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

Pengaruh Ekstrak Paederia foetida pada Kadar Kolesterol Total Tikus Model Hiperlipidemia yang Diinduksi Deksametason

Hiperlipidemia merupakan istilah yang mengacu pada kelainan yang menyebabkan peningkatan profil lipid dalam tubuh manusia. Menurut WHO, secara global, sepertiga penyakit jantung iskemik dikaitkan dengan kadar kolesterol yang tinggi. Peningkatan kadar kolesterol diperkirakan menyebabkan 94,9 juta disability adjusted life year (DALYs) dan 4,32 juta kematian. Penelitian ini bertujuan untuk mengevaluasi pengaruh ekstrak etanol Paederia foetida (EEPF) pada kadar kolesterol total tikus model hiperlipidemia yang diinduksi deksametason. Penelitian Penelitian eksperimen in vivo ini dilakukan dengan menggunakan desain penelitian post-test only complete randomized design (CRD). Proses penelitian dilaksanakan di Departemen Biokimia, Fakultas Kedokteran, Universitas Airlangga, Surabaya, Indonesia, dari bulan Juni 2021 hingga November 2021. Pembuatan EEPF dilakukan dengan metode maserasi pada pelarut etanol 96%. Hewan coba yang digunakan adalah tikus galur Wistar albino jantan berjumlah 30 ekor, sehat, dan berat badan 150-200 gram. Penelitian dilaksanakan dengan membagi rata hewan coba secara acak menjadi kelompok kontrol normal, kontrol patogen, kelompok simvastatin, kelompok EEPF 250 mg/kg, dan kelompok EEPF 500 mg/kg. Sampel darah diambil dari vena pada bagian ekor dan kadar kolesterol total diukur dengan metode point of care testing (POCT). Analisis data dilakukan dengan One-way ANOVA dilanjutkan dengan uji post hoc Dunnett. Hasil penelitian menunjukkan, pemberian deksametason (10 mg/kg) selama 14 hari menyebabkan peningkatan kadar kolesterol total yang signifikan, sedangkan pada kelompok perlakuan simvastatin, EEPF 250 mg/kg, dan EEPF 500 mg/kg terjadi penurunan signifikan pada kadar kolesterol total jika dibandingkan dengan kelompok kontrol patogenik (P<0,001, P<0,05, P<0,05). Pemberian ekstrak etanol Paederia foetida dapat menurunkan kadar kolesterol total pada tikus model hiperlipidemia yang diinduksi deksametason.

Filarial Lymphedema Patients Are Characterized by Exhausted CD4+ T Cells

Worldwide, more than 200 million people are infected with filariae which can cause severe symptoms leading to reduced quality of life and contribute to disability-adjusted life years (DALYs). In particular, lymphatic filariasis (LF) caused by Wuchereria bancrofti can lead to lymphedema (LE) and consequently presents a serious health problem. To understand why only a fraction of the infected individuals develop pathology, it is essential to understand how filariae regulate host immunity. The central role of T cells for immunity against filariae has been shown in several studies. However, there is little knowledge about T cell exhaustion, which causes T cell dysfunction and impaired immune responses, in this group of individuals. Recently, we showed that LE patients from Ghana harbor distinct patterns of exhausted effector and memory CD8+ T cell subsets. Based on these findings, we now characterized CD4+ T cell subsets from the same Ghanaian patient cohort by analyzing distinct markers within a 13-colour flow cytometry panel. We revealed that LE patients had increased frequencies of CD4+ T cells expressing exhaustion-associated receptors such as KLRG-1, TIM-3 and PD-1 compared to healthy endemic normal and W. bancrofti-infected individuals. Moreover, CD4+ T cells in LE patients were characterized by distinct co-expression patterns of inhibitory receptors. Collectively with the previous findings on CD8+ T cell exhaustion patterns, the data shown here demonstrates that filarial LE patients harbor distinct subsets of exhausted T cells. Thus, T cell exhaustion patterns in LE patients need attention especially in regards to susceptibility of concomitant infections and should be taken into consideration for LE management measures.

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.

Estimating the direct Disability-Adjusted Life Years (DALYs) associated with SARS-CoV-2 (COVID-19) in the Republic of Ireland: The first full year

Objectives Burden of Disease frameworks facilitate estimation of the health impact of diseases to be translated into a single measure, such as the Disability-Adjusted-Life-Year (DALY). Methods DALYs were calculated as the sum of Years of Life Lost (YLL) and Years Lived with Disability (YLD) directly associated with COVID-19 in the Republic of Ireland (RoI) from March 01, 2020, to February 28, 2021. Life expectancy is based on the Global Burden of Disease (GBD) Study life tables for 2019. Results There were 220,273 confirmed cases with a total of 4,500 deaths as a direct result of COVID-19. DALYs were estimated to be 51,532.1 (95% Uncertainty Intervals [UI] 50,671.6, 52,294.3). Overall, YLL contributed to 98.7% of the DALYs. Of total symptomatic cases, 6.5% required hospitalisation and of those hospitalised 10.8% required intensive care unit treatment. COVID-19 was likely to be the second highest cause of death over our study's duration. Conclusion Estimating the burden of a disease at national level is useful for comparing its impact with other diseases in the population and across populations. This work sets out to standardise a COVID-19 BoD methodology framework for the RoI and comparable nations in the EU.

