This invitation was delivered in the Talkshow held by RS UNS to commemorate the world TBC Day under the topic of ‘Investment to Eliminate TBC, Save the Nation,’ on Tuesday (22/3/2022) through UNS Hospital’s official Instagram @rumahsakituns and YouTube live streaming.

Prof. Reviono stated that the world target in 2030 is to reduce the TBC cases by 80% to 20% of the current cases and to reduce 90% of the mortality rate to 10%. “To achieve this elimination target is not an easy task because many problems still require support from all community members. Such as reducing the risk factors that cause failure in TBC treatment. Because it needs funding, energy, and efforts, therefore, the investment is to strengthen the factors that could prevent the failure of TBC treatment,” he stated.

TBC is an illness caused by mycobacterium tuberculosis that often affects lung tissue, although it is not limited to the lung tissues. The illness could affect the brain membrane or brain itself, and even the intestines. TBC infection remains dangerous no matter what organ it affects, and it is one of the old illnesses that is hard to eliminate. Many patients often received late diagnoses and had infected others because of it. “Chronic illness has slow symptoms; thus, people infected with TBC often adapt to their symptoms,” Prof. Reviono stated.

TBC is an endemic illness and is widespread evenly in all provinces in Indonesia. The risk factors that affect one’s immunity to this illness are diabetes, renal failure, malnutrition, and densely populated area with a lack of ventilation and sunlight. During the Covid-19 pandemic, TBC cases tended to decrease worldwide, and Indonesia contributed to the significant decline in this number. The stay-at-home policy is suspected to be the cause of this decrease. However, Prof. Reviono stated that the cases do not decline per se, but instead, the infection is not detected until later on.

The Difference between TBC and Other Lung Infections

TBC was considered suspect, with two weeks (minimum) as its special symptom. Chronic TBC is marked with systemic symptoms such as fever, low appetite, and declined weight. TBC is different from other lung illnesses such as asthma and pneumonia in terms of its causes, time, and onset, with pneumonia tends to be rapid and acute. TBC is treated using TBC medicines, while pneumonia is treated according to its cause. TBC treatment is also harder because of its rapid multiplication and thick cell membrane.

TBC Prevention and Treatment

The existing research showed that six months of treatment is the standard for TBC. After such treatment, the level of bacteria usually decreases and does not affect one’s health. However, lung tissues damages could vary from mild, medium, and severe. “So, if the damage was mild, usually the recovery or lung tissue revolution could return to its initial state. But if (the damage) was medium or severe, there is a cavity (hole in the lung) that could cause residual symptoms, such as coughs. If it is (residual symptom) only cough without other systemic symptoms, without fever, or decreased appetite, I think it could be treated using common cough medicine; it is just symptomatic. But if there is a continuation of these symptoms, you have to be careful. Doctors will investigate if there is recurrence or there may be comorbid or accompanying disease, then that will be considered,” Prof. Reviono stated.

TBC has four populations, extra-cellular, which could be eliminated easily using antibiotic drugs; intracellular, acidic condition, and dormant, which is impossible to eliminate but manageable so that the bacteria do not cause clinical symptoms. Therefore, people with a good immune system do not need treatment unless they start to show symptoms. “This could lead to latent TB. Once they show immune responses, we usually took two methods, Mantoux and interferon-gamma tests. Treatment is provided once the immune responses are higher than the normal score. But it is preventive in the form of TB preventive therapy,” Prof. Reviono stated.

People recovering from TB could get reinfected if they have close contact with infected people. The current TBC diagnostic is conducted using Molecular Rapid Test (TCM) as the most sensitive test. Although this test is not available in community health centers, samples could be sent to health facilities that run such tests. As a preventive measure, there is also the Bacillus Calmette–Guérin (BCG) vaccine for TBC that, even though it is not yet effective, could prevent severe TBC infection.

TBC in Children

Children generally show different conditions from adults infected with TBC. TBC infection in children is primarily complex or closed TB without the involvement of the respiratory tract. Children also can’t infect others with their symptoms, and the main concern once a child is infected is to find out where the infection came from. “In children, the first infection could not infect other children. In conclusion, children can be infected but cannot infect others,” Prof. Reviono concluded.

TBC symptoms in children are different from adults. In adults, the symptoms are dominated by a cough with phlegm that is not found in children, who usually have a cough with a chronic fever that occurs each day, although it is not high. Children also show decreased appetite or low weights compared to their fellows (below normal) and usually are not diagnosed using TCM. Humas UNS

Reporter: Erliska Yuniar Purbayani
Editor: Dwi Hastuti

The post Commemorating World TBC Day, UNS Hospital Physician Invited the Community to Prevent TBC Cases in Indonesia appeared first on Universitas Sebelas Maret.

“The purpose of this webinar is to increase public understanding regarding the dangers of female circumcision or Female Genital Mutilation or Cutting (FGM/C). It also aims to reduce the rampant practice of FGM,” said the Student of the International Relations (HI) Study Program, Faculty of Social and Political Sciences (FISIP) UNS, Audrey Nethania Wibowo, while serving as the Moderator for the event.

According to the World Health Organization (WHO) Key Facts, FGM refers to any actions such as the cutting and tearing of female genital organs, including actions taken intentionally to change or injure female genital organs without medical indications. Audrey added that female circumcision or FGM culture still persists in Indonesia. Even though FGM is included in dangerous actions that are exclusively aimed at women or girls, ironically, this practice that has a clear physical and psychological impact persists in our country.

“Therefore, this webinar also fosters awareness of FGM practices that can hurt women. Because few Indonesian people consider FGM as a custom to follow. Although some people are aware of the adverse effects of FGM on health, they still do so to women for acceptance in the community. This thought is what must be improved,” Audrey continued.

