Occupational Health and Safety Profile of a Flour Mill in Jakarta

Occupational health and safety of workers in large industries is important for the performance of the industry and productivity of workers. A large flour mill in Jakarta was selected to assess the occupational health and safety profile of such industries. The questionnaire used is adopted from the ILO/RI Ministry of Man­ power standard questionnaires, 1,425 male and 160 female workers were employed in the factory. The main flour mill product was wheat flour and pasta. Lighting is adequate in the factory, ex ept the pasta packing unit. Noise, dust and vibration are potential hazards in the d illing unit. The workers rarely used personal protective equipment: There was a high prevalence of respiratory disease among workers. Most employees adopted non-ergonomic posture during work at the packing unit. This increased complaints of low back pain and varicose veins. Work accidents frequently occurred at the workshop, but not at the drilling unit. Indiscriminate positioning of materials was observed at the workshop. Finally, we recommend health promotion on the use of protective equipment for disease prevention

Evaluation of Environmental Health in Kemayoran Public High Rise Building, Central Jakarta

Tujuan penelitian adalah untuk memperoleh data kesehatan dan lingkungan dari warga penghuni rumah susun Kemayoran, Jakarta Pusat. Metode penelitian adalah secara observasi dengan rancangan studi secara potong lintang. Instrumen penelitian menggunakan kuesioner tertutup dengan 49 variabel. Hasil penelitian menunjukkan bahwa perbedaan ditemukan pada bahan bakar untuk memasak dari minyak tanah (sebelum) menjadi fasilitas gas (sesudah) . Jarang ditein.ukan larva nyamuk pada tempat penampungan air terbuka karena ketidakteraturan pemasokan air bersih di rumah susun. Terjadi peningkatan pengeluaran bulanan untuk makanan dan fasilifas lain karena penghuni harus membayar lebih banyak untuk fasilitas rumah susun. Ditemukan kepadatan penghuni per luas tipe rumah yang melebihi standar ideal. Disarankan agar dalam pengelolaan rumah susun perlu dilakukan penyuluhan secara teratur kepada warga tentang kebiasaan tinggal di rumah susun, kebersihan dan sosialisasi antara tetangga rumah susun tersebut

Factors Influence the Utilization of Community Participation (POSBINDU)

Introduction: Posbindu is a form of public participation to conduct early detection and monitoring of risk factors for non-communicable diseases (NCD), and where it was carried out in as an integrated-manner, routine and periodic event. Posbindu itself aimed to promotethe community participation in prevention and early detection of risk factors for non-communicable disease (NCD). Non-communicable diseases is the biggest killer in the world,causing approximately 60% of global deaths. More than 9 millions of all deaths related to NCD occurredunder the age 60 years old, and 90% premature deaths incidenceoccurs incountries where significant number of population were low income-population. In Indonesia, death related to NCD are growing in an alarming rate, from aproximately 41% at the year 1995, striking 59,5% at year 2007. According to Basic Health Survey of 2007, NCD related deaths ranked number 6 in a top ten Death list.The growing rate of NCD prevalence are to become a serious threat upon national Development, death risk from disease related conditon will negatively impact human resources nationwide, which the effect will surely not limited to health aspect only but expanded to economic aspect.Meanwhile, Posbindu program had not reach its popularity as it should have been. In some region, posbindu visits by locals has decreased. At the study area, existing data showed that, only as much as 10% of the local population was using Posbindu service. In many regions, Posbindu were deemed to merge with geriatric social health care, as the major user was the geriatric population. Objective: to determine the factors that influence utilization of posbindu. Methods: This study was a cross-sectional study of 120 people in productive age (aged between 18-59 years) including individuals who nevervisit posbindu. In this study there were 3 groups of factors that can affect utilization of posbindu, the predisposing factors (age,sex,education level,occupation, knowledge from cader counsels,understanding about posbindu, awarrness, distance to posbindu, administration fee), and the reinforcing factors (family support, socialization of posbindu). Data were collected from February 2015 through to March 2015 Results: Respondents who do not utilize posbindu service are as many as 25% while 75% of respondents utilize posbindu. At bivariate analysis, we found several significant relationship between independent variable and utilization of posbindu : age (OR=3.46 ; 95% Confidence interval 0.96-12.43), education level (OR=0.17 ; 95% Confidence interval 0.03-0.772), knowledge (OR=3.82 ; 95% Confidence interval 1.60-9.09), awareness (OR=3.76 ; 95% Confidence interval 1.44-9.82), family support (OR=1.84 ; 95% Confidence interval 0.79-4.27), significant relationship between socialization of posbindu and utilization of posbindu (p=0.000), and also administration fee (OR=4.57 ; 95% Confidence interval 1.88-11.06). Multivariate analysis shows that respondent with higher education tend not to utilize posbindu service (OR=0.17 ; 95% Confidence interval 0.03-0.89), and those who did not mind for administration fee have the greater possibility to utilize posbindu service (OR=3.79 ; 95% Confidence interval 01.33-10.80). Conclusion: Several factors were conceived as aspects that affected the utilization of the Posbindu, but the level of education and administration fee are more prominent. Necessary efforts need to be conducted for people in productive age to promote their health, especially in community participation

