Anggi Lukman Wicaksana

Indonesia is currently fighting against a novel coronavirus disease, known as COVID-19. Current information of COVID-19 is crucial for healthcare providers. This study aimed to explore the current prevalence, characteristics, and comorbidities of patients with COVID-19 in Indonesia. We obtained data of the confirmed cases of COVID-19, characteristics and comorbidities from the official website of Indonesia COVID-19 Task Force. The data were extracted, explored and discussed to respond to the research aims. Up to June 3rd, 2020, it was reported there were 28,233 confirmed cases of COVID-19 in Indonesia. The current prevalence of COVID-19 case was 0.11‰ and transmission was distributed to all provinces in Indonesia. Almost one-third of the COVID-19 infections were in the age group of 31-45 years (29.3%) but the highest mortality rate occurred in elderly people (17.68%). Overall, males slightly dominated and contributed only 6.84% to the mortality rate. Cough (76.2%), history of fever (50.4%), and current fever (47.1%) were the most common symptoms among the patients with COVID-19. For comorbidities, patients with COVID-19 had higher numbers of hypertension (52.1%), diabetes (33.6%), and other cardiovascular diseases (20.9%). Those three comorbidities led the greater proportion of deaths among other comorbidities. The COVID-19 pandemic is still a new challenge for Indonesia.

BACKGROUND: The Association of Southeast Asian Nations (ASEAN) has undergone substantial epidemiological changes over the past three decades, characterised by a growing burden of cardiovascular disease. This study provides an epidemiological overview of cardiovascular diseases across ASEAN. METHODS: As part of the Global Burden of Diseases, Injuries, and Risk Factors Study 2021, we assessed the prevalence, mortality, years of life lost, years lived with disability, and disability-adjusted life-years (DALYs) of 12 cardiovascular diseases, stratified by age, sex, and location, for ten ASEAN member states (Brunei, Cambodia, Indonesia, Laos, Malaysia, Myanmar, the Philippines, Singapore, Thailand, and Viet Nam) from 1990 to 2021. We examined the contribution of major risk factors associated with cardiovascular disease. Diverse data sources and meta-analytical modelling techniques were used to synthesise data and generate consistent estimates for each metric. FINDINGS: In 2021, there were 36·8 million (95% uncertainty interval 34·4-38·8) prevalent cases of cardiovascular disease and 1·66 million (1·51-1·80) cardiovascular disease deaths across ASEAN. The total number of DALYs was 42·4 million (38·4-46·2), making cardiovascular disease the leading cause of disease burden in the region. Compared with 1990, the number of individuals with cardiovascular disease has increased by 148·1% (144·0-152·5), whereas the age-standardised prevalence rate rose by 2·5% (1·4-3·6). The highest age-standardised prevalence rate was in Malaysia, followed by Indonesia. The top three leading cardiovascular diseases with the highest age-standardised prevalence rates were ischaemic heart disease (2070·6 [1831·3-2358·2] per 100 000 people), lower extremity peripheral arterial disease (1380·8 [1189·8-1598·7] per 100 000 people), and stroke (1300·6 [1230·5-1375·4] per 100 000 people). The age-standardised mortality rate was highest in Laos (410·9 deaths [337·2-485·9] per 100 000 people). Most cardiovascular disease burden was attributed to high systolic blood pressure, dietary risks, air pollution, high low-density lipoprotein cholesterol, and tobacco use, with high BMI and high fasting plasma glucose rapidly rising as attributive factors. INTERPRETATION: Cardiovascular disease remained the leading cause of mortality and morbidity in ASEAN in 2021. The number of individuals with cardiovascular disease is expected to rise with an ageing population and socioeconomic advancement. Given the disparities across ASEAN, interventions must be tailored at all levels to address the needs in prevention, treatment, and management. FUNDING: The Gates Foundation.

BACKGROUND: The Association of Southeast Asian Nations (ASEAN), a geopolitical and economic network of ten member states, recognises mental disorders as a health priority; however, sparse epidemiological data hinder the development of effective strategies to reduce their prevalence and burden. We aimed to examine the prevalence, morbidity, and disease burden associated with ten mental disorders from 1990 to 2021 in the ASEAN. METHODS: As part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD 2021), we analysed estimates for depressive disorders, anxiety disorders, bipolar disorders, schizophrenia, autism spectrum disorders, conduct disorder, attention-deficit hyperactivity disorder (ADHD), eating disorders, idiopathic developmental intellectual disability, and other mental disorders in ten ASEAN member states (Brunei, Cambodia, Indonesia, Laos, Malaysia, Myanmar, the Philippines, Singapore, Thailand, and Viet Nam). Case definitions were based on Diagnostic and Statistical Manual of Mental Disorders or ICD criteria. Prevalence estimates by age, sex, year, and location were derived using DisMod-MR 2.1, a Bayesian meta-regression modelling tool. Disease burden was quantified by estimating years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs). Estimates are presented with 95% uncertainty intervals (UIs). FINDINGS: In 2021, 80·4 million (95% UI 73·8-87·2) cases of mental disorders were reported across ASEAN countries, representing a 70·0% (63·5-77·2) increase since 1990. The age-standardised prevalence of mental disorders was 11·9% (10·9-12·9) in 2021, ranging from 10·1% (9·1-11·3) in Viet Nam to 13·2% (11·6-15·3) in Malaysia, with anxiety and depressive disorders being the most common. The age-standardised prevalence of mental disorders increased by 6·5% (3·7-9·8) between 1990 and 2021. Mental disorders accounted for 11·2 million (8·5-14·3) DALYs in 2021, representing an 87·4% (81·1-94·0) increase since 1990. The 10-14 years age group had the highest disease burden attributable to mental disorders, which accounted for 16·3% (12·7-20·5) of total DALYs in this age group. The largest relative increases in the number of cases of mental disorders between 1990 and 2021 were seen in older adults (182·8% [174·9-192·1] among those aged ≥70 years), despite small relative changes in prevalence in these age groups. INTERPRETATION: The increase in mental disorder prevalence and burden found in this study might partly reflect recent improvements in detection. However, mental disorders now rank among the top ten causes of disease burden in all ASEAN countries except Myanmar, underscoring the urgent need for a comprehensive intersectoral approach to address prevention and treatment gaps across entire populations. FUNDING: Gates Foundation.