Epidemiological Clinical Index for Community Health Workers in Malaria Case Early Detection in East Nusa Tenggara

Background: East Nusa Tenggara (NTT) is the province with the highest malaria morbidity rate in Indonesia. The Provincial Health Office reported that Annual Parasite Incidence (API) in 2009 was 31 cases per 1000 inhabitants. Compared with the WHO standard, i.e API>5‰, then almost all districts/cities in NTT were high endemicity areas. The aim of this study was to formulate the clinical index of malaria for community health workers for early detection of malaria cases in Lembata Island and Adonara, East Nusa Tenggara. Subjects and Method: This was an analytic observational study with a cross-sectional design. This study was conducted in Lembata and Adonara Island, East Nusa Tenggara from April to December 2014. A sample of 428 cases of malaria based on thick drip blood examination was selected for this study by stratified random sampling. The independent variables were symptoms and clinical signs of malaria. The dependent variable was thick drip blood examination of malaria. The data were collected by questionnaire and analyzed by a multiple logistic regression. Results: Seven variables predicted malaria case: long fever (OR= 2.40; 95% CI= 2.20 to 5.75; p<0.001), chill(OR= 2.80; 95% CI= 1.19 to 3.69; p= 0.011), sweating (OR= 2.8; 95% CI= 1.19 to 3.6; p= 0.014), back pain (OR= 2.40; 95% CI= 1.11 to 3.51; p= 0.054), sore throat (OR= 3.80; 95% CI= 2.17 to 5.85; p <0.001), bitter mouth (OR= 3.60; 95% CI= 2.09 to 5.18; p= 0.011), pale face (OR= 4.20; 95% CI= 3.31 to 6.77; p< 0.001). The ROC curve had a sensitivity of 80.1% and a specificity of 66.2%. Conclusion: Seven variables can be used to predict malaria cases: long fever, chill, sweating, back pain, sore throat, bitter mouth, and pale face. Keywords: epidemiological clinical index, malaria case, early detection, community health worker

Holistic Care for Leprosy Patients in Lembata District, East Nusa Tenggara

Background: Lembata is a district in East Nusa Tenggara with various infectious and non-infectious diseases, including leprosy. The monthly incidence of leprosy increase by 1-2 new cases of leprosy per village. In Lembata there is Lembata Damian Hospital, a leprosy hospital established in 1959. Lembata District has a population of 157,265 people, most of than have low education level. The local government implemented a new approach of leprosy treatment emphasizing holistic treatment including medical, psychological, social, and spiritual treatment with the objective to cure and to improve the quality of life of leprosy patients. This study aimed to assess the effectiveness of the holistic leprosy treatment in Lembata District, East Nusa Tenggara. Subjects and Method: This was a qualitative study with problem solving approach. The holistic treatment applied to leprosy patients consisted of some components. In order to develop immune system in the body, the patients received local food nutritional intake, including maize, tubers, papaya fruit and leaf, and kelor leaf. To heal ulcers and wounds, the patients received blended topical herbal treatment, consisting of local papaya leaf, kelor leaf, turmeric tuber, and salt. The psychological component of holistic treatment aimed to prevent stress, feeling of despair, feeling of isolation, and lack of self confidence. The social component of holistic treatment empowered patients to be accepted by the surrounding community members. The spiritual component of holistic treatment attempted to enhance motivation by practicing prayer. The holistic treatment was developed by Porat Antonius. The data were collected by in-depth interview and direct observation. Results: As many as 76 cases of leprosy cases were identified through laboratory examination conducted at Damian hospital. As many as 33 leprosy cases received the holistic treatment in addition to anti-leprosy medical drugs. 19 of all 33 leprosy patients treated with the holistic treatment were cured. 14 patients refused to participate in the holistic treatment. Conclusion: Delving in local wisdom, the holistic treatment in complementary with modern anti-leprosy drugs can be used to cure leprosy patients and to improve their quality of life. Further studies, however, need to be carried out to provide rigorous scientific evidence on the effectiveness of the holistic treatment. Keywords: Leprosy, holistic treatment, herbal medicine, quality of lif

Quality of Health Care in the City Hospital of Kupang (Description of Health Care Terms Based Facilities, HR, and Facilities in the City Hospital of Kupang) in 2014

Implementation of Hospital services still have opportunities to improve the quality of service and take advantage of its resources, both human resources and financial resources, or capital economically and effectively. To improve the quality of service is not just a technical problem and the task of the hospital, but also our duty as a community, hopefully with the good cooperation, the services of the institution will be better. The purpose of this research is to find out the customer satisfaction, related to the medical technical services, and administrative services at the General Hospital of the city of Kupang. This type of research is descriptive research, which aims to describe or explain the events that occurred urgent nowadays. With cross sectional approach, which is an approach where the measurements or observations were made at the same time. Samples in this study is a part of the population which have been determined in accordance with the inclusion criteria, i.e. Clients Kupang City Hospital, concierge service providers in the hospital. Frequency distribution table is used for data analysis. The results obtained are the various deficiencies in the hospital from various aspects, especially the infrastructure and human resources. Thus, it can be recommended that the provision of infrastructure and equipment are needed to support the services in Kupang city hospital

