Reducing maternal mortality ratio (MMR) is a high priority public health issue in developing countries such as Indonesia. The current MMR in Indonesia is 126/100,000 live births. Optimum use of ...available healthcare facilities for delivery can avert maternal deaths. This study aimed to determine the factors associated with healthcare facility utilization for childbirth in Kuantan Singingi regency, Riau province, Indonesia 2017.
We conducted a community-based cross-sectional study in 15 sub-districts of Kuantan Singingi regency from May-June 2017. We selected 320 mothers from 15 sub-districts who delivered in the last 3 months (February-April 2017). Trained data enumerators collected the relevant data by using a pre-tested semi-structured questionnaire. We used Cox regression analysis to determine the factors associated with delivery at healthcare facilities. Prevalence Ratio (PR) with a 95% confidence interval (CI) for childbirth at healthcare facilities was the key outcome measure.
Only 54.4% (174) of the 320 mothers delivered at healthcare facilities. Knowledge about pregnancy danger signs (PR = 1.59, 95%CI:1.15-2.2), attitude towards healthcare services (PR = 0.79, 95%CI:0.33-1.89), and access to health care services (PR = 0.39, 95%CI:0.18-0.84) were the dominant factors of childbirth at healthcare facilities. There was an interaction between attitude and access to healthcare influencing delivery at healthcare facilities.
Utilization of healthcare facilities for childbirth was low in Kuantan Singingi regency. Knowledge of pregnancy danger signs was an independent correlate of childbirth at healthcare facilities. Also, the interaction between attitude and access to healthcare showed a significant influence on childbirth at healthcare facilities. We recommend strengthening of existing maternal and child health program with a particular emphasis on complete and quality antenatal care, health education on danger signs of pregnancy and childbirth, and promoting positive attitudes towards healthcare facilities.
Chronic kidney disease of unknown etiology (CKDu) in agricultural population is an increasing issue. This study aims to obtain a prevalence estimate of CKDu in male rice farmers in West Java, ...Indonesia; and analyze the relationship between CKDu and environmental and occupational factors. The study design was cross-sectional. This study included 354 healthy male farmers in two rice agriculture areas in West Java with different altitudes (low altitude and high-altitude location). This research included blood and urine sampling from the farmers for serum creatinine (SCr) level and proteinuria; questionnaire on demographic information, occupational factors and other risk factors for CKDu. We measured ambient temperature and humidity in both study locations for environmental factors. From SCr level and proteinuria, we categorized the farmers into five stages of CKD; then we distinguished CKDu from CKD if the farmers had stage 1–4 of CKD but without diabetes, hypertension and other traditional causes. Data were analyzed with multivariate logistic regression to get prevalence odd ratios of CKDu and its relationship with environmental and occupational factors, adjusted with other risk factors of CKDu. The overall prevalence of CKD was 24.9% and CKDu was 18.6%. For the environmental factors, farm location (high altitude versus low altitude location) was associated with CKDu (Prevalence Odds Ratio (POR): 2.0; 95% CI: 1.2–3.5). For the occupational factors, although not significant, the risk of CKDu increased with the longer use of insecticide and with the more frequent of insecticide use. We suggested that there was a need to conduct future research to investigate more on the association of those environmental and occupational factors with CKDu.
•Most caregivers had positive beliefs about routine immunisation.•Many children aged 2–24 months were not up-to-date with all vaccines for age.•Uptake was associated with education, income and ease ...of access to immunisation.•Child illness and perceived vaccine unavailability were key reasons for missed/delayed immunisation.•Interventions should focus on strategies that are responsive to the context-specific needs and priorities of districts and communities.
The COVID-19 pandemic contributed to significant health services declines in South-East Asia including Indonesia, which experienced a decline in routine immunisation of children. This study investigated the influence of the pandemic on the beliefs and experiences of caregivers of children related to routine immunisation.
This study involved a cross-sectional survey among 1399 caregivers of children aged 0–24 months in Central Java and West Nusa Tenggara provinces from March–April 2022. Data on beliefs and experiences of childhood immunizations were captured using core items from the WHO/UNICEF Behavioural and Social Drivers of Immunization (BeSD) survey. Bivariate and multivariate logistic regression analyses identified factors associated with uptake of routine immunisations.
