Spatial Patterns Associating Low Birth Weight with Environmental and Behavioral Factors

Low birth weight (LBW) is a significant public health problem in the world. It was estimated globally by the World Health Organization (WHO) that prevalence of LBW was 15% of all births. In Murung Raya district LBW cases remain high. This paper aimed to identify and discuss the relationship between environmental risk factors with LBW in Murung Raya.A spatial analysis was conducted with 150 women as the total participantswho were recruited through the incidence data in 2013-2014. The questionnaires, medical records, and geographic data were measured by Stata software, ArcGis, SatScan, and Geoda. The study results indicated there was significant correlation between health behavior and environmental variables with the strength of external neighborhood effect across LBW risk factors. More intense clustering of high values (hot spots) was found through the spatial analysis showing that most of the cases were located near the defined buffer zone. This research demonstrates that the spatial pattern analysis provided greater statistical power to detect an effect that was not apparent in the previous epidemiology studies

Dampak infeksi nosokomial luka operasi terhadap biaya perawatan di Unit Kebidanan dan Kandungan RSU Sleman tahun 1992/1993

Nosocomial postoperative wound infection is a combined clinical and managerial problem. This report discusses the impact of nosocomial postoperative wound infection on the cost of hospitalization, in the Obstetric and Gynecologic unit, Sleman General Hospital in 1992/1993. There are two methods of nosocomial postoperative wound infection examination used in this study, namely: (1) comparative analysis among infected with uninfected and (2) subjective comparison study. The result of the first method showed a total cost increase of Rp. 74,877.00 and subjective comparison yielded total cost increase of Rp. 3,112,371.80. Based on the diagnosis, the additional cost of nosocomial infection is as follows: (1) for Cephalopelvic DisproportionRp. 224,081.61(2) for twin pregnancy, premature rupture of membranes, and prolonged pregnancyRp 290,457.09(3) for uterine myoma (30 hospital days), the additional cost of nosocomial infection is Rp 513,564.66(4) for premature rupture of membrane, and fetal distress, Rp. 75,793.87(5) for malignant neoplasm of ovaryRp. 328,838.70(6) for malignant neoplasm of uterine cervix, Rp. 374,326.44(7) for premature rupture of membranes, prolonged first stage and failure of vacuum extraction, the additional cost of nosocomial infection is Rp. 251,563.22(8) for premature rupture of membranes, failure of induction of labor by medical methods and fetal distress, Rp. 177,619.35(9) for uterine myoma (12 hospital days), 876,126.86. It is recommended, therefore, that nosocomial infection control committee should be established in Sleman General Hospital. The Committee will assist the hospital director in planning, implementing, monitoring and evaluating nosocomial infection control activities. A social marketing program to improve aseptic techniques, the use of appropriate antiseptic and the maintenance of sterility in the operating room should be implemented so that nosocomial infection can be prevented and may reduce the cost of hospital care. Key words: nosocomial infection - post operative wound infection - cost of treatment - comparative analysis - subjective comparison Infeksi nosokomial luka operasi merupakan masalah klinis dan manajerial. Tulisan ini merupakan laporan penelitian deskriptif yang membahas dampak infeksi nosokomial luka operasi terhadap biaya perawatan di Unit Kebidanan dan Kandungan Rumah Sakit Umum Sleman tahun 1992/1993. Penelitian infeksi nosokomial luka operasi ini dilakukan dengan 2 cara yaitu: dengan cara studi perbandingan antara infeksi dengan yang tidak infeksi dan dengan cara perbandingan subjektif atau kasus per kasus dengan metode Drummond dan double distribution. Hasil penelitian ini menunjukkan bahwa dengan cara studi perbandingan terdapat kenaikan biaya rawat yang ditanggung pasien sebesar Rp. 74.871,00. Sedangkan dengan perbandingan pasien dan RSU sebesar Rp. 3.112.371,80. Hasil lain berdasarkan perbedaan diagnosis penyakit, tambahan biaya akibat infeksi nosokomial untuk masing-masing diagnosis adalah sebagai berikut: (1) Disproporsi Kepala Panggul, Rp. 224.081,61(2) Kembar, Ketuban Pecah Dini, Serotinous, Rp. 290.457,08(3) Myoma Uteri (30 hart rawat), Rp. 513.564,66(4) Ketuban Pecah Dini, Ancaman Fetal Distress, Rp. 75.793,87(5) Carcinoma Ovarium, Rp. 328.837,7(6) Carcinoma cervix, Rp.374.326,44(7) Ketuban Pecah Dini, Kala I Lama, Ekstraksi vacum

