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1.
Hum Reprod ; 2021 Nov 06.
Artículo en Inglés | MEDLINE | ID: mdl-34741174

RESUMEN

STUDY QUESTION: Is there an association between maternal occupational exposure to endocrine-disrupting chemicals (EDCs) early in pregnancy and subgroups of congenital anomalies of kidney and urinary tract (CAKUT), and hypospadias? SUMMARY ANSWER: Exposure to specific EDCs can increase the risk of CAKUT and no association with hypospadias was observed. WHAT IS KNOWN ALREADY: Previous studies showed an association between maternal occupational exposure to EDCs and hypospadias. However, little is known about the effect of these chemicals on the development of CAKUT, especially subgroups of urinary tract anomalies. STUDY DESIGN, SIZE, DURATION: For this case-control study, cases with urogenital anomalies from the European Concerted Action on Congenital Anomalies and Twins Northern Netherlands (Eurocat NNL) registry and non-malformed controls from the Lifelines children cohort (living in the same catchment region as Eurocat NNL) born between 1997 and 2013 were selected. This study included 530 cases with CAKUT, 364 cases with hypospadias, 7 cases with both a urinary tract anomaly and hypospadias and 5602 non-malformed controls. Cases with a genetic or chromosomal anomaly were excluded, and to avoid genetic correlation, we also excluded cases in which a sibling with the same defect was included. PARTICIPANTS/MATERIALS, SETTING, METHODS: Information on maternal occupation held early in pregnancy was collected via self-administered questionnaires. Job titles were translated into occupational exposure to EDCs using a job-exposure matrix (JEM). Adjusted odds ratios (aORs) and 95% CIs were estimated to assess the association between maternal occupational exposure to EDCs (and to specific types of EDCs) and CAKUT and hypospadias. MAIN RESULTS AND THE ROLE OF CHANCE: For CAKUT and hypospadias, 23.1% and 22.9% of the cases were exposed to EDCs, respectively, whereas 19.8% of the controls were exposed. We found an association between maternal occupational exposure to organic solvents/alkylphenolic compounds and CAKUT (aOR 1.41, 95% CI 1.01-1.97) that became stronger when combinations of urinary tract anomalies co-occurred with other defects (aOR 7.51, 95% CI 2.41-23.43). An association was also observed for exposure to phthalates/benzophenones/parabens/siloxanes and CAKUT (aOR 1.56, 95% CI 1.06-2.29), specifically urinary collecting system anomalies (aOR 1.62, 95% CI 1.03-2.54) and combinations of urinary tract anomalies (aOR 2.90, 95% CI 1.09-7.71). We observed no association between EDC exposure and hypospadias. LIMITATIONS, REASONS FOR CAUTION: The different study designs of Eurocat NNL and Lifelines could have introduced differential information bias. Also, exposure misclassification could be an issue: it is possible that the actual exposure differed from the exposure estimated by the JEM. In addition, women could also have been exposed to other exposures not included in the analysis, which could have resulted in residual confounding by co-exposures. WIDER IMPLICATIONS OF THE FINDINGS: Women, their healthcare providers, and their employers need to be aware that occupational exposure to specific EDCs early in pregnancy may be associated with CAKUT in their offspring. An occupational hygienist should be consulted in order to take exposure to those specific EDCs into consideration when risk assessments are carried out at the workplace. STUDY FUNDING/COMPETING INTEREST(S): N.S. was paid by the Graduate School of Medical Sciences (MD/PhD programme), University Medical Center Groningen (UMCG), Groningen, the Netherlands. Eurocat Northern Netherlands is funded by the Dutch Ministry of Health, Welfare and Sports. The Lifelines Biobank initiative has been made possible by subsidy from the Dutch Ministry of Health, Welfare and Sport, the Dutch Ministry of Economic Affairs, the University Medical Center Groningen (UMCG the Netherlands), University Groningen and the Northern Provinces of the Netherlands. The authors report no conflict of interest. TRIAL REGISTRATION NO: N/A.

2.
BMC Public Health ; 21(1): 1548, 2021 08 13.
Artículo en Inglés | MEDLINE | ID: mdl-34388992

RESUMEN

BACKGROUND: Poor access to health care providers was among the contributing factors to less prompt and ineffective malaria treatment. This limitation could cause severe diseases in remote areas. This study examined the sub-national disparities and predictors in accessing anti-malarial drug treatment among adults in Eastern Indonesia. METHODS: The study analyzed a subset of the 2018 National Basic Health Survey conducted in all 34 provinces in Indonesia. We extracted socio-demographic data of 4655 adult respondents diagnosed with malaria in the past 12 months in five provinces in Eastern Indonesia. The association between socio-demographic factors and the access to anti-malarial drug treatment was assessed using logistic regression. RESULTS: Over 20% of respondents diagnosed with malaria within last 12 months admitted that they did not receive anti-malarial drug treatment (range 12-29.9%). The proportion of untreated cases was 12.0% in East Nusa Tenggara, 29.9% in Maluku, 23.1% in North Maluku, 12.7% in West Papua, and 15.6% in Papua. The likelihood of receiving anti-malarial drug treatment was statistically lower in Maluku (adjusted OR = 0.258; 95% CI 0.161-0.143) and North Maluku (adjusted OR = 0.473; 95% CI 0.266-0.840) than those in Eastern Nusa Tenggara (reference). Urban respondents were less likely to receive malaria treatment than rural (adjusted OR = 0.545; 95% CI 0.431-0.689). CONCLUSIONS: This study found that there were sub-national disparities in accessing anti-malarial drug treatment in Eastern Indonesia, with a high proportion of untreated malaria cases across the areas. Findings from this study could be used as baseline information to improve access to anti-malarial drug treatment and better target malaria intervention in Eastern Indonesia.


