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After the first, imported, laboratory-confirmed case of monkeypox in human was reported in Singapore on May 2019, countries in Asia started to strengthen disease surveillance systems. One challenge in preventing monkeypox is a lack of knowledge, particularly among healthcare workers. The aim of this study was to assess the knowledge of monkeypox among general practitioners (GPs) in Indonesia. A cross-sectional online survey was conducted. The survey collected participants’ knowledge on a 21-item scale and explanatory variables. A two-step logistic regression analysis was employed to assess the predictors of knowledge of monkeypox. A total of 432 GPs were included; 10.0% and 36.5% of them had a good knowledge using an 80% and 70% cutoff point for knowledge domain, respectively. No explanatory variables were associated with knowledge when using 80% cutoff point. Using the lower cutoff, there was lower knowledge among GPs who graduated from universities located in Sumatra or other islands versus Java (adjusted odds ratio (aOR): 0.53; 95%CI: 0.28–0.97, p = 0.041) and among those were older than 30 years compared to younger GPs (aOR: 0.61; 95%CI: 0.39–0.96, p = 0.033). GPs working in private clinics had less knowledge compared to GPs in community health centers (aOR: 0.55; 95%CI: 0.31–0.99, p = 0.047). In conclusion, knowledge of monkeypox among GPs in Indonesia is relatively low in all groups. Increasing knowledge of monkeypox will be key to improving the capacity of GPs to respond to human monkeypox cases and to report into a disease surveillance system.

Objective: To assess healthcare workers’ knowledge of novel coronavirus disease 2019 (COVID-19) in the early phase of the outbreak in Indonesia. Methods: A cross-sectional survey was conducted in 12 hospitals in Indonesia from March 6 to March 25, 2020. Healthcare workers’ knowledge on COVID-19 was assessed, and demographic data, workplace characteristics, and medical professional characteristics as well as the current local situation of COVID-19 were collected. To characterize determinants associated with knowledge, a logistic regression analysis was employed. Results: Out of 288 healthcare workers who completed the interview-assisted questionnaire, 149 (51.7%) respondents had a good knowledge. Nurses and other types of healthcare workers had lower odds of having good knowledge compared to doctors: adjusted odds ratio (aOR): 0.38; 95% CI: 0.20-0.72 and aOR: 0.31; 95% CI: 0.13-0.73, respectively. Compared to healthcare workers who had medical practice experience less than 5 years, those who had worked for more than 10 years had lower knowledge (aOR: 0.43; 95% CI: 0.20-0.90). Healthcare workers who worked in the infection department had higher knowledge compared to those in the emergency room (aOR: 14.33; 95% CI: 3.67-55.88). Conclusions: The knowledge of COVID-19 among surveyed healthcare workers was relatively low. The COVID-19 response in Indonesia will require further education and enhancement of the capacity of healthcare workers in the emergency room where COVID-19 patients may be treated the earliest.

Background Understanding people’s perceptions of the economic benefits of a potential Zika vaccine (ZV) is critical to accelerating its introduction into either public sector programs or private market. The aim of this study was to assess the acceptance and willingness-to-pay (WTP) for a hypothetical ZV and the associated explanatory variables in Indonesia. Methods We conducted a health facility-based cross-sectional study in Aceh and West Sumatra province from 1 February to 13 June 2018. Patients who visited outpatient departments, have had children or were expecting their first child, were approached and interviewed to collect information on acceptance, WTP, demographic and socio-economic variables and attitudes towards childhood vaccines. Associations of explanatory variables influencing acceptance and WTP were assessed using logistic regression and linear regression analysis, respectively. Results In total, 956 respondents were included in the final analysis of acceptance, of whom 338 (35.3%) expressed their WTP. We found that 757 (79.1%) of the respondents were likely to be vaccinated and to recommend their partner to be vaccinated. Higher educational attainment, having a job, having heard about Zika and a good attitude towards childhood vaccination were associated with ZV acceptance in the univariate analyses. In the multivariate analysis, attitude towards childhood vaccination was the strongest predictor for ZV vaccination. We found the geometric mean and median of WTP was US$ 13.1 (95% CI: 11.37–15.09) and US$ 7.0 (95% CI: 4.47–10.98), respectively. In the final model, having heard about Zika, having a job, and higher income were associated with a higher WTP. Conclusion Although the acceptance rate of the ZV is relatively high in Indonesia, less than 40% of respondents are willing to pay, underscoring the need for a low-cost, high-quality vaccine and public sector subsidies for Zika vaccinations in the country.

