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Vaccination Status and Symptom Severity in Covid-19 Patients
No full textWe are still attempting to reduce COVID-19 morbidity and mortality through several means, including immunization. In early December 2021, Indonesia had 49.19% coverage of the second COVID-19 vaccination. Researching and collecting data on the association between vaccine completion and symptom severity is critical to persuade individuals to vaccinate. This study aims to examine the relationship between COVID-19 vaccination status and the degree of symptom severity in COVID-19 patients. This cross-sectional study used secondary data from the medical records of COVID-19 patients at the PDHI Yogyakarta Islamic Hospital from June to October 2021. The "PeduliLindungi" application was used to acquire vaccination status information. We used the chi-square test and multiple logistic regression for bivariate and multivariate analyses. The study enrolled 112 participants who met the criteria. The severity of COVID-19 symptoms was related to vaccination status and hypertension. Patients who were unvaccinated or had only partially vaccinated were 62.383 times more likely to develop severe and critical severity (aOR 62.383; 95% CI 12.129-320.861). Patients with hypertension were 3.643 times more likely than those without hypertension to experience severe or critical symptoms (aOR=3.643; 95% CI 1.025-12.952). Male gender, elderly age, chronic lung illness, and diabetes mellitus slightly increased the likelihood of severe symptoms but were not statistically significant. Complete immunization is strongly advised to reduce the risk of severe or critical symptoms.
The Leading Causes of Death among Adult Mortality: Data Analysis of Sleman Health and Demographic Surveillance System, Indonesia
No full textDetermining the cause of death (CoD) is crucial for effective health policy and decision-making, particularly in population health programs. The World Health Organization (WHO) developed the Verbal Autopsy (VA) tool to ascertain CoD through verbal information, particularly in countries lacking comprehensive vital registration systems. In Indonesia, the health landscape is shifting from communicable diseases to non-communicable diseases (NCDs), highlighting the need for updated mortality surveillance. This study aimed to determine the major causes of death among adult mortality in Sleman Health and Demographic Surveillance System (HDSS) Indonesia. A demographic surveillance system was employed to monitor vital events, including mortality, with verbal autopsy interviews conducted for each death. A total of 279 adult deaths (ages 15 years and older) from the first two cycles of surveillance were analyzed. Trained enumerators conducted verbal autopsy interviews with informants close to the deceased. The InterVA program was used to process the verbal autopsy data, identifying the CoD for 274 adult deaths. Descriptive analysis was performed to determine the proportion of each cause of death, and Chi-square tests were used to assess differences in proportions. The findings revealed that 68.2% (95% CI: 62.38–73.72) of deaths were due to NCDs, including stroke, heart disease, diabetes, asthma, and chronic liver disease. Infectious diseases accounted for 24.8% (95% CI: 19.82–30.37), while injuries (primarily accidents) contributed to 6.6% (95% CI: 3.94–10.18). Stroke was the leading cause of death, particularly in individuals aged 50–64 years (21.2%, 95% CI: 16.48–26.49), followed by acute respiratory infections, including pneumonia (10.6%, 95% CI: 7.2–14.85). The study concluded that NCDs, particularly stroke, are the leading causes of adult mortality in Sleman HDSS, with significant contributions from acute respiratory infections and injuries. It is recommended for future research to further develop Verbal Autopsy technology, such as AI-based applications that can improve the accuracy of determining the cause of death
Factors Affecting HIV Test in Public Health Center at Childbearing Age : A Cross – Sectional Analysis of Demographic and Health Survey in Indonesia
