RESUMEN
The HIV test is an important strategy for HIV prevention and treatment, starting from screening individuals who are unaware of being infected with HIV and requiring antiretroviral therapy. Information about sexual behavior factors related to HIV testing initiatives among MSM in Indonesia is still limited. Previous studies only showed the correlation of various sexual behavior variables with the decision whether to obtain an HIV test or not; but did not learn whether the HIV testing was obtained due to personal initiative or invited by others. This research can be used as a reference for developing an HIV testing program based on sexual behavior variables. This research aims to study the sexual behavior factors related to the personal initiative on taking the HIV test among men who have sex with men (MSM). We used cross-sectional study among 300 MSM who had an HIV test. This research found that homosexual orientation was negative factor related to the personal initiative for obtaining an HIV test. Sexual behavior among MSM is correlated with the personal initiative to take HIV testing. Further investigation should emphasize among homosexuals because they do not have the initiative to take an HIV test.
Le test du VIH est une stratégie importante pour la prévention et le traitement du VIH, qui commence par le dépistage des personnes qui ignorent qu'elles sont infectées par le VIH et qui nécessitent un traitement antirétroviral. Les informations sur les facteurs de comportement sexuel liés aux initiatives de dépistage du VIH parmi les HSH en Indonésie sont encore limitées. Des études antérieures ont uniquement montré la corrélation entre diverses variables du comportement sexuel et la décision d'obtenir ou non un test de dépistage du VIH; mais n'a pas appris si le test du VIH avait été obtenu grâce à une initiative personnelle ou sur invitation d'autres personnes. Cette recherche peut servir de référence pour développer un programme de dépistage du VIH basé sur des variables de comportement sexuel. Cette recherche vise à étudier les facteurs de comportement sexuel liés à l'initiative personnelle de faire le test du VIH chez les hommes ayant des rapports sexuels avec des hommes (HSH). Nous avons utilisé une étude transversale auprès de 300 HSH ayant subi un test de dépistage du VIH. Cette recherche a révélé que l'orientation homosexuelle était un facteur négatif lié à l'initiative personnelle d'obtenir un test de dépistage du VIH. Le comportement sexuel des HSH est corrélé à l'initiative personnelle de se soumettre au test du VIH. Une enquête plus approfondie devrait être menée auprès des homosexuels car ils n'ont pas l'initiative de faire un test de dépistage du VIH.
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Infecciones por VIH , Prueba de VIH , Homosexualidad Masculina , Conducta Sexual , Humanos , Masculino , Indonesia , Homosexualidad Masculina/estadística & datos numéricos , Homosexualidad Masculina/psicología , Estudios Transversales , Infecciones por VIH/diagnóstico , Infecciones por VIH/prevención & control , Adulto , Adulto Joven , Conocimientos, Actitudes y Práctica en Salud , Encuestas y Cuestionarios , Aceptación de la Atención de Salud/estadística & datos numéricos , Aceptación de la Atención de Salud/psicología , Tamizaje Masivo , Parejas Sexuales , Persona de Mediana Edad , Asunción de RiesgosRESUMEN
Tuberous Sclerosis Complex (TSC) is a rare genetic disorder that primarily affects the central nervous system and various body organs. This case series describes the case history of 2 siblings from the same parents who were diagnosed with TSC. Case 1 is a 13-year-old girl with bilateral renal AML (angiomyolipoma), multiple fat nodules in the liver, and subependymal nodules with tubers revealed in the brain magnetic resonance imaging (MRI). Case 2 is her brother, a 6-year-old boy, who presented with manifestations of subependymal giant cell astrocytoma (SEGA) and renal AML. TSC must be managed with early diagnosis and intervention due to the risk of hamartoma enlargement. These 2 cases found in siblings underline the varied clinical presentations of TSC and the complexities faced by families with TSC. Early diagnosis is important to avoid TSC-related complications because, as time goes by, the disease will impact the patient's quality of life and increase morbidity and mortality. This case series also highlights the advantages of dermatological screening for the early detection of TSC, family screening, the need for multiple imaging modalities and counseling of family members with TSC, as well as the need for ongoing follow-up of this rare disorder.