Aktivitas Fisik dan Konsumsi Camilan pada Remaja Obesitas

Tujuan: Penelitian ini untuk mengetahui adanya perbedaan aktivitas fisik dan konsumsi camilan pada remaja obesitas di desa dan kota di Bantul.Metode: Penelitian ini menggunakan rancangan penelitian case control, dengan populasi remaja sekolah menengah atas (SMA) negeri di Kabupaten Bantul. Kasus adalah remaja yang didiagnosis obesitas pada tahap skrining, sedangkan kontrol adalah remaja dengan berat badan normal. Analisis data meliputi univariabel yang menyajikan distribusi frekuensi, bivariabel dengan uji chi-square dan uji-t dan mulitivariabel dengan uji regresi logistik.Hasil: Remaja dengan aktivitas fisik ringan memiliki peluang hampir 5 kali lebih besar mengalami obesitas dibandingkan remaja dengan aktivitas fisik sedang (OR 4,96 (CI 95%:2.14 -11.63). Hubungan antara jenis camilan dan obesitas juga memiliki hubungan yang bermakna secara statistik dan praktis, yaitu obesitas banyak di temukan sebanyak 2 kali lebih besar pada remaja dengan konsumsi camilan goreng dibandingkan dengan remaja yang mengkonsumsi camilan non goreng.Kesimpulan: Terdapat perbedaan rerata berat dan asupan camilan pada remaja obesitas dan non obesitas. Aktivitas fisik ringan, frekuensi camilan tinggi, jenis camilan gorengan, berat camilan dan asupan camilan tinggi berpeluang lebih besar meningkatkan obesitas remaja

Paramater on Maternal Delivery Referral Process

Introduction: The rate of maternal mortality in Indonesia according to 2002–2003 Indonesian Demographic and Health Survey (IDHS) was 307 per 100,000 live births. The direct causes of maternal deaths, among others, are prolonged labor, hemorrhage, infection, and preeclampsia. Referral system includes referring responsibility to better facilitated healthcare sites to obtain more adequate services. However, maternal referral process in Banjar District still faces some problems such as referral health providers with inadequate skills of handling emergency cases, insufficient means of transportation, and no referral letter or partograph. Usually, when referred, the pregnant woman is only accompanied by her family so that she is brought to the referral site without being equipped with infusion. The objective of the study was to evaluate the parameter of maternal delivery referral in Ratu Zalekha Martapura District Hospital. Method: This study used observational study with a cross-sectional study design using quantitative and qualitative approaches. Samples were 107 delivering women referred to hospitals selected with non probability sampling. Data were analyzed with Chi-square (χ) and logistic regression test. Result: Quality maternal referral process resulted in healthy women 78.8%. Post delivery women's health was greater in quality maternal referral process (RP = 2.1; 95% CI = 1.28–3.52). Normal delivery had an opportunity towards post delivery women's health (RP = 1.6; 95% CI = 1.13–2.20). In addition, time needed to reach the referral sites and referral birth attendants were significantly associated with maternal referral process (p = 0.002 and p = 0.002). Meanwhile, women's condition when referred was insignificant statistically. Discussion: Quality maternal referral process could likely improve post delivery women's health.Normal delivery affected the women's health condition

Faktor yang Memengaruhi Partisipasi Ibu Hamil Melakukan Skrining HIV di Puskesmas YOGYAKARTA

Factors affecting pregnant women's participation in HIV screening test in public health care centers of YogyakartaPurposeThis study aimed to explore the behavioral factors that influence pregnant women's participation in HIV testing in public health centers of Yogyakarta. MethodsThis research used quantitative and qualitative methods with a quantitative analytical descriptive design and cross-sectional observational approach to determine any association between independent variables and the dependent variable. Qualitative in-depth interviews were conducted to support the results of the quantitative research. ResultsResults showed 92.94% of respondents had been HIV tested with an average age of 25-34 years. Almost all pregnant women had an HIV test in a clinic although not all mothers have the knowledge, perceived susceptibility, perceived severity, and perceived benefits. While the exposure information, and support of health workers were high, and there was a perception of low resistance, since the HIV test is a test done by health workers and an initiative of the government program. ConclusionThis study recommends that counseling and information on HIV and HIV testing from health workers and support from related agencies are needed. Subsequent research could examine factors that affect healthcare workers' performance in providing education to health-care users

Hubungan antara Homosistein dan Nitrit Oksid pada Hipertensi Esensial di Jawa Tengah, Indonesia

