AVIAN INFLUENZA SITUATION

The highly pathogenic avian influenza A (H5N1) epizootic (animal outbreak) in Asia, Europe, the Near East, and Africa is not expected to diminish significantly in the short term. It is likely that H5N1 virus infections among domestic poultry have become endemic in certain areas and that sporadic human infections resulting from direct contact with infected poultry and/or wild birds will continue to occur. So far, the spread of H5N1 virus from person-to-person has been very rare, limited and unsustained. However, this epizootic continues to pose an important public health threat.

There is little pre-existing natural immunity to H5N1 virus infection in the human population. If H5N1 viruses gain the ability for efficient and sustained transmission among humans, an influenza pandemic could result, with potentially high rates of illness and death worldwide. No evidence for genetic reassortment between human and avian influenza A virus genes has been found to date, and there is no evidence of any significant changes to circulating H5N1 virus strains to suggest greater transmissibility to or among humans. Genetic sequencing of avian influenza A (H5N1) viruses from human cases in Vietnam, Thailand, and Indonesia shows resistance to the antiviral medications amantadine and rimantadine, two of the medications commonly used for treatment of influenza. This leaves two remaining antiviral medications (oseltamivir and zanamivir) that should still be effective against currently circulating strains of H5N1 viruses. A small number of oseltamivir resistant H5N1 virus infections of humans have been reported. Efforts to produce pre-pandemic vaccine candidates for humans that would be effective against avian influenza A (H5N1) viruses are ongoing. However, no H5N1 vaccines are currently available for human use.

Research suggests that currently circulating strains of H5N1 viruses are becoming more capable of causing disease (pathogenic) in animals than were earlier H5N1 viruses. One study found that ducks infected with H5N1 virus are now shedding more virus for longer periods without showing symptoms of illness. This finding has implications for the role of ducks in transmitting disease to other birds and possibly to humans as well. Additionally, other findings have documented H5N1 virus infection among pigs in China and Vietnam; H5N1 virus infection of cats (experimental infection of housecats in the Netherlands, isolation of H5N1 virus from domestic cats in Germany and Thailand, and detection of H5N1 viral RNA in domestic cats in Iraq and Austria); H5N1 virus infection of dogs (isolation of H5N1 virus from a domestic dog in Thailand); and isolation of H5N1 viruses from tigers and leopards at zoos in Thailand). In addition, H5N1 virus infection in a wild stone marten (a weasel-like mammal) was reported in Germany and in a wild civet cat in Vietnam. Avian influenza A (H5N1) virus strains that emerged in Asia in 2003 continue to evolve and may adapt so that other mammals may be susceptible to infection as well.

Notable findings of epidemiologic investigations of human H5N1 cases include:

• Thailand, 2004: An investigation concluded that probable limited human-to-human spread of influenza A (H5N1) had occurred in a family as a result of prolonged and very close contact between an ill child and her mother in a hospital. Transmission did not continue beyond one person.
• Vietnam, 2004: While the majority of known human H5N1 cases have begun with respiratory symptoms, one atypical fatal H5N1 case in a child in southern Vietnam presented with fever, diarrhea and seizures, and was initially diagnosed as encephalitis. The etiology was identified retrospectively as H5N1 virus through testing of cerebrospinal fluid, fecal matter, and throat and serum samples. Further research is needed to ascertain the implications of such findings.
• Vietnam, 2005: Investigations suggest transmission of H5N1 viruses to two persons through consumption of uncooked duck blood.
• Azerbaijan, 2006: Investigations revealed contact with H5N1-infected wild dead birds (swans) as the most plausible source of infection in several cases in teenagers involved in removing feathers from the birds.
• Indonesia, 2006: WHO reported evidence of limited human-to-human spread of H5N1 virus. In this situation, 8 people in one family were affected, with 7 deaths. H5N1 virus was isolated from 7 cases. The first family member is thought to have become ill through contact with infected poultry. This person then infected six family members. One of those six people (a child) then infected another family member (his father). No further spread outside of the exposed family was documented or suspected.
• Vietnam, 2006: A study reported a correlation between high H5N1 viral concentration and elevated inflammatory cytokine levels in fatal cases. The authors concluded that early antiviral treatment is needed to suppress H5N1 viral replication to prevent the inflammatory response that appears to be implicated in the pathogenesis of H5N1 virus infection.

