Dewa Nyoman Wirawan
Department Of Community And Preventive Medicine Faculty Of Medicine Udayana University

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Risk Factors of Poor Glycaemic Control among Patients with Type 2 Diabetes Mellitus at the Primary Health Center of Kembiritan Banyuwangi Regency Rizki Yulia Purwitaningtyas; I Wayan Gede Artawan Eka Putra; Dewa Nyoman Wirawan
Public Health and Preventive Medicine Archive Vol. 3 No. 1 (2015)
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53638/phpma.2015.v3.i1.p13

Abstract

Background and purpose: Number of patients with type 2 diabetes mellitus in Kembiritan Primary Health Center has increased as many as 160 in 2013 to 215 in 2014. This study was conducted to determine risk factors of poor glycaemic control among patients with type 2 diabetes mellitus in the Primary Health Center of Kembiritan Banyuwangi. Methods: The research design was a case control study of 55 patients with poor glycaemic control of diabetes mellitus as cases and 55 patients with good glycaemic control of diabetes mellitus as controls (1:1), who were randomly selected from the registers of patients with diabetes mellitus at the primary health center during 2014. Data was collected through interviews at the primary health center during March-May 2015 using questionnaires. Data was analyzed by univariate, bivariate (chi square test) and multivariate using logistic regression. Results: Bivariate analysis showed that duration of disease and nutritional status significantly increase risks of poor glycaemic control respectively with OR=2.9 (95%CI: 1.20-7.54) and OR=5.7 (95%CI: 1.82-21.04). Multivariate analysis showed four factors that increase the risk of poor glycaemic control, namely duration of disease with adjusted OR=3.8 (95% CI: 1.37 to 10.59), medication adherence, with adjusted OR=3.7 (95% CI : 1.30 to 10.59), nutritional status, with adjusted OR=6.6 (95%CI: 2.01-21.44) and distance of health facilities, with adjusted OR=3.1 (95%CI: 1.19-7.95). Conclusion: Risk factors for poor glycaemic control among patients with type 2 diabetes mellitus were disease duration, adherence of medication, nutritional status and distance to health facilities.
Tantangan dalam akreditasi terbitan berkala ilmiah Dewa Nyoman Wirawan
Public Health and Preventive Medicine Archive Vol. 1 No. 1 (2013)
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53638/phpma.2013.v1.i1.p01

Abstract

Dengan adanya Peraturan Direktur Jendral Pendidikan Tinggi Nomor 49/Dikti/Kep/2011 tentang Pedoman Akreditasi Terbitan Ilmiah maka langkah-langkah dalam tiga tahun ke depan yang perlu ditempuh menjadi sangat jelas dan rinci baik bagi pengelola maupun calon penulis tetapi akan diperlukan kerja amat keras untuk mewujudkannya. Namun, dengan semangat yang tinggi, dedikasi dan kerja keras, baik dari pengelola maupun calon penulis, maka saya yakin akreditasi Public Health and Preventive Medicine Archive pada akhir tahun 2016 akan bisa diraih. Semoga kita semua mendapatkan berkah dari Tuhan Yang Maha Esa.
History of contact and age as determinants of rubella among children in Badung District year 2012 I Ketut Subrata; Anak Agung Sagung Sawitri; Dewa Nyoman Wirawan
Public Health and Preventive Medicine Archive Vol. 1 No. 1 (2013)
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53638/phpma.2013.v1.i1.p02

Abstract

Rubella remains as a health concern in Bali. There have been seven times rubella outbreaks in the last two years, three of which occurred in Badung. No previous research exploring risk factors of rubella have been conducted in Bali. This case control study aimed to obtain the description of risk factors contributing to the incidence of rubella among children in Badung. Total samples were 69 cases and 138 controls. Data were collected by document analysis, interviews, observation and measurements. The instruments used are questionnaires, digital scales brand AND, multifunctional height gauge and meter. Data were analysed using univariate, bivariate and multivariate (logistic regression) methods. The majority of subjects were school-age 170 (82.1%), in a good nutrition status 193 (93.2%), non-immunised 197 (95.2%) and never had contact with the patient 118 (57%). The socioeconomic status is 172 (83.1%) above the regional minimum wage, 77 (37.2%) as private sector employees and 153 (86%) were highly educated. There were four variables found to increase risk of contracting rubella: children age OR=7.19 [95%CI: 2.12-24.36], contact history OR=45.23 [95%CI: 17.67-115.77], residential density OR=2.9 [95%CI: 1.31-6.46] and ventilation OR=3.34 [95%CI: 1.67-6.68]. In the multivariate analysis, contact history OR=44.09 [95%CI: 16.51-117.74] and age OR=16.83 [95%CI: 3.46-18.84] are two dominant factors contributing to rubella among children. Health promotion related to prevention and control, research with accurate diagnosis for control and considering rubella vaccination as a national program need to be conducted.
Environmental conditions, mobility and history of contact as determinants of dengue haemorrhagic fever in Denpasar, 2012 Kenyem Subagia; Anak Agung Sagung Sawitri; Dewa Nyoman Wirawan
Public Health and Preventive Medicine Archive Vol. 1 No. 1 (2013)
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53638/phpma.2013.v1.i1.p03

