Prevention and control of leptospirosis require an understanding of risk factors. This review identifies risk factors associated with leptospirosis infection from countries in the Asia-Pacific region, and compares and contrasts these data with those available from Indonesia. MEDLINE, PubMed, and Scopus databases were used to search for relevant articles. Indonesian gray literature was searched for leptospirosis risk factor studies in Indonesia. A total of 34 articles were included in this review. The contrast between peer-reviewed publications and Indonesian gray literature revealed that the variety of risk factors associated with leptospirosis infection is region or area specific. The presence of skin wounds, the existence of rodents, especially rats, and activities related to contact with contaminated surface water are factors frequently reported to have significant association with leptospirosis infection in human in Indonesia and in other Asia-Pacific countries.

To investigate rickettsioses and leptospirosis among urban residents of Semarang, Indonesia, we tested the blood of 137 patients with fever. Evidence of Rickettsia typhi, the agent of murine typhus, was found in 9 patients. Another 9 patients showed inconclusive serologic results. Thirteen patients received a diagnosis of leptospirosis. No dual infections were detected.

Background: Sputum smear microscopy is the standard diagnostic method for detection of smear positive pulmonary tuberculosis (TB). Insufficient quality of sputum might result in missing cases. In this study we aimed at assessing the quality of sputum in a district in Central Java and determining patient and health worker factors associated with submission of three good quality sputum samples.

SummaryLeptospirosis is a zoonosis of worldwide distribution, spread by the urine of infected animals. It is a major public health problem, especially in developing countries, where circumstances for transmission are most favourable. The clinical picture varies from mild disease to a severe illness with haemostatic derangements and multiorgan failure eventually leading to death. Although the haemorrhagic complications of severe disease are serious, the pathophysiology is scarcely elucidated. The complex mechanisms involved in inflammation-induced coagulation activation are extensively studied in various infectious diseases, i.e. Gram-negative sepsis. Tissue factor-mediated coagulation activation, impairment of anticoagulant and fibrinolytic pathways in close concert with the cytokine network are thought to be important. But for human leptospirosis, data are limited. Because of the growing interest in this field, the impact of leptospirosis, and the availability of new therapeutic strategies, we reviewed the evidence regarding the role of coagulation in leptospirosis and provide suggestions for future research.

Background: Children's Tuberculosis (TB) (p = 0.049; OR = 2.918; 95% CI = 1.005 to 8.472), density occupancy (p = 0.020; OR = 3.379; 95% CI = 1.212 to 9.417), humidity (p = 0.025; OR = 3.236; 95% CI = 1.156 to 9.058) and ventilation (p = 0.022; OR = 3.224; 95% CI = 1.182 to 8.797). Conclusion:The density occupancy, humidity, ventilation, mother's knowledge are a risk factor pulmonary TB incidence of children in Pekalongan City.

Leptospirosis, a zoonotic disease, transmitted to human trough contact with contaminated animal urine and contaminated environment. Demak District is an endemic area where cases increased in the past 2 years. The aim of the study was to map environmental risk factor of Leptospirosis and to determine Leptospirosis vulnerable zone using cross-sectional study design. There were 42 cases mapped by GPS and overlaid using remote sensing (Quickbird image) by using ArcView program then interpreted by Spatial Feature and Spatial Analyses. Leptospirosis cases were spread out and grouped in Demak Sub District area. More cases were males (61.9%), 21-50 years old age group (59.3%) and farmers (40.4%). Spatial analyses showed that all the leptospirosis cases took place in the area with low plain <47 msl, rainfall ≥220 mm/month (64.7%), clay soil (100%), buffer river <50 m (71.4%), presence of rat (100%), wastewater disposal (100%), waste disposal facilities (97.7%), flood’s profile (28.6%), tidal inundation’s profile (7.1%), vegetation (59.5%). Leptospirosis high-risk zone was in 37,801.8 ha (41.32%), moderate risk zone was 43,570.23 ha (48.55%), and low-risk zone was 9,090.96 ha (10.13%). Densely populated housing, bad environment condition, and the presence of rat and puddles that were contaminated by rat’s urine were risk factors of Leptospirosis cases in Demak District.

