A Study on The Prevalence and Control of Non Communicable Diseases in Subang, West Java

Background: According to Basic Health Research, in 2013 non-communicable diseases (NCDs) with high prevalence were: (1) hypertension (10.5%), (2) stroke (6.6%), (3) asthma (5%), (4) chronic obstructive pulmonary disease (COPD) (4%), (5) diabetes mellitus (1.3%), (6) cancer (1%), (7) coronary heart disease (0.5%). This study aimed to describe the prevalence and control of NCDs in Subang, West Java. Subjects and Method: A survey was carried out in Subang, West Java. A sample of health personnel was selected for this study. The data were collected by in depth-interview. Input data (man, money, material, method, and machine), process data (NCDs management), and outcome data (NCDs prevalence) were obtained from document review. Results: In 2016, prevalence of hypertension was 9.27%, diabetes mellitus 3.81%, obesity 1.19%, COPD 0.50%, stroke 0.07%, breast cancer 0.01%, osteoporosis 0.66%, and asthma 1.76%. As many as 63.1% of all NCDs patients were women, 58% were older than 55 years, 32.6% aged 45 to 54 years, 9.4% aged 18 to 45 years. Conclusion: Most of all NCDs patients in Subang, West Java are women aged ≥18 years. Control program of NCDs showed that human resource input of NCDs is limited, NCDs financial is sufficient, medication for NCDs is sufficient. NCDs guidebook and NCDs technical guidelines are not available at Cipunagara health center. Keywords: non-communicable diseases, prevalence, contro

FACTORS THAT INFLUENCES OF PEOPLE LIVING WITH HIV / AIDS (PLWHA) IN VCT DIVISION OF GENERAL HOSPITAL WALUYO JATI KRAKSAAN DISTRICT PROBOLINGGO

HIV / AIDS have a some symptoms that impair the system immune. HIV / AIDS became an international problem with morbidity and mortality are still high. Based on from the Ditjen PP & PL, Kemenkes RI, 2014 reported 15 534 new HIV cases and 1,700 new AIDS cases. The discovery of ARV (anti-retroviral) encourage a revolution in the care of people living with HIV in the developed world. Although antiretroviral treatment can reduce the risk of death, but the death of people living with HIV still persist. This study aims to analyze and explain the effect of treatment on survival. Quantitative research methods to design a retrospective cohort study, a sample of 209 people living with HIV who received antiretroviral treatment in 2013 and 2015 in hospitals Waluyo Jati, Probolinggo, East Java. Secondary Treatment,Adherence, Stage,Age,Sex, Occupation,Education,Mariage status, Opportunistic Infection,CD4 collection using medical record in poly VCT, univariate analysis using frequency distribution, bivariate with log rank, kamplan meier, multivariate cox regression. The results showed that the variables associated with survival of ODHA treatment, adherence to treatment, clinical stage, opportunistic infection and CD4 cell count, adherence is the dominant factor with HR4,638,95% CI 1.267 to 3.908, p value 0,000, R² 9.6 %, average days obedient 900 days; disobedient 599 days, treatment combinations and no combination HR2,225,95% CI 1.267 to 3.908, the p value 0,005, R² 31.2%, the mean survival day combination of 712 days, not 869 days combinations; HR0,463 CD4 count, 95% CI 0.152 to 1.390, the p value 0,170, ² 8.6%, the average CD4> 350 as many as 932 days, CD4 <350 794 days. Conclusion ODHA dutifully taking the drughad a fivefold higher risk for long survival with a contribution of 10%. Keywords : Survival Of People Living With HIV, CD4, Aderence, Treatmen

The Association between Hormonal Injection Contraceptive and Blood Pressure in Women of Reproductive Age at Kembangan Communityhealth Center, Jakarta

