Stigma Associated with COVID-19 Among Health Care Workers in Indonesia

OBJECTIVE

The aim of this study was to assess the stigma associated with coronavirus disease - 2019 (COVID-19) among health care workers (HCWs) in Indonesia during the early phase of the pandemic.

METHODS

A cross-sectional study was conducted in 12 hospitals across the country in March, 2020. A logistic regression was employed to assess the association between stigma and explanatory variables.

RESULTS

In total, 288 HCWs were surveyed, of which 93.4% had never experienced any outbreaks. Approximately 21.9% of the respondents had stigma associated with COVID-19. HCWs who were doctors, had not participated in trainings related to COVID-19, worked in the capital of the province, worked at private hospitals, or worked at a hospital with COVID-19 triage protocols were likely to have no stigma associated with COVID-19.

CONCLUSIONS

The stigma associated with COVID-19 is relatively high among HCWs in the early phase of the COVID-19 pandemic in Indonesia. Adequate dissemination of knowledge and adequate protection are necessary to reduce stigma among HCWs.

Penerapan Protokol Enhance Recovery After Surgery ( ERAS ) Pada Pasien Operasi Elektif Digestif Sebagai Upaya Menurunkan Length Of Stay Pasien Pasca Pembedahan di RSUD dr. Zainoel Abidin Banda Aceh Tahun 2019

Protokol Enhanced Recovery After Surgery (ERAS) merupakan konsep yang terdiri dari beberapa komponen berupa tim multidisiplin dan pendekatan multimodal untuk mempercepat proses penyembuhan dan mengurangi resiko komplikasi pasca pembedahan berdasarkan pendekatan ilmu kedokteran berbasis bukti. Menilai pengaruh penerapan protokol ERAS dalam menurunkan Length of Stay (LOS) pasca pembedahan di RSUD dr. Zainoel Abidin Banda Aceh Penelitian ini merupakan penelitian uji klinis yang dilakukan terhadap pasien operasi elektif bedah digestif. Subjek penelitian dibedakan menjadi 2 kelompok yakni kelompok dengan protokol dan tanpa protokol ERAS. Penelitian dilakukan selama 5 bulan sejak bulan April hingga Agustus 2019. Uji statistik Mann Whitney digunakan untuk menilai perbedaan rerata LOS antar kelompok dengan tingkat kepercayaan 95%. Sebanyak 84 pasien terlibat dalam penelitian ini dengan distribusi 42 orang pada masing – masing kelompok. Kelompok ERAS memiliki rerata usia 43,92 ± 14,56 tahun dan kelompok tanpa ERAS adalah 50,26 ± 14,23 tahun. Secara statistik, LOS antar kelompok berbeda secara bermakna (p < 0,001) dengan rerata secara berurutan 6,21 hari dan 10,81 hari. Perubahan paradigma terhadap perawatan pasien berdasarkan protokol ERAS mulai dari preoperatif, intraoperatif dan postoperatif yag melibatkan dokter bedah, anestesi dan perawatan di ruangan memberikan keuntungan terhadap pasien dan sistem pelayanan kesehatan dengan mempersingkat masa perawatan, minimal komplikasi dan efektifitas biaya. Penerapan protokol ERAS efektif menurunkan Length of Stay pasien operasi elektif digestif di RSUD dr. Zainoel Abidin Banda Aceh

Pengaruh Pencucian Luka Operasi Elektif Bedah Saraf Menggunakan Dilusi Povidone Iodine Dan Pemberian Madu Untuk Mencegah Infeksi Daerah Operasi Di RSUD Dr. Zainoel Abidin Tahun 2018

Infeksi daerah operasi (IDO) adalah infeksi yang terjadi baik ditinjau dari insisi ataupun organ/ruang yang terjadi dalam 30 hari setelah operasi atau dalam waktu 1 tahun apabila terdapat implan. Penggunaan madu saat perawatan luka menjadi salah satu langkah untuk mencegah IDO. Madu memiliki berbagai kandungan kimia aktif yang dapat mempercepat proses penyembuhan luka. Tujuan penelitian ini adalah untuk mengetahui efektifitas pemberian madu untuk mencegah IDO pada pasien operasi elektif bedah saraf Rumah Sakit Umum Daerah Dr. Zainoel Abidin Banda Aceh. Penelitian ini merupakan penelitian uji klinis dengan desain paralel. Sebanyak 54 orang pasien operasi elektif venticuloperitoneal (VP) shunt terlibat dalam penelitian dan dibagi menjadi dua kelompo, yaitu kelompok yang mendapat perlakuan dilusi povidone iodine + perawatan luka (Kelompok A) dengan madu dan kelompok dengan perawatan luka standar (Kelompok B) dengan jumlah masing – masing 27 orang. Uji t tidak berpasangan digunakan untuk menganalisis perbedaan skor IDO dengan tingkat kepercayaan 95%. Secara statistik terdapat peredaan yang bermakna skor IDO antar kelompok (p < 0,038) dengan nilai rerata masing – masing secara berurutan 2,30 ± 1,56 dan 3,22 ± 1,62. Madu memiliki tekanan osmotik tinggi dan berfungsi terutama sebagai suatu medium hiperosmolar yang menyebabkan terjadinya aktivitas pembersihan luka dan mencegah pertumbuhan bakteri. Zat yang terkandung memiliki spektrum potensi antibakterial sangat luas yang menghambat pertumbuhan kuman gram positif ataupun negatif, serta kuman aerob ataupun anaerob. Pencucian luka pasca operasi elektif ventriculoperitoneal (VP) shunt di RSUD Dr. Zainoel Abidin Banda Aceh menggunakan dilusi povidone iodine dan perawatan luka dengan madu efektif mencegah infeksi daerah operasi.

