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Cini KI, Dumuid D, Francis KL, Wulan NR, Sawyer SM, Handy Agung F, Pham MD, Kennedy EC, Fisher J, Tran T, Medise BE, Devaera Y, Riyanti A, Wiweko B, Kaligis F, Wiguna T, Ansariadi A, Azzopardi PS. The relationship between non-communicable disease risk and mental wellbeing in adolescence: a cross-sectional study utilising objective measures in Indonesia. BMC Public Health 2024; 24:3416. [PMID: 39695503 DOI: 10.1186/s12889-024-20902-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2024] [Accepted: 11/29/2024] [Indexed: 12/20/2024] Open
Abstract
BACKGROUND Risk factors for non-communicable diseases (NCDs, cardiovascular diseases, cancers, chronic respiratory diseases, diabetes, and mental disorders) arise in adolescence but are mostly framed as relevant to health in adulthood; little is known about the relationship between co-occurring NCD risks and mental wellbeing in young people. This study aims to describe the prevalence and co-occurrence of distinct NCD risk factors, and how they relate to current mental wellbeing amongst adolescents in Indonesia, a young and populous country where NCD burden is increasing rapidly. METHODS We assessed NCD risk and mental wellbeing amongst 1,331 school-based 16-18-year-olds in Jakarta (N = 609) and South Sulawesi (N = 722). Five domains of NCD risk (adiposity, substance use, physical inactivity, excess sedentary time, and diet) were either measured or self-reported. In Jakarta, we also measured blood glucose, triglycerides, cholesterol, and blood pressure. Wellbeing was assessed using three indicators: general quality of life (QoL), physical function QoL, and psychological distress. We used linear regression to estimate the associations between co-occurring risks and wellbeing, adjusted for covariates of wellbeing: province, sex, socioeconomic status, and religion. RESULTS NCD risk clustering was common, and more than half of adolescents had co-occurring risks in 3 or more of the 5 domains (58.9% (95%CI 53.7-63.9)). Adolescents with any NCD risk were more likely to report psychological distress, with this relationship most pronounced in those with excess sedentary time spent on video gaming and computer use. A higher number of NCD risk factors was associated with poorer psychological wellbeing and decreased general and physical function QoL. In the Jakarta subsample, reduced HDL and raised blood glucose was associated with psychological distress; and a higher number of risk biomarkers was associated with lower physical function QoL. CONCLUSIONS Our analysis also shows that these NCD risks (both individual risks and co-occurring risk count) are related to poorer profiles of mental wellbeing in adolescents, after adjusting for likely confounders.
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Affiliation(s)
- Karly I Cini
- Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Australia.
- Department of Paediatrics, School of Medicine Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia.
- Burnet Institute, Melbourne, Australia.
| | - Dorothea Dumuid
- Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Australia
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), Allied Health & Human Performance, University of South Australia, Adelaide, Australia
| | - Kate L Francis
- Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Australia
- Department of Paediatrics, School of Medicine Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia
| | | | - Susan M Sawyer
- Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Australia
- Department of Paediatrics, School of Medicine Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia
| | | | - Minh D Pham
- Burnet Institute, Melbourne, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Elissa C Kennedy
- Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Australia
- Burnet Institute, Melbourne, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Jane Fisher
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Thach Tran
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Bernie E Medise
- Cipto Mangunkusumo Hospital, Jakarta, Indonesia
- Department of Child Health, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Yoga Devaera
- Cipto Mangunkusumo Hospital, Jakarta, Indonesia
- Department of Child Health, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
- Universitas Indonesia Hospital, Depok, Indonesia
| | - Aida Riyanti
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Budi Wiweko
- Cipto Mangunkusumo Hospital, Jakarta, Indonesia
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
- Indonesia Medical Education Research Insitute (IMERI), Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Fransiska Kaligis
- Cipto Mangunkusumo Hospital, Jakarta, Indonesia
- Department of Psychiatry, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Tjhin Wiguna
- Cipto Mangunkusumo Hospital, Jakarta, Indonesia
- Department of Psychiatry, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Ansariadi Ansariadi
- Centre for Epidemiology and Population Health Studies, Faculty of Public Health, Hasanuddin University, Makassar, Indonesia
| | - Peter S Azzopardi
- Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Australia
- Department of Paediatrics, School of Medicine Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia
- Burnet Institute, Melbourne, Australia
- Adolescent Health and Wellbeing Program, The Kids Research Institute, Adelaide, Australia
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2
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Brice SN, Boutilier JJ, Palmer G, Harper PR, Knight V, Tuson M, Gartner D. Close-Up on Ambulance Service Estimation in Indonesia: Monte Carlo Simulation Study. Interact J Med Res 2024; 13:e54240. [PMID: 39671572 DOI: 10.2196/54240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 07/22/2024] [Accepted: 09/30/2024] [Indexed: 12/15/2024] Open
Abstract
BACKGROUND Emergency medical services have a pivotal role in giving timely and appropriate responses to emergency events caused by medical, natural, or human-caused disasters. To provide adequate resources for the emergency services, such as ambulances, it is necessary to understand the demand for such services. In Indonesia, estimates of demand for emergency services cannot be obtained easily due to a lack of published literature or official reports concerning the matter. OBJECTIVE This study aimed to ascertain an estimate of the annual volume of hospital emergency visits and the corresponding demand for ambulance services in the city of Jakarta. METHODS In this study, we addressed the problem of emergency services demand estimation when aggregated detailed data are not available or are not part of the routine data collection. We used survey data together with the local Office of National Statistics reports and sample data from hospital emergency departments to establish parameter estimation. This involved estimating 4 parameters: the population of each area per period (day and night), the annual per capita hospital emergency visits, the probability of an emergency taking place in each period, and the rate of ambulance need per area. Monte Carlo simulation and naïve methods were used to generate an estimation for the mean ambulance needs per area in Jakarta. RESULTS The results estimated that the total annual ambulance need in Jakarta is between 83,000 and 241,000. Assuming the rate of ambulance usage in Jakarta at 9.3%, we estimated the total annual hospital emergency visits in Jakarta at around 0.9-2.6 million. The study also found that the estimation from using the simulation method was smaller than the average (naïve) methods (P<.001). CONCLUSIONS The results provide an estimation of the annual emergency services needed for the city of Jakarta. In the absence of aggregated routinely collected data on emergency medical service usage in Jakarta, our results provide insights into whether the current emergency services, such as ambulances, have been adequately provided.
