The association between malaria incidences and air temperature at Kulon Progo District, Yogyakarta Special Province

Malaria is still a public health problem in Indonesia including in Kulon Progo District, Yogyakarta Special Province. Kulon Progo District remains become malaria endemic area, with significant number of malaria cases for more than the last ten years. Previous studies proved that malaria transmission is associated with climatic conditions. However, these conditions have never been investigated in Kulon Progo District. The aim of this ecological study was to investigate the association between the distribution of malaria cases and climatic condition in the Kulon Progo District using spatial-temporal approach. A total of 1439 malaria cases were collected during the period of 2005-2015. Time-trend, bivariate analysis, and spatial analysis were performed. The results showed that air temperature lag 0 (p = 0.0000; r = 0.5225), air temperature lag 1 (p = 0.0009; r = 0.2850), air temperature lag 2 (p = 0.0329; r = 0.1858) related to the incidence of malaria. Spatial analysis and time-trend analysis also showed direct relationship pattern between malaria and air temperature. In conclusion, there is a relationship between malaria cases and air temperature in Kulon Progo District. Spatial analysis approach is important for early alert system, to decrease morbidity and mortality due to malaria

mHealth intervention to knowledge level and family planning participation of unmet need women in Sleman District: Randomized Controlled Trial (RCT)

Latar belakang: Rendahnya pencapaian program keluarga berencana di Indonesia selama tahun-tahun ini membutuhkan pendekatan yang komprehensif tetapi memiliki tujuan. Salah satu eksposur informasi yang menargetkan wanita menikah usia reproduksi telah ditetapkan sebelumnya sebagai proyek percontohan di beberapa daerah di Indonesia dengan aplikasi Skata. Kabupaten Sleman sebagai populasi terbesar dan terpadat di Provinsi DIY menjadi tantangan dan peluang sementara wanita unmet need adalah yang tertinggi sebagai perhatian tentang efek samping dari metode kontrasepsi. Menerima informasi yang salah dan kurangnya sumber daya manusia / konselor keluarga berencana yang tersedia di setiap desa menjadi alasan untuk mengeksplorasi efektivitas Skata dalam mencapai indikator keluarga berencana di lapangan.Tujuan: Mengukur efektivitas intervensi kesehatan terhadap tingkat pengetahuan dan partisipasi dalam program keluarga berencana di kalangan wanita unmet need di Kabupaten Sleman.Metode: Penelitian eksperimental dengan desain uji terkontrol acak (RCT). Populasi penelitian adalah wanita unmet need di Kabupaten Sleman, sampel diperoleh secara acak yang memenuhi kriteria inklusi dan eksklusi. Ukuran sampel adalah 207 peserta menggunakan rumus Lemeshow dengan kekuatan 0,80. Variabel independen adalah intervensi kesehatan keliling. Variabel dependen adalah tingkat pengetahuan dan partisipasi dalam program keluarga berencana, yang diperoleh dengan daftar periksa instrumen penelitian melalui wawancara. Analisis data termasuk statistik deskriptif, bivariat (chi-square) dan analisis multivariat (regresi logistik).Hasil: Analisis McNemar untuk perbedaan tingkat pengetahuan pra dan posttest menunjukkan perbedaan yang signifikan (p = 0,0002). Analisis chi-square tidak menunjukkan korelasi yang signifikan antara intervensi mHealth dan tingkat pengetahuan (p = 0,1287) tetapi korelasi intervensi mHealth dan partisipasi keluarga berencana menunjukkan nilai yang signifikan (p = 0,030). Analisis regresi logistik untuk proporsi tingkat pengetahuan dalam dua kelompok tidak memiliki perbedaan yang signifikan sedangkan partisipasi keluarga berencana menunjukkan perbedaan yang signifikan antara intervensi dan kelompok kontrol dengan OR 1,85 (95% CI = 1,06-3,25)Kesimpulan: Pemanfaatan kesehatan kurang efektif dalam meningkatkan tingkat pengetahuan tetapi menunjukkan bukti yang efektif dalam meningkatkan partisipasi keluarga berencana pada wanita unmet need. Usia menunjukkan bukti yang memengaruhi partisipasi keluarga berencana di antara wanita unmet need

Acceptance Analysis of the Electronic Kohort Information System for Maternal and Child Health Using the Technology Acceptance Model at the Bima City Health Center

