ORCID Profile
0000-0002-8374-5213
Current Organisations
CNR
,
Universitas Udayana Fakultas Kedokteran
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Proteins and Peptides | Characterisation of Biological Macromolecules | Medicinal and Biomolecular Chemistry | Biologically Active Molecules
Expanding Knowledge in the Chemical Sciences | Expanding Knowledge in the Biological Sciences |
Publisher: DiscoverSys, Inc.
Date: 12-2018
Abstract: Background and purpose: Hypertension is a major risk factor for stroke. Despite efforts to control hypertension with pharmacological and non-pharmacological therapies, the prevalence of and death from stroke is reported to be increasing. This study aims to determine the association of hypertension self-management with the incidence of stroke in patients with hypertension.Methods: A case-control study was conducted involving 44 patients suffering from hypertension and who had suffered a stroke as a case, as well as 44 patients with hypertension and no stroke as a control. Data on self-management of diet, physical activity, stress mitigation efforts, alcohol consumption, and medication adherence were collected using self administered questionnaire. Data on the diagnosis of hypertension, stroke and history of comorbidities were obtained from the patient's medical records. Multivariatee analysis using logistic regression was employed to assess the association between hypertension self-management with the incidence of stroke in patients with hypertension.Results: Characteristics of cases and controls did not differ in education, marital and socioeconomic status, but differed in age and employment. Multivariate analysis showed that there were three components of hypertension self-management associated with the incidence of stroke, namely poor adherence to medication (AOR=7.28 95%CI: 2.19-24.17), poor self-management of stress (AOR=5.45 95%CI: 1.56-18.99), and poor management of self-regulated diet (AOR=5.28 95%CI: 1.31-21.32).Conclusions: Medication adherence, diet and stress management are the three main components of self-management that are associated with stroke events among hypertension patients. Efforts to increase medication adherence, diet and stress management should be enhanced.
Publisher: DiscoverSys, Inc.
Date: 07-2017
Abstract: Background and purpose: Malaria is a public health problem in Eastern Indonesia, especially in East Nusa Tenggara. Insecticide-treated bed net was massively distributed in 2014, however the incidence of malaria in Ende District remains high. This study aims to examine association between the use of insecticide-treated bed net and malaria infection.Methods: A case control study was conducted in Wewaria Subdistrict, Ende District in 2016 involving 67 cases and 134 controls. Data on the use of insecticide-treated bed net which include methods of net use, net use practice, net maintenance and its current conditions were obtained through interviews and observations. Physical conditions of respondent’s house that include conditions of the wall, floor, window, ventilation, ceiling and lighting were also documented through observations. Data were analysed using logistic regression.Results: Cases and control groups were comparable for gender (p=1), age (p=0.9), education level (p=0.9) and occupation (p=0.6). This study found that five variables were associated with malaria infection: irregular use of the insecticide-treated bed net (AOR=4.08 95%CI: 1.87-8.89), torn net (AOR=2.23 95%CI: 1.10-4.54), inadequate lighting (AOR=3.64 95%CI: 1.77-7.47), humid floor (AOR=3.02 95%CI: 1.24-7.34) and holes or broken ceiling (AOR=2.41 95%CI: 1.02-5.72).Conclusions: The use of insecticide-treated bed net and physical conditions of the house are risk factors for malaria infection.
Publisher: JMIR Publications Inc.
