Exergy Analysis of Boiler Process Powered by Biogas Fuel in Ethanol Production Plant:A Preliminary Analysis

This paper investigates a fluidized bed boiler used in an ethanol production plant. The boiler uses biogas fuel produced by the waste system of the distillation unit within this ethanol plant. Using Engineering Equation Solver (EES), a mathematical model is developed by employing the exergy analysis. Before the study was undertaken, initial operating data of the components in the plant was collected. The results show that the boiler system has an overall efficiency of 68.238 %. The exergy efficiency in each component was also calculated. The evaporator and heat exchanger have the lowest efficiency at 45.97% and 28.96%, respectively. The efficiencies of the other components are 61.41% for the pump water pit, 54.42% for the soft water tank and 66.39% for the de-aerator

Hubungan Umur dan Jenis Kelamin Terhadap Keberhasilan PITC (Provider Initiated Testing And Counselling) Pada Pasien TB Di Kota Medan Tahun 2017

Tuberculosis is a public health issue. Prevalence of tuberculosis in 2017 is estimated 824.000 cases in which making Indonesia the third country in the world with biggest burden TB and the seventh country with biggest burden in HIV-TB. PITC in primary health care is a Health Ministry program. PITC is the only test and counseling to motivated TB patient to get HIV test. The aim of this study is to analyze relationship between age and gender with the success of PITC in TB patients to know the HIV status at Medan in 2017. Method This research is a descriptive-analytic study with cross-sectional approach. the population in this study is TB patients with age 15-49 years old wo had TB diagnosed either with bacteriologic or clinical in primary health care at Medan in 2017. Medan is chosen because Medan is one of eight cities with the highest burden of TB and HIV in Indonesia, also it has complete recording of TB patients. The sample of this study is all TB patients in primary health care at Medan in 2017 who had PITC in total 2.228 from all TB patients in total 5.039 patients. Data analysis using SPSS to search for p value and Odds Ratio (OR). Result 250 of 2.228 (11,22%) patients is positive in HIV test. Statistics analysis using chi-square test shows p value 0.000 (p<0.05) and OR = 1.905 for relationship between gender and HIV test positive. Also, p value of 0,006 (p<0,05) and OR = 1.459 for relationship between age and HIV test positive. In this study with the implementation of PITC in TB patients in primary health care at Medan there is a relationship between sex and age with HIV infection

Spatial variation of tuberculosis risk in Indonesia 2010-2019

Background: As the second-highest country in tuberculosis (TB) cases globally, Indonesia has experienced an increasing trend of notification rate in the last ten years; however, the 34 provinces may have different risks. This study aims to examine TB risk variation across Indonesia in 2010-2019. Methods: A descriptive analysis was conducted on TB routine data of 2010-2019 from the Ministry of Health. Cases included all types of TB patients. Total cases, incidence rate (IR), and standardized morbidity ratio (SMR) were calculated for each province and national level during the period. Distributions of IRs and SMRs were displayed on maps. Results: During 2010-2019, 3,866,447 TB cases occurred in Indonesia, and the national IR was 1,523 per 100,000 populations. The highest proportion of cases and IR were in West Java (20.6%, 314 per 100,000); while the lowest was in North Kalimantan (0.2%, 3 per 100,000). Higher risks of TB occurred in DKI Jakarta (SMR 1.9), Papua (1.7), North Sulawesi (1.7), Maluku (1.5) and West Papua (1.5) among others. The smallest SMRs were found in Bali and Yogyakarta (0.5). Conclusion: TB risk varied across Indonesia in 2010-2019, with a higher risk in DKI Jakarta and several provinces in eastern Indonesia. Given the underreporting nature of routine data,&nbsp;validation is required when using the finding of this study in the local-level intervention. Keywords: tuberculosis, TB, standardized morbidity ratio, spatial variation, risk &nbsp; Abstrak Latar belakang: Sebagai negara dengan jumlah kasus tuberkulosis (TB) terbesar kedua di dunia, Indonesia menunjukkan tren peningkatan notification rate di sepuluh tahun terakhir. Akan tetapi, risiko TB di 34 provinsi bisa saja berbeda-beda. Artikel ini bertujuan mengkaji variasi risiko TB di Indonesia pada tahun 2010-2019. Metode: Data rutin TB tahun 2010-2019 dari Kementerian Kesehatan dianalisis secara deskriptif. Kasus TB didefinisikan sebagai semua tipe pasien TB. Total jumlah kasus, incidence rate (IR), dan standardized morbidity ratio (SMR) dihitung untuk tiap provinsi dan tingkat nasional selama periode tersebut. Sebaran IR dan SMR diplot di atas peta. Hasil: Selama 2010-2019, terdapat 3.866.447 kasus TB dan IR nasional 1.523 per 100.000 populasi. Proporsi kasus dan IR terbesar ada di Jawa Barat (20,6%, 314 per 100.000) dan terkecil di Kalimantan Utara (0,2%, 3 per 100.000). Risiko TB lebih tinggi di antaranya terjadi di DKI Jakarta (SMR 1,9), Papua (1,7), Sulawesi Utara (1,7), Maluku (1,5) dan Papua Barat (1,5). Standardized Morbidity Ratio terendah ditemukan di Bali dan Yogyakarta (0,5). Kesimpulan: Dapat disimpulkan bahwa risiko TB beragam di seluruh Indonesia selama 2010-2019, di mana DKI Jakarta dan beberapa provinsi di timur Indonesia memiliki risiko lebih tinggi. Mengingat adanya kurang lapor dalam data rutin, validasi diperlukan jika menggunakan temuan studi ini dalam intervensi di tingkat lokal. Kata kunci: tuberkulosis, TB, standardized morbidity ratio, variasi spasial, risiko &nbsp