No full textThe National HIV/AIDS Strategy predicts that 86% of people with HIV (PLHIV) worldwide will know their HIV status by 2022, the remaining 14% do not know that they have HIV and still need access to HIV testing services. As an effort to realize the Sustainable Development Goals and to reduce the incidence of HIV/AIDS by 2030, the Indonesian Ministry of Health needs to design and implement appropriate prevention mechanisms related to HIV/AIDS by conducting early detection of HIV, namely by empowering Community Health Centers to provide HIV testing services and counseling. This study aims to analyze the factors influencing HIV testing at Public Health Centers among women of childbearing age in Indonesia. This study uses a cross-sectional design with data from the 2017 Indonesian Demographic Health Survey (SDKI). Data were analyzed using the logistic regression. The variable in this study were demographic sharacteristics and HIV testing. HIV testing at Public Health Centers among childbearing age in Indonesia was at 32.5%. Several factors influencing HIV testing were identified, including region (OR: 1.22, 95% CI: 1.10 - 1.35), wealth index (OR: 0.82, 95% CI: 0.74 - 0.91), residence (OR: 0.82, 95% CI: 0.74 - 0.91), health insurance coverage (OR: 1.15, 95% CI: 1.04 - 1.27), level of knowledge (OR: 0.92, 95% CI: 0.83 - 1.01), stigma (OR: 0.81, 95% CI: 0.73 - 0.90), and AIDS knowledge source from health professionals (OR: 1.90, 95% CI: 1.70 - 2.12). To optimize HIV testing coverage, healthcare workers should enhance awareness by providing comprehensive HIV/AIDS education. This can be done through various media, such as posters, brochures, and community-involved seminars. The government must ensure HIV testing services are accessible in all regions, including rural and remote areas. Additionally, continuous monitoring and evaluation of HIV testing programs at Public Health Centers are necessary. This will help improve and tailor programs to meet community needs and address influencing factors effectively.
Self-Efficacy as a Predictor of Interdialytic Weight Gain (IDWG) in End Stage Renal Disease Patients
No full textExcessive interdialytic weight gain in End Stage Renal Disease (ESRD) patients may reduce their quality of life well-being. High self-efficacy (belief in one\u27s own ability) can increase the patient\u27s readiness to live a better quality of life. The purpose of this study is to ascertain how interdialytic weight gain (IDWG) and self-efficacy relate to each other in patients with end-stage renal disease. This study uses a correlational quantitative design type with a cross-sectional method approach. The sampling method used purposive sampling with a total of 107 respondents. Univariate data analysis test to determine the characteristics of respondents. The Spearman Rank correlation test is used in bivariate analysis to determine the relationship between two variables, while the cross sectional design is to analyze the relationship between variables that have been collected at one time simultaneously. The results of this study were 69 patients (64.5%) had low self-efficacy and a moderate IDWG category of 56 patients (52.3%). The Rank-Spearman test results obtained a p-value of 0.000 and a positive Spearman correlation value (r) of 0.565. The conclusion that can be drawn is that there is a strong and significant relationship between self-efficacy and IDWG in patients with end stage renal disease. The suggestion from this study is that hospital managers consider making policies related to the service and care of ESRD patients by providing regular education related to fluid restriction compliance by applying media in the form of educational videos or leaflets or posters in the waiting room
The Relationship between Prediabetes and Prehypertension with Vascular Elasticity in Medical Students
No full textPrediabetes and prehypertension are known to affect vascular elasticity, and the prevalence of these conditions among young adults is increasing. This study examines the relationship between prediabetes and prehypertension with vascular elasticity in medical students. The study utilized a cross-sectional design and the technique of simple random sampling, involving a total of 69 students. The research subjects\u27 criteria were medical students aged 18–25 years who were non-smokers, did not consume alcohol, had no history of diabetes or hypertension, and were not taking medications affecting blood pressure or blood glucose levels. Vascular elasticity, blood pressure, and fasting blood glucose levels were measured using an Accelerated Photoplethysmograph Analyzer SA-3000P, a digital sphygmomanometer, and a glucometer, respectively. The findings indicated no differences in gender, BMI, age, and physical activity between the suboptimal vascular elasticity and the normal+optimal elasticity groups (p > 0.05). The Chi-square test identified significant differences in vascular elasticity between the prediabetes and normal groups (p = 0.009; PR = 1.6; CI = 1.1–2.2), the prehypertension and normal groups (p = 0.026; PR = 1.5; CI = 1.1–2.2), and the prediabetes+prehypertension and normal groups (p = 0.002; PR = 3.5; CI = 1.4–8.3). These findings indicate that prediabetes, prehypertension, or both conditions are associated with reduced vascular elasticity
