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COVID-19 that started from Wuhan city of China in December 2019 has caused millions of worldwide infections. In Indonesia, the first two cases were reported on 2 March 2020 and the major response to control the virus transmission was the declaration of large-scale social restrictions, or PSBB. The main objective of this study was to identify the epidemiological trends, role of PSBB in reducing the cases as well as the spatial distribution of the confirmed cases of COVID-19 in DKI Jakarta province. The study design comprised an ecological and case-series study exploring the epidemiological trends and distribution of COVID-19 in DKI Jakarta based on secondary surveillance data. The results showed an increasing epidemiological trend of COVID- 19. Based on the data analysed between March and December 2020, Central Jakarta was the municipality most affected among all other municipalities in the province. The incidence rate as well as case fatality rate was the highest and differed significantly with other municipalities. The implementation of PSBB played a positive role in reducing the average daily COVID-19 cases despite the fact that the association was not significant. There was a positive spatial autocorrelation of COVID-19 with the neighboring kelurahan in the city. There were fifteen COVID-19 hotspots in different parts of Jakarta but majority of them were based in West Jakarta
Program Imunisasi di Indonesia tahun 1997 mencakup 7 (tujuh) jenis antigen sesuai anjuran WHO. Pada tahun 1990 secara nasional Indonesia mencapai status Universal Child Immunization (UCI). Pemantauan Wilayah Setempat (PWS) terbukti telah berhasil memantau cakupan sampai mencapai target Universal Child Immunization (UCI), Meskipun cakupan imunisasi di Kota Bekasi cukup tinggi, namun wabah campak masih tetap tinggi, sehingga perlu dilihat penyebabnya.Dari hasil penelitian diketahui salah satu penyebabnya adalah faktor kepatuhan petugas coldchain dan vaksin dalam menerapkan Standar Operasional Prosedur Imunisasi.Penelitian tentang kepatuhan petugas terhadap Standar Operasional Prosedur Imunisasi (SOPI) pada pengelola coldchain dan vaksin dilakukan dengan disain cross-Sectional dengan pendekatan kuantitatif. Banyaknya responder 62 orang dengan total populasi yang berasal dari 31 puskesmas yang tersebar di Kota Bekasi.Adapun tujuan penelitian ini untuk mengetahui kepatuhan petugas dalam menerapkan SOPI yang dilihat dari faktor internal dan eksternal. Prosentase petugas yang patuh terhadap SOPI sebanyak 32 orang (52 %), sedangkan yang tidak patuh 30 orang (48 %). Hasil penelitian menunjukkan bahwa tidak terdapat faktor eksternal hanya terdapat satu variabel (variabel imbalan) yang memiliki hubungan bermakna dengan kepatuhan, karena variabel imbalan p < 0,05. Selain itu faktor internal dan eksternal yang memiliki p < 0,25, menjadi kandidat dalam model.Hasil penelitian menunjukkan terdapat 4 (empat) variabel dengan p < 0,25, yaitu dari faktor internal adalah pendidikan, pengetahuan, dan motivasi, sedangkan faktor eksternal adalah imbalan.Adapun anaiisa keeratan hubungan pada 4 (empat) variabel tersebut menyatakan bahwa, petugas dengan latar belakang pendidikan medis mempunyai peluang untuk patuh 2,18 kali dibanding non-medis. Sedangkan petugas dengan tingkat pengetahuan baik mempunyai peluang untuk patuh 2,33 kali dibanding petugas dengan tingkat pengetahuan buruk.Selain itu petugas yang memiliki motivasi baik tingkat kepatuhannya 5,26 kali dibanding petugas yang memiliki motivasi buruk. Begitu pula dengan variabel imbalan, terlihat bahwa petugas yang mendapat imbalan baik berpeluang untuk patuh sebesar 8,46 kali dibanding petugas yang mendapat imbalan buruk.Berdasarkan hal tersebut diatas, kesimpulan secara umum adalah tingkat kepatuhan petugas terhadap Standar Opersional Prosedur Imunisasi pada pengelola coldchain dan vaksin di Kota Bekasi tahun 2002 belum balk, dan disarankan kepada Dinas Kesehatan Kota Bekasi perlu menetapkan kebijakan yang berkaitan dengan strategi intensifikasi peningkatan penerimaan keuangan, dan membuat kebijakan kesehatan tentang peningkatan kualitas sumber daya manusia terutama yang berhubungan dengan pengetahuan melalui peningkatan frekuensi dan kualitas pelatihan dan supervisi petugas coldchain dan vaksin.Direktorat Jenderal Pemberantasan Penyakit Menular dan Penyehatan Lingkungan selaku pengelola program disarankan supaya meningkatkan alokasi biaya untuk pelatihan petugas imunisasi.
