Hadyana Sukandar

Complementary and alternative medicine use decreases adherence to prescribed medication in diabetes patients

Context: The use of complementary and alternative medicine (CAM) is common among type 2 diabetes mellitus (T2DM) patients in Indonesia and may potentially affect adherence to prescribed diabetes medication, leading to uncontrolled blood sugar levels and complications. Aims: The objectives of this study were to analyze the association of CAM use with adherence to prescribed diabetes medication and to identify predictors of low adherence to prescribed diabetes medication. Settings and Design: A cross-sectional survey was done in a secondary health care facility in Bandung city, Indonesia. Data were collected between February and April 2014 from 114 respondents selected through consecutive sampling. Statistical Analysis Used: Chi-square test and ordinal logistic regression were used for statistical analysis. Results: The result showed that 64.9% of the respondents used CAM with herbal products (54.4%), ceragem (16.7%), and massage (12.3%) as the most widely used types. CAM use was found to significantly decrease adherence to prescribed diabetes medication (P < 0.05). The multivariate analysis suggested that the predictors of low adherence were CAM used [adjusted odds ratio (ORadj) 6.16; 2.44-15.52], gender (ORadj2.57; 1.05-6.31), and age (ORadj4.25; 1.53-11.31). Conclusions: CAM use decreased adherence to prescribed medication in T2DM patients. Gender and age were also associated with adherence. Instead of ignoring CAM use among patients, health professionals should have increased awareness and better training about CAM so that they can provide patients with relevant information and assist them in their decision-making regarding CAM use.

64 Body Mass Index correlates with Lipid Profile in Jatinangor Population

Background: Obesity is an emerging epidemical issue. The percentage of individuals with high BMI consistently escalates in every year. Non-communicable disease such as hypertension, coronary heart disease (CHD) and stroke, are influenced by risk factors. One of the important risk factors is the increasing BMI and high concentration of lipid profile. The aim of this study is to discover the causal inference between BMI and concentration of lipid profile. Method: Cross-sectional design was conducted in this study. Secondary data was collected from previous study entitled “Primary and Secondary Prevention in Jatinangor society”. Sample subjects consisted of 99 individuals. Obtained data was analyzed using Spearmans Rank correlation test. Result: Characteristic of subjects from the obtained data showed that as much of 55% of the subjects were having overly high BMI (overweight and obese). Mean of BMI was 26.44 kg/m2 and lipid profile (Total cholesterol: 194.60 mg/dL; HDL-C: 42.52 mg/dL; LDL-C: 126.61 mg/dL) in female were higher compared to male (Total cholesterol: 188.6 mg/dL; HDL-C: 35.7 mg/dL; LDL-C: 123.4 mg/dL) except for male TG was higher(147 mg/dL) rather than female (132.1 mg/dL). Significant correlation was found between BMI and total cholesterol (rs = 0.244 p = 0.015), BMI and HDL-C (rs = −0.222 p = 0.027), BMI and LDL-C (rs = 0.223 p = 0.026), BMI and TG (rs = 0.242 p = 0.016). Conclusion: There was significant correlation between BMI and lipid profile.

