Hubungan Faktor Petugas Puskesmas dengan Cakupan Penderita Tuberculosis Paru BTA Positif

Background: Tuberculosis (TB) disease is a major health problem either in developed or developing countries. According to WHO TB happens to 25,205 people worldwide everyday, ending in mortality to 4,657 people. Indonesia is in the third rank of TB cases in the world after India and China. TB in Indonesia happens to 1,464 people everyday, ending in mortality to 241 people. The identification of suspect and positive acid fast bacillus is a performance indicator of lung TB program. At District of Bengkulu 2007 lung TB patients' identification was still below the national target, i.e. 38.193. The screening and identification of patients is generally done by nurses at polyclinics and laboratory staff. Nurses are health professionals at the front liners of health services with quite large composition (40%).Objective: To identify factors of the health center in relation to the coverage of positive acid fast bacillus lung TB patients at District of Bengkulu Utara.Method: This was an observational study with a cross sectional design. Location of the study was microscopic referral health centers, independently managed health centers, and satellite health centers at District of Bengkulu Utara. Samples consisted of staff of polyclinic and laboratories. Data were obtained through questionnaire and observation and presented using frequency distribution tables and multilevel regression and linear regression methods.Result: The result of multivariate analysis showed that variables related to the coverage of lung TB patients were skills of staff with b=1.3 (p=0.000) and facilities with b=1.5 (p=0.000).Conclusion: Skills of staff, training of staff, and availability of facilities were related to the coverage of positive acid fast bacillus lung TB patients at District of Bengkulu Utara; therefore it was necessary to improve skills of staff through on the job training and improve facilities for the identification of lung TB patients

Kualitas hidup penderita tuberkulosis resisten obat di kabupaten Banyumas

Latar Belakang: Insidens TB resistan obat (TB MDR) di Kabupaten Banyumas cenderung meningkat setiap tahunnya dengan CFR 28,6-33,3%. TB MDR mempunyai dampak secara klinis dan mempengaruhi kualitas hidup. Sejauh ini, penelitian tentang kualitas hidup penderita TB MDR masih belum banyak digali. Penelitian ini bertujuan untuk mengetahui gambaran kualitas hidup TB MDR dan karakeristik sosiodemografi, klinik dan dukungan sosial. Manfaat dari penelitian ini dapat digunakan sebagai evaluasi kualitas pelayanan kesehatan, dampak intervensi dan efek samping pengobatan.Metode: Penelitian deskriptif desain studi cross sectional dengan sampel jenuh sebesar 22 penderita yang memenuhi kriteria inklusi dan ekslusi. Variabel bebasnya adalah: sosiodemografi (umur, jenis kelamin, status perkawinan, tempat tinggal, tingkat pendidikan, status pekerjaan, dan tingkat penghasilan), faktor klinik (tahap pengobatan, efek samping obat, riwayat pengobatan TB sebelumnya, penyakit ko-morbid, jenis TB, dan riwayat konsumsi rokok/alkohol/narkoba), dan dukungan sosial (menggunakan kuesioner MOS-SSS), sedangkan variabel terikatnya adalah kualitas hidup penderita TB MDR (menggunakan kuesioner SF-36). Data dianalisis secara desktiptif dan disajikan dalam bentuk distribusi frekuensi dan tabulasi silang.Hasil: Sebesar 54,5% laki-laki; 50,0% kelompok umur dewasa; 59,1% menikah; 22,7% bercerai; 72,7% tinggal di pedesaan; 95,5% berpendidikan dasar&lanjutan; 45,5% karyawan swasta (sebelum sakit); 77,3% tidak bekerja (setelah sakit); 72,7% berpenghasilan rendah; 54,5% menjalani pengobatan tahap lanjutan; 95,5% pengobatan ulang (45% kasus kambuh; 40,9% kasus gagal/tidak konversi); 90,9% mengalami efek samping obat (ringan/berat); 36,4% mempunyai penyakit komorbid; 45,5% mempunyai riwayat merokok, 31,8% mempunyai riwayat konsumsi alkohol; 54,5% dukungan sosial kategori kurang; memiliki kualitas hidup buruk (31,8%) dan sedang (36.4%).Kesimpulan: Kualitas hidup penderita TB MDR cenderung memburuk dengan dukungan sosial yang kurang, terutama dukungan kasih sayang, emosional dan material. Perlu dilakukan upaya untuk meningkatkan kualitas hidup dan dukungan sosial melalui pembentukan peer support group sebagai wadah untuk memberikan konseling, KIE, motivasi, pelatihan keterampilan serta dukungan sosial bagi mereka. Quality of life among patients with multi-drug resistant tuberculosis in the district of BanyumasPurposeThis study was conducted to investigate the quality of life among patients with multi-drug resistant tuberculosis and to examine factors associated with them. MethodsData from an in-depth interview, involved 22 patients with multi-drug resistant tuberculosis, were used in this study. ResultsThis study showed 54.5% males, 50.0% adults, 59.1% married, 22.7% divorced, 72.7% lived in rural, 95.5% had basic education, 45.5% as a private employment (before sick), 77.3% as unemployment (after sick), 72.7% low income, 54.5% in continuation phase, 95.5%  re-treatment (45% relapse and 40.9% failure cases), 90.9% had drugs side effects (mild/severe); 36.4% had comorbidity; 45.5% smokers, 31.8% falcoholics; 54.5% lack of social support; 31.8% poor and 36.4% moderate quality of life. ConclusionPatients with multi-drug resistant tuberculosis had a worse quality of life and lack social support. Health worker needs to improve their quality of life and social support through establishing a peer support groups to give counseling, information education, communication, motivation, and skills training for them

