The Effectiveness and Safety of Favipiravir in COVID-19 Hospitalized Patients in Bali, Indonesia

COVID-19 is a major public health problem, with still questionable specific cure. Favipiravir is a COVID-19 antiviral that is included in several drugs, potentially a therapy for COVID-19. This study aimed to analyze its efficacy and safety in moderate to critical hospitalized patients. This study was a retrospective cohort in Denpasar City, Bali Province, Indonesia, from August 2020 to January 2021. There was a total of 192 patients; 96 patients in the favipiravir group and 96 patients in the non-favipiravir group (remdesivir/oseltamivir). Effectivity was measured by assessing the clinical condition at the end of the isolation period of 14 days. The favipiravir group showed better clinical conditions than the non-favipiravir group (79.2% vs. 56.3%; aRR 2.196; 95% CI = 1.084 – 4.451, p=0.029), seen from being free of fever and respiratory problems. Stratification analysis demonstrated that the clinical improvement was significantly different in the severe/critical group in favor of favipiravir (RR 1,573; 95% CI = 1.139-2.172). The most common non-serious adverse events (AE) found in the use of favipiravir were gastrointestinal disturbances (12.5%). In conclusion, favipiravir is effective in severe/critical cases, and no serious adverse events were found in its use. Appropriate treatment is expected to help in reducing the public health burden.

Knowledge, Attitudes, and Practices of Health Personnel in Responding to the COVID-19 Outbreak in Indonesia

The COVID-19 outbreak, which originated in China, has spread to all countries worldwide, including Indonesia. Until July 2021, the growth rate has been gradually increasing, and cases have been found in all 34 provinces of Indonesia. This cross-sectional study aimed to investigate the knowledge, attitudes, and practices (KAP) of health personnel in public health centers towards the COVID-19 outbreak in Indonesia using online self-report questionnaires. A total of 440 respondents contributed to this online survey. The level of average KAP were 7.7 out of 10.0, 14.3 out of 15.0, and 31.9 out of 36.0, respectively. There was no significant association between respondents’ characteristics (sex, marital status, and age) and their KAP, which showed p > 0.05 for all variables. It can be concluded that the level of KAP was good even though the respondents’ characteristics had no association with KAP.

Breastfeeding Knowledge and Behavior in Lactational Amenorrhea Method (LAM) as a Natural Contraceptive

The lactational amenorrhea method (LAM) is a natural contraceptive that is highly effective after the three essential criteria are fulfilled. However, there is a significantly low adoption resulting from poor knowledge and correct practices. This study aimed to determine the correlation between knowledge and behavior of breastfeeding mothers on breastfeeding as a natural contraceptive. This was an analytic observational study with a cross-sectional design involving 89 breastfeeding mothers and was performed from January to March 2018. Furthermore, data were collected using a questionnaire, and the results showed knowledge of breastfeeding mothers to be good (59.6%) and not good (51.7%). However, the individual’s behavior towards the implementation of LAM was not good (48.3%) and good (40.4%). Based on the statistical test, there was a correlation between knowledge and behavior of breastfeeding mothers, with a p-value of 0.006 (OR = 3.463; 95% CI = 1.411 – 8.498). In brief, knowledge of LAM amongst the participants is good, despite the poor application in terms of behavior. Also, a relationship was also established between the knowledge and behavior of breastfeeding mothers as a natural contraceptive.

Predictors of the COVID-19 Social Distancing Practice among Undergraduate Health Students in Samarinda City, Indonesia: A Cross-Sectional Study

Social distancing is a health protocol recommended by the World Health Organization (WHO) for reducing the spread of COVID-19. Undergraduate health students play an important role in the dissemination of accurate information. This study identified predictors that influenced the COVID-19 social distancing practice and examined the sources of social distancing information among undergraduate health students in Samarinda City, Indonesia. This cross-sectional online survey study (March-April 2021) to involved 422 undergraduate students from medicine, public health, and pharmacy faculties at Mulawarman University. Binary logistic regression was conducted to identify factors associated with the COVID-19 social distancing practice. The results showed that age (AOR 1.47; 95% CI 1.97–2.22, p = 0.045), sex (AOR 2.26; 95% CI 1.38–3.69, p=0.001), and attitude (AOR 2.61, 95% CI: 1.75, 3.90, p<0.001) were significantly associated with social distancing practices. The top three sources of COVID-19 social distancing information used were social media (80.6%), websites (14.0%), and television (3.8%). The study findings encourage the government to disseminate more health information on social media and education programs to this target population.

How Risky People of Getting COVID-19 based on their Daily Activities?

In Indonesia at the end of 2020, COVID-19 cases were increasing and predicted to continue, as Indonesia had not yet passed the peak of the pandemic curve. The government had implemented mobility restrictions to reduce exposure to COVID-19. However, there is still a lack of studies in Indonesia that have assessed the risks of COVID-19 transmission based on people’s daily activities. This study aimed to identify the risk of people getting COVID-19 based on their daily activities. This study used a cross-sectional study design. It took 315 respondents under non probability sampling from September to October 2020. The data were analyzed using thechi-square test with α 0.05. This study showed that the risk percentage of people being infected with COVID-19 based on their daily activities was 15.56% at low risk, 63.81% at moderate-low risk, 17.14% at moderate risk, and 3.9% at moderate-high risk. Factors that were significantly related to the risk of getting COVID-19 in terms of daily activities were biological sex, attitude, and COVID-19 preventive behavior. The conclusion of this study was that the assessment of the risk of getting COVID-19 could be derived from daily activities carried out during the peak of the pandemic.

