Browsing by Subject "Indonesia"

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    Diagnosis of neglected tropical diseases among patients with persistent digestive disorders (diarrhoea and/or abdominal pain [greater than or equal to]14days): Pierrea multi-country, prospective, non-experimental case-control study
    (BioMed Central Ltd, 2015) Polman, Katja; Becker, Soren; Alirol, Emilie; Bhatta, Nisha; Bhattarai, Narayan; Bottieau, Emmanuel; Bratschi, Martin; Burza, Sakib; Coulibaly, Jean; Doumbia, Mama; Horie, Ninon; Jacobs, Jan; Khanal, Basudha; Landoure, Aly; Mahendradhata, Yodi; Meheu
    BACKGROUND: Diarrhoea still accounts for considerable mortality and morbidity worldwide. The highest burden is concentrated in tropical areas where populations lack access to clean water, adequate sanitation and hygiene. In contrast to acute diarrhoea (<14days), the spectrum of pathogens that may give rise to persistent diarrhoea ([greater than or equal to]14days) and persistent abdominal pain is poorly understood. It is conceivable that pathogens causing neglected tropical diseases play a major role, but few studies investigated this issue. Clinical management and diagnostic work-up of persistent digestive disorders in the tropics therefore remain inadequate. Hence, important aspects regarding the pathogenesis, epidemiology, clinical symptomatology and treatment options for patients presenting with persistent diarrhoea and persistent abdominal pain should be investigated in multi-centric clinical studies.METHODS/DESIGN:This multi-country, prospective, non-experimental case-control study will assess persistent diarrhoea ([greater than or equal to]14days; in individuals aged [greater than or equal to]1year) and persistent abdominal pain ([greater than or equal to]14days; in children/adolescents aged 1-18 years) in up to 2000 symptomatic patients and 2000 matched controls. Subjects from Cote d'Ivoire, Indonesia, Mali and Nepal will be clinically examined and interviewed using a detailed case report form. Additionally, each participant will provide a stool sample that will be examined using a suite of diagnostic methods (i.e., microscopic techniques, rapid diagnostic tests, stool culture and polymerase chain reaction) for the presence of bacterial and parasitic pathogens. Treatment will be offered to all infected participants and the clinical treatment response will be recorded. Data obtained will be utilised to develop patient-centred clinical algorithms that will be validated in primary health care centres in the four study countries in subsequent studies.DISCUSSION:Our research will deepen the understanding of the importance of persistent diarrhoea and related digestive disorders in the tropics. A diversity of intestinal pathogens will be assessed for potential associations with persistent diarrhoea and persistent abdominal pain. Different diagnostic methods will be compared, clinical symptoms investigated and diagnosis-treatment algorithms developed for validation in selected primary health care centres. The findings from this study will improve differential diagnosis and evidence-based clinical management of digestive syndromes in the tropics.TRIAL REGISTRATION:ClinicalTrials.gov; identifier: NCT02105714.
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    Incidence of catastrophic health spending in Indonesia: insights from a Household Panel Study 2018–2019
    (BioMed Central, 2023-09-06) Fattah, Rifqi A.; Cheng, Qinglu; Thabrany, Hasbullah; Susilo, Dwidjo; Satrya, Aryana; Haemmerli, Manon; Kosen, Soewarta; Novitasari, Danty; Puteri, Gemala C.; Adawiyah, Eviati; Hayen, Andrew; Gilson, Lucy; Mills, Anne; Tangcharoensathien, Viroj; Jan, Stephen; Asante, Augustine; Wiseman, Virginia
    Background Indonesia implemented one of the world’s largest single-payer national health insurance schemes (the Jaminan Kesehatan Nasional or JKN) in 2014. This study aims to assess the incidence of catastrophic health spending (CHS) and its determinants and trends between 2018 and 2019 by which time JKN enrolment coverage exceeded 80%. Methods This study analysed data collected from a two-round cross-sectional household survey conducted in ten provinces of Indonesia in February–April 2018 and August–October 2019. The incidence of CHS was defined as the proportion of households with out-of-pocket (OOP) health spending exceeding 10% of household consumption expenditure. Chi-squared tests were used to compare the incidences of CHS across subgroups for each household characteristic. Logistic regression models were used to investigate factors associated with incurring CHS and the trend over time. Sensitivity analyses assessing the incidence of CHS based on a higher threshold of 25% of total household expenditure were conducted. Results The overall incidence of CHS at the 10% threshold fell from 7.9% to 2018 to 4.4% in 2019. The logistic regression models showed that households with JKN membership experienced significantly lower incidence of CHS compared to households without insurance coverage in both years. The poorest households were more likely to incur CHS compared to households in other wealth quintiles. Other predictors of incurring CHS included living in rural areas and visiting private health facilities. Conclusions This study demonstrated that the overall incidence of CHS decreased in Indonesia between 2018 and 2019. OOP payments for health care and the risk of CHS still loom high among JKN members and among the lowest income households. More needs to be done to further contain OOP payments and further research is needed to investigate whether CHS pushes households below the poverty line.