Economics of Non-Communicable Diseases in Indonesia

The Economics of Non-Communicable Diseases in Indonesia provides new data on the economic burden of NCDs in the country, and puts it in perspective by drawing a comparison with India and China. With this new addition to the series on the economics of NCDs, the World Economic Forum aims to advance the understanding of the expected economic output loss at the country level, particularly in countries in economic and epidemiological transition. The evidence presented provides a starting point in reorienting the dialogue on investing in healthy living and NCD prevention in Indonesia towards the view that a healthy population is an important factor for sustainable growth.

Use of eye care services among diabetic patients in urban Indonesia.

OBJECTIVES:

To assess the use of eye care and its predictors among diabetic patients in Indonesia.

METHODS:

Diabetic patients aged 18 years and older were recruited consecutively from a university clinic and 2 community clinics in Jakarta, Indonesia. Information obtained by questionnaire and record review included demographic and socioeconomic status, knowledge about diabetic retinopathy, and ocular and medical history. The main outcome was self-reported or record history of an eye examination by an eye care professional with dilation of the pupil within the preceding year.

RESULTS:

Among 196 participants (mean [SD] age, 58.4 [9.4] years; 61.5% female), 166 (84.7%) had not undergone ocular examination in the last year, including 100 of 119 patients (84.0%) at the university clinic. Fewer than half (82 of 166 [49.4%]) of all patients reported being told of the need for eye examinations by their physician. In regression analyses, factors associated with having an eye examination were higher diabetic retinopathy knowledge score (odds ratio = 1.52; P = .01) and years since being diagnosed as having diabetes (odds ratio = 1.71 for third vs first tertile; P = .02). Education, income, health insurance status, and diagnosis of diabetic retinopathy were not predictive of examination. The most common reasons given by subjects for not having had eye examinations concerned lack of knowledge about the need for care (97 of 160 subjects [60.6%]), while financial barriers were cited by only 22 of 160 subjects (13.8%).

CONCLUSION:

The low proportion of diabetic subjects receiving recommended annual eye examinations in Indonesia might be improved through patient and physician education.

Early assessment of visual acuity after cataract surgery in rural Indonesia.

BACKGROUND: The accuracy and impact on service uptake of early examination after cataract surgery is not known. DESIGN:   Prospective cohort study. PARTICIPANTS: Cataract patients in rural Indonesia. METHODS: Visual acuity was measured preoperatively, 1day, 1-3, 4-6 and >12weeks after surgery, and 6-8months postoperatively at an outreach examination. Acceptance of second-eye surgery and spectacles was evaluated. MAIN OUTCOME MEASURE: Presenting visual acuity in the operated eye. RESULTS: Among 241 subjects (extracapsular surgery 84%), examinations at 1day, 1-3, 4-6 and >12weeks and 6-8months were completed for 100% (241), 90.9% (219), 67.6% (163), 22.0% (53) and 80.0% (193), respectively. Among subjects at the final examination (mean age 65.8±10.6years, 51.8% male), 73.6% had bilateral preoperative presenting visual acuity≤6/60. By 4-6weeks, the proportion with good (≥6/18) or poor (≤6/60) visual acuity did not differ significantly from the final examination. Among 49 persons accepting free second-eye surgery, 69.4% (34) and 16.3% (8) returned to clinic at 4-6 and >12weeks, respectively. Among 131 patients (67.9%) paying US$7 for glasses, 94 (71.8%) and 30 (22.9%) attended 4- to 6- and >12-week examinations, respectively. CONCLUSION: Even with large-incision surgery, early assessment of postoperative vision is representative of final vision, and may help deliver postoperative services to more of those needing them. © 2011 The Authors. Clinical and Experimental Ophthalmology © 2011 Royal Australian and New Zealand College of Ophthalmologists.