Date: 13-01-2021
DOI: 10.2196/27168
Publisher: MDPI AG
Date: 05-02-2021
DOI: 10.3390/IDR13010015
Abstract: This study explores the contribution of counseling to improving acceptance of and adherence to anti-retroviral therapy (ART) among people living with HIV (PLHIV) and identifies key issues associated with its implementation. We conducted a longitudinal mixed-methods study in Bali Province between 2015 and 2017. The study participants were 170 newly diagnosed PLHIV and 17 outreach-counselor workers (OWs). We interviewed PLHIV for their experiences in receiving counseling, and acceptance of and adherence to ART. We surveyed four counseling domains (privacy, contents, frequency, and duration) and explored the key findings through in-depth interviews. In addition, 24 exit interviews and record reviews were performed. Quantitative data were analyzed descriptively, and qualitative data were analyzed thematically. Out of 170 PLHIV who received the counseling program, 139 (81.76%) accepted ART, and 52 (37.4%) discontinued ART in six months of follow up. Although counselors covered most of the content (16/17 components), the median time and frequency of counseling were insufficient. Despite a high score of HIV counseling provided to PLHIV in our study location, the overall acceptance of and adherence to ART remains fair or moderate. Our study suggests that counseling before ART initiation is inadequate for improving acceptance and adherence to ART in Bali Province. This reduced effectiveness is influenced by internal issues (interpersonal skills, limited technical capacity) and external factors both from PLHIV and society (stigma, disclosure, discrimination).
Publisher: Public Library of Science (PLoS)
Date: 31-08-2022
DOI: 10.1371/JOURNAL.PGPH.0000727
Abstract: The international tourist destination of Bali reported its first case of Coronavirus Disease 2019 or COVID-19 in March 2020. To better understand the extent of exposure of Bali’s 4.3 million inhabitants to the COVID-19 virus, we performed two repeated cross-sectional serosurveys stratified by urban and rural areas. We used a highly specific multiplex assay that detects antibodies to three different viral antigens. We also assessed demographic and social risk factors and history of symptoms. Our results show that the virus was widespread in Bali by late 2020, with 16.73% (95% CI 12.22–21.12) of the population having been infected by that time. We saw no differences in seroprevalence between urban and rural areas, possibly due to extensive population mixing, and similar levels of seroprevalence by gender and among age groups, except for lower seroprevalence in the very young. We observed no difference in seroprevalence between our two closely spaced surveys. In iduals reporting symptoms in the past six months were about twice as likely to be seropositive as those not reporting symptoms. Based upon official statistics for laboratory diagnosed cases for the six months prior to the survey, we estimate that for every reported case an additional 52 cases, at least, were undetected. Our results support the hypothesis that by late 2020 the virus was widespread in Bali, but largely undetected by surveillance.
Publisher: DiscoverSys, Inc.
Date: 12-2016
Abstract: Background and purpose: Infant mortality rate in Indonesia is still high and is largely related to low birthweight (LBW) infants. Previous studies reported the socio demographic and clinical factors as determinants of mortality of LBW infants, but rarely examined factors related to their health services. This study aimed to determine the demographic, clinical and health services as determinants of mortality of LBW infants during hospitalization.Methods: This study was a retrospective using cohort data of medical record of LBW infants in Karangasem Hospital since January 2012 to October 2014. Logistic regression was done to determine the relationship between demographic, clinical and health services factors with LBW infants’ mortality.Results: The proportion of mortality among LBW infants during hospitalization was 12.12%. Most parents (64.6%) live in good access to health services. The proportion of female infants (51.4%) was higher than male. LBW infants who were born in hospital (85.7%) greater than born outside hospital. Vaginal delivery (75.3%) was greater than C-section. Preterm infants (57.1%) was greater than at term with median of birthweight was 2100 grams. Proportion of asphyxia, respiratory distress syndrome (RDS), sepsis, hypoglycemia and hypothermia, respectively 24.1%, 4.66%, 0.78%, 7.92% and 3.73%. Variables associated with LBW mortality were increasing of 50 grams of birthweight, asphyxia, RDS and referred infants.Conclusion: The mortality of LBW infants during hospitalization was 12.12% with increasing of 50 grams of birthweight, asphyxia, RDS and referred infants found as determinant factors.