Asunto(s)
Antimaláricos , Malaria , Preparaciones Farmacéuticas , Adulto , Antimaláricos/uso terapéutico , Humanos , Indonesia/epidemiología , Malaria/tratamiento farmacológico , Malaria/epidemiología , Población Rural
3.
J Infect Public Health ; 14(10): 1320-1327, 2021 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-34175236

RESUMEN

BACKGROUND: World Health Organization has reported fifty countries have now detected the new coronavirus (B.1.1.7 variant) since a couple of months ago. In Indonesia, the B.1.1.7 cases have been found in several provinces since January 2021, although they are still in a lower number than the old variant of COVID-19. Therefore, this study aims to create a forecast analysis regarding the occasions of COVID-19 and B.1.1.7 cases based on data from the 1st January to 18th March 2021, and also analyze the association between meteorological factors with B.1.1.7 incidences in three different provinces of Indonesia such as the West Java, South Sumatra and East Kalimantan. METHODS: We used the Autoregressive Moving Average Models (ARIMA) to forecast the number of cases in the upcoming 14 days and the Spearman correlation analysis to analyze the relationship between B.1.1.7 cases and meteorological variables such as temperature, humidity, rainfall, sunshine, and wind speed. RESULTS: The results of the study showed the fitted ARIMA models forecasted there was an increase in the daily cases in three provinces. The total cases in three provinces would increase by 36% (West Java), 13.5% (South Sumatra), and 30% (East Kalimantan) as compared with actual cases until the end of 14 days later. The temperature, rainfall and sunshine factors were the main contributors for B.1.1.7 cases with each correlation coefficients; r = -0.230; p < 0.05, r = 0.211; p < 0.05 and r = -0.418; p < 0.01, respectively. CONCLUSIONS: We recapitulated that this investigation was the first preliminary study to analyze a short-term forecast regarding COVID-19 and B.1.1.7 cases as well as to determine the associated meteorological factors that become primary contributors to the virus spread.


Asunto(s)
COVID-19 , SARS-CoV-2 , Tiempo (Meteorología) , COVID-19/epidemiología , COVID-19/virología , Humanos , Humedad , Indonesia/epidemiología , Conceptos Meteorológicos
4.
PLoS Negl Trop Dis ; 14(10): e0008746, 2020 10.
Artículo en Inglés | MEDLINE | ID: mdl-33064728

RESUMEN

Leprosy is a stigmatizing, chronic infection which degenerates the nervous system and often leads to incapacitation. Multi-drug therapy which consists of dapsone, rifampicin and clofazimine has been effective to combat this disease. In Indonesia, especially in Papua Island, leprosy is still a problem. Furthermore, there had been higher reports of Dapsone Hypersensitivity Syndrome (DHS) which also challenges leprosy elimination in certain aspects. Globally, DHS has a prevalence rate of 1.4% and a fatality rate up to 13%. The aim of this study is to validate HLA-B*13:01, a previously discovered biomarker for DHS in the Chinese population, as a biomarker for DHS in the Papua population.This is a case-control study of 34 leprosy patients who presented themselves with DHS (case subjects) and 52 leprosy patients without DHS (control subjects). Patients were recruited from 2 provinces: Papua and West Papua. DNA was extracted from 3 ml blood specimens. HLA-B alleles were typed using the gold-standard sequence based typing method. Results were then analysed using logistic regression and risk assessment was carried out. The results of HLA-typing showed that HLA-B*13:01 was the most significant allele associated with DHS, with odds ratio = 233.64 and P-value = 7.11×10-9, confirming the strong association of HLA-B*13:01 to DHS in the Papua population. The sensitivity of this biomarker is 91.2% and specificity is 96.2%, with an area under the curve of 0.95. HLA-B*13:01 is validated as a biomarker for DHS in leprosy patients in Papua, Indonesia, and can potentially be a good predictor of DHS to help prevent this condition in the future.


