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All Journal International Journal of Public Health Science (IJPHS) INDONESIAN JOURNAL OF BIOMEDICAL SCIENCES Journal of Public Health Research and Community Health Development (JPH RECODE) Public Health and Preventive Medicine Archive
Dewa Nyoman Wirawan
Department Of Community And Preventive Medicine Faculty Of Medicine Udayana University
Health Professions Medicine & Pharmacology Public Health

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Meningkatnya angka kematian ibu (MMRatio): apakah betul? Dewa Nyoman Wirawan
Public Health and Preventive Medicine Archive Vol. 2 No. 1 (2014)
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53638/phpma.2014.v2.i1.p01

Abstract

Dengan demikian, perlu amat hati-hati bila memakai data SDKI tahun 2012 untuk menentukan pencapaian target MDGs di Indonesia. Penelitian lain yang juga mengukur kematian ibu secara nasional adalah Sensus Penduduk 2010 yang sampai saat ini belum dipublikasikan hasilnya. Ada baiknya MMRatio dari hasil Sensus Penduduk 2010 juga dipublikasikan secara transparan disertai ulasan tentang kelemahan-kelemahannya sehingga bisa dikaji oleh berbagai pihak yang pakar di bidangnya.
Trends in HIV Prevalence, Condom Use and Associated Factors among Female Sex Workers in Denpasar, Bali, Indonesia Dewa Nyoman Wirawan; Emily Rowe; Made Suarjaya; Luh Putu Sri Armini
Public Health and Preventive Medicine Archive Vol. 2 No. 1 (2014)
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53638/phpma.2014.v2.i1.p02

Abstract

Objectives: The purpose of this paper is to review trends of HIV prevalence, condom use and associated risk factors among the female sex workers (FSW) in Denpasar, Bali. Methods: To analyze trends of HIV prevalence, surveillance data from 2000-2013 was used. Survey data from 2007 to 2013 was referenced for analysis of condom use trends. Data on associated risk factors was taken from 2012 integrated HIV and behavior survey. Results and conclusion: HIV prevalence among direct FSW in 2000 was as low as 1.6% (95%CI: 0.05-3.15) and continued to rise, reaching a prevalence peak of 22.5% (95%CI: 16.4-26.6) in 2010. HIV prevalence began to decline in 2011, 2012 and 2013. Analysis unearthed similar prevalence trends among indirect FSW albeit with a much lower prevalence of 0.25% in 2001, rising to 7.2% in 2010 and declining to 2.2% in 2013. The proportion of direct FSW reporting to always wear condoms in the last working week increased from 38% in 2007 (95%CI: 33.3-42.7) to 65% in 2013 (95%CI: 60.4-69.6). Multivariate analysis with logistic regression indicated that the significant risk factor with HIV prevalence was the specific grouping of FSW, in that low/mid-price are more at risk in comparison to high price with OR=4.37 (95%CI: 1.42-13.38). Risk factors associated with condom use was also the specific group of FSW, high price reported higher condom use with OR=4.04 (95%CI:2.03-8.04) and greater role of sex work site ‘pimps’ in encouraging their FSW to reject clients refusing to wear condoms with OR=2.06 (95%CI: 1.29-3.30). HIV prevalence among indirect and high-price direct FSW was much lower compared to prevalence in low/mid-price direct FSW. HIV prevalence and condom use among direct FSW population are significantly associated with group price range and the role of ‘pimps’.
Home Sanitation and Nutritional Status as Risk Factors of Pulmonary Tuberculosis (TB) at Karang Taliwang Health Centre, Mataram, West Nusa Tenggara Lisa Sutiasih; Dewa Nyoman Wirawan; Anak Agung Sagung Sawitri
Public Health and Preventive Medicine Archive Vol. 2 No. 1 (2014)
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53638/phpma.2014.v2.i1.p10

