Journal of Epidemiology and Public Health
e-ISSN: 2549-0273 Publisher: Masters Program in Public Health, Universitas Sebelas Maret, Indonesia Editor in Chief: Prof. Bhisma Murti, Universitas Sebelas Maret, Indonesia Aim and Scope The Journal of Epidemiology and Public Health (JEPH) is an open-access, peer-reviewed international journal dedicated to advancing knowledge and research in the fields of epidemiology and public health. Established on June 2, 2015, JEPH publishes high-quality original research articles, systematic reviews, and meta-analyses on a quarterly basis. Our mission is to contribute to the global improvement of population health by disseminating rigorous scientific evidence that informs public health policy, practice, and education. The journal seeks to highlight innovative research that addresses contemporary health challenges, with a particular emphasis on health disparities, disease prevention, health promotion, and health systems strengthening. JEPH welcomes contributions from researchers around the world and is particularly committed to amplifying the voices of scholars from low- and middle-income countries (LMICs). We encourage submissions that tackle regionally relevant health issues, apply robust epidemiological methods, and propose evidence-based solutions to pressing public health problems. Key areas of interest include, but are not limited to: Epidemiological studies of communicable and non-communicable diseases Social determinants of health and health inequalities Health systems research and policy evaluation Public health interventions and health promotion Environmental and occupational health Global health and health equity Biostatistics and methodological advances in epidemiological research Pandemic preparedness and response JEPH is officially accredited by the Ministry of Research, Technology, and Higher Education, Government of Indonesia, under decree No. 10/C/C3/DT.05.00/2025. The journal holds SINTA 2 status, valid from July 16, 2022, to July 16, 2027. Through the publication of high-impact, policy-relevant research, JEPH aims to foster the exchange of knowledge across disciplines and regions and to support the development of evidence-based solutions to the world’s most pressing public health challenges.
Masters Program in Public Health, Universitas Sebelas Maret, Indonesia
Type 2 Diabetes Mellitus is the Risk Factor for Multi-drug Resistance Tuberculosis: A Meta-Analysis
Background: Type 2 Diabetes Mellitus (T2DM) has a significant risk of developing active Tuber-culosis (TB) and complicates its treatment. There is no conclusive evidence on whether TB-T2DM comorbidities are associated with an increased risk of Multidrug Resistant Tuberculosis (MDR-TB). The study aims to analyze and estimate the relationship of T2DM to MDR-TB incidence and to estimate the size of the combined effect. Subjects and Method: This study was a meta-analysis with PICO, Population: patients actively undergoing MDR-TB treatment. Intervention: Patients with comorbid Type 2 Diabetes Mellitus. Comparison: Tuberculosis patients without comorbid Type 2 diabetes mellitus. Output: MDR-TB (Multidrug Resistant Tuberculosis). The articles used in this study were obtained from databases with keywords to search for articles were ("Diabetes Mellitus, Type 2" OR "diabetic" OR "diabetes") AND "tuberculosis" AND ("Tuberculosis, Multidrug-Resistant" OR "drug resistance" OR "multidrug-resistant" OR "multidrug resistant" OR "multidrug resistance" OR "drug-resistant" OR "drug resistant"). Articles were selected based on inclusion criteria, is published in the form of an English full-text article from January 2015 to January 2025, reporting the relationship between T2DM and MDR-TB among TB patients. The articles were selected using the PRISMA flow diagram and analyzed using the Review Manager 5.3 application. Results: This meta-analysis consisted of 9 articles originating from Europe, Asia, Africa and America. Results of the meta-analysis showed that the cohort study of type 2 diabetes mellitus had a 4.11 times greater risk of developing MDR-TB compared to people who did not have type 2 diabetes mellitus. In a control case study of type 2 diabetes mellitus, there was a 3.11 times greater risk of developing MDR-TB than people without type 2 diabetes mellitus, and both were statistically significant (aOR= 3.39; CI 95%= 2.05 to 8.24; p= 0.001). Conclusion: Type 2 diabetes mellitus is a risk factor for MDR TB.
