Faculty of Public Health Journal Universitas Indonesia
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Kepatuhan Pengobatan pada Pasien Tuberkulosis dan Faktor-Faktor yang Mempengaruhinya: Tinjauan Sistematis
Full text linkTuberkulosis (TB) merupakan penyakit menular yang disebabkan oleh bacillus mycobacterium tuberculosis. Ketidakpatuhan dalam pengobatan kerap menjadi masalah secara global, karena jika tidak mengikuti rangkaian pengobatan secara benar dapat menyebabkan resistensi obat, kambuhnya kembali penyakit, bahkan sampai kematian. Tujuan artikel ini adalah untuk mengetahui kepatuhan pengobatan pasien TB paru dan faktor-faktor yang mempengaruhinya pada studi observasional. Terdapat empat database (PubMed, Scopus, EMBASE dan MEDLINE) yang digunakan untuk menulusuri artikel. Kata kunci yang digunakan untuk pencarian diantaranya: (tuberculosis) OR (TB) AND (treatment adherence) OR (treatment compliance) OR (medication adherence) OR (medication compliance) AND (directly observed treatment shortcourse) OR (DOTS). Ditemukan sebanyak lima artikel yang relevan digunakan untuk tinjauan dalam artikel ini. Penelusuran artikel mengacu pada PRISMA diagram. Analisis dilakukan terhadap beberapa artikel dari Asia, Afrika dan Timur Tengah. Penelitian dilakukan pada pasien TB paru dimana terdapat tiga artikel yang menggunakan desain kasus kontrol dan dua artikel menggunakan desain cross-sectional. Faktor-faktor yang mempengaruhi kepatuhan pasien TB diantaranya adalah usia, status pekerjaan, efek samping obat, jarak, pengetahuan TB, peran keluarga dalam memberikan pengawasan serta dukungan dalam menjalani pengobatan, hubungan yang baik antara dokter dan pasien serta stigma. Diperlukan upaya untuk meningkatkan kepatuhan pasien dengan pembangunan dan pengembangan dalam pemberian layanan kesehatanagar pasien dapat mengakses pelayanan kesehatan secara maksimal, khususnya bagi pasien yang terhambat oleh jarak dan biaya. Selain itu, memberikan edukasi terkait TB, meningkatkan hubungan pasien dan dokter, dukungan keluarga baik secara fisik dan spiritual juga dibutuhkan untuk menjaga niat pasien dan memberikan kekuatan secara psikologis terhadap stigma yang mungkin diterima dari orang-orang sekitar
Perceptions of Health Workers regarding the COVID-19 Vaccine Report Application in Ogan Ilir Regency, South Sumatra
Full text linkThe Lapor Vaksin COVID-19 Application was developed to support a vaccination coverage surveillance database sourced from community self-report. This application provides data on vaccination coverage and allows users to view updates to educational content about vaccines and visualization of COVID-19 vaccine data in real-time. This study aims to analyze the perception among health worker about Lapor Vaksin COVID-19 application in the community. This study uses descriptive research with a case study design. This study was conducted in September 2021 through a virtual zoom meeting, in Ogan Ilir Regency, South Sumatra. The research sample was 42 health workers consisting of vaccine officers at the Health Office, RSUD and Puskesmas in Ogan Ilir Regency who were selected by purposive sampling. Data is presented descriptively. Based on the evaluation results of the application's use, more than half of the respondents were quite satisfied (52.4%) with the Lapor Vaksin COVID-19 application. This application can be used and developed as an alternative to the COVID-19 surveillance database
Situation Analysis of Health Problems in Depok City in 2021