Human H5N1 Cases

(WHO) has reported human cases of avian influenza A (H5N1) in Asia, Africa, the Pacific, Europe and the Near East. Indonesia and Vietnam have reported the highest number of H5N1 cases to date. Overall mortality in reported H5N1 cases is approximately 60%. The majority of cases have occurred among children and adults aged less than 40 years old. Mortality was highest in cases aged 10-19 years old. Studies have documented the most significant risk factors for human H5N1 infection to be direct contact with sick or dead poultry or wild birds, or visiting a live poultry market. Most human H5N1 cases have been hospitalized late in their illness with severe respiratory disease. A small number of clinically mild H5N1 cases have been reported. The current cumulative number of confirmed human cases of avian influenza A/(H5N1) is available on the WHO Avian Influenza website. Despite the high mortality, human cases of H5N1 remain rare to date.

Clusters of Human H5N1 Cases

Clusters of human H5N1 cases ranging from 2-8 cases per cluster have been identified in most countries that have reported H5N1 cases. Nearly all of the cluster cases have occurred among blood-related family members living in the same household. Whether such clusters are related to genetic or other factors is currently unknown. While most people in these clusters have been infected with H5N1 virus through direct contact with sick or dead poultry or wild birds, limited human-to-human transmission of H5N1 virus cannot be excluded in some clusters.

Epidemiology HIV/AIDS

Main article: AIDS pandemic

Estimated prevalence of HIV among young adults (15-49) per country at the end of 2005.

UNAIDS and the WHO estimate that AIDS has killed more than 25 million people since it was first recognized in 1981, making it one of the most destructive pandemics in recorded history. Despite recent improved access to antiretroviral treatment and care in many regions of the world, the AIDS pandemic claimed an estimated 2.8 million (between 2.4 and 3.3 million) lives in 2005 of which more than half a million (570,000) were children.^[3]

In 2007, between 30.6 and 36.1 million people were believed to live with HIV, and it killed an estimated 2.1 million people that year, including 330,000 children; there were 2.5 million new infections.^[125]

Sub-Saharan Africa remains by far the worst-affected region, with an estimated 21.6 to 27.4 million people currently living with HIV. Two million [1.5–3.0 million] of them are children younger than 15 years of age. More than 64% of all people living with HIV are in sub-Saharan Africa, as are more than three quarters of all women living with HIV. In 2005, there were 12.0 million [10.6–13.6 million] AIDS orphans living in sub-Saharan Africa 2005.^[3] South & South East Asia are second-worst affected with 15% of the total. AIDS accounts for the deaths of 500,000 children in this region. South Africa has the largest number of HIV patients in the world followed by Nigeria.^[126] India has an estimated 2.5 million infections (0.23% of population), making India the country with the third largest population of HIV patients. In the 35 African nations with the highest prevalence, average life expectancy is 48.3 years—6.5 years less than it would be without the disease.^[127]

The latest evaluation report of the World Bank's Operations Evaluation Department assesses the development effectiveness of the World Bank's country-level HIV/AIDS assistance defined as policy dialogue, analytic work, and lending with the explicit objective of reducing the scope or impact of the AIDS epidemic.^[128] This is the first comprehensive evaluation of the World Bank's HIV/AIDS support to countries, from the beginning of the epidemic through mid-2004. Because the Bank aims to assist in implementation of national government programmes, their experience provides important insights on how national AIDS programmes can be made more effective.

