rata-rata asupan vitamin E  pada responden hipertensi sebesar 3,06 ±1,2 mg dan pada tekanan darah normal sebesar 3,34 ±1,23 mg. Kesimpulan: Asupan vitamin C dan IMT tidak berhubungan signifikan dengan kejadian hipertensi. Rata-rata asupan vitamin A, C, dan E lebih besar pada responden kelompok tekanan darah normal