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PubMed2003

Vitamin A capsule distribution to control vitamin A deficiency in Indonesia: effect of supplementation in pre-school children and compliance with the programme.

OBJECTIVE: The aim of this study was to evaluate the effectiveness of a widespread vitamin A supplementation programme and to describe indicators of compliance with the programme in Indonesia. DESIGN: Prospective cohort study. Children's anthropometric data were gathered at baseline (June 2000) and 4 months later (2 months after supplementation in August 2000). Serum retinol, haemoglobin, ferritin, alpha1-acid glycoprotein and C-reactive protein were measured at baseline and at follow-up. Caregivers of the children were interviewed using a questionnaire. SETTING: Semi-urban and rural areas of Semarang district, Central Java, Indonesia. SUBJECTS: Children aged 1-5 years. RESULTS: After the supplementation, the proportion of children with a low concentration of retinol decreased in recipients from 18.8 to 14.5%. However, in non-recipients, the prevalence of vitamin A deficiency increased from 31.9 to 37.5%, this prevalence being significantly higher than in recipients. A significant decrease occurred in the proportion of recipients with low ferritin (26.5 to 16.2%) and haemoglobin (25.7 to 15.3%), whereas the proportions did not show a significant change after supplementation for non-recipients. Modest linear growth was detected in recipients after supplementation but there was no effect on ponderal growth. The coverage rate of the supplementation in the study areas was 60%. There was an association between compliance of the caregivers and their knowledge about the potential benefit of vitamin A supplementation, the place where sick children were taken and age of the children. CONCLUSIONS: The vitamin A supplementation programme marginally decreased the proportion of vitamin A deficiency and had a marginal effect on the nutritional status of recipients. More than one micronutrient intervention is needed to increase the effectiveness of the supplementation programme. To increase compliance and coverage in the supplementation programme, nutrition communication and private healthcare practices need to be included in the programme.

Body Height↗
PubMed1988

Urban development patterns in Indonesia.

The author examines recent urban development in Indonesia. "Analysis of urban developments in Indonesia has been hampered in the past by weak data. Recently, the National Urban Development Strategy (NUDS) project has generated a set of improved data. This paper aims at elaborating and supplementing the NUDS study. After a discussion of definitional problems, an analysis is carried out of urban growth rates at the provincial level. Private investment is shown to be a principal determinant of urban growth rates. Other significant determinants are rural immigration and the present level of urbanisation. Private investment is shown to be strongly biased towards provinces with large urban areas. In addition, polarisation is studied at the level of individual cities. It is found that a period of rapidly increasing polarisation has come to an end during the last decade."

Asia↗
PubMed1988

Fertility trends in Indonesia, 1967-1985.

Fertility trends in Indonesia for the period 1967-1985 are analyzed. Data are from the Indonesian censuses of 1971 and 1980 and from the 1985 Intercensal Survey (SUPAS 85); they concern fertility rates by province, marital status, and for the general population. An overview of the sociocultural factors that affect data reliability and a discussion of the effectiveness of the date of last birth method are included. The authors conclude that the evidence "has confirmed the existence of a major fertility decline throughout Indonesia. The pace of the decline has been faster in 1980-85 than during the 70s. On present trends, it should be possible to reach the ambitious target of halving fertility between 1979 and 1990."

Asia↗
PubMedDate not supplied

Natural co-occurrence of aflatoxins and Fusarium mycotoxins (fumonisins, deoxynivalenol, nivalenol and zearalenone) in corn from Indonesia.

Sixteen corn samples collected from Indonesia were analysed for aflatoxins (AF), fumonisins (FM), trichothecenes and zearalenone (ZEA) using high-performance liquid chromatography and gas chromatography-mass spectrometry. AF were detected in 11 (69%) samples at a mean level of 119 ng/g (maximum 487 ng/g) and FM in all of the samples at a mean level of 895 ng/g (maximum 2970 ng/g). Deoxynivalenol (DON), nivalenol (NIV) and ZEA were each detected in two (12%) samples; 21 and 32 ng/g, 49 and 169 ng/g, and 11 and 12 ng/g, respectively. All of the AF-contaminated samples were co-contaminated with FM. Mycological study showed all of the AF-contaminated samples were infected with A. flavus/A. parasiticus, and the FM-contaminated samples were either infected with F. moniliforme (50%), F. proliferatum (12%), F. nygamai (6%) or F. decemcellulare (38%). Supportive mycological studies showed that Fusarium species isolated from Indonesian corn were capable of producing a mean level of 10,000 micrograms/g FM. Based on these results, the correlation between FM-producers and AF-producers on kernel infection and contamination of these mycotoxins in corn was discussed. This is the first report on the natural co-occurrence of AF and various Fusarium mycotoxins, including DON and NIV in corn from Indonesia, and also the first report on the natural occurrence of DON in corn from hot areas of Southeast Asia.