Asunto(s)
Dapsona/efectos adversos , Hipersensibilidad a las Drogas/prevención & control , Antígeno HLA-B13/genética , Leprostáticos/efectos adversos , Lepra/tratamiento farmacológico , Adolescente , Adulto , Alelos , Biomarcadores , Estudios de Casos y Controles , Clofazimina/administración & dosificación , Dapsona/administración & dosificación , Hipersensibilidad a las Drogas/epidemiología , Quimioterapia Combinada , Femenino , Humanos , Indonesia , Leprostáticos/administración & dosificación , Modelos Logísticos , Masculino , Rifampin/administración & dosificación , Medición de Riesgo , Síndrome , Adulto Joven
5.
Nat Commun ; 11(1): 4556, 2020 09 11.
Artículo en Inglés | MEDLINE | ID: mdl-32917883

RESUMEN

Previous genetic studies have identified local population structure within the Netherlands; however their resolution is limited by use of unlinked markers and absence of external reference data. Here we apply advanced haplotype sharing methods (ChromoPainter/fineSTRUCTURE) to study fine-grained population genetic structure and demographic change across the Netherlands using genome-wide single nucleotide polymorphism data (1,626 individuals) with associated geography (1,422 individuals). We identify 40 haplotypic clusters exhibiting strong north/south variation and fine-scale differentiation within provinces. Clustering is tied to country-wide ancestry gradients from neighbouring lands and to locally restricted gene flow across major Dutch rivers. North-south structure is temporally stable, with west-east differentiation more transient, potentially influenced by migrations during the middle ages. Despite superexponential population growth, regional demographic estimates reveal population crashes contemporaneous with the Black Death. Within Dutch and international data, GWAS incorporating fine-grained haplotypic covariates are less confounded than standard methods.


Asunto(s)
Grupos Étnicos/genética , Genética de Población , Estudio de Asociación del Genoma Completo , Estudios de Casos y Controles , Análisis por Conglomerados , Emigración e Inmigración , Grupo de Ascendencia Continental Europea/genética , Flujo Génico , Variación Genética/genética , Genoma , Geografía , Haplotipos , Humanos , Persona de Mediana Edad , Modelos Genéticos , Países Bajos , Polimorfismo de Nucleótido Simple
6.
Addiction ; 115(12): 2382-2392, 2020 12.
Artículo en Inglés | MEDLINE | ID: mdl-32386096

RESUMEN

AIMS: To investigate to what extent the adoption of local smoke-free policies (SFPs) in Indonesia in 2007-13 was associated with changes in adult smoking behaviour. DESIGN: A quasi-experimental study. SETTING: Indonesia, 2007 and 2013. PARTICIPANTS: A total of 1 052 611 > 25-year-old adults. Data were derived from the 2007 and 2013 Indonesian national health survey. MEASUREMENTS: For both years, provincial and district SFPs were identified from government documents in 497 districts in 33 provinces. Multi-level logistic regression analysis assessed the association of adoption of provincial and district SFPs between 2007 and 2013 with smoking continuation (among ever-smokers), current smoking and high smoking intensity (among current smokers). We controlled for survey year, SFP in 2007, socio-demographics and district characteristics. FINDINGS: Provincial SFP exposure was associated with lower odds of smoking continuation [strong SFP versus no SFP: odds ratio (OR) = 0.71, 95% confidence interval (CI) = 0.66-0.76] and smoking intensity (strong SFP: OR= 0.91, 95% CI = 0.86-0.97), but also with higher odds of current smoking (strong SFP versus no SFP: OR = 1.08; 95% CI = 1.04-1.12). District SFP exposure was associated with higher odds of smoking continuation (strong SFP versus no SFP: OR = 1.07, 95% CI = 1.01-1.14) and current smoking (strong SFP versus no SFP: OR = 1.09, 95% CI = 1.05-1.14), but with lower odds of smoking intensity (moderately strong SFP versus no SFP: OR = 0.95, 95% CI = 0.91-0.99). CONCLUSIONS: There may be an association between the adoption of local smoke-free policies in Indonesia and decreased adult smoking intensity. However, the evidence is inconsistent, which may reflect problems with policy implementation and enforcement.


Asunto(s)
Política para Fumadores , Fumar/epidemiología , Adulto , Femenino , Conocimientos, Actitudes y Práctica en Salud , Encuestas Epidemiológicas , Humanos , Indonesia/epidemiología , Masculino , Persona de Mediana Edad
7.
PLoS One ; 15(5): e0232909, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32379812

RESUMEN

BACKGROUND: Geographical variation may likely influence the effectiveness of prevention efforts for malaria across Indonesia, in addition to factors at the individual level, household level, and contextual factors. This study aimed to describe preventive practices at individual and a household levels applied by rural communities in five provinces in eastern Indonesia and its association with the incidence of malaria among adult (≥15 years) populations. METHODS: This study analyzed a subset of data of nationally representative community-based survey 2018 Riset Kesehatan Dasar (Riskesdas). Data for socio-demographic (age, gender, education and occupation) and preventive behaviors (use of mosquito bed nets while slept, insecticide-treated mosquito nets (ITNs), mosquito repellent, mosquito electric rackets, mosquito coil/electric anti-mosquito mats, and mosquito window screen) were collected. Data were analyzed using bivariate and multivariable logistic regression model. RESULTS: Total of 56,159 respondents (n = 23,070 households) living in rural areas in Maluku (n = 8044), North Maluku (n = 7356), East Nusa Tenggara (n = 23,254), West Papua (n = 5759) and Papua (n = 11,746) were included in the study. In the multivariable models, using a bed net while slept likely reduced the odds of self-reported malaria among Maluku participants. Reduced odds ratios of self-reported malaria were identified in those participants who used ITNs (North Maluku, ENT, Papua), repellent (Maluku, West Papua, Papua), anti-mosquito racket (ENT), coil (Maluku, North Maluku, Papua) and window screen (West Papua, Papua). CONCLUSION: Our study concluded that the protective effects of preventive practices were varied among localities, suggesting the need for specific intervention programs.


