Associations of Contact History, Smoking Status, Nutrition Status, and Arv Treatment, with Tb-Hiv Co-Infection among People with Hiv/Aids

Background: Tuberculosis (TB) and HIV co-infection causes a heavy burden on health care systems and poses particular diagnostic and therapeutic challenges. Studies into predictors of TB-HIV co-infection is lacking in Indonesia. This study aimed to examine the associations of contact history, smoking status, nutrition status, and ARV treatment, with TB-HIV co-infection among people with HIV/AIDS. Subjects and Method: This was a cross sectional study conducted in Balige, North Sumatera. A sample of 82 people living with HIV/AIDS were selected for this study, comprising 41 cases with and 41 controls without TB-HIV co-infection. The dependent variable was TB-HIV co-infection. The independent variables were contact history, smoking status, nutrition status, and ARV treatment. The data on HIV/AIDS co-infection were taken from the medical record at HKBP Committee HIV/AIDS service in Balige. Other variables were measured by questionnaire. Data were analyzed by multiple logistic regression. Results: 82.9% of sample had no contact history, 56.1% had poor nutrition status, 78% were smokers, and 58.5% had irregular ARV treatment. TB-HIV coinfection increased with poor nutrition status (OR= 3.48; p= 0.014), smoking status (OR= 3.39; p= 0.021), and irregular ARV treatment (OR= 10.16; p<0.001). Conclusion: TB-HIV co-infection increases with poor nutrition status, smoking status, and irregular ARV treatment. Keywords: TB-HIV co-infection, nutrition status, smoking status, ARV treatment

Multiple Sexual Partners, Condom Use, and Their Associations with Hiv Infection among Man Who Have Sex with Man in Medan

Background: Human Immunodeficiency Virus (HIV) continues to be a major global public health issue, having claimed more than 35 million lives so far. In 2017, 940 000 people died from HIV-related causes globally. There were approximately 36.9 million people living with HIV at the end of 2017 with 1.8 million people becoming newly infected in 2017 globally. Key populations are groups who are at increased risk of HIV irrespective of epidemic type or local context. They include: men who have sex with men, people who inject drugs, people in prisons and other closed settings, sex workers and their clients, and transgender people. This study aimed to examine multiple sexual partners, condom use, and their associations with HIV infection among man who have sex with man (MSM) in Medan, North Sumatera. Subjects and Method: This was a case control study conducted at puskesmas (community health centre) Teladan in Medan, North Sumatera, in May 2018. A sample of 96 MSM was selected for this study. The dependent variable HIV infection. The independent variables were multiple sexual partners and condom use. The HIV status was taken from the medical record. The other data were collected by questionnaire. The data were analyzed by a multiple logistic regression. Results: Multiple sexual partners (OR= 2.93; 95% CI= 1.25 to 6.86; p= 0.022) and no condom use (OR= 2.83; 95% CI= 1.23 to 6.52; p= 0.024) were associated with an increased risk of HIV. Conclusion: Multiple sexual partners and no condom use are associated with an increased risk of HIV. Keywords: HIV, multiple sexual partners, condom use, men who have sex with me

Spatial Analysis and Risk Factors of Tuberculosis in Dairi District, North Sumatera

Background: In 2016, Dairi district ranked tenth highest incidence of tuberculosis (TB) in North Sumatera. Sidikalang sub-district was the main contributor of the incidence. This study aimed to conduct spatial analysis and to determine risk factors of lung TB in Dairi district, North Sumatera. Subjects and Method: This was a case control study carried out in Sidikalang sub-district, Dairi district, North Sumatera. A sample of 116 subjects were selected for this study consisting of 58 lung TB cases and 58 controls. The dependent variable was incidence of lung TB. The independent variables were nutritional status and smoking. Data on lung TB status was taken from the medical record. The other data were collected by questionnaire. The data were analyzed by a spatial analysis and a multiple logistic regression. Results: There was a lung tuberculosis cluster in Sidikalang sub-district, North Sumatera, with cluster center located at 2.739740 North Longitude, 98.324160 East Longitude. Poor nutritional status (OR= 19.91; 95% CI= 6.99 to 56.77; p<0.001) and smoking (OR= 3.72; CI= 1.11 to 12.82; p= 0.037) were associated with an increased risk of lung TB. Conclusion: Poor nutritional status and smoking are associated with an increased risk of lung TB. Keywords: lung tuberculosis, nutritional status, smoking, cluster, spatial analysi