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Effect of Noise Exposure on Occupational Stress and Hypertension among Workers: a Meta-Analysis
Background: The work environment greatly affects the health condition of the workers so that there are no work-related accidents or occupational diseases. Noisy physical environmental factors above the threshold value have a risk of causing occupational diseases such as psychological work stress and hypertension. This study aims to analyze the effect of noise exposure on occupational stress and hypertension among workers. Subjects and Method: This study is a systematic review and meta analysis with the following PICO. P: working society, I: exposure noise ≥85 dBA, C: not exposed to noise ≥85 dBA, O: Stress and Hypertension. This study used of articles published between 2009 and 2022 were comprehensively searched for using electronic databases like PubMed, ProQuest, Scopus, and Google Scholar. The keywords to search for articles were “noise exposure” OR “occupational noise” AND “occupational stress” OR “work stress” AND “hypertension”. The adjusted odds ratio was used to evaluate the effect size (aOR). To evaluate the bias risk, the Critical Appraisal Skill Program (CASP) was used. Articles were analyzed using the Review Manager 5.3 application. Results: This study includes 14 papers, using cross-sectional and case-control study designs, from Asia, including Indonesia, Malaysia, China, Jordan, and South Korea. Based on 5 studies cross-sectional on the effects of exposure to noise in the event of work stress, work stress increases 4.88 times compared to workers who are not exposed to noise (aOR=4.88; 95% CI= 1.77 to 13.47; p= 0.002). 9 subgroup studies with cross-sectional and case-control study designs on the effect of noise exposure showed an increase of 2.47 times the incidence of hypertension compared to workers who were not exposed to noise at work (aOR= 2.47; 95% CI= 1.75 to 3.48; p<0.001). Conclusion: Exposure to noise increases the risk of work-related stress and hypertension. Suggestions that can be made are to carry out engineering, periodic measurements, work time management, workforce education and use of PPE.
The Impact of Long-Term Particulate Matter with Diameter Micrometers ≤2.5 Exposure on Type 2 Diabetes Risk: A Meta-Analysis
Background: The rising global prevalence of type 2 diabetes (T2D) has prompted investigations into environmental risk factors beyond traditional lifestyle causes. Air pollution, particularly fine particulate matter (PM₂.₅) has emerged as a potential contributor to diabetes. This systematic review synthesizes evidence from large scale cohort studies to evaluate the association between long term air pollution exposure and T2D risk. Subjects and Method: We analyzed prospective cohort studies (2020–2025) assessing air pollution and incident T2D, sourced from PubMed, Web of Science and EMBASE using the search terms: ("air pollution" OR "PM2.5") AND ("type 2 diabetes" OR "T2D") AND ("cohort" OR "longitudinal"). We using PECO framework (Populatio= adults population; Exposure=High Exposure of PM2.5; Comparison=Low Exposure of PM2.5; Outcomes=T2D). The independent variable was Exposure of PM2.5 and dependent variable was T2D. Primary studies included were cohort manuscript published in english with year of publication between 2020 until 2025, reported adjusted hazard ratios (aHR), and the subjects was adults without diabetes at baseline. Studies were evaluated using the CASP Scale, and data were analyzed using RevMan 13. Results: This study includes 9 papers, using Cohort study designs, from China, United Kingdom, South Korea and United States. PM₂.₅ exposure consistently increased T2D risk with stronger effects at lower exposure levels (aHR = 1.24; 95% Cl = 1.07 to 1.42; p=0.004). Conclusion: Long-term PM₂.₅ exposure significantly increases T2D risk and progression
Effect of Early Mobilization on Intestinal Peristaltic Recovery As Prevention of Paralytic Ileus in Post Cesarean Section Patients
Background: The majority of cesarean section deliveries use spinal anesthesia which can have an effect on the deterioration of the gastrointestinal system so that intestinal peristalsis becomes slow. Slow intestinal peristaltic function leads to difficulty defecation and prolongs the day of treatment, in some cases can increase the risk of paralytic ileus. To prevent the risk of complications, intervention can be carried out in postoperative cesarean section patients with early mobilization. This study aims to determine the effect of early mobilization on intestinal peristaltic recovery in post- cesarean section patients. Subjects and Method: This was a quasy experiment conducted at Islamic Hospital in Demak, Central Java, from July to December 2024. A sample of 58 post-cesarean section mothers was selected using purposive sampling and divided into two groups. Assessment of intestinal peristaltic variables through auscultation examination with a stethoscope and early mobilization using observation sheet instruments. Intestinal peristaltic recovery between two groups were examined logistic regression. Results: There was a difference in intestinal peristaltic recovery in post- cesarean section patients between the intervention group and the control group (p=0.000) with the mean value of intestinal peristalsis in the intervention group of 25.45 (SD=6.07) and in the control group of 11.38 (SD=7.69). Patients who were given early mobilization had a 4.48 times faster chance of recovery of intestinal peristalsis. Conclusion: Early mobilization had a positive impact on the recovery of intestinal peristaltic (p<0.05). Health workers should not only provide education, but also assistance in the implement-tation of early mobilization, especially in the first 24 hours post- cesarean section. Keywords: early mobilization, intestinal peristaltics, post cesarean section.