Background: The essential hypertension has been related to endothelium-dependent vasodilatation disorders that result of decreasing of nitric oxide (NO) bioavailability. Decreasing of NO can be caused by increase of homocysteine level.Objective: This study is aimed at finding out the effect of homocysteine level on nitric oxide level in essential hypertension, and relationship between NO and blood pressure and hypertension risk in Central Java.Method: This study was case-control nested, in “Surveillance of Non-Communicable Diseases” in Purworejo, Central Java. The subjects were men with essential hypertension and 20-60 years old that had normal value of urine creatinine, blood glucose, cholesterol and triacylglycerol. They didn\u27t take antihypertension drugs. The methods of Pfeiffer, et al. was used to identify total plasma homocysteine level. NO level was determined by Nitric Oxide Colorimetric Assay Kit (BioVision Cat.K262200).Result: The homocysteine level of the hypertension is higher than that of the non- hypertension (16.15 + 12.69 vs 12.73 + 5.73; P=0.035), whereas the nitric oxide level of the hypertension is lower than that of the non-hypertension (8.22 + 1.88 vs 9.49 + 3.05; P=0.003). Homcysteine level was significantly correlated with nitric oxide level (P=0,016). Negative correlation between nitric oxide level and systolic and diastolic pressures was significant (P=0,005; P=0,045), respectively in subjects of 40-60 years old but not significant (P=0,106; P=0,269), respectively in those younger (20-39 years old). The relationship between nitric oxide and hypertension risk was significant (P=0,005) in subjects of 40-60 years old but not significant (P=0,062) in those younger (20-39years old).Conclusion: The high homocysteine level is a risk factor of hypertension, that reduces the NO bioavailability. The reducing of NO bioavailability was related to increase of blood pressure and hypertension risk, especially it was in the old men

Kasus Hipertensi pada Kehamilan di Indonesia

Latar Belakang: Hipertensi dalam kehamilan (HDK) merupakan kelainan vaskular yang terjadi sebelum kehamilan atau timbul dalam kehamilan atau pada masa nifas. Lebih dari 30% kematian maternal di Indonesia disebabkan oleh HDK. HDK merupakan penyebab utama morbiditas dan mortalitas maternal, fetal dan neonatal. Gambaran etiologi HDK masih belum jelas, sehingga kelainan ini sering dikenal the diseases of theory. Upaya dini untuk mengidentifikasi hipertensi dalam kehamilan dapat dilakukan dengan mengetahui faktor risiko hipertensi baik yang dapat diubah (modifiable) yaitu perilaku sehat & yang tidak bisa diubah (nonmodifiable) seperti faktor risiko yang melekat pada ibu. Penelitian ini bertujuan untuk mengkaji faktor risiko gangguan hipertensi dalam kehamilan di Indonesia. Metode: Penelitian ini merupakan jenis penelitian observasional analitik dengan menggunakan rancangan cross-sectional. Pengambilan sampel dilakukan dengan teknik consecutive sampling dan berasal dari 447 kabupaten dan 33 propinsi di Indonesia. Subjek penelitian adalah seluruh ibu hamil yang menjadi sampel Riskesdas tahun 2013 yang berusia 15-54 tahun dengan jumlah 9.024 ibu hamil. Chi-square dan binomial regression digunakan untuk menghitung pengaruh faktor risiko HDK dengan melihat nilai rasio prevalensi (RP). Hasil: Prevalensi hipertensi ibu hamil sebesar 6,18% (558 orang) setelah disesuaikan dengan variabel luar yang berpotensi sebagai confounder. Jumlah hipertensi paling banyak di Propinsi Jawa Barat yaitu 59 ibu hamil (10,57%). Overweight dan hipertensi kronik berhubungan terhadap gangguan hipertensi dalam kehamilan dengan RP: 2,13 (95%CI 1,80-2,51) pada overweight dan RP: 4,36 (95%CI 3,61-5,26) pada hipertensi kronik. Penggunaan alat kontrasepsi bukan merupakan faktor risikoterhadap gangguan hipertensi di Indonesia RP 0,92 (95%CI 0,76-1,10). Kesimpulan: Overweight dan hipertensi kronik merupakan faktor risiko kejadian gangguan hipertensi dalam kehamilan di Indonesia. Ibu hamil diharapkan dapat menjaga berat badan ideal yang dianjurkan pada masa gestasi dan lebih mewaspadai risiko yang dapat meningkatkan kejadian hipertensi dalam kehamilan seperti riwayat hipertensi kronik