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Untapped Potential: A Qualitative Study of a Hospital-Based Dengue Surveillance System
Umeå universitet, Medicinska fakulteten, Institutionen för epidemiologi och global hälsa. Department of Public Health, Universitas Ahmad Dahlan, Yogyakarta, Indonesia.ORCID-id: 0000-0002-7299-0360
Umeå universitet, Medicinska fakulteten, Institutionen för epidemiologi och global hälsa.ORCID-id: 0000-00033036-8546
Laboratory of Pharmacy Management and Community Pharmacy, Department of Pharmaceutics, Universitas Gadjah Mada, Yogyakarta, Indonesia.
Department of Public Health, Universitas Ahmad Dahlan, Yogyakarta, Indonesia.
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2020 (Engelska)Ingår i: American Journal of Tropical Medicine and Hygiene, ISSN 0002-9637, E-ISSN 1476-1645, Vol. 103, nr 1, s. 120-131Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

The incidence and geographical distribution of dengue fever has increased in recent decades. The actual disease burden is unknown owing to frequent underreporting and misclassification of cases. A well-functioning system for diagnosing, treating, and reporting cases is of prime importance as disease statistics is the foundation for decisions aiming to control the disease. This study aimed to explore the hospital-based disease surveillance system in Yogyakarta, a dengue-endemic region on Java, Indonesia. Semi-structured interviews were performed with 16 informants from four hospitals, including five general practitioners, three internists, four pediatricians, and four administrative staff working with administration relating to dengue diagnostics and reporting. Data were analyzed using content analysis. A theme arose from the analysis "Dengue surveillance stands and falls by the rigor of the health system." The theme, and underlying categories and subcategories, describes a surveillance system that in the best-case scenario works well and is likely to produce reliable dengue case data. However, there is a lack of synchronization between regulations and guidelines in different hospitals and some friction between regulatory bodies and the care provider. Knowledge among the staff appears to vary, and many clinical and financial decisions are made rather arbitrarily, which ultimately might lead to unequal health service delivery. In conclusion, the dengue surveillance system under study could improve further, particularly by ensuring that all regulations and recommended procedures are standardized and that all staff are given the best opportunity to stay updated on dengue-related matters, clinical as well as regulatory, on a regular basis.

Ort, förlag, år, upplaga, sidor
American Society of Tropical Medicine and Hygiene , 2020. Vol. 103, nr 1, s. 120-131
Nationell ämneskategori
Folkhälsovetenskap, global hälsa och socialmedicin
Identifikatorer
URN: urn:nbn:se:umu:diva-171043DOI: 10.4269/ajtmh.19-0719ISI: 000577191000029PubMedID: 32394883Scopus ID: 2-s2.0-85088205708OAI: oai:DiVA.org:umu-171043DiVA, id: diva2:1431785
Tillgänglig från: 2020-05-25 Skapad: 2020-05-25 Senast uppdaterad: 2025-02-20Bibliografiskt granskad
Ingår i avhandling
1. Dengue Prevention and Control in Indonesia: a case study in Yogyakarta City
Öppna denna publikation i ny flik eller fönster >>Dengue Prevention and Control in Indonesia: a case study in Yogyakarta City
2020 (Engelska)Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
Abstract [en]

Background: Integrated efforts that involve many public health sectors are required to combatdengue in any setting. Hospitals are responsible for providing accurate diagnosis and reportingconfirmed dengue cases to the health authorities, which serves as an alarm for increasingpreventive measures. Community participation in dengue vector control is essential becauseit affects sustainability and cost-effectiveness of preventive and control. This thesis aimed toprovide an in-depth understanding of dengue prevention and control in Yogyakarta, Indonesia,in order to contribute to strengthening the country’s health system and the implementation ofstandardized and well-accepted dengue control strategies. Several aspects have been studiedin term of dengue prevention and control (case management and reporting, surveillance andvector control) in a dengue-endemic region of Indonesia – namely, Yogyakarta.

Methods: This thesis comprises four individual research studies: Knowledge, Attitude andPractice (KAP) survey, control card intervention, implementation of the Jumantik programmeand dengue case management and reporting in hospital. A descriptive analysis, followed by apre-post assessment, was performed in the community. A mixed-method approach was usedfor assessing the Jumantik programme and qualitative approach was conducted for the hospitalstudy.

Results: The findings indicated that: (i) KAP regarding dengue vector control were sufficient butcertain aspects still had weaknesses; (ii) level of community participation in vector control wasnot satisfactory for several reasons, including lacking time, being busy with work and memberof the community feel that vector control was not their responsibility; (iii) the Jumantikprogramme dealt with various obstacles, especially those related to public acceptance; (iv)coordination between the district health office and hospitals for early dengue detection didnot run optimally. We also found that standard operating procedures for dengue managementdiffered between hospitals.

Conclusions: The results clearly show that dengue prevention and control efforts in Yogyakartaface certain challenges that must be addressed. While many World Health Organizationrecommendations are being followed, the weaknesses found in some aspects of theimplementation, as well as the lack of integration for various dengue prevention and controlelements, need to be promptly addressed.

Ort, förlag, år, upplaga, sidor
Umeå: Umeå universitet, 2020. s. 71
Serie
Umeå University medical dissertations, ISSN 0346-6612 ; 2102
Nyckelord
dengue, control and prevention, community empowerment, diagnostic and case reporting
Nationell ämneskategori
Folkhälsovetenskap, global hälsa och socialmedicin
Identifikatorer
urn:nbn:se:umu:diva-176142 (URN)978-91-7855-383-9 (ISBN)978-91-7855-382-2 (ISBN)
Disputation
2020-11-17, Zoom Meeting: https://umu.zoom.us/j/61800219535, Password zoom meeting: 382146, Umeå, 08:30 (Engelska)
Opponent
Handledare
Tillgänglig från: 2020-10-27 Skapad: 2020-10-21 Senast uppdaterad: 2025-02-20Bibliografiskt granskad

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