The Relationship Between Macronutrient Intake and Stunting Among Children Aged 1–2 Years: Quantitative and Qualitative Approaches
Background: Stunting among children aged 1–2 years remains a critical public health concern in Indonesia, particularly during the vital 1,000-day window of child development. This study aimed to analyze the relationship between macronutrient intake and stunting using a mixed-methods approach. Subjects and Method: This was a sequential explanatory mixed-methods study conducted from February 2024 to May 2025 at Community Health Center Dadok Tunggul Hitam, Padang City. The quantitative component employed a case-control design involving 66 children aged 1–2 years, divided equally into stunted (cases) and non-stunted (controls) groups. Sampling was conducted purposively for cases and by simple matching for controls. The independent variables were intake of carbohydrates, proteins, and fats; the dependent variable was stunting, defined using WHO growth standards. Macronutrient intake was assessed via a 24-hour recall. Data were analyzed using Chi-square tests to determine associations, and Odds Ratios (OR) with 95% Confidence Intervals (CI) were reported. The qualitative phase included interviews with mothers, health workers, and community volunteers, analyzed thematically using NVivo 12. Results: Children with inadequate carbohydrate intake were significantly more likely to be stunted (OR=3.50; 95% CI=1.27 to 9.64; p=0.015). No statistically significant associations were found for protein intake (OR=2.60; 95% CI=0.91 to 7.44; p=0.074) or fat intake (OR=2.44; 95% CI=0.89 to 6.70; p=0.082). Qualitative findings revealed barriers such as loss of appetite during illness, preference for snacks, food aversions, and limited maternal knowledge and resources, all of which contributed to inadequate macronutrient intake. Conclusion: Inadequate carbohydrate intake was significantly associated with stunting in children aged 1–2 years. Contextual factors such as eating behavior and parental feeding practices further influenced nutritional outcomes. Interventions should address both dietary intake and behavioral barriers within families.
Effect of Banana Consumption to Reducing Hyperemesis Gravidarum In Pregnant Women
Background: Hyperemesis gravidarum (HG) is a severe form of nausea and vomiting during pregnancy that can lead to dehydration, weight loss, and nutritional deficiencies, posing risks to both maternal and fetal health. Exploring the potential of banana consumption as a natural, accessible intervention may offer a simple dietary strategy to alleviate HG symptoms and improve maternal well-being. This study aimed to determine whether banana comsumption contributes to a decrease in the number of cases of nausea and vomiting experienced by pregnant women. Subjects and Method: This was a quasi experiment conducted at the Mitra Siaga Hospital, Tegal, Central Java, Indonesia, in April-May 2024. A number of 30 pregnant women with hyperemesis gravidarum was selected using purposive sampling. Hyperemesis gravidarum was measured using Pregnancy Unique Quantification of Emesis and Nausea (PUQE) questionnaire. Difference score of hyperemesis gravidarum before and after intervention was examined using t test. Results: The results of the Wilcoxon test before and after consuming bananas with Confidence Interval 95% showed p-value = 0.000, with a significance level of p-value 0.000 < 0.05, which indicates that banana consumption is effective in reducing complaints of nausea and vomiting in hyperemesis gravidarum mothers at Mitra Siaga Hospital, Tegal. The results of the linear regression test of the effect of banana consumption on hyperemesis gravidarum t value = 20.110 > t table and the significance level of p-value 0.000 < 0.05, which indicates that banana consumption has a positive and significant effect on reducing complaints of nausea and vomiting in mothers with hyperemesis gravidarum at Mitra Siaga Hospital, Tegal. Conclusion: Banana consumption can reduce vomiting in pregnant women.
