Pathogenic Leptospira contamination in the environment: a systematic review.

Background: The pathogenic Leptospira is maintained in renal tubules of certain animals, mostly rodents, and excreted in the urine which can contaminate the environment. It is necessary to detect pathogenic Leptospira in environmental samples. Knowing the survival of Leptospira in the environment (water and soil) can provide an overview of where and how they can be transmitted to humans. Objective: Therefore, this study aimed to provide a systematic overview of pathogenic Leptospira presence in water and soil environment, the various species of pathogenic Leptospira that are harmful for human, and the ability to survive using a systematic review method. Methods: The search process used four databases: PubMed, Science Direct, Scopus, and ProQuest. Furthermore, the articles sought were published from 2000 to July 2021, and 38 were analysed. Results: The pathogenic Leptospira contamination in water was higher in urban areas, while soil samples were higher in rural areas. Various pathogenic Leptospira detected in the environment were L. alstonii, L. kmetyi, L. noguchii, and L. interrogans. Those pathogenic Leptospira can survive in water at 4-30°C and at pH < 7; in soil, it can survive at a humidity of < 20% and a pH < 6. Conclusion: Urban and rural areas have the same risk for leptospirosis disease because pathogenic Leptospira (P1).

Community Behaviors That Affect the Incidence of Leptospirosis in West Jakarta, Indonesia.

Background: Leptospirosis is an infectious disease caused by a pathogenic Leptospira species transmitted directly or indirectly from animals to humans. It is endemic in Southeast Asia in several countries, including Indonesia and Thailand. Therefore, this study aimed to determine the effect of community behavior on the incidence of leptospirosis in West Jakarta in 2019. Methods: The study used a case-control design, and data were obtained from the West Jakarta Health Office. The sample included 140 respondents, consisting of 70 leptospirosis patients (cases) and 70 participants who did not suffer from the disease (controls) in a 1:1 ratio. Results: In the bivariate analysis, there were significant effects on leptospirosis incidence from knowledge (odds ratio [OR] = 18.789), occupation (OR = 31.875), injury history (OR = 20.842), and recreation (OR = 0.294). Multivariate analysis showed significant effects based on occupation, present wounds, and recreation records. Occupation was a dominant factor in leptospirosis in West Jakarta (OR 54.116: 95% confidence interval: 4.435-660.372). Conclusion: The dominant factors for leptospirosis were risky occupations, followed by a history of injuries.

Knowledge, attitudes, and behaviour of college students in disposing used masks during the COVID-19 pandemic in DKI Jakarta Province.

Background: The COVID-19 pandemic has increased the need for mask production which has caused the problem of mask waste generating in the environment without being managed. This research was conducted to determine the relationship between knowledge, attitudes, and sociodemographic factors with college student behaviours in managing household mask waste in Daerah Khusus Ibukota (DKI) Jakarta Province. Methods: This study used a quantitative approach and cross-sectional study design. Data collection was carried out using an online questionnaire consisting of the respondents' sociodemographic, knowledge, attitudes, and behaviours. Results: The majority of students had high knowledge (63.3%), positive attitudes (52.5%), and good behaviours (50.6%). Statistically, there was a significant relationship between knowledge and behaviours (p = 0.022), but there was no significant relationship between attitudes and behaviours (p = 0.269). In addition, the sociodemographic factor variables showed a significant relationship between place of residence and behaviours (p = 0.008). However, there was no significant relationship between age, gender, education, and study program groups and behaviours (p > 0.05). Multivariate analysis showed that living with family was a dominant factor for bad behaviours (OR 1.664, 95% CI=1.124-2.464), and the second risk factor was the low level of knowledge has a significant relationship with the behaviours of mask waste management at home (OR=1.559, 95% CI=1.044-2.330). Conclusions: Students who live alone also show better behaviour compared to students who live with their families. The place of residence variable has the greatest influence on the behaviour of mask waste management at the household, followed by the knowledge variable.

The relationship between climate change and malaria in South-East Asia: A systematic review of the evidence.