Factors Associated with Delayed Diagnosis among Tuberculosis Patient in Kebumen District

ABSTRACTIntroduction: Tuberculosis is a major global health problem. It is estimated that almost 9 million new cases detected in 2011 and 1.4 million died because of TB. Early diagnosis and effective treatment are the key elements of the TB control program. Delayed diagnosis associated with a longer duration of infectiousness, increase the severity of the disease, more severe complication and even death.Objectives: To determine the factors associated with delayed diagnosis among tuberculosis patients in Kebumen District.Methods : A cross sectional study among newly diagnosed TB patients in April to June 2013 in Kebumen was conducted. The data was collected using a questionnaire interviewing officers of government health care facilities which have implemented DOTS programs already. Data was analyzed by a logistic regression test with confidence interval (CI) of 95%.Results: Eighty five pulmonary TB patients were studied consisting of 65 TB smear positive and 20 smear negative/roentgen positive patients. The median duration of delayed patients was 3.9 weeks; delayed health service was 2.6 weeks and delayed diagnosis was 7.6 weeks. Multivariate analysis showed that factors associated with delayed diagnosis were the type of health services which first visited (p value = 0.002 and OR = 6.87), level of knowledge about TB (p value = 0.002 and OR = 6.41), educational level (p value = 0.024 and OR = 5.68) and the number of visits to health service (p value = 0.021 and OR = 3.87).Conclusion : The median duration of delayed diagnosis was 7.6 weeks. Delayed diagnosis among TB patients in Kebumen Distict was associated with type of health services which is non-DOTS, low level of knowledge about TB,  low levels of education and the number of visits to health services ≥3 times.Keywords: delayed diagnosis, TB patients, Kebumen Distric

Hubungan Faktor Petugas Puskesmas dengan Cakupan Penderita Tuberculosis Paru BTA Positif

Background: Tuberculosis (TB) disease is a major health problem either in developed or developing countries. According to WHO TB happens to 25,205 people worldwide everyday,  ending in mortality to 4,657 people. Indonesia is in the third rank of TB cases in the world after India and China. TB in Indonesia happens to 1,464 people everyday, ending in mortality to 241 people. The identification of suspect and positive acid fast bacillus is a performance indicator of lung TB program. At District of Bengkulu 2007 lung TB patients’ identification was still below the national target, i.e. 38.193. The screening and identification of patients is generally done by nurses at polyclinics and laboratory staff. Nurses are health professionals at the front liners of health services with quite large composition (40%).Objective: To identify factors of the health center in relation to the coverage of positive acid fast bacillus lung TB patients at District of Bengkulu Utara.Method: This was an observational study with a cross sectional design. Location of the study was microscopic referral health centers, independently managed health centers, and satellite health centers at District of Bengkulu Utara. Samples consisted of staff of polyclinic and laboratories. Data were obtained through questionnaire and observation and presented using frequency distribution tables and multilevel regression and linear regression methods.Result: The result of multivariate analysis showed that variables related to the coverage of lung TB patients were skills of staff with b=1.3 (p=0.000) and facilities with b=1.5 (p=0.000).Conclusion: Skills of staff, training of staff, and availability of facilities were related to the coverage of positive acid fast bacillus lung TB patients at District of Bengkulu Utara; therefore it was necessary to improve skills of staff through on the job training and improve facilities for the identification of lung TB patients.Keywords: lung TB, nurses, laboratory staff, TB patient identificatio

