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Pneumonia is one of the significant causes of death in developing countries, including Indonesia. As the capital of West Java, Bandung is one of the cities with the highest pneumonia cases in this province. The objective of this study was to conduct cost-minimization analysis of pneumonia treatment in Indonesia by using one of the private hospitals in Bandung as a reference case. The use of cefuroxime and ceftizoxime was considered in adult hospitalized patients. In addition, ampicillin-sulbactam and ceftriaxone usage was compared in pediatric hospitalized patients. A cross-sectional descriptive study was applied by collecting data retrospectively from medical records of adult and pediatric patients who met the inclusion criteria at one of the private hospitals in Bandung from January 2017 to December 2018. We applied the following inclusion criteria: (i) adult (> 20 years old) and pediatric (0–5 years old) patients who were diagnosed with pneumonia; and (ii) adult patients who received cefuroxime or ceftizoxime antibiotic therapy and pediatric patients who received ampicillin-sulbactam or ceftriaxone antibiotic therapy. We excluded patients who were diagnosed with any other co-morbidities and who did not complete the treatment. The result showed that drug cost was the primary contributor to total treatment cost in adult and pediatric patients. We calculated the average total treatment cost with ceftizoxime and cefuroxime in adult patients at $149.39 and $193.05, respectively, and the average total treatment cost with ampicillin-sulbactam and ceftriaxone in pediatric patients at $202.83 and $192.77, respectively. We also estimated the LoS in a group of ceftizoxime and cefuroxime in adult patients at 3.8 and 4.1 days, respectively, and the LoS in a group of ampicillin-sulbactam and ceftriaxone in pediatric patients at 3.9 and 5.3 days, respectively. In conclusion, using ceftizoxime to treat hospitalized pneumonia in adult patients would require less cost and yield shorter LoS than cefuroxime. Using ampicillin-sulbactam to treat hospitalized pneumonia in pediatric patients would require higher costs and yield shorter LoS than ceftriaxone. [ABSTRACT FROM AUTHOR]

As one of Gavi, the Vaccine Alliance (previously the Global Alliance for Vaccines and Immunization), graduating countries, Indonesia is still eligible to access Gavi price for PCV13, PCV10 A and B. This study aims to estimate the economic impact of switch from the existing product/presentation of PCV (single-dose of PCV13) to the new product/presentation of PCV (multi-dose of PCV13, PCV10 A and B) since PCV is one of the most expensive vaccines in the Expanded Program on Immunization (EPI) schedule. Assuming that Gavi-Advance Market Commitment (AMC) price for all PCVs can be accessed in 2021, the use of multi-dose PCV13, PCV10 A and PCV10 B with Gavi-AMC price in 2021–2024 were considered as respective scenarios. The result showed that the scenario assuming the use of single-dose of PCV13 with contract price in 2019–2020 that would be switched into multi-dose of PCV10 B with Gavi-AMC price in 2021–2024 resulted in the highest potential saving, compared with other scenarios. Our analysis suggests an economic advantage to switch from single-dose into a multi-dose presentation. Vaccination coverage, vaccine price, vaccine wastage and additional Gavi-AMC vaccine costs were considered to be the most influential parameter affecting the savings in all scenarios. Applying the effectiveness of PCV13 and PCV10 A on reducing the risk for invasive pneumococcal disease (IPD), potential averted incidence of IPD in children under one year of age during 2019–2024 would be 246,164 and 105,587 in both scenarios. Despite the result confirmed that PCV13 may provide an additional benefit, a more comprehensive economic evaluation study is required to investigate further the comparison of cost-effectiveness values among all PCVs in Indonesia. [ABSTRACT FROM AUTHOR]

Metabolic diseases result from interactions between genetic and lifestyle factors. Understanding the combined influences of single-nucleotide polymorphisms (SNPs) and lifestyle is crucial. This study employs genetic risk scores (GRS) to assess SNPs, providing insight beyond single gene/SNP studies by revealing synergistic effects. Here, we aim to investigate the association of a 23-SNP GRS with metabolic disease-related traits (obesity and type 2 diabetes) to understand if these associations are altered by lifestyle/dietary factors. For this study, 106 Minangkabau women were included and underwent physical, anthropometric, biochemical, dietary and genetic evaluations. The interaction of GRS with lifestyle factors was analyzed using linear regression models, adjusting for potential confounders. No statistically significant associations were observed between GRS and metabolic traits; however, this study demonstrates a novel interaction observed between 13-SNP GRS and monounsaturated fatty acid (MUFA) intake, and that it had an effect on HbA1c levels ( p = 0.026). Minangkabau women with low MUFA intake (≤7.0 g/day) and >13 risk alleles had significantly higher HbA1c levels ( p = 0.010). This finding has implications for public health, suggesting the need for large-scale studies to confirm our results before implementing dietary interventions in the Indonesian population. Identifying genetic influences on dietary response can inform personalized nutrition strategies to reduce the risk of metabolic disease.