Ko-infeksi asimptomatik helminthiasis pada pasien tuberkulosis paru di Surabaya kota: studi pendahuluan

BACKGROUNDPulmonary tuberculosis (TB) is a leading cause of morbidity and mortality, and East Java province is the second largest contributor of co-infection in Indonesia. Asymptomatic helminth infection among pulmonary tuberculosis patients causes another public health problem. Few data relate to helminth infection based on clinical and immunological outcomes of pulmonary TB in highly endemic areas. METHODSThis study was designed as a preliminary study and aimed to determine helminth co-infection among TB patients with a macroscopic assessment. This cross-sectional study was conducted in June-August 2017. RESULTSAmong 16 treated active TB patients from TB cohort data of Tanakali Kedinding health center found that 56% were stool smear-positive for Trichuris trichiura eggs, but had no clinical symptoms. CONCLUSIONWhether or not the helminth infection may have an impact on the diagnosis and treatment of active TB remains to be further investigated. Co-infection could be inhibited by the host immune response and improve the prognosis of TB treatment.LATAR BELAKANGPenyakit tuberculosis paru (TB) hingga saat ini masih menjadi penyebab utama tingginya angka morbiditas dan mortalitas, dan propinsi Jawa Timur termasuk penyumbang penderita kedua terbanyak di Indonesia. Hanya sedikit data informasi diketahui terkait infeksi kecacingan yang terjadi pada penderita TB baik secara klinis dan imunologi pada daerah endemis. METODEStudi ini di desain sebagai studi awal dan bertujuan untuk menilai ko-infeksi kecacingan diantara penderita TB. Studi potong-lintang ini dilakukan pada bulan Juni-Agustus 2017.HASILEnam belas penderita aktif TB berdasarkan data kohort tuberkulosis Puskesmas Tanakali Kedinding, didapatkan 56%-nya positif kecacingan dengan ditemukannya telur Trichuris trichiura.KESIMPULANWalaupun efek dari infeksi kecacingan tidak berdampak terhadap diagnosis dan pengobatan tuberkulosis, akan tetapi sebaiknya penderita yang terdeteksi sebagai tuberkulosis aktif, dilakukan skrining kecacingan terlebih dahulu. Ko-infeksi dapat dihampat oleh respon imun penderita dan meningkatkan prognosis pengobatan tuberkulosis.&nbsp

Evaluation of National Health Insurance Program Implementation in Jakarta Province, Indonesia

The implementation of National Health Insurance in several regions in Indonesia faces challenges, such as health service providers, health insurance management , and the community. The outcome that occurs may vary depending on the implementation of different aspects of governance, equity or social justice, and aspects of service quality. Therefore, research was conducted by evaluating the implementation of the national health insurance in DKI Jakarta Province. The evaluation is carried out based on the 2019 JKN road map target indicators, grouped into three aspects: including governance, achievement of equal distribution of health services (equity), and quality of service. This research used a mixed-methods design that combined the approach of quantitative and qualitative elements. Quantitative data were collected from secondary data from Health Social Security Agency (BPJS Kesehatan), the National Social Security Council Monitoring and Evaluation System (Sismonev DJSN). The qualitative data comes from in-depth interviews with selected informants using the purposive sampling technique. The result was that DKI Province had achieved the JKN membership target. There are still JKN participants who are inactive / in arrears from participants in the government and private wage-earning segments. Health facilities and human health resources have met the standards, but related to the package of benefits for heart diseases services, the availability of cardiac specialists and cath lab facilities has not been evenly distributed, especially in the Seribu Islands. Patient preferences in choosing the desired health service resulted in implementing a tiered referral system and back-referral still having problems in health facilities.

Paradigma baru penggunaan statin: efek kardioprotektif atau penyebab onset baru diabetes melitus?