Abstract

Bali Province is endemic for Dengue Hemorrhagic Fever (DHF). Denpasar is reported to have the highest cases with incidence rates of 143.2 per 100.000 persons in 2011. Vaccine has not been available until recently and efforts to control the endemic are only achieved modest result. This case control study was aimed to identify risk factors for high incidence rate of DHF in Denpasar. Total cases were 80 and controls were 160 persons. The variables explored were characteristics of the respondents, indoor and outdoor environtment, respondent mobility, history of contact with the DHF patients and larvae presence in public places with a maximum radius of 100 m from respondent’s residence. The data were collected from documents, interviews and observations. The instruments used were questionnaires and check lists. Data analysis was carried out using univariate, bivariate (chi-square) and multivariate (logistic regression) analysis. Bivariate analysis showed several factors which increase the risk of dengue incidence in Denpasar: age OR=1.88 [95%CI: 1.09-3.23], indoor condition OR=8.27 [95%CI: 2.63-26.07], mobility OR=2.78 [95%CI: 1.57-4.92] and contact history OR=2.85 [95%CI: 1.62-5.03]. After multivariate analysis, the variables that contributed to increase the risk of DHF incidence in Denpasar were age OR=1.09 [95%CI: 1.06-1.11], indoor environment condition OR=10.74 [95%CI: 2.94-39.32], respondent mobility OR=3.12 [95%CI: 1.55-6.28] and history of contact OR=2.4 [95%CI: 1.21-4.79]. Health promotion need to be improved to prevent DHF by increasing indoor environmental quality including intervention to refregerator drainage and residual water tapping at dispenser
Low proportion of contact among people attending early detection for pulmonary tuberculosis in South Denpasar I Public Health Centre year 2012 Anak Agung Gede Agung; Anak Agung Sagung Sawitri; Dewa Nyoman Wirawan
Public Health and Preventive Medicine Archive Vol. 1 No. 1 (2013)
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53638/phpma.2013.v1.i1.p09

Abstract

Family members with positive BTA tuberculosis (TB) are vulnerable to be infected due to regular contact. However, awareness of early detection is still low, resulting in low rates of TB suspect identification and low detection of new cases in the public health centre. The study aims to measure the proportion of contacts in the house for people attending early detection for pulmonary tuberculosis, and to analyse the influence of perception of contacts to the behavior of early detection. This cross-sectional analytic study include 110 respondents taken from all family members of BTA pulmonary TB cases as recorded in TB register at South Denpasar I Public Health Center between 2010 and 2011. There were 49 samples who have ever underwent early detection and 61 samples have not. Data collected were analysed using univariate, bivariate (chi square) and multivariate with cox regression. The proportion of contact in the house who underwent early detection is still low (22.55%). The perception of vulnerability and threat were found to be associated with the early detection behavior. Cox regression analysis however showed none of those variables associated with the early detection of pulmonary tuberculosis. The study concluded that only small proportion of people who had contact with TB patient in a house was underwent early detection. The perception of vulnerability and threat influence the early detection behavior of pulmonary tuberculosis in South Denpasar I Public Health Center. The awareness campaign to increase early detection of pulmonary tuberculosis needs to be improved through enhancing the knowledge regarding the spread of TB and its symptoms.
Tantangan dalam upaya penemuan anak usia di bawah usia lima tahun dengan gizi buruk Dewa Nyoman Wirawan
Public Health and Preventive Medicine Archive Vol. 1 No. 2 (2013)
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53638/phpma.2013.v1.i2.p01

