The urban features of informal settlements in Jakarta, Indonesia.
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ABSTRACT:
SUBMITTER: Alzamil W
PROVIDER: S-EPMC5684097 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:IntroductionAlthough the number of people receiving antiretroviral therapy (ART) in Indonesia has increased in recent years, little is known about the specific characteristics affecting adherence in this population. Indonesia is different from most of its neighbors given that it is a geographically and culturally diverse country, with a large Muslim population. We aimed to identify the current rate of adherence and explore factors that influence ART adherence.MethodsData were collected from ART-prescribed outpatients on an HIV registry at a North Jakarta hospital in 2012. Socio-demographic and behavioral characteristics were explored as factors associated with adherence using logistics regression analyses. Chi squared test was used to compare the difference between proportions. Reasons for missing medication were analyzed descriptively.ResultsTwo hundred and sixty-one patients participated, of whom 77% reported ART adherence in the last 3 months. The level of social support experienced was independently associated with adherence where some social support (p?=?0.018) and good social support (p?=?0.039) improved adherence compared to poor social support. Frequently cited reasons for not taking ART medication included forgetting to take medication (67%), busy with something else (63%) and asleep at medication time (60%).DiscussionThis study identified that an increase in the level of social support experienced by ART-prescribed patients was positively associated with adherence. Social support may minimize the impact of stigma among ART prescribed patients. Based on these findings, if social support is not available, alternative support through community-based organizations is recommended to maximize treatment success.
| S-EPMC4168004 | biostudies-literature
Project description:Setting: The introduction of accredited social health activists (ASHAs, community workers) in the community is encouraged by the Government of India as being of universal benefit for maternal and infant health. Objectives: In two informal settlements in Chandigarh, India, one with ASHAs and the other without, we assessed 1) whether ASHAs influenced certain selected maternal and infant health indicators, and 2) perceptions among women who did not contact the ASHAs. Design: This was a mixed-methods study conducted from April 2013 to March 2016 using quantitative (retrospective programme data) and qualitative (free-listing) components. Results: The increase in institutional deliveries from 2013 to 2015 was marginal, and was similar in both areas (86-99% in the settlement with ASHAs and 88-97% in the settlement without). Bacille Calmette-Guérin and pentavalent vaccination coverage were close to 100% in both areas during the 3 years of the study. Antenatal registration in the first trimester increased from 49% to 52% in the settlement with ASHAs and from 53% to 71% in the settlement without. Between 18% and 35% of women did not complete at least three antenatal visits. 'Not knowing ASHAs' and 'not feeling a need for ASHAs' were the main reasons for not using their services. Conclusion: While success has been achieved for institutional deliveries and immunisation coverage even without the ASHAs, their presence plays an important role in improving antenatal indicators.
| S-EPMC5526485 | biostudies-other
Project description:HIV-1 and Hepatitis B and C viruses coinfection is common in Sub-Saharan Africa due to similar routes of transmission and high levels of poverty. Most studies on HIV-1 and Hepatitis B and C viruses have occurred in hospital settings and blood transfusion units. Data on Hepatitis B and C viruses and HIV-1 coinfection in informal urban settlements in Kenya are scanty, yet they could partly explain the disproportionately high morbidity and mortality associated with HIV-1 infections in these slums.The objective of this study was to determine the prevalence of HIV and Hepatitis B and C dual infection in urban slums in Nairobi.Blood samples were collected from residents of Viwandani and Korogocho between 2006 and 2007. A structured questionnaire was used to obtain socio-demographic data from participants. Samples were screened for Hepatitis B surface antigen (HBsAg), anti-HCV and anti-HIV-1. Statistical analysis was done using STATA.Samples were successfully collected from 418 (32%) men and 890 (68%) females. The HIV-1, HBV and HCV prevalence was 20.4%, 13.3% and 0.76% respectively at the time of the study. Of the 268 (20.4%) HIV-1 positive participants, 56 (4.26%) had HBV while 6 (0.46%) had HCV. Of the 1041 HIV-1 negative participants, 117 (8.9%) had HBV while 4 (0.31%) had HCV. Only two people (0.15%) were co-infected with all the three viruses together.The odds of getting hepatitis infection were higher in HIV-1 participants (for HBV OR 2.08,p<0.005 and for HCV OR 5.93, p<0.005). HIV prevalence rates were similar in both informal settlements. HIV infection was highest in age group 35-39 years and among the divorced/separated or widowed. Prevalence of all viruses was highest in those who did not have any formal education.The HIV prevalence in these informal settlements suggests a higher rate than what is observed nationally. The prevalence rates of HBV are significantly higher in the HIV-1 positive and negative populations. HCV as well as triple HIV-1, HBV and HCV coinfection are uncommon in Korogocho and Viwandani. This clearly indicates the need for HIV-1 control programmes and hepatitis B virus vaccination to be promoted through public awareness as preventive strategy.