Knowledge, Preventive Practice, and The Risk of Dengue Hemorrhagic Fever in Kupang, East Nusa Tenggara

Background: Dengue/dengue hemorrhagic fever (DHF) has been one of the most important resurgent tropical diseases in the past 17 years. Its incidence in East Nusa Tenggara has been increasing from 2011 to 2013. This study aimed to investigate the associations between knowledge, preventive practice, and the risk of dengue hemorrhagic fever in Kupang, East Nusa Tenggara. Subjects and Method: This was a case-control study conducted at 8 Puskesmas (Community Health Center) in Kupang, East Nusa Tenggara, Indonesia, from March to May 2016. A total of 72 subjects were selected for this study by fixed disease sampling, consisting of 36 DHF cases and 36 controls. The dependent variable was DHF. The independent variables were knowledge on DHF and DHF preventive practice including draining, hoarding and burying. The data were collected by questionnaire and interview. The data were analyzed by multiple logistic regression. Results: Poor knowledge on DHF (OR= 4.85; 95% CI= 1.62 to 14.49; p= 0.005) and poor DHF preventive practice (OR= 4.72; 95% CI= 1.60 to 13.91; p= 0.005) were associated with an increased risk of DHF. Conclusion: Poor knowledge of DHF and poor DHF preventive practice are associated with an increased risk of DHF. Keywords: knowledge, preventive practice, dengue hemorrhagic fever

Kajian Spasial Faktor Risiko Terjadinya Kejadian Luar Biasa Campak dengan Geographical Information System

Cakupan imunisasi yang tinggi bukan jaminan tidak terjadi Kejadian Luar Biasa (KLB) campak. Penelitian ini bertujuan mengetahui faktor risiko penyebab terjadinya KLB campak di wilayah kerja Puskesmas KualinKabupaten TTS. Metode penelitian ini menggunakan pendekatan kualitatif dan kuantitatif. Data primer dari hasil investigasi KLB campak dan wawancara dengan responden. Jumlah sampel sebanyak 204 responden yang terdiri dari 102 kasus yang diambil dengan metode total sampling dan 102 kontrol yang diambil dengan metode purposive sampling. Desain penelitian yang digunakan adalah cross sectional study dan data analisis secaraspacial menggunakan GIS. Data dianalisis menggunakan uji chi-square. Penelitian ini menunjukkan sebanyak 94,1% berumur <15 tahun, dengan persentase laki-laki sebesar 54,9%, tidak diimunisasi 93,1%, dan sebesar 67,5% penderita tidak memperoleh vitamin A. Hasil uji chi-square diperoleh umur, vitamin A, status imunisasi, status gizi, pendapatan keluarga, kepadatan hunian, penyakit infeksi dan riwayat kontak sebagai faktor risiko terjadinya KLB Campak. Faktor risiko yang bersifat sebagai protektor adalah status imunisasi, pemberian vitamin A, status gizi, tingkat kepadatan hunian dan penyakit infeksi

Factors Associated with Diarrhea in Noebeba, Middle South Timor, East Nusa Tenggara

Background: Acute diarrheal diseases remain a leading cause of global morbidity and mortality particularly among young children in resource-limited countries. Large studies are also currently underway evaluating novel and potential easy-to-implement water sanitation and hygiene (WASH) preventive strategies. This study aimed to examine factors associated with diarrhea in Noebeba, South Timor Tengah. Subjects and Method: This was a cross-sectional study conducted in Noebeba, Middle South Timor, East Nusa Tenggara. A sample of 355 mothers was selected for this study by simple random sampling. The dependent variable was diarrhea. The independent variables were household water container ownership, latrine ownership, maternal knowledge, handwashing practice, trash bin, and food sanitation. The data were collected by questionnaire. The data were analyzed by a multiple logistic regression. Results: Household water container ownership (OR= 0.21; p= 0.003), latrine ownership (OR= 0.32; p< 0.001), good maternal knowledge (OR= 0.62; p<0.001), and handwashing practice (OR= 0.41; p< 0.001) were associated with a decreased incidence of diarrhea. Trash bin and food sanitation did not show statistical significance with incidence of diarrhea. Conclusion: Household water container ownership, latrine ownership, good maternal knowledge, and handwashing practice, are associated with a decreased incidence of diarrhea. Keywords: diarrhea, hygiene, sanitation, risk factor

The Associations of Internal Factors, Sources of Information, and Family Role with Premarital Sexual Behavior among Adolescents in Kupang, East Nusa Tenggara

