Indonesia: A republic stretching from the Indian Ocean east to New Guinea, comprising six main islands: Java, Sumatra, Bali, Kalimantan (the Indonesian portion of the island of Borneo), Sulawesi (formerly known as the Celebes) and Irian Jaya (the western part of New Guinea). Its capital is Djakarta. The ethnic groups living there are largely Chinese, Arab, Eurasian, Indian, and Pakistani; 85% of the peoples are of the Islamic faith.Asia, Southeastern: The geographical area of Asia comprising BORNEO; BRUNEI; CAMBODIA; INDONESIA; LAOS; MALAYSIA; the MEKONG VALLEY; MYANMAR (formerly Burma), the PHILIPPINES; SINGAPORE; THAILAND; and VIETNAM.Malaria, Vivax: Malaria caused by PLASMODIUM VIVAX. This form of malaria is less severe than MALARIA, FALCIPARUM, but there is a higher probability for relapses to occur. Febrile paroxysms often occur every other day.Terrorism: The use or threatened use of force or violence against persons or property in violation of criminal laws for purposes of intimidation, coercion, or ransom, in support of political or social objectives.Chemical Terrorism: The use of chemical agents in TERRORISM. This includes the malevolent use of nerve agents, blood agents, blister agents, and choking agents (NOXAE).Quality of Life: A generic concept reflecting concern with the modification and enhancement of life attributes, e.g., physical, political, moral and social environment; the overall condition of a human life.Cystitis, Interstitial: A condition with recurring discomfort or pain in the URINARY BLADDER and the surrounding pelvic region without an identifiable disease. Severity of pain in interstitial cystitis varies greatly and often is accompanied by increased urination frequency and urgency.Delphi Technique: An iterative questionnaire designed to measure consensus among individual responses. In the classic Delphi approach, there is no interaction between responder and interviewer.Dipteryx: A plant genus of the family FABACEAE. Members contain COUMARINS.Nevus of Ota: A macular lesion on the side of the FACE, involving the CONJUNCTIVA and EYELIDS, as well as the adjacent facial skin, SCLERA; OCULOMOTOR MUSCLES; and PERIOSTEUM. Histological features vary from those of a MONGOLIAN SPOT to those of a BLUE NEVUS.Jewelry: Objects of precious metal usually containing gems and worn to enhance personal appearance. Health concerns include possible contamination from lead content or bacteria.Stevens-Johnson Syndrome: Rare cutaneous eruption characterized by extensive KERATINOCYTE apoptosis resulting in skin detachment with mucosal involvement. It is often provoked by the use of drugs (e.g., antibiotics and anticonvulsants) or associated with PNEUMONIA, MYCOPLASMA. It is considered a continuum of Toxic Epidermal Necrolysis.Laser Therapy: The use of photothermal effects of LASERS to coagulate, incise, vaporize, resect, dissect, or resurface tissue.Lentigo: Small circumscribed melanoses resembling, but differing histologically from, freckles. The concept includes senile lentigo ('liver spots') and nevoid lentigo (nevus spilus, lentigo simplex) and may also occur in association with multiple congenital defects or congenital syndromes (e.g., Peutz-Jeghers syndrome).United Nations: An international organization whose members include most of the sovereign nations of the world with headquarters in New York City. The primary objectives of the organization are to maintain peace and security and to achieve international cooperation in solving international economic, social, cultural, or humanitarian problems.Agriculture: The science, art or practice of cultivating soil, producing crops, and raising livestock.Encyclopedias as Topic: Works containing information articles on subjects in every field of knowledge, usually arranged in alphabetical order, or a similar work limited to a special field or subject. (From The ALA Glossary of Library and Information Science, 1983)Matrix Metalloproteinase 15: A transmembrane domain-containing matrix metalloproteinase that plays a role in the cleavage of proteins in the pericellular environment. It is synthesized as an inactive zymogen that is activated by the action of ENDOPEPTIDASES such as MATRIX METALLOPROTEINASE 14.West Indies: Islands lying between southeastern North America and northern South America, enclosing the Caribbean Sea. They comprise the Greater Antilles (CUBA; DOMINICAN REPUBLIC; HAITI; JAMAICA; and PUERTO RICO), the Lesser Antilles (ANTIGUA AND BARBUDA and the other Leeward Islands, BARBADOS; MARTINIQUE and the other Windward Islands, NETHERLANDS ANTILLES; VIRGIN ISLANDS OF THE UNITED STATES, BRITISH VIRGINI ISLANDS, and the islands north of Venezuela which include TRINIDAD AND TOBAGO), and the BAHAMAS. (From Webster's New Geographical Dictionary, 1988, p1330)Borneo: An island in the Malay Archipelago, east of Sumatra, north of Java, and west of Celebes. It is the third largest island in the world. Its name is a Portuguese alteration of BRUNEI, located on it. (From Webster's New Geographical Dictionary, 1988, p163; Room, Brewer's Dictionary of Names, 1992, p73)Financial Support: The provision of monetary resources including money or capital and credit; obtaining or furnishing money or capital for a purchase or enterprise and the funds so obtained. (From Random House Unabridged Dictionary, 2d ed.)International Cooperation: The interaction of persons or groups of persons representing various nations in the pursuit of a common goal or interest.Europe, EasternResource Allocation: Societal or individual decisions about the equitable distribution of available resources.Delivery of Health Care: The concept concerned with all aspects of providing and distributing health services to a patient population.Osmotic Fragility: RED BLOOD CELL sensitivity to change in OSMOTIC PRESSURE. When exposed to a hypotonic concentration of sodium in a solution, red cells take in more water, swell until the capacity of the cell membrane is exceeded, and burst.Airports: Terminal facilities used for aircraft takeoff and landing and including facilities for handling passengers. (from McGraw-Hill Dictionary of Scientific and Technical Terms, 6th ed.)Transportation: The means of moving persons, animals, goods, or materials from one place to another.Weather: The state of the ATMOSPHERE over minutes to months.Typhoid Fever: An acute systemic febrile infection caused by SALMONELLA TYPHI, a serotype of SALMONELLA ENTERICA.Automobiles: A usually four-wheeled automotive vehicle designed for passenger transportation and commonly propelled by an internal-combustion engine using a volatile fuel. (Webster, 1973)Railroads: Permanent roads having a line of rails fixed to ties and laid to gage, usually on a leveled or graded ballasted roadbed and providing a track for freight cars, passenger cars, and other rolling stock. Cars are designed to be drawn by locomotives or sometimes propelled by self-contained motors. (From Webster's 3d) The concept includes the organizational and administrative aspects of railroads as well.Radiography, Dental, Digital: A rapid, low-dose, digital imaging system using a small intraoral sensor instead of radiographic film, an intensifying screen, and a charge-coupled device. It presents the possibility of reduced patient exposure and minimal distortion, although resolution and latitude are inferior to standard dental radiography. A receiver is placed in the mouth, routing signals to a computer which images the signals on a screen or in print. It includes digitizing from x-ray film or any other detector. (From MEDLINE abstracts; personal communication from Dr. Charles Berthold, NIDR)Software: Sequential operating programs and data which instruct the functioning of a digital computer.Algorithms: A procedure consisting of a sequence of algebraic formulas and/or logical steps to calculate or determine a given task.Software Design: Specifications and instructions applied to the software.Laser Capture Microdissection: Techniques using a laser to cut away and harvest a specific cell or cluster of cells from a tissue section while viewing it under the microscope.Molecular Sequence Data: Descriptions of specific amino acid, carbohydrate, or nucleotide sequences which have appeared in the published literature and/or are deposited in and maintained by databanks such as GENBANK, European Molecular Biology Laboratory (EMBL), National Biomedical Research Foundation (NBRF), or other sequence repositories.