Construction of Validity and Reliability of The SBAR-Based Assessment Scale among Nurses
No full textSituation, Background, Assessment, Recommendation (SBAR) is a communication tool used to convey information clearly and in a structured manner, especially in the context of health services. The implementation of this assesment scale consideration has not been carried out optimally for nurses in the hospital. This study aims to analyze the validity and reliability of the SBAR-based weighing evaluation instrument from primary nurses and associate nurses. Multivariate validity and reliability test using the Exploratory Factors Analysis (EFA) test. The results aim to validate the instrument content. The numbers in the table show the loading factor values for each statement item which have been sorted from the largest value to the smallest value for each component. Statement items are valid and have an important correlation in the handover implementation instrument if they have a factor loading value of <0.40. Of the 25 statement items, 8 items were invalid, namely item numbers 2,3,4,6,10,12,17,19 while the other 17 items were declared valid and formed 4 components (Component 1; Situation indicator, Component 2; Backgound indicator, Component 3; Assessment indicator, Component 4; Assesment) which were used as indicators for compiling the SBAR-based handover implementation instrument. CFA test results were the relative chi-square value (CMIN/df) shows a fairly good fit with a ratio <5, the comparative fit index (CFI) value indicates marginal fit because it is in the range 0.80<CFI <0.90, The root mean square error (RMSEA) value indicates a reasonable agreement with a value of <0.08, the goodness-of-fit (GoF) value indicates a good fit because it is >0.80. It can be interpreted that based on the results of the CFA analysis it has fulfilled the construct feasibility test so that in general it can be said that the handover evaluation instrument by primary nurses and associate nurses is fit to be used in measuring handover implementation.
Treatment Duration and Its Impact on the Number of Polymorphonuclear, Mononuclear and Neutrophil Lymphocyte Ratio as Indicators of Recovery Rate in Tuberculosis Patients
No full textThe calculation of leukocyte types can be used to assess the level of infection or inflammation, particularly through the neutrophil-lymphocyte ratio (NLR). The NLR has been established as a useful biomarker for predicting bacteremia. Although differential leukocyte count and the neutrophil–lymphocyte ratio (NLR) have been widely proposed as indicators of infection and inflammation, their clinical interpretation remains unclear across disease states, particularly in tuberculosis. Current evidence is limited regarding how leukocyte profiles and NLR change during standard anti tuberculosis treatment (ATT), especially in the early and intermediate phases of therapy. Furthermore, it is not well established whether changes in leukocyte subtypes reflect treatment response or disease recovery in tuberculosis patients. Therefore, there is a need to quantify changes in leukocytes and NLR during TB treatment and to determine their potential role as readily accessible biomarkers for monitoring therapy outcomes. The goal of this study was to determine the effect of treatment duration on the number of polymorphonuclear cells, mononuclear cells, and the neutrophil-lymphocyte ratio as indicators of recovery in TB patients. This study employed a cross-sectional design with an analytical observational approach, involving 26 TB patients undergoing treatment for 1 to 6 months. The results showed the following average cell counts (per microliter) over the treatment period: basophils at 0.04, eosinophils at 0.30, neutrophils at 4.10, lymphocytes at 2.36, monocytes at 1.84, and a neutrophil-lymphocyte ratio of 0.53. One-way ANOVA analysis revealed a positive correlation between basophils, neutrophils, lymphocytes, monocytes, and the neutrophil-lymphocyte ratio with TB recovery. In conclusion, treatment of TB patients during the fourth to sixth month, or in the advanced phase of treatment showed differences in the number of polymorphonuclear cells, mononuclear cells and the NLR ratio compared to intensive phase treatment in TB patients at the Karang Taliwang and akranegara Health Centers
The Hospital Characteristics (Public and Private) Utilization by Caesarean Section Delivery in Thailand