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Affiliation(s)
- Syaribah N Brice
- School of Mathematics, Cardiff University, Cardiff, United Kingdom
| | | | - Geraint Palmer
- School of Mathematics, Cardiff University, Cardiff, United Kingdom
| | - Paul R Harper
- School of Mathematics, Cardiff University, Cardiff, United Kingdom
| | - Vincent Knight
- School of Mathematics, Cardiff University, Cardiff, United Kingdom
| | - Mark Tuson
- School of Mathematics, Cardiff University, Cardiff, United Kingdom
| | - Daniel Gartner
- School of Mathematics, Cardiff University, Cardiff, United Kingdom
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Pham MD, Wulan NR, Sawyer SM, Agius PA, Fisher J, Tran T, Medise BE, Devaera Y, Riyanti A, Ansariadi A, Cini K, Kennedy E, Wiweko B, Luchters S, Kaligis F, Wiguna T, Azzopardi PS. Mental Health Problems Among Indonesian Adolescents: Findings of a Cross-Sectional Study Utilizing Validated Scales and Innovative Sampling Methods. J Adolesc Health 2024; 75:929-938. [PMID: 39387724 DOI: 10.1016/j.jadohealth.2024.07.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2024] [Revised: 07/11/2024] [Accepted: 07/12/2024] [Indexed: 10/15/2024]
Abstract
PURPOSE This study aimed to estimate the prevalence of mental health problems and identify potential risk and protective exposures for adolescents in Indonesia. METHODS An innovative sampling approach was applied to simultaneously recruit school- and community-based adolescents aged 16-18 years old from Jakarta (urban megacity) and South Sulawesi (remote province). We used multistage cluster sampling for in-school (N = 1,337) and respondent driven sampling for out-of-school (N = 824) adolescents. Mental health was measured using two validated scales: Kessler-10 and Center for Epidemiologic Studies Depression Scale-Revised. Psychiatric interviews were conducted in a subsample (N = 196) of students from Jakarta to validate the self-report scales. RESULTS The estimated population prevalence of psychological distress and depression were 24.3% (95% CI = 21.5-27.2) and 12.6% (10.5-14.4) for in-school and 23.7% (20.7-26.7) and 23.5% (20.4-26.5) for out-of-school adolescents, respectively. In participants who completed a psychiatric interview, common psychiatric morbidities were social anxiety, depression, and suicidality. Compared to in-school females, male in-school adolescents reported a lower prevalence of psychological distress (16.9% (13.1-20.7) vs. 30.4% (26.4-34.4)) and depression (10.1% (7.2-13.1) vs. 14.6 (11.4-17.8)). By contrast, for out-of-school adolescents, males reported a higher prevalence of psychological distress (25.2% (21.6-28.9) vs. 20.2% (15.1-25.3)) and depression (26.3% (22.5-30.1) vs. 16.9% (11.8-21.9)). In-school adolescents who did not seek healthcare despite a perceived need were more likely to report psychological distress and depression. DISCUSSION Adolescent mental health problems are highly prevalent in Indonesia, with substantial variation by gender, geography, and school enrolment. This study and its approach to sampling and measurement may serve as a model to improving mental health surveillance across other settings.
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Affiliation(s)
- Minh D Pham
- Burnet Institute, Melbourne, Australia; Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, Australia.
| | - Nisaa R Wulan
- Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, Australia
| | - Susan M Sawyer
- Murdoch Children's Research Institute, Melbourne, Australia; Centre for Adolescent Health, Royal Children's Hospital, Melbourne, Australia; Department of Paediatrics, The University of Melbourne, Melbourne, Australia
| | - Paul A Agius
- Burnet Institute, Melbourne, Australia; Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, Australia; Faculty of Health, Deakin University, Melbourne, Australia
| | - Jane Fisher
- Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, Australia
| | - Thach Tran
- Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, Australia
| | - Bernie E Medise
- Cipto Mangunkusumo Hospital, Jakarta, Indonesia; Department of Child Health, Universitas Indonesia, Jakarta, Indonesia
| | - Yoga Devaera
- Department of Child Health, Universitas Indonesia, Jakarta, Indonesia
| | - Aida Riyanti
- Department of Obstetrics and Gynaecology, Universitas Indonesia, Jakarta, Indonesia
| | - Ansariadi Ansariadi
- Centre for Epidemiology and Population Health Studies, Faculty of Public Health, Hasanuddin University, Makassar, Indonesia
| | - Karly Cini
- Murdoch Children's Research Institute, Melbourne, Australia; Centre for Adolescent Health, Royal Children's Hospital, Melbourne, Australia; Department of Paediatrics, The University of Melbourne, Melbourne, Australia
| | - Elissa Kennedy
- Burnet Institute, Melbourne, Australia; Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, Australia; Murdoch Children's Research Institute, Melbourne, Australia
| | - Budi Wiweko
- Research and Social Services, Universitas Indonesia, Jakarta, Indonesia
| | - Stanley Luchters
- Liverpool School of Tropical Medicine (LSTM), Liverpool, United Kingdom; Centre for Sexual Health and HIV & AIDS Research (CeSHHAR), Zimbabwe, Harare, Zimbabwe; Department of Public Health and Primary Care, International Centre for Reproductive Health, Ghent University, Ghent, Belgium
| | - Fransiska Kaligis
- Cipto Mangunkusumo Hospital, Jakarta, Indonesia; Department of Psychiatry, Universitas Indonesia, Jakarta, Indonesia
| | - Tjhin Wiguna
- Cipto Mangunkusumo Hospital, Jakarta, Indonesia; Department of Psychiatry, Universitas Indonesia, Jakarta, Indonesia
| | - Peter S Azzopardi
- Burnet Institute, Melbourne, Australia; Centre for Adolescent Health, Royal Children's Hospital, Melbourne, Australia; South Australian Health and Medical Research Institute, Adelaide, Australia.
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Fuady A, Anindhita M, Haniifah M, Ahsan A, Sugiharto A, Haya MAN, Pakasi T, Kusuma D, Solikha DA, Ali PB, Widyahening IS. Bridging the gap: financing health promotion and disease prevention in Indonesia. Health Res Policy Syst 2024; 22:146. [PMID: 39407235 PMCID: PMC11481782 DOI: 10.1186/s12961-024-01206-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2024] [Accepted: 08/01/2024] [Indexed: 10/19/2024] Open
Abstract
BACKGROUND Spending on preventive care in low- and middle-income countries (LMICs), including Indonesia, is much lower than spending on curative care. There has been a pressing need to develop a clear pathway to increase spending on preventive care. This study aimed to assess the current financing landscape for health promotion and disease prevention in Indonesia and, subsequently, to develop a framework and recommendations for future health promotion financing in the country. METHODS We adopted a mixed-method approach to gather information from all relevant stakeholders from December 2022 to June 2023. For the qualitative approach, we conducted (a) in-depth interviews (IDIs) and (b) focus group discussions (FGDs) with government officials at national and district levels, academics, professional organizations, healthcare workers in primary healthcare centres (PHCs), community health volunteers, non governmental organizations and private companies. For the quantitative approach, we applied a national online survey to healthcare workers involved in health promotion in PHCs. IDIs and FGDs were conducted with purposefully selected resource persons at the national level, five selected districts across Indonesia, and within 15 primary health offices and their communities. All qualitative data were recorded, transcribed, coded, interpreted, and then triangulated with national survey findings to develop the financing framework. RESULTS We identified gaps between the theory and practice of health promotion and disease prevention. These included the limited scope of health promotion initiatives, lack of direction and coordination between ministries, agencies and government levels, limited availability and capacity of health promoters, various yet uncoordinated funding resources and inflexibility in using the funds. To bridge the gap, the framework we developed suggests strengthening the legal and regulatory basis, strategically prioritizing financing arrangements, promoting evidence-based health promotion activities, developing the capacity of health promoters, enhancing the health financing information system and improving monitoring and evaluation. CONCLUSIONS Identified gaps and challenges in health promotion and disease prevention initiatives inform the development of our framework for future health promotion financing. This framework assists the national government in organizing national health promotion financing strategies and potentially serves as a valuable model for other LMICs.
