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Kata kunci: Diabetes melitus tipe 2, prediabetes, stres, dewasa
Prediabetes is a golden period in delaying the occurrence of type 2 diabetes mellitus because in this period the course of the disease can still be stopped. The study aim was to knowing the impact of stress on the conversion of prediabetes to type 2 diabetes mellitus in adults. This study used retrospective cohort design. The data used are secondary data from the Cohort Study of Risk Factors for Non-Communicable Diseases in Bogor, Indonesia. Data collection in this study was carried out since 2011 until 2015 with a total population of 5890. Based on the exclusion and inclusion criteria, the total of study participants were 1059. During 5 years of follow-up, among prediabetic adults there were 169 subjects categorized as T2DM and 219 subjects categorized as stressed. Bivariate analysis shows that stress and age at baseline is a risk factor on the conversion of prediabetes to T2DM (p < 0,05). Final model on multivariate analysis, shows the hazard ratio of stress was 1.815 (95% CI: 1.307 - 2.520) with p < 0.05. This findings, expected to be used as information and motivation in an effort to make prevention and control of T2DM. Especially in individuals with prediabetes who suffer from stress because it has an impact with conversion of prediabetes to T2DM.
Key words: Type 2 diabetes mellitus, prediabetes, stress, adults
Kehamilan Tidak Diinginkan (KTD) terjadi setidaknya sebanyak 121 juta kasus secara global dari tahun 2015-2019. Tingginya angka prevalens ini menunjukkan bahwa KTD merupakan salah satu masalah kesehatan masyarakat yang dapat membawa banyak dampak negatif baik dalam bidang kesehatan, sosial dan finansial. Dari seluruh KTD yang terjadi secara global, setengahnya berakhir dengan aborsi. Kematian Ibu yang mengalami KTD juga berhubungan dengan karena kurangnya perawatan antenatal yang dapat meningkatkan risiko komplikasi kehamilan akibat ketidaktahuannya tentang kehamilannya. Kunci untuk mencegah KTD adalah menggunakan kontrasepsi dengan begitu WUS dan PUS dapat merencanakan atau menunda kehamilan. Untuk memahami KTD lebih baik dapat dilakukan dengan mengenali faktor apa saja yang berhubungan dengan KTD. Bertujuan untuk mengetahui faktor apa saja yang berhubungan dengan Kehamilan Tidak Diinginkan. Penelitian ini menggunakan desain studi cross-sectional menggunakan data sekunder SDKI 2017. Sampel penelitian adalah Wanita Usia Subur yang sedang hamil saat survei dilakukan. Prevalensi kehamilan tidak diinginkan adalah sebesar 7,5% dengan 6,8% merupakan kehamilan yang tidak tepat waktu dan 0,7% kehamilan tidak diinginkan sama sekali. Faktor Intrapersonal, yakni; Usia, [PR 0,59 CI 95%: 0,37-0,97 p-value 0,036], Status Perkawinan [PR 6,03 CI 95% 3,7-9,9 p-value 0,000] dan Paritas [PR 0,42 CI 95% 0,26-0,67 p-value 0,000) dan Faktor Struktural, yaitu; Wilayah Tempat Tinggal [PR 1,625 CI 95% 1,06-2,57 , nilai p = 0,024] memiliki hubungan yang signifikan dengan Kejadian Kehamilan Tidak Diinginkan di Indonesia tahun 2017. Diperlukan lebih banyak edukasi kesehatan reproduksi yang tak hanya mencakup aspek biologis namun juga akibat dari sosial, mental dan finansial dari KTD. Pemerintah juga perlu menetapkan UU yang lebih ketat terhadap usia minimal perkawinan dan memastikan WUS mendapatkan akses yang baik terhadap kontrasepsi. Selain itu juga surveilans bagi akseptor KB perlu lebih diperhatikan agar perencanaan kehamilan dapat lebih efektif untuk menghindari KTD.
