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One of the efforts to stop the COVID-19 pandemic is by vaccination. The first dose vaccination in DKI Jakarta has been done on January 14, 2021 and the second dose on March 1st, 2021. Health care workers that have been vaccinated with complete dose until the 28 of March were 120.490 people. However, the number of health care workers infected post vaccinated until June 6, 2021 is 724 people. A cross-sectional study has been done to observe the risk factors of Covid-19 infection on health care workers post vaccinated using secondary data (reports of DKI Jakarta health care workers who have received complete doses of vaccination from March-May 2021) and primary data (a questionnaire distributed to all health care workers who have received a complete doses of vaccination from March-May 2021). The result of this study shows us that there are 6 variables related to the incidence of COVID-19 infection in post-vaccination health care workers in DKI Jakarta, consist of: age (PR 0,63; p=0,002), hypertension (PR 1,52; p=0,009), face to face with patients (PR: 2,02; p=<0,0001), with the most dominant risk factor is a history of COVID-19 infection (PR: 2,16; p=0,001). Health care workers who are >37 years old, have a history of diabetes mellitus, a history of hypertension, a history of COVID-19 infection, face to face with patients, and using PPE level 1 in their daily work are prioritized to get a booster vaccinations
Insidens kasus tuberkulosis (TBC) anak di Indonesia diperkirakan mencapai 11,7% dari total kasus TB. Tidak semua individu terpapar TBC akan menjadi sakit, namun kemungkinan reaktivasi lebih tinggi pada anak , terutama pada anak di bawah lima tahun. Kontak serumah lebih berisiko. Nutrisi baik makro maupun mikro mempengaruhi kejadian TBC pada anak. Studi menyatakan Vitamin D dan Seng berperan dalam peningkatan imunitas. Namun penelitian tentang pemberian suplementasi vitamin D dan Seng serta upaya perbaikan nutrisi dalam pencegahan infeksi TBC pada balita belum dilakukan. Penelitian ini bertujuan untuk mengetahui efek pemberian suplementasi dan konseling diet dalam pencegahan infeksi TBC pada balita kontakserumah TBC paru terkonfirmasi bakteriologis di DKI Jakarta. Kami melakukan penelitian quasi eksperimen pada balita kontak serumah TBC paru bakteriologis di 25 kecamatan di DKI Jakarta. Kelompok intervensi diberikan vitamin D 400-600 IU/hari dan Seng 10-20mg/hari tergantung usia selama 3 bulan serta konseling diet pada orang tua. Balita yang masuk dalam sampel adalah balita yang tidak terinfeksi dan atau sakit TBC, tidak gizi buruk, HIV negative dan tidak menderita penyakit kronis lain. Setiap bulan dilakukan recall diet 24 jam untuk mengukur nutrisi dan status gizi. Setelah 3 bulan akan dihitung balita yang terinfeksi dan tidak dengan menggunakan tes tuberculin. Analisa multivariat dilakukan dengan GEE. Berdasarkan hasil penelitian, insidenss kumulatif infeksi TBC pada kelompok intervensi 5% sedangkan pada kelompok kontrol 23%. Pemberian intervensi meningkatkan konsumsi vitamin D pada balita yakni dari 3 mcg menjadi 14,9 mcg dan Seng 3.8 mg menjadi 18.2 mg. Pada balita terinfeksi, konsumsi vitamin D dan Seng lebih rendah. Besarnya risiko kejadian infeksi TBC dengan pemberian intervensi adalah 0.22 kali ( 95% CI 0.08-0.57 p. value 0.002). Pemberian suplementasi vitamin D dan Seng serta konseling diet menurunkan kejadian infeksi TBC pada balita kontak serumah hingga 78%. Kata Kunci : Infeksi TBC pada balita kontak serumah, suplementasi vitamin D dan Seng, quasi eksperimen, tes tuberculin
The incidence of childhood tuberculosis (TB) in Indonesia is estimated to be 11.7% of total TB cases. Not all individuals exposed to TB will become ill, but the likelihood of reactivation is higher in children, especially children under five years old. Household contacts are more at risk. Both macro and mikro nutriens influence the incidence of TB in children. Studies suggest that vitamin D and zinc play a role in boosting immunity. However, research on vitamin D and zinc supplementation and nutritional improvement efforts in preventing tuberculosis infection in children under five years of age has not been conducted. This study aims to