BACKGROUND: Indonesia has set 2030 as its deadline for elimination of malaria transmission in the archipelago, with regional deadlines established according to present levels of malaria endemicity and strength of health infrastructure. The Municipality of Sabang which historically had one of the highest levels of malaria in Aceh province aims to achieve elimination by the end of 2013. METHOD: From 2008 to 2010, baseline surveys of malaria interventions, mapping of all confirmed malaria cases, categorization of residual foci of malaria transmission and vector surveys were conducted in Sabang, Aceh, a pilot district for malaria elimination in Indonesia. To inform future elimination efforts, mass screening from the focal areas to measure prevalence of malaria with both microscopy and PCR was conducted. G6PD deficiency prevalence was also measured.Result: Despite its small size, a diverse mixture of potential malaria vectors were documented in Sabang, including Anopheles sundaicus, Anopheles minimus, Anopheles aconitus and Anopheles dirus. Over a two-year span, the number of sub-villages with ongoing malaria transmission reduced from 61 to 43. Coverage of malaria diagnosis and treatment, IRS, and LLINs was over 80%. Screening of 16,229 residents detected 19 positive people, for a point prevalence of 0.12%. Of the 19 positive cases, three symptomatic infections and five asymptomatic infections were detected with microscopy and 11 asymptomatic infections were detected with PCR. Of the 19 cases, seven were infected with Plasmodium falciparum, 11 were infected with Plasmodium vivax, and one subject was infected with both species. Analysis of the 937 blood samples for G6PD deficiency revealed two subjects (0.2%) with deficient G6PD. DISCUSSION: The interventions carried out by the government of Sabang have dramatically reduced the burden of malaria over the past seven years. The first phase, carried out between 2005 and 2007, included improved malaria diagnosis, introduction of ACT for treatment, and scale-up of coverage of IRS and LLINs. The second phase, from 2008 to 2010, was initiated to eliminate the persist residual transmission of malaria, consisted of development of a malaria database to ensure rapid case reporting and investigation, stratification of malaria foci to guide interventions, and active case detection to hunt symptomatic and asymptomatic malaria carriers.
The devastating 2004 Indian Ocean tsunami caught millions of coastal residents and the scientific community off-guard. Subsequent research in the Indian Ocean basin has identified prehistoric tsunamis, but the timing and recurrence intervals of such events are uncertain. Here we present an extraordinary 7,400 year stratigraphic sequence of prehistoric tsunami deposits from a coastal cave in Aceh, Indonesia. This record demonstrates that at least 11 prehistoric tsunamis struck the Aceh coast between 7,400 and 2,900 years ago. The average time period between tsunamis is about 450 years with intervals ranging from a long, dormant period of over 2,000 years, to multiple tsunamis within the span of a century. Although there is evidence that the likelihood of another tsunamigenic earthquake in Aceh province is high, these variable recurrence intervals suggest that long dormant periods may follow Sunda megathrust ruptures as large as that of the 2004 Indian Ocean tsunami.
Men may find women with small feet relative to body size more attractive because foot size reliably indexes nubility-i.e., age and parity. I collected judgments of attractiveness in response to drawings of women with varying foot sizes from a sample of 159 Karo Batak respondents from North Sumatra, Indonesia, as part of a collaborative project on foot size and attractiveness. The data revealed a contrarian preference among the Karo Batak for women with big feet. The judgments were compared with the results of an existing cross-cultural study that found a preference for women with small feet in aggregate, but a mix of small- and large-foot preferences in the societies taken individually. Using contingency table analysis, I found that ecology and less exposure to Western media were associated with a preference for women with big feet; patriarchal values were not. The findings suggest that human mating preferences may arise in response to local ecological conditions, and may persist and spread via cultural transmission. This has implications for the concept of universality espoused in some versions of evolutionary psychology.
This study investigated the recollections of child survivors of the 2004 Asian tsunami in terms of their vantage point and posttraumatic stress disorder (PTSD) responses. Five years after the tsunami, 110 children (aged 7-13 years) living in Aceh, Indonesia were assessed for source of memories of the tsunami (personal memory or second-hand source), vantage point of the memory, and were administered the Children’s Revised Impact of Event Scale-13. Fifty-three children (48%) met criteria for PTSD. Two-thirds of children reported direct memories of the tsunami and one-third reported having memories based on reports from other people. More children (97%) who reported an indirect memory of the tsunami recalled the event from an onlooker’s perspective to some extent than those who recalled the event directly (63%). Boys were more likely to rely on stories from others to reconstruct their memory of the tsunami, and to adopt an observer perspective. Boys who adopted an observer’s perspective had less severe PTSD than those who adopted a field perspective. These findings suggest that, at least in the case of boys, an observer perspectives of trauma can be associated with levels of PTSD.
