KOORDINASI PELAYANAN KESEHATAN PENGUNGSI BENCANA GUNUNG MERAPI

Background: The eruption of Mount Merapi in Yogyakartahas caused dangerous impact to the people’s health. It is importantto provide a good health care services during emergencyresponse. Maguwoharjo is a shelter with the largestnumber of refugees, but health care staff are not well distributed.The coordination on health care service is important toovercome the health problems during emergency response.Aim: To describe effetiveness of coordination of care providedfor the refugees.Methods: This was a qualitative study using in-depth interviewsmethod to collect data. The informants were representativesfrom Yogyakarta provincial health office, Sleman districthealth office, primary health care center of Depok, NonGovernment Office/NGO, and former refugees. To ensure thevalidity of data, triangulation was carried out.Results: The coordination of health care service to refugeesis studied from its communication and organization. The communicationwas done by regular meetings in the morning andin the afternoon involving shelter’s coordinator, volunteer’scoordinator, and representative from both provincial and districthealth office. Not only by the regular meeting, but also byusing SMS gateway and skype (internet-based). There wasalso a hierarchial structure to organize all health care staffand their responsibilities during emergency response. Untilend of the evacuation, there was no outbreaks, incidence ofdisease was decreased, and infectious diseases were controlled.However, health care personels and adequate facilitieswere lacking, and standard operating procedure to providegood health services to refugees was not available.Conclusion: The coordination of health services for refugeesduring the emergency was effective but still needs toimprove information and use of SOP.Keywords: effectiveness, coordination, health care, refugee

Penemuan Kasus Tuberkulosis pada Pekerja Migran Indonesia

Indonesia menempati urutan ketiga dengan beban kasus TBC tertinggi di dunia dengan estimasi 824.000 kasus TBC pada tahun 2020. Pekerja migran adalah kelompok berisiko terkena TBC namun kasus TBC pada pekerja migran tidak diketahui dalam sistem surveilans TBC nasional.  Penelitian ini bertujuan untuk menjelaskan upaya penemuan kasus TBC pada pekerja migran pada tahapan sebelum bekerja dan masa tunggu Penelitian kualitatif dengan tipe Rapid Assessment Procedure. Pengumpulan data dilakukan dengan melakukan wawancara mendalam, diskusi kelompok, dan observasi ke sarana kesehatan pemeriksa calon PMI (CPMI), balai kesehatan kerja dan dinas kesehatan.Semua hasil wawancara direkam dan dibuatkan transkrip, kemudian dikelola, dikode, dan dianalisis. Data disajikan menggunakan analisis tematik  Skrining TBC di puskesmas belum sesuai Permenaker nomor 9 tahun 2019. Skrining TBC untuk menemukan kasus TBC sedini mungkin perlu diprioritaskan mengingat jumlah kasus TBC yang tinggi di Indonesia. Penemuan kasus TBC dapat dilakukan di sarana kesehatan pemeriksa CPMI (rumah sakit atau klinik), tempat penampungan dan Desmigratif. Penemuan kasus TBC pada PMI belum optimal pada tahapan sebelum bekerja dan masa tunggu. Hasil skrining TBC di puskesmas perlu diwajibkan sebelum pemeriksaan lebih lanjut di sarana kesehatan pemeriksa CPM

Experiences and Lessons from a Multicountry NIDIAG Study on Persistent Digestive Disorders in the Tropics.