There are approximately 121 million unintended pregnancies globally from 2015 to 2019. Those high numbers show that unplanned pregnancy is still a significant public health problem, especially when half of all unintended pregnancies ended up in abortion. Unwanted pregnancy also brings other negative effects aside from the health aspect, such as social and financial problems. Women who are experiencing unintended pregnancy tend to neglect their, and the fetus’ health such as missing antenatal care, which risks higher pregnancy complications that can lead to maternal death. Maternal and Neonatal Death Rate is one of the indicators for the 3rd SDGs. Contraception is the key to preventing unplanned or unintended pregnancy. It is important to find out what are the factors contributing to Unintended Pregnancies so that we have the correct information that would be considered for making an effective preventative public health policy and health laws. This study aims to recognize the factors related to unintended pregnancy, in hopes that by knowing the risk factors, unintended pregnancy can be prevented. This study was conducted using cross-sectional studies and uses Indonesian DHS 2017 Secondary Data, the sample for this study is women of childbearing age who were currently pregnant during the survey. The prevalence of unintended pregnancy in Indonesia is 7,5%, which consist of 6,8% of mistimed pregnancy and 0,7% of unwanted pregnancy. Intrapersonal Factors such as Age [PR 0,59 CI 95%: 0,37-0,97 p-value 0,036], Marriage Status [PR 6,03 CI 95% 3,7-9,9 p-value 0,001] and Parity [PR 0,42 CI 95% 0,26-0,67 p-value 0,001) and Structural Factor such as Place of Residence [PR 1,625 CI 95% 1,06-2,57 , p value = 0,024] has statistically significant association (p-value <0,05) with the cases of Unintended Pregnancy in Indonesia 2017. More reproductive health education is needed which does not only cover biological aspects but also the social, mental and financial consequences of unwanted pregnancy. The government also needs to enact stricter laws regarding the minimum age for marriage and ensure that women of childbearing age can have good access to contraception. In addition, surveillance for family planning acceptors needs to be paid more attention so that pregnancy planning can be more effective in preventing unwanted pregnancies. Keywords: Unintended Pregnancy, Unwanted Pregnancy, Women of Childbearing Age, Factors related to unintended pregnancy
Coronary Heart Disease (CHD) is a leading cause of death in the cardiovascular group. Obesity could increase a person's risk of progression from prediabetes to type 2 DM and increase the risk of cardiovascular disease. Prediabetes with obesity increases the risk of CHD events based on Cardiometabolic Disease Staging (CMDS). This study was used a retrospective cohort study design using secondary data on NCD Risk Factor Cohort Study in 2011-2018. The sample was 493 obese adult respondents in population of NCD Risk Factor Cohort Study whom met this study inclusion and exclusion criteria. The results of multivariate analysis using cox regression after being controlled by age and duration of obesity found that prediabetes had HR = 0.80 (95% CI: 0.462- 1.387), p = 0.429 which means the relationship between prediabetes with CHD events in obese adult respondents was not statistically significant.
One of the new emerging challenges in TB controlling is multidrug resistanttuberculosis (MDR TB). MDR TB is a type of TB resistant caused by theunresponsiveness (resistancy) of Mycobacterium tuberculosis to at least isoniazidand rifampicin in which both are the most effective anti-TB drugs in first line.This study was aimed to determine the influencing factors for the timing ofsputum culture conversion among pulmonary MDR TB patients. This study wasconducted in Labuang Baji General Hospital, Makassar City started from April2015 to June 2015. Cohort-retrospective design was performed in this study.There were 183 patients involved in this study consisted of 139 (76,0%) patientswith sputum culture conversion, 4 (2,2%) patients with no sputum cultureconversion, and 40 (21,8%) patients were loss to follow up. The result of thestudy shows that the probability of sputum culture conversion of Pulmonary MDRTB was 95,52%. Multivariate analysis showed that the interruption of treatment(HR:0,45; 95%CI: 0,26-0,79), Diabetes Mellitus (DM) before 33 days (HR:0,75;95%CI: 0,29-1,95), DM after 33 days (HR:1,95; 95%CI: 0,90-7,60), previouslytreated with FLDs (HR:0,32; 95%CI: 0,12-0,90), and previously treated withSLDs (HR:0,27; 95%CI: 0,10-0,77) were found to be the influencing factors forthe sputum culture conversion among pulmonary MDR TB. Complete andintensive care are needed among pulmonary MDR TB in MDR TB polyclinic byobserving the interruption of treatment, DM, and history of previous treatment.Keywords: Diabetes mellitus, history of previous treatment, pulmonary MDR TB,sputum culture conversion, treatment interruption.