In dengue-endemic countries such as Indonesia, Zika may be misdiagnosed as dengue, leading to underestimates of Zika disease and less foreknowledge of pregnancy-related complications such as microcephaly. Objective: To assess the attitudes of frontline physicians in a dengue-endemic country toward testing for Zika infection among patients with dengue-like illnesses. Methods: A cross-sectional online survey was conducted among general practitioners (GPs) in Indonesia. The survey assessed their attitude and also collected sociodemographic data, characteristics of their medical education, professional background, and workplace, and exposure to Zika cases. A two-step logistic regression analysis was used to assess possible variables associated with these attitudes. Results: A total of 370 GPs were included in the final analysis of which 70.8% had good attitude. Unadjusted analyses suggested that GPs who were 30 years old or older and those who had medical experience five years or longer had lower odds of having a positive attitude compared to those who aged younger than 30 years and those who had medical experience less than five years, OR: 0.58; 95%CI: 0.37, 0.91 and OR: 0.55; 95%CI: 0.35, 0.86, respectively. No explanatory variable was associated with attitude in the fully adjusted model. Conclusion: Our findings point to younger GPs with a shorter medical experience being more likely to consider testing for Zika infection among their patients presenting with dengue-like illnesses. Strategic initiatives may be needed to enhance older or longer-experienced physicians' capacity in diagnosing Zika infection.

This study was conducted to quantify the trend in dengue notifications in the country in 2017 and to explore the possible determinants. Annual nation-wide dengue notification data were obtained from the National Disease Surveillance of Ministry of Health of Indonesia. Annual incidence rate (IR) and case fatality rate (CFR) in 2017 and the previous years were quantified and compared. Correlations between annual larva free index (LFI), implementation coverage of integrated vector management (IVM), El Niño Southern Oscillation (Niño3.4), Dipole Mode Index (DMI), Zika virus seropositivity and the percent change in IR and CFR of dengue were examined. The change of dengue IR and CFRs were mapped. In 2017, dengue IR was declined by 71% (22.55 per 100,000 population) compared to 2016 (77.96 per 100,000 population) while the CFR was slightly reduced from 0.79% to 0.75%. Reduction in IR and CFR occurred in 94.1% and 70.1% out of 34 provinces, respectively. The trend of dengue IR seems to be influenced by Niño3.4 but there is no clear evidence that Niño3.4 is the main reason for dengue reduction in 2017. It is difficult to elucidate that the reduction of dengue in 2017 was associated with previous Zika outbreaks. In conclusion, there was a significant reduction on dengue notifications in Indonesia in 2017. Further investigation is needed to look at the role of climate on the decline of dengue IR at finer temporal scale. In addition, study on the role of cross-protective immunity generated by Zika infection on dengue incidence is also warranted.

Objectives:The aim of this study was to determine the level of coronavirus disease 2019 (COVID-19) risk perceptions in Indonesia and characterize predictors of perceptions.Methods:An online cross-sectional study was conducted. A questionnaire assessed perceived risk and collected independent variables, including sociodemographic data. A multivariable linear regression model was used to characterize the relationship between independent variables and perceived risk.Results:We included 1379 respondents in the final analysis with the mean and median of perceived risk score was 19.21% and 10.0%, respectively. Respondents aged between 21 and 30 years had the highest perceived risk, and those who were unmarried had 4.3% higher perceived risk compared with those who were married. Compared with the lowest monthly income group, those making Indonesian Rupiah (IDR) 6-10 million and more than IDR 10 million a month believed they had 4.2% and 8.8% higher risk, respectively. Citizens who lived in cities and health-care workers also had a higher perceived risk compared with those in the rural areas and non–health-care workers, respectively.Conclusions:Perceived risk of COVID-19 in Indonesia is relatively low, and this could hamper the adoption of preventive measures of COVID-19. Efforts to increase the awareness and perceived risk are important to prevent the pandemic from escalating.

