Praba Ginandjar

Profile of glycated-hemoglobin, antioxidant vitamin and cytokine levels in pulmonary tuberculosis patients: A cross sectional study at Pulmonary Diseases Center Semarang City, Indonesia

Background Uncontrolled blood glucose, which marked by high level of HbA1c, increases risk of pulmonary TB because of cellular immunity dysfunction. This study aimed to analyze profile of glycated hemoglobin, antioxidant vitamins status and cytokines levels in active pulmonary TB patients. Methods This was a cross sectional study, conducted at Pulmonary Diseases Center Semarang City, Indonesia. Study subject consisted of 62 pulmonary TB patients, diagnosed with positive acid fast bacilli and chest X-ray. ELISA was used to measure IFN-γ and IL-12. Status of antioxidant vitamins was determined by concentration of vitamin A and E using HPLC. Blood glucose control was determined by HbA1c concentration (HbA1c ≥7% is considered as uncontrolled). Results A significant difference of age between pulmonary tuberculosis patients with normal and uncontrolled blood glucose (p = 0.000) was showed, while all other characteristics (sex, education, occupation) did not differ with p = 0.050, 0.280, 0.380 respectively. Mean HbA1c was 7.25 ± 2.70%. Prevalence of uncontrolled glucose among pulmonary TB patients was 29%. Levels of IFN-γ and IL-12 did not differ according to HbA1c concentration (p = 0.159 and p = 0.965 respectively). Pulmonary tuberculosis patients with uncontrolled blood glucose has higher vitamin E (p = 0.006), while vitamin A did not differ significantly (p = 0.478). Conclusions This study supports the importance of performing diabetes screening among pulmonary TB patients. Further study needs to be done to determine the feasibility of TB-DM co-management.

Risk Factor for Blood-borne Disease (Study in Blood Donors at Semarang District)

Blood-borne disease is one of communicable disease through blood contamination. The aims of this study to determine risk factors for diseases transmitted from blood donors in Semarang District. The design study was a cross sectional with analytic approach. The subjects were blood donors (400 people) using an accidental sampling method. Statistical analyzed with fisher exact test and prevalence ratio with 95% significance level. Results showed the prevalence of hepatitis B and HIV was 1.5% (6 people) and 0.5% (2 people). Hepatitis C infection in this study was not found. From the statistical test showed that history of sexual behavior as a risk factor incidence of infectious disease through blood POR = 30.992; 95% CI (6.908 – 139.041) with p = 0.001. Knowledge, types of injection drug use, sharing needles, blood transfusions, organ transplants, surgery, dialysis, dental examination, tattooing and piercing, and contact with the patient were not risk factors for the incidence of infectious diseases through blood in Semarang District. Indonesia Red Cross in Semarang District should conduct dissemination to the blood donors on the sidelines of the implementation of activities related blood donor infectious diseases transmitted by blood including agent, transmission, natural history, prevention and treatment.

Malaria in Open and Closed Communities in Namrole, Buru Selatan District, Maluku Island, Indonesia

Malaria remains a public health problem in Buru Selatan District, an area with opened and closed communities. This study aimed to describe malaria prevalence and its related factors in opened and closed communities in Namrole, Buru Selatan District. This study was a cross sectional study to measure prevalence of malaria in open and close communities of Buru Selatan District. Study location was in Namrole Sub-District. Subject was selected by purposive sampling, consisted of 128 subjects (64 subjects from opened community and 64 subjects from closed community). Malaria was diagnosed by thin and thick blood smear. Data was presented as proportion. Statistical analysis used Chi-Square to analyse the data. Characteristics of subject (age, gender, occupation) were equal between malaria and non-malaria subjects, except for age in closed community. Prevalence of malaria in this study was 33.6% decrease from the prevalence a year earlier (35.5%). Malaria in closed community was higher than opened community and was clustered in forest. In general, malaria did not relate to behavior although taking medicine differs between malaria and non-malaria group. Malaria in closed community is higher than opened community, mostly asymptomatic, and clustered in forest. The closed community is an area with traditional life and lack of health facilities. This condition is a challenge in malaria elimination program.