Berbagai Faktor yang Memengaruhi Kejadian Demam Berdarah Dengue di Kota Bandung

Abstract. Dengue haemorrhagic fever (DHF) incidence rate in Aceh Province for the past three years 2012-2014 were fluctuated from 51‰, 29 ‰ and 45 ‰. The most widely used larvacide to control larvae Ae. aegypti is temefos, in Indonesia 1% temefos (abate 1SG) started used in 1976, and since 1980 has been used for the eradication program of Ae. aegypti larvae. The intensive use of temefos will be not a problem until population were dominated by resistant individuals. The purpose of this study was to determine the status of susceptibility of Ae. aegypti larvae against temefos in three dengue fever endemic areas in Aceh. We conducted an observational study to examine the susceptibility of Ae. aegypti population in 3 districts of Aceh Province: Banda Aceh, Lhokseumawe and Aceh Besar. Entomological survey and larval collection was assigned. Larvae then reared in laboratory until third generation. Third and early fourth instars stage of Ae. aegypti larvae were used as test samples. Susceptibility test was undergo based on World Health Organization guidelines. Results shows that larva Ae. aegypti from Banda Aceh (100%) and Lhokseumawe (99%) districts was still susceptible, while Aceh Besar (97%) indicates tolerance to temefos 0,02%. In conclusion, temefos still effective to be used as larvicide for vector control in those three endemic of dengue fever in Aceh Province. The priority vector control program that can be suggested is put mosquito breeding place eradication called PSN as a proactive movement in community. Keywords : Aedes aegypti, temefos, susceptibility, insecticide, Aceh Abstrak. Angka insidensi demam berdarah dengue (DBD) di Provinsi Aceh tahun 2012-2014 berturut turut 51‰ menurun 29 ‰ dan meningkat kembali 45 ‰. Penggunaan larvasida temefos 1% (abate ISG) untuk mengendalikan larva Aedes aegypti sudah digunakan oleh program sejak 1976. Penggunaan larvasida tidak akan menjadi masalah sampai suatu populasi didominasi oleh individu-individu yang resisten. Tujuan dari penelitian ini adalah menentukan status kerentanan larva Ae. aegypti terhadap temefos di tiga kabupaten/kota endemis DBD di Provinsi Aceh. Penelitian observasional ini menggunakan desain potong lintang. Pengumpulan data dilakukan selama bulan Mei-Juni 2015 dengan lokasi penelitian di tiga Kabupaten/Kota yang tersebar di Provinsi Aceh, yaitu Kota Lhokseumawe, Banda Aceh dan Kabupaten Aceh Besar. Survei larva Ae. aegypti dilakukan pada 100 rumah terpilih di setiap kab/kota dengan pengamatan pada kontainer yang dapat menampung air di dalam dan luar rumah. Larva Ae. aegypti yang diperoleh kemudian dipelihara sehingga didapatkan nyamuk generasi ketiga. Spesimen uji yang digunakan adalah larva instar III dan atau IV awal berdasarkan metodologi WHO. Hasil uji terhadap temefos 0,02 ppm menunjukkan bahwa larva Ae. aegypti dari semua wilayah yang diteliti Kota Lhokseumawe (100%) dan Banda Aceh (99%) masih rentan kecuali di Kabupaten Aceh Besar (97%) sudah toleran terhadap insektisida tersebut. Kesimpulan penelitian adalah temefos masih layak digunakan sebagai larvasida dalam pengendalian vektor di tiga kabupaten/kota endemis DBD di Provinsi Aceh. Upaya pengendalian yang lebih utama diterapkan adalah Gerakan Pemberantasan Sarang Nyamuk (PSN) sebagai gerakan proaktif di masyarakat. Kata Kunci : Aedes aegypti, kerentanan, insektisida, temefos, AcehAbstract . Dengue Hemorrhagic Fever (DHF) reemerged as a significant public health problem, which reflects the difficulty in sustaining DHF control program. Community-based strategy to control Aedes aegypti breeding sites needs to be understood. The objective of this study is to understand contributed factors to DHF based on characteristics, the availability of basic sanitation, knowledge, perception, and attitude towards DHF prevention program. A survey conducted to 2035 households in 12 districts and 16 villages in Kota Bandung in April to June 2015 using stratified random sampling method. A questionnaire was administered to collect information on variables related to economic status, knowledge on DBD, risk perception and practices associated with Aedes aegypti breeding sites, also basic sanitation facilities. The analysis used was correlation and generalized estimating equation (GEE). Results showed that gender, basic sanitation availability, knowledge about dengue in general, knowledge about DHF symptoms, and perception about the disease contribute to dengue cases (p ≤ 0.05). The conclusion of this study is factors contributed to dengue cases were sex, education, basic sanitation, knowledge about dengue in general, knowledge about DHF