Full text linkBased on 2021 data, from the results of problem identification, 16 health problems in Depok City were assessed. Maternal mortality was selected as a priority problem with 65 cases of maternal death or 155.58 per 100,000 live births. COVID-19 infection is the most common cause of maternal death. This study aims to provide an overview of maternal death circumstances in Depok because of prioritization following situation analysis of health problems. This situation analysis was conducted in Depok with a quantitative and qualitative approach analyzed using the PAHO-adapted Hanlon involving the participation of 17 respondents from the Health Office and the Head of the PHC in Depok. Primary and secondary quantitative data were collected using questionnaires, the Ministry of Health's Strategic Plan 2020-2024, Regional Medium-Term Development Plan 2016-2021, and Health Profile 2021. Qualitative data was obtained through interviews with respondents. Maternal mortality got a PAHO score of 42.37. This disease is a priority health problem in Depok. Most pregnant women had a high risk due to a lack of knowledge about pregnancy and a lack of participation in attending pregnancy class programs and pregnancy checks. Lack of family support for the health of pregnant women and there are also challenges in recording and reporting which must be based on an identity card so that cases sometimes do not live in the area but are recorded in the area. There are still some challenges in controlling maternal mortality. Promotive, preventive efforts such as conducting refresher training for health workers and volunteers, counseling, and presenting exciting material in pregnant women's classes to increase pregnant women's knowledge and family support. Cross-sector coordination and community leaders must be concerned with all parties to support and assist in screening pregnant women
Hubungan Akses Layanan Kesehatan dengan Penggunaan Metode Kontrasepsi Jangka Panjang di Indonesia: Analisis Data SKAP KKBPK 2019
Full text linkProgram KB di Indonesia khususnya penggunaan MKJP menjadi upaya pemerintah dalam mengendalikan penduduk, khususnya pada kelompok berisiko. Namun, penggunaan mix-method MKJP di Indonesia relatif masih rendah, yaitu 24,6% dibandingkan negara ASEAN lainnya. Wanita menikah di Indonesia masih mengalami masalah dalam mengakses layanan kesehatan seperti masih tingginya angka unmet-need serta rendahnya presentase wanita terpapar informasi dari penyuluh lapangan KB dan informed choice KB. Penelitian ini bertujuan untuk mengidentifikasi indikator akses layanan kesehatan dan mengetahui hubungan akses layanan kesehatan dengan penggunaan MKJP. Penelitian ini menggunakan data SKAP KKBPK 2019 dengan desain penelitian cross-sectional. Analisis univariat dilakukan untuk mengidentifikasi indikator akses layanan kesehatan sedangkan analisis bivariat dan multivariat digunakan untuk melihat hubungan akses layanan kesehatan dengan penggunaan MKJP. Ditemukan 75,3% wanita masih mengalami minimal 1 masalah terkait akses layanan kesehatan. Proporsi penggunaan MKJP oleh wanita menikah usia 15-49 tahun di Indonesia adalah 29,2%. Ada hubungan yang signifikan antara akses layanan kesehatan dengan penggunaan MKJP setelah dikontrol variabel pendidikan dan keinginan memiliki anak (AOR=1.19; 95% CI=1.091-1.312). Disimpulkan penggunaan MKJP di Indonesia relatif rendah. Upaya pemerintah seperti memanfaatkan tim pendamping keluarga sebagai jejaring fasilitas layanan KB, mengoptimalkan penyuluhan KB dengan pendekatan keluarga sehat dan KB lestari, dan mengoptimalkan layanan KB sesuai standar perlu dilakukan untuk mengurangi masalah terkait akses layanan kesehatan
Keterpaparan Informasi Narkoba dan Perilaku Pencarian Rehabilitasi: Studi Kasus Pada Penyalahguna Narkoba di Rumah Kos
Full text linkKeterpaparan informasi narkoba merupakan faktor penting dalam pengetahuan dan perubahan perilaku, terutama untuk melakukan rehabilitasi. Rumah kos merupakan populasi yang dianggap rawan terhadap penyalahgunaan narkoba. Tujuan dari penelitian ini adalah untuk mengetahui hubungan keterpaparan informasi narkoba dengan perilaku pencarian rehabilitasi pada pengguna narkoba di rumah kos. Analisis regresi logistik ganda digunakan untuk menilai hubungan yang signifikan pada α=0,05. Hasil penelitian ini menunjukkan bahwa penyalahguna narkoba di rumah kos yang memiliki keterpaparan informasi yang baik memiliki kecenderungan untuk 3,8 kali lebih besar untuk berperilaku mencari rehabilitasi dibandingkan dengan mereka yang keterpaparan informasinya kurang (ORa=3,8; 95% CI=0,7 – 21,5), setelah dikontrol oleh variabel umur, pekerjaan, dan pendapatan atau uang saku perbulan