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Affiliation(s)
- Ahmad Fuady
- Department of Community Medicine, Faculty of Medicine, Universitas Indonesia, Pegangsaan Timur No 16, Jakarta, 10310, Indonesia.
- Primary Health Care Research and Innovation Centre, Indonesian Medical Education and Research Institute, Faculty of Medicine, Universitas Indonesia, Jakarta, 10430, Indonesia.
| | - Mariska Anindhita
- Primary Health Care Research and Innovation Centre, Indonesian Medical Education and Research Institute, Faculty of Medicine, Universitas Indonesia, Jakarta, 10430, Indonesia
| | - Matsna Haniifah
- Primary Health Care Research and Innovation Centre, Indonesian Medical Education and Research Institute, Faculty of Medicine, Universitas Indonesia, Jakarta, 10430, Indonesia
| | - Abdillah Ahsan
- Department of Economics, Faculty of Economics and Business, Universitas Indonesia, Depok, 16424, Indonesia
| | - Agus Sugiharto
- Department of Community Medicine, Faculty of Medicine, Universitas Indonesia, Pegangsaan Timur No 16, Jakarta, 10310, Indonesia
| | - Marinda Asiah Nuril Haya
- Department of Community Medicine, Faculty of Medicine, Universitas Indonesia, Pegangsaan Timur No 16, Jakarta, 10310, Indonesia
- Primary Health Care Research and Innovation Centre, Indonesian Medical Education and Research Institute, Faculty of Medicine, Universitas Indonesia, Jakarta, 10430, Indonesia
| | - Trevino Pakasi
- Department of Community Medicine, Faculty of Medicine, Universitas Indonesia, Pegangsaan Timur No 16, Jakarta, 10310, Indonesia
- Primary Health Care Research and Innovation Centre, Indonesian Medical Education and Research Institute, Faculty of Medicine, Universitas Indonesia, Jakarta, 10430, Indonesia
| | - Dian Kusuma
- Department of Health Services Research and Management, School of Health & Psychological Sciences, City University of London, London, EC1V 0HB, UK
| | - Dewi Amila Solikha
- Public Health and Nutrition, Ministry of National Development Planning, Jalan Taman Suropati No. 2, Jakarta, 10310, Indonesia
| | - Pungkas Bahjuri Ali
- Public Health and Nutrition, Ministry of National Development Planning, Jalan Taman Suropati No. 2, Jakarta, 10310, Indonesia
| | - Indah Suci Widyahening
- Department of Community Medicine, Faculty of Medicine, Universitas Indonesia, Pegangsaan Timur No 16, Jakarta, 10310, Indonesia
- Primary Health Care Research and Innovation Centre, Indonesian Medical Education and Research Institute, Faculty of Medicine, Universitas Indonesia, Jakarta, 10430, Indonesia
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5
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Idris I, Wahid I, Antonjaya U, Johar E, Kleib FH, Sriyani IY, Dewantari AK, Daming O, Duharing M, Sappe F, Hasan H, Yudhaputri FA, Syafruddin D, Myint KSA. Spectrum of respiratory viruses identified from SARS-CoV-2-negative human respiratory tract specimens in Watansoppeng, Indonesia. Access Microbiol 2024; 6:000840.v3. [PMID: 39399533 PMCID: PMC11469065 DOI: 10.1099/acmi.0.000840.v3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2024] [Accepted: 09/06/2024] [Indexed: 10/15/2024] Open
Abstract
Respiratory infections account for millions of hospital admissions worldwide. The aetiology of respiratory infections can be attributed to a diverse range of pathogens including viruses, bacteria and fungi. SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2)-negative specimens from Wattansoppeng city, South Sulawesi, were analysed to study the spectrum of respiratory viruses. Samples were screened for influenza virus, enterovirus, Paramyxoviridae, Nipah virus, Coronaviridae and Pneumoviridae. Of 210 specimens, 19 were positive for respiratory syncytial virus (RSV)-A, RSV-B, human parainfluenza virus type 1 (HPIV-1), HPIV-2, human rhinovirus (HRV)-A, HRV-B, HRV-C, human metapneumovirus (HMPV), influenza A virus (IAV) and coxsackievirus A6 (CV-A6). Influenza virus was of seasonal H3N2 subtype. The HMPVs were of genotypes B1 and A2a, while one RSV-A was of the ON-1 genotype. The viruses mostly affected children with unknown severity.
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Affiliation(s)
- Irfan Idris
- Faculty of Medicine, Universitas Hasanuddin, Makassar, Indonesia
| | - Isra Wahid
- Faculty of Medicine, Universitas Hasanuddin, Makassar, Indonesia
| | - Ungke Antonjaya
- Oxford University Clinical Research Unit Indonesia, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Edison Johar
- Eijkman Institute for Molecular Biology, Jakarta, Indonesia
- Exeins Health Initiative, Jakarta, Indonesia
| | - Fiqry Hasan Kleib
- Eijkman Institute for Molecular Biology, Jakarta, Indonesia
- Exeins Health Initiative, Jakarta, Indonesia
| | - Ida Yus Sriyani
- Eijkman Institute for Molecular Biology, Jakarta, Indonesia
- Exeins Health Initiative, Jakarta, Indonesia
| | | | | | | | | | - Hajar Hasan
- Faculty of Medicine, Universitas Hasanuddin, Makassar, Indonesia
| | | | - Din Syafruddin
- Faculty of Medicine, Universitas Hasanuddin, Makassar, Indonesia
| | - Khin Saw Aye Myint
- Eijkman Institute for Molecular Biology, Jakarta, Indonesia
- Exeins Health Initiative, Jakarta, Indonesia
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Agustian D, Arya IFD, Adnani QES, Wiwaha G, Bashari MH, Nurdiawan W, Bandiara R, Hasansulama W, Berbudi A, Nugraha GI, Permadi W, Anwar R, Afriandi I, Kartasasmita A, Hidayat YM, Achmad TH, Norcini J. Academic Health System Framework for Health Services Transformation: A Perspective View from West Java, Indonesia. ADVANCES IN MEDICAL EDUCATION AND PRACTICE 2024; 15:957-969. [PMID: 39411275 PMCID: PMC11476372 DOI: 10.2147/amep.s474314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/19/2024] [Accepted: 09/02/2024] [Indexed: 10/19/2024]
Abstract
Although the field of medicine has made significant progress in recent decades, low and middle-income countries continue to face significant difficulties in addressing the unprecedented obstacles to improving health. Medical schools should play a critical role in driving health services reform and take on a new leadership role in strengthening the health system. This paper discusses a conceptual framework and outlines the Academic Health Systems (AHS) agenda in Indonesia. A comprehensive analysis was conducted on the existing literature and frameworks regarding AHS, applying the system thinking method, which engages stakeholders actively. The findings and interpretations from interviews, focus groups, and collaborative workshops were consolidated and a set of proposed frameworks, fundamental principles, and a route for enhancing the health system in Indonesia were put forward. Our recommendations include transformative learning, community engagement, and translational research as pillar principles of AHS program. These recommendations have the potential to be modified and implemented in other low- and middle-income countries.
