Vaccination Status and In-hospital Mortality Among Adults With COVID-19 in Jakarta, Indonesia: A Retrospective Hospital-based Cohort Study.

OBJECTIVES: Prospective studies on vaccination status and mortality related to coronavirus disease 2019 (COVID-19) in low-resource settings are still limited. We assessed the association between vaccination status (full, partial, or none) and in-hospital mortality among COVID-19 patients at most hospitals in Jakarta, Indonesia during the Delta predomination wave. METHODS: We conducted a retrospective cohort study among hospitalized COVID-19 patients who met the study criteria (>18 years old and admitted for inpatient treatment because of laboratory-confirmed severe acute respiratory syndrome coronavirus 2 infection). We linked individual-level data in the hospital admission database with vaccination records. Several socio-demographic and clinical characteristics were also analyzed. A Cox proportional hazards regression model was used to explore the association between vaccination status and in-hospital mortality in this patient group. RESULTS: In total, 40 827 patients were included in this study. Of these, 70% were unvaccinated (n=28 543) and 19.3% (n=7882) died during hospitalization. The mean age of the patients was 49 years (range, 35-59), 53.2% were female, 22.0% had hypertension, and 14.2% were treated in the intensive care unit, and the median hospital length of stay across the group was 9 days. Our study showed that the risk of in-hospital mortality among fully and partially vaccinated patients was lower than among unvaccinated adults (adjusted hazard ratio [aHR], 0.43; 95% confidence interval [CI], 0.40 to 0.47 and aHR, 0.70; 95% CI, 0.64 to 0.77, respectively). CONCLUSIONS: Vaccinated patients had fewer severe outcomes among hospitalized adults during the Delta wave in Jakarta. These features should be carefully considered by healthcare professionals in treating adults within this patient group.

Mother's Media Use and Children's Vaccination Status in Indonesia: A Community-Based Cross-Sectional Study.

Exposing appropriate information to mothers is a key factor for children's immunization status. This study aims to assess the influence of mothers' media use on their children's vaccination status in Indonesia, using the 2017 Indonesia Demographic Health Survey data. A multilevel multinomial logistic regression model was employed. Mothers who used media irregularly and regularly had higher odds of having partially vaccinated children (vs unvaccinated) than mothers who never used media with adjusted odds ratio (aOR): 1.74; 95% Confidence interval (95% CI): 1.06-2.85 and aOR: 1.48; 95% CI: 1.02-2.16, respectively. Furthermore, they had higher odds of having a fully vaccinated child (vs unvaccinated) (aOR: 1.86; 95% CI: 1.12-3.08 for irregular media use and aOR: 2.41; 95% CI: 1.64-3.53 for regular media use vs. no media use). Our findings suggest that mothers' media use could positively affect their children's vaccination status by increasing mothers' knowledge about children's vaccination.

Quality of Life Assessment and Pain Severity in Breast Cancer Patients Prior to Palliative Oncology Treatment in Indonesia: A Cross-Sectional Study.

PURPOSE: Studies assessing quality of life (QOL) in palliative care settings are still scarce. We assessed the QOL score and pain severity in advanced breast cancer patients at the National Cancer Hospital in Indonesia and associations between QOL domains with QOL and pain scores. MATERIALS AND METHODS: A total of 160 patients who met the study inclusion criteria (female, >18 years old, diagnosed with stage III or IV breast cancer) answered the European Organization for Research and Treatment of Cancer QOL questionnaire (EORTC QLQ-C15-PAL) and the visual analogue scale (VAS) tool for pain severity, prior to palliative oncology treatment. Additionally, several sociodemographic and clinical characteristics were collected. Linear regression models, adjusted for age, the Karnofsky Performance Status (KPS) score, and specific QOL domains were used to explore the associations between the global QOL and VAS scores with the different QOL domains. RESULTS: The patients had a mean age of 50 years (range: 29-76). The overall score for QOL and score for VAS was (mean ± SD) 78.02 ± 15.34 and 2.1 ± 2.4, respectively. The analysis demonstrated that the domains of emotional functioning (effect estimate: 0.25; 95% CI: 0.14 to 0.37), fatigue (-0.21; -0.33 to -0.09), pain (-0.13; -0.25 to -0.01), insomnia (-0.25; -0.37 to -0.13), and appetite loss (-0.13; -0.25 to -0.008) were associated with the QOL score. Only the KPS score (-0.28; -0.46 to -0.11) was associated with the VAS score. CONCLUSION: Our study showed high QOL and low VAS scores in advanced breast cancer patients prior to palliative oncology treatment. Several QOL domains (emotional functioning, fatigue, pain, insomnia, and appetite loss) were associated with QOL and the KPS was associated with the pain score. Therefore, these specific QOL domains should be given priority in improving QOL in this patient group.