Nutrition Education Effect on Anemia Incidence in Female Adolescents: Meta-Analysis for Future Health Post-COVID-19 Pandemic
Full text linkFemale adolescents are at a heightened risk of anemia due to inadequate iron intake and absorption, blood loss during menstruation, and an escalated need for iron to support rapid growth. This study examined the impact of nutrition education on the incidence of anemia in adolescent girls. The investigation was conducted through a systematic review and meta-analysis, employing articles from reputable sources such as Google Scholar, JAMA Network, PubMed, ScienceDirect, The New England Journal of Medicine, Lancet, and ProQuest, published between 2013 and 2021. The keywords for data retrieval were"nutrition education" and "adolescent anemia girls." Furthermore, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline was used to select and organize publications for this study. Using Review Manager 5.3 Software, full-text articles meeting meta-analysis criteria were selected, resulting in 7 out of the 257 retrieved articles being included. The findings suggested that nutrition education indeed impacts the incidence of anemia in adolescent girls (p-value<0.001; aOR = 2.10; 95% CI = 1.60-2.76)
Analysis of Climate and Environmental Risk Factors on Dengue Hemorrhagic Fever Incidence in Bogor District
Full text linkDengue Hemorrhagic Fever (DHF) is transmitted through the bites of Aedes aegypti and Aedes albopictus mosquitoes and is still becoming endemic in Bogor District. This quantitative correlation study with an ecological approach aimed to analyze how DHF incidence is influenced by climate factors, population density, Larvae Free Rate (LFR), and the area altitude factor. Secondary data were obtained from the Bogor Regency Health Office; the Central Bureau of Statistics of Bogor District; and the Meteorology, Climatology, and Geophysics Agency. In this study, the spatial analysis method was also used, but only on the area altitude factor. The study’s results showed a significant relationship between climate factors, such as air humidity at a Time Lag of 0 months (r=0.394) and the altitude factor (r=-0.350), and DHF incidence in the Bogor District from 2017 to 2022. Spatial data shows that in districts with lower altitudes, such as Cibinong, Cileungsi, and Gunung Putri, DHF incidence tends to be higher. The Bogor District Health Office, together with the community, may enhance efforts to prevent and control DHF, especially during seasonal transitions and in areas with lower altitudes. Cross-sector collaboration with the Meteorology, Climatology, and Geophysics Agency is also necessary to remain vigilant during climate fluctuations
A Qualitative Exploration of Exclusive Breastfeeding Practices Among Karen Ethnicity Mothers in Northern Thailand Remote Rural Areas
Full text linkLow exclusive breastfeeding rates among the Karen ethnic group in Northern Thailand's remote rural areas underscore the need to understand knowledge, attitudes, and social support to develop targeted interventions. This qualitative study examined exclusive breastfeeding practices and the factors influencing breastfeeding behavior among 14 Karen Ethnicity Mothers (KEMs) in Northern Thailand. A structured interview was used to collect the data, a triangular method to determine the data's validity, and a content analysis method to examine the data revealed seven themes and 14 subthemes. This study identified three key factors for successful breastfeeding: self-motivation, social support, and effective problem management, which included overcoming the family's anti-breastfeeding beliefs. Conversely, unsuccessful breastfeeding stemmed from four issues: inadequate maternal knowledge and misconceptions, family beliefs and culture, maternal health problems, and economic constraints. Therefore, the success of breastfeeding was heavily influenced by both personal and environmental factors. As a result, every KEM should be encouraged to recognize the importance of breastfeeding and to exclusively breastfeed for at least six months, especially those living in remote rural areas and have a different way of life than the natives
