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PubMed2000

Detecting cervical infection among family planning clients: difficulties at the primary health-care level in Indonesia.

In developing and testing an operational model for the integration of reproductive tract infection/sexually transmitted disease (RTI/STD) management into existing family planning (FP) services in Indonesia, this study allowed for assessment of disease prevalence and evaluation of diagnostic methods for detection of endocervicitis caused by chlamydial infection and/or gonorrhoea. Data were collected over 28 weeks in 1997 at 2 FP clinics in the low-income harbour neighbourhood of North Jakarta. Among 486 consenting female FP clients, prevalence of chlamydial infection was 9.3%, gonorrhoea 1.2%, trichomoniasis 4.5% and syphilis 0.8%. Clinically observed abnormal vaginal discharge, cervical inflammation and vaginal lesions/ulcers were all associated with cervical infection (P<0.05), but insufficiently sensitive (<60%). Clinical diagnosis for cervical infection had 48.8% sensitivity, 75.4% specificity, but only 18.3% positive predictive value (PPV). On-site Gram stains for gonorrhoea were 83.3% sensitive and 94.5% specific, but had only 16.1% PPV. Presence of mucopurulent cervicitis was only 39.6% sensitive for cervical STD, with PPV of only 16.3%. Development of an affordable and accurate detection tool for chlamydial infection remains the main obstacle to effective RTI/STD management in this population.

Adult↗
PubMed2000

Determinants of condom use in female sex workers in Surabaya, Indonesia.

In the developing world condom use among sex workers and their clients plays a dominant role in the transmission of HIV/STD. In Surabaya, Indonesia, data from the 1993 STD prevalence survey in female sex workers (brothels, street, massage parlours, barber shops, call-girl houses, and nightclubs) reveal that only 5% (33/692) of the brothel workers and 14% (25/177) of the street walkers had condoms in their possession at the time of the interview. During the last paid sexual intercourse, sex workers from the brothels, streets, and nightclubs used condoms infrequently (14%, 20%, and 25%, respectively). Sex workers from massage parlours, barber shops, and call girls were about 5 to 3 times more likely to use condoms than sex workers from nightclubs (adjusted odds ratio of 3.5, 4.9, and 4.2, respectively); thus condom promotion programmes should be targeted at sex workers at brothels, streets, and nightclubs. Programmes should include: (1) free distribution of condoms to sex establishments at the initial stage, and condom social marketing at later stages; (2) penalties, including legal sanctions, against any sex establishments that do not consistently use condoms; (3) participation of brothel owners and madams in encouraging sex workers to consistently have clients use condoms during sexual intercourse; and (4) establishment of sentinel surveillance to monitor STD/HIV and condom-use compliance.

Adolescent↗
PubMed1998

Risk profile of female sex workers who participate in a routine penicillin prophylaxis programme in Surabaya, Indonesia.

We conducted a sexually transmitted disease (STD) prevalence survey of 1867 female sex workers in Surabaya, Indonesia, some of whom reported participation in a routine penicillin prophylaxis programme. In Surabaya, 34% of female sex workers had received a prophylactic penicillin injection programme from the government within 28 days. Sex workers who had received routine prophylaxis injection were more likely to be less educated, to work in brothel complexes, and to have more customers per week than other sex workers. The prevalence rates of syphilis, gonorrhoea, chlamydia, and trichomoniasis were higher among sex workers who received the routine penicillin treatment than among those who had not received antibiotic treatment in the last 28 days. However, after adjustment for age, education, fee per sex act, number of customers, and condom use in the previous 7 days, only trichomoniasis was still significantly different (adjusted odds ratio of 3.2). High-risk women were more likely to participate in the routine penicillin prophylaxis programme. The lack of a demonstrable individual-level protection from this prophylaxis treatment programme in this cross-sectional study appears due to differential uptake of penicillin prophylaxis by women at higher presumptive risk for STD. Randomized clinical trials and mathematical modelling, together with observational data such as presented here, all can contribute to optimal understanding of a complex intervention like mass chemoprophylaxis for STD among female sex workers.

Adult↗
PubMed2001

Measuring women's psychological well-being in Indonesia.

This paper describes the development of a set of measures of women's psychological well-being in Indonesia, identifies meaningful clusters of women based on the well-being measures, and explores the sociodemographic factors associated with these well-being clusters. This is the first published study to measure psychological well-being among a large sample of Indonesians and the first to focus on women in that country. Rather than use standard measures of psychological well-being developed in Western nations and untested among Asian women, focus groups were conducted to develop an understanding of Indonesian women's perceptions of their own well-being. The focus group findings were used to develop 41 questionnaire items to measure psychological well-being, and the questionnaire was administered to 796 women in Sumatra and Lampung. Factor analysis reduced the well-being variables into five factors accounting for 45% of the total variance: (1) general negative feelings; (2) satisfaction with relationships and ability to control fertility; (3) satisfaction with economic, family and personal conditions; (4) negative feelings regarding marital and domestic issues; and (5) ability to pursue activities outside the home. We constructed five scales based on these factors. Based on their scores on these scales, women grouped into three clusters differentiated by their scores on four of the five scales. Low levels of psychological well-being were associated in bivariate analyses with: (1) rural residence; (2) young age (under age 30); (3) marriage before age 20; (4) low socioeconomic status; and (5) lower educational attainment.

