RESUMEN
Database URL: https://www.crop-diversity.org/mgis/.
Asunto(s)
Bases de Datos Genéticas , Técnicas de Genotipaje , Musa , Programas Informáticos , Secuenciación de Nucleótidos de Alto Rendimiento , Musa/clasificación , Musa/genética , Semillas/clasificación , Semillas/genéticaRESUMEN
Respiratory syncytial virus (RSV) is an important cause of morbidity in children worldwide, although data from equatorial regions are limited. We analysed climatic, spatial, and temporal data for children presenting to hospitals in Lombok island, Indonesia with clinical pneumonia. During the study period, 2878 children presented and 741 RSV cases were identified. In multivariate analysis with an 8-day lag, occurrence of rain was associated with 64% higher incidence of RSV disease [incidence rate ratio (IRR) 1.64, 95% confidence interval (CI) 1.13-2.38]. A 1% rise in mean relative humidity and 1 degree C increase in mean air temperature was associated with a 6% (IRR 1.06, 95% CI 1.03-1.10) and 44% (IRR 1.44, 95% CI 1.24-1.66) increase in RSV cases, respectively. Four statistically significant local clusters of RSV pneumonia were identified within the annual island-wide epidemics. This study demonstrates statistical association of monsoon-associated weather in equatorial Indonesia with RSV. Moreover, within the island-wide epidemics, localized RSV outbreaks suggest local factors influence RSV disease.
Asunto(s)
Neumonía Viral/epidemiología , Infecciones por Virus Sincitial Respiratorio/epidemiología , Clima Tropical , Geografía , Humanos , Humedad , Incidencia , Indonesia/epidemiología , Lactante , Recién Nacido , Análisis Multivariante , Lluvia , Virus Sincitiales Respiratorios/aislamiento & purificación , Estadística como Asunto , Temperatura , Factores de TiempoRESUMEN
We assessed the use and acceptability of an injection device (Uniject) prefilled with oxytocin, as part of active management of third-stage labor (AMTL) by Indonesian midwives attending home births. We interviewed 140 village midwives (bidan di desa) and 2220 mothers whose deliveries they attended during the intervention period. We completed baseline and post-intervention assessments to determine their experiences and views of oxytocin Uniject use. Delivery logs and supervisory reports were reviewed. The assessment was done in three rural districts and one municipality in Lombok. Injection practices and oxytocin availability did not change dramatically, although dose accuracy, use of sterile injection equipment, and proper disposal improved when the Uniject device was used. Midwives had little difficulty using the Uniject device properly; they overwhelmingly preferred it to standard needles and syringes. Postpartum hemorrhage rates did not change substantially. Oxytocin via Uniject holds promise for safer, more convenient use of oxytocin by trained midwives attending home deliveries, thereby potentially reducing the incidence of postpartum hemorrhage.
Asunto(s)
Embalaje de Medicamentos/métodos , Partería/métodos , Oxitocina/administración & dosificación , Hemorragia Posparto/prevención & control , Jeringas , Actitud del Personal de Salud , Contaminación de Medicamentos/prevención & control , Diseño de Equipo , Femenino , Humanos , Indonesia , Inyecciones , Tercer Periodo del Trabajo de Parto , Eliminación de Residuos Sanitarios/normas , Partería/educación , Satisfacción del Paciente , Embarazo , Encuestas y CuestionariosRESUMEN
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.
Asunto(s)
Nasofaringe/microbiología , Infecciones Neumocócicas/microbiología , Antibacterianos/farmacología , Preescolar , Farmacorresistencia Microbiana , Humanos , Indonesia/epidemiología , Lactante , Recién Nacido , Pruebas de Sensibilidad Microbiana , Nasofaringe/patología , Infecciones Neumocócicas/epidemiología , Prevalencia , Estudios Prospectivos , Serotipificación , Streptococcus pneumoniae/clasificación , Streptococcus pneumoniae/efectos de los fármacos , Streptococcus pneumoniae/aislamiento & purificaciónRESUMEN
Using age and cause-specific childhood mortality in Lombok, Indonesia, as a factor for determining the appropriateness of introducing Haemophilus influenzae type b (Hib) and pneumococcal vaccines, the study describes a cross-sectional, hamlet-level mortality survey in 40 of 305 villages in Lombok Island, Indonesia. Causes of death were assessed with a standardized verbal-autopsy questionnaire. One thousand four hundred ninety-nine births and 141 deaths occurring among children aged less than 2 years were identified, with 43% of deaths occurring during the first 2 months of life. The infant mortality rate was 89 (95% CI: 75, 104) per 1,000 live-births. All mortality rates are reported per 1,000 live-births. To examine children whose deaths could potentially have been prevented through vaccination with Hib or pneumococcal vaccine, deaths due to acute respiratory infection (ARI) and central nervous system (CNS) infections among children, aged 2-23 months, were analyzed. ARI and CNS infections caused 58% (mortality rate: 31 per 1,000 live-births; 95% CI: 23, 41) and 17% (mortality rate: 9 per 1,000 live-births; 95% CI: 5, 16), respectively, of all deaths within this age group. Between the ages of 2 and 23 months, 5% of all babies born alive died of ARI, and another 1% died of CNS infections. Our results indicate that current efforts to reduce childhood mortality should focus on reducing ARI and meningitis. These efforts should include evaluating the impact of Hib and pneumococcal vaccines within the routine Expanded Programme on Immunization system.