Background: The association between hormonal injection contraceptive and hypertension has been long well-established. However, little is known about the relative odds of hypertension in women who used hormonal injection contraceptive in Jakarta. This study aimed to estimate the association between hormonal injection contraceptive and hypertension in women of reproductive age at Kembangan Community Health Center, Jakarta. Subjects and Method: This was a cross-sectioal study conducted at Kembangan Community Health Center, Jakarta in June 2014. A sample of 161 women of reproductive age was selected for this study by fixed exposure sampling, consisting of 80 women who had used hormonal injection con­tra­ceptive and 81 women who had used non-hormonal contraceptive. The dependent variable was blood pressure. The independent variable was use of hormonal injection contraceptive. The blood pressure was measured by sphygmomanometer. The data on the use of hormonal injection contraceptive was taken from the health record at Kembangan Community Health Center. The magnitude of the association between hormonal injection contraceptive and hypertension was measured by OR and tested by Chi-square. Results: The odds of hypertension increased with the use of hormonal injection contraceptive (OR= 7.82; 95% CI= 2.23 to 27.43; p= 0.001). Conclusion: Women who have used hormonal injection contraceptive at Kembangan Community Health Center, Jakarta, have eight times as many odds of hypertension than those who have use non-hormonal injection contraceptive. The health personnel at Community Health Center should be aware and monitor blood pressure of women who use hormonal injection contraceptive regularly in order to early detect hypertension and take the necessary action. Keywords: hormonal injection contraceptive, hypertensio

Integrating the landscape epidemiology and genetics of RNA viruses: rabies in domestic dogs as a model

Landscape epidemiology and landscape genetics combine advances in molecular techniques, spatial analyses and epidemiological models to generate a more real-world understanding of infectious disease dynamics and provide powerful new tools for the study of RNA viruses. Using dog rabies as a model we have identified how key questions regarding viral spread and persistence can be addressed using a combination of these techniques. In contrast to wildlife rabies, investigations into the landscape epidemiology of domestic dog rabies requires more detailed assessment of the role of humans in disease spread, including the incorporation of anthropogenic landscape features, human movements and socio-cultural factors into spatial models. In particular, identifying and quantifying the influence of anthropogenic features on pathogen spread and measuring the permeability of dispersal barriers are important considerations for planning control strategies, and may differ according to cultural, social and geographical variation across countries or continents. Challenges for dog rabies research include the development of metapopulation models and transmission networks using genetic information to uncover potential source/sink dynamics and identify the main routes of viral dissemination. Information generated from a landscape genetics approach will facilitate spatially strategic control programmes that accommodate for heterogeneities in the landscape and therefore utilise resources in the most cost-effective way. This can include the efficient placement of vaccine barriers, surveillance points and adaptive management for large-scale control programmes

Ko-Infeksi HIV-TB: Studi Cross Sectional

WHO states that co-infection of the disease that is often experienced by HIV/AIDS patients is Tuberculosis and is the main cause of mortality for HIV/AIDS patients. This study aims to determine the determinants of HIV-TB infection. Analytical research using case-control study design. The research sample was medical record data of HIV-TB co-infected patients at RSPI Prof. Dr. Sulianti Saroso in 2011-2016. The sample size is 160 with a random sampling technique. Analysis of univariate, bivariate, and multivariate data. The results showed that the factors of access to health facilities, weight loss, comorbid with other OIs, CD4 values ​​6 months after ARV and COPD were associated with HIV-TB infection with HIV in patients and the determinant factor of HIV-TB infection was weight loss. The incidence of HIV-TB Co-Infection can be influenced by factors of the patient's clinical condition and environmental factors. To improve services at the HIV department and TB DOTS department it is necessary to measure body weight for the nutritional status of HIV/AIDS patients.WHO menyebutkan koinfeksi penyakit yang sering dialami pasien HIV/AIDS adalah Tuberkulosis dan menjadi penyebab mortalitas utama pasien HIV/AIDS. Penelitian ini bertuuan untuk mengetahui determinan infeksi HIV-TB. Penelitian analitik menggunakan desain studi kasus kontrol. Sampel penelitian data rekam medik pasien HIV di RSPI Prof Dr Sulianti Saroso Tahun 2011-2016. Besar sampel 160 dengan teknik ramdom sampling. Analisa data univariat, bivariat dan multivariat. Hasil  menunjukkan bahwa faktor akses ke fasilitas kesehatan, penurunan berat badan, komorbid dengan IO lainnya, Nilai CD4 6 bulan setelah ARV dan PPK yang berhubungan terhadap infeksi HIV-TB dengan HIV pada pasien dan faktor determinan infeksi HIV-TB yaitu faktor penurunan berat badan. Kejadian Ko-Infeksi HIV-TB dapat dipengaruhi oleh faktor kondisi klinis pasien dan faktor lingkungan. Untuk peningkatan pelayanan di Pokja HIV dan Pokja TB DOTS diperlukan pengukuran berat badan untuk status gizi pasien HIV/AIDS.