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Satu-satunya jalan keluar untuk mengatasi tantangan ini adalah mencari secara aktif dari rumah ke rumah dan difokuskan pada rumah tangga miskin yang datanya saat ini telah tersedia di seluruh Indonesia dalam data base Program Perlindungan Sosial 2011. Dengan duduk bersama, kesulitan pendanaan dalam memberikan insentif kepada kader untuk menjalankan tugas kunjungan dari rumah ke rumah pasti bisa dicarikan jalan keluarnya.
Long-term trends in Neisseria gonorrhoeae and Chlamydia trachomatis prevalence among brothel-based female sex workers in Denpasar, Bali, Indonesia Dewa Nyoman Wirawan; Emily Rowe; Fonny Silfanus; Putri Pidari; Gusti Ayu Satriani; Dewa Suyetna
Public Health and Preventive Medicine Archive Vol. 1 No. 2 (2013)
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53638/phpma.2013.v1.i2.p02

Abstract

The objective of this study is to analyze the long-term trends of Neisseria gonorrhoeae (NG) and Chlamydia trachomatis (CT) infections and risk factors among female sex workers (FSW) in Denpasar, Bali, Indonesia. In order to understand the long-term trends, secondary data was examined from the years 1997-1999, 2004, 2007, 2009 and 2010; to analyze associated factors, data from 2010 was used. Analysis indicates an overall decrease of NG prevalence in Bali from 60.5% (95%CI: 56.6-64.5) in 1997 to 22% (95%CI: 16.8-27.1) in 2010. CT prevalence has also experienced a long term decline but not to the same degree as NG. Findings from analysis of surveys in 2004 and 2010 indicate that there is a strong relationship between condom use in the last sexual transaction with NG infection (p=0.02), duration of sex work (p=0.02), number of clients in the last week (p=0.01), clinic visit intervals and clinic visit frequency. CT prevalence was associated with the number of clients (p=0.04) and clinic visit frequency. Unfortunately, these were the only variables collected therefore a multivariate analysis was not possible. High prevalence of both NG and CT is associated with the high mobility of FSW and low condom use. There is a significant long-term decrease of NG prevalence from 60.5% to 22%. However, CT experienced an insignificant long term decrease from 41.3% to 35%.
Risk factors of maternal mortality due to complications in pregnancy, delivery and postpartum in Bima Regency 2011–2012 Sri Juharni; I Ketut Tangking Widarsa; Dewa Nyoman Wirawan
Public Health and Preventive Medicine Archive Vol. 1 No. 2 (2013)
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53638/phpma.2013.v1.i2.p05

Abstract

The maternal mortality rate (MMR) in West Nusa Tenggara Province in 2010 is about 350/100,000 live births. This figure is higher than national and other provincial figures. Bima that constitutes a regency of West Nusa Tenggara Province has high maternal mortality cases for period of 2011-2012, namely 20 cases. The Ministry of Health classified 3 factors that affect maternal mortality, namely: medical, non-medical and health service factors. The study was aimed at finding out the risk factors that affect maternal mortality. This study is a case control study with the total samples of 20 cases and 60 controls. The data were collected through interviews by using the questionnaires. The collected data were then cross-checked with the registers existing at midwives, health record cards of pregnant women and verbal autopsy documents. The univariate, bivariate and multivariate analyses were done. Bivariate analysis was using chi square test and multivariate analysis was using logistic regression. The study revealed that factors which increase the maternal mortality rate are the level of Hb<10 gr% (OR=15.19; 95%CI: 3.25–70.97), delayed decision-making (OR=9.28; 95%CI: 2.15–84.80) and delayed medical treatment at referral facilities (OR=13.16; 95%CI: 2.28–104.86). As conclusion, the most contributing factor to maternal mortality is the level of Hb<10 gr%. The efforts to reduce mortality rate should be conducted including increasing Hb level of pregnant women, improving basic obstetric emergency handlings at community health centres for midwives/medical doctors and to improve better referral systems.
Determinant factors of infant mortality in Bima District in 2012 Rini Hendari; I Ketut Tangking Widarsa; Dewa Nyoman Wirawan
Public Health and Preventive Medicine Archive Vol. 1 No. 2 (2013)
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53638/phpma.2013.v1.i2.p09