No full textCesarean delivery (C-section) rates continue to rise worldwide, with Thailand showing a significant spike in the past two decades, surpassing WHO recommended rates. Hospital characteristics, such as ownership, financial incentives, and medical staffing patterns, can influence cesarean delivery rates. Private hospitals may be more susceptible to non-medical motivations, while public hospitals often face high patient volumes and resource constraints. This study aimed to investigate the use of cesarean delivery in relation to hospital characteristics, with a comparative focus between public and private hospitals in Thailand. This study used a cross-sectional quantitative approach with secondary data from the Thailand Multi Indicator Survey (MICS) 2022. The study sample consisted of 1,046 women who delivered by cesarean section and 1,720 women who did not, with the dependent variable being hospital utilization by caesarean section delivery. Data analysis was performed using univariate, bivariate (Chi-square test), and multivariate (binary logistic regression) tests to analyze the effect of independent variables on the choice of hospital type. The study findings were that in women undergoing cesarean section, wealth and region of residence were significantly associated with private hospital utilization, with women from the fourth wealth quintile (OR = 14.61; 95% CI: 1.88–113.85) and the richest (OR = 23.67; 95% CI: 3.03–185.09) more likely to use private hospitals than the poorest, while those living outside Bangkok were less likely. In women without cesarean section, living in rural areas (OR = 0.36; 95% CI: 0.16–0.81) and outside Bangkok also significantly decreased the odds of private hospital utilization
Differences in Lead Levels on Doors and Walls of Children\u27s Homes: A Cross-sectional Study in Java, Indonesia
No full textChildren are one of the most vulnerable groups to lead exposure. Exposure in children is primarily related to hand-to-mouth activities and environmental conditions. Studies on lead level in homes measurements, which are linked to blood lead levels in children, are still rare. The objective of the study was to identify lead levels on painted surfaces, consisting of doors and walls, in the homes of children aged 12-59 months who had high blood lead levels (≥ 20 μg/dl). The method was a cross- sectional study conducted in Java, Indonesia, comparing lead exposed and unexposed in areas with battery recycling activities to a demographically similar control area without such activities (Cinangneng-Bogor). The results showed among the 145 inspected homes in the exposed areas, 40 were measured on doors and 93 on walls; meanwhile among the 240 inspected homes in the unexposed areas, 35 were measured on doors and 36 on walls. In the exposed areas, the lead levels at the door ranged from 0.00 µg/cm2 – 891.36 µg/cm2 and it was not different (p = 0,671) from that in the unexposed areas, i.e. ranged from 0.00 µg/cm2 – 537.03 µg/cm2. Meanwhile, the lead levels at the walls in the exposed areas were measured ranged from 0.00 µg/cm2 – 279.21 µg/cm2 (median 0.65 µg/cm2), and it was significantly different (p <0.001) from that in the unexposed area, i.e. ranged from 0.00 µg/cm2 – 45.64 µg/cm2 (median 0.00 µg/cm2). The findings of lead exposure in the children’s homes lead to a strong recommendation to regulate the elimination of lead in the household paints, and to escalate community concern of domestic lead hazards
Hypertension and Salt Consumption: A Story from A Coastal Area
No full textIndonesia has a high prevalence of hypertension accompanied by relatively high salt consumption, posing a significant public health concern, particularly in coastal areas where salty foods and saline water are commonly available. This study aimed to analyze the relationship between salt consumption and hypertension grade among residents in a coastal area. A cross-sectional study was conducted involving 174 hypertensive patients in Pangandaran District who had recorded blood pressure measurements at the local health center. Data on respondents’ characteristics, including age, sex, education level, occupation, and income, were collected. Salt intake was assessed using a Semi-Quantitative Food Frequency Questionnaire (SQ-FFQ). Multiple logistic regression analysis was performed to examine the association between salt consumption and hypertension grade while controlling for potential confounding variables. The mean sodium intake among respondents was 1312.11 ± 596.27 mg/day. Salt consumption was significantly associated with hypertension grade (β = 0.001; p = 0.004) after adjustment for education level and type of occupation. In conclusion, higher salt consumption is significantly associated with increased severity of hypertension in coastal populations, highlighting the need for targeted dietary interventions to reduce salt intake in these areas