Abstract

Background and purpose: Tuberculosis (TB) is a continuing health problem in Mataram, particularly at the Karang Taliwang Health Centre (KTHC), which has the highest prevalence of TB - 294/100,000 in 2010; 173/100,000 in 2011. This study investigates the risk factors of pulmonary TB in KTHC. Methods: Study design used was a case control, 46 respondents with pulmonary TB and 92 persons without either TB/acute respiratory infection were controls. Variables examined were: house sanitation, socio-economic, nutrition, cigarette smoke exposure, other infections and immunisation status. Data was obtained by direct survey on site, measurement using role meter, hygrometer, lux-meter, mistar and HIV test. Data were analysed using univariate, bivariate and multivariate analysis. Results: Bivariate analysis shows that risk factors were house sanitation (ventilation, humidity, light and population density), socio-economic factors, nutritional status and other disease. Multivariate analysis indicated risk factors were: ventilation with OR=2.87 (95%CI: 1.01-8.20), humidity with OR=3.91 (95%CI: 1.28-11.89), sunlight access with OR=4.46 (95%CI: 1.34-14.85), temperature with OR=5.41 (95%CI: 1.90-15.39), nutrition with OR=6.74 (95%CI: 2.52-18.02). These factors contributed to 48.9% TB occurences. Conclusion: This study found that house sanitation and nutritional status are risk factors of of TB transmission at KTHC, Mataram.
Factors related to Acceptance of HIV Testing by Pregnant Mothers in Health Centres in Denpasar City Ni Ketut Arniti; Luh Putu Wulandari; Dewa Nyoman Wirawan
Public Health and Preventive Medicine Archive Vol. 2 No. 1 (2014)
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53638/phpma.2014.v2.i1.p12

Abstract

Purpose: To determine reasons of pregnant mothers to undergo HIV testing and factors influencing this decision. Methods: The study design was a cross-sectional survey with a sample of 120 pregnant mothers seeking antenatal care in two sites: Puskesmas I Denpasar Utara and Puskesmas II Denpasar Selatan, during the period of 26 March to 22 April 2014. Data were collected through interviews using a structured questionnaire. Data were analysed using univariate to determine the frequency distribution of each variable, bivariate to determine the relationship between the dependent variable with each independent variable by the chi-squared test and multivariate analysis performed by logistic regression to determine the dominant factors to improve the acceptance of pregnant mothers to HIV testing. Results: Reasons to undergo HIV testing were on recommendation from health providers (65.8%), concern for personal status (61.7%) and concerns about possibility of vertical transmission (19.2%). Bivariate analysis showed that the acceptance by pregnant mothers was higher in mothers unemployed (75.8%; p=0.033), good knowledge about HIV and its transmission (78.4%; p=0.001), was susceptible to HIV/AIDS (72.0%; p=0.019), the perception that HIV/AIDS is a severe disease (77.0%; p≤0.001), perceptions of the benefits of HIV testing (70.8%; p=0.002), absence perceived barriers (100%; p≤0.001) as well as good support from husband/family (87.7%; p≤0.001). Multivariate analysis showed that factors influencing were support from husband/family with OR=8.71 (95%CI: 2.89-26.28), perception of severity of HIV with OR=3.39 (95%CI: 1.08-10.69) and employment status with OR=2.82 (95%CI: 1.07-7.42). Conclusion: The majority of women to undergo HIV testing because of recommendations by staff and a desire to know HIV status. Acceptance of HIV testing among pregnant mothers was influenced by the support of the husband/family, the perception of the severity of HIV / AIDS, and employment status.
Tobacco Smoke Exposure as Risk Factor in Early Neonatal Death in Mataram, Nusa Tenggara Barat (NTB) Musrifa; Luh Putu Lila Wulandari; Dewa Nyoman Wirawan
Public Health and Preventive Medicine Archive Vol. 2 No. 1 (2014)
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53638/phpma.2014.v2.i1.p13