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Affiliation(s)
- Dwi Agustian
- Department of Public Health, Faculty of Medicine, Universitas Padjadjaran, Bandung, West Java, Indonesia
| | - Insi Farisa Desy Arya
- Department of Public Health, Faculty of Medicine, Universitas Padjadjaran, Bandung, West Java, Indonesia
| | | | - Guswan Wiwaha
- Department of Public Health, Faculty of Medicine, Universitas Padjadjaran, Bandung, West Java, Indonesia
| | - Muhammad Hasan Bashari
- Department of Biomedical Sciences, Faculty of Medicine, Universitas Padjadjaran, Bandung, West Java, Indonesia
| | - Windi Nurdiawan
- Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Padjadjaran, Bandung, West Java, Indonesia
| | - Ria Bandiara
- Department of Internal Medicine, Faculty of Medicine, Universitas Padjadjaran, Bandung, West Java, Indonesia
| | - Wijana Hasansulama
- Department of Otolaryngology, Head and Neck Surgery, Faculty of Medicine, Universitas Padjadjaran, Bandung, West Java, Indonesia
| | - Afiat Berbudi
- Department of Biomedical Sciences, Faculty of Medicine, Universitas Padjadjaran, Bandung, West Java, Indonesia
| | - Gaga Irawan Nugraha
- Department of Biomedical Sciences, Faculty of Medicine, Universitas Padjadjaran, Bandung, West Java, Indonesia
| | - Wiryawan Permadi
- Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Padjadjaran, Bandung, West Java, Indonesia
| | - Ruswana Anwar
- Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Padjadjaran, Bandung, West Java, Indonesia
| | - Irvan Afriandi
- Department of Public Health, Faculty of Medicine, Universitas Padjadjaran, Bandung, West Java, Indonesia
| | - Arief Kartasasmita
- Department of Ophthalmology, Faculty of Medicine, Universitas Padjadjaran, Bandung, West Java, Indonesia
| | - Yudi Mulyana Hidayat
- Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Padjadjaran, Bandung, West Java, Indonesia
| | - Tri Hanggono Achmad
- Department of Biomedical Sciences, Faculty of Medicine, Universitas Padjadjaran, Bandung, West Java, Indonesia
| | - John Norcini
- Department of Psychiatry, SUNY Upstate Medical University, Philadelphia, PA, USA
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Amalia R, Susanti A, Lutfatulatifah. The role of telepathology in advancing healthcare in Central Kalimantan, Indonesia. J Public Health (Oxf) 2024:fdae251. [PMID: 39263939 DOI: 10.1093/pubmed/fdae251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2024] [Accepted: 08/23/2024] [Indexed: 09/13/2024] Open
Affiliation(s)
- Riza Amalia
- Guidance and Counseling Department, Universitas Negeri Malang, Jl. Semarang, No 5, Malang, East Java, 65145, Indonesia
- Guidance and Counseling Department, Universitas Muhammadiyah Sampit, Jl. KH. Dewantara No 3, Sampit, 74311, Indonesia
| | - Alwita Susanti
- Guidance and Counseling Department, Universitas Muhammadiyah Sampit, Jl. KH. Dewantara No 3, Sampit, 74311, Indonesia
- Universitas Lambung Mangkurat, Jl. Brigjen H. Hasan Basri, Banjarmasin, South Kalimantan, 70122, Indonesia
- Faculty of Health Sciences, Universitas Muhammadiyah Sampit, Jl. Pramuka No 100, Sampit, Kabupaten Kotawaringin Timur, Central Kalimantan, 74311, Indonesia
| | - Lutfatulatifah
- Guidance and Counseling Department, Universitas Negeri Malang, Jl. Semarang, No 5, Malang, East Java, 65145, Indonesia
- IAIN Syekh Nurjati, Jl. Perjuangan, Cirebon, West Java, Indonesia
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Aminde LN, Nugraheni WP, Mubasyiroh R, Rachmawati T, Dwirahmadi F, Martini S, Kusumawardani N, Veerman JL. Cost-effectiveness analysis of low-sodium potassium-rich salt substitutes in Indonesia: an equity modelling study. THE LANCET REGIONAL HEALTH. SOUTHEAST ASIA 2024; 26:100432. [PMID: 39081840 PMCID: PMC11287158 DOI: 10.1016/j.lansea.2024.100432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Revised: 03/30/2024] [Accepted: 05/22/2024] [Indexed: 08/02/2024]
Abstract
Background Evidence suggests low-sodium potassium-rich salt substitutes (LSSS) are effective in reducing blood pressure (BP). However, the health and economic impacts of LSSS in Indonesia are currently unknown. Methods We developed a proportional multistate lifetable Markov model to assess a government-led strategy implementing the use of LSSS compared to current regular salt consumption. BP data were derived from the Indonesian Basic Health Research Survey (RISKESDAS 2018), while epidemiological data were from the Global Burden of Disease 2019 study. We estimated implementation costs and the impact of changes in BP on disease events and healthcare costs, and incremental cost-effectiveness ratios. Outcomes were simulated over different time horizons for the 2019 Indonesian population overall, and by income quintiles. Probabilistic sensitivity analysis was done to capture uncertainty. Findings Over the first 10 years, LSSS could prevent 1.5 million non-fatal cardiovascular disease (CVD) events (8.3%-19.4% reduction) and 643,000 incident chronic kidney disease (CKD) cases (8.2% reduction), while averting over 200,000 CVD and CKD deaths (0.2%-5.2% reduction). This translated to over 24.6 million health-adjusted life years (HALYs) gained over the lifetime of the population, and reduced CVD-related health inequalities (concentration index, -0.075, 95% CI: -0.088 to -0.062). Implementation cost (US$ 1.2 billion [IDR 17.2 trillion] total; US$ 4.5 [IDR 63,665] per capita, as of July 2019) was outweighed by the net health expenditure savings (∼US$ 2 billion [IDR 27.7 trillion] total; US$ 7.3 [IDR 103,300] per capita) in the first 10 years. LSSS were cost-saving over the lifetime, and very cost-effective even with a high LSSS price. Interpretation Scaling the use of LSSS nationally could be a cost-saving strategy to prevent substantial cardiovascular and kidney disease burden in Indonesia. Funding Griffith University Postdoctoral Fellowship.