The Effects of Smoking and Dyslipidemia on Coronary Artery Disease among Women at Dr. Pirngadi Hospital, Medan, North Sumatera

Background: Coronary artery disease (CAD), also known as ischemic heart disease, is the most common type of heart disease. Globally, CAD is the leading cause of death and is predicted to remain so for the next 20 years. Each year, approximately 3.8 million men and 3.4 million women die from CAD. In 2020, it is estimated that this disease will be responsible for a total of 11.1 million deaths globally. This study aimed to examine the effects of smoking and dyslipidemia on CAD among women at Dr. Pirngadi hospital, Medan, North Sumatera. Subjects and Method: This was a case control study conducted at Dr. Pirngadi General Hospital, Medan, North Sumatera. A sample 124 women ≤45 years of age was selected in this study. The dependent variable was coronary artery disease. The independent variables were smoking and dyslipidemia. The CAD and dyslipidemia data were obtained from the medical record. The smoking data were collected by questionnaire. The data were analyzed by a multiple logistic regression. Results: The risk of coronary artery disease increased with smoking (OR= 3.76; 95% CI= 1.66 to 8.53; p= 0.002) and dyslipidemia (OR= 5.32; 95% CI= 2.31 to 12.22; p< 0.001). Conclusion: The risk of coronary artery disease increases with smoking and dyslipidemia. Keywords: coronary artery disease, smoking, dyslipidemi

The Associations of Duration of Exposure and Tenure with Urine Hippuric Acid Level among Workers at Printing Industry in Medan, North Sumatera

Background: Hippuric acid has been recognized for many decades as a constituent of the urine. In addition, hippuric acid in 24-hour urine collections is a potential biomarker for fruit and vegetable consumption. As previous studies have shown, fasting plasma hippuric acid significantly increased after a 12 week healthy diet enriched in bilberries, whole grain products and fatty fish compared to a control group, while no changes occurred in a whole grain enriched diet group. This study aimed to estimate the associations of duration of exposure and tenure with hippuric acid level among workers at printing industry in Medan, North Sumatera. Subjects and Method: This was a cross sectional study conducted at printing industry in Medan, North Sumatera. A total of 16 workers were selected for this study. The dependent variable was urine hippuric acid level. The independent variables were duration of exposure and tenure. The correlations between urine hippuric acid and duration of exposure and tenure were measured by Pearson correlation coefficient (r). Results: Urine hippuric acid level decreased with duration of exposure (r= -0.25; p= 0.047) and tenure (r= -0.19; p= 0.002). Conclusion: Urine hippuric acid level decreases with duration of exposure and tenure. Keywords: urine hippuric acid, duration of exposure, tenure

Effectiveness of Persuasive Communication Training for Tuberculosis Drug Supervisors in Medan, North Sumatera

