Nurjazuli

Insufficient quality of sputum submitted for tuberculosis diagnosis and associated factors, in Klaten district, Indonesia

BackgroundSputum smear microscopy is the standard diagnostic method for detection of smear positive pulmonary tuberculosis (TB). Insufficient quality of sputum might result in missing cases. In this study we aimed at assessing the quality of sputum in a district in Central Java and determining patient and health worker factors associated with submission of three good quality sputum samples.MethodsIn 16 health centers information was collected on the quality of sputum submitted by TB suspects, i.e. volume, color, and viscosity. TB suspects were interviewed to assess their knowledge of TB, motivation to provide sputum and whether they were informed why and how to produce a sputum sample. Health workers were interviewed to assess what information they provided to TB suspects about the reason for sputum examination, methods to produce sputum and characteristics of a good quality sputum sample. All health worker and patient factors were evaluated for association with sputum quality.ResultsOf 387 TB suspects, 294 (76.0%) could be traced and interviewed, and of 272 (70.3%) information about sputum quality was available. Of those 203 (74.6%) submitted three samples, 90 (33.1%) provided at least one good sample, and 37 (13.6%) provided three good quality sputum samples. Of the 272 TB suspects, 168 (61.8%) mentioned that information on the reason for sputum examination was provided, 66 (24.3%) remembered that they were informed about how to produce sputum and 40 (14.7%) recalled being informed about the characteristics of good quality sputum. Paramedics reported to provide often/always information on the importance of sputum examination, and when to produce sputum. Information on how to produce sputum and characteristics of a good sputum sample was less often provided. None of the studied patient characteristics or health worker factors was associated with providing good quality sputum.ConclusionA considerable number of TB suspects did not provide three sputum samples and a large number of sputum samples were of insufficient quality. Training of health workers in providing health education to the TB suspect about the reason for sputum examination and how to produce a good quality sputum sample should be a priority of the TB program.