Aktivitas fisik dan kejadian hipertensi pada pekerja: analisis data Riskesdas 2013

ABSTRAKLatar belakang: Hipertensi yang dibiarkan dapat menyebabkan komplikasi terhadap jantung, otak, mata dan ginjal. Prevalensi hipertensi menurut jenis pekerjaan pada pegawai 20,6%, wiraswasta 24,7%, petani, nelayan dan buruh: 25%. Aktivitas fisik pekerja berdasarkan data Riskesdas 2013 yang masih kurang yaitu pegawai 23,3%; wiraswasta 18,3%; dan petani, nelayan, dan buruh 13,4%. Variabel luar yang mempengaruhi hipertensi yaitu faktor risiko yang dapat diubah dan tidak dapat diubah. Tujuan: untuk mengetahui pengaruh aktivitas fisik dan variabel luar terhadap hipertensi pada pekerja.Metode: Penelitian kuantitatif non eksperimen menggunakan data Riskesdas 2013 dengan rancangan cross sectional. Populasi sebanyak 1.027.763 dengan sampel yang memenuhi kriteria inklusi yaitu responden mempunyai pekerjaan utama, berusia ≥ 15 tahun, diukur tinggi badan, berat badan, lingkar perut, tekanan darah, dan tidak sedang hamil, sebanyak 371.713. Data dianalisis secara univariabel, bivariabel dan multivariabel.Hasil: Aktivitas fisik mempengaruhi kejadian hipertensi pada pekerja dengan OR sebesar 1,25 (CI 95%: 1,21-1,28), aktivitas fisik dengan melibatkan variabel luar menjadi 1,16 (CI 95%: 1,13-1,19). Variabel luar yang menjadi faktor risiko hipertensi meliputi umur, obesitas, obesitas abdominal, kebiasaan merokok setiap hari, jumlah rokok 10-20 batang/hari, kebiasaan konsumsi makanan berlemak, konsumsi sayur < 3 porsi/hari, stres, riwayat DM, gagal ginjal kronis dan batu ginjal.Kesimpulan: Aktivitas fisik berpengaruh terhadap kejadian hipertensi pada pekerja.Physical activity and hypertension incidence among workers: analysis of basic health survey 2013Purpose:  This research aimed to know the influence of physical activity and external variables on hypertension in workers. Methods: We used secondary data for our research which is Basic Health Research (Riskesdas) 2013. The total population was 1,027,763. Our inclusion criteria were: have a main job, aged ≥15 years, measured height, measured weight, measured abdominal circumference, measured blood pressure, and not pregnant. We found 371,713 respondents matching our criteria. We analyzed our data using chi square and logistic regression with 5% level of significance. Results: Physical activity affects the incidence of hypertension in workers with OR of 1.25 (95% CI: 1.21-1.28), physical activity involving external variables to 1.16 (95% CI: 1.13-1.19). External variables that became hypertension risk factors include: age, obesity, abdominal obesity, daily smoking habits, 10-20 cigarette/day cigarettes, consumption of fatty foods, vegetables consumption <3 servings/day, stress, history of DM, chronic renal failure and kidney stones. Conclusion: Physical activity affects the incidence of hypertension in workers

Peran kepala puskesmas SKM dan non SKM dalam meningkatkan kemampuan manajerial puskesmas di kabupaten Oku Timur