The Maternal and Child Health (MCH) Program in Indonesia is faced with a diversity of achievements between regions caused by disparities in the capacity of the health system and exacerbated by the Covid-19 pandemic which has caused a decrease in service activities and reporting quality so that digitalization of services is needed.  This type of research is qualitative research with the design of phenomenological studies using thematic analysis with the help of the Nvivo 12 application. Primary data collection was carried out by means of observation and in-depth interviews with research informants by purposive sampling. To increase the credibility of the data use source triangulation. The research informants consisted of the head of the family health services section, the head of the health centers and the midwife as the user of the e-cohort.  Thirteen informants (11 women and 2 men) participated in the study. Most informants can use the core functions of the e-cohort app navigation menu. The study proposes that the perceived perception of ease of use may not be in line with the perceived expediency of explaining variations in the successful acceptance of MCH e-cohort applications. The study also found that there were differences in outcomes between user perceptions at the operational level and policy makers at the managerial level. In general, the analysis collects several types of obstacles and potentially problems that negatively affect the usefulness of the e-cohort application : not being able to make the work of midwives easier and faster, ineffective and not so much to increase the productivity of performance. With regard to ease of use, users feel that the e-cohort can be easily learned and used.  The e-cohort is considered to have value as a system that makes the work of midwives more difficult and hinders the work, however, the appearance, elements, features and design are perceived to be quite easy to use. In addition, users also highlight the need to consider how the system can be implemented in order to minimize the impact and optimize usabilit

Fatalitas dan Analisis Spasial Kecelakaan Lalu Lintas di Gunung Kidul

Fatality and spatial analysis of road traffic accident in Gunung KidulPurposeThis study is aimed to conduct further analysis of road accidents fatality and accident-potential area using geographic information system.MethodsThis was an analytic observational study using cross-sectional study design. Samples are all traffic accident recorded in police departement accident registry from January 1st to December 31st 2015. Data will be analyzed using poisson regression with robust variance and accident location will be analyzed spatially using ArcGIS 10.4 software.ResultsThe result revealed that 06.00-11.59 a.m (PR 0.31, 95% CI 0.144-0.687) or 12.00-17.59 p.m (PR 0.40; 95% CI 0.184-0.865), uphill roadway geometric (PR 2.16, 95% CI 1.144-4.094) or winding roadway (PR 1.80, 95% CI 1.013-3.213) and single accident type (PR 3.59; 95% CI 1.953-6.592) were significant factors affecting road traffic fatalities. Accident-prone locations to traffic accidents in Gunungkidul are clustered on several streets, such as Yogyakarta-Wonosari Street, Karangmojo-Semin Road, Wonosari Semanu Street and Wonosari Baron Street..ConclusionsFatal traffic accident in Gunungkidul are influenced by environmental conditions and accident types. Multisectoral coordination was needed to improve intervention to population at risk and stakeholders need to make efforts to modify the environment related to road geometric conditions to minimize the occurrence of accidents

Penggunaan Data Surveilans Gabungan dan Meteorologi untuk Memprediksi Demam Berdarah Dengue di YOGYAKARTA

Use of a combined surveillance and meteorological data for predicting dengue hemorrhagic fever in YogyakartaPurposeThis study aimed to predict the incidence of dengue hemorrhagic fever using meteorological data such as rainfall, rainy days, air temperature, humidity, and dengue hemorrhagic fever surveillance data month by month in Northern Yogyakarta Municipality (Climatic Zone 138) through 2010-2016.MethodThis research was a descriptive study with a predictive design with temporal approach. This research processed secondary data of DHF incidence from Yogyakarta Municipality Health Office and climate variables from Meteorology Climatology and Geophysics Agency (BMKG) Yogyakarta from 2010 to 2016. Data were analyzed with univariate tests and presented in frequency distribution, bivariate analysis was performed using Pearson/ Spearman correlation tests, and multivariate analysis used Poisson regression, negative binomial regression, and generalized poisson regression tests.ResultsDHF incidence in Northern Yogyakarta Municipality (Climatic Zone 138) was associated with meteorological factors in the same month up to 3 months earlier. Predictors of DHF case were dengue incidence of previous month, rainfall 2 months earlier, current temperature, and relative humidity of the previous month.ConclusionThe best prediction model of DHF incidence in Northern Yogyakarta Municipality (Climatic Zone 138) was a combination of surveillance and meteorological data. It is necessary to develop an awareness system of DHF incidence with meteorological database and surveillance in order to control the incidence of DHF in Yogyakarta Municipality

Kebijakan Pemerintah Daerah dalam Meningkatkan Sistem Rujukan Kesehatan Daerah Kepulauan di Kabupaten Lingga Provinsi Kepulauan Riau