ANALISIS SPASIAL FAKTOR LINGKUNGAN DAN KEJADIAN DBD DI KABUPATEN DEMAK

Abstract Induced Pluripotent Stemcell (iPS) are adult cells which the genetic information in the nucleus of those cells being reprogrammed (reprogram) by inserting exogenous pluripotential genes. The exogenous gene transduction is using vectors, such as lentivirus, retrovirus, or adenovirus, which suppressed the gene expression of the original cells, so they will express the transduced exogenous gene. Viral vectors are then used to reprogramming and producing iPS clones that are pluripotent. iPS derived from adult cells of patient with certain diseases will be used as a tool to study the mechanisms of those specific diseases and the effects of selected drugs against the diseases. Several previous studies have shown that iPS clones developed from specific genetic disease have its original genotype and retain the character of the response to the drug that similar as the original adult cells. Opportunities for the utilization of autologous iPS cell therapy in the future is wide open as expected iPS transplant will not be rejected when transplanted back to the patient. Behind all its potential, iPS production is still facing some problems to be applicable clinically. The use of viruses as vectors may cause problems due to virus gene sequences may be integrated into the genome of the DNA donor cell, thereby causing mutations of the iPS clones. Several subsequent studies have succeeded in replacing the use of viruses as vectors, but the level of efficiency obtained is still very low. Another problem that arises is that epigenetic changes may occur in iPS cultures. Many advanced research related to iPS may be developed in Indonesia and is necessary to improve the production efficiency of iPS and solve iPS clones epigenetic changes problems in the future. Keywords: iPS, pluripotency, transduction, transfection. Abstrak Induced Pluripotent Stemcell (iPS) adalah sel somatic dewasa yang informasi genetika dalam inti selnyadiprogram ulang (reprogram) dengan cara memasukkan gen-gen eksogen yang memberikan ciri pluripotensial. Transduksi gen eksogen ini menggunakan vektor, seperti lentivirus, retrovirus, atau adenovirus, yang ditekan ekspresi gen aslinya, sehingga akan mengekspresikan sel eksogen yang ditransduksikan.Virus vektor tersebut selanjutnya digunakan untuk reprogram dan membuat klon iPS yang bersifat pluripoten. Sel dewasa yang akan dijadikan iPS diambil dari penderita penyakit tertentu dan selanjutnya klon iPS dapat dimanfaatkan sebagai alat untuk mempelajari mekanisme terjadinya penyakit dan efek obat terpilih terhadap penyakit tersebut. Beberapa penelitian terdahulu telah membuktikanbahwa kloni PS yang dikembangkan dari penderita penyakit genetik tertentu tetap memiliki karakter genotip dan respon terhadap obat yang sama dengan sel dewasa asalnya. Peluang pemanfaatan iPS otologus untuk terapi sel dimasa mendatang terbuka lebar karena diperkirakan iPS tidak akan mengalami proses rejeksi saat ditransplantasikan kembali kepada penderita yang bersangkutan. Dibalik segala potensinya, iPS masih memiliki beberapa kekurangan untuk diaplikasikan secara klinis. Penggunaan virus sebagai vektor dapat menimbulkan masalah karena sekuens gen virus mungkin berintegrasi dengan genom DNA sel donor, sehingga akan menyebabkan risiko terjadinya mutasipada klon iPS yang dihasilkan. Beberapa penelitian selanjutnya berhasil mengganti penggunaan virus sebagai vektor, namun tingkat efisiensi yang didapat masih sangat rendah. Masalah lain yang timbul adalah perubahan epigenetik yang dapat terjadi pada kultur iPS.Banyak penelitian lanjutan terkait iPS yang dapat dikembangkan di Indonesia dan sangat diperlukan untuk meningkatkan efisiensi produksi iPS dan mengatasi masalah perubahan epigenetik klon iPS dimasa mendatang. Kata Kunci: iPS, pluripotensi, transduksi, transfeksi.

Hubungan Kadar Merkuri (Hg) dengan Profil Darah Pekerja Pertambangan Emas Tradisional di Desa Jendi Kecamatan Selogiri Kabupaten Wonogiri

Background: mercury is neurotoxic substance which can produce some health effect, depends on impact ofduration of exposure and quantity mercury used. Gold miner had a high risk of continously impact which maycause many health disorder, one of them is blood profile interference.The purpose of this reasearch was to know the relationship between mercury concentration in blood with bloodprofile of traditional mining gold worker in Jendi village, Selogiri Sub District, Wonogiri District.Methods: The study design was an analytic observational research. Research subject were whole of workers whowere working in mining gold. Variables in this research were mercury (Hg) in blood and blood profile. Datacollection using interview, observation, and measurement technique. Data would be analyzed using Kendal’s Taucorrelation.Result: The results showed that the average of Hg in blood was 7,819 ppb. It was over toxic level (eˆ 5,8 ppb) andaverage blood profile consist of haemoglobin, erythrocyte, leukocyte, platelet, hematocrit, MCV, MCH, andMCHC were 14,771 gr/dl; 4,9536 jt/mmk; 7,5679 rb/mmk; 334,26 rb/mmk; 43,833%, 88,6333 fl; 29,8833 pg;33,6976. Bivariate analysis showed the significant relationship between mercury (Hg) in blood with bloodprofile (amount of leukocyte) p-value 0,017 and rho 0,257.Conclusion: The conclusion of the research was Hg rates in blood had a toxic limit standard so it can change theblood profile (decreased amount of leukocyte). It was recommended for gold miner to used a personal protectiveequipment like mask, lowering smoking habbit, checked-up, and make lots of green area at mining gold. Keywords : mercury in blood, blood profile, mining gold worker

Studi Deskriptif Kejadian Demam Berdarah Dengue (DBD) Dengan Pendekatan Spasial Di Kota Kupang (Analisis Data sekunder Tahun 2010-2011)

