Evaluation of the malaria elimination programme in Muara Enim Regency: a qualitative study from Indonesia.

BACKGROUND: Malaria remains an enduring public health concern in Indonesia, exacerbated by its equatorial climate that fosters the proliferation of Anopheles mosquitoes. This study seeks to assess the performance of the malaria elimination programme comprehensively. METHODS: Between May and August 2022, a qualitative study was conducted in Muara Enim Regency, South Sumatra Province, involving 22 healthcare professionals from diverse backgrounds. These informants were strategically chosen for their pivotal roles in providing profound insights into various facets of the malaria elimination programme. This encompasses inputs such as human resources, budgetary allocation, and infrastructural support; processes like case identification and management, capacity enhancement, epidemiological surveillance, prevention measures, outbreak control, and enhanced communication and educational initiatives; and, notably, the programme's outcomes. Data were collected through 3-h Focus Group Discussions (FGDs) divided into two groups, each with 12 participants: healthcare professionals and programme managers. Additionally, in-depth interviews (IDIs) were conducted with ten informants. Employing the Input-Process-Output (IPO) model, this study meticulously analysed the healthcare system dynamics and the interventions' efficacy. RESULTS: The study unveiled many challenges during the input phase, including the absence of entomologists and a shortage of diagnostic tools. Despite these obstacles, it documented remarkable accomplishments in the output domain, marked by significant advancements in the distribution of mosquito nets and the successful implementation of the Early Warning System (EWS). Despite the adversities, the programme has made substantial strides towards malaria elimination. CONCLUSIONS: Urgent action is imperative to bolster the effectiveness of the malaria elimination programme. Key measures encompass augmenting the entomologist workforce, optimizing resource allocation, and ensuring stringent adherence to regional regulations. Addressing these concerns will enhance programme efficacy, yielding enduring public health benefits. This research substantially contributes to Indonesia's ongoing malaria elimination endeavours, furnishing actionable insights for programme enhancement. Consequently, this research holds significant importance for the malaria elimination drive.

Waste anesthetic gases have a significant association with deoxyribonucleic acid (DNA) damage: A systematic review and meta-analysis of 2,732 participants.

Introduction: Operating room workers are at risk of experiencing adverse effects due to occupational exposure to waste anesthetic gases (WAGs). One of the consequences of long-term WAGs exposure is the probability of developing deoxyribonucleic acid (DNA) damage. This systematic review investigated the link between WAGs and DNA damage in operating room workers. Methods: PubMed, Science Direct, ProQuest, Scopus, and EbscoHost, as well as hand-searching, were used to find literature on the relationship between WAGs and DNA damage. Three independent reviewers independently assessed the study's quality. Meta-analysis was conducted for several DNA damage indicators, such as comet assay (DNA damage score, tail's length, tail's DNA percentage), micronuclei formation, and total chromosomal aberration. Results: This systematic review included 29 eligible studies (2732 participants). The majority of the studies used a cross-sectional design. From our meta-analysis, which compared the extent of DNA damage in operating room workers to the unexposed group, operating room workers exposed to WAGs had a significantly higher DNA damage indicator, including DNA damage score, comet tail's length, comet tail's DNA percentage, micronuclei formation, and total chromosomal aberration (p < 0.05) than non-exposed group. Conclusion: Waste anesthetic gases have been found to significantly impact DNA damage indicators in operating room personnel, including comet assay, micronuclei development, and chromosomal aberration. To reduce the impact of exposure, hospital and operating room personnel should take preventive measures, such as by adapting scavenger method.

Risk factors of malaria transmission in mining workers in Muara Enim, South Sumatra, Indonesia.

Eliminating malaria by 2030 is stated as goal three in the UN's Sustainable Development Goals (SDGs). However, malaria still remains a significant public health problem. This study aims to identify the factors determining malaria transmission in artisanal or small-scale miner (ASM) communities in three villages: Tanjung Agung, Tanjung Lalang, and Penyandingan, located in the Tanjung Enim District, Muara Enim, South Sumatra, Indonesia. Researchers conducted a cross-sectional study involving 92 participants from the study area. They used a logistic regression model to investigate the risk factors related to malaria occurrence. The multivariable analysis revealed that age (Adjusted Prevalence Ratio (APR) = 7.989 with 95% CI 1.724-37.002) and mosquito breeding (APR = 7.685 with 95% CI 1.502-39.309) were risk factors for malaria. On the other hand, higher education (APR = 0.104 with 95% CI 0.027-0.403), the use of mosquito repellent (APR = 0.138 with 95% CI 0.035-0.549), and the condition of house walls (APR = 0.145 with 95% CI 0.0414-0.511) were identified as protective factors. The current study highlights age and mosquito breeding sites as risk factors for malaria. Additionally, higher education, insect repellent use, and the condition of house walls are protective factors against malaria. Therefore, reducing risk factors and increasing protective measures through effective communication, information, and education are highly recommended to eliminate malaria in mining areas.

