ABSTRACT
Background: The incidence of tuberculosis (TB) in the city of Bandar Lampung, Indonesia, increased during the period 2009–2011, although the cure rate for TB cases treated under the directly observed treatment, short course (DOTS) strategy in the city has been maintained at more than 85%. Cluster analysis is recognized as an interactive tool that can be used to identify the significance of spatially grouping sites of TB incidence. This study aimed to identify space–time clusters of TB during January to July 2012 in Bandar Lampung, and assess whether clustering co-occurred with locations of high population density and poverty. Methods: Medical records were obtained of smear-positive TB patients who were receiving treatment at DOTS facilities, located at 27 primary health centres and one hospital, during the period January to July 2012. Data on home addresses from all cases were geocoded into latitude and longitude coordinates, using global positioning system (GPS) tools. The coordinate data were then analysed using SaTScan. Results: Two significant clusters were identified with P value of 0.05 for the primary cluster and 0.1 for the secondary cluster. Clusters occurred in areas with high population density and a high proportion of poor families and poor housing conditions. The short radius of the clusters also indicated the possibility of local transmission of TB. Conclusions: The incidence of TB in Bandar Lampung was not randomly distributed, but significantly concentrated in two clusters. Identification of clusters of TB, together with its etiological factors such as social determinants, and risk factors, can be used to support TB control programmes, particularly those aiming to reach vulnerable populations, and intensified case-finding.
ABSTRACT
The problem of diarrhea can be controlled through environmental factors and good habits. The Ministry of Health of the Republic of Indonesia has designed a simple indicator to evaluate the family health potential, the Family Health Potential Index (FHPI). This study aims to evaluate the effect of FHPI and other indicators on the risk of diarrhea. The data were obtained through a survey carried out by a team from the Family Physician Studies, Graduate Program of the Universitas Sebelas Maret. The survey was held from August to September 2003 in 5 provinces receiving the Family Health and Nutrition (FHN) project. The subjects were 1500 heads of poor families chosen by stratified random sampling. Interviews and observations were carried out by special trained interviewers and held in the subjects’ homes. The use of potable water from the water system and well source built during the FHN project lowered the risk of diarrhea by 66% compared to the use of water from other sources (adjusted odds ratio= 0.34; 95% confidence interval = 0.16 - 0.70). Disposing of garbage using pits, sewers, rivers, or simply burying in the ground, increased the risk of diarrhea by twice compared with the specific method. Providing potable water from the water system or well and proving special tank for garbage disposal were important in order to lower the risk of occurrence diarrhea in a family. The use of non-dirt floors of houses as an FHPI specifically for diarrhea should be studied further.
Subject(s)
Diarrhea , Drinking Water , Environmental HealthABSTRACT
The Purpose of this study was to identify factors that influence the self-esteem of the schooler of families in poverty. A descriptive, correlational, and cross-sectional study design was used. The data were collected from February to March, 2001. Convenient sampling was done from 194 subjects living in Jeju Do, but 167 subjects among these were used for the study analysis. Hierarchical Stepwise Regression was used to identify significant factors. The results of this study were as follows: In general, self-esteem status of the schooler in poor families was relatively poor. In stepwise regression analysis, self-esteem status was significantly influenced by emotional home environment, duration of poverty and frequency of parent-child tactics. These variables explained 26.8% of the variance of schooler's self-esteem. Conclusively, it is recommended that nursing intervention programs for schooler in poor family should be a focus to enhance the economic context as well as family effect.