Background: The number of new leprosy cases is declining globally, but the disability caused by leprosy remains an important disease burden. The chance of disability is increased by delayed case detection. This review focusses on the individual and community determinants of delayed leprosy case detection. Methods: This study was conducted according to the PRISMA guidelines (Preferred Reporting Items for Systematic Reviews and Meta-Analysis). The study protocol is registered in PROSPERO (code: CRD42020189274). To identify determinants of delayed detection, data was collected from five electronic databases: Embase.com, Medline All Ovid, Web of Science, Cochrane CENTRAL, and the WHO Global Health Library. Results: We included 27 papers from 4315 records assessed. They originated in twelve countries, had been published between January 1, 2000, and January 31, 2021, and described the factors related to delayed leprosy case detection, the duration of the delayed case, and the percentage of Grade 2 Disability (G2D). The median delay in detection ranged from 12 to 36 months, the mean delay ranged from 11.5 to 64.1 months, and the percentage of G2D ranged from 5.6 to 43.2%. Health-service-seeking behavior was the most common factor associated with delayed detection. The most common individual factors were older age, being male, having a lower disease-symptom perception, having multibacillary leprosy, and lack of knowledge. The most common socioeconomic factors were living in a rural area, performing agricultural labor, and being unemployed. Stigma was the most common social and community factor. Conclusions: Delayed leprosy case detection is clearly correlated with increased disability and should therefore be a priority of leprosy programs. Interventions should focus on determinants of delayed case detection such as health-service-seeking behavior, and should consider relevant individual, socioeconomic, and community factors, including stigmatization. Further study is required of the health service-related factors contributing to delay.

Background: In new leprosy cases, grade 2 disability (G2D) is still a public health burden worldwide. It is often associated with the delayed leprosy diagnoses that healthcare systems should play a crucial role in preventing. The aim of this systematic review was to identify healthcare factors related to delays in case detection in leprosy. Methods: PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) was used as a guideline in this research. The study protocol was registered in the PROSPERO (International Prospective Register of Systematic Reviews) with reference code CRD42020189274. Data was collected from five electronic databases: Embase, Medline All Ovid, Web of Science, Cochrane CENTRAL, and the WHO Global Health Library. Results: After applying the selection criteria for original empirical studies, and after removing duplicates, we included 20 papers from 4313 records. They had been conducted in ten countries and published between January 1, 2000, and January 31, 2021. We identified three categories of healthcare factors related to delayed case. 1) Structural factors, such as i) financial and logistic issues, and geographical circumstances (which we classified as barriers); ii) Health service organization and management including the level of decentralization (classified as facilitators). 2) Health service factors, such as problems or shortages involving referral centers, healthcare personnel, and case-detection methods. 3) Intermediate factors, such as misdiagnosis, higher numbers of consultations before diagnosis, and inappropriate healthcare services visited by people with leprosy. Conclusions: Delays in leprosy case detection are due mainly to misdiagnosis. It is crucial to improve the training and capacity of healthcare staff. To avoid misdiagnosis and reduce detection delays, national leprosy control programs should ensure the sustainability of leprosy control within integrated health services.

Background: Leprosy is a public health burden in Indonesia with a high number of new cases every year and a high proportion of disability among new cases. Case detection delay (CDD) can contribute to ongoing transmission and increased disability chances among leprosy patients. This study aimed to establish the CDD of leprosy and the factors associated with detection delay in Indonesia. Method: Community-based study with a cross-sectional design. Data were collected through interviews about sociodemographic and behavioral factors, anticipated stigma, and duration of CDD. Leprosy classification and case detection methods were obtained from health service records. A random sample was taken of 126 leprosy patients registered between 1st October 2020 and 31st March 2022 in the Tegal regency in the Central Java Province. Data were analysed by descriptive and analytical statistics using multiple linear regression. Results: The mean CDD, patient delay, and health system delay were 13.0 months, 9.7 months, and 3.2 months, respectively. Factors associated with longer CDD are younger age (below 35 years), male, found through passive case detection, and not having a family member with leprosy. Factors associated with longer patient delay were being younger (below 35 years), being male, not having a family member with leprosy, and anticipated stigma of leprosy. It was not possible to reliably identify factors associated with health system delay. Conclusion: CDD in leprosy should be reduced in Indonesia. The Indonesian National Leprosy Control Program (NLCP) is advised to adopt an integrated intervention programme combining active case detection with targeted health education to reduce CDD and thereby preventing disabilities in people affected by leprosy.