Environmental determinants and risk behaviour in the case of indigenous malaria in Muara Enim Regency, Indonesia: A case-control design.

INTRODUCTION: Malaria is a significant public health concern in Indonesia. Muara Enim Regency is one of the districts in South Sumatra with the most important number of indigenous malaria cases in the last three years (2018-2020). Therefore, this study aimed to identify determinants of indigenous malaria in the Muara Enim Regency. METHODS: This study was designed as a case-control study. A stratified random sample in 2018, 2019, and 2020 was used at the Primary Health Centres (PHCs) areas of Tanjung Enim and Tanjung Agung. The sample included 49 cases and 49 controls. Indigenous malaria determinants were discovered using both bivariable and multivariable logistic regression models. RESULT: The multivariable logistic regression model results show that mosquito repellent reduces malaria risk by 71% (AOR = 0.29, 95% CI: 0.11-0.64). Besides, the presence of wire mesh on ventilation reduces the risk of malaria by 76% (AOR = 0.24, 95% CI: 0.10-0.57), and the distance from mosquito breeding sites near hundred meters and fewer increases the risk of malaria by 3.88 fold (AOR = 3.88; 95% CI: 1.67-8.97). CONCLUSIONS: Multivariable analysis revealed distance from mosquito breeding sites as a risk factor for malaria. Besides, the study shows that using insect repellent, wire netting in ventilation, eliminating mosquito breeding sites, mosquito repellent or protective clothing, and improving house conditions were protective factors for indigenous malaria. Therefore, preventive and promotional efforts are essential as the first step toward malaria elimination at the study site, including avoiding direct contact between residents and vectors near mosquito breeding sites.

Association of vitamin D with deoxyribonucleic acid (dna) damage: A systematic review of animal and human studies.

Vitamin D has anti-proliferative, anti-inflammatory, and apoptotic abilities. Vitamin D deficiency can induce deoxyribonucleic acid (DNA) damage. The aim of the study was to create a systematic review to analyze the relationship between vitamin D and DNA damage in various populations. PubMed, Scopus, EbscoHost, Google Scholar, and Epistemonikos were used to identify literature regarding the relationship between vitamin D and DNA damage. Assessment of study quality was carried out by three independent reviewers individually. A total of 25 studies were assessed as eligible and included in our study. Twelve studies were conducted in humans consisting of two studies with experimental design and ten studies with observational pattern. Meanwhile, thirteen studies were conducted in animals (in vivo). It is found that the majority of studies demonstrated that vitamin D prevents DNA damage and minimizes the impact of DNA damage that has occurred (p<0.05). However, two studies (8%) did not find such an association and one research only found a specific association in the cord blood, not in maternal blood. Vitamin D has a protective effect against DNA damage. A diet rich in vitamin D and vitamin D supplementation is recommended to prevent DNA damage.

Is T-Wave Alternans a Repolarization Abnormality Marker in COVID-19? An Investigation on the Potentialities of Portable Electrocardiogram Device.