Abstract

Objective: To investigate tobacco smoke exposure as risk factor of early neonatal death in Mataram, NTB. Method: The study design was case control with a total sample of 87 consisting of 29 cases and 58 controls (1:2). Dependent variable was early neonatal death, independent variable was tobacco smoke exposure. Frequency of antenatal visit, family income, delivery complications, anemia and low birth weight were confounding variables. Data were collected through interview and registered cohort data from nine health centres during the period of 1 January-31 December 2013. Data were analyzed by using bivariate and multivariate (logistic regression) to calculate crude OR and adjusted OR. Result: Results of bivariate analysis indicated that tobacco smoke exposure during pregnancy, extent of exposure ≥3 cigarettes/days during pregnancy, and amount of exposure ≥6 cigarettes/days last 24 hours were 2.75 (95%CI: 0.72-10.50); 2.34 (95%CI: 0.77-7.08); and 2.18 (95%CI: 0.65-7.29) respectively, increasing neonatal death but was not statistically significant. Multivariate analysis indicated that tobacco smoke exposure during pregnancy was 1.32 (95%CI: 0.03-69.90). OR of other variables: low birth weight, family income under IDR 1,100,000,- and delivery complications were 204.39 (95%CI: 20.37-2050.07); 7.86 (95%CI: 1.45-42.83) and 7.55 (95%CI: 1.01-56.38) respectively. Conclusion: Tobacco smoke exposure was not statistically significant risk factor, specifically the smoking habits of the husband. Study discovered that low birth weight, family income under IDR 1,100,000,- and delivery complication during birth were statistically significant factors. Further study is needed to confirm these findings.
Retrospective Longitudinal Analysis: Loss to Follow Up Undergoing Antiretroviral Therapy in Kerti Praja Foundation Bali 2002-2012 Desak Nyoman Widyanthini; Anak Agung Sawitri Sawitri; Dewa Nyoman Wirawan
Public Health and Preventive Medicine Archive Vol. 2 No. 1 (2014)
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53638/phpma.2014.v2.i1.p15

Abstract

Background and purpose: Lower loss to follow up (LTFU) is one indicator of the success of antiretroviral therapy (ART). In 2013 the Indonesian Ministry of Health reported that the cumulative percentage of LTFU was as high as 17.3%. To date, there has been no retrospective research into LTFU on people living with HIV/AIDS (PLHIV) in Bali, particularly to investigate PLHIV client characteristics. Methods: This descriptive longitudinal study was conducted to analyze secondary data from records of PLHIV initiating ART between 2002-2012 at Clinic Amertha, Kerti Praja Foundation (YKP). The sample was PLHIV receiving ART at the YKP from 2002-2012 that had first received ART in YKP and had minimum 2 consultations. Data used was that recorded in the medical records. Variables were: age, gender, occupation, the presence of ART supervisor, and HIV transmission mode. Data were analyzed descriptively to obtain insight into characteristics of LTFU clients per 100 person years (PY). Length of time since LTFU was assessed. Results: The sample was 548: 77 (14,1%) were LTFU with crude incidence of LTFU at 5.15 per 100 PY. Median time of LTFU was not reached in this study, because of the low outcome incidence. Specific LTFU incidence was higher in women (6.6 per 100 PY), younger age (6.0 per 100 PY), and female sex workers (7.3 per 100 PY). Lack of ART supervisor (9.3 per 100 PY) and homosexual (9.1 per 100 PY) also had higher LTFU incidence. Conclusion: Specific LTFU incidence was higher in women, younger age, female sex workers, lack of ART supervisor, and homosexual.
Risk Factors of Pulmonary Smear Positive Tuberculosis Incidence in Dili District Timor Leste 2014 Jacinta dos Santos Guterres; Luh Putu Lila Wulandari; Dewa Nyoman Wirawan
Public Health and Preventive Medicine Archive Vol. 2 No. 2 (2014)
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53638/phpma.2018.v2.i2.p14

