JAMINAN KESEHATAN DAN PENDAPATAN KELUARGA BALITA STUNTING

Balita stunting berkontribusi terhadap 1,5 juta (15%) kematian anak balita di dunia dan menyebabkan 55 juta Disability-Adjusted Life Years (DALYs) yaitu hilangnya masa hidup sehat setiap tahun. Jaminan kesehatan dan pendapatan keluarga merupakan salah satu faktor yang berhubungan tidak langsung dengan kejadian stunting. Akan tetapi dapat mempengaruhi ketersediaan sumber gizi serta perlindungan diri saat menanganai permasalahan infeksi pada balita yang bermuara pada resiko kejadian stunting. Tujuan penelitian : Untuk mengetahui gambaran kepemilikan jaminan kesehatan serta pendapatan keluarga balita stunting. Metodologi penelitian : Jenis penelitian yang digunakan adalah penelitian kuantitatif dengan metode deskriptif. Populasi dalam penelitian ini adalah ibu yang memiliki balita stunting Di Desa Sukamulya Kecamatan Singaparna sebanyak 18 orang. Tehnik pengambilan sampling menggunakan total sampling. Analisis data dilakukan dengan menggunakan analisis univariat dimana hasil disajikan dalam bentuk presentase dan dibuat secara naratif. Hasil penelitian : Terdapat 38,9% keluarga balita stunting yang tidak memiliki jaminan kesehatan, mayoritas jenis jaminan kesehatan yang dimiliki oleh keluarga stunting adalah Kartu Indonesia Sehat serta mayoritas pendapatan keluarga balita stunting di Desa Sukamulya Kecamatan Singaparna adalah dibawah UMR yaitu 72,2%. Kesimpulan dan saran : Keluarga dapat meningkatkan pencarian informasi tentang pentingnya memiliki jaminan kesehatan seghingga dapat memanfaatkan pelayanan yang disediakan sebagai program penyelesaian permasalahan stunting. Selain itu program perbaikan gizi keluarga melalui pemanfaatan lahan masyarakat dapat membantu dalam pemenuhan kebutuhan gizi masyarakat. Kata kunci: Stunting, Kepemilikan jaminan kesehatan, pendapatan keluarga, balita

Global, regional, and national burdens of hip osteoarthritis from 1990 to 2019: estimates from the 2019 Global Burden of Disease Study

Background Hip osteoarthritis is a common disabling condition of the hip joint and is associated with a substantial health burden. We assessed the epidemiological patterns of hip osteoarthritis from 1990 to 2019 by sex, age, and socio-demographic index (SDI). Methods Age-standardized rates (ASRs) were obtained for the incidence and disability-adjusted life years (DALYs) of hip osteoarthritis from 1990 to 2019 for 21 regions, encompassing a total of 204 countries and territories. The estimated annual percentage changes (EAPCs) of ASRs were calculated to evaluate the trends in the incidence and DALYs of hip osteoarthritis over these 30 years. Results Globally, from 1990 to 2019, the age-standardized incidence rate (ASIR) of hip osteoarthritis increased from 17.02 per 100,000 persons to 18.70 per 100,000 persons, with an upward trend in the EAPC of 0.32 (0.29–0.34), whereas the age-standardized DALY rate increased from 11.54 per 100,000 persons to 12.57 per 100,000 persons, with an EAPC of 0.29 (0.27–0.32). In 2019, the EAPCs of the ASIR and age-standardized DALY rate of hip osteoarthritis were positively associated with the SDI of hip osteoarthritis. In 1990 and 2019, the incidence of hip osteoarthritis was unimodally distributed across different age groups, with a peak incidence in the 60–64-year-old age group, whereas the DALYs increased with age. Conclusions The incidence and DALYs of hip osteoarthritis have been increasing globally. The EAPCs of the ASIR and age-standardized DALY rate were particularly significant in developed regions and varied across nations and regions, indicating the urgent need for governments and medical institutions to increase the awareness regarding risk factors, consequences of hip osteoarthritis.

Population-Based Epidemiology Study of Paraneoplastic Neurologic Syndromes

ObjectivesPopulation-based epidemiologic data for paraneoplastic neurologic syndromes (PNSs) in the United States are lacking. Our objective was to evaluate the incidence, prevalence, and associated morbidity of PNS.MethodsWe performed a population-based epidemiology study in Olmsted County, Minnesota, with patients identified between January 1, 1987, and December 31, 2018, using the medical records linkage system of the Rochester Epidemiology Project (REP) who met the definite/probable 2021 PNS criteria and 2004 PNS criteria. Patients with dermatomyositis and myasthenia gravis with underlying tumors were included. Age- and sex-specific population counts were obtained from REP resources for January 1, 2014 (prevalence denominator) and annually for 1987–2018 (incidence denominator). Morbidity was estimated using disability-adjusted life years (DALYs; years lived with disability [YLD] plus years of life lost [YLL]).ResultsThere were 28 patients with PNS identified (50% female) residing in Olmsted County, Minnesota, with median age at diagnosis of 54.5 (IQR 46.5–69.0) years. All patients had a cancer diagnosis, and 18 (64%) patients were neural autoantibody positive including antineuronal nuclear autoantibody type 1 (ANNA-1/anti-Hu; n = 1), ANNA-2/anti-Ri (n = 1), muscle-type acetylcholine receptor (AChR; n = 6), Purkinje cell cytoplasmic antibody type 1 (PCA-1/anti-Yo; n = 1), kelch-like protein 11 (KLH11; n = 3), collapsin response mediator protein 5 (CRMP-5/anti-CV2; n = 2), α-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid receptor (n = 1), neurofilament light chain (n = 1), leucine zipper 4 (LUZP4; n = 1), and unclassified neural antibodies (n = 1). PNS incidence was 0.6/100,000 person-years and increased over time from 0.4/100,000 person-years (1987–2002) to 0.8/100,000 person-years (2003–2018) (p = 0.06). Prevalence was 5.4/100,000 people. The median follow-up period after PNS diagnosis was 3.1 years (IQR, 1.1–9.9 years). Total disability-adjusted life years (DALYs) for 28 patients with PNS were 472.7 years, based on total years of life lost (YLL) for patients dying between 1987 and 2018 (n = 15) of 445.3 years plus years lived with disability (YLD) 27.4 years.DiscussionPNSs are rare neurologic disorders but are associated with severe morbidity and mortality. The estimated number of prevalent PNS cases in the United States is 17,099, and predicted DALY for all US PNS cases is 292,393 years. Their apparent increasing rate of detection is attributable to increasing physician awareness and availability of serologic testing.

Healthcare Delivery among Yoruba Bonesetters in Southwest Nigeria and the Need for Collaboration with Orthodox Orthopedic Healthcare Services: A Mixed Method Study

This study covers three purposively chosen states; Ogun, Ondo, and Oyo, in southwestern Nigeria. Primary data were collected using three sets of questionnaires. The respondent-driven sampling (RDS) technique was employed in selecting the respondents for the study. A total of 69 traditional bonesetters (TBS), 130 TBS patients, and 15 orthopedic surgeons were interviewed. The study reveals that majority (91.2%) of the TBS in the study area claimed that they had received an average of 11 patients from orthodox hospitals in the year preceding the survey while about 9.0% of the respondents reported that 78 Soladoye S. Asa, Matthew O. Ilori, and Lawrence A. Akinyoola they had on the average advised 6 patients per year to relocate to orthodox hospitals. The study also reveals the views of TBS areas of need from government to include recognition (93.7%) and integration into the country’s health system (63.5%). A majority (93.3%) of the orthopedic surgeons reported having received patients from TBS, and each surgeon had received, on average, 37 patients per year. All the orthopedic surgeons surveyed believed that TBS lacked knowledge in the management of bone injuries, apart from setting bones. Other issues considered critical by the doctors in the management of fractures by TBS included lack of training in the biology of bones (86.7%) and inability to refer cases to modern health facilities (73.3%). The proportion of orthopedic surgeons who had ever thought of a possible interaction between TBS and orthopedic surgeons was 80.0% while 86.7% would advise the establishment of such interaction. Furthermore, the study reveals that more than half (54.6%) of TBS patients made a TBS clinic their first choice for treatment. The paper concludes that integration will go a long way to improving the health of the population, thereby significantly reducing deaths or disability-adjusted life years (DALYs) lost.

The burden of zoonoses in Paraguay: A systematic review

Introduction Underestimation of zoonoses is exacerbated in low and middle-income countries due mainly to inequalities with serious consequences in healthcare. This is difficult to gauge and reduce the impact of those diseases. Our study focuses on Paraguay, where the livestock industry is one of the major components of the country’s economy. Therefore, the rationale of this study was to develop a case study in Paraguay to estimate the dual impact of zoonotic diseases on both the human health and animal health sector and thus determine the societal burden of such diseases. Methodology/Principal findings We conducted a systemic review (including a meta-analysis) to assess the burden of zoonoses in Paraguay, including official reports and grey literature of disease incidence and prevalence. We estimated the Disability Adjusted Life Years (DALYs) and Zoonosis Disability Adjusted Life Years (zDALYs) to measure the difference between the current health status and the desired health situation of animals and the Paraguayan population based on 50 zoonotic diseases suggested by the WHO (World Health Organization), OIE (World Organization for Animal Health) and the National Health in Paraguay. The total DALYs represent 19,384 (95% CI: from 15,805 to 29,733), and zDALYs, 62,178 (95% CI: from 48,696 to 77,188). According to the results, the priority pathogens for DALYs are E. coli, Trypanosoma cruzi, Leishmania spp, and Toxoplasma gondii. When we include the additional animal health burden, the most important pathogens are Brucella spp, E. coli, Trypanosoma cruzi, and Fasciola hepatica for zDALYs. Conclusion/Significance This is the first study to integrate DALYs and zDALYs with important clues related to the health status of Paraguay. Through DALYs and zDALYs, our perspective becomes more complete because we consider not only human health but also animal health. This is important for setting priorities in disease control, especially in a society where livestock contribute significantly to the economy and to human well-being.

The estimated disease burden of acute COVID-19 in the Netherlands in 2020, in disability-adjusted life-years

Background. The impact of the COVID-19 pandemic on population health is recognised as being substantial, yet few studies have attempted to quantify to what extent infection causes mild or moderate symptoms only, requires hospital and/or intensive care unit (ICU) admission, results in prolonged and chronic illness, or leads to premature death. Our objectives were to quantify the total disease burden of acute COVID-19 in the Netherlands in 2020 using the disability-adjusted life-years (DALY) measure, and to investigate how disease burden varies between age-groups and occupation categories.Methods. Using standard methods and diverse data sources (registered COVID-19 deaths, hospital and ICU admissions, population-level seroprevalence, mandatory notifications, and the literature) , we estimated the total years of life lost (YLL), years lived with disability (YLD), DALY and DALY per 100,000 population due to COVID-19, excluding its post-acute sequelae, and additionally stratified by 5-year age-group and occupation.Results. The total disease burden in the Netherlands in 2020 due to acute COVID-19 was 273,500 (95% CI: 268,500–278,800) DALY, and the per-capita burden was 1570 (95% CI: 1540–1600) DALY/100,000, of which 99.4% consisted of YLL. The per-capita burden increased steeply with age, starting from the 60-64 years age-group. The per-capita burden by occupation category was highest for healthcare workers and lowest for the catering sector.Conclusions. SARS-CoV-2 infection and associated premature mortality was responsible for a considerable direct health burden in the Netherlands, despite extensive public health measures. Total DALY were much higher than for other high-burden infectious diseases, but lower than the estimated annual burden from coronary heart disease. These findings are valuable for informing public health decision-makers regarding the expected health burden due to COVID-19 among subgroups of the population, and the possible gains from targeted preventative interventions.

Global, Regional, and National Death, and Disability-Adjusted Life-Years (DALYs) for Cardiovascular Disease in 2017 and Trends and Risk Analysis From 1990 to 2017 Using the Global Burden of Disease Study and Implications for Prevention

Background: Cardiovascular disease is the leading cause of death worldwide and a major barrier to sustainable human development. The objective of this study was to evaluate the global, sex, age, region, and country-related cardiovascular disease (CVD) burden, as well as the trends, risk factors, and implications for the prevention of CVD.Methods: Detailed information from 1990 to 2017, including global, regional, and national rates of CVD, and 11 categories of mortality and disability-adjusted life years (DALYs) were collected from the Global Burden of Disease Study 2017. The time-dependent change in the trends of CVD burdens was evaluated by annual percentage change.Results: More than 17 million people died from CVD in 2017, which was approximately two times as many as cancer, and increased nearly 50% compared with 1990. Ischemic heart disease and stroke accounted for 85% of the total age-standardized death rate (ASDR) of CVD. The ASDR and age-standardized DALYs rate (ASYR) of CVD were 1.5 times greater in men compared with women. People over the age of 50 were especially at risk for developing CVD, with the number of cases and deaths in this age group accounting for more than 90% of all age groups. CVD mortality was related to regional economic development and the social demographic index. In regions with a high economic income or socio-demographic index, there was a greater decline in the ASDR of CVD. The ASDR of CVD in high SDI regions decreased more than 50% from 1990 to 2017. Tobacco use, diets low in whole grains, diets high in sodium, and high systolic blood pressure were the important risk factors related to CVD mortality.Conclusions: CVD remains a major cause of death and chronic disability in all regions of the world. Ischemic heart disease and stroke account for the majority of deaths related to CVD. Although the mortality rate for CVD has declined in recent years from a global perspective, the results of CVD data in 2017 suggest that the mortality and DALYs of CVD varied in different ages, sexes, and countries/regions around the world. Therefore, it is necessary to elucidate the specific characteristics of global CVD burden and establish more effective and targeted prevention strategies.

Estimation of Burden of Cystic Echinococcosis in Iran Using Disability Adjusted Life Years (DALYs) in 2018

Background: Human hydatidosis as a public concern has increased in a number of countries that have reduced control programs for the disease due to lack of resources or policies. We aimed to estimate Disability-Adjusted Life Years (DALYs) for human hydatidosis in Iran in 2018. Methods: Data were collected from the Center of Communicable Diseases Control, Ministry of Health &Medical Education, Tehran, Iran in 2018. To calculate DALYs, years of life lost due to premature death (YLL) with years of life with disability (YLD) were calculated according to the formula as DALY = YLL + YLD. The standard life expectancy lost method (SEYLL) was used to calculate the years lost due to premature death. Results: DALYs for human hydatidosis was calculated as 1210.12 years (YLD equals to 177.12 and YLL equals to 1033) in Iran for the year 2018. It was estimated to be 700.2 years for men and 509.8 years for women. DALYs in men were significantly different from women (P= 0.001) so DALYs were more in men than women were. YLD was calculated at 78.228 years in men and 98.892 years in women and in both men and women at 177.12 years. YLD was significantly different in women compared to men (P=0.001), so YLD in women was more than in men. Conclusion: We reached considerable indices for hydatidosis in our study. Therefore, disease prevention and control programs in Iran seem necessary by the policy makers.