Role of the head of public health centers from public health graduates and others on improving managerial skills in East OkuPurposeThis study aimed to understand how public health and non-public health backgrounds affect management skill of primary health care heads, based on ten managerial roles. MethodsThis study was a descriptive study with case-series method, using qualitative methods supported by quantitative data. Eight people were recruited as respondents. They consisted of 4 people that were primary healthcare heads with public health background and 4 people that were primary healthcare heads with non-public health background. Respondents were recruited by purposive sampling. Data collection was performed using in-depth interviews and questionnaire. ResultsPrimary healthcare head with public health background owned more work experience than those with non-public health background. Period of employment in primary health care had an influence on managerial capabilities. There were no significant differences of period of employment in primary health care head positions among the longest with the least to the managerial capabilities. Primary health care heads who had been trained with PIM IV training and other structural positions were known to have better management capabilities, especially compared to the leadership role of those who had not been trained.ConclusionThere was no significant difference in managerial capacity between primary health care heads with public health and those with non-public health background.Role of the head of public health centers from public health graduates and others on improving managerial skills in East OkuPurposeThis study aimed to understand how public health and non-public health backgrounds affect management skill of primary health care heads, based on ten managerial roles. MethodsThis study was a descriptive study with case-series method, using qualitative methods supported by quantitative data. Eight people were recruited as respondents. They consisted of 4 people that were primary healthcare heads with public health background and 4 people that were primary healthcare heads with non-public health background. Respondents were recruited by purposive sampling. Data collection was performed using in-depth interviews and questionnaire. ResultsPrimary healthcare head with public health background owned more work experience than those with non-public health background. Period of employment in primary health care had an influence on managerial capabilities. There were no significant differences of period of employment in primary health care head positions among the longest with the least to the managerial capabilities. Primary health care heads who had been trained with PIM IV training and other structural positions were known to have better management capabilities, especially compared to the leadership role of those who had not been trained.ConclusionThere was no significant difference in managerial capacity between primary health care heads with public health and those with non-public health background

Determinan penggunaan kelambu berinsektisida di Bengkulu: analisis riskesdas

Determinant factors affecting the use of insecticide-treated nets in Bengkulu: analysis from basic health survey 2013PurposeThis study aimed to identify determinant factors that influence the use of insecticide-treated nets and to evaluate the effectivity of the mosquito nets usage, in pregnant women and young children in Bengkulu, based on  basic health survey 2013.MethodThis study used a cross-sectional design. Study population were all members of households in Bengkulu that used insecticide-treated nets, based on basic health survey 2013.ResultsThere were no significant correlations between employment status, education, vulnerable children, use of community health center, housing, and use of wire gauze with insecticide-treated nets. Multivariate logistic regression tests showed that there were some socio-demographic variables, behavior, and environment that affected mosquito net usage.ConclusionSocial determinants of demographic factors, behavioral determinant factors, environmental determinant factors, and presence of children affected the use of insecticide-treated nets, but the use of mosquito nets was not effective against vulnerable groups (pregnant women).Tujuan: Penelitian ini mengidentifikasi faktor yang mempengaruhi penggunaan kelambu berinsektisida terutama bagi ibu hamil dan balita di Bengkulu.Metode: Penelitian berbasis data sekunder riskesdas tahun 2013.Hasil: Status pekerjaan, pendidikan, balita, pemanfaatan puskesmas, tempat tinggal, penggunaan kawat kassa berhubungan dengan penggunaan kelambu berinsektisida. Sosial demografi, perilaku dan lingkungan adalah faktor-faktor dominan yang berpengaruh.Kesimpulan: Ada pengaruh sosial demografi, faktor perilaku dan lingkungan terhadap penggunaan kelambu berinsektisida, namun tidak efektif bagi ibu hamil