Ignasius Luti1, Mubasysyir Hasanbasri2, Lutfan Lazuardi21 Dinas Kesehatan Kabupaten Lingga, Kepulauan Riau2 Program Studi Ilmu Kesehatan Masyarakat, Fakultas Kedokteran,Universitas Gadjah Mada, YogyakartaABSRACTBackground: One of the critical issues in the development ofnational health care is the limited accessibility to health services.Such problems also occur in Linga District of KepulauanRiau Province. It is caused by many factors, such as geographicallocation, cost, number of health personnel and conditionof health care facilities, such as health centers and theirnetworks which are not accessible to the public. Several attemptshave been made, for example, by improving the statusof sub-health centers to be health centers, health centers tobe treatment centers, assinging health workers both medicaland paramedical, improving health financing and making budgetpolicies. However, its implementation has not been maximal.In accordance with the above background, it would requirea study on the role of local government policy in improvingthe referral system which is useful to know the problemsin the field, so that in the future a variety of improvement canbe done.Objective: To determine the referral system in the islandsarea of Linga District.Methods: This was a case-study research. The researchsubjects were head of health centers / health center doctors,nurses/midwife assistants, ambulance drivers/sea ambulancedrivers, patient families, community figures, jamkesmas/Jamkesda managers, head of health care section/head ofhealth office, director of local hospital/mobile hospital and emergencyroom nurses. The variables in this study were independentvariable (referral system) and dependent variable (ambulanceservice). The research location was in Linga Districtof Kepualauan Riau Province.Results: The results showed that policy efforts of the LingaGovernment District in improving the referral system had existed.The existing financing policy had encompassed twoaspects both from the demand side (medical expenses) andfrom the supply side (a system that supported health care).The process of referral from primary care to advanced serviceshad been going well although there was still lack as theunavailability and completeness of services. Most of the healthworkers had received training; there were also specialist doctors(in collaboration with the faculty of medicine), but networkingin the referral process was done partially and notintegrated.Conclusion: The health referral system in Linga District hadrun pretty well, but did not fully involve community participationin an integrated service system. The local government in thiscase Linga District Health Office needs to revitalize as well asaccelerate the development of Desa Siaga (alert villages) readinessto increase community participation in the developmentof a referral system.Keywords: policy, referral systems, islands, ambulance servic

Risk Factor of HIV Infection Among Young Agein Voluntary Counseling Testing (VCT) Clinics of Yogyakarta

ABSTRACTIntroduction: HIV/AIDS is a health problem in the world. The Highest HIV/AIDS cases in Indonesia were reported in young age groups, including in Province of Yogyakarta (DIY). Knowing the determinant and risk factors of HIVis necessary to determine effective prevention programs, especially in young agewhich one of the vulnerable populations, either because of individual and family characteristics, media influence, peer pressure, substance use and risky behavior.Objectives: To know the relationship between risk factors for HIV infection amongyoung age in VCT clinic of Yogyakarta.Methods: This study used a cross-sectional design and the population was young clients at VCT clinics of Yogyakarta. Samples were obtained from VCT clinics of Griya LenteraPKBI Yogyakarta and Edelweis Clinics of Dr Sardjito Hospital. Variable risk factors were obtained byquestionnaire and interviews than HIV test results was obtained from VCT clinics.Results: Of the 62 respondents, 74.2% were female, age average were 24,4 years old, 41.9% level education were junior high school, 82.3% had migration, 62.9% received less monitoring from families, 61.3% ever use the TV / HP for pornography, 56.5% getting high sexual pressure from peers, 62.9% had been smoking and alcohol consumption, 98.4% had ever sexual intercourse, 95.2% had sexual intercourse in the last 6 months, 93.5% risky sexual intercourse, 32.3% HIV positive and 55% through heterosexual.Conclusion: HIV infection among young people in VCT Clinic of Yogyakarta, by bivariate analysis correlated with gender, residency status, education level, relationship with parents, TV / mobile and internet used to watch pornography. However, according to multivariate analysis, HIV infection correlated with education level at senior high school and college, residing with their parents/ family and in the last 6 months are still using alcohol and illicit drugs. It is recommended to enhance more comprehensive prevention for young people in accordance with the factors associated with HIV risk behaviour.Keywords: HIV infection, young age, individual characteristics, family, peers, media usage, substance use, risky behavior

Overview of The Incidence and Risk Factors for Nosocomial Infections Using a Geographic Information System Maps