Environmental Risk Factors and Hookworm Infection among Schoolchildren in Rural Areas of Indonesia
Background: The prevalence of hookworm infection is a serious public health concern globally. Java Island and Kalimantan Island have differential environmental risk factors of hookworm infection, espe­cial­ly in rural areas of Indonesia, which have high-risk environmental factors for the prevalence of hook­worm infection. This study aimed to investigate the infection rates and correlation between environmental risk factors and the prevalence of hookworm infection. Subjects and Method: This was a cross-sectional study conducted among 226 school children from rural East Java province, Central Java Province, and East Kalimantan Province, Indonesia. A simple random sampling method was applied to select participants from each school area. This study used two diagnostic methods: Kato Katz and Koga agar plate culture/KAP culture for diagnosing hookworm infections. Environmental variables examined included soil texture, organic carbon content, clay content, soil pH, rainfall volume, number of rainy days, humidity, temperature, elevation, vegetation type, and pet infection status. Pearson's chi-square analysis was used to study the correlation between environmental factors and hookworm infection. Results: Hookworm, Strongyloides sp, and Ascaris sp infections were found in this study; 137 (60.63%), 25 (11.1%), and 124 (9.84%), respectively. Environmental risk factors such as rainy season, quality of soil, and infection with hookworm in pets have a significant correlation (p<0.050) with hookworm infection among schoolchildren in a rural area in Indonesia. Conclusion: The prevalence of hookworm infection correlates with environmental factors, and the findings in this research could contribute to decreasing the prevalence of hookworm infection, espe­cially among schoolchildren in rural areas.
Maintaining Occupational Health: An Analysis of Fatigue and Safety Compliance in Construction Workers
Background: Safety compliance is a critical component in preventing workplace accidents and ensuring employee well-being. Various factors may influence workers’ adherence to safety protocols, including individual characteristics such as education level and fatigue. The purpose of this study was to examine the relationships between education level, work fatigue, and safety compliance. Subjects and Method: This cross-sectional study involved 137 respondents, categorized by fatigue status. The dependent variable was safety compliance. Independent variables included work fatigue and education level. Instruments included the Fatigue Assessment Scale (FAS) questionnaire for fatigue. Data analysis utilized the chi-square test for fatigue and education levels. Results: The proportion of workers who comply with safety procedures varies across education levels, but the differences are not statistically significant. In contrast, workers with higher levels of fatigue were significantly more compliant with safety practices than those with lower fatigue.. Conclusion: These findings highlight the complexity of behavioral responses to workplace demands and the need for targeted interventions.
Determinants of Dementia Among the Elderly in Jakarta, Indonesia
Background: The incidence of dementia rises sharply, and it is expected to grow worldwide in the decades ahead. This study aimed to investigate the determinants of dementia among the elderly in Jakarta, Indonesia. Subjects and Method: A cross-sectional design was employed in the Aisyah organization at Jakarta City, Indonesia. A total of 65 elderly people were selected using Stratified random sampling. The dependent variable was dementia. The independent variables were education, occupation, married status, and exercise routine. The dementia was assessed using the Mini-Mental State Examination (MMSE) questionnaire, which was translated into Bahasa. Results: The participants had an education level of high school or below (52.31%), were not married (53.85%), and were not working (55.38%). The majority reported frequent exercise (92.31%), and 44.62% were identified with dementia. Bivariate analysis showed that higher education (OR = 0.92; 95% CI= 0.26 to 3.22; p= 0.002) and being married (OR= 0.94; 95% CI= 0.34 to 2.61; p= 0.020) were significantly associated with lower dementia risk. Exercise routine showed a strong protective effect (OR = 0.17; 95% CI= 0.01 to 1.79; p= 0.043), while occupational status was not significantly associated (p= 0.074). In multivariate analysis, only exercise routine remained significantly associated with dementia (OR= 0.17; 95% CI= 0.01 to 1.78; p= 0.042), suggesting it as an independent protective factor after controlling for confounders. Conclusion: Regular physical activity was identified as a significant protective factor against dementia among the elderly. Promoting exercise may be an effective strategy for dementia prevention in this population.
Impact of Pesticide Exposure on Farmer Metabolism Systems : A Systematic Review
Background: Farmers are informal sector workers exposed to multiple health risks due to the unsafe use or storage of pesticides. Farmer are at high risk of pesticide poisoning, which can affect their metabolic disorders. This review aims to systematically examine the impact of pesticide exposure on health disorders in farmers’ metabolic systems. Subjects and Method: This was a systematic review using the PICO model. The keywords used for the search for the study were “Impact” and “Pesticide” AND “Exposure” AND “Farmers’” AND “Meta­bolism System” in various databases. The inclusion criteria in this study were studies discussing varia­bles, research articles, and articles published from 2021 onwards, while the exclusion criteria were articles that do not have access or are not full-text. Data were collected using the extraction form, which includes PICO, and assessed using the PRISMA diagram. Data analysis was done descriptively by comparing the research results. Results: The study found that pesticide exposure can affect the metabolic system, potentially damaging cells and causing oxidative stress by damaging lipids, proteins, and DNA, leading to genetic mutations and cell degeneration. The impact of exposure to glyphosate and arsenic pesticides causes liver and kidney function damage and decreased cardiovascular health. Exposure to paraquat, glyphosate, and oxyfluorophene causes Thyroid Cancer. Exposure to organophosphate and organo­chlorine pesticides causes Parkinson’s. Insecticides, herbicides, and fungicides cause sleep disorders. In addition, herbicide pesticides have a significant relationship with type 2 diabetes. Conclusion: Based on research findings, pesticide exposure impacts farmers’ metabolic systems, including the incidence of Chronic Kidney Disease, decline in cardiovascular health, Thyroid Cancer, Parkinson’s Disease, Sleep Disorders, and Type 2 Diabetes.