A Survival Analysis of Successful and Poor Treatment Outcome Among Patients with Drug-Resistant Tuberculosis and the Associated Factors: A Retrospective Cohort Study.

BACKGROUND: Tuberculosis and its resistance are a major global health problem in the world. The increased incidence and mortality of tuberculosis in Indonesia remain a big public health issue especially in Jakarta Province. No published studies have focused on assessing the outcome treatment of tuberculosis resistance both in success and death. We aimed this study to assess the survival of cured and death outcomes as well as the determinant factors which might influence drugs resistant tuberculosis in Jakarta between 2010 and 2015. METHODS: this study analyzed the national electronic tuberculosis register (e-TB Manager) of Jakarta province in 2010 to 2015. All adult patients who lived in Jakarta province and were diagnosed with multidrug-resistant tuberculosis (MDR-TB) and extensively drug-resistant tuberculosis (XDR-TB) were eligible for the study. Kaplan Meier survival curve was used, together with log-rank test and Chi-Square (X2) test for descriptive analysis. Cox regression analysis helped determine the potential risk factors. Several risk factors were analyzed in this study, including age, gender, residency, HIV status, resistance status, and history of previous treatment. RESULTS: we analyzed 553 samples in this study. The drug-resistant tuberculosis cases increased gradually from 2010 to 2015. Of all cases, 248 and 67 patients were cured and death, respectively. There was a difference in survival rate between patients diagnosed with MDR-TB and XDR-TB with successful treatment. Poor treatment outcome (death) among patients was predicted by age greater than 60 years old (HR 3.48; 95% CI 1.48 - 8.38, p-value = 0.004). CONCLUSION: there was a difference survival rates between success treatment (cured) and poor treatment outcome (death) during six years of observation. Age of patients is a single-predictor in survival of death. While, HIV status and resistance status were predictors in survival of cured.

Quality of life of cancer patients at palliative care units in developing countries: systematic review of the published literature.

PURPOSE: This systematic review aims to summarize factors that influence the quality of life (QOL) of advanced cancer patients in palliative care (PC) in developing countries. Understanding this context in developing countries milieu is necessary; however, this outcome is rarely reported. METHODS: Following the PRISMA guidelines, the electronic databases MEDLINE, Embase, CINAHL, and Web of Science were systematically searched using the search terms: QOL, cancer, PC, and names of all developing countries. Studies with less than ten subjects, qualitative or pilot studies, reviews, conference abstracts, and that reported validation of QOL questionnaires were excluded. RESULTS: Fifty-five studies from 15 developing countries in the African (n = 5), Latin America and the Caribbean (n = 10), and Asian (n = 40) region were included in the narrative synthesis. 65.4% were cross-sectional, 27.3% were cohort studies, 7.3% were RCTs or quasi-experimental studies. Around 30 QOL factors were studied with 20 different types of QOL instruments. Advanced cancer patients who were older, married/ever married, participated in additional care within PC, used complementary and alternative medicine (CAM), and practiced spirituality/religiosity showed higher QOL score. Low educational level and high depression were associated with a lower QOL. CONCLUSION: Various factors affect QOL among cancer patients in PC. Patients valued the use of CAMs; however, the quality and safety aspects should be properly addressed. Important factors that influenced the QOL score were social and spiritual support. While there is a general need to develop PC strategies further, recognizing patients' needs should be prioritized in national cancer programs.

Influence of Micronutrient Consumption by Tuberculosis Patients on the Sputum Conversion Rate: A Systematic Review and Meta-analysis Study.

BACKGROUND: infectious disease is one of the global health challenge in the world, including tuberculosis. Some factors significantly associated with increased treatment success, including the duration of treatment or treatment compliance, use more than three sensitive drugs, individualized regimen, and weight-related to micronutrient. METHODS: a systematic review and meta-analysis study of randomized control trial studies conducted and reported by preferred reporting items for systematic reviews and meta-analyses. The primary data source was online publications, consist of three bases data, which subscribed by Universitas Indonesia, they are Proquest, EBSCO CINAHL, EBSCO Dentistry. Risk of bias was assessed using the Cochrane risk-of-bias tool, and data were analyzed using Review Manager 2015. RESULTS: there were eight full paper rates as relevant studies. There was a significant difference of effect among the intervention group compared the control group (or placebo group). RR of the pooled estimate was 1.12 (95% CI: 1.06 - 1.18) with heterogeneity study 36%. While, the poled calculated based on type of micronutrient from seven studies showed there was no difference of sputum conversion between Vitamin D and placebo group (RR-1.05, 95% CI 0.99 - 1.12) with heterogeneity study 0% and a significant result seems among Zinc and Retinol intervention (RR=1.21, 95% CI 1.09 - 1.35) with heterogeneity study 40%. CONCLUSION: micronutrient intervention during tuberculosis treatment has a positive effect toward to sputum conversion among patient. Zinc and retinol influence sputum conversion while vitamin D did not.