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Background: sepsis is a life-threatening organ dysfunction caused by an excessive host immunological response to infection. The incidence of sepsis is increasing every year, and sepsis is the primary cause of mortality in intensive care units (ICUs). DIC is a coagulopathy syndrome that causes microvascular and macrovascular thrombosis and increases the risk of bleeding due to consumptive coagulopathy. The pathophysiology of DIC in sepsis is complex, and further research is required to investigate the involved mechanisms and risk factors. Method: this study is a prognostic analysis of a retrospective cohort. Samples were patients diagnosed with sepsis and admitted to Cipto Mangunkusumo National General Hospital from January 2016 to October 2022. Research subjects were followed until occurrence of DIC during sepsis or recovery from sepsis. The research subjects were selected from medical records using a consecutive total sampling approach. The inclusion criteria were patients aged ≥18 years old and diagnosed with sepsis according to qSOFA criteria with a score of 2. The exclusion criterion was an incomplete medical record. Bivariate and multivariate logistic regression analyses were performed to determine which independent variables contributed to the incidence of DIC and obtain the odds ratios (ORs). p < 0.05 was considered to indicate a statistically significant difference. Results: a total of 248 patients were included after considering the inclusion and exclusion criteria. Of these, 50 (20.2%) septic patients developed DIC. In the multivariate analysis, albumin ≤2.5 g/dL (OR: 2.363; 95% CI: 1.201−4.649), respiratory infection (OR: 2.414; 95% CI: 1.046−5.571), and antibiotic treatment ≥1 h (OR: 2.181; 95% CI: 1.014−4.689) were associated with DIC development. On the basis of the ROC curve, the area under the curve (AUC) was determined to be 0.705 with 95% CI = (0.631−0.778). Conclusion: in our study, the prevalence of DIC in septic patients was 20.2%. Low albumin, respiratory infection, and antibiotic treatment ≥1 h were found to be risk factors for development of DIC in septic patients.
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The hypertension rate in Indonesia has increased significantly in the past five years, but there is limited information about the hypertension risk of farmers. Our study assesses the prevalence of hypertension in this population and examines the proportional risk of various work environment and lifestyle factors among farmers. A cross-sectional study was conducted in high and low heat stress agriculture areas of West Java, Indonesia. There were 354 male farmers aged 25 to 73 years old who participated in the study. We measured blood pressure and used a questionnaire on self-reported use of anti-hypertension drugs or diagnosis by a medical professional to define hypertension. We assessed occupational factors including farming methods, heat stress and pesticide use, and personal factors including obesity, food intake, smoking status, alcohol consumption. Multivariate analysis was used to evaluate factors potentially associated with prevalence of hypertension. Forty-six percent of farmers experience hypertension. Farming in a location with higher heat stress (WBGT) was significantly associated with increased risk of hypertension (adjusted prevalence ratio (aPR) 1.41, 95% confidence interval (CI) 1.01, 1.95). Farmers who used pesticide sprayers had an increased risk of hypertension (aPR 1.90, 95% CI 0.93, 3.87). No personal/lifestyle characteristics were significantly associated with hypertension, although ever smoking and ever consuming alcohol had an increased prevalence of hypertension. This study shows the importance of work environmental factors in the prevalence of hypertension and the necessity of public health education, identification and treatment of this "silent killer" among Indonesian farmers.
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Hipertensión , Exposición Profesional , Oryza , Plaguicidas , Adulto , Anciano , Agricultura , Estudios Transversales , Agricultores , Humanos , Hipertensión/inducido químicamente , Hipertensión/epidemiología , Indonesia/epidemiología , Persona de Mediana Edad , Exposición Profesional/efectos adversos , Plaguicidas/efectos adversosRESUMEN
BACKGROUND: Children who inhabit the same house with tuberculosis (TB) patients are at high risk for infection and illness with TB. Nutritional status (stunting) in children is related to the child's ability to withstand MTB (Mycobacterium Tuberculosis). This study aims to estimated the prevalence of tuberculosis infection and its relationship to stunting in children (under five years) with household contact (HHC) with new TB cases. METHODS: A cross-sectional design was implemented. Conducted in July 2018-April 2019 at 13 Public Health Center in Makassar City. The sample size was calculated using one sample situation-about precision formula. Samples were children under five who had contact with new diagnosed TB cases. Tuberculosis infection was measured by TST (tuberculin skin test). Logistic regression with causal model to examine TB infection relationship with stunting and covariate variable, analyzed using Stata/MP 13.0 software. RESULTS: One hundred twenty-six (126) eligible children. Prevalence of tuberculosis infection was 38.10%. Frequency of stunted was 31 children (24.60%). Stunted nutritional status (aPR): 2.36, 95% CI 1.60-3.44), boys (aPR: 1.47, 95% CI 0.96-2.25), not getting BCG immunization (aPR: 1.58, 95%) CI 0.89-2.82), and high contact intensity (aPR: 2.62, 95% CI 1.10-6.22) best predicted the tuberculosis infection in children with TB case household contacts with a model contribution of 64%. CONCLUSION: Stunted nutritional status (moderate and severe), boys, not getting BCG immunization, and high contact intensity are the determinants of TB infection transmission in children HHC with TB. Children under five years of age who have close contact with TB cases should be targeted for priority interventions to prevent the transmission of TB infection and progressing to TB cases.