Global Research Trends on Preconception Care on the Infertility Prevention: A Bibliometric Study
Background: Infertility affects approximately one in six individuals globally and remains a growing reproductive health concern, often linked to modifiable risk factors present before conception. Preconception care (PCC) has gained recognition as a preventive strategy, however the implementation of PCC at scale remains challenged and yet its research landscape in relation to infertility remains under-mapped.This study aimed to analyze global research trends on preconception care in the context of infertility prevention using bibliometric methods. Subjects and Method: A bibliometric analysis was conducted using the Scopus database, with data retrieved on May 12, 2024. The search strategy included terms related to PCC and infertility, yielding 486 eligible publications after screening. Included documents were English-language publications in final form, relevant to preconception care and infertility, and classified as articles, reviews, conference papers, or book materials. Analysis was performed using Scopus tools, Biblioshiny (R), and VOSviewer to examine publication trends, key contributors, and thematic evolution. Results: A total of 486 publications from 1991 to 2025 were identified, with an annual growth rate of 6.43%. Most documents were original articles (67.7%) and reviews (28.4%), authored by 2,529 contributors across 307 publication sources. Several national strategies have formalized PCC into broader public health policy to reduce disparities in pregnancy outcomes and unmet fertility needs, but there remains a critical gap in the global PCC research agenda, such as the heterogeneity in intervention protocols. Conclusion: Research on preconception care in the context of infertility prevention has expanded steadily. However, Future research should prioritize longitudinal and interventional studies, foster global collaboration, and align with broader reproductive justice goals to strengthen the evidence base. Ultimately, enhancing the visibility and implementation of PCC in both clinical and public health domains will be pivotal in addressing modifiable infertility risks and promoting equitable reproductive outcomes worldwide.
Effect of Parenting Style on the Incidence of Sibling Rivalry in Children in Surakarta, Central Java
Background: Proper parenting can reduce incidents of jealousy, competition, or arguments. (siblings' rivalry) a child towards the presence of a new sibling. One solution to the sibling effect rivalry through parents who encourage children to change their behavior, knowledge, and values that are considered appropriate so that children can be independent, grow and develop healthily and optimally, and have a sense of believe self, characteristic flavor want to know, friendly, and oriented towards progress without drop the one others. This study aimed to analyze the influence of parenting patterns on sibling rivalry in children in Surakarta. Subjects and Method: This study employed a cross-sectional design and was conducted in the Sangkrah area, Surakarta, Indonesia. The study population consisted of parents who had more than one child under the age of five. A total of 120 respondents were selected using systematic random sampling. The independent variable in this study was parenting patterns, while the dependent variable was sibling rivalry, which was measured using a nominal scale. Data were collected directly through a structured questionnaire. The data were then analyzed using bivariate analysis with the Chi-Square test. Results: The study showed that 77.5% (93 children) experienced sibling abuse. rivalry among them, 7 people have an authoritarian parenting style (5.8%), 101 people have a democratic (84.2%), 78 people have a permissive (65%), and 11 parents have a passive (9.2%). Permissive (OR= 1.65; 95% CI= 0.68 to 3.98) and passive parenting style (OR = 2.29; 95% CI = 0.54 to 9.66) increased the likelihood of sibling rivalry, by the associations were statistically non-significant. Conclusion: There is no significant influence of the four parenting patterns on sibling incidents. rivalry is insignificant.