Thiamine deficiency is prevalent in a selected group of urban Indonesian elderly people. (1/1154)

This cross-sectional study involved 204 elderly individuals (93 males and 111 females). Subjects were randomly recruited using a list on which all 60-75 y-old-people living in seven sub-villages in Jakarta were included. The usual food intake was estimated using semiquantitative food frequency questionnaires. Hemoglobin, plasma retinol, vitamin B-12, red blood cell folate and the percentage stimulation of erythrocyte transketolase (ETK), as an indicator of thiamine status, were analyzed. Median energy intake was below the assessed requirement. More than 75% of the subjects had iron and thiamine intakes of approximately 2/3 of the recommended daily intake, and 20.2% of the study population had folate intake of approximately 2/3 of the recommended daily intake. Intakes of vitamins A and B-12 were adequate. Biochemical assessments demonstrated that 36.6% of the subjects had low thiamine levels (ETK stimulation > 25%). The elderly men tended to have lower thiamine levels than the elderly women. The overall prevalence of anemia was 28.9%, and the elderly women were affected more than the elderly men. Low biochemical status of vitamins A, B-12 and RBC folate was found in 5.4%, 8.8 % and 2.9% of the subjects, respectively. Dietary intakes of thiamine and folate were associated with ETK stimulation and plasma vitamin B-12 concentration (r = 0.176, P = 0.012 and r = 0.77, P = 0.001), respectively. Results of this study suggest that anemia, thiamine and possibly vitamin B-12 deficiency are prevalent in the elderly living in Indonesia. Clearly, micronutrient supplementation may be beneficial for the Indonesian elderly population living in underprivileged areas.  (+info)

Malaria prophylaxis using azithromycin: a double-blind, placebo-controlled trial in Irian Jaya, Indonesia. (2/1154)

New drugs are needed for preventing drug-resistant Plasmodium falciparum malaria. The prophylactic efficacy of azithromycin against P. falciparum in malaria-immune Kenyans was 83%. We conducted a double-blind, placebo-controlled trial to determine the prophylactic efficacy of azithromycin against multidrug-resistant P. falciparum malaria and chloroquine-resistant Plasmodium vivax malaria in Indonesian adults with limited immunity. After radical cure therapy, 300 randomized subjects received azithromycin (148 subjects, 750-mg loading dose followed by 250 mg/d), placebo (77), or doxycycline (75, 100 mg/d). The end point was slide-proven parasitemia. There were 58 P. falciparum and 29 P. vivax prophylaxis failures over 20 weeks. Using incidence rates, the protective efficacy of azithromycin relative to placebo was 71.6% (95% confidence interval [CI], 50.3-83.8) against P. falciparum malaria and 98.9% (95% CI, 93.1-99.9) against P. vivax malaria. Corresponding figures for doxycycline were 96.3% (95% CI, 85.4-99.6) and 98% (95% CI, 88.0-99.9), respectively. Daily azithromycin offered excellent protection against P. vivax malaria but modest protection against P. falciparum malaria.  (+info)

Home delivery of heat-stable vaccines in Indonesia: outreach immunization with a prefilled, single-use injection device. (3/1154)

Extending immunization coverage to underserved populations will require innovative immunization strategies. This study evaluated one such strategy: the use of a prefilled, single-use injection device for outreach immunization by village midwives. The device, UniJect, is designed to prevent refilling or reuse. Stored at ambient temperatures for up to 1 month in midwives' homes, vaccine-filled UniJect devices were immediately available for outreach. Between July 1995 and April 1996, 110 midwives on the Indonesia islands of Lombok and Bali visited the homes of newborn infants to deliver hepatitis B vaccine to the infants and tetanus toxoid to their mothers. Observations and interviews showed that the midwives used the device properly and safely to administer approximately 10,000 sterile injections in home settings. There were no problems with excessive heat exposure during the storage or delivery of vaccine. Injection recipients and midwives expressed a strong preference for the UniJect device over a standard syringe. Use of the prefilled device outside the cold chain simplified the logistics and facilitated the speed and efficiency of home visits, while the single-dose format minimized vaccine wastage.  (+info)

Health maintenance organizations in developing countries: what can we expect? (4/1154)

Health maintenance organizations (HMOs) are a relatively new and alternative means of providing health care, combining a risk-sharing (insurance) function with health service provision. Their potential for lowering costs has attracted great interest in the USA and elsewhere, and has raised questions regarding their applicability to other settings. Little attention, however, has been given to critically reviewing the experience with HMOs in other countries, particularly concerning their introduction to settings other than the USA. This paper first reviews the current experience of HMOs in low- and middle-income countries, including Argentina, Bolivia, Brazil, Colombia, Ecuador, Uruguay, Chile and Indonesia. Secondly, the paper reviews the USA experience with HMOs: prerequisites for the establishment of HMOs in the USA are identified and discussed, followed by a review of the performance of HMOs in terms of cost containment, integration of care and quality of care for the elderly and poor. The analysis concludes that difficulties may arise when implementing HMOs in developing countries, and that potential adverse effects on the overall health care delivery system may occur. These should be avoided by careful analyses of a nation's health care system.  (+info)

