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High-risk Human Papillomavirus (HR-HPV) is the necessary factor for the development of cervical cancer. The use of hormonal contraception has been associated with HR-HPV risk infection. However, the existing study results are not conclusive. There is very limited relevant data available in Indonesia. Hence, this study is aimed to evaluate the association between the use of hormonal contraceptives and infection risk of HR-HPV based on data from a 2019 screening program held by Indonesian Cancer Foundation, Jakarta branch, in Jakarta. This is a case-control study using secondary data from a cervical cancer screening program in Jakarta during January-December 2019. The case group is subjects with positive HPV-DNA test results from Hybrid Capture 2. The control group is randomly selected from the screening participants with negative HPV-DNA test results, with a ratio with the case is 2:1, and frequency matched based on area of domicile. Data is analyzed using multivariate analysis, unconditional logistic regression. The number of case in this study is 172 and 344 subjects in the control group. The prevalence of HR-HPV infection from the whole screening program is 6,56%. Most study participants were not using any kind of contraception methods (62,79% cases; 49,13% control). The risk of HR-HPV is crude OR 0,64 (95% CI 0,39-1,04, p=0,06) and adjusted OR 0,97 (95% CI 0,53-1,79; p=0,93). in current user of hormonal contraceptives. Whilst the association in the past users of hormonal contraception prior the test is crude OR 0,55 (95%CI 0,37-0,83; p=0,002) and adjusted OR 0,53 (95% 0,34-0,82; p=0,005). There is no significant association between the current user of hormonal contraceptives and the risk of HR-HPV infection. On the other hand there is a significant negative association in the past user group.
Background: Depok City experienced an increase of 110 cervical cancer cases in 2021-2022. Most cases of cervical cancer are caused by human papillomavirus (HPV) infection. The HPV immunization program in Indonesia is integrated with school immunization. The national HPV coverage in 2021 is 78.5% at dose 1 and 60.6% at dose 2 and the latest coverage data for Depok City in 2023 is 85.3% (below the 90% target). Immunization coverage depends on the role of parents as decision makers for child immunization. This study aims to find the determinants of children's HPV immunization status, especially from the parents' aspect and get information on the reasons why children do not receive the vaccine. Methods: The study design used was cross sectional with cluster random sampling technique. This study conducted univariate analysis using frequency distribution and bivariate analysis using logistic regression. Results: HPV immunization coverage in the sample population was 79.2%. The top two reasons for not vaccinating children were lack of information from the school (41.5%) and sickness or absence from school (26.8%). Bivariate analysis showed that low perceived parental barriers (OR 3.57; 95% CI: 1.69-7.51) and parents who received enough information support from providers (OR 2.86; 95% CI 1.14-7.22) had greater odds of HPV immunization. Conclusions: The high number of uninformed parents/guardians from schools and missed immunizations implies the need to evaluate information delivery procedures and proactively contact parents/guardians of recurrent missed immunizations.
Kanker serviks uteri masih menjadi masalah kesehatan masyarakat di Indonesia. Kejadian kanker serviks uteri sebesar 12,6/100000 wanita dan angka kematiannya sebesar 7,0/100000 wanita (IARC, 2008). Hal ini dimungkinkan karena faktor resiko yang masih belum tertangani di masyarakat. Multi paritas (khususnya paritas > 4 kali) atau jumlah melahirkan pada wanita sebagai salah satu faktor resiko kanker serviks uteri ternyata masih tinggi di masyarakat. Penelitian ini ingin mengetahui pengaruh paritas > 4 kali terhadap kejadian kanker serviks uteri di 6 rumah sakit Indonesia. Penelitian dilakukan dengan desain kasus kontrol berbasis rumah sakit, dengan sampel sebanyak 364 wanita yang telah dipasangkan berdasarkan asal rumah sakit dan umur interval 10 tahun. Analisis multivariat menggunakan conditional logistic regression. Hasil menunjukkan bahwa paritas > 4 meningkatkan resiko kanker serviks uteri OR: 1,85 ; CI 95% (1,14 -3,02). Oleh karenanya usaha untuk pengembangan program yang dapat membatasi kelahiran seperti program Keluarga berencana akan membantu menurunkan terjadinya kasus serviks uteri.
LATAR BELAKANG: Banyak faktor mempengaruhi prognosis luka bakar, data di Indonesia belum ada yang rinci. Dengan mengetahui faktor prognostik terpenting, akan dimungkinkan menetapkan penatalaksanaan yang tepat_ Perbaikan standar penatalaksana an membawa perbaikan nyata untuk menekan mortalitas.METODE: Penelitian kohort historikal menggunakan subyek penderita luka bakar rawat inap di RSCM Januari I998-Mei 2001. Semua yang memenuhi kriteria inklusi diambil. Analisis data dengan survival analysis menggunakan Cox proportional hazard untuk mencari perhitungan ketahanan hidup.HASIL: Dari 156 penderita didapat angka mortalitas 27,6%. Penderita terbanyak berusia 19 tahun, laki-laki lebih banyak 1,6 x dari perempuan. Penyebab tersering api (55,1%) dan terjadi dirurnah (72,4%). Ditemukan luka bakar terbanyak derajat 2° (76,9%) dengan Iuas terbanyak 27%, interquartile range 19-43%. Faktor prognostik terpenting dengan nilai hazard ratio (HR) dan 95% confidence interval (CI) masing-masing adalah syok-SIRS 12,05 (2,36;60,95), trombositopeni 10,78 (2,23;52,05), trauma inhalasi 5,20 (2,77;9,77), syok 4,87 (1,25;18,98) dan luas>50% 4,35 (1,22;15,59)KESIMPULAN: Penatalaksanaan resusitasi cairan yang tepat dan resusitasi jalan napas dapat menekan angka mortalitas penderita luka bakar. Trombositopeni merupakan salah satu petanda awal kemungkinan sepsis/SIRS.Prognostic factors in moderate and severe burn patients at Dr. Cipto Mangunkusumo National General Hospital Jakarta 1998-May 2001.
BACKGROUND: Several factors influence the outcome of burn injuries. Knowing the most important factors influencing the outcome of burn might be helpfull in developing new strategies for patient care. Improvement of burn patients management can reduce mortality rate.METHODS: Data from historical cohort were analyzed using Cox proportional hazard. One hundred fifty six burn patients hospitalized at Dr. Cipto Mangunkusumo National General Hospital from January 1998-May 2001 were selected consecutively according to inclusion criteria.RESULTS: From the 156 patients studied, mortality rate was 27,6%. Median patient age was 19 years , male : female ratio 1,6:1. The most common cause of thermal injury was flame (55,1%) and the majority occured at home (72,4%). Second degree burns were dominant (76,9%) with median burn size 27% Total Body Surface Area ( interquartile 19-43). The most important prognostic factors, hazard ratios and 95% confidence interval were shock with SIRS 12,05 (2,36;60,95), thrombocytopenia 10,78 (2,23;52,05), inhalation injury 5,20 (2,77;9,77), shock 4,87 (1,25;18,98) and burn size >50% 4,35 (1,22;15,59).CONCLUSIONS: Adequate fluid rescusitation and respiratory rescusitation can overcome important factors influencing burn patients outcome in order to reduce mortality rate. Thrombocytopenia can be use as an early sign of impending sepsis/SIRS.