Background: The unpredictability of the progression of coronavirus disease 2019 (COVID-19) may be attributed to the low precision of the tools used to predict the prognosis of this disease. Objective: To identify the predictors associated with poor clinical outcomes in patients with COVID-19. Methods: Relevant articles from PubMed, Embase, Cochrane, and Web of Science were searched and extracted as of April 5, 2020. Data of interest were collected and evaluated for their compatibility for the meta-analysis. Cumulative calculations to determine the correlation and effect estimates were performed using the Z test. Results: In total, 19 papers recording 1,934 mild and 1,644 severe cases of COVID-19 were included. Based on the initial evaluation, 62 potential risk factors were identified for the meta-analysis. Several comorbidities, including chronic respiratory disease, cardiovascular disease, diabetes mellitus, and hypertension were observed more frequent among patients with severe COVID-19 than with the mild ones. Compared to the mild form, severe COVID-19 was associated with symptoms such as dyspnea, anorexia, fatigue, increased respiratory rate, and high systolic blood pressure. Lower levels of lymphocytes and hemoglobin; elevated levels of leukocytes, aspartate aminotransferase, alanine aminotransferase, blood creatinine, blood urea nitrogen, high-sensitivity troponin, creatine kinase, high-sensitivity C-reactive protein, interleukin 6, D-dimer, ferritin, lactate dehydrogenase, and procalcitonin; and a high erythrocyte sedimentation rate were also associated with severe COVID-19. Conclusion: More than 30 risk factors are associated with a higher risk of severe COVID-19. These may serve as useful baseline parameters in the development of prediction tools for COVID-19 prognosis.

Background Although there is no licensed vaccine for monkeypox, smallpox vaccine has been shown to be 85% effective in preventing the monkeypox. This study was conducted to assess the willingness of frontline healthcare providers to be vaccinated with smallpox vaccine to prevent monkeypox. Methods A cross-sectional study was conducted in Indonesia. The willingness was assessed under two scenarios: fully subsidized and non-subsidized vaccine. Explanatory variables such as sociodemographic profile, workplace and professional characteristics, and knowledge of monkeypox were collected. A logistic regression assessed the influence of these explanatory variables on participants' willingness. Results Out of 510 received participants' responses, 407 (79.8%) were analyzed. With a fully subsidized vaccine scenario, 381 (93.6%) of the participants were willing to be vaccinated and in an unadjusted analysis, gender, education, monthly income, and type of workplace were associated with willingness. With a non-subsidized vaccine (i.e. the vaccine price was US$ 17.9), the proportion who were willing to be vaccinated decreased to 71.9%. In adjusted analyses for both scenarios, gender was the only independent predictor for willingness; men were less willing to be vaccinated than women, adjusted odds ratio (aOR): 0.37; 95% confidence interval (CI): 0.16, 0.87 and aOR: 0.42; 95%CI: 0.27, 0.67, respectively for subsidized and non-subsidized scenario. Conclusion Vaccine price and gender are important factors for physicians' willingness to be vaccinated for smallpox vaccine prevent monkeypox in Indonesia. These findings indicate that achieving high vaccine converge may require partially or fully subsidized vaccines, along with a clear guideline and recommendation from authorities.

Penelitian ini bertujuan untuk mengetahui perbedaan motivasi dan hasil belajar peserta didik dengan penerapan model Learning Cycle 7E pada materi interaksi makhluk hidup di SMP. Penelitian ini menggunakan metode quasi experimental design , yaitu dengan rancangan pretest-posttest control group design , pemilihan sampel menggunakan teknik purposive sampling . Penelitian ini dilaksanakan di SMP Negeri 8 dan SMP Negeri 18 Banda Aceh. Instrument penelitian menggunakan tes soal pilihan ganda yang berjumlah 30 butir dan angket motivasi belajar peserta didik. Analisis data perbedaan hasil belajar kelas kontrol dan eksperimen menggunakan uji idependent sampel t-test dan uji Mann Whitney pada taraf signifikan 0,05. Angket motivasi peserta didik dianalisis dengan statistik deskriptif . Hasil penelitian diperoleh bahwa motivasi belajar kelas eksperimen dan kelas kontrol berbeda secara signifikan dengan perolehan nilai Z hitung 3,211 >Z tabel 1,96. Hasil belajar kelas eksperimen dan kontrol juga berbeda secara signifikan dengan perolehan nilai (t hitung 8,06>t tabel 1,99). Kesimpulan dalam penelitian ini yaitu terdapat perbedaan motivasi dan hasil belajar belajar peserta didik antara kelas eksperimen dengan kelas kontrol peserta didik di SMP N 8 dan SMP N 18 Banda Aceh. Kata kunci: Learning Cycle 7E , Motivasi Belajar, Hasil Belajar, Interaksi Makhluk Hidup