Aflatoxins↗
PubMed2006

HIV testing experience of drug users in Bali, Indonesia.

Recently, large increases have been noted in injection drug use and HIV prevalence among drug users in Indonesia. The objective of this study was to examine the experience of drug users with HIV testing in Bali, Indonesia. In-depth interviews were conducted with a sample of 40 drug users who had injected heroin in the Denpasar, Bali area. The users' experience with testing highlighted the importance of pre- and post-test counselling that provides clear information, confidentiality and assistance in developing social support.

Adolescent↗
PubMed1993

AIDS and STDs: risk behaviour patterns among female sex workers in Bali, Indonesia.

This study investigated AIDS and STD knowledge, risk behaviour patterns and condom use among three distinct groups of female commercial sex workers (CSWs) in Bali, Indonesia. Individual in-depth interviews were conducted with 71 female CSWs. These CSW groups differ in the prices they charge, their places and modes of employment, educational backgrounds, levels of AIDS and STD knowledge, number of clients served and levels of condom use. Knowledge of the routes of transmission and appropriate prevention practices is low among all groups, and despite significant differences in their number of clients and their condom use, all groups report high levels of STD symptoms. Although HIV seroprevalence rates are currently low in Indonesia, high risk sexual behaviour patterns place all three groups of CSWs and their clients at great risk of infection. Interventions targeted to specific groups of CSWs and clients should be undertaken as soon as possible, including educational activities utilizing peer educators, condom promotion and distribution, together with improved STD diagnosis and treatment for CSWs and their clients.

Acquired Immunodeficiency Syndrome↗
PubMed2006

The development of psychiatry in Indonesia: from colonial to modern times.

During the colonial period, mental health care policy in the Dutch East Indies was centred on the mental hospital, which provided custodial care. In 1949, independent Indonesia inherited four very large mental hospitals, about 10 acute-care clinics in the major cities, and an agricultural colony. During the 1950s, mental hospital care remained largely custodial. In 1966, the Directorate of Mental Health adopted the three-fold principles of prevention, treatment, and rehabilitation as the foundation of a comprehensive mental health care system. During the 1970s and 1980s, the number of mental hospitals in Indonesia doubled and a variety of treatment methods were introduced. Special attention was given to the care provided by dukuns, or indigenous healers.

Attitude to Health↗
PubMed2006

Mental health model of care programmes after the tsunami in Aceh, Indonesia.

Before the tsunami, there was no systematic training provided for General Practitioners (GPs) and nurses in issues related to mental health and psychosocial support in times of disasters. After the tsunami, the Department of Psychiatry, Faculty of Medicine, University of Indonesia in Jakarta was contracted to organize a special two-week intensive training programme on basic psychiatry for 13 GPs from Banda Aceh Mental Hospital. To improve the nursing practice, a Professional Nursing Practice Model (MPKP) has been piloted in two wards in Banda Aceh Mental Hospital. This is a model of best practice for nursing care and management in an open ward system developed by the School of Nursing group and implemented in several mental hospitals in Indonesia. Basic training of GPs located at the primary healthcare level is being carried out based on the existing Ministry of Health curriculum for GPs. It covers 14 conditions listed in the International Classification of Diseases (ICD) Primary Care classification and has been conducted in 11 tsunami-affected districts. Currently, a total of 169 GPs have been trained. In general, there is an increasing interest among primary care doctors in mental health. Currently, community mental healthcare is provided in 11 districts in Aceh and two districts in North Sumatra by 277 Community Mental Health Nurses (CMHN) who have received basic training. Two thousand six hundred and two cases of serious mental disorders (mostly chronic psychosis) have been detected and treated by the CMHN and the doctors in Primary Health Centres (PHC). CMHN can provide a vital link between patients in the community and doctors in PHC. Two years after the earthquake and tsunami in Aceh, psychosocial intervention should continue and mental healthcare should be made available not only at Banda Aceh Mental Hospital, but also general health services, including PHC services.