Background :Dengue Haemorrhagic Fever (DHF), an endemic disease in Kupang, has been an enormous health issue throughout years, as it frequently causes outbreak. The risk factors of the disease, according to certain variables; time, location, civil and population density, climate, precipitation, temperature, humidity, and disease incidence, are still remaining unknown. Therefore, no predictive agent to estimate the DHF outbreak in Kupang has been found. Methode : The research is a obsevasional study, with a spatial approach. The research variables were inspected at same time and the samples were taken from the whole population; all secondary data on Health Department registration record of Kupang. The data was presented on tables and were analyzed by descriptive method. Result : The result of the secondary data analysis indicated that the endemic trend of DHF profile in Kupang has been decreasing over the last 2 years, however the number of exposed area towards DHF endemic increases. DHF IR showed decreasing trend; particular decline was noted on 2011 (55.45 per 100.000 people) compared to 2010. Highest proportion of DHF patient was found on age 5 – 9 years, followed by age 1 – 4 years, and age 15-19 years. There was changed phenomenon in time, distribution pattern and age; from younger age into productive age, with increasing proportion. There were 6 kecamatan and 44 kelurahan that proned to DHF. DHF IR reached the highest point at 2010, in Kecamatan Kota Raja (122.80 per 100.000 people), the lowest point indicated at Kecamatan Kelapa Lima 50.55 per 100.000 people. In 2011, highest IR was indicated at Kecamatan Kota Lama (84.64 per 100.000 people) while the lowest IR indicated at Kecamatan Alak (35.40 per 100.000 people). Certain factors are believed to take effect on DHF incidence, these factors are; population density, location, precipitation, air temperature and humidity. Keywords: DHF, incidence, descriptive, spatial

Faktor Risiko Pencemaran Mikrobiologi pada Air Minum Isi Ulang di Kabupaten Tegal

Background : Water is a real absolute necessity for humans as well as fresh air and healthy food. Result of inspection of drinking water refilling quality in Tegal Regency at 2011 showed the existence of microbiology contamination, from 138 drinking water refilling samples, in which 67 samples (48,6%) did not meet the standard for MPN Coliform and E.coli.The purpose this research was to know microbiological contamination risk factor of drinking water refilling in Tegal Regency. Methods : Design applied was cross-sectional. Independent variable in this research was standard water quality, quality of filtration, quality of desinfection and the dependent variable was water quality drinks product from drinking water refilling station. Population at this research was drinking water refilling station in Tegal Regency which amounts to 197. Sampling in random sampling that sample was taken in random. Test Chi-Square applied to test the relation of microbiology contamination risk factor of drinking water refilling with microbiology quality of product water from drinking water refilling station. Results : The result of inspection of standard water quality, 36 samples ( 55,4%) MPN ineligibility Coliform and 12 samples ( 18,5%) ineligibility Ecoli. Result of inspection of water quality drinks product DAMIU, 32 samples ( 49,2%) MPN ineligibility Coliform and 10 samples ( 15,4%) ineligibility Ecoli. Result of observation quality of filtration, 31 samples ( 47,7%) with quality of filtration is not good. Result of observation quality of desinfeksi, 28 samples ( 43,1%) with quality of desinfeksi is not good. The results of the research showed there was significant association between quality of water microbiology standard (p-value=0,0001), quality of filtration (p-value=0,0001), quality of desinfection (p-value=0,0001) with quality of product water microbiology in drinking water refilling station Tegal Regency at 2012. Product drinking water from drinking water refilling station using ineligible standard water of MPN coliform had risk 5,6 times compared to using standard water. Product drinking water from drinking water refilling station with quality of filtration that was not good had up risk 34 times compared to if the quality of filtration was good Product drinking water from drinking water refilling station with quality of desinfection which was not good had risk 9,2 times compared to if the good quality of desinfection. Recomendation : The owners of the drinking water refilling station was obliged to guarantee water quality to drink produced by it is safe for health. Public expected to be more attentively in consuming water product from drinking water refilling station. Health Department needs more increases construction and observation to drinking water refilling station. Keywords : Microbiological Contamination of Drinking Water Refilling,Tegal Regency