Latar belakang: Sumur gali adalah salah satu sarana penyedia air bersih yang digunakan oleh masyarakat Kelurahan Jabungan. Dari 31 sumur, terdapat 16 warga yang menggunakan untuk keperluan air minum. Pada tahun 2017 dilakukan pemeriksaan kualitas total coliform air sumur pada 3 sampel dengan hasil masing-masing >300CFU/100ml yang menunjukkan bahwa sampel tersebut tidak layak untuk digunakan sebagai air bersih dan air minum. Penelitian ini bertujuan menganalisis secara spasial kejadian diare dengan keberadaan sumur gali di Kelurahan Jabungan Kota Semarang. Metode: Jenis penelitian ini adalah observasional dengan populasi yaitu seluruh sumur gali dan masyarakat yang terkena diare yang berjumlah 31 sumur dan 20 warga. Penentuan jumlah sampel menggunakan metode total sampling. Data diperoleh dari hasil survei, pengukuran dan sampling yang kemudian dianalisis secara spasial dengan pendekatan overlay. Hasil: Dalam penelitian ini didapatkan hasil yaitu terdapat 87,1% sumur dengan total coliform >50 CFU/100 ml, 87,1% sumur yang jarak dengan jamban <11meter dan 87,1% sumur yang berjarak dengan septictank <11meter. Hasil analisis overlay menunjukkan adanya keterkaitan antara kejadian diare dengan kondisi bakteriologis sumue gai dan jarak sumur gali dengan sumber pencemar, dimana kondisi sumur gali yang kualitas bakteriologis dan jaraknya dengan sumber pencemar tidak memenuhi syarat maka dapat meningkatkan peluang terjadinya kasus diare di rumah dengan kondisi sumur gali tersebut. Simpulan: Penelitian ini menyimpulkan bahwa sebaran kejadian diare di Kelurahan Jabungan banyak ditemukan pada rumah yang memiliki sumur gali dengan kualitas bakteriologis air yang tidak memenuhi persyaratan yaitu >50 CFU / 100 ml sampel dan jarak dengan jamban dan/atau septictank <11 meter. ABSTRACT Title:  Spatial Analysis of Diarrhea with Quality of Well Water in Jabungan, Semarang City   Background: Dug wells are one of the clean water supply facilities used by the Jabungan Sub-district community. Of the 31 wells, 16 residents are needed to use it for drinking water. In 2017 an examination of total well water quality in 3 samples with results of> 300CFU / 100 ml each indicated that the samples were not suitable for use as clean water and drinking water. This study discusses the spatial analysis of diarrhea events by digging wells in Jabungan Sub-district, Semarang. Method: This type of research is observational with a population of all wells and people who spend diarrhea that requires 31 wells and 20 residents. Determination of the number of samples using the total sampling method. Data obtained from the results of surveys, measurements and sampling are then spatially analyzed by obtaining overlays. Results: In this study the results obtained were about 87.1% of wells with a total coliform> 50 CFU / 100 ml, 87.1% of wells with a distance of <11 meters and 87.1% of wells needed with septic tank <11 meters. The results of the overlay analysis show a link between the incidence of diarrhea with the bacteriological condition of the sumai and the distance of the dug well to the source of the pollutant, where the condition of the dug well with bacteriological quality and the distance from the source of the pollutant are needed to ensure this. Conclusion: This study concludes that the distribution of diarrhea in Jabungan Sub-district is found in homes that have dug wells with water bacteriological quality that do not meet the requirements of> 50 CFU / 100 ml sample and distance from latrines and / or septic tank <11 meters.