Prediktor faktor kekambuhan tuberkulosis di kabupaten Bantul

Latarbelakang: Program DOTS berhasil meningkatkan penemuan kasus TB paru BTA positif, namun tingkat kekambuhan TB paru masih ditemukan sebesar 3-5% hingga tahun 2014. Kekambuhan merupakan indikator penting keberhasilan jangka panjang pengobatan TB paru dan merupakan suspek MDR (multi drug resistence). Tujuan penelitian ini adalah mengetahui faktor yang berhubungan dengan kekambuhan TB.Metode: Desain penelitian adalah kohort retrospektif. Data yang digunakan adalah register TB kabupaten Bantul tahun 2003-2014 terdaftar ada 3418 pasien. Pengambilan sampel dilakukan dengan metode non random dengan purposive sampling berdasarkan kritera inklusi tedapat 904 sampel. Variable yang diukur adalah usia, jenis kelamin, pengawas menelan obat, fasilitas pelayanan kesehatan, social ekonomi dan konversi dahak. Analisis data menggunakan cox proportion hazard model untuk menentukan kejadian serta kapan terjadinya suatu event. Hasil penelitian: Jenis kelamin laki-laki (HR=0,91 p-value=0,17) usia >40 tahun (HR=1,03 p-value=0,59), penghasilan rendah (HR=0,89 p-value=0,11) bukan prediktor kekambuhan TB, sedangkan pengobatan di rumah sakit (HR=0,81 p-value=0,00), tidak konversi dahak (HR=0,58 p-value=0,00), kegagalan pengobatan (HR=0,49 95%CI 0,37-0,64), dan pengobatan kurang/lebih dari 6 bulan (HR=0,008 95%CI 0,00-0,07) merupakan prediktor kekambuhan TB. Terdapat 56 (6,18%) dari 904 pasien yang mengalami kekambuhan setelah sembuh atau gagal dalam pengobatan. Rata-rata pasien kambuh setelah 17 bulan selesai pengobatan pertamnaya.Kesimpulan: Fasiltas kesehatan, konversi dahak, status akhir pengobatan dan lama pengobatan merupakan faktor kekambuhan Tb paru, sehingga tepat untuk memprediksi kekambuhan TB di Kabupaten Bantul.Predictors of tuberculosis recurrence in the district of Bantul PurposeThe purpose of this research was to identify associated factors of TB recurrence. MethodsThe study design was a retrospective cohort. We  used TB cases registered in Bantul regency data in 2003-2014 that consisted of 3418 patients. Sampling was conducted by non-random methods with purposive sampling based on inclusion criteria of 904 samples. The variables measured were: age, sex, drug swallowing supervisor, health service facility, socioeconomic and sputum conversion. We used the Cox proportional hazard model for data analysis to determine the rate of occurrence and timing of the occurrence of an event. ResultsMale sex (HR = 0.91; p-value = 0.17) age> 40 years (HR = 1.03; p-value = 0.59), low income (HR = 0.89; p-value = 0.11) were not predictors of TB recurrence, while hospital treatment (HR = 0.81; p-value = 0.00), no sputum conversion (HR = 0.58; p-value = 0.00), treatment failure (HR = 0.49; 95% CI: 0.37-0.64), and treatment of less than 6 months (HR = 0.008; 95% CI: 0.00-0.07) were predictors of TB recurrence. There were 56 (6.18%) of 904 patients who experienced relapse after cured or failed treatment. The average patient relapsed after 17 months of completion of the first treatment. ConclusionHealth facilities, sputum conversion, end-of-treatment status and duration of treatment are pulmonary TB recurrence factors, and as a result can be used to predict TB recurrence in the district of Bantul

Analisis beban ekonomi kejadian luar biasa campak di Daerah Istimewa Yogyakarta

Economic burden analysis of measles outbreak in the Special Region of Yogyakarta 2015Purpose This study aimed to analyze the economic burden due to outbreaks of measles in the household sector in Yogyakarta.Methods This research was a descriptive study with survey design, with data collected of direct and indirect costs for patients exposed to measles, by conducting interviews of 177 respondents using a questionnaire. Secondary data was compared in the form of outbreaks of measles in 2014 and 2015, to research in February-March, 2016.Results The number of outbreaks of measles patients who visited health facilities reached 163 patients (92.09%). Total medical costs were IDR 17.982.000, non-medical costs IDR 7.804.900, so the total direct cost of IDR was 25.786.900 (average IDR 145. 700). Total indirect costs were IDR 11.720.000 (average IDR 156. 300). The economic burden of measles outbreak was IDR 37.506.900 (average IDR 211. 900). Generally, the cost that is paid out of pocket amounted to 6.32% of household income, not yet considered catastrophic. Regression analysis showed the duration of illness averaged more than 10 days (p = 0.002 with some status of hospitalization (p = 0.000).Conclusions The economic burden of outbreaks of measles in the province in 2015 was IDR 37.506.900, including direct and indirect costs. Medical costs are the dominant component of direct costs. The factors that were related to the economic burden are the duration of illness of more than 10 days and inpatient status. There needs to be an advocacy to the community about the use of health care and prevention of measles by way of measles immunization.Latar belakang: Jumlah kasus campak di DIY Tahun 2014 mencapai 1.222 kasus. Jumlah ini menempatkan DIY menjadi provinsi dengan jumlah kasus campak terbanyak ketiga setelah DKI Jakarta dan Aceh. Kejadian luar biasa campak di 2014 sebanyak 10 kali dengan 262 kasus, 2015, 1 kali dengan 14 kasus. Penelitian ini bertujuan untuk menganalisis beban ekonomi akibat KLB campak pada sektor rumah tangga.Metode: Penelitian deskriptif dengan desain survei, data yang dikumpulkan   biaya langsung dan tidak langsung selama pasien terkena campak, dilakukan wawancara kepada 177 responden menggunakan kuesioner. Data skunder berupa kejadian luar biasa campak tahun 2014 dan 2015. Penelitian pada Februari - Maret 2016.Hasil: Jumlah pasien  KLB campak yang berkunjung ke fasilitas kesehatan sejumlah 163 pasien (92,09%). Total biaya medis Rp 17.982.000, biaya non medis Rp 7.804.900, sehingga total biaya langsung Rp 25.786.900 (rata-rata Rp 145.700). Total biaya tidak langsung Rp 11.720.000 (rata-rata Rp 156.300). Beban ekonomi KLB campak Rp 37.506.900 (rata-rata Rp 211.900). Secara umum biaya yang di keluarkan (out of pocket) sebesar 6,32% dari pendapatan rumah tangga, belum sampai katastropik. Hasil analisis regresi menunjukan durasi sakit lebih 10 hari (p=0,002 dan status rawat inap (p=0,000).Kesimpulan: Beban ekonomi KLB campak di Provinsi DIY tahun 2015 adalah Rp 37.506.900. Meliputi biaya langsung dan biaya tidak langsung. komponen yang dominan adalah biaya langsung. Faktor yang berhubungan dengan beban ekonomi adalah durasi sakit lebih dari 10 hari dan status rawat inap. Perlu advokasi kepada masyarkat tentang pemanfaatan jaminan kesehatan dan pencegahan campak dengan cara imunisasi campak

