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

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

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

<p>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.</p> <p>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 (<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.</p> <p>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.</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

DETERMINANTS OF DENGUE HEMORRHAGIC FEVER OUTBREAK IN CIPAYUNG, EAST JAKARTA

Background: Dengue hemorrhagic fever (DHF) is an infectious disease that is caused by dengue virus. To date no specific medicine is available for this disease. Jakarta Province ranks 5th in the incidence of DHF. In 2014, the cumulative incidence (CI) of DHF was 48.7 cases/100,000. In Cipayung sub district (East Jakarta), there were 136 new cases of DHF (CI= 52.1/100.000) in 2015. This study aimed to investigate the determinants of DHF outbreak in Cipayung, East Jakarta. Subjects and Method: This was a cross-sectional study, conducted in Cipayung, East Jakarta. A sample of 594 households were selected at random for this study. The dependent variable was DHF. The independent variables were dweller density, water container drainage, container supervision. The data were collected using questionnaire and observation. The data was analyzed by multiple logistic regression. Results: DHF incidence was affected by container supervision <1 time per week (OR= 2.45; 95% CI= 1.57 to 3.84; p<0.001), container drainage <4 times/month (OR= 1.82; 95% CI= 1.19 to 2.79; p= 0.006), dweller density <4 (OR=0.61; 95% CI= 0.42 to 0.87; p=0.007). Conclusion: DHF incidence is affected by container supervision <1 time per week, container drainage <4 times/month, dweller density <4. Keywords: DHF, container drainage, container supervision, dweller densit