Improving routine health data in Indonesia: Utilising the WHO data quality tool for Aplikasi Satu Data Kesehatan

INTRODUCTION

Assessment of data quality in the era of big data is crucial for effective data management and use. However, there are gaps in data quality assessment for routine health data to ensure accountability. Therefore, this research aims to improve the routine health data quality that have been collected and integrated into Aplikasi Satu Data Kesehatan (ASDK) as the primary health data system in Indonesia.

MATERIALS AND METHODS

This descriptive study utilises a desk review approach and employs the WHO Data Quality Assurance (DQA) Tool to assess data quality of ASDK. The analysis involves measuring eight health indicators from ASDK and Survei Status Gizi Indonesia (SSGI) conducted in 2022. The assessment focuses on various dimensions of data quality, including completeness of variables, consistency over time, consistency between indicators, outliers and external consistency.

RESULTS

Current study shows that routine health data in Indonesia performs high-quality data in terms of completeness and internal consistency. The dimension of data completeness demonstrates high levels of variable completeness with most variables achieving 100% of the completeness.

CONCLUSION

Based on the analysis of eight routine health data variables using five dimensions of data quality namely completeness of variables, consistency over time, consistency between indicators, outliers. and external consistency. It shows that completeness and internal consistency of data in ASDK has demonstrated a high data quality.

A randomized cross-over study comparing the performance of HD integra™ central concentrate system versus pre-produced concentrate in hemodialysis

BACKGROUND

Pre-produced bicarbonate concentrates (PPC) are still widely used in developing countries despite its cost and risk but Central Concentrate System (CCS) is lacking in data to support its wider adoption.

METHODS

We conducted an 8-week randomized crossover study on 16 Hemodialysis machines to compare CCS versus PPC. Performance is assessed by solute concentrations while safety is assessed by microbial count, endotoxin level and adverse event reporting.

RESULTS

Microbial counts and endotoxin levels were monitored on 48 occasions during the 8-week study for the CCS arm of the study. The levels were all below the action limit during the study. No patient reported any adverse events. Dialysate Sodium, Chloride and Bicarbonate concentrations were measured on a total of 128 occasions for each arm of the study. The relative deviations of Sodium, Chloride and Bicarbonate concentration were within ±5% of their nominal values for both. The 95% Confidence Intervals for the ratio of the mean solute concentrations on the CCS to PPC lie within the tolerance limit of ±5%.

CONCLUSION

Modern CCS is bacteriologically safe and its performance statistically equivalent to PPC.

Bilateral epidural extension of thoracic capillary vertebral (intraosseous) hemangioma mimicking spinal meningioma

We describe a rare case of vertebra (intraosseous) hemangioma with bilateral and symmetrical epidural extension causing cord compression in a 24-year-old woman. The epidural component was isointense to cord on both T1 and T2 sequences, and enhanced markedly and homogenously following gadolinium administration. The gradual in onset and progressive nature with the typical enhancing pattern lead the neurosurgeon to the more common diagnosis of spinal meningioma. Epidural extension of vertebral hemangiomas causing cord compression is rarely reported. Review of literatures reveal that cases that have been reported are of unilateral extension into epidural space and of cavernous type. This is the first case report of capillary vertebral (intraossous) hemangioma with bilateral extension through both intervetebral foramen into the epidural space causing myelopathy.

Non-accidental fatal head injury in small children--a clinico-pathological correlation

Non-accidental head injury leading to massive intracranial trauma has been identified as a leading cause of death in small children. In a typical case, a child usually below the age of one year is violently shaken, leading to rupture of the connecting veins between the dura mater and the brain substance with variable degrees of bleeding into the subdural space resulting in increased intracranial pressure. The accompanying venous thrombosis affecting the vessels of the brain substance leads to cerebral hypoxia and cellular death. In this study conducted throughout the year 1999, all children below the age of 3 years who were admitted to Hospital Kuala Lumpur and had died due to non-accidental injuries were included. Postmortems, including histopathological studies, were conducted to determine the most likely mechanisms of the injuries. Ten cases were identified for the whole year. In 2 cases, both below one year of age, the features presented showed evidence of violent shaking of the infants. In 6 other cases whose average age was 13 (range 4-24) months, there were evidences of direct trauma and violent shaking. In the last two cases, aged 24 and 33 months respectively, there was only evidence of direct trauma on the heads without being shaken. This study shows that death due to intracranial trauma caused by shaking with or without direct impact is the most frequent cause of mortality in abused children. Death due to direct impact between the head and another object is a less frequent occurrence.