Asunto(s)
Infecciones por Haemophilus/mortalidad , Vacunas contra Haemophilus/economía , Infecciones Neumocócicas/mortalidad , Vacunas Neumococicas/economía , Factores de Edad , Causas de Muerte , Análisis Costo-Beneficio , Estudios Transversales , Femenino , Infecciones por Haemophilus/inmunología , Infecciones por Haemophilus/prevención & control , Vacunas contra Haemophilus/uso terapéutico , Haemophilus influenzae tipo b/inmunología , Humanos , Indonesia/epidemiología , Lactante , Mortalidad Infantil , Masculino , Infecciones Neumocócicas/inmunología , Infecciones Neumocócicas/prevención & control , Vacunas Neumococicas/uso terapéutico , Encuestas y CuestionariosRESUMEN
Autodestruct syringes can reduce the improper reuse of syringes, which present a significant risk in the transmission of bloodborne pathogens in developing countries, especially during immunization campaigns owing to the high number of injections given per session. SoloShot is an autodestruct syringe, distributed by UNICEF, which has been shown to be safer and easier to use than standard syringes. This study analyses the accuracy and dose-efficiency of SoloShot, compared with disposable syringes, during a national tetanus toxoid immunization campaign on the Indonesian island of Lombok. Observation and dose measurements revealed that SoloShot syringes delivered more precise and consistent doses and 15% more doses per vial than disposable syringes. Vaccine savings may partially be offset by the higher price of SoloShot. Vaccinators preferred SoloShot, describing it as easier to use, faster, and more accurate than the disposable syringe. The study indicates that SoloShot is highly appropriate for use in immunization campaigns by reducing vaccine wastage and improving injection safety.
PIP: The reuse and improper sterilization of syringes used in immunization campaigns present significant risks of transmission of blood-borne pathogens. This study assessed the accuracy and dose-efficiency of SoloShot, an autodestruct syringe distributed by UNICEF, during a 1996 national tetanus toxoid immunization campaign on the Indonesian island of Lombok. The eight vaccinators were Indonesian Ministry of Health personnel and midwives from subdistrict health centers. Sites were randomly assigned to SoloShot or the disposable syringe. During the 4-day campaign, a total of 385 doses were delivered with SoloShot and 433 with the disposable syringe. SoloShot delivered an average of 1.02 (15%) more doses per vial than the disposable syringe and provided a mean dose closer to the ideal of 0.5 ml. As a result of a greater amount of dead space in the disposable syringe, an average of 2.6 doses of vaccine per vial were wasted compared with 1.2 doses for SoloShot. A questionnaire on user acceptability revealed that vaccinators preferred SoloShot on six of the nine indicators, including overall preference. SoloShot was considered faster, easier to use, and more accurate than the disposable syringe. Overall, these findings suggest that use of SoloShot in national immunization campaigns could reduce vaccine wastage while improving injection safety.