symptoms and perception about the disease. Program planning should also include factors and the need for the local community. Keywords : knowledge, attitude, risk perception, basic sanitation, dengue Abstrak . Munculnya kembali Demam Berdarah Dengue (DBD) sebagai masalah kesehatan masyarakat yang utama menunjukkan sulitnya mempertahankan kelangsungan program pencegahan dan pemberantasan penyakit ini. Pengetahuan yang memadai mengenai DBD dan metode untuk mencegahnya harus dapat dimengerti oleh masyarakat sebelum mereka mau berpartisipasi aktif. Penelitian ini bertujuan untuk mengetahui faktor-faktor yang mempengaruhi kejadian DBD di Kota Bandung. Penelitian ini merupakan survei pada 2035 rumah tangga di 12 kecamatan dan 16 desa di Kota Bandung pada Bulan Mei – Juni 2015 yang dilakukan dengan metode stratified random sampling. Kuesioner dipergunakan untuk mengetahui faktor-faktor karakteristik, pengetahuan mengenai DBD, persepsi risiko dan sikap dalam pemberantasan sarang nyamuk serta fasilitas sanitasi dasar. Analisis data menggunakan analisis korelasi serta Generalized Estimating Equation (GEE). Hasil menunjukkan jenis kelamin, pendidikan, ketersediaan sanitasi, pengetahuan umum mengenai DBD, pengetahuan mengenai gejala DBD, dan persepsi mengenai DBD menjadi faktor yang memberikan pengaruh terhadap kejadian DBD (p<0,005). Simpulan penelitian adalah faktor yang memengaruhi kejadian DBD di Kota Bandung adalah jenis kelamin, pendidikan tinggi, sanitasi, pengetahuan umum mengenai DBD, pengetahuan mengenai gejala DBD dan persepsi mengenai DBD. Perencanaan program sebaiknya mengikut sertakan faktor karakteristik lokal masyarakat. Kata Kunci : DBD, sanitasi dasar, persepsi, pengetahuan, pencegahanAbstrak. Penelitian ini bertujuan untuk menentukan tingkat risiko penularan DBD di wilayah endemis DBD di Kabupaten Bone, Kota Palopo dan Kota Makassar Provinsi Sulawesi Selatan. Penelitian dilaksanakan Bulan Mei-Juni 2015 pada rumah tangga secara sistematik sampling sebanyak 100 rumah pada setiap wilayah kerja puskesmas endemis DBD tertinggi di Kab. Bone (Watampone), Kota Palopo (Wara) dan Kota Makassar (Mangasa) Provinsi Sulawesi Selatan. Data dianalisis untuk menunjukkan indikator surveilans larva (HI, CI, dan BI) dan density figure. Data disajikan dengan jumlah larva berdasarkan jenis kontainer, persentase dan distribusi kontainer. Nilai ABJ ketiga puskesmas termasuk rendah Watampone: 53%, Wara: 54%, Mangasa: 68%. Persentase CI (angka container) larva tertinggi adalah Puskesmas Watampone (17, 78%), selanjutnya Wara (17,71%) dan Mangasa (15,47%). Berdasarkan perhitungan HI, CI dan BI, density figure dari ketiga kabupaten pada kategori sedang hingga tinggi dan Maya index menunjukkan tingkat risiko penularan DBD sedang. Hasil menunjukkan bahwa Density figure pada kontainer rumah tangga yang diperiksa sedang hingga tinggi. Kampanye pencegahan DBD yang kuat, deteksi kasus dari rumah ke rumah dan upaya persuasif yang mengedukasi mengenai hal ini penting dilakukan untuk meningkatkan kesadaran masyarakat agar ikut berpartisipasi dan lebih waspada terhadap DBD. Kata Kunci : DBD, larva, Aedes aegypti, kontainer, Maya Indeks Abstract. The aim of this research is to determine of transmission risk level of Dengue Hemorrhagic Fever (DHF) endemic area in District of Bone, Municipal of Palopo, and Municipal of Makassar, South Sulawesi province. Study held in May-June 2015 to 100 households by systematically sampling method in three highest local healthcare center work area in each endemic in District of Bone (Watampone), Municipal of Palopo (Wara), and Municipal of Makassar (Mangasa), South Sulawesi Province. Data analyzed to show the indicators of DHF surveillance (House Index, Container Index, and Breteau Index) and density figure. Data served with the number of larva in each inspected container, percentage and distribution of containers. Larval free house indices values of three local healthcare center were Watampone: 53%, Wara: 54%, and Mangasa: 68%. The highest container indices values were local healthcare center of Watampone (17.78%), Wara (17.71%) and Mangasa (15.47%) respectively. According to HI, CI and BI, density figure calculation, the study areas were categorized as moderate to high risk to DHF and the Maya index indicate the moderate risk to DHF transmission. Density figure of household water containers were moderate to high. Stronger campaign, door to door case detection and educating persuasive efforts concerning DHF case is important to be done in order to awaken the community awareness including stake holder to contribute to solve on DHF problem. Keywords : Dengue Hemorrhagic Fever, larva, Aedes aegypti, container, Maya index.