The impact of face-to-face educational outreach on diarrhoea treatment in pharmacies. (5/1154)

Private pharmacies are an important source of health care in developing countries. A number of studies have documented deficiencies in treatment, but little has been done to improve practices. We conducted two controlled trials to determine the efficacy of face-to-face educational outreach in improving communication and product sales for cases of diarrhoea in children in 194 private pharmacies in two developing countries. A training guide was developed to enable a national diarrhoea control programme to identify problems and their causes in pharmacies, using quantitative and qualitative research methods. The guide also facilitates the design, implementation, and evaluation of an educational intervention, which includes brief one-on-one meetings between diarrhoea programme educators and pharmacists/owners, followed by one small group training session with all counter attendants working in the pharmacies. We evaluated the short-term impact of this intervention using a before-and-after comparison group design in Kenya, and a randomized controlled design in Indonesia, with the pharmacy as unit of analysis in both countries (n = 107 pharmacies in Kenya; n = 87 in Indonesia). Using trained surrogate patients posing as mothers of a child under five with diarrhoea, we measured sales of oral rehydration salts (ORS); sales of antidiarrhoeal agents; and history-taking and advice to continue fluids and food. We also measured knowledge about dehydration and drugs to treat diarrhoea among Kenyan pharmacy employees after training. Major discrepancies were found at baseline between reported and observed behaviour. For example, 66% of pharmacy attendants in Kenya, and 53% in Indonesia, reported selling ORS for the previous case of child diarrhoea, but in only 33% and 5% of surrogate patient visits was ORS actually sold for such cases. After training, there was a significant increase in knowledge about diarrhoea and its treatment among counter attendants in Kenya, where these changes were measured. Sales of ORS in intervention pharmacies increased by an average of 30% in Kenya (almost a two-fold increase) and 21% in Indonesia compared to controls (p < 0.05); antidiarrhoeal sales declined by an average of 15% in Kenya and 20% in Indonesia compared to controls (p < 0.05). There was a trend toward increased communication in both countries, and in Kenya we observed significant increases in discussion of dehydration during pharmacy visits (p < 0.05). We conclude that face-to-face training of pharmacy attendants which targets deficits in knowledge and specific problem behaviours can result in significant short-term improvements in product sales and communication with customers. The positive effects and cost-effectiveness of such programmes need to be tested over a longer period for other health problems and in other countries.  (+info)

Three countries' experience with Norplant introduction. (6/1154)

Despite international efforts to plan for Norplant introduction, the method has drawn the attention of critics of family planning programmes, and has raised several issues for debate since it was introduced into family planning programmes. The experiences of three countries with the introduction of Norplant highlight some of the unique features of the method that have affected its introduction. Indonesia, Bangladesh and the United States represent diverse cultural settings and systems of family planning provision. Experience in each country has highlighted the need to focus on quality of care for clients, most notably the need for good counselling and attention to removal as well as insertion. The cost of Norplant also has influenced its introduction in each country. Another issue includes the need to work with women's health advocacy groups, which is illustrated particularly in Bangladesh. Finally, the role of litigation in the United States, and its potential role in influencing Norplant introduction in other countries, is discussed. These three countries' experience illustrate the importance of understanding the programmatic context of contraceptive introduction.  (+info)

Anti-filarial IgG4 in men and women living in Brugia malayi-endemic areas. (7/1154)