Asunto(s)
Malaria/prevención & control , Control de Mosquitos/métodos , Adolescente , Adulto , Antimaláricos/farmacología , Estudios Transversales , Composición Familiar , Femenino , Conocimientos, Actitudes y Práctica en Salud , Humanos , Incidencia , Indonesia/epidemiología , Repelentes de Insectos , Mosquiteros Tratados con Insecticida/estadística & datos numéricos , Malaria/epidemiología , Masculino , Oportunidad Relativa , Prevalencia , Población Rural/estadística & datos numéricos , Autoinforme , Encuestas y Cuestionarios/estadística & datos numéricos
8.
Environ Int ; 140: 105603, 2020 07.
Artículo en Inglés | MEDLINE | ID: mdl-32344253

RESUMEN

BACKGROUND: Recently emerging evidence suggests an association between particulate matter less than 2.5 µm in diameter (PM2.5) exposure and diabetes risk. However, evidence from Asia is limited. Here, we evaluated the association between PM2.5 exposure and the prevalence of diabetes mellitus in one of the most populated countries in Asia, Indonesia. METHODS: We used the 2013 Indonesia Basic Health Research, which surveyed households in 487 regencies/municipalities in all 33 provinces in Indonesia (n = 647,947). We assigned individual exposure to PM2.5 using QGIS software. Multilevel logistic regression with a random intercept based on village and cubic spline analysis were used to assess the association between PM2.5 exposure and the prevalence of diabetes mellitus. We also assessed the lower exposure at which PM2.5 has potential adverse effects. RESULTS: We included 647,947 subjects with a mean age of 41.9 years in our study. Exposure to PM2.5 levels was associated with a 10-unit increase in PM2.5 (fully adjusted odds ratio: 1.09; 95% confidence interval: 1.05-1.14). The findings were consistent for quartile increases in PM2.5 levels and the cubic spline function. Even when we restricted to those exposed to PM2.5 concentrations of less than 10.0 µg/m3 in accordance with the recommended guidelines for annual exposure to PM2.5 made by the World Health Organization, the association remained elevated, especially among subjects living in the urban areas. Hence, we were unable to establish a safe threshold for PM2.5 and the risk of diabetes. CONCLUSIONS: Our findings suggest a positive association between PM2.5 exposure and prevalence of diabetes mellitus, which is possibly below the current recommended guidelines. Further studies are needed to ascertain the causal association of this finding.


Asunto(s)
Contaminantes Atmosféricos , Contaminación del Aire , Diabetes Mellitus , Adulto , Contaminantes Atmosféricos/análisis , Contaminación del Aire/análisis , Asia , Diabetes Mellitus/epidemiología , Exposición a Riesgos Ambientales/efectos adversos , Exposición a Riesgos Ambientales/análisis , Humanos , Indonesia/epidemiología , Material Particulado/efectos adversos , Material Particulado/análisis , Prevalencia
9.
Tohoku J Exp Med ; 250(2): 95-108, 2020 02.
Artículo en Inglés | MEDLINE | ID: mdl-32074515

RESUMEN

In developed countries, the relationship between education level, wealth, and healthy aging have been found to be mediated by modifiable risk factors, such as obesity, physical activities, and smoking status. The present study was to investigate the association between education level, monthly per-capita expenditure (PCE), and healthy aging in the older Indonesian population, and to clarify modifiable risk factors that mediate this association. A 7-year prospective longitudinal study (2007-2014) was conducted on 696 older Indonesian individuals (≥ 50 years) living in 13 different provinces in Indonesia during the survey periods. Data on educational level, PCE, and modifiable risk factors were collected in 2007. Information on healthy aging was obtained in both 2007 and 2014. A multivariate-adjusted logistic regression model was used to estimate the odds ratio (ORs) and 95% confidence intervals (CIs) for healthy aging by education level and PCE. The mediating effects were estimated using a four-way effect decomposition. Out of 696 eligible subjects, 206 (29.6%) were judged as healthy aging in 2014. The OR (95% CI) for healthy aging for participants with a higher education level was 1.81 (1.23-2.65) compared with those with a lower education level, and no significant association was observed between PCE and healthy aging. An association was thus observed between education level and healthy aging, but not PCE. Importantly, the association between education level, PCE, and healthy aging does not appear to be mediated by the modifiable risk factors. Priorities in making health policy would be different between developed countries and developing countries.