The Fact which is Have a Relation with Employee Obedience to the Operational Immunization Standard Procedure for Executor of Coldchain and Vaccine in Bekasi, West Java 2002Indonesia immunization program in 1997 has 7 (seven) contents of antigent that suitable with the WHO suggest.In 1990 by a national, Indonesia get the status Universal Child Immunization (UCI). Small fresh district has successful to water fish until it gets the Universal Child Immunization (UCI) target.Eventhough the immunization in Bekasi is high enough, but the measles epidemic still high, so that we have to find the cause.From the observation, we know that the one of the cause is an employee obedience factor of Coldchain and Vaccine in making decision of The Operational Immunization Standard Procedure.The observation about the employee obedience by the Operational Immunization Standard Procedure (SOPI :Standart Operasional Prosedure Imunisasi), for executor Coldchain and Vaccine is done by cross sectional design with Quantitative approximation.More respondence 62 persons with population who come from 31 public clinic in Bekasi. The purpose from this observation is for knowing the employee in running the SOPI which is get from the internal and external factor.Presentation of employee who's obey by SOPI is 32 persons (52%), and then who hasn't obey is 30 persons (48%). The observation shows that there hasn't got a good relation between the internal and external factor with obedience, because P>0.005, and the external there is only one variable (wages variable), which is has a good relation with obedience, because the wages variable is P<0.005.Beside of that, the internal and external which have P<0.25, can be a candidate in models. The observation shows us that there are 4 (four) variables with P<0.25 from internal factor, they are study, knowledge, and motivation, but the external factor is a wages.The analyze fixed relation at 4 (four) variables, tell us that the medical educational background has an opportunity for obey 2.18 times than non medical. And an employee with a good step education has an opportunity for obey 2.33 times than employee who has bad education.Beside of that, the employee who has a good motivation, the step obedience is 5.26 times than the employee who has bad motivation. The same with wages variable, show us that an employee who has good wages, has opportunity for obey 8,46 times than an employee who has bad wages.Base from that case, the regular summary is a step obedience for Operational Immunization Standard Procedure at the executor of Coldchain and Vaccine in Bekasi in 2002, hasn't good enough, and there is a suggestion for the healthy dines service to make a healthy policy about the important grade Quality of human resource, which have relation with knowledge by the grade of frequency and training quality and employee supervisor of Coldchain and Vaccine.Directorate General Communicable Disease Control and Environmental Health as a program executor is suggest for manage a cost to an employee training immunization.
Background mobility is the process of moving people from one area to another happening every day, month and year both domestically and abroad with varied objectives to meet the needs of the lives of these people. The purpose of this study was to determine the relationship between migrants' mobility and factors. Method is to use a case-control approach aimed at analyzing the implications and effects of exposure and disease from high-risk and low-mobility migrants at risk of HIV incidence. Sample was 390 population and community groups visiting VCT (Voluntary Counseling and Testing) tests at 1 Hospital and 4 Puskesmas in Mimika Regency. Eligible populations are all mobile risk migrants visiting VCT test sites both in hospitals and health centers in the 2017 and 2018 periods. Results of 390 respondents were 157 cases and 234 controls, sample selection there were 138 respondents consisting of 13 cases and 125 controls were not cited because they came from the key population, so there were 253 samples, consisting of 144 cases and 109 controls. 144 and 109 controls in the data there were respondents who did not answer the question and so had to be excluded, 78 cases and 28 controls were excluded then the number of samples for analysis was determined that 66 cases and 81 high mobility controls had 4 times the risk of being infected, Sociodemographic characteristics of migrants with male sex men at risk 6 times, young adults (17-35 years) at risk 5 times, educated low risk at 0.1 times, precarious work at risk 2 times, knowledge less risk 13 times, no relationship with HIV incidence, no relationship coverage HIV programs with HIV incidence, Increased HIV infection in migrant populations with high mobility m is an excess (negative) from the development of the Mimika Regency, Papua Province
Increased incidence of drug-resistant tuberculosis (DRTB) is a major public health problem in Indonesia. One of risk factors for the emergence of DRTB case is a high prevalence of type-2 diabetes mellitus (DM). The prevalence of type-2 DM in patients with DRTB is very high, ranging from 18.8% to 23.3%. This study aimed to determine relationship between type-2 DM and the incidence of DRTB in Malay community, Riau Province, in 2014-2018. The quantitative study design was case control in 251 cases (DRTB) and 502 controls (drug-sensitive tuberculosis / DSTB). Quantitative data were obtained from DRTB secondary data, namely Form 01.DRTB, Form 03.DRTB, medical records and electronic TB manager (e-TB manager); while, DSTB secondary data were obtained from DSTB Form.01, DSTB Form.03, medical records and Integrated Tuberculosis Information System. The independent variable was type-2 DM, and the covariate variables were