Factors Associated with Pregnant Women's Compliance with Fit-to-Fly Recommendations at El Tari Airport in 2024
Background: Fit-to-fly recommendations for pregnant women are regulated in Indonesia’s civil aviation guidelines. Noncompliance may pose health risks for both mother and fetus during air travel. This study aimed to identify factors associated with pregnant women’s compliance with fit-to-fly recommendations at El Tari Airport in 2024. Subjects and Method: A cross-sectional study was conducted from January to March 2024 at El Tari Airport, Kupang. A total of 130 pregnant passengers who applied for fit-to-fly letters at the BKK Class I Airport Health Post were selected using simple random sampling. The dependent variable was compliance with fit-to-fly recommendations. Independent variables included maternal age, gestational age, parity, education level, travel reasons, document completeness, exposure to information, family support, and maternal knowledge. Data were collected using a structured questionnaire and analyzed using univariate, bivariate, and multivariate methods with multiple logistic regression. Results: Gestational age (OR=6.79; 95%CI: 2.06–22.41; p=0.002), parity (OR=8.00; 95%CI: 2.61–22.54; p<0.001), education level (OR=5.49; 95%CI: 1.47–20.41; p=0.011), and maternal knowledge (OR=6.75; 95%CI: 2.13–21.34; p=0.001) were significantly associated with compliance. Other factors such as exposure to information, maternal age, document completeness, travel reasons, and family support showed no statistically significant association.. Conclusion: Gestational age, parity, education level, and maternal knowledge were significant determinants of compliance with fit-to-fly recommendations among pregnant women. These findings highlight the importance of targeted health education and screening prior to air travel during pregnancy.
Children Under 5 Years as Predicting Dengue Transmission in Kebumen District, Indonesia: Case Study Mapping Approaches
Background: Dengue disease is still a problem in the world. Factors affecting population main importance for dengue transmission. The dengue cases severity 34.40% in Indonesia, and the study area is an endemic dengue. The study aimed to determine factors causing dengue transmission in the Kebumen district, Central Java Province. Subjects and Method: A cross-sectional study was conducted in 460 villages in Kebumen district, Central Java. The study was conducted in 2024 by taking dengue data from medical records in the period January 2023 to December 2023. The number of dengue cases during the study period was 395 cases that were diagnosed. The dependent variable is transmission zone. The status village transmission is a number of dengue cases> 2 cases in the village during the study based on medical records. The independent variables are children under 5 years, the incidence rate of dengue, the incidence rate area, the incidence rate density, and population age > 70 years (elderly). Data of dengue cases were obtained from medical record. The data were analyzed with an independent t-test, linear regression test, and survival test (Cox proportional hazards). Results: The incidence rate averaged 30.17 higher than the government standard, with 10 cases/ 100,000 population for each village, and was higher in March. The population, density, children under 5 years, elderly upper 70 years, incidence density, incidence case, incidence areas, and large no significant differences between village transmission and no transmission p≤0.050, and variable contributing to dengue transmission R2= 0.39 or 39.20%. The hazard time for infection (HR = 0.62; CI95%= 0.46 to 0.83). Conclusion: The zone is high risk for dengue transmission, 24.6% of the 460. The factors significantly related to dengue transmission in the village as population size, population density, children under 5 years, elderly upper 70 years, incidence density, incidence case, and incidence area contributing to dengue transmission, R2= 0.39. The main factor contributing to dengue transmission is incidence density, β= 69.95.
Evaluating the Effectiveness of Measles Surveillance Systems in Africa: A Systematic Review of Epidemiological Trends, and Laboratory Performance
Background: As efforts to eliminate measles advance, it becomes essential to enhance the sensitivity of surveillance systems. This involves identifying and thoroughly investigating all cases presented with fever and rash. This systematic review evaluates the effectiveness of measles surveillance systems in Africa, focusing on epidemiological trends, vaccination coverage, and laboratory performance. Methodology: A comprehensive search strategy was employed across five databases, PubMed, MEDLINE, Embase, Scopus, and Google Scholar—to identify peer-reviewed studies published between 2014 and 2024. From an initial pool of 124 articles, eight met the inclusion criteria and were critically appraised using both quantitative and qualitative tools. Result: The findings highlight several systemic challenges, including the sub-optimal performance of measles surveillance systems, gaps in immunization coverage, and significant regional disparities in disease burden. Common deficiencies include inadequate case reporting, limited laboratory capacity, and insufficient training of frontline health workers. Moreover, low vaccine uptake, especially for the second dose (MCV2)—was attributed to supply chain issues, vaccine hesitancy, and geographic barriers. Conclusion: The review underscores the urgent need for improved laboratory infrastructure, expanded training, community engagement, and equitable access to immunization services. Strengthening these areas is critical to enhancing measles surveillance and achieving elimination goals across the continent. Keyword: Measles, surveillance systems. Laboratory performance, immunization.