Abstract

Background and objectives: According to the WHO, the pulmonary tuberculosis (TB) in Timor-Leste is estimated to have the highest mortality rate in the region which is 45 per 100,000 populations. The aim of this study was to determine the risk factors for pulmonary tuberculosis in the Dili District. Methods: The study design was a case-control. Cases were patients with positive BTA pulmonary tuberculosis, and controls were non TB patients registered at two TB clinics (Motael and Bairro-Pite) and the three public health centers (Comoro, Formosa and Becora) in Dili, July 2013 - February 2014. Numbers of samples were 138 people consisting of 46 cases and 92 controls (1:2). Risk factors studied were smoking habits, contact with patients, nutritional status, family income, population density, sun lighting, ventilation and the use of firewood for cooking. Data were collected through interviews, observation and measurement. Bivariate analysis was performed to determine the similarity between cases and controls and to calculate the crude OR. Multivariate analysis with logistic regression was performed to determine adjusted risk factors that contribute to the increasing TB patients. Results: There were no significant differences between cases and control groups in age, gender, education and occupation (p>0.05). Bivariate analysis showed that the risk factors of pulmonary tuberculosis were the contact with patients (OR=2.809; 95%CI: 1.337-5.900), nutritional status (OR=2.380; 95%CI: 1.096-5.169), the sun lighting (OR=8.090; 95%CI: 3.468-18.872) and ventilation (OR=6.141; 95%CI: 2.709-13.924). Multivariate analysis showed that the significant risk factors were the contact with patients (OR=3.428; 95%CI: 1.455-8.075) and exposure to sunlight (OR=4.601; 95% CI: 1.336-15.845). Conclusion: The contact with patients and the exposure to sunlight were the risk factors for pulmonary TB of positive BTA at the Dili District of Timor Leste.
Mengembalikan Kondisi Bali Menjadi Bebas Rabies Dewa Nyoman Wirawan
Public Health and Preventive Medicine Archive Vol. 3 No. 2 (2015)
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53638/phpma.2015.v3.i2.p01

Abstract

Upaya-upaya yang bisa ditempuh untuk kembali pada kondisi Bali sebelum tahun 2008 yaitu bebas rabies, antara lain seperti berikut. 1) Melakukan vaksinasi rutin setiap tahun pada sekurangkurangnya 70% dari populasi anjing. Hal ini juga akan meningkatkan citra Bali di manca negara sehingga turis tidak merasa khawatir untuk datang ke Bali. 2) Karena vaksinasi anjing harus dilakukan setiap tahun, maka agar pelaksanaannya bisa berkelanjutan dan bisa mencapai cakupan 70%, perlu dibentuk Tim Rabies Tingkat Desa. 3) Tim Rabies Tingkat Desa perlu dilatih dalam hal: a) keterampilan pendekatan kepada masyarakat, b) pemetaan jumlah anjing di masing-masing desa, c) teknik menangkap anjing yang sulit ditangkap, d) pemberian tanda yang baik pada anjing sesudah diberikan vaksinasi, e) teknik surveilans, f) sistem pencatatan dan pelaporan serta g) cara-cara pertolongan pertama yang benar bila ada anggota masyarakat yang digigit anjing. 4) Sebelum dilakukan pada semua desa, diperlukan pelatihan di 3-4 desa sebagai percontohan. Kelemahan dan kekurangan dalam percontohan kemudian disempurnakan sebelum diterapkan pada jumlah desa yang lebih banyak. 5) Pelatihan hendaknya dilaksanakan oleh pelatih profesional yang telah berpengalaman dalam bidang pemberdayaan masyarakat, pelatihan partisipatif dan penanggulangan rabies. 6) Penanggulangan rabies di masing-masing desa hendaknya dirancang dalam penyusunan Rencana Pembangunan Jangka Menengah Desa (RPJM Desa) dan Rencana Kerja Pemerintah Desa (RKP Desa) dan insentif untuk Tim Rabies Tingkat Desa dianggarkan dalam Anggaran Pendapatan dan Belanja Desa (APB Desa) yang dananya bersumber dari Alokasi Dana Desa (ADD). 7) Tata laksana penanggulangan rabies pada manusia (pengadaan VAR, keberlanjutan rabies center, pelatihan-pelatihan kepada petugas kesehatan serta kegiatan lainnya) yang telah dilaksanakan selama ini hendaknya tetap dipertahankan atau disempurnakan.
Duration of Exclusive Breastfeeding, Housing and Environmental Conditions as Risk Factors of Pneumonia among Under–Five Children at Public Health Center II South Denpasar Ni Kadek Ethi Yudiastuti; Anak Agung Sagung Sawitri; Dewa Nyoman Wirawan
Public Health and Preventive Medicine Archive Vol. 3 No. 2 (2015)
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53638/phpma.2015.v3.i2.p02