Asunto(s)
Escolaridad , Gastos en Salud , Envejecimiento Saludable/fisiología , Encuestas y Cuestionarios , Anciano , Familia , Femenino , Humanos , Indonesia/epidemiología , Masculino , Persona de Mediana Edad , Factores de Riesgo
10.
Int J Drug Policy ; 71: 93-102, 2019 09.
Artículo en Inglés | MEDLINE | ID: mdl-31254728

RESUMEN

BACKGROUND: Even though Indonesia has not ratified the Framework Convention on Tobacco Control (FCTC), district and provincial stakeholders are increasingly adopting smoke-free policies (SFPs). This study aimed to 1) assess whether local SFP adoption in Indonesia followed a horizontal or vertical diffusion pattern and 2) identify district characteristics that are associated with the SFP adoption. METHODS: Policy documents enacted during 2004-2015 were compiled from 33 provinces and 510 districts in Indonesia. First, we described the geographical distributions of the policy adoption. Second, we ran logistic regression to assess the associations of district SFP adoption with having adjacent districts that had adopted SFPs (i.e. horizontal diffusion) and being situated in a province that had adopted SFPs (i.e. vertical diffusion). Third, the associations between district characteristics (population density, GDP, tobacco production) and SFP adoption were assessed using logistic regression. RESULTS: By 2015, a total of 17 provinces and 143 districts had adopted SFPs. Districts with SFPs were more concentrated in the western part of Indonesia. Adoption was more likely in districts of which adjacent districts had already adopted SFPs (OR: 2.02; 95%CI: 1.26-3.23), and less likely when the province had already adopted SFPs (OR: 0.19; 95%CI: 0.11 - 0.34). Adoption was more likely in districts with higher GDP (OR high vs low GDP: 3.28; 95%CI: 1.80-5.98) and higher population density (OR high vs low density: 6.57; 95%CI: 3.63-11.9). High tobacco production showed a strong inverse association with SPF adoption (OR high vs. no production: 0.36; 95%CI: 0.17-0.74). CONCLUSIONS: Smoke-free policy adoption in Indonesian districts followed a horizontal diffusion pattern, with poorer and rural districts lagging behind in their policy adoption. Our results indicate that local-level policy development is important for smoke-free policy adoption in countries with decentralised governments, but that effective advocacy is needed to counteract tobacco industry interference.


Asunto(s)
Regulación Gubernamental , Política para Fumadores/tendencias , Industria del Tabaco/legislación & jurisprudencia , Humanos , Indonesia
11.
BMC Pediatr ; 19(1): 212, 2019 06 28.
Artículo en Inglés | MEDLINE | ID: mdl-31253110

RESUMEN

OBJECTIVE: It has been established that genetic factors play a substantial role in the development of neonatal hyperbilirubinemia. The population of Indonesia and other Southeast Asian countries has similar, yet different genetic makeup compared to the rest of Asia. Aside from UGT1A1, variants of SLCO1B1 have also been known to contribute to the severity of neonatal hyperbilirubinemia in Asian populations. Since there has been no report on SLCO1B1 polymorphism in relation with hyperbilirubinemia in Indonesia, this study aims to explore incidence of SLCO1B1*1B polymorphism in Indonesia based on 3 hospitals from different provinces and population, and their association with hyperbilirubinemia severity. METHODS: Our study included 88 neonates with mild and moderate-severe hyperbilirubinemia from 3 NICU in hospitals representing homogenous and heterogenous populations: Biak General Hospital Papua, Cipto Mangunkusumo Hospital (Jakarta), and M Yunus Hospital (Bengkulu). We collected samples between November 2016 and September 2017. DNA was obtained from existing samples of the patients from previous studies and were subjected to Polymerase Chain Reaction - Restriction Fragment Length Polymorphism (PCR-RFLP). We analyzed the *1B variant located in exon 5 of SLCO1B1 with TaqI restriction endonuclease. Clinical, demographic, and laboratory data was also collected from medical records and parents' interviews. RESULTS: The most dominant variant of SLCO1B1*1B in our population is the homozygous G/G (68.18%), followed by heterozygous A/G (26.14%), and wild type A/A (5.68%). The heterozygous A/G had an Odds Ratio (OR) of 0.73 (95% CI 0.10-5.2) and homozygous G/G with OR of 0.51 (95%CI 0.08-3.27), both were not significant. Genotypic distribution across the different centers were also similar and not significant. The significant risk factors for moderate-severe hyperbilirubinemia were the population the neonate originated from (p = < 0.001) and the delivery location (p = 0.001), while SLCO1B1*1B was not associated with the different severity of hyperbilirubinemia. CONCLUSIONS: SLCO1B1*1B is not associated with higher bilirubin levels among neonates with hyperbilirubinemia in Indonesia. Further study is needed to find other potentially important genetic polymorphisms in the development of severe hyperbilirubinemia in Indonesia.


Asunto(s)
Hiperbilirrubinemia Neonatal/genética , Transportador 1 de Anión Orgánico Específico del Hígado/genética , Polimorfismo de Longitud del Fragmento de Restricción , Bilirrubina/sangre , Estudios Transversales , Femenino , Heterocigoto , Homocigoto , Humanos , Hiperbilirrubinemia Neonatal/sangre , Incidencia , Indonesia , Recién Nacido , Masculino , Oportunidad Relativa , Factores de Riesgo , Índice de Severidad de la Enfermedad
12.
Acta Med Indones ; 50(2): 96-103, 2018 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-29950527

RESUMEN

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.