Statistical analysis and visualization services for spatially integrated social science datasets

The field of Spatially Integrated Social Science (SISS) recognizes that much data of interest to social scientists has an associated geographic location. SISS systems use geographic location as the basis for integrating heterogeneous social science data sets and for visualizing and analyzing the integrated results through mapping interfaces. However, sourcing data sets, aggregating data captured at different spatial scales, and implementing statistical analysis techniques over the data are highly complex and challenging steps, beyond the capabilities of many social scientists. The aim of the UQ SISS eResearch Facility (SISS-eRF) is to remove this burden from social scientists by providing a Web interface that allows researchers to quickly access relevant Australian socio-spatial datasets (e.g. census data, voting data), aggregate them spatially, conduct statistical modeling on the datasets and visualize spatial distribution patterns and statistical results. This paper describes the technical architecture and components of SISS-eRF and discusses the reasons that underpin the technological choices. It describes some case studies that demonstrate how SISS-eRF is being applied to prove hypotheses that relate particular voting patterns with socio-economic parameters (e.g., gender, age, housing, income, education, employment, religion/culture). Finally we outline our future plans for extending and deploying SISS-eRF across the Australian Social Science Community

Applying the Innov8 approach for reviewing national health programmes to leave no one behind: lessons learnt from Indonesia

Koller TS, Saint VA, Floranita R, et al. Applying the Innov8 approach for reviewing national health programmes to leave no one behind: lessons learnt from Indonesia. Global Health Action. 2018;11(sup1):63-69.The World Health Organization's Innov8 Approach for Reviewing National Health Programmes to Leave No One Behind is an eight-step process that supports the operationalization of the Sustainable Development Goals' commitment to 'leave no one behind'. In 2014-2015, Innov8 was adapted and applied in Indonesia to review how the national neonatal and maternal health action plans could become more equity-oriented, rights-based and gender-responsive, and better address critical social determinants of health. The process was led by the Indonesian Ministry of Health, with the support of WHO. It involved a wide range of actors and aligned with/fed into the drafting of the maternal newborn health action plan and the implementation planning of the newborn action plan. Key activities included a sensitization meeting, diagnostic checklist, review workshop and in-country work by the review teams. This 'methods forum' article describes this adaptation and application process, the outcomes and lessons learnt. In conjunction with other sources, Innov8 findings and recommendations informed national and sub-national maternal and neonatal action plans and programming to strengthen a 'leave no one behind' approach. As follow-up during 2015-2017, components of the Innov8 methodology were integrated into district-level planning processes for maternal and newborn health, and Innov8 helped generate demand for health inequality monitoring and its use in planning. In Indonesia, Innov8 enhanced national capacity for equity-oriented, rights-based and gender-responsive approaches and addressing critical social determinants of health. Adaptation for the national planning context (e.g. decentralized structure) and linking with health inequality monitoring capacity building were important lessons learnt. The pilot of Innov8 in Indonesia suggests that this approach can help operationalize the SDGs' commitment to leave no one behind, in particular in relation to influencing programming and monitoring and evaluation

The development of the national tuberculosis research priority in Indonesia: A comprehensive mixed-method approach

Ranked second in global tuberculosis (TB) incidence, Indonesia has developed a National Strategy for TB Prevention and Control 2020–2024 to accelerate the TB elimination program. Research and innovation are key pillars to support the program and need to be prioritised. This study aimed to develop updated national TB research priorities in Indonesia. This study was a mixed-methods study consisting of an open survey, a published literature survey, and Delphi survey. The open survey invited all related TB stakeholders to answer (a) the main barriers of the TB program and (b) the need for studies to support TB elimination. The published literature survey retrieved scientific articles published in national and international journals between 2015 and 2020 to identify gaps between published research and the current national strategy for TB control. The online survey and literature survey informed a panel of TB experts in a two-phase Delphi Survey to select the top 10 priority research topics. We identified 322 articles and analysed 1143 open survey responses. Through two-phases Delphi surveys, top ten research categories were listed: early TB detection; diagnosis and treatment of DR-TB; contact investigation; case detection and treatment of child TB; TB preventive therapy; government policy; laboratory for drug-sensitive- and drug-resistant-TB diagnosis; treatment adherence; diagnostic tool development; and community empowerment. This study also found the gap between stakeholders’ interests and the importance of translating research into policy and practice. TB research priorities have been identified through the involvement of various stakeholders. The combination of an online survey, a published literature survey, and a Delphi survey was a rigorous methodology and was fit to build a systematic consensus about the priority of TB research

Budgetary impact of using BPaL for treating extensively drug-resistant tuberculosis.