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Affiliation(s)
- Leopold Ndemnge Aminde
- Public Health & Economics Modelling Group, School of Medicine & Dentistry, Griffith University, Gold Coast, QLD, Australia
| | - Wahyu Pudji Nugraheni
- Research Center for Public Health and Nutrition, National Research and Innovation Agency, Jakarta, Indonesia
| | - Rofingatul Mubasyiroh
- Research Center for Public Health and Nutrition, National Research and Innovation Agency, Jakarta, Indonesia
| | - Tety Rachmawati
- Research Center for Public Health and Nutrition, National Research and Innovation Agency, Jakarta, Indonesia
| | - Febi Dwirahmadi
- Centre for Environment and Population Health, School of Medicine & Dentistry, Griffith University, Gold Coast, Australia
| | - Santi Martini
- Department of Epidemiology, Biostatistics, Population Studies and Health Promotion, Faculty of Public Health, Universitas Airlangga, Surabaya, Indonesia
| | - Nunik Kusumawardani
- Research Center for Public Health and Nutrition, National Research and Innovation Agency, Jakarta, Indonesia
| | - J Lennert Veerman
- Public Health & Economics Modelling Group, School of Medicine & Dentistry, Griffith University, Gold Coast, QLD, Australia
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9
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Cecyli C, Tharani V, Dayana BAA, Priyadarsini A, Jagadeeswari J. Assessment of Body Image Perception and Quality of Life among Oncology Patients. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2024; 16:S3015. [PMID: 39346273 PMCID: PMC11426691 DOI: 10.4103/jpbs.jpbs_536_24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2024] [Revised: 05/18/2024] [Accepted: 05/20/2024] [Indexed: 10/01/2024] Open
Affiliation(s)
- C Cecyli
- Department of Medical Surgical Nursing, Saveetha College of Nursing, Saveetha Institute of Medical and Technical Sciences, Thandalam, Chennai, Tamil Nadu, India
| | - V Tharani
- Department of Medical Surgical Nursing, Saveetha College of Nursing, Saveetha Institute of Medical and Technical Sciences, Thandalam, Chennai, Tamil Nadu, India
| | - B A A Dayana
- Department of Medical Surgical Nursing, Saveetha College of Nursing, Saveetha Institute of Medical and Technical Sciences, Thandalam, Chennai, Tamil Nadu, India
| | - A Priyadarsini
- Department of Medical Surgical Nursing, Saveetha College of Nursing, Saveetha Institute of Medical and Technical Sciences, Thandalam, Chennai, Tamil Nadu, India
| | - J Jagadeeswari
- Department of Medical Surgical Nursing, Saveetha College of Nursing, Saveetha Institute of Medical and Technical Sciences, Thandalam, Chennai, Tamil Nadu, India
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Fauk NK, Seran AL, Aylward P, Mwanri L, Ward PR. Parental Migration and the Social and Mental Well-Being Challenges among Indonesian Left-Behind Children: A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:793. [PMID: 38929039 PMCID: PMC11203627 DOI: 10.3390/ijerph21060793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2024] [Revised: 06/07/2024] [Accepted: 06/17/2024] [Indexed: 06/28/2024]
Abstract
Parental labour migration, of either one or both parents, has been associated with various challenges among left-behind children (LBC). However, there is a limited understanding of the LBC's own views and experiences of social and mental well-being and how the new daily life circumstances they encounter following their parents' migration impact them. This study aimed to understand the influence of parental migration and its aftermath on the social and mental well-being of adolescents (referred to as LBC) in two rural districts in Indonesia. Employing a qualitative design, data were collected through individual in-depth interviews with LBC (n = 24) aged 14 to 18 years, recruited using the snowball sampling technique. Data were thematically analysed, guided by a qualitative data analysis framework. The findings showed that parental migration negatively impacted the social well-being of LBC. This impact was reflected in negative labelling from friends and changes in familial roles which influenced their social interactions and activities with peers. Parental migration was also associated with challenges to the mental well-being of LBC. These manifested in the LBC experiencing fractured emotional bonds, leading to negative emotions, including stress, anxiety, sadness, depression, frustration, loss of motivation, and self-imposed isolation, which were associated with their parents' migration and abrupt disruptions in parent-child communication. The transition to new life situations with caregivers after parental migration and the dynamics within the caregivers' households were additional factors that detrimentally affected their mental well-being. Unmet basic needs and educational needs due to financial hardships faced by mothers and caregivers further exacerbated mental health challenges for the children. The findings indicate the importance and improvement of policies and interventions in Indonesia (e.g., counselling services, non-cash food assistance, family hope program, direct cash assistance) that cover and address the diverse needs of mothers or caregivers and the LBC.
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Affiliation(s)
- Nelsensius Klau Fauk
- Centre for Public Health, Equity and Human Flourishing, Torrens University Australia, 88 Wakefield St, Adelaide, SA 5000, Australia; (P.A.); (L.M.)
| | - Alfonsa Liquory Seran
- Atapupu Public Health Centre, Health Department of Belu District, Atambua Belu 85752, Indonesia;
| | - Paul Aylward
- Centre for Public Health, Equity and Human Flourishing, Torrens University Australia, 88 Wakefield St, Adelaide, SA 5000, Australia; (P.A.); (L.M.)
| | - Lillian Mwanri
- Centre for Public Health, Equity and Human Flourishing, Torrens University Australia, 88 Wakefield St, Adelaide, SA 5000, Australia; (P.A.); (L.M.)
| | - Paul Russell Ward
- Centre for Public Health, Equity and Human Flourishing, Torrens University Australia, 88 Wakefield St, Adelaide, SA 5000, Australia; (P.A.); (L.M.)
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11
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Sukor N, Sunthornyothin S, Tran TV, Tarigan TJ, Mercado-Asis LB, Sum S, Aung MW, Yong AML, Tedjo T, Villa M, Khaing NEE, Azizan EA, Kang WH, Lim V, Teo AED, Zhang M, Tran H, Puar TH. Health Care Challenges in the Management of Primary Aldosteronism in Southeast Asia. J Clin Endocrinol Metab 2024; 109:1718-1725. [PMID: 38261997 PMCID: PMC11180499 DOI: 10.1210/clinem/dgae039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 12/22/2023] [Accepted: 01/18/2024] [Indexed: 01/25/2024]
Abstract
CONTEXT While guidelines have been formulated for the management of primary aldosteronism (PA), following these recommendations may be challenging in developing countries with limited health care access. OBJECTIVE We aimed to assess the availability and affordability of health care resources for managing PA in the Association of Southeast Asian Nations (ASEAN) region, which includes low-middle-income countries. METHODS We instituted a questionnaire-based survey to specialists managing PA, assessing the availability and affordability of investigations and treatment. Population and income status data were taken from the national census and registries. RESULTS Nine ASEAN country members (48 respondents) participated. While screening with aldosterone-renin ratio is performed in all countries, confirmatory testing is routinely performed in only 6 countries due to lack of facilities and local assays, and cost constraint. Assays are locally available in only 4 countries, and some centers have a test turnaround time exceeding 3 weeks. In 7 countries (combined population of 442 million), adrenal vein sampling (AVS) is not routinely performed due to insufficient radiological facilities or trained personnel, and cost constraint. Most patients have access to adrenalectomy and medications. In 6 countries, the cost of AVS and adrenalectomy combined is more than 30% of its annual gross domestic product per capita. While most patients had access to spironolactone, it was not universally affordable. CONCLUSION Large populations currently do not have access to the health care resources required for the optimal management of PA. Greater efforts are required to improve health care access and affordability. Future guideline revisions for PA may need to consider these limitations.
