ABSTRACT. Hemorrhagic fever with renal syndrome (HFRS) is a rodent-borne zoonotic disease caused by hantavirus infection. Many HFRS cases have been reported in East Asia and North Europe, while the situation in Southeast Asia remains unclear. In this study, the prevalence of hantavirus infection in rodents and humans in Thousand Islands regency, which is close to the port of Jakarta, one of the largest historic ports in Indonesia, was investigated. A total of 170 rodents were captured in 2005, and 27 (15.9%) of the rodents were antibody-positive against Hantaan virus antigen in an immunofluorescence assay (IFA) and Western blotting. Despite the high prevalence in rodents, human sera collected from 31 patients with fever of unknown origin and 20 healthy volunteers in the islands in 2009 did not show positive reaction to the antigen in IFA. To identify the virus in rodents genetically, a total of 59 rodents were captured in 2009. Sera from the rodents were screened for antibody by ELISA, and lung tissues were subjected to RT-PCR. 20 (33.9%) of the 59 rodents were antibody-positive, and 3 of those 20 rodents were positive for S and M genome segments of hantaviruses. Genetic analysis showed that the viruses belonged to Seoul virus and formed a cluster with those in Vietnam and Singapore. These results suggest that a unique group of Seoul viruses has spread widely in Southeast Asia.

Ectoparasites were sampled from small mammals collected in West Java, West Sumatra, North Sulawesi, and East Kalimantan, Indonesia, in 2007-2008 and were screened for evidence of infection from bacteria in the Rickettsaceae family. During eight trap nights at eight sites, 208 fleas were collected from 96 of 507 small mammals trapped from four orders (379 Rodentia; 123 Soricomorpha; two Carnivora; three Scandentia). Two species of fleas were collected: Xenopsylla cheopis (n = 204) and Nosopsyllus spp. (n = 4). Among the 208 fleas collected, 171 X. cheopis were removed from rats (Rattus spp.) and 33 X. cheopis from shrews (Suncus murinus). X. cheopis were pooled and tested for DNA from rickettsial agents Rickettsia typhi, Rickettsia felis, and spotted fever group rickettsiae. R. typhi, the agent of murine typhus, was detected in X. cheopis collected from small mammals in West Java and East Kalimantan. R. felis was detected in X. cheopis collected from small mammals in Manado, North Sulawesi. R. felis and spotted fever group rickettsiae were detected in a pool of X. cheopis collected from an animal in East Kalimantan. Sixteen percent of the X. cheopis pools were found positive for Rickettsia spp.; four (10.8%) R. typhi, one (2.7%) R. felis, and one (2.7%) codetection of R. felis and a spotted fever group rickettsia. These data suggest that rickettsial infections remain a threat to human health across Indonesia.

Bekasi City is one of the dengue-endemic areas in West Java province which has fluctuated the number of cases annually. Dengue transmission was influenced by the interaction between humans, virus, vector, and environmental factors. This study was conducted to analyze environmental factors and source reduction practices related to the status of dengue hemorrhagic fever (DHF) transmission in Bekasi. This study was an observational study with a cross-sectional design that was carried out in Mustikajaya Sub-district, Bekasi City. Total samples were 280 households from two villages. The obtained data were analyzed using chi-square and multivariate logistic regression with a p-value of 0.05. Bivariate analysis results showed that plants were taller than five meters (OR=7,98 95% CI=2,83-22,45), uneven growing vegetation (OR = 2.14 95% CI = 1.21-3, 78), even growing vegetation (OR = 8.84 95% CI-2.84-27.54), frequency of cleaning water containers at least once a week (OR = 2.9 95% CI = 1.77-4.78), and the use of anti-mosquito  (OR = 2.2 95% CI = 1.37-3.61) related to DHF transmission in Mustikajaya Sub-district. Dominant variables that contributed to the high dengue transmission in Mustikajaya District were the frequency of cleaning water containers and the use of household anti-mosquitoes. The socialization and evaluation of source reduction at the community level need to be improved so that the DHF control will be more effective Abstrak Kota Bekasi merupakan salah satu wilayah endemis Demam Berdarah Dengue (DBD) di Provinsi Jawa Barat dengan jumlah kasus fluktuatif setiap tahun. Transmisi DBD dipengaruhi oleh interakasi antara manusia, virus, nyamuk vektor, dan faktor lingkungan. Tujuan penelitian adalah menganalisis faktor lingkungan dan perilaku Pemberantasan Sarang Nyamuk (PSN) yang berhubungan dengan status transmisi DBD di Kota Bekasi. Penelitian ini merupakan studi observasional dengan desain cross sectional yang dilaksanakan di Kecamatan Mustikaya, Kota Bekasi. Jumlah sampel sebanyak 280 rumah tangga di dua kelurahan. Data dianalisis menggunakan chi square dan regresi logistik berganda dengan nilai P sebesar 0,05%. Hasil analisis bivariat menunjukkan bahwa tinggi tanaman lebih dari lima meter (OR=7,98 95% CI=2,83–22,45), rimbunan tanaman tidak merata (OR=2,14 95% CI=1,21-3,78) dan vegetasi tersebar merata (OR=8,84 95% CI-2,84-27,54), frekuensi membersihkan Tempat Penampungan Air (TPA) minimal satu minggu sekali (OR=2,9 95% CI=1,77-4,78), serta penggunaan obat anti nyamuk (OR=2,2 95% CI=1,37-3,61) berhubungan dengan transmisi DBD di Kecamatan Mustikajaya. Variabel dominan yang berkontribusi pada tingginya transmisi kasus DBD di Kecamatan Mustikajaya yaitu frekuensi membersihkan TPA dan penggunaan obat anti nyamuk. Sosialisasi dan evaluasi PSN di tingkat masyarakat perlu ditingkatkan agar pelaksanaannya lebih efektif dalam pengendalian DBD di Kota Bekasi.

