Background Aedes aegypti is the main vector of several arthropod-borne viral infections in the tropics profoundly affecting humans, such as dengue fever (DF), West Nile (WN), chikungunya and more recently Zika. Eradication of Aedes still largely depends on insecticides, which is the most cost-effective strategy, and often inefficient due to resistance development in exposed Aedes populations. We here conducted a study of Ae. aegypti resistance towards several insecticides regularly used in the city of Denpasar, Bali, Indonesia.Methods Aedes aegypti egg samples were collected with ovitraps and thereafter hatched in the insectary of the Gadjah Mada University. The F0 generation was used for all bioassay-related experiments and knockdown resistance (kdr) assays.ResultsResults clearly showed resistance development of Ae. aegypti against tested insecticides. Mortalities of Ae. aegypti were less than 90% with highest resistance observed against 0.75% permethrin. Mosquitoes from the southern parts of Denpasar presented high level of resistance pattern in comparison to those from the western and northern parts of Denpasar. Kdr analysis of voltage-gated sodium channel (Vgsc) gene showed significant association to S989P and V1016G mutations linked to resistance phenotypes against 0.75% permethrin. Conversely, Ae. aegypti F1534C gene mutation did not result in any significant correlation to resistance development.ConclusionsPeriodically surveillance of insecticide resistances in Ae. aegypti mosquitoes will help local public health authorities to set better goals and allow proper evaluation of on-going mosquito control strategies. Initial detection of insecticide resistance will contribute to conduct proper actions in delaying mosquito resistance development such as insecticide rotation or combination of compounds in order to prolong chemical efficacy in combating Ae. aegypti vectors in Indonesia.

The implementation of the Human Papillomavirus (HPV) vaccination program is still experiencing obstacles in several developing countries. This setback is related to the lack of knowledge and the high cost of the vaccine so that it affects people's behavior about the HPV vaccine. HPV vaccination in adolescents itself as primary prevention has not been widely conducted by adolescents in Indonesia. The results of previous studies showed that not many teenagers had vaccinated against HPV by using self-financing guarantees such as health savings. The obstacles faced in implementing HPV vaccination are that the vaccine is still expensive and there is lack of knowledge of parents and adolescents about the importance of HPV immunization. This formative research using qualitative methods was conducted to analyze the implementation plan of the HPV vaccination program. Data were collected through focus group discussions (FGD) and in-depth interviews. At the end of each FGD activity or interview, transcription and thematic analysis based on content were done. The FGD participants were ten teachers, while the in-depth interview participants were one school committee. This study found two main themes, namely the scheme of implementing the HPV vaccination program and obstacles to the implementation of HPV vaccination. Schools generally supported the program implementation. However, parents still question the importance of the HPV vaccination for their daughters and consider the vaccine costs expensive. Implementation of the HPV vaccination program must consider the existing program schemes in schools and possible obstacles. The results suggested that for the next HPV vaccination program, the facilitators should provide intense and relevant education to parents about the importance and side effects of HPV immunization, and are expected to build a willingness of parents to vaccinate their daughters and seek vaccination costs, one of which can be through a savings program.

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COVID-19 is currently a global problem where transmission is fast and easy to humans. The disease can be symptomatic or without symptoms. Patients with the disease can transmit COVID-19 when the medical team is exposed to these patients. Prevention of transmission as well as early recognition of exposed medical teams is our focus of attention to residents and consultants obgin on our part. The aim of this activity is to evaluate the transmission prevention policies and early detection of COVID-19 in the Obstetrics and Gynecology (OBSGYN) Department, Faculty of Medicine, Public Health, and Nursing Universitas Gadjah Mada and Sardjito General Hospital. This activity is a management of prevention of transmission and early detection of transmission of COVID-19 among staff and residents of the OBSGYN. The data comes from the report of the COVID-19 team from the OBSGYN Department and the medical records of staff and residents. To prevent the transmission of COVID infection, actions taken by the OBSGYN Department are : a) arrangement of staff and resident watch schedules, b) use of PPE (Personal Protective Equipment) according to protocol, c) tracing or exposure tracking and d) early detection. Resident watch schedule arrangement is carried out by withdrawing residents from network hospitals so that the division of duty schedules at Sardjito General Hospital in a day is divided into 2 shifts of 12 hours each. The PPE usage policy is adjusted to the level of the COVID exposure space and in accordance with established standards. A total of 65 out of 74 residents (88%) had been exposed to suspected COVID-19 patients, and of the exposed residents 12 residents (18%) were isolated independently because of clinical manifestations, exposure to rapid COVID (+) patients or exposure to COVID (+) confirmed patients from the results of the PCR swab. As many as 13 out of 27 staff (48%) have undergone a rapid COVID-19 test with a 100% negative result, 66 of the 74 residents (89%) have undergone a COVID-19 rapid test with a 100% negative result. Efforts to prevent the transmission of COVID-19 have been carried out by the Department of OBSGYN, the results of screening with rapid tests gave negative results on all examinations.