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Affiliation(s)
- Norlela Sukor
- Department of Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 50300, Malaysia
- Department of Medicine, Hospital Canselor Tuanku Muhriz, Kuala Lumpur 56000, Malaysia
| | - Sarat Sunthornyothin
- Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand
| | - Thang V Tran
- Department of Endocrinology, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City 700000, Vietnam
| | - Tri Juli Tarigan
- Division of Endocrinology, Department of Internal Medicine, Faculty of Medicine, University of Indonesia, Cipto Mangunkusumo Hospital, Jakarta 10430, Indonesia
| | | | - Satha Sum
- Department of Internal Medicine, Calmette Hospital, Phnom Penh 12201, Cambodia
| | - Moe Wint Aung
- Department of Endocrinology, University of Medicine 1, Yangon General Hospital, Yangon 11131, Myanmar
| | - Alice M L Yong
- Department of Internal Medicine, R.I.P.A.S. Hospital, Bandar Seri Begawan BA1712, Brunei Darussalam
| | - Tania Tedjo
- Department of Internal Medicine, Faculty of Medicine, Universitas Diponegoro, Semarang, Jawa Tengah 50275, Indonesia
| | - Michael Villa
- Philippines Center for Diabetes, Thyroid and Endocrine Disorders, St. Luke's Medical Center, Taguig 1634, Philippines
| | - Nang Ei Ei Khaing
- Health Services Research, Changi General Hospital, Singapore 529889, Singapore
| | - Elena Aisha Azizan
- Department of Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 50300, Malaysia
- Department of Medicine, Hospital Canselor Tuanku Muhriz, Kuala Lumpur 56000, Malaysia
| | - Waye Hann Kang
- Department of Medicine, Faculty of Medicine and Health Sciences, University Tunku Abdul Rahman, Kuala Lumpur 53300, Malaysia
| | - Vivien Lim
- Gleneagles Medical Centre, Singapore 258500, Singapore
| | - Ada E D Teo
- Department of Medicine, Division of Endocrinology, National University Health System, Singapore 119228, Singapore
| | - Meifen Zhang
- Department of Endocrinology, Changi General Hospital, Singapore 529889, Singapore
| | - Hieu Tran
- Department of Endocrinology, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City 700000, Vietnam
| | - Troy H Puar
- Department of Endocrinology, Changi General Hospital, Singapore 529889, Singapore
- Duke National University of Singapore (NUS) Medical School, Singapore 169857, Singapore
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12
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Gupta R, Gaur K, Ahuja S, Anjana RM. Recent studies on hypertension prevalence and control in India 2023. Hypertens Res 2024; 47:1445-1456. [PMID: 38379011 DOI: 10.1038/s41440-024-01585-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 12/27/2023] [Accepted: 12/30/2023] [Indexed: 02/22/2024]
Abstract
Hypertension is the most important chronic disease risk factor in India. Recent epidemiological studies have reported that hypertension is increasing in India with a more rapid increase in rural and young populations. Fifth National Family Health Survey (NFHS-5) and Indian Council of Medical Research-INDIAB surveys have reported that there are substantial geographic variations in hypertension prevalence with greater prevalence in more developed states and districts of the country. There is a high prevalence of young-age hypertension, especially in the less developed states. The incidence of adverse events from hypertension-related cardiovascular disease is significantly greater in India than in more developed countries. A low level of hypertension awareness, treatment, and control, especially in rural and underserved urban populations is an important finding. In this narrative review, we highlight recent nationwide studies and unique features of hypertension in India and suggest strategies for better hypertension management and control.
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Affiliation(s)
- Rajeev Gupta
- Department of Preventive Cardiology & Medicine, Eternal Heart Care Centre & Research Institute, Jaipur, India.
- Research Board, Mahatma Gandhi University of Medical Sciences and Technology, Jaipur, India.
| | - Kiran Gaur
- Department of Statistics, Mathematics and Computer Science, Government SKN Agriculture University, Jobner, Jaipur, India
| | - Shiva Ahuja
- Department of Orthodontics, Jaipur Dental College, Jaipur, India
| | - Ranjit Mohan Anjana
- Madras Diabetes Research Foundation & Dr Mohan's Diabetes Research Centre, Chennai, India
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Anggraini D, Siregar FM, Rosdiana D, Kemal RA, Yovi I, Triani ZD, Jasmin N, Dwijelita N, Webb JR, Mayo M, Kaestli M, Currie BJ. Epidemiology and genetic diversity of Burkholderia pseudomallei from Riau Province, Indonesia. PLoS Negl Trop Dis 2024; 18:e0012195. [PMID: 38805481 PMCID: PMC11161056 DOI: 10.1371/journal.pntd.0012195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 06/07/2024] [Accepted: 05/06/2024] [Indexed: 05/30/2024] Open
Abstract
Melioidosis is a bacterial infection caused by Burkholderia pseudomallei, that is common in tropical and subtropical countries including Southeast Asia and Northern Australia. The magnitude of undiagnosed and untreated melioidosis across the country remains unclear. Given its proximity to regions with high infection rates, Riau Province on Sumatera Island is anticipated to have endemic melioidosis. This study reports retrospectively collected data on 68 culture-confirmed melioidosis cases from two hospitals in Riau Province between January 1, 2009, and December 31, 2021, with full clinical data available on 41 cases. We also describe whole genome sequencing and genotypic analysis of six isolates of B. pseudomallei. The mean age of the melioidosis patients was 49.1 (SD 11.5) years, 85% were male and the most common risk factor was diabetes mellitus (78%). Pulmonary infection was the most common presentation (39%), and overall mortality was 41%. Lung as a focal infection (aOR: 6.43; 95% CI: 1.13-36.59, p = 0.036) and bacteremia (aOR: 15.21; 95% CI: 2.59-89.31, p = 0.003) were significantly associated with death. Multilocus sequence typing analysis conducted on six B.pseudomallei genomes identified three sequence types (STs), namely novel ST1794 (n = 3), ST46 (n = 2), and ST289 (n = 1). A phylogenetic tree of Riau B. pseudomallei whole genome sequences with a global dataset of genomes clearly distinguished the genomes of B. pseudomallei in Indonesia from the ancestral Australian clade and classified them within the Asian clade. This study expands the known presence of B. pseudomallei within Indonesia and confirms that Indonesian B. pseudomallei are genetically linked to those in the rest of Southeast Asia. It is anticipated that melioidosis will be found in other locations across Indonesia as laboratory capacities improve and standardized protocols for detecting and confirming suspected cases of melioidosis are more widely implemented.