Knowledge, attitude, and practice regarding dengue virus infection among inhabitants of Aceh, Indonesia: a cross-sectional study

BACKGROUND

The Indonesian region of Aceh was the area most severely affected by the earthquake and tsunami of 26 December 2004. Department of Health data reveal an upward trend of dengue cases in Aceh since the events of the tsunami. Despite the increasing incidence of dengue in the region, there is limited understanding of dengue among the general population of Aceh. The aim of this study was to assess the knowledge, attitude, and practice (KAP) regarding dengue among the people of Aceh, Indonesia in order to design intervention strategies for an effective dengue prevention program.

METHODS

A community-based cross-sectional study was conducted in Aceh between November 2014 and March 2015 with a total of 609 participants living in seven regencies and two municipalities. Information on the socio-demographic characteristics of participants and their KAP regarding dengue was collected using a pre-tested structured questionnaire. The KAP status (good vs. poor) of participants with different socio-demographic characteristics was compared using Chi Square-test, ANOVA or Fisher's exact test as appropriate. Logistic regression analysis was used to determine the predictors of each KAP domain.

RESULTS

We found that 45% of participants had good knowledge regarding dengue and only 32% had good attitudes and good dengue preventive practices. There was a significant positive correlation between knowledge and attitudes, knowledge and practice, and attitudes and practice. In addition, people who had good knowledge were 2.7 times more likely to have good attitudes, and people who had good attitudes were 2.2 times more likely to have good practices regarding dengue. The level of education, occupation, marital status, monthly income, socioeconomic status (SES) and living in the city were associated with the knowledge level. Occupation, SES, and having experienced dengue fever were associated with attitudes. Education, occupation, SES and type of residence were associated with preventive practices.

CONCLUSION

Our study suggests that dengue prevention programs are required to increase KAP levels regarding dengue in the communities of Aceh.

Modifiable determinants of attitude towards dengue vaccination among healthy inhabitants of Aceh, Indonesia: Findings from a community-based survey

OBJECTIVE

To explore and understand the attitude towards dengue vaccination and its modifiable determinants among inhabitants of Aceh (northern Sumatra Island, Indonesia), the region that was most severely affected by the earthquake and tsunami of 26 December 2004.

METHODS

A community-based, cross-sectional study was conducted among 535 healthy inhabitants in nine regencies (Kabupaten or Kotamadya) of Aceh that were selected randomly from November 2014 to March 2015. A set of validated, pre-tested, structured questionnaires was used to guide the interviews. The questionnaires covered a range of explanatory variables and one outcome variable (attitude to dengue vaccination). Multi-step logistic regression analysis and Spearman's rank correlation were used to test the role of explanatory variables for the outcome variable.

RESULTS

More than 70% of the participants had a poor attitude towards dengue vaccination. Modifiable determinants associated with poor attitude to dengue vaccination were low education level, working as farmers and traditional market traders, low socioeconomic status and poor knowledge, attitude and practice regarding dengue fever (P < 0.05). The KAP domain scores were correlated strongly with attitude to dengue vaccination, rs = 0.25, rs = 0.67 and rs = 0.20, respectively (P < 0.001). Multivariate analysis found that independent predictors associated with attitude towards dengue vaccination among study participants were only sex and attitude towards dengue fever (P < 0.001).

CONCLUSIONS

This study reveals that low KAP regarding dengue fever, low education level and low socioeconomic status are associated with a poor attitude towards dengue vaccination. Therefore, inhabitants of suburbs who are working as farmers or traditional market traders with low socioeconomic status are the most appropriate target group for a dengue vaccine introduction program.

Community Willingness to Participate in a Dengue Study in Aceh Province, Indonesia

BACKGROUND

Dengue virus infection is the most rapidly spreading vector-borne disease in the world. Essential research on dengue virus transmission and its prevention requires community participation. Therefore, it is crucial to understand the factors that are associated with the willingness of communities in high prevalence areas to participate in dengue research. The aim of this study was to explore factors associated with the willingness of healthy community members in Aceh province, Indonesia, to participate in dengue research that would require phlebotomy.

METHODOLOGY/PRINCIPAL FINDINGS

A community-based cross-sectional study was carried out in nine regencies and municipalities of Aceh from November 2014 to March 2015. Interviews using a set of validated questionnaires were conducted to collect data on demography, history of dengue infection, socioeconomic status, and knowledge, attitude and practice regarding dengue fever. Two-step logistic regression and Spearman's rank correlation (rs) analysis were used to assess the influence of independent variables on dependent variables. Among 535 participants, less than 20% had a good willingness to participate in the dengue study. The factors associated with good willingness to participate were being female, working as a civil servant, private employee or entrepreneur, having a high socioeconomic status and good knowledge, attitude and practice regarding dengue. Good knowledge and attitude regarding dengue were positive independent predictors of willingness to participate (OR: 2.30 [95% CI: 1.36-3.90] and 3.73 [95% CI: 2.24-6.21], respectively).

CONCLUSION/SIGNIFICANCE

The willingness to participate in dengue research is very low among community members in Aceh, and the two most important associated factors are knowledge and attitude regarding dengue. To increase participation rate, efforts to improve the knowledge and attitude of community members regarding dengue fever and dengue-related research is required before such studies are launched.