The Impact of Childhood Trauma on Adolescent Sexual Health: A Scoping Review
Background: Violence against children is a serious global problem. The United Nations reports that more than one billion children experience violence every year. Childhood trauma resulting from such violence has a significant impact on adolescent sexual health, increasing the risk of early sexual initiation and sexually transmitted infections. This study aimed to identify the nature and scope of available research literature on the impact of childhood trauma on adolescent sexual health. Subjects and Method: This was a scoping review within the Arkey and O'Maley approach. The framework used in this study employed PCC (population, concept, and context). The population includes adolescents with childhood trauma, the concept focuses on adolescent sexual health, and the context is childhood trauma. The inclusion criteria in this study were primary research articles using English or Indonesian published in the last 10 years (2015 to 2025), full-text articles, and free. Article selection used Rayyan described in the PRISMA Flowchart, and the Critical Appraisal article assessment used Joanna Briggs Institute (JBI). Results: The results of the study, which included a total of 9 articles, stated that childhood trauma in children can be caused by various forms of violence against children, including physical violence, sexual violence, verbal violence, parental divorce, domestic violence, and neglect. All types of childhood trauma are significantly associated with risky health outcomes such as early sex, unmarital sex, teenage pregnancy, being a teenage parent, consuming illegal drugs and alcohol, and early puberty. Each increase in the type of childhood trauma experiences significantly increases risky sexual health. Conclusion: Adolescents who have childhood trauma are more at risk of various types of high-risk health behaviors such as early sexual intercourse, casual sex, teenage pregnancy, becoming teenage parents, at risk of Sexually Transmitted Infections (STIs), early puberty, consuming illegal drugs and alcohol, and committing violence.
EFFECTIVENESS OF LOW GLYCEMIC INDEX HIGH PROTEIN DIET ON AGES AND INTERLEUIKIN-6 LEVELS IN PCOS-INSULIN RESISTANCE MODEL MICE
Background: A dietary approach that is low in carbohydrates and high in protein may enhance the management of polycystic ovary syndrome (PCOS) by assessing serum concentrations of Interleukin 6 and AGEs. This study aimed to evaluate the effects of a low carbohydrate, high protein diet in PCOS insulin resistance model mice on the level of AGEs and Interleukin 6. Subjects and Method: This study used a post test only control group design, true experimental design. The number of samples in this study was 18 mice divided into 3 groups. The number of samples in each group was added 20% of the initial number of samples as a reserve for mice that died. The sample comparised six female rattus norvegicus mice aged 2-3 months, weighing 150-200 gr. The independent variable was the low glycemic index high protein (LGHIP) diet. The dependent variables were AGEs and Interleukin-6. Examination of blood serum of mice ELISA measurement of AGEs and IL-6 levels. Anova and Post Hoc tests were performed to compare AGEs and IL-6 levels between groups. Results: LGIHP diet decreased IL-6 levels of PCOS-IR model mice (p= 0.002). There was a significant difference between the K- and P groups in IL-6 levels (p= 0.002). Changes in AGEs levels between groups showed a significant difference (p= 0.015). Post Hoc test for AGEs levels showed significant differences between the K- and P groups (p= 0.023), the K+ group with the P group (p= 0.047). Conclusion: The LGIHP diet may serve as a potential dietary strategy for managing PCOS-IR. Regulating diet especially carbohydrates and glucose can improve the response to glucose secretion and inflammatory pathways, thereby affecting the significant risk of PCOS severity. Keywords: low glycemic index high protein diet, AGEs, IL-6, polycystic ovary syndrome.