determine the effect of supplementation and dietary counseling in preventing TB infection in young children with bacteriologically confirmed pulmonary TB in DKI Jakarta. We conducted a quasi-experimental study among infants with bacteriologically confirmed pulmonary TB home contacts in 25 subdistricts in DKI Jakarta. The intervention group received vitamin D 400-600 IU/day and Zinc 10-20mg/day depending on age for 3 months, as well as nutritional counseling for parents. Included in the sample were infants who were not infected and/or sick with TB, not malnourished, HIV negative, and not suffering from any other chronic diseases. A 24-hour dietary recall to measure diet and nutritional status was conducted every month. After 3 months, infected and uninfected children were counted using the tuberculin test. Multivariate analysis was performed using GEE. Based on the results of the study, the cumulative incidence of TB infection was 5% in the intervention group and 23% in the control group. The intervention increased vitamin D consumption in toddlers from 3 mcg to 14.9 mcg and zinc from 3.8 mg to 18.2 mg. Vitamin D and zinc intake was lower among infected infants. The risk of TB infection with the intervention was 0.22 times (95% CI 0.08-0.57 p. value 0.002). Provision of vitamin D and zinc supplementation and dietary advice reduced the risk of TB infection. Keywords: Infection of TB in Household contact children under five years age, Tuberculin Test, Suplementation of vitamin D and zinc, Quasi experimental studies
Infeksi saluran pernafasan akut (ISPA) masih merupakan masalah kesehatan global terutama di negara berkembang. Di Indonesia angka kesakitan ISPA menempati urutan pertama. Demikian pula pada jemaah haji Indonesia. selama menjalani ibadah haji di Arab Saudi. Berdasarkan hasil laporan pelayanan kesehatan haji Indonesia di Arab Saudi, proporsi kunjungan kesakitan ISPA mencapai 51.18% (tahun 2000) dan 59.37 % (tahun 2001) yang, merupakan angka kunjungan kesakitan tertinggi dibandingkan penyakit lain. Penelitian ini dilakukan untuk mengetahui pengaruh makanan tambahan ganggang biru hijau (Food Suplemen Spirulina) terhadap kejadian kesakitan ISPA pada jemaah haji kelompok terbang (kloter) 54 - JKG DKI Jakarta selama pelaksanaan haji di Arab Saudi tahun 2002. Desain penelitian adalah randomized controlled trial double blind dengan penentuan kelompok penelitian (perlakuan dan kontrol) dilakukan secara acak berstrata dari 250 responden terpilih. Jumlah sampel diperoleh dari 430 orang calon responden sesuai kriteria inklusi dan eksklusi. Jumlah sampel yang dapat dianalisis sebanyak 189 responden (96.43% dari sampel minimal = 196) dengan rincian kelompok perlakuan 94 orang dan kelompok kontrol 95 orang, kekuatan (power) penelitian 86.8%. Hasil analisis randomisasi menunjukkan kelompok perlakuan sebanding (komparabilitas) dengan kelompok kontrol. Berdasarkan keseluruhan proses analisis, dari enam variabel yang diduga kemungkinan mempengaruhi tindakan perlakuan dan kejadian ISPA hanya variabel vitamin yang memberi efek terhadap Spirulina dengan hasil uji homogenitas diperoleh nilai p < 0.001. Dan berdasarkan hasil analisis akhir diperoleh bahwa apabila seorang jemaah haji kloter 54 - JKG DKI Jakarta tidak mengkonsumsi Spirulina dan vitamin selama melaksanakan ibadah haji mempunyai risiko untuk menderita ISPA sebesar dua kali dibandingkan mereka yang mengkonsumsi keduanya. Apabila jemaah haji mengkonsumsi vitamin saja, maka akan mempunyai risiko untuk menderita ISPA sebesar tiga perlima kali (RR F 0.61, 95% CI = 0.26 - 1.43) atau akan memperoleh perlindungan sebesar satu setengah kali dibandingkan mereka yang tidak mengkonsumsi keduanya. Sedangkan apabila jemaah haji hanya mengkonsumsi Spirulina saja, maka akan mempunyai risiko menderita ISPA sebesar setengah kali (RR = 0.51, 95% CI = 0.35 - 0.75) atau akan memperoleh perlindungan sebesar dua kali untuk tidak menderita ISPA dibandingkan dengan mereka yang tidak mengkonsumsi Spiru/ina dan vitamin. Tetapi bila seorang jemaah haji kloter 54 - JKG DKI Jakarta mengkonsumsi Spirulina dan vitamin ternyata mempunyai risiko tiga perlima kali untuk menderita ISPA dibanding mereka yang tidak mengkonsumsi keduanya atau hampir tidak berbeda