Managing Seasonal Influenza: Oseltamivir Treatment Policy in Indonesia?

To manage cases of avian influenza A/H5N1 virus infection and in anticipation of a pandemic triggered by this virus, Indonesia purchased and distributed oseltamivir to the government health facilities. Oseltamivir is an antiviral drug that was developed for the treatment of influenza infections. Disease surveillance and research suggests that seasonal influenza (A/H1N1, A/H3N2 or B) results in considerable morbidity and mortality in Indonesia, where over 15% of influenza-like illness and severe acute respiratory illness patients test positive for the influenza virus. Indonesia currently limits oseltamivir for the management of avian influenza A/ H5N1cases and in anticipation of a pandemic triggered by the A/H5N1 virus. We present the evidence for the use of oseltamivir in the treatment of seasonal influenza infections so that doctors have the option to prescribe the drug. We propose that the benefits of this approach will largely outweigh the risk of antiviral resistance. We recommend that oseltamivir be available for administration to patients with seasonal influenza infections especially for those hospitalized and for groups with high risk of complications and adverse outcomes. Overall, this will reduce morbidity and mortality of seasonal influenza.Key words: antiviral, policy, Indonesia, influenza, treatment

Semarang waterfront city is a unique ecosystem with a great variety of potentialities as well as problems in the utilization of natural resources, particularly in the trade-off between economic growth and ecological preservation. Based on those conditions, the research is mainly focused upon designing some scenarios on environmental management, which ensure a profitable synergy of all stakeholders without sacrificing the principles of environmental conservation. Secondly, it is to design an interaction model among variables in the bio-physic, economy and social subsystems, in order to increase sources of learning and sustainable use of natural resources. Using a dynamic system, the main inputs of the designed model are the feasibility of natural resources management as a product of extended cost-benefit analysis (ECBA), the suitable option of natural resources management, as an input of comparative performance index (CPI), the integrated sustainability of using multidimensional scaling, the suitable land-use planning through geographic information system (GIS). From those main inputs the waterfront city environmental management policy can be observed as an output of analytical hierarchy processes (AHP). The feasibility study shows that all of natural resources management options are feasible to be developed, where sustainable management, sustainable harvest and beach protected areas depict the most feasible management options. Based on the results of the integrated sustainability research using multidimension scaling, the management of waterfront cities has to prioritize attention to the five important factors, i.e., (1) the issues of community empowerment; (2) the rate of land utilization; (3) the contribution of the industrial sector; (4) the availability of electricity and; (5) the availability of community organizations. Key words: sustainable environmental management, coastal and marine zone, dynamic and spatial dynamic system, waterfront policy strategy

Semarang waterfront city is a unique ecosystem with a great variety of potentialities as well as problems in the utilization of natural resources, particularly in the trade-off between economic growth and ecological preservation. Based on those conditions, the research is mainly focused upon designing some scenarios on environmental management, which ensure a profitable synergy of all stakeholders without sacrificing the principles of environmental conservation. Secondly, it is to design an interaction model among variables in the bio-physic, economy and social subsystems, in order to increase sources of learning and sustainable use of natural resources. Using a dynamic system, the main inputs of the designed model are the feasibility of natural resources management as a product of extended cost-benefit analysis (ECBA), the suitable option of natural resources management, as an input of comparative performance index (CPI), the integrated sustainability of using multidimensional scaling, the suitable land-use planning through geographic information system (GIS). From those main inputs the waterfront city environmental management policy can be observed as an output of analytical hierarchy processes (AHP).  The feasibility study shows that all of natural resources management options are feasible to be developed, where sustainable management, sustainable harvest and beach protected areas depict the most feasible management options.  Based on the results of the integrated sustainability research using multidimension scaling, the management of waterfront cities has to prioritize attention to the five important factors, i.e., (1) the issues of community empowerment; (2) the rate of land utilization; (3) the contribution of the industrial sector; (4) the availability of electricity and; (5) the availability of community organizations. Key words: sustainable environmental management, coastal and marine zone, dynamic and spatial dynamic system, waterfront policy strateg