Catchment Area, Health↗
PubMed2003

Housing improvement projects in Indonesia: responding to local demand.

For more than three decades, environmental health programmes in Indonesia have emphasized prevention and treatment of the high incidence of disease among villagers. One of the main causes of disease is the unhygienic conditions of typical rural houses - two-room constructions with dirt floors and walls of lightly fired bricks or woven bamboo skins. While most houses have few or no windows, the occupants frequently cook, eat, sleep and even keep animals in a single room. The main objective of the housing improvement programme was to improve air circulation and introduce more sunlight to kill bacteria, avoid dampness and eliminate smoke from cooking. The programme encourages villagers to construct a permanent floor, enlarge existing windows or insert new windows for good ventilation. This presentation will share the 'success stories' of housing improvement projects in Indonesia that adopted demand-responsive approaches instead of the conventional 'supply approach'. Through exercises like Wealth Classification and Social Mapping, a demand-responsive approach lets the community decide who is eligible for assistance, resulting in higher participation and accurate information on community demand and on materials needed. In addition to the successes, the failures will be discussed at field level. This presentation will discuss the lessons learned from: the World Bank-funded Kalisemut Case Study; government's Family Welfare Movement; Plan International's project in Yogyakarta, and AusAID-funded Sustainable Development through Community Participation Project in Lombok.

Communicable Disease Control↗
PubMedDate not supplied

Involving husbands in safe motherhood: effects of the SUAMI SIAGA campaign in Indonesia.

Maternal death has implications for the entire family, although few, if any, interventions have addressed the role that the husband could play in his wife's pregnancy and delivery. The Suami SIAGA Campaign in Indonesia was a multi-media entertainment-education intervention, implemented in 1999/2000, that targeted husbands with messages about birth preparedness. The present paper presents the effects of this campaign (1) on the acquisition of new knowledge by husbands about birth preparedness, and (2) on husbands' action toward becoming an alert husband (a Suami SIAGA). When husbands were directly exposed to the messages from the Suami SIAGA campaign, new knowledge gain and birth preparedness activities occurred. However, the interaction of direct exposure to the campaign and the interpersonal communication stimulated by the campaign about Suami SIAGA was an even stronger predictor of knowledge gain and birth preparedness actions. Limitations of the study included post-only measures and a relatively short time period between the intervention and impact evaluation. We suggest that communication campaigns to educate husbands and to stimulate discussion about the innovative concept of birth preparedness may contribute to improved birth outcomes in Indonesia.

Adolescent↗
PubMed2001

Streptococcus pneumoniae nasopharyngeal carriage prevalence, serotype distribution, and resistance patterns among children on Lombok Island, Indonesia.

Few data exist on childhood pneumococcal carriage prevalence, serotype distribution, and resistance patterns for Indonesia, the world's fourth most populous country. During August 1997, nasopharyngeal samples were collected from a population-based, island-wide sample of 484 healthy children (age, 0-25 months) from Lombok Island, Indonesia. Two hundred twenty-one pneumococcal isolates were identified, for a carriage prevalence of 48%; 66% of isolates were of serogroup or serotype 6, 23, 15, 33, or 12. All isolates were susceptible to penicillin and cefotaxime. Twelve percent of the isolates were nonsusceptible to sulfamethoxazole or chloramphenicol and 4% were nonsusceptible to both of these drugs. Nonsusceptible organisms were most frequently serogroup or serotype 6, 12, and 33. Lombok has a moderate pneumococcal carriage prevalence and a relatively low proportion of resistant isolates. At least 3 of the 5 most common serogroups and serotypes and 2 of the 3 most common nonsusceptible serogroups and serotypes are not included in the current 7-valent pneumococcal conjugate vaccine.

Anti-Bacterial Agents↗
PubMed2002

Randomized, placebo-controlled trial of atovaquone/proguanil for the prevention of Plasmodium falciparum or Plasmodium vivax malaria among migrants to Papua, Indonesia.

