Health Seeking Behavior among Patients with Tuberculosis in Dr. Hasan Sadikin General Hospital Bandung, Indonesia in November 2012

Background: Dr. Hasan Sadikin General Hospital is the main referral hospital in West Java, Indonesia, treating yearly 1.000 tuberculosis cases of whom most  are in severe condition. The severity of the disease is probably affected by the poor patient’s health seeking behavior.The objective of this study was to assess the pattern of patients with tuberculosis’s health seeking behavior before being treated in Dr. Hasan Sadikin General Hospital, Bandung.Methods: A descriptive study was  carried out in November 2012 on 56 patients in the Drug Observed Treatment Shortcourse (DOTS) Clinic at Dr. Hasan Sadikin General Hospital (RSHS) to assess the number and type of health services visited prior to RSHS. The inclusion criteria were patients who were diagnosed with TB for the first time, aged at least 19 years old. The data were collected using an open-ended questionnaire and presented as percentage.Results: A total of 32 respondents (57%) sought for initial treatment by going to professional health care centers (the medical doctors, puskesmas, or hospitals), the rests sought for traditional treatment (7%), self-treatment (29%), or no medication prior to the treatment at RSHS (7%). Fifty five percent of respondents did more than one type of health seeking behavior. The average time between the first complaint until the respondents got treatment was 5 months.Conclusions: The patients with tuberculosis’s treatment seeking behavior is various prior to the treatment at RSHS and there are still patients who seek treatments  to the non-profesional health care. DOI: 10.15850/amj.v2n3.49

PERANAN WANITA KARIR DALAM MEMBIMBING BELAJAR ANAK PADA MATA PELAJARAN EKONOMI DI DESA SENDAYAN KECAMATAN KAMPAR UTARA KABUPATEN KAMPAR

Berdasarkan pengamatan penulis di lapangan, wanita karir selain mengurus kebutuhan rumah tangga dia juga melakukan aktivitas-aktivitas lain untuk membantu ekonomi keluarga baik di rumah maupun di luar rumah, dan hal itu tentu menyita waktu, pemikiran dan tenaga. Namun wanita karir tersebut masih melakukan bimbingan belajar anaknya di rumah, seperti membantu menjawab PR yang kurang dipahami anak. Adapun yang menjadi tujuan dari penelitian ini adalah untuk mengetahui peranan wanita karir dalam membimbing belajar anak pada mata pelajaran ekonomi di Desa Sendayan Kecamatan Kampar Utara Kabupaten Kampar. Subjek penelitian adalah para wanita karier yang berada di desa Sendayan Kecamatan Kampar Utara Utara yang berprofesi sebagai Guru, pedagang, Petani Sawah, Petani Karet, Petani Sawit, Pegawai Pemerintahan dan Wiraswasta sebanyak 210 orang. Objek penelitian adalah peranan wanita karier dalam membimbing belajar anaknya pada mata pelajaran ekonomi di Desa Sendayan. Berdasarkan hasil analisa penelitian yang telah peneliti uraikan pada Bab. IV, maka dapat diambil kesimpulan bahwa: 1) Hasil belajar anak pada mata pelajaran ekonomi di desa Sendayan Kecamatan Kampar Utara Kabupaten Kampar tergolong dalam kategori baik, karena jika dirata-ratakan seluruhnya berjumlah 76.12. 2) Aktivitas belajar anak dalam belajar ekonomi di desa Sendayan Kecamatan Kampar Utara Kabupaten Kampar yang terbanyak adalah aktifitas membaca dan juga menulis. Artinya, anak dalam belajar ekonomi di desa Sendayan Kecamatan Kampar Utara Kabupaten Kampar dianggap cukup baik. 3) Peranan Wanita Karir dalam membimbing anaknya dalam mata pelajaran ekonomi di Desa Sendayan Kecamatan Kampar Utara Kabupaten Kampar ditinjau dari keseluruhan aspek tergolong “baik”, dimana responden penelitian yang berjumlah 52 orang yang menyatakan benar sebesar 73.5%, Sedangkan responden yang menyatakan cukup benar sebesar 25.1%, dan responden yang menyatakan tidak benar sebesar 1.4%

Diabetes is a Strong Predictor of Mortality During Tuberculosis Treatment: A Prospective Cohort Study Among Tuberculosis Patients from Mwanza, Tanzania.