Background: Earlier studies reported that parents play a significant role in the sexual development and behaviors of their children. Parental monitoring and supervision are important paths for keeping adolescents from risky situations and activities while the teen develops responsible decision making skills. A supportive relationship between the parent and adolescent is important for enhancing communication and supervision. Empirical studies into this issue, however, is scanty in East Nusa Tenggara. This study aimed to analyze the associations of parental role and source of information on reproductive health, with unhealthy premarital sex behavior among adolescents in Kupang, East Nusa Tenggara. Subjects and Method: This was a cross sectional study conducted in Kupang, East Nusa Tenggara. A sample of 90 adolescents were selected for this study. The dependent variable was unhealthy sex behavior. The independent variables were role of parents and source of information on reproductive health. The data were collected by questionnaire and analyzed by a multiple logistic regression. Results: The risk of unhealthy premarital sex behavior increased with weak role of parents (OR= 2.74; p= 0.045) and negative source of information on reproductive health (OR= 2.20; p= 0.033). Conclusion: The risk of unhealthy premarital sex behavior increases with weak role of parents and negative source of information on reproductive health. Keywords: premarital, sex behavior, unhealthy, role of parents, source of information, reproductive health

Hygiene Sanitation and Detection Of Rhodamin B in Sauce and Formalin in Meatball at Meatball Tavern, Kupang, East Nusa Tenggara

Background: Food safety and sanitation is an essential part of the food industry. While it is important to be able to deliver food quickly and profitably, the importance of food safety and sanitation cannot be underestimated. Fast food retailers such as meatball tavern are common in Kupang, East Nusa Tenggara. Therefore it is worth studying the food safety and sanitation among the existing fast food retailers. This study aimed to examine hygiene sanitation and detection of rhodamin B in sauce and formalin in meatball at meatball tavern, Kupang, East Nusa Tenggara. Subjects and Method: This was a cross-sectional study conducted at meatball taverns, Kupang, East Nusa Tenggara, Indonesia. A total of 16 meatball taverns were selected for this study by total sampling. The dependent variables were hygiene sanitation, rhodamin B content in sauce, and formalin content in meatball. The independent variables were selection of foodstuff, food storage, processing place, equipment, food handlers, food transport, and food provision. The data were collected by observation and laboratory examination. The data were described accordingly. Results: Hygiene and sanitation in food selection and food storage were good (70-100%). Hygiene and sanitation in food handling and processing were fair (50-78%). Hygiene and sanitation of processing places were variable from poor to moderate (36-72%). Hygiene and sanitation of equipment were good (70-100%). Food stewardship was very good (87-100%). Rhodamin B content was absent in sauce. Formalin content was absent in meatball. Conclusion: Hygiene and sanitation levels in various aspect of food preparation and handling at meatball taverns were variable ranging from poor to very good level. Keywords: hygiene, sanitation, meatball, tavern, formalin, rhodamin B

Factors Associated with The Use of Antenatal Care in East Sumba, East Nusa Tenggara

Background: Antenatal care (ANC) is very important to pregnant women as it helps prevent mother and child mortality, prevent complications, helps foster a good relationship between the husband and wife, mother and child and father. Good antenatal care includes regular screening which can detect and prevent early complications such as hypertension and pregnancy diabetes; both of which can dramatically affect the fetus. Early detection means regular monitoring and treatment. This study aimed to analyze factors associated with the use of ANC in East Sumba, East Nusa Tenggara. Subjects and Method: This was an cross sectional study conducted in East Sumba, East Nusa Tenggara. A sample of 254 pregnant women were selected for this study by simple random sampling. The dependent variable was use of ANC. The independent variables were being a housewife, receiving husband's support, and social support. The data were collected by questionnaire and analyzed by a multiple logistic regression. Results: The use of ANC was associated with being a housewife (b= 0.88; 95% CI= 1.30 to 4.48; p= 0.005), receiving husband's support (b= 0.72; 95% CI= 0.25 to 0.95; p= 0.035), and social support (b= 1.52; 95% CI= 0.10 to 0.51; p<0.001). Conclusion: The use of ANC is associated with being a housewife, receiving husband's support and social support. Keywords: housewife, husband's support, social support, antenatal care, utilizatio

Factors Associated with Patient Satisfaction at Prof. Dr. W. Z Johannes General Hospital, Kupang, East Nusa Tenggara

Background: Patient satisfaction is an important factor for the survival of health care delivery system. It is used as a measure of quality of care at the level of the individual provider as well as for health care systems and programs. Earlier studies have shown that patient satisfaction correlates with adherence to treatment, loyalty to a provider, and lower medico legal risk. This study aimed to examine factors associated with patient satisfaction at Prof. Dr.W.Z Johannes general hospital, Kupang, East Nusa Tenggara. Subjects and Method: This was a cross-sectional study conducted at Prof. Dr. W. Z Johannes General Hospital, Kupang, East Nusa Tenggara, Indonesia. A total of 88 patients were selected by simple random sampling. The dependent variable was satisfaction. The independent variables were response time and social health insurance. The data were collected by questionnaire and interview. The data were analyzed by chi-square test. Results: Factors influencing patient satisfaction were fast response time (OR= 1.71; 95% CI= 1.25 to 2.40; p= 0.003) and covered by social health insurance (OR= 1.90; 95% CI= 1.19 to 3.05; p= 0.007). Conclusion: Factors influencing patient satisfaction are fast response time and covered by social insurance. Keywords: patient satisfaction, response time, social health insurance