Studi Evaluasi Pelatihan Penatalaksanaan Pms dengan Pendekatan Sindrom di Beberapa Kabupaten di Jawa Timur

Sexually Transmitted Diseases (STD continue to become major public health problems. Most of STD patients present with urethral or vaginal discharge, even though the causes may be of different micro-organisms. The Syndromic Approach (SA) is an algorithm for STD management currently recommended by the WHO. Diagnosis are made based on clinical signs and symptoms using a certain flowchard-without laboratory confirmation, and all possible causes will be treated. IEC are also given and the patients' partners are notified. The East Java Provincial health office has trained Puskesmas' and hospitals' doctors and paramedics on this new STD management approach.The objecttive of this study is to evaluate the implementation of SA in some Puskesmas and private clinics which personnels have been trained before. Using direct observation, document research, interviews and focus group discussions, data and information on the benefit of SA, the obstacles in implementing SA, and recommendations to improve the health providers' performance in STD management are collected. Results are hopefully used as inpc;ts in improving the STD control program, provincially as well as nationally

STUDI EVALUASI PELATIHAN PENATALAKSANAAN PMS DENGAN PENDEKATAN SINDROM DI BEBERAPA KABUPATEN DI JAWA TIMUR

Sexually Transmitted Diseases (STD continue to become major public health problems. Most of STD patients present with urethral or vaginal discharge, even though the causes may be of different micro-organisms. The Syndromic Approach (SA) is an algorithm for STD management currently recommended by the WHO. Diagnosis are made based on clinical signs and symptoms using a certain flowchard-without laboratory confirmation, and all possible causes will be treated. IEC are also given and the patients' partners are notified. The East Java Provincial health office has trained Puskesmas' and hospitals' doctors and paramedics on this new STD management approach.The objecttive of this  study is to evaluate the implementation of SA in some Puskesmas and  private clinics which personnels have been trained before. Using direct observation, document research, interviews and focus group discussions, data and information on the benefit of SA, the obstacles in implementing SA, and recommendations to improve the health providers' performance in STD management are collected. Results are hopefully used as inpc;ts in improving the STD control program, provincially as well as nationally

Validasi Pemeriksaan Infeksi Menular Seksual Secara Pendekatan Sindrom Pada Kelompok Wanita Berperilaku Risiko Tinggi

Accurate and adequate treatment of STIs is a critical component of STI-control activities to reduce transmission and sequelaes. On the other hand, chronic shortage in skilled staff and laboratory equipment in many countries necessitate the use of clinical skills more in order to diagnose and differentiate STIs. For these places, the WHO has recommended and produced a protocol of it syndromic approach management of STIs in place of treatment by -etiology. Since 1997 the Indonesia Ministry of Health has been conducting national training on this method. However, the syndromic approach for vaginal discharge is known to be problematic since differentiation among cervicitis, vaginitis, and even normal condition is difficult. The main objective of this study is to determine the sensitivity, specificity and positive predictive value of the syndromic approach management of women with signs and/or symptoms of abnormal vaginal discharge. The sample population were women with high risk sexual behaviors in East Java and North Sulawesi provinces. The laboratory tests using DNA hybridization probe technique (the PACE 2 test, Gen-Probe, San Diego, Calif.) for Neisseria gonorrhoeae and Chlamydia trachomatis were used as gold standard. In addition, we also compared the clinical approach widely used by clinicians (mainly at hospitals) with laboratory results. A total of 439 participants was recruited purposively (230 from E. Java and 209 from N.Sulawesi). In E.Java, the sensitivity, specificity, and predictive value of the syndromic management for vaginal discharge are 31%, 83%, and 59%, respectively, and in N.Sulawesi 49%, 56%, and 40%,respectively. The clinical approach did not show better results. In E.Java the sensitivity, specificity, and positive predictive value are 13%, 89%, and 50%, res­pectively, while in N.Sulawesi they are 42%, 61%, and 39%, respectively. As a conclusion, the current form of syndromic management has little use for STI screening among high risk women. Further studies by adding more criteria to the syndromes are needed to improve this method

Hepatitis E, Central African Republic

Hepatitis E, Central African Republi

Human influenza A H5N1 in Indonesia: health care service-associated delays in treatment initiation.

