Risks of Plasmodium Falciparumparasitemia Among 10 Years or Below Children in Indonesia: a 2010 National Study

Background:In 2007, in Indonesia 80% of a total 495 districts/municipalities was malaria endemic. Most malaria parasitemia is P. falciparum, and it is related to several risk factors. This analysis aimed to identify dominant risk factors related to P. falciparummalaria parasitemia among children 10 years or below.Methods: This analysis used a part of Basic Health Research year 2010 data. A total of 72,105 people were examined parasitemia using Rapid Diagnostic Test Nusa Tenggara Barat (RDT Brand NTB). They were 16,666 children aged 10 years old and below. We used logistic regression analysis to identify determinant risk of positive P. falciparum.Results:The prevalence of positive P. falciparumwas 1.1%. Compared with urban children, rural children had 3.3-fold higher risk to be positive P. falciparum parasitemia [adjusted odds ratio (ORa)=3.34; 95% confidence interval (CI) = 2.23–5.02].Conclusion:Rural than urban under 10 years children had higher risk to be positive P. falciparum. (Health Science Indones 2012;2:xx-xx

Studi Pemanfaatan dan Keamanan Kombinasi Metformin dengan Ekstrak Campuran Andrographis Paniculatadan Syzygium Polyanthum untuk Pengobatan Diabetes Mellitus (Preliminary Study)

Background: Use of Andrographis paniculata and Syzigium polyanthum have been used widely, on the contrary the benefit and safety have not been scientifically proven. This study aimed to overview and analyze benefit and safety the extract of Andrographis paniculata and Syzigium polyanthum mixture to decrease blood glucose concentration. Methods: It was an experiment study among intervension and control groups by a block random sampling with pre-post test design. Data were collected by questionnaires and also data among intervension group, therapy of conventional antidiabetic of metformin in combination to the herbal extract of Andrographis paniculata and Syzigium polyanthum mixture (1: 1) with among control group, of metformin. A total samples of 30 Diabetes Mellitus respondents were selected among males or females, aged 40-60 years with blood glucose concentration of 140-220 mg/dl, has no history of hypertension or has mild hypertension. The samples were devided in 2 groups composed of 15 persons among intervsion and 15 persons among control groups, respectively The intervension group was given metformin 500 mg once a day in the morning taken 15 minutes after breakfast in combination to the extract of Andrographis paniculata and Syzigium polyanthum mixture (1: 1) of 700 mg. The control group was given metformin 500 mg on ce a day in the morning taken 15 minutes after breakfast in combination to placebo. The duration of therapy was 4 weeks. Data were taken by anamnesa, physical diagnose, laboratory examination offasting blood glucose and Oral Glucose Tolerance Test (OGTT) in every week. Meanwhile for examination side effects on liver and run function test in every 2 (two) week. The data were analyzed descriptively and t test. Results: Results showed that the intervension group given metformin in combination to the extract of Andrographis paniculata and Syzigium polyanthum mixture (1:1) of 700 mg could significantly decrease fasting blood glucose but could not significantly decrease OGTT in comprasion to control group given metformin with placebo. There were no side effects on liver and kidney function test in the therapy of herbal extract of Andrographis paniculata and Syzigium polyanthum mixture in duration of 4 we eks. It concluded that the herbal extract of Andrographis paniculata and Syzigium polyanthum mixture is safe

Analisis Implementasi Kebijakan Eliminasi Malaria di Provinsi Bali

Background: ln ASEAN, lndonesia is one ofthree countries with the highest malaria morbidy ln lndonesia 396 (80%) of the total 495 districts/municipalities year 2007 were malaria endemie areas. In malaria control program, the Ministry of Health decreed Number 293 year 2009 on Malaria Eliminanition. It aimed to assess the implementation Ministry of Health decreed Number 293 year 2009 on Malaria Eliminanition in Bali Province, with specific objectives to assess understanding, implementation, innovation, budgetting and roles of government to support malaria elimination in Province Bali. Methods: It was observational study with cross sectional design, carried out in Bali Province and Karangasem District. Data were collected in September year 2011 by focus group discussion either in provincial and district level at Health Offices, District Planning Beureau, interrelated sectors (Department of Fisheries and Marine Resources, Department of Tourism, Department of Public Development, Department of Forestry, Department of Agriculture, Port Health Office, Department of Education, Department of Information and Communication, hospital), Health Centers (for district level) as well as document study Data were analyzed by content analysis. Data were validating by triangulation among provincial and district health office staffs, health policy expert and researchers. Results: The understanding of Ministry of Health decreed Number 293 year 2009 on Malaria Eliminanition in Bali at Provincial Health Office was good, but at interrelated sectors had not knew on the policy The policy implementation that the Governor issued Governor Regulation Number 10 year 2010 on activities in implementing malaria elimination in Bali Province and Karangasem District Regulation Number 2 year 2010 on malaria elimination in Karangasem District. The implementation of malaria elimination policy in Bali Provincial Health Office and Karangasem District Health Office were in accordance to Ministry of Health strategy Interrelated sectors activities were directly or indirectly in synergy with malaria elimination policy Innovation strategy activities in supporting the malaria elimination had be en developed in the district. The budgetting for malaria elimination policy in Bali Province and Karangasem District still depend local budget. The roles of local governments to support policies are by issueing policies/regulations, financing and socialization activities. Treatment should be based on new treatment strategies using artemisinin or ACT to prevent primary drug resistance of malaria. The budgetting for malaria program in Bali Province should be increased, either the total or the source. Then, it needs to develop Malaria Working Group both at the provincial and district levels so interrelated sector activities could be coordinated and integrated with the Health Offices activities to achieve malaria elimination by year 2012

