Background and Aims Retinopathy of prematurity (ROP) is a severe disease in preterm infants. It is seen more frequently in Low‐Middle Income Countries (LMIC) like Indonesia compared to High‐Income Countries (HIC). Risk factors for ROP development are ‐extreme‐ preterm birth, use of oxygen, neonatal infections, respiratory problems, inadequate nutrition, and blood and exchange transfusions. In this paper, we give an overview of steps that can be taken in LMIC to prevent ROP and provide guidelines for screening and treating ROP. Methods Based on the literature search and data obtained by us in Indonesia's studies, we propose guidelines for the prevention, screening, and treatment of ROP in preterm infants in LMIC. Results Prevention of ROP starts before birth with preventing preterm labor, transferring a mother who might deliver <32 weeks to a perinatal center and giving corticosteroids to mothers that might deliver <34 weeks. Newborn resuscitation must be done using room air or, in the case of very preterm infants (<29‐32 weeks) by using 30% oxygen. Respiratory problems must be prevented by starting continuous positive airway pressure (CPAP) in all preterm infants <32 weeks and in case of respiratory problems in more mature infants. If needed, the surfactant should be given in a minimally invasive manner, as ROP's lower incidence was found using this technique. The use of oxygen must be strictly regulated with a saturation monitor of 91‐95%. Infections must be prevented as much as possible. Both oral and parenteral nutrition should be started in all preterm infants on day one of life with preferably mothers' milk. Blood transfusions can be prevented by reducing the amount of blood needed for laboratory analysis. Discussion Preterm babies should be born in facilities able to care for them optimally. The use of oxygen must be strictly regulated. ROP screening is mandatory in infants born <34 weeks, and infants who received supplemental oxygen for a prolonged period. In case of progression of ROP, immediate mandatory treatment is required. Conclusion Concerted action is needed to reduce the incidence of ROP in LMIC. "STOP ‐ R1O2P3" is an acronym that can help implement standard practices in all neonatal intensive care units in LMIC to prevent development and progression.
The COVID-19 pandemic has had an unprecedented impact on health, society, and the economy globally and in Indonesia.The World Health Organization (WHO) recommended the use of intra-action reviews (IARs) to identify best practices, gaps, and lessons learned to make real-time improvements to the COVID-19 response. The Emergency Committee of the International Health Regulations (2005) has recommended that countries share COVID-19 best practices and lessons learned with peer countries through IARs. Using WHO-established methodology, we conducted the first IAR of Indonesia's COVID-19 response from January through August 2020. The review covered 10 thematic areas (pillars): (1) command and coordination; (2) operational support and logistics; (3) surveillance, rapid response teams, risk assessment, and field investigation; (4) laboratories;(5) case management; (6) infection prevention and control; (7) risk communication and community empowerment; (8) points of entry, international travel, and transportation; (9) large-scale social restrictions; and (10) maintaining essential health services and systems. We held focus group discussions with a variety of stakeholders from a range of government departments, provincial health offices, and nongovernmental organizations. We used the results of the focus group discussions and other key findings from the IAR to formulate recommendations. The IAR identified key areas for improvement at national and subnational levels across all 10 pillars. Priority recommendations included improving multisectoral coordination and monitoring of COVID-19 response plan indicators; strengthening implementation of public health response measures, including case detection, isolation, infection prevention and control, contact tracing, and quarantine; and improving data collection, analysis, and reporting to inform public health risk assessment and response. The IAR is a useful tool for reviewing progress and identifying areas to improve the COVID-19 response in real time and provides a means to share information on areas of need with COVID-19 response partners and contributes to International Health Regulations (2005) core capacity development.
Stunting, atau perawakan pendek, berhubungan erat dengan hambatankemampuan kognitif dan kualitas hidup. Prevalensi stunting di Indonesiamencapai 30,8% tahun 2018. Stunting dipengaruhi pemenuhan nutrisi diawal kehidupan, salah satunya melalui ASI eksklusif. Meskipun cakupan ASIeksklusif di Indonesia sudah 74,5%, hubungan stunting dengan ASI eksklusifseringkali tidak konsisten akibat keberagaman kuantitas dan kualitas ASI.Penelitian ini ingin mengetahui efek ASI eksklusif terhadap stunting diKabupaten Bogor, sebagai salah satu daerah tinggi stunting di Indonesia.Penelitian dengan desain potong lintang ini dilaksanakan di PuskesmasKecamatan Ciampea, Kabupaten Bogor, pada Februari sampai April 2019.Kriteria inklusi adalah balita usia 6-59 bulan yang berkunjung ke poliklinik.Informasi pemberian ASI eksklusif diperoleh dari wawancara terstruktur,sementara stunting ditetapkan dengan antropometri terstandar. Dari 162balita, 117 (72,22%) mendapat ASI eksklusif dan 64 subjek (39,51%)mengalami stunting. Pada analisis multivariat, ditemukan interaksi padastrata usia ibu saat hamil > 30 tahun dan < 30 tahun, sehingga rasioprevalens (PR) ASI eksklusif terhadap kejadian stunting adalah 0,41 IK95%0,23-0,74 dan 1,74 IK95% 0,93-3,24; p Mantel-Haenszel < 0,001 secaraberturut-turut. Penelitian ini menyimpulkan bahwa ASI eksklusif dapatbersifat protektif terhadap stunting bila usia ibu saat hamil > 30 tahun.Selain meningkatkan cakupan, diperlukan upaya meningkatkan kualitasASI eksklusif untuk mengoptimalkan upaya pencegahan stunting
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