A Mixed Method Study of Tuberculosis Case Management in Hospital of West and Central Java, Indonesia

Background : Indonesia as the second largest contributor of Tuberculosis (TB) has adopted the WHO recommendation through DOTS strategy to reduce disease burden in both government and private hospitals. Effectiveness of DOTS implementation in healthcare centers has been reported. However, few studies found that the TB treatment success rate in hospitals was still low. The objectives of the study were to assess case detection and the implementation of DOTS strategy in hospital. Methods : Study was conducted in 8 hospitals in West Java and Central Java that had implemented DOTS strategy during a two-year period (2007-2008). Mixed methods were used to obtain data on tratment strategy quantilatively and its exploration qualitatively, particularly the practice performed by hospital staff and the patients experience. Results : Hospitals did not refer many new TB cases to healthcare centers. All patients, treatment observers and the heads of DOTS team of the private hospitals stated that medication was always available at the hospital. Some public hospitlas reported lack of stock of OAT due to large patient numbers. Seven out of the 8 hospitals had allocated treatment observers. Public and private hospitals had achieved treatment success rate of 61 to 74% for smear-positive and negative cases. However, there was a high proportion of cases that defaulted from treatment, the majority of which was among smear-negative cases in public hospitl (29%). Conclusions : Overall success rate of TB treatment in hospital was low. Strengthening of TB case management in hospital throught improved training of helath-care personnel is needed to reduce the burden of TB in Indonesia

ELIMINATION OF BREEDING PLACES AT SCHOOL AS A CONTROL OF DHF IN SEMARANG

Abstrak Semarang merupakan kota endemis DBD dengan angka kesakitan dan kematian DBD tinggi. Insidens kumulatif DBD pada anak tahun 2011-2012 sebesar 97,66 dan 112,2 per 100.000 penduduk. Desain studi cross sectional dilakukan untuk menggambarkan factor yang berhubungan dengan PSN (Pemberantasan Sarang Nyamuk) pada masyarakat sekolah di Semarang. Sampel penelitian adalah seluruh warga sekolah sebanyak 499 orang yang terdiri dari murid, guru, staf administrasi, dan tukang bersih-bersih/tukang kebun sekolah. Sebagian besar warga sekolah memiliki kebiasaan PSN baik (58%), pengetahuan PSN dan DBD baik (53%), memiliki sikap PSN positif (64%). Terdapat korelasi signifikan antara latar belakang pendidikan (p=0,015), pengetahuan PSN (p=0,000), sikap PSN (p=0,000), terpapar informasi PSN (p=0,009) dengan kebiasaan PSN baik. Seseorang dengan latar pendidikan tinggi diestimasi sebesar 1,6 kali (95% CI: 1,11 – 2,34) melakukan PSN baik dibandingkan pendidikan rendah. Seseorang dengan pengetahuan PSN baik diestimasi 10 kali melakukan PSN (95% CI: 6,57 – 15,13). Semakin positif sikap PSN maka 2,2 kali akan melakukan PSN baik (95% CI: 1,54 – 3,25). Seseorang yang terpapar informasi PSN memiliki kemungkinan 2,2 kali melakukan PSN dengan baik. Disarankan untuk meningkatkan promosi kesehatan di bidang PSN DBD pada warga sekolah karena dengan mengoptimalkan fungsi UKS (Unit Kesehatan Sekolah) seperti pengaktifan dokter kecil dan anak pemantau jentik.   Kata Kunci: DBD, PSN, perilaku  Kesmasindo, Volume 7( 1) Juli 2014, Hal 22-3