dengan apabila jemaah haji hanya mengkonsumsi vitamin saja, namun tidak berpengaruh bermakna karena nilai rentang RR dengan 95% confiden interval melampui nilai 0 (RR = 0.56, dengan 95% CI = 0.28 -1,12). Sehingga berdasarkan hasil penelitian ini dapat ditarik kesimpulan bahwa ada pengaruh yang signifikan antara mengkonsumsi makanan tambahan ganggang biru hijau (food suplemen Spirulina) terhadap kejadian kesakitan 1SPA. Untuk menunjang program upaya peningkatan pelayanan kesehatan terhadap haji Indonesia di tanah air dan di Arab Saudi, maka makanan tambahan Spirulina dapat diberikan kepada calon jemaah haji dengan karakteristik yang sama dengan kloter 54 - JKG DKI Jakarta atau jemaah haji Indonesia lainnya secara hati-hati. Spirulina yang diberikan kepada jemaah haji kloter 54 - JKG DKI Jakarta merupakan makanan tambahan yang tinggi protein dan mengandung komponen lain yang sesuai dengan kebutuhan gizi jemaah haji dalam mengimbangi kondisi lingkungan Arab Saudi yang tidak bersahabat dengan mobilitas dan aktifitas ibadah yang tinggi dalam waktu yang terbatas. Disamping itu, masih perlu dilakukan penelitian yang lebih representatif dan luas untuk mengetahui seberapa besar pengaruh tunggal dan efek samping pemberian Spirulina tidak hanya pada jemaah haji, tetapi juga terhadap masyarakat luas.
The effect of Food Supplement Spirulina on the phenomenon of Acute Respiratory Infection to the Haj Pilgrimage of Flight Group 54 -JKG of Jakarta of the year 2002Acute Respiratory Tract Infection (ARI) has been a global health problem particularly in developing countries. In Indonesia ARI takes the first sequence of illness. So as for the Indonesian haj collective pilgrimage during their haj ritual performance in Saudi Arabia, the proportion of ARI illness visit reached rate, 51.18 % (in 2000) and .59.37 % (in 2001) which formed the highest illness visit compared to other illness. This research was done to find out the effect of Food Supplement Spirulina to the ARI illness of the haj pilgrimage of flight group 54 - JKG of Jakarta during the haj pilgrim operational in Saudi Arabia in the year 2002. Research group determination (treatment and control) were taken randomly level from 250 persons out of 430 persons of prospective respondent. The number of samples which could be analyzed were 189 respondents (96.43 % of the minimum sample = 196) as specified that the treated group were 94 persons and controlled group were 95 persons, the research power was 86.8 %. The result of randomized analysis indicated the treated group was comparable with controlled group. Based on the whole analysis process of the six variables that were suspected had the probable influenced the treatment and AR.1 event only the vitamin variable which caused effect to Spirulina with homogeneity test the value p < 0.001. And based on the final research analysis it was obtained that if a haj pilgrimage of flight group 54 - JKG of Jakarta has not consumed Spirulina and vitamin during his ha ritual performance would have the risk of suffering from ARI two times compared to those who have consumed both Spirulina and vitamin. If the haj pilgrimage consumed only vitamin, there was the probability of risk of suffering from ARI to the rate of three upon five (3I5) times (RR = 0.61, 95% CI = 0.26 - 1.43) or would gain one and half times protection compared to those who have not consumed both Spirulina and vitamin. Whereas if a haj pilgrimage has consumed only Spirulina, would have the probable risk of suffering from ARI a half time (RR = 0.51, 95% CI = 0.35 - 0.75) or would gain two times protection of not suffering from ARI compared to those who have not consumed Spirulina and vitamin. But if a haj pilgrimage of flight group 54 - JKG of half time (RR - 0.51, 95% CI = 0.35 - 0.75) or would gain two times protection of not suffering from ARI compared to those who have not consumed Spirulina and vitamin. But if a haj pilgrimage of flight group 54 - JIG of Jakarta has consumed Spirulina and vitamin apparently had the risk of three upon five (315) times of suffering from ARI compared to those who have not consumed both Spirulina and vitamin or almost not different from if the haj pilgrimage has consumed only vitamin, yet has not have