Awareness, Treatment and Control of Hypertension in Jatinangor sub–District between March–November 2014

Background: Hypertension is usually asymptomatic until an acute cardiovascular event occurs; screening for hypertension is a critical aspect of preventive medicine. Awareness of blood pressure is important to successfully control hypertension. More than two thirds of hypertensive populations are either unaware of their elevated blood pressure or are not treated adequately to minimize the cardiovascular risk. The research aimed to evaluate the awareness, treatment and control of hypertension among hypertensive patient and general community. Methods: A descriptive study was conducted based on the secondary data from the bigger research ‘Epidemiology of Hypertension and Albuminuria in Jatinangor Community’. Secondary data of 626 respondents who met the criteria was included in this study. Awareness was based on positive family history and/or past history of hypertension diagnosed by health provider. Treatment was based on self–reported regular use of antihypertensive drug and controlled was defined as individuals with blood pressure lower than 140/90 mmHg in an individual during survey. Results: Among the 626 participants, 229 had hypertension during measurement and 147 were aware of the diagnosis, of those who were aware of the diagnosis the majority (111) were receiving pharmacological treatment but only minority receiving treatment were controlled (24). Conclusions: The prevalence of hypertension in Jatinangor is high, whereas awareness, treatment and controlled are still poor.

Prevalence of Hypertension and Its Complications in Jatinangor 2014

Background: Hypertension is the most common health problem in adult and its complication leads to death. This study is conducted to determine the prevalence of hypertension and its complication in Jatinangor on 2014. Method: This study was a descriptive study with a cross-sectional approach which used responden with age above 18 years old from Epidemiology of Hypertension and Albuminuria project at urban, sub-urban, and rural in Jatinangor 2014. Data collected were blood pressure, clinical presentation and diagnosis of heart attack, clinical presentation and diagnosis of stroke, diagnosis of heart failure, and diagnosis of renal disease. Results: From 828 responden, the prevalence of hypertension in Jatinangor was 37.8%. The high prevalence of hypertension in Jatinangor occurred in age group >70 years old, female, and who lived in sub-urban. Prevalence of complication due to hypertension in Jatinangor was 33.9%. Based on community group, prevalence of complication due to hypertension in urban, sub-urban and rural was 38.8%, 23.9%, 39.2%, respectively. The most common complication due to hypertension in Jatinangor was heart attack (n = 53) and stroke (n = 29). Conclusions: Jatinangor has a higher prevalence of hypertension compare to national rate. The prevalence of complication due to hypertension is also high. Based on community characteristics, the highest prevalence of hypertension occurred in sub-urban community and highest prevalence of its complication occurred in rural community.

Correlation between Waist Circumference and Hypertension in Jatinangor

Background: Hypertension is defined as systolic pressure of ≥ 140 mmHg and/or diastolic pressure of ≥ 90 mmHg. Obesity is one out of many preventable risk factors for hypertension and plays a crucial role. Obesity is classified into general obesity and central obesity. The objective of the study was to determine the correlation between waist circumference as an antropometric index for central obesity and hypertension. Methods: Data was collected from 437 respondents in Jatinangor, Sumedang. Research methods used in this study was an analytic study with cross-sectional design. Questionnaires and measurements were administered between August–November 2014. Result: Waist circumference is positively and significantly correlated with hypertension (p-value <0.001). The prevalent ratio is 1.64 (CI 95% 1.28–2.11). Waist circumference has determinant coefficient 0.104 to systolic pressure and 0.13 to diastolic pressure. Conclusion: There was correlation between waist circumference as an antropometric index for central obesity and hypertension.