While nearly all caregivers (95.7%) reported wanting their child to receive all recommended routine immunisations, only 40.3% of children aged 2–24 months were up-to-date with all vaccines for age. Factors associated with up-to-date included higher parental education (aOR: 1.76, 95% CI 1.02–3.05), higher household income (aOR: 1.54, 95% CI 1.09–2.18), and caregivers who found it moderately or very easy to get immunisations (aOR: 2.26/2.22, 95% CI 1.06–4.83/1.06–4.69).
Recovery efforts should prioritise responding to the factors associated with immunisation status (e.g., perceived ease of access) and on families experiencing disadvantage (e.g., caregivers with lower education and household income) to ensure protections against future outbreaks that are responsive to the context-specific needs and priorities of districts and communities.
Economic burden of dengue in Indonesia Nadjib, Mardiati; Setiawan, Ery; Putri, Septiara ...
PLoS neglected tropical diseases,
01/2019, Letnik:
13, Številka:
1
Journal Article
Recenzirano
Odprti dostop
Dengue is associated with significant economic expenditure and it is estimated that the Asia Pacific region accounts for >50% of the global cost. Indonesia has one of the world's highest dengue ...burdens; Aedes aegypti and Aedes albopictus are the primary and secondary vectors. In the absence of local data on disease cost, this study estimated the annual economic burden during 2015 of both hospitalized and ambulatory dengue cases in Indonesia.
Total 2015 dengue costs were calculated using both prospective and retrospective methods using data from public and private hospitals and health centres in three provinces: Yogyakarta, Bali and Jakarta. Direct costs were extracted from billing systems and claims; a patient survey captured indirect and out-of-pocket costs at discharge and 2 weeks later. Adjustments across sites based on similar clinical practices and healthcare landscapes were performed to fill gaps in cost estimates. The national burden of dengue was extrapolated from provincial data using data from the three sites and applying an empirically-derived epidemiological expansion factor.
Total direct and indirect costs per dengue case assessed at Yogyakarta, Bali and Jakarta were US$791, US$1,241 and US$1,250, respectively. Total 2015 economic burden of dengue in Indonesia was estimated at US$381.15 million which comprised US$355.2 million for hospitalized and US$26.2 million for ambulatory care cases.
Dengue imposes a substantial economic burden for Indonesian public payers and society. Complemented with an appropriate weighting method and by accounting for local specificities and practices, these data may support national level public health decision making for prevention/control of dengue in public health priority lists.
This study aimed to assess the prevalence of blood lead levels (BLLs) among children 1 to 5 years old who reside near and distant to informally used lead-acid battery (ULAB) recycling locations and ...examine risk factors for elevated BLLs. A cross-sectional study was conducted in three greater Jakarta neighborhoods where informal ULAB recycling occurs. Venous BLLs among 279 children were analyzed using portable blood lead testing machines. Demographic, child activities, and sources of lead exposure inside and outside homes were assessed. Multivariate analysis was performed to evaluate factors associated with the prevalence of BLLs. Forty-seven percent of children had BLLs ≥ 5 µg/dL and 9% had BLLs ≥ 10 µg/dL. No differences in geometric mean BLLs were observed between children who lived near and distant to ULAB locations. Older child age groups Prevalence Ratio (PR) 2.14, 95% Confidence Interval (CI) 1.16, 4.18) and low household income (PR 1.58, 95% CI 1.03, 2.40) were associated with BLLs 5-9 µg/dL. Low educational attainment of the child's father (PR 3.17, 95% CI 1.23, 8.16) and frequent outdoor child activity (PR 4.93, 95% CI 1.09, 22.21) were predictors of BLLs ≥ 10 µg/dL. This study shows the association between lead exposure among children and environmental sources. Public health officials can consider expanded surveillance, health care provider education, and development of strategies to reduce lead exposure.
ABSTRACT
Dengue Hemorrhagic Fever (DHF) is an endemic disease in the tropical area. The spread of the disease can occur fast if it is not controlled. DHF is caused by the dengue virus that is ...transmitted through Aedes aegypti dan Aedes albopictus. According to Bangka District Health Office, It was reported that the number of DHF cases in 2017 was 51 and 50 cases in 2018 (until March 2018). The objective of this study was to know the association between the water container and DHF cases in West Bangka District in 2018. This was a case- control study with a total respondent of 183 respondents and the ratio of case and control was 1:2. The results showed that the presence of Aedes larvae (OR=0,007; p-value=0,007; 95% CI: 1,59-19,96), presence of water container (OR=5,12; p-value=0,01; 95% CI: 1,47- 17,86), water container opened/closed (OR=2,72; p-value=0,063; 95% CI: 0,94-7,84) were associated with DHF cases. Houses where Aedes larvae were founded, in or outside the house (with container index >20%) have a 5.6 times higher risk to be contracted with DHF compare to houses with no Aedes larva. In addition, houses with water containers can be founded near the houses have a 5.1 times higher risk to be contracted with DHF. Houses with opened water containers were associated with DHF with 2.7 times higher risk to be infected with DHF. Therefore, community participation in eliminating mosquitoes breeding places needs to be encouraged.