Persepsi Sehat-sakit dan Pola Pencarian Pengobatan Masyarakat Daerah Pelabuhan (Kajian Kualitatif di Daerah Pelabuhan Tanjung Perak)

The problems of urban health should be concerned because of the rapid development of cities, especially in highly populated areas as in ports and industry centers. The study aimed to identify people seeking behaviors in the port areas, the perception on health-sick in the port communities, and the responses to health center's services. This was a qualitative study. Respondents were selected by local Rukun Tetangga (Households Leaders) or Rukun Warga (administrative unit at the next-to-lowest level in city) based on the income in each areas which categorized as not enough. Selected respondents were divided in 2 (two) groups, men workers and fertile aged women. The location of the study were at Rukun Warga 9 and 6 of Kelurahan Perak Utara (North Perak Kelurahan) and at Rukun Warga 2 of Kelurahan Perak Utara (North Perak Kelurahan) in Pabean Cantikan Sub-district, Tanjung Perak port areas. Data were collected by focus group discussion (FGD) in 3 (three) sub-groups of men workers and fertile aged women, respectively. There were 8-10 respondents in each sub-groups. The data were analyzed by content analysis methods. Results showed the perception on health-sick in men workers was wider in comparison to fertile aged women because if they were having influenza but still could work then they considered not sick, meanwhile for the fertile aged women if they were feeling differences in their bodies then they consider as sick. But both groups had the same perception on health­ sick for their children, there were "healthy children if they were not fusser, not weak, moving, actively play. The groups were also had the same perception on dental sick that was a severe sick. Furthermore, the majority mentioned that if getting sick, they did self medication firstly then if not getting better they visit health workers. But for their children if getting sick, they were directly sent to health workers. The responses for health center services varied in both groups. The selection to health center was merely because of cheap although mostly said that they were not free enough to express their concerns, medication was not good and examiners were not doctors. It concludes there was a wider perception on health among man worker groups and the pattern of health seeking behavior was by self medication at first, then if not better to health workers. The community still used traditional treatments. The health center services were not a good choice because the people were not sure for the quality and the kind of medication, beside was the open time was limited

Analisis Hubungan Status Otonomi Puskesmas dengan Motivasi Karyawan di Kabupaten Sleman, Pasuruan dan Kota Blitar

Backgrounds: Since decentralization year 2001, various innovations have been made by the districts or municipalities, especially on delegating broader decision space for management of community health centers to meet demands for qualified medical care. Objective: This study aimed to determine the relationship on autonomy level at health centers (decision space) of employee motivation. The motivation of employees was related to the concept of Motivating Potential Score, that composed of Skill Variety, Task Identity, Task Significance, Autonomy, and Job Feedback. Methods: tt was an observational study with a cross sectional design, carried out at Puskesmas Depok /I (150 type), Sleman District, Yogyakarta Province and at Puskesmas Bangil (self-management type), Pasuruan District, and Puskesmas Karangsari (free type), Blitar Municipality both in East Java Province. The study was done from May to December 2009. Respondents were employees at public health centers taken by random sampling to proportional size. Analysis were to assess the status of autonomy relationship with employee motivation at public health centers, tested by anova and combined with qualitative analysis from in-depth interviews to heads of the centers. Results: Results showed that most employeer motivation at each type of health centers was cathegorized as fairly autonomy status for public health center with 150 (62.5%), self-management (72%) and free type (75.7%). The Anova test were F = 1.450 at p-value = 0.240 (p > 0.05). Hence, it could be said there was no difference on employee motivation at health center type, 150, self-managed and free type. Recommendations: This study recommends that heads of community health centers should be able to encourage development of intrinsic motivation to create leadership to give inspiration for employees and supportive work environment, empowering employees, delegating meaningful work and enhancing employee competenc