ELIMINATION OF BREEDING PLACES AT SCHOOL AS A CONTROL OF DHF IN SEMARANG

Abstrak Semarang merupakan kota endemis DBD dengan angka kesakitan dan kematian DBD tinggi. Insidens kumulatif DBD pada anak tahun 2011-2012 sebesar 97,66 dan 112,2 per 100.000 penduduk. Desain studi cross sectional dilakukan untuk menggambarkan factor yang berhubungan dengan PSN (Pemberantasan Sarang Nyamuk) pada masyarakat sekolah di Semarang. Sampel penelitian adalah seluruh warga sekolah sebanyak 499 orang yang terdiri dari murid, guru, staf administrasi, dan tukang bersih-bersih/tukang kebun sekolah. Sebagian besar warga sekolah memiliki kebiasaan PSN baik (58%), pengetahuan PSN dan DBD baik (53%), memiliki sikap PSN positif (64%). Terdapat korelasi signifikan antara latar belakang pendidikan (p=0,015), pengetahuan PSN (p=0,000), sikap PSN (p=0,000), terpapar informasi PSN (p=0,009) dengan kebiasaan PSN baik. Seseorang dengan latar pendidikan tinggi diestimasi sebesar 1,6 kali (95% CI: 1,11 – 2,34) melakukan PSN baik dibandingkan pendidikan rendah. Seseorang dengan pengetahuan PSN baik diestimasi 10 kali melakukan PSN (95% CI: 6,57 – 15,13). Semakin positif sikap PSN maka 2,2 kali akan melakukan PSN baik (95% CI: 1,54 – 3,25). Seseorang yang terpapar informasi PSN memiliki kemungkinan 2,2 kali melakukan PSN dengan baik. Disarankan untuk meningkatkan promosi kesehatan di bidang PSN DBD pada warga sekolah karena dengan mengoptimalkan fungsi UKS (Unit Kesehatan Sekolah) seperti pengaktifan dokter kecil dan anak pemantau jentik.   Kata Kunci: DBD, PSN, perilaku  Kesmasindo, Volume 7( 1) Juli 2014, Hal 22-3

Risk Factors of Hypertension in Menopausal Women in Rejomulyo, Madiun

Hypertension is a state of blood pressure > 90 mmHg (diastolic). Incidence of women hypertension in Rejomulyo from January to November 2013 reached 28.4%, in which 87% were menopausal. Risk factors increased since early menopausal period. The aim of the study was to analyze risk factors of hypertension in menopausal women in Tejomulyo, Madiun. An observational analysis was conducted with cross-sectional study design. Samples were 90 menopausal women aged 50-80 years using staratified random sampling. Bivariate analysis showed association between obesity (p=0.023;CI: 1.4-116.8), abdominal obesity (p=0.002; CI: 1.8-24.9), family history suffering of hypertension (p=0.018;CI: 1.2-7.1), elderly age (p=0.028;CI: 1.2-12.9), high stress level (p=0.001;CI: 2.9-19.4) and often natrium consumption (p=0.001;CI: 2.4-15.2). Multivariate analysis showed that risk factors of hypertension were abdominal obesity (POR adj=9.2 CI: 1.7-50.9), elderly age or>65 years old (POR adj=8.6;CI: 1.6-45.1), high stress level (POR adj=8.6;CI: 2.6-28.3) and often natrium consumption (POR adj=6.4;CI: 1.9-20.5). This study found that risk factors of hypertension were abdominal obesity, elderly age (>65 years old), high stress level, and high natrium consumption. Tawangrejo HEalth Center should be in collaboration with relevant sectors such as the PKK and health cadres

ANALISIS TINGKAT KESEJAHTERAAN KARYAWAN TERHADAP KINERJA KARYAWAN (Survey Di PKU Muhammadiyah Baturetno)