Semarang waterfront is a unique ecosystem which has a variety potentialities and problem of using some natural resources, especially in the trade-off between economic growth and ecological preservation. Generally the handling operation of waterfront city in Indonesia is not effective, caused by (1) low budged and increase the poverty; (2) over loaded investment; (3) destroyed of ecology and ecosystem; (4) the lost of local wisdom; and (5) other problem in commonly urban city. Based on these conditions, this research aimed to design an environmental management policy ensuring a profitable synergy of all stakeholders without sacrificing the principles of environmental conservation. The objective of this study was to analyze the index and sustainability status of the Semarang waterfront area, based on five sustainable dimensions. Secondary data resources have been used from literature study and references, primary data have been received from questionairy feedback and expert judgement survey. The analysis used multi dimensional scalling (MDS) method, called Rap-WITEPA, and the results were stated in the index and sustainability status.The second objective was to analyze the attributes that affect sensitivity on index and sustainability status and the effect of error using Laverage and Monte Carlo Analysis. The result of this study show that ecological dimension was in the status of less sustainable (49,34), economical dimension was sufficient sustainable (53,96), socio-culture dimension was sufficient sustainable (52,21), dimension of infrastructure and technology was sufficient sustainable (56,72) and dimension of law & institutional was the highest sufficient sustainability value index (57,19). Out of 94 attributes analyzed, there were 50 attributes need to be handled immediately as they affect sensitivity on the increase of index and sustainability status with negligible error in the level of 95% confidence limit. It was concluded that an important factor of waterfront city handling operation design in Semarang is social community development, land use efficiency, industry contribution, electricity, and local society organization. Key words: sustainability index, sustainability status, waterfront city

Semarang waterfront is a unique ecosystem which has a variety potentialities and problem of using some natural resources, especially in the trade-off between economic growth and ecological preservation.  Generally the handling operation of waterfront city in Indonesia is not effective, caused by (1) low budged and increase the poverty; (2) over loaded investment; (3) destroyed of ecology and ecosystem; (4) the lost of local wisdom; and (5) other problem in commonly urban city.  Based on these conditions, this research aimed to design an environmental management policy ensuring a profitable synergy of all stakeholders without sacrificing the principles of environmental conservation.  The objective of this study was to analyze the index and sustainability status of the Semarang waterfront area, based on five sustainable dimensions.  Secondary data resources have been used from literature study and references, primary data have been received from questionairy feedback and expert judgement survey.  The analysis  used multi dimensional scalling (MDS) method, called Rap-WITEPA, and the results were stated in the index and sustainability status.The second objective was to analyze the attributes that affect sensitivity on index and sustainability status and the effect of error using Laverage and Monte Carlo Analysis.  The result of this study show that ecological dimension was in the status of less sustainable (49,34), economical dimension was sufficient sustainable (53,96), socio-culture dimension was sufficient sustainable (52,21), dimension of infrastructure and technology was sufficient sustainable (56,72) and dimension of law & institutional was the highest sufficient sustainability value index (57,19).  Out of 94 attributes analyzed, there were 50 attributes need to be handled immediately as they affect sensitivity on the increase of index and sustainability status with negligible error in the level of 95% confidence limit.  It was concluded that an important factor of waterfront city handling operation design in Semarang is social community development, land use efficiency, industry contribution, electricity, and local society organization.   Key words: sustainability index, sustainability status, waterfront cit

Short Report: Hepatitis B Infection and Severe \u3ci\u3ePlasmodium Falciparum\u3c/i\u3e Malaria in Vietnamese Adults

We investigated the prevalence of infection with hepatitis B virus among adult Vietnamese patients hospitalized for severe Plasmodium falciparum malaria. Sera from patients admitted with severe malaria in Ho Chi Minh City, Vietnam, between May 1991 and January 1996 were assayed for hepatitis B surface antigen (HBsAg) by a commercial enzyme-linked immunosorbent assay kit. The overall prevalence of HBsAg was 23.77% (77 of 324). This was higher than reported estimates of prevalence in the general catchment population for the study hospital (mean, 9.8%; range, 9–16%). No association was found between risk of death caused by severe malaria and HBsAg. Patients admitted with cerebral malaria had a slightly greater risk of registering positive for HBsAg (relative risk, 1.28; 95% confidence interval, 1.04–1.58) relative to other manifestations of severe malaria. Chronic infection with hepatitis B virus may be a risk factor for severe malaria

Evaluation of Diagnostic Assays for Hepatitis E Virus in Outbreak Settings

Hepatitis E virus (HEV) is a major cause of hepatitis. We evaluated five HEV antibody diagnostic assays by using outbreak specimens. The Abbott immunoglobulin G (IgG), Genelabs IgG, and Walter Reed Army Institute of Research (WRAIR) IgM assays were about 90% sensitive; the Abbott IgG and WRAIR total Ig and IgM assays were more than 90% specific