Quality of Life among Patients with Hypertension Type 1 in Jatinangor 2014

Background: Hypertension has become one of the major public health problems in the word. Hypertension causes stroke andischemic heart disease, and affect the quality of life (QOL) among hypertensive patients, both from physical, physiological, social relationship, and environmental domain. The purpose of this study to identify QOL among patients with hypertension type 1 in Jatinangor. Methods: This descriptive study was conducted in Jatinangor in 2014, using the selective-prevalence method. Sixty two respondents were selected using convenience sampling. The face-to-face interview was conducted using WHOQOL-BREF questionnaire. Results: Mean scores of QOL were 52.6 (SD10.5), 66.5 (SD 12.1),59.2 (SD 13.3) for physical,psychological, sosial relationship, and environmental domain. From total score, the mean score of QOL was 59.0 (SD 8.47). From the physical domain,the respondents felt more dependence on medical therapy. From the psychological domain, the respondents felt more acceptance with their body image. From the social relationships, the respondents satisfied with the social support. From environmental domain, the respondents have little opportunity for leisure activities. Female, 45–54 years old, educational history of graduated from university, and did not remember their hypertension history tend to have higher QOL. Conclusions: QOL among patients with hypertension type 1 are highest score found in psychological domain and lowest score found in physical domain.

Correlation between the Correct Use of Drug and the Achievement of Blood Pressure Control

Background: Globally, the prevalence of hypertension reaches 40%. Hypertension is the third cause of death after stroke and tuberculosis in Indonesia. Its prevalence reaches 26.5%. The correct use of drug therapy is one of the factors controlling blood pressure in patients with hypertension in order to prevent its complications. This study was conducted to assess the correlation between the correct use of drug therapy and achievement of controlled blood pressure. Methods: This study was conducted in Jatinangor from April to November 2014. Thedata used in this study wasthe secondary data from previous study, “Epidemiology ofHypertension and Albuminuria in Jatinangor”. This study was an analytical comparative study with cross-sectional approach. Minimum sample required 86 respondents. The correct use of drug therapy defined as correct in term of name, dose, frequency, combination and current use of drug; achievement of blood pressure control defined as normal blood pressure on direct examination. Data were processed using Fishers exact test. Results: Among 88 respondents who underwent drug therapy, there were8 (9.1%) respondent underwent drug therapy correctly; 22 respondents achieved controlled blood pressure but none of them underwent correct drug therapy. The results showed that there is no correlation between the correct use of drug therapy and achievement of blood pressure control. (p = 0.089). Conclusion: There is no correlation between the correct use of drug therapy and achievement of blood pressure control.

Correlation between Food Frequency Questionnaire Sodium Scoring and Predictive24-Hour Sodium Urine

Background: 24 – hour Sodium urine is the gold standard for estimating daily sodium intake. Although it is the gold standard, it is expensive and difficult to obtain a good sample. Alternatively, we can use food frequency questionnaire, which is relatively cheap and easy to obtain. The purpose of this study is to know the correlation between sodium scoring of a food frequency questionnaire and predictive 24-hour sodium urine. Methods: Thiscross – sectional correlative study was taken from29 people, aged 18–59 years old in Jatinangor. The food list of the questionnaire used in this study was modified based on a qualitative study in Jatinangor. The sodium content of the food was calculated by computer software based on the general recipe of 20people in Jatinangor, which was obtained by the same qualitative study. Afternoon spot urine sample was used as the replacement of 24 – hour urine sample, then the sodium level of the spot urine was converted to 24 – hour sodium urine by Tanaka formula. The correlation was analyzed by using computer software. Results: The correlation between food frequency questionnaire scoring and predictive 24-hour sodium that is analyzed with pearson method was insignificant (r = −0.169, p = 0.381) Conclusions: The correlation is insignificant, this result may arise due to some confounders and limitation of the study.