Publisher: MDPI AG
Date: 10-10-2020
DOI: 10.3390/TROPICALMED5040158
Abstract: Indonesia has not implemented HIV pre-exposure prophylaxis (PrEP) despite global calls for its scale-up, and there is limited information about attitudes towards PrEP among its potential users. We aim to present a PrEP cascade among men who have sex with men (MSM) and transgender women (known locally as “waria”) in Denpasar, Bali, from a cross-sectional survey with 220 HIV-negative MSM/waria recruited from one clinic in Denpasar. Only 16.4% of participants had heard of PrEP before. From first-to-last steps included in the cascade, we found 77.3% (170/220) of participants were classified with HIV high risk, 75.9% (129/170) perceived themselves as being at high risk, 81.4% (105/129) expressed interest in using PrEP, 78.1% (82/105) were willing to do PrEP procedures, 48.8% (40/82) were willing to pay 500,000–600,000 IDR, and only two participants had ever been on PrEP before (5.0% of those willing to pay and 0.9% of the total s le). Multivariate logistic regression analysis showed that self-perception of high HIV risk was lower among older age groups (p 0.001 among 30–39 p = 0.002 among 40) and higher among participants with multiple sex partners (p = 0.016). Interest in using PrEP was lower among participants with high social engagement as MSM/waria (p = 0.002) and was higher among participants with multiple sex partners (p = 0.020) and inconsistent condom use (p = 0.011). This study has shown a significantly low level of PrEP awareness among its participants and decreases in interest in PrEP use due to procedure and cost. It suggested that an appropriate PrEP c aign is needed if PrEP is going to be introduced in Indonesia.
Publisher: DiscoverSys, Inc.
Date: 07-2019
Abstract: Background and purpose: Pentavalent booster immunization coverage in Denpasar City is reported to be relatively low. This study aims to determine the prevalence and determinants of pentavalent immunization uptake.Methods: A cross-sectional study was conducted in one banjar (hamlet) which was selected purposively in the work area of Public Health Centre (PHC) I West Denpasar, Bali Province. Banjar was selected with consideration of the ersity of local residents and migrants. All mothers who had children aged 3-5 years (138 people) in the banjar were chosen as respondents. Interviews were conducted in each respondent's house with variables included age, education, employment, parity, region of origin, knowledge on immunization, perception of susceptibility to and severity of disease, perceptions of benefits and barriers to immunization, sources of information, family support and acceptance of immunization. Data analysis was performed with poisson regression to determine the determinants of pentavalent booster immunization.Results: The majority of respondents were aged years, high school education or above, unemployed, had 1-2 children and were from Bali. The proportion of respondents who reported that their children had been given pentavalent immunization in children aged three to five years was found to be 78.3%. Immunization prevalence was found to be higher in the population that originated from Bali (82.1%). Determinants of pentavalent immunization are perceptions of benefits (APR=4.78 95%CI: 1.35-16.96), and more sources of information (APR=1.21 95%CI: 1.04-1.41).Conclusion: The prevalence of pentavalent booster immunization is found to be lower than the average prevalence of the Bali Province but higher than the reported coverage of Denpasar City. The determinants of immunization acceptance was perception of high benefits and more sources of information. Information dissemination on the benefits of pentavalent booster immunization in children needs to be enhanced through health workers and various media to increase the coverage of pentavalent immunization.
Publisher: Wiley
Date: 15-10-2021
DOI: 10.1002/HPM.3356
Abstract: Indonesia faces a continuous threat from communicable disease outbreaks. The current COVID‐19 outbreak, the previous one of SARS, and many other infectious outbreaks encountered in the country warn of the need to develop comprehensive early warning systems to enable timely health responses in the long run. In this article, we argue that over the counter medication sales data at community pharmacies in Indonesia can potentially augment and increase the detection power of the current syndromic surveillance system, particularly in dealing with COVID‐19 and other future infectious disease outbreaks in the country. This article discusses the experience of other countries in employing pharmacy medication sales data to serve as potential syndromic surveillance platform and contribute to pandemic responses. We argue why it is worth considering utilising medication sales data from pharmacies in Indonesia to support the current surveillance system which enables the provision of early warnings of disease outbreaks. We then discuss the potential challenges of operationalising these data and suggest a way forward for the development and implementation of the syndromic surveillance system at community pharmacy settings in Indonesia. While there are several challenges in developing a workable system in Indonesia that need to be addressed, introducing a syndromic surveillance system using pharmacy‐setting medication sales data is worth investigating in the country.