The Healthy Indonesia Program with a Family Approach (PISPK) is conducted by the health center (puskesmas), which addressed to closer the public access to health services with a family target. Puskesmas would accept data and information from family health profiles (Prokesga) based on evidence, that needs to manage adequately so can be utilized as a document of drafting the action plan. Evaluation of the PISPK implementation in 2019 shows that the majority of puskesmas do not conduct and utilize PISPK Data. This study aims to describe how to manage, analyze, and utilization PISPK Data at puskesmas. The analysis is part of the PISPK implementation research conducted by the Center for Research and Development of Health Resources and Services through Participatory Action Research (PAR) approach in 8 puskesmas in Indonesia (2017-2018) using mixed methods. We had performed a Focus Group Discussion for the surveyor and an in-depth interview with the Head of Health Centers. PISPK Data analysed using Excel and SPSS. Results showed that still not proficient in data management and utilization at puskesmas sites. It is caused by several obstacles involve an administrative change of city or district; update of the healthy family application; restricted access of raw data, internet connection, and Prokesga storage, including limitations of data analysis skill also. Barriers can be minimalized use manual analysis and special training for management and data analysis. Results of data analysis for PISPK can also be used to determine program targets, to make a map of the individual problem, family, and area, which is utilized to arrange a draft of the Action Plan. Abstrak Program Indonesia Sehat dengan Pendekatan Keluarga (PISPK) dilaksanakan oleh puskesmas untuk mendekatkan akses pelayanan kesehatan dengan target keluarga. Puskesmas akan mendapatkan data dan informasi dari profil kesehatan keluarga (Prokesga) berdasar evidence yang perlu dikelola dengan baik sehingga dapat dimanfaatkan sebagai bahan penyusunan rencana usulan kegiatan. Evaluasi pelaksanaan PISPK 2019 menunjukkan mayoritas puskesmas belum melakukan analisis dan pemanfaatan data PISPK. Untuk itu, tulisan ini bertujuan menggambarkan bagaimana pengelolaan, analisis, dan pemanfaatan data PISPK di puskesmas. Analisis merupakan bagian dari riset implementasi PISPK yang dilakukan oleh Puslitbang Sumber Daya dan Pelayanan Kesehatan melalui pendekatan Parcipatory Action Research (PAR) di 8 puskesmas di Indonesia pada tahun 2017-2018 dengan metode kualitatif dan kuantitatif. Dilakukan Focus Group Discussion (FGD) terhadap petugas puskesmas dan wawancara mendalam kepada kepala puskesmas. Data PISPK diolah dengan menggunakan excel dan SPSS. Hasil menunjukkan bahwa pengelolaan dan pemanfaatan data PISPK di puskesmas lokus belum optimal. Hal ini terkendala, antara lain: perubahan administratif kota/kabupaten, perubahan versi aplikasi KS; tidak ada akses terhadap raw data; terbatasnya sinyal internet dan tempat penyimpanan Prokesga, termasuk juga keterbatasan kemampuan analisis data. Kendala dapat diminimalisir dengan analisis manual, dan pelatihan khusus manajemen dan analisis data. Hasil analisis data PISPK dapat digunakan dalam menentukan sasaran program, membuat peta masalah individu, keluarga dan wilayah yang dapat dimanfaatkan untuk penyusunan rencana usulan kegiatan.

Angka Kematian Ibu (AKI) tahun 2022 mencapai 207 per 100.000 kelahiran hidup. sedangkan Angka Kematian Bayi neonatal (usia 0-28 hari) mencapai 11,7 dari 1.000 bayi lahir hidup pada 2021. AKI ini berada di atas target Renstra yaitu 190 per 100.000 kelahiran hidup. Sebanyak 62% kedua kasus tersebut terjadi di fasilitas kesehatan rujukan tingkat lanjut (FKRTL). Meski masih memprihatikan namun ini menjadi penanda bahwa akses terhadap fasilitas kesehatan sudah lebih baik. Tujuan penelitian ini untuk mengetahui pengaruh status ekonomi keluarga, kepemilikan jaminan kesehatan dan faktor lainnya dalam keputusan keluarga menentukan tempat ibu bersalin. Sampel pada penelitian ini adalah wanita usia 10 – 54 tahun; berstatus kawin atau pernah kawin. Sebanyak 43.545 responden diambil dari data Susenas tahun 2019. Maximum Likelihood digunakan sebagai estimator dalam analisis yang dilakukan dengan model logit. Hasil penelitian menunjukkan secara bersama-sama variabel status ekonomi keluarga, kepemilikan jaminan kesehatan, usia, status kawin, pendidikan, lama pendidikan ibu, pekerjaan, wilayah tempat tinggal dan kepemilikan rumah signifikan berpengaruh terhadap pemilihan fasilitas kesehatan sebagai tempat bersalin dengan nilai p-value < 0,05 pada hasil uji logit. Pemilihan faskes sebagai tempat bersalin 1,728 kali lebih tinggi pada wanita yang memiliki jaminan kesehatan (? = 0,000; 95% CI 1,641 – 1,819). Keputusan memilih faskes untuk tempat bersalin dipengaruhi cukup signifikan oleh faktor ada tidaknya jaminan kesehatan yang dimiliki oleh ibu. Faktor lain yang ikut berpengaruh adalah usia, pendidikan, jumlah tahun menjalani pendidikan, wilayah tempat tinggal, status bekerja, kepemilikan rumah, status kawin dan status ekonomi keluarga yang dibagi menjadi 5 kuintil.