Knowledge and Pattern of Preventive Behaviors Among Relatives of Breast Cancer Patients in Yogyakarta Pre and During the COVID-19 Pandemic
Full text linkBreast cancer is still one of the leading causes of death in Indonesia. The multifactorial causes of breast cancer, including heredity, carries a risk for the sufferers’ relatives. Vigilance in female relatives of breast cancer patients increases due to hereditary risk factors for having the same disease. This anthropological study aimed to reveal the mosaic of breast cancer patients’ female relatives’ knowledge of such a risk and their efforts to prevent it. Qualitative data collection through interviews was conducted with 13 female family members of breast cancer patients in Yogyakarta aged 17-65 years. The data analysis was done through an emic approach by examining the informants’ views on the situation and their solutions. All of the informants believed that breast cancer is a malignant and deadly disease if it is not detected early and not properly treated. They were all fully aware of their risk as a family member to have the same disease. Their preventive measures included medical (early examination, breast self-examination, laboratory check, or consultation with the doctor) and non-medical (changes in eating and drinking behavior, reducing stress, exercising, and wearing masks). Besides, they also made religious efforts by praying to God to be given a healthy life and for the patients to be healed and their offspring to be free from this disease
Analisis Survival: Hubungan Konversi Sputum dengan Keberhasilan Pengobatan Pasien Tuberkulosis Resistan Obat di Indonesia
Full text linkAngka keberhasilan pengobatan Tuberkulosis Resistan Obat (TB RO) di Indonesia masih rendah. Konversi sputum dapat menjadi monitoring awal untuk memantau keberhasilan pengobatan. Penelitian ini bertujuan untuk melihat hubungan antara konversi sputum ≤3 bulan dengan keberhasilan pengobatan. Penelitian ini menggunakan desain studi kohort retrospektif dengan data yang bersumber dari sistem informasi tuberkulosis Kementerian Kesehatan RI. Populasi pada penelitian ini adalah pasien TB RO yang memulai pengobatan tahun 2020-2021 di Indonesia dengan jumlah sampel sebanyak 8.025 kasus dan participation rate sebesar 88,6%. Kurva Kaplan Meier dengan uji log-rank dibuat untuk analisis deskriptif, sedangkan analisis regresi Cox digunakan untuk melihat hubungan antara konversi sputum dengan keberhasilan pengobatan. Hasil analisis menunjukkan bahwa 45,9% pasien konversi sputum ≤ 3 bulan pengobatan dengan 74,6% memiliki keberhasilan pengobatan. Secara keseluruhan median time untuk keberhasilan pengobatan berdasarkan konversi sputum ≤ 3 bulan adalah bulan ke-18. Hasil analisis multivariat menunjukkan konversi sputum≤3 bulan 1,25 (95% CI 1,18-1,34) lebih tinggi peluangnya untuk mencapai keberhasilan pengobatan dibandingkan pasien yang tidak konversi ≤3 bulan setelah dikontrol oleh status HIV dan paduan pengobatan. Berdasarkan hasil penelitian ini dapat disimpulkan bahwa monitoring konversi sputum dapat menjadi cara untuk melakukan monitoring keberhasilan pengobatan sedini mungkin. Konversi sputum merupakan standar yang dilakukan untuk pemantauan pengobatan pasien TB RO. Namun jumlah laboratorium yang dapat melakukan pemeriksaan untuk konversi pada pasien TB RO masih terbatas. Perlu adanya perluasan layanan dan peningkatan mutu layanan untuk melakukan pemeriksaan konversi sputum pada pasien TB RO