In early December 2019, an outbreak of coronavirus disease 2019 (COVID-19), caused by a novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), occurred in Wuhan City, Hubei Province, China. On January 30, 2020 the World Health Organization declared the outbreak as a Public Health Emergency of International Concern. As of February 14, 2020, 49,053 laboratory-confirmed and 1,381 deaths have been reported globally. Perceived risk of acquiring disease has led many governments to institute a variety of control measures. We conducted a literature review of publicly available information to summarize knowledge about the pathogen and the current epidemic. In this literature review, the causative agent, pathogenesis and immune responses, epidemiology, diagnosis, treatment and management of the disease, control and preventions strategies are all reviewed. Keywords: 2019-nCoV, COVID-19, Outbreak, SARS-CoV-2, Novel coronavirus

Background The aim of this study was to assess the knowledge and attitudes towards pregnancy-related issues of Zika virus (ZIKV) infection among general practitioners (GPs), a frontline healthcare worker group, in Indonesia. Methods A cross-sectional, online survey assessing knowledge and attitudes towards ZIKV infection on multiple-item scales was sent to GPs in the Sumatra and Java islands of Indonesia. The associations between independent factors and either knowledge or attitude were assessed with logistic regressions. The correlation and association between knowledge and attitude were estimated. Results We included 457 (53.7%) out of 850 responses in the analysis. Among these, 304 (66.5%) and 111 (24.2%) respondents had a good knowledge and attitude, respectively. No demographic, workplace, professional development, or experiential characteristics related to ZIKV infection were associated with knowledge. In the multivariate analysis, only contact experience was associated with attitude. There was a significant, positive correlation between knowledge and attitude scores. Conclusions Although knowledge of pregnancy-related complications of ZIKV infection is relatively high among GPs in Indonesia, more than 75% of them had a poor attitude towards pregnancy-related issues of Zika. Strategies for enhancing the capacity of GPs to develop positive attitudes and respond to ZIKV infection are needed. Electronic supplementary material The online version of this article (10.1186/s12879-019-4297-4) contains supplementary material, which is available to authorized users.

Background: Some Ebola vaccines have been developed and tested in phase III clinical trials. However, assessment of whether public have willingness to purchase or not, especially in unaffected areas, is lacking. The aim of this study was to determine willingness to pay (WTP) for a hypothetical Ebola vaccine in Indonesia. Methods: A cross-sectional study was conducted from 1 August to 30 December 2015 in five cities in Aceh province of Indonesia. Patients’ family members who visited outpatient departments were approached and interviewed about their sociodemographic characteristics, knowledge of Ebola, attitude towards vaccination practice and their WTP for a hypothetical Ebola vaccine. A multivariable linear regression model assessed the relationship between these explanatory variables and WTP. Results: During the study, 500 participants were approached and interviewed. There were 424 (84.8%) respondents who completed the interview and 74% (311/424) expressed their acceptance for an Ebola vaccine. There were 288 participants who were willing to pay for an Ebola vaccine (92.6% out of 311). The mean of WTP was US$2.08 (95% CI: 1.75-2.42). The final multivariable model indicated that young age, high educational attainment, working as a private employee, entrepreneur or civil servant (compared to farmers), being unmarried, and residing in a suburb (compared to a city) were associated with higher WTP. Conclusions: Although the proportion of the participants who would accept the Ebola vaccine was relatively high, the amount they were willing to pay for Ebola vaccine was very low. This finding would indicate the need of subsidies for Ebola vaccine in the country.