BACKGROUND: Indonesia has had more recorded human cases of influenza A H5N1 than any other country, with one of the world's highest case fatality rates. Understanding barriers to treatment may help ensure life-saving influenza-specific treatment is provided early enough to meaningfully improve clinical outcomes. METHODS: Data for this observational study of humans infected with influenza A H5N1 were obtained primarily from Ministry of Health, Provincial and District Health Office clinical records. Data included time from symptom onset to presentation for medical care, source of medical care provided, influenza virology, time to initiation of influenza-specific treatment with antiviral drugs, and survival. RESULTS: Data on 124 human cases of virologically confirmed avian influenza were collected between September 2005 and December 2010, representing 73% of all reported Indonesia cases. The median time from health service presentation to antiviral drug initiation was 7.0 days. Time to viral testing was highly correlated with starting antiviral treatment (p < 0.0001). We found substantial variability in the time to viral testing (p = 0.04) by type of medical care provider. Antivirals were started promptly after diagnosis (median 0 days). CONCLUSIONS: Delays in the delivery of appropriate care to human cases of avian influenza H5N1 in Indonesia appear related to delays in diagnosis rather than presentation to health care settings. Either cases are not suspected of being H5N1 cases until nearly one week after presenting for medical care, or viral testing and/or antiviral treatment is not available where patients are presenting for care. Health system delays have increased since 2007

Female commercial sex workers in Kramat Tunggak, Jakarta, Indonesia

Indonesia is predicted to face a severe AIDS epidemic in the near future. More than 60% of the reported HIV-positive cases in Indonesia can be attributed to heterosexual transmission; therefore, by the nature of their work, female commercial sex workers (FCSWs) constitute one of the communities at risk. No meaningful or effective STD/HIV prevention programs for FCSWs can be planned if there is no contextual understanding of these women as persons, the nature and the risks of their job and their relations with their clients and managers. Just as it is incorrect to assume that all women enter prostitution for the same reasons, educational approaches that are modeled on shallow stereotypes will be ineffective. Interweaving qualitative and quantitative methods, this research investigates the FCSWs in an 'official' brothel complex in Jakarta, Indonesia. Results of this study give insights of four typologies of FCSWs observed in Kramat Tunggak. The personal, professional, social and other differences which influenced the women into full-time sex work and affected their willingness and ability to engage in healthy and protective behaviors, are presented. Finally, based on those findings a recommendation on how to deliver health messages to the FCSWs is offered.Sex workers Brothels STD/AIDS Indonesia

Perkawinan Sehat, Tips Untuk Sang Dara

Perkawinan sebuah tali suci yang mengikat dua insan untuk bersama-sama mengarungi hidup sebagai suatu pasangan. Tali suci yang tidak terlihat ini sering dilambangkan sebagai sepasang cincin yang melingkar di jari manis sang pasangan . Tali suci yang menggambarkan janji, kesepakatan untuk saling bersetia, dalam keadaan susah dan senang. Perkawinan didambakan hampir sumua dara. Perkawinan tidak sekedar mengikat dua insan.23 X 15 cm ; 210 hl

VALIDASI PEMERIKSAAN INFEKSI MENULAR SEKSUAL SECARA PENDEKATAN SINDROM PADA KELOMPOK WANITA BERPERILAKU RISIKO TINGGI

<p class="Style2">Accurate and adequate treatment of STIs is a critical component of STI-control activities to reduce transmission and sequelaes. On the other hand, chronic shortage in skilled staff and laboratory equipment in many countries necessitate the use of clinical skills more in order to diagnose and differentiate STIs. For these places, the WHO has recommended and produced a protocol of it syndromic approach management of STIs in place of treatment by -etiology. Since 1997 the Indonesia Ministry of Health has been conducting national training on this method. However, the syndromic approach for vaginal discharge is known to be problematic since differentiation among cervicitis, vaginitis, and even normal condition is difficult.</p> <p class="Style2">The main objective of this study is to determine the sensitivity, specificity and positive predictive value of the syndromic approach management of women with signs and/or symptoms of abnormal vaginal discharge. The sample population were women with high risk sexual behaviors in East Java and North Sulawesi provinces. The laboratory tests using DNA hybridization probe technique (the PACE 2 test, Gen-Probe, San Diego, Calif.) for <em>Neisseria gonorrhoeae and Chlamydia trachomatis</em> were used as gold standard. In addition, we also compared the clinical approach widely used by clinicians (mainly at hospitals) with laboratory results.</p> <p class="Style2">A total of 439 participants was recruited purposively (230 from E. Java and 209 from N.Sulawesi). In E.Java, the sensitivity, specificity, and predictive value of the syndromic management for vaginal discharge are 31%, 83%, and 59%, respectively, and in N.Sulawesi 49%, 56%, and 40%,respectively. The clinical approach did not show better results. In E.Java the sensitivity, specificity, and positive predictive value are 13%, 89%, and 50%, res­pectively, while in N.Sulawesi they are 42%, 61%, and 39%, respectively. As a conclusion, the current form of syndromic management has little use for STI screening among high risk women. Further studies by adding more criteria to the syndromes are needed to improve this method.</p