To assess whether antifilarial IgG4 can be used to study various epidemiological facets of filarial infections, we studied this isotype in 238 individuals resident in areas endemic for brugian filariasis, focusing on the differences between men and women. In the study area, the prevalence of microfilariae was 6.7% and the prevalence of antifilarial IgG4 was 49.2%. All microfilariae carriers were positive for antifilarial IgG4, whereas a proportion of the endemic normals (94/208) and clephantiasis patients (7/14) had IgG4 antibodies to filarial antigens. Data were analysed as a function of gender in distinct clinical groups and stratified for age. The prevalence of microfilariae was higher in males in all age groups, as reflected in significantly higher antifilarial IgG4 antibody levels compared to females. The prevalence of IgG4 increased to reach a plateau at the age of 30 years in both males and females. These results indicate that antifilarial IgG4 antibodies can reflect the differences in the extent of infection in males and females as measured by microfilarial counts, and that this parameter can be used for epidemiological assessments of filarial infection.  (+info)

Endometrial breakdown in women using Norplant is associated with migratory cells expressing matrix metalloproteinase-9 (gelatinase B). (8/1154)

Norplant, subdermally implanted slow-release levonorgestrel, is an effective and widely used contraceptive agent but has a high rate of discontinuation due to unacceptable abnormal uterine bleeding. Matrix metalloproteinases (MMPs) are expressed in normal cycling endometrium and are postulated to be responsible for the tissue breakdown at menstruation. We have compared the immunolocalization of MMP-9 and migratory cells in endometrium from Indonesian women using Norplant with normal controls. Positive MMP-9 immunostaining was observed intracellularly within stromal and intravascular leukocytes and extracellularly in areas of tissue lysis adjacent to these migratory cells. The MMP-9 positive cells were identified as neutrophils, eosinophils, CD3+ T-cells and macrophages. Quantitative assessment revealed that the number of MMP-9 positive cells, neutrophils and eosinophils were significantly increased in those endometrial biopsies from Norplant users displaying a shedding morphology and in normal controls at menstruation. There was no correlation between the number of MMP-9 positive cells and the number of bleeding days reported. Endometrial immunostaining for tissue inhibitor of metalloproteinases was similar in Norplant users and normal controls. These results suggest that MMP-9, an enzyme capable of degrading basement membrane components, may be involved in endometrial breakdown in women using Norplant.  (+info)

  • This study will be conducted at six methadone clinics in Jakarta, Indonesia where the HIV prevalence among injecting drug users ranges between 50- 86%, with collaborators from the Drug Dependence Hospital in Jakarta, the University of Pennsylvania and Yale University. (
  • Indonesia is the world's sixth worst market for income inequality. (
  • Between 2013 and 2017, there has been a 10.0% annual increase in the retail sales of powdered skim milk in Indonesia. (
  • Indonesia has been part of the global influenza surveillance since the establishment of a National Influenza Center (NIC) at the National Institute of Health Research and Development (NIHRD) by the Indonesian Ministry of Health in 1975. (
  • The large geographical area of the Republic of Indonesia poses a real challenge to provide prompt and accurate diagnosis nationally. (
  • This was the main reason to establish a laboratory network for H5N1 diagnosis in Indonesia. (
  • Evolutionary and transmission dynamics of reassortant H5N1 influenza virus in Indonesia. (
  • In this study, we present phylogenetic evidences for the interlineage reassortment among H5N1 HPAI viruses isolated from humans, cats, and birds in Indonesia, and identify the potential genetic parents of the reassorted genome segments. (
  • People cross a smog-covered river in Pekanbaru, Riau province, Indonesia. (
  • Iodine status measured as urinary iodine excretion in school children has improved in recent years in Indonesia, including Central Java province. (
  • With a population of 261.1 million, Indonesia is the largest consumer market in Southeast Asia. (
  • Lebih dari itu, bahwa tantangan terberat akan dihadapi pelaku usaha Indonesia di beberapa tahun kedepan ini. (
  • Indonesia has rejected Malaysian complaints about hazardous smoke drifting from its forest fires across the border, saying blazes were also raging in parts of Malaysia and on Malaysian-owned plantations in Indonesia. (
  • Forest fires have become an almost annual occurence in Indonesia, especially in dry years, and Indonesia's neighbours have complained of the thick, choking haze wafting in, raising concern about health and the impact on tourism. (
  • Indonesia has a population of about 250,000 people, of which almost a quarter live in West Java, an area of 35,377 km2 (Wikipedia 2014). (
  • The recent years also saws the exploration on the frontier basins, especially in the eastern Indonesia. (
  • Standard and economy brands have the largest market share as targeted Indonesia consumers are mostly of lower income. (