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Transmisión de Enfermedad Infecciosa , Composición Familiar , Trastornos del Crecimiento , Desnutrición , Mycobacterium tuberculosis , Tuberculosis , Preescolar , Trazado de Contacto/métodos , Trazado de Contacto/estadística & datos numéricos , Estudios Transversales , Transmisión de Enfermedad Infecciosa/prevención & control , Transmisión de Enfermedad Infecciosa/estadística & datos numéricos , Femenino , Trastornos del Crecimiento/diagnóstico , Trastornos del Crecimiento/epidemiología , Humanos , Indonesia/epidemiología , Tuberculosis Latente/diagnóstico , Tuberculosis Latente/epidemiología , Masculino , Desnutrición/diagnóstico , Desnutrición/epidemiología , Mycobacterium tuberculosis/aislamiento & purificación , Mycobacterium tuberculosis/patogenicidad , Estado Nutricional , Prevalencia , Medición de Riesgo/métodos , Tuberculosis/diagnóstico , Tuberculosis/epidemiología , Tuberculosis/prevención & controlRESUMEN
Examining the WBGT (Wet Bulb Globe Temperature) profiles in the two study locations was intended to show temperature differences during the week of the study. Information obtained from the weather stations that provide contextual long-term information on heat and humidity also showed temperature differences. The average measured temperature and humidity in the past year from each of these weather stations show an average heat index of 22 °C in Bogor and an average heat index of 32 °C in Karawang. Interpretation of the chronic kidney disease (CKD) and chronic kidney disease of unknown etiology (CKDu) findings was more complicated because we also found that farmers in our two locations reported differences in the use of mechanization in their farming, presumably impacting their workloads.
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Oryza , Insuficiencia Renal Crónica , Agricultores , Calor , Humanos , Humedad , Indonesia/epidemiología , Salud Pública , Insuficiencia Renal Crónica/epidemiología , Insuficiencia Renal Crónica/etiología , Factores de RiesgoRESUMEN
Chronic kidney disease of unknown etiology (CKDu) in agricultural population is an increasing issue. This study aims to obtain a prevalence estimate of CKDu in male rice farmers in West Java, Indonesia; and analyze the relationship between CKDu and environmental and occupational factors. The study design was cross-sectional. This study included 354 healthy male farmers in two rice agriculture areas in West Java with different altitudes (low altitude and high-altitude location). This research included blood and urine sampling from the farmers for serum creatinine (SCr) level and proteinuria; questionnaire on demographic information, occupational factors and other risk factors for CKDu. We measured ambient temperature and humidity in both study locations for environmental factors. From SCr level and proteinuria, we categorized the farmers into five stages of CKD; then we distinguished CKDu from CKD if the farmers had stage 1-4 of CKD but without diabetes, hypertension and other traditional causes. Data were analyzed with multivariate logistic regression to get prevalence odd ratios of CKDu and its relationship with environmental and occupational factors, adjusted with other risk factors of CKDu. The overall prevalence of CKD was 24.9% and CKDu was 18.6%. For the environmental factors, farm location (high altitude versus low altitude location) was associated with CKDu (Prevalence Odds Ratio (POR): 2.0; 95% CI: 1.2-3.5). For the occupational factors, although not significant, the risk of CKDu increased with the longer use of insecticide and with the more frequent of insecticide use. We suggested that there was a need to conduct future research to investigate more on the association of those environmental and occupational factors with CKDu.