Asunto(s)
Equipos Desechables , Inmunización/instrumentación , Jeringas , Toxoide Tetánico/administración & dosificación , Adulto , Técnicos Medios en Salud/educación , Femenino , Humanos , Programas de Inmunización , Encuestas y CuestionariosRESUMEN
Extending immunization coverage to underserved populations will require innovative immunization strategies. This study evaluated one such strategy: the use of a prefilled, single-use injection device for outreach immunization by village midwives. The device, UniJect, is designed to prevent refilling or reuse. Stored at ambient temperatures for up to 1 month in midwives' homes, vaccine-filled UniJect devices were immediately available for outreach. Between July 1995 and April 1996, 110 midwives on the Indonesia islands of Lombok and Bali visited the homes of newborn infants to deliver hepatitis B vaccine to the infants and tetanus toxoid to their mothers. Observations and interviews showed that the midwives used the device properly and safely to administer approximately 10,000 sterile injections in home settings. There were no problems with excessive heat exposure during the storage or delivery of vaccine. Injection recipients and midwives expressed a strong preference for the UniJect device over a standard syringe. Use of the prefilled device outside the cold chain simplified the logistics and facilitated the speed and efficiency of home visits, while the single-dose format minimized vaccine wastage.
PIP: Recent studies have found that up to 30% of injections given for immunization are not sterile. Disposable syringes are reused and reusable syringes are often improperly sterilized. Findings are presented from an evaluation of the use of a prefilled, single-use injection device for outreach immunization by village midwives. Such devices can reduce the transmission of bloodborne pathogens and diseases, and reduce vaccine wastage associated with multi-dose vials. The device evaluated, UniJect, is designed to prevent refilling or reuse. Stored at ambient temperatures for up to 1 month in midwives' homes, vaccine-filled UniJect devices were immediately available for use. Between July 1995 and April 1996, 110 midwives on the Indonesian islands of Lombok and Bali visited the homes of newborn infants to deliver hepatitis B vaccine to infants and tetanus toxoid to their mothers. Observations and interviews found that the midwives safely and properly used the device to administer approximately 10,000 sterile injections in home settings. No problems were experienced with excessive heat exposure during the storage or delivery of vaccine. Injection recipients and midwives strongly preferred the UniJect device over a standard syringe. Furthermore, use of the prefilled device outside of the cold chain simplified the logistics and facilitated the speed and efficiency of home visits, while the single-dose format minimized vaccine wastage.
Asunto(s)
Servicios de Atención de Salud a Domicilio , Programas de Inmunización , Jeringas , Vacunación/instrumentación , Vacunas , Adulto , Análisis Costo-Beneficio , Femenino , Hepatitis B/prevención & control , Vacunas contra Hepatitis B/administración & dosificación , Humanos , Programas de Inmunización/economía , Indonesia , Lactante , Recién Nacido , Masculino , Partería , Seguridad , Toxoide Tetánico/administración & dosificación , Vacunación/economía , Vacunas/economíaAsunto(s)
Jeringas , Programas de Inmunización , Vacunas , Vacunación , Estudio Comparativo , IndonesiaRESUMEN
BACKGROUND: The Haemophilus influenzae type b (Hib) nasopharyngeal carriage prevalence and invasive disease incidence rates are unknown in Indonesia; consequently Hib vaccine is not included in the routine vaccine schedule. METHODS: To determine carriage prevalence we conducted a population-based, island-wide prospective study of a systematic sample of 484 children 0 to 2 years of age in Lombok, Indonesia. We conducted a risk factor questionnaire and determined serotypes and antibiotic sensitivity patterns. RESULTS: We identified 155 H. influenzae isolates, of which 22 were type b and 12 were encapsulated but not type b. The age- and population-weighted Hib carriage prevalence, adjusted for the sampling design, was 4.6% (95% confidence interval, 3.7 to 5.5%). Children younger than 6 months of age had a carriage prevalence less than one-half that of older children, and carriage varied within the four administrative regions of the island; otherwise no risk factors for Hib carriage were identified. All Hib specimens were sensitive to ampicillin and 20 (91%) were sensitive to chloramphenicol. CONCLUSIONS: The Hib carriage prevalence in Lombok is similar to that found in developed countries before vaccine introduction. This suggests that further studies should proceed to determine whether Lombok has invasive disease rates as high as those that justified vaccine introduction in developed countries.
Asunto(s)
Portador Sano/epidemiología , Infecciones por Haemophilus/epidemiología , Haemophilus influenzae tipo b , Preescolar , Farmacorresistencia Microbiana , Haemophilus influenzae tipo b/efectos de los fármacos , Haemophilus influenzae tipo b/aislamiento & purificación , Humanos , Indonesia/epidemiología , Lactante , Nasofaringe/microbiología , Prevalencia , Estudios Prospectivos , Factores de RiesgoRESUMEN
The Lombok Hepatitis B (HB) Model Immunization Project was the first mass infant HB immunization project in Indonesia. Key aspects were the procurement of low-cost HB vaccine, integration into routine infant immunization services, and delivery of the first dose in the home within 1 week of birth. The project achieved > 90% coverage with 3 doses of vaccine. The prevalence of HB surface antigen was 1.4% in infants who received 3 doses (with the first dose within 7 days of birth) and 3.0% in those who received the first dose > 7 days after birth, compared with a baseline prevalence of 6.2% (P < .001 in each case). Most vaccine failures occurred in children born to HBe antigen-positive mothers. Antibody prevalence and titers did not correlate with protection. HB vaccine can be successfully integrated into the Expanded Programme on Immunization (EPI), strengthening the EPI and significantly reducing chronic HB infection.