Adult↗
PubMed2006

Mass fatality management following the South Asian tsunami disaster: case studies in Thailand, Indonesia, and Sri Lanka.

BACKGROUND: Following natural disasters, mismanagement of the dead has consequences for the psychological well-being of survivors. However, no technical guidelines currently exist for managing mass fatalities following large natural disasters. Existing methods of mass fatality management are not directly transferable as they are designed for transport accidents and acts of terrorism. Furthermore, no information is currently available about post-disaster management of the dead following previous large natural disasters. METHODS AND FINDINGS: After the tsunami disaster on 26 December 2004, we conducted three descriptive case studies to systematically document how the dead were managed in Thailand, Indonesia, and Sri Lanka. We considered the following parameters: body recovery and storage, identification, disposal of human remains, and health risks from dead bodies. We used participant observations as members of post-tsunami response teams, conducted semi-structured interviews with key informants, and collected information from published and unpublished documents. Refrigeration for preserving human remains was not available soon enough after the disaster, necessitating the use of other methods such as dry ice or temporary burial. No country had sufficient forensic capacity to identify thousands of victims. Rapid decomposition made visual identification almost impossible after 24-48 h. In Thailand, most forensic identification was made using dental and fingerprint data. Few victims were identified from DNA. Lack of national or local mass fatality plans further limited the quality and timeliness of response, a problem which was exacerbated by the absence of practical field guidelines or an international agency providing technical support. CONCLUSIONS: Emergency response should not add to the distress of affected communities by inappropriately disposing of the victims. The rights of survivors to see their dead treated with dignity and respect requires practical guidelines and technical support. Mass fatality management following natural disasters needs to be informed by further field research and supported by a network of regional and international forensic institutes and agencies.

Disaster Planning↗
PubMed2026

Hepatitis B virus genome mutations in precore and basal core promoter regions among HBeAg-negative chronic hepatitis B patients with high viral load in Indonesia.

Hepatitis B e antigen (HBeAg) is widely used as a marker for active HBV replication and serves as a surrogate for HBV DNA&#x2009;>&#x2009;200,000 IU/mL to determine eligibility for tenofovir disoproxil fumarate (TDF) prophylaxis to prevent vertical transmission, according to WHO guidelines. However, some HBeAg-negative patients still harbor high viral loads. Mutations in the precore (PC) and basal core promoter (BCP) regions may reduce or abolish HBeAg expression without necessarily suppressing viral replication. Next-generation sequencing (NGS)-based characterization of these mutations remains limited in Indonesia. This study aimed to analyze the mutation prevalence in the BCP and PC regions associated with HBeAg negativity in Indonesian patients. We conducted a cross-sectional study of 32 chronic HBV treatment-na&#xef;ve, unvaccinated patients with HBV DNA&#x2009;>&#x2009;200,000 IU/mL (16 HBeAg-negative, 16 HBeAg-positive) at Cipto Mangunkusumo General Hospital. BCP and PC mutations were analyzed using NGS, classifying mutations as major (mutation frequency index [MFI] &#x2265;20%) or minor (MFI 1-&#x2009;<&#x2009;20%). Associations were analyzed using the Chi-square or Fisher's exact test and p-values were adjusted using the Benjamini-Hochberg procedure. Among 29 major mutation sites, PC mutations A1846T/C and G1896A were more frequent in HBeAg-negative than HBeAg-positive patients (81.3% vs 6.3% and 75.0% vs 12.5%, respectively; all adjusted p&#x2009;=&#x2009;0.019). Combined analysis showed higher mutation frequencies in HBeAg-negative patients (93.8%, 81.3%, and 62.5% for A1846T/C, G1896A, and G1899A, respectively; all adjusted p&#x2009;=&#x2009;0.015). In conclusion, HBeAg-negative patients with high viral loads are strongly associated with PC mutations, particularly G1896A, A1846T/C, and G1899A. These exploratory findings provide regional NGS-based molecular evidence that established PC mutations may contribute to the coexistence of HBeAg negativity and continued high-level HBV replication in Indonesian patients. Larger studies incorporating broader virological and clinical comparison groups are required to determine the clinical significance of these findings.

