AbstrakSampai dengan tahun 2013 dilaporkan ada 13 kasus leptospirosis di Kabupaten Banyumas.Terjadinya peningkatan kasus selama dua tahun terakhir perlu mendapat perhatian dari berbagai pihak agar kasus leptospirosis bisa segera ditangani. Tujuan penelitian ini adalah memetakan kasus leptospirosis dan menganalisis faktor risiko lingkungan dan perilaku yang memengaruhi leptospirosis. Penelitian ini menggunakan desain studi observasional kasus kontrol. Pengumpulan data dilakukan dengan wawancara, observasi, dan pengukuran. Analisis data menggunakan analisis spasial, analisis univariat, dan bivariat. Kasus adalah penderita leptospirosis berjumlah 13 orang dan kontrol adalah tetangga kasus yang tidak menderita leptospirosis berjumlah 52 orang. Hasil pemetaan menunjukkan kasus leptospirosis di Kabupaten Banyumas termasuk daerah aliran sungai dengan radius 600 meter ke sungai; seluruh kasus dekat dengan sawah (jarak < 1 km); sebagian besar memiliki vegetasi ≥ 3 jenis dan berada di daerah dengan curah hujan tinggi. Faktor lingkungan yang terbukti berhubungan dengan leptospirosis adalah kondisi jalan yang buruk sekitar rumah (OR = 4,90; CI 95% = 1,35 _ 17,10). Faktor perilaku yang berhubungan dengan leptospirosis adalah kebiasaan mandi/mencuci di sungai (OR = 4,35; 95% CI = 1,21 _ 15,60), riwayat peran serta dalam kegiatan sosial yang beresiko (OR = 12,00; 95% CI = 1,45 _ 99,09) dan penggunaan alat pelindung diri (OR = 7,50; 95% CI = 1,00 _ 62,18). Kata kunci: Leptospirosis, lingkungan, pemetaan, perilaku AbstractThere were 13 Leptospirosis cases in Banyumas in 2013. The increasing incidents in last 2 years should get an attention from all institutions. The study conducted was to map incidence of leptospirosis and analyze the environmental and behavior risk factors which associated leptospirosis case. This research was observational by case-control approach. The data was collected through interviews, observation and test. For analyzing the data, the researcher applied spatial analysis, univariate, and bivariate analysis. It was 13 leptospirosis cases and 52 people as the controls; they are the neighbors who are free from leptospirosis.The mapping showed that leptospirosis cases in Banyumas were along the riverin 600 meters radius, all cases with the distance of 0 _ 1 km into the rice field, had vegetation ≥ 3 species and those were in areas with high rainfall intensity. Environmental risk factor associated with leptospirosis was a bad road conditions around the house (OR = 4,90; CI 95% = 1,35 _ 17,10). Behavior risk factors werethe bathing/washing habit in the river (OR = 4,35; 95% CI = 1,21 _ 15,60, a history of participation in social activities (OR = 12,00; 95% CI = 1,45 _ 99,09)and the use of personal protective equipment (OR = 7,50; 95% CI = 1,00 _ 62,18).

Malaria remains one of the essential public health problems in Indonesia. The year 2015 was originally set as the elimination target in Java Island, but there are still several regencies on Java reporting malaria cases. Spatial technology helps determine local variations in malaria transmission, control risk areas and assess the outcome of interventions. Information on distribution patterns of malaria at the sub-district level, presented as spatial, temporal, and spatiotemporal data, is vital in planning control interventions. Information on malaria transmission at the sub-district level in three regencies in Java (Banyumas, Kebumen, and Purbalingga) was collected from the Agency for Regional Development (Bappeda), the Population and Civil Registration Agency (Disdukcapil) and Statistics Indonesia (BPS). Global spatial autocorrelation and space-time clustering was investigated together with purely spatial and purely temporal analyses using geographical information systems (GIS) by ArcGis 10.2 and SaTScan 8.0 to detect areas at high risk of malaria. Our results show that malaria was spatially clustered in the study area in central Java, in particular in the Banyumas and Purbalingga regencies. The temporal analysis revealed that malaria clusters predominantly appeared in the period January-April. The results of the spatiotemporal analysis showed that there was one most likely malaria cluster and three secondary clusters in southern central Java. The most likely cluster was located in Purbalingga Regency covering one sub-district and remaining from the beginning of 2016 to the end of 2018. The approach used can assist the setting of resource priorities to control and eliminate malaria.