Vaccines Cold Chain Monitoring: A Cross Sectional Study at Three District In Indonesia

Vaccine cold chain is a procedure that is used to keep vaccines at a certain temperature. The aim was to describe the vaccine cold chain management of basic immunization program in health centers district. The study design descriptive observational. The samples was Health Centers (HCs); 12 HCs in Sarolangun Jambi Province, 16 HCs in Brebes Central Java Province, and 24 HCs in Temanggung Central Java Provice. Basic immunization vaccines were BCG, DPT-HB-HIB, Polio, and Measles. The results showed proportion of officers graduated from college in Sorolangun, Brebes, and Temanggung were 66.7%, 81.3%, and 52.0% respectively. Proportion of HC that did not have thermometer and fridge freeze was mostly found in Temanggung (52%) and in Sorolangun (91.7%). The heat-sensitive vaccines arranged near the evaporator mostly found in Temanggung (88%), while freeze-sensitive vaccines prepared away of the evaporator mostly in Brebes (100%). Freezer temperature recording chart is not available mostly found in Sorolangun and Brebes (50%), In Sorolangun 41.7% of the officers monitoring 2 times a day and mostly (91.7%) the refrigerator thermostat tape was not isolated. The officers did not perform daily maintenance (50%), weekly (66.7%), and montly (33.3%) mostly found in Sorolangun. From this study we can conclude there is no vaccine immunization program management in Sarolangun, Brebes, and Temanggung that managed according to Ministry of Health Regulations number 42/2013 on the Implementation of immunization. Improvement oversight, control over management of vaccine and management personal, also managing the temperature of the vaccine were recommended.

Implementation of Water Safety Plans (WSPs): A Case Study in the Coastal Area in Semarang City, Indonesia

An area of 508.28 hectares in North Semarang is flooded by tidal inundation, including Bandarharjo village, which could affect water quality in the area. People in Bandarharjo use safe water from deep groundwater, without disinfection process. More than 90% of water samples in the Bandaharjo village had poor bacteriological quality. The aimed of the research was to describe the implementation of Water Safety Plans (WSPs) program in Bandarharjo village. This was a descriptive study with steps for implementations adopted the guidelines and tools of the World Health Organization. The steps consist of introducing WSPs program, team building, training the team, examination of water safety before risk assessment, risk assessment, minor repair I, examination of water safety risk, minor repair II (after monitoring). Data were analyzed using descriptive methods. WSPs program has been introduced and formed WSPs team, and the training of the team has been conducted. The team was able to conduct risks assessment, planned the activities, examined water quality, conduct minor repair and monitoring at the source, distribution, and households connection. The WSPs program could be implemented in the coastal area in Semarang, however regularly supervision and some adjustment are needed.

The need of adequate information to achieve total compliance of mass drug administration in Pekalongan

World Health Organization (WHO) initiated The Global Program to Eliminate Lymphatic Filariasis (LF) through mass drug administration (MDA). PEkalongan started MDA in 2011. Yet the LF prevalence in 2015 remained exceed the threshold (1%). This study aimed to describe the inhibiting factors related to the compliance of MDA in community level. This was a rapid survey with cross sectional approach. A two-stages random sampling was used in this study. In the first stage, 25 clusters were randomly selected from 27 villages with proportionate to population size (PPS) methods (C-Survey). In the second stage, 10 subjects were randomly selected from each cluster. Subjects consisted of 250 respondents from 25 selected clusters. Variables consisted of MDA coverage, practice of taking medication during MDA, enabling and inhibiting factors to MDA in community level. The results showed most respondents had poor knowledge on filariasis, which influence awareness of the disease. Health-illness perception, did not receive the drugs, lactation, side effect, and size of the drugs were dominant factors of non-compliance to MDA. MDA information and community empowerment were needed to improve MDA coverage. Further study to explore the appropriate model of socialization will support the success of MDA program

Potential impact of climate variability on respiratory diseases in infant and children in Semarang

Temperature, humidity, and rainfall may influence respiratory disease, including acute respiratory infection (ARI) and pneumonia. In Semarang, the temperature and humidity has increased 0.1°C and 1.6% respectively during 2002-2011. ARI and pneumonia in children under 5 years had increased during 2012-2014. This study aimed to analyze the relationship of climate variability and ARI and pneumonia incidence. It was an ecological study. Subject consisted of patients visited primary health care of Bandarharjo from 2011 to 2015. Pneumonia was related to infants (<1-year-old) and children (1-4 years old), while ARI was related to children (≥5 years old). Data of climate was obtained from Agency for Meteorology, Climatology and Geophysics (BMKG) Semarang. Pearson correlation (α=0.05) was used to analyse the correlation of the 60 samples. Mean of temperature was 27.96° C, relative humidity was 74.73%, and rainfall was 179.98 mm/month. The total of ARI was 38523 cases and pneumonia was 1558 cases. Temperature, humidity, and rainfall had no correlation to pneumonia. Humidity had a significant correlation to ARI on female children and total ARI (r=0.3 and r=0.26; p–value=0.02 and 0.04 respectively). Rainfall and temperature had no correlation to total ARI. This study concluded humidity has potential impact to ARI.