Korelasi Faktor Ibu dengan Status Kesehatan Gigi dan Mulut Anak Taman Kanak-Kanak di Kelurahan Kemayoran Kecamatan Krembangan, Kota Surabaya

Caries among children 1–4 years in Indonesia was 10.4%. Maintenance of dental and oral health among under five children and kindergarten depent on their mothers. Mother's knowledge on dental and oral health maintenance is lack. The study aimed to determine the correlation of maternal knowledge, attitude, and behaviour behavior on maintenance of dental and oral health to their children dental and oral health status. It was an observational study with a cross sectional design. The study was conducted to kindergarden in Kelurahan Kemayoran, Surabaya city. There were 73 mothers and 73 of their children recruited. The independent variables were knowledge, attitude, and practice of mothers on maintenance of dental and oral health and the dependent variables was their children dental and oral health status. Data were collected by interview and the dental and oral health status by intra-oral dental examination. Analysis was by Spearmen correlation test. The majority of mothers were aged 30-39 years old, middle education, with Rp.1,000,000,- to Rp.2,000,000,- monthly income. For their children were relatively higher girls and 78.1% with bad dental and oral health status. The knowledge of mothers on maintenamce dental and oral health was not correlated to their children dental and health status possibly the lowest (30.1%) mothers knowledge on bruishing teeth conducted together with their children. Meanwhile, the mother attitute was correlated (r = 0.272) to their children dental and health status, ρ = 0.01. It was as more than half of mothers very agree that their children should brush their teeth twice a day. The behaviour of mothers on maintenance dental and oral health was not correalated as none of caries teeth was patched. Primary Health Centers should enhance education on the right knowledge on maintenance of dental and oral hygiene of children, especially among mothers

Faktor Determinan Budaya Kesehatan dalam Penularan Penyakit Tb Paru

Background: TB DO TS Strategy policy as the government's efforts in order to decrease TB patients is facilitated through the state budget cost resources, budget, global foreign aid fund, and the WHO. This qualitative study aimed to determinan poeing on cultural efforts in the prevention of pulmonary TB disease. Method of data collection participatory observation, in-depth interviews in patients with pulmonary TB and families, health care workers in the provinces, and districts. FGD on public figures, cross-sector and NGOs. Research sites in the city of Pariaman, West Lombok district and the district Rote Ndao NTT. Results:The results showed cultural determinants of health factors on the prevalence of pulmonary TB disease is a public perception of ilness Roe Ndao district, that of pulmonary TB disease as a hereditary disease, infectious disease and "Hosse". Norma betel nut as a treat for guests, custom home Sel, Sei traditional beliefs of newborns who smoked for 40 days with ground floor houses almost 50% of the population. Norms, stigma society in urban areas Pariaman, pulmonary TB disease as a disease because Tamakan, due to use-for others who are not happy, as evidenced by the habits, behavior of people carelessly throw spit spot. In western Sumatra, the city of Pariaman norms, fear of stigma, shame as people with TB, so there are many people who call it the perception of pain as a disease of old Cough, cough 40 days, dry cough, and asthma. Confidence/belief communities in the western province of NTB Lombok district who think if drinking water used Kiai progenitor Ishmael receive healing. Supervisory personnel selection as taking medication/PMO less in accordance with existing social structures in local communities, tribes sasak NTB, Rote tribe. Recommendalion: is required from a variety of participatory other NGOs, in an integrated cross-sector to perform the preventive, promotive control TB disease of the housing ministry, social ministry and education ministry Improvement program of passive case finding by health workers to be pro active case finding by cadres who require training

Assessment of Inter-program and Inter-sector Roles to Support the Achievement of Malaria Elimination in Riau Islands Province, Indonesia

There were 396 (80%) out of 495 malaria-endemic districts/cities in Indonesia in 2007 leading to the issuance of Health Ministerial Decree No. 293 in the year 2009 on malaria elimination. Therefore, the study was needed to determine the inter-sector roles to support malaria elimination in Riau Islands. The study was an observational study with a cross sectional design. Data were collected through focus group discussions involving institutions, such as the Regional Development Planning Agency, Office of Public Works, Office of Environmental Affairs, Office of Marine and Fisheries, and private sectors. Data were analyzed by content analysis. The results revealed that roles of key stakeholders were determined. For instance, drainage constructions by the Office of Public Works led water flow or eliminated pools for malaria vectors breeding. The Office of Environment Affairs restored such environmental conditions to avoid Anopheles mosquitoes breeding places. The Office of Marine and Fisheries reared certain fish as predators of the Anopheles to stop malaria transmission. Under decentralization, roles of the Local Government or District Secretary is required to synergize the inter-sector collaboration. Collaboration between local governments and private sectors should be enhanced through Environmental Impact Assessment for broad and healthy environmental development