Background: Climatic change is an inescapable fact that implies alterations in seasons where weather occurrences have their schedules shift from the regular and magnitudes intensify to more extreme variations over a multi-year period. Southeast Asia is one of the many regions experiencing changes in climate and concurrently still has endemicities of malaria. Given that previous studies have suggested the influence of climate on malaria's vector the Anopheles mosquitoes and parasite the Plasmodium group, this study was conducted to review the evidence of associations made between malaria cases and climatic variables in Southeast Asia throughout a multi-year period. Methods: Our systematic literature review was informed by the PRISMA guidelines and registered in PROSPERO: CRD42022301826 on 5 th February 2022. We searched for original articles in English and Indonesian that focused on the associations between climatic variables and malaria cases. Results: The initial identification stage resulted in 535 records of possible relevance and after abstract screening and eligibility assessment we included 19 research articles for the systematic review. Based on the reviewed articles, changing temperatures, precipitation, humidity and windspeed were considered for statistical association across a multi-year period and are correlated with malaria cases in various regions throughout Southeast Asia. Conclusions: According to the review of evidence, climatic variables that exhibited a statistically significant correlation with malaria cases include temperatures, precipitation, and humidity. The strength of each climatic variable varies across studies. Our systematic review of the limited evidence indicates that further research for the Southeast Asia region remains to be explored.

Attitude towards dengue control efforts with the potential of digital technology during COVID-19: partial least squares-structural equation modeling.

Background: Dengue fever is still a public health issue in Indonesia, and during the coronavirus disease 2019 (COVID-19) pandemic, integrated digital technology will be required for its control. This study aims to identify critical indicators influencing attitudes towards dengue control related to the potential for implementing digital technology. Methods: This was a cross-sectional survey, with 515 people willing to fill out an online questionnaire. The analysis was conducted using Partial Least Square-Structural Equation Modelling (PLS-SEM). There were 46 indicators used to assess attitudes toward dengue control, which were organized into six variables: the need for digital information systems, perceptions of being threatened with dengue, the benefits of dengue control programs, program constraints, environmental factors and attitudes in dengue control. Results:  The source of information needed for dengue control was mainly through social media. There was a positive relationship between perception of environmental factors to perception of dengue threat, perception of program constraints, perception of program benefits, and perception of digital technology needs. Perception of program benefits and threatened perception of dengue have a positive relationship with perception of digital technology needs. Conclusions: This model showed the variables perception of digital technology and perception of benefits had a positive association with attitude towards dengue control.

Support of the Implementation of a Whistleblowing System for Smoke-Free Environments: A Mixed Methods Approach.

Enforcement of a smoke-free policy is of vital concern in support of the health of smokers and bystanders. Indonesia has issued a smoke-free law, but implementation and enforcement lie with the regional and municipal governments. In a survey of 225 respondents recruited via schools, knowledge about the health effects of smoking and the smoke-free regulation, as well as attitudes towards and commitment and support of the enforcement of the smoke-free regulation in the Kendari City through an electronic whistleblowing system was examined. Furthermore, the participants were asked about the smoking status and smoking behavior. About half of the respondents were students (teenagers), the other half-their parents. Male respondents were strongly overrepresented (85%). Only 18% of the respondents declared to be smokers, mostly adults and males. Both the smokers and the non-smokers supported the smoke-free law and its enforcement through a whistleblowing system. Representatives of the local government were interviewed and participated in focus group discussions. In general, they also exhibited strong support of an electronic enforcement tool. However, issues of efficiency, costs, and responsibility must still be resolved. Nevertheless, an electronic whistleblowing system has the potential to further the health and livelihoods in a community like the Kendari City.

The existence and characteristics of rats and shrews in endemic leptospirosis areas and types of ectoparasites: a case study of West Jakarta, Indonesia.