Background Case detection delay (CDD) is associated with grade 2 disability (G2D) in leprosy, a substantial disease burden worldwide. The standardized CDD questionnaire was developed to determine the period of CDD and its related factors. In Indonesia, the incidence of leprosy and G2D is high and an instrument to measure CDD is lacking. This study describes the translation and cross-cultural adaptation process and evaluates the CDD questionnaire in the Indonesian context. Methods We first did forward–backward translation into Bahasa Indonesia and cross-culturally adapted the CDD questionnaire. We then performed face-to-face three-step test interviews in a pilot test to evaluate the understanding of leprosy patients and the content validity of the CDD questionnaire (n = 15). Finally, the reliability and construct validity of the CDD questionnaire were tested in 50 leprosy patients in Tegal Regency, Indonesia. Results The interviews showed that leprosy patients understood the CDD questionnaire well. The content and construct validity were adequate according to linguistic validation and statistical hypothesis testing. The internal consistency test with a Cronbach alpha showed that the CDD questionnaire measures one underlying construct. The reproducibility test, including the test–retest reliability and agreement test, indicated excellent reliability. Conclusions The version of the CDD questionnaire in Bahasa Indonesia is an instrument with good validity and reliability to determine CDD in Indonesia. We recommend its implementation in the leprosy control programme of Indonesia for monitoring early case detection and thereby avoiding leprosy disability.

Angka kematian Ibu dan Bayi di Jateng masih tinggi. Kejadian kematian tersebut juga terdapat diwilayah kerja Puskesmas Duren. PWS KIA adalah alat manajemen yang sudah dikembangkan oleh Kemenkes RI, untuk mendeteksi dini penyebab kematian bayi dan ibu. Dengan deteksi sedini mungkin, maka penyebab kematian dapat dihindarkan dan berakibat pada menurunnya angka kematian ibu dan bayi. Namun demikian kenyataan dilapangan menunjukkan bahwa masih terdapat ketidak lengkapan, ketidak akuratan dan keterlambatan pelaporan PWS KIA, termasuk di Puskesmas Duren, Kec. Bandungan, Kab. Semarang. Oleh karena itu perlu diketahui faktor apa saja yang terkait dengan kinerja petugas puskesmas dalam kegiatan PWS KIA. Penelitian bersifat observasional deskriptif, dengan pendekatan crosssectional,dengan analisis data kuantitatif. Populasi penelitian adalah Bidan diwilayah Puskesmas Duren. Hasil menunjukkan bahwa pencatatan PWS KIA hanya menggunakan pencatatan kohort dan buku KIA, sementara Buku bantu dan Kartu ibu hampir tidak digunakan. Tingkat akurasi data pencatatan dan pelaporan hanya mencapai 70%, sedangkan ketepatan waktu pelaporan hanya 80 %. Ada 2 bidan desa yang tidak melaporkan tepat waktu selama 2 bulan. Skor kualitas data hanya mencapai 66 %. Tabulasi silang menunjukan ada keterkaitan motivasi,beban kerja, fasilitas dan masa kerja terhadap kualitas data yang baik.Disarankan untuk pemberian motivasi dan menggunakan teknologi Informasi. Maternal and Infant mortality rate is still high in Central Java. The incidence of these deaths also occurred in the region Puskesmas Duren. Local Area Monitoring of MCH program is a management tool that has been developed by the Ministry of Health of Indonesia, which serves to detect the cause of the premature infant and maternal mortality. With early detection, the cause of death can be avoided and result in reduced maternal and infant mortality. However, the fact that there are in the field shows that there is still a lack of completeness, inaccuracies and delays in reporting of Local Area Monitoring of MCH, including Puskesmas Duren, District Bandungan, Semarang regency Therefore, it is important to know what factors are associated with health center personnel in the performance of the Local Area Monitoring of MCH activities.  The Research is a descriptive observational study, the cross-sectional approach, the quantitative data analysis. Population  of this study was the midwife who worked in the region Puskesmas Duren. Result of this study were  used Recording Document are Kohort and Buku KIA. The level of accuracy of data recording and reporting only reached 70 % , while the timeliness of reporting only 80 % . There are two midwives who do not report on time for 2 months . Data quality scores only reached 66 % . Cross-tabulation showed there is  linkage motivation , workload , facilities and working period with  the quality of data. Suggestion for motivation and use of information technology