Background: Cardiac arrhythmias are significantly associated with poor outcomes in coronavirus disease 2019 (COVID-19) patients. Microvolt T-wave alternans (TWA) can be automatically quantified and has been recognized as a representation of repolarization heterogeneity and linked to arrhythmogenesis in various cardiovascular diseases. This study aimed to explore the correlation between microvolt TWA and COVID-19 pathology. Methods: Patients suspected of COVID-19 in Mohammad Hoesin General Hospital were consecutively evaluated using Alivecor® Kardiamobile 6L™ portable electrocardiogram (ECG) device. Severe COVID-19 patients or those who are unable to cooperate in active ECG self-recording were excluded from the study. TWA was detected and its amplitude was quantified using the novel enhanced adaptive match filter (EAMF) method. Results: A total of 175 patients, 114 COVID-19 patients (polymerase chain reaction (PCR)-positive group), and 61 non-COVID-19 patients (PCR-negative group) were enrolled in the study. PCR-positive group was subdivided according to the severity of COVID-19 pathology into mild and moderate severity subgroups. Baseline TWA levels were similar between both groups during admission (42.47 ± 26.52 µV vs. 44.72 ± 38.21 µV), but higher TWA levels were observed during discharge in the PCR-positive compared to the PCR-negative group (53.45 ± 34.42 µV vs. 25.15 ± 17.64 µV, P = 0.03). The correlation between PCR-positive result in COVID-19 and TWA value was significant, after adjustment of other confounding variables (R2 = 0.081, P = 0.030). There was no significant difference in TWA levels between mild and moderate severity subgroups in patients with COVID-19, both during admission (44.29 ± 27.14 µV vs. 36.75 ± 24.46 µV, P = 0.34) and discharge (49.47 ± 33.62 µV vs. 61.09 ± 35.99 µV, P = 0.33). Conclusions: Higher TWA values can be observed on follow-up ECG obtained during discharge in the PCR-positive COVID-19 patients.

Routine laboratory tests: Potential practical parameters to detect coronavirus disease-2019 in resource-limited settings.

INTRODUCTION: The diagnosis of Coronavirus Disease-2019 (COVID-19), an ongoing global pandemic with more than 3 million cases worldwide both in developed and developing countries, requires molecular or serological tests that are not available in some settings. This systematic review provides further evidence to assess the diagnostic accuracy of routine laboratory tests to detect COVID-19 in suspected COVID-19 patients in resource-limited point of care and mobile laboratory. METHODOLOGY: Comprehensive and systematic literature search in electronic databases (PubMed, Cochrane, and Online Wiley Library) was conducted to retrieve studies published between December 2019 and April 2020 reporting the diagnostic value of routine laboratory tests in the diagnosis of COVID-19. The quality of each study was assessed using QUADAS2. Literature search and study selection were depicted in PRISMA 2009 Flow Diagram. RESULTS: Three studies were included in this review. Two studies reported poor accuracy (AUC 0.075 and 0.624) of lymphopenia to detect COVID-19. One study reports good accuracy (AUC 0.858) of neutrophilia to detect COVID-19 amongst suspected cases. One multi-gated cross-sectional study reports poor discriminatory ability (AUC 0.65) of neutrophilia to discriminate between COVID-19 and CAP. Because of its big variability between patients and poor diagnostic accuracy (AUC 0.112 and 0.624), leukocyte count should not be a single parameter to determine COVID-19 patient status. CONCLUSIONS: Neutrophil percentage might be helpful to determine COVID-19 status for suspected patients at the primary point of care or even in a mobile laboratory for countries with limited resources, but further study is needed to support this statement.

A systematic review on neutrophil extracellular traps and its prognostication role in COVID-19 patients.

Neutrophil extracellular traps (NETs) are extracellular webs composed of neutrophil granular and nuclear elements. Because of the potentially dangerous amplification circuit between inflammation and tissue damage, NETs are becoming one of the investigated components in the current Coronavirus Disease 2019 (COVID-19) pandemic. The purpose of this systematic review is to summarize studies on the role of NETs in determining the prognosis of COVID-19 patients. The study used six databases: PubMed, Science Direct, EBSCOHost, Europe PMC, ProQuest, and Scopus. This literature search was implemented until October 31, 2021. The search terms were determined specifically for each databases, generally included the Neutrophil Extracellular Traps, COVID-19, and prognosis. The Newcastle Ottawa Scale (NOS) was then used to assess the risk of bias. Ten studies with a total of 810 participants were chosen based on the attainment of the prerequisite. Two were of high quality, seven were of moderate quality, and the rest were of low quality. The majority of studies compared COVID-19 to healthy control. Thrombosis was observed in three studies, while four studies recorded the need for mechanical ventilation. In COVID-19 patients, the early NETs concentration or the evolving NETs degradations can predict patient mortality. Based on their interactions with inflammatory and organ dysfunction markers, it is concluded that NETs play a significant role in navigating the severity of COVID-19 patients and thus impacting their prognosis.