Asunto(s)
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/epidemiología
13.
Br J Nutr ; 120(2): 198-203, 2018 07.
Artículo en Inglés | MEDLINE | ID: mdl-29720288

RESUMEN

The current measures of cognitive functioning in adulthood do not indicate a long-term association with prenatal exposure to the Dutch famine. However, whether such association emerges in China is poorly understood. We aimed to investigate the potential effect of prenatal exposure to the 1959-1961 Chinese famine on adult cognitive impairment. We obtained data from the Second National Sample Survey on Disability implemented in thirty-one provinces in 2006, and restricted our analysis to 387 093 individuals born in 1956-1965. Cognitive impairment was defined as intelligence quotient (IQ) score under 70 and IQ of adults was evaluated by the Wechsler Adult Intelligence Scale - China Revision. Famine severity was defined as excess death rate. The famine impact on adult cognitive impairment was estimated by difference-in-difference models, established by examining the variations of famine exposure across birth cohorts. Results show that compared with adults born in 1956-1958, those who were exposed to Chinese famine during gestation (born in 1959-1961) were at greater risk of cognitive impairment in the total sample. Stratified analyses showed that this effect was evident in males and females, but only in rural, not in urban areas. In conclusion, prenatal exposure to famine had an enduring deleterious effect on risk of cognitive impairment in rural adults.


Asunto(s)
Disfunción Cognitiva/diagnóstico , Trastornos Nutricionales , Complicaciones del Embarazo , Efectos Tardíos de la Exposición Prenatal , Inanición , Adulto , Grupo de Ascendencia Continental Asiática , China/epidemiología , Disfunción Cognitiva/complicaciones , Estudios de Cohortes , Personas con Discapacidad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Países Bajos , Parto , Embarazo , Atención Prenatal , Prevalencia , Población Rural , Población Urbana
14.
BMC Health Serv Res ; 17(1): 105, 2017 02 02.
Artículo en Inglés | MEDLINE | ID: mdl-28148258

RESUMEN

BACKGROUND: The growing momentum for quality and affordable health care for all has given rise to the recent global universal health coverage (UHC) movement. As part of Indonesia's strategy to achieve the goal of UHC, large investments have been made to increase health access for the poor, resulting in the implementation of various health insurance schemes targeted towards the poor and near-poor, including the Jamkesmas program. In the backdrop of Indonesia's aspiration to reach UHC is the high rate of maternal mortality that disproportionally affects poor women. The objective of this study was to evaluate the association of health facility and skilled birth deliveries among poor women with and without Jamkesmas and explore perceived barriers to health insurance membership and maternal health service utilization. METHODS: We used a mixed-methods design. Utilizing data from the 2012 Indonesian Demographic and Health Survey (n = 45,607), secondary analysis using propensity score matching was performed on key outcomes of interest: health facility delivery (HFD) and skilled birth delivery (SBD). In-depth interviews (n = 51) were conducted in the provinces of Jakarta and Banten among poor women, midwives, and government representatives. Thematic framework analysis was performed on qualitative data to explore perceived barriers. RESULTS: In 2012, 63.0% of women did not have health insurance; 19.1% had Jamkesmas. Poor women with Jamkesmas were 19% (OR = 1.19 [1.03-1.37]) more likely to have HFD and 17% (OR = 1.17 [1.01-1.35]) more likely to have SBD compared to poor women without insurance. Qualitative interviews highlighted key issues, including: lack of proper documentation for health insurance registration; the preference of pregnant women to deliver in their parents' village; the use of traditional birth attendants; distance to health facilities; shortage of qualified health providers; overcrowded health facilities; and lack of health facility accreditation. CONCLUSIONS: Poor women with Jamkesmas membership had a modest increase in HFD and SBD. These findings are consistent with economic theory that health insurance coverage can reduce financial barriers to care and increase service uptake. However, factors such as socio-cultural beliefs, accessibility, and quality of care are important elements that need to be addressed as part of the national UHC agenda to improve maternal health services in Indonesia.


Asunto(s)
Accesibilidad a los Servicios de Salud/economía , Seguro de Salud/estadística & datos numéricos , Servicios de Salud Materna/estadística & datos numéricos , Pobreza/estadística & datos numéricos , Adolescente , Adulto , Parto Obstétrico/economía , Parto Obstétrico/estadística & datos numéricos , Femenino , Humanos , Indonesia , Seguro de Salud/economía , Servicios de Salud Materna/economía , Mortalidad Materna , Persona de Mediana Edad , Partería/estadística & datos numéricos , Pobreza/economía , Embarazo , Cobertura Universal del Seguro de Salud/economía , Cobertura Universal del Seguro de Salud/estadística & datos numéricos , Adulto Joven
15.
Artículo en Inglés | MEDLINE | ID: mdl-27598178

RESUMEN

Handwashing with soap is recognized as a cost-effective intervention to reduce morbidity and mortality associated with enteric and respiratory infections. This study analyzes rural Indonesian households' hygiene behaviors and attitudes to examine how motivations for handwashing, locations of handwashing space in the household, and handwashing moments are associated with handwashing with soap as potential determinants of the behavior. The analysis was conducted using results from a UNICEF cross-sectional study of 1700 households in six districts across three provinces of Indonesia. A composite measure of handwashing with soap was developed that included self-reported handwashing, a handwashing demonstration, and observed handwashing materials and location of facilities in the home. Prevalence ratios were calculated to analyze associations between handwashing with soap and hypothesized determinants of the behavior. Our results showed that determinants that had a significant association with handwashing with soap included: (1) a desire to smell nice; (2) interpersonal influences; (3) the presence of handwashing places within 10 paces of the kitchen and the toilet; and (4) key handwashing moments when hands felt dirty, including after eating and after cleaning child stools. This study concludes that handwashing with soap may be more effectively promoted through the use of non-health messages.