3-Hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors atau yang biasa disebut sebagai statin, merupakan obat yang sudah digunakan sejak 30 tahun silam dan merupakan salah satu obat yang paling sering digunakan untuk terapi dislipidemia. Menurut hasil terbaru dari banyak studi observasional, randomized controlled trials (RCTs) dan meta-analyses telah mengonfirmasi adanya korelasi kejadian diabetes melitus (new-onset diabetes mellitus/NODM) setelah inisiasi penggunaan statin. Mekanisme spesifik terkait pengaruh statin terhadap kejadian diabetes melitus masih belum sepenuhnya dipahami, namun gangguan fungsi sel beta pankreas melalui calcium channel blockade, berkurangnya sensitivitas jaringan terhadap insulin akibat berkurangnya ekspresi GLUT 4, rendahnya kadar adiponektin dan mungkin mekanisme lainnya diduga menjadi faktor pencetus NODM. Sebagaimana yang kita tahu, statin digunakan dalam terapi dislipidemia serta pencegahan baik primer maupun sekunder terhadap kejadian penyakit kardiovaskular melalui efek pleiotropiknya. Namun, dengan adanya keterkaitan kejadian NODM maka makna protektif penggunaan statin menjadi berkurang. Pada artikel ini akan dibahas mengenai kemungkinan mekanisme statin terkait kejadian NODM dan makna penggunaanya sebagai pencegahan penyakit kardiovaskular

Adequate Visits, Inadequate Service: Comprehensiveness of ANC in Samarinda & Balikpapan, East Kalimantan

Introduction: With reference to the recommended essential antenatal services in Indonesia, this study assessed the provision of essential minimum care to pregnant women who attended government primary healthcare centres. Methods: Using a structured questionnaire, exit interviews were conducted with 182 pregnant women in their third trimesterfollowi ng receipt ofANC at primary health care centres intwo cities of East Kalimantan province, Indonesia. Results: For those who attended the government health care centres, access toANC intenns of number of visits and the timing of the visits were quite close to the national recommendations. At the government health centres a majority, however, did not receive the full set of even basic antenatal care components. The research also pointed that despite attending the government health centre for four or moreANC visits many women used the ANC services provided by the private doctors as well. Concluslon: The ANC at the government primary care facilities lacks comprehensiveness, and quality improvement measures are necessary if these services are to contribute to better health of mother and babies. The health departments and those involved in managing national safe motherhood initiatives should not besatisfied with the infonnation that a large number of pregnant women may now be accessing ANC from skilled health care providers

Ebola virus – new threat to global health

Ebola hemorrhagic fever is a fatal infectious disease of humans and primates. The disease is caused by single-stranded RNA viruses belonging to the family Filoviridae. The Ebola virus started to emerge in 1976, in an outbreak that almost simultaneously attacked two countries, namely Zaire and Sudan. (1) Around 500 cases were reported, with a case fatality rate of  88% in Zaire and 53% in Sudan. Although occurring at the same time, the Ebola viruses in the two countries were of different species, by serologic criteria as well as by sequence analysis.(2) The following Ebola virus species have been found: Zaire ebolavirus, Sudan ebolavirus, Cote d’Ivoire ebolavirus, Reston ebolavirus, and Bundibugyo ebolavirus.(1)  Since September 2014, more than 4000 confirmed cases of Ebola virus disease, with more than 2000 deaths, have been reported in West African countries, such as Guinea, Liberia, Nigeria, Senegal, and Sierra Leone.(3)     The Ebola outbreak started in Guinea in Desember 2013.(4) Nine months after the occurrence of the first cases, there was a weekly increase in the number of reported cases and deaths. There is now a global warning for nations to be on the alert against the spread of the Ebola virus.  Therefore the World Health Organization has declared the situation to be a public health emergency of international concern.(3) At the present time the Ebola outbreak is developing and spreading, so there are substantial challenges in controlling the outbreak, halting its transmission, and  providing clinical services to Ebola virus patients. However, the detection of patients with Ebola infection requires adequate diagnostic facilities, accompanied by treatment clinics and medicines, so as to help in containing the disease. The Ebola virus infection is mainly spread by contact with body fluids of symptomatic patients, and its transmission can be prevented by early diagnosis, contact tracing, isolation of patients, patient care, and infection control.(4,5)     Since it became known that two American healthcare workers in Liberia had become infected with the Ebola virus, the Ebola outbreak in West Africa has attracted much attention and caused anxiety in many countries.(7) This is not the first viral outbreak in West Africa that has  caused concern in advanced countries. Between 1928-1929, a yellow fever outbreak in West Africa resulted in the deaths of prominent research workers from America, England, and  Japan.(7)     Although several ecological aspects of the virus are known, there is still much to be investigated in relation to its ecology. Fruit bats are thought to be one of the reservoirs of the Ebola virus, although other animals may also be susceptible to the Ebola virus and be able to infect humans.(6) It is thought that infection in humans first occur at the time of exposure to body fluids from animal reservoirs of the virus, or intermediate animal hosts.(1) A study conducted by Pourrut et al.(8) reported that 4% of bats in Gabon were positive for immunoglobulins to the Zaire ebolavirus. This seems to provide evidence of bats as carriers of Ebola viruses and as a source of Ebola infection. Furthermore, person-to-person transmission may also occur through direct contact with body fluids from the patients. The incubation period of Ebola virus disease is between 1 and 21 days. The signs and symptoms are acute fever, shivering, headache, and myalgia, followed by rashes, sore throat, nausea, vomiting, diarrhea, and abdominal pain.(1) Around half of the patients show signs of hemorrhage, such as hemorrhage of the nasal cavity, hematuria, gastrointestinal hemorrhage, and vaginal hemorrhage in women. Wamala et al.(1) report that around 59% of patients who die from Ebola virus have hemorrhages. The case fatality rate of Zaire ebolavirus and  Sudan ebolavirus varies from 53%-90%.(1)     The outbreak occurring in the Bundibugyo district, Uganda, in August – December 2007 showed three successive transmission cycles. Each transmission cycle lasted  6  weeks, with an interval of 3-11 days, and was marked by a typical peaking of the outbreak, followed by a gradual decline.(1)     Frieden et al.(9) list three types of preventive interventions. The first is strict control of the infection in healthcare settings, because the greatest risk of transmission is not the obvious one from the patients, but from delayed detection and isolation. The second is education of local communities regarding habits that may spread the disease, and the third is to avoid consumption of raw meat of wild animals.     The Ebola virus outbreak constitutes a serious warning that epidemics may occur anywhere and places every afflicted nation at risk. Therefore it is essential to institute measures to stop its spread and its future threat, which is a moral obligation of members of the health profession, whether academicians, researchers, or health ministry officials