Background: Limitations of data regarding risk factors that affect the incidence of leptospirosis in endemic areas make leptospirosis control in Leptospirosis endemic areas not effective. Therefore, a study is needed to determine the factors that influence the occurence of Leptospirosis in an area. Methods: An observasional analytic was conducted with case control study design. The population in this study were all patients found at the Hospital in Pati Regency who showed clinical symptoms of Leptospirosis (fever >38 o C, severe headache, calf muscle pain, red / yellowish red eyes) and had a laboratory examination with Leptotek Lateral Flow and recorded on medical records. The sample in this study were 44 cases and 44 controls with consecutive sampling technique. Data were analyzed by chi-square and logistic regression. Results: Variables that influence the occurence of leptospirosis are the characteristic of the non-ratproof house with OR = 3.14 (95% CI = 1.16-8.47), the existence of rats in and around the house with OR = 3.66 (95% CI = 1.67-12.28), the behavior of walking barefoot during outdoor activities with OR = 1.57 (95% CI = 1.31-10.28). Conclusion: Several factors that have been proven to have an effect on the occurence of leptospirosis are the characteristic of the non-ratproof house, the existence of rats in and around the house and the behavior of walking barefoot during outdoor activities.

Tujuan penelitian ini adalah untuk menganalisis apakah ada pengaruh antara dimensi kualitas pelayanan yaitu tangible, reliability, responsiveness, assurance, dan empathy terhadap kepuasan pasien peserta BPJS Kesehatan di instalasi rawat jalan RSUD dr. H. Soewondo Kendal.Penelitian ini menggunakan metode  pendekatan kuantitatif dengan desain cross sectional . Populasi penelitian adalah pasien rawat jalan peserta BPJS Kesehatan di poli rawat jalan RSUD dr. H. Soewondo Kendal, sedangkan subyeknya adalah pasien peserta BPJS Kesehatan di poli rawat jalan yang telah pernah periksa minimal 2-3 kali dengan menggunakan kartu BPJS Kesehatan. Pengumpulan data menggunakan cara Non Probability Sampling. Data diolah dan dianalisisi dengan analisis Smart PLS. Besar sampel sejumlah 100 orang responden dan menggunakan teknik Purposive Sampling untuk pengambilan sampel.   Berdasarkan analisis dengan Smart PLS hasil penelitian menunjukkan bahwa tangible / bentuk fisik  mempunyai pengaruh positif secara signifikan terhadap kepuasan pasien dengan nilai t-hitung 3,043 > 1.96 , reliability / keandalan mempunyai pengaruh positif secara signifikan terhadap kepuasan pasien dengan nilai t-hitung 2,571 > 1.96, responsiveness / daya tanggap  mempunyai pengaruh positif secara signifikan terhadap kepuasan pasien dengan nilai t-hitung 3,101 > 1.96, assurance / jaminan tidak mempunyai pengaruh positif secara signifikan terhadap kepuasan pasien dengan nilai t-hitung 1,491 < 1.96, dan empathy / perhatian  mempunyai pengaruh positif secara signifikan terhadap kepuasan pasien dengan nilai t-hitung 3,469 > 1.96. Hasil uji hipotesis ini menunjukkan bahwa tidak semua dimensi kualitas pelayanan berpengaruh terhadap kepuasan pasien peserta BPJS Kesehatan.Kesimpulan penelitian ini adalah empat dari lima dimensi kualitas pelayanan yang diteliti mempunyai pengaruh positip secara signifikan terhadap kepuasan pasien peserta BPJS Kesehatan di Instalasi Rawat Jalan RSUD dr. H. Soewondo. Dimensi mutu tangible, reliability, responsiveness dan emphaty mempunyai pengaruh terhadap kepuasan pasien peserta BPJS Kesehatan di Instalasi Rawat Jalan RSUD dr. H. Soewondo dan dimensi assurance tidak mempunyai pengaruh terhadap kepuasan pasien.