Faktor Lingkungan dan Perilaku yang Berhubungan dengan Kejadian Stunting pada Siswa SD di Wilayah Pertanian (Penelitian di Kecamatan Bulakamba Kabupaten Brebes)

Background : Stunting is identified by comparing measurements of childrent’s heights to the NCHS WHO2005growth reference population : children who fall potential as a result of suboptimal health and/or nutritionalconditions. Stunting prevalence in Indonesia still high level, this indicated health problem because associatedwith increase in morbidity and mortality, low cognitive capability and improper physical function.The purpose inthis study was to determine many environmental factors and behaviour associated with incidence of stunting.Methods : It was an observational research with case-control study design.Subject were divided into two groups: case and control groups in Elementary School student class 4 and 5 with 37 subject in case group and 53 subjectin the control group. Variables examined in this study was a history of exposure to pesticides, history of cigarettesmoke exposure, mosquito smoke exposure history, a history of using plastic as a place to store food is still hot,urinaryexcretioniodine (UEI), levels of urinary thyocyanate, anemia, TSH levels, Cholinesterase levels and BodyMass Index.Data was collected by interviewing, observation and measurement. Data would be analyzed using independent t–test or Mann Withney), bivariate analisys using Chi-Square and multivariate analysis using logistic regression.Result :This study indicated that the incidence of stunting was 37 %; 56,8% of them had history of pesticidesexposure. The results of the bivariate analysis showed that the risk factor of stunting in student is a history ofpesticides exposure with Odds Ratio (OR) 2,625. The result of logistic regression test showed there was asignificant association between the incidence of stunting with a history of pesticide exposure(OR 2,39).Conclusion :The history of pesticides exposure was the risk factor for stunting. Key words : Environmental and behaviour factors, stuting, elementary student, agriculture areas.

Evaluasi Manajemen Lingkungan Pengendalian Vektor Dalam Upaya Pemberantasan Penyakit Malaria di Kota Ternate

Background : Malaria is one tropical disease that continues spread to this day, lead to suffering of millions peoples in various parts of the world. In Indonesia, malaria is still one of the major health problems. Ternate city is one area in eastern Indonesia that has high endemicity. The reports of malaria from seven Puskesmas (Community Health Center) showed that rates of malaria per 1000 population (API) in 2010 was 6 ‰. There are three Puskesmas included in the HCI (High Case Incidence) that is the malaria-endemic areas with API rate >5/1000 population. These Puskesmas, among others Puskesmas Kalumpang (11 ‰), Puskesmas Gambesi (7 ‰) and Puskesmas Siko (6 ‰). This research aimed to evaluate the environmental management of vector control in effort of malaria disease eradication in Ternate City. This research was a descriptive research using a survey method. Population in this research were people who involved either directly or indirectly in the program of malaria eradication in Dinkes Ternate, some Puskesmas officers and related institutions. Data obtained in primary through interviews with questionnaires and secondary with archives study / documents / observation sheet. Methods : This research was a descriptive research using a survey method. Population in this research were people who involved either directly or indirectly in the program of malaria eradication in Dinkes Ternate, some Puskesmas officers and related institutions. Data obtained in primary through interviews with questionnaires and secondary with archives study/documents/ observation sheet. Result : The results showed that implementation of malaria eradication in Health Department of Ternate City was done based on circumstances of the incidence of clinical malaria patient were reported and adjusted to the available funds. Evaluation results of vector control showed that Implementation of the environmental management covering an operational techniques aspect (middle categories), institutions aspect (middle categories), financing aspect (middle categories), regulation aspect (good categories) and participation of community aspect (middle categories). Conclusion : Conclusion of this research is environmental management of vector control in Ternate city included middle category. Key words : Environmental Management, Vector Control, Malaria incidence.