Background: Adherence to tuberculosis (TB) treatment is crucial to achieving cure while avoiding the emergence of drug resistance. Directly observed treatment (DOT) means that a supervisor watches the patient swallowing the tablets. This ensures that a TB patient takes the right drugs, in the right doses, at the right intervals. DOT is applicable in outpatient settings. The supervisor may be a health worker or a trained and supervised member of the community. The effectiveness of drug supervision may be enhanced by improving the supervisor’s knowledge, attitude, and skill in persuasive communication so as to enhance patients adherence to TB treatment. This study aimed to determine the effectiveness of training on persuasive communication among TB drug supervisors in Medan, North Sumatera. Subjects and Methods: This was a quasi experiment (non-randomized) before and after with no control design conducted at Puskesmas (Community Health Center), Medan, North Sumatera. A sample of 18 drug supervisor was selected for this study. The dependent variable was knowledge and attitude about persuasive communication. The independent variable was training on persuasive communication. The data were collected by questionnaire before and after training. The data before and after training were compared and tested by Wilcoxon test. Results: Both scores of knowledge and attitude in persuasive communication after training were higher than before training, and they were statistically significant. Conclusion: Training is effective to improve knowledge and attitude in persuasive communication among TB drug supervisors. Keywords: tuberculosis, persuasive communication, drug supervisor

The Effect of Maternal Knowledge and Husband Job Type on The Risk of Hiv Infection among Housewives in Balige, North Sumatera

Background: HIV continues to be a major global public health issue, having claimed more than 35 million lives so far. In 2017, 940,000 people died from HIV-related causes globally. There were approximately 36.9 million people living with HIV at the end of 2017 with 1.8 million people becoming newly infected in 2017 globally. Previous study reported that there are two types of men: “adventurous” ones and “loyal” ones. The adventurous ones were said to go from work to the street, and to forget their homes. Housewives living with an adventurous type of husband are hypothesized to have a higher risk of HIV infection. This study aimed to examine the effect of maternal knowledge and husband job type on HIV infection among housewives in Balige, North Sumatera. Subjects and Method: This was a case control study conducted at AIDS HKBP Balige committee, North Sumatera. A sample of 90 housewives was selected for this study, consisting of 45 housewives with positive HIV and 45 housewives with negative HIV. The dependent variable was HIV infection. The independent variables were maternal knowledge and husband job type (in-town versus out-of-town job type). Data on HIV infection status were obtained from the medical record. The other data were collected by questionnaire. The data were analyzed by a multiple logistic regression. Results: The risk of HIV infection increased with poor maternal knowledge (OR= 3.43; 95% CI= 1.81 to 6.49; p<0.001) and out-of-town husband job type (OR= 2.50; 95% CI= 0.95 to 6.52; p= 0.063). Conclusion: The risk of HIV infection increases with poor maternal knowledge and out-of-town husband job type. Keywords: HIV infection, maternal knowledge, husband job typ

The Effects of Multiple Sexual Partners and Condoms Use on the Incidence of HIV in Men Having Sex with Men

Background: HIV has become a problem in the international community. Rapid transmission of HIV becomes a threatfor the entire global community in order to prevent an increasingly widespread. One of the factors that causes HIV is unhealthy sexual behavior. This study aimed to determine the effect of changing partners and condom use on HIV incidence in men having sex with Men (MSM) in the Teladan Health Center in Medan.Subjects and Method: This was case-control study conducted at Teladan Health Center, in May 2018. A sample of 96 study subjects was selected for this study. The dependent variable was the incidence of HIV. The independent variables were multiple sex partners and condom use. HIV status was obtained from medical record. The other variables were measured by questionnaire. The data were analyzed by a multiple logistic regression.Results: Multiple sexual partners (OR= 2.93; 95% CI= 1.25 to 6.86; p= 0.022) and absence of condom use (OR= 2.83; 95% CI= 1.23 to 6.52; p= 0.024) increased the risk of HIV among men having sex with men.Conclusions: The occurrence of HIV in MSM is probably 2.9 times due changing partner actions and 2.8 times due to the inconsistent condom use.Keywords: HIV, multiple, sexual partners, condom use, men having sex with menCorrespondence:Evi Erlinda Wati. Masters Program in Public Health, Faculty of Public Health, Universitas Sumatera Utara. Jl. Universitas No. 21 Kampus USU Medan 20155, Sumatera Utara. Email: [email protected]. Mobile: +08126347701Journal of Health Promotion and Behavior (2018), 3(3): 150-154https://doi.org/10.26911/thejhpb.2018.03.03.0