Zika virus (ZIKV) infection, a public health emergency of international concern, has recently been confirmed in Indonesia. However, to date, there has been no study to assess how prepared healthcare workers in Indonesia are to confront this emerging infectious disease. The aim of this study was to assess the attitudes of medical doctors in Indonesia towards ZIKV infection and its associated explanatory variables. A cross-sectional self-administered online survey was conducted from 3 May to 3 June 2016 in Aceh province, Indonesia. A pre-tested questionnaire was used to collect data on doctors' attitudes towards ZIKV infection and a range of explanatory variables (basic demographic data, professional characteristics, workplace characteristics and facilities, and medical experience related to ZIKV infection). Associations between attitude and explanatory variables were assessed using multiple-step logistic regression. We received 631 responses, 424 (67.19%) of which were included in the final analysis. Approximately 64% (271) of doctors had a poor attitude towards ZIKV infection. Experience considering ZIKV infection as a differential diagnosis and attendance at a national conference was associated with a good attitude, with odds ratios (OR) of 3.93 (95% confidence interval [CI]: 1.15-13.49) and 1.69 (95% CI: 1.03-2.76), respectively. Unexpectedly, doctors who had attended an international conference and those working at places that had molecular diagnostic (polymerase chain reaction based testing) facilities had lower odds of having a good attitude (OR: 0.35 [95% CI: 0.15-0.84] and 0.42 [95% CI: 0.19-0.95], respectively). In conclusion, the attitude towards ZIKV infection is relatively poor among doctors in Aceh. Therefore, strategies for enhancing their capacity to respond to ZIKV infection are needed. The survey concept and tools were well accepted by the participants of this study, suggesting that this rapid assessment could be rolled out across the Indonesian archipelago and elsewhere to identify and regionally differentiate unmet needs of disease and outbreak preparedness.
Purpose Problems in health-care leadership are serious in West Sumatra, Indonesia, especially in hospitals, which are controlled locally. The purpose of this paper is to present the experience of three hospitals in balancing the conflicting demands of the national health-care system and the traditional model of leadership in the local community. Design/methodology/approach Three case studies of the hospital leadership dynamic in West Sumatra were developed from in-depth interviews with directors, senior administrators and a representative selection of employees in various professional categories. Findings An analysis of findings shows that traditional views about leadership remain strong in the community and color the expectations of hospital staff. Hospital directors, however, are bound by the modern management practices of the national system. This conflict has intensified since regional autonomy which emphasizes the local culture much more than in the past. Research limitations/implications The research was carried out in one Indonesian province and was limited to three hospitals of different types. Practical implications The findings elucidate a potential underlying cause of problems in hospital management in Indonesia and may inform culturally appropriate ways of addressing them. Originality/value The social and cultural contexts of management have not been rigorously studied in Indonesia. The relationship between local and national culture reported here likely has a similar effect in other parts of the country.
Dengue virus infection is the most rapidly spreading vector-borne disease in the world. Essential research on dengue virus transmission and its prevention requires community participation. Therefore, it is crucial to understand the factors that are associated with the willingness of communities in high prevalence areas to participate in dengue research. The aim of this study was to explore factors associated with the willingness of healthy community members in Aceh province, Indonesia, to participate in dengue research that would require phlebotomy.
En el presente artículo se da a conocer una estrategia de intervención llevada a cabo con adultos mayores en la comuna de Paredones, sexta región de Chile, con posterioridad al terremoto y tsunami del 27 de febrero 2010 en Chile, en el contexto de una investigación sobre fortalezas y vulnerabilidades desplegadas por este grupo etario, con posterioridad a un desastre natural. Se presenta una descripción del desarrollo metodológico de la intervención y de los sustentos teóricos y conceptuales en los que se basa. Como resultado de este proceso, se propone una estrategia que trabaje a través de la identificación de las propias experiencias y fortalezas de los sujetos. De tal forma se minimizan los efectos negativos de los determinantes sociales de la salud (como la edad y el lugar de residencia) en contexto de crisis; permitiendo a los adultos mayores fortalecer sus recursos individuales y colectivos, en pro de su bienestar psicosocial.
Posyandu, or pos pelayanan terpadu (integrated service post), is a community-based activity for health services in Indonesia. According to the Indonesian Basic Health Survey, the prevalence of children under five in Indonesia who suffered from being underweight was 19.6 %. The wasting was 12.1 % and the stunting was 37.2 % in 2013, and these values have not changed greatly from 2007; much greater than the WHO targets of, less than 10 % underweight, 5 % wasting, and 20 % stunting. In Aceh were 26.6, 16.8, and 43.3 %, respectively. Also, the participation percentages of mothers to Posyandu was about 45 %, far below the national target of 100 %. In Aceh Province, the percentage was even lower (34 % in 2013). This study aimed to investigate the factors influencing participation of mothers in Posyandu.
To assess the risk for preterm deliveries <37 week of gestation and associated prevalence of vaginal infection in a rural setting after the tsunami in Banda Aceh, Indonesia.