Asunto(s)
Infecciones Bacterianas/epidemiología , Infecciones Bacterianas/prevención & control , Higiene de las Manos/estadística & datos numéricos , Educación en Salud/métodos , Jabones , Adolescente , Adulto , Infecciones Bacterianas/microbiología , Análisis Costo-Beneficio , Estudios Transversales , Composición Familiar , Femenino , Desinfección de las Manos/economía , Desinfección de las Manos/métodos , Higiene de las Manos/economía , Conocimientos, Actitudes y Práctica en Salud , Humanos , Indonesia/epidemiología , Masculino , Persona de Mediana Edad , Motivación , Prevalencia , Población Rural , Adulto Joven
16.
BMC Public Health ; 16: 631, 2016 07 22.
Artículo en Inglés | MEDLINE | ID: mdl-27449022

RESUMEN

BACKGROUND: A large international literature has found a positive association between social capital and measures of physical and mental health. However, there is a paucity of research on the links between social capital and healthy ageing in a developing country environment, where universal social security coverage is absent and health infrastructure is poor. METHOD: In this paper, we develop and empirically test a model of the linkages between social capital and the health outcomes for older adults in Indonesia, using data from the Indonesian Family Life Survey-East (IFLS-East), conducted in 2012. Using multivariate regression analysis, we examine whether social capital plays a role in mitigating poor health among older individuals aged 50 years and above in Indonesia's most vulnerable provinces. We test the robustness of these social capital variables across different health measures (self-assessed health, Activities of Daily Living (ADL), measures of chronic illness and mental health measures), as well as across different demographic groups, after controlling for an array of socio-economic, demographic and geographic characteristics. RESULTS: Our findings show that access to better social capital (using measures of neighbourhood trust and community participation) is associated with a higher degree of physical mobility, independence, and mental well-being among older individuals but has no influence on chronic illnesses. These results are consistent when we estimate samples disaggregated by gender, rural/urban residence, and by age categories. CONCLUSION: From a policy perspective these results point to the importance of social capital measures in moderating the influence of poor health, particularly in the Activities of Daily Living.


Asunto(s)
Actividades Cotidianas , Envejecimiento , Estado de Salud , Capital Social , Anciano , Anciano de 80 o más Años , Ambiente , Femenino , Servicios de Salud para Ancianos , Humanos , Indonesia , Masculino , Persona de Mediana Edad
17.
Vaccine ; 34(34): 3961-6, 2016 07 25.
Artículo en Inglés | MEDLINE | ID: mdl-27349839

RESUMEN

BACKGROUND: During the 2009/2010 season, information on adverse events after administration of seasonal and pandemic influenza vaccines was collected by different active surveys in the Netherlands. In the present paper, we compared data from a paper-based questionnaire with data from a web-based questionnaire with respect to outcomes and target population, in order to guide future influenza vaccine safety monitoring. METHODS: The paper-based survey collected data from patients who attended primary care practices in the province of Utrecht for influenza vaccination. The web-based survey recruited participants from the general population all provinces of the Netherlands. To analyze the association between study approach and the reported local and systemic adverse events, a generalized estimation equation model was applied. We adjusted for age, gender, comorbidity, previous vaccination and socio-economic status score. RESULTS: No significant differences were found between the two studies approaches in reporting local reactions (OR: 0.98, 95% CI 0.88-1.10) and systemic AEs (OR: 1.12, 95% CI 0.99-1.27). There were important differences in the age groups that responded. The elderly were more represented in the paper-based survey where participants were recruited via GPs (79%⩾60years) compared to 37% in the web-based survey where participants were recruited via internet. CONCLUSION: The paper-based survey with recruitment of participants through GPs is more representative for the target group of influenza vaccination compared to the web-based survey with recruitment of participants via internet. A web-based approach with recruitment of participants via internet seems more suitable for situations where information about adverse events on a national level is desirable. We recommend to recruit participants for a web-based survey during mass vaccinations sessions by GPs to comply with the recommendations of the European Centre for Disease Prevention Control.


Asunto(s)
Sistemas de Registro de Reacción Adversa a Medicamentos , Recolección de Datos/métodos , Vacunas contra la Influenza/efectos adversos , Encuestas y Cuestionarios , Adulto , Anciano , Femenino , Humanos , Vacunas contra la Influenza/uso terapéutico , Gripe Humana/prevención & control , Internet , Masculino , Persona de Mediana Edad , Países Bajos , Pandemias/prevención & control
18.
Parasit Vectors ; 8: 548, 2015 Oct 22.
Artículo en Inglés | MEDLINE | ID: mdl-26490878