Humans↗
PubMed1994

Cleft palate rehabilitation: interim strategies in Indonesia.

The following is a discussion of the formidable obstacles to cleft palate rehabilitation in Indonesia, including frequent feeding deaths, lack of timely surgery, lack of speech therapists, and lack of follow-up opportunities. It describes the work of a remarkable group of Indonesian professionals who, along with a few interested Western associates, are searching for ways to provide treatment and care for needy patients with cleft lip and palate. It details the various strategies being attempted to overcome some of these obstacles.

Articulation Disorders↗
PubMed1989

A recent increase of breastfeeding duration in Jakarta, Indonesia.

Comparison of breastfeeding practices from two similar surveys conducted in Jakarta, Indonesia shows an increase in breastfeeding duration from 14.4 months in 1976 to 19.8 months in 1983. This increase was predominantly among noneducated women (20.3 months among noneducated women versus 0.9 months among women with greater than elementary education). Among working women breastfeeding duration declined slightly (1.1 months). Unlike industrialized countries where increases in breastfeeding have occurred initially among the higher socioeconomic groups, recent increases in Jakarta have occurred initially among the lower socioeconomic groups. If breastfeeding practices among working or better educated women who delivered mostly in hospitals or clinics are to be improved, the breastfeeding promotion programs should be targeted to these groups.

Adult↗
PubMed2004

Desiccation tolerance of the tardigrade Milnesium tardigradum collected in Sapporo, Japan, and Bogor, Indonesia.

A tardigrade Milnesium tardigradum showed anhydrobiotic capacity, in which the desiccation tolerance, given by the mean survival rate under desiccation at different relative humidity levels, was significantly higher in the Sapporo (Japan) population than that in the Bogor (Indonesia) population. Accordingly, the surviving tardigrades took a significantly longer time for revival in Bogor than those in Sapporo. The higher tolerance of the Sapporo population is thought to be related to the low relative humidity and low temperature such that the animals experience 41% RH in May and often -10 degrees C or lower in winter.

Adaptation, Physiological↗
PubMed1996

A comparative study of color preferences in Japan, China and Indonesia, with emphasis on the preference for white.

To measure and compare the main color-preference tendencies in Japan, China, and Indonesia, 490 subjects (175 Japanese, 158 Chinese, and 157 Indonesian) were asked to choose from a color chart the three colors they liked most and the three they liked least and to state the reasons for their choices. Analysis of the choices by correspondence analysis showed that each area (country) shows tendencies for unique color preference and that there are statistically significant differences in the frequency of selection of colors of certain hues and tones. However, a high preference for white was common to all areas, along with preferences for some other colors. The successive studies done by the author have shown a common strong preference for white in other Asian areas as well. The reasons given for the choices suggested that associative images based on environmental and cultural aspects may be important influences on color preference.

Adult↗
PubMed2006

Preventable risk factors for noncommunicable diseases in rural Indonesia: prevalence study using WHO STEPS approach.

OBJECTIVE: To gain a better understanding of the health transition in Indonesia, we sought to describe the prevalence and distribution of risk factors for noncommunicable diseases and to identify the risk-factor burden among a rural population and an urban population. METHODS: Using the protocol of the WHO STEPwise approach to Surveillance (STEPS), risk factors for noncommunicable diseases were determined for 1502 men and 1461 women aged 15-74 years at the Purworejo Demographic Surveillance Site in 2001. FINDINGS: Smoking prevalence was high among men (913/1539; weighted percentage=53.9.%) in both rural and urban populations; it was almost non-existent among women. A higher proportion of the urban population and the richest quintile of the rural population had high blood pressure and were classified as being overweight or obese when compared with the poorest quintile of the rural population. Those classified as being in the richest quintile who lived in the rural area were 1.5 times more likely to have raised blood pressure and 8 times more likely to be overweight than those classified as being in the poorest quintile and living in the rural area. Clustering of risk factors was higher among those classified as being in the richest quintile of those living in the rural area compared with those classified as being in the poorest quintile; and the risks of clustering were just 20-30% lower compared with the urban population. CONCLUSION: Both the rural and urban populations in Purworejo face an unequally distributed burden of risk factors for noncommunicable diseases. The burden among the most well-off group in the rural area has already reached a level similar to that found in the urban area. The implementation of the WHO STEPS approach was feasible, and it provides a comprehensive picture of the burden of risk factors, allowing appropriate health interventions to be implemented to address health inequities.

Adolescent↗
PubMed2006

Total approach is a must for small and medium enterprises to attain sustainable working conditions and environment, with special reference to Bali, Indonesia.