Penelitian ini bertujuan untuk mengetahui perbedaan hasil belajar siswa menggunakan model pembelajaran kooperatif tipe STAD dan Jigsaw pada materi sistem reproduksi manusia. Metode penelitian adalah metode eksperimen dengan desain kontrol grup tes awal dan tes akhir. Penelitian telah dilaksanakan pada kelas XI IPA 3 menggunakan model kooperatif tipe STAD dan kelas XI IPA 1 menggunakan model kooperatif tipe Jigsaw di MAN I Takengon. Instrumen yang digunakan adalah instrumen tes hasil belajar. Teknik pengumpulan data dengan mengumpulkan data kemampuan awal siswa (pre-test), data kemampuan akhir siswa (post-tes), data peningkatan pemahaman konsep (N-Gain). Analisis data hasil belajar menggunakan uji-t. Hasil penelitian menunjukkan bahwa hasil belajar siswa kelas eksperimen STAD dan Jigsaw diperoleh t hitung 25,20 dan t tabel 1,65. Kesimpulan dari penelitian ini adalah terdapat perbedaan hasil belajar siswa antara kelas eksperimen STAD dan Jigsaw. Kata Kunci: Kooperatif tipe STAD, Jigsaw, Sistem Reproduksi Manusia. This research is aimed to know the difference of study result using cooperative study model for STAD and Jigsaw type in the material of human reproduction system material. The research method is experiment method with one control group design for beginning and ending test. It has been done at XI IPA 3 class using cooperative model of STAD type and XI IPA 1 class using cooperative model of Jigsaw type at MAN 1 Takengon. Instruments used are study result test. Data collecting techniques by collecting data of students beginning capability (pre test), data of students ending capability (post test), data of concept understanding improvement (N-Gain). Data analysis of study result was using t-test. The result showed that students’ study result of STAD and Jigsaw experiment class gives t-counted is 25,20 and t-table is 1,65. The conclusion of this research was, there was a student study result difference between STAD experiment class and Jigsaw. Keyword: CooperativeSTAD, Jigsaw, Reproductive System.

Rendahnya hasil belajar siswa dilihat dari nilai ujian akhir semester, hal ini disebabkan target waktu untuk mencapai isi pembelajaran dan keterbatasan guru dalam mengolah pembelajaran khususnya ketika ada materi yang menyangkut dengan praktikum seperti halnya materi hidrolisis garam. Penelitian ini dilakukan dengan metode quasi eksperimental dengan pretest-posttest group design yang dilaksanakan di SMAN 12 Banda Aceh tahun akademik 2015/2016, yang terdiri masing-masing 25 siswa kelas eksperimen dan kelas kontrol. Pengumpulan data dilakukan dengan 3 (dua) instrumen; 1) Tes untuk melihat peningkatan KPS siswa pada pokok bahasan hidrolisis garam; 2) Angket motivasi untuk melihat peningkatan motivasi belajar siswa; dan 3) Angket respon untuk melihat tanggapan siswa terhadap model pembelajaran berbasis masalah dengan menggunakan metode praktikum. Uji normalitas dilakukan untuk melihat kenormalan data dan menunjukkan bahwa data berdistribusi normal. Hasil penelitian menunjukkan bahwa 1) pembelajaran berbasis masalah menggunakan metode praktikum dapat mempengaruhi keterampilan proses sain siswa dalam belajar kimia. Hal ini dapat dilihat tingginya perolehan skor N-Gain pada kelas eksperimen dibandingkan penerapan pembelajaran konvensional di kelas kontrol; 2) pembelajaran pembelajaran berbasis masalah menggunakan metode praktikum dapat meningkatkan motivasi belajar siswa dalam belajar kimia; 3) Respon siswa terhadap penerapan pembelajaran berbasis masalah menggunakan metode praktikum pada pokok bahasan hidrolisis garam mendapatkan respon positif dari siswa. Kata Kunci: PBM, metode praktikum, KPS, motivasi belajar, hidrolisis garam. Abstract . Low student learning outcomes seen from the final exams, and this is the target date for achieving the learning content and limitations of the teachers in the process of learning, especially when there is material pertaining to the lab as well as the material salt hydrolysis. This research was conducted by quasi experimental method with a pretest-posttest group design conducted at SMAN 12 Banda Aceh academic year 2015/2016, which consists of 25 students in the experimental class and same as the control class. The data collection is done with three instruments; 1) Tests to see an increase in KPS students on the subject of salt hydrolysis; 2) Questionnaire motivation to see an increase in student motivation; and 3) Questionnaire responses to see the students' of the problem based learning using practical methods. Normality test is done to see the normality of data and shows that the normal distribution of data. The results showed that 1) the problem-based learning using practical methods can affect science process skills of students in learning chemistry. This can be seen high score of N-Gain acquisition of the experimental class compared to conventional classroom learning application control; 2) learning problem-based learning using practical methods may increase students' motivation to learn chemistry; 3) The response of students to the application of problem-based learning using practical methods on the topic of salt hydrolysis get a positive response from students. Keywords : PBL , practical methods, SPS , motivation to learn, salt hydrolysis.