Tujuan dari penelitian ini adalah untuk menganalisis kinerja karyawan PKU Muhammadiyah Baturetno ditinjau dari tingkat kesejahteraan karyawan (pendapatan atau gaji, pemberian tunjangan, lingkungan kerja, dan promosi jabatan). Penelitian ini dilaksanakan diPKU Muhammadiyah pada September 2011. Populasi yang digunakan adalah seluruh Karyawan PKU Muhammadiyah sedangkan sampel diambil sebanyak 35 karyawan dengan metode convinience sampling. Metode pengumpulan data yang dilakukan adalah studi pustaka, dokumentasi, dan metode survei dengan teknik kuisioner. Analisis data menggunakan analisis regresi linier berganda , Uji t, dan Uji F dengan program SPSS 16.0. Berdasarkan hasil analisis dan pembahasan pada penelitian di PKU Muhammadiyah yang menyatakan apakah “Terdapat pengaruh signifikan antara pendapatan/gaji, pemberian tunjangan, lingkungan kerja, dan promosi jabatan terhadap kinerja karyawan”, tidak terbukti, karena dapat dilihat nilai signifikan dari empat variabel hanya TOTLK yang mempunyai nilai 0,05 maka yang mempunyai pengaruh signifikan hanyalah lingkungan kerja dan variabel lain tidak ada pengaruh yang signifikan terhadap kinerja karyawan. Hasil perhitungan untuk nilai R square (R2) dengan bantuan program SPSS 16.0 dalam analisis regresi berganda diperoleh angka koefisien determinasi atau R2 sebesar 0,206 Hal ini berarti 20,6% variasi perubahan kinerja karyawan dijelaskan oleh variasi perubahan faktor-faktor variabel independen (gaji, pemberian tunjangan, lingkungan kerja, dan promosi jabatan). Sementara sisanya sebesar 79,4% diterangkan oleh faktor lain yang tidak ikut terobservasi

FAKTOR YANG MEMPENGARUHI KAPASITAS VITAL PARU LANSIA DI KELURAHAN KARANGGENENG KECAMATAN BOYOLALI KABUPATEN BOYOLALI TAHUN 2010

ABSTRACT In elderly lung function decline due to reduced elasticity of the respiratory muscle fibers, decline in lung function will be more severe if the person concerned has smoking and lack of exercise. The research was to prove the association of smoking and exercise habits with lung vital capacity of elderly in Karanggeneng, Boyolali. This research was an analytical survey using cross sectional study. The populations study were elderly men aged ≥ 60 years who lived in the village of Karanggeneng.The subjects were 52 elderly taken by simple random sampling technique. Subjects underwent pulmonary function test to assess FEV1/FVC, FEV1, and FVC. The results showed that there was an association of smoking habits (p = 0.013), duaration of smoking (p = 0.001), type of cigarettes (p = 0.017), and exercise (p = 0.017) with lung vital capacity. However, there were not proven association of smoking status, frequency of smoking, type of exercise, frequency of exercise, exercise duration, and exercise habits with lung vital capacity.  The conclusion was smoking habits related with the decline of lung vital capacity and exercise regularly can reduced it so it was suggested for the elderly to stop smoking and do exercise regularly. Kata Kunci : lansia, kapasitas vital paru, olahraga, merokok Kesmasindo, Volume 4(2)Juli 2011, hlm. 137-14

FAKTOR YANG MEMPENGARUHI KAPASITAS VITAL PARU LANSIA DI KELURAHAN KARANGGENENG KECAMATAN BOYOLALI KABUPATEN BOYOLALI TAHUN 2010

ABSTRACT In elderly lung function decline due to reduced elasticity of the respiratory muscle fibers, decline in lung function will be more severe if the person concerned has smoking and lack of exercise. The research was to prove the association of smoking and exercise habits with lung vital capacity of elderly in Karanggeneng, Boyolali. This research was an analytical survey using cross sectional study. The populations study were elderly men aged ≥ 60 years who lived in the village of Karanggeneng.The subjects were 52 elderly taken by simple random sampling technique. Subjects underwent pulmonary function test to assess FEV1/FVC, FEV1, and FVC. The results showed that there was an association of smoking habits (p = 0.013), duaration of smoking (p = 0.001), type of cigarettes (p = 0.017), and exercise (p = 0.017) with lung vital capacity. However, there were not proven association of smoking status, frequency of smoking, type of exercise, frequency of exercise, exercise duration, and exercise habits with lung vital capacity.  The conclusion was smoking habits related with the decline of lung vital capacity and exercise regularly can reduced it so it was suggested for the elderly to stop smoking and do exercise regularly. Kata Kunci : lansia, kapasitas vital paru, olahraga, merokok Kesmasindo, Volume 4(2)Juli 2011, hlm. 137-14