Abstract

The infant mortality is the death of a child before the age of one year, can be caused by endogenous and exogenous factors. The infant mortality rates influenced by family income, maternal age, birth spacing, the frequency of the ANC visits, the place of delivery, birth weight, breastfeeding, immunisation, maternal knowledge about infant care, clean water sources sanitationary and education related to infant mortality. The purpose of this research was to identify the determinant factors of infant mortality in Bima regency. The type of research is observational analytic, with a case-control study design. The cases were infant who died in January to December 2012, while the control were infant who still alive on the same period. Cases and controls were selected from the community of Bima District. They were selected by using stratified proportional sampling technique and in total they were 153 respondents with a ratio of 1 to 2. Data was collected through interviews and midwives registers documentation. Data were analysed using chi square test and logistic regression. The result showed that the birth weight <2500 gr OR=6.69 (95%CI: 2.11-21.16), birth spacing <24 months OR=6.69 (95%CI: 2.11-21.16), maternal age <20 or >35 years OR=6.63 (95%CI: 1.84-23.90), not exclusively breastfeeding OR=6.23 (95%CI: 2.10-18.46), education related to infant mortality OR=6.02 (95%CI: 2.17-16.65) and clean water sources sanitationary OR=3.72 (95%CI: 1.35-10.25). It can be concluded that birth weight <2500 gr, spacing births <24 months, maternal age <20 or >35 years, not exclusively breastfeeding, education related to infant mortality, clean water sources sanitationary were determinants of infant mortality with the overall contribution of 61.1%. Improving education and promotion related to nutritional requirement for pregnant women, delay in age of marriage, pregnancy planning and exclusive breastfeeding in Bima District are highly essential.
Ledakan pertumbuhan penduduk di Provinsi Bali dan solusinya Dewa Nyoman Wirawan
Public Health and Preventive Medicine Archive Vol. 1 No. 2 (2013)
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53638/phpma.2013.v1.i2.p14

Abstract

Diperlukan penelitian untuk mengetahui perbedaan TFR dan pola pemakaian kontrasepsi pada penduduk migran dan penduduk lokal sehingga program dan jenis pelayanan bisa dikhususkan pada masing-masing kelompok tersebut. Misalnya, bila penduduk migran lebih memilih implan (KB Susuk), maka perlu disediakan pelayanan kontrasepsi jenis ini di daerah-daerah pemukiman mereka.
Co-Authors A.A.A.A. Candrawati Anak Agung Gede Agung Anak Agung Ngurah Gede Dharmayuda Brad Otto Claire Ryan Desak Nyoman Purniati Desak Nyoman Widyanthini Desak Putu Yulita Kurniati Dewa Ayu Ketut Sri Abadi Dewa Suyetna Dewi, Desak Made Sintha Kurnia Dinar Lubis Dinar Lubis Emily Rowe Emily Rowe Fonny Silfanus Gusti Ayu Satriani I Gusti Agung Trisna Windiani I Gusti Lanang Sidiartha I Ketut Duara I Ketut Subrata I Made Ady Wirawan I Made Bakta I Nyoman Sudiatmika I Nyoman Sutarsa I Putu Adiartha Griadhi I Wayan Gede Artawan Eka Putra I.N. Adnyana Surapathi Ida Ayu Dwi Astuti Minaka Ida Ayu Putri Widhiastuti Ifa Nurhasanah Irma Rubianti Jacinta dos Santos Guterres K Tangking Widarsa Kadek Dwi Ariesthi Kadek Tresna Adhi Kenyem Subagia Ketut Suarjana Ketut Tuti Parwati Merati Komang Ayu Kartika Sari Lina Anggaraeni Dwijayanti Lisa Sutiasih Luh Nyoman Sumiati Luh Pitriyanti Luh Putu Lila Wulandari Luh Putu Sri Armini Luh Putu Wulandari Luh Seri Ani Made Pasek Kardiwinata Made Suarjaya Mangku Karmaya Mangku Karmaya Musrifa Ni Kadek Ayu Dwi Utami Ds Ni Kadek Ethi Yudiastuti Ni Ketut Arniti Ni Luh Astri Indraswari Ni Luh Dea Kumala Sari Karang Ni Luh Putu Suariyani Ni Luh Putu Sudiasih Ni Made Ari Febriyanti Ni Putu Diwyami Ni Wayan Arya Utami, Ni Wayan Arya Ni Wayan Sri Rahayuni Nyoman Suardani Pande Putu Januraga Putri Pidari Putu Ayu Merry Antarina Putu Ayu Ratna Darmayanti Putu Ika Farmani Putu Sri Utami Putu Sukma Megaputri Rini Hendari Rizki Yulia Purwitaningtyas Sawitri, Anak Agung Sagung Shannon Turnbul Sri Juharni Vennesa Vitari Maureen Susanto Widya Aryati Widya Dwijayanti