| S-EPMC4466314 | biostudies-other
Project description:ObjectiveTo determine whether the prevalence of stunting differed between an intervention group and a control group and to identify factors associated with the children's linear growth.DesignThis was a follow-up study of mother-child pairs who participated in a 2012-2015 cluster randomised controlled trial. Linear mixed effects models were performed to model the children's linear growth and identify the determinants of child linear growth.SettingThe study was conducted in two slums in Nairobi. The intervention group received monthly nutrition education and counselling (NEC) during pregnancy and infancy period.ParticipantsA birth cohort of 1004 was followed up every 3 months after delivery to the 13th month. However, as a result of dropouts, a total of 438 mother-child pairs participated during the 55-month follow-up. The loss to follow-up baseline characteristics did not differ from those included for analysis.ResultsLength-for-age z-scores decreased from birth to the 13th month, mean -1·42 (sd 2·04), with the control group (33·5 %) reporting a significantly higher prevalence of stunting than the intervention group (28·6 %). Conversely, the scores increased in the 55th month, mean -0·89 (sd 1·04), with significantly more males (16·5 %) stunted in the control group than in the intervention group (8·3 %). Being in the control group, being a male child, often vomiting/regurgitating food, mother's stature of <154 cm and early weaning were negatively associated with children's linear growth.ConclusionsHome-based maternal NEC reduced stunting among under five years; however, the long-term benefits of this intervention on children's health need to be elucidated.
| S-EPMC7611536 | biostudies-literature
Project description:IntroductionIncreasing urban populations have led to the growth of informal settlements, with contaminated environments linked to poor human health through a range of interlinked pathways. Here, we describe the design and methods for the Revitalising Informal Settlements and their Environments (RISE) study, a transdisciplinary randomised trial evaluating impacts of an intervention to upgrade urban informal settlements in two Asia-Pacific countries.Methods and analysisRISE is a cluster randomised controlled trial among 12 settlements in Makassar, Indonesia, and 12 in Suva, Fiji. Six settlements in each country have been randomised to receive the intervention at the outset; the remainder will serve as controls and be offered intervention delivery after trial completion. The intervention involves a water-sensitive approach, delivering site-specific, modular, decentralised infrastructure primarily aimed at improving health by decreasing exposure to environmental faecal contamination. Consenting households within each informal settlement site have been enrolled, with longitudinal assessment to involve health and well-being surveys, and human and environmental sampling. Primary outcomes will be evaluated in children under 5 years of age and include prevalence and diversity of gastrointestinal pathogens, abundance and diversity of antimicrobial resistance (AMR) genes in gastrointestinal microorganisms and markers of gastrointestinal inflammation. Diverse secondary outcomes include changes in microbial contamination; abundance and diversity of pathogens and AMR genes in environmental samples; impacts on ecological biodiversity and microclimates; mosquito vector abundance; anthropometric assessments, nutrition markers and systemic inflammation in children; caregiver-reported and self-reported health symptoms and healthcare utilisation; and measures of individual and community psychological, emotional and economic well-being. The study aims to provide proof-of-concept evidence to inform policies on upgrading of informal settlements to improve environments and human health and well-being.EthicsStudy protocols have been approved by ethics boards at Monash University, Fiji National University and Hasanuddin University.Trial registration numberACTRN12618000633280; Pre-results.