Abstract

Background and purpose: In 2012, the South Denpasar II Public Health Center (PHC) had the 2nd highest percentage of reported cases of pneumonia (15.9%). This study aims to determine duration of exclusive breastfeeding, housing and environment conditions as risk factors of pneumonia among under-five children. Methods: The study design was a case control. The cases were 60 under-five children with pneumonia and recorded in the PHC register between 1 January 2014 to 31 March 2015. Controls were 60 healthy under-five children visiting the PHC during study. Interviews with parents were conducted using questionnaires, and observation carried out using specific guidelines. Measurements of house physical environment variables were conducted using hygrometer, lux meter and roll meter. Data were analyzed using Stata SE 12.1. Results: Characteristics of mothers were comparable in terms of age, education, and income; while the children were comparable in terms of age and gender. Risk factors found to increase pneumonia were duration of exclusive breastfeeding <2 months with OR=5.24 (95%CI: 1.96-14.01), no Hib and pneumococcal immunization with OR=3.68 (95%CI: 1.11-12.17), access to natural lighting with OR=2.72 (95%CI: 1.05-7.00) and house density with OR=3.11 (95%CI: 1.18-8.19). Frequency of acute respiratory tract infection (ARTI) >1 time in 6 months with OR=10.14 (95%CI: 3.67-28.02) were also found to be risk factors. Conclusion: Duration of exclusive breastfeeding, lack of natural lighting and house density were risk factors for pneumonia among under-five children.
Perceived Benefits as Variable Related to Voluntary Enrolment in the National Health Insurance Program (JKN) at Public Health Centre I East Denpasar Ida Ayu Putri Widhiastuti; Pande Putu Januraga; Dewa Nyoman Wirawan
Public Health and Preventive Medicine Archive Vol. 3 No. 2 (2015)
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53638/phpma.2015.v3.i2.p13

Abstract

Background and purpose: By 2019 all Indonesian citizens should be covered by the JKN program. In 2015 the proportion of population covered by JKN was 53.4%, constituting 34.0% paid by the government, 4.3% by their employer and 3.9% independently, while 57.8% were not covered by JKN. In order to achieve universal coverage there needs to be increased enrolment from non-government employees and people who work independently. This study aims to understand the relationship between out patient enrolment and sociodemographic variables, information about JKN, perceived risk of falling sick, perceived benefits and barriers to access JKN. Methods: Cross sectional sample survey was conducted among 188 households, consist of 94 non-employee JKN participants and 94 respondents not yet enrolled. Data was collected through interview and analyzed by univariate, bivariate and multivariate analysis using logistic regression. Results: Exposure to JKN information was 89.36%. Bivariate and multivariate analysis showed that the only variable associated with JKN enrollment was perceived benefits with adjusted OR=4.53 (95%CI: 2.15-9.55). There was no association with sociodemographic variables, information regarding JKN and health status risk perception. Conclusion: Variable connected with voluntary JKN enrolment at Primary Health Care I Denpasar East was perception of benefits.
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