Protein intake as a determinant factor of physical activity in older persons

Worldwide, the proportion of people aged 60 and over is growing faster than any other age group. It has been well-established that the aging process can be associated with increased susceptibility to chronic conditions, disability, and co-morbidity, which however may be minimized or even partially reversed by physical activity. The assessment of physical activity is becoming an increasingly important component in the evaluation of elderly persons. Nutritional intake and status play an essential role in determining the physical activity level potentially capable of minimizing the health burden of older persons. The objective of this study was to find out whether nutritional intake and status were correlated with physical activity in community-dwelling older persons. The study population included 219 aged 60 to 69 years, of whom complete measures of socio-demographic characteristics, nutritional status, nutritional intake and physical activity were obtained. Serum total protein, albumin, globulin and hemoglobin concentration were measured as nutritional indicators (biomarkers). The nutrient content of food intakes was analyzed and calculated by “Nutrisurvey” software. Analysis indicated that there was a significant correlation between nutritional biomarkers [total protein (r=-0.211; p=0.002) and globulin (r=-0.247; p=0.000)] and physical activity. Compared to other food intakes, intakes of carbohydrate (r=0.241; p=0.001) and animal protein (r=0.149; p=0.027) were significantly correlated with physical activity. Our findings lend support to the existence among healthy older persons of a relationship between nutrional intake and status and physical activity

Asesmen risiko jatuh dan performa fungsional terhadap kualitas hidup lansia

LATAR BELAKANG Kualitas hidup adalah kualitas yang dirasakan dalam kehidupan sehari-hari tiap individu, yaitu suatu penilaian atas kesejahteraan mereka atau ketiadaannya. Penuaan merupakan masalah yang dapat mempengaruhi kesehatan. Penurunan performa fungsional dan meningkatnya risiko jatuh seringkali ditemukan pada proses penuaan. Rendahnya tingkat kesehatan individu dapat mempengaruhi kualitas hidup. Tujuan penelitian ini adalah untuk menentukan hubungan risiko jatuh dan performa fungsional terhadap kualitas hidup lansia. METODE Desain penelitian yang dipilih adalah observasional analitik dengan pendekatan studi potong silang yang diikuti 124 lansia pada tiga Pusaka Jakarta Pusat. Pengumpulan data dilakukan dengan wawancara dan pemeriksaan fisik. Kualitas hidup dinilai dengan kuesioner SF-12. Faktor risiko jatuh dinilai dengan wawancara menggunakan kuesioner Johns Hopkins. Performa fungsional dinilai dengan uji The Timed Up and Go (TUG). Analisis data menggunakan program SPSS versi 23 for Macintosh dengan tingkat kemaknaan p<0,05. HASIL Dari 124 responden, 43,5% lansia mengalami penurunan kualitas hidup. Sebanyak 64,5% lansia memiliki risiko jatuh sedang. Dan terdapat 57,7% lansia mengalami penurunan performa fungsional. Terdapat hubungan yang bermakna secara statistik antara risiko jatuh dengan kualitas hidup terhadap lansia (p = 0,020). Selain itu juga terdapat hubungan yang bermakna antara performa fungsional dengan kualitas hidup terhadap lansia (p = 0,020). KESIMPULAN Penelitian ini menunjukkan adanya hubungan antara risiko jatuh dan performa fungsional dengan kualitas hidup terhadap lansia