New cases of childhood leprosy in two male siblings in low endemic province: an iceberg phenomenon?

Children are the leprosy population most at risk; multibacillary infections are common. We reported pediatric cases with WHO-multibacillary lepromatous type morbus Hansen. We discovered several hypopigmented patches on the right upper arm, anesthesia-filled claw hands, and infiltrates in the ears in one 17- year-old child. In the other case (13-year-old), we discovered reduced sensory sensitivity in nearly every area of the body, infiltrates on the ear, and numerous irregular hypopigmented plaques on the belly, lumbar, and gluteus. Both patients had positive acidfast bacteria. After three months of treatment, multibacillary leprosy patients began to show improvement. Low socioeconomic and environmental conditions, as well as a history of intimate contact with leprosy patients, have been identified as risk factors.

Service Delivery Reforms for Asian Ageing Societies: A Cross-Country Study Between Japan, South Korea, China, Thailand, Indonesia, and the Philippines.

INTRODUCTION: Japan's health policies to address the most advanced-aged society have been the target of focus in Asia, but no studies have investigated this issue using tools for cross-country comparisons. THEORY AND METHODS: A cross-country study design was used to compare healthcare reform policies with a framework in Japan, Korea, Thailand, China, Indonesia, and the Philippines. Data were collected via document reviews and key informant interviews. RESULTS: Three distinctions were identified. First, all countries except for the Philippines have policy decisions regarding reforms for the existing service delivery systems for healthcare, long-term care and welfare. Second, the most extensive service delivery reform is currently being implemented in Japan, whose system is shifting to primary health care. Third, the direction of the transformation of service delivery system is different between Thailand and China despite a similar level of ageing society. China has made progress on facility-based care integration between health and social care, whereas Thailand is focusing on home-based care. CONCLUSIONS AND DISCUSSION: Doctor and hospital-based healthcare delivery system requires more drastic reform for an aged society. This fact implies that strengthening primary health care is not only useful for current health issues but also an investment for the aged society near future in low- and middle-income countries.

School-based education to prevent bullying in high schools in Indonesia.

BACKGROUND: The Global School-based Health Survey showed that 20.6% of Indonesian students aged 13-17 years old were bullied. The proportion was lower than those reported from Southeast Asian countries (28.3-51.0%). School education was reported to contribute to the reduction of bullying, but no similar study has been done in Indonesia. This study aimed to explore the role of school-based education in preventing bullying in high schools in Indonesia. METHODS: In-depth interviews with principals and focus group discussions with teachers from five schools in Mataram City were conducted in 2018. Data were transcribed and analyzed using thematic analysis. Participant observations and document reviews were conducted to verify the data. RESULTS: Seven themes emerged: (i) Bullying as a problem; (ii) Causes of bullying; (iii) Effects of bullying; (iv) Curricular interventions; (v) Cultural interventions; (vi) Institutional interventions; and (vii) Challenges and recommendations regarding current interventions. Curricular interventions include Pancasila (state ideology or principles of the state's philosophy) and civic education, and religious education, while cultural interventions include cultural practices and extracurricular activities. The schools provide an enabling environment by maintaining a good physical environment and implementing policies to prevent bullying. These activities promote the prevention of school bullying. CONCLUSIONS: This study demonstrated that moral education in curriculum and cultural activities are avenues for the prevention of school bullying. The implementation of both religious education and civic education encouraged the creation of values among students. In Indonesia, current interventions should be continued and must be modified to respond with societal changes.

Trends and changes in the knowledge of mother-to-child transmission means of HIV among Vietnamese women aged 15-49 years and its associated factors: findings from the Multiple Indicator Cluster Surveys, 2000-2014.

This study aims to characterize trends and changes in the prevalence of knowledge of mother-to-child transmission (MTCT) means of HIV as well as to identify its associated socioeconomic factors among Vietnamese women. This is a repeated cross-sectional study using data from the Vietnam Multiple Indicator Cluster Surveys 2000, 2006, 2011 and 2014. We found that a slow increase was found in the trend of adequate knowledge of HIV transmission means from mother to child among women between 2000 and 2014 (41.81% in 2000, 45.66% in 2006, 49.58% in 2011, and 46.83% in 2014). Most women knew that HIV could be transmitted during pregnancy, however, more than half of women did not know all three ways of MTCT. Socioeconomic factors including age, ethnicity, education level, and economic status as factors that affected full knowledge of MTCT means. The study helps to design public health programs to raise 15-49-year-old women's knowledge in HIV transmission means from mother to child as well as can provide a quite strong case for policy adaptation to improve women's health in the time to come.