<p>Experiences and Lessons from a Multicountry NIDIAG Study on Persistent Digestive Disorders in the Tropics</p

Diagnostic comparison of Baermann funnel, Koga agar plate culture and polymerase chain reaction for detection of human Strongyloides stercoralis infection in Maluku, Indonesia

Human infection with the nematode Strongyloides stercoralis, which may have a life-threatening course, primarily occurs in tropical settings. Epidemiological data on the occurrence of strongyloidiasis are scarce, and microscopic stool-based detection methods are insensitive. Polymerase chain reaction (PCR) assays have been developed, yet conflicting results have been reported. Our goal was to determine whether there was diagnostic agreement between an in-house PCR and two microscopic techniques, the Baermann funnel (BM) and the Koga agar plate culture (KAP) for the detection of S. stercoralis in stool samples. Eighty ethanol-fixed stool samples stemming from a cross-sectional survey in Maluku, Indonesia, were purposefully selected for PCR analysis. The final sample size comprised four groups, each with 20 samples: group 1, positive for S. stercoralis on both BM and KAP; group 2, positive only by BM; group 3, positive only by KAP; and group 4, negative on both BM and KAP. A Strongyloides-specific PCR targeting the internal transcribed spacer 2 (ITS2) region was carried out in an Indonesian reference laboratory. The overall agreement between PCR and microscopy was 61% (49/80 samples), being highest in group 1 (15/20, 75%) and lowest in group 3 (9/20, 45%). PCR revealed eight additional S. stercoralis infections in group 4. Future studies should elucidate the 'true' infection status of samples that are negative by PCR, but positive upon microscopy. Taken together, there is a lack of agreement between microscopy and PCR results for the diagnosis of human S. stercoralis infection in Indonesia. ClinicalTrials.gov (identifier: NCT02105714)

Diagnosis of neglected tropical diseases among patients with persistent digestive disorders (diarrhoea and/or abdominal pain ≥14 days) : Pierrea multi-country, prospective, non-experimental case-control study

Diarrhoea still accounts for considerable mortality and morbidity worldwide. The highest burden is concentrated in tropical areas where populations lack access to clean water, adequate sanitation and hygiene. In contrast to acute diarrhoea (>14 days), the spectrum of pathogens that may give rise to persistent diarrhoea (≥14 days) and persistent abdominal pain is poorly understood. It is conceivable that pathogens causing neglected tropical diseases play a major role, but few studies investigated this issue. Clinical management and diagnostic work-up of persistent digestive disorders in the tropics therefore remain inadequate. Hence, important aspects regarding the pathogenesis, epidemiology, clinical symptomatology and treatment options for patients presenting with persistent diarrhoea and persistent abdominal pain should be investigated in multi-centric clinical studies.; This multi-country, prospective, non-experimental case-control study will assess persistent diarrhoea (≥14 days; in individuals aged ≥1 year) and persistent abdominal pain (≥14 days; in children/adolescents aged 1-18 years) in up to 2000 symptomatic patients and 2000 matched controls. Subjects from Côte d'Ivoire, Indonesia, Mali and Nepal will be clinically examined and interviewed using a detailed case report form. Additionally, each participant will provide a stool sample that will be examined using a suite of diagnostic methods (i.e., microscopic techniques, rapid diagnostic tests, stool culture and polymerase chain reaction) for the presence of bacterial and parasitic pathogens. Treatment will be offered to all infected participants and the clinical treatment response will be recorded. Data obtained will be utilised to develop patient-centred clinical algorithms that will be validated in primary health care centres in the four study countries in subsequent studies. Our research will deepen the understanding of the importance of persistent diarrhoea and related digestive disorders in the tropics. A diversity of intestinal pathogens will be assessed for potential associations with persistent diarrhoea and persistent abdominal pain. Different diagnostic methods will be compared, clinical symptoms investigated and diagnosis-treatment algorithms developed for validation in selected="selected" primary health care centres. The findings from this study will improve differential diagnosis and evidence-based clinical management of digestive syndromes in the tropics.; ClinicalTrials.gov; identifier: NCT02105714

Principal elements of the NIDIAG digestive study and the respective standard operating procedures (SOPs) used.

<p>Principal elements of the NIDIAG digestive study and the respective standard operating procedures (SOPs) used.</p

Set of standard operating procedures (SOPs) used in the NIDIAG study on persistent digestive disorders.

<p>Set of standard operating procedures (SOPs) used in the NIDIAG study on persistent digestive disorders.</p