INTRODUCTION: Bedaquiline, pretomanid and linezolid (BPaL) is a new all oral, 6-month regimen comprised of bedaquiline, the new drug pretomanid and linezolid, endorsed by the WHO for use under operational research conditions in patients with extensively drug-resistant tuberculosis (XDR-TB). We quantified per-patient treatment costs and the 5-year budgetary impact of introducing BPaL in Indonesia, Kyrgyzstan and Nigeria. METHODS: Per-patient treatment cost of BPaL regimen was compared head-to-head with the conventional XDR-TB treatment regimen for respective countries based on cost estimates primarily assessed using microcosting method and expected frequency of each TB service. The 5-year budget impact of gradual introduction of BPaL against the status quo was assessed using a Markov model that represented patient’s treatment management and outcome pathways. RESULTS: The cost per patient completing treatment with BPaL was US$7142 in Indonesia, US$4782 in Kyrgyzstan and US$7152 in Nigeria – 57$128 780) in XDR-TB treatment-related expenditure in Indonesia, 15% (US$700 247) in Kyrgyzstan and 32$1 543 047) in Nigeria. CONCLUSION: Our study demonstrates that the BPaL regimen can be highly cost-saving compared with the conventional regimens to treat patients with XDR-TB in high drug-resistant TB burden settings. This supports the rapid adoption of the BPaL regimen to address the significant programmatic and clinical challenges in managing patients with XDR-TB in high DR-TB burden countries

Budgetary impact of using BPaL for treating extensively drug-resistant tuberculosis

Introduction Bedaquiline, pretomanid and linezolid (BPaL) is a new all oral, 6-month regimen comprised of bedaquiline, the new drug pretomanid and linezolid, endorsed by the WHO for use under operational research conditions in patients with extensively drug-resistant tuberculosis (XDR-TB). We quantified per-patient treatment costs and the 5-year budgetary impact of introducing BPaL in Indonesia, Kyrgyzstan and Nigeria. Methods Per-patient treatment cost of BPaL regimen was compared head-to-head with the conventional XDR-TB treatment regimen for respective countries based on cost estimates primarily assessed using microcosting method and expected frequency of each TB service. The 5-year budget impact of gradual introduction of BPaL against the status quo was assessed using a Markov model that represented patient's treatment management and outcome pathways. Results The cost per patient completing treatment with BPaL was US$7142 in Indonesia, US$4782 in Kyrgyzstan and US$7152 in Nigeria - 57$128 780) in XDR-TB treatment-related expenditure in Indonesia, 15% (US$700 247) in Kyrgyzstan and 32$1 543 047) in Nigeria. Conclusion Our study demonstrates that the BPaL regimen can be highly cost-saving compared with the conventional regimens to treat patients with XDR-TB in high drug-resistant TB burden settings. This supports the rapid adoption of the BPaL regimen to address the significant programmatic and clinical challenges in managing patients with XDR-TB in high DR-TB burden countries

Impacts of COVID-19-related service disruptions on TB incidence and deaths in Indonesia, Kyrgyzstan, Malawi, Mozambique, and Peru: Implications for national TB responses.

Initial global-level estimates reported in June 2020 by the World Health Organization suggested that levels of disruption to TB service delivery could be as high as 25%-50% and result in an additional 6·3 million cases of tuberculosis (TB) and an additional 1·4 million TB-related deaths attributable to COVID-19 between 2020 and 2025. Quarterly epidemiological estimates and programmatic TB data capturing disruption levels to each TB service were collected by National TB Programmes in Indonesia, Kyrgyzstan, Malawi, Mozambique, and Peru. Data from 2019, for a pre-COVID-19 baseline, and throughout 2020, together with the NTP's COVID-19 response plans, were used within Optima TB models to project TB incidence and deaths over five years because of COVID-19-related disruptions, and the extent to which those impacts may be mitigated through proposed catch-up strategies in each country. Countries reported disruptions of up to 64% to demand-driven TB diagnosis. However, TB service availability disruptions were shorter and less severe, with TB treatment experiencing levels of disruption of up to 21%. We predicted that under the worse-case scenario cumulative new latent TB infections, new active TB infections, and TB-related deaths could increase by up to 23%, 11%, and 20%, respectively, by 2024. However, three of the five countries were on track to mitigate these increases to 3% or less by maintaining TB services in 2021 and 2022 and by implementing proposed catch-up strategies. Indonesia was already experiencing the worse-case scenario, which could lead to 270,000 additional active TB infections and 36,000 additional TB-related deaths by the end of 2024. The COVID-19 pandemic is projected to negatively affect progress towards 2035 End TB targets, especially in countries already off-track. Findings highlight both successful TB service delivery adaptions in 2020 and the need to proactively maintain TB service availability despite potential future waves of more transmissible COVID-19 variants