Background: This study aimed to determine the presence and species of the rats and shrews that can potentially cause leptospirosis in West Jakarta, Indonesia, and the species of ectoparasites found in them. Methods: The research was a descriptive study employing a cross-sectional approach. The study population was all species of rats and shrews in the region and the sample collection technique used was purposive sampling. The traps were installed in the homes of respondents who had suffered from leptospirosis and their closest neighbors, with a total of 521 traps. Leptospirosis data based on secondary data was obtained from West Jakarta Health Office (2016-August 2019). The technique for catching rats involved using humane live traps, while the identification of the rats and ectoparasites was done in the laboratory. Results: It was found that more rats were caught in Cengkareng Timur sub-district, Cengkareng District, with a percentage of 14.8%, while the least in Duri Kepa, Kapuk, Kedaung Kali Angke and Kedoya Utara with a percentage of 3.7%. The rats were mostly found in East Cengkareng Sub-District, with the most common type being Rattus rattus (74.1 %) and the least Suncus murinus (11.1%); more male rats were caught (66.7%) than female (33.3%). The type of ectoparasite found in the rats was fleas. Xenopsylla cheopis was the most common type, at 83.3% and more fleas were male, at 66.7%. The most common rat species was Rattus rattus. The ectoparasite most commonly found in them was the female flea Xenopsylla cheopis.Conclusions:  Rattus rattus and Xenopsylla cheopis were found in an East Cengkareng sub-district. Surveys, monitoring, and control of rats and ectoparasites are essential for the preparedness and development of an early warning system of possible diseases that they can cause.

A systematic review of the case findings, testing and management of COVID-19.

Background: Mass testing and adequate management are essential to terminate the spread of coronavirus disease 2019 (COVID-19). This testing is due to the possibility of unidentified cases, especially ones without COVID-19 related symptoms. This review aimed to examine the outcome of the existing studies on the ways of identifying COVID-19 cases, and determine the populations at risk, symptom and diagnostic test management of  COVID-19. Methods: The articles reviewed were scientific publications on the PubMed, Science Direct, ProQuest, and Scopus databases. The keywords used to obtain the data were COVID-19, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and case detection, case management or diagnostic test. We applied the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Population, Intervention, Control and Outcomes (PICO) approaches. Results: A total of 21 articles from 13 countries met the inclusion criteria and were further analyzed qualitatively. However, 62% of the articles used a rapid antibody test for screening rather than a rapid antigen test. According to the rapid antigen test, 51.3% were positive, with men aged above 50 years recording the highest number of cases. Furthermore, 57.1% of patients were symptomatic, while diagnostic tests' sensitivity and specificity increased to 100% in 14 days after the onset. Conclusions:  Real-time polymerase chain reaction (RT-PCR)  is recommended by the World Health Organization for detection of COVID-19. Suppose it is unavailable, the rapid antigen test is used as an alternative rather than the rapid antibody test. Diagnosis is expected to be confirmed using the PCR and serological assay to achieve an early diagnosis of COVID-19, according to disease progression, gradual rapid tests can be used, such as rapid antigen in an earlier week and antibody tests confirmed by RT-PCR and serological assay in the second week of COVID-19.

Current status of insecticide resistance in malaria vectors in the Asian countries: a systematic review.

Background: The application of insecticides for malaria vector control has remained a global problem, due to the current trend of increased resistance against these chemicals. This study aims to determine the insecticide-resistant status in Asia and how to implement the necessary interventions. Moreover, the implications of resistance in malaria vector control in this region were studied. Methods: This systematic review was conducted using a predefined protocol based on PRISMA-retrieved articles from four science databases, namely ProQuest, Science Direct, EBSCO, and PubMed in the last ten years (2009 to 2019). The searching process utilized four main combinations of the following keywords: malaria, vector control, insecticide, and Asia. In ProQuest, malaria control, as well as an insecticide, were used as keywords. The following criteria were included in the filter, namely full text, the source of each article, scholarly journal, Asia, and publication date as in the last ten years. Results: There were 1408 articles retrieved during the initial search (ProQuest=722, Science Direct=267, EBSCO=50, PubMed=285, and Scopus=84). During the screening, 27 articles were excluded because of duplication, 1361 based on title and abstract incompatibility with the inclusion criteria, and 20 due to content differences. In the final screening process, 15 articles were chosen to be analyzed. From the 15 articles, it is known that there was dichlorodiphenyltrichloroethane (DDT) and pyrethroids resistance in several anopheles species with a mortality rate of less than 80%. Conclusions: The report on the pyrethroid resistance was complicated, since this insecticide was considered effective in malaria vector control. Therefore, several strategies were required, including the management plans in selecting insecticides, using a rotation system during interventions in the field, regular monitoring, and integrating vector control based on physics, chemistry, and biology. All of these need to be supported by cross-sector policies and cooperation in achieving the 2030 malaria-free target.