EVALUATION OF LEPTOSPIROSIS CONTROL MANAGEMENT BASED ON ONE HEALTH IN BOYOLALI DISTRICT

Evaluation of leptospirosis control management based on one health in Boyolali DistrictPurpose: The study aims to evaluate the control of leptospirosis in Boyolali Regency. Method: This study was a descriptive observational. Samples were conducted with purposive sampling techniques for Boyolali District Health Office, Boyolali District Animal Husbandry Office, Boyolali District Agricultural Service, and 9 health centers with findings of leptospirosis cases in 2017-2018. Variables that evaluated included inputs, planning, implementation, output. Data were collected through Observational and interviews. Results: Seventy percent of health workers have received training. Rapid diagnosis tests (RDTs) are not available at the primary health care but available in the Health Office. Data collection is reported passively. Examination of leptospirosis cases in livestock if there are findings in humans. However, the main reservoir (rat) was not inspected by the Agriculture Office. Every case that found was reported to the Boyolali District Health Office and received treatment.Conclusion: Leptospirosis control in Boyolali Regency has not successful. It was depicted by cases of death a year after the adoption of the one health concept. Improving both quality of human resources on a regular basis and increasing collaboration between various sectors such as community leaders, religious leaders, the Livestock Service Office, the Agriculture Service, and other relevant agencies were needed.Background: Leptospirosis is serious problem in various countries. Boyolali Regency have implemented one health concept  for leptospirosis control program since 2017. Leptospirosis cases increased every years. It had reported 34 cases and 9 deaths in 2017. The study aims to evaluate the control of leptospirosis in Boyolali Regency.Method: This study was descriptive observational. Samples were conducted with purposive sampling technics for Boyolali District Health Office, Boyolali District Animal Husbandry Office, Boyolali District Agricultural Service, and 9 health centers with findings of leptospirosis cases in 2017-2018. Variables  that evaluated included inputs (human resources, funds, facilities, and tools), planning, implementation, output (number of cases, the scope of management, reported, of accuracy. Data were collected throught Observational and interviews.Results: Seventy percent of health workers have received training. Rapid diagnosis tests (RDTs) are not available at the primary health care, case were diagnosed with RDTs in Health Office. Data collection is reported passively. Animal husbandary office did not have objective finding cases livestock. Examination of leptospirosis cases in livestock if there are findings in humans. However, the main reservoir (rat) was not inspected by the Agriculture Office. Rats control were implemented through killed, burned, arrested and given drugs. Every case that found was reported to the Boyolali District Health Office and received treatment.Conclusion: Leptospirosis control in Boyolali Regency has not successful. It was depicted by cases of death in a year after the adoption of the one health concept. Improving both quality of human resources on a regular basis and increasing collaboration between various sectors such as community leaders, religious leaders, the Livestock Service Office, the Agriculture Service, and other relevant agencies were needed