senseful influence because of the stretching value RR with 95% confidence interval exceed the value 0 (RR = 0,56, by 95% CI = 0.28 - 1.12). Therefore based on the result of this research it could be concluded that there is a significant effect between consuming the food supplement Spirulina upon the ARI illness. In supporting the establishment program in the effort of improving the Indonesian haj health service in Indonesia and Saudi Arabia, the food supplement Spirulina is regarded to be reasonable to be carefully given to the prospective haj pilgrimage with the similar characteristic to the haj pilgrimage of flight group 54 - JKG of Jakarta or other Indonesian haj pilgrimage. Spirulina which was given to the haj pilgrimage flight group 54 - JKG of Jakarta is a food supplement with high protein and contains other components, which is suitable for the body nutrient in matching with the unpleasant environment condition of Saudi Arabia with mobility and heavy activities of ha ritual performance in the very limited time. Beside representative and extensive research is necessary to be operated to realize how great is the single influence and the side effect of supplying the Spirulina not only to the haj pilgrimage, but also to the public.
Introduction: Comorbid Diabetes Mellitus (DM) is one of the risk factors for Coronavirus Diseases (COVID-19) mortality. Aim of this study is to determine the association of comorbid diabetes mellitus and COVID-19 mortality among COVID-19 confirmed cases in DKI Jakarta for period March-August 2020, after being controlled with confounding variables. Methode: The study design is a retrospective cohort. The inclusion criteria are confirmed cases of COVID-19 with Polymerase Chain Reaction (PCR) reported to the DKI Jakarta provincial health office, with complete variables. Exclusion criteria is pregnant women. Of the total 41,008 cases in the Jakarta provincial health office's COVID-19 report, there are 30,641 cases that met the inclusion and exclusion criteria. 1,480 samples in this study are taken from all (740) COVID-19 cases with comorbid DM and 740 COVID-19 cases without comorbid DM which are taken through simple random sampling of 29,901 COVID-19 cases without comorbid DM. The data were analyzed using cox proportional hazard regression. The study result indicates that the crude association between DM and mortality among COVID-19 confirmed cases is Crude Hazard Ratio (CHR) 7,4 (95% CI 4,5-12,3, pValue < 0,001). While association between DM and mortality among COVID-19 confirmed cases after being controlled by covariates (hypertensive comorbidities and age groups (> 50 years and < 50 years) is 3.9 (95% CI 2.2- 6.8, p Value <0.001), which means that COVID-19 cases with comorbid DM have a 3.9 times risk of death. Discussion: The results of this study are in line with other studies that indicate DM co- morbidities increase the risk of death from COVID-19. To reduce the incidence of death in COVID-19 cases with comorbid DM, a strategy for preventing and treating COVID- 19 with triage and special attention is needed for rapid and prompt management and monitoring for COVID-19 cases with comorbid DM.
COVID-19 is a global health problem. Clinical manifestations are asymptomatic to death. This study aims to determine the risk factors for death of COVID-19 patients in DKI Jakarta Province. The study design was a retrospective cohort using secondary data from the Epidemiological Investigation Form at the DKI Jakarta Provincial Health Office (2 March - 20 December 2020). The sample is a confirmed patient of COVID-19 based on RT-PCR, age 18 years, the last condition recorded: alive or dead, recorded at the DKI Jakarta Provincial Health Office, and comes from the DKI Jakarta Province. Patients who were self-isolating and being treated were excluded from this study. Cox regression analysis of 100,540 samples showed that the variables that increased the risk of death of COVID-19 patients were male (RR = 1.28 [95% CI: 1.11-1.47]; p = 0.001), age 40-59 years (RR = 5.62 [95% CI: 4.37-7.23]; p<0.001), age 60 years (RR = 12.99 [95% CI: 10.03-16.81]; p<0.001), shortness of breath (RR = 2.50 [CI 95%: 2.06-3.03]; p<0.001), pneumonia (RR = 5.39 [CI95%: 4.14-6.59]; p0).