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Affiliation(s)
- Dewi Anggraini
- Department of Microbiology, Faculty of Medicine, Universitas Riau, Pekanbaru, Indonesia
- Arifin Achmad General Hospital, Riau Province, Pekanbaru, Indonesia
- Eka Hospital Pekanbaru, Pekanbaru, Indonesia
| | - Fajri Marindra Siregar
- Arifin Achmad General Hospital, Riau Province, Pekanbaru, Indonesia
- Department of Biochemistry, Faculty of Medicine, Universitas Riau, Pekanbaru, Indonesia
| | - Dani Rosdiana
- Arifin Achmad General Hospital, Riau Province, Pekanbaru, Indonesia
- Department of Internal Medicine, Faculty of Medicine, Universitas Riau, Pekanbaru, Indonesia
| | - Rahmat Azhari Kemal
- Arifin Achmad General Hospital, Riau Province, Pekanbaru, Indonesia
- Department of Medical Biology, Faculty of Medicine, Universitas Riau, Pekanbaru, Indonesia
| | - Indra Yovi
- Arifin Achmad General Hospital, Riau Province, Pekanbaru, Indonesia
- Eka Hospital Pekanbaru, Pekanbaru, Indonesia
- Department of Pulmonology, Faculty of Medicine, Universitas Riau, Pekanbaru, Indonesia
| | | | - Novira Jasmin
- Department of Microbiology, Faculty of Medicine, Universitas Riau, Pekanbaru, Indonesia
| | - Norsila Dwijelita
- Department of Microbiology, Faculty of Medicine, Universitas Riau, Pekanbaru, Indonesia
| | - Jessica R. Webb
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
- Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
| | - Mark Mayo
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Mirjam Kaestli
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Bart J. Currie
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
- Department of Infectious Diseases, Royal Darwin Hospital, Darwin, Northern Territory, Australia
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Putra KAN, Suyasa IGPD, Kamaryati NP, Dharmapatni NWK. Development of a self-care guideline to prevent rehospitalization in stroke patients: a modified Delphi study. JURNAL NERS 2024; 19:21-30. [DOI: 10.20473/jn.v19i1.48937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2025] Open
Abstract
Introduction: Since 2007, the number of stroke cases in Indonesia has continued to increase. Stroke patients who have passed the acute phase of stroke still have a risk of recurrent stroke and rehospitalization. This study aimed to develop self-care guidelines to prevent the rehospitalization of stroke patients.
Methods: A three-round modified Delphi study was applied to a panel of 24 experts with different fields of expertise, consisting of doctors, nurses, families, and patients. In the first round, data were collected through a literature review and semi-structured interviews. In the second and third rounds, data were collected using a survey questionnaire on a 9-point Likert scale.
Results: The first round produced seven themes around self-care activities, including drug therapy, physical exercise, diet and nutrition, stress management, self-motivation, functional status screening, and control for risk factors. In the second round, all types of self-care in the first round were agreed upon for content in preparing the guidebook. The third round resulted in agreement on the guidebook that had been designed, with scores of 8 and above by 100% of the expert panel.
Conclusions: The development of a self-care guidebook to prevent rehospitalization of stroke patients through a three-round Delphi study has reached a consensus among the entire panel of experts. Further research by testing guidebooks in the healthcare system is needed to determine their effectiveness in preventing re-hospitalization in stroke patients.
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15
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Jupp D, Ayuandini S, Tobing F, Halim D, Kenangalem E, Sumiwi ME, Prameswari HD, Theodora M, Susanto H, Dewi RTP, Supriyanto D, Kurnia B, Shetye M, Ndoen E, Onishi Y. How using light touch immersion research revealed important insights into the lack of progress in malaria elimination in Eastern Indonesia. Malar J 2024; 23:59. [PMID: 38413921 PMCID: PMC10898039 DOI: 10.1186/s12936-024-04865-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 01/29/2024] [Indexed: 02/29/2024] Open
Abstract
BACKGROUND By 2022, the Government of Indonesia had successfully eliminated malaria in 389 out of 514 districts but continues to face a challenge in Eastern Indonesia where 95% of the total 2021 malaria cases were reported from Papua, West Papua and Nusa Tenggara Timur provinces. There is an increased recognition that malaria elimination will require a better understanding of the human behavioural factors hindering malaria prevention and treatment, informed by local context and local practice. METHODS This research used a light-touch immersion research approach. Field researchers lived in communities over several days to gather data through informal conversations, group-based discussions using visual tools, participant observation and direct experience. The study was conducted in four high malaria endemic areas in Papua, West Papua, and Sumba Islands in Nusa Tenggara Timur. RESULTS The research highlights how people's perception of malaria has changed since the introduction of effective treatment which, in turn, has contributed to a casual attitude towards early testing and adherence to malaria treatment. It also confirms that people rarely accept there is a link between mosquitoes and malaria based on their experience but nevertheless take precautions against the annoyance of mosquitoes. There is widespread recognition that babies and small children, elderly and incomers are more likely to be seriously affected by malaria and separately, more troubled by mosquitoes than indigenous adult populations. This is primarily explained by acclimatization and strong immune systems among the latter. CONCLUSIONS Using immersion research enabled behaviour research within a naturalistic setting, which in turn enabled experiential-led analysis of findings and revealed previously unrecognized insights into attitudes towards malaria in Eastern Indonesia. The research provides explanations of people's lack of motivation to consistently use bed nets, seek early diagnosis or complete courses of treatment. The felt concern for the wellbeing of vulnerable populations highlighted during light touch immersion provides an entry point for future social behaviour change communication interventions. Rather than trying to explain transmission to people who deny this connection, the research concludes that it may be better to focus separately on the two problems of malaria and mosquitoes (especially for vulnerable groups) thereby resonating with local people's own experience and felt concerns.
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Cini KI, Wulan NR, Dumuid D, Nurjannah Triputri A, Abbsar I, Li L, Priambodo DA, Sameve GE, Camellia A, Francis KL, Sawyer SM, Patton GC, Ansariadi A, Azzopardi PS. Towards responsive policy and actions to address non-communicable disease risks amongst adolescents in Indonesia: insights from key stakeholders. THE LANCET REGIONAL HEALTH. SOUTHEAST ASIA 2023; 18:100260. [PMID: 38028160 PMCID: PMC10667299 DOI: 10.1016/j.lansea.2023.100260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 07/02/2023] [Accepted: 07/21/2023] [Indexed: 12/01/2023]
Abstract
Background Non-communicable diseases (NCDs) such as cancer, diabetes, heart disease, mental disorder and chronic lung conditions are the leading cause of death and disability in Indonesia. Adolescence is when risks for NCDs emerge and it is also an important life stage for intervention, yet young people are often at the margins of NCD policy and actions. This study aimed to understand how policies and actions should address NCD risks (tobacco smoking, inadequate physical activity, and diet) for adolescents in Indonesia, and how young people can be meaningfully involved. Methods Qualitative in-depth interviews over videoconference (n = 21) were conducted in English or Bahasa with stakeholders in Indonesia. Participants included policymakers, implementation partners, and advocates who were focused on adolescent health or NCDs. Interviews were recorded, transcribed, translated, and thematically analysed using NVivo12. Findings were disseminated to participants for validation and feedback. Youth participants (n = 7) attended an additional workshop and considered recommendations and actions arising from this research. Findings Participants identified that government and non-government organisations are acting on NCDs in Indonesia, but few of the existing initiatives target adolescents, and adolescent services rarely addressed NCD risks. Participants also felt that policies to protect adolescents from NCD risks (i.e., smoke-free areas in public) were not always enforced. For programs or initiatives focused on adolescent health, those that had engaged adolescents as co-creators and leaders were perceived to be more successful. As such, participants recommended more meaningful engagement of young people, including young people's leadership of initiatives. Additional recommendations included the need for intersectoral engagement and a 'whole-of-government' approach to prevention given the complex determinants of NCD risks, and the need for evidence-based actions that are underpinned by quality data to enable monitoring of progress. Interpretation There is a recognised need to strengthen policies and actions to address NCD risks amongst adolescents in Indonesia. Meaningful youth engagement that allows young people to take the lead, intersectoral actions, and evidence-based data driven responses were key strategies identified. Funding UNICEF East Asia and Pacific Regional Office.