Microbial community of black band disease on infection, healthy and dead part of scleractinian Montipora sp. colony at Seribu islands, Indonesia

It is crucial to understand the microbial community associated with the host when attempting to discern the pathogen responsible for disease outbreaks in scleractinian corals. This study determines changes in the bacterial community associated with Montipora sp. in response to black band disease in Indonesian waters. Healthy, diseased, and dead Montipora sp. (n = 3 for each sample type per location) were collected from three different locations (Pari Island, Pramuka Island, and Peteloran Island). DGGE (Denaturing Gradient Gel Electrophoresis) was carried out to identify the bacterial community associated with each sample type and histological analysis was conducted to identify pathogens associated with specific tissues. Various Desulfovibrio species were found as novelty to be associated with infection samples, including Desulfovibrio desulfuricans, Desulfovibrio magneticus, and Desulfovibrio gigas, Bacillus benzoevorans, Bacillus farraginis in genus which previously associated with pathogenicity in corals. Various bacterial species associated with uninfected corals were lost in diseased and dead samples. Unlike healthy samples, coral tissues such as the epidermis, endodermis, zooxanthellae were not present on dead samples under histological observation. Liberated zooxanthellae and cyanobacteria were found in black band diseased Montipora sp. samples.

Prevalence and Incidence of Black Band Disease of Scleractinian Corals in the Kepulauan Seribu Region of Indonesia

Black band disease (BBD) is the oldest recognised disease associated with scleractinian corals. However, despite this, few BBD surveys have been conducted in the Indonesian archipelago, one of the world’s hot spots for coral diversity. In this study, we show that BBD was recorded in the reefs of Kepulauan Seribu, Indonesia, at the time of surveying. The disease was found to mainly infect corals of the genus Montipora. In some instances, upwards of 177 colonies (31.64%) were found to be infected at specific sites. Prevalence of the disease ranged from 0.31% to 31.64% of Montipora sp. colonies throughout the archipelago. Although BBD was found at all sites, lower frequencies were
associated with sites closest to the mainland (17.99 km), as well as those that were furthest away (63.65 km). Despite there being no linear relationship between distance from major population centers and BBD incidence, high incidences of this disease were associated with sites characterized by higher
levels of light intensity. Furthermore, surveys revealed that outbreaks peaked during the transitional period between the dry and rainy seasons. Therefore, we suggest that future surveys for disease prevalence in this region of Indonesia should focus on these transitory periods.

'Mining money': science, legal technologies & working the borderlands of global finance

This paper explores the roles of science and market devices in the commodification of ‘nature’ and the configuration of flows of speculative capital. It focuses on mineral prospecting and the market for shares in ‘junior’ mining companies. In recent years these companies have expanded the reach of their exploration activities overseas, taking advantage of innovations in exploration methodologies and the liberalisation of fiscal and property regimes in ‘emerging’ mineral rich developing countries. Recent literature has explored how the reconfiguration of notions of ‘risk’ has structured the uneven distribution of rents. It is increasingly evident that neoliberal framing of environmental, political, social and economic risks has set in motion overflows that multinational mining capital had not bargained for (e.g. nationalisation, violence and political resistance). However, the role of ‘geological risk’ in animating flows of mining finance is often assumed as a ‘technical’ given. Yet geological knowledge claims, translated locally, designed to travel globally, assemble heterogeneous elements within distanciated regimes of metrology, valuation and commodity production. This paper explores how knowledge of nature is enrolled within systems of property relations, focusing on the genealogy of the knowledge practices that animate contemporary circuits of speculative mining finance. It argues that the financing of mineral prospecting mobilises pragmatic and situated forms of knowledge rather than actuarially driven calculations that promise predictability. A Canadian public enquiry struck in the wake of scandal associated with Bre-X’s prospecting activities in Indonesia is used to glean insights into the ways in which the construction of a system of public warrant to underpin financial speculation is predicated upon particular subjectivities and the outworking of everyday practices and struggles over ‘value’. Reflection on practical investments in processes of standardisation, rituals of verification and systems of accreditation reveal much about how the materiality of things shape the ways in which regional and global financial circuits are integrated, selectively transforming existing social relations and forms of knowledge production.