Penelitian tentang Performans Sapi Aceh yang diberikan Pakan EcengGondok (Eichhornia Crassipes) Fermentasi dengan Probiotik Aspergillusniger sebagai Subtitusi Rumput Gajah dan Rumput Lapangan telah dilakukan di Laboratorium Lapangan Peternakan Prodi Peternakan Fakultas Pertanian Universitas Syiah Kuala Darussalam Banda Aceh. Penelitian ini berlangsung selama 112 haridari tanggal 24 Januari 2016 – 08 Mei 2016.Tujuan penelitian ini adalah untuk mengetahui performans sapi Aceh jantan yang diberikanpakan eceng gondok yang difermentasi dengan Aspergillus nigersebagai subtitusi rumput gajah dan rumput lapangan. Materi penelitian ini adalah 4 ekor sapi Aceh jantan dan menggunakan Rancangan Bujur Sangkar Latin (RBSL), yang terdiri dari 4 perlakuan dan 4 ulangan, Masing-masing perlakuan adalah pelakuan A(0% eceng gondok fermentasi) perlakuan B (10% eceng gondok fermentasi), perlakuan C (20% eceng gondok fermentasi),dan pelakuan D (30% eceng gondok fermentasi). Data penelitian yang diperoleh dianalisis menggunakan ANOVA (Analysis of Variance). Parameter yang diamati adalah:Pertambahan berat badan, Konsumsi pakan, dan Konversi pakan. Hasil penelitian menunjukkan tidak terjadi perbedaan yang nyata (P0.05) terhadap konsumsi pakan dan konversi pakan. Namun terjadi perbedaan yang nyata (p0,05) pada parameter pertambahan berat badan. Performance of Aceh Bullock that Given Feed Water Hyacinth (Eichhornia Crassipes) with Fermentation Probiotic Aspergillus Niger as a Substitute Elephant Grass and Grass Field Abstract. Experiment on Performance of Aceh Bulls was given feed water hyacinth (Eichhornia crassipes) Fermentation with Probiotics Aspergillus niger as substitution of Elephant Grass and Grass Field has done in Field Laboratory Animal Husbandry Faculty of Agriculture, the University of Syiah Kuala in Banda Aceh Darussalam. The study lasted 112 days from the date of January 24, 2016 - May 8, 2016. The purpose of this study was to determine the performance of Aceh Bulls are given feed hyacinth fermented with Aspergillus niger as a substitute for grass and field turf. The material of this study was 4 Aceh Bulls and using design Latin square (RBSL), which consists of 4 treatments and 4 repitulations, each treatment is the carrying out of A (0% water hyacinth fermentation) treatment B (10% water hyacinth fermentation ), treatment C (20% water hyacinth fermentation), and treatment D (30% water hyacinth fermentation). The research data were analyzed using ANOVA (Analysis of Variance). Parameters measured were: weight gain, feed intake, feed conversion. The results showed no differences were significant against (P 0.05), feed intake and feed conversion. But there is a significant difference (p 0.05) on the parameters of weight gain

Background Hepatitis B (HepB) is a major public health concern in Malaysia yet little is known about knowledge and awareness of this infection in the country. Such information is essential for designing effective intervention strategies for HepB prevention and control. The aim of this study was to characterize knowledge and awareness regarding HepB in Malaysia and to identify their associated sociodemographic determinants. Methods A community-based cross-sectional survey was conducted between January and May 2016 in Selangor state of Malaysia. A two-stage cluster random sampling design was used and one adult member of selected households was interviewed face-to-face. Logistic regression was used to estimate the differences in knowledge and awareness between groups. Results A total of 764 households completed the interviews and were included in the final analysis. Only 36.9 and 38.8% of the participants had good knowledge and awareness, respectively. The factors associated with good knowledge were being in the 35–44 year age group, Malay ethnicity, high educational attainment and high family income. Being Chinese, being older and having high educational attainment were determinants of having good awareness towards HepB. Participants who had good knowledge were 2.5 times more likely to also have good awareness (OR: 2.41, 95% CI: 1.78–3.26, p

Table S1. STROBE checklist of the study. (PDF 162 kb)

Completed of STROBE checklist of the study. (PDF 478 kb)

Individual characteristics and risk bias assessment of included studies in the systematic review (PDF 532 kb)

Detailed questions used to assess knowledge and attitude domain. (PDF 342 kb)