Factors that influence adherence to antiretroviral treatment in an urban population, Jakarta, Indonesia

INTRODUCTION Although the number of people receiving antiretroviral therapy (ART) in Indonesia has increased in recent years, little is known about the specific characteristics affecting adherence in this population. Indonesia is different from most of its neighbors given that it is a geographically and culturally diverse country, with a large Muslim population. We aimed to identify the current rate of adherence and explore factors that influence ART adherence. METHODS Data were collected from ART-prescribed outpatients on an HIV registry at a North Jakarta hospital in 2012. Socio-demographic and behavioral characteristics were explored as factors associated with adherence using logistics regression analyses. Chi squared test was used to compare the difference between proportions. Reasons for missing medication were analyzed descriptively. RESULTS Two hundred and sixty-one patients participated, of whom 77% reported ART adherence in the last 3 months. The level of social support experienced was independently associated with adherence where some social support (p = 0.018) and good social support (p = 0.039) improved adherence compared to poor social support. Frequently cited reasons for not taking ART medication included forgetting to take medication (67%), busy with something else (63%) and asleep at medication time (60%). DISCUSSION This study identified that an increase in the level of social support experienced by ART-prescribed patients was positively associated with adherence. Social support may minimize the impact of stigma among ART prescribed patients. Based on these findings, if social support is not available, alternative support through community-based organizations is recommended to maximize treatment success

Surveillance guidelines for disease elimination: a case study of canine rabies

Surveillance is a critical component of disease control programmes but is often poorly resourced, particularly in developing countries lacking good infrastructure and especially for zoonoses which require combined veterinary and medical capacity and collaboration. Here we examine how successful control, and ultimately disease elimination, depends on effective surveillance. We estimated that detection probabilities of &lt;0.1 are broadly typical of rabies surveillance in endemic countries and areas without a history of rabies. Using outbreak simulation techniques we investigated how the probability of detection affects outbreak spread, and outcomes of response strategies such as time to control an outbreak, probability of elimination, and the certainty of declaring freedom from disease. Assuming realistically poor surveillance (probability of detection &lt;0.1), we show that proactive mass dog vaccination is much more effective at controlling rabies and no more costly than campaigns that vaccinate in response to case detection. Control through proactive vaccination followed by 2 years of continuous monitoring and vaccination should be sufficient to guarantee elimination from an isolated area not subject to repeat introductions. We recommend that rabies control programmes ought to be able to maintain surveillance levels that detect at least 5% (and ideally 10%) of all cases to improve their prospects of eliminating rabies, and this can be achieved through greater intersectoral collaboration. Our approach illustrates how surveillance is critical for the control and elimination of diseases such as canine rabies and can provide minimum surveillance requirements and technical guidance for elimination programmes under a broad-range of circumstances

Designing programs for eliminating canine rabies from islands: Bali, Indonesia as a case study