Food safety knowledge, attitudes, and practices of food handlers at kitchen premises in the Port 'X' area, North Jakarta, Indonesia 2018.

Improper food handling can be a major cause of food contamination. To prevent food contamination, the food handler should have good knowledge, display a positive attitude, and practice proper food handling practices. This study aimed to evaluate the food safety and personal hygiene knowledge, attitudes, and practices of food handlers at kitchen premises in the Port 'X' area in North Jakarta, Indonesia. This study uses a cross-sectional design. The research was conducted in April 2018 and May 2018. Data were collected from 72 food handlers from kitchens located in the Port 'X' area in North Jakarta. Data collection was performed through interviews and observations, using questionnaires and checklists as research instruments. The results show a significant correlation between the level of knowledge about food safety and the attitude of food handlers (p=0.01), and attitude scores were significantly higher among food handlers who reported attending a previous food safety training course (p=0.002) with (r=0.302) it means a weak uphill (positive) linear relationship attitude scores and training that food handlers attended. This study found a significant relationship between the knowledge and attitude of food handlers, but there was no significant relationship between knowledge or attitude and food handling practices. Thus, it is recommended that training activities for food handlers be held regularly, as the food safety knowledge obtained from training or courses can translate into the improvement of attitudes and food handling practices.

The implementation of the five keys to safer food in campus cafeterias and the effects on Escherichia coli contamination.

The World Health Organization developed five keys to safer food's guidelines. This study aimed to determine the relationships between food handlers' knowledge, attitudes, and behavior to the guideline and Escherichia coli (E. coli) contamination of food served at campus cafeterias. This cross-sectional study was carried out by interviewing 98 food handlers selling food and by testing samples for E. coli. The dependent variable was E. coli contamination, while the independent variables were the knowledge, attitudes, and behavior of food handlers based on the guideline. Each independent variable had five sub-variables that corresponded to the guideline. The data were analyzed using chisquare and logistic regression tests. The results showed that food handlers' knowledge of cooking food thoroughly was significantly related to E. coli contamination (P=0.54 [P<0.05]; OR=2.990;95%CI:1.093- 8.180). Furthermore, the food handlers' attitudes toward cooking food thoroughly were related to E. coli contamination (P=0.58 [P<0.05]; OR=0.385;95%CI:0.157- 0.944). There were two factors related to E. coli contamination: the food handlers' knowledge of and attitudes toward the third key of the five keys to food safety.

Attitude to COVID-19 Prevention With Large-Scale Social Restrictions (PSBB) in Indonesia: Partial Least Squares Structural Equation Modeling.

There is a continuous increase in the number of COVID-19 cases in Indonesia. To control its spread, the government has implemented several strategies, such as policies associated with large-scale social restrictions (Indonesian: Pembatasan Sosial Berskala Besar or PSBB). The purpose of this study is to determine the variables that influence attitudes toward PSBB policies in Indonesia. This is a cross-sectional study with data obtained from 856 respondents from all provinces in Indonesia using the partial least squares and structural equation model (PLS-SEM). A total of 23 indicators were used to examine these policies, which were grouped into five variables: benefits of the PSBB (5 indicators), positive perception (5 indicators), negative perception (3 indicators), threatened perceptions of COVID-19 (5 indicators), and attitude toward the PSBB policy (5 indicators). The model explains over 50% of attitudes exhibited toward PSBB policy implementation and how it is influenced by the perceived benefits, negative and positive perceptions as well as the threat associated with COVID-19. The policy of stay at home, physical distancing, and always using face masks needs to be continued for the public to have a supportive attitude of the PSBB policy in preventing the transmission of COVID-19.

Current management of household hazardous waste (HHW) in the Asian region.