The Indonesian Strategy to Achieve Universal Health Coverage through National Health Insurance System: Its Challenges in Human Resources

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Are We Passing on Violence to the Next Generation?: Gender Norms and Gender-based Violence Attitudes among Early Adolescents in Indonesia

Intensification of gender norms during puberty affects adolescents’ perceptions and behavior related to violence. This study examined the association between gender norms and gender-based violence (GBV) among early adolescents considering socio-ecological variables using cross-sectional data from 3,618 Indonesian Global Early Adolescent Study pupils. Chi-square tests with simple and multiple logistic regression analyses examined how different factors' levels predict GBV. Among boys, GBV attitudes were found high (53%). Furthermore, they also had high heteronormative expectations, threatened feelings, experiences of violence, porn access, and 5+ adverse childhood experiences (ACEs). Logistic regression results revealed that adolescent boys having one or two scores of gender norms at the above-median are 1.3 times more likely to commit GBV and even 2.2 times higher if all were above median [AOR(CI) =1.3(1.1-1.6); 2.2(1.7-2.8)], respectively. Boys, having 5+ ACEs, and stronger endorsement on heteronormative relationships were also more likely to commit GBV [AOR(CI) =1.5(1.3-1.7); 1.5(1.2-1.9); 1.5 (1.3-1.7)], respectively. This research concluded that unequal gender norms intensified during puberty strongly correlate to attitudes towards GBV among early adolescents. Strengthening the individual aspects by providing a more conducive environment, such as comprehensive sexual education at school, is essential to prevent GBV.

Mental Fatigue and Its Associated Factors among Coal Mining Workers after One Year of the COVID-19 Pandemic in Indonesia

Mental fatigue among coal mining operators was related to driving activities that require high concentration. This study aimed to determine factors that contributed to mental fatigue among coal mine operators in Indonesia, specifically in Kalimantan and Sumatra, after a one-year COVID-19 pandemic. This cross-sectional study was conducted among 480 operators from two companies and seven sites. A self-administrated questionnaire in the Google Form was used to measure mental fatigue, the non-work-related factors (age, education, marital status, residence, and stress level), and work-related factors (working periods, shift pattern, type of shift, and work area in mining). The data analyzed using Chi-square and binomial logistic regression showed that the prevalence of mental fatigue was 32.3%. Operators with moderate stress and working in the pit area demonstrated a significant association with mental fatigue (p-va lue<0.001). Multivariable analysis showed that medium stress (ORadj: 2.11, 95% CI: 1.41 to 3.15) and working in the pit (ORadj: 2.27, 95% CI: 1.45 to 3.57) had a positive association with mental fatigue. Thus, the pit condition and stress levels were the dominant factors influencing mental fatigue and became points to manage mental fatigue in coal mining operators in Kalimantan and Sumatra.

The COVID-19 Pandemic: Role of Coping Humor and Internal Health Locus of Control on Social Dysfunction and Anxiety & Depression

The concerns about the impact of social distancing on mental health have been widely discussed. This study aimed to know the predictive effect of coping humor and Internal Health Locus of Control (Internal HLoC) on social dysfunction and anxiety & depression during the implementation of the COVID-19 social distancing agenda. This study was also intended to assess the effect of humor content on coping humor. A quantitative approach was used as the method ofthe study with 243 online-recruited participants, and PLS-SEM analysis was applied to find out the predictive effect in this study. The results and conclusions showed that anxiety & depression predict social dysfunction (β = 0.584, t-value = 11.93, f2 = 0.563). It was found that coping humor was able to directly increase the Internal HLoC (β = 0.187, t-value = 2.60, f2 = 0.036) and indirectly decrease social dysfunction (β = -0.144, t-value = 2.85) and anxiety & depression (β = -0.070, t-value = 2.42). Humor content unrelated to the issue of COVID-19 directly increase the coping-humor level (β = 0.266, t-value = 4.13,f2= 0.076), and indirectly increase Internal HLoC (β = 0.050, t-value = 2.07), and decrease anxiety & depression level (β = -0.046, t-value = 2.20). On the other hand, Internal HLoC directly decrease levels of social dysfunction (β = -0.233, t-value = 4.126, f2 = 0.089) and anxiety & depression (β = -0.373, t-value= 7.84, f2 = 0.161).

The Seroprevalence of Toxoplasma Gondii in Cats at the House of Maternal Women with Toxoplasmosis in Badung, Indonesia

Toxoplasmosis is a zoonotic disease caused by infection with the parasite called Toxoplasma gondii (T. gondii). The health and social impacts of the infection are enormous, including miscarriage, hydrocephalus, blindness, and mental retardation. The occurrence of toxoplasmosis in maternal women cannot be separated from cats around their houses. This study aimed to determine the seroprevalence of the parasite in cats found in the human carriers residences and identified the risk factors of toxoplasmosis in maternal women in Badung District, Bali Province, Indonesia. A total of 80 cat serum samples were obtained from two residential groups, 40 from the housing where the maternal women were infected and another 40 from where there were no identified sufferers of the disease. All the samples were examined using the enzyme-linked immunosorbent assay (ELISA) method to detect the presence of antibodies T. gondii in feral cat serum. The results showed that 47.5% of the examined subjects had the said antibodies. As much as 65% came from housing with cases of toxoplasmosis in maternal mothers, and 30% came from residences with none. The presence of feral cats is a major risk factor for the transmission of T. gondii to humans.