Publisher: JMIR Publications Inc.
Date: 13-01-2021
Abstract: ew HIV infections in Indonesia continue to be concentrated among key populations, including female sex workers (FSWs). However, increasing HIV testing among this subpopulation remains a challenge, necessitating exploration into alternative testing modalities. his study aims to assess whether the addition of an oral fluid testing option in community settings would increase the rate of HIV case identification among FSWs. Because the study was implemented early in the outbreak of COVID-19 in Indonesia, a secondary objective is to assess approaches and tools for implementing both community outreach and community HIV screening for FSWs during pandemic conditions. e undertook a community-based randomized trial in 23 national priority districts in which community outreach services were being provided. Community-based screening using an oral fluid-based rapid test was added to the community outreach standard of care in intervention districts with clients having the option of performing the test themselves or being assisted by outreach workers. A web-based system was created to screen for eligibility and collect participant data and test results, facilitating the process for both unassisted and assisted participants. Participants with reactive screening results were encouraged to undergo HIV testing at a health facility to confirm their diagnosis and initiate antiretroviral treatment as needed. Multiple means of recruitment were deployed including through outreach workers and social media c aigns. f the 1907 FSWs who registered, met the eligibility criteria, and gave consent to participate, 1545 undertook community oral fluid test (OFT) screening. Most (1516/1545, 98.1%) opted for assisted screening. Recruitment via social media fell far short of expectations as many who registered independently for the OFT because of the social media c aign did not identify as FSWs. They were eventually not eligible to participate, but their interest points to the possibility of implementing HIV self-testing in the general population. The successful recruitment through outreach workers, facilitated by social media, indicates that their roles remain crucial in accessing FSW networks and improving HIV testing uptake. he addition of HIV self-testing to the standard of care supported by a web-based data collection system was able to increase HIV case identification among FSWs in intervention districts. The high satisfaction of OFT users and the interest of the general population toward this alternative testing modality are promising for scaling up community HIV screening nationally. linicalTrials.gov NCT04578145 t2/show/NCT04578145 R1-10.2196/27168
Publisher: Institute of Advanced Engineering and Science
Date: 09-2021
DOI: 10.11591/IJPHS.V10I3.20917
Abstract: Perceptions of people living with HIV and AIDS (PLHIV) about antiretroviral treatment (ART) is crucial for improving adherence. This study aims to examine the dynamics of perceptions during the early phase of ART. A longitudinal study involving newly diagnosed PLHIV was conducted. Interviews were carried out at the time of HIV diagnosis and at three months after ART initiation. Data were analyzed by comparing proportion of good perception across the continuum of HIV diagnosis, ART initiation and threemonths follow-up, and were tested using Chi-square. From 170 PLHIV participated in the study, 81.76% had initiated ART and 73.4% remained on ART at three-months of follow-up. Several positive perception items were significantly decreased: ability to take ART at work and ability to continue treatment if experiencing side effects, effectiveness of ART, confidentiality, unwanted disclosure, and level of support from outreach workers. Ability to follow instruction from physician was significantly increased, and negative attitudes toward ART were decreased across the continuum. Adherence to ART is a continuous process, and is influenced by the dynamics perceptions among PLHIV. Understanding these dynamics is crucial to formulate strategies that can promote and maintain positive attitudes toward ART as well as living with HIV more broadly.
Start Date: 07-2019
End Date: 12-2022
Amount: $490,000.00
Funder: Australian Research Council
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