age, sex, education, occupation, residence category, marital status, HIV status and previous TB treatment record. In supporting the quantitative study, qualitative study was conducted with life history approach using a small group discussion method and in-depth interview. Quantitative data were analysed with logistic regression. Quantitative study results showed that peoples with type-2 DM had a 2.27 times risk (95% CI: 1.58-3.27) to experience the incidence of DRTB if compared to peoples without type-2 DM after controlling for occupation, residence, marital status and previous TB treatment record. The results of qualitative study were to obtain a record of the incidence of type-2 DM that occurred earlier than the incidence of DRTB and to examine socio-cultural risk factors affecting the occurrence of DRTB in the Malay community, Riau Province. Possible socio-cultural risk factors associated with DRTB were habits of drinking sweet drinks, adherence to taking DRTB medicine, adherence to taking DM medicine, and the community of Mainland Malay
Latar Belakang: Resistensi terhadap antibiotik pada Neisseria gonorrhoeae merupakan tantangan kesehatan global. WHO memperkirakan pada tahun 2020 ada 82,4 juta kasus gon-ore pada orang dewasa (15-49 tahun), dengan prevalensi tinggi di Afrika dan Pasi-fik Barat. Di Indonesia, prevalensi gonore pada tahun 2015 menurut survei terpadu biologis dan perilaku (STBP) adalah 21,2% pada Wanita Pekerja Seks (WPS), 12,7% pada Lelaki Seks dengan Lelaki (LSL), dan 12,2% pada Waria. Penanganan gonore dengan antibiotik dihadapkan pada masalah resistensi yang diperburuk oleh praktik swamedikasi, yang dilakukan oleh 86% rumah tangga di Indonesia menurut Riskesdas 2013. Pemantauan resistensi gonore di Indonesia belum dilakukan secara berkala, dan metode kultur/difusi cakram yang dianggap standar emas masih me-merlukan keahlian khusus dan prosedur yang kompleks. Saat ini, belum terdapat data yang dipublikasikan mengenai pengujian resistensi gonore menggunakan metode molekuler di Indonesia dan kaitannya praktik swamedikasi antibiotik di ka-langan populasi kunci di Indonesia. Tujuan: Untuk mengetahui pola resistensi gonore menggunakan metode real-time PCR dan menilai hubungan praktik swamedikasi antibiotik serta faktor risiko lainnya dengan resistensi gonore. Metode: potong lintang digunakan untuk mengeksplorasi praktik swamedikasi anti-biotik. Pemeriksaan resistensi dilakukan pada sampel dari STBP dari 12 provinsi dan klinik kesehatan seksual di Jakarta, menggunakan real-time PCR dengan empat primer dan probe untuk mendeteksi resistensi terhadap penisilin, siprofloksasin, dan sefalosporin. Hasil: Penelitian menunjukkan hasil resistensi gonore yang tinggi, dengan sampel STBP menunjukkan resistensi siprofloksasin 94%, penisilin 84%, sedangkan di klinik, resistensi siprofloksasin 90%, penisilin 71%, dan sefalosporin 8%. Praktik swamedikasi ditemukan pada 62% responden STBP dan 57% pengunjung klinik. Analisis menunjukkan bahwa praktik swamedikasi, terutama dengan penisilin, meningkatkan risiko resistensi gonore setelah dikontrol dengan pendapatan. Faktor-faktor yang mempengaruhi swamedikasi termasuk sikap yang mendukung dan pen-dapatan bulanan. Kesimpulan: Tingginya prevalensi resistensi gonore dan praktik swamedikasi anti-biotik berkontribusi pada peningkatan risiko resistensi antibiotik gonore. Faktor risiko yang signifikan dalam swamedikasi adalah sikap dan pendapatan.
Background: Antibiotic resistance in Neisseria gonorrhoeae is a global health challenge. In 2020, WHO estimated there were 82.4 million gonorrhea cases among adults aged 15-49, with high prevalence in Africa and the Western Pacific. In Indonesia, according to the 2015 integrated biological and behavioral survey (IBBS), gonorrhea prevalence was 21.2% among Female Sex Workers (FSW), 12.7% among Men who have Sex with Men (MSM), and 12.2% among Transgender women. The gonorrhea treatment with antibiotics is facing resistance issues, exacerbated by the practice of self-medication, performed by 86% of households in Indonesia based on Riskesdas 2013 report. Gonorrhea resistance monitoring has not been conducted regularly in Indonesia, and the culture/disk diffusion method, considered the gold standard, however it requires specialized skills and complex procedures. Currently, there is no published data on gonorrhea resistance testing using molecular methods in Indonesia and its association antibiotic self-medication practice among key populations. Objective: To determine the gonorrhea resistance patterns using real-time PCR method and to assess its relationship with self-medication antibiotic practices and other risk factors with gonorrhea resistance. Method: A cross-sectional method used to explore antibiotic self-medication practices. Resistance testing conducted on samples from 12 IBBS provinces and sexual health clinics in Jakarta, using real-time PCR with four primers and probes to detect resistance to penicillin, ciprofloxacin, and cephalosporins. Results: The study showed high gonorrhea resistance, IBBS samples showed 94% resistance to ciprofloxacin, 84% to penicillin, while in clinics, ciprofloxacin resistance was 90%, penicillin 71%, and cephalosporin 8%. Self-medication practices were found in 62% of IBBS respondents and 57% of clinic visitors. Analysis showed that self-medication practices, especially with penicillin, increased the risk of gonorrhea resistance after controlling for income. Factors influencing self-medication included attitudes supporting self-medication and monthly income. Conclusion: The high prevalence of gonorrhea resistance and antibiotic self-medication practice contribute to the increased risk of antibiotic resistance in gonorrhea. Significant risk factors in self-medication are attitude toward self-medication and monthly income.