ABSTRAK Upaya pengendalian demam berdarah dititik beratkan pada penggerakan potensi masyarakat untuk dapat berperan serta dalam Pengendalian Sarang Nyamuk (PSN) melalui 3M plus. Tempat Penampungan Air (TPA) merupakan salah satu tempat perkembangbiakan jentik Aedes Aegyti, semakin banyak TPA yang digunakan berpotensi untuk menjadi tempat perkembangbiakan jentik. Berdasarkan data Dinas Kesehatan Kabupaten Bangka Barat jumlah kasus DBD pada tahun 2017 sebanyak 51 kasus dan sampai bulan maret 2018 sebanyak 50 kasus terlaporkan. Tujuan penelitian adalah untuk mengetahui pengaruh tempat penampungan air dengan kejadian DBD di Kabupaten Bangka Barat. Desain penelitian adalah case control dengan jumlah total responden adalah 183 responden dengan perbandingan kasus dan kontrol adalah 1:2. Hasil penelitian menunjukkan tempat penampungan air terbuka/tertutup (OR=2,72; p-value=0,063; 95% CI: 0,94-7,84), keberadaan jentik (OR=0,007; p-value=0,007; 95% CI: 1,59-19,96), tempat penampungan air (OR=5,12; p-value=0,01; 95% CI: 1,47-17,86). Rumah dengan tempat penampungan terbuka mempunyai risiko 2,7 kali lebih besar untuk transmisi DBD, rumah yang ditemukan jentik di tempat penampungan air dalam maupun di luar rumah (CI >20%) mempunyai risiko 5,6 kali lebih besar untuk terkena DBD dan rumah yang disekitarnya ditemukan tempat penampungan air berisiko 5,1 kali lebih besar untuk menderita DBD. Pengelola program DBD agar terus melaksanakan kegiatan – kegiatan penanggulangan dan tatalaksana kasus DBD.
BackgroundThe COVID-19 pandemic resulted in extreme strain on health systems including the health workforce, essential health services and vaccination coverage. We examined disruptions to ...immunisation and maternal and child health (MCH) services, concerns of personal well-being and delivery of healthcare during the pandemic as well as factors associated with self-reported trauma or burnout among healthcare providers (HCPs).MethodsIn March–April 2022, we conducted a cross-sectional survey among HCPs in two provinces of Indonesia. HCPs involved in COVID-19 or routine immunisation and MCH services were randomly selected from district/city health office registration lists. We descriptively analysed service disruptions experienced by HCPs as well as trauma, burnout and concerns of personal well-being and delivery of healthcare during the pandemic. Multivariate logistic regression analyses were undertaken to identify factors associated with trauma or burnout.ResultsWe recruited 604 HCPs. Mobilisation of staff from routine health services to COVID-19 response duties was a key reason for service disruptions (87.9%). Strategies such as community outreach and task shifting were implemented to overcome disruptions. Trauma or burnout during the pandemic was reported by 64.1% HCPs, with 23.5% reporting worse mental or emotional health.Factors associated with trauma or burnout included delivery of COVID-19 immunisation (adjusted OR (aOR) 2.54, 95% CI 1.08 to 5.94); and delivery of both COVID-19 immunisation and routine immunisation compared with no involvement in vaccination programmes (aOR 2.42, 95% CI 1.06 to 5.52); poor treatment in the workplace (aOR 2.26, 95% CI 1.51 to 3.38) and lower confidence to respond to patient queries on COVID-19 immunisation (aOR 1.51, 95% CI 1.03 to 2.22).ConclusionHCPs experienced service disruptions, trauma and burnout and implemented strategies to minimise disruptions to service delivery and improve patient experiences. Our study highlights the need to ensure that workforce resilience and strategies to protect and support HCPs are considered for pandemic planning, preparedness and management.