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Agricultura , Agroquímicos/efectos adversos , Agricultores , Enfermedades Profesionales/epidemiología , Exposición Profesional/efectos adversos , Oryza , Insuficiencia Renal Crónica/etiología , Creatinina/sangre , Estudios Transversales , Humanos , Indonesia/epidemiología , Masculino , Enfermedades Profesionales/etiología , Prevalencia , Proteinuria/sangre , Insuficiencia Renal Crónica/epidemiología , Factores de RiesgoRESUMEN
This study aimed to assess the prevalence of blood lead levels (BLLs) among children 1 to 5 years old who reside near and distant to informally used lead-acid battery (ULAB) recycling locations and examine risk factors for elevated BLLs. A cross-sectional study was conducted in three greater Jakarta neighborhoods where informal ULAB recycling occurs. Venous BLLs among 279 children were analyzed using portable blood lead testing machines. Demographic, child activities, and sources of lead exposure inside and outside homes were assessed. Multivariate analysis was performed to evaluate factors associated with the prevalence of BLLs. Forty-seven percent of children had BLLs ≥ 5 µg/dL and 9% had BLLs ≥ 10 µg/dL. No differences in geometric mean BLLs were observed between children who lived near and distant to ULAB locations. Older child age groups [Prevalence Ratio (PR) 2.14, 95% Confidence Interval (CI) 1.16, 4.18) and low household income (PR 1.58, 95% CI 1.03, 2.40) were associated with BLLs 5-9 µg/dL. Low educational attainment of the child's father (PR 3.17, 95% CI 1.23, 8.16) and frequent outdoor child activity (PR 4.93, 95% CI 1.09, 22.21) were predictors of BLLs ≥ 10 µg/dL. This study shows the association between lead exposure among children and environmental sources. Public health officials can consider expanded surveillance, health care provider education, and development of strategies to reduce lead exposure.
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Suministros de Energía Eléctrica , Contaminantes Ambientales/sangre , Plomo/sangre , Reciclaje , Preescolar , Ciudades , Monitoreo del Ambiente , Femenino , Humanos , Indonesia , Lactante , Masculino , Factores de RiesgoRESUMEN
BACKGROUND: cardiovascular diseases (CVD) is the most common cause of death in Indonesia. We aimed to examine risks of CVD in workers aged 40 to 69 year related to their occupational status. METHODS: a cross-sectional study in all provinces of Indonesia. Data from a large-scale national health survey called RISKESDAS were used to analyze factors associated with CVD. Analysis was restricted to the working population aged 40 to 69 year. There were 137,378 subjects included in the analysis. Cox's regression analysis was modified to calculate prevalence ratio for the association of CVD with diabetes mellitus (DM), hypertension, stress, body mass index (BMI), smoking, and particular demographic factors. RESULTS: CVD was associated with occupation; white collar workers were about 1.6 times as likely to be diagnosed with CVD as to blue collar workers. However, blue collar workers were more likely to report symptoms of CVD than white collar workers. Prevalence of CVD was higher in women than men, increasing by age and education attainment. Hypertension, DM, stress, and increased BMI added the prediction of CVD: prevalence ratio (PR) was 1.72 (95% CI 1.59-1.86), 3.89 (95% CI 3.43-4.44), 3.02 (95% CI 2.77-3.29) and 1.42 (95% CI 1.28-1.57) for BMI ≥27 relative to <25 kg/m2, respectively. The study could not explain the association with smoking. CONCLUSION: this study added evidence of major risk factors which could be modified to reduce CVD. Some associations were likely to reflect access to health care.
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Enfermedades Cardiovasculares/epidemiología , Estado de Salud , Ocupaciones/clasificación , Adulto , Distribución por Edad , Anciano , Índice de Masa Corporal , Estudios Transversales , Diabetes Mellitus/epidemiología , Escolaridad , Femenino , Encuestas Epidemiológicas , Humanos , Indonesia/epidemiología , Masculino , Persona de Mediana Edad , Modelos de Riesgos Proporcionales , Factores de Riesgo , Distribución por Sexo , Fumar/epidemiologíaRESUMEN
Risk of aplastic anemia (AA) from occupational exposures to pesticides and industrial chemicals was evaluated in a hospital-based case control study in Thailand (541 cases of AA and 2261 controls). Exposure data were obtained via participants' self-reports and by experts' assessments and the data from these 2 exposure assessment methods were compared. There was an increased risk of AA associated with several classes of pesticides measured by either self-report or expert assessment. The strongest associations were seen in those whose exposures were identified both by self-report and by expert assessment. Comparing very high/high to no exposure, odds ratios (95% confidence intervals) were as follows: for organophosphates 3.20 (1.87-5.46), carbamates 4.75 (1.92-11.75), organochlorines 6.04 (1.31-27.84), and paraquat 2.17 (1.11-4.25). There were correlations among the pesticides because many types were used in the same job, so it was not possible to determine whether these risks were independent or because of confounding of one by another.