Attention and assistance to enhance the role of small and medium scale enterprises (SMEs) by the government is more emphasized due to the success of SMEs in earning significant amount of foreign currency when Indonesia had to face economical crisis in 1997. This policy has been highly recognized again since the bombing tragedy in 2002; with the excellent evidence to show how important SMEs is in helping and maintaining the economic development of Bali. But in the implementation the assistance needs to be remanaged again in a more proper and appropriate way to attain the ultimate goals. The three economic potentials, agriculture in broad sense, tourism and SMEs (cottage industry included), must be developed in harmony, interdependence, support and complementary each other, if possible as synergist to obtain sustainable development of Bali. While assistance to SMEs must be done in a more coordinated way among the government technical offices, universities, NGOs, banking, and other social community institutions. By doing so, there would be no duplication or gap, nor creation of new disadvantageous problems. It could be in form of ergonomics, occupational health and safety impacts and problems in particular, and in adverse working conditions and environment in general. Therefore it is a must at this moment to carry out total approach in helping SMEs, by integrating the effort to improve their working conditions and environment, built-in within the effort to enhance SMEs'quality of life through economic assistance. In this process a total approach through SHIP approach and Appropriate Technology intervention must be done wisely and timely. By so doing, SMEs'sustainable working conditions and environment shall be attained.

Capital Financing↗
PubMed2006

Mesocyclops brevisetosus (Cyclopoida: Cyclopoidae) as a potential biological control agent against mosquito larvae in Indonesia.

Mesocyclops brevisetosus Dussart and Sarnita, an indigenous copepod in Indonesia, was evaluated as a potentially useful biological control agent against larval Aedes (Stegomyia). In the laboratory, female M. brevisetosus were found to readily consume mosquito larvae of species from 3 genera (Aedes aegypti, Culex quinquefaciatus, and Anopheles farauti). Mesocyclops brevisetosus preferentially fed on larvae of Ae. aegypti (mean 95% consumed), followed by Cx. quinquefasciatus (71%) and An. farauti (54%) during a 24-h period. An individual copepod consumed up to 43 1st and 2nd instars of Ae. aegypti within a 24-h period. In the field, a density of 25 adult copepods/400 ml of water in an artificial container prevented the establishment of Aedes mosquitoes by 98% compared to the control container (without copepods). A density of 50 copepods/400 ml of water completely prevented infestation with Aedes. Over a 12-wk period, evaluation of M. brevisetosus-treated ovitraps reduced Ae. aegypti by 38-100% compared to ovitraps without copepods. The introduced gravid copepods increased 2.5-6.7 times over the original cohort. Mesocyclops brevisetosus showed high fecundity in culture, with a mean of 58 nauplii produced per individual gestation cycle.

Animals↗
PubMedDate not supplied

Murine typhus in travelers returning from Indonesia.

We report the first three documented cases of murine typhus imported into Europe from Indonesia, discuss clues for the diagnosis of the disease, and urge that murine fever be considered in the diagnosis of febrile disease in travelers.

Adult↗
PubMedDate not supplied

Cyclospora cayetanensis among expatriate and indigenous populations of West Java, Indonesia.

From January 1995 through July 1998, we investigated the occurrence of Cyclospora cayetanensis infection associated with gastrointestinal illness or diarrhea in foreign residents and natives of West Java, Indonesia. We found that C. cayetanensis was the main protozoal cause of gastrointestinal illness and diarrhea in adult foreign residents during the wet season. The parasite rarely caused illness in the indigenous population or in children.

Adult↗
PubMed2002

Human exposure to herpesvirus B-seropositive macaques, Bali, Indonesia.

Herpesvirus B (Cercopithecine herpesvirus 1) has been implicated as the cause of approximately 40 cases of meningoencephalitis affecting persons in direct or indirect contact with laboratory macaques. However, the threat of herpesvirus B in nonlaboratory settings worldwide remains to be addressed. We investigated the potential for exposure to herpesvirus B in workers at a "monkey forest" (a temple that has become a tourist attraction because of its monkeys) in Bali, Indonesia. In July 2000, 105 workers at the Sangeh Monkey Forest in Central Bali were surveyed about contact with macaques (Macaca fascicularis). Nearly half of those interviewed had either been bitten or scratched by a macaque. Prevalence of injury was higher in those who fed macaques. Serum from 31 of 38 Sangeh macaques contained antibodies to herpesvirus B. We conclude that workers coming into contact with macaques at the Sangeh Monkey Forest are at risk for exposure to herpesvirus B.

Adult↗
PubMed2005

Cyclosporiasis outbreak, Indonesia.

We describe an outbreak of Cyclospora cayetanensis infection among Dutch participants at a scientific meeting in September 2001 in Bogor, Indonesia. Fifty percent of the investigated participants were positive for C. cayetanensis. To our knowledge, this outbreak is the first caused by C. cayetanensis among susceptible persons in a disease-endemic area.

Case-Control Studies↗