Asunto(s)
Vacunas contra Hepatitis B , Hepatitis B/prevención & control , Programas de Inmunización , Vacuna BCG , Recolección de Datos , Vacuna contra Difteria, Tétanos y Tos Ferina , Métodos Epidemiológicos , Femenino , Hepatitis B/epidemiología , Anticuerpos contra la Hepatitis B/sangre , Antígenos de Superficie de la Hepatitis B/sangre , Antígenos e de la Hepatitis B/sangre , Humanos , Programas de Inmunización/economía , Programas de Inmunización/normas , Esquemas de Inmunización , Indonesia/epidemiología , Lactante , Recién Nacido , Vacuna Antisarampión , Educación del Paciente como Asunto , Vacuna Antipolio de Virus Inactivados , Prevalencia , Organización Mundial de la SaludRESUMEN
This article describes response to a questionnaire requesting information from parents about their knowledge of hospital facilities/procedures and their satisfaction with the routines associated with the admission of their children for 24-hour growth hormone monitoring. The adjustment of children to stressful medical procedures is more successful if parents can act as "therapeutic allies" to their children. Unless parents have a clear understanding of (and satisfaction with) the procedures their children must undergo, they cannot be expected to fulfill this role adequately. By isolating areas in which parental knowledge is lacking or inaccurate, as well as areas of dissatisfaction, the nursing staff is in a better position to improve patient adjustment to medical procedures and to plan ways of improving patient care. The results of this study indicate that more information about hospital facilities needs to be provided to parents of children who have not had previous hospital admissions. In general, however, most parents were satisfied with the explanation given for why their children had to have growth hormone monitoring and the routines associated with the procedure.
Asunto(s)
Niño Hospitalizado , Comportamiento del Consumidor/estadística & datos numéricos , Departamentos de Hospitales/organización & administración , Monitoreo Fisiológico/normas , Padres/psicología , Evaluación de Procesos, Atención de Salud , Australia , Niño , Preescolar , Estudios de Evaluación como Asunto , Femenino , Trastornos del Crecimiento/diagnóstico , Trastornos del Crecimiento/terapia , Departamentos de Hospitales/normas , Humanos , Masculino , Monitoreo Fisiológico/métodos , Investigación , Encuestas y CuestionariosRESUMEN
The incidence, mortality and clinical features of measles enteritis were reported among 6484 infants and children admitted to the Pediatric Ward Dr. Pirngadi General Hospital Medan from 1st January 1987 until 31st December 1988. Of these 6484 children, 2685 suffered from gastroenteritis and 82 from measles. There were 31 cases of measles enteritis (1.2% of all gastroenteritis cases or 37.8% of measles cases). Most of measles enteritis cases (74.2%) were in the age group of 6-24 months and no case was found under six months old. The mortality of measles enteritis with bronchopneumonia and encephalitis was 25.0% while the mortality of measles enteritis with bronchopneumonia was 13.3%. There were no deaths in children just with measles enteritis alone. The overall mortality of measles enteritis with or without accompanying disease was 12.9%. The age specific death rate of measles enteritis was highest (23.1%) in the 13-24 month age group.