Hospitalized patients have a high risk of getting nosocomial infections due to various reasons. They tend to be more susceptible to infection because oftheir underlying disease condition, and they have higher when patients undergo invasive procedures. If the patient’s immune system is impaired, thenon-pathogenic microorganism are capable of causing disease. Map is a method of illustrating an epidemiologic effectively . Maps can be used to showplace of incidence. Mapping the incidence of nosocomial infections in Sultan Agung Hospital is a method developed for the surveillance of nosocomialinfections. This type of research is a quantitative study with a cross sectional design. This study illustrates the risk factors of nosocomial infection withincidence of nosocomial infections that occur based on time point. Risk factors are extrinsic and intrinsic factors. Based on the spatial image on the map,in extrinsic incidence of nosocomial infections is Plebitis. Genesis Plebitis incidence correlates with the placement of hand washing points handrub. Whilethe intrinsic factor in the Plebitis image and ILO most inpatient distribution in patients aged 50 years with impaired skin integrity due to infusion andphysically due to decreased immunity associated with a variety of underlying diseases. Incidence of nosocomial infections in the inpatient unit is theprimary predisposing factors such as age and clinical issues related predisposing underlying disease can weaken the immune system of the patient, so thatthe procedures and even the most basic medical treatment could potentially cause nosocomial infection

Risk Factors of Tuberculosis at Women in Cilacap District

Introduction: Tuberculosis (TB) is disease a second major cause of deaths worldwide among infectious diseases, killing nearly 2 million people each year. The variety of problems will arise if the woman was suffering TB especially who are married, pregnant, and have children. Her role as a housewife who had to carry out physical or mental care of children while taking care of her husband will be disturbed. The prevalence of smear positive pulmonary Tuberculosis (TB) in 6 region health center in Cilacap District at 2012,  women higher than men.Objectives: To know probability of pregnancy, marital status, parity, physical activity, level of education, level of knowledge, the kitchen smoke pollution, history contact with TB patient, residential density, ventilation against TB incidence in women.Methods: The type of research was observational analytical case-control design. Sample is 102 people consisting of as many as 51 cases and 51 control. Sampling is done with proportional random sampling techniques. Data were analyzed with the univariabel, bivariabel analysis, and multivariable.Results: Pregnancy (OR 1.2 95% CI 2.4-23.7 p0.04), parity (OR 3.5, 95% CI 1.3-9.7 p 0.01), history of contacts (OR 3.8 95% CI 1.4-10.4 p 0.01) ventilation (OR 2.4 95% CI 7,5-23.7 p 0.00) as a risk factor for the occurrence of TB in women.Conclusion: The incidence of TB in women in Cilacap District a more probable or risk greater in women who were pregnant, high parity, had a history of contacts, and stay at home with the bad ventilation. Probability of them was 99.5% Keywords: Tuberculosis, Women, Risk Factors INTISARIPendahuluan: Tuberkulosis (TB) adalah penyakit penyebab utama ke-dua kematian di seluruh dunia di antara penyakit menular, membunuh hampir 2 juta orang setiap tahun.Risiko TB pada wanita meningkat selama usia produktif. Berbagai masalah akan muncul jika wanita menderita TB mengingat peran wanita terutama yang sudah menikah, hamil, dan memiliki anak. Perannya sebagai seorang ibu rumah tangga yang harus melaksanakan tugas pengasuhan fisik maupun mental anak-anak sekaligus mengurus suami akan terganggu.Prevalensi TB paru BTA positif di 6 wilayah Puskesmas Kabupaten Cilacap tahun 2012 pada wanita lebih tinggi dibandingkan pada pria. Tujuan: Untuk mengetahui peluang status perkawinan, kehamilan,paritas, aktivitas fisik, tingkat pendidikan, tingkat pengetahuan, polusi asap dapur, riwayat kontak serumah, kepadatan hunian, dan luas ventilasi rumah terhadap kejadian TB pada wanita.Metode: Jenis penelitian ini adalahpenelitian analitik observasional dengan rancangan kasus kontrol.Besar sampel adalah sebanyak 102 orang terdiri dari 51 orang kasus dan 51 orang kontrol.Pengambilan sampel dilakukan dengan teknik proporsional random sampling.Data dianalisis dengan analisis univariabel, bivariabel, dan multivariabel.Hasil: Hasil uji  multivariat, kehamilan (OR 1,2 CI 95% 2,4-23,7 p 0,04), paritas (OR 3,5 CI 95% 1,3-9,7 p 0,01), riwayat kontak (OR 3,8 CI 95% 1,4-10,4 p 0,01) ventilasi (OR 7,5 CI 95% 2,4-23,7 p 0,00) sebagai faktor risiko terjadinya TB pada wanita.Simpulan: Kejadian TB pada wanita di Kabupaten Cilacap berpeluang atau berisiko lebih besar pada wanita yang hamil, paritas tinggi, mempunyai riwayat kontak, dan tinggal di rumah dengan ventilasi yang tidak memenuhi syarat kesehatan. Probabilitas subyek dengan faktor risiko tersebut untuk menderita TB sebesar 99,5%. Kata kunci: tuberkulosis, wanita, faktor risik