Background This review intends to explore the household hazardous waste (HHW) generation rates, HHW management, and people's awareness regarding HHW in Asian countries based on the economic levels using the available published articles. Methods This is a systematic review of the scientific literature based on several databases, namely Scopus, ProQuest, PubMed, Sage Journals, and Elsevier's Science Direct from 2008 to 2018. Results HHW generation rates in various Asian cities do not seem to be influenced by the countries' financial status, except for e-waste. The variety in HHW generation rates among Asian countries might be due to various reasons, which include differences in (1) sampling frame/locations; (2) sampling size; (3) study duration; (4) seasons; (5) study year; and (6) HHW definition/composition. Governmental intervention programs on HHW management have been implemented in some of the Asian countries, mostly in high and upper-middle income groups although misconducts are still found. There is a tendency for economically developed countries to ship their e-waste to less-developed countries, where the system relies heavily on the informal sectors where unsafe treatments are often discovered. Low level of awareness regarding HHW risks is mostly identified in the lower-middle income group. However, even though high and upper-middle income groups have a better awareness of HHW, many people do not entirely follow the recommended practices. Conclusion The lack of enforced regulation and proper treatment infrastructure may lead to HHW being mixed with general household waste, which is found in many Asian countries, despite their income levels. In addition, a good awareness of HHW does not guarantee proper handling of it.

Perceived effectiveness of pictorial health warnings on changes in smoking behaviour in Asia: a literature review.

BACKGROUND: Several Asian countries have implemented pictorial health warnings on cigarette packs as suggested by the World Health Organization with various policies based on countries' systems. The study is aimed to analyse multiple research studies on the perceived effectiveness of Pictorial Health Warnings as a deterrent to smoking intention and as a stimulant of smoking behaviour in smokers and non-smokers in Asian countries. METHOD: Peer-reviewed articles were identified through multiple science databases indexed by Scopus, MEDLINE or PubMed. The review was limited to articles that reported original research findings, were conducted in Asian countries and were available for review by January 2010. A PRISMA Flow diagram was used to identify the articles through the process of data screening and extractions. RESULT: A total of 14 original articles which met the criteria were included in the review, consisting of 12 quantitative studies and 2 studies with both quantitative and qualitative methods from 17 jurisdictions. The reviewed studies found that pictorial health warnings were associated with a greater perception of salience (reading and noticing the warning), emotional effects, and cognitive increase. Additionally, in the reviewed studies, pictorial health warnings were perceived as more effective in deterring smoking initiation and encouraging smoking cessation than text-only warnings. Several studies also evaluated the effectiveness of a new pictorial warning compared with the old one. However, the relevance of refreshing the pictures of pictorial health warnings and the length of the effective period of the implementation of pictorial health warnings were less frequently studied. CONCLUSION: Pictorial health warnings perceived as more effective in deterring smoking initiation among non-smokers and as well as in stimulating smoking cessation among smokers. Future studies on pictorial health warnings should study the relevance of changing or refreshing pictorial health warning on cigarette packages in a period of time.

Escherichia coli contamination of babies' food-serving utensils in a district of West Sumatra, Indonesia.

BACKGROUND: Contamination of baby's complementary food may occur with Escherichia coli from several sources including unclean utensils. We examined the relationship between socio-economic conditions, environmental factors, characteristics of food handlers and contamination of babies food-serving utensils with E. coli. METHODS: The study was conducted in 21 villages of the Community Health Centre (CHC) Selayo in Indonesia. A cross-sectional design was used. A sample of 142 households, which had a 6-12 month-old baby on complementary food, was chosen randomly using midwives' registration books. Respondents were interviewed using a semi-structured questionnaire. Check-lists were used for observations. Standard laboratory methods were used for collection of specimen and confirmation of contamination with E. coli. RESULTS: More than half of the respondents (59.2%) used water that had high risk of contamination and 61.3% of the latrines did not meet the criteria of a healthy latrine. Waste management practices of nearly all respondents (97.9%) were below the standards set by the Ministry of Health. More than half of the respondents (68.3%) did not wash their hands with soap for 20 seconds and 52.1% did not use flowing water for washing hands. Majority of the respondents' hands (57%, 81/142) and 72.2% (104/142) of the eating utensils were found to be contaminated by E. coli. Contaminated hands of food handlers were more likely to contaminate the babies food-serving utensils (OR: 3.7; 95%CI: 1.62-8.46, p 0.002). CONCLUSION: Contamination of the hands of food handler was associated with contamination of babies food-serving utensils by E. coli. Hence, food handlers should be trained on proper hand washing methods.