RESUMEN

BACKGROUND: Every year more than 200,000 new leprosy cases are registered globally. This number has been fairly stable over the past 8 years. WHO has set a target to interrupt the transmission of leprosy globally by 2020. The aim of this study is to investigate whether this target, interpreted as global elimination, is feasible given the current control strategy. We focus on the three most important endemic countries, India, Brazil and Indonesia, which together account for more than 80 % of all newly registered leprosy cases. METHODS: We used the existing individual-based model SIMCOLEP to predict future trends of leprosy incidence given the current control strategy in each country. SIMCOLEP simulates the spread of M. leprae in a population that is structured in households. Current control consists of passive and active case detection, and multidrug therapy (MDT). Predictions of leprosy incidence were made for each country as well as for one high-endemic region within each country: Chhattisgarh (India), Pará State (Brazil) and Madura (Indonesia). Data for model quantification came from: National Leprosy Elimination Program (India), SINAN database (Brazil), and Netherlands Leprosy Relief (Indonesia). RESULTS: Our projections of future leprosy incidence all show a downward trend. In 2020, the country-level leprosy incidence has decreased to 6.2, 6.1 and 3.3 per 100,000 in India, Brazil and Indonesia, respectively, meeting the elimination target of less than 10 per 100,000. However, elimination may not be achieved in time for the high-endemic regions. The leprosy incidence in 2020 is predicted to be 16.2, 21.1 and 19.3 per 100,000 in Chhattisgarh, Pará and Madura, respectively, and the target may only be achieved in another 5 to 10 years. CONCLUSIONS: Our predictions show that although country-level elimination is reached by 2020, leprosy is likely to remain a problem in the high-endemic regions (i.e. states, districts and provinces with multimillion populations), which account for most of the cases in a country.


Asunto(s)
Erradicación de la Enfermedad , Transmisión de Enfermedad Infecciosa/prevención & control , Lepra/epidemiología , Lepra/prevención & control , Antibacterianos/uso terapéutico , Brasil/epidemiología , Quimioterapia Combinada/métodos , Enfermedades Endémicas , Incidencia , India/epidemiología , Indonesia/epidemiología , Modelos Teóricos , Organización Mundial de la Salud
19.
Eur J Hum Genet ; 22(2): 221-7, 2014 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-23714750

RESUMEN

Within the Netherlands a national network of biobanks has been established (Biobanking and Biomolecular Research Infrastructure-Netherlands (BBMRI-NL)) as a national node of the European BBMRI. One of the aims of BBMRI-NL is to enrich biobanks with different types of molecular and phenotype data. Here, we describe the Genome of the Netherlands (GoNL), one of the projects within BBMRI-NL. GoNL is a whole-genome-sequencing project in a representative sample consisting of 250 trio-families from all provinces in the Netherlands, which aims to characterize DNA sequence variation in the Dutch population. The parent-offspring trios include adult individuals ranging in age from 19 to 87 years (mean=53 years; SD=16 years) from birth cohorts 1910-1994. Sequencing was done on blood-derived DNA from uncultured cells and accomplished coverage was 14-15x. The family-based design represents a unique resource to assess the frequency of regional variants, accurately reconstruct haplotypes by family-based phasing, characterize short indels and complex structural variants, and establish the rate of de novo mutational events. GoNL will also serve as a reference panel for imputation in the available genome-wide association studies in Dutch and other cohorts to refine association signals and uncover population-specific variants. GoNL will create a catalog of human genetic variation in this sample that is uniquely characterized with respect to micro-geographic location and a wide range of phenotypes. The resource will be made available to the research and medical community to guide the interpretation of sequencing projects. The present paper summarizes the global characteristics of the project.


Asunto(s)
Variación Genética , Genoma Humano , Adulto , Anciano , Anciano de 80 o más Años , Bases de Datos Genéticas , Femenino , Frecuencia de los Genes , Secuenciación de Nucleótidos de Alto Rendimiento , Humanos , Masculino , Persona de Mediana Edad , Países Bajos , Filogeografía , Análisis de Secuencia de ADN , Adulto Joven
20.
J Physiother ; 59(4): 255-61, 2013 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-24287219

RESUMEN

QUESTION: What are reference values for grip strength in children and adolescents based on a large and heterogeneous study population? What is the association of grip strength with age, gender, weight, and height in this population? DESIGN: Cross-sectional study. PARTICIPANTS: Participants were recruited from schools in the northern provinces of the Netherlands. The study included healthy children and adolescents ranging in age from 4 to 15 years. OUTCOME MEASURES: All children had their height (cm) and weight (kg) measured and were allowed a total of four attempts using the Jamar hand dynamometer: twice with each hand. Grip strength scores (kg) were recorded for the dominant and non-dominant hands. RESULTS: The study population comprised 2241 children and adolescents. Reference values for both genders are provided according to age and dominance. Grip strength shows a linear and parallel progression for both genders until the age of 11 or 12, after which grip strength development shows an acceleration that is more prominent in boys. CONCLUSION: There is a significant difference in grip strength with each ascending year of age in favour of the older group, as well as a trend for boys to be stronger than girls in all age groups between 4 and 15 years. Weight and especially height have a strong association with grip strength in children.


Asunto(s)
Estatura , Peso Corporal , Fuerza de la Mano , Adolescente , Niño , Preescolar , Estudios de Cohortes , Estudios Transversales , Femenino , Humanos , Masculino , Valores de Referencia , Factores Sexuales
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