&lt;p&gt;Background: Canine rabies is one of the most important and feared zoonotic diseases in the world. In some regions rabies elimination is being successfully coordinated, whereas in others rabies is endemic and continues to spread to uninfected areas. As epidemics emerge, both accepted and contentious control methods are used, as questions remain over the most effective strategy to eliminate rabies. The Indonesian island of Bali was rabies-free until 2008 when an epidemic in domestic dogs began, resulting in the deaths of over 100 people. Here we analyze data from the epidemic and compare the effectiveness of control methods at eliminating rabies.&lt;/p&gt; &lt;p&gt;Methodology/Principal Findings: Using data from Bali, we estimated the basic reproductive number, R0, of rabies in dogs, to be ~1·2, almost identical to that obtained in ten–fold less dense dog populations and suggesting rabies will not be effectively controlled by reducing dog density. We then developed a model to compare options for mass dog vaccination. Comprehensive high coverage was the single most important factor for achieving elimination, with omission of even small areas (&#60;0.5% of the dog population) jeopardizing success. Parameterizing the model with data from the 2010 and 2011 vaccination campaigns, we show that a comprehensive high coverage campaign in 2012 would likely result in elimination, saving ~550 human lives and ~$15 million in prophylaxis costs over the next ten years.&lt;/p&gt; &lt;p&gt;Conclusions/Significance: The elimination of rabies from Bali will not be achieved through achievable reductions in dog density. To ensure elimination, concerted high coverage, repeated, mass dog vaccination campaigns are necessary and the cooperation of all regions of the island is critical. Momentum is building towards development of a strategy for the global elimination of canine rabies, and this study offers valuable new insights about the dynamics and control of this disease, with immediate practical relevance.&lt;/p&gt

A Survey of Dog Owners in Remote Northern Australian Indigenous Communities to Inform Rabies Incursion Planning

Australia is underprepared for a rabies incursion due to a lack of information about how a rabies outbreak would spread within the susceptible canine populations and which control strategies would be best to control it. The aim of this study was to collect information to parameterize a recently developed dog rabies spread model as well as use this information to gauge how the community would accept potential control strategies. Such information–together with model outputs–would be used to inform decision makers on the best control strategies and improve Australia’s preparedness against a canine rabies incursion. The parameters this study focussed on were detection time, vaccination rates and dog-culling and dog movement restriction compliance. A cross-sectional survey of 31 dog-owners, using a questionnaire, was undertaken in the five communities of the Northern Peninsular Area (NPA) in northern Australia regarding community dog movements, veterinary visits, reporting systems, perceptions of sick dogs and potential human behaviours during hypothetical rabies outbreaks. It highlighted the significant shortfalls in veterinary care that would need to be vastly improved during an outbreak, who educational programs should be targeted towards and which dog movements should be restricted. The results indicate that men were significantly more likely than women to allow their dogs to roam and to move their dogs. The current low vaccination rate of 12% highlighted the limited veterinary services that would need to be substantially increased to achieve effective rabies control. Participation in mass vaccination was accepted by 100% of the respondents. There was lower acceptance for other possible rabies control strategies with 10–20% of the respondents stating a resistance to both a mass culling program and a ban on dog movements. Consequently, movement bans and mass dog culling would have limited effectiveness as a control strategy in the NPA community. More than half of the respondents said that they would report their sick dogs within a week. This would lead to a much more optimistic rabies detection time than observed in other regions with recent dog rabies outbreaks. Findings from this study can be used to parameterize a recently developed dog rabies spread model as well as to develop informed policies for managing a future rabies incursion, thus improving Australia’s preparedness against a canine rabies incursion. Author Summary Australia is underprepared for a rabies incursion due to limited information about how a rabies outbreak would behave and which control strategies would be best to control it. A disease spread model of rabies has been developed to help policy-makers decide on the best response to a rabies incursion. However, data to inform this model are lacking. Therefore, the aim of this study was to gather information to parameterize the existing rabies spread model and to gauge how the community would accept potential control strategies. A survey of dog-owners, using a questionnaire, was undertaken in five remote, indigenous communities in northern Australia. We found that compared to women, men were more likely to allow their dogs to roam and to move their dogs. The current vaccination rates in these dog populations are low due to limited veterinary services. This would make delivery of vaccine in the event of a rabies incursion potentially challenging. However, compliance of dog owners with mass vaccination campaigns would be high. However, compliance with movement control of dogs might be problematic, as would the mass culling of dogs, although, rabies detection following an incursion could optimistically occur within a week