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Affiliation(s)
- Karly I. Cini
- Global Adolescent Health Group, Maternal Child and Adolescent Health Program, Burnet Institute, Melbourne, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Australia
- Department of Paediatrics, Faculty of Medicine, Dentistry, and Health Sciences, University of Melbourne, Melbourne, Australia
| | - Nisaa R. Wulan
- Global Adolescent Health Group, Maternal Child and Adolescent Health Program, Burnet Institute, Melbourne, Australia
| | - Dorothea Dumuid
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), Allied Health & Human Performance, University of South Australia, Australia
| | - Alifah Nurjannah Triputri
- Centre for Epidemiology and Population Health Studies, Faculty of Public Health, Hasanuddin University, Makassar, Indonesia
| | - Iffat Abbsar
- Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Australia
- Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
| | - Luo Li
- Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Australia
- Department of Paediatrics, Faculty of Medicine, Dentistry, and Health Sciences, University of Melbourne, Melbourne, Australia
| | - Diandra A. Priambodo
- Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Australia
- Faculty of Medicine, University of Indonesia, Jakarta, Indonesia
| | | | | | - Kate L. Francis
- Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Australia
- Department of Paediatrics, Faculty of Medicine, Dentistry, and Health Sciences, University of Melbourne, Melbourne, Australia
| | - Susan M. Sawyer
- Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Australia
- Department of Paediatrics, Faculty of Medicine, Dentistry, and Health Sciences, University of Melbourne, Melbourne, Australia
| | - George C. Patton
- Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Australia
- Department of Paediatrics, Faculty of Medicine, Dentistry, and Health Sciences, University of Melbourne, Melbourne, Australia
| | - Ansariadi Ansariadi
- Centre for Epidemiology and Population Health Studies, Faculty of Public Health, Hasanuddin University, Makassar, Indonesia
| | - Peter S. Azzopardi
- Global Adolescent Health Group, Maternal Child and Adolescent Health Program, Burnet Institute, Melbourne, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Australia
- Department of Paediatrics, Faculty of Medicine, Dentistry, and Health Sciences, University of Melbourne, Melbourne, Australia
- Adolescent Health and Wellbeing Program, Telethon Kids Institute, Adelaide, South Australia, Australia
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Maher CG, Ferreira G, Jones C. Global Burden of Disease data for Indonesia. Lancet Glob Health 2023; 11:e335. [PMID: 36796974 DOI: 10.1016/s2214-109x(23)00005-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 12/19/2022] [Indexed: 02/16/2023]
Affiliation(s)
- Christopher G Maher
- The Institute of Musculoskeletal Health, University of Sydney, Sydney 2050, NSW, Australia.
| | - Giovanni Ferreira
- The Institute of Musculoskeletal Health, University of Sydney, Sydney 2050, NSW, Australia
| | - Caitlin Jones
- The Institute of Musculoskeletal Health, University of Sydney, Sydney 2050, NSW, Australia
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Global Burden of Disease data for Indonesia - Authors' reply. Lancet Glob Health 2023; 11:e337. [PMID: 36796976 DOI: 10.1016/s2214-109x(22)00558-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 12/21/2022] [Indexed: 02/16/2023]
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19
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Sari EF, Johnson NW, McCullough MJ, Cirillo N. Global Burden of Disease Data for Indonesia. Lancet Glob Health 2023; 11:e336. [PMID: 36796975 DOI: 10.1016/s2214-109x(23)00004-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 12/19/2022] [Indexed: 02/16/2023]
Affiliation(s)
- Elizabeth Fitriana Sari
- Melbourne Dental School, The University of Melbourne, Carlton, VIC 3053, Australia; Dentistry Discipline, Department of Rural Clinical Science, La Trobe Rural Health School, Bendigo, VIC, Australia; Faculty of Dentistry, Universitas Padjadjaran, Bandung, Indonesia
| | - Newell W Johnson
- Menzies Health Institute Queensland (NWJ) and School of Medicine and Dentistry, Griffith University, Gold Coast, QLD, Australia; Faculty of Dentistry Oral and Craniofacial Sciences, King's College London, London, UK
| | | | - Nicola Cirillo
- Melbourne Dental School, The University of Melbourne, Carlton, VIC 3053, Australia.
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Khasanah U, Efendi F, Has EMM, Adnani QES, Ramadhan K, Arna YD, Almutairi WM. Healthcare-seeking behavior for children aged 0-59 months: Evidence from 2002-2017 Indonesia Demographic and Health Surveys. PLoS One 2023; 18:e0281543. [PMID: 36758015 PMCID: PMC9910639 DOI: 10.1371/journal.pone.0281543] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 01/25/2023] [Indexed: 02/10/2023] Open
Abstract
BACKGROUND AND OBJECTIVE Healthcare-seeking behavior for children is crucial for reducing disease severity. Such behavior can improve child health outcomes and prevent child morbidity and mortality. The present study sought to analyze the determinants of mothers' engagement in healthcare-seeking behavior for children with common childhood diseases, focusing on mothers of children aged 0-59 months in Indonesia. METHODS This cross-sectional study comprised a secondary data analysis using the 2002-2017 Indonesia Demographic and Health Survey (IDHS) databases. We included all women surveyed aged 15-49 years old who had children under five years of age. We weighted the univariate, bivariate, and multivariate logistic regression analysis of healthcare-seeking behavior for children aged 0-59 months. RESULTS We analyzed data for 24,529 women whose children were under five years of age at the time of survey. Common diseases, such as diarrhea, fever, and acute respiratory infection (ARI) were the most frequently cited reasons for healthcare-seeking behavior. During 2002-2017, the proportion of mothers seeking healthcare for their children with diarrhea increased from 67.70% to 69.88%, that with fever increased from 61.48% to 71.64% and that ARI increased from 64.01% to 76.75%. Multivariate analysis revealed that child's age, child's birth order, mother's education, ability to meet expenses, distance to nearest healthcare facility, wealth index, place of residence, and region of residence, were significantly associated with healthcare-seeking behavior. CONCLUSION Various individual and environmental-level factors influence healthcare-seeking behavior for childhood diseases. Available, accessible, and affordable health service facilities are recommended to assist socio-economically and geographically disadvantaged families.
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Affiliation(s)
| | - Ferry Efendi
- Faculty of Nursing, Universitas Airlangga, Surabaya, Indonesia
| | | | | | - Kadar Ramadhan
- Department of Midwifery, Poltekkes Kemenkes Palu, Palu, Indonesia
- Center for Stunting Studies, STBM and Disaster Health, Poltekkes Kemenkes Palu, Palu, Indonesia
| | | | - Wedad M Almutairi
- Faculty of Nursing, Maternity and Childhood Department, King Abdulaziz University, Jeddah, Saudi Arabia
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Oktaria V, Mahendradhata Y. The health status of Indonesia's provinces: the double burden of diseases and inequality gap. Lancet Glob Health 2022; 10:e1547-e1548. [DOI: 10.1016/s2214-109x(22)00405-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 08/26/2022] [Indexed: 11/05/2022]
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