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Enteritis/epidemiología , Sarampión/complicaciones , Niño , Preescolar , Comorbilidad , Enteritis/etiología , Enteritis/mortalidad , Femenino , Hospitales , Humanos , Incidencia , Indonesia/epidemiología , Lactante , Tiempo de Internación/estadística & datos numéricos , Masculino , Estado Nutricional , Estudios RetrospectivosRESUMEN
A retrospective study had been done at the outpatient clinic sub division of Pediatric Gastroenterology, Dr. Pirngcdi Hospital Medan, comprising patients from 1 January 1985-31 December 1987. There were 874 patients. Three hundred seventy eight (43.25%) patients consisting of 210 (55.56%) males and 168 (44.44%) females had intestinal parasitic infestations. The youngest patient was 5 months and the oldest was 14 years and 3 months. Ascaris lumbricoides was found in 215 patients (24.60%) while Trichuris trichiura, hookworm, Oxyuris vermicularis, Hymenolepis nana, and Taenia were in 152 (17.39%), 13 (1.49%), 4 (0.46%), 15 (1.72%) and 4 (0.46%) cases respectively. Entamoeba histolytica was found in 121 (13.84%) and Giardia lamblia in 16 (1.83%) patients. The highest age specific attack rate was found in the age group of 5-10 years (65.67%). Ascaris lumbricoides was most frequently found namely in 100 children (26.46%), followed by Entameba histolytica in 73 (19.31%) and mixed infestation of Ascaris lumbricoides and Trichuris trichiura in 68 (17.99%) patients. One hundred seventy three (66.28%) under five patients with intestinal parasitic infestation had malnutrition while of the 433 under fives without intestinal parasitic infestation only 201 (46.42%) suffered from malnutrition (P less than 0.001).
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Enfermedades Parasitarias/epidemiología , Adolescente , Factores de Edad , Niño , Preescolar , Femenino , Gastroenterología , Humanos , Indonesia , Lactante , Masculino , Servicio Ambulatorio en Hospital , Estudios RetrospectivosRESUMEN
A retrospective study was done on infants and children hospitalized from January 1, 1988 to December 31, 1988 at the Pediatric Ward of Dr. Pirngadi Hospital, Medan. In this period a total of 3370 patients had been hospitalized and 1356 (40.24%) had gastroenteritis of whom 96 patients (7.08%) died. The causes of death as the complications were encephalopathy in 27 patients (28.12%), bronchopneumonia in 32 (33.33%), shock in 27 (28.12%), sepsis in 6 (6.25%) and acidosis in 4 (4.17%). Fifty one (53.12%) of those 96 patients who died were in the age group of under one year. The age specific mortality rate was highest in the age group of 1 month (14.28%). Of those 1356 patients with gastroenteritis 566 (41.74%) were well nourished of whom 8 patients died (1.42%); mildly malnourished in 532 patients of whom 36 (6.77%) died; and severely malnourished in 258 patients of whom 52 (20.16%) died. As far as the duration of illness was concerned 43 patients (12.73%) who died had a history of illness at home of 1 day. Beside the complications of the disease it seemed that the nutritional factors might have interfered with the mortality of patients with gastroenteritis.
Asunto(s)
Gastroenteritis/mortalidad , Trastornos de la Nutrición del Niño/complicaciones , Preescolar , Femenino , Gastroenteritis/complicaciones , Departamentos de Hospitales , Hospitales , Humanos , Indonesia , Lactante , Masculino , Estudios RetrospectivosRESUMEN
A retrospective study was done on infants with diarrhea who were hospitalized at the Pediatric ward of Dr. Pirngadi Hospital, Medan in a period of one year (January 1 to December 31, 1986). There were 3317 hospitalized patients and 1506 (45.40%) of them had diarrhea. Of these, 773 (51.32%) were in the age group of under 2 years. Thirty eight patients (4.91%) with infantile diarrhea died and prolonged diarrhea was found in 54 (6.98%) cases.
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Diarrea Infantil/epidemiología , Enfermedad Crónica , Diarrea Infantil/complicaciones , Femenino , Departamentos de Hospitales , Hospitales , Humanos , Indonesia/epidemiología , Lactante , Masculino , Estudios RetrospectivosRESUMEN
A retrospective study has been done on infants and children attending to the Pediatric Gastroenterology Outpatient Clinic of Dr. Pirngadi General Hospital in Medan, from 1985 through 1987. During the study there were 874 patients, 477 (54.58%) suffered from diarrhea, 209 (23.91%) had bloody stool, 20 (2.99%) jaundice, 57 (6.52%) abdominal pain, 48 (5.49%) abdominal distention, 30 (3.43%) vomiting, 13 (1.49%) constipation, and 20 (2.29%) others. Of all cases with diarrhoea, watery diarrhoea were found in only 319 (66.88%), diarrhoea with vomiting 84 (17.61%), and bloody diarrhoea 74 (15.51%). Stool examination in patients with diarrhoea revealed 144 (30.19%) cases with Candida albicans, while 16 (3.35%) of them with steatorrhoea. Of 63 patients with diarrhoea on which the clinitest had been performed, sugar intolerance were found in 30 (47.62%) cases.