| S-EPMC7798802 | biostudies-literature
Project description:BACKGROUND:Approximately 70% of the global burden of dengue disease occurs on the Asian continent, where many large urban centres provide optimal environments for sustained endemic transmission and periodic epidemic cycles. Jakarta, the capital of Indonesia, is a densely populated megacity with hyperendemic dengue transmission. Characterization of the spatiotemporal distribution of dengue transmission intensity is of key importance for optimal implementation of novel control and prevention programmes, including vaccination. In this paper we use mathematical models to provide the first detailed description of spatial and temporal variability in dengue transmission intensity in Jakarta. METHODOLOGY/PRINCIPAL FINDINGS:We applied catalytic models in a Bayesian framework to age-stratified dengue case notification data to estimate dengue force of infection and reporting probabilities in 42 subdistricts of Jakarta. The model was fitted to yearly and average annual data covering a 10-year period between 2008 and 2017. We estimated a long-term average annual transmission intensity of 0.130 (95%CrI: 0.129-0.131) per year in Jakarta province, ranging from 0.090 (95%CrI: 0.077-0.103) to 0.164 (95%CrI: 0.153-0.174) across subdistricts. Annual average transmission intensity in Jakarta province during the 10-year period ranged from 0.012 (95%CrI: 0.011-0.013) in 2017 to 0.124 (95%CrI: 0.121-0.128) in 2016. CONCLUSIONS/SIGNIFICANCE:While the absolute number of dengue case notifications cannot be relied upon as a measure of endemicity, the age-distribution of reported dengue cases provides valuable insights into the underlying nature of transmission. Our estimates from yearly and average annual case notification data represent the first detailed estimates of dengue transmission intensity in Jakarta's subdistricts. These will be important to consider when assessing the population-level impact and cost-effectiveness of potential control and prevention programmes in Jakarta province, such as the controlled release of Wolbachia-carrying mosquitoes and vaccination.
| S-EPMC7080271 | biostudies-literature
Project description:The data collection strategy involved the use of multiple methods. While Primary source of data were collected through the use of structured and semi-structured interviews, focus group discussions and a questionnaire household survey; secondary data were gathered from published and unpublished materials and land related legal and policy documents. Primary data were gathered through house to house survey directly administered to a random sample of 244 household heads. Besides to the household survey, primary data were collected via in-depth interviews, and focus group discussion. Interviews were conducted with land brokers, land speculators, key informants and governmental officials. Focus group discussion was executed in two different sessions: one from kebele 04 and the other from the municipality. A total of 87 people from government officials, land brokers and speculators and key informants were interviewed. Secondary data were collected from available documents and land-related legal and policy documents. The data collection process is followed by a detailed qualitative and quantitative data analysis. The qualitative analysis part includes analysis of data obtained from interviews and focus group discussions. However, statistical analysis includes descriptive statistics such as cross tabulation, percentage and correlation were employed using IBM SPSS 20. Informal settlement continues to be a challenge in the contemporary urbanization in Ethiopia. Thus, these dataset have important implications for urban land policy both at local, national and wider audience beyond Ethiopia to reconsider urban informality. The data of this manuscript is associated with the publication [10.1016/j.landusepol.2020.104573].