The increasing prevalence of resistance to antimalarial drugs reduces options for malaria prophylaxis. Atovaquone/proguanil (Malarone; GlaxoSmithKline) has been >95% effective in preventing Plasmodium falciparum malaria in lifelong residents of areas of holoendemicity, but data from persons without clinical immunity or who are at risk for Plasmodium vivax malaria have not been described. We conducted a randomized, double-blinded study involving 297 people from areas of nonendemicity in Indonesia who migrated to Papua (where malaria is endemic) < or =26 months before the study period. Subjects received prophylaxis with 1 Malarone tablet (250 mg of atovaquone and 100 mg of proguanil hydrochloride; n=148) or placebo (n=149) per day for 20 weeks. Hematologic and clinical chemistry values did not change significantly. The protective efficacy of atovaquone/proguanil was 84% (95% confidence interval [CI], 44%-95%) for P. vivax malaria, 96% (95% CI, 72%-99%) for P. falciparum malaria, and 93% (95% CI, 77%-98%) overall. Atovaquone/proguanil was well tolerated, safe, and effective for the prevention of drug-resistant P. vivax and P. falciparum malaria in individuals without prior malaria exposure who migrated to Papua, Indonesia.

Adolescent↗
PubMed2002

Weight-gain patterns from prepregnancy until delivery among women in Central Java, Indonesia.

BACKGROUND: Representative data on pregnancy weight-gain patterns from developing countries are scarce. The reasons include difficulties in obtaining population-based samples and in collecting data before and throughout pregnancy. OBJECTIVE: The objective was to measure weight-gain patterns from prepregnancy until after delivery in a population-based sample of rural Indonesian women. DESIGN: Two cross-sectional surveys of nutritional status among nonpregnant women of reproductive age were carried out through a surveillance system in Purworejo District, Central Java, Indonesia, in 1996 and 1997. Between 1996 and 1998, 846 newly pregnant women were enrolled in a cohort study in which weight was monitored monthly throughout pregnancy. Prepregnancy weights and other anthropometric measures were available for 251 of the women who had live births. RESULTS: Before pregnancy, 16.7% of the women had chronic energy deficiency and 10.0% were obese. The mean total pregnancy weight gain for all the women was 8.3 +/- 3.6 kg, and 79% did not meet the international recommendation regarding weight gain for their prepregnant body mass index. The rate of weight gain was highest during the second trimester (0.34 kg/wk). In the first and third trimesters, it was 0.08 and 0.26 kg/wk, respectively. Total weight gain was associated with prepregnant body mass index, education, and socioeconomic status. CONCLUSIONS: Many women in rural Central Java, Indonesia, enter pregnancy with suboptimal nutritional status. For most of these women, total weight gain during pregnancy is insufficient. It is likely that this contributes to adverse health outcomes for both the mothers and their newborns.

Adolescent↗
PubMed2000

Fat intake and breast cancer risk in an area where fat intake is low: a case-control study in Indonesia.

BACKGROUND: Associations of fat and other macronutrients with breast cancer risk are not clear in areas where fat intake is low. METHODS: We conducted a hospital-based case-control study from 1992 to 1995 in Jakarta, Indonesia. RESULTS: The study, based on 226 cases and 452 age and socioeconomic status matched controls, provided the following findings. (a) In the pre-marriage period, the greater the fat or protein consumption, the larger the risk, whereas decreasing risk with increasing carbohydrate intake was detected. The odds ratio (OR) for the highest quartile of intake relative to the lowest was 8.47 (95% CI: 4.03-17.8) for fat, 2.19 (95% CI: 1.30-3.69) for protein, and 0.16 (95% CI: 0.08-0.31) for carbohydrate. A positive association with fat and a negative one with carbohydrate were also observed for the post-marriage period, but of weaker magnitude compared to the pre-marriage period. (b) The effects of macronutrient intakes were stronger among premenopausal than among postmenopausal women. (c) Most of the associations of protein and carbohydrate were insignificant after adjustment for fat intake. CONCLUSIONS: These findings suggest that fat intake might be an important determinant of breast cancer among populations with a low fat diet in Indonesia.

Adult↗
PubMed1995

Flagellar serotypes of Salmonella typhi in Indonesia: relationships among motility, invasiveness, and clinical illness.

While the H1-d flagellar serotype of Salmonella typhi has been found worldwide, the H1-j serotype occurs only in Indonesia. A cross-sectional survey in Indonesia compared epidemiologic, clinical, and pathogenetic characteristics of these two serotypes. S. typhi isolates were collected from patients with acute typhoid fever in four Indonesian cities. Flagellar serotype was determined by polymerase chain reaction amplification of the fliC locus of the flg gene. Of 321 isolates, 51 (15.9%) were H1-j. Patients with H1-j infection were older than those with H1-d (P < .001). Among 30 patients with known clinical outcomes, H1-j infection was associated with milder clinical illness than H1-d (P = .06). In vitro, H1-j isolates were both less motile on semi-solid agar plates (P = .004) and less invasive of HEp-2 cells (P = .002) than H1-d isolates. The association of decreased severity of illness with decreased motility and invasiveness suggests that flagellar properties are a component of S. typhi's virulence.