Strong evidence suggests diabetes may be associated with tuberculosis (TB) and could influence TB treatment outcomes. We assessed the role of diabetes on sputum culture conversion and mortality among patients undergoing TB treatment. A total of 1250 Tanzanian TB patients were followed prospectively during TB treatment with sputum culture after 2 and 5 months. Survival status was assessed at least 1 year after initiation of treatment. At baseline, all participants underwent testing for diabetes and HIV, and the serum concentration of the acute phase reactant alpha-1 glycoprotein (AGP) was determined. There were no differences between participants with and without diabetes regarding the proportion of positive cultures at 2 (3.8% vs. 5.8%) and 5 (1.3% vs. 0.9%) months (P > 0.46). However, among patients with a positive TB culture, relatively more patients with diabetes died before the 5-month follow-up. Within the initial 100 days of TB treatment, diabetes was associated with a fivefold increased risk of mortality (RR 5.09, 95% CI 2.36; 11.02, P < 0.001) among HIV uninfected, and a twofold increase among HIV co-infected patient (RR 2.33 95% CI 1.20; 4.53, P = 0.012), while diabetes was not associated with long-term mortality. Further adjustment with AGP did not change the estimates. Diabetes considerably increases risk of early mortality during TB treatment. The effect may not be explained by increased severity of TB, but could be due to impaired TB treatment response. Research is needed to clarify the mechanism and to assess whether glycaemic control improves survival

Health Seeking Behavior among Patients with Tuberculosis in Dr. Hasan Sadikin General Hospital Bandung, Indonesia in November 2012

Background: Dr. Hasan Sadikin General Hospital is the main referral hospital in West Java, Indonesia, treating yearly 1.000 tuberculosis cases of whom most are in severe condition. The severity of the disease is probably affected by the poor patient’s health seeking behavior.The objective of this study was to assess the pattern of patients with tuberculosis’s health seeking behavior before being treated in Dr. Hasan Sadikin General Hospital, Bandung. Methods: A descriptive study was carried out in November 2012 on 56 patients in the Drug Observed Treatment Shortcourse (DOTS) Clinic at Dr. Hasan Sadikin General Hospital (RSHS) to assess the number and type of health services visited prior to RSHS. The inclusion criteria were patients who were diagnosed with TB for the first time, aged at least 19 years old. The data were collected using an open-ended questionnaire and presented as percentage. Results: A total of 32 respondents (57%) sought for initial treatment by going to professional health care centers (the medical doctors, puskesmas, or hospitals), the rests sought for traditional treatment (7%), self-treatment (29%), or no medication prior to the treatment at RSHS (7%). Fifty five percent of respondents did more than one type of health seeking behavior. The average time between the first complaint until the respondents got treatment was 5 months. Conclusions: The patients with tuberculosis’s treatment seeking behavior is various prior to the treatment at RSHS and there are still patients who seek treatments to the non-profesional health care

Studi Kasus Ketidakpatuhan Orang Kontak Serumah Terhadap Anjuran Pemeriksaan Tuberkulosis

Non-adherence of household contacts to undergo screening for Tuberculosis (TB) is a dynamic and complex phenomenon of the various factors related to behaviour. The objective of this study was to explore the behaviours related to non-adherence of household contacts to undergo screening for TB. This study is a descriptive case study that was conducted at the Pajajaran village, Bandung city. Participant were 9 household contacts of smear positive TB patients and 6 nurses who is working in the Pasirkaliki Community Health Center (CHC). Data collection was performed with the study documentation, non-structured passive observation, in-depth interview, and focus group discussion (FGD). Data analysis was according to Miles and Huberman model, which consist of data reduction, data display and drawing conclusions. The result includes perception of vulnerability of TB, perceptions of seriousness of TB, perceptions of benefits of TB screening, and cues to action for the TB patients household contact. The result showed that perceptions of the household contact of TB vulnerability were: fear of infection, make the separation and accept fate. Perceptions of the seriousness of TB were that TB could cause death and feelings of shame or inferiority. As for the perception of benefits was by doing screening,it will be known whether household contacts are exposed to TB or not. While the cues to action for household contact to perform screening for TB was if they are sick or have emerging symptoms of TB. The nurses knew that according to P2TB (TB management program) standards, the household contacts of TB patients should undergo screening for TB, especially for smear-positive pulmonary TB patients and paediatric TB. They knew that TB screening was done through sputum smear microscopy. Nurses\u27 perceptions about the barriers in carrying out their role and function were limited number of human resources in CHC, lack of education, and the presence of abundance tasks at the clinic.

Knowledge, Attitude, and Practice of Undergraduate Medical Students in Indonesia on the COVID-19 Prevention

Background: Coronavirus Disease 2019 (COVID-19) caused a global pandemic since March 2020. Undergraduate medical students, who would later be referred to as students, were encouraged to educate Indonesian society about COVID-19. This study aimed to evaluate the knowledge, attitude, and practice of Indonesian students on COVID-19 prevention. Methods: An online cross-sectional study was conducted between August 22 and September 2, 2020, with a minimum sample size of 1068 subjects. The questionnaire was sent to 86 Faculty of Medicine (FoM) in Indonesia. The questionnaire consisted of knowledge, attitude, and practice section, with a total score, 15, 60, and 45, respectively. Scores above median were considered as sufficient knowledge, and positive attitude, and positive practice. Association between knowledge, attitude, and practice with gender, year of study, location of FoM, and source of information were tested using Chi-Square Test. Correlation among knowledge, attitude, and practice scores was tested using Spearman Rank Test. Results: Among 1390 participated students, 51.4%, 55.7%, and 56.3% had sufficient knowledge, positive attitude, and, positive practice, respectively. There were associations between knowledge and gender, year of study, location of FoM, and source of information (p&lt;0.05), between attitude and gender, year of study, and source of information (p&lt;0.05), and between practice and gender and source of information (p&lt;0.05). There were weak correlations between knowledge with attitude (r=0.246, p&lt;0.001) and between attitude and practice (r=0.272, p&lt;0.001). Conclusions: Half of medical students in Indonesia showed sufficient knowledge, positive attitude, and positive practice on COVID-19 prevention. Hence, improvement towards COVID-19 prevention is required