Drug-resistant tuberculosis (TB) patients have a greater risk of loss to follow-up (LTFU) than drug-sensitive TB patients, due to their longer treatment duration. This study aimed to determine the ...influence of decentralization and patient type on LTFU among multidrug-resistant TB (MDR-TB) patients in Indonesia. A retrospective cohort study was conducted at all MDR-TB treatment healthcare facilities in Indonesia from 014 to 2015. Using total sampling technique, 961 patients were examined and sampled. Of these patients, 86.03% were decentralized. Patients were classified into types as follows: 35.17% were “relapse” patients, 5.52% were “new,” 13.94% were classified as “after LTFU” patients, 23.10% were “treatment failure category 1” patients, 20.29% were “treatment failure category 2” patients, and 1.90% were classified as “other types” patients. Decentralization reduced LTFU risk by up to 46% (HR = 0.54, 95% CI 0.35–0.84). LFTU in “after LTFU,” “treatment failure category 2,” and “other types” patients was higher by 50%, 53%, 74%, respectively compared to LFTU occurrence in “relapse” (baseline) patients. Among “treatment failure category 2 patients, female patients were 2.13 times more likely to have an occurrence of LFTU, while male patients were 0.55 times as likely to have an occurrence of LFTU, compared to “relapse” type patients of the same sex.
Background. The double product (DP) acts as an index for myocardial oxygen demand, derived from the multiplication of systolic blood pressure (SBP) and pulse rate (PR). This research aimed to explore ...the association between high myocardial oxygen demand and extended hospital stays among acute ischemic stroke patients in Indonesia. Methods. This study was a retrospective cohort study carried out from January 2022 to December 2022 at a regional referral hospital located in Jakarta, Indonesia. Participants were chosen consecutively until the necessary sample size was achieved. Information extracted from medical records encompassed baseline sociodemographic and clinical variables. Univariate and bivariate analyses were performed, along with multivariate analysis utilizing Cox proportional hazards, to determine the correlation between elevated myocardial oxygen demand index and length of hospital stay (LOS). Results. A total of 366 patients were included, with a mean age of 60.05 ± 10.41 years, and 60.4% were male. The mean length of hospital stay was 3.4 ± 3.55 days. Bivariate analysis revealed a significant association between high myocardial oxygen demand index (RR 3.184, 95% CI 1.097-9.258, p=0.028), sepsis (RR 1.942, 95% CI 1.024-4.145, p=0.045), and severe anemia (RR 2.610, 95% CI 1.291-1.465, p=0.036) with prolonged length of stay. Multivariate analysis demonstrated that the high myocardial oxygen demand group had a significantly higher association with prolonged length of stay compared to the normal-to-low myocardial oxygen demand group (RR 2.116, 95% CI , p=0.035) after controlling for sepsis and severe anemia variables. Conclusions. The High Myocardial Oxygen Demand Index is significantly correlated with extended length of stay among patients with acute ischemic stroke, both before and after adjusting for other potential covariates that could impact treatment duration in such patients.
Drug resistant TB patients had a greater risk of LTFU than drug-sensitive TB patients due to longer treatment duration. The aims of this study were to determine the influence of decentralization and ...type of patient to LTFU in MDR-TB patients in Indonesia. This study was conducted in May-June 2018 at Sub Directorate of TB - Ministry of Health of the Republic of Indonesia. The study design was retrospective cohort. Samples were taken in total sampling with a total of 961 patients. 86.3% of patients were decentralized. Based on the type, the patient consists of 35.17% relapse, 5.52% new, 13.94% after LTFU, 23.10% failure category 1, 20.29% failure category 2, 1.9 % other patients. In multivariate analysis revealed that decentralization reduced the probability of LTFU up to 46% (HR 0.54, 95% CI 0.35-0.84). For patient type, treatment after LTFU, failure category 2 and others increased the probability of LTFU by 50% (HR 2,02; 95% CI 1,18-3,45), 53% (HR 2,13; 95% CI 1,24-3,66), and 74% (HR 3,80; 95% CI 1,54-9,36) consecutively compared with the type of relapse patients (baseline). Health workers were suggested to spend more time in communicating, informing and educating about TB treatment and the benefits of decentralization to MDR-TB patients. Moreover, it is suggested to conduct patient type screening in the beginning of the treatment to be able to identify the risk of LTFU.
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