Unwanted Pregnancy and Maternal Mental Health Based on the WHO SRQ-20: A Meta-Analysis
Background: The WHO (2019) reported that approximately 10% of pregnant women and 13% of postpartum women globally experience maternal mental health disorders. Several studies have identified unintended pregnancy as a contributing factor to these disorders. This systematic review and meta-analysis aimed to analyze and estimate the association between unintended pregnancy and maternal mental health disorders (MHD), using studies that applied the WHO Self-Reporting Questionnaire-20 (SRQ-20). Subjects and Method: A systematic review and meta-analysis followed PRISMA guidelines and was registered in PROSPERO (CRD42025634410). Article searches were conducted up to January 15, 2025, in PubMed, ScienceDirect, Google Scholar, and Scopus using the keywords: “SRQ” AND (“mental health” OR “psychological well-being” OR “mental disorder”) AND (“unwanted pregnancy” OR “unintended pregnancy” OR “unplanned pregnancy”) AND (“mother” OR “maternal”). Inclusion criteria focused on observational studies using the WHO SRQ-20 to assess maternal mental health among women with unintended and intended pregnancies. Meta-analysis was performed using R Studio, with effect sizes reported as risk ratios (RR) or adjusted odds ratios (aOR) and 95% confidence intervals. Heterogeneity was assessed using the I² statistic, and funnel plots were generated to examine publication bias. Results: A total of 12 studies from Ethiopia, Indonesia, India, Vietnam, Brazil, and Malawi, comprising 85,862 participants, were included in this meta-analysis. A total of 12 studies with a total of 85,862 participants were analyzed in this meta-analysis. The results showed that unintended pregnancy significantly increased the risk of maternal MHD. This finding was consistent in both cohort and cross-sectional studies, with effect sizes of (RR = 1.49; CI95%= 1.03 to 2.15; p= 0.030) and (aOR= 1.83; CI95%= 1.35 to 2.47; p < 0.001), respectively. Conclusion: These findings highlight the strong association between unintended pregnancy and MHD. Limitations include high heterogeneity among studies, potential publication bias, and the predominance of observational designs, which preclude causal inferences. Despite these limitations, the results underscore the need for interventions that prioritize the overall health of pregnant women.
Lifestyle among Sports Students: Correlations of Physical Activity, Smoking, Coffee, Screen Time, and Sleep Quality
Background: A healthy lifestyle is an important factor in achieving a high quality of life.. However, research exploring the impact of smoking habits on physical activity levels among students remains limited. This study aims to determine the correlation between smoking habits and physical activity among sports students. Subjects and Methods: This quantitative research study employed a simple random sampling technique to select 105 students from the Sports Coaching Education program. The students completed self-administered questionnaires to assess their daily smoking habits and weekly physical activity levels. In this study, smoking habits are the dependent variable, while physical activity is the independent variable. The data were analyzed using the Spearman Correlation Test to determine the strength and direction of the relationship between the two variables. Results: The results indicated that 26% of the student population were active smokers, and 27% had insufficient levels of physical activity. Although no statistically significant correlation (p= 0.627) was found between smoking habits and physical activity among the students, a negative correlation trend (r= -0.048) was observed. This suggests that higher smoking levels may be associated with decreased physical activity levels. Conclusion: These results demonstrate that increased smoking may reduce physical activity participation. Therefore, promoting healthy lifestyles among students is crucial for enhancing their life quality.
Spatial Analysis of Determinants of Hypertension Incidence in Kota Lama Subdistrict, Kupang, Indonesia
Background: Cardiovascular diseases such as hypertension, heart attack, and stroke are chronic non-communicable diseases influenced by genetic, physiological, environmental, and behavioral factors. Geographic Information Systems (GIS) can be utilized for spatial analysis to identify risk factors, distribution patterns, and determinants of diseases, including hypertension. This study aims to examine the determinants of hypertension using a spatial analysis approach in Kota Lama Subdistrict, Kupang City. Subjects and Method: This study employed an ecological study design using an observational analytic method with a cross-sectional approach. The population consisted of residents aged ≥18 years in Kota Lama Subdistrict. A total of 400 individuals diagnosed with hypertension were selected using simple random sampling. The variables examined were age, overweight, lack of physical activity, high-salt diet, alcohol consumption, medication adherence, economic level, and distance to health facilities. Instruments used included a sphygmomanometer, microtoise, weight scale, and questionnaire. Spatial analysis was conducted using the GeoDa application with Regression, Bivariate Local Moran’s Index, Multivariate Local Geary, and Spatial Empirical Bayes tests. Results: The results showed significant associations and clustered spatial autocorrelation with low-to-high relative risk (RR) observed in the subdistricts of LLBK, Bonipoi, Solor, Fatubesi, Oeba, Nefonaek, and Pasir Panjang for the variables: age (p=0.001, I=0.70), overweight (p<0.001, I=0.64), lack of physical activity (p=0.00, I=0.63), high-salt diet (p=0.00, I=0.63), and alcohol consumption (p<0.001, I=0.69). There were no significant associations for variables such as irregular medication intake, economic level, and distance to health facilities, with p-values of 1.000 > α (0.050). Conclusion: Age, overweight, physical inactivity, high-salt diet, and alcohol consumption are significant determinants and show positive clustered spatial autocorrelation with hypertension. It is recommended that individuals over 40 years of age regularly monitor their blood pressure, maintain a healthy diet, engage in sufficient physical activity, and for those with hypertension, adhere to regular medication intake.