Base Sequence↗
PubMed1985

Multiple antibiotic resistance plasmids in Enterobacteriaceae isolated from diarrhoeal specimens of hospitalized children in Indonesia.

We studied the plasmid and antibiotic resistance characteristics of 35 strains of Enterobacteriaceae recovered from faecal specimens of children with diarrhoea in Central General Hospital, Bandung, Indonesia. Twenty three Escherichia coli, three Providencia, three Proteus, three Klebsiella, two Enterobacter and one Citrobacter were examined. All strains were multiply resistant, many carrying six to nine antibiotic resistances. Most of these resistances were transferable to a laboratory E. coli strain and were carried on large-sized plasmids. All recently-described tetracycline resistance determinants (Classes A----D) were represented; the most common was the Class B, or TN10 type. The TEM-1 beta-lactamase was detected in 17 out of 21 ampicillin-resistant strains examined. The OXA-1, PSE-1, and SHV-1 enzymes were also found. Of 23 plasmids tested, all could be classified into one of eight different incompatibility groups: IncFII, IncN, IncB, IncF1, IncI1, IncI2, IncH2 and IncT. These studies demonstrate the existence of large multiresistant transferable plasmids representing common incompatibility groups and bearing common tetracycline and ampicillin resistance determinants in enteric strains isolated from children hospitalized in Indonesia.

Child↗
PubMed2001

Household food insecurity was prevalent in Java during Indonesia's economic crisis.

Valid assessment of household food security is important, particularly in rapidly changing circumstances such as the economic crisis that struck Indonesia in 1998. The Cornell-Radimer tool for measuring household food security has now been used in several social and economic settings. An adaptation of this tool was used in the context of the economic crisis of Java, Indonesia in June-August 1998 in a survey of 1423 mothers with children < 5 y old. Qualitative and quantitative data contributed to understanding food insecurity and provided evidence for some aspects of validity. The data showed substantial household food insecurity with 94.2% of households found to be uncertain or insecure about their food situation in the previous year. Of respondents, 11% reported losing weight in the previous year because of lack of food. Food security in Java was undoubtedly compromised by the economic crisis. These results suggest, on the basis of qualitative and quantitative understandings of food insecurity, that this tool provided a useful measure of the situation in Java in 1998. From this study and others done recently, such a tool or ones constructed using a similar approach have been found to be useful in various settings in which there is a need to understand and identify household food insecurity for purposes of estimating and monitoring prevalence and targeting of policies and programs. Further research to validate this approach in various settings is warranted.

Adult↗
PubMed1995

AIDS knowledge, risk behaviors, and factors related to condom use among male commercial sex workers and male tourist clients in Bali, Indonesia.

OBJECTIVES: To describe the AIDS/sexually transmitted diseases (STD) knowledge and risk behaviors, and to determine factors related to condom use among male commercial sex workers (CSW) and male tourist clients in Bali, Indonesia. DESIGN: Individual survey interviews were conducted with a sample of 80 male CSW and 100 tourist clients in the Kuta area of Bali. METHODS: Survey interviews included detailed questions on AIDS/STD knowledge, sexual behavior, and psychosocial measures related to risk taking. RESULTS: Most of the male CSW had heard about AIDS and other STD, although some misconceptions about transmission and risks of different sexual practices remained. Both oral and anal intercourse with tourists were common and condom use was far from consistent. Factors related to condom use for anal intercourse with tourist clients were condom beliefs, self efficacy, susceptibility to STD infection, and STD knowledge. Tourist clients were mainly from Australia and Europe and many had paid for sex in other parts of Indonesia as well as in high prevalence countries. Knowledge of AIDS/STD was very good among the tourists and previous experience with STD was common. Factors related to condom use with male CSW were condom beliefs and self efficacy. CONCLUSION: There is a very active and mobile group of male CSW and tourist clients present in Bali. Interventions with these men are needed due to the low level of knowledge about AIDS among CSW, their experience with STD and STD symptoms, and their level of risky sexual behavior.

Acquired Immunodeficiency Syndrome↗