The development of HAART as effective therapy for HIV infection and AIDS has substantially reduced the death rate from this disease in those areas where these drugs are widely available. This has created the misperception that the disease has vanished. In fact, as the life expectancy of persons with AIDS has increased in countries where HAART is widely used, the number of persons living with AIDS has increased substantially. In the United States, the number of persons with AIDS increased from about 35,000 in 1988 to over 220,000 in 1996 and 312,000 in 2002^[129]

In Africa, the number of MTCT and the prevalence of AIDS is beginning to reverse decades of steady progress in child survival. Countries such as Uganda are attempting to curb the MTCT epidemic by offering VCT (voluntary counselling and testing), PMTCT (prevention of mother-to-child transmission) and ANC (ante-natal care) services, which include the distribution of antiretroviral therapy.

HIV Prevalence

Traditionally, HIV prevalence estimates have been derived from data from sentinel surveillance systems that monitored HIV rates among pregnant women and high-risk populations using statistical systems. By collecting blood for HIV testing from representative samples of the population of men and women in a country, MEASURE DHS can provide nationally representative estimates of HIV rates.

Both sentinel surveillance and population-based data sources of prevalence data can and should be used to track HIV epidemics. Population-based testing can only be undertaken every 3 to 5 years in most countries, because of the size and expense of the surveys. Sentinel surveillance testing is often reported annually, and provides a good benchmark for measuring progress over short time periods.

In addition, population-based testing is dependent on the population’s willingness to be voluntarily tested for HIV. In cases where the characteristics of those who agreed to be tested are different than those who refused testing, bias may result. The current DHS reports with HIV testing include analysis of non-response bias.

MEASURE DHS has conducted population-based HIV testing since 2001. The MEASURE DHS testing protocol provides for anonymous, informed, and voluntary testing of women and men. All respondents receive referrals for free testing, counseling, and educational materials.

The linkage of DHS HIV test results to the full DHS survey record (without personal identifiers) allows for an in-depth analysis of the sociodemographic and behavioral factors associated with HIV infection. Datasets showing test results and variables to link them to other findings from the DHS or AIS are available for research and study

Lowongan PERTAMINA

D3/S1/S2 (LULUSAN BARU)

Kebutuhan D3/S1/S2 (Lulusan Baru) adalah untuk memenuhi rencana tenaga kerja bagi Direktorat Hulu (Eksplorasi & Produksi), Direktorat Pengolahan (Kilang), Direktorat Pemasaran & Niaga, dan Fungsi Korporat (Keuangan, Umum, SDM, Pengembangan Bisnis, Hukum, Sekretaris Perseroan, Sistem & Teknologi Informasi, Satuan Pengawas Internal dan Supply Chain).

Khusus Pelamar D3 agar memilih wilayah rekrutmen yang diminati.

Persyaratan bagi calon kandidat D3/S1/S2 (Lulusan Baru):

1. Pendidikan terakhir (sesuai klasifikasi diatas) dari Akademi/ Perguruan Tinggi Terakreditasi
2. IPK untuk S1/S2 minimal 3 dari skala 4
3. IPK D3 minimal 2,75 dari skala 4
4. Dapat mengoperasikan komputer (minimal Open Office)
5. Dapat berbahasa Inggris dengan balk (lisan dan tulisan)
6. Bersedia mengikuti tahapan proses seleksi di Jakarta, biaya dari dan ke tempat seleksi menjadi tanggungan peserta
7. Bersedia ditempatkan di seluruh wilayah kerja Pertamina

Batasan usia:

• Pelamar D3 Maksimal 24 tahun (kelahiran sesudah 31 Desember 1984)
• Pelamar S1 Maksimal 27 tahun (kelahiran sesudah 31 Desember 1981)
• Pelamar S2 Maksimal 32 tahun (kelahiran sesudah 31 Desember 1976)

Kebutuhan jurusan:

• Teknik Industri
• Teknik Mesin
• Teknik Elektro
• Teknik Kimia
• Teknik Informatika/Komputer
• Teknik Lingkungan
• Instrumentasi/Teknik Fisika
• Teknik Sipil
• Teknik Perminyakan
• Teknik Perkapalan
• Teknik Mesin Kapal
• Teknik Pembangunan Kapal
• MIPA -Kimia
• Kimia Analis
• Ekonomi
• Manajemen
• Akuntansi
• Hukum
• Komunikasi
• Sosial Politik
• Psikologi
• Administrasi
• Sekretaris
• Metalurgi
• Geodesi
• Geologi
• Geofisika
• Kesehatan Masyarakat
• Kesehatan & Keselamatan Kerja
• Statistik

Untuk mengisi lamaran, silakan mengunjungi website kami, www.pertamina.com

Penyakit Jantung Koroner

DEFINISI Penyakit Arteri Koroner / penyakit jantung koroner (Coronary Artery Disease) ditandai dengan adanya endapan lemak yang berkumpul di dalam sel yang melapisi dinding suatu arteri koroner dan menyumbat aliran darah. Endapan lemak (ateroma atau plak) terbentuk secara bertahap dan tersebar di percabangan besar dari kedua arteri koroner utama, yang mengelilingi jantung dan menyediakan darah bagi jantung. Proses pembentukan ateroma ini disebut aterosklerosis. Ateroma bisa menonjol ke dalam arteri dan menyebabkan arteri menjadi sempit. Jika ateroma terus membesar, bagian dari ateroma bisa pecah dan masuk ke dalam aliran darah atau bisa terbentuk bekuan darah di permukaan ateroma tersebut. Supaya bisa berkontraksi dan memompa secara normal, otot jantung (miokardium) memerlukan pasokan darah yang kaya akan oksigen dari arteri koroner. Jika penyumbatan arteri koroner semakin memburuk, bisa terjadi iskemi (berkurangnya pasokan darah) pada otot jantung, menyebabkan kerusakan jantung. Penyebab utama dari iskemi miokardial adalah penyakit arteri koroner. Komplikasi utama dari penyakit arteri koroner adalah angina dan serangan jantung (infark miokardial).

PENYEBAB Penyakit arteri koroner bisa menyerang semua ras, tetapi angka kejadian paling tinggi ditemukan pada orang kulit putih. Tetapi ras sendiri tampaknya bukan merupakan faktor penting dalam gaya hidup seseorang. Secara spesifik, faktor-faktor yang meningkatkan resiko terjadinya penyakit arteri koroner adalah: Diet kaya lemak Merokok Malas berolah raga. Kolesterol dan Penyakit Arteri Koroner Resiko terjadinya penyakit arteri koroner meningkat pada peningkatan kadar kolesterol total dan kolesterol LDL (kolesterol jahat) dalam darah. Jika terjadi peningkatan kadar kolesterol HDL (kolesterol baik), maka resiko terjadinya penyakit arteri koroner akan menurun. Makanan mempengaruhi kadar kolesterol total dan karena itu makanan juga mempengaruhi resiko terjadinya penyakit arteri koroner. Merubah pola makan (dan bila perlu mengkonsumsi obat dari dokter) bisa menurunkan kadar kolesterol. Menurunkan kadar kolesterol total dan kolesterol LDL bisa memperlambat atau mencegah berkembangnya penyakit arteri koroner. Menurunkan kadar LDL sangat besar keuntungannya bagi seseorang yang memiliki faktor resiko berikut: Merokok sigaret Tekanan darah tinggi Kegemukan Malas berolah raga Kadar trigliserida tinggi Keturunan Steroid pria (androgen).

PENCEGAHAN Resiko terjadinya penyakit arteri koroner bisa dikurangi dengan melakukan beberapa tindakan berikut: Berhenti merokok Menurunkan tekanan darah Mengurangi berat badan Melakukan olah raga.