Banyumas has not reached the elimination of malaria yet. One of the efforts is done by community empowerment by establishing malaria Community Health Workers (CHWs/JMD). JMD are people who conduct the discovery and medication of malaria in Active Case Detection (ACD). The research aims at describing JMDs attitude and knowledge towards the malaria elimination in Banyumas Regency in 2015. Quantitative research with cross sectional design was performed in the study. There were 15 JMDs spreading across in 7 public health centers/Puskesmas. The results show that most of JMDs were male with primary education background. They are mostly employed and do not join any training within 3 years. The average age of JMDs is 48.4 years old although there are some workers who are over 65 years old. 33.3% of JMDs are in low-medium categories, and there are 26.7% JMDs who have negative attitude to malaria. All JMDs have less skill such as not to do home visits as scheduled, not to do periodic reports, not to send blood preparations immediately and unstandardized of the blood preparation.

Background: The implementation of the COVID-19 vaccination is still being carried out in Indonesia to enhance immunity against SARS Cov-2 infection. However, the information about vaccination service satisfaction is still very limited. This study aims to assess how satisfied Covid-19 vaccination service users are in Indonesia. Design and methods: This is an analytic study with a cross-sectional design was conducted through an online survey in the third week of June 2022. People with a minimum age of 17 years, having received at least one COVID-19 vaccination, and residing in Indonesia were allowed to participate in this study. We used the SERVQUAL model as an instrument, measuring five aspects covering tangibility, responsiveness, reliability, assurance, and empathy. The analysis carried out included univariate analysis and bivariate test using chi-square statistical test. Results: A total of 509 respondents were included in this study. The findings of this study revealed that there was not much of a difference between the satisfied (50.1%) and dissatisfied categories (49.9%) of vaccination users. Of the five dimensions measured, the highest level of dissatisfaction is in tangibility particularly on facility (48.7%), while the highest level of satisfaction is in reliability (the vaccination service following applicable procedures; 59.7%). We find out that vaccination location ( p = 0.038), provision of refreshment/reward/incentives ( p = 0.001), providing emergency contact post-vaccination ( p = 0.000), and observation time post-vaccination ( p = 0.000) were associated with the satisfaction of users. Conclusion: Many respondents in this study are still dissatisfied with the COVID-19 vaccination services, so it is necessary for taking continuous efforts to raise the quality of vaccination services to increase user satisfaction.

Indonesia merupakan salah satu dari 5 negara dengan insiden tertinggi di dunia. Penemuan penderita TB paru secara aktif di masyarakat sangat penting untuk mencegah penularan lebih lanjut. Alternatif program pemberantasan TB paru adalah dengan Active Case Finding yaitu menjaring suspek TB paru dengan melibatkan peran serta masyarakat termasuk kader untuk meningkatkan angka cakupan (coverage) penemuan, pemeriksaan dan pengobatan TB paru. Kabupaten Banyumas termasuk kategori risiko sedang dalam kasus TB paru. Desa Linggasari Kecamatan Kembaran Kabupaten Banyumas merupakan salah satu dengan yang angka Case Detection Rate (CDR) atau angka penemuan kasus rendah. Karakteristik lain desa ini adalah merupakan desa salah satu desa dengan tingkat sosial ekonomi rendah. Kader yang ada di Linggasari mempunyai pengetahuan yang terbatas tentang TB paru, yang berdampak pada sedikitnya penemuan aktif penderita TB paru di Desa Linggasari. Untuk membantu mengatasi masalah ada beberapa upaya yang dilakukan pengkaderan, pendidikan/pelatihan dan pendampingan. Hasil kegiatan menunjukkan ada perubahan pengetahuan dan ketrampilan kader dalam penemuan penderita TB paru. Diharapkan dari kader ini dapat membantu proses penemuan, pengobatan dan pengawasan penderita TB paru sehingga menjadikan masyarakat sehat dan produktif.