Table S2. Questionnaire used in the study. (PDF 201 kb)

Background Despite the high number of chikungunya cases in Indonesia in recent years, comprehensive epidemiological data are lacking. The systematic review was undertaken to provide data on incidence, the seroprevalence of anti-Chikungunya virus (CHIKV) IgM and IgG antibodies, mortality, the genotypes of circulating CHIKV and travel-related cases of chikungunya in the country. In addition, a phylogenetic and evolutionary analysis of Indonesian CHIKV was conducted. Methods A systematic review was conducted to identify eligible studies from EMBASE, MEDLINE, PubMed and Web of Science as of October 16th 2017. Studies describing the incidence, seroprevalence of IgM and IgG, mortality, genotypes and travel-associated chikungunya were systematically reviewed. The maximum likelihood phylogenetic and evolutionary rate was estimated using Randomized Axelerated Maximum Likelihood (RAxML), and the Bayesian Markov chain Monte Carlo (MCMC) method identified the Time to Most Recent Common Ancestors (TMRCA) of Indonesian CHIKV. The systematic review was registered in the PROSPERO database (CRD42017078205). Results Chikungunya incidence ranged between 0.16-36.2 cases per 100,000 person-year. Overall, the median seroprevalence of anti-CHIKV IgM antibodies in both outbreak and non-outbreak scenarios was 13.3% (17.7 and 7.3% for outbreak and non-outbreak events, respectively). The median seroprevalence of IgG antibodies in both outbreak and non-outbreak settings was 18.5% (range 0.0–73.1%). There were 130 Indonesian CHIKV sequences available, of which 120 (92.3%) were of the Asian genotype and 10 (7.7%) belonged to the East/Central/South African (ECSA) genotype. The ECSA genotype was first isolated in Indonesia in 2008 and was continually sampled until 2011. All ECSA viruses sampled in Indonesia appear to be closely related to viruses that caused massive outbreaks in Southeast Asia countries during the same period. Massive nationwide chikungunya outbreaks in Indonesia were reported during 2009–2010 with a total of 137,655 cases. Our spatio-temporal, phylogenetic and evolutionary data suggest that these outbreaks were likely associated with the introduction of the ECSA genotype of CHIKV to Indonesia. Conclusions Although no deaths have been recorded, the seroprevalence of anti-CHIKV IgM and IgG in the Indonesian population have been relatively high in recent years following re-emergence in early 2001. There is sufficient evidence to suggest that the introduction of ECSA into Indonesia was likely associated with massive chikungunya outbreaks during 2009–2010. Electronic supplementary material The online version of this article (10.1186/s12879-019-3857-y) contains supplementary material, which is available to authorized users.

Objective To provide a national incidence rate and case fatality rate of dengue hemorrhagic fever in Indonesia through an analysis of the National Disease Surveillance database from the Directorate General of Disease Prevention and Control of Ministry of Health. Results Available data has indicated an increasing trend of dengue hemorrhagic fever incidence in Indonesia over the past 50 years. Incidence rates appear to be cyclic, peaking approximately every 6–8 years. In contrast, the case fatality rate has decreased approximately by half each decade, since 1980. Java Island contributed the highest average number of dengue hemorrhagic fever cases each year. In recent years, Bali and Borneo (Kalimantan) have had the highest incidence while Papua Island, the easternmost region of the Indonesian archipelago, has had the lowest incidence.

Although epidemiological and molecular epidemiological (serotype, genotype, and lineage information) data are available for several major cities in Indonesia, there is yet to be a comprehensive national study of dengue in Indonesia over time. This study was conducted to provide a comprehensive epidemiology of circulating dengue viruses (DENV) in Indonesia between 1973 and 2016. This was conducted through a systematic review of the literature and phylogenetic analysis of available DENV sequences. Available data from National Disease Surveillance System have indicated an increasing trend of dengue incidence in Indonesia over the past 50 years. Incidence rates appear to be cyclic, peaking approximately every 6 to 8 years. In contrast, the case fatality rate has decreased approximately by half with each decade since 1980. Over this 50-year time span, serotype shifts, genotype displacement within DENV-1 and DENV-2, and introduction of DENV-1 and DENV-3 genotype from other countries occurred. These events were associated with increased incidence of dengue cases. Our study also provides a valuable national snapshot of DENV genetic diversity in Indonesia that may contribute to development of more effective dengue vaccine compositions for the region.