Meanwhile, this webinar invited speakers from the Indonesia National Commission on Violence Against Women (Komnas Perempuan) Commissioner, Dr. Retty Ratnawati, M.Sc. Dr. Retty explains about Prevention & Elimination of Female Genital Mutilation (P2GP) or Female Genital Mutilation/Cutting (FGM/C).

Dr. Retty said the P2GP practice is still implemented in Indonesia because it is seen as a hereditary culture and is considered a religious order. “In contrast, the medicalization of P2GP can indirectly cause greater damage due to more invasive surgical procedures performed. The parents’ viewpoint who say that P2GP has benefits for their daughters contradicts the evidence from the medical side. The media side indicated that this practice has a harmful impact on girls’ physical and mental health,” explained Dr. Retty.

The stance taken by the Komnas Perempuan regarding the practice of P2GP or FGM is to encourage the integration of an inclusive and intersectional human rights perspective in reproductive health policies. That is by paying special attention to the policy of Zero Tolerance toward P2GP practices. “Female circumcision, in any form, needs to be abolished because P2GP is a form of sexual violence based on gender against women. That also a symbol of a discriminatory act against women,” said Dr. Retty. Furthermore, Dr. Retty also encourages every Indonesian to understand P2GP impact, to take decisive action to stop discrimination, hoaxes, and myths related to P2GP, and to fight for the right to sexual and reproductive health.

The second speaker was the Obstetrics and Gynecology Specialist, Dr. Muhammad Fadli, Sp. OG Dr. Fadli explained the Impact and Implications of Female Circumcision. “The practice of female circumcision or FGM or P2GP has no medical benefits because it will cause severe complications, both acute or chronic. Additionally, this action has also been abandoned in Indonesian Medicine for a long time,” concluded Dr. Fadli. Humas UNS

Reporter: Lina Khoirun Nisa
Editor: Dwi Hastuti

The post UNS MUN Club Hosted Webinar on Circumcision Practices in Women appeared first on Universitas Sebelas Maret.

The government of Indonesia took a quick response toward the issue by prohibiting foreign nationals (WNA) who visited South Africa, Botswana, Namibia, Zimbabwe, Lesotho, Mozambique, Eswatini, Malawi, Angola, Zambia, and Hongkong in the last 14 days from entering Indonesia. Indonesian people who have a history of visiting the mentioned countries and coming back to Indonesia will undergo 14 days starting from Monday (29/11/2021) 00.01 Jakarta Time.

The spread of the Omicron variant also grasps the attention of Covid-19 Taskforce spokesperson and the Clinal Pathology Specialist Universitas Sebelas Maret (UNS) Surakarta Hospital, Tonang Dwi Ardyanto dr. SpPK, Ph.D.

Although until Tuesday (30/11/2021), the Indonesian government has not confirmed the Omicron variant in Indonesia, it does not mean that the community could be ignorant and disregard the health protocols. With the increase in the reporting over Omicron spread, the community needs to be more careful and apply strict health protocols to prevent the case of Delta variant on July-August in the next Christmas and New Year holidays.

“These days, several countries have reported, including Australia. Those reporting are succeeded in detecting (the new variant). (Countries) that have not reported is not mean that they are free from the new variant. Maybe because they have not yet been successful in detecting it (the new variant),” dr. Tonang said to uns.ac.id on Tuesday (30/11/2021).

Regarding the severity of the new variant, dr. Tonang explained that the information continues to develop according to the spread of this new variant. He asked the community not to be too worried over the severity of the new variant but instead be aware of the issues. He also hoped that the emergency units in hospitals could be more ready in case the infection rate peaked due to the Omicron variant. He does not want Covid-19 patients to get poor service like in the July-August case.

“The malignancy greatly depends on the local condition. The death proportion (CFR) of the Delta variant, for example, is actually low. Although the cases were extreme in several countries, the death percentage was low,” he explained.

dr. Tonang added that Covid-19 handling is focused on the level of spread; therefore, the number of infections could be monitored, infection cases do not soar, health care facilities have the capability to provide services until the infection rate decreases. “What we need to consider is the infection rate. If the cases are soaring, the hospital collapses, beds are not available, (patients) queued in the emergency units, or even forced to stay at home that increases the risk, increases the death rate. It means that we need to be aware of,” dr. Tonang added.

The Wave of Covid-19 Spread

During the 1.5 years of the Covid-19 pandemic globally, Indonesia has experienced two waves that caused a spike in infection rate and death rate. dr. Tonang explained that there are two possible conditions when the wave of Covid-19 occurs. The first condition, the managed ones, when the case is high, but those confirmed with Covid-19 are isolated, and patients could access health care.

“Second (condition), from the beginning of the wave, the spread is uncontrollable, infection rate increases, cases increasing, and, I’m very sorry to say, many died, then after a lot of people got infected, the cases decreasing because the virus couldn’t find a new place to multiply,” dr. Tonang said.

Thus, dr. Tonang asked the government to ensure the community discipline in implementing the health protocols, help in separating the sources of infection through isolation, treat people showing Covid-19 symptoms, and vaccinate people. These efforts also need support by community behavior in wearing a mask, washing hands, and limiting interaction between Indonesia and other countries.

“The two are the government responsibilities because it is impossible for the people to perform it. (The community) could only support. Let us monitor and continue reminding the government if needed so that the government performs their responsibilities,” dr. Tonang stated. Humas UNS

Reporter: Y. C. A Sanjaya
Editor: Dwi Hastuti

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