Comparison of Diabetes Mellitus Prevalence between Universal and Targeted Screening among Tuberculosis Patients in Resource Limited Settings

BACKGROUND: Diabetes Mellitus (DM) increases the risk of active Tuberculosis (TB) infection and treatment failure. Therefore, screening of DM is important in TB patients. However, it may not be possible to screen all patients where resources are limited. This study aimed to compare the sensitivity of universal screening and targeted screening methods in the detection of DM among TB patients. SUBJECT AND METHODS: TANDEM study was conducted from February to June 2016. This project consisted of prevalence study and clinical trial on TB-DM. A sample of TB patients aged ≥ 35 years old was selected for this study. The prevalence of the universal screening method was compared with that of the targeted method in the detection of DM among the TB patients. RESULTS: By universal screening, 128 out of 748 (17.11%) TB patients were confirmed to have DM. By targeted screening, 30 out of 85 (35.29%) TB patients were confirmed to have DM. This difference in prevalence between the two screening methods was statistically significant (p<0.001). Mean age (year) of TB patients with DM was 53.38 (SD=9.72), whereas mean HbA1c was 10.77% (SD=3.10). CONCLUSION: The prevalence of targeted screening method in the detection of DM among TB patients was higher than that of universal screening method. The targeted screening method has the potential to be used in resource-poor settings. Keywords: prevalence, diabetes mellitus, universal screening, targeted screening, tuberculosi

Level of Knowledge about Tuberculosis among Type 2 Diabetes Mellitus Patients at the Endocrine Clinic Dr. Hasan Sadikin General Hospital Bandung

Background: Diabetes Mellitus (DM) is one of the risk factors for tuberculosis (TB). Knowledge of TB is essential in prevention control for the person at risk. This study aimed to describe the level of knowledge about TB among DM patients. Methods: A cross sectional study was performed involving 72 adult DM patients at the Endocrine Clinic, Dr. Hasan Sadikin General Hospital Bandung. The subjects were interviewed using a standardized questionnaire including socio-demographic information and knowledge about TB: manifestation of TB, transmission, treatment, DM-TB co-infections, and status acquiring TB information in the last 12 months. Knowledge was categorized as high, moderate and low if total scores were >75, 56–75 and <56 respectively. Data were presented descriptively as percentage and mean (SD) after testing for the normality of distribution. Results: The mean of age of subjects was 56.6 years, and 55% were female. Most were unemployed (72.2%), had an education background lower than high school (75%), and lived in Bandung (91.7%).  The mean score of knowledge was 54.4. Proportion of subjects based on the level of knowledge which is high, moderate and low, were 29.2%, 26.4%, and 44.4% respectively.  Conclusions: The level of knowledge about TB among Type 2 DM patients at the Endocrine Clinic Dr. Hasan Sadikin General Hospital Bandung was low. TB education program among DM patients needs to be improved

Screening patients with Diabetes Mellitus for Tuberculosis in China.

Objective  There is a high burden of both diabetes (DM) and tuberculosis (TB) in China, and as DM increases the risk of TB and adversely affects TB treatment outcomes, there is a need for bidirectional screening of the two diseases. How this is best performed is not well determined. In this pilot project in China, we aimed to assess the feasibility and results of screening DM patients for TB within the routine healthcare setting of five DM clinics. Method  Agreement on how to screen, monitor and record was reached in May 2011 at a national stakeholders meeting, and training was carried out for staff in the five clinics in July 2011. Implementation started in September 2011, and we report on 7 months of activities up to 31 March 2012. DM patients were screened for TB at each clinic attendance using a symptom-based enquiry, and those positive to any symptom were referred for TB investigations. Results  In the three quarters, 72% of 3174 patients, 79% of 7196 patients and 68% of 4972 patients were recorded as having been screened for TB, resulting in 7 patients found who were already known to have TB, 92 with a positive TB symptom screen and 48 of these newly diagnosed with TB as a result of referral and investigation. All patients except one were started on anti-TB treatment. TB case notification rates in screened DM patients were several times higher than those of the general population, were highest for the five sites combined in the final quarter (774/100 000) and were highest in one of the five clinics in the final quarter (804/100 000) where there was intensive in-house training, special assignment of staff for screening and colocation of services. Conclusion  This pilot project shows that it is feasible to carry out screening of DM patients for TB resulting in high detection rates of TB. This has major public health and patient-related implications