| S-EPMC7221159 | biostudies-literature
Project description:We evaluated an adaptation of a large-scale community-based management of acute malnutrition program run by an NGO with government partnerships, in informal settlements of Mumbai, India. The program aimed to reduce the prevalence of wasting among children under age 3 and covered a population of approximately 300,000.This study used a mixed-methods approach including a quasi-experimental design to compare prevalence estimates of wasting in intervention areas with neighboring informal settlements. Cross-sectional data were collected from March through November 2014 for the baseline and October through December 2015 for the endline. Endline data were analyzed using mixed-effects logistic regression models, adjusting for child, maternal, and household characteristics. In addition, we conducted in-depth interviews with 37 stakeholders (13 staff and 24 mothers) who reported on salient features that contributed to successful implementation of the program.We interviewed 2,578 caregivers at baseline and 3,455 at endline in intervention areas. In comparison areas, we interviewed 2,082 caregivers at baseline and 2,122 at endline. At endline, the prevalence of wasting decreased by 28% (18% to 13%) in intervention areas and by 5% (16.9% to 16%) in comparison areas. Analysis of the endline data indicated that children in intervention areas were significantly less likely to be malnourished (adjusted odds ratio, 0.81; confidence interval, 0.67 to 0.99). Stakeholders identified 4 main features as contributing to the success of the program: (1) tailoring and reinforcement of information provided to caregivers in informal settings, (2) constant field presence of staff, (3) holistic case management of issues beyond immediate malnourishment, and (4) persistence of field staff in persuading reluctant families. Staff capabilities were enhanced through training, stringent monitoring mechanisms, and support from senior staff in tackling difficult cases.NGO-government partnerships can revitalize existing community-based programs in urban India. Critical to success are processes that include reinforced knowledge-building of caregivers, a high level of field support and encouragement to the community, and constant monitoring and follow-up of cases by all staff levels.
| S-EPMC5878065 | biostudies-literature
Project description:High-throughput epidemiological typing systems that provide phylogenetic and genotypic information are beneficial for tracking bacterial pathogens in the field. The incidence of Salmonella enterica serovar Typhi infection in Indonesia is high and is associated with atypical phenotypic traits such as expression of the j and the z66 flagellum antigens. Utilizing a high-throughput genotyping platform to investigate known nucleotide polymorphisms dispersed around the genome, we determined the haplotypes of 140 serovar Typhi isolates associated with Indonesia. We identified nine distinct serovar Typhi haplotypes circulating in Indonesia for more than 30 years, with eight of these present in a single Jakarta suburb within a 2-year period. One dominant haplotype, H59, is associated with j and z66 flagellum expression, representing a potential pathotype unique to Indonesia. Phylogenetic analysis suggests that H59 z66(+), j(+) isolates emerged relatively recently in terms of the origin of serovar Typhi and are geographically restricted. These data demonstrate the potential of high-throughput genotyping platforms for analyzing serovar Typhi populations in the field. The study also provides insight into the evolution of serovar Typhi and demonstrates the value of a molecular epidemiological technique that is exchangeable, that is internet friendly, and that has global utility.
| S-EPMC2395080 | biostudies-other
Project description:BackgroundThis study aimed to evaluate the prevalence of tooth wear among preschool children in Jakarta, Indonesia, and examine the risk factors associated with its occurrence.MethodsAn epidemiological survey was conducted with a cross-sectional study design. The participants were recruited via cluster sampling. Tooth wear was clinically assessed by one examiner using the Basic Erosive Wear Examination (BEWE) criteria. The children's caries experience was also recorded. The parents of the participating children completed a self-administered questionnaire to answer demographic questions about the children and gather information about the children's diet and oral health behaviors as well as the parents' dental health-related knowledge. The data were analyzed using the Chi-square test and binary logistic regression.ResultsA total of 752 five-year-old children were invited to participate, with 691 (92%) enrolling in the study. Tooth wear occurred in 23% (161/691, BEWE > 0) of the participants, in which 78% (125/161) had at least one moderate tooth wear status (BEWE = 2). The consumption of citrus drinks, fruit juice, and vitamin C supplement drinks, together with the child's caries experience, the father's education level, and the family's socioeconomic status, were significantly associated with tooth wear.ConclusionsThe five-year-old preschool children in Jakarta had a relatively low prevalence of tooth wear. Those consuming more acidic drinks, those with a higher socioeconomic status, and those with an absence of caries experience had a higher risk of tooth wear.
| S-EPMC6702728 | biostudies-literature