World Stroke Organization (WSO): Global Stroke Fact Sheet 2022

Stroke remains the second-leading cause of death and the third-leading cause of death and disability combined (as expressed by disability-adjusted life-years lost – DALYs) in the world. The estimated global cost of stroke is over US$721 billion (0.66% of the global GDP). From 1990 to 2019, the burden (in terms of the absolute number of cases) increased substantially (70.0% increase in incident strokes, 43.0% deaths from stroke, 102.0% prevalent strokes, and 143.0% DALYs), with the bulk of the global stroke burden (86.0% of deaths and 89.0% of DALYs) residing in lower-income and lower-middle-income countries (LMIC). This World Stroke Organisation (WSO) Global Stroke Fact Sheet 2022 provides the most updated information that can be used to inform communication with all internal and external stakeholders; all statistics have been reviewed and approved for use by the WSO Executive Committee as well as leaders from the Global Burden of Disease research group.

FINANCIAL IMPACT OF MENTAL ILLNESS AND HOW TO MEASURE THE CONSEQUENCES

This article shows the economic impact of mental illness, as well as various cost-estimating approaches. To assess the burden of mental diseases, there are three different ways: the human capital, the economic growth and the value of statistical life approach. The first focuses on indirect and direct costs. Moreover, the effect of mental illness on economic development can only be approximated implicitly. Thus, the lack of production is primary estimated for somatic conditions compared to their corresponding quantity of disability-adjusted life years (DALYs). The total economic productivity drop associated with mental illnesses between 2011 and 2030 is rated to be US$16.3 trillion globally. Furthermore, the value of statistical life (VSL) method suggests that trade-offs between risks and capital should be used to assess the probability of injury or death due to psychiatric illness. This computation is equivalent to that of cardiovascular disease and bigger than that of cancer. However, greater activism is required to better the existing condition.

Prevention and control of dengue and Chikungunya in Colombia: A cost-effectiveness analysis

Background Chikungunya and dengue are emerging diseases that have caused large outbreaks in various regions of the world. Both are both spread by Aedes aegypti and Aedes albopictus mosquitos. We developed a dynamic transmission model of chikungunya and dengue, calibrated to data from Colombia (June 2014 –December 2017). Methodology/Principal findings We evaluated the health benefits and cost-effectiveness of residual insecticide treatment, long-lasting insecticide-treated nets, routine dengue vaccination for children aged 9, catchup vaccination for individuals aged 10–19 or 10–29, and portfolios of these interventions. Model calibration resulted in 300 realistic transmission parameters sets that produced close matches to disease-specific incidence and deaths. Insecticide was the preferred intervention and was cost-effective. Insecticide averted an estimated 95 chikungunya cases and 114 dengue cases per 100,000 people, 61 deaths, and 4,523 disability-adjusted life years (DALYs). In sensitivity analysis, strategies that included dengue vaccination were cost-effective only when the vaccine cost was 14% of the current price. Conclusions/Significance Insecticide to prevent chikungunya and dengue in Columbia could generate significant health benefits and be cost-effective. Because of limits on diagnostic accuracy and vaccine efficacy, the cost of dengue testing and vaccination must decrease dramatically for such vaccination to be cost-effective in Colombia. The vectors for chikungunya and dengue have recently spread to new regions, highlighting the importance of understanding the effectiveness and cost-effectiveness of policies aimed at preventing these diseases.

COVID-19 Vaccines Cost-Effectiveness Analysis: A Scenario for Iran

COVID-19 vaccines are supposed to be critical measure for ending the pandemic. Governments had to decide on the type of vaccine to provide for their population. In this decision-making process, cost-effectiveness analysis is considered a helpful tool. This study is a cost-effectiveness analysis utilized to calculate the incremental cost per averted disability-adjusted life year (DALY) by vaccination compared to no vaccination for different COVID-19 vaccines. The incremental cost-effectiveness ratio (ICER) for a vaccination with COVID-19 vaccines was estimated at 6.2 to 121.2 USD to avert one DALY and 566.8 to 10,957.7 USD per one death. The lowest and highest ICERs belong to Ad26.COV2.S and CoronaVac, respectively. Considering the scenario of Iran, vaccines